Special Needs

Question 1

Dental implications of special needs

Answer 1

• hypodontia
  -higher caries
  -higher perio
  -dental anxiety
  -barriers

Question 2

Management of excess saliva/drooling

Answer 2

• SLT
  
  • improve lip seal
  • improve swallow
• pharmacology
  
  • scopolamine/hyoscine patch
  • botox injections
• surgical

Question 3

What is cerebral palsy

Answer 3

Most common physical disability in childhood
Affects posture and parts of body
Non progressive lesions of motor pathways in developing brain

Question 4

Types of cerebral palsy

Answer 4

Spasticity
Ataxic
Dyskinetic

Question 5

Dental implications of CP

Answer 5

• poor OH - struggle with OH
  -gingival hyperplasia
  -enamel hypoplasia
• bruxism
• gag reflex
• perio
• self mutilation
• difficult tolerating dental Tx

Question 6

What is cyanotic and acyonotic.

Answer 6

• cyanotic: deoxygenated blood able to enter systemic circulation
• acyanotic: normal levels of oxyhaemoglobin in systemic circulation

Question 7

What is important in patients at risk of IE

Answer 7

• optimal oral hygiene
• avoid dental infection (close monitoring and early management of caries)
• more radical treatment plan to ensure the mouth is kept free from any oral sources of infection (removal of teeth with deep decay/ hall crowns contraindicated)
• liaison with cardiology to explore need for antibiotic prophylaxis prior to invasive procedures

Question 8

What is leukaemia

Answer 8

Blood cancer of WBC
Affects lymphocytes and myeloid cells
Mostly acute lymphoblastic leukaemia

Question 9

Oral symptoms of leukaemia

Answer 9

• mucosal/gingival haemorrhage
• gingival enlargement
• mouth and throat infections - candida or herpetic
• immunosuppression
• thrombocytopenia
• unusual mobility of teeth
• petechiae
• mucosal pallor
• treatment can affect developing dentition - reduced roots
• oral mucositis

Question 10

What is chemo

Answer 10

Cytotoxic drugs selective toxicity to rapidly dividing cancer cells

Can cause mucositis , increased infection and bleeding risk ,can affect developing dentition, hypoplasia ,microdontia

Question 11

What can be impact of radiotherapy dentally

Answer 11

-mucosistis
-decreased salivary flow = caries
-risk of ORN

Question 12

What is von willebrands

Answer 12

Deficiency of von willebrand factor
Most common inherited bleeding disorder
Autosomal dominant
Low vWF and factor VIII

Question 13

What is haemophilia A

Answer 13

Factor VIII

X linked recessive

Question 14

What does haemophilia B affect

Answer 14

Factor IX

Question 15

IQ classification

Answer 15

• mild - 50-70
• moderate - 35-49
• severe 20-34
• profound <20