special needs and oral medicine Flashcards
What dental implications are there for children with special needs? (5)
- Fewer Teeth
- More untreated dental caries
- Greater prevalence of periodontal disease
- Dental fear & Anxiety
- More barriers to delivery of dental care
What are the impacts of dental disease in special needs children in terms of treatment? (5)
- delayed diagnosis
- Delayed Management
- More multidisciplinary planning
- Greater risk of sepsis/pain
- reduced quality of life
Disability can be split into which 4 categories? (4)
- Physical
- Medical
- Sensory
- Mental
Describe Cerebral Palsy (4)
- Most common physical disability in childhood
- It affects movement and posture
- Occurs from brain damage before, during or after birth
- They may also have sensory or mental disabilities in addition
What are the dental considerations for someone with cerebral palsy?
- Poor oral hygiene due to difficulty brushing
- Enamel hypoplasia
- Drooling
- difficult to access
- uncontrollable movements
- enhanced gag reflex
What barriers to regular attendance are there from patients with special needs? and what can a dentist do to help? (10)
- they may be busy with other appointments - collaborate and plan
- They may have challenging behaviours - empathy/support/planning
- may have difficulty parking and gaining access to the clinic - plan ahead
- frequent illness - empathy and support
- parental attitudes - educate to promote good knowledge and positive change
What barriers to dietary changes exist amongst special needs patients? and what help could you provide? (12)
*Atypical food clearance
*Food holding/regurgitation
*Restricted/limited diet
*Pureed foods
*Fortified foods
*Sugary medicines
*Food treats used as rewards
___________________
Solutions:
*collaborate empathise support
*Consider additional mouth care
*Consider 2800ppm toothpaste
*Set achievable and realistic goals
*Work with other healthcare professionals
What medical conditions should we be particularly aware of in special needs patients? (7)
- cardiac malformations
- Epilepsy
- Renal
- Metabolic disorders such as diabetes
- Cystic Fibrosis
- Oncology
- Haemophilia
- Adrenal insufficiency
what are the dental considerations of how you might treat someone with cardiac heart defects? (5)
- susceptible to infective endocarditis
- Increases bleeding if on warfarin or aspirin
- Higher risk under GA
- Caution of adrenaline in LA
- Liaising with medical colleagues
what type of cancer accounts for 1/3 of all paediatric cases? (1)
*acute leukemia
Brain tumours account for how many paediatric oncology cases? (1)
1/4
what oral symptoms might you expect to see in a paediatric oncology patient? (5)
- Mucosal haemorrhage
- Gingival enlargement
- Mouth and throat infections
- Oral Mucositis
- Oncology treatment affecting developing dentition
Name three common bleeding disorders (3)
- Von williebrand’s disease
- Haemophilia A
- Haemophilia B
How can you prepare a treatment plan for a patient with a bleeding disorder that requires extractions, scale and polish or even a smaller filling?
For smaller procedures, such as the filling, prioritise these treatments using a wand anaesthetic system and get all of them done first.
When going on to complete the extractions and scale and polish (which may cause excessive bleeding) it should be planned with a haematology team so that they can get factor cover. All treatments that may provoke bleeding should be aimed to be completed within this window.
What sensory impairments might you come across and what communication aids can we use to assist us in treatment? (6)
- Visual Impairment - Braille
- Hearing Impairment - sign language interpreter
- Autistic Spectrum Disorder - boardmaker pictures
