Special Needs II Flashcards
according to the Equality Act 2010, what is disability? give examples of impairments
a physical or mental impairment
- with substantial and long-term adverse effect
- on ability to carry out day to day activity
impairments
- sensory
- fluctuating or recurring
- progressive
- auto-immune
- learning disability
- mental health
- developmental
what are reasonable adjustments - equality act 2010
adjustments to prevent placing a individual at a disadvantage compared to others not disabled
5 types of disability
physical
medical
sensory
intellectual
neuro-developmental
what does dental special needs include?
any disability + emotional needs or oral developmental problems
Intellectual Disability
- definition
- what it entails
definition = IQ<70
entails reduced ability
- to understand new information
- learn new skills
- cope independently
whats the 3 top clinical guidelines for disabilities?
- recognise everyone as an individual
- everyone has a right to participate in decisions affecting their life
- provide the necessary support
Down’s Syndrome
- what disability is it associated with?
- aetiology
- epidemiology
- what other conditions is it associated with?
- characteristic features
- oral features
- intellectual disability
aetiology - trisomy 21 - extra copy chromo 21
epidemiology - 0.1%
associated conditions:
- hypotonia - decreased muscle tone
- congenital heart disease
- acute leukaemia
features:
- oval, flattened face
- flat nasal bridge
- short neck
- upward slop to eyes
- straight hair
- short dysplastic ears
oral features
- large, fissured tongue
- small maxilla
- class III malocclusion
- malformed/less number of teeth
- delayed eruption of teeth
- prone to perio
Physical Disability
- definition
- example conditions
a condition affecting a persons body
- = loss or reduction of way their body functions
examples
- cerebral palsy
- muscular dystrophy
- juvenile rheumatoid arthritis
Cerebral Palsy
- what disability is it associated with?
- definition and aetiology
- other associations affecting lifestyle
- general features
- dental considerations
physical impairment, intellectual and sensory
group of disorders affecting movement, muscle tone, balance and posture
- caused by abnormality/disruption in brain development
lifestyle associations
- difficulty eating/swallowing
- epilepsy/seizure
general features
- abnormal muscle tone
- spasticity
- athetosis
dental considerations
- hard to chew/swallow
- difficulty with jaw muscles
- more saliva
- difficult to use a toothbrush
- gag reflex
- gingival overgrowth
- lip, tongue and cheek biting
Medical Impairment
- give some conditions which may lead to medical impairment
cardiac disease
respiratory disease
bleeding disorders
diabetes
organ transplants
malignancy
Childhood Cardiac Conditions
- Congenital Heart Defects
- types
- what to ask the child/parent
- what needs to be considered
types
- cyanotic heart defect
- non-cyanotic heart defect
ask
- which diagnosis
- who the cardiologist is
- upcoming surgeries
- risk of infective endocarditis?
- increased risk of ga?
what to consider
- endocarditis
- compromised stress tolerance
- anticoagulation
if a pt has a blood disorder, what needs to be considered?
anticoagulation/clotting
general anaesthetic
Sensory Impairment
- definition
- how can you consider communication
a condition in which 1+ senses are impaired
- sight loss/hearing loss/partial or complete
communication considerations
- remove mask for lip reading
- speak louder, lessen background noise
- BSL
- interpreters
- written or verbal information
Neurodevelopmental Disability
- defintion and aetiology
lifelong condition
- caused by difference in brain development
Autism
- what disability is it associated with
- defintion
- how does it affect oral health care
- neurodevelopment disability
a persistent deficit in social communication and interaction
- restricted, repetitive behaviours, interest or activities
oral care
- difficulty complying with advise and OHI
- difficulty attending and receiving tx
what is SEMH?
- aetiologies
- how may it present
social, emotional, mental health needs
can arise from abuse/neglect
can present in behaviours - anxiety or at school
oral developmental problems
- definition
- give 2 examples
conditions that arise due to problems in development of oral structures
examples
- ectodermal dysplasia
- cleft lip
Ectodermal Dysplasia
- definition
- Hydrotic Ectodermal Dysplasia and oral features
primary inherited disorders affecting 2+ structured derived from ectoderm
- skin, hair, nails, sweat glands, teeth
HH ectodermal dysplasia
- less sweat than usual
- affects sweat glands and teeth
= less teeth, sharp, conical, short
Cleft Lip and Palate
- definition
- investigations
- complications
- what to ask
failure of the medial nasal and maxillary prominences to fuse
investigations
- can be detected on the ultrasound
- can be unilateral or bilateral
complications
- feeding difficulties
- speech problems
questions
- who treated it
- the nature and severity
- what tx was done
what comes under the OHI prevention?
toothbrushing
fluoride toothpaste
- high risk - <10 - 1,350-1,500ppm fluoride, 2,800ppm 10-16 years old
diet advice
fissure sealants
what resources can be used for prevention evidence?
Toolkit - Delivering Better Oral Health
SDCEP Prevention and Management of Dental Caries in Children
how do you formulate a treatment plan for a pt with special needs
gain consent from the patient/parent
plan without the disability
- make adjustments to the plan after
why may a special needs pt be more challenging?
- lack of access
- poorer communication and understanding
- unwanted movements
- anxiety regarding the dentist
- document all of this so you are better prepared to care for the patient each visit
how may you deal with an anxious patient?
non-pharmacological technique
- behavioural management
pharmacological technique
- inhalation sedation
- GA
what are the levels of dental care and carers?
level 1
- GDP
- anyone undertaken foundation training
level 2
- clinician with enhanced skills, maybe specialist
level 3
- specialist in paediatric dentistry
level 4
- consultant in paediatric dentistry
what does the Community Dental Service include?
paediatric dentistry
special care dentistry in adults
prison dentistry
urgent dental care
what does the Hospital Dental Services include?
consultants in:
- pads and special care for adults
- specialise advice and treatment
- postgraduate training
