SpecialNeedsFinal Flashcards
What is defined as a long lasting health condition that limits a person’s ability to see or hear, physical activity of mental capabilities?
Impairment
What is defined as personal limitations that representt a substantial disadvantage when attempting to function in society?
Disability
What is defined as a group of malformations, deformations and malformation sequences, etc. that occur together due to some identifiable underlying cause?
Syndrome
What is defined as A disability characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills that originates before the age of 18?
Intellectual Disability
Intellectual disability is defined as originating before WHAT AGE?
18
What is the MOST COMMON developmental disability and how many people are affected by it?
intellectual disability…6.2-7.5 million people
What % of people with intellectual disability have MILD impairment?
87%
What is the usual cause of an intellectual disability?
it is usually unknown
Developmental Disabilities: often occur in the _______ period and manifest before age ___.
developmental…22
Developmental Disabilities: Often present at ______
BIRTH
Developmental Disabilities: What are the 4 types?
1.Intellectual Disability 2.Cerebral Palsy 3.Epilepsy 4.Autism
Instead of saying birth defect, we say
congenital disability
Informed consent is grounded in the principle of patient ________
autonomy
What is the process of communication
between a doctor and patient in which a patient grants
permission for the proposed treatment?
informed consent
What are 2 examples of acceptable witnesses to informed consent?
1.dental staff 2.NON-relative to patient
How many titles are there of the ADA and which one is most relevant to dentists? What year was the ADA passed?
5 titles…. Title III is relevant because we are preforming a public service..1990
Wheelchair accessibility: Minimum width of hall and passageways is ___ feet for wheelchair to pass through.
3 feet
Wheelchair accessibility: Need at least __ feet (in diameter ) circle to turn a wheel chair around
5 feet
Wheelchair accessibility: Best to treat patient in WHICH CHAIR?? if possible…
the DENTAL CHAIR
Behavioral Hx: 1. Ability to _______
communicate
Behavioral Hx: 2. Reactions to sensory ______ such as noise, touch, and light
stimuli
Behavioral Hx: 3. Stereotypic _______
behaviors
Behavioral Hx: 4. Previous _______/______ experiences?
dental/medical
What protocol is this??? Need to identify type and likelihood of risk associated with the specific dental procedure…
Risk Assessment
Medical Consult: To request _______ when signs of systemic disease are discovered in the dental office (i.e. hypertension, syncope)
EVALUATION
Medical Consult: To request specific __________ necessary for appropriate treatment modifications.
information
Medical Consult: To determine whether or not providing dental treatment is _______, given patient’s health conditions
prudent
Medical Consult: To request a _______ in patient’s therapy in order to benefit oral health
CHANGE
Medical Consult: IS NOT!!!!! clearance or __________ for treatment!!!!
permission
What is the MOST COMMON malformation syndrome?
Downs Syndrome (Trisomy 21)
In Trisomy 21: What is the typical range of intellectual disability? What is the average IQ?
moderate to severe…50
What % of people with Downs Syndrome have congenital heart defects?
40-50%
People with Down Syndrome may have Impaired _______ – specifically, impaired _______ function
immunity…NEUTROPHIL
What % of people with Down Syndrome have hypothyroidism?
16-20%
In people with Trisomy 21: ______ anomalies are common
AIRWAY
What % of people with Trisomy 21 have atlanto-axial instability?
14%
Dental characteristics of Trisomy 21: Which teeth present as missing or peg-shaped?
lateral incisors
Oral Findings of Trisomy 21: Maxillary _______ (frequently resulting in crowding and/or impactions)
hypoplasia
Oral Findings of Trisomy 21: Class ____ malocclusion
III
Oral Findings of Trisomy 21: Anomalies in tooth number and morphology (_________)
taurodontism
Oral Findings of Trisomy 21: Increased incidence of _______ disease, may present as early as ________
periodontal…childhood!
Oral Findings of Trisomy 21: Relative ________ (because of maxillary hypoplasia)
macroglossia
_________ is a chronic disorder of movement or coordination, caused by injury to the immature brain during the prenatal or perinatal period
Cerebral Palsy
CP is a developmental disability characterized by damage to the ______ areas in the developing brain.
motor
CP is a ______ encephalopathy; that is, the original brain lesion DOES NOT PROGRESS or enlarge
STATIC
What type of CP is characterized by increased muscle tone, tightness, and stiff-jerky movements? What % of cases?
Spastic….70-80 %
What type of CP is characterized by Low muscle tone, loose-uncontrolled body movement? What % of cases?
Dyskinetic….10-15%
Which type of CP is characterized by affected balance and depth perception? What % of cases?
Ataxic… less than 5%
Risk Factors for Cerebral Palsy: _________ infections
intrauterine
Risk Factors for Cerebral Palsy: Maternal exposure to toxic or _______ agents
teratogenic
Risk Factors for Cerebral Palsy: Material abdominal _______
trauma
Risk Factors for Cerebral Palsy: if the mom gives multiple _____
births
Risk Factors for Cerebral Palsy: These hyper CNS events…
seizures
Risk Factors for Cerebral Palsy: Premature birth (____)
less than 32 weeks
Risk Factors for Cerebral Palsy: Low birth weight (less than _____g or ___lbs)
2500g (5.5 lbs)
Risk Factors for Cerebral Palsy: Intracranial ________
hemorrhage
Risk Factors for Cerebral Palsy: _______ and/or bradycardia
Hypoxia
Risk Factors for Cerebral Palsy: Hyper_______emia
hyperbillirubemia
WHAT IS An umbrella term used for a group of genetic diseases characterized by progressive weakness and degeneration of skeletal or voluntary muscles which control movement?
Muscular Dystrophy
In Muscular Dystrophy, which type of muscle may or may not be involved?
cardiac/other involuntary muscle
These are all under the umbrella term of ________: Duchenne, Becker, Fascioscapulohumeral, Emery-Dreyfus, Limb-girdle, Myotonic, Congenital
muscular dystrophy
Are muscular dystrophy oral characteristics progressive?
yes
Muscular Dystrophy – Oral Characteristics: Anterior _______ , ______glossia, and/or (term for excessive saliva)
open bite, macroglossia, sialorreha
Muscular Dystrophy – Oral Characteristics: ________ of maxillary and mandibular arches
EXPANSION
Muscular Dystrophy – Oral Characteristics: Similar to CP – patients with gait problems are at increase risk for dental ______
trauma
What type of seizure? Brief, shock like jerk of muscle or groups of muscles, Affects neck, shoulders, upper arms, body and upper legs, Duration
MYO-CLONIC
What are the two AntiConvulsant meds we discussed with oral complications?
Phenytoin and Carbamazepine
Phenytoin Oral Side effects: Gingival ________, Scrupulous dental care, visits every ___ months, Consider the use of chlorhexidine and _______ rinses…Severe cases require surgical reduction
hyperplasia…3 months, folic acid
Carbamazepine: ________ and stomatitis with increased caries, Consider use of topical _______ to reduce incidence of caries
XEROSTOMIA…flouride
Patients with seizures can receive dental treatment when they are rare: less than _____ / year
1x/year
If a seizure last longer than 5 minutes or is repetitive, it is _________
status epilepticus
Osteogenesis Imperfecta is what type of inheritance? What type of collagen synthesis is affected?
Autosomal Dominant…Type I Collagen
Ellis-van Creveld Syndrome is what type of inheritance?….Commonly found in old order ______ population due to the “founder effect”
Autosomal Recessive..Amish
Ellis-van Creveld Syndrome is AKA ___________ Dysplasia
Chondroectodermal
What is responsible for the LARGEST PERCENTAGE OF BIRTH DEFECTS?
Multifactorial Inheritance
These three disorders are a result of ________: Asthma, Coronary Artery disease, Alzheimer Disease
multifactorial inheritance
What is the common presentation with all of these syndromes? Crouzon Syndrome Apert Syndrome
Pfeiffer Syndrome
CRANIO-SYNO-TOSIS
Which syndrome? Abnormal skull shape, Ocular hypertelorism, proptosis, beaked nose Obstructive apnea…WHAT TYPE OF INHERITANCE IS IT?
CROU-ZON…Autosomal Dominant
Autism is diagnosed based on _______
BEHAVIOR
Etiology of Autism is currently ________; however many theories exist: Genetic, Neurotransmitter defect ________, Infection, Metabolic error, Immunologic disorder, Environmental (exposure to toxins in utero or early childhood)
UNKNOWN….seratonin
What % of people with Autism also have intellectual disability?
70%
What % of people with Autism also have seizure disorders?
30%
_______ is diagnosed when there is sufficient severity to interfere with daily functioning!
dementia
What % range of dementia is considered Alzheimers Disease?
40-65%
What is the prevalence of Alzheimers Disease in people over 85 years old???
47%. holy shit.
What is the average life span of people with AD?
8-10 years (range 3-20 years)
_______ program: Purpose is to investigate and resolve complaints of residents of nursing facilities, board and care facilities, and other adult care homes
Ombudsman
Elder abuse affects an estimated ____ million older Americans, but some estimates can say its __x that amount…
2.1 million…5x
A dentist who fails to report elder abuse can be guilty of a class ___ misdemeanor
class 1
_________ is the most prevalent unmet health
need among children with special health care needs.*
dental care
Combination of _______ status & membership in an underserved racial or ethnic group associated with a greater magnitude of disparity in all 3 areas.”
disability
What does WISH stand for?
W: Wound healing ability, I:Immune strength S:Stress toleration, H: Hemostasis
What are the three types of consent?
Explicit, Implied, Specific
Which type of consent is needed for Dental extractions, implants or bone recontouring?
Specific
