8 - Dentistry for children with disabilities Flashcards
What are the different classifications of disability?
- intellectual
- physical
- sensory
- medically compromised
What are the clinical implications of social communication with a child with ASD?
- may have limited language so use preferred mode of communication ie makaton
- think literally so use concrete language and avoid jokes
- body language is not always understood
- may not understand unwritten social rules
- find people unpredictable so ensure everything is explained clearly
- can appear uninterested so check understanding
What are the clinical implications of routine with a child with ASD?
- may become upset if routine is interrupted so ensure same features of each appointment
- may need acclimatised
- if possible, follow the same routine at each appointment (and same staff)
What are the clinical implications of special interests with a child with ASD?
Make the effort to learn about their own interests and note of of these in notes to put patient at ease
What are the clinical implications of sensory difficulties with a child with ASD?
- avoid stimuli that can trigger child if possible
- use ear defenders or other aids
- can find waiting rooms difficult so have first appointment of day or wait in side room
- withdrawal or meltdown can be in response to overstimulation - don’t disturb unless essential
- may have strong dislikes of flavours so mild toothpaste is ideal
How do you manage a child with ASD in the dental surgery?
- prepare yourself and the patient
- questionnaire to parent can be useful for first appointment
- use any sensory aids the child needs
- keep environment quiet
What are the dental features associated with downs syndrome?
- maxillary hypoplasia
- class III occlusion
- macroglossia
- AOB
- hypdontia
- microdontia
- predisposed to periodontal disease (inhibited macrophages and neutrophils)
What are the different types of cerebral palsy?
- spastic
- ataxic
- dyskinetic
- can be mixed
Describe spastic cerebral palsy.
- most common type
- affects cortex in brain
- causes increased muscle tone
- can be described as diplegic, hemiplegic or quadriplegic
Describe ataxic cerebral palsy.
- affects cerebellum
- coordination and balance are affected
- difficulty with movements that require lots on control ie writing
Describe dyskinetic cerebral palsy.
- basal ganglia affected
- cause uncontrollable movements
- face be affected and person can struggle with swallowing and talking
Define diplegia.
Legs are affected, arms are less affected or not at all
Define hemiplegia.
One side of the body affected and arm is usually more affected than leg
Define quadriplegia.
All four limbs, trunk and face affected
What are the dental implications for people with cerebral palsy?
- find it hard to remain still and accept dental treatment
- malocclusion more common
- increased risk of dental trauma
- high prevalence of bruxism
- drooling
- poor OH
- unsafe swallowing (calculus if PEG fed)
- hyperplastic gingivitis
