Dental care of special needs pt

Question 1

Downs syndrome is caused by?

Answer 1

chromosomal disorder

Question 2

what are some physical features of downs syndrome?

Answer 2

large tongue/hands/fingers

Question 3

what are some dental anomalies seen in downs syndrome patients?

Answer 3

delayed primary exfoliation
commonly congenitally missing teeth
hypoplastic teeth
increased susceptibility to perio

Question 4

how would you care for a pt with downs syndrome?

Answer 4

modify a TB to ease brushing
prevention
only carry out necessary tx

Question 5

what is fragile X syndrome?

Answer 5

genetic disorder causing mental impairment and learning disabilities. common in males

Question 6

how to tx a pt with fragile X?

Answer 6

prevention

only do tx that can be tolerated

Question 7

what problems do patients with autism or schizophrenia have?

Answer 7

probs with communication

hard to understand expressions or tone

Question 8

how to tx a pt with autism or schizophrenia?

Answer 8

non tx apps
prevention
make sure to keep waits short/short sessions

Question 9

what is aspergers?

Answer 9

average or above intelligence is common

dysplexia/dyspraxia/ADHD/epilepsy

Question 10

what is dyslexia?

Answer 10

cognition problems
varies in severity
main problem is understanding

Question 11

what is ADHD?

Answer 11

cannot sit still
hard to respond to requests
problems with OH routine at home

Question 12

how to tx an ADHD pt?

Answer 12

short apps
easy and short tasks
keep taking breaks from mouth

Question 13

what type of emotional disorders can have an impact dentally?

Answer 13

eating disorders = tooth wear

Question 14

what is cerebal palsy?

Answer 14

abnormal brain development causing impaired co ordination and movement
caused by - infection in early pregnancy, premature birth or bleeding on the brain

Question 15

what is spina bifida?

Answer 15

vertebrae unfused at birth

low levels of folic acid during pregnancy

Question 16

what is MS?

Answer 16

progressive atrophy and disability

muscle weakness

Question 17

what challenges present with a pt with MS?

Answer 17

gag and cough relfexes
hypoplastic sensitive teeth
limited mouth access
manouvering wheelchair
lifting pts
excessive saliva flow
self inflicted oral wounds

Question 18

how to tx an MS pt?

Answer 18

aggressive prevention
intervene early
modify Tx plan if necessary

Question 19

how to care for a pt with blindness or visual impairment?

Answer 19

tell then do
reassure
show how TB feels etc
address pt not carer
do not shout

Question 20

how to care for a deaf pt/hearing difficulties?

Answer 20

sign language/lip reading
visual aids
no masks
sit in front when communicating

Question 21

what prevention can be done to pts with a disability?

Answer 21

electric TB may be helpful
min risk of fluorosis will outweigh the tx risks
chx on swabs if TB not tolerated