Disabled children Flashcards
(36 cards)
What is the definition of disability
“Physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities”
-Equality Act 2010
What are the stats of children with a disability
In the UK 6% of children aged 0 - 17 years old have a disability
What are the classifications of disabilities
Intellectual/behavioural
-Learning disability
-Autism Spectrum Disorder
-Down syndrome
Physical
-Cerebral Palsy
Sensory
-Vision impairment
-Hearing loss
Medically compromised
-Oncology
-Cardiac
-Haemophilia
What may a child with autism struggle with
Social Communication
Social Interaction
Repetative and restrictive behaviour
Over or undersensitivity to light, sound, taste or touch
Extreme anxiety
Meltdowns or shutdowns
If a patient has autism and may not speak or have limited language what stratagies could you use
Use preffered mode of communication
-makaton
-visual symbols
If a patient has autism and always think people mean exactly what stragies could you use
Use concrete language, give direct requests and avoid jokes
If a patient has autism and doesnt understand facial expressions or body language well what could your stratagies be
Avoid body lanaguage, hestures, or facial expressions without accompanying verbal instruction
If a patient has autism and may not understand unwritten social rules what stratagies is there
Be aware of this before hand a react calmy so the child if they do something like stand too close
If a patienht finds other people unpredictable what can you do to handle this
explain clearly what is happening this can be aided with pictures
If a patient with autism loves routine what can you do to handle this
try and prepare them for visits to the surgery and if they are new to the practice or if carrying out something they have not had done before try and prepare for this by showing them what is going to happen at the next visit and giving them pictures with a list of what is going to happen at the next visit so they can prepare for this in advance
What are the dental features of down syndrome
Maxillary hypoplasia
Class III occlusion
Macroglossia
Anterior open bite
Hypodontia/microdontia
Predisposition to periodontal disease
-due to impaired phagocyte function in neutrophils and monocytes combined with poor oral hygiene
What is the most common physical disability
Cerebral palsy
What are th 3 types of cerebral palsy and there affects
Spastic (80%)
-Area of brain affected, cortex
-Affect, Increased muscle tone
Ataxic CP
-affects the cerebellum and presents with difficulty with co-ordination and balance
Dyskinetic CP
-affects the basal ganglia and presents with uncontrollable movements
What are the dental considerations for patients with cerebral palsy
Difficulty tolerating dental treatment
Increased rate of malocclusion
-(maj. classII) may be due to hypotonia of the facial musculature/ tongue movement and mouth breathing
Increased risk dental trauma
High prevalence of bruxism
Drooling
Poor oral hygiene
-complicated by dyskinetic movement/ difficulty holding a brush/ oral reflexes/ decreased mouth clearing
Pathological oral reflexes – biting
Calculus if peg fed
Periodontal disease
-ue to calculus deposits, impaired OH and increased incidence of Mouth breathing
Hyperplastic gingivitis
Self mutilation
Unsafe swallow
If a patient has sensory impairments what could you use
Visual- Braille
Hearing- BSL interpreting service, hearing loops
ASD- Makaton, boardmaker pictures, widget symbols
What is leukaemia
Blood cancer of WBC
Can affect:
-Lymphocytes
-Myeloid cells (including neutrophils)
3/4 cases are Acute Lymphoblastic Leukaemia
Can present with
-Pallor
-Increased bleeding/bruising (lack of platelets)
-Infection (lack of functioning WBC)
What are oral manifestations of leukaemia
-Gingival swelling
-Ulceration
-Spontaneous gingival bleeding
-Unusual mobility of teeth
-Petechiae
-Mucosal pallor
-Herpetic infections
-Candidosis
What cancer treatment can have oral complications
-Surgery to the head and neck
-Chemotherapy
-Radiotherapy to the head and neck
-Bone Marrow Transplant – involves chemotherapy +/- total body irradiation
What dental affects can chemotherapy have
Short term:
Effect on Mucous membrane = Mucositis
Effect on bone marrow:
-Decreased Neutrophils = increased infection risk
-Decreased platelets = increased bleeding risk
Longer term:
-Affect developing dentition;
Enamel hypoplasia/ microdontia/ thin roots
What dental affects does radiotherapy have
Short term:
Oral Mucosa=mucositis – most severe at 2-4 weeks
Salivary glands=decreased flow/increased velocity – often permanent
Hyposalivsation can lead to:
-Caries
-Taste disturbance
-IO infection – candida/ acute ascending sialodenitis
Taste buds=direct damage – loss/alteration to taste = altered diet
Longer term:
Malocclusion
Increased risk soft tissue neoplasm
Risk of osteoradionecrosis
Affects to developing dentition
Hypodontia/ microdontia/ enamel hypoplasia/ defects of root formation
What are the implications for dental care in childhood cancer
Children with cancer are managed by the dental team in the children’s hospital
Dental assessment prior to commencement of cancer therapy
All infectious dental/oral foci should be removed before the start of cancer therapy
Optimal oral hygiene important
Dental support throughout treatment
Management of dental effects of treatment including mucositis
Close liaison with oncology team if treatment required
What congenital cardiac defects classifications are there
Cyanotic: Deoxygenated blood able to enter systemic circulation
Acyanotic: Normal levels of oxyhaemoglobin in the systemic circulation
What is the most common Cyanotic and Acyanotic defects
Ventricular septal defect is the most common acyanotic CCD
Tetralogy of Fallot is the most common cyanotic CCD
What are the dental complications of congenital cardiac defects
Medications which increase bleeding tendency: warfarin or aspirin
Higher risk of general anaesthetic, often requiring support from a cardiac anaesthetist
Careful use of adrenaline containing LA
Increased risk of enamel hypoplasia
Risk of infective endocarditis resulting from an oral bacteraemia
