intellectual impairment PBL

Question 1

asthmatic pt ask

Answer 1

• inhlaers used?
• hospitalisation
• frequency of asthma attacks
• when last had an attack

Question 2

how to avoid triggering asthma attack?

Answer 2

proper suction, dental dam use

avoid prolonged supone positions

anxiety levels - assess and help manage if risk triggering attack

Question 3

how can proper suction and use of dental dam prevent asthma attack

Answer 3

limit amount of particles so reduce chance of allergy induced asthma

Question 4

what is important to check before commencing dental tx on asthma pt

Answer 4

rescue inhaler on hand

Question 5

3 characteristics of ASD

Answer 5

• social interaction
• social communication
• limited and restricted patterns in bahviour

Question 6

pain management of broken tooth in ASD pt

Answer 6

ideally smooth off - but unlikely due to compliance issues

chlorohexidine/salt water wash (prevent secondary infection)- assess ability to swallow

Question 7

traumatic ulcer Tx

Answer 7

hopefully go away after a few weeks

monitor

Question 8

GA tx consider when

Answer 8

• uncooperative pt
• volume of disease large
• pain and infection

Question 9

AWI tx needs to be

Answer 9

least invasive option

minimum necessary treatment

Question 10

pros of GA if ASD, dentally anxious pt with lots of clinical needs

Answer 10

single appointment

less anxiety/stress for them

so pt best interest

Question 11

lower splint cons

Answer 11

caries risk

erosion risk

Question 12

ASD connection to bruxist habit

Answer 12

clench/tight gives comfort

Question 13

bruxism can cause

Answer 13

NCTSL

trauma can result if no occluding teeth

Question 14

is large volume of extractions and bruxist ASD pt - what tx is worth considering if going for GA

Answer 14

full clearance

prevent future issues

Question 15

taurodontism

Answer 15

condition found in molar teeth whereby the body of the tooth and pulp chamber is enlarged verically at the expense of the roots

causing the floor of the pulp and furcation of the tooth to be moved apically done the root

Question 16

Kilnefelter syndrome

Answer 16

males are born with an extra copy of X chromosome (XXY)

Question 17

male sex chromosomes

Answer 17

XY

Question 18

females X chromosome

Answer 18

XX

Question 19

effect of Kilnefelter syndrome

Answer 19

XXY

x chromosome interferes with sexual development meaning that the individual will produce less testosterone (the male sex hormone) than usual

Question 20

is Kilnefelter syndrome inherited

Answer 20

not directly inherited

equal chance mother and father having extra X chromosome

sperm or egg having extra X chromosome is random

Question 21

prevalence of Kilnefelter syndrome

Answer 21

1 in 660 males (quite common)

higher risk is mother over 35 years old

Question 22

when is Kilnefelter syndrome usually found

Answer 22

aren’t any early symptoms usually

so found when man goes for fertility test

Question 23

symptoms of Kilnefelter’s

Answer 23

• shy and low self confidence
• literacy and attention problems (dyslexia, dyspraxia)
• low energy levels
• socialising and expressing feelings difficulties
• puberty changes later and different from usual
• INFERTILITY - tx to help

majority have normal and healthy lives

Question 24

health problems associated with Kilnefelters

Answer 24

increased risk of

• type 2 diabetes
• osteoporosis
• obesity
• CVD and blood clots
• lupus and autoimmune diseases
• hypothyroidism
• anxiety, depression, learning difficulties

Question 25

tx for Kilnefelters

Answer 25

no cure * testosterone replacement therapy * fertility tx * breast reduction surgery to remove excess tisssue * occupational therapy * physio therapy * speech and language theraoy

Question 26

pre contemplative

Answer 26

no intention of change behaviour (smoking) may be unaware of consequences

Question 27

issues with smoking

Answer 27

* inc risk oral cancer * inc risk caries * stained teeth * systemic risks - lung cancer * cost

Question 28

bleeding gums impact on OH

Answer 28

pt may not like taste of blood in mouth so may avoid that area not good - worsen gum condition encourage brushing in that area

Question 29

ulcer causes

Answer 29

* trauma * malignant lesions * inflammatory conditions * nutient deficiency * adverse drug reaction

Question 30

traumatic causes of ulcers inc

Answer 30

biting cheek or tongue brushing harshly poorly fitting denture fractured tooth/ restoration

Question 31

what to do if ulcer presists 3 weeks +

Answer 31

if ulcer presits 3 weeks+ and unexplained cause refer pt to urgent care for further investigation/biopsy to exclude oral cancer

Question 32

3 key signs of oral ulcer

Answer 32

pain in the lips/oral cavity inflammation and redness abnormal appearance

Question 33

traumatic ulcer tx

Answer 33

tx cause of tx (e.g. fractured tooth - smooth sharp edges) arrange review appoinment 4-7 days should see some resolution in ulcer

Question 34

soothe ulcers

Answer 34

saline rinse (1 tsp salt in warm water) chlorohexidine mouthwash is pain limiting OH (0.2% 10ml 2x day until resolved) analgesics topical corticosteroids (hydrocortisone oromucosal tablets - dissolved at site of lesion) topical anaesthetics (benzydamine mouthwash or oromucosal spray)

Question 35

oral cancer classic presentation

Answer 35

deep ulceration rolled margins red and white patches of mucosa