MSA 2020 - part B Flashcards
What are the three different courses of action which can be taken in a case of child abuse?
Preventative Dental team management
Preventative multi-agency management
Child protection referral
Explain what would happen with a preventative multi-agency approach in relation to child abuse?
If preventative dental management fails, then proceed to contact other professionals and liaise with the child’s, teacher or GMP for example.
Come up with a plan to help, set goals and arrange to follow up.
List TWO advantages of extraction of first permanent molars of poor prognosis at this stage of development?
The space will be closed by the 7’s moving into the 6’s place.
The child will have a caries free dentition.
List TWO disadvantages of extraction of first permanent molars of poor prognosis at this stage of development?
Can increase dental anxiety due to the traumatic experience of having an Ex at such a young age
Might require GA which has its own risks.
Space may remain and lose a permanent tooth.
Which guidance document would you refer to for advice on dealing with patients on Warfarin AND within what timeframe should this test be carried out prior to the extractions?
SDCEP
72-24hrs depending if stable or not
Below what level would it be safe to continue with extractions?
below INR 4
A fit and healthy patient presents to the surgery to have the surgical removal of a carious 48.
Anatomically, which nerves must be anaesthetised to remove this tooth safely?
IAN
Lingual
Long buccal
Name for a painful, unpleasant or neuralgic sensation that lasts for a fraction of a second?
Dysaethesia
Give THREE clinical reasons that could account for this neuro-sensory deficit.
A needle may have hit the nerve during LA administration crushing the nerve or cutting it.
The nerve may have been lacerated during incisions.
Direct Trauma to the nerve from the use of extraction instruments.
What two pieces of legislation in the U.K. has sought to ensure that all new dental practice premises are built to allow people with an impairment or disability equal access.
2010 Equality Act
2004 Disability Act
This gentleman could be described as being a person with a disability.
The definition of disability varies between the medical model and the social model. Briefly describe the difference between the two models in their definition of disability.
The Medical model would describe it as a restriction or lack of ability to conduct activities in a range that is normal for people.
The social model would include people with impairments or that are handicapped but are still able to perform a task that is considered within the normal range.
Having gained consent from this patient, you are now required to examine him. You are unable to do this safely with him in his current position in his wheelchair. He is unable to weight bear.
Name TWO options that are available to allow for the improved positioning of this gentleman to allow for a safe dental examination.
Use a hoist to get the patient into the dental chair
Use a wheelchair recliner if you have one
Which particular aspect related to his cerebral palsy may affect the dentist’s access to the mouth?
What non-pharmacological adjuncts are available to overcome this and aid the dentist’s access to the mouth?
Patients have limited mouth opening due to muscle tone being affected. This can make the mouth more rigid.
Massage the muscle to relax it.
Use a mouth opening prop to hold the mouth open.
List FOUR physical characteristics which are associated with Down’s Syndrome
Wide spaced eyes Flat face esp, nasal cavity Large tongue small maxilla and larger mandible meaning class 3 relationship small ears Short neck
To confirm a diagnosis of Down’s Syndrome a genetic test is undertaken. What genetic change is responsible for Down’s Syndrome?
Trisomy 21
Meaning the person has three copies of chromosome 21
List TWO medical aspects of Down’s Syndrome which may have resulted in his lack of capacity.
Increased risk of dementia Alzheimer’s
Due to their IQ and mental capacity, don’t properly understand so therefore cannot consent.
What are the 5 things a patient must demonstrate to show they have capacity?
Acting making decisions Communicating decisions Understanding decisions Retaining the information long enough, Having memory of the decision.
What are the 5 key principles of the adults with incapacity Act 2000.
Code of practice.
Must be of benefit to the patient
Minimum necessary intervention
Take into account the wishes of the adult
Consult with relevant others such as friends and family
Excercise residual capacity.
Who appoints a welfare guardian?
The court if an adult doesn’t possess the capacity.
Who appoints a welfare power of attorney?
The patient while they still have capacity
Who can consent to dental Tx?
• Patients with capacity
• Welfare Powers of Attorney
• Welfare Guardians
• Medical & Dental* practitioners under Section 47 of AWI Act (General Authority to Treat)
Dentists need to have had specific training
MP can from the day they qualify
What are the 3 elements of valid consent?
For consent to be valid, it must be voluntary
informed,
and the person consenting must have the capacity to make the decision
List TWO features associated with Down’s Syndrome that are likely to have contributed to his periodontal disease?
Increased risk of diabetes
Poorer manual dexterity so therefore lower levels of OH
Mark has previously experienced Infective Endocarditis. In line with SDCEP guidance, he will require antibiotic prophylaxis for the removal of his 6 remaining teeth. He has no known allergies.
What antibiotic, when should you give it to him and what dose of antibiotic should be prescribed for Mark?
Amoxicillin
2g orally
Given 60mins before Tx
