Neuralogical Impairment Flashcards
How might you approach taking a history of a patient with dementia?
Try to speak to the patient first as it is their appt
Get any info from them possible
Speak clear and simply
What signs might show the patients is in pain?
Aggression
Irritability
Behaviour change
Off norm behaviour
Why might an elderly patient in care present with xerostomia?
Poly pharmacy
Often dehydrated
Why might a neurologically impaired patient have erythematous palate?
How might treat?
Stomatitis due to poor denture hygiene
Carers not carrying out oral hygiene measures
Treat with denture hygiene
Topical miconazole, chlorhexadine or systemic anti fungal
How might capacity for treatment be checked?
Chunk and check
Give small chunk of info then get pt to show understanding
What are some main foreseeable difficulties in a dementia patient?
capacity to consent decreasing over time
Issue with possible cooperation for treatment
Treatment planning to accommodate for dementia
What are some 1st stage dementia symptoms?
STML
Impaired judgement
Disorientation in time and place
What are some stage 2 dementia symptoms
Intellect loss
Aphasia
Loss of ability to care for oneself e.g. clothing and feeding
What are some third stage dementia symptoms
Apathy
Loss of communication
Anxiety and depression
Absolute dependence
If dementia patient unable to communicate pain, what might they be doing?
pulling, pointing to or holding their face
Having issues sleeping
Exhibiting abnormal behaviour patterns
Showing aggression or irritability
What national programme is there that helps train care home staff in caring for the oral health of the individuals in a care home?
What did it implement?
Caring for smiles
It implemented regular assessments of individuals mouths and liaison with dental staff to develop a tailored treatment plan to each individuals needs
What are the 3 key characteristics of MRONJ
- Previously on antiresoptive or antiangiogenic drugs
- Exposed bone or bone that can be probed via fistulae that has persisted for more than 8 weeks
- No history of radiation therapy to the jaws or obvious other metastatic disease
How might one manage a patient with low risk of MRONJ?
When other options not feasible, complete X-LARGE, oral surgery etc as minimally invasive as possible such as not raising flaps and achieving good haemostasis
Can be done in primary care
Review everything at 4 weeks
How might manage a patient with high risk MRONJ?
Contact OMFS to determine if patient should still be seen in primary care or referral is appropriate
Include full histories and do so by letter
