Outcome 2 - Special Care Patients

Question 1

The following DA roles are incorporated to assist patients with special needs:

Answer 1

-training and ability to use specialized equipment
-develop preventive measures
-decrease patient anxiety

Question 2

Define Special Care

Answer 2

Each patient needs will need to be addressed individually and the dental assistant will aid the dentist in various ways.

Dental treatment will be modified to accommodate preexisitng or new medical and/or dental conditions.

Question 3

Aging population may face certain oral health conditions such as:

Answer 3

-xerostomia
-periodontal disease
-tooth decay
-dark and brittle teeth
-bone resorption

Question 4

Common Developmental disorders are:

Answer 4

-Intellectual disability
-Down Syndrome
-Autism

Question 5

Common Physical Disorders:

Answer 5

-Patient using a wheelchair
-Vision impairment
-Hearing Impairment

Question 6

Common Neurologic Disorders:

Answer 6

-Alzheimer’s Disease
-Seizures
-Multiple Sclerosis
-Cerebrovascular Accident (Stroke)

Question 7

Common Neuromuscular Disorders:

Answer 7

-Muscular Dystrophy
-Parkinson’s Disease
-Cerebral Palsy
-Arthritis

Question 8

Common Cardiovascular Disorders:

Answer 8

-Contentive Heart Failure
-Hypertension
-Angina
-Endocarditis

Question 9

Common Pulmonary Disorders:

Answer 9

-Allergies
-Bronchial Asthma
-COPD

Question 10

Common Behavioral and Psychiatric Disorders

Answer 10

-Anxiety
-Depression
-Eating Disorders
-Bipolar Disorders
-Substance Abuse

Question 11

How are treatment/procedures modified for Special Care Patients?

Answer 11

The Modifications depend on the patient.

Question 12

Special Care Patients include:

Answer 12

-the elderly
-patients with physical disabilities
-patients with mental disabilities
-patients with disorders
-neglected or abused patients

Question 13

When does special care for geriatric patients begin?

Answer 13

As soon as they enter the dental office.

Question 14

How can the dental team assess an elderly patients mobility/level of independent function?

Answer 14

By close observation of their gait, stance and responses to questions, the dental team can assess their mobility and level of independent functioning.

Question 15

What is most important during elderly patient appointment?

Answer 15

Elimination of dental pain should be foremost, then retention of the existing dentition within the limits of the patient acceptance and ability to pay

Question 16

What time of day should appointments for elderly patients take place?

Answer 16

Most dental visits for geriatric patients should be kept short, and occur at a time of day they are most comfortable with sitting and keeping their mouths open. Some patients will have exacttimes when they must eat or take medications which must be respected.

Question 17

Where should a wheelchair or walker be left during a dental appointment?

Answer 17

Remember that wheelchairs or walkers enable patients to have mobility, and as such are very important to them. Leave them within view of the patient when possible and treat them with the same respect that you would any personal belonging.

Question 18

How to prepare a vision impaired client for treatment?

Answer 18

Ensure that all procedures are fully explained verbally.

Question 19

How should patients with hearing lost be prepared for treatment?

Answer 19

They should be offered written instructions so they don’t miss or misinterpret directions.

Question 20

How to manage appointment for a patient with Mental Disabilities?

Answer 20

They may require repetition of instructions or written instructions.

May be best to involve the same members of the dental team in their care at each appointment to ensure consistency and familiarization.

May respond well to reward and reinforcement when being given instructions.

Tell, show, do technique is effective tool

Question 21

Treatment for Patients with Disorders

Answer 21

Is planned and given when symptoms of the disorder are controlled (often by medication). When treating the patient, plan on following simple routines that will become familiar to the patient. Any increased stimulation should be avoided such as sound or images. The atmosphere should be restful and calming

Question 22

Documentation of Neglected or Abused Patients

Answer 22

Patients suspected of suffering from neglect or abuse must have documentation completed for future reference and comparision.

• Completed by dentist, witnessed by DA.
• It is a legal obligation to report suspected cases of abuse and neglect of children and persons in institutions in AB. The dental team must be prepared to share findings with authorities and provide evidence in court if necessary.

Question 23

What must a documentation/record of suspected abuse/neglect contain?

Answer 23

This record must include date, time and place of the observed conditions including if at all possible photographs, radiographs and diagrams.

Question 24

To make special care patients more comfortable during a dental procedure, use the following:

Answer 24

Mouth Props
Rubber Dam
Nitrous Oxide
Oral Sedation
Headphones

For physical impairments:
Positioning Devices
Stabilizing Devices

Question 25

How is a Mouth Prop beneficial for a special care patient?

Answer 25

Helps the patient keep their mouth open without tiring the jaw too much

Question 26

How is a Rubber Dam beneficial for a special care patient?

Answer 26

Helps in keeping the treatment area dry and the tongue out of the way.

Question 27

How is Nitrous Oxide beneficial for a special care patient?

Answer 27

This is a form of inhalation sedation which diminishes pain sensation and induces a feeling of well-being or euphoria. It is particuarly helpful when working with anxious patients.

Question 28

How is Oral Sedation beneficial for a special care patient?

Answer 28

Comes in the form of a pill or liquid. This medication is intended to reduce anxiety and/or induce a calming sedative effect much like a sleeping pill.

Question 29

How are Headphones beneficial for a special care patient?

Answer 29

A simple tool that is often overlooked. Using headphones helps reduce the sounds of the dental hand piece and suction which often causes anxiety in patients.

Question 30

How are positioning devices beneficial for patients with physical impairments?

Answer 30

These are specially-designed cushions and supports that either allow a patient to remain in a wheelchair for treatment or make them more comfortable when transferred to a dental chair

Question 31

How are stabilizing devicess beneficial for patients with physical impairments?

Answer 31

These are used to minimize any movement by the patient which may interfere with dental treatment.

Question 32

At home, special care patients can benefit by using the following:

Answer 32

Powered toothbrushes Modified toothbrushes Floss holders Specialized toothbrushes & mouth rinses

Question 33

How do powered toothbrushes benefit special care patients?

Answer 33

These are available for those patients with limited manual dexterity. They limit the amount of movement and pressure required to adequately clean the teeth once the device has been properly located on the teeth.

Question 34

How do modified toothbruses benefit special are patients?

Answer 34

If the special care patient wants to use a traditional toothbrush, the handle can be modified with Styrofoam to increase the circumference and make it easier to grip.

Question 35

How do floss holders benefit special care patients?

Answer 35

These may be used to allow the patient greater access and dexterity in posterior areas

Question 36

How do Specialized Toothpastes & mouth rinses benefit special care patients?

Answer 36

These are available for those experiencing xerostomia. They cointain enzymes that mimic those found in saliva as well as medications to stimulate the salivary glands to produce more saliva

Question 37

What is a Category I Patient?

Answer 37

Healthy patients who require no special modifications.

Question 38

What is a Category II Patient?

Answer 38

Patients with medical conditions who require scheduling changes or shorter appointments.

Question 39

What is a Category III Patient?

Answer 39

Patients with medical conditions who have life long impliccations; these patients require modifications in dental treatment planning, including alterations in anesthetic, types of dental materials, and patient positioning

Question 40

What is a Category IV Patient?

Answer 40

Patients with medical conditions who require more significant modifications in dental treatment planning including treatment to meet dental needs within the operating room.

Question 41

What is a Category V Patient?

Answer 41

Patients with serious medical conditions who require only limited care to eliminate serious acute oral disease; includes patients who must be kept free of pain and discomfort.