Prevention at Individual and Population Level in Patients with Disabilities Flashcards
(46 cards)
What is the purpose of having an MDT looking after the healthcare with a patient with a disability?
Encourages/facilitates the safe delivery of care
What can be done to help patients with oral care and prevention if they have disability but are capable of independent living?
Maximise existing skills
Establish routines
What can be done to help patients with oral care and prevention if they have disability and are dependent?
Engage carers
Provide appropriate education
Facilitate support
Which conditions may cause people to experience drooling?
Developmental disabilities
Cerebral palsy
Progressive neurological conditions
-> parkinsons
-> MND
What can be done to prevent drooling in patients?
- Head Positioning and Posture
- Speech and Language Therapy
- Behavioural techniques
- Medication and Surgery
What can cause dehydration, xerostomia and dysphagia in patients who are hospitalised?
oOxygen therapy
oMouth breathing
oSide-effects of medications
oReduced food and fluid intake
Which habits in patients who suffer from dysphagia can contribute to oral disease?
- Pouching
- Modification of consistency of foods and liquid- suggest swallowing issue
- Nutritional changes
- Sip Feeding- increased caries risk
- Risk of Aspiration
What is pouching, what can it cause, how can it be checked?
Keeping foods and medicines (iron tablets, alendronic acids can result in communications) in buccal sulcus
Can result in cervical and root caries
Check this to see if anything is being held- clear with gloved finger
What techniques can be helpful to aid oral care in those with dysphagia?
Get patient in upright position
Encourage patient to spit out toothpaste if they can
Use of suction toothbrush
Use of hand over hand technique
Adaptions to toothbrush handle
Using 2 toothbrushes- one to brush teeth, one to hold muscosa out of the way/mop mucous off tissues
Mouth guard/finger props
Why are foam sticks not recommended for OH in patients who have dysphagia?
Ineffective at removing plaque
Risk of aspiration and choking as the foam can become detached or be bitten off (especially if it is left soaking in liquid)
Why do patients who are PEG fed or nil by mouth still need oral hygiene?
Still need oral health care as they still get biofilm development or may still take food orally
Tissues must be kept moist
What are the issues with tasters? How can this be prevented?
Tend to be sweet (contain sugar) to help with dry mouth
Discuss with carers as this can cause caries
Knoppert tasters- non-cariogenic option
Which toothpastes may helpful for OH in patients with learning and disabilities?
Ora-nurse- unflavoured
SLS free/non-foaming- if swallowing issue
-> Sensodyne, oranurse, ultradex, biotene
How is the 2 toothbrush technique carried out?
- Thick handled rubber toothbrush
- Used between the occlusion as a prop
- Mop and Go-
Using gauze to wipe mucosa and teeth where mucus
has deposited - 2 Person approach:
-> 1 to support brushing -> 1 to support induviudal
What is open wide?
Programme for disabled people of middle age to improve oral hygiene
Broad- not specific to people with stroke, ASD etc
Aims to facilitate patients to look after their own mouths are far as possible
What are the different aspects of open wide programme?
Unit 1 – Core Oral Health Knowledge
-> educating patients about prevention, risk factors
Unit 2 – Practical Oral Care
-> OH, denture care, strategies to overcome barriers
Unit 3 – Oral Health Documentation
-> OHA, Oral care plan, daily oral care plan
What are action cards? Who are they used for?
Communication resource (similar to social stories) which explains task such as OH in steps
-> useful for people with ASD
Which adjuncts to communication can be helpful to aid consultation with patients with learning and physical disability?
Makaton
Picture boards
Letter boards
Wrist bands
Talking mats
Draw/write
Technology
How should a dentist communicate with patients who have learning and physical disability?
Smile
Be caring, calm, friendly
Speak clearly at appropriate pace
Use short sentences with certain words
Remain positive- do not show frustration
Make use of gentle touch if appropriate
What can be done to empower patients who have learning and physical disability when communicating?
Prompt
Encourage
Support
How should OH advice be given to patients with learning and physical disabilities?
Discuss at eye level with patient
Put pea sized amount on small headed toothbrush
Systematic approach
-> Outside surfaces
-> inside surfaces
-> chewing surfaces
-> mucosa
Encourage patient to spit toothpaste out (don’t rinse)
What can be done to make OH easier/more enjoyable for patient’s with learning and physical disability?
Counting and singing
Give meaning to toothbrush- Different coloured toothpaste for each segment
-> Patient associates certain parts of mouth
Timing- do at best time for patient, do at same time in same place to create routine
Make sure the lighting is adequate
Dignified environment
What head position should disabled patients with gag reflex and dysphagia be encouraged to be in when carrying out OH?
Forwards and downwards
What is the bridging technique? How can it be applied to tooth brushing for people with disabilities?
This helps to engage a person with the task through their senses and helps them to understand the task
Describe and show them the toothbrush, then mimic brushing your own teeth
Give another toothbrush to the individual. They may mirror your behaviour and brush their own teeth.
