Special Needs

Question 1

What are the four types of disability?

Answer 1

Physical
Medical
Sensory
Mental

Question 2

What are the four types of cerebral palsy?

Answer 2

Spastic
Athetoid
Rigid
Ataxic

Question 3

What are the dental features of cerebral palsy?

Answer 3

Poor OH
Gingival hyperplasia
Enamel hypoplasia
Bruxism
Malocclusion
Dental trauma
Drooling
Access
Uncontrollable movements
Enhanced gag reflex

Question 4

What are the dental aspects of congenital heart defects?

Answer 4

Increased risk of infective endocarditis
Increased bleeding tendency if on warfarin/aspirin
High risk under GA
Careful use of LA with adrenaline

Question 5

What are the dental aspects of children with cancer/tumours?

Answer 5

Oral symptoms - mucosal/gingival haemorrhage, gingival enlargement, mouth & throat infections, oral mucositis
Immunosuppression
Thrombocytopenia
Developing dentition

Question 6

What is dyspraxia?

Answer 6

Disorder affecting motor skill development

Question 7

What is the triad of impairments (autism)?

Answer 7

Social communication
Social interaction
Social imagination

Question 8

What things may someone with ASD like/dislike in the dental surgery?

Answer 8

Touch
Light
Noise
Smell
Texture
Dental unit controls
Water

Question 9

How should you prepare for a patient with ASD?

Answer 9

Get parent to prepare child before visit
Learn their likes and dislikes
Send them board maker symbols
Be ready on time
Use simple language
Use patients name frequently

Question 10

What is the definition of learning disability?

Answer 10

A state of arrested or incomplete development of mind resulting in significant impairment of intellectual, adaptive and social functioning.

Question 11

What is dyscalculia?

Answer 11

Severe difficulty in making arithmetical calculations

Question 12

What are the dental features of Down’s syndrome?

Answer 12

Maxillary hypoplasia
Class III occlusion
Macroglossia (large tongue)
Anterior open bite
Hypodontia & microdontia
Predisposition to periodontal disease

Question 13

What medical problems are linked to Down’s syndrome?

Answer 13

Cardiac defect
Leukaemia
Epilepsy
Alzheimer’s/dementia

Question 14

What four factors are required for development of caries?

Answer 14

Teeth
Plaque
Sugar
Time

Question 15

What prevents a child from brushing their teeth?

Answer 15

Manual dexterity - disability
Unwilling to brush - gingivae tender/bleeding
Inability to understand - autism

Question 16

What may prevent a parent from brushing their child’s teeth?

Answer 16

Manual dexterity - awkward positioning
Unwilling to brush - revulsion, panic at sight of blood
Inability to get toothbrush into child’s mouth

Question 17

What aids are available for toothbrushing?

Answer 17

Finger stop & bite props
Duraphat toothpaste (10y+)
Modified toothbrushes

Question 18

What dietary factors hinder prevention of tooth decay?

Answer 18

Soft diet - food not cleared
Sugary treats as rewards
Drinks - sipping juice throughout the day
Sugary medicine - antibiotics, lactulose

Question 19

When would IV sedation be contraindicated?

Answer 19

Those undergoing Bleomycin therapy

Those with musculoskeletal disorders

Question 20

What drugs can be used for IV sedation?

Answer 20

Midazolam

Propofol (requires anaesthetist)

Question 21

What are the indications for GA?

Answer 21

No co-operation
Extensive treatment required
Medically compromised patient

Question 22

What are the contraindications for GA?

Answer 22

Medically compromised

Question 23

What are the possible complications of dental disease in children with disability?

Answer 23

Delayed diagnosis
Delayed management
Medical complications
Reduced quality of life
Reduced self-esteem