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Flashcards in Special Needs Deck (87):
1

Long lasting health condition that limits a person't ability to see, hear, physical activity, mental capabilities

Impairment

2

limitations that represent a substantial disadvantage when attempting to function in society

Disability

3

group of malformations, deformations, and malformation Sequences, occur together due to some identifiable underlying cause

Syndrome

4

4 Models of Disability:

Traditional/Moral model

Medical/Rehab model

Social model

Integrative/disability (biopsychosocial model)

5

How many children suffer from Developmental Disability?

1 in 6

6

What is the most common developmental disability?

Affects _____ million people

____% have mild impairment

Cause usually unknown

Intellectual

6.2 - 7.5

87%

True

7

Developmental Disability manifests prior to what age?

describes _____ disabilities

22

life-long

8

4 most prominent Developmental Disabilities:

Intellectual

Cerabral Palsy

Epilepsy

Autism

9

2 trends affecting dental care for individuals w/ ID/DD

Increased life expectancy

Deinstututionalization

10

Collection of conceptional, social, and practical skills learned/performed by people in their everyday lives:

Adaptive Behavior

11

Language/literacy; money, time, numbers, self-direction:

interpersonal skills, social responsibility, gullibility, etc

activities of daily living, personal care, occupational skills, healthcare, travel, etc

Conceptual skills

Social skills

Practical skills

12

3 examples of individuals who can serve as a Witness to consent:

Dental assistant

Other dental staff

Non-relative of patient

13

3 types of Informed Consent:

Explicit

Implied

Specific

14

3 people that can provide consent if pt can't:

Guardian

Medical Power of Attorney

Public Fiduciary

15

Failure to collect consent can result in what 3 things?

Criminal charges

Lawsuit

Negligent behavior

16

ADA - American with Disabilities Act, prohibits...

services to indivisuals w/ disabilities must be offered in most ______ setting appropriate to the needs of the individual (including dental offices)

discrimination on basis of disability

integrated

17

Wheelchair accessibility, minimum width of hallway:

_____ feet diameter to turn wheelchair around

Best to Tx pt where?

3 feet

5 feet

in chair

18

Remember to take _____ off chair, use sliding board when transferring pt

______ and ______ the chair

foot rests (and sides, leg holders)

position and lock

19

Behavioral Hx w/ caregiver includes what 4 things?

communication abilities

rxns to sensitive stimuli

steriotypic behaviors

previous dental/med experiences

20

in Behavioral Hx what is important to ask?

techniques/suggestions to distract pt during Tx

*music, game, etc

21

Pt should have what kind of environment for care?

Least restrictive possible

*most participation possible

22

Medical/Social Hx, oral hygiene ability, sitting time, sedation/anesthetic contraindications, ability/willingness for RPD, esthetics

Tx plan - whole person

23

Past exp. dental care

med conditions

meds taking - side effects

sensory impairments?

Know your pt!

24

3 types of sensory impairments:

Hearing loss

Visual

Hypersensitivity (sound, touch, lighting)

25

SOAP:

Subjective (CC, Hx)

Objective (clinical, radiographic, vitals)

Assessment (diagnosis, risk assess)

Plan (Tx, mods, procedures)

26

ID type/risk associated w/ dental procedure:

AAOM risk assessment

27

Risk assessment based on what 4 things:

Med Hx

Exam (vitals/clinical/radiographic)

Lab/diagnostics

Consultations

28

3 questions to ask in Risk Assessment:

likelihood of adverse event during procedure

nature/severity of adverse event

appropriate setting for Tx

29

4 Purposes for Medical Consult:

Request evaluation (systemic disease)

Specific info (Tx mods)

Determine if dental Tx prudent

Request change in pts therapy

30

1 reason NOT to get consult:

clearance/permission

31

Good Med Consult must be concise, specific, request only ________

Avoid asking clearance, use a _______

Know current protocols/guidelines, inform physician of ______ and ________

contact info for dental provider/physician, and get Pt's ________

pertinent facts

checklist

diagnosis, planned Tx

informed consent for info release

32

What is the most common malformation syndrome?

Trisomy 21

33

Mean IQ Trisomy 21:

often equivalent to _____ grade level

Congenital heart defects in _____%

Impaired immunity from decreased _______ function

Hypothyroidism in ______ %

_______ anomalies common

Atlanto-axial instability in ______%

50

6th

40-50%

neutrophil

16-20%

Airway

14%

34

Trisomy 21 Increased incidence of what 5 dental deficits:

Missing LI's

Peg laterals

Excessive spacing

short rounded roots

Maxillary hypoplasia

35

Maxillary hypoplasia in Trisomy 21 causes _______

Class ______ malocclusion

What tooth anomaly:

increased incidence of _____ disease

Relative _______

Perio disease present when?

crowding

III

Taurodontism

perio

macroglossia

early childhood

36

Chronic disorder of movement/coordination, caused by injury to the immature brain during prenatal/perinatal period:

Damages ____ areas of developing brain

Is a ______ encephalopathy

Cerebral Palsy

Motor

Static

37

CP, Spastic ____%

Dyskinetic/Athetoid _____% (low tone, loose, uncontrolled)

Ataxic _____% (balance, depth perception)

70-80%

10-15%

less than 5%

38

Most common type of Dementia:

Alzheimer's

39

% Dementia: Alzheimers:

Mixed Alzheimers/Vascular:

Lewy Body Variant:

Frontal Temporal

Vascular

Brain injury

40-65%

20-40%

25%

10-20%

10-20%

4%

40

T/F
infection, teratogens, trauma, multiple births, seizures, illness, premature birth, low birth weight, intracraneal hemorrhage, hypoxia/bradycardia, hyperbilirubinemia are risk factors for CP

True

41

Umbrella term for Progressive genetic diseases degenerating skeletal/voluntary muscles

*cardiac muscle/other involuntaries may or may not be involved

Muscular Dystrophy

42

7 most common types of neuromuscular disorders (Muscular Dystrophy)

Duchenne

Becker

Fascioscapulohumeral

Emery-Dreifuss

Limb-girdle

Myotonic dystrophy

Congenital

43

Describe oral characteristics of Muscular Dystrophy:

Can include what 3 oral manifestations:

Mx/Mn arch consideration:

Similar to CP b/c pts w/ gait problems are at increased risk for dental trauma:

variable, progressive (depending on disease severity)

ant open bite, MACROglossia, sialorrhea

expansion

True

44

What type of seizure is brief, shock-like, and usually does NOT affect consciousness

Myoclonic

45

Myoclonic seizure affects neck, shoulders, ____ arms, body, and ____ legs

Duration:

Consciousness:

EEG:

upper, upper

less than 1 second

not usually impaired

polyspike and slow wave discharge

46

T/F
Even pts compliant w/ meds have breakthrough seizures

True

47

Breakthrough seizures can be related to physical stress/pain

True

48

4 possible triggers for Breakthrough Seizures:

LA overdose/inadvertent intravascular injection

Hypoxia secondary to vasovagal syncopy

hypoglycemia/insulin OD

Cerebral vascular accident/Transient ischemic attacks

49

2 Anticonvulsants and their side effects:

Phenytoin - gingival hyperplasia

Carbamazepine - xerostomia/stomatitis/increased caries

50

Phenytoin, consider use of ____ and ______

Carbamazepine, consider using ______ to reduce caries from xerostomia

CHX, folic acid

topical fluoride

51

T/F
It is important to determine if the masticatory apparatus is involved in a seizure

True

52

4 conditions upon which seizure pt can be treated:

Seizure free (w/ or w/o meds)

Rare seizures (less than 1/yr)

not involve masticatory apparatus

no special needs

53

What 2 seizure types do not involve the masticatory apparatus?

absence

myoclonic

54

2 seizure conditions requiring special consideration for dental Tx:

involves masticatory apparatus

generalized tonic-clonic

55

If seizure, Place dental chair in what position?

place pt on what side?

if seizure lasts more than ____ minutes, call 911

can administer _____ L/min Oxygen if pt cyanotic

if lasts longer than ___ min, Status Epilepticus

supine (low to floor)

left

3

6-8

5 min

56

3 types of single gene disorders:

auto dom

auto rec

x-linked

57

OI (osteogenesis imperfecta) inheritance:

mutation is genes that code for what?

clinical class system developed in 1970 by David ______

Autosomal Dominant

type I collagen

Sillence

58

OI defect at ______ on chromosome 17

______ on chromosome 7

Col1A1

Col1A2

59

4 factors determining effect of teratogen:

timing

length

species

genetic predisposition

60

What type of inheritance is responsible for the largest percentage of birth defects?

Multifactorial

61

3 multifactorial diseases:

Asthma

Coronary artery

Alzheimers

62

4 categories of craniofacial disorders:

craniosynostosis syndromes

clefting syndromes

branchial arch disorders

dental, gingival, perio (syndromes)

63

T/F
There are no specific genetic, medical lab tests available for autism and Diagnosis is based on behavior

True

64

In ASD there is enormous variation on _____ patterns and _____ of symptoms

behavioral

severity

65

ASD etiology:

unknown

*genetic, neurotransmitter defect, infection, metabolic errors, immunologic, environmental - all theories

66

5 Indications for further eval (ASD):

no babbling, cooing by 12 months

no pointing, waving, grasping by 12 months

no single words by 16 months

no 2 words by 24 months

loss of language/social skills

67

6 characteristics ASD:

insistence on sameness

repetitive (stereotypical) movements

unresponsive to verbal cues, no eye contact

difficulty expressing needs

social situation difficulty

attachment to objects

68

6 impairments of ASD:

sensorimotor

echolalia

no symbolic thinking

self-injury

intellectual disability

seizure

69

ASD, ____% have intellectual disability

____% have seizures:

70%

30%

70

4 behavior management strategies for ASD:

Hx

peculiarities/stereotypic

communication

noise, touch, light sensitivities

71

ASD, after Hx, before Tx:

desensitization (familiarize w/ dental environment, staff

72

3 Behavior management strategies:

Tell-show-do

immediate positive/neg reinforcement

Modeling (sibling)

73

ABA

Medical immobilization, sedation, general anesthesia

applied behavioral analysis

*behavioral management ASD

74

3 reasons for medical immobilization:

uncooperative due to lack of maturity

unable to cooperate due to mental/physical disability

safety of pt/practitioner

75

Some ASD pts like restraints, others don't, be sure to obtain...

consent from guardian

76

How many americans have a disability?

50 million

77

Premedicate in what 4 conditions?

Prosthetic heart valve

bacterial endocarditis hx

heart transplant w/ valvulopathy

congenital heart defects

78

Dementia is the deterioration of mental faculty due to what?

organic disease/disorder of brain

79

Dementia is defined by what?

severity to interfere w/ daily functioning

80

Dementia is characterized by multiple cognitive defects, memory impairment, and at least one of the following 5 disturbances:

aphasia (idea)

amnesia

agnosia (objects)

apraxia (coordination)

executive functioning (goal directed behavior)

81

Prevalence Alzheimers increases w/ age, but most often above...

Avg lifespan of people w/ Alzheimers:

65

8-10 yrs

82

investigates/resolves complaints of residents in nursing facilities, board and care facilities, etc

long-term care ombudsman program

83

Every year ____ million older americans are victims of elder abuse

every case reported, probably ____ not reported

abused elders tend to die earlier

2.1

5

True

84

Elder abuse, dentist should report to...

Academy of general dentistry, dentists 1st line of defense, must take action

Adult Protective Services

True

85

Trauma, injuries, bruising, confinement, isolation, passivity, depression, anxiety, large financial withdrawals, unpaid bills

think elder abuse

86

Warning signs of Elder Abuse may include what 3 things?

Bleeding gums

poor dentition

oral hygiene

87

Reporting abuse, dentist required to take photographs, include _______

if you're guilty of not reporting, it is a....

radiologic exams

class 1 misdemeanor

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