Special Needs

Question 1

what are the 2 basic causes of impairments and disabilities?

Answer 1

1-congenital

2-acquired (trauma, toxins, disease)

Question 2

what are the 4 types of impairments/disabilities?

Answer 2

1-neurological
2-developmental
3-physical
4-physiological

Question 3

what are the 5 types of special needs

Answer 3

1-physical impairments and disease
2-cognitive disorders and developmental delay
3-mental/psychological
4-sensory disorders
5-behavior

Question 4

what are the 6 manifestations of special needs

Answer 4

1-syndromes
2-disease
3-birth defects
4-physiological
5-traumatic brain injuries
6-psychological

Question 5

kids with special needs have impairments that impact what 5 areas of life?

Answer 5

1-communication
2-work capabilities
3-self care
4-mobility
5-learning and development

Question 6

what percent of the households in American have SHCN patients?

Answer 6

20%

*60% of those struggle with self care

Question 7

dental care delivery for SHCN has what 7 steps?

Answer 7

1-gather info
2-assess
3-id risks
4-preventative care instructions
5-tx plan and impementation
6-make accommodations
7-consult/refer

Question 8

Aside from cc and meds, what 2 things should be gathered as info?

Answer 8

1-medical diagnosis

2-other doctors working with pt

Question 9

when assessing the risk of the patient, what kinds of things are considered?

Answer 9

abilities, care takers, diet, meds, habits, fears

Question 10

4 ways to give preventative instructions

Answer 10

1-demonstrate
2-stand in front of px, cradle head, brush their teeth
3-knee to knee dentistry
4- recline pt

Question 11

what are 4 ways to desensitize and reduce anxiety?

Answer 11

1-give tour
2-show tell do
3- simple sentences
5- allow px to touch, taste, smell

*many more tips in power point

Question 12

T/F if px is in wheel chair, lift them onto dental chair

Answer 12

false, leave them in their own chair

Question 13

T/F patients should bring soothing devices to help them keep calm

Answer 13

true

Question 14

T/F many SHCN patients avoid treatment due to fear

Answer 14

true

*care takers have fear too

Question 15

what are some of the challenges of working with SHCN patients?

Answer 15

involuntary reflexes, 
restricted mouth opening
excessive clenching/grinding
gingival overgrowth
crowded teeth
trauma
food impaction
physiologic factors

Question 16

what 3 things may indicate general anesthesia over local?

Answer 16

1-inability to cooperate
2-extensive decay
3-extensive calculus/plaque

Question 17

3 things to evaluate

Answer 17

1-diet
2-fluoride exposure
3-side effects of meds

Question 18

T/F individuals with SHCN are at an increased risk for oral disease

Answer 18

True

Question 19

mild cases of SHCN do well with _____ appointments, immobilization and ______ sedation

Answer 19

short, conscious

*severe-general anesthesia

Question 20

what 3 situations call for protective stabilization?

Answer 20

1-immediate diagnosis
2-other things have failed
3-safety of dr, staff, etc

Question 21

4 contraindications for stabilization

Answer 21

1-cooperative patient
2-unsafe due to physical/medical conditions
3-patients have previous bad experience with it
4-non-sedated pts with non-emergent tx with long appointments

Question 22

T/F it is a bad idea to take radiographs on the 2nd visit

Answer 22

False. Good idea because patient has gotten used to the place

Question 23

5 considerations for wheelchair bound patients

Answer 23

1-tip wheelchair back
2-head stabilization
3- keep back inclined to facilitate swallowing
4-be aware of arms
5-use pillows for support

Question 24

some characteristics of down syndrome include ______ tongue and open bite _____ lips, missing or______ teeth,_____ perio rate, __ % heart disease, high ______ and erosion

Answer 24

large, fissured
malformed
 high
40
attrition

Question 25

T/F restraints and sedation can have calming effects in pts with autism

Answer 25

true *normal life span, limited communication, many appointments to acclimate, general anesthesia

Question 26

what disability is one of the primary handicapping conditions of childhood?

Answer 26

cerebral palsy *damage to brain pre and post natal, decreased o2 during deliver, up to paralysis, irregular gait, bad diet, involuntary moments, mild to severe

Question 27

T/F patients with CF should be fully reclined

Answer 27

false, keep upright to clear secretions

Question 28

T/FCF patients have high caries risk and low plaque and calculus risk

Answer 28

false, opposite

Question 29

the best lip readers only comprehend what % of what is said?

Answer 29

30-40

Question 30

T/F blind people still have light sensitivity

Answer 30

true *use sunglasses

Question 31

why is it important to know they patients degree of physical and intellectual impairments before tx?

Answer 31

so you don't confuse involuntary movements or sounds as being uncooperative *use empathy

Question 32

What are 5 tips to offer reassurance?

Answer 32

``` 1-comforting gestures 2-establish a rapport 3-guide/assist 4-care giver support 5-describe procedures ```

Question 33

what 5 modifications can be done during tx to make things easier

Answer 33

``` 1-bite block 2-stabilize head 3-modify tooth brush (make handle fatter) for at home care 4-electric brushes 5- floss holders ```

Question 34

T/F frequent breaks to regroup can be helpful

Answer 34

true * minimize chair time * avoid abrupt movements, lights, sounds

Question 35

T/F more frequent appointments can help with desensitizing the pt

Answer 35

true * tell show do * use parent's help

Question 36

what is epidermolysis bulsa (EB)?

Answer 36

a very rare genetic connective tissue disorder * recessive dystrophic best known * breakdown and blistering of outer skin and mucosa * possible poorly formed enamel

Question 37

T/F people with EB don't blister on the soft tissues of the mouth and esophagus

Answer 37

False, * They blister everywhere with minimal friction, no cure * scarring, chronic pain, squamous cell carcinoma

Question 38

T/F scarring of EB restricts mouth opening

Answer 38

true *often a challenge to eat leading to malnutrion