Week 5 Mani- Special Child Flashcards
1
Q
How to manage mentally retarded patient?
A
- Familiarize patient to clinic and dental personnel
- Speech must be simple and slow
- One instruction at a time
- Listen to patients carefully
- Appointment should be short and in morning
- Don’t display instruments before patient arrives
- Tell show do
2
Q
What is downs syndrome caused by?
A
- 21st trisomy
Aetiologies: advanced maternal age and chromosomal abnormalities
3
Q
What are features of down’s syndrome patients
A
- Short neck
- Flat nasal bridge
- Round skull
- Flattened face
- Ears at lower level
- Hypotonic muscles
- Lower IQ (wide spectrum)
- Small maxilla
- Eyes:
- Oblique palpebral fissures
- Scanty eyelashes
- Epicanthic folds
3
Q
What are associated conditions with down’s syndrome?
A
- Congenital heart problems
- Duodenal atresia
- Umbilical hernia
- Acute lymphoplastic leukaemia
4
Q
What are oral manifestations of downs syndrome?
A
- Macroglossia
- Retarded eruption
- Bifid uvula
- Anterior open bite (assoc with underdeveloped jaws)
- Thickened lips
- High arch palate
- Perio disease (lower immunity)
- Hypo and microdontia
5
Q
How are downs syndrome patients managed?
A
- Generally cooperative
- AB prophylaxis
- Normal preventative regimen
- Tell show do
- Sedation/GA
- Pulp therapy contraindicated if they had cardiac condition
6
Q
What is cerebral palsy?
A
Non-progressive lesion, which occurs in developing brain
7
Q
What is the etiology of CP?
A
- Meningitis
- Toxemia
- Jaundice
- Metal poisoning
8
Q
What are characteristics of spasticity CP?
A
- Inc motor tone (difficulty moving limb)
- Limited control of neck muscles
- Tightness of jaw muscles
- Lack of coordination of intraoral perioral and masticatory musculature → avoid removable appliances (risk of aspiration)
- Excess drooling
9
Q
What are characteristics of dyskinetic CP?
A
- Uncontrolled movements → careful when use instruments and LA
- Slow, twisting, writhing involuntary movements
- Quick jerky movements
- Facial grimacing
10
Q
What are types of CP?
A
- Spasticity
- Athetosis
- Ataxia
- Mixed
11
Q
What are features of ataxic CP?
A
- Poor uncoordinated movements
- Difficult in grasping objects
12
Q
What reflexes are assoc with CP?
A
- Asymmetric tonic neck reflex (if you turn head, the arm and leg on same side can extend and stiffen
- Tonic labyrinth reflex: if pt in supine, legs and arms may straighten out, and neck and back can arch
- Startle reflex: sudden involuntary, forceful bodily movements when exposed to unexpected noises
13
Q
What are dental problems with CP?
A
- Dental caries (assoc with oral health neglect)
- Perio problems
- Malocclusion
- Bruxism, TMJ problems
- Trauma
14
Q
How to manage CP patients?
A
- Treat in wheelchair sometimes
- Avoid abrupt movements, light and noises
- Use LA with stabilisation against sudden movements
- Use rubber dam to avoid hyperactive tongue movements and aspiration
- GA
