any restriction or lack of ability (resulting from an impairment) to perform an activity in the manner or within the range considered normal for a human being of the same age, sex, and background. It referes to any reduction of a person's activity that has resulted from an acute or chronic health condition and affects motor, sensory, or mental functions
disabled
Name 4 areas where a patient with a disability may have special requirements:
transportation
time and frequency of appointment
patient positioning
What are some special requirements a disabled pt may need in regards to transportation?
wheelchair transport vehicle
ride transportation service
What special requirements might a disabled pt need in regards to appointment length and time?
schedule appointments around their meal time
don't schedule them for too long
pt may like morining better if they have more energy; or afternoon better if it takes them a long time to get ready
How many feet wide should a handicapped parking space be?
13 feet
How wide must the walk-way be for wheelchair accomodation?
3 feet wide
How many inches should the door open to accomodate a handicapped or disabled patient?
32 inches
What are 3 types of wheel chair transfers?
mobile pt
immobile pt
sliding board transfer
which wheel chair transfer is described: face chair in same direction as dental chair at 30* angle to it; face pt with feet outside pts for pivoting; place hands under pt's arms and grasp waist in the back; help lift pt up and set down on dental chair
mobile pt transfer
which wheel chair transfer am I describing: requires two aids, one behind, and places hands under patients arm below the elbows pressing forearms against pt; the other places one arm under thighs and other under calves; then lift and move together
immobile pt transfer
which wheel chair transfer is described: adjust seat of dental chair slightly lower than wheel chair, place sliding board under hip of pt and across to dental chair; pt then shifts weight and slides along the board
sliding board transfer
What are two things used in body stabilization of disabled patients?
pediwrap
papoose board
made of nylon mesh and encloses pt from neck to ankles; frequently used with support straps about the pts legs and arms
pediwrap
a board with padded wraps to enclose a pt
papoose board
Who must you obtain written consent from before use of any restraint or stabilization?
gaurdian
self-care group including those who can floss and brush their own teeth
high functioning level
partial care group includes those capable of carrying out at least part of their oral hygiene needs but who require considerable training
moderate functioning level
total care group includes those who are unable to attend to their own care and are therefore dependant
low functioning level
What are 7 preventive program components in disease and prevention control?
education
biofilm control
fluorides
pit and fissure sealants
diet counseling
smoking cessation
regular exams and tx at intervals as recommended by dentist or DH
failure to perform daily personal oral hygiene can be due to what 3 cooperation factors?
lack of knowledge and understanding about the need for biofilm removal
lack of motivation to carry out daily routines
lack of necessary mental or physical coordination to carry out oral hygiene measures
What type of dentifrice is recommended for the disabled pt?
one with fluoride
When should a dentifrice not be used in a disabled pt?
when they can't control saliva, rinse, or spit
true or false. Dentifrice is not essential to biofilm removal, and another method of dayily fluoride application may be more appropriate
true
What are 8 common oral problems seen in the homebound pt?
need for routine check up
losing weight/not eating due to oral problems
toothache/pain/abscess/swelling
trauma/fractured teeth
loose teeth
lost fillings/crowns
dental caries
loose, uncomfortable, or lost dentures
What are 8 barriers for homebound pts in accessing dental care?
limited ambulation
transportation unavailable
cost
fear
pts' health attitudes and beliefs
pt's daily pain level
ageism or negative attitude of practitioner
limited availability of practitioners who provide homebound care
true or false. Systemic conditions can affect oral health status. Poor oral health can affect systemic conditions
both are true
oral pain/discomfort can compromise ______ status
nutritional
oral health status and oral cleanliness can affect what 3 other things related to over all health?
self esteem
quality of life
ability to communicate
Three important aspects in preparing for a visit to the homebound pt include what?
understanding the pt - health history and questionnaire prior to appt
instruments and equipment - have everything you need ready to go
appointment time - be flexible and arrange a time that works best for your pt.
In care for the terminally ill patient, what is the emphasis on?
symptom relief and clean oral environment (palliative care) this may enhance the pt's quality of life
What is the major difference in providing DH care for terminally ill pts then for standard pts?
the focus is on short term palliative care rather than long term preventive care
What are 3 objectives of care for the terminally ill pt?
provide oral care then emphasizes pt comfort
provide pain relief
provide a clean mouth environment
What percent of hopsice care pts have some kind of difficulty wearing their dentures? Why
70%
due to severe weight loss
a dental hygienist with advanced education and certification in specialty areas who is licensed to provode a wide range of services including, but not limited to diagnostic, preventive, restorative, and therapeutic services directly to the public, the model for thes midlevel practitioner is similar to a nurse practitioner
Advanced Dental Hygiene Practitioner
a disadvantage for an individual, resulting from an impairment or a disability, that limits or prevents fulfillment of a role that is within the normal range for a human of the same age, sex, and social and culutural factors as the affected individual
handicapped
What is the main difference between handicapped and disabled?
disabled deals more with physical impairments
What are 3 examples of barriers to dental care for the handicapped and disabled pt? And whom do they affect?
attitude, physical, and financial barriers
patient, family/care giver/gaurdian, or dental professional
external traumatic force that can cause the impairment of spinal cord function
spinal cord injury
One half of all spinal cord injuries are caused by what? What are 3 other causes for spinal cord injuries? And who does it mostly affect?
motor vehicle accidents
falls, diving accidents, or violence
teenage or young adult men
a sudden loss of brain function resulting from interference of the blood supply to a part of the brain
Cerebrovascular accident (CVA or stroke)
What are two different types of signs and symptoms seen in a CVA pt?
transient aschemic attack TIA
residual or chronic effects
What are 7 examples of chronic or residual symptoms seen in victims who have experienced a stroke?
problems with:
paralysis
articulation
salivation
sensory
visual impairment
mental function
personal factors
What are 8 predisposing factors for a stroke?
atherosclerosis
hypertension
hypercholesterolemia
tobacco use
cardiovascular disease
diabetes mellitus
use of oral contraceptives
drug abuse
What is the greatest risk factor that leads to stroke?
hypertension
What is one tool used in dental hygiene that can detect that a stroke might occur?
panoramic radiograph
In looking at a pano, what can be seen on it to indicate risk for stroke?
calcification in carotid artery seen inferior and posterior to the inferior border of the mandible
dental treatment is not advised until how long after a pt has had a stroke?
6 months
an autoimmune neuromuscular disease charcterized by weakness and fatigability of summetrical voluntary muscles; facial and oral parts served by certain cranial nerves in this disease are involved early
myasthenia gravis
What are three symptoms that might be early indicators of myasthenia gravis?
weakness of eye movement
diplopia (double vision)
ptosis (drooping eye lids)
What are 3 oral and facial problems associated with myasthenia gravis?
swallowing difficulties (dysphagia) and lack of facial expression
disturbed speech and expression with a weak voice that sounds muffled
may need to support chin while talking
What are 3 appointment factors you may need to consider for treating a pt with myasthenia gravis?
short early appointments
frequent appointments
make sure office has emergency supplies ready and environment is stress free
a chronic demylenating disease of the central nervous system characterized by progressive disability
multiple sclerosis (MS)
What are 2 important appointment considerations for pts with MS?
a warm, quiet, and comfortable atmosphere
frequent and short appointments
paralysis of facial muscles innervated by the facial or seventh cranial nerve
Bell's palsy
What are 3 possible causes of Bell's palsy? (even though real cause is unknown)
