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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
Name 4 areas where a patient with a disability may have special requirements:
- 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?
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?
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?
made of nylon mesh and encloses pt from neck to ankles; frequently used with support straps about the pts legs and arms
a board with padded wraps to enclose a pt
Who must you obtain written consent from before use of any restraint or stabilization?
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?
- biofilm control
- 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
What are 8 common oral problems seen in the homebound pt?
- need for routine check up
- losing weight/not eating due to oral problems
- 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
- 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
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
- 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
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:
- visual impairment
- mental function
- personal factors
What are 8 predisposing factors for a stroke?
- tobacco use
- cardiovascular disease
- diabetes mellitus
- use of oral contraceptives
- drug abuse
What is the greatest risk factor that leads to stroke?
What is one tool used in dental hygiene that can detect that a stroke might occur?
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?
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
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
What are 3 possible causes of Bell's palsy? (even though real cause is unknown)
- bacterial and viral infections
- herpes simplex injury
- trauma from oral surgery