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What are 6 other health considerations that are often seen in pts with cleft lip or palat?
- other congenital anomalies - often accompany the disability
- facial deformities
- infections - upper respiratory and middle ear
- airway and breathing difficulties
- speech difficulty
- hearing loss
true or false. There is rarely a single cause for cleft lip or palate
During what time of pregnency is the significant time for influences from environmental factors for cleft lip and palat?
early in first trimester
What are 5 environmental risk factors for cleft lip or palate?
- tobacco use
- alcohol consumption
- teratogenic agents: phenytoin, vitamin A (isotretinoin), corticosteriods, drugs of abuse
- inadequate diet - folic acid
- lack of adequate prenateal care
How can a cleft lip or palate affect tooth development?
higher incidence of missing and supernumerary teeth, and abnormalities of tooth forme
how can cleft lip or palate affect occlusion?
high percentage require ortho care because of malocclusion, and new ortho therapy may be required after each surgery
How does an open palate affect a person with cleft palate?
can't suck on a nipple as a baby, and breast milk may pass into the nasal cavity
how can cleft lip or palate affect muscle coordination?
- lack of coordination of lips, tongue, cheeks, floor of mouth, or throat
- compensatory habits formed to produce normal sounds in speech
How can cleft lip or palate affect periodontal tissues?
- dental biofilm accumulates more around irregularly positioned teeth, and inability to keep lips closed around mouth during breathing
- early perio with bone loss is often seen at cleft sites
- perio loss in layers is greates at cleft sites
Why are dental caries seen so often in pts with cleft lip and palate?
- malpositioned teeth
- mastication problems
- diet selection
- biofilm retention
cleft lip and/or palate frequently occur as part of a _________ with other __________
How often should dental appointments be scheduled for a pt with cleft lip or palate?
every 3 or 4 months
What are 4 objectives for hygiene treatment of pt with cleft lip or palate?
- review bioflim control measures
- provide encouragement to pt to maintaint health of supporting structures
- remove all calc and smooth the tooth surface
- supervise dental caries prevention program
What are 3 appointment considerations seen with pts with cleft lip or palate?
- pt apprehension - due to being in hospital settings so often
- communication - speech or hearing may be compromised
- motivation - pts may be quiet, unresponsive, or overly bold
3 important areas to focus on in pt instruction for the pt with a cleft lip or palate include:
- personal oral care procedures
- smoking cessation
a condition in which injury to parts of the brain has occurred prenatally, natally, or postnatally and has resulted in paralysis or disruption of motor parts
What are 5 possible causes of cerebral palsy befor birth?
- anoxia during pregnancy
- infection during pregnancy
- blood type incompatibility
- nutrutional lack
- maternal diabetes
What are 4 possible causes of cerebral palsy later in life than in pregnancy?
- infectious disease - meningitis or encephalitis
- lead poisoning
- direct trauma from accidents or battering
What are 6 oral manifestations seen in pts with cerebral palsy?
- disturbance of musculature - facial grimace, asymmetry, probems chewing and swallowing
- fractured teeth
- dental caries
- periodontal infections: phenytoin induced gingival overgrowth, biofilm control
How often are patients with cerebral palsy mentally retarded?
in fewer than 50% of individuals
Name 11 other health considerations besides oral manifestations seen in pts with cerebral palsy
- mixed combo of symptoms
- mental retardation
- learning disability
- sensory disorders - seeing and hearing
congenital defect or opening in the spinal column. A portion of the spinal membranes may protrude through the opeing with or with out spinal cord tissue
- spina bifida
What are 3 important considerations in dental care for a pt with myelomeningocele (or spina bifida)?
- premedication - pts with ventriculoatrial shunts require it
- latex allergy - common in pts with spina bifida
- gingival care - pts who suffer from seizures may be taking phenytoin and suffer from gingival hyperplasia
disease characterized by progressive severe weakness and loss of use of group of muscles
What are the 2 main types of muscular dystrophies?
the duchenne type of muscular dystrophy is limited to ________ and transmitted by _________ carriers
What is the age of onset for the duchenne type of muscular dystrophy?
usually between ages 2-5, but before 10
What are 6 physical manifestations of duchenne muscular dystrophy?
- enlargement of certain muscles
- weakness of hips - frequent falls
- lordosis - abdominal protuberance
- gait - waddle, and difficult balance
- progressive muscular wasting
- intellectual impairment
true or false. Males and females are equally affected by the facioscapulohumeral muscular dystrophy type
What is the age of onset for pts with facioscapulohumeral muscular dystrophy?
between 10 and 18 yrs
What are some characteristics that show a pt has facioscapulohumeral muscular dystrophy?
- facial muscles involved - orbicularis oris
- prominent scapulae with weak shoulder muscles
- difficulty closing eyes completely
no perception of visula stimuli; lack or loss of ability to see
less than 20/200 vision with corrective eyeglasses
What are the 7 leading causes of age-related blindness?
- diabetic retinopathy
- age-related macular degeneration
- senile cataracts
- vascular disease
What is the origin of at least one half of the blindness in children? Give examples
- prenatal origing from:
- infections such as rubella
What are 3 other, not prenatal, causes of blindness in children?
- retinopathy of prematurity
What are 4 important factors to take into consideration with the blind patient?
- Tell pt about things in great detail
- pt relies more on other senses cuz of lack of site
- keep things neat and orderly, let them know if you've rearranged something
- be careful with your tone of voice
How should you handle a situation when the blind pt has a dog guide?
- do not disturb the dog
- ask pt were the do would be best placed or seated
disease in which the optic nerve is damaged, leading to progressive irreversible loss of vision. It is often, but not always associated with increased pressure of fluid in the eye
true or false. tilting a pt back with glaucoma may increase pain and pressure in the eyts, so avoid it
true or false. sensitivity to light is characteristicc of many eye conditions, so avoid shining the light in their eyes
When hearing is impaired to the extent that it has no practical value for the purpose of spoken communication, a person is considered what?
When hearing is defective but functional with or without a hearing aid, what terms are used?
- person who is hard of hearing
- hearing loss
What are 2 main causes of hearing impairments?
- heredity - prenatal infection in mother like rubella or birth trauma
- chronic inner ear infections or infectious diseases such as meningitis, trauma, and toxic effects
outer or middle ear invovlement of the conduction pathways to the inner ear
conductive hearing loss
damage to the sensory hair cells of the inner ear or the nerves that supply the inner ear
sensorineural hearing loss
combination of conductive and sensorineural hearing loss
mixed hearing loss
damage of the nerves or nuclei of the central nervous system in the brain or the pathways to the brain
central hearing loss
What act requires clinicians to acquire certain aids and services such as removal of physical barriers, the use of braille materials, having large printed materials, written instructions, taped texts, qualified interpreters, assistive listening head sets, and text telephone devices
Americans with Disabilities Act (ADA)
absence of sense of smell by damage to olfactory nerve
lessened sensitivity to odors
a disorder with the sense of smell
olfactory dysfunction characterized by the inability of the brain to properly identify an odors natural smell
inability to recognize objects by use of the senses
loss of taste functions in the tongue
reduced ability to taste things
distortion of the sense of taste
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