Pediatric Special Care Dentistry

Июль 27, 2022

Главная
Медицина
Pediatric Special Care Dentistry

Содержание

2. Special Health Care Needs Definition: Persons with a physical, developmental, mental, sensory, behavioral, cognitive, &/or emotional
3. Common Special Needs Asthma Down Syndrome Developmental/Behavioral Disabilities Autism Asperger Syndrome ADHD Ectodermal Dysplasia Craniofacial malformations
4. Asthma Definition: A chronic disease involving the respiratory system in which the airways occasionally constrict, become
5. Understanding an Attack An asthma attack occurs after there is a trigger Multiple phases
6. Common Oral Findings Increased dental caries More erosion More calculus More gingivitis Throat irritation (steroids) Candida
7. Dental Considerations Good preventive program Rinse/drink water after inhaler use Chronic nebulizer patients ? may require
8. Down Syndrome Definition: Chromosomal disorder caused by the presence of all or part of an extra
9. Common Oral Findings Microdontia Hypodontia Macroglossia Fissured tongue Class III malocclusion Open mouth posture Decreased caries
10. Dental Considerations Congential heart disease Compromised immune system Chronic upper respiratory problems Atlanto-axial instability Varying degree
11. Image taken from: http://fig.cox.miami.edu/Faculty/Dana/down.jpg
12. Developmental/Behavioral Disability Autism spectrum disorder is a general term for a group of complex disorders of
13. Signs & Symptoms Doesn’t respond to his/her own name Acts deaf Does not smile socially Does
14. Asperger Syndrome Previously, Asperger and Autism were subcategories under the heading of Pervasive Developmental Disorders. The
15. Common Oral Findings Varies depending on the severity Increased caries Poor oral hygiene Overall, few unusual
16. Dental Considerations More for autism than Asperger Sensory sensitivity Light, dental tools, water, noise, staff Unpredictable
17. Attention Deficit Hyperactivity Disorder Most common mental disorder among children Hyperactive and unable to control their
18. Ectodermal Dysplasia Definition: Hereditary condition in which there are abnormalities of the cranial-facial structure, digits, and
19. Common Oral Findings Congenitally missing teeth Peg shaped teeth Enamel hypoplasia Increased dental caries Diastema Thick
20. Dental Considerations Caries control Cosmetic dentistry Multiple sets of dentures as the child ages & the
22. Craniofacial Malformations Cleft lip/palate Definition: The sub-division of the body's lip and palate during gestation
23. Cleft Lip & Palate Cleft lip classification Class I: Unilateral notching of the vermilion not extending
24. Oral Findings/Dental Considerations Complications Feeding difficulty Speech difficulty Excessive air intake (burps often) Choking Nasal discharge
25. Fronto-Nasal Dysplasia
26. Cerebral Palsy Definition: Cerebral palsy refers to any number of neurological disorders that permanently affects body
27. Characteristics Eye problems Delayed reflexes Facial grimacing Swallowing difficulties Poor balance Hearing loss MR in ~50%
28. Dental Considerations Increased caries risk Enamel erosion Poor gingival health/POH Heavy calculus (if fed with G-tube)
29. Amelogenesis Imperfecta Inherited disease 1 in 700-15,000 Subtypes
32. Psychological Limitations Anxiety H/o traumatic experience Innate, unprovoked, un-triggered Eating Disorders Anorexia Nervosa Bulimia Nervosa Nervous
34. Скачать презентацию

Слайд 2

Special Health Care Needs
Definition: Persons with a physical, developmental, mental, sensory,

behavioral, cognitive, &/or emotional impairment or limiting condition that requires medical management, health care intervention, &/or use of specialized services/programs

Слайд 3

Common Special Needs
Asthma
Down Syndrome
Developmental/Behavioral Disabilities
Autism
Asperger Syndrome
ADHD
Ectodermal Dysplasia
Craniofacial malformations
Cerebral Palsy
Amelogenesis Imperfecta
Psychological

Limitations
Anxiety
Eating disorders
Nervous habits

Слайд 4

Asthma
Definition: A chronic disease involving the respiratory system in which the

airways occasionally constrict, become inflamed, and are lined with excessive amounts of mucus, often in response to one or more triggers
Asthma Classification

Слайд 5

Understanding an Attack
An asthma attack occurs after there is a

trigger
Multiple phases

Слайд 6

Common Oral Findings
Increased dental caries
More erosion
More calculus
More gingivitis
Throat irritation

(steroids)
Candida infections
Dental facial effects
Increase occurrence of posterior cross bite
Increased anterior facial height
Increased overjet
High palate

Слайд 7

Dental Considerations
Good preventive program
Rinse/drink water after inhaler use
Chronic nebulizer patients ?

may require antifungal treatment
Afternoon appointments (2pm to 6pm)
Review history of last attack/last medication use/frequency of attacks/last hospitalization
Avoid prolonged supine positions
Be aware of dental instrument placement
Reappoint if patient is wheezing, has difficulty breathing
Use rubber dam

Слайд 8

Down Syndrome
Definition: Chromosomal disorder caused by the presence of all or

part of an extra chromosome #21

Слайд 9

Common Oral Findings
Microdontia
Hypodontia
Macroglossia
Fissured tongue
Class III malocclusion
Open mouth posture

Decreased caries risk
Increased periodontal risk
Delayed eruption/overretained teeth
Atypical root morphology
Enamel hypoplasia

Слайд 10

Dental Considerations
Congential heart disease
Compromised immune system
Chronic upper respiratory problems
Atlanto-axial

instability
Varying degree of intellectual impairment

Слайд 11

Image taken from: http://fig.cox.miami.edu/Faculty/Dana/down.jpg

Слайд 12

Developmental/Behavioral Disability
Autism spectrum disorder is a general term for a group

of complex disorders of brain development. These disorders are characterized by varying degrees of difficulties in social interaction, communication and repetitive actions.

Слайд 13

Signs & Symptoms
Doesn’t respond to his/her own name
Acts deaf
Does

not smile socially
Does not point or use gestures by age 1
No “babbling/baby talk” by 12 mos or no words by 16 mos
Talks but does not communicate
Loss of any social/communication skills
Lack of spontaneous/make believe play
Little or no eye contact
Engages in repetitive behaviors
Overly focused interests

Слайд 14

Asperger Syndrome
Previously, Asperger and Autism were subcategories under the heading of

Pervasive Developmental Disorders. The American Psychiatric Association has now recategorize both conditions under ASD.
Difference with Asperger is there is no general delay in language or cognitive development. It is characterized by difficulties in social interaction and restricted patterns of behaviors/interests. Typically of normal or above normal intelligence

Слайд 15

Common Oral Findings
Varies depending on the severity
Increased caries
Poor oral

hygiene
Overall, few unusual dental findings

Слайд 16

Dental Considerations
More for autism than Asperger
Sensory sensitivity
Light, dental tools, water, noise,

staff
Unpredictable bodily movements
Self injurious behavior
Obsessive routines/repetitive behaviors
Obtain thorough medical & dental history
Treatment with GA

Слайд 17

Attention Deficit Hyperactivity Disorder
Most common mental disorder among children
Hyperactive and unable

to control their impulses
Difficulty focusing/paying attention
Three subcategories
Inattention
Hyperactivity
Impulsivity
Diagnosis has criteria of 9 factors
Diagnosis for under 17 years (meet 6 of 9 criteria)
Diagnosis for over 17 years (meet 5)

Слайд 18

Ectodermal Dysplasia
Definition: Hereditary condition in which there are abnormalities of the

cranial-facial structure, digits, and 2 or more ectodermal
structures
Hair
Teeth
Nails
Skin
Sweat glands
There are many variations of this condition
Diagnosis

Слайд 19

Common Oral Findings
Congenitally missing teeth
Peg shaped teeth
Enamel hypoplasia
Increased dental caries

Diastema
Thick lips
Large chin
Underdeveloped alveolar ridges

Слайд 20

Dental Considerations
Caries control
Cosmetic dentistry
Multiple sets of dentures as the child

ages & the maxillo-mandibular structure changes
Full coverage crowns

Слайд 21

Слайд 22

Craniofacial Malformations
Cleft lip/palate
Definition: The sub-division of the body's lip and palate

during gestation

Слайд 23

Cleft Lip & Palate
Cleft lip classification
Class I: Unilateral notching of the

vermilion not extending into lip
Class II: Unilateral notching of the vermilion border with the cleft extending into the lip but not including the floor of the nose
Class III: Unilateral cleft of the vermilion border of the lip extending into the floor of the nose
Class IV: Any bilateral cleft of the lip whether it is incomplete or complete notching
Cleft palate classification
Class I: Involves only the soft palate
Class II: Involves the soft & hard palate but not alveolar process
Class III: Involves both soft & hard palates & alveolar process on one side of the premaxillary area
Class IV: Involves both soft & hard palates & continues through the alveolus on both sides of the premaxilla, leaving it free & often mobile

Слайд 24

Oral Findings/Dental Considerations
Complications
Feeding difficulty
Speech difficulty
Excessive air intake (burps often)

Choking
Nasal discharge
Treatment
Surgery for repair
Intraoral devices to mold lip & palate
Bone grafts in severe cases

Слайд 25

Fronto-Nasal Dysplasia

Слайд 26

Cerebral Palsy
Definition: Cerebral palsy refers to any number of neurological disorders

that permanently affects body movement and muscle coordination. It is due to damage to the developing brain either during or shortly after birth.
Although cerebral palsy affects muscle movement, it isn’t caused by problems in the muscles or nerves – it is caused by abnormalities in parts of the brain that control muscle movements
This is the most common physical disability among children

Слайд 27

Characteristics
Eye problems
Delayed reflexes
Facial grimacing
Swallowing difficulties
Poor balance
Hearing

loss
MR in ~50% of cases
Behavioral problems

Слайд 28

Dental Considerations
Increased caries risk
Enamel erosion
Poor gingival health/POH
Heavy calculus (if fed

with G-tube)
Malocclusion ? Overjet & spacing
Delayed eruption of permanent dentition
Bruxism common
Increased/sensitive gag reflex
Drooling
Often requires dental treatment with GA

Слайд 29

Amelogenesis Imperfecta
Inherited disease
1 in 700-15,000
Subtypes

Слайд 30

Слайд 31

Слайд 32

Psychological Limitations
Anxiety
H/o traumatic experience
Innate, unprovoked, un-triggered
Eating Disorders
Anorexia Nervosa
Bulimia Nervosa
Nervous

Habits
Nail biting
Lip licking
Self injurious behavior

Pediatric Special Care Dentistry

Содержание

Special Health Care NeedsDefinition: Persons with a physical, developmental, mental, sensory,

Common Special NeedsAsthmaDown SyndromeDevelopmental/Behavioral DisabilitiesAutismAsperger SyndromeADHD Ectodermal DysplasiaCraniofacial malformationsCerebral PalsyAmelogenesis ImperfectaPsychological

AsthmaDefinition: A chronic disease involving the respiratory system in which the

Understanding an Attack An asthma attack occurs after there is a

Common Oral FindingsIncreased dental cariesMore erosion More calculusMore gingivitis Throat irritation

Dental ConsiderationsGood preventive programRinse/drink water after inhaler useChronic nebulizer patients ?

Down SyndromeDefinition: Chromosomal disorder caused by the presence of all or

Common Oral Findings Microdontia HypodontiaMacroglossiaFissured tongueClass III malocclusion Open mouth posture

Dental ConsiderationsCongential heart diseaseCompromised immune system Chronic upper respiratory problems Atlanto-axial

Image taken from: http://fig.cox.miami.edu/Faculty/Dana/down.jpg

Developmental/Behavioral DisabilityAutism spectrum disorder is a general term for a group

Signs & Symptoms Doesn’t respond to his/her own name Acts deafDoes

Asperger SyndromePreviously, Asperger and Autism were subcategories under the heading of

Common Oral FindingsVaries depending on the severity Increased caries Poor oral

Dental ConsiderationsMore for autism than AspergerSensory sensitivityLight, dental tools, water, noise,

Attention Deficit Hyperactivity DisorderMost common mental disorder among childrenHyperactive and unable

Ectodermal DysplasiaDefinition: Hereditary condition in which there are abnormalities of the

Common Oral FindingsCongenitally missing teethPeg shaped teethEnamel hypoplasia Increased dental caries

Dental ConsiderationsCaries controlCosmetic dentistry Multiple sets of dentures as the child

Craniofacial MalformationsCleft lip/palateDefinition: The sub-division of the body's lip and palate

Cleft Lip & PalateCleft lip classificationClass I: Unilateral notching of the

Oral Findings/Dental ConsiderationsComplicationsFeeding difficulty Speech difficulty Excessive air intake (burps often)