Wilkins Workbook Chapter 51

Questions and Answers

Briefly describe the components included in the two main sections of the World Health Organization international classifications of functioning disability and health.

Part 1: Functioning and Disability - Body Functions (mental, sensory, voice and speech, CV, hematologic, immunologic, respiratory, digestive, metabolic, endocrine, genitourinary, reproductive, neuromusculoskeletal, movement, skin) and Body Structures (structures of the NS, eye, ear, voice, CV, hematologic, immunologic, respiratory, digestive, metabolic, endocrine, genitourinary, reproductive, neuromusculoskeletal, movement, skin). Part 2: Contextual Factors - Activities and Participation (learning, tasks, communication, mobility, self-care, domestic life, interpersonal interactions, major life areas, community life) and Environmental Factors (products, environmental changes, support, attitudes, services).

In what way does the ADA define the responsibility of the dental practitioner in meeting the needs of a patient with a hearing or vision impairment?

Eliminate discrimination, ensure treatment, effective communication, provide aids.

What is the definition of visual impairment?

A visual condition that impacts a person's abilities to succeed in normal everyday activities.

What does the term legally blind mean?

Having central vision of not more than 20/200 in the better eye with correction or peripheral fields of no more than 20 degrees. Signup and view all the answers

What during pregnancy is the cause of at least half of the blindness in children?

Prenatal origin resulting from maternal infections such as rubella, syphilis, and toxoplasmosis. Signup and view all the answers

Define glaucoma.

A group of eye diseases characterized by increased intraocular pressure. Signup and view all the answers

What does it mean to be deaf?

When hearing is impaired to the extent that it has no practical value for the purpose of spoken communication. Signup and view all the answers

What description phrase is sometimes used for a patient who cannot hear as well as someone with normal hearing?

Hearing loss. Signup and view all the answers

Describe a cochlear implant.

A surgically implanted electronic device that provides a sense of sound to a person who is profoundly deaf or severely hard of hearing. Signup and view all the answers

Define a barrier-free dental treatment facility.

An area freely accessible to all without discrimination on the basis of a disability; obstacles to passage or communication have been removed. Signup and view all the answers

How wide must outdoor walkways and indoor passageways be to accommodate a wheelchair?

3 foot wide walkway for outdoor; 32 inches for doors; 3 foot wide for indoor passageways. Signup and view all the answers

An appropriately constructed wheelchair ramp entrance has a handrail and a gentle slope that rises _ for every _ in length.

1 inch; 12 inches. Signup and view all the answers

Lightweight doors with lever handles must open at least ___ wide for a wheelchair to pass through.

32 inches. Signup and view all the answers

A dental chair that is accessible for wheelchair transfers can be lowered to at least ___ from the floor.

19 inches. Signup and view all the answers

List three areas of risk assessment to consider when treating a patient with a disability.

Oral manifestations, functional ability, medical status. Signup and view all the answers

List common oral findings in patients with a disability that can be a source of increased risk for oral disease.

Dental caries, periodontal disease, malocclusion, oral and craniofacial anomalies, parafunctional habits, trauma, weakness or paralysis, drooling. Signup and view all the answers

List common oral effects related to drug therapies used to treat patients with disabilities.

Increased dental caries due to xerostomia, gingival enlargement, oral ulcerations, mucositis, susceptibility to infection. Signup and view all the answers

List the components of an oral disease prevention and control program for a patient with a disability.

Objectives, preventive care introduction, dental biofilm removal, use of fluorides, pit and fissure sealants, diet instructions. Signup and view all the answers

Functioning ability for ADL/IADL 0 indicates what?

Individuals can floss and brush; varying degrees of encouragement needed. Signup and view all the answers

Functioning ability for ADL/IADL 1 and 2 means what?

Individuals are capable of some oral hygiene needs but require training, assistance, and direct supervision. Signup and view all the answers

Functioning ability for ADL/IADL 3 indicates what?

Individuals who are unable to attend to their own care and are therefore dependent. Signup and view all the answers

What is the dental hygienist's role in providing oral hygiene instructions for an individual identified as having a moderate or low functioning level?

To train caregivers as needed to ensure thorough daily care is provided or supervised. Signup and view all the answers

When should you recommend that the use of a dentifrice version be limited or eliminated from the oral care regimen of a patient with a disability?

When the patient cannot expectorate, cannot rinse, has a gag reflex, cannot control saliva, or has limiting visibility. Signup and view all the answers

What recommendations can you make to a patient who cannot use a dentifrice to receive the benefits of fluoride?

Fluoride water, dietary supplement, professionally applied fluoride (varnish), fluoride gel, silver diamine fluoride. Signup and view all the answers

Self-care aids can make a difference in the ability of a patient or caregiver to maximize the effectiveness of oral care. List the general prerequisites of a good oral self-care aid.

Cleanable, durable, resistant to fluids, replaceable, inexpensive. Signup and view all the answers

Identify three general modifications that can be made to a toothbrush handle to enhance the ability of a patient with a disability to provide oral self-care.

Widen the handle, attach the handle to the hand, lengthen the handle. Signup and view all the answers

What factors will you take into consideration when recommending the use of a power-assisted toothbrush for a patient with a disability?

Weight, ease of use for the on/off button, tolerability of vibrations, cost. Signup and view all the answers

Briefly describe modifications that can be made to help a patient with a disability care for removable dental prostheses.

Use a fingernail brush or attach a brush to the sink with suction cups and move the appliance against the sink bowl. Signup and view all the answers

In your own words, describe the position a caregiver can use to be most effective when providing daily oral care for a person with disabilities.

Have the caregiver stand or sit behind the patient and stabilize the patient's head while brushing and flossing. Signup and view all the answers

List factors to take into consideration when planning dietary recommendations for a patient with a disability.

Eating habits, problems with mastication, conditions affecting facial musculature. Signup and view all the answers

Unless an extreme cognitive impairment has been identified, communication related to dental hygiene care is always addressed first to?

The patient first and the caregiver second. Signup and view all the answers

Identify three individuals who can provide the needed information for the first visit of your patient with a disability.

Caregiver, case worker, counselor. Signup and view all the answers

List factors to consider when scheduling appointments for an individual with a disability.

Special requirements, transportation, time considerations, patient reception. Signup and view all the answers

List factors that contribute to safety and comfortable positioning or stabilization of your patient with a disability while in the dental chair.

Adapt chair position, body adjustments, extremity movement, body enclosure, head stabilization, oral stabilization. Signup and view all the answers

What precautions are required if protective stabilization is considered?

Inform the patient and caregivers of risks, monitor physical and psychological well-being, be aware of mobile teeth, and fatigue of masticatory muscles. Signup and view all the answers

Describe a technique for safely stabilizing a patient's head during dental treatment.

Place the non-dominant arm around the patient's head for stabilization. Signup and view all the answers

List the types of aids that can be used to stabilize the patient's mouth while providing dental hygiene treatment during daily oral care provided by the caregiver.

Molt mouth prop, rubber bite block. Signup and view all the answers

List the precautions to observe if you are using a mouth prop.

Monitor for a sudden respiratory change. Signup and view all the answers

Explain some actions the dental hygienist can take to assure understanding when providing oral hygiene instructions for a patient with a visual impairment.

Actions can include speaking clearly, using descriptive language, and providing tactile demonstrations. Signup and view all the answers

Why do you always speak to patients who have a significant visual impairment before you enter and leave the room and before you touch them during dental hygiene treatment?

To prevent embarrassment of the patient speaking to someone who is not present. Signup and view all the answers

What is ASL?

American Sign Language; a visual/gestural language with a unique grammar and syntax used by deaf individuals. Signup and view all the answers

If your patient is speech reading, what can you do to enhance their understanding during oral hygiene instructions?

Ensure clear visibility of your face when speaking, use simple language and repeat important points. Signup and view all the answers

List three basic types of wheelchair transfers.

Stand and pivot technique, transfer patient who is immobile with two aides, sliding board transfer. Signup and view all the answers

What is the first thing you should do before starting a wheelchair transfer?

Clear the area. Signup and view all the answers

Who can give you advice on how best to help during a wheelchair transfer?

The patient, parent, or caregiver. Signup and view all the answers

List three factors that take special consideration during a wheelchair transfer.

Chair padding, bags and catheters, spasms. Signup and view all the answers

Describe the position of the wheelchair with respect to the position of the dental chair when transferring your patient from the wheelchair to the dental chair.

Face the wheelchair in the same direction as the dental chair at an angle of 30 degrees for mobile transfer; parallel for immobile transfer. Signup and view all the answers

It makes sense when transferring your patient back to the wheelchair after treatment to position the seat of the dental chair slightly ___ than the seat of the wheelchair.

Higher. Signup and view all the answers

If you are helping your patient with a mobile transfer from a wheelchair to the dental chair, where are your patient's arms and hands?

The patient places arms around the clinician's neck or hands on the wheelchair to push up. Signup and view all the answers

Describe the position of the first aide's hands/arms when two people are helping with an immobile patient transfer.

The first aide is positioned behind the wheelchair, placing arms under the patient's upper arm and grasping the patient's wrist. Signup and view all the answers

What is the responsibility of the second assistant during an immobile patient transfer?

They will initiate and lead the lift. Signup and view all the answers

What is your role when seating a patient with a walker, crutches, or a cane in the dental chair?

Clear the area, position the chair at the correct height, ask for assistance needs, guide and assist, move walking aids out of the way. Signup and view all the answers

What are the best ways to evaluate the success of an in-service program?

Direct observation of care, comparison of biofilm levels before and after. Signup and view all the answers

Study Notes

World Health Organization Classifications

Part 1: Functioning and Disability
- Body Functions include mental, sensory, and various system functions.
- Body Structures encompass structures of the nervous system, sensory organs, and related systems.
Part 2: Contextual Factors
- Activities and Participation cover communication, mobility, self-care, and community life.
- Environmental Factors include technology, environmental changes, support systems, and attitudes.

ADA Responsibilities in Dentistry

Prohibition against discrimination of patients with hearing or vision impairments.
Obligation to ensure effective communication during treatment.
Requirement to provide necessary aids for accessibility.

Visual and Hearing Impairments

Visual Impairment: Condition affecting daily activities; can include legal blindness defined as 20/200 visual acuity or limited peripheral vision.
Hearing Loss: A term for a patient who cannot hear as well as those with normal hearing, with profound deafness defined by practical inaudibility for spoken communication.

Common Conditions and Risks

Cochlear Implant: A device providing a sense of sound to the profoundly deaf or severely hard of hearing.
Blindness in Children: At least half caused by maternal infections during pregnancy, such as rubella and syphilis.

Dental Facility and Equipment Accessibility

Barrier-Free Facilities: Must be accessible without obstacles for individuals with disabilities.
Width Requirements: Walkways need to be at least 3 feet wide; doorways should be 32 inches.
Dental Chair: Should lower to at least 19 inches for easy transfer from a wheelchair.

Oral Health Risks for Patients with Disabilities

Common oral findings include dental caries, periodontal disease, malocclusion, and trauma.
Drug therapies may cause xerostomia, gingival enlargement, and oral ulcerations.

Oral Hygiene Programs

Components of a Prevention Program: Establish objectives, introduce prevention care, ensure effective biofilm removal, provide fluoride treatments, and educate on diet.

Functional Ability in Daily Activities

Levels of Assistance: Range from independent brushing to complete dependence on caregivers, with varying degrees of training and supervision needed.

Caregiver Involvement

Caregivers play a vital role in supporting oral hygiene through training and stable positioning during care.

Dietary Recommendations

Recommendations should consider current eating habits, food preparation difficulty, and oral health factors affecting mastication and swallowing.

Patient Communication

Always address the patient first, even if cognitive impairment is suspected. Use clear instructions for those with visual or hearing impairments.

Wheelchair Transfers

Transfer Techniques: Include stand-and-pivot, two-assist transfers, and sliding board transfers with safety clearance required prior to initiation.
Optimal positioning of equipment and the dental chair is critical for effective transfers.

Evaluation of Care Programs

Assess success through direct observation, comparing biofilm levels before and after implementation of preventive measures.

Training Topics for Staff

Include biofilm control, fluoride applications, denture care, and management of xerostomia in training sessions.

These notes encapsulate critical information from the provided content, facilitating effective study and understanding of caring for patients with disabilities in a dental context.

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Description

This quiz focuses on the components of the World Health Organization's international classifications related to disability and health. It covers key aspects of functioning and disability, including various body systems and functions involved. Ideal for students and professionals working in health and disability fields.