National Board Review (NBDHE)- Special Needs Patients (Questions & Answers) Rated 100% Correct!!

ADD/ADHD - Short-term memory loss Short appointments in the AM Keep eye contact Tell, show, do *** Addison's Disease - Primary adrenal insufficiency Hypotension Dehydration Low blood sugar Oral manifestations: oral pigmentation, melanotic macules on oral mucosa Bronzing yellow-brown discoloration Alcohol Addiction - No nitrous-oxide No alcohol mouthrinse Alzheimers - Lower acetylcholine levels Fluoride and antimicrobials contraindicated Short appointments Give OHI to caregiver Angina attack during dental appointment - One tablet nitroglycerin every 5 minutes No more than 3 tablets in 15 minutes Give only if systolic*** BP is 100 or higherAngina Pectoris - AKA Coronary heart disease, Arteriosclerotic heart disease, or Ischemic heart disease Lack of O2 - ischemia Keep nitroglycerin in dark colored, sealed glass vial -- must be no older than 6 months Nitro can be given as premed, but no antibiotic Asthma - Increased risk for caries, due to use of inhaler Mouth breather Triggers: allergies, cold air, exercise, anxiety, etc. Tell pt to bring inhaler to appointment if used No aspirin No air polisher or ultrasonic scaler No anesthesia w/ epinephrine due to bisulfites Nitrous-oxide sedation recommended Autism - Possible increased caries Prefer set routines May exhibit self-abusive behavior No eye contact Short, frequent appointments in calm environment Toothbrushing as a "motion" Bell's Palsy - Cranial Nerve VII -- Facial Nerve Cause unknown, associated with viral infections or nerve damage Need eye and airway protection during appointment May use corticosteroids or antiviral treatments C-4 - None, needs ventilator QuadriplegicC-5 - Minimal, partial shoulder and partial elbow C-6 - Sit, eat with devices C-7 - Personal self-care with devices C8-T1 - Personal self-care, wheel chair transfer Can periodontal disease increase blood glucose levels in people with diabetes? - Yes Cardiac Arrhythmias - Do not give epinephrine No premed needed Uncontrolled = contraindication for dental tx Can use ultrasonic if the pacemaker is shielded Cerebral Palsy - Not a disease and is not contagious ** TMJ dysfunction Tongue thrusting and mouth breathing Bruxing/Attrition Gingival hyperplasia due to meds Avoid injury by utilizing fulcrum and assistant w/ high speed suction Electric toothbrush Cerebrovascular Accident (stroke) - Increased risk of periodontal disease and caries No tx for 6 months after stroke Avoid sensory overload Depression is commonChronic Bronchitis - "Blue bloater" Inflammation of lining of bronchial tubes -- narrows airways Sounds like smoker's cough Females Chronic Renal Failure - Hypertension risk increases Dialysis: calculus, caries, periodontal disease Risk for Hep B and C due to contaminated machines Antibiotic premed if atrioventricular fistula, shunt, or transplant Appointment day after dialysis Home fluoride & tartar control toothpaste recommended