ทันตกรรมสำหรับคนพิการ โดย อ.ทพญ.มาลี อรุณากูร ม.มหิดล

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ทันตกรรมสำหรับคนพิการ โดย อ.ทพญ.มาลี อรุณากูร ม.มหิดล

  1. 1. .
  2. 2. Cerebral palsy (C.P.)
  3. 3. 50-75% , 25%(nystagmus) (strabismus) 50% 1/3 25 %
  4. 4. Delayed growth and development. failure to thrive C.P. spastic quadriparesis.Spinal deformities.Speech and language disorders.DroolingIncontinenceStereognosia
  5. 5. C.P.
  6. 6. C.P.Bruxism: mouth guard
  7. 7. C.P.Rumination: ( demineralization)
  8. 8. C.P.Pouching:
  9. 9. C.P.Pica: 1 (Pica Diseases)
  10. 10. C.P. gastroesophageal refluxGingival overgrowth
  11. 11. C.P. enamel hypoplasia Bruxism and tooth clenching( )Fracture and avulsion of the anterior teeth (fall)
  12. 12. C.P.Many clinicians : Higher DMF rate than normal Higher score of decay Higher score of missing Fewer score of filling
  13. 13. C.P.Malocclusion : Weyman 1971 Spastic C.P. more prone to Class II division2 and unilateral crossbite Athetosis C.P. more Class II division1 with high narrow palate, tongue thrust, and anterior open bite Ataxic C.P. exhibits Class II division1
  14. 14. :
  15. 15. :
  16. 16. :* *
  17. 17. (Tender, love and care) :Behavior shaping management technique - - (Tell - show do)
  18. 18. :
  19. 19. : Diet counseling Fluoride ; routine oral exam.,topical fluoride application, sealant
  20. 20. :
  21. 21. preset
  22. 22. mouth propPapoose board
  23. 23. clamp . short acting anesthetics
  24. 24. * *
  25. 25. / - .(emergency)
  26. 26. IQ = M.A. x 100 C.A.M.A. (Mental age)C.A. (Chronological age) 100 IQ 70
  27. 27. (Tender love andcare) .
  28. 28. Tell- show-do (Distraction) (Reinforcement)(Immobilization in cases with hyperactive)
  29. 29. Mild sedative + immobilization Mouth prop
  30. 30. Ultra short acting anesthetics
  31. 31. (Down s syndrome)Trisomy 21John Langdon Down 1865
  32. 32. -Cataract 5%Brush-field spots
  33. 33. 30-40% sleep apnea5-10%
  34. 34. 70 mild-moderate M.R.
  35. 35. IQtell-show-do
  36. 36. ( )
  37. 37. Ornitz & Ritvo (1976) 2/3 3/4Young (1989) 75-80 %2/31/31-2 %
  38. 38. 70-80 % 40-60 %/ 44 % 25-40 % 25-40 % 10-30 %
  39. 39. 10 %
  40. 40. 1 : 2,000Green D, Flanagan D (2006) 1: 150 : =4:1
  41. 41. 5
  42. 42. : :
  43. 43. . /
  44. 44. Tell-show-do ( )
  45. 45. . explorer
  46. 46. Hyperactive child :
  47. 47. Hyperactive child :
  48. 48. Visual pedagogy in dentistry for children with autism Visual pedagogy Backman B,Pilebro C. Visual pedagogy in dentistry for children with autism. ASDC J Dent Child.1999.
  49. 49. Visual pedagogy in dentistry for children with autism The front door The waiting room
  50. 50. Visual pedagogy in dentistry for children with autism The dentist The operating room The lamp
  51. 51. Visual pedagogy in dentistry for children with autism Mouth wide open Instrument and objects to be used.
  52. 52. Visual pedagogy in dentistry for children with autism Visual pedagogy is a way of introducing dentistry to children with autism.
  53. 53. Visual pedagogy
  54. 54. Visual pedagogy
  55. 55. Visual pedagogy
  56. 56. Visual pedagogy
  57. 57. Visual pedagogy
  58. 58. Visual pedagogy
  59. 59. Visual pedagogy
  60. 60. Visual pedagogy
  61. 61. Visual pedagogy 2
  62. 62. //
  63. 63. /
  64. 64. /
  65. 65. Preventive management High caries risks Oral hygiene instruction o o Scrub technique o o o o o
  66. 66. Preventive management Diet counseling 6
  67. 67. Preventive management Fluoride Professional topical fluoride [Fluoride varnish] Fluoride supplement Fluoride toothpaste Pit & fissure sealant Injuries prevention counseling Regular professional supervision recall
  68. 68. Mouth protector :
  69. 69. .
  70. 70. :
  71. 71. 26-90 dB > 90 dB
  72. 72. Oral method of communicationManual method of communicationTotal communication
  73. 73. Manual method
  74. 74. Finger spelling of Thai alphabets
  75. 75. /
  76. 76. Lip reading 2-3 (Not emphatic words)
  77. 77. Body language & feeling (Facial expression) (Posture) (Movement)
  78. 78. Thank you for your attention Dtmak @ mahidol.ac.th
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