Dental management of children with special health care needsaravindhanarumugam1
hope this will throw a light in understanding special children and dental management of the same particularly for pediatric dentistry PGs .children with genetic diseases and emotionally handicapped ( child abuse and neglect ) are not discussed here as they are separate topics.
dr. aravindhan
https://userupload.net/5x4jgtw5sqs2
Behaviour modelling is frequently used to modify children's behaviour. The psychological techniques of encouragement-reprobation are an integral part of the behaviour shaping. Three hundred clinically healthy children were recruited in this study. They were aged 54-96 months and allocated to three groups according to the specific technique used: group 1 in which we applied the "live patients model" technique, in group 2 the "encouragement-reprobation" techniques was applied and group 3 was a control group. The patient's behaviour was assessed using L. Venham's Cooperative Behavioral Scale. A behavioral improvement was noticed in the experimental groups after applying the techniques for behaviour modification. The comparison shows a statistically significant difference between the two experimental groups and the control one and absence of a significant difference between the influenced groups. The study shows that there is a stable for behaviour
Dental management of children with special health care needsaravindhanarumugam1
hope this will throw a light in understanding special children and dental management of the same particularly for pediatric dentistry PGs .children with genetic diseases and emotionally handicapped ( child abuse and neglect ) are not discussed here as they are separate topics.
dr. aravindhan
https://userupload.net/5x4jgtw5sqs2
Behaviour modelling is frequently used to modify children's behaviour. The psychological techniques of encouragement-reprobation are an integral part of the behaviour shaping. Three hundred clinically healthy children were recruited in this study. They were aged 54-96 months and allocated to three groups according to the specific technique used: group 1 in which we applied the "live patients model" technique, in group 2 the "encouragement-reprobation" techniques was applied and group 3 was a control group. The patient's behaviour was assessed using L. Venham's Cooperative Behavioral Scale. A behavioral improvement was noticed in the experimental groups after applying the techniques for behaviour modification. The comparison shows a statistically significant difference between the two experimental groups and the control one and absence of a significant difference between the influenced groups. The study shows that there is a stable for behaviour
common oral baits like tongue thrusting,nail biting,thumb sucking, lip biting, mouth breathing have been described in detail with their clinical features,oral manifestations and treatment and prevention part. removable and fixed appliances have been described in brief for various habits.
The presentation features the understanding of a special child i.e. a physically or mentally challenged child for better assessment of his/her medical and dental problems to provide a proper approach for the specific treatment.
common oral baits like tongue thrusting,nail biting,thumb sucking, lip biting, mouth breathing have been described in detail with their clinical features,oral manifestations and treatment and prevention part. removable and fixed appliances have been described in brief for various habits.
The presentation features the understanding of a special child i.e. a physically or mentally challenged child for better assessment of his/her medical and dental problems to provide a proper approach for the specific treatment.
School-Based Hearing Guideline for The City of Davaojudarobillosnow
Physical impairment can not and should never be made a reason to undermine a person’s capabilities and/ or capacities to perform “normally” and even, excellently in his/her own field.
India's First Special School Health Program for all students to cover child & kids Wellness & prevention through extensive medical checkups & sessions.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
2. DEFINITION
A Handicapped child is one who has a Mental, Physical, Medical or
Social condition that prevents him or her from achieving full
potential as compared to other children of the same age including
those of a social, recreational, educational and vocational nature.
(WHO 1980).
According to AAPD 1996 that a person should be considered
dentally handicapped if there is pain, infection or lack of functional
dentition that affects him or her as follows:
1. Restricts consumption of a diet adequate to support growth and
energy needs.
2. Delays or alters growth and development.
3. Inhibits major life activity like work, learning, communication and
recreation.
6. ASSESSMENT AND DIAGNOSIS
Initial dental examination of a handicapped child should be carried
out after obtaining a thorough medical and dental history.
Family physician should be consulted if necessary.
The first dental appointment is very important as it lays the
foundation for future treatment procedures and dentist should take
sufficient time to communicate with the parents and thereby
establishes a good relationship with them.
Radiographs plays an important role in diagnosis.(use of bitewing
tabs tied with floss, use off lead apron and thyroid collar for both
patient and dentist while taking radiographs).
7. AIMS AND OBJECTIVES OF TREATMENT
The primary aim is to treat the child
in the most efficient manner with
the least amount of trauma to the
child, dentist or the parent.
Techniques for management of
handicapped child
8. PHYSICAL RESTRAINTS
It is used to restrict the
freedom of movement of
disabled child.
It is also called as PROTECTIVE
STABLIZATION.
12. DENTAL HOME FOR CHILDREN WITH SPECIAL
HEALTH CARE NEEDS
It includes all aspects of oral health that result from the interaction
of the child, parents and pediatric dentist.
SHCN Patients who have dental home receives appropriate
preventive and routine care and reduces the child's risk of oral
diseases.
In 1999 Nowak described the term in relation to the desired
recurrence of preventive oral health supervisory services as
propagated by the AAPD.
Doykos suggests that early association with a dentist has the
benefit of reduced cost of care as compared to those who delay
the first dental visit.
13. Home dental care should begin during infancy.
The dental surgeon should advice the parents to gently
clean the incisors with a soft cloth or an infant
toothbrush.
For older children who are unwilling or physically
unable to cooperate, the dentist should teach the
correct tooth brushing techniques to the parent or
guardian.
14. PLAQUE CONTROL PROGRAMME
Plaque control programme is essential in monitoring oral hygiene
status.
The brushing technique for disabled patients having limited ability
to brush should be effective and simple.
Horizontal scrub method is recommended as it is easy to perform
and provides good results. The technique consists of gentle
horizontal strokes on buccal, lingual and occlusal surfaces of all
teeth.
A soft multi-tufted nylon toothbrush should be used.
17. FLUORIDE EXPOSURE
Systemic fluoride supplementation in
the form of drops and tablets.
A night time 0.4% stannous fluoride
“brush on gel” in reducing dental
caries.
18. PREVENTIVE RESTORATIONS
Pit and fissure sealants to reduce
occlusal caries.
For severe bruxism and interproximal
caries…..stainless steel crown.
20. VARIOUS DISABLITIES AND THEIR MANAGEMENT
MENTALLY CHALLENGED OR SUBNORMAL CHILDREN:
According to American Association of Mental Deficiency
(AAMD) it is defined as sub-average general intellectual
functioning which originates during the developmental
period and is associated with impairment in adaptive
behaviour.
Various intelligence tests used to assess the intellectual
development of child.
1. Stanford-Binet general intelligence test
2. Wechsler intelligence scale for children
22. Intelligence Quotient (IQ) = Mental Age x 100
Chronological Age
IQ was given by Stern in 1913
If MA = CA, IQ = 100
If MA > CA, IQ > 100
If MA < CA, IQ < 100
23. 2. Wechsler intelligence scale for children
This scale was developed in 1949 and was revised 25 years later in 1974
Divided into 2 sub-tests
a. Verbal subtests
b. Performance subtests
IQ range Grade
140 and above Very superior
120 to 139 Superior
90 to 119 High average
80 to 89 Low average
70 to 79 Borderline
69 and below Mental retardation
24. Level of Handicap IQ Score
Stanford-Binet Wechsler
Mild 52-67 55-69
Moderate 36-51 40-54
Severe 20-35 25-39
Profound Below 20 Below 25
Educable mentally 67-52 69-55
Subnormal
Trainable mentally 51-36 54-40
Subnormal
Non trainable 35 and Below 39 and Below
26. MANAGEMENT
Dental caries and periodontal diseases are the most common dental
problems in mentally challenged patients. These problems are mainly due
to dental neglect.
Maintenance of oral hygiene:
Electric tooth brush may be easier for the child to use.
Flossing if possible by using floss holder.
Pit and fissure sealants
Application of topical fluoride, fluoride supplements.
Antimicrobial mouth rinses
Periodic recalls
