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Theory DH 2 Test 1
Theory of Dental Hygiene Test 1 (Intro-arthritis)
|influences that affect our attitude towards disabled people
|media, government, parents, teachers, peers
|what are the feelings of personal self worth?
|what is "people first language"?
|language that emphasized the fact that disability is a part of the human condition and all people want to be described by their abilities rather than labeled by their disabilities
|what is the american's with disabilities act? (ADA act)
|federal law that prohibits discrimination in access to services and employment against persons who are disabled
|who is considered disabled?
|any person with a physical or mental impairment that substantially limits one or more major life activities, a person who has a record of such impairment
|what type of impairments are not covered by the ADA?
|Impairments that are transitory and minor
|what is the DH-4 of healthy people 2020?
|reduce the proportion of people with disabilities who report delays in receiving primary and periodic preventive care due to specific barriers
|what is the DH-5 of healthy people 2020?
|increase the proportion of youth with special health care needs whose health care provider has discussed transition planning from pediatric to adult health care
|what is deinstitutionalization?
|intended to help "normalize" the client and give them greater independence
|what is the fraction of the residential facilities that report inadequate access to dental care is a significant issue for their residents?
|what are the barriers to receiving dental care?
|financial, architectural, transportation, attitudinal, motivational, educational, legislative
|what is the number one reason why disabled do not seek dental care?
|what are the two federally funded programs administered by the social security administration?
|SSI or supplemental security insurance program SSDI or social security disability insurance
|what are the adult qualifications for social security?
|disability severe enough to prevent him or her from doing substantial work and is expected to last for at least 12 months or result in death
|what are the monthly earnings for social security for adults?
|1070 for non blind individuals 1800 for blind individuals
|when is social security disability benefits paid?
|sixth full months after the date you disability began disability began in Jan, paid in July
|what are the qualifications for children on social security
|physical or mental condition that can be medically proven which results in marked and severe functional limitations, limitation in two broad areas of functioning, medical condition lasting 12 months or result in death
|what is the supplemental security insurance program or SSI?
|a federal income assistance program for low income, aged, blind and disabled persons
|what are the qualifications for supplemental security insurance program or SSI?
|65 years old, blind, or disabled. Individual income is less than 1070 for non blind and 1800 for blind per month, total assets are less than 2,000
|what are the qualifications for supplemental security insurance program of SSI for couples?
|less than 1070 per month and total assets are less than 3,000
|how much does supplemental security insurance program pay?
|individual can receive up to 721.00 couples can receive up to 1082.00
|what are the benefits of SSI or supplemental security insurance program?
|Medicaid, food stamps, Texas Medicaid dental program
|what is the Texas Medicaid Dental program?
|Texas health steps, available to kids up to 21 years of age, eligibility begins at 12 months
|what is social security disability insurance? (SSDI)
|based on work history, available to those who worked approximately 5 full years out of the past 10 years and have become disabled you need to have worked long enough and recently enough to qualify
|what are the benefits of social security disability insurance (SSDI)
|Qualify for Medicare usually covers all hospital serves for people over 65
|how does the credit system work in social security disability insurance?
|earn one credit for each 1200 of wages, total maximum credit that you can earn in one year is 4 or (4,800) number of work credits you need to qualify depends on the age when you became disabled need 40 credits, 20 earned in last 10 year
|what is reasonable modification?
|change of the work environment or change in in the way job duties are performed that enables a qualified person with a disability to perform the essential functions of the position
|ADA definition or reasonable workplace accommodations
|acquiring or modifying equipment physically altering work site modifying work schedule providing readers or interpreters CANNOT CREATE HARDSHIP
|what happens to people who become disabled on the job?
|if there is another job available that they can perform it should be offered if there is not a job available, you are not required to continue to employ that person
|what is readily achievable?
|easily accomplished and able to be done without much difficulty or expense
|what is the definition of Normalization?
|Process that enables challenged individuals to engage in normal patterns of every day
|what is the definition of Mainstreaming
|Incorporating individuals with special needs into conventional activities
|what is the definition of Deinstitutionalization
|Allows challenged persons to live and function independently with little or no assistance from a caregiver
|what is the definition of Major Life activities
|Term “disability” is associated with limited in a major life activity. Those that the average person in the general population can perform with little or no difficulty
|what is the definition of Impairment
|Occur as a result of pathology, accident or disease and includes any loss or abnormality physiologic, anatomic or mental in function which may or may not be permanent
|what is the definition of Activity limitation
|Difficulty to take part in conventional lifestyle situations for reasons that may be beyond the client’s control
|what is the definition of Participation restriction
|Inability to take part in conventional lifestyle situations for reasons that may be beyond the client’s control
|what is the definition of Developmental Disability
|Occurs congenitally or during the developmental period of a child, period that lasts from birth to 22 years. Generally chronic in nature, continue throughout the person’s life and appear as mental, physical or combined impairments
|what is the definition of Acquired Disability
|Occur after the age of 22 year or are caused by disease, trauma or injury to the body
|what is the definition of Age associated disability
|Occurs later in life typically over the age of 65, have higher risk of developing chronic diseases
|what is the definition of Basic activities of daily living
|Activities required for personal care such as feeding, dressing, grooming, bathing and toileting
|what is the definition of Instrumental activities of daily living
|Encompasses more complex tasks required for independent living
|what is the definition of Auxiliary Aids
|Qualified interpreters, assistive listening devices, notetakers, telephone handset amplifiers, written written materials for persons with hearing impairments, qualified readers and telephones
|what is the definition of Undue Burden
|Defined in the law as a significant difficulty of expense. There is no formula in the law or regulations for determining what constitutes significant difficulty or expense, but several factors should be considered
|what factors should be considered in undue burden?
|Overall size and financial resources of the business Nature of the business and the nature and cost of the accommodations needed
|what is the definition of TDD?
|Telecommunication device for the deaf
|what is the definition of Qualified person with a disability
|A qualified person with a disability is one who satisfies the requisite skill, experience, education and other job related requirements of the position and can perform the essential functions of the job, with or without reasonable accommodation
|what is the definition of Essential Functions of the Job
|Primary job duties that are intrinsic to the employment position, the reason why the position exists
|what is the definition of Reasonable Accommodation
|Reasonable modification of the work environment, or a change in the way job duties are performed, that enables a qualified person with a disability to perform the essential functions of the position
|what is a Transfer Belt?
|Straps secured around the client’s wait to provide a place to hold the client in the event that the person begins to fall during the transfer process. These are especially useful with clients who have little to no upper body strength such as tetraplegics
|what is a sliding board?
|Used to assist the client with fair to good upper body strength by helping the client slide out of the wheelchair, across the board, and into the dental chair
|how do you use a sliding board?
|The wheel chair must be positioned beside the dental chair, and the arms to both chairs must be removed to accommodate the board One end of the board is placed underneath the client, the other end is laid across the dental chair
|when should a sliding transfer be used?
|patients who have sound upper body strength
|when should a one person transfer be used?
|patients who have a good sense of balance, high level of motivation and strength and mobility necessary to support themselves while standing
|when should a two person transfer be used?
|patients who are unable to support themselves by their upper or lower body or whose ability to transfer is difficult to evaluate
|what is an intellectual disability?
|characterized by significant limitations both in intellectual functioning and adaptive behavior, originates before the age of 18
|what is intellectual functioning?
|reasoning, learning, problem solving
|what is adaptive behavior?
|conceptual, social and adaptive skills
|is intellectual disability just determined by an IQ test?
|no but it is a major tool measuring intellectual functioning or a capacity for learning test score below 70 indicates a limitation in intellectual functioning
|what is the most common genetic causes of mental impairment?
|mutations in the X-linked genes
|what are the steps of classification of mental deficiency
|first step: administer a standardized IQ and adaptive skills test second step: describe person's strengths and weaknesses Third step: interdisciplinary team determines needed support
|what is the IQ score of mild intellectual disability
|50-70 adult mental age from 9-12 years academic skill level: 6th grade
|what is the IQ score of moderate intellectual disability
|IQ score of 35-55 adult mental age from 6-9 years academic skill level: 2nd-3rd grade
|what is the IQ score of severe intellectual disability
|IQ score 20-40 adult mental age from 3-6 years academic skill: may learn alphabet and simple counting
|what is the IQ score of profound intellectual disability
|IQ score of less than 20
|when should you schedule a person with an intellectual disability?
|in the morning
|what is the recall interval of a person with an intellectual disability?
|how is down syndrome caused?
|extra copy of chromosome 21 47 chromosomes instead of 46
|what is the most common cardiovascular disease for a down syndrome kid?
|ventricular septal defect
|what is the prevalence of caries in down syndrome individuals?
|low prevalence of dental caries, higher concentration of specific IgA antibodies S. mutans in saliva
|what is the oral findings in down syndrome?
|high incidence of periodontal disease, pattern of bone loss resembles juvenile periodontitis
|chewing and regurgitating food
|what is high level functioning in self care?
|capable of providing self care
|what is moderate level functioning in self care?
|capable of at least part of oral hygiene but need lots of training and assistance
|what is low level functioning in self care?
|dependent on someone for total care
|what is frankl 1 functioning level
|definitely negative behavior, refuses treatment, cries, combative, may be withdrawn
|what is fankl 2 functioning level
|negative, reluctant to accept treatment, uncooperative, may be withdrawn
|what is fankl 3 functioning level
|positive, accept treatments with caution, willing to comply with treatment
|what is fankl 4 functioning level
|definitely positive, good rapport with dental team, has a great time, interested in dental procedures
|what patient could the universal cuff be used for?
|unable to flex fingers
|what patient could the electric tooth brush or hydra brush be used for?
|no arm movement
|what patient could a tennis ball on a tooth brush be used for?
|weak flexion of fingers
|what patient could an extended handle be used for?
|limited arm movement
|what are the disadvantages of electric tooth brush?
|extra weight of toothbrush is not good for lose with limited arm strength on off mechanism may be difficult to use vibrations may bother some individuals
|what is a stabilization device?
|any device that is used to help maintain head and or body stability or to keep mouth open
|what is fragile X syndrome?
|a defect in the long arm on the X chromosome in females
|What are the most common teeth to be missing in children with down syndrome?
|3rd molars, second premolars, lower anterior teeth
|what is the most common tooth for torodontism?
|what do deficiencies in vitamin A produce?
|poor healing and increased gum bleeding
|what is Phenylketonuria
|Excess levels of amino acids in the blood stream, have to avoid sources of protein in die
|what is Hypoxemia
|Intracranial hemorrhage due to lack of oxygen to a babies' brain
|what is Kernicterus
|Toxic accumulation of bilirubin in the brain
|what is Trisomy 21 Syndrome
|Failure of a pair of number 21 chromosomes to segregate (nondisjunction) during the formation of either an egg or sperm before conception, is not inherited, has no known cause
|what is Translocation
|Hereditary and occurs when a piece of chromosome in pair 21 breaks off and attaches to another chromosome, usually chromosome 14, 21, or 22
|what is Mosaicism
|Occurs in only 1% of children with down syndrome; it is a result of an error in one of the first cell divisions shortly after conception
|what is Mental age
|Age reflected in the level of functioning
|what is chronological age
|True age based on date of birth
|what are Epicanthal Folds
|Folds of skin extending from the root of the nose to the median end of the eyebrow
|what are Brushfield Spots
|Iris of the eye is speckled with marks
|what is Scoliosis
|Curvature of the spine
|what is Brachycephaly
|Broad, short head
|what is Hypotelorism
|Abnormal closeness of the eyes
|what is Simian crease
|Single palmer crease on hands
|what is Atlanto-Axial Instability
|Abnormal mobility of the upper two cervical vertebrae (C1 and C2) caused by congenital ligamentous laxity
|what is a Plicated Tongue
|Characterized by a single midline fissure, a double midline fissure or multiple fissures of various patterns, lengths and depths that appear on the anterior two thirds of the tongue’s dorsal surface
|what is a Hypotonic tongue
|Protruding tongue because the tongue has a weak frenulum and a weak midline junction and its anterior two thirds are excessively concave
|Oral motor dysfunction (3 observations that generally indicate dysfunction)
|Inadequate wiping motion of the tongue along the buccal surfaces of the teeth Inadequate lip closure with drooling Moderate to severe speech articulation problems
|Construction of adaptive aids (5 factors)
|Should be easily changeable when no longer effective and inexpensive Aid must be cleanable Aid must be durable Can withstand exposure to water and saliva Aid should be resistant to the absorption of oral fluids
|what is Range of Motion
|The client’s ability to reach the oral cavity with the arms and hands is determined. Extent of range of motion dictates the length of the device required to accommodate physical limitations in reaching the mouth
|what is Grip Strength
|o Clients with arthritis or neuromuscular disorders experience difficulty holding a device that is too narrow or too small To assess grip strength have the client grasp various sizes of foam cylinders
|what is arthritis?
|inflammation of the joint
|what is osteoarthritis caused by
|breakdown of articular cartilage, over growth of bone and impaired function
|what are the main points of osteoarthritis
|asymmetrical, one or two joints involved, weight bearing joints, pain in joints usually lasts less than 15 minutes, occurs after age 60
|what nodes are only associated with osteoarthritis?
|bouchard's nodes Heberden's nodes
|what is bouchard's nodes
|painless bony enlargement on the proximal interphalangeal joint (middle finger)
|what is heberden's nodes
|painless bony growths of the distal interphalangeal joints (small joint at the end of the finger
|what are the main points for rheumatoid arthritis?
|systemic involvement, occurs between ages 35-50, can feel heat and see swelling from inflammation, stiffness that lasts longer than an hour, bilateral symmetrical
|how does rheumatoid arthritis occur?
|synovial membrane becomes inflamed and erodes cartilage, pannus forms and then is replaced by scar tissue, finally bone is fused
|what are the deformities in rheumatoid arthritis?
|swan neck deformity boutonniere deformity
|what are the disease modifying anti rheumatic drugs?
|gold compounds, pencillamine, antimalarial agents, sulfasalazine, immunosuppressives
|what are the common immunosuppresive therapy
|imuran, cyclophosphamide, methotrexate, cyclosporine, leflunomide