Management of Special Needs Patients Flashcards

A patient with Type 1 diabetes presents for a dental hygiene appointment. Which oral manifestation is MOST associated with poorly controlled diabetes?

Answer: Severe generalized periodontitis with poor healing

Poorly controlled diabetes is bidirectionally linked with severe periodontitis; hyperglycemia impairs neutrophil function and healing, worsening periodontal disease, which in turn worsens glycemic control.

When treating a patient with hemophilia A, the dental hygienist should be MOST concerned about:

Answer: Prolonged bleeding after scaling/surgical procedures due to deficiency of clotting Factor VIII

Hemophilia A is caused by a deficiency of clotting Factor VIII, resulting in impaired coagulation and risk of prolonged, potentially life-threatening bleeding after dental procedures.

A patient with Down syndrome (trisomy 21) commonly presents with which oral feature that affects dental hygiene care?

Answer: Generalized hypotonia of the tongue and facial muscles with macroglossia and increased periodontal disease susceptibility

Down syndrome is associated with hypotonia (reduced muscle tone), relative or apparent macroglossia, mouth breathing, increased periodontal susceptibility due to impaired immune function, and dental anomalies.

Which of the following describes an appropriate modification when providing dental hygiene care to a patient who is wheelchair-bound and cannot be transferred to the dental chair?

Answer: Treating the patient in their wheelchair using a headrest attachment, positioning the clinician behind the patient

Patients who cannot be transferred should be treated in their wheelchair using a portable headrest and ergonomic positioning, with full access to oral cavity when possible.

A patient taking bisphosphonate medication for osteoporosis is considered at risk for which dental-specific complication?

Answer: Medication-related osteonecrosis of the jaw (MRONJ) after invasive dental procedures

Bisphosphonates accumulate in bone and inhibit osteoclast activity; invasive dental procedures (extractions, implants) in such patients can trigger medication-related osteonecrosis of the jaw (MRONJ).

A 7-year-old patient with autism spectrum disorder (ASD) becomes dysregulated during a dental hygiene appointment. Which BEST describes an appropriate approach?

Answer: Use a tell-show-do technique, maintain a calm and predictable environment, and allow sensory accommodations

Tell-show-do, reduced sensory stimulation, a predictable routine, and calm communication are evidence-based behavioral approaches for patients with ASD in the dental setting.