patient with speical needs تمريض عمليات

8/8/2019 patient with speical needs

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12008 1670

120081595

120082695

Islamic University - Gaza

Faculty of Nursing

Report about

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persons with p hy s ical a nd m en tal d is abiliti es fac e chall enges in th e ir liv es e v er y d ay. Whil e th ose with a mil d or m oder at e d is ability a re abl e t o liv e on th e ir o w n independen tly,o th ers may re ly on a ca reg iv er f or s im p le ta sks li ke bathi ng a nd dress ing . R e c e ivi ng den tal ca re s h ou ld no t b e a no th er h urd le f or th ese ind ivi du al s . With gre at er nu mb ers o f

peop le with spe cial needs res id ing in th e c o mm un ity


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m ore gener al den ti s t s willm ore gener al den ti s t s willen c oun t er su ch p ati en t s seek ing ca re; th e en c oun t er su ch p ati en t s seek ing ca re; th e den tal t e am m us t b e re a d y t o pro vi de thatden tal t e am m us t b e re a d y t o pro vi de thatca re . By pro vi d ing needed ca re th e den talca re . By pro vi d ing needed ca re th e den talt e am ca n c on t r ib u t e t o th e or al h e alth,t e am ca n c on t r ib u t e t o th e or al h e alth,o v er all w e ll ness a nd person al se lf o v er all w e ll ness a nd person al se lf-- es t ee m o f es t ee m o f a p ati en t with a d is abilitya p ati en t with a d is ability ..


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11) Aft er re a d ing thi s a r ticl e th e re a der ) Aft er re a d ing thi s a r ticl e th e re a der s h ou ld b e abl e t o :s h ou ld b e abl e t o :

* de fi ne spe cial ca re den ti s t r y.* de fi ne spe cial ca re den ti s t r y.

* c ons ider p hy s ical fact ors in th e o ffic e that* c ons ider p hy s ical fact ors in th e o ffic e thatin fl uen c e pro vi s ion o f den tal ca re f or th e in fl uen c e pro vi s ion o f den tal ca re f or th e spe cial needs p ati en t.spe cial needs p ati en t.

* s tat e des ign cha r act er is tic s o f a ba rr ier* s tat e des ign cha r act er is tic s o f a ba rr ier --f ree or un iv ers al des ign en vi ron m en t.f ree or un iv ers al des ign en vi ron m en t.

* d is c uss s im p le des ign cha nges t o a n * d is c uss s im p le des ign cha nges t o a n ex is ti ng facility t o im pro v e acc ess f or ex is ti ng facility t o im pro v e acc ess f or d is abl ed ind ivi du al s .d is abl ed ind ivi du al s .


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* li s t m e th ods that will h e lp desens itiz e th e * li s t m e th ods that will h e lp desens itiz e th e p ati en t t o den tal t re atm en t.p ati en t t o den tal t re atm en t.

* des c r ib e th e r ati on al e , m e th ods a nd * des c r ib e th e r ati on al e , m e th ods a nd c on t r ai nd icati ons f or use o f b od yc on t r ai nd icati ons f or use o f b od ys tabilizati on/res t r ai n t dur ing den tals tabilizati on/res t r ai n t dur ing den talt re atm en t.t re atm en t.

* des c r ib e th e r ati on al e a nd pre ca u ti ons f or * des c r ib e th e r ati on al e a nd pre ca u ti ons f or use o f a c o mm er cial a nd o ffic euse o f a c o mm er cial a nd o ffic e --fab r icat ed fab r icat ed m ou th prop .m ou th prop .

* li s t th e in f or mati on that i s ne c ess a r y f or * li s t th e in f or mati on that i s ne c ess a r y f or proper re c ord do c u m en tati on f or use o f proper re c ord do c u m en tati on f or use o f s tabilizati on dur ing den tal ca re .s tabilizati on dur ing den tal ca re .


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11 --S pe cial ca re den ti s t r y i s th e S pe cial ca re den ti s t r y i s th e de liv er y o f den tal ca re tail ored t o th e de liv er y o f den tal ca re tail ored t o th e ind ivi du al needs o f p ati en t s wh o hav e ind ivi du al needs o f p ati en t s wh o hav e d is abli ng m ed ical c ond iti ons or d is abli ng m ed ical c ond iti ons or m en tal or ps ych o log ical limitati ons m en tal or ps ych o log ical limitati ons that requ ire c ons ider ati on b e y ond that requ ire c ons ider ati on b e y ond rou ti ne a ppro ach es ."rou ti ne a ppro ach es ."


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((22 ) Pati en t s with d is abiliti es ) Pati en t s with d is abiliti es

presen tpresen t with a wi de r a nge o f c ond iti ons with a wi de r a nge o f c ond iti ons a nd le v e l o f im p ai r m en t. SCD may b e a nd le v e l o f im p ai r m en t. SCD may b e ne c ess a r y f or persons with se v ere ne c ess a r y f or persons with se v ere m o v e m en t d isorders , ch ron ic m en tal ill ness ,m o v e m en t d isorders , ch ron ic m en tal ill ness ,persons wh o a re a du lt s in a ge b u t wh o persons wh o a re a du lt s in a ge b u t wh o f un cti on at a chil d's le v e l, a nd th ose withf un cti on at a chil d's le v e l, a nd th ose withser ious m ed ical c ond iti ons wh o a re at r isk ser ious m ed ical c ond iti ons wh o a re at r isk f or a d v erse ou tc o m es in th e den tal se tti ng f or a d v erse ou tc o m es in th e den tal se tti ng un less t re at ed by a kno wl edge abl e un less t re at ed by a kno wl edge abl e

pr actiti oner .pr actiti oner .


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((33 ) For so m e peop le SCD may b e ) For so m e peop le SCD may b e

needed on ly at c er tai n per iods o f lif e needed on ly at c er tai n per iods o f lif e a nd no t at o th ers . Di s abl ed persons a nd no t at o th ers . Di s abl ed persons wh o ca n express need a nd ca n acc ess wh o ca n express need a nd ca n acc ess den tal ca re on th e ir o w n do no tden tal ca re on th e ir o w n do no t

requ ire SCD. I n order t o pro vi de arequ ire SCD. I n order t o pro vi de atail ored ca re p la n t o m ee t th e needs tail ored ca re p la n t o m ee t th e needs o f e ach i nd ivi du al p ati en t SCDo f e ach i nd ivi du al p ati en t SCDrequ ires a h o li s tic vi e w o f or al h e alth.requ ires a h o li s tic vi e w o f or al h e alth.Co mm un icati on with all m e mb ers o f Co mm un icati on with all m e mb ers o f th e h e alth ca re t e am, family,th e h e alth ca re t e am, family,ca reg iv er , p hy s icia n , so cial ser vic es ca reg iv er , p hy s icia n , so cial ser vic es a nd th e den tal t e am i s essen tiala nd th e den tal t e am i s essen tial


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D oes y our o ffic e hav e ha nd ica p acc ess?

* D o y ou f ee l c o mf or tabl e or hav e y ou ha d exper ien c e t r a ns f err ing p ati en t s t o th e den tal chai r?

* I s th e den tal h e alth t e am familia r with th e

or al h e alth pro bl e m s fac ed by peop le withd is abiliti es?


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* D oes y our o ffic e hav e m ou th props or * D oes y our o ffic e hav e m ou th props or suppor tiv e de vic es t o ai d p ati en t s wh o maysuppor tiv e de vic es t o ai d p ati en t s wh o may

hav e d iffic u lti es in open ing th e ir m ou th s? hav e d iffic u lti es in open ing th e ir m ou th s? * I s th e den tal h e alth t e am kno wl edge abl e * I s th e den tal h e alth t e am kno wl edge abl e ab ou t a ss is tiv e de vic es t o en abl e y our ab ou t a ss is tiv e de vic es t o en abl e y our p ati en t s t o b e m ore independen t i n p ati en t s t o b e m ore independen t i n

ma n a g ing th e ir o w n or al hy g iene? ma n a g ing th e ir o w n or al hy g iene? * Are y ou familia r with b e ing abl e t o * Are y ou familia r with b e ing abl e t o pres c r ib e a person al or al hy g iene progr ampres c r ib e a person al or al hy g iene progr amf or a n ind ivi du al with i n t e ll e ct u al / p hy s icalf or a n ind ivi du al with i n t e ll e ct u al / p hy s ical

d is abiliti es ba sed on hi s or h er le v e l o f d is abiliti es ba sed on hi s or h er le v e l o f unders ta nd ing a nd ability ? (unders ta nd ing a nd ability ? (55 ))


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For m os t pr actic es th e th oug ht o f For m os t pr actic es th e th oug ht o f acc o mm od ati ng th ese p ati en t s may at fi rs tacc o mm od ati ng th ese p ati en t s may at fi rs tsee m o v er wh e lmi ng . Lac k o f exper ien c e ,see m o v er wh e lmi ng . Lac k o f exper ien c e ,d isrup ti on o f th e o ffic e rou ti ne , need f or d isrup ti on o f th e o ffic e rou ti ne , need f or spe cial faciliti es a nd equ ip m en t a nd spe cial faciliti es a nd equ ip m en t a nd in a dequ at e c o m pens ati on a re per c ep ti ons in a dequ at e c o m pens ati on a re per c ep ti ons that ca n b e o v er c o m e . S o m e ind ivi du al s withthat ca n b e o v er c o m e . S o m e ind ivi du al s withse v ere m ed ical or m o v e m en t pro bl e m s mayse v ere m ed ical or m o v e m en t pro bl e m s mayneed t o b e t re at ed in a h osp ital b u t th ose need t o b e t re at ed in a h osp ital b u t th ose with mil d or m oder at e d is ability ca n b e with mil d or m oder at e d is ability ca n b e t re at ed in th e pr ivat e pr actic e . M os tt re at ed in th e pr ivat e pr actic e . M os tpro c edures used f or th e gener al popu lati on pro c edures used f or th e gener al popu lati on ca n b e a pp li ed t o th e p ati en t with spe cialca n b e a pp li ed t o th e p ati en t with spe cialneeds . S o m e m od ificati ons t o t re atm en tneeds . S o m e m od ificati ons t o t re atm en tmay b e ne c ess a r y al ong with c o m p a ss ion may b e ne c ess a r y al ong with c o m p a ss ion a nd t o ler a n c e in e ach s it u ati on .a nd t o ler a n c e in e ach s it u ati on .


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T h e Am er ica ns with Di s abiliti es Act ( ADA ) o f T h e Am er ica ns with Di s abiliti es Act ( ADA ) o f 199 2 199 2 pro hibit s d is c r imi n ati on a g ai ns t apro hibit s d is c r imi n ati on a g ai ns t aperson with a d is ability wh o is seek ing person with a d is ability wh o is seek ing acc ess t o ser vic es , i n cl ud ing den tal ser vic es .acc ess t o ser vic es , i n cl ud ing den tal ser vic es .Alth oug h th e law s may va r y by s tat e , city or Alth oug h th e law s may va r y by s tat e , city or c oun ty th e ADA se t s s ta nd a rds a nd b u il d ing c oun ty th e ADA se t s s ta nd a rds a nd b u il d ing c odes f or ne w c ons t ru cti on t o c re at e c odes f or ne w c ons t ru cti on t o c re at e ba rr ierba rr ier --f ree or un iv ers al des ign f ree or un iv ers al des ign en vi ron m en t s that ma ke faciliti es a nd en vi ron m en t s that ma ke faciliti es a nd ser vic es us abl e by e v er y one . Acc ord ing t o ser vic es us abl e by e v er y one . Acc ord ing t o T itl e T itl e 3 3 o f th e law y ou a re requ ired t o ma ke o f th e law y ou a re requ ired t o ma ke m od ificati ons t o a n ex is ti ng facility thatm od ificati ons t o a n ex is ti ng facility thatall o w s acc ess by persons with d is abiliti es .all o w s acc ess by persons with d is abiliti es .D es ign cha r act er is tic s f or a Ba rr ierD es ign cha r act er is tic s f or a Ba rr ier --F ree Free FacilityFacility


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R e m o val o f ba rr iers fi rs t s ta r t s with a th oroug hR e m o val o f ba rr iers fi rs t s ta r t s with a th oroug he val u ati on o f th e p hy s ical o ffic e sp ac e . Sim p le e val u ati on o f th e p hy s ical o ffic e sp ac e . Sim p le cha nges need no t b e expens iv e , su ch a s a dd ing cha nges need no t b e expens iv e , su ch a s a dd ing ha ndr ail s t o hallway s a nd gr ab ba rs in ha ndr ail s t o hallway s a nd gr ab ba rs in res t roo m s , cha ng ing door kno b s t o a [ e v er ty pe ,res t roo m s , cha ng ing door kno b s t o a [ e v er ty pe ,re a rr a ng ing f urn it ure in th e wait a re a withre a rr a ng ing f urn it ure in th e wait a re a withva r ious chai r h e ig ht s in cl ud ing sp ac e f or ava r ious chai r h e ig ht s in cl ud ing sp ac e f or awh ee lchai r , ma k ing ma g azi ne r ac ks re achabl e ,wh ee lchai r , ma k ing ma g azi ne r ac ks re achabl e ,rep laci ng hi g h p il e ca rpe t with nonsk id fl oor rep laci ng hi g h p il e ca rpe t with nonsk id fl oor c o v er ings , a nd e limi n ati ng ha ng ing p la n t s a nd c o v er ings , a nd e limi n ati ng ha ng ing p la n t s a nd a re a rugs . F or e a s y en t r a n c e t o th e b u il d ing a re a rugs . F or e a s y en t r a n c e t o th e b u il d ing c ons ider a por tabl e r am p . T h e den tal t e am ca n c ons ider a por tabl e r am p . T h e den tal t e am ca n b e c o m e activ e p la nners by a sk ing p ati en t s f or b e c o m e activ e p la nners by a sk ing p ati en t s f or th e ir inpu t on h o w t o ma ke th e o ffic e m ore th e ir inpu t on h o w t o ma ke th e o ffic e m ore acc ess ibl e or by c on tacti ng lo cal d is abilityacc ess ibl e or by c on tacti ng lo cal d is ability

org a n izati ons f or a d vic e on a b ro a d r a nge o f org a n izati ons f or a d vic e on a b ro a d r a nge o f d is abiliti es . (d is abiliti es . (77 ) Co m p lia n c e in f or mati on f or ne w) Co m p lia n c e in f or mati on f or ne wc ons t ru cti on a s w e ll a s regu lati ons a nd c ons t ru cti on a s w e ll a s regu lati ons a nd ch e c k li s t s f or re m o val o f ex is ti ng ba rr iers a re ch e c k li s t s f or re m o val o f ex is ti ng ba rr iers a re availabl e at th e Am er ica ns with Di s abiliti es Actavailabl e at th e Am er ica ns with Di s abiliti es Actw e b s it e . (w e b s it e . (88 ))


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Mos t p ati en t s with a d is ability or th e ir ca reg iv ers willMos t p ati en t s with a d is ability or th e ir ca reg iv ers willb e prep a red t o d is c uss t re atm en t i ssues wh en th e yb e prep a red t o d is c uss t re atm en t i ssues wh en th e yfi rs t c on tact y our o ffic e t o s ch edu le a n a ppo in tm en t.fi rs t c on tact y our o ffic e t o s ch edu le a n a ppo in tm en t.An acc ur at e a nd c urren t h e alth hi s t or y i s essen tial.An acc ur at e a nd c urren t h e alth hi s t or y i s essen tial.Depend ing on th e d is ability a nd/or m ed icalDepend ing on th e d is ability a nd/or m ed icalc ond iti on , a c onsu ltati on with th e p ati en t 's p hy s icia n ,c ond iti on , a c onsu ltati on with th e p ati en t 's p hy s icia n ,c ounse lor a nd o th er m e mb ers o f th e re habilitati on c ounse lor a nd o th er m e mb ers o f th e re habilitati on t e am may b e ne c ess a r y t o ensure t re atm en t i s s af e t e am may b e ne c ess a r y t o ensure t re atm en t i s s af e a nd e ff e ctiv e .a nd e ff e ctiv e .P re t re atm en t p la nn ing h e lps t o de t er mi ne whatP re t re atm en t p la nn ing h e lps t o de t er mi ne whatprep a r ati on needs t o b e ta ken b e f ore th e prep a r ati on needs t o b e ta ken b e f ore th e

a ppo in tm en t. It may s av e val u abl e tim e , ma k ing th e a ppo in tm en t. It may s av e val u abl e tim e , ma k ing th e a ppo in tm en t a su cc ess f u l a nd pos itiv e exper ien c e f or a ppo in tm en t a su cc ess f u l a nd pos itiv e exper ien c e f or e v er y one . F or m s ca n b e mail ed a nd fill ed ou t ah e a d e v er y one . F or m s ca n b e mail ed a nd fill ed ou t ah e a d o f tim e . A p h one in t er vi e w ca n pro vi de a d is abilityo f tim e . A p h one in t er vi e w ca n pro vi de a d is abilitypro fil e de taili ng pro bl e m s or limitati ons that im p actpro fil e de taili ng pro bl e m s or limitati ons that im p actca re . F or ex am p le , if th e p ati en t i s us ing a wh ee lca re . F or ex am p le , if th e p ati en t i s us ing a wh ee l--chai r ,chai r ,


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what i s th e degree o f m o bility a nd will y ou need h e lp what i s th e degree o f m o bility a nd will y ou need h e lp t r a ns f err ing th e p ati en t t o th e den tal chai r? D oes th e t r a ns f err ing th e p ati en t t o th e den tal chai r? D oes th e p ati en t need a n tibi o tic pre m ed icati on f or t re atm en t ? p ati en t need a n tibi o tic pre m ed icati on f or t re atm en t ? Wh o will l eg ally pro vi de c onsen t f or t re atm en t ? WhatWh o will l eg ally pro vi de c onsen t f or t re atm en t ? Whata re th e p ati en t 's li kes , d is li kes , f e a rs a nd limitati ons? a re th e p ati en t 's li kes , d is li kes , f e a rs a nd limitati ons?

Appo in tm en t s may b e dependen t on t r a nspor tati on Appo in tm en t s may b e dependen t on t r a nspor tati on issues su ch a s reser vi ng spe cial v e hicl es . T h ere issues su ch a s reser vi ng spe cial v e hicl es . T h ere s h ou ld b e no c on flict with b o w e l a nd bla dder s h ou ld b e no c on flict with b o w e l a nd bla dder e limi n ati on , m e al s or m ed ici ne s ch edu les . F or th e e limi n ati on , m e al s or m ed ici ne s ch edu les . F or th e y oung p ati en t, n a p tim e ca n b e a c ons ider ati on .y oung p ati en t, n a p tim e ca n b e a c ons ider ati on .

Den tal ca re f or th e d is abl ed p ati en t will alm os t alway s Den tal ca re f or th e d is abl ed p ati en t will alm os t alway s ta ke ex t r a tim e a nd ca nno t b e h urr ied . H o w e v er ,ta ke ex t r a tim e a nd ca nno t b e h urr ied . H o w e v er ,m o bility a nd neuro m us c u la r pro bl e m s , m en talm o bility a nd neuro m us c u la r pro bl e m s , m en talca p abiliti es , b e havi or pro bl e m s , p hy s ical s tami n a a nd ca p abiliti es , b e havi or pro bl e m s , p hy s ical s tami n a a nd

s itti ng t o ler a n c e may requ ire pro vi d ing on ly a s malls itti ng t o ler a n c e may requ ire pro vi d ing on ly a s mallam oun t o f t re atm en t at e ach vi s it. A mi dam oun t o f t re atm en t at e ach vi s it. A mi d --m orn ing m orn ing a ppo in tm en t may b e th e m os t i de al tim e . P ersons witha ppo in tm en t may b e th e m os t i de al tim e . P ersons withd is abiliti es o ft en need tim e t o prep a re f or th e vi s it,d is abiliti es o ft en need tim e t o prep a re f or th e vi s it,wait tim e is usu ally mi n imal, a nd e a r ly i n th e d ay th e wait tim e is usu ally mi n imal, a nd e a r ly i n th e d ay th e p ati en t a nd th e s taff a re at th e ir b es t.p ati en t a nd th e s taff a re at th e ir b es t.


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I nd ivi du al s with spe cial needs may b ene fit f ro mI nd ivi du al s with spe cial needs may b ene fit f ro mm e th ods that h e lp desens itiz e th e m t o den talm e th ods that h e lp desens itiz e th e m t o den talt re atm en t. B e f ore th e vi s it family m e mb ers or t re atm en t. B e f ore th e vi s it family m e mb ers or ca reg iv ers ca n familia r iz e th e p ati en t with or alca reg iv ers ca n familia r iz e th e p ati en t with or alma n ipu lati on with a d aily t oo thma n ipu lati on with a d aily t oo th--b rus hi ng rou ti ne atb rus hi ng rou ti ne at

h o m e in familia r surround ings . D en tal t e am m e mb ers h o m e in familia r surround ings . D en tal t e am m e mb ers ca n ins t ru ct ca reg iv ers in proper t e ch n ique t o av o id ca n ins t ru ct ca reg iv ers in proper t e ch n ique t o av o id a n y i njur y. Fi gure a n y i njur y. Fi gure 1 1 a nd Fi gure a nd Fi gure 2 2 ( r ig ht ) ill us t r at e ( r ig ht ) ill us t r at e proper pro c edure all o wi ng f or h e a d s tabilizati on proper pro c edure all o wi ng f or h e a d s tabilizati on dur ing t oo th b rus hi ng .dur ing t oo th b rus hi ng .

T o redu c e a nx ie ty with s t r a ngers a nd un familia r T o redu c e a nx ie ty with s t r a ngers a nd un familia r en vi ron m en t s , vi s it s t o th e den tal o ffic e b e f ore ca re en vi ron m en t s , vi s it s t o th e den tal o ffic e b e f ore ca re b eg ins may b e h e lp f u l. Hav e th e p ati en t s t op at th e b eg ins may b e h e lp f u l. Hav e th e p ati en t s t op at th e o ffic e dur ing tim es o th er tha n rou ti ne o ffic e h ours .o ffic e dur ing tim es o th er tha n rou ti ne o ffic e h ours .


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O b ser vi ng a family m e mb er re c e ivi ng ca re in th e O b ser vi ng a family m e mb er re c e ivi ng ca re in th e t re atm en t a re a may all o w th e p ati en t t o mimict re atm en t a re a may all o w th e p ati en t t o mimicdes ir abl e b e havi or . O n th e fi rs t vi s it f or t re atm en t th e des ir abl e b e havi or . O n th e fi rs t vi s it f or t re atm en t th e p ati en t ca n s it qu ie tly i n th e chai r with a familyp ati en t ca n s it qu ie tly i n th e chai r with a familym e mb er or ca reg iv er ne a r by t o o ff er re a ssur a n c e .m e mb er or ca reg iv er ne a r by t o o ff er re a ssur a n c e .Whil e re la xed in th e chai r , th e ir t ee th ca n b e gen tlyWhil e re la xed in th e chai r , th e ir t ee th ca n b e gen tlyb rus h ed . F or th e se c ond vi s it f o ll o w th e s am e rou ti ne b rus h ed . F or th e se c ond vi s it f o ll o w th e s am e rou ti ne a nd if th e p ati en t re mai ns re la xed a mi nor den tala nd if th e p ati en t re mai ns re la xed a mi nor den talpro c edure su ch a s a cl e a n ing or a s im p le res t or ati on pro c edure su ch a s a cl e a n ing or a s im p le res t or ati on ca n b e per f or m ed .ca n b e per f or m ed .

If thi s pro c ess is su cc ess f u l m ore c o m p lex t re atm en tIf thi s pro c ess is su cc ess f u l m ore c o m p lex t re atm en tmay b e gr a du ally a dded . T h e den tal t e am s h ou ld may b e gr a du ally a dded . T h e den tal t e am s h ou ld c on ti nu ally m on it or th e p ati en t 's b e havi or dur ing c on ti nu ally m on it or th e p ati en t 's b e havi or dur ing e ach vi s it. If at a n y tim e th e p ati en t b e c o m es e ach vi s it. If at a n y tim e th e p ati en t b e c o m es un c ooper ativ e th e a ppo in tm en t s h ou ld b e t er mi n at ed un c ooper ativ e th e a ppo in tm en t s h ou ld b e t er mi n at ed f or th e d ay. If a res t or ati on ha s b een s ta r t ed a nd f or th e d ay. If a res t or ati on ha s b een s ta r t ed a nd t re atm en t m us t end , th e pr actiti oner ca n qu ic k lyt re atm en t m us t end , th e pr actiti oner ca n qu ic k lyp lac e a t e m por a r y filli ng t o b e c o m p le t ed at a lat er p lac e a t e m por a r y filli ng t o b e c o m p le t ed at a lat er tim e . If th ese m e th ods a re no t su cc ess f u l den taltim e . If th ese m e th ods a re no t su cc ess f u l den talpro c edures may hav e t o b e c o m p le t ed us ing sed ati on pro c edures may hav e t o b e c o m p le t ed us ing sed ati on a nd/or res t r ai n t. (a nd/or res t r ai n t. ( 99 ,, 1010) )


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Di s abl ed p ati en t s f requen tly hav e pro bl e m s withDi s abl ed p ati en t s f requen tly hav e pro bl e m s withsuppor t, bala n c e a nd e v en a ggress iv e b e havi or .suppor t, bala n c e a nd e v en a ggress iv e b e havi or .

S udden in v o lun ta r y b od y m o v e m en t s su ch a s S udden in v o lun ta r y b od y m o v e m en t s su ch a s m us cl e sp a s m s ca n b e a d a nger t o th e p ati en tm us cl e sp a s m s ca n b e a d a nger t o th e p ati en ta nd th e den tal t e am dur ing t re atm en t. S e v ere a nd th e den tal t e am dur ing t re atm en t. S e v ere ca ses c ou ld requ ire sed ati on or gener alca ses c ou ld requ ire sed ati on or gener ala nes th es ia a nd h osp italizati on mi g ht th en b e a nes th es ia a nd h osp italizati on mi g ht th en b e a ppropr iat e .a ppropr iat e .

I n th e o ffic e , s tabilizati on with or with ou tI n th e o ffic e , s tabilizati on with or with ou tres t r ai n t may b e used t o ma ke th e p ati en t f ee lres t r ai n t may b e used t o ma ke th e p ati en t f ee lc o mf or tabl e a nd se c ure a nd all o w f or s af e a nd c o mf or tabl e a nd se c ure a nd all o w f or s af e a nd e ff e ctiv e de liv er y o f qu ality ca re . Pill o w s , ro ll ed e ff e ctiv e de liv er y o f qu ality ca re . Pill o w s , ro ll ed bla nke t s or t o w e ls may b e p lac ed under th e bla nke t s or t o w e ls may b e p lac ed under th e p ati en t 's knees a nd ne c k t o pre v en t m us cl e p ati en t 's knees a nd ne c k t o pre v en t m us cl e sp a s m s a nd pro vi de a dd iti on al suppor t. Asp a s m s a nd pro vi de a dd iti on al suppor t. Ab e a n ba g chai r p lac ed on th e den tal chai r willb e a n ba g chai r p lac ed on th e den tal chai r willc on f or m t o th e p ati en t 's b od y whil e filli ng th e c on f or m t o th e p ati en t 's b od y whil e filli ng th e sp ac e b e tw een th e p ati en t a nd th e den tal chai r .sp ac e b e tw een th e p ati en t a nd th e den tal chai r .


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Mou th props may b e ne c ess a r y t o pro vi de ca re Mou th props may b e ne c ess a r y t o pro vi de ca re b e ca use a d is abl ed person may lac k ability, or b e ca use a d is abl ed person may lac k ability, or may no t wa n t t o keep th e ir m ou th open . U se o f amay no t wa n t t o keep th e ir m ou th open . U se o f a

m ou th prop no t on ly pro vi des pro t e cti on f ro m th e m ou th prop no t on ly pro vi des pro t e cti on f ro m th e p ati en t sudden ly cl os ing th e ir m ou th b u t ca n p ati en t sudden ly cl os ing th e ir m ou th b u t ca n im pro v e acc ess a nd vi s ibility f or th e den tal t e am.im pro v e acc ess a nd vi s ibility f or th e den tal t e am.T r ai n ing on t e ch n ique f or s af e use may b e T r ai n ing on t e ch n ique f or s af e use may b e requ ired .requ ired .

A l ong p ie c e o f den tal fl oss s h ou ld b e ti ed A l ong p ie c e o f den tal fl oss s h ou ld b e ti ed th roug h th e h o le in a c o mm er cially availabl e prop th roug h th e h o le in a c o mm er cially availabl e prop a nd kep t ou t s ide th e m ou th f or e a s y re m o val i n a nd kep t ou t s ide th e m ou th f or e a s y re m o val i n ca se o f a b re athi ng pro bl e m. I nexpens iv e e a s y t o ca se o f a b re athi ng pro bl e m. I nexpens iv e e a s y t o use m ou th props ca n re a d ily b e a sse mbl ed us ing use m ou th props ca n re a d ily b e a sse mbl ed us ing mat er ial s in y our o ffic e . T a pe t oge th er fiv e mat er ial s in y our o ffic e . T a pe t oge th er fiv e w ooden t ongue depressors a nd fa s t en withw ooden t ongue depressors a nd fa s t en withwat erproo f ta pe . W r a p a nd ta pe se v er al p ie c es o f wat erproo f ta pe . W r a p a nd ta pe se v er al p ie c es o f g a u z e a round one end . G en tly p lac e th e g a u z e a round one end . G en tly p lac e th e c us hi oned end b e tw een th e t ee th.c us hi oned end b e tw een th e t ee th.


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T hi s ty pe o f prop ca n b e c us t o miz ed f or th e T hi s ty pe o f prop ca n b e c us t o miz ed f or th e am oun t o f bit e open ing des ired . O ne end o f aam oun t o f bit e open ing des ired . O ne end o f af o lded , m o is t ened wa s hcl o th or se v er alf o lded , m o is t ened wa s hcl o th or se v er al

g a u z e squ a res f o lded t oge th er a nd g a u z e squ a res f o lded t oge th er a nd m o is t ened ca n ser v e t o keep th e m ou th openm o is t ened ca n ser v e t o keep th e m ou th open

I n c ons ider ing th e use o f b od y s tabilizati on I n c ons ider ing th e use o f b od y s tabilizati on or res t r ai n t cli n icia ns s h ou ld b e awa re o f th e or res t r ai n t cli n icia ns s h ou ld b e awa re o f th e s ta nd a rds a nd regu lati ons o f th e ir s tat e's s ta nd a rds a nd regu lati ons o f th e ir s tat e's D en tal P r actic e Act. A dd iti on al edu cati on or aD en tal P r actic e Act. A dd iti on al edu cati on or aper mit may b e ne c ess a r y i n so m e s tat es .per mit may b e ne c ess a r y i n so m e s tat es .

T h e den ti s t s h ou ld alway s ch oose th e le a s tT h e den ti s t s h ou ld alway s ch oose th e le a s tres t r ictiv e b u t s af e a nd e ff e ctiv e m e th od . Ares t r ictiv e b u t s af e a nd e ff e ctiv e m e th od . Ath oroug h e val u ati on o f th e p ati en t 's m ed icalth oroug h e val u ati on o f th e p ati en t 's m ed icalhi s t or y a nd den tal needs is essen tial. A n yhi s t or y a nd den tal needs is essen tial. A n yuse o f thi s pr actic e ha s th e po t en tial f or use o f thi s pr actic e ha s th e po t en tial f or injur y t o th e p ati en t,injur y t o th e p ati en t,


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th ere f ore it s use dur ing t re atm en t m us t b e th ere f ore it s use dur ing t re atm en t m us t b e ca re f u lly m on it ored a nd re a ssessed at regu la r ca re f u lly m on it ored a nd re a ssessed at regu la r

in t er val s . Stabilizati on a round ex t re miti es or th e in t er val s . Stabilizati on a round ex t re miti es or th e ch es t m us t no t activ e ly res t r ict ci r c u lati on or ch es t m us t no t activ e ly res t r ict ci r c u lati on or resp ir ati on a nd m us t b e t er mi n at ed if th e resp ir ati on a nd m us t b e t er mi n at ed if th e pro c edure is ca us ing se v ere s t ress t o th e p ati en t.pro c edure is ca us ing se v ere s t ress t o th e p ati en t.Con t r ai nd icati ons f or s tabilizati on in cl ude th ose Con t r ai nd icati ons f or s tabilizati on in cl ude th ose wh o ca nno t b e imm o biliz ed s af e ly due t o wh o ca nno t b e imm o biliz ed s af e ly due t o

a sso ciat ed p hy s ical or m ed ical c ond iti ons . F or a sso ciat ed p hy s ical or m ed ical c ond iti ons . F or ex am p le , th e use o f res t r ai n t may c o m pro mi se ex am p le , th e use o f res t r ai n t may c o m pro mi se resp ir at or y f un cti on f or th e p ati en t wh o ha s resp ir at or y f un cti on f or th e p ati en t wh o ha s a s thma.a s thma.

I n f or m ed c onsen t f ro m th e p ati en t or leg alI n f or m ed c onsen t f ro m th e p ati en t or leg alca reg iv er m us t b e o btai ned b e f ore t re atm en t. A n ca reg iv er m us t b e o btai ned b e f ore t re atm en t. A n exp la n ati on reg a rd ing th e need f or res t r ai n t,exp la n ati on reg a rd ing th e need f or res t r ai n t,proposed m e th ods , r isks a nd b ene fit s a nd poss ibl e proposed m e th ods , r isks a nd b ene fit s a nd poss ibl e c o m p licati ons is ne c ess a r y. A n y d is c uss ion s h ou ld c o m p licati ons is ne c ess a r y. A n y d is c uss ion s h ou ld all o w a n oppor t un ity f or th e p ati en t or ca reg iv er t o all o w a n oppor t un ity f or th e p ati en t or ca reg iv er t o respond respond


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11 . I n f or m ed c onsen t. I n f or m ed c onsen t

22 . I nd icati on f or use . I nd icati on f or use

33 . T y pe o f s tabilizati on a nd/or res t r ai n t. T y pe o f s tabilizati on a nd/or res t r ai n t

44. D ur ati on o f a pp licati on . D ur ati on o f a pp licati on

55 . B e havi or e val u ati on dur ing pro c edure . B e havi or e val u ati on dur ing pro c edure

66. T h e le v e l o f su cc ess or fail ure o f th e . T h e le v e l o f su cc ess or fail ure o f th e pro c edurepro c edure


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P ersons with d is abiliti es do presen t chall enges f or P ersons with d is abiliti es do presen t chall enges f or th e den tal t e am b u t m os t ca n re c e iv e ca re in th e th e den tal t e am b u t m os t ca n re c e iv e ca re in th e pr ivat e o ffic e with a f e w m od ificati ons t o t re atm en t.pr ivat e o ffic e with a f e w m od ificati ons t o t re atm en t.T h e fi rs t s t ep that will all o w acc ess t o ca re f or th ese T h e fi rs t s t ep that will all o w acc ess t o ca re f or th ese p ati en t s s ta r t s with th e p hy s ical sp ac e o f y our p ati en t s s ta r t s with th e p hy s ical sp ac e o f y our pr actic e . M os t ne w b u il d ings a re des igned t o c ode pr actic e . M os t ne w b u il d ings a re des igned t o c ode a nd a re c ons idered "ba rr iera nd a re c ons idered "ba rr ier --f ree ." F or a n ex is ti ng f ree ." F or a n ex is ti ng o ffic e sp ac e so m e s im p le cha nges will en abl e o ffic e sp ac e so m e s im p le cha nges will en abl e c o m p lia n c e with th e ADA whil e pro vi d ing acc ess t o c o m p lia n c e with th e ADA whil e pro vi d ing acc ess t o ca re f or e v er y one .ca re f or e v er y one .

P re t re atm en t p la nn ing , proper p ati en t a ssess m en t,P re t re atm en t p la nn ing , proper p ati en t a ssess m en t,s ch edu li ng a nd poss ibl e desens itizati on t e ch n iques s ch edu li ng a nd poss ibl e desens itizati on t e ch n iques h e lp ma ke a su cc ess f u l a ppo in tm en t poss ibl e .h e lp ma ke a su cc ess f u l a ppo in tm en t poss ibl e .Be ca use o f sudden in v o lun ta r y m o v e m en t s or Be ca use o f sudden in v o lun ta r y m o v e m en t s or b e havi or issues th e p ati en t may requ ire so m e f or m o f b e havi or issues th e p ati en t may requ ire so m e f or m o f b od y s tabilizati on or res t r ai n t t e ch n iques . T h oroug hb od y s tabilizati on or res t r ai n t t e ch n iques . T h oroug hm ed ical hi s t or y, i n f or m ed c onsen t b e f ore t re atm en tm ed ical hi s t or y, i n f or m ed c onsen t b e f ore t re atm en ta nd proper do c u m en tati on a re essen tial.a nd proper do c u m en tati on a re essen tial.


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