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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
Post Registration Qualifications for Dental Care Professionals: Questions and Answers is a comprehensive revision aid for dental nurses seeking to gain post-registration certification for professional development.
- Chapters cover qualifications in special care dental nursing, oral health education, dental sedation nursing, dental implant nursing, dental radiography and orthodontic dental nursing
- Questions are accompanied by clear explanations of the correct answers, reflecting the latest standards and practices
- Supported by a companion website which features sample questions mirroring each exam format
- An essential resource for dental care professionals who are looking to further advance their careers
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Seitenzahl: 882
Veröffentlichungsjahr: 2015
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Table of Contents
Cover
Title Page
Copyright
How to use this book
Acknowledgements
Nicola Rogers
Rebecca Davies
Wendy Lee
Dominic O'Sullivan
Frances Marriott
About the companion website
Chapter 1: Special care dental nursing
SECTION I Questions: Disability awareness
SECTION II Questions: Facilitating access
SECTION III Questions: Communication
SECTION IV Questions: Diversity of need
SECTION V Questions: Preparing for patient visit
SECTION VI Questions: Patient care during treatment
SECTION VII Questions: Pain and anxiety management
SECTION VIII Questions: Promoting good oral health
SECTION I Answers: Disability awareness
SECTION II Answers: Facilitating access
SECTION III Answers: Communication
SECTION IV Answers: Diversity of need
SECTION V Answers: Preparing for patient visit
SECTION VI Answers: Patient care during treatment
SECTION VII Answers: Pain and anxiety management
SECTION VIII Answers: Promoting good oral health
Chapter 2: Oral health education
SECTION I Questions: Society and oral health
SECTION II Questions: Implementing oral health education and promotion
SECTION III Questions: Communication
SECTION IV Questions: The oral cavity
SECTION V Questions: Oral diseases and conditions
SECTION VI Questions: Patient groups
SECTION VII Questions: Self care skills for effective oral hygiene
SECTION VIII Questions: Improving public ‘response ability’
SECTION I Answers: Society and oral health
SECTION II Answers: Implementing oral health education and promotion
SECTION III Answers: Communication
SECTION IV Answers: The oral cavity
SECTION V Answers: Oral diseases and conditions
SECTION VI Answers: Patient groups
SECTION VII Answers: Self care skills for effective oral hygiene
SECTION VIII Answers: Improving public ‘response ability’
Chapter 3: Dental sedation nursing
SECTION I Questions: Reasons for the provision of sedation
SECTION II Questions: Medico-legal aspects of dental sedation
SECTION III Questions: Role of the sedation nurse
SECTION IV Questions: Monitoring and equipment used
SECTION V Questions: Patient selection
SECTION VI Questions: Types of sedation
SECTION VII Questions: Medical emergencies
SECTION VIII Questions: Essential anatomy
SECTION I Answers: Reasons for the provision of sedation
SECTION II Answers: Medico-legal aspects of dental sedation
SECTION III Answers: Role of the sedation nurse
SECTION IV Answers: Monitoring and equipment used
SECTION V Answers: Patient selection
SECTION VI Answers: Types of sedation
SECTION VII Answers: Medical emergencies
SECTION VIII Answers: Essential anatomy
Chapter 4: Dental implant nursing
SECTION I Questions: Indications for dental implant use
SECTION II Questions: Medico-legal aspects of dental implant use
SECTION III Questions: Role of the dental nurse
SECTION IV Questions: Implant components and terminology
SECTION V Questions: Patient assessment for dental implants
SECTION VI Questions: Implant surgery
SECTION VII Questions: Implant restorative procedures
SECTION VIII Questions: Implant aftercare and maintenance
SECTION I Answers: Indications for dental implant use
SECTION II Answers: Medico-legal aspects of dental implant use
SECTION III Answers: Role of the dental nurse
SECTION IV Answers: Implant components and terminology
SECTION V Answers: Patient assessment for dental implants
SECTION VI Answers: Implant surgery
SECTION VII Answers: Implant restorative procedures
SECTION VIII Answers: Implant aftercare and maintenance
Chapter 5: Dental radiography
SECTION I Questions: Radiation physics
SECTION II Questions: Radiation dose and the biological risks associated with X-rays
SECTION III Questions: Radiation protection
SECTION IV Questions: Image receptors and processing
SECTION V Questions: Image quality and quality assurance
SECTION VI Questions: Patient care
SECTION VII Questions: Dental radiography
SECTION VIII Questions: Radiological interpretation
SECTION I Answers: Radiation physics
SECTION II Answers: Radiation dose and the biological risks associated with X-rays
SECTION III Answers: Radiation protection
SECTION IV Answers: Image receptors and processing
SECTION V Answers: Image quality and quality assurance
SECTION VI Answers: Patient care
SECTION VII Answers: Dental radiography
SECTION VIII Answers: Radiological interpretation
Bibliography
Chapter 6: Orthodontic dental nursing
SECTION I Questions: Anatomy useful to orthodontics
SECTION II Questions: Classifications and terminology
SECTION III Questions: Records
SECTION IV Questions: Appliances
SECTION V Questions: Interdisciplinary care
SECTION I Answers: Anatomy useful to orthodontics
SECTION II Answers: Classifications and terminology
SECTION III Answers: Records
SECTION IV Answers: Appliances
SECTION V Answers: Interdisciplinary care
End User License Agreement
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Guide
Cover
Table of Contents
Begin Reading
List of Illustrations
Chapter 5: Dental radiography
Figure 5.1
Figure 5.2
Figure 5.3
Figure 5.4
Figure 5.5
Figure 5.6
Figure 5.7
Figure 5.8
Figure 5.9
Figure 5.10
Figure 5.11
Figure 5.12
Figure 5.13
Figure 5.14
Figure 5.15
Figure 5.16
Figure 5.17
Figure 5.18
Figure 5.19
Figure 5.20
Figure 5.21
Figure 5.22
Figure 5.23
Figure 5.24
Figure 5.25
Figure 5.26
Figure 5.27
Figure 5.28
Figure 5.29
Figure 5.30
Figure 5.31
Figure 5.32
Figure 5.33
Figure 5.34
Figure 5.35
Figure 5.36
Chapter 6: Orthodontic dental nursing
Figure 6.1
Figure 6.2
Figure 6.3
Figure 6.4
Figure 6.5
Figure 6.6
Figure 6.7
Figure 6.8
Figure 6.9
Figure 6.10
Figure 6.11
Figure 6.12
Figure 6.13
Figure 6.14
Figure 6.15
Figure 6.16
Figure 6.17
Figure 6.18
List of Tables
Post registration qualifications for dental care professionals
Questions and answers
Nicola Rogers RDN, NEBDN National Certificate in Dental Nursing, NEBDN Certificate in Dental Sedation Nursing, NEBDN Certificate in Dental Radiography, NEBDN Certificate in Oral Health Education
Tutor of the Year 2010 (DDU Educational Awards)Author of Basic Guide to Dental Sedation NursingDental Nurse Tutor, Pre and Post Registration TrainingBristol Dental HospitalBristol, UK
Rebecca Davies BChD (Hons), MFDSRCS (Eng), MSc, DDRRCR
Consultant and Honorary Senior Lecturer in Dental and Maxillofacial RadiologyUniversity Hospitals Bristol NHS Foundation TrustBristol Dental HospitalBristol, UK
Wendy Lee Dip Orth Ther (Edin)
DCP TutorBristol Dental HospitalBristol, UK
Dominic O′Sullivan BDS, FDSRCS (Eng), PhD, FDS (Rest Dent) RCS, FHEA
Professor in Restorative DentistryProgramme Director for MSc in Dental ImplantologyGraduate Director for School of Oral and Dental SciencesBristol Dental HospitalBristol, UK
Frances Marriott RDH MRSPH Cert Ed, Diploma in Dental Hygiene
Royal Society of Public Health–Diploma in Nutrition and DietStonebridge Associated Colleges–Diploma in Post Traumatic Stress DisorderCertificate in Education (University of Plymouth)Company Director–Focus Oral Health CICPlymouth, UK
This edition first published 2016 © 2016 by John Wiley & Sons Ltd.
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The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting a specific method, diagnosis, or treatment by health science practitioners for any particular patient. The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of fitness for a particular purpose. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom.
Library of Congress Cataloging-in-Publication Data applied Data
Rogers, Nicola, 1962- , author.
Post registration qualifications for dental care professionals : questions and answers / Nicola Rogers, Rebecca Davies, Wendy Lee, Dominic O'Sullivan, Frances Marriott.
p. ; cm.
ISBN 978-1-118-71116-3 (pbk.)
I. Davies, Rebecca, 1972- , author. II. Lee, Wendy, 1963- , author. III. O′Sullivan, Dominic, 1968- , author. IV. Marriott, Frances, 1958- , author. V. Title.
[DNLM: 1. Dental Assistants‐Examination Questions. 2. Dental Care‐Examination Questions. WU 18.2]
RK57
617.60076– dc23
2015022533
A catalogue record for this book is available from the British Library.
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.
Cover image: lushik/Getty Images
How to use this book
This book is a revision resource tool which has been written with dental nurses in mind to assist them in establishing any gaps in their personal knowledge, enabling them to prepare for any final assessment/examination. However, it could be used by other members of the dental team preparing for forthcoming examinations. It is split into subject areas, assigning a chapter to each topic to reflect the current ones where dental nurses can access courses and qualifications, being designed to aid preparation for final examinations. It has been written in a user-friendly manner covering all aspects relevant to the National Examining Board for Dental Nurses' examinations.
Although subjects are stand-alone, additional questions relating to common topics such as law and ethics, medical emergencies, cross-infection control, health and safety, and patient care may be found in other chapters.
There is no intention of instructing/criticising clinicians, or any professionals on their role in the clinical environment, which has only been explained to further the knowledge of dental nurses through this revision resource book. Any offence is entirely unintended and apologies are tendered for any perceived affront.
Dental nurses are subsequently reminded/warned that on no account should they undertake any duty that is solely the province of any other General Dental Council or Health Care Professional.
Acknowledgements
Nicola Rogers
To my husband David and son Sean, both of whom I am very proud for their own personal achievements, for the love, perseverance and continual support they have shown while I have been writing this chapter.
To my parents Nigel and Valerie for always being there for me, encouraging and supporting me in everything I do, especially my Father who has constantly given his time to reading and helping me correct the sedation chapter.
To the other authors for agreeing to write their chapters within this book and Wiley Blackwell for publishing it, thereby making my vision possible to provide DCPs with a valuable revision resource.
Rebecca Davies
I have endeavoured to write a selection of questions primarily to test dental nurses, hygienists and therapists on dental radiography and radiology. I give no excuses for some of the difficult questions that lie ahead. For those of you who will take dental radiographs you have a responsibility to your patients, your colleagues, members of the public and yourselves to have a good knowledge and respect for ionising radiation.
Many people have helped me along this journey, and to all of them I am extremely grateful.
To my friend Nikki Rogers, thank you for asking me to join your collaboration and for your continual support.
To my departmental colleagues Jos Sewell, Stuart Grange, Lynn Wilcox, Tracey Cunningham, Jane Luker, and Louise Denning, thank you for all you have done.
To John Rout and Eric Whaites, I am truly grateful for the time you have given in providing your feedback and expert advice on the content of this chapter. Both of you have inspired me with your teaching and knowledge over the years.
To my mum, Margaret, heartfelt thanks for reading my work and correcting the grammar. Some things never change.
Finally, special thanks to my husband Scott and my beautiful children Esme and Harry for their help, love, encouragement and understanding at all times.
Wendy Lee
Dedicated to all the dental nurses who have shown, and will continue to show, enormous commitment and effort to improve their professional skills and understanding of Orthodontics to the benefit of their patients.
Special thanks must go to Clare McNamara, Consultant Orthodontist, whose inspirational leadership and enthusiasm ensures a high standard is taught within our courses.
Dominic O'Sullivan
To Nikki and Wiley Blackwell for inviting me to take part in this book. To my parents and family for encouraging me and supporting me throughout my education and career and for always being there for me. Especially my father for his incredibly wise words of advice over the years.
Frances Marriott
First of all, a huge thank you to my dear husband Steve and sons Bryn and Dean for all of their support. Steve has been at my side for practically the whole of my dental career (we met very soon after I had qualified as a Dental Hygienist). He continues to provide unwavering support through all of the very personal and professional challenges I am still working through to this very day. Indeed, my lovely family can state the key dental public health messages with 100% accuracy too!
Over the years, other family members and good friends have been a real source of support too. Through their continued positivity, kindness and generous goodwill, the vision of having a totally ‘non-clinical’ community based Oral Health Education and Information service (Focus Oral Health CIC) has been achieved – special thanks go to my colleague Lorraine and her family for signing up to our ‘journey’.
Without a doubt, I also thank all of the patients I have cared for throughout my years in Special Care Dentistry. It has been a true privilege to meet such a diverse community of people who, in all honesty, have both enriched my clinical practice and actually taught me my ‘job’. It is intentional, therefore, that some details within my chapters on Special Care Dentistry and Oral Health Education is indeed based on personal learning and authentic experience.
About the companion website
This book is accompanied by a companion website:
www.wiley.com/go/rogers/post-registration-dental-care-questions
The website includes:
Example questions reflecting different methods of assessment.
Chapter 1Special care dental nursing
CHAPTER CONTENTS
SECTION I Questions: Disability awareness
Impairment and disability
Related legislation and guidelines – consent
Barriers to access
SECTION II Questions: Facilitating access
Providing special care dentistry
Reasonable adjustments
Oral health screening
SECTION III Questions: Communication
Pre-visit information – supporting patient and carer
Sensory impairment
Alternative communication
SECTION IV Questions: Diversity of need
Medically compromising conditions
Cancer and palliative care
Learning and physical disabilities
SECTION V Questions: Preparing for patient visit
Patient assessment
Organising patient transport
Domiciliary care
SECTION VI Questions: Patient care during treatment
Role of the dental nurse
Ongoing risk assessment
Treatment modification
SECTION VII Questions: Pain and anxiety management
Different types of pain
Non-pharmacological pain and behavioural management
Mental health
SECTION VIII Questions: Promoting good oral health
Whole life spectrum
Interdisciplinary and multi-agency working
Facilitating good oral health
SECTION I Answers: Disability awareness
Impairment and disability
Related legislation and guidelines – consent
Barriers to access
SECTION II Answers: Facilitating access
Providing special care dentistry
Reasonable adjustments
Oral health screening
SECTION III Answers: Communication
Pre-visit information – supporting patient and carer
Sensory impairment
Alternative communication
SECTION IV Answers: Diversity of need
Medically compromising conditions
Cancer and palliative care
Learning and physical disabilities
SECTION V Answers: Preparing for patient visit
Patient assessment
Organising patient transport
Domiciliary care
SECTION VI Answers: Patient care during treatment
Role of the dental nurse
Ongoing risk assessment
Treatment modification
SECTION VII Answers: Pain and anxiety management
Different types of pain
Non-pharmacological pain and behavioural management
Mental health
SECTION VIII Answers: Promoting good oral health
Whole life spectrum
Interdisciplinary and multi-agency working
Facilitating good oral health
SECTION I Questions: Disability awareness
LEARNING OUTCOMES
At the end of this section, you should be able to identify any gaps in knowledge associated with the following:
Impairment and disability
Related legislation and guidelines – consent
Barriers to access
Impairment and disability
1.
Define the term ‘Impairment’.
2.
Define the term ‘Disability’.
3.
Disability can be listed under four main classifications. What are these?
4.
Give an example of an impairment for each of the four classifications of disability.
5.
What is meant by the Social Model of Disability?
6.
What is meant by the Medical Model of Disability?
Related legislation and guidelines – consent
1.
State three key legislative Acts which help inform the delivery of Special Care Dentistry.
2.
In 2011, the ‘Public Sector Equality Duty’ became part of the Equality Act. State one action the amendment required that public organisations need to take.
3.
State three ‘dentally related’ documents which help inform delivery of oral health care for people with disabilities.
4.
In relation to Health and Social Care, a new Act was introduced in 2012 – what was it called?
5.
When determining a new way of working or a new policy in healthcare provision, what is an EIA?
6.
From date of diagnosis, progressive conditions such as HIV, Cancer and Multiple Sclerosis are covered by which key disability related legislation?
7.
In relation to obtaining consent in England and Wales, what do the letters MCA stand for?
8.
When did the MCA come into force?
9.
In relation to obtaining consent in Scotland, which Act is involved?
10.
When did this Act come into force?
11.
A person who supports another person (who lacks capacity and has no appropriate family or friends to consult) to make decisions is called an IMCA? What does this stand for?
12.
State two types of situation when the services of an IMCA may be necessary.
13.
Another form of advocacy support is via an IMHA – what do these letters stand for?
14.
To protect a vulnerable person from harm, DoLS may be implemented – what is this?
15.
State three ways in which the 'principles' of informed consent can be implemented.
Barriers to access
1.
State two ways patient general anxiety may be triggered/increased in the dental waiting room.
2.
State three ‘physical’ environmental barriers to access dental care.
3.
State three ‘organisational’ barriers to access dental care.
4.
State three ‘social’ barriers to access dental care.
5.
State two ‘cultural’ barriers to access dental care.
6.
State three ‘medical’ barriers in relation to patient care and management.
7.
State three ‘communication’ barriers in relation to patient care and management.
SECTION II Questions: Facilitating access
LEARNING OUTCOMES
At the end of this section, you should be able to identify any gaps in knowledge associated with the following:
Providing special care dentistry
Reasonable adjustments
Oral health screening
Providing special care dentistry
1.
What is Special Care Dentistry?
2.
Describe three ‘community’ providers of Special Care Dentistry.
3.
State three dental specialties that may be found in the Hospital setting.
4.
Describe the purpose of a mobile dental unit.
5.
State four ways that provision of a dental service in a mobile dental unit may differ from working in a fixed clinic?
Reasonable adjustments
1.
Describe four examples of environmental ‘reasonable adjustments’ for gaining access to the dental clinical setting.
2.
Describe four examples of environmental ‘reasonable adjustments’ upon entering the dental clinical setting.
3.
State three considerations in relation to seating arrangements in the waiting room.
4.
Give an example of a ‘reasonable adjustment’ in relation to information provision.
5.
How can a patient who needs help to complete their medical history be supported?
6.
Give an example of ‘inclusive’ language to replace the statement ‘disabled toilet’.
7.
'Disability etiquette' is important. Give an example of steps to take when meeting a person who is a wheelchair user.
8.
Give an example of considerations to take when meeting a person who requires help with navigation.
Oral health screening
1.
Oral health screenings are carried out by Community Dental Services. What is the correct name for this work?
2.
Give two advantages of carrying out oral health screenings.
3.
Give three disadvantages of carrying out oral health screenings.
4.
State five considerations during the initial planning of an oral health screening.
5.
State three considerations required on arriving at the venue on day of oral health screening.
6.
State six items required for carrying out an oral health screening.
7.
State three considerations required for after an oral health screening has been carried out.
SECTION III Questions: Communication
LEARNING OUTCOMES
At the end of this section, you should be able to identify any gaps in knowledge associated with:
Pre-visit information – supporting patient and carer
Sensory impairment
Alternative communication
Pre-visit information – supporting patient and carer
1.
When scheduling an initial dental visit, state at least three considerations to be made.
2.
State two pieces of information a Dental Nurse could provide to the patient/carer prior to attending the dental clinic.
3.
State two pieces of information a Dental Nurse could provide to the patient/carer prior to attending for actual dental treatment.
4.
‘Personal preference’ information helps in determining successful outcomes for patients – give four examples of what this could include.
5.
What communication and interpersonal skills are required to enhance support for individuals with diverse needs?
6.
State two health-related conditions that may impair communication.
7.
What are the four modalities of language?
8.
What does the term Dysarthria mean?
9.
What is an inability to understand spoken or written work known as?
10.
State three ‘environmental’ barriers to effective communication in the clinical setting.
Sensory impairment
1.
What is meant by the term sight loss?
2.
Partial sight is categorised by different levels – what are they?
3.
Define the term blindness.
4.
What are the leading causes of sight loss?
5.
What are the leading causes of blindness?
6.
Define visual impairment.
7.
What is meant by visual acuity?
8.
Myopia is the clinical term for which eye condition?
9.
What is the role of an Optometrist?
10.
What is the role of an Ophthalmologist?
11.
What is the role of an Orthoptist?
12.
How can hearing impairment occur?
13.
What is tinnitus?
14.
State three ways in which effective communication for people with hearing impairment may be facilitated.
15.
What is a hearing loop system?
16.
What is a Cochlear implant?
17.
State three ways in which effective communication for someone with visual impairment may be facilitated.
18.
State three ways information may be effectively provided for someone with visual impairment.
19.
State three ways effective communication for people with a cognitive disability may be facilitated.
20.
When providing information for a person with Learning Disability – what is meant by the term ‘sequencing’?
21.
State three ways in which effective communication for people with speech impairment may be facilitated.
22.
State three ways in which effective communication for people with mobility impairment may be facilitated.
23.
A person with Autism may have several ‘sensory’ challenges – name four.
Alternative communication
1.
BSL is a communication method used predominately by members of the Deaf community – what is it?
2.
Lip reading is what type of communication?
3.
The Total Communication approach uses a combination of communication methods – state five methods that may be included.
4.
What is Makaton?
5.
Give the name of two commonly used picture symbol sets.
6.
What is Braille?
7.
What is Moon?
8.
What is the deaf-blind manual alphabet?
9.
How does the ‘block alphabet’ differ from the deaf-blind manual alphabet?
10.
Name two non-verbal methods of communication that are based purely on physical movement.
11.
State an alternative method for verbal communication to occur via use of technology.
12.
What is a picture board?
13.
When could an Alternative and Augmentative Communication (AAC) system be used?
14.
State one way in which an Alternative and Augmentative Communication (AAC) system may be operated.
15.
How can telecommunications items be adapted to support effective communication?
16.
Interpreters can be employed to assist with communication – name two types of interpreters.
17.
Describe the three common steps used during the teaching of a new skill.
18.
What is the purpose of a palatal lift (training) device?
SECTION IV Questions: Diversity of need
LEARNING OUTCOMES
At the end of this section, you should be able to identify any gaps in knowledge associated with provision of dental care for patients of all ages who may have:
Medically compromising conditions
Cancer and palliative care
Learning and physical disabilities
Medically compromising conditions
1.
What is the difference between a sign and a symptom?
2.
In relation to ‘cardiac’ complications, what is a VSD?
3.
What is meant by the term cardiovascular disease (CVD)?
4.
Mention two types of CVD.
5.
In relation to CVD, there are two main reasons for a ‘reduced’ blood flow – what are they?
6.
In relation to respiratory complications, what do the letters COPD stand for?
7.
When trying to ascertain how far a patient may be able to lie back in dental chair, what useful, simple questions may be asked?
8.
What is Asthma?
9.
Application of topical fluoride varnish is contraindicated in some patients with Asthma – state the exclusion criteria.
10.
What is a tracheotomy (or tracheostomy)?
11.
What is Anaemia?
12.
State three common orofacial signs/symptoms of Anaemia.
13.
Define what is meant by a ‘bleeding disorder’.
14.
What is Haemophilia?
15.
Factor VIII is used in the treatment of which coagulation disorder?
16.
What is Christmas disease?
17.
What intraoral signs may be seen in relation to von Willebrand's disease?
18.
What do the letters INR stand for?
19.
Which is the commonly prescribed drug monitored by carrying out INR checks?
20.
Diabetes can occur in all ages – what are the two main types?
21.
Give the name of a drug commonly prescribed in relation to Diabetes controlled by diet.
22.
What is Liver Cirrhosis?
23.
How may Liver Cirrhosis be caused?
24.
State an oral presentation affecting ‘hard’ dental tissue that may present in a patient with Liver Cirrhosis.
25.
State an oral presentation affecting ‘soft’ oral tissue that may present in a patient with Liver Cirrhosis.
26.
What is Hepatitis?
27.
Hepatitis viruses are referred to as ‘types’ – state two of the five main ones.
28.
Which types of Hepatitis are of particular interest in the dental setting?
29.
For which Hepatitis a vaccination can be given as part of ‘Personal Protective Equipment’?
30.
What do the letters HIV stand for?
31.
State three oral lesions/conditions strongly associated with HIV infection.
32.
Advanced stage HIV may progress to AIDS – what do these letters AIDS stand for?
33.
The CD4 count for a person with AIDS is likely to be below which level?
34.
Define the term Kidney Disease.
35.
How does End Stage Renal Disease (ERSD) differ from chronic Kidney Disease?
36.
What is the difference between Peritoneal Dialysis and Haemodialysis?
37.
Define the term Gastrointestinal Disease.
38.
What is Crohn's Disease?
39.
State two orofacial signs of Crohn's Disease.
40.
What do the letters GERD (or GORD) stand for?
41.
What is Rheumatoid Arthritis?
42.
How can Rheumatoid Arthritis impact on oral health?
43.
What is Sjogren's Syndrome?
44.
How can Sjogren's Syndrome impact on oral health?
45.
What is Scleroderma?
46.
How can Scleroderma affect oral care?
47.
What is meant by Neurodisability?
48.
State three types of difficulty that may occur due to Neurodisability.
49.
Give an example of a ‘progressive’ neurological disease.
50.
State two reasons why acquired brain injury may occur.
51.
What is the correct term to describe a ‘lack of oxygen’ to the brain or other tissues?
52.
Give an example of a neurological ‘acquired’ disability.
53.
What is the correct medical term for a Stroke and why may a Stroke occur?
54.
In relation to the risk of Stroke – what is a TIA?
55.
What is Dementia?
56.
State two types of Dementia.
57.
What is Multiple Sclerosis?
58.
Multiple Sclerosis may present in three different stages – what are these?
59.
Epilepsy is a symptom of an underlying neurological disorder – what is a seizure?
60.
What sort of physical presentations may precede a seizure?
61.
What does the term ‘absence’ mean in relation to seizures?
62.
Describe what may be seen in relation to Tonic and Clonic seizures.
63.
What is the name of the condition involving a neural tube defect of the spinal cord at birth?
64.
What is Huntington's Disease?
65.
What is Cystic Fibrosis?
Cancer and palliative care
1.
Define Chemotherapy.
2.
Define Radiotherapy.
3.
In relation to treatment of cancer, what is Oral Mucositis?
4.
State two signs/symptoms of Oral Mucositis.
5.
What is trismus?
6.
Define the terms benign and malignant.
7.
Define the term lesion.
8.
Define the term histopathology.
9.
Define the term sedative filling.
10.
What does the term therapeutic mean?
11.
What does the term palliative care mean?
12.
Pain control can also be influenced by use of an appropriate bed and bedding – state two types of mattress that may enhance patient comfort.
13.
A palliative care team could include a variety of members from the multidisciplinary team – state two disciplines that may be included.
Learning and physical disabilities
1.
What is meant by ‘Learning Disability, Learning Difficulty and Intellectual Disability’ within adult Health and Social Care.
2.
Define ‘Learning Difficulty’ within education services.
3.
In UK education services, what do the letters SEN stand for?
4.
What type of need/s may a person with Profound and Multiple Learning Disability (PMLD) have?
5.
What do the letters ‘IQ’ stand for?
6.
What is Dyslexia?
7.
What is Fragile X Syndrome?
8.
What is Duchenne Muscular Dystrophy?
9.
What is Down's Syndrome and how does it occur?
10.
State five physical features that may present in a patient with Down's Syndrome.
11.
When treating a patient with Down's Syndrome, care must be taken with positioning in relation to neck region – why?
12.
Drinking alcohol during pregnancy may result in the baby being born with which syndrome?
13.
Autism is a lifelong developmental disability. When does it tend to appear?
14.
Which ‘umbrella term’ covers the range of disorders that includes Autism?
15.
In relation to Autistic Spectrum Disorder (ASD) – what is the ‘Triad of Impairment’?
16.
What is Asperger's Syndrome?
17.
What does ADHD stand for?
18.
Name a bone disorder commonly found in older women.
19.
What is Paget's Disease?
20.
What is Scoliosis?
21.
Spinal Cord Injury may result in Monoplegia, Paraplegia or Quadriplegia – how do they differ from each other?
22.
In what other ways can Spinal Cord Injury affect the limbs and the body?
23.
What does the term ‘gait’ relate to?
24.
Give an example of ‘fine’ and ‘gross’ motor movements.
25.
Which part of the brain controls balance and muscle tone?
26.
What is Dyskinesia?
27.
What is Dyspraxia or Apraxia?
28.
What is the difference between Hypertonia and Hypotonia?
29.
Describe the term Dystonia.
30.
What is the name of the toxin used to treat patients who have Dystonia?
31.
Define Cerebral Palsy.
32.
What are the main causes of Cerebral Palsy?
33.
State two factors that may increase the risk of Cerebral Palsy.
34.
State two main types of Cerebral Palsy.
35.
What common orofacial presentations may be seen in Cerebral Palsy?
SECTION V Questions: Preparing for patient visit
LEARNING OUTCOMES
At the end of this section, you should be able to identify any gaps in knowledge associated with caring for patients in clinical and domiciliary settings:
Patient assessment
Organising patient transport
Domiciliary care
Patient assessment
1.
The term ‘vulnerable/disadvantaged’ groups commonly refer to which key ‘age’ groups?
2.
The term ‘vulnerable/disadvantaged’ groups include which ‘income-related’ groups?
3.
The term ‘vulnerable/disadvantaged’ groups may include groups who experience ‘discrimination or other social disadvantage’ – State three examples.
4.
What sort of ‘population areas’ could the term ‘vulnerable/disadvantaged’ be applied to?
5.
What key information needs to be collated prior to the patient attending for treatment? State four considerations.
6.
State three considerations to be taken when caring specifically for people who are wheelchair users.
7.
Give three ways how the dental nurse can ensure that an appropriate ‘treatment setting’ is available for patient.
8.
State three patient criteria likely to be included in a Special Care ‘case mix’ model.
9.
State five steps that can be taken to help reduce the risk of medical emergencies.
10.
What does the abbreviation ASA stand for?
11.
What is the name of an assessment scale commonly used to measure dental anxiety?
12.
What is meant by the term Dysphagia?
13.
What are the factors involved in Dysphagia?
14.
State three signs or symptoms of Dysphagia.
15.
What is the main purpose of carrying out a ‘videofluoroscopy’?
16.
Why are IV bisphosphonates of interest to the dental team?
Organising patient transport
1.
State three considerations around ‘patient assistance’ that can help inform arrangement of patient transport.
2.
State two considerations around ‘patient treatment’ that can help inform arrangement of patient transport.
3.
State two factors that may influence the type of transport organised.
4.
State two factors to take into account if the patient requires ambulance transport.
5.
State two considerations around ‘patient treatment’ that can help inform arrangement of transport to take the patient home.
6.
State some ways to minimise the risk of difficulties with ‘organised’ transport.
Domiciliary care
1.
State two types of patients who may require domiciliary dental care.
2.
Give two ‘pros’ for carrying out domiciliary dental care.
3.
Give two ‘cons’ for carrying out domiciliary dental care.
4.
Risk assessments are required for provision of domiciliary dental care – state five topic areas that these could/should cover.
5.
State four planning considerations required for a domiciliary visit in relation to safety of
dental team
.
6.
State four planning considerations required for a domiciliary visit in relation to
patient safety
.
7.
On arrival at venue, what measures can be implemented to support delivery of safe and effective dental care?
8.
State two types of treatment that may be carried out in the domiciliary setting.
9.
State two ways
how
treatment may be modified especially if working in the ‘non-clinical’ setting.
10.
Give three reasons
why
treatment may need to be modified especially if working in the ‘non-clinical’ setting.
11.
When working on a domiciliary basis, list ten items that may be found in the ‘dental treatment kit’.
12.
When working on a domiciliary basis, list five items that may be found in the ‘administration kit’.
SECTION VI Questions: Patient care during treatment
LEARNING OUTCOMES
At the end of this section, you should be able to identify any gaps in knowledge associated with the care of patients with diverse needs during treatment:
Role of the dental nurse
Ongoing risk assessment
Treatment modification
Role of the dental nurse
1.
State two ways in which a patient with diverse needs may be supported during treatment.
2.
What are the main four ways in which the dental nurse can provide support for a patient?
3.
How can dental team ensure that patient is kept as fully informed as possible throughout treatment?
4.
For a patient with dental phobia, state two 'management' techniques that could be used.
5.
Suggest three ways in which a patient with Autism may be supported during dental treatment.
6.
Describe what is meant by a 'physical' intervention.
7.
State three ways of supporting patients with an extreme gag reflex to cope with treatment.
8.
State two reasons how oral function and/or structure may prevent access to the mouth.
9.
What is the correct term for a very small lower jaw?
10.
What is the correct term for a very large tongue?
11.
In what ways a very large tongue can impact on delivery of dental treatment?
12.
What is a ‘frenum’?
13.
How can a ‘frenum’ or ‘frena’ impact on delivery of oral care?
14.
What is Ankyloglossia?
15.
State one way in which safe access to the oral cavity during treatment may be achieved.
16.
State how the Dental Nurse can provide ongoing support for patients during treatment.
Ongoing risk assessment
1.
State three key areas of training very pertinent to Special Care Dentistry.
2.
State three factors in relation to the safe moving and handling of a patient.
3.
What is the purpose of a ‘wheelchair platform’?
4.
What additional factor needs to be considered if a patient has no sensation in his or her legs?
5.
Describe two items that may be used to assist a patient to 'transfer' to the dental chair.
6.
The letters FAST assist as a 'check list' for early recognition of a Stroke – what do the letters stand for?
7.
How can the risk of medical emergencies be reduced?
8.
Some medical conditions can be aggravated by stress. – Give one example.
9.
Some conditions can affect patient ability to co-operate. Give one example
10.
State one long-term condition that can impact on actual dental treatment.
11.
When providing dental care for people with Special Care Needs, what medical/health barriers may need to be considered? State two examples.
Treatment modification
1.
Give three reasons
why
treatment may need to be modified.
2.
State two ways in which the delivery 'timeframe' for treatment can be modified.
3.
State three ways in which the delivery of treatment can be modified.
SECTION VII Questions: Pain and anxiety management
LEARNING OUTCOMES
At the end of this section, you should be able to identify any gaps in knowledge associated with the identification of pain in people, particularly those with cognitive impairment:
Different types of pain
Non-pharmacological pain and behavioural management
Mental health
Different types of pain
1.
In relation to dental pain, what signs may be noted in people who are unable to verbally express their need?
2.
People with Special Care Needs will experience dental pain both on an acute and chronic basis. State two reasons for dental pain.
3.
What is the difference between the clenching of the teeth and bruxism?
4.
What does the term ‘extra-oral’ mean?
5.
Describe the term ‘mucous membrane’.
6.
Mention two different types of pain.
7.
What is Acupuncture?
8.
What is Acupressure?
9.
Thinking about unpredictable patient responses, what is the term for an exaggerated response to pain?
10.
What is Allodynia?
Non-pharmacological pain and behavioural management
1.
What is meant by the term ‘non-pharmacological’ interventions?
2.
What factors need to be taken into account in relation to a non-pharmacologic approach?
3.
What is meant by the term ‘behavioural management’?
4.
Give an example of behavioural management technique.
5.
What is a papoose board used for?
6.
Distraction may be used to support pain management. How is the technique thought to work?
7.
Providing information for a patient may help to alleviate their stress. What factors need considering prior to offering this?
8.
A patient may have his or her own techniques for controlling pain. What might these be?
9.
Application of either heat or cold can help with pain relief. Describe how both may work.
10.
Appropriate 'patient positioning' contributes to both pain relief and comfort. How can this be achieved?
11.
Young children can be supported by using the 'knee to knee' approach. What is this?
12.
What is Cognitive Behavioural Therapy?
13.
What do the letters NLP stand for?
14.
State four simple steps that can be taken to help acclimatise a person with Special Care Needs to the dental clinical environment.
Mental health
1.
Define the term ‘Mental Health Impairment’.
2.
What are Affective Disorders?
3.
How may a patient with ‘depression’ present in the dental setting?
4.
What is Manic Depression also known as?
5.
Sometimes a person may hear voices or have periods where they see things that other people may not. What is the name of this disorder?
6.
How may Mental Health and related treatments affect oral health and dental care?
7.
If a patient had a personality disorder, how may this affect his or her behaviour?
8.
What sort of feelings a person who self-harms may have?
9.
What is Agoraphobia?
10.
What is a Phobia?
11.
A patient who is anxious may have several physical symptoms. State two of them.
12.
What signs and symptoms may be seen during a panic attack?
13.
What is meant by the term ‘Neurosis’?
14.
Obsessive Compulsive Disorder has two main parts – what are they?
15.
What is the name of the appetite disorder that involves compulsive eating?
16.
What is Pica?
17.
Name two commonly known Eating Disorders.
18.
Orthorexia is classed as a similar condition to an Eating Disorder. What does it mean?
19.
What is the S.C.O.F.F questionnaire?
20.
What is the layer of fine body hair that can develop on a person with an Eating Disorder called?
21.
State three physical signs that a dental professional may notice in a person with an Eating Disorder.
22.
State some orofacial signs of Recreational Drug use.
23.
State some other ways in which alcohol abuse may impact on health.
SECTION VIII Questions: Promoting good oral health
LEARNING OUTCOMES
At the end of this section, you should be able to identify any gaps in knowledge associated with early development and shared care with the wider interdisciplinary team:
Whole life spectrum
Interdisciplinary and multi-agency working
Facilitating good oral health
Whole life spectrum
1.
What are the age ranges in relation to the terms Infant, Child and Adolescent?
2.
The ‘perinatal’ period covers which time period?
3.
What does the term ‘congenital’ mean?
4.
What is meant by the term ‘birth defect’?
5.
State one type of defect that comes under the classification of ‘birth defect’?
6.
Define the term cleft palate.
7.
What is an ‘acquired’ disability?
8.
Give an example of a ‘physical’ acquired disability.
9.
What is the age range for a ‘developmental disability’ to occur?
10.
What is meant by the term ‘developmental delay’?
11.
State two domains (types) of developmental delay that may be found in children.
12.
What is meant by the term ‘global’ developmental delay?
13.
State three reasons why ‘developmental disability’ may occur.
14.
What is ‘intellectual’ disability?
15.
In relation to the ageing process, what terms may help indicate the potential level of support that may be needed?
16.
What term is used to describe dental care provision specifically for children?
17.
What term is used to describe dental care specifically provided towards an 'older' population group?
18.
During growth and development of facial structures, an orthognathic opinion may be required – what would this assessment primarily involve?
19.
What is meant by the term ‘prosthesis’?
20.
What is an obturator?
Interdisciplinary and multi-agency working
1.
In relation to holistic care, what is meant by the letters ‘MDT’?
2.
Delivering Better Oral Health, 3rd edition, contains a letter template for a GDP to communicate with a GMP – what is the purpose of the template?
3.
Health Care colleagues work in many different patient care areas. Which care areas are identified by the letters SALT, CPN and OT ?
4.
State the name of the main nutritional screening tool used in care settings.
5.
What is the difference between Enteral and Parenteral Nutrition?
6.
State three methods of Enteral Nutrition.
7.
A patient is receiving Bobath therapy – what is it?
8.
A patient requires an orthotic assessment – what is it?
9.
What is the purpose of an orthosis and give one example.
Facilitating good oral health
1.
When providing oral health information for a person with Special Care Needs to carry out at home, give three examples of appropriate information.
2.
When providing oral health information for a person with Special Care Needs about preventive dental care in the clinic, give an example of appropriate information.
3.
Discuss how a carer may be supported to provide safe and effective oral care.
4.
How can ‘dry’ tooth brushing support delivery of effective oral care in patients with diverse health needs?
5.
How can oral hygiene items be adapted for a person who has limited manual dexterity?
6.
State four factors to be taken into account when discussing a new toothbrush for a person with Special Care Needs.
7.
Thinking about types of toothpaste for patients with Special Care Needs, state three factors that may help encourage use.
8.
When advising a carer on delivery of oral care, state four considerations that need to be made in relation to both patient/carer.
9.
When working with carers, what other points should be advised prior to carrying out oral care for another person?
10.
What sort of ‘visual aid’ may assist a carer to carry out effective oral care for patients on a more personalised basis?
11.
Discuss additional advice that could be included in relation to wearing of dentures.
12.
Family members may request new dentures to be provided for their loved one. State two aspects that need to be considered in such discussions.
13.
When supplementary nutrition (high-calorie drinks) is required, what advice can be given to reduce the risk of dental caries?
14.
In relation to dietary choices, state two other ‘external’ factors that may influence intake.
15.
What ‘anticipatory’ guidance could be given in relation to the risk of trauma to teeth?
SECTION I Answers: Disability awareness
Impairment and disability
1.
‘Impairment’ – a loss or abnormality of structure or function including psychological function.
2.
‘Disability’ – a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on a person's ability to do normal daily activities.
3.
Four main classifications of disability – Mental, Sensory, Physical, Cognitive.
4.
Mental
disability – mood swings/depression; unable to socialise/interact with people; emotional distress.
Sensory
disability – decreased hearing, poor vision, speech impairment.
Physical
disability – poor/no mobility, poor co-ordination, respiratory stress.
Cognitive
disability – reduced learning ability, unable to pay attention or concentrate, poor memory/recall ability.
5.
Social Model of disability is caused by the way society ‘operates’ rather than by a person's actual impairment or difference. This model explores how restrictions and barriers can be removed to enable the person to have an independent life through more control and choice (more inclusive ways of living).
6.
Medical Model of disability – the person is disabled due to their impairment or difference. Emphasis is more on what is 'wrong' with a person and that it is their impairment or additional need that should be 'treated' rather than identifying changes which could be put in place to support the person more effectively. Reinforces low expectation and aspiration leading to people losing independence and restriction of choice.
Related legislation and guidelines – consent
1.
Mental Health Act (1983), Disability Discrimination Act (1995), Disability Equality Duty (2006), Human Rights Act (1998), Mental Capacity Act (2005), Principles of Mental Capacity Act (2007), Deprivation of Liberty Safeguards (DOLS), Equality Act (2010), Health and Social Care Act (2012), Care Act (2014).
2.
Eliminate discrimination of people who are disabled. Be proactive in equality of opportunity. Foster good relations between people who are disabled and those who have no disability.
3.
NICE Guideline 19 Dental Recall (2004).
Choosing better oral health: An oral health plan for England (Department of Health 2005). Meeting the challenges of oral Health for Older People: A Strategic Review (commissioned and funded by Department of Health 2005). Guidelines for the Development of Local Standards of Oral Health Care for People with Dementia (funded by Department of Health 2006). Valuing people's oral health: A good practice guide for improving oral health of children and adults with disabilities (British Association for the Study of Community Dentistry, British Society of Disability and Oral Health, British Society of Paediatric Dentistry 2007). Guidelines for the Oral Healthcare of Stroke Survivors (British Society Gerodontology 2010). Clinical Guidelines and Integrated Care Pathways for the Oral Health Care of People with Learning Disabilities (Princess Diana Memorial Fund, British Society of Disability and Oral Health, Royal College Surgeons 2012).
Delivering Better Oral Health: An evidence-based toolkit for prevention, 3rd edition (Public Health England June 2014).
4.
Health and Social Care Act 2012
5.
Equality Impact Assessment – one tool for examining main functions and policies of an organisation (whether potential exists for people to be affected differently). Purpose is to identify and address any existing or potential inequalities.
6.
Equality Act 2010
7.
Mental Capacity Act
8.
MCA – statutory requirement in 2007. This law applies to everyone involved in care, treatment and support of people older than the age of 16 years in England and Wales who lack capacity to make all or some decisions for themselves.
9.
Adult with Incapacity (Scotland) Act
10.
2000
11.
Independent Mental Capacity Advocate
12.
Independent Mental Capacity Advocacy may be called upon when serious medical treatment is being provided, withdrawn or stopped (unless in an emergency situation and referral may still be required afterwards);for a hospital stay of more than 28 days; during care reviews or adult protection proceedings and if the NHS or local authority propose changes to accommodation arrangements leading to a stay of more than eight weeks in a care home.
13.
Independent Mental Health Advocate – introduced in 2009 – legal duty to provide Independent Mental Health Advocacy to patients who qualify under the Mental Health Act 1983.
14.
Deprivation of Liberty Safeguards
15.
Always work within legal, societal and ethical frameworks. Use of Mental Capacity Act. Work with other agencies/family members towards patient ‘best interests’. Share information as necessary (especially regarding safeguarding concerns). Work confidentially and be aware of situations when confidentiality may be broken. Use of a translator if English is not the first language or other alternative communication tool. Record all interventions.
Barriers to access
1.
Patient anxiety may be increased via unfriendly attitude of reception team. Patient can hear items of equipment being used (especially the dental handpiece) or due to the ‘clinical’ smell from some of the dental materials. Dental team is running late so appointment is delayed (this could also lead to additional stress for the patient particularly if they have another appointment to get to after their dental visit).
2.
‘Environmental’ barriers include clinic is too difficult for patients to get to – could be due to lack of transport, that is, the practice is not on a bus route or patient is non-driver. Also due to health needs, patient may not be able to travel for too long or for too far (risk of pressure sores or anxiety level will be increased too much). Clinic building may have steps up to the front door or, once in the building, there is no ground floor clinic. Actual dental surgery is too small to accommodate people who are wheelchair users (may be carer/s too).
3.
‘Organisational barriers’ – Clinic opening times is too restrictive, for example, not open at weekends (this could be particularly difficult if the patient and/or carer works during the week).
Certain type of ‘patient image’ portrayed via practice literature, range of services offered (mainly implants rather than ‘family’ access), type of posters and magazines in the waiting room. Treatment needs of patients are outside the role of GDP – factors include lack of confidence and experience, not enough appropriate training (or access to training). Skill mix in dental team is restricted or not enough staff. Lack of treatment facilities such as being unable to offer sedation. No funding to cover costs for Special Care facilities. Treatment delivery can be time-consuming and too costly to provide in General Dental Practice.
4.
‘Social’ barriers include poverty – poor lifestyle choices leading to higher dental disease risk (use of tobacco products, convenience foods). Financial – patients are unable to afford cost of treatment. Cost of taking time off from work resulting in loss of income (This can apply to carer also). Lack of knowledge regarding health cost exemption criteria – unable to access forms (as many online) or if have the form, unable to complete (poor vision, low literacy).
5.
‘Cultural barriers’ – Dental team attitude – lack of understanding, lack of empathy towards patient/caregiver needs. Patients may have low health literacy and lack knowledge on how to access services and their eligibility for care. Dental care has a low priority due to own cultural background and influence of primary socialisation. Parent/carer has a lack of knowledge about dental disease and this can be more difficult if ‘shared care’ is in place as this is likely to be inter-generational so will be an even wider difference in attitude. Dental team may not understand requirements for certain religious practices (for example dental treatment during Ramadan may be too risky for some patients because if any water is swallowed then their period of ‘fasting’ will be broken).
6.
