MODULE 1

Ages and dental visits

0-2 years

Key takeaways

DA and dentist must work together
initial convo should be with child and parent, ideally using child on parents lap to include them
warm and friendly introduction
tell show do
- explain basically
- show what we will use
- do the treatment
good OHI to set them up for life
warm goodbye

Sensorimotor 0-2 years of age
- differentiate self from objects
- recognises self as agent of action
- object permanence
preoperational thought 2-7 years
- thought pattern not well developed
- ego centric
- unable to encompass another persons point of view
- objects classified by feature
- inflexible
- language development still
- ability to predict outcomes is developing
concrete operations 7-11 years
- logical reasoning, consider others POV, assess more than one aspect of situation
- classify objects according to several features and can order in a series
- abstract thought not well developed
formal operations
- logical abstract thinking so that different possibilities for action can be considered
- become concerned with hypothetical, future and ideological problems

quality of infant primary care giver interaction is important factor in development of insecure and anxious patterns of behaviour in a child
affect ability to
- form stable relationships
- develop self sense of worth
- move towards independence

Special need

what is a disability

impairment
- the loss or abnormality of physiological, psychological or anatomical structure or function
disability
- outcome of the interaction between person with an impairment and the attitudinal and environmental barriers thaey may face

Medical model

views people with a disability as being broken and incapable of fitting into mainstream society
disability is a problem that belongs to the individual
responsibility of person with disability to overcome the barriers they face
charitable model
views people with disability as being vulnerable, and reliant on people without disability to perform certain tasks
undermines autonomy of people with disabilities
social model
asserts that the limitations experienced by people with disability are the result of inaccessible systems and processes in mainstream society
3 major barriers
physical - exclusion from built environment
institutional - systematic exclusion or neglect in social, legal, educational, religious and political institutions
attitudinal - negative valuations of disabled people by non disabled people
Human rights model
recognises that people with disability have the same rights as everyone else in society, and says that governments around the world have a role to play in upholding these rights
experiences and disabilities are unique to each person, and contributes to sense of identity
ability to reach potential is hindered by barriers and attitudes in society, not by differing ability

a persons decision given voluntarily to agree to a healthcare treatment, procedure or other intervention that is made
- following provision of accurate and relevant information about healthcare intervention and options available
- with adequate knowledge and understanding of the benefits and material risks of the proposed intervention relevant to the person who would be having the treatment, procedure or other intervention

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seek legal guidance if unsure
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Tokenism

policy or practice of limited inclusion of members of a minority group, usually creating a false appearance of inclusive practices

Special care dentistry

concerned with providing and enabling the delivery of oral care for people with an impairment or disability,
concerned with improvement of oral health of individuals and groups in society who have an impairment and/or disability
requires holistic approach

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Exceptions to practitioners duty to provide information

therapeutic privilege, practitioner may withhold information in very limited circumstances if that information would seriously harm the patients health or welfare
emergency treatment to an extent that is reasonably required, where the patient is temporarily unable to consent

oral or written, may be implied in certain circumstances
written consent should be obtained for more complex, risky procedures or surgery

Capacity

in short term, acute mental illness, drugs or alcohol may render patient incapable of consent
senile, intellectually disabled or mentally ill patients may lack the capacity to consent
adult patient may appoint an agent to make treatment decisions, against the possibility that the patient might become incompetent
a child under age of 18 years old can consent to any medical or similar procedures if he or she has sufficient intelligence and maturity to understand the nature and consequence of the treatment
if a child refuses treatment, a parent may only consent on the child's behalf if the child lacks the capacity to consent
- may be beyond power of parent to consent to major irreversible treatment and the intervention of the courts might be necessary