Understanding Mobility Issues and Physical Disabilities: Key Terms and Definitions

disability is an umbrella term for:

impairment, activity limitations, participation restrictions

why are patients with disabilities at a greater risk for oral health disparities?

harder for them to access care

traumatic brain injury

- mild to severe

- dexterity issues (holding toothbrush)

- difficulty with self care

social issues from TBI

memory, thinking, sensory processing, poor communication, behavioral issues

spinal cord dysfunction causes

trauma, infections, disorders, ALS, congenital deformities

diplegia

like parts on either side of the body (both arms or both legs)

paraplegia

legs and in some cases, lower part of the body

hemiplegia

one side of the body

tetraplegia

all four limbs from neck down

spina bifida

A congenital defect of the spine in which part of the spinal cord and its meninges are exposed through a gap in the backbone. It often causes paralysis of the lower limbs, and sometimes a mental handicap.

ASA for spina bifida

II-III

associated health issues for spina bifida

90% chance of hydrocephalus, latex allergy is common, mobility/growth issues

oral health issues with spina bifida

gag reflex, dexterity issues, increased caries risk, use mouth prop/ may have catheter or bowel assistance

treatment for spina bifida

nerve cannot be repaired or regenerated, so there is no real cure

muscular dystrophy

group of 30 genetic disorders that causes atrophy and dysfunction of the muscular system

ADL level 0

individuals who are capable of brushing and flossing their own teeth (children w/ supervision)

ADL level 1 and 2

individuals capable of carrying out at least part of OHI but require considerable training, assistance and direct supervision

ADL level 3

unable to perform own care, confined to bed *increase recare

considerations for a dental appt

- limit supine and aerosols

- higher risk for infection

- possible pre-med and pre-procedural rinse

- bring dental chair to comfortable height

- shortened appointments

- adjust OHI for intellectual levels

sliding board transfer

adjust board, transfer by sliding, pt may do themselves, repeat in reverse back to wheelchair

considerations for home care

goals, modified toothbrush, fluoride varnish, more frequent recalls, antiseptic rinse **include caregiver and show them

who should be considered for toothbrush aids?

patients with fixed grip, low dexterity, limited movement

mobile patient

lock wheelchair, hug with their arms over our arms, pivot to chair and assist with legs as needed

squat/pivot transfer for immobile pt

remove arm rest, grasp pt around waist and lift bottom high enough for clearance, assist them to swing hips from wheelchair to dental chair

two person dependent lift

1 person hugs pt from behind and 1 person scoops legs; both lift and turn together, placing pt in dental chair

princess lift

approach pt from side and grasp around trunk and under knees