The following presentation was originally developed for individuals and families by Achieva (a Western PA service provider). Now offered as a webcast production, ODP is providing this valuable resource to Supports Coordinators and SC Supervisors for professional development. In order to receive credit for completing this course, you need to complete all course requirements and print the certificate of achievement. 1
Welcome to Lesson 8: Emergency Situations and of Dental Health for Individuals with Disabilities. Please adjust your computer volume so that it is at a comfortable listening level for you. 2
There are three goals for this lesson. First we will talk about how to figure out the level of support that you need for dental procedures, including routine dental care, as well as fillings or extractions. Second, we will talk about care after a dental operation, and how to be sure that you know what to do when you get home. Third, we will talk about dental emergencies: what they are and what to do. 3
Going the dentist is hard for many people, but there are some ways to make visits better. In this lesson we ll begin to talk about ways to help someone relax during the visit, as well as some of the medications that can be used. We ll also talk about dental operations and emergencies to help identify what needs to happen in those situations. 4
The most frequent type of dental visit is for preventive care. This is where the hygienist cleans your teeth and then the dentist looks for problems. Having your teeth cleaned means that you have to sit in a seat with your mouth open. Sometimes it is hard to sit still or the dental chair is difficult to get into. Try to think about these things before you go to the dentist in order to prepare. If you use a wheelchair or a walking aid, then talk with the dental office before you come to figure out how the office can accommodate your needs. If you have trouble getting into a chair, make sure that they put the dental chair at the right height for you to easily get onto the chair. Don t be afraid to ask them to change the height. Think about how long you can sit without a break. Don t be afraid to let the hygienist know how long you can sit without a break so that they can stop and let you move a bit before you get tired. This will help you get through the appointment. Don t forget to look at the level of care information to determine what your level of care is. Remember that it may be different depending on the procedure or what is going to happen at the visit. For example, everyone needs some sedation to have a wisdom tooth removed, but some people also need sedation for routine visits. Following those guidelines and discussing them with your dentist will help the visit go more smoothly. There are also ways to make visits go smoothly that don t involve the use of medication. These include relaxation and desensitization activities which we will talk about in a future lesson. Be sure to use your experience to learn what works and what doesn t so that you can make your next visit better. 5
When to consider using medication for a dental visit. 6
What should you do if the dental visit is not successful, even if you were prepared? You may need a higher level of care for that procedure. Or you may only need a higher level of care while you are working on desensitization or relaxation activities. There are different kinds of medications to help. 7
Medication used for sedation or to decrease anxiety or nervousness in the dental office can be used in many ways. It may be a pre medication, a medicine that is prescribed by your physician or the dentist to take before coming to the dentist office. This medication often makes people a little sleepy and so if you are going to use it you should make sure that you have someone to come to the office with you. Other types of medication may be given in the dentist office. This often requires that the dentist have a special permit so not every dentist will be able to do this. These include sedative or antianxiety medication that is given by vein when you are in the dental chair. Typically a needle will be put into a vein and the medication given through that needle. The medication usually makes people sleepy and they often don t remember much about what happened after the medication wears off. Inhalational agents like nitrous oxide or laughing gas can also be used. For this you have to breathe into a mask in order for the medication to work. After it begins to work, then the dentist will do the needed procedure. All sedative and antianxiety medication have risks and the dentist may need to monitor your oxygen levels or airway during the procedure. It is important to remember that you may not need to use sedation for all procedures and that learning some relaxation techniques could decrease your need for medication as well. 8
Most dental procedures require some special treatment after the procedure. If you have a filling put in because you had a cavity or hole in your tooth, then you will not be able to eat for a period after the filling. Having an extraction or tooth pulled often means that you have to keep a gauze or bandage in the area where your tooth was in order to stop the bleeding. The dentist will want to make sure that the bleeding stops before you leave. If there is a lot of blood on the gauze, then the dentist may want to put a new gauze in. You or someone with you may need to put pressure on the socket or place where your tooth was for a while to stop the bleeding. Be sure that you use gloves for this. Make sure that you have something like a plastic bag to put the dirty gauze in so that you don t expose others to your blood. You will be given other instructions about what to do and not do after your surgery. Often the dentist will not want you to sip through a straw once you have had a tooth removed. You will need to make sure that you have all of the instructions written down so that you don t forget them. Also remember that you may have some pain associated with the procedure and be sure to ask the dentist what you can take. The dentist might give you a prescription or have you use some over the counter pain medication. Depending on your operation and your personal health, the dentist may give you other medication or you may have instructions from your physician about how to take any other medication that you are on around the time of your dental surgery. Be sure to ask the dentist how to contact them in an emergency and what to look for. They should be able to tell you some of the things that might happen and whether or not you need to do anything about them before you go home. 9
What kinds of events are dental emergencies? Generally traumatic injuries to the mouth and teeth are emergencies. So if you crack or break a tooth, then you should call your dentist. Sometimes a tooth will get knocked out. If this occurs then put it in some milk and seek immediate dental care. The sooner you get to the dentist the better the chance of putting the tooth back in your mouth and having it reattach itself. If you are in an accident and think that you have an injury to your jaw or face, then you can go to the emergency room for evaluation. Lacerations or deeper cuts on your lips or face may need to have stitches and should be seen by a physician. Swelling of your face with or without pain should also be evaluated. Dental abscesses or infections of the tooth and gums can make your face swell and also give you a fever and pain in the area. Often the dentist will recommend treatment with an antibiotic to start to treat the infection before doing a dental procedure. 10
There are three important things to remember from this lesson. The first is to identify what will make your dental visit the most successful and learn about things that work and those that don t. The second is to make sure that you have all of the instructions that you need for care after you have had a dental procedure. The third is to remember to seek care for the dental emergencies that we talked about. 11
Thank you for viewing this webcast. 12