What is a Disability?

1. What is a Disability? According to the World Health Organization, a disability is “any restriction or lack (resulting from any impairment) of ability to perform an activity in the manner or within the range considered normal for a human being.”

2. What is a Handicap? • The World Health Organization's definition of a handicap is the "loss or limitation of opportunities to take part in the life of the community on an equal level with others; encounter a person with disability and social, physical environment. • Is an inability to accomplish something one might want to do. The term emphasize the focus on shortcomings in the environment and in many tasks and activities, ex. in education occupation, information or communication (social dimension)."

3. Degree of Inability Another way to dissect the terms "disability" and "handicap" is to look at the degree of inability a person experiences. A Person is completely unable to do something, then that would be considered a disability. If the person is simply limited in doing something, then that is considered a handicap.

4. For example, being bound to a wheelchair is a disability but needing crutches to help you walk is a handicap because you can still walk.

5. Political Correctness One difference between the two terms is political correctness. Society views the term "disabled" as a politically correct way of saying "handicapped." If you want to be politically correct in your language and are not interested in the subtle difference between these two terms, use "disabled."

6. Preadolescent to Postmenopausal Patients

7. Adolescence and Puberty • Stages of adolescence • Early – 10-13 yrs • Middle – 14-17 yrs • Late – 18-21 yrs • Pubertal changes • Rapid changes in body size, shape, composition • Between ages 9-17, usually completed in 3-4 years • Influenced by diet, race, heredity • Females begin puberty before males

8. Considerations • Hormones maintain body homeostasis • Hormones are transported by blood or lymph • Major endocrine glands • pituitary, thyroid, parathyroid, pancreas, adrenals, gonads • Hormone imbalance = physical and mental disturbances • Effects reproductive system development and function

9. Physical Development • Hormonal influences • Ovaries (estrogens) • Testes (androgens) • Female development • Male development • Growth spurt • Poor coordination • Need: fuel, activities, rest

10. Psychosocial Development • Changes • Independence from parents • Importance of body image • Peer codes and lifestyles • Establishment of identity • Relevance in oral hygiene care • Understand growth patterns • Insight into changes to direct motivation

11. Personal Factors For The Adolecent Patient • Anxiety • Increased self-interest • Growing independence • Authority figures questioned • Concern over physical characteristics • Acne • Obesity • Delayed/early development

12. Nutritional Requirements • Related to hormonal influence • Males highest need, 2nd only to pregnancy • Under nutrition • Boys: overactivity and poor diet • Girls: voluntary diet restrictions, poor diet • Eating disorders • Iron deficiency anemia • Girls after onset of menses

13. Oral Health Problems found in Adolescents • Oral manifestations of STDs • Tobacco use • Illicit drug use • Oral contraceptives and pregnancy • Eating disorders • Body piercings

14. Periodontal issues - Juvenile Periodontitis • One form of early-onset periodontal disease is known as localized juvenile periodontitis. Juvenile periodontitis typically may be first observed in individuals around puberty, ages 11 to 13. The two forms of juvenile periodontitis are generalized and localized. The localized form has characteristic clinical features

15. 14 year old with Juvenile Periodontitis

16. Care Of the patient with Juvenile Periodontitis • Short-term antibiotic therapy in conjunction with non-surgical treatment can have a significant impact on the loosely adherent flora. Conservative therapy may arrest the periodontal breakdown

17. Dental Hygiene Care • Patient approach • Don’t lecture, highlight positive, show interest • Patient history • Health history questions • Personal responsibility • Parental approval/clearance

18. Localized Periodontitis • Localized juvenile periodontitis is not a common finding in clinical practice. However, it does have a significant prevalence in the population. In the United States, the highest prevalence of localized juvenile periodontitis is among the African-American population. Females may be more susceptible than males

19. Dental Hygiene Care • If the disease process is observed at a very early stage, treatment can include subgingival scaling and root planning in conjunction with antibiotic therapy. • The bacteria associated with this disease process are particularly susceptible to antibiotics such as tetracycline or doxycycline..

20. Other Oral Conditions and the adolescent • Dental caries • Diet, growth demands, emotional stress • Periodontal infections • Biofilm-induced puberty gingivitis, exaggerated response • Risk factors for periodontitis • Poor OH, ortho, plaque accumulation, systemic factors • Destructive periodontal diseases • Aggressive or chronic, localized or generalized

21. Education Of The Adolescent Patient • Patient education • OHI and motivation • Caries control program • Instrumentation, Fluoride tx, and re-evals throughout growth • Instruction in self-care procedures • Encourage nutritional awareness

22. Eating Disorders Across the life span

23. Eating Disorders • An eating disorder is an illnesses that cause serious disturbances to your everyday diet, such as eating extremely small amounts of food, severely overeating or binging and purging

24. Eating Disorders: • Eating disorders frequently appear during the teen years or young adulthood but may also develop during childhood or later in life.1,2 Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder (pg 984- Darby)

25. Menopause • Description • Complete and permanent cessation of menstruation • Characteristics • Usually 47-55 yrs • Hot flashes, headaches, night sweats, sleeping problems • Vaginal dryness and infections • Emotional disturbances, mood swings, anxiety, • Weight gain • Postmenopausal effects • Bone problems, fragile skin, predisposition to HBP, diabetes, atherosclerosis

26. Menopause • Associated with decreased estrogen levels include, Night sweats and sleeping problems which may lead to feeling tired, stressed and or tense • Emotional disturbances Alterations in estrogen level may result in mood swings, depression, irritability, and difficulty with concentration or memory

27. Oral Manifestations associated with Menopause • Thinning of the oral epithelial lining and decreased keratinization • Glossodynia- burning sensations of the tongue • Altered taste perception ( salty, peppery, sour) • Xerostomia, and Alveolar bone loss

28. Dental Hygiene Care • Appointment suggestions • Efficiency, calmness, room temperature • Patient instruction • Saliva substitutes, OHI, fluoride therapies • Diet • Noncariogenic, fiber, low-fat, calcium, low alcohol, decrease caffiene • Fluoride therapies-Home applied FL2, for all in this age group

29. Review A common nutritional deficiency that accompanies the onset of menstruation is: A) vitamin A B) vitamin D C) iron D) magnesium E) folate

30. Review The master endocrine gland that regulates the output of hormones by other glands is: A) thyroid B) parathyroid C) pancreas D) adrenal E) pituitary

31. Answer E) pituitary The pituitary gland is the master gland that regulates hormone output by other glands. The thyroid, parathyroid, pancreas, and adrenal glands are the major glands that secrete hormones that regulate growth and development, energy production, food metabolism, reproductive processes, and the body response to stress.

32. Answer C) iron Lack of iron due to blood loss during menstruation can cause iron deficiency anemia. The other deficiencies would be commonly associated with dietary factors.