Download presentation
Presentation is loading. Please wait.
Published byOsborn Eaton Modified over 8 years ago
1
DH201 CLINICIAL SCIENCES III Lisa Mayo, RDH, BSDH “You must learn a new way to THINK before you can master a new way to BE.” Marianne Williamson
2
1. Scoliosis 2. Muscular Dystrophy 3. Arthritis 4. Scleroderma
5
Curving of spine as a ‘C’ or ‘S’ shape more than 10 ◦ Wedging & rotation of the vertebrae Secondary scoliosis Result of a neuromuscular conditions (ex: spina bifida, CP) May see radiopacity in center of a pano Best results = tx’d when young
8
People having reached skeletal maturity are less likely to have a worsening case S&S Uneven musculature on one side of the spine A rib prominence or a prominent shoulder blade, caused by rotation of the ribcage Uneven hips, arms or leg lengths Diminished lung capacity Pressure on heart
12
Atrophy of skeletal, striated muscles Types 1. Duchenne type 2. Limb-girdle dystrophy 3. Facioscapulohumeral dystrophy 4. Becker: Similar to Duchenne type, but more benign with a later onset (5–15yrs) 5. Emery–Dreifuss: 5–30yrs, severe cardiomyopathy and risk for sudden death 6. Oculopharyngeal & myotonic dystrophies: Rare, 20–50yrs, slowly progressive, extensive involvement of orofacial muscles
13
Characteristics Swelling of affected muscles, destruction of striated bands, cytoplasm & fatty deposits replace muscle Muscular weakness and pain Oral characteristics Mastication problems Speech problems Mouth breathing – HALITOSIS Drooling, excessive salivation Increased perio, caries
14
Males (transmitted by female carriers) Present at birth – apparent 2-5yrs of age Weakness of hips, lordosis, waddling gait, balance issues, muscle wasting Arrhythmias and cardiomyopathy common Cardiomyopathy makes it harder for your heart to pump & deliver blood to the rest of your body Rarely live past 30 Fully disabled by puberty, confined to wheelchair
16
Males:Females equal 6-20yrs (average age 13yrs) Oral side effects Facial, eye muscle issues Gaping of lips - similar to mouth breathers Malocclusion, TMD Systemic side effects Cardiac involvement rare Scapulae prominent, shoulder muscles weak = difficulty raising arms Progression slower than Duchenne & progression may arrest
18
Affects hips, shoulders, pelvis Progression varies: rapid vs slow Manifests in late childhood/early adolescence Cardiomyopathy common May become wheeelchair bound
19
Tx Considerations Protect airway Powered oral hygiene devises may be contraindicated Wheelchair transfer Premed if heart conditions present Consult with MD
21
Inflammation in a joint Most common causes of chronic illness in USA Acute & chronic forms Contributing factors Infectious agents, traumatic disorders, endocrine abnormalities, tumors, allergy and drug reactions, inherited
22
1. Rheumatoid arthritis 2. Juvenile RA 3. Degenerative joint disease/Osteoarthritis
23
Chronic, immunologic systemic disease in which inflammation of the joints occurs in exacerbations & remissions Etiology: Unknown Onset 20-40yrs More women than men
24
S&S Joint pain & swelling Fingers, hands, knees affected 1 st Stiffness: morning, after periods of inactivity Weakness, fatigue, loss of appetite, loss of weight, anemia, low-grade fever Subcutaneous nodules in elbows, wrists, fingers TMD common Difficulty chewing
28
Medical treatment 1. Pain relief 2. PT & OT 3. Nutritional counseling 4. Meds NSAIDs Trexall(Methotrexate): autoimmune diseases & cancer Gold compounds(Ridaura) Imuran(azathioprine): immunosuppressive Cyclosporin: immunosuppressive Humera: TNF (tumor necrosis factor)-blocker (TNF- α causes joint swelling & inflammation) 5. Joint replacement surgery
29
Relationship to periodontal disease RA & perio are both chronic inflammatory diseases Pathogenesis of both is similar Extent & severity of perio disease with RA under research
30
Under 16yrs of age Differs from adult RA Onset more acute, prolonged fever, enlargement of the spleen & lymph nodes Inflammation of many joints (esp knees, wrists, spine) TMD, limited opening Progression: complete remissions or ↑ disability that continues for yrs Tx: meds, activity to maintain function
31
Affects weight-bearing joints Inflammation is not the joint problem like RA Predisposing factors Repeated trauma (athletes) Obesity Age-related change in tissues Mechanical/loading stress Genetics 85% cases >70yrs Progression of disease leads to pain, deformity, limited movement TMJ usually not involved
33
Joint pain and impaired motor function Joint replacement and antibiotic premedication Oral self care if hands involved Offer home care aids that accommodate issues
35
A chronic immunologic systemic disease in which joint inflammation occurs during periods of exacerbation and remission defines: a. Progressive systemic sclerosis b. Rheumatoid arthritis c. Tubular sclerosis d. Lupus erythematosus
36
A chronic immunologic systemic disease in which joint inflammation occurs during periods of exacerbation and remission defines: a. Progressive systemic sclerosis b. Rheumatoid arthritis c. Tubular sclerosis d. Lupus erythematosus
37
Which of the following devises would you recommend for an arthritis patient? a. Flossing instruction b. Oral irrigator c. Manual toothbrush d. Electric toothbrush
38
Which of the following devises would you recommend for an arthritis patient? a. Flossing instruction b. Oral irrigator c. Manual toothbrush d. Electric toothbrush
40
Chronic autoimmune disorder Affects connective tissue – over production of collagen Hardening, thickening, shrinking of ct Immobility & rigidity of skin Limits opening of mouth Death = renal, cardiac failure, pulmonary insufficiency, intestinal malabsorption Etiology Collagen synthesis irregularities, immunologic disorders, microvascular abnormalities
41
1 st symptom Episodic vasoconstriction of hands Discoloration of fingers when cold
42
Oral Characteristics Xerostomia Widened PDL Thin, rigid lips Difficulty in opening and closing mouth Thin, pale, tender, rigid mucosa & gingiva ↑ mobility Difficult mastication Tongue may be immobile Speech difficult
43
Which of the following diseases is an autoimmune disorder of connective tissue characterized by an overproduction of collagen? a. Scleroderma b. Systemic lupus c. Multiple sclerosis d. Rheumatoid arthritis
44
Which of the following diseases is an autoimmune disorder of connective tissue characterized by an overproduction of collagen? a. Scleroderma b. Systemic lupus c. Multiple sclerosis d. Rheumatoid arthritis
Similar presentations
© 2024 SlidePlayer.com Inc.
All rights reserved.