24.2

Patient Management

To effectively manage the patient with a hypersensitive gag reflex, the dental radiographer must be aware of (and manage) these issues.

Helpful Hints

Deferring the patient’s mind from “gagging” is very helpful, and telling the patient to wiggle their toes or say their ABCs with their toes helps distract them from what is happening.

The following are helpful hints when dealing with a patient with special needs:

• Never suggest gagging
• Do reassure the patient
• Do suggest breathing
• Do try to distract the patient
• Do try to reduce tactile stimuli
• Do use a topical anesthetic

Patients with Disabilities

Disability is a physical or mental impairment that substantially limits one or more of an individual’s major life activities.

Physical Disabilities

When dealing with a patient who has physical disabilities, use terminology that can be understood by the patient but avoid “baby talk.” If a person does not have the use of upper limbs and a beam alignment device cannot be used to stabilize receptor placement, the dental radiographer may ask the caregiver to assist with the holding of the receptor.

Some physical disabilities include:

• Vision impairment: must communicate using clear verbal explanations
• Hearing impairment: ask the patient how they prefer to communicate and can ask caregiver to serve as interpreter
• Mobility impairment: ask whether a patient needs assistance

Developmental Disabilities

Developmental disabilities are “a substantial impairment of mental or physical functioning that occurs before the age of 22 and is of indefinite duration.” You may encounter problems with coordination or comprehension of instructions, and extraoral exposures may be used for patients who cannot tolerate intraoral receptor exposure. It is also important to remember to talk to the patient and not the patient’s caregiver.

Patient Management Helpful Hints

Make sure you ask before assisting a person with a disability.

The following are helpful hints with managing a patient with a disability:

• Do practice the Golden Rule
• Do not ask personal questions about a disability
• Do think before you speak
• Do offer assistance before asking the patient for assistance
• Do talk directly to the person with a disability

Pediatric Patients

Pediatrics is the branch of dentistry dealing with the diagnosis and treatment of dental diseases in children. When dealing with children, you want to avoid “baby talk,” use positive reinforcement with children, always commend them on a job well done, and you must move quickly, have all settings ready, and remind the child to hold still.

The dental radiographer must be aware of the following in pediatric care:

• Tooth eruption sequences
• Prescribing of dental images
• Recommended techniques
• Types of examinations
• Digital sensor issues
• Patient and equipment preparations
• Patient management