Page 54 - e-book สถาบันทันตกรรม
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ผังแนวทางวางแผนการรักษาทางทันตกรรมในผูปวยที่มีภาวะสมองเสื่อม (ดัดแปลงมาจาก Ettinger et al.2000) Dementia patient
Edentulous Evaluation of oral health-candida
Dry mouth-saliva substitute
Denture treatment - new/reline/remake
Palliative care-tissue conditioner
Conscious
Comatose
Lip moistened / Lubricated clean mouth / tongue Emergency treatment only
Patient / Family / Caregiver seeks care
Dental problem
Asymptomatic
Symptomatic
Assessment of dependency
Level of co-operation
Physical / chemical restraint
Frail
Functionally independent
Level of cognitive impairment
Functionally dependent
Able benefit from treatment
Unable benefit from treatment
No treatment
No restraint
General anesthesia
Level of physical impairment
Yes
No
Able to maintain hygiene or with help
Risk / benefit of treatment
Low / high
Unable to maintain hygiene Are teeth value ?
Can person use denture ?
No treatment
Informed consent
Possible by individual
High / low
No treatment
Rational dental care
Possible by significant other
Professional consent Consent not possible
Rehabilitative & constructive, comprehensive care
Maintenance & monitoring Limited treatment
Emergency care
Pain and infection control only
No treatment
