why won’t he sit still?…because he can’t! - a study on adhd
DESCRIPTION
Ever wonder why some of our young patients just can’t sit still in the dental chair, or focus on what we are saying, or just brush their teeth daily like we remind them every time we see them? There may not be a simple answer to these questions if that said child has AD/HD or another comorbid disorder. This course educates the dental professional on AD/HD and provides the tools necessary to ensure a pleasant experience for these patients in the dental environment.TRANSCRIPT
Smiles Across America Webinar Series
Date: 03/29/2016
Why Won’t He Sit
Still?…Because He Can’t!
/Oral Health America @Smile4Health
Connect with OHA!
/Oral Health America @Smile4Health
HOUSEKEEPING INFORMATION
• Please remember to MUTE your phone.
• Questions are welcome! We’ll allow 10-15 minutes after the presentation for questions.• Questions will be accepted in writing through the control
panel on the upper right hand of your screen.
• Submit questions at any time; we will address them at the end of the presentation.
• Webinar is being recorded; for rebroadcast on OHA’s website – OralHealthAmerica.org
• Your feedback is important to us. Please take our brief webinar evaluation after this session; link will be sent via email.
CE Credit Available
OUR MISSION
Oral Health America’s mission is to change lives by
connecting communities
with resources to drive access to care, increase
health literacy, and advocate for policies that
improve overall health through better oral health for
all Americans, especially those most vulnerable.
OHA PRIORITIES
ADVOCACYHEALTH
LITERACYACCESS
OHA’s Programs and Campaigns are designed to improve
access to care, oral health literacy and policies that
prioritize the impact of oral health on the overall health of all
Americans – particularly those most vulnerable.
Campaigns for Oral Health Equity
Educate the public, including policy makers, about the importance of oral health for overall health
Emphasize the need to prioritize oral disease alongside other serious health conditions
Advocate for policies that positively impact programs and stakeholders
Current campaigns include:
toothwisdom.org Demonstration
Projects
Professional
Symposia
Advocacy Health Education &
Communications
Technical Assistance
Product Donation
Grant Funding
Why Won’t He Won’t Sit Still? …… Because He Can’t!
Working Effectively with AD/HD in the Dental Office
Lisa Dowst-Mayo, RDH, BSDH
Pursuing Masters of Healthcare Administration
Ohio University
Class Clown!
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FIVE PRIMARY PROBLEMS
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THREE TYPES
1.
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2.
1902
1970
1987
USA 5-8% (2.5 million)
Japan 7%
China 6-8%
New Zealand 7%
AD/HD PREVALENCE
Parents will spend 2x amount of money raising a
child with AD/HD
If not graduate high school = Economist’s
estimate cost to society = $370,000-$450,000
AD/HD COSTS
Defiant behavior leads to Resentment by other siblingsTurbulent family life Frequent school punishments ↑ Risk for early substance abuse
AD/HD UNTREATED/UNDIAGNOSED
30-50% Repeat a grade @ least 1x
35% Fail to graduate high school
60% Failed social relationships
AD/HD Driving Stats
30% engaged in theft
40% substance use
20% set serious fires in their communities
25% expelled from high school
↑ Teen pregnancy rates
↑ STD rates
AD/HD TEENS
www.chadd.org
CHADD
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1. HEREDITARY DISORDER
2 Genes associated with AD/HD
1. D4RD Related to personality dimension known as
novelty seeking
2. DAT1 Regulates dopamine activity in the brain Influences how quickly dopamine is removed from
the synapse Dopamine affects emotion, perception,
movement
1. HEREDITARY DISORDER
Frontal-Orbital Responsible for inhibiting behavior, sustaining
attention, employing self-control, planning for the future
Leads to deficient catecholamine's (dopamine, norepi) Why medications are effective
2. Abnormal Brain Development
ANS catecholamine
Disturbances w/ dopamine signaling systems
Spinal samples shown decreased levels
3. Dopamine Levels in Brain
Source: www.drugabuse.gov
DSM-V
MD / Pediatrician
Psychiatrists
Clinical Psychologists
Clinical Social Workers
Neurologists
PROFESSIONALS WHO DIAGNOSE
COMPREHENSIVE EVALUATION
Needs to take place before an official diagnosis is made
Variety of sources Child needs to meet ALL DSM-5 criteria
www.wordpress.com
MULTIMODAL APPROACH Recommended way to manage AD/HD
Involves parents, professionals, child educators,
management techniques, medication, school
accommodations
“Treatment should be tailored to the unique
needs of each child and family.” (CHADD website)
NOT recommended as sole tx
Best if parents are only going to utilize 1 tx
option
1/6-1/2 ADHD patients
2 classes 1. Stimulant2. Non-Stimulant
70-90% show improvement
MEDICATIONS
MEDICATIONS
Proprietary Name Generic Name Type
Adderall Amphetamine/Dextroamphetamine Stimulant
Concerta Methylphenidate Stimulant
Daytrana Methylphenidate patch Stimulant
Dexedrine Dextroamphetamine Stimulant
Dectrostat Dextroamphetamine Stimulant
Focalin Dexmethylphenidate Stimulant
Metadate Methylphenidate Stimulant
Methylin Methylphenidate hydrochloride Stimulant
Ritalin Methylphenidate Stimulant
Straterra Atomoxetine Non-Stimulant
Vyvanse Lisdexamfetamine Stimulant
www.sodahead.com
PRIOR TO APPT
GREETING
COMMUNICATION
β
ORAL HYGIENE
PAIN TOLERANCE
Question and Answer Session
• Questions are welcome! This session may last for 10-15 minutes.
• Write your questions in your control panel on the upper right hand of your screen.
• Submit questions at any time.
CE Credit Available