12/04 Flashcards
1
Q
Cvek pulpotomy
A
partial pulpotomy
2
Q
If pulp exposure larger
A
cervical pulpotomy
- non setting CaOH
- GI
- Comp
3
Q
GI
A
self cure
4
Q
Primary review
A
161
1 week
6 months
1 year
5
Q
Permanent
A
661
6
Q
2 weeks splint
A
SEA
7
Q
Which must require RCT?
A
Avulsion
Intrusion
- survival of pulp is low
8
Q
A
- OH
- chlorohexidine gluconate 0.12% twice daily for 1 week
- brush with soft toothbrush
- soft diet
- analgesia
- no contact sports
- check tetanus immunisation
9
Q
A
- reassurance
- history, any medical issues
- trauma history
- E/O- abuse, no step deformity, haemorrhage
- I/O - no laceration, mobility, transillumination for fracture, SLEUTH
- diagnose
- radiograph?
- emergency tx
10
Q
Complications can you get after trauma of primary teeth?
A
- discolouration
- vitality lost
- delayed exfoliation
- infection
11
Q
Complication of perm tooth
A
- dilaceration
- delayed eruption
- odontoformation
- enamel defect
- ectopic
- arrested development
12
Q
Most common in permanent
A
enamel dentine fracture
13
Q
yellow
A
- ## close monitor
14
Q
pink
A
- cervical root resorption
- RCT
- bleeding of pulp
15
Q
grey
A
- pulp death
- break down of blood product
16
Q
Factors affect diagnosis
A
- time between trauma and tx
- PDL damage
- type of injury
- infection
- stage of root development
17
Q
Follow up of radiograph
A
- absence of PAP
- absence of furcation/ bone loss
- ideal continued root development
- no radiolucency
- no internal/ external R
18
Q
Percussion note
A
dull - root fracture
high metallic - ankylose
19
Q
Apexification vs Apexogenesis
A
Apexification - non- vital, open apex, artificial plug
- MTA, Biodentine
Apexogenesis- vital, allow it to grow
20
Q
On radiograph, how do tell is ERR?
A
- take 2 PA
- root surface will be ragged
- actually RC is still one straight line
- change in position in parallax
21
Q
Tramline
A
- external
- indistinct root surface
Internal
- root surface intact
- tramline not distinct
22
Q
Tx for dilaceration
A
- rule out embedded fragments
- ortho repositioning
- suture
23
Q
SHANARRI
- wellbeing indication
- national practice model
- record information about child
A
GIRFEC - get it right for every children
- safe
- healthy
- active
- nutured
- achieving
- responsible
- respected
- included
24
Q
A
part of GIRFEC
25
Resilience matrix
GIRFEC
26
Steps when you suspect child abuse
- talk with dental team; call parents and set appt times; offer support; set target, monitor progress, keep records
- multidisciplinary team (school nurse, social work, senior colleague, health visitor, GMP, GDP) - pt < 5 yrs who has multiple FTA
- child protection referral; check if child if child is in child protection team, follow up in writing for statement of concern
27
measures you take to prevent child from maltreatment, growing in safe and caring environment and prevent impairement of child
28
Signs of child abuse
- bruising
- bilateral bruising
- bite marks
- burn marks
- hair pulling
- bruised ears
- bruising of different timelines
- tattoo bruising
- slap marks
29
Safety Triangle
- ear
- side of face
- neck
- top of shoulders
30
Intraoral
- tearing of frenum
- lip bruising
- bruising on palate
31
aetiology of child abuse
- drug use
- alcoholic
- mental health
32
Role as a GDP about child abuse
- recognise
- referral
- record
33
Suspicion index of child abuse
- delayed presentation
- previous untreated injury
- delayed in seeking help
- multiple failed attendance
- story doesn't match up
- story vague
- abnormal interraction between child and parent
34
Abnormalities in
- microdontia
- hypodontia (DS, CLP, ectodermal dysplasia)
- macrodontia
- germination fusion
- Hyperdontia (CLP, Gardeners)
- Talon cusp
35
Tooth shape
- dens in dente
- Talon cusp
36
Manage dens- in dente
- seal pit
37
Talon cusp management
- selective grinding
- FV
38
Amelogenesis imperfecta
- congenital
- gene mutation affect enamel ECM molecule including amelogenin, enamalin and KLK4
39
Types of AI
- hypoplastic
- hypomineralise
- hypomaturation
- mixed with taurodontism
40
Consequences of AI
- sensitivity
- poor bonding
- susceptible to caries
41
MIH vs AI
AI - hereditary
MIH - environment
42
Radiographically for Ai
- opacity
43
types of DI
- osteogenesis imperfecta
- afro-african
44
Presentation of DI type 1
- multiple bone fracture
- blue sclera
45
DI radiograph
- obliterated pulp
- bulbous crown
46
if pt comes in with enamel defects?
- family history
- any pregnancy trimester issues/ health
- social (malnutrition)
- if mum took any fluoride supplements
- if its a preborn baby
- any chicken pox/ measles
47
Tx for AI?
- composite veneers
- SSC
- fissure sealant
- metal onlay
- prevention
- ortho to fix openbite
48
SDF
- silver diamine fluoride
- 38% of 44800 ppm
- arrest caries
- block dentinal tubules
- antibacterial
- remineralisation
49
Contraindication
- irreversible pulpitis
- allergy to silver, fluoride and ammonia, iodine
- ulcer
- pregnant
- thyroid gland medication/ therapy if potassium iodide in SDF
- cannot involve pulp
50
Indication
- pre-cooperative pt
- self cleansing
- asymptomatic caries into dentine
- buy time to avoid/ delay GA/ sedation
- buy time for exfoliation
- colophony allergy if cannot use FV
- MIH
51
Disadvantages
- metallic taste
- temporary tattoo if on mucosa
- expensive
- difficult to diagnose
52
Review after SDF
- 2-4 weeks
- repeat if caries is still soft
- restore with hall crown/ GIC
53
Procedure
- vaseline around mucosa
- clean cavity
- gingival mask to isolate
- clean, dry
- apply SDF
- leave for 3 mins
- use cotton pellet to absorb excess
-
54
If pt has asthma
- reversible airway obstruction and bronchospasms
- blue- salbutamol (reliever, short acting b2 agonist)
- brown - prevent, long acting b2 agonist, cortisosteroid, increase candidiasis risk, use spacer, rinse after use
- if hospitalized in last 12 months
- use colophony free FV, ProFluorid
- need to know trigger
- dry mouth, higher caries risk
- erosion from inhaler if they don't rinse
- avoid NSAIDS or Ibuprofen- causes bronchospasm
55
How do you manage asthma attack in hospital setting
- administer 100% O2
- 2 puffs inhaler
- 4 puffs/ min
- call ambulance 999
If unconscious then CPR then call 999
56
Asthma stages
- life threatening: everything goes down
- acute severe asthma: tachycardia, breathing> 25 breaths/ min
57
Haemophilia
X- linked recessive
A - factor 8
B - factor 9
Severe- clotting factor < 1%
Moderate 2-5 %
Mild 6-40%
Carrier >50%
Injection- need to do infiltration, cannot do IDB and Lingual infiltration
- liaise with haemophilia team
- if platelet count more than 100x10'9..., then can treat in GDP, provided FBC in less than 10 days
- hospital more than 50
- neutrophil more than 1, can treat tooth; if less than 1, give AB
58
vWB
autosomal dominant
- lack of vWB factor and f8
59
Autism
- they don't like foaming toothpaste, so give Oranurse
- give like adapted toothbrush if they don't like toothbrush
- quiet environment
- leaflet for them to familiarise with clinic
- ADHD, OCD, Dyslexia, Epilepsy
60
Cerebral palsy
4 types
- spastic: cortex
- ataxic: cerebellum
- dyskinetic: basal ganglia
- mixed
- Bruxism
- thick saliva
- delayed eruption
- caries
- enamel malformation
61
Down syndrome
E/O and I/O features
62
Diabetes type 1 and 2
63
Medical condition related to congenital heart defect
- DS
- Turner- small jaw, malocclusion, high palatal vault
- William syndrome
- Noonan syndrome
- Kabuki syndrome
64
Hutchinson's incisors
- syphillis
-
65
most common oral cancer
acute lymphomablasmic leukaemia
66
Behavioural management
- acclimitisation
- tell show do
- motivational interviewing
-
67
Anxiety vs Dental phobia
dental phobia is avoidance
- behavioural
