2. Growth and Development Flashcards
Jaw relationship at birth (3)
Gum pads widely separated anteriorly
Tongue resting on lower gum pad
Tongue in contact with lower lip
Characteristics of primary dentition (5)
Incisors upright Incisors are spaced Teeth are smaller Reduced overjet Whiter in colour than permanent teeth
Psychology of child development includes (5)
Motor Cognitive Perceptual Language Social
Features of motor development (3)
Predictability of early ‘motor milestones’ suggests that it must be genetically programmed
Completed in infancy – changes following the ability to walk are refinements
Hand-eye coordination gradually becomes more precise and elaborate with increasing experience
Stages of cognitive development (4)
Sensorimotor
Pre-operational thought
Concrete operations
Formal operations
Features of sensorimotor development (2)
Until about 2 years old
Prime object is object permanence
Features of pre-operational though development (4)
2-7 years
Allows child to predict outcomes of behaviour
Facilitated by language development
Egocentric
Unable to understand why areas and volumes remain unchanged even though shape and position may change
Features of concrete operations (4)
7-11 years
Apply logic
Able to see others perspective
Still difficult to think in an abstract manner
Features of formal operations (2)
From 11 years
Logical abstract thinking, therefore different possibilities for an action can be considered
Features of perceptual development (3)
It is difficult to know what babies are experience perceptually
Compared to an adult, a child of 6 will cover less of an object, take in less information and become fixated on details
Selective attention by 7 years
Features of language development (2)
A lack of appropriate stimulation will retard/inhibit a child’s learning, particularly language
A child needs language to be able to think about what he/she sees and hears
Features of language development of a one year old (3)
Understands - vocabulary of 20 words, simple phrases, relates objects to words
Uses - 2-3 words, repetitive babble, tuneful jargon
Sounds - B, D, M
Features of language development of a two year old (3)
Understands - simple commands, questions, joins in action songs
Uses - vocabulary of 100 words, puts two words together, echolalia
Sounds - P, T, K, G, N
Features of language development of a three year old (3)
Understands - prepositions (on, under, etc.), functions of object, simple conversations
Uses - 4-word sentences, what, who, where, relates experiences
Sounds - F, S, L
Features of language development of a four year old (3)
Understands - colours, numbers, tenses, complex instructions
Uses - long grammatical sentences, relates stories
Sounds - V, Z, Ch, J
Types of disorders of speech and language (9)
Learning difficulties Cerebral palsy Autism Delayed speech and language development Head injury Acquired neurological disorders Non-fluency Dysphonia Craniofacial disorders
Features of normal speech (2)
Requires competent airway and articulators
Classified by place, manner and voice
Features of cleft type speech (3)
Resonance
Articulation
Nasal emission
Definition of velopharyngeal incompetence, VPI (2)
Failure of the body’s ability to temporarily close the communication between the nasal cavity and the mouth
Due an anatomic dysfunction of the soft palate or of the lateral or posterior wall of the pharynx
Types of cleft treatment (5)
Feeding Early intervention Input modelling Articulation therapy Communication support
Features of secondary cleft surgery (5)
Nasal revision Fistula closure Pharyngoplasty Alveolar bone graft Osteotomy
Normal development of feeding skills in an infant pre-40wks (2)
28wks - non-nutritive sucking
34wks - nutritive sucking
Normal development of feeding skills in an infant 0-3mths (5)
Normal oral tone Rhythmic sucking Primitive reflexes (gag, rooting, suck/swallow) Semi-reclined feeding position Liquid diet
Normal development of feeding skills in an infant 4-6mths (5)
Head control More control of suck/swallow Munching Move towards semi-solid diet Start babbling
Normal development of feeding skills in an infant 7-9mths (7)
Sitting feeding position Mashed consistency Finger food Upper lip involvement Chewing and bolus formation Bite reflex Mouthing
Normal development of feeding skills in an infant 10-12mths (5)
Lumpy food Sustained bite Active lip closure Chewing - lateralisation Cup drinking
Normal development of feeding skills in an infant 24mths
Mature and integrated feeding pattern
Effect of the family unit (5)
Behaviour contagion
Well-intended but improper preparation
Discuss dental treatment within hearing of the child
Enhancing the child’s anxiety
Threatening the child with dental treatment
Paediatric assessment involves (6)
Pain Past dental history Relevant past medical history Social history Level of understanding and potential cooperation Level of anxiety
Components of behaviour management (3)
Communication
Education
Interaction
Manifestations of anxiety in children (13)
(Related to age sex and social class) Thumb-sucking Nose-picking Nail-biting Clumsiness Stuttering Stomach pain Need to go to toilet Headache Dizziness Fidgeting No speech Clinging to parent Hiding
Paediatric dentistry children influencing factors (6)
Each child’s own psychological make-up
Understanding
Emotional development
Previous adverse dental/medical experience
Attitude and previous experience of family/peer-group
The behaviour of the dentist and wider dental team
Components of good dentist-child communication (4)
Improves the information obtained from the patient
Enables the dentist to communicate information to the patient
Increases the likelihood of patient compliance
Decreases patient anxiety
Components of communication (3)
Verbal (5%)
Paralinguistic (30%)
Non-verbal (65%)
Features of verbal communication (3)
This consists of the actual words the person uses
Try to avoid the use of jargon and specific terms that the patient might not understand
Children are not small adults. The approach and language used with them can be modified to match their abilities and understanding
Features of paralinguistic communication (2)
This refers to the tone of voice used by the individual
Loudness has been one aspect of paralinguistic communication that has been investigated in the dental field with children. It was found issuing commands in a loud voice was more effective than using a normal voice
Features of non-verbal communication (2)
Includes a range of behaviours and environmental factors which we often interpret without conscious awareness
Facial expression, gaze, gesture, bodily contact, spatial awareness, clothes (especially PPE)
Role of dentist in reducing child anxiety (7)
Preventing pain Being friendly and establishing trust and a rapport Working quickly Having a calm manner Giving moral support Being re-assuring about pain Empathy
Examples of increasing fear-related behaviours (5)
Ignoring or denying feelings Inappropriate reassurance Coercing/coaxing Humiliating Losing your patience with the patient
Links between pain and anxiety (2)
Anxious subjects are more likely than non-anxious to report pain
This points to the psychological role in pain perception
Influences of pain perception (6)
Anxiety Previous experience Expectation Anticipation Communication Control
