33. Pediatric Dentistry Flashcards
BQ: how many teeth erupted at 16 months old?
12 teeth
MEMORIZE RULE OF 4
Teeth present immediately after birth
Natal teeth
Danger of natal teeth
Tx = ?
Mandible is hypocalcified so natal teeth (mn incisor) is mobile.
Danger of ASPIRATION!!!
Tx: EXO
Teeth present within the “first 30 days” after birth
Neonatal teeth
Same with natal: dangerous
BQ: Tetracycline staining can affect a child’s teeth until what age?
8 years
BQ: What stage in nolla’s is the “START OF TOOTH ERUPTION”
Stage 6
Any deciduous tooth extracted PRIOR to stage 6 will result to:
Delayed eruption
Any deciduous tooth extracted AFTER or DURING stage 6 will result to:
Rapid extraction
BQ: Stage of nolla’s wherein “TOOTH IS SEEN CLINICALLY”
Stage 8 = 2/3 root completed
BQ: ✨
- Doesn’t resemble any teeth= UNIQUE 👏🏻
- POT BELLY app 🐷
- no Central fossa ❌
- BIG Mb cervical ridge = Pot belly 🐷
- Rounded and short DISTAL “D = ) “
- Flat and Long MESIAL
Primary mandibular 1st molar / Lower D ✨🐷
BQ: ONLY ANTERIOR teeth that has a greater width that height
Primary maxillary cental incisors
BQ: how many lobes does peg shaped laterals have??
1 to 2 lobes
Go for 1!!!!
How many lobes in Mx 1st molars?
5 lobes
Largest cusp of Mx 1st Molar?
MLi cusp
All PMs = 4 lobes ; EXCEPT:
Mn 2nd PM = 5 lobes
All anterior teeth: how many lobes?
4 lobes
of lobes of 2nd molars
4 lobes
Mother is center of his world
2 yrs old
Big talker
Brief attention span
4 yrs old
Loves to learn new things
Likes to dramatize things
8 y/o
Increase interest in appearance
12 y/o
Management for 2y/o
Knee to knee position
Management for 4y/o
Distraction
Management for 8y/o
Tell show do
BQ: First dental visit
Before 1st tooth erupts (before 6mos)
Or no later than 1st bday
First tooth brush:
First tooth erupts
First flossing:
When 2 teeth are touching
lesions that appear in newborns:
Epstein pearls - yellow white seen in palatal or gingiva
Bohn’s nodules
BQ: Whitish cyst seen in gingiva of newborn
Bohn’s nodules (newBOHNS)
Type of px pag may overcritical parents (naghahanap ng mali)
Timid shy bashful
Type of px pag may overprotective parents
Defiant
Spoiled brat
Incorrigible : hindi naccorrect!
Least ideal type of px
Fearful
Types of pxs for SEDATION
Px with syndromes
Fearful
Incorrigible
BQ: Child hides at the back of parent
Frankl behavioral rating scale = sa boards mga situations!
F1 = no tx!!
Definitely negative
Shows negative attitude but not pronounced
✅ Tx but Defiant (nagwawala)
F2 - negative
Likes and accepts the tx but CAUTIOUS (asks kung ano yan, para san yan)
F3 - positive
Laughing and enjoying the situation
F4 - def positive
Verbal praises or toys after tx
Positive reinforcement
Used for pxs who can understand but is defiant
❌ not for HANDICAPPED and VERY YOUNG children
Aversive technique or HOM
BQ: before any procedure ask for
Parents consent
BQ: Protective stabilization used for pedo pxs with cerebral palsy
Velcro straps
Protective stabilizations
Papoose board
Velcro straps
Most common route for sedation of Pedia
Oral route
Most common drug for sedation of pedia
Chloral hydrate
BQ: Nitrous oxide produces only:
ANALGESIA ONLY
With minimal sedation
Most common adverse effect of nitrous oxide
Nausea
Another is: hypoxia
After administration of nitrous oxide give:
100% oxygen
Administering conc of N2O2
70% n2o2
30% o2
Maintaining conc of N2O2:
30% n2o2
70% o2
Type of play: no peer inv
Solitary
Type of play: observing others play
On looking
Type of play: play act along side pero wlang pansinan
Parallel play
Type of play: with interaction
Associative play
Type of play: highest form of play (w/ roles: doctor engr etc)
Cooperative
Tetralogy of dental caries:
Diet - high sucrose!
Host - tooth
Time - freq and duration
Microorganism - s mutans
which is more impt in dental caries: frequency or duration?
Frequency
Which is more impt in THUMBSUCKING: frequency or duration?
Duration
Responsible for demineralization
Lactic acid!!
Lactic acid is a byproduct of
Anaerobic glycolysis
(Breakdown of glucose= 2atp and 2 pyruvate
PYRUVATE: goes to anaerobic glycolysis kasi wala naman mitochondria ung bacteria hindi sya pwde sa aerobic glycolysis. End product ng anaerobic = lactic acid)
BQ: When you put PFS on top of caries: will it progress or arrest?
Arrest!!!
BQ: What is the first bacteria to colonize the mouth after birthv
Strep salivarius
BQ: most numerous microorganism
“Streptococcus”
BQ: ph of saliva
6.2 to 7.0 (weak acid) = remineralization ✅
BQ: initial sign of dental caries
White spots or incipient caries
- reversible by fluoride app
BQ: Critical ph for demineralization
5.5 to 5.7
BQ: What tooth mineral is affected first when there is active caries
A. Calcium
B. Phosphate
C. Carbonate
Carbonate!!!!!
Reversible with fluoride
Most effective way of fluoride therapy:
Systemic or FLUORIDATION
Sa water
Fluoride therapy by dentist
Fluoridization - dentiZt
BQ: 2 y/o px : < 0.3ppm fluoride conc: What is the supplemental fluoride recommendation??
0.25mg
6mos to 3yrs = 0.25mg supp if <0.3ppm
Maximum absorption of fluoride is upto what age
16y/o
BQ: Optimal fluoride recommendation in the Philippines
A. 0.6 - 0.7
B. 0.7 - 0.8
C. 1.0 - 1.2
D. 1.2 -1.5
0.7 - 0.8
BQ: Fluoride can inhibit what enzymes?
Phosphatase
Enolase (enzyme for lactic acid formation)
BQ: Where is the site of excretion of Fluoride?
Kidneys
BQ: What is the optimal fluoride concentration for public water?
0.7-1.2ppm
Hot/cold
BQ: determines optimal fluoride concentration
Temperature / Climate
Hot = ⬇️
Cold = ⬆️
BQ: Topical fluoride will NOT CAUSE FLUOROSIS ❌ only SYSTEMIC will.
Topical fluoride = ❌ fluorosis
Systemic = ✅ fluorosis
BQ: Fluorosis
A. Pandemic
B. Endemic
C. Epidemic
Endemic!!! Localized
BQ: What tooth surfaces benefit the most in fluoride therapy
Proximal and smooth surfaces
BQ: Fluoride converts HYDROXYAPATITE crystals into
Fluoroapatite (more resistant to acid)
Tooth paste contains how many ppm of fluoride
1,100ppm
BQ: Conc of fluoride in fluoride varnish
5% NaF
Conc of NaF
2-5% NaF
Conc of Acidulated Phosphate Fluoride or APF
- uses polystyrene tray
- not allowed to eat for 30mins
1.23%
Conc of Stannous fluoride
- least used because has BROWN discoloration
8%
ph of NaF
9.2 NaF
Ph of APF
3-3.5 APF
pH of SnF
2.1-2.3 SnF
Adult lethal dose of Fluoride
4-5g
Child lethal dose of fluoride
15mg/kg
Tx for fluoride toxicity
Boards go for: MILK OF MAGNESIA
- Syrup of ipecac
BQ: Computing childs dosage: uses WEIGHT
Clarks rule
Formula of clark’s rule
CHILD DOSE = WEIGHT in lbs / 150
BQ: uses AGE in computing for childs dosage
YOUNG’S rule
Formula for Young’s rule
CHILD DOSE = AGE / AGE+12
BQ: for infants dosage
Fried’s rule
Formula for Fried’s rule or inFant dose
Infant dose = age in mos / 150
Paracetamol
mkd:
mg/ml:
Paracetamol
mkd: 10-15
mg/ml: 120/5
Amox
mkd:
mg/ml:
Amox
mkd: 20-40
mg/ml: 250/5ml / 3 dose
Clindamycin
mkd:
mg/ml:
Clindamycin
mkd: 10-25
mg/ml: 250/5ml / 3-4 doses
Yellow teeth; hypersensitivity
Amelogenesis imperfecta
BQ: Type of amelogenesis imperfecta characterized by dec # of cells; pitted appearance
Enamel hypoplasia
BQ: Type of amelogenesis imperfecta characterized by soft enamel
Enamel hypocalcification
Gray brown teeth
Dentinogenesis imperfecta
Most common type of dentinogenesis imperfecta
Type II / Hereditary Opalescent dentin
Type III dentinogenesis imperfecta is aka
Brandy wine
BQ: Pattern of Early childhood caries
Cervical of Mx incisors
mx post
Mn post
Mn incisors
Punched out erosions covered by gray pseudomembrane
NUG/Trench mouth/ vincents dse
Causative agent of NUG
FuPS
Assoc with class III Mx def
Achondroplasia
Downs syndrome
Assoc with skeletal class III
Gigantism
Acromegaly
BQ: “diff in eating”
Primary herpetic gingivostomatitis
Causative agent of Primary herpetic gingivostomatitis
HSV-1 (dormant in CN V)
What do you call the secondary infection of HSV-1
Herpes labiais or cold sores
BQ: Painful ulcers in the posterior of oral cavity: soft palate, pharyn
Herpangina
BQ: Coxsackie A virus causes what diseases
Herpangina
Hand foot mouth dse
BQ: Summer illness
Herpangina
BQ: Type of apthous ulcer assoc with scarring
Major
Frequent recurrences of ulcers should be screened for
DM and BEHCET’S SYNDROME
Diabetes mellitus triad
Polydipsia
Polyphagia
Polyuria
BQ: Px with “inguinal and EYE ULCERS” (—generalized blood vessel inflammation)
Behcet’s syndrome
Cleft of hard palate
Uranoschisis
Celft of soft palate
Staphyloschisis
Rule of 10 for cleft LIP
10wks
10lbs
10gm/dL of Hb
>10,000 wbc
BQ: Needs love and affection
Down’s syndrome
BQ: Diseases assoc with DELAYED ERUPTION (sa boards:except)
Downs syndrome Cretinism (hypothy in children) Hypothyroidism Hypopituitarism Gingival fibromatosis
BQ: Resto matl for Down’s
A. Gold
B. Amalgam
C. Composite
D. GI
A. gold
BQ: Clinical sign “FEW TEETH”
Cleidocranial dysplasia
Lining of eruption cyst
Syratified squamous
Whitish gingival cyst of newborns
Bohn’s nodules
Indicated for vital tooth with provoked pain
—1.8mm of dentin thickness bet pulp and carious lesion
—root resorbed not >/= to 2/3 of deciduous
Pulpotomy
BQ: medicament for pulpo of deciduous tooth
—-Not for younf perm teeth bec open apex
Formocresol
BQ: Medicament for pulpo of permanent tooth
—-not for deciduous: can cause INTERNAL ROOT RESORPTION
Calcium hydroxide pulpo
BQ: Other name for Internal root resorption
Pink tooth of mummery
Other term for open apex
Blunderbuss apex
BQ: Partial pulpotomy
Cvek pulpotomy
Indicated for infected pulp with SPONTANEOUS PAIN/ NOCTURNAL PAIN or for NON VITAL with PERIRADICULAR PAIN
Pulpectomy
BQ: matl used for obturation (pulpec)
Zoe
Tx: primary symptomatic provoked
Pulpo
Tx: primary symp spontaneous
Pulpec
Tx: primary asymp
Observe
Tx: primary loosening or displacement
Observe
Tx: primary avulsion
No tx! DO NOT REIMPLANT
Tx: permanent loosening or displacement
Reposition and stabilize for 2weeks
Tx: permanent avulsion
Reimplant with in 30mins and stabilize for 2wks
Avulsed tooth can be stored in
Hanks soln or NSS
Milk
Saliva
Complication of avulsion
Rejection
Elli’s classification of tooth trauma: ENAMEL
Type I
Elli’s: DENTIN
Type II
Elli’s: Exposed pulp
Type III
Elli’s: non vital or without loss of crown
Ellis IV
Elli’s: Tooth loss-trauma
Ellis V
BQ: Elli’s: root fracture
Ellis VI
Ellis: displacement
Ellis VII
Elli’s: LOSS OF CROWN
Ellis VIII
Ellis: deciduous teeth
Ellis IX
What is More common in Primary anterior teeth
Fracture or Displacement?
Displacement (most common intrusion)
What is More common in Permanent anterior teeth
Fracture or Displacement?
Fracture
Chemically induced root formation indicated for NON VITAL young PERMANENT teeth with OPEN APEX
Apexification
CaOH/MTA stimulates what embryonic structure to close apex
HERS
Principa content of MTA
Portland cement
+ gypsum and bismuth
Physiologic development of APEX
Apexogenesis
Direct pulp cap
CaOH
Indirect pulp cap
GI
Finish line in ant strip of crown
Featheredge finish line
Ant SOC labial and prox reduction
1mm
Incisal reduction in SOC
1-1.5
Lingual red in SOC
0.5
BQ: Overall reduction size in SSC
1.5mm
Finish line of SSC
1mm subgingival featheredge
