5 - Infant Oral Health Flashcards
What problems can arise from having natal teeth?
- Potential for nursing difficulty
- Potential for aspiration
- Potential for traumatic ulcer of the ventral surface of the tongue (Riga-Fede)
- Potential for trauma to the mucosa of the opposing arch
Where do most natal teeth appear?
Mandibular anterior incisor region. More than half the time they occur in pairs.
When would you extract a natal tooth?
- Risk of aspiration
- Does not have functional integrity
- Problem for the child in nursing
- Are supernumerary teeth
No literature describes the risk of aspiration of natal teeth, so removal should be based primarily on the appearance, firmness, and likelihood of function of the tooth.
What is the probability that natal teeth are members of the normal complement of primary teeth?
There is an overwhelming probability that a natal or neonatal tooth is one of the normal primary teeth. Fewer than 10% in most surveys are supernumeraries.
What is the difference between a natal and neonatal tooth?
Natal tooth - tooth present at birth
Neonatal tooth - tooth that erupts after birth within the first 30 days of life
What are the differential diagnoses for a natal tooth?
- Keratin-filled body such as a Bohn’s nodule or a mucus retention cyst.
What is the significance of a nut allergy?
Possible cross reactivity of various substances in patients with nut allergy, including some kinds of fluoride varnish.
What foods account for 90% of food allergies?
Cow’s milk, hen’s eggs, soy, peanuts, tree nuts, wheat, fish and shellfish.
What food allergies do children often outgrow and which food allergies are not outgrown and are lifelong problems?
Food allergies that children often outgrow - milk, soy, egg and wheat allergies.
Food allergies that are not outgrown and are lifelong problems - nuts and shellfish.
What are the drug treatments for GERD?
- Acid-neutralizers (milk of magnesia)
- Histamine-2 blockers (ranitidine/Zantac)
- Prokinetic agents (cisapride/Propulsid)
- Proton pump inhibitors (omeprazole/Prilosec)
What are the soft tissue complications of GERD?
Chronic laryngitis, laryngeal ulcers, chronic sore throat.
What are clinical risk factors believed to be indicative of an elevated susceptibility to dental caries?
- Poorly formed teeth or teeth with deep pits and fissures
- Existing dental caries including white spot lesions or decalcification
- Plaque on teeth
What are some alternatives to a night time bottle that can be offered to parents trying to break their child of a bedtime habit?
- Substitute water or gradually dilute the contents of the bottle over several nights with water.
- Clean the teeth well and take the bottle away when the child falls asleep.
- A pacifier or other object can be substituted for the bottle.
- The parent can read or rock the child to sleep.
For carious lesions how deep can you do ITR?
Carious lesions suited for ITR should be confined to dentin with sound enamel margins and no pulpal involvement.
What are some characteristics of fluoride varnish that make it superior to traditional gels and foams for use in a child?
Current fluoride varnish formulations:
- Taste good
- Tooth colored
- High concentration of fluoride
- Stay on the teeth longer
- Do not require a prolonged period of time without drinking as do other formulations
The effectiveness of fluoride varnish is well established, while the use of foams or gels in brush-on regimens enjoys little scientific support.
What recordkeeping entries are recommended when using protective stabilization for a child for dental treatment?
The operator should record:
- Reason for its use
- Additional consent provided by parents
- Type of stabilization
- How long it was used and any side effects and its efficacy
What is the dietary pattern that is considered normal for a child from six months to twelve months?
- A child may be breast or bottle fed into six months of age.
- In the next six months, breastfeeding may be stopped or continued, depending on the needs and wishes of the mother and child. Some solid food is introduced in this period as well and bottle feeding ends with a transition to a cup at meal times.
- At 12 months, the child should be feeding himself and drinking from a cup on a trial basis since the process is initially messy.
When are most oral habits lost?
Most habits are lost by the third year of life.
What are the four characteristics of Tetralogy of Fallot?
- Overriding aorta
- VSD
- Pulmonary stenosis
- Right ventricular hypertrophy
What are tet spells in Tetralogy of Fallot?
Transient and often unpredictable episodes of respiratory difficulty that can be life threatening.
What are the oral findings in Down Syndrome?
- Mouth breathers/open mouth
- Relative mandibular prognathism
- Small, conical and missing teeth
- Retained primary teeth
- Large and protruding tongue
- Small maxilla (hypoplastic maxilla)
- Precious periodontal disease
What questions need to be asked for a patient who has a severe cardiac disease?
- Description and name of the condition
- Previous treatment
- Cardiologist contact
- Limitations and other morbidity
- Medications the patient takes and the frequency
What are the cardiac conditions requiring infective endocarditis prophylaxis?
The AHA considers:
High risk:
- Prosthetic valves
- Previous infective endocarditis
- Complex cyanotic heart disease
- Surgically constructed shunts and conduits
Moderate risk:
- Acquired valvular dysfunction
- Hypertrophic cardiomyopathy
- Mitral valve prolapse with regurgitation
What are the considerations for radiographic examination?
- Cooperation
- Number and placement of teeth present
- Contacts between teeth
- Existing disease
What are the three categories of information used to make a caries risk assessment as defined by the AAPD?
- History
- Clinical evaluation
- Supplemental professional assessment
