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Clinical Knowledge 2 > Assessing the Child Patient > Flashcards

Assessing the Child Patient Flashcards

1
Q

What are the elements of the assessment of dental caries in children?

A
  • parent/carer motivation and responsibility
  • patient history
  • clinical examination
  • caries risk assessment
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2
Q

What are some factors that can contribute to the difficulty in establishing healthy behaviours?

A
  • education, family or social issues
  • indivuduals with differing life priorities
  • complex child care arrangements
  • parent/carers lack of knowledge for the prevention of dental disease
  • children/families with intellectual, medical, metal/physical health or other disabilities
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3
Q

What does the DCby1 stand for?

A

Dental check by 1 years old

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4
Q

What is the aim of the DCby1 initiative?

A
  • get the child to see a clinician as soon as their first teeth come in, before their birthday
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5
Q

What shoulve be included in the revelant medical history of a child?

A
  • CVS
  • CNS
  • Respiratory
  • Drugs/medication
  • allergies
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6
Q

What should be included in the social history of a child?

A
  • number and age of siblings
  • influence of social status
  • distance travelled
  • parental attitude towards dental health
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7
Q

What should be included in the relevant dental history of a child?

A
  • pattern of dental attendance
  • previous dental experience
  • history of fillins/LA/GA
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8
Q

E/O examination of a child should include …

A
  • physical development
  • intellectual development
  • speech
  • hands (dexterity)
  • head and neck (same as adult)
  • how comfortable is the patient in the chair
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9
Q

I/O examination is dependent on cooperation of a child, What should be included?

A
  • soft tissues
  • hard tissues
  • oral hygiene
  • plaque disclosure
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10
Q

What shoud be recorded when reporting the occlusion of a child?

A
  • overjet
  • overbite
  • molar relationships
  • cross bite
  • habit- thumb sucking , dummies
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11
Q

What is the IOTN?

A

Index of orthodontic needs
a screening process for children in mixed dentition phase

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12
Q

What is an overjet?

A
  • how far forward the teeth are
  • horizontal overlap
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13
Q

What is an overbite?

A
  • vertical overlap
  • excessie vertical distance between upper and lower front teeth
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14
Q

What are the characteristics of the O’Leary Plaque index?

A
  • records the presence of plaque on all teeth
  • mesial, distal, buccal, palatal/lingual surfaces discussed
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15
Q

When should you record plaque scores in children?

A
  • at each examination particularly if child is at an increased caries risk
  • on open carious lesions at recall visits for lesions where prevention-alone strategy has previously been selected
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16
Q

What are the possible BPE codes for children 7-11 years old? Why is this?

A

0,1,2

this is because of false pocketing

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17
Q

What are the possible BPE codes for children aged 12-17?

A

full range of BPE codes
0,1,2,3,4,*

permanent teeth have erupted

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18
Q

Who should the the simplified BPE be performed on?

A

patients under 18

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19
Q

What are the index teeth for the simplified BPE?

A

UR6 UR1 UL6
LL6 LL1 LL6

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20
Q

How should the primary dentition be assessed for caries, pain and sepsis?

A
  • diagnose carious lesions
  • assess for pain and sepsis
  • assess the risk of pain and sepsis before exfoliation
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21
Q

How should you deal with arrested caries in a primary tooth and why?

A
  • leave behind
  • reinforce OHI, TB
  • fluoride varnish
  • avoids potential trauma from extraction/restoration of tooth
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22
Q

What is essential for the visual diagnosis of the presence of caries?

A
  • ensure all teeth are clean
  • ensure all teeth are dry
  • well illuminated
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23
Q

What is not an acceptable technique for diagnosis caries in pits and fissures?

A

probing

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24
Q

When is probing an acceptable method of assessing caries activity? Why ?

A

already exposed dentine

helps to establish whether dentine is hard or soft

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25
Q

What does an ICDAS restoration and sealant code of 0 indicate?

A

tooth not restored or sealed

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26
Q

What does an ICDAS restoration and sealant code of 1 indicate?

A

partial sealant

27
Q

What does an ICDAS restoration and sealant code of 2 indicate?

A

full sealant

28
Q

What does an ICDAS restoration and sealant code of 3 indicate?

A

tooth coloured restoration

29
Q

What does an ICDAS restoration and sealant code of 4 indicate?

A

amalgam restoration

30
Q

What does an ICDAS restoration and sealant code of 5 indicate?

A

stainless steel crown

31
Q

What does an ICDAS restoration and sealant code of 6 indicate?

A

porcelain, gold, PFM, crwon or veneer

32
Q

What does an ICDAS restoration and sealant code of 7 indicate?

A

lost or broken restoration

33
Q

What does an ICDAS restoration and sealant code of 8 indicate?

A

temporary restoration

34
Q

What does an ICDAS caries surface code of 0 indicate?

A

sound tooth surface

35
Q

What does an ICDAS caries surface code of 1 indicate?

A

first visual change of enamel

36
Q

What does an ICDAS caries surface code of 2 indicate?

A

distinct visual change of enamel

37
Q

What does an ICDAS caries surface code of 3 indicate?

A

enamel breakdown, no dentine visible

38
Q

What does an ICDAS caries surface code of 4 indicate?

A

underlying dentinall shadow (not cavitated into dentine)

39
Q

What does an ICDAS caries surface code of 5 indicate?

A

distinct cavity with visible dentine

40
Q

What does an ICDAS caries surface code of 6 indicate?

A

extensive distincy cavity with visible dentine

41
Q

What does an ICDAS score of 97 indicate?

A

tooth extracted as a result of caries

42
Q

What does an ICDAS score of 98 indicate?

A

tooth missing for other reason

43
Q

What does an ICDAS score of 99 indicate?

A

unerupted

44
Q

What does an ICDAS score of P indicate?

A

implant

45
Q

When should you start taking bitewings of children and why?

A

from the age of 4
this is when they have started developing contacts in their primary dentition

46
Q

Why should bitewing radiographs be used as an adjunct to diagnosisng caries in children aged 4 and above?

A

broad contact points of primary dentition make approximal caried difficult to see in clinical examination alonw

47
Q

When is there a valid reason/justification for not taking radiographs? What must you do in this case?

A

if you are able to assess proximal surfaces clinically

you must record this justification in the notes

48
Q

What equipment can you use for taking a bitewing in a child?

A

F speed, size 0 film
film holder
adhesive tabs (less compliant children)

49
Q

What is the size of a size 0 film?

A

22mm x 35mm

50
Q

What is the disadvantage of using an adhesive tab ? What is the alternative in this case?

A

more overlaps present
makes it difficult to assess proximal lesions

may opt for an OPT instead

51
Q

What are the treatment options for dental sepsis in a child?

A
  • extraction
  • pulp therapy if possible
  • in exceptional circumstanded, monitor asymptomatic dental sepsis for up to 3 months while the child is acclimatised to the dental environment
52
Q

What are the indications of established dental sepsis?

A
  • interradicular radiolucency
  • tenderness to percussion of a non-exfoliating tooth
  • alveolar tenderness, sinus/swelling
  • non- physiological mobility
53
Q

What is a sinus?

A

this is where there is pus exiting the soft tissue
An indication of dental sepsis

54
Q

How can you assess the risk of pain or sepsis developing before exfoliation?

A
  • extent of a lesion
  • site of lesion (interproximal where biofilm removal is difficult?)
  • activity of lesion
  • time of exfoliation- how long will it take before exfoliation
  • number of other lesions present in dentition
  • anticipated cooperation of child now and in the future
  • anticipared cooperation of parent/carer with preventive measures
  • range of clinical procedures the clinician is able or willing to provide
  • medical status child- taking medications containing sugars?
55
Q

In a case where there is clinically evident signs and symptoms of pain or sepsis but it is likely for exfoliation without further issues, what is the management strategy to be employed?

A

closely monitor patient
patient is given **enhanced prevention **

56
Q

Give an example of an enhanced prevention technique?

A

modification of carious lesion to be self cleansing. Flouride more able to get into lesion, less likely to progress

57
Q

What is the caries risk a deciding factor for?

A

recall and bitewing interval

58
Q

What are the evidence based indicators of a child being at increased risk of developing caries within the next 3 years?

A
  • previous caries experience- DMFT
  • resident in area of deprivation- home postcode
  • healthcare workers opinion- referal from health visitor, public health nurse, dental health support worker who has identified need for additional preventive care
59
Q

What are the 3 caries prevention interventions we do for all patients, including those of low risk?

A
  • check diet
  • OHI- TB technique
  • topical fluoride
60
Q

What component of fluoride varnish carries a risk of allergy development?

A

colophony

61
Q

What is the concentration of fluoride in fluoride varnish?

A

22 600 ppm
2.26% NaF

62
Q

How often should fluoride varnish be applied for low risk children?

A

every 2 years

63
Q

Outline a comprehensive oral health assessment/focussed oral health review

A
  • assessment of patient history- MH,SH,DH, anxiety
  • assessment of oral health status- H/N, I/O, periodontal
  • diagnosis and risk assessment- from diagnosis, assess risk information
  • personal care plan

Clinical Knowledge 2 (40 decks)

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