BDS3

Question 1

What are the 3 main types of cerebral palsy?

Answer 1

Spastic
Ataxic
Dyskinetic

Question 2

What is spastic cerebral palsy?
What part of the brain is affected?

Answer 2

Increase in muscle tone so the muscles are stiff, making movements more awkward
Diplegia- only in legs
Hemiplagia- affects one half of the body
Quadriplegia- affects all 4 limbs, patient cannot walk
The cortex is affected

Question 3

What is ataxic cerebral palsy?
What part of the brain is affected?

Answer 3

Problems with coordination and balance
Unsteady when they walk and have trouble controlling movements
The cerebellum is affected

Question 4

What is dyskinetic cerebral palsy?

Answer 4

Problems controlling movements of their hands, arms, feet and legs making it difficult to sit or walk
Movements are uncontrollable, can be slow and writhing or rapid and jerky
The basal ganglia is affected

Question 5

What are the oral manifestations of leukaemia?

Answer 5

Gingival swelling
Ulceration
Spontaneous bleeding
Candidosis
Unusual mobility

Question 6

What does the primary level of haemostasis involve?

Answer 6

Vasoconstriction after injury
Platelet plug formation

Question 7

What is Von Willebrand’s Disease?

Answer 7

Inherited deficiency of von willebrand’s factor

Question 8

How does Von Willebrand’s Factor act?

Answer 8

Mediates platelet aggregation
Mediates platelet adhesion
Carrier of Factor VIII

Question 9

What is child protection?

Answer 9

Activity undertaken to protect specific children who are suffering, or at risk of suffering significant harm

Question 10

What are ‘Children in Need’?

Answer 10

Those who require additional support or services to achieve their full potential

Question 11

What does safeguarding children include?

Answer 11

Measures taken to minimise the risks of harm to children
This includes;
-protecting children from maltreatment
-preventing impairment of children’s health or development
-ensuring that children are growing up in a safe and caring environment

Question 12

What is child abuse and neglect?

Answer 12

Anything which those entrusted with care of children do, or fail to do, which damages their prospects of safe and healthy development into adulthood

Question 13

What is the definition of child abuse?

Answer 13

3 elements all must be present
-significant harm to the child
-carer has some responsibility for that harm
-significant connection between carer’s responsibility for child and harm to child

Question 14

What guidance in Scotland is for child safety?

Answer 14

Children and Young People’s Act 2014
Getting It Right for Every Child (GIRFEC)
National guidance for child protection in Scotland 2014

Question 15

What are the 3 main concerns when it comes to parenting capacity?

Answer 15

Domestic violence
Drug and alcohol misuse
Mental health problems

Question 16

What types of child abuse are there?

Answer 16

Physical
Emotional
Neglect
Sexual

Question 17

What is dental neglect?

Answer 17

Wilful failure of a parent or guardian to seek and follow through with treatment necessary to ensure a level of oral health essential for adequate function and freedom from pain or infection
Persistent failure to meet a child’s basic oral health needs, likely to result in the serious impairment of a child’s oral health or general health or development

Question 18

What are the 3 stages for managing dental neglect?

Answer 18

Preventive dental team management
Preventive multi-agency management
Child protection referral

Question 19

What is a preventive dental team management approach?

Answer 19

Raise concerns with parents, offer support, set targets, keep records and monitor progress

Question 20

What is a preventive multi-agency management approach?

Answer 20

Liaise with other professionals to see if concerns are shared
Check if child is subject to a child protection plan

Question 21

What is a child protection referral?

Answer 21

Used in complex or deteriorating situations
Referral is to social services
-usually by telephone followed up in writing

Question 22

What can create an index of suspicion that a child is being abused?

Answer 22

Delay in seeking help
Story is vague
Account not compatible with injury
Parents mood abnormal
History of previous injury
History of violence within the family

Question 23

What % of injuries are on the head and neck in abuse cases?

Answer 23

approx 60%

Question 24

What should be carried out by the dentist prior to a child starting cancer treatments?

Answer 24

All infections should be removed
Optimal oral hygiene is important to minimise the risk of mucositis and decrease the risk of oral infections

Question 25

What are congenital heart defects?
What are they classified as?

Answer 25

A problem with the structure of the heart that is present at birth
Cyanotic- deoxygenated blood able to enter to systemic circulation
Acyanotic- normal levels of oxyhaemoglobin in the systemic circulation

Question 26

What are the dental implications in individuals with congenital heart defects?

Answer 26

Medications that increase bleeding tendency; warfarin or aspirin
Higher risk of GA
Caution when using adrenaline containing LA
Increased risk of enamel hypoplasia
Risk of infective endocarditis

Question 27

What is pulp canal obliteration?

Answer 27

Response of a vital pulp to a traumatic dental injury
Progressive hard tissue formation within pulp cavity
Gradual narrowing of pulp chamber and pulp canal- total or partial obliteration of these spaces
Affected tooth can appear opaque or slightly yellow

Question 28

What are the external root resorption types?

Answer 28

Surface
External infection related inflammatory root resorption
Cervical
Ankylosis related replacement root resorption

Question 29

What are the internal root resorption types?

Answer 29

Internal infection related inflammatory root resorption

Question 30

What is external surface resorption?

Answer 30

Superficial resorption repaired with new cementum
Response to a localised injury
Not progressive

Question 31

What is external infection related inflammatory root resorption?
How is it initiated?
Management?

Answer 31

Non-vital tooth with infected pulp canals
Initiated by PDL damage (propagated by infected root canal toxins reaching the external root surface through dentinal tubules)
Progress can be extremely aggressive
Management
-remove the stimulus
-endodontic treatment with non-setting calcium hydroxide for 4-6 weeks before obturation

Question 32

What is cervical resorption?
How is it initiated?

Answer 32

An unusual form of external infection related inflammatory root resorption
Initiated by damage to the root surface in the cervical region
It is propagated by infected root canal contents or the periodontal microflora

Question 33

What is ankylosis related inflammatory root resorption?
Treatment?

Answer 33

Initiated by severe damage to the PDL and cementum and normal repair does not occur
Root is involved in remodelling and is replaced by bone
Radiographically
–ragged root outline with no obvious PDL space separating it from the surrounding bone
There is no effective treatment, but you should plan for loss even though it may be many years later

Question 34

What is Internal Infection Related Inflammatory Root Resorption?
Radiographic appearance?
Treatment?

Answer 34

Occurs due to progressive pulp necrosis- infected materials in non-vital coronal part of canal propagates resorption by underling the vital tissue and rapid destruction follows
Radiographically
–symmetrical expansion of root canal walls, tramlines of root canal are indistinct
Treatment
–remove stimulus and perform endodontic treatment with non-setting CaOH for 4-6 weeks before obturating

Question 35

What is Enamel Hypomineralisation?
Treatment?

Answer 35

Qualitative defect of enamel i.e. normal thickness but poorly mineralised
White/yellow defect
Treatment
–no treatment
–composite masking and tooth whitening

Question 36

What is Enamel Hypoplasia?
Treatment?

Answer 36

Quantitative defect of enamel i.e. reduced thickness but normal mineralisation
Yellow/brown defects
Treatment
–composite masking

Question 37

What is a Dilaceration abnormality?
Management?

Answer 37

Abrupt deviation of the long axis of the crown or root portion of the tooth
Management
-surgical exposure and orthodontic realignment, improve aesthetics restoratively

Question 38

What is the management of delayed eruption?

Answer 38

Premature loss of a primary tooth can result in delayed eruption of around 1 year due to thickened mucosa
Radiograph if it is more than 6 months delayed compared to contralateral tooth
Surgical exposure and orthodontic realignment may be required