BDS4 Paediatrics PPs Flashcards
What teeth should be probed in a BPE on a 13 year old?
16
11
26
36
31
46
What is the normal depth from ECJ to alveolar bone crest in teenagers?
0.4-1.9mm
What medical conditions would cause a 13 year old to have BPE scores of 3/
Epilepsy = phenytoin
Immunosuppression = cyclosporin
Diabetes
A child patient attends with a fractured 11.
List 3 questions you would ask in regards to traumatised tooth?
- How long ago it occurred?
- Is the tooth fragment accounted for?
- How did it happen?
A child patient attends with a fractured 11.
List 4 things that determine the prognosis of the traumatised tooth when discussing with parents.
- Stage of root development
- Pulpal exposure [size & time]
- Additional damage to PDL/alveolar support
- Presence of infection
A child patient attends with a fractured 11. They cannot account for the lost fragment.
Where might you suspect the fragment of this tooth to be & how would you manage this? (3)
Swallowed fragment = A&E referral for scan
Inhaled fragment = A&E referral for chest x-ray
Embedded in soft tissue = radiograph to confirm & refer to OS for management
Parents complain that their child has white/yellow/brown stains on teeth.
List 8 questions you would ask the patients mum:
Prenatal = illness during pregnancy (gestational diabetes, anaemia)? issues in third trimester (pre-eclampsia)?
Perinatal = birth trauma or anoxia? hypokalaemia? pre-term birth? forceps?
Post natal = how long did child breastfeed? illness in early childhood?
Socioeconomic status?
Childhood infections? (measule, rubella, chickenpox)
Parents complain that their child has white/yellow/brown stains on teeth.
Teeth affected are all FPMs and incisors. What condition is this likely to be & is it inherited?
MIH
- not inherited
Parents complain that their child has white/yellow/brown stains on teeth.
List 5 questions you would ask to rule out fluorisis:
- What toothpaste concentration is used?
- Does pt live in fluorodated water zone?
- Any fluoride supplement use?
- Ask about OH regimine
- Does child have access to high strength toothpaste indirectly
At what age should you begin palpating for canines in the buccal sulcus?
Age 9
An 8 year old child attends with hypodontia.
Name 2 syndromes associated with hypodontia:
- Down’s Syndrome
- Ectodermal Dysplasia
An 8 year old child attends with hypodontia.
How may hypodontia present to a GDP?
- Asymmetric eruption
- Delayed eruption
- Missing primary teeth
- Delayed exfoliation of primary tooth
- Pt has cleft lip/palate
How can cleft lip & palate be classified?
LAHSHAL classification
- lip
- alveolus
- hard palate
- soft palate
An 8 year old child attends with hypodontia.
Of all the people with missing teeth, how many have missing primary teeth & how many have missing permanent teeth?
Primary hypodontia = <1%
Permanent hypodontia = approx. 6%
What 4 medical conditions are Down Syndrome children predisposed to?
- Cardiac defects
- Leukaemia
- Epilepsy
- Alzheimers
What are 4 general extra-oral features of down syndrome children?
- Small nose & flat nasal bridge
- Eyes that slant upwards and outwards
- Flat back of head
- Small mouth
What are 6 general intra-oral features of down syndrome children?
- Macroglossia
- Class III occlusion
- Hypodontia
- AOB
- Microdontia
- Hypoplasia
- Periodontal disease predisposition
A 7 y/o high caries risk patient attends.
What are the things assessed when determining caries risk?
- Fluoride use
- Toothbrushing
- Medical history
- Diet
- Previous evidence of caries
- Social history/SIMD
- Saliva quality
A child presents to your practise complaining of how their upper teeth look & you suspect fluorosis.
Where can fluoride be found in food?
- Tea
- Beer
- Bony fish
- Cucumber/pickles
- Spinach
- Potatoes
- White rice
The mother of a young child phones your practise stating that her son had ingested fluoride toothpaste and she is worried.
What 3 questions should you ask?
- How old is the child?
- What concentration is the toothpaste?
- How much toothpaste swallowed?
The mother of a young child phones your practise stating that her son had ingested fluoride toothpaste and she is worried.
If he has ingested a possible toxic dose, what is your advice?
<5mg/kg = give calcium orally (milk) and observe for a few hours
5-15mg/kg = give calcium orally (milk) and admit to hospital
> 15mg/kg = refer to hospital immediately for cardiac monitoring & support
Why would you not use ferric sulphate in an anterior tooth?
Stains tooth!
3 year old child attends with blisters on his gums.
What is the likely diagnosis?
Primary herpetic gingivostomatitis
3 year old child attends with blisters on his gums. You suspect primary herpetic gingivostomatitis.
What other signs and symptoms may be present?
- painful mouth so lack of food/fluid intake
- halitosis
- fever
- malaise
- cervical lymphadenopathy
3 year old child attends with blisters on his gums. You suspect primary herpetic gingivostomatitis.
What is the likely diagnosis?
Initial infection of herpes simplex virus type 1
3 year old child attends with blisters on his gums. You suspect primary herpetic gingivostomatitis.
How is pt managed?
- Reassure parents that lesions heal spontaneously in 7-10 days
- Advise plenty of bed rest and fluid intake
- Analgesic advice
- OHI
- Chlorhexidine use
3 year old child attends with blisters on his gums. You suspect primary herpetic gingivostomatitis.
What problems may arise in future?
- herpes labialis
- Bell’s palsy
What are the indications for a SSC?
- When >2 surfaces affected with extensive lesions
- Space needs to be maintained
- Poorly co-operating children that cannot cope with LA or conventional restorative work
- MIH/enamel defect cases
How is a SSC placed conventionally in a child?
- LA
- 1mm occlusal surface removed
- contacts cleared
- crown selected & sized
- isolate & dry tooth
- place GIC into crown and seat over tooth
- wipe away excess cement & floss contacts
- gingival blanching should be seen
What are the advantages of planned XLA of 1st permanent molars?
- If done at correct time, spontaneous closure will occur & 7 will move into 6 place
- Allows for caries free dentition without spacing
- Can be used as an orthodontic advantage
What signs are indicative of suitability of FPM planned XLA?
- Start of calcification of bifurcation of unerupted 7s
- Ideally all premolars & 3rd molars present
- Class 1 incisor relationship & mild buccal crowding
- If medical history rules out endodontic procedures
Name 2 disadvantages of planned FPM XLAs in children?
- May require GA in children
- Bad experience for child
What is the most common cardiac defect in children? What condition is it most commonly associated with?
Ventricular septal defect
Down’s syndrome
Name 6 medical issues seen in children with Down’s Syndrome:
- leukaemia
- epilepsy
- hypothyroidism
- periodontal disease
- coeliac disease
- alzheimers
What are the disadvantages of microabrasion?
- removes 100micron layer of enamel
- requires protective apparatus
- cannot be delegated to hygienist/therapist
What is the triad of impairment in reference to patients with autism?
Core features/areas of difficulty commonly observed in individuals with autism
- Social interaction
- Social communication
- Social imagination
What features do patients with autism have?
- sensory sensitivity
- learning difficulties
- epilepsy
- OCD
- social struggles
How may anxiety be measured in children?
MCDAS(f)
- 8-12 y/o
- Scores range from 8-45
- >19 indicate anxiety
- >27 extreme dental anxiety
List 8 behavioural management techniques used to aid in the treatment of anxious children:
- Tell-show-do
- Positive reinforcement
- Distraction
- Desensitisation
- CBT
- Acclimatisation
- Modelling
- Allow control via stop signals
What are the indications for placing fissure sealants?
- All f[pits & fissures of 6s as soon after eruption for all children
- If high caries risk = all Ds, Es, 5s, 6s & 7s
- If pt has deep fissure pattern
- If medically compromised
- Learning disability
Give 2 materials that can be used for placing fissure sealants:
- Bis-GMA
- GIC
What are the 4 types of cerebral palsy?
- Spastic
- Ataxic
- Athetoid
- Mixed
What is cystic fibrosis and why does it occur?
- genetic disorder that causes thick & sticky mucous production + buildup
- mutation of the CFTR gene
What are the general signs & symptoms of CF?
- Persistent cough with mucous production
- Shortness of breath
- Finger clubbing
- Pancreatic insufficiency leading to poor digestion & nutritional deficiency
- Failure to thrive in infants
- Thick salivary condition
What are the dental considerations of cystic fibrosis patients?
- Xerostomia
- Increased caries risk due to poor saliva quality
- Avoidance of GA & sedation
