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SDCEP Guidance > Caries in Children > Flashcards

Caries in Children Flashcards

1
Q

when should the first assessment of a child be carried out

A

before the child is 6 months

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2
Q

what aspects need to be included in a child’s assessment to improve personal care plan

A

parent/ carer motivation and responsibility
patient history
clinical examination
caries risk assessment

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3
Q

how should you greet a child entering the surgery

A

make eye contact (crouch)
greet them by their name
say hello my name is…

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4
Q

what should be included in your social history for a child

A

which adults provide care for the child
which days and times are easiest for parent to bring the child in
the name of the medical practice they attend

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5
Q

what should be assessed in a clinical assessment for a child

A

the childs plaque levels
toothbrushing skills
primary and permanent dentition for caries

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6
Q

what is the technique used for examining a younger patient

A

knee to knee exam

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7
Q

talk a parent through a knee to knee exam

A

parent will sit across from the dentist with the child facing the parent, parent holds the childs hand while lowering the childs head into the clinicians lap, parent should continue to hold the childs hands and smile at them
use mirror to examine the mouth
at the end encourage the parent to give the child a cuddle

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8
Q

what might enamel caries look like on the primary dentition

A

white appearance, matt, opaque and chalky white

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9
Q

what should you ensure before assessing the presence of caries

A

teeth are completely clean and dry

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10
Q

why is probing not an acceptable method for detecting carious lesions in pits and fissures

A

it damaged pits and fissures

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11
Q

what would an arrested enamel lesion present as

A

usually feel smooth to run a ball ended probe down the surface

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12
Q

what would an active enamel lesion present as

A

the surface would feel rough and the probe drags

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13
Q

how do you determine how active a dentine lesion is

A

the softer the lesion the more active
radiograph

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14
Q

what is important to determine when looking at carious dentine on a radiograph

A

that there is a clear band of normal looking dentine between the carious lesion and the pulp

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15
Q

how regularly can you take bitewings for children at increased risk of developing caries

A

6-12 months

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16
Q

what is the standard time period to wait between taking radiographs for children

A

2 years

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17
Q

what is an initial occlusal carious lesion in primary teeth

A

non-cavitated dentine shadow or minimal enamel cavitation

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18
Q

what is an advanced occlusal carious lesion in primary teeth

A

dentine shadow or cavitation with visible dentine

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19
Q

what is an initial proximal carious lesion in primary teeth

A

white spot lesion or shadow

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20
Q

what is an advanced proximal carious lesion in primary teeth

A

enamel cavitation and dentine shadow or caivity with visible dentine

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21
Q

what is an initial anterior carious lesion in primary teeth

A

white spot lesions but no dentinal carious

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22
Q

what is an advanced anterior carious lesion in primary teeth

A

cavitation or dentine shadow

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23
Q

what is a pulpal involvement carious lesion in primary teeth

A

any tooth with clinical pulpal exposure or no clear separation between carious lesion and dental pulp radiographically

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24
Q

what is an initial occlusal carious lesion in permanent dentition

A

noncavitated enamel carious lesions that show white spot lesions, discoloured or stained fissures

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25
what is molar incisor hypo-mineralisation
a developmental condition that affects the first permanent molars and incisors
26
what are the aspects of MIH
poor quality of enamel means the teeth are prone to breakdown anc can be painful on toothbrushing
27
where are sinuses usually found
non-attached mucosa adjacent to the attached mucosa
28
what are some indicators of dental infection
tenderness to percussion alveolar tenderness non-physiological mobility inter-radicular radiolucency
29
what plaque score mark would you give a perfectly clean tooth
10/10
30
what plaque score mark would you give a tooth with plaque line around the cervical margin
8/10
31
what plaque score mark would you give a tooth with plaque covering the cervical third of the crown covered
6/10
32
what plaque score mark would you give a tooth with the middle third of the crown covered in plaque
4/10
33
what are the 7 aspects of caries risk assessment
dietary habits clinical evidence socioeconomic status use of fluoride plaque control saliva medical history
34
how to manage pain in a child from reversible pulpitis
manage the carious lesion may allow for pulpal healing
35
how do you manage pain from irreversible pulpitis in a child who is pre-cooperative
try to dress with corticosteroid antibiotic paste analgesia primary tooth - refer for treatment/ XLA with sedation or GA permanent tooth - carry out RCT or XLA
36
how do you manage pain associated with abscesses in children
pulpectomy in primary teeth and permanent extraction
37
how should you treat irreversible pulpitis in a pre-cooperative child
dress with sub-lining of corticosteroid antibiotic pain and prescribe pain relief extract primary teeth under sedation RCT permanent teeth under sedation
38
how to manage dental abscesses in children
local measures to control infection prescribe antibiotics and pain relief
39
when should antibiotics only be prescribed
when there is evidence of spreading infection - swelling, cellulitis, lymph node involvement or fever and malaise
40
what is the standard OH advice for children
daily brushing with fluoride toothpaste tailored to specific individuals
41
how much toothpaste should a child under 3 use
a smear
42
how much toothpaste should a child over 3 use
a pea sized amount
43
what fluoride dosage toothpaste should standard risk children use
1000-1500 ppmF
44
what fluoride dosage of toothpaste should increased risk children use
1350/ 1500 ppmF for under 10s 2800 ppmF for over 10s
45
how often should you advise/ remind child and parent of standard risk of brushing technique
yearly
46
what should children and parents be told during OH advice yearly
brush first thing in the morning and last thing at night age appropriate toothpaste with the correct fluoride spit dont rinse supervise until children can brush their teeth properly show how to brush teeth on the child
47
how often should you show a standard caries risk child how to brush their teeth
3 minutes annually
48
how often should children with enhanced prevention receive OH advice
at every recall visit
49
what strength of fluoride toothpaste should enhanced prevention children receive aged 10-16
2800 ppmF
50
how long should you advise children and parents to avoid eating or drinking anything after brushing teeth
30 mins
51
in the standard prevention for all children when should fissure sealants be placed
as soon as possible after first permanent molars erupt
52
what is the first choice material for fissure sealants
resin based
53
when should glass ionomer fissure sealants be used
uncooperative children concerns about moisture control partially erupted teeth
54
what is the press-finger technique for GIC sealants
place small amount of GIC on one finger tip and petroleum jelly on the adjacent finger tip wipe tooth surface with cotton wool first if possible firmly apply the GIC to the tooth keep finger in place for 2 minutes place the petroleum jelly finger in the mouth and switch to cover the GIC with jelly before moisture contamination occurs
55
what should all children over the age of 2 have applied twice a year
sodium fluoride varnish
56
name the technique for resin fissure sealant application
clean tooth so it is free from debris check air line is free from water isolate tooth using cotton wool rolls, saliva ejector and dry guard etch tooth for 30 seconds wash etch off straight into aspirator and dry apply resin sealant light cure sealant check for flash with probe
57
what percentage of fluoride is in sodium fluoride varnish
5%
58
for children on enhanced prevention how often should fluoride varnish be applied
4 times a year for children over 2
59
when can you advise use of an alcohol free mouthwash
from 7 years of age
60
what are conraindications of placing fluoride varnish
a child hospitalised due to severe asthma or who is allergic to sticking plaster (colophony allergy)
61
what dose of fluoride dose Duraphat varnish contain
22,600 ppmF
62
describe the procedure of fluoride varnish application
isolate and thoroughly dry teeth a quadrant at a time apply small amount of fluoride varnish using small brush advise soft foods and liquids may be consumed from 30 minutes after application child should wait at least 4 hours before brushing their teeth or chewing hard food
63
how much duraphat varnish should be used in children 2-5 years
0.25 ml
64
how much duraphat should be used for children aged 5-7
0.4ml
65
how long should soft foods and liquids be avoided after FVA
30 mins
66
how long should a child wait before brushing their teeth after FVA
4 hours
67
how should non-cavitated occlusal lesions be treated in primary teeth
fissure sealants over them or Hall crown technique if child is uncooperative
68
how should primary teeth with occlusal caries into dentine be treated
selective caries removal and restore with composite or GI hall crown technique if child is uncooperative
69
if an advanced proximal carious lesion is present in primary teeth how should it be treated
hall crown technique selective caries removal and restore using composite
70
why should complete caries removal not be carried out in primary teeth
significantly higher risk of pulpal exposure
71
how should white spot lesions on anterior primary teeth be treated
site specific prevention and monitor
72
how should advanced lesions on anterior primary teeth be treated
selective caries removal and restore using composite, RMGI
73
a separator can be used to clinically assess proximal caries - how long should it be left in for
5 days
74
when is optimal to remove 6s if of poor prognosis
bifurcation of the 7s are seen forming on full mouth panoramic 7s and 8s are present class I incisor relationship
75
when is the hall crown technique only successful
when there is a layer of unaffected dentine between the lesion and the pulp teeth where there is no layer of unaffected dentine but they are asymptomatic
76
what coloured ring is used for taking bitewings in children
red with size 0 film
77
name 4 indicators of established dental infection
tenderness to percussion in non-exfoliating tooth alveolar tenderness, sinus or swelling non-physiological mobility radiographic signs (radicular radiolucency)
78
what is the modified child dental anxiety scale
MCDAS is 8 questions about specific dental procedure there is a facial version also available
79
what is the aim of behavioural management
promote positive attitude to dental care and facilitate ongoing prevention and care
80
name five examples of behaviour management strategies
communication enhancing control tell show do positive reinforcement distraction
81
give examples of non-verbal communication in the dental practice
facial expressions eye contact gestures body movement
82
what is enhancing control
stop signals
83
what is tell show do
tell using appropriate language show apparatus used in procedure check child is happy before commencing
84
how can you get children to practice relaxation in the surgery
get them to place a hand on their tummy ask them to breathe in slowly and deeply repeat this three times
85
how would you treat irreversible pulpitis in a cooperative child
primary dentition - carry out XLA or appropriate pulp therapy Permanent - carry out RCT or XLA
86
how are dental abscesses treated in pre-cooperative children/ multi abscessed teeth
local measures to control infection abx if indicated analgesia primary - refer for XLA with sedation or GA permanent - carry out RCT or XLA
87
what four things would make you think there are signs of spreading infection from dental abscess
swelling cellulitis lymph node involvement fever/ malaise
88
what dietary advice should you give to children/ their carers
limit consumption of food and drinks containing sugar drink only water or milk between meal times do not place anything that is not milk or water in bottles if a child has a bottle at bedtime it should only have water

SDCEP Guidance (17 decks)

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