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Childrens Dental Health > CDH > Flashcards

CDH Flashcards

1
Q

Who has parental responsibility?

A
  • Birth Mother
  • Birth Father (if married at birth or on birth certificate after 1st Dec 2003)
  • Others e.g. relatives, local authorities, ineligible fathers if
    a) PR agreement with mother
    b) PR order from court
    c) Residence order from court
    d) Become child’s guardian
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2
Q

What radiographs would you take for a new patient with

a) Primary
b) Mixed
c) Permanent dentition

A

a) BW or lateral obliques

b and c) BW and more views if needed

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3
Q

What radiographs would you take for a recall of a high risk patient with

a) Primary
b) Mixed
c) Permanent dentition

A

a) BW 6-12 mo
b) BW 6-12 mo
c) BW 12 mo

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4
Q

What radiographs would you take for a recall of a low risk patient with

a) Primary
b) Mixed
c) Permanent dentition

A

a) BW 12-24 mo
b) BW 12-24 mo
c) BW 24-36 mo

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5
Q

What radiographs would you take for growth development?

A

DPT

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6
Q

What pharmacological techniques are used for behaviour management?

A
  • Inhalation sedation
  • Oral sedation
  • IV sedation
  • Nasal sedation
  • General anaethetic
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7
Q

What are the 5 Pillars of Prevention?

A
  • Review and recall
  • Fluoride
  • Fissure sealant
  • Oral hygiene
  • Diet
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8
Q

What are the a) advantages and b) disadvantages of GIC?

A

a) Fluoride, caries control, aesthetic, adhesive

b) Poor strength and longevity - not permanent, long setting time, brittle, radioluscent

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9
Q

What are the a) advantages and b) disadvantages of compomer?

A

a) ?Fluoride, average strength and longevity, adhesive, aesthetic, radio-opaque, command set
b) Technique sensitive

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10
Q

What are the a) advantages and b) disadvantages of composite?

A

a) Aesthetic, strength and longevity, command set

b) Technique sensitive, problems diagnosing secondary caries

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11
Q

What are the a) advantages and b) disadvantages of amalgam?

A

a) Strength, longevity, moisture

b) Aesthetics, destructive and banned in under 15s

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12
Q

What are the a) advantages and b) disadvantages of PFMC (NiTi)?

A

a) Strength, good seal, longevity, quick to use

b) Aesthetics, more difficult (Hall)

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13
Q

Why do we do extractions for

a) Balancing
b) Compensating

A

a) Prevent centreline shift

b) Prevent overeruption

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14
Q

Which primary teeth should we try to maintain and why?

A

Es - to prevent migration of 6s

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15
Q

When is the best time to extract the 6s?

A

When 7s are bifurcating (about 9.5yrs) on radiograph

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16
Q

What are the social factors affecting caries risk?

A
  • Mothers education
  • Attendance pattern
  • Access to dental care
  • Siblings with caries (same diet)
  • Vulnerable group
  • Dental anxiety
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17
Q

What are the medical factors affecting caries risk?

A
  • Dexterity for OHI
  • Behaviour and compliance
  • Sugary medications
  • Xerostomia (radiotherapy/chemo)
  • Diet (chronic disease may have sugary diet)
  • Must rely on carers for OH
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18
Q

What are the dental factors affecting caries risk?

A
  • Fixed or removable appliances
  • Crowding
  • Hypoplastic/ hypomineralised teeth
  • Current active caries
  • DMFT/dmft >4
  • Caries in 6s at 6 years old (only just erupted)
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19
Q

At what concentration and above is the fluoride concentration only apparent/beneficial?

A

1000ppm

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20
Q

What are the risk factors for flourosis?

A
  • Age started brushing
  • Inappropriate use F supplements
  • Frequency of brushing/swallowing toothpaste
  • Residence in optimally F area
  • Soya or milk based infant formula use
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21
Q

What time period for recalls:

a) Shortest interval for all pts
b) Longest interval for <18yrs
c) Longest interval for >18yrs

A

a) 3 month
b) 12 month
c) 24 month

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22
Q

What is the concentration of fluoride varnish?

A

22,600ppmF / 2.2% NaF

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23
Q

In who is Duraphat fluoride varnish contraindicated and what is used instead?

A
  • History of hypersensitivity to Colophony
  • Asthmatics
  • Gingival ulceration or stomatitis

Use ProFluorid

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24
Q

What is the post-op instruction for fluoride varnish use?

A
  • No food/drinks for 30mins

- Soft food/drinks for 4 hours

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25
Q

What are the single application dosages for fluoride varnish for:

a) Primary
b) Mixed
c) Permanent

A

a) up to 0.25ml (5.65mgF)
b) up to 0.4ml (9.04mgF)
c) up to 0.75ml (16.95mgF)

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26
Q

What are the methods of acclimatisation?

A
  • Tell, show, do
  • Distraction
  • Desensitisation
  • Modelling
  • Hypnosis
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27
Q

What are the 3 stages of desensitisation?

A

1) Train pt to relax
2) Build hierarchy of fearful scenarios
3) Gradually introduce fearful stimuli

28
Q

What drugs are used in

a) Oral sedation + when is it used
b) Inhalation sedation + why is it safe + when is it used

A

a) Diazepam and Medazolam. Young child or learning disability as a pre-med to GA
b) Nitrous Oxide. Recovery rapid, no drug interations, no respiratory depression. Co-operative but fearful patient

29
Q

In the ICDAS/ ICCMS, what does Code 0 indicate?

A

Sound tooth surface - no evidence visible caries although developmental defects may be present such as fluorosis, tooth wear or stains

30
Q

In the ICDAS/ ICCMS, what does Code 1/2 indicate?

A

Initial stage caries - Visual changes in enamel e.g. WSL but no evidence of surface breakdown

31
Q

In the ICDAS/ ICCMS, what does Code 3/4 indicate?

A

Moderate stage caries - White or brown spot lesion with localised enamel breakdown
3 = No visible dentine exposure
4 = underlying dentine shadow

32
Q

In the ICDAS/ ICCMS, what does Code 5/6 indicate?

A

Extensive stage caries - distinct cavity in opaque or discoloured enamel with visible dentine

33
Q

What are the differential diagnoses for carious lesions?

A
  • Fluorosis
  • Amelogenesis imperfecta (genetic - pitting)
  • Hypoplasia
  • Staining
  • Anatomical pits
  • Radiolucent restorations
  • Tooth loss from wear
34
Q

What methods of diagnosing involve visual light?

A
  • Direct visual examination
  • FOTI (fibre optic, dark patches where caries)
  • QLF (quantitative light induced fluorescence - demineralisation reduces fluorescence)
35
Q

What are the novel diagnostic X rays?

A
  • Digital subtraction radiology

- Digital image enhancement

36
Q

What method of diagnosis uses laser light?

A

Diagnodent - detects occlusal caries

37
Q

What method of diagnosis used electrical current?

A

Electrical conductance mechanism (ECM) - enamel poor conductor

38
Q

What method of diagnosis uses spectroscopy?

A

AC Impedance Spectroscopy Technology (ACIST) - measures mineral density

39
Q

What method of diagnosis uses bioluminescence?

A

Photo-protein detection

40
Q

What method of caries diagnosis can be used for free smooth surface (buccal/lingual)?

A
  • Visual
  • FOTI
  • QLF
41
Q

What method of caries diagnosis can be used for pit and fissure?

A
  • Visual limited
  • Radiograph
  • Diagnodent
  • QLF
  • ECM
42
Q

What method of caries diagnosis can be used for approximal caries?

A
  • Visual for late stage
  • Bitewing
  • FOTI and diFOTI
  • ECM
43
Q

How does the periodontium of the primary dentition differ?

A
  • PDL has fewer connective tissue fibres
  • PDL more vascular
  • Alveolar bone more vascular and fewer trabeculae (tooth exfoliates easier)
  • Thinner epithelia
  • Attached gingiva less variable in width
  • Periodontal space wider as thinner cementum and cortical plates
  • Less keratinisation
  • Looks redder
44
Q

What happens clinically when

a) Primary teeth erupt
b) Permanent teeth erupt

A

a) Localised hyperaemia, swollen rounded papillae, >3mm sulcus depth (false pocketing)
b) JE migrates so large sulcus depth

45
Q

At what age should the gingivae be stable around the lower incisors, 3s, 5s and 6s

A

12 years

46
Q

Why does puberty link to gingivitis?

a) Oestrogen
b) Progesterone
c) Oestradiol

A

a) Increases cellularity of tissues
b) Increases permeability of gingival vasculature
c) Supports growth of BP microbes

47
Q

What 3 drugs will induce gingival hyperplasia?

A
  • Ciclosporin (prevents organ rejection)
  • Nifedipine (CCB to reduce nephrotoxity of ciclosporin)
  • Phenytoin (anticonvulsant for epilepsy) - overproduction of collagen
48
Q

For gingival enlargement:

a) Where in the mouth is it worse?
b) What is the management?

A

a) Anterior and labially

b) OH and debridement, recontouring, gingivectomy, change of meds

49
Q

What is an example of non-drug induced gingival enlargement?

A

Removable appliance and poor OH

50
Q

What is gingivitis artefacta/ factitious gingivitis?

A

Self inflicted picking on gingivae

51
Q

Where do we want ectopic teeth to erupt through?

A

Keratinised gingivae - more stable than lining mucosa

52
Q

If a childs permanent incisors have gingival recession what are the potential causes?

A
  • Labially displaced
  • Labial tipping of roots from ortho (crown palatally displaced)
  • Narrow zone KG
53
Q

What are the likely causes of LoA in these areas

a) Buccal/palatal
b) Interproximal

A

a) Toothbrushing or trauma

b) Pathological

54
Q

What teeth are measured in the modified BPE and what codes are used for what age group?

A

UR6, UR1, UL6, LR6, LL1, LL6
7-11yrs = 0,1,2
12-18yrs= full range

55
Q

For aggressive perio disease in the primary dentition:

a) What are the signs of general perio disease
b) What microbes are involved
c) What is the treatment

A

a) Complete tooth loss by 4yrs and often suffer other infections
b) Aa, Pg, Fn, Ec
c) Intense debridement +/- amoxicillin/metronidazole and monitor secondary dentition and culture subgingival flora

56
Q

For aggressive perio disease in the permanent dentition:

a) What are the signs of general and localised perio disease
b) What microbes are involved
c) What is the treatment

A

a) Localised = 6s and 1s, Generalised >14 teeth
b) Mainly Aa
c) Regular scaling and RSI, 2/52 course tetracycline or 1/52 amoxicillin and metronidazole

57
Q

What systemic disorders have periodontal features due to PMNL, enzyme reaction or collagen synthesis defects?

A
  • Ehlers-Danlos Type VIII Syndrome
  • Neutropenia’s (familial or cyclic)
  • Chediak-Higashi syndrome
  • Papillon-Levevre syndrome
  • Leukocyte- adhesion deficiency syndrome
  • Diabetes
58
Q

What are the features of Papillon-Lefevre syndrome? What is now used for this?

A
  • Periodontitis (will need full denture, vertical and horizontal bone loss)
  • Palmar plantar hyperkeratosis
  • Cathepsin C gene defect

Acitretin now used

59
Q

What is cyclic neutropenia clinical features of cyclic neutropenia? What is its features clinically?

A

Gene encoding neutrophil elastase, varies according to bone marrow activity
Three week cycle of gingival bleeding

60
Q

What are the options for anterior tooth restorations?

A
  • Adhesive restoration
  • Flouride varnish
  • Interproximal stripping with long tapered bur, soflex discs or interproximal polishing strips to clear contact points but not used
61
Q

What is the risks with erupting teeth and PFMCs?

A
  • Risk of coming off as successor tooth erupting

- If too big can impact 6s

62
Q

Why should you not prescribe aspirin to children?

A

Reye’s syndrome - sudden illness and vomiting as increased levels of NH3 and H+, brain swells, liver failure

63
Q

Although prescriptions should be weight related, what is the rule of thumb for:

a) <5yrs
b) >5yrs
c) >10yrs

A

a) 1/4 adult dose
b) 1/2 adult dose
c) adult dose

64
Q

What is the treatment for teething?

A
  • Massage
  • Dry drool
  • Teething toys and reassurance
  • Topical analgesia, systemic analgesias (lignocaine and antibacterial agent = cetalkonium chloride)
65
Q

To what children should ibroprofen not be given?

A
  • Under 6 months
  • Asthmatics
  • Renal and liver disease

Childrens Dental Health (1 decks)

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