CDH 4.9

Question 1

What age can you palpate maxillary canines?

Answer 1

9 years old

Question 2

What are the consequences of early loss of a primary tooth?

Answer 2

Space loss
Delayed/early eruption of permanent teeth
Loss of function

Question 3

How does infra occlusion occur?

Answer 3

Disruption of repair/resorption cycle - repair becomes too prevalent, can get ankylosis of root rather than maintenance of PDL

Question 4

What are the clinical features of infra occluded primary teeth?

Answer 4

Mobility - might exfoliate 
Extent - looking at contact point as some may be below level 
Tipping of adjacent teeth 
Over-eruption of opposing tooth 
Percussion sound

Question 5

What are compensating extractions?

Answer 5

Extractions completed in the opposite arch

Never in primary teeth!!

Question 6

What are balancing extractions in the primary dentition? and why is this carried out?

Answer 6

Extractions on contralateral tooth in same are

To reduce risk of a midline shift

Question 7

What are the commonly and least common teeth to be balanced in extractions of primary teeth?

Answer 7

Always Cs, sometimes Ds and never Es

Question 8

Why 1.would and 2.wouldn’t first primary molar be balanced in extractions?

Answer 8

1. Planning GA/sedation, and if patient is non co-operative in case midline shift were to occur
2. Spaced dentition, co-operative patient under LA and contralateral tooth healthy, therefore wait and see if midline shift is occurring then extract

Question 9

How are impacted first permanent molars on a second primary molar managed?

Answer 9

Await spontaneous disimpaction
Disimpact 6 with a separator
Reduce distal surface of E
Extract E

Question 10

What makes a first permanent molar of poor long-term prognosis?

Answer 10

Moderate to severely hypo-mineralised - where they have breakdown, sensitivity, pain
Caries extending 2/3 into dentine
Teeth which have 2 surface restoration

Question 11

When is the ideal timing to extract first permanent molars of poor prognosis?

Answer 11

8 years old (9 years old according to Alex rushworth)

Bifurcation of lower second molars

Question 12

What age would you extract a C to allow eruption of 3?

Answer 12

11 year olds

Question 13

How can you correct an anterior crossbite?

Answer 13

URA - upper removable appliance

2x4 - fixed appliance

Question 14

When is functional appliance therapy indicated for an EARLY referral?

Answer 14

Evidence of psychological harm to child, bullying due to dental appearance
Multiple episodes of dental trauma