CH. 57 Pediatric Dentistry Flashcards
is the child’s actual age in terms of years and months.
chronologic age
refers to the child’s level of intellectual capacity and development.
mental age
describes the child’s level of emotional maturity.
emotional maturity
advantage of open bay concept in a pediatric dental office
it provides reassurance by allowing pediatric patients to see other children who are receiving care.
The program of study and hands-on experience prepares the pediatric specialist to meet the needs of :
infants, children, adolescents, and persons with special needs.
A well-known psychiatrist who formulated the stages of socialization of children and teenagers
Erik Erikson
the stage where the the child requires control and structure in his or her environment.
play age (3-5) years
is the period of socialization, which involves learning to “get along” with people, learning the rules and guidelines of society, and learning to accept these social requirements
children at this age have learned to overcome fears of objects and situations that were once quite frightening to them.
School age
Self-determination. Childhood process of becoming independent.
autonomy
Erikson’s Stages of Development
-Learning basic trust
-Learning Autonomy
-Play age
-School age
-Adolescense
The child has all of the basic needs met and is well handled, nurtured, and loved, to develop trust and security.
Learning basic trust
This is a transitional stage of physical and psychological human development generally occurring during the period from puberty to young adulthood
ages 12 to 20, young people acquire self-certainty
Adolescence
Dr. Spencer Frankl developed one of the most widely used systems, to measure a pediatric patient’s behavior
Frankl Scale
Frankl Scale for Pediatric Dental Patient Behavior
- Definitely negatice
2.Negative
3.Positive
4.Definitely positive
Refusal of treatment, crying forcefully, fearful, other evidence of extreme negativism
definitely negative
Reluctance to accept treatment; uncooperative; some evidence of negative attitude but not pronounced, that is, no sudden withdrawal
negative
Acceptance of treatment; cautious at times; willingness to comply, at times with reservation, but follows directions
positive
Good rapport with dentist; interested in dental procedures; laughing and enjoying the situation
definitely positive
Dental procedures can be accomplished for patients of all ages if the dental team practices the following procedural guidelines:
- Be honest with the child
-Use helpful child languages
-Tell, show, and do
-Give positive reinforcement
___________ (speaking calmly but firmly) will usually prevent the need for additional steps.
voice control
The use of restraint can be either _______ or
_______ to help lessen a patient’s movement or activity to a minimum.
pharmacologic
physical
_____ is the most frequently used sedation, and ________ agents administered orally are the second most use pharmacologic techniques with children
ntirous oxide
sedative/antianxiety
Additional steps for restraining a child can be taken with the use of ______ ______
protective stabilization
any manual method, physical or mechanical device, material, or equipment that immobilizes or reduces the ability of a patient to move his or her arms, legs, body, or head freely.
protective stabilization
a device that gently “hugs” or wraps around the child’s arms, legs, and middle section during a procedure.
can be adapted for the younger child who has been sedated or for the patient with special needs who may have limited control of his or her movement.
papoose board
What dictates whether treatment is provided in the pediatric dental office or in the hospital setting.
severity of each patients disorder
a state of functioning that begins in childhood and is characterized by limitations in intelligence and in adaptive skills.
intellectual disability
describes individuals with intelligence quotients (IQs) ranging from 50 up to 70. These individuals characteristically develop social and communication skills during the preschool years, with minimal impairment in sensorimotor areas; they often seem to be developing normally until a later age.
mild intellectual disability
describes individuals with IQs ranging from 35 up to 55. These individuals talk or learn to communicate during the preschool years.
moderate intellectual disability
describes individuals with IQs ranging from 20 up to 40. During the preschool period, these individuals display poor motor development and acquire little or no communicative speech.
severe intellectual disability
describes individuals with IQs below 20 to 25. During the early years, these children display minimal capacity for sensorimotor functioning. A highly structured environment with constant aid and supervision is necessary throughout life.
profound intellectual disability
Chromosomal defect that results in abnormal physical characteristics and mental impairment; also called trisomy 21
down syndrome
The common physical characteristics unique to a Down patient are
- back of the head is flattened
-eyes are slanted and almond shaped - bridge of the nose is slightly depressed.
Frequently, patients with Down syndrome have anomalies in dental development. Eruption of teeth may be delayed, with the primary incisors not erupting until after _ year of age.
Teeth may be small and peg-shaped, often with malocclusion.
1
patients with disabilities such as down syndrome should be approached in terms of______ and abilities, not in terms of chronologic age.
mental age
a developmental disorder that affects how information is processed in the brain by altering how nerve cells and their synapses connect and organize.
autism
Signs of autism disorder are evident before a child reaches __ years of age,
3
autism can be characterized by :
-Difficulty in social interaction,
-Difficulty in verbal and nonverbal communication
-Repetitive behaviors.
Patients with autism are often receiving psychotropic medications, which can cause _____
xerostomia (dry mouth)
a broad term that is used to describe a group of nonprogressive
neural disorders caused by
prenatal or
postnatal brain damage before the central nervous system has reached maturity
cerebral palsy
The resultant brain damage of cerebral palsy manifests (presents) as a malfunction of motor centers and is characterized by:
-paralysis
-muscle weakness
- lack of coordination
-disorders of motor function.
Cerebral palsy most often is classified according to the type of ____ __________
motor disturbance
The two most common types of motor disturbance in Cerebral palsy :
spasticity
athetosis
is characterized by a state of increased muscle tension that manifests as an exaggerated stretch reflex.
spasticity
marked by uncontrollable, involuntary, purposeless, and poorly coordinated movements of the body, face, and extremities; grimacing, drooling, and speech defects are present.
athetosis
When should the first dental appointment for a child take place?
around their 1st bday or when the first tooth erupts
when should a child start to have regular dental examinations ?
2 years old
The medical and dental history should include information about what?
childs general medical and dental health background
Specific Information Noted in the Pediatric Medical history
-past hospitalizations while under general anesthesia
-date of last visit to dr.
-medications taken in the past
-daily medications
-allergies
-weight at birth
-parental report on level of learning
Specific Information Noted in the Pediatric dental history
• Primary concern about the child’s dental health
• Satisfaction with appearance of teeth
• Bleeding gums with brushing
• Finger, thumb, or pacifier habits
• Fluoride and toothbrush habits
• Inherited family dental characteristics
Depending on the child’s age, the dentist will complete these examinations:
extraoral exam
intraoral soft tissue exam
(includes charting and radiographs)
The AAPD recommends radiographs every __months for children with a high risk for tooth decay
6
A radiographic examination is necessary if a complete diagnosis is to be made.
t or f
TRUE
is used to evaluate the patient’s profile to determine skeletal characteristics.
Any facial deviation or asymmetry of the eyes, ears, or nose may be a symptom of an undiagnosed syndrome, and the child should be referred to an appropriate professional for complete evaluation.
extraoral examination
evaluates the child’s gingiva and periodontium using a gingival score and/or a periodontal plaque score
intraoral soft tissue examination
The primary or mixed dentition is examined with the _______to determine spacing and crowding of teeth
occlusion
The role of the pediatric dentist is to communicate the importance of preventive dental health in such areas as
oral hygiene
fluoride use
diet
preventive procedures
The AAPD recommends a dental checkup _____ a year for most children
twice
Children between the ages of _ months and __ years should have a daily intake of fluoride.
6
16
a gel-like substance designed to release fluoride on enamel and root structure
good for patients who are more susceptible to decay.
flouride varnish
protects the grooved and pitted surfaces of teeth, especially the chewing surfaces of back teeth, where most cavities in children are found
sealants
allows the dentist to prevent or eliminate irregularities and malposition in the developing dentofacial region.
preventative treatment
Preventive orthodontics includes the following:
-CONTROL decay
-use of SPACE MAINTAINER
-use of APLLIANCES to correct oral habits
-EARLY DETECTIONof genetic and congenital anomalies
- SUPERVISION of the natural exfoliation (shedding) of the primary teeth.
allows the dentist to intercede or correct problems as they develop.
Interceptive treatment
Three types of mouth guards are used for contact sports :
-commercial mouth guards
-mouth-formed protectors
-CUSTOM-fitted vacuum-formed guards.
Primary teeth are charted with the same classifications as permanent teeth, and amalgam and composite resin materials are used for restorative purposes.
The only difference is that the pediatric dentist adapts to a smaller dentition and mouth size by using special instruments, accessories, and techniques.
T OR F
TRUE
what can you tell a child when you are placing rubber dam on their tooth
tell them you are placing “raincoat” for the tooth
Two types of matrices are used when primary teeth are restored
t band
spot welded band
Deep caries is much more likely to affect the _____ teeth, and _____ is much more likely to affect the anterior teeth.
posterior
trauma
Indirect and direct pulp capping can be indicated for a newly erupted ______ tooth to promote pulpal healing and stimulate the production of reparative dentin
permanent
the complete removal of the coronal portion of the dental pulp. The goal of this procedure is to remove the portion of the pulp that is inflamed while maintaining the healthy vital pulp tissue within the canals of the primary tooth
pulpotamy
A pulpotomy can be accomplished with two different types of medicaments:
-Mineral trioxide aggregate (MTA)
-calcium hydroxide pulpotomy
A stainless-steel crown is the restoration of choice for the following reasons:
• can be prepared and placed at a single appointment,
•durable to last until the primary teeth are replaced by the permanent teeth.
• almost always well tolerated by the gingiva of young patients.
• much less expensive than cast restorations.
The two types of crowns typically used in pediatric dentistry are :
pretrimmed and precontoured stainless steel crowns.
type of crowns that have straight sides but undergo festooning to follow a line parallel to the gingival crest.
These must be trimmed and contoured to fit the tooth.
pretrimmed crowns
type of crowns that are already festooned and
contoured. Some additional trimming and contouring may be necessary, but this need is usually minimal.
precontoured crowns
Injuries to primary teeth commonly occur around __ to __ years of age—the “toddler” stage
1 - 2/12 years
most frequently injured teeth in primary dentition
maxillary central incisors
when a primary teeth is injured, can the permanent teeth under it be affected as well?
yes
when would Complete documentation of an accident, clinical examination, vitality testing, and radiographic examination are completed at the emergency visit be done?.
fractures of the child’s anterior teeth
The dentist often prefers to delay restorative treatment for _ to _ weeks after a tooth fracture to avoid any further trauma to the pulp of an injured tooth.
3-6
during the recovery period after a fracture injury what will the dentist do?
(1) provide temporary relief by covering all exposed dentin with calcium hydroxide to prevent thermal sensitivity
(2) place an interim covering of resin material.
is the result of an injury in which the tooth is forcibly driven into the alveolus so that only a portion of the crown is visible.
intrusion
injuries that occur when the teeth are displaced from their position.
Extrusion and lateral luxation injuries
Primary teeth tend to undergo root resorption more quickly after injuries of this type, and they tend to become mobile.
Extrusion and lateral luxation injuries
what kind of avulsed teeth will not be replanted
primary teeth
Torn away or dislodged by force.
avulsed
what do you do with an avulsed tooth
• Recover the tooth immediately.
• Wrap the tooth in moistened piece of cloth or towel.
• Go immediately to the dentist’s office.
The success rate for replantation of permanent teeth is highest when the tooth is replanted within __ minutes of the accident
30
What to Include When Reporting Child Abuse
• Name, address, gender, age, height, and weight of the child
• Name and address of the adult who has custody of the child
• Description of the current physical and emotional abuse or neglect of the child
• Evidence of previous injuries or negligence
• Information that may assist in establishing the causes of injuries
• Sketches or photographs documenting the nature and location of injuries
the specialized area of dentistry that focuses on providing oral healthcare according to the needs of infants, children, adolescents, and individuals with special needs
pediatric dentistry
The pediatric patient is treated with the same ____ of dignity and ____ as is provided to an adult.
respect
individuality
The rapport developed during the________ can establish an attitude toward dental health that will last for a child’s lifetime.
initial examinatoin
Examples of Ways to Include a Young Child in a Procedure
• Have the child select the type of safety eyewear that he or she would like to wear today.
• Say to the child, “Point to the tooth you would like me to start with.”
• Have the child point to the tooth that was “smiling for the camera” (radiograph).
• Allow the child to choose the flavor of fluoride.
• Ask the child to hold the saliva ejector during the procedure.
