Development and Dentistry

Question 1

why are children referred to paediatric dentists ?

Answer 1

fear and poor behaviour management,

temperament, character

Question 2

what is development ?

Answer 2

physical - maturation of body structures, normative sequences
motor - attainment of motor skills e.g. teeth brushing, orderly progression
cognitive - intellectual functioning
social - dealing with others

Question 3

what are the 4 stages of cognitive development ?

Answer 3

sensory motor stage (0-2 years) - knowledge of the world through movements and sensations
pre-operational stage (2-7 years) - language development, role play, egocentrism (unable to see others’ points of view)
concrete operational stage (7-11 years) - logical thinking, understand concept of conversation
formal operational stage (12-adulthood) - deductive reasoning, understanding of abstract ideas

Question 4

what is the process of language development ?

Answer 4

3 months - cooing
4 months - babbling 
12 months - 1st word
18 months - 20 words, single utterances 
24 months - 250 words, 2 word utterances 
30 months - 500 words, 3+ utterances

Question 5

what is the process of developing fearful reactions in children ?

Answer 5

7-10 months
stranger anxiety,
separation anxiety

Question 6

how can stranger anxiety be overcome in the dental surgery ?

Answer 6

keep familiar carers close at hand,
social referencing - parents friendly to dentist,
make setting more familiar - toys, posters, time allowed to be accustomed,
be less intrusive - let child set pace,
don’t wear lab coat/have instruments out

Question 7

what behaviors are associated with dental anxiety/fear ?

Answer 7

moving hands,
putting hands over mouth, 
crying loudly,
shaking the legs,
moving left/right,
moving legs up/down

Question 8

what behavioral disorders may be encountered in a dental surgery ?

Answer 8

ADHD,
learning difficulties,
autism

Question 9

what are the characteristics of ADHD ?

Answer 9

inattention, hyperactivity, impulsivity, less responsive, less focused, poor oral health habits

Question 10

how can children’s behavior be controlled in a dental clinic ?

Answer 10

clear goals for each visit,
reward desirable behaviors,
forced choice - ask closed questions,
tell, show, do

Question 11

what are the 3 types of learned behaviour ?

Answer 11

classical conditoning, operant conditioning, social learning

Question 12

give examples of 5 behaviour management techniques

Answer 12

reinforcement - verbal, rewards
desensitisation - tell show do, distraction, explanation, modelling
communication - stop signals, non verbal e.g. hand holding
aversion - voice control
pharmacology - sedation

Question 13

how do children convey pain according to Piaget ?

Answer 13

pre operational stage - pain is a global phenomenon
operational/concrete - understanding improves over time
formal operational - understand what hurts and why and how much

Question 14

how do peer relationships affect social development ?

Answer 14

importance of appearance - 
associated with popularity, affects social/phycological adjustment
bullying - 
facial/dental abnormalities, 
physical, verbal, relational

Question 15

define child abuse

Answer 15

when an adult harms a child or young person under the age of 18

Question 16

what types of children are abused ?

Answer 16

children who are more defiant, unresponsive, irritable, unwell, look different

Question 17

what types of adults abuse children ?

Answer 17

those with stronger physiological reactions to all social signals,
those who were abused/neglected, interpret distress as criticism/rejection

Question 18

what should be done if child abuse is suspected ?

Answer 18

assess likelihood of harm, 
explain concerns to child/parent, 
discuss with an appropriate colleague,
refer to social services,
backed up in writing within 48 hours

Question 19

what is the relevance of schizophrenia to dentistry ?

Answer 19

increased alcohol/tobacco use,
xerostomia,
hypertension

Question 20

what is the relevance of OCD to dentistry ?

Answer 20

high levels of dental anxiety,

tooth wear

Question 21

what is the relevance of bipolar disorder to dentistry ?

Answer 21

episodes of abnormally elevated mood,

poor OH, calculus, periodontal disease, caries, xerostomia, missing teeth

Question 22

what is the relevance of eating disorders to dentistry ?

Answer 22

Prader-Willi, anorexia nervosa, bulimia nervosa-
erosion, parotid gland hypertrophy, saliva,
mucosal lesions,
different gag reflexes,
exposed dentine

Question 23

what is Pica and how is it relevant to dentistry ?

Answer 23

persistent intake of non nutritive substances,
abnormal appetite for food ingredients,
associated with development/learning disabilities,
trauma to soft tissue/tooth wear

Question 24

describe the Frankl behaviour rating scale

Answer 24

1 - definitely negative - refusal of treatment, crying, fearful
2 - negative - reluctant to accept treatment, uncooperative, sullen, withdrawn
3 - positive - acceptance of treatment, cautious at times, complies
4 - definitely positive - good rapport, interested in treatment, laughing, enjoying the situation