Early Child Visit

Question 1

What are the 2 phases of Piaget’s categorization

Answer 1

1st phase (18m-4 years) - rapid mental development

2nd phase (4-7yrs) - sensorimotor movements restricted to real objects

Question 2

What are the characteristics of 3-6year olds? What are the dental implications?

Answer 2

• Illogical
• Think but cannot reverse thoughts
• inability to understand an object when it changes
• centration: only one aspect of a situation
• egocentric

Dental implications:

• do not attempt logical explanations
• use TSD

Question 3

Explain the changes of the preschool to preconception stage

Answer 3

The child can categorize objects with more complex thoughts and outgrows tendency to center thoughts. They begin to acquire reading/writing skills with an increased vocabulary. They are able to tolerate separation from parents, thus, is ready for school

Question 4

What is one of or the most important sign you should look out for during an extra-oral examination?

Answer 4

Bruises or lacerations

Other general signs you watch out for:

• hair/skin
• symmetry
• lymphadenopathy
• trismus

Question 5

When evaluating a child for orthodontics – what 2 types of space are we on the lookout for? What are the classifications for anterior segment spaces?

Answer 5

We are looking for 2 types of spaces:
- primary space – mesial to maxillary canine and distal to the mandibular canine

Developmental space - space present between remaining teeth

Anterior segment:

• Baume 1 - space between anterior teeth’
• Baume 2 - no space present on anti over segment

Question 6

What are the 3 primary molar relationships to be on the lookout for?

Answer 6

Distal step, flush terminal plane, and medial step

Question 7

What can each of the primary molar relationships lead to in their permanent relationships?

Answer 7

Distal step –> class II but can be End-End

Flush terminal plane –> End to end but can be class I

Mesial step –> class I but can be class III

Question 8

Early dental visits provide parents with ____________ to help children stop sucking habits by _____________

(Oral habits)

Answer 8

Anticipatory guidance

By age 36 months (3years)

Question 9

When do primary teeth complete eruption?

Answer 9

24-36 months. Root formation completed by age 3

Question 10

True or false: primary crowns are wider MD than the length of permanent crowns?

Answer 10

True

Question 11

True or false - primary teeth have shorter and bigger roots compared to the crown length and width of permanent teeth?

Answer 11

False - primary teeth have a longer and narrower roots compared to permanent crown length and width

Question 12

True or false: facial and lingual cervical thirds of primary anterior crowns are more prominent than their permanent counterparts.

Answer 12

True

Question 13

True or false - the roots of primary teeth are more long and slender compared to the roots of permanent molars

Answer 13

True

Question 14

True or false: the roots of permanent molars flare out closer to the cervical area and apex than do the roots of primary molars

Answer 14

False - the primary roots flare out more in the cervical and apical areas of the roots than the permanent molars

Question 15

True or false: the enamel is thinner (approximately 1mm) on primary teeth than permanent teeth

Answer 15

True

Question 16

True or false: the pulp horns (especially the mesial pulp horn) are higher in permanent molars

Answer 16

False - the pulp horns (especially the mesial) are higher in primary molars

Question 17

The maxillary central incisor properties (5)

Answer 17

• MD width is greater than the cervicoincisor length
• Labial surface is smooth
• Well-developed marginal ridges and distinct cingulum on lingual surface
• No mamelons
• Root is cone shaped with tapered sides

Question 18

Properties of maxillary lateral incisors (3)

Answer 18

• The cervicoincisor length is greater than the MD width
• Incisal edge is more rounded on the mesial and distal sides
• Root is similar to that of the central incisor, but longer in proportion to the crown

Question 19

Properties of maxillary canines (6)

Answer 19

• more constricted at the cervical region vs. incisors
• Incisal and distal surfaces are more convex
• sharper and longer cusp than permanent canine
• mesial cusp ridge is longer than distal cusp ridge
• appears wide and short
• long, slender, tapering root that is more than 2x the length of the crown

Question 20

Properties of mandibular central incisor (4)

Answer 20

• smaller than maxillary incisor – labiolingual measurement is 1mm less
• labial surface flat with no developmental grooves
• lingual surfaces are convex presenting marginal ridges and cingulum
• Incisal edge is straight and bisects crown labiolingually

Question 21

Properties of mandibular lateral incisors (3)

Answer 21

• slightly larger than mandibular central incisor except labiolingually
• lingual surface has greater concavity between marginal ridges
• Incisal edge slopes towards distal

Question 22

Properties of mandibular canine (3)

Answer 22

• crown slightly shorter than maxillary canine
• root is 2mm shorter than maxillary canine
• not as large labiolingually than maxillary canine

Question 23

Properties of maxillary first molar (5)

Answer 23

• greatest dimension is at the MD contact areas
• ML cusp is largest and sharpest
• DL cusp is poorly defined, small, and round
• Buccal surface is smooth
• 3 rootsL long, slender, and widely spread

Question 24

Properties of maxillary second molars (5)

Answer 24

• most similar to maxillary first permanent molar
• two well-defined buccal cusps with developmental grooves between them
• crown is larger than primary first molar
• lingual surface you can see: ML, DL cusps, and cusp of Arabella
• oblique ridge connects ML and DB cusps

Question 25

Properties of mandibular first molars (8)

Answer 25

• does not resemble any permanent teeth
• from the Buccal view, mesial outline is almost straight form contact to cervical region
• two distinct Buccal cusps with no distinct developmental groove (MB cusp is larger and longer – 2/3 of Buccal surface)
• ML cusp is larger, longer and sharper than DL cusp
• crown is wider MD than cervico-occlusally
• mesial marginal ridge is very well developed
• prominent MB cervical ridge
• no central fossa

Question 26

Properties of mandibular second molars (6)

Answer 26

• resembles mandibular first permanent molar
• MB, DB, and distal cusp are almost equal in size
• mesial marginal ridge is more developed than distal marginal ridge
• occlusal form appears rectangular with slight distal convergence
• roots long and slender with flare mesial dismally in middle and apical thirds

Question 27

What size sensor is generally used on children for BW and posterior PA

Answer 27

Size 0

Question 28

Where does the central ray enter for x-rays in children for BWs?

Answer 28

Enters through occlusal plane at a point below the pupil of the eye with a vertical angle of +8 to +10 degrees

Question 29

What angle is the maxillary PA radiograph supposed to be taken?

Answer 29

Beam at right angle to the film – usually +30 degrees

Question 30

What angle are mandibular PA radiographs supposed to be taken?

Answer 30

Right angle to the film starting at an angle of about 5 degrees

Question 31

What size sensor is used for anterior maxillary teeth and where is the ray directed?

Answer 31

Size 2 and directed at the spices of central incisors a centimeter above the tip of the nose. The vertical angular ion is +60 degrees

Question 32

What is the recommended toothpaste dose for children below and above 2 years of age

Answer 32

2years is .2mg (pea size)

Question 33

When does the child undergo cognitive changes?

Answer 33

Ages 3-6 - referred to as preschool years