Exam 2 - Oral Health/Cleft Lip

Question 1

How many primary teeth do babies have and at what age should they all be present?

Answer 1

20

Age 3

Question 2

What allows baby teeth decay to advance quickly?

Answer 2

Thin enamel

Question 3

When do baby teeth first start coming in?

Answer 3

4-15mo

*later for premature and low birth weight babies

Question 4

Which baby teeth are usually lost first?

Answer 4

Lower incisors

Question 5

When does eruption of permanent teeth being and end?

Answer 5

6-12

Question 6

What is mixed dentition?

Answer 6

Primary and permanent teeth

Question 7

Why is it important to maintain healthy baby teeth?

Answer 7

The baby teeth can directly affect the permanent teeth

Question 8

How do early caries (cavities) present?

Answer 8

Decalcification

White spots that don’t wipe off

Question 9

How do you prevent progression of caries?

Answer 9

Plaque removal and fluoride

Question 10

What are the stages of caries progression?

Answer 10

1. Decalcification
2. Moderate caries
3. Severe caries

Question 11

How do moderate caries (cavities) present?

Answer 11

Brown or black spots

Question 12

How do severe caries (cavities) present?

Answer 12

Risk of fracture
Affects chewing
High risk of infection

Question 13

What is a major cause of Early Childhood Caries (ECC)?

Answer 13

Refined carbohhydrates

Question 14

What is Early Childhood Carries (ECC)?

Answer 14

Results in severe decay and destruction

Transmissible (younger than age 5)

Question 15

If a parent or sibling has cavities why are their children at higher risk for also developing cavities?

Answer 15

Transfer of bacteria

Question 16

If a child uses a bottle after 15mo why are they at higher risk of developing cavities?

Answer 16

Carbs have more contact with teeth

Question 17

When is breast milk cariogenic?

Answer 17

When combined with carbohydrates

Question 18

When should oral hygiene be introduced?

Answer 18

Once teeth are present following feeding (breast or bottle)

Question 19

When should a sippy cup be introduced, and when should a bottle be eliminated?

Answer 19

Introduce a cup as soon as child can sit up unsupported and eliminate bottle by 1 year

Question 20

When should fruit juice be given?

Answer 20

WIth meals

Question 21

What types of food should be avoided?

Answer 21

Avoid sticky foods: raisins, fruit leathers, candy

Question 22

Can teething cause diarrhea, rashes, or fever?

Answer 22

No

Question 23

What are some helpful tips for parents with teething babies?

Answer 23

• Give the baby something cold to chew
• Regularly wash teething rings
• Rub gums with a clean finger
• Acetaminophen

Question 24

When should children discontinue sucking habits?

Answer 24

2-4

QUIT by age 4

Question 25

What is the toothbrushing recommendation for children <1y?

Answer 25

Clean with soft toothbrush

Question 26

What is the toothbrushing recommendation for children 1-2y?

Answer 26

Parent should perform brushing with a smear of fluoride toothpaste 2x/day

Question 27

What is the toothbrushing recommendation for children 2-6y?

Answer 27

Pea-sized fluoride toothpaste 2x/day parent perform/supervise

Question 28

What is the toothbrushing recommendation for children >6y?

Answer 28

Brush with fluoride toothpaste 2x/day

Question 29

How much fluoride toothpaste should a child under the age of 2 use?

Answer 29

Smear

Question 30

How much fluoride toothpaste should a child under the age of 2-6 use?

Answer 30

Pea-sized

Question 31

What can excessive fluoride cause?

Answer 31

Flurosis

Question 32

When does threat of fluorosis disappear?

Answer 32

Age 8

Question 33

When can a start brushing independently?

Answer 33

Age 6

Question 34

When should flossing begin? And at what age do children no longer need assistance?

Answer 34

When teeth touch | Age 8-10

Question 35

What are the most common structural birth detects?

Answer 35

Orofacial clefts

Question 36

What are some risk factors for orofacial clefts?

Answer 36

Maternal smoking, drinking, diabetes, and obesity

Question 37

What populations have the highest prevalence of orofacial clefts?

Answer 37

American Indian

Question 38

How do clefts affect feeding?

Answer 38

- Difficulty forming negative pressure for sucking breast or bottle - Overcome with nipples that extend further - Frequent burping necessary due to baby swallowing air - Feed more upright

Question 39

How do clefts affect ears?

Answer 39

- Slack palate muscles close middle ear space leaving no mechanism for drainage - Bacteria from nasopharynx accumulate in fluid leading to infection - Chronic inflammation leads to hearing impairment

Question 40

How do clefts affect speech?

Answer 40

1. Retardation of consonant sounds 2. Hypernasality may remain after surgical repair 3. Dental malocclusion (abnormal bite) and abnormal tongue placement may produce an articulation problem 4. Hearing problem

Question 41

What are associated anomalies of clefts? (3)

Answer 41

30% have other anomalies 10% have congenital heart disease 10% have some degree of mental retardation

Question 42

How are nasoalveolar moldings (NAM) used?

Answer 42

- NAM shapes mouth and improves nose as early as first week - Worn 24 hours a day only removed for cleaning - Unilateral clefts 3 months - Bilateral clefts 6 months - Aid with feeding

Question 43

How do clefts cause dental problems?

Answer 43

- Clefts affect the development of primary and permanent teeth - Absence of teeth or supernumeraries (extra teeth) - Can affect the development of the upper jaw