EXAM I Examination of the Mouth and Other Relevant Structures; Radiographic Technique

Question 1

when should a child first see the dentist? when is the goal for a child having a dental home?

Answer 1

• within 6 months of the eruption of their first tooth (usually by age 1)
• goal for a dental home is by age 1

Question 2

what is the most common chronic childhood disease?

Answer 2

tooth decay

5x more comon than asthma

4x more common than early childhood obesity

20x more common than diabetes

Question 3

is demineralization more common on maxillary or mandibular teeth? why?

Answer 3

maxillary teeth, mostly due to protection of the mandibular teeth by the tongue and pooling of saliva

Question 4

what is an eruption hematoma? what is the treatment?

Answer 4

• as a tooth erupts through the gingiva, it can cause a blood blister below the tissue
• no treatment, other than teething exercises

Question 5

what is the eruption/shedding sequence/timing of deciduous teeth?

Answer 5

(sequence is more important for class rather than dates)

Question 6

is it an issue if a child’s teeth are erupting late?

Answer 6

no

Question 7

how many high risk factors are needed to make someone a high-risk candidate for caries?

Answer 7

one

Question 8

___ is described as exposing patients to ionizing radiation only if there is no other way to obtain the diagnostic information or if this exposure will psotiively influence the diagnosis, treatment, and patient’s health

Answer 8

justification principle

Question 9

___ is described as always keeping the radiation dose as low as reasonably achievable

Answer 9

limitation principle

Question 10

___ is described as obtaining the best quality images possible

Answer 10

optimization principle

Question 11

___ is the formation of a cancer, whereby normal cells are transformed into cancer cells. the process is characterized by changes at the cellular, genetic, and epigenetic levels and abnormal cell division

Answer 11

carcinogenesis

Question 12

___ is the development of physical defects in an embryo

Answer 12

teratogenesis

Question 13

___ is the process by which the genetic information of an organism is changed, resulting in a mutation

Answer 13

mutagenesis

Question 14

what 3 things are children at risk for developing as a result of too much radiation?

Answer 14

carcinogenesis, teratogenesis, and mutagenesis

Question 15

the estimated risks of developing a fatal cancer as a result of diagnostic radiographs for children under 10 years old has what multiplication factor? what about age 10-20?

Answer 15

• <10 = 3x
• 10-20 = 2x
• risk decreases with age

Question 16

when is a good time to take a panoramic film?

Answer 16

around age 6-8, just as a screening measure to rule out pathology, then again around 12, then again as needed if the patient is being evaluated for orthodontics

not necessary to take one every year

Question 17

___ is the process of providing practical, developmentally-appropriate information about children’s health to prepare parents for the significant physical, emotional, and psychological milestones

Answer 17

anticipatory guidance

Question 18

are avulsions (luxation) or crown/root fractures more common in children who fall?

Answer 18

avulsions

Question 19

what are biological factors that put children at high caries risk?

Answer 19

• mother/primary caregiver has active caries
• parent/caregiver has low socioeconomic status
• child has >3 between meal sugar-containing snacks or beverages per day
• child is put to bed with a bottle containing natural or added sugar

Question 20

what are biological factors that put children at moderate caries risk?

Answer 20

• child has special health care needs
• child is a recent immigrant

Question 21

what are protective factors that put children at low caries risk?

Answer 21

• child receives optimally-fluoridated drinking water or fluoride supplements
• child has teeth brushed daily with fluoridated toothpaste
• child receives topical fluoride from health professional
• child has dental home/regular dental care

Question 22

what are clinical findings that put children at high caries risk?

Answer 22

• child has >1 decayed/missing/filled surfaces
• child has active white spot lesions or enamel defects
• child has elevated mutans streptococci levels

Question 23

what are clinical findings that put children at moderate caries risk?

Answer 23

child has plaque on teeth

Question 24

in addition to the typical examination components of a 6-24 month old, what components are added in the examination of children 3-12 years old?

Answer 24

• assessment and treatment of developing malocclusion
• assessment for pit and fissure sealants

Question 25

in addition to the typical examination components of a child <12 years old, what components are added in the examination of children >12 years old?

Answer 25

• substance abuse counseling
• counseling for intraoral/perioral piercing
• assessment and/or removal of third molars
• transition to adult dental care

Question 26

when should perio screening be initiated in children?

Answer 26

following the eruption of permanent incisors and first molars

Question 27

what are common radiographs taken for dento-alveolar trauma affecting maxillary incisors? what about evaluating a possible mandibular fracture?

Answer 27

• maxillary incisor trauma - PA and occlusal radiographs
• mandibular fracture - pano, possibly consider a CBCT

Question 28

what are useful radiographs for special needs patients?

Answer 28

lateral oblique and occlusal radiographs

Question 29

what are the guidelines for prescribing radiographs for a new patient with primary dentition only?

Answer 29

• individualized
• open contacts and no evidence of decay - no radiographs required
• proximal contacts and/or evidence of decay will need radiographs

Question 30

what are the guidelines for prescribing radiographs for a new patient with transitional dentition?

Answer 30

• individualized
• posterio BWX, pano, PA

Question 31

what are the guidelines for prescribing radiographs for a new patient with permanent dentition (adolescent)?

Answer 31

• individualized
• BWX, pano, PA
• if generalized evidence of decay, or history of extensive treatment - FMX

Question 32

what are the guidelines for prescribing radiographs for a recall patient with clinical caries, with primary dentition only? what about transitional dentition? permanent dentition (adolescent)?

Answer 32

• BWX at 6-12 month intervals if proximal surfaces can’t be seen
• same for all

Question 33

what are the guidelines for prescribing radiographs for a recall patient with no clinical caries, is not at increased risk for caries, and has primary dentition only?

Answer 33

BWX at 12-24 month intervals if proximal surfaces can’t be seen

Question 34

what are the guidelines for prescribing radiographs for a recall patient with no clinical caries, is not at increased risk for caries, and has transitional dentition?

Answer 34

BWX at 12-24 month intervals if proximal surfaces can’t be seen

Question 35

what are the guidelines for prescribing radiographs for a recall patient with no clinical caries, is not at increased risk for caries, and has permanent dentition (adolescent)?

Answer 35

BWX at 18-36 month intervals

Question 36

what are the guidelines for prescribing radiographs for a recall patient with perio who has primary dentition only? transitional dentition? permanent dentition (adolescent)?

Answer 36

clinical judgement

Question 37

what are the guidelines for prescribing radiographs for monitoring of growth and development in a child with primary dentition only?

Answer 37

clinical judgement

Question 38

what are the guidelines for prescribing radiographs for monitoring of growth and development in a child with transitional dentition?

Answer 38

clinical judgement

Question 39

what are the guidelines for prescribing radiographs for monitoring of growth and development in a child with permanent dentition (adolescent)?

Answer 39

clinical judgement, plus pano and/or PA to assess developing 3rd molars