General paeds Flashcards
what are 4 indications for radiographs as part of a treatment plan?
Caries detection
Caries progression
Unerupted teeth
Root resorption
At what age should you start taking bitewings at?
5 years
What are the 3 agents in ledermix?
Devitalising
Antibiotic
Steroid
Name 2 cariogenic bacteria?
Strep mutans, lactobacilli
Name 2 non-cariogenic bacteria
Strep oralis
Strep Salivarus
Where does the operator stand and the child sit for the following extractions?
Uppers
LLQ
LRQ
Uppers- you stand in front with child at 30 degrees up
LRQ- stand behind and child as low as possible
LLQ- you stand in front but child at elbow height
What are 4 complications that can occur post extraction?
Dry socket
Further bleeding
Infection
prolonged anaesthesia
What are the post of instructions given after XLA?
POIG
Soft diet
Don’t exercise for rest of day
don’t rinse for rest of day
if bleeding, roll up tissue and bite down for 10 mins
written instruction on whre to go if bleeding etc
What are the components of a functional appliance? (4)
Baseplate- to hold components together
Activator- springs for tooth movement
Retention- clasps to hold appliance in
Anchorage- resistance against unwanted tooth movement
What radiographs are most commonly taken prior to functional therapy? (2)
DPT
Lateral ceph
What are 4 ways of making space in the dentition
XLA
Inner enamel reduction
expansion (quadhelix)
Functional appliance
Why might you extract a maxillary central?
3
trauma
pathology
dilaceration
Why might you extract a mandibular incisor?
3
fanned incisor
Lingual displacement with good 1-3 contact
tooth size discrepancy
What can cause a midline diastema? (3)
prominent frenum
proclined maxillary incisors
spacing
What disease can be mistaken for teething?
Primary herpatic gingivostomatitis
What are 3 oral features of herpangina?
Sore throat
Dysphagia
Vesicles on soft palate
What nerve does Ramsey Hunt syndrome affect and what are the signs of it?
Facial Rash in ear Facial palsy Anterior 2/3 loss of taste Ulcers on soft palate
What causes root dilaceration?
Damage to the tooth germ during root development
What is an invaginated tooth?
Normal tooth tissue in abnormal form
Dens en dente
What are the signs and symptoms of chickenpox? (7)
Rash of papules, pustules, macules, vesicles Airbourne and droplet spread incubation of 2-3 weeks Cervical lymphadenopathy Malaise Fever ulcers
What are 5 outcomes of trauma?
MIH Pulp death Root resorption Resorption of permanent tooth germ Ankylosis Dilaceration
What are the 5 types of child abuse and what is an example of each?
Sexual- pregnancy
Neglect- poor hygiene, dirty clothes
Dental neglect- multiple Ga, gross caries
Emotional- withdrawn, over reacts to mistakes
Physical- unexplained injuries, shying away from physical contact etc
What is an oral sign of measles?
Koplik spots- red macules with white necrotic centres
What are 7 common reasons for oral pain in children?
Infection Caries Trauma Wear Abscess Eruption St (ulcers burns)
What is the history of reversible pulpitis?
Sweet hot cold pain
Pain goes when stimulus removed
Pain mainly when eating
What is the history of irreversible pulpitis?
Pain is constant
Pain keeps awake at night
Only relieved by analgesics
What is the clinical sign and radiograph findings of reversible pulpitis?
Early caries lesion
Caries into dentine
What is the clinical sign and radiographic findings of irreversible pulpitis?
Marginal ridge breakdown
Radiolucency
Caries close to pulp
what is stabalisation and what are the steps of it?
It is to buy you time in an unco-operative kid who has multiple caries- remove from margins and dress with GI
Allows for the lesion to arrest and not to progress
Good for the pre- cooperative patient
what is temporisation?
Pain relief when you cannot do the permanent restoration or extraction at the time
What indicated a child is a high caries rate?
Caries in buccal pits and fissures of molars
What are the indications for a SSC?
Large class 2 cavities Occlusal caries Badly broken down teeth (marginal ridge loss) Following pulp therapy Hard tissue anomolies
What is discing?
Is it a technique used with anterior aproximal caries to make a lesion self cleansing but good preventative measures must be taken
What is different about the angle of the mandible in a child compared to an adult?
the angle is more obtuse so the formamina is lower
What are patients with down’s syndrome at risk of?
Perio disease Hypodontia Hypoplasia High caries risk delayed exfoliation of primary teeth (maybe due to hypodontia)
What are the movements involved with extracting teeth?
Apical push and buccal-lingual socket expanding movements
What are the post op advice/actions after an extraction? (7)
Pinch socket to apply pressure
Get patient to bite down for 5 mins on a bite pack
you must achieve haemostasis before sending patient away
POIG
Don’t exercise or rinse for rest of the day
If bleeds at home then roll up tissue and bite down for 10 mins
Review in 1 week
What are the paracetamol dosages for children
1-5= 120-250 mg 6-12= 250-500 12+= 500mg
What are the 3 peak ages for trauma? What is an example for each?
2-4= walking 8-10= sports at school 14-46= contact sports/drinking
What is the protocol for a trauma patient coming in? (12)
Check for any head injuries
Check the dental injury
If there is blood in the corner of the eye then it can indicate a fractured zygoma so don’t blow the nose
Where is the tooth? Any tooth fragments brought with them?
Does the story fit?
Do any emergency dental treatment required
Document everything
Clean up the patient
Take clinical photographs and radiographs
review in 1 week
Check if had tetanus
Ask if any LOC, vomitting, double vision
What 2 types of dental injuries can occur due to trauma?
Injury to the tooth due to hard hit
Injury to the socket due to a soft hit (elbow)
what is luxation?
Displacement of the tooth in the alveolar bone
What is concussion?
Injury to the tooth without displacement of mobility. Injury to the PDL so haemorrhage and oedema in the ligament
What are the clinical signs of concussion?
TTP
What is subluxation?
Mobility but not displacement of the tooth
What is the clinical signs of subluxation?
gingival bleeding
mobility
What is the management of concussion and subluxation?
soft diet for 1 week PA radiograph check if had tetanus follow up in 1 week Splint if sublux
What is the management of intrusive luxation?
Allow to re erupt
If fully intruded then extract most likely
If no movement in 3 weeks get ortho involved
What is the management of avulsion of a permanent tooth?
Give La
re implant tooth and gently bite down
Why would you carry out a desensitising pulp therapy? (4)
reduce inflammation on pulp to carry on with a pulp therapy
With a carious exposure but no signs or symptoms
hyperalgesic pulp
hyperaemic pulp
What are the contra indications for a functional appliance?
Over 14 years Poor OH Poor compliance Malocclusion is severe Condyle disease
What are down’s syndrome patients at risk of?
Perio disease Hypodontia Microdontia High caries rate Hypolastic teeth Delayed exfoliation of primary teeth
What are the 3 age peaks for trauma?
2-4
8-10
14-16
What is concussion?
injury to the tooth without displacement
Why do you check for vitality 1 week post trauma?
The tooth will be sore on the day so will be inaccurate
What is the management for concussion?
PA radiograph
follow up in 1 week
Advise a soft diet
Check if had tetanus
Wha is the management for subluxation?
Soft diet Review in 1 week Splint for 2 weeks Check if had tetanus PA radiograph
What is germination?
developmental separation of a single tooth germ to produce 2 separate teeth
What is fusion?
Union of two normally separated adjacent teeth (2 canals 1 tooth)
