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BDS2 CDS Paedriatric > Growth and Development > Flashcards

Growth and Development Flashcards

1
Q

what happens in baby clinics

A

weighed
height taken (length lying down)
head circumference measure

check meeting milestones

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2
Q

jaw relationships at birth

A

Gum pads widely separated anteriorly - gap

Tongue resting on lower gum pad

Tongue in contact with lower lip
- Later, rest behinds teeth

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3
Q

sequence of eruption of primary teeth (basic)

A

From anterior to posterior

As a general rule mandibular tooth erupt before maxillary

Eruption begins at 6 months

Eruption of deciduous dentition is in most cases complete by 24 months of age

But wide variation

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4
Q

5 characteristics of primary dentition

A 
Incisors upright 
Incisors spaced
Teeth are smaller
Reduced overjet 
More white in colour
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5
Q

5 areas in psychology of child development

A 
Motor
Cognitive 
Perceptual 
Language 
Social
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6
Q

motor development in children

A

Predictability of early “motor milestones” suggests that it must be genetically programmed.

Completed in infancy

  • changes following the ability to walk are refinements.
  • Post 14 months

Eye-hand coordination gradually becomes more precise and elaborate with increasing experience.

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7
Q

4 stages in cognitive development in children

A

sensorimotor

preoperational thought

concrete operations

formal operations

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8
Q

sensorimotor stage of cognitive development in children

A

Until about 2 years, prime achievement is object permanence

  • Infant can think of things as permanent and still existing when out of sight
  • Can’t think of objects without actually having to see them
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9
Q

preoperational thought stage of cognitive development in children

A

2 to 7 years.

Allows child to predict outcomes of behaviour.
- Facilitated by language development.

Thought patterns are still egocentric
- unable to see another person’s point of view.

Unable to understand why areas and volumes remain unchanged even though their shape or position my change.

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10
Q

concrete operations stage of cognitive child development

A

7 to 11 years.

Able to apply logical reasoning and consider another person’s point of view.
- Important for dentist – see other perspectives explain to child e.g. how happy parent will be if they sit nicely

Thinking is rooted in concrete objects
difficult to think in a more abstract manner

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11
Q

formal operations stage in cognitive development of children

A

begins at 11 years

beginning of logical abstract thinking so that different possibilities for an action can be considered.

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12
Q

perceptual development of children

A

Difficult to know what babies are experiencing perceptually.
- Most research looks at eye movement.

Compared to an adult a 6 year old will cover less of an object, take in less information and become fixated on details.

Selective attention by 7 years.

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13
Q

language development of children holdbacks (2)

A

A lack of appropriate stimulation will retard a child’s learning, particularly language.
- No talking from parent to child – even though one sided, important as baby listening

A child needs language to be able to think about what she/he sees and hears.

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14
Q

1 year old understands

A

vocab of 20 words

  • simple phrases
  • relates object to word e.g. toy name
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15
Q

1 year old uses

A

2-3 words

  • repetitive babble
  • tuneful jargon
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16
Q

1 year old sounds

A

b
d
m

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17
Q

2 year old understands

A

simple commands

  • questions
  • joins in action songs e.g. incy wincy spider
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18
Q

2 year old uses

A

vocabulary of 100 words

puts 2 words together

echolalia (copies what you say)

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19
Q

2 year old sounds

A 
p
t
k
g
n
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20
Q

3 tear old understands

A

prepositions (on, under etc)

functions of object

simple conversations

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21
Q

3 year old uses

A

4 word sentences

  • what, who, where
  • relates experiences
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22
Q

3 year old sounds

A

f
s
l

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23
Q

4 year old understands

A

colours

numbers

tenses

complex instructions

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24
Q

4 year old uses

A

long grammatical sentences

relates stories

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25
Q

4 year old sounds

A

v
z
ch
j

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26
Q

9 disorders of speech and language that can occur

A

Learning difficulties

Cerebral palsy

Autism

Delayed speech and
language development

Head injury

Acquired neurological disorders

Non fluency

Dysphonia

Craniofacial disorder

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27
Q

what is needed for normal speech production

A

competent airway and articulators (lip, teeth, tongue etc)

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28
Q

normal speech production is classified by (3)

A

place

manner

voice

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29
Q

cleft type speech qualities

A

resonance

articulation

nasal emission

30
Q

velopharyngeal incompetence (VPI)

A

unable to block off nasal passageway to rest of passageways

unable to have normal speech

31
Q

oro-nasal fistula

A

air goes up into nose from oral cavity so can’t make some sounds

unable to have normal speech

32
Q

class III occlusion

A

protruding mandible

can cause problem in producing dentate sounds

unable to have normal speech

33
Q

3 roles of cleft team

A

assessment
diagnosis
treatment

as early as possible

34
Q

different people in cleft team (multidisciplinary team)

A

Speech and Language Therapist

Primary cleft surgeon

Secondary cleft surgeon

Orthodontist

Paediatric dentist

ENT surgeon

Geneticist

Nurse

Psychologist

35
Q

initial treatment of clefts

A

Feeding
- Can’t be breast fed as unable to have suction from lips

Early intervention

Input modelling

Articulation therapy

36
Q

when would cleft lip surgery tend to be

A

3 months

37
Q

secondary cleft surgery can be

A

Nasal revision

Fistula closure
-Secondary hole in palate due to surgery

Pharyngoplasty

Alveolar bone graft
- At cleft site to allow permanent teeth to erupt

Osteotomy

38
Q

2 types of non cleft VPI

A

bifid uvula

no uvula

(both cases back of palate wrong so unable to have normal speech)

39
Q

development of feeding skills of infant - pre 40 weeks (in utero)

A

28 weeks – non-nutritive sucking

34 weeks – nutritive sucking

40
Q

development of feeding skills of infant - 0-3 months

A

Normal oral tone

Rhythmical sucking

Primitive reflexes

  • Gag
  • Rooting
  • Suck/swallow

Semi-recline feeding position

Liquid diet

41
Q

development of feeding skills of infant - 4-6 months

A

Head control

More control of suck/swallow

Munching

Move towards semi solid diet (UK not recommended to wean till 6 months)

Starts babbling

42
Q

development of feeding skills of infant - 7-9 months

A

Sitting feeding position

Mashed consistency

Finger food

Upper lip involvement

Chewing and bolus formation

Bite reflex

Mouthing

43
Q

development of feeding skills of infant - 10-12 months

A

Lumpy food

Sustained bite (continuous chewing)

Active lip closure

Chewing – lateralisation

Cup drinking

44
Q

development of feeding skills of infant - 24 months

A

a mature and integrate feeding pattern

45
Q

when does baby start non-nutritive sucking

A

28 weeks in utero

46
Q

when does the baby start nutritive sucking

A

34 weeks in utero

47
Q

3 considerations to remember when communicating with children

A

develop natural skills over time

environment conversation happening

its a 2 way process - LISTEN

48
Q

5 effects of family unit

A

behaviour contagion

well-intentioned but improper preparation

discuss dental treatment within hearing of the child
-ensure they understand simultaneously or explain to them first

enhancing the child’s anxiety

threatening the child with dental treatment

49
Q

assessment to be carried out when child pt comes to surgery

A

pain

past dental history

relevant past medical history

social history

level of understanding and potential co-operation

level of anxiety

50
Q

what is a knee-to-knee examination

A

for children under age of 3

not on dental chair

held in patients lap and you kneel in front

51
Q

3 areas to successful behaviour management

A

communication

education

interaction

52
Q

things that frighten children

A

the unknown

sight of the anaesthetic syringe

sight, sound and sensation of the drill

mutilation

choking

perceived expectation of ill-treatment/ trauma

strangers
- calm and friendly on initial visit

53
Q

dental anxiety in children prevalence

A

16% of school-age children are afraid of the dentist and consequently avoid attending

54
Q

children Vs adult dental anxiety

A

Children display their anxiety differently from adults
- they are more irrational and less restrained.

There is wide variation between individual children, this may be is largely genetically determined.

Some children who refuse dental treatment have been shown to generally have difficulty adapting to change.

55
Q

examples of manifestation of anxiety in children

A 
Thumb-sucking 
Nail biting 
Nose picking 
Clumsiness
Stuttering 
Stomach pain
Need to go to the toilet
Headache 
Dizziness 
Fidgeting 
No speech 
Clinging to parent 
Hiding

related to: age, sex, social class

56
Q

influencing factors on whether child will suffer from dental anxiety

A

each child’s own psychological make-up

understanding

emotional development

previous adverse dental/ medical experience
- scarring memory

attitude & previous experience of family/ peer-group

the behaviour of the dentist

57
Q

child interactions DO NOT

A 
bribe 
coax
shout 
bully 
threaten 
allow child to have all their own way
58
Q

should you show empathy when tx child

A

yes

create an environment in which the child feels safe

  • use a kind empathetic approach using directive guidance, and reinforcement to establish co-operation and obtain a rapport
  • allow the child some control (e.g. hand signal)

question for feeling

  • are you alright? Are you OK? Are you getting tired?
  • show you understand their feeling – acknowledge but move on (know disliked but will benefit it)
59
Q

good dentist to child communication

A

Improves the information obtained from the patient

Enables the dentist to communicate information to the patient

Increases the likelihood of patient compliance

Decreases patient anxiety

relate to what they know - films etc

60
Q

breakdown of components of communication

A

verbal 5%

para-linguitic 30%

non-verbal 65%

61
Q

verbal communication

A

This consists of the actual words the person uses.

Try to avoid the use of jargon and specific terms that the patient might not understand
- Children are not small adults.

The approach and language used with them can be modified to match their abilities and understanding

62
Q

dental language alternatives examples for children

A

Cotton Wool Roll’s= Tooth Pillow’s
- Give one to touch and feel

Topical Anaesthetic= Bubble gum or minty gel

Probe= pointer/tooth counter

Excavator= Tooth Spoon

High Speed= Tooth Shower

Slow Speed= “Mr Bumpy”, Tooth Scrubber

Local Anaesthetic= Special Spray, Sleepy Juice

Be careful if autistic – very literal, so don’t use anything that could scare them

use analogies

63
Q

paralinguistic communication

A

This refers to the tone of voice used by the individual.

Loudness has been one aspect of paralinguistic communication that has been investigated in the dental field with children.
- It was found issuing commands in a loud voice was more effective than using a normal voice

64
Q

non-verbal communication

A

Includes a range of behaviours and environmental factors which we often interpret without conscious awareness

  • Facial expression
  • Gaze
  • Gesture
  • Bodily contact
  • Clothes
  • Spatial
65
Q

dentist role in reducing child’s anxiety

A

Preventing pain

Being friendly & establish trust

Working quickly

Having a calm manner

Giving moral support

Being re-assuring about pain
- Avoid using “pain”, “sharp” etc as this is all they will hear

Empathy

66
Q

dentist role in increasing fear in children

A

Ignoring or denying feelings

Inappropriate reassurance
- “Nearly done” avoid

Coercing/Coaxing

Humiliating

Losing your patience with the patient

67
Q

parents role in child’s for dental visit

A

dentist should advise the parent how to prepare the child for the visit

  • a pre-appointment letter,
  • rehearsal (if wanted)

supportive care prior to each stressful procedure

can be beneficial to be not in room

68
Q

beneficial for child for parent to be present?

A

Research suggests that the child’s behaviour is unaffected by parental presence or absence

The exception would appear to be children less than 4 years of age who have been shown to behave better with a parent present.

69
Q

when would parents be excluded from surgery child is in

A

try to in most cases

especially if:

  • Unable to refrain from competing with the dentist for their child’s attention.
  • Unintentionally convey their own anxieties to their child through body language and words.

Involving the parent in the planning stages and outlining their role as a passive but silent helper may provide a comforting presence (explain your behavior modifying technique so they are not shocked if you raise voice)

70
Q

what is inclusive parent role in dentistry and when needed

A

Patient is incapable or unwilling to sit for examination
- positioning the child in the lap of the parent permits the child to be in direct visual and physical contact with the parent (knee-to-knee)

Opportunity exists for the parent to witness the behaviour the clinician must contend with

71
Q

what is the link between pain and anxiety

A

Anxious subjects are more likely than non-anxious to report pain
- This points to the psychological role in pain perception

Anxiety, previous experience, expectation, anticipation, communication and control can influence pain perception

72
Q

how to minimise pain and anxiety in child Tx

A

Care should be taken not to hurt any child

Restorative care is usually carried out under local analgesia

A painless technique of administering LA is of vital importance - Wand
An introduction to topical and LA is an integral part of treatment (cotton wool roll)

BDS2 CDS Paedriatric (7 decks)

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