History and examination

Question 1

List features of the primary dentition

Answer 1

• Thin uniform enamel layer
• Thin dentine layer
• Very white
• Large pulp
• Divergent, thin roots with fine root canals
• Broad contacts

Question 2

List features of the permanent dentition

Answer 2

• Variable enamel thickness, with a thicker dentine later
• Usually white-yellow
• Small pulp getting smaller with age
• Deep fissures

Question 3

List the history taken at a new child pt examination

Answer 3

Accompanying person 
Referred by 
CO and HPC 
MH, DH, SH 
Diet history 
OH 
Habits

Question 4

List basic examination procedure for a first appt?

Answer 4

EO
IO 
Full dental charting
Plaque score and BPE (depending on age) 
Caries risk 
Occlusal assessment 
Behaviour score

Question 5

Age and BPE

Answer 5

<7 - NO BPE
7-11 - BPE codes 0, 1 and 2 on index teeth
12-17 - full BPE scores on index teeth

Question 6

What are the index teeth in paediatric BPE

Answer 6

61/16

61/16

Question 7

What are the Frankl Behaviours scale scores?

Answer 7

– = very negative (crying, refusal, nothing done)
- = some evidence of negative attitude
+ = positive but cautious behaviour at times
++ = very positive, interested, laughing

Question 8

Who can provide consent in paeds

Answer 8

• Mother
• Father (if on birth cert, married to mother at time of birth or has a parental court responsibility)
• Legal guardian
• Local authority designated in a care order

Question 9

Age of consent

Answer 9

16+ can legally consent to any dental tx without consent of parent or guardian

Gillick/Fraser competent if deemed so by the dental professional

Question 10

What will caries risk assessment determine in the care plan?

Answer 10

Prevention required, recall period and intervals between radiographs

Question 11

What is caries risk assessment

Answer 11

Identifying the patients susceptibility to dental caries

Question 12

What can increase caries risk?

Answer 12

Diet 
Poor OH/use of fluoride 
Social status 
MH - poor saliva, sugary medicines 
Appliances in the mouth

Question 13

What are the 3 evidence-based factors indicating high-risk caries in children?

Answer 13

• Previous caries experience (dmfs)
• Resident in deprived area
• Healthcare worker’s opinion

Question 14

What to assess during occlusal assessment?

Answer 14

• Dental age corresponding to chronological age
• Incisor and molar relationship
• Any discrepancies indicating ortho assessment

Question 15

What are ideal/common occlusal features in the primary dentition?

Answer 15

• Spaced dentition
• Overbite which develops into edge to edge
• Flush terminal plane molar relationship
• Midline diastema

Question 16

What major occlusal pathologies should be investigated?

Answer 16

• Asymmetrical eruption > 6m
• Any unerupted tooth >6 months outside normal eruption time
• Unable to palpate upper 3s in buccal sulcus from 9-10

Question 17

ICDAS score 0

Answer 17

Sound tooth tissue

Question 18

ICDAS score 1

Answer 18

First visual change in enamel showing opacity or discolouration (white or brown) on prolonged air drying

Question 19

ICDAS score 2

Answer 19

Distinct visual change in enamel when wet and after prolonged drying

Question 20

ICDAS score 3

Answer 20

Local enamel breakdown (without signs of dentine involvement) when wet and dry

Question 21

ICDAS score 4

Answer 21

Underlying shadow from dentine visible

Question 22

ICDAS score 5

Answer 22

Distinct cavity visible involving dentine

Question 23

ICDAS score 6

Answer 23

Extensive cavity >half the tooth surface involved, distinct cavity with visible dentine

Question 24

Brief ICDAS scoring

Answer 24

0 - sound 
1 - enamel WSL or BSL on drying 
2 - enamel lesion when wet 
3 - localised enamel breakdown, wet and dry
4 - dentine shadow 
5 - visible dentine involvement 
6 - >half tooth w visible dentine