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PEDIATRIC DENTISTRY > L.12,13,14-Radio, LA, Ext > Flashcards

L.12,13,14-Radio, LA, Ext Flashcards

1
Q

The most important point about Radiographs for a patient: there is no general indication for taking radiographs, a ________ is performed first, then other assessments. Then if there are indications, a _______ is taken.

A

clinical exam…radiograph

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2
Q

SLOB RULE: If an object moves WITH the head (same) it is on the _______ (aka ______) side of the arch.

A

Lingual (Palatal)

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3
Q

SLOB RULE: If an object moves OPPOSITE to the head of the x-ray beam, the object is on the ________ (aka ______) of the arch.

A

buccal…labial

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4
Q

What is the nickname for a bitewing?

A

a “caries detecting” radiograph

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5
Q

The recommendations for taking x-rays are subject to clinical judgment and may not apply to _____ patient.
They are to be used by dentists only after reviewing the patient’s health history and completing a clinical _______.

A

EVERY…EXAM

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6
Q

Dental Radiation accounts for __% of al healthcare x-rays

A

1%

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7
Q

Which gland is most susceptible to dental radiograph exposure?

A

thyroid

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8
Q

In radiology: Know What You ______ to See Before You Shoot

A

EXPECT

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9
Q

What are the 8 indications for dental x-rays in children?

A

1.Growth and Development (pano) 2.Caries 3.Pulp 4.Integrity 5. Bone 6.Post op 7.Anomalies 8. Pain/Swelling

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10
Q

What % of carious lesions can be seen by X-ray?

A

40-50%

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11
Q

Size 0 films are typically for children under ___ years of age. They can be used for what 2 views?

A

7…bitewings and PA

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12
Q

Size 1 film is typically used for children over ___ years and for these two views:

A

7 years…bitewings and PA

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13
Q

Size 2 film is considered for what age range and what position?

A

Adults and posterior (bitewings, PA, modified occlusal)

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14
Q

Size __ film is used for LARGE occlusal shots and works for most children…they can be used for an ________ lateral view

A

4….extraoral

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15
Q

What is the best behavioral control method to used for x-rays?

A

Tell, show, do

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16
Q

How often do I take x-rays? every ______ as long as there is evidence of caries or High Risk Factors

A

6 months

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17
Q

How often do I take x-rays? every ____-____ if no caries and no high risk factors

A

12-24 mo

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18
Q

How often do I take x-rays? For an adolescent at LOW risk for caries take every ___-____

A

18-36 mo

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19
Q

Interesting…how long does it take for caries to progress through the OUTER half of enamel on a PRIMARY tooth?

A

1 year

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20
Q

Interesting…how long does it take for caries to progress through the INNER half of enamel on a PRIMARY tooth?

A

1 year

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21
Q

Interesting…how long does it take for caries to progress through the enamel on a PERMANENT tooth?

A

3 years

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22
Q

We never take routine ________ view films. There must always be a reason for these films.

A

occlusal

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23
Q

How many views of a traumatized tooth do we take?

A

3

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24
Q

The dose from a Pano is equivalent to how many PA’s?

A

4

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25
Q

The main anatomical differences for kiddo’s: 1. Short and narrow ________ 2. Mandibular foramen located ______ the mandibular occlusal plane 3. ________ bony structure 4. Bone is less _______, so infiltration has quick onset

A

1.ascending ramus 2.below 3.small 4.dense

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26
Q

Which maxillary injection is ROUTINELY USED in pedo? When administering this shot, always start on the ______ side of the tooth…

A

infiltration…DISTAL

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27
Q

What is a good supplemental injection on the maxillary to aid in numbing the palatal tissues?

A

interdental

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28
Q

Mandibular infiltrations can be useful in pedo too! Mainly for which teeth?

A

incisors, cuspids, and minor operative on primary molars

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29
Q

Which mandibular injection can anesthetize all 5 primary teeth?

A

The incisive nerve block

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30
Q

Topical Anesthetic: Systemic absorption of a ________ topical anesthetic must be considered when calculating the total amount of anesthetic administered
________ topicals have little or no absorption potential

A

lidocaine….benzocaine

31
Q

**What is the most common complication to local anesthetic in pedo?*

A

Self inflicted trauma from chewing of the lip

32
Q

What are the two ways you can overdose a pedo patient with LA? So what are the two methods for making sure this does not happen?

A

1.IV injection 2.large volumes…1.ASPIRATE 2.CALCULATE

33
Q

Local anesthetic toxicity develops when the blood level of the drug in the ______ or ______ becomes too high

A

brain…heart

34
Q

What are the 2 main effects of LA overdose? (IN ORDER PLEASE!)

A

1.CNS EXCITATION followed by seizure 2.CNS DEPRESSION followed by unconsciousness

35
Q

What are the final effects of LA overdose?

A

CardioRespiratory Arrest

36
Q

What is the key to handling a negative reaction to Local Anesthetic?

A

Make sure airway is open and administer O2!!!

37
Q

Two popular anesthetic solutions used in Pediatrics:
________ ___% and ________ __%…Both have Epinephrine 1:100,000….Anesthetic Cartridges are labeled 1.7 or 1.8ml depending on manufacture….You should calculate for ___ ml

A

Lidocaine 2%…..Septocaine 4%…Calculate for 1.8ml

38
Q

What does 2% mean? ___mg/ml and therefore ___ml (amount of liquid in vial) x ___mg/ml = ____mg of 2% lidocaine in a cartridge

A

20mg/ml….1.8ml x 20mg/ml = 36mg of 2% lidocaine in a cartridge

39
Q

**HOW MANY mg of 2% lidocaine is in a stopper full? (hint…0.2ml)

A

0.2ml x 20mg/ml = 4 mg of Lidocaine 2% in a stopper full

40
Q

How many mg of 2% lidocaine is in 1 ml of solution?

A

1ml x 20mg/ml = 20mg of Lidocaine 2% in a ml of solution

41
Q

How many mg of SEPTOCAINE 4% is in a 1.8ml solution?

A

1.8ml x 40mg/ml = 72mg of Septocaine 2%

42
Q

***How many mg of Septocaine 4% is in a stopper full?

A

0.2ml x 40mg/ml = 8mg of Septocaine 4%

43
Q

*** What is the MAX DOSE/Weight for Lidocaine 2% with Epi? (in BOTH mg/kg and mg/lb pleeeeze)

A

4.4mg/kg (or 2mg/lb)

44
Q

*** What is the max dose for Septocaine 4% with epi? (in both mg/kg and mg/lb pleeeze)

A

7mg/kg (or 3.18 mg/lb)

45
Q

What if a 100 lb child needs both Lido 2% and Septo 4%…what is the maximum dose for each and which number do you not exceed?

A

Lido 2% max = 200 mg….Septo 4% max = 318 lbs….dont exceed the lower number with overall amount of either drug

46
Q

Without looking at body weight (which needs to be done first), what are the ABSOLUTE MAXIMUM DOSAGES for Lidocaine 2% and Septocaine 4%?

A

Lido 2% = 300 mg… Sept 4% = 500mg

47
Q

What is the main problem with vasoconstrictor in the LA?

A

it prolongs numbness in the area and leads to more cheek/lip biting

48
Q

Calculate dosage of Epi 1:100,000….. How many mg/ml? how many mg/cartridge?

A

.01mg/ml x 1.8ml = .018 mg Epi/ cartidge

49
Q

What is the conversion for kg to lbs? What is the BADASS method for mentally converting lbs to kg?

A

1 kg = 2.2 lbs…..since were in America- (Lbs/2) - 10% = Kg….example: 100lbs/2 - 5 = 45kg when actual is 45.45)

50
Q

What is the major thing to look out for in an obese child/patient?

A

blood volume does not necessarily relate to body weight!

51
Q

Every injection we do in Pedo uses 1/4 of a cartridge, EXCEPT Which two?

A
  1. IA nerve block and 2. IA for canines…they both use 1/2 cartridge
52
Q

DOCUMENTATION OF LADocumentation must include the type and dosage of local anesthetic in ______. Vasoconstrictors, if any, must be noted either in _________ or concentration

A

mg….mg

53
Q

DOCUMENTATION OF LA Documentation may include the ____ of injection(s) given (eg, infiltration, block), _______ selection and patient’s reaction to the injection.

A

type…needle

54
Q

DOCUMENTATION OF LA__________ instructions (eg, behavioral and dietary precautions) should be given
to the patient and/or caregiver.

A

Postoperative

55
Q

DOCUMENTATION OF LAIf the local anesthetic was administered in conjunction with sedative drugs, the
doses of all agents must be noted on a ____-based record.

A

TIME BASED (nitrous yo!)

56
Q

DOCUMENTATION OF LAin patients for whom the maximum dosage of local anesthetic may be a concern,
the ______ should be documented preoperatively.

A

weight

57
Q

What are the optimal % of N20 and O2 during delivery?

A

30-50% N20 and 70-50% O2

58
Q

How long do you diffuse N2O with pure O2 for full recovery??

A

5 min

59
Q

What is the minimum ventilation (in L) for N20? (Hint it = 500mL Tidal Volume x 12 RR)

A

500ml TV x 12 RR = MI of 6L

60
Q

Contraindications for N2O: Which lung disease? Which inner ear pressure? Which trimester for Pregnancy?

A
  1. COPD 2.Otitis Media 3.1st Trimester
61
Q

Is it safe to administer N2O to a patient with Asthma?

A

YES! even indicated for it

62
Q

We typically use _____ induciton in administering N20 to adults, and ______ induction when administering to kids..

A

titration…rapid

63
Q

In adults, what are the % ranges for N20?

A

40-60%!!! (Peds were 30-50%)

64
Q

EXAMPLE: Total Flow of N20…___L of O2/ ___L of N2O = 40% N2O…

A

3L of O2 / 2 L of N20 = 2/5 or 40% of N2O

65
Q

How much excess gas is excavated in a scavenging system?

A

97% of the gas is scavenged

66
Q

**IN BRODSKY’s scale: Which classification would you never sedate? What % coverage do we have?

A

class 4 = more than 75% of airway covered by the tonsils

67
Q

VITALS: Pulse and Respiratory rate _______ with age. Blood Pressure ________.

A

decrease…increases

68
Q

What is the quickest way to estimate BP on a kiddo?

A

Systolic = 90 + (2xAge)…example-Systolic BP for a 5 year old = 90 + (5x2) =100

69
Q

What is the FIRST concern with PEDO ext?

A

the permanent successor

70
Q

Which forceps and what hand movements do you use for a primary anterior ext?

A

1 and ROTATIONAL movement ONLY!! (don’t Fx the buccal or ling plate!!)

71
Q

Which forceps and what hand movements do you use for maxillary primary molars?

A

150small…palatal, buccal, palatal (NO rotation)

72
Q

**Separated Roots during Ext: Attempt to REMOVE when, clearly visible, accessible, and there is low risk of ______ the permanent tooth below!

A

damaging

73
Q

**Separated Roots during Ext: leave them when the fragment is ______ and immobile, and there is a high risk of damage or displacement of the permanent tooth

A

embedded

74
Q

Which size gauze to you leave at the extraction site with a pedo patient? (think about risk of aspiration)

A

4x4

PEDIATRIC DENTISTRY (11 decks)

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