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Pediatric Dentistry > Midterm > Flashcards

Midterm Flashcards

1
Q

If the pH falls below __ a dysbiotic microbiome categorized by and increase in the acidic biofilm species

A

5
Normal mouth pH = 7
Demineralization starts at pH 5.5

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2
Q

Presence of 1+ decayed (non-cavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces in any primary tooth in child under age 6

A

Early childhood caries (ECC)

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3
Q

Describe severe early childhood caries (S-ECC)

A

<3 yr : any sign of smooth surface caries
3-5 yr: 1+ cavitated, missing or filled smooth surfaces in primary maxillary anterior teeth
decayed, missing or filled score of greater than or equal to:
4 (age 3), 5 (age 4), 6 (age 5)

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4
Q

establish dental home within __ months of first tooth or __

A

6
12 months of age

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5
Q

Primary
Secondary
Tertiary preventative measures for ECC

A

Primary: needs to begin before disease occurs, education, limited sugar intake, avoid nighttime bottles, avoid baby bottle/breastfeeding past 12 months, brushing x2 day, topical fluoride treatment, fluoridated water

Secondary: prevent progression of/remineralization of caries before cavitation stage, early detection, sealants, more frequent fluoride varnish

Tertiary: SDF, restoration

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6
Q

Crown structure of a pediatric patient

A

Onion shaped
converging towards the occlusal

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7
Q

In a pediatric tooth, Enamel rods in cervical area are directed to the

A

occlusal (change class II prep shape)

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8
Q

Is enamel and dentin thinner or thicker in a pediatric tooth

A

Thinner (1-1.5 max width to ADJ)

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9
Q

Contact on a pediatric tooth are

A

broad and flat

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10
Q

Color of a pediatric tooth

A

Lighter (B2-A1)

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11
Q

Root shape of a pediatric tooth

A

narrower and longer compared to their crown length (permanent teeth have shorter thicker roots)

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12
Q

Resorption begins when __ of root is formed
Tooth is shed when __ of root is formed

A

1/3
1/2

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13
Q

Furcations on primary teeth

A

Closer to the crown (more susceptible to damage)

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14
Q

Pulp structure of pediatric teeth

A

larger chambers
pulp horns closer to outer surface
mesial pulp horn is higher

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15
Q

__ teeth should be erupted before age 3

A

20

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16
Q

Primary molars are replaced by

A

permanent premolars

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17
Q

2nd primary molars resemble __ , maxillary 1st primary molars resemble __ , mandibular 1st molars resemble __

A

1st permanent molars
1st permanent premolars
none (milk man)

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18
Q

Teeth present at birth

A

natal teeth

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19
Q

Neonatal teeth

A

Teeth that erupt within 30 days of birth

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20
Q

when the developing tooth moves inside the alveolar bone but cannot yet be seen clinically

A

Pre Emergent eruption
(begins once the root formation has started)

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21
Q

Emergence: when a cusp or an incisal edge of a tooth first penetrates the gingiva. Occurs when __ is established.

A

75% of the final root length

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22
Q

This must exist to move the tooth

A

eruption force

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23
Q

When does eruption occur

A

Follows a circadian rhythm, occurs mainly during early hours of sleep or after meals

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24
Q

Post emerging eruption

A

continuous movement until it reaches occlusion (faster during this stage)
Eruption does not stop once the tooth is in occlusion- continues to equal the rate of the vertical growth of the face
On average a molar erupts about 10 mm after occlusion

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25
Q

Primary teeth eruption

A

Mandibular incisors
maxillary incisors
Maxillary lateral incisors
mandibular lateral incisors
Maxillary 1st molars
mandibular 1st molars
Maxillary canines
Mandibular canines
Mandibular 2nd molars
maxillary 2nd molars

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26
Q

Comp exam care pathway

A

Interview
Oral exam
Detection
Images
Occlusion
Susceptibility

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27
Q

What is used to asses pain

A

FLACC

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28
Q

Probing primary teeth should be done after __ as tolerated by the child

A

eruption of 1st permanent molars and incisors

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29
Q

What do the colors of plaque tablets mean

A

Pink = 24 hour plaque
Purple = 48 hour plaque
Blue = 1 week plaque (pH = 3)

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30
Q

Biofilm removal: teach the parent to __
when should cleaning first occur?

A

Lift the lip
Clean baby gums using damp washcloth day after home
1 yr soft toothbrush and fluoride smear

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31
Q

Caries risk assessment tool (CAT-AAPD) should be performed as soon as

A

first primary tooth erupts

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32
Q

04HIP
PEDBEH
03HIP
01HIP

A

general consent
Pediatric behavior management
auth for use imaging
notice of privacy

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33
Q

D0150
D0120
D0140

A

Comprehensive exam
recall exam
emergency exam

34
Q

Non-nutrutive sucking habit >3yr =

A

malocclusion (class II)

35
Q

Sugar consumption is higher among children whose mothers were

A

younger
had less schooling
smoked

36
Q

Babies breastfed in the 1st hour of life

A

consume less sugar during first 6 months

37
Q

Acidic foods =
Alkaline foods =

A

demineralize
remineralize
(cows milk contains calcium, phosphorus, casein to stabilize plaque pH)

38
Q

Appearance of occlusal surfaces (pit and fissure)
ICDAS 0
ICDAS 1
ICDAS 2
ICDAS 3
ICDAS 4
ICDAS 5
ICDAS 6

A

0 = sound
1 and 2 = initial
3 and 4 = moderate
5 and 6 = advanced

39
Q

This should not be used to detect disease before clinical examination

A

radiographs

40
Q

used for diagnosis of pulp status, decay depth, root development/resorption, furcation

A

PA

41
Q

used for diagnosis of proximal caries, measure bone loss, pulp status

A

BWX
If there is an interproximal lesion on one side of the mouth it is usually mirrored on the other side of the mouth

42
Q

used for diagnosis of crowding, extra or missing teeth, after dental trauma, any other pathology

A

Pano

43
Q

No root formation of permanent tooth + extraction of primary tooth =

A

Permanent tooth will not erupt

44
Q

½ to 2/3 root formation of permanent tooth + extraction of primary tooth =

A

Permanent tooth will erupt faster

45
Q

Radiographs on a new pediatric patient

A

2-4 BWXs capture D of 2nd primary molar to D of canine (size 0-1 sensor)
(Pano if mixed dentition)

46
Q

Recall pediatric patient and radiographs

A

BWXs every 6, 12, 24 months depending on CRA

47
Q

Transitional dentition (6-7 years) radiographs

A

bitewings, panoramic
Panoramic - growth and development problems
Panoramic every 5 years

48
Q

Adolescent radiographs

A

every 5 years panoramic, bitewings (2-4 depending on caries risk)

49
Q

When to take a PA on a child

A

Pulp status
Decay depth
Root development / resorption
Furcation

50
Q

distal of max and mand 2nd primary molars are in same vertical plane

A

flush terminal plane (develops into Class 1)

51
Q

distal of mand 2nd primary molar is more distal than max 2nd primary molar

A

distal step
(develops into Class 2)

52
Q

distal of mand 2nd primary molar is more mesial than max 2nd primary molar

A

mesial step (develops into Class 3)

53
Q

Mixed dentition: __ used to classify occlusion when 1st molars are missing

A

canines

54
Q

Primate spaces:

A

large spaces found mesial to maxillary primary canines and distal to mandibular canines
(helps molars erupt into class I occlusion)
(no space = crowding)

55
Q

Caries risk assessment
High risk:
Moderate risk:
Low risk:

A

disease indicators present or risk factors outweigh protective factors

no disease indicators, risk and protective factors balanced

no disease indicators, very few risk factors

56
Q

Disease indicator (High caries risk) (7)

A

White spots
decalcification enamel defects
obvious decay
Restoration present
Plaque obvious
gums bleed easily
Inadequate saliva flow

57
Q

Mother active dental decay
Bottle other than water, milk or formula
Continued bottle use
Child sleeps with bottle
Frequent >3x/day snacks
Saliva reducing factors (meds, cancer treatment, genetics)
Incr risk of infection and decay
Developmental problems
Caregiver low health literacy
Drug use
Orthodontic appliance
Deep pit and fissures

A

intra and extra oral Risk factors (moderate risk if equal to protective factors, high risk if outweighs)

58
Q

pH indicating paper place __
blue/green = __, yellow = __

A

lingual of mandibular molars
basic
acidic

59
Q

Saliva check: Bite wax for 3-5 minutes spit saliva into cup
Stimulated flow rate: measured in mL (should be above __)

A

1mL/min

60
Q

divided into different age groups (0-3, 3-5) risk divided by feeding patterns

A

CAMBRA

61
Q

What caries risk assessment do we find in axium

A

AAPD-CRA

62
Q

Chlorhexidine is effective against __ but __ is resistant

A

S. mutans
Lactobacilli
(opposite charges attract)

63
Q

Explain 1X1X1

A

Chlorhexidine can lowe bacterial challenge by using daily one week each month

64
Q

Understand the relevance of systemic fluorides on tooth formation

A

Ameloblasts secrete enamel matrix proteins (amelogenin) mineralized in 2nd stage to form enamel
External factors (fluoride) can stop development/mineralization of enamel (ameloblast stop secreting)
= Enamel Defects

65
Q

ability to influence processes by facilitating calcium and phosphate precipitation

A

FLuoride

66
Q

= drinking water
= mouthwash
= pediatric toothpaste used to be
= toothpaste

A

0.1 – 1 ppm
50-250ppm
500-600ppm
1000-1450ppm

67
Q

When the pH in the mouth falls below 5.5 the teeth demineralize

A

-Ca and PO4 minerals are removed from the tooth –> saliva is hyper mineralized
-formation of white spot lesions
-When the pH is reestablished at 7.0 the Ca and PO4 minerals are incorporated from the saliva back into the tooth structure
-Fluoride helps Ca and PO4 be incorporated faster and more efficiently
-forms calcium fluorate (CaF) : accumulates in smooth enamel and dental plaque

68
Q

Pediatric Fluorides
Brush x2 day with >__
Smear (__) for kids under 3yr that cant spit, pea sized (__) for kids over 3yr that can spit

A

1,000ppmF
0.1mg F
0.25mg F

69
Q

Varnishes
__ (5% NaF)
Can be used to reduce tooth sensitivity

A

22,600 ppm

70
Q

Turns tooth black, arrests lesion without having to numb or drill tooth

A

Silver Diamine Fluoride (SDF)

71
Q

%NaF / 2.2 = %F
%F x 10,000 = ppm

A

Ex: 5% NaF / 2.2 = 2.26%F x 10,000 = 22,600 ppm

72
Q

caries reduction after 5 yr (reduced 70% compared to chlorhexidine or fluoride
varnish)

A

Xylitol

73
Q

Pericoronitis:

A

inflammation of gums around wisdom teeth, happens when don’t brush properly

74
Q

38% (44,800ppm), changes microbiome (kills some bacteria, allows other bacteria to grow)
Arrests carious lesions
Stains tooth black (put Vaseline on gums to prevent from staining)
High caries risk pt
Used for very young pt who otherwise would have to be under anesthesia to do restoration

A

SDF

75
Q

remove carious tissue using hand instruments only, restore with material that sticks to tooth (glass ionomer)

A

atraumatic restorative treatment (ART)

(Should not be used when: abscess, fistula, pulp exposed, chronic inflammation of
pulp, inaccessible to hand instrument)

76
Q

restore, arrest or prevent progression of caries when traditional cavity prep is not feasible

A

interim therapeutic restorations (ITR)

77
Q

use separators to create space in between teeth, remove separators after 15mins, choose prefabricated crown of appropriate height, fill with GI, cement onto tooth, clean excess
-decay is sealed under preformed metal crown (PMC) without LA, tooth preparation or caries removal

A

Hall technique

78
Q

Lesion in a permanent vs primary tooth

A

Lesion in permanent tooth: cavitation follows single canal (enamel rods/dentinal tubules) into dentin towards the pulp

Lesion in primary tooth: lesion is bigger, spreads faster and over larger area
(Gets to pulp faster)

79
Q

5 dentin types

A

Destroyed
Infected (bacteria, soft)
Affected (demineralized)
Sclerotic
Normal

80
Q

__ single most important factor in protecting pulp against injury

A

Remaining dental thickness

Pediatric Dentistry (1 decks)

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