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Paediatric Dentistry Flashcards

1
Q

what is a gingival cyst and where might you find it

A

white colour gingival lesion where keratin is formed
not to worry about

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2
Q

what is an eruption cyst

A

cyst overlying where the developing tooth is about to erupt
turns blue because it is filled with blood
resolves once tooth erupts

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3
Q

what role does the dental follicle play in tooth eruption

A

when it is activated it initiates osteoclast activity in the alveolar bone ahead of the tooth and clear a path of eruption

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4
Q

what is the order of eruption of primary teeth

A

A B D C E

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5
Q

when does the lower A tend to erupt

A

4-6 months

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6
Q

when does the B tend to erupt

A

7-16 months

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7
Q

when does the D usually tend to erupt

A

13-19 months

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8
Q

when does the C tend to erupt

A

16-22 months

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9
Q

when do Es tend to erupt

A

15-33 months

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10
Q

when do teeth in the same series erupt in comparison to their contra-lateral tooth normally

A

within 3 months

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11
Q

give four differences between the crowns of primary vs permanent teeth

A

primary incisors smaller in crown and root length
primary molars are wider mesio-distally
primary molar crowns are more bulbous
primary teeth are whiter

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12
Q

what is anthropoid spacing

A

maxilla - space in front of the C
mandible - space behind the C

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13
Q

how do permanent incisors develop relative to the position of primary incisors

A

paltal

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14
Q

from date of eruption, how long does it take for the permanent tooth root to complete apexogenesis

A

3 years

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15
Q

what is MIH

A

the hypomineralisation of 1-4 permanent molars frequently associated with affected incisors

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16
Q

what is hypomineralisation

A

disturbance in the formation of enamel which results in a reduced mineral content

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17
Q

what is hypoplastic enamel

A

a reduce in the bulk or thickness of normal mineralised enamel

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18
Q

what are the two types of enamel hypoplasia

A

true - enamel never formed
acquired - post-eruptive loss of enamel bulk

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19
Q

what are three theorised reasons why MIH teeth are very sensitive

A

Dentine hypersensitivity - due to the porous enamel
Peripheral sensitivity - pulpal inflammation leads to sensitisation
Central sensitisation - - from continued nociceptive input

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20
Q

how can MIH present

A

small, demarcated discoloured areas
dark, yellow areas that fracture off

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21
Q

how is MIH treated

A

micro-abrasion to remove outer surface of enamel to treat the brown or yellow parts
then bleaching to sort out the white/ cream parts

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22
Q

what are treatment options for MIH in molars

A

composite/ GIC restorations
stainless steel crowns
XLA

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23
Q

how are incisors with MIH treated

A

micro-abrasion
resin infiltration into patches
external bleaching
localised composite placement

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24
Q

why might you do endodontic treatment on primary molars

A

to try avoid unplanned extractions of primary teeth

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25
give three disadvantages of extracting primary molars
loss of space decreased masticatory function impeded speech development
26
give three indications that pulp treatment would be achievable in the primary dentition
good co-operation missing permanent successor medical history does not allow extraction
27
give three contra-indications for undertaking pulp treatment in children
poor co-operation poor dental attendance advanced root resorption
28
what are the two main aims of pulpotomy
radicular pulp is preserved bleeding controlled
28
what medicament would you use when undertaking a pulpotomy to arrest any bleeding and for how long
ferric sulphate for 20 seconds
28
how should pulpotomies in primary teeth be restored
root stumps covered with ZOE paste/ CaOH or MTA build up GIC core preformed metal crown on top
29
what are the three lining options for over root stumps of pulpotomies
calcium hydroxide ZOE MTA
30
what should you evaluate when looking at the pulp in a pulpotomy
bleeding bright red and haemostasis = uninflamed pulp deep crimson blood and continued bleeding after pressure = inflamed pulp
31
what are the two overall categories of dental trauma
dental hard tissue and pulp trauma supporting tissue trauma
32
what is a concussion injury
PDL injury tooth TTP but not displaced no bleeding in sulcus
33
what is a subluxation injury
tooth TTP and increased mobility tooth not displaced bleeding from gingiva
34
what is lateral luxation injury
tooth displaced in palatal/ lingual or labial direction
35
What is intrusion injury
tooth displaced through labial bone plate or impinging on permanent tooth bud
36
what is an extrusion injury
partial displacement of the tooth out of its socket
37
what is an avulsion injury
tooth is completely displaced out of its socket
38
what are the six features of a trauma stamp
mobility colour TTP sinus percussion note radiograph
39
a patient attends with an enamel fracture - what are your treatment options
if missing fragment can be accounted for - bond back on smooth edges and place composite
40
a patient attends with an uncomplicated crown fracture with the exposed dentine being more than 0.5mm from the pulp - what is your treatment
cover exposed dentine with GIC or use bonding agent and composite
41
a patient attends with an uncomplicated crown fracture in which the dentine is within 0.5mm of the pulp - what is your treatment
CaOH lining placed and cover with GIC
42
what are the follow up times for an enamel fracture
6-8 weeks 1 year
43
what are the follow up times for an uncomplicated crown fracture
6-8 weeks 1 year
44
what is your treatment for a patient who attends with a complicated crown fracture and the apex is open
Pulp cap partial pulpotomy
45
a patient attends with a complicated crown fracture and the root development is completed - what is your treatment
patial pulpotomy
46
name 2 materials that could be placed on top of a pulp wound
non-setting calcium hydroxide non-staining calcium silicate
47
what is the follow up for a complicated crown fracture
6-8 weeks 3 months 6 months 1 year
48
a patient attends with a crown-root fracture with no pulp exposure and the tooth looks restorable - what is your treatment
cover exposed dentine with GIC
49
a patient attends with a crown-root fracture with a pulp exposure and the tooth looks restorable - what is your treatment
partial pulpotomy - in immature teeth pulpectomy - mature teeth where root formation is finished
50
a patient attends with a crown-root fracture that is unrestorable - what is your treatment
extract the loose fragments
51
what is the follow up regime for an uncomplicated and complicated crown-root fracture
1 week 6-8 weeks 3 months 6 months 1 year (yearly for 5 years)
52
a patient attends with a root fracture where the coronal aspect has not been displaced - what is your treatment
no treatment
53
a patient attends with a root fracture where the coronal fragment is displaced but not excessively mobile - what is your treatment
leave coronal fragment to spontaneously reposition
54
a patient attends with a root fracture where the coronal fragment is displaced and the crown is excessively mobile - what is your treatment
extract loose coronal fragment reposition loose coronal fragment and splint for 4 weeks
55
in which direction do root fracture lines tend to run
obliquely
56
what is the follow up regime for a root fracture
4-5 weeks 6-8 weeks 4 months 6 months 1 year yearly for 5 years
57
a patient attends with an alveolar fracture - what is your treatment
reposition the displaced segment stabilise with a flexible splint for 4 weeks suture any gingival lacerations
58
what is the follow up regime for an alveolar fracture
4-5 weeks 6-8 weeks 4 months 6 months 1 year yearly for 5 years
59
what is the treatment for a patient presenting with a concussion injury
no treatment
60
what is the follow up regime for concussion injury
4 weeks 1 year
61
a patient presents with a subluxation injury - what is your treatment
no treatment or passive flexible splint for 2 weeks if tooth excessively mobile
62
what is the follow up regime for a subluxation injury
2 weeks 3 months 6 months 1 year
63
a patient attends with an extrusion injury - what is your treatment
reposition tooth stabilise for 2 weeks with splint
64
what is the follow up regime for an extrusion injury
2 weeks 4 weeks 8 weeks 3 months 6 months 1 year yearly for 5 years
65
a patient presents with a lateral luxation injury - what is your treatment
palpate gingiva to feel apex of the tooth and push down on it while moving the coronal part of the tooth where you want it splint for 4 weeks endodontic evaluation at 2 week review
66
what is most likely to happen in a tooth with complete root formation after a lateral luxation injury
the pulp will most likely become necrotic and RCT should be started
67
what is hoped to happen when a tooth with incomplete root formation has a lateral luxation injury
spontaneous revascularisation occurs
68
what is the follow up regime for an lateral luxation injury
2 weeks 4 weeks 8 weeks 3 months 6 months 1 year yearly for 5 years
69
a patient attends with an intrusion injury - what is your treatment
allow spontaneous repositioning if no repositioning in 4 weeks - orthodontic repositioning required
70
what is the follow up regime for an intrusion injury
2 weeks 4 weeks 8 weeks 3 months 6 months 1 year yearly for 5 years
71
what types of injuries will require a flexible splint
luxated avulsed root fractured
72
give three instructions for at home care following a TDI
avoid contact sports good oral hygiene rinse with antibacterial agent (eg chlorhexidine)
73
name three indications for GA for children's dental treatment
medical compromising conditions difficult or complex dental treatment very young children
74
when is the primary dentition usually complete by
2 and a half - 3 years of age
75
what is leeway space
primary molars wider than premolars that will replace them 1.5mm per side on upper arch 2.5 per side on lower arch
76
what is the definition of MIH
hypomineralisation of systemic origin of 1-4 permanent molars, frequently associated with affected incisors
77
what is meant by hypomineralisation
disturbance of enamel formation resulting in reduced mineral content
78
what is meant by hypoplasia of enamel
reduced thickness of enamel
79
name three possible factors for MIH
measles rubella chicken pox
80
name three clinical problems MIH poses
loss of tooth substance sensitivity appearance
81
name three treatment options for MIH molars
composite/ GI restorations stainless steel crowns planned extractions
82
name five treatment options for MIH incisors
micro-abrasion resin infiltration into patches external bleaching localised composite placement veneers
83
name three broad ways in which children become dentally anxious
conditioning modelling information
84
name three characteristics of anxious patients
low pain threshold pessimism high neuroticism
85
what is used to assess anxiety in patients (adults)
modified dental anxiety scale (MDAS)
86
what is the cut off score for severe dental fear/ anxiety on MDAS
19/25
87
name two tools you can use to assess anxiety in children from 4-16
The Venham Picture test (4-11) Modified Child Dental Anxiety Scale faces version (8-16)
88
give three treatment strategies for mild/ moderate anxiety
acknowledge patient's anxiety and provide control teach coping strategies inhalation sedation

FINALS (25 decks)

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