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FINALS > Paediatric Dentistry > Flashcards

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
Q

give three disadvantages of extracting primary molars

A

loss of space
decreased masticatory function
impeded speech development

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26
Q

give three indications that pulp treatment would be achievable in the primary dentition

A

good co-operation
missing permanent successor
medical history does not allow extraction

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27
Q

give three contra-indications for undertaking pulp treatment in children

A

poor co-operation
poor dental attendance
advanced root resorption

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28
Q

what are the two main aims of pulpotomy

A

radicular pulp is preserved
bleeding controlled

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28
Q

what medicament would you use when undertaking a pulpotomy to arrest any bleeding and for how long

A

ferric sulphate for 20 seconds

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28
Q

how should pulpotomies in primary teeth be restored

A

root stumps covered with ZOE paste/ CaOH or MTA
build up GIC core
preformed metal crown on top

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29
Q

what are the three lining options for over root stumps of pulpotomies

A

calcium hydroxide
ZOE
MTA

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30
Q

what should you evaluate when looking at the pulp in a pulpotomy

A

bleeding
bright red and haemostasis = uninflamed pulp
deep crimson blood and continued bleeding after pressure = inflamed pulp

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31
Q

what are the two overall categories of dental trauma

A

dental hard tissue and pulp trauma
supporting tissue trauma

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32
Q

what is a concussion injury

A

PDL injury
tooth TTP but not displaced
no bleeding in sulcus

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33
Q

what is a subluxation injury

A

tooth TTP and increased mobility
tooth not displaced
bleeding from gingiva

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34
Q

what is lateral luxation injury

A

tooth displaced in palatal/ lingual or labial direction

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35
Q

What is intrusion injury

A

tooth displaced through labial bone plate or impinging on permanent tooth bud

36
Q

what is an extrusion injury

A

partial displacement of the tooth out of its socket

37
Q

what is an avulsion injury

A

tooth is completely displaced out of its socket

38
Q

what are the six features of a trauma stamp

A

mobility
colour
TTP
sinus
percussion note
radiograph

39
Q

a patient attends with an enamel fracture - what are your treatment options

A

if missing fragment can be accounted for - bond back on
smooth edges and place composite

40
Q

a patient attends with an uncomplicated crown fracture with the exposed dentine being more than 0.5mm from the pulp - what is your treatment

A

cover exposed dentine with GIC or use bonding agent and composite

41
Q

a patient attends with an uncomplicated crown fracture in which the dentine is within 0.5mm of the pulp - what is your treatment

A

CaOH lining placed and cover with GIC

42
Q

what are the follow up times for an enamel fracture

A

6-8 weeks
1 year

43
Q

what are the follow up times for an uncomplicated crown fracture

A

6-8 weeks
1 year

44
Q

what is your treatment for a patient who attends with a complicated crown fracture and the apex is open

A

Pulp cap
partial pulpotomy

45
Q

a patient attends with a complicated crown fracture and the root development is completed - what is your treatment

A

patial pulpotomy

46
Q

name 2 materials that could be placed on top of a pulp wound

A

non-setting calcium hydroxide
non-staining calcium silicate

47
Q

what is the follow up for a complicated crown fracture

A

6-8 weeks
3 months
6 months
1 year

48
Q

a patient attends with a crown-root fracture with no pulp exposure and the tooth looks restorable - what is your treatment

A

cover exposed dentine with GIC

49
Q

a patient attends with a crown-root fracture with a pulp exposure and the tooth looks restorable - what is your treatment

A

partial pulpotomy - in immature teeth
pulpectomy - mature teeth where root formation is finished

50
Q

a patient attends with a crown-root fracture that is unrestorable - what is your treatment

A

extract the loose fragments

51
Q

what is the follow up regime for an uncomplicated and complicated crown-root fracture

A

1 week
6-8 weeks
3 months
6 months
1 year
(yearly for 5 years)

52
Q

a patient attends with a root fracture where the coronal aspect has not been displaced - what is your treatment

A

no treatment

53
Q

a patient attends with a root fracture where the coronal fragment is displaced but not excessively mobile - what is your treatment

A

leave coronal fragment to spontaneously reposition

54
Q

a patient attends with a root fracture where the coronal fragment is displaced and the crown is excessively mobile - what is your treatment

A

extract loose coronal fragment
reposition loose coronal fragment and splint for 4 weeks

55
Q

in which direction do root fracture lines tend to run

A

obliquely

56
Q

what is the follow up regime for a root fracture

A

4-5 weeks
6-8 weeks
4 months
6 months
1 year
yearly for 5 years

57
Q

a patient attends with an alveolar fracture - what is your treatment

A

reposition the displaced segment
stabilise with a flexible splint for 4 weeks
suture any gingival lacerations

58
Q

what is the follow up regime for an alveolar fracture

A

4-5 weeks
6-8 weeks
4 months
6 months
1 year
yearly for 5 years

59
Q

what is the treatment for a patient presenting with a concussion injury

A

no treatment

60
Q

what is the follow up regime for concussion injury

A

4 weeks
1 year

61
Q

a patient presents with a subluxation injury - what is your treatment

A

no treatment
or passive flexible splint for 2 weeks if tooth excessively mobile

62
Q

what is the follow up regime for a subluxation injury

A

2 weeks
3 months
6 months
1 year

63
Q

a patient attends with an extrusion injury - what is your treatment

A

reposition tooth
stabilise for 2 weeks with splint

64
Q

what is the follow up regime for an extrusion injury

A

2 weeks
4 weeks
8 weeks
3 months
6 months
1 year
yearly for 5 years

65
Q

a patient presents with a lateral luxation injury - what is your treatment

A

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
Q

what is most likely to happen in a tooth with complete root formation after a lateral luxation injury

A

the pulp will most likely become necrotic and RCT should be started

67
Q

what is hoped to happen when a tooth with incomplete root formation has a lateral luxation injury

A

spontaneous revascularisation occurs

68
Q

what is the follow up regime for an lateral luxation injury

A

2 weeks
4 weeks
8 weeks
3 months
6 months
1 year
yearly for 5 years

69
Q

a patient attends with an intrusion injury - what is your treatment

A

allow spontaneous repositioning
if no repositioning in 4 weeks - orthodontic repositioning required

70
Q

what is the follow up regime for an intrusion injury

A

2 weeks
4 weeks
8 weeks
3 months
6 months
1 year
yearly for 5 years

71
Q

what types of injuries will require a flexible splint

A

luxated
avulsed
root fractured

72
Q

give three instructions for at home care following a TDI

A

avoid contact sports
good oral hygiene
rinse with antibacterial agent (eg chlorhexidine)

73
Q

name three indications for GA for children’s dental treatment

A

medical compromising conditions
difficult or complex dental treatment
very young children

74
Q

when is the primary dentition usually complete by

A

2 and a half - 3 years of age

75
Q

what is leeway space

A

primary molars wider than premolars that will replace them
1.5mm per side on upper arch
2.5 per side on lower arch

76
Q

what is the definition of MIH

A

hypomineralisation of systemic origin of 1-4 permanent molars, frequently associated with affected incisors

77
Q

what is meant by hypomineralisation

A

disturbance of enamel formation resulting in reduced mineral content

78
Q

what is meant by hypoplasia of enamel

A

reduced thickness of enamel

79
Q

name three possible factors for MIH

A

measles
rubella
chicken pox

80
Q

name three clinical problems MIH poses

A

loss of tooth substance
sensitivity
appearance

81
Q

name three treatment options for MIH molars

A

composite/ GI restorations
stainless steel crowns
planned extractions

82
Q

name five treatment options for MIH incisors

A

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

83
Q

name three broad ways in which children become dentally anxious

A

conditioning
modelling
information

84
Q

name three characteristics of anxious patients

A

low pain threshold
pessimism
high neuroticism

85
Q

what is used to assess anxiety in patients (adults)

A

modified dental anxiety scale (MDAS)

86
Q

what is the cut off score for severe dental fear/ anxiety on MDAS

A

19/25

87
Q

name two tools you can use to assess anxiety in children from 4-16

A

The Venham Picture test (4-11)
Modified Child Dental Anxiety Scale faces version (8-16)

88
Q

give three treatment strategies for mild/ moderate anxiety

A

acknowledge patient’s anxiety and provide control
teach coping strategies
inhalation sedation

FINALS (25 decks)

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