Paediatric dentistry Flashcards
what are the principle aims of paediatric Tx?
development and maintenance of healthy, functional and attractive primary and secondary dentition
freedom from pain and infection
happy and cooperative patient
prevention is key
what behaviour management techniques can you use?
Behaviour shaping reinforcement modelling desensitisation Tell/Show/Do
what types of medical management techniques are there?
sedation: oral (>12) IV (>12) IH (>7) GA
How would you manage a child with reversible pulpitis?
emergency management: LA, excavate caries, restore with coltisol. if exposed pulp and vital, use iodoform
definitive: pulpotomy and SSC/extraction
How would you manage a child with irreversible pulpitis?
emergency management: LA, excavate caries, dress with iodoform, restore with coltisol, GI
definitive: pulpotomy/pulpectomy/extraction
What are general causes of delayed/failure of eruption?
Hereditary gingivofibromatosis, Down Syndrom, Gardner syndrome, hypothyroidism, cleidocranial dysostosis, rickets
What are local causes of delayed/failure of eruption?
congenital absence, crowding, retention of primary, supernumerary, dilaceration, dentigetous cyst, trauma to primary causing apical displacement, abnormal position of crypt, primary failure of eruption
What are infraoccluded teeth, how do you classify and what is the treatment
primary molar failing to maintain occlusion height and position with relation to adjacent teeth
If the marginal ridge is above the contact area - mild
if the marginal ridge is at the contact area - moderate
if the marginal ridge is below the contact area - severe
Radiographs to look for sucessor and ankylosis
monitor if successor is present
if no successor - planned XLA
What is hypodontia?
developmental absence of more than one tooth
8s, 2s, 5s
what is hyperdontia?
supernumerary teeth. Conical, tuberculate, supplemental, odontome
What are causes of hypomineralisation?
infection (turner tooth), trauma, irradiation, ameliogenensis imperfecta
What is MIH and what are the treatment options?
hypomineralisation of the enamel of 6s and 1s
yellow/white opacities
increased sensitivity, increase caries
veneers for incisors, extraction of poor prognosis molars
What do teeth with dentinogenesis imperfecta look like radiographically?
opalescent brown/blue image, bulbous crowns, short roots, narrow flame shaped pulps
List abnormalities of tooth form
gemination, fusion, macrodontia, microdontia, dens in dente (fissure seal as soon as possible after eruption), dilaceration (ortho to realign), turner tooth, taurodontism (elongation of pulp chamber)
What can cause extrinsic staining of a tooth?
chromogenic bacteria, diet, CHX MW, dietary tanins, poor OH and demineralisation
treat with abrasive prophy paste and OHI
What can cause intrinsic staining of a tooth?
Infection, ABs, enamel opacities, prohpyria, pulp necrosis, root canal medicaments
What is the method for microabrasion?
take tooth shade and imaging before treatment.
Gain consent, ensure pt understands it wont make teeth more white, just less brown
best on brown and orange defects
place petroleum jelly on gingiva
mix up bicarb and water paste, place on gingiva around tooth
place dam and wedgets to isolate teeth for MA - ensure no part of tooth is covered
place 18% HCl and pumice mix on tooth, rub for 5 seconds, wash, dry, repeat
max of 10x5 seconds, removes 100um of enamel
place non-coloured FV on tooth
smooth with finest sandpaper discs and final polish with toothpaste
take post op images, review 6 weeks after. post op instructions
Restoration materials for children
Cant use amalgam anymore - minimata convention
GI - quick, adhesion, F- release. poor wear resistance
RMGI - technique sensitive, good retention and wear resistance
compomer - modified composite, very moisure sensitive, good longevity
composite - needs good isolation, longer to place, good aesthetics and wear
SSC - good for molars
Hall technique - biological treatment for caries. well tolerated, quick to place
Indications for SSC
Broken down primary molar pulp therapy in primary molar interim measure for secondary molar if pt needs crown but too young developmental abnormalities severe tooth loss from bruxism
Method of hall technique
place separators a couple of days before check molar for pulp pathology (not suitable) select correct size fill with GI cement place on tooth - child bites down clear away excess cement
Risk factors for nursing bottle caries
elongated breast feeding
milk bottle at night
feeding from a bottle with something other than milk or water
why is there a specific pattern for nursing bottle caries?
max primary incisors then molars. mand incisors are protected from tongue and saliva
indication for pulp therapy in children
child has medical condition (bleeding etc), tooth must be restorable
breakdown of marginal ridge, symptomatic, TTP, buccal swelling, sinus, interradicular radiolucency
How do you do a pulpotomy?
vital primary molar pulp
amputation of coronal pulp, leaving healthy radicular pulp
LA and rubber dam
cavity prep and excavate caries
remove pulp chamber roof
amputate coronal pulp with sterile round bur
cotton wool pledget with ferric sulphate (molar) or saline (incisors) for 1min
apply coltisol dressing
restore tooth
How do you do a pulpectomy
treatment of choice for non-vital pulps
LA and rubber dam
remove necrotic pulp, file and irrigate canals with NaOCl
place iodoform paste in canal
restore with ZOE/coltisol and place SSC in molar
Common viral oral infections
primary herpetic gingivostomatitis secondary herpes labialis HFM disease herpangina warts chicken pox mumps measles
Common bacterial oral infections
impetigo
strep throat
ANUG
Common fungal oral infections
Candida - pseudomembranous candidiasis
Common causes of ulceration in children
aphthous ulcerations, trauma, acuter herpetic gingivostomatitis, herpangina, HFM, glandular fever
common causes of soft tissue swelling in children
Abscess, mucocele, eruption cyst, epulides, papilloma
What is hypodontia?
Missing tooth (not 8s)
