Paediatric Pastpapers Flashcards
Q1 A 13 year old female patient with discoloured upper incisors is very upset by the appearance of these teeth. It is affecting her at school and she won’t smile. Apart from the discolouration she is clinically symptom free and all the teeth are vital.
- what baseline information and/or special tests would you undertake pre-treatment (3 marks)
Q1 A 13 year old female patient with discoloured upper incisors is very upset by the appearance of these teeth. It is affecting her at school and she won’t smile. Apart from the discolouration she is clinically symptom free and all the teeth are vital.
- You decide to provide a course of microabrasion initially using 18% hydrochloric acid with pumice. Outline the eight stages in the treatment (4 marks)
Q1 A 13 year old female patient with discoloured upper incisors is very upset by the appearance of these teeth. It is affecting her at school and she won’t smile. Apart from the discolouration she is clinically symptom free and all the teeth are vital.
- What information would you give the patient after treatment (1 mark)
Q1 A 13 year old female patient with discoloured upper incisors is very upset by the appearance of these teeth. It is affecting her at school and she won’t smile. Apart from the discolouration she is clinically symptom free and all the teeth are vital.
- You decide to provide a course of vital bleaching following microabrasion. What bleaching agent will you use and at what strength (2 marks)
Q2 A 3 year old child is brought to your surgery following trauma to his upper left central incisor.
- Suggest four aspects of the presentation/history which should make you suspect non-accidental injury (4 marks)
- history of previous injury
- account not compatible with injury
- vague story from parent
- delay in seeking help
- childs appearance and interaction with parents abnormal
- history of violence within family
Q2 A 3 year old child is brought to your surgery following trauma to his upper left central incisor.
- List two possible common sequelae to the primary dentition following the trauma (2 marks)
- discolouration
- discolouration and infection
- delayed exfoliation
Q2 A 3 year old child is brought to your surgery following trauma to his upper left central incisor.
- List four possible sequelae to the permanent dentition following the trauma (4 marks)
- root resorption
- pulp necrosis and infection
- pulp canal obliteration
- breakdown of marginal gingiva and bone
Q3 You have conducted a clinical and radiographical examination of a 6 year old child. You have decided to provide a primary molar pulpotomy on tooth 55
- List four indications for a pulpotomy on a primary molar (4 marks)
- enamel dentine pulp fracture
- crown-root fracture
- pulpitis with irreversible symptoms (vital pulp)
- advanced carious lesion with no clear band of dentine visible radiographically that separates the lesion and pulp
Q3 You have conducted a clinical and radiographical examination of a 6 year old child. You have decided to provide a primary molar pulpotomy on tooth 55
- Describe the stages involved in the primary molar pulpotomy procedure (4 marks)
Q3 You have conducted a clinical and radiographical examination of a 6 year old child. You have decided to provide a primary molar pulpotomy on tooth 55
During the above treatment plan you decide to provide a pulpectomy instead. What factors could have influenced this decision (2 marks)
Q4 You have started work in a new practice and an 11 year old patient attends for a check-up. In her notes you see that she sustained a lateral luxation injury to tooth 11 around 18 months ago
- Suggest six clinical assessments or investigations you would carry out as part of the patient’s trauma review (3 marks)
Trauma stamp
- colour
- mobility
- TTP
- radiograph
- sinus
- percussion note
Q4 You have started work in a new practice and an 11 year old patient attends for a check-up. In her notes you see that she sustained a lateral luxation injury to tooth 11 around 18 months ago
You take a radiograph (see paeds word doc)
2. what type of resorption is affecting tooth 11 and what makes this form of resorption progress (2 marks)
- External infection related inflammatory root resorption
- Resorptive activity is initiated by PDL damage following trauma but it is propagated by root canal toxins reaching the external root surface through patent dentinal tubules
Q4 You have started work in a new practice and an 11 year old patient attends for a check-up. In her notes you see that she sustained a lateral luxation injury to tooth 11 around 18 months ago
- what is your treatment plan now (2 marks)
If the infected canal contents are removed, the propagated stimulus is lost and the lesion is usually arrested. Therefore endodontic treatment should be initiated - remove stimulus and apply non-setting CaOH for 4-6 weeks within the canals and then obturate with gutta percha
Q4 You have started work in a new practice and an 11 year old patient attends for a check-up. In her notes you see that she sustained a lateral luxation injury to tooth 11 around 18 months ago
- What is a lateral luxation injury
Lateral luxation is defined as displacement of a tooth in socket in a direction other than axially (palatally lingually or labially). Displacement is accompanied by communication or fracture of either the labial or palatal/lingual bone. The PDL suffers both tearing and crushing injuries
Q4 You have started work in a new practice and an 11 year old patient attends for a check-up. In her notes you see that she sustained a lateral luxation injury to tooth 11 around 18 months ago
- You warn the patient and parent that the long term prognosis for the tooth is poor if the resorption fails to stop. What would you tell them about immediate, intermediate and long term treatment options should the resorption continue (3 marks)
Q5 A patient presents at your practice complaining of how their upper front teeth look
- Describe the appearance of dental fluorosis (2 marks)
Q5 A patient presents at your practice complaining of how their upper front teeth look
- what percentage of fluoride is the optimum in drinking water (1 mark)
Q5 A patient presents at your practice complaining of how their upper front teeth look
- Name 3 methods of delivering fluoride to an 8 year old and provide the concentrations for each method (3 marks)
Q5 A patient presents at your practice complaining of how their upper front teeth look
- What is the local action of fluoride in the oral cavity (3 marks)
Q5 A patient presents at your practice complaining of how their upper front teeth look
- Give the best treatment option for fluorosis and 2 advantages of this treatment (2 marks)
Q6 The mother of one of your young patients phones your practice stating that her son has ingested fluoride toothpaste and she is worried.
- What three questions should you ask mum? (3 marks)
Q6 The mother of one of your young patients phones your practice stating that her son has ingested fluoride toothpaste and she is worried
- If he has ingested a potentially toxic dose, what is your advice (2 marks)
Q6 The mother of one of your young patients phones your practice stating that her son has ingested fluoride toothpaste and she is worried
- What is the most common cause of fluorosis in the UK (1 mark)
Q6 The mother of one of your young patients phones your practice stating that her son has ingested fluoride toothpaste and she is worried
- If the patient is 10 with fluorosis, what would your first line of treatment be? (1 mark)
Q6 The mother of one of your young patients phones your practice stating that her son has ingested fluoride toothpaste and she is worried
- Please provide the fluoride supplement values for the following patients, all living in an area of <0.3ppm fluoridated water (3 marks)
Age 1 -
Age 4 -
Age 7 -
Q7 A 10 year old boy presents to your practice after having fallen and banged his upper front tooth. On examination you diagnose a subluxation.
Give 3 diagnostic features of a subluxation (3 marks)
- increased mobility
- no displacement
- gingival bleeding
Q7 A 10 year old boy presents to your practice after having fallen and banged his upper front tooth. On examination you diagnose a subluxation.
- What type of splint would you place, for how long and draw it below (2 marks)
passive, flexible splint for 2 weeks. Composite and wire splint - 0.4mm stainless steel wire secured to traumatised tooth and one uninjured tooth on each side of traumatised tooth.
Q7 A 10 year old boy presents to your practice after having fallen and banged his upper front tooth. On examination you diagnose a subluxation.
- When would you review this patient (1 mark)
- 2 weeks for splint removal
- 12 weeks
- 6 months
- 1 year
Q7 A 10 year old boy presents to your practice after having fallen and banged his upper front tooth. On examination you diagnose a subluxation.
- Name 2 features you would be assessing radiographically (2 marks)
root development and any root resorption - comparison with contralateral tooth
Q7 A 10 year old boy presents to your practice after having fallen and banged his upper front tooth. On examination you diagnose a subluxation.
- How would internal inflammatory root resorption present both clinically and radiographically? What would it indicate about the tooth? What medicament would you place to attempt to halt root resorption? (2 marks)
- Clinically it may present as pink discolouration of the affected tooth
- Radiographically it may present as a rounded symmetrical expansion of root canal walls. The tramlines of the root canal are indistinct and the root surface is intact
Q8 A 13 year old child attends the surgery with a BPE score of 3 - what does a BPE score of 3 mean
Q8 A 13 year old child attends the surgery with a BPE score of 3
- What teeth should be probed in a 13 year old to obtain a BPE score?
Q8 A 13 year old child attends the surgery with a BPE score of 3
- What is the normal depth from ECJ to the alveolar bone crest?
Q8 A 13 year old child attends the surgery with a BPE score of 3
- What medical condition could cause a 13 year old to have a BPE score of 3?
Q8 A 13 year old child attends the surgery with a BPE score of 3
If the child is not on medication what other condition may cause this?
Q8 A 13 year old child attends the surgery with a BPE score of 3
What 4 investigations should you do when a child presents with a BPE of 3
Q8 A 13 year old child attends the surgery with a BPE score of 3
What is the treatment plan?
Q9 A patient attends with a fractured 11
- List 2 questions you would ask in regards to the traumatised tooth
- when did the injury occur
- where did the injury occur
- how did the injury occur
- are there any associated symptoms or injuries
- are there any lost teeth or fragments
Q9 A patient attends with a fractured 11
- List 4 things that determine the prognosis of the traumatised tooth when discussing with parents
Q9 A patient attends with a fractured 11
- Where do you suspect the fragment of this tooth is and how do you manage this?
Q9 A patient attends with a fractured 11
The tooth has an enamel dentine fracture, what is the treatment plan for this type of trauma?
Q9 A patient attends with a fractured 11
What do you discuss with the patient regarding treatment of this trauma?
Q9 A patient attends with a fractured 11
You decide to place composite, the patient has a heart valve defect - what would you change about your treatment plan
Q10 A Patients parent complains that the patient has white/yellow/brown stains on teeth
- List 8 questions you would ask the patients mum
Q10 A Patients parent complains that the patient has white/yellow/brown stains on teeth
- The teeth affected are all 1st permanent molars, centrals and lateral - what is the condition likely to be and is it likely to be inherited?
Q10 A Patients parent complains that the patient has white/yellow/brown stains on teeth
- List 5 questions you would ask to rule out fluorosis
Q10 A Patients parent complains that the patient has white/yellow/brown stains on teeth
- What is MIH
Q10 A Patients parent complains that the patient has white/yellow/brown stains on teeth
- List three potential problems of 16, 26, 36 and 46 in future
Q10 A Patients parent complains that the patient has white/yellow/brown stains on teeth
What treatment options are available for MIH
Q11 A child attends with a discoloured tooth
- what questions would you ask if you were querying previous trauma?
- when did the injury occur
- how did the injury occur
- did you receive any treatment previously
- has symptoms changed since trauma
- has tooth colour changed
Q11 A child attends with a discoloured tooth
- What diagnostic tests check for vitality of the tooth
- electric pulp test
- ethyl chloride test
- radiographs
Q11 A child attends with a discoloured tooth
What are the treatment options for a tooth that has had previous trauma (subluxation)
if excessive mobility, flexible passive splint for 2 weeks
Follow up clinically and radiographically at 2 weeks, 12 weeks, 6 months, 1 year
Q12 Suspected child abuse
- what 4 things wold make you suspect a non accidental injury?
Q12 suspected child abuse
- Give two effects of trauma on primary teeth
Q12 suspected child abuse
- Give 4 effects of trauma on permanent dentition
Q13 Down syndrome
- What four medical conditions are Down Syndrome children predisposed to?
Q13 Downs syndrome
- what are 4 general extra oral features of Down syndrome children
Q13 Down syndrome
- What are 6 intra oral features of Down Syndrome children
Q13 Down syndrome
- Give six examples of how the prevention treatment plan may be altered for these patients
Q14 High caries risk
- What is the caries risk assessment criteria
Q14 high caries risk (7yo)
- Name some clinical trauma review factors
Q14 high caries risk (7yo)
- What 8 factors make up a prevention plan?