Paediatric Tutorials

Question 1

What is the MCDAS scale?

Answer 1

A system for assessing childrens anxiety, on a scale of 1(comfortable) to 5 (not comfortable).

Question 2

What are the eight questions asked on an MCDAS questionaire?

Answer 2

How do you feel about…

…going to the dentist?
…having your teeth looked at?
… having your teeth scraped?
…having an injection in the gum?
…having a filling?
…having a tooth taken out?
…going to sleep for treatment?
…having gas and air?

Question 3

What is cleft lip and palate?

Answer 3

Splits in the upper lip, roof of the mouth, or both. These result from syndromes caused by genetic defects.

Question 4

Why does cleft lip and palate pose a problem for a childs oral health?

Answer 4

• issues with crowding
• Food traps
• Lack of bone
• Supernumary teeth
• Hypodontia, hyperdontia
• Microdontia, macrodontia
• Enamel defects

Question 5

How should you ask about whether social work for a child?

Answer 5

If not brought in by parent, ask if they have a social worker - which everyone is asked now.

Question 6

What is enamel hypoplasia?

Answer 6

The tooth mineral has not formed correctly, resulting in a lack of quality tooth substance.

Question 7

What can cause enamel hypoplasia?

Answer 7

Genertic disorders such as amelogenisis imperfecta.

Environmental disruptions during natal/neonatal development.

Question 8

What is enamel hypomineralisation?

Answer 8

A lack of the amount of mineral available to form enamel, commonly affecting molars and incisors.

Question 9

What treatment options are there for enamel defects?

Answer 9

Restorative - composite/indirect

Resin infiltration

Abrasion

Preventative resin restorations (PRR)

Question 10

What are the potential risks/symptoms of enamel defects?

Answer 10

Sensitivity/pain
Aesthetic impact
Higher risk of caries

Question 11

What surgeries may a cleft lip/palate patient require?

Answer 11

Plastic surgery to repair cleft
Rhinoplasty
Orthognathic surgery
Bone grafting

Question 12

What is meant by the term post eruptive breakdown?

Answer 12

Breakdown of tooth material after eruption has begun.

Question 13

Which teeth should be fissure sealed?

Answer 13

Fissures of molars and premolars

Also consider pits of anterior teeth

Consider dens en dentate

Question 14

How does enamel hypoplasia present?

Answer 14

Pitted or scored teeth.

Question 15

How does enamel hypomineralisation present?

Answer 15

Mottled/patchy teeth.

Question 16

What aspects make up a caries risk assessment?

Answer 16

Previous history of caries
Area of disadvantage
DMF teeth
Quality of OH
Dietary habbit

Question 17

Why might articaine be indicated in patients with MIH teeth?

Answer 17

MIH are historically more difficult to anaesthetise, so articiane may be indicated over lidocaine.

Question 18

What is type I diabetes?

Answer 18

Insulin deficient diabetes insipidus.

Pancreas doesn’t produce enough insulin, so glucose cannot get into cells and, and remains in blood.

Question 19

How can type I diabetes affect dental health?

Answer 19

Higher risk of perio
Poor wound healing
Increased ulcer prevalence
Hypoglycaemia during treatment.

Question 20

What blood glucose level is indicative of hypoglycaemia?

Answer 20

<4mmol/L glucose

Question 21

How can insulin be delivered?

Answer 21

Typically by injection
Insulin pump can also be used

Question 22

What are the categories of heart defects?

Answer 22

Obstructive defects:
- Pulmonary stenosis
- Biscuspid valve defect
- Subaortic stenosis
- Coartation of the aorta

Septal defects:
- Atrial septal defect
- Ventricular septal defect

Question 23

What syndromes are commonly associated with heart defects?

Answer 23

Down’s
Turner
Williams
Noonan

Question 24

What is the incidence of congenital heart defect?

Answer 24

1% of infants.

Question 25

What is VSD?

Answer 25

A communication between the two ventricles of the heart.

The severity is determined by size, location, and shape.

Question 26

If you were unsure whether a patient with cardiac defects required ABx for prophylaxis against IE, who would you consult?

Answer 26

Patients cardiologist with support from the SDCEP.

Question 27

What is the incidence of infective endocarditis?

Answer 27

Up to 1:10,000 per year.

Question 28

Who is most at risk of developing IE?

Answer 28

Adults over the age of 60, with artificial heart valves.