Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS4 CDS > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

What are treatment options for discoloured teeth?

A

Microabrasion, bleaching, resin infiltration, local comp rest., veneers - direct and indirect, do nothing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what should be recorded in the pre-op sheet for discoloured teeth

A

clinical photos, sensibility testing, shade, diagram of defect, radiographs, patient assessment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is micro abrasion

A

the removal of the surface layer of opaque enamel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are some advantages of micro abrasion

A

removes brown/yellow stain, effective, conservative, inexpensive, can be used before bleaching, easily performed, permanent results

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are some disadvantages of micro abrasion

A

removal of enamel - destructive, senstivity, may get more staining
need protective wear for patient, dentist and nurse
HCl is caustic
results are unpredictable - may appear more yellow
must be done by dentist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the clinical technique for micro abrasion

A

protect soft tissues with dental dam
place sodium bicarbonate guard behind teeth
slurry of HCl for 5 seconds on tooth - can repeat 10 times but wash off and review colour and shape after each one
once happy - place fluoride varnish - clinpro is more white in colour
polish with sandpaper - the finer/smoother prisms look less stained
polish with toothpaste

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how much enamel is lost with micro abrasion and compare this to enamel etching

A

100 microns are lost with micro abrasion - 10 are lost with etching so losing 10x the amount

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

when and why must micro abrasion be reviewed

A

review 4-6 weeks after, advise patient not to drink or eat highly coloured foods as teeth are dehydrated and will stain. Review as can offer a second cycle but only if some improvement has been seen with first lot, if not the second wont work either. Can only do 2 rounds. Must take pre and post op photographs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what bleaching techniques are available for a vital tooth

A

external bleaching only. Chairside power bleaching or at home night guard bleaching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what bleaching techniques are available for a non-vital tooth

A

internal bleaching - inside outside technique, walking bleach technique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

why is chairside bleaching not normally recommended

A

it uses rapidly reactive, unstable hydrogen peroxide - damage to soft tissue and eyes - causes sensitvity and more expensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what instructions are given to patients for night guard at home bleaching

A

brush teeth with toothpaste
place gel in mouth guard
put in over teeth and seat - remove excess from gums
rinse gently and dont swallow
wear over night or for at least 2 hours
brush teeth and rinse with cold water
sensitive toothpaste may be required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are advantages of non-vital tooth bleaching

A

conservative, good results, gingival level of adolescents is unstable for fixed restoration so this is good in mean time, simple, no irritation to gingiva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are important factors when deciding if a non-vital tooth is appropriate for internal bleaching

A

good root filling - to length and condensed, no pathology
anterior teeth without large restorations
not amalgam discolouration
not fluorosis or tetracycline discolouration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the clinical technique of walking bleach - non vital internal bleaching

A

access cavity, remove GP to ECJ, place bleaching agent on cotton wool ball and place in access, place dry cotton wool ball on top and then GI over this. 2 weeks later, remove GI and replace balls - can do this up 6-10 times. Regression of 50% at 2-6 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the clinical technique of inside out bleaching

A

access cavity, custom mouthguard made. Patient puts bleaching agent in back of tooth and mouth guard. replaces the gel every 2 hours except through the night. wear guard all the time except when eating and cleaning. 10% carbamide peroxide used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are potential complications with non vital bleaching

A

over bleaching, brittleness, external cervical resorption, failure to bleach, spilling of bleaching agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how can external cervical resorption be prevented

A

layer of GI cement above GP cone - but can prevent adequate bleaching
non setting calcium hydroxide placed for 2 weeks before final restoration - neutralises any acidity in PL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is resin infiltration

A

infiltration of enamel lesions with low-viscosity resin and cured. surface layer is eroded with etch, lesion becomes desicated and gives access - resin placed and can infiltrate through. causes lesions to lose discolouration and appear similar to sound enamel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the parts to caries risk assessment

A

clinical evidence, diet, plaque control, fluoride exposure, medical history, social history, saliva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the parts to preventions

A

fluoride varnish, fluoride toothpaste, fluoride supplement, fissure sealants, radiographs, diet advice, change medication, toothbrushing advice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what guidelines are used for caries risk and prevention

A

sign 138, SDCEP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what toothbrushing advice should be given

A

brush twice a day, including once before bed, fluoride toothpaste, spit dont rinse, should be supervised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the indication for fissure sealants

A

for all first permanent molars of all children regardless of risk factor
in high risk children - deciduous molars caries free, and premolars

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what are the steps for fissure sealants

A

patient and tooth selection
tooth isolation - rubber dam, cotton wool
clean tooth - pumice and slurry
etch - 35% phosphoric acid and dry
apply resin sealant
light cure
check retention, remove flash, check for air bubbles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what materials are required for fissure sealants

A

rubber dam or cotton wool roll, dry guard, saliva ejector
35% etch
pumice and slow speed
resin
light cure
probe, excavator, microbrush, mirror

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

how can hard tissue defects be divided and give examples

A

localised - trauma or abscess of primary
generalised - environmental or hereditary
environmental - fluorosis or MIH
hereditary - ameleogenesis imperfecta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is the difference hypomineralisation and hypoplastic

A

2 phases of enamel development - secretory and mineralisation
secretory lays down jelly like shape of tooth, if there is a problem with this - the tooth will be hypoplastic - insufficient bulk/thickness of enamel
mineralisation - increasing mineral content and thus hardness - if there is a problem with this, the tooth will be hypomineralised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is AI and how is it diagnosed

A

AI is an inherited condition in which there is a malfunction with enamel development - either secretory or mineralisation. diagnosis - family history, appearance (affects all teeth, tooth size, colour, shape, yellow/brown or white), radiographic - no difference between enamel and dentine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what medical conditions have an enamel defect - not ameleogenesis imperfecta

A

epidermolysis bullosa, prader-willi, downs

31
Q

how to tell the difference between fluorosis and MIH

A

MIH - only molars and incisors
fluoride - all teeth
ask if they lived in fluorodated area

32
Q

what questions are asked to get diagnosis of MIH

A

pre-natal - problems in last trimester of pregnancy - pre-eclampsia, gestational diabetes, infections

natal - premature birth, time special baby unit, traumatic birth

post-natal - infections in first year of life, how long they were breast fed for

33
Q

what is the calcification dates of FPMs and incisors

A

FPMs - 7-8 months after ovluation, crown formed at 1 year of life
incisors - start 3-4 months after birth, complete by 3-6 years

34
Q

when would you consider balancing an XLA

A

XLA of tooth on same arch but condralateral side - prevent midline shift
primary canines

35
Q

when would you consider compensating an XLA

A

XLA of same tooth on opposite arch - opposing tooth
prevent over eruption
if XLA of lower FPM - XLA upper FPM, over eruption would prevent drifting of 7 and space closure

36
Q

what guidelines are available for planned XLA of FPM

A

RCS Clinical Effectiveness Committee 2009

37
Q

what is the order of treatment planning

A

prevention and acclimitisation first - OHI, Diet advice, fluoride varnish - can introduce aspirator, cotton wool rolls, 3n1
fissure sealants - polish with prophy cup to introduce slow speed
small restorations with no LA - stabilisation phase
larger restorations with LA - start with maxillary
pulpotomy and extractions

38
Q

what is fluorosis

A

defect in mineralisation of enamel due to high levels of systemic fluoride during enamel development, causes white lines in mild form or brown/yellow marks in more severe form

39
Q

what age are children at risk of fluorosis until

A

until calcification is complete of all crowns - age 8 on SIGN 138 guidelines
for cosmetic purposes - until age 3 for anterior crown development

40
Q

what is the recommended fluoride levels for children

A

until age 8 - 0.1mg/kg/day
from age 8 - 10mg/day
supplement
until age 3 - 0.25mg/day
age 3-6 - 0.5mg/day
6+ 1mg/kg/day

41
Q

what are the recommendations for different levels of fluoride ingestion

A

less than 5mg/kg - give calcium (milk) orally and observe
5-15mg/kg - give calcium (milk or calcium gluconate) and take to hospital for observation
more than 15mg/kg - urgent hospital referral, intensive care and cardiac obs - IV cardiac gluconate

42
Q

what are the components fear and anxiety

A

physiological - breathlessness, perspiration, palpitations
cognitive - hypervigilance, loss of concentration, inability to remember
behavioural - avoidance, asking questions, missing appts

43
Q

how can you reduce a patients anxiety

A

acclimitisation
giving the patient control - stop signals, rest breaks, providing them information

44
Q

how can cerebral palsy effect dental health

A

poor manual dexterity - poor OH
limb spasms - unable to get dental treatment safely
gag reflex
regurgitation - acid causing erosion
not in control of their diet or OH

45
Q

how can a patient in a wheelchair be treated

A

transfer board
wheelchair recliner
hoist

46
Q

what legislation protects children

A

children and young people act 2014

47
Q

what are types of abuse

A

sexual, physical, emotional, neglect

48
Q

what is dental neglect defined as

A

british society of paeds - the persistent failure to meet childs oral health needs likely to result in impairment of childs oral or general health or development

49
Q

what does dental disease put children at risk of

A

severe infections, teasing, multiple GAs, repeated antibiotics - resistance

50
Q

what is indicators of dental neglect

A

obvious dental disease apparent to non-dental professional, but no treatment sought after
missing multiple appoints despite support given to carer - not returned for treatment
impact on child - sleep loss, eating effected, missing school, teasing

51
Q

what guidance should be followed when managing suspected abuse/neglect

A

british dental association
child protection and dental team

52
Q

what are the stages of management of suspected dental neglect/abuse

A

stage 1 - dental team management
stage 2 - preventative multi-agency management
stage 3 - child protection referral

53
Q

what medical condition is associated with supernumerary teeth

A

cleidocranial dysplasia

54
Q

what are some anomalies related to shape of teeth

A

peg shaped laterals
dens in dentine
talon cusp
dilaceration

55
Q

what is the relevance of osteogenesis imperfecta

A

often associated with dentinogenesis imperfecta, have multiple fractured bones

56
Q

what are dentine conditions that only effect dentine

A

dentinogenesis imperfecta type 2
dentine dysplasia

57
Q

what medical conditions are associated with dentine anomalies

A

osteogenesis imperfecta
ehlers-danos syndrome
rickets

58
Q

what should be considered when deciding to extract fpm

A

AGE, skeletal pattern, future ortho needs, quality of teeth

59
Q

what are causes of delayed eruption

A

medical conditions - downs, hypothyroidism
premature, low birth weight
malnutrition
gingival hyperplasia

60
Q

what are causes of delayed exfoliation

A

trauma, infra-occlusion, ectopic successor, hypodontia

61
Q

what are causes of premature exfoliation

A

trauma
following pulpotomy
immunological deficiency

62
Q

what advice should be given to all patients post trauma

A

avoid contact sports for 2 weeks
soft diet for 2 weeks
maintain good oral hygiene - soft brush after every meal
and rinse with chlorhexidine 0.12% twice a day

63
Q

what are types of trauma complications

A

pulpal necrosis and infection
root resorption
pulp canal obliteration
break down of marginal gingiva and bone

64
Q

how does replacement resorption happen and how does it appear

A

severe damage to PDL, osteoblasts faster at healing than PDL fibroblasts, PDL becomes replaced with bone - dentine fused directly to bone
appears - tooth is infraoccluded as included in bone remodelling, no PDL space seen radiographically

65
Q

what is pulp canal obliteration

A

response of vital pulp - progressive hard tissue formation within pulp chamber - narrowing of pulp chamber and canal

66
Q

what types of trauma is pulp canal obliteration more likely to be seen

A

luxation, extrusion, intrusion, root fractures

67
Q

why do immature teeth have a better prognosis following trauma

A

wider apices - more blood vessels - better healing capacity

68
Q

what is subluxation and what are the symptoms

A

damage to surrounding tooth structures, no displacement but may have mobility
symptoms - increased mobility, TTP, bleeding at gingival crevice

69
Q

what is lateral luxation and what are the symptoms

A

displacement of tooth in a socket in any direction other than axially
symptoms - tooth immobile, ankylosis percussion note (metallic), fracture of alveolus, sensibility tests likely to be negative

70
Q

why is RCT initiated in a closed apex tooth following lateral luxation

A

high chance of pulpal necrosis, doing pulp extirpation early prevents external infection related root resorption

71
Q

how can root fractures be classified and why is this helpful

A

apical third, mid third, coronal third
coronal third fractures have the worst prognosis and must be splinted for 4 months

72
Q

if a tooth has discoloured yellow following trauma, what is this indicative of

A

pulp canal obliteration - tertiary dentine laid down in pulp chamber, reduces light transmission

73
Q

what are the properties of splints

A

must be passive and flexible
must allow for adequate oral hygiene
must allow for clinical monitoring and sensibility tests
ease of placement
aesthetics

BDS4 CDS (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions