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BDS3 exam prep > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

what is concussion

A

tooth tender to touch but NOT DISPLACED

IADT definition
= An injury to the tooth-supporting structures without mobility or displacement of the tooth, but with pain to percussion

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2
Q

what is subluxation

A

tooth tender to touch, has increased mobility but NOT DISPLACED

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3
Q

what is lateral luxation

A

tooth displaced usually palatal/lingual or labial direction

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4
Q

what is intrusion

A

tooth usually displaced through the labial bone plate, or it can impinge on the permanent tooth bud

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5
Q

what is extrusion

A

partial displacement of tooth out of its socket

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6
Q

what is avulsion

A

tooth completely out of the socket

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7
Q

what does the trauma stamp involve

A

mobility
colour
TTP
sinus
percussion note
radiograph

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8
Q

management of lateral luxation

A
  1. if minimal/no occlusal interference - allow reposition spontaneously
  2. severe displacement
    (1) extract
    (2) reposition +/- splint
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9
Q

management of intrusion

A

allow spontaneously reposition

dependent of direction of displacement, may effect permanent tooth germ OR displaced towards/through labial bone plate

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10
Q

management of extrusion

A
  1. if not interfering with occlusion - spontaneous repositioning
  2. excessive mobility or extruded >3mm - EXTRACT
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11
Q

management of avulsion

A

radiograph to confirm
do not replant

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12
Q

management of alveolar fracture

A

reposition segment
stabilise with a flexible splint to adjacent uninjured teeth for 4 weeks

may need to be extracted after alveolar stability has been achieved

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13
Q

direct complications of dental trauma to the primary tooth + management

A

discolouration - asymptomatic - no treatment, review

discolouration + infection - symptomatic - extract OR endo treat

delayed exfoliation - monitor for consequences to developing occlusion

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14
Q

in terms of LONG TERM EFFECTS what type of traumatic injury (primary tooth) causes the most disturbances

A

intrusion

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15
Q

what is the most common injury/anomaly to permanent tooth post primary tooth trauma

A

enamel defects (44%)

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16
Q

what are types of enamel defects

A

enamel hypomineralisation
enamel hypoplasia

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17
Q

what is enamel hypomineralisation + treatment

A
  • it is qualitative defect to enamel i.e. normal thickness but poorly mineralised
  • white/yellow defect

Treatment
1. no treatment
2. composite masking +/- localised removal
3. tooth whitening

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18
Q

what is enamel hypoplasia + treatment

A
  • it is qualitative defect of enamel i.e. reduced thickness but normal mineralisation
  • yellow/brown defects

Treatment
1. no treatment
2. composite masking

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19
Q

what is dilaceration

A

abrupt deviation of the long axis of the crown or root portion of the tooth

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20
Q

what are crown dilaceration management options

A
  1. surgical exposure and orthodontic realignment
    2 improve aesthetics restoratively
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21
Q

what is the treatment for root dilaceration/angulation/duplication

A

combined surgical and orthodontic approach

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22
Q

why can premature loss of a primary tooth result in delayed eruption? how long is the delay

A

delayed for around 1 year and it is due to thickened mucosa

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23
Q

what are the treatment options for ectopic tooth position

A
  1. surgical exposure and orthodontic realignment
  2. extraction
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24
Q

what are the treatment options for arrested development

A
  1. endodontic treatment
  2. extraction
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25
Q

treatment options for complete failure of tooth to form

A

tooth germ sequestrate spontaneously
OR
require removal

26
Q

what is an odontome?

A

a growth in which both epithelial and mesenchymal cells exhibit complete differentiation with the result that functional ameloblasts and odontoblasts form enamel and dentine

27
Q

a) What is EADT and EAT

A
  • EADT is extra alveolar dry time (the time which an avulsed tooth is in air i.e., outside the mouth but not in an appropriate storage medium)
  • EAT is extra alveolar time (the total time the avulsed tooth is outside the mouth i.e., in air and in storage medium)
28
Q

what are some potential storage mediums for an avulsed tooth

A

saliva
normal saline
milk

29
Q

what information would you give someone phoning up about an avulsion

A
  • Tell patient to hold tooth by the crown (explain that this is the part of the tooth you can see when a person smiles, and do not hold it by the root)
  • Rinse under cold water
  • Reimplant immediately (replace in socket and tell child to bite down)
  • Seek urgent dental advice
30
Q

what form of splint is use for subluxation and what is the min time the splint should be in place for?

A

a flexible splint
2 weeks

31
Q

what is the fluoride regime for a high risk 4y/o

A

2800 ppmF toothpaste

32
Q

what age is it suitable to deliver mouthwash to a paediatric patient?

A

no recommended under age of 6

33
Q

what fluoride dose is toxic and how do you treat specific amounts?

A

toxic dose for 4 y/o child is 75mg

<5mg/kg should give calcium orally (milk) and observe for a few hours

5-15mg/kg should give calcium orally (milk, calcium gluconate, calcium lactate) and admit to hospital

> 15mg/kg should admit to hospital immediately, cardiac monitoring and life support, IV calcium gluconate

34
Q

list potential treatments and what order would you carry them out on a nervous child

A
  1. OHI
  2. fluoride varnish
  3. fissure sealants
  4. hall crown
  5. upper filling no LA
  6. upper filling with LA
  7. lower filling with LA
  8. pulpotomy
  9. extraction
35
Q

before prescribing fluoride mouth rinse what should you check?

A

patient’s age
use of any other fluoride supplements

36
Q

what is the daily strength of fluoride in mouth rinse?

A

225ppmF

37
Q

ED fracture - what is the treatment

A
  • account for fragment
  • bond fragment to tooth or place a ‘composite bandage’ (if the fracture is close to the pulp, line the restoration)
    -take 2 PA radiographs top rule out root fracture/luxation and radiograph lip/cheek to rule out embedded fragment
  • do sensibility testing and evaluate tooth maturity
  • provide a definitive restoration
  • follow up for 6-8 weeks, 6 months and then 1 year
38
Q

what are 4 non radiographic signs and symptoms to monitor over time

A
  • sensibility test
  • colour of tooth
  • sinus
  • mobility
39
Q

what are 4 radiographic signs the tooth is non-vital

A
  • internal and external inflammatory resorption
  • periapical pathology
  • root development has ceased (width and length of canal not growing)
40
Q

how does the nursing bottle caries pattern happen

A

caries which affect the upper anterior and molar teeth
- caused by inappropriate use of feeding cups and bottles

41
Q

a child has carious lower 6s what are you looking for in a radiograph (OPT) for suitable extraction timing

A

furcation of 7s forming
presence of developing premolars and 3rd molars

42
Q

what is the treatment option for upper non carious 6 (when you can lower carious 6s)

A

extraction to compensate for the lack of lower 6s - if not extracted tooth will over erupt

43
Q

2 advantages of extraction of carious 6s at the correct time

A

patient would have caries free dentition
the 7s should drift mesially into the space where the 6 originally was

44
Q

what are 2 disadvantages of extraction of carious 6s

A

loss of a tooth in the permanent dentition
could leave to spacing if the 5s drift distally

45
Q

what are 2 ways of extraction for an anxious child

A

GA
sedation (behavioural management technique)

46
Q

Management of an ED fracture in an 8 year old boy

A
  • Account for the missing fragment
  • Either bond fragment to tooth or place a ‘composite bandage’
  • Take 2 periapical radiographs to rule out luxation injury or root fracture
  • Take radiographs of soft tissue lacerations to ensure no fragments are present
  • Carry out sensibility test
  • Follow up at 6-8 weeks, 6 months and 1 year
47
Q

4 radiographic signs a tooth is non-vital

A

internal inflammatory resorption
external inflammatory resorption
periapical pathology
The cease of root development over time (at follow ups, width and length of canal is not forming at rate it should/in line with contralateral tooth)

48
Q

What are some effects of trauma on permanent successor

A
  • Enamel defects (hypomineralisation or hypoplasia)
  • Abnormal tooth or root morphology
  • Ectopic tooth position
  • Delayed eruption
  • Arrest in tooth formation
  • Odontoma formation
49
Q

what are indications a child’s trauma is non-accidental

A
  • Repeated unexplained injuries
  • The explanation for the injury does not add up
  • bruises in unusual sites (not over bone, behind ears, backs of hands)
  • Burns
50
Q

what are some behaviour management methods for an anxious child

A
  • Positive reinforcement
  • Tell, show and do
  • Acclimatisation
  • Systemic desensitisation
  • Voice control
  • Distraction
  • Imitation of others – role modelling
  • Hypnosis
51
Q

general aims of EMERGENCY treatment

A
  • retain vitality of damaged/displaced tooth
  • treat exposed pulp
  • reduction and immobilisation of displaced teeth
  • tetanus prophylaxis
52
Q

general aims of INTERMEDIATE treatment

A

+/- pulp treatment
restoration (minimally)

53
Q

general aims of PERMANENT treatment

A
  • apexigenesis
  • apexification
  • root filling +/- root extrusion
  • gingival and alveolar collar modification if required
  • coronal restoration
54
Q

how to manage a enamel fracture

A
  • bond fragment tooth OR grind sharp edges
  • take 2 PAs to rule out root fracture/luxation
  • follow up 6-8weeks, 6 months, 1 year
55
Q

Following a subluxation injury a tooth will be

A

tender to touch/light tapping and have increased mobility

56
Q

Treatment guidelines for an avulsed permanent tooth with an open apex advise that:

A

if a tooth cannot be reimplanted immediately at the scene of injury, milk is a suitable storage medium

57
Q

What radiographic finding would suggest loss of vitality following dental trauma

A

External inflammatory root resorption (EIRR)

58
Q

An 11-year-old child presents to your Practice 48 hours after sustaining a complicated crown fracture to tooth 21. what should be done

A

A pulpotomy (Cvek or coronal) should be completed

59
Q

Following an intrusion injury of 3-7mm to tooth 11 in a 13-year-old child what is likely

A

Pulpal necrosis is likely

60
Q

what does it mean when you get root fractures in permanent teeth following dental trauma

A

loss of vitality of both the coronal and apical portions of the tooth is likely

61
Q

what permanent tooth injuries has a splinting time of 4 weeks?

A

Lateral luxation

62
Q

what does it mean when teeth present with pulp canal obliteration?

A

It occurs more frequently in teeth with open apices

BDS3 exam prep (13 decks)

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