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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
treatment options for complete failure of tooth to form
tooth germ sequestrate spontaneously OR require removal
26
what is an odontome?
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
a) What is EADT and EAT
- 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
what are some potential storage mediums for an avulsed tooth
saliva normal saline milk
29
what information would you give someone phoning up about an avulsion
- 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
what form of splint is use for subluxation and what is the min time the splint should be in place for?
a flexible splint 2 weeks
31
what is the fluoride regime for a high risk 4y/o
2800 ppmF toothpaste
32
what age is it suitable to deliver mouthwash to a paediatric patient?
no recommended under age of 6
33
what fluoride dose is toxic and how do you treat specific amounts?
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
list potential treatments and what order would you carry them out on a nervous child
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
before prescribing fluoride mouth rinse what should you check?
patient's age use of any other fluoride supplements
36
what is the daily strength of fluoride in mouth rinse?
225ppmF
37
ED fracture - what is the treatment
- 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
what are 4 non radiographic signs and symptoms to monitor over time
- sensibility test - colour of tooth - sinus - mobility
39
what are 4 radiographic signs the tooth is non-vital
- internal and external inflammatory resorption - periapical pathology - root development has ceased (width and length of canal not growing)
40
how does the nursing bottle caries pattern happen
caries which affect the upper anterior and molar teeth - caused by inappropriate use of feeding cups and bottles
41
a child has carious lower 6s what are you looking for in a radiograph (OPT) for suitable extraction timing
furcation of 7s forming presence of developing premolars and 3rd molars
42
what is the treatment option for upper non carious 6 (when you can lower carious 6s)
extraction to compensate for the lack of lower 6s - if not extracted tooth will over erupt
43
2 advantages of extraction of carious 6s at the correct time
patient would have caries free dentition the 7s should drift mesially into the space where the 6 originally was
44
what are 2 disadvantages of extraction of carious 6s
loss of a tooth in the permanent dentition could leave to spacing if the 5s drift distally
45
what are 2 ways of extraction for an anxious child
GA sedation (behavioural management technique)
46
Management of an ED fracture in an 8 year old boy
- 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
4 radiographic signs a tooth is non-vital
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
What are some effects of trauma on permanent successor
- Enamel defects (hypomineralisation or hypoplasia) - Abnormal tooth or root morphology - Ectopic tooth position - Delayed eruption - Arrest in tooth formation - Odontoma formation
49
what are indications a child's trauma is non-accidental
- 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
what are some behaviour management methods for an anxious child
- Positive reinforcement - Tell, show and do - Acclimatisation - Systemic desensitisation - Voice control - Distraction - Imitation of others – role modelling - Hypnosis
51
general aims of EMERGENCY treatment
- retain vitality of damaged/displaced tooth - treat exposed pulp - reduction and immobilisation of displaced teeth - tetanus prophylaxis
52
general aims of INTERMEDIATE treatment
+/- pulp treatment restoration (minimally)
53
general aims of PERMANENT treatment
- apexigenesis - apexification - root filling +/- root extrusion - gingival and alveolar collar modification if required - coronal restoration
54
how to manage a enamel fracture
- 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
Following a subluxation injury a tooth will be
tender to touch/light tapping and have increased mobility
56
Treatment guidelines for an avulsed permanent tooth with an open apex advise that:
if a tooth cannot be reimplanted immediately at the scene of injury, milk is a suitable storage medium
57
What radiographic finding would suggest loss of vitality following dental trauma
External inflammatory root resorption (EIRR)
58
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 pulpotomy (Cvek or coronal) should be completed
59
Following an intrusion injury of 3-7mm to tooth 11 in a 13-year-old child what is likely
Pulpal necrosis is likely
60
what does it mean when you get root fractures in permanent teeth following dental trauma
loss of vitality of both the coronal and apical portions of the tooth is likely
61
what permanent tooth injuries has a splinting time of 4 weeks?
Lateral luxation
62
what does it mean when teeth present with pulp canal obliteration?
It occurs more frequently in teeth with open apices

BDS3 exam prep (13 decks)

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