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BDS Finals > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

Eruption Sequence for Primary Teeth

A

a
b
d
c
e

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2
Q

Which arch tends to erupt first

A

Lowers before uppers

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3
Q

When do primary teeth erupt

A

6 months - 2.5 years

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4
Q

Eruption sequence for permanent maxillary teeth

A

6
1
2
4
5
3
7
8

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5
Q

Eruption sequence for permanent mandibular teeth

A

6
1
2
3
4
5
7
8

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6
Q

How long should it take for a contralateral tooth to erupt

A

6 months or less

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7
Q

When should you be able to palpate upper canines

A

By the age of 10/11

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8
Q

Balancing extraction

A

Take out the contralateral tooth

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9
Q

Compensating extraction

A

Take out the opposing tooth in opposing arch (upper/lower)

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10
Q

Which primary teeth should be balanced

A

Cs
Ds under GA

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11
Q

Which teeth should be compensated (2)

A

Lower 6
If taking upper, don’t take lower

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12
Q

When is the ideal time to take out lower 6s (4)

A
  1. When the furcation begins to form on 7s
  2. In patients whose 8s are present
  3. In Class I patients
  4. In patients with mild/moderate crowding
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13
Q

What can be used to deter digit sucking

A

Habit breakers
Can be removable or fixed

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14
Q

When should digit sucking be stopped for teeth to return to normal eruption

A

Before the age of 10

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15
Q

Infra-occluded deciduous teeth

A

Tooth has ankylosed to bone
More common in lower

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16
Q

Infra-occluded deciduous teeth treatment (2)

A

If permanent successor - no treatment
If no permanent successor - wait a year then extract when 1mm of crown left showing

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17
Q

What are good signs for upper canines being in the correct position in mixed dentition

A

Mobile Cs
Distally tipped laterals

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18
Q

What can be done about ectopic canines

A

Extract both Cs (even if only 1 is ectopic)
Can be done up to the age of 13

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19
Q

Toothpaste for a high risk 2 year old

A

1450ppm smear

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20
Q

Ages for simplified BPE

A

7-11 years

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21
Q

Ages for normal BPE

A

12+

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22
Q

Simplified BPE codes

A

0, 1, 2

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23
Q

When should fluoride varnish be applied

A

2+ years old
Twice a year

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24
Q

Which surfaces of lower molar should also be fissure sealed

A

Occlusal and buccal

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25
Q

Which surfaces of upper molars should be fissure sealed

A

Occlusal and palatal

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26
Q

What can be used as a fissure sealant if a child is uncooperative

A

Glass ionomer

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27
Q

Contraindications to F varnish (6)

A
  1. Ulcerative gingivitis
  2. Stomatitis
  3. Sensitivity to colophony
  4. Severe cases of asthma
  5. Allergy
  6. Allergy to Elastoplast
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28
Q

Plaque Scores - Paeds

A

10 - Perfectly clean teeth
8 - Plaque at cervical margin
6 - Cervical third plaque
4 - Middle third plaque

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29
Q

When does calcification of upper third molars occur

A

7-9 years

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30
Q

When does calcification of lower third molars occur

A

8-10 years

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31
Q

No third molars seen on radiograph by age 14

A

If not seen by this age they will are unlikely to develop at all

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32
Q

Fissure Sealant Function (2)

A
  1. Obliterate the fissures
  2. Remove sheltered environment in which caries thrives
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33
Q

Positioning for fissure sealant

A

LL - In front of patient
Behind for all other quadrants

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34
Q

Moisture control aids (4)

A
  1. Dry guards
  2. Saliva ejector
  3. Cotton wool rolls
  4. Suction
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35
Q

What teeth should be fissure sealed in high risk individuals (6)

A

4, 5, 6, 7
Palatal pit on upper laterals
Large cingulums

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36
Q

Technique for applying resin fissure sealant (7)

A
  1. Teeth cleaned
  2. Tooth isolated with dam or cotton wool
  3. Surface etched for 20-30 seconds
  4. Surface washed and dried
  5. Cotton wool replaced
  6. Place and light cure sealant
  7. Inspect
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37
Q

Technique for GIC fissure sealant (4)

A
  1. Can use 20% polyacrylic acid to etch but not necessary
  2. Tooth isolated
  3. GIC run into fissures
  4. Infilled resin, petroleum jelly or fluoride varnish placed to protect material
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38
Q

Quality assurance of fissure sealants (2)

A
  1. Run probe along - shouldn’t ping off
  2. Should look like the shape of the fissures not a pool of material
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39
Q

What children are eligible for fissure sealants (4)

A
  1. Children with special needs
  2. Children from a disadvantaged background
  3. Extensive caries in primary dentition
  4. If a 6 develops caries
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40
Q

How often should radiographs be taken for children

A

Low risk 12-18 months
High risk 6 months

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41
Q

From what age can you legally consent in Scotland

A

16

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42
Q

Can children consent

A

Yes if they are deemed Gillick competent

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43
Q

What concentration of fluoride is fluoride varnish

A

22,600 ppm F

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44
Q

Oral reservoirs for fluoride (2)

A

Mineral deposits (CaF)
Biologically/bacterially bound (CaF)

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45
Q

Dosage of F 0.25mg

A

6m-3y

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46
Q

Dosage of F 0.5mg

A

3-6 years

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47
Q

Dosage of F 1mgF

A

> 6 years

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48
Q

Properties of duraphat (3)

A

Sodium fluoride
50mg/ml
22,600ppm F

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49
Q

Fluorosis (2)

A

Chronic toxicity
Developmental defect of enamel

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50
Q

How much F do young children need to swallow to risk fluorosis (3)

A

1mg / day - 1 year old
2mg / day - 5-6 year old
Fluorosis still possible at recommended intakes

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51
Q

Recommended F intake per day

A

0.05-0.07 mg/kg

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52
Q

Is fluorosis due to topical or systemic F

A

Systemic

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53
Q

What can cause primary teeth to be red

A

Porphyria

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54
Q

Which type of trauma is most common in children

A

Luxation

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55
Q

Trauma history - MH (3)

A
  1. R. Fever
  2. Congenital heart defects
  3. Immunosuppression
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56
Q

Trauma history - the injury (5)

A
  1. When
  2. Where
  3. How
  4. Any other symptoms
  5. Lost teeth/fragments
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57
Q

What may help show cracks in teeth (3)

A

Transillumination
Probing
Percussion

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58
Q

Types of luxation (3)

A

Lateral
Intrusive
Extrusive

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59
Q

Long term effects of trauma on primary teeth (3)

A
  1. Discolouration
  2. Infection
  3. Delayed exfoliation
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60
Q

Discolouration immediately after trauma

A

Tooth may remain vital

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61
Q

Gradual discolouration weeks after trauma

A

Tooth non vital

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62
Q

Delayed exfoliation after trauma treatment

A

Extraction

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63
Q

Long term effects of trauma in permanent teeth (7)

A
  1. Enamel defects
  2. Abnormal tooth/root morphology
  3. Delayed eruption
  4. Ectopic tooth position
  5. arrest in tooth formation
  6. Complete failure of tooth to form
  7. Odontome formation
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64
Q

How likely are enamel defects after paediatric trauma

A

44%

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65
Q

How likely is abnormal tooth/root morphology after paediatric trauma

A

8%

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66
Q

How long can premature exfoliation delay a permanent tooth by

A

1 year due to thickened mucosa

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67
Q

Home management for paeds trauma (4)

A
  1. Soft diet for 2 weeks
  2. Brush with soft brush after every meal
  3. CHXD mw (0.12%) by parents 2x a day
  4. Avoid contact sports
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68
Q

How often should paeds trauma be reviewed? (3)

A
  1. 1, 3, 6 monthly
  2. Radiographs 6 month
  3. Intrusion more often
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69
Q

Enamel dentine fracture treatment (2)

A

Restore/bandage with composite or compomer
Don’t use GI

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70
Q

Enamel dentine pulp fracture treatment

A

Endo or extract

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71
Q

Crown and root fracture treatment (2)

A
  1. Extract coronal fragment
  2. Leave root it will resorb physiologically
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72
Q

Alveolar bone fracture treatment (3)

A
  1. Reposition segment
  2. Splint for 3-4 weeks
  3. Teeth may need to be extracted after stability has been achieved
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73
Q

Concussion/Subluxation treatment

A

Observation

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74
Q

Lateral luxation treatment (3)

A

Repositionunder LA
Flexible splint 4 weeks
2 week endo eval

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75
Q

Characteristic of primary teeth (4)

A
  1. Bulbous crown
  2. Splayed roots
  3. Cervical constriction
  4. Colour
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76
Q

What does a sinus indicate after trauma

A

Infection

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77
Q

Yellow tooth after trauma

A

Pulp obliterated, more dentine laid down

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78
Q

Grey tooth after trauma

A

Tooth non vital

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79
Q

Pink tooth immediately after trauma

A

More blood products in tooth

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80
Q

Pink tooth long after trauma

A

Root resorption

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81
Q

What colour can indicate an exfoliating tooth

A

Pink as gum is beginning to show underneath tooth

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82
Q

Mobility after trauma can indicate (2)

A

Infection
Root fracture

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83
Q

Rock solid teeth after trauma (3)

A

Be suspicious
Ankylosis
Luxation and poor reposition

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84
Q

Why is a tooth more likely to fracture after CaOH

A

It denatures collagen and makes the tooth more brittle

85
Q

Sensibility testing in children

A

Notoriously unreliable

86
Q

EPT numbers in paediatric trauma patients (2)

A

Compare them to adjacent teeth
Only important between visits if a tooth was responding and now isn’t

87
Q

How many signed of a non-vital tooth are needed to perform RCT in a paediatric trauma patient

A

> 2

88
Q

TAB

A

Transient Apical Breakdown

89
Q

Transient apical breakdown (2)

A

Tooth resorbs at tip to try and let neurovascular bundle back into tooth
Needs close review

90
Q

General types of paeds trauma

A

Hard tissue (teeth)
PDL

91
Q

Treatment options for instrinsic discolouration of anterior teeth (6)

A
  1. Enamel micro abrasion
  2. Vital bleaching
  3. Non-vital bleaching
  4. Resin infiltrate
  5. Composite
  6. Veneers
92
Q

Pre op records for all discoloured teeth (5)

A
  1. Clinical photos
  2. Shade
  3. Sensibility testing
  4. Diagram of defect
  5. Pt assessment - VAS
93
Q

VAS

A

Visual Analogue Scale

94
Q

For discoloured teeth, what shade should be recorded

A

Shade of background and defect

95
Q

What is microabrasion

A

Acid and pumice

96
Q

Maximum application of microabrasion

A

10 x 5 seconds
OR
5 x 10 seconds

97
Q

What is used to neutralise acid used in microabrasion

A

Sodium bicarbonate

98
Q

What should be done after microabrasion (4)

A
  1. Polish with finest soft flex disc
  2. F varnish (not yellow)
  3. Post op photos
  4. Review 4-6 weeks
99
Q

How many times can microabrasion be carried out

A

Only once

100
Q

How much enamel does acid etching remove

A

100 microns

101
Q

Advantages of microabrasion (4)

A
  1. Conservative
  2. Cheap
  3. Low maintenance
  4. Permanent results
102
Q

What types of stain can microabrasion be used on (3)

A

Yellow-brown
White
Multi coloured

103
Q

Disadvantages of microabrasion (3)

A
  1. Removes enamel
  2. Dental dam
  3. Prediction of outcome difficult
104
Q

Warnings for the pt after microabrasion (3)

A
  1. Teeth dehydrated
  2. Avoid highly coloured food or drinks for 24+ hours
  3. If dying hair keep mouth shut
105
Q

What should you wait for when bleaching young peoples teeth

A

Canines to fully erupt

106
Q

PDS

A

Public Dental Service

107
Q

Who are monthly capitation payments doubled for

A

Children with special needs/those who the GDP needs to spend double the time with

108
Q

How does SIMD impact monthly capitation fee

A

Extra 25p per month where postcode is SIMD 1

109
Q

What ages do you administer F varnish

A

2-12

110
Q

How often do you administer F varnish in high risk children

A

2x a year

111
Q

Important milestone ages for kids

A

3, 6, 9, 12

112
Q

How long does it normally take the same tooth to erupt in the opposing arch

A

A year or less

113
Q

Hypomineralisation symptoms that require treatment (3)

A
  1. Hypersensitivity
  2. Crumbling back teeth
  3. Aesthetic concerns
114
Q

Hypomineralisation management options (6)

A
  1. Seal
  2. Restore
  3. PMC
  4. Extraction (correct timing)
  5. Aesthetic mgmt
  6. Seek specialist opinion
115
Q

By age 3…

A

All primary teeth should have erupted

116
Q

By age 6…

A

FPM should have erupted

117
Q

By age 9…

A

All permanent incisors erupted and canine palpable

118
Q

By age 12…

A

Most if not all of primary dentition should have exfoliated

119
Q

Things than can cause dry mouth in children (6)

A
  1. Diabetes
  2. Beta 2 antagonists
  3. Corticosteroid inhalers
  4. Anticonvulsants
  5. Antiepileptics
  6. Acne tx
120
Q

MI

A

Motivational Interviewing

121
Q

SDF

A

Silver Diamine Fluoride

122
Q

Concentration of SDF

A

44,800ppmF

123
Q

How does SDF work (3)

A
  1. Occludes dentinal tubules
  2. Silver is antibacterial
  3. F encourages remineralisation
124
Q

Why can caries be worse in primary molars (3)

A
  1. Wider contact areas
  2. Larger pulps
  3. Faster spread into pulp
125
Q

Why do we take radiographs so often for high risk kids

A

Caries can be underdiagnosed by up to 50% without them

126
Q

If bitewings not possible, how can you check for caries

A

Separators

127
Q

How old do children need to be for amalgam

A

15

128
Q

Referral pathways for children (4)

A
  1. PDS
  2. Ortho
  3. HDS
  4. Non dental (child protection/social services)
129
Q

When does root formation occur in relation to eruption

A

Within 3 years of crown eruption

130
Q

At what age will root calcification of third molars occur

A

18-25

131
Q

FiCTION protocol

A

Filling children’s teeth: Indicated or not?

132
Q

Most successful restorative tx option for caries in primary teeth

A

PMC
Hall technique

133
Q

Common problems with stainless steel crowns (3)

A
  1. Rocking
  2. Canting
  3. Loss of Space
134
Q

Rocking of SS crown cause

A

Cervical margin >1mm away

135
Q

Canting of SS crown cause

A

Uneven occlusal reduction

136
Q

Types of failure from Hall technique

A

Minor
Major

137
Q

Minor failure from Hall technique (4)

A
  1. Secondary caries
  2. Crown lost
  3. Requires intervention
  4. Reversible pulpitis treated w/o pulpotomy or extraction
138
Q

Major failure from Hall technique (4)

A
  1. Irreversible pulpitis
  2. Abscess
  3. Interradicular radiolucency
  4. Filling lost and tooth unrestorable
139
Q

Paeds - Indications for pulp tx (5)

A
  1. Co-operation
  2. MH precludes extraction
  3. Missing permanent successor
  4. Necessity to preserve tooth
  5. Child <9
140
Q

Paeds - Contraindications for pulp tx (6)

A
  1. Poor co-operation
  2. Poor attendance
  3. Cardiac defect
  4. Multiple grossly carious teeth
  5. Advanced root resorption
  6. Severe/recurrent pain/infection
141
Q

Primary tooth pulp cap success rates

A

Poor

142
Q

Paeds pulpal evaluation

A

Normal bleeding - uninflamed pulp
Abnormal bleeding - inflamed pulp

143
Q

Normal bleeding of pulp (2)

A
  1. Bright red
  2. Good haemostasis
144
Q

Abnormal bleeding of pulp (2)

A
  1. Deep crimson
  2. Continued bleeding after pressure
145
Q

Pulpotomy

A

Vital

146
Q

Pulpectomy

A

Non-vital

147
Q

Can severe infection in a primary molar with facial swelling be treated with pulpectomy

A

No - extract

148
Q

AET

A

Acid Etched Tip

149
Q

What can be used for a dentine bandage

A

Composite or compomer

150
Q

When is a pulp cap indicated (2)

A

Small exposure
<24 hours old

151
Q

Why are pulpotomies used in immature teeth

A

Root formation can continue
Apexigenesis

152
Q

Pulpectomy in an immature tooth (2)

A
  1. Apical barrier formation
  2. Mineral trioxide aggregate used
153
Q

How long should you wait for MTA to harden

A

24 hours

154
Q

Exposed Pulp Tx Options (3)

A
  1. Pulp cap - small, <24hrs
  2. Pulpotomy - large
  3. Pulpectomy - large
155
Q

Avulsed teeth first aid (6)

A
  1. Store in fresh milk/saliva
  2. Don’t let dry out
  3. Don’t touch root
  4. Quick rinse under water IF obvious debris
  5. Re-implant quickly
  6. See a dentist immediately
156
Q

If caries just in enamel in children

A

Fissure sealant

157
Q

If caries into dentine but small in children

A

PRR
SR

158
Q

PRR

A

Preventative Resin Restoration

159
Q

SR

A

Sealant Restoration

160
Q

TDI

A

Traumatic Dental Injury

161
Q

Follow up time for uncomplicated crown fractures (2)

A

6-8 weeks
1 year

162
Q

Follow up time for root fracture (6)

A

4 weeks
6-8 weeks
4 months
6 months
1 year
5 years

163
Q

When should the splint be removed following a root or alveolar fracture (2)

A

4 weeks
4 months if cervical third root fracture

164
Q

Concussion follow up (2)

A

4 weeks
1 year

165
Q

Follow up for luxation (7)

A

2 weeks
4 weeks
8 weeks
12 weeks
6 months
1 year
Yearly 5 years

166
Q

Time limit for retransplantation of avulsed teeth

A

60 minutes

167
Q

Flexible splint is used for (3)

A

Avulsions
Luxations
Some fractures

168
Q

Rigid splint is used for

A

Dento-alveolar fractures

169
Q

Wire used for flexible splints

A

0.6 SSW

170
Q

Follow-up time for complicated crown fracture (4)

A

6-8 weeks
3 months
6 months
1 year

171
Q

Follow up time for crown-root fracture (6)

A

1 weeks
6-8 weeks
3 months
6 months
1 year
5 years - yearly

172
Q

Follow up time for subluxation (4)

A

2 weeks
12 weeks
6 months
1 year

173
Q

Difference in enamel-dentine fracture tx compared to enamel only (3)

A
  1. Segment must be rehydrated in saline for 20 minutes prior to rebonding
  2. Exposed dentine needs GI or bonding agent + composite
  3. If within 0.5mm of pulp - CaOH lining
174
Q

Best storage mediums for an avulsed tooth (5)

A

Milk
HBSS
Saliva
Saline
Water

175
Q

Apexification

A

Open apex filled with CaOH to stimulate hard barrier

176
Q

Follow up for mature apex avulsion (6)

A

2 weeks
1 month
3 months
6 months
1 year
Yearly 5x

177
Q

Follow up for immature apex avulsion (7)

A

2 weeks
1 month
2 months
3 months
6 months
1 year
Yearly 5x

178
Q

Endo for immature apex avulsion

A

Do not initiate unless definitive signs of pulp necrosis and infection

179
Q

Favourable outcomes for avulsion - closed (8)

A
  1. Asymptomatic
  2. Functional
  3. Normal mobility
  4. TTP -
  5. Normal percussive sound
  6. No radiographic evidence of resorption
  7. No radiolucencies
  8. Lamina dura normal
180
Q

Favourable outcomes for avulsion - open (7)

A
  1. Asymptomatic
  2. Functional
  3. Normal mobility
  4. TTP -
  5. Normal percussive sound
  6. Continued root formation
  7. Pulp canal obliteration (healing)
181
Q

Types of resorption that can occur post avulsion (2)

A
  1. External inflammatory
  2. Ankylosis related replacement
182
Q

Dental anomalies (4)

A
  1. Number
  2. Size and shape
  3. Structure
  4. Eruption and exfoliation
183
Q

Conditions associated with hypodontia (4)

A
  1. Ectodermal dysplasia
  2. Down syndromee
  3. Cleft palate
  4. Hurler’s syndrome
184
Q

Problem with missing laterals

A

Overeruption of canines - restorative issues

185
Q

Age for veneers

A

Early 20s

186
Q

Most common cause of delayed eruption of permanent incisor

A

Supernumerary

187
Q

Accessory cusp

A

Talon cusp

188
Q

Management of dens in dente

A

Seal and enhanced prevention as difficult to RCT

189
Q

Root anomalies (4)

A
  1. Short roots
  2. Radiotherapy
  3. Dentine dysplasias
  4. Accessory roots
190
Q

Enamel anomalies (5)

A
  1. Amelogenesis imperfecta
  2. Environmental enamel hypoplasia
  3. Localised enamel hypoplasia
  4. Hypomineralised enamel
  5. Hypoplastic enamel
191
Q

Hypomineralised enamel (2)

A

Shape of tooth correct
Qualitative issue

192
Q

Hypoplastic enamel (3)

A

Quantitative problem
Shape incorrect
Can often see levels

193
Q

Amelogenesis imperfecta types (4)

A
  1. Hypoplastic
  2. Hypomineralised
  3. Hypomaturation
  4. Mixed with taurodontism
193
Q

Amelogenesis imperfecta gene

A

X linked
Autosomal

194
Q

Amelogenesis imperfecta diagnosis (5)

A
  1. Affects all teeth
  2. Affects both dentitions
  3. May be new
  4. Family history
  5. Radiographs
195
Q

Amelogenesis imperfecta - Hypoplastic type

A

Enamel crystals do not grow to correct length

196
Q

Amelogenesis imperfecta - hypomineralised type

A

Crystallites fail to grow in thickness and in width

197
Q

Amelogenesis imperfecta - hypomaturational

A

Enamel crystals grow incompletely in thickness or width but to normal length with incomplete mineralisation

198
Q

Amelogenesis imperfecta problems (6)

A
  1. Sensitivity
  2. Caries risk
  3. Aesthetics
  4. Poor OH
  5. Delayed eruption
  6. AOB
199
Q

Amelogenesis imperfecta management (6)

A
  1. Prevention
  2. Composite veneers
  3. Fissure sealants
  4. Metal onlays
  5. SSC
  6. Ortho
200
Q

Dentine anomalies (4)

A
  1. Dentinogenesis imperfecta
  2. Dentine dysplasia
  3. Odontodysplasia
  4. Systemic disturbance
201
Q

Dentinogenesis imperfecta diagnosis (5)

A
  1. Both dentitions affected
  2. Enamel loss
  3. Family history
  4. Bulbous crowns (can be mistaken for primary teeth - check roots)
  5. Obliterated pulps (I & II)
202
Q

Dentinogenesis imperfecta problems (4)

A
  1. Aesthetics
  2. Caries risk
  3. Spontaneous abscess susceptibility
  4. Poor prognosis
203
Q

Dentinogenesis imperfecta management (5)

A
  1. Enhanced prevention
  2. Composite veneers
  3. Overdentures
  4. Removal prostheses
  5. SSC
204
Q

Limited to dentine only (3)

A
  1. Dentinogenesis imperfecta type II
  2. Dentine dysplasia types I & II
  3. Fibrous dysplasia of dentine
205
Q

Tooth structure defects general tx overview (3)

A
  1. Prevention and pain control
  2. Restoration of lost tissue
  3. Harness growth
206
Q

Cementum anomalies (2)

A
  1. Cleidocranial dysplasia
  2. Hypophosphatasia
207
Q

Delayed eruption associations (4)

A
  1. LBW children
  2. Malnutrition
  3. Downs
  4. Cleidocranial dysplasia
208
Q

Premature exfoliation associations (3)

A
  1. Trauma
  2. Hypophosphatasia
  3. Cyclic neutropnaemia

BDS Finals (23 decks)

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