Paediatrics Flashcards
caries in the following teeth
54 52 51 | 61 62 64
84 | 74
what is the name of the caries distribution
early childhood caries
nursing bottle caries
why are the specific teeth affected in early childhood/nursing bottle caries
the tongue protects lower incisors
upper anteriors are the first to erupt
upper incisors are the first in contact with the milk/substance in the baby bottle
canines are not yet erupted
causes of early childhood/nursing bottle caries
prolonged bottle feeding
bottles at night
bottles used as a pacifier
poor OH
high sugar/acidic within bottle
transmission of strep
what fluoride regime for 2y/o with early childhood/nursing caries
1350-1500ppm fluoride toothpaste
fluoride varnish applied 4x year
recommendations regarding toothbrushing regime for high risk 2y/o
brush 2x day
fluoride toothpaste, use a smear
spit not rinse
supervised
brush for 2 mins
demonstrate to the dentist
deciding order of treatment
- OHI and diet advice
- fluoride varnish
- fissure seal
- small occlusal with no LA
- occlusal on upper with LA
- interprox on lower molar LA
- lower molar for pulp therapy
- XLA upper molar
aspects of a child’s behaviour confirming they are anxious
fidgeting, refusal to open mouth, crying, clinging to parent, not sitting in chair, complaining
perspiration, feelings of unease, breathlessness
signs of abuse/neglect
severe untreated pain, bruising/cuts on face, sleep loss, contusions, burns, tooth trauma
further questions to ask when investigating suspicion of abuse/neglect
how did they get the bruise/cut
have they been in an accident
how long ago
history of previous injuries
sign 83 guideline on toothbrushing
toothbrushing 2x daily
supervised toothbrushing
brush before age of one or when first tooth comes in
how long should a diet diary be kept
3 days
child has carious teeth and parent fails to bring them back for 2 appts
what next
document in notes
safeguard nurse, child protection adviser, social services
what 3 courses of action may take place as a result of onward discussion to social services when suspicious of abuse/neglect
investigation, initial assessment, discussion, gathering of information
no action
immediate danger = child protection by sherrif officer for child to be removed by police
emergency tx of dentine/enamel fracture of tooth 11
temporary filling of GI to cover exposed area
signs/symptoms to look for in dentine/enamel fracture in longitudinal monitoring
colour of tooth, pain of tooth, mobility of tooth, sensitivity of tooth, misalignment of tooth or ones beside
radiographic signs which may be present if dentine/enamel fracture tooth 11 becomes non-vital
external root resorption, periapical radiolucency, empty pulp chamber/root canal, widening of PDL
pulp canal obliteration
loss of lamina dura
prevention of further injury of dentine/enamel fracture 11
mouth guard, special fit from lab
reasons for a child to be dentally anxious
media coverage, prior dental experience, family experience/opinion, poor knowledge of tx, expectation of pain
how to treat an anxious child
acclimation, work quickly, calm, empathy, give them stop signals, explain
behavioural management methods of dentally anxious child
positive reinforcement, tell-show-do, desensitisation, distraction, relaxation techniques, stop signalsvoice control
enhanced control
behaviour shaping
what is EADT and EAT
EADT = extra alveolar dry time = time before tooth is placed in storage medium or reimplanted
EAT = extra alveolar time = total time tooth has been avulsed and in storage medium
storage mediums for an avulsed tooth
saliva, milk, saline, HBSS
what information would you give to someone on the phone about an avulsion
handle the tooth by the crown, not the root
place in storage medium
wash of any debris
reimplant
get to dentist ASAP
what type of splint is used for subluxation and for how long
flexible splint, 1 tooth each side
2 weeks
