Paediatrics Flashcards
what two types of commonly used medications may present an adverse risk to asthmatic patients
NSAIDs
aspirin
why may patients with asthma be at a higher risk for developing caries
prolonged use of beta-2 agonist inhalers can reduce salivary flow and make the oral environment acidic
a lot of asthmatics also mouth breathe
why may patients with asthma be more susceptible to oral candidal infections
long term use of inhaled corticosteroids
reduced saliva flow
how can an asthmatic’s candida risk be reduced
rinse mouth after taking medication
chew sugar free gum
use antimicrobial mouthwash after taking medicine
prescription of oral fluconazole or nystatin
why are fluoride varnishes contra-indicated in asthmatics
colophony
what is MIH
hypomineralisation of first permanent molars with the permanent incisors affected as well
what is the radiographic and clinical evidence for the best time to extract FPMs of poor prognosis
bifurcation of 7s calcifying
5s and 8s present on radiograph
mild buccal segment crowding
class I incisors
what are the treatments for FPMs with MIH
early detection, OHI, diet advice, NaF varnish application
GIC restorations
timed extractions
restore with composite resins
PMCs
pulp therapy in compromised molars
what are treatments for anterior teeth with MIH
microabrasion
resin infiltration
external bleaching
composite restorations
what type of prevention should cleft lip and palate patients receive
enhanced prevention
why may patients with CL/P experience more dental caries
difficulty maintaining OH in cleft area
hypoplastic enamel
crowding and supernumerary teeth in cleft area
delayed oral clearance and reduced saliva flow
mouth breathing
what dental anomalies are associated with CL/P patients
hypodontia
supernumerary teeth
shape and size anomalies (macro/microdontia)
developmental defects (hypoplasia/ hypomineralisation)
when is the use of clotting factor replacement therapy indicated in dental treatment
before invasive oral surgery and the use of IAN block
what is haemophilia
X linked hereditary disorder
Haemophilia A is deficiency of factor VIII and Haemophilia B is a deficiency of Factor IX
what are the plasma activity levels for mild, moderate and severe for haemophilia
mild - 6-40IU/dL
moderate - 2-5 IU/dL
severe - less than I IU/dL
what is the role of DDAVP
to release bound factor VIII
how is dental treatment undertaken in haemophilia patients
careful not to damage the oral mucosa
can be given dentures as long as the dentures do not traumatise mucosa
risk of bleeding with matrix bands and wedges must be controlled
what anaesthesia and analgesia information should you give to a patient with haemophilia
no NSAIDs unless previously discussed with haematologist
aspirin not to be used
IDB and lingual infiltration only given after raising clotting factors by appropriate replacement therapy
what is Von Willebrand Disease
deficiency of Von Willebrand Factor
vWF stabilises factor VIII and enables platelet interaction with blood vessel wall
what 4 ways can haemophilia patients be managed in the dental setting
coagulation factor replacement therapy (IV infusion 30 minutes before procedure)
release of endogenous stores (DDAVP)
improve clot stability with antifibrinolytic drugs (tranexamic acid given two hours before and continued for 7-10 days after)
local haemostatic measures
name four examples of local haemostatic measures
sutures
oxidised cellulose (surgicel)
surgical splints
diathermy
local anaesthetic containing vasoconstrictor
what is the minimum pre-operative plasma factor level for a dental extraction to be safely performed
50%
what would a patient with factor inhibitors need to receive instead of factor concentrate
factor VIIa
what pre-operative techniques should be done before treating a haemophilia patient
check plan with haemophilia clinic
factor replacement therapy
antifibrinolytic therapy
clean mouth
what peri-operative techniques should be used for a patient with haemophilia
local haemostatic control
operator precision
no IDB or lingual infiltration
take tooth out atrumatically
do not leave any root remnants
what post operative techniques should be used for a patient with haemophilia
no aspirin or NSAIDs
tranexamic acid
surgicel and suture
pressure
if still bleeding in 24 hours phone haemophilia centre
warm salty mouthwash after 24 hours
why may patients who are nervous bleed more
increased heart rate causes blood to be pumped around body at higher rate which decrease the effect of vasoconstrictors
