Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Finals > Paedriatric Dentistry > Flashcards

Paedriatric Dentistry Flashcards

1
Q

What are the indications for Inhalation Sedation in Adults and Children? (6)

A

Anxiety
Needle phobia
Gagging
Traumatic procedures
Medical conditions aggravated by stress
Unaccompanied adults requiring sedation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the contraindications of Inhalation Sedation in Adults and Children? (7)

A

Common cold
Tonsillar/Adenoidal enlargement
Severe COPD
First trimester of pregnancy
Fear of ‘mask’/ Claustrophobia
Patients with limited ability to understand
Obstruction of the operation field by mask

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the components of the equipment utilised in Inhalation Sedation? (7)

A

Gas cylinders
Pressure reducing valves
Flow control meter
Reservoir bag
Gas delivery hoses
Nasal hood
Waste gas scavenging system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the purpose of the Flow Control Meter in the equipment used in Inhalation sedation?

A

Measures flow rates of up to 10 l/min
Blue= nitrous oxide
Clear= oxygen
Accuracy +/- 5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the function of the Reservoir bag component of the Inhalation Sedation equipment?

A

2-3 litre bag; rubber or silicone
Should move visibly with each breath and must not collapse
Monitors respiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the diameter of the gas delivery hose component of the Inhalation Sedation equipment?

A

2.5cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the function of each hose of the gas delivery hoses in the Inhalation Sedation equipment?

A

One hose: delivers fresh gases from the machine
One hose: delivers waste gas to scavenging system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are examples of Safety features of Inhalation Sedation equipment?

A

Pin Index System
Diameter Index System
Minimum Oxygen Delivery
Oxygen Fail Safe
Air entrainment valve
Oxygen flush button
Oxygen monitor
Reservoir bag
Colour coding
Scavenging System
Oxygen and Nitrous oxide pressure dials
Pressure reducing valves
One way expiratory valve
Quick fit connection for positive pressure oxygen delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the function of a Pin Index System in Inhalation Sedation?

A

Prevents the wrong cylinder being attached to the

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the function of the Diameter index system in Inhalation Sedation?

A

Prevents cross connection of piping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the minimum oxygen delivery in Inhalation Sedation?

A

30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When does the oxygen fail safe kick in in Inhalation Sedation?

A

When oxygen pressure <40 psi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the advantages of Inhalation Sedation? (9)

A

Rapid onset (2-3mins)
Rapid peak action (3-5mins)
Flexible duration
Rapid recovery
No injection (for sedation not LA)
Few side effects on patient
Drug not metabolised
Some analgesia (better for ischaemic > inflammatory pain)
No amnesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the disadvantages of Inhalation Sedation? (8)

A

Expensive equipment
Expensive gases
Space occupying equipment
Environmental concerns
Requires ability to breath through nose
Chronic exposure risk (potentially)
Staff addiction
Difficult to accurately determine actual dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the signs of adequate sedation? (10)

A

Patient relaxed/comfortable
Patient awake
Reduced blink rate
Laryngeal reflexes unaffected
Vital signs unaffected
Gag reflex obtunded/reduced
Mouth open on request
Decreased reaction to painful stimuli
Decrease in spontaneous movement
Verbal contact maintained

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the symptoms of adequate Inhalation Sedation? (10)

A

Mental and physical relaxation
Lessened awareness of pain
Paraesthesia: lips, fingers, toes, legs, tongue
Lethargy
Euphoria
Detachment ‘floating feeling’
Warmth
Altered awareness of time
Dreaming
Small controllable ‘fits of giggles’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the signs and symptoms of over sedation (Inhalation Sedation)? (9)

A

Mouth closing
Spontaneous mouth breathing
Nausea/Vomiting
Irrational and sluggish responses
Decreased cooperation
Incoherent speech
Uncontrolled laughter/tears
Patient no longer enjoying effects
Loss of Consciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the pre-operative instructions prior to Inhalation Sedation? (8)

A

Have a light meal before appointment
Take routine medications
Child accompanied by competed adult
Adults must be accompanied on their first appointment
Do not drink alcohol on day of appointment
Wear sensible clothing
Arrange care of children during and after appointment
Plan to remain in clinic up to 30 minutes after treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Discuss Inhalation Sedation Technique:

A

Set up
Select nasal hood and connect hoses
Set dial to 100% O2
Set flow to 5-6l per min and position on patient nose
Encourage nasal breathing and verify reservoir bag movements
Reduce O2 by 10%
One min later reduce O2 by 10%
Reduce by 5% per minute until patient ready

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What should you do to the O2 concentration when patient is over sedated?

A

Increase O2 in 5-10% increments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What should you do to the O2 concentration if the patient is under sedated?

A

Decrease O2 in 5% increments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What should you do to get to the recovery phase of Inhalation Sedation?

A

Increase O2 to 100%
Administer 100% for 2-3 minutes
Remove hood and turn gas flow off
Return patient up right, praise and reassure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Why do you leave the O2 at 100% for 2-3 minutes in Inhalation Sedation?

A

To prevent diffusion hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the success rate for Inhalation Sedation and why does it vary?

A

50-90%
Patient populations, greater success with orthodontic extractions, poorer in patients with pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the important aspects of a social history for IV sedation assessment?

A

Nature of fear
Phobia vs anxiety
General vs Specific
Anxiety questionnaire
Occupation
Escort
Alcohol
Responsibilities
Transport
Age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the important aspects of a dental history for IV sedation assessment?

A

Referral source
Previous bad experiences
Previous sedation/GA
Symptoms
Proposed procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the important aspects of a medical history for IV sedation assessment?

A

Drug history/allergy
Recreational drug use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which drugs increase the sedative effect of midazolam?

A

Alcohol
Opioids
Erythromycin
Antidepressants
Antihistamines
Antipsychotics
Recreational drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is ASA 1?

A

Normal healthy patient
Non smoker
Minimal alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is ASA 2?

A

Mild systemic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is ASA 3?

A

Severe systemic disease
Limits activity but not incapacitating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is ASA 4?

A

Severe systemic disease
Constant threat to life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is ASA 5?

A

Moribund
Not expected to live >24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is ASA 6?

A

Brain dead for organ donation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Which ASA can be treated in primary care?

A

1 and 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Which ASA can be treated in secondary care?

A

3 and 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What questions should you ask an asthmatic in regard to IV sedation?

A

What drugs do they take and how often?
Have they been hospitalised?
Is it exacerbated by stress?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the definition of pharmacodynamic interactions?

A

Interactions between drugs which have similar or antagonistic pharmacological effects or side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the definition of pharmacokinetic interactions?

A

One drug alters the absorption, distribution, metabolism or excretion of another thereby increasing or reducing the amount of drug available in the system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What ASA category does pregnant put a person in?

A

ASA 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are the important features of a general examination for IV sedation?

A

Signs of anxiety
Discomfort with surroundings
Eye contact
Speech
Vital signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are the vital signs?

A

Heart rate
Blood pressure
Oxygen saturation
BMI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the BMI for underweight?

A

<18.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the BMI for healthy weight?

A

18.5-24.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the BMI for overweight?

A

25-29.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the BMI for obese?

A

30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the BMI cut off for sedation?

A

35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is a good working time for IV sedation patients?

A

45 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What are the ideal features of an IV sedation agent?

A

Anxiolysis
Sedative effect
Ease of administration
Non-irritant
Quick onset
Quick recovery
No side effects
Amnesia
Low cost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is the mode of action of benzodiazepines?

A

Acts on receptors in CNS to enhance effect of GABA
Prolongs the time for receptor repolarisation
Mimics effect of glycine on receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What allows benzodiazepines to attach to receptors?

A

Benzene ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Why do sedative agents cause respiratory depression?

A

CNS depression and muscle relaxation
Decreases cerebral response to increased carbon dioxide
Synergistic relationship with other CNS depressants
Increased respiratory depression in already compromised patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

How do sedative agents affect the cardiovascular system?

A

Decrease blood pressure by muscle relaxation decreasing vascular resistance
Increasing heart rate due to baroreceptor reflex compensating for blood pressure fall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What are the side effects of sedative agents?

A

Tolerance
Dependance
Sexual fantasies (increases with dose)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Why is diazepam not given in water?

A

It is insoluble in water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is the elimination half life of diazepam?

A

43 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What is the dosage of diazepam?

A

0.1-0.2mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is the current gold standard sedative?

A

Midazolam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is the elimination half life of midazolam?

A

90-150 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Where is the metabolism of midazolam?

A

Liver and extra hepatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What are the advantages of midazolam over diazepam?

A

Painless
Quicker onset
Quicker recovery
More reliable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Who makes up the sedation team?

A

Operator; sedationist
Second sedation trained person: dental nurse etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

How often is sedation training?

A

Annually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Why is the dorsum of the hand a cannulation site?

A

Accessible
Superficial and visible
Poorly tethered
Affected by peripheral vasoconstriction so may need to warm up hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What is the second choice for cannulation area?

A

Antecubital fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What is ametop gel?

A

A topical anaesthetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

When must the assessment for intravenous sedation be carried out?

A

On a separate day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What must be done pre-operatively to intravenous sedation?

A

Pulse and blood pressure
Reconfirm consent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

How is a patient monitored during intravenous sedation?

A

High volume aspiration
Pulse oximeter
Non invasive blood pressure (NIBP) measurements every 5-10 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What emergency drugs should be prepared during intravenous sedation?

A

Flumazenil (antagonises benzodiazepines)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What is the drug administration of midazolam?

A

2mg bolus
1mg increments every minute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What is the drug administration of midazolam?

A

2mg bolus
1mg increments every minute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is the end point of intravenous sedation?

A

Slurring and slowing of speech
Relaxed
Delayed response to commands
Willingness to accept treatment
Vergil’s sign ptosis
Eves sign-loss of motor coordination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What is the maximum dose of midazolam?

A

7.5mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What makes the therapeautic dose of midazolam change?

A

Sleep
Alcohol
Stress
Drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What makes the therapeautic dose of midazolam change?

A

Sleep
Alcohol
Stress
Drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What are the steps for managing respiratory depression?

A

Talk, shake, hurt
Head tilt, chin lift, jaw thrust
O2 (2l/min via nasal cannulae)
O2 (5l/min via Hudson mask)
Flumazenil
Ambu bag
Airways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What is the preparation and dose of Flumazenil?

A

500mcg in 5ml
Dose; 200mcg then 100mcg increments every minute until a response is seen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What is the half life of Flumazenil?

A

50 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What is anéxate?

A

Flumazenil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What is the meaning of Child Protection?

A

Activity undertaken to protect specific children who are suffering, or are at risk of suffering harm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What is the meaning of Children in Need?

A

Those who require additional support or services to achieve their full potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What is the meaning of Safeguarding Children?

A

Measures taken to minimise risks of harm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What are three methods of safeguarding children?

A

Protecting children from maltreatment
Preventing impairment of children’s health or development
Ensuring children grow up in a safe and caring environment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What are the three factors of child abuse?

A

Carer has some responsibility for the harm
Significant connection between the carer’s responsibility to the child and the harm to the child
Significant harm to the child

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

What are the features of a wellbeing wheel?

A

Achieving
Active
Healthy
Included
Nurtured
Respected
Safe
Responsible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Which three features can decrease parental capacity?

A

Domestic abuse
Drug and alcohol misuse
Mental health problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What 4 factors are associated with vulnerable children?

A

Under 5’s
Irregular attenders
Medical problems and disability
Looked after children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What 4 factors are associated with vulnerable children?

A

Under 5’s
Irregular attenders
Medical problems and disability
Looked after children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What are the five types of neglect?

A

Nutrition
Warmth, clothing and shelter
Hygiene and healthcare
Stimulation and education
Affection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What are the short term effects of childhood neglect?

A

Physical health
Emotional health
Social and cognitive development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What are the long term effects of child neglect?

A

Increased arrests
Suicide attempts
Major depression
Diabetes
Heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

What are three indicators of dental neglect?

A

Obvious dental decay
Impact on child
Practical care offered, child does not return for treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

What are the three stages of management for child neglect?

A

Preventive Dental Team Management
Preventive Multi-agency Management
Child Protection Referral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

What are the ten features of the Index of Suspicion?

A

Delay in seeking help
Story is vague, lacking in detail and varies from person to person
Account is not compatible with the injury
Parent’s mood is abnormal
Parents behaviour is a cause for concern- refusal of treatment or hospital admission, aggression to staff
Child’s appearance and interaction with parent is abnormal
Child may contradict parents
History of previous injury
History of violence within family

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

What are the expectations of the dental team when dealing with child neglect?

A

Observe
Record
Communicate
Refer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

X

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What percentage of abuse injuries are found in the head and neck area?

A

60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

What is motivational interviewing and how is it conducted?

A

Translating knowledge into behaviour
Seek permission, open questions, affirmations, reflective listening, summarising

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

What is standard prevention?

A

Tooth brushing demo once a year
OHI and diet advice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

What is enhanced prevention?

A

Tooth brushing demo and diet advice each appointment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Where should fissure sealant be placed in enhanced prevention?

A

2’s palatal pits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

What is the toxic dose of fluoride?

A

5mg/kg body weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

What % of 2800 ppm toothpaste is fluoride?

A

0.619%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

What age does tooth trauma most commonly occur?

A

2-4 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

What gender is mostly affected by tooth trauma?

A

Male

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Which teeth are mostly affected by tooth trauma?

A

Maxillary incisors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

What are the features of a concussed tooth?

A

Tender to touch
No displacement
No increased mobility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

What are the features of subluxation?

A

Tender to touch
No displacement
Increased mobility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

What are the features of lateral luxation?

A

Tooth displaced in palatal/lingual/labial direction

111
Q

What are the features of lateral luxation?

A

Tooth displaced in palatal/lingual/labial dirección

112
Q

What are the features of intrusion?

A

Tooth displaced apically

113
Q

What are the features of extrusion?

A

Partial displacement of tooth out of socket

114
Q

What are the features of extrusion?

A

Partial displacement of tooth out of socket

115
Q

What are the features of avulsion?

A

Tooth completely out of its socket

116
Q

What are the four features of a paediatric patient assessment?

A

History
Patient factors
Goals
Treatment plan

117
Q

What do patient factors consist of?

A

Understanding
Co-operation
Coping style

118
Q

What does MCDASf stand for?

A

Modified child dental anxiety scale (faces)

119
Q

What are the options of methods of pain and anxiety management?

A

Non-pharmacological behaviour management
Local anaesthesia
Sedation
General anaesthetic

120
Q

What is used for inhalation sedation?

A

Nitrous oxide and oxygen

121
Q

What are the indications of inhalation sedation in paeds?

A

Age (must be amenable to hypnotic suggestion, understand nasal breathing)
Anxiety level (mild to moderate)
Management of gag reflex
Medical considerations
Previous dental history
Dental needs

122
Q

What are the contraindications for inhalation sedation in paeds?

A

Age (under 4)
Anxiety level
Medical considerations
Previous dental history
Dental needs
Patient choice

123
Q

What is the consenting procedure for inhalation sedation in paeds?

A

Check understanding
Written pre-operative and post-operative instructions

124
Q

What are the important factors of providing inhalation sedation in paeds?

A

Keep talking to patient
Ensure child avoids mouth breathing

125
Q

What are the important factors of providing inhalation sedation in paeds?

A

Keep talking to patient
Ensure child avoids mouth breathing
Monitor
Post op instructions

126
Q

What drugs are used for IV sedation in paeds?

A

Midazolam
Propofol

127
Q

What are the indications for IV sedation in paeds?

A

Age
Anxiety level
Medical considerations
Previous dental history
Dental needs

128
Q

What are the contraindications for IV sedation?

A

Age
Anxiety level
Medical considerations
Dental needs

129
Q

What does TCI mean?

A

Target controlled infusion

130
Q

When is TCI Propofol used?

A

For very long and short procedures
Mean rapid onset and recovery

131
Q

What is the consenting procedure for IV sedation in paeds?

A

Check understanding
Written pre and post op instructions

132
Q

What are the alternative sedative techniques to IV and inhalation sedation?

A

Oral and transmucosal sedation

133
Q

What are the 9 features of a trauma stamp?

A

Radiograph
TTP
Colour
Ethyl Chloride
Thermal
Sinus
Mobility
Displacement
Percussion

134
Q

What are the radiographic signs of tooth trauma?

A

Periapical radiolucency
Internal inflammatory resorption
External inflammatory resorption
Ankylosis

135
Q

What is the definition of a strong recommendation?

A

Based on available information, weighing up balance of benefit vs risk, almost all individuals would choose this option

136
Q

What is the aim of pads dental treatment?

A

To reduce the risk of the child experiencing pain, infection or treatment-induced anxiety

137
Q

What does a comprehensive assessment include?

A

Patient history
Clinical examination
Caries risk assessment

138
Q

What are the five factors of motivational interviewing?

A

Seek permission
Open questions
Affirmations
Reflective listening
Summarising

139
Q

Where should fissure sealant be placed in enhanced prevention patients?

A

2’s palatal pits

140
Q

What are the components of silver diamine fluoride?

A

Silver
Fluoride
Ammonium ions

141
Q

What are the indications for use of SDF?

A

Asymptomatic cavitated carious lesions in primary teeth
Non-restorable dentinal lesions
Root caries
Pre-cooperative children and adults whose behaviour/medical conditions limit invasive restorative treatment

142
Q

What are the contraindications for use of SDF?

A

Not able/willing to brush teeth
Potassium iodide contraindicated in pregnant/breast feeding women, patients undergoing thyroid surgery/medication
Patients with ulceration, mucositis, stomatitis
Allergy to silver, fluoride or ammonia

143
Q

What method can be used for needle desensitisation?

A

Teach relaxation
Explain LA
Practice LA
Deliver LA

143
Q

What prevention should be carried out alongside providing SDF?

A

Dietary advice
OHI
Topical fluoride application

144
Q

What are the causes of child dental anxiety?

A

Parental anxiety
Difficult medical experiences
Difficult dental experiences

145
Q

What are some physiological and somatic associations with dental anxiety?

A

Breathlessness
Perspiration
Unease

146
Q

What is concussion?

A

An injury to the tooth supporting structures without increased mobility or displacement
Pain to percussion

147
Q

What are three signs of a brain injury?

A

Amnesia
Vomiting
Nausea

148
Q

How long should an avulsed primary tooth be under review?

A

Until eruption of the permanent

149
Q

What is the role of dental professionals in regard to neglect?

A

Know how to refer concerns about abuse or neglect
Know who to contact for further advice about abuse or neglect of children
Raise concerns about the possible abuse or neglect of children

149
Q

What is the definition of child protection?

A

Activity undertaken to protect specific children who are suffering or at risk of suffering significant harm

149
Q

Which act made it illegal to smack a child?

A

The Children (Equal Protection from Assault) (Scotland) Bill

150
Q

What are three examples of factors that can decrease parenting capacity?

A

Domestic violence
Drug/alcohol misuse
Mental health problems

151
Q

How many children per year are killed by a parent/parent substitute?

A

10

152
Q

Why does neglect of neglect occur?

A

Neglect is less incident focused

153
Q

What are three long term effects of child neglect?

A

Greater incidence of heart disease
Greater incidence of diabetes
Greater incidence of neglect

154
Q

What are the three stages in managing dental neglect?

A

Preventive dental team management
Preventive multi-disciplinary agency management
Child protection referral

155
Q

Which % of serious head injuries in the first year of life are non-accidental?

A

95%

156
Q

What % of abuse injuries are found on the head and neck?

A

60%

157
Q

At what age range do primary teeth erupt?

A

6 months to 2.5 years

158
Q

What is the order of primary tooth eruption?

A

a b d c e

159
Q

What are four factors of primary tooth occlusion?

A

Upright incisors
Spaced
Terminal E’s: flush terminal plane
Class I molar relationship

160
Q

How common are natal teeth?

A

1 in 3000

161
Q

What are the three phases of tooth eruption?

A

Pre-eruptive phase
Eruptive phase
Post-eruptive phase

162
Q

What happens during the pre-eruptive phase?

A

Crown formation

163
Q

What happens during the eruptive phase?

A

Crown reaches occlusal plane

164
Q

What are the two stage of the eruptive phase?

A

Intra-osseous
Extra-osseous

165
Q

What happens during the post-eruptive phase?

A

Tooth movement/eruption

166
Q

What are the three stages of the intra-osseous phase?

A

Root formation
Movement occlusally or incisally
Reduced enamel epithelium fuses with the oral epithelium

167
Q

What are the three stages of the extra-osseous phase?

A

Penetration of crown through epithelium
Crown moves until contact with opposing tooth
Environmental factors: muscles from cheeks, lips and tongue determine final position

168
Q

What is the gubernacular cord?

A

Remnant of the dental lamina that allows the permanent tooth to retain contact with the lamina propria of the oral mucosa

169
Q

What are the roles of the dental follicle?

A

Initiates resorption of the bone overlying the tooth
Creates eruption pathway
Promotes alveolar bone growth

170
Q
A
171
Q

What are the radiographic signs of a non-vital tooth on a radiograph?

A

Furcation bone loss
External and Internal resorption
Radiolucencies
Periapical periodontitis

172
Q

What is the treatment for an enamel-dentine fracture?

A

Bond fragment/composite bandage
2 Periapicla radiographs to rule out root fracture/luxation

173
Q

What is the treatment for an enamel-dentine fracture?

A

Bond fragment/composite bandage
2 Periapicla radiographs to rule out root fracture/luxation

174
Q

What does preventive dental team management involve?

A

Single unit approach
Raise concerns with parents
Offer support
Set targets
Keep records
Monitor progress

175
Q

What does preventive multi-agency management involve?

A

Liase with other professionals to see if concerns are shared
Child may be subject to common assessment framework (CAF)
Check if child is subject to child protection plans
Agree joint plan of action; to be reviewed at agreed intervals
Letter to health visitor of child under 5 who fails to respond to letter from practice

176
Q

What does a child protection referral involve?

A

Follow local guidelines
Refer to social services if required

177
Q

What does a child protection referral involve?

A

Follow local guidelines
Refer to social services if required

178
Q

What are the long term effects of trauma on the permanent dentition?

A

Discolouration
Delayed exfoliation of primary
Enamel defects (44%)
Abnormal tooth/root morphology
Crown or root duplication
Delayed eruption (1%)
Ectopic tooth position
Arrest in development
Complete failure in permanent tooth formation
Odontome formation
Undeveloped tooth germ

179
Q

What does immediate vs delayed discolouration suggests?

A

Immediate- vital tooth
Delayed- non-vital tooth

180
Q

What is the treatment for hypomineralisation?

A

Mask with composite
Localised removal and restore with composite
External bleaching

181
Q

What is the treatment for hypoplasia?

A

Repair with composite or porcelain veneers when gingival level is stabilised at 16 years old

182
Q

What is the treatment for crown/root dilacerations?

A

Surgical exposure and orthodontic treatment

183
Q

Why can primary tooth trauma lead to delayed permanent tooth eruption?

A

Premature loss of primary teeth
Delayed eruption due to thickened mucosa

184
Q

What is the treatment for delayed permanent tooth eruption?

A

Surgical exposure and orthodontic treatment

185
Q

What is the treatment for delayed permanent tooth eruption?

A

Surgical exposure and orthodontic treatment

186
Q

When should you not replant an avulsed tooth?

A

Immunocompromised
Other more serious injuries
Very immature apex and >90 mins EAT
Very immature lower incisors in young people finding it difficult to cope

187
Q

What are the clinical findings of dentó-alveolar fracture?

A

Complete fracture from buccal to lingual
Segment mobility and displacement with several teeth moving together
Occlusal disturbance

188
Q

What is the treatment of a dentó-alveolar fracture?

A

Reposition any displaced segment
Stabilise by splinting for 4 weeks
Suture gingival lacerations if present
Monitor pulp condition of all involved teeth

189
Q

How long should a lateral luxation be splinted?

A

4 weeks

190
Q

What is the sequel are of trauma to primary teeth?

A

Discolouration
Infection
Delayed exfoliation

191
Q

What is dilaceration?

A

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

192
Q

What are the contraindications for preformed metal crowns?

A

Irreversible Pulpitis
Periapical pathology
Insufficient tooth tissue to retain crown

193
Q

What are the contrindications to fluoride varnish?

A

Hospitalised due to severe asthma
Allergy in last 12 months
Allergy to sticky plasters/ colophony

194
Q

What is the difference between a trauma splint and an orthodontic wire?

A

Trauma splint- 0.4mm
Ortho wire- 0.7mm

195
Q

What are the SDCEP plaque scores?

A

10: perfectly clean tooth
8: line of plaque around cervical margin
6: cervical 1/3 crown
4: middle 1/3 crown

196
Q

How long should a mid/apical root fracture be splinted?

A

4 weeks

197
Q

What is the treatment of an enamel fracture?

A

Bond fragment or smooth
Take 2 periapicals

198
Q

When should an enamel fracture be reviewed?

A

6-8 weeks
6 months
1 year

199
Q

What is the treatment of an enamel dentine fracture?

A

Bond or composite bandage
Take 2 periapicals

200
Q

When should an enamel dentine fracture be reviewed?

A

6-8 weeks
6 months
1 year

201
Q

What is the treatment of an enamel dentine pulp fracture if less than 1mm?

A

Pulp cap

202
Q

What is the treatment of an enamel dentine pulp fracture if more than 1mm or untreated for 24 hours?

A

Partial pulpotomy

203
Q

What is the treatment of an enamel dentine pulp fracture if the tooth is non vital?

A

Pulpotomy

204
Q

When should an enamel dentine pulp fracture be reviewed?

A

6-8 weeks
6 months
1 year

205
Q

What is the treatment of a crown root fracture?

A

Post crown
Fragment removal
Decoronate

206
Q

What is the treatment of a concussion?

A

No treatment

207
Q

When should you review a concussion?

A

4 weeks
1 year

208
Q

What is the treatment of a subluxation?

A

No treatment or splint

209
Q

When should you review a subluxation injury?

A

2 weeks (SR)
12 weeks
6 months
1 year

210
Q

How long should you splint for a subluxation injury?

A

2 weeks

211
Q

What is the treatment for a lateral luxation?

A

Reposition under LA
Splint

212
Q

How long should you splint a lateral luxation?

A

4 weeks

213
Q

When should you review a lateral luxation?

A

2 weeks
4 weeks (SR)
8 weeks
12 weeks
6 months
Annually

214
Q

What is the treatment for intrusion of an immature tooth?

A

Spontaneous reposition
Orthodontic reposition after 4 weeks

215
Q

What is the treatment of <3mm intrusion of a mature tooth?

A

Spontaneous reposition
Reposition after 8 weeks

216
Q

What is the treatment of a 3-7mm intrusion of a mature tooth?

A

Surgical or orthodontic repositioning

217
Q

What is the treatment of a >7mm intrusion of a mature tooth?

A

Surgical repositioning

218
Q

How long should you splint for an intrusion?

A

4 weeks

219
Q

When should you review an intrusion injury?

A

2 weeks
4 weeks (SR)
8 weeks
12 weeks
6 months
1 year

220
Q

What is the treatment of an extrusion injury?

A

Reposition and splint

221
Q

How long should you splint an extrusion injury?

A

2 weeks

222
Q

When should you review an extrusion injury?

A

2 weeks (SR)
4 weeks
12 weeks
6 months
1 year
Annual

223
Q

What is the treatment of an avulsion of a tooth with a closed apex?

A

Replant and splint
Endo after 2 weeks

224
Q

When should you review an avulsion on a closed apex tooth?

A

2 weeks (SR)
4 weeks
3 months
6 months
1 year
Annually

225
Q

How long should you splint an avulsion?

A

2 weeks

226
Q

What is the treatment of an avulsion of an open apex tooth?

A

Replant

227
Q

When should you review an avulsion on an open apex tooth?

A

2 weeks (SR)
1 month
2 months
3 months
6 months
1 year
Annually

228
Q

What is the treatment of an alveolar fracture?

A

Reposition and splint

229
Q

How long should you splint an alveolar fracture?

A

4 weeks

230
Q

How long should you splint an alveolar fracture?

A

4 weeks

231
Q

When should you review an alveolar fracture?

A

4 weeks (SR)
6 weeks
4 months
6 months
1 year
Annually

232
Q

When should pulp treatment be carried out in paediatrics?

A

MH excludes extraction
Good cooperation
Good attendance e

233
Q

How does pulp treatment failure present?

A

Furcation bone loss
Internal inflammatory resorption
External inflammatory resorption
PAP

234
Q

What are methods of anxiety management?

A

Distraction
Tell-show-do
Acclimatisation
Desensitisation
Role modelling
Positive reinforcement

235
Q

How does post replant resorption present?

A

Internal inflammation
External inflammation
External surface resorption
Replacement ankylosis

236
Q

What teeth are affected by early childhood caries and why?

A

Upper anteriors and molar teeth due to inappropriate use of feeding cups and bottles

237
Q

How can early childhood caries be prevented?

A

Diet: promote and support breast-feeding
Fluoride: no benefit of fluoride supplements during pregnancy
Oral hygiene

238
Q

What dietary advice should be given to prevent early childhood caries?

A

Use of a feeding cup rather than bottle from 6 months (free-flow spout)
Drinks containing free sugars should never be put in a bottle
Children should not be put to bed with a feeder bottle or cup
Soya milk is potentially cariogenic
Avoid sweetened drinks
Food and confectionary containing free sugars should be minimised and restricted to meal times
Non sugar sweeteners recommended
Plain water or milk between meals
Sugar free medications

239
Q

What advice should be given for the consumption of sweetened drinks if they are going to be drank?

A

Meal times only
Diluted
Drink through a straw (to back of mouth)

240
Q

What are examples of good non-cariogenic snacks?

A

Cheese
Milk
Fruite
Savoury sandwiches
Crackers
Breadsticks

241
Q

What should be included in a diet diary?

A

Everything eaten
At least one day must be a Saturday/Sundat

242
Q

What are the modes of getting fluoride?

A

Fluoridated water
Toothpaste
Supplements: drops, tablets, mouthwash
Professional delivered: varnishes

243
Q

When should toothbrushing begin?

A

As soon as the first primary tooth erupts

244
Q

What age lacks the dexterity to independently brush their teeth effectively?

A

Under 8

245
Q

What concentration of fluoride is in children’s toothpaste?

A

1000ppm

246
Q

What age is children’s toothpaste used?

A

First tooth - 3 years

247
Q

What is the fluoride concentration of standard toothpaste?

A

1400-1500ppm

248
Q

What is the fluoride concentration of enhanced toothpaste?

A

2800 or 5000ppm

249
Q

What advice should be given to parents once their childs first tooth has erupted?

A

1000ppm toothpaste
Smear of toothpaste
Spit out don’t swallow
Small headed toothbrush

250
Q

From what age should a pea sized amount of toothpaste be used?

A

> 3 years

251
Q

What is the level of fluoride toxicity?

A

5mg/kg body weight

252
Q

What is the management for a fluoride accident if <5mg/kg administered?

A

Give milk (calcium) and observe for a few hours

253
Q

What is the management for a fluoride accident if 5-15mg/kg administered?

A

Give milk and admit to hospital

254
Q

What is the management for a fluoride accident if >15mg/kg administered?

A

Admit to hospital
IV calcium gluconate
Cardiac monitoring and life support

255
Q

How often do high risk children get radiographs?

A

6 months

256
Q

How often do standard risk children get radiographs?

A

12-18 months

257
Q

What are the disadvantages of a primary tooth extraction?

A

Loss of space; increased malocclusion
Decreased masticatory function
Decreased speech development
Psychological disturbance
Trauma

258
Q

What are the indications for paediatric pulp treatment?

A

Good co-operation
Medican history precludes extraction
Missing permanent successor
Need to persevere tooth as a space maintainer
Child under 9 years old

259
Q

What are the contraindications for paediatric pulp treatment?

A

Poor co-operation
Poor dental attendance
Advanced root resorption
Cardiac defect
Multiple grossly carious teeth
Recurrent pain/infection

260
Q

What are the stages of a pulpotomy?

A

Remove roof of pulp chamber
Remove coronal pulp with sterile excavator/slow large round steel bur
Place a cotton pellet with ferric sulphate for 20 seconds
Place zinc oxide/eugenol in pulp chamber and restore using metal preformed crown

261
Q

What are the stages of pulpectomy?

A

Remove roof of pulp chamber
Remove contents of pulp chamber
Use files to remove pulpal tissue (-2mm of length)
Irrigate with chlorhexidine, dry with paper points
Obturate canals with vitapex (CaOH) and iodoform paste
Seal with ZOE/GIC and restore with preformed metal crown

262
Q

What are the indications for pulpectomy over pulpotomy?

A

Non-vital pulp
Irreversible pulpits

263
Q

What are clinical signs of pulpectomy failure?

A

Pathological mobility
Fistula/chronic sinus
Pain

264
Q

What are radiographic signs of pulpectomy?

A

Radiolucency
External/internal resorption
Furcation bone loss

265
Q

What traumas are splinted for 2 weeks on a flexible splint?

A

Avulsion

266
Q

What traumas are splinted for 4 weeks on a flexible splint?

A

Luxation
Root fracture

267
Q

What traumas are splinted for 4 weeks on a rigid splint?

A

Dento-alveolar fracture

268
Q

What are the advantages of the hall technique?

A

No LA needed
Not invasive
Less stressful for patient
Effective
Retains tooth

269
Q

What instruments are used for the placement of hall crowns?

A

Preformed metal crowns
GI luting cement
Diamond tapered separating bur
Crown crimping pliers
Curved crown scissors

270
Q

What factors are considered when sizing up SS crowns?

A

Trial and error
Measuring m-d length

271
Q

What are the indications for hall technique?

A

No pulp involvement
Remaining tooth tissue

Finals (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions