Paeds Flashcards
what age is this pt
6 or 7
what other permanent teeth will be present at this time
6s
name given to the space between teh upper central incisors
midline diastema
what has caused the space between upper centrals here?
low frenal attachment
what is the likely cause of the general appearance of the lower centrals?
fluorosis
how is fluorisis likely to have arisen
excess ingestion of fluoride during development of the teeth
what permanent teeth are likely to be affected by fluorisis
upper central and lateral incisors
lower central and lateral incisors
canines
first premolars
second premolars
first molars
3 tx options for lower central incisors
microabrasion
composite restorations
strip crowns
which primary teeth are still present
55 (upper right E)
54 (upper right D)
53 (upper right C)
63 (upper left C)
age?
10/11/12 year old
tx option for retained primary teeth on RHS
extract
caries risk category for this pt
and why
high risk
- existing restorations
- new carious lesions
- early loss of primary tooth (upper left D, 64)
radiographs would you take to futher investigate caries in posterior teeth
bitewings
if no caries radiographically in 6s, which preventative tx would you give them
fissure sealants
caries risk category for pt and why
high risk
- existing restorations in lower right E and D and lower left D (85, 84, 74)
- buccal swelling adj to lower right E (85)
- new carious lesion in lower left E (75)
which teeth have been temporised
84 and 85
what is erupting distal to 85 and when does this usually erupt
46
6 years old
what preventative tx would you give 46 when erupted
fissure sealant
give F preparationsa and doses suitable for this pt who lives in an area with less than 0.3ppm F in drinking water
- fluoride toothpaste 1450ppm (high risk)
- duraphat/F varnish 22600ppm
- fluoride mouthwash 225ppm
- fluoride tablets, 1mg
primary teeth still present
55, 53
63, 65
which primary teeth have been extracted early
54
64
name given to forward movement of teeth into extraction site
mesial drift
caries risk category for pt and why
high risk
- early loss/extraction of primary molars
- exisiting restorations
- new carious lesions
radiographs needed to investigate caries in posterior teeth
bitewings
bitewings showed minimal caries in 26 - what type of restoration would you place
preventative resin restoration
primary teeth still present
75
85
caries risk categroy and why
high risk
- exisiting restorations
- new carious lesions
- early loss/extraction of primary teeth
what age do premenent premolars erupt
10/11 years
pt is 9
give 2 F containing preparations, and doses, which would be suitable for them given they live in an area with less than 0.3ppm Fluoride in drinking water
- F toothpaste 1450ppm
- F toothpaste 2800ppm
- F varnish/duraphat 22600ppm
- F mouthwash 250ppm
classify injury sustained to upper right central and lateral incisors (12 and 11)
luxation/extrusion
likely due to trauma
in what type of malocclusion is injury to the upper anterior teeth most likelyto occur?
Class II div 1
what type of splint and for how long?
flexible
2-4 weeks
OH advice to give this pt before they leave surgery
- don’t brush for the first day
- use a soft toothbrush after the first day
- use CHX for first 7 days
3 ways to monitor traumatised teeth long term
- colour
- percussion
- vitality testing - EPT, ethyl chloride
classify injury to 11
enamel and dentine fracture
likely due to trauma
material used to restore 11
composite resin or copomer
4 ways to monitor 11 long term
- radiographs
- colour
- percussion
- vitality testing - EPT, ethyl chloride
other non-carious disease evident on anterior teeth (non-trauma)
and eg causative agents
non carious tooth surface loss
- carbonated (fizzy) drinks
- fruit juice
- fruit (oranges, lemons)
- acid gastro-intestinal reflux
11 may be non vital
suggeted how?
colour change
likely trauma
radiograph to investigate 11
anterior periapical
initial tx plan for 11
RCT
2 long term methods of improving appearance of 11
internal bleaching
veneer
evidence of marginal gingivitis in this pt
eg chair side methods of improving their oral hygiene
- disclosing tablets
- tooth brushing demo/ instruction
- prophy polish
pt is 14 and high caries risk and lives in area with less than 0.3ppm F drinking water
name and dosage of suitable F preps
- F toothpaste 2800ppm
- F varnish/Duraphat, 22600ppm
- F mouthwash, 250ppm
age of pt
6 or 7
other permanent teeht expect to be erupting
6s
name for spacing between upper centrals
cause of it here
midline diastema
low frenal attachment
what pathology can be seen here and likely cause
ulcer
trauma from tooth brush
high caries risk pt
tx for 6s when erupted
fissure sealant
F prep and doses suitable for this pt who lives in area with less than 0.3ppm F water
- F toothpaste 2800ppmF (high risk)
- F varnish/Duraphat (22600ppm)
- F mouthwash, 250ppm
cause of lower soft tissue lesion adj to lower first permanent molar
dental abscess
radiograph to further investigate lower moalr region
periapical
likely tx choice for tooth by swelling
extraction
example congenital cardiac abnormality
- ASD
- VSD
- mitral valve stenosis/regurgitation
- aortic valve stenosis/regurgitation
- coartication of the aorta
- tetralogy of Fallot
if child had a congential cardiac abnormality, how would you amend management
extraction under antibiotic cover
child is 5 and high caries risk
give F prep and doses suitable
lives in area less than 0.3ppmF water
- F toothpaste 1000ppm
- F varnish/duraphat 22600ppm
- F tablets 1mg daily
what type of radiograph
OPT
full panoramic
which 2 primary teeth are still present
55
65
which two permanent teeth are congenitally absent
35
45
caries risk category and why
high risk
- existing restorations
- new carious lesions
age of second permanent molars erupting and preventative tx needed for them
12 years old
fissure sealants
type of radiographs
periapicals
teeth with PA pathology associated
12
11
21
24
teeth with caries
17
15
12
21
22
25
tx given to 11
RCT
post and core
caries risk category and why
hugh caries risk
- existing restorations
- new carious lesions
- early loss/extraction permanent teeth
radiograph type
bitewings
caries risk category and why
high caries risk
- existing restorations
- new carious lesions
*
primary teeth with restorations
65 MO
75 MO
84 DO
radiograph type
upper anterior oblique occlusal
primary anterior teeth shown
- 52, 51
61, 62, 63
anterior teeth have suffered trauma
give methods to monitor them long term
- colour
- TTP
- mobility
- radiograph
advice to child’s patrents regarding possible long term complications associated with traumatised primary incisors
- loss of vitality
- abscess risk
- may require extraction
- delayed exfoliation
advice to child’s parents about possible long term complications associated with permanet incisor teeth following trauma to primary incisors
- delayed eruption
- ectopic eruption
- damage to crown development - hypoplasia
- hypomineralisation
- damage to root development - dilaceration
name given to technique enabling localisation of unerupted permanent canine
does permanent canine lie buccal or palatal to arch
parallax
palatal
primary tooth still present
63
age of permanet canine eruption
11/12/13 years
tx to encourage spontaneous alignment of the permenent canine
extraction primary canine
age of pt
6/7 years
age of pt
10 or 11
classify traumatic injury sustained to 21
material used to repair
enamel and dentine fracture
composite resin or compomer
what primary teeth are still present
55
54
64
65
75
85
what age would you expect the second primary molars to exfoliate?
10 or 11
age of pt and caries risk category
9
high
which primary teeth have been extracted early?
65
85
which permanent teeth have been restored
26
46
which radiograph views are these
upper anterior oblique occlusal
periapical
classify the trauma to 11 and give likely causes
middle third root fracture
- fall
- RTA
- sport
- fight
give the type of splint nad length of time used for this case
flexible splint
4 weeks
which portion of the root would you extirpate if the tooth became non-vital
what would you use to dress the canal initially
after what length of time would you expect a calcified barrier to be formed
coronal portion of root
Ca(OH)2
6-12 months
age of pt
9
primary teeth present
55, 54, 53
63, 64, 65
73, 74, 75
85, 84. 83
classify trauma to 11
enamle/dentine/pulp (complicated) fracture
injury to 11 happened more than 24hrs ago
name procedure you would initially carry out and give medication used
at what intervals after initial visit would you take radiographs to reassess tooth
pulpotomy
Ca(OH)2
3 months then 6 months
Caries risk assesment acronym
My Old Car Did Fly Scotland to Siberia
MHx
OH (plaque control)
Clinical assessment
Diet
Fluoride
Siblings’ caries and Social Hx
Saliva
caries prevention
radiographs frequency
fissure sealants - bisGMA resin
fluoride toothpaste and OHI - high risk under 3 1450ppmF smear, above 10 2800ppmF, above 16 5000ppmF
fluoride supplements - mouthwash 225ppm,
sugar free medications
diet advice
fluoride varnish - 22600ppmF
F acts to
stops demineralisation
speeds up reminerilsation
stops bacterial metabolism
makes stronger mineral - fluroapatite
