Paeds Flashcards
difference in rigid and flexible splint
rigid = 2 teeth either side flexible = 1 tooth either side
alternative treatment for temporary splint
foil + ZOE
vacuum formed splint - terrible for OH
how to mix GI
3 scoops of powder : 3 drops of distilled water
how soon does avulsed tooth need to be reinserted to avoid root therapy?
<45 mins from avulsion if open apex
immediate intervention to avulsed tooth
- do not touch root
- rinse for 10 secs in cold water
- reinsert if you can
- store in saliva or cold milk
- use gauze to stop bleeding
- get emergency appointment
deciduous tooth eruption sequence
in sequence with exception of canines i.e. centrals, laterals, first primary molars canines, second primary molars.
1 2 4 3 5
lowers erupt before uppers with exception of lateral incisors
what is leeway space
extra mesiodistal space occupied by primary molars which are wider than the premolars that replace them
- 5mm per side in maxilla
- 5mm per side mandible
deciduous vs permanent pulp
deciduous pulp horns are larger in proportion to crown that surrounds them and pulp horns extend higher occlusally
narrower, more slender, and flare apically best describes primary or permanent roots
primary
what teeth would you expect an 8yr old child to have
both first permanent molars
upper and lower centrals
upper and lower laterals
definition of mixed dentition
begins from when first permanent tooth erupts to the exfoliation of the last permanent tooth
eruption sequence of lower permanent teeth
6 1 2 3 4 5 7 8
6 1 2 4 5 3 7 8 is the eruption sequence of what
upper permanent teeth
significant morphology of primary first molars
both upper and lower have a prominent tubercle on mesiobuccal cusp
significant morphology of lower second primary molars
3 buccal cusps which have a lingual lean
significant morphology of upper primary second molars
prominent transverse ridge
primate spacing
spacing mesial to upper canine and distal to lower canine
characteristics of deciduous incisors
upright - increased proclination in permanent teeth causing a increased A-P arch length
less overjet
indications for fissure sealants
high caries risk (molars and premolars should be sealed on eruption)
medically compromised children
learning difficulties
materials used in fissure sealants
etch
bis GMA
why conventional endo can’t be used for primary teeth
- roots are variable - number/divergence/curvature
- ribbon shaped canals have many interconnections
- psychological resorption of roots prior to exfoliation
- root morphology changes with age so resorbable filling materials must be used unlike standard ones
- if canals instrumented beyond apices the permanent successor could be damaged
indications for pulp therapy (6)
good cooperation / medical history preludes extraction / missing permanent successor i.e. hypodontia / over-riding necessity to preserve both i.e. space maintainer / child under 9yrs / not necessary to use GA
contraindications for pulp therapy
poor cooperation / poor motivation / multiple gross carious teeth / medical history / tooth unrestorable / severe pain and infection / space management / advanced root resorption / pus in pulp chamber / gross bone loss
normal bleeding in pulp
bright red in colour
good haemostasis
uninflamed pulp
abnormal bleeding
deep crimson
continued bleeding after pressure
inflamed pulp
signs of non vital pulp
- hyperaemic pulp (lots of bleeding)
- pulp necrosis
- furcation involvement
symptoms of non vital pulp
- irreversible pulpitis
- periapical periodontitis
- chronic sinus
what is vitapex
CaOH and iodoform paste
why use vitapex
resorbs from apical tissues in 1wk-2mths harmless to permanent tooth germ radiopaque does not set to hard mass easy to insert and remove
minor failure of hall technique
- secondary caries
- crown worn / lost / requires additional intervention
- restoration lost but tooth restorable
- reversible pulpitis treated without pulpectomy or extraction
major failure of hall technique
- irreversible pulpitis
- abscess requiring pulpotomy or extraction
- interradicular radiolucency
- filling lost and tooth unrestorable
risk factors for caries in children
OH, diet, bacterial exposure, socio-economic status, breast/bottle fed, fluoride exposure, parental smoking, parental OH
nursing caries - where and why
upper anterior and upper/lower molars due to inappropriate use of feeding bottles/cups i.e. should always have free flow spout
prevention of caries in children
diet - swap sugary snacks for savoury i.e. cheese, breadsticks, fruit fluoride - varnish and mouthwash OH - should begin on eruption of first primary tooth / assisted / twice daily / smear of toothpaste free flow spout with plain drink 1000ppmF 3 yrs 1000-1500ppmF 4-16 <10yrs high risk 1500ppmF >10yrs high risk 2800ppmF (duraphat)
fluoride varnish
twice yearly for pre school kids at increased risk of caries
indication for fissure sealants
high caries risk - should have perm molars and premolars sealed on eruption
medically compromised
learning difficulties
what is a fissure sealant
a protective plastic coating used to seal pits and fissures to prevent food and bacteria getting caught in them and causing decay
extraction of FPM
may help with spacing if prognosis poor
optimal occlusion obtained when:
- bifurcation of lower 7 seen forming on OTP (8.5-10yrs)
- 5s and 8s are all present and in good position
-mid buccal segment crowding
-class I incisor relationship
fissure restorations
if stained enamel then remove 1mm of tissue, should not be like a prep, then use flowable > fissure seal
how to tell what age in mixed dentition
6s = 6yrs upper centrals and lower laterals = 7yrs all incisors = 8yrs lower canines = 9yrs premolars = 10yrs upper canines = 11yrs 7s = 12yrs
