Paeds Flashcards
WHEN DO YOU USE A TRAUMA SPLINT
when a child has an avulsed permanent tooth
HOW LONG SHOULD A TRAUMA SPLINT BE ON FOR WHEN THE TOOTH WAS AVULSED OR EXTRUDED
2 weeks
ADVICE FOR PARENTS WHEN A TOOTH IS AVULSED
keep tooth in milk or saliva don't allow tooth to dry out if there's debris - run under cold water for 10 seconds holding crown don't touch the root reimplant it quickly
WHAT MATERIAL IS THE WIRE USED IN TRUAMA SPLINT
0.6/0.3mm stainless steel
WHAT INSTURMENT IS USED TO BEND THE WIRE FOR A TRUAMA SPLINT
adams pliers
PROCEDURE OF A TRUMA SPLINT
cut wire to length of three teeth and bend
etch 3 teeth - frosted looking enamel
dry teeth
prime and bond
cure 20s
composite
sink wire in using tweezers and adjust - away from ging margin
thin covering of comp over wire using hand instrument
cure 20s
smooth composite and wire
WHY IS THE BENDING OF THE WIRE IMPORTANT
as it must stay as a passive appliance and not act as an ortho appliance
WHAT IS THE BEST WIRE METHOD FOR A TRAUMA SPLINT
composite wire
OTHER WIRE OPTIONS FOR TRAUMA SPLINT
acrylic wire (thicker) vacuum formed splint
WHAT DOES AVULSED MEAN
the tooth has been fully dislodged from the socket
WHAT CAN HAPPEN TO AN AVULSED TOOTH
hypoxia and necrosis of the pulp
IN WHICH CASES SHOULD A TRAUMA SPLINT BE ON FOR 4 WEEKS
luxation
apical/mid 3rd root fractures
dento-alveolar fracture
IN WHICH CASE WOULD A TRAUMA SPLINT BE REQUIRED FOR AN ADDITIONAL 4 WEEKS
breakdown/fracture of marginal bone
WHICH CASES WOULD EMAN A TRUAMA SPLINT IS REQUIRED FOR 4WEEKS - 4 MONTHS
cervical 1/3 root fracture
WHAT ARE EARLY MOUTH PROBLEMS
gingival cysts : Epstein’s pearls / Bohns nodules - keratin
neonatal/natal teeth
congenital epulis : cell proliferation at alveolar ridge
eruption cysts : blue
WHAT DOES SYSTEMIC DISTURBANCES OF CALCIFICATION CAUSE
enamel defects
WHAT DOES A DIFFICULT PRENANCY / DIFFICULT BIRTH CAUSE IN TEETH
non-inheritied congenital primary dentition defects
WHAT ARE THE CALCIFICATIONS OF DEVEOPING TEETH AT BIRTH
A = 1/2 B - 1/3 D = 1/2 C = tip E = 1/3 6 = tip of cusps
WHAT IS THE STAGES OF THE TOOTH ERUPTION PROCESS
cellular proliferation at apex
localised change in blood/hydrostatic pressure
metabolic activity in PDL
resorption of overlying hard tissue - dental follicle enzymes
stops when tooth contacts something
WHY DOES TOOTH ERUPTION HAPPEN ALL THROUGH LIFE
to compensate for vertical growth of jaws and toothwear
WHICH JAWS TEETH ERUPT FIRST
WHAT ARE THE EXCEPTIONS
lower
except B and 5
HOW SOON DO THE CONTRALATERAL TEETH ERUPT WITHIN EACHOTHER IN PRIMARY JAW
3 months
WHEN IS THE PRIMARY DENTITION COMPLETE
2.5-3 years old
WHAT IS THE ERUPTION SEQUENCE OF PRIMARY TEETH
ABDCE
WHEN DO THE As ERUPT
4-6months (0 years old)
WHEN DO THE Bs ERUPT
7-16 months(0.5-1.5 years old)
WHEN DO THE Ds ERUPT
13-19 months (1 year old)
WHEN DO THE Cs ERUPT
16-22 months (1 years old)
WHEN DO THE Es ERUPT
15-33 months (1-2years old)
PRIMARY CROWNS COMPARED TO PERMANENT
whiter, wider M-D molars, smaller
PRIMARY ROOTS COMPARED TO PERMANENT
narrower
longer
flare apically
PRIMARY ROOT CANALS COMPARED TO PERMANENT
ribbon shaped
multi interconnecting and accessory canals = impossible to fully clean
PRIMARY ENAMEL COMPARED TO PERMANENT
thinner
consistent thickness all over
PRIMARY DENTINE COMPARED TO PERMANENT
coronal dentine much thinner
PRIMARY OCCLUSION COMPARED TO PERMANENT
should have anterior spacing so permanents wont be crowded
anthropoid/primate spacing = M to upper canines and D to lower canines
leeway space = extra M-D space on molars (1.5mm upper, 2.5mm lower)
PRIMARY ROOT FORMANTION (APEXOGENESIS) COMPARED TO PERMANENT
1.5 years compared to 3 years
PRIMARY ARCH LENGTH COMPARED TO PERMANENT
primary arch ends where permanent molars would start
PRIMARY OVERJET COMPARED TO PERMANENT
reduced
PRIMARY INCISORS COMPARED TO PERMANENT
more upright instead of reclined like permanents
PRIMARY CENTRAL INCISORS TOOTH MORPHOLOGY
root bends distally
mesial edge straighter than distal
HOW TO TELL UPPER AND LOWER PRIMARY CENTRAL INCISORS APART
upper are wider and less symmetrical M-D = easier to tell if its L/R
root flares DISTALLY
PRIMARY CANINES TOOTH MORPHOLOGY
mesial edge straighter - distal one flares straight after ADJ
HOW TO TELL UPPER AND LOWER PRIMARY CANINES APART
upper are more bulbous compared
UPPER FIRST PRIMARY MOLAR MORPHOLOGY
looks like no other tooth
prominent MB tubercle
squarer occlusally than lower
LOWER FIRST PRIMARY MOLAR TOOTH MORPHOLOGY
prominent MB tubercle
more rectangle occlusally than upper (more leeway space needed for lowers)
UPPER SECOND PRIMARY MOLAR MORPHOLOGY
transverse ridge MP -> DB
3 roots 2 B and 1 P
LOWER SECOND PRIMARY MOLAR MORPHOLOGY
3 buccal cusps
like FPMS
WHAT AGE IS MIXED DENTITION
6-11
WHICH TOOTH ERUPTS FIRST
lower FPMs
WHICH TOOTH ERUPTS LAST
7s or 8s
WHICH TEETH COME IN AT AGE 10
4s and 5s
ERUPTION SEQUENCE OF UPPER ARCH
61245378
ERUTPION SEQUENCE OF LOWERS
61234578
WHAT AGE DOSE THE UPPER 6S COME IN
6
WHAT AGE DO THE UPPER 1S COME IN
7
WHAT AGE DO THE UPPER 2S COME IN
8
WHAT AGE DO THE UPPER 4S COME IN
10
WHAT AGE DO THE UPPER 5S COME IN
10
WHAT AGE DO THE UPPER 3S COME IN
11
WHAT AGE DO THE UPPER 7S COME IN
12
WHAT AGE DO THE LOWER 6S COME IN
6
WHAT AGE DO THE LOWER 1S COME IN
6
WHAT AGE DO THE LOWER 2S COME IN
7
WHAT AGE DO THE LOWER 3S COME IN
9
WHAT AGE DO THE LOWER 4S COME IN
10
WHAT AGE DO THE LOWER 5S COME IN
10
WHAT AGE DO THE LOWER 7S COME IN
12
WHICH AGE DO NO TEETH COME IN FOR THE UPPER
9
WHICH AGES DO NO TEETH OME IN FOR THE LOWER
8
11
WHAT CAUSES AND INCREASED ANTRO-POSTERIOR ARCH LENGTH WHEN THE PERMANENT TEETH COME IN
the incisors come in at a more proclined position
WHAT IS THE UGLY DUCKING PHASE
transient spacing of the permanent incisors when the first come in caused by the unerupted canines
both facing distally
sorts out when canines erupt
WHAT ARE OPERATIVE DIFFERENCES BETWEEN CHILDRENA AND ADULTS
coop -maturity - behaviour access tooth size and shape restorative material choices preventative care constant change : developing dentition
WHEN IS LA NOT REQUIRED IN CHILDREN RESTORATIONS
minimal cavity that can be hand excavated or just the slow speed
WHATS THE ONLY TIME YOU REMOVE THE TRANSVERSE RIDGE OF THE UPPER E
when its undermined by caries - other wise keep it
HOW WIDE CAN OCCLUSAL CAVITITIES BE IN KIDS
just remove pits and fissures
1.5mm - width of bur
HOW DO YOU PREPARE A PROXIMAL CAVITY IN CHILDREN
occlusal prep
extend proximally creating isthmus and drop box down creating gingival floor - clear step
clear contacts
WHAT MATERIAL IS USED TO RESTORE CERVICAL CARIES ON AN INCISOR
GIC - cover with Vaseline(moisture control)
/compomer
WHAT MATERIAL IS USED TO REPLACE INTERPROXIMAL INCISOR CARIES
composite
compomer
WHAT ARE BOARD SEPARATORS FOR
tooth separation
can be before hall crown
HOW TO BOARD SEPARATORS WORK
floss them in and then see patient 3-5 days later
should fall out or be taken out
RULES TO GET A HALL CROWN
no pupal involvement = xray
sufficient tissue left to retain crown
WHAT SHOULD THE FIT OF A HALL CROWN BE
below the gingival margins / below margins of cavitation
HALL CROWN PROCEDURE
choose crown try in GI luting cement dry tooth crown over tooth palatal to buccal partially seat and either hold with finger / let child bite in it and hold for 2-3 mins remove cement from margins
WHY MUST THE HALL CROWN BE HELD FOR 2-3 MINS
to prevent any springing back which would remove GIC from margins and reduce effective seal
WHAT TO REASSURE PARENT AND CHILD ABOUT AFTER PREFROMED METAL CROWN
gingiva which is normal and will adjust
meant to be tight
used to it in 24hours
occlusion adjusts in a few weeks
STAINLESS STEEL CROWN TECHNIQUE TOOTH PREP
remove contact - knife edged
reduce occlusally 2mm - no more than 5mm
smooth corners
WHAT PLIERS ARE USED TO CONTOUR SS CROWNS
crown crimping pliers
COMMON PROBLEMS WITH PREFORMED METAL CROWNS
rocking - crown not fitting tooth - adjust prep
canting - uneven reduction of occlusal surface
loss of space - not enough space
MINOR FAILURES OF PREFORMED CROWNS
new/secondary caries
filling or crown lost/ needs intervention
restoration lost but restorable
reversible pulpitis treated without pulpotomy / extraction
MAJOR FAILURES OF PREFORMED CROWNS
irreversible pulpitis or abcess = pulpotomy / extraction
filling lost tooth unrestorable
interradicular radiolucency
SPLIT DAM TECHNIQUE
floss clamp
clamp tooth
2 holes 1cm apart - scissors to connect them
dam over clamp - hold anteriorly with widget
frame
WHAT TO CONSIDER WHEN DECIDING IF YOU SHOULD RESTORE A TOOTH OR NOT
longevity and cooperation
TYPES OF SPACE MAINTAINERS
band and loop - when tooth lost early
distal show retainer
WHAT DOES HYPOMINERALISED MEAN
disturbed enamel formation - all the enamel is present but has lesser mineral content - looks different
WHAT DOES HYPOPLASTIC MEAN
normal mineral content but not all enamel there
EFFECT OF MIIH ON THE PULP
more BV - bring immune cells
more immune cells
more nervous tissue
CLINICAL EFFECT OF MIH
loss of tooth substance has greater effect : tooth wear, secondary caries, breakdown enamel
sensitivity
appearence
WHAT TYPES OF PAIN ARE ASSOCIATED WITH MIH
central sensitisation
dentine hyper sensitivity
peripheral sensitivity - pulp
CAUSE OF MIH
unknown - but critical point of enamel development = 1st year of life so consider
pre-natal - preeclampsia / gestational diabetes
perinatal - birth trauma
post natal - prolonged breast feeding / childhood infections
HOW TO TREAT MIH MOLARS
comp/GI restorations
SS crowns
adhesively retained copings
extract
WHY SHOULD LOWER 6S WITH BAD MIH BE REMOVED AGE 8.5-9.5
as this is when there is calcification of the 7s bifurcation = 6s removed and 7s will tip into 6 place and look normal
doesn’t matter when in uppers it will just happen
HOW TO TREAT MIH INCISORS
acid pumice microabraison resin infiltration external bleaching localised comp placement combination of above full veneers in composite - change to porcelain when 20 and ging margin calmed down
WHAT IS THE JAW RELATIONSHIP AT BIRTH
gum pads separated anteriorly - cant close mouth
tongue touches lip - changes
WHAT ARE THE 5 FACTORS IN THE PSYCHOLOGY OF A CHILDS DEVELOPMENT
social cognitive motor language perceptual
WHAT ARE THE 4 STAGES OF A CHILDS COGNITIVE DEVELOMENT
sensorimotor
preoperational thought
concrete options
formal operations
WHAT IS A DENTALLY RELEVANT DISORDER OF SPEECH AND LANGUAGE
cleft lip/palate : cleft speech
WHAT ARE THE FEATURES OF CLEFT SPEECH
oro-nasal fistula
velopharyngeal incompetence
nasal emission, articulation and resonance
HOW IS CELFT SPEECH TREATED
other surgeries different bottle teets articulation therapy communication support input modelling early intervention
THINGS TO DO WITH A CHILD IN DENTAL SURGERY
explain validate their feeling but try to move forward with them give them control be empathetic get the parent involves - sit on knee language alternatives give them a chnace to speak
WHEN WORKING OUT AGE OF A CHILD BASED ON PICTURES WHAT TO LOOK FOR
FPMS =6 incisors lower = 6 incisors upper 1 lower 2 =7 incisors upper 2 = 8 lower canine = 9 premolars (lower 2 can = 11) = 10 upper canine = 11 molars 7s = 12 molars 8s = 16-25
WHAT DOES THE FACE DEVELOP FROM
pharyngeal arches
WHICH CLEFT CAN BE BILATERAL/UNILATERAL
lip
palate can only be in middle
WHAT CAUSES CLEFT LIP
failure of fusion of the maxillary prominence with the medial nasal processes
WHAT IS THE CAUSE OF MEDIAN CLEFT LIP
failure of the 2 medial nasal process to fuse
WHICH CLEFT IS MORE LIKELY IN MALES
lip
WHICH CLEFT ID MORE LIKELY IN FEMALES
palate
WHAT CAUSES CLEFT PALATE
failure of the 2 palatal shelves to fuse at midline
WHICH CELFT IS EASIER SEEN EARLIER ON ULTRASOUND
lip at 20 weeks
WHAT TIME CAN YOU DO EARLY INTERVENTION FOR CLEFT LIP
3-6 months
WHAT TIME CAN YOU DO EARLY INTERVENTION FOR CLEFT PALATE
6-12 months
WHAT ISSUES DOES CLEFT CAUSE THAT ARE HARD TO SOLVE
breastfeeding - cant form seal
hearing issues / more vulnerable to ear infections
dental/speech problems
teeth don’t develop correctly