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BDS Exam style questions > Paeds > Flashcards

Paeds Flashcards

1
Q

Patient taken to clinic by mum’s boyfriend, losing sleep due to dental pain, has gross caries, vague medical history, pyrexic (likely acute PA abscess). What would you want to establish prior to examination? What would your short term management be?

A

Who the legal guardian of the patient is

Thorough medical history

Consent- record everything

Short term tx- drainage, analgesia, AB, schedule review

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2
Q

What behavioural management techniques can be used to maximise cooperation in children?

A

Tell Show Do
-> Give age appropriate description
-> Show patient in inocuous extra-oral way
-> Start treatment without delay

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3
Q

How do you address the issue of a child patient’s non-attendance?

A

Ensure up to date contact details, Record everything in notes, Contact mum by phone or any other guardians, Discuss with mother the necessity of jodi to come (someone else to consent), Inform mum possibility of child protection getting involved if non-compliance, Set the next appointment on the phone (get appropriate escort)

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4
Q

What evidence based brushing advice can be given to prevent further dental caries in children?

A

Use smear if <3, pea size if >3

Use 1450ppmF tooth paste

Use electric toothbrush

Spit don’t rinse

Modified base technique- 45 degree angle from gingival margin (listen for Sh)

Disclosing tablets

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5
Q

What does BPE score of 3 mean?

A

Probing depth- 3.5-5.5mm

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6
Q

What teeth should you prob to obtain BPE?

A

Modified BPE until age 12
-> 16, 11, 26, 36, 31, 46
-> code 0-2 only

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7
Q

What is the normal depth from CEJ to bone crest?

A

2mm

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8
Q

What condition can result in periodontal disease in children?

A

Diabetes

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9
Q

What investigations can you do for a child aged 13 with BPEs of 3?

A

Diet diary

Radiographs

PGI

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10
Q

What treatment would you do for a child aged 13 with BPEs of 3?

A

PMPR

Specialist referral

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11
Q

What questions would you ask a patient when they have traumatic fracture of a tooth?

A

How did it happen?

When did it happen?

Did you keep hold of missing compment?

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12
Q

What factors can affect prognosis of traumatised tooth?

A

Time since it occured

Maturity of tooth- apex closed or open

Type of fracture- is it complicated involving pulp
-> if it is how large is exposure

Vitality of tooth

Mobility

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13
Q

What should you inform the patient’s parents of when they have fractured a tooth traumatically?

A

Complications- discolouration, pain, sinus/infection, damage to adjacent teeth

Prognosis of tooth

Treatment options

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14
Q

Where may a fractured fragment of tooth end up, how are these managed?

A

Swallowed- send to A+E

Inhaled- send to A+E for chest x-ray

Embedded in soft tissue- remove and consider suture

Into the environment around patient- restore without fragment

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15
Q

How would you manage an ED fracture?

A
  • Take 2 PAs to rule out root fracture or lunation
  • Soft tissue radiographs
  • Bond fragment or place composite bandage
  • Sensibility testing
  • Evaluation of tooth maturity
  • Place definitive restoration
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16
Q

What questions would you ask a patient about if they have white, brown, yellow stains on their teeth?

A

During pregnancy - natural birth

Prenatal - Severe illness of mum during pregnancy: anaemia, gestational diabetes

Perinatal - Birth trauma/anoxia, Preterm birth

Postnatal - Prolonged breastfeeding, Fever and medications

Childhood infection - measles, rubella, chicken pox

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17
Q

What is the condition causing yellow, brown spots on all permanent molars and incisors likely to be?

A

MIH
-> is this genetic

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18
Q

What can you ask a patient about in order to rule out Fluorosis?

A

Is water fluoridated in their area

Do they use supplements

Are they using F toothpaste excessively

Is sibling or parent using higher strength toothpaste

Have they swallowed toothpaste as a younger child

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19
Q

What are the issues when restoring teeth with MIH?

A

Susceptible to caries

Poor bonding- difficult to restore

Poor long term prognosis

Need for complex/extensive treatment in future
-> may involve orthodontist

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20
Q

A co-operative 10 year old patient attends with moderate crowding requesting orthodontic treatment, but has poor oral hygiene and cavitated caries into dentine in the first permanent molars.
Describe your management of the case:

A

History- find out if patient in pain, ask patient if they have any concerns

CRA- diet, F exposure, socio-economic status, OH, medicine, saliva quality, MH

Take OPT/bitewings- assess for caries, review dental development

Prevention- 4 x FV per year, 2800ppmF toothpaste, OHI, fissure sealants

Treatment required before ortho can be carried out- restorations, extractions
-> preferred method of anaesthesia

Discuss orthodontic treatment
-> find out patient concerns
-> Risks and benefits

Discuss reason why ortho isn’t possible at moment
-> OH must be improved- motivate patient

Assess child protection and neglect

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21
Q

What are the risks of ortho?

A

Root resorption
Relapse
Recession
Decalcification
Other- wear, failed treatment, ST trauma, loss of perio support

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22
Q

What are the risks of extracting 6s?

A

Mesial tipping of 7

Distal migration of 5

-> extract at time of buccal bifurcation of 7 forming to optimise space

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23
Q

What are the treatment options for impacted first molars?

A

If not severe- consider extraction of E

Disimpact 6- place ortho separator/brass wire for a week (check for signs of eruption)

Use appliance to push 6 back- difficult as it is partially erupted
-> bond fixed appliance component to 6 to distalise it using PFS

Distal discing of Es- give more space for eruption (can result in a bit of crowding)

Consider pre-molar extractions to alleviate crowding

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24
Q

What features of the permanent dentition allow for replacement of primary teeth without crowding?

A
  • Leeway space- 3, 4, 5 take up less space than primary c, d, e
    -> 1.5mm each side in upper/2.5mm in lower

Growth of maxilla/mandible

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25
Q

What materials would you use for splinting an extruded tooth?

A

Flexible stainless steel wire

Cemented with composite resin shields (acid etch tooth with 37% phosphoric acid)

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26
Q

How long is a splint places for extrusion?

A

2 weeks

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27
Q

What tests (apart from radiographs) would you do for an extrusion?

A

Sensibility testing- EPT/ECL

Mobility

TTP

Assess colour

Look for related sinus

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28
Q

What are some of the radiographic features you may see in a tooth which has had a traumatic extrusion?

A

Widened PDL

Loss of lamina dura

Inflammatory root resorption- ext, int

Altered root development

PA pathology

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29
Q

What advice is given for an avulsion over the phone?

A

Do not handle by root

Do not reimplant primary tooth

Gently rinse under cold running water for 10 secs

If permanent tooth- reimplant and bite on tissue
-> or store in saliva/buccal sulcus>milk>saline

Get to GDP ASAP

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30
Q

What checks should be done when patient has avulsed tooth?

A

Tetanus status

How and where incident occured

Time elapsed since incident- EADT/EAT

Was the patient unconscious- A+E

Account for tooth fragments

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31
Q

What splint is used in an avulsion?

A

If <60 mins EAT- 2 weeks flexible

If >60 mins EAT- 4 weeks flexible

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32
Q

What are the common outcomes following avulsion?

A

Perio outcomes
-> regeneration
-> PDL cement healing
-> ankylosis
-> uncontrolled infection

Pulpal outcomes
-> Regeneration (esp if open apices)
-> Uncontrolled infection/necrosis

Root resorption

Discolouration

Mobility

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33
Q

What are the signs of Dentinogenesis Imperfecta/OI?

A

Wheel chair bound

Multiple bone fractures

Bulbous crowns (amber translucent- grey)

Blue sclera

Pulp obliteration (difficult to RCT)

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34
Q

What are the radiographic signs of DI?

A

Appear like primary teeth with normal root formation

Large pulps- become obliterated

Occult abscess formation (no demonstrable clinical disease)

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35
Q

How is DI managed?

A

Prevention

Composite veneers

Overdentures

Removable prostheses

Stainless steel crowns- lack of tissue to bond to

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36
Q

What are extra oral signs of Down’s syndrome?

A

Cataracts

Small mid face

Oblique palpebral fissures

Short/thick neck

Small ears

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37
Q

What are intra-oral signs of Downs syndrome?

A

Periodontal disease

AOB

Tongue thrust

Macroglossia

Class III jaw relationship

Spacing

Hypodontia

Microdontia

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38
Q

What are the restorative options for patient with Down’s?

A

Enhanced prevention- F supplements, high dose F toothpaste, double sided brush, 2 brush technique

If good cooperation- treat as normally as possible

If placing fissure sealants- consider GI if issue with moisture control

If uncooperative- may require GA

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39
Q

What are the types of healing following root fracture?

A

Calcified tissue union across fracture line

connective tissue

calcified + connective tissue

Osseous healing

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40
Q

What is considered as non-healing root fracture ?

A

Granulation tissue formation

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41
Q

How are root fractures managed?

A

Clean area with water then saline/CHX

If undisplaced- monitor

if displaced- reposition tooth with digital pressure (+/- LA)

Splint for 4 weeks

Review- 6-8 weeks, 6 months, 1 year, 5 years

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42
Q

How would you managed non-vital root fractures?

A

Extirpate to fracture line

Dress with non-setting CaOH then MTA/biodentine to fracture line

Obturate with GP to fracture line

OR XLA

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43
Q

What are the signs of Fluorosis?

A

Varies with severity:

White spots/flecks

Brown spots

Mottling/pitting

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44
Q

What are the vehicles for F delivery?

A

Toothpaste

Fluoride Varnish

Mouthwashes

Supplement tablets

Water

Milk

Salt

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45
Q

How is Fluorosis managed?

A

Accept

Microabrasion

Composite veneers

Porcelain veneers (over 18)

Tooth whitening- may make white spots whiter

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46
Q

What are the advantages of NV bleaching?

A
  • Simple
  • Tooth conserving- original tooth morphology
  • Gingival tissues not irritated by restoration
  • Adolescent gingival level not a restorative consideration
  • No laboratory assistance for ‘walking bleach’
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47
Q

What are the disadvantages of NV bleaching?

A
  • External cervical resorption
  • Spillage of bleaching agents
  • Failure to bleach
  • Over bleaching
  • Brittleness of tooth crown (when no coronal filling present)
  • Not suitable for amalgam, tetracycline or fluorosis staining
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48
Q

What are the steps in the walking bleach technique?

A
  1. Remove root filling to level below CEJ
  2. Clean out tooth with ultrasonic
  3. Place CWP covered in bleaching agent (10% CP)
  4. Place dry CWP on top
  5. Seal with GIC/RMGIC

Renew within 2 weeks (can be done 6-10 times)
-> if no change after 3-4 renewals then stop
-> when happy place final restoration

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49
Q

What is the only splint used for primary teeth?

A

Flexible 4 week splint if alveolar bone fracture

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50
Q

What is the difference between a flexible and rigid splint?

A

Flexible- passive, so no tooth movement

Rigid- active, can put force on teeth causing movement

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51
Q

How is an avulsed tooth with EADT <60 mins managed?

A

If open apex- replant/splint for 2 weeks and monitor as it may revascularise

If closed apex
-> Splint 2 weeks
-> pulp extirpation 0-10 days
-> Place AB steroid paste for 2 weeks
-> Place NS CaOH
-> Obturate within 6-8 weeks

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52
Q

What is the management of an avulsed tooth with EADT >60mins?

A

Scrub root clean of dead PDL cells

EO endo (or extirpate at 7-10 days, place CaOH for 4 weeks and obturate)

Replant tooth under LA

Splint 4 weeks- flexible

Consider AB

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53
Q

What should dentist ask a patient’s mother who is worried about them swallowing F toothpaste?

A

What quantity toothpaste was swallowed?

What strength of toothpaste?

What age is the child?

What weight is the child?

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54
Q

What advice should the dentist give if the patient has swallowed the toxic dose?

A

Go to hospital

Give calcium orally- milk

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55
Q

What are the toxic doses of Fluoride and the action?

A

5mg/kg body weight = give milk and observe
5-15mg/kg = give child milk and admit to hospital
> 15mg/kg = immediate hospital admission for cardiac monitoring, life support and IV calcium gluconate

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56
Q

What is the most common causes of Fluorosis in UK?

A

Fluoride in water supply

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57
Q

What is the first line of treatment for Fluorosis?

A

Microabrasion

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58
Q

What F supplements can be given to a 1 year old?

A

0.25mg drops

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59
Q

What fluoride supplements can be give to a 4 year old?

A

0.5mg chewable table

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60
Q

What F supplementation can be given to a 7 year old?

A

F Mouthwash- 225pm

1mg tablet

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61
Q

What is the likely diagnosis for a patient who is 3 and has blisters on her gums?

A

Primary Herpetic Gingivostomatitis

62
Q

How do blisters appear in PHG?

A

As vesicles which disrupt giving round fibrin covered ulcers

63
Q

What other symptoms may a patient with PHG have?

A

Fever

Halitosis

Lymphadenopathy

Poor appetite/reluctance to eat

Nausea/malaise

64
Q

What is the cause of PHG?

A

HSV

65
Q

How do you manage patient with PHG?

A

Self limiting- support
-> reassure
-> rest
-> fluids
-> encourage eating
-> analgesia

66
Q

What future issues may HSV cause for the patient?

A

Shingles

Herpes labialis- cold sores

Bells palsy

67
Q

What time frames in the child’s life are implicated in MIH? Why are these times important?

A

Prenatal, Neonatal, Postnatal

-> development of 6s starts before birth
-> enamel matrix of FPM crown is complete by 1 year (incisors by 2)

68
Q

What are the signs and symptoms of MIH?

A

Well demarcated opacities

Chalky brown, white, yellow patched

High caries rate

Poor bonding

Asymmetrical pattern

69
Q

What are the treatment options for MIH molars?

A

Composite restoration (bonding issues?)

GIC

Stainless steel crown

Adhesively retained coping- bell glass/gold

Extraction (when dental age 8.5-9.5)

70
Q

What toothpaste would be advised for different age groups?

A

Age <3
LR = 1000ppm
High risk = 1350-1500ppm

Age 3-9
LR = 1350-1500ppm
High risk = 1350-1500ppm

Age >10
LR = 1350-1500ppm
High risk = 2800ppm (5000ppm if over 16)

71
Q

What are the topical effects of F?

A

Promotes remineralisation

Formation of Fluoroapetite- helps strengthen tooth structure

Bacteriocidal

72
Q

What are the systemic effects of Fluoride?

A

Fluorosis

73
Q

What are the effects of primary tooth trauma on primary tooth?

A

Dicolouration

Infection

Delayed exfoliation

74
Q

What are the effects of primary tooth trauma on permanent tooth?

A

Enamel defects

Delayed eruption

Dilaceration

Duplication

Ectopic teeth

Arrest in formation

Agenesia

Odontome formation

75
Q

What are the eruption dates for primary dentition?

A

upper A = 8 months
upper B = 10-13 months
upper C = 1.5-2 years
upper D = 1-1.5 years
upper E = 2.5-3 years

lower A = 6 months
lower B = 10.5 months
lower C = 1.5-2 years
lower D = 1-1.5 years
lower E = 2-2.5 years

76
Q

What are the eruption dates for permanent dentition?

A

upper centrals = 7
upper laterals = 8
upper canines = 11
upper 1st premolar = 10 (always comes in before the 2nd)
upper 2nd premolar = 11
upper 1st permanent molar = 6
upper 2nd permanent molar = 12

lower centrals = 6
lower laterals = 7
lower canines = 9
lower 1st premolar = 10 (always comes in before the 2nd)
lower 2nd premolar = 11
lower 1st permanent molar = 6
lower 2nd permanent molar = 12

77
Q

When do roots fully form?

A

Apexogenesis takes 3 years after eruption

78
Q

What are some of the factors in the index of suspicion in injured child?

A

Delay in seeking help

Vague story
-> account not compatible

Parents mood abnormal

History of family violence

History of previous injuries

Child interaction with parent is abnormal

Child says something contradictory

79
Q

What orofacial injuries are considered suspicious?

A

Cigarette burns

Hbites

Ear/neck injuries

Brusing not on bony prominence

Grip marks

Slap marks

80
Q

What are the steps in referring a child to child protection services?

A

Observe
Record- what patient says, take photographs
Communicate
Refer for assessment

Refer to social services by telephone then in writing

81
Q

What are the indications for a pulpotomy?

A

Good co-operation

Medical history precludes extraction

Missing permanent successor

Over-riding necessity to preserve the tooth
e.g. space maintainer

Child under 9 years of age

82
Q

What are the contraindications for pulpotomy?

A

Poor co-operation

Poor dental attendance

Cardiac defect

Multiple grossly carious teeth
advanced root resorption

Severe/ recurrent pain or infection

83
Q

How is a pulpotomy carried out in posterior tooth?

A

USE LOCAL ANAESTHETIC and RUBBER DAM

1) Remove roof of pulp chamber
2) Remove coronal pulp with sterile excavator or slow running large round steel bur
3) Place a cotton pledget with ferric sulphate for 20 seconds
4) Place zinc oxide/ eugenol in the pulp chamber and restore using a preformed metal crown with GIC core

84
Q

What are the clinical signs of failure in a pulpotomy?

A

Pathological mobility

Fistula / chronic sinus

Pain

-> review 6 monthly

85
Q

What are the radiographic signs of failed pulpotomy?

A

increased radiolucency
external / internal resorption
furcation bone loss

-> review 12-18 monthly

86
Q

What is a partial pulpotomy?

A

Only remove 2mm until you reach healthy tissue, then place CaOH with vitrebond then composite on top

87
Q

How is a pulpectomy carried out?

A

If Non-vital / hyperaemic pulp:
1. Open roof of pulp chamber
2. Remove contents of pulp chamber
3. Use files to remove pulpal tissue from canals to 2mm short of EWL (worked out off radiograph only)
4. Irrigate with chlorhexidine and dry with paper points
5. Obturate canals with Vitapex® which is a CaOH and iodoform paste (Alternatively a very thin mix of ZOE)
6. Seal with thick mix of ZOE/GI and restore with a preformed metal crown

88
Q

What are the types of amelogenesis imperfecta?

A

Hypoplastic- enamel crystals do not grow to the correct length

Hypocalcified- crystallites fail to grow in thickness and width

Hypomaturational- enamel crystals grow incompletely in thickness or width but to normal length with incomplete mineralisation

Mixed forms- assoc. with taurodontism

89
Q

What is the cause of AI?

A

Mutations involving:

Enamel extracellular matrix molecules

Amelogenin/ Enamelin

Kallikrein 4

90
Q

What issues may occur as a result of AI?

A

Sensitivity

Caries/ acid susceptibility

Poor aesthetics- brown colour

Poor oral hygiene

Delayed eruption

Anterior open bite

Bonding issues

91
Q

How is AI managed?

A

Preventive therapy

Composite veneers/ composite wash

Fissure sealants

Metal onlays

Stainless steel crowns

Orthodontics

92
Q

What are examples of other causes of enamel defects?

A

Epidermolysis bullosa
Incontinenta pigmenti
Down’s
Prader-Willi
Porphyria
Tuberous sclerosis
Pseudohypoparathyroidism
Hurler’s

93
Q

A 4 year old patient presents with gross caries across her anteriors, including the smooth surface. What is your likely diagnosis?

A

Nursing bottle caries
-> cariogenic drinks given in bottle for child to drink throughout the night

94
Q

How is bottle caries managed?

A

Tell parent not to give child anything to eat or drink following night time brush

Enhanced prevention- 1450 toothpaste, F tablets, FV 4x yearly

OHI- spit don’t rinse, be accompanied by adult

Diet advice- milk and water only between meals, sugar free variations, limit to <4 sugar intakes per day, avoid hidden sugars

Caries removal
-> complete or partial depending on cooperation
-> consider SDF
-> consider GA for extraction

95
Q

What are the different types of dentinogenesis imperfecta?

A

Type I- osteogenesis imperfecta

Type II- autosomal dominant

Brandywine

96
Q

What are the radiographic features of DI?

A

Appear like primary teeth with normal root formation

Large pulps- become obliterated

Occult abscess formation (no demonstrable clinical disease)

97
Q

What are the issues associated with DI?

A

Aesthetics

Caries / acid susceptibility

Spontaneous abscess formation

-> poor prognosis

98
Q

How is DI managed?

A

Prevention

Composite veneers

Overdentures

Removable prostheses

Stainless steel crowns- lack of tissue to bond to

99
Q

What are the indications for a SSC?

A
  • > 2 surfaces affected
  • Extensive 2 surface lesions
  • Pulpotomy / pulpectomy
  • Developmental defects
  • # d primary molars
  • XS tooth surface loss
  • High caries rate
  • Impaired OH
  • Space maintainer
100
Q

How is a conventional SSC placed conventionally?

A
  1. Measure crown- mesio-distal length or tooth/space with separators
  2. Place LA and rubber dam
  3. Break contact area and produce knife edge finish mesially and distally (careful not to damage adjacent tooth)
  4. Occlusal reduction 1-2mm
  5. Remove any sharp angles buccally and lingually
  6. Dry tooth
  7. Fill crown with GIC and cement (remove excess with probe)
  8. Check contacts and occlusion
101
Q

How else can SSC be placed?

A

Hall technique

102
Q

What are the features of a failed SSC?

A

Rocking

Canting

Crown lost

Crown broken

Secondary caries

Abscesses

Radiolucency on radiograph

103
Q

What are the advantages of planned extraction of first permanent molars?

A

Relief of crowding

Caries free dentition

Reduced orthodontic need

104
Q

What signs indicate suitability for planed removal of 6s?

A

Bifurcation of 7s forming
8s present
Class 1
Reduced OB
Moderate lower crowding
Mild- moderate upper crowding

105
Q

What are the disadvantages of planned extraction of 6s?

A

May provoke DFA

May require GA

Anaesthesia may be difficult

106
Q

What is the most common cardiac defect in children?

A

VSD

107
Q

What condition is congenital heart defects associated with?

A

Down’s

108
Q

What other medical issues are seen in downs?

A

Epilepsy

Alzheimers

Leukaemia

Periodontal disease

Cataracts

Hypothyroidism

109
Q

What must be considered when treating patients with ASD?

A

Anticoagulant therapy

Avoid sedation

Consider ABP for invasive procedures

110
Q

What are the parts of a trauma stamp?

A

TTP
Sinus
Colour
Percussion notes
Mobility
Displacement
EPT
Ethyl Chloride
Radiographs

111
Q

How is external inflammatory resorption managed?

A

RCT?

112
Q

What are the parts of a caries risk assessment?

A

Clinical evidence

Diet

Saliva quality

MH

SH

F experience

OH

113
Q

What are the aspects of the prevention plan for caries?

A
  1. OHI
  2. Diet advice
  3. F toothpaste
  4. F varnish
  5. F supplements
  6. FS
  7. Radiographs
  8. Sugar free meds
114
Q

How often should you take a bitewing in a high caries risk patient?

A

Every 6 months

115
Q

What toothpaste strength would you advise for a 7 year old?

A

1450

116
Q

What is the optimum concentration of fluoride in water?

A

1ppm

117
Q

What foods and drinks contain Fluoride?

A

Shell fish

Raisins

Tea

118
Q

What is the cause of external inflammatory root resorption?

A

Necrotic pulp - bacterial or dental trauma in origin
-> periapical inflammatory lesion precipitates the resorption process

Restorations encroaching on pulp horns

Inflammation from adjacent teeth

119
Q

What are the clinical signs of external inflammatory root resorption?

A

Possible- sinus, swelling, apical tenderness, TTP

Mobility may be increased

Negative to sensibility testing as pulp is necrotic

120
Q

How does external inflammatory root resorption appear on radiograph?

A

Radiolucency but you can still see lines of root canal system
-> superimposed

121
Q

How is a tooth with external inflammatory resorption managed?

A

RCT- CaOH for 3 months then obturate

Extraction

122
Q

What are the indications for microabrasion?

A

Fluorosis

Ortho decalcification

MIH

Prior to veneering if dark stain

123
Q

What are the advantages of microabrasion?

A
  • Easily performed
  • Conservative
  • Inexpensive
  • Teeth need minimal subsequent maintenance
  • Fast acting
  • Removes yellow-brown, white and multi-coloured stains
  • Results are permanent
  • Can use before or after bleaching
  • Can be combined with addition of composite
124
Q

What are the disadvantages of microabrasion?

A

*Removes enamel
-> Sensitivity
-> Teeth may become more susceptible to staining
* HCl acid compounds are caustic
* Requires protective apparatus for patient, dentist and dental nurse
* Teeth can appear more yellow as dentine can shine through
* Must be done in dental surgery

125
Q

What are the steps in carrying out microabrasion?

A
  1. PPE for patient and team
  2. Clean with pumice and water
  3. Vaseline on soft tissues
  4. Place rubber dam (essential)
  5. Place sodium bicarbonate guard on gingival
  6. Remove enamel with HCL/pumice slurry with slow speed rubber cup- maximum is 10 x 5 sec applications (review shade/shape each time)
  7. Apply FV- pro-fluoride
  8. Polish with finest sandpaper disc
  9. Polish with toothpaste
126
Q

What are the types of resorption you may see on radiograph of traumatised tooth?

A
127
Q

How is hypodontia diagnosed?

A

OPT

128
Q

How can missing anteriors due to hypodontia be replaced?

A

Cantilever bridge

RPD

129
Q

Who are the members in the MDT for hypodontia?

A

GDP

Orthodontist

Restorative specialist

130
Q

What conditions are associated with hypodontia?

A

Anhydrotic ectodermal dysplasia

Down’s

CLP

131
Q

What are the incidences of hypodontia in primary and permanent dentitions?

A

0.9%- primary

6%- permanent

132
Q

What records should be taken before microabrasion?

A

Photos

Diagrams of marks

Shade recording

Sensibility tests

133
Q

What should you warn patient about after carrying out procedure?

A

No heavily coloured food or drink for 24 hours
-> Anything that would stain a white tee

134
Q

What type of bleaching at what concentration is commonly used for bleaching in children?

A

10% carbide peroxide
-> 3.3% H2O2, 6.6% urea

135
Q

How do you work out the aetiology of discolouration of upper central?

A

Ask about trauma to primary tooth

Ask about childhood medication

Consider what the colour is and link it to diseae

136
Q

What are the reasons that a child may be anxious when attending dentist?

A

Parental preparation

Fear of unknown

Media

Negative previous experience

Negative medical experience

Pain and discomfort

Fear of needles

137
Q

How is anxiety measured in children?

A

Faces modified MCDAS

138
Q

What are examples of behavioural management techniques used for children?

A

Tell show do

Acclimatisation

Role modelling

Desensitisation

Scouting visits

Distraction

Relaxation

Positive reinforcement

Hypnotherapy

139
Q

What is the most likely diagnosis for a 6 year old in pain with gross caries of lower molar and buccal swelling?

A

Acute apical abscess

140
Q

What are the treatment options for acute apical abscess in children?

A

XLA (if bleeding disorder- avoid or send to specialist)

Pulptomy/ectomy with SSC

141
Q

What are examples of local haemostatic agents that could be used for child with Haemophilia A?

A

LA with vasoconstrictor

Surgicel

Transexamic acid

Thrombin powder

Fibrin

Ferric sulphate

142
Q

What is the triad of impairment in autism?

A

Social communication

Social interaction

Social imagination

143
Q

What are the features of ASD?

A

Self injurious behaviour

Learning difficulties

Sensory overload

Restricted behaviour patterns

Epilepsy

Sleep disorders

Dyslexia/dyspraxia

144
Q

How are patients with autism managed in dental setting?

A

Plan the visit: with information leaflets, social story, acclimitisation visit

Timing: first thing in the morning, first thing after lunch, wait in the car beforehand

Environment: quiet surgery, no radio, no interruptions, fluoride varnish taste

Communication: makaton, talking boards, literal speech, avoid casual chit chat

Oranurse toothpaste is helpful if child is sensitive to foaming

145
Q

What are the indications for fissure sealants?

A

High caries risk- seal molars/premolars on eruption

Medically compromised children- seal all

Children with learning difficulties, physical disabilities, Mental disabilities
-> seal all

146
Q

What materials can be used as fissure sealants?

A

Bis GMA resin

GIC

147
Q

What are the steps in placing fissure sealants?

A
  1. Isolate with dam/cotton wool and dry guards
  2. Clean occlusal surface with pumice and water
  3. Etch with 35% phosphoric acid for 20 secs (avoid soft tissue)
  4. Wash etch directly into aspirator
  5. Dry tooth- check for frosted/chalky appearance
  6. Add resin fissure sealant- manipulate and remove excess with micro brush or probe
  7. Cure for 30s
  8. Check retention by trying to dislodge with probe
148
Q

What are the 4 types of Cerebral Palsy?

A

Spastic

Ataxic

Athenoid

Mixed

-> further divided into hemi, di, para, quadriplegia

149
Q

What is cystic fibrosis?

A

Inherited defect on cell chloride channels where excess mucous is produced
-> mostly affects lung and pancreas
-> abnormality of CFTR gene on chromosome 7

150
Q

What are the signs and symptoms of CF?

A

Cough

Liver dysfunction

OP

Recurrent chest infection

Prolonged diarrhoea

Reduced fertility

Poor weight gain

Diabetic symptoms

151
Q

What are the dental implications of CF?

A

Thick saliva

Increased calculus

Enamel defects

Long term AB- tetracycline staining

High caries risk

BDS Exam style questions (15 decks)

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