Paeds Flashcards
what are the 5 types of crown fracture injuries to teeth?
what are the management options for these 5 types of tooth fracture injuries for PRIMARY teeth?
what are the 7 types of injuries that can occur to the supporting tooth tissues?
what is the management for each of these in PRIMARY dentition?
what are the 8 stages of an examination following a PRIMARY dentition injury?
- MH (3)
- ## examination tests/ special tests
- reassurance
- ensure reduce anxiety of dentist
2.history
- CO history
- MH - extra treatment needed if congenital heart defect, immunosuppression (cancer) or rehumatic fever ALSO tetanus vaccine status?
- legal guardian
- examination
- extra oral (jaw break, mouth opening, CSF[nose/ear], lacerations, haemotoma etc
- intra (soft tissue foreign bodies, bone, occlusion, mobility, transillumination, percussion (dull tone if fracture), tactile probe test, sensibility tests) - diagnosis
- emergancy treatment
- observation (UNLESS - occlusal interferance, risk of aspiration or injestion) - important informaiton (Advice)
- advise on (analgesia, soft tooth brush after every meal, 0.12% chlorhexidine TOPICALLY (2x/day), signs of infection, soft diet/small bits for 10-14days - Further treatment and review
- management of tissue damage - Review
what % chlorhexidine mouthwash is used for adults (12 and over) and which is for children (under 12 but over 6)
0.2% adults and 0.12% for children if stated okat by doctor or dentist
What are the 10 possible effects of PRIMARY tooth trauma on:
i. primary dentition (3)
ii. permanent successor (7)
Primary tooth
1. disolouration
2. discolouration and infection
3. delayed exfoliation
Permanent successor
1. enamel defects (hypomineralisation/hypoplasia)
2. abnormal crown/root morphology (dilaceration)
3. delayed eruption
4. ectopic tooth position
5. arrested development
6. complete failure of tooth forming
7. odontome formation
re: effects of minor PRIMARY tooth trauma on primary dentition
- describe the 3 effects
- what are their treatemnt options
re: effects of PRIMARY tooth trauma on PERMANENT dentition
- describe the 7 effects
- what are their treatemnt options
- why can delayed eruption occur in early loss of a deciduous and how long is normal
- which type of primary tooth trauma tends to cause the most damage to the predecessor tooth
- is there more likley to be damage to the predecessor tooth if the patient is younger or older at the time of primary tooth injury
- intrusion
- younger > chance of issue with predecessor
Mixed dentition stage: trauma to the Permanent teeth:
1. prognosis effected by?
2. emergancy treatment
3. immediate treatment
4. longer term treatment
difference between
1. apexification
2. apexogenesis
- promoting calcification at apex of non vital tooth
- promoting root formation of vital tooth (i.e. only doing cornonal pulpotomy to preserve pulp in canals = continuing root formation (dentine thickness and apex reduction in size) - anything to keep pulp alive
what ages is there a better prognosis for injury to early permanent dentition and why?
before 9-10 years old, as most often incisors and root completion not until these ages
as larger neurovascular bundle at open apex means less likely to have necrosis
treatment in early mixed dentition patient on permanent incisors:
1. enamel fracture
2. dentine-enamel fracture
treatment in early mixed dentition patient on permanent incisors:
- complicated fracture (pulp involved)
* 3 treatment and their reasons for having to be done
- pulp cap (if <24hrs and <1mm)
- partial pulpotomy (>24hrs and >1mm)
- coronal pulpotomy (hyperaemic or necrotic pulp)
Trauma sticker:
- when used
- how long used for
- what it notes (7)
- what the different tooth colours mean
- mixed dentition permanent tooth trauma
- 2 years (senibility tests primarily)
- image
- image
mixed dentition: incisor crown root fracture, treatment options for
1. no pulpal involvement (5)
2. pulpal involvment
when are the follow up visits for paeds trauma patients
what do at these visits
- 6-8 weeks
- 6 months
- 1 year
trauma sticker investigations (7) again and compared
radiogrpahs
* root formation
* pathology
* comparison
* internal inflammatory resorption
^ wrong, actually =
2w, 4w, 8w, 3m, 6m, 1y x5
root treatment for open apex permanent incisors
- options for filling apex
- process carried out
* file length compared to working length
* what used at apex/what this causes
* what are the 4 layers of restoration from apex to coronal definitive rest.
permanent dentition trauma: what is the treatemnt and follow up times for a tooth concussion and subluxation?
permanent dentition trauma: what is the treatemnt and follow up times for a extrusion and intrusion injury ?
when would a patient need a tetanus booster if they have had an avulsed tooth
if they are unclear about their vaccine status and the tooth was reimplanted after being in contact with dirt
permanent dentition trauma: what is the treatemnt and follow up times for a lateral luxation injury ?
Permanent dentition trauma: Avulsion
- emergancy treatment
* critical factors
* factors influencing success - Tx when closed apex (EADT related)
- Tx when open apex
- CONTRINDICATIONS to re-planting tooth (4)
for what dental traumas is splinting only required for 2 weeks, those for 4 and one that is for 4 months?
needs 2 weeks
1. subluxation
2. extrusion
3. avulsion
need 4 weeks:
* intrusion
* lateral luxation
* dento-alveolar fracture
* mid-apical third root fracture
needs 4 months
* cervical third root fracture
- what is pulp obliteration and its effect
- what are the 2 types of root resorption and what are their causes
what are 4 different colours a tooth can become once traumatised (from interal origin)
how is each caused
what does each mean
6 signs of a necrotic pulp
4 disability classifications that can deem a child to have special needs?
definition of learning difficulty
autism
- what
- effects
- related conditions
- methods of non-verbal help
- dental likes/dislikes
- important prep before this type of appointment
Cause = trisomy 21 (3 of this chromosome)
down syndrom
- linked dental issues
- other linked isseus
- examination options
- aids for toothbrushing
- recommendations for toothpaste and positioning when brushing
- how dental treatment can be carried out and indications for this method of treatment
- aims of individual treatments
what does ASD stand for
Autism specrum disorder
cerebral palsy (CP)
- what
- cause
- effects
- associated issues
- three types
- dental considerations
- sensory impairment help (3)
leukaemia
- what
- signs
- oral manifestations
- effects of chemo
- effects of radiotehrapy
- dental implications
congenital heart defects
- what
- linked to what issue within special care individuals
- dental implications
impacts of child disability on dental disease?
common injuries in child abuse cases
safeguarding children
- definition
- abuse (aetiology, categories and vulnerable groups)
- neglect (common groups, short and long term effects, e stages in managment)
- legalities involved
how a paeds simplified BPE (sBPE) is done, scored and treatment/recall
Same 3.5 - 5.5
Paeds: what are the two types of plaque scores and what is the type of bleeding score carried out and why in this way?
Signs for suspicion of child abuse (9)
- delay in seeking help
- vague story
- sorry changes from person to person
- unlikely story
- parent behaviour
- child parent interaction abnormal
- child says something contradictory
- history of injury
- history of fam violence
3 stages of action
4 stages of protecting children from abuse as a dentists?
1….. voice concern and discuss action with NAMED PERSON
- Raise concern with parent, offer support, set target, keep records and monitor progress
- Preventative multiagency management
- liase with other professionals health visitor, school nurse, GMP, social worker
- agree joint plan of action
- letter to HV of children <5 who fail to attend and reply to letters - Child protection referral
- if deteriorating situation or complex
- notification of concern form
If worsens / not comin for needed tx = child protection order
Observe
Record
Communicate
Refer for assessment
Outcome dependent on if child at risk of immediate danger
Nursing bottle caries:
- what is it
- causes
- caries pattern
- nursing bottle with highly cariogenic drinks like milk, diluted juice or fizzy drinks, specifically given over night
- pattern = upper anteriors first/worst, upper and lower posteriors, lower anteriors not effected/minimally as covered by tongue
Fluoride application to a child that is:
- high varies risk
- current caries
- low caries risk
High = every 6m visit
Caries = more frequently (3-4m)
Low = annually or 6 monthly
Behavioural management techniques for treating anxious children? (5)
Tell-show-do
Positive reinforcement (praise)
Distraction technique (music/video)
Gradual exposure (build up to invasive)
Sedation / GA
