paeds Flashcards
discuss hall crown placement technique
- child sitting upright
- ensure space between contacts
- protect airway with gauze
- size crown (do not push on, assess for spring)
- fill with GI cement
- seat crown and ask pt to bite
- clear excess cement and floss contacts
how long for separators for hall crown
3-5 days
FV application process
- isolate and dry teeth one quadrant at a time
- use microbrush to apply varnish
post fluoride varnish application patient instructions
no soft foods or drinks for 30 mins
no hard foods for 4 hours
no toothbrushing for 4 hours
how much fluoride varnish to use (duraphat 22,600ppm)
0.25ml for primary dentition
0.4ml mixed dentition
when not to use duraphat
severe asthma (hospitalised in last year)
colophony allergy (sticky plasters)
site specific prevention
demonstrate toothbrushing of site
dietary advice
FV 4 x a year
what are the 4 prevention mechanisms detailed in SDCEP guidance
toothbrushing
diet advice
fluoride varnish application
fissure sealants
how to treat pain in primary dentition
assess whether reversible , irreversible or abscess
- reversible - hall crown or selective
- irreversible - corticosteroid paste and temp dressing or pulpotomy
- abscess - extraction or refer
how to manage (primary teeth)
- advanced proximal lesions
- advanced occlusal lesions
- advanced anterior lesions
(if not close to exfoliation)
proximal - hall crown
occlusal - selective removal or hall crown
anterior - selective
All other situs - site specific prevention
how to manage initial, moderate and extensive occlusal lesions in permanent teeth of children
initial - FS
moderate - complete removal
extensive - stepwise
how to manage initial, moderate and extensive proximal lesions in permanent teeth of children
initial - FS or site specific
moderate - complete
extensive - stepwise
how to manage initial, moderate and extensive anterior lesions in permanent teeth of children
initial - site specific
advanced - complete or selective
describe resin FS application
- clean tooth with cotton wool roll/ TB and paste
- dry and isolate tooth (CWR, dry guard, saliva ejector)
- etch tooth 30s
- change CWR
- apply resin sealant and cure
- check integrity with probe
describe GI FS application
- dry tooth with CWR
- apply GI to tooth with finger - 2 mins
- cover with vaseline
standard and enhanced prevention - toothbrushing
standard: annual demonstration and advice, 1000ppm under 3s, 1350 -1500 3-10
enhanced: every recall demonstration and advice, 1350-1500 3-10 or 2800 in 10+
standard and enhanced prevention - diet
standard: annual advice re feeder cups, healthy snacks, drink choices
enhanced: advice at every recall
standard and enhanced prevention - FS
standard - all permanent molars ASAP, check integrity at each appointment and top up as required
enhanced - as standard + FS permanent lateral pits, Ds and Es
standard and enhanced prevention - topical fluoride
standard - at least FV 2 x year
enhanced - 4 x year
7 elements of caries risk
clinical evidence
medical history
saliva
fluoride
diet
social history (socioeconomic)
plaque
name 4 strategies to aid behaviour management
tell show do
structured time
positive reinforcement
distraction
relaxation
order of priority for treating caries in children
- manage pain
- plan and discuss prevention
- prevention measures for permanent teeth
- management of carious primary teeth
how often should bitewings be taken
start at 4 years old
- every 6-12 months for high risk
- every 2 years for low risk
