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BDS 3 CDS > Paeds > Flashcards

Paeds Flashcards

1
Q

what are the parts of caries risk assessment

A

clinical evidence, fluoride exposure, diet, plaque control, medical history, social history, saliva

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2
Q

what are the parts of prevention

A

radiographs, fluoride varnish, fluoride supplement, diet advice, toothbruhsing advice, sugar free medication, fluoride toothpaste, fissure sealant

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3
Q

how frequently should fluoride varnish be applied in both high and low risk patients

A

4 times a year high risk
twice a year low risk
fluoride varnish - 22,600ppm

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4
Q

what are the fluoride toothpaste levels for patient younger than 3 years old, both high and low risk

A

smear of toothpaste
high risk - 13500-15000
low risk 1000ppm

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5
Q

what are the fluoride levels in tooth paste for patients 3-10 both high and low risk

A

pea size amount
low risk - 10000ppm
high risk 15000ppm

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6
Q

what are the fluoride levels in toothpaste for patients 10-16, both high and low risk

A

pea size amount
low risk - 15000ppm
high risk - 28000ppm

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7
Q

how does fluoride work

A

fluoride ions incorporated into hydroxyapatite, forms fluorapatite, stronger and less soluble in acid, enhance reminerallisation, prevent demineralisation, arrest caries, inhibit caries - prevents metabolising of bacteria

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8
Q

at what level is fluoride toxic

A

5mg/kg

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9
Q

what is the ideal time for extraction of lower 6s and why

A

calcification of bifurcation of 7s, seen radiographically. Allow for 7s to move forward and close space, caries free dentition with no spaces

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10
Q

what are disadvantages of removal of 6s

A

a lot for child to deal with, might need general anaesthetic, risks associated with this

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11
Q

what causes bottle caries

A

bottle overnight with milk, high sugar, low saliva and low clearance, sugar sits on upper incisors and first molars, lower incisors protected by tongue

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12
Q

what are some behaviour management techniques

A

tell show do, positive reinforcement, acclimitisation, voice control

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13
Q

what are some things that cause concern for neglect

A

delay in presenting with pain
injuries in non-accidental areas - cheek, face, ear, pinching or burn marks
vague story
story not matching injuries

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14
Q

optimal dose of fluoride in water

A

1mg

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15
Q

where can fluoride be found, other than water

A

milk, salt

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16
Q

what instructions should be given for brushing

A

should be supervised, brush twice a day - once at night before bed and at one other point, fluoride toothpaste, spit dont rinse, brush teeth as soon as erupt

17
Q

what order should treatment be carried out

A

pain management, OHI, prevention (fluoride varnish, fissure sealant), small restorations without LA, LA restorations upper first, the pulp treatment

18
Q

what is on the trauma stamp for permanent teeth

A

radiograph, mobility, TTP, percussion note, EPT, ECL, colour and sinus

19
Q

what determines the prognosis of permanent teeth after traum

A

type of injury, stage of root development, time between injury and treatment, PDL damage, infection present

20
Q

how are teeth with enamel fracture treated

A

either file down the sharp edges, or add composite to smooth out, review 6-8 weeks, 6 months, 12 months

21
Q

how are teeth with enamel and dentine fractures treated

A

dentine bandage, restoration - if close to pulp, CaOH can be put as a liner, review 6-8 weeks, 6 months, 12 months,

22
Q

how are teeth with enamel, dentine and pulp fractures treated

A

if less than 1mm and within 24 hours - direct pulp cap
if larger than 1mm or longer than 24 hours - partial pulpotomy, remove 2mm of coronal pulp, place CaOH and GI
if hyperaemic or necrotic - full pulpotomy
review in 6-8 weeks, 6 months and a year

23
Q

how are root fractures classified and what has a better prognosis

A

apical, middle or coronal third

apical third has best prognosis - more PDL for crown to be held in by

24
Q

how are different root fractures treated

A

apical and middle - flexible splint for 2 weeks

coronal third - flexible splint for 4 week

25
Q

what are different outcomes of root fracture

A

calcified tissue laid down - similar to dentine
connective tissue - eburnation, rounding of fracture
bony - osteoblasts lay down bone along fracture line, two separate entities

26
Q

what is concussion and subluxation and what is treatment and prognosis for each

A

concussion - damage to tooth and surrounding structures but no bleeding, mobility or displacement. normally no treatment required. chance of pulp survival high - 100 and 95%, root resorption low
review - 4 weeks, 6-8 weeks and year
subluxation - damage to tooth and surrounding structures, bleeding and mobility but no displacement. treatment - dont always need splint but may improve comfort, 2 week flexible splint, prognosis good 100 and 85% pulp survival, root resorption 1% and 3%
review - 2 weeks, 4 weeks, 6-8 weeks, 6 months and year

27
Q

what is extrusion and lateral luxation, treatment options and prognosis

A

extrusion - axial displacement of tooth, PDL damaged, reduce and reposition, flexible splint for 2 weeks, prognosis 95% and 45% pulp survival, root resorption 5% and 7%
lateral luxation - displacement in non-axial direction, PDL damaged - tear and crushing injury. reposition and flexible splint for 4 week. pulp survival 95% and 25% root resorption 7% and 38%

review - 2 weeks, 4 weeks, 6-8 weeks, 3 months, 6 months and then yearly for 5 years

28
Q

what is intrusion, treatment options and prognosis

A

displacement of tooth axially up the socket, crushing the PDL. requires extrusion. if open apex, less than 7mm - spontaneous. if open apex more than 7mm - orthodontic or surgical extrusion. if closed apex less than 3mm - spontaneous, 3-7mm orthodontic or surgical, more than 7mm - surgical. prognosis not good - closed apex will need RCT, better to initiate immediately to prevent external inflammatory resorption

29
Q

what first aid should be given for avulsion

A

dont handle tooth by root, by crown only
if obvious debris rinse in cold water for 10 seconds
re-implant immediately if possible
if not, place in milk, saliva or physiological saline as storage medium.
go to dentist ASAP

30
Q

what is EAT and EADT

A

extra alveolar time - out mouth

extra alveolar dry time - out mouth but not in storage medium

31
Q

what is treatment for an avulsed tooth with an open apex and EAT less than 60 minutes

A

remove any debris, re-implant, confirm position clinically and radiographically, flexible splint for 2 weeks, chlorhexidine mouthwash twice a day. review 2 weeks, 4 weeks, 2 months, 3 months, 6 months, yearly

32
Q

what is treatment for an avulsed tooth with a closed apex and EAT less than 60 minutes

A

remove any debris, re-implant, flexible splint for 2 weeks, carry out RCT within 10 days of trauma, place steroid antibiotic paste, remove in 2 weeks and place CaOH for 4-6 weeks, then obturate with GP. review 3 months, 6 months and yearly

33
Q

what is treatment for an avulsed tooth with an open apex and EAT more than 60 minutes

A

remove any debris, re-implant, flexible splint for 4 weeks, review closely for signs of non vitality 2 weeks, 4 weeks, 2 months, 3 months, 6 months, yearly for 5 years

34
Q

what is treatment for an avulsed tooth with a closed apex and EAT more than 60 minutes

A

remove any PDL cells, carry out RCT outside mouth if able, re-implant, flexible splint for 4 weeks. If RCT not done outside mouth, do it inside but within 10 days of trauma to prevent infection related root resorption

35
Q

what are patient instructions after trauma

A

soft diet for 2 weeks, no contact sports for 2 weeks, brush as normal with soft brush, chlorhexidine mouthwash 2 times a day for 10 days

36
Q

what are radiographic signs of non-vitality

A

root resorption - infection related, inflammatory caused
absence of continued root formation - root length and width unlike condralateral tooth
infection present - periapical abscess

37
Q

what is damage to primary dentition after trauma

A

discolouration, with or without infection

delayed exfoliation

38
Q

what is damage to permanent dentition after trauma to primary

A

enamel defects - hypomineralisation or hypoplasia
delayed eruption
arrest in tooth formation
ectopic eruption

39
Q

what is the review period for primary trauma

A

after initial treatment, review after 1 month, 3months, 6 months and year

BDS 3 CDS (7 decks)

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