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BDS3 OSCE PREP > PAEDS OSCE PREP > Flashcards

PAEDS OSCE PREP Flashcards

1
Q

What generalised toothbrushing advice would you give to all paediatric patients and their carers?

A
  • Start brushing from the eruption of first tooth
  • Children should be assisted or supervised once dexterity gained
  • 2x a day, for a minimum of 2 minutes, spit don’t rinse
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2
Q

What fluoride toothpaste would be used in a standard risk child under 3 years old?

A

a SMEAR of 1000-1500ppmF

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3
Q

What fluoride toothpaste would be used in a high risk child under 3 years old?

A

a SMEAR of 1350-1500ppmF

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4
Q

What fluoride toothpaste would be used in a standard risk child 3+ years old?

A

a PEA-SIZED amount of 1000-1500ppmF

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5
Q

What fluoride toothpaste would be used in a high risk child 3+ years old?

A

a PEA SIZED amount of 1350-1500ppmF

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6
Q

What fluoride toothpaste would be used in a high risk child 10+ years old?

A

2800ppmF toothpaste

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7
Q

What is the pneumonic that is involved in motivational interviewing?

A

SOARS
- seek permission
- open questions
- affirmations
- reflective listening
- summarising

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8
Q

What is involved in step one of health behaviour change using motivational interviewing?

A

Explore current practise and attitudes using a motivational interviewing approach
- SOARS

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9
Q

What is involved in step two of health behaviour change using motivational interviewing?

A

educational intervention
- improve knowledge and skills

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10
Q

What is involved in step three of health behaviour change using motivational interviewing?

A

Action planning
- set time, date and place to start

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11
Q

What is involved in step four of health behaviour change using motivational interviewing?

A

Encourage habit formation
- achieve sufficient repetition

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12
Q

What is involved in step five of health behaviour change using motivational interviewing?

A

REPEAT EVERYTHING at each visit to maintain behaviour change

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13
Q

How can action planning be used to encourage toothbrushing in paediatric patients?

A

Ask what routine habits exist each day (e.g getting changed in the morning and night) that could be used as a reminder to brush teeth immediately afterwards
- good way to make toothbrushing a habit

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14
Q

How often should hands-on brushing instruction be given to high risk paediatric patients?

A

At each recall visit for at least 3 minutes

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15
Q

What are the steps in toothbrushing instruction technique given to paediatric patients and their carers? *brief

A
  • Decide if parent/carer is going to brush all surfaces of teeth in one section of mouth OR the same surface of each complete arch before moving on
  • Carer can decide to stand behind/in front of child
  • Dentist shows how to do it and then gets patient/carer to try
  • Short scrubbing motion
  • Should take 2 minutes
  • Don’t drink or eat acidic things 30 mins before brushing
  • Ensure to brush partially erupted teeth
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16
Q

What is diet advice for paediatric patients?

A
  • limit consumption of sugary foods/drinks and confine to meal times
  • drink only water or milk between meals
  • have healthy snacks
  • do not put sugary drinks in feeding bottles
  • do not eat or drink (apart from tap water) after brushing teeth at night
  • be aware of hidden sugars in food
  • be aware of acid content in fizzy drinks
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17
Q

What are examples of healthy foods/snacks to recommend to paediatric patients?

A
  • fresh fruit (sugary be careful!)
  • carrot
  • peppers
  • breadsticks
  • oatcakes
  • low fat cheese
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18
Q

In higher risk paediatric patients, how would you assess their diet and provide advice?

A

Diet diary (3-5 days and at least one of the days is a weekend)
- advise based on diary

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19
Q

What are the standards for fissure sealant placement in paediatric patients?

A

Place sealants in all pits and fissures of permanent molars ASAP after eruption
- ensure buccal pits of lower FPM and palatal fissures of upper FPMs are sealed
- use Bis-GMA if cooperative (first choice)
- use GI if uncooperative

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20
Q

How would you check that a fissure sealant has be placed correctly?

A
  • Try to dislodge sealant with a sharp probe
  • Check with probe for blow holes/ledges
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21
Q

What is the gold standard for moisture control when placing fissure sealants? What can be used if this is unacceptable?

A

Gold standard = dental dam

Used instead = cotton wool rolls, saliva ejector, dry guards

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22
Q

Explain the steps of GI use as a fissure sealant option:

A
  • Place a small amount of GI on one finger tip and petroleum jelly on the adjacent finger
  • If able to wipe the tooth with cotton wool roll to dry
  • Firmly apply the finger tip with glass ionomer to the tooth surface to be sealed, keep in place for 2 minutes
  • Place the second finger in mouth and rapidly switch fingers to cover GI with petroleum jelly
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23
Q

What is the minimum age for fluoride varnish application?

A

2 years old

24
Q

How often should fluoride varnish be applied to children’s teeth?

A

Minimum 2x per year BUT up to 4x per year for high risk patients

25
Q

What is the concentration of fluoride varnish used in practise?

A

22,600ppmF (5%)

26
Q

When is use of fluoride varnish contraindicated?

A
  • Severe asthma
  • Allergy to colophony
27
Q

What amount of fluoride varnish should be used for children aged 2-5 years old?

A

0.25ml

28
Q

What amount of fluoride varnish should be used for children aged 5+ years old?

A

0.4ml

29
Q

After application of fluoride varnish, what instructions do you give to the patient and carer?

A
  • Avoid eating and drinking for at least 30mins (longer better)
  • Eat soft foods for the rest of day
  • Brush teeth as usual that night
  • Teeth may appear yellow but this will fade with eating and brushing
30
Q

What is the safely tolerated dose of fluoride?

A

1mg/kg

31
Q

What is a potentially lethal dose of fluoride?

A

5mg/kg

32
Q

What is in a trauma stamp?

A
  • colour
  • TTP
  • mobility
  • sinus
  • percussion note
  • radiograph
  • sensibility testing
33
Q

A child patient has knocked out their front tooth, what advice do you give to the parent over the phone?

A
  • Reassure patient/parent and calm them down
  • Is the patient awake or exhibiting any signs of concussion/confusion/sickness.. if so send to A&E
  • Pick up tooth via CROWN not root
  • If visibly soiled run under water for 10s
  • Replace into socket if possible, if not store tooth in saliva/milk/saline
  • Get to dentist ASAP (<45 mins best)
34
Q

What aftercare should be advised after trauma to primary teeth such as avulsion/luxation?

A
  • Use analgesia
  • Soft diet for 10-14 days
  • Brush teeth with soft toothbrush after every meal be careful
  • Topical chlorhexidine 0.12% mouthrinse if able
  • Look for signs of infection
35
Q

A child experiences an enamel fracture, what is the follow-up regime?

A

Review appointments at:
- 6-8 weeks
- 6 months
- 1 years

*Take radiograph and complete trauma stamp

36
Q

A child experiences an enamel-dentine fracture, what is the follow-up regime?

A

Review appointments at:
- 6-8 weeks
- 6 months
- 1 years

*Take radiograph and complete trauma stamp

37
Q

A child experiences an enamel-dentine-pulp fracture, what treatment options do you have?

A
  • pulp cap
  • partial pulpotomy
38
Q

A child experiences an enamel-dentine fracture and you place a direct pulp cap, what is the follow-up regime?

A
  • clinical follow up after 1 week
  • clinical and radiographic follow up after 6-8 weeks
  • clinical and radiographic follow up 6 months
  • clinical and radiographic follow up after 1 year
39
Q

A child experiences an enamel-dentine fracture and you complete a partial pulpotomy, what is the follow-up regime?

A
  • clinical follow up after 1 week
  • 6-8weeks
  • 6 months
  • 1 year
40
Q

What % of all school children experience dental trauma?

A

25%

41
Q

What is the most common injury in the primary dentition?

A

Luxation

42
Q

What is the follow up regime for a paediatric patient who has suffered concussion to a permanent tooth?

A

Clinical and radiographic follow up
- 4 weeks
- 1 year

43
Q

What is the follow up regime for a paediatric patient who has suffered subluxation to a permanent tooth?

A

Clinical and radiographic follow ups
- 2 weeks (including splint removal)
- 12 weeks
- 6 months
- 1 year

44
Q

What are you checking at a follow up review of concussion/subluxation?

A
  • trauma stamp
  • sensibility tests
  • radiographs = root development, comparison with contralateral tooth, resorption
45
Q

What is the follow up regime for a paediatric patient who has suffered extrusion to a permanent tooth?

A

Clinical and radiographic follow ups
- 2 weeks (including splint removal)
- 4 weeks
- 8 weeks
- 12 weeks
- 6 months
- 1 year
- Annually for 5 years

46
Q

What is the follow up regime for a paediatric patient who has suffered lateral luxation to a permanent tooth?

A

Clinical, radiographic and endodontic check
- 2 weeks

Clinical and radiographic follow ups
- 4 weeks (splint removal)
- 8 weeks
- 12 weeks
- 6 months
- 1 year
- Annually for 5 years

47
Q

What is the follow up regime for a paediatric patient who has suffered intrusion to a permanent tooth?

A

Clinical and radiographic follow ups
- 2 weeks
- 4 weeks (including splint removal)
- 8 weeks
- 12 weeks
- 6 months
- 1 year
- Annually for 5 years

48
Q

What is the follow up regime for a paediatric patient who has suffered avulsion to a permanent tooth with closed apex?

A

Follow up:
- 2 weeks (splint removal too)
- 4 weeks
- 3 months
- 6 months
- 1 year
- Annually for 5 years

49
Q

What is the follow up regime for a paediatric patient who has suffered avulsion to a permanent tooth with open apex?

A

Follow ups
- 2 weeks (splint removal)
- 1 month
- 2 months
- 3 months
- 6 months
- 1 year
- annually for 5 years

50
Q

When would you decide NOT to replant a permanent tooth that has suffered avulsion?

A
  • child immunocompromised
  • other serious injuries require priority emergency treatment
  • very immature apex and extended EAT (>90 mins)
51
Q

What is the follow up regime for a paediatric patient who has suffered dento-alveolar fracture to permanent teeth?

A

Follow ups
- 4 weeks (splint removal)
- 6-8 weeks
- 4 months
- 6 months
- 1 year
- annually for 5 years

52
Q

What advice would you give to a patient that has experienced dento-alveolar fracture?

A
  • soft diet for 7 days
  • avoid contact sport
  • brush teeth but be careful
  • use Chlorhexidine 0.12%
53
Q

What types of splint can be used in paediatric patients chair side?

A
  • composite and wire
  • titanium trauma splint
  • composite***
  • orthodontic brackets & wire
  • acrylic
54
Q

What types of splint can be used in paediatric patients lab made?

A
  • vacuum-formed splint
  • acrylic
55
Q

What are the most common post-trauma complications of permanent teeth?

A
  • pulp necrosis and infection
  • pulp canal obliteration
  • root resorption
  • breakdown of marginal gingiva and bone

BDS3 OSCE PREP (9 decks)

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