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FINALS!!! > Paeds - revision notes > Flashcards

Paeds - revision notes Flashcards

1
Q

Fluoride mouth wash

A

> 8 years old
225ppm
10ml a day

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2
Q

Lee way space

A

is the mesio distal space between primary molars that is bigger than the distance that the permanent pre molars will replace
1.5m = upper
2.5mm = loweer

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3
Q

High risk children

A

no fluoride
consumption of high sugarary snacks
unstimulatated saliva flow <0.7ml/min
new carious lessions
existing restorationss
early loss of primary teeth

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4
Q

Rx for durphat

A

22800ppm - 0.619% sodium fluoride)

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5
Q

BPE in children

A

7-11 = 16,11,26,36,41,46
codes 0-2

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6
Q

Plq levels

A

10/10 = clean tooth
8/10 = plq cervical margin
6/10 = ple cervical 1/3
4/10 = plq on middle 1/3

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7
Q

Radiographs

A

high = 6-12months
low = 12-18 months

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8
Q

Sequence of restiorations

A

fluroide varnish
fissure sealatns
preventative restorations
simple fillings
fillings involoing la bunt not into pulp
pulpotomie/pulpectomies
XLA

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9
Q

elements of caries risk assessment

A

dietary advice
saliva
Medical history
fluoride use
plq control
clincial evidence
socail hisotry

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10
Q

Preventative programme

A

fissure sealants
fluoride varnish
fluoride supplmentation
radiographs
toothburshing insturction
diet advice
sugar free meds
fluoride tp

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11
Q

Ramptant caires

A

10 or more carious lesions

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12
Q

Flurodie varnish

A

22600ppm applied either 2 or 4 times a year
contra - ulcerative stomatitis, allergy to elastoplast, colophony, sevre asthma, gingivitis

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13
Q

Fluoride varnish advice after placement

A

avoid eating and drinking for 1 hr
brush teeth as normal at night
might have temp yellow staining
avoid fluoride suplments for rest of day
soft diet

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14
Q

Causes of nursing bottle caries

A

surgary drinks in bottles
swirling of jucies in mouth
inapporparate feeding bootles
poor oh
prolonged brest feeding
not using straw with fizzy drinks

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15
Q

SDF

A

44,800ppm
used in asymptomatic carious lesions teeth
MIH sens
meidcally hx risks XLA
carious lesions that are cleansable
root caries
delay in GA or sedation

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16
Q

Contra of SDF

A

allergy to silver, ammounium or fluoride
allergy to potassium oriodine
stomatitis, mucositits,
caries to pulp or infection

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17
Q

SDF risks

A

decay continues to develop
stains clothing
leaves metallic taste
temp stains soft tissues
can discolour cavitated lesions black
discolouration of tooth fillings

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18
Q

when would you not carry out endo

A

pt has cardiac defect
immunocompromised
poor healing potential

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19
Q

Vital pulpotomy aim

A

to remove the infected cornal part of the radicular pulp, stop bleeding and main the apical portion of pulp

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20
Q

Steps in vital pulpotomy

A

LA, rubber dam and gain acces to carious lesion
remove carious lesion and gain acees to the roof of bulb chamber with diamond bur
remove the cornoal pulp with steel bur or excavator
establisht ehextent of bleeding apply a ferric sulphate soaked pellet over the pulp and gain haemharrage control, if bleeding continues then reapply and wait till control achieved
resotre with ZOE paste and GIC core adn then restroation

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21
Q

Ferric sulphate

A

only used in primary teeth as casues staining and darkenin in adults
use nsCAOH or CaOH in adults

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22
Q

follow up for vital pulpotomy

A

6months clincally
12months radiographically looking for furcaiton involvement, pa path, internal and external resoorption

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23
Q

Pulp capping

A

mainins the vitatility of the tooth <24hrs exposure
arrest heammrahge with pressure and damp cotton wool rool
apply CaOH over the site and then resotre

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24
Q

Non vital pulpectomy

A

the only option to save a non vital tooth
pulp necrosis, chronic sinus, pa perio, bleeding pulp or inflammed pulp

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25
Q

Apexification

A

induces a calcified barrier in the root of incomplete or open apices with a necrotic pulp

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26
Q

Non vital tooth on xray

A

Pa radioluency
external or internal root resoprtion
widening of PDL
loss of lamina dura
anklyosis

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27
Q

Contraindications to inhaltion sedation

A

can’t breathe through nose
common cold
severe asthma
tonsillar enlargement
severe copd

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28
Q

Reasons good for inhaltion sedation

A

rapid onset
quick recovery
no needles/cannulation
no amnesia
drug is not metabolised in liver
adults do not need cahperone
matinance of protective reflexes

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29
Q

Contraindications of GA

A

allergy to the Ga drug
liver function issues
renal issues
ECG abnormalities - long QT syndrome
Cystic fibrosis
Severe astham - class ASA 3 and 4
resp disease
cogential heart defects
sickle cell anemia

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30
Q

Fasting for GA

A

6 hrs - no solids
4 hrs - no milk
2hrs - no clear fluids

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31
Q

GA recommendations

A

stop smoking 12 hrs before GA
Alcohol - if regular the liver enzymes can be reduced which has an affected on absorbing the anesthetitc
need escort home and someone to monitor them for 12 hrs

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32
Q

Extrinsic staining

A

tea/coffee/drinks
poor OH
smoking
drugs - iron = black, CHX = brown/ blakc

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33
Q

Intrinsic local staining

A

infection/path present
internal resoprtion
caries
injury/infection

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34
Q

Systemic staining

A

flurosis
amelgeogensis imprefect
dentitignsisi imprefecta
drus - tetracycline
bilirubim

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35
Q

10% carbamide peroxide brown down to

A

3% hydrogen peroixde
7% urea

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36
Q

When are composite veneers not apporpriate

A

in children the pulp horns and chambers and stillll quite large
the gingival contour is still immature

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37
Q

Causes of toothwear in children

A

parafunctional habits
gastric probs
dietary issues

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38
Q

Objective of resotring tooth wear

A

improve senstiivity
to have a balanced occlusion
to resotre function
to presevre remaining tooth tissue
support remaining tooth struture

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39
Q

When is microabrasion indicated

A

flurosis
trauma to teeth
MIH
post ortho demineralisation
white/brown surface staiing

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40
Q

Advantages of microabrasion

A

quick and easy
non invasive
conservative of tooth structure
no LA required
effective
not expensive

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41
Q

Disadvatanges of microabrasion

A

HCl caustic
has to be carried out at GDP
unpredicatble outcome
removes enmale so can lead to sens

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42
Q

Steps in microabrsion

A

apply rubber dam and pumice and water to tooth to clean
then apply petreleum jelly to soft tissues
then apply sodium bicarbonate to gingivae
apply Hcl slurry for 5secs on each tooth and rinse
repeat 10 times and review
wash and polish with flexi discs and apply flurodie varnish to help with reminerlisaiton and sens
review in 4-6weeks

** advise not to consume dark fluids and food for 24hrs

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43
Q

Other types of tx for disclouration

A

resin infiltration
bleaching - vital bleaching e.g chairside bleaching, non vital bleaching

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44
Q

Types of non vital bleaching

A

walking tech - which creates cavity into pulp chamber and bleach applied directly in and sealed over and reapplied at intervals
inside out tech - where cavity cut into pulp and pt then applies bleaching gel in tray and into mouth and over the area with pulp cavity

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45
Q

Hypomineralisation

A

where there is reduced enamel formed or the ennamle mineral content is reduced

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46
Q

Hypoplastic

A

enamel bulkl, thickness is reduced
enamel morophology is not right

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47
Q

Questions to ask for MIH

A

pre natal - mum in 3rd trimester, pre-elampsia, gestational diabetes
peri natal - traumatic birth, baby full term or premature
post natal - prolonged breast feeding >6months, fever, meds, resp issues, chickenpox, mumps

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48
Q

Clincal issues with MIH

A

sens
tooth wear
appearance
breakdown of enamel
secondary caries

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49
Q

Traumatic injuries what toask

A

how the injury occured?
when the injury occured
where the injury occured - to establish if tetnus is required
crown framgments lost etc
amensia, concussion, vomiting, headaches
have they had previous dental trauma

Mh - allergies - for antibiotics
Tetanus in last 5 years
bleeeding disorders
congientia lheart defect, immunosuppresion or rhemuatic fever as don’t want to carry out endo

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50
Q

Avulsions more successful when

A

minimal damadge to the pulp and perio ligament
the correct sotrage medium and the extra avlolar time small

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51
Q

When not to reimplant a tooth

A

if child is immunocomporomised
if the child has other medically issues that take priorioty
pt lacks co-operation

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52
Q

Public advice for avulsion

A

hold the tooth by the crown
remove debris with cold running water and a plug in the sink
try and reimplant into the socket
if can’t store in milk or saliva
seek dental advice

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53
Q

Avulsion

A

complete removal of the tooth from the socket
sepration of PDL and exposure of root surface

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54
Q

Concussion

A

there is no rupture of the perio ligament
limited ging bleeding, some swelling
no increase in mobility
TTP yes

tx - soft diet, good oh, chex and gentle brushing

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55
Q

Subluxation

A

rupture to some PDL and some mobility present
Tooth is ttp
no displacmeent present

Tx - clean area with saline, water and chx and fleible splint for 2 weeks

56
Q

Extrusion

A

rupture of the PDL and pulp
tooth appears to be elongated and out of socket
TTP and mobile

Tx - La with vaso, clean area and saline
flexible splint for 2weeks

57
Q

Lateral luxation

A

rupture of the perio ligament and pulp and damage to the aveloar plate
high metallic sound present
not mobile
axial and apical impaction

Pulpal necrosis is high especially if closed apex and resoprtion and ankylosis present

Tx reposition under LA and clean area with ater and saline, reposition with flexible splint for 4 weeks

58
Q

Lateral luxation

A

rupture of the perio ligament and pulp and damage to the aveloar plate
high metallic sound present
not mobile

Tx reposition under LA and clean area with ater and saline, reposition with flexible splint for 4 weeks

59
Q

Intrusion injury

A

rupture of perio ligament, pulp and the alveolar plate and driving axially and apically

Pulpal necrosis is high especially if closed apex and resoprtion and ankylosis present

Flexible splint for 2weeks and start endo after 2 weeks placiing CaOh

60
Q

Dental alveolar fracture

A

flexible splint for 4 weeks

61
Q

Trauma stamp

A

colour
notation
displacement
sinus
sens
TTP
mobility
radiograph

62
Q

Prognosis of tooth depends on

A

type of injury
time between innjury and tx
the extent of damge to PDL
presence of infection
stge of root development

63
Q

Flexible splint

A

don’t brush for 1st day
sfot diet
Chx mw for 7 days
use a soft bristle brush
avoid contact sports

64
Q

Enamel fracture

A

smooth down sharp fragment or bond back to tooth
2PA’s to rule out root fracture or lateral luxaiton

65
Q

Enamel dentine fracture

A

bond fragment back to tooth or place comp bandage
2pa’s to rule out root fracture or lateral luxation

66
Q

Enamel dentine pulp fracture

A

partial pulpotomy or pulp capping

67
Q

Crown root fracture with no pulp exposure

A

then remove the fragment with forceps
may need to suture ging margins and laceration
clean area with water, saline and chx
apply gi or comp on exposed area and restore with comp

68
Q

Crown root fracture with pulp exposure

A

the same but could require xla, gingivectomy, surgical extrusion

69
Q

Coronal root fracture

A

flexible splint for 4months

70
Q

apical or middle 1/3 fracture

A

flexible splint for 4 weeks

71
Q

Pulpan necrosis

A

pink colour means intrapulpal bleeding, pulp still vital

72
Q

Pulpal obliteration

A

yellow or opqaue colour (normally exfoliates)

73
Q

Root resorption

A

external = intrusive
internal - subluxation

74
Q

Traumatised primary tooth complications

A

delayed exfoliation
loss of vitality
abscess risk
dilcaeration of permanent

75
Q

Permanenet tooth trauma following

A

hypoplasia
hypominaerlasation
delayed eruption
delayed exofliation
ectopical eruption
damage to crown/root development

76
Q

Child abuse categories

A

sexual
emtional
neglect
physical
failure to thrive

77
Q

Index of suspicion for child abuse

A

a vague story
the story does not add up with the injuries
the child and parents behavious is odd
the child will not interact with you
delay in seeking help
parents mood abnormal
hx of violence
child says something

78
Q

Dental neglect

A

is the persistent failure for a childs basic oral health needs to be meet and signficantly impacts on their overall oral and general health

79
Q

Options for dental neglect referral

A
  1. preventative dental team response
  2. preventative multi agecny response - social workers, health care visitor, GP, may have a child protection plan or common assessment fraemwork)
  3. child proteiton referall
80
Q

Behaviour management techniques

A

tell show do
positive reinforcement
desenstitisation
hyponosis
CBT
relaxation
role modelling
distraction
voice control
stop signals
aclimitsasation

81
Q

tests for children anxiety

A

Picture tests
venham picture scale
facial image scale
Modificed dental anxiety scale

82
Q

dental phobia

A

severe dental anxiety

83
Q

dental anxiety

A

a sense of apprehension that something dreadful is going to happen coupled with a sense of losing control

84
Q

dental fear

A

a normal emtional reaction to one or more stimuli in the dental environment

85
Q

dental phobia

A

a severe form of dental anxiety

86
Q

dental aniety

A

a serve state of apprehension that something dreadful is going to happen coupled with losing control

87
Q

dental fear

A

a normal state of emotional reaction to one or mores timuli in the dental enviornment

88
Q

Hypodontia

A

lower 2nd premolar and then upper lateral incisors

89
Q

Casues of hypodontia

A

cleft paltae
down syndrome
ectodermal dysplasia
incontenti pigmenti
Hurler’s syndrome

Can cause overeuption

90
Q

Causes of supernunmerary teeth

A

cleft palate
cleidocranial dysplasia
Gardner’s syndrome

Males more than femals and the mxialla more common

91
Q

Types of supernunmerary

A

conical - cone shaped
supplemental - same tooth
tuberculate - barrel shaped
odontome - irregualr mass of dental hard tissue

92
Q

Miicrdontia

A

pituaitry dwarfism
radio and chemo

93
Q

Macrodontia

A

pituatiry giangtism

94
Q

Double teeth

A

fusion of 2 teeth
gemination -1 tooth splits into 2

95
Q

Talon cusp

A

a horn like shape projected from cingulum of upper maxialry incisor

Do nothing
file enamel down and place fs
pulpotomy or pulpectomy

96
Q

Taurodontism

A

enlarged pulp chamber - CEJ to birfucation of roots longer than the root length

Occurs due to failure of hertwigs root sheath

97
Q

Signs and symptoms of amleogensis imprefecta

A

small teeth
discoloured
yellow teeth
AOB
pitted and grooved
prone to wear

It is when the enamel fails to develop correctly
autosomal dominant or x linked recessive

98
Q

Types of amlegoegenisis imprefecta

A

hypominealised
hypocalcificied - yellow opaque colouring, soft enamelm enamel dull, lifeless and honey coloured
hypoplasitc - enamel is strong but small quantitiy
hypomaturation - soft enamel especially at the cervical region

99
Q

Dentiogensisi imprefecta

A

type 1 - odontgensis imperfecta
Type 2 - autosomal dominant
Bradywine

100
Q

Dentingensis imperfecta symptoms

A

blue, grey, yellow, brown colour
roots short and thin
bulbous crown
pulp canals oblitereated

101
Q

probs with imperfecta conditinos

A

poor aesthetics
exposure of dentine causing sens
poor oh, caries, ging
chipping and atrriton of enamel

102
Q

Dealyed eruption of primary teeth

A

low brith weight, preterm birth
Conditions - down syndrome, turners syndrome, hypothyrodism, hypopiturism, clediocranial dysplasia

103
Q

Dealyed eruption of permanent dentition

A

truma
supernumary
ectopic successor
odontoms
impaction

104
Q

Hyoplasia

A

local - infection or trauma
generalised - liver probs, measeles, mumps TB, nutritional

105
Q

Hand foot and mouth diseases

A

casued by coxsackie A16
Casues skin rashes on hands and feet
sores and blisters in the oral cavity
takes 7-10days to resolve
tends to occur in children<5yrs

Tx - NSAIDS, fluids, soft diet, bland diet, reassurance, bed rest

106
Q

Herpangina

A

a viral infection casued by coxsackie A
Casues painful bliseters with ahlo vesicles on soft palate, uvula and tonsilar area
Less painful and shroter duration than HSV1
Gerernal malaise, raised lymph nodes, sore throat,

Tx - fluid intake, bland diet, soft diet, bed rest, analgesics avoid aspirin

107
Q

Primary herpetic gingivostomatitis

A

a viral infection caused by the herpes simplex virus 1
casues painful ulcerations and blisters in the mouth
fiery red appearance
the tongue can appear white
takes 10-14 days to resolve

fever, general malasie, vomiting, loss of apetite

Tx - bed rest, fluid intake, NSAID, soft diet, viral drugs -acylovir

108
Q

Cerebral Palsy

A

a learning disability which affects movement and posture

Mixed
Dyskienetic - involuntary movements
Ataxic - shaky movements which affect balance
Spastic - stiffness and difficulty moving limbs

109
Q

Dental features of cerebral palsy

A

ging hyperplasia
enamel hyperplasia
poor OH
drooling
enhanced gag reflex
bruxism
malocclusion

110
Q

Difficulty for dentists and cerbral palsy

A

involuntary movemetns
enhanced gag reflex
poor posture
diffuclty opening mouth and intential tremor

111
Q

Down syndrome

A

a neurodevelopmental disroder that means there is an extra copy of chromsome 21

112
Q

General health probs with down syndrome

A

aleziher’s/ dementia
hypothyroidism
cogential heart defects
eye problems
epilpsy
leukameia

113
Q

Dental and down syndomre

A

hypodontia
Class 3 malocclsuion
AOB
small lips
posterior cross bite
fissured tongue

114
Q

Autism

A

neurdovelopmental condition which affects the persons ability to communicate and language
diffuclty understainding open ended questions
poor fine motor skills
obbessive behavious
fixation
repetitive behaviour

115
Q

Dental and autism

A

bruxism
dry mouth
can’t understand pain
limited diet
can’t brush
salivation
delayed eruption

116
Q

Tech for autism appts

A

short appts
use persons name
same dentist
same time
same room
encourage parent to attend
tell show do
short commands
sunglasses for bright lights
earphones for noise
avoid contact

117
Q

Congential bleeding disorders

A

Von willebrand
Heamophillia A
Heamophillia B

118
Q

Acquired bleeding disorders

A

Vit K
clotting antibiodies
liver disease
anticogulants

119
Q

Cystic fibrossi

A

autosomsomal recessive of long chromsome 7
casues theicked and excess mucous production
finger clubbing
delayer eruption
enamel defects
can’t have GA - resp failure

120
Q

HIV

A

xerostomia
salivary gland enlgargment
Kaopsi’s sarcoma
ging and perio lesions
orla ulceration and candidiosis

Avoid GA as recurrent chest infections

121
Q

Red cell disorders

A

ulcerations, pale mucosoa, angular chelitits, candida infections

Iron - microcytic, low serum and ferritin
Vit B12 - seen in vegans, chrons and coliac
Folate - macrocytic - renal dialsys, chron’s celiac

122
Q

Ulcerative colitis

A

inflamation of the lining of the bowel

123
Q

Crohns diseases

A

sens to alpha gliden in gluten
macrocytic anemia
apthous ulders
hypoplasia
depapillation of tongue

124
Q

Crohns diseases

A

mucosa fissured, cobblstone, OFG
Jegunum - folate absoprtion
illieum - Vit B12 absorption

angular chelitis, mucosal tages, submental lyphadenopathy

125
Q

Epilpsy

A

decreases GABA neurotransmitted which leads to abnormal cell to cell propagation

Clonic/tonic
absence (pettit mal)
atonin/myoclonic

Ging hyperplasia, cervical lyphadenopathy, delayed eruption, folate deficiency, bleeding issues

126
Q

Asthma

A

excess mucous production
inflammation of the linining of the airways
increases smooth muscle tone

Dry cough, GORD casuing palatal erioson, dry mouth, ulcerations, caries

Avoid in ASA3 and 4
Can have inhalation sedation

Beta 2 agonsit decreases saliva and corotocsteriods can cause adrenal suppression

Avoid aspirin and NSAIDs as allergy to penciliin
Stress and anxiety can induce symptoms

127
Q

Chronic renal failure

A

excessive plq accumulation
enamel hypoplasia
pulp obliteration
ging overgrown

128
Q

Hyper in diabetes

A

acetone in breath
weak pulse
nasuea/vomiting
loss of consciousness
dry skin
rapid breathing
thrist increase

129
Q

Oral issues with diabetes

A

oral ulcerations
angular chelitis
caries
perio
poor wound healing
bad taste/altered taste
burning mouth,
candidosis

130
Q

Features of diabetes

A

lethargy
polyuria
polydipsia
weight loss
dehydration
muscle wasting
shock/coma
paraesthetsia

131
Q

Thrombocytopenia

A

reduction in circulatory platelets
normal = 150x10^9-400x10^9
lowest dentsit can treat = 50 x10^9

132
Q

What to avoid in renal diseases

A

paracetamol
tetracycline
penicillin

133
Q

Partial pulptomy

A

3mm around exposure removed

134
Q

Contro of pulpotomy

A

muliple carious lesions
poor pt co-operation
tooth is near exfoliation
unrestorable
abscess present
MH - caridac defect, immuno, RF

135
Q

Indications for pulpotomy

A

avoids GA
Mh compromised XLA
space maintaner
normal pulp
reversible pulptitis
no radipgrahic signs of infection
caries 2/3rd into dentine
no permanenet successor

136
Q

Triangle of safety

A

side of face
neck
shoulder
ear

FINALS!!! (20 decks)

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