Paeds Tutorials Flashcards
- 10 year old patient
- unhappy with front teeth appearance
- Sensitivity while brushing
- Asthamtic
- brushes twice daily with 1450ppm
What is your diagnosis? (4)
- MIH in upper and lower molars permanent molars
- Anterior tooth wear (NCTSL)
- Upper moderate crowding
- Lower mild crowding
- 10 year old patient
- unhappy with front teeth appearance
- Sensitivity while brushing
- Asthamtic
- brushes twice daily with 1450ppm
What is their caries risk assessment? and what further investigations would you do ? (2)
- High risk due to
Asthma = xerostomia - Diet diary to analyse diet and assess risk
- Ask about asthma inhalers ; nature of asthma and triggers , medications
- 10 year old patient
- unhappy with front teeth appearance
- Sensitivity while brushing
- Asthamtic
- brushes twice daily with 1450ppm
What are the favourable signs of extraction of permanent first molars? (4)
- Patient age is 8-10
- Calcification of the bifurcation of the 7s
- Calcification of the 8s
- Class I incisor relationship
- 10 year old patient
- unhappy with front teeth appearance
- Sensitivity while brushing
- Asthamtic
- brushes twice daily with 1450ppm
When would you compensate an extraction of a permanent first molar?
- when the upper 6 will by unopposed for a long time - to avoid over eruption
- when there is a clear occlusal requirement ( not aligned teeth interfering with the occlusion)
What is molar incisor hypo-mineralisation?
Hypo-mineralisation of systemic origin affecting 1-4 permanent molars usually associated with affected molars.
What is the suggested etiological factors of MIH? (pre-natal)
- Pre-eclampsia
- gestational diabetes
- general health in 3rd trimester
What is the suggested etiological factors in MIH? (natal)
- Prolonged delivery ( may cause trauma during birth
- Early delivery ( immature)
What is the suggested etiological factors in MIH? (post-natal)
- Infections to child - measles , rubella , chicken pox
- Prolonged breast feeding
- Medications while breastfeeding (mother and child)
- Socioeconomic status
( First year in the child’s life)
What are the symptoms of MIH? (2)
- Tooth sensitivity
- Aesthetic concerns
What are the signs of MIH? (4)
- Demarcated opacities with varied translucency in enamel (molars ± incisors)
- Tooth discolourations (brown/yellow)
- Severe NCTSL
- Secondary caries
What important medical history information should you gather for a child with asthma? (5)
- Nature of asthma
- History of hospital addmissions due to asthma
- Triggers and exacerbating factors
- Record FEV1 / PEFR values if known
- Medication doses and frequency of use
What does FEV1 / PEFR values tell you about an asthmatic patient?
- Measurements to assess lung function
- Degree of airway obstruction and severity of asthma
- important in monitoring asthma
What can suggest for a patient who is on high doses of corticosteroid for asthma for a prolonged time ?
- consider steroid cover
What triggers can exacerbate asthma? (3)
- Anxiety
- Colophony
- Local anaesthesia - sulphites (presevatives)
- Dust/debris
How can the nature of asthma affect a child’s dental management plan? (7)
- Educate patient about their increased risk of oral disease due to asthma
- OHI for prevention and the use of FV (consider colophony free)
- Diet advice - sugar free drinks
- Rinse after inhaler use
- Use spacer after inhaler use
- Make appropriate referrals for the increased risk of erosion
- There are many possible triggers of acute asthma attacks - try to minimise these
What can be the triggers of asthma in the dental setting? (6)
- Colophony in fluoride varnish
- Debris from enamel
- Prolonged supine position
- NSAIDs and Opiods
- Anxiety
- Aerosols
Where might you seek assistance from for the management of asthmatic patients?
- Consult with patient GP or special care dentist
- John 6 years old with dental anxiety
- Intermittent pain (right side of mouth)
- Mom wrote Cleft in MH form
- Drinks juice throughout the day and does not like water
- Today came for a clinical examination , OPT taken
What further information (excluding MH) would you want from john history? (3)
- Social history - impact of CLP
- Visits to hospital
- Patient GP details
What medical history is important to gather for a CLP patient? (3)
- Type of cleft condition
- Cardiac conditions (defects?)
- History of cleft-related surgery undertaken
What are the extra-oral findings in a cleft lip and palate patient? (3)
- Class III skeletal presentation
- Maxillary Hypoplasia ( or non if only palate)
- Communication between upper lip and nostrils
What are the intraoral findings of a CLP patient? (9)
- Hypodontia
- Hypoplastic teeth
- Hypomineralised teeth
- Microdontia
- Macrodontia
- Crowding
- Misaligned upper arch
- Communication between nasal and oral cavity
- Caries and periodontal involvement
Which practitioners are involved in the CLP patients management? (7)
- Special cleft nurse
- Orthodontist
- Paediatric dentist
- GP
- GDP
- Speech therapist
- Psychologist
What is the treatment timeline for a CLP patient? (5)
- 3-6 months - lip closure
- 6-12 months - palate closure
- 8-10 years - alveolar bone graft
- 12-15 years - definitive orthodontics
- 18-20 years - orthognathic surgery
What supportive resources are available for CLP patients and parents?
CLAPA ( cleft and lip palate association)