Pediatric Behaviour Types

Question 1

Pediatric behaviour types

Answer 1

Cooperative——— Willing

Avoidant————- Timid, tries to avoid dentist

Fearful————— Anxious

Defiant————— Stubborn, spoilt

Tense—————— cooperative, nervous

Whinning————- Continuous wailing

Question 2

Consistent finding in children with CONGENITAL ICTHYOSIS

Answer 2

DILACERATION

A radiograph is needed to confirm whether there is fusion or gemination.

Question 3

Mechanism of action of FLUORIDE in caries abatement

Answer 3

1. Increased resistance of tooth structure to DEMINERALISATION.
2. Enhanced REMINERALISATION of Early carious lesion.
3. Impaired cariogenic activity of Dental Plaque, through disruption of bacterial metabolism n function.

Question 4

Some important shooters

Answer 4

The most common Premedication used prior giving general anesthesia in children is VERSED(Midazolam)

In a young child , premedication with Barbiturates may cause Paradoxical excitement.

After extracting a tooth on a child, the biggest postoperative concern is THE PREVENTION OF LIP BITING.

Question 5

Nitrous oxide for conscious sedation in children

Answer 5

Minimum alveolar concentration of nitrous oxide is 50%.

Total flow rate is 4 to 6L/min for most children.

Maintenance dose during dental appointments is 30-35%.

On termination of nitrous oxide administration, inhalation of 100% oxygen for not less than 3-5 minutes is recommended in order to prevent Diffusion hypoxia.

Question 6

Anhidrotic Ectodermal Dysplasia

Answer 6

Most well known form of Ectodermal dysplasia.

X- linked recessive trait

Conical anterior teeth

Lack of perspiration due to partial or complete absence of sweat glands.

Question 7

Supernumerary teeth

Answer 7

Supernumerary teeth in cleidocranial dysplasia ranges from 10-60.

Most often found in…
Maxillary midline region(mesiodens)» Distal to maxillary molars» Mandibular premolar region.

Question 8

BehaviourManagement in a child with down syndrome

Answer 8

1. Child is affectionate ,fearful of quick movements but capable of learning dental procedures.
2. Often have difficulty accepting dental care but cooperation can be improved by gradual exposure to dental office.
3. Need a comprehensive preventive program.

Question 9

Dental management of well-controlled diabetic consists of the following

Answer 9

1. Advise patient to eat a normal meal before the appointment to avoid development of hypoglycaemia.
2. Have a glucose source available to treat onset of hypoglycaemia.
3. If dental procedure is anticipated to be stressful, consult patient’s physician regarding adjustment of insulin dosage.
4. Consider utilization of prophylactic antibiotics for surgery ,endodontics and periodontal therapy to minimize the risk of infection.

Question 10

The most common craniosynostotic syndrome occuring with syndactyly is

Answer 10

Apert Syndrome

Features——

Peaked head
Parrot beaked nose
Mitten hands
Sock feet

Question 11

Relative timeline of cleft lip and palate surgery

Answer 11

1 to 3 months: Dentomaxillary appliance inserted to help mold and form lip and palate prior surgery.

3 to 4 months: Cleft lip is repaired.

9 months : Cleft palate is repaired.

5 to 9 years: BONE GRAFT is placed if cleft goes through alveolar ridge.

12 to 16 years : Orthodontic treatment started.

> 15 years: Finishing surgeries and/ or maxillary/ mandibular surgeries.

Question 12

Intrinsic tooth discolouration

Answer 12

CONGENITAL ERYTHROPOIETIC PORPHYRIA— reddish brown teeth, fluoresce under UV Light.

CYSTIC FIBROSIS— Yellowish gray to dark brown

ERYTHROBLASTOSIS FETALIS— Blue green color due to excessive destruction of erythrocytes.

TETRACYCLINE THERAPY— Yellowish two brown and gray to black . stain permanent teeth that have not completed enamel formation at the time of drug Usage.

AMELOGENESIS IMPERFECTA— White opaque to yellow to brown teeth.

DENTINOGENESIS IMPERFECTA— opalescent teeth

DENTAL FLUOROSIS— Yellow to brown pigmentation

HYPERBILIRUBENIMIA— yellow green tint on tooth surfaces.

Question 13

Dental Findings in child with hypothyroidism cretinism

Answer 13

Under developed multiple with over developed maxilla

Anterior open bite

Macroglossia

Flaring of anterior teeth

Thickened lips due to glycosaminoglycan deposit

Unerupted yet fully developed permanent dentition

Question 14

American hear Association recommends antibiotic prophylaxis prior to dental procedures in patients with history of

Answer 14

Congenital heart disease

Rheumatic heart disease

Prosthetic heart valve

Previous infective endocarditis

Patients with repaired congenital heart defect with the residual defects

Heart transplant recipients who develop valvulopathy.

Question 15

Maximum recommended dose of LA with or without vasoconstriction in child

Answer 15

4.4 mg/ kg

ABSOLUTE MAXIMUM DOSE is 300 mg.