PEDIATRIC DENTISTRY Flashcards
The primary mandibular lateral incisors typically erupts when a child is about ___ old.
A. 14-18 months
B. 6-10 months
C. 17-23 months
D. 10-16 months
As compared with permanent teeth, primary teeth have?
A. Pulp horns further away from the tooth surface
B. Smaller pulp relative to crown size
C. Thicker and shorter roots
D. Increased number of accessory canals in pulpal floor
Morphologically, the primary mandibular second molar strikingly resembles the permanent?
A. mand. 2nd molar
B. mand. 1st molar
C. max. 2nd molar
D. max. 1st molar
What is the space maintainer most often used when the primary first molar needs to be prematurely extracted?
A. band and loop maintainer
B. nance’s appliance
C. lingual arch appliance
D. distal shoe space maintainer
________ is a process in which a single tooth germ splits or shows an attempt at splitting to
form two completely or partially separated crowns.
A. concrescence
B. gemination
C. fusion
D. dens in dente
_______ is the bedrock strategy on which all of pediatric dental behavior management rests.
A. tell-show-do
B. positive reinforcement
C. distraction
D. nonverbal communication
At what stage of development of a tooth does amelogenesis-imperfecta occurs?
A. Proliferation
B. Histodifferentiation
C. Apposition
D. Initiation
An 11 year old patient fractured a permanent central incisor. The next day, a pin point pulp
exposure is evident. The treatment of choice would be to?
A. Perform a pulpotomy
B. Perform a partial pulpectomy
C. Institute gutta percha endodontic procedures
D. Perform a direct pulp cap with CaOH
E. Institute a lingual arch
What is the most common traumatic injury received by deciduous anterior teeth?
A. Ellis type I
B. Ellis type VI
C. Ellis type VII
D. Ellis type V
When determining the dosage of systemic fluoride supplements for a child, it is most
important to consider the child’s?
A. Age and weight
B. Age and fluoride content of drinking water
C. Age and mean annual temperature
D. Weight and fluoride content of drinking water
A 7-year-old has a 4-mm maxillary midline diastema. Which of the following should be done?
A. Brackets should be placed to close it.
B. A radiograph should be taken to rule out the presence of a supernumerary tooth.
C. Nothing should be done. It will close on its own.
D. Nothing should be done. Treatment should be deferred until the rest of the permanent
dentition erupts.
The crowns of all 20 primary teeth begin to calcify?
A. between 3rd
to 6th week in utero
B. between 7th
to 9th months in utero
C. during the 2nd
trimester
D. at birth
Which of the following is the most frequently utilized route of administration for sedation in
pediatric patients?
A. Oral
B. Inhalation
C. IV
D. IM
A young permanent incisor with an open apex has a pinpoint exposure due to a traumatic
injury that occurred 24 hours previously. The best treatment is _____.
A. Place calcium hydroxide on the pinpoint exposure
B. Open the pulp chamber to find healthy pulp tissue and perform a pulpotomy
C. Initiate a calcium hydroxide pulpectomy
D. Initiate conventional root canal treatment with gutta-percha
Mario, aged 8 has lost his primary maxillary second molar. What type of space maintainer can
be used?
A. loop with the permanent first molar as the abutment tooth
B. transpalatal bar
C. nance holding arch
D. band and loop with primary 1st molar as the abutment tooth
A child presents to your office after a fall from a tree, during which his primary maxillary
central incisor was avulsed. The mother has brought the tooth in a cup of milk and says the fall
occurred 2 hours ago. What is the best treatment for this patient?
A. Replant the tooth, stabilize the tooth for 1 to 2 weeks at which time a pulpotomy should be
performed
B. Replant the tooth, stabilize for 1 to 2 weeks, and then perform a pulpectomy
C. Replant tooth, stabilize for 1 to 2 weeks, and begin apexification if pulp necrosis is evident
D. Take a radiograph, irrigate socket, do not replant tooth
Indirect pulp treatment is a procedure performed in a tooth with?
A. A necrotic pulp
B. A deep carious lesion adjacent to the pulp
C. A periapical radiolucency
D. Pulp tissue that is irreversibly infected due to caries or trauma
A 9 year old patient has fractured the root of the permanent maxillary right lateral incisor.
There is no other identifiable injury. The fracture occurred around the middle of the root. What is
the indicated course of therapy at this time?
A. Begin endodontic therapy immediately
B. Extract the tooth and the root remnant if possible
C. Do nothing if the tooth seems fairly stable
D. Splint the tooth to the adjacent two or three teeth
The condition among primary molars that causes its failure to establish its final occlusal level?
A. Impaction
B. Ankylosis
C. Ectopic eruption
D. Premature resorption
In a dental situation the basic fear of most children under 2 years of age is concerned with?
A. separation from the parent
B. injections of local anesthesia
C. the reason for dental treatment
D. the instruments to perform dental treatment
A 6-year-old patient has a dark brown discoloration of his maxillary central incisors. The
discoloration started following trauma accompanied with a facial sinus tract. What is the
treatment of choice?
A. Extraction
B. Pulpectomy
C. Pulpotomy
D. Direct pulp treatment
Which of the following is the best indicator of success of a pulpotomy in an immature
permanent tooth?
A. Patient comfort
B. Stable vitality readings
C. Continuation of root formation
D. Formation of a dentinal bridge covering the pulp stumps in the root canal
A 3-year-old child has a primary central incisor that has been completely intruded into
alveolar structures without perforation of the labial plate. Radiographic examination reveals no
root fracture or contact with the permanent successor. Treatment of choice is to?
A. Prescribe antibiotic therapy and tetanus injection
B. Bring the tooth into position and ligate it
C. Perform a modified endodontic procedure immediately
D. Observe periodically for re-eruption
If a child in your clinic requires prophylactic antibiotic to prevent bacterial endocarditis, which
regimen is correct?
A. amoxicillin 75mg/kg 2 hrs prior to dental appointment
B. amoxicillin 50mg/kg 1 hr prior to dental appointment
C. amoxicillin 25mg/kg 2 hrs prior to dental appointment
D. amoxicillin 100mg/kg 1 hr prior to dental appointment
A child in the “ugly duckling” stage is characterized by?
A. Absence of maxillary incisors
B. Presence of only one maxillary central incisor
C. Diastema between 2 central incisors
D. Flat nasal bone
The first teeth to become involved in nursing bottle caries usually are?
A. mandibular molars
B. maxillary anterior teeth
C. mandibular anterior teeth
D. maxillary molars
The calcification of maxillary and mandibular permanent first molars occurs?
A. between 3rd
to 6th months in utero
B. at birth
C. during the 3rd
trimester
D. at the age of 1.5 to 2 years
The maxillary central incisor of a 2 year old child was traumatically intruded 4mm apically into
the alveolus. What immediate treatment will you do?
A. Careful removal of the incisor
B. Make the patient as comfortable as possible w/o disturbing the tooth
C. Appositioning of intruded tooth
D. Repositioning and splinting of intruded tooth
What is the best restoration for a deciduous molar of a 5 year old child with an MOD cavity,
with the carious lesion 3mm away from the pulp as seen through the radiograph?
A. amalgam
B. glass ionomer
C. SSC
D. pulpotomy
Discolored primary teeth that are symptom-free and show no radiographic changes are best
treated by?
A. No treatment
B. Extirpation of pulp tissue followed by the placement of ZOE paste in the root canal space
C. Extraction
D. Pulpotomy
Pediatric anesthetic formula which uses a child’s weight in pounds?
A. Fried’s
B. Clark’s
C. Young’s
D. Dean’s
Primary upper right central incisor
A. 51
B. 61
C. 71
D. 81
If a child’s teeth do not form, this would primarily affect the growth of the?
A. Maxilla
B. Mandible
C. Alveolar bone
D. Whole face
A permanent incisor with an open apex is extruded 4 mm following an injury 15 minutes ago.
What is the treatment of choice?
A. No immediate treatment, monitor closely for vitality.
B. Reposition, splint, monitor closely for vitality.
C. Reposition, splint, initiate calcium hydroxide pulpotomy.
D. Reposition, splint, initiate calcium hydroxide pulpectomy.
Which of the following has the greatest influence on a child’s reaction to his initial visit in the
dental office?
A. The parent
B. The dentist
C. The dental assistant
D. The environment of the operatory
E. The decor of the reception room
A 3-year-old child has a 2 mm diastema between primary maxillary central incisors. The
mother is worries and consults a dentist. The dentist should advise the mother that?
A. A frenectomy should be considered
B. A habit probably caused this condition
C. A radiograph of the area must be taken
D. The child will need early orthodontic treatment
E. None of the above
Radiographs of a 5-year-old patient show permanent maxillary first molars inclined mesially
with resulting resorption of the distal portions of the roots of primary second molars. The
condition described is?
A. Ankylosis
B. Ectopic eruption
C. Premature eruption
D. Internal resorption
E. Intrafollicular resorption
The average age at which calcification of crowns of permanent central incisors is completed
is?
A. 4-5 years of age
B. 6-7 years of age
C. at birth
D. 2-3 years of age
A 6-year-old child presents with a Class I fracture to a tooth with an immature apex. What is
the treatment of choice for this patient?
A. Restore tooth
B. Place calcium hydroxide to exposed dentin, restore tooth
C. Perform pulpotomy, then temporarily restore
D. Perform pulpectomy, place stainless steel crown
E. Extract tooth, place space maintainer
Which of the following deficiency is not implicated in enamel hypoplasia?
A. calcium deficiency
B. avitaminosis A
C. avitaminosis D
D. avitaminosis B
Which of the following is the MOST convenient method for examining and 18-month-old child?
A. The child sitting in the dental chair and a parent at the chairside
B. A parent sitting in the dental chair and the child sitting on the parent’s lap facing forward
C. The dentist and parent in a knee-to-knee position with the child’s head in the dentist’s lap
D. The dentist and parent in a knee-to-knee position with the child’s head in the parent’s lap
A 9 year old child who has fractured a maxillary central incisor arrives at a dental office w/in
an hour following the accident. The fracture involves the mesio-incisal angle of the crown and
exposes the dentin and a large portion of the pulp. Proper treatment of the pulp would include
coverage with a crown and?
A. Direct pulp cap
B. Formocresol pulpotomy
C. ZOE pulp cap
D. CaOH Pulpotomy
E. None of the above
When treating a child who is obviously afraid, the dentist should?
A. use restraint
B. use HOME
C. permit the child to express his fear
D. avoid all reference to the child’s fear
What is the characteristic of a child who is completely uncooperative and crying, wherein
there’s difficulty to make any progress in treatment?
A. frankl 1
B. frankl 2
C. frankl 3
D. frankl 4
A vital permanent tooth has an irreversible pulpitis and an open apex. Which of the following
represents the treatment of choice for this tooth?
A. Formocresol pulpotomy
B. Indirect pulp therapy
C. Calcium hydroxide pulpotomy
D. Conventional root canal therapy
E. Apexification
Bite wing radiographs should be made?
A. annually beginning at age 6 years
B. at age 3 years and every 6 months thereafter
C. only after primary molar proximal spaces are contact
D. at age 3 years and every 2 years to age 12 years
The first permanent molar typically erupts when a child is about ___ years old.
A. 8-9
B. 13-14
C. 11-22
D. 5-6
The definition of primate space is:
A. The space mesial to the mandibular primary canines and distal to the maxillary primary canines
B. The space distal to the mandibular primary canines and distal to the maxillary primary canines
C. The space mesial to the maxillary primary canines and distal to the mandibular primary
canines
D. The space mesial to the maxillary primary canines only
An 8-year-old patient presents to your office for an emergency visit with a traumatic exposure
of tooth #9. The treatment of choice for this patient is:
A. Root-end closure procedure / apexification
B. Traditional root canal therapy
C. Vital pulp therapy/apexogenesis
D. Partial pulpectomy
E. Temporization and reevaluation in 1 week
A 4-year-old child has fallen and hit his central incisor. Over time, the tooth has become
increasingly more discolored and does not resolve. The most likely cause of the discoloration is:
A. Endemic fluorosis
B. Systemic drugs
C. Enamel hypocalcification
D. Intrapulpal hemorrhage
E. Amelogenesis imperfecta
A 9-year-old patient has avulsed tooth #8 in a playground accident. His mother has recovered
the tooth and has called to ask how it should be stored while she gets her son to your office. The
best way to store an avulsed tooth for the best prognosis is:
A. Dry
B. Tap water
C. Saline
D. Saliva
E. Milk
A primary tooth has an exposed vital pulp. The tooth has less than two-third of its root
remaining and caries perforating the furcation. There is a succedaneous tooth forming normally
apical to the tooth. The treatment of choice for this tooth is:
A. Indirect pulp cap
B. Pulp cap
C. Pulpotomy
D. Extraction
E. Root canal therapy
Which of the following best illustrates the reason why calcium hydroxide is not used
endodontic procedures involving the primary dentition?
A. Can cause external resorption
B. Promotes the formation of reparative dentin
C. Has an alkaline pH
D. Produces no anti-microbial effect
A 15-year-old male with a history of epilepsy and grand mal seizures presents for routine
dental care. His medical history is otherwise unremarkable. Upon examination, he is noted to
have generalized moderate gingival hyperplasia. Which of the following drugs is the most likely
cause of his gingival hyperplasia?
A. Sodium valproate
B. Cyclosporine
C. Verapamil
D. Nifedipine
Excision of the frenum when midline diastema occur between two maxillary incisors is
indicated __________.
A. Before orthodontic treatment
B. When the central incisors begin to change position
C. When the child is 12 years old
D. When all permanent teeth are fully erupted
Pulpal infection in primary mandibular posterior teeth is first manifested on a radiograph in the
area __________.
A. Of bifurcation
B. At the apex of the root
C. Around the permanent tooth bud
D. Near the crest of the alveolar bone
E. None of the above
An 8 year old girl has a diastema between her maxillary central incisors. The maxillary lateral
incisors are erupted and in the proper position. The diastema can be caused by?
A. an abnormal frenum attachment
B. a mesiodens
C. the normal developmental process
D. A and C
E. A and B
F. all of the above
A 12-year-old boy has arrived in your office after a fall that fractured tooth #9 up to the
gingival margin on the mesial aspect with a pulp exposure. What is the appropriate treatment?
A. Extraction
B. Pulpotomy
C. Direct pulp cap
D. Root canal therapy
E. Apexogenesis
What determines the maximum dose of local anesthesia for a child?
A. Age
B. Weight
C. The procedure to be accomplished
D. The desired degree of pulpal anesthesia
Which of the following is the best space maintainer?
A. A nance holding arch
B. A fixed lingual arch
C. A band and loop appliance
D. A removable acrylic appliance
E. A pulpectomized primary molar
If the eruption sequence of permanent teeth is normal, one can expect?
A. Maxillary second premolars to precede maxillary first premolars
B. Maxillary second premolars to precede maxillary canines
C. Maxillary canines to precede mandibular canines
D. Both a and c
E. Both b and c
Which of the following represents the normal relationship of the primary canines?
A. The distal inclined plane of a maxillary canine articulates with the mesial inclined plane of the
mandibular canine
B. The mesial inclined plane of a maxillary canine articulates with the distal inclined plane of the
mandibular canine
C. Normal articulation of primary canines is cusp to cusp
D. Either a or b above, depending on age
Surgery on the hard palate of a 3-year-old cleft patient may inhibit growth centers, causing
the facial profile to become
A. Straight
B. Elongated
C. Shortened
D. More convex
E. More concave
If one has injected 2 carpules of 2% lidocaine to produce local anesthesia for dental
procedures, how many milligrams of anesthetic has the patient received?
A. 36 mg
B. 42 mg
C. 72 mg
D. 96 mg
If a 7-year-old patient loses a primary mandibular canine about the same time the adjacent
lateral incisor is erupting or shortly thereafter, the dentist should be alert to the possibility of
A. A tongue habit
B. A developing crossbite
C. Early eruption of the permanent canine
D. Crowding of the mandibular anterior teeth
The following signs and symptoms are contraindicated for a pulpotomy in a primary molar
except?
A. Internal resorption
B. History of cellulitis
C. History of severe toothache at night
D. History of sensitivity to cold drinks
The following are advantages of using a rubber dam except?
A. Muffles cries of a child
B. Aids in management of child behavior
C. Reduces the danger of aspiration of debris
D. Permits greater control of the operating field
All of the following are correct with regards to treatment of a diastema except:
A. Spaces will always close as permanent canines erupt.
B. Diastema of 2 mm or less usually closes spontaneously if lateral incisors are in good position.
C. Teeth should be aligned first if the diastema is caused by an abnormal frenum.
D. In such cases, a frenectomy should be performed after canines have erupted.
The psychological basis for the use of the “tell-show-do” approach to child management in
the dental office is that?
A. It overcomes the basic fears known to be present at birth
B. It is the most effective approach to overcoming the influences of overindulgence
C. Children are less likely to fear that with which they are familiar
D. The technique distracts the patient from the more unpleasant procedures
A 3-year-old female presents with Stickler syndrome. Upon examination, she is noted to have
the following abnormalities: posterior displacement of her tongue, cleft palate, and mandibular
micrognathia. This triad of anomalies is well recognized and is seen isolated and in association
with other syndromes. What is this triad of anomalies more commonly known as?
A. Klinefelter sequence
B. Apert sequence
C. Pierre Robin sequence
D. Gorlin sequence
E. Gardner sequence
A pediatric patient is scheduled to have multiple restorative procedures carried out in the
operating room under anesthesia. The drug chosen for anesthesia is fentanyl. Should this patient
show signs of respiratory depression, what would be the appropriate reversal agent?
A. Epinephrine
B. Naloxone
C. Flumazenil
D. Clonidine
E. Hydrocortisone
A child fractured a permanent maxillary central incisor 15mins ago. Examination of the tooth
reveals a very small (pin-point) pulp exposure and a wide open root apex. This condition is best
treated by?
A. Formocresol pulpotomy
B. Pulpectomy and root canal
C. Calcium hydroxide pulpotomy
D. Direct pulp capping with CaOH
E. Direct pulp capping with ZOE
The following are generalized causes of delayed tooth eruption except?
A. hereditary gingival fibromatosis
B. down syndrome
C. rickets
D. hyperparathyroidism
Primary molar relationships are known as?
A. class relationships
B. step relationships
C. primitive relationships
D. occlusion relationships
A child has maxillary incisor protrusion, an anterior open bite, crowded lower anteriors, and a
high palatal vault. Which of the following most likely caused this problem?
A. mouth breathing
B. thumb sucking
C. tongue thrusting
D. using a pacifier
E. nocturnal grinding
The primary teeth erupt in which of the following sequences?
A. ABCDE
B. BACDE
C. ABDCE
D. ACBDE
Primary teeth are more constricted at the cervical 3rd than their permanent counterparts.
Pulp chambers are comparatively smaller in primary teeth.
A. Both statements are true.
B. Both statements are false.
C. The first statement is true; the second is false.
D. The first statement is false; the second is true.
Both the mesial-step and flush-terminal-plane relationships usually result in the development
of a?
A. Class I permanent molar occlusion
B. Class II permanent molar occlusion
C. Class III permanent molar occiusion
On which primary tooth can one find an oblique ridge and, occasionally, a fifth cusp of
Carabelli?
A. Mandibular 1st molar
B. Mandibular 2nd molar
C. Maxillary 1st molar
D. Maxillary 2nd molar
Which of the following is the smallest primary molar?
A. Maxillary 1st
B. Maxillary 2nd
C. Mandibular 1st
D. Mandibular 2nd
All of the primary teeth have just completed root formation at what age?
A. 1-1 and 1/2 years
B. 1 and 1/2-2 years
C. 2-3 years
D. 3-4 years
E. 4-5 years
How many cusps does the primary mandibular 2nd molar typically have?
A. 1
B. 2
C. 3
D. 4
E. 5
Permanent incisors often erupt ______ to their primary counterparts.
A. buccal
B. lingual
C. directly underneath
D. lateral
The differential diagnosis of white “spots” of the enamel of primary and permanent teeth
should include disorders that have a substantiated cause. Which of the following DO NOT have
an evidence-based causal relationship with enamel hypoplasia?
A. Rickets
B. Congenital syphilis
C. Measles
D. Fluorosis
A 6 year old patient weighing 25 kilograms has to undergo extraction. How many anesthetic
carpules are allowed for her?
A. 2 carpules
B. 2.5 carpules
C. 1.4 carpules
D. 3 carpules
Fluoride varnish contains?
A. 8% stannous fluoride
B. 1.23% acidulated phosphate fluoride
C. 5% sodium fluoride
D. 2% sodium fluoride
Radiograph examination revealed several missing primary and permanent teeth. No teeth had
been extracted. History indicated practically no perspiration during hot, summer months. What’s
the diagnosis?
A. Cleidocranial dysostosis
B. Ectodermal dysplasia
C. Pierre robin syndorme
D. Treacher collins syndrome
Radiograph reveal absence of pulp chamber of the second molar. This is pathognomonic of?
A. Cleidocranial dysostosis
B. Amelogenesis imperfecta
C. Hutchinson’s dentition
D. Dentinogenesis imperfecta
A 7-year-old child shows premature loss of primary mandibular canines. He has no caries in
his remaining teeth. This situation strongly suggests?
A. Caries
B. Lack of dental care
C. Insufficient arch length
D. A developing Class III malocclusion
Systemic etiologic factors that are said to be associated with enamel defects such as
hypoplasia occur generally in what period of time?
A. Before birth.
B. Generally after birth and before the age of 6 years.
C. During the first year postpartum for Hutchinson’s incisors.
D. During birth.
All these conditions are associated with supernumerary teeth except:
A. Gardner syndrome
B. Down syndrome
C. Ectodermal dysplasia
D. Cleidocranial dysplasia
E. Sturge–Weber syndrome
The most common congenitally missing primary tooth is the?
A. primary mandibular canine
B. primary maxillary lateral incisor
C. primary maxillary canine
D. primary mandibular first molar
A child, age 7 and 1/2, has a 2.5mm space between the permanent maxillary central incisors.
The lateral incisors are half erupted. Advice to the parent should be that?
A. The condition should be corrected because it is hindering the eruption of the lateral incisors
B. Research has not at this time found a reason for the condition, but it will be self-correcting
C. At this age the condition is not regarded as abnormal
D. The lingual frenum should be dissected immediately
E. The condition should be corrected for esthetic reasons
At what age is a child expected to have 12 primary teeth and 12 permanent teeth?
A. 6 and 1/2 years
B. 7 and 1/2 years
C. 8 and 1/2 years
D. 10 and 1/2 years
E. 12 and 1/2 years
Which of the following is used to maintain the space of one prematurely missing primary
molar?
A. Lingual holding arch
B. Distal shoe
C. Band and loop
D. A and B
E. B and C
A pediatric patient has premature loss of tooth #A, but tooth #B is present, and #3 has not
erupted yet. What is the best space maintainer for this situation
A. Hawley with finger spring
B. Hawley without finger spring
C. Distal shoe
D. Nance appliance
The treatment of choice for a normal girl whose dental age is 10 years and who has lost a
primary mandibular first molar is?
A. A steel crown and loop space maintainer
B. An acrylic unilateral partial denture
C. A band and loop space maintainer
D. A temporary three-unit bridge
E. No treatment
Extremely early loss of primary teeth results in?
A. no change in the time of eruption of the permanent teeth
B. early eruption of the permanent teeth
C. delayed eruption of the permanent teeth
D. ankylosis of the permanent tooth
A stainless steel crown should normally extend below the gingival crest approximately
______mm.
A. 1.0
B. 1.5
C. 2.0
D. 2.5
E. None of the above
Which of the following medicaments is indicated to obturate the canals of a primary tooth in
which a pulpectomy was performed?
A. Gutta percha
B. Calcium hydroxide
C. Zinc oxide eugenol
D. Calcium hydroxide - CMCP paste
