Pediatrics and Edentulous patients

Question 1

2 areas of concern when working with pediatric patients

Answer 1

Smaller mouth

Don’t always cooperate

Question 2

When should a child’s first dental visit be?

Answer 2

Usually at 3 years but as early as 6 months

Radiographs not taken until contacts close, around 6 years

Question 3

Reasons for radiographs at preschool age

Answer 3

• examining development
• lesions
• accident and injury, examine extent of damage
• can accurately see carious lesions

Question 4

What disturbances in normal development may we look for with radiographs?

Answer 4

• permanent tooth may not erupt within normal time
• a tooth may be missing
• may be blocked in its normal eruptive passage
• malposed or impacted

Question 5

What will we see on pediatric radiographs?

Answer 5

• erupted primary-teeth – usually all present by age 3

- developing permanent teeth located within the alveolar bone

Question 6

What should happen during the childs first visit?

Answer 6

• Parents present
• Establish rapport
• Explain what youre doing; show them the equipment, let them touch, show them “pictures” of what youre going to do. Show them theirs after
• Demonstrate how to sit/act

Question 7

How to handle the refractory (uncooperative) child

Answer 7

• be firm
• let them know you are in command
• if they wont enter the room alone, have parents come in
• do not physically force them to cooperate

Question 8

What will dentist prescribe radiographs based on?

Answer 8

• teeth present
• caries risk
• age
• ability to cooperate

Question 9

The most satisfactory pedodontic images are

Answer 9

• intraoral bite-wings of posterior teeth

- periapical exposures of both arches

Question 10

Procedure for PA and BW

Answer 10

Same as with adults but compensate for smaller mouth; BAT instead of PT, use largest receptor possible

Question 11

When does a molar exposure need to be taken?

Answer 11

When the childs 12 year molars are developed or developing. Not usually until after 8 years

Question 12

What size film is used for occlusals

Answer 12

2 or 4

Question 13

Indications for occlusal images

Answer 13

To detect pathology, process of healing, eruption patterns, measure changes in the size or shape of the dental arches. Detection of foreign bodies

Question 14

Maxillary Topographical

Answer 14

• occlusal plane parallel to floor

- obtain horizontal and vertical angulation with BAT

Question 15

Maxillary Cross -Sectional

Answer 15

• same as topographical

- V.A. is increased; CR perpendicular to occlusal plane (+75).

Question 16

Mandibular topographical

Answer 16

occlusal plane is at 45o angle to the plane of the floor; bisect angle

Question 17

Mandibular Cross-Sectional

Answer 17

central ray is perpendicular to occlusal plane; Cross Sectional teeth will appear round and short.

Question 18

Pedodontic Image Alternatives

Answer 18

Panorex

Question 19

Reasons for taking images of edentulous patient

Answer 19

• to see if the infectious process is still present
• periodontal disease resulting in loss of teeth
• retained root tips
• unerupted teeth
• abnormalities of bone
• cyst

Question 20

Easiest method for surveying the edentulous patient

Answer 20

Panoramic

Question 21

Area of interest for edentulous radiographs

Answer 21

The ridges of maxillary and mandibular arches instead of the teeth and
supporting structure

Question 22

Are bitewings and FMS the same for edentulous patients?

Answer 22

bitewings are eliminated

FMS is the same
-Vertical placement of receptor should not extend more than ¼ “ above or below the ridge

Question 23

Patient with Small Ridge or No Ridge

Answer 23

1. receptor will be almost parallel to the floor
2. except for mandibular molars
3. vertical angulation is increased

Question 24

Receptor Holder for edentulous patients

Answer 24

• An intra oral receptor holder may be used
• The B.A.T. is still employed if needed
• The angulation is less severe in comparison to not using a receptor holder
• Cotton roll must be used on the biting surface
  a. for patient comfort
  b. for stabilization (takes the place of the crowns of teeth )