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ABGD study > Pedo- ABGD > Flashcards

Pedo- ABGD Flashcards

1
Q

What is the eruption sequence for primary teeth?

A

ABDCE

Max: In months:
(6-10: 8-12: 11-18: 16-20: 20-30)
Mand:
(5-8: 7-10: 11-18: 16-20: 20-30)

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2
Q

What is the eruption sequence for MAX PERM teeth?

A

61245378

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3
Q

What is the eruption sequence for MAND PERM teeth?

A

61234578

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4
Q

Spacing- name of classification and types

A

Baume Type 1: 2/3 of primary dentition, generalized
Type 2: 1/3 non-spaced

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5
Q

Ideal overjet, Overbite and overlap in primary dentition

A

OJ: 0-3mm
OB: 2mm
OL: 30-50%

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6
Q

Describe the mesial step and what it will likely lead to?

A

mandibular is forward (most like class 1, MB in mand B groove)- 14% of patients
most likely to class 1
possible class III

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7
Q

Describe the distal step and what it will likely lead to?

A

Md is back. always lead to class II
10% of patients

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8
Q

Describe the flush and what it will likely lead to?

A

End to end- 76% of patients
56% have a late mesial shift to class I
46% stay end to end or shift to class II

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9
Q

What is the best predictor of sagittal relationships?

A

primary canines

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10
Q

What is incisor liability

A

size different between primary and perm incisors. larger perm

gained from spacing in primary dentition, labial eruption of perm incisors, and intercainine width increase

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11
Q

What is the incisor liability for max arch

A

7.1mm (ortho says 7mm)

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12
Q

What is the incisor liability for mand arch

A

5.1mm (ortho says 6mm)

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13
Q

What is the intercanine width increase? MAX and MAND

A

MAX: 3mm
MAND: 2.4mm

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14
Q

What is leeway space?

A

Size difference in perm pm and primary molars. primary molars are larger. M-D AKA

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15
Q

What is the anticipated space gained in MAX and MAND leeway space?

A

MAX: 0.9-1.2mm/side
MAND: 1.7-2.4mm/side

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16
Q

What is the late mesial shift?

A

loss of leeway. M tipping of PERM 1st molars after primary 2M exfoliate. Helps to make class I

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17
Q

What is the Early mesial shift

A

closure of space. Perm molars guide on the primary 2M roots and closes the space ~4yo.

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18
Q

neonatal is

A

during the 1st month after of birth

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19
Q

natal is

A

@birth

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20
Q

What are 3 pediatric oral anomalies - neonatal or natal?

A

Bohn Nodules
Dental Lamina Cyst
Epstein Pearls
Staining

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21
Q

Mucous gland tissue on the MAX RIDGE is called

A

Bohn nodules

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22
Q

Remnants of the dental lamina on the CREST of the alveolar ridge

A

Dental Lamina Cysts

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23
Q

trapped epithelial remnants on the mid palatal raphe

A

Epstein pearls

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24
Q

What causes color changes in developing teeth?

A

Tetracycline at 3-5 months-7years
CF, Trauma

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25
Q

What 4 teeth are most likely likely to be congenitally missing?

A

3rdM > Mand 2PM > Max Lat > Max 2PM

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26
Q

What is it called when there is one root but two crowns

A

Gemination

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27
Q

What is it called when there are two teeth together- typically with 2 pulps.

A

Fusion- no additional teeth. sometimes looks like a missing tooth.

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28
Q

What are the benefits of Fluoride

A

inhibit demineralization, remineralization, antibacterial (disrupts enzyme systems) decrease in solubility of the tooth

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29
Q

What is the % and ppm of the F ion in toothpaste

A

0.1%, 1000ppm

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30
Q

What is the % and ppm of the F ion in rx toothpaste (prevident)

A

1.1%, 5000ppm

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31
Q

What is the % and ppm of the F ion in mouth rinses like ACT?

A

.05% NaF, 227ppm
0.2 NaF = 900ppm

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32
Q

What is the % and ppm of the F ion in varnish

A

5% NaF, 22,700ppm
1.23% APF = 12,300 can etch porcelain

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33
Q

Optimal level of F in water?

A

0.7ppm

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34
Q

If the patient is > than 6 mo old, how much to supplement fluoride?

A

H2O has <0.3
6mo-3y = 0.25
3y-6y = 0.5mg
6-16y = 1g
H2O has 0.3-0.6
3-6yo =0.25
6-16 = 0.5 mg

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35
Q

How much more F release do we see from SDF?

A

2-3x more

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36
Q

Whats the caries reduction % when using SDF?

A

80%

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37
Q

How much SDF and what ppm?

A

35% SDF = 44,800 ppm F

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38
Q

Contraindications for SDF?

A

desquamative gingiva, allergy to silver, esthetic conerns
Dont give the SSKI (potassium iodide-delays staining) to someone who is pregnant

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39
Q

How many teeth does one drop of SDF treat?

A

5-8

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40
Q

How to apply SDF?

A

Dry tooth, apply, wait 30-60 seconds, dry.

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41
Q

What is the makeup of SDF

A

24.4-28.8% silver, 5-5.9% F at a pH of 10

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42
Q

How does SDF provide benefits?

A

F: squamous layer plugs for dentin tubules. fluorapatite.

Silver is antimicrobial and breaks down membranes, inhibits DNA replication, fights MMP and collagenases to resist enzymatic destruction.

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43
Q

What is the pH of SdF

A

10

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44
Q

Early childhood caries- how to define?

A

any caries in a kid younger than 6yo

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45
Q

Severe ECC- how to define?

A

caries in anyone under 3
DMF >/= 4@3yo
5@4yo
6@5yo

DMF- decayed missing filled

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46
Q

How to pulpotomy- on primary teeth

A

remove infected tissue. using fomocresol(1min), ferric sulfate (10-15 sec), 5% NaOCl (30 secs) elecrosurg or lazer, stop bleeding and disinfect.
Place MTA or Biodentine on top.

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47
Q

What are the 3 zones of fixation when using fomocresol?

A
  1. Acidophillic
    2 Broad pale staining
  2. Zone of inflammation
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48
Q

Pulpectomy- how to? on primary teeth

A

clean and shape. Obturated with CaOH, zinc Oxide/Eugenol, or Iodoform/CaHydroxide.

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49
Q

What are the conversion ratio for the types of Fluoride?

A

NaF = 2.2, SnF2 = 4.1 APF = 1

50
Q

What ppm is 2% F?

A

2% F x 10= 20 mg/g
20mg/g / 2.2(conversion ratio) = 9.009 mg/g F ion x 1000 = 9090 ppm

51
Q

What is the toxicity of F per kg?

A

5mg F / Kg
LETHAL 15mg F/kg

Death in 4 hrs.

52
Q

Signs of F toxicity?

A

GI, CNS; Death in 4 hrs

53
Q

Is it toxic:
A 30 lb(13.62 kg) 3yr old ingests 3oz of Aim toothpaste where there is 170g in 6oz

A

YES its toxic..

0.24% NaF x 10= 2.4/2.2= =1.090 mg/g F ion= 1090 ppm=1mg/mL

3oz=85mL or 85mg F

13.62 x 5mg/kg(toxic)=68.1mg

54
Q

Space Maintenance: PRIMARY DENTITION: what to do if 2M are missing?

A

distal shoe

55
Q

Space Maintenance: PRIMARY DENTITION: what to do if 1M are missing?

A

Band & Loop/ Crown and loop

56
Q

Space Maintenance: PRIMARY DENTITION: what to do if multiple molars are missing?

A

Removable acrylic saddle

57
Q

Space Maintenance: Early Mixed DENTITION: what to do if 2M are missing?

A

MAX: Nance, Transpalatal Arch, B&L(r)
MAND: B&L (r)

57
Q

Space Maintenance: early mixed DENTITION: what to do if multiple molars are missing?

A

Mx: Nance, Transpalatal Arch
Md: Removable acrylic saddle

58
Q

Space Maintenance: Early Mixed DENTITION: what to do if 1M are missing?

A

B&L or NON

58
Q

Space Maintenance: LATE Mixed DENTITION: what to do if 2M are missing?

A

Mx: Nance, Transpalatal Arch
Md: LLHA

59
Q

Space Maintenance: LATE Mixed DENTITION: what to do if 1M are missing?

A

None

60
Q

Space Maintenance: LATE Mixed DENTITION: what to do if 1M are missing?

A

Mx Nance
Md: LLHA

61
Q

How to define Early Mixed dentition

A

First permanent molars erupted
Some or none of the permanent incisors erupted

Lower lingual holding arch could impede eruption

62
Q

How to define Late mixed dentition

A

Permanent first molars erupted
All permanent incisors erupted

63
Q

Frankel scale: most compliant to least

A

4, 3, 2, 1

64
Q

What doe N2O effect?

A

CNS for anxiolysis, slight analgesia

65
Q

What % of N2o is ideal

A

30-40%, no more than 50%

66
Q

Contraindications to N2O

A

COPD, drug dependencies, 1st trimester of Pregnancy, Nasal obstruction, large meal within 2 hrs, tx with bleomycin sulfate, methylenetetrahydrofolate reductase deficiency, B12 deficiency

67
Q

What is the max Lido dose for pedo

A

4.4mg/kg

67
Q

What is the max mepivicaine dose for pedo?

A

4.4mg/kg

67
Q

What is the max septodose for pedo?

A

7mg/kg

68
Q

What is the dosage for APAP for kids <12?

A

10-15mg/kg/dose
Q4-6H
MAX: 90mg/kg/day

68
Q

What is the dosage for IBU for kids <12

A

4-10mg/kg/dose
Q6-8h
max: 40mg/kg/day

68
Q

ITR vs ART?

A

IRT: GI cements, provisional WITH F/U
ART: no f/u planned

68
Q

What drugs might be used for sedation other than N2O?

A

Midazolam (Versed), Triazolam, Diazepam, - benzos
Meperidine/Hydroxyzine

68
Q

What is the classification system and scale for tonsils?

A

Brodsky:
1: <25%
2: 2-50%
3: 50-75%
4: >75%

69
Q

Mallampati classification

A

1-4.

70
Q

What is different about the enamel and dentin of primary teeth vs perm

A

primary teeth have thinner enamel and dentin, with enamel rods directing occlusal
broader, flatter contact. brighter and lighter in color

71
Q

Primate spaces- where?

A

Mand- Distal to the canine
Maxillary -Mesial to the canine

72
Q

Average (early) age of eruption of primary central incisors?

A

MAND: 5 mp
Max: 6 mo

73
Q

Average age of eruption of primary laterals

A

MAND: 7
Max: 8 mo

74
Q

Average age of eruption of primary canines

A

16-20 months

75
Q

Average age of eruption of primary 1M?

A

11-18 months

76
Q

Average age of eruption of primary 2M?

A

20-30 months

77
Q

When do primary teeth start calcification?

A

4 months in utero

78
Q

What is the order of eruption for adults

A

Mand CI then Max CI
MAN LI, then MaxLI
Mad Can
Mx then Mand- 1PM
Mx then mand 2PM
MAX canine
2M
3M

78
Q

At what age does the 1st perm molars calcify

A

birth

79
Q

At what age does the lateral incisors erupt?

A

Mx 8-9,
Md: 7-8

79
Q

At what age does the central incisors erupt?

A

Mx: 7-8y
Md: 6-7 y

80
Q

At what age does the canines erupt?

A

Mx: 11-12
Md: 9-11

81
Q

At what age does the 1PM erupt?

A

10-12 y

82
Q

At what age does the 2PM erupt?

A

Mx: 10-12, Md: 11-13

83
Q

At what age does the 1M erupt?

A

5.5-7

84
Q

At what age does the 2M erupt?

A

12-14

85
Q

At what age does the 3M erupt?

A

17-30

86
Q

Ages Crowns are complete?

A

C: 4-5
LI: 4-5
Can 6-7
1PM: 5-6
2PM: 6-7
1M: 30-36 months
2M: 7-8

87
Q

At what age do roots finish forming?

A

C: 4-5
LI: 4-5
Can 6-7
1PM: 5-6
2PM: 6-7
1M: 30-36 months
2M: 7-8

88
Q

When do D E F G exfoliate?

A

6-8yrs

89
Q

When do N O P Q exfoliate?

A

6-8yrs

90
Q

When do C H M R exfoliate?

A

10-11

91
Q

When do B I L S exfoliate?

A

10-11

92
Q

When do A J K T exfoliate?

A

12-13

93
Q

What are some behavior
management options for a
crying child in your dental chair?

A

Positive pre-visit imagery
Direct observation
Tell-show-tell
Ask-tell-ask
Voice Control
Non-verbal communication
Positive reinforcement and descriptive praise
Distraction
Memory restructuring
Parental presence or absence
Communication techniques w/ parents
Nitrous oxide and oxygen inhalation

94
Q

What is the ideal amount of nitrous oxide to administer?
What is the maximum limit?

A

ideal: 30-40%,
Max 50%
O2 always 50%>

95
Q

What are some contraindications to Nitrous
Oxide usage?

A

COPD
Severe emotional disturbances
Drug related dependencies
1st trimester of pregnancy
Nasal obstruction
Inability to accept nasal hood
Large meal within 2 hours of tx
Treatment with bleomycin sulfate (ABX used in
chemotherapy)
Methylenetetrahydrofolate reductase deficiency
(enzyme responsible for processing amino acids)
Vitamin B12 deficiency

96
Q

What makes a primary tooth a poor candidate for
pulpotomy?

A

If there is a history of:
Severe toothache
Persistent toothache
Abnormal mobility
Percussion pain

97
Q

When would you consider a CVEK pulpotomy? Describe the technique

A

Vital Tooth pulp exposure, asymptomatic Partial pulpotomy, preserves pulp vitality, allows apexogenesis

Technique:
RDI, Sterile bur, remove 2-3mm of pulp, hemostasis (CHX or NaOCl), MTA, CaOH, restore with sealing restoration, radiographs at 6, 12 months

98
Q

What is CAMBRA?

A

Caries Management By Risk Assessment
-current decay levels (# of decayed
teeth)
-current bacterial challenge
-decay history (DMF index)
-dietary habits
-current meds
-saliva status (amt, buffering)
-medical conditions
-oral appliances present
-oral hygiene habits

99
Q

What should be done in the
case of fluoride toxicity?

A
  • <8mg/kg: milk, observe
  • > 8mg/kg or unknown: induce vomiting, milk, ER,
    they will lavage with 1-5% calcium chloride soon (Fl binds in stomach)
    Milk can help reduce absorption
    Ex. 1 6oz tube of toothpaste is about 180mg Fl for a 30lb (15kg) child, half the tube (3oz) would be toxic

Symptoms of toxicity: Gastric and Headaches

100
Q

What is the treatment of a
trauma case?

A

Check head and C-spine
Check soft tissue
Treat Teeth

101
Q

Best Transport media for
avulsed teeth

A
  1. Tooth socket
  2. Cell preserving fluid (hank’s balanced salt solution)
  3. Milk
  4. Sterile saline
  5. Saran Wrap
  6. Saliva
    NOT WATER and try NOT dry
102
Q

What is SDF? How does it work?

A

-38% silver diamine Fl
-44,800ppm Fl
-approved for sensitivity; off label use for caries reduction
-80% caries reduction (twice that of Fl alone)
-2-3x Fl retained than other types
-silver is anti-microbial: breaks cell membranes, inhibits DNA replication
-“zombie effect”: bacteria consume SDF impregnated bacteria
-Fl prevents demineralization and promotes
remineralization
-squamous layer plus dentin tubules, decreases sensitivity
-counteracts MMPs and cysteine catchepsins
(collagenases) to resist enzymatic digestion

103
Q

SDF Advantages and
Disadvantages

A

Advantages:
-inexpensive
-quick
-no anesthetic
Disadvantages:
-unesthetic
-doesn’t restore form/function

104
Q

Describe the SMART Technique

A

Place opaque GI over SDF
treated lesion

105
Q

Different types of fluoride
levels (PPM)
Varnish:
SDF:
ACT:
OTC Toothpaste:
ClinPro/Prevident:

A

Varnish: 22,700
SDF: 44,800
ACT: 227
OTC Toothpaste: 1,000
ClinPro/Prevident: 5,000

106
Q

Physical differences between
primary and permanent teeth

A

Primary:
-thinner enamel
-broader contacts
-more bulbous crowns
-wider M-D
-shorter O-C

107
Q

How much Fl is in water?

A

0.7-1.2 PPM

108
Q

What is a serial extraction and
its sequence?

A

-Phase 1 Orthodontics when there is severe crowding (>10mm/arch) but no skeletal problem
-Not a sub for comprehensive care, potentially makes phase 2 easier
-NOT ROUTINE

Goal: Prevent Incisor Crowding

No Set EXT sequence:
-prim incisors (if necessary)
- prim canines (8-9) to allow room for incisors
-lower primary first molar (encourages early eruption of PM when root is 2/3rd formed
-*lower canine usually erupts prior to lower premolars
-first premolars for canine space

109
Q

Exfoliation Sequence for
Primary Teeth:

A

Max:ABDEC
(7-8: 8-9: 9-11: 9-12: 11-12)
Mand: ABCDE
(6-7: 7-8: 9-11: 10-12: 11-13)

110
Q
A

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