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PEDO Competency Flashcards

1
Q

are generally associated with

recent bruising

A

red/purple/blue

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2
Q

Class III Fractures Emergency Treatment Primary teeth

options

A

•  Partial pulpotomy in immature incisor
–  Ram D, Holan G. Partial pulpotomy in a
traumatized primary incisor with pulp exposure. Pediatr Dent 16:44-48, 1994
dentition. Dent Traumatol 18:287-298, 2002 deflections of succeeding permanent incisors
•  Pulpotomy when no resorption has begun
–  Flores M. Traumatic injuries in the primary •  Pulpectomy with resorbable paste – 20%
–  Coll et al. 1996, Flaitz et al. 1989 •  Extraction

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3
Q

Injuries to Developing Teeth are greatest at what age

A

1-3

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4
Q

Intrusion Emergency Treatment Permanent teeth Closed apex, up to 3 mm

A

spontaneous

eruption

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5
Q

contraindications to LLHA

A

–  Permanent incisors unerupted

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6
Q

Class III Fractures Emergency Treatment Primary teeth

often depends on what

A

pt’s behavior

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7
Q 
•  An injury to
the tooth-
supporting
structures
with abnormal
loosening, but
without
displacement
of the tooth
A

Subluxation

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8
Q

Intrusion Emergency Treatment Permanent teeth

•  Open apex, up to 7 mm:

A

spontaneous

eruption

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9
Q

–  loss of primary second molar before eruption
of permanent first molar
what space maintainer

A

distal shoe

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10
Q

are generally associated

with older healing bruising

A

Yellow/brown and green

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11
Q

Lateral Luxation Emergency Treatment Permanent teeth

A
  •   Reposition with digital pressure
  •   Flexible splint for 4 weeks
  •   Rx chlorhexidine mouth rinse
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12
Q

Extrusion Emergency Treatment Permanent teeth

A
  •   Reposition with digital pressure
  •   Flexible splint for 2 weeks
  •   Rx chlorhexidine mouth rinse
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13
Q

Intrusion Emergency Treatment Permanent teeth Closed apex, 3-7 mm

A

orthodontic or surgical

repositioning

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14
Q

Home Care

for splinted teeth

A 
•  NO BITING
on splinted
teeth!
 •  Soft diet
 •  Good oral
hygiene
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15
Q

Premature loss in the primary dentition

generally leads to what

A

delays eruption of the successor

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16
Q

Lateral Luxation Emergency Treatment Primary teeth

Retrusion

A

–  if no occlusal interference, then allow
spontaneous repositioning
–  with occlusal interference, must be
repositioned (but do not splint) or extracted

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17
Q

Craniofacial, head, face, neck injuries in

more than in childabuse

A

more than half

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18
Q

goal of the cvek partial pulpopotmy is to what

A

maintain tooth vitality. take a PA to see if the root is still growing

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19
Q

Intrusion Emergency Treatment Primary teeth

A

•  If tooth was displaced labially (toward or
through labial bone plate), then allow
spontaneous re-eruption
•  If tooth displaced into developing tooth
bud, then extract

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20
Q

Avulsion
 Follow-Up Permanent Teeth

A 
Pulpectomy:
remove pulp and
fill with CaOH
within 7-14 days
 •  Complete gutta
percha fill in 2-12
months
–  No need to
complete endo if it
becomes
ankylosed
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21
Q

Nance & TPA

are indicated when

A

–  Bilateral tooth loss in maxilla

–  edentulous span more than one tooth in maxilla

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22
Q

•  A complete
displacement
of the tooth out
of its socket

A

Avulsion

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23
Q

contraindications for space maintenance for using band and loop

A

Edentulous space is more than one tooth

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24
Q 
•  A displacement of
the tooth in a
direction other
than axially
•  This is
accompanied by
comminution or
fracture of the
alveolar socket
A

Lateral Luxation

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25
Class III Fractures Emergency Treatment Permanent teeth | Mature tooth with closed apex
–  Pulpectomy
26
what is different about the IAN block in a child
```  The mandibular foramen is situated slightly lower and more posterior in a child.  Lower than the level of the occlusal plane. ```
27
Subluxation Follow-Up
*   Follow-up in 2 weeks | *   Radiograph in 1 month
28
Class II Fractures Emergency Treatment Primary teeth
•  Do nothing? •  Composite/GI “Band-Aid” –  then monitor for symptoms •  Restore with composite/GI?
29
Emergency Treatment Primary teeth | Severe
–  Extract
30
name the diagnosis | –  capable of healing and therapy
Reversible pulpitis
31
are the most common type of injury | in abused and non-abused children
Bruises
32
Youngest children most vulnerable | •  70% that die from abuse are under
4
33
Extrusion Follow-Up Permanent teeth
•  Pulpectomy: remove pulp and fill with CaOH within 7-14 days •  Complete gutta percha fill in 2 months if no inflammatory resorption
34
three pulpotomy medicaments
*   Formocresol *   Ferric Sulfate *   Mineral Trioxide Aggregate (MTA)
35
is someone required by law to report if they suspect or know that child abuse if occurring.
mandated reporter
36
Considerations in the Mixed Dentition •  Regarding loss of primary first molars
Regarding loss of primary first molars: –  Space loss is negligible if the permanent first molars are erupted and in occlusion and primary second molars remain –  Space maintenance is unnecessary
37
Concussion
 Emergency Treatment Primary teeth
*   No emergency treatment *   Discuss potential sequelae with parents *   Monitor for symptoms
38
Intrusion Emergency Treatment Permanent teeth Open apex, more than 7 mm
orthodontic or | surgical repositioning
39
Extrusion Emergency Treatment Primary teeth •  Minor (<3mm)
–  Reposition (but don’t splint) | –  Spontaneous alignment
40
Indirect Pulp Cap (IPC) | •  Selection Criteria
–  Restorable tooth –  Near pulp exposure radiographically –  VITAL Pulp:
41
Class I Fractures Emergency Treatment Primary teeth
•  Do nothing? •  Smooth rough edges •  Restore with composite?
42
``` An injury to the tooth-supporting structures without abnormal loosening or displacement of the tooth but with marked reaction to percussion. ```
concussion
43
–  Bilateral tooth loss after eruption of permanent | incisors in mandible what space maintener to use
LLHA
44
Class II Fractures Emergency Treatment Permanent teeth
``` •  Do nothing? •  Bond fragment if available •  Composite/GI “Band-Aid” –  then monitor for symptoms •  Restore with composite/GI ```
45
–  Bilateral loss of a primary molar before the eruption of the permanent incisors what space maintenance to use
Band and Loop
46
Lateral Luxation Emergency Treatment Primary teeth | Protrusion
–  Extract (contact with developing tooth bud)
47
A displacement of the tooth into the alveolar bone
Intrusive Luxation
48
Considerations in the Mixed Dentition •  If it’s getting close to normal exfoliation, then premature loss
If it’s getting close to normal exfoliation, then premature loss accelerates eruption of successor
49
Long acting, most toxic | anethestheic
Bupivicaine
50
Sequelae of Dental Trauma What parents should watch for
•  Watch for it to start hurting –  Waking up at night –  Stops eating and drinking •  Color change •  Swelling –  Facial swelling –  “Pimple” of pus on the gums above the tooth •  Tooth getting loose
51
–  Most space loss occurs within
6 months
52
Common Appliances | used in space maintenance
Band and Loop •  Lingual Arch –  Lower lingual holding arch (LLHA) in mandibular –  Nance or transpalatal arch (TPA) in maxillary
53
areas tend to be bruised from abusive | mechanisms
soft tissue
54
max dose with epinephrine of articaine
7.0mg/kg
55
Transport Media | for avulsed tooth
``` •  Hank’s Balanced Salt Solution (HBSS) • MILK •  Saline •  Saliva (buccal vestibule) •  Water, if none above available ```
56
what space maintenance device to use Unilateral loss of primary first molar before eruption of permanent first molar or primary second molar
Band and Loop
57
Avulsion
 Emergency Treatment Primary Teeth
NEVER | re-implant primary teeth!
58
procedure for avulsion of immature permannet teeth
``` Revascularization (these are not the specifics) •  Stimulate bleeding through apex •  Place MTA on top of clot •  Allows continued root development and root wall thickening ```
59
Avulsion
 Emergency Treatment Permanent Teeth
•  Reimplant as soon as possible. Every minute counts! •  Flexible splint for 2 weeks •  Medications
60
Concussion
 Emergency Treatment Permanent teeth
*   No emergency treatment *   Discuss potential sequelae with parents *   Monitor for symptoms
61
Medications for Avulsion
 Emergency Treatment Permanent Teeth
–  Systemic antibiotics –  Chlorhexidine mouth rinse –  Ibuprofen: pain + inhibits bone resorption –  Tetanus?
62
Lateral Luxation Follow-Up Permanent teeth
•  Pulpectomy: remove pulp and fill with CaOH within 7-14 days •  Complete gutta percha fill in 2-4 months if no inflammatory resorption
63
1kg = how many pounds
2
64
Avulsion
 Follow-Up Immature Permanent Teeth | have the best prognosis when
Best prognosis if replanted within 20 minutes
65
Indications for VITAL Pulp Therapy
Intermittent, short duration pain | —  Thermal or chemical stimulation
66
Don’t use in pedo: methemoglobinemia anethesia
Prilocaine
67
Avulsion
 Follow-Up Immature Permanent Teeth
``` •  Replant and splint as with mature teeth •  Recall every 3-4 weeks •  If signs of necrosis, extirpate pulp and do revascularization procedure ```
68
Subluxation Emergency Treatment Primary teeth
*   No emergency treatment *   Monitor for symptoms *   Tooth may tighten
69
Class I Fractures Emergency Treatment Permanent teeth
•  Do nothing? •  Smooth rough edges •  Restore with composite?
70
``` Sharp demarcation between injured and healthy skin •  Implies that the affected area has ```
  Implies that the affected area has been immersed in a hot liquid
71
Pulpotomy | •  Selection Criteria
``` –  Restorable tooth with carious pulp exposure –  VITAL Pulp: •  NO spontaneous pain •  NO clinical signs •  NO radiographic signs ```
72
Intrusion Emergency Treatment Permanent teeth Closed apex, more than 7 mm
surgical | repositioning
73
``` A partial displacement of the tooth out of its socket ```
Extrusive Luxation
74
Class III Fractures Emergency Treatment Permanent teeth •  Young tooth with open apex or closed apex
–  Direct pulp cap | –  Partial pulpotomy (Cvek technique)
75
max dose with epinephrine of lidocaine
4.4mg/kg
76
Intrusion Follow-Up Permanent teeth | •  Pulpectomy
remove pulp and fill with CaOH within 7-14 days Complete gutta percha fill in 2 months if no inflammatory resorption
77
–  Edentulous span more than one tooth in mandible | what space maintainer to use
LLHA
78
are among the most common seen in abused children
Abusive injuries to the head and neck region are among the most common seen in abused children
79
how long to splint teeth
•  Maintain splint up to 2 weeks, longer if tooth demonstrates excessive mobility
80
Management at Site of Injury | for avulsed tooth
``` •  Replant immediately, if possible •  If contaminated, rinse with saline •  When cannot be replanted, place tooth in best transport medium available ```
81
``` This injury is accompanied by comminution or fracture of the alveolar socket ```
Intrusive Luxation
82
Subluxation Emergency Treatment Permanent teeth
*   No emergency treatment *   Monitor for symptoms *   Tooth may tighten
83
Pulpectomy | •  Selection Criteria:
``` –  Restorable Tooth –  Irreversible pulpitis or necrotic pulp –  Spontaneous pain –  Clinical signs –  Radiographic signs ```
84
One dental anesthetic cartridge = _mL
1.7 ml*
85
Establishment of a | dental home begins no later
12 months
86
what type of exam is used for kids
knee-to-knee
87
how much tooth paste for children under three
smear or rice-sized
88
how much toothpaste for children 3-6
pea sized
89
how often to apply fluoride varnish to moderate risk children
every 6 months
90
how often to apply fluoride varnish to high risk children
every three months
91
Any smooth surface caries in a child under | 3 is
severe-ECC
92
Kids need help brushing until
they can tie their | shoes
93
potential problems of sucking thumb
•  anterior open bite •  reduced arch width •  altered skeletal growth

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