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Pedo > Pedo Final > Flashcards

Pedo Final Flashcards

1
Q

Minimal sedation

A

Respond normally
Some cognitive function and coordination may be impaired
Respiratory and cardiovascular function unaffected

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2
Q

Moderate Sedation

A

More effort required to get a response
Crying can be expected in young patients
Airway is intact
Ventilation and cardiovascular function intact

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3
Q

Deep sedation

A

Loss of protective reflexes
Loss of ability to maintain airway
Cardiovascular function may be impaired

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4
Q

5 Goals of Sedation

A
  1. Guard the patients’ safety and welfare
  2. Minimize discomfort and pain
  3. Control anxiety, minimize psychological trauma, maximize amnesia
  4. Control behavior and movement to allow safe completion of procedure
  5. Return patient to state of safe discharge
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5
Q

Office must have adequate what to provide sedation

A

Equipment to manage emergencies
Trained in monitoring
ACLS or PALS trained

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6
Q

1-3 yrs
Heart Rate
Blood Pressure
Respiratory Rate

A

70-110
90-105/55-70
20-30

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7
Q

3-6 yrs
Heart Rate
Blood Pressure
Respiratory Rate

A

65-110
95-110/60-75
20-25

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8
Q

6-12
Heart Rate
Blood Pressure
Respiratory Rate

A

60-95
100-120/60-75
14-22

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9
Q

12 yrs
Heart Rate
Blood Pressure
Respiratory Rate

A

55-85
110-135/65-85
12-18

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10
Q

When airway is too obscured

A

+3 or +4

Anything more than 50% blocked

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11
Q

ASA Class I

A

A normal healthy patient

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12
Q

ASA Class II

A

A patient with mild systemic disease (controlled reactive airway disease)

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13
Q

ASA class III

A

A patient with severe systemic disease (a child who is actively wheezing)

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14
Q

ASA class IV

A

A patient with severe systemic disease (a child with status asthmaticus)

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15
Q

ASA class V

A

A moribund patient who is not expected to survive without operation (a patient with severe cardiomyopathy requiring heart transplantation)

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16
Q

Medical History Evaluation

A

Allergies & previous reactions
Current medications. Dosage, time, route
Diseases or abnormalities, pregnancy in adolescent
Previous hospitalizations
History of previous sedation or anesthesia
Review of body systems
Family history of disease or sedation reactions
Age and weight

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17
Q

Physical Evaluation

A

Vital signs
Airway patency and tonsilar size
ASA classification
Name, address & telephone (# of child’s medical home)

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18
Q

Look up eating instructions concerning sedation procedure

A

in the book

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19
Q

Eating and drinking instructions before sedation

A

No milk or solid foods 6 hours before appointment
Clear liquids are allowed 3 hours before
Everyone in household must know this

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20
Q

Clear liquids

A 
Water
Fruit juice without pulp
Carbonated beverages
Clear tea or black coffee
up to 2 hours before - AAPD
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21
Q

AAPD dietary insturctions

A

clear liquids up to 2 hours before
Breast mild up to 4 hours before
Infant formula up to 6 hours before
Non-human milk up to 6 hours before
A light meal - up to 6 hours before
-avoid fatty foods/meats that take a long time to digest
Medications can be taken with sip of water on day of procedure

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22
Q

Dietary restrictions to avoid

A

Emesis

throwing up

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23
Q

Look up - child care after sedation

informed consent

A

forms

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24
Q

Eruption times table

A

table

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25
Q

White spicule of hard tissue overlying the central fossa of a mandibular first permanent molar

A

Sequestrum

No treatment, unless symptoms

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26
Q

Natal teeth

Neonatal teeth

A

natal - teeth present at birth
Neonatal - teeth that erupt in first 30 days following birth
less than 10% of neonatal teeth are supernumerary

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27
Q

Behaviors at 2 years

A 
Gross motor skill like run and jump
see and touch
Attached to parents
No sharing
some interest in self help
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28
Q

Behaviors at 4 years

A

Impose powers
Small social groups, reaches out
Independent self help skill
Thank you and please

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29
Q

Behaviors at 5 years

A 
Consolidation period
More deliberate
Pride in possession
Start giving up comfort objects
Play nice with other kids
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30
Q

IQ

A

Mental age

Avoid making assumptions based on size or other development

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31
Q

Degrees of Mental Retardation

A

Mild - Educable
Moderate - Trainable
Severe
Profound

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32
Q

Mild mental retardation

A

Educable
85% of all with retardation
need a little extra help but end up doing just fine

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33
Q

Moderate mental retardation

A

Trainable

with support and training they can still function

34
Q

Severe mental retardation

A

simple tasks

need lots of support and generally line in a group home type setting

35
Q

Profound mental retardation

A

Identifiable neurologic disorder

36
Q

Parental Anxiety

A

anxious parents = anxious kids

37
Q

Cooperation classifications

A

Cooperative
Lacking in cooperative ability
Potentially cooperative

38
Q

Frankl Behavioral Rating Scale

Rating 1

A

Definitely negative

Refusal of treatment, forceful crying, fearfulness, or any other overt evidence of extreme negativism

39
Q

Frankl Behavioral Rating Scale

Rating 2

A

Negative
Reluctance to accept treatment, uncooperativeness, some evidence of negative attitude but not pronounced (sullen, withdrawn)

40
Q

Frankl Behavioral Rating Scale

Rating 3

A

Positive
Acceptance of treatment
cautious behavior at times
willingness to comply with the dentist, at times with reservation

41
Q

Frankl Behavioral Rating Scale

Rating 4

A

Definitely positive
Good rapport with the dentist
interest in the dental procedures
Laughter and enjoyment

42
Q

Fundamentals of behavior guidance

A 
Positive Approach
Team attitude
Organization
Truthfulness 
Tolerance
Flexibility
43
Q

Positive Approach

A

Children respond to what is expect by the dentist to some extent
Use positive statements

44
Q

Team Attitude

A

Warmth and interest, pleasant smiles, note any hobbies or accomplishment

45
Q

Organization

A

Establish who will bring the patient back, etc.

Delays and indecisiveness make kids nervous

46
Q

Truthfulness

A

Everything is completely black or white to kids

tell the truth and establish trust

47
Q

Tolerance

A

figure out when you are the most tolerant and try to schedule your patients accordingly

48
Q

Flexibility

A

be ready to switch it up at any time as needed

49
Q

More important than the comprehension of actual words

A

the tone and volume of communication

50
Q

Behavior shaping model

A

state the goal or task
Explain the necessity
Divide it up
Explain at an appropriate level of understanding
Successive approximations. Tell, show, do. keep the kid as informed as possible about what’s going on
Reinforce appropriate behavior - be specific and praise skills
Disregard minor inappropriate behavior since paying attention to it may be reinforcing

51
Q

Retraining

A

need to determine what caused the bad association in the child’s mind and then create a good one instead

52
Q

Aversive conditioning

A

Hand over mouth - screaming and kicking are linked to restraint such as this
last resort
old practice

53
Q

Practical considerations for behavioral management

A

Scheduling - don’t keep kids waiting, mornings usually better
Length of appointment may become an issue
Having parents wait in waiting room may be better
Treasure box, don’t bribe, never promise beforehand

54
Q

Which molar pulp chambers are bigger in primary teeth - Max or Mand

A

Mandibular molar chambers are bigger

55
Q

Indications for protective liner

A

Normal pulp
Placed in deep areas of a prep to minimize injury to pulp
Promotes pulp tissue healing and decreases sensitivity
Tertiary Dentin formation

56
Q

Protective liner materials

A

GLUMA - glutaraldehyde and HEMA, desensitizer, disinfectant
Calcium Hydroxide
Bonding Agents
Glass Ionomers

57
Q

Indirect Pulp Cap Indications

A

No pulpitis
deepest carious dentin is not removed
Pulp deemed ‘healable’ from procedure

58
Q

Indirect Pulp Cap Materials

A

Calcium Hydroxide - topped with glass ionomer or ZOE to provide seal against microleakage

ZOE
Resin Modified Glass Ionomer
Glass Ionomer Cement

59
Q

Direct Pulp Cap Indications

A

Normal pulp
small mechanical or traumatic exposure
Not recommended in primary teeth

60
Q

Direct Pulp Cap Materials

A

Calcium Hydroxide
MTA

Glass ionomer or ZOE should seal these materials

61
Q

Pulpotomy Indications

A

When caries removal results in pulp exposure in a primary tooth
can be healthy or pulpitis pulp

62
Q

Pulpotomy Materials

A

Devitalization/Fixation - Formocresol

Preservation - Ferric sulfate (may mask pulpal signs) and chlorhexidine

Regeneration - MTA

Sealing and filling coronal pulp chamber - ZOE

63
Q

Pulpectomy Indications

A

Primary tooth with irreversible pulpitis or necrosis
Radicular pulp exhibits problems
Hemorrhaging not controlled
Minimal or no root resorption

64
Q

Pulpectomy Materials

A

ZOE

Iodoform paste - bacteriocidal, resorbable

65
Q

Contraindications to pulp therapy in primary teeth

A

Pathologic internal or external root resorption
Close to exfoliation
Periapical abscess formation with swelling and drainage - unless tooth is deemed important
Cellulitis
Unrestorable tooth
Medically complex pts

66
Q

Differences for immature permanent teeth - pulpotomy

A

More conservative pulpal access
Reparative/regenerative materials - Calcium hydroxide and MTA
Promotes maturation and apexogenesis

67
Q

Differences for immature permanent teeth - Pulpectomy

A

More conservative access
Calcium hydroxide and MTA
Apexification
Endodontic referral

68
Q

Acid etching for bonding first done when

A

1955

69
Q

Sealants use which materials

A

Bis-GMA resin

Urethane Dimethacrylates

70
Q

Activation of sealants

A

Used to be by UV

Now by visible light at 470nm

71
Q

Sealants may be filled with what materials

A

SiO2 or quartz

72
Q

Colors of selants

A

clear, white, pink, amber

light activated color

73
Q

Sealant effect on caries

A

Cariostatic
by mechanically obstructing pits and grooves and preventing bacterial penetration

Can halt incipient caries, but should not be placed over deeper caries

74
Q

Effectiveness of sealants mainly linked to

A

length of retention

75
Q

Pros and cons to glass ionomer sealants

A

fluoride release, less need for stringent isolation
longevity is a concern, more follow-up
Ineffective as long term sealants for pit and fissures

76
Q

Topical fluoride application and sealant bond

A

topical fluoride does not affect bonding of sealants

77
Q

Sealants may be contraindicated when

A

Rampant caries
Well coalesced pits and fissures
When patient cannot cooperate

78
Q

How long to etch for

A

20 mins - may be longer for for high fluoride or primary teeth
lasers not as good as acid

79
Q

Direct resin crowns -

A

use celluloid crown form to build up composite resin

80
Q

Hypoplastic 1st molars that need immediate restoration

A

should be treated with bonded composite or GI build up to save tooth structure
Not a SSC due to aggressive preparation

81
Q

Alternative restoration treatment

A

Scoop out caries

fill with GI

Pedo (1 decks)

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