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Reference Manual Flashcards

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1
Q

Primary central incisors: Calcification, Formation Complete, Maxillary Eruption, Mandibular Eruption, Maxillary Exfoliation, Mandibular Exfoliation

A
  • Calcification: 4th fetal mo
  • Formation complete at: 18-24 mo
  • Eruption
    • Max: 6-10 mo
    • Mand: 5-8 mo
  • Exfoliation
    • Max: 7-8 yo
    • Mand: 6-7 yo
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2
Q

Primary lateral incisors: Calcification, Formation Complete, Maxillary Eruption, Mandibular Eruption, Maxillary Exfoliation, Mandibular Exfoliation

A
  • Calcification: 4th fetal mo
  • Formation complete at: 18-24 mo
  • Eruption
    • Max: 8-12 mo
    • Mand: 7-10 mo
  • Exfoliation
    • Max: 8-9 yo
    • Mand: 7-8 yo
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3
Q

Primary canines: Calcification, Formation Complete, Maxillary Eruption, Mandibular Eruption, Maxillary Exfoliation, Mandibular Exfoliation

A
  • Calcification: 4th fetal mo
  • Formation complete at: 30-39 mo
  • Eruption
    • Max: 16-20 mo
    • Mand: 16-20 mo
  • Exfoliation
    • Max: 11-12 yo
    • Mand: 9-11 yo
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4
Q

Primary 1st molars: Calcification, Formation Complete, Maxillary Eruption, Mandibular Eruption, Maxillary Exfoliation, Mandibular Exfoliation

A
  • Calcification: 4th fetal mo
  • Formation complete at: 24-30 mo
  • Eruption
    • Max: 11-18 mo
    • Mand: 11-18 mo
  • Exfoliation
    • Max: 9-11 yo
    • Mand: 10-12 yo
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5
Q

Primary 2nd molars: Calcification, Formation Complete, Maxillary Eruption, Mandibular Eruption, Maxillary Exfoliation, Mandibular Exfoliation

A
  • Calcification: 4th fetal mo
  • Formation complete at: 36 mo
  • Eruption
    • Max: 20-30 mo
    • Mand: 20-30 mo
  • Exfoliation
    • Max: 9-12 yo
    • Mand: 11-13 yo
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6
Q

Permanent central incisors: Calcification begins at, Crown (enamel) compete at, Root complete at, Maxillary Eruption, Mandibular Eruption

A
  • Calcification begins at: 3-4 mo
  • Crown (enamel) complete at: 4-5 yo
  • Roots complete at: 9-10 yo
  • Eruption
    • Max: 7-8 yo (3)
    • Mand: 6-7 yo (2)
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7
Q

Permanent central incisors: Calcification begins at, Crown (enamel) compete at, Root complete at, Maxillary Eruption, Mandibular Eruption

A
  • Calcification begins at: 3-4 mo
  • Crown (enamel) complete at: 4-5 yo
  • Roots complete at: 9-10 yo
  • Eruption
    • Max: 7-8 yo (3)
    • Mand: 6-7 yo (2)
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8
Q

Permanent lateral incisors: Calcification begins at, Crown (enamel) compete at, Root complete at, Maxillary Eruption, Mandibular Eruption

A
  • Calcification begins at:
    • Max: 10-12 mo
    • Mand: 3-4 mo
  • Crown (enamel) complete at: 4-5 yo
  • Roots complete at:
    • Max: 11 yo
    • Mand: 10 yo
  • Eruption
    • Max: 8-9 yo (5)
    • Mand: 7-8 yo (4)
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9
Q

Permanent canines: Calcification begins at, Crown (enamel) compete at, Root complete at, Maxillary Eruption, Mandibular Eruption

A
  • Calcification begins at: 4-5 mo
  • Crown (enamel) complete at: 6-7 yo
  • Roots complete at: 12-15 yo
  • Eruption
    • Max: 11-12 yo (11)
    • Mand: 9-11 yo (6)
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10
Q

1st Premolars: Calcification begins at, Crown (enamel) compete at, Root complete at, Maxillary Eruption, Mandibular Eruption

A
  • Calcification begins at: 18-24 mo
  • Crown (enamel) complete at: 5-6 yo
  • Roots complete at: 12-13 yo
  • Eruption
    • Max: 10-11 yo (7)
    • Mand: 10-12 yo (8)
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11
Q

2nd Premolars: Calcification begins at, Crown (enamel) compete at, Root complete at, Maxillary Eruption, Mandibular Eruption

A
  • Calcification begins at: 24-30 mo
  • Crown (enamel) complete at: 6-7 yo
  • Roots complete at: 12-14 yo
  • Eruption
    • Max: 10-12 yo (9)
    • Mand: 11-13 yo (10)
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12
Q

1st Molars: Calcification begins at, Crown (enamel) compete at, Root complete at, Maxillary Eruption, Mandibular Eruption

A
  • Calcification begins at: Birth
  • Crown (enamel) complete at: 30-36 mo
  • Roots complete at: 9-10 yo
  • Eruption
    • Max: 5.5-7 yo (1)
    • Mand: 5.5-7 yo (1a)
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13
Q

2nd Molars: Calcification begins at, Crown (enamel) compete at, Root complete at, Maxillary Eruption, Mandibular Eruption

A
  • Calcification begins at: 30-36 mo
  • Crown (enamel) complete at: 7-8 yo
  • Roots complete at: 14-16 yo
  • Eruption
    • Max: 12-14 yo (12)
    • Mand: 12-14 yo (12a)
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14
Q

3rd Molars: Calcification begins at, Maxillary Eruption, Mandibular Eruption

A
  • Calcification begins at:
    • Max: 7-9 yo
    • Mand: 8-10 yo
  • Eruption
    • Max: 17-30 yo (13)
    • Mand: 17-30 yo (13a)
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15
Q

Instructions to person at site of avulsion

A
  • Seek medical attention if loss of consciousness, signs of neurological impairment, or other major medical concerns.
  • Rinse avulsed tooth gently in milk, saline, or saliva; care not to touch root w/ fingers.
  • If possible, replant avulsed tooth.
  • If unable to replant tooth, place in physiologic storage medium (milk, HBSS, saliva, or saline).
  • Seek immediate dental treatment.
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16
Q

Upon arrival to dental facility following avulsion of permanent tooth

A
  • General neurological assessment
  • If the tooth was not previously replanted or stored in physiologic medium, rinse the root structure w/ gentle stream of saline until all visible contaminants are removed and stored in physiologic medium
  • Review med hx (including tetanus immunization status) and details of injury
  • Consider taking photographs
  • Evaluate for abuse
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17
Q

How should you prepare the site for replantation following avulsion of permanent tooth?

A
  • Anesthetize area, giving consideration to using block injection techniques and no vasoconstrictor
  • Irrigate socket w/ gentle stream of sterile saline, removing coagulum
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18
Q

Post-op management for avulsion of permanent tooth w/ open apex (>1mm)

A
  • Rx 7-day course of abx (e.g. amoxicillin or penicillin, alternative for penicillin-allergic patients; doxycycline has demonstrated anti-resorptive, anti-osteoclastic, anti-inflammatory, and antibacterial effects but is not recommended for patients <12yo)
  • Rx chlorhexidine rinse 2x/day for 2 weeks
  • Refer to medical professional for tetanus booster PRN
  • @ 2 weeks, remove splint (unless bony fracture occurred) and evaluate clinically + radiographically for pulpal revascularization, infection, pulpal necrosis, and root resorption
  • Initiate pulpal revascularization, apexification, or RCT as soon as definitive clinical and/or radiographic pathology presents
  • Frequent, regular f/u evaluations (every 4 weeks) are initiated initially
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19
Q

Post-op management for avulsion of permanent tooth w/ closed apex (<1mm)

A
  • Rx 7-day course of abx (e.g. amoxicillin or penicillin, alternative for penicillin-allergic patients; doxycycline has demonstrated anti-resorptive, anti-osteoclastic, anti-inflammatory, and antibacterial effects but is not recommended for patients <12yo)
  • Rx chlorhexidine rinse 2x/day for 2 weeks
  • Refer to medical professional for tetanus booster PRN
  • Initiate RCT (e.g. calcium hydroxide) w/in 2 weeks of replantation
  • @ 2 weeks, remove splint (unless bony fracture occurred) and evaluate clinically + radiographically for pulpal revascularization, infection, pulpal necrosis, and root resorption
    • Bony fracture = rigid splint for 4 weeks
  • F/u evaluations: 1mo, 3mo, 6mo, 12mo, and annually for 5 years
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20
Q

What information is collected from the patient during acute traumatic injuries (assessment + documentation)?

A
  • Name, DOB, date, time
  • History
    • Med hx:
      • Allergies
      • Meds
      • Last tetanus inoculation
      • Other findings
    • H/o incident:
      • Date + time of injury
      • Time elapsed since injury
      • Who witnessed the event
      • Description (what, where, how)
    • Management prior to exam
      • By whom? Describe
    • Complaints + reported conditions
      • Altered orientation/mental status
      • Headache/nausea/vomiting
      • Hemorrhage from ears/nose
      • Loss of consciousness
      • Neck pain
      • Other body injuries
      • Pain on opening/closing
      • Abnormal/painful occlusion
      • Spontaneous dental pain
      • Tooth sensitive to air/thermal change
      • Displaced or loosened teeth
      • Fractured tooth
      • Missing/avulsed tooth
        • Was missing tooth found?
      • Other complaints
      • Previous dental trauma
      • Use of oral appliance
      • Non-nutritive oral habit
  • Extraoral exam
    • Craniofacial assessment
      • Cranial nerve deficit
      • Suspected facial fracture
      • TMJ deviation/asymmetry
      • Hemorrhage/drainage
      • Swelling
      • Contusion
      • Laceration
      • Abrasion
      • Puncture
      • Burns
      • Foreign body
      • Other
  • Intraoral exam
    • Soft Tissue Injuries
    • Occlusal Assessment
  • Dental assessment
  • Radiographs
  • Treatment
  • Instructions + disposition
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21
Q

CPR: Compression-ventilation ratio w/o advanced airway, adults + adolescents

A

1 or 2 rescuers

30:2

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22
Q

CPR: Compression-ventilation ratio w/ advanced airway, adults + adolescents

A
  • Continuous compressions at a rate of 100-120/min
  • 1 breath every 6 sec (10 breaths/min)
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23
Q

CPR: Compression-ventilation ratio w/o advanced airway, children + infants

A
  • 1 rescuer = 30:2
  • 2+ rescuers = 15:2
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24
Q

CPR: Compression-ventilation ratio w/o advanced airway, children + infants

A
  • Continuous compressions at a rate of 100-120/min
  • Give 1 breath every 2-3 sec (20-30 breaths/min)
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25
Q

CPR: Compression depth for adults + adolescents

A

At least 2 in (5cm)

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26
Q

CPR: Compression depth for children (1yr to puberty)

A

At least ⅓ AP diameter of chest, ~2in (5cm)

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27
Q

CPR: Compression depth for infants (<1yo, excluding newborns)

A

At least ⅓ AP diameter of chest, ~1.5in (4cm)

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28
Q

CPR: Hand placement - adults

A

2 hands on the lower half of the breastbone (sternum)

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29
Q

CPR: Hand placement - adults

A

2 hands on the lower half of the breastbone (sternum)

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30
Q

CPR: Hand placement - children (1yo-puberty)

A

2 hands or 1 hand (optional for very small children) on the lower half of the breastbone (sternum)

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31
Q

CPR: Hand placement - infants (<1yo, excluding newborns)

A
  • 1 rescuer:
    • 2 fingers or 2 thumbs in the center of the chest, just below the nipple line
  • 2 rescuers:
    • 2 thumb-circling hands in the center of the chest, just below the nipple line
  • If the rescuer is unable to achieve the recommended depth, it may be reasonable to use the heel of one hand
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32
Q

CPR: Minimizing interruptions

A

Limit interruptions in chest compressions to <10 sec** w/ a CCF (chest compression fraction) goal of **80%

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33
Q

CPR: Compression depth should be no more than __

A

2.4 inches (6cm)

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34
Q

How do you calculate BMI?

A

Weight (kg) ÷ Stature (cm) ÷ Stature (cm) x 10,000

OR

Weight (lb) ÷ Stature (in) ÷ Stature (in) x 703

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35
Q

x and y axis of BMI charts

A

x = age (years)

y = BMI (kg/m3)

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36
Q

What vaccinations do children age 4mo-6yo receive?

A
  • Birth - 6wks
    • Hep B
    • Rotavirus (RV)
    • Diphtheria, tetanus, and acellular pertussis (DTaP)
    • Haemophilus influenzae type B (Hib)
    • Pneumococcal conjugate (PCV13)
    • Inactivated poliovirus (IPV <18yrs)
  • 12mo
    • Measles, mumps rubella (MMR)
    • Varicella (VAR)
    • Hep A
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37
Q

What vaccinations do children age 7-18yo receive?

A
  • 7yo
    • Tetanus, diphtheria, acellular pertussis (Tdap ≥7yrs)
  • 9yo
    • Human papillomavirus
  • Meningococcal ACWY
  • Hep A
  • Hep B
  • Inactivated polio
  • MMR
  • Varicella
  • Dengue
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38
Q

Vaccine doses administered __ before the minimum age or interval are considered valid

A

≤4 days

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39
Q

Vaccine doses administered __ before the minimum age or interval are considered invalid and should be repeated as age appropriate

A

≥5 days

The repeat dose should be spaced after the invalid dose by the recommended minimum interval

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40
Q

All routine child + adolescent vaccines are covered by the National Vaccine Injury Compensation Program (VICP) except for __ ?

A

Pneumococcal polysaccharide vaccine (PPSV23)

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41
Q

The Advisory Committee on Immunization Practices (ACIP) recommends use of COVID-19 vaccines within the scope of the __

A

Emergency Use Authorization or Biologics License Application for the particular vaccine

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42
Q

Diphtheria, tetanus, and pertussis (DTaP) vaccination

A
  • Minimum age: 6wks
  • Routine vax: 5 dose series at 2, 4, 6, 15-18mo, 4-6yr
    • Prospectively: Dose 4 may be administered as early as 12mo if at least 6mo have elapsed since dose 3.
    • Retrospectively: A 4th dose that was inadvertently administered as early as age 12mo may be counted if at least 4mo have elapsed since dose 3.
  • Catch up vax
    • Dose 5 is not necessary if dose 4 was administered at 4yo+ and at least 6mo after dose 3.
  • *Wound management in children <7yo** w/ h/o 3+ doses of tetanus-toxoid-containing vaccine:
  • *For all wounds except clean + minor wounds, administer DTaP if >5yr since last dose.**
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43
Q

Haemophilus influenzae type B vaccination

A
  • Minimum age: 6wks
  • Routine vax:
    • 4 dose series at 2, 4, 6mo, booster at 12-15mo
      • Vaxelis is not recommended for booster
    • 3 dose series at 2, 4mo, booster at 12-15mo
  • Catch up vax
    • Unvaccinated at age 15–59mo: Administer 1 dose.
    • Previously unvaccinated children age 60mo+ who are not considered high risk: Do not require catch-up vaccination
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44
Q

Dengue vaccination

A
  • Minimum age: 9yo
  • Routine vax: 9-16yo living in dengue endemic areas + have lab confirmation of previous dengue infection
    • 3 dose series: 0, 6, 12mo

Endemic areas: Puerto Rico, American Samoa, US Virgin Islands, Federated States of Micronesia, Republic of Marshall Islands, + Republic of Palau

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45
Q

Haemophilus influenzae type B vaccination: Special situations

A
  • Chemotherapy/radiation tx: Doses administered w/in 14 days of starting therapy or during therapy should be repeated at least 3mo after therapy completion
  • Hematopoietic stem cell transplant (HSCT): 4 dose series 6-12mo after successful transplant, regardless of Hib vax hx
  • Anatomic/functional asplenia (including sickle cell disease): Unvaccinated 5yr+ 1 dose
  • Elective splenectomy: Unvaccinated 15mo+ 1 dose (preferably at least 14 days preop)
  • HIV infection: Unvaccinated 5-18yo 1 dose
  • Immunoglobulin deficiency, early component complement deficiency:
46
Q

Hep A vaccination

A
  • Minimum age: 12mo for routine vaccination
47
Q

Hep B vaccination

A
  • Birth dose: monovalent HepB vaccine only
  • Mother is HBsAg negative
    • All medically stable infants ≥2000 g: 1 dose within 24hr of birth
    • Infants <2000 g: Administer 1 dose at chronological age 1mo or hospital discharge (whichever is earlier and even if weight is still <2000 g)
  • Mother is HBsAg positive
    • Give HepB vaccine + hepatitis B immune globulin (HBIG) (in separate limbs) within 12hr of birth, regardless of birth weight
      • Infants <2000 g: Give 3 additional doses of vaccine (total of 4 doses) beginning at 1mo
  • Determine mother’s HBsAg status ASAP. If mother is HBsAg positive, give HBIG to infants ≥2000 g as soon as possible, but no later than 7 days old
  • Minimum age for final dose: 24weeks
  • Revaccination not typically recommended for those w/ normal immune status who were vaccinated as infants, children, adolescents or adults.
  • Post-vaccination serology testing + revaccination (if anti-HBs < 10mlU/mL) recommended in certain populations:
    • Infants born to HBsAg positive mothers
    • Hemodialysis patients
    • Immunocompromised
48
Q

HPV vaccine

A
  • Minimum: HPV vaccine @11-12yo (can start @9yo)
    • Age 9-14yo - 2 doses
    • Age 15yo+ - 3 doses
  • Not recommended until after pregnancy
    • No intervention needed if vaccinated during pregnancy
49
Q

Flu vaccine

A
  • Minimum age: 6mo, 2yr, 18yo
    • Age 6mo-8yr: 2 doses for those how have received fewer than 2 flu vaccines before July 1, 2021 or whose flu vaccine history is unknown
    • Children 6mo-8yr: 1 dose for those who have received at least 2 flu vaccines before July 1, 2021
    • 1 dose for all patients 9yo and younger
50
Q

MMR

A
  • Minimum age: 12mo
  • For dose 1 in children 12-47mo, it is recommended to administer MMR + varicella vaccines separately. MMRV may be used if parents have a preference.
51
Q

Meningococcal serogroup A, C, W, Y vaccination

A
  • Minimum age: 2mo, 9mo, 2yo
  • Anatomic or functional asplenia (included sickle cell disease):
    • Menveo
    • Menactra
      • W/ persistent complement component deficiency or complement inhibitor use
      • Anatomic or functional asplenia, sickle cell disease, or HIV
    • MenQuadfi
  • Travel in countries w/ hyperendemic or epidemic meningococcal disease, including countries in the African meningitis belt or during the Hajj
    • Menveo
    • Menactra
  • First year college students living in residential housing (if not vaccinated at 16yo) or military recruits
    • Menveo
    • Menactra
    • MenQuadfi
      *
52
Q

Tetanus, diphtheria, pertussis (Tdap) + wound management

A
  • 7yo+ w/ h/o 3 or more doses of tetanus toxoid containing vaccine:
    • Clean + minor wounds: Tdap or Td if >10yr since last dose
    • All other wounds: Tdap or Td if >5yr since last dose
  • Tdap is preferred for persons 11yo+ who have not previously received Tdap or whose Tdap hx is unknown
  • If tetanus-toxoid containing vaccine is indicated for pregnant adolsecent, use Tdap
53
Q

Contraindications for live attenuated flu vaccine

A
  • Severe allergic rxn previously w/ any egg-based flu vaccine
  • Severe allergic rxn to any vaccine component
  • Children 2-4yo w/ h/o asthma or wheezing
  • Anatomic or functional asplenia
  • Immunocompromised (may be due to meds + HIV infection)
  • Close contacts of severely immunosuppressed who require a protected envt
  • Pregnancy
  • Cochlear implant
  • Active communication between CSF + oropharynx, nasopharynx, nose, ear or any other cranial CSF leak
  • Children + adolescents receiving aspirin or salicylate-containing meds
  • Received influenza antiviral meds oseltamivir or zanamivir w/in previous 48hr, peramivir w/in previous 5 days, or baloxavir w/in previous 17 days
54
Q

Vaccines during pregnancy

A
  • Precautions
    • Dengue
    • Meningococcal B
    • Poliovirus, inactivated
  • Contraindicated
    • Influenza, live attenuated
    • Heplisav-B (hepB)
    • MMR
    • Varicella
55
Q

Food intake patterns at 1000, 1200, 1400 calories are designed to meet the nutritional needs of __

A

2-8yo children

56
Q

Food intake patterns from 1600-3200 calories are designed to meet the nutritional needs of __

A

Children 9yo+ and adults

57
Q

If a child 4-8yo needs more calories and is following a pattern at 1600 calories or more, recommended amount from __ group should be __ per day.

A

If a child 4-8yo needs more calories and is following a pattern at 1600 calories or more, recommended amount from dairy group should be 2.5 cups per day.

58
Q

Protein foods

A

All seafood, meats, poultry, eggs, soy products, nuts, seeds. Meats + poultry should be lean or low-fat and nuts should be unsalted. Legumes (beans + peas) can be considered part of this group as well as the vegetable group but should be counted in one group only

59
Q

Dairy

A

All milk, including lactose-free and lactose-reduced products + fortified soy beverages (soymilk), yogurt, frozen yogurt, dairy desserts, cheeses. Most choices should be fat-free or low-fat. Cream, sour cream, cream cheese are not included due to their low calcium content

60
Q

Quantity equivalents for each food group

A
  • Fruits + vegetables, 1 cup = 1 cup raw or cooked fruit or vegetable, 1 cup fruit or vegetable juice, 2 cups leafy salad greens, ½ cup dried fruit or vegetable
  • Grains, 1oz = ½ cup cooked rice, pasta or cereal, 1oz dry pasta or rice, 1 medium (1oz) slice bread, 1oz of ready to eat cereal (~1cup of flaked cereal)
  • Protein foods, 1oz = 1oz lean meat, poultry or seafood, 1 egg, ¼ cup cooked beans/tofu, 1Tbsp peanut butter, ½oz nuts/seeds
  • Dairy, 1 cup = 1 cup milk, yogurt, or fortified soymilk, 1½oz natural cheese or 2 oz of processed cheese

All foods are assumed to be in nutrient-dense forms, lean or low-fat + prepared w/o added fats, sugars, refined starches or salt.

The overall eating pattern should not exceed the limits of <10% of calories from added sugars + <10% of calories from saturated fats

61
Q

Alcohol per day

A

Limit of up to 1 drink/day for women, 2 drinks/day for men

62
Q

Speech + Language Milestones: birth-3mo

A
  • Hearing + Understanding
    • Startles at loud sounds
    • Quiets or smiles when you talk
    • Seems to recognize your voice; quiets if crying
  • Talking
    • Makes cooing sounds
    • Cries change for different needs
    • Smiles at people
63
Q

Speech + Language Milestones: 4-6mo

A
  • Hearing + Understanding
    • Moves eyes in the direction of sounds
    • Responds to changes in your tone of voice
    • Notices toys that make sounds
    • Pays attention to music
  • Talking
    • Coos + babbles when playing alone or with you
    • Makes speech-like babbling sounds, like pa, ba, mi
    • Giggles + laughs
    • Makes sounds when happy or upset
64
Q

Speech + Language Milestones: 7mo-1yo

A
  • Hearing + Understanding
    • Turns + looks in direction of sounds
    • Looks when you point
    • Turn when you call his/her name
    • Understands words for common items + people - “cup, truck, juice, daddy”
    • Starts to respond to simple words + phrases, like “no, come here, want more”
    • Plays games w/ you, like peek-a-boo + pat-a-cake
    • Listens to songs + stories for a short time
  • Talking
    • Babbles long strings of sounds, like mimi, upup, bababa
    • Uses sounds + gestures to get + keep attention
    • Points to objects + shows them to others
    • Uses gestures like waving bye, reaching for “up”, shaking head no
    • Imitates different speech sounds
    • Says 1 or 2 words, like “hi, dog, dada, mama, uh oh.” This will happen around 1st birthday but sounds may not be clear
65
Q

Speech + Language Milestones: 1-2yo

A
  • Hearing + Understanding
    • Understands differences in meaning go-stop, big-little, up-down
    • Follows 2-part directions like “get the spoon and put it on the table”
    • Understands new words quickly
  • Talking
    • Has a word for almost everything
    • Talks about things that are not in the room
    • Uses k, g, f, t, d, n in words
    • Uses words like in, on, under
    • Uses two- or three-words to talk about + ask for things
    • People who know your child can understand him/her
    • Asks “why”?
    • Puts 3 words together to talk about things. May repeat some words + sounds
66
Q

Speech + Language Milestones: 3-4yo

A
  • Hearing + Understanding
    • Responds when you call from another room
    • Understands words for some colors
    • Understands words for some shapes
    • Understands words for family
  • Talking
    • Answers simple who, what, where questions
    • Says rhyming words
    • Uses pronouns like I, you, me, we, they
    • Uses some plural words
    • Most people understand what your child says
    • Asks when and how questions
    • Puts 4 words together. May make some mistakes
    • Talks about what happened during the day. Uses 4 sentences at a time
67
Q

Speech + Language Milestones: 4-5yo

A
  • Hearing + Understanding
    • Understands words for order “first, next, last”
    • Understands words for time “yesterday, today, tomorrow”
    • Follows longer directions
    • Follows classroom directions
    • Hears + understands most of what she hears at home + in school
  • Talking
    • Says all speech sounds in words. May make mistakes on sounds that are harder to say like l, s, r, v, z, ch, sh, th
    • Responds to “What did you say?”
    • Talks w/o repeating sounds or words most of the time
    • Names letters + numbers
    • Uses sentences that have more than 1 action word, like jump, play, get. May make some mistakes
    • Tells a short story
    • Keeps a conversation going
    • Talks in different ways, depending on the listener + place. Your child may use short sentences w/ younger children. Make talk louder outside than inside
68
Q

Case selection for SDF

A
  • Patients who may benefit
    • High caries risk who have active cavitated caries in anterior or posterior teeth
    • Presenting w/ behavioral or medical management challenges + cavitate caries lesions
    • W/ multiple cavitated caries lesions that may not all be treated in one visit
    • W/ dental caries that are difficult to tx
    • W/o access to or w/ difficulty accessing dental care
  • Tooth selection
    • No clinical signs of pulpal inflammation or reports of unsolicited/spontaneous pain
    • Cavitated caries lesions that are not encroaching on the pulp; radiographs should be taken to assess depth of caries if possible
    • Cavitated lesions on any surface as long as they are accessible w/ a brush for applying SDF (ortho separators may be used)
69
Q

How long should you try to keep SDF isolated for?

A

As long as 3 minutes

70
Q

Anterior vs posterior - which teeth have higher rates of arrest w/ SDF?

A

Anterior

71
Q

SDF Follow up

A

2-4 weeks after initial tx to check the arrest of the lesions treated.

72
Q

What lab values are included on a CBC?

A
  • Hemoglobin
  • Hematocrit
  • RBC
  • WBC
73
Q

Hemoglobin: Normal lab value, Function, Significance

A
  • Normal value: 10.5-18 g/dL
  • Function: Measures oxygen carrying capacity of blood
  • Significance:
    • Low: Hemorrhage, anemia
    • High: Polycythemia
74
Q

Hematocrit: Normal lab value, Function, Significance

A
  • Normal value: 32-52%
  • Function: Measures relative value of cells + plasma in blood
  • Significance:
    • Low: Hemorrhage, anemia
    • High: Polycythemia, dehydration
75
Q

RBC: Normal lab value, Function, Significance

A
  • Normal value: 4-6 million/mm3
  • Function: Measures oxygen-carrying capacity of blood
  • Significance:
    • Low: Hemorrhage, anemia
    • High: Polycythemia, heart disease, pulmonary disease
76
Q

WBC: Normal lab value, Function, Significance

A
  • Normal value:
    • 1-23mo: 6,000-14,000/mm3
    • 2-9yo: 4,000-12,000/mm3
    • 10-18yo: 4,000-10,500/mm3
  • Function: Measures host defense against inflammatory agents
  • Significance:
    • Low: Aplastic anemia, drug toxicity, specific infections
    • High: Inflammation, trauma, toxicity, leukemia
77
Q

What lab values are included in differential counts?

A
  • Neutrophils
  • Lymphocytes
  • Eosinophils
  • Basophils
  • Monocytes
78
Q

Neutrophils: Absolute counts, Significance

A
  • Absolute counts: 1,500-8,000/mm3
  • Significance:
    • Increase in bacterial infections, hemorrhage, diabetic acidosis
    • Absolute Neutrophil Count (ANC) <1,000/mm3: Patient at increased risk for infection; defer elective dental treatment
79
Q

Lymphocytes: Absolute counts, Significance

A
  • Absolute counts: 1,500-3,000/mm3
  • Significance:
    • Viral + bacterial infections
    • Acute + chronic lymphocytic leukemia
    • Antigen reaction
80
Q

Eosinophils: Absolute counts, Significance

A
  • Absolute counts: 50-250/mm3
  • Significance: Increase in parasitic + allergic conditions, blood dyscrasias, pernicious anemia
81
Q

Basophils: Absolute counts, Significance

A
  • Absolute counts: 15-50/mm3
  • Significance: Increase in types of blood dyscrasias
82
Q

Monocytes: Absolute counts, Significance

A
  • Absolute counts: 285-500/mm3
  • Significance: Hodgkin’s disease, lipid storage disease, recovery from severe infections, monocytic leukemia
83
Q

Below what ANC value should elective dental treatment be deferred?

A

ANC <1,000/mm3: Patient at increased risk for infection. Defer elective dental treatment

84
Q

What is included on a bleeding screen?

A
  • Prothrombin time
  • Partial thromboplastin time
  • Platelets
  • Bleeding time (adult)
  • INR
85
Q

Prothrombin time: Normal lab value, Function, Significance

A
  • Normal lab value: 12.7-15.4 seconds
  • Function: Measures extrinsic clotting of blood.
  • Significance:
    • Prolonged in liver disease
    • Impaired Vitamin K production
    • Surgical trauma w/ blood loss
86
Q

Partial thromboplastin time: Normal lab value, Function, Significance

A
  • Normal lab value: By laboratory control
  • Function: Measures intrinsic clotting of blood, congenital clotting disorders.
  • Significance: Prolonged in hemophilia A, B, and C + Von Willebrand’s disease
87
Q

Platelets: Normal lab value, Function, Significance

A
  • Normal lab value: 150,000-400,000/mm3
  • Function: Measures clotting potential.
  • Significance:
    • Increased in polycythemia, leukemia, severe hemorrhage
    • Decreased in thrombocytopenia purpura
88
Q

Bleeding Time (adults): Normal lab value, Function, Significance

A
  • Normal lab value: <7.1 minutes
  • Function: Measures quality of platelets.
  • Significance: Prolonged in thrombocytopenia.
89
Q

INR: Normal lab value, Function, Significance

A
  • Normal lab value:
    • W/o anticoagulant therapy: 1
    • W/ anticoagulant therapeutic range: 2-3
  • Function: Measures extrinsic clotting function.
  • Significance: Increased w/ anticoagulant therapy.
90
Q

What tests are included on a urinalysis?

A
  • Volume
  • Specific gravity
  • pH
  • Casts
91
Q

Volume: Normal lab value, Function, Significance

A
  • Normal lab value: 1,000-2,000 mL/day
  • Function: –
  • Significance: Increased in diabetes mellitus, chronic nephritis
92
Q

Specific gravity: Normal lab value, Function, Significance

A
  • Normal lab value: 1.015-1.025
  • Function: Measures the degree of tubular reabsorption + dehydration.
  • Significance:
    • Increased in diabetes mellitus.
    • Decreased in acute nephritis, diabetes insipidus, aldosteronism.
93
Q

pH: Normal lab value, Function, Significance

A
  • Normal lab value: 5.0-9.0
  • Function: Reflects acidosis + alkalosis.
  • Significance:
    • Acidic: Diabetes, acidosis, prolonged fever.
    • Alkaline: Urinary tract infection, alkalosis.
94
Q

Casts: Normal lab value, Function, Significance

A
  • Normal lab value: 1-2 per high power field.
  • Function: –
  • Significance: Renal tubule degeneration occurring in cardiac failure, pregnancy, and hemogobinuric-nephrosis.
95
Q

Measured electrolytes in labs

A
  • Sodium
  • Potassium
  • Bicarbonate
  • Chloride
96
Q

Sodium (Na): Normal lab value, Function, Significance

A
  • Normal lab value: 134-143 mmol/L
  • Function: –
  • Significance: Increased in Cushing’s syndrome
98
Q

Potassium (K): Normal lab value, Function, Significance

A
  • Normal lab value: 3.3-4.6 mmol/L
  • Function: –
  • Significance: Increased in tissue breakdown
98
Q

Bicarbonate (HCO3): Normal lab value, Function, Significance

A
  • Normal lab value:
    • Venous: 22-29 mmol/L
    • Arterial: 21-28 mmol/L
  • Function: Reflects acid-base balance
  • Significance: –
99
Q

Chloride (Cl): Normal lab value, Function, Significance

A
  • Normal lab value: 98-106 mmol/L
  • Function: –
  • Significance: Increased in renal disease + hypertension
100
Q

C-reactive protein (CRP): Normal lab value, Significance

A
  • Normal lab value: 0.08-1.58 mg/dL
    • **Range is age dependent**
  • Significance:
    • Increase in infection
    • Indicates an acute phase of the inflammatory metabolic response
101
Q

Acetaminophen: Forms, usual oral dosage

A
  • Forms: Liquid, tablet, oral disintegrating tablet, caplet, rectal suppository, injectable
  • Usual oral dosage:
    • Children <12yo: 10-15 mg/kg/dose every 4-6hr as needed (max 75 mg/kg/24hr, but not to exceed 4g/24hr)
    • Children ≥12yo + adults: 325-650 mg every 4-6hr OR 1,000 mg 3-4x daily as needed (max 4g/24hr)
102
Q

What services are included under MNC?

A
  • Sedation, GA, utilization of surgical facilities.
  • Includes all supportive health care services that are necessary for the optimal quality therapeutic + preventive oral care
  • Take into account the patient’s age, developmental status, psychosocial well-being, in addition to the clinical setting appropriate to meet the needs of the patient + family
103
Q

Dental caries is __ of childhood.

A

Caries is the most common chronic disease of childhood.

~60% of children experience cares in primary teeth by 5yo.

104
Q

What % of children have experienced caries by 17yo?

A

78%

105
Q

What % of caries in school-aged children occur in pits + fissures?

A

90%

106
Q

How much of the US population does not benefit from CWF?

A

>⅓

107
Q

A child who receives sealants is __ to receive restorative services over the next __ years than children who do not

A

A child who receives sealants is 72% less likely to receive restorative services over the next 3 years than children who do not

108
Q

What is the success rate of sealants w/ follow up care?

A

80-90% - even after a decade

109
Q

How many children in the US have been diagnosed w/ a mental health disorder?

A

1 in 5

110
Q

What are the most commonly diagnosed mental health conditions in children?

A
  • ADHD
    • >6 million children under 18yo
  • Behavioral problems
  • Anxiety
    • 4.4 million
  • Depression
    • 1.9 million
111
Q

What percent of children diagnosed w/ mental health conditions receive treatment for their disorder?

A

20%

* (22 decks)

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