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Module 5 Exam > Restorative Management of the Primary Dentition > Flashcards

Restorative Management of the Primary Dentition Flashcards

1
Q

Why restore the primary dentition?

A

To restore form
To restore aesthetics
To restore function
Maintain space
Acclimatisation
Avoiding sepsis and infection to permanent successors
To avoid extraction

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2
Q

Why does caries progress quicker in the primary dentition?

A

dentine and enamel are less highly mineralised

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3
Q

what are the differences between primary teeth and permanent teeth?

A

smaller
shorter crown
enamel layer is thinner
less dentine in proportion to tooth size
pulp is RELATIVELY larger
pulp horns are nearer the surface - mesially especially
curved roots
contact points are flatter and wider

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4
Q

How many root canals do deciduous molars usually have?

A

3
sometimes 4, sometimes 2

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5
Q

where do the root canals sit in a lower primary molar?

A

mesio buccally
mesio lingually
distally

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6
Q

where do the root canals usually sit in upper primary molars?

A

mesio bucally
disto bucally
palatally

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7
Q

what should you consider when forming your treatment plan?

A

take into account the individual child, their behaviour, level of anxiety, what access is like etc

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8
Q

what are the stages of the treatment plan (in order)?

A

relief of pain
prevention - OHI, diet advice
professional prevention - fluoride application, fissures sealant
restorative aspects
extractions
behaviour management
reinforce prevention

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9
Q

why should you start with the simplest procedure on a child?

A

don’t want to traumatise them
make their experience positive
acclimatisation

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10
Q

what is the minimum age to give your own consent?

A

16

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11
Q

what is Gillick competency?

A

a young person under 16 with capacity to make any relevant decision (if you as a clinician believes they understand the procedure even if mum or dad is unhappy you can take this as consent)

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12
Q

what are the common causes of oral pain in children?

A

abscess
caries
trauma
tooth wear
infection
soft tissue lesions
exfoliation/eruption

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13
Q

What would the history of reversible pulpitis be if presented?

A

precipitated by sweet/hot/cold
pain stops when stimuli is removed
short duration
mainly occurs when eating

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14
Q

what would the history of irreversible pulpitis be if presented?

A

constant
relieved only by analgesics
kept awake
symptoms of reversible but untreated

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15
Q

what would you see on examination if reversible pulpitis was present?

A

early carious lesions

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16
Q

what would you see on examination if irreversible pulpitis was present?

A

lymphadenopathy
raised temp
extensive marginal ridge destruction
infection of the sinus
intra oral swelling

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17
Q

what would reversible puplitis look like on a radiograph?

A

caries into dentine

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18
Q

what would irreversibvle pulpitis look like on na radiograph?

A

caries close to pulp
radiolucency

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19
Q

how to know whether to restore or extract?

A

what type of pulpitis is it?
is there enough tooth tissue left to carry out a restoration
has there been previous extractions
would you be leaving a functional dentition if you were to take more teeth out
would we cause early drift and eruption of the permanent dentition if we extracted teeth too early

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20
Q

restore when possible especially when…

A

majority of other carious teeth are restorable
compliance
patient and parent keen to save
space maintenance
prev hypodontia
for adequate function

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21
Q

extract when…

A

don’t want to leave asymmetry for function - balancing extractions
non compliance
no parental support
no attendance beyond pain relief

22
Q

what is temporisation?

A

placing a temporary dressing on tooth to get patient out of pain, stop tooth feeling sharp etc
arrange pt to come back for a permanent restoration, extraction or review
usually involves 1 or 2 teeth

23
Q

what is stabilisation?

A

usually involves a lot of teeth
open cavities in mouth, remove as much caries as possible from amelo dentinal junction as possible, place temp dressing, stops disease getting worse
take time to restore teeth one at a time

24
Q

what is the purpose of stabilisation?

A

to buy yourself some time

25
Q

what is the value of stabilisation?

A

preventing lesion progression
arresting caries
prevention of sensitivity

26
Q

what is the typical sequence of treating a child?

A

temporary dressing or relief of pain
OHI/prevention/ placement of F/S/ fluoride application
restorations, pulp therapy, extractions (maxilla first)
operative tx in mandible IDB treat whole quadrant if and when possible
anterior restorations

27
Q

when restoring a primary tooth should an isthmus be used?

A

no because it is not relevant to the primary dentition
cant use amalgam in the primary dentition

28
Q

what are the 2 main factors that affect the choice of material used to restore a primary tooth?

A
  1. those relating to the tooth
  2. factors relating to the patient
29
Q

what are the tooth factors involved in the decision making of material?

A

extent of carious lesion
cavity shape after caries removal

30
Q

what are the patient factors involved in the decision making of material?

A

efficacy of isolation and moisture control
caries rate
aesthetic expectations

31
Q

what is the main downside of the hall crown technique?

A

child or parent don’t think it is aesthetically pleasing

32
Q

which area is usually first to decay in the primary dentition?

A

proximal surface

33
Q

which area would be cavitated to show a high caries risk in a child?

A

occlusal/pit and fissures

34
Q

who stated that no amalgam should be used in the deciduous dentition?

A

minimata treaty
1st July 2018

35
Q

what is the gold standard restoration for class II cavities?

A

stainless steel crowns

36
Q

how do stainless steel crowns work?

A

deciduous tooth morphology holds the key to the retention of the stainless steel crown. it is held by the cervical constriction

37
Q

what is the material of choice for an occlusal conventional restoration?

A

compomer, GIC, composite

38
Q

what are the indications to use a stainless steel crown for restoring primary molars?

A

Large class II cavities]
following a pulpotomy
hard tissue anomaly (amelo imperfecta)

39
Q

how do you select the right size of stainless steel crown?

A

measure the mesiodistal width of the crown in the mouth
or
trial and error

40
Q

what is the most common cause of anterior caries in children < 3

A

bottle mouth caries

41
Q

what is discing?

A

using a disc to flatten edge of cavity, meaning its no longer retentive for food or plaque - should stop or arrest lesion

42
Q

what are the disadvantages of using composite on primary teeth?

A

poor moisture control
behaviour issues
difficult to get composite to bond due to such small amounts of enamel and dentine

43
Q

what are the disadvantages of using GIC on the primary dentition?

A

isnt ideal fro proximal cavities as it doesnt have durability of wear strength to last any length of time

44
Q

what are the advantages of using GIC?

A

good for temporisation and stabilisation
releases fluoride but not enough evidence to see if this is effective

45
Q

up to what age should a short needle be used for an IDB?

A

7

46
Q

what is the maximum safe dosage for lidocaine?

A

1/10th per 1kg

47
Q

what is the maximum safe dosage for prilocaine?

A

1/11th per 1kg

48
Q

what is the anatomical differences in adult and child mandibles?

A

angle of the mandible is more obtuse in a child
ID foramen is slightly lower and is at or just above level of occusal plane

49
Q

what is the rule of 10?

A

tells you whether you can do an IDB or infiltration?

50
Q

what is the sum for the rule of 10?

A

childs tooth + tooth number

51
Q

what number in the rule of 10 implies an IDB is safe?

A

> 10

52
Q

what number in the rule of 10 implies an infiltration is the safest option?

A

≤10

Module 5 Exam (14 decks)

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