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SDCEP Guidance > Caries in Children > Flashcards

Caries in Children Flashcards

1
Q

when should the first assessment of a child be carried out

A

before the child is 6 months

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2
Q

what aspects need to be included in a child’s assessment to improve personal care plan

A

parent/ carer motivation and responsibility
patient history
clinical examination
caries risk assessment

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3
Q

how should you greet a child entering the surgery

A

make eye contact (crouch)
greet them by their name
say hello my name is…

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4
Q

what should be included in your social history for a child

A

which adults provide care for the child
which days and times are easiest for parent to bring the child in
the name of the medical practice they attend

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5
Q

what should be assessed in a clinical assessment for a child

A

the childs plaque levels
toothbrushing skills
primary and permanent dentition for caries

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6
Q

what is the technique used for examining a younger patient

A

knee to knee exam

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7
Q

talk a parent through a knee to knee exam

A

parent will sit across from the dentist with the child facing the parent, parent holds the childs hand while lowering the childs head into the clinicians lap, parent should continue to hold the childs hands and smile at them
use mirror to examine the mouth
at the end encourage the parent to give the child a cuddle

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8
Q

what might enamel caries look like on the primary dentition

A

white appearance, matt, opaque and chalky white

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9
Q

what should you ensure before assessing the presence of caries

A

teeth are completely clean and dry

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10
Q

why is probing not an acceptable method for detecting carious lesions in pits and fissures

A

it damaged pits and fissures

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11
Q

what would an arrested enamel lesion present as

A

usually feel smooth to run a ball ended probe down the surface

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12
Q

what would an active enamel lesion present as

A

the surface would feel rough and the probe drags

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13
Q

how do you determine how active a dentine lesion is

A

the softer the lesion the more active
radiograph

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14
Q

what is important to determine when looking at carious dentine on a radiograph

A

that there is a clear band of normal looking dentine between the carious lesion and the pulp

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15
Q

how regularly can you take bitewings for children at increased risk of developing caries

A

6-12 months

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16
Q

what is the standard time period to wait between taking radiographs for children

A

2 years

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17
Q

what is an initial occlusal carious lesion in primary teeth

A

non-cavitated dentine shadow or minimal enamel cavitation

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18
Q

what is an advanced occlusal carious lesion in primary teeth

A

dentine shadow or cavitation with visible dentine

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19
Q

what is an initial proximal carious lesion in primary teeth

A

white spot lesion or shadow

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20
Q

what is an advanced proximal carious lesion in primary teeth

A

enamel cavitation and dentine shadow or caivity with visible dentine

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21
Q

what is an initial anterior carious lesion in primary teeth

A

white spot lesions but no dentinal carious

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22
Q

what is an advanced anterior carious lesion in primary teeth

A

cavitation or dentine shadow

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23
Q

what is a pulpal involvement carious lesion in primary teeth

A

any tooth with clinical pulpal exposure or no clear separation between carious lesion and dental pulp radiographically

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24
Q

what is an initial occlusal carious lesion in permanent dentition

A

noncavitated enamel carious lesions that show white spot lesions, discoloured or stained fissures

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25
Q

what is molar incisor hypo-mineralisation

A

a developmental condition that affects the first permanent molars and incisors

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26
Q

what are the aspects of MIH

A

poor quality of enamel means the teeth are prone to breakdown anc can be painful on toothbrushing

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27
Q

where are sinuses usually found

A

non-attached mucosa adjacent to the attached mucosa

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28
Q

what are some indicators of dental infection

A

tenderness to percussion
alveolar tenderness
non-physiological mobility
inter-radicular radiolucency

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29
Q

what plaque score mark would you give a perfectly clean tooth

A

10/10

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30
Q

what plaque score mark would you give a tooth with plaque line around the cervical margin

A

8/10

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31
Q

what plaque score mark would you give a tooth with plaque covering the cervical third of the crown covered

A

6/10

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32
Q

what plaque score mark would you give a tooth with the middle third of the crown covered in plaque

A

4/10

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33
Q

what are the 7 aspects of caries risk assessment

A

dietary habits
clinical evidence
socioeconomic status
use of fluoride
plaque control
saliva
medical history

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34
Q

how to manage pain in a child from reversible pulpitis

A

manage the carious lesion may allow for pulpal healing

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35
Q

how do you manage pain from irreversible pulpitis in a child who is pre-cooperative

A

try to dress with corticosteroid antibiotic paste
analgesia
primary tooth - refer for treatment/ XLA with sedation or GA
permanent tooth - carry out RCT or XLA

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36
Q

how do you manage pain associated with abscesses in children

A

pulpectomy in primary teeth and permanent
extraction

37
Q

how should you treat irreversible pulpitis in a pre-cooperative child

A

dress with sub-lining of corticosteroid antibiotic pain and prescribe pain relief
extract primary teeth under sedation
RCT permanent teeth under sedation

38
Q

how to manage dental abscesses in children

A

local measures to control infection
prescribe antibiotics and pain relief

39
Q

when should antibiotics only be prescribed

A

when there is evidence of spreading infection - swelling, cellulitis, lymph node involvement or fever and malaise

40
Q

what is the standard OH advice for children

A

daily brushing with fluoride toothpaste
tailored to specific individuals

41
Q

how much toothpaste should a child under 3 use

A

a smear

42
Q

how much toothpaste should a child over 3 use

A

a pea sized amount

43
Q

what fluoride dosage toothpaste should standard risk children use

A

1000-1500 ppmF

44
Q

what fluoride dosage of toothpaste should increased risk children use

A

1350/ 1500 ppmF for under 10s
2800 ppmF for over 10s

45
Q

how often should you advise/ remind child and parent of standard risk of brushing technique

A

yearly

46
Q

what should children and parents be told during OH advice yearly

A

brush first thing in the morning and last thing at night
age appropriate toothpaste with the correct fluoride
spit dont rinse
supervise until children can brush their teeth properly
show how to brush teeth on the child

47
Q

how often should you show a standard caries risk child how to brush their teeth

A

3 minutes annually

48
Q

how often should children with enhanced prevention receive OH advice

A

at every recall visit

49
Q

what strength of fluoride toothpaste should enhanced prevention children receive aged 10-16

A

2800 ppmF

50
Q

how long should you advise children and parents to avoid eating or drinking anything after brushing teeth

A

30 mins

51
Q

in the standard prevention for all children when should fissure sealants be placed

A

as soon as possible after first permanent molars erupt

52
Q

what is the first choice material for fissure sealants

A

resin based

53
Q

when should glass ionomer fissure sealants be used

A

uncooperative children
concerns about moisture control
partially erupted teeth

54
Q

what is the press-finger technique for GIC sealants

A

place small amount of GIC on one finger tip and petroleum jelly on the adjacent finger tip
wipe tooth surface with cotton wool first if possible
firmly apply the GIC to the tooth
keep finger in place for 2 minutes
place the petroleum jelly finger in the mouth and switch to cover the GIC with jelly before moisture contamination occurs

55
Q

what should all children over the age of 2 have applied twice a year

A

sodium fluoride varnish

56
Q

name the technique for resin fissure sealant application

A

clean tooth so it is free from debris
check air line is free from water
isolate tooth using cotton wool rolls, saliva ejector and dry guard
etch tooth for 30 seconds
wash etch off straight into aspirator and dry
apply resin sealant
light cure sealant
check for flash with probe

57
Q

what percentage of fluoride is in sodium fluoride varnish

A

5%

58
Q

for children on enhanced prevention how often should fluoride varnish be applied

A

4 times a year for children over 2

59
Q

when can you advise use of an alcohol free mouthwash

A

from 7 years of age

60
Q

what are conraindications of placing fluoride varnish

A

a child hospitalised due to severe asthma or who is allergic to sticking plaster (colophony allergy)

61
Q

what dose of fluoride dose Duraphat varnish contain

A

22,600 ppmF

62
Q

describe the procedure of fluoride varnish application

A

isolate and thoroughly dry teeth a quadrant at a time
apply small amount of fluoride varnish using small brush
advise soft foods and liquids may be consumed from 30 minutes after application
child should wait at least 4 hours before brushing their teeth or chewing hard food

63
Q

how much duraphat varnish should be used in children 2-5 years

A

0.25 ml

64
Q

how much duraphat should be used for children aged 5-7

A

0.4ml

65
Q

how long should soft foods and liquids be avoided after FVA

A

30 mins

66
Q

how long should a child wait before brushing their teeth after FVA

A

4 hours

67
Q

how should non-cavitated occlusal lesions be treated in primary teeth

A

fissure sealants over them or Hall crown technique if child is uncooperative

68
Q

how should primary teeth with occlusal caries into dentine be treated

A

selective caries removal and restore with composite or GI
hall crown technique if child is uncooperative

69
Q

if an advanced proximal carious lesion is present in primary teeth how should it be treated

A

hall crown technique
selective caries removal and restore using composite

70
Q

why should complete caries removal not be carried out in primary teeth

A

significantly higher risk of pulpal exposure

71
Q

how should white spot lesions on anterior primary teeth be treated

A

site specific prevention and monitor

72
Q

how should advanced lesions on anterior primary teeth be treated

A

selective caries removal and restore using composite, RMGI

73
Q

a separator can be used to clinically assess proximal caries - how long should it be left in for

A

5 days

74
Q

when is optimal to remove 6s if of poor prognosis

A

bifurcation of the 7s are seen forming on full mouth panoramic
7s and 8s are present
class I incisor relationship

75
Q

when is the hall crown technique only successful

A

when there is a layer of unaffected dentine between the lesion and the pulp
teeth where there is no layer of unaffected dentine but they are asymptomatic

76
Q

what coloured ring is used for taking bitewings in children

A

red with size 0 film

77
Q

name 4 indicators of established dental infection

A

tenderness to percussion in non-exfoliating tooth
alveolar tenderness, sinus or swelling
non-physiological mobility
radiographic signs (radicular radiolucency)

78
Q

what is the modified child dental anxiety scale

A

MCDAS is 8 questions about specific dental procedure
there is a facial version also available

79
Q

what is the aim of behavioural management

A

promote positive attitude to dental care and facilitate ongoing prevention and care

80
Q

name five examples of behaviour management strategies

A

communication
enhancing control
tell show do
positive reinforcement
distraction

81
Q

give examples of non-verbal communication in the dental practice

A

facial expressions
eye contact
gestures
body movement

82
Q

what is enhancing control

A

stop signals

83
Q

what is tell show do

A

tell using appropriate language
show apparatus used in procedure
check child is happy before commencing

84
Q

how can you get children to practice relaxation in the surgery

A

get them to place a hand on their tummy
ask them to breathe in slowly and deeply
repeat this three times

85
Q

how would you treat irreversible pulpitis in a cooperative child

A

primary dentition - carry out XLA or appropriate pulp therapy
Permanent - carry out RCT or XLA

86
Q

how are dental abscesses treated in pre-cooperative children/ multi abscessed teeth

A

local measures to control infection
abx if indicated
analgesia
primary - refer for XLA with sedation or GA
permanent - carry out RCT or XLA

87
Q

what four things would make you think there are signs of spreading infection from dental abscess

A

swelling
cellulitis
lymph node involvement
fever/ malaise

88
Q

what dietary advice should you give to children/ their carers

A

limit consumption of food and drinks containing sugar
drink only water or milk between meal times
do not place anything that is not milk or water in bottles
if a child has a bottle at bedtime it should only have water

SDCEP Guidance (17 decks)

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