Child Dental Health: All lectures Flashcards
(97 cards)
1
Q
Q1: What groups does each age group fall in to:
1-3 years infants
3-5 years pre school
5-12 years school age
12-16 years adolescents
A
1-3 years infants
3-5 years pre school
5-12 years school age
12-16 years adolescents
2
Q
Q2: child development is a process every child goes through, which involves learning and mastering skills, what are the 5 main areas of development.
A
- Cognitive
- Speech and language
- Social and emotional
- Fine motor skill
- Gross motor skill
3
Q
Q3: what would be the main two groups, which have many factors in place that can affect a child’s development?
A
Biological and Social.
4
Q
Q4: name some points on what influences the way children act when they come into the clinic?
A
- Age
- Personality
- Culture
- Previous experience
- Family stories, both good and bad
- The way the dental team act
- The ambience/ the look of the clinic
5
Q
Q5: what are the communication techniques we can use to manage children patient?
A
- Tell show do
- Modelling
- Positive reinforcement
- Active listening
- Repetition by the parent
6
Q
Q6: communication can be thought as a three-way process, what are the three processes?
A
- Giving information
- Getting information
- Checking information has been understood
7
Q
Q7: what are the three parts of communication and the percentage of each part?
A
- Tone 38%
- Non-verbal 55%
- Actual words 7%
8
Q
Q8: “treatment alliance” is between who?
A
Dental team, the parents, and the patient.
9
Q
Q9: parents in or out of the surgery has both negative and positive affects on the child patient, a negative such as behaviour contagion is what?
A
Transferring their anxiety.
10
Q
Q1: what does TIPPS stand for?
A
Talk, instruct, practice, plan, support
11
Q
Q2: what are the two main non-pharmacological methods to aid treatment delivery?
A
- Gain rapport with patient.
- Give control to the patient
12
Q
Q3: before seeing the child patient it is important to speak to the parent, what would be explained to the parent?
A
Explain to the parent the importance of their role and how you will work together.
13
Q
Q4: what are the benefits of familiarising the child with the dental surgery environment?
A
Child is familiar with the procedures
14
Q
Q5: what could you do to enhance the childs feeling of control in a dental chair?
A
Allow child to help operate the chair, give them a stop signal and give them a go signal to.
15
Q
Q6: it is important that the child has a stop signal and that you respond immediately, failure to do so can result in what?
A
Breakdown in trust.
16
Q
Q7: tell – show – do appears to work best when there are what levels of anxiety in the patient?
A
Low anxiety level
17
Q
Q8: tell-show-do is used to familiarise patients with what type of procedures?
A
New procedures
18
Q
Q9: how can introduce stimuli, that causes a fear or phobia in a manner to achieve desensitisation?
A
Introduce the stimuli in a graded manner.
19
Q
Q10: it is important when introducing a stimuli which generates fear/phobia to use what methods at the same time?
A
Relaxation and breathing techniques.
20
Q
Q11: structured time allows the child to know how long something is going to go on for, what should structured time be used with (procedures)?
A
Giving LA, hand pieces
21
Q
Q12: how many steps are there in the motivational interviewing?
A
5 steps.
22
Q
Q13: when would you only use IANB in a child?
A
For pulpotomy procedures on lower Es only
23
Q
Q14: for extractions of lower Es what type method would you use to achieve anaesthesia?
A
Buccal and lingual infiltrations.
24
Q
Q15: what type of infiltration should be administered prior to palatal infiltration in a childs case?
A
Intra-papillary infiltration.
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Q16: the maximum recommended dose of lidocaine is how many mg per kg, with an absolute ceiling of how many mg?
4.4 mg per kg, with an absolute ceiling of 300mg
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Q17: 2% lidocaine translates into 20 mg per 1ml, therefore a cartridge of 2.2 ml contains how many mg of lidocaine? 44 mg
44 mg
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Q18: the maximum ceiling of 300 mg translates as just under how many cartridges (44 mg of lidocaine per cartridge)?
7 cartridges (6.8 to be precise)
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Q19: for a 25kg child, what would be the max dose of lidocaine that can be used?
25 x 4.4 = 110 mg (two cartridge = 88 mg + half a cartridge = 22 mg total = 110mg) a total of 2.5 cartridges of lidocaine
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Q20: which agent is used in IV sedation?
Midazolam
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Q21: IV sedation has unpredictable results in children, therefore not recommended below what age?
15 years
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Q22: how long does it take to recover from IV sedation?
Not fully recovered until next day
32
Q1: what would you use silver diamine fluoride for?
Silver diamine fluoride is a topical medication used to treat/arrest and prevent dental caries and relive dental hypersensitivity.
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Q2: a child who manages good oral hygiene at a younger age is expected to what at an older age?
Mange better with treatments and prevention.
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Q3: what are the two guidelines available to help assist in prevention of dental caries in children?
Sign and SDCEP.
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Q4: 5 oral health packs are given to children as part of the child smile initiative. At what age do they receive the packs and how many?
At age 3 they are given two packs, at age 4 they are given two packs, and at age 5 they are given 1 pack.
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Q5: every newborn is routinely linked to child smile via their?
Health visitor/public health nurse
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Q6: when examining a patient, and they do not have a diagnosis, however they have a poor knowledge/attitude/skills, what can you put down as diagnosis?
increased caries risk due to poor knowledge/attitude/skills.
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Q7: following risk assessment children and young people who are under the age of 18, who are at a standard risk of developing dental caries should be advised to use fluoride toothpaste in the range of?
1,000 to 1,500 ppmf
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Q8: following risk assessment children aged 10 to 16 years who are at an increased risk of developing dental caries should be advised to use fluoride toothpaste in the concentration of?
2,800 ppmf
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Q9: Dundee Dental Hospital uses a level 5 plaque index, how much of your tooth surface would have to be covered in plaque to score a 10/10?
Tooth surface is perfectly clean with no visible plaque.
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Q10: Dundee Dental Hospital uses a level 5 plaque index, how much of your tooth surface would have to be covered in plaque to score a 4/10?
2/3 covered. Tooth surface covered with abundant plaque.
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Q11: Dundee Dental Hospital uses a level 5 plaque index, how much of your teeth would have to be covered in plaque to score a 6/10?
1/3 covered. Visible plaque along gingival margin
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Q12: Dundee Dental Hospital uses a level 5 plaque index, how much of your teeth would have to be covered in plaque to score an 8/10?
Appears clean but dental plaque can be removed from gingival 1/3
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Q1: there are a number of key differences between the primary and permanent teeth, what are the differences between the contact points between primary and permanent teeth?
Primary teeth have larger contact points, located in the middle third of the teeth compared to permanent teeth.
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Q2: there are a number of key differences between the primary and permanent teeth, how does the pulp to crown ratio compare between primary and permanent teeth?
Primary teeth have a larger pulp to crown ratio, compared to permanent teeth.
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Q3: primary teeth have bulbous roots with complex pulp canal structure and, of course they are designed to exfoliate, what does bulbous mean?
Fat, round or bulging.
47
Q4: what is silver diamine fluoride (SDF)?
Is a topical medicament that can be used to manage and prevent dental caries, as well as reliving dentinal hypersensitivity.
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Q5: what are the properties in silver diamine fluoride that help manage and prevent dental caries?
Silver compounds possess antimicrobial properties and fluoride is used in the remineralisation of enamel and dentine.
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Q6: what must you ensure that the parent knows before you have applied the silver diamine fluoride?
That the lesion will go dark black.
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Q7: ensuring the patient is adequately protected to minimize the risk of staining to tissues and clothing, what can you do to the lips to protect it from staining?
Applying petroleum jelly on it.
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Q8: following the completion of silver diamine procedure, how would you remove the excess SDF?
Air-drying or by dabbing the treated lesion with a cotton pellet.
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Q9: what is ART?
ART stands for Atraumatic restorative treatment, which is a minimally interventive approach.
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Q10: Atraumatic restorative treatment uses which equipment to carry out the minimally interventive approach?
ART involves selective caries removal using on hand instruments and the placement of a glass ionomer cement (GIC) restoration.
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Q11: what would be the best treatment choice for managing single surface cavities in both primary and permanent teeth, with a minimal interventive approach?
Atraumatic restorative treatment.
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Q12: ART cavity is prepared to prevent lesion progression. When creating an ART cavity what must you make sure you have established, which will allow for an efficient sealing?
Established clean peripheral margins.
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Q13: ART is particularly useful for children who have what type of issues?
Pre-cooperative or anxious.
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Q14: which hand instrument would you use to remove loose carious dentine from the periphery of the cavity?
Excavators.
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Q15: once the cavity has been prepared in an ART what would you fill it with?
Glass ionomer material
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Q16: once you have placed glass ionomer material in the ART cavity, what must be placed on the glass ionomer after you have removed your fingers for two minutes?
Petroleum jelly must be applied to the surface of the tooth, this acts as a barrier against moisture.
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Q17: after the glass ionomer has been placed what must you advise the patient to do?
Not to eat or drink anything for the next 1 hour except water.
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Q18: what are the indications for use of silver diamine fluoride?
1. Patients high risk developing caries
2. Pre-cooperative children
3. Treatment challenged by behavioural or medical conditions
4. Patients with several carious lesions that may not all be treated in one visit
5. Difficult to treat dental carious lesions
6. Patients without access to dental care.
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Q19: what are the contraindications for use of silver diamine fluoride?
- Silver allergy
- Pain, irreversible pulpitis or periapical periodontitis
- Infection
- Patient refusing treatment
- Unable to isolate tooth.
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Q20: how many roots are there in the lower primary molars and where are their roots located?
Lower primary molars have two roots and their respected roots/root canal are located mesial and distal.
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Q21: how many roots are there in the upper primary molars and what are the locations for these roots?
Upper primary molars have 3 roots and they are located mesiobuccal, distobuccal, and palatal.
65
Q1: orthodontic separators are elastic loops that can be placed between the teeth.
They are stretched to place between teeth and shrink back to their original shape and size, pushing the teeth apart as they do so.
Before fitting a preformed metal crown using the hall technique, how long would you have the separators in prior to the crown placement?
3-7 days
66
Q2: how does the use of orthodontic separators help aid caries diagnosis?
by allowing visualisation and access to the proximal contacts.
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Q3: what would you use prior to using proximal sealants to gain access to proximal regions?
Orthodontic separators.
68
Q4: which tooth would be treated in the hall techniques?
Primary molar tooth
69
Q5: the hall technique is a method of “sealing in” caries within a primary molar tooth what is done to the primary molar tooth to prepare for the Hall technique?
No major preparation is needed other than cleaned tooth, this includes no caries removal, tooth preparation or the use of local anaesthetic.
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Q6: the hall technique is particularly useful for restoring teeth with multi-surface carious lesions, what must be checked clinically and radiographically before the procedure is done?
The tooth must have no clinical or radiographic signs of pulpal pathology.
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Q7: the Hall technique manipulates the plaques environment by sealing it into the tooth, separating it from substrates, how does this change the bacterial profile in the caries?
Bacteria that is present in the plaques environment that is constantly receiving nutrients, will eventually favour a profile that makes it cariogenic.
By restricting its supply, the bacterial profile in the caries changes significantly to a less cariogenic community and as a result the lesion does not progress.
72
Q8: the Hall technique starts with establishing a baseline indicator of occlusal vertical dimension, what is a occlusal vertical dimension?
is a term used in dentistry to indicate the superior-inferior relationship of the maxilla and the mandible when the teeth are occluded in maximum intercuspation.
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Q9: before placing the metal crown in the Hall technique, you must gently remove the separators that are placed in the proximal regions, what instruments would you use to achieve this?
Excavator or flat plastic.
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Q10: the preformed metal crowns that are commonly used are available in sizes 4, 5 and 6. What must you measure, and what instrument would you use to carry out this measurement?
The mesio-distal width and the buccal-lingual width of the tooth, this can be measured using a number of devices however the most effective device is a periodontal probe.
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Q11: what must be loaded in the crown before inserting in on to the molar?
The crown must be loaded with a glass ionomer luting cement and should be filled at least 1/3 of its capacity.
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Q12: after the placing of the metal crown, what must be recorded?
The measurement for the occlusal vertical dimension must be recorded again.
With the recordings taken you can now work out if there has been an increase in occlusal vertical dimension.
77
Q1: what is the pulpotomy technique?
This is a technique where inflamed and possibly infected coronal pulp tissue is removed from a carious tooth to preserve healthy radicular pulp.
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Q2: how would you gain access to the pulp chamber when performing a pulpotomy?
Gain access to the pulp chamber using the high speed hand piece with the diamond bur.
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Q3: once you have entered the pulp chamber you should observe bleeding from the pulp, if bleeding does not occur and the pulp appears necrotic, what can be assumed?
That the pulp is non-vital and a pulpotomy would not be the appropriate course of treatment, a pulpectomy is required or extraction.
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Q4: the removal of the coronal pulp will be done using a slow speed handpiece, what type of bur would be used?
A large rosehead bur.
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Q5: what is haemostasis?
Haemostasis is a process to prevent and stop bleeding.
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Q6: once the coronal pulp has been removed in a pulpotomy, haemostasis needs to be achieved, how do you do this?
Placing a cotton pellet soaked in ferric sulphate into the remaining pulpal tissue and canal entrances. Use tweezers to deliver the cotton pellet into the access cavity, pressing firmly.
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Q7: how long would you leave the ferric sulphate in contact with the pulpal tissue?
For 1-2 minutes
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Q8: what would be placed in the pulp chamber after haemostasis been achieved in a pulpotomy?
Fill the pulp chamber with zinc oxide eugenol material. And the place a preformed metal crown.
85
Q1: you see a patient with fluctuant swelling and presenting with pain. The swelling is quite high in the buccal sulcus, you decide not to do an extraction today, why did you come to this conclusion?
There is too much swelling to infiltrate the region with local anaesthetic.
86
Q2:evidence based research undergone by WHO states that an intake of free sugars up to ------- times a day will increase risk of developing caries significantly.
Four
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Q3: vipeholm studies showed eating sticky sweets between meals increased caries by between ……. To ……… times.
4 to 10
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Q4: what are the three key requirements for affecting change in health related behaviour?
Knowledge (what to do).
Skills (how to do it).
Attitude (the motivation to do it).
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Q5: the primary mineral in saliva is hydroxy-apatite, when fluoride is added to the oral environment, the hydroxyl in the apatite crystal can be replaced by the f- ions to produce what? And how does this affect the solubility? The replacement of the hydroxyl by the f- leads to the formation of the fluorapatite, which is less soluble
The replacement of the hydroxyl by the f- leads to the formation of the fluorapatite, which is less soluble
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Q6: what would be the contraindications of using duraphat a commonly used fluoride varnish?
- Asthma
- Allergies to colophony
- Elastoplast
- Patients with ulcerative gingivitis/stomatitis
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Q7: Sign 138 recommends fluoride varnish should be applied at least how many times a year?
Twice
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Q8: how much fluoride varnish should be used for patients aged 2-5?
0.25ml
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Q9: how much fluoride varnish should be used for patients aged 6?
0.4ml
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Q9: what is the toxic dose of fluoride?
Is 5mg per Kg
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Q10: what do you do in acute overdose of fluoride?
Minimize absorption by giving calcium containing solution e.g. milk,
find out how old the child is or how much they weigh,
find out how much has been consumed and transfer to A&E for a full assesment
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Q11: enamel fluorosis and primary dentine fluorosis occur as a result of excess fluoride ingestion and only while the teeth are what?
Whilst the teeth are forming.
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