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BDS2 CLINICAL Paediatric Dentistry COPY > Child Growth and Development > Flashcards

Child Growth and Development Flashcards

1
Q

How is the anatomy of babies different to that of adults

A

o The gum pads are widely separated anteriorly so there is a gap between them
o The tongue comes forward and rests on the lower gum pad whereas later on it tucks behind the teeth
o The tongue is in contact with the lower lip

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2
Q

When does eruption begin

A

6 months (variation normal)

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3
Q

When does eruption of of deciduous dentition finish

A

24 months (variation normal)

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4
Q

What is the general rule of eruption

A

mandibular teeth BEFORE maxillary
except lateral incisors in primary dentition
except second premolar in permanent dentition

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5
Q

What is the eruption dates for the primary lower teeth

A

6, 7, 16, 12, 20

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6
Q

What is the eruption dates for the primary upper teeth

A

7, 9, 18, 14, 24

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7
Q

What are the characteristics of the primary dentition

A 
	Incisors upright 
	Incisors are spaced
	Teeth are smaller
	Reduced overjet
	More white in colour
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8
Q

What is the psychology of child development

A 
	Motor 
	Cognitive 
	Perceptual 
	Language 
	Social
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9
Q

Describe motor development

A

early ‘motor milestones’
changes following ability to walk are refinements
eye/hand coordination gradually becomes precise and elaborate with increasing experience

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10
Q

When do most children learn to walk

A

14 months

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11
Q

What are these stages of cognitive development

A

sensorimotor
preoperational thought
concrete operations
formal operations

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12
Q

When does the sensorimotor stage begin

A

at birth, lasts until 2 YO

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13
Q

What is the prime objective of the sensorimotor stage

A

object permanence – this is a child’s understanding that objects continue to exist even though they cannot be seen or heard

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14
Q

How long is the preoperaitonal thought stage

A

Happens from 2-7 years

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15
Q

What happens in the preoperational thought stage

A

o Allows child to predict outcomes of behaviour
o Facilitated by language development
o Egocentric
o Unable to understand why areas and volumes remain unchanged even though shape and position may change

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16
Q

When is the concrete operations stage

A

7-11 years
Apply logic
Able to see others perspective
Still difficult to think in abstract manner

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17
Q

What is the formal operations stage

A

o From 11 years
o Logical abstract thinking before different possibilities for an action can be considered – can think about consequence of not having certain treatments etc

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18
Q

What is perceptual development

A

 Compared to an adult, a 6 year old will cover less of an object, take in less information and become fixated on details
 Selective attention by 7 years

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19
Q

What is required for children to develop language

A

being surrounded by the language

parents talking to them

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20
Q

What does a one year old understand

A

 Vocab of about 20 words
 Simple phrases
 Relates objects to words

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21
Q

What does a one year old use in terms of language

A

 2-3 words
 Repetitive babble
 Tuneful jargon

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22
Q

What sounds can a one year old make

A

b, d, m

be dreadful man

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23
Q

What can a two year old understand

A

 Simple commands
 Questions
 Joins in action songs

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24
Q

What can a two year old use in terms of language

A

 Vocab of 100 words
 Puts two words together
 Echolalia (copies of what you say)

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25
Q

What sounds can a two year old make

A

p, t, k, g, n

petty to know good names

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26
Q

What can a 3 year old understand

A

 Prepositions (on, under etc)
 Functions of objects
 Simple conversations

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27
Q

What can a three year old use in terms of language

A

 4 word sentences
 What, who, where
 Relates experience

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28
Q

What sounds can a 3 year old make

A

f, s, l

love fake snow

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29
Q

What can a 4year old understand

A

 Colours, numbers, tenses

 Complex instructions

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30
Q

What can a 4 year old use

A

 Long grammatical sentences

 Relates stories

31
Q

What sounds can a 4 year old make

A

v, z, ch, j

chad jumps very zazzy

32
Q

What are disorders of speech and language

A 
	Learning difficulties 
	Cerebral palsy
	Autism 
	Delayed speech and language development
	Head injury
	Acquired neurological disorders
	Non-fluency
	Dysphasia
	Craniofacial disorders
33
Q

What does normal speech production require

A

 Competent airway and articulations (tongue, teeth, etc)

34
Q

What is normal speech production classified by

A

o Place
o Manner
o Voice

35
Q

How does cleft type speech differ

A

 Resonance
 Articulation
 Nasal emission of the sounds

36
Q

What is velopharyngeal incompetence

A

 Unable to block off nasal passageway to rest of the passageways

37
Q

What does an oro-nasal fistula result in

A

 Air is going to go up into the nasal cavity as it is not blocked off

38
Q

What does a class III occlusion result in

A

in difficulty in articulating sounds due to the position of the articulators

39
Q

What is the role of the cleft team

A

 Assessment
 Diagnosis
 Treatment

40
Q

What is the multidisciplinary team for cleft care

A 
o	Speech and language therapist
o	Primary cleft surgeon
o	Orthodontist
o	Paediatric dentist
o	ENT surgeon
o	Geneticist
o	Nurse
o	Psychologist
41
Q

What is the treatment for cleft palate

A 
	Feeding 
	Early intervention
	Input modelling
	Articulation therapy
	Communication support
42
Q

What is secondary surgery

A 
	Nasal revision
	Fistula closure 
 Pharyngoplasty
	Alveolar bone graft 
	Osteotomy
43
Q

Why is fistula closure sometimes needed

A

as the child grows sometimes it bursts open again causing a fistula

44
Q

What is the pharyngoplasty for

A

try to get nasopharyngeal competence a bit better

45
Q

What is the alveolar bone graft for

A

lots of them do at the cleft site to allow permanent teeth to erupt

46
Q

What is a non cleft VPI

A

 Back of the palate is not correct and can’t close over so there is communication between the oral cavity and nasal passage

47
Q

What is the pre 40 week gestation development of feeding

A

o 28 weeks – non nutritive sucking

o 34 weeks – nutritive sucking

48
Q

What is the 0-3 month development of feeding skills

A 
o	Normal oral tone
o	Rhythmical sucking
o	Primitive reflexes
	Gag
	Rooting
	Suck/swallow
o	Semireclined feeding position 
o	Liquid diet
49
Q

What is the 4-6 months development of feeding skills

A 
o	Head control 
o	More control of suck/swallow
o	Munching
o	Move towards a semi solid diet
o	Starts babbling 
o	In the UK, weaning is not recommended until 6 months of age
50
Q

What is the 7-9 months development of feeding skills

A

o Sitting feeding position – upright position
o Mashed food consistency
o Finger food
o Upper lip involvement – controls where food is going
o Chewing and bolus formation
o Bite reflex
o Mouthing

51
Q

What is the 10-12 months development of feeding skills

A 
o	Lumpy food – can eat this
o	Sustained bite 
o	Active lip closure – to stop food falling out 
o	Chewing – lateralisation 
o	Cup drinking
52
Q

What is the 24 month development of feeding skills

A

o A mature and integrated feeding pattern

53
Q

What is the effect of the family unit

A

behavior contagion
well intentioned but improper preparation
discuss dental treatment within hearing of child
enhance child’s anxiety
threatening child with dental treatment

54
Q

How should you assess children

A 
	Pain?
	Past dental history
	Relevant PMH 
	Social history
	Level of understanding and potential cooperation 
	Level of anxiety
55
Q

What are things that frighten a child

A

 The unknown
 The sight of the anaesthetic syringe
 Sight, sound and sensation of the drill
 Mutilation
 Choking
 Perceived expectation of ill-treatment/trauma
 Strangers – for a first visit, things need to be calm and friendly

56
Q

How does children display anxiety different from adults

A

more irrational and less restrained

57
Q

What are manifestations of anxiety

A 
o	Thumb sucking
o	Nail biting
o	Nose picking
o	Clumsiness
o	Stuttering 
o	Stomach pain
o	Need to go to toilet
o	Headache
o	Dizziness
o	Fidgeting
o	No speech
o	Clinging to parent 
o	Hiding
58
Q

What is manifestation of anxiety related to

A

age, sex and social class

59
Q

What are influencing factors on a child

A

 Each child’s own psychological makeup
 Understanding of what you are doing
 Emotional development
 Previous adverse dental/medical experience
 Attitude and previous experience of family/peer group

60
Q

What should you not do to a child

A 
o	Bribe
o	Coax
o	Shout
o	Bully
o	Threaten 
o	Allow child to have all their own way
61
Q

What should you do for a child regarding empathy

A

 Create an environment in which the child feels safe
 Use a kind empathetic approach using a directive guidance and reinforcement to establish cooperation and obtain a rapport
 Praise good behaviour
 Allow the child some control e.g hand signal
 Question for feeling

62
Q

What is the role of the dentist

A

good communication

reducing child anxiety

63
Q

What does good dentist to child communication allow

A

o Improves the information obtained from the patient
o Enables the dentist to communicate information to the patient
o Increases the likelihood of patient compliance
o Decreases patient anxiety

64
Q

What are the components of communication

A

verbal
paralinguistic
nonverbal communication

65
Q

How should you verbally communicate

A

 Try to avoid jargon
 Approach and language used with the children can be modified to match their abilities and understanding
 Language alternatives

66
Q

What are examples of language alternatives

A
  • Cotton wool roll = tooth pillow
  • Topical anaesthetic = bubble gum or minty gel
  • Probe = pointer/tooth counter
  • Excavator = tooth spoon
  • High speed = tooth shower
  • Slow speed = mr bumpy, tooth scrubber
  • LA = special spray, sleepy juice
67
Q

How should you communicate paralinguistically

A

 This refers to the tone of voice used

 Issuing commands in a loud voice is more effective than using a normal voice

68
Q

How should you communicate non verbally

A 
	Includes a range of behaviours and environmental factors which we often interpret without conscious awareness 
•	Facial expression
•	Gaze
•	Gesture
•	Bodily contact
•	Clothes
spatial
69
Q

How do you reduce child anxiety

A 
o	Preventing pain
o	Being friendly and establish trust 
o	Working quickly
o	Having a calm manner
o	Giving moral support
o	Being re-assuring about pain
o	Empathy
70
Q

What are things that increase fear related behavior

A 
	Ignoring or denying feelings
•	Ask them how they feel and acknowledge it
	Inappropriate reassurance
•	Often comes from parents 
	Coercing/coaxing
	Humiliating
	Losing your patience with the patient
71
Q

How should parents prepare for the dental visit

A

o Dentist should advice parent on how to prepare the child for the visit
o Rehearsal
o Supportive care prior to each stressful procedure

72
Q

When may exclusion of the parent from surgery be a good option

A

o Unable to refrain from competing with the dentist for their child’s attention
o Unintentionally convey their own anxieties to their child through body language and words

73
Q

When is involving the parent in the planning stages a good idea

A

outlining their role as a passive but silent helper may provide a comforting presence e.g if you are going to do the bad cop role

74
Q

What is the link between pain and anxiety

A

 Anxious subjects are more likely than non anxious to report pain
 This points to the psychological role in pain perception
 Anxiety, previous experience, expectation, anticipation, communication and control can influence pain perception
 Care should be taken not to hurt any child
 Restorative is usually carried out under LA
 A painless technique of administering LA is of vital importance
 An introduction to topical and LA is an integral part of treatment

BDS2 CLINICAL Paediatric Dentistry COPY (9 decks)

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