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Pulse Pedodontics > Deck 1 > Flashcards

Deck 1 Flashcards

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0
Q

Keys triad

A

Host, agent and substrate factors interaction is essential for initiation and progress of caries

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1
Q

Critical pH at which demineralisation starts

A

5.2 - 5.5

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2
Q

Tooth factors in Keys triad

A

Composition (surface > subsurface enamel)
Morphology (pits and fissures, hypoplasia)
Position (malalignment)

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3
Q

Window of infectivity

A

S. mutans
19-31 months of age
6-12 years of age

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4
Q

Infected dentin stain

A

Stained by 1% acid red solution in 0.2% propylene glycol

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5
Q

Elements that increase caries experience

A

Trace elements like selenium, cadmium, lead, barium

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6
Q

Lactose content of breast milk

A

7.2%

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7
Q

Lactose content of bovine milk

A

4.5%

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8
Q

Lactose content of Milk powder

A

7%

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9
Q

MDS MD

A

Maternally derived strep mutans disease AKA early childhood caries

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10
Q

What is the main method of transmission of early childhood caries

A

Kissing

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11
Q

Caridex

A

Chemo-mechanical system of caries removal

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12
Q

Caridex solution 1

A

Sodium hypochlorite

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13
Q

Caridex solution 2

A

Glycine
Aminobutyric acid
Sodium chloride
Sodium hydroxide

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14
Q

Types of sugar substitutes

A

Caloric sweeteners

Non-calorie sweeteners

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15
Q

Non-calorie sweeteners

A 
Saccharin
Aspartame (Nutra sweetener)
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16
Q

Caloric sweeteners

A 
Xylitol
Lactitol
Sorbitol
Lycasin
Maltitol
Invert sugar
Coupling sugar
Sorbose
Palatinose
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17
Q

Different morphologies of fissures

A

V, U, I, K types

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18
Q

Different types of fissures

A

Self-cleaning

Caries-susceptible

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19
Q

Types of self-cleaning fissures

A

V, U

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20
Q

Types of caries susceptible fissures

A

I, K

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21
Q

How do you restore self-cleaning fissures

A

Non-invasive techniques

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22
Q

How do you restore caries susceptible fissures

A

Invasive technique

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23
Q

Dental cripple

A

Child who has lost many teeth

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24
Pulp treatment for traumatised primary incisors involving only enamel
Observation
25
Pulp treatment for trauma in primary incisors involving enamel and dentin
ca(OH)2 or GIC lining
26
Pulp treatment for primary incisors with trauma involving enamel, dentin and pulp
Enamel+Dentin+Pulp: formocresol pulpotomy; pulpectomy if devital or irreversible pulpitis
27
Treatment modalities for root fracture in primary incisors
Observation, extraction, splinting
28
Treatment modalities for pulp in avulsion of primary incisors
None
30
Treatment modalities for pulp in displaced primary incisors
Observation, extraction
31
Treatment modalities for pulp in intruded primary incisor
If no damage to permanent tooth crypt, wait for it to erupt. If damage occurs, extraction indicated.
32
Restoration in traumatised primary incisors involving enamel only
- Smoothen rough edges | - Apply fluoride
33
Restoration in traumatised primary incisors involving enamel and dentin
- Acid etch composite resin - Open faced stainless steel crown - Polycarbonate crown
34
Restoration in traumatised primary incisors involving enamel, dentin and pulp
- Open faced stainless steel crown - Composite resin - Strip crown
35
Restoration in traumatised primary incisors involving root fracture
Space maintainer if required
36
Restoration in traumatised primary incisors involving avulsion
Space maintainer if required
37
Restoration in traumatised primary incisors involving displacement
- Immobilization | - Space maintainer if required
38
Restoration in traumatised primary incisors involving intrusion
None
39
Pulp treatment for trauma in permanent incisor involving enamel
Observe
40
Pulp treatment for trauma in permanent incisor involving enamel and dentin
Calcium hydroxide liner
41
Pulp treatment for trauma in permanent incisor involving enamel, dentin and pulp
IF apex is OPEN, - DPC - Calcium hydroxide pulpotomy - Apexification IF apex is CLOSED - DPC - Pulpectomy
42
Pulp treatment for trauma in permanent incisor involving root fracture in cervical one third
- RCT | - Extraction
43
Pulp treatment for trauma in permanent incisor involving root fracture in middle one third
Splint
44
Pulp treatment for trauma in permanent incisor involving root fracture in apical one third
Splint
45
Pulp treatment for trauma in permanent incisor involving avulsion
Reimplant, splint for 10-14 days, observe
46
Pulp treatment for trauma in permanent incisor involving mild displacement
Observe
47
Pulp treatment for trauma in permanent incisor involving severe displacement
Splint
48
Pulp treatment for trauma in permanent incisor involving mild concussion with mobility
Observe
49
Pulp treatment for trauma in permanent incisor involving severe concussion with mobility
Splint
50
Restoration indicated after trauma in permanent incisor involving enamel
- Smoothen rough edges | - Acid etch composite resin
51
Pulp treatment for trauma in permanent incisor involving enamel and dentin
- Acid etch composite resin | - To retain the restoration, temporary crowns like acrylic, polycarbonate and open faced SS crowns are used
52
Pulp treatment for trauma in permanent incisor involving enamel, dentin and pulp (open apex)
- Acid etch composite resin | - To retain the restoration, temporary crowns like acrylic, polycarbonate and open faced SS crowns are used
53
Restoration indicated after trauma in permanent incisor involving enamel, dentin and pulp (closed apex)
- Acid etch composite - Jacket crown - Post core crown
54
Restoration indicated after trauma in permanent incisor involving root fracture
- Gold core with PFM crown - Space maintainer - Fixed prosthetic appliance
55
Restoration indicated after trauma in permanent incisor involving avulsion
none
56
Restoration indicated after trauma in permanent incisor involving displacement
Immobilisation
57
Restoration indicated after trauma in permanent incisor involving concussion with mobility
- Relieve from occlusion | - Immobilisation
58
Classification of anterior tooth fractures is given by --
Andresen / WHO
59
Fractures of enamel (Andresen)
873.60
60
Fracture of enamel and dentin (Andresen)
873.61
61
Pulp exposures (Andresen)
873.62
62
Root fractures (Andresen)
873.63
63
Crown and root fracture (Andresen)
873.64
64
Concussion or luxation (Andresen)
873.65
65
Intrusion or extrusion (Andresen)
873.66
66
Avulsion (Andresen)
873.68
67
Soft tissue injury (Andresen)
873.69
68
Vitality tests
- Heat test with gutta percha - Ethyl chloride - Ice - Electric pulp tester - Carbon dioxide snow
69
When does pulp testing give false readings?
- If root formation is incomplete | - If the tooth has a temporary crown or splint
70
Which teeth should be tested during a vitality test?
Teeth in the immediate area as well as the opposing arch
71
How do you diagnose pulp death with a vitality test?
If the injured tooth requires more current than that for a normal tooth to give a response
72
How do you diagnose pulpal inflammation with a vitality test?
If less current is needed to elicit a response from the traumatised tooth
73
What is the response of a tooth tested immediately after trauma for vitality?
IT may be negative as it may be in a state of shock
74
How long must you wait before retesting a traumatised tooth for vitality?
A week to 10 days.
75
What methods determine vitality based on nerve supply of pulp?
Electric and thermal tests
76
What methods determine vitality based on blood supply of pulp?
Laser doppler flow meter and pulse oximeter
77
Under what circumstances would you get false negative results in pulp vitality tests?
- Presence of calcification | - Presence of pulp stones
78
Under what circumstances would you get false positive results in pulp vitality tests?
In the presence of moist gangrenous pulp remnants
79
How many radiographs must you take for a full mouth survey in a patient who is 1-3 years old?
4 - 2 Anterior IOPAs and 2 Bitewings
80
How many radiographs must you take for a full mouth survey in a patient who is 3-6 years old?
12. Anterior IOPAs - 6 Posterior IOPAs - 4 Bitewing - 2
81
How many radiographs must you take for a full mouth survey in a patient who is 6-12 years old?
14. Anterior IOPAs - 8 Posterior IOPAs - 4 Bitewing - 2
82
How many radiographs must you take for a full mouth survey in a patient who is over 12 years old?
20. Anterior IOPAs - 8 Posterior IOPAs - 8 Bitewing - 4
83
List of recent techniques of LA
- EMLA - Denti patch - Jet injections - Wand - TENS
84
EMLA
Eutectic Mixture of LA
85
MoA of EMLA
Diffuses through intact skin and reduces pain during needle injection through skin
86
Composition of EMLA
(5% cream) - 25 micrograms/gram of Lidocaine - 25 micrograms/gram of prilocaine
87
When is EMLA used?
It is applied to skin at least 1 hour before injection
88
When is EMLA contraindicated?
Children below 6 years of age
89
Denti Patch
Controlled releasing devices
90
MoA of Denti Patch
Topical agent is incorporated into a matrix, which will adhere to mucosa and allow slow release of anaesthetic drug
91
List some available denti patch systems
Lidocaine transoral delivery system in 10% and 20% concentrations
92
Jet injections aka...?
Needle less anaesthesia
93
MoA of Jet injections
Can penetrate mucous membranes / skin under pressure without causing excessive tissue trauma
94
Brand names of Jet injections
- Syriget | - Madjet
95
What is Wand?
A computer controlled injection system
96
Dosage in wand
Controlled by computer
97
TENS
Trans-Electronic Nerve Stimulation
98
MoA of TENS
Electronic stimulation of nerve endings is used for anaesthetic effect
99
When is TENS indicated?
- Needle phobic patients | - Where local anaesthesia is ineffective
100
Conscious sedation vs GA
- Several visits vs Single sitting - Cooperative (anxious) vs Uncooperative - Conscious, airway maintained vs Ventilation - No premedication and investigations required - NPO not required
101
Pre-cooperative stage
Non-cooperative 2 year-olds
102
Which children are said to have a behaviour problem?
Potentially cooperative children. They can be made cooperative by applying behaviour modification techniques
103
What is pre-appointment behaviour modification?
Anything that is said or done to positively influence the child's behaviour before the child enters a dental operatory.
104
Euphemism for rubber dam
Raincoat
105
Euphemism for alginate
Pudding
106
Euphemism for sealant
Tooth paint
107
Euphemism for topical fluoride
Cavity fighter
108
Euphemism for suction
Vacuum cleaner
109
Euphemism for study models
Statues
110
Euphemism for high speed
Whistle
111
Euphemism for low speed
Motorcycle
112
What is restraining?
A technique of making a negative behaviour child who had previous unpleasant dental experience cooperative by demonstrating a difference such as performing nitrous oxide sedation.
113
Different types of reinforcement
- Positive reinforcement - Negative reinforcement - Social reinforcement - Material reinforcement
114
Positive reinforcer
One whose contivgent presentation increases the frequency of behaviour
115
Example of positive reinforcer
Gifts
116
Negative reinforcer
One whose contingent withdrawal increases the frequency of behaviour
117
Example of negative reinforcer
Withdrawal of mother
118
Social reinforcers
- Praise - Positive facial expression - Shake hand
119
Material reinforcers
- Toys | - Games
120
Bio-feedback
Use of certain instruments to detect certain physiological processes associated with fear
121
Cleft Lip
- Failure of fusion between median nasal process and maxillary process - Failure of mesodermal migration between the two layered epithelial membrane
122
Cleft palate
- Failure of fusion of two palatal shelves - Rupture of inclusion cyst at the site of fusion - Failure of the tongue to drop down
123
Incidence of CLCP
1 in 750 infants (finn)
124
CL incidence
25%
125
CP incidence
25%
126
CL+P incidence
50%
127
In whom is CL+P seen more often?
Males
128
In whom is CP seen more often?
Females
129
Which is more common, Unilateral or bilateral CL?
Unilateral - left sided preponderance.
130
Etiology of CLP
- Genetic factors (monogenic) - Environmental factors - Gene-environment interactions (polygenic)
131
Protocol for dental care of CLP at birth
- Feeding plate | - Pre-surgical orthopaedics
132
Protocol for dental care of CLP at 3-5 months
- Alignment of primary teeth - Palatal expansion with simple fixed appliance like W-arch and Arnold expander - Cleft lip repair
133
Protocol for dental care of CLP at 12 months
- Pedodontic review - Cleft Palate repair - Speech pathologists first assessment
134
Protocol for dental care of CLP at 2-8 years
- Pedodontic review - Orthodontic consultation - Preventive measures - Restorative care - Review by ENT, plastic surgeons
135
Protocol for dental care of CLP at 8-15 years
- Suitability about bone grafting - Orthodontic treatment - Speech pathologist review - Review by plastic surgeon
136
Rule of 10 in CL repair
Hb - 10 gm% Age - 10 weeks Weight - 10 lbs TLC - < 10,000/cu.mm
137
Types of CL repair
Millard's rotation advancement flap | Tennison-Randall triangular flap
138
When should CP be repaired for best results?
Between the ages of 1 and 1.5 years.
139
Types of CP repair
Langenback repair | Veu Wardill Killner V-Y push back palatoplasty
140
What are the different criteria based on which drug dosage can be calculated?
- Age - Body Weight - British National Formulae - Body Surface Area
141
Youngs formula for Calculating drug dosage
[Child's age/(age+12)] * Adult dose
142
Cushing's formula for calculating drug dosage
(Child's age/24) * Adult dose
143
Cowling's formula for calculating drug dosage
(Age to the next birthday/24) * Adult dose
144
Clark's rule for calculating drug dosage
[Child weight (lbs)/150] * Adult dose
145
Augsberges rule for calculating drug dosage
0.7 * Weight in lbs = % of adult dose
146
British National Formulae
2 weeks of age - 12.5% Adult dose 1 year of age - 25% Adult dose 7 years of age - 50% Adult dose 12 years of age - 75% Adult dose
147
Forbes Rule
Child dose = [BSA (sq.m) of child/BSA in adult of same sex] * Adult dose
148
Standard BSA for males
1.7 sq. metres
149
Pedodontic triangle
Child, dentist and parents
150
What is the apex of the pedodontic triangle?
Child
151
Sizes of intraoral films
Size 0 Size 1 Size 2
152
Uses of Size 0 Intraoral film
- Bitewings | - IOPAs in small children
153
Uses of Size 1 Intraoral film
Anterior teeth in adults
154
Uses of Size 2 Intraoral film
- Anterior occlusal radiograph - IOPA in mixed/permanent dentition - Bitewing in mixed/permanent dentition
155
Uses of 57 x 76 mm films
Occlusal films for visualizing the entire maxillary or mandibular arches
156
Uses of 1.5 x 7 inch films
- TMJ | - Lateral oblique
157
Uses of 8 x 10 inch films
- Lateral cephalograms - Paranasal sinus view etc
158
Uses of 6 x 12 inch films
OPG
159
Fontanelles present at birth
- Anterior fontanelle - Posterior fontanelle - Sphenoid or anterolateral fontanelle - Posterolateral or mastoid fontanelle
160
Anterolateral fontanelle, aka
Sphenoid fontanelle
161
Posterolateral fontanelle, aka
Mastoid fontanelle
162
Anterior fontanelle location
Between two parietal bones and the frontal bone
163
When does the anterior fontanelle close?
18 - 24 months after birth
164
Where is the posterior fontanelle located?
Between the two parietal bones and the occipital bone
165
When does the posterior fontanelle close?
2 months after birth
166
Where is the Sphenoid fontanelle located?
Between the frontal, parietal, temporal and sphenoid bones
167
When does the sphenoid fontanelle close?
3 months after birth.
168
Where is the posterolateral fontanelle locted?
Between the parietal, occipital and temporal bones
169
When does the mastoid fontanelle close?
Between 1 - 12 months after birth.
170
Buccal pad of fat, aka
- Corpus adiposum | - Bichat's fat pad
171
What is the function of the buccal pad of fat in the child?
It is the child's reserve of energy.
172
Syndromes associated with natal and neonatal teeth
- Chondroectodermal dysplasia - Hallermann-Streiff syndrome and pachyonchia congenita - Ellisvan Creveland and Rigafede syndrome
173
Psychodynamic theories of child psychology
- Psychosexual / Psychoanalytical theory (Freud) - Psychosocial / Developmental tasks theory (Erik Erickson) - Cognitive theory (Piaget)
174
Behavioural theories of child psychology
- Cognitive theory of needs (Massler) - Social learning theory (Bandura) - Classical conditioning (Pavlov) - Operant conditioning (Skinner)
175
The three parts of Psychosexual theory
- Id - Ego - Superego
176
What is the id?
Id is the most primitive part of personality from which the other two systems develop.
177
What principle does the id operate on?
It operates on the pleasure principle and attempts to obtain pleasure.
178
When does the Ego develop?
Ego develops from Id in the 2nd to 6th month of life.
179
How is the Ego different from Id?
It brings the understanding that impulses cannot always be gratified immediately.
180
What is the Superego?
The superego represents the internalized representation of the values and morals of the society as taught to the child by the parents and other elders. It strives for perfection.
181
Oedipus complex
The desire in young boys to have sexual relations with the mother.
182
Electra complex
The development of attraction in young girls towards their father
183
What are the principles involved in Pavlov's classical conditioning?
- Generalization - Extinction - Discrimination
184
What are the stages that childhood is divided into, according to Mahler's theory?
- Normal autistic phase - Normal symbiotic phase - Separation individualization phase
185
What is the age of the child during which he undergoes the normal autistic phase?
0 - 1 years old.
186
What is the age of the child during which he undergoes the normal symbiotic phase?
4 weeks to 4 years old
187
What is the age of the child during which he undergoes the separation individualisation phase?
5 - 36 months
188
What is operant conditioning?
Individual response is changed as a result of reinforcement or extinction of previous responses, diminishing the frequency of satisfactory outcomes.
189
What is the principle of operant conditioning?
The consequence of behaviour itself acts as stimulus and affects the future behaviour.
190
What are the four basic types of operant conditioning described by Skinner?
- Positive reinforcement - Negative reinforcement - Omission - Punishment
191
How did Piaget formulate his Cognitive theory?
Piaget formulated his theory from direct observation of children by asking them about their thinking.
192
What is Cognitive theory about?
Piaget's theory is about how children and adolescents think and acquire knowledge.
193
What does the Cognitive theory say?
The environment does not shape child behaviour but the child and adult actively seek to understand the environment.
194
What is the self-actualization theory?
The need to understand the totality of a person
195
What does Massler mean by "Hierarchy of needs"?
Needs are arranged in a hierarchy, and as one general type of need is satisfied, another higher order will emerge. Basic needs -> Biological needs -> Psychological needs.
196
What is the psychosocial theory also known as?
Developmental tasks theory
197
How many stages did Erickson describe in his theory?
8 stages of the life cycle which are turning points / periods.
198
What aspect of children did Erickson concentrate on when devising his theory?
Erickson concentrated on a child's development covering the entire span of the life cycle from infancy to childhood through to old age.
199
Which is the most complete, clinically useful and theoretically sophisticated form of behaviour therapy, and why?
Bandura's Social Learning theory, because it provides more explanatory concepts and encompasses a broader range of phenomena.
200
4 types of crying
- Obstinate cry - Frightened cry - Hurt cry - Compensatory cry
201
Types of crying are given by _____
Elsbach
202
What is characteristic of an Obstinate cry?
A loud, high-pitched, siren-like wail.
203
What accompanies an Obstinate cry?
Temper tantrum with accompanying kicking, biting etc.
204
What does the obstinate cry represent?
The child's external response to anxiety.
205
What are the characteristic features of a frightened cry?
A torrent of tears with convulsive breath catching sobs.
206
What is the reason behind the frightened cry?
A frightened child is not crying to have his way, but his fear has overcome his reasoning.
207
What are the characteristic features of a hurt cry?
- Small whimper - Single tear filling from the corner of the eye and running down the child's cheek - No sound or resistance to the treatment procedure.
208
What is the reason for a hurt cry?
It is a simple reaction to the stimulus of pain. (Tears may be the only manifestation.)
209
What is the compensatory cry?
It is not a cry at all. It is a sound that the child makes with the drill. When the drill stops, the cry stops.
210
How does the compensatory cry manifest itself?
There are no tears, no sobs, just a constant whining noise.
211
Fear vs anxiety
Fear is a reaction to known danger while anxiety is a reaction to unknown danger.
212
What are the different types of fear?
- Innate fear - Subjective fear - Objective fear
213
What is innate fear?
- It is the fear that results without stimuli or previous experience.
214
What is subjective fear?
Fear transmitted to individuals from family experiences, peers (friends/media)
215
What is innate fear dependent on?
It is dependent on vulnerability of the individual.
216
What is objective fear?
Fear due to previous experience, events, objects.
217
What are the different types of mother behaviour?
- Overprotective dominant - Overindulgent - Underafffectionate - Rejecting - Authoritarian
218
How does the child of an overprotective dominant mother behave?
The child is shy, submissive and anxious.
219
How does the child of an overindulgent mother behave?
The child is aggressive, demanding and throws temper tantrums.
220
How does the child of an under-affectionate mother behave?
The child is usually well-behaved, but may be unable to cooperate, shy and may cry easily.
221
How does the child of a rejecting mother behave?
The child is aggressive, overactive and disobedient.
222
How does the child of an authoritarian mother behave?
The child is evasive and dawdling.
223
Classify behaviour management
- Pharmacological approach | - Non-pharmacological approach
224
What is non-pharmacological approach also known as?
psychological approach
225
What are the different types of non-pharmacological approaches to behaviour management?
1. Communication 2. Behaviour modification (shaping) 3. Behaviour management
226
Techniques of behaviour modification (shaping)
- desensitisation - modelling - contingency management
227
Techniques of behaviour management
- audio analgesia - biofeedback - voice control - hypnosis - humour - coping - relaxation - implosion therapy - aversive conditioning
228
Pharmacological methods of behaviour management
- premedication - conscious sedation - general anaesthesia
229
What are the two types of communication?
- verbal | - non-verbal
230
At what age of children is verbal communication best suited?
in young children over 3 years of age
231
How should the voice be during verbal communication?
Voice should be constant and gentle. The tone of voice should express empathy and firmness.
232
How is non-verbal communication done?
It is by body language. - Smiling - Eye contact - Touching the child - Giving a hug
233
What is desensitization?
The technique involves teaching the patient how to induce a state of deep muscle relaxation and describing imaginary scenes relevant to his fear.
234
Indications of desensitization
- Child's initial visit - At subsequent appointments when introducing dental procedures which are new to the patient. - When treating referral patients
235
In which children is Tell-Show-Do effective?
Children over 3 years of age.
236
How is the TSD technique used?
First, the dentist tells the child what is going to be done in simple words. Second, the dentist demonstrates the exact procedure to the child Finally, the dentist performs the procedure exactly as it was described and demonstrated.
237
how is modelling done?
The child patient is allowed to observe one or more individuals, who demonstrate a positive behaviour in a particular situation.
238
What is contingency management?
The presentation or withdrawal of reinforces (either positive or negative).
239
What is a positive reinforcer?
A reinforcer whose contingent presentation increases the frequency of a behaviour.
240
What is a negative reinforcer?
A reinforcer whose contingent withdrawal increases the frequency of a behaviour.
241
What is audio analgesia also known as?
White noise.
242
How does audio analgesia work?
An auditory stimulus such as pleasant music has been used to reduce stress and also to reduce the reaction to pain.
243
What is biofeedback used for?
The use of certain instruments to detect certain physiological processes (such as BP) associated with fear.
244
When is biofeedback used?
It is useful in anxiety and stress-related disorders, where the subject is taught to control the signals.
245
How does humour work?
Humour helps to elevate the mood of the child which then helps the child to relax.
246
What is coping?
Coping is the mechanism by which the child copes up with the dentist's treatment by establishing a close or trusting relationship with the doctor or the nurse.
247
What is voice control?
The modification of intensity and pitch of one's own voice in an attempt to dominate the interaction between the dentist and the child.
248
How is voice control used by a dentist?
The dentist may speak in a loud voice in order to gain a child's attention. Once he gains the child's attention, he may speak softer, adjusting his voice to the activity of the child.
249
When is voice control used?
It is used in conjunction with some form of physical restraints and HOME technique.
250
What is Implosion therapy?
It comprises of HOME, voice control and physical restraints.
251
What is aversive conditioning?
It is a safe and effective method of managing Frankel's extremely negative behaviour.
252
What are the two common methods used in aversive conditioning?
- HOME | - Physical restraint.
253
Who introduced HOME?
Evangeline Jordan
254
When is HOME indicated?
In a healthy 3-6 year old child, who can understand simple verbal commands.
255
When is HOME contraindicated?
In children under 3 years of age and in physically or mentally handicapped children.
256
What are the routes of administration in pharmacological management of a child patient?
- Inhalation - Oral - Intramuscular - Intravenous
257
What are the drugs administered by inhalation in a child patient being pharmacologically managed?
Nitrous Oxide (N2O)
258
What are the drugs administered orally in a child patient being pharmacologically managed?
- Hydroxyzine - Chloralhydrate - Promethazine - Diazepam - Triazolam - Chlorpromazine
259
What are the drugs administered intramuscularly in a child patient being pharmacologically managed?
- Ketamine | - Midazolam
260
What are the drugs administered intravenously in a child patient being pharmacologically managed?
Midazolam
261
Diffusion hypoxia
When nitrous oxide is removed it escapes into the alveoli with such rapidity that oxygen present becomes diluted, thus the CO2 - O2 exchange is disrupted and a period of hypoxia is created.
262
How is diffusion hypoxia avoided?
The patient is maintained on 100% oxygen for 5-10 minutes.
263
What are the precautions to be taken when administering promethazine to a child?
Use with caution in children with - Sleep apnea - a family history of Sudden Infant Death Syndrome
264
Which drug is contraindicated in a family with a history of SIDS?
Promethazine
265
What is the "lytic cocktail"?
A combination of Chlorpromazine, meperidine and promethazine used in conscious sedation
266
When is chlorpromazine contraindicated?
When the patient is on CNS depressants, as it has its own CNS depressant action
267
What are the side-effects of using diazepam?
- Thrombophlebitis - Ataxia - prolonged CNS effects
268
What is the side-effect of Midazolam?
It causes respiratory depression.
269
Of diazepam and midazolam, which one is better and why?
Midazolam, because it is twice as potent as diazepam, and has minimal possibility of thrombophlebitis.
270
What side effect could barbiturates have?
They may paradoxically cause hyper-excitability in children instead of sedation.
271
What is Chloral hydrate?
An extremely well known and widely used drug for conscious sedation.
272
Ephebodontics
Dentistry for adolescents
273
Occult Caries
Carious lesions that are hidden, i.e., not clinically diagnosed, but detected only on radiographs.
274
Mechanism of formation of fluoride bombs
Increased fluoride exposure --> remineralisation of enamel (continued cavitation in dentin) --> masked lesions by intact enamel surface
275
Caries tetrology
4 factors - Keyes triad -- tooth, microflora and local substrate PLUS fourth factor -- time.
276
Cariogram
A method of illustrating the interaction of factors contributing to the development of caries
277
Who introduced the cariogram?
Brathall et al
278
What is a cariogram?
A pie circle diagram divided into five sectors, in five colours.
279
FOTI
Fiber Optic Trans-Illumination
280
Principle of FOTI
There is a different index of light transmission for decayed and sound teeth
281
What is the difference in index of light transmission between decayed and sound tooth structure?
Decayed tooth structure has a lower index of light transmission.
282
How does an area of decay show up in FOTI?
A darkened shadow
283
Where is the use of FOTI effective?
In the anterior region.
284
DIAGNOdent
A method of caries detection
285
What principle is DIAGNOdent based on?
The principle of fluorescence.
286
What is the range of the DIAGNOdent system?
-9 to 99 (-9 = healthiest)
287
When is the use of DIAGNOdent most beneficial?
Early, precavitation stage of caries detection.
288
Dyes used in caries detection
- Calcein - Zygo ZL-22 - Fuschin - Acid red system - Alpha - Aminoacridine
289
Dyes used in detection of enamel caries
- Calcein - Zygo ZL-22 - Fuschin
290
Dyes used in detection of dentinal caries
- Acid red system | - Alpha aminoacridine
291
What is the base resin in most sealants?
BIS-GMA
292
Which were the first pit-and-fissure sealants to be introduced?
Cyanoacrylates
293
Who developed the rubber dam?
Barnum
294
What are the different materials in which rubber dam sheets are available?
- Latex | - Non-latex
295
What are the different sizes in which rubber dam sheets are available?
- 5"x5" (latex only) | - 6"x6" (latex and non-latex)
296
Where is rubber dam placed normally in primary dentition?
Over c, d, e.
297
KCP
Kinetic Cavity Preparation
298
Kinetic Cavity Preparation
Used fine particles of powder fired at high speed in a controlled manner instead of traditional high and low speed drills
299
Advantages of KCP
- No vibrations or pain sensation | - No need for anaesthesia in most cases
300
Who developed GIC?
Wilson and Kent
301
ART
Atraumatic Restorative Treatment
302
What is ART?
The placement of restorative material such as GIC in large occlusal cavity.
303
What is the principle behind ART?
Once the bacterial involvement is eliminated and further ingress prevented, it is possible for tooth structure to heal.
304
Who introduced stainless steel crowns?
Humphrey
305
Composition of Stainless steel crowns
Chromium - 17 - 19% Nickel - 10-13% Iron - 67% Other elements - 4%
306
Composition of Nickel-base crown
Nickel - 72% Chromium - 14% Iron - 6-10% Other elements - 4-8%
307
Indications of stainless steel crowns
- excessive decay in primary or young permanent teeth - Teeth with developmental or hypoplastic defects - After pulp therapy - As preventive restorations in patients who are highly susceptible to caries - As an abutment for a space maintainer or prosthetic appliance - As temporary restoration of a fractured tooth - Bruxism - In cases of single tooth cross bite by using reverse stainless steel crown.
308
Occlusal reduction for SScrown
1.5-2 mm
309
Primal reduction for SScrown
1-1.5 mm
310
Buccolingual reduction for SScrown
Very minimal or no reduction
311
Finish line for SScrown
Feather edge finish line
312
Finish margin for SScrown
Subgingival -- 1 mm below gingival crest
313
What is the most commonly used filling material for primary teeth?
ZnOE paste
314
Disadvantages of ZOE paste
- Underfilling | - Difference between its rate of resorption and that of tooth root
315
KRI paste
Iodoform paste
316
Advantages of KRI paste
- Long-lasting bactericidal potential | - Since it doesn't set into a hard mass, it can be removed if re-treatment is required.
317
Vitapex
A combination of calcium hydroxide and iodoform mixture.
318
Advantages of Vitapex
- Easy to apply - Resorbs at a slightly faster rate than does the root - No toxic effects on permanent tooth bud
319
Which is considered the nearly ideal tooth filling material?
Vitapex (Calcium hydroxide - iodoform mixture)
320
Use of gutta percha in primary teeth
Contraindicated since it is not resorbable.
321
Commonly used root canal materials for primary teeth
- Vitapex - Maisto paste - KRI Paste - Walkhoff paste
322
Composition of Maisto paste
- Zinc oxide - Iodoform - Thymol - Chlorphenol camphor - Lanolin
323
KRI paste
- Iodoform - Camphor - Parachlorophenol - Menthol
324
Walkhoff paste
- Parachlorophenol - Camphor - Menthol
325
Fixed space regainers
- Hotz lingual arch | - Lip bumper
326
Uses of fixed space regainers
To move the molar distally
327
IQ calculation
(Mental age/Chronological age) * 100
328
IQ > 140
Very superior
329
IQ 120 - 139
Superior
330
IQ 110 - 119
High average
331
IQ 90 - 109
Average
332
IQ 80 - 89
Low average
333
IQ 70 - 79
Borderline impaired
334
IQ < 69
Mentally retarded
335
Functions of Gerber space maintainer
Moves posterior tooth distally and anterior tooth mesially.
336
Functions of Lip bumper or lip plumber
Bilateral distal movement of first permanent molars
337
Indications of Hotz lingual arch
Used only when lower first molar alone drifted mesially but canines and premolars have not shifted distally.
338
Rhinomanometry
Used to detect extent of mouth breathing
339
Rhinomanometry aka
Inductive plethysmography
340
Which universal clamp is used to stabilise the rubber dam during the mixed dentition period?
5.5 #206
341
Prevalence of gingivitis in children
99%
342
Unique characteristics of attached gingiva in children
- Interdental clefts | - Retrocuspid papilla
343
Interdental clefts
Normal anatomic features found in the interradicular zones underlying the saddle areas.
344
Retrocuspid papilla location
1mm below the free gingiva on attached gingiva lingual to the mandibular canine
345
Incidence of retrocuspid papilla
- 85% children | - decreases with age
346
Probing depth of clinically normal gingival sulcus in humans
2-3 mm
347
Difference in sulcus depth between primary teeth and permanent teeth
- Comparitively greater in primary teeth | - mean = 1.4 - 2.1 mm
348
Most prevalent type of gingival change in childhood
Chronic marginal gingivitis
349
Epulis
Pink, pedunculated, submucosal mass usually arising from the anterior maxillary alveolar ridge.
350
How does epulis present?
With feeding difficulties
351
How common are breathing problems with epulis?
Rare
352
In whom is epulis more common?
Males
353
What is the treatment of epulis?
Local excision
354
What is the difference between the periodontal ligament of deciduous teeth and that of permanent dentition?
PDL of deciduous teeth is wider.
355
Chieloscopy
A procedure used in identification of suspects by the use of lip prints
356
Where are space maintainers contraindicated?
Crowded occlusions
357
Verruca vulgaris
Exophytic paopillomatous lesion indistinguishable clinically from oral squamous cell papillomas
358
Verruca vulgaris aka
Common wart
359
Eruption cyst
Blood filled cyst most commonly seen in primary second molar or first permanent molar regions
360
When is the eruption sequestrum seen?
In children at the time of eruption of the first permanent molar
361
Which primary teeth are most often observed to be ankylosed?
Mandibular primary molars
362
Rampant caries
Applied to a caries rate of 10 or more lesions per year.
363
Which type of sugar causes the most rampant multisurface cavitation in vitro?
Sucrose | rather than glocose, fructose, sorbital, starch etc
364
When should the parents start cleaning the child's mouth?
When the first tooth erupts
365
Folacin
Folic acid
366
What is folic acid essential for?
Formation and maturation of both red and white cells
367
What are caloric sugar substitutes?
Those that are not fermented by plaque flora
368
Which one is sweeter, saccharin or sucrose?
Saccharin is 100 times sweeter than sucrose
369
Aspartame, aka
nutra sweet
370
Composition of aspartame
- Aminoacids - Aspartic acid - Phenylalanine
371
Which one is sweeter, aspartame or sucrose?
Aspartame, 200x sweeter
372
Which one is sweeter, Aspartame or saccharin?
Aspartame, 2x sweeter.
373
What is the first choice for a clamp in first permanent molar?
Ivory No. 7, can be used for both maxillary and mandibular teeth.
374
Hypnodontics
Use of hypnosis in dentistry
375
Who coined the term hypnodontics?
Richardson
376
Phobia of pain, known as..?
Algophobia
377
Cystic fibrosis
Multi-system disease involving most of the exocrine glands.
378
Characteristic features of cystic fibrosis
- High viscous secretion causing duct obstruction - Airway infection and maldigestion caused by pancreatic insufficiency - Chronic respiratory and GI disease
379
Why do patients with cystic fibrosis have chronic respiratory and GI disease?
Defective gland secretions --> Abnormal water and electrolyte transport across epithelial cells --> question.
380
What is the colour of the teeth of most children with cystic fibrosis?
Dark
381
What is the reason for the discolouration of the teeth of children with cystic fibrosis?
- the disease - therapeutic agents (tetracyclines) - both
382
Calcium hydroxide introduced by...
Herman
383
Calcium hydroxide introduced in...
1930
384
How long should Calcium hydroxide be retained in IPC?
For 6-8 weeks.
385
Calcium hydroxide pulpotomy in children
Not advised because of the chance of internal resorption occurring.
386
Greatest chances of pulp exposure during restorative procedures
Mesiobuccal pulp horn of - permanent maxillary first molar - primary 1st molars Mesiolingual pulp horn of permanent mandibular 1st molar
387
Smallest primary tooth
Lower central incisor
388
Smallest primary molar
Maxillary first molar
389
Molar tubercle of Zucker candle is present in
Primary maxillary first molar
390
Molar tubercle of Zuckercandle
Well-developed cervical ridge in upper first molar
391
Primary molar that resembles permanent premolars
Primary maxillary first molar
392
Primary maxillary second molar resembles
Permanent maxillary first molar
393
Primary mandibular second molar resembles
Permanent mandibular first molar
394
Primary molar wich does not resemble any permanent tooth
Primary mandibular first molar
395
Long and sharp mesiolingual cusp is an outstanding feature of..
Deciduous first mandibular molar
396
Fifth cusp or cusp of Carabelli is present in
Primary maxillary second molar
397
Primary molar in which anatomy of pulp contraindicates and MOD preparation
Mandibular first molar
398
Breast feeding should be stopped when the child is _____ years old
1.5
399
Cervical mesiobuccal ridge is a feature of
Mandibular primary first molar
400
Primary tooth most susceptible to caries
Mandibular second molar
401
Teeth least commonly involved in nursing bottle caries
Mandibular incisors
402
Teeth more involved in nursing bottle caries
Maxillary incisors
403
Treatment of submerged tooth
If permanent tooth bud present- Surgical extraction of involved tooth, only after the patient has crossed the normal exfoliation time. If permanent tooth bud is not present- Fixed prosthesis planned, only after the curve of Spee is established.
404
What aspect of the saliva makes the tooth resistant to caries?
Presence of higher amounts of proline-rich proteins
405
Which type of milk has the highest risk of nursing caries -- Bovine, milk products or human milk?
Human -- 7.4% lactose content.
406
Which is more important -- the number of sugar intakes or the amount?
Number.
407
How much time is required to evaluate the success of apexification procedures?
3 years
408
How much time is required to evaluate the success of apexogenesis procedures?
9-12 months to 18 months.
409
First reported child abuse case
1871 - Mary Allen
410
Battered Child Syndrome
Type of physical abuse reported by Henry Kenpe in 1962
411
Clinical features of Battered Child Syndrome
- Fractures of long bones - Subdural hematoma - Failure to thrive - Soft tissue swellings - Skin bruising - Retinal hemorrhages
412
Munchausen's Syndrome features
- Parentally induced - Bleeding from various sites - Recurrent sepsis due to injection of contaminated solutions - Chronic diarrhea due to administration of laxatives - Recurrent fever - Skin rashes
413
Child abuse vs Child neglect
``` Abuse = Acute Neglect = Chronic ```
414
What is the difference between the time of onset of action of water and fat soluble drugs in adults and children?
Children have a higher body fat and water content, hence these drugs take a longer amount of time to act.
415
Safe dose of LA with adrenaline
7mg/kg body weight
416
Safe dose of LA without adrenaline
4.5 mg/kg body weight
417
STD
Safely Tolerated Dose
418
STD of fluorides
8 - 16 mg/kg body weight
419
CLD
Certainly lethal dose
420
CLD of fluoride
32 - 64 mg/kg
421
Basket-Crown technique
In stainless steel crowns a window is prepared on the labial side for improvement in esthetics.
422
Reverse stainless steel crown technique
- Used to correct cross bite | - Lingual portion of the crown acts as an inclined plane
423
Factors that change design of cavity in deciduous teeth
- Overall size of tooth - Thickness of enamel and dentin - Large pulp horn - Buccal bulge and cervical constriction - Wider contacts - Wider dentinal tubules
424
How is sensitivity prevented in restoration?
- Using coolants during cavity preparation - Slow speed of instrument - Biocompatible restorative material with suitable base
425
Estman Pattern bur
Aerotor burs with a metallic stopper at 1.5 mm from the tip
426
Difference between normal and pedo size burs
Normal length of bur: 19mm | Pedo size bur: 16mm
427
Which pedo bur serves the purpose of round and straight fissure bur?
Pear-shaped bur no. 330
428
Which pedo bur serves the purpose of the inverted cone bur?
Inverted cone bur no 34
429
What are the main factors which change the design of class 2 cavity in pedo patients
- Direction of enamel rods | - Cervical constriction in proximal area influences proximal box preparation
430
What is the maximum depth in class 2 cavity in deciduous t eeth
2.5 mm
431
Where should the gingival wall be placed in a pedo patient?
Due to cervical constriction gingival wall should not be too gingival as it will be too close to the pulp chambers.
432
What is the maximum depth of the gingival floor in a pedo class 2 cavity?
1 mm
433
How does the width of the proximal box change in deciduous teeth?
It is more, so that the margins are located in self-cleansing areas.
434
Ideal width of isthmus
1/3 of intercuspal distance
435
Minimum width of isthmus
1.5 mm
436
How wide should the gingival floor of the box be?
1mm
437
On which surfaces can retention grooves be made in a pediatric class 2 preparation?
- Buccoaxial wall - Linguoaxial wall - Never pulpal wall
438
Mechanism of Chemico-mechanical caries removal
Chemicals are used to soften the demineralised dentin by hydrolysing the partially degraded collagen fibres
439
What is the final reaction product of Caridex solutions?
N-monochloro amino butyric acid
440
What is the function of N-monochloro amino butyric acid?
It softens the dentin
441
Polycarbonate crowns
Tooth coloured esthetic crowns for "anterior deciduous teeth"
442
What is the polycarbonate crown made up of?
A thermoplastic resin, made up of aromatic linear polyesters of carbonic acid
443
Mink and Bennet technique
A technique for modification of Stainless steel crowns according to tooth size
444
Medicaments for devitalisation in pulpotomy
- Formocresol | - Mummifying paste
445
Medicaments for preservation in pulpotomy
- Calcium hydroxide, Ferric Sulphate - Glutaraldehyde - Electrocautery
446
Medicaments for regeneration in pulpotomy
- Bone morphogenic protein | - Tricalcium phosphate
447
Sweet-Pulpotomy
Another name for formocresol pulpotomy
448
How many visits does it take for formocresol pulpotomy?
4
449
Original Buckley's formula
COntains equal parts formaldehyde and cresol
450
Concentration of Buckley's formocresol used today
1/5, i.e., 20% formocresol
451
Current Buckley's formula
- Cresol - 35% - Formaldehyde - 19% - Water and glycerin - 15%
452
How is formocresol pulpotomy done?
A pellet of cotton is slightly dampened with 1:5 concentration of Buckley's formula and placed in contact with the pulp stumps. It is allows to act for 5 minutes
453
Chain reaction in formocresol pulpotomy
- Formocresol bonds with aminoacids of pulp and makes it nonvital - It also inactivates the enzymes of the pulp (like hyaluronidase) - Results in fixation of pulp - Pulp becomes inert and resistant to all enqumatic reactions
454
What chemicals does formocresol react with in the pulp?
- Amino acids | - Enzymes
455
What is the result of formocresol pulpotomy
Pulp becomes inert and resistant to all enzymatic reactions.
456
Zones after formocresol application
- Zone of fixation - Zone of atrophy - Zone of inflammation - Zone of vital pulp
457
Precautions with formocresol
SInce it is caustic, care must be taken to avoid contact with gingival tissues
458
Who introduced mummifying paste?
Hobson
459
Composition of mummifying paste
- Paraformaldehyde - Lignocaine - Propylene glycol - Carbowax - Caramine
460
Filling materials and medicaments for pulpectomy
- ZnOE - Calcium hydroxide - Iodoform paste - Vitapex - Poly-antibiotic paste
461
Reasons for using ZnOE in pulpectomy.
It is resorbable and easily available.
462
Reasons for use of iodoform paste in pulpectomy
It doesn't set.
463
Media for preserving avulsed tooth
Balanced Hank's solution (AKA trade name Save-a-tooth solution)
464
Balanced Hank's solution
Isotonic salt solution

Pulse Pedodontics (2 decks)

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