Paediatric Pastpapers Flashcards
(157 cards)
1
Q
Q1 A 13 year old female patient with discoloured upper incisors is very upset by the appearance of these teeth. It is affecting her at school and she won’t smile. Apart from the discolouration she is clinically symptom free and all the teeth are vital.
- what baseline information and/or special tests would you undertake pre-treatment (3 marks)
A
2
Q
Q1 A 13 year old female patient with discoloured upper incisors is very upset by the appearance of these teeth. It is affecting her at school and she won’t smile. Apart from the discolouration she is clinically symptom free and all the teeth are vital.
- You decide to provide a course of microabrasion initially using 18% hydrochloric acid with pumice. Outline the eight stages in the treatment (4 marks)
A
3
Q
Q1 A 13 year old female patient with discoloured upper incisors is very upset by the appearance of these teeth. It is affecting her at school and she won’t smile. Apart from the discolouration she is clinically symptom free and all the teeth are vital.
- What information would you give the patient after treatment (1 mark)
A
4
Q
Q1 A 13 year old female patient with discoloured upper incisors is very upset by the appearance of these teeth. It is affecting her at school and she won’t smile. Apart from the discolouration she is clinically symptom free and all the teeth are vital.
- You decide to provide a course of vital bleaching following microabrasion. What bleaching agent will you use and at what strength (2 marks)
A
5
Q
Q2 A 3 year old child is brought to your surgery following trauma to his upper left central incisor.
- Suggest four aspects of the presentation/history which should make you suspect non-accidental injury (4 marks)
A
- history of previous injury
- account not compatible with injury
- vague story from parent
- delay in seeking help
- childs appearance and interaction with parents abnormal
- history of violence within family
6
Q
Q2 A 3 year old child is brought to your surgery following trauma to his upper left central incisor.
- List two possible common sequelae to the primary dentition following the trauma (2 marks)
A
- discolouration
- discolouration and infection
- delayed exfoliation
7
Q
Q2 A 3 year old child is brought to your surgery following trauma to his upper left central incisor.
- List four possible sequelae to the permanent dentition following the trauma (4 marks)
A
- root resorption
- pulp necrosis and infection
- pulp canal obliteration
- breakdown of marginal gingiva and bone
8
Q
Q3 You have conducted a clinical and radiographical examination of a 6 year old child. You have decided to provide a primary molar pulpotomy on tooth 55
- List four indications for a pulpotomy on a primary molar (4 marks)
A
- enamel dentine pulp fracture
- crown-root fracture
- pulpitis with irreversible symptoms (vital pulp)
- advanced carious lesion with no clear band of dentine visible radiographically that separates the lesion and pulp
9
Q
Q3 You have conducted a clinical and radiographical examination of a 6 year old child. You have decided to provide a primary molar pulpotomy on tooth 55
- Describe the stages involved in the primary molar pulpotomy procedure (4 marks)
A
10
Q
Q3 You have conducted a clinical and radiographical examination of a 6 year old child. You have decided to provide a primary molar pulpotomy on tooth 55
During the above treatment plan you decide to provide a pulpectomy instead. What factors could have influenced this decision (2 marks)
A
11
Q
Q4 You have started work in a new practice and an 11 year old patient attends for a check-up. In her notes you see that she sustained a lateral luxation injury to tooth 11 around 18 months ago
- Suggest six clinical assessments or investigations you would carry out as part of the patient’s trauma review (3 marks)
A
Trauma stamp
- colour
- mobility
- TTP
- radiograph
- sinus
- percussion note
12
Q
Q4 You have started work in a new practice and an 11 year old patient attends for a check-up. In her notes you see that she sustained a lateral luxation injury to tooth 11 around 18 months ago
You take a radiograph (see paeds word doc)
2. what type of resorption is affecting tooth 11 and what makes this form of resorption progress (2 marks)
A
- External infection related inflammatory root resorption
- Resorptive activity is initiated by PDL damage following trauma but it is propagated by root canal toxins reaching the external root surface through patent dentinal tubules
13
Q
Q4 You have started work in a new practice and an 11 year old patient attends for a check-up. In her notes you see that she sustained a lateral luxation injury to tooth 11 around 18 months ago
- what is your treatment plan now (2 marks)
A
If the infected canal contents are removed, the propagated stimulus is lost and the lesion is usually arrested. Therefore endodontic treatment should be initiated - remove stimulus and apply non-setting CaOH for 4-6 weeks within the canals and then obturate with gutta percha
14
Q
Q4 You have started work in a new practice and an 11 year old patient attends for a check-up. In her notes you see that she sustained a lateral luxation injury to tooth 11 around 18 months ago
- What is a lateral luxation injury
A
Lateral luxation is defined as displacement of a tooth in socket in a direction other than axially (palatally lingually or labially). Displacement is accompanied by communication or fracture of either the labial or palatal/lingual bone. The PDL suffers both tearing and crushing injuries
15
Q
Q4 You have started work in a new practice and an 11 year old patient attends for a check-up. In her notes you see that she sustained a lateral luxation injury to tooth 11 around 18 months ago
- You warn the patient and parent that the long term prognosis for the tooth is poor if the resorption fails to stop. What would you tell them about immediate, intermediate and long term treatment options should the resorption continue (3 marks)
A
16
Q
Q5 A patient presents at your practice complaining of how their upper front teeth look
- Describe the appearance of dental fluorosis (2 marks)
A
17
Q
Q5 A patient presents at your practice complaining of how their upper front teeth look
- what percentage of fluoride is the optimum in drinking water (1 mark)
A
18
Q
Q5 A patient presents at your practice complaining of how their upper front teeth look
- Name 3 methods of delivering fluoride to an 8 year old and provide the concentrations for each method (3 marks)
A
19
Q
Q5 A patient presents at your practice complaining of how their upper front teeth look
- What is the local action of fluoride in the oral cavity (3 marks)
A
20
Q
Q5 A patient presents at your practice complaining of how their upper front teeth look
- Give the best treatment option for fluorosis and 2 advantages of this treatment (2 marks)
A
21
Q
Q6 The mother of one of your young patients phones your practice stating that her son has ingested fluoride toothpaste and she is worried.
- What three questions should you ask mum? (3 marks)
A
22
Q
Q6 The mother of one of your young patients phones your practice stating that her son has ingested fluoride toothpaste and she is worried
- If he has ingested a potentially toxic dose, what is your advice (2 marks)
A
23
Q
Q6 The mother of one of your young patients phones your practice stating that her son has ingested fluoride toothpaste and she is worried
- What is the most common cause of fluorosis in the UK (1 mark)
A
24
Q
Q6 The mother of one of your young patients phones your practice stating that her son has ingested fluoride toothpaste and she is worried
- If the patient is 10 with fluorosis, what would your first line of treatment be? (1 mark)
A
25
Q6 The mother of one of your young patients phones your practice stating that her son has ingested fluoride toothpaste and she is worried
5. Please provide the fluoride supplement values for the following patients, all living in an area of <0.3ppm fluoridated water (3 marks)
Age 1 -
Age 4 -
Age 7 -
26
Q7 A 10 year old boy presents to your practice after having fallen and banged his upper front tooth. On examination you diagnose a subluxation.
Give 3 diagnostic features of a subluxation (3 marks)
- increased mobility
- no displacement
- gingival bleeding
27
Q7 A 10 year old boy presents to your practice after having fallen and banged his upper front tooth. On examination you diagnose a subluxation.
2. What type of splint would you place, for how long and draw it below (2 marks)
passive, flexible splint for 2 weeks. Composite and wire splint - 0.4mm stainless steel wire secured to traumatised tooth and one uninjured tooth on each side of traumatised tooth.
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Q7 A 10 year old boy presents to your practice after having fallen and banged his upper front tooth. On examination you diagnose a subluxation.
3. When would you review this patient (1 mark)
- 2 weeks for splint removal
- 12 weeks
- 6 months
- 1 year
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Q7 A 10 year old boy presents to your practice after having fallen and banged his upper front tooth. On examination you diagnose a subluxation.
4. Name 2 features you would be assessing radiographically (2 marks)
root development and any root resorption - comparison with contralateral tooth
30
Q7 A 10 year old boy presents to your practice after having fallen and banged his upper front tooth. On examination you diagnose a subluxation.
5. How would internal inflammatory root resorption present both clinically and radiographically? What would it indicate about the tooth? What medicament would you place to attempt to halt root resorption? (2 marks)
- Clinically it may present as pink discolouration of the affected tooth
- Radiographically it may present as a rounded symmetrical expansion of root canal walls. The tramlines of the root canal are indistinct and the root surface is intact
31
Q8 A 13 year old child attends the surgery with a BPE score of 3 - what does a BPE score of 3 mean
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Q8 A 13 year old child attends the surgery with a BPE score of 3
2. What teeth should be probed in a 13 year old to obtain a BPE score?
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Q8 A 13 year old child attends the surgery with a BPE score of 3
3. What is the normal depth from ECJ to the alveolar bone crest?
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Q8 A 13 year old child attends the surgery with a BPE score of 3
4. What medical condition could cause a 13 year old to have a BPE score of 3?
35
Q8 A 13 year old child attends the surgery with a BPE score of 3
If the child is not on medication what other condition may cause this?
36
Q8 A 13 year old child attends the surgery with a BPE score of 3
What 4 investigations should you do when a child presents with a BPE of 3
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Q8 A 13 year old child attends the surgery with a BPE score of 3
What is the treatment plan?
38
Q9 A patient attends with a fractured 11
1. List 2 questions you would ask in regards to the traumatised tooth
- when did the injury occur
- where did the injury occur
- how did the injury occur
- are there any associated symptoms or injuries
- are there any lost teeth or fragments
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Q9 A patient attends with a fractured 11
2. List 4 things that determine the prognosis of the traumatised tooth when discussing with parents
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Q9 A patient attends with a fractured 11
3. Where do you suspect the fragment of this tooth is and how do you manage this?
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Q9 A patient attends with a fractured 11
The tooth has an enamel dentine fracture, what is the treatment plan for this type of trauma?
42
Q9 A patient attends with a fractured 11
What do you discuss with the patient regarding treatment of this trauma?
43
Q9 A patient attends with a fractured 11
You decide to place composite, the patient has a heart valve defect - what would you change about your treatment plan
44
Q10 A Patients parent complains that the patient has white/yellow/brown stains on teeth
1. List 8 questions you would ask the patients mum
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Q10 A Patients parent complains that the patient has white/yellow/brown stains on teeth
2. The teeth affected are all 1st permanent molars, centrals and lateral - what is the condition likely to be and is it likely to be inherited?
46
Q10 A Patients parent complains that the patient has white/yellow/brown stains on teeth
3. List 5 questions you would ask to rule out fluorosis
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Q10 A Patients parent complains that the patient has white/yellow/brown stains on teeth
4. What is MIH
48
Q10 A Patients parent complains that the patient has white/yellow/brown stains on teeth
5. List three potential problems of 16, 26, 36 and 46 in future
49
Q10 A Patients parent complains that the patient has white/yellow/brown stains on teeth
What treatment options are available for MIH
50
Q11 A child attends with a discoloured tooth
1. what questions would you ask if you were querying previous trauma?
- when did the injury occur
- how did the injury occur
- did you receive any treatment previously
- has symptoms changed since trauma
- has tooth colour changed
51
Q11 A child attends with a discoloured tooth
2. What diagnostic tests check for vitality of the tooth
- electric pulp test
- ethyl chloride test
- radiographs
52
Q11 A child attends with a discoloured tooth
What are the treatment options for a tooth that has had previous trauma (subluxation)
if excessive mobility, flexible passive splint for 2 weeks
Follow up clinically and radiographically at 2 weeks, 12 weeks, 6 months, 1 year
53
Q12 Suspected child abuse
1. what 4 things wold make you suspect a non accidental injury?
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Q12 suspected child abuse
2. Give two effects of trauma on primary teeth
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Q12 suspected child abuse
3. Give 4 effects of trauma on permanent dentition
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Q13 Down syndrome
1. What four medical conditions are Down Syndrome children predisposed to?
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Q13 Downs syndrome
2. what are 4 general extra oral features of Down syndrome children
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Q13 Down syndrome
3. What are 6 intra oral features of Down Syndrome children
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Q13 Down syndrome
4. Give six examples of how the prevention treatment plan may be altered for these patients
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Q14 High caries risk
1. What is the caries risk assessment criteria
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Q14 high caries risk (7yo)
2. Name some clinical trauma review factors
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Q14 high caries risk (7yo)
3. What 8 factors make up a prevention plan?
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Q14 high caries risk
4. How often should you take bitewing radiographs for high caries risk children?
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Q14 high caries risk
5. What tooth paste strengths are used in children
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Q14 high caries risk
6. what is the time interval between fluoride varnishes
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Q14 high caries risk
7. What is the most appropriate fluoride supplement
67
Q14 high caries risk
8. How does fluoride work?
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Q14 high caries risk
9. what other treatment can be done to protect a high risk child?
69
Q15 a 6 year old child presents with pain in the lower right quadrant due to grossly carious 85 and a buccal swelling. The patient suffers haemophilia A
1. What is the likely diagnosis?
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Q15 a 6 year old child presents with pain in the lower right quadrant due to grossly carious 85 and a buccal swelling. The patient suffers haemophilia A
2. What is the treatment choice for this patient and why
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Q15 a 6 year old child presents with pain in the lower right quadrant due to grossly carious 85 and a buccal swelling. The patient suffers haemophilia A
3. like 8 stages of this treatment
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Q15 a 6 year old child presents with pain in the lower right quadrant due to grossly carious 85 and a buccal swelling. The patient suffers haemophilia A
4. Name 2 local haemostatic agents
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Q16 A patient who is 10/11 years old presents with extrusion of their 11
1. What is extrusion
extrusion injury is when a tooth is displaced partially out of socket. The PDL will experience tearing injuries. The tooth appears elongated, is mobile and bleeding is present form gingival sulcus
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Q16 A patient who is 10/11 years old presents with extrusion of their 11
2. Draw and label your splint and what materials you would use
- passive flexible splint using composite and wire on tooth 12, 11 and 21
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Q16 A patient who is 10/11 years old presents with extrusion of their 11
3. how long would you splint for
2 weeks
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Q16 A patient who is 10/11 years old presents with extrusion of their 11
4. what 4 tests would you do at a check-up apart from a radiograph
sensibility testing: EPT and ethly chloride
trauma stamp: check colour, mobility, sinus, TTP and percussion note. Compare with previous trauma stamps. Compare radiographs with previous radiographs
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Q17 Osteogenesis imperfecta and dentinogenesis imperfecta
1. What are the types of dentinogenesis imperfecta?
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Q17 Osteogenesis imperfecta and dentinogenesis imperfecta
2. what are the clinical signs of dentinogenesis imperfecta and osteogenesis imperfecta?
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Q17 Osteogenesis imperfecta and dentinogenesis imperfecta
what are the radiographic signs?
80
Q17 Osteogenesis imperfecta and dentinogenesis imperfecta
what are the restorative options
81
Q18 A cooperative 10 year old child attends with moderate crowding requesting orthodontic treatment, but has poor oral hygiene and cavitated caries into dentine in the 1st permanent molars.
Describe your management of this case
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Q18 A cooperative 10 year old child attends with moderate crowding requesting orthodontic treatment, but has poor oral hygiene and cavitated caries into dentine in the 1st permanent molars.
2. Describe the risk benefit discussion that you would have with the patient and parent
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Q19 A 5 year old brought to the clinic with mums boyfriend - she did not sleep due to dental pain. She has never been to the dentist before due to the mothers fear. The BF is vague about medical history and she is small for her age. She is pyrexic, in pain and has a swollen left side of face associated with gross caries in all primary molar teeth. You provisionally diagnose acute periapical abscess
1. What should you establish prior to examination of Jodi
84
Q19 A 5 year old brought to the clinic with mums boyfriend - she did not sleep due to dental pain. She has never been to the dentist before due to the mothers fear. The BF is vague about medical history and she is small for her age. She is pyrexic, in pain and has a swollen left side of face associated with gross caries in all primary molar teeth. You provisionally diagnose acute periapical abscess
2. Describe in detail 1 behavioural management technique and how you could use it to maximise a patients cooperation
85
Q19 A 5 year old brought to the clinic with mums boyfriend - she did not sleep due to dental pain. She has never been to the dentist before due to the mothers fear. The BF is vague about medical history and she is small for her age. She is pyrexic, in pain and has a swollen left side of face associated with gross caries in all primary molar teeth. You provisionally diagnose acute periapical abscess
3. Patient is classed as pre-cooperative before treatment, what would be your short term management?
86
Q19 A 5 year old brought to the clinic with mums boyfriend - she did not sleep due to dental pain. She has never been to the dentist before due to the mothers fear. The BF is vague about medical history and she is small for her age. She is pyrexic, in pain and has a swollen left side of face associated with gross caries in all primary molar teeth. You provisionally diagnose acute periapical abscess
4. How would you address the issue of the child's non-attendence?
87
Q19 A 5 year old brought to the clinic with mums boyfriend - she did not sleep due to dental pain. She has never been to the dentist before due to the mothers fear. The BF is vague about medical history and she is small for her age. She is pyrexic, in pain and has a swollen left side of face associated with gross caries in all primary molar teeth. You provisionally diagnose acute periapical abscess
5. what evidence based brushing advice would you give to help prevent further caries?
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Q20 - pulpotomy
1. What are the indications for a pulpotomy
89
Q20
2. What is the procedure for a pulpotomy
90
Q20
3. Describe primary incisor pulpotomy vs primary molar pulpotomy technique
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Q20
4. How is failure monitored clinically and radiographically
92
Q20
5. when is a full coronal pulpotomy used, what does it follow on from and what treatment can be done afterwards
93
Q20
6. What are the indications for a pulpectomy?
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Q20
7. What is the process of a pulpectomy
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Q21 Tooth 11 has a traumatic exposure
What two factors would influence your choice of treatment
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Q21 tooth 11 has a traumatic exposure
How would you treat this in practice and describe the method
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Q22 Tooth eruption dates
What are the eruption dates for the primary dentition
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Q22 what are the eruption dates for the permanent dentition
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Q23 Amelogenesis imperfecta
Name 4 types of amelogenesis imperfecta
100
Q23 what are the causes of amelogenesis imperfecta
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Q23 what problems may occur with this condition
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Q23 how is amelogenesis imperfecta managed
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Q23 name 3 other causes of enamel defects
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Q24 dentinogenesis imperfecta
Name 3 types of dentinogenesis imperfecta
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Q24 dentinogenesis imperfecta
What may be seen radiographically
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Q24 dentinogenesis imperfecta
What problems are associated
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Q24 dentinogenesis imperfecta
How are they managed?
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Q25 Child abuse
What are factors in your index of suspicion
109
Q25 child abuse
What orofacial injuries are suspicious
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Q25 child abuse
you wish to refer the child - who do you refer to and how do you do it?
111
Q26 a 3 year old child attends with blisters on gums
what is the likely diagnosis?
112
Q26 a 3 year old child attends with blisters on gums
how might the blisters appear?
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Q26 a 3 year old child attends with blisters on gums
what other signs and symptoms may be present
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Q26 a 3 year old child attends with blisters on gums
what is the likely cause?
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Q26 a 3 year old child attends with blisters on gums
how is the patient managed
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Q26 a 3 year old child attends with blisters on gums
what future issues may this virus cause
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Q27 a 4 year old with cross caries across anteriors, including smooth surface caries, enters your practice
what is the likely diagnosis
118
Q27 a 4 year old with cross caries across anteriors, including smooth surface caries, enters your practice
how does this present
119
Q27 a 4 year old with cross caries across anteriors, including smooth surface caries, enters your practice
how does this occur
120
Q27 a 4 year old with cross caries across anteriors, including smooth surface caries, enters your practice
what is your treatment plan
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Q28 SSC
What are the indications for a SSC?
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Q28 how are SSC placed conventionally
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Q28 how else may SSC be placed
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Q28 how can SSC be judged to have failed
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Q29 cardiac defects
what is the most common cardiac defect in children
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Q29 cardiac defects
what condition is most commonly associated with it
127
Q29 cardiac defects
name 6 other medical issues seen in Downs syndrome patients
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Q29 cardiac defects
how is this managed in the dental setting
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Q30 microabrasion
What are the indications for microabrasion
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Q30 microabrasion
what are the advantages and disadvantages of this treatment
131
Q30 microabrasion
how is it carried out
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Q31 autism
Regarding autism, what is the triad of impairment
133
Q31 autism
what other features does this condition have
134
Q31 autism
how are they managed in a dental setting
135
Q32 Down syndrome
A 9 year old child with Down Syndrome attends your clinic for the first time for routine care
1. Name 4 associated medical conditions that Down Syndrome children have an increased chance of presenting with during their childhood (2 marks)
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Q32 Down syndrome
A 9 year old child with Down Syndrome attends your clinic for the first time for routine care
2. What are four classical presenting extra oral features involving the head and neck of child with down syndrome
137
Q32 Down syndrome
A 9 year old child with Down Syndrome attends your clinic for the first time for routine care
3. Name 6 possible intra-oral manifestations of Down Syndrome
138
Q32 Down syndrome
A 9 year old child with Down Syndrome attends your clinic for the first time for routine care
4. Discuss the impact of the patients condition on the preventive care treatment that will be provided Give six examples (3 marks)
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Q33 A child enters your practice and they appear nervous
What are the reasons for a child to be anxious before visiting the dentist
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Q33 A child enters your practice and they appear nervous
How may anxiety manifest
141
Q33 A child enters your practice and they appear nervous
How may anxiety be measured in children
142
Q33 A child enters your practice and they appear nervous
Give 8 behavioural management techniques
143
Q34 Fissure Sealants
What are the indications for placing fissure sealants
144
Q34 Fissure Sealants
Give two materials which can be used
145
Q34 Describe the technique for placing fissure sealants
146
Q35 Cerebral Palsy
What are 4 types of cerebral palsy
147
Q35 cerebral palsy
how are they classified
148
Q35 cerebral palsy
what is cystic fibrosis
149
Q35 cerebral palsy
What are the general signs and symptoms of CF
150
Q35 cerebral palsy
What are the dental considerations
151
Q36 Avulsion
What instructions is given to a parent when a child has avulsed their tooth
152
Q36 avulsion
What medium is best for storage
153
Q36 avulsion
What should you check upon arrival
154
Q36 avulsion
What type of splint is advised
155
Q36 avulsion
what is EADT
156
Q36 avulsion
What are the common outcomes of avulsion
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Q36 avulsion
What medical history information is significant
