Paeds Flashcards Preview

Paediatrics > Paeds > Flashcards

Flashcards in Paeds Deck (120)
Loading flashcards...
1
Q

What is the definition of early childhood caries

A

The presence of one or more decayed, missing or filled tooth surfaces in any primarytooth in a child under 6 years old.

2
Q

What is the most durable restoration in primary molars?

A

Stainless Steel Crowns

3
Q

What is the pre-emptive analgesia dose for children prior to dental appts

A

One off dose of:

  • 30mg/kg paracetamol, 30 to 60 minutes prior to appt.
4
Q

What timeframe prior to exfoliation are primary teeth not worth restoring

A

If its due to exfoliate in 6-12 months, not worth restoring.

Instead, extract or temporarily dress.

5
Q

How do you judge time to exfoliation of teeth?

A

Levels of resorption

6
Q
A
7
Q

Why is dental amalgam an indirect threat to human health?

A

When released into the environment, can undergo conversion to methylmercury by aquative microbes, and get concentrated in the human food chain

8
Q

What is the NZDA stance on restorations and pregnant women:

A
  • precaution - during pregnancy, where clinically reasonable, to avoid elective dental procedures, including the placement or removal of ANY filling material
9
Q

Trace amounts of what are released from dental resins thoruh salivary enzymatic hydrolysis?

What is the health implication?

A

Bisphenol A

Estrogenic.

10
Q

SSC are recommended for:

A
  • Primary tooth lesions greater than 2 surfaces
  • Pulp tx teeth
11
Q

Hall technique contra-indications

A
  • Dental anxious children
  • Advanced carious lesions (non vital teeth)
  • Accessible single surface lesions
  • Pre-existing open bite
  • Time limitations
  • Inter-radicular radiolucency
12
Q

Why is it important to re-erupt an intruded tooth immediately

A

It will ankylose and become unvital.

13
Q

Will an intruded tooth erupt on its own?

A

No as will ankylose

14
Q
A
15
Q

What is the optimum range for community water fluoridation

A

0.8 to 1.2 ppm

16
Q

Who might be recommended fluoride tablets?

A

People aged 3+ at high caries risk

17
Q

In NZ fluoride rinses are contra-indicated for:

A
  • Children under 6
  • People over 6 who are low risk
18
Q

What amount of fluoride is in fluoride gels/foams

A

2%

19
Q

What is the amount of fluoride in duraphat

A

22600 ppm

20
Q

Who can have duraphat?

A

People over 12 months old at high caries risk

21
Q

Except for ……….there is no valid reason to place a restoration at the time a lesion is detected

A
  • Frank cavitation
  • Radiolucency extending more than 1/3 into dentine
22
Q

Evidence says proximal infiltration of lesions is significantly more effective than fluoride

True or false

A

True

23
Q

Method for preventing fluorosis at home -

A

Use recommended amount of TP

24
Q
A
25
Q

What is the difference between ICDAS 5 and 6?

A

ICDAS 5 is a distinct cavity with visible dentine.

ICDAS 6 is an extensive cavity with visible dentine.

26
Q

Approximal lesions who radiolucencies are confined to the outer half of the dentine, are likely to be cavitated.

True or false

A

FALSE. so they’re good candidates for remineralisation therapy.

27
Q

LIst 5 difference between the crowns of primary and permanent teeth

A
  • Smaller and whiter
  • Thinner enamel and dentine
  • Broad contact areas
  • Narrower occlusal table
  • Bulbous crowns/cervical constriction
28
Q

List 3 differences between the pulp of primary and permanent teeth

A
  • Larger pulp chamber
  • Prominent pulp horns
  • Curved chamber floor
29
Q

3 Differences between the roots of primary and permanent teeth

A
  • Flared
  • Longer and slender
  • Narrow (mesial-distal)
    *
30
Q

In the primary dentition what is used instead of angles molar classification

A

Terminal planes

31
Q

Newly erupted teeth are less caries susceptible.

True or false

A

FALSE!

They are porous so more susceptible, until the enamel matures

32
Q

Why is it better to have dry enamel for detection of caries?

A

Larger refractive index between air/enamel vs water/enamel

33
Q

What number do P lesions go up to?

A

P5 - radiolucency extends to inner half of dentine

34
Q

What number do ICDAS codes go up to?

A

6

35
Q

What % of enamel is inorganic?

A

96%

36
Q

Which is qualitative?

a) Hypomineralization
b) Hypoplasia

A

Hypomineralisation

37
Q

Which is quantitative?

a) Hypomineralization
b) Hypoplasia

A

b) Hypoplasia

38
Q

What are the 5 judgement criteria used in the diagnosis of MIH?

A
  1. Demarcated opacity
  2. Post eruptive enamel breakdown
  3. Atypical restoration
  4. Extracted molar due to MIH
  5. Unerupted teeth
39
Q

Demarcated opacities associated with MIH can be what colour?

A

White, yellow or brown

40
Q

What is the global prevalence of MIH

A

14.2%

41
Q

What condiiton appears to be associated with MIH

A

Fever or other early childhood illness

42
Q

Amoxicillin may cause MIH

True or false

A

False

43
Q

What teeth are used in MIH diagnosis?

A

Permanent first molars, and affected incisors

44
Q

Enamel of teeth affected with MIH has been found to have a mean % reduction in mineral content and an increase in protein content.

A

28%

45
Q

What has been found to potentially enhance bonding of resin adhesives to hypomineralised enamel?

A

5% NaOCl - Ekambrin 2016

46
Q

When does a tx plan ‘expire’

A

6 months

47
Q

List 3 medication conditions which might result in oligodontia

A
  • Ectodermal dysplasia
  • Clefting
  • Down syndrome
48
Q

Term used for supernumerary tooth in the anterior maxilla:

A

Mesiodens

49
Q

3 conditions associated with supernumerary teeth:

A
  • Cleidocranial dysplasia
  • Cleft lip and palate
  • Gardner syndrome
50
Q

4 problems caused by presence of supernumerary teeth?

A
  • Obstruction of tooth eruption
  • Displacement of teeth
  • Crowing of teeth
  • Cystic change
51
Q

Ideally get consent for any patients under:

A

16

52
Q

What are some key developmental issues you should look for in children:

A
  • No canines palpable by 9
  • Hypomin on 6s
  • Peg laterals - monitor for canine issues
  • No successor
  • Ankylosis of over-retained primary
53
Q

3 options for tx of macrodontia

A
  • Stripping
  • build up antimere
  • exo and prosthetic
54
Q

condition which often presents with microdontia:

A

ectodermal dysplasia

55
Q

Why do you need to xray double teeth?

A

Check if roots/pulp chambers are merged

56
Q

Management of dens in dente or dens invaginatus

A

Seal to prevent pulp necrosis

If necrosed - RCT if morphology favourable

57
Q

How to prevent tubercle fracture of a dens evaginatus (occlusal enamel pearl)

A
  • Before it comes into occlusion, support sides of tubercle with composite resin and recontour occlusal surface to produce a central tidge.
  • After tooth comes into complete occlusion, grind off, then seal
58
Q

List 2 systemic causes of delayed tooth eruption, and 4 local causes

A
  • Hypothyroidism
  • Hypopituitarism
  • Supernumerary
  • Hereditary gingival fibromatosis
  • Ectopic tooth bud
  • Crowding
  • Dilacerations
  • Early exo of primary
59
Q

What might cause delayed tooth exfoliation?

A
  • Infraocclusion
  • Double primary teeth
  • Ectopic permanent tooth
  • Trauma
60
Q

List 7 methods of behavioural management

A
  1. Desensitisation
  2. Tell-show-do
  3. Positive reinforcement
  4. Distraction
  5. Behaviour shaping
  6. Modelling
  7. Voice control
61
Q

Methods of behaviour management where anxieties are dealt with by exposing him/her to a series of dental experiences in order of increasing anxiety

A

Desensitisation

62
Q

What is behaviour shaping?

A

Comination of Tell show do, positive reinforcement and distraction to shape behaviour

63
Q

What is modelling, as a behavioural management method?

A

Children develop from observation and imitation of others, eg learned conditioning

64
Q
A
65
Q

NSAIDs should be avoided in children with what common condition

A

Asthma

66
Q

What is the likely cause of a child presenting with facial swelling and acute pain tender to touch?

A

A necrotic pulp. Treat with drainage via tooth or soft tissue, and extract.

If systemic - abs

67
Q

5 symptoms of teething

A
  • Sleepless
  • Increase saliva and dribble
  • Flushed cheecks
  • Increased urge to bite
  • Eruption cyst
68
Q
A
69
Q

2 best management tools for teething

A
  • Teething rings
  • Pain relief
  • AVOID cariogenic comforters
70
Q

Management of lip bite -

A

Chlorhex mouth rinse

71
Q

Managment for primary gingivostomatitis

A
  • Chlorhex mouthrinse
  • Keep up liquids
  • Symptomatic care
72
Q

How long does Primary gingivostomatitis usually last

A

10 days

73
Q

In what case would you prescribe a young patient with primary gingivostomatitis to the hospital

A

Immunocompromised

74
Q

Upper frenum laceration can be associated with:

A

Force feeding

75
Q

4 symptoms of asthma

A
  • Cough (dry and repetitive)
  • Wheeze
  • Breathlessness
  • In attack may have speech difficulty, pulse increase, cyanosis
76
Q

5 oral manifestations of asthma

A
  • High caries prevalence
  • Xerostomia
  • Oral candidosis
  • Gingivitis
  • Malocclusion
77
Q

What should you do in an asthma attack

A
  1. Stop tx, ensure airway is clear
  2. Give B2 agonist inhaler - two puffs repeatedly
  3. Call for help
  4. Oxygen if available
  5. Maintain calm environment until help arrives
78
Q

Life long, neuro-developmental disorder that often becomes apparent before age 7. Tx with Ritalin and Adderall.

A
79
Q
A
80
Q

Oral risks associated with ADHD

A
  • High caries risk
  • Traumatic injuries - falls
81
Q

Advice for treating ADHD patients

A
  • Book apps 30-60 mins after taking stimulant medication
  • Eye to eye contact
  • Short clear instructions
  • Tell show do
82
Q

Condition caused by deficiency of clotting factor VIII

A

Haemophilia A

83
Q

Condition associated with deficiency of clotting factor IX

A

Haemophilia B

84
Q

Congenial bleeding disorder resulting from a quantitative or qualitative deficiency of a plasma glycoprotein which has a function in haemostasis

A

Von Willebrands disease

85
Q

Briefly describe normal clotting process

A
  • Bleeding starts
  • Vessels constrict
  • Platelet plug forms
  • Fibrin clot
86
Q

What is the purpose of platelets?

A

Provide a surface for blood clotting to occur on

87
Q

LA containing epinephrine should not be used for patients taking beta blockers.

why?

A

Can induce hypertension and cardiovascular complication

88
Q

There is no need to alter or stop anticoagulant therapy before minor oral surgery procedure, if the INR level is below:

A

4

89
Q

What procedure is not recommended for children with congenital heart defects

A

Pulp therapy. Because higher incidence of associated chronic infections.

90
Q

For pts with congenital heart conditions, when should appts be scheduled

A

Late morning.

Short and stress free

91
Q

Oral manifestations of chronic renal disease-

A
  • Bad odor/metallic taste sensation increased
  • Concentration of urea in saliva
  • Xerostomia
  • Paleness of mucosal membrane due to anaemia
  • Gingival bleeding from platelet dysfunction
  • Enamel hypoplasia
92
Q

What is the primary tx related concern for patients with chronic renal disease

A

Bleeding tendency.

93
Q

Patients with chronic renal disease should be prescribed prophylactic antibiotics.

Why

A

Immunosuppression

94
Q

Dentla procedures should ideally be performed on day of dialysis

True or false

A

False

95
Q

How long after transplant should patients avoid elective dental tx

A

6 months

96
Q

Why is potential for oral infections high in patients after transplanation

A

They receive immunosuppressive therapy

97
Q

Oral manifestations of crohns disease:

A
  • Oral ulceration particularly buccal mucosa
  • Cobblestone appearance of buccal mucosa
  • Oral mucosal tags
  • Cracks at the corners of the mouth
  • Dental caries
  • Gingival bleeding
  • Fissured tongue
98
Q

Oral manifestations of Epilepsy

A
  • Dental trauma
  • Drug induced hyperplasia
  • RAS like ulcerations
  • Root shortening
  • Hypercementosis
  • Delayed tooth eruption
99
Q

When should epilepsy patients be scheduled?

A

Early in morning. Make sure have taken medication.

100
Q

What MUST you have for patients with epilepsy in the surgery

A

Dark glasses. Light can trigger seizures.

101
Q

Methotrexate oral side effect:

A

Ulcers

102
Q

Oral manifestations of Juvenile Idiopathic Arthritis

A
  • Gingivitis
  • High caries incidence
  • Oral ulcerations
  • TMJ pain
  • Maloccluisons
103
Q

Oral Manifestations of Diabetes

A
  • Increased caries risk due to xerostomia
  • Accelerated tooth eruption with increasing age
  • Gingivitis with high risk perio
  • Salivary gland dysfunction
  • Imparired or delayed wound healing
  • Taste dysfunction
  • Candidia
104
Q

Ideal appt time for diabetes patients:

A

Short, morning appts. Ensure has eaten a meal and taken usual medication prior to tx.

105
Q

Why is it important for people with diabetes to have a regular recall?

A

Perio can significantly worsen diabetes and associated cardiac disease.

106
Q

What should you do in a hypoglycemic episode:

A

Patient conscious - high dose glucose

Unconscious or unable to swallow - glucagon sub-cut

107
Q

Oral manifestations of cancer

A
  • Mucosal changes
  • dry mouth
  • Infection risk
  • Caries risk
  • Bleeding risk
108
Q
A
109
Q

What are the first baby teeth to erupt?

A

Lower incisors, and upper incisor

110
Q

What usually erupts after the primary lower and upper incisors erupt?

A

The lateral incisors

111
Q

List the order of tooth eruption of primary teeth

A
  1. Central incisors
  2. Lateral incisors
  3. First molars
  4. Canines
  5. Second molars
112
Q

What age do lower primary centrals usually erupt?

A

6-10 months

113
Q

What age do the primary central incisors usually shed

A

6-7

114
Q

What permanent teeth erupt first and when?

A

Centrals and first molars

6-8 years

115
Q

What age do wisdom teeth usually erupt

A

17-21

116
Q

What age should the permanent canines erupt?

A

10-12

117
Q
A
118
Q

Primary herpetic gingivostomatitis is seen in children between the ages of 6 months and 6 years. RAS in the herpetiform presentation is mainly seen in people 10-40 years old.

a) Both statements are true
b) Both statements are false
c) Statement one is true, statement two is false
d) Statement one is false, statement two is true

A

c) Statement one is true, statement two is false.

119
Q

Which of the following statements regarding pre-emptive analgesia for a child is correct for paracetamol

a) 20mg/kg 45-60 mins before procedure
b) 25mg/kg 60-100 mins before procedure
c) 30mg/kg 45-60 mins before procedure
d) 30mg/kg 60-100 mins before procedure

A

c)

120
Q
A