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BDS > Paeds > Flashcards

Paeds Flashcards

1
Q

3 policies within Scotland regarding child protection

A

GIRFEC

CYPA 2014

National guidance for CP in Scotland 2014

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2
Q

3 stages of managing dental neglect

A

Preventive dental team management

Preventive multi-agency management

Child protection referral

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3
Q

Explain step 1 of managing dental neglect (4)

A
  • Raise concerns with parents
  • Offer support
  • Set targets
  • Monitor progress
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4
Q

Explain step 2 of managing dental neglect

A
  • Obtain details regarding HV from GMP
  • Communicate with health visitor about concerns
  • HV will visit family and arrange appointments
  • Check if child is subject to child protection plan
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5
Q

Explain step 3 of managing dental neglect

A

Referral to social services by telephone followed by writing

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6
Q

5 examples of non-accidental injuries

A
  • Delayed presentation
  • Injuries that do not match with history
  • Soft tissue injuries
  • Injuries to both sides of body
  • Injuries with specific pattern
  • Injuries to the triangle of safety
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7
Q

4 responsibilities of the dental team in managing child abuse/ neglect

A
  • Observe
  • Record
  • Communicate
  • Refer for assessment
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8
Q

3 people you can go to for help and advice in managing child abuse/ neglect

A
  • Experienced colleague
  • Named safeguarding doctor/ nurse
  • Social services (social care direct)
  • CPA
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9
Q

Home care instructions for parent and child who had trauma to dentition

A
  • analgesia
  • soft diet 10 - 14 days
  • brush teeth after every meal
  • apply topical CHX MR using gauze
  • warn re signs of infections + possible complications to dentition
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10
Q

Management of enamel-dentin fracture with no pulpal exposure in primary dentition (3)

A
  • Account for fractured fragment
  • Apply GI/ composite bandage
  • Restore definitively with composite
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11
Q

Management of complicated crown fracture in primary dentition (2)

A
  • Account for fractured fragment
  • LA, pulpotomy, dress with non setting CaOH, temporise with GI, restore with composite
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12
Q

Management of crown root fracture in primary dentition (4)

A
  • remove loose fragment & determine if crown can be restored
  • if restorable
    – no pulp exposed, GI bandage
    – pulp exposed, pulpotomy/ RCT
  • if unrestorable, XLA loose fragments
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13
Q

Management of crown root fracture in primary dentition (5)

A
  • no tx if coronal fragment not displaced
  • if coronal fragment displaced but not excessively mobile allow to reposition spontaneously
  • if coronal fragment displaced & excessively mobile & interfering with occlusion:
    – XLA loose coronal fragment
    – reposition loose coronal fragment +/- splint
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14
Q

Management of concussion in primary dentition (2)

A

no tx
KUO

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15
Q

Management of subluxation in primary dentition (2)

A

no tx
KUO

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16
Q

Management of lateral luxation in primary dentition (2)

A

(a) minimal/ no occlusal interference
- allow to reposition spontaneously

(b) severe displacement
- XLA OR
- reposition +/- splint

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17
Q

Management of intrusion in primary dentition (1)

A

allow to spontaneously reposition

18
Q

diagnostic radiographs for intrusion in primary dentition (2)

A
  • PA PLUS
  • lateral pre maxilla

to assess danger to permanent tooth + counselling re prognosis

19
Q

Management of intrusion in primary dentition (2)

A

(a) Interfering with occlusion
- allow to spontaneously reposition

(b) excessively mobile/ extruded >3mm
- XLA

20
Q

Management of avulsion in primary dentition (2)

A
  • radiograph to exclude intrusion
  • DO NOT replant tooth
21
Q

Management of alveolar fracture in primary dentition (3)

A
  • reposition segment
  • stabilise with splint 4/52
  • may need to XLA teeth after alveolar bone stable
22
Q

3 sequelae of trauma to primary tooth

A
  1. discolouration
  2. discolouration & infection
  3. delayed exfoliation
23
Q

Complications of trauma in primary dentition to permanent successor

A
  1. enamel hypomineralisation
  2. enamel hypoplasia
  3. dilaceration
  4. arrested development of permanent tooth
  5. complete failure of permanent tooth to form
  6. ectopic permanent teeth
  7. delayed exfoliation of primary teeth
  8. delayed eruption
  9. odontome
24
Q

Why sensibility testing may be unreliable in children’s teeth? (from IADT guidelines permanent teeth)

A
  • Transient lack of neural response
  • Undifferentiation of A-delta fibres in young teeth
  • Common in post-traumatic pulp healing (esp after luxation)
25
Q

3 medical conditions to be aware of if a child presents with dental trauma (which may affect treatment)

A
  • Rheumatic fever
  • Congenital heart defects
  • Immunosuppression
26
Q

6 E/O findings to note when examining trauma (think of facial/jaw fractures)

A
  • Laceration
  • Haematoma
  • haemorrhage/ CSF leakage
  • Subconjunctival haemorrhage
  • Bony step deformities
  • Limited mouth opening
27
Q

7 things to note in a trauma sticker

A
  • Colour
  • Sinus
  • Mobility
  • TTP
  • Percussion note
  • Sensibility testing (cold & EPT)
  • Radiogaphs
28
Q

5 aspects which affect the prognosis of teeth

A
  • Type of injury
  • Injury to PDL
  • Time between injury and presentation
  • Stage of root development
  • Presence of infection
29
Q

Management of enamel fractures in permanent dentition

A
  • 2 PA’s to rule out root fracture/ luxation
  • Bond enamel fragment back
  • Smooth enamel +/- definitive composite restoration
  • Recall 6-8 wks, 6 mo, 1 yr
30
Q

Management of enamel dentin fracture in permanent dentition

A
  • Account for fragment
  • 2 PA’s to rule out fractures, luxation
  • Radiograph soft tissues to rule out embedded fragments
  • Bond fragment to tooth// GI/ composite bandage
  • Definitive comp restoration
    Recall 6-8 wks, 6 mo, 1 yr
31
Q

3 management options of enamel-dentin pulp fractures in permanent dentition

A
  1. Direct pulp capping
  2. Partial pulptomy
  3. Coronal pulpotomy
32
Q

When is direct pulp capping indicated? (2)

A
  • <24 hrs since injury
  • Tiny (1mm) pulpal exposure
33
Q

How is direct-pulp capping carried out? (6)

A
  • LA, rubber dam
  • Clean tooth with water then NaOCl
  • Dry with CWP, attempt haemostasis w saline soaked CWP
  • If haemostasis achieved, place setting CaOH
  • Temporise with GI
  • Restore with composite restoration
  • RV 6-8 wk, 6 mo, 1 yr
34
Q

When is partial pulpotomy indicated? (3)

A
  • > 24 hrs since injury
  • > 1mm pulpal exposure
  • Haemostasis cannot be achieved/ haemorrhage during direct pulp capping
35
Q

How is partial pulpotomy carried out? (7)

A
  • LA, rubber dam
  • Clean tooth with saline then NaOCl
  • Remove 2mm of pulp surrounding exposure using high speed diamond round bur
  • Dry and arrest bleeding with saline soaked CWP
  • If haemostasis achieved dress with non setting CaOH
  • Temporise with GI
  • Restore with comp
    RV 6-8 wk, 6 mo, 1 yr
36
Q

When is full coronal pulpotomy indicated?

A

When pulp is necrotic/

Haemostasis cannot be achieved during partial pulpotomy

37
Q

When is RCT indicated in immature incisors?

A

Signs of infection/ pulpal necrosis

38
Q

What is a clinical problem when obturating immature incisors? (1) 3 options to overcome this problem (3)

A
  • No apical stop for obturation
  • Apexogenesis (CaOH in canals to stimulate hard tissue formation)
  • Apical plug with MTA/ biodentine
  • Regenerative endodontic technique
39
Q

Describe the steps for an open apex pulpectomy

A
  • LA, rubber dam
  • Access
  • Control haemorrhage with - LA/ sterile water
  • Working length radiograph
  • File to 2mm short of EWL
  • Disinfect with NaOCl
  • Temporise with non setting CaOH (no longer than 4-6 wks), CWP and GI
  • Apical plug using MTA
  • Heated GP obturation
40
Q

6 management options of crown root fractures

A
  • Remove fragment and restore
  • Remove fragment & gingivectomy (palatal subgingivally extended fractures)
  • Extrude apical fragment orthodontically, RCT, post and crown
  • Surgical extrusion
  • Decoronate
  • Extract
41
Q
A

BDS (4 decks)

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