paeds and ortho

Question 1

extra oral examination for a child who wants ortho - what should be looked at

Answer 1

symmetry
lymph nodes
mouth opening
TMJ
MOM

skeletal pattern - AP, transverse and vertical
STs - lip trap, lip competence, naso-labial angle

Question 2

6 questions to ask if child presents with enamel defects

Answer 2

• do any other family members have these defects
• did the baby teeth have these defects
• what toothpaste was used when they were very little
• have they always lived in a non fluoridated water area
• any illness during 3rd trimester
• any childhood illness in 1st two years
• full term baby?

Question 3

appearance of enamel hypoplasia

Answer 3

enamel may be uniformly thin or grooved/ pitted

Question 4

appearance of chronological hypoplasia

Answer 4

affect multiple teeth in a symmetrical linear fashion affecting all the enamel growing on teeth over a particular time frame

Question 5

how would an enamel defect due to primary tooth trauma present

Answer 5

localised defect

Question 6

turner tooth

Answer 6

enamel defect in permanent tooth due to periapical disease in primary tooth

Question 7

radiation dose for PAs vs OPT

Answer 7

PA - 4msv
OPT - 20msv
if >5 PAs in kids is OPT better

Question 8

widened PDL around root of developing teeth

Answer 8

normal part of tooth development

Question 8

normal age for calcification of bifurcation of 7s

Answer 8

8.5-9.5
after this time spontaneous space closure by mesial movement of 7s is unlikely

Question 9

what molar class is over eruption most likely

Answer 9

class 1

Question 10

why are FPMs rarely orthodontic extraction of choice

Answer 10

space often lost due to mesial drist of 7
remote from anterior crowding and overjets

Question 11

what age is appropriate for orthodontic or paeds specialist opinion regarding poor prognosis 1st permanent molars

Answer 11

8-9

Question 12

questions to ask if retained deciduous teeth

Answer 12

• ever any trauma
• any teeth extracted in past
• any family history of missing teeth

Question 13

what age to start fluoride varnish

Answer 13

2

Question 14

what age to start bitewings

Answer 14

4

Question 15

frequency of bitewings

Answer 15

high risk - every 6/12 months
low risk - every 2 years

Question 16

3 indicators os established infection

Answer 16

TTP in a non exfoliating tooth
alveolar tenderness, swelling or sinus
non physiological movement
radiographic signs

Question 17

name 4 behaviour management techniques

Answer 17

enahnced control
positive reinforcement
structured time
relaxation
systematic desensitisation

Question 18

how to bring about behaviour change

Answer 18

motivational interviewing approach
S - seek permission
O - open questions
A - affirmations
R - reflective listening
S - summary

Question 19

how can discomfort of LA be reduced in children

Answer 19

topical anaesthesia
slow injection technique
wand
distraction
chasing anaesthesia

Question 20

safeguarding, causes of concern in the dental practice

Answer 20

repeated GAs
repeated attendance in pain
failure to complete treatment plan
irregular attendance and failed appointments