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Dentistry > Paeds and Trauma > Flashcards

Paeds and Trauma Flashcards

1
Q

What is the treatment for reversible pulpitis?

A

Restore or place a dressing and restore later

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2
Q

What is a rigid splint?

A

Rigid splint is when there are two uninjured teeth on either side of the trauma

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3
Q

How long is the splint time for root fractures in the coronal third?

A

4 months

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4
Q

What are the two main management options for amelogenesis imperfecta?

A
  • composite restorations on anteriors (bonding may be an issue)
  • full coverage restorations (particularly for posterior dentition)
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5
Q

What age can you prescribe 5000ppm fluoride toothpaste?

A

16 + years old

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6
Q

When will deciduous maxillary centrals erupt?

A

8-12months

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7
Q

What teeth do you expect to see in a 3year old?

A

All deciduous teeth

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8
Q

When will deciduous mandibular laterals erupt?

A

10-16months

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9
Q

What are the four different types of supernumerary teeth?

A
  • mesiodens (midline)
  • supplemental (look like normal tooth
  • conical
  • tuberculate (more than one cusp)
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10
Q

What teeth are most likely to be affected by macrodontia?

A

maxillary centrals then mandibular 5s

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11
Q

What is the treatment for intrusive luxation in mature teeth with less than 3mm displacement?

A

● allow re-eruption without intervention for 8 weeks
- If no movement, reposition surgically
- flexible splint for 4 WEEKS
● Pulp almost always becomes necrotic, appropriate RCT 2 weeks after injury

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12
Q

When do the permanent maxillary 4s erupt?

A

9-11years

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13
Q

What teeth would you expect to be present in a 12 month old?

A

As, Bs upper and lower

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14
Q

How can you manage sensitivity caused by MIH?

A
  • 5% sodium fluoride varnish
  • Sensitive toothpastes
  • 0.4% stannous fluoride gels
  • CPP-ACP (tooth mousse)
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15
Q

What is lateral luxation?

A

When there is displacement of a tooth in an apical direction into the alveolar bone

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16
Q

What is the treatment for this lesion in permanent dentition?

A

Site specific prevention or seal

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17
Q

What are the benefits of tooth mousse?

A

good for use of white spot lesions in ortho; reduces sensitivity; and supposedly increases mineralisation

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18
Q

When would you splint for subluxation and how long for?

A

A flexible splint may be used to stabilise the tooth for up to 2 WEEKS but only if there is excessive mobility or tenderness on biting

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19
Q

What is tooth mousse and why might some people prefer it?

A

CPP-ACP: a calcium phosphate topical cream - it does not contain fluoride

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20
Q

Why do you have to be extra careful when treating talon cusp teeth?

A

The extra cusp may have their own pulp so don’t go and smooth it down with a high speed

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21
Q

How long do you wait for a contralateral tooth to erupt before you get concerned?

A

6 months

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22
Q

What is molar-incisor hypomineralisation?

A

A qualitative defect of the enamel due to lack of mineralisation during development

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23
Q

What is the colour of dentinogenesis imperfecta in permanent teeth?

A

grey/translucent

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24
Q

When will deciduous maxillary canines erupt?

A

16-24months

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25
Q

How does turners tooth happen?

A

It affects successional teeth (often second premolars) from infection around the interradicular area of the preceding deciduous tooth

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26
Q

What is a talon cusp?

A

An extra cusp that arises on an anterior tooth

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27
Q

When do the permanent maxillary 6s erupt?

A

6-7years

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28
Q

What is the treatment for this lesion in primary dentition?

A

Site specific prevention (preferred) or sealant/infiltration

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29
Q

How many canals do maxillary Es have?

A

3

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30
Q

When do the permanent mandibular 5s erupt?

A

11-12years

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31
Q

What are the stages if there is an unerupted central incisor?

A
  1. Monitor
  2. Radiograph
  3. Refer
  4. See if supernumerary erupts
  5. Maintain the space
  6. Extract supernumerary (probably under GA)
    - then wait for eruption or gold chain
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32
Q

What is this dental anomaly?

A

Dentinogenesis imperfecta

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33
Q

What is the treatment for this lesion in permanent dentition?

A

Stepwise caries removal and restore

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34
Q

What is this dental anomaly?

A

Dentinogenesis imperfecta

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35
Q

What is avulsion?

A

Complete loss of a tooth as a result of trauma

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36
Q

What is an unsafe dose of fluoride? (requires hospital admission)

A

5mg/kg of body weight

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37
Q

What is the treatment for root fractures in the apical or middle third?

A

● If displaced, reposition the coronal fragment as soon as possible
● Check positioning radiographically
● Stabilise with a passive flexible splint for 4 WEEKS
● RCT coronal section if pulp necrosis occurs

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38
Q

What is this dental anomaly?

A

Turner’s tooth

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39
Q

What is this dental anomaly?

A

Amelogenesis Imperfecta

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40
Q

What is the pain diagnosis for these symptoms:
● Spontaneous pain (wakes child up at night)
● Does not resolve on removal or stimulus
● Pain to hot/cold
● Does not resolve with placement of temporary dressing

A

Irreversible pulpitis

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41
Q

What should you give a patient that has had 1-5mg/kg of fluoride?

A

milk

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42
Q

What is the treatment for this lesion in permanent dentition?

A

Stepwise caries removal and restore

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43
Q

What is the treatment for dental abscesses in cooperative children?

A

Primary teeth: XLA or pulp therapy
Permanent teeth: RCT or XLA

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44
Q

What is the treatment for enamel-dentine-pulp fractures in immature teeth?

A

● Partial pulpotomy
● Pulp capping

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45
Q

What are the symptoms of reversible pulpitis?

A

● Pain to cold/sweet
● Tooth not TTP
● Resolves on removal of stimulus
● Tooth difficult to localise

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46
Q

What is the pain diagnosis for these symptoms:
● Spontaneous pain (wakes the child at night)
● Tooth mobile and TTP
● Swelling
● Malaise (general feeling of unwell)

A

Dental abscess

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47
Q

What is this dental anomaly?

A

Talon cusp

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48
Q

What teeth are normally effected by bottle induced caries?

A

upper As but Ds may also be affected

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49
Q

What age can you prescribe 2800ppm fluoride toothpaste?

A

10 + years old

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50
Q

What is this dental anomaly?

A

Amelogenesis Imperfecta

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51
Q

What are the different types of double teeth?

A

Germination (two crowns, one bud); fusion (two tooth germs form one large crown)

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52
Q

How long do you splint for alveolar fractures?

A

4 Weeks

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53
Q

What is the prevalence of MIH?

A

affects 1 in 4 children worldwide

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54
Q

When will deciduous mandibular first molars erupt?

A

12-16months

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55
Q

When do the permanent maxillary lateral incisors erupt?

A

8-9years

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56
Q

What medical condition common in children contraindicates fluoride varnish and why?

A

Asthmatics (due to potential allergic reaction to colophony)

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57
Q

What dentition are most likely to be effected by microdontia?

A

upper laterals

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58
Q

What permanent teeth do you expect to be present in an 11 year old?

A

upper: 1s, 2s, 3s?, 4s, 5s?, 6s
lower: 1s, 2s, 3s, 4s, 5s?, 6s,

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59
Q

When do the permanent maxillary 5s erupt?

A

10-12years

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60
Q

When will deciduous mandibular centrals erupt?

A

6-10months

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61
Q

When do the permanent mandibular 6s erupt?

A

6-7years

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62
Q

What is the treatment for double teeth?

A

fissure sealants to prevent caries in the abnormal anatomy

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63
Q

What is the pain diagnosis for these symptoms:
● Pain to cold/sweet
● Tooth not TTP
● Resolves on removal of stimulus
● Tooth difficult to localise

A

Reversible pulpitis

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64
Q

What length of extraoral dry time for an avulsed tooth do you assume the PDL is non-viable?

A

30 mins
Kept in a solution = <60mins

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65
Q

When is root formation complete for primary teeth?

A

12-18 months post eruption

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66
Q

What is the primary treatment option for bottle induced caries?

A

advice

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67
Q

What is the treatment for enamel-dentine-pulp fractures in mature teeth?

A

● Conservative pulp treatment (i.e. partial pulpotomy)
● Non-setting calcium hydroxide lining
● If posts are required, RCT is the preferred treatment
● If the tooth fragment is available, it can be bonded back to the tooth (rehydrate the fragment first in either water or saline for 20 minutes)
● In the absence of the fragment, cover the exposed pulp with GI or composite

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68
Q

How long is the splint time for root fractures in the apical or middle third?

A

4 weeks

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69
Q

When will deciduous maxillary laterals erupt?

A

9-13months

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70
Q

What is the prevalence of dentinogenesis imperfecta?

A

1:8k

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71
Q

What is the treatment for this lesion in permanent dentition?

A

Selective or complete caries removal

72
Q

When do the permanent mandibular central incisors erupt?

A

6-7years

73
Q

When do the permanent maxillary central incisors erupt?

A

7-8years

74
Q

What is the lethal dose of fluoride?

A

32-64mg/kg of body weight

75
Q

What are the most common missing teeth (in order)? (4)

A

in order: 8s, lower 5s, upper 2s, upper 5s

76
Q

When will deciduous maxillary first molars erupt?

A

12-16months

77
Q

What advice do you give for a child 3-6 years old with normal caries risk?

A

2x daily supervised brushing
- pea sized (minimum 1350ppm)
- spit don’t rinse

78
Q

What is the treatment for this lesion in primary dentition?

A

Fissure seal or site-specific prevention

79
Q

What is specific about the LA you use when treating alveolar fractures?

A

You ideally don’t want it to be a vasoconstrictor

80
Q

What teeth do you expect to be present in a 13 year old child?

A

All permanent dentition other than 8s

81
Q

What is the main issue with dens in dente?

A

can result in an area of caries and is difficult to treat endodontically

82
Q

What is the treatment for this lesion in primary dentition?

A

Selective caries removal (preferred) or hall crown

83
Q

How long do you splint for lateral luxation?

A

4 weeks

84
Q

What is dens in dente?

A

a tooth within a tooth - when a localised area of the crown is folded inwards

85
Q

What is a flexible splint?

A

Flexible splint is when there is one uninjured tooth on either side of the trauma

86
Q

Ideally within what time frame should an avulsed tooth be replanted?

A

Within 15 minutes

87
Q

What is this dental anomaly?

A

MIH

88
Q

What age can you place amalgam in a mouth?

A

15 years old

89
Q

What is the treatment for enamel-only fractures?

A

● If the tooth fragment is available, it can be bonded back to the tooth
● If fracture is minor, edges can be smoothed
● Composite resin placed

90
Q

When do the permanent maxillary canines erupt?

A

11-12years (but begin palpating at 9years)

91
Q

What is the colour of dentinogenesis imperfecta in primary teeth?

A

amber

92
Q

What type of trauma is this?

A

Extrusive luxation

93
Q

What is the treatment for irreversible pulpitis in precooperative children?

A

Primary teeth: refer for XGA of sedation
Permanent teeth: RCT or extraction, refer

94
Q

What do you do if a patient comes in with an avulsed tooth?

A
  1. clean tooth with milk or HBSS, clean socket with saline
  2. LA, place and check positioning
  3. splint for 2 weeks
  4. suture if needed
  5. RCT 2 weeks after reimplantation
  6. Antibiotics
  7. Check tetanus status
95
Q

When is the crown completed for permanent teeth?

A

3-5 years before eruption

96
Q

What is the treatment for intrusive luxation in mature teeth with 3-7mm displacement?

A

● Reposition surgically
- Flexible splint for 4 WEEKS
● Pulp almost always becomes necrotic, appropriate RCT 2 weeks after injury

97
Q

What will a patient that has had more than 5mg/kg of fluoride need?

A

gastric leverage

98
Q

When do the permanent mandibular 7s erupt?

A

11-13years

99
Q

What is the treatment for alveolar fractures?

A

● Reposition any displaced segment
● Check reposition radiographically
● Stabilise with flexible splint for 4 WEEKS

100
Q

What are the three types of dentinogenesis imperfecta?

A

Type I (associated with osteogenesis imperfecta)
Type II (DI on its own)
Type III (Brandywine isolate)

101
Q

How long do you splint for with extrusive luxation?

A

2 weeks unless there is break down/fracture of the marginal bone - then its 4 weeks

102
Q

Why do you not RCT deciduous dentition?

A

their roots resorb

103
Q

How long do you splint an avulsed tooth?

A

2 weeks
If alveolar fractures are involved, 4 weeks

104
Q

What advice do you give a patient after avulsion?

A

● Avoid contact sports
● Soft diet for 2 weeks
● Brush teeth with soft toothbrush after each meal
● Use chlorhexidine mouthwash (0.12%) twice a day for 2 weeks

105
Q

What is this dental anomaly?

A

Dental fluorosis

106
Q

What advice do you give for a child under 3 years old with normal caries risk?

A

Brush teeth 2x daily once erupted with toothpaste
- smear (minimum 1000ppm)

107
Q

What is this dental anomaly?

A

Microdontia

108
Q

How many canals do maxillary Ds have?

A

3

109
Q

What is the treatment for enamel-dentine fractures?

A

● If fragment is available and intact, you can bond it back to the tooth (rehydrate the fragment first in either water or saline for 20 minutes)
● Cover the exposed dentine with GI or composite
● If the exposed dentine is within 0.5mm of the dental pulp (pink but no bleeding), place a calcium hydroxide lining and cover with a material such as GI

110
Q

Give me the basic steps of a pulpmotomy

A
  1. LA
  2. rubberdam
  3. access
  4. remove contents of pulp chamber
  5. wash with 3 in 1 (no air)
  6. cotton wool with ferric sulphate (for bleeding)
  7. zinc oxide eugenol cement
  8. SSC
111
Q

How often do you apply fluoride varnish for a child with a high caries risk?

A

4x yearly

112
Q

What is this dental anomaly?

A

Macrodontia

113
Q

what it this type of trauma?

A

Lateral luxation

114
Q

How many canals do mandibular Ds have?

A

2 (mesial and distal)

115
Q

What permanent teeth would you expect to see in a 9 year old?

A

upper: 1s, 2s, 6s
lower: 1s, 2s, 3s?, 6s

116
Q

What are the distinctive dental features of cleidocranial dysostosis? (3)

A
  • delayed loss of primary teeth
  • delayed/failed eruption
  • supernumerary teeth
117
Q

What is this dental anomaly?

A

MIH

118
Q

What is stepwise caries removal?

A

When the carious tissue is first removed until soft dentin is reached and then a temporary restoration is placed. Months later, the restoration and carious tissue are removed until firm dentin is reached and a permanent restoration is then placed

119
Q

Why is interproximal caries common in children but difficult to see clinically?

A

they have broad, flat contact points

120
Q

What teeth would you expect to see in a 7 year old?

A

Deciduous: upper B-E; lower C-E
Permanent: upper 1+6s; lower 1+2+6s

121
Q

How often do you apply fluoride varnish for a patient aged 0-6 years old with a standard caries risk?

A

2x yearly

122
Q

What type of wire are splints made from?

A

0.4mm stainless steel wire

123
Q

What is extrusive luxation?

A

when there is displacement of the tooth out of its socket in an incisal/axial direction

124
Q

What are the 7 main caries risks to go over in an assessment?

A

● Diet
● Oral hygiene/plaque
● Fluoride use
● Social history (especially socio-economic status)
● Medical history
● Saliva
● Previous disease

125
Q

What is the safe dose of fluoride?

A

1mg/kg of body weight

126
Q

What is the treatment for this lesion in primary dentition?

A

Hall crown (preferred) or selective caries removal

127
Q

How many canals do mandibular Es have?

A

2 (mesial and distal)

128
Q

If both Ds and Es are needing hall crowns, which do you do first and why?

A

Es because they have a much easier morphology and it helps ease the patient into treatment and they are also going to be in the mouth longer

129
Q

At what age are you not to put amalgams in?

A

anyone 15 years old and under

130
Q

What are the symptoms of irreversible pulpitis?

A

● Spontaneous pain (wakes child up at night)
● Does not resolve on removal or stimulus
● Pain to hot/cold
● Does not resolve with placement of temporary dressing

131
Q

What is the treatment for irreversible pulpitis in cooperative children?

A

Primary teeth: XLA or pulp therapy
Permanent teeth: RCT or XLA

132
Q

What is the main treatment for dentinogenesis imperfecta in molars?

A

Cast restorations on occlusal surfaces as it protects from wear

133
Q

When do the permanent mandibular 4s erupt?

A

10-12years

134
Q

What BPE measurements do you do on children aged 12-17 years?

A

codes 0-4 for only 6s and 1s

135
Q

What is lateral luxation?

A

When there is displacement of the tooth in any lateral direction, usually associated with a fracture or compression of the alveolar socket wall or facial cortical bone

136
Q

What is the treatment for extrusive lucation?

A

● Reposition the tooth by gently pushing it back into the tooth socket under LA
● Flexible splint for 2 WEEKS
- If there is breakdown/fracture of the marginal bone, splint for 4 weeks
● Monitor the pulp and if it becomes necrotic, RCT

137
Q

What do you do if a patient comes in after an avulsion but the tooth has been replanted prior?

A
  1. clean the area with saline, water or chlorhexidine
  2. check and correct the positioning
  3. splint for 2 weeks
  4. suture if needed
  5. RCT 2 weeks after reimplantation
  6. Antibiotics
  7. Check tetanus status
138
Q

How often should you review a child who is a high caries risk?

A

3/4monthly

139
Q

What is the treatment for hypodontia?

A

space closure or space opening (for prosthesis) - refer/discuss with ortho, paeds and restorative specialists

140
Q

When will deciduous mandibular canines erupt?

A

16-24months

141
Q

What is Turner’s tooth?

A

an underdevelopment in enamel from a disturbance in the enamel and dentine formation (allegedly infection around deciduous tooth and effects successional tooth)

142
Q

What is concussion in regards to periodontal injuries?

A

Trauma that has caused bruising (normal mobility)

143
Q

What are the symptoms for a dental abscess?

A

● Spontaneous pain (wakes the child at night)
● Tooth mobile and TTP
● Swelling
● Malaise (general feeling of unwell)

144
Q

What is the treatment for this lesion in permanent dentition?

A

Selective or complete caries removal and restore

145
Q

What is the prevelance of amelogenesis imperfecta?

A

1:700-4000

146
Q

When will deciduous maxillary second molars erupt?

A

24-32months

147
Q

When will deciduous mandibular second molars erupt?

A

24-32months

148
Q

What is the normal ppm of fluoride varnish?

A

22600ppm

149
Q

What is the prevelance of hypodontia?

A

less than 1% in primary dentition and 3-6% in permanent dentition

150
Q

What is the treatment for this lesion in permanent dentition?

A

Fissure sealants or composite; seal remaining fissures

151
Q

What are the simplest classifications of amelogenesis imperfecta?(2)

A

hypomineralised (full thickness but weaker - impaired bond strength) and hypoplastic enamel (thin but normal strength enamel)

152
Q

When do the permanent maxillary 7s erupt?

A

12-13years

153
Q

When extracting 6s, what do you ideal want to wait until?

A

The bifurcation had formed radiographically on the 7s (boxer short stage)

154
Q

What endodontic anomaly is common in dentinogenesis imperfecta?

A

pulp canal obliteration

155
Q

What are the main syndromes linked with hypodontia?(3)

A
  • trisomy 21 (down syndrome)
  • ectodermal dysplasia
  • mutations in the MSX1 gene
156
Q

What is the main treatment for dentinogenesis imperfecta in anteriors?

A

veneers - aesthetics and protects from wear

157
Q

What teeth would you expect to see present in a 24month old?

A

Upper and lower: As, Bs, Cs, Ds
(Es may have began to erupt)

158
Q

What is the treatment for root fractures of the coronal 1/3?

A

● If displaced, reposition the coronal fragment as soon as possible
● Check positioning radiographically
● Stabilise with a passive flexible splint for 4 MONTHS
● RCT coronal section if pulp necrosis occurs

159
Q

When do the permanent mandibular lateral incisors erupt?

A

7-8years

160
Q

When do the permanent mandibular 3s erupt?

A

9-10years

161
Q

What pathological issues are common with dentinogenesis imperfecta?

A

spontaneous abscesses

162
Q

What are the ideal solutions to place an avulsed tooth in?

A

Starting with best: milk, HBSS, saliva, saline

163
Q

What is the treatment for intrusive luxation in immature teeth?

A

● Allow for re-eruption without intervention
● If no eruption within 4 weeks, initial orthodontic repositioning
● Monitor pulp condition

164
Q

At what age do you do a BPE as normal?

A

18+ years

165
Q

What is the treatment for lateral luxation?

A

● Reposition the tooth gently by disengaging it from its ‘locked’ position under LA
● Flexible splint for 4 WEEKS
● Monitor the pulp and if it becomes necrotic, RCT

166
Q

What is Gillick Competency?

A

When a young person under 16 has the capacity to make an informed decision and consent to treatment

167
Q

What permanent teeth do you expect to be present in a 10 year old?

A

Upper: 1s, 2, 4s?, 6s
Lower: 1s, 2s, 3s, 4s?, 6s

168
Q

What is subluxation?

A

When the tooth is loosened but not displaced

169
Q

What are the main clinical problems associated with dentinogenesis imperfecta?(6)

A
  • aesthetics
  • chipping/attrition of enamel
  • exposure of dentine
  • poor OH
  • gingivitis
  • caries
170
Q

What BPE measurements do you use for children aged 7-11years old?

A

codes 0-2 for only 6s and 1s

171
Q

What do patients with MIH usually come in complaining of?

A

breakdown off teeth, sensitivity, aesthetic concerns or failed restorations

172
Q

What is turners tooth?

A

Turner’s Tooth, also called enamel hypoplasia, is a condition that reduces a tooth’s enamel thickness, increases tooth sensitivity, leaves the affected tooth more susceptible to decay, and results in an unsightly appearance

173
Q

When would you consider sealing all 7s on eruption?

A

if more than one 6 displays caries

174
Q

What is the treatment for dental abscesses in pre-cooperative children?

A

Primary: refer for XGA or sedation
Permanent RCT or XLA, refer

175
Q

How often do you take bitewings on a child?

A

Low caries risk = 2 year bitewings
High caries risk = 6 month bitewings

176
Q

What is this dental anomaly?

A

Dens in dente

Dentistry (7 decks)

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