PAEDS - medically compromised child

Question 1

what classes a baby as premature?

Answer 1

born before 37 weeks

Question 2

prematurity incidence?

Answer 2

8%

Question 3

what scan will you find out the gender of the baby and if they have any medical issues?

Answer 3

20 week scan

Question 4

what syndromes can be screened for with an optional blood test?

Answer 4

down syndrome - trisomy 21
edward syndrome - trisomy 18
patau syndrome - trisomy 13

Question 5

complications of spina bifida?

Answer 5

serious cardiac abnormalities, kidney problems, and cleft lip and palate

Question 6

how is whooping cough relevant to dentistry?

Answer 6

if the baby experienced this early on in life, can predilect MIH due to respiratory and hypoxic issues

Question 7

implications of meningitis?

Answer 7

brain injury
hearing and sight loss
behavioural changes
amputation
enamel defects in developing dentition

Question 8

dental features of angelman syndrome?

Answer 8

seizures
wide mouth with spaced dentition
drooling and excessive chewing
sleep disturbance
large tongue

Question 9

dental implication of Goldenhar syndrome?

Answer 9

cleft lip/ palate
underdeveloped facial muscles
congenital heart defects
kidney issues

Question 10

dental implications of treacher collins?

Answer 10

skeletal class II
cleft palate
spacing, hypodontia

Question 11

dental implication of Pierre robin sequence?

Answer 11

micrognathia (small jaw)
cleft palate

Question 12

dental implication of Sturge weber?

Answer 12

facial haemangioma - related to distribution of trigeminal nerve

Question 13

cleft lip and/or palate incidence?

Answer 13

1.35 in every 1000 live births

Question 14

how is cleft lip/palate classified?

Answer 14

a mapping system

Question 15

what is the most common type of clefts?

Answer 15

soft palate only
unilateral complete (LHS)
hard and soft palate

Question 16

aetiology of cleft lip and palate?

Answer 16

genetic: MSX1, TGFA
environmental: phenytoin, alcohol, smoking, high levels of ionising radiation

Question 17

when are clefts referred to as syndromic?

Answer 17

when 1 or more additional features are involved

Question 18

what are the associated dental anomalies with cleft lip/ palate?

Answer 18

• class III skeletal/ incisors
• hypodontia (upper laterals of the side of the cleft)
• supernumeraries
• size and shape abnormalities
• hypomineralisation
• retrognathic maxilla and mandible

Question 19

what surgeries does a pt with cleft lip/palate undertake and when?

Answer 19

lip closure at 3 months
palate closure at 12 months

max fax at 9 years for alveolar bone graft and 18 years for an osteotomy

Question 20

what therapy do cleft lip/palate pts undertake?

Answer 20

speech therapy and visits to ENT specialists

Question 21

what dental treatments do cleft lip/palate pts require?

Answer 21

joint ortho and restorative

Question 22

what is spina bifida?

Answer 22

neural tube defect - babies spine and cord doesnt develop properly

Question 23

what supplement can be given to pregnant mothers for prevention of spina bifida?

Answer 23

folic acid

Question 24

why do patients with hydrocephalus carry a medical warning card?

Answer 24

if their shunt gets blocked/ infected this is a medical emergency

Question 25

what is hydrocephalus associated with?

Answer 25

spina bifida mumps or rubella during pregnancy

Question 26

what may pts teeth look like after a liver transplant?

Answer 26

green

Question 27

what medications may transplant pts be on which is of relevance to dentistry?

Answer 27

ciclosporin - gingival overgrowth

Question 28

why would graft vs host disease arise?

Answer 28

HLA matching/ tissue typing with transplants

Question 29

how does graft vs host disease present in the mouth?

Answer 29

lichenoid hyperkeratotic erythema ulceration mucosal atopy fibrosis *increased risk of oral cancer!!!

Question 30

why should you refer a child if they lose primary teeth early (esp before age3)?

Answer 30

can imply there is an underlying systemic medical condition

Question 31

how does hypophosphotasia present in the mouth?

Answer 31

exfoliation of teeth with roots intact reduced dentine enlarged pulp chambers

Question 32

how does papillon lefevre syndrome present in the mouth?

Answer 32

severe inflammation and degeneration of periodontal tissues early exfoliation of teeth

Question 33

what is a glass child?

Answer 33

a child with a sibling with a chronic illness

Question 34

what is buccal caries on primary incisors a sign of?

Answer 34

bottle caries

Question 35

what causes a sickle cell crisis?

Answer 35

stress, pain, infection, extreme temperatures