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Flashcards in Pedo Final Deck (104):
1

What are the strengths and advantages to the main resin restoration materials?

Glass ionomers may be considered pharmacologically therapeutic because they release fluoride over time; they also have minimal shrinkage during setting. Composite resins possess durability and superior esthetic qualities. When managed properly, both materials are capable of providing superior marginal sealing at the tooth– restorative material interface.

2

Verbal communication with younger children is best initiated with complimentary comments, followed by questions that elicit an answer other than “yes” or “no.”  True or False?

True

3

Behavioral goals for most children include:

A. Leaning back in the chair

B. Legs out straight

C. Hands on their tummy

D. Counting teeth

E. All of the above

E

4

What are the instructions for sedation procedures regarding changes in health?

  • It is important to notify the office of the developement of a cold, cough, fever, or any illness within 14 days before the sedation appointment.  For your child's safety, the sedation may need to be rescheduled.

5

What is mild mental retardation?

Also called educable.  It is the largest group of retardation and comprises 85% of people with mental retardation.  They develop social and communciation skills in the preschool years and can grow to live succesfully in the community as adults.

6

What is a "get to know me" form?

A form to fill out for a special needs patient (not for everyone).  It is a guide to each child with autism.

7

What are the main activity instructions before a sedation procedure?

  1. Plan the child's sleep and awakening times to encourage the usual amount of sleep the day before the sedation appointment
  2. Please arrive on time for your scheduled appointment. 
  3. The legal guardian must accompany the child to the sedation appointment
  4. A second responsible adult must join you and your child at the time of discharge.  This enables one adult to drive the car while the other focuses on the child.
  5. Make sure your child uses the restroom before the sedation.

8

How does tell-show-do differ from behavior shaping?

  • As well as demanding the reinforcement of cooperative behavior, behavior shaping also includes the need to retrace steps if misbehavior occurs. For example, if a child is shown an instrument and looks away, the dentist must revert to the explanatory portion of the procedure. Behavior shaping requires that the “desired behavior” be observed along the way.

9

What should you expect from children with autism or special needs as they grow up?

That they'll progress behaviorally and do better in your office

10

What are the main activity instructions after the sedation procedure?

  1. Your child may take a long nap.  He/she may sleep from 3 to 8 hours and may be drowsy and irritable for up to 24 hours after the sedation.  When asleep, you should be able to awaken him/her easily.
  2. Your child may be unsteady when walking or crawling and will need support to protect him/her from injury.  An adult must be with the child at all times until the child has returned to his/her usualy state of alertness.
  3. Closely supervise any activity for the remainder of the day.

11

What is the Frankl behavioral rating scale?

  1. Definitely negative
  2. Negative
  3. Positive
  4. Definitively positive

 

Can be used shorthand, with --, -, +, ++

12

When are glass ionomer selants most often indicated?

  • Glass ionomer may be useful as a sealant material in deeply fissured primary molars that are difficult to isolate due to the child's precooperative behavior and in partially erupted permanent molars that the clinician believes are at risk for developing decay. In such cases, glass ionomer materials must be considered a provisional sealant to be reevaluated and probably replaced with resin­based sealants when better isolation is possible. Because questions exist regarding the strength and retention of glass ionomer, further long­ term research is necessary before it is recommended as a routine pit and fissure sealant material.

13

What two behaviors together usually predict success for simple operative treatment?

A. Sitting in mom's lap for the exam

B. Performing a normal exam in the dental chair

C. Taking bite wing x-rays

D. B and C only

E. None of the above

D

14

What are some key points from the "care of your child after sedation" form?

  • "today your child had dental treatment under conscious sedation"
  • Children respond to sedation in their own way
  • They won't be able to walk, so carry or wheelchair
  • Child should not ride bikes, play outside, handle sharp objects, work with tools, climb stairs, until they are back to normal for at least 1 hour
  • Keep child home from school or daycare after treatment and possibly the next day if still drowsy or can't walk, should be back to normal within 24 hours
  • Begin giving clear liquids like juices, water, popsicles or broth.  If child does not vomit after 30 minutes, you may continue with solid foods
  • Reasons to call the doctor include: you can't arouse your child, child is unable to eat or drink, child has pain or vomiting, child develops a rash.

15

According to the literature, what percent of pediatric patients reported dental fear/anxiety?

9%.  Girls more so than boys.  And dental fear was closely associated with temperamental traits such as shyness, inhibition, and negative emotionality, and behavioral problems were associated with activity and impulsivity.

16

Treating adults involves a one-to-one relationship and treating a child involves a one-to-two relationship.  True or False?

True

17

Which phosphoric acid concentrations are recommended for sealants? And for how long?

  • 30% to 50%. 20 seconds.  
  • Enamel rich with fluorhydroxyapatite may be resistant to etching and may need to be exposed for longer periods. Primary teeth may also sometimes be resistant to etching and may require a longer etching time.
  • Dentin bonding agents can be helpful when isolation is not feasible or on buccal surfaces of molars which have lower retention rates.

18

What are the eight recommendations of the AAPD regarding the support for sealant use?

1. Bonded resin sealants, placed by appropriately trained dental personnel, are safe, effective, and underused in preventing pit and fissure caries on at­risk surfaces. Effectiveness is increased with good technique and appropriate follow­up and resealing as necessary.

2. Sealant benefit is increased by placement on surfaces judged to be at high risk or surfaces that already exhibit incipient carious lesions. Placing sealant over minimal­enamel caries has been shown to be effective at inhibiting lesion progression. As with all dental treatment, appropriate follow­up care is recommended.

3. The best evaluation of risk is made by an experienced clinician using indicators of tooth morphology, clinical diagnostics, past caries history, past fluoride history, and present oral hygiene.

4. Caries risk, and therefore potential sealant benefit, may exist in any tooth with a pit or fissure, at any age, including primary teeth of children and permanent teeth of children and adults.

5. Sealant placement methods should include careful cleaning of the pits and fissures without removal of any appreciable enamel. Some circumstances may indicate use of a minimal­ enameloplasty technique.

6. Placement of a low­-viscosity, hydrophilic material­ bonding layer as part of or under the actual sealant has been shown to enhance the long­-term retention and effectiveness.

7. Glass ionomer materials have been shown to be ineffective as pit and fissure sealants but can be used as transitional sealants.

8. The profession must be alert to new preventive methods effective against pit and fissure caries. These may include changes in dental materials or technology.

19

What color are sealants?

  • Sealant materials may be transparent or opaque. Opaque materials are available in tooth color or white. Transparent sealants are clear, pink, or amber. The clear and tooth­colored sealants are esthetic but are difficult to detect at recall examinations. Recent advances in sealant technology include light­activated coloring agents that allow for color change during and/or after polymerization. These compositional changes do not affect the sealant, but only offer some arguable benefit in the recognition of sealed surfaces.

20

What is severe mental retardation?

About 3 to 4 % are in this.  As adults, they can perform simple talks in a specific setting.

21

Chemicallly cured sealants exhibit a smaller chance of incorporating air bubbles than do light-cured sealants.  True or False?

False, mixing is required which can screw it up.

22

What are some steps of the D-termined program by Tesini?

A. Do treatment no matter what the cost

B. Divide the skill

C. Drill the skill

D. Drill and fill at the first appointment

E. B & C only

E

23

What things should you keep the same at each appointment?

A. Same assistant

B. Same doctor

C. Same routine

D. Change things up, kids do well with change

E. A, B, & C only

E

24

What are the six requisites of sedation?

  1. Through knowledge of agent used
  2. Carefully planned & documented rational for use of drug
  3. Evaluate patient for contraindications
  4. Informed consent
  5. Office must be adequate: equipment to manage emergencies, trained in monitoring, ACLS or PALS trained
  6. Mobil emergency medical services available

25

A child's coordination cannot be judged by physical size.  True or False?

True

26

Sealants may be able to help arrest incipient caries, but sealants should not be placed over deeper caries.  True or False?

True

27

What is an ASA class III child?

  • A patient with severe systemic disease (a child who is actively wheezing)

28

Children under age 3 generally:

A. Can sit in the dental chair alone

B. Can take bite wing x rays

C. Are easily treated in the dental office

D. Want to sit in mom's lap

E. None of the above

D

29

What are 3 keys to success when working with children?

  1. Speed
  2. Excellent distraction
  3. Excellent pain control

30

When you are not sure how to treat a child, what should you do?

A. Treat them like your own child

B. Maximize revenue for the office

C. Get the treatment done no matter what the cost

D. Do treatment you are not qualified to do

E. None of the above

A. Treat them like your own child

31

What are the developmental changes of a five year old?

  • Undergoes a period of consolidation, deliberate
  • Takes pride in possessions
  • Relinquishes comfort objects such as a blanket or thumb
  • Plays cooperatively with peers

32

What should the SCC prep on primary molars look like?

  • A local anesthetic should be administered and a rubber dam placed as for other restorative procedures. The proximal surfaces are reduced using a No. 69L bur at high speed ( Fig. 18­20 (f20) ). Care must be taken not to damage adjacent tooth surfaces during the proximal reductions. A wooden wedge may be placed tightly between the surface being reduced and the adjacent surface to provide a slight separation between the teeth for better access. Near­vertical reductions are made on the proximal surfaces and carried gingivally until the contact with the adjacent tooth is broken and an explorer can be passed freely between the prepared tooth and the adjacent tooth. The gingival margin of the preparation on the proximal surface should be a smooth feathered edge with no ledge or shoulder present. The cusps and the occlusal portion of the tooth may then be reduced with a No. 69L bur revolving at high speed. The general contour of the occlusal surface is followed, and approximately 1 mm of clearance with the opposing teeth is required.
  • It is usually not necessary to reduce the buccal or lingual surfaces; in fact, it is desirable to have an undercut on these surfaces to aid in the retention of the contoured crown. In some cases, however, it may be necessary to reduce the distinct buccal bulge, particularly on the first primary molar.

33

Resin-modified glass ionomer restorations placed in box-­only preparations were more likely to show adhesive failure than those placed in dovetail preparations.  True or False?

True

34

How do you establish yourself as a strong communicator with the patients?

  • Help parents step back & hear one voice, the Dr.'s
  • Simple, clear message
  • Voice control and tone (stern talk)
  • Multisensory communication
  • Problem ownership
  • Active listening
  • Appropriate responses

35

What are the developmental changes of a two year old?

  • Geared to gross motor skills, running, jumping
  • Likes to see and touch
  • Very attached to parent
  • Plays alone, rarely shares
  • Has limited vocabulary
  • Becoming interested in self-help skills

36

What is an ASA class II child?

  • A patient with mild systemic disease (controlled reactive airway disease)

37

What are the best ways to clean pits and fissures prior to etching and sealant placement?

  • Acid etching completely removes the enamel pellicle, and a dental prophylaxis (even with a dental explorer) does not increase the retention of sealants. From a practical standpoint, in cases of poor oral hygiene, fissure cleansing with a rotating dry bristle brush may be beneficial.
  • Pope and colleagues found that the use of a quarter round bur produced the greatest penetration of the sealant into etched enamel in laboratory studies. The use of an aluminum oxide air abrasion system allows sealant penetration greater than that achievable by use of pumice or a dry bristle brush alone.
  • Teeth prepared with the bur exhibited the least microleakage. The amount of microleakage in the conventional and air abrasion groups was about equal.

38

What are the main two reasons why we have so many dietary restrictions for sedation patients?

  • First, emesis during or immediately after a sedative procedure is a potential complication that can result in aspiration of stomach contents leading to laryngospasm or severe airway obstruction. Aspiration may even present difficulties later in the form of aspiration pneumonia. At the very least, it creates an unfavorable disruption of the office routine.
  • Second, because most sedative agents are administered by the oral route, drug uptake is maximized when the stomach is empty.

39

It is important that communication with young patients occur from multiple sources while in the dental chair.  True or False?

False, just the dentist.

40

What are the main six office/dental team strategies to manage behavior of parents and kids?

  1. Pre appointment behavior guidance
  2. Positive approach
  3. Organization-flow in office
  4. Truthfulness-under promise/over deliver
  5. Tolerance
  6. Flexibility

41

What can you do to reduce anxiety at the patient's first appointment?

A. Do treatment at the first appointment

B. Take a tour of the office on the website prior to the appointment

C. Do not use the D-termined program

D. A & C only

E. None of the above

B

42

What is an ASA class I child?

  • A normal healthy patient

43

What is the definition of moderate sedation?

  • More effort required to get a response
  • Crying can be expected in young patients
  • Airway is intact
  • Ventilation and cardiovascular function intact

44

For an incipient class I cavity in a very young child, a rubber dam or local anesthetic is often not used.  True or False?

True

45

What are the six dietary instructions for sedation procedures given by the AAPD?

  1. Clear liquids: water, fruit juices without pulp, carbonated beverages, clear tea or black coffee up to 2 hours before the procedure
  2. Breast milk up to 4 hours prior to the procedure
  3. Infant formula up to 6 hours before the procedure
  4. Non-human milk up to 6 hours prior to the procedure
  5. A light meal up to 6 hours prior to procedure, avoid fatty foods/meats that take a long time to digest
  6. Necessary medications can be taken with a sip of water on the day of the procedure

46

Trinkets and toys can be used as bribes if warranted.  True or False?

False, they should not be promised or used as bribes.  A bribe is promised to induce the behavior. A reward is recognition of good behavior after completion of the operation, without previously implied promise.

47

Development of a child is unitary, you can quantify it with one single aspect.  True or False?

False

48

What is the heart rate, blood pressure, and respiratory rate for a kid aged 1 to 3?

Heart Rate: 70 to 110

Blood pressure: 90 to 105/55 to 70

Respiratory Rate: 20 to 30

49

What is profound mental retardation?

Makes up about 1 to 2%.  A highly structured setting with individualized care and supervision is required.

50

An exam on a child under age 3 usually includes:

A. Sittin in the dental chair

B. Tooth brush prophy and fluoride treatment

C. Bite wing x-rays

D. All of the above

E. None of the above

B

51

What is moderate mental retardation?

Trainable.  Makes up about 10% of people with mental retardation.  They profit from vocational training and can attend pesonal care with moderate supervision.

52

What questions are asked on the "get to know me" form?

  1. What medical problem they have, name and diagnosis
  2. what should you do with this child (sounds, lights)
  3. Special things they like
  4. Special interests
  5. Communciations/sensory issues
  6. It asks about appointment scheduling

53

Deficient sealants are still effective in caries prevention.  True or False?

False.  They are not.  They require regular maintenance and repair or replacement.

54

What things should you keep the same for children with autism?

  • They need routine/stability
  • Same dentist, tx room, assistants, wear same smock

55

What is the Binet IQ formula for children?

You take the average age for the tasks they are doing, and divide by their actual age, and times by 100, and that can tell you their mental age so you don't make wrong assumptions based on size and other development.

56

How can you reduce kid's anxiety at office?

  1. Education, reassurance, talk therapy
  2. They like to have something with them, stuffed animals, parents, etc.

57

What are eight goals we should have for each patient?

  1. Enter room
  2. Sit in chair
  3. Lay chair back
  4. Legs straight out
  5. Hands on tummy
  6. Open mouth
  7. Count teeth
  8. Do some treatment

(Mom can practice these at home)

58

What eight things do we collect as part of the medical history evaluation?

  1. Allergies and previous reactions
  2. Current medications.  Dosage, time, route
  3. Disease or abnormalities, pregnancy in adolescent
  4. Previous hospitalizations
  5. History of previous sedation or anesthesia
  6. Review of body systems
  7. Family history of disease or sedation reactions
  8. Age and weight

59

What are the five main goals of sedation?

  1. Guard the patient's safety and welfare
  2. Minimize discomfort and pain
  3. Control anxiety, minimize psychological trauma, maximize amnesia
  4. Control behavior and movement to allow safe completion of procedure
  5. Return patient to state of safe discharge

60

When are SSC's for posterior primary teeth indicated?

1. Restorations for primary or young permanent teeth with extensive and/or multiple carious lesions

2. Restorations for hypoplastic primary or permanent teeth that cannot be adequately restored with bonded restorations

3. Restorations for teeth with hereditary anomalies, such as dentinogenesis imperfecta or amelogenesis imperfecta

4. Restorations for pulpotomized or pulpectomized primary or young permanent teeth when there is increased danger of fracture of the remaining coronal tooth structure

5. Restorations for fractured teeth


6. Restorations for primary teeth to be used as abutments for appliances

7. Attachments for habit­breaking and orthodontic appliances

61

What is the definition of minimal sedation?

  • They respond normally
  • Some cognitive function & coordination may be impaired
  • Respiratory and cardiovascular function unaffected

62

What is the heart rate, blood pressure, and respiratory rate for a kid aged 3 to 6?

Heart rate: 65 to 110

Blood pressure: 95 to 110/60 to 75

Respiratory rate: 20 to 25

63

Children 3-6 years of age generally:

A. Can sit in the dental chair

B. Can have a normal dental exam

C. Can tolerate simple dental procedures

D. All of the above

E. None of the above

D

64

When was etching with phosphoric acid first done?

1955, Buonocore

65

What are some goals you should have for most patients?

A. Entering the treatment room

B. Having legs out straight

C. Opening the mouth

D. Getting some treatment done

E. All of the above

E

66

What are the three eating and drinking instructions before the sedation procedure?

  1. No milk or solid foods 6 hours before the sedation appointment
  2. Clear liquids such as water, clear juices, gelatin, popsicles, or broth, may be given up to 3 hours before the appointment
  3. Let everyone in the home know the above information, because siblings or others living in the home often unknowingly feed the child

67

When was the bis-GMA resin first invented?

1965, Bowen

  • This is the base resin to most of the current commercial sealants. Urethane dimethacrylate and other dimethacrylates are alternative resins used in sealant materials.

68

What are the developmental changes of a 3 year old?

  • Less egocentric, likes to please
  • Has very active imagination, likes stories
  • Remains closely attached to parent

69

What are the developmental changes of a four year old?

  • Tries to impose powers
  • Participates in small social groups
  • Reaches out-expansive period
  • Shows many independent self-help skills
  • Knows thank you and please

70

Placing a hand on a child's shoulder while sitting chairside was shown to help children relax, especially those 7 to 10 years of age.  True or False?

True

71

What is alternative or atraumatic restorative treatment?

  • Alternative or atraumatic restorative treatment, or ART, has become a popular descriptive term to describe a conservative method of managing both small and large carious lesions when treating the disease by more traditional restorative procedures is impossible or impractical for many reasons, including lack of access to traditional dental settings. This method may prevent pain and preserve teeth in individuals who do not have access to regular and conventional oral health care. ART may be performed with only hand instruments when no other dental equipment is available, but it may be useful sometimes in the conventional dental setting as well. ART does not require the complete excavation of dentinal caries before placement of the restorative material. This is not a totally new concept in dentistry, but it has enjoyed renewed recognition as a viable restorative approach because of the development of the more durable fluoride­releasing glass ionomer and resin­modified glass ionomer restorative materials.

  • This technique is promoted and endorsed by the World Health Organization with the goals of preserving tooth structure, reducing infection, and avoiding discomfort.

72

What are the main parental variables in determining the dental visit outcome?

  • Anxiety
  • Medical experiences
  • Dental awareness

73

What three things should you keep the same at each appointment?

  1. Assistant
  2. Doctor
  3. Routine

74

When are stainless steel crowns most often used?

  • Stainless steel crowns have undoubtedly preserved the function of many primary teeth that otherwise would have been unrestorable. In addition, stainless steel crowns are often used to restore all posterior teeth in young patients with high risk for caries who exhibit multiple proximal lesions that could otherwise be restored with silver amalgam or esthetic materials. Crowns are used instead simply because they better protect all posterior tooth surfaces from developing additional caries and because the posterior crown restoration has proven to be the most durable and cost effective in the primary dentition. Anterior, as well as posterior, stainless steel crowns may have labial and/or occlusal resin or porcelain veneers to enhance esthetics.

75

What is an ASA class IV child?

  • A patient with severe systemic disease (a child with status asthmaticus)

76

What percent of sealants need to be repaired or replaced yearly?

5% to 10%

77

What are the seven steps of the behavior-shaping model?

1. State the general goal or task to the child at the outset.

2. Explain the necessity for the procedure. A child who understands the reason is more likely to cooperate.

3. Divide the explanation for the procedure. Children cannot always grasp the overall procedure with a single explanation; consequently, they have to be led through the procedure slowly.

4. Give all explanations at a child's level of understanding. Use euphemisms appropriately.

5. Use successive approximations. Since its introduction in 1959, tell­show­do has remained a cornerstone of behavior guidance. Tell­show­do is a series of successive approximations. It is a component of behavior shaping that should be routinely used by all members of the dental team who work with children. Dental assistants, dental hygienists, and dentists should demonstrate various instruments step by step before their application by telling, showing, and doing. When the dentist works intraorally, a pediatric patient should be shown as much of the procedure as possible. Only when the child has a view of the procedures being undertaken are successive approximations being performed properly.

6. Reinforce appropriate behavior. Be as specific as possible, because specific reinforcement is more effective than a generalized approach. This advice is supported by the clinical research of Weinstein and colleagues, who studied dentists' responses to children's behavior and found that immediate and specific reinforcements were most consistently followed by reductions in children's fear­related behaviors.


7. Disregard minor inappropriate behavior. Ignored minor misbehavior tends to extinguish itself when it is not reinforced.

78

What are three characteristics of a child with autism?

  1. Needs sameness
  2. Private room
  3. Nervous/anxious

79

What are the different tonsillar sizes for airway management?

  • 0 = in fossa
  • +1 = <25%
  • +2 = >25%, <50%
  • +3 = >50%, <75%
  • +4 = >75%

 

  • If you have tonsils that are +3 (class 3), 50% occluding and less than <75%, than you can't do sedation

80

Listening to the spoken words may be more important in establishing rapport with the older child than guiding the behavior of a younger child, for whom attention to nonverbal behavior often is more crucial.  True or False

True

81

It is better to send "I" messages than "You" messages.  True or False?

True.  These messages establish the focus of the problem, such as “I can't fix your teeth if you don't open your mouth wide.”

82

What is the heart rate, blood pressure, and respiratory rate for a kid aged 12?

Heart rate: 55 to 85

Blood pressure: 110 to 135/65 to 85

Respiratory rate: 12 to 18

83

What are the two important principles for selecting a stainless steel crown size?

  • First, the operator must establish the correct occlusogingival crown length; and second, the crown margins should be shaped circumferentially to follow the natural contours of the tooth's marginal gingivae. The crown should be reduced in height, if necessary, until it clears the occlusion and is approximately 0.5 to 1 mm beneath the free margin of the gingival tissue.

84

Occlusal surfaces that are already carious with involvement of dentin require restorations rather than sealant treatments.  True or False?

True

85

What are the 5 steps of the D-termined program (Dr. Tesini)?

  1. Divide the skill
  2. Demonstrate the skill
  3. Drill the skill
  4. Delight the learner
  5. Delegate the skill

86

What are the three behavioral categories of Wright's clinical classification?

  1. Cooperative
  2. Lacking in cooperative ability
  3. Potentially cooperative

87

What is the heart rate, blood pressure, and respiratory rate for a kid aged 6 to 12?

Heart rate: 60 to 95

Blood pressure: 100 to 120/60 to 75

Respiratory rate: 14 to 22

88

What are the four items of information we collect as part of the physical evaluation?

  1. Vital signs
  2. Airway patency and tonsilar size
  3. ASA classification
  4. Name, address & telephone (# of child's medical home)

89

What is the best way to learn about special needs children?

Have one of your own

90

What is the definition of deep sedation?

  • Loss of protective reflexes
  • Loss of ability to maintain airway
  • Cardiovascular function may be impaired

91

Clinical studies have shown that topical fluoride interferes with the bonding between sealant and enamel. True or False?

False, it does not interfere.

92

Which age group benefited the most from the parent's presence chairside?

3.5 to 4 year olds.

93

The use of pit and fissure sealants is contraindicated when rampant caries or interproximal lesions are present.  True or False?

True

94

The concept of ______ is essential to safe sedation?

Rescue.  Must follow guidelines of ADA, AAPD, AAP.  Cannot learn by experimentation.

95

How were and how are sealants cured?

  • The early light­activated sealants were polymerized by the action of ultraviolet rays (which are no longer used) on a benzoin methyl ether or higheralkyl benzoin ethers to activate the peroxide curing system. The visible light– curing sealants have diketones and aromatic ketones, which are sensitive to visible light in the wavelength region of 470 nm (blue region). Some sealants contain filler, usually silicon dioxide microfill or even quartz.

96

What are some of the morphological considerations for primary teeth preparations?

  • The characteristic sharp lingual inclination occlusally of the facial surfaces results in the formation of a distinct faciogingival ridge that ends abruptly at the cementoenamel junction. The sharp constriction at the neck of the primary molar necessitates special care in the formation of the gingival floor during class II cavity preparation. The buccal and lingual surfaces of the molars converging sharply occlusally form a narrow occlusal surface or food table; this is especially true of the first primary molar.
  • The pulpal outline of the primary teeth follows the dentoenamel junction more closely than that of the permanent teeth. The pulpal horns are longer and more pointed than the cusps would indicate. The dentin also has less bulk or thickness, and so the pulp is proportionately larger than that of the permanent teeth. The enamel of the primary teeth is thin but of uniform thickness. The enamel surface tends to be parallel to the dentinoenamel junction.

97

How is a laminate veneer placed on a tooth?

  • The intraenamel preparation includes removal of 0.5 to 1 mm of facial enamel, tapering to about 0.25 to 0.5 mm at the cervical margin. This margin is finished in a well­defined chamfer level with the crest of the gingival margin or not more than 0.5 mm subgingivally. The incisal margin may end just short of the incisal edge, or it may include the entire incisal edge ending on the lingual surface. It is better not to place incisal margins where direct incising forces occur. Bonded porcelain techniques have significant value in cosmetic dental procedures

98

What is the biggest issue with sedating children that gets overlooked?

Airway management

99

If a child will take bitewings x-rays and do a normal exam, what else can you expect?

That they wil hand simple operative treatment just fine

100

Normal voice commands reduced disruptive behaviors more effectively than loud voice commands.  True or False?

False.  Loud commands are better.The comprehension of actual words is not as important as the tone and volume.

101

A rounded angle between the pulpal floor and the axial wall of a two­-surface preparation should be avoided. Sharp angles throughout the preparation will result in less concentration of stresses and will permit better adaptation of the restorative material into the extremities of the preparation. True or False?

False, the opposite is true.

102

What is an ASA class V child?

  • A moribund patient who is not expected to survive without operation (a patient with severe cardiomyopathy requiring heart transplantation)

103

What things should you ask on a "get to know me form?"

A. What you should do

B. What you should not do

C. The best time of the day for the child

D. Special medical problems

E. All of the above

E

104

Radiographs should be considered on children:

A. When all the teeth are spaced and there is no evidence of decay

B. When posterior molars are in contact and you suspect active decay

C. When upper incisors are in contact and you suspect decay

D. A only

E. B and C only

E