Pediatric Dentistry: Questions and Answers for Students, Exams of Orthodontics

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Pediatric Dentistry - Chapter 57

Would it be possible to see a 21-year old patient in a pediatric office? - not unless they have a special healthcare need that would need pediatric help What is unique about the treatment setting of a pediatric practice? - open bay concept What types of patients are seen in a pediatric practice? - infants, children, and adolescents Is it possible for a child to be 10 years old but to act like a 7 year old? If so what are you describing about this patient? - yes there mental age At what developmental stage do children first want control and structure of their environment ? - play age ( 3-5) When would a papoose board be used? - when a parent is to anxious to hold the child What types of skills are limited in a mentally challenged child? - social and communication skills What is another term for down syndrome? - trisomy Would it be common for you to treat a cerebral palsy patient in a wheel chair? If so, why? - no, they usually get home treatment When should a child first see the dentist? - around their first birthday If a patient is at high risk for decay how often should radiographs be taken? - every 6 months Would fluoride varnish be used on a child? - fluoride tooth paste What procedure is recommended for children to protect the pits and fissures of posterior teeth? - sealants Is an appliance that is placed to stop a patient from sucking the thumb considered interceptive or preventive orthodontics? - preventive

As a swimmer should you wear a mouth guard? - no What types of matrices are commonly used on primary teeth? - Tband and spot-welded band What endodontic procedure would most likely be performed on a primary tooth? - pulp therapy Would a child be referred to a prosthodontics for placement of a stainless steel crown? - yes What happens when a tooth is avulsed? - It can be replanted Pediatric Dentistry - Specialized are of dentistry limited to the care of children from birth through adolescence, with additional focus in providing oral health care to patients with special needs. Pediatric Dental Office Setting -

1. Display cheerfulness in a pleasant environment with nonthreathening decor.
2. Treatment areas are designed with an open bay concept in mind.
3. Dental personnel dress in bright coordinating colors. Preventive Dentistry includes: - Oral hygiene, fluoride, diet, sealants, oral or facial development and sports safety. At What age should the children take fluoride daily? - Between the ages of 6 mons. And 16 years Mouth guard - Protective equipment that should be worn during any recreational sport that might injure the mouth area. Dental Assistant Role -
4. Chair side assisting
5. Educator - POH instructions
6. Expanded Functions: mechanical polish, topical fluoride treatments, radiographs, cement removal, sealant application, topical anesthetic Pits and Fissures Sealants - Opaque plastic material applied to the posterior teeth as a barrier to protect against decay. Restorative Procedures - Amalgam and composite Endodontic Procedure - Pulp capping and Pulpotomy

Prosthodontic Procedure - Stainless Steel Crown Indications for Stainless Steel Crown - Extensive decay, treatment following pulpotomy, abutment for space maintainer, temporary restoration of fractured teeth Nursing bottle syndrome or sippy cup can cause - Rampant decay in baby or toddler Coronal polish (mechanical) - Routine procedure given during exam appointments. Fluoride given after polish. Mouth guards - Protection for children that are involved in contact sports. Two common procedures for preventative/interceptive orthodontic treatment -

1. Space maintainers are designed to maintain a space until permanent tooth erupts.
2. Orthodontics used to correct oral habits Oral habits of a child - Thumb sucking Tongue thrusting Thumb sucking causes - Open bite Abnormal muscle function malocclusion Speech problems Tongue thrusting - Habit in which the child pushed tongue against the anterior teeth during swallowing. This causes an open bite. Pediatric Patient - Chronological age Mental age Emotional age Chronological age - The child's actual age in terms of years and months. Stages of Childhood - Birth to 2 years - children are too young to be expected to cooperate in dental treatment. 3-5 years - child welcomes an active role in the treatment experience. 6-12 years - child is learned to overcome fears of objects and situations. Behavior Management - -Be honest with the child

-Consider the child's point of view -Use tell, show, do -Give positive reinforcement. Techniques that may be used to modify behavior to a challenging child patient. -

1. Distraction, voice control, modeling
2. Premedication, nitrous oxide, physical restraint (these must need a written consent) Causes of dental injuries to children - Automobile accidents, bicycle accidents, sports injuries, child abuse Fractured teeth - Common emergency in a pediatric practice. Anterior teeth are most often involved ( maxillary central incisors) The dentist should do to a patient with fractured tooth. - Complete documentation of the accident. Clinical examination. Radiographs. Vitality testing. Traumatic Intrusion - The tooth is forcibly driven into the alveolus so that only a portion of the crown is visible. Intrusion - Displacement of a tooth into its socket as a result of injury. Traumatic Extrusion - Occurs when teeth are displaced from their position. How would a dentist stabilize a tooth after an injury? - A splint is generally required to stabilize mobile teeth. Avulsed teeth - A tooth is torn away or dislodged completely by force. Instructions for avulsed teeth accident -
3. Recover tooth immediately
4. Wrap the tooth in moistened gauze (milk, water, saline or saliva)
5. Go immediately to dental office. Are Dental Assistant legally required to report child abuse? - No. However, dental team has moral responsibility to report known/suspected abuse cases to the dentist. Who in the dental office should report child abuse? - Dentist Which teeth are injured most frequently? - Anterior teeth

When should a child first see the dentist? - Around Child's first birthday Type of Pediatric Patients - Chronological Age Mental Age Emotional Age Frankl Scale -

• Developed by Dr. Spencer Frankl.
• Used to measure pediatric patient's behavior. Cerebral Palsy - Neural disorder of motor function caused by brain damage. Down Syndrome - Chromosomal defect that results in abnormal physical characteristics and mental impairment, also called TRISOMY. Mental Retardation - Disorder in which an individual's intelligence in underdeveloped. Papoose Board - Type restraining device that holds a pediatric patient's arms, hands and legs still. At what age would a person most likely be referred to a general dentist from their pediatric dentist? - 17 What is unique about the treatment areas of a pediatric practice? - Many are designed with the open bay concept. Describe the type of patients seen in a pediatric practice. - Healthy adolescent Special needs children Special needs adults What are you describing when you say that a child is 10 years old but behave like a 6-year- old? - Emotional age At what age stage of life does a child first want control of, and structure in his or her environment? - 3 to 5 years of age How would Dr. Frankl describe a positive child? - Accepts treatment Is willing to comply Follows direction

Which situation could include the use of a papoose board for the protection of the patient? - Sedation of a 12-year-old Which of the following have limitations in children who are mentally challenged? - Speech IQ Another name for Down Syndrome is? - Trisomy 21 Cerebral palsy is a no progressive neural disorder caused by? - Brain damage At what age should a child first see a dentist for a regular examination? - 2 years If a patient has a high risk of decay, how often should radiographs be taken? - Every six months How is fluoride varnish prescribed for children with a high decay rate? - As a direct fluoride application What procedure is recommended to protect the pits and fissures of posterior teeth? - Sealants At what phase of orthodontics would a pediatric dentist intercede in getting a patient to stop sucking his or her thumb? - Prevention If you are a competitive swimmer, is it recommended that you wear a mouth guard? - No What matrices are used on primary teeth? - T-band What Endodontic procedure would be preformed on primary teeth? - Pulpectomy Would a child be referred to a prosthodontist for the placement of a stainless steal crown? - No In children, which teeth are most frequently injured? - Maxillary anterior When a tooth is avulsed, it has? - Come out How does the dentist stabilize a tooth after an injury? - With a temporary splint

Who in the dental office is legally required to report child abuse? - Dentist What could be a possible sign of child abuse? - Chipped or fractured teeth Bruises Scars on the lips or tongue What organization should be contacted if someone suspects child abuse? - Child protective services of the public health Analogy - Comparison of similarities between things that are otherwise not alike. Athetosis - Type of involuntary movement of the body, face, and extremities. Autonomy - Childhood process of becoming independent. Avulsed - Torn away or dislodged by force. Cerebral palsy - Neutral disorder of motor function caused by brain damage. Contour - To shape or conform an object. Chronologic age - Actual age (months,years) of pediatric patients. Down syndrome - Chromosomal defect that results in abnormal physical characteristics and mental impairment; also called trisomy 22. Emotional age - Measure of the level of emotional maturity of pediatric patients. Extrusion - Displacement of a tooth from its socket as a result of injury. Frankl scale - Scale designed to evaluate patient behavior. Intellectual disability - Disorder in which an individual's intelligence is underdeveloped. Luxation -

Dislocation Mental age - Measure of the level of intellectual capacity and development of pediatric patients. Neural - Referring to the brain, nervous system, and nerve pathways. Open bay - Concept of open design used in pediatric dental practices. Papoose board - Type of restraining device that holds a pediatric patients hands, arms, and legs still. Pediatric dentistry - Dental specialty concerned with neonatal through adolescent patients, as well as patients with special needs in these age groups. Postnatal - After birth Prenatal - Before birth Pulpotomy - Removal of the coronal portion of a vital pulp from a tooth. Spasticity - Exaggerated movement of the arms and legs. T-band - Type of matrix band used for primary teeth. Describe the types of patients seen at a Pediatric office. -

1. Healthy adolescents
2. Special needs children
3. Special needs adults