Pediatric Dentistry Exam 3

Front 1

Which systemic disease is least correct when formulating a differential diagnosis based only on clinical observation of petichiae?

- Sickle cell disease
- Mononucleosis
- Leukemia
- Rubeola

Back 1

Sickle cell disease

Front 2

What is the term for a ball of food, mucus, vegetable fiber, hair or other material that cannot be digested in the stomach, which can cause blockage, ulcers and bleeding?

- bartosz
- bolusz
- bunzah
- bezoar

Back 2

bezoar

Front 3

What is Riga Fede?

- when the natal tooth forms granulomatous tissue around it; can be seen during breast-feeding
- a substance used to fill endodontically-treated teeth
- an impression material
- an ulcerative, granulomatous disorder that results from repetitive trauma to the oral mucosa

Back 3

an ulcerative, granulomatous disorder that results from repetitive trauma to the oral mucosa

Front 4

During a ferric sulfate pulpotomy, you remove the pulpal tissue down to the root orifice(s) with a round bur and flush the debris. What is the next step?

- scrub ferric sulfate solution against the pulp stumps for 10 to 30 seconds
- firmly hold a water-moistened cotton pellet against the pulp stump(s) for 2 to 3 minutes
- place a ferric sulfate soaked pellet against the pulp stumps for 5 minutes
- fill the chamber with a thick mix of zinc oxide – eugenol paste

Back 4

firmly hold a water-moistened cotton pellet against the pulp stump(s) for 2 to 3 minutes

Front 5

When considering the factors that determine alterations in oral structures due to digit sucking, which one is the most critical?

- size of the digit
- level of forces generated
- number of times per day
- interval of time

Back 5

interval of time

Front 6

Which of the following oral habits will not cause a posterior crossbite?

- pacifier sucking
- thumb sucking
- tongue thrust
- mouth breathing

Back 6

tongue thrust

Front 7

When in centric occlusion, a 5-year-old thumb-sucker's posterior teeth are in maximum intercuspation but the anterior teeth are apart by approximately 7mm – no overbite exists. What is the most likely cause?

- a genetic defect such as Klüver-Bucy
- a birth defect such as clefting of the primary palate
- intrusion of the maxillary centrals and laterals
- orthopedic remodeling of the maxillary bone

Back 7

orthopedic remodeling of the maxillary bone

Front 8

A 5-year-old thumbsucker has a left posterior crossbite from canine to second primary molar. What could have caused the posterior crossbite?

- This particular condition is congenital and not related to the thumbsucking
- Anterior positioning of the tongue during swallowing redirects growth of the palatal plates
- There is remolding of the maxillary arch by the muscles of mastication/facial expression during thumbsucking

Back 8

There is remolding of the maxillary arch by the muscles of mastication/facial expression during thumbsucking

Front 9

When considering treating a left posterior crossbite from canine to second primary molar, what would the treatment of choice be, together with a palatal expansion device?

- unilateral expansion of maxillary arch on the affected side
- bilateral expansion of the maxillary arch

Back 9

bilateral expansion of the maxillary arch

Front 10

You work out a plan with 5-year-old thumbsucker's parents to set a goal and help monitor her progress towards habit cessation, rewarding her every half-day that her attempts are successful. They make a 4-week calendar, divide the days in to morning and afternoon and she earns a gold star every half-day period she doesn’t suck her thumb. If she earns enough gold stars, her parents will buy her an Adam Lambert doll. What is a contract like this an example of?

- token reinforcement
- reframing
- positive reinforcement
- covariant control
- contingency management

Back 10

contingency management

Front 11

You work out a plan with 5-year-old thumbsucker's parents to set a goal and help monitor her progress towards habit cessation, rewarding her every half-day that her attempts are successful. They make a 4-week calendar, divide the days in to morning and afternoon and she earns a gold star every half-day period she doesn’t suck her thumb. If she earns enough gold stars, her parents will buy her an Adam Lambert doll. Rewarding her with a gold star on the calendar each time she succeeds is an example of what?

- token reinforcement
- reframing
- positive reinforcement
- covariant control
- contingency management

Back 11

token reinforcement

Front 12

A 5-year-old thumbsucker is trying hard to quit and has made some progress. But, sometimes when she is asleep, she unconsciously pops her thumb in her mouth. What should you recommend adding to your course of therapy?

- modified Nance appliance with a thumb crib
- extraoral reminder like a special band-aid on her thumb
- Ace bandage around her elbow to prevent her bending her arm

Back 12

Ace bandage around her elbow to prevent her bending her arm

Front 13

The mother of a 5-year-old thumbsucker has some concerns that the malocclusion will manifest itself in the permanent dentition as well. At this point, what should you suggest?

- aggressive appliance therapy with an active Hawley retainer to extinguish the habit and close the open bite
- postponing any orthodontic intervention and continue with habit intervention using the psychological approach

Back 13

postponing any orthodontic intervention and continue with habit intervention using the psychological approach

Front 14

What should an Andreasen “Complicated Crown-Root Fracture” on tooth #E in a 5-year-old be treated with?

- a Cvek pulpotomy
- extrusion followed by a complete root canal
- extraction

Back 14

extraction

Front 15

In order to assure complete comfort during extraction of tooth #E, the local anesthetic infiltration injection(s) include anesthetizing branches of which nerve(s)?

- nasopalatine & right ASA
- nasopalatine, left ASA
- right ASA
- left ASA
- nasopalatine, right ASA, left ASA

Back 15

nasopalatine, right ASA, left ASA

Front 16

If a child weighs 20kg, what is the maximum number of 1.7 mL carpules of lidocaine 2% with 1:100,000 epinephrine that you can you safely administer?

- 1
- 2
- 3
- 4
- 5

Back 16

2

(20kg x 4.4mg/kg) = 88mg
88mg/(34mg/capsule) = 2.58

Front 17

How can Frankl3 behavior be described?

- definitely positive and had a good connection with you
- reluctant to accept treatment and had a negative attitude
- following your directions, at times with hesitation
- openly negative and refused to cooperate

Back 17

following your directions, at times with hesitation

Front 18

A 2-year-old female in excellent health fell striking her anterior maxillary teeth on a coffee table. Clinically, #E still has some intact clinical crown showing above the free gingival margin. Your radiograph, shows that both #E & #F are intruded - #F to a greater degree and completely submerged below the gingiva. What treatment do you recommend?

- Extract both teeth
- Extract left primary central incisor and leave right primary central incisor
- Extract right primary central incisor and leave left primary central incisor
- Surgically reposition both teeth and splint for 7 to 10 days and follow closely
- Leave alone and hope for eruption

Back 18

Leave alone and hope for eruption

Front 19

A 2-year-old female in excellent health fell striking her anterior maxillary teeth on a coffee table. Clinically, #E still has some intact clinical crown showing above the free gingival margin. Your radiograph, shows that both #E & #F are intruded - #F to a greater degree and completely submerged below the gingiva. If the child had been 5 years old at the time of the accident, there would be a greater chance of injury to the developing permanent dentition.

- The statement is true
- The statement is false

Back 19

The statement is false

Front 20

On a radiograph, a primary incisor that is intruded to the lingual, invading the follicle, becomes ___________, when compared to the non-intruded teeth.

- elongated
- foreshortened

Back 20

elongated

Front 21

A 2-year-old female in excellent health fell striking her anterior maxillary teeth on a coffee table. Clinically, #E still has some intact clinical crown showing above the free gingival margin. Your radiograph, shows that both #E & #F are intruded - #F to a greater degree and completely submerged below the gingiva. Had teeth #E & #F been avulsed, why would replantation be contraindicated?

- there is a high degree of failure for replanted teeth
- replantation may cause injury to the succedaneous tooth
- both of the above

Back 21

both of the above

Front 22

A 3-year-old male was hit in mouth, injuring the left maxillary central incisor. Periapical radiograph shows no root fracture. Clinically, tooth is displaced approximately 2mm to the lingual, resulting in an anterior crossbite. What is your diagnosis/description?

- Concussion injury
- Subluxated tooth
- Luxated tooth
- Extruded tooth

Back 22

Luxated tooth

Front 23

A 3-year-old male was hit in mouth, injuring the left maxillary central incisor. Periapical radiograph shows no root fracture. Clinically, tooth is displaced approximately 2mm to the lingual, resulting in an anterior crossbite. What treatment is indicated?
- Extraction
- Reposition with finger pressure and hold for a short time
- Reposition with finger pressure and splint
- Incisal reduction until there is no contact with opposing teeth

Back 23

Reposition with finger pressure and hold for a short time

Front 24

A 3-year-old male was hit in mouth, injuring the left maxillary central incisor. Periapical radiograph shows no root fracture. Clinically, tooth is displaced approximately 2mm to the lingual, resulting in an anterior crossbite. Simple correction of the anterior crossbite can be accomplished with tongue blade therapy. Success is dependent upon all of the following conditions except which one?

- complete root formation
- enough mesiodistal space in which to move the teeth
- a naturally occuring overbite to hold the tooth in its new position
- frequent use of the tongueblade with measured duration

Back 24

complete root formation

Front 25

A 3-year-old male was hit in mouth, injuring the left maxillary central incisor. Periapical radiograph shows no root fracture. Clinically, tooth is displaced approximately 2mm to the lingual, resulting in an anterior crossbite. The tooth eventually darkens in color and has a small draining abscess noted underneath the lip near the mucobuccal fold. Radiographically, the root is intact, with no sign of pathological root resorption, but it is quite evident that there is apical bone loss. There is no abnormal mobility. What treatment is recommended?

- extraction
- apexification with a mixture of calcium hydroxide, barium and an antimicrobial agent
- complete pulpectomy and filled with an absorbable paste
- simple ferric sulfate pulpotomy

Back 25

complete pulpectomy and filled with an absorbable paste

Front 26

What would be the Frankl score for a child who was ‘reluctant to accept treatment and had a negative attitude, but not pronounced?”

- 1
- 2
- 3
- 4

Back 26

2

Front 27

What is/are the advantage(s) of nitrous oxide/oxygen as an analgesic/anxiolytic agent?

- the ability to titrate the drug until the desired effect is reached and to terminate the drug’s effect as soon as the gas mixture is discontinued
- the onset and duration of action is similar to an oral dose of a sedative agent, but easier to deliver
- the recovery time is dependent upon the percent oxygen in the mix
- all of the above

Back 27

the ability to titrate the drug until the desired effect is reached and to terminate the drug’s effect as soon as the gas mixture is discontinued

Front 28

A 3-year-old will be your first patient in the morning and you plan on using nitrous oxide. What should you instruct his mother to do if he is hungry?

- make sure he eats nothing after midnight
- allow him a light breakfast
- give him only clear liquids and Jell-O
- allow him liquids, but no solid food

Back 28

allow him a light breakfast

Front 29

If the flow meter from the blue gas tank registers 2 L/min of medical gas and the flow meter from the green gas tank registers 3 L/min of medical gas. How much oxygen is he receiving?

- About 20%
- About 33%
- About 40%
- About 60%
- About 66%

Back 29

About 60%

Front 30

This optimal level of sedation is frequently characterized by all the following clinical signs except which one?

- quickened eye movement directed towards peripheral sounds
- drooping eyelids
- warm, tingly feelings of the extremities
- slight relaxation of the extremities

Back 30

quickened eye movement directed towards peripheral sounds

Front 31

A child is very relaxed under the influence of nitrous oxide, but is still aware of his environment. He asks you if he is going to get a ‘shot’ for this operative visit. He is going to get a shot. What should you tell him?

- increase the percent of nitrous oxide until he falls asleep
- ignore the question since the amnesic effects of the nitrous oxide will wipe away any unpleasant memories of the appointment
- let him know, in simple terms, that you will be putting his tooth to sleep
- lie and say no

Back 31

let him know, in simple terms, that you will be putting his tooth to sleep

Front 32

Why should you discourage a child from talking while receiving nitrous oxide/oxygen mix?

- you cannot work on someone who is talking
- talking increases the chances of him becoming anorexic
- the phenomenon known as diffusion hypoxia
- talking increases operator exposure to the gas
- both the first and fourth options

Back 32

both the first and fourth options

Front 33

In order to prevent diffusion hypoxia from occurring, you should run a child on 100% oxygen for a minimum period of how long at the end of the appointment?

- 3 to 5
- 6 to 10
- 1 to 2

Back 33

3 to 5

Front 34

What must be included in the treatment record for a child who receives nitrous oxide?

- signed informed consent
- percent nitrous oxide or oxygen levels attained and maintained
- period of time the gas mixture was used
- documentation of adequate recovery
- all of the above

Back 34

all of the above

Front 35

If a child becomes oversedated on nitrous oxide, what would you notice?

- eyes fixed and nonresponsive
- slurring of words
- signs of nausea
- all of the above

Back 35

all of the above

Front 36

What does the Andreasen Classification “Uncomplicated Crown Fracture” equate to in the Ellis Classification(s)?

- Class I
- Class II
- Class III
- Class I & II

Back 36

Class I & II

Front 37

Although Class III Ellis fractures are generally restored with a composite buildup after proper pulp protection/treatment, when may an anterior stainless steel crown be the interim treatment of choice?

- the fracture is extensive
- bleeding cannot be controlled
- moisture control is difficult
- all of the above

Back 37

all of the above

Front 38

Which of the following is/are true about the calcium hydroxide polpotomy for permanent teeth?

- it is used to treat a Class II Ellis fracture
- it can be used successfully up to 2 weeks after injury with pulp exposure
- it causes internal resorption
- both the first and second choices

Back 38

it can be used successfully up to 2 weeks after injury with pulp exposure

Front 39

Root fractures in the which part can be treated by reducing the fracture segments and rigidly splinting for 10 -12 weeks?

- cervical third
- middle third
- apical third
- cervical and middle thirds
- middle and apical thirds

Back 39

middle and apical thirds

Front 40

Of the following media for storing an avulsed tooth, which is the least desirable because it injures the cells of the attached periodontal ligament?

- Hanks Balanced Salt Solution
- milk
- physiologic saline
- saliva
- tap water

Back 40

tap water

Front 41

When replanting a permanent tooth with a mature root, you should eliminate the necrotic tissues from the root surface by mechanically curetting or, alternatively, soaking in which solution for 3 minutes?

- a very dry Bombay Sapphire martini
- doxycycline solution
- chlorhexidine
- citric acid
- Hanks Balanced Salt Solution

Back 41

citric acid

Front 42

Who developed the Cognitive Development Stage Theory by observing his own children?

- Freud
- Punwani
- Skinner
- Piaget
- Bowlby

Back 42

Piaget

Front 43

Children will begin to understand cause/effect links such as “not brushing teeth increases their chance of cavities” at around what age?

- 3
- 5
- 7

Back 43

5

Front 44

Separation anxiety (separating parent/child) peaks at what age?
- 1 to 2
- 3 to 4
- 5 to 6

Back 44

1 to 2

Front 45

Separation anxiety (separating parent/child) is fairly well-controlled by what age?

- 1 to 2
- 3 to 4
- 5 to 6

Back 45

3 to 4

Front 46

In general, it can be assumed that children do not have good control over their emotions; rather emotions have control of them.

- The statement is true
- The statement is false

Back 46

The statement is true

Front 47

Because of the potential parental interference during delivery of care (think “Treatment Triangle”), parents should never be allowed in the operatory other than during the medical/dental history interview.

- The statement is true.
- The statement is false.

Back 47

The statement is false

Front 48

Gently holding your hand over your screaming patient’s mouth to get their attention is an accepted method of behavior management.

- The statement is true
- The statement is false

Back 48

The statement is false

Front 49

What is the best course of treatment for a root fracture in the apical third of tooth #F in an 11-year-old?

- Extirpate pulp, place calcium hydroxide agent, place light wire splint for 7 to 10 days, follow with gutta percha fill after 2 weeks
- Reposition segments, place fixed splint for 6 to 12 weeks and follow closely
- No treatment and follow closely
- Extract tooth place removable partial denture. When patient is age 18, place implant
- Refer to endodontist

Back 49

Reposition segments, place fixed splint for 6 to 12 weeks and follow closely

Front 50

You get an emergency call. A hysterical parent calls from a cell phone saying her 8 year old son was hit in the face with a hockey stick and two upper front teeth were knocked out. She has the teeth. This happened about ten minutes ago. The child is very upset and she wants to know what to do. What are your immediate instructions?

- Go to emergency room
- Place teeth in cup of milk
- Place teeth in cup of water
- Replant teeth
- None of the above

Back 50

Replant the teeth

Front 51

A light wire splint is placed to secure replanted teeth #8 & #9 in normal position in an 8-year-old. How long does the splint remain?

- 7 to 10 days
- 3 to 5 days
- 7 to 10 weeks
- 3 to 5 weeks
- Until root ends mature

Back 51

7 to 10 days

Front 52

A child falls and knocks out teeth #8 & #9. If the root ends are immature and the extra-oral dry time is less than 60 minutes, what is the appropriate procedure?

- place in Hank’s buffered salt solution, soak in 1% doxycycline for 5 minutes and replant
- first place in sodium fluoride for 5 minutes, then soak in citric acid for 3 minutes followed by replantation
- soak in citric acid for 3 minutes and rinse well, place in sodium fluoride for 5 minutes, then replant
- None of the above

Back 52

place in Hank’s buffered salt solution, soak in 1% doxycycline for 5 minutes and replant

Front 53

An 8-year-old falls and knocks out teeth #8 & #9. If the root ends are mature when is the best time to extirpate the pulp and place calcium hydroxide?

- 3 weeks after replantation
- 7 to 14 days after replantation
- Wait until evidence of pulp degeneration
- 3 to 5 days after replantation
- None of the above

Back 53

7 to 14 days after replantation

Front 54

A healthy female, age, 5 struck her maxillary anterior teeth on car window in an accident while on vacation 2 weeks ago. Parents took her to local dentist. He simply looked at teeth and said nothing could be done. Mother is upset because daughter had “such beautiful straight teeth." What actions do you take?

- Agree with previous dentist; do nothing
- Complete a good clinical exam, take x-rays. If root is normal, place monofilament splint for 7 to 10 days and follow closely
- Complete a good clinical exam, take x-rays. If root is normal, extract
- Complete a good clinical exam, take x-rays. If the root is normal, no treatment at this time. Check in 6 weeks
- Complete a good clinical exam, take x-rays. If root is normal, extrude tooth, place monofilament splint for 7 to 10 days

Back 54

Complete a good clinical exam, take x-rays. If the root is normal, no treatment at this time. Check in 6 weeks

Front 55

While on vacation a 10 year old male reportedly falls from bike and fractures the right maxillary central incisor. A week later he comes to see you. Examination shows slight bleeding at fracture site and pain in this area. Child abuse is ruled out. What classification of injury is this?
- Uncomplicated crown fracture
- Class II fracture
- Complicated crown root fracture
- Complicated crown fracture
- Uncomplicated crown root fracture

Back 55

Complicated crown fracture

Front 56

While on vacation this 10 year old male reportedly falls from bike and fractures the right maxillary central incisor. A week later he comes to see you. Examination shows slight bleeding at fracture site and pain in this area. Child abuse is ruled out. What treatment is indicated?

- Formocresol pulpotomy
- Pulpectomy
- Cvek pulpotomy
- Traditional root canal therapy
- Extract

Back 56

Cvek pulpotomy

Front 57

While on vacation a 10 year old male reportedly falls from bike and fractures the right maxillary central incisor. 12 days later he comes to see you. Examination shows slight bleeding at fracture site and pain in this area. Child abuse is ruled out. What is the best treatment?

- Formocresol pulpotomy
- Pulpectomy
- Cvek pulpotomy
- Traditional root canal therapy
- Extract

Back 57

Cvek pulpotomy

Front 58

Would you expect a maxillary central incisor in a 7-year-old to have immature roots?

- Yes
- No

Back 58

Yes

Front 59

What is the best treatment for a Class II fracture of a maxillary central incisor in a 7-year-old?

- Cover fractured area with composite and place light wire splint.
- Cover fractured area with composite and place monofilament splint.
- Cement a band over the tooth and place a rigid splint.
- Cover fracture with composite and follow closely.
- Smooth sharp edges and reappoint.

Back 59

Cover fracture with composite and follow closely.

Front 60

What is the space maintainer of choice for a 6-year-old who has had tooth #T removed?

- a band and loop
- a lingual holding arch
- a unilateral followed by a bilateral after the eruption of the permanent anteriors
- a Nance
- none of the above

Back 60

a unilateral followed by a bilateral after the eruption of the permanent anteriors

Front 61

Teeth # B and #I on a 6-year-old have small draining abscesses and are mobile. Neither tooth cause the patient pain. Radiographically, the caries is through the furcation on both teeth. What is the treatment of choice for both teeth?

- removal
- pulpectomy
- MTA pulpotomy
- apexification

Back 61

removal

Front 62

Which local anesthetic infiltration injection(s) will assure complete comfort during extraction of tooth #B?

- greater palatine & PSA
- greater palatine & MSA
- MSA & PSA
- greater palatine, MSA & PSA
- PSA

Back 62

greater palatine & MSA

Front 63

If the child weighs 46 lbs, how many 1.7 mL carpules of 2% lidocaine with 1:100,000 epinephrine can be safely administered?

- 1
- 2
- 3
- 4
- 5

Back 63

2

Front 64

Tooth #J on a 6-year-old requires a pulpotomy. What medicament should you plan on using?

- An astringent like ferric sulfate
- A hard setting calcium hydroxide product like Dycal
- A hard setting steroid/antibiotic combination like Ledermix
- A soft setting paste like Vitapex

Back 64

An astringent like ferric sulfate

Front 65

Which of the following accurately describes a Frankl4 categorization?

- definitely positive and had a good connection with you
- reluctant to accept treatment and had a negative attitude
- openly negative and refused to cooperate

Back 65

definitely positive and had a good connection with you

Front 66

In order to adequately anesthetize tooth #K, which nerves need to be anesthetized?

- long buccal and lingual nerves
- long buccal, lingual, and inferior alveolar
- inferior alveolar
- inferior alveolar and lingual
- inferior alveolar and long buccal

Back 66

long buccal, lingual, and inferior alveolar

Front 67

While removing the caries on tooth #E, you expose the pulp. The size of the exposure is approximately 2 mm in diameter and is surrounded by carious dentin. What should you elect to do?

- cover the exposure with a dentin stimulating medication such as calcium hydroxide
- remove the tooth
- perform a calcium hydroxide pulpotomy
- perform a ferric sulfate pulpotomy

Back 67

perform a ferric sulfate pulpotomy

Front 68

After performing a ferric sulfate pulpotomy on tooth #K in a 6-year-old, what should you use as a final restoration?

- amalgam
- resin-modified glass ionomer
- a stainless steel crown
- IRM
- composite

Back 68

a stainless steel crown

Front 69

At what age does tooth #K exfoliate?

- 11 to 12
- 7 to 8
- 13 to 14
- 9 to 10

Back 69

11 to 12

Front 70

You intentionally allowed a patient's little brother to watch his sister at the last two appointments (you are placing sealants without the need for nitrous oxide); he seemed more curious than afraid. This is an example of the which behavior guidance technique?

- modeling
- distraction
- desensitization
- tell, show, do

Back 70

modeling

Front 71

Of the list below, which finding is not associated with mouth breathing?

- Class II
- Protrusion and spacing of the maxillary anterior teeth
- Narrow vaulted palate
- Dry, swollen gingiva
- Linguoversion of the mandibular centrals

Back 71

Linguoversion of the mandibular centrals