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51 Cards in this Set

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How can you restore primary anterior teeth?
1. Interproximal Stripping
2. Composite resins/Glass ionomer fillings
3. Composite resin strip crowns
If saline is unavailable, what other solutions are appropriate to store an avulsed tooth?
PHYSIOLOGIC Medias:
- Saliva
- Saline
- Milk
- Culture medias

(note: do NOT use tapwater, chlorhexidine, chloramine, alcohol)
When do you need a space maintainer?
PREMATURE loss of primary 1st & 2nd Molars
Each side in the Mandibular arch contains ____ leeway space. Whereas, each side in the Maxillary arch is ____.
Mandibular 2.5 mm

Maxilla 1.5 mm
____________ refers to maintaining the mediodistal relationship in a given dental arch. -The significance is in reducing severity of malocclusion.
Space Maintenance
What are the two names for a bite block?
Molt Mouth Prop
Tooth Pillow
What are the components of a first dental visit, including timing of that visit?
1. When 1st teeth erupt or no later than 1 year of age
2. Oral exam knee-to-knee
3. Discuss dental milestones
What are components of the Medical History?
1. Patient's physician & date of last appointment
2. Birth history & past hospital visits, possible abnormal dental findings
3. Status of current medical treatment
4. Immunizations, allergies, etc
What are components of the social history?
1. Where child lives, goes to school, hobbies, pets, siblings can help build rapport
2. May also help avoid uncomfortable or embarrassing topics
3. Identify parent who will routinely bring in child an obtain consent for treatment
What types of things should be included in the anticipitory guidance?
1. OHI
2. Diet
3. Fluoride needs
4. Establish regular dental care
What are questions that should be asked regarding trauma?
1. When did the trauma occur?
2. How did the trauma occur?
3. Were there any other injuries?
4. What initial treatment was given?
5. Have there been any other dental injuries in the past?
6. Are immunizations up to date?
Dental injuries may become the subject of litigation or insurance claims therefore a thorough ________ and _________ is mandatory. Whenever possible injuries should be ___________.
History & Examination
Photographed
What should be examined for a trauma patient?
1. Extra-oral wounds and palpation of the face
2. Injuries to oral mucosa or gingiva
3. Palpation of alveolus
4. Displacement of teeth
5. Abnormalities in occlusion
6. Extent of tooth fractures, pulp exposure, color changes
7. Mobility of teeth
8. Sensitivity to percussion
What is a NEUROLOGICAL SCALE that aims to give a reliable, objective way of recording the conscious state of a person for initial as well as subsequent assessment?
Glasgow Coma Scale
The degree of mobility for the Mobility Test is?
0 no loosening
1-2 mm horizontal loosening
3 mm axial loosening
Which of the following is ideal to use to test the pulp?
a) Percussion test
b) Electric pulp testing
c) Thermal pulp testing
Percussion test
As a baseline, all traumatized teeth should be radiographed to assess?
Stage of root development
Injuries to root & supporting structures
How do you locate intruded teeth?
Use lateral film showing nasal area - double exposure time
What is the most common type of injury to the upper primary incisors?
Intrusive Luxation
One of the most potentially damaging injuries to the developing permanent teeth.
T/F
Avulsed primary teeth should be replanted as soon as possible for best chance of survival
False
DO NOT REPLANT AVULSED PRIMARY TEETH
What is a very important consideration in all injuries to permanent teeth?
The status of the root end (i.e. opened or closed)
T/F
It is common to leave small enamel fractures untreated for young patients
True
Cosmetic acid etch restorations can be done
What are the choices of therapy for fractures of permanent teeth involving small pulp exposures?
Direct pulp caps
Partial pulpotomies
In a fractured tooth with a small pulp exposure, what do you use is the exposure occurred Less than 2 hours ago?
Direct pulp cap
In a fractured tooth with a small pulp exposure, what do you use is the exposure occurred More than 2 hours ago?
Cveck pulpotomy (partial pulpotomy)
How do you do a Cvek pulpotomy?
1. Removal of contaminated pulp tissue (2 mm) with high speed diamond bur w/saline or water irrigation.
2. Non-setting calcium hydroxide is placed over the pulp remnant
3. Covered w/setting calcium hydroxide (must be placed over vital tissue)
4. GI cement base and the tooth is restored w/composite resin
How do you treat Large fractures and Open apices?
Pulpotomy to maintain the vitality of the teeth and allow for continued root formation
How do you treat Large fractures and Closed apices?
RCT
How do you treat root fractures?
Fixed splinting for 3 months
What types of splints are used for avulsed teeth?
Flexible splint
What is the primary management for all emergencies?
Basic Life Support
What are the 7 most likely Pedo Emergencies?
1. Asthma attack
2. Allergen reaction
3. Seizure
4. Airway obstruction
5. Drug overdose
6. Hypoglycemia
7. Syncope
How can you prevent aspiration emergencies?
1. Rubber dam or oral packing
2. Floss on rubber dam clamp
3. Floss on cotton rolls and gauze
4. Chair position
5. Control patient behavior & movement prior to treating
Where are EpiPens delivered?
AnteroLateral aspect of the thigh
What should you do if a seizure lasts longer than 5 minutes?
Administer IV diazepam
Continue BLS if diazepam is not availale
Activate EMS
What are the causes of syncope?
1. Fear, pain, or apprehension (vasovagal syncope)
2. Rising quickly from lying down (orthostatic syncope)
3. Hypoglycemia (metabolic syncope)
4. Transient Cerebral Ischemia
What needles do you use for kids?
IA - 27 gauge short
Infiltration - 30 gauge short or super short
If you adequately dry an area and keep it isolated with cotton rolls, do you truly require a rubber dam?
Yes
Why do you use a rubber dam?
1. Patient protection - prevents aspiration
2. Patient management - prevents child's tongue from getting in the way
3. Better access and visualization - Improved quality of restorative care
If the parents are difficult, or more difficult than the child to deal with, are there ways to limit their involvement in the management of the child against their wishes?
No
What types of rubber dam clamps do you use in your office? with wings or without?
W8A wingless - primary 2nd molars
W14A wingless - permanent 1st molars (erupting)
How do you prevent your patient from swalling a ssc?
Sit the patient at a 45 degree angle to the floor
Place your thumb on top of the crown when attempting to remove it
When do you extract kids teeth?
Carious or fractured nonrestorable teeth
Over retained or ankylosed primary teeth preventing eruption of permanent teeth
How do you check for signs of profound anesthesia for a patient about to have an extracted tooth?
1. Press surrounding tissue w/instrument
2. Percuss the tooth
3. Wiggle on the tooth slightly to insure adequate pain control is present
During pulpotomies & pulpectomies, what is used to fix the tissue?
1:5 dilution of Buckley's formacresol
When would you perform a 2-stage pulpectomy vs. a 1-stage?
Necrotic radicular pulp = 2 stage
Irreversibly inflamed radicular pulp = 1 stage
What are the 4 steps of the initial exam?
1. Chief complaint
2. Medical history
3. Social history
4. Dental history
What are some good Open-ended questions you should ask during the medical history?
Is your child in good health?
Past serious illnesses?
When was the last time your child was seen by PCP?
Is your child up to date on immunizations?
Medications?
Allergies?
Was your child ever hospitalized for any reason at all?
What is the equivalent molar relationship to a class 1?
Flush-terminal plane relationship
How should you plan out your treatment planning?
Treatment by quadrant
-Most serious quadrant first
-Permanent teeth before deciduous teeth
-Posterior teeth before anterior teeth

EXCEPTION: if the patient is in pain, treat that area first.
What are 2 important things to include in your documentation that you might not in an adult?
Detail any instructions to the parent
Note behavior of the child