Tooth Development and Anatomy

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Questions and Answers

What is the most common age for the eruption of primary canines?

  • 17 - 23 months
  • 9 - 10 years
  • 11 - 12 years
  • 16 - 22 months (correct)

Which type of dental treatment is most appropriate for a child with extensive caries after pulpotomy?

  • Stainless steel crown (correct)
  • Amalgam restoration
  • Composite restoration
  • Silver diamine fluoride

What is the primary characteristic of supernumerary teeth?

  • They are always located in the mandible.
  • They cannot block the eruption of permanent teeth.
  • There are no associated complications.
  • Mesiodens is the most common type. (correct)

Which condition occurs when a permanent tooth erupts in the wrong path?

<p>Ectopic eruption (D)</p> Signup and view all the answers

What is the primary feature of enamel hypocalcification?

<p>Resulting in white spots on enamel. (B)</p> Signup and view all the answers

In which scenario should a direct pulp cap be considered?

<p>For small pulp exposure due to trauma. (D)</p> Signup and view all the answers

Which of the following is a common cause of acute necrotizing ulcerative gingivitis?

<p>Poor oral hygiene. (C)</p> Signup and view all the answers

What are the characteristic features of primary teeth compared to permanent teeth?

<p>Whiter, more translucent crowns with larger pulp chambers. (C)</p> Signup and view all the answers

After the loss of a primary molar before the age of 7, what happens to premolar eruption?

<p>It will be delayed. (B)</p> Signup and view all the answers

Which statement about root resorption in primary teeth is false?

<p>It always occurs internally. (C)</p> Signup and view all the answers

What is the purpose of space maintenance after premature loss of primary teeth?

<p>To prevent movement of permanent teeth. (B)</p> Signup and view all the answers

What is a common treatment for a primary tooth exhibiting signs of pulpal necrosis?

<p>Pulpotomy. (C)</p> Signup and view all the answers

Which dental appliance is best suited for maintaining space after the loss of a primary third molar?

<p>Distal shoe. (B)</p> Signup and view all the answers

What is a notable effect of fluorosis on enamel?

<p>Surface appears mottled or discolored. (C)</p> Signup and view all the answers

What is the primary purpose of a Picture Exchange Communication System?

<p>To facilitate communication using pictures (A)</p> Signup and view all the answers

Which of the following describes conscious sedation?

<p>A state of depressed consciousness that allows response to commands (C)</p> Signup and view all the answers

What is the maximum dose of local anesthesia recommended for children?

<p>4.4 mg/kg (B)</p> Signup and view all the answers

Which of the following is NOT a common block used in children?

<p>Maxillary central (D)</p> Signup and view all the answers

How is 'distraction' used in pediatric dentistry?

<p>To divert the child's attention away from dental procedures (A)</p> Signup and view all the answers

Which schedule of fluoride supplementation is appropriate for a child aged 3 to 6 years living in an area with a water fluoride level of 0.3 - 0.6 PPM?

<p>0.50 mg per day (D)</p> Signup and view all the answers

What behavioral condition is more prevalent in boys than girls?

<p>Attention-deficit/hyperactivity disorder (B)</p> Signup and view all the answers

What is a common side effect of nitrous oxide used in sedation?

<p>Nausea (C)</p> Signup and view all the answers

What condition is described as 'Baby bottle syndrome'?

<p>Cavities in children under 6 (C)</p> Signup and view all the answers

Which of the following is a management technique often used for children with autism?

<p>Tell-show-do (D)</p> Signup and view all the answers

What can thumbsucking cause in terms of dental effects?

<p>An increase in overjet and anterior open bite. (A)</p> Signup and view all the answers

What is the primary use of protective stabilization in pediatric dentistry?

<p>To prevent movement during procedures (C)</p> Signup and view all the answers

What factors can constrain the use of nitrous oxide for sedation?

<p>Age under 2 years, severe asthma with wheezing (B)</p> Signup and view all the answers

Which of the following statements about general anesthesia is accurate?

<p>It involves a state of sleep-like unconsciousness. (A)</p> Signup and view all the answers

Flashcards

Picture exchange communication system (PECS)

Using pictures to communicate, often used for individuals with communication difficulties.

Behavior shaping

A technique that uses positive reinforcement to develop desired behaviors. Small steps are rewarded, leading to more complex actions.

Systematic desensitization

Exposing a patient to a dental appointment gradually, reducing anxiety with each step.

Distraction

Diverting a child's attention away from a procedure to reduce anxiety.

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Pre-visit imagery

Creating a positive context about the dentist visit by showing happy images and stories.

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Familiarization

A dental appointment focusing on introducing the dental setting, making it less scary.

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Voice control

Using changes in voice volume, tone, and pace to get a child's attention or comply with instructions.

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Conscious sedation

A state of depressed consciousness where the patient can respond to commands or touch.

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General anesthesia

A sleep-like state of unconsciousness, where the patient doesn't respond to stimuli.

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Protective stabilization

Using a papoose or another person to restrict a child's movement.

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Minimal sedation (Anxiolysis)

Nitrous oxide (laughing gas) used at a concentration of less than 50%, often with other medications, to reduce anxiety.

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Moderate sedation (Conscious sedation)

Nitrous oxide used at a concentration of more than 50%, often with other medications, for deeper sedation.

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Deep sedation (IV sedation)

Intravenous medications like midazolam, propofol, or ketamine are used for a deep state of sedation.

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General anesthesia

Medications such as ketamine, propofol, or thiopental are used to induce a state of unconsciousness.

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Maximum dose of local anesthetic

The maximum safe dose of local anesthetic for children is 4.4 milligrams per kilogram of body weight.

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Eruption sequence of primary teeth

Eruption of primary teeth occurs in a specific sequence that follows a pattern: Central, Lateral, Canine, 1st Molar, 2nd Molar, with Mandibular eruption happening earlier than Maxillary.

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Supernumerary tooth

An extra tooth that erupts in addition to the normal number of teeth.

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Congenitally missing tooth

A condition where a tooth is missing from birth. Most common primary tooth affected is the maxillary lateral incisor. For permanent teeth, the most common missing teeth are third molars, followed by mandibular second premolars and maxillary lateral incisors.

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Dilaceration

An abnormal bend in the root of a tooth, often due to trauma to the corresponding primary tooth.

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Enamel hypocalcification

A mineralization defect in enamel that results in white spots. It can be caused by fluorosis, a condition caused by excessive fluoride intake.

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General differences between primary and permanent teeth

The primary teeth are whiter and more translucent compared to permanent teeth. They also have a larger pulp and more divergent roots.

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Mesiodens

The most common supernumerary tooth, often found positioned palatally between the maxillary central incisors. It can block the eruption of permanent teeth.

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Primate space

A space between the primary maxillary lateral incisor and canine, and between the mandibular canine and first molar. It helps accommodate the eruption of permanent canines.

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Interdental space

The space between primary incisors. This space accommodates the larger size of permanent incisors.

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Leeway space

The difference in size between primary molars and permanent premolars. It provides space for the eruption of permanent premolars.

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Space maintenance

The process of maintaining space for the eruption of permanent teeth after the premature loss of primary teeth.

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Appliances for early loss of primary teeth

An appliance used to maintain space after the premature loss of primary teeth. It can be used for various tooth types, each appliance designed to address specific needs.

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Rule of 7

A rule that states that if a primary molar is lost before age 7, the eruption of the premolar will be delayed. If lost after age 7, the eruption will be accelerated.

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Space closure

The process of the gums closing in the space left after the loss of a primary tooth. Most movement occurs within the first 4-8 weeks after loss, with closure completed in 6 months.

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Ectopic eruption

A permanent tooth that erupts in the wrong position or direction. Wisdom teeth and canines are the most common teeth to erupt ectopically.

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Study Notes

Tooth Development

  • Tooth development proceeds through stages: initiation, bud, cap, bell, apposition, and maturation.
  • Primary teeth erupt before permanent teeth.
  • Maxillary and mandibular teeth erupt at different ages.
  • Palmar notation for eruption sequence is ABDCE.

Developmental Disturbances

  • Supernumerary teeth, most commonly a mesiodens, can obstruct the eruption of permanent teeth.
  • Congenitally missing teeth: maxillary lateral incisors are the most common missing permanent teeth.

Primary Tooth Anatomy

  • Differences in enamel and dentin thickness and structure between primary and permanent teeth exist.
  • Enamel rods are more occlusally directed in the gingival third of primary teeth compared to permanent teeth
  • Primary maxillary central incisors have the widest mesiodistal width.
  • Primary mandibular central incisors are the smallest tooth.
  • Primary maxillary first molars have a more prominent cervical bulge.

Primary Tooth Treatments

  • Fluoride varnish prevents caries and halts decay in smooth surface incipient lesions.
  • Amalgam is a more conservative option than amalgam, and extends into pits and fissures.
  • Sealants, placed in occlusal pits and fissures, act as a barrier against caries.
  • Stainless steel crowns, suitable for extensive caries, provide function until primary tooth exfoliates.
  • Silver diamine fluoride (SDF) arrests active caries.
  • Indirect pulp caps are used for deep caries near the pulp, but not exposed pulp.
  • Pulpotomies remove the coronal pulp tissue; pulpectomies remove the entire pulp.
  • Extractions are considered when teeth are non-restorable.

Space Management

  • Primate spaces exist between primary maxillary and mandibular teeth.
  • Interdental spaces are vital for permanent incisor eruption.
  • Leeway spaces are the difference in size between primary molars and permanent premolars.
  • Space management approaches include space maintenance and space regaining techniques, which can help with premature loss.

Trauma to Primary Teeth

  • Medical history is crucial to be acquired to assess risk factors.
  • Root resorption, often a result of trauma, can be internal or external.
  • Tooth fractures can result from a variety of mechanisms.
  • Intrusion, extrusion, lateral luxation, and avulsion are common types of injuries.
  • Alveolar fractures can result from various factors.

Child Behavior

  • The Frankl rating scale is used to assess the cooperation level of patients.
  • Behavioral methods include basic techniques like animal assisted therapy, anticipatory guidance, and aversive conditioning.
  • Advanced techniques include conscious sedation and general anesthesia.
  • Local anesthesia is useful for minimizing discomfort.

Fluoride Supplements

  • Fluoride supplementation recommendations vary based on drinking water fluoride levels and child age.

Early Childhood Caries

  • Early childhood caries is a significant concern.
  • Factors, like high-sugar diets, frequent juice consumption, and a lack of oral hygiene, increase the chance of early childhood caries.

Child Abuse and Neglect

  • Dentists must identify and report suspected child abuse or neglect.
  • Most suspected cases happen in children under 3, with abuse cases being both physical and emotional, and neglect cases resulting from the failure to fulfill basic needs.

Child Behavior Conditions

  • Attention-deficit/hyperactivity disorder (ADHD) and Autism Spectrum Disorder (ASD) are recognized behavioral conditions that may affect a child's response to dental treatment.

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