FK-4-Principles of genetic, congenital, and developmental diseases and conditions and their clinical  features to understand patient risk-ORAL HEALTH MANAGEMENT

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Questions and Answers

Which oral health concern is most likely to be observed in a pediatric patient diagnosed with cerebral palsy?

  • Reduced risk of tooth attrition as a result of softer dietary preferences.
  • Decreased susceptibility to dental caries due to altered dietary habits.
  • Enhanced plaque control because of increased saliva production.
  • Increased incidence of periodontal disease and caries, alongside difficulties in mastication and swallowing. (correct)

A child diagnosed with achondroplasia, a genetic condition affecting bone growth, is most likely to exhibit which type of malocclusion?

  • Class I malocclusion, characterized by a normal molar relationship.
  • Open bite malocclusion
  • Class II malocclusion, indicated by overjet and a distal molar relationship.
  • Class III malocclusion, marked by underbite and a mesial molar relationship. (correct)

Craniosynostosis, characterized by premature fusion of cranial sutures, may affect maxillomandibular development, potentially influencing:

  • Exclusively the susceptibility to enamel hypoplasia due to altered calcium metabolism.
  • Occlusion and the potential necessity for orthognathic surgery later in life. (correct)
  • Only the health and maintenance potential of periodontal tissues.
  • Only the timing and sequence of primary tooth eruption.

The observation of greenish discoloration on the incisal third of mandibular incisors in a 6-month-old infant may raise suspicion about which aspect of the maternal history?

<p>Underlying medical conditions during pregnancy that influenced enamel and dentin development. (D)</p>
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An enamel defect resulting from the incomplete formation of the enamel matrix is correctly termed:

<p>Enamel hypoplasia, defined by the incomplete formation of the enamel matrix. (A)</p>
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Agents, including aspirin, valium, and cigarette smoke (hypoxia), capable of inducing developmental abnormalities in utero, are collectively known as:

<p>Teratogens that cause developmental malformations. (D)</p>
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Which statement accurately describes a key characteristic of enamel hypocalcification?

<p>The enamel is present in less than normal quantities and may be soft and porous. (B)</p>
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When considering developmental (or fissural) non-odontogenic cysts, which of the following options is typically included?

<p>Nasopalatine duct (canal) cyst and nasolabial (nasoalveolar) cyst. (B)</p>
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Which of the listed non-odontogenic cysts are regarded as congenital in origin?

<p>Thyroglossal duct cyst and branchial cyst. (C)</p>
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How should a patient with a genetic predisposition to aggressive periodontitis be optimally managed?

<p>Implementing tailored treatment plans with more frequent and comprehensive periodontal evaluations. (B)</p>
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What oral manifestation is commonly observed in children with Down syndrome?

<p>Delayed eruption of teeth along with a greater susceptibility to periodontal disease. (D)</p>
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The identification of supernumerary teeth in a patient's dental history is most relevant to:

<p>Determining the potential for impaction of normal teeth and consequent need for surgical or orthodontic intervention. (D)</p>
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When managing oral health in patients with cleft lip and palate from infancy through adolescence, a key consideration includes:

<p>Addressing feeding difficulties, speech development, orthodontic needs, and heightened risk of dental caries and periodontal disease. (C)</p>
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A patient with osteogenesis imperfecta, which impairs collagen production, may exhibit which characteristic that impacts restorative dental treatment?

<p>Opalescent teeth with easily chipped enamel (dentinogenesis imperfecta). (A)</p>
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In pediatric dentistry, recognizing variations in the typical tooth eruption sequence is vital as it may reveal underlying developmental concerns, such as:

<p>The presence of local impediments like cysts or supernumerary teeth. (A)</p>
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Upon examining a panoramic radiograph, a dentist notes multiple unerupted teeth in a young patient; this observation might suggest:

<p>A developmental irregularity affecting tooth eruption, which may be linked to genetic syndromes. (C)</p>
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When macroglossia is observed, which complication can it likely contribute to in oral health management?

<p>An elevated risk of malocclusion in addition to challenges in mastication, swallowing and speech. (C)</p>
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What risk is most increased in patients with certain congenital conditions that negatively affect salivary gland development and function, leading to decreased salivary flow?

<p>Increased risk of primarily dental caries and difficulty swallowing. (C)</p>
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What does a patient's report to their dentist of a febrile illness during their mother's pregnancy may signify?

<p>It interferes with the ideal development of dental hard tissues creating defects like enamel hypoplasia. (C)</p>
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What particular oral conditions that showcase a familial tendency may a dentist be on the lookout for?

<p>Aggressive forms of periodontal disease or certain types of oral cancer (B)</p>
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A pediatric patient presents with multiple, small, scattered white or brown spots on their permanent incisors. The patient's mother reports frequent high fevers during the first trimester of pregnancy. This presentation is most consistent with:

<p>Enamel hypoplasia secondary to the febrile illness during pregnancy. (D)</p>
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A 7-year-old patient is diagnosed with cleidocranial dysplasia. Radiographic examination reveals numerous impacted supernumerary teeth, delayed eruption of permanent teeth, and hypoplastic or absent clavicles. Based on these findings, what is the most appropriate initial oral health management strategy?

<p>Creating space for the eruption of permanent teeth and periodic monitoring of eruption patterns. (A)</p>
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During a routine oral examination of a 10-year-old patient, a dentist observes a painless, slow-growing, bony hard swelling on the lingual aspect of the mandible in the premolar region. Radiographic examination reveals a well-defined radiopaque mass attached to the bone. The most likely diagnosis is:

<p>Torus mandibularis (D)</p>
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A 9-year-old child presents with a chief complaint of a gingival mass between the maxillary central incisors that bleeds easily. Clinical examination reveals a pedunculated, red, easily bleeding lesion arising from the interdental papilla. The teeth are vital and there is no radiographic evidence of bone involvement. Which is the most likely diagnosis?

<p>Pyogenic granuloma (C)</p>
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A 12-year-old patient undergoing orthodontic treatment presents with localized gingival enlargement around the brackets. The gingiva is erythematous, edematous, and bleeds upon probing. The most appropriate initial management of this condition includes:

<p>Reinforcement of oral hygiene instructions and professional cleaning (A)</p>
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A 5-year-old patient has a history of recurrent upper respiratory infections and mouth breathing. Clinical examination reveals elongated facial features, anterior open bite, and gingivitis. What is the most likely cause of this patient's malocclusion?

<p>Mouth breathing (A)</p>
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A 6-year-old patient presents with premature loss of the mandibular primary second molar due to extensive caries. Which of the following space maintainers is most appropriate in this situation?

<p>Lingual arch (B)</p>
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A 4-year-old child presents with severe early childhood caries (S-ECC). The maxillary incisors are severely decayed with pulpal involvement, and the primary molars have multiple cavitated lesions. Extraction of the maxillary incisors is deemed necessary. What is the most appropriate space maintenance strategy for this patient?

<p>Placement of a maxillary Hawley appliance with prosthetic teeth (B)</p>
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A 7-year-old patient fractured his maxillary central incisor during a fall. Clinical and radiographic examination reveals a complicated crown fracture with pulp exposure. What is the most appropriate treatment?

<p>Pulpotomy (D)</p>
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During a sports-related injury, an 8-year-old patient avulses a permanent maxillary central incisor. The tooth is recovered immediately, rinsed with saline, and the patient is brought to the dental office within 30 minutes. What is the most appropriate immediate management?

<p>Replant the tooth (B)</p>
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A 13-year-old female patient presents with generalized enamel erosion, particularly on the palatal surfaces of the maxillary teeth. The patient reports frequent episodes of self-induced vomiting due to concerns about body weight. The most likely diagnosis is:

<p>Bulimia nervosa (A)</p>
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A 15-year-old patient with type 1 diabetes presents with gingival inflammation, deep periodontal pockets, and radiographic evidence of bone loss around multiple teeth. The patient reports difficulty maintaining consistent blood sugar levels. The most likely diagnosis is:

<p>Aggressive periodontitis (A)</p>
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A 4-year-old child has multiple carious lesions on the primary molars and incisors, poor oral hygiene and high sugar consumption. The most appropriate intervention to address this patient's caries risk includes:

<p>Individualized treatment plan including dietary counseling and oral hygiene instructions (C)</p>
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During a follow-up appointment, a 10-year-old patient exhibits poor compliance with oral hygiene instructions despite multiple attempts at education. The patient's parent reports difficulties managing the child's behavior at home. Which intervention is most appropriate?

<p>Recommend behavior modification techniques (A)</p>
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A 14-year-old patient undergoing orthodontic treatment has difficulty maintaining adequate oral hygiene, resulting in generalized gingivitis and localized gingival enlargement around the orthodontic brackets. The patient has limited dexterity due to cerebral palsy. Which would be most effective?

<p>Recommend using dental appliances to assist in controlling oral hygiene (B)</p>
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A dentist notes enamel defects, including areas of hypoplasia on the permanent incisors and molars of an 8-year-old. This condition is MOST likely related to:

<p>Molar Incisor Hypomineralization (MIH) (D)</p>
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Flashcards

Cerebral Palsy Oral Health Concerns

Difficulty with chewing/swallowing and increased periodontal disease/caries.

Achondroplasia

A genetic bone disorder affecting bone growth.

Achondroplasia Malocclusion Type

Class III malocclusion is very common in children.

Craniosynostosis

Premature closure of skull sutures that impacts maxilla/mandible.

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Craniosynostosis Impact

Can affect growth/position of jaws, needing orthognathic surgery.

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Greenish Incisor Discoloration

Conditions during pregnancy affect developing enamel and dentin.

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Enamel Hypoplasia

Incomplete formation of enamel matrix.

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Teratogens

Agents causing developmental abnormalities in utero.

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Enamel Hypocalcification

Enamel with reduced mineralization, softer than normal.

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Developmental Non-Odontogenic Cysts

Nasopalatine duct (canal) and nasolabial (nasoalveolar) cyst.

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Congenital Non-Odontogenic Cysts

Thyroglossal duct cyst and branchial cyst.

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Aggressive Periodontitis Management

More frequent periodontal evaluations and treatment plans.

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Down Syndrome Oral Features

Delayed eruption and higher periodontal disease risk.

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Supernumerary Teeth Concerns

Potential impaction and need for intervention or surgical removal.

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Cleft Palate Oral Health

Feeding difficulties, speech, orthodontic needs, caries, periodontal disease.

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Osteogenesis Imperfecta Dental

Opalescent teeth with enamel that chips easily.

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Abnormal Eruption Sequence

Cysts or supernumerary teeth.

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Multiple Unerupted Teeth

Multiple unerupted teeth linked to genetic syndromes.

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Macroglossia Impact

Difficulties in mastication, swallowing, speech, and risks for malocclusion.

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Reduced Salivary Flow

Dental caries and difficulty swallowing.

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Maternal Illness Effects

Defects like enamel hypoplasia.

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Genetic Disease Risk

Aggressive periodontal disease and oral cancer.

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Study Notes

Oral Health Management & Developmental Considerations

  • Patients with cerebral palsy often experience difficulties in mastication and swallowing
  • Cerebral palsy is related to a higher incidence of periodontal disease and caries, which need to be taken into account when managing oral health.

Malocclusion & Achondroplasia

  • Class III malocclusion is commonly seen in children diagnosed with achondroplasia.
  • Class III malocclusion is a critical consideration for orthodontic management in patients with achondroplasia

Premature Suture Closure (Craniosynostosis)

  • Craniosynostosis is premature closure of skull sutures
  • Can impact maxilla, mandible, and overall jaw development
  • Growth and positioning of the jaws are affected by abnormal skull development, impacting occlusion
  • Orthognathic surgery is potentially required.

Enamel Discoloration & Maternal Health

  • Greenish discoloration in a 6-month-old's incisors can indicate maternal conditions during pregnancy
  • Development of tooth formation can be influenced by the maternal conditions during pregnancy

Enamel Defects: Hypoplasia

  • Enamel hypoplasia is an enamel defect resulting from incomplete enamel matrix formation
  • Enamel hypoplasia is a developmental disturbance
  • Understanding Enamel hypoplasia assists in diagnosing and managing teeth

Teratogens

  • Teratogens are agents like aspirin, valium, prescribed drugs, and cigarette smoke
  • Teratogens cause developmental abnormalities in utero
  • Knowledge about teratogens is key for identifying possible congenital oral health risks.

Enamel Hypocalcification

  • Enamel hypocalcification yields enamel with normal or slightly reduced quantity but with less mineralization which makes teeth feel soft.
  • Understanding of Enamel hypocalcification can influence preventative and restorative treatment planning.

Non-Odontogenic Cysts

  • Nasopalatine duct (canal) cysts and nasolabial (nasoalveolar) cysts are developmental and non-odontogenic
  • Diagnosing these cyst types can assist with addressing oral pathology.

Congenital Cysts

  • Thyroglossal duct cysts and branchial cysts are congenital non-odontogenic cysts
  • Congenital cysts are present at birth

Aggressive Periodontitis & Genetic Predisposition

  • Patients with a genetic predisposition require comprehensive periodontal evaluations
  • More frequent periodontal evaluations and tailored treatment plans are needed
  • A proactive and tailored approach for oral health management, including monitoring and special treatment, is needed

Down Syndrome & Oral Manifestations

  • Children with Down syndrome often have a delayed eruption of teeth
  • Children with Down syndrome have a higher susceptibility to periodontal disease
  • Individuals with the genetic disorder require modified oral health management.

Supernumerary Teeth

  • Supernumerary teeth indicate crowding, misalignment, and impaction of adjacent teeth.
  • Careful planning for orthodontic treatment or surgical removal is required, can impact oral development and function.

Cleft Lip and Palate Management

  • Cleft lip and palate impact various aspects of oral function and development
  • Comprehensive management involves feeding, speech, orthodontics, and preventive dental care
  • Comprehensive management can address an increased risk of dental caries and periodontal disease

Osteogenesis Imperfecta

  • Osteogenesis imperfecta is a genetic disorder that affects collagen production.
  • Osteogenesis imperfecta is associated with dentinogenesis imperfecta
  • This condition involves opalescent and structurally weak teeth that are prone to chipping
  • Restorative treatment planning and material selection are impacted

Tooth Eruption Abnormalities

  • Deviations from normal tooth eruption sequence can indicate underlying developmental issues
  • Deviations from normal tooth eruption can be caused by cysts or supernumerary teeth

Multiple Unerupted Teeth

  • Multiple unerupted teeth, noticed via panoramic radiograph, may indicate developmental anomaly
  • Affecting tooth eruption may be linked to genetic syndromes.

Macroglossia

  • Macroglossia is an abnormally large tongue
  • Macroglossia can complicate oral health management
  • Macroglossia can cause difficulties with mastication, swallowing, and speech, as well as increased risk of developing malocclusion

Reduced Salivary Flow Effects

  • Reduced salivary flow is linked to congenital issues, it elevates dental caries risk
  • Reduced salivary flow impacts decreased buffering capacity/clearance of debris that can cause difficulty swallowing

Maternal Illness During Pregnancy

  • A mother's febrile illness during pregnancy can interfere with normal dental formation
  • Maternal infections during pregnancy can lead to defects like enamel hypoplasia
  • Infections cross placenta and affect fetal enamel and dentin of teeth

Familial Tendencies

  • Genetic inheritance determines risks, such as aggressive forms of periodontal disease and certain types of oral cancer
  • Enhanced risk assessment, early intervention, and personalized preventive strategies are needed in oral health

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