Pedodontics Miscellaneous Questions And Answers

Miscellaneous Short Essays

Question 1. Young Permanent Teeth.
Answer:

Young Permanent Teeth Characteristics:

• Less convergence of buccal and lingual surfaces
• Curved occlusal surface
• Enamel thickness is more i.e. 2-3 mm
• Larger in dimension
• Enamel rods are oriented gingivally
• Bulbous roots
• Smaller pulp chamber
• Less degree of pulpal cellularity and vascularity
• Restricted apical foramen
• Localized infection

Young Permanent Teeth Importance:

• Erupts at the age of 5-6 years
• Defects in enamel formation
• Susceptible to plaque accumulation
• Deep pit and fissures
• Irregular enamel rods
• Need of fluoride application

Question 2. Dental HOME.
Answer:

Introduced by Nowak

Dental HOME Features:

• Acceptability
• Family-centered
• Continuous
• Comprehensive
• Co-ordinated
• Compassionate
• Culturally competent

Dental HOME Advantages:

• Early intervention
• Create awareness among parents
• Create positive attitude in children since 1st year of his life
• Emphasizes on preventive approaches

Question 3. Dental Health Education.
Answer:

• It is a process that informs, motivates, and helps people to adopt and maintain healthy practices and lifestyles, advocate environmental changes as needed, to facilitate the goal, and conduct professional training and research.

Dental Health Education Contents:

• Human biology
• Nutrition
• Hygiene
• Family health care
• Control of diseases

Read And Learn More: Pedodontics Short Essays Question And Answers

• Mental health
• Prevention of accidents
• Use of health services

Dental Health Education Ways:

• Audio-visual aids
• Individual approach
• Group discussion
• Lectures
• Workshops
• Panel discussion
• Dramas
• Seminars
• Mass approach

Question 4. Morphological differences between primary and permanent dentition.
Answer:

Question 5. Cleft lip and palate.
Answer:

Cleft lip and palate Classification:

• • Davis and Ritchie Classification:
    • Group 1 – Prealveolar clefts – Involves only lip
    • Group 2 – Post alveolar clefts
    • Involves palate and alveolar ridge
    • Group 3 – Alveolar clefts
    • Involves the palate alveolar ridge and lip
  • Veau’s Classification (1931):
    • Group 1 – Involves only soft palate
    • Group 2 – Involves palate up to incisive foramen
    • Group 3 – Involves palate, lip, and alveolar ridge unilaterally
    • Group 4 – Involves palate, lip, and alveolar ridge bilaterally
  • Kernahan’s Stripped Y’ Classification:
    • Block 1 and 6 – Lip
    • Block 2 and 5 – Alveolus
    • Block 3 and 4 – Hard palate anterior to incisive foramen
    • Block 7 and 8 – Hard palate posterior to the incisive foramen
  • Lahshal Classification:
    • L- Lip
    • A-Alveolus
    • H – Hard palate
    • S – Soft palate
    • H – Hard palate
    • A-Alveolus
    • L – Lip

Cleft lip and palate Treatment:

• The cleft palate is treated at different stages

1. Birth-Initial assessment:

• Pre-surgical orthopedics
• It is done by extra-oral strapping across the pre-maxilla
  • 3 months – Primary lip repair
  • 9-18 months – Palate repair
  • 2 years – Speech assessment
  • 3-5 years – Lip revisional surgery
  • 8-9 years – Initial interventional orthodontics
  • 10 years – Alveolar bone grafts
  • 12-14 years – Definitive orthodontics
  • 16 years – Nasal revisional surgery
  • 17-20 years – Orthognathic surgery

Question 6. Infant oral health care.
Answer:

• Infant oral health care is a foundation on which a lifetime of preventive education and dental care can be built in order to help acquire optimal oral health into childhood and adulthood

Infant oral health care Goals:

• To identify, intercept and modify the potentially harmful parenting practices that may adversely affect the infant’s oral health
• Parent education right from the prenatal period highlights the importance of their role in the prevention of the disease for their child
• Parent orientation to perceive dental services as an integral part of an infant’s overall health program
• Periodic evaluation of the orofacial development and oral health by the clinician

Infant oral health care Significance:

• Infant oral health care is important due to the following reasons
• Infectious diseases of the oral cavity
• Traumatic injuries to the developing dentition
• Habits such as thumb sucking
• Child abuse and neglect
• Care of the alternatively abled children
• Problems of speech and language

Question 7. Prophylactic odontomy.
Answer:

• Prophylactic odontoma was proposed by Hyatt in 1936
• He advocated the placement of small amalgam restorations in pits and fissures of newly erupted teeth before the appearance of clinical signs of decay
• Later when they fully erupt, a small occlusal cavity should be prepared and filled with amalgam
• He recommended eliminating all susceptible fissures by cutting a shallow minimal width class I cavity in the enamel and then filling it with amalgam

Prophylactic odontoma Advantages:

• Small filling, minimal pulpal irritation
• Painless technique

Prophylactic odontoma Disadvantages:

• Use of cutting instruments
• The tooth is always subjected to unnecessary reduction

Question 8. Chronology of permanent dentition.
Answer:

Question 9. Child abuse and neglect
Answer:

1. Child Abuse

• It is defined as the non-accidental physical injury, minimal or fatal, inflicted upon children by persons caring for them
• It is an overt act of commission of a caretaker-physical, emotional or sexual

Child Abuse Types:

• Physical abuse
• Educational abuse
• Emotional abuse
• Sexual abuse
• Failure to thrive
• International drugging or poisoning
• Munchausen syndrome by proxy

2. Neglect

• Neglect is an act of omission or failure to provide food, shelter, clothing, health care, safety need, dental care, and supervision

Neglect Types:

• Emotional neglect
• Health care neglect
• Physical neglect

Question 10. Brushing techniques
Answer:

Miscellaneous Short Answers

Question 1. Anticipatory Guidance.
Answer:

• Introduced by Nowak in 1995
• It is a proactive, developmental^ based counseling technique that focuses on the needs of a child at each stage of life
• Provide insight into the development of a child
• Consider various milestones of dental development
• Make the parents more at ease during a childhood visit
• This prevents many dental problems from occurring

Question 2. Bruxism.
Answer:

• It is a habitual grinding of teeth either during sleep in the night or unconsciously during day time.

Bruxism Causes:

• Occlusal disturbances
• Emotional disturbances
• Occupational

Bruxism Features:

• Attrition of teeth
• Loosening and drifting of teeth
• Gingival recession
• Hypertrophy of muscles
• Sensitivity of teeth
• Facial pain
• Trismus

Bruxism Treatment:

• Use of occlusal splints

Question 3. Horizontal Scrub Brushing Technique.
Answer:

• Position of Bristle – 90° to the tooth surface
• Brushing motion – Horizontal strokes
• Effective in – Supragingival cleansing
• Use – On a regular basis
• Disadvantage – Ineffective in interproximal cleansing

Question 4. Fone’s method of Brushing.
Answer:

• Position of Bristle – 90° to the tooth surface
• Effective in – Supragingival cleansing
• Used in – taught to children by their parents

Fone’s Method of Brushing Technique:

• The child is made to stand in front of the mirror
• Ask the child to make large circles in front of the mirror
• Gradually decrease the size of the circle up to it reaches the oral cavity

Question 5. Electronic/Powered toothbrush.
Answer:

• The head of a powered toothbrush is smaller than that of a manual toothbrush

Electronic Pattern:

• Reciprocating – back-and-forth movement
• Arcuate – up and down movement
• Elliptical – combination

Electronic Uses:

• Parental brushing of children’s teeth
• For physically handicapped patients
• For mentally retarded patients
• Aged patients
• Patients with poor dexterity

Question 6. Disclosing agents.
Answer:

• It is prepared in liquid, tablet or lozenge form that contains a dye or other coloring agent
• It is used to identify bacterial plaque deposits for instruction, evaluation, and research

Disclosing agents Agents Used:

• Iodine containing solutions
• Skinners solution
• Tincture of iodine
• Bismarck Brown
• Merbromin
• Erythrosin
• Fluorescein
• Two-tone

Disclosing agents Purpose:

• Patient’s education
• Self-education
• Evaluating the effectiveness of treatment

Question 7. FDI system.
Answer:

• It is a two-digit system introduced by the federal dentaire international (FDI)

1. For permanent dentition:

• The first digit indicates the quadrant and is num¬bered from 1 to 4
• The second digit indicates the tooth number starting from the central incisor as 1 to the 3rd molar as 8
• Thus
  • 18 17 16 15 14 13 12 11/ 21 22 23 24 25 26 27 28
  • 48 47 46 45 44 43 42 41/ 31 32 33 34 35 36 37 38

2. For primary dentition:

• The first digit indicates the quadrant and is num¬bered from 5 to 8
• The second digit indicates the tooth number starting from the central incisor as 1 to the 2nd molar as 5
• Thus
  • 55 54 53 52 51/61 62 63 64 65
  • 85 84 83 82 81/ 71 72 73 74 75

Question 8. Dentrifices for children.
Answer:

Commonly available kid’s toothpaste in India are

• Kidodent: It contains sodium mono fluorophosphate 0.38% w/w, xylitol, fluoride content 500 ppm
• Bubble: Contains sodium mono fluorophosphate 0.35% w/w, fluoride content 500 ppm
• Initiate: Contains sodium mono fluorophosphate 0.38% w/w, xylitol, fluoride content 500 ppm

Question 9. Bitewing radiograph.
Answer:

• Bitewing films are used to record the crown of maxillary and mandibular teeth in one film
• These are one of the best currently available methods to detect early interproximal caries

Bitewing radiograph Sizes:

• Size 0- For posteriors
• Size 1- For anteriors

Bitewing radiograph Uses:

• They are particularly valuable for detecting inter-proximal caries in the early stages of development
• Visualize the alveolar crest and assessment of periodontal disease in an easier way
• They are especially effective and useful for detecting calculus deposits in interproximal areas
• Useful in periodic check-ups of the teeth for detection of new caries and of early periodontal change

Question 10. MTA.
Answer:

• Mineral trioxide aggregate has been recently recommended as pulp capping agent in primary teeth
• It has been proved that it is better than formocresol

MTA Disadvantages:

• Pulp canal obliteration
• It is costly

Question 11. Mandibular primary first molar.
Answer:

Buccal Aspect:

• It has a straight outline
• The Crown constricts at the cervix
• The distal portion is shorter than the mesial portion
• The mesial cusp is larger than the distal cusp
• Roots are long and slender

Lingual Aspect:

• Crown and root converge lingually
• The distolingual cusp is rounded
• The mesiolingual cusp is long and sharp

Mesial Aspect:

• Mesiolingual and mesiobuccal cusp are seen
• The mesial marginal ridge is well developed

Distal Aspect:

• The distal root is rounded, shorter, and tapers apically

Occlusal Aspect:

• The mesiolingual cusp is largest and well developed
• The buccal developmental groove divided the two buccal cusps
• The central developmental groove separates mesiobuccal and mesiolingual cusps
• Two supplemental grooves are seen

Question 12. SLOB technique.
Answer:

SLOB technique Method:

• Two radiographs are taken
• First one with proper technique and angulation
• The second radiograph is taken by either changing the ver¬tical or horizontal angulation

SLOB technique Interpretation:

• When the dental structure or object seen in the second radiograph appears to have moved in the same direction as the shift of the position-indicating device , the structure is said to be positioned lingually
• If the object appears to have moved in the opposite direction, then the object is said to be positioned buccally
• SLOB rule: Same side Lingual Opposite side Buccal

Question 13. Panoramic radiography.
Answer:

Definition:

• It is a technique for producing a single tomographic image of the facial structures that induce both the maxillary and mandible dental arches and their supporting structures

Panoramic radiography Indications:

• As a substitute for full mouth intraoral periapical radiograph
• For evaluation of tooth development for children, the mixed dentition and also the aged
• For assist and assess the patient for and during orthodontic treatment
• To establish the site and size of lesions
• Prior to any surgical procedures
• For the detection of fractures
• For follow-up of treatment, the progress of pathology or postoperative bony healing
• Investigation of TMJ dysfunction
• To study the antrum
• For an overall view of the alveolar bone levels
• Assessment of underlying bone diseases
• Evaluation of developmental anomalies
• Evaluation of bone level before inserting implants

Panoramic radiography Limitations:

• Areas of diagnostic interest outside the focal trough may be poorly visualized
• Poor diagnostic value in terms of magnification, distor¬tion, loss of details
• There is an overlapping of teeth in the bicuspid area of the maxilla and the mandible
• In cases of pronounced inclination, the anterior teeth are poorly defined
• The density of the spine causes a lack of clarity in the central portion of the film
• Formation of ghost images due to soft tissue shadows and air spaces

Question 14. Personal Protective Equipment.
Answer:

1. Hand washing:

2. Gloves:

• Protects against contamination
• Changed between patients and for the same patient if it is worn/torn

Gloves Types:

• Surgical
• Latex
• Vinyl
• Double gloves for HBV and HIV [Hepatitis B Virus and Human Immunodeficiency Virus]

3. Face masks:

• Protects from inhalation of aerosols
• Prevents spatter from patient’s mouth
• Prevents splashes of contaminated solution
• Changed once per hour/between patients / whenever it becomes moist

4. Protective clothing:

• Reusable/disposable gowns with long sleeves, high neck, and long knee length

5. Eyewear:

• Prevention against Hepatitis B
• Prevent bacterial/viral contact

Question 15. Affected and Infected Dentin.
Answer:

Infected Dentin

• Irreversible denatured collagen
• Infiltrated with bacteria
• Notremineralizable
• Should be removed
• Darker
• Softer
• Lacks sensation
• Indistinct cross bands
• Stained with:
• 0.2% propylene glycol
• 10% acid red solution
• 0.5% basic Fuschia

Affected Dentin:

• Reversible denatured collagen
• Not infiltrated
• Remineralize
• Left
• It is cannot be stained with any solution
• Distinct cross bands sensitive behind
• Harder Lighter while cavity preparation

Question 16. Diffusion hypoxia
Answer:

• When soluble gases like nitrous oxide are breathed in large quantities they can be dissolved in body fluids rapidly
• This can lead to a temporary increase in the concentration of oxygen and carbon dioxide in the alveolus, causing an increase in their respective partial pressures
• When a patient is recovering from nitrous oxide sedation large quantities of the gas cross from the blood into the alveolus
• Thus for a short period of time, the oxygen and carbon dioxide in the alveolus are diluted by this gas
• This could potentially cause the partial pressure of oxygen to decrease and could temporarily lead to hypoxia
• This effect would only last a couple of minutes
• It can be avoided by increasing the fractional inspired oxygen concentration when recovering from nitrous oxide anesthesia

Question 17. Advantages of school dental health
Answer:

Aims at the prevention and maintenance

• Less initial cost
• Fewer man hours
• Treatment of early lesions
• Maintains topical and other preventive measures
• Bills are equalized and regularly spaced
• The child develops the habit of visiting the dentist regularly
• Establish a positive impression of dentists on the community
• Periodontal disease is interrupted at/near the beginning
• Confines dental disease to small early increments

Question 18. Classification of mouthguards
Answer:

1. Stock mouth protectors

• They are preformed and ready to wear
• Inexpensive

2. Mouth formed – boil and bite type

• May offer a better fit
• Made from thermoplastic material
• It is placed in hot water to soften then placed in the mouth and shaped around the teeth using finger and tongue pressure

3. Custom fitted

• They are individually designed and made in a dental office or laboratory
• It is expensive as it requires special material for use
• It provides the most comfort, best fit, and protection

Question 19. Objectives of dental health education
Answer:

• To cultivate the desirable health practices and health habits
• To develop a healthy attitude
• To develop dental health consciousness
• To teach rules of prevention of diseases
• To eradicate diseases through health drive programs
• To improve the oral condition
• To influence the parents and other adults through the health educative program for better habits and attitudes in children

Question 20. Ankyloglossia
Answer:

It is a result of a short, tight, thick, lingual frenulum

Ankyloglossia Classification:

• Based on the anatomical appearance
  • Type 1: Frenulum attached to tip of the tongue in front of the alveolar ridge in low lip sulcus
  • Type 2: Attaches 2-4 mm behind tongue tip and attaches on the alveolar ridge
  • Type 3: Attaches to mid-tongue and middle of the floor of the mouth, usually tighter and less elastic. The tip of the tongue appears “heart-shaped”
  • Type 4: Attaches against the base of the tongue, is shiny and very inelastic
• Based on the distance of the insertion of the lingual frenum to the tip of the tongue
  • Normal: 16 mm
  • Class 1 (Mild): 12-16 mm
  • Class 2 (Moderate): 8-12 mm
  • Class 3 (Severe): 4-8 mm
  • Class 4 (Complete): 0-4 mm

Ankyloglossia Significance:

• In majority of the cases it resolves spontaneously
• They are asymptomatic
• It may lead to
  • Difficulty in breastfeeding, articulation problems
  • Gingival recession
  • Open bite
  • Abnormal facial development

Ankyloglossia Treatment:

• Frenectomy
• Frenuloplasty

Question 21. Characteristic features of abused child
Answer:

Definition

• It is defined as the non-accidental physical injury, minimal or fatal, inflicted upon children by persons caring for them
• It is an overt act of commission of a caretaker-physical, emotional or sexual

Abuse child Characteristics

• There are no spontaneous smiles and almost no eye contact among abused children
• Lack of cleanliness
• Presence of short stature with respect to age
• Malnutrition
• Overdressed children
• Periorbital ecchymosis, scleral hemorrhage, ptosis, deviated nasal septum, cigarette burn marks, and hand slap marks
• Fractured anterior teeth

Question 22. Bite marks
Answer:

Definition

• It is a mark caused by teeth alone or in combination with other oral parts or consists of teeth marks produced by the antagonist teeth which can be as two op-posing arch marks

Bite marks Classification

1. Depending on the binding agent

• Human
• Animals
• Mechanical

2. Depending on the material bitten

• Skin
• Perishable items
• Non-perishable items

3. Depending on the degree of biting

• Definite bite marks
• Amorous bite marks
• Aggressive bite marks

Bite marks Characteristics

• An elliptical or ovoid pattern containing tooth and arch marks
• Presence of 4-5 teeth marks reflecting the shape of their incisal or occlusal surfaces
• Presence or absence of each tooth
• The peculiar shape of each tooth
• Mesiodistal dimensions
• Arch form and size
• Relationship between the upper and lower jaws