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PEDIATRIC DENTISTRY EXAM WITH QUESTION AND ANSWERS UPDATED 2024, Exams of Pediatrics

London School of Hygiene & Tropical Medicine (LSHTM)Pediatrics

PEDIATRIC DENTISTRY EXAM WITH QUESTION AND ANSWERS UPDATED 2024

Typology: Exams

2023/2024

Available from 08/02/2024

DANTUTOR 🇬🇧

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Pediatric Dentistry Exam I

What is the most important function of the primary dentition? -

- *Space maintenance* for the permanent teeth

T/F

The primary 2nd molar is replaced by the permanent 2nd molar. The primary dentition has 12 less teeth

than the permanent dentition with five teeth per quadrant. -

- False: it is replaced by the permanent 2nd premolar

- True

What are the 5 functions of the primary dentition? -

- Space maintenance

- Mastication

- Growth of jaws: stimulated through mastication and forces imposed on the PDL allows for continuous

bone turnover

- Speech: however, they are not required for speech, only *aid* in speech

- Esthetic function: more of an issue for parents than patients

Growth of the jaws is stimulated through which 2 processes? -

mastication and developing height of dental arches

How do primary teeth compare to permanent teeth in size? Which 2 buzzwords compare the size of

primary teeth to their perm. counterparts? -

- Primary teeth are smaller in all dimensions when compared to their permanent counterparts

- Think in terms of "shallower and narrower"

What 2 words describe primary incisors? -

Short and wide

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Pediatric Dentistry Exam I

What is the most important function of the primary dentition? -

Space maintenance for the permanent teeth T/F The primary 2nd molar is replaced by the permanent 2nd molar. The primary dentition has 12 less teeth than the permanent dentition with five teeth per quadrant. -
False: it is replaced by the permanent 2nd premolar
True What are the 5 functions of the primary dentition? -
Space maintenance
Mastication
Growth of jaws: stimulated through mastication and forces imposed on the PDL allows for continuous bone turnover
Speech: however, they are not required for speech, only aid in speech
Esthetic function: more of an issue for parents than patients Growth of the jaws is stimulated through which 2 processes? - mastication and developing height of dental arches How do primary teeth compare to permanent teeth in size? Which 2 buzzwords compare the size of primary teeth to their perm. counterparts? -
Primary teeth are smaller in all dimensions when compared to their permanent counterparts
Think in terms of "shallower and narrower" What 2 words describe primary incisors? - Short and wide

How do primary molars compare to permanent molars in shape (crown and roots) 8? -

Bulbous and squatty
Narrower occlusal table
Bulge at gingival margin
Cervical constriction
Broad, flat contact areas which extend nearly to the gingival crest
Longer, thinner roots in proportion to crown size with "ribbon shaped" canals
Roots flared M-D and curved to accommodate the tooth bud
Enamel and dentin are thinner relatively to larger pulp Which primary tooth has the most pronounced bulge at the gingival margin? -
Primary 1st mandibular molar on the MB How does the enamel of primary teeth compare to permanent teeth? -
Enamel always thinner in primary teeth with a uniform thickness of 0.75 - 1.0 mm
Primary teeth are also whiter How do enamel rods of primary teeth compare to permanent teeth? -
primary enamel rods at the gingival 1/3 do not slant gingivally but rather incline occlusally How does the dentin of primary teeth compare to permanent teeth? -
Dentin is thinner in proportion to tooth size How do the pulp chambers of primary molars compare to permanent molars (2)? How do they change with age? -
Proportionately larger primary pulp chambers
Primary pulp horns extend further into the crown and follow the outline of the crown
Becomes smaller with age

Purpose: to introduce yourself to the patient and their parent and vice versa, communicate well to begin building trust with the patient, and be a low-key and easy appointment for everyone
The tone should be easy going and run smoothly How can good communication be established during the dental visit? - Explain clearly what the visit will entail and what the parents and child can expect What are the 5 areas covered under Data gathering? -
Chief complaint
Medical hx
Dental hx
PT's social history
Radiographs What 7 components of the medical history do you need to know about your patient's general health? -
Medical conditions/illnesses: asthma, ADD, ADHD, heart problems
Current medications including OTC & herbal
Allergies: drugs, sedative agents, food, latex
Hospitalizations: reason, date, & outcome
Surgeries: reason, date, & outcome
Immunization status: including tetanus
Traumatic injuries: reason, date, outcome When taking the medical history of adolescents, what 6 additional factors should be looked at? -
Nutritional and dietary considerations
Eating disorders
Alcohol and Substance abuse
OTC meds and supplements
Body art

Pregnancy How often should the medical history be updated? -
- Should be updated at every visit When reviewing the dental history of the patient, what 11 factors should be addressed? -
- Previous dental experiences?
Family history of caries?
Dental pain & infection?
Diet and habits
Behavior of child during previous treatment
Date of last radiographs
Oral hygiene practices
Fluoride use
Oral habits (thumbsucking)
Trauma history
Dental home (an established dental practice with routine recall) Generate appropriate questions to evaluate the following components of the dental history:
Previous dental experiences
Family history of caries
Dental Pain and infection
Diet and Habits
Behavior of child during past treatment -
- What did you think about your last visit?
Do your brothers or sisters have cavities?
Does anything hurt in your mouth? Where?
Do you drink a lot of soda or juice? How much?
Previous behavior: ask parent

Visual examination What 7 factors make up the comprehensive clinical evaluation? -
- Vital signs: HR, BP, RR
Extra-oral exam: general impression of health
Intra-oral exam: soft and hard tissues
Radiographic assessment
Caries Risk assessment: high, moderate, low
Behavioral assessment
Charting caries What are the 6 main components to the extra-oral exam? - Motor functions Speech Head & neck symmetry Lymph nodes TMJ Swellings, bruises, lesions, and scars When seeing a new patient, why is it important to take HR and BP along with noting any other abnormalities? -
- This provides you with a baseline for all future appointments and lets you refer back to your notes to determine whether there is something going on with the patient at future appointments Why is it important to assess the developing occlusion? -
- Some occlusal factors will alter the restorative treatment plan (even if the parents have no orthodontic concerns) What 3 can be determined through radiographic assessment? -
- Dental age

Developmental abnormalities
Development of premolars (watch for maxillary canine impaction) T/F Most children normally present with moderate gingivitis. A Frankl score of 1 indicates the patient was well behaved. The behavior of a child rarely changes throughout multiple dental visits. -
- True
False: a Frankl score of 1 means the child was a very poorly behaved patient; a score of 4 means the child was an excellent patient
False: the behavior of a child should improve throughout a single appointment and with subsequent appointments After a thorough medical history and comprehensive evaluation, a ____________ should be made. Give an example. -
- Diagnosis
"Tooth A has MO caries, C has stainless steel crown" Following a diagnosis, the ____________ and ____________ should be presented to the parents. Detail what this involves. -
- Treatment planning & informed consent
During the treatment planning presentation, all alternatives should be presented along with a preventive plan. This is also when you would speak with the parents about using nitrous, oral sedation, or sedation in the OR What is treatment planning based on (3)? -
- clinical findings
parent's preferences
child's behavior When delivering your treatment plan to parents what 4 components should be included? -
- Anticipatory guidance

Visiting the dentist can be very stressful and may trigger an asthma attack in a child with poorly controlled asthma Why is taking good radiographs very important in a child? -
This is typically the first thing you do with a child; if you take the radiographs correctly without scaring the child, it builds trust Which behavioral management tech can be used for taking radiographs of children? - "Tell-Show-Do" T/F Take the most difficult film first when taking radiographs on children. Use lots of positive reinforcement when taking radiographs on children. Bitewing radiographs are the easiest radiograph to take. -
False: take the easiest film first
True
False: occlusal radiographs are the easiest to take What 4 steps should be done before placing radiographic film into a child's mouth? -
Tell-show-do
Have child focus on an object in the room so they don't follow the x-ray tube head
Have x-ray tube close to the final angle
Convential film may be bent to avoid causing the child pain What terminology can be used for x ray, xray machine, and to instruct the child to sit still when taking radiographs? -
camera
"Can you be as still as a statue while i take pictures"
elephant nose What are 3 tricks that can be used to distract the PT when taking films? -

pointing the toes
breathing through nose
following secondhand on a clock Which film sizes can be used for anterior occlusal radiographs in the primary and mixed dentition and how? -
Size 2 and size 4
Size 2 is used to take anterior occlusal films of both maxillary and mandibular anterior primary teeth and during the mixed dentition stage involving permanent anterior teeth When is Size 0 film used for pediatric radiographs? -
Used for bitewings before full eruption of the permanent 1st molars (less than 6-7 age) When are size 1 films used? T/F most clinics may not have this size. -
when size 2 is uncomfortable for bitewings
true When is Size 2 film used for pediatric radiographs (4)? -
Mx & Md anterior occlusals (primary and during mixed dentition involving perm. anterior teeth)
Anterior periapical
Bitewings
Posterior periapical after full eruption of permanent 1st molars When is Size 4 film used for pediatric radiographs? -
Large Occlusal radiographs when size 2 is too small T/F Size 4 films are not available in digital? - True

For digital: place metal button away from beam (black in hole/non-button side) In both cases, 1 mm of film extends beyond incisal edges Describe the technique when taking mandibular occlusal radiographs on children 3? -

Long axis of size 2 film from ear to ear
Tip child's chin up 45 degrees and position tube head at the tip of the chin
Total angulation of patient's head and tube head is - 60 degrees (x ray tube head tilts 15 degrees) Which film sizes are used for anterior periapical radiographs (primary and mixed)? - Size 2 (same as anterior occlusals) When would anterior periapical radiographs be taken instead of anterior occlusal radiographs in children? -
Anterior periapicals are taken after eruption of permanent incisors
(still taken for diagnosis of trauma or caries) List the 2 criteria for diagnostic film of anterior periapical radiographs. -
Apices of permanent incisors visible + 1mm of bone past the apices
Normal bone must be visible around all periapical areas of suspected pathology How should the film and tube head be positioned when taking anterior maxillary periapical radiographs on children (5)? -
A-T line parallel to floor
Long axis of Size 2 film anterior to posterior
Film extends 1mm beyond the incisal edges
Center film on midline
Tube head positioned 55° above tip of the nose How should the Film and Tube head be positioned when taking anterior Mandibular Periapical radiographs on children? -

A-T line up from floor 30°
Long axis of film anterior to posterior
Film extends 1mm beyond the incisal edges
Center film on midline
Tube head at - 25°, under tip of chin Which tool may be used for anterior PAs instead of precision instruments? - Snap-a-ray What is the #1 reasons why BWs are taken? -
interproximal caries What are the 7 indications for taking pediatric bitewing radiographs? Include film size. -
Diagnose interproximal decay
diagnose occlusal caries and relationship of caries to pulp
Diagnose pathology/eruption disturbances
Diagnose periodontal disease
Primary dentition: only take if the contacts are closed (Size 0)
1 R and 1 L bitewing in the mixed dentition (Size 1 or 2)
2R and 2 L bitewings taken after eruption of permanent 2nd molars (Size 2) How should BWs be taken on an 8 year old? -
take 1L and 1R BW with a size 1 (use size 2 if 10 - 12 years old) How should BWs be taken on a 13 years old? -
take 2 right and 2 left with a size 2 film What are the 3 criteria for diagnostic BWs? -
interproximal area seen, without overlap, on at least one film

How should the film and tube head be positioned when taking maxillary posterior periapical radiographs on children (3)? -

Film placed in Snap-a-ray
Occlusal plane parallel to floor
Tube head positioned below pupil on A-T line at 40° How should the film and tube head be positioned when taking mandibular posterior periapical radiographs on children? -
Film placed in Snap-a-ray
Occlusal plane parallel to floor
Tube head positioned below border of mandible at - 10° If an infection is present in primary molar teeth, where will it be located? -
Typically, infections and abscesses are found in the furcal regions of teeth due to their thin cementum in this region When is the Snap-A-Ray used? -
Only for PA radiographs (anterior and posterior PAs) What are some euphemisms used when taking radiographs? -
"Open wide like a (favorite animal)_"
"Bite down like you're chewing _(favorite food)"
"I'm going to take a few pictures with my magic camera" T/F Routine examination alone is adequate to prevent oral disease. Some patients may require examinations and preventive services at more frequent intervals than 6 months. -
False: Oral health promotion is needed, including anticipatory guidance and adjunctive interventions (fluoride application) which should be done at all new patient exams and recall exams

True When is the first examination recommended for children? The most common interval between examinations is how long? -
- At the time of eruption of the 1st tooth and no later than 12 months
Recall exams every 6 months How should OHI (oral health instructions) be given to children (3 steps)? -
- Have child demonstrate their own technique first
Give positive feedback
Tell and show the child and parent how to brush A _____ size amount of toothpaste should be used. Tell children that they should brush _____ times a day with ______ toothpaste. Children older than _____ should be taught how to floss. -
- Pea-size
2 times a day with fluoride toothpaste (1,000 ppm F-)
9 years old; prior to this age, parents should be flossing their children's teeth Which motion should be used to brush teeth? - Circular or small scrubbing motion T/F prior to 9 yrs old, flossing is not needed? - false - parents should be taught how to floss their child's teeth A __ of fluoridated toothpaste can be used for children under 2 years old. This amount decreases the risk of __? -
- Smear
Fluorosis A pea-size amount of toothpaste is appropriate for children of which ages? -

Which method should be used for doing a prophy? - tell - show - do (TSD) Explain how you would perform a RC prophy using TSD on a child. -

"Hi (child's name) today, I'm going to use my magic toothbrush and toothpaste to get rid of all the tiny bugs from your teeth. I'll also need the help of my mini-vacuum and tooth shower"
After telling them, use the rubber cup on child's fingernail to show them how you will tickle their teeth. (Note: children like choices so let them choose their flavor of paste)
Use a small amount of paste with slow speed to clean teeth one by one. Rinse after completion of each arch and suction to remove paste and water Give a euphemisms for the following objects:
Prophy cup
Rubber cup handpiece
Prophy paste
Suction (2)
Air-Water Syringe -
Prophy cup: Magic toothbrush
Rubber cup handpiece: Tooth tickler
Prophy paste: toothpaste
Suction: Mr. Thirsty, mini-vacuum
Air-water syringe: tooth shower After teeth prophy what should be done next? - Fluoride application Dietary analysis is part of ____ _____ assessment? -
Caries risk assessment

What 3 pathological factors contribute to the caries process? -

Acid-producing bacteria
Frequent consumption of carbohydrates
Low saliva flow What 3 protective factors help prevent the development of caries? -
Saliva flow
Fluoride
Antibacterials Ideally, __________ ___________ starting at the first dental visit should give parents the information they need to prevent caries from occurring. -
Anticipatory guidance What 4 specific things should you ask a parent about their child's diet? Will parents always be upfront about this? -
Juice consumption
Sippy-cup use
Snacking
Frequency of snacking & use
No; parents will sometimes feel guilty if their child has caries and may try to hide some of the less desirable dietary practices You suggest to a parent that their child shouldn't snack between meals. The parent informs you that this is impossible. What snacks would you suggest (3)? What is a positive way to suggest a dietary change to a parent from juices and soda? -
Fruit, yogurt, cheese
"How about trying to drink more milk and water instead of juice and soda?" What technique should be used for the parent to help them stay on track for providing proper OH to child? -

PEDIATRIC DENTISTRY EXAM WITH QUESTION AND ANSWERS UPDATED 2024, Exams of Pediatrics

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Pediatric Dentistry Exam I