CLINICAL CASES IN PEDIATRIC
DENTISTRY, 2ND EDITION EXAM
QUESTIONS WITH VERIFIED
ANSWERS
What are current recommendations for inclusion of fluoride dentrifice in
toothbrushing for children under three years of age ? - ANSWER-Caregivers should
begin brushing children's teeth as soon as they erupt by using no more than a smear
or "grain of rice" sized amount of fluoride dentrifice
What are properties of GIC that make them ideal for ITR ? - ANSWER-Glass
ionomers have several properties that make them ideal for this procedure. They are
less sensitive to moisture in the cavity, release fluoride, and are adherent to dentin,
and some formulations can be light-cured. They are also tooth colored and can
provide esthetic restorations.
What are some characteristics of fluoride varnish that make it superior to traditional
gels and foams for use in a child of this age ? - ANSWER-Current fluoride varnish
formulations have a more pleasant taste, are tooth colored, have a high
concentration of fluoride, stay on the teeth longer, and do not require a prolonged
period of time without drinking as do other formulations.
What record-keeping entries are recommended when using protective stabilization
for a child for dental treatment ? - ANSWER-When protective stabilization is used,
the operator should record the reason for its use, the additional consent provided by
the parents, the type of stabilization, how long it was use and any side effects, and
its efficacy
What characteristics of sugar in the diet that can contribute to caries should be
discussed with parents when making recommendations for its reduction ? -
ANSWER-Sugar intake counseling should examine the types (sucrose or other
sugars), amounts (quantified in number of exposures), consistency (liquid or solid),
frequency, patterns, and attempts at clearance or removal.
What are some important questions that nee to be asked when taking a medical
history with a patient who has severe cardiac disease? - ANSWER-Description and
name of the condition, previous treatment, cardiologist contact, limitations and other
morbidity, medication(s) the patient takes and the frequency
What are some other cardiac conditions requiring infective endocarditis prophylaxis ?
- ANSWER-The AHA considers prosthetic valves, previous infective endocarditis,
complex cyanotic heart disease, and surgically constructed shunts and conduits as
high risk; acquired valvular dysfunction, hypertrophic cardiomyopathy, and mitral
valve prolapse with regurgitation are considered moderate risk
,List five oral manifestations found in patients with Down Syndrome. - ANSWER-
Down syndrome patients tend to be mouth breathers, have a relative mandibular
prognathism, small and conical teeth, retained primary teeth, large and protruding
tongues, small maxilla, and precocious periodontal disease
What are considerations for radiographic examination in this patient (Down
Syndrome )? - ANSWER-Some of the factors considered in choosing a radiographic
survey include cooperation, number and placement of teeth present, contacts
between teeth and existing disease
What are considerations regarding the intake of fruit juice during infancy ? -
ANSWER-Human milk or infant formula is recommended is the only nutrient fed to
infants until approximately six months of age, and it is optimal to completely avoid
the use of juice in infants before one year of age.
What are elements of a systematic approach to GERD in a child this age (16 months
old) ? - ANSWER-The immediate and long-term treatment plans hinge on successful
medical management of GERD. Close interaction with the child's physician is
necessary. After a comprehensive assessment , diet modification, medication, and/or
surgery may be indicated. Depending on the stage deterioration of the dentition ,
local noninvasive measures should be considered first, followed by definitive
restorative care if needed. Fluorides figure prominently in this intervention to
remineralize enamel.
What are the contraindications to application of SDF ? - ANSWER-Symptomatic
teeth, necrotic teeth, history of allergy to silver, and a relative contraindication of
desquamative gingivitis or mucositis
What steps should be taken to minimize the risk of toxicity when using SDF in a very
young child ? - ANSWER-Limit to one drop of 38% SDF per 10 kg of child body
weight and limit application to a maximum of five teeth at one session although no
toxicity or systemic adverse events have been reported with 38% SDF
What is the mechanism of action of SDF ? - ANSWER-The high concentration of
fluoride promotes remineralization and inhibits demineralization, while silver ions are
bactericidal and inhibit biofilm formation.
Describe the components of motivational interviewing. - ANSWER-Motivation
interviewing aims to provide an empathic, supportive, yet directive counseling style
to enhance motivation for positive behavioral change, based on partnership,
acceptance, compassion, and evocation. Open ended questions are frequently used.
What particular clinical situations are most appropriate for a nonoperative disease
management approach as opposed to definitive care ? - ANSWER-Children who are
uncooperative or who have cavitated lesions on teeth nearing exfoliation and
children with special health care needs for whom the risks of traditional care and
behavior guidance strategies outweigh the potential benefits are the most
appropriate candidates for nonoperative disease management.
, What are the three categories of information used to makes a caries risk assessment
as defined by the AAPD ? - ANSWER-Biological factors, protective factors, and
clinical findings
What will be helpful to identify overweight and/or obesity in children older than two
years of age ? - ANSWER-Body mass index (BMI) calculation
What is the purpose of the sealant placement in a preventive resin restoration ? -
ANSWER-Eliminate the need to extend the preparation to prevent future decay and
to fill any voids in the surface of the hybrid resin based composite created during
finishing.
What is a contraindication to placing a resin restoration ? - ANSWER-Inability to
isolate tooth; known allergy to resin-based composite material
Is the wear of resin-based composite a significant concern when placing a resin
restoration ? - ANSWER-No. Current materials have biomechanical properties that
can reduce the risk of excessive wear.
A resin-modified restoration would not be appropriate for:
A. A low caries risk child
B. A moderate caries risk child
C. a high caries risk child - ANSWER-C. A high caries risk child
The proximal walls of a class II preparation in a primary molar should:
A. Converge
B. Be parallel
C. Diverge - ANSWER-A. Converge
The cavosurface margin of a class II preparation in a primary molar should:
A. Be beveled 0.5mm
B. Be beveled 1.0mm
C. Be beveled 2.0mm
D. Not be beveled - ANSWER-D. Not be beveled
Placing a primer adhesive prior to the placement of a resin-modified GIC:
A. Increases the compressive strength of the GIC
B. Increases the bond strength to tooth structure
C. Decreases the permeability of the GIC - ANSWER-B. Increases the bond strength
to tooth structure
A GIC setting reaction occurs over:
A. Five minutes
B. Ten minutes
C. One hour
D. 24 hours - ANSWER-D. 24 hours
In the cavity preparation for primary teeth, is the cavosurface margin beveled ? -
ANSWER-Yes
DENTISTRY, 2ND EDITION EXAM
QUESTIONS WITH VERIFIED
ANSWERS
What are current recommendations for inclusion of fluoride dentrifice in
toothbrushing for children under three years of age ? - ANSWER-Caregivers should
begin brushing children's teeth as soon as they erupt by using no more than a smear
or "grain of rice" sized amount of fluoride dentrifice
What are properties of GIC that make them ideal for ITR ? - ANSWER-Glass
ionomers have several properties that make them ideal for this procedure. They are
less sensitive to moisture in the cavity, release fluoride, and are adherent to dentin,
and some formulations can be light-cured. They are also tooth colored and can
provide esthetic restorations.
What are some characteristics of fluoride varnish that make it superior to traditional
gels and foams for use in a child of this age ? - ANSWER-Current fluoride varnish
formulations have a more pleasant taste, are tooth colored, have a high
concentration of fluoride, stay on the teeth longer, and do not require a prolonged
period of time without drinking as do other formulations.
What record-keeping entries are recommended when using protective stabilization
for a child for dental treatment ? - ANSWER-When protective stabilization is used,
the operator should record the reason for its use, the additional consent provided by
the parents, the type of stabilization, how long it was use and any side effects, and
its efficacy
What characteristics of sugar in the diet that can contribute to caries should be
discussed with parents when making recommendations for its reduction ? -
ANSWER-Sugar intake counseling should examine the types (sucrose or other
sugars), amounts (quantified in number of exposures), consistency (liquid or solid),
frequency, patterns, and attempts at clearance or removal.
What are some important questions that nee to be asked when taking a medical
history with a patient who has severe cardiac disease? - ANSWER-Description and
name of the condition, previous treatment, cardiologist contact, limitations and other
morbidity, medication(s) the patient takes and the frequency
What are some other cardiac conditions requiring infective endocarditis prophylaxis ?
- ANSWER-The AHA considers prosthetic valves, previous infective endocarditis,
complex cyanotic heart disease, and surgically constructed shunts and conduits as
high risk; acquired valvular dysfunction, hypertrophic cardiomyopathy, and mitral
valve prolapse with regurgitation are considered moderate risk
,List five oral manifestations found in patients with Down Syndrome. - ANSWER-
Down syndrome patients tend to be mouth breathers, have a relative mandibular
prognathism, small and conical teeth, retained primary teeth, large and protruding
tongues, small maxilla, and precocious periodontal disease
What are considerations for radiographic examination in this patient (Down
Syndrome )? - ANSWER-Some of the factors considered in choosing a radiographic
survey include cooperation, number and placement of teeth present, contacts
between teeth and existing disease
What are considerations regarding the intake of fruit juice during infancy ? -
ANSWER-Human milk or infant formula is recommended is the only nutrient fed to
infants until approximately six months of age, and it is optimal to completely avoid
the use of juice in infants before one year of age.
What are elements of a systematic approach to GERD in a child this age (16 months
old) ? - ANSWER-The immediate and long-term treatment plans hinge on successful
medical management of GERD. Close interaction with the child's physician is
necessary. After a comprehensive assessment , diet modification, medication, and/or
surgery may be indicated. Depending on the stage deterioration of the dentition ,
local noninvasive measures should be considered first, followed by definitive
restorative care if needed. Fluorides figure prominently in this intervention to
remineralize enamel.
What are the contraindications to application of SDF ? - ANSWER-Symptomatic
teeth, necrotic teeth, history of allergy to silver, and a relative contraindication of
desquamative gingivitis or mucositis
What steps should be taken to minimize the risk of toxicity when using SDF in a very
young child ? - ANSWER-Limit to one drop of 38% SDF per 10 kg of child body
weight and limit application to a maximum of five teeth at one session although no
toxicity or systemic adverse events have been reported with 38% SDF
What is the mechanism of action of SDF ? - ANSWER-The high concentration of
fluoride promotes remineralization and inhibits demineralization, while silver ions are
bactericidal and inhibit biofilm formation.
Describe the components of motivational interviewing. - ANSWER-Motivation
interviewing aims to provide an empathic, supportive, yet directive counseling style
to enhance motivation for positive behavioral change, based on partnership,
acceptance, compassion, and evocation. Open ended questions are frequently used.
What particular clinical situations are most appropriate for a nonoperative disease
management approach as opposed to definitive care ? - ANSWER-Children who are
uncooperative or who have cavitated lesions on teeth nearing exfoliation and
children with special health care needs for whom the risks of traditional care and
behavior guidance strategies outweigh the potential benefits are the most
appropriate candidates for nonoperative disease management.
, What are the three categories of information used to makes a caries risk assessment
as defined by the AAPD ? - ANSWER-Biological factors, protective factors, and
clinical findings
What will be helpful to identify overweight and/or obesity in children older than two
years of age ? - ANSWER-Body mass index (BMI) calculation
What is the purpose of the sealant placement in a preventive resin restoration ? -
ANSWER-Eliminate the need to extend the preparation to prevent future decay and
to fill any voids in the surface of the hybrid resin based composite created during
finishing.
What is a contraindication to placing a resin restoration ? - ANSWER-Inability to
isolate tooth; known allergy to resin-based composite material
Is the wear of resin-based composite a significant concern when placing a resin
restoration ? - ANSWER-No. Current materials have biomechanical properties that
can reduce the risk of excessive wear.
A resin-modified restoration would not be appropriate for:
A. A low caries risk child
B. A moderate caries risk child
C. a high caries risk child - ANSWER-C. A high caries risk child
The proximal walls of a class II preparation in a primary molar should:
A. Converge
B. Be parallel
C. Diverge - ANSWER-A. Converge
The cavosurface margin of a class II preparation in a primary molar should:
A. Be beveled 0.5mm
B. Be beveled 1.0mm
C. Be beveled 2.0mm
D. Not be beveled - ANSWER-D. Not be beveled
Placing a primer adhesive prior to the placement of a resin-modified GIC:
A. Increases the compressive strength of the GIC
B. Increases the bond strength to tooth structure
C. Decreases the permeability of the GIC - ANSWER-B. Increases the bond strength
to tooth structure
A GIC setting reaction occurs over:
A. Five minutes
B. Ten minutes
C. One hour
D. 24 hours - ANSWER-D. 24 hours
In the cavity preparation for primary teeth, is the cavosurface margin beveled ? -
ANSWER-Yes
