Comprehensive FNP Study Guide
Chapters 20, 30, 31, & 32: Dental, Eye, Ear, and Respiratory
Disorders
This guide focuses on the highest-yield content commonly tested in FNP pediatric primary care
courses and certification exams.
CHAPTER 20: DENTAL & ORAL HEALTH
Key Exam Facts
Dental Home
Establish by:
o Age 1 year OR
o Within 6 months of first tooth eruption
First tooth usually erupts around 6 months
Primary Teeth
Total = 20 teeth
Eruption begins:
o Mandibular central incisors (6-10 months)
Complete by:
o 2-3 years
Permanent Teeth
Total = 32 teeth
First permanent tooth:
o Mandibular central incisors OR first molars (~6 years)
Teething
Symptoms:
Drooling
Irritability
Chewing
Mild gum discomfort
,NOT caused by:
High fever
Significant diarrhea
Severe illness
Early Childhood Caries (ECC)
Risk Factors
Bottle in bed
Frequent juice intake
High sugar diet
Poor oral hygiene
Maternal caries history
Clinical Findings
Early:
White chalky lesions
Advanced:
Brown/black cavitations
Tooth destruction
Prevention
Brush twice daily
Fluoride toothpaste
Fluoride varnish
Limit sugary beverages
Avoid bottle in bed
Fluoride Recommendations
Under 3 years:
Smear-sized toothpaste
Age 3-6:
, Pea-sized amount
Ankyloglossia (Tongue Tie)
Findings
Restricted tongue movement
Breastfeeding difficulties
Maternal nipple pain
Management
Observation
Frenotomy if feeding affected
Aphthous Ulcers (Canker Sores)
Findings
Painful shallow ulcers
Gray-white center
Red halo
Treatment
Supportive care
Topical corticosteroids if severe
Geographic Tongue
Findings
Migrating smooth red patches
White borders
Benign
Treatment
, Reassurance
Oral Candidiasis (Thrush)
Findings
White plaques
Cannot be scraped off
Treatment
Nystatin suspension
Treat breastfeeding mother if necessary
Herpetic Gingivostomatitis
Cause
HSV-1
Findings
Fever
Painful oral ulcers
Gingival swelling
Treatment
Hydration
Pain control
Acyclovir if early/severe
Dental Trauma
Avulsed Permanent Tooth
1. Pick up by crown only
2. Rinse gently
Chapters 20, 30, 31, & 32: Dental, Eye, Ear, and Respiratory
Disorders
This guide focuses on the highest-yield content commonly tested in FNP pediatric primary care
courses and certification exams.
CHAPTER 20: DENTAL & ORAL HEALTH
Key Exam Facts
Dental Home
Establish by:
o Age 1 year OR
o Within 6 months of first tooth eruption
First tooth usually erupts around 6 months
Primary Teeth
Total = 20 teeth
Eruption begins:
o Mandibular central incisors (6-10 months)
Complete by:
o 2-3 years
Permanent Teeth
Total = 32 teeth
First permanent tooth:
o Mandibular central incisors OR first molars (~6 years)
Teething
Symptoms:
Drooling
Irritability
Chewing
Mild gum discomfort
,NOT caused by:
High fever
Significant diarrhea
Severe illness
Early Childhood Caries (ECC)
Risk Factors
Bottle in bed
Frequent juice intake
High sugar diet
Poor oral hygiene
Maternal caries history
Clinical Findings
Early:
White chalky lesions
Advanced:
Brown/black cavitations
Tooth destruction
Prevention
Brush twice daily
Fluoride toothpaste
Fluoride varnish
Limit sugary beverages
Avoid bottle in bed
Fluoride Recommendations
Under 3 years:
Smear-sized toothpaste
Age 3-6:
, Pea-sized amount
Ankyloglossia (Tongue Tie)
Findings
Restricted tongue movement
Breastfeeding difficulties
Maternal nipple pain
Management
Observation
Frenotomy if feeding affected
Aphthous Ulcers (Canker Sores)
Findings
Painful shallow ulcers
Gray-white center
Red halo
Treatment
Supportive care
Topical corticosteroids if severe
Geographic Tongue
Findings
Migrating smooth red patches
White borders
Benign
Treatment
, Reassurance
Oral Candidiasis (Thrush)
Findings
White plaques
Cannot be scraped off
Treatment
Nystatin suspension
Treat breastfeeding mother if necessary
Herpetic Gingivostomatitis
Cause
HSV-1
Findings
Fever
Painful oral ulcers
Gingival swelling
Treatment
Hydration
Pain control
Acyclovir if early/severe
Dental Trauma
Avulsed Permanent Tooth
1. Pick up by crown only
2. Rinse gently
