1) Why not use composite on primary posterior teeth???????????
2) After orthodontic treatment patient with no systemic disease developes high fever ....WHY ??????
3) What forceps do you use to remove mesial root of mandibular molar ????
4) What is Brown discoloration around gingiva on porcelin ????
5) Best treatment for localized aggressive periodontitis ???? what antibiotics??
6) Most common caries 5-17 years of age ??? (occ, mesial, distal, proximal)
7) Oligodontia and hypodontia are signs of what syndrome ???
What do we need to know about cerebral palsy ????????????????
1 due to low wear resistance will not mintain the arch length
2 dehydration
3 cryer elevator
4 tetracyclin
5
6 occlusal , thats we do pit and foissure sealants
7 ectodermal dysplasia
ORAL FINDINGS IN CHILDREN WITH CEREBRAL PALSY
Children with cerebral palsy frequently have gastroesophageal reflux, as well as episodes of vomiting. Either problem can lead to dental erosion, or loss of tooth structure.
Gingival overgrowth, due to seizure medications, is a frequent problem in children with cerebral palsy.
Orofacial findings in spastic cerebral palsy:
The head is tensely reclined.
The mouth is open, and facial movements are tense.
The tongue is hypertonic and cigar-shaped.
There is tongue thrust during swallowing and speaking.
Since the upper lip is underdeveloped, it does not produce enough pressure on the front teeth to align them correctly.
Orofacial findings in athetotic cerebral palsy:
The tongue shows spontaneous wave-like movements.
There may be an abrupt and wide opening of the mouth, which can lead to jaw dislocation.
There is an uncoordinated movement of tongue, jaw, and face muscles.
Orofacial findings in hypotonic cerebral palsy:
The tongue is large, flat, and protruded.
Facial movements are weak, and the upper lip is inactive.
THE ROLE OF THE DENTIST
The dentist should try to schedule appointments for children with cerebral palsy early in the day.
Obtain the child's medical history before the first appointment so that any necessary medical consultations can be arranged.
Try to develop a good rapport with the child.
Gain the cooperation of the cerebral palsied child by using behavior management techniques such as: tell-show-do, positive reinforcement, and voice control.
A child with severe cognitive disability may require repetition of commands and requests, which will enhance comprehension.
A child with severe visual impairment needs a verbal description of the planned dental procedures. This will help prevent fear and anxiety.
Communication can also be accomplished using nonverbal techniques, especially for children with hearing impairment
The dentist may need to use sedation techniques to calm a child – if the child's medical situation permits. Some children can only be treated under general anesthesia, however.
Children with cerebral palsy may have a severe gag reflex – making it difficult to take dental radiographs.
Two modified radiographic techniques for use in children with cerebral palsy are:
the 45 degree oblique head plate, and the reverse bite wing (buccal technique).
In the oblique plate radiographic technique:
a film cassette is held against the patient's cheek. The patient's had is rotated and tilted. The x-ray cylinder is placed just inferior and posterior to the angle of the mandible on the opposite side of the face.
In the buccal bite wing technique:
the film packet is placed between the teeth and the cheek. The x-ray cylinder is then placed below the lower border of the mandible on the opposite side of the face.
When dental treatment is performed, stainless steel crowns are often used when the posterior teeth have caries.
Fixed bridgework is usually not done for patients with cerebral palsy because of the increased risk of falling and dental injury. Patients with frequent seizures should normally not have fixed bridgework done because of the possibility of damage to the supporting teeth or bone during a seizure-related fall.
The dentist should discuss the option of myofunctional therapy for young children who have orofacial and tongue hypotonia. This treatment may increase the muscle tone of the lips, as well as keep the tongue inside of the mouth.
The dentist should instruct parents on proper home dental hygiene procedures.
Counsel parents about growth and development of the teeth and orofacial structures.
Provide relevant dietary counseling.
Periodic dental recall appointments are highly recommended in order to supervise and evaluate a patient's oral hygiene. Recall appointments also allow the dentist to monitor any gingival overgrowth which may be caused by anti-seizure medications.
Good luck to you all I will be taking the exam in the middle of june!
