Pediatric Dentistry
What this domain tests
Pediatric dentistry tests behaviour management, caries prevention, primary tooth restoration, pulp therapy, trauma and growth guidance. The exam stresses age-appropriate decisions and child safety.
Core rules
- Behaviour management includes tell-show-do and positive reinforcement; parental separation may be needed. Avoid restraint unless it is an emergency.
- Early childhood caries affects maxillary incisors first. Risk factors include night-time bottle feeding, frequent sugars and poor hygiene. Prevention includes fluoride varnish, dietary advice and oral hygiene.
- Fluoride varnish is 22,600 ppm and is used for high-risk children. Toothpaste strength should be age-appropriate; avoid excessive ingestion to prevent fluorosis.
- Primary teeth have thinner enamel, larger pulps and more convergent roots. Pulpotomy is for vital pulp; pulpectomy is for irreversible pulpitis.
- Stainless steel crowns are used for extensive primary molar caries; strip crowns for anterior teeth.
- Avulsed permanent tooth: replant immediately or store in milk or saline. Do not replant a primary tooth because of the risk to the permanent germ. Splint flexibly for about 2 weeks.
- Space maintenance is needed after early loss; sealants protect pits and fissures.
Worked example
A 7-year-old falls and avulses a permanent maxillary central incisor; the tooth is dry and out of the socket for 45 minutes. Correct action: handle by the crown, rinse briefly with saline, replant gently, apply a flexible splint and refer for endodontic assessment. Do not soak the root in water or scrub it.
Traps
- Do not replant a primary avulsed tooth; it can damage the developing permanent tooth.
- Do not prescribe tetracycline to children under 8; it stains teeth.
- Fluoride varnish is not a substitute for treating cavitated lesions.
- Pulpotomy is not for a necrotic pulp.