Kuwait Dental Board Pediatric Dentistry flashcards

31 cards. Read the term and the definition here. The deck at the top of this page is optional.

Scammon growth curves

Four tissue growth patterns: neural (rapid early, ~95% by age 6-7), lymphoid (peaks ~10-12 years at 200%), general somatic (S-shaped), and genital. Guides timing of craniofacial and orthodontic intervention.

CVM stages

Cervical vertebral maturation stages CS1-CS6 assessed on lateral cephalogram. CS3-CS4 indicates peak mandibular growth, the optimal window for growth modification; CS5-CS6 indicates growth cessation.

Pierre Robin sequence

Triad of micrognathia, glossoptosis, and U-shaped cleft palate. Airway management ranges from prone positioning to nasopharyngeal airway or mandibular distraction; catch-up mandibular growth often occurs.

Cleft lip repair timing

Cleft lip repair typically at 3-6 months using the rule of 10s: 10 weeks old, 10 lb weight, 10 g/dL hemoglobin. Cleft palate repair at 9-12 months before speech develops.

Frankl behavior scale

Four-point rating: 1 definitely negative, 2 negative, 3 positive, 4 definitely positive. Ratings 1-2 predict poor cooperation and guide escalation of behavior guidance techniques.

Tell-show-do

First-line behavior guidance: explain the procedure in child-friendly terms, demonstrate with instruments, then perform. Reduces anxiety and is not deception because the child is shown actual instruments.

Nitrous oxide contraindications

Contraindicated in nasal obstruction, recent middle-ear disease, B12 deficiency, first-trimester pregnancy, and severe COPD. Typical concentration 30-50% with minimum 3 L/min flow and scavenging.

Informed consent process

Requires guardian permission plus child assent by developmental capacity. Document discussion of risks, benefits, alternatives, and consequences of no treatment; a signature alone is insufficient.

Fluoride varnish protocol

5% NaF (22,600 ppm) applied 2-4 times/year for moderate/high caries risk and at least twice yearly from first tooth eruption. Safe for all ages; avoid in ulcerative gingivitis.

Fluoride toothpaste amounts

Smear/rice-grain size from first tooth to age 3; pea-size from age 3-6. Supervise brushing and discourage swallowing; high-fluoride 5000 ppm only for children 6+ at high risk.

Silver diamine fluoride

38% SDF arrests active cavitated lesions and blackens carious tissue. Useful for uncooperative or medically fragile children; counsel parents about staining; not a substitute for restorative care when feasible.

Early childhood caries

Any caries in children under 6. Severe ECC includes any smooth-surface caries under age 3 or one or more lesions in ages 3-5. Managed with risk-based prevention plus restorative or arrestive care.

Hall technique

Cementation of a stainless steel crown over a primary molar without tooth preparation, sealing caries. Indicated for cavitated or non-cavitated lesions without pulpal involvement; requires patient acceptance of occlusal changes.

Stainless steel crown indications

Restoration of choice for multi-surface caries in primary molars and for pulp-treated primary teeth. Also used for hypoplastic teeth, fractures, and space maintenance when a crown-and-loop is needed.

Space maintainers

Band-and-loop or crown-and-loop for single posterior tooth loss; Nance or transpalatal arch for bilateral loss; lingual holding arch for lower arch. Place soon after extraction to prevent space loss.

Pulpotomy indications

Vital, symptom-free or reversibly inflamed primary molar with coronal pulp exposure and no radicular pathology. MTA or ferric sulfate preferred over formocresol; pulpectomy for irreversible pulpitis or necrosis.

Avulsed permanent tooth

Replant immediately if possible; store in milk, saline, or HBSS. Closed apex with dry time under 60 minutes: replant, flexible splint 2 weeks, root canal within 2 weeks. Do not replant primary teeth.

Splinting durations

Flexible splint: 2 weeks for subluxation or extrusion, 4 weeks for lateral luxation and root fracture, 4 months for cervical root fracture. Rigid splints increase ankylosis risk.

Cvek pulpotomy

Partial pulpotomy removing 1-2 mm of exposed pulp to healthy tissue, then placing calcium hydroxide or MTA and sealing. Indicated for traumatic pulp exposure in immature permanent teeth with short exposure time.

Riga-Fede disease

Traumatic ulceration of the ventral tongue in infants with natal or neonatal teeth. Management includes smoothing the tooth, protective barrier, or extraction if severe feeding problems.

Mucocele management

Most common on lower lip from minor salivary gland duct trauma. Treatment is excision with gland removal; recurrence is common if the gland is not removed.

Herpetic gingivostomatitis

Primary HSV-1 infection in children 6 months-5 years with fever and vesicles on gingiva and mucosa. Supportive care and hydration; acyclovir if severe or within 72 hours.

Infective endocarditis prophylaxis

Indicated for high-risk cardiac conditions before gingival manipulation or mucosal perforation. Amoxicillin 50 mg/kg (max 2 g) 30-60 minutes before; clindamycin or azithromycin if penicillin-allergic.

Local anesthetic maximum doses

Lidocaine 2% with 1:100,000 epinephrine: 4.4 mg/kg (2 mg/lb). Articaine 4%: 7 mg/kg (5 mg/kg under age 4). Mepivacaine 3%: 6.6 mg/kg. Calculate by body weight before injection.

Odontogenic infection management

Most commonly from necrotic primary molars. Treat with pulpectomy or extraction, incision and drainage if fluctuant, and antibiotics only as adjunct when systemic signs (fever, swelling, trismus) are present.

Anterior crossbite correction

Correct early to prevent mandibular displacement and gingival recession. Options include removable appliance with posterior bite plane and Z-spring, 2x4 fixed appliance, or reversed stainless steel crown for a single primary incisor.

Rapid maxillary expansion

Indicated for transverse maxillary deficiency with posterior crossbite. Expansion 0.5-1 mm/day; monitor for pain and tissue blanching; retention needed after expansion to prevent relapse.

Ectopic first molar eruption

First permanent molar fails to erupt and resorbs the primary second molar. Use separators, brass wire, or distalize; early intervention prevents space loss and impaction.

Autism dental management

Sensory hypersensitivity and need for predictability. Use visual schedules, social stories, desensitization visits, and minimize sensory stimuli (noise, light, taste). Coordinate with caregivers for successful visits.

Down syndrome considerations

Higher prevalence of periodontal disease, delayed eruption, hypodontia, macroglossia, and atlantoaxial instability. Avoid extreme neck extension and obtain cervical spine evaluation if symptomatic.

Child protection reporting

Dentists are mandated reporters of suspected abuse or neglect in most jurisdictions. Document objective findings and report to appropriate authorities; failure to report may carry legal consequences.