Pediatric Dentistry
This domain tests child behaviour management, prevention, primary tooth restoration, pulp therapy, space maintenance and dental trauma. The exam expects child-specific doses and an understanding that primary teeth are important.
Behaviour and prevention
- Tell-show-do, positive reinforcement and modelling build cooperation. Treat pain and infection first; consider nitrous oxide or sedation only with appropriate training and consent.
- Fluoride varnish is effective for caries prevention. Sealants protect susceptible pits and fissures. Diet advice should target frequency of sugar exposure.
- Early childhood caries affects primary teeth, often maxillary incisors first; it is preventable and behavour-related, not inevitable.
Restorative and pulp care
- Stainless steel crowns are durable for primary molars with extensive caries. Pulpotomy preserves radicular pulp; pulpectomy removes it when the pulp is irreversibly inflamed or necrotic.
- Space maintainers preserve arch length after premature loss. Trauma to primary teeth must be assessed for displacement and effect on the permanent successor.
Worked example
A 4-year-old has multiple carious primary molars, pain and poor cooperation. Reasoning: address pain and infection, use behaviour management, restore with stainless steel crowns or pulp therapy as indicated, apply fluoride varnish, and educate parents about diet and hygiene. Extraction of all affected teeth is not the default.
Traps that cost marks
Primary teeth are not disposable; premature loss causes space loss. Do not use adult local anaesthetic doses. Fluoride tablets are not a substitute for varnish. Do not perform pulpectomy without assessing the permanent successor. Record behaviour and consent carefully.