Pediatric Dentistry
What the exam tests
Pediatric Dentistry tests caries risk, behaviour management, primary-dentition treatment, trauma, eruption, and safeguarding. The exam expects child-specific decisions, not miniature adult dentistry.
Core rules
- Caries risk assessment drives prevention: diet, fluoride exposure, plaque control, previous caries, medical status, and parental caries.
- Use age-appropriate fluoride toothpaste and professional fluoride varnish. Silver diamine fluoride can arrest active dentinal caries, but it stains and is not a substitute for definitive care.
- Treat early childhood caries by controlling active disease, restoring function and aesthetics, and planning prevention. The Hall technique can seal caries in primary molars when case selection is correct.
- Pulpotomy and pulpectomy have specific indications; do not apply adult endodontic criteria to primary teeth.
- Behaviour management includes tell-show-do, positive reinforcement, and nitrous oxide where trained. Use careful local anaesthetic dosing by weight.
- In trauma, avulsed permanent teeth are replanted immediately if possible, stored in milk or saline, and splinted; follow up for pulp necrosis and ankylosis.
- Monitor eruption and space; space maintainers prevent loss of arch length.
Worked example
A 4-year-old has multiple carious maxillary incisors, a carious 74, and high caries risk. The child is anxious but cooperative with tell-show-do. Plan: diet and fluoride counselling, fluoride varnish, arrest anterior caries with SDF or restore if aesthetics demand, manage 74 with the Hall technique or a restoration, and review. If behaviour deteriorates or disease is widespread, consider specialist or general anaesthetic care. The parents receive written prevention advice.
Traps
- Restoring teeth without addressing diet and fluoride.
- Using adult local anaesthetic doses.
- Replanting a primary tooth after avulsion.
- Missing safeguarding signs.