DGPD 711 2008

Introduction to Pediatric Dentistry

Final Examination
May 9, 2008

Name______________________

1. Mrs. Blackstone informs you that Jessica has been diagnosed with
moderate mental retardation and developmental delay. You would expect
her IQ to be in the range of
(a) 80-89
(b) 69-79
(c) 52-68
(d) 36-51
(e) 20-35
2. The average age at which a child can sit alone is
(a) 2 months
(b) 4 months
(c) 7 months
(d) 9 months
(e) None of the above
3. Morphologically, which primary tooth does not resemble any of the
permanent teeth?
(a) mandibular canine
(b) maxillary lateral incisor
(c) both maxillary and mandibular first molars
(d) both maxillary and mandibular central incisors
(e) none of the above

4. According to Kraus and Jordan, the primary central incisor begins to

calcify at approximately what week in utero?
(a) first
(b) third
(c) seventh
(d) fourteenth
(e) twentieth

5. Disturbances in the initiation stage of tooth development may result in

(a) continued budding of the enamel organ
(b) congenital absence of a primary tooth
(c) congenital absence of a permanent tooth
(d) all of the above
(e) only (b) and (c)
6. Law and Lunt believe which primary teeth in the maxilla erupt earlier than
those in the mandible?
(a) lateral incisor, first molar, canine
(b) central incisor, lateral incisor, first molar
(c) only the central incisor
(d) only the canine
(e) both the central incisor and canine
7. The greatest tendency for lateral growth in the maxilla will occur with the
eruption of the
(a) lateral incisor
(b) canine
(c) first molar
(d) central incisor
(e) third molar
8. Teething causes
(a) fever
(b) diarrhea
(c) otitis media (middle ear infections)
(d) infection
(e) none of the above
9. Mrs. Smith, Tommys aunt, brings her five-year-old daughter Christine to
you for her first dental visit. On examination, you note that #19 and #30
are just erupting into the oral cavity. Her mother asks if she is getting her
permanent teeth early. You explain that in fact her permanent teeth are
erupting
(a) early
(b) right on time
(c) late
(d) none of the above

10. Usually spontaneous correction of lingually erupted mandibular central

incisors occurs by the age
(a) 5 years
(b) 6 years 2 months
(c) 7years
(d) 8.years 2 months
(e) 9 years 8 months
11. The presence of a distal step will
(a) allow the permanent first molar in the mandible erupt into a
developing Class II malocclusion
(b) permit the maxillary first molar to erupt into a Class I occlusion
(c) encourage the second premolar to erupt early
(d) stimulate no mesial shift
(e) none of the above
12. With a straight terminal plane and no primate spaces, the molar
adjustment mechanism most beneficial for Class I molar relationship will
occur with the
(a) early mesial shift
(b) late mesial shift
(c) exfoliation of the primary incisors
(d) eruption of the permanent incisor
(e) no shift at all
13. Ethel comes to your office for her first dental visit. She is very courteous
and has a very active imagination. She will be a very good patient, says
her mother, Blanche. You would expect her to be about what age?
(a) one year
(b) two years
(c) three years
(d) five years
(e) six years
14. In shaping behavior, which of the following apply?
(a) explain to child on his/her level of understanding
(b) state the goal to the child at the beginning
(c) use the tell-show-do technique
(d) all of the above
(e) only (a) and (c)

15. Most investigators, with few exceptions, reflect a significant correlation

between a childs cooperative behavior during the first dental visit and
(a) childs playmates
(b) sibling rivalry
(c) parental age
(d) socioeconomic status
(e) None of the above
16. According to Baume, spaced primary arches generally produced
(a) initial anterior crowding of the permanent incisors
(b) favorable alignment of the permanent incisors
(c) rotations of the permanent incisors
(d) early eruption of the permanent incisors
(e) none of the above
17. The primary molar flush terminal plane occurs with what frequency in the
population at five years of age?
(a) 25%
(b) 37%
(c) 49%
(d) 57%
(e) 86%
18. Baume classified the type of occlusion based on spaces between the
primary teeth. His closed dentition is termed
(a) Type I
(b) Type II
(c) Type III
(d) Type IV
(e) none of the above
19. What is the percentage of final Class I occlusion at the age of twelve after
all of the adjustment mechanisms are complete?
(a) 3%
(b) 25%
(c) 39%
(d) 59%
(e) 78%

20. The late mesial shift occurs when

(a) the permanent molars erupt
(b) the permanent canines erupt
(c) the primary incisors exfoliate
(d) the primary molars exfoliate
(e) the mandibular incisors erupt.

21. Differences in growth size, direction, velocity, and timing are observed
among individuals. Generally, females mature how many years before
males?
(a) one year
(b) two years
(c) three years
(d) four years
(e) males and females mature at the same time.
22. The incidence of cleft lip and palate in the US according to McDonald,
Avery and Dean is
(a) 1 in 500
(b) 1 in 1500
(c) 1 in 2000
(d) 3 in 750 2000
(e) None of the above
23. Dental specialists on the cleft team include
(a) pediatric dentists and orthodontists
(b) oral surgeons and maxillofacial prosthodontists
(c) oral pathologists and periodontists
(d) all of the above
(e) only (a) and (b)
24. Team care for cleft lip/palate individuals is critical because of the
(a) complexity of the clefting problem
(b) need for specialists in the rehabilitation process
(c) age of the patient
(d) all of the above
(e) only (a) and (b)

25. Multidisciplinary sequencing of treatment in cleft care begins with Stage 1

which consists of
(a) primary dentition stage
(b) late primary or early mixed dentition stage
(c) permanent dentition stage
(d) maxillary orthopedic stage
(e) none of the above
26. Premaxillary retraction in bilateral cleft lip/palate care sometimes is
necessary to
(a) properly align the protruding premaxilla prior to surgery
(b) assist the plastic surgeon in lip closure
(c) help to prevent posterior crossbites
(d) all of the above
(e) only (a) and (b)
27. Which primary tooth is most frequently missing in bilateral cleft lip and
palate patients?
(a) central incisor
(b) lateral incisor
(c) canine
(d) first molar
(e) second molar
28. The fundamental problem in cleft lip/palate rehabilitation is
(a) mandibular hypoplasia
(b) cranial base dysmorphology
(c) maxillary hypoplasia
(d) posterior cranial suture fusion
(e) premaxillary extension
29. Treatment of dental alignment issues that arise during Stage III of cleft
palate rehabilitation concentrate on
(a) correction of a developing traumatic occlusion in the anterior area
(b) posterior segmental alignment and crossbite correction
(c) preparation for alveolar bone grafting
(d) all of the above
(e) only (a) and (c)

30. Sometimes it is necessary to perform a LeFort I maxillary advancement in

cleft patients in Stage V rehabilitation to correct a severely retrusive
maxilla. This procedure is done in females around
(a) 10 years of age
(b) 12 years of age
(c) 15 years of age
(d) 18 years of age
(e) 25 years of age
31. The purpose of secondary alveolar bone grafting in either unilateral or
bilateral cleft patients is to
(a) provide boney support for the teeth adjacent to the cleft
(b) provide bone through which teeth can erupt
(c) support the alar base of the nose
(d) all of the above
(e) only (a) and (b)
32. What is the prevalence of isolated cleft lip in all clefting patients?
(a) 25%
(b) 40%
(c) 60%
(d) 75%
(e) 80%
33. Neural tissue has attained what percent of adult size at birth?
(a) 20-30
(b) 30-45
(c) 60-70
(d) 75-85
(e) 90+
34. Which of the following is true?
(a) different parts of the craniofacial complex grow at different rates
(b) growth of primary cartilage and functioning spaces has little
directing influence on craniofacial pattern change
(c) growth of the head and face tends to demonstrate relative
equivalency
(d) all of the above
(e) only (a) and (c)

35. The maximum velocity or peak height velocity of growth is attained

approximately how many years after pubertal onset?
(a) 6 months
(b) 1 year
(c) 2 years
(d) 3 years
(e) 4 years
36. Ideal arch pattern for a 7 year old child might include
(a) tight proximal contacts
(b) curved occlusal plane
(c) excessive leeway space
(d) all of the above
(e) only (a) and (c)
37. In general, there are a number of ways available to increase the dental
arch space. These include
(a) move molars distally
(b) reduce the number of teeth in the dental arch by extraction
(c) decrease the mesial-distal dimension of the teeth present in the
arch
(d) all of the above
(e) only (a) and (b)

38. Early childhood caries generally demonstrates a typical pattern of carious

involvement. Which of the following teeth are generally not involved?
(a) Maxillary central incisors
(b) Mandibular central incisors
(c) Maxillary primary first molars
(d) Mandibular primary first molars
39. Which of the following would be the appropriate age specific oral home
care for a healthy 4 year old child?
(a) Soft bristle toothbrush, with non-fluoridated toothpaste.
(b) Soft bristle toothbrush, with a pea-sized amount of fluoridated
toothpaste.
(c) Moistened cloth wrapped around the parents finger to remove
plaque.
(d) Powered toothbrush with non-fluoridated toothpaste.

40. Which of the following symptoms would be expected with an acute

alveolar abscess?
(a) slight fever, with one or more teeth exhibiting percussion
sensitivity
(b) Lymphadenopathy
(c) Established fistula on the buccal alveolar ridge.
(d) Well defined radiographic periapical or furcation lesion.
41. Which of the following statements best define a hamartoma?
(a) Abnormal, disorganized tissue growth
(b) A tumor with components of all germ layers, ectoderm, mesoderm,
and endoderm.
(c) Normal tissue, but growing in an area it would not normally be
expected to be in.
(d) Normal tissue in an area it would be expected to be, but
growing in a disorganized mass.
42. While conducting a clinical examination you count one additional crown,
but radiographs reveal a normal number of roots. Your diagnosis would
be:
(a) Fusion
(b) Germination
(c) Dens in Dente
(d) Acrodynia
43. Which of the following are true regarding hypophosphatasia?
(a) Tooth loss may be spontaneous or due to minor trauma
(b) Tooth loss occurring without severe gingival inflammation
(c) Primary teeth retained longer than expected.
(d) Both A and B are correct
44. Enamel hypoplasia resulting from local infection is often called:
(a) Acrodynia
(b) Cherubism
(c) Turners tooth
(d) Pre-eruptive caries

45. The following symptoms describe which disorder or syndrome? Teeth are
reddish-brown to gray in appearance with little enamel remaining. The
exposed dentin easily is abraded.
(a) Ectodermal Dysplasia
(b) Dentin Dysplasia
(c) Amelogenesis Imperfecta
(d) Dentinogenesis Imperfecta
46. Which of the following statements is true regarding Amelogenesis
Imperfecta?
(a) Abnormal root morphology
(b) Abnormal pulpal outline
(c) Affects the primary dentition only
(d) Affects enamel only
47. A mother brings her eight year old son, Bobby, to your office. She is
concerned about the 3mm space that exists between teeth # 8 and 9.
During your clinical exam you find an abnormal maxillary labial frenum
attachment. Your recommendation is:
(a) Schedule laser tissue recontouring of the frenum within six weeks.
(b) Refer to an orthodontist to close the space with conventional
orthodontics.
(c) Advise the mother to wait until the maxillary canines have
erupted.
(d) Tell the mother that it is normal and nothing can or should be done
.
48. Six year old Mary presents to your office. After radiographs are taken you
perform a clinical exam. You observe the following symptoms:
Hypodontia with remaining teeth conical in appearance, deficient alveolar
ridges and protrusive lower lip. Your initial diagnosis for Mary is
(a) Amelogenesis Imperfecta
(b) Dentinogenesis Imperfecta
(c) Dentin Dysplasia
(d) None of the above

49. Five year old Jimmy presents to your office for an exam. His mother is
concerned about a large bump that she noticed on his lower lip. Mom has
been aware of the bump for more than two months. Mom reports the
bump does not change size, but occasionally becomes red (she suspects
that Jimmy is biting the bump). Your exam reveals a smooth domeshaped benign lesion of loose connective tissue, and the lesion does not
blanch with pressure. Your diagnosis is
(a) Mucocele
(b) Fibroma
(c) Odontoma
(d) Hemangioma
50. While performing a clinical exam on three year old Sally, you observe a
hemangioma on her tongue. After explaining to Sallys apprehensive
mother what a hamangioma is, she asks what you are going to do about it.
The best recommended treatment is
(a) Surgical excision
(b) Prescribe antibiotics
(c) Advise that this type of lesion often will go away by itself. If not a
laser can be used for removal.
(d) All of the above are correct
51. A lesion that radiographs reveal is expansile in nature and associated
with the crown of an unerupted tooth best describes a.
(a) Dentigerous cyst
(b) Fibroma
(c) Central giant cell granuloma
(d) Congenital epulis
52. What is the best treatment for an eruption cyst?
(a) Anesthetize the patient and surgically incise the cyst exposing the
incisal edge of the erupting tooth.
(b) Prescribe antibiotics.
(c) Advise the parents that the cyst will resolve on its own as the
tooth erupts.
(d) Recommend an aspirational biopsy be performed.

53. Your assistant brings you a periapical radiograph taken on seven year old
Molly. The radiograph reveals a large lesion consisting of several small
radiopacities in the area of the mandibular premolar region that does not
resemble a tooth. After the lesion is removed it is sent off for biopsy. The
histology report reveals that the lesion consists of small formations of
enamel and dentin. The correct diagnosis would be
(a) Ameloblastoma
(b) Complex odontoma
(c) Odontogenic keratocyst
(d) Ossifying fibroma
54..Baby Jessica was born with a large, pink, smooth, pedunculated mass
arising from her maxillary anterior alveolar ridge. What is the correct
diagnosis and best recommended treatment of this type of lesion?
(a) Congenital Epulis requiring surgical excision.
(b) Congenital Epulis requiring no treatment.
(c) Hemangioma requiring no treatment.
(d) Central giant cell granuloma requiring surgical excision
55. Dissolution of enamel begins to occur at which pH?
(a) 5.0
(b) 5.5
(c) 6.0
(d) 6.5
56. Once cavitation of enamel occurs it cannot be remineralized. Caries in
cavitated enamel cannot become arrested.
(a) The first and second statements are true
(b) The first and second statements are false
(c) The first statement is true, and the second statement is false.
(d) The first statement is false, and the second statement is true.
57. Which of the following statements is true regarding caries?
(a) Multi-factorial and self limiting disease.
(b) Communicable and non-preventable disease
(c) Infectious disease which cannot be treated with a simple
course of
antibiotics.
(d) None of the above are true.

58. Which of the following statements is an example of indirect transmission

of caries?
(a) Mother and child sharing the same spoon.
(b) Aunt Mildred kissing her 18 month old niece.
(c) Infant touching older brothers mouth.
(d) None of the above.
59. All of the following characteristics are true except one. Which is the
exception?
(a) Enamel calcification is not complete at the time of tooth eruption.
(b) Permanent molars often have deep and non-coalesced pits and
fissures.
(c) Crowded and misaligned teeth are more difficult to clean and
therefore more likely to become carious.
(d) Children do not acquire the bacterium that creates caries until
after three years of age.
60. Which of the following statements is correct regarding the Caries-risk
Assessment Tool (CAT)?
(a) CAT provides a means of classifying what a childs caries risk will
be during infancy only and can not be applied to any child older than 3
years of age.
(b) CAT renders a diagnosis.
(c) Individuals using CAT must be familiar with the clinical
presentation of caries.
(d) A childs Caries-risk Assessment does not change and once a child
is assigned a risk level that level will remain constant.