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DGPD 711 2006

Introduction to Pediatric Dentistry


Final Examination
May 9, 2006
1.

Mary Helen comes to your office for her first dental visit. She is very
courteous and says please and thank you. You would expect her to be
about what age?
(a)
(b)
(c)
(d)
(e)

2.

explain to child on his/her level of understanding


dont disregard minor inappropriate behavior
use the tell-show-do technique
all of the above
only (a) and (c)

Most investigators, with few exceptions, reflect a significant correlation


between a childs cooperative behavior during the first dental visit and
(a)
(b)
(c)
(d)
(e)

4.

one year
two years
three years
four years
six years

In shaping behavior, which of the following apply?


(a)
(b)
(c)
(d)
(e)

3.

Name______________________

maternal anxiety
sibling rivalry
parental age
childs playmates
all of the above

Mrs. Jones 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)
(b)
(c)
(d)
(e)

80-89
69-79
52-68
36-51
20-35

5.

The average age at which a child can walk alone is


(a)
(b)
(c)
(d)
(e)

6.

Which of the following can play a role in preappointment behavior


modification?
(a)
(b)
(c)
(d)
(e)

7.

first
third
sixth
ninth
eleventh

A supernumerary tooth is the result of


(a)
(b)
(c)
(d)
(e)

9.

films or videotapes of cooperative young patients


modeling by parent on recall visit
preappoingment mailings
all of the above
only (a) and (c)

According to Kraus and Jordan, the first macroscopic indication of


morphologic tooth development occurs at approximately what week in
utero?
(a)
(b)
(c)
(d)
(e)

8.

2 months
4 months
7 months
11 months
13 months

continued budding of the enamel organ


failure of the tooth germ to develop
a molecular accident in the apposition stage
lack of inorganic calcium salts for deposition in the enamel matrix
failure of the dental papilla to give rise to odontoblasts

Disturbances in the histodifferentation stage of tooth development will


result in
(a)
(b)
(c)
(d)
(e)

abnormal number of teeth


an odontoma
abnormal structure of enamel or dentin
a missing tooth
only (a) and (d)

10.

There is considerable resemblance between the maxillary primary second


molar and the
(a)
(b)
(c)
(d)
(e)

11.

The primary teeth are


(a)
(b)
(c)
(d)
(e)

12.

usually smaller mesiodistally than their successors


are similar in size and resemble each other
do not have permanent successors
usually larger mesiodistally than their successors
only (b) and (c)

Mrs. Duckworth brings her six and one-half year old daughter Barbel to
you for her first dental visit. On examination, you note that #24 and #25
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)
(b)
(c)
(d)

14.

always larger than their permanent counterparts


lighter in color than permanent teeth
without nerve innervation
all calcified after birth
completely calcified before birth

The mandibular first and second primary molar crowns are


(a)
(b)
(c)
(d)
(e)

13.

maxillary primary first molar


maxillary primary canine
maxillary permanent first molar
mandibular permanent first molar
mandibular permanent second molar

early
right on time
late
none of the above

This is your second day of practice and you see Amy, a two year and nine
months old child who shows you her three dolls she brought to the office.
On oral examination, according to Lunt and Law how many teeth should
she have?
(a)
(b)
(c)
(d)
(e)

four
eight
twelve
sixteen
all twenty

15.

Mrs. Brown brings her son Tom to the office for a routine recall
examination. She inquires about sealants and the appropriate time to
place them on Toms first permanent molars. You explain to her that
these teeth, according to Logan and Kronfeld, erupt between _________
and that as soon as they have cleared the tissue on the distal of the tooth,
he may be ready for this preventive measure.
(a)
(b)
(c)
(d)
(e)

16.

Kurt had #L surgically removed due to internal resorption at age nine. You
would expect # 21 to
(a)
(b)
(c)
(d)
(e)

17.

erupt early
come in at the normal time
be delayed in eruption
be malformed
may not erupt at all

Conditions that can delay the eruption teeth include


(a)
(b)
(c)
(d)
(e)

18.

5-6 years
6-7 years
7-8 years
8-9 years
9-10 years

Trisomy 21
cleidocranial dysplasia
hypothyroidism
all of the above
only (a) and (b)

Usually spontaneous correction of lingually erupted mandibular central


incisors occurs by the age
(a)
(b)
(c)
(d)
(e)

5 years
6 years 2 months
7 years
8 years 2 months
9 years 8 months

19.

Differences in growth size, direction, velocity, and timing are observed


among individuals. Generally, females mature how many years before
males?
(a)
(b)
(c)
(d)
(e)

20.

The presence of a mesial step will


(a)
(b)
(c)
(d)
(e)

21.

early mesial shift


late mesial shift
exfoliation of the primary incisors
eruption of the permanent incisor
no shift at all

The most common feature of dental arch malocclusion is


(a)
(b)
(c)
(d)
(e)

23.

allow the permanent first molar in the mandible erupt into a Class II
occlusion
permit the maxillary first molar to erupt into a Class III occlusion
encourage the second premolar to erupt early
stimulate a late mesial shift
none of the above

With a straight terminal plane and no primate spaces, the molar


adjustment mechanism most beneficial for proper molar relationship will
occur with the
(a)
(b)
(c)
(d)
(e)

22.

one year
two years
three years
four years
males and females mature at the same time.

spacing
crowding
rotations
missing teeth
all of the above

The primary molar mesial step terminus occurs with what frequency in the
population at five years of age?
(a)
(b)
(c)
(d)
(e)

25%
37%
49%
57%
86%

24.

It is desirable to have the mandibular permanent canines erupt before the


(a)
(b)
(c)
(d)
(e)

25.

The greatest tendency for lateral growth in the mandibular arch will occur
with the eruption of the
(a)
(b)
(c)
(d)
(e)

26.

erupt within the first 30 days


are present at birth
are always supernumerary teeth
are mainly primary molars
erupt more slowly than normal

Baume classified the type of occlusion based on spaces between the


primary teeth. His spaced dentition is termed
(a)
(b)
(c)
(d)
(e)

28.

first molars
central incisors
lateral incisors
canines
premolars

Neonatal teeth are those which


(a)
(b)
(c)
(d)
(e)

27.

mandibular first premolar


mandibular first molar
mandibular incisors
mandibular second premolar
both (a) and (d)

Type I
Type II
Type III
Type IV
none of the above

What is the percentage of final occlusion at the age of twelve after all of
the adjustment mechanisms are complete?
(a)
(b)
(c)
(d)
(e)

3%
25%
39%
59%
78%

29.

The late mesial shift occurs when


(a)
(b)
(c)
(d)
(e)

30.

the primate space closes


all permanent canines erupt
the third molars erupt
the primary molars exfoliate
the mandibular incisors erupt.

What microorganism has been implicated as the major and most virulent
of the caries producing microorganism?
(a)
(b)
(c)
(d)
(e)

aciduric lactobacilli
certain strains of sarcinae
streptococcus mutans
diphtheroids
staphylococci

31. In the caries process, a white spot on enamel can best be described as
(a)
(b)
(c)
(d)
(e)

the beginning of dentin destruction


incipient subsurface enamel lesion
plaque buildup
irreversible enamel pathology
monomolecular layer preventing adherence of microorganisms

32. The most common interproximal site for caries in primary teeth is
(a)
(b)
(c)
(d)
(e)
33.

mesial surface of the incisors


distal surface of second mandibular molar
mesial surface of the mandibular first molar
distal surface of the mandibular first molar
mesial surface of the maxillary first molar

According to the AAPD Guidelines for fluoride therapy, if the communal


water supply contains less than .3 ppm of fluoride, the recommended daily
supplement for a 8 year old child would be
(a)
(b)
(c)
(d)
(e)

0
.25 mg
.5 mg.
1.0 mg
none of the above

34.

Remineralization of enamel can best be described as


(a)
(b)
(c)
(d)
(e)

35.

The most common fluoride used in the dental office today is


(a)
(b)
(c)
(d)
(e)

36.

(d)
(e)

Home fluorides are excellent for children of all ages


Fluoride varnishes are easily applied at home
In general, the concentration of fluoride in fluoridated
communal water supplies is .8 to 1.2 ppm
Fluoride supplements can be purchased over-the-counter
There is no eating or drinking for three hours following topical
fluoride treatments in the dental office.

The clinical appearance of early childhood caries (ECC) is seen in the


(a)
(b)
(c)
(d)
(e)

38.

2% NaF
8% SnF2
1.23% APF
.05% NaF
5% NaF

Which of the following is true regarding fluorides?


(a)
(b)
(c)

37.

a dynamic, continuous process of reversed demineralization


the beginning of the carious process
static neutralization of plaque
dynamic replacement of fluoroapatite with hydroxyapatite
formation of new enamel matrix and subsequent enamel deposition

maxillary and mandibular primary anterior teeth


maxillary anterior teeth, maxillary and mandibular first primary
molars, and sometimes the mandibular primary canines
maxillary and mandibular primary anterior teeth, mandibular
primary first molars
maxillary and mandibular first primary molars, mandibular primary
canines, and the mandibular incisors
maxillary anterior primary teeth, mandibular first permanent molars,
mandibular primary canines

The acids that initially decalcify enamel have a pH of


(a)
(b)
(c)
(d)
(e)

7.5 to 7.2
7.0 to 6.8
6.6 to 6.3
6.2 to 5.9
5.5 to 5.2

39.

Which of the following is not true regarding saliva?


(a)
(b)
(c)
(d)
(e)

40.

Low risk caries indicators include


(a)
(b)
(c)
(d)
(e)

41.

five
ten
fifteen
thirty
sixty

The complex etiology of dental decay centers on which of the following


factors?
(a)
(b)
(c)
(d)
(e)

43.

high caregiver socioeconomic status


regular dental care
no caries in the past 24 months
all of the above
only (b) and (c)

Following topical fluoride administration, a patient should not eat, drink, or


rinse for how many minutes after the treatment to maximize fluoride
uptake in the enamel?
(a)
(b)
(c)
(d)
(e)

42.

Salivary secretion can be stimulated by both the parasympathetic


and sympathetic fibers.
Salivary flow decreases during sleep.
Head and neck irradiation results in salivary gland dysfunction.
Complete absence of saliva will result in a septic mouth with
rampant caries.
The viscosity of saliva has no effect on the carious process.

tooth susceptibility
refined carbohydrates
time
all of the above
only (a) and (b)

The most common method for removing plaque from the surfaces of teeth
is
(a)
(b)
(c)
(d)
(e)

floss
water pick
toothbrush
toothpicks
none of the above

44.

A number of variables enter into the design and fabrication of


toothbrushes. These variables include
(a)
(b)
(c)
(d)
(e)

45.

The ideal chemotherapeutic plaque control agent should have


(a)
(b)
(c)
(d)
(e)

46.

quaternary ammonium compounds


pyrimidines
iodine
protease
Listerine

Chlorhexidine is considered a
(a)
(b)
(c)
(d)
(e)

48.

specificity only for pathogenic bacteria


chemical stability during storage
toxicologic safety
ecologic safety so as not to adversely alter the microbiotic flora
all the above

An example of a noncharged phenolic antiseptic agent is


(a)
(b)
(c)
(d)
(e)

47.

the bristle material


length, diameter and number of fibers
angulation of brush head
all of the above
only (a) and (b)

oxygenating agent
halogen
antibiotic
enzyme
positively charged organic molecule

The American Academy of Pediatric Dentistry recommends that the childs


first dental visit should be
(a)
(b)
(c)
(d)
(e)

before birth
approximately at the time of eruption of the first tooth or at
least by one year
as soon as the terrible twos are over
at the age of three
none of the above

49.

Fluoride mouth rinses are not recommended for children under the age of
_____because of the possibility of swallowing too much fluoride.
(a)
(b)
(c)
(d)
(e)

50.

Early exfoliation of primary teeth may be associated with


(a)
(b)
(c)
(d)
(e)

51.

nutritional deficiencies
infected primary molars
radiation
all of the above
only (a) and (c)

The radiographic appearance of dentinogenesis imperfecta consists of


(a)
(b)
(c)
(d)
(e)

53.

hypophosphatasia
fibrous dysplasia
cyclic neutropenia
all of the above
only (a) and (c)

Enamel hypoplasia can be related to which of the following factors:


(a)
(b)
(c)
(d)
(e)

52.

9
8
7
6
5

opalescent color to the teeth


small or obliterated pulp chambers
thin crowns with very bulbous roots
abnormal dentin-enamel junction
all of the above

Clinical features of ectodermal dysplasia (ED) may consist of


(a)
(b)
(c)
(d)
(e)

conical shaped anterior teeth


protuberant lips
congenitally missing teeth
all of the above
only (a) and (c)

54.

Macroglossia may be associated with


(a)
(b)
(c)
(d)
(e)

55.

Taurodontism is best described as


(a)
(b)
(c)
(d)
(e)

56.

(b)
(c)
(d)
(e)

two independent primary or permanent teeth with separate


pulp chambers and separate crowns unite
two crowns develop with one root
two independent teeth develop from one bud
there is continued budding of the enamel organ
none of the above

Many dentists believe that surgery for an abnormal maxillary labial frenum
should be delayed until after the eruption of the permanent lateral incisors
and canines because
(a)
(b)
(c)
(d)
(e)

58.

elongated pulp chambers


elevated number of tooth buds
complete failure of tooth development
abnormally large teeth
none of the above

Fusion occurs when


(a)

57.

hypothyroidism
Beckwith-Wiedemann Syndrome
Downs Syndrome
all of the above
Only (a) and (c)

insurance will not cover the procedure until adulthood


in most cases normal contact between the maxillary central
incisors will develop and the existing diastema will close
the child will not cooperate
only (a) and (c)
none of the above

Tetracycline tooth discoloration is rarely seen today because


(a)
(b)
(c)
(d)
(e)

most infections can be treated with antibiotics that do not


cause tooth discoloration
tetracyclines do not cross the placental barrier
tetracycline is deposited in the enamel and not the dentin
tetracyclines have been taken off the market and are no longer in
use
none of the above

59.

The incidence of cleft lip and palate in the US according to McDonald,


Avery and Dean is
(a)
(b)
(c)
(d)
(e)

60.

Mandibular micrognathia may be associated with


(a)
(b)
(c)
(d)
(e)

61.

complexity of the clefting problem


need for specialists in the rehabilitation process
age of the patient
all of the above
only (a) and (b)

Multidisciplinary sequencing of treatment in cleft care begins with Stage 1


which consists of
(a)
(b)
(c)
(d)
(e)

63.

Robin Sequence
ankylosis of the mandible
Stickler Syndrome
all of the above
only (a) and (c)

Team care for cleft lip/palate individuals is critical because of the


(a)
(b)
(c)
(d)
(e)

62.

1 in 1000
1 in 1500
1 in 2000
3 in 750 2000
1 in 20,000

primary dentition stage


late primary or early mixed dentition stage
permanent dentition stage
maxillary orthopedic stage
none of the above

Premaxillary retraction in bilateral cleft lip/palate care sometimes is


necessary to
(a)
(b)
(c)
(d)
(e)

properly align the protruding premaxilla prior to surgery


assist the plastic surgeon in lip closure
help to prevent posterior crossbites
all of the above
only (a) and (b)

64.

A passive alveolar molding appliance sometimes is necessary to


(a)
(b)
(c)
(d)
(e)

65.

The fundamental problem in cleft lip/palate rehabilitation is


(a)
(b)
(c)
(d)
(e)

66.

correction of a developing traumatic occlusion in the anterior area


posterior segmental alignment
preventing destruction of enamel in the involved dental arches
all of the above
only (a) and (c)

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 males around
(a)
(b)
(c)
(d)
(e)

68.

mandibular hypoplasia
cranial base malfunction
maxillary hypoplasia
posterior cranial suture fusion
premaxillary extension

Treatment of dental alignment issues that arise during Stage III of cleft
palate rehabilitation concentrate on
(a)
(b)
(c)
(d)
(e)

67.

provide cross arch stability


reorient the maxillary frenum toward the mid-sagittal plane
assist in orthopedic molding of the cleft segments
all of the above
only (a) and (c)

10 years of age
12 years of age
15 years of age
18 years of age
25 years of age

The purpose of secondary alveolar bone grafting in either unilateral or


bilateral cleft patients is to
(a)
(b)
(c)
(d)
(e)

provide boney support for the teeth adjacent to the cleft


provide bone through which teeth can erupt
support the alar base of the nose
all of the above
only (a) and (b)

69.

The focus of cleft care in Stage II is


(a)
(b)
(c)
(d)
(e)

70.

focused on establishing and maintaining oral health


primary alveolar bone grafting
corrective orthognathic surgery
placement of orthodontic appliances
palatoplasty

What is the prevalence of cleft lip only in all clefting patients?


(a)
(b)
(c)
(d)
(e)

25%
40%
60%
75%
80%