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Indirect pulp capping procedures on primary molars are indicated when:

 # Indirect pulp capping procedures on primary molars are indicated when:
A. Removal of decay has exposed the pulp
B. A tooth has a large, long-standing lesion with a history of continuous pain
C. The carious lesion has just penetrated to DEJ
D. The carious lesion is suspected of producing exposure of the pulp



The correct answer is C. The carious lesion has just penetrated to DEJ. 

Indirect Pulp Treatment (IPT)
• Indications: tooth with deep carious lesion, vital pulp
• Objectives: preservation of vitality, arrest of caries advance, formation of tertiary dentin.
• Technique: excavation of most affected dentin, application of medicament over thin layer of sound or carious dentin with no clinically evident pulpal exposure, place Ca(OH)2 or glass ionomer cement, restoration should seal completely, e.g. stainless steel crown
• re-entry for completion of caries removal is not necessary.

Reference: AAPD Handbook of Pediatric Dentistry, Third Edition. Page no 79

The most caries susceptible teeth in permanent dentition are:

 # The most caries susceptible teeth in permanent dentition are:
A. Lower anterior
B. Second bicuspids
C. First molars
D. Second molars



The correct answer is C. First molars.

Based on the data analyses of the present study, it is concluded that first permanent molars had greatest caries prevalence followed by second permanent molars. Statistically significant associations were found between caries in first permanent molars and caries in other permanent teeth particularly central incisors, premolars, and second molars. Dental caries develops soon after the eruption of permanent first molars and can transmit to other permanent teeth; therefore, school-based oral health promotion programs should address younger children so that high prevalence of caries can be controlled in adolescents with early prevention. Oral health education should be raised in the community through oral health campaigns. Adequate access to public preventive and restorative dental programs and services should be ensured for all the children.

Reference:  First Permanent Molar Caries and its Association with Carious Lesions in Other Permanent Teeth, Muhammad Ashraf Nazir1 , Eman Bakhurji2 , Balgis Osman Gaffar3 , Asim Al-Ansari4 , Khalifa Sulaiman Al-Khalifa5


Natal teeth are seen:

 # Natal teeth are seen:
A. Within first 30 days of birth
B. Erupt at three months of age
C. At the time of birth
D. At 6 months of age


The correct answer is C. At the time of birth.

The prevalence of natal teeth (teeth present at birth) and neonatal teeth (teeth that erupt during the first 30 days) is low. Leung conducted a retrospective study of hospital records of 50,892 infants born in Calgary, Alberta (Canada). 27 These records identified 15 infants found to have natal teeth, a prevalence of 1 in 3392 births. In another survey Kates and colleagues found the calculated prevalence of natal teeth to be 1 in 3667 among 11,000 infants when the survey information was obtained indirectly; however, in a group of 7155 infants actually examined, the prevalence was found to be 1 in 716.28.

Reference: McDONALD AND AVERY’S DENTISTRY FOR THE CHILD AND ADOLESCENT, TENTH EDITION  Page: 355


Delayed eruption of at least part of the dentition is a recognized feature of all of the following EXCEPT:

 # Delayed eruption of at least part of the dentition is  a recognized feature of all of the following EXCEPT:
A. Rickets
B. Congenital hyperthyroidism
C. Cleidocranial dysplasia
D. Cherubism



The correct answer is B. Congenital hyperthyroidism.

DELAYED ERUPTION is seen in conditions like:
# Systemic conditons
• Rickets
• Down syndrome
• Hypopituitarism
• Cleidocranial dysplasia
• Achondroplasia
• Cretinism (Congenital Hypothyroidism)
• Fibromatosis gingiva
• Cherubism

# Local conditions
• Fibromatosis gingivae
• Premature exfoliation of primary teeth
• Thickened gingiva

In hyperthyroidism, premature shedding of deciduous teeth and accelerated eruption of permanent teeth is seen.

Reference: Dental Pulse, 9th Edition Volume2 Page No. 604

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