MFDS Part 1 - Membership of Faculty of Dental Surgery Paediatric Dentistry Principles Questions and Answers — Questions and Answers
Question 1: A 5-year-old child attends for their first dental examination and is visibly anxious. According to standard UK practice, which of the following non-pharmacological behaviour management techniques should be employed first to introduce the child to the clinical environment and instruments?
- Tell-Show-Do (Correct answer)
- Negative reinforcement
- Hand-over-mouth exercise (HOME)
- Voice control
Correct answer: Tell-Show-Do
Tell-Show-Do is a fundamental and widely accepted technique in paediatric dentistry for introducing a new or potentially anxiety-provoking procedure. It involves explaining the procedure in simple terms (Tell), demonstrating it, for example on a model or the clinician's finger (Show), and then performing it on the child (Do). This technique builds trust and desensitises the child. Voice control is a component of communication, but not a standalone introductory technique. Negative reinforcement and HOME are considered outdated and inappropriate techniques in modern UK paediatric dentistry.
Question 2: A dentist is planning to restore a carious primary molar in a 6-year-old child using the Hall Technique. Radiographic and clinical examination are essential to determine suitability. Which of the following findings is a definitive contraindication for this technique?
- The child has moderate dental anxiety.
- The carious lesion involves two surfaces of the tooth.
- Clinical signs of a dental abscess related to the tooth. (Correct answer)
- A clear band of dentine is visible between the caries and the pulp on the radiograph.
Correct answer: Clinical signs of a dental abscess related to the tooth.
The Hall Technique is a biological approach that seals caries within the tooth, and it is only suitable for vital teeth with no evidence of irreversible pulpitis or infection. Clinical signs of a dental abscess (such as swelling, a sinus tract, or spontaneous pain) or radiographic evidence of periradicular pathology are absolute contraindications, as the tooth is non-vital and requires extraction or pulpectomy. The technique is often used for anxious children and is designed for multi-surface lesions. A clear band of dentine on the radiograph is an indicator that the technique may be suitable.
Question 3: A 3-year-old child presents after a fall, having intruded their maxillary primary central incisor (51). Clinically, the tooth is barely visible. A radiograph confirms the apex has been displaced buccally, away from the developing permanent tooth germ. According to the International Association of Dental Traumatology (IADT) guidelines followed in the UK, what is the most appropriate management?
- Surgical repositioning and splinting of the tooth.
- Immediate extraction to prevent damage to the permanent tooth.
- Prescription of systemic antibiotics and active surveillance.
- Advise the parent to monitor for spontaneous re-eruption. (Correct answer)
Correct answer: Advise the parent to monitor for spontaneous re-eruption.
For an intruded primary tooth, especially when the apex is displaced buccally (away from the permanent successor), the standard of care is to allow for spontaneous re-eruption. This typically occurs over several months. Active intervention like surgical repositioning or extraction is generally avoided unless there is evidence of infection or the apex is impinging on the permanent tooth germ, as these interventions carry their own risk of iatrogenic damage to the successor.
Question 4: According to the 'Delivering Better Oral Health' toolkit, a key evidence-based guide for prevention in the UK, which material is recommended as the first choice for fissure sealing permanent molars in children?
- Glass-ionomer based sealant
- Resin-based sealant (Correct answer)
- Compomer-based sealant
- Polyacid-modified composite resin sealant
Correct answer: Resin-based sealant
The 'Delivering Better Oral Health' toolkit explicitly recommends resin-based sealants as the first-choice material for fissure sealing permanent molars. This recommendation is based on strong evidence demonstrating their superior long-term retention and effectiveness in preventing dental caries compared to other materials. Glass-ionomer sealants are noted as a useful alternative where moisture control is difficult, but they are not the primary choice.
Question 5: In the UK, the care of children with a cleft lip and/or palate is managed by centralised NHS cleft services following a specific treatment timeline. At approximately what age is the primary surgical repair of a cleft lip typically performed?
- 3 months (Correct answer)
- 12 months
- Within the first week of life
- 18 months
Correct answer: 3 months
The standard protocol in UK cleft centres is to perform the primary lip repair surgery when the baby is around 3 months old. This timing allows the infant to establish feeding and gain weight, and is often guided by the 'rule of tens' (e.g., 10 weeks old, 10 pounds weight). The repair of a cleft palate is performed later, typically between 6 and 12 months of age.
Question 6: A 7-year-old child, assessed as having a high risk of developing caries, attends for an examination. Her primary molars are in contact, preventing visual inspection of the interproximal surfaces. In line with the Faculty of General Dental Practice (UK) 'Selection Criteria for Dental Radiography', what is the recommended maximum interval for taking posterior bitewing radiographs for this child?
- Every 24 months.
- Every 12 months.
- Every 6 months. (Correct answer)
- Only when symptoms arise.
Correct answer: Every 6 months.
The FGDP (UK) guidelines recommend that for children assessed as being at high risk of caries, posterior bitewing radiographs should be taken at 6-monthly intervals once posterior contacts are closed. This increased frequency is justified by the need for early detection of lesions in patients who are more susceptible to rapid caries progression. For low-risk children, the interval can be extended to 12-24 months.
MFDS Part 1 - Membership of Faculty of Dental Surgery Paediatric Dentistry Principles Questions and Answers
A 5-year-old child attends for their first dental examination and is visibly anxious.
According to standard UK practice, which of the following non-pharmacological behaviour management techniques should be employed first to introduce the child to the clinical environment and instruments?