ORE Part 2 Paediatric Dentistry 1 — Questions and Answers
Question 1: According to NICE guidelines, what is the recommended frequency of bitewing radiographs for a high-caries-risk child aged 6–12 years?
- 6-monthly (Correct answer)
- Annually
- Every 2 years
- Only when symptomatic
Correct answer: 6-monthly
NICE guidelines recommend 6-monthly bitewing radiographs for children at high caries risk to detect interproximal caries early when the primary dentition is fully in contact.
Question 2: What is the recommended management of early enamel caries (d1–d2) in primary molars according to the Caries in Teeth (CiT) traffic light system?
- Non-operative management with fluoride varnish and dietary advice (Correct answer)
- Immediate restoration
- Pulpotomy
- Extraction
Correct answer: Non-operative management with fluoride varnish and dietary advice
Early enamel lesions (d1–d2) in primary teeth should be managed non-operatively with topical fluoride (fluoride varnish 22,600 ppm twice yearly for high risk), dietary counselling, and monitoring.
Question 3: What is the Hall Technique for managing carious primary molars?
- Sealing caries under a preformed metal crown without caries removal (Correct answer)
- Complete caries removal before crown placement
- Using glass ionomer to seal caries only
- Extracting the tooth and placing a space maintainer
Correct answer: Sealing caries under a preformed metal crown without caries removal
The Hall Technique involves placing a preformed stainless steel crown (SSC) over a carious primary molar without caries removal or tooth preparation, sealing bacteria under the crown.
Question 4: What is the most appropriate local anaesthetic for a child undergoing extraction of a lower primary molar?
- 2% lidocaine with 1:80,000 adrenaline (IANB) (Correct answer)
- Topical benzocaine only
- Prilocaine without vasoconstrictor
- Articaine 4% alone
Correct answer: 2% lidocaine with 1:80,000 adrenaline (IANB)
Inferior alveolar nerve block with 2% lidocaine and 1:80,000 adrenaline is the standard anaesthetic for lower primary molar extractions, ensuring complete anaesthesia for the procedure.
Question 5: What is the recommended treatment for a primary tooth with irreversible pulpitis in a cooperative 6-year-old?
- Extraction or pulpectomy if strategic, to prevent damage to underlying permanent tooth (Correct answer)
- Pulpotomy
- Direct pulp cap
- Monitoring without treatment
Correct answer: Extraction or pulpectomy if strategic, to prevent damage to underlying permanent tooth
Irreversible pulpitis in a primary tooth warrants extraction (or pulpectomy if the tooth is strategic for space maintenance), as untreated irreversible pulpitis risks abscess and damage to the permanent successor.
Question 6: Which fluoride varnish concentration is recommended for application in children at high caries risk in the UK?
- 22,600 ppm fluoride (Duraphat 5% varnish) (Correct answer)
- 1,000 ppm
- 2,800 ppm
- 500 ppm
Correct answer: 22,600 ppm fluoride (Duraphat 5% varnish)
Duraphat 5% sodium fluoride varnish (22,600 ppm) is the recommended professional topical fluoride for high-risk children, applied by a dental professional at least twice yearly.
ORE Part 2 Paediatric Dentistry 1
According to NICE guidelines, what is the recommended frequency of bitewing radiographs for a high-caries-risk child aged 6–12 years?