Diploma of the Faculty of Dental Surgery (MFDS) Paediatric Dentistry and Orthodontics Syllabus

Paediatric Dentistry and Orthodontics syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Paediatric Dentistry and Orthodontics in Diploma of the Faculty of Dental Surgery (MFDS), not a summary of it.

1. 1

   Child Development and Behaviour Management

   4 topics

   • Tooth eruption and dental development
     • Primary, mixed and permanent dentition stages
   • Behaviour management techniques
     • Tell-show-do and acclimatisation
   • Communicating with children and parents
   • Dental anxiety in children
2. 2

   Caries Management in Children

   5 topics

   • Caries risk assessment in the young patient
   • Restoration of primary teeth
     • Hall technique and preformed metal crowns
   • Pulp therapy in primary teeth
     • Pulpotomy and pulpectomy
   • Management of early childhood caries
   • Prevention strategies for children
3. 3

   Paediatric Trauma and Developmental Anomalies

   4 topics

   • Management of dental trauma
     • Avulsion, luxation and crown/root fractures
     • IADT guidelines and follow-up
   • Enamel and dentine defects
     • Molar incisor hypomineralisation, amelogenesis imperfecta
   • Hypodontia and supernumerary teeth
   • Non-accidental injury and safeguarding children
4. 4

   Orthodontic Assessment and Management

   5 topics

   • Malocclusion classification
     • Incisor and molar relationships, IOTN
   • Orthodontic assessment and records
   • Management of the developing dentition
     • Space maintenance and interceptive treatment
   • Recognising malocclusions requiring referral
   • Retention and stability principles

Paediatric Dentistry and Orthodontics flashcards for Diploma of the Faculty of Dental Surgery (MFDS)

25 of 53 cards from the Paediatric Dentistry and Orthodontics deck — real questions with worked answers.

1. At what age do the first primary teeth (mandibular central incisors) typically erupt, and when is the primary dentition usually complete?

   Mandibular central incisors erupt at around 6 months; the primary dentition (20 teeth) is usually complete by approximately 2.5-3 years of age.

2. State the typical eruption sequence of the primary teeth.

   Central incisor (A) → lateral incisor (B) → first molar (D) → canine (C) → second molar (E). Note the first molar erupts before the canine.

3. When does the first permanent tooth typically erupt, and which tooth is it?

   At approximately 6 years of age, the first permanent molar (the 'six-year molar') erupts, usually before or alongside the lower central incisors.

4. What is the difference in eruption timing referred to as the 'ugly duckling stage'?

   A transient developmental malocclusion (around 8-9 years) where erupting permanent canines press on lateral incisor roots, causing flaring/spacing of the upper incisors. It is normal and usually self-corrects as canines erupt.

5. Describe the Tell-Show-Do behaviour management technique.

   A graded exposure technique: Tell the child what will happen in age-appropriate language, Show the instrument/procedure on a tooth or model, then Do the procedure. It familiarises and desensitises the child, reducing anxiety.

6. What is 'voice control' as a behaviour management technique, and a key caution?

   A sudden, firm alteration in tone/volume/pace to gain attention and stop unwanted behaviour. Caution: it must not be perceived as aggressive or shaming; parental consent/understanding is advisable as some find it controversial.

7. Define 'positive reinforcement' and 'distraction' in paediatric behaviour management.

   Positive reinforcement: rewarding desired behaviour (praise, stickers) to increase its recurrence. Distraction: diverting the child's attention (stories, music, video) away from the procedure to reduce perceived stress.

8. What behaviour management technique is now generally considered unacceptable/outdated in modern UK paediatric dentistry?

   Hand-over-mouth exercise (HOME), and physical restraint without consent. These are no longer endorsed; modern practice emphasises consent-based, non-aversive techniques.

9. Name three principles of effective communication with a young child in the dental setting.

   Use simple age-appropriate language (avoid frightening words like 'needle/drill', use euphemisms), get down to the child's eye level, and use positive non-threatening vocabulary (e.g. 'sleepy juice', 'tooth counter').

10. Why is communicating with the parent as well as the child important, and what is one pitfall?

    Parents provide history, consent, and reinforce behaviour at home. Pitfall: an anxious parent can transmit anxiety to the child; sometimes asking an over-anxious parent to remain quiet/observe helps the child cooperate.

11. What is the difference between dental anxiety, dental fear, and dental phobia in children?

    Anxiety: anticipatory unease about a future dental event. Fear: reaction to a specific perceived threat present in the moment. Phobia: a persistent, excessive, irrational fear leading to avoidance, often disproportionate to actual threat.

12. Name a validated tool used to assess dental anxiety in children.

    The Modified Child Dental Anxiety Scale (MCDAS / MCDASf with faces), and the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS).

13. List the main factors assessed in a caries risk assessment for a child.

    Diet (sugar frequency), fluoride exposure, oral hygiene/plaque control, past caries experience, social/medical history, saliva, and clinical/radiographic findings. Past caries experience is the strongest predictor of future caries.

14. What fluoride toothpaste concentration is recommended for a high-caries-risk child aged 0-3 in the UK (Delivering Better Oral Health)?

    For high-risk children under 3, use toothpaste containing at least $1000\,\text{ppm}$ fluoride. Standard healthy children under 3 use a smear of $\geq 1000\,\text{ppm}$ paste.

15. What fluoride toothpaste strength is recommended for high-caries-risk children aged 10+ in the UK?

    $2800\,\text{ppm}$ fluoride toothpaste may be prescribed for high-risk children aged 10 and over; $5000\,\text{ppm}$ for those 16 and over.

16. How often should fluoride varnish be applied for caries prevention in children, and at what concentration?

    Fluoride varnish ($22{,}600\,\text{ppm}$, i.e. $2.26\%$ NaF / Duraphat) applied at least twice yearly, and up to 4 times yearly for high-risk children.

17. What restorative material is commonly used for primary teeth and why is it advantageous?

    Glass ionomer cement and resin-modified GIC are widely used because they chemically bond to tooth, release fluoride, and are moisture-tolerant. For multi-surface caries, preformed (stainless steel) crowns are the most durable option.

18. What is the Hall Technique for managing carious primary molars?

    A biological, minimally invasive method where a preformed metal (stainless steel) crown is cemented over a carious primary molar with no caries removal, no local anaesthetic, and no tooth preparation, sealing the caries to arrest it.

19. What is the principle behind sealing caries (e.g. Hall crowns, fissure sealing over caries)?

    Isolating the carious lesion from the oral biofilm and dietary substrate deprives cariogenic bacteria of nutrients, arresting lesion progression without complete caries removal.

20. When is pulpotomy indicated in a primary tooth, and what does it involve?

    Indicated for reversible/coronal pulpitis with a vital radicular pulp and carious exposure. It involves removing the coronal pulp, placing a medicament (e.g. ferric sulphate, MTA, or Biodentine) over the radicular stumps, then restoring (usually with a preformed crown).

21. What is the difference between a pulpotomy and a pulpectomy in primary teeth?

    Pulpotomy: removal of coronal pulp only, radicular pulp left vital. Pulpectomy: complete removal of coronal and radicular pulp, canals filled with a resorbable material (e.g. zinc oxide-eugenol or iodoform paste) — indicated for irreversible pulpitis or necrosis.

22. Why must non-resorbable materials (e.g. gutta-percha) be avoided in primary tooth root fillings?

    Primary tooth roots physiologically resorb before exfoliation; the root filling must resorb with the root. Resorbable pastes (ZOE, iodoform-based) are used so they do not impede eruption of the permanent successor.

23. Define Early Childhood Caries (ECC) and Severe ECC (S-ECC).

    ECC: presence of one or more decayed (cavitated or non-cavitated), missing (due to caries) or filled tooth surfaces in any primary tooth in a child under 6. S-ECC: any smooth-surface caries under age 3, or specific dmfs thresholds at given ages.

24. What feeding habit is the classic cause of 'nursing/bottle caries' and which teeth are affected/spared?

    Prolonged/nocturnal bottle feeding with sugary drinks or on-demand breastfeeding. Maxillary incisors are affected first; the mandibular incisors are typically spared (protected by the tongue and saliva from sublingual glands).

25. Outline the key prevention strategies (the 'evidence-based prevention' package) for children.

    Twice-daily brushing with fluoride toothpaste (supervised, spit don't rinse), dietary advice to reduce sugar frequency, fluoride varnish application, fissure sealants on permanent molars, and regular recall based on risk.

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