Overseas Registration Exam (ORE) 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 Overseas Registration Exam (ORE), not a summary of it.

1. 1

   Child Assessment and Behaviour Management

   3 topics

   • Examination of the Child Patient and Consent Issues
   • Behaviour Management Techniques
   • Eruption Dates and the Developing Dentition
2. 2

   Management of Dental Caries in Children

   3 topics

   • Restoration of Primary and Young Permanent Teeth
     • Hall technique and preformed metal crowns
     • Indirect and selective caries removal in children
   • Pulp Therapy in Primary Teeth
     • Pulpotomy and pulpectomy indications
   • Vital Pulp Therapy in Immature Permanent Teeth
3. 3

   Preventive Paediatric Dentistry

   3 topics

   • Fluoride: Toothpaste, Varnish and Supplements
   • Fissure Sealants and Diet Advice
   • Delivering Better Oral Health Toolkit Guidance
4. 4

   Developmental Anomalies and Trauma

   3 topics

   • Enamel and Dentine Defects (MIH, Amelogenesis, Dentinogenesis)
   • Hypodontia and Supernumerary Teeth
   • Traumatic Injuries to Primary and Permanent Teeth
5. 5

   Orthodontics

   4 topics

   • Orthodontic Assessment and Classification
     • Incisor and skeletal classification
     • IOTN and indications for treatment
   • Malocclusion and Aetiology
     • Crowding, spacing and crossbites
     • Impacted and ectopic teeth
   • Interceptive Treatment and Space Maintenance
   • Appliances and Referral for Specialist Care

Paediatric Dentistry and Orthodontics flashcards for Overseas Registration Exam (ORE)

25 of 58 cards from the Paediatric Dentistry and Orthodontics deck — real questions with worked answers.

1. What four core elements must be assessed when taking a history and examining a child dental patient?

   Presenting complaint and history, medical/dental/social history, extra-oral and intra-oral examination, and an assessment of the child's cooperation/anxiety level (plus carer interaction). Special senses such as the child's behaviour and developmental stage are also noted.

2. In the UK, who can give valid consent for the dental treatment of a child under 16?

   A person with parental responsibility, or the child themselves if assessed as Gillick competent (having sufficient understanding and intelligence to fully appreciate the proposed treatment).

3. What is the legal concept of 'Gillick competence'?

   A child under 16 may consent to their own treatment without parental knowledge or permission if they have sufficient maturity and intelligence to understand fully what is proposed, including risks and alternatives.

4. What are the Fraser guidelines originally concerned with?

   They set out criteria for providing contraceptive/sexual health advice and treatment to under-16s without parental consent; often used interchangeably with Gillick competence for assessing a young person's capacity to consent.

5. List the non-pharmacological behaviour management technique known as 'Tell-Show-Do'.

   Tell: explain the procedure in age-appropriate language. Show: demonstrate the procedure (sights, sounds, sensations) in a non-threatening way. Do: carry out the procedure exactly as shown, with minimal delay.

6. Define 'positive reinforcement' as a behaviour management technique.

   Strengthening desired behaviour by rewarding it (praise, stickers, tokens), increasing the likelihood the child repeats cooperative behaviour.

7. What is 'voice control' in paediatric behaviour management?

   A controlled alteration of voice volume, tone or pace to influence and direct the child's behaviour and gain attention; should be used judiciously and explained to carers beforehand.

8. What pharmacological options are available for managing an anxious child in dentistry?

   Inhalation sedation with nitrous oxide/oxygen (relative analgesia), oral/intravenous conscious sedation, and general anaesthesia for the most uncooperative children or extensive treatment needs.

9. At what ages do the primary (deciduous) teeth typically begin and complete eruption?

   Eruption begins around 6 months (lower central incisors) and the full primary dentition of 20 teeth is usually complete by approximately 2.5-3 years of age.

10. State the usual eruption sequence of primary teeth.

    Central incisor (A) ~6-10 months, lateral incisor (B) ~10-16 months, first molar (D) ~13-19 months, canine (C) ~16-23 months, second molar (E) ~23-33 months.

11. At what age do the first permanent molars and lower central incisors typically erupt?

    Approximately 6 years of age, marking the start of the mixed dentition stage.

12. Give the approximate eruption ages of the permanent maxillary teeth.

    Central incisor 7-8 yrs, lateral incisor 8-9 yrs, canine 11-12 yrs, first premolar 10-11 yrs, second premolar 10-12 yrs, first molar 6-7 yrs, second molar 12-13 yrs, third molar 17-21 yrs.

13. What is the 'ugly duckling' stage of dental development?

    A normal transient stage (~8-9 yrs) where the maxillary permanent incisors erupt with a midline diastema and distal crown tipping, caused by developing canines pressing on the incisor roots; it self-corrects as canines erupt.

14. Why are primary teeth more susceptible to rapid caries progression than permanent teeth?

    They have thinner enamel and dentine, larger pulp horns closer to the surface, and broad flat contact areas, so caries reaches the pulp faster.

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

    A biological/non-invasive method where a preformed metal (stainless steel) crown is cemented over a carious primary molar without local anaesthesia, caries removal or tooth preparation, sealing the lesion to arrest it.

16. What restorative material is generally preferred for restoring primary molars in load-bearing situations and why?

    Preformed metal (stainless steel) crowns, because they have superior longevity and lower failure/re-treatment rates compared with intracoronal restorations in multi-surface primary molar caries.

17. What is the difference between indirect and direct pulp capping?

    Indirect pulp capping leaves a thin layer of carious/affected dentine over the pulp and places a protective lining to avoid exposure. Direct pulp capping places a material (e.g. calcium hydroxide or MTA) directly onto a small exposed but healthy pulp to maintain vitality.

18. Define pulpotomy in a primary tooth.

    Removal of the coronal pulp tissue while retaining the vital radicular (root) pulp, which is then treated with a medicament (e.g. ferric sulfate, MTA) and the tooth restored, usually with a preformed metal crown.

19. When is a pulpectomy indicated in a primary tooth, and what does it involve?

    Indicated when the radicular pulp is irreversibly inflamed or necrotic. It involves removing all coronal and radicular pulp tissue and obturating the canals with a resorbable material such as zinc oxide-eugenol or iodoform/calcium hydroxide paste.

20. What medicament has largely replaced formocresol for primary molar pulpotomies and why?

    Ferric sulfate and MTA, because of concerns over formocresol's toxicity, mutagenicity and potential carcinogenicity.

21. What is apexogenesis in an immature permanent tooth?

    A vital pulp therapy aiming to preserve the vital radicular pulp so that normal root development and physiological apical closure continue.

22. What is apexification, and what materials are used?

    Inducing a calcified apical barrier (or placing an artificial one) in a non-vital immature permanent tooth to allow root canal filling. Traditionally calcium hydroxide over months; now commonly an MTA apical plug in a single visit.

23. What is regenerative endodontics (revascularisation) in an immature non-vital permanent tooth?

    A procedure that disinfects the canal, induces a blood clot/scaffold from the periapical tissues, and seals with MTA to allow continued root development (thickening of walls and apical closure) by stem-cell-mediated tissue ingrowth.

24. Why is MTA favoured for vital pulp therapy in immature permanent teeth?

    It provides a good biological seal, is biocompatible, promotes hard-tissue (dentine bridge) formation, and sets in the presence of moisture/blood.

25. What fluoride concentration toothpaste is recommended for children aged 0-3 years at standard caries risk in the UK?

    A toothpaste containing at least 1000 ppm fluoride, using only a smear amount, twice daily.

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