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WorksheetsNowak Chapter 24-28
Total questions: 90
Worksheet time: 46mins
Which is the least controversial nonpharmacologic behavior management approach?
Positive reinforcement
Distraction
Modeling
TSD
What consent is recommended when providing passive protective stabilization?
Verbal
Written
Informed
What are the four specific elements of memory restructuring?
Observation, verbalization, abstract examples, sense of worth
Visual reminder, verbalization, concrete examples, sense of accomplishment
Direct instruction, verbalization, concrete examples, sense of self-worth
Vocal reminder, verbalization, abstract examples, sense of accomplishment
What is fundamental in providing dentistry for children?
Adequate pain management
TSD
Temperament
Parenting style
What is the correct correlation between parenting style and child behavior?
Authoritarian parenting and decreased anxiety
Permissive parenting and positive behavior
Authoritarian parenting and increased anxiety
Authoritative parenting style and negative behavior
Parental presence is MOST helpful when:
Parents are overly controlling
The child has separation anxiety
The child is uncommunicative
The parent refuses to leave
Which factor most strongly predicts a child’s response to behavior guidance techniques?
Parent socioeconomic status
Parent’s perceived dental anxiety
Length of the appointment
Age of the child alone
In the Frankl Behavior Rating Scale, a child who is “reluctant but follows directions with some reassurance” is rated:
1
2
3
4
Which behavior guidance technique is considered advanced rather than basic?
Tell-Show-Do
Distraction
Voice control
Papoose
The following description describes what type of parenting style? “High parental responsiveness and high demand for obedience, but shows warmth and involvement”
Authoritative parent
Permissive Parent
Authoritarian parent
Loving Parent
Gingival enlargement is most likely found with which medications?
Beta Blockers
Nsaids
Ca Channel blockers
Opioids
Which of the following is associated with severe periodontitis and hyperkeratosis of the palms and soles of feet?
Papillon- Lefevre Syndrome
Autism
Guillain-Bare Syndrome
None of the above
Localized Aggressive Periodontitis in the Permanent Dentition is typically characterized by the loss of attachment and bone around which permanent teeth?
Second molars and canines
First molars and incisors
First molars and first premolars
Incisors and canines.
Which antibiotic is typically used for Localized Aggressive Periodontitis in the Permanent Dentition?
Tetracyclines
Cephalosporins
Rifampin
Metronidazole
Which of the systemic conditions are associated with periodontal disease?
Diabetes
Down syndrome
Neutropenia
All the above
The peak prevalence of puberty-associated gingivitis occurs at what age?
Girls- 9 yrs, Boys-11 yrs
Girls- 10 yrs, Boys-13 yrs
Girls- 12 yrs, Boys-14 yrs
Girls- 13 yrs, Boys-10 yrs
Antibiotic of choice for Localized Aggressive Periodontitis is:
Bacitracin
Pen VK
Clindamycin
Metronidazole
Approximately what percentage of teenages with insulin-dependent diabetes mellitus have significant periodontal disease?
2-5%
5-10%
10-15%
20-25%
The loss of attachment and recession that occurs with a labially malpositioned tooth is often referred to as:
Fenestration
Dehiscence
Stripping
Reduced epithelium
Frena are best described as:
Mucosal folds with enclosed muscle tissue
Extensions of the gingival connective tissue
Periodontal ligaments
Fibrous tissue without muscle fibers
What is the most common cause of posterior tooth loss in primary dentition?
Trauma
Caries
Congenital absence
Ankylosis
Which appliance is most commonly used for unilateral loss of a primary molar?
Nance appliance
Band and loop
Distal shoe
Hawley retainer
Which appliance is indicated when a primary second molar is lost before eruption of the permanent first molar?
Crown and loop
Distal shoe
Transpalatal arch
Lower lingual holding arch
What is considered the best space maintenance strategy?
Band and loop appliance
Distal shoe appliance
Good restorative and preventive dentistry
Removable partial denture
Which appliance is contraindicated in medically compromised patients or those at risk for infective endocarditis?
Band and loop
Distal shoe
Nance appliance
Hawley retainer
Which fixed bilateral appliance requires eruption of the permanent mandibular incisors before placement?
Transpalatal arch
Nance
Lower lingual holding arch
Groper appliance
Which appliance is most appropriate when multiple primary molars are missing in both quadrants of the maxilla?
Lower lingual holding arch
Nance appliance
Band and loop
Distal shoe
Early loss of a primary incisor typically results in:
Significant anterior space loss
Minimal space loss unless canines are unerupted or crowding exists
Severe midline shift in most cases
Delayed eruption of permanent incisors
True or False: A reverse band and loop can be used as an alternative to a distal shoe when the permanent first molar is partially erupted.
True
False
Which statement about impressions for laboratory‑fabricated space maintainers is TRUE?
Compound impressions are the most accurate
Bands should always be included in the impression
Alginate or PVS impressions provide the best accuracy
Large model bases improve appliance fit
How may orthodontic care differ for a child with special needs?
Appointment lengths may be longer
Treatment plans may be more flexible and staged to allow for possible discontinuation
Materials may need to be varied due to specific sensitivities of the patient
All of the above
Orthodontic force causes deflection of alveolar bone, creating stress lines that stimulate bone remodeling. After initial tooth displacement, movement pauses until necrotic tissue is removed. Which theory does this describe?
Pressure–Tension Theory
Bone Bending Theory
Functional Matrix Theory
Wolff’s Law
Which of the following statements is NOT correct regarding thumb-sucking in the primary dentition only?
Management should be directed primarily toward elimination of the habit
Appliance therapy is rarely indicated
Occlusal changes associated with thumb-sucking may resolve spontaneously after habit cessation
Interceptive orthodontic treatment should be initiated immediately to correct the excessive overbite
What habits can lead to an open bite? Select all that apply.
Thumb-sucking
Pacifier use
Tongue-thrusting
Over-eruption of incisors
Orthodontic tooth movement occurs due to force-induced changes in the PDL/bone. Pressure areas experience reduced blood flow and undermine resorption, while tension areas show increased cellular activity and new bone.
Which theory of orthodontic tooth movement does this describe?
Bone Bending Theory
Pressure-Tension Theory
Functional Matrix Theory
Wolff’s Law
Which of the following is true regarding oral habits for children aged 3-6?
Digit and pacifier habits should be stopped before the start of this period
The changes are irreversible
Appliances are usually required to correct improper teeth position
Childing wanting to stop the behavior is the most important in habit cessation
Which is true of digit sucking habits?
A force of 25g is enough to tip a tooth
Approximately 2/3 end by age 5
The intensity of force of a digit sucking habit the most important factor in tooth movement
Common cause of anterior crossbite
Thumb and finger habits
Decrease overjet
Increase overbite
Lead to more clockwise maxillary-mandibular jaw relationship
Can cause extrusion of incisors
Which of the following methods is least successful for correcting a thumb habit when the child sucks their thumb to help fall asleep?
Counseling
Reminder Therapy
Reward system
Adjunctive therapy
What is this beaded appliance called?
Nance
Crib
Quad Helix
Bluegrass
According to Bimstein et al., how does the prevalence of gingivitis in children compare to dental caries?
Gingivitis is much less prevalent than dental caries
Gingivitis is equally or more prevalent than dental caries
Gingivitis only occurs in children with dental caries
Gingivitis is not prevalent as discussed in the younger age group.
According to Bimstein et al., the main reason gingivitis in children has received less attention that dental caries is because:
It is less prevalent in children
It is easier to treat
It does not appear clinically severe
Its long-term health impact is underappreciated
What percentage of cases in the study ended with a Class I molar relationship in the permanent dentition?
44%
61.6%
34.3%
19.4%
Which initial molar relationship in the deciduous dentition most strongly predicts a Class II molar relationship in the permanent dentition?
Flush terminal plane
Mesial step
Distal step
End-to-end relationship
Which initial molar relationship in the deciduous dentition most strongly predicts a Class II molar relationship in the permanent dentition?
Flush terminal plane
Mesial step
Distal step
End-to-end relationship
According to Cozza’s systematic review, which factor most strongly influences the effectiveness of functional appliances in promoting mandibular growth in Class II malocclusion?
Appliance design
Patient compliance
Timing during pubertal growth spurt
Duration of treatment
Which functional appliance demonstrated the highest treatment efficiency for mandibular growth in the review?
Twin-Block
Herbst
Activator
Bionator
According to Ngan, Alkire, and Fields (1999), what is the recommended treatment for moderate crowding (5-9mm)?
Preservation of leeway space alone will resolve the crowding
Limited expansion in the late mixed dentition is sufficient
Most cases will require permanent teeth to preserve facial esthetics and soft tissue integrity
Serial extraction should be initiated immediately
According to Ngan, Alkire, and Fields (1999), what is the recommended timing for referring a patient with moderate crowding to a specialist for orthodontic treatment?
Late primary dentition
Early mixed dentition
Late mixed dentition
In the Iowa Facial Growth Study examining the relationship between childhood BMI and dental development, which finding best describes the predictive value of early BMI measurements?
BMI at age 8 years was the strongest predictor of dental development at age 12
BMI at age 4 years predicted the timing of dental development at age 12
BMI measurements showed no predictive value for future dental development
Only current BMI, not historical BMI, correlated with dental development
According to the study's findings on dental eruption timing, which statement accurately reflects the relationship between BMI and specific tooth eruption?
Overall dental development scores showed no correlation with eruption timing
Only maxillary teeth showed earlier eruption in children with high BMI
BMI at young ages had long term effects including early dental maturation.
The rate of dental development remained constant across growth periods.
What characteristic did premolars often show at the time of early eruption?
Overdeveloped roots
Shorter-than-expected root length
No root formation
Complete root development
What type of tooth movement commonly occurred after premature loss of deciduous molars?
Distal drift of premolars
Lingual tipping of incisors
Distal tipping of canines
Mesial drift of premolars
What type of headgear is used to repair class 2 Maloccusion with a vertical growth pattern?
Reverse pull headgear
High pull headgear
Cervical pull headgear
In severe cases of class 2 malocclusion, 2-phased treatment is always the recommendation.
True
False
Which arch is most susceptible to clinically significant space loss following premature loss of a primary first molar?
Maxillary arch
Mandibular arch
Both arches equally
Neither arch shows significant changes
Compared with premature loss of primary second molars, loss of primary first molars generally results in:
Greater space loss
Similar space loss
Less space loss
Complete arch collapse
Which appliance in the study by Woon SC, Thiruvenkatachari showed statistically significant short-term improvement in both skeletal and dental effects for Class III malocclusion?
Chin cup
Protraction mask
Removable Mandibular retractor
Tandem Traction bow appliance
What is the major limitation identified in the studies included in the review by Woon SC, Thiruvenkatachari?
Lack of short-term data
No studies done later in life
High risk of bias in most studies
Compliance of patient till the age of 17-18 years
Which imaging technique was used to measure adenoid and tonsil volumes in this study?
MRI
Cone Beam Computed Tomography (CBCT)
Traditional CT Scan
Ultrasound
What percentage of tonsil volume reduction was observed on average in the expansion group?
16.8%
24.8%
38.5%
75.4%
According to AAP guidelines, at what ages should standardized screening for Autism Spectrum Disorder be performed?
12 and 18 months
18 and 24 months
24 and 36 months
Only when concerns are raised
Which of the following is emphasized in the AAP report for managing children with ASD?
Exclusive reliance on pharmacologic therapy
Early identification and family-centered, multidisciplinary care
Delaying intervention until school age
Limiting evaluation to behavioral symptoms only
Which are examples of why some children have developed oral aversions?
Preterm birth with prolonged intubation
Hypersensitivity to texture, smells, tastes, colors
Dependence on caregivers
When should pediatricians encourage parents of children with developmental disabilities to seek dental care?
By 1 year of age
Between 6-12 months
“First visit by first birthday”
All of the above
In the Shapiro et al. study examining sensory-adapted dental environments for children with developmental disabilities, which outcome measure showed the greatest statistical significance?
Altering lighting, sounds, and tactile stimulation had no signifacant effect on anxiety levels
Non-pharmacological sensory based interventions off no effectiveness
A SADE should effectiveness in decreasing anxiety compared to normal dental settings.
According to the study findings, what was the mean duration of anxious behaviors in children with developmental disabilities when treated in the sensory-adapted dental environment compared to the regular dental environment?
5.26 minutes vs. 13.56 minutes
9.04 minutes vs. 23.44 minutes
8.49 minutes vs. 15.50 minutes
331 minutes vs. 1.94 minutes
What did the authors find regarding long‑term skill retention in children with ASD?
Most children lost their skills between visits
Skills were maintained only with monthly appointments
Most children retained their dental skills even with long gaps between visits
Skill retention was unpredictable and inconsistent
Which component was central to the success of the desensitization approach?
Use of pharmacologic sedation
Rapid exposure to all procedures in one visit
Predictability, repetition, and gradual exposure
Use of restraints to improve cooperation
In any childhood population, what approximate percentage sustains over half of the biomedical and psychiatric morbidities?
10%
20%
30%
d.
40%
50%
This is considered the single most powerful epidemiologic predictor of health and disease.
Socioeconomic factor (SES)
Body mass index (BMI)
Reading levels
Social epigenetics
A parent objects to voice control because it is perceived as disrespectful. According to the article, the best clinician response is to:
Proceed because it is clinically effective
Explain that it is the standard of care
Modify behavior guidance and discuss alternatives
Refer the child immediately
Which scenario best demonstrates culturally influenced compliance challenges?
A child refusing fluoride varnish
A parent preferring traditional remedies before dental treatment
A child crying during local anesthesia
A parent requesting shorter appointments
The study by Hoge et al, controlled for which variable in the analysis of covariance?
Gender
Age
Previous dental experience
Type of dental procedure
Which pain scale was used in the study by Hoge et al?
Faces Pain scale
Wong-Baker Faces Pain scale
Numeric rating scale
Faces Pain Scale-Revised
Which parenting style was associated with the best child behavior and least dental caries?
Authoritarian
Permissive
Authoritative
Neglectful
Which factor, besides parenting style, was linked to better child behavior during the first dental visit?
High sugar consumption
Attendance at daycare
Lack of dental insurance
History of dental pain
What was the primary purpose of using a visual schedule system in the pilot study on dental care for children with autism?
To replace traditional dental cleaning methods
To improve task completion and reduce anxiety during dental visits
For fun
To shorten overall appointment duration by half
Which of the following outcomes was observed in children using the visual schedule system compared to the control group?
Increased behavioral distress
Slower completion of procedural steps
More steps completed and reduced distress
No significant difference in performance
What technique did Hispanic parents rank above tell show do in the study by Martinez Mier et al (2019)?
General anesthesia
Active restraint
Voice control
Nitrous oxide
Which technique was highly accepted among all 3 study groups in Martinez Mier et al (2019)?
General anesthesia
Tell show do
Active restraint
Nitrous oxide
According to Nelson's continuum of behavior guidance framework, which factors must clinicians consider when selecting the appropriate behavior guidance technique for a pediatric patient?
Only the child's age and dental procedure complexity
Parental expectations, child temperament, and technical procedures necessary to complete care
Insurance coverage and appointment duration
Only previous dental history and sibling behavior patterns
What is the primary goal of effectively using techniques within the continuum of behavior guidance in pediatric dentistry?
To minimize appointment time and maximize practice efficiency
To eliminate the need for pharmacological interventions in all cases
To maintain a healing relationship with the family while addressing dental disease and empowering the child for lifetime dental care
To ensure parents remain in the waiting room during all procedures
Which type of measure is often most appropriate for younger children?
Self‑report questionnaires
Physiological monitoring only
Visual or behavior‑based scales
Parent‑completed anxiety inventories
Which major limitation did the authors identify across many existing anxiety measures?
They are too short to be useful
They lack strong validation across different populations
They require expensive equipment
They cannot be used in clinical settings
How does dental anxiety differ from dental phobia?
Dental anxiety is more intense
Dental phobia is rational
Dental anxiety is moderate, while dental phobia is intense and irrational
There is no difference
From an ABPD behavior guidance perspective, sensory adaptation is best classified as:
Pharmacologic behavior guidance
Advanced restrictive technique
Non-pharmacologic adjunctive behavior guidance
Emergency management technique
Which patient would be the best candidate for sensory-adapted dental treatment?
Neurotypical child with mild dental fear
Child with ASD and hypersensitivity to sound and touch
Child requiring extensive oral surgery
Adolescent with dental phobia requesting sedation
30 years ago, which of the following was less used due to more evidence of a paternalistic approach in dental treatment?
Parental absence
Voice control
Hand over mouth
Oral sedation
Which of the following might not be the reason for high usage of nitrous oxide in pediatric practice?
Change in parenting style influencing the child’s behavior
Parents choosing less aversive techniques
Changing dental trends
High parental expectations for positive dental experience for their child
