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BDS3 OSCE > 1 > Flashcards

1 Flashcards

1
Q

C/O ask

A

bleeding gums

bad breath

sensitivity

mobility

spacing

receding gums

pain

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2
Q

HPC

guide

A

SOCRATES

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3
Q

SOCRATES

A

S ite

O nset

C haracter

R adiation

A ssociation

T ime course

E xacerbate/relief

S everity

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4
Q

PDH ask

A

regulat attender or only when in pain?

Tx today or previously for presenting complaint?

age of restorative work/dentures?

LA given before? issues?

OH habits?

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5
Q

MH ask

A
  • DJ HEART BBT
  • CVS, CNS, Resp, GIT, Genito-urinary, Vascular, Immune, Endo, Dermatology
  • long term conditions (current or past)
  • medications
  • allergies
  • currently fit and well?
  • seeing doctor for anythiing?
  • any past hospital in stays?
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6
Q

DJ HEART BBT

A

DJ HEART BBT

D iabetes

J aundice

H igh BP

E pilepsy

Rh Fever

TB

BBV

B leeding tendency

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7
Q

FH ask

A

presenting conditions or others?

Periodontitis? (gum disease)

Cancers?

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8
Q

SH ask

A

smoking - how long and how many, vape

alcohol - how much per week- unit

diet - snacking, sugars in teas, fizzy drinks

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9
Q

E/O exam

A
  • assess when walk into room
    • limp
  • check TMJ
    • clicking, deviation on opening, history of locking
  • check lymph nodes
    • neck, cheeks, submandibular and behind ear
  • check cracked lips
  • asymmetry
  • check masseter and temporails
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10
Q

I/O exam

A
  • any lumps, bumps, swellings
  • lips, tongue, cheeks, had and soft palate, floor of mouth, oropharynx
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11
Q

Dental exam

A
  • missing teeth
  • abnormalities: PE, crowding, diastema
  • Restorations
    • type
    • number
    • distribution
    • carious
    • #
    • leaked
  • attrition, abrasion, erosion
    • distribution and severity
  • endo
  • occlusion - abnormalities
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12
Q

periodontal exam

A

visual

  • supra gingival plaque and calculus deposits
  • hyperplasia, recession, gigival erythma

Probing

  • BPE then 6PPC (3 or 4)
    • BOP distibution
    • plaque retentive factors
    • sub-gingival calculus
    • furcation involvement
    • mobility

TTP

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13
Q

DRS ABC

A

D anger

R esponse

S hout for help

A irways

B reathing

C irculation

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14
Q

Response

check

A

gently shake and ask can you hear me?

no response -> shout

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15
Q

Airways

check

A

if blocked finger sweep and/or aspiration

gentle head tild and jaw thrust as long as no chance of neck or vertebral injury

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16
Q

breathing

check

A

ear to mouth and look at chest to see if rise and fall

10 seconds

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17
Q

circulation

check

A

assess 10 seconds by listening, feeling for air with cheek and looking for chest movement, while at same time feeling for carotid pulse

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18
Q

what to say to helper in CPR defib situation

A

phone for ambulance - inform cardiac arrest, exact location inc floor and contact number

fetch a defibrilator and bag-valve mask and oxygen

chest compressions with two hands, 5-6cm deep at 120bpm

2 breaths given from BVM with good seal after 30 compressions, repeat

defib - get help to do compressions whilst you set up

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19
Q

paeds BLS

A

SSSABCR

Safety

Stimuli response (don’t shake <2 year olds)

Shout for help (ambulance, bag-valve)

Airways (pinkie sweep)

Breathing (If not breathing, give 5 rescue breaths before continuing – no tilt chin lift)

Circulation (Brachial pulse in infants, if <60bpm then begin compressions

  • Just above bottom of sternum with 2 thumbs to 1/3 of the A-P depth
  • At a rate of 120bpm and a ratio of 15 compressions to 2 breaths)

Reassess after 1 minute

  • With children a carotid pulse can be taken & the head tilt chin lift manoeuvre is OK*
  • Compressions are done with 1 han*
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20
Q

paeds if choking

A

For an infant:

  • Alternate between lying face down along arm downwards with head supported and give 5 sharp slaps to the back to encourage coughing
  • Lying face up give 5 sharp upward facing compressions to the sternum.

For a Child:

  • Lean over knee, support chest and give 5 sharp slaps to the back
  • Alternate with 5 upwardly rotating abdominal thrusts.
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21
Q

angina

A

chest pain due to ischaemia (lack of blood flow; lack of O2) of the heart muscle

characterised by retrosternal chest pain or discomfort (tightness/heaviness) that may radiate to the arms, shoulders and neck

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22
Q

stable angina

A

chest pain/discomfort that often occurs with activity or stress and is relieved by rest

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23
Q

unstable angina

A

lack of blood flow and oxygen that may lead to a heart attack

refer to GMP or ambulance

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24
Q

Myocardial infarction

A

heart attack occurs when blood flow to a part of you heart is blocked for a long enough time that part of the heart muscle is damaged or dies

differs from angina in that pain is more severe and persistent, not relieved by rest and can cause death of heart muscle

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25
Q

Tx for angina/MI in dental chair

A

stop tx and sit upright

oxygen 15L via non-rebreathing mask

GTN spray (if BP <70mmHs as if weak they may collapse)

Aspirin 300mg crushed/chewed

get urgent help if angina persists or if MI

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26
Q

how to tell if angine leads to MI

A

A airways Clear

B breathing - Tachypnoea (rapid, shallow)

C chest pain/Pulse inc/BP inc/ tachycardic

D Varies depending on extent

E anxiety/nausea/vomiting

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27
Q

7 emergency drugs

A
  • Oxygen
  • Salbutamol
  • Midazolam
  • Adrenaline
  • GTN spray
  • Aspirin
  • Glucagon

Only Stunning Men Are Getting Actural Girls

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28
Q

Oxygen

emergency med

A

give 15L/min to anyone who is feeling unwell

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29
Q

Salbutamol

emergeny med

A

give two 100microgram actuations to anyone with a wheeze

In severe asthma case up to ten actuations should be delivered into a bag-valve-mask and given to the patient

Stridor may be caused by a foreign body in the airway – salbutamol should not be given.

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30
Q

Midazolam

emergency med

A

squirt 10mg into the buccal sulcus of person having repeated or prolonged seizures (epileptics who have changed their medication)

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31
Q

Adrenaline

emergency med

A

½ an ampule of 1:1000 parts adrenaline (0.5mg) should be given as an IM injection using the Z-plasty admin route disruption technique to someone with a life-threatening anaphylactic shock

  • If the condition is worsening, the injection can be repeated in the other leg.

2 needles: First may be blunt from drawing liquids – painful injection

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32
Q

GTN spray

emegency med

A

Two actuations can be given sublingually to patients suffering from an acute stable angina attack

The condition should also resolve with rest and will normally present on exercise.

If the condition does not improve then they may be having an MI or unstable angina (see aspirin)

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33
Q

Aspirin

emergency med

A

300mg to be taken crushed or chewed by persons having a myocardial infarction

They should be referred immediately to hospital.

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34
Q

Glucagon

emergency med

A

1mg intramuscular injection to patients suffering a hypoglycaemic coma (Type 1 Diabetics)

Will reduce all glucose stores from the liver

As soon as conscious should be given sugar in a quickly absorbable form.

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35
Q

INR stands for

A

international normalised ratio

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36
Q

Warfarin

action

A

inhibits coagulation by vitamin K anatgonism (listed under coumarins)

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37
Q

INR extraction minimum

A

4

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38
Q

warafarin interactions

A
  • Antibiotics (Metronidazole increase effect)
  • Carbamazepine inhibits
  • Don’t use NSAIDS (ibuprofen)
    • Antiplatelet effect will increase Bleeding time (inc effects)
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39
Q

how to dx Sjorgens when pt presents with dry mouth?

A
  • Dry eyes and mouth clinical exam
  • Blood tests for Anti-La antibody first
    • Also Anti-Ro and ANA
  • Histopathology assessment of a labial secondary salivary gland biopsy
  • Radionucleotide assessment into a salivary duct, Imaging.
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40
Q

complications of Sjorgens

A
  • dry mouth
  • burning mouth
  • difficulty swallowing and speaking
  • increased risk of oral infection and caries
  • difficulty with denture retention
  • long-term risk of salivary lymphoma
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41
Q

5As of smoking cessation

A

Ask

Advise

Assess

Assist

Arrange

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42
Q

Ask in smoking cessation

A

smoker? how many per day? when first cigarette of the day? how many years?

want to stop? interested in stopping? interested in help?

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43
Q

Advise in smoking cessation

A

aware of health benefits of quitting?

single most effective way of improving health status

past failures will improve chances this time round as not easy to do

lung cancer and heart disease, oral cancer, gum disease and stained teeth

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44
Q

Assess in smoking cessation

A

desire to stop smoking?

help must be offered

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45
Q

Assist in smoking cessation

A

negotiate a stop date

review previous failed attempts and anticipate problems, suggest enlisting family and friends

inform of NRT availability and NHS Stop Smoking Service

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46
Q

Arrange in Smoking cessation

A

arrange follow up

arrange NHS SSS referral (one to one or group), monitor, support and encourage at future dental appointments

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47
Q

reversible pulpitis

A

Mild inflammation to pulp: Caries, exposed dentine, defective restoration

Tooth may respond more than normal to certain stimuli such as heat and sweet.

  • Stimuli tend to produce a sharp pain (A delta) that resolves within 5-10 secs after the stimuli removed.

Cause of inflammation (eg caries) is removed -> pulp-dentine complex will return to normal

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48
Q

irreversible pulpitis

(symptomatic or asymptomatic)

A

Dull aching pain lasts minutes or hours

  • Worse at night or when lying down due to an increase in intra pulpal pressure
  • Symptoms may be initiated by temperature changes

Min radiograph changes til advanced – If it is then PDL widening

Removal of the causal factor does not lead to pulpal regeneration

If left untreated will become necrotic.

Treatment: RCT/XLA

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49
Q

necorsis

A

blood supply non existent

Asymptomatic before it extends to Periodontium

  • Negative to EPT & cold sensitivity
  • TTP positive
  • Radiographic PDL thickening & PA lucency

Tx: XLA/Endo

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50
Q

acute necrotising ulcerative gingivitis ANUG

tx

A

debridement, oxidising mouthwash, CHX mouthwash, OHI

drugs

  • metronidazole 200mg 3xday 3-5 days
  • amoxicillin 250mhg 3xday 7-10 days
  • oxidising hydrogen peroxide mouthwash
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51
Q

ANUG predisposing factors

A

stress

smoking

poor OH

young and immunocompromised

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52
Q

acute necrotising ulcerative periodontitis ANUP

tx

A
  • metronizadole 200mg 3-5days
  • chlorohexidine digluconate (bisguanide)
    • 0.2% 10ml = 20mg; twice a day
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53
Q

chlorohexidine

A

bisguanide mouthwash

0.2% 10ml twice daily

substantivity 12 hours

dicatonic action

  • one cation binds to the pellicle coated teeth
  • other bactieral cell membrane
  • low concentration - increase permeability
  • high concentration - precipitation of cytoplasm and cell death
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54
Q
A
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55
Q

upper anterior straight forceps

A

13-23

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56
Q

upper universal forceps

A

14, 15, 24, 25

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57
Q

upper molar forceps

A

beak to cheek

6 back

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58
Q

lower universal forceps

A

35 - 45

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59
Q

lower molar forceps

A

left and right sets

6s back

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60
Q

cowhorn forceps

A

useful for browken down lower molars

squeeze out

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61
Q

bayonet forceps

A

upper 8s

help reach back

have roots version too

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62
Q

elevators

A

loosen PDL, widen space for easier forcecp access

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63
Q

luxators

A

tear PDL

sharp

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64
Q

when to stand behind pt for extraction

A

only loower right molars (right handed operator)

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65
Q

3 types of elevators

A

couplands

cryers

warwick james

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66
Q

post op extraction instructions

A

Don’t rinse for several hours, or not til the next day. Don’t be vigorous when you do

  • Rinse the next day with hot salty water & gently swirl around 4 times a day for a minute

Avoid trauma. Don’t explore the socket with finger/tongue

Avoid hot food day of extraction. Eat on the other side of the mouth

Avoid excessive exercise

Avoid smoking/drinking on day of extraction

Brush as normal

Advice on bleeding

  • if bleeds bite on damp gauze 20 mins & bleeding should stop
  • If bleeding doesn’t stop then contact GDH&S or hospital(A&E)

May have slight discomfort so take pain killers before the LA wears off.

  • Take whatever you normally take and continue as instructed on packet

If any problem contact GDH&S (dry socket; sutures removed)

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67
Q

post op pain killer caution with

A
  • Elderly
  • Peptic ulceration/GORD
  • Pregnant
  • U16 (Reye’s)
  • Renal/cardiac/hepatic impaired
  • Asthmatics (unless had before)
  • History of NSAIDs hypersensitive
  • Taking other NSAIDs
  • On long term steroids (gastric ulcers)
  • Warfarin

liver or kidney disease - need reduced dose

alcohol dependence - caution

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68
Q

ibuprofen prescription

A

200 or 400mg tablets 3-4 times per day after food

  • Do not take more than 6 tablets (2.4g) in 24 hour.

follow box

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69
Q

paracetamol prescriptions

A

500mg tablets 1 or 2 tablets every 4 hours

  • Do not take more than 8 tablets (4g) in 24 hours

follow box

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70
Q

co-codamol composition

A

paracetamol with 8 or 30g codeine

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71
Q

what to record from LA vile

A

batch number and expiry date

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72
Q

LA for high BP or heart problems

A

adrenaline free

prilocaine with felypressin

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73
Q

prilocaine with felypressin

vasoconstrivtive effect?

A

contains synthetic vasoconstrictor so effects of anaesthetic will last

  • don’t use lidocaine w/o adrenaline - no vasoconstrictor so effects won’t last
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74
Q

if pt on Beta Blocker what LA to use

A

adrenaline free or limit quantity (3 cartridges max)

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75
Q

pt on anti-depressant tri-cyclics LA

A

adreanaline free or limit quantity

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76
Q

normal LA circumstances (standard)

A

2.2ml 2% lidocaine 1/80,000 adrenaline

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77
Q

EDTA solution role

A

irrigant

15%

removes smear layer

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78
Q

3 irrigant examples

A

EDTA 15%

sodium hypochlorite 0.5-6%

chlorohexidine 0.2%

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79
Q

sodium hypochlorite irrigant role

A

disinfects and dissloves pulpal remnants, disrupts organic portion of the smear layer

0.5-6%

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80
Q

chlorohexidine irrigant role

A

0.2%

disinfects canal

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81
Q

S files work in

A

coronal and mid root area

2/3 WL

S1, S2

82
Q

order of files in endo

A

K files 10, 15, 20 to resistance

S1, S2 to WL with brushing motion

apical shaping with S files

F1, F2, F3 etc to WL

83
Q

F1 diameter and taper

A

20

7%

84
Q

F2 diameter and taper

A

25

8%

85
Q

F3 diameter and taper

A

30

9%

86
Q

F4 diameter and taper

A

40

6%

87
Q

F5 diameter and taper

A

50

5%

88
Q

paper points

job

A

ensure the canal is dry before medicating or obturating

89
Q

examples of intervisit endo medication to prevent infection

A
  • ultracal/hypocal/dycal
  • non-setting CaOH
90
Q

example of intervisit medication for hot, infected pulps to reduce inflammation

A

Ledermix

Corticosteroid and antibiotic mixture

91
Q

GP points

A

obturation material

cold lateral compation or thermafill techniques

needs AH Plus sealer

92
Q

Riva is

A

GI

93
Q

Relyx is

A

RMGI

94
Q

Vitrebond/vitremer is

A

RMGI

95
Q

Kalzinol/sedanol is

A

ZOE (used in primary as RCT as its resorbable)

96
Q

obturation materials options

A

GP points with AH Plus sealer

Resilon (resin based) with different sealer

97
Q

Mouthwash for children

A

225ppm for 7+

98
Q

if 5mg/kg F ingested

A

give milk and observe

reached potentially lethal dose

99
Q

if 5-15mg/kg F ingested

A

milk and go to hospital

100
Q

if over 15mg F ingested

A

go to hosptial for cardiac monitoring and IV calcium gluconate

101
Q

max safely tolerated dose F

A

1mg/kg

102
Q

certainly toxic dose F

A

32-54mg/kg F

(5-10g toothpaste in 75kg)

103
Q

potentially lethal dose F

A

5mg/kg

104
Q

factiors influencing caries risk

A
  • Diet
  • Plaque control
  • Fermentable carbohydrate intake
  • Fluoride use
  • Medical history
  • Social history – siblings’ caries/deprivation
  • Clinical evidence – DMFT/ortho/dentures/no FS
  • Saliva volume and quality
105
Q

6month to 6 year old toothpaste (unless high risk)

A

1000ppmF

(smear for <2)

106
Q

toothpaste for:

>6 low risk

>3 high risk

A

1450ppmF toothpaste

107
Q

toothpaste for:

>10 high risk

A

28000ppmF

108
Q

toothpaste for:

>16 high risk

A

5000ppmF

109
Q

moisture control technqiues for paeds

A

dental dam

cotton wool rolls

Dry Guard (parotid sheath)

tongue retractor

aspirator

saliva ejecter

110
Q

Caries risk assessment looks at

A
  • MH
  • OH (plaque control)
  • clinical assessmeent
  • diet
  • fluoride
  • FH - siblings caries
  • SH
  • saliva
111
Q

Splinting times and possible construction

primary teeth

A

dento-alveolar fracture

reposition and splint 3-4 weeks

112
Q

Splinting times and possible construction

permanent teeth

concussion

A

none

113
Q

Splinting times and possible construction

permanenent teeth

subluxation

A

2 weeks flexible

114
Q

Splinting times and possible construction

permanenent teeth

intrusive and extrusive luxation

A

reposition and 2 weeks flexible

115
Q

Splinting times and possible construction

permanenent teeth

avulsion

A

replantation and 2 weeks flexible

116
Q

Splinting times and possible construction

permanenent teeth

lateral luxation

A

reposition and 4 weeks flexible

117
Q

Splinting times and possible construction

permanenent teeth

root fracture apical 2/3

A

replantation and 4 weeks flexible

118
Q

Splinting times and possible construction

permanenent teeth

root fracture coronal 1/3

A

replantation and 4 months flexible

119
Q

Splinting times and possible construction

permanenent teeth

dento-alveolar fracture

A

reposition and 4 weeks rigid

120
Q

diet diary

A

3 days: Everything eaten & when.

Choose 1 weekend day and 2 week days.

121
Q

radiographic report includes

A
  1. Type of radiograph
  2. Grade of x-ray (A - diagonitically acceptable or N - not)
  3. What teeth you can see
  4. What you can see on the teeth
  • e.g: RCT, PCC
  • Bone levels
  • Caries
  • Defective restorations
  • PA pathology
122
Q

radiographic film holders

red

A

bitewings

123
Q

radiographic film holders

yellow

A

posteiror periapical for image of a complete tooth including the root

124
Q

radiographic film holders

blue

A

anterior periapical for complete anterior tooth including the root

125
Q

radiographic film holders

green

A

endo for ID working lengths

126
Q

film size for bitewings

A

2 for permanent teeht

0 for deciduous

127
Q

anterior PA and endo films size

A

0

128
Q

posteiror PA and endo film size

A

2

129
Q

fitting an ortho appliance

A
  1. Right pt; Right appliance
  2. Appliance matches prescripton
  3. Sharp edges
  4. Integrity of wire (CoCr)
  5. Fits in mouth w/o blanching
  6. Posterior retention
  7. Anterior retention
  8. ​Tighten finger springs – Activates active component (Always receive active component in passive form)
    1mm tooth movement per month
  9. demonstrate correct procedure for removing and insertion of appliance, get pt to show you
  10. book review appointment 6 weeks
130
Q

how to check retention

A

Flyovers then arrowheads

  • High flyover – “gum stripper”
  • Arrowheads – wire into gums at undercut
131
Q

pt instruction when get ortho appliance

A
  1. Will feel big & bulky – you will get used to it
  2. May be mild discomfort – this indicates it is working
  3. Will impinge on speech – practise reading out loud
  4. You may drool a lot especially first 24 hours
  5. Wear all the time – ESP mealtimes
  6. Clean after every meal. Remove & store for contact & active sports
  7. Non-compliance significantly increases treatment time
  8. Avoid hard sticky foods & fizzy drinks
  9. Be cautious with hot food & drinks
  10. Emergency contact number
132
Q

Correcting Overbite & Moving canines palatally

ARAB

A

A:

  • 13 and 23 buccal canine retractors 0.5mm HSSW & 0.5mm tubing – strength & rigidity

R:

  • Adams clasp 0.7mm HSSW 16 and 26
  • Southend clasp 0.7 HSSW 11 and 21

A: …..

B:

  • Self cure PMMA
  • FABP
    • 6.5mmm O/J so 9.5mm FABP
133
Q

anterior cross bite

ARAB

A

A:

  • Z-spring 0.5mm HSSW

R:

  • 16 and 26 Adams clasp 0.7mm HSSW
  • 14 and 24 Adams 0.7mm HSSW

A: ……

B:

  • Self cure PMMA (Heat cure also available – monomer allergy)
  • FPBP
134
Q

posterior cross bite

ARAB

A

A:

  • Midline palatal screw

R:

  • 16 and 26 Adams clasp
  • 14 and 24 Adams clasp HSSW

A: ….

B:

  • Self cure PMMA
  • FPBP – will keep teeth apart while movement is ongoing
135
Q

distalising canine (make space/close space)

ARAB

A

A:

  • 13 and 23 palatal finger spring + guard 0.5mm HSSW

R:

  • 16 and 26 adams clasps 0.7mm H.S.S.W
  • 11 and 21 Southend Clasp .7 H.S.S.W

A: …..

B:

  • Self cure PMMA

If clasps being placed on primary teeth then its 0.6 H.S.S.W

136
Q

lab card for primary impressions

A

Impressions in alginate or impression compound

Pour in 50:50 plaster/stone

Please construct upper and lower custom trays in light cured PMMA, non-perforated, with upper 2mm spacing and lower 1mm spacing (close fitting) , intra oral handles and finger stops

137
Q

lab card for master impresions

A

Impressions in addition silicone or polyether

Please pour in 100% dental stone and construct wax rims for jaw registration

Return rims on casts.

138
Q

lab card for jaw reg

A

Please mount casts in registration and set teeth for wax trial

Return wax trial dentures on mounted casts. Specific instructions: Diastemas

139
Q

lab card for wax re-trial

A

Re-Trial:

remount casts and make specified changed for second trial.

140
Q

lab cards for finishing after wax trial

A

please wax up for finish and process in heat cured acrylic resin

141
Q

maxillary primary support for denture

A

hard palate

maxillary tuberosities

142
Q

maxillary secondary support for denture

A

alveolar ridge

rugae area

buccal shelves

143
Q

post dam location on maxillar

A

along vibrating line;

in front of palatine fovea and through the hamular notches

144
Q

areas of relief on maxillary denture

A

incisive papilla and palatine torus

labial and buccal frena are muscle attachments and shouldn’t be encroached on

145
Q

mandibular denture primary support areas

A

buccal shelf

pear shaped pad

146
Q

mandibular denture secondary support

A

buccal and lingual slopes of alveolar ridge

147
Q

areas of relief for mandibular denture

A

lingual, buccal and labial frena (lingual is mylohyoid muscle)

148
Q

area utilised for retention in mandibular denture

A

lingual pouch

149
Q

boxed imp tray

A

(partially) dentate

150
Q

non-boxed imp tray

A

edentulous

151
Q

impression materials

A

alginate

impression compound

agar

extrude/Virtual

impregum

152
Q

alginate is

A

irreversible hydrocolloid

153
Q

agar is

A

reversible hydrocolloid

154
Q

extrude/virtual is

A

PVS (addition silicone)

155
Q

impregum is

A

polyehter

156
Q

impression compound is

A

non-elastic

157
Q

transfer lines for jaw reg

A
  • High smile line – can get an idea of how much tooth will show when smiling
  • Centre line – the midline of the teeth matches the midline of the patient’s face
  • Canine line – dictates the size of tooth to be used.
  • Residual alveolar line – so that the teeth are set in such a way above the lower residual ridges that the contacts are on this line
  • Alveolar contour line – because if the teeth are set on a slope then the denture may be displaced during function
  • Rim profile – to ensure adequate lip support
158
Q

jaw registration data

A

OVD

Centre line

Canine line

High lip line

Occ plane

Arch-form width (width-lip support)

  • Profile of upper rim trimmed by dentist is transferred onto the occlusal plane guide (clear Perspex sheet)
    • provide the arch form for setting teeth.
  • Centre of the lower ridge is transferred onto the occlusal plane guide
  • Centre line is transferred onto the casts and the occlusal plane guide.
  • Canine lines marked at the level distal to the incisive papilla on the cast.
  • Contour of occlusal rim is marked to show the flat area of the ridge where teeth should be placed.
159
Q

denture hygiene

instructions to pt

A

Instructions to patient

Insertion and removal

Advice re pain

Denture cleansing advice

160
Q

denture cleansing advice

alkaline hypochlorites

A

e. g. Dentural and Milton
* Don’t leave cobalt chromium dentures for longer than 10 mins as they can corrode.

Superior cleaning properties

Effective dissolution of plaque

Stain removal properties

Bacterial and fungicidal properties

  • Possible bleaching of acrylic resin
  • Residual taste after use (rinse)
161
Q

denture cleansing advice

effervescent peroxides

A

e.g. Steradent and Boots effervesant original

Powder of tablets

Rapid in action and simple to use

  • Problems can arise if very hot water used with denture, it can cause bleaching

Additional mechanical cleansing action

Bubbles created by the release of Oxygen which may dislodge debris

162
Q

first thing to do when receive any appliance

A

always check right prescription for right pt and right cast

163
Q

things to put on prosth prescription

A
  • stage
  • time and clinic needed for
  • disinfected
  • special tray - spacer? perforated? handle?
  • material to be used
  • positions of rests and clasps need to match drawing
  • rest seats need marked
  • indicate path of insertion

check casts for

  • overtrimmed
  • broken
  • stuck together
  • drag
  • air bubbles
164
Q

fixed prosth troubleshotting

A
  • state teeth to be used as pontics
  • how much tissue to be recovered? large amount of resorption needed?
  • type material to be used
    • stating ‘resin retained’ not enough
  • type of bridge
    • cantilever
    • fixed-fixed
    • fixed-cantilever
  • check prescription and cast - need right teeth present
  • inc lower cast - occlusion
  • shade for teeth and features? translucent edge for incisors?
165
Q

ortho prescription troubleshotting

A
  • check drawing and prescription match
  • gauge of wire
    • 0.7mm HSSW for retentive
    • 0.5mm HSSW for active
    • buccal canine retractors need I.D tubing
  • FABP needs to be O/J + 3mm
166
Q

crown prescriptions

primary impressions

A

please pour upper and lower primary impressions in 100% dental stone for study casts

167
Q

crown prescriptions

mounting casts with facebow

A

please mount upper castss and transfer onto av. value articulator using facebow registration

articulate lower cast to upper in ICP and fabricate custom incisal table

168
Q

mini sickle

A

red

  • double-ended point scaler with two cutting edges on each blade
  • Buccal and lingual embrasure surfaces supra-gingivally and in the pocket orifice
169
Q

columbia currette

4R-4L

A

red

  • A double-ended universal curette with 2 cutting edges on each blade
  • Sub-ging scaling anywhere in the mouth. Limited access to deep pockets.
170
Q

gracey currette 1-2

A

grey

  • A double-ended curette, each blade having a single cutting edge
  • Fine/deep sub-gingival scaling of upper and lower anterior teeth
171
Q

gracey currette 7-8

A

green

  • A double-ended curette, each blade having a single cutting edge
  • Fine/deep sub-gingival scaling of buccal/lingual surfaces of posterior teeth
172
Q

gracey currette 11-12

A

orange

  • A double-ended curette, each blade having a single cutting edge
  • Fine/deep sub-gingival scaling of mesial surfaces of posterior teeth
173
Q

gracey currette 13-14

A

blue

  • A double-ended curette, each blade having a single cutting edge
  • Fine/deep sub-gingival scaling of the distal surfaces of posterior teeth
174
Q

hoe scaler 134-135

A

yellow

  • A double-ended instrument
  • Gross supra- and sub-gingival scaling mainly on buccal and lingual surfaces.
175
Q

hoe scaler 156-157

A

red

  • A double-ended instrument
  • Gross supra- and sub-gingival scaling mainly on mesial and distal surface
176
Q

teeth 43-33 scaling labial and lingual

position

A

7 o clock

177
Q

teeth 44-48 buccal

scaling position

A

9 o clock

178
Q

teeth 34-38 lingual scaling position

A

9 o clock

179
Q

teeth 14-18 buccal scaling position

A

9 o clock

180
Q

teeth 44-48 lingual scaling position

A

11 o clock

181
Q

teeth 34-38 buccal scaling position

A

11 o clock

182
Q

teeth 13-23 labial and palatal scaling position

A

11 o clock

183
Q

teeth 14-18 palatal scaling positon

A

11 o clock

184
Q

teeth 24-28 buccal and palatal scaling position

A

11 o clock

185
Q

social hand washing

A

plain/antimicrobial soap & water or alcohol based hand gel if hands not visibly soiled.

Used for removing transient organisms

186
Q

hygienic hand wash

A

Liquid soap and water and then alcohol gel or antimicrobial soap or antiseptic hand cleanser

  • removing transient micro-organisms and reducing resident micro-organisms

6 step soap and water followed by alcohol gel or just alcohol gel if visibly clean, before and after patient contact before seeing pt and donning PPE

187
Q

surgical scrub

A

Longer and more thorough hand washing that includes lower arms

Hibi scrub often used

antiseptic hand cleansers

(liquid soap and water followed by ABHR)

188
Q

decontamination

hand washer

A

Washing visible blood off i.e forceps etc

189
Q

decontamination

disinfect

A

anything that has touched the pt

190
Q

decontamination

sterilise

A

anything that has crossed mucous membrane

191
Q

measuring capacity

4 things

A
  • Does the patient have a broad understanding of the procedure, its benefits and risks?
  • Do they have knowledge of any alternatives available?
  • Are they able to retain this information for a reasonable time?
  • Are they able to make a decision and communicate this choice? (Consider residual capacity)
192
Q

remember about capacity

A

Capacity fluctuates and is specific to each action/decision.

Patients may have capacity for some things but not others. It is NOT all or nothing.

assess each time

193
Q

Adult’s with Incapacity Act 2000 (Scotland)

5 key

A
  • benefit
  • minimum intervention
  • present and past wishes
  • consultation with relevant others
  • encourage residual capacity
194
Q

MMSE

used for

A

mini-mental state exam

Diagose dementia & help assess prognosis & severity

  • 27/30 is normal

What is the date? Time? PM? 3 things & repeat back

195
Q

donning PPE

A

apron

mask

visor

ABHR

gloves

196
Q

doffing PPE

A

gloves

ABHR

visor

mask

apron

197
Q

AGP Donning

A

carried out in AGP room before pt arrives

  • Single use disposable gown
  • FFP3 mask - straps adjusted and nose adjusted to ensure seal
  • Disposable hat -all hair tucked in
  • Visor over
  • Nitrile gloves
  • Sterile gloves over the cuffs of gown
198
Q

AGP doffing

A

when pt left the AGP room

  • Sterile gloves dispose
  • Nitril gloves - can be retained for cleaning if needs
  • Sanitise hands
  • Neck, waist pull gown off and roll in - dispose
  • Hand gel
  • Visor and hat removed
  • FFP3 mask doffed outside of aerosol room - sanitise hands, remove mase by handling sides and straps and sanitise
199
Q

please construct a URA to reduce OJ 22, 21, 11, 12 and reduce OB

4s extracted and canines moved distal previously

A

Active components

  • 22,21,11,12 Robert’s retract 0.5mm HSSW + 0.5mm ID tubing

Retention

  • Posterior retention
    • 16+26 Adam’s clasps 0.7mm HSSW

Stops

  • 13+ 23 mesial stops 0.7mm HSSW flattened (stops canines relapsing these are passive components)

Anchorage

  • Good and bad moving 4 teeth but all have small roots and moving same direction

Base plate

  • Self cure PMMA with flat anterior bite plane OJ+3mm
200
Q

Aim: please construct a URA to retract buccally placed 13 and bring 23 in the line of arch and reduce OB

A

Active components

  • 13 buccal canine retractor 0.5mm HSSW with 0.5mm ID tubing
  • 23 palatal finger spring and guard 0.5mm HSSW

Retention

  • Posterior retention
    • 16+26 Adam’s clasps 0.7mm HSSW
  • Anterior retention
    • 11+21 southend clasp 0.7mm HSSW

Anchorage

  • Good only moving 2 teeth

Base plate

  • Self cure PMMA with flat anterior bite plane OJ+3mm

BDS3 OSCE (6 decks)

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