2015 MSA Flashcards by David Jack

Give 2 reasons for non-setting CaOH as an inter appointment medicament?

High pH gives it antimicrobial properties
Prolonged effect

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List 3 reasons for obturating

Entomb any surviving microorganisms in the root canal
Prevent ingress of fluids into the root canal which would promote growth of microorganisms
Prevent microorganisms from the oral environment entering the root canal

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What are the components of GP?

GP - 20%
Zinc oxide - 65%
Radiopacifier - 10%
Plasticiser - 5%

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Give 3 reasons for using a sealer when using cold lateral compaction?

Seals area between dentinal wall and core
Fills voids and irregularities in canal
Lubricates the canal

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What is the technical term for a dry socket?

Alveolar osteitis - inflammation of the lamina dura

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List 3 predisposing factors for a dry socket

Mandibular teeth
Females
Smoking

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List 3 signs or symptoms of a dry socket

Dull, aching pain
Malodour from socket
Pain keeps patient awake at night

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How is a dry socket managed?

Reassure patient
Recommend optimal analgesics
LA
Debridement of socket
Antiseptic pack eg alvogyl

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List 3 common features of Parkinson’s

Bradykinesia - slow movement
Resting tremors
Postural instability

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What is the difference between Parkinson’s and other cerebellar diseases?

Parkinson’s causes resting tremors, other cerebellar diseases have intentional, active tremors

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What is the most likely reason for dry mouth?

Medications

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How would you prevent a patient from losing their dentures?

Put patient initials on denture during fabrication
Keep dentures in a labelled case

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What are the 2 most important reasons for not extracting teeth for a patient with Parkinson’s

Tremor could make extractions difficult
Will require a prosthesis to replace teeth and patient won’t tolerate the denture making process

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What 2 key principles affect the future oral health for a patient with Parkinson’s?

Masticatory function
Relief of pain

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What muscle is most important for elevating the mandible?

Temporalis

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What muscle is most important for protruding the mandible?

Lateral pterygoid

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Name 3 forms of candidosis

Pseudomembranous
Hyperplastic
Erythematous

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Name an antifungal that can treat candidosis and describe its method of action

Fluconazole
Inhibits synthesis of ergosterol, a component of the fungal cell membrane

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Name 1 other species of candida other than C. albicans and describe how to differentiate the two

C. glabrata
C. glabrata is unaffected by azole antifungals and so polyenes are required to treat it

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Give 2 signs that a child patient is anxious

Delay of time by asking questions
Ask to go to the toilet

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What is SIMD?

Scottish Index of Multiple Deprivation
Ranks data zones based on level of deprivation using factors such as employment, crime, income, housing and education

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Give 4 risk factors of oral cancer

Smoking
Alcohol consumption
HIV infection
Malnutrition

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Give another name for master impressions?

Definitive impressions

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What 2 factors affect the physical retention of dentures?

Border seal
Proper extension into the vestibular sulcus

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What 2 anatomical features are used for positioning of the border of upper impression?

Hamular notch Vibrating line

What 3 anatomical features should be included on mandibular impressions?

Buccal shelf Retromolar pad Residual ridge

What 2 materials can be used on lower impressions?

Alginate Polyether

List 2 characteristics of biofilm ECM that causes resistance to antimicrobials

Protective layer preventing penetration of antimicrobials Impairs diffusion of antimicrobials

Name 2 bacteria heavily involved in periodontal disease

P. gingivalis T. forsythia

Name 2 bacteria heavily involved in caries

S. mutans A.a.

List 2 key features that enable bacteria to adhere and survive in acidic environments

Adhesins - proteins that bind to receptors on tooth surface Extracellular polysaccharides - form a sticky matrix

List 3 PPE for carrying out manual cleaning and why

Heavy duty gloves - protect from sharps injuries Apron - protect scrubs from contamination of microorganisms Visor - protect face and eyes from splashing

When should the ultrasonic cleaner be de-gassed and why

Before every production cycle Removes air bubbles The bubbles produced by the ultrasonic process would collapse with the air bubbles, reducing the efficacy of the machine

What are the 2 types of manual cleaning and name an example instrument of each

Immersion - dental mirror Non-immersion - handpiece

Why is deionised water used in the steriliser?

Impurities in ionised water would coat the instruments negatively affecting the sterilisation process

What percentage of patients are affected by sensitivity from bleaching?

60%

Name 3 predisposing factors likely to cause sensitivity

Pre-existing sensitivity High concentration of bleaching agent Gingival recession

What is the method of action for external cervical resorption from bleaching?

Diffusion of hydrogen peroxide through dentine into periodontal tissues

Give 2 causes of root resorption from bleaching

High concentration of hydrogen peroxide Heat

How can you prevent root resorption when bleaching?

Maintain good OH Place 1mm RMGIC over GP to seal canal

Give 3 reasons for non surgical perio tx before surgical

Deep pockets may heal after non-surgical treatment Non surgical can reduce inflammation, making following surgical procedures more effective Allows evaluation of patients motivation and plaque control

What are 2 indications for surgical periodontal tx at re-evaluation?

Excellent oral hygiene Deep persisting pockets of 5mm or more

When should you re-evaluate non-surgical periodontal treatment?

6-8 weeks

What is the aim of surgical periodontal treatment?

To arrest the disease by gaining access to complete root surface debridement To regenerate lost periodontal tissue

What are 3 supportive roles of a GDP after surgical perio tx has been carried out by a specialist?

Annual 6 point pocket chart with modified plaque and bleeding scores Supra and subgingival PMPR Review oral hygiene and use TIPPS

How can radiotherapy of the head and neck form ulcers?

Radiotherapy destroys the protective barrier of the oral mucosa leading to inflammation and the formation of ulcers

Why is enhanced prevention needed for ulcers after radiotherapy?

Severe pain from oral mucositis may inhibit oral hygiene measures and have a severe impact on eating

What is the complication of extractions after radiotherapy and why is this the case?

ORN Radiotherapy can damage the blood vessels and bone tissue in the jaw which can impair healing

List 4 effects chemotherapy has on blood count

Reduced red cells Reduced platelets Reduced white cells Decreased clotting factors

List 4 things that can be used to diagnose Alzheimer’s

Dementia screen to eliminate treatable causes Cognitive testing Neurological examination Urinalysis

Who can consent for a patient with Alzheimer’s

Power of Attorney Welfare Guardian

What are the capacity acts relevant in Scotland and England?

Adults with Incapacity (Scotland) Act 2000 The Mental Capacity Act 2005

What 3 questions can you ask a patient who wants to quit smoking?

Have you ever tried to quit before? How many attempts have you had? What helped when you attempted before?

What 2 services can you refer a patient who wants to quit smoking to?

Pharmacy Smoking cessation services - quit your way

What are the 2 types of e-cigarettes?

Direct to lung Restricted direct to lung

What advice should you give a patient regarding e-cigarettes?

The long term effects are unknown They contain nicotine but not cancer causing tobacco They are safer to use than cigarettes

List 4 initial management options for an upper central incisor that has failed to erupt

Case history, especially regarding trauma Extra oral examination Intra oral examination Radiograph - upper anterior oblique occlusal or periapical

List 2 causes of failed eruption of permanent teeth

Supernumeraries Dilaceration of root

What are the 4 principles of aims of ortho treatment for an unerupted central incisor

Remove the primary predecessor and any supernumeraries Create and maintain space Wait 12 months if patient is under 9 Expose and bond gold chain to tooth and apply orthodontic traction

What line for an OPT should be parallel to the floor?

Frankfort plane

Why may anteriors be magnified in an OPT?

Patient too far back in machine (canines behind canine guidance line)

Why may posteriors on one side be magnified in an OPT?

Patient rotated in machine

List 3 features of a ghost image

Always higher On the opposite side Horizontally magnified

Pre-extraction of 48, 38 is fine, what type of radiograph should be used?

Right sided OPT

What radiograph should be used for a child with caries who cannot tolerate bitewings?

OPT with deciduous dentition setting

What border of the maxillary sinus is horizontal above the molars?

Inferior

What border of the maxillary sinus is vertical above the 3rd molar?

Posterior

What special investigation should be carried out for carious lower 6s?

Bitewings

What are you looking for in suitable extraction timing of 6s?

Calcification of bifurcation of 7s 5s and 8s present

List 2 advantages of extraction of 6s at the correct time

Caries free dentition Mesial drift of 7s will fill spaces

List 2 disadvantages of extraction of 6s at the correct time

Risks associated with GA Permanent tooth extraction is a demanding process for a child, any traumatic experiences could give them a negative view of dental care in the future

What are 2 extraction methods for an anxious child?

GA Inhalation sedation

What nerves need to be anaesthetised for extraction of 45?

Inferior alveolar nerve Lingual nerve

List 2 ways you can test for anaesthesia

Probe buccal and lingual sulcus - patient should feel pressure but no pain Ethyl chloride test on tooth - should feel no sensation

Name 3 possible nerve deficits

Neurapraxia Axonotmesis Neurotmesis

Name 3 causes of nerve damage

Crushing Cutting injury Transection of nerve