2015 MSA Flashcards
Give 2 reasons for non-setting CaOH as an inter appointment medicament?
High pH gives it antimicrobial properties
Prolonged effect
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
What are the components of GP?
GP - 20%
Zinc oxide - 65%
Radiopacifier - 10%
Plasticiser - 5%
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
What is the technical term for a dry socket?
Alveolar osteitis - inflammation of the lamina dura
List 3 predisposing factors for a dry socket
Mandibular teeth
Females
Smoking
List 3 signs or symptoms of a dry socket
Dull, aching pain
Malodour from socket
Pain keeps patient awake at night
How is a dry socket managed?
Reassure patient
Recommend optimal analgesics
LA
Debridement of socket
Antiseptic pack eg alvogyl
List 3 common features of Parkinson’s
Bradykinesia - slow movement
Resting tremors
Postural instability
What is the difference between Parkinson’s and other cerebellar diseases?
Parkinson’s causes resting tremors, other cerebellar diseases have intentional, active tremors
What is the most likely reason for dry mouth?
Medications
How would you prevent a patient from losing their dentures?
Put patient initials on denture during fabrication
Keep dentures in a labelled case
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
What 2 key principles affect the future oral health for a patient with Parkinson’s?
Masticatory function
Relief of pain
What muscle is most important for elevating the mandible?
Temporalis
What muscle is most important for protruding the mandible?
Lateral pterygoid
Name 3 forms of candidosis
Pseudomembranous
Hyperplastic
Erythematous
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
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
Give 2 signs that a child patient is anxious
Delay of time by asking questions
Ask to go to the toilet
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
Give 4 risk factors of oral cancer
Smoking
Alcohol consumption
HIV infection
Malnutrition
Give another name for master impressions?
Definitive impressions
What 2 factors affect the physical retention of dentures?
Border seal
Proper extension into the vestibular sulcus
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
