2017 MSA Flashcards
What is reversible pulpitis?
Pulpal inflammation that should resolve following removal of the etiology
Short/sharp pain on application of cold stimulus which lingers for a few seconds after stimulus removed
What is symptomatic irreversible pulpitis?
Pulpal inflammation that is incapable of healing
Characterised by sharp pain upon thermal stimulus and lingering pain for more than 30s after stimulus is removed
Pain is spontaneous and keeps patient awake at night, analgesics typically ineffective
If a patient has sensitivity to heat and cold lasting for a few seconds, what is the diagnosis?
Reversible pulpitis
If a patient has pain on pressure, what is the diagnosis?
Symptomatic apical periodontitis
What is the treatment for reversible pulpitis?
Removal of stimulus and review to check if pulp has returned to normal status
What is the treatment for symptomatic apical periodontitis?
RCT or extraction
What is gaseous porosity?
Voids in the material occurring when PMMA is cured fast
Usually happens in thicker sections of the acrylic
What 2 things does a mould liner help with?
More comfortable in patients mouth
Can promote healing and reduce inflammation of soft tissues
Distributes occlusal forces more evenly
Give 2 reasons why you can’t leave acrylic dentures in dry environments for too long
Warping so denture may be unable to fit patient
Can lose moisture and become brittle
Give two thermal properties of acrylic dentures and explain why they are important
Low thermal conductivity - denture base is not be able to transmit heat well to the palate therefore patient is less sensitive to the temperature of food and liquids
High softening temperature - must inform the patient not to clean the denture using boiling water
What radiograph can be taken for an uncooperative child with caries on 16, 36 and 46 that need extraction?
OPT
What would you do with the 26 if 16, 36 and 46 need extracted?
Compensating extraction
What things should you look out for in a radiograph to choose a suitable time for permanent molar extraction?
Calcification of bifurcation of 7s
Presence of 8s
Give 2 advantages of extraction of permanent molars at the correct time
Allows for a caries free dentition
Allows for space closure through mesial drift of 7s
Give 2 disadvantages of extraction of permanent molars at the correct time
Associated risks of GA
Extraction of permanent molar can be demanding for a child at this stage and negative experiences may affect future dental visits
Name 2 things needed for a 3 year old child to carry out extractions
Gain consent from person with parental responsibility
Write referral letter for GA
Give 4 peri-operative complications during extraction of a mandibular premolar
Abnormal resistance
Soft tissue damage
Damage to nerves
Alveolar bone fracture
What 2 types of administration of LA is needed for extraction of a mandibular premolar?
Buccal infiltration
Lingual infiltration
Give 2 ways you can check for anaesthesia?
Probe into the gingival sulcus around the tooth and check if any pain is felt
Ethyl chloride test should have no response
Name 3 neurone-sensory defecits
Paraesthesia
Anaesthesia
Hypoaesthesia
Name 3 possible causes of neuro-sensory defecits
Crushing
Cutting injury
Transection of nerve
Give 4 signs that trauma in a child is non-accidental
Delay in presentation
Untreated injury
Repeated injuries
History of injuries don’t match clinical findings
Name 2 effects trauma has on the primary dentition
Discolouration
Infection
Name 4 effects primary trauma has on the permanent dentition
Delayed eruption
Ectopic eruption
Ankylosis
Dilaceration of root
Give 4 ways to stop a digit sucking habit
Positive reinforcement
Elastoplast on finger
Habit breaker device
Bitter tasting nail polish
Name 4 occlusal presentations of digit sucking
Proclined upper incisors
Retroclined lower incisors
Anterior open bite
Unilateral posterior crossbite
Explain what happens to the posterior dentition during thumb sucking
Thumb is placed where tongue should be so cheek muscles push upper teeth palatally resulting in a narrower upper arch
The teeth meet cusp to cusp so the mandible must deviate to one side on closing to achieve ICP, resulting in a unilateral posterior crossbite
What is the Scottish Index of Multiple Deprivation?
Area based index which ranks data zones within Scotland in order of deprivation
Give 4 modifiable aetiologies of head and neck cancer
Smoking
Alcohol intake
Sun exposure
Malnutrition
Name 2 common reasons for an unerupted central incisor
Trauma
Supernumeraries
Give 4 steps to help with clinical diagnosis of an unerupted central incisor at the same visit
Detailed medical and dental history
Extraoral examination
Intra oral examination
Take a radiograph
How should an unerupted central incisor be treated? (4 marks)
Remove primary teeth and supernumeraries
Create and maintain space
Monitor for 12 months if patient is under 9
Expose and bond gold chain and apply orthodontic traction
What antibiotic, dose, amount and duration is prescribed for acute necrotising gingivitis?
Metronidazole 400mg 3 times daily for 3 days
What 2 pieces of advice should be given about metronidazole?
Do not drink alcohol
It interacts with warfarin
What 2 treatments should be given on a follow up appointment for necrotising gingivitis?
Debridement with LA
OHI
Give 2 ways biofilms help with resistance
ECM acts as a physical barrier preventing antimicrobial agents from penetrating
ECM impairs diffusion of antimicrobial agents
Name 2 microorganisms associated with caries
S. mutans
A.a
Name 2 perio microorganisms (red socransky’s)
P. gingivalis
T. forsythia
What aids acid adherence and acid tolerance in caries forming microorganisms? (2 marks)
Adhesins - proteins that bind to tooth surface
Extracellular polysaccharides - form a sticky matrix
What is a null hypothesis?
Statement suggesting there is no statistical significance in a set of data
What is a confidence interval?
Range you can be confident data will lie within 95 times out of 100
What is an odds ratio?
The chances of the event happening in the exposure group over the chances of the event happening in the placebo group
What are the 2 types of manual washing?
Immersion
Non-immersion
Give an example of an instrument used in each type of washing
Immersion - dental mirror
Non-immersion - handpiece
Why do we degas an ultrasonic?
There are air bubbles inside water normally, during the process any bubbles created will collapse into air bubbles
This would reduce the efficiency of the machine
How often do you degas an ultrasonic?
Before every production cycle
Why shouldn’t handpieces be placed in an ultrasonic?
They shouldn’t be immersed in water
The ultrasonic activity can damage the high speed turbine of the hand piece
Why is demineralised water used in a steriliser?
The substance in mineralised water endotoxin would coat the surface of the instruments if used
What are the constituents of GP?
GP - 15%
Zinc oxide - 65%
Radiopacifier - 15%
Plasticiser - 5%
Give 3 reasons for obturating
Entomb remaining surviving microorganisms within the root canal system
Prevent ingress of fluid into root canal space which will promote growth of the surviving microorganisms
Prevent entry of microbes from the oral environment due to coronal leakage
Give 2 properties of non-setting CaOH
High pH - antimicrobial properties
Prolonged effect
What are 3 functions of a sealer?
Lubricate canal
Seal space between dentinal wall and core
Fill voids and irregularities within canal
Name 2 things that provide retention for a denture?
Border seal
Incorporation of post dam
What 2 anatomical features help identify where the posterior border should be placed for the upper denture?
Hamular notch
Vibrating line
What 2 impression materials would you take for an edentulous patient on the mandibular arch?
Alginate
Polyether
What is being dentally fit?
Good oral health with no active caries or dental infections and having good oral hygiene
What is a multidisciplinary team?
Group of healthcare professionals from different specialities who work together to provide the best and most holistic care possible for the patient
Name 4 people that can be involved in a MDT
Dentist
Surgeon
Oncologist
Pathologist
Name 4 oral implications of radiotherapy
Xerostomia
Oral mucositis
Increased risk of ORN
Limited opening due to trismus
What 3 features of cerebral palsy impair access to the mouth?
Muscle stiffness
Muscle weakness
Random and uncontrolled body movements
Name 2 ways to open a patients mouth?
Open wide mouth rests
Bedi shield
Give 2 ways to tilt a patient back for access
Wheelchair recliner
Reclining wheelchair
How can you ensure a patient has access to the upper floor?
Handrail
Lift
What can you use to communicate if a patient cannot speak or write?
Makaton
Picture boards
Electrical tablet
What are the differences between medical models and social models in relation to disability?
Social models - disability is caused by how society is organised rather than the persons difference
Medical models - disability is caused by a persons abnormality and should be fixed through medicine
What is xerostomia?
Dry mouth caused by reduced salivary flow
Name 4 oral problems exacerbated by xerostomia
Caries
Periodontal disease
Candida infection
Oral mucositis
Name 4 drugs that cause xerostomia
Tricyclics
Diuretics
Nicotine
Opioids
Name 2 other causes of xerostomia
Radiotherapy
HIV
Why may anteriors be magnified in an OPT?
Canine positioned behind canine guidance line (patient too far back in machine)
Why may posteriors be magnified on one side of an OPT?
Patient rotated in the machine
What plane is horizontal to the floor during an OPT?
Frankfort plane
What kind of OPT should be taken for a partially erupted 48, no sign of 38?
Righ sided OPT
What OPT radiograph should be taken for a child who is unable to take bitewings?
OPT setting for deciduous dentition
In an OPT, what part of the maxillary sinus is immediately above the premolars and immediately above the third molars?
Premolars - inferior border
Third molars - posterior border
Where is the mental foramen?
Between the apices of the lower premolars
What 2 structures does the mental nerve innervate?
Lower lip
Chin
