2017 MSA Flashcards by David Jack

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

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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

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If a patient has sensitivity to heat and cold lasting for a few seconds, what is the diagnosis?

Reversible pulpitis

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If a patient has pain on pressure, what is the diagnosis?

Symptomatic apical periodontitis

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What is the treatment for reversible pulpitis?

Removal of stimulus and review to check if pulp has returned to normal status

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What is the treatment for symptomatic apical periodontitis?

RCT or extraction

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What is gaseous porosity?

Voids in the material occurring when PMMA is cured fast
Usually happens in thicker sections of the acrylic

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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

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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

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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

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What radiograph can be taken for an uncooperative child with caries on 16, 36 and 46 that need extraction?

OPT

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What would you do with the 26 if 16, 36 and 46 need extracted?

Compensating extraction

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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

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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

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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

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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

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Give 4 peri-operative complications during extraction of a mandibular premolar

Abnormal resistance
Soft tissue damage
Damage to nerves
Alveolar bone fracture

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What 2 types of administration of LA is needed for extraction of a mandibular premolar?

Buccal infiltration
Lingual infiltration

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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

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Name 3 neurone-sensory defecits

Paraesthesia
Anaesthesia
Hypoaesthesia

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Name 3 possible causes of neuro-sensory defecits

Crushing
Cutting injury
Transection of nerve

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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

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Name 2 effects trauma has on the primary dentition

Discolouration
Infection

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Name 4 effects primary trauma has on the permanent dentition

Delayed eruption
Ectopic eruption
Ankylosis
Dilaceration of root

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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