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BDS3 past papers > 2021 > Flashcards

2021 Flashcards

1
Q

What nerves must be anaesthetised to remove tooth 48 safely

A

Inferior Alveolar Nerve
Lingual nerve
Long buccal nerve

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2
Q

What are two different ways to assess anaesthesia has been achieved?

A
  • Probe around the tooth and ask the patient if they feel anything sharp
  • ask if the patients lips and tongue feel numb
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3
Q

What is the dental terminology for pins and needle feeling or partial loss of sensation ?

A

Parasthesia

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4
Q

What is the dental terminology for painful, unpleasant sensation lasting for a fraction of a second ?

A

dysesthesia

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5
Q

What is the dental terminology for total loss of sensation?

A

Anaesthesia

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6
Q

What are 3 clinical reasons that could account for neurological-sensory deficits?

A
  • crushing injury
  • cutting/shredding injury
  • transection of the nerve
  • damage due to LA
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7
Q

What is the correct terminology for dry socket?

A

localised alveolar osteitis

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8
Q

What are predisposing factors of dry socket?

A
  • smoking
  • excessive mouth rinsing after extraction
  • excessive trauma during extraction
  • previous dry socket
  • more common in mandibular extractions
  • More common in posterior extractions
  • More common in females
  • Oral contraceptive pill
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9
Q

What are signs and symptoms of sry socket ?

A

pain disturbing the patients sleep
pain radiating to the ear
dull aching pain
bad breath (halitosis)
bad taste in the mouth
exposed bone that may be sensitive

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10
Q

What is the management for dry socket?

A
  • reassure and support the patient
  • debridement to remove the old clot and encourage new clot formation
  • irrigate the socket with warm saline
  • may give systemic analgesia
  • antiseptic pack (BIP)
  • advice patient on analgesia and hot salty mouthwash
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11
Q

What are risk factors of oral cancer ?

A
  • smoking
  • Alcohol intake
  • HPV
  • sunlight
  • nutritional deficiencies
  • candida infections
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12
Q

What radiation dose increases the risk of osteoradionecrosis?

A

doses over 60 Gy

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13
Q

What are oral complications of radiotherapy?

A
  • osteoradionecrosis
  • radiation caries
  • hypogeusia - loss of taste due to radiation affecting taste buds
  • xerostomia - may be due to damage of salivary glands
  • difficulty wearing dentures
  • more prone to fungal infections
  • trismus may occur due to replacement fibrosis of muscles of mastication
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14
Q

what sites of the teeth are affected by radiation caries?

A
  • gingival margins and incisor edges
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15
Q

what are causes of radiation caries?

A
  • dry mouth
  • loss of taste
  • change in diet
  • hypersensitivity of teeth makes OH difficult
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16
Q

What do you need to know about patients who have had radiotherapy?

A
  • what dose of radiation was given
  • what area of the body was exposed to the radiation
  • duration of treatment
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17
Q

What are preventative measures used for patients who have had radiotherapy?

A
  • OHI
  • higher concentration of fluoride toothpaste
  • fluoride varnish
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18
Q

how do you treat osteoradionecrosis?

A
  • irrigation of necrotic debris
  • remove loose sequestra
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19
Q

What methods help prevent risk of osteoradionecrosis?

A
  • scale teeth near extraction site and use chlorohexidine mouthwash
  • careful extraction technique
  • antibiotics, chlorhexidine mouthwash and review
  • hyperbaric oxygen before and after extraction to increase local tissue oxygenation
  • close soft tissues
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19
Q

What methods help prevent risk of osteoradionecrosis?

A
  • scale teeth near extraction site and use chlorohexidine mouthwash
  • careful extraction technique
  • antibiotics, chlorhexidine mouthwash and review
  • hyperbaric oxygen before and after extraction to increase local tissue oxygenation
  • close soft tissues
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20
Q

What is the most common cause of facial trauma in a female patients?

A

Domestic Abuse

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21
Q

What are the forms of abuse that may be involved in domestic abuse?

A
  • Physical violence
  • Verbal abuse
  • Emotional abuse
  • Sexual abuse
  • Financial Abuse
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22
Q

What process should you follow to ask about the possibility of domestic abuse

A

AVDR

Ask - ask about abuse in a private setting

Validate - show you are concerned about them

Document - be specific and detailed, use patients own words and describe injuries in as much detail as possible

Refer - signpost to appropriate services

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23
Q

What are physical signs you may see in domestic abuse ?

A
  • repeated injuries
  • Bruises at different stages if healing
  • dental/maxillofacial injuries
  • facial bruising, strangle marks around the neck or fingertip bruising
  • TMJ problems
    -Orofacial pain
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24
Q

What are causes of liver cirrhosis

A
  • Alcohol
  • Hepatitis virus
  • fatty liver disease
  • autoimmune causes:primary billary cirrhosis
  • haemochromatosis
  • hepatocellular carcinoma
  • drug induced
25
Q

what does dentally fit mean

A
  • no active pathology
  • consider removing teeth of poor long-term prognosis
  • establish preventative plan
26
Q

why should a patient be dentally fit before a transplant

A

the patient will be immunosuppressed for the rest of their life so must reduce the risk of further dental intervention in the future

27
Q

what teeth can be justified to extract when making a patient dentally fit

A

teeth with periapical periodontitis or other pathology
teeth with poor prognosis - highly restored and secondary caries

28
Q

what causes thrombocytopenia to occur

A

splenic sequestration

impaired hepatic synthesis

increased degredation of thrombopoeitin by platelets sequestered in the congested spleen

drug related - alcohol, penecillin based drugs or heparin

29
Q

what platelet level is considered safe to treat in general practise

A

> 100 x 10^9 / L

30
Q

why might patients with advanced alcoholic liver disease have increased risk of bleeding

A
  • thrombocytopenia
  • medication induced, patient may be taking heparin
  • liver disease may have been caused by hepatitis or HIV which both affect bleeding
  • clotting factors essential for coagulation are formed in the liver. If the liver is not functioning proerly these will not be present and affects coagulation ability
30
Q

why might patients with advanced alcoholic liver disease have increased risk of bleeding

A
  • thrombocytopenia
  • medication induced, patient may be taking heparin
  • liver disease may have been caused by hepatitis or HIV which both affect bleeding
  • clotting factors essential for coagulation are formed in the liver. If the liver is not functioning proerly these will not be present and affects coagulation ability
31
Q

What are the types of dementia

A

Alzheimers
Vascular dementia
Dementia with lewy bodies

32
Q

what are early stages of dementia?

A

Short term memory loss

confusion

Anxiety, agitation or distress

Communication issues - decline in ability to talk or write

33
Q

What are middle stages of dementia

A

support required for everyday activites e.g. washing, dressing, using the bathroom

Increasing forgetfulness

Distress, aggrression or anger

Risk of wandering

behaving inappropriately e.g. going out in pyjamas and slippers

34
Q

what are end stage

A

inability to recognise familiar objects, surroundings or people

Increased physical frailty - may shuffle when walk or become confined to a bed or wheelchair

difficulty eating and swallowing

asphagia

35
Q

who can provide section 47 AWI certificate for dental treatment

A

dentist who has done additional training

general medical practicioners

consultants in-charge of patient care

36
Q

What is the antibiotic and dose given for antibiotic prophylaxis

A

amoxicillan 3g

clyndamicin 600mg

37
Q

how long before a procedure is AB prophylaxis taken and what guidance is this from

A

1 hour

SDCEP guidance

38
Q

what are indications of child abuse/neglect?

A
  • irregular attenders - only attend when in pain
  • delayed seeking attention/help for injuries
  • injuries to the triangle of safety (ears, neck and side of face)
  • Injuries to the head and neck
  • injuries to both sides of the body
  • untreated injuries
39
Q

What would you ask if you suspect child abuse

A

ask what caused the injury and see if the story matches clinical finding

Has there been a reason for delay in seeking advice

40
Q

who could you discuss concerns with about child abuse

A

Child protection adviser
Named safeguarding nurse

41
Q

what are the stages in managing child neglect?

A

Preventative dental team management - raise concerns with the parents, offer support, set targets and monitor progress

Preventative multi-agency management - liase with other professionals (e.g. health visitor, GMP, school nurse) and agree joint plan of action

Child protection referral - follow local guidelines to refer to social services

42
Q

how do you refer to child services?

A

initially by telephone
follow up referral in writing

43
Q

what is the treatment for dentine enamel fracture

A

cover all exposed dentine with glass ionomer or composite

44
Q

what would you look for clinically when monitoring this patient

A
  • normal mobility
  • no TTP
  • discolouration
  • Infection
45
Q

what are radiographic signs a tooth is non vital

A

internal inflammatory resorption
External inflammatory resorption
Periapical abscess
Widened PDL
Loss of lamina dura

46
Q

what appliance might help prevent injury to anterior teeth

A

splint

47
Q

explain the distribution of decay in nursing bottle caries

A

lower incisors protected by the tongue
Maxillary incisors are affected worst as they erupt first
Affects molar teeth
if habit continues teeth will be affected in the sequence of eruption

48
Q

what causes nursing bottle caries

A

going to bed with a bottle of milk or juice

prolonged breastfeeding

baby using bottle as a comforter rather than a dummy

inappropriate use of feeding bottles and cups - should not contain sugar juice or milk

49
Q

fluoride regime for 2 year old with caries

A

1500 ppmF toothpaste 2x daily

50
Q

fluoride regime for 2 year old with caries

A

1500 ppmF toothpaste 2x daily

51
Q

What are recommendations to make for toothbrushing

A
  • brush 2x daily with a smear of toothpaste (state concentration)
  • Parent should be brushing teeth for the child
  • do not rinse mouth after brushing
  • use a small headed toothbrush with soft bristles
52
Q

What are local causes of maloclussion

A
  • variation on tooth number
  • variation in tooth size or form
  • abnomralities of tooth position
  • Local abnormalities of soft tissue
  • Local pathology
53
Q

what are examples of variation in tooth number

A

supernumary teeth
hypodontia
Retained primary teeth
early loss of primary teeth
unschedules loss of permanent teeth

54
Q

what are the types of supernumary teeth

A

conical
tuberculate
supernumary
odontome

55
Q

what are 2 ways to assess AP skeletal pattern

A

Palpate skeletal bases
visual assessment

56
Q

what are possible non-skeletal factors that can because class 2 div 2 occlusion

A
  • lip trap
  • digit sucking
  • crowding
57
Q

what appliance can be used to correct class II div 2 malocclusion

A

functional appliance - twin block

58
Q

how does mandibular growth occur

A

growth occurs at condylar cartilage

growth occurs by surface remodelling ( resorption and deposition of bone)

results in increase in height of the ramus and increase in the length of the dental arch to accomodate teeth

growth is downwards and forwards

BDS3 past papers (8 decks)

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