2021 MSA Part 1 Flashcards
What nerves must be anaesthetised for the surgical removal of 48?
Inferior alveolar nerve
Lingual nerve
Buccal nerve
Give 2 ways you can assess anaesthesia has been achieved for extraction of the 48
Ask patient if right lip and tongue feel numb
Probe the gingiva adjacent to the 48 - patient should feel pressure but no pain
What word describes pins and needles or partial loss of sensation?
Paraesthesia
What word describes a painful, unpleasant or neuralgic sensation that lasts for a fraction of a second?
Dysaesthesia
What word describes a total loss of sensation?
Anaesthesia
Give 3 clinical reasons that can account for a neuro-sensory deficit of the right lip and chin region?
Damage to the IAN during LA placement
Transaction of nerve
Cutting injury
What is the correct term for a dry socket?
Localised osteitis - inflammation affecting lamina dura
Give 3 predisposing factors that could contribute to a dry socket
Any 3 from:
Mandibular teeth
Molar teeth
Females gender
Smoking
Oral contraceptive pill
Excessive trauma during extraction
Excessive trauma post extraction
Family history/previous dry socket
Give 3 signs or symptoms for a dry socket
Any 3 from:
Dull aching pain
Pain can keep patient up at night
Pain can radiate to patients ear
Bone is sensitive and the source of pain
Bad odour from the socket
How would you manage a dry socket? 3 marks
Any 3 from:
Support patient
Systemic analgesics
LA
Irrigate socket with warm saline
Curettage/debridement
Antiseptic pack (alvogyl)
Advise patient on analgesia and hot salty mouthwash
Review patient/change packs and dressings
Do not prescribe antibiotics as it is not infection
Remember to check initially that it is a dry socket and that no tooth fragments or bony sequestra remain
Give 4 risk factors for mouth cancer
Smoking tobacco
Alcohol
Diet low in fruit and vegetables
Immunosuppression
What information about a patients radiotherapy tx do you need to know?
The dosage of radiotherapy received
Field of exposure
What dose of radiotherapy increases the risk of ORN?
60Gy
Describe the pattern of decay unique to radiation caries?
Cervical margins affected
How would you manage unrestorable teeth if a patient has an increased risk of ORN?
Begin primary orthograde endodontics and decoronate
Give 2 oral complications associated with radiation therapy, other than ORN and radiation caries, to the head and neck
Any 2 from:
Oral mucositis
Candida infections
Traumatic ulceration
Reactivation of Herpes Simplex virus
Xerostomia
Trismus
Dental erosion
Caries
Periodontal disease
Give 2 preventative measures that should be implemented to reduce the risk of future dental disease for patients who have received radiotherapy to the head and neck
2,800ppm fluoride toothpaste
Tooth mousse
Give a management strategy for established ORN
Hyperbaric oxygen therapy
Other than alcohol, give two causes of liver crrhosis
Any 2 from:
Chronic hepatitis B and C
Non alcoholic fatty liver disease
Autoimmune hepatitis
Biliary cirrhosis
List 2 priorities for a patient in order to render them dentally fit
Any 2 from:
No active caries
Periodontal health
No dental infection
Good oral hygiene