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
Why is it important to establish oral health prior to receiving a transplant?
To reduce risk of infection
What reasons can provide justification for the removal of teeth
Unrestorable due to caries
Increased mobility due to periodontal disease or occlusal trauma
An impacted tooth to decrease the risk of infection and overcrowding
To treat overcrowding
Give 2 reasons why thrombocytopenia may occur?
Any 2 from:
Medication side effects such as heparin
Decreased production of platelets from leukaemia or lymphoma
Deficiency of Vitamin B12 or folate
Viral infection such as Hep C or HIV
In thrombocytopenia, above what level is it acceptable to undertake an extraction in the GDP setting without consulting an appropriate medical or specialist dental professional?
100
Other than thrombocytpenia, explain why a patient with advanced alcoholic liver disease may have an increased risk of bleeding?
Decreased production of clotting factors
Name 3 types of dementia
Any 3 from:
Alzheimer’s
Vascular dementia
Dementia with Lewy Bodies
Frontotemporal
Give 4 signs or symptoms present in someone with late stage dementia?
Any 4 from:
Inability to recognise familiar objects, surroundings and people
Increasing physical frailty
Difficulty eating and swallowing
Incontinence
Gradual loss of speech
List 2 people who can provide a capacity assessment for dental treatment in accordance with the Adult’s with Incapacity Act 2000
A registered medical practitioner
A registered dental practitioner
If a patient requires oral antibiotic prophylaxis for 6 extractions and they have no known allergies, what antibiotic should be prescribed and what is the dosage?
Amoxicillin
3g
How long before a dental procedure should antibiotic prophylaxis be administered and what guidance is this from?
1 hour
SDCEP
A child presents complaining of severe pain and lack of sleep for the last 6 weeks with bruising on their right cheek and a small abrasion on their right temple.
What might you be concerned about as a result of seeing the child?
What two parts of the presentation led you to have these concerns?
Child abuse
Significant harm to the child
The child is a new patient to the practice
The child has been in pain for 6 weeks
What questions can be asked to further an investigation when you have concerns of child abuse? (2 marks)
What specifically happened when you got that bruise?
Who was there when you got the bruise?
Unsure tbh
Who can you discuss further action about child abuse with? (1 mark)
Social services
If a parent fails to bring a child back for 2 appointments for caries treatment, what are the next two stages in the management of dental neglect?
Preventative multi-agency management
Child protection referral
In the last stage of management of dental neglect how do you share your concerns initially and then what do you follow this up with? (2 marks)
Send a letter to the health visitor
Health visitor visits and contacts dentist to arrange new appointment
Health visitor given details of appointment
Describe emergency management of a dentine/enamel fracture?
Cover all exposed dentine with GIC or composite
List 4 signs or symptoms (excluding radiographic) which you would look for in longitudinal monitoring of a patient with an enamel/dentine fracture?
Any 4 from:
Mobility
Colour
TTP
Sinus
Percussion note
What four radiographic signs might be present if a tooth becomes non-vital?
Periapical radiolucency
Widened PDL space
Loss of lamina dura
Root resorption
How can you prevent further injury to anterior teeth during rugby matches? (1 mark)
Wear a protective mouth guard during the match
Caries are present on 54, 52, 51, 61, 62, 64, 74, 84
What diagnostic name is given to this caries distribution? (1 mark)
Why are the specified teeth affected and not others? (3 marks)
Nursing caries
Lower incisors are protected by the tongue
Maxillary incisors are the first teeth to erupt
The maxillary incisors are most exposed to sugary liquids
List 4 causes of nursing caries
Prolonged bottle feeding
Frequent exposure to sugary liquids
Use of medicines containing sugar
Poor oral hygiene
What fluoride regime can you follow in the dental surgery setting for a child with nursing caries? (2 marks)
Recommend the use of 1350-1500ppm fluoride toothpaste
Ensure that sodium fluoride varnish 22,600ppm is applied twice annually in the dental surgery (in addition to the twice annually from childsmile)
Give four recommendations you would make regarding tooth brushing for a child with nursing caries?
Brush twice a day, including last thing at night
Spit, don’t rinse
Supervise children until they can brush their teeth effectively
Use the recommended amount of fluoride toothpaste
Give a definition of local causes of malocclusion
A problem or abnormality within either arch, usually confined to one, two or several teeth producing a malocclusion
Local causes of malocclusion may be due to variation in tooth number. Give 4 examples of these conditions
Any 4 from:
Supernumerary teeth (extra)
Hypodontia (developmentally absent teeth)
Retained primary teeth
Early loss of primary teeth
Unscheduled loss of permanent teeth
List 4 types of supernumerary?
Conical
Tubercular
Supplemental
Odontome
What is the incisor relationship of a patient who’s upper incisors are proclined or of average inclination and there is an increase in overjet?
Class II div I
Describe 2 methods you could use to clinically assess a patient’s antero-posterior skeletal pattern
Visual assessment
Palpate skeletal bases
Give two possible non-skeletal aetiological factors that can contribute to a class II malocclusion
Digit sucking habit
Mouth breathing
What type of orthodontic appliance might be used to harness growth potential for a patient with a class II malocclusion?
A functional appliance
Give a very brief account of how it is thought that mandibular growth occurs (3 marks)
Grows downwards and forwards
Growth occurs at the condylar cartilage
Growth occurs by surface remodelling
If a patient has a forward growth rotation, describe a skeletal feature that you could expect to observe?
A short face
