2021 MSA Part 1 Flashcards by David Jack

What nerves must be anaesthetised for the surgical removal of 48?

Inferior alveolar nerve
Lingual nerve
Buccal nerve

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

What word describes pins and needles or partial loss of sensation?

Paraesthesia

How well did you know this?

Not at all

Perfectly

What word describes a painful, unpleasant or neuralgic sensation that lasts for a fraction of a second?

Dysaesthesia

How well did you know this?

Not at all

Perfectly

What word describes a total loss of sensation?

Anaesthesia

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

What is the correct term for a dry socket?

Localised osteitis - inflammation affecting lamina dura

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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 well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

Give 4 risk factors for mouth cancer

Smoking tobacco
Alcohol
Diet low in fruit and vegetables
Immunosuppression

How well did you know this?

Not at all

Perfectly

What information about a patients radiotherapy tx do you need to know?

The dosage of radiotherapy received
Field of exposure

How well did you know this?

Not at all

Perfectly

What dose of radiotherapy increases the risk of ORN?

60Gy

How well did you know this?

Not at all

Perfectly

Describe the pattern of decay unique to radiation caries?

Cervical margins affected

How well did you know this?

Not at all

Perfectly

How would you manage unrestorable teeth if a patient has an increased risk of ORN?

Begin primary orthograde endodontics and decoronate

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

Give a management strategy for established ORN

Hyperbaric oxygen therapy

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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