4

Question 1

definition of local causes of malocclusion

Answer 1

a localised problem or abnormality within either arch, usually confined to one, two or several teeth producing a malocclusion

tend to get worse with time

Question 2

name 5 local causes of malocclusion

Answer 2

variation in tooth number
variation in tooth size or form
abnormalities of tooth position
local abnormalities of soft tissues
local pathology

Question 3

what teeth are usually affected by nursing caries

Answer 3

upper anteriors and molars

Question 4

why are lower anterior teeth spared during early childhood caries

Answer 4

protective action of the tongue
saliva from sublingual and submandibular glands wash them

Question 5

why is the pattern of upper anteriors and molars seen in nursing caries

Answer 5

upper incisors and molars are some of first to erupt so will experience cariogenic habit for longer
protective function of the tongue and saliva flow protects the lower anteriors
enamel on primary teeth is thinner than permanent so can be demineralised more rapidly after eruption

Question 6

name 4 potential aetiologies of nursing caries

Answer 6

those taking sugary medications
having sugary juice or milk from a bottle over night
sugary drinks or food between meals
pooling of milk or juice in the mouth due to improper swallowing

Question 7

appliance option for class II div i

Answer 7

twin block functional appliance

Question 8

name 2 methods to clinically assess a patients antero-posterior skeletal pattern

Answer 8

Assess visually by looking at the patient side on
Use index and middle finger to palpate the concavities of anterior maxilla and anterior mandible - ideally maxilla should be 2-3mm anterior

Question 9

hypoaesthesia

Answer 9

partial or total loss of sensation

Question 10

discuss growth of the mandible

Answer 10

Grows downwards and forwards
Meckels cartilage, from the first pharyngeal arch, acts as a template.
It is formed via intramembranous ossification.
Growth post birth is dependent on secondary cartilage and surface deposition.
There are 3 main sites of secondary cartilage: coronoid, symphyseal and condylar.
Coronoid and symphyseal dissapear not long after birth but condylar remains and can see growth up until about 20 years old.
Surface deposition sees mainly resorption lingually and anteriorly and deposition posteriorly and laterally
Growth sees significant acceleration during pubertal growth spurt

Question 11

what treatment could you do for a patient at risk of ORN whose coronal portion of tooth is unrestorable but the root unaffected

Answer 11

coronectomy

Question 12

treatment of osteoradionecrosis

Answer 12

hyperbaric oxygen
removal of loose sequestra
irrigation of necrotic debris

Question 13

hyperaesthesia

Answer 13

increased/ heightened sensation

Question 14

name 4 ways a nerve could be damaged during an extraction procedure

Answer 14

crushed
transected
LA injected directly into nerve
cut by surgical instruments

Question 15

factors contributing to radiation caries

Answer 15

dry mouth
change in diet
difficult OH due to pain

Question 16

oral complications of radiotherapy (3)

Answer 16

trismus - fibrosis of MOM
xerostomia - damaged salivary glands
increased risk of fungal infections
risk of ORN
radiation caries

Question 17

2 dental priorities prior to starting cancer treatment

Answer 17

institute prevention
remove any potential sources of infection

Question 18

name 3 members of the multidisciplinary team involved in cancer treatment

Answer 18

oncologist
radiologist
dietician
surgeon
physio

Question 19

dentist role during cancer treatment

Answer 19

diet advice
fluoride preparations - varnish , trays, toothpaste
treatment/ symptomatic relief of mucositis
Antibacterial mouthwash if too painful to brush

Question 20

3 stages in managing dental neglect

Answer 20

1 - preventative dental team management
2 - preventative multi agency management
3 - child protection referral