ALL OSCE QUESTIONS Flashcards
Take a pain history
Site of pain
Onset of pain
Character of the pain
Does it radiate anywhere else
Anything alleviate the pain
Time pain comes on
Anything make it worse
Severity of the pain
Take a medical history
Cardiovascular issues
Respiratory issues
GIT issues
Liver or kidney issues
Endocrine diseases
Bleeding disorders
Neurological issues
Psychiatric
Dermatological issues
Musculoskeletal issues
Pregnancy
Allergies
2 purposes of rubber dam other than moisture control in fissure sealants
Patient safety to prevent aspiration of foreign objects
Patient is very cooperative so can tolerate it
2 CI for rubbery dam in paeds fissure seal
Latex allergy
Small mouth size
Very uncooperative
ASD
Where would one place an IDB?
Hold thumb at coronoid notch and place injection 1mm above occlusal plane in the triangle made by the coronoid notch and the pterygomandibular raphe
Approach from contralateral premolars
Orthodontic definition of retention
How does adams clasp do this?
Resistance to displacement forces away from hard palate
Arrowhead engages the small mesiobuccal and distobuccal undercuts
Take a smoking history
What type of tobacco do you use
How many do you smoke per day
How long have you been using for
How early in the morning do you first light up
Any behaviours or routines that stimulate you to smoke, e.g getting home from work, eating lunch etc
Have you ever considered quitting
Have you ever tried? How many attempts?
What things helped you, what didnt?
Would you be interested now?
Give smoking quitting advice
It would benefit greatly to quit
There are local support services around such as local pharmacies offer quitting advice
Website called quit your way which helps provide support and advice on quitting
Consider nicotine replacement therapy, use of nicotine patches can help reduce cravings
Use of e cigarettes could be beneficial
Give some advice on e cigs
Co use of e cig and reduced cigarettes is good as you are lowering exposure
Likely they are safer however not prolonged enough evidence to say for certain
In no circumstance is smoking cigarettes more beneficial than it is smoking e cigarettes
If fully on e cigarettes give strong reinforcement that it is positive there have fully Eliminated tobacco
Three types of elevator methods
Wheel and axle
Wedge
Lever
Write a lab card for primary lower impressions
Pls pour PI in 50:50 plaster:stone and construct 1/2mm spaced non perforated PMMA resin tray with handle
Lab card for upper PI
Pls pour PI in 50:50 plaster:stone and construct 1/2mm spaced special tray in light cured acrylic with a handle
Write lab card for master IMPS
Pls pour MI in 100% dental stone and construct upper and lower wax record blocks on light cured bases
Lab card for jaw reg?
Please mount casts to registration taken - on an average value articulator
Set upper teeth to record block
Set lower teeth to upper teeth
Lab card for denture trial / insertion
Please wax up for finish and process in heat cured PMMA, i mark post dam.
or
Remount casts and make specified change if needed
What prescribe to fix an anterior crossbite
A - z spring 0.5mm HSSW
R - adams clasp 44, 66 0.7mm HSSW
A - PMMA baseplate, only moving 1 tooth
B - flat posterior bite plane, self cure PMMA
What prescribe for a posterior crossbite?
A - mid palatal screw 0.5mm HSSW
R - adams clasp 0.7mm HSSW 44 66
A- only moving 2 teeth?
B - self cure PMMA, posterior bite plane
How retract canines?
A - palatal finger springs, 0.5mm HSSW
R - adams clasp 66, Southend clasp 11 .7 HSSW
A - only moving 2 teeth
B - self cure PMMA
How move canine palatal?
A - buccal canine retractor 0.5HSSW
R - adams clasp 66, Southend clasp 11, 0.7 HSSW
A - only moving 2 teeth
B - self cure PMMA
How cure overbite and overjet
A - 12-22 Roberts retractor 0.5mm HSSW
R - adams clasp 66 0.7mm HSSW
A -
B - self cure PMMA, FABP at OPJ+3mm
Process for BLS?
Danger check
Response check
Airway check, finger sweep if necessary
Breathing, check chest for breathing or agonal breathing
Cardiovascular, check pulse while listening for breathing
Call 999 - cardiac arrest, tell them where we are and phone number. Say we need oxygen bag valve mask, defibrillator and oxygen tank
Start compressions and breaths
What to write for a crown prescription for primary imps?
Pour imps in 100% stone and construct study models
Crown prescription for face bow record?
Mount upper cast on arcon articulator and construct customised incisal table
Prescription for crown special trays?
Construct non perforated acrylic special tray with 3mm wax spacer and extra oral handle
Prescription for crown master imps
Pour in 100% stone to construct definitive casts. Mount on articulator with jaw registration. Section tooth FDI for MCC with metal palatal surface with canine guidance + labial aspect in porcelain with inter-proximal contact
What teeth are scaled at 7 o’clock
43-33 all
What teeth are done at 9 o’clock
Buccal LRS
Lingual LLS
Buccal URS
What teeth scaled at 11 o’clock
Buccal and palatal of ULS
UAS
Palatal URS
Lingual LRS
Buccal LLS
What colour are all the curettes?
Grey = anterior
Orange = mesial
Blue = distal
Green = buccal / lingual
Red hoe = mesial and distal
Yellow hoe = buccal and lingual
Mini sickle = embrasures
Columbia = universal
Give post op instruction for extraction
Do not rinse mouth today, but from tomorrow start rinsing mouth with warm saline 3-4 times per day
Avoid hot drinks and hot / hard foods today while the LA wears off
Avoid smoking and alcohol today
Avoid any heavy exercise or things that can elevate your blood pressure
Do not explore the socket with your finger, toothbrush etc as it can dislodge the clot
Take OTC paracetamol and ibuprofen for pain, for no more than 3 days, do not exceed recommended dose and advised to take them before the local anaesthetic wears off
If socket begins to bleed again, bite down on damp gauze for 15-30 minutes
If bleeding doesn’t stop, contacts GDSH or A&E
If pain gets worse after 2-3 days come back to us
Give denture hygiene advice
Clean it after every meal over sink of water so dont break it, use simple detergent and water
Don’t leave it in overnight, leave it in a glass of water
Clean the fitting surfaces as well as the occlusal surfaces
What is RIVA?
RIVA = RMGIC, used to replace missing dentine. Can be used as a cavity base or even cement in crowns etc. also can be used for cervical restorations as bonds to tooth surface.
What is dycal / ultracal?
CaOH liner used for pulp capping or as a cavity base/lining material. Used for small pulpal exposures too.
Stimulate secondary dentine deposition
What is vitrebond?
Cavity liner / base
GIC - fluoride releasing
Bond to dentine
Light cure
What is ledermix?
Ledermix = antibiotic and steroid used on vital pulp. Intramediciament used between visits
Good as a sub lining for very deep cavities
What is RelyX?
RelyX = Resin based luting cement, dual cure. Used to cement veneers etc.
No need for DBA or primer
Good for cementing crowns etc
How would one do a diet diary?
Must be recorded over at least 3 days including one weekend day
Record what they eat, how much and the time
What are the stages of treatment planning and what do they entail?
Immediate - relief of pain
Initial treatment - HPT, restoration of carious lesions, alter any defective restorations, PMPR, OHI etc
Re-evaluation - reevaluate oral hygiene and oral condition
Definitive treatment - endodontics, fixed pros, large restorations. Has pT been complaint with OH? Removeable pros etc.
Maintenance - maintaining oral condition
Emergency drug for angina? Doses and how would u treat?
GTN spray, 400mg/dose for unstable angina - sublingually
If mild attack, continue with dental treatment, if severe then give oxygen and call ambulance
Drug for asthma attack? When to call ambulance?
Salbutamol inhaler 100mg/dose
For asthma or mild anaphylaxis in airways
If doesn’t respond rapidly or signs of severe attack, give O2 and call ambulance
What drug for anaphylaxis? How is it administered?
0.5mg/ml adrenaline
IM injection into thigh
Pull skin taught, aspirate and deposit, pull out half way, let skin loose, then all way out.
Drug for MI?
300mg dispensable aspirin, without water ideally so it can work faster
Treatment for hypoglycaemia?
1mg IM glucose injection and glucose such as sugar drink
What treatment for seizures?
Ensure safe environment, if it persists consider 10mg midazolam via buccal mucosa route
Treatment for syncope?
Lie flat and raise legs
Eruption dates of lower permanent teeth?
Lower incisors - 6
Lower laterals - 7
Lower canines - 9
Lower 1st premolar - 10
Lower 2nd premolar - 11
Lower first molar - 6
Lower second molar - 12
Wisdom - 17/18
Eruption dates of upper permanent teeth?
C Incisor - 7
Lateral incisor - 8
Canine - 11
First premolar - 10
Second premolar - 11
First molar - 6
Second molar - 12
Third molar - 17/18
Aim of a bitewing radiograph?
See the mesial of the canine to the distal of the 7, preferably no overlap, critical to see EDJ
Aim of a periapical?
See one full tooth and root and surrounding structures associated with the tooth
What LA give to someone with high blood pressure or heart issues?
Adrenaline free prilocaine with felypressin
Contains synthetic vasoconstrictor so LA does last long enough
What if can’t give felypressin and must use lidocaine for heart issue patients?
No more than 3 cartridges with adrenaline, can use adrenaline free but will not last as long
