BDS3 Flashcards
How does a confidence interval show significant evidence has been found for a study
If it does not overlap 0
How much of the retromolar pad should be covered by a complete dentrue
2/3
What are the stages in conventional complete denture design (7)
- Assessment
- Primary impressions
- Master impressions
- Registration
- Trial insertion
- Insertion/Delivery
- Maintenance/Review
What makes it easier to see a patients vibrating line
Get them to say ah
How do you know an impression tray is too small
The flanges hit the ridge or do not cover all the areas
How do you know which kind of impression material to use? (3)
If there are undercuts use an elastic material
If there are bounded saddles - alginate.
Free end saddles - alginate + compound
Where should you stand to take a maxillary impression
Behind the patient
Where should you stand to take a mandibular impression
In front of the patient
How should you assess/inspect a primary impression (4)
- Denture bearing area covered?
- Peripheral seal achieved?
- Adequate surface detail?
- No or minimal voids
How should you assess a master impression (4)
- Denture bearing area covered?
- Good functional sulcus?
- Adequate surface detail?
- No or minimal voids
What are the steps in a complete denture registration visit? (7)
- Measure vertical dimension and establish face height
- Adjust upper block for retention
- Adjust upper for tooth position
- Adjust upper for occlusal plane
- Lower tooth position
- Registration
- Selection of teeth
What equipment is needed at a complete denture registration visit? (4)
- Iron
- Wax Knife
- Foxes bite plane
- Willis bite gauge
What does LIMBO stand for (Complete dentures)
Lip support Incisal level Midline Buccal corridor Occlusal plane
What should you mark on an occlusal record block (Complete dentures) (3)
- Midline
- Canine line
- High lip line
How do you calculate freeway space?
Resting vertical dimension - OVD
How do you decide what width of teeth to use for complete dentures?
Using a transparent flexible mirror, measure from the distal side of each canine and use this to select teeth
What different types of posterior teeth are available for dentures (3)
Cuspless
Hybrid (12 degree angle)
Cuspled teeth (33 degree angle)
What should you do with a trial wax denture before the patient arrives
Test it on an articulator
How can you tell if a complete denture is underextended
Insert the denture and move the tissues away
If the denture drops, it is under/over extended
What is a post dam
A lip on the back of a denture to give a better peripheral seal
Instructions for patients that have been given a complete denture (3)
- Remove the denture at night
- Clean it regularly
- Build up difficulty of food
Kennedy Class I
Bilateral free end saddle
Kennedy Class II
Unilateral free end saddle
Kennedy Class III
Bounded saddle
Kennedy Class IV
Anterior bounded saddle crossing midline
Modification of Kennedy classes
How many extra saddles there are, not included in the classification
Craddocks Class 1
Tooth borne support
Craddocks Class 2
Mucosa born support
Craddocks Class 3
Combination tooth and mucosa support
Support
Resistance to vertical movement
Retention
Resistance to displacement in a vertical direction
Stability
Resistance to horizontal movement
Retention methods for RPD (3)
- Claps
- Soft tissue undercuts
- Path of insertion
Indirect retention
Resistance to rotational displacement
Stages in producing a RPD (5)
- Assessment, primary impressions and denture design
- Master impressions
- Framework trial + record occlusion
- Tooth trial
- Review
Why would you need a Primary Record Block (RPD)
To see how the teeth meet if it is not obvious
What does a Primary Record Block do to the treatment plan
Adds an extra session before the casts can be mounted on an articulator
Instructions to the technician after master impressions for RPD for a cobalt chrome base
Pour model in improved stone
Construct framework as per design
Instructions to technician after master impressions for RPD for an acrylic denture base
Pour model in stone
Construct record block with shellac base
When should radiographs be taken for denture patients (2)
To asess abutment teeth
To check for pathologies and/or retained roots
How do you use adhesive for impression material
Apply the adhesive to all sides of the tray, including the outside. Then wait for the solvent to evaporate before applying the impression material
Steps in taking a history from a patient (5)
C/O HPC PDH MH SH
Constituents of Stainless Steel (4)
- Primary iron
- Second most is chromium
- Nickel
- Titanium (Strength)
Advantages of URAs (6)
- Excellent anchorage
- Cheaper than fixed
- Less chair side time
- OH easier to maintain
- Non destructive to tooth surface
- Can easily reduce overbite
Disadvantages of URAs (6)
- Less precise control of movement
- Teeth cannot be intruded or extruded
- Can be easily removed
- Only 1-2 teeth can be moved at a time
- Specialist technical staff required
- Rotations very difficult to correct
ARAB
Active Components
Retentive
Anchorage
Baseplate
HSSW
Hard Stainless Steel Wire
FABP
Flat Anterior Bite Plane
For URAs, how many teeth can be moved and by how much
1-2 teeth at a time
1mm per month
For URAs, how does thickness of wire relate to force
The thicker the wire, the more force will be applied
Types of clasp for URAs (3)
Adams clasp
Southend clasp
Labial bow
What thickness of wire are retentive components for URAs
- 7mm
0. 6mm for deciduous teeth
What thickness of wire are active components for URAs
0.5mm
Types of active components for URAs (5)
Finger Spring Z Spring T Spring Flapper Spring Buccal Canine Retractor
Components of a Finger Spring and what they do (4)
- Tag (attaches to acrylic)
- Coil (Where force comes from)
- Guard (Allows active arm to slide along it)
- Arm
What is a Z Spring used for? (3)
Used to push teeth forward
Can be used for small amounts of rotation
Uncoiled to activate it
What is the function of a buccal canine retractor
Moves teeth back into the line of arch
BPE 0 (3)
Black band completely visible
No calculus/overhangs
No bleeding on probing
BPE 1 (3)
Black band completely visible
No calculus/overhangs
Bleeding after probing
BPE 2 (2)
Black band completely visible
Supra- or sub- gingival calculus/overhands present
BPE 3 (2)
Black band partially visible
Probing depths of 3.5-5.5mm
BPE 4 (2)
Black band entirely within the pocket
Probing depths of 6mm or more
BPE *
Furcation involvement
BPE 0 Treatment
No need for periodontal treatment
BPE 1 Treatment
OHI
BPE 2 Treatment (2)
OHI
Removal of plaque retentive factors including supra- and sub- gingival calculus
BPE 3 Treatment (2)
OHI
Root surface debridement
BPE 4 Treatment (3)
OHI
RSD
Assess need for more complex treatment and referral to a specialist
When should radiographs be taken to assess bone levels
When a BPE of 3 or 4 is found
Mini Sickle (2)
Two cutting edges on each blade for buccal and lingual
Used supra-gingivally
Columbia Curette (2)
Two cutting edges on each blade
Used sub-gingivally
Which part of a hand scalar should be parallel to the long axis of the tooth
Lower terminal shank
When should a 6 point pocket chart be carried out
When a BPE of 3, 4 or * is found
What is recorded on a six point pocket chart (6)
- Gingival Margin
- Probing depth
- Loss of attachment
- Bleeding on probing
- Mobility
- Furcation involvement
What probe is used for a six point pocket chart
PCP 12 Probe
How is loss of attachment calculated
Probing depth + recession
Mobility Grade 1
<1mm movement
Mobility Grade 2
1-2mm movement
Mobility Grade 3
2+mm and or rotation or depression
When does recession have a negative value
If the gingival margin is above the ACJ
Coronal to the ACJ
Furcation Grade 1 (2)
Initial furcation involvement
Furcation opening can be felt on probing but involvement is less than one third of the tooth width
Furcation Grade 2 (2)
Partial furcation involvement
Loss of support exceeds on third of the tooth width but does not include the total width of the furcation
Furcation Grade 3 (2)
Through and through involvement
Probe can pass through the entire furcation
Gracey Curette (2)
Single cutting blade
Used for fine/deep sub- gingival scaling of anteriors
Hoe Scalar
Gross supra- and sub-gingival scaling mainly on buccal and lingual surfaces
How is a border seal achieved on dentures
Achieved by extending the denture flanges to the depth of the functional sulcus
How should you test the retention of an upper denture
Pull on an anterior tooth
How should you test stability of a denture
Trying to rock it back and forth
What do the black bands mean on a PCP 12 probe when carrying out a 6 point pocket chart
3, 6, 9, 12
Definition of impressions
A reverse or negative of the tissues
Decontamination of an impression
Rinse under the tap to remove gross saliva
Perform for 10 minutes after
What should be mentioned on a prescription card for special trays (5)
Light cured acrylic special trays Intra/Extra-oral handles Spacing - Alginate (3mm) - Silicone/polyether - Spaced 2mm (upper) - Close fitting 0.5-1mm (lower)
What should you mark on a primary impression
Where you would like the special tray with an indelible pencil
What should the nasolabial angle be with good lip support from a denture
90 degrees
How do you check the incisal level of a denture
Get the patient to say f or v
Drop the lower lip should have around 1mm of tooth showing
Upper anterior tooth position on complete dentures
Ideally less than 1cm to incisive papilla. 1cm isn’t very stable
Where should canines be on a complete denture
Below the nose
What should you use and how should you adjust the wax record block for the occlusal plane (4)
Foxes bite plane
Hold a ruler parallel to it
Should be flat or angled up slightly at the back
Don’t alter incisors, only the back
Lower anterior tooth position for complete dentures
Should be over the ridge or very slightly forward
Lower posterior tooth position for complete dentures
Should be over the residual ridge in the neutral zone
In a tooth trial which denture should be inserted first
Lower
Upper can be dislodged when placing lower
What should you check during a tooth trial (5)
- Extension
- Retention
- Stability
- Occlusion (Resting Face Height first)
- Appearance
SDA
Shortened Dental Arch
How much of the undercut should a clasp arm engage
1/3
Classification of Ridges (6)
I. Dentate II. Post extraction III. Broad alveolar process IV. Knife edge V. Flat ridge (no alveolar process) VI. Submerged ridge (loss of basal bone)
Advice for new dentures regarding pain (3)
- If there is minor pain, persevere it will subside
- If there is major pain take them out and put old dentures in
- Put new dentures in the morning of dental appointment so we can see where they rub
What aspect should not be recorded by compound impression material
The teeth
If this happens, simply cut the impression compound to cut out the teeth
How are impressions disinfected
Rinse gross saliva
Perform for 10 minutes
What helps check occlusion for a partial denture
Use a natural tooth contact
Types of Gypsum Product (3)
Dental Plaster
Dental Stone
Improved Stone
How much more likely are periodontal patients to lose teeth off they don’t return for regular visits
5.6
What should be established when a patients periodontitis keeps recurring
Why there has been recurrence
Periodontitis Stage 1
Less then 15% or 2mm bone loss at worst site
Periodontitis Stage 2
Coronal third of root of bone loss
Periodontitis Stage 3
Mid two thirds of root of bone loss
Periodontitis Stage 4
Apical third of root of bone loss
If they patient has lost teeth due to periodontitis what stage should they be assigned
Stage 4
How is the grade for periodontal bone loss calculated
Percentage of bone loss divided by age
Periodontitis Grade A (3)
<0.5
Bone loss less than half the patients age
Slow
Periodontitis Grade B (2)
0.5-1.0
Moderate
Periodontitis Grade C (3)
> 1
Rapid
Max bone loss more than the patients age
How is localised periodontitis defined
Effects less then 30% of teeth
How is generalised periodontitis defined
Effects more than 30% of teeth
What are the components of a full periodontal diagnosis (5)
- Stage
- Grade
- Periodontitis status/stability
- Risk Factors
- Generalised/Localised
Currently stable periodontitis (3)
- BoP less than 10%
- PPD less than 4mm
- No BoP at 4mm sites
Currently in remission periodontitis (3)
- BoP 10% or more
- PPD 4mm or more
- No BoP at 4mm sites
Currently unstable periodontitis (2)
PPD 5mm or more
BoP at 4mm sites
Non-plaque induced gingivitis
Uncommon and will need a specialist to help diagnose
What can cause periodontitis without plaque
Squamous cell carcinoma
Langerhans cell histiocytosis
Modifications made to teeth for dentures (3)
Cutting rest seats
Composite build up
Cutting guide planes
When should a denture design be completed for a cobalt chrome denture
Before master impressions are taken
At the primary impression stage
Name Ramfjords teeth (6)
16, 21, 24, 36, 41, 44
How can you assess patient engagement with periodontal services
Modified plaque and bleeding scores
What surfaces are used for modified plaque scores (3)
Interproximal
Buccal/Lingual
Occlusal
Modified Plaque Scores (3)
0 - No plaque
1 - No visible plaque but a probe skimmed over tooth reveals plaque
2 - Plaque visible without probe
How do you calculate a modified plaque score
Add up the score for each surface and divide by 36 (or maximum possible score)
What does modified bleeding score measure
Marginal bleeding which indicate how well the patient is able to carry out effective plaque control daily
How should you carry out a Modified Bleeding Score
Use Ramfjords teeth
Run a probe around them at 45 degrees in a continuous sweep
Check for bleeding up to 30 seconds after
How do you calculate modified bleeding score
Total divided by 24 (or maximum possible score)
What should you do if one of Ramfjords teeth is missing
Use a similar alternative tooth
If there is no alternative tooth, code N is used and maximum possible score is changed
When should you record modified plaque and bleeding scores
Not needed at initial session
Every subsequent session
What are the goals for modified plaque and bleeding scores
Plaque - < 30%
Bleeding - < 35%
Or more than a 50% improvement
What two things must consent be?
Valid and Legal
Capacity (4)
- Make a reasoned decision
- Communicate the decision
- Understand the decision
- Retain memory of the decision
Principles of legal consent (3)
- Ability
- Informed
- Voluntary
Principles of valid consent (2)
Ongoing, patient still agrees
Specific to the proposed dental treatment only
Principles of negligence (4)
Dentist owed a duty of care
Duty of care breached (standard of care)
Breach caused or materially contributed to damage (causation)
Damage was reasonable foreseeable and had negative consequences
Principles of the Adults with Incapacity Act (5)
Benefit Minimum necessary intervention Take account of the wishes of the adult Consultation with relevant others Encourage 'residual capacity'
Assessing capacity (4)
Keep language appropriate
Break up information into segments
Ask patient to explain to you what you have discussed
Assess retention - ask at another visit
Welfare Power of Attorney (2)
Powers come into effect when the adult becomes incapable
Welfare Power of Attorney document must be seen and entered into dental notes
Continuing Power of Attorney
Only covers financial affairs and property
Who can consent to treatment (4)
Patients with capacity
Welfare powers of attorney
Welfare guardians
Dentists with special training (under section 47 of AWI Act)
Can treatment be given if an adult does not have capacity or a proxy
Yes if a valid certificate of incapacity is issued for treatment
AND
The principles of the AWI Act are followed
What type of current do X-Ray producers need
Direct Current
How do X-Ray machines get current from the mains
They have generators which modify AC so that it becomes DC
This process is called rectification
Inverse Square Law - Radiology
The further the patient stands from the X-ray beam, the lower the dose.
Doubling the distance will quarter the dose
Parallax
An apparent change in the position of an object caused by a real change in the position of the observer
What might X-Ray photons do as they travel through tissue (4)
Pass through unaltered
Scatter without losing energy
Scatter and be absorbed
Be absorbed
X-Ray attenuation
Reduction in number of photons within beam.
Result of absorption and scatter
What colour are areas on an X-Ray with complete attenuation
White
How can scatter be reduced
Reduction of area irradiated also called collimation
What is the absorbed radiation dose measured in
Grays
What is effective radiation dose measured in
Sieverts
What acts apply to disabled people in dental care
Discrimination Act
Equality Act
Eruption Sequence for Primary Teeth
a-b-d-c-e
Lowers before uppers
When do primary teeth erupt
6 months - 2.5 years
Eruption sequence for permanent maxillary teeth
6-1-2-4-5-3-7-8
Eruption sequence for permanent mandibular teeth
6-1-2-3-4-5-7-8
How long should it take for a contralateral tooth to erupt
6 months or less
When should you be able to palpate the upper canines
By the age of 10/11
Balancing extraction
Take out the contralateral tooth
Compensating extraction
Take out the opposing tooth in opposing arch (upper/lower)
Which primary teeth should be balanced
C’s
D’s under GA
Which teeth should be compensated (2)
6s - if taking lower, take upper
If taking upper, don’t take lower
When is the ideal time to take out lower 6s (4)
When the furcation begins to form on 7s
In patients whose 8s are present
In Class I patients
In patients with mild/moderate crowding
Why are posterior cross bites overcorrected
As 50% of them relapse
What can be used to deter digit sucking
Habit breakers
Can be removable or fixed
When should digit sucking be stopped for teeth to return to normal eruption
Before the age of 10
Infra-occluded deciduous teeth
Tooth has ankylosed to bone
More common in lower than upper
What should you do with infra-occluded deciduous teeth
If permanent successor - no treatment
If no permanent successor - wait a year then extract when 1mm of crown left showing
What are good signs for upper canines being in the correct position in the mixed dentition (2)
Mobile C’s
Distally tipped laterals
What can be done about ectopic canines
Extract both C’s (even if only 1 is ectopic)
Can be done up to the age of 13
What can be done for class III patients (interceptive orthodontics)
If the patient can achieve an edge to edge bite on incisors, URA is possible
If not, refer patients when they are under 10
Arthritis definition
Inflammation of the joints
Arthrosis
Non-inflammatory joint disease
Arthralgia
Joint pain
Osteoclasts
Remove bone
Osteoblasts
Build bone
What minerals are needed for bone deposition (3)
Calcium
Phosphate
Vitamin D
Osteomalacia (3)
Poorly mineralised osteoid matrix and cartilage growth plate
Can be called rickets if it occurs during bone formation
Related to calcium deficiency
Osteoporosis
Loss of mineral and matrix
Bisphosphonates Use
Used to treat bone diseases like osteoporosis
Gout
Uric acid crystal deposition in joints
Dental aspects of gout (2)
Avoid aspirin
Medication may give oral ulceration
Dental aspects of osteoarthritis (2)
Bleeding tendency
Oral ulceration possible due to NSAIDs
Dental aspects of SLE (systemic lupus erythematosis)
4
Oral ulceration
GA risk
Bleeding tendency
Impaired drug metabolism
Dental aspects of Sjogens syndrome (5)
Oral infection Caries risk Denture retention Salivary lymphoma Sialosis
Sialosis (3)
Salivary gland disease
Asymptomatic
Non-inflammatory
Dental aspects of systemic sclerosis (4)
Swallowing difficulties
Erosion
Limited mouth opening and tongue movement
Widening of PDL
Multiple Sclerosis
Demyelination of axons
Dental aspects of MS (4)
Limited mobility
Treat under LA
Chronic orofacial pain risk
Higher trigeminal neuralgia risk
Dental aspects of motor neurone disease (2)
Drooling and swallowing difficulties
Muscle weakness in head and neck
Dental aspects of Parkinson’s (2)
Tremor - difficulty accepting treatment
Dry mouth
Dental aspects of antidepressants (4)
Dry mouth
Caries (lithium)
Sedation
Facial dyskinesias
Epilepsy (3)
Reduced GABA levels in the brain
Abnormal cell-cell message propagation
Abnormal discharge from neurones in the brain
Who is at risk of a febrile seizure
Children above 38 degrees
Classification of epilepsy (3)
Tonic/clonic
Absence
Myoclonic/atonic
Dental complications of treatment for epilepsy (3)
Gingival hyperplasia (phenytoin) Bleeding tendency (valproate) Folate deficiency (rare)
How should you assess the risk of a fit for an epilepsy patient (5)
Good and bad phases When were last three fits Compliance with medication Changes in medication Treat at times of low risk
Categories of mental health disorders
Neuroses
Psychoses
Neuroses
Conditions where contact with reality is retained
Psychoses
Conditions where contact with reality is lost
Anxiolytic Drugs
Bendodiazepines (pam drugs)
Rheumatoid arthritis
Initially a disease of the synovium with gradual inflammatory joint destruction
Dental aspects of Rheumatoid arthritis (5)
Bleeding risk - NSAIDs Infection risk - Steroids Oral lichenoid reactions Oral ulceration Oral pigmentation
Dental aspects of ankylosing spondylitis (3)
GA risk
Limited mouth opening
Limited neck flexion
What regulations govern radiation practices
Ionising Radiation Regulations 2017
Ionising Radiation and Medical Exposure Regulations 2017
Haemangioma (3)
Collection of blood vessels whose walls have burst
Can grow to be large
Can be removed by a specialist
Fibroepythelial Polyp (3)
Can be on a stalk
Mucosa same as surrounding mucosa
Better to remove if large as they can continue to grow
Black Hairy Tongue (3)
Overgrowth of the surface of the tongue
Gentle forward toothbrushing
More common in pipe smokers
Atrophic Glossitis (4)
Smooth tongue
Caused by iron or B12 deficiency
Will ulcer if not fixed
Ask GP for routine bloods
Frictional Keratosis (3)
Due to trauma
Keratinisation
If you can’t discern where a white patch has come from (trauma) you MUST get a biopsy
Denture Stomatitis (2)
Candida Infection
Patient must remove denture at night and soak in solution
Angular cheilitis (5)
Can be due to denture hygiene or staphylococcus or skin folds - face not dried or uncommonly low iron levels Treat reason before medicating
Which salivary replacement should never be used for patients with their natural teeth
Glandosane as it is pH 5
Lichen Planus vs Lichenoid reactions
Lichen Planus is an autoimmune condition
Lichenoid reactions mimic this but are reactions to drugs
Bisphosphonates (2)
Incorporated in skeleton
Inhibit bone turnover
Risk Factors for BRONJ (8)
Extremes of age Concurrent use of corticosteroids Systemic conditions affecting bone turnover Malignancy Chemotherapy, radiotherapy Duration of therapy Previous diagnosis of BRONJ Drug Potency
Oral risk factors for BRONJ (6)
Invasive dental procedures Denture trauma Poor oral hygiene Periodontal disease Alcohol or tobacco use Thin mucosal coverage
How to treat patients on bisphosphonates
Warn patient of risk of BRONJ
Make sure they fully understand
Still treat
BRONJ
Bisphosphonate Related Osteonecrosis of the Jaw
Indications for Extraction (5)
Unrestorable teeth Traumatic position Symptomatic partially erupted teeth Orthodontic indications Interference with construction of dentures
Direct vs Indirect Restorations
Direct - Can be placed in a single visit
Indirect - Fabricated outside the mouth
Indirect Restoration Stages (4)
Preparation
Temporisation
Impression and occlusal records
Cementation
Types of inlays/onlays (4)
Composite
Gold
Porcelain
Ceromeric
Social History - SAMML CHOFD
Smoking Alcohol Mobility Marital Status Living Condition Carers Habits Occupation Family History Diet
Advantages of indirect restorations over direct (3)
Superior materials
Superior margins
Wont deteriorate over time
Disadvantages of indirect restorations over direct (2)
Time
Cost
RMD
Reusable Medical Devices
LDU
Local Decontamination Unit
AWD
Automatic Washer Disinfector
What two parts of the cleaning cycle occur in the AWD
Cleaning and Disinfection
Stages AWD goes through (3)
Prewash/flush
Main wash
Rinse
Most important factor for long term success of a crown
Coronal seal
Maxillary incisor access cavity
Triangular
Mandibular anterior access cavity
Ovoid
Maxillary molar access cavity
Trapezoid - very mesial
Mandibular molar access cavity
Trapezoid - central
Which crown material is better if a retentive cavity can be cut
Ceromeric
Which crown material gives a better bond
Porcelain
What is the length of biological width
CT + Junctional epithelium
2mm
Percentage of dry sockets/osteonecrosis (3)
2-3%
20-30% lower 8s
1/1000 w/bisphosphonates
Angulation in panoramic radiograph
8 degrees
What should you ask the patient to do before taking a panoramic radiograph
Put their tongue to the roof of their mouth of there will be a dark line across the teeth (air)
Most common physical impairment in children
Cerebral palsy
How can osteoarthritis be improved (2)
Pain improved with NSAIDs
Lose weight
Name an arrhythmia
Atrial Fibrillation
Tori
Harmless bony growth
Torus if singular
Lingual nerve position
Between medial pterygoid and mandible
What is medial to zygomatic arch
Masseter
Sclerotic canal
Calcification in the root canal system
What helps a sclerotic canal
EDTA chelating agent 17%
What is used to clean blood spillages and what concentration
Sodium hypochlorite
10,000ppm
What are the products of glycolysis
Glucose - > Pyruvate, NADH & ATP
Glycocalyx function
Adhesion and protection
Niche definition
Behaviour of an organism in ecological environment
Function of an organism within an ecosystem
Where does NH+ of LA bind
Voltage gated sodium channels - active gate
Why should drug dosage be reduced for elderly patients
Reduced excretory capacity in kidney
How is a film radiographic image produced (6)
Development Rinsing Fixation Removing Washing Drying
What is KVP
Peak Kilovoltage
Max voltage applied across x-ray tube
How does an increase in voltage effect scatter
Increases scatter
What should you give for virus, bacteria, caries
Chlorhexidine
Rotation direction of condyle on working side
Vertical
Haemophilia A
Factor VIII
Curve of Monson
Combination of curve of Spee and curve of Wilson
Curve of Wilson
Occlusion of posterior teeth conform to a curved plane
Curve of Spee
Upwards inclination of mandibular posterior teeth
Radiograph too dark
Overexposed
Developer left on too long
How often should radiology equipment be tested
Daily
Types of cerebral palsy (4)
Spastic
Ataxic
Dyskinetic
Combined
How can you make a veneer more adhesive
Lab with 10% acid
What acid etch is used in dentistry
37% phosphoric acid
Which material is used in the canal system in between visits
Non setting calcium hydroxide
Toothpaste used for high risk 2 year old
1000ppm
What is the primary aim of an audit
To ensure standards are being met - Improve healthcare
If a patient has an oesophageal infection what nodes will show on palpation
Deep cervical
What isnt alcohol based hand rub effective against
C.diff
Viscoelasticity definition
Ability to regenerate shape after stress is removed
Dental aspects of Downs syndrome
Early onset periodontitis
Treatment of osteoarthritis
Prednisolone
Class III Technical definition
Mandible <2-3mm in front of maxilla
Properties of stainless steel (7)
Non-corrosive Cheap Flexible Non-toxic Strong Biocompatible Ductile
Aims of orthodontic treatment (3)
Good aesthetics
Functional
Stable occlusion
Uses of study casts (7)
Record keeping Track progress Insight when patient isn't there Design appliances More info - better informed decisions Teaching purposes Retrospective studies
Anchorage definition
Resistance to unwanted tooth movement and displacement forces
Displacement forces (5)
Tongue Mastication Speech Gravity Active Component
Size of FABP
Overjet + 3mm
Baseplate material for URAs
Self cure PMMA
Fissure Sealant Function (2)
Obliterate fissures
Remove sheltered environment in which caries thrives
Positioning for fissure sealant
In front of patient for lower left
Behind for all other quadrants
Moisture control aids (4)
Dry guards
Saliva ejector
Cotton wool rolls
Suction
Surfaces of 6s for fissure sealants
Palatal Upper
Lower Buccal
What teeth should be fissure sealed in high risk individuals
4, 5, 6, 7
Palatal pit on upper laterals
Technique for applying resin fissure sealant (7)
Teeth cleaned - Plaque and debris removed
Tooth isolated either with dam or cotton wool
Surface etched for 20-30 seconds
Surface washed and dried
Cotton wool replaced
Place and light cure sealant
Inspect
Technique for GIC fissure sealant (4)
Can use 20% polyacrilic acid to etch but not required
Tooth isolated
GIC run into fissures
Infilled resin, petroleum jelly or fluoride varnish can be placed to protect material
Quality assurance of fissure sealants (2)
Run probe alone - shouldn’t ping off
Should look like the shape of the fissures not a pool of material
Which children are eligible for fissure sealants (4)
Children with special needs
Children from a disadvantaged background
Extensive caries in primary dentition
If a 6 develops caries
Caries Risk Assessment (7)
Clinical Evidence Dietary Habits Social History Use of Fluoride Plaque Control Saliva Medical History
How often should radiographs be taken for children
Low risk - 12-18 months
High risk - 6 months
CRA - Clinical Evidence (3)
Caries experience
Orthodontics
Prosthodontics
CRA - Caries Experience (3)
DMFT equal to or greater than 5 - high risk
Caries in 6s at 6yo - high risk
3 year caries increment equal to or greater than 3 - high risk
CRA - Diet
3 or more sugar intakes a day - high risk
CRA - Social History
SIMD Category
Single parents
Inequalities
CRA - Medical History (4)
Medically compromised
Physical disability
Xerostomia
Long term polypharmacy
Preventative Elements - CRA (8)
Radiographs Toothbrushing instruction Strength of fluoride toothpaste Fluoride toothpaste Fluoride supplements Diet advice Sugar free meds
Fitting the URA
DASIIPAADS
Details match Appliance matches Sharp edges Integrity of wirework (work hardening) Insert appliance Posterior retention Anterior retention Activate appliance Demonstrate insertion and removal to patient See patient every 4-6 weeks
Patient information for URA
BESWIRRAME
Big and bulky Excess salivation Speech may be difficult at first Worn 24/7 Initial discomfort Remove after meals and clean Remove before contact sport Avoid hard/sticky foods Missing appointments Emergency details
Post Op Instructions (13)
PNBDEPES JSBAA
Pain Numbness Bleeding continues - damp gauze Don't rinse for 24 hours Eat on other side of mouth Probe - Dont probe socket Exercise - Not for 24 hours Swelling normal - 2 days Jaw may be stiff Sensitive teeth on either side Brush as normal Avoid smoking Avoid alcohol
From what age can you legally consent in Scotland
16
Can children consent
Yes if they are deemed Gillick competent
Who can consent on behalf of the child (3)
Mother automatically
Dad if named on birth certificate or married to Mum
These rights kept after divorce
What should be discussed with patient regarding treatment before consent can be gained (6)
Treatment options Risks and benefits of each Likely prognosis Recommended option What may happen if treatment isn't carried out Material risks
When is consent not required
Emergency situation where consent cannot be obtained
Adults with incapacity under certain conditions
Main risks for all extractions (10)
Pain Swelling Bruising Bleeding Infection Damage to adjacent tooth Tooth/root fracture Jaw stiffness Dry socket Nerve damage
Risks for maxillary extractions (3)
Loss of tooth into maxillary antrum
Creation of OAC/OAF
Fracture of maxillary tuberosity
Risks for mandibular extractions (4)
Mandibular fracture
TMJ dislocation
Nerve damage - 8s
Higher risk of dry socket than for maxillary teeth
Digital Receptors (2)
Phosphor Plate
Solid-Slate Sensor
Film Receptors (2)
Direct Action
Indirect Action
Size 0 Receptor
Anterior Periapicals
Size 2 Receptor
Bitewings
Posterior Periapicals
Size 4 Receptor
Occlusal Radiographs
Pulp Diagnoses (7)
Normal pulp Reversible pulpitis Symptomatic irreversible pulpitis Asymptomatic irreversible pulpitis Pulpal necrosis Previously treated Previously initiated
5 A’s of smoking cessation
Ask Advise Assess Assist Arrange follow up
Smoking history (5)
What do you smoke How long have you smoked How many a day What time do you have your first Have you ever tried/considered quitting
Quitting history (4)
When did you last try
How many times have you tried
What helped/motivated you
Would you like to try again
Treatment Planning Stages (4)
Provisional Treatment Plan
Re-Evaluation
Definitive Treatment Plan
Review/Maintenance
Provisional Treatment Plan Stages (2)
Immediate (pain relief)
Stabilisation