Candidate Guide Flashcards
True or false… pit and fissure occlusal, lingual, buccal, or facial restorations are not to be included unless there is an obvious cavitation on the photographs and/or radiolucency on the radiographs, or tactile evidence of caries is noted in the “clinical findings” section of the patient record.
True
True or false… candidates must specify the material to be used for the restoration.
False. Howeve,r they must specify whether the restoration will be a direct or indirect restoration
True or false… bases, build-ups, pins, and posts need not be specified in the treatment plan
True, they do not need to be specified. Direct or indirect is good enough
True or false… OHI should be listed on the treatment plan
False.. it is assumed that OHI will be provided for every patient
True or false… topical fluoride application is assumed in conjunction with dental prophylaxis.
False. Topical fluoride application is not included in the definition of dental prophylaxis. Therefore, if indicated, fluoride should be listed seperately.
Following submission of the treatment plan, additional questions or tasks related to the case are presented. The first case will have ___ items. The second case will have ___. The third case will have___ items.
4-5
7-8
4-5
True or false… answers to the supplemental questions should be answered in complete sentences
False. It is not necessary
What is the definition of a critical error in the CTP exam?
Critical errors are those likely to cause life-threatening harm or severe morbidity that may require hospitalization
What are some examples of critical errors?
Prescribing medications contrary to patient medical history and/or dosages exceeding safe guidelines
What are the AAPD guidelines for maximum dosage for lidocaine?
2mg/lb
4.4 mg/kg
how do you convert lbs to kg?
Lbs x 2.2
What is the maximum dosage for mepivicaine (carbocaine)?
2 mg/lb
4.4 mg/kg
What is the maximum total dosage for lidocaine and mepivicaine?
300mg
What is the maximum dosage for articaine?
3.2mg/lb
7mg/kg
What is the maximum total dosage for articaine?
500mg
What is the maximum dosage for prilocaine?
2.7mg/lb
6mg/kg
What is the maximum total dosage for prilocaine?
400mg
What is the maximum dosage for bupivicaine? (Marcaine)
- 6mg/lb
1. 3 mg/kg
What is the maximum total dosage for bupivicaine?
90mg
Define caries for CTP
Caries has definitive resistance to the perpendicular withdrawal of the explorer and may have a dry leathery apperance
Define prophy for CTP
Removal of plaque, calculus, and stains, to control local irritation factors and frequently involves scaling of coronal and subgingival surfaces of the teeth
***application of fluoride is NOT included in the definition of dental prophylaxis
How should periodontal treatment be stated? Give an example
By quadrant, including the number of teeth.
S/RP 4 quads of 4 or more teeth
Prophylaxis, S/RP: UR and LL 1-3 teeth
Prophylaxis, S/RP: UL 4 or more teeth
A decision to treat perio should be based on ___, ___, and ____. What are the requirements for SRP?
CAL (clinical attachment loss)
Periodontal pocket depth (PD)
BOP
Teeth having CAL with pocket depths of 5 or greater
Or…..
Teeth having CAL with pocket depths 4 or greater WITH BOP
Define periodontal “good”prognosis
Involves one or more of the following:
Health or slight CAL, adequate periodontal support, no mobility, no furcation involvement, and control of etiological factors to assure the tooth would be relatively easy to maintain, assuming full patient compliance
Define “fair” periodontal prognosis
Involves one or more of the following: CAL to the point that the tooth could not be considered to have a good prognosis, which would include slight or moderate CAL and/or Class 1 mobility or furcation involvement. The location and depth of the furcation would allow proper maintenance with full patient compliance
Define periodontal “poor” prognosis
Involves one or more of the following: severe CAL resulting in a poor crown to root ratio, poor root form, class 2 furcations not easily accessible to maintain, or class 3 furcations, class 2 or 3 mobility, significant root proximity
Define “hopeless” perio prognosis
Involves one or more of the factors listed in poor prognosis with inadequate attachment to maintain the tooth in health, comfort, and function. Extraction is suggested, as active periodontal therapy (non-surgical or surgical) is unlikely to improve the current status of the tooth
What is the antibiotic prophylaxis for an adult?
2 grams amoxicillin 30-60 minutes before procedure
What is the antibiotic prophylaxis for children?
50mg per kilogram
What is the antibiotic prophylaxis regimen for an adult who cannot take oral medication?
2g ampicillin IM or IV
50mg/kg IM or IV for children
What is the antibiotic prophylaxis for an adult allergic to penicillins?
600mg clindamycin
What is the antibiotic prophylaxis protocol for children allergic to penicillins?
20mg/kg clindamycin
Name 4 cardiac conditions that require antibiotic prophylaxis
Prosthetic cardiac valve
Previous infective endocarditis
Congenital heart disease
Cardiac transplantation recipients who develop cardiac valvuopathy
True or false… as of 2015 (updated for CTP), the ADA guideline states “in general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infections”
True
But, patients with a history of complications associated with their joint replacement surgery wo are undergoing dental procedures that include gingival or mucosal incision, prophylactic antibiotics should only be considered after consultation with the patient and orthopedic surgeon.
For a simple tooth extraction, for patients on warfarin, treatment can be safely performed without high risk of bleeding, providing that the INR is equal to or less than ___ on the day of extraction
3.5
What is the prescription for acetaminophen for adults and children 12 and older?
500mg every 4-6 hours
Maximum 4 grams per 24 hours
What is the prescription for acetaminophen for children under the age of 12?
10mg/kg/dose every 4-6 hours
Max 75mg/kg/24 hours
What is the prescription for ibuprofen for children less than 50kg?
10mg/kg/dose every 6-8 hours
Maximum single dose 400mg: 40mg/kg/24hours
What is the prescription for children 12 or older for ibuprofen?
200mg every 4-6 hours (max 1.2grams/24 hours)
What is the the prescription for ibuprofen for adults?
200-400mg/dose every 4-6hours
Max = 1.2g/24hours
True or false… codeine and other opioid analgesics are not recommended for children by the AAP
True, it is NOT recommended
What is the prescription for amoxicillin for children < 40kg?
20-40mg/kg/day in divided doses every 8 hours
Max 500mg/dose
What is the prescription for amoxicillin for adults?
500mg every 8 hours
What is the prescription for clindamycin for children?
8-20 mg/kg/day in 3-4 divided doses as hydrochloride
(20mg/kg/day in 4 divided doses)
Or
8-25mg/kg/day in 3-4 divided doses as palmitate
What is the prescription for clindamycin for adults?
150-450mg every 6 hours (maximum 1.8g day)
300mg every 6 hours
What is the prescription for topical nystatin for angular cheilitis?
Ointment (100,000 units/g)
For all ages: apply a thin layer to angles of mouth 4 times/day for 14 days or until complete healing
What is the prescription for topical/transmucsoal agent for oral candidiasis? (Clotrimazole)
Lozenge 10mg
(Do not use for patients under 3 years of age)
Dissolve one troche 5 times a day for 14 days
What is the nystatin topical prescription for oral candidiasis for infants (children under 3)
Suspension (100,000 units mL)
200,000-400,000 (2-4 mL) 4times/day; 1/2 of dose placed in each side of mouth
What is the prescription for systemic acyclovir for primary herpetic gingivostomatitis? Children and adult
Children = 15mg/kg 5 times/day for 7 days
Adults 400 mg 3-5times/day for 10 days
What is the prescription for systemic agent for herpes labialis? Children and adults
Acyclovir
Children 20mg/kg/dose 4 times/day 5 days (maximum 400mg/dose)
Adults 400mg 3 times/day for 5 days
What is the prescription for topical acyclovir for herpes labialis?
Acyclovir cream 5%
Children over 12 and adults. Apply a thin layer on the lesion 5 times daily for 4 days
What is the prescription for docosanol (abreva)?
Cream 10%
Children over 12 and adults
Apply a thin layer on the lesion 5 times a day for up to 10 days
What is the prescription for chlorhexidine gluconate?
Dental solution 0.12%
Children 8 and up and adults
Rinse with 15 ml 2 times/day
What is the prescription for topical corticosteroids for apthous ulcers?
Dexamethasone
Form = elixir
Adolescents and adults: rinse with 5ml 4 times/day for 2 minutes and expectorate. Do not exceed 7 day course
You estimate a patient requiring amoxicillin prophylaxis requires 3-4 dental appointments. Write the prescription.
Amoxicllin 500mg tabs
16 capsules
Take 4 tabs one hour prior to appointment
What is the eruption phone number for maxillary teeth?
781-0062
What is the eruption phone number for mandibular teeth?
679-0160
Fluoride level of drinking water < 0.3PPM. Child is less than 6 months old. What is the recommended fluoride supplementation?
None
Fluoride level of drinking water < 0.3PPM. Child is 6 months - 3 years old. What is the recommended fluoride supplementation?
0.25mg daily
Fluoride level of drinking water < 0.3PPM. Child 3 years - 6 years old. What is the recommended fluoride supplementation?
0.5mg daily
Fluoride level of drinking water < 0.3PPM. Child is 6 years to 16 years old. What is the recommended fluoride supplementation?
1mg daily
Fluoride level of drinking water 0.3-0.6PPM. Child is less than 6 months old. What is the recommended fluoride supplementation?
None
Fluoride level of drinking water 0.3-0.6PPM. Child is 6 months - 3 years old. What is the recommended fluoride supplementation?
None
Fluoride level of drinking water 0.3-0.6PPM. Child is 3 years - 6 years old. What is the recommended fluoride supplementation?
0.25mg daily
Fluoride level of drinking water 0.3-0.6PPM. Child is 6 years - 16 years old. What is the recommended fluoride supplementation?
0.5mg daily
Fluoride level of drinking water is over 0.6PPM. What is the recommended fluoride supplementation for any age?
No supplementation
When is azithromycin prescribed?
When patient is allergic to penicillins and clindamycin doesn’t work well.
What is the typical dosage for azithromycin?
500mg every 24 hours for 3 days
What is the eruption pattern for primary maxillary teeth? (In months)
8 9 16 13 25
What is the eruption pattern for mandibular teeth in months?
6 10 17 14 23
Pre diabetes has an HbA1C of what range?
5.7-6.3
Diabetes is classified as an HbA1C of ___ and above. Anything over ___ is dangerous
- 4
7. 6
What do you prescribe a patient who is allergic to penicillins and is unable to take oral medication?
Clindamycin 600mg IM or IV
If bone is to be manipulated and the patient is taking PO bisphosphonates, what should you do?
Obtain informed consent
If bone is to be manipulated and patient is on IV bisphosphonates, what should you do?
Bone manipulation is to be avoided.
Refer to OS if BRONJ is suspected
Which anesthetic is the best to use if the patient is pregnant? Which class is it?
Lidocaine (category B)
True or false… NO2 should be avoided in preganancy
True, especially avoid in first 2 trimesters
True or false… aspirin and ibuprofen should be avoided in pregnancy
True. Stick to acetomenophen
In patients with pace makers, what should you avoid?
Electronic pulp testers
Apex locators
Ultrasonic
Electrosurgery
Local anesthetics with epi
How much epi is in a 1/200,000 cartridge?
0.009
How much epi is in a 1/100,000 cartridge?
0.018mg
How much epi is in a 1/50,000 cartridge?
0.036mg
What class of drugs are the following?
Warfarin
Dabigatran
Heparin
Xeralto
Antiplatelet/anticoagulant
Name 6 contraindications to vasoconstrictors (epi)
- Heart diseases (unstable angina, recent myocardial infarction, recent coronary bypass surgery, refractory arrhythmias, uncontrolled congestive heart failure, uncontrolled severe hypertension)
- uncontrolled hyperthyroidism
- uncontrolled diabetes
- sulphite allergies
- steroid-dependent asthma
- pheochromocytoma
Moderate to severe asthma
Name some examples when you should take precautions in using epi.
Patients taking tricyclic antidepressants
Pts taking phenothiazine compounds
Pts taking monoamine oxidase inhibitors
Pts taking beta-blockers
Cocaine abusers
Pts taking digioxin
General anesthesia with halothane
Define stage 1 hypertension
130-139
Over
80-89
Define stage 2 hypertension (severe)
140 or higher
Over
90 or higher
In what case is it considered a hypertensive crisis?
> 180 and/or over >120
What drug may be used to give to an epileptic patient undergoing a prolonged seizure?
Midazolam
5 minutes or longer or 3 or more seizures in an hour
What are some treatment modifications for patients on dialysis?
Best time for dental treatment is the day after dialysis (not day of due to anticoagulants given during dialysis)
Don’t take blood pressure on same arm with the shunt
Consult with physician about antibiotic prophylaxis
What drug type is Norco and Lortab?
Hydrocodone
What is the dosing for hydrocodone?
5mg every 6 hours for 24 - 48 hours
