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Case Presentation > Case Presentation > Flashcards

Case Presentation Flashcards

1
Q

what does SOCRATES stand for

A

site
onset
character
radiating
associating factors
time
exacerbating factors
scale 1-10

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2
Q

apart from SOCRATES, what else is it important to ask about pain

A

are they up at night
have they tried any medication and is this working

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3
Q

what is symptomatic irreversible pulpitis

A

clinical diagnosis based on subjective and objective findings indicating that the vital inflamed pulp is incapable of healing

can have lingering thermal pain, spontaneous pain and referred pain

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4
Q

what is symptomatic apical periodontitis

A

inflammation of apical periodontium producing clinical symptoms including a painful response to biting and/or percussion or palpation
might or might not be associated with an apical radiolucent area

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5
Q

what 2 parts of an endodontic diagnosis is needed

A

pulpal and apical

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6
Q

what is normal pulp

A

clinical diagnostic category in which the pulp is symptom-free and normally responsive to pulp testing

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7
Q

what is reversible pulpitis

A

clinical diagnosis based on subjective and objective findings that the inflammation should resolve and the pulp return to normal

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8
Q

what is asymptomatic irreversible pulpitis

A

vital inflamed pulp is incapable of healing
no clinical symptoms but inflammation produced by caries, caries excavation, trauma

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9
Q

what is pulp necrosis

A

clinical diagnostic category indicating the death of the dental pulp
pulp usually nonresponsive to pulp testing

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10
Q

what is previously treated

A

tooth has been endodontically treated and the canals are obturated with various filling materials other than intracanal medicaments

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11
Q

what is previously initiated therapy

A

tooth has been previously treated by partial endodontic therapy

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12
Q

what is normal apical tissues

A

periradicular tissues that are not sensitive to percussion or palpation testing
lamina dura intact and PDL uniform

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13
Q

what is asymptomatic apical periodontitis

A

inflammation and destruction of apical periodontium that is of pulpal origin
appears as an apical radiolucent area and does not produce clinical symptoms

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14
Q

what is acute apical abscess

A

inflammatory reaction to pulpal infection and necrosis characterised by rapid onset spontaneous pain, tenderness of the tooth to pressure, pus formation and swelling of associated tissues

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15
Q

what is chronic apical abscess

A

inflammatory reaction to pulpal infection and necrosis characterised by gradual onset, little or no discomfort and the intermittent discharge of pus through an associated sinus tract

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16
Q

what is condensing osteitis

A

diffuse radiopaque lesion representing a localised bony reaction to a low grade inflammatory stimulus usually seen at the apex of a tooth

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17
Q

origin and insertion of masster

A

O - zygomatic arch
I - angle of mandible

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18
Q

origin and insertion of temporalis

A

O - temporal fossa
I - coronoid process

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19
Q

origin and insertion of medial pterygoid

A

O - medial surface lateral pterygoid plate
I - zygomatic arch

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20
Q

origin and insertion of lateral pterygoid

A

O - base of skull and lateral surface of lateral pterygoid plate
I - condyle surface

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21
Q

what is the blood supply to TMJ

A

deep auricular artery

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22
Q

what is nerve supply to TMJ

A

auriculotemporal, masseteric, posterior temporal nerve

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23
Q

if someone gets pain in the TMJ what bit of it feels pain and why

A

bilaminar zone
articular disc slips forward and bilaminar zone becomes compressed by the condyle

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24
Q

what are the causes of TMD

A

myofascial pain
disc displacement
degenerative disease
chronic recurrent dislocation
ankylosis
hyperplasia
neoplasia
infection

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25
Q

if the TMJ is clicking what TMJ disease is this indicative of

A

anterior disc displacement with reduction

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26
Q

what is the pathogenesis of TMD

A

inflammation of muscles
trauma
stress
psychogenic
occlusal abnormalities

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27
Q

what is the extra oral examination of TMD

A

muscles of mastication
joints
jaw movements
facial asymmetry

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28
Q

what is the intra-oral examination of TMD

A

interincisal mouth opening
signs of parafunctional habits
muscles of mastication

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29
Q

what are the special investigations used for TMD

A

OPT
CT
MRI
transcranial view
nuclear imaging
arthrography
ultrasound

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30
Q

common clinical features of TMD

A

intermittent pain
muscle/joint/ear pain
trismus/locking
clicking/popping joint noises
headaches
crepitus (later on)

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31
Q

differential diagnosis of TMJ

A

dental pain
sinusitis
ear pathology
salivary gland pathology
referred neck pain
headache
atypical facial pain
trigeminal neuralgia
angina
condylar fracture
temporal arteritis

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32
Q

reversible treatment of TMD

A

patient education
medication
counselling
physical therapy
splints
bite raising appliance

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33
Q

counselling for TMD

A

reassurance
soft diet
masticate bilaterally
no wide opening
no chewing gum
dont incise food
cut food into small pieces
stop parafunctional habits
support mouth on opening

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34
Q

medications used for TMD

A

NSAIDs
muscle relaxants
tricyclic antidepressants
botox
steroids

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35
Q

what types of splint can be used for TMD

A

bite raising appliances
anterior repositioning splint

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36
Q

what does a bite raising appliance do

A

stabilise occlusion and improve function of masticatory muscles thereby decreasing abnormal activity

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37
Q

what is the irreversible treatment of TMD

A

occlusal adjustment
surgery

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38
Q

why does joint clicking occur with disc displacement

A

lack of coordinated movement between the condyle and articular disc

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39
Q

what is the mechanics of disc displacement with reduction

A

disc initially displaced anteriorly by the condyle during opening until disc reduction occurs

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40
Q

signs of disc displacement with reduction

A

jaw tightness and mandible deviation

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41
Q

if disc displacement with reduction is left untreated what can it lead to

A

osteoarthritis

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42
Q

treatment for disc displacement with reduction if it is not painful

A

no treatment

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43
Q

treatment for disc displacement if it is painful

A

counselling
limit mouth opening
bite raising appliance
surgery occasionally

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44
Q

what are the 3 classifications of TMD

A

joint degeneration
internal derangement
no joint pathology

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45
Q

factors of caries

A

tooth
substrate
bacteria
time

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46
Q

how does bacteria attach to the enamel

A

due to saliva which acts as a primer

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47
Q

what does enamel caries do to enamel structure

A

enlarges gaps between rods

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48
Q

how does the stephan curve work when you already have white spot lesions

A

active lesions have a very low drop and persist for longer period

inactive lesions have slight reduction but doesnt stay there

no lesions will never reach pH of 5.5 and will have quick resolution

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49
Q

what acid is produced by microorganisms to cause caries

A

lactic acid

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50
Q

why are active sites (enamel lesions) more susceptible to a drop in pH

A

because the bacteria thrives here so the sites are more virulent for producing acid

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51
Q

if you see grey enamel what does this mean

A

there is no longer dentine supporting the enamel as the caries has extended

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52
Q

when is fluoroapatite formed

A

during demineralisation and remineralisation

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53
Q

what does streptococcus mutans need to produce acid

A

sucrose

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54
Q

what minerals remineralise enamel

A

phosphate
calcium
fluoride

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55
Q

what are the 7 elements of caries risk

A

clinical evidence
dietary habits
social history
fluoride use
plaque control
saliva
medical history

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56
Q

what is given to patients to assess their diet and how long do they use it for

A

four day diet diary
at least one day over the weekend

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57
Q

what are the 8 elements of preventive programme

A

radiographs
toothbrushing instruction
strength of F in toothpaste
F varnish
F supplementation
diet advice
fissure sealants
sugar free medicine

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58
Q

name some safe snacks

A

milk/water
fruit
savoury sandwiches
crackers and cheese
breadsticks
crisps

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59
Q

what are the steps of caries progression

A

adhesion
survival and growth
biofilm formation
complex plaque
acid
caries

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60
Q

what is the proportion of streptococcus mutans linked to

A

high sugar diet

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61
Q

what are the characteristics of strep mutans

A

glycolytic systems
EPS/sucrose metabolism
attachment mechanisms
greater acidogenicity
ecological competitiveness at low pH
genomic characteristics

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62
Q

what does the Stephan curve show

A

the fall in pH below the critical level of pH 5.5 at which demineralisation of enamel occurs, following intake of food and drink, and how long it takes to get back to neutral pH

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63
Q

microorganism present with endodontic infections

A

enterococcous faecalis

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64
Q

virulence factors of enterococcous faecalis

A

endotoxins
adhesins
collagenases
hyaluronidase
immune evasion

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65
Q

what percentage of adults have asthma

A

2-5%

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66
Q

what is the cellular response of asthma

A

allergen triggers IgE production
B and T cell interaction
degranulation of mast cells
narrowing of airway, oedema and mucous secretion

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67
Q

what is asthma

A

airway narrowing due to:
bronchial smooth muscle constriction
bronchial mucosal oedema
excessive mucous secretion into the airway lumen

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68
Q

what is air flow related to

A

radius of the bronchus to the power of 8

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69
Q

what are the symptoms of asthma

A

cough
wheeze
shortness of breath
diurnal variation
difficulty breathing out

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70
Q

when is asthma worse

A

overnight and early morning

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71
Q

what tracks airway resistance in asthma

A

peak expiratory flow rate (PEFR)

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72
Q

how do you compare the PEFR measurements for asthma

A

compare morning with morning etc

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73
Q

what are the triggers for asthma

A

unknown
infections
environmental - dust
cold air
atopy

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74
Q

what is the acute biphasic response of asthma

A

early response with acute asthma attack
attack later on again if corticosteroids are not used

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75
Q

what are the core asthma drugs

A

LA and SA beta adrenergic agonists
low and high dose corticosteroids
adjuvant therapy (biologics, prednisolone)

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76
Q

what are the stages of asthma therapy (in terms of what inhalers are used related to severity)

A

mild intermittent
regular preventer
initial add on
persistent poor control
continuous or frequent oral steroids

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77
Q

my patient is on salbutamol and beclomethasone/foromoterol, what stage of asthma therapy are they on

A

initial add on therapy

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78
Q

what type of drug is salbutamol

A

beta adrenergic agonist

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79
Q

what are the actions of beta adrenergic agonists

A

relax bronchial smooth muscle (reduce bronchoconstriction and resting bronchial tone)

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80
Q

when do you start taking corticosteroids for asthma

A

if you are using a SA beta agonist more than 3 times a week use a low dose

move onto high dose if symptoms indicate need for it

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81
Q

my patient has mild asthma, what does this mean

what if she had moderate asthma what drug would she be taking as well

A

she only uses low dose steroid inhaler and short acting beta agonist

long acting beta agonist for moderate therapy

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82
Q

what should a dentist know about asthma

A

that the patient has asthma
the severity of the patients asthma
the triggers for the patients asthma and how to avoid these
know how to assess and treat a patient during an acute asthma attack

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83
Q

action of beclomethasone

A

anti-inflammatory reducing the swelling and irritation in the lungs
reduces the release of inflammatory mediators (histamines, leukotrienes, cytokines) by acting on specific receptors within the cell resulting in altered gene expression

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84
Q

side effects of beclomethasone

A

headache
ORAL CANDIDIASIS
pneumonia
ALTERED TASE
voice alteration

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85
Q

how do you reduce the risk of candidiasis with oral steroid use

A

spacer devices
rinsing the mouth with water after inhalation
antifungal oral suspension or gel to treat

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86
Q

what type of drug is formoterol fumarate

A

long acting bronchodilators

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87
Q

what is a drug that formoterol interacts with to produce hypokalaemia that is commonly given in dentistry

A

fluconazole

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88
Q

side effects for formoterol

A

dizziness
muscle cramps
nausea
altered taste

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89
Q

side effects for salbutamol

A

muscle cramps

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90
Q

what is the effect of using beclomethasone and formoterol together

A

make breathing easier by providing relief from symptoms such as shortness of breath, wheezing and cough
prevent symptoms of asthma

91
Q

common side effect of fostair

A

oral candida
headache
hoarseness

92
Q

what is benign paroxysmal positional vertigo

A

sensation of spinning with certain head movements as a result of a problem in the inner ear

93
Q

triggers of BPPV

A

ear conditions
tilting head up or down
lying down
getting up

94
Q

medication used for BPPV in severe cases

A

vestibular suppressant medication - meclizine

95
Q

procedures for severe BPPV

A

semi-circular canal occlusion

96
Q

therapy for BPPV

A

repositioning manoeuvres

97
Q

specialists to consult for BPPV

A

GP
otolaryngologist
neurologist

98
Q

what is going on in the ear with BPPV

A

crystals from the otolith organs (which are gravity sensitive) become dislodged and move into the semi-circular canals in the vestibular labyrinth so now the semi-circular canals are sensitive to head position changes making you dizzy

99
Q

how quick do SA beta agonists work and how long do they last for

A

2-3 minutes
lasts 4-6 hours

100
Q

how quick do LA beta agonists work and how long do they last for

A

1-2 hours
lasts 12-15 hours

101
Q

fostair is a compound preparation made of 2 drugs, what type of therapy is this used for

A

maintenance and reliever therapy

102
Q

what type of hypersensitivity reaction is asthma

A

type 1 - exaggerated IgE mediated immune response

103
Q

what type of hypersensitivity reaction is a metal allergy

A

type 4 - delayed hypersensitivity (takes longer for it to show)

overreaction of T helper cells (cell-mediated response)

104
Q

how does type 4 hypersensitivity reactions work

A

CD4 cells recognise foreign antigens
macrophages secrete IL-12 stimulating the proliferation of more CD4 cells and CD8 cells
CD8 cells destroy target cells while macrophages form giant cells
gives excessive cytokine production and tissue damage, inflammation

105
Q

how does a type 1 hypersensitivity reaction work

A

during exposure to allergen the immune system recognises antigen as foreign
antigen presenting cells process the allergen and present it to T helper cells
T helper cells activate B cells leading to IgE antibodies specific to allergen
allergen binds to IgE antibodies already attached to mast cells and basophils which releases histamine

106
Q

how does sensodyne claim to work

A

builds a protective layer over sensitive areas of your teeth
helps to reduce sensitivity by shielding the nerve endings from external stimuli

107
Q

fluoride content of sensodyne

A

1450ppmF

108
Q

what can smoking do to your mouth

A

staining
periodontal disease
loss of teeth
oral cancer
halitosis

109
Q

what is pack years in relation to smoking

A

unit for measuring the amount a person has smoked over a long period of time

110
Q

how do you work out a pack year

A

multiplying the number of packs of cigarettes smoked per day by the number of years the person has smoked

111
Q

what is a pack year defined as

A

twenty cigarettes smoked every day for one year

112
Q

effect of alcohol on oral health

A

xerostomia
halitosis
oral cancer
caries
erosion

113
Q

what smoking cessation services are available

A

quit your way
pharmacy services

114
Q

safe units of alcohol

A

14 per week

115
Q

what causes an amalgam tattoo

A

amalgam particles embedded in soft tissues corrode over time and macrophages take up exogenous particles leading to staining of fibres

116
Q

when is a 6PPC done and why

A

3 months after treatment
to allow time for the gingivae to heal and clinical reattachment

117
Q

what does BPE 0 mean

A

probing <3.5mm
black band visible
<3mm pocket
no BOP
no calculus

118
Q

what does BPE 1 mean

A

probing <3.5mm
black band visible
<3mm pocket
BOP present
no calculus

119
Q

what does BPE 2 mean

A

probing <3.5mm
black band visible
<3mm pocket
BOP maybe
definitely calculus

120
Q

what does BPE 3 mean

A

probing 3.5-5.5mm
partially visible black band
4-5mm pockets
BOP possible
calculus possible

121
Q

what does BPE 4 mean

A

probing >5.5mm
no black band
>6mm pockets
BOP possible
calculus possible

122
Q

treatment for BPE 0

A

OHI

123
Q

treatment for BPE 1

A

OHI

124
Q

treatment for BPE 2

A

OHI and remove calculus and plaque retentive factors

125
Q

treatment for BPE 3

A

OHI
radiographs
decide if periodontitis or not
PMPR

126
Q

treatment for BPE 4

A

OHI
PMPR

127
Q

if you have BPE code 3 when do you do a 6ppc if you are following the BSP guidelines

A

after treatment

128
Q

what reattaches after periodontal treatment

A

long junctional epithelium

129
Q

what are ramfjords teeth

A

16
21
24
36
41
44

130
Q

what is marginal bleeding a reflection of

A

how well the patient can carry out effective plaque control DAILY

131
Q

what is modified plaque a reflection of

A

how well the patient is performing plaque removal

132
Q

going by ramjords scores what is an engaged patient

A

<35% bleeding
<30% plaque

OR

greater than 50% improvement in both

133
Q

properties of chlorhexidine

A

absorption to oral surfaces
long substantivity
fairly broad antimicrobial spectrum
interferes with taste
stains

134
Q

why do we use 6PPC

A

to monitor the periodontal condition of the teeth of someone with periodontitis

135
Q

what does generalised periodontitis mean

A

affecting >30% of teeth

136
Q

what does stage 3 periodontitis mean

A

mid third of root

137
Q

what does grade A periodontitis mean

A

slow rate of progression
(<0.5)

138
Q

what does currently unstable mean with periodontitis

A

PPD >5mm
or
PPD >4mm and BOP

139
Q

if someone was stable with periodontitis what does this look like

A

BOP <10%
PPD <4mm
no BOP at 4mm sites

140
Q

what is step 1 of S3 guidelines

A

explain disease
OHI
reduce risk factors
interdental cleaning
PMPR of clinical crown

141
Q

what is step 2 of S3 guidelines

A

reinforce OH
risk factor control
subgingival PMPR

142
Q

what is step 3 of S3 guidelines

A

MANAGE NON-RESPONDING SITES
moderate pockets (4-5mm) = subgingival instrumentation
deep pockets (>6mm) = consider alternative causes
consider referral for surgery

143
Q

what is step 4 of S3 guidelines

A

targeted PMPR
supportive care
reinforce OHI and risk factor control

144
Q

what rate of diagnostically acceptable radiographs is seen as an acceptable amount for IRMER17

A

95%

145
Q

regarding IMRER17 who is the employer

A

someone other than an employee who carries out or engages others to carry out medical exposure

if NHS practice then it is NHS
if private then it is practice owner

146
Q

who is the operator in IRMER17

A

anyone who is entitled by the employer to carry out a practical aspect

147
Q

who is the practitioner in IRMER17

A

registered healthcare professional entitled by employer to take responsibility for an individual exposure

148
Q

who is the referrer in IRMER17

A

registered healthcare professional who is responsible for referring individuals to the practitioner for specific exposures to be undertaken in accordance with the employers recommendations

149
Q

responsibility of the referrer in IRMER

A

providing sufficient medical data to practitioner to enable justification

150
Q

responsibility of the practitioner in IRMER

A

justification of each exam
ensure doses ALARP
comply with employers procedures

151
Q

responsibilities of the operator in IRMER

A

select equipment and methods to limit dose
follow employers procedures
not perform exam unless authorised as justified

152
Q

what is justified, optimised, limited

A

J - more good then harm
O - ALARP
limited - individual radiation dose limits

153
Q

what sets the guideline radiation dose levels for patients undergoing examinations

A

diagnostic reference levels

154
Q

diagnostic reference levels of intraorals for adults

A

1.7mGy

155
Q

how do amalgam overhangs occur

A

when a matrix band is not properly adapted

156
Q

how do you remove amalgam overhands

A

at the time with carver
flame bur
ultrasonic scaler
curettes
diamond bur
finishing bur

157
Q

what is a common side effect of amalgam overhangs

A

periodontal disease
amalgam tattoo

158
Q

why do buccal cusp fractures occur on MOD amalgam premolars

A

anatomical vulnerability - absence of both marginal ridges weakens the tooth by 60%
MOD compromises tooth structure
amalgam does not bond - stress concentration

159
Q

what diet advice would you give a patient

A

reduce sugar intakes/only at meal times
if snacking stick to non-cariogenic snacks
dont use excess sugar (in tea etc)
try to have less than 3 sugar intakes per day
be wary of acidic drinks/food

160
Q

what would you use to extract retained roots

A

luxator
elevator
root forceps

161
Q

management of an OAC

A

if small then encourage clot and suture closed
if large then refer for buccal advancement flap

162
Q

what are the principles of cavity design and preparation

A

identify and remove carious enamel
remove enamel to identify maximal extent of lesion at ADJ and smooth the enamel margins
remove peripheral caries in dentine from ADJ then circumferentially deeper
only then remove deep caries over the pulp
outline form modification
internal design modification

163
Q

how does saltwater help healing tissues after an extraction

A

creates an environment hostile to bacteria to prevent infection and other post-extraction complications
increases the pH making it a more alkaline environment
promotes gingival fibroblast migration to regulate wound repair

164
Q

what are the advantages of hot salty mouthwash after an extraction

A

reduced bacterial growth
soothing effect
improved blood circulation (warmth)
gentle cleansing
reduced swelling

165
Q

what are the parts of composite resin

A

filler particles
resin
camphorquinone
low weight dimethacrylates
silane coupling agent

166
Q

what monomer is used in composite

A

BIS-GMA

167
Q

what do monomers do in composite

A

undergoes free radical addition polymerisation
is a difunctional molecule which has C=C bonds to facilitate crosslinking

168
Q

what is the effect of adding filler particles to composite

A

improved mechanical properties
lower thermal expansion
lower polymerisation shrinkage
less heat of polymerisation
improved aesthetics

169
Q

advantages of using light cure

A

extended working time
less finishing time
immediate finishing
less waste
higher filler levels
less porosity

170
Q

what is depth of cure

A

depth at which material hardness is about 80% that of the cured surface

171
Q

problem with materials that are light cured

A

light/material mismatch
premature polymerisation
optimistic depth of cure
recommended setting times too short
polymerisation shrinkage

172
Q

what rise of temperature is accepted as a potentially irreversible traumatising to the pulp

A

5.5 degrees

173
Q

strength of composite

A

350MPa

174
Q

youngs modulus of composite

A

12GPa

175
Q

how do you bond to enamel

A

acid etch

176
Q

how do you bond to dentine

A

dentine bonding agent

177
Q

bond strength of composite

A

40MPa

178
Q

what are the advantages of a composite onlay to a direct composite

A

better mechanical performance
significant reduction in polymerisation shrinkage
maximise marginal integrity
ideal proximal contacts
excellent anatomic morphology
optimal aesthetics

179
Q

what is the advantage of a composite onlay over a porcelain onlay

A

not as abrasive
transfer of masticatory forces are considerably less
greater capacity to absorb compressive loading forces

180
Q

how is bond strength of indirect restorations increased

A

etching with hydrofluoric acid
sandblasting

181
Q

disadvantages of indirect composite onlays

A

ABSORBS STAINS
increased cost and time
requires two appointments
fabrication of temporary restoration
low potential for repair

182
Q

uses of onlays

A

tooth wear
FRACTURED CUSPS
restoration of root treated teeth
replace failed directs
minor bridge retainers

183
Q

what should the internal preparations of a tooth be for an onlay

A

no undercuts
rounded internal line angles
shoulder or chamfer margins
4-6 degree tapered walls
margins not on occlusal contact points

184
Q

what was the appointment like for onlay prep

A

prepare the tooth
impression with PVS and lab putty
bite registration
lower impression
make temporary with protemp and cement with temp bond
check occlusion

185
Q

what was the appointment like for onlay cementation

A

remove temporary
try in onlay
cement with dual cure composite and DBA
check occlusion
finish if need to

186
Q

what cement is used to cement composite onlays

A

dual cure composite and DBA

187
Q

when are onlays considered

A

when there is no or little intracoronal shape to the preparation and retention is poor

188
Q

what is retention provided by for onlays

A

adhesive cement but should also incorporate conventional tooth preparation for retention

189
Q

how are indirect composites cured and what does this do for them

A

cured by heat, pressure and intense light
improves strength, reduces wear
reduction in polymerisation shrinkage

190
Q

what is the bond for dual cure composite resin cements

A

micromechanical and C=C bond

191
Q

why do you want to use a dual cure cement for composite onlays

A

light penetration is poor
although they are dual cure, if they are not light cured the mechanical properties decrease by 25%

192
Q

what sensibility tests are available

A

EPT
ethyl chloride
TTP

193
Q

what are the problems with sensibility testing

A

stimulate nerve fibres
does not indicate blood supply state
periradicular inflammation can occur before necrosis
hard testing multirooted teeth

194
Q

what is the process of mechanical debridement of the root canal

A

preparation of tooth
access cavity preparation
creating straight line access
initial negotiation
coronal flaring
working length determination
apical preparation

195
Q

what impression material is used when taking impressions for indirect restorations

A

addition cured silicone - polyvinylsiloxane

196
Q

what body of PVS is used for impressions of crown prep etc

A

light body on the tooth and then heavy body/lab putty in the tray

197
Q

what is the single stage technique of impressions for indirects

A

light body used around the teeth and heavy body in tray will push material into hard to get areas around the teeth

198
Q

what is the ISO standard of surface replication for an elastomer

A

grooves of 20um replicated

199
Q

what is the shark fin test testing and what would you see with a good result

A

flow under pressure

big fin

200
Q

how do you optimise mucosal support for upper partial acrylic dentures

A

using connector over centre of palate

201
Q

what gives direct retention for an upper acrylic partial denture

A

good fit
cohesion
wrought clasps

202
Q

how much gingivae should be left clear of the denture base if you are making a partial acrylic denture

A

3mm of clearance

203
Q

what makes up debris left on dentures

A

salivary proteins and bacteria
oral debris
calculus

204
Q

what are the effects of poor denture hygiene

A

caries
periodontal disease
denture stomatitis
halitosis
pain

205
Q

what can be used for mechanical denture cleaning

A

soap and soft brush
ultrasonics

206
Q

what can be used for chemical cleaning of acrylic dentures

A

alkaline peroxides (the tablets)
fairy liquid
milton steriliser
toothpaste - abrasive

207
Q

what is the hygiene advice for denture wearers

A

brush dentures daily
soak dentures daily
leave out at night
visit dentist regularly

208
Q

how do you get used to new dentures

A

practice speaking out loud (reading)
learn to eat with them in
practice adjusting your denture (in and out of mouth)
wear them for as long as you can during the day

209
Q

what is clinical governance

A

systematic approach to maintaining and improving the quality of patient care within a health system

210
Q

what are the dimensions of healthcare quality

A

person-centred
safe
effective
efficient
equitable
timely

211
Q

how do you promote implementation of research in clinical practice

A

critical appraisal of literature
development of clinical guidelines and protocols
implementation strategies

212
Q

what is the aim of clinical guidelines

A

provide recommendations for the treatment and care of individuals
be used to develop standards for clinical audit
be used in education and training of health professionals
help patients to make informed decisions
improve communication between patient and health professional

213
Q

what is the aim of SDCEP

A

support dental teams throughout Scotland by providing guidance developed by the profession for the profession on topics identified as priorities for dentistry in Scotland

214
Q

what are the SDCEP recommendations based on

A

current legislation/professional regulations
group consensus after critical evaluation of evidence
group consensus after considering expert opinion

215
Q

what are the key clinical governance activities

A

CPD
evidence based practice
openness on poor performance and practice
risk management
clinical audit
peer review
Critical incident review
research project
quality improvement projects

216
Q

what should CPD do

A

provide NHS staff opportunity to continuously update skills and knowledge
result in delivery of modern, effective and high quality care
identify training needs across professions to aid clinical team-working

217
Q

what is the mandatory CPD

A

100hrs within 5yr cycle at least 10hrs across 2 consecutive yrs

218
Q

what are the highly recommended areas to do CPD for

A

MEDICAL EMERGENCIES
DISINFECTION AND DECONTAMINATION
RADIOGRAPHY AND RADIATION PROTECTION
legal and ethical issues
complaints handling
oral cancer
safeguarding children and young people

219
Q

what is clinical audit

A

a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and implementation of change

ENSURE WHAT SHOULD BE DONE IS BEING DONE AND IF IT NOT IT PROVIDES A FRAMEWORK TO ENABLE IMPROVEMENTS

220
Q

steps of clinical audit

A

select topic
set agreed standards and decide on data requirements
observe practice and collect data
analyse data and determine any deviation from standards
identify any areas of change required
make necessary changes
repeat audit process and determine whether improvements have occurred

221
Q

what is the audit cycle

A

identify problem or issue
set criteria and standards
observe practice/data collection
compare performance with criteria and standards
implement change

222
Q

what are the educational strengths of an audit

A

encourages learning about new techniques and treatments
modifies attitudes and management of clinical conditions
indicate gaps in knowledge and/or skills

223
Q

what is the process of enhanced significant event analysis for critical incident review

A

set up a meeting to discuss events
meet and undertake a structured analysis
implement changes and monitor progress
write up report
seek external comment/feedback

224
Q
A

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