general clinical practice need to know

Question 1

what is xerostomia?

Answer 1

dry mouth caused by reduced salivary flow
clinically diagnosed if unstimulated salivary flow <0.3ml

Question 2

list oral problems which are exacerbated by xerostomia

Answer 2

caries
periodontal disease
candida infection
mucositis

Question 3

give causes of xerostomia

Answer 3

radiotherapy/ chemotherapy
sjrogren’s syndrome
HIV
epstein Barr virus

Question 4

what are the predisposing factors of oral candidosis?

Answer 4

prolonged antibiotic use
poor oral hygiene
denture wearer
immunocompromised
diabetes
dialysis
burn unit patient

Question 5

what infections can be caused by candida?

Answer 5

periodontitis
denture stomatitis
UTIs
endocarditis

Question 6

what classification of oral candidosis is shown here?

Answer 6

pseudomembranous

Question 7

what classification of oral candidosis is shown here?

Answer 7

chronic hyperplastic

Question 8

what classification of oral candidosis is shown here?

Answer 8

angular chelitis

Question 9

what are the 3 types of erthematous candidosis?

Answer 9

newtons type 1- localised inflammation
newtons type 2- diffuse inflammation
newtons type 3- granular inflammation

Question 10

how would you treat denture stomatitis in an immunocomprosed patient?

Answer 10

systemic antifungal- fluconazole
topical antifungal (nystatin)/ chlorhexidine rinse

Question 11

Q
how would you treat an oral fungal infection in a patient with poor oral hygiene?

Answer 11

need to improve oral hygiene first
chlorhexidine rinse

Question 12

how would you treat an oral fungal infection in a patient with dry mouth?

Answer 12

topical antifungal e.g. nystatin
avoid systemic antifungals

Question 13

how would you treat an oral fungal infection in a patient with large erosive lesions?

Answer 13

same as an immunocompromised patient
systemic antifungal with either topical antifungal or chlorhexidine rinse

Question 14

what are causes of an overhang?

Answer 14

poor adaptation of the matrix band
excessive force applied when condensing amalgam

Question 15

what are the short and long term complications of overhangs?

Answer 15

food trap
difficulty cleaning
plaque stagnation
secondary caries
gingivitis and periodontal diseae

Question 16

what is the preferred method for correcting an overhang?

Answer 16

replacement of the restoration

Question 17

what are all of the treatment options for correcting an overhang?

Answer 17

replace restoration
finishing strips
soft flex files

Question 18

list functions of a provisional crown for an EDP# and exposed RCT

Answer 18

improve aesthetics and provide pt with realistic expectations
improve functions of mastication and speech
resolve gingival inflammation and provide adequate gingival health prior to fitting the definitive restoration
to act as a marker for the dentist for tooth prep
prevents sensitivity
preserves tooth vitality
used as isolation for RCT

Question 19

name 3 types of prefabricated crowns

Answer 19

polycarbonate crowns
clear plastic
metal (aluminium/stainless steel)

Question 20

give disadvantages of prefabricated crowns

Answer 20

inaccurate fit ervically, occlusally, interdentally
if a large bank of crowns is needed it is very expensive

Question 21

what factors can result in tooth mobility?

Answer 21

traumatic occlusion (bruxism)
trauma
periodontal disease
dental abscess

Question 22

when would you intervene a mobile tooth?

Answer 22

progressively increasing mobility
gives rise to symptoms
creates difficulty with restorative treatment
risk of aspiration
affecting occlusion

Question 23

how would you expect a mobile tooth to react to HPT?

Answer 23

decrease in mobility
clinical attachment will be gained

Question 24

A patient has mobile lower incisors and refuses XLA. What would you advise him and what are the disadvantages of this?

Answer 24

Splinting may be appropriate when there is tooth mobility caused by advanced LOA/if tooth mobility is causing discomfort or difficulty in chewing.

However, splinting does not influence the rate of periodontal destruction and it may create hygiene difficulties.

It is a Tx of last resort.

Question 25

What is the purpose of a post ?

Answer 25

To retain the core

Question 26

What is a ferrule ?

Answer 26

a 1-2mm dentine collar required to place a post

Question 27

What are the types of posts?

Answer 27

manufactured - pre-formed

material - cast metal, steel, zirconia, carbon, glass fibre

shape - parallel sided or tapered

Question 28

How much gutta percha should be left in the canal space when placing a post?

Answer 28

at least 3-5mm

Question 29

What is the purpose of placing a post?

Answer 29

Resistance/Retention for a compromised crown

Question 30

How do you determine the difference between a facial palsy and a stroke?

Answer 30

Stroke - patient can wrinkle forehead and blink

facial palsy - face is affected on the same side where LA was given, cannot move upper or lower face

Stroke affects the opposite side of the body from the location in the brain that is affected

Question 31

Explain neurologically the difference between stoke and facial palsy

Answer 31

The upper half of the face is supplied by both contralateral and ipsilateral innervation

The lower half of the face is only supplied by contralateral innervation

Lesions affecting the motor cortex (STROKE) result in contralateral weakens of lower face muscles but the upper muscles of the face are spared due to innervation from the opposite side

Lesions affecting the facial nerve in the brainstem (FACIAL PALSY) affect ipsilateral innervation for both upper and lower muscles

Question 32

How would you manage a patient that has a facial palsy due to LA?

Answer 32

Reassure the patient
explain the sensation and muscle control will return once the LA wears off
Give the patient an eyepatch or tape the eye closed to protect the eye until blinking function returns
give emergency contact number