Little black book notes Flashcards
What inheritance pattern does haemophilia follow?
Sex linked recessive
What are two weaknesses of DOACS
They have no standardised testing for monitoring
They have no antidote
If a patient presents to you and in their medical history they are taking, metaforamin, dapagliflozin and sulfonylureas. What might this suggest to you
This is triple therapy medication for a patient with diabetes, this suggests that it is a challenge to keep this patients diabetes under control
Patient presents to you complaining of ‘’ white patch on their palate, it can be scraped off but leaves a bleeding base when removed’’
What could this be and how would you manage it
Pseudomembranous candidiosis
Denture hygiene should be observed - denture should be removed at night
Toothbrush and gauze to clean the palate
What two medications are contraindicated for miconazole and what should be prescribed instead
Warfarin and statins
These patients should instead be prescribed nyastatin
You are examining a patient and while carrying out their intra-oral exam you note that the mucosa is continuously getting stuck to the mirror, that there are food residues left in the oral cavity and that their is a frothiness of the patients saliva
What condition could this raise suspicion of
Sjrogens syndrome
What is the minimum temperature and time for the sterilisers in the LDU
134-137 degrees for minimum of 3 minutes
Why may it be a good idea to make someone with pseudomebranous candidosis a new denture
Candidal species have the ability to penetrate acrylic dentures
Why are the ultrasonic baths degassed at the start of each day and at each water change
This is to get rid of airbubbles to prevent interference as this will reduce the efficacy of cleaning
Why might someone with COPD have polycythaemia ( high Hg)
This is because these patients are hypoxic for long, this then induces erythropoietin realease from the kidney and therefor an increase in red blood cell production
What are causes of micro cytic anaemia
Iron deficiecey
Thalassemia
B12/folate defiency results in what kind of anaemia
Macro cytic
Name 3 reasons that a radiographic film image may be pale
Film was removed from the solution to early
Solution was too cold
Solution was too dilute
What is the difference between IRR17 and IRMER17 and who enforces each
IRR17 - deals with the occupational exposure of the general public
Enforced by health and safety officer
IRMER17 - deals with the medical exposure of the patient
Enforced by heath improvement Scotland
If you were wanting to send away to the lab for bacteria present in a patient with gingivitis how would you do that
Paper point to swab the subgingival plaque- from the base of the periodontal pocket
Which kind of Candida is resistant to fluconazole and what should b prescribed instead
Candida Glabrata
Nyastatin should be given
What is the bacteria present in endodotnic infections and how does this differ between primary and secondary infections
Enterococcus faecalis
In primary it is gram negative bacteria and in secondary it is grampostiove
What are the microbial stages of caries
Adhesion
Survival and growth
Biofilm formation
Complex plaque
Acid
Caries
If a dentist is to consent for a patient without capacity under act 47 of adults with incapacity they must adhere to 5 principles
What are these
Intervention must benefit the adult
Must be the least invasive option
Have regard to the adults past wishes
Take into account the wishes of the adults closest relatives, primary caregivers
Encourage participation of the adult as much as possible - residual capacity
In accordance with Andrew’s 6 keys of occlusion what should the molar relationship be
Distal surface of the distobuccal cusp of the upper 6s occludes with the mesial. Surface of the mesiobuccal cusp of the lower second molar
What are the occlusal effects of a digit sucking habit
Proclination of the upper incisors
Retroclination of lower incisors
Localised AOB
Narrow upper arch and/or unilateral postieor cross bite
How would you manage a patient that has a digit sucking habit
Positive reinforcement
Bitter nail polish o the nails
Glove on hand
Habit breaker appliance - such as a URA with goal post
What things would you be looking for when assessing a RCT on a radiograph
Coronal seal
Well condensed
Continuously tapering
Within 1-2mm of apex
No apical pathology
What is the ideal core design for MCC
6 degree taper
2mm clearance for MCC
What are the three ideal features for post design
Parallel - prevents wedging and fracture
Non threaded - avoids stresses
Cement retained - buffer between masticatory forces and tooth
What is a ferrule
1.5mm of circumferential Dentine above the gingivae
How much GP should be left apically in post core crow prep
3-5mm
In lateral cephalometric radiographs the SNA angle relates the maxilla to the anterior cranial base
What is the average value for this
81 degrees (+/-3)
In lateral cephalometric radiographs the SNB angle relates the mandible to anterior cranial base what is the average value for this
78 degrees (+/-3)
In lateral cephalometric radiographs the ANB angle relates the mandible to the maxilla what is the average value for this
3(+/-2)0
Patients ceph radiograph states that there SNA angle is average, there SNB angle is decreased and that they have a ANB angle of >5
What skeletal class would you expect this patient to be
Class 2
Patients ceph radiograph states that there SNA angle is decreased, there SNB angle is average and that they have a ANB angle of <1
What skeletal class would you expect this patient to be
Class 3
What the two ways that vertical sketel relationship can be measured
Frankfort Mandibular plane angle
Assessment of lower face height
What is the average value for the Frankfort mandibular plane angle
27(+/-4)
What on average is the LAFH-TAFH in lateral cephalometric radiographs
55%
What is the gold standard for restoration of posteior teeth
Cuspal protection restoration
What are the three methods of debridement
Physical
Irrigation
Suction
Name 4 types of sutures
Resorable monofilament - monocryl
Resorable polyfilament - vicryl rapide
Non Resorable monofilament - prolene
Non Resorable polyfilament - mersilk
What kind of bur must be used for bone removal and why
An electric straight hand piece with an saline cooled bur
This is because air turbines cannot be used as they will blow air into the tissues and create surgical emphysema which can be life threatening
What is the origin and insertion of the temporalis muscle
O - temporal fossa
I - coronal process of the mandible and anterior border of the ramus
What is the origin and insertion of the masseter muscle
O - maxillary process of zygomatic bone and inferior border of zygomatic arch
I - angle and lateral surface of ramus of mandible
The medial ptergygoid muscle has to heads a deep and superficial.
Name both the origins and insertions of each - the insetion is the same
Deep
- O = medial surface of lateral pterygoid plate
- I = medial surface of ramus and angle of the mandible
Superficial
- O = maxillary tuberosity and pyramidal process of the palate bone
- I = medial surface of rammed and angle of mandible
The lateral ptergyoid muscle has two head, an upper and lower what are the origins of each and the insetion of both
upper - infratemporal fossa of greater wing of spehnoid
lower - lateral surface of lateral pterygoid plate
They both insert into the front of neck of mandible
What is the function difference of the intrinsic and extrinsic muscles of the tongue
Intrinsic - alter shape of the tongue
Extrinsic - alter postion of the tongue
Which extrinsic muscle of the tongue is the only one that protrudes the tongue
genioglossus
Where are the intrinsic and extrinsic muscles of the tongue separated
the saggital septum
All muscles of the tongue recieve motor innervation from the hypoglossal nerve, which is the only muscle that does not?
where does that muscle recieve its motor nerve supply
Palatoglossus and it comes from the vagus nerve
The general sensation of the tongue is split into anterior 2/3 and posterior 1/3, which two nerves supply each
Anterior 2/3 is supplied by the lingual branch of the trigeminal nerve
Posterior 1/3 by the lingual branch of glossophanrygeal nerve
Like general sensation supply the special sensation is also split into anterior 2/3 and posterior 2/3 - what nerve supplies each section
Anterior 2/3 - Facial nerve via the chorda tympani
posterior 1/3 - lingual branch of glossopharyngeal
You are working in general practice and a child presents to your surgery with a root fracture.
On examination the coronal fragment is displaced excessively mobile and causing occlusal interference.
What are the two treatment options
1- Extract coronal fragment, apical fragment should be left in place to be resorbed
2 - Gently reposition the loose fragment, if unstable in its new position then can SPLINT with flexible splint for 4 weeks
What is the difference in the formulas of the filling materials of GI and RMGIC and there cement forms
In both GI and RMGIC there cemet forms contain a smaller particle size
RMGIC contains HEMA, what is a potential problem with HEMA
HEMA is cytotoxic and irritatant to the pulp - therefore it is essential that no monomer remains
What is porcelain etched with and why
Hydrofluroic acid - to roughen and make the surface more retentive
Patient presents to your surgery. During initial consultation you learn that the patient is in their early twenties, is a smoker and is currently going through an exam period at university.
On examination you find that marginal gingival ulceration with loss of interdental papillae and grey sloughing on top of the ulcers
what is the provisional diagnosis and managment
Acute necrotising ulcerative gingivitis
- debridement
- 0.2% chlorohexdine 2xdaily
- OHI, smoking cessation
- review in 10 days - continue PMPR
If there is systemic involvement
- metronidazole 200mg 3xdaily for 3 days
What is the difference in crown prep for procelain and metal ceramic crowns
In a porcelain crown there is a shoulder margin
In a metal ceramic crown there is a chamfer margin
What are the components of GP
Zinc
Rubber
Resin
Barium Sulphate - makes It radiopaque
Name three reasons for obturating
To create an apical seal
To provide a physical barrier that prevents microorganisms and other bacteria entering root Canal system
Seals in any microorganisms that are left behind in root canal system
What is the purpose of sealer in RCT
Acts as a lubricant
Seals space between GP points
Seals space between wall and dentine core
Seals lateral cancels
What are 4 advantages of an upper removable appliance
Excellent anchorage
Shorter chairside time
Oral hygiene is easier to maintain
Non destructive to the tooth surface
What is the maximum percentage of hydrogen peroxide in home bleaching
6%
What are the functions of posterior palatal seal
Aids in retention
prevents food accumulation
compensation for polymerisation shrinkage
reduces tenancy for gag reflex as it prevents the formation of gap between the denture case and the soft palate during functional movement
What are the stress bearing areas in the maxilla
Hard palate
residual alveolar ridge
What are the stress bearing areas in the mandible
Buccal Shelf and residual alveolar ridge
What is the best material to use to restore root caries and why
Glass ionomer
This is because glass ionomer does not cause pulpal irritantion, it contains 20% fluoride release
It is anticarciogenic and antibacterial
State 4 surgical principles
Maximal access with minimal trauma
Use scalpel in one continuous stroke
Minimal trauma to the dental papillae
Keep tissue moist - irrigate while working
What is the main blood supply of the tongue
The lingual artery
Which nerve does the chorda tympani join onto and where does this happen
The chorda tympani joins the lingual nerve and this happens in the infratemporal fossa
You are working in general practice and a child presents to you with a complicated crown fracture following trauma.
What is your management?
Make sure that in trauma history location of tooth and fragments is accounted for
Preserve the pulp via a pulpotomy
Non setting CaOH should be applied over the exposed pulp and then GI covered and then sealed with a restoration
What are 4 effects on the permanent tooth from trauma
Failure to erupt
White or brown discolouration
Crown dilatercation
Disturbance in eruption
Why is CaOH effective to place over an exposed pulp
CaOH has a ph of 12-14 so it has chemical properties which cause the formation of tertiary dentine so this then rebuilds the dentine between the pulp and the resotivtaive material so that the pulp is able to stay heathy and reduces need for RCT
What is used to record the distance between the condoles
Face bow
What is a rotation movement of the mandible
This is when there is a small amount of mouth opening up to 20mm
The condyle and the articulate disc remain in the fossa
There is no downwards to forwards movement
During the bennet movement ( lateral translation) what stops the movment going to far to one side
Bony wall of the glenoid fossa
What is posselts envelope
The extreme mandibular movements.
Which plane is posselts envelope in
The saggital plane
During protrusion of the mandible there should be no posterior contact, if there is what is this called
Protrusive interference
What is the bennet angle
This is the path of the non working condyle in the horizontal plane during lateral excursion
What are 4 things that are present in a mutually protected occlusion
Canine guidance
Poster dissoclusion
No non working or working side contacts
No protrusive interference
Why do we want to avoid posterior contact during dynamic movment
We want free way space during dynamic movment
If the posterior teeth are always in contact the muscles will become tired and painful
What is fremitus
This is a type of occlusal trauma
Increased movement of teeth when subjected to occlusal forces
What is the difference between and overjet and overbite
Overjet - is the horizontal overlap of the teeth
Overbite - is the vertical overlap of the teeth
What kind of dynamic movment is often seen in toothwear
Bilateral group function
Define cross bite
One of more teeth abnormally positioned buccally/lingually or labially
What are the two types of bruxism
Centric - clenching
Eccentric - para functional grinding
A child has an early loss of there ‘e’s what must we do
This requires a space maintainer because if not the 6 will drift mesially and block the eruption of the 5s
If there is early loss of deciduous ‘c’s do we use balance or compensating extractions
We balance when extracting ‘c’s to prevent a midline short
Define interceptive ortho
Interceptive ortho is any procedure that will reduce or eliminate the severity of a malocclusion
What is Lee-way space
Lee- way space is the extra mesio-distal space occupied by the primary molars to accommodate for the permanent premolars.
Maxilla = 1.5mm
Mandible =2.5mm
10% of all desicious molars become infraoccluded - why does this happen
This happens because there is ankylosis of the primary tooth
The bone continues to grow around it and the primary tooth gets left behind
What kind of percussion note would come from an infraocluded tooth
Dull
What are 4 reasons that we want to treat increased overjet early
Trauma risk
Incompetent lips
Appearance - self esteem/bullying
Difficult to achieve correction once stopped growing
For growth of both the maxilla and the mandible, out of height length and width what stops growing first
Width is completed before the pubertal growth spurt
What are the three endo design objectives
Create a continuously tapering funnel shape
Maintain apical foramen in original position
Keep apical opening as small as possible
What prob be can be used in endo to explore pulp chamber and identify orifices
DG16 - double ended probe
How do you determine CWL
Pass 10 file into canal and advance to EWL
Take apex locator and using a watch winding motion until a ‘0’ reading
This is the PDL
Measure the file and subtract 1mm
This is the corrected working length
What is estimated working length
This is the length at which instrumentation should be
Obtained by measure prep radiograph distance between coronal reference point and radiographic apex then subtract 1
What is the master apical file
This is the largest diameter file taken to working length and therefore represents the final prepared size of the canal of apical proton of canal at WL
Name 4 functions of irrigation
Dissolves organic debris
Disinfects canal
Lubricates canal
Removes debris from prep
What is the function of EDTA in endo prep
Removes smear layer
What are the three components of SDF
Fluoride 44,800ppm
Ammonia
Silver
Why is SDF useful as a caries detection agent
This is because is stains Carious lesions permanently black but does not have an effect on sound enamel
What is sialadenitis
This is inflammation of the salivary glands, this can happen in xerostomia
It can look like mumps and it happen as the salivary glands are over working due to the lack of saliva
What is unusual about the presentation of radiation induced caries
They tend to present on the cerival margins and incisal edges
What condition might pentoxyfyllne and vitamin E be considered for the prevention of
Osteo-radionecrosis
Encourages blood vessels healing, protects healing and reduces inflammation
What are two characteristics of biofilm ECM that makes it resistance to anti-microbial
Traps and binds antimicrobial agents preventing them getting to the cell
Creates a low nutrient/. Low 02envirment that allows bacteria to evade the effect of anti-microbial
Glycocalyx
What is key info that must be on a waste transfer note and how long must the hazourdous waste register be kept
Description of waste
Orgin of waste
Quantity of waste
Transport destination
3 years
What are 3 aims of suturing
Approximate tissues, compress blood vessels and cover bone
Prevent wound breakdown and achieve haemostatis
Prevent enters of forgein bodes
Three aims of flap deign
Good access
Adequate vision
Maintance of good vascular supply
Good aesthetic outcome
Patient comes to your surgery following an extraction. From the history the patient tells you ;
They have a pain worse than toothache that is keeping them up at night,
It is a dull achy pain that is radiating to thier ear
They have a bad taste in their mouth and they fell as low it smells
What is your provisional diagnosis
Alveolar osteitis (dry socket)
Following a diagnosis of dry socket what is your management of this patient
Supportive management first - you must reassure the patient that the wrong tooth has not been extracted and advise analgesia
Provide the patient with LA and irrigate with saline in the area.
Begin debridement on the area to encourage clot formation
Can provide an antiseptic pack
What histological feature of oral antral fistula prevents it from closing
It is epithelial lined e
What are post operative instructions for someone with an oral antral communication
No nose blowing
Don’t Drink through a straw
Sneeze with mouth open so not to create pressure
After how long does an oral antral communication then become a fistula
6 weeks
What is osteomyltitis
This is invasion of the bacteria into the cancellous bone which causes soft tissue inflammation and oedema in the closed bone marrow space
Why is osteomyltis more common in the mandible than in the maxilla
This is because the the mandibles primary blood supply id from the inferior alveolar artery whereas the maxilla has a rich blood supply
Radiographic appearance of osteomyelitis may take 10/12 days to appear, what may it look like
Increased radioluney with a ‘’moth like’’ appearance
How many weeks of not healing until you suspect a patient has MRONJ
8 weeks
Why do bisphosphoantes lead to MRONJ
They inhibit osteoclasts activity so inhibit bone resorption and therefore bone renewal
What are the three special considerations for infective endocarditis prophylaxis
Patients with previous endocarditis
Patients with a prosthetic valve
Patients with a congenital heart disease
What do you use to achieve haemostatis in pulptomy and why
Ferric sulphate
It controls pulpal bleeding and prompts formation of clot over radicular pulp
State three reasons why you may make replica dentures
A spare set of satisfactory dentures
An elderly patient who has worn satisfacotry dentures for many years
Replacing immediate dentures
What is the neutral zone in the maxilla
The neutral zone is a specific area where the functions the musculature will not unseat the denture and the forces of the tongue are neutralised by forces generated by the lips and cheeks
What are 4 purposes of orthodontic study models
Record keeping
Allows monitoring of progress
Allows inspection of perspectives that cannot be seen in the mouth
Demonstration and motivation for the patient
Treatment planning
During instrumentation in endo where is teh ideal end oint for shaping/obturation
2mm from apical Foramen
What are three specific warnings you would give the patient when prescribing metronidazole
No alcohol
Take with food
Finish course
What is a border position of the mandible
Maximum opening of the mandible in any plabe
What is a border position of the mandible
Maximum opening of the mandible in any plabe
What are 4 patient related factors which should be considered when interpreting results in a study
Patients oral hygiene
Patients diet
Patients pDH
Patients MH
Name the principles of orthodontic managment for the non-eruption of central incisors
Remove supernumaries or retained primary teeth
Maintain space
If they are less than 9. - monitor for12 month
If it fails to erupt or the patient is over 9 - expose and bond gold chain for orthodontic traction
If when looking at a radiograph theincisor teeth seem horizontally magnified what has happened
The patient is too far back
If when looking at a radiograph the posterior teeth on one side are wider than the other, what has happened?
The mid saggital plane is not centered
What are three features that apply to ghost images
They are appear more superior
They appear on the contra-lateral side
They appear horizontally magnified
Lisr two ways you could check that anaesthesia has been achieved
Ask patient if there chin and lip feel numb and compare to the other side
Probe around gingival margin
What are two features in someone with Down syndrome that could lead to thier periodontal disease?
Upregualtion of inflammatory mediators
Impaired neutrophil chemotaxis
Name 4 risk factors for mouth cancer
Smoking alcohol use
Poor nutrition
HPV
Obesity
What information about a patients radiothepry would we want to ask
Dosage and target of treatment
What dose of radiotherapy increases the risk of ORN
60 grays
Tthere are two types of manual cleaning what are they and name one instrument that would be cleaned in each way
Immersion - mirror
Non Emersion - hand piece
What are to key virulence factors of strep mutants
ATPase and glucans
When viewing the OPT you notice that it looks like a ‘’smiling occlusal plane’’ what has happened in the machine
The patient has had their chin down in the machine
When viewing an OPT there is distortion on one side and the posterior teeth on that side look larger, what has happened in the machine
The mid saggital plane was not centered
If the patient is too far forward in the OPT machine, how will the incisors appear
They will appear narrower
This is because they are now BUCCAL to the focal trough
If a patient is too far backwards in an OPT machine, how will the incisors appear?
They will appear wider
This is because they are now lingual to the focal trough
Name two advantages of using orthogonal program when taking OPTs
They reduce the overlap of the teeth
They are a more accurate representation of interdental bone levels
Why is the bite peg important when taking radiographs
This is because it forces the patient into edge to edge occlusion
This ensures that both arches are within the focal trough
What are three instructions that you must give to your patient while they are in the OPT machine?
Stay still
Tongue to top of the mouth
Do not talk or swallow w
What is the typical angulation of the beam in panoramic radiography
8 degrees above horizontal
If when the patient is in the OPT machine they slump, how might the image look
There will be an excessive cervical spine shadow
Patient attends your surgery and on examination it is noted that they have 1-2mm of crowding on the lower arch. What would be ur management for this?
Enamel stripping
Metal sand paper interproximally
Why is it when there is more severe crowding we tend to take the 4s rather than the 5s
This is because even though the 5s tend to be bigger, to get more space it is better to take the 4s due to the mesial drift of the 6s
What are three limitations of stock trays
They rarely fit accurately
They often require modification
It may be difficult to obtain necessary border seal
What is the difference between mucocompression and mucostatis
Mucocoompression is when pressure is applied to the mucosa so that the shape of the tissues is recorded
Mucostatis is when there is minimum pressure applied to the tissues at rest
Name three reasons that you would not provide your patient with a veneer
Poor oral hygiene
High caries rate
Gingival recession or root exposure
State the 6 principles of crown preparation
- Preservation of tooth structure
- Retention and resistance
- Structural durability
4.Marginal integrity - Preservation of the periodontium
- Aesthetics
What are the three ways structural durability is achieved in crown prep
Occlusal reduction - minimum 2mm
Functional cusp bevel - these cusps take the occlusal load
Axial reduction
Define retention in crown prep
Prevents removal of restoration along path of insertion or long axis of tooth prep
Define resistance in crown prep
Prevents dislodgement of restoration by forces directed in an apical or oblique direction and prevents movement of restoration under occlusal forces
Preserving the periodontium is one of the principles of crown preparation, what are three things that the margin of the restoration should be to achieve this?
- Smooth and fully exposed to cleansing action
- Placed where dentist should be able to finish it and patient able to clean it
- Placed supra-gingival or at gingival margin where possible
Why would you be wearing placing a ceramic crown in a patient with a bruxism habit?
Ceramic can wear natural tooth tissue
What are two situations that intermittent non axial force may occur
When a clasp over a tooth is too tight
When a patient has a para functional habit
Why is there more coronal movement when force is applied to a tooth, in a tooth which has had previous perio compared to a healthy periodontium
This is due to the position of the fulcrum ( point of rotation)
In normal bone levels the fulcrum is at the level of the alveolar bone however in a reduced periodontium the fulcrum is much more apical causing there to be a greater amount of coronal movement
A larger lever
Tooth mobility does not always indicate a pathological state of affairs! What may it instead represent?
This may indicate successful adaptation of the periodontium to functional demands and/or reflect the nature of the remaining attachment
Tooth mobility can be accepted unless what…
It is progressively increasing
It gives rise to symptoms - such as interference with occlusion
This creates difficulty in restorative work such as in bridges
What would be considered a successful adaptive response to occlusal trauma
PDL width would increase until the forces can be adequately dissipated then PDL would stabilise
Tooth mobility would be increased as a result
What is a pathological response of the periodontium to occlusal trauma
If the forces are too great the PDL width will continue to increase, the PDL width and tooth mobility fail to reach a stable phase
What are 4 key properties that you must look for in an investment material
- Porosity - to trap gases that are released in casting of the alloy
- Expansion - to counter the alloys shrinkage on cooling
- Strength - withstand pressure during cooling
- Stability - doesn’t degrade
What are he two components of investment materials and what do they do
Refractory - some form of silica. This withstands high temperatures and undergoes expansion
Binder - gyspum or phosphate. This provides substance
What kind of alloy is gyspum bonded used for
GOLD alloys
Anything that has a melting point of over 1200 cannot use gypsum
What is the mechanism of pain
Trauma and infection lead to breakdown of membrane phospholipid producing ARACHIONDONIC acid, this is then broken down to produce prostaglandins.
Prostaglandins sensitise other tissues to inflammatory mediators
What is the mechanism of action of aspirin
Inhibits cox1 and 2 leading to a reduction of production of prostaglandins
What are the 4 groups that aspirin is contraindicated in
Children under 16 and breastfeeding
Previous or active peptic ulceration
Haemophilia
Hypersensitive to aspirin/ NSAIDS
What is Reye’s syndrome
Happens in children it is fatty deposits in the liver and encephalopathy
What is the max dose of aspirin
4g
What is the BNFs stance on dihydrocodie for dental pain
Due to the side affects of nausea and vomiting the BNF states that there is little value for dental pain
What is the mode of action for paracetamol
Hydroperoxides are generated from the metabolism of arachidonic acid by COX and exert a postive feedback to stimulate cox activity
This feedback is. Blocked by paracetamol thus directly inhibiting COX especially in the brain
What is the antidote for dyhydrocodeine
Naloxone
What are three cautions for paracetamol
1.hepatic impairment
2. Renal impairment
3. Alcohol dependence
What dosage of fluoride tablet would you give a child between 3 and 6 years
0.5mg
Mutually protected occlusion is the gold standard, what are the 4 things involved in this
Canine guidance
Posterior disocclusion
No non working/working side contacts
No protrusive interference
What are 4 affects of trauma to the primary tooth on the developing permanent tooth
Failure to erupt
Crown dilaceration
White or brown discolouration
Disturbance in eruption
Child presents to your surgery fit and well, no complaints. However on examination you notice white brown discolouration of the upper anteriors and cavitation of the first primary molars . What do you think has happened here
This is presentation of nursing bottle caries aka early childhood caries
This is usually from inappropriate use of a bottle or a feeding cup
What are the three stages in the the management of dental neglect
- Preventative dental team management
- Preventative multiagency Management
- Child protection referral
What features may raise concern for you that a child is being abused
Delay in presentation of pain
Clinical findings and story do not match up
Bruises on child’s face that are at different stages of healing
Previous concerns about the child or the child’s siblings
When assessing a patient who you think has xerostomia what scale would you use?
The Challacombe score can be used to assess dry mouth in Sjögren syndrome and to assess salivary flow and therefore calculate a risk of dental caries, which are more likely in drier mouths.
A frontward growth rotation would result in what kind of face and what would you see clinically
Short face and a deep bite
A patient has a backward growth rotation and a long face, clinically what kind of of bite would you expect to see
Anterior open bite
What kind of ossification do the mandible and maxilla form by
Intramembranous ossification
Bone is layer down directly onto primitive mesenchyme tissse
The vault of the skull Also forms in this way
Name 4 dental aspects of a patient with Cleft lip and/or palate
Hypodntia
Crowding
Impaction
Caries
What are 4 physical features of foetal alcohol syndrome
Small head
Short nose
Small mandible
Large upper lip with deficient philtrum
What are three indications for taking a lateral cephalogram
To aid in diagnosis
To treatment plan
To progress monitoring
What is the prevelacne of schizophrenia
1-2%
Lithium can be used as a mood stabilising drug - what must we be wary of in dentistry with this
Cannot prescribe NSAIDS or metronidazole
What are some dental concerns in relation to anorexia nervosa
Dry mouth
Infections
Bleeding gums from lack of vitamins
Dopamine antagonist drugs can cause extra-pyramidal side affects, name some of these
Akathesia - restlessness
Dystonia - muscles involuntary contract
Parkinsonism - tremor, slow movement, stiffness
Tardive dyskinesia
- uncontrollable facial movements - these do not go away when medication is stopped
What are 3 causes of cone cutting in radiograph
Incorrect assembly of the holder
Incorrect alignment between the X-ray tube and the receptor holder
Incorrect orientation of rectangular collimation
If we are assessing a vertical shift using the parallax technique, what are 2 sets of radiographs we could use
Panoramic and oblique occlusal
Panoramic and lower PA
