Mock Case Pres

Question 1

What is Propanolol?

Answer 1

• beta blocker
• used as a anti-depressant for patient
• slows down heart rate and makes it easier for heart to pump blood around body
• block the release of stress hormones adrenaline and noradrenaline in certain parts of body

Question 2

Side effects of Propanolol

Answer 2

• cold hands
• predisposition to asthma attacks
• may ask the pt/ consult GP about why pt is having beta blockers as pt is asthmatic

Question 3

What is Setraline?

Answer 3

• a type of antidepressant
• a selective serotonin reuptake inhibitor (SSRI)

Question 4

How does Setraline work?

Answer 4

• works by increasing the levels of mood- enhancing chemical called serotonin in brain

Question 5

How does SSRI work?

Answer 5

• increases serotonin levels in brain
• good influence on mood, emotion and sleep
• works by blocking reuptake, more serotonin is available to pass further messages between nerve cells

Question 6

Asthma with Dentistry?

Question 7

What is Salbutamol?

Answer 7

• fast- acting bronchodilator
• short acting beta 2 adrenergic agonist
• relaxes muscles in lungs and widening airways
• relieve symptoms of asthma and chronic obstructive pulmonary disease (COPD)
• usually blue inhaler

Question 8

Salbutamol side effects in dentistry

Answer 8

• decrease in salivary flow rate
• hence, lead to reduction in protection of oral cavity by saliva due to reduced levels of defense components
• increase in caries and perio problems

Question 9

What to advice patients with salbutamol inhaler

Answer 9

• rinse mouth after using inhalers
• chew sugarless gum after drug administration to help neutralise the salivary pH and stimulate salivary flow
• could use a spacer device to minimise contact of drug and oropharynx

Question 10

What is Flixotide inhaler?

Answer 10

• known as inhaled fluticasone
• corticosteroids
• know whether pt is on blue steroid treatment card
• steroid inhaler
• asthma preventer containing fluticasone propionate
• reduce inflammation of lungs and prevent asthma attacks

Question 11

Side effects of Flixotide

Answer 11

• oral thrush
• oropharyngeal candidiasis
• sore throat
• Cushings syndrome
• affect adrenal insufficiency

Question 12

Side effects of inhalation therapy on oral health

Answer 12

• xerostomia
• dental caries
• candidiasis
• ulceration
• gingivitis
• periodontitis
• taste change

Low pH is a risk factor for demineralization of tooth

Question 13

How is caries form?

Answer 13

• saliva is supersaturated with calcium and phosphate ions, capable of remineralising early stages of caries, particularly when fluoride is present
• fluoride slows down progression of caries
• when salivary flow is absent, it increases food retention
• buffering capacity is lost, hence acidic environment is encourage and persists longer
• hence this encourage acidic bacteria relish acid conditions and continue to to metabolise carb in low pH
• dental caries is due to imbalance of saliva, plaque, tooth, microflora and dietary substrate over a certain period of time

Question 14

Palliative care for Xerostomia

Answer 14

• more frequent sips of water
• intake of moist sugar- free diet
• avoid strong flavouring and alcohol
• use salivary stimulants/ salivary substitute
• lemon drops to activate salivary glands
• frequent meals to increase salivary flow
• tooth mousse for remineralising tooth
• Pilocarpine as drugs fro stimulating saliva
• salivary substitutes, ie: lonzenges, sprays, mouth rinses

Question 15

How to treat candidiasis?

Answer 15

• treat with topical anti-fungal agents
• Nystatin ointment

Question 16

Adrenal insufficiency with Dentistry?

Question 17

SOCRATES

Answer 17

site- where is the pain
onset- how long have you had this for? how did it happen?
character- how would you describe it? sharp or dull pain? sensitive to hot/ cold?
radiation- does the pain spread anywhere else?
associating factors- are there any other symptoms?
time- has the pain change over time?
exacerbating factors/ relieving - taken any painkillers? anything worsen/ relief pain?
scale - 0-10

Question 18

What is bimaxillary osteotomy?

Answer 18

• double jaw surgery, carried out inside mouth
• used to correct maxillofacial deformities that affect both jaws
• aims to realign both jaws for better alignment of teeth
• class 3 or openbite patients or class 2

Question 19

Muscles of Mastication

Answer 19

• masseter
• temporalis
• lateral pterygoid
• medial pterygoid

Question 20

Lymph nodes of the head

Answer 20

Question 21

What causes linea alba?

Answer 21

• chronic friction between teeth and lining of cheek
• may develop other symptoms, ie: pain/ numbness which will then need further examination
• sometimes confused with leukoplakia, which is early detection of oral cancer

Question 22

Perio classification

Answer 22

Question 23

Why is it better to eat sugar during meal times?

Answer 23

• when sugar is consumed, it reacts with bacteria in plaque and forms acid that destroy teeth and weakens enamel
• have with savoury snacks, alkaline
• flow of saliva slows down during the night and leaves mouth more at risk from decay
• limits the amount of time your mouth is at risk

Question 24

Perio staging and grading

Answer 24