Msa Flashcards
Two pathogens that cause catheter associated infections
E. coli
Staphylococcus aureus
What drug counteracts benzodiazepine sedation
Flumazenil
List THREE ways to reduce infection risk when undertaking aseptic surgery
Hand hygiene
PPE
Sterilized instruments
What are THREE short term effects of child neglect
Mental/emotional health
Social development
Cognitive development
What are THREE long term effects of child neglect
Suicide
Depression
Arrest
Diabetes/heart disease
What is competent and incompetent lips? (2 marks)
Competent lips: upper and lower lips meet at rest and maintain anterior oral seal, relaxed mentalis muscle
Incompetent lips: lips don’t meet at rest and cant maintain oral seal, relaxed mentalis muscle
What circumoral musculature is involved with lip competence
Mentalis muscle
Patients with incompetent lips can’t keep lips together without lots of strain on mentalis muscle
How does incompetent lips effect the upper and lower incisors
Proclined upper incisors
Retroclined lower incisors
Increased OJ
Can lead to AOB
What is a strap lower lip?
Hyperactive lower lip
How does a strap lower lip effect upper and lower incisors
Strap lower lip with competent lips: retrocline upper teeth
Strap lower lip with incompetent lips: retrocline lower teeth
A fit and healthy patient presents to the surgery to have the surgical removal of the lower right third permeant molar (48).
- Anatomically, which nerves must be anaesthetised to remove this tooth safely? (3 marks)
1) Right inferior alveolar nerve
2) Right lingual nerve
3) Right long buccal nerve
A fit and healthy patient presents to the surgery to have the surgical removal of the lower right third permeant molar (48).
List TWO different ways you could assess that anaesthesia has been achieved? (1 mark)
ASK the patient if the right half of their tongue/lip/chin is numb
CHECK by probing adjacent to the 48 buccal/lingual
After a 48 extraction the patient presents one week later with neuro-sensory deficit affecting the right chin and lip region. Using the descriptions below provide the dental terminology. (3 marks)
i) pins and needles feeling, or partial loss of sensation:
ii) painful, unpleasant or neuralgic sensation that lasts for a fraction of a second:
iii) total loss of sensation
i) Paresthesia
ii) Dysesthesia
iii) Anesthesia
Give THREE clinical reasons that could account for neuro-sensory deficit during a 48 extraction (3 marks)
Crushing (1 mark)
Cutting (1 mark)
Damage to the nerve from the local anesthetic (1 mark)
A patient returns to the clinic with symptoms and signs of a dry socket.
What is the correct terminology for this? (1 mark)
Alveolar osteitis
List THREE predisposing factors that could contribute to dry socket? (3 marks)
Smoking (1 mark)
Sex: Female (1 mark)
More common to occur in molar extractions and more likely to occur in the mandible (1 mark)
List THREE symptoms or signs that a patient with dry socket may present with (3 marks)
Moderate to severe dull aching pain (1 mark)
Can radiate to patients ear and keeps them awake at night (1 mark)
Bad smell and taste (1 mark)
How would you manage dry socket (3 marks)
Supportive: reassurance and analgesics (1 mark)
LA, irrigate socket with warm saline, curettage and debridement (1 mark)
Antiseptic pack with Alvogyl (1 mark)
List FIVE risk factors for mouth cancer (2 marks)
Immunosuppression (0.5 marks)
Socioeconomic status (0.5 marks)
Age (0.5 marks)??
Tobacco use (0.5 marks)
Alcohol consumption (0.5 marks)
Diet low in fruits and vegetables (0.5 marks)
Mr Clarke received adjuvant radiotherapy to treat his mouth cancer. What TWO additional pieces of information do you require to know about the radiotherapy treatment he received?
Radiation dosage and duration (1 mark)
Radiation field (1 mark)
What dose of radiotherapy delivered to the primary tumour increases the risk of osteoradionecrosis (1 mark)
50-60 Gy (Gray)
Describe the pattern of decay evidenced, which is unique to radiation caries. (1 mark)
Occur at cervical margins and may affect incisal edges (1 mark)
Following clinical investigation, the coronal tooth structure of all the remaining teeth is found to be extensively decayed and therefore deemed unrestorable.
How would you manage these teeth given that that Mr Clarke is at an increased risk of osteoradionecrosis? (1 mark)
Provide primary orthograde endodontics and decoronate (1 mark)
List TWO oral complications associated with radiation therapy, other than osteoradionecrosis and radiation caries, to the head and neck. (1 mark)
Dry mouth (0.5 mark)
Radiation mucositis (0.5 mark)
List TWO preventative measures that should be implemented to reduce the risk of future dental disease for patients who have received radiotherapy to the head and neck. (1 mark)
Increased fluoride toothpaste: 2800ppm or 5000ppm (0.5 mark)
Tooth mousse (0.5 mark)
List ONE management strategy for established osteoradionecrosis of the jaw? (1 mark)
HBOT: hyperbaric oxygen therapy
Other than alcohol, list TWO causes of liver cirrhosis (1 mark)
Hepatitis B and C (0.5 mark)
Nonalcoholic fatty liver disease (NAFLD) (0.5 mark)
Patients undergoing Liver Transplantation are required to achieve a status known as “being dentally fit” prior to being listed for surgery.
List TWO priorities for such a patient in order to render them dentally fit (2 marks)
Treatment of active dental infections such as apical infections and gross caries (0.5 marks)
Extraction of hopeless and diseased teeth that cannot be restored (0.5 marks)
Why is it important to establish oral health prior to receiving a transplant? (1 mark)
Reduced risk of infection and faster recovery
Thrombocytopenia is a common finding in people with advanced alcoholic liver disease. List TWO reasons why thrombocytopenia may occur. (2 marks)
Decreased thrombopoietin production by the liver (1 mark)
Enlarged spleen (splenomegaly) causing increased removal of platelets by the spleen (1 mark)
If thrombocytopenia occurs in isolation, above what level is it safe to undertake a dental extraction in the general dental practice setting without consulting an appropriate medical or specialist dental professional? (1 mark)
Dental hospital: above 50,000/microlitre
General dental practice: above 100,000/microlitre (1 mark)
Above what number does neutrophils count have to be to undertake a dental extraction in the general dental practice setting without consulting an appropriate medical or specialist dental professional? (1 mark)
Above 1 (1,000 microlitre)
Other than thrombocytopenia, explain why a patient with advanced alcoholic liver disease may have an increased risk of bleeding (1 mark)
Decreased synthesis of clotting factors by the liver (1 mark)
Name THREE types of Dementia (3 marks)
Alzheimer’s disease (1 mark)
Vascular dementia (1 mark)
Lewy body dementia (1 mark)
List FOUR signs or symptoms present in someone with EARLY STAGE dementia (2 marks)
Loss of short-term memory
Confusion
Anxiety
Inability to manage everyday tasks.
List FOUR signs or symptoms present in someone with MIDDLE STAGE dementia (2 marks)
Anger, aggression and mood changes
Risk of wandering
May behave inappropriately
May experience hallucinations
List FOUR signs or symptoms present in someone with LATE STAGE dementia (2 marks)
Inability to recognize familiar objects or people (0.5 mark)
Difficulty eating and swallowing (0.5 mark)
Increasing physical frailty (0.5 mark)
Incontinence and speech loss (0.5 mark)
Following your assessment, you determine that the best course of action is for removal of her 6 remaining teeth due to grade 3 mobility.
As a general dental practitioner, you do not have the ability to assess the capacity of an individual.
List TWO people who can provide a capacity assessment for dental treatment in accordance with the Adult’s with Incapacity Act 2000. (2 marks)
Mental health officer (MHO) (1 mark)
A registered medical practitioner such as a doctor or psychiatrist (1 mark)
As Mrs Anderson has had a heart valve replaced, you speak to her consultant cardiologist who requests that she is provided with oral antibiotic prophylaxis for the removal of her 6 remaining teeth. She has no known allergies.
Name the ANTIBIOTIC and the DOSE which should be prescribed? (2 marks)
Amoxicillin 3g orally (2 marks)
As Mrs Anderson has had a heart valve replaced, you speak to her consultant cardiologist who requests that she is provided with oral antibiotic prophylaxis for the removal of her 6 remaining teeth. She has no known allergies
How long before the procedure should you administer antibiotics AND which guidance does this come from? (1 mark)
Taken one hour before the dental procedure and this is according to the SDCEP guidelines (1 mark)
A 4-year-old child is brought to your surgery complaining of severe pain and sleep loss for the last six weeks. The child is a new patient to your practice. On extraoral examination you notice that the child has bruising on their right cheek and a small abrasion on their right temple
What might you be concerned about as a result of seeing this child? (1 mark)
Child abuse or neglect (1 mark)
A 4-year-old child is brought to your surgery complaining of severe pain and sleep loss for the last six weeks. The child is a new patient to your practice. On extraoral examination you notice that the child has bruising on their right cheek and a small abrasion on their right temple
Which TWO parts of this presentation led you to have concerns of child abuse or neglect (2 marks
Later presentation of severe pain/sleep loss for 6 weeks (1 mark)
Multiple injuries on different parts of the face (1 mark)
A 4-year-old child is brought to your surgery complaining of severe pain and sleep loss for the last six weeks. The child is a new patient to your practice. On extraoral examination you notice that the child has bruising on their right cheek and a small abrasion on their right temple
Suggest TWO questions which you would ask next to further investigate your concerns? (2 marks)
How did child sustain injuries (1 mark)
Why was the child not brought to the surgery earlier (1 mark)
A 4-year-old child is brought to your surgery complaining of severe pain and sleep loss for the last six weeks. The child is a new patient to your practice. On extraoral examination you notice that the child has bruising on their right cheek and a small abrasion on their right temple
You decide that some aspect of the responses to your questions warrants further action.
i) Who should you discuss this with? (1 mark)
i) As a result of this onward discussion what THREE different courses of action may take place? (3 marks)
i) Child protection advisor (1 mark)
ii) Further investigations are undertaken, and the child protection advisor gets back to you (1 mark)
The child is referred directly to the lead pediatrician (1 mark)
The child protection advisor asks you to refer directly to social services (1 mark)
You establish the only concern is regarding dental caries. After ensuring the painful tooth is treated you tell the parent that the child has a number of other carious teeth requiring attention and make two appointments for them to come back. The parent fails to bring the child back for either of these appointments. What should you do next? (1 mark)
Preventative multi agency management: inform the family health visitor (1 mark)
You establish the only concern is regarding dental caries. After ensuring the painful tooth is treated you tell the parent that the child has a number of other carious teeth requiring attention and make two appointments for them to come back (stage 1 preventive management of dental neglect). The parent fails to bring the child back for either of these appointments. What are the next two stages in the management of dental neglect?
Preventative multi agency management: inform the family health visitor (1 mark)
Child protection referral: call social services and then follow up by writing them (1 mark)
In the last stage of the management of dental neglect how do you share your concerns initially and then what do you follow this up with? (2 marks)
You would initially call social services then follow this up with writing to them for a child protection referral (2 marks)
Describe your emergency treatment of dentine/enamel fracture. (1 mark)
Cover all exposed dentine with glass ionomer/ composite (1 mark)
An 8-year-old boy presents to you with a dentine/enamel fracture of tooth 11 sustained during a school rugby match. List FOUR signs and/or symptoms (excluding radiographic) which you would look for in longitudinal monitoring of this patient. (4 marks)
Color change of tooth (1 mark)
Presence of a sinus or abscess (1 mark)
Surrounding soft tissue swelling (1 mark)
Increased mobility (1 mark)
The patient has another rugby match in 2 weeks time. How might you help prevent injury to anterior teeth? (1 mark)
Suggest he wears a gumshield/mouth guard (1 mark)
A 2-year-old attends your surgery with his mother. She is concerned by the appearance of his upper teeth.
There is caries in the following teeth: 54 52 51 61 62 64 84 74
What diagnostic name would you give to this caries distribution? (1 mark)
Early childhood caries (ECC) or nursing bottle caries (same thing different name 1 mark)
A 2-year-old attends your surgery with his mother. She is concerned by the appearance of his upper teeth.
There is caries in the following teeth: 54 52 51 61 62 64 84 74
Why are the specified teeth affected in this distribution, and not others? (3 marks)
Reduced salivary flow on upper teeth (1 mark)
Upper anterior are more susceptible to frequent sugar exposure from nursing bottles (1 mark)
Lower anterior teeth have greater salivary flow due to major salivary glands and pooling of saliva (1 mark)
List FOUR causes of nursing bottle caries (2 marks)
Putting juice or milk in feeding bottle (0.5 mark)
Falling asleep with the feeding bottle (0.5 mark)
Poor oral hygiene (0.5 mark)
The use of feeding bottles beyond infancy/6months (0.5 mark)
What fluoride regime could you follow in the dental surgery setting for a child with nursing bottle caries? (2 marks)
Fluoride varnish Duraphat 22,600ppmF fluoride 4 times a year (1 mark)
Silver diamine fluoride 44,800ppmF or APF (acidulated phosphate fluoride) (1 mark)
List FOUR of the recommendations you would make regarding tooth brushing for this patient.
“2 year old paeds question.”
Smear of toothpaste (0.5 mark)
1000ppmF fluoride toothpaste (0.5 mark)
Spit do not rinse (0.5 mark)
Brush twice daily (0.5 mark)
Give a definition of local causes of malocclusion? (2 marks)
A localized abnormality within either arch, usually caused by one, two or several teeth producing a malocclusion (2 marks)
Local causes of malocclusion may be due to variation in tooth number. Please give FOUR examples of these conditions: (4 marks)
1) Supernumerary teeth (1 mark)
2) Hypodontia (1 mark)
3) Retained primary teeth (1 mark)
4) Early loss of primary teeth (1 mark)
List FOUR types of supernumerary? (4 marks)
1) Conical (1 mark)
2) Tuberculate (1 mark)
3) Supplemental (1 mark)
4) Odontome (1 mark)
Describe TWO methods you could use to clinically assess a patient’s antero-posterior skeletal pattern. (2 marks)
Visual assessment (1 mark)
Palpate skeletal bases (1 mark)
Give TWO possible non-skeletal aetiological factors that can contribute to a class II division 1 incisor relationship malocclusion? (2 marks)
Digit sucking habit (1 mark)
Lower lip trap can procline upper incisors (1 mark)
What type of orthodontic appliance might be used to harness growth potential for the patient with a class II division 1 incisor relationship malocclusion (1 mark)
Functional appliance (1 mark)
Give a very brief account of how it is thought that mandibular growth occurs (3 marks)
The mandible develops through intramembranous ossification but is preceded by Meckel’s cartilage. (1 mark)
The mandible develops as several units including a condylar, coronoid, angular and alveolar unit all responding to different growth stimuli (1 mark)
The coronoid cartilage disappears long before birth and the symphyseal just after birth. Growth continues at the condylar cartilage until about 20 years of age. (1 mark)
If a patient subsequently has forward growth rotation, describe a skeletal feature that you could expect to observe? (1 mark)
More acute gonial angle, deep bite and short face (1 mark)
What faults in the placement of a restoration are likely to have led to a marginal overhang in amalgam (2 marks)
Incorrect placement of the matrix band and wedges (1 mark)
Inadequate adaptation/condensing of the material (1 mark)
What problems could a marginal overhang give rise to, in the short and long term (4 marks)
Plaque retentive factor (short term) (1 mark)
Difficulty in cleaning (short term) (1 mark)
Secondary caries (long term) (1 mark)
Gingivitis, periodontitis, tooth fracture (long term) (1 mark)
List TWO ways to correct a marginal overhang and which is the preferred/best method (3 marks)
Remove the restoration completely or partially and restore it again (1 mark)
Use a high speed handpiece with a yellow band finishing bur to remove the overhang (1 mark)
Removing and replacing the restoration is the best method (1 mark)
List 3 predisposing factors for necrotizing periodontal disease (3 marks)
Smoking
Stress
Poor oral hygiene
The patient is anxious and reluctant to have any dental treatment. What risks of no treatment do you explain to the patient for necrotizing periodontal disease? (1 mark)
Necrosis of the interdental papilla resulting in gingival craters and systemic risks including fever and malaise (1 mark)
The patient agrees to treatment for necrotizing periodontal disease. What treatment do you provide today? (3 marks)
Careful superficial debridement with an ultrasonic to remove mineralized deposits. (1 mark)
Advise the patient not to brush the area aggressively and use chlorhexidine mouthwash 0.12% (1 mark)
Provide dietary advice, stress relief and vitamin supplementation (1 mark)
Ms. White returns for another emergency appointment 2 days later after treatment of her necrotizing periodontal disease. She feels the gums are still very painful and is now complaining of fever and feeling generally tired and unwell. What treatment would you provide? (2 marks)
Metronidazole: 400mg TID 3 days (1 mark)
Arrange a review appointment in 1-2 weeks (1 mark)
What is the average value of the sagittal condylar guidance angle which may be used on an articulator? (1 mark)
30 degrees (1 mark)
Why is the retruded axis important in clinical dentistry?
Because it is a reproducible jaw position (1 mark)
The retruded axis is said to be a border position of the mandible. What is a border position? (1 mark)
One determined by the anatomy of the TMJ and associated musculature (1 mark)
What TWO records are required for mounting casts on a semi adjustable or average value articulator? (2 marks)
Facebow (1 mark)
Interocclusal record (bite registration) (1 mark)
What is the average distance in millimeters between resting vertical dimension and occlusal vertical dimension and what is this clinical distance referred to as? (2 marks)
2-4mm (1 mark)
Freeway Space (1 mark)
Herbert Schilder described in 1974 the concept of chemomechanical disinfection. In his paper he outlines design principles that should be applied during root canal shaping.
Name the design principles outlined by Herbert Schilder. (3 marks)
Create a continuously tapering funnel shape (1 mark)
Maintain apical foramen in original position (1 mark)
Keep apical opening as small as possible (1 mark)
Besides disinfection of the root canal space name TWO other objectives of irrigant use in root canal treatment? (2 marks)
Removal of smear layer (1 mark)
Lubrication (1 mark)
What is the ideal primary endodontic irrigant AND at what concentration range is it most effective? (2 marks)
Sodium hypochlorite (1 mark)
3-6% (1 mark)
Name THREE factors important for the function of primary endodontic irrigant? (3 marks)
1) Concentration (1 mark)
2) Volume (1 mark)
3) Contact time (time in canal) (1 mark)
What are the two main differences in composition between decorative and dental ceramic (2 marks)
Decorative ceramics has a much higher composition of koalin 50+% with no glass (1 mark)
Dental ceramics has a much higher composition of feldspar: 70-80% with 15% glass (1 mark)
Explain what the following terms mean with regard to optical properties of the materials.
i) Translucency (2 marks)
ii) Opalescence (2 marks)
i) Translucency: The ability of a material to allow light to pass through but be scattered at one of the surfaces (1 mark) or leading to a blurring of the transmitted light (1 mark)
The ability of a translucent material to appear blue in reflected light (1 mark) and orange/yellow in transmitted light (1 mark)
How can you modify the ceramic surface to make it more retentive prior to using silane? (1 mark)
Etch with Hydrofluoric acid (1 mark)
Chemically how does a silane coupling agent work when bonding composite to ceramic? (2 marks)
The hydroxyl group on one end if the silane molecule reacts with oxide groups on the ceramic surface (1 mark)
The C=C bond on the other end reacts with similar groups in the composite material (1 mark).
Silane coupling agents are a component part of composite resin materials
What is the function of silane in a composite restorative material? (1 mark)
It chemically bonds the filler particles to the resin matrix (1 mark)
A 56 year old male patient comes to the dental practice for a routine dental examination.
You can see from the notes that he smokes 20 cigarettes per day. What other questions would you ask him around his tobacco use and to ascertain whether he would be interested in quitting? (4 marks)
When did he start smoking and the number of years smoked?
What type of cigarettes did you smoke? e.g rollups
Have you ever tried to quit and how many attempts?
Are you interested in quitting now?
A 56 year old male patient comes to the dental practice for a routine dental examination.
You can see from the notes that he smokes 20 cigarettes per day.
He admits that he feels that he is very dependent on tobacco. Give a definition of dependence.
Compulsive phycological and physiological need for a habit forming substance
Name one model/approach that could be used to help a smoker quit?
Ask
Advise
Act
Microbial biofilms are an important lifestyle within the oral cavity, and are associated with caries and periodontal disease.
Name TWO characteristics of biofilm extracellular matrix (ECM) that confers resistance from antimicrobial agents. (2 marks)
Contain polysaccharides that form a protective barrier and storage (glycogen) (1 mark)??
Binding proteins: like glucan binding proteins (1 mark)??
Glycocalyx for protection (1 mark)
Glucans: facilitates biofilm formation (1 mark)
Name TWO important bacteria clearly implicated in periodontal disease, based on Socransky’s red ‘disease’ complex. (2 marks)
Porphyromonas gingivalis
Tannerella forsythia
Name TWO bacteria associated with caries development (2 marks)
Streptococcus mutans
Viellonella spp.
What TWO key features that enable cariogenic organisms to stick to enamel surfaces and autoaggregate, and to survive within an acidic environment? (2 marks)
Form adhesins which help them adhere to enamel (1 mark)
Acid tolerance due to ATPase membrane pumps that help pump out H+ ions (1 mark)
Name TWO systemic diseases that have been shown to be associated with periodontal biofilms? (2 marks)
Diabetes mellitus (1 mark)
Cardiovascular disease (1 mark)
In the correct order, what are the 5 core stages of the washer-disinfector cycle (5 marks)
Flush/Prewash (1 mark)
Main wash (1 mark)
Rinse (1 mark)
Thermal Disinfection (1 mark)
Drying (1 mark)
For each of the named stages below, describe the function/purpose of the stage (5 marks)
Flush/Prewash
Main wash
Rinse
Thermal Disinfection
Drying
Flush/Prewash: removes gross contamination
Main wash: remove biological matter
Rinse: removes any remaining residue; biological or chemical
Thermal Disinfection: actively kills microorganisms with the use of heated water
Drying: removes any remaining moisture from instruments
What is the most common cause of facial trauma in a female patient? (1 mark)
Physical abuse (1 mark)
Aside from physical violence list FOUR other forms of abuse that might be involved in domestic abuse (2 marks)
Sexual (0.5 mark)
Emotional (0.5 mark)
Verbal (0.5 mark)
Financial (0.5 mark)
What process should you follow to ask about the possibility of domestic abuse and briefly describe? (4 marks)
AVDR
Ask: ask about the abuse ‘Is everything okay?’ (1 mark)
Validate: showing someone that you are concerned about them ‘I am concerned about your safety’ (1 mark)
Document: be specific and detailed when recording what the patient tells you. Consider photos
Refer: signpost patient to appropriate services
List FOUR physical signs you might see in domestic abuse? (2 marks)
Bruises at different stages of healing (0.5 mark)
Facial bruising (0.5 mark)
Strangle marks around neck (0.5 mark)
Fingertip bruises around the arms (0.5 mark)
List TWO categories of patient who may be considered to be more at risk in terms of domestic abuse than others (1 mark)
Women (0.5 mark)
Long term illness or disability (0.5 mark)
List FOUR benefits that digital radiography has over film radiography (4 marks)
No need for chemical processing (1 mark)
Easy storage & archiving of images (1 mark)
Easy transfer/sharing of images (1 mark)
Images can be manipulated (1 mark)
When taking periapical or bitewing radiographs, rectangular collimation is used to shape the X-ray beam so that it matches the shape of the radiographic receptor in the mouth. Explain what the benefit of this is. (2 marks)
Dose optimization: to reduce the dose to patient by 50% (1 mark)
Reduces the amount of scattered radiation to operator (1 mark)
Rectangular collimators contain the metal lead.
What chemical property of lead makes it particularly effective at absorbing X-ray photons? (1 mark)
High atomic number meaning a large number of protons in it nucleus
During a radiographic exposure the dentist must not stand too close to the patient or X-ray source. What is the minimum distance recommended by UK guidance? (1 mark)
1.5 meters in a controlled area
All medical radiation exposures must be justified. What does the term “justification” mean in the context of deciding whether or not to take a dental radiograph? (1 mark)
Clinical consideration of whether the benefits of the radiograph must outweigh the risks of exposure
ALARP is an important phrase in radiation protection. What does this abbreviation stand for? (1 mark)
As Low As Reasonably Practicable (1 mark)
List TWO ways in which the researchers might minimise bias in a randomized control trial?
Explain in what ways they reduce bias (4 marks)
Randomization: randomly assign participants so that the outcome is not based on factors like age or gender or socioeconomic factors (2 marks)
Blinding: blind the participants and assessors to which group they have been assigned so that the results do not influence either of them (2 marks)
ARD is 9% and the CI is -0.8% to 18.9%
What does this tell you about the data
Cl overlaps 0 value of no difference - therefore insufficient evidence
Aims: to compare the effectiveness of a novel sonic power toothbrush compared to a manual toothbrush in the reduction of plaque.
Methods: 130 adults attending general dental practice were allocated to one of the two types of toothbrush for twice-daily tooth brushing over 4 weeks. Plaque scores were measured at baseline and at 4 weeks follow-up.
Results: The sonic toothbrush was more effective at reducing plaque than the manual toothbrush.
Produce a P-I-C-O for this study (2 marks)
Population: Adults attending general dental practice
Intervention: Using a sonic power toothbrush for twice-daily tooth brushing
Comparison: Using a manual toothbrush for twice-daily tooth brushing
Outcome: Reduction in plaque scores with the use of sonic toothbrush over manual toothbrushing
What type of handpiece is used for bone removal? (1 mark)
Electrical straight handpiece with saline cooled bur (1 mark)
What are TWO aims for raising a flap in oral surgery? (2 marks)
To gain maximal access to underlying structures and tissues (1 mark)
To protect the surrounding soft tissues by reducing trauma to them (1 mark)
What are 4 factors that influence flap design in oral surgery?
Aim of the surgical procedure (1 mark)
Condition of the surrounding tissues (1 mark)
Location of the surgical site (1 mark)
Wound healing (1 mark)
What is the drug family of apixaban (1 mark)
Direct oral anticoagulants (DOAC) (1 mark)
What does apixaban inhibit (1 mark)
Free and clot bound Factor Xa and prothrombinase (1 mark)
Besides being an anticoagulant what is apixaban used for (2 marks)
Prevent blood clots and stroke in patients with atrial fibrillation, deep vein thrombosis, or pulmonary embolism (2 marks)
What blood test would you do before treatment of a patient on apixaban? (1 mark)
Chromogenic anti-Xa assays
What do you ask the patient to do with dosage for simple treatment vs complex extraction (2 marks)
“apixiban question”
Simple treatment: treat without interrupting medication (1 mark)
Complex extraction: miss morning dose before treatment and take usual evening time dose (1 mark)
What are 3 methods of achieving hemostatic control (3 marks)
Even and firm pressure (1 mark)
Suturing (1 mark)
LA with adrenaline (1 mark)
What are FOUR physical features of down syndrome (2 marks)
Short neck (0.5 mark)
Flattened facial profile and nose (0.5 mark)
Low muscle tone (0.5 mark)
Small head, ears and mouth (0.5 mark)
What is the result of a genetic test of a patient with down syndrome (1 mark)
Trisomy of chromosome 21 (1 mark)
List TWO reasons why patients with down syndrome have an increased risk of periodontal disease (2 marks)
Immune system dysfunction
Difficulties with OH
State TWO reasons why patients with down syndrome have no capacity (1 mark)
AMCUR
Incapable of understanding decisions
Incapable of making decisions
List TWO features associated with Down’s Syndrome that are likely to have contributed to his periodontal disease? (2 marks)
Inability to self-care: poor oral hygiene
Systemic immunodeficiency
What is the difference between welfare guardian and welfare power of attorney (2 marks)
A guardianship is applied for through the courts (and can take up to 6 months to be granted) whereas a power of attorney is drawn up by a solicitor (1 mark)
A guardianship is for a fixed period of time whereas a power of attorney stays in force unless revoked by the person granting the power of attorney or death (1 mark)
What is the antibiotic commonly used for antibiotic prophylaxis and what dose? (1 mark)
Amoxicillin 3g orally (1 mark)
What is the antibiotic commonly used for antibiotic prophylaxis if the patient is allergic to Amoxicillin and what dose? (1 mark)
Clindamycin 600mg
When do you prescribe antibiotic prophylaxis and when should the patient take it (1 mark)
For high risk patient. 1 hour before dental procedure (1 mark)
What are 3 features of Parkinson’s disease (3 marks)
Resting tremors (1 mark)
Bradykinesia: difficulty initiating movement (1 mark)
Rigidity (poor posture): stiffness of muscles (1 mark)
How does Parkinson’s differ from other cerebellar diseases (2 marks)
Disease of the basal ganglia caused by loss of dopamine producing cells in the substantia nigra
Other cerebellar diseases primarily affect the cerebellum (1 mark)
Other cerebellar diseases usually have an intension tremor while Parkinson’s has a resting tremor (1 mark)
What is the reason for dry mouth in patients with Parkinson’s disease (1 mark)
They are usually taking anticholinergics and dopaminergic which cause xerostomia
Parkinson’s also affects the ANS (1 mark)
How do you prevent dentures being lost in care homes? (2 marks)
Ensure correct labelling and storage of residents dentures (1 mark)
Mark initials on the denture using sandpaper or a sealant (1 mark)
What are TWO most important things to consider in the provision of the future treatment of patients with Parkinson’s disease
Their tremor will get worse so plan treatment early on (1 mark)
Prevention: modified oral hygiene instruction (1 mark)
What is ONE reason you should not extract teeth for dentures in a patient with Parkinson’s disease
Poor candidates for dentures due to poor neuromuscular control and dry mouth from anticholinergics
Describe TWO clinical ways to assess the vertical skeletal relationship? (2 marks)
Cephalometric analysis of LAFH/TAFH ratio (1 mark)
Assess FMPA: Frankfort mandibular planes angle (1 mark)
What position should the patients head be in when performing skeletal assessment in orthodontics (1 mark)
Frankfort horizontal plane should be parallel to the floor
Which external reference plane of the patient should you position horizontally when setting up for a panoramic radiograph? (1 mark)
Frankfort plane (1 mark)
What is used to bond porcelain to composite luting resin (1 mark)
Silane coupling agent (1 mark)
How is porcelain surface prepped in the lab for bonding (1 mark)
Etched with hydrofluoric acid
Why would you still light cure a dual cured composite luting resin? (1 mark)
In dual cured materials the physical properties are reduced by 25% if they are not light cured. (1 mark)
When would you use a dual cured composite luting resin (1 mark)
If the restoration is thick use a dual cured (1 mark)
What would you do to metal in a lab to prepare it (1 mark)
Sandblasting or etching (cannot etch precious metals)
What chemical agent is used to bond metal (1 mark)
MDP and 4 META (1 mark)
What are FOUR things you should ask patients about smoking (4 marks)
How long have you been smoking for?
How many cigarettes a day do you smoke?
What products do you use/smoke?
What age did you start smoking?
What metal can be used for an acid-etch retained bridge (1 mark)
cobalt chromium (1 mark)
What are THREE things to tell them about e-cigs (3 marks)
Safety in the long term is not known (1 mark)
Aid to quitting (1 mark)
Less toxic alternative to cigarette smoking but still have side effects (1 mark)
What are 2 advice services you should refer patients to for smoking cessation help (2 marks)
Quit Your Way Scotland (NHS smoking cessation) (1 mark)
Smokeline Scotland (1 mark)
Community pharmacy too
What is the methodology for smoking cessation (1 mark)
Ask, Advise, Act (1 mark)
What is an impression material that would require a 3mm spacer when constructing a special tray and why do we use the spacer? (2 marks)
Alginate material (1 mark)
Accommodates the flow of the alginate and to properly adapt to the contours of the teeth and soft tissues (1 mark)
Why would you prefer to use alginate over a silicone impression material? (2 marks)
Alginate is cheaper (1 mark)
Alginate is easier to use and tolerate due to quick set (1 mark)
Alginate is mucostatic and will take an accurate record of the tissues without displacement
Silicone is mucocompressive and is likely to tear not effective if undercuts are present
Give TWO examples of support areas for a complete upper denture (2 marks)
Primary support: hard palate
Secondary support: ridge crest
What is the primary support area for a complete lower denture (1 mark)
Buccal shelf (1 mark)
What is the anatomical landmark for the extension of the buccal shelf for a complete lower denture. What muscle lies adjacent to this landmark (2 marks)
External oblique ridge (1 mark)
Buccinator (1 mark)
What part of the mandible can interfere during a maxillary working impression (1 mark)
Retromolar pads (1 mark)
What is the most important factor for preventing healthcare associated infections (1 mark)
Hand hygiene (1 mark)
What are the 10 Standard Infection Control Precautions SCIP’s (5 marks)
1) Assessment of infection risk
2) Hand hygiene
3) Respiratory and cough hygiene
4) PPE
5) Safe management of the care environment
6) Safe management of care equipment
7) Safe management of healthcare linen
8) Safe management of blood and body fluids
9) Safe disposal of waste
10) Occupational safety
What AGENT is used for blood spillages and what STRENGTH (concentration) is used and for how LONG (3 marks)
Sodium hypochlorite (1 mark)
10,000 ppm chlorine (1 mark)
At least 3 minutes for follow manufacturers instructions (1 mark)
How would you break the chain of infection for the transmission of dirty forceps (1 mark)
Mode of transmission is the link that needs to be interrupted. Wear PPE to handle the forceps then disinfect and sterilize the forceps
How long should you leave an irrigant in a root canal for endodontic treatment (1 mark)
10 minutes (follow manufacturers instructions)
What are 4 indications that a trauma incident was not accidental? (4 marks)
“child”
1) Delay in seeking help (1 mark)
2) History of the trauma is vague or contradictory to child (1 mark)
3) Explanation does not fit the clinical findings (1 mark)
4) Parents behavior raises concerns (1 mark)
What are TWO effects of trauma on primary teeth (2 marks)
Discoloration and infection (1 mark)
Delayed exfoliation (1 mark)
What are FOUR long term effects that trauma can have on permanent teeth (4 marks)
Pulp Necrosis & Infection (1 mark)
Discoloration (1 mark)
Root Resorption (1 mark)
Dilaceration (1 mark)
When is the ideal time to remove 6s (2 marks)
7’s bifurcation calcifying
8’s present
Class 1 occlusion with an average or reduced overbite
Moderate lower crowding
Moderate upper crowding
Why is there an ideal time to remove 6s with poor prognosis? (2 marks)
Allows the development of a caries/infection free dentition into adolescence (1 mark)
To achieve an optimal occlusal result (1 mark)
What are the disadvantages of removing 6s (2 mark)
May require compensating extraction to achieve optimal occlusion (1 mark)
The risk of extraction including bone loss, infection, shifting of adjacent teeth, changes to bite (1 mark)
If you remove a lower with poor prognosis what would you do with the upper 6 that is non carious (1 mark)
Compensating extraction of upper 6 required (1 mark)
What are FOUR reasons for a child to be anxious (4 marks)
Parental anxiety (1 mark)
Negative experiences (PDH) (1 mark)
Child suffers from anxiety (PMH) (1 mark)
Behavior of the dental staff (1 mark)
New environment (1 mark)
What are TWO ways to treat anxious child (2 marks)
Through the use of sedation (1 mark)
Using behavioral management techniques and acclimating the child to the procedure (1 mark)
What are FOUR behavior management methods (4 marks)
Positive reinforcement (1 mark)
Distraction techniques (1 mark)
Tell-show-do (1 mark)
Stop, go and rest signals (1 mark)
What FOUR borders of the maxillary sinus are seen in an OPT (2 marks)
Roof (0.5 mark)
Floor (0.5 mark)
Medial wall (0.5 mark)
Posterior wall (0.5 mark)
What is the reason for anterior teeth to be horizontally magnified in an OPT (1 mark)
Patient is too far back in the machine or too close to x-ray source (1 mark)
What horizontal reference line is used when taking an OPT and the patient is viewed from the lateral aspect
Frankfort plane
What is the reason posterior teeth is magnified on one side of the OPT (1 mark)
Patient is rotated in the machine or patient not biting symmetrical between incisors on bite peg (1 mark)
DO NOT accept tilting
What are TWO treatment options for a perio-endo lesion (2 marks)
RCT, observe, RSD for residual pockets if required following 3 months after RCT
What would you ask about the social history of a perio-endo patient (1 mark)
Do you smoke or use tobacco products (1 mark)
What THREE investigations would you perform for a patient with a perio-endo lesion (1 mark)
1) Radiographic assessment: periapical
2) Sensibility testing: ethyl chloride or EPT
3) 6PPC to check for furcation and probing depth
What are FOUR factors that cause oral candidiasis (2 marks)
Medications like prolonged antibiotic use
Immunocompromised
Poor oral hygiene
Denture wearers
Name the organism and virulence factor which causes candidiasis (2 marks)
Candida albicans: hyphae for penetration
What are the FOUR key stages to plaque formation (2 marks)
1) Adhesion
2) Colonization
3) Maturation
4) Acid production
How would you test for Candida albicans and suggest lab identification method (2 marks)
Germ tube formation test
Chromogenic agar identification method. Candida will be blue-green
Give TWO antifungal examples (azole and polyene) and the mechanism for both (2 marks)
Fluconazole (azole): inhibits the synthesis of ergosterol
Nystatin (polyene): bind to ergosterol and disrupt membrane
Besides a randomized control trial, give THREE other study designs and explain them (6 marks)
Cohort - follow group over time, identify those that get disease. Used for incidence (2 marks)
Case control study- the study of people with a disease and a suitable control group of people without the disease. Retrospective study (2 marks)
Cross sectional study- observational study that analyses data collected from a population, used to estimate prevalence (2 marks)
List FOUR patient related factors which should be considered when interpreting the results of a RCT of ultrasonic vs manual tooth brushing
Age
Medical history
Tooth condition
Tooth type
How could an amalgam container be kept safe (2 marks)
Spill and leak proof (1 mark)
Mercury vapor suppressant (1 mark)
What are THREE aims of an audit (3 marks)
Quality assurance (1 mark)
Performance evaluation (1 mark)
Continuous improvement (1 mark)
You are a vocational trainee at a new dental practice. Principal dentist notices there is something lacking in the waste disposal procedures and asks you to look into it and present your findings.
Draw a flowchart: (5 marks)
Set guidelines - Observe practice - Compare with guidelines - Implement change
What are the FOUR principles of waste management (4 marks)
Segregation (1 mark)
Storage (1 mark)
Disposal (1 mark)
Documentation (1 mark)
Name THREE regulations for waste disposal (3 marks)
Environmental Protection Act (EPA)
Controlled Waste Regulations (CWR)
Waste (Scotland) Regulations (WR)
COSHH Act
A patient comes in with an enamel dentine pulp fracture with an exposed root canal treatment. List FIVE functions of a provisional crown in this scenario (5 marks)
Improve aesthetics
Restore function
Protects the remaining structure
Prevents sensitivity and provides comfort
Guidance for the permanent restoration
List THREE types of prefabricated crowns (3 marks)
Metal crowns: stainless steel, aluminum (1 mark)
Polycarbonate crowns (1 mark)
Clear plastic crowns (1 mark)
List TWO disadvantages of a prefabricated crown (2 marks)
Requires a large bank of crowns (1 mark)
Inaccurate and less customizable (1 mark)
Name the constituents of stainless steal and their percent composition (4 marks)
Iron: 72%
Chromium: 18%
Nickel: 8%
Titanium: 1.7%
Carbon: 0.3%
What is work hardening? (3 marks)
Work hardening is the strengthening of a metal by plastic deformation. (1 mark)
The wire is made by drawing the metal in a cold state through a series of dies of successively smaller diameter. (1 mark)
Each time the material is deformed, its structure becomes more complex and more resistant to further deformation (1 mark)
What is meant by springiness? (1 mark)
Rate at which a material returns to it’s original shape after being subjected to large deflections
Name TWO disadvantages of self cure PMMA (2 marks)
Residual monomer - irritant (1 mark)
Poor mechanical properties since chemical activation is less efficient (1 mark)
What are FOUR factors that can result in tooth mobility (4 marks)
Periodontal inflammation
Attachment loss
Widening of the periodontal ligament (occlusal trauma)
The morphology and length of the roots
Periapical bone loss
Pathology affecting the roots – resorption, trauma, etc.
In which TWO circumstances would you intervene if a patient presented with tooth mobility (2 marks)
Progressively increasing mobility (1 mark)
Tooth mobility gives rise to symptoms such as difficulty chewing or discomfort (1 mark)
Would you expect tooth mobility to increase or decrease in a patient with moderate/advanced periodontal disease following hygiene phase therapy? Explain why (2 marks)
It would be more likely to decrease (1 mark) due to increased tone in the supra-alveolar soft tissues leading to resistance to movement (1 mark).
A patient has mobile lower incisors and refuses extraction as a treatment option. Horizontal bone loss is seen on radiograph. What would you advise him and what are the disadvantages of this? (2 marks)
Splinting may be appropriate however, splinting does not influence the rate of periodontal destruction and it may create hygiene difficulties. It is a treatment of last resort (2 marks)
List FOUR peri-operative complications (4 marks)
Fracture of tooth/root
Dislocation of TMJ
Damage to soft tissues
Damage to adjacent teeth
The patient’s root fractures during a standard extraction procedure. What radiograph would you take? (1 mark)
Periapical (1 mark)
Where is the position of the mental foramen (1 mark)
Between the apices of the lower 4 and 5 (1 mark)
Draw the flap design for a surgical extraction of a 44 (2 marks)
Learn this
What TWO structures does the mental nerve innervate (2 marks)
Lower lip and chin up to midline (1 mark)
Buccal gingiva of lower anterior teeth including premolars up to midline (1 mark)
What TWO information do you need before an extraction of a patient on Warfarin (2 marks)
INR (1 mark)
Date of INR (1 mark)
What INR would you carry out an extraction if the patient is taking Warfarin and when should this be done (2 marks)
If INR below 4 (1 mark)
Ideally no more than 24 hours before procedure (1 mark)
What is the most appropriate analgesic for a patient taking Warfarin (1 mark)
Paracetamol
If a patients INR is unstable. How would a GP assess this?
Review the patients medical history and medications (1 mark)
Monitor the patients INR closely and adjust medication dosages (1 mark)
Would you make any alterations regarding a patient on apixaban for an extraction of tooth 16? (1 mark)
Miss the morning dose and take usual evening dose (1 mark)
(According to SDCEP extraction of upper molar is moderate risk)
Would you make any alterations regarding a patient on apixaban for an extraction of tooth 31? (1 mark)
No (1 mark)
According to SDCEP extraction of lower central is low risk
A dentist causes a facial palsy as a result of a right inferior alveolar nerve block. The patient has a sore right temporomandibular joint
How is facial palsy caused (2 marks)
If the LA is deposited too far posteriorly and into the parotid gland where the facial nerve runs through (1 mark)
LA will cause paralysis of the facial nerve which innervates the facial muscles (1 mark)
Describe THREE differences between a stroke and a facial palsy (3 marks)
A stroke is caused by a disruption of blood to the brain, while facial palsy is caused by damage to the facial nerve (1 mark)
A stroke affects the contralateral muscles while facial palsy affects ipsilateral muscles (1 mark)
In a stroke the patient can still wrinkle their forehead while facial palsy the patient cannot on the affected side (1 mark)
Explain the neural anatomy which accounts for the difference in facial palsy and a stroke (3 marks)
In facial palsy it is a LMN lesion which affects all the muscles on the ipsilateral side (1 mark)
The facial nerve innervates the facial muscles therefore damage or dysfunction leads to complete loss of motor control to the muscles on the affected side (1 mark)
A stroke is an UMN lesion which provides motor innervation to the contralateral side. The upper motor nucleus however has bilateral innervation therefore the upper muscles of the contralateral side are unaffected hence why patient can wrinkle forehead
(1 mark)
Name FOUR ways you can initially manage a patient with facial palsy (2 marks)
Reassurance
Cover eye with pad until blink reflex returns
Let someone else drive them home
Consider ibuprofen for pain or discomfort
You take an impression of an MOD for a ceromeric inlay. How would you determine if this impression is usable (3 marks)
Make sure the impression captures the full extent of the preparation
Make sure there are no tears or air blows in the impression
Make sure all intended teeth and soft tissues are captured accurately
List FOUR potential faults with an impression (4 marks)
Air bubbles
Tear in the material
Voids: incomplete capture of anatomy
Distortion of the material
How would you decontaminate the impression immediately after taking it (3 marks)
Rinse under cold water
Place in perform for 10 minutes
Remove from perform and rinse under cold water
Cover material in damp paper towel and place into sealable bag with a label
Give FOUR reasons why non setting calcium hydroxide an ideal inter-appointment medicament (2 marks)
Prolonged effectiveness: can remain active between appointments
Antibacterial properties
Biocompatible
Easy to use
What are THREE reasons for obturating a root canal? (3 marks)
Seal the root canal system and prevent ingress of bacteria from coronal leak (1 mark)
To support and strengthen the remaining tooth structure (1 mark)
Prevents root infection from periradicular exudate via apical foramen (1 mark)
Other than rubber what are the components of Gutta percha (2 marks)
Zinc oxide: 65%
Gutta percha: 20%
Radiopacifiers: 10%
Plasticizers: 5%
What are THREE reasons for a sealer when using cold lateral compaction (3 marks)
Create fluid tight seal and acts as adhesive (1 mark)
Fills voids and irregularities in canal thus preventing ingress of bacteria (1 mark)
Lubricates the canal during obturation (1 mark)
What are the TWO most important muscle of mastication for elevating the mandible (2 marks)
Masseter (1 mark)
Temporalis (1 mark)
What is the PRIMARY muscle of mastication for protruding the mandible (1 mark)
Lateral pterygoid muscle (1 mark)
What is the anterior convex part of the temporomandibular joint (1 mark)
Articular eminence/tubercle (1 mark)
What is the posterior concave part of the temporomandibular joint (1 mark)
Glenoid/mandibular fossa (1 mark)
What is ONE species other than Candida albicans that causes candidiasis and how can you differentiate (2 marks)
Candida glabrata: culture and sensitivity test to differentiate (2 marks)
What are THREE forms of candidiasis? (3 marks)
Oral candidiasis (1 mark)
Genital candidiasis (1 mark)
Cutaneous candidiasis (1 mark)
What are THREE forms of oral candidiasis (3 marks)
Pseudomembranous candidiasis: thrush (1 mark)
Erythematous candidiasis: denture induced stomatitis (1 mark)
Hyperplastic candidiasis: candidal leukoplakia (1 mark)
Order the following list of treatments
Upper restoration with LA
Upper restoration with no LA
Fluoride varnish
Lower restoration with LA
Fissure sealants
Pulpotomy
OHI
Extraction
(8 marks)
OHI
Fluoride varnish
Fissure sealants
Upper restoration with no LA
Upper restoration with LA
Lower restoration with LA
Pulpotomy
Extraction
What are FOUR signs that a child is anxious at the dentist (2 marks)
Crying or expressing fear
Difficulty communicating
Clinging on to parent or caregiver
Physical signs: sweating and trembling
What is SIMD (1 mark)
The Scottish Index of Multiple Deprivation (SIMD) is a tool used to measure the level of deprivation experienced by different areas of Scotland. (1 mark)
What are the SEVEN factors of deprivation (7 marks)
income
Employment
Education
Health
Crime
Skills and training
Geographic access to services
What is another name for master impressions (1 mark)
Definitive impressions (1 mark)
What are TWO factors that affect physical retention of a denture (2 mark)
Accurate fit (1 mark) ??
Cohesion and adhesion: salivary quality of patient (1 mark)
Border seal: by incorporating post dam (1 mark)
What are TWO anatomical features for the positioning of the posterior border of the upper denture (2 marks)
Vibrating line (1 mark)
Hamular notch (1 mark)
Name 3 anatomical features to include on a mandibular impression (3 marks)
Retromolar pads (1 mark)
Lingual pouch (1 mark)
Buccal shelf (1 mark)
Name TWO materials you can use for master impressions of the lower arch (2 marks)
Alginate (1 mark)
Silicone elastomers: polyvinyl siloxane (1 mark)
A nurse does not wash her hands before a patient. What should you do (2 marks)
Politely remind the nurse to wash her hands (1 mark)
Remind the nurse the importance of hand hygiene
If the nurse does not comply report the incident to appropriate authority (1 mark)
You decide to give a presentation about hand hygiene. What are FOUR things to include (4 marks)
When to wash your hands
How to wash your hands
What to wash with
Why to wash hands
You see a dentist wear double gloves and book a blood disease patient at the end of the day. What would you tell the dentist? (2 marks)
There is no added benefit to double gloving in standard dental procedures and it can be wasteful (1 mark)
The dentist should follow SICPs for ALL patients and not discriminate by booking blood diseased patients at the end of the day in case there is an emergency and the patient needs to go to hospital. (1 mark)
After informing the dentist of the standard operating procedure what are TWO things you should do? (2 marks)
“double gloved blood disease question”
Implement model for improvement (1 mark)
Document (1 mark)
What is FOUR PPE you need for carrying out manual cleaning and why would you need each one (4 marks)
Gown: splashing onto clothes (1 mark)
Face shield: aerosols (1 mark)
Heavy duty rubber gloves (marigold): sharps (1 mark)
Face mask: protects mouth and nose from aerosols (1 mark)
When should you degas the ultrasonic bath (1 mark)
Every time it is filled from empty (1 mark)
Why should you degas the ultrasonic bath (1 mark)
To remove air/oxygen (1 mark)
How does degassing the ultrasonic bath affect it (1 mark)
Air/oxygen will prevent ultrasonic bubbles from reaching all surfaces of instrument (1 mark)
Provide one good reason why dental handpieces should not be placed in the ultrasonic cleaner (1 mark)
May be damaged by ultrasonic activity (1 mark)
What are TWO types of manual cleaning and name an example for each (2 marks)
Immersion: dental mirror
Non immersion: handpieces
Why do you use deionized water in the sterilizer (1 mark)
To prevent the deposit of minerals on the instruments (1 mark)
What percentage of patients are affected by sensitivity caused by tooth whitening (1 mark)
60%+ (1 mark)
What are THREE predisposing factors likely to cause sensitivity after tooth whitening (3 marks)
Pre-existing sensitivity (1 mark)
Gingival recession (1 mark)
High concentration of bleaching agent (1 mark)
One of the risks of internal non vital bleaching is external cervical resorption. What is the method of action for this? (2 marks)
Due to diffusion of H2O2 through dentine into periodontal tissues (2 marks)
One of the risks of internal non vital bleaching is external cervical resorption. What are TWO causes for this?
High concentration of H2O2 (1 mark)
Heat (1 mark)
How do you prevent root resorption from internal non vital bleaching (2 marks)
Remove GP from pulp chamber and 1mm below ACJ. Place 1mm RMGIC over GP to seal canal. This seals dentine and prevents root resorption (1 mark)
Use appropriate concentration of H2O2 and heat (1 mark)
What are TWO indications for surgical consideration at the reevaluation stage of a patient with periodontal disease (2 marks)
Good OH (1 mark)
Persistent deep pockets ≥ 6mm (1 mark)
