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BDS3 OSCE > OSCE 2 > Flashcards

OSCE 2 Flashcards

1
Q

what are the contra-indications of 2.2ml lidocaine 2% with 1:80,000 adrenaline

A

sensitivity to adrenaline or latex, uncontrolled CVD, taking tricyclics or beta blockers

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2
Q

what is used as an alternative to lidocaine

A

citanest 3% with octapressin

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3
Q

what patients should not be prescribed NSAIDs for post op painkillers

A

pregnant or on warfarin

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4
Q

what is the prescribed dose for ibuprofen

A

400mg x 3-4 daily

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5
Q

what are some cautions to we aware of with ibuprofen

A

elderly - reduced drug metabolism
peptic ulcers or GORD - may exacerbate
asthmatics
history of NSAID hypersensitivity
taking other NSAIDs
on long term steroid use - susceptible to gastric ulcers

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6
Q

outline 10 points of post op instructions

A

take it easy - no exercising
expect pain
swelling, bruising, tenderness and stiffness common
take care eating and drinking
dont wash out mouth for like 6 hours
eat on opposite side of the mouth and leave site alone
if bleeding occurs at home bite down on damp gauze for 20-30 mins
avoid smoking for as long as possible and no alcohol for 24 hours
starting the day after swirl warm salty mouthwash for 3-4 times per day
give written instructions
come back if any problems

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7
Q

what are the 5As to smoking cessation

A

ask - how many per day, when did you start?
advise - health benefits of quitting
assess - desire to stop smoking
assist - negotiate a stop date and review previous attempts
arrange follow up - NHS SSS referal

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8
Q

if a patient presents with dry mouth that is unusual what other special tests might you do

A

dry eyes also?
blood tests checking for anti-La antibody
histopathology assessment of labial secondary salivary gland

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9
Q

what are some complications of Sjogrens syndrome

A

dry mouth and eyes
difficulty with speech and swallowing
burning mouth
increased risk of oral infection and caries
difficulty with denture retention
salivary lymphoma

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10
Q

what is included in a trauma stamp

A

colour
TTP
percussion note
sinus
mobility
radiograph

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11
Q

treatment for enamel fracture in primary dentition

A

smooth sharp edges

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12
Q

what is the treatment for enamel-dentine fracture in primary dentition

A

cover exposed dentine in GI or composite bandage
lost tooth structure restored immediately with composite or at a later visit

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13
Q

what is the treatment for enamel-dentine-pulp fracture in primary dentition

A

partial pulpotomy
extraction

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14
Q

treatment for crown-root fracture in primary dentition

A

if restorable and no pulp exposure - cover exposed dentine with GI
if restorable and pulp exposed - pulpotomy or endo
if unrestorable - extract

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15
Q

treatment for root fracture of primary tooth

A

coronal fragment not displaced - no treatment
coronal fragment displaced but not mobile - leave coronal fragment to spontaneously reposition
coronal fragment displaced and excessive mobility - extract loose coronal fragment or reposition and splint

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16
Q

management of concussion in deciduous dentition

A

no treatment
observation

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17
Q

management of subluxation in deciduous dentition

A

no treatment
observe

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18
Q

treatment for lateral luxation of deciduous teeth

A

allow reposition spontaneously
reposition and splint
extract

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19
Q

treatment for intrusion of deciduous teeth

A

spontaneous repositioning

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20
Q

where would the apex be displaced if on the radiograph the tooth appears shortened to contralateral tooth and the apical tip of intruded tooth can be seen

A

apex displaced towards/ through labial tissues

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21
Q

where would the apex be displaced if on the radiograph the apex of intruded tooth cannot be visualised and tooth appears to be elongated compared to contralateral teeth

A

apex displaced towards permanent tooth germ

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22
Q

treatment for extrusion of a deciduous tooth

A

not interfering with occlusion - spontaneous repositioning
excessive mobility - extract

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23
Q

treatment for avulsion of deciduous tooth

A

radiograph to confirm
do NOT re-implant

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24
Q

treatment of alveolar fracture in deciduous dentition

A

reposition segment
splint for 4 weeks with uninjured teeth

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25
Q

what are the three direct complications of trauma to primary teeth

A

discolouration
discolouration and infection
delayed exfoliation

26
Q

what is enamel hypomineralisation

A

qualitative defect of enamel - normal thickness but poorly mineralised

27
Q

what is enamel hypoplasia

A

quantitive defect of enamel - reduced thickness but normal mineralisation

28
Q

what is a dilacerated root

A

abrupt deviation of the long axis of the crown or root portion of the tooth

29
Q

what might cause delayed eruption of permanent teeth

A

premature loss of a primary tooth can result in delayed eruption of up to a year due to thickened mucosa

30
Q

what may a duller note on percussion of the tooth indicate

A

root fracture

31
Q

how long should sensibility tests be continued after injury

A

2 years

32
Q

what are the follow up times for an enamel fracture

A

6-8 weeks, 6 months and 1 year

33
Q

what are the follow up times for an enamel-dentine fracture

A

6-8 weeks, 6 months and 1 year

34
Q

what three things do you evaluate when dealing with an enamel-dentine-pulp fracture

A

size of pulp exposure
time since injury
associated PDL injuries

35
Q

when would you do a direct pulp cap

A

enamel-dentine- pulp fracture but tooth is non-TTP and positive sensibility tests

36
Q

when would you do a partial pulpotomy

A

larger exposure or been more than 24 hours since trauma

37
Q

how much of the pulp is removed in a partial pulpotomy

A

2mm

38
Q

how do you achieve haemostasis in partial pulpotomy

A

cotton wool soaked pellet in saline

39
Q

when would you do a full coronal pulpotomy

A

if hyperaemic or necrotic pulp

40
Q

why do we sometimes leave vital pulp tissue in the canal

A

to allow normal root growth (apexogenesis)

41
Q

what is the clinical findings for a concussion injury

A

pain on percussion

42
Q

what is the followup for concussion injury

A

4 weeks and 1 year

43
Q

what is the clinical findings for subluxation

A

increased mobility
TTP
bleeding from gingival crevice

44
Q

what are the follow up times for subluxation

A

2 weeks - splint removal
12 weeks
6 months
1 year

45
Q

what are clinical findings of an extrusion injury

A

tooth appears elongated
displaced palatally
tooth mobile
bleeding from gingival sulcus

46
Q

what are the follow up times for extrusion injury

A

2 weeks - splint removal
4 weeks, 8 weeks, 12 weeks
6 months and 1 year

47
Q

what are the clinical findings of a lateral luxation injury

A

tooth appears displaced
tooth immobile
high ankylotic percussion tone
bleeding from gingival sulcus

48
Q

what occurs in a lateral luxation injury in a tooth with incomplete root formation

A

spontaneous revascularisation may occur

49
Q

what occurs in a lateral luxation injury in a tooth with complete root formation

A

pulp will become necrotic - corticosteroid antibiotic or CaOH as intra-canal medicament to prevent inflammatory external resorption

50
Q

what are the follow up times for lateral luxation injury

A

2, 4, 8 weeks
6 months and 1 year

51
Q

what are the clinical findings of an intrusion injury

A

crown appears shortened
bleeding from gingivae
ankylotic high percussion tone

52
Q

what are the follow up times for an intrusion injury

A

2, 4 8 and 12 weeks
6 months and 1 year

53
Q

what are the clinical findings with an avulsed tooth

A

socket empty or filled with coagulum

54
Q

what is EADT

A

extra-alveolar dry time

55
Q

what is EAT

A

extra-alveolar time

56
Q

when should endodontic treatment be commenced for avulsed teeth with closed apices

A

2 weeks after

57
Q

when would you not replant an avulsed tooth

A

child immunocompromised
other serious injuries requiring professional emergency treatment

58
Q

when is a splint removed for a dento-alveoalr fracture

A

4 weeks

59
Q

what are three pieces of advice for dento-alveolar fractures

A

soft diet for 7 days
avoid contact sports while splint in
careful oral hygiene and use of chlorhexidine gluconate mouthwash (0.12%)

60
Q

what are two types of splint

A

chairside
lab-made

61
Q

what diameter of stainless steel is used for splint wire 0.4mm

A

BDS3 OSCE (4 decks)

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