Others Flashcards
What policy type was for increasing smoking age?
Improving national public policy
What toothpaste component is for anti calculus?
Sodium pyrophosphate
Zinc citrate
Patient is hit on head and has an extra dura haemorrhage, what blood vessel has caused this?
Middle meningeal artery
The 1st maxillary molar is not getting numb, what accessory nerve needs to be anaesthetised?
MB root - middle superior alveolar nerve
DB and palatal root - posterior superior alveolar nerve
Patient with haemophilia A (factor 8) what type of blood test do they get to check clotting?
Partial thromboplastin time (PTT)
- longer in haemophilia
Patient needs INR checked what is the lab test called?
International normalised ratio - prothrombin time (PT)
An OFG patient has lower lip swelling but doesn’t have an app for 2 months, what week schedule and items should be cut out of diet?
Carbonated drinks, cinnamon, benzoates, E210-E219
8 weeks
What safety mechanism is in inhalation sedation to switch off gases?
Oxygen flow less than 30%, nitrous oxide stops flowing
With inhalation sedation, what percentage of gases would switch off occur?
Oxygen less than 30%
What are the general values for use of nitrous oxide for inhalation sedation?
Plane II
20-55% nitrous oxide
Minimum 30% oxygen with 10% titration of nitrous oxide every minute
How is nitrous oxide carried in the blood?
As free gas as it does not bind to haemoglobin meaning it is rapidly excreted
What accessory nerve for ‘LL6 has been anaesthetised if lip and tongue is numb?
Posterior division of mandibular nerve - lingual nerve
How much nitrous oxide is required for inhalation sedation in a 10yr old boy?
20-50%
Young male patient has ventricular septal defect correction. Surgery as a child and requires orthodontic separator placement, is antibiotic prophylaxis required?
No, not high risk and non invasive process
What is the best restoration for pulp cap on a lower primary molar affecting occlusal surface only?
PMC
Patient requires hard acrylic splint, what is required when making this?
Maintain canine guidance, contact in RCP and posterior disclussion
What is the definition of prevalence vs incidence?
Prevalence measures rate of occurrence of new cases of disease/condition in a specified population in any given time perio d
Incidence measures how much of a disease or condition there is in a population at a particular point in time (ppl with diabetes in EK)
What criteria is needed for screening for disease?
- Must have test available which picks up disease before symptoms develop.
- test must be reasonably accurate
- test must be reasonably simple to perform and acceptable
- benefits of screening must be greater than any potential harm or risks it could cause
- cost of test must not be more than benefit
- must have treatment at early stage of condition which will make difference to outcome
- condition being screened must be important to health and well being
- must be organised, efficient plan for what happens if test is positive
What type of molecule is chlorhexidine?
Positively charged bisbiguanide compound
Patient has Alzheimer’s, very confused and won’t allow dental exam but has lower swelling in past 24hrs, no systemic symptoms, what do you do?
- Give antibiotics and pain relief
- refer to hospital
- wait for family member to consent before treatment
???
Patients has tonsil swelling and neck mass what virus would you test for? They are non smoker and no alcohol intake
HPV
What virus causes hairy leukoplakia?
EBV
What condition causes non eruption of permanent dentition?
Cleidocranial dysplasia (dystosis)
GAPO syndrome
Rutherford syndrome
Patients has small jaw and cleft palate at birth, what condition is this likely to be?
Pierre robin syndrome
How does the maxilla develop?
1st pharyngeal arch
When would you get most vapour mercury from amalgam?
Removing amalgam
What is the function of fluoride with regards to hydroxyapatite?
Fluoride ions replace hydroxyl groups and increases the rate of remineralisation, reduces demineralisation and stability and is less soluble.
When a patient ears sugar what is the cause of the slough feeling on the teeth with regards to bacteria taking sugar and making what molecule?
Bacteria makes dextran polysaccharide or lactic acid from sucrose/glucose/fructose/lactose through glycolysis.
Patient has red patches in front of circumvallate papilla what is the likely condition?
Median rhomboid glossitis (MRG - central papillary atrophy)
Patient has tongue soreness to sour and sweet/spicy food, patches on tongue can be red then white and it comes and goes, what is the likely condition?
Geographic tongue (benign migratory glossitis)
What is the likely cause of erythema of the palate from wearing habit breaker?
Poor oral hygiene causing candidosis
What space is required for a lingual bar?
7-8mm
3mm from gingival margin , 4mm for bar and 1mm from functional depth of FoM
What is the polymerisation shrinkage % of composite/
1-4%
What are the BPE scores for bleeding and for plaque present?
BPE 2 - bleeding, supra or sub gingival calculus, overhangs
Patient has upper and lower 6s, upper and lower 1s and 2sand lower 3s, what is likely age?
9-10years
A patient has a 7mm pocket ŵirh the tooth requiring multiple re cemented post, what is the likely cause of failure and deep pocket?
Vertical root fracture
What is chlorhexidine function with the biofilm?
It reacts with the negatively charged groups on the cell surface causing irreversible loss of cytoplasmic constituents, membrane damage and enzyme inhibition
A 16year old has small fractures on incisal edges of teeth, what would be the initial treatment?
Discuss diet and give dietary advice and grinding habits discussed
A patient is suffering from intrinsic erosion what would be the testing for this?
24hr oesophageal pH monitoring
A late teen early 20s patient has punched out papilla, erythema and bleeding but no pocketing, what Is the likely diagnosis?
ANUG
What is the typical metronidazole prescription for periodontal conditions?
400mg 3x daily for 3 days
What antibiotic regime is required for post aggressive perio?
Metronidazole and amoxicillin
What is the function of doxycycline?
Tetracycline class that inhibits synthesis of bacterial proteins by binding to 30s ribosomal subunit
What is the definition of indirect retention?
Resistance to rotational displacement forces
What is the difference between meta analysis and systematic reviews?
Systematic review is detailed, systematic and transparent means of gathering, appraising and synthesising evidence to answer a well defined question.
Meta analysis is a statistical procedure for combining numerical data from multiple separate studies - only conducted in context of systematic reviews
How would a bilateral condylar fracture be managed?
IMF and conservative management
ORIF and IMF if severe/deranged occlusion
What xrays are required for mandibular fractures?
OPG and PA mandible
What percentage of parotid tumours are malignant?
15-20%
Patient has slow growing mass on parotid gland, what is the likely diagnosis?
Pleomorphic adenoma
What symptoms of mandibular fracture would mean ORIF is required?
Occlusal derangement
White spongy naevus is passed down from grandfather to father to son, what is the inheritance pattern?
Autosomal dominant
Son with multiple cysts of upper jaw and mum had similar condition, they are asymptomatic. What is the possible diagnosis?
Gorlin goltz syndrome (naevoid basal cell carcinoma syndrome)
What bacteria causes angular cheilitis?
Staphylococcus aureus - gram positive bacterium
Why would you carry out a retrograde root end apicetomy at 90degrees angle?
To reduce number of exposed dentinal tubules and to ensure access to all the apical anatomy
Silicate material is better for deep carious lesions, why?
Higher pH
What is the best type of scaler for RSD?
Gracey curettes
What Deficiency causes a pale tongue?
B12 or poss iron
Man is on cannibals, medications that end in tixol with facial and head pain wanting all his teeth extracted, what is the diagnosis?
Atypical facial pain
Patient is on warfarin and INR is 6, was taking amoxicillin, metronidazole ibuprofen and paracetamol. What has caused the rise in INR?
Metronidazole
Patient has lower floor of mouth swelling, what X-ray is required?
Lower mandibular occlusal
Staff not adhering to CPD or basic mandatory training what would you do as practice principle?
Explain that they will get wring to struck off if not adhering to GDC guidelines, raising concerns and appraisals.
Patients has unilocular swelling associated with unerupted wisdom tooth what is likely diagnosis?
Dentigerous cyst
Patient has orthodontic treatment and attends as new patient complaining about poor treatment due to squint bottom teeth and wants to complain about orthodontist and wants it fixed what would you do?
Refer to new orthodontist or telephone old orthodontist
Patient has swelling associated with angle of mandible with protein content <4g/dL, what is it?
Ameloblastoma
Patient attends for new exam but doesn’t get results of exam, partner phoned asking for results. What do you do?
Don’t tell him due to confidentiality
Patient had a tooth that is not TTP,not vital,pain to hot that lingers for hours. What is likely diagnosis?
Irreversible pulpitis
Patient has perio Endo lesion, what should be the initial treatment?
Endodontic treatment
Patient is on warfarin has denture stomatitis, what medication should be given?
Nystatin 100,000units 4x daily for 7 days and continue use for 48 hours after lesions have resolved.
What is the main sign of an ulcer that is malignant?
Cervical lymphadenopathy
Been there for >2 weeks bleeding, hard, raised rolled border, non homogenous
Patient with lesion that shows moderate severe dysplasia with no other medical notes, what do you do?
Refer to MaxFacs for regular biopsy
Patient has ulcer on floor of mouth that she had just noticed, doesn’t have any other symptoms, what do you do?
Review in 1 week
What is the most suitable aspect of a canine for it be used for camouflaging?
Width of crown
How should a 11 be positioned?
Same length as tip of 13
Decay missing filled teeth index, why is it not as accurate as other indices?
Accounts for other reasons than just decay
Study involving group of mums from ethnic background with problems in children, what type of study
Prospective cohort
Lateral Pontic 12 onto 13 has debonded after 2 years and there is heavy wear now seen on the teeth. What is the cause of debonding?
Heavy occlusion of canine guidance
Patient has CVA and lower denture fitted fine but now doesn’t, what would you do?
Realign or rebase due to lack of muscular control
Patient with short acting acute pain across zygoma, what is likely condition?
Trigeminal neuralgia
Infraorbital block for apicetomy multiple anterior teeth and patient now has diplopia, why?
CN3,4,6 damage
Patient cannot abduct the eye due to being hit on face, what muscle has been damaged?
Lateral rectus muscle
What muscle does the facial nerve supply?
Obicularis oris
Patient has 5mm ulcers that last a week but come and go, genital ulcers, joint pain, red sore eyes. What is likely diagnosis?
Behçet’s disease
Avulsed tooth and patient replanted after 3 hours with no treatment, what resorption is likely to occur?
Replacement causing ankylosis
What is the role of 17% EDTA?
Removes the smear layer
3yr old high caries risk, what fluoride amount should they receive?
1350-1500ppm
66yr old patient with high caries rate, what fluoride amount should they receive?
5000ppm
What would cause the highest score of IOTN?
14mm OJ
With regards to therapist scope of practice, what can they not do?
Extraction of permanent teeth
RCT
Patient has a class 3 malocclusion and doesn’t want fixed appliances but wants to make occlusion better, what device would you use?
Functional
SNA and SNA increased and SNA/max =8, what is the skeletal classification?
Class 2 possibly severe
Patient has bOP, over hanging margins, no calculus, no bans below gum during BPE - what is the code?
BPE 2
What drug will most likely interact with lidocaine and adrenaline?
Beta blockers atenolol
Patient with gingival hyperplasia after kidney transplant, what medication is the patient likely on?
Cyclosporine
What medications are likely to cause gingival hyperplasia linked with cardiac disease?
Calcium channel blockers
Amlodopine, nifidepine
What is the best type of crown to put on a canine?
MCC
20yr old with 6mm recession on canine post orthodontic treatment with plaque deposits throughout mouth, what would you initially do?
OHI
Patient has 6mm recession on maxillary molar with no other recession or perio, why has this happened?
Over zealous brushing
Where do crown margins generally sit?
Above gingival margin
Diabetic man during dental treatment goes unconscious, what do you do?
Glucagon IM injection
Patient has an anterior crossbite what appliance is used to fix this?
Z spring
10yr old boy during dental treatment goes floppy, pale, clamy, but has a pulse, what has happened?
Vasovagal syncope
Patient has difficult extraction and comes to practice with throbbing excruciating pain, fetor oris and is a smoker. What is the likely diagnosis?
Alveolar osteitis - dry socket
Poor attender male who is anxious has multiple carious teeth, poor socioeconomic status, sore gums and teeth, what is the initial management?
Recognise his anxiety and explain what can be done
Autistic girl who’s mum wants her to have orthodontic treatment but she is poorly cooperative won’t allow exam and radiographs, what do you do?
Explain to mum orthodontics is not feasible and reduce expectations
What is the millers classification for 3mm movement buccal lingual?
Class 3
Patient has anaphylaxis reaction, what is the type of hypersensitivity reaction?
Type 1: immediate - anaphylactic reaction
What type of cells are affected by HIV?
T helper cells (CD4)
What does nicotine do with regards to periodontal disease?
Reduces MMPs and disrupts collagen synthesis
What is the surface of the tooth like when etch and bond is used with regards to smear and hybrid layers?
Hybrid layer is a collagen network infiltrated with resin monomers
How many roots does a deciduous upper molar have?
3
What is required in the periodontal statement based on the 2017 perio classification?
Staging 1-4 (amount of bone lost)
Grading A-C ( amount of bone loss/age)
Stability and risk factors
What tooth is rotated for an extraction?
Lower premolars and canines
25mm file won’t get to the apex of a tooth, what tooth will this likely be?
Upper canine
What cement is used for fibre posts?
Dual cure composite cement (Nexus)
When would you consider periodontal surgery?
- indicated for pockets >6mm probing pocket depth measurements
- gingivectomy can be considered for a patient with drug induced gingival hyperplasia
- apical repositioning surgery allows a reduction in proving depths measurements
Regarding major connectors for mandibular metal based removable partial dentures what is required?
- minimum of 3mm between gingival margins of the remaining teeth and superior part of lingual bar connector
- lingual plate connector offers more indirect retention than a lingual bar
- lingual plate connectors causes more plaque retention than a lingual bar
With regards to cysts recurrence following enucleation is common with?
Odontogenic keratocysts and unicystic ameloblastoma
If a root treated tooth previously had a disto-occlusal amalgam which restoration is best suited post RCT?
Crown
58yr old attending for extraction of upper right canine and lateral incisor and his upper left 2nd premolar and 1st molar, ŵith insertion of an immediate partial denture. After extracting the teeth, you attempt to insert the denture but are unable to seat it. Why has this occurred?
Bony undercut not blocked out
40yr old women undergoes lateral cephalogram orthognathic planning. On reviews well defined rounded lucent lesions are sen throughout the skull. What is most likely diagnosis?
Multiple myeloma
You appoint a new receptionist to the staff of your dental practice. Following successful completion of his/her probationary period, how often is it recommended that his/her performance should be appraised?
Every 12 months
56yr man presents with generalised gingival enlargement. What class of drugs is most likely to be taking?
Calcium channel blocker
You are designing an occlusal rest seat on the mandibular left 1st premolar for a partial cobalt chrome denture. What is the optimal depth that the marginal ridge should be reduced?
1.5mm
Patient presents with discoloured lower incisor teeth and associated swelling. What clinical findings would be most of use in helping determining it’s cause?
Loss of vitality
53yr old women diagnosed with burning mouth syndrome, what part of mouth is most commonly affected?
Tongue
What is the most appropriate antibiotic for a patient with liver failure and dental abscess?
Cefuroxime
Amoxicillin
12yr old patient with permanent dentition attends for an orthodontic assessment, what is the most likely screening tool to be used?
Index of orthodontic treatment need
30yr old man requires extraction of left mandibular and maxillary 3rd molars. He is very nervous. He is fit and well and weighs 70kg. What would be the preferred technique of administration of IV sedation midazolam to achieve an appropriate level of sedation?
No bolus dose and titration of 1mg increments
What cannot be changed during construction of a set of complete dentures?
Condylar guidance angle
16ye old girl in the permanent dentition presents complaining about her back to front bite. What is the likely definition of the incision classification?
The lower incisors are anterior to the cingulum plateau of the opposing upper incisors and a reverse overjet is present
Patient brings a letter from an oral MaxFacs surgery department stating they had a unilateral lower motor neurone lesion of the facial nerve last year which resolved after a few months. What signs would you have seen at the time?
A weakness of all the muscles of facial expression and the eye will not close on the ipsilateral side of the lesion
39yr old man with severe anxiety attends for dental treatment. His GP has prescribed him medication for the long term management of his generalised anxiety disorder. What medications has he likely been prescribed?
Fluoxetine
You are about to undertake procedure on a healthy 20kg 5yr old child. What is the maximum dose of 2% lidocaine with 1:80,000 adrenaline can be administered?
4.4ml
Your new dental nurse sustains a needle stick injury. She has been appropriately immunised. In this situation what disease carries the highest risk of cross infection after needle stick injury?
Hepatitis c
While working in dental public health you are asked to help design a study into the benefits of fluoridation of the water supply on the local population. What study design is most appropriate?
Randomised controlled trial
What cell population is the major progenitor for a new connective tissue attachment in guided tissue regeneration?
Periodontal ligament fibroblasts
32yr old women who does not smoke or drink alcohol has a close relative who has died of oral cancer. She has asked you for advice on oral cancer prevention . What is the most likely to reduce her risk of developing oral carcinoma?
Eat at least 5 portions of fruit or veg daily
20yr old women complains she has discolouration of her upper anterior teeth. On examination she has mild fluorosis of the upper incisors. What is the most appropriate initial management?
Tray whitening
25yr old man presents a month after an alleged assault, complaining of a tender maxillary central incisor. It is slightly buccally displaced, vital and causing mild occlusal interference with grade 2 mobility. Radiographic examination reveals no root or alveolar fracture, what is the appropriate initial management?
Orthodontic repositioning
What is the most appropriate instrument for scaling in a 45yr old patient presenting with calculus around an implant stabilised bridge?
Unfilled resin plastic tipped instruments
45year old women attends with diagnosed burning mouth syndrome, what is the most common clinical feature?
Usually bilateral
33yr old women is referred to an oral surgeon according to nice what is the most significant indication for extraction of a mesio-angular impacted lower third molar?
2 episodes of severe pericoronitis
You surgically remove a difficult lower 3rd molar, deep ŵith surgical straight bur during the procedure and notice a lot of bleeding from the site. The patient returns with profound numbness of the lower left lip and chin the next afternoon, what is best course of action?
Send an urgent referral to local oral MaxFacs surgery unit and phone department for advice
25yr old man is assaulted, he has fracture of the left zygomatic arch and surgery is planned. What muscle has an attachment to the superior border of the arch of the zygomatic bone?
Temporalis
