PAST PAPER STATIONS Flashcards
What are the criteria for good bitewing radiographs?
- show buccal teeth from MESIAL OF FIRST PREMOLAR to DISTAL OF LAST TOOTH (upper and lower equally)
- MUST be able to see enamel dentine junction
- no overlap of teeth
What are the criteria for good periapical radiographs?
- FULL LENGTH of (at least) one tooth
- surrounding anatomical features (e.g apex, bone, sinus, nerve canals)
Patient attends with NUG, what do you prescribe and what instructions do you give?
Prescribe = 1x 400mg Metronidazole, 3 times a day, for 3 days AND 0.2% Chlorhexidine mouthrinse
- finish course
- unsuitable for pregnant patients and warfarin patients
- avoid alcohol
Instructions = clean teeth as normal, be careful around punched out papillae, rince twice a day with 10ml of 0.2% Chlorhexidine do this at a separate time from brushing as toothpaste will make it not work, use 1450ppm toothpaste 2x per day, interdental cleaning if possible
What is the mini-sickle? What is it used for?
Double-ended point scaler with 2 cutting edges on each blade
- buccal and lingual embrasure areas anywhere in mouth
What is the columbia universal curette? What is it used for?
A curved, spoon shaped blade with 2 cutting edges. Cutting edges meet to form a rounded toe.
- supra and subgingival scaling anywhere in mouth
What is the red hoe scaler? What is it used for?
Blade set at 100º angle to shank & cutting edge bevelled at 45º.
- used on mesial and distal surfaces subgingivally with cutting angle of 90º to tooth surface
What is the yellow hoe scaler? What is it used for?
Blade set at 100º angle to shank & cutting edge bevelled at 45º.
- used on buccal and lingual surfaces subgingivally with cutting angle of 90º to tooth surface
How many cutting edges do gracey curettes have?
One
Describe gracey curettes:
- One cutting edge
- Angle of 110º between lower shank & face of the blade
- Cutting angle of 70º
- Blade curves in 2 planes
- Double ended & mirror image pairs
What is the grey Gracey Curette used to scale?
Anterior teeth (upper and lower)
What is the green Gracey Curette used to scale?
Buccal and lingual surfaces of posterior teeth
What is the orange Gracey Curette used to scale?
Mesial surfaces of posterior teeth
What is the blue Gracey Curette used to scale?
distal surfaces of posterior teeth
What colour is the 1-2 Gracey Curette?
grey
What colour is the 7-8 Gracey Curette?
green
What colour is the 11-12 Gracey Curette?
orange
What colour is the 13-14 Gracey Curette?
blue
What is charted in complete 6PPC?
- gingival margin
- pocket depth
- loss of attachment
- BOP
- mobility
- furcations
A score of Code 2 is given in the modified plaque score when:
There are visible plaque deposits
Which are Ramfjords teeth?
16, 21, 24, 36, 41, 44
When scaling labial and lingual surfaces of teeth 43-33, where does the operator sit?
7 o’clock position
When scaling buccal surfaces of teeth 44-48, where does the operator sit?
9 o’clock
When scaling lingual surfaces of teeth 34-38, where does the operator sit?
9 o’clock position
When scaling buccal surfaces of teeth 14-18, where does the operator sit?
9 o’clock
When scaling lingual surfaces of teeth 44-48, where does the operator sit?
11 o’clock
When scaling buccal surfaces of teeth 34-38, where does the operator sit?
11 o’clock
When scaling labial palatal surfaces of teeth 13-23, where does the operator sit?
11 o’clock
When scaling palatal surfaces of teeth 14-18, where does the operator sit?
11 o’clock
When scaling buccal and palatal surfaces of teeth 24-28, where does the operator sit?
11 o’clock
What is the periodontal grade based on? what are the options?
% bone loss DIVIDED BY patients age
<0.5 = Grade A (slow rate of progression)
0.5-1.0 = Grade B (moderate rate of progression)
>1.0 = Grade C (rapid rate of progression)
What is the periodontal stage based on? what are the options?
Amount of interproximal bone loss (at worst site)
<15% = Stage I
Coronal Third = Stage II
Mid Third = Stage III
Apical Third = Stage IV
What does staging show in periodontal diagnoses?
The severity of disease
What does grading show in periodontal diagnoses?
Speed of progression of disease
What is stability of disease in periodontal diagnoses assessed by?
Presence of inflammation (BOP)
What blood test would you take if you suspected your patient had anaemia?
Full blood count
- look at mean cell volume
What mean cell volume result would suggest patient had microcytic anaemia?
<80fl
What mean cell volume result would suggest patient had normocytic anaemia?
80-100fl
What mean cell volume result would suggest patient had macrocytic anaemia?
> 100fl
What are some causes of microcytic anaemia?
- iron deficiency
- alpha/beta thalaessemia
- chronic inflammatory disease
What are some causes of macrocytic anaemia?
- vitamin B12 deficiency (pernicious anaemia)
- folate deficiency
- hypothyroidism
- alcohol abuse
- pregnancy
- drug induced (methotrexate)
What are some causes of normocytic anaemia?
- blood loss/bleeding
- haemolytic anaemia
- bone marrow disorder
Why can bone marrow disorders lead to anaemia?
Bone marrow unable to produce RBCs that package haemoglobin
Why can chronic kidney disease lead to anaemia?
Reduced erythropoietin levels (produced in kidney)
Why can hypothyroidism lead to anaemia?
Thyroid hormones facilitate erythropoesis
What is pernicious anaemia?
Anaemia caused by Vitamin B12 deficiency due to lack of intrinsic factor
What blood tests should be taken in a patient with suspected haemolytic anaemia and what results would be seen?
- LDH (elevated)
- Reticulocyte ( elevated)
- Biliruben (elevated)
- Haptoglobin (low)
What are the signs of anaemia?
- pallor
- tachycardia
- scleral icterus (jaundice eyes)
- enlarged liver & spleen
What are some symptoms of anaemia?
- tired & weak
- dizzy
- shortness of breath
- palpitations
Why do we mark the high smile line on record blocks?
Gives an idea of how much tooth will show when smiling
Why do we mark the centre line on record block?
To ensure midline of teeth matches up with patients face midline
What does the canine line on record blocks dictate?
The size of tooth to use
What does INR stand for?
International Normalised Ratio
Patient presents with excessively dry mouth, how would you test for Sjögren’s syndrome?
- also dry eyes?
- blood test to check for Anti-La antibody (Anti-Ro & ANA also)
- biopsy/imaging of salivary gland
What areas may need to be relieved on an upper denture?
Incisive papilla and palatine torus
What is the lingual pouch used for in lower dentures?
Retention
What emergency drugs are used in dental practises for medical emergencies?
Oxygen = 15L/min for everything
Adrenaline = 1:1000 0.5mg IM injection
GTN spray = 400 micrograms, 2 puffs under tongue
Aspirin = 300mg chewed
Salbutamol = 2x 100microgram actuations to anyone with a wheeze hold for 10s. In severe asthma patients give up to 10 actuations via spacer device let them breathe for 20s
Glucose = fast acting gel
Glucagon = 1mg IM injection
Midazolam = 10mg via buccal mucosa when prolonged seizures
Give the name of a polyether impression material & give some uses:
Impregum
- situations where high accuracy is needed
- crowns, bridges, implants
Give the name of a irreversible hydrocolloid impression material & give some properties:
Alginate
- primary impressions
- diagnostic casts
- study models
Give the name of a reversible hydrocolloid impression material & give some properties:
Agar
- high accurate scenarios
- implant restorations, complex restorative cases, orthodontic studies
Give the name of a addition silicone impression material & give some properties:
Polyvinyl siloxane
- crown, bridges and implants
- cases with deep subgingival margins
Give the name of a non-elastic impression material & give some properties:
Impression compound
- dentures
- temporary crowns and bridges
- special trays
What pieces of equipment are use in paediatrics to achieve moisture control?
- dental dam
- cotton wool rolls
- parotid shield/dry guard
- tongue retractor
- aspirator
- saliva ejector
At what age to permanent lower central incisors erupt (approx.)?
6 years old
At what age to permanent lower first molars erupt (approx.)?
6 years old
At what age to permanent upper central incisors erupt (approx.)?
7 years old
At what age to permanent lower lateral incisors erupt (approx.)?
7 years old
At what age to permanent upper lateral incisors erupt (approx.)?
8 years old
At what age to permanent lower canines erupt (approx.)?
9 years old
At what age to permanent upper & lower first premolars erupt (approx.)?
10 years old
At what age to permanent upper second premolars erupt (approx.)?
10.5 years old
At what age to permanent upper canines erupt (approx.)?
11 years old
At what age to permanent lower second premolars erupt (approx.)?
11 years old
At what age to permanent lower second molars erupt (approx.)?
11 years old
At what age to permanent upper second molars erupt (approx.)?
12 years old
At what age to permanent upper and lower third molars erupt (approx.)?
17 years old
What does SOCRATES stand for?
- Site
- Onset
- Character
- Radiation
- Associated factors
- Time course
- Exacerbate/relieving factors
- Severity
What should be checked during the extra-oral exam?
- Symmetry
- TMJ = clicking, deviation on opening, locking
- Lymph nodes = any swelling/hardness/tenderness
- MOM = any tenderness etc.
What should be checked during an intra-oral exam?
- Buccal mucosa
- Labial mucosa
- Tongue surfaces
- Palate (hard & soft)
- Floor of mouth
- Gingiva
What is angina?
Chest pain due to ischemia (lack of blood flow; lack of oxygen) of the heart muscle
- characterise by restrosternal chest pain or discomfort (tightness/heaviness) that may radiate
What is stable angina vs unstable angina?
Stable = chest pain or discomfort that occurs during activity or stress and is relieved by rest
Unstable = lack of blood flow and oxygen that occurs at rest and may lead to a heart attack. Refer to GMP or ambulance if worsening
What do you do if your patient is experiencing angina?
- stop treatment & sit upright
- oxygen 15L/min via breathing mask
- GTN spray
- Aspirin 300mg chewed
What drugs does warfarin interact with ?
- Metronidazole
- NSAIDs (ibuprofen/aspirin)
- Carbamazepine inhibits warfarin
What complications will a patient with Sjögren’s syndrome suffer with?
- dry mouth
- burning mouth
- caries
- difficulty with denture retention
- difficulty with speech and swallowing
- increased risk of oral infection
- long-term risk of salivary lymphoma
What occurs during the “ask” portion of the 5 As?
- do you smoke?
- how many per day?
- when first cigarette in day?
- why do you smoke?
What occurs during the “advise” portion of the 5 As?
- Are you aware of the health benefits of quitting?
- Quitting is the single most effective way to improve health status
- Past failure will increase chances this time round
- Causes: lung cancer, heart disease, oral cancer, gum disease, stained teeth
What occurs during the “assess” portion of the 5 As?
- Have you ever considered quitting?
- Would you like help?
What occurs during the “assist” portion of the 5 As?
- Negotiate a stop date
- Review previous failed attempts and anticipate problems
- Inform of nicotine replacement therapy/e-cigs
What occurs during the “arrange” portion of the 5 As?
- refer to services
- monitor
- support and encourage continued cessation at future appointments
What are the 5 R’s associated with smoking cessation?
- Relevant benefits
- Risks
- Rewards
- Roadblocks
- Repeat
What is reversible pulpitis?
- Mild inflammation to pulp caused by caries, exposed dentine, defective restoration
- Tooth may respond more to cold & sweet (usually not warm)
- Stimuli produces sharp pain (A delta) that resolves within 5-10 seconds after stimuli removed
- Once inflammation is removed pulp returns to normal & symptoms subside
What is irreversible pulpitis?
- Can be symptomatic or asymptomatic
- Dull aching pain that lasts minutes or hours (c fibres)
- Worse at night or when lying down due to increase in intra pulpal pressure
- Removal of causal factor does not lead to pulp regeneration
- If left untreated will become necrotic (XLA or RCT)
You are about to give LA to a patient, what are the steps of the procedure?
- Open cartridge and check expiration date & batch number
- Secure needle into handle & ensure click
- Pull back safety sheathe to click once
- Test LA to see if it works
- Pull safety sheathe down until going to use
Why are paper points used in endodontics?
To ensure canal is dry before medicating or obturating
What is Ledermix?
Corticosteroid and antibiotic mixture that helps hot, infected pulps to reduce inflammation
What are the constituents of Gutta Percha?
- 20% gutta percha
- 65% zinc oxide
- 10% radiopacifiers
- 5% plasticers
What are the parts of caries risk assessment?
- medical history
- oral hygiene/plaque control
- clinical evidence of caries
- diet
- fluoride use
- saliva
- social history
How long is a splint placed in PRIMARY dento-alveolar fracture?
3-4 weeks
How long is a splint placed in Subluxation?
2 weeks flexible
How long is a splint placed in intrusive and extrusive luxation?
2 weeks flexible
How long is a splint placed in avulsion?
2 weeks flexible
How long is a splint placed in lateral luxation?
4 weeks flexible
What are alkaline hypochlorites good for in denture cleaning?
- effective dissolution of plaque
- stain removal properties
- bacterial and fungicidal properties
What are some cons of using alkaline hypochlorites to clean dentures?
- possible bleaching of acrylic resin
- residual taste after use
