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1
Q

Surgical removal of the lower right third permanent molar (48) which nerves must be anaesthetised?

A

Inferior alveolar nerve
Lingual nerve

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2
Q

What are 2 different ways to test anaesthesia for 48?

A

Using a probe to check the PDL if patient can feel sharp
Use the probe on the patients lip, should feel a difference in the left hand side and the right hand side

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3
Q

List 4 risk factors for mouth cancer.

A

Smoking
Alcohol
HPV
Immunosuppressed

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4
Q

What dose of radiotherapy delivered to the primary tumour increases the risk of ORN?

A

60 Gy

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5
Q

What additional pieces of information do you require to know about radiotherapy treatment?

A

Field of limitation
Dose

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6
Q

List 3 Oral Complications of radiation therapy (other than ORN and radiation caries)

A

Oral Mucositis
Traumatic ulceration
Xerostomia

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7
Q

List 2 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.

A

Regular examinations every 6 months
Avoid invasive treatment that could traumatise the bone
Consider decoronising and leaving the roots in situ

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8
Q

List one management strategy for established ORN in the jaw?

A

Use of chlorhexidine mouthwash (Corsodyl)
Hyperbaric oxygen

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9
Q

Other than Alcohol, list 2 causes of liver cirrhosis?

A

Hepatitis C
Hepatitis B
Non-Alcoholic Fatty Liver disease

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10
Q

List 2 priorities for a patient to render them dentally fit.

A

Good oral hygiene with a regular oral hygiene regime
Remove any infection and potential infection

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11
Q

List 2 reasons why thrombocytopenia may occur in patients with advanced alcoholic liver disease.

A

Occurs due to lower thrombopoietin production in the liver and reduced thrombopoiesis in the bone marrow and consequently thrombocytopenia

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12
Q

Other than thrombocytopenia, why might a patient with advanced alcoholic liver disease may have an increased risk of bleeding?

A

Due to less clotting factors being present in the blood, meaning that the blood doesn’t clot so bleeding does not stop as easily.

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13
Q

Name 3 types of Dementia?

A

Alzheimer’s
Vascular
Dementia with Lewy Bodies
Frontotemporal

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14
Q

List 4 signs or symptoms in someone with Late Stage Dementia.

A

Loss of Speech
Incontinence
Physical frailty, struggle to walk
Difficulty eating and sometimes swallowing

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15
Q

List 2 people who can provide a capacity assessment for dental treatment in accordance with the AWI Act 2000?

A

Doctor
Dentist who has completed the required training

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16
Q

What are the 3 antibiotics that can be given for antibiotic prophylaxis?
Dose?
Time before treatment?

A

Amoxicillin, 60 mins before treatment, 3g
Clindamycin, 60 mins before treatment 600mg (2 capsules)
Azithromycin, 60 mins before treatment 500mg (12.5ml)

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17
Q

What are the predisposing factors of dry socket?

A

More common in mandible than maxilla
More common in females
More common in molars
Smoking after extraction
Oral contraceptive pills
Excessive trauma during extraction

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18
Q

What are the symptoms of a dry socket?

A

Pain keeps patient awake at night
Dull aching pain
Throbbing pain which can radiate to the ears
Halitosis (bad smell) and patient might complain of bad taste

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19
Q

What is the management of a dry socket?

A

Support and reassure the patient
Give systemic analgesia
LA to manage the pain
Irrigate the socket with warm saline
Pack with antiseptic (alvogyl)

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20
Q

What types of tissues can you anaesthetise?

A

Dental Pulp
Buccal Gingivae
Lingual Gingivae

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21
Q

What sensation does Anaesthesia give?

A

Numbness

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22
Q

What sensation does Parasethsia give?

A

Tingling

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23
Q

What sensation does Dysaesthesia give?

A

Unpleasant sensation/pain

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24
Q

What sensation does Hypoaesthesia give?

A

Reduced sensation

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25
What sensation does Hyperaesthesia give?
Increased/heightened sensation
26
What 4 short term impacts can child neglect have?
Physical Health Emotional Health Social Development Cognitive Development
27
What long term affects can child neglect have?
Arrest Depression Heart Disease Suicide
28
What 3 stages are involved in the management of child neglect?
1. Preventative dental team management 2. Preventative multi agency management 3. Child protection referral
29
What do you see on an X-ray of a non-vital tooth?
Ankylosis Internal Root Resorption External Root Resorption Peri-apical radiolucency
30
In nursing bottle caries, why are only certain teeth affected?
Lower incisors are protected by the tongue Sequence of eruption (maxillary incisors erupt first) If the habit continues other teeth will be affected such as the mandibular canine and all the first primary molars
31
What are some causes of Nursing Bottle Caries?
No brushing of teeth- minimal exposure of fluoride Child goes to bed with bottle inside their mouth (long exposure to cariogenic sugars) Prolonged breast feeding Baby may not swallow the contents of the bottle and swirl it around their mouth for a long term
32
What is the correct terminology for a dry socket
Alveolar Osteitis
33
What are the 4 types of supernumerary teeth?
Conical Tuberculate Supplemental Odontome
34
What is the definition of local causes of malocclusion?
A localised problem or abnormality within either arch, usually confined to one, two or several teeth producing a malocclusion
35
How does a variation in tooth number affect malocclusion? 4 examples
Supernumerary teeth Hypodontia Variation of timing --retained primary teeth --early loss of primary teeth --unscheduled loss of permanent teeth
36
What problems can an overhang give rise to in the short and long term?
Short term -Act as a plaque trap making it difficult to keep clean -Food gets stuck in this area -Trauma to the soft tissues Long term -Secondary caries -Failure of restoration -Periodontal disease
37
What further investigations would you carry out if you suspect necrotising periodontal disease?
Radiographs
38
What are the predisposing factors for necrotising periodontal disease?
Stress Nutritional deficiencies Immune-compromised Sleep deprivation Smoking
39
What is the first line of treatment for necrotising periodontal disease?
Debridement and antibiotics (usually metronidazole) Superficial debridement to remove the soft and mineralised deposits Chlorhexidine mouthwash to be used twice daily OHI advice and predisposing factors risk assessments
40
What is the risk of no treatment to necrotising periodontitis?
Pain will persist or it will spread to other areas of the mouth
41
A patient with necrotising periodontal disease returns 2 days later. She feels the gums are still painful and is now complaining of fever and feeling generally tired and unwell , what do you do? (not finished)
200mg Metronidazole 3 times daily for 3 days
42
What are the objectives of irrigant use in root canal treatment?
Disinfection Flushing out debris Dissolving tissue
43
What is the ideal primary endodontic irrigant and what concentration range is it most effective?
Sodium Hypochlorite 0.5-3%
44
What are the 2 main differences in the composition between decorative and dental ceramics?
Decorative ceramics contain Kaolin Dental ceramics contain feldspar and silica Dental ceramics contain glass
45
Define Opalescence
The ability of a translucent material to appear blue in reflected light and orange/yellow in transmitted light
46
Define translucency.
The ability of a material to allow light to pass through but be scattered at one of the surfaces or internally leading to a blurring of the transmitted light
47
Name 2 bacteria associated with caries development.
Streptococcus mutans Actinomyces Lactobacillus
48
Name 2 bacteria associated with periodontal disease.
P. gingivalis Prevotella intermedia Fusobacterium
49
What two key features enable cariogenic organisms stick to enamel surfaces and autoaggregate, and to survive within an acidic environment?
Acid tolerance and adaptation --ATPase release Alter cell membranes DNA protective features Low solubility, glucans, glucosyltransferases
50
Name 2 systemic diseases that have been shown to be associated with periodontal biofilms.
Diabetes Osteoporosis Alzheimer's
51
What are the 5 core stages of the washer-disinfector cycle?
Flush/prewash Main Wash Rinse Thermal disinfection Drying
52
Describe the 5 core stages of the washer-disinfector cycle?
Flush/pre-wash -saturates the contamination and removes gross contamination Main wash -detergent is used to remove biological matter Rinse -removes any remaining residue, biological or chemical Thermal Disinfection -actively kills microorganisms with heated water Drying -Uses hot air to remove any remaining moisture from the surface of instruments
53
What is PICO?
Population Intervention Comparison Outcome
54
What is the most common cause of facial trauma in a female patient?
Domestic Abuse
55
What are the 5 types of abuse that might be involved in domestic abuse?
Physical Emotional Verbal Financial Sexual
56
What process should you follow to ask about the possibility of domestic abuse and briefly describe?
Ask - ask about abuse in as private a setting as you can using non-judgemental language Validate - i.e. you do not deserve to be hurt or hit no matter what happened Document- describe injuries in as much detail as possible using the person's own words Refer- signpost to services available
57
List 4 physical signs you might see in domestic abuse.
Repeated injuries Bruises at different stages of healing Unlikely explanations for injury Facial bruising or strangle marks around the neck, bruises behind the ears
58
List 2 categories of patient who may be considered to be more at risk in terms of abuse than others.
Long term illness or disability Mental health problems Pregnancy
59
List 4 benefits that digital radiography has over film radiography?
Easy transferring/sharing of images Images can be manipulated Easy storage & archiving of images No need for chemical processing Easy back-up of images
60
What is the minimum distance recommended by UK guidance for the dentist to stand from the patient?
1.5m
61
What property of lead makes it particularly effective at absorbing x-ray photons?
high density
62
What does ALARP stand for?
As low as reasonably possible
63
What does the term justification mean in the context of deciding whether or not to take a dental radiograph?
Practices must have sufficient benefit to individuals or society in order to offset the detriment
64
What does dose limitation mean?
System of individual dose limits so that the risks to individuals are acceptable
65
Give 2 fluoride containing preparations, and their doses which would be suitable for a child living in an area with less than 0.3ppm fluoride in the drinking water?
Fluoride Varnish-Duraphat 22,600ppm Fluoride mouthwas, 225ppm Fluoride toothpaste 1450ppm
66
Give 2 reasons a child would be high caries risk?
Early loss/extraction of primary molars New carious lesions Existing restorations
67
At what age do permanent pre-molars erupt?
10-11 years old
68
In which type of malocclusion is injury to the upper anterior teeth most likely to occur?
Class II division 1
69
Give 3 causes of non-carious tooth surface loss?
Carbonated juice Fruit juices Acid gastro-intestinal reflux Grinding teeth
70
Give 2 chairside methods of improving the colour of a non-vital tooth in the long-term?
Internal bleaching Veneer
71
Give 2 chair side methods of improving a child's oral hygiene?
Tooth brushing demonstration/instruction Disclosing tablets/solution
72
What is the cause of a midline diastema?
Low frenal attachment
73
Name 2 types of congenital cardiac abnormality?
Mitral valve stenosis Aortic valve stenosis Atrial septal defect Ventricular septal defect
74
Give 3 methods to monitor teeth affected by trauma long-term.
Mobility Radiographs TTP, percussion Colour
75
Give 2 pieces of advice which you would give to any child's parents regarding possible long-term complications associated with traumatised primary incisors.
Loss of vitality Abscess risk May require extraction Delayed exfoliation
76
Give 2 pieces of advice which you would give to any child's parents regarding possible long-term complications associated with the permanent incisor teeth following trauma to primary incisors.
Delayed eruption Damage to crown development -hypoplasia -hypomineralisation Ectopic eruption
77
What name is given to this technique enabling localisation of the unerupted permanent canine?
Parallax
78
What are the 7 elements of caries risk?
Clinical evidence Fluoride use Medical history Social history Plaque control Dietary habits Saliva
79
What is the normal fluoride concentration in water?
1ppm if fluoridated 0.3ppm if not
80
What is the mechanism by which topical fluoride helps to prevent cavities?
It promotes remineralisation. It affects plaque by inhibiting the bacteria in plaque from producing acid
81
What is adherence?
Describes the degree to which a patient correctly follows medical advice. Usually it is to do with medication regimes
82
What is the fluoride tablet dosage for <0.3ppm in water supply? (0-6months, 6months-3yrs, 3yrs to 6yrs and 6yrs plus)?
0-6 months - 0mg/day 6months -3yrs - 0.25mg/day 3yrs-6yrs- 0.5mg/day 6years plus- 1mg/day
83
What is the fluoride tablet dosage for <0.6ppm in water supply (0-6months, 6months-3yrs, 3yrs to 6yrs and 6yrs plus)?
0-6months- 0mg/day 6months-3yrs- 0mg/day 3yrs to 6yrs-0.25mg/day 6yrs plus- 0.5mg/day
84
What is a risk factor? (PMHP)
An environmental, behavioural or biological factor confirmed by temporal sequence, usually increasing the probability of a disease occurring and if absent/removed reduces the probability
85
What is a cross sectional study? Uses?
The observation of a defined population at a single point in time (or time interval) Used for -estimating prevalence of a disease -investigate potential risk factors
86
What is a cohort study?
Establish a group of individuals in population Measure exposures Follow up over a period of time Identify those that develop disease (outcome of interest)
87
How do nicotine patches work?
Nicotine patch is a transdermal patch that releases nicotine into the body through the skin
88
What are the 2 prescription medications to help smokers stop?
Varenicline Bupropion
89
What is the removal rate of alcohol in blood?
15mg/100ml/hr
90
What is the level of alcohol which can cause death?
400mg/100ml commonly fatal
91
Describe the cycle of change? (alcohol)
Precontemplation -there is no need to change, my friends drink more Contemplation -I hear what you are saying, I know it is bad for me Preparation -I am going to cut down drinking next week Action -I have cut down on my drinking Maintenance -I have only been drinking 1 night a week for the last 6 months
92
What are competent lips?
Upper and lower lip meet at rest and maintain anterior oral seal, relaxed mentalis muscle

MSA Questions (3 decks)

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