PMHP

Question 0

Define “discrediting stigma”

Answer 0

When the disfigurement is obvious and visible; and cannot be hidden

Question 1

Define negligence

Answer 1

The omission to do something which a reasonable practitioner would do; or, doing something a reasonable practitioner would not do.

Question 2

Define “discreditable stigma”

Answer 2

Disfigurement only known to sufferer and a few others; eg. Psoriasis, mastectomy

Question 3

Define enacted stigma

Answer 3

The reaction of others e.g. Pity, disgust, bullying, shunning, mockery

Question 4

Define felt stigma

Answer 4

The loss of self esteem of the sufferer; more prevalent than enacted stigma
E.g fear of rejection, withdrawal, depression, anxiety

Question 5

Define epidemiology

Answer 5

The study of populations in order to determine the frequency and distribution of disease

Question 6

Name 4 socio-demographic factors

Answer 6

Age
Ethnicity
Gender
Class

Question 7

Name 4 socio-psychological factors

Answer 7

Attitudes
Knowledge
Previous experience
Experiences in country of origin

Question 8

Name 3 barriers (inhibiting factors) of visiting dentist

Answer 8

Cost
Anxiety
Language

Question 9

Name 3 triggers (enabling factors) for going to the dentist

Answer 9

Pain
Impact
Regularity

Question 10

Name 5 oral health related behaviours that affect oral health status

Answer 10

Service use (attendance)
Tooth cleaning
Smoking
Chewing tobacco
Diet

Question 11

Define “hypomineralised”

Answer 11

Disturbance of enamel formation resulting in reduced mineral content

Question 12

Define “hypoplastic”

Answer 12

Decreased bulk or thickness of enamel
2 types: True- enamel never formed
Acquired- post eruptive loss of enamel bulk

Question 13

What is the prevalence of molar incisor hypomineralisation?

Answer 13

10-20%

Question 14

Name 3 clinical problems of MIH

Answer 14

1) Loss of tooth substance
- breakdown of enamel
- tooth wear
- secondary caries
2) Sensitivity
3) Appearance

Question 15

Treatment of options for MIH (molars)

Answer 15

Composite/GIC restoration
Stainless steel crowns
Extraction

Question 16

Treatment options for MIH (incisors)

Answer 16

Acid pumice micro abrasion
External bleaching
Localised composite placement
Full composite veneers
Full porcelain veneers

Question 17

3 main symptoms of depression

Answer 17

Decreased energy
Low mood
Anhedonia (lack of enjoyment from things previously enjoyed)

Question 18

What oral health effects can depression cause?

Answer 18

Decreased oral hygiene and adherence to advice due to self neglect

Comfort eating resulting in increased sugary snacks and therefore increased risk of caries

Xerostomia due to antidepressants

Decreased immune response

Question 19

Name some physical symptoms of anxiety

Answer 19

Dry mouth
Headache
Muscle tension
Heart palpitations
Hyperventilation

Question 20

Name some psychological symptoms of anxiety

Answer 20

Poor concentration
Feelings of fear or impending doom
Dizziness
Restlessness
Insomnia

Question 21

Name oral health effects of anxiety

Answer 21

Physiological:

• Altered immune response which affects susceptibility to periodontitis
• Altered salivary secretion leading to dry mouth
• More likely to smoke/drink/eat

Pathological:

• Anorexia nervosa
• Bulimia nervosa

Question 22

Define dental fear

Answer 22

Reaction to one or more threatening stimuli in dental environment
E.g. Drill

Question 23

Define dental anxiety

Answer 23

Feeling of dread; apprehension; “losing control”; fear

More generalised than dental fear

Question 24

Define dental phobia

Answer 24

Severe type of dental anxiety

Manifested as marked and persistent anxiety in relation to clearly discernible objects or dental environment in general

Question 25

What are the 3 cause of dental anxieties?

Answer 25

Conditioning: from own experiences and reactions

Modelling: from the fear of parents

Information: fear of unknown, or from hear frightening information from others

Question 26

How is anxiety measured in adults?

Answer 26

Dental anxiety scale (tick box test)

Question 27

How is dental anxiety measured in children?

Answer 27

The Vanham picture test

Question 28

What disadvantages does the test to measure children’s anxiety have?

Answer 28

Pictures are all of boys

Pictures can be somewhat ambiguous

Question 29

How can anxiety be managed?

Answer 29

Acknowledge anxiety
Create a trusting relationship
Be realistic
Be predictable
Give patient control
Coping strategies
Medication
Desensitisation 
Relaxation training
Establish fear hierarchy
Repeatedly expose to feared event

Question 30

Name actions that could be causes for complaint

Answer 30

Screw ups, mistakes
Deficiency in clinical standard
Unnecessary treatment
Confidentiality breach
Proper consent not obtained
Unprofessional manner
Inappropriate conduct

Question 31

What is the standard in Scotland, which if failed to meet is negligent?

Answer 31

1. There is a usual and normal practice
2. The dentist did not adopt that practice
3. The course the dentist adopted is one which no dentist of ordinary skill would have taken if acting with ordinary care

Question 32

What 4 things does negligence result from?

Answer 32

Failure to:
Meet the duty/standard of care
Undertake the usual standards
Leading to harm/ damage
Which was foreseeable

Question 33

Under what circumstances can consent be given? (6)

Answer 33

Voluntary
Still valid
Specific to treatment
Appropriately informed
Capacity
No pressure

Question 34

What 5 conditions must be met for a person to have capacity?

Answer 34

Ability to decide
Ability to make reasonable decision
Ability to understand decision
Will later remember decision
Able to communicate decision