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BDS 3 Sem 1 > Pre-exam questions > Flashcards

Pre-exam questions Flashcards

1
Q

What does COLDSPA stand for?

A

Character
Onset
Location
Duration
Severitty
Pattern
Associated factors

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2
Q

What are two major categories of comparative tests?

A
  1. Peripradicular - percussion, palpation, biting test
  2. Pulpal - thermal tests, eletric pulp tests, diagnostic anaesthetic tests, test cavity

REMEBER TO ASSESS OTHER TEETH FIRST BEFORE THE TOOTH YOU SUSPECT

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3
Q

What is the status of the pulp if the pulp sensebility test came back with no response?

A

No response = non-vital pulp or false- negaitve

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4
Q

What is the status of the pulp if the sensibility test came back with a mild response?

A

Mild response = normal pulpal health

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5
Q

What is the status of the pulp if the sensibility test came back with a strong bu brief response?

A

Strong but brief response = reversible pulpitis

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6
Q

What is the status of the pulp if the sensibility test came back with a strong but lingering response?

A

Strong but lingering = irreversible pulpitis

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7
Q

What are some of the causes of false negatives during pulpal sensibility testing?

A
  1. Calcified canals
  2. Immature apex
  3. trauma
  4. Premedication of the patient
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8
Q

When would you do a pulp test?

A
  1. Prior to restorative dental treatment
  2. Prior to root canal therapy
  3. Following trauma to teeth
  4. Prior to other dental treatment
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9
Q

What is DPR?

A

DPR or Dental Panoramic Tomography - a body section imaging technique that results in a wide, curved image layer depicting the maxillary and mandibular dental arches and their supporting structures

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10
Q

What are some of the advantages of DPR imaging?

A
  1. All teeth and supporting structures are shown in one mage
  2. Allows comparison of left and right sides to assess for symmetry
  3. Image is easy for patient to understand
  4. Reasonably comfortable
  5. Minimal infection control procedures
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11
Q

What are the disadvantages of the DPR technique?

A
  1. Reduced resolution/detail compared to intraoral films
  2. Superimpositions - of all soft tissue and hard tissue
  3. May not be suitable for children under 5 or those unable to stand still
  4. Wheelchair access may be difficult
  5. Anatomical variation can make imaging difficult
  6. Equipment is relatively expensive
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12
Q

How to maintain staff safety during the OPG?

A
  1. Distance
  2. Position
  3. SHielding
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13
Q

What is the clinical importance of the focal trough?

A
  1. Structures within the trough are relativley well defined int he final image
  2. The closer a structure is to the centre of the trough the more sharply defined is the final image. The further, the blurrier.
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14
Q

What happens to the structures that lie buccaly to the trough?

A

There is a reduction in horizontal plain is reduced - making the object less wide

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15
Q

What happens to the structures that lie lingually to the trough?

A

There is a magnification in the horizontal plain - making the objects more wide

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16
Q

What will happen if the patient rotates their head during taking of the DPR?

A

You will experience both distortions - meaning that one of the sides will appear wider than usuall and the other slimmer than usual

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17
Q

What are primary and secondary images?

A
  1. Primary - real images
  2. Secondary - ghost images

Primary - occur when the structure lies between the centre of rotation and the detector - objects in front of the centre of rotation - rather further from the tube

Secondary - occur when the structure lies between tube head and centre of rotation - object is behind the centre of rotation - rather closer to the tube

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18
Q

How do we identify secondary images?

A
  1. They are blurred and put of focus
  2. They have the same orientation as the primary image
  3. They are larger than primary image
  4. They are higher up and on the opposite side
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19
Q

How to examine the entire panoramic images?

A
  1. Examine for quality of the image first - check image sharpness, contrast and density
  2. Examine the image for patient preperation and positioning
  3. Examine the image fro diagnostic purposes - are structure examined well displayed?
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20
Q

What are the zones of the panoramic imaging assessment?

A

Zone 1 - Nose and sinuses
Zone 2 - Md Body
Zone 3 - Articular Eminence, Condyle, Mx Tuberosities, Pterygo Mx
Fissures, EAM, Cervical Spine
Zone 4 - Epiglottis
Zone 5 - Md Ramus and Spine
Zone 6 - Dentition

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21
Q

How would you describe any radiographic finding on a DPR?

A
  1. Multipel or solitary
  2. Monostotic (affecting single bone) or polyostotic (affecting multiple bones
  3. Locaiton
  4. Unileral or bilaterla
  5. Size
  6. Shape
  7. Border
  8. Density
  9. Impact on adjacent structure
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22
Q

How do you record consent on titanium?

A

Use #CONSENT:
1. When you take initial consent for an examination
2. On the date that the patient agrees to the proposed treatment plan
3. If during the Course of Care, your initial treatment plan is altered

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23
Q

What type of framework are you going to use to access hard tissue or soft tissue abnormalities?

A

Site
Size
Morphology
Colour
Cosnistency
Texture

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24
Q

What is abrasion?

A

It is a loss of tooth structure due to contact with an exogenous item. It is characterised by a specific pattern - a good example is a cervical lesion

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25
Q

What is erosion?

A

Loss of tooth structure due to a strong acidic sources. Characterised by scooping pattern and exposed dentine. Hard to restore due to loss of dentinal collagens

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26
Q

What is attrition?

A

Loss of tooth structure due to tooth-tooth contact

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27
Q

What is dental alginate?

A

It is an irreversible hydrocolloid material that is used in dentistry for impressions

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28
Q

What is the role of sodium alginate in alginate material?

A

Sodium alginate forms a hydrogel former

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29
Q

What is the role of calcium sulphate dihydrate in alginate material?

A

It provide calcium ions

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30
Q

What is the role of sodium phosphate in alginate material?

A

It controls working time - acts as a retarder of the rapid use of calcium within the reaction

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31
Q

Describe the setting process of alginate.

A
  1. When mixed with water, a cross-link polymer chain is formed, resulting in a three-dimensional network structure
  2. Calcium sulphate dihydrate provides the Ca ions for the cross-linking reaction that the sol to a gel
  3. In order to decrease the setting time, sodium phosphate is added, which acts as a retarder, decreasing the number of Ca ions available for cross linking
  4. When a certain threshold of Ca ions have been achieved, the cross linking reaction fully sets
32
Q

What is syneresis?

A

It is the loss of fluid within the alginate gel - this causes shrinkage

33
Q

What is evaporation?

A

It is the loss of water from the surface of the alginate gel - this causes shrinkage

34
Q

What is imbibition?

A

It is swelling of the alginate if immersed in water - this causes distortion

35
Q

What are the criteria to assess alginate impresion?

A
  1. Alginate mix is homogenous and smooth - is it mixed well, is it too runny
  2. Tray appropriate size - are all teeth included and past the tuberocity area
  3. Alginate has had adequate time to be inserted into the mouth, seated onto the teeth and set prior to removal - is it seated on teeth correctly, has it set, has the material flown past the CEJ
  4. Adequate amount of alginate in tray and the treay has been seated and muscled trimmed correctly - has muscle been trimmed, have the tongue been placed properly
  5. Tray has been removed correctly
36
Q

What are three most common anaesthetics used in the ADH

A
  1. 2% Lignocaine with 1:80000 adrenaline (Lignospan special)
  2. 3% Mepivicaine (Scandonest Plain)
  3. 4% Articaine with 1:100000 adrenaline (Articadent)
37
Q

What is the purpose of methylparabens in LA solution?

A

They act as an antibacterial preservative?

38
Q

What is the purpose of bisulphote in LA solution?

A

They act as an anti-oxidant for the vasoconstrictor

39
Q

What are the three important aspects of performing an appropriate inferior alveolar block?

A
  1. Level - coronoid notch, 1 cm above lower occlusal plane, midway between arches with mouth wide open
  2. Angle - opposite premoalrs
  3. Entry point - pterygotempora depression - but this may be missing so rely on the palpation of the coronoid notch
40
Q

What to do in SADS if a patient shows symptoms of syncope?

A
  1. Stop dental treatment
  2. Elevate patient’s legs to achieve a position where their head is lower than the heart. If patient is in dental chair, tilt the chair back to a horizontal angulation
  3. Allow patient to recover slowly
  4. Measure patient’s blood pressure & heart rate
41
Q

What are the steps to gingival assessment?

A

C - colour
C - contour
C - consistency
T - texture
E - exudate

42
Q

What are the steps to ILA?

A
  1. Patient
  2. CC
  3. MHx
  4. SHx
  5. DHx
  6. Exam
43
Q

What is TRIM?

A

TRIM is an acronomy for:
Timing
Relevance
Involvment
Method

44
Q

How would you assess the teeth on the radiograph?

A
  1. State what radigraph and side you are looking at
  2. FDI: notatation with restorations and radioopacities
  3. Pathology: radiolucencies, extent and causes
45
Q

What are the steps to occlusal analysis?

A

1.Teeth present/missing
2.Morphology of teeth
3.Wear - mild, moderate, sever
4.Crowding,spacingrotations
5.Axail inclanations
6.Shape of dental arch
7.Cruve of spee and wilsons curve
8.Angle molar classification/canine classification
9.Overbite (%) / overjet (mm)
10.Mediolateral

46
Q

What nerve innovate the upper molars?

A

The posterior superior alveolar nerve

47
Q

What nerve innovates the upper premolars?

A

The middle superior alveolar nerve

48
Q

What nerve innovates the anterior upper teeth?

A

The anterior superior alveolar nerve

49
Q

During odontogenic infection, what is the path of least resistance in the mandible?

A
  1. If above the mylohyoid line, the infection would progress lingually, eroding the lingual cortical plate and entering the sublingual space. This will elevate the tongue and create diffuculties with breathing
  2. If below the mylohyoid line, the infection would progress down into the submandibular space. This may causes swelling near the angle of the ,and able to potentially causing trismus and therefore diffuculties chewing..
50
Q

What does informed consent include?

A
  1. Alternatives and all options for treatment
  2. Information surrouding the nature and what the treatment involves
  3. Risks of treatment
  4. Pros and Cons of treatment and No intervention
  5. Cost of treatment
51
Q

How to write a diagnostic statement for gingivitis?

A
  1. Extend - localised or generalised depending on the BOP
  2. Disease - gingivitis
  3. Specification - biofilm induced, mediated by pregnancy or leukemia
52
Q

How do we treat necrotising gingivitis?

A
  1. Debridment under LA (removal of biofilm, calculus and necrotic tissues)
  2. Local irrigation with chlorhexidine 0.2%
  3. Antibiotic therapy - Metronidazole 400 mg orally, 12-hourly, 3-5days
  4. Review and reffer when needed
53
Q

How to write a diagnostic statement for periodontitis?

A
  1. Type of periodontal disease - periodontitis
  2. Disease extent - generalised or localised
  3. Stage - I, II, III, IV
  4. Grade - A, B, C
  5. Current disease status - stable, remission, unstable
  6. Risk profile smoking, diabetes, etc

E.g. Periodontitis; generalised, Stage III, Grade C, currently unstable. Risk factors: smoking 20cig/day

54
Q

What are indications for indirect pulp capping?

A
  1. Deep cavity
  2. No pulpal exposure
  3. Removal of all infected dentine may result in pulpal exposure
  4. No signs or symptoms of irreversible pulpits
55
Q

What is the most important aspect of indirect pulp capping?

A

CORONAL SEAL IS VITAL.

56
Q

Why can facial paralysis occur during IANB administration?

A

Cause: needle was positioned too far posteriorly & LA administered instead in the body of the parotid gland where facial and tympanic nerve run through

Signs + sympotms: Facial paralysis, unilateral, drooping of eyelid and upper lip / corner of mouth

Managment:
1. Tell patient this is temporary
2. Tell patient to not rub their eye
3. Cover the affected eye with eye patch
4. Keep under observation until better
5. No driving back home
6. IF not recovered in 12 hours - will need a medical review

57
Q

Why can truisms occur during IANB application?

A

Causes: Trauma to the muscles or blood vessels, often caused by withdrawing the needle through tissue distension

Signs + symptoms: may present as a prologned spasm of the jaw muscles with limited or complete inability to open the mouth, or pain associated with mouth opening

Managment: Usual improvement within 48-72 hurs with up to 6 weeks for complete recovery. Patient may seek heat therapy, wamr saline rinse, soft diet & jaw exercises.

58
Q

Why can soft tissue damage occur during IANB administration?

A

Cause: It is usually self-inflicted injury by the aptient themselves; induced trauma or burn

Sings + symptoms: May present as a soft tissue lesion, accompanied by localised pain and swelling. More noticeable once LA has worn off.

Managment: Provide appropriate post-operative insructions. If sever, antibiotics may be prescribed to void infection. Warm saline rinses.

59
Q

Why can temporary blidness occur during the IANB administration?

A

Cause: Intravascular administaton. Pathway: Inferior alveolar nerve into middle meningeal artery into opthalmic artery causing loss of vision

Signs + Symptoms: Loss of vision a few minutes post IANB administration.

Managment: Stop dental treaatment. Call 000 because patient needs to go to the emergency department. CPR if patient is unconcious.

60
Q

Why can persisten anaesthesia occur when administering IANB?

A

Cause: Direct sensory nerve damage caused by the needle. Injecting too much LA at high concentrations. Haemorrhage from around/near the neural sheath put pressure on the nerve

Signs + symptoms: paraesthesia will vary depending on structures involved - usually drooling, numbness, pins & needles. If damage to lingual nerve there can be altered taste sensation.

Management: Paraesthesia resolves within approx 8 weeks, if above 8 weeks refer to oral surgeons. Reassure patient and reassess

61
Q

Why can heart palpitations occur during administration of IANB?

A

Cause: Intravascular injection may cause an excitation of the cardiovascular system

Signs + symptoms: Tachycardia, palpitations and headache

Management: Typically only short in duration. Ensure to stop procedure and monitor the patient.

62
Q

Why can oedema occur during IANB administration?

A

Cause: May be caused by physical trauma, an allergic response, haemorrhage or irritation

Signs + symptoms: Present as a swelling tissues on the medial side of the ramus after deposition of LA

Managment: Pressure and cold compress applied to the area for 3-5 minutes, acoompanied by warm saline rinse

63
Q

Why can tingly in the trap and throat happen during IANB administration?

A

Causes: 1) LA travelling down the brachial plexus (unlikely)
2) LA deposited too far back into the fascia surrounding pharyngeal muscles -> anaesthetised supraclavicular branch of cervical plexus that innervates ur traps -> arm numbness (more likely)

Sing + symptoms: Tingling in the throat and trap

Managment: Reassure patient it is temporary. Monitor. If the paraesthesia is persistent, need to get medical care.

64
Q

How would you write a treatment plan?

A

Using this framework:
1. Completion of all histories
2. Taking consent for additional testing: e.g.tri-plaque gel
or radiographs
3. Diagnosis and treatment plan presentation to the patient + consent for treatment plan
4. Pain management/CC
5. Preventative care: e.g. oral hygine instructions
6. In chair treatment
7. Close date recall with reassessment of ongoing condition changes
8. Transition to regular recall

65
Q

How would you write your statement for LA administration?

A
  1. Put the local anaesthetic : 5% lidocaine Ziagel placed into buccal sulcus near 22
  2. Put the technique : Supraperiosteal infiltration
  3. Put the anaesthetic and amount and purpose: Lignospan special (2% lignocaine with 1:80000 adrenaline), 1/2 carpule for both soft tissue and pulpal anesthesia
66
Q

What are the 5 important aspects of keeping records

A
  1. Detail
  2. Accuracy
  3. Legibility
  4. Accessibility
  5. Retention
67
Q

What is the key differene between the Miller technique and Tube shift technique in localisation?

A
  1. Miller technique - two radiographs are taken at right angles to each other - good at determining the position of an impacted tooth
  2. Tube shift - a slight shift of the tube is needed after the first radiograph (SLOB) to discern which root is which
68
Q

What is the purpose of a facebow?

A

It relates a patients maxillary arch to the intercondylar axis and the point orbital and enable these relationships to be transferred to an artiulator where this can be reproduced

69
Q

What is the purpose of a facebow?

A

It relates a patients maxillary arch to the intercondylar axis and the point orbital and enable these relationships to be transferred to an artiulator where this can be reproduced

70
Q

How do you perform a cold test?

A
  1. Identify a tooth in question
  2. Dry the tooth thoroughly and also try a tooth that you would use a base reading (maybe two)
  3. Explain to the patient to indicate if they feel pain using their hand
  4. Ask the DA to apply endofrost on a cotton bud while you retract the tissue over the tooth you going to use as base reading
  5. Carefully, without touching soft tissue, place the cotton bud with endo frost on the tooth that is used as baseline
  6. When the patient reacts, remove the cotton bud and ask how they feel - it should be “It felt cold but it went aaway fast”
  7. Now move on to the tooth in question and repeat the procedure
71
Q

How do you perform and Electric pulp test?

A
  1. Ensure the patient understands what the procedures entitles
  2. identify the tooth of interest
  3. Dry the tooth thoroughly and also try a tooth that you would use a base reading (maybe two)
  4. Ask the patient to hold on to the lip clip for you
  5. Ask the patient to indicate when they feel something by raising their hand up
  6. Make sure that the light on the Electric pulp test is visible by operator, apply tooth paste to the tip of the EPT pen for conduction and begin conduction on the baseline tooth - carefully without touching the soft tissue and maintaining appropriate moisture control
  7. When patient reacts, record the reading and move onto the tooth in question
72
Q

How to perform indirect pulp capping?

A
  1. Do normal steps of caries removal BUT do not remove all of the infected dentine
  2. When try to remove as much infected as possible, slowly, preferably not using a power headpiece with leaving a small layer at the bottom of the cavity prep
  3. Using RMGIC or GIC base cover the cavity, incrementally, ensuring THERE IS APPROPRIATLEY CORONAL SEAL
  4. Reduce the RMGIC and replace with Resin
  5. Tell the patient they might experience sesativity in the tooth, thus might needs to take some NSAIDS -recall in 3 months for re-examination if the tooth remains asymptomatic
73
Q

What are the potential causes of reaction to LA for a patient with dental anxiety?

A

Patient causes: panic attack due to hyperventilation and dental anxiety

Operator: Intravascular injection

Or Both at the same time

74
Q

How to manage a gagging patient?

A
  1. Let them know in advance
  2. Use fast set alginate
  3. Use warmer water
  4. Use salt on the roof of the mouth
  5. Add wax to the posterior of the tray
  6. Ask the patient to lean forward to reduce flow to the back of the mouth
  7. Get a vomit bag for the patient
  8. TRY NOT TO REMOVE THE TRAY
75
Q

If a GP point is present in a radiograph, what intraoral signs will you experience?

A
  1. Draining sinus
  2. Non-responsive to sensibility test
  3. Tenderness to percussion
  4. Tooth mobility
  5. Tenderness to apical palpation

BDS 3 Sem 1 (21 decks)

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