Scope of practice and risks

Question 1

What can dental nurses not do that cannot be done even under prescription?

Answer 1

Diagnose and treatment plan

Question 2

What is the one task that orthodontic therapists can do that isn’t under prescription?

Answer 2

They do everything under prescription except recording IOTN.

Question 3

What can orthodontic therapists never do regardless of prescription?

Answer 3

Modify arch wires, give LA, scaling, recement crowns, place temp dressing, diagnose or treatment plan.

Question 4

What can dental therapists do without prescription?

Answer 4

Can do everything a hygienist does as well as restore primary and secondary teeth, carry out pulpotomy, extract primary teeth and place preformed crowns on primary teeth.

Question 5

What can dental technicians do without prescription?

Answer 5

Can repair dentures direct to members of public

Question 6

What can clinical dental technicians do?

Answer 6

They can provide complete denture direct to patients but cannot provide anything that involves teeth.

Question 7

What is statutory duty of candour?

Answer 7

Since 2014 all nhs primary care staff must recognise and report serious events including never events to CQC, NRLS, PHE or HSE/HUS (Scotland)

Question 8

What is the risk from a BW/PA X-ray?

Answer 8

1:10million

Question 9

What is the risk from a OPG?

Answer 9

1:1million

Question 10

What is the risk of developing cancer using effective dose from dental X-ray for males and females?

Answer 10

Males:
- 1:50,000 per mSv

Females:
- 1:18,000 per mSv

Question 11

What is absorbed dose?

Answer 11

Mean energy imparted to a unit of mass of tissue by radiation (grays)

Question 12

What is equivalent dose?

Answer 12

The absorbed dose is weighted to take account of the type of radiation (mSv)

Question 13

What is the effective dose?

Answer 13

Weighted to take account both radiation type and radio sensitivity of the tissue/organ being irradiated (Sv or mSv)

Question 14

What is the effective dose for BW/PA, OPG and CBCT?

Answer 14

BW/PA
- 0.3-21.6mSv

OPG
- 2.7-38mSv

CBCT
- 11-214mSv

Question 15

What is the increased risk from smoking and alcohol for development of OSCC?

Answer 15

Synergistic effect

38x more likely to develop SCC

Question 16

Smokers are more likely to have periodontal destruction but by how much is the risk?

Answer 16

6x more likely

1-4 cigarettes/day causes 50% increase in risk of periodontitis

Question 17

What percentage of population has moderate vs severe periodontitis?

Answer 17

Moderate 37%

Severe 8%

Question 18

With regards to survival rates what is the rate for conventional bridges vs RBB vs implants?

Answer 18

Conventional bridges
- 5yr 94% survival

RBB

• 5yr 88%; 10yr 44%
• average lifespan 7yr

Implants

• 5yr 94.5%
• 10-15yr 90%

Question 19

What are the survival and success rates for primary and Re-RCT at 4yrs?

Answer 19

Primary RCT
- 4yrs 95.4% and success 83%

Re-RCT
- 4yrs 95.3% and success 80%

Question 20

What are the 3 types of Endodontic outcomes?

Answer 20

Favourable (success)
- absence of clinical and radiology signs/symptoms

Uncertain (survival)
- lesion has remained same size

Unfavourable (failure)

• signs of infection
• apical area on X-ray at 4yrs or has only diminished in size
• signs of root resorption

Question 21

What are the rates of BBV transmission for HIV, Hep C and Hep B?

Answer 21

HIV 1:300 0.3%
Hep C 1:30 3%
Hep B 1:3 30%