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BDS3 OSCE PREP > ORAL SURGERY PREP > Flashcards

ORAL SURGERY PREP Flashcards

1
Q

What is the best post-operative analgesic to prescribe for dental related pain?

A

Iburprofen NSAID

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2
Q

What are the main areas to cover when giving post-operative instructions after oral surgery?

A
  • expect pain
  • expect bruising/swelling (especially if a surgical)
  • get on top of analgesia
  • how to prevent bleeding
  • how to stop bleeding if it occurs
  • avoid smoking & alcohol
  • may experience TMJ problems, teeth sensitivity
  • rinses & when to start
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3
Q

What should a patient do before the anaesthetic wears off?

A

Take analgesia
(ibuprofen and paracetamol)

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4
Q

What must you warn the patient NOT to do before anaesthetic wears off?

A

Don’t eat foods (hot especially) until anaesthetic wears off incase you traumatise wound or soft tissues accidentally

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5
Q

In which groups do you need to be cautious when prescribing Ibuprofen?

A
  • GIT problems
  • elderly
  • pregnancy
  • renal, cardiac or hepatic impairment
  • hypersensitivity to NSAIDs
  • asthma
  • already taking NSAIDs
  • anticoag patients
  • long term steroid patients
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6
Q

What dose of ibuprofen is recommended for dental pain post extraction?

A

2x 200mg ibuprofen tablets 4x a day
(after food)

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7
Q

What is the max dosage of ibuprofen?

A

2.4g daily

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8
Q

In which patients should paracetamol prescription be cautioned?

A
  • hepatic impairment
  • renal impairment
  • alcohol dependence
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9
Q

What is the recommended paracetamol dose for post-operative dental pain?

A

2x 500mg paracetamol every 4-6 hours

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10
Q

What is the max dose for paracetamol?

A

4g daily (8 tablets)

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11
Q

How many tablets can cause serious paracetamol overdose?

A

20-30 tablets (10-15g)

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12
Q

How can patients prevent post-operative socket bleeding?

A
  • avoid exploring socket with finger/tongue/toothbrush
  • avoid exercise or excessive movements
  • avoid hot/hard foods
  • avoid alcohol
  • do not rinse for 24 hours
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13
Q

What should patients do if they experience bleeding post-operatively after an extraction?

A
  • bite on damp gauze/tissue for 20-30 mins
  • if persists, replace and do this again for up to 1 hour
  • if still persists, contact dental practise/out of hours dentist
  • if unable to reach dentist, go to A&E
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14
Q

Why should patients avoid smoking after an extraction?

A

Can cause dry socket

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15
Q

When do patients tend to reach maximum swelling after a difficult extraction?

A

2 days after

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16
Q

You have performed a surgical extraction and have placed sutures, what information do you give to patients?

A

LEAVE THEM ALONE & DO NOT PULL
- sutures can be resorbable or non-resorbable

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17
Q

How long should you wait before and after eating when doing Chlorhexidine mouth rinses?

A

1 hour as Chlorhexidine can stain teeth but this is less likely if there’s no food particles on teeth

18
Q

What should patient do if they experience swelling?

A

Use ICE PACKS (not heat as this will make worse)
- 5 minutes on/5 mins off/5 mins on
- do this for 1-2 hours

19
Q

WHEN should you stand behind the patients right shoulder during oral surgery procedures?

A

Removing teeth from the
- lower right quadrant
- lower right molars & premolars

20
Q

Name all the lower forceps used in oral surgery practise & what teeth they are used to extract:

A
  1. Lower universal forceps = 35-45 (also molar roots)
  2. Lower molar forceps = lower molars
  3. Cowhorn forceps = lower 6s
21
Q

Name all the upper forceps used in oral surgery practise & what teeth they are used to extract:

A
  1. Straight upper forceps = 13-23
  2. Upper universal forceps = 15-25
  3. Upper molar forceps (right & left) = upper molars
  4. Bayonet forceps = upper 8s
22
Q

What is the function of a luxator?

A

Break PDL around tooth to mobilise it

23
Q

What scalpel blades are commonly used in oral surgery?

A
  • Schwann-Morton Blade 11
  • Blade 15
24
Q

What is the typical Lidocaine LA solution used in OS?

A

2.2ml cartridge Lidocaine 2% [amide]
- 1:80,000 adrenaline
- 44mg per cartridge

25
Q

What is the typical Prilocaine LA solution used in OS?

A

2.2ml Citanest 3% (prilocaine) [amide]
- Felypressin vasoconstrictor
- 66mg per cartridge

26
Q

What is the typical Articaine LA solution used in OS?

A

2.2ml Articaine 4% [amide]
- 1:100,000 adrenaline
- 88mg per cartridge

27
Q

What is the maximum safe dosage of Lidocaine WITH adrenaline?

A

4.4mg/kg

28
Q

What is the maximum safe dosage of Lidocaine without adrenaline?

A

3mg/kg

29
Q

What is the maximum safe dosage of Prilocaine 4%?

A

6mg/kg

30
Q

What is the maximum safe dosage of Articaine 4%?

A

5mg/kg

31
Q

How can LA administration accidentally cause trismus?

A

IDB too low and into medial pterygoid

32
Q

What is the function of a periotome?

A

Severs the periodontal ligament
- thin, blade/like tip
- inserted between tooth & surrounding bone
- allows for controlled & gentle extraction to minimise trauma

33
Q

What types of elevators are used in dentistry OS?

A
  • Cryers (right & left)
  • Warwick James (straight, right & left)
  • Couplands (different sizes)
34
Q

What are the three basic modes of action of elevators used in OS?

A
  • wheel and axle
  • lever
  • wedge
35
Q

What are the principles of use of elevators?

A
  • avoid excessive force
  • support the instrument to avoid injury
  • direct applied force away from major structures
  • never use adjacent tooth as fulcrum
  • keep them sharp and in good shape
  • establish force of application
36
Q

What are the uses of elevators?

A
  • provide a point of application for forceps
  • loosen teeth prior to using forceps
  • extract teeth
  • removal of root stumps
  • removal of retained roots
  • removal of root apices
37
Q

What debridement is used in Oral Surgery?

A

Physical = bone file or handpiece to remove sharp bony edges OR mitchell’s trimmer / victorias curette to remove soft tissue

Irrigation = sterile saline into socket & flap

Suction = aspirate socket & under flap to remove debris

38
Q

When should non-absorbable sutures ALWAYS be used?

A
  • closure of OAF
  • extended retention periods required
39
Q

What is the disadvantage of using polyfilament/multifilament sutures?

A

Prone to wicking
- oral fluids and bacteria can infiltrate the suture

40
Q

What shape is the cross section of a suture needle?

A

Triangular

BDS3 OSCE PREP (9 decks)

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