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🤍Past papers > 2019 Paper > Flashcards

2019 Paper Flashcards

1
Q

What are predisposing factors of dry socket?

A
  • Previous dry socket
  • Smoking
  • Disturbance of Blood clot - e.g. mouth rinsing
  • Mandibular extraction
  • Excessive trauma during extraction
  • Oral contraceptive Pill
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2
Q

What are the symptoms of dry socket?

A
  • Sensitive exposed bone
  • Pain disrupting sleep
  • Throbbing pain radiating to the ear
  • Dull achy pain
  • Halitosis
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3
Q

How do you manage dry socket?

A

-Support and reassure patient
-Debridement to remove blood clot to encourage new clotting
- Irrigate with warm saline
- Systemic analgesia

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4
Q

What type of injection(s) is used for 48 extraction?

A
  • Right IDB with lingual block
  • Long buccal infiltration
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5
Q

Explain how to anaesthetise all the sites required for extraction of 48?

A
  • Dental pulp - Right IDB
  • Buccal gingiva - Right Long buccal infiltration
  • Lingual gingival - Lingual nerve block of right IDB
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6
Q

Explain how to anaesthetise lower premolars and canine for extraction?

A
  • Mental nerve block
  • Buccal infiltration
  • Lingual infiltration

Could do IDB for premolars but risk not fully anaesthetised

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7
Q

Explain how to anaesthetise lower canine and incisors for extraction?

A
  • Buccal infiltration
  • Lingual infiltration
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8
Q

What are 3 clinical features for sensory deficits for nerves?

A
  • Anaesthesia- numbness
  • Paraesthesia - tingling
  • Dysesthesia - unpleasant sensation/pain
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9
Q

What are the short term effects of child neglect?

A
  • Reduced self esteem
  • Malnutrition
  • Affects physical health
  • Affects emotional health
  • Affects cognitive development
  • Affects social development
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10
Q

What are the long term effects of child neglect?

A

As adults they are at higher risk of:
- Incarceration
- Suicide
- Depression
- Domestic abuse (victim or abuser)
- Diabetes
- Heart Disease

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11
Q

What is the management for child neglect?

A
  • Preventative dental team management (e.g. raise concern with parent, offer support, set targets, monitor progress)
  • preventative multi agency management (e.g. lease with GMP, social worker, health visitor)
  • Child protection referral
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12
Q

What is the treatment for enamel dentine fracture in children?

A
  • cover exposed dentine with glass ionomer or composite
  • may restore lost tooth tissue immediately or at future visit
  • take radiograph to determine no further damage
  • follow up 6-8 weeks and 1 year
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13
Q

What are the categories of a trauma stamp?

A
  • Sinus
  • Mobility
  • Colour
  • TTP
  • Percussion note
  • Radiograph
  • ECL
  • EPT

Science Makes Christy Take Panic-attacks Regularly Every Evening

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14
Q

What is seen radiographically for a non vital tooth?

A
  • Ankylosis
  • Internal root resorption
  • External root resorption
  • Periodical radiolucency
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15
Q

Why are only specific teeth affected by nursing bottle caries?

A
  • The tongue protects the lower incisors!!
  • Sequence of eruption (maxillary incisors erupt first)
  • Child can hold the milk at the back of their mouth
  • Palatal surface of upper incisors due to position of teet
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16
Q

What are the causes of nursing bottle caries?

A
  • Giving a child a bottle during the night
  • Child holds the contents in mouth and swirls it around teeth
  • No brushing of teeth
  • Prolonged breast feeding
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17
Q

What are the causes of nursing bottle caries?

A
  • Giving a child a bottle during the night
  • Child holds the contents in mouth and swirls it around teeth
  • No brushing of teeth
  • Prolonged breast feeding
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18
Q

What is the fluoride regime for child with nursing bottle caries?

A
  • Fluoride varnish application
  • Increase concentration of fluoride in toothpaste depending on the childs age
  • fissure seal all permanent pre molars and molar when suitably erupted (age dependant)
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19
Q

What is the toothbrushing instruction for parent with children?

A
  • Tell them the recommended amount of toothpaste on the brush dependant on age
  • tell them size, shape and bristle specification of toothbrush
  • brush for 2 minutes, twice daily supervised
  • Spit toothpaste out and don’t rinse the mouth afterwards
  • Brush teeth in small circular motions on all tooth surfaces
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20
Q

Define competent lips

A

Upper and lower lip meet at rest and maintain anterior oral seal

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21
Q

Define incompetent lips

A

Upper and lower teeth do not meet at rest and anterior oral seal is not maintained

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22
Q

What are the issues of incompetent lips

A

face might not develop properly
Increased risk of trauma
Bullying
Longer face
Impeded speech
Mouth breathing that leads to dry mouth

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23
Q

What other feature of the lips is common when there is incompetent lips

A

Lip trap - this causes proclaimed upper incisors

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24
Q

What are the signs of digit sucking habit?

A
  • Anterior open bite
  • Proclination of upper anterior teeth
  • Retroclination of lower anterior teeth
  • Unilateral posterior cross bite
  • Narrow upper arch
  • Reduced over bite
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25
Q

How to stop a digit sucking habit?

A
  • Positive reinforcement
  • Acid/ bad tasting nail polish
  • Fixed habit breaker (tongue rake)
  • Removable habit breaker (URA)
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26
Q

Effect of digit habit on posterior teeth

A
  • posterior unilateral cross bite caused by the sucking action from the cheeks which narrows the maxillary dentition
  • The mandible is held in a lower position than normal
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27
Q

Describe a Randomised Control Trial

A

Gold standard study design for effectiveness and efficacy when comparing one treatment to another

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28
Q

Describe a Cohort Study

A

Prospective study that recruits groups of people who do not have disease at the time of recruitment for study

Assesses risk factors and epidemiology of the disease

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29
Q

Describe a case control study

A

Retrospective study which compares individuals with the disease to individuals without the disease

Traces back to assess risk factors through past history and exposure

These are less robust than cohort studies
Used before cohort study

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30
Q

When is a confidence interval significant?

A

If the confidence interval does not overlap 0

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31
Q

What are the causes of congestive heart disease?

A
  • Coronary artery disease
  • Myocardial Infarction
  • Cardiomyopathy
  • Heart attack
  • Hypertension
  • Valve disease
  • Alcohol
  • Diabetes
  • Idiopathic causes
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32
Q

What are the symptoms of congestive heart disease?

A
  • Shortness of breath
  • Swelling of the abdomen
  • Tachycardia
  • Bradycardia
  • Sweating
  • Fatigue
  • Cough or wheezing
  • Oedema of the leg
  • Chest pain
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33
Q

What is the treatment for congestive heart disease?

A

medication - ACE inhibitors, beta blockers, diuretics
lifestyle changes - balanced diet, stop smoking, exercise

Surgery - Transplant, replacement valves, coronary bypass
Devices - pacemaker,LVAD

Patient needs to be dentally fit before surgery etc

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34
Q

Discuss ABP for dental procedures

A

infective endocarditis is caused by oral bacteria - streptococcus viridians

contact cardiologist and discuss if ABP required

discuss ABP with patient and allow them to make informed decision if they want ABP

Procedures that may require ABP:
- placement of matrix band
- use of clamps
-

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35
Q

What groups are at risk of Infective endocarditis

A
  • Adults and children with conditions affecting the structure of the heart
  • Adults and children who have previously had infective endocarditis
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36
Q

Explain what infective endocarditis is

A

An infection of the lining of the heart, usually the valves, caused by bacteria that enter the blood from outside the body

37
Q

What are the 3 options for ABP

A
  • amoxicillin - 3g oral powder sachet, 60 minutes before procedure
  • Clindamycin - 2x 300mg capsule, 60 minutes before procedure
  • Azithromycin - 500mg (12.5ml), 60 minutes before the procedure
38
Q

What organisms are involved in caries?

A

Streptococcus mutans
Lactobacilli acidophilus

39
Q

What are the virulence factors involved in carious bacteria

A
  • Adhesins - Spa P gene mediates binding/adhesion to tooth surface
  • Acid tolerance - survive at low pH
  • Acidogenicity - produces acid
  • Binding proteins - e.g. glucan binding protein
40
Q

What organisms are involved in periodontal disease

A
  • P. gingivitis
  • Tannerella forsythia
  • Treponema denticola
  • Prevotella intermedia
41
Q

What are the virulence factors involved in periodontal disease?

A
  • Fimbriae
  • Proteases
  • Endotoxins
  • Capsular polysaccharide and outer membrane vesicles
  • Tissue toxic metabolic by-products
42
Q

Why do biofilms not allow antibiotics to penetrate them?

A

Biofilms can produce a penetration barrier of LPS which prevents antimicrobials and antibiotics from penetrating

Biofilms require mechanical disruption so antibiotics won’t work alone

43
Q

What are causes of liver cirrhoisis?

A
  • Alcohol Abuse
  • Viral hepatitis (hep B, C and D)
  • Non Alcoholic Fatty Liver Disease
  • Cystic fibrosis
  • Copper accumulated in the liver (Wilson’s Disease)
  • Infection (e.g. syphilis)
  • Iron build up in the body (hemochrombtosis)
44
Q

What causes thrombocytopenia?

A
  • Leukemia
  • Viral infections (e.g. Epstein Barr virus or HIV)
  • Splenomegaly associated with portal hypertension
  • Bone marrow suppression by Hepatitis C
  • Anti cancer agents
45
Q

How to clean up a blood spillage?

A
  • Wear PPE (gloves, apron, visors/goggles)
  • Contain with a paper towel
  • Assemble the spillage kit
  • Sprinkle chlorine releasing granules (what type and how long)
  • Clear affected area with paper towel and dispose of as clinical waste
  • Clean with warm water and detergent
  • Clear any sharps
  • Perform hand hygiene
46
Q

What chemical is used to clean a blood spillage and how to use it?

A

Sodium hypochloride
Sodium dischloro-iso-cyanurate

10,000 ppm chlorine for 3-5 minutes or per manufactures instructions

47
Q

How long do you keep hazardous waste records for?

A

3 years

48
Q

What are the 5 principles that underpin the AWI Act

A
  • benefit
  • Minimum necessary intervention (least restrictive)
  • Consult relevant others
  • Take into account previous and current wishes
  • Exercise residual capacity
49
Q

What are the 3 types of power of attorney and what can they consent to?

A
  • Continuing Power of Attorney - CANT consent to dental treatment
  • Welfare Power of Attorney - CAN consent to dental treatment
  • Combined Power of Attorney - CAN consent to dental treatment
50
Q

What are the 2 types of Guardianship Orders and what can they consent to?

A
  • Welfare Guardian - CAN consent to dental treatment
  • Financial Guardian - CANNOT consent to dental treatment
51
Q

Who can consent to dental treatment?

A
  • Patients with capacity
  • Welfare power of Attorney
  • Welfare Guardian
  • Medical and Dental Practitioners under Section 47 of AWI Act
52
Q

What is a risk of GA in elderly ?

A
  • death
  • Post GA delirium
53
Q

Why do overhangs occur?

A
  • Poor adaptation of matrix band
  • Excessive force applied when condensing amalgam
54
Q

How do you improve an overhang?

A
  • Use a finishing strip or soft flex disc
  • Replace the restoration
55
Q

What are the consequences of an overhang?

A
  • Food/plaque trap
  • Difficult to clean
  • Secondary caries
  • May cause gingivitis or periodontitis
56
Q

What is the horizontal line parallel to the floor during an OPT?

A

Frankfurt plane

57
Q

Why can anterior teeth appear horizontally wider in an OPT?

A
  • Patient too far back in the machine
  • Canine is behind the guideline
58
Q

Why can posterior teeth appear horizontally wider on one side of OPT?

A

The patient has rotated within the machine during exposure

59
Q

What radiograph will be taken for patients who can’t tolerate bitewings?

A

Full OPT in setting 4 (not showing condylar process)

60
Q

What are the features of a ghost image?

A
  • Always higher than actual location
  • Always horizontally magnified
  • on the opposite side

Can interfere with diagnosis

61
Q

What type of radiograph is needed before 48 extraction?

A

Right Side OPT on setting 4

62
Q

What maxillary sinus border shows horizontally above the molars?

A

Inferior border

63
Q

What maxillary sinus border shows vertically to the 3rd molar?

A

Posterior border

64
Q

What do you call a secondary impression?

A

Master impressions

OR

Definitive impressions

65
Q

What features of a denture provide support and retention?

A

-Post dam
- Border seal

66
Q

What anatomical features are relevant for the position of the posterior border of the upper denture?

A
  • Hamular notch
  • Palatine Fovea at Vibrating line
  • Border of the hard palate
67
Q

What anatomical features are considered for lower dentures?

A
  • Residual ridge
  • Buccal shelf
  • Retromolar Pad
68
Q

What 2 materials can be used for masters on lowers?

A
  • Alginate
  • Polyvinyl siloxane
  • Polyether/impregum
69
Q

What impression material would you use for edentulous patients?

A
  • Impression compound - polysulfide material
  • Alginate
70
Q

How many canals are in the upper central incisors?

A

1

71
Q

How many canals are in the upper lateral incisors?

A

1

72
Q

How many canals are in the upper canines?

A

1

73
Q

How many canals in the upper first premolars?

A

2

74
Q

How many canals are in the upper second premolar?

A

1

75
Q

How many canals are in the upper first molars?

A

4

76
Q

How many canals are in the upper second molar?

A

3

77
Q

How many canals are in the lower anterior teeth?

A

1

78
Q

How many canals are in lower premolar teeth?

A

1

79
Q

How many canals are in lower molar teeth?

A

3

80
Q

Define Working Length

A

the distance from a coronal reference point to the point at which canal preparation and obturation should terminate

81
Q

How do you determine working length?

A
  • From a radiograph
  • From a electronic pulp locator (apex locator)
  • Paper point length
82
Q

Give reason why non-surgical perio treatment should be done before surgical?

A
  • Deep pockets may heal following non-surgical therapy
  • Improve soft tissue consistency for easier surgical management
  • Allow evaluation of patients motivation and plaque control
83
Q

What are indications for surgical periodontitis treatment at re-evaluation of non-surgical therapy?

A
  • Pockets of 5mm or greater persisting
  • Furcation involvement

Needs to be in the presence of excellent oral hygiene!

84
Q

What is the aim of surgical periodontitis therapy?

A
  • To arrest the disease by gaining access to complete root surface debridement
  • To regenerate lost periodontal tissue
85
Q

What is the follow-up required for surgical periodontitis treatment?

A
  • Review OH and use OH TIPPS
  • remove sub and supra gingival plaque and calculus deposits
  • periodontal pocket chart annually
86
Q

When do you review non surgical periodontal treatment?

A

6-8 weeks post procedure

87
Q

What are the 5 A’s used in smoking cessation?

A
  • Ask
  • Advice
    -Assess
    -Assist
    Arrange a referral
88
Q

What do you do if a patient doesn’t want to quit currently?

A
  • advice on the benefits of quitting smoking
  • explain that support is available should they decide they want it
  • Document discussion in the notes

🤍Past papers (4 decks)

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