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BDS3 OSCE > quizlet > Flashcards

quizlet Flashcards

1
Q

advice for dealing with splint

A

careful OH. particularly aroudn area

no contact sports

soft diet initially and avoid hard and sticky foods

possible chlorohexidine

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2
Q

advice for dealing with avulsed tooth

A

pick up ny crown, not root

rinse under cold running water for 10s

reinsert if possible, if not store in saliva or milk

get appointment ASAP

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3
Q

define sterile

A

theoretical probability of there being a viable microorganism on devise is equal to or less than 1 in a million

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4
Q

describe 4 streams of waste disposal

A

black = domestic

orange = low risk clinical

yellow = high risk clincal

red = special waste

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5
Q

describe a mobility test

A

apply gentle finger pressure and see how much tooth moves bucco-lingually

grade 0 - no apparent mobility

grade 1- <1mm mobility

grade 2- 1-2mm mobility

grade 3- >2mm mobility + occlusoapical movement

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6
Q

describe CPR in adults

A

30:2 compressions to breaths

compression 2 per second, 5-5cm deep

give 15l per min 100% oxygen

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7
Q

describe Craddock classification

A

describes support

1 - tooth borne

2- mucosa borne

3 - mixed

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8
Q

types of elevators

A

warwick james - right, left, straight

coupland’s - 5 types (1 = narrow)

Cryer’s - right and left, sharp beak

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9
Q

different levels of bleeding risk in dental setting

A

low - LA, BPE, supragingival scaling

medium - simple extractions, incision of swelling, 6PPC, PMPR, subgingival

high - complex extractions (3+ or adj), flaps, biopsies

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10
Q

external inflammatory resorption and how you would treat it

A

necrotic pulp releases bacteria that damage PDL

looks moth eaten on radiograph

RCT with CaOH left for 6 weeks pre-obturation

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11
Q

describe external surface resorption

A

pressure results in PDL damage

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12
Q

describe internal inflammatory resorption and how you would treat it

A

non vital pulp causes damage within tooth, resulting in ‘ballooning’ of pulp space

RCT with CaOH left with 6 weeks pre-obturation

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13
Q

descrive Kennedy’s classification

A

describes saddles

I - bilateral free end saddle

II - unilateral free end saddle

III - bounded saddle

IV - anterior bounded saddle over midline

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14
Q

describe lower extraction forceps

A

beak at right angle to handles

lower universal - 1s to 5s

lower roots - roots

lower molars - triangular beak for furcation

cowhorns - broken and multirooted teeth

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15
Q

possible smoking cessation discussion with a pt

A

5As

Ask - if willing to talk if and what they smoke

Advise - best to quit for oral and general health (clots,
higher bp, double heart attack)

Assess - how much they smoke? pack years? willingness to quit?

Assist - signpost to pharmacological and counselling services, set up plan, 4x more likely to quit with
support & 50-70% more likely with nicotine replacement therapy

Arrange - follow up at next appointment

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16
Q

describe replacement resorption

A

ankylosis

bony healing due to severe PDL damage

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17
Q

ARAB in URA design

A

active component - moves teeth via force

retention - resists dislodging forces

anchorage - resistance to unwanted tooth movement

baseplate - connection, retention, anchorage

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18
Q

chain of infection

A

infectious agent

reservoir

portal of exit

mode of transmission

portal of entry

susceptible host

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19
Q

BPE scores

A

0 - no bleeding, no pockets >3mm, no calculus

1 - bleeding, but no pockets >3mm or calculus

2 - calculus or overhangs

3 - pockets 3-5mm

4 - pockets >5mm

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20
Q

describe nickel titanium

A

exotic metal - exhibits super-elasticity, undergoing phase transistion when stressed to cope with it better

martensititc form - softer than austentitic

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21
Q

electrip pulp testing process

A

set dial to zero and attach tip

apply paste to tooth

hold on tooth and direct pt to hold it

slowly increase dial

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22
Q

describe external vital tooth whitening process

A

chairside - clean, dental dam, bleach, heat/light, wash, dry, repeat

home - apply dot to vacuum formed splint on the buccal of each tooth and wear fr at least 2 hours per day

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23
Q

process of internal non-vital tooth whitening

A

remove GP from pulp chamber and 1mm below ACJ, then seal GP with RMGIC and etch

then fill with bleaching gel and seal with cotton wool and GIC

repeat weekly until shade achieved

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24
Q

process of washer disinfector

A

neutral detergent for 12s at 80 degrees - ensure no overlap and hinges open

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25
Q

tx planning stages

A

immediate - releif of acute problems/pain

intial - e.g. HPT, restorations

re-evaluation - re-assess perio status

re-constructive - e.g. endo, pros

maintenance - review restorations

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26
Q

descibe the two types of Adam’s pliers

A

no 64 - straight edges, right angles

no 65 - one curved beak, coil formers

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27
Q

two types of manual wash

A

immersible - under water with detergent

non-immersible - wipe with cloth

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28
Q

describe the upper extraction forceps

A

beak in line with handles

upper straight - 1s and 2s

upper universals - for canines and premolars

upper roots - roots

upper molar - beak to cheek

upper bayonet - 3rd molars

upper bayonet roots - 3rd molar roots

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29
Q

how to determine occlusal plane

A

parallel to ala-tragus line

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30
Q

how can use elevators

A

rotate

lever

wedge

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31
Q

how does apixaban work

A

factor Xa inhibitor

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32
Q

how does bone resorb on edentulous arches

A

upper - up and in (narrower)

lower - down and out (wider)

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33
Q

how does dabigatran work

A

direct thrombin inhibitor

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34
Q

how does GI luting cement bond to tooh surface

A

bonds to calcium ions in enamel

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35
Q

how do you calculate Loss of attachment

A

add ginigval margin value (from gingival margin to ACJ, positive if recession, negative if inflammed)

to pocket depth (gingival margin to base of pocket)

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36
Q

deal with sharps injury

A

stop treatment and safely dispse of sharp

squeeze area to encourage bleeding

wash with water and non-antimicrobial soap

cover with waterproof dressing

inform pt

risk asses pt

document and contact occupational health

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37
Q

how to extract a tooth

A

support alveolar bone with left finger and thumb

place beaks far down root on ACJ

push to preak PDL and twist (single rooted - buccal to midline, multirooted - fingure of 8)

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38
Q

how to mix Glass ionomer

A

3 scoops to 3 drops distilled water

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39
Q

handpiece safety tests

A

try to rotate back cap anticlockwise

try to pull bur out of handpiece

rotate bur between fingers (should be smooth)

try to move bur laterally

check it running for 5secs for sound

(also ensure safely in chuck)

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40
Q

how to select an oropharngeal airway

A

hold base at angle of mandible and mouthpiece should rest level with incisors

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41
Q

how is retention achieved in complete dentures

A

accurate fit and flanges extended to sulcus depth and border seal with post-dam on uppers

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42
Q

how is retention achieved in RPD

A

clasps (ring, single, I bar)

guide planes (parallel surface on abutments)

altered path of insertion

RPI (for free end saddles)

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43
Q

how long should 6 step hand hygiene take

A

40-60 seconds for handwash

20-30 seconds for ABHR

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44
Q

how many teeth should be in sectant to qualify for BPE to be recorded

A

2

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45
Q

how to deal with suspected domestic abuse

A

Ask (e.g. i’ve noticed [injury] is everything OK? Are you safe?)

Validate (e.g. i am concerned for your safety, this is not OK)

Document - clearly in notes, in their words, specify injury

Refer by signposting pt e.g. Scottish Domestic Abuse Helpline

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46
Q

how to deal with bodily fluid spillage

A

cordon off area

assess spillage type

collect equipment

put on PPE

clean (sodium hypochlorite or sodium dichloroisocyanurate 10,000 for blood or 1000 urine)

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47
Q

how to tx alveolar bone #

A

reposition and splint

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48
Q

how to tx acute asthma attack

A

assess pt - if life threatening (will become bradycardic and dec resp rate) then transfer to hospital

sit upright and give their inhaler or 4 puffs of salbutamol

give 15l/min 100% oxygen

if doesn’t response in 5 mins send to hospital

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49
Q

how to tx acute coronary incident

A

give 15l/min 100% oxygen

give 2 puff GTN sublingually

if pain continues repeat GTN after 3mins

if pain continues, call 999 and give 300mg dispersible aspirin

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50
Q

how to tx anaphylaxis

A

assess pt and call 999

lie flat and raise feet to restore blood pressure

remove source of anaphylaxis if possible

give 15l/min 100% oxygen

give 0.5ml intramuscular adreanline

repeat adrenaline in 5 mins if necessary

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51
Q

how to treat ANUG

A

ultrasonic debridement

OHI

chlorhexidine

possible antibiotics if systemic

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52
Q

how to tx permanent avulsion injury

A

if <60mins out of mouth: replant and 2 week splint (with RCT within 10 days if closed apex)

if >60mins out of mouth: replant with 4 week splint (with RCT within 10 days if closed apex)

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53
Q

how to tx permanent concussion injury

A

occlusal relief if pain on biting

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54
Q

how to tx a permanent crown-root fracture

A

restore or remove fragments or extract

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55
Q

how to tx permanent enamel-dentine fracture

A

take 2 periapicals to ensure no luxation or root fracture bond fragment or composite bandage

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56
Q

how to tx a permanent enamel-dentine-pulp fracture

A

if vital tooth and small exposure <24hrs: pulp cap

if vital tooth but larger or older: pulpotomy

if non vital: pulpectomy

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57
Q

how to tx permanent enamel #

A

take 2 periapicals to ensure no luxation or root #

bond fragment and smooth edges

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58
Q

how to treat a permanent extrusion injury

A

reposition under LA and 2 week flexible splint

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59
Q

how to treat permanent intrusion injury

A

if open apex up to 7mm or closed up to 3mm can leave to spontaneously re-erupt

if larger injury on open apex or closed apex - orthodontic and/or surgical

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60
Q

how to tx permanent lateral luxation injury

A

reposition under LA and 4 week flexible splint

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61
Q

how to tx permanent root #

A

apical or middle 1/3: 4 weeks splint

coronal 1/3: 4 month splint

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62
Q

how would you treat a permanent subluxation injury

A

possible occlusal relief (add composite or file down) if pain on biting

2 week flexible splint

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63
Q

how to tx epilepsy

A

secure airway and give oxygen

if long fit (>5mins) or repeated, give midazolam

if first fit or different symptoms - hospital

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64
Q

how to tx hypoglycaemia

A

give 15l/min 100% oxygen

if concious, give 10-20g oral glucose

if unconcious, give 1mg glucagon injection

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65
Q

how to tx irrversible pulpitis

A

RCT or extract

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66
Q

how to tx primary avulsion

A

don’t replant

radiograph to ensure no remaining fragments

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67
Q

how to tx primary crown-root #

A

extract coronal fragments

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68
Q

how to tx primary extrusion

A

extract

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69
Q

how to tx primary lateral luxation

A

if no occlusal interference allow to spontaneously reposition

if there is - extract

70
Q

how to tx reversible pulpitis

A

dress and restore

71
Q

how to treat syncope

A

lie flat and raise feet if possible

loosen any tight clothing around neck

give 15l/mins 100% oxygen until concious

72
Q

negative response to sensibility test

how to continue

A

check if TTP

radiograph (possible thickend PDL)

73
Q

INR and warfarin

A

normally 2-3

can tx if <4 (take up to 72hrs before if well controlled, ideally 24hrs)

74
Q

2 sealers used in endo

A

epoxy resin

calcium silicate (bioceramic)

75
Q

noraml diabetic blood glucose levels

A

before eating: 4-7mmol/l

after eating: under 9mmol/l

76
Q

normal levels for HbA1c (controlled diabetic)

A

48mmol/mol (6.5%)

77
Q

pt presents with high resp rate and tachycardua and can’t complete sentences in one breath

A

acute asthma attack

78
Q

pt presents with pain, hallitosis and bleeding gum

on examination, there are large ulcers on their papillae that are covered with greyish slough - when this is removed the tissue begin bleeding

A

necrotising periodontal disease

79
Q

pt presents with severe, crushing central chest pain that radiates to left arm

A

acute coronary incident (angina or MI)

80
Q

pt presents with tachycardia, sweating, shaking, issues concentrating, slurred speech, they then begin to lose conciousness

A

hypoglycaemia

81
Q

pt presents with upper airway oedema and bronchospasm, stridor and wheeze, tachycardia, inc resp rate

A

anaphylaxis

82
Q

state causes of tooth discoluration

A

intrinsic: dental materals, age, fluorsis, CF
extrinsic: smoking, tanins

83
Q

state relevant legislation for decontamination

A

Health and Safety at Work Act 1974

84
Q

articaine strength

A

4%

1:100,000 adrenline

85
Q

lidocaine

strength

A

2% 1:80,000 adrenaline

86
Q

prilocaine strength

A

3%

0.03IU/ml felypressin

87
Q

types of RPD connector

A

plate/strap (thin, mucosal support)

bar (thicker tooth support)

88
Q

3 types of hand hygiene

A

social

hygienic

surgical

89
Q

7 elements of caries risk assessment

A

clinical evidence

medical history

social history

dietary habits

plaque control

saliva

fluoride use

90
Q

use of elevators

A

mobilise teeth

91
Q

issues with BPE

A

doesn’t describe extent of disease

pocket depth can be misleading (e.g. false pockets)

92
Q

risk factors for ANUG

A

immunocompromised (HIV, malnutrition)

smoker

93
Q

types of steriliser

A

N type - no vacuum

B type - vacuum

94
Q

5 moments to perform hand hygiene

A

before touching pt

after touching pt

after touching pt surroundings

before aspectic procedure

after body fluid exposure risk

95
Q

8 elements of caries prevention

A

radiographs (high risk - 6 monthly, low risk primary/mixed dentition - 12-18 months, low risk -adults 2 years)

dietary advice

OHI

fluoride varnish (22,600ppm 3 or 6 monthly)

fluoride supplements

fissure sealants (35% etch and bis-GMA resin)

sugar free medicine

96
Q

components of amalgam

A

silver tin, copper, and mercury

97
Q

components of glass ionomer

A

polyacrylic acid and silica and aluminium dioxide

98
Q

conditions for sterilisation

A

134 degrees at 2.25bar pressure for at least 3mins

99
Q

principles of cavity preparation

A

Access - identify and remove carious enamel

Extent - remove enamel to reveal lesion at ADJ

Remove Dentinal Caries - peripherallly from ADJ inwards, then remove deep caries over pulp

Modifications - smooth and remove sharp angles

Outline form - depending on restoration

100
Q

stages of hygiene phase therapy

A

dental health education

OHI

scaling

PMPR

overhang removal

101
Q

LA block too far back

A

parotid gland hit -> facial palsy

102
Q

what can’t be placed in ultrasonic machine

A

handpieces

103
Q

what component is activated by coiling

A

Robert’s retractor

104
Q

factors affect sodium hypochlorite function

A

concentration

volume

contact with debris

mechanical agitation

105
Q

what impacts the prognosis of permanent trauma

A

stage of root development

type of injury

presence of infection

PDL injury

time before treatment

106
Q

what is a concussion tooth injury

A

pain on percussion but no increased mobility or displacment

107
Q

use of luxator

A

breaking the PDL

108
Q

what is subluxation injury

A

increased mobility but no displacment

109
Q

what is collimation

A

lead device reduces size and shape of x-ray beam

therefore reducing irradiated tissue

110
Q

what is TempBond made of

A

temporary luting cement made of two paste system - base (ZnO) + accelerator (eugenol +resin) soft for easy removal

111
Q

what is the ‘artwork’ of cast

A

non anatomical area

112
Q

what is the difference between RMGI restorative material and RMGI luting cement

A

smaller partical size

113
Q

what is the hamular notch

A

indent at junction of maxillar and hamulus of sphenoid bone - distal border of denture

114
Q

what is maximum tooth whitening gel strength

A

6% hydrogen peroxide (equates to 10-15% carbamine peroxide)

115
Q

max x-ray beam diameter

A

60mm

116
Q

min focus to skin distance

A

20cm

117
Q

order of donning PPE

A

hand hygiene

apron

mask

visor/goggles

gloves

118
Q

doffing PPE

A

gloves

apron

visor/goggles

mask

hand hygiene

119
Q

paralleling technique for xray

A

image receptor and object parallel but not in contact

120
Q

process of decontamination

A

washer disinfector

manual wash

ultrasonic

cold water rinse

washer disnfector

steriliser

121
Q

Sinner Circle

A

factors determining the success of a wash (chemicals, energy, termperature, time)

122
Q

what is used to bond composite

A

hydroxymethacrylate in acetone solvent

123
Q

what is used to etch teeth and why

A

35% phosphotic acid creates micromechanical roughness in enamel and helps solubilise dentine to create hybrid layer (exposed collagen fibrils embedded in resin)

124
Q

what makes up an intraoral film holder

A

bite block + film support + connecting rod + beam aiming device

125
Q

what makes up composite

A

resin - bis-GMA (from bisphenol glucidyl methacrylate)

glass filler - silica or quartz

photoiniatitor - camphorquinone (440nm)

silane coupling agents

dimethacrylates

126
Q

what makes up tooth whitening gel

A

carbamine peroxide

carbopol (thickens)

fluoride (decreases sensitivty)

127
Q

what medicament can be used on a particularly inflammed pulp

A

ledermix antimicrobial paste (corticosteroid and tetracycline)

128
Q

what might cause a false negative response to sensibility test

A

large restoration

thick lining

tertiary dentine

129
Q

what migh cause a false positive result to a sensibility test

A

multirooted, some pulp may be vital and some non vital

canal full of pus

pt apprehensive and over reacts

130
Q

what may cause pulpitis

A

caries

trauma

multiple restorations

131
Q

what nerves are at risk during lower 3rd molar extractions

A

lingual

inferior alveolar

mylohyoid

buccal

132
Q

Qs to ask about trauma

A

what happened?

when?

where is the tooth now?

133
Q

pt gets BPE 3 what to do

A

6PPC in the area of 3

(SDCEP recommends pre and post tx, BSP recommends only after)

134
Q

pt has BPE 4 what to do

A

full moiuth 6PPC pre and post tx

135
Q

needle size use for block

A

35mm (long)

136
Q

needle for infiltration

A

25mm (short)

137
Q

film sizes for intraoral xrays

A

size 0 = deciduous BW or anterior PA

size 1 = anterior PA

size 2 = adult BW or posterior PA

size 4 = occlusals

138
Q

sizes of intraoral film

A

size 0 = 21x24mm

size 1 = 24x40mm

size 2 = 30x40mm

size 4 = 70x50mm

139
Q

speed of high speed handpiece

A

400,00rpm

140
Q

speed of slow speed handpiece

A

20,000rpm

141
Q

tests do to for permanent trauma

A

sinus

colour

TTP

percussion note

mobility

eletric pulp test

ethyl chloride

radiographs

142
Q

tests to do for primary trauma

A

sinus

colour

TTP

percussion note

mobility

radiograph

143
Q

types of caridac arrest that are shockable

A

ventricular fibrillation

tachycardia

(2/4)

144
Q

when does a primary intrusion injury risk damage to permanent successor

A

if it is palatally displaced

145
Q

when to use a flat posterior bite plane and why

A

z-spring: to prevent lower teeth interfering with movement (props open bite)

mid-palatal screw: to prevent lower arch expansion

146
Q

blue gracey

A

subgingival of distal posteriors

147
Q

columbia currette

A

anywhere (sub and supra gingival - limited sub)

148
Q

green gracey

A

subginigival buccal/lingual of posteriors

149
Q

mini sickle

A

anywhere supragingivally

150
Q

orange gracey

A

sungiviguval mesial of posteriors

151
Q

red Hoe

A

sub and supraginigial mesio/distal

152
Q

yellow Hoe

A

sub and supra gingival buccal/lingual

153
Q

where do you get support on complete dentures

A

upper = residual ridge, palate

lower = residual ridge, buccal shelf, retromolar pads

154
Q

where to extend labial surface of complete dentrures

A

10mm in front of incisive papillae

155
Q

why is copped added to amalgam

A

reacts with mercury-tin (product of silver-tim and mercury reaction) as it has low corrosion adn is weak so removing it improve properties

156
Q

why is paediatric BLS different

A

anatomical differences - short neck, large head, large tonguem funnel shaped trachea

physiological differences - low resp reseve means high resp and pulse rate

157
Q

why is RMGI better than GI

A

less soluble

better aesthetics

better tensile strength and wear resistance

158
Q

normal non diabetic level HbA1c

A

below 42mmol/l (below 6%)

159
Q

aim perio

A

arrest disease process

regenerate loss tissue

maintain perio health long term

160
Q

valid consent (3)

A

specific to treatment

remains valid (pt still agrees)

was obtained recently enough

161
Q

decide capacity

A
  • to act/decide
  • to make a reasoned decision
  • to communicate a decision
  • to understand a decision
  • to retain memory of decision
162
Q

GDC standards

A
  1. Put pt interest first
  2. communicate effectively with pts
  3. obtain valid consent
  4. maintain and protect pt’s info
  5. have a clear and effective complaints procedure
  6. work with colleagues in a way that is in pts best interest
  7. maintain, develop and work within your professional knowledge and skill
  8. raise concerns if pts are at risk
  9. make sure your professional behaviour maintains pt confidence in you and the dental profession
163
Q

to obtain valid consent (4)

A
  • informed - associated risk, costs, alternatives
  • voluntary
  • not coerced
  • not manipulated
164
Q

bacterial infections

1st step

A

local measures - incision and drain

165
Q

bactetial infections

1st line antibiotics

A

penicillin V

250mg tablets, 4xdaily, 5 day regime

(severe adults - can double whole dose)

don’t prescribe if allergy to pencillin

166
Q

bacterial infections

2nd line antibiotics

A

amoxicilllin 500mg capsules, 1 capsule 3xday for 5 days

(severe adults - can double whole dose)

don’t prescribe if allergy to pencillin (if pencillin V doesn’t work)

167
Q

bacterial infections

3rd line antibiotics

A

metronidazole 400mg capsules, 1 capsule 3xday, 5 days

if allergic to penicillin or as adjunt to amoxicillin

not if on warfarin

168
Q

BPE 1 action

A

OHI

Plaque and gingivitis scores

bleeding chart

169
Q

BPE 2 action

A

OHI

Plaque and gingivitis and bleeding charts

PMPR

170
Q

BPE 3 actions

A

OHI

Plaque and gingivitis and bleeding charts

PMPR

radiographs for attachment loss in scoring sextants and 6PPC

171
Q

BPE 4 actions

A

OHI

Plaque and gingivitis and bleeding charts

PMPR

full mouth 6PPC

possible refer

172
Q

components activated by uncoiling

A

Palatal finger spring

Z spring

Buccal canine retractor

(awat from midline)

BDS3 OSCE (6 decks)

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