sba mega questions Flashcards by em doz

Which of the following is a key recommendation for all children to prevent dental caries?

A. Avoid using fluoride toothpaste under age 7
B. Brush once a day without supervision
C. Use fluoride toothpaste appropriate to the child’s age and risk level
D. Rinse thoroughly after brushing
E. Use mouthwash instead of brushing

C. Use fluoride toothpaste appropriate to the child’s age and risk level

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When assessing carious lesions radiographically, which of the following best describes an initial proximal lesion?

A. Lesion extending into the inner third of dentine
B. White spot lesion confined to enamel
C. Cavitation with visible dentine
D. Clinical pulpal exposure
E. Crown destroyed by caries

B. White spot lesion confined to enamel

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At what minimum age is the application of fluoride varnish recommended at least twice per year for all children?

A. Birth
B. 1 year
C. 2 years
D. 5 years
E. 7 years

C. 2 years

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Which of the following is NOT considered a factor when assessing the risk of caries in children?

A. Frequency of sugary food and drink consumption
B. Use of fluoride
C. Presence of orthodontic appliances
D. Previous caries experience
E. Socioeconomic status

C. Presence of orthodontic appliances

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Which behaviour management technique involves gradually introducing a child to a feared stimulus while encouraging relaxation?

A. Tell-show-do
B. Positive reinforcement
C. Systematic desensitisation
D. Distraction
E. Enhancing control

C. Systematic desensitisation

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Which of the following techniques is considered minimally invasive and suitable for occlusal caries in primary molars?

A. Hall Technique
B. Complete caries removal and restoration
C. Extraction
D. Pulpotomy
E. Stepwise caries removal

A. Hall Technique

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Which statement about managing pain due to irreversible pulpitis in a primary tooth is CORRECT?

A. Immediate extraction is always necessary
B. No treatment is indicated if asymptomatic
C. Pulpotomy may be considered to preserve the tooth
D. Antibiotics are first-line treatment
E. Monitoring is sufficient

C. Pulpotomy may be considered to preserve the tooth

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Which of the following is a strong indicator of dental neglect?

A. Fluorosis
B. Persistent failure to attend scheduled dental appointments
C. MIH
D. Supervised brushing twice daily
E. Use of non-fluoride toothpaste

B. Persistent failure to attend scheduled dental appointments

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Which method is considered most reliable for detecting caries during clinical examination?
A. Tactile probing of fissures
B. Visual inspection on wet teeth
C. Visual inspection on clean, dry teeth
D. Use of disclosing tablets only
E. Asking the parent

C. Visual inspection on clean, dry teeth

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In relation to radiographic frequency, what is the recommended interval for bitewing radiographs in children at increased caries risk?

A. Every 3 months
B. Every 6–12 months
C. Every 18 months
D. Every 2 years
E. Only when symptoms present

B. Every 6–12 months

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Which immunoglobulin predominates in the saliva and contributes to mucosal immunity?

A. IgG
B. IgM
C. IgE
D. IgA
E. IgD

D. IgA

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Hyperkeratosis refers to:

A. Thickened connective tissue
B. Increased keratin layer
C. Melanin overproduction
D. Loss of desmosomes
E. Submucosal swelling

B. Increased keratin layer

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Which condition is most likely to cause macrocytic anaemia with megaloblasts in a blood film?

A. Iron deficiency
B. Pernicious anaemia
C. Coeliac disease
D. Thalassemia
E. Chronic infection

B. Pernicious anaemia

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Which of the following biopsy techniques is most appropriate for diagnosing small oral ulcers?

A. Fine needle aspirate
B. Incisional biopsy
C. Excisional biopsy
D. Punch biopsy
E. Smear biopsy

C. Excisional biopsy

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Direct immunofluorescence is especially important in diagnosing:

A. Leukoplakia
B. Oral squamous cell carcinoma
C. Immunobullous disorders
D. Aphthous ulcers
E. Periodontal abscesses

C. Immunobullous disorders
(mucous membrane pemphigoid etc.)

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In which location is orthokeratinized epithelium predominantly found?

A. Buccal mucosa
B. Soft palate
C. Floor of the mouth
D. Hard palate
E. Ventral surface of tongue

D. Hard palate

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What is the most likely cause of desquamative gingivitis?

A. Periodontal pocketing
B. Poor brushing technique
C. Mucocutaneous diseases like lichen planus
D. Bacterial plaque
E. Vitamin K deficiency

C. Mucocutaneous diseases like lichen planus

(it’s a variant of lichen planus!!)

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A panoramic radiograph is most appropriate for evaluating:

A. TMJ disc displacement
B. Soft tissue ulcers
C. Periapical pathology
D. Widespread bony changes
E. Facial nerve lesions

D. Widespread bony changes

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Which condition is most strongly associated with oral candidiasis in the absence of dentures?

A. Iron deficiency
B. Sialolithiasis
C. Oral squamous cell carcinoma
D. Ameloblastoma
E. Dental fluorosis

A. Iron deficiency

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Which systemic condition is classically associated with “overripe strawberry” gingivae?

A. Pemphigus vulgaris
B. Lichen planus
C. Wegener’s granulomatosis
D. Behçet’s syndrome
E. Lupus erythematosus

C. Wegener’s granulomatosis

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What is the first-line screening investigation in a patient with persistent oral ulcers and suspected systemic deficiency?

A. CT scan
B. Salivary gland biopsy
C. Serum folate and B12
D. Periapical radiograph
E. Urinalysis

C. Serum folate and B12

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Which of the following is not typically a cause of macrocytic anaemia?

A. Alcoholism
B. Folate deficiency
C. Iron deficiency
D. Vitamin B12 deficiency
E. Hypothyroidism

C. Iron deficiency (microlytic!)

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Which of the following is the most appropriate material for a maxillary edentulous first impression?

A. Silicone putty
B. Polyether
C. Alginate
D. Impression compound
E. Zinc oxide eugenol

C. Alginate

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Which of the following is the greatest clinical consequence of insufficient freeway space (FWS) in a complete denture?

A. Angular cheilitis
B. Alveolar bone resorption
C. Poor aesthetics
D. Cheek biting
E. Mandibular deviation

B. Alveolar bone resorption

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Which of the following is the greatest clinical consequence of insufficient freeway space (FWS) in a complete denture? A. Angular cheilitis B. Alveolar bone resorption C. Poor aesthetics D. Cheek biting E. Mandibular deviation

B. Alveolar bone resorption

When using synthetic elastomer for second mandibular impressions in resorbed ridges, which combination is most appropriate? A. Alginate base + wax wash B. Heavy-body silicone + light-body silicone wash C. Light-body PVS + wax spacers D. Polyether base + zinc oxide eugenol E. Alginate + greenstick compound

B. Heavy-body silicone + light-body silicone wash

Which factor most contributes to denture-related stomatitis (DRS)? A. Streptococcus mutans B. Candida albicans C. Lactobacillus D. Actinomyces E. Poor dietary calcium intake

B. Candida albicans

Which is a contraindication for the copy denture technique? A. Good occlusion B. Mild under-extension C. Patient aged over 75 D. Inappropriate tooth position and neutral zone E. Minor loss of denture retention

D. Inappropriate tooth position and neutral zone

What is the primary purpose of tissue stops in special trays? A. Increase tray retention B. Improve patient comfort C. Prevent overextension D. Ensure uniform impression material thickness E. Capture the frenal attachments

D. Ensure uniform impression material thickness

In the copy denture technique, what is the most suitable impression material for wash impressions? A. Alginate B. Greenstick compound C. Medium-bodied silicone D. Polyether E. Plaster of Paris

C. Medium-bodied silicone

Which feature of a lower complete denture improves denture stability the most? A. Highly polished surface B. Overextension into buccal sulcus C. Anterior rim centered over alveolar ridge D. Placement of post dam E. Increased freeway space

C. Anterior rim centered over alveolar ridge

Which of the following statements about relines is true? A. Alginate is ideal for wash reline impressions B. Chairside soft liners are always permanent C. Visco-gel is a type of tissue conditioner D. Relines are suitable for all Co-Cr frameworks E. Relines are contraindicated in free-end saddles

C. Visco-gel is a type of tissue conditioner

Why should undercuts on the master cast be blocked out before casting a Co-Cr framework? A. Prevent distortion of alginate B. Facilitate laboratory mounting C. Prevent framework locking on cast D. Create extra retention E. Support occlusal rims

C. Prevent framework locking on cast

What feature of an occlusal rest helps prevent movement of the denture base? A. Bucco-lingual width B. Gingival clearance C. 90-degree angle to minor connector D. 1 mm minimum depth E. Flange design

D. 1 mm minimum depth

What is the ideal time to schedule a review appointment after denture insertion? A. 24 hours B. 48 hours C. 5 days D. 7 days E. 14 days

D. 7 days

Which of the following would most likely require a new jaw registration? A. Incorrect midline B. Posterior open bite C. Shade mismatch D. Tooth prominence E. Median diastema request

B. Posterior open bite

Which of the following is a contraindication for providing an indirect restoration on the undergraduate clinic? A. Long clinical crown B. Good ferrule effect C. High caries risk D. Restored occlusal contacts E. Slightly tilted tooth

C. High caries risk

What is the minimum crown height advised for a conventionally retained restoration on molars? A. 2 mm B. 3 mm C. 4 mm D. 5 mm E. 6 mm

C. 4 mm

What is the recommended occlusal clearance for a ceramic onlay? A. 0.5–1.0 mm B. 1.0 mm C. 1.5–2.0 mm D. 2.0–2.5 mm E. 3.0 mm

C. 1.5–2.0 mm

Which cement is recommended for conventional luting of a full gold crown? A. Zinc phosphate B. Glass ionomer (AquaCem®) C. Resin composite cement D. Polyether cement E. Resin-modified GIC

B. Glass ionomer (AquaCem®)

For a lithium disilicate crown, what is the preferred minimum occlusal clearance? A. 0.5 mm B. 1.0 mm C. 1.2 mm D. 1.5 mm E. 2.0 mm

D. 1.5 mm

When bonding a ceramic veneer, which acid is used to etch the tooth surface? A. Hydrofluoric acid B. Maleic acid C. Polyacrylic acid D. Orthophosphoric acid E. Citric acid

D. Orthophosphoric acid (normal etch!)

Which of the following is a contraindication for an onlay restoration? A. 3mm cusp base B. Deep subgingival margin C. Large existing restoration D. Non-functional cusp fracture E. Toothwear

B. Deep subgingival margin

What is the minimum axial reduction for a full gold crown? A. 0.3 mm B. 0.5 mm C. 1.0 mm D. 1.5 mm E. 2.0 mm

C. 1.0 mm

For a resin-bonded bridge (RBB), which is an essential tooth preparation feature if needed? A. Dovetail retention B. Lingual shoulder C. 180° wraparound and centrally located rest seat D. Subgingival margin E. Slot preparation

C. 180° wraparound and centrally located rest seat

Which type of crown is contraindicated for a cantilevered bridge on the UG clinic? A. Gold crown B. MCC C. ACC (IPS e.max Press) D. Zirconia crown E. Composite crown

C. ACC (IPS e.max Press)

What is the practical recommended convergence angle between axial walls in fixed prep? A. 0–5° B. 5–10° C. 10–20° D. 20–30° E. 25–40°

C. 10–20° (because 6-10 isn’t achievable)

ich retraction method is preferred for shallow sulcus with <2mm gingiva? A. Twin cord B. Astringent paste C. Electrosurgery D. Single cord E. Retraction paste only

D. Single cord (1 is better than nothing)

In bonding all-ceramic crowns, silane coupling agent is applied: A. To the tooth surface only B. To enamel and dentine C. To the intaglio of the crown D. To the crown margin only E. To opposing teeth

C. To the intaglio of the crown

Which of the following is a valid reason to use 0.2% chlorhexidine as an irrigant? A. As a final rinse B. In all anterior cases C. If the patient is allergic to NaOCl D. When rubber dam isolation is suboptimal E. When using EDTA

D. When rubber dam isolation is suboptimal

Which of the following is considered a contraindication to proceeding with definitive root canal treatment? A. Deep restoration present B. Mild canal curvature C. Unstable oral health D. History of mild pain E. Presence of pulp stones

C. Unstable oral health

The recommended irrigant to remove the smear layer is: A. 1% NaOCl B. 2% CHX C. 17% EDTA D. 5% hypochlorous acid E. Sterile saline

C. 17% EDTA

When using an apex locator, which action indicates you can avoid a working length radiograph? A. Any single zero reading B. Tactile sensation confirms apex C. Repeatable consistent zero reading x3 D. Patient confirms numbness E. Use of WaveOne file to the apex

C. Repeatable consistent zero reading x3

Which material is recommended for inter-visit dressing in a necrotic tooth? A. Odontopaste B. 2% CHX C. Eugenol D. Non-setting calcium hydroxide E. Cavit

D. Non-setting calcium hydroxide

Which material is recommended for inter-visit dressing in an acutely painful tooth where instrumentation is incomplete? A. Odontopaste B. 2% CHX C. Eugenol D. Non-setting calcium hydroxide E. Cavit

A. Odontopaste - THIS IS ledermix

What is the correct placement for the GP point after obturation? A. 2 mm above the CEJ B. At the level of the gingival margin C. To the canal orifice, trimmed at CEJ D. 2 mm short of apex E. Beyond the apex

C. To the canal orifice, trimmed at CEJ

What is the recommended method to check for straight-line access? A. Take a working length radiograph B. Use magnification C. Insert an ISO 10 file 2–3mm into canal D. Blow air and observe movement E. Place EDTA

C. Insert an ISO 10 file 2–3mm into canal

In a re-treatment case using WaveOne, which instrument is used to gain patency after initial removal of GP? A. S1 Protaper B. Machtou plugger C. ISO 10 or 15 K-file D. Rotary spreader E. Hedström file

C. ISO 10 or 15 K-file

Which of the following steps is necessary before obturation? A. Presence of GP in place B. Previous obturation radiograph C. Symptom-free status and healed sinus D. Provisional restoration already fitted E. Use of CHX

C. Symptom-free status and healed sinus

Which part of the EndoRay holder system is disposable? A. Ring B. Arm C. Basket D. Handle E. None

C. Basket

A 7-year-old boy attends with his mother. On examination, you identify a white spot lesion on the upper left first permanent molar, with no cavitation. The child brushes once daily and drinks sugary drinks between meals. What is the most appropriate next step? A. Place a preformed metal crown B. Apply fluoride varnish and reinforce oral hygiene advice C. Extract the tooth D. Restore with composite resin E. Refer for orthodontic evaluation

B. Apply fluoride varnish and reinforce oral hygiene advice

A 5-year-old girl attends for her first dental visit. She is tearful, hides behind her parent and refuses to sit on the dental chair. Her parent says she’s always been afraid of “doctors”. What is the most appropriate first-line behaviour management strategy? A. Use general anaesthesia B. Use protective stabilisation C. Systematic desensitisation and tell-show-do D. Proceed with radiographs anyway E. Book her in for an extraction under sedation

C. Systematic desensitisation and tell-show-do

4-year-old child from a high-deprivation area has multiple anterior carious lesions and drinks juice from a bottle at night. The parent is unsure about brushing techniques. What is the best indicator that this child is at high caries risk? A. Lives in a deprived area B. Attends nursery C. Uses fluoride toothpaste D. Eats vegetables at lunch E. Has siblings with no caries

A. Lives in a deprived area

An 8-year-old boy presents with a cavitated lesion in the lower right first permanent molar. The lesion appears confined to enamel clinically. Radiograph shows radiolucency extending to the enamel-dentine junction only. What is the most appropriate management? A. Pulpotomy B. Extraction C. Fissure sealant D. Complete caries removal and composite restoration E. Stainless steel crown

C. Fissure sealant

A 6-year-old girl attends with pain on eating sweets. You detect cavitation with visible dentine on the lower E, which is expected to exfoliate within 6 months. What is the most appropriate management? A. Extraction B. Pulpotomy and crown C. Non-restorative cavity control with monitoring D. Apply GIC and recall in 6 months E. Refer for GA extraction

C. Non-restorative cavity control with monitoring

A 9-year-old boy with molar-incisor hypomineralisation (MIH) presents with sensitivity in the upper first permanent molar. Enamel is yellow and defective with occlusal breakdown. What is the most appropriate management? A. Fluoride varnish only B. Extraction of the molar C. Place a composite restoration D. Consider stainless steel crown or bonding agent and monitor E. Place a porcelain crown

D. Consider stainless steel crown or bonding agent and monitor Reasoning: You CAN place a PMC on a permanent tooth as an interim restoration until the child is older and can tolerate a permenant crown.

A 3-year-old presents with a large cavitated lesion on the lower right D. The parent reports no pain, and the tooth is expected to exfoliate in 2 years. Clinical signs indicate no infection. What is the most appropriate option? A. Pulpotomy B. Complete caries removal C. Monitor only D. Non-restorative cavity control E. Extraction

D. Non-restorative cavity control

A 12-year-old with a high caries risk presents for recall. His last radiographs were taken 9 months ago, and his posterior contacts remain closed. No new caries is seen clinically. What is the most appropriate timing for the next bitewing radiograph? A. In 3 months B. In 6 months C. In 12 months D. In 2 years E. Not needed unless symptoms arise

C. In 12 months

A 5-year-old girl is brought in by a grandparent who reports swelling above a molar. You find a sinus tract adjacent to the upper D and inter-radicular radiolucency on radiograph. What is the most appropriate management? A. Extraction B. Pulpotomy C. Antibiotics only D. Fissure sealant E. Non-restorative management

A. Extraction

A 6-year-old child is caries-free but recently moved to a high-deprivation area. What is the correct frequency for fluoride varnish application? A. Only if caries develops B. Once a year C. Twice a year D. Every 6 months only if white spots are present E. Once every 2 years

C. Twice a year

A 10-year-old patient’s grandmother calls the practice to ask whether he attended his morning appointment. She believes he skipped school. How should you respond? A. Confirm the child attended B. Say the information is confidential C. Tell her the child did not attend D. Ask the dentist first before answering E. Say you’ll check and call back later

B. Say the information is confidential (This protects confidentiality under the Data Protection Act 2018 and Caldicott Principles.) Pt information is only on a need to know basis with consent from the patient or PR holder

A patient has died and their adult daughter asks to see their dental records, stating she believes a mistake was made in their treatment. Which law governs her right to access these records? A. Mental Capacity Act 2005 B. Human Rights Act 1998 C. Access to Health Records Act 1990 D. Data Protection Act 2018 E. Freedom of Information Act 2000

C. Access to Health Records Act 1990

A parent requests that their 15-year-old child receive fluoride treatment, but the child refuses despite understanding the risks and benefits. What is the most appropriate action? A. Proceed with parent’s consent B. Proceed because the child is under 16 C. Delay treatment and respect the child’s decision D. Seek legal advice E. Proceed if the nurse agrees

C. Delay treatment and respect the child’s decision (A 15-year-old may be Gillick competent; their informed refusal must be respected.)

A dental nurse overhears a colleague mocking a patient with a speech impediment while they are recieving treatment with them. What is the nurse’s most appropriate first action? A. Confront them immediately in front of others B. Tell the receptionist C. Report the concern to the practice manager D. Ignore it and assume it's a joke E. Send an anonymous complaint

C. Report the concern to the practice manager (This aligns with the GDC standards and duty to raise concerns.)

You’re treating a 13-year-old boy who discloses he’s scared to go home due to frequent beatings by his uncle. What is your most appropriate action? A. Ask for more detail, document it then report to safeguarding lead B. Reassure the child and keep it confidential C. Document what is said and inform the parent D. Ignore it unless bruising is visible E. Wait to see if he brings it up again but inform social services

A. Ask for more detail, document it then report to safeguarding lead

A dental receptionist accidentally discloses a patient’s appointment time to someone pretending to be their partner over the phone. What law has potentially been breached? A. Freedom of Information Act B. Employment Rights Act C. Children Act D. Data Protection Act 2018 E. COSHH Regulations

D. Data Protection Act 2018

A 14-year-old patient with mild learning difficulties is brought in by their older sister. You are unsure whether the patient understands the proposed treatment. What is your first step? A. Ask the sister to consent as she is legal guardian B. Proceed with treatment C. Assess the young person’s capacity D. Wait for a parent E. Refer to social services

C. Assess the young person’s capacity (Mental Capacity Act 2005 and GDC principles require assessing capacity first.)

A dentist is reported for failing to wear PPE correctly during aerosol-generating procedures. This breaches which legislation? A. RIDDOR B. Employment Rights Act C. Health and Safety at Work Act 1974 D. CQC Regulations E. Human Rights Act

C. Health and Safety at Work Act 1974

A patient with advanced dementia requires an extraction. They are unable to understand or retain any information about the procedure. What is the next step? A. Delay treatment B. Proceed with the family’s verbal consent C. Assess their capicity, then act in best interests D. Refer to the safeguarding team E. Sedate the patient immediately

C. Assess their capicity, then act in best interests (As per the Mental Capacity Act 2005, if they did not have capacity then you would normally have a best interest meeting involving their legal guardian/family and legal advice too)

You receive an email from a journalist requesting internal data on the number of complaints received in the last year. Which law covers how you must respond? A. Access to Health Records Act B. Data Protection Act C. Freedom of Information Act 2000 D. Employment Rights Act E. Equality Act

C. Freedom of Information Act 2000 (if the information does not contain any personal information protected by the Data protection Act then you are required to provide it within 20 working days)

During a fire drill, a trainee refuses to leave the practice area. Who is legally responsible for ensuring staff comply with evacuation procedures? A. Receptionist B. Fire marshal only C. Practice manager and employer D. The individual only E. Health and Safety Executive

C. Practice manager and employer

A 16-year-old patient discloses to you that they are self-harming and don’t want anyone to know. They seem emotionally stable. What should you do? A. Inform their GP without consent B. Keep it confidential unless risk escalates C. Always inform parents D. Call social services immediately E. Refuse to treat the patient

B. Keep it confidential unless risk escalates (Difficult one as balancing confidentiality with safeguarding responsibilities.)

A dental student posts a photo online of a patient’s dental cast with name and hospital ID visible. Which principle has been breached? A. Consent B. Veracity C. Data protection D. Equality E. Justice

C. Data protection

A patient requests access to all the information held about them in the dental practice. Which of the following is correct? A. They must request it through their GP B. It must be provided within 20 working days C. The practice may charge a standard fee D. Only electronic data is covered E. You must verify their identity before releasing it

E. You must verify their identity before releasing it

You see your colleague take home a bottle of local anaesthetic “just in case.” What is your obligation? A. Ignore it if it's not yours B. Ask if they have permission C. Report to a line manager or controlled drugs officer D. Call the GDC E. Inform the local pharmacy

C. Report to a line manager or controlled drugs officer

A patient with a visual impairment is being rushed through consent forms without adequate explanation. Which legislation protects them from discrimination? A. Freedom of Information Act B. Health and Social Care Act C. Employment Rights Act D. Equality Act 2010 E. Human Rights Act

D. Equality Act 2010 (Protected charateristic)

A junior nurse in the practice is being excluded from team meetings due to their accent and age. Which law would this breach? A. COSHH B. Data Protection Act C. Equality Act 2010 D. IRMER17 E. Safeguarding Vulnerable Group

C. Equality Act 2010 (Protected charateristic)

You are concerned that a dental colleague is attending work under the influence of alcohol. What is your primary duty? A. Confront them immediately B. Call the GDC C. Notify the CQC D. Raise concerns following local policy E. Ignore it unless a patient complains

D. Raise concerns following local policy

A parent with joint custody requests records of their child’s dental care, but you’re unsure if they have legal access. What should you check? A. Whether the parent lives with the child B. Whether they have parental responsibility C. Whether the other parent consents D. The child’s school E. If the child has consented

B. Whether they have parental responsibility

A 45-year-old woman presents with a white, lace-like lesion on the buccal mucosa. She reports a burning sensation when consuming spicy foods. The lesion is bilateral and asymptomatic otherwise. What is the most likely diagnosis? A. Oral candidiasis B. Oral lichen planus C. Leukoplakia D. Oral hairy leukoplakia E. Frictional keratosis

B. Oral lichen planus

A 60-year-old man presents with a non-healing ulcer on the lateral border of the tongue, present for 6 weeks. He is a smoker and consumes alcohol regularly. The ulcer has indurated edges and is painless. What is the most appropriate next step? A. Prescribe antifungal medication B. Reassure and review in 2 weeks C. Urgent referral for biopsy D. Prescribe antiviral medication E. Advise smoking cessation and monitor

C. Urgent referral for biopsy

A 35-year-old HIV-positive patient presents with a white lesion on the lateral border of the tongue that cannot be scraped off. The lesion has a corrugated appearance. What is the most likely diagnosis? A. Oral candidiasis B. Oral lichen planus C. Oral hairy leukoplakia D. Leukoplakia E. Frictional keratosis

C. Oral hairy leukoplakia (associated with HIV)

A 28-year-old woman presents with multiple painful ulcers on the non-keratinized mucosa. She reports similar episodes occurring several times a year. The ulcers are round with a yellowish base and erythematous halo. What is the most likely diagnosis? A. Herpetic stomatitis B. Major aphthous ulcers C. Minor aphthous ulcers D. Traumatic ulcers E. Behçet's disease

C. Minor aphthous ulcers

50-year-old man presents with a red, velvety lesion on the floor of the mouth. He is a heavy smoker and consumes alcohol daily. The lesion has been present for 2 months without pain. What is the most appropriate management? A. Prescribe antifungal medication B. Reassure and monitor C. Urgent referral for biopsy D. Advise smoking cessation and review in 6 months E. Prescribe topical corticosteroids

C. Urgent referral for biopsy

A 65-year-old woman presents with a white patch on the buccal mucosa that cannot be scraped off. She is asymptomatic, and the lesion has been present for several months. What is the most likely diagnosis? A. Oral candidiasis B. Oral lichen planus C. Leukoplakia D. Oral hairy leukoplakia E. Frictional keratosis

C. Leukoplakia

A 40-year-old woman presents with a burning sensation in the mouth and a red, depapillated tongue. She reports a history of iron-deficiency anemia. What is the most likely diagnosis? A. Geographic tongue B. Median rhomboid glossitis C. Erythematous candidiasis D. Atrophic glossitis E. Lichen planus

D. Atrophic glossitis

A 30-year-old man presents with multiple vesicles on the hard palate that have ruptured to form ulcers. He reports fever and malaise. The lesions are painful. What is the most likely diagnosis? A. Herpetic stomatitis B. Major aphthous ulcers C. Minor aphthous ulcers D. Traumatic ulcers E. Erythema multiforme

A. Herpetic stomatitis

A 55-year-old man presents with a non-healing ulcer on the lower lip. He works as a gardener. The ulcer has rolled edges and is painless. What is the most likely diagnosis? A. Traumatic ulcer B. Squamous cell carcinoma C. Basal cell carcinoma D. Actinic cheilitis E. Herpes labialis

B. Squamous cell carcinoma

A 70-year-old woman presents with a white patch on the lateral border of the tongue. She wears ill-fitting dentures, and the lesion is adjacent to the denture flange. What is the most likely diagnosis? A. Oral candidiasis B. Frictional keratosis C. Leukoplakia D. Oral lichen planus E. Oral hairy leukoplakia

B. Frictional keratosis

A 52-year-old woman presents with multiple painful erosions on the buccal mucosa and gingiva. She reports a history of similar episodes. Nikolsky's sign is positive. What is the most likely diagnosis? A. Oral lichen planus B. Pemphigus vulgaris C. Mucous membrane pemphigoid D. Erythema Multiforme E. Aphthous ulcers

B . Pemphigus vulgaris

A 60-year-old man presents with desquamative gingivitis and intact bullae on the palate. The lesions are chronic and heal with scarring. What is the most likely diagnosis? A. Pemphigus vulgaris B. Mucous membrane pemphigoid C. Erosive lichen planus D. Bullous pemphigoid E. Herpetic stomatitis

B. Mucous membrane pemphigoid

A 45-year-old smoker presents with a mixed red and white lesion on the lateral tongue that has been present for 3 months. The lesion is asymptomatic. What is the most appropriate next step? A. Prescribe antifungal medication B. Reassure and monitor C. Urgent referral for biopsy D. Advise smoking cessation and review in 6 months E. Prescribe topical corticosteroids

C. Urgent referral for biopsy

A 30-year-old woman presents with a burning sensation on the tongue and a red, depapillated area in the midline dorsum. She is a smoker and uses inhaled corticosteroids. What is the most likely diagnosis? A. Median rhomboid glossitis B. Geographic tongue C. Erythematous candidiasis D. Atrophic glossitis E. Lichen planus

A. Median rhomboid glossitis

A 25-year-old man presents with multiple tiny, painful ulcers on the non-keratinized mucosa. He reports similar episodes occurring several times a year. The ulcers are round with a yellowish base and erythematous halo. What is the most likely diagnosis? A. Herpetic stomatitis B. Major aphthous ulcers C. Minor aphthous ulcers D. Herpetiform aphthous ulcers E. Behçet's disease

D. Herpetiform aphthous ulcers

A 50-year-old woman presents with a red, velvety lesion on the floor of the mouth. She is a non-smoker and reports no pain. The lesion has been present for 2 months. What is the most likely diagnosis? A. Erythroplakia B. Erythematous candidiasis C. Geographic tongue D. Lichen planus E. Trauma-induced ulcer

A. Erythroplakia

A 68-year-old woman presents with a slowly enlarging pigmented lesion on the hard palate. She has no history of trauma or amalgam restorations. On examination, the lesion is asymmetric, dark brown to black, and irregularly shaped. What is the most appropriate next step? A. Reassure and review in 6 months B. Remove adjacent amalgam restoration C. Prescribe antifungal treatment D. Arrange urgent biopsy E. Order serum B12 and folate

D. Arrange urgent biopsy (Suspicious pigmented lesion without an obvious cause must be biopsied to rule out oral malignant melanoma)

A 60-year-old man presents with a proliferative mass in the buccal sulcus. He wears upper dentures, which appear to fit poorly. The lesion is firm and not painful. He has nasal congestion and mild paraesthesia over his cheek. What is the most appropriate next investigation? A. Trial denture adjustment B. Fungal culture C. Radiograph of the maxilla D. Full blood count E. MRI of the brain

C. Radiograph of the maxilla (Consider carcinoma of the maxillary antrum when buccal lesions and nasal symptoms coexist)

A 33-year-old female presents with painful red patches on her tongue that change location over days. She has a history of iron deficiency anaemia and reports worsening fatigue. What is the most appropriate initial investigation? A. B12 and folate levels B. Biopsy C. Antifungal swab D. Patch testing E. Swab for herpes simplex

A. B12 and folate levels (Geographic tongue worsened by anaemia; anaemia should be ruled out first)

A 52-year-old man presents with a chronic white lesion on the lateral tongue. He smokes 20 cigarettes daily and consumes alcohol regularly. The lesion is slightly raised and non-removable. What is the most likely diagnosis? A. Oral candidiasis B. Leukoplakia C. Hairy leukoplakia D. Frictional keratosis E. Lichen planus

B. Leukoplakia

A 55-year-old man presents with ulcerated lips and mucosa after starting sulfonamide antibiotics. He also has conjunctivitis and a mild fever. Nikolsky's sign is positive. What is the most likely diagnosis? A. Pemphigus Vulgaris B. Stevens–Johnson syndrome C. Lupus erythematosus D. Erythema multiforme minor E. Fixed drug eruption

B. Stevens–Johnson syndrome (Mucocutaneous reaction with systemic symptoms = severe drug hypersensitivity reaction)

B. Leukoplakia

A 42-year-old woman presents with bilateral parotid swelling, dry mouth, and dry eyes. She has difficulty swallowing dry foods and multiple carious teeth. What is the most appropriate blood test? A. Serum calcium B. ANCA C. Rheumatoid factor and anti-Ro/La D. FBC E. TSH

C. Rheumatoid factor and anti-Ro/La

A 39-year-old woman has a white striated lesion on the buccal mucosa, extending to the gingivae, with areas of erosion. She has no systemic symptoms. Biopsy shows a band-like infiltrate of T-lymphocytes below the basal layer. What is the most likely diagnosis? A. Pemphigus vulgaris B. Lichen planus C. Erythema multiforme D. Discoid lupus erythematosus E. Oral candidiasis

B. Lichen planus (Histological hallmark: saw-tooth rete pegs and band of lymphocytes = lichen planus)

A 62-year-old patient develops sudden onset of blood-filled blisters on the palate during meals. They rupture easily and heal within days. Full blood count and clotting are normal. What is the most likely diagnosis? A. Bullous pemphigoid B. Pemphigus vulgaris C. Angina bullosa haemorrhagica D. Thrombocytopenia E. Stevens–Johnson syndrome

C. Angina bullosa haemorrhagica ( A self limiting condition with no obvious cause that resolves in 1/2 weeks)

A 15-year-old boy attends your surgery for a routine examination. His upper right permanent canine is yet to erupt. His upper left permanent canine erupted at the appropriate age. At approximately what age would you expect this tooth to have erupted? (Select one answer from the options listed below.) A- 6–7.4 years B- 7.5–8.9 years C- 9–10.4 years D- 10.5–11.9 years E- 12–13.4 years

D- 10.5–11.9 years

A 14-month-old girl is brought to the surgery by her mother. She is concerned that a gap is present between some of her child’s developing upper teeth. Which teeth would you expect to have erupted in the maxillary arch of this child? (Select one answer from the options listed below.) A- As and Bs B- As, Bs, and Ds C- As, Bs, Cs, and Ds D- As, Bs, Ds, and Es E- As, Bs, Cs, Ds, and Es

B- As, Bs, and Ds

The babysitter of a 4-year-old boy telephones the practice, as the child fell down a staircase and has knocked out his upper right deciduous central incisor. The boy was momentarily unconscious but appears normal now. Which is the single most appropriate advice to give to the babysitter over the phone? A- Bring the child to the practice to have it re-implanted by a dentist B- Do not re-implant, and reassure the babysitter not to worry C- Do not re-implant, and take the child to the local A&E D- Re-implant the tooth at home, and bring the child to the practice E- Re-implant the tooth, take the child to the local A&E

C- Do not re-implant, and take the child to the local A&E

A 3-year-old girl attends, following a recent fall. The crown of the upper left primary central incisor (ULA) is significantly displaced labially (protruded). The tooth is non-mobile. A radiograph confirms the clinical diagnosis of lateral luxation. Which is the single most appropriate treatment? A- Extract the ULA B- Orthodontic repositioning C- Refer for specialist care D- Reposition the ULA E- Review after 2–3 weeks

A- Extract the ULA

A 7-year-old girl has had a pulpotomy performed on her lower right second primary molar. Which single coronal restoration is considered the most appropriate? A- Amalgam B- compomer C- Composite D- Glass ionomer cement (GIC) E- Preformed metal crown (PMC)

E- Preformed metal crown (PMC)

A grossly carious lower right permanent first molar (LR6) is extracted from a 9-year-old boy. The child’s parents are keen to know how likely the lower permanent second molar (LR7) is to fill the gap created. Which is the single best predictor that the LR7 will erupt into a good clinical position? A- Age of the patient B- Atraumatic extraction technique C- Early calcification at the LR7 root bifurcation D- Lack of periapical pathology around the LR6 E- Presence of a space maintainer following LR6 extraction

C- Early calcification at the LR7 root bifurcation (About good position not when to extract the LR6)

A 7-year-old girl has been referred for extraction of all of her carious primary molars under general anaesthesia (GA). Extensive oral hygiene instructions and preventive advice were given to the child and her parents prior to their GA appointment. Which is the single most appropriate future management for this child? A- Refer for specialist care due to high caries rate B- Three-month recall for 4-yearly topical fluoride application C- Three-month recall for twice-yearly topical fluoride application D- Three-month recall with fluoride application and fissure sealing of permanent molars E- Three-month recall with high fluoride toothpaste prescription (2800 ppm)

D- Three-month recall with fluoride application and fissure sealing of permanent molars

A 15-year-old girl has a mid-third root fracture of her upper left permanent central incisor (UL1). It is decided to splint the tooth to reduce the risk of future tooth loss. Which is the single most appropriate length of time for the tooth to be splinted with a flexible splint? A- 2 weeks B- 4 weeks C- 8 weeks D- 4 months E- Indefinitely

B- 4 weeks

An 8-year-old boy has occlusal caries in his lower right first permanent molar. He is an irregular attender. Clinically, the caries is minimal and confined to the distal section of the fissure system. A bitewing radiograph shows the caries extends into the outer third of the dentine. Which is the single most appropriate restorative management strategy for this tooth? A- Amalgam restoration B- Composite restoration C- Fissure sealant D- Preformed metal crown (PMC) E- Preventive resin restoration

E- Preventive resin restoration

An 8-year-old boy attends, following a recent fall in the playground. His upper right permanent central incisor (UR1) has been intruded by 5 mm. A radiograph confirms the UR1 is present with incomplete root development. Which is the single most appropriate course of action regarding the UR1? A- Commence immediate root canal treatment B- Extraction C- Orthodontic repositioning D- Review after 2–3 weeks E- Surgical repositioning

D- Review after 2–3 weeks

E- Preventive resin restoration

An 8-year-old boy has a complicated crown fracture of his upper right permanent central incisor (UR1), which happened the previous morning (>24 hours). The tooth is positive to sensibility testing. Which is the single most appropriate management? A- Apexification B- Direct pulp cap C- Extraction D- Pulpotomy E- Root canal treatment

D- Pulpotomy (over 24 hours)

A 9-year-old boy has deep pitting of the palatal aspect of both permanent maxillary lateral incisors. A diagnosis of dens invaginatus is made. The boy reports no symptoms from the teeth, which respond positively to sensibility testing. Which is the single most appropriate management? A- Composite restorations of the upper lateral incisors B- Extract the upper lateral incisors C- Fissure-seal the upper lateral incisors D- Oral hygiene instruction and monitor E- Root canal treatment on the upper lateral incisors

C- Fissure-seal the upper lateral incisors

A 9-year-old boy has an unrestorable, grossly carious lower right first permanent molar (LR6) and a heavily restored upper right first permanent molar (UR6). The remainder of the permanent dentition is present radiographically, caries-free and minimally restored. They have a Class I incisal and molar relationship with well-aligned arches. Due to compliance issues, general anaesthesia is required. For which single treatment should the patient be consented? A- Extract the LR6 and all of the remaining first permanent molars (FPMs) B- Extract the LR6 and the contralateral LL6 C- Extract the LR6 and the opposing UR6 D- Extract the LR6 tooth only E- Extract the UR6 and extirpate the LR6

C- Extract the LR6 and the opposing UR6 (It is suggested that, with FPMs, when a lower molar is removed, removal of the opposing upper FPM should be given close consideration to prevent over-eruption)

A 9-year-old boy attends for an examination. The enamel on all his primary and secondary teeth appears dull, frosty and pitted. There is considerable post eruptive breakdown of a number of teeth and marked sensitivity. Bitewings show numerous carious lesions and enamel that is less radiopaque than the underlying dentine. Which is the single most likely diagnosis? A- Amelogenesis imperfecta (AI) B- Dentinogenesis imperfecta (DI) C- Fluorosis D- Molar incisor hypoplasia (MIH) E- Taurodontism

A- Amelogenesis imperfecta (AI)

A 5-year-old boy with uncontrolled diabetes has gross caries in all of his primary molars. He is very anxious and considered uncooperative. The teeth are unrestorable and asymptomatic. Which is the single most appropriate treatment strategy to manage his carious molars? A- Await natural exfoliation B- Extraction using general anaesthesia (GA) as a day case C- Extraction using GA as an inpatient D- Extraction using inhalation sedation E- Extraction using local anaesthesia

C- Extraction using GA as an inpatient (The patient has a complex medical history which means the decayed teeth should be removed and due to having poorly controlled diabetes it is better to have this as an inpatient overnight GA rather than a day case)

A 7-year-old boy attends with his mother for a routine examination where he is assessed by a foundation dentist (first year post-qualification). The child had multiple primary teeth extracted under general anaesthesia (GA) 18 months ago. Occlusal caries is diagnosed in his lower right first permanent molar, which is partially erupted. The boy was not brought to two subsequent appointments for the restoration. What is the single most appropriate management strategy the dentist should take in this scenario? A- Contact the child’s general medical practitioner (GMP) B- Contact the local safeguarding nurse C- Discharge from the practice D- Discuss with their foundation trainer E- Refer to social services

D- Discuss with their foundation trainer (As you are only junior this is usually your first line of contact with any complicated situations like this)

A 44-year-old woman is having non-surgical root surface debridement for chronic periodontitis. These instruments have single cutting edges on the working tip to enable more efficient removal of deposits and to avoid iatrogenic damage. What is the optimal angle between the cutting edge and the tooth surface when in function? A- 15° B- 30° C- 45° D- 70° E- 90°

D- 70°

A 27-year-old man attends, complaining of loose teeth. He is medically fit and well and has never smoked. He reports rapid development of mobility, affecting all of his lower anterior teeth and lower right first permanent molar. Periapical radiographs provided by his general dental practitioner show progression of horizontal bone loss from 20% to 50% in the last 12 months. His oral hygiene is good, and he is aware that his father and paternal grandfather suffered from pyorrhoea. Which single bacteria is most commonly associated with the disease above? A- Aggregatibacter actinomycetemcomitans B- Fusobacterium nucleatum C- Porphyromonas gingivalis D- Prevotella intermedia E- Tannerella forsythia

A- Aggregatibacter actinomycetemcomitans (perio bacteria)

A 22-year-old woman has bleeding gums and severe pain around her lower front teeth. She has type 1 diabetes mellitus, and she is a heavy smoker (5 pack years). Her gingivae around the lower incisors are acutely tender and inflamed, and there is ulceration, combined with loss of the papilla. No significant probing depths or associated bone loss on the radiographs are noted, but there is an unpleasant odour. Which is the single most likely diagnosis? A- Plaque-induced gingivitis B- Molar–incisor, grade C periodontitis C- Necrotizing gingivitis D- Periodontal abscess E- Periodontitis as a manifestation of systemic disease

C- Necrotizing gingivitis

A 52-year-old man has generalized stage II, grade B periodontitis. Oral hygiene instruction was instigated immediately, along with non-surgical periodontal therapy, providing full mouth root surface debridement (RSD). Upon a 3-month review, he has demonstrated no improvement in oral hygiene and his lack of motivation is apparent; heavy plaque deposits are present on all teeth surfaces. What is the single most appropriate next step in his management? A- Commence a second round of RSD B- Prescribe antibiotics to tackle periodontitis C- Provide another round of RSD & prescribe antibiotics to tackle periodititis D- Re-address oral hygiene instruction E- Refer to a specialist periodontist for periodontal management

D- Re-address oral hygiene instruction

A 37-year-old woman has received a course of non-surgical periodontal therapy in the undergraduate clinic. At review, loss of attachment charting demonstrates generalized reduction in periodontal probing depths, combined with only minor amounts of associated recession. The clinical tutor asks the presenting student which type of healing is most likely to have occurred in this scenario. A- Regeneration: normal bony and junctional architecture is regained B- Regeneration and repair: mainly new bone and periodontal ligament (PDL) are formed, but some healing results from a long junctional epithelium (JE) C- Regeneration and repair: the majority of reduction is from a long JE, but some new bone height and PDL are formed D- Repair: a fibrous connection of scar tissue has formed E- Repair: a long JE attachment has formed

E- Repair: a long JE attachment has formed

A 45-year-old man has severe maxillary anterior toothwear. Marked sclerotic dentine is exposed, with 1 mm of supra-gingival tooth remaining. Dento-alveolar compensation has occurred, and there is no inter-occlusal space for restorations. The surrounding periodontium appears healthy, with no periodontal bone loss and normal root lengths. Which is the single most appropriate procedure to facilitate the direct restoration of these teeth? A- Apically repositioned flap B- Crown lengthening C- Gingivectomy D- Reduction of mandibular incisor height E- Overdenture provision

B- Crown lengthening

A 24-year-old woman has a Class II Millers recession defect, for which a connective tissue graft and a coronally advanced flap are planned. She has excellent oral hygiene, and all four wisdom teeth. Which is the single most appropriate intraoral site for taking her graft? A- Attached gingivae B- Buccal mucosa C- Buccal shelf D- Hard palate E- Retromolar pad

D- Hard palate

A consultant delivers a seminar on the pathogenesis of periodontal disease. Complement activation is discussed with regard to innate immunity, and a junior dental student asks how bacteria stimulate the complement cascade. Which single cell surface structure stimulates this cascade? A- Immunoglobulin G (IgG) B- Interleukin-1 (IL-1) C- Lipopolysaccharide (LPS) D- Membrane attack complex (MAC) E- Pathogen recognition receptors (PRRs)

C- Lipopolysaccharide (LPS)

A 34-year-old man is being reviewed, following two courses of non-surgical periodontal therapy. He has stopped smoking 1 year ago and has no other risk factors. His recent plaque score is 23%, and he has three localized areas of isolated probing depth, which radiographically demonstrate angular vertical defects, with up to 50% of bone loss. A range of infrabony defects are identified when probing, and he has been treatment-planned for regenerative surgery. Which single type of defect has the most predictable outcome? A- One-walled defect B- Two-walled defect C- Three-walled defect D- Circumferential defect E- No walled defect

C- Three-walled defect

A 46-year-old woman is reviewed 6 weeks after placing a metallo-ceramic crown on her upper right central incisor. The colour match is reasonable, although the crown appears slightly opaque. She also has marked localized marginal gingivitis, with fine subgingival calculus deposits that were not evident prior to crown cementation. The crown margins are 0.5 mm intra-sulcular and are well adapted and smooth on probing. Which single additional aspect of the prosthodontic treatment is most likely to be responsible for the gingivitis? A- Bulbous emergence profile B- Excess cement C- Negative crown margins D- Sensitivity to adhesive resin cement E- Supracrestal attached tissue encroachment

A- Bulbous emergence profile (Margins were smooth, no excess cement detected, sesitivity is very rare and it only has gone 0.5mm so it's not in the biological width)

A 28-year-old man attends with a continuous aching pain from his upper left first permanent molar (UL6). It occurs spontaneously, disturbs sleep, and is partly relieved by paracetamol. Chewing or biting does not exacerbate the symptoms. The heavily restored UL6 was hyperresponsive to refrigerant (EndoFrost®). All other special investigations were normal. Which is the single most likely diagnosis? A- Acute apical abscess B- Atypical facial pain C- Chronic apical periodontitis D- Irreversible pulpitis E- Periodontal abscess

D- Irreversible pulpitis

A 45-year-old man has sharp pain to cold from his upper right posterior teeth; the pain ceases immediately on removal of the stimulus. He has multiple cervical abrasion cavities. Which single type of sensory nerve fibre is primarily responsible for his pain? A- A-β B- A-δ C- C D- Parasympathetic E- Sympathetic

B- A-δ

A 45-year-old man is having root canal treatment on his upper left first premolar. After scouting the canal with a small hand file, a rotary file system is introduced with an ISO 25 tip size and a 10-degree taper (25/.10) until resistance is felt. Subsequently, files with a smaller taper are introduced until the working length is reached (25/.06 → 25/.04). What single concept of endodontic preparation does this technique follow? A- Apico-coronal B- Circumferential C- Crown-down D- Modified double flare E- Step back

C- Crown-down

A 52-year-old woman has a sudden onset of severe pain and an altered sensation under her eye, following irrigation during root canal retreatment on a maxillary canine. Which is the single most likely complication? A- Extrusion of sodium hypochlorite B- Inadvertent instrumentation of the infraorbital nerve C- Lateral perforation D- Root fracture E- Transportation of apical constriction

A- Extrusion of sodium hypochlorite (Pain and swelling are the most notable symptoms of a hypochlorite accident)

A 32-year-old man has recently completed root canal treatment on a lower molar that is missing both marginal ridges. Which is the single most appropriate method to restore his tooth? A- A bonded intracoronal amalgam restoration B- A bonded intracoronal composite restoration C- A ceramic inlay D- A full coverage gold crown E- A gold inlay

D- A full coverage gold crown

A consultant is discussing the aetiology and management of dental caries. On his slides, he highlights a histological slice from a progressing carious lesion. Specifically, the consultant discusses the importance of a translucent zone identified histologically within the dentine. A fellow colleague asks what this zone represents. A- The caries-infected zone B- The zone of hypermineralized dentine known as tubular sclerosis C- The zone of hypermineralized surface enamel under which the carious process takes place D- The zone of sound dentine immediately adjacent to the pulp complex E- The zone of subsurface caries spread along the amelodentinal junction

B- The zone of hypermineralized dentine known as tubular sclerosis

A foundation dentist is conducting a root canal treatment on the lower right second premolar of a 26-year-old woman. Whilst irrigating with chlorhexidine, she notes that the concentration is only 0.2% and asks her nurse for an alternative irrigant. The nurse goes to see the foundation trainer to see if they can borrow their sodium hypochlorite. The foundation trainer says that it is not advisable to use both solutions concomitantly because it might affect overall bacterial decontamination. What is the single main reason for this advice? A- A precipitate is produced, which can block dentinal tubules from further irrigant effects B- A reaction between the irrigants results in the production of a bacterial growth factor C- Adjunctive sodium hypochlorite has no clinical benefits over chlorhexidine alone D- The combination of solutions causes selective decontamination and overgrowth of the more pathogenic bacteria E- The residual film produced causes degradation of gutta percha, allowing bacterial leakage.

A- A precipitate is produced, which can block dentinal tubules from further irritant effects.

A 17-year-old adolescent man is referred for root canal treatment of an upper central incisor with an immature apex. The tooth is non-vital and shows comparable root length to the contralateral incisor. Which is the single most appropriate technique to endodontically treat his tooth? A- Apexification with repeated dressings of non-setting calcium hydroxide B- Apical plug formation with bioceramic material C- Cvek pulpotomy D- Endodontic surgery E- Regenerative endodontic procedures

B- Apical plug formation with bioceramic material

A 47-year-old man is having root canal treatment on his upper first molar, which has curved roots. Following coronal preparation of the mesiobuccal canal, an electronic apex locator (EAL) is used and provides a reproducible reading. This is 2 mm shorter than the estimated working length (EWL) from the preoperative radiograph. What is the single most appropriate initial management? A- Obturate to the EWL and review B- Obturate to the EWL, followed by apicectomy C- Prepare using the reading of the EAL D- Take a new radiograph to check for potential perforations E- Take a parallax technique radiograph of the molar to identify the apex

C- Prepare using the reading of the EAL

A 43-year-old woman has pain from a lower central incisor that has previously received root canal treatment. Radiographically, a small, diffuse periapical lesion is present, but the obturation follows the root anatomy and appears adequate. A parallax radiograph indicates asymmetrical distribution of the obturation. What is the single most likely cause of failure? A- Cyst formation B- Missed canal C- Perforation D- Root fracture E- Transportation of the apex

B- Missed canal (45% of mandibular central incisors have 2 canals)

A 58-year-old woman with failed root canal treatment is seen in a new patient consultation clinic. A junior dental student asks about the process of root canal failure. She is aware that certain bacteria have significant dentine adherence capabilities and can survive harsh environments by demineralizing dentine and degrading collagen. Which is the single most likely causative organism in this scenario? A- Aggregatibacter actinomycetemcomitans B- Enterococcus faecalis C- Neisseria gonorrhoeae D- Prevotella intermedia E- Streptococcus mutans

B- Enterococcus faecalis

A 32-year-old man has pain from his upper right central incisor (UR1), having previously fallen off his bicycle 2 years ago. Radiographically, the UR1 apex appears moth-eaten and is 10% shorter in root length than the adjacent central incisor. Additionally, there is periapical radiolucency. What is the single most likely diagnosis? A- External cervical resorption B- External inflammatory resorption C- External replacement resorption D- External surface resorption E- Transient apical breakdown

B- External inflammatory resorption (Moth eaten)

A 58-year-old woman is seen in a new patient clinic, having been referred with a fractured rotary instrument in the upper right first permanent molar. Radiographically, the file has fractured high up, occluding the majority of the canal. The consultant suggests that the use of a reciprocating file system or balanced force technique might have prevented this. For what single primary mechanical reason is this? A- Higher rotational speeds, increasing speed of preparation B- Limits heat from friction, increasing the cyclical fatigue limit of nickel titanium (NiTi) C- No longer requires a pecking motion of use, thus reducing flexural fatigue D- Non-continuous rotation prevents file binding and reduces the risk of torsional fracture E- Off-centre rotational pattern, facilitating debris removal

D- Non-continuous rotation prevents file binding and reduces the risk of torsional fracture

An 18-year-old man is having root canal treatment on his lower left first permanent molar. Following access to the pulp chamber, three canals are identified: two mesial canals—mesiobuccal (MB) and mesio-lingual (ML)—and one distal canal. The distal canal is identified as buccally positioned by 2 mm in relation to the mesiodistal midline of the tooth. What is the single most appropriate next step? A- Coronal flare all three canals B- Determine the working lengths C- Investigate for a fourth canal orifice D- Place a rubber dam, as access has been achieved E- Take a periapical radiograph to exclude a perforation

C- Investigate for a fourth canal orifice (Many mandibular first molars have 4 canals)

A cone beam computed tomography (CBCT) scan shows a missed palatal canal, a well-obturated buccal canal, and a periapical lesion. What is the single most appropriate management to save the tooth? A- Antibiotics, a new crown, and monitoring of the apical lesion B- Apicectomy and a new crown C- Extraction D- Obturate the palatal canal and new crown E- Root canal retreatment and new crown

E- Root canal retreatment and new crown (Solely obturating the missed canal would not be advised in this situation, as the buccal canal is likely to be contaminated)

A 36-year-old man is having the restoration of a recently endodontically treated permanent molar tooth. Only the palatal wall remains in its entirety, but there is 2 mm of supra-gingival dentine elsewhere. What is the single most appropriate method to retain the core? A- Multiple dentine pins B- Nayyar core C- Post-preparation in the mesiobuccal canal D- Post-preparation in the palatal canal E- Split post-technique

B- Nayyar core

An undergraduate dental student is conducting re-root canal treatment on a 36-year-old man. During the session, the clinical tutor notices that the student is cycling between sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) and advises against doing this. Instead they suggest just to do a penultimate rinse with EDTA prior to obturation. What is the single main reason for changing the irrigation protocol? A- Collagen dissolution B- Dentine erosion C- File corrosion D- Root resorption E- NaOCl extrusion

B- Dentine erosion (EDTA is dentine chelating)

A 24-year-old woman has returned to the United Kingdom to get married in 4 weeks. She is interested in whitening her teeth, whilst she prepares for her wedding. She would like to know more about the process of tooth whitening. Which single percentage of hydrogen peroxide is likely to give the quickest results for this patient? A- 1% B- 6% C- 10% D- 16% E- 30%

B- 6% (6% hydrogen peroxide but 16% carbamide peroxide)

A 47-year-old woman is undergoing planning for a full mouth rehabilitation. Before taking the interocclusal record, the clinician manipulates her into retruded contact position (RCP). Which is the single most appropriate description of this position? A- The initial tooth contact following the rotational movement of the mandible B- The initial tooth contact whilst closing around the terminal hinge axis C- The only clinically reproducible initial tooth contacts D- The position of the condyle whilst closing in the habitual position E- The position of the condyle whilst in its most relaxed functional position during closure

B- The initial tooth contact whilst closing around the terminal hinge axis

A 79-year-old edentulous man has a loose upper complete denture. After the primary impressions are taken, the dentist explains that more impressions will be taken at the next appointment. The patient asks why this is necessary. What is the single main reason for the second impression? A- To accurately record soft tissue detail to improve the denture’s adaption B- To correct faults in the primary impression C- To identify the path of insertion of the dentures D- To outline to the technician the neutral zone for tooth placement E- To record and define the full functional limits of the denture-bearing area

E- To record and define the full functional limits of the denture-bearing area.

A 64-year-old woman is treatment-planned to have an immediate maxillary complete denture following a full clearance. Prior to the clearance, she is warned that the dentures will need remaking in 6 months to 1 year. Which is the single most appropriate rationale for this warning? A- Bony remodelling will result in occlusal irregularities B- Bony remodelling will result in overextended dentures C- Bony remodelling will result in poor denture adaptation D- Bony remodelling will result in poor tooth positioning E- The patient might complain if they are unaware they will have to pay again

C- Bony remodelling will result in poor denture adaptation

An 87-year-old edentulous woman has worn dentures and is requesting a new set. As she has no complaints with her current set and has worn them for 15 years, it is decided to provide a new set via the copy technique. Which surfaces of the dentures can be changed easily using this technique? (Select one answer from the options listed below.) A- Fitting and occlusal surfaces B- Fitting and polished surfaces C- Occlusal and polished surfaces D- Occlusal surfaces only E- Polished surfaces only

A- Fitting and occlusal surfaces (polished surfaces can’t be changed)

An 80-year-old man attends his jaw registration appointment. He is happy with the appearance and position of the anterior teeth on his old maxillary denture, so it is decided to copy this to the new denture. Which is the single most appropriate device to aid the clinician in doing this at the chair side? A- Alma gauge B- Fox’s occlusal plane guide C- Iwanson gauge D- Steel ruler E- Willis bite gauge

A- Alma gauge (measures incisive papilla)

A 45-year-old woman is having a new cobalt-chrome partial denture made. The primary models have been surveyed and returned with the special trays. She has a lone-standing upper right second molar that would make a useful tooth for direct retention with a cast cobalt-chrome clasp. What is the single most appropriate clasp length and undercut required for this type of clasp? A- 0.25 mm and 8 mm B- 0.25 mm and 15 mm C- 0.5 mm and 8 mm D- 0.5 mm and 12 mm E- 0.5 mm and 14 mm

B- 0.25 mm and 15 mm

A 19-year-old woman is referred, following completion of her orthodontic treatment for the replacement of her missing lateral incisors. Medically she is fit and well and has a minimally restored dentition. There is insufficient interradicular space for dental implants, and the patient is advised to have adhesive bridgework over conventional bridgework. What is the single main reason for this advice? A- Aesthetic B- Cheap to produce C- Ease of construction D- Low biological cost E- Reduced clinical time

D- Low biological cost (less tooth structure removed)

A 36-year-old man attends an emergency appointment with a decoronated upper right second premolar. The tooth has been previously root-treated, but only 1 mm of supra-gingival tooth tissue remains. It is decided that a post crown is required, but before continuing, the patient is warned the prognosis is guarded and that there is a risk of root fracture long term. What single prognostic feature may increase the risk of root fracture in this scenario? A- Limited ferrule B- Long post length C- Narrow post width D- Shallow retention grooves E- Unfavourable crown–root ratio

A- Limited ferrule

A 72-year-old man has just had a set of complete dentures delivered. The articulation is checked, and adjustments are made to ensure bilateral balanced articulation. Which cusps should be adjusted to prevent unwanted change to the occlusal vertical dimension (OVD)? A- Buccal upper, lingual lower B- Distal upper, mesial lower C- Lingual upper, buccal lower D- Mesial upper, distal lower E- Palatal upper, buccal lower

A- Buccal upper, lingual lower BULL- **non working cusps**, adjust these PUBL- working cusps, don't adjust these

A 68-year-old woman attends for the try-in of her cobalt-chrome denture framework. At the appointment, it does not fit. Having spoken to the laboratory technician, it is discovered that the wrong type of refractory model was used. What is the single main reason this type of model is required in the production of cobalt-chrome dentures? A- To assist in the flow of the molten metal over the cast, preventing air blows B- To block out unwanted undercut C- To facilitate the placement of an investing sprue onto the wax pattern D- To maintain the registration previously recorded, as the original model is often damaged during the casting process E- To withstand casting temperatures and expand/contract in a similar manner to the alloy

E- To withstand casting temperatures and expand/contract in a similar manner to the alloy (Basically the gypsum cast can't withstand 1000°C temperature, so silican ones need to be made)

A 74-year-old woman attends, following the fit of a new set of conventional complete dentures. She complains of generalized aching pain from her cheeks bilaterally, which started a few days after getting the new dentures. She also feels that her teeth ‘clatter together’ when she is speaking. What is the single most likely cause of the problem? A- An overcontoured base plate in the canine regions B- Inadequate freeway space (FWS) C- Increased overjet (OJ) D- Overextension of both the upper and lower dentures E- Unilateral, unbalanced contact in intercuspal position (ICP)

B- Inadequate freeway space (FWS)

E- To withstand casting temperatures and expand/contract in a similar manner to the alloy (Basically the gypsum cast can't withstand 1000°C temperature, so silican ones need to be made)

A 37-year-old man is having his four maxillary incisor metallo-ceramic crowns replaced. He has a Class II div 2 incisal relationship, and the anterior guidance is deemed satisfactory. The guidance is planned to be copied from the preoperative mounted study models. Which single element of a semi-adjustable articulator can be used for this purpose? A- Condylar guidance angle B- Incisal guidance table C- Intercondylar width D- Occlusal table E- Progressive side shift

B- Incisal guidance table

A 68-year-old woman attends for a routine check-up. It is noticed that her bridge replacing the upper right canine, which is of a double abutment design, has failed. The upper right second premolar has caries under the retainer. She is advised that the bridge will need to be removed but that a new bridge design will be used because double abutting retainers is no longer considered an appropriate design. What is the single most important reason why this design is not considered appropriate? A- Excessive costs B- Increased occlusal forces increase the risk of crown fracture C- Link retainers have a negative impact on periodontal health D- No mechanical benefit is gained over a cantilever design E- Partial debonding of the distal retainer frequently goes unnoticed

E- Partial debonding of the distal retainer frequently goes unnoticed

A 29-year-old woman has severe localized anterior toothwear affecting her mandibular incisors, with no inter-occlusal space present. Direct composite restorations have been placed, and posterior teeth are no longer in contact. The patient is advised that her ‘bite’ will feel different for a while, but it will eventually re-establish. What single movement is most likely to occur in the posterior teeth? A- Eruption B- Intrusion C- No movement—restoration at new occlusal vertical dimension (OVD) required D- Rotation E- Tipping

A- Eruption (overeruption of posteriors as they are propped open from anteriors)

An 18-year-old woman has a failed single cantilever resin-bonded bridge (RBB) replacing her upper right lateral incisor. What is the single most likely reason for failure of her bridge? A- Abutment failure B- Debonding C- Emergence profile D- Shade match E- Pulp necrosis

B- Debonding

A 25-year-old woman is having a routine examination. Dental caries is suspected buccally on the lower right first permanent molar. The tooth is dried with air, and a white spot lesion becomes more evident. What is the single main explanation for this? A- Change in caries assessment index B- Change in desiccation index C- Change in index of treatment need D- Change in light index E- Change in refractive index

E- Change in refractive index (different when dried compared to wet)

B- Debonding

A 51-year-old woman is having a gold shell crown placed on her upper right first permanent molar (UR6). Following occlusal reduction of 1 mm, a further 0.5 mm of height is reduced over the palatal cusp. What is the single main reason for doing this? A- Aids retention and resistance form B- Better structural durability C- Improved marginal integrity D- Maintains cleansability E- Preserves tooth structure

B- Better structural durability

A 68-year-old woman attends, complaining of a loose upper denture. Clinically, she has an edentulous maxilla and retained lower incisor teeth. She is not currently wearing a lower denture and does not take her upper denture out at night. The upper denture is loose, and the premaxilla is mobile and ‘flabby’. What is the single most appropriate diagnosis? A-Apertognathia B- Bezold–Brucke effect C- Bonwill triad D- Combination syndrome E- Kelly’s sign

D- Combination syndrome (combination of upper complete denture and lower normal teeth)

An 82-year-old man attends, wishing to have new dentures made. He only has his mandibular incisor teeth remaining, which are severely proclined, and the residual alveolar ridge is grossly resorbed. It is decided to construct a swing-lock denture to try and provide a satisfactory lower partial denture. When designing the connectors, which single combination would be the most appropriate? A- Fixed labial bar and hinged lingual plate B- Hinged labial bar and lingual plate C- Hinged labial bar and sublingual bar D- Lingual plate and coronally approaching clasps E- Lingual plate and gingivally approaching clasps

B- Hinged labial bar and lingual plate

A 53-year-old man has a deep disto-occlusal-lingual amalgam restoration incorporating the cusp on his vital lower right first permanent molar. It is due to be replaced. The tooth has historically been affected by attachment loss, and the restoration margin is supra-gingival but extends below the cemento–enamel junction. He returns after 2 weeks, complaining of food packing. Given that it was very challenging initially to restore the contact point, what would be the single most appropriate course of action? A- Addition of amalgam to the contact point B- Provide additional oral hygiene instruction C- Provide new direct composite resin restoration D- Replace the amalgam using a wedge E- Restore with an indirect extra-coronal restoration

E- Restore with an indirect extra-coronal restoration (onlay)

A 56-year-old woman is having her single implant crown restored. It is opposing a natural tooth. The static occlusal contact is left ‘light’ (i.e. roughly 20–30 μm of space between the prosthesis and the opposing natural tooth during gentle occlusion). What is the single main reason for doing so? A- Account for periodontal ligament compression around the natural teeth B- Compensate for the wear of the natural dentition over time C- Minimize the risk of potential excursive interferences D- Reduce stress accumulation in, and prevent fracture of, the abutment screw E- Reduce the time taken to fit the crown

A- Account for periodontal ligament compression around the natural teeth

A local colleague is overheard recommending a local personal trainer who is offering tooth whitening with 10% carbamide peroxide. This person’s name is not on the General Dental Council (GDC) register. Which single UK law does this contravene, and how would you manage the scenario? A- Dentists Act 1984—contact the GDC B- Dentists Act 1984—contact Trading Standards C- Health and Medicines Act 1988—contact the GDC D- Health and Medicines Act 1988—contact the Medicines and Healthcare Products Regulatory Agency (MHRA) E- The Cosmetic Products Enforcement Regulations 2013—contact the MHRA

A- Dentists Act 1984—contact the GDC

A 74-year-old man requires the extraction of his upper right second premolar (UR5). He is currently taking warfarin for a recent deep vein thrombosis. His international normalized ratio (INR) was recorded as 2.6 when it was last assessed and has been stable over the last 3 months. What is the maximum time recommended between the extraction and the last INR reading? A- 12 hours B- 24 hours C- 36 hours D- 48 hours E- 72 hours

E- 72 hours

24-year-old man with an 8-pack year smoking history attends in pain, following a routine extraction of his lower left first permanent molar (LL6) 3 days ago. He has deep-seated, severe pain around the extraction site. Medically, he is fit and well. Which is the single most likely cause of his pain? A- Alveolar osteitis B- Fractured jaw C- Osteomyelitis D- Osteonecrosis of the jaw E- Retained root

A- Alveolar osteitis (Dry socket)

A 64-year-old woman requires the extraction of her lower right first molar. She previously received intravenous (IV) zoledronic acid for breast cancer 6 years ago. Although no longer receiving zoledronic acid, she is now taking denosumab. Which is the single most appropriate management? A- Extract the tooth atraumatically B- Extract the tooth under antibiotic prophylaxis C- Maintain the roots as an overdenture abutment D- Perform surgical removal of the tooth E- Refer to your local Oral Surgery/Oral Maxillofacial Department

E- Refer to your local Oral Surgery/Oral Maxillofacial Department

A 21-year-old man has been referred with recurrent bouts of pericoronitis associated with his lower left third molar (LL8). A dental panoramic tomogram (DPT) is taken, and incidentally, a large unilocular lesion surrounding the crown of the unerupted lower right third molar (LR8) is identified. What is the single most likely diagnosis of this lesion? A- Calcifying epithelial odontogenic tumour (Pindborg tumour) B- Dentigerous cyst C- Odontogenic keratocyst D- Odontogenic myxoma E- Paradental cyst

B- Dentigerous cyst (Unerupted tooth)

A 23-year-old woman is having the extraction of an asymptomatic upper right wisdom tooth. During the procedure, a large palatal mucosal tear appears adjacent to the tooth, and the segment is now mobile. Which single complication is most likely to have occurred? A- Crown fracture B- Oro-antral communication C- Oro-antral fistula D- Root fracture E- Tuberosity fracture

E- Tuberosity fracture

A 46-year-old woman is reviewed following the extraction of an upper right first molar (UR6). She says that she has been unable to smoke properly since the extraction and has noticed a salty discharge. A diagnosis of oroantral communication is made, and surgical correction planned. Which is the single most appropriate surgical management in this situation? A- Buccal advancement flap B- Modified three-sided flap C- Palatal rotation flap D- Semi-lunar flap E- Two-sided flap

A- Buccal advancement flap

A 27-year-old man received a blow to the right side of his head during a rugby match and has blurry vision, which is corrected by tilting his head. On ocular examination, his right eye appears elevated and he reports double vision when he attempts to look straight down to read. Which single cranial nerve is most likely to have been traumatized? A- Abducens B- Infraorbital C- Oculomotor D- Optic E- Trochlear

E- Trochlear (Trochlear CN IV innervates the superior oblique muscle which depresses the eyeball. Trochlear is most common cranial nerve to be affected by trauma)

A 36-year-old woman with a large submandibular abscess is scheduled for extra-oral drainage. An incision is made approximately 2 cm below, and parallel with, the body of the mandible on the right-hand side. Which single nerve is at greatest risk when carrying out this procedure? A- Cervical branch of the facial nerve B- Lingual branch of the mandibular nerve C- Mandibular branch of the facial nerve D- Mental branch of the mandibular nerve E- Transverse cervical of the cervical plexus

C- Mandibular branch of the facial nerve

A 28-year-old woman had her lower left third molar extracted 6 months ago. The practice subsequently received a letter from her solicitor requesting access to the patient’s clinical records, using a subject access request. Under which single law is this request legally valid? A- Access to Health Records Act 1990 B- Access to Medical Reports Act 1988 C- Data Protection Act 2018 D- Dentists Act 1984 E- Freedom of Information Act 2000

C- Data Protection Act 2018

A 45-year-old woman has a sore tongue. She has red atrophic areas on the dorsum and lateral border of the tongue with demarcated white borders. She says that the appearance has been inconsistent over time. What is the single most likely diagnosis? A- Ankyloglossia B- Geographic tongue C- Glossodynia D- Macroglossia E- Median rhomboid glossitis

B- Geographic tongue

A 33-year-old woman has recent-onset pain from her jaw. She has recently become a new mother. The pain radiates towards her ear and is worse in the mornings. Her temporomandibular joint (TMJ) clicks on opening and closing but is unrestricted and causes no discomfort. Pain is elicited on palpation of the masseter muscles. What is the single most appropriate first-line treatment? A- Prescribe non-steroidal anti-inflammatory drugs B- Provide a soft occlusal splint C- Reassure and advise a soft diet with warm compresses D- Refer for acupuncture E- Refer for arthrocentesis

C- Reassure and advise a soft diet with warm compresses (stress)

A fit and well 14-year-old adolescent girl has a well-circumscribed brown, pigmented area on her lower lip. She says that it is unchanged since she noticed it 2 years ago. Clinically, it is an isolated lesion, flush with the labial mucosa, and measuring 3 × 2 mm in size. What is the single most likely diagnosis? A- Amalgam tattoo B- Malignant melanoma C- Melanotic macule D- Pigmentation due to Peutz–Jeghers syndrome E- Pigmented naevus

C- Melanotic macule (no associating factors to make you suspect PJ)

A 44-year-old woman has painless white lesions bilaterally on her buccal mucosa, which have been present for 4 months. She recently had a patchy rash on her shins, which has resolved. She has multiple amalgam fillings in the upper right and lower right permanent molars. What is the single most likely diagnosis? A- Chronic hyperplastic candidiasis (CHC) B- Lichenoid reaction C- Oral lichen planus D- Squamous cell carcinoma E- White sponge naevus (WSN)

C- Oral lichen planus

A medically fit and well 25-year-old woman has recurrent soreness under her tongue. She has approximately 20 ulcers, each of which is a couple of millimetres in diameter on the floor of her mouth. What is the single most likely diagnosis? A- Crohn’s disease B- Herpetiform recurrent aphthous stomatitis (RAS) C- Major RAS D- Minor RAS E- Traumatic ulcer

B- Herpetiform recurrent aphthous stomatitis (RAS)

A 60-year-old man has a red patch limited to the denture-bearing area of his maxilla. His dentures have been recently remade and are well fitting. A provisional diagnosis of chronic erythematous candidiasis is made. However, he has atrial fibrillation and is taking warfarin. What is the single most appropriate management? A- Reinforce denture hygiene and prescribe amphotericin tablets B- Reinforce denture hygiene and prescribe chloramphenicol ointment C- Reinforce denture hygiene and prescribe chlorhexidine gel D- Reinforce denture hygiene and prescribe miconazole oral gel E- Reinforce denture hygiene and prescribe nystatin suspension

E- Reinforce denture hygiene and prescribe nystatin suspension

A 3-year-old girl has bloody crusty lips, widespread oral ulceration, and a temperature of 38.5°C. Her mother reports that the condition has lasted for over 3 weeks and says that she is struggling to eat. What is the single most appropriate management? A- Prescribe aciclovir tablets B- Prescribe benzydamine hydrochloride mouthwash C- Prescribe chlorhexidine gluconate mouthwash D- Reassure the mother and monitor E- Refer for a specialist’s opinion

E- Refer for a specialist’s opinion (Primary herpetic gingivo stomatitis should have stopped after 2 weeks)

A 28-year-old woman presents with this intraoral appearance of cobblestoning. She says that her previous dentist has suggested avoiding cinnamon in her diet. She has no systemic symptoms, but her lower lip is enlarged. What is the single most likely diagnosis? A- Coeliac disease B- Crohn’s disease C- Linea alba D- Orofacial granulomatosis (OFG) E- Ulcerative colitis

D- Orofacial granulomatosis (READ THE Q)

A 79-year-old man has sore, crusted skin lesions at the corner of his mouth. He wears very old complete dentures, which have a freeway space of 12 mm. Swab results indicate mixed Candida albicans and Staphylococcus aureus infection, and blood tests exclude haematinic deficiencies. Which is the single most appropriate management? A- Prescribe fusidic acid cream, and arrange for new dentures to be made with a decreased occlusal vertical dimension (OVD) B- Prescribe fusidic acid cream, and arrange for new dentures to be made with an increased OVD C- Prescribe miconazole cream, and arrange for new dentures to be made with a decreased OVD D- Prescribe miconazole cream, and arrange for new dentures to be made with an increased OVD E- Prescribe nystatin suspension, and arrange for new dentures to be made with an increased OVD

D- Prescribe miconazole cream, and arrange for new dentures to be made with an increased OVD

A 57-year-old woman has a dry mouth and dry eyes. Recent blood tests confirm anti-Ro and anti-La autoantibodies, and a labial gland biopsy demonstrates multiple dense foci of lymphocytic infiltrate in a 4mm2 area. She is otherwise fit and well, with no other medical conditions. What is the single most likely diagnosis? A- Chronic bacterial sialadenitis B- Primary Sjögren’s syndrome C- Sarcoidosis D- Sicca syndrome E- Systemic lupus erythematosus (SLE)

B- Primary Sjögren’s syndrome

A 39-year-old man attends the Maxillofacial Department with sweating on eating and flushing of the skin. He had a pleomorphic adenoma surgically removed from his right parotid approximately 12 weeks ago. What is the single most likely diagnosis? A- Frey’s syndrome B- Graves’ disease C- Horner’s syndrome D- Melkersson–Rosenthal syndrome E- Sicca syndrome

A- Frey’s syndrome (rare neurological condition that causes you to sweat excessively while eating or thinking about food)

A 50-year-old woman has right-sided jaw pain. She describes it as a recurrent, excruciating shooting ‘electric shock’-like pain of rapid onset and short duration. What is the single most likely preliminary diagnosis? A- Atypical facial pain B- Glossopharyngeal neuralgia C- Irreversible pulpitis D- Reversible pulpitis E- Trigeminal neuralgia

E- Trigeminal neuralgia

A 73-year-old man has been suffering with ongoing pain for the past 3 months. He has severe, sudden-onset unilateral headaches, which becomes worse when chewing. He has a temperature of 38.6°C. The area is tender to touch, and the pulse from the side of the head on the affected side is not detectable. Which is the single most likely diagnosis? A- Atypical facial pain B- Cluster headache C- Myofascial pain D- Temporal arteritis E- Trigeminal neuralgia

D- Temporal arteritis (Temporal arteritis is a type of vasculitis, affecting the superficial temporal artery. Pain may be elicited when chewing, as the temporal muscles become ischaemic. The condition usually presents in older patients)

A 38-year-old man has diffuse bilateral white lesions on his buccal mucosa and floor of his mouth. The lesions are asymptomatic but have a rough texture. He has never smoked and says he has had the lesions since 12 years of age. What is the single most likely diagnosis? A- Frictional keratosis B- Leukoedema C- Lichen planus D- Stomatitis nicotina E- White sponge naevus

E- White sponge naevus (Rough texture, since childhood, doesn't smoke)

A fit and healthy 27-year-old man is concerned about a lesion on his tongue. He does not report any other lesions anywhere else. The lesion is non-tender, and no other oral lesions are seen, but cervical lymphadenopathy is detectable. He is a non-smoker. A blood test is requested to aid diagnosis for the suspected lesion. What is the single most likely provisional diagnosis? A- Major recurrent aphthous stomatitis B- Primary syphilitic chancre C- Squamous cell carcinoma D- Traumatic ulcer E- Tuberculosis

B- Primary syphilitic chancre (systemic infection)

A 62-year-old woman has a recurrent swelling under her tongue during mealtimes. She has a mobile, unilateral, firm submandibular swelling. She is allergic to iodine. Which is the single most appropriate definitive investigation? A- Computed tomography of the mandible B- Fine-needle aspiration C- Magnetic resonance imaging of the mandible D- Sialography E- Standard true lower occlusal radiograph

C- MRI of the mandible (**Sialography involves Iodine** and an occlusal radiograph is not a definitve investigation)

A 65-year-old man attends, complaining of a red sore tongue. He also reports backache and ongoing fatigue for the past 3 months. He had radiotherapy for an extramedullary plasmacytoma in his upper respiratory tract 4 years previously. Blood tests from his general medical practitioner confirm hypercalcaemia, normocytic and normochromic anaemia, and elevated immunoglobulins. What is the single most likely diagnosis? A- Chondrosarcoma B- Langerhans cell histiocytosis X C- Metastatic squamous cell carcinoma D- Multiple myeloma E- Paget’s disease of bone

D- Multiple myeloma (affects WBC, multiple because can spread to other areas)

A 24-year-old man who is diagnosed with moderate autistic spectrum disorder has bleeding swollen gums, which his carers have been unable to brush because they are sore. He appears lethargic and only eats crisps. Early loss of periodontal attachment is present, and generalized hyperplastic gingivae are noted. His full blood count (FBC) shows a white blood cell (WBC) count of 7.4 × 109/L. The patient takes melatonin. What is the single most likely diagnosis? A- Acute lymphoblastic leukaemia (ALL) B- Acute necrotizing ulcerative gingivitis (ANUG) C- Drug-induced gingival overgrowth (DIGO) D- Pyogenic granuloma E- Vitamin C deficiency

E- Vitamin C deficiency (White blood cell count normal so not leukaemia but bad diet so lethargic because of that)

A 19-year-old man recently had his unerupted LR8 surgically extracted. A cyst is also removed that is associated with the lateral aspect of the unerupted crown. Histopathology shows a regular cyst lining, consisting of stratified squamous epithelium. The basal cells are palisaded columnar cells which show high levels of mitotic figures. Parakeratinization is noted on the surface epithelial cells. The cyst contents were pale, with a low protein content consisting mainly of albumin. What is the single most likely diagnosis? A- Dentigerous cyst B- Eruption cyst C- Lateral periodontal cyst D- Odontogenic keratocyst E- Radicular cyst

D- Odontogenic keratocyst (present when tooth isn’t there)

A 62-year-old man attends for a review of his Behçet’s disease, following a recent episode of uveitis. Upon arrival, he trips on some torn carpet in the entrance of your practice and is taken by ambulance to Accident and Emergency after losing consciousness briefly. The fall results in a broken jaw, and the patient is admitted to hospital for 2 days and requires 4 weeks off work. To which single organization should this incident be reported? A- Care Quality Commission B- Dental Indemnity Firm C- Environment Agency D- General Dental Council E- Health and Safety Executive

E- Health and Safety Executive (A general health and safety issue)

A 15-year-old girl attends the Emergency Department at the local dental hospital. She suffers from type 1 diabetes mellitus. Damage to which single cell type in the pancreas would lead to the patient’s condition? A- Alpha cells B- Beta cells C- Delta cells D- Epsilon cells E- Gamma cells

B- Beta cells

A 78-year-old man with poorly controlled type 2 diabetes requires extraction of his lower right first permanent molar (LR6), as he has a periapical abscess on the tooth. He is extremely nervous and, uncommonly for him, did not eat breakfast. During treatment, the patient begins to sweat profusely; he then begins to shake violently and stops responding. What is the single most likely explanation for the presentation? A- Brain tumour B- Epileptic seizure C- Hypoglycaemic attack D- Odontogenic sepsis E- Pseudoseizure

C- Hypoglycaemic attack (can fit with hypo, **I did the same**)

A 67-year-old man with chronic obstructive pulmonary disease (COPD) attends for a routine restoration. During treatment, he starts to cough and asks if the treatment can be stopped. He sits up and is visibly working hard to breathe. His respiratory rate is 30 breaths per minute. His cough is productive and appears to be clear, but his lips start to develop a blue tinge. Whilst the nurse applies a pulse oximeter, what is the next single most appropriate management? A- High-flow oxygen at 10–15 L/minute (through a non-rebreather mask) B- Low-flow oxygen at 2–3 L/minute (through nasal cannulae) C- Medium-flow oxygen at 5–10 L/minute (through a simple face mask) D- Titrate oxygen levels to between 88% and 92% (through a non-rebreather mask) E- Titrate oxygen levels to between 92% and 98% (through a simple face mask)

A- High-flow oxygen at 10–15 L/minute (through a non-rebreather mask) **what you administer in an ME**

An unaccompanied 79-year-old woman attends her dentist for extraction of her upper right first permanent molar (UR6). She takes warfarin for atrial fibrillation, and her latest international normalized ratio (INR) was 3.1 three days ago. Following the extraction, the socket is packed with a haemostatic agent and sutured; however, after 20 minutes of pressure, the patient is still bleeding. What is the single most appropriate next management strategy? A- Ask the patient to continue applying pressure to the area at home and pause the warfarin until the bleeding stops B- Ask the patient to go to the local Emergency Department C- Continue applying pressure over the area and call for an ambulance D- Give high-flow oxygen and suction the blood from the mouth E- Give the patient an intravascular injection of vitamin K

C- Continue applying pressure over the area and call for an ambulance

A 35-year-old man attends his orthodontist for a review, after completing a course of orthodontic treatment 12 months ago. His retainers no longer fit even, though he has worn them consistently every other night. Clinically, spacing has developed between his anterior teeth, and his facial appearance has changed from his post-operative photos. He now has more prominent supra-orbital ridges and widening of the nose and jaw, and has noticed tingling in both hands. What is the single most likely cause in this scenario? A- Addison’s syndrome B- Anabolic steroid use C- Conn’s syndrome D- Cushing’s syndrome E- Pituitary tumour

E- Pituitary tumour (Growing)

A previously fit and well 55-year-old woman attends her dentist, complaining of recent-onset gingival swelling. She apologizes for being late to the appointment but explains that she has been chronically tired for the past couple of months and slept through her alarm. She is short of breath from walking up the stairs and has multiple bruises visible on her arms as she takes off her coat. Clinically, she has bilateral cervical lymphadenopathy and swollen pale gingivae, which bleed spontaneously. What is the single most likely diagnosis? A- Acute myeloblastic leukaemia B- Acute lymphocytic leukaemia C- Beta-thalassaemia D- Chronic myeloblastic leukaemia E- Non-Hodgkin’s lymphoma

A- Acute myeloblastic leukaemia (ALL is the most common childrens leukaemia, but AML is the most common in adulthood)

A 70-year-old man attends for a routine examination. He has recently fallen and fractured his foot. He takes time getting up off the chair and shuffles into the surgery. His handwriting on the new patient questionnaire is extremely small and spidery. He is expressionless, whilst recounting the history of his recurrent falls. What is the single most likely cause of the recurrent falls? A- Benign paroxysmal positional vertigo (BPPV) B- Cerebellopontine angle (CPA) tumour C- Labyrinthitis D- Parkinson’s disease E- Posterior circulation infarct

D- Parkinson’s disease

A 37-year-old woman attends for a routine scale and polish. Medically, she is under investigation with her general practitioner for symptoms of excessive thirst, palpitations, excess sweating, and recent weight loss. Clinically, she has a large lump in her neck. The lump moves when she swallows, but not when she sticks her tongue out. What is the single most likely cause for her neck lump? A- Diabetes insipidus (DI) B- Graves’ disease C- Hashimoto’s thyroiditis D- Thyroid cancer E- Tuberculosis (TB)

B- Graves’ disease (Graves is hyperthyroidism causing- excess sweating, and recent weight loss Hashimoto's is hypothyroidism causing- lethargy, depression and weight gain)

A 65-year-old man presents with a large dental abscess in the lower right quadrant. He suffers from polymyalgia rheumatica (PMR), for which he has recently been taking high-dose prednisolone. He has not taken his medication for the last 2 days, as he knows steroids ‘make infections worse’. He is profusely sweaty and looks extremely unwell. His current temperature is 39°C, and his blood pressure is 70/50 mmHg. His blood sugar is 2.9 mmol/L. What is the single most likely underlying cause for his presentation? A- Acquired immune deficiency syndrome (AIDS) B- Addison’s disease C- Adrenal crisis D- Hyperadrenalism E- Septic shock

C- Adrenal crisis (prednisolone can suppress cortisol secretion)

A 75-year-old man with hypertension attends for the fit of his upper complete denture. During insertion of the denture, he begins slurring his speech, and then the left corner of his mouth droops. When he sees the abnormalities in the mirror, he becomes alarmed and raises both his eyebrows in surprise. At his next review, he reports he went to hospital, but the symptoms resolved after half a day, and he is now under review with his doctor. What was the single most likely diagnosis? A- Bell’s palsy B- Cerebrovascular accident (CVA) C- Subarachnoid haemorrhage (SAH) D- Transient ischaemic attack (TIA) E- Vertebrobasilar insufficiency

D- Transient ischaemic attack (TIA) (Being able to raise both eyebrows differentiates from Bell’s palsy)

A 45-year-old man presents to the dental hospital emergency clinic with toothache. He denies any medical problems but admits to drinking 2 L of cider a day. The sclerae of his eyes are faintly yellow; his abdomen is distended, and he appears to have red, spider-like patterns on the skin of his face and neck. On examination, the lower left second molar (LL7) displays gross subgingival caries and requires extraction. The patient is in severe pain and wants immediate treatment. What is the next single most appropriate course of action? A- Decline to extract the tooth and prescribe a course of metronidazole B- Decline to extract the tooth and extirpate to alleviate pain C- Extract the tooth as normal immediately D- Extract the tooth tomorrow, asking the patient not to drink until then E- Request a full blood count, liver function tests, and a clotting screen

E- Request a full blood count, liver function tests, and a clotting screen (Alcoholic and shows signs of liver failure)

A 59-year-old woman attends for the first time, complaining of wobbly teeth. She has a smoking history of 40 pack years but has recently quit. She has a chronic cough and is seen to be using a bloodstained handkerchief. Her left eye is sunken in, with a smaller pupil, compared to the right eye, and her left eyelid is also drooping. What is the single most likely underlying diagnosis? A- Mesothelioma B- Pancoast tumour C- Pneumothorax D- Pulmonary embolism (PE) E- Tuberculosis (TB)

B- Pancoast tumour (A type of lung tumour that presents with a droopy eye) **blood stained sputum doesn’t always = TB**

A 32-year-old man attends for a routine appointment. He is a recovering intravenous drug user, has a smoking history of 25 pack years, and drinks six cans of lager every day. He has had a cough and been experiencing night sweats for the past 4 weeks. He says his clothes feel a lot looser in the last 6 months. Clinically, a dark purple, irregular lump is seen on the upper left buccal gingiva, which the patient was unaware of. White plaques are present on his tongue, which can be scraped off. What is the single most likely underlying diagnosis? A- Acquired immune deficiency syndrome B- Candida albicans infection C- Malignant melanoma D- Oral squamous cell carcinoma E- Tuberculosis

A- Acquired immune deficiency syndrome AIDS

An 85-year-old man is brought for a routine appointment in his wheelchair, accompanied by his carer. He appears very drowsy, and his carer states he has been sleeping excessively over the last 2 days. He has been off his food and not drinking much. He wakes up intermittently, complaining of toothache. The only new medication he has started taking is over-the-counter ibuprofen. His other medications include bisoprolol, candesartan, aspirin, glaucoma eye drops, and a morphine patch. His carer explains he has barely woken up over the last 2 days, not even to go to the bathroom. Attempts to rouse him are to no avail. Upon performing a sternal rub, he opens his eyes and moves his hands over the sternal area. He makes an attempt to mumble something, but it is not comprehensible. What is the single correct Glasgow coma scale (GCS) score for this gentleman? A- 3 B- 6 C- 7 D- 8 E- 9

E- 9 (2 + 3 + 4)

A 65-year-old woman requires an extraction due to advanced periodontal disease. She suffers from stage 5 chronic kidney disease (CKD) and has haemodialysis three times a week. When is the single most appropriate time for the extraction? A- Four hours after dialysis B- One day before dialysis C- The day after dialysis D- The morning of dialysis E- Two days prior to dialysis

C- The day after dialysis (blood thinning effects of heparin have diminished)

Prior to the administration of a local anaesthetic, a 25-year-old man with well-controlled epilepsy begins to have a tonic–clonic seizure. The dental chair is laid flat, and high-flow oxygen is delivered through a non-rebreather mask. His blood sugar is checked, whilst your nurse has called for an ambulance; the result is 5.3 mmol/L. After 5 minutes, the seizure has not self-terminated. What is the single best intervention that should be available in dental practices? A- Buccal midazolam 10 mg B- Intravenous lorazepam 4 mg C- Intravenous phenytoin infusion 140 mL (10%) D- Oral diazepam 10 mg E- Rectal diazepam 35 mg

A- Buccal midazolam 10 mg

A 40-year-old insulin-dependent diabetic man becomes very sweaty and tremulous during a dental examination. He thinks his sugars are low and asks whether any sweets are available. As the nurse goes to get some, he rapidly deteriorates, developing speech slurring before losing consciousness. He is still breathing and has a pulse. What would be the single best course of action to take? A- Administer 10 mL of oral glucose gel B- Administer high-flow oxygen and 300 mg of soluble aspirin dissolved in water C- Infuse 20 units/mL of insulin intravenously D- Inject glucagon 1 mg intramuscularly E- Use ammonium carbonate 1 puff nasally

D- Inject glucagon 1 mg intramuscularly

A nurse raises the alarm as she finds a 77-year-old man unconscious. She has already called for an ambulance, but she wants help managing him. Following the ABCDE approach, after 10 seconds, no pulse or respiratory effort is noted. Another nurse has retrieved the resuscitation trolley. What would be the single best immediate course of action to take? A- Administer a precordial thump, whilst an automated external defibrillator (AED) is attached B- Begin chest compressions at a rate of 15:2 (15 compressions and then 2 breaths), whilst an AED is attached C- Begin chest compressions at a rate of 30:2 (30 compressions and then 2 rescue breaths), whilst an AED is attached D- Begin continuous chest compressions at a rate of 100–110, whilst an AED is attached and oxygen is continuously delivered E- Place the patient in the recovery position, and continuously deliver oxygen until the ambulance arrives

C- Begin chest compressions at a rate of 30:2 (30 compressions and then 2 rescue breaths), whilst an AED is attached

A 29-year-old woman attends, concerned about the recent dark staining of her teeth. She has acne vulgaris, iron deficiency anaemia associated with heavy periods, hay fever, and gastro-oesophageal disease (GORD). She has also been regularly using 0.2% chlorhexidine digluconate mouthwash for periodontal disease for the past 3 months, having seen a television advert. Her most recent prescription is shown below: Doxycycline 100 mg once daily (OD) Diphenhydramine 25 mg four times daily (QDS) Ferrous fumarate tablets 210 mg twice daily (BD) Lansoprazole 15 mg OD Which single medication is most likely responsible for the discoloration in this scenario? A- Chlorhexidine digluconate B- Diphenhydramine C- Doxycycline D- Ferrous fumarate E- Lansoprazole

A- Chlorhexidine digluconate (Extrensic staining)

A 40-year-old woman enters the dental surgery, visibly breathless, coughing, and wheezing. She expresses that her fingers feel tingly but struggles to complete her sentence. She is a known asthmatic, so the nurse exits the room to call for an ambulance. What is the single most appropriate next step? A- Administer beclomethasone 10 mg orally B- Administer ten puffs of salbutamol via a spacer C- Administer adrenaline 0.5 mg intramuscularly D- Measure her peak expiratory flow rate (PEFR) before administering any drugs E- Oxygen via a non-rebreather mask at 10–15 L/minute

B- Administer ten puffs of salbutamol via a spacer

A 68-year-old woman is waiting for a dental appointment. Whilst waiting, they become flushed, clammy, and short of breath. A dental team are called to help, at which point she tells them she has some central crushing chest pain that radiates into her jaw and to her left arm. She has tried her glyceryl trinitrate (GTN) spray, with no effect on her symptoms. What is the single most likely diagnosis? A- Acute coronary syndrome (ACS) B- Angina attack C- Aortic aneurysm rupture D- Oesophageal spasm E- Pulmonary embolus

A- Acute coronary syndrome (ACS) **like an MI but present in unstable angina**

A 64-year-old man attends his local dental practice for surgical extraction of his upper right first molar (UR6). He is anxious as he sits in the chair. Medically, he takes insulin for diabetes mellitus, ramipril for hypertension, and atorvastatin for high cholesterol. After administration of the local anaesthetic, he begins to experience crushing central chest pain that radiates to his neck and left arm. He is noticeably clammy and short of breath. Which medications from the emergency kit are the most appropriate for managing this situation? A- Oxygen and midazolam B- Oxygen, aspirin, glyceryl trinitrate C- Oxygen, aspirin, salbutamol D- Oxygen, glucose, glucagon E- Oxygen, salbutamol, adrenaline

B- Oxygen, aspirin, glyceryl trinitrate

A 70-year-old man attends as a new patient. He is being treated for hypertension and ischaemic heart disease by his doctor. He has had a coronary artery stent placed 3 years ago and a renal transplant roughly 20 years ago. He takes bendroflumethiazide, nifedipine, atorvastatin, clopidogrel, and ciclosporin. Clinically, his gingivae are very enlarged, with a lobular shape, and there are deep periodontal pockets. Which single medication is most likely responsible for the signs? A- Atorvastatin B- Bendroflumethiazide C- Ciclosporin D- Clopidogrel E- Nifedipine

C- Ciclosporin (gingival hypoplasia)

A 23-year-old woman presents with severe facial swelling and signs suggestive of systemic involvement. Antibiotics are prescribed and administered at the dental practice, before referring her to the local Maxillofacial Unit. Whilst awaiting the taxi, the receptionist notices a deterioration in her situation. She has developed an urticarial rash, an audible wheeze, cold sweaty hands, and a thready, rapid, pulse. What is the single most appropriate next step to take? A- Administer five puffs of the Ventolin® inhaler via a spacer B- Administer 10 mg of chlorphenamine orally C- Administer hydrocortisone 200 mg intramuscularly (IM) D- Administer adrenaline 0.5 mg IM E- Administer 0.5 mL of 1:1000 adrenaline intravenously

D- Administer adrenaline 0.5 mg IM

A 58-year-old woman, who has smoked 26 pack years, has a past medical history of breast cancer, rheumatoid arthritis, osteoporosis, and Crohn’s disease. She historically received radiotherapy for breast cancer and is currently taking methotrexate, folic acid, prednisolone, and twice-yearly denosumab injections. She had an extraction 3 months ago, but there is no evidence of healing and exposed necrotic bone is present. What is the single most likely causative agent for the pathology? A- Denosumab B- Methotrexate C- Prednisolone D- Radiotherapy E- Smoking

A- Denosumab (bisphosphonate)

A 24-year-old man attends as a new patient. He has just returned from working as a holiday rep in Ibiza. He has been taking numerous recreational drugs, caffeinated drinks, and his usual antidepressant (citalopram). Clinically, he has scalloping of the lateral borders of the tongue, occlusal wear facets on opposing cusps, and hypertrophic masseters. Which single recreational drug is most likely linked to these findings? A- Caffeine B- Cocaine C- Ketamine D- Marijuana E- MDMA (3,4-methylenedioxymethamphetamine)

E- MDMA (3,4-methylenedioxymethamphetamine)

A 55-year-old woman attends, complaining of multiple large mouth ulcers over the last 3 months. She sees her cardiologist for severe angina who started a new oral medication 9 weeks ago. She takes this regularly and uses her glycerin trinitrate spray, as necessary. Clinically, the mouth ulcers are similar in appearance to major recurrent aphthous stomatitis (RAS). It is suspected that the new medication is linked to the mouth ulcers. Which single commonly prescribed cardiac medication has the patient most likely been prescribed? A- Bisoprolol B- Naproxen C- Nicorandil D- Nifedipine E- Ramipri

C- Nicorandil

A 34-year-old man attended the Emergency Department 2 days ago, complaining of toothache. He was diagnosed (provisionally) with a dental abscess, prescribed amoxicillin, and advised to see his dentist. Since then, he has been feeling progressively unwell, with fever and sore throat. Numerous painful mouth ulcers have stopped him eating and drinking normally, and he has developed a rash on his abdomen. There are a number of lesions which display a red and white target appearance, some of which have blistered. What is the single most likely diagnosis? A- Erythema multiforme minor B- Erythema multiforme major C- Primary herpetic gingivostomatitis D- Staphylococcal scalded skin syndrome E- Steven–Johnson syndrome (SJS)

E- Steven–Johnson syndrome (SJS) (More severe than EM)

An 82-year-old man with hypertension, angina, and epilepsy presents for a routine examination. He is concerned that his breath has begun to smell in the last 3 weeks. He does not feel he has a dry mouth; his diet is unchanged, and routine dental examination does not appear to offer a cause for his halitosis. His cardiologist has changed one of his medications 2 months ago. Which single commonly prescribed medication for his medical problems could explain his halitosis? A- Bendroflumethiazide B- Isosorbide C- Lamotrigine D- Ramipril E- Ranitidine

B- Isosorbide dinitrate

An 81-year-old woman presents as an emergency after having had a simple extraction by a colleague earlier that day. Bleeding has still not stopped, but because she was nervous, she forgot to mention before the extraction that she has been started on ticagrelor following a coronary artery stent placement 4 months ago. Clinically, the socket has been packed and sutured but oozes blood every time it is agitated. Her blood pressure is 129/78 mmHg, and her pulse is 72 beats per minute. Which therapeutic intervention may be of benefit in this situation? A- Intravenous (IV) protamine sulfate B- IV prothrombin complex C- Oral vitamin K D- Topical 15.5% ferrous sulfate E- Tranexamic acid 5% mouthwash

E- Tranexamic acid 5% mouthwash (Ticagrelor is a an anti-platelet)

A 62-year-old man with hypertension attends for a routine dental examination. He begins to complain of sudden-onset, severe headache at the back of his head 5 minutes after walking into your room. He mentions he has never experienced any headaches in his life and that the pain feels like he was being hit with a cricket bat. The nurse is asked to call for an ambulance. After 10 minutes of onset, the pain becomes unbearable and he develops an aversion to light and says that his neck feels stiff and he wants to vomit. What is the single most likely diagnosis? A- Idiopathic intracranial hypertension B- Meningitis C- Migraine D- Subarachnoid haemorrhage E- Trigeminal neuralgia

D- Subarachnoid haemorrhage (Lot faster acting than meningitis)

A new dental nurse is unclear on the medical emergency protocols within the practice. She informs the practice manager that she has not carried out any continuing professional development (CPD) during her first 12 months as a registered nurse. What is the single most appropriate action in these circumstances? A- Advise the nurse to complete a minimum of 10 hours of CPD in the next 12 months, in line with her current personal development plan B- Advise the nurse to contact the General Dental Council (GDC) about her situation C- Give the nurse the practice’s standard development plan for new nurses, for the remaining 4 years of her CPD cycle D- Reassure the nurse and inform her she must complete 150 hours of CPD by the end of her 5-year cycle, of which 50 hours must be verifiable E- Reassure the nurse and inform her she must complete 50 hours of verifiable CPD in each 5-year cycle

A- Advise the nurse to complete a minimum of 10 hours of CPD in the next 12 months, in line with her current personal development plan (E is still correct but A is more important action)

A 39-year-old woman has just had four dental restorations performed, under intravenous (IV) conscious sedation with midazolam. After completing treatment, there are 2 mL of midazolam left. Which single option is the most appropriate for managing the remaining drug? A- All remaining midazolam should be administered B- Decant into a sterile container for storage C- Denature or irretrievably dispose of the remaining midazolam D- Securely store all remaining midazolam in the original packaging E- Sign midazolam back into the local pharmacy/controlled drug store

C- Denature or irretrievably dispose of the remaining midazolam

A 9-year-old boy has a Class II skeletal discrepancy and would benefit from a functional appliance. What would be the most ideal age range at which to begin his treatment in order to utilize his pubertal growth spurt? A- 10–11 years B-12–13 years C- 14–15 years D- 16–17 years E- Over 17 years

B-12–13 years

A 12-year-old boy has an orthodontic assessment and his incisor relationship is to be classified. His lower incisor edges are posterior to the cingulum plateau of his upper incisors. The overjet is 2 mm, and the upper incisors are retroclined. Which is the single most appropriate British Standards Institute Incisor classification? A- Class I B- Class II C- Class II division 1 D- Class II division 2 E- Class III

D- Class II division 2

A local dental practice is reviewing its storage requirements and looking to dispose of old study models. The practice manager has identified study models taken 4 years ago for a patient who received orthodontic treatment at the age of 11 years, who is no longer seen at the practice. What single piece of advice should be given to manage these models? A- Dispose of the models as clinical waste B- Dispose of the models as hazardous waste C- Securely send the models to her new dentist D- Store the models for a further 10 years E- Store the models for a further 14 years

D- Store the models for a further 10 years (Study models are an important part of case planning and assessment in orthodontics. They are part of a patient’s clinical records and, as such, should be kept for a minimum of 11 years or until the patient is 25 years old (whichever is longer).

A 27-year-old man has a left inferior alveolar nerve block prior to a dental restoration. After 2 minutes, he reports he has lost feeling along the left side of his face. Clinically, there is ptosis of the left eye, which he cannot close fully, as well as drooping of the left corner of the mouth. Into what single anatomical space has the local anaesthetic most likely been administered? A- Buccal space B- Carotid sheath C- Parotid capsule D- Pterygomandibular space E- Submasseteric space

C- Parotid capsule

A 7-year-old fit and well boy attends with his mother for two dental restorations under inhalation sedation with nitrous oxide. The practice is equipped with a Matrix MDM® Flowmeter machine. What is the maximum percentage of nitrous oxide that can be provided to in this scenario? A- 65% B- 70% C- 75% D- 80% E- 85%

B- 70%

A 7-year-old fit and well girl is receiving treatment under inhalation sedation. Nitrous oxide has been delivered at a concentration of 50% and a flow rate of 5 L/minute, to achieve adequate sedation. All planned dental treatment has been completed without complication, and the session is about to be finished. What is the single most appropriate action to complete sedation safely? A- Decrease the flow rate of the gases incrementally over 2 minutes B- Increase the oxygen concentration to 100% for 2 minutes C- Reduce the nitrous oxide concentration incrementally D- Remove the nasal hood E- Switch off the nitrous oxide delivery system

B- Increase the oxygen concentration to 100% for 2 minutes

A 50-year-old man is receiving an inferior alveolar nerve block for a composite restoration. The clinician inadvertently needle-sticks his thumb, while withdrawing the needle. When the glove is removed, there is a small puncture wound which is not actively bleeding. What is the single most appropriate first stage of management for this event? A- Assess the relevant medical history of the patient involved B- Clean the wound under running water C- Contact your local Occupational Health Department D- Encourage the wound to bleed E- Place a sterile dressing on the wound

D- Encourage the wound to bleed

A 52-year-old woman is undergoing intravenous (IV) conscious sedation for a simple restoration. She is anxious about dental injections. The final dose is titrated, based on her response. At which single point would it be most appropriate to attempt treatment? A- When the patient accepts local anaesthesia B- When the patient becomes motionless C- When the patient no longer responds to pain D- When the patient’s breathing rate is <10 breaths per minute E- When the patient’s oxygen saturation drops below 90%

A- When the patient accepts local anaesthesia **you can’t do anything when pt is unconscious!**

A 45-year-old fit and well woman suffers with dental anxiety and is offered the option of having her treatment completed under intravenous sedation with midazolam. As part of the informed consent process, the properties of midazolam are discussed. From which single medicinal property will this patient derive the most benefit? A- Amnesic B- Anaesthetic C- Analgesic D- Anticonvulsive E- Antiemetic

A- Amnesic (think community)

A 35-year-old woman is under intravenous (IV) sedation with midazolam for extraction of the lower left first premolar (LL4). Before starting the extraction, her eyes have become closed and she fails to respond to verbal commands. Which single pharmacological agent is the most appropriate to administer in this scenario? A- Activated charcoal B- Flumazenil C- Midazolam D- N-acetylcysteine E- Naloxone

B- Flumazenil (Reversal agent) **n-acetylcysteine is paracetamol**

A 24-year-old fit and well, dentally anxious woman attends for an extraction under intravenous sedation with midazolam. She has recently been diagnosed with an allergy to ester compounds. Which single commonly used dental anaesthetic would be contraindicated for the management of this patient? A- Benzocaine 20% topical gel B- Lidocaine 2% with 1:80,000 adrenaline C- Mepivacaine 3% plain D- Prilocaine 3% with felypressin E- Prilocaine 4% plain

A- Benzocaine 20% topical gel

A 10-year-old boy is being treated with inhalation sedation which has been titrated to a dose of 60% nitrous oxide. During the treatment, he begins to twitch, his pupils dilate, and his eyes become divergent. When spoken to, he mumbles incomprehensibly. What would be the single most appropriate first-line action? A- Ask the nurse to call for an ambulance B- Ask the patient to take deep breaths C- Continue treatment D- Decrease the flow rate of the nitrous oxide/oxygen mix E- Give 100% oxygen

E- Give 100% oxygen (signs of oversedation- oxygen rapidly expells the NO2)

A 21-year-old fit and well man is being prepared for treatment under intravenous sedation with midazolam. Treatment includes extraction of the upper left second premolar (UL5) and ultrasonic scaling. He arrives alone and plans to get public transport back home at the end of his appointment. What is the single most suitable course of action in this scenario? A- Carry out the scaling under sedation, but defer the extraction B- Continue as planned, and arrange for your nurse to escort him home C- Do not carry out any sedation until the patient has an escort present D- Provide sedation as planned, but ask the patient to book a taxi first E- Provide sedation as planned, as this patient does not require an escort

C- Do not carry out any sedation until the patient has an escort present

A 47-year-old woman has been referred for treatment under intravenous conscious sedation. Her medical history includes bipolar disorder, severe chronic obstructive pulmonary disease (COPD), poorly controlled non-insulin-dependent diabetes mellitus (NIDDM), hypertension, and ischaemic heart disease (IHD). She had ‘happy gas’ a long time ago for dental treatment and requests this instead, as it worked well previously. Which single medical condition is considered a contraindication for inhalation sedation (IHS) with nitrous oxide? A- Bipolar disorder B- Hypertension C- IHD D- Poorly controlled NIDDM E- Severe COPD

E- Severe COPD

A 70-year-old man presents to the Oral Surgery Department for consultation regarding the surgical extraction of a grossly carious, partially erupted lower left third molar (LL8). Medically, he suffers from Parkinson’s disease and moderate claustrophobia. He reports dental anxiety after a previous bad experience as a child. What is the single most appropriate strategy for anaesthesia? A- General anaesthesia with sevoflurane B- Intravenous sedation with midazolam C- Local anaesthesia with prilocaine D- Oral sedation with diazepam E- Relative analgesia with nitrous oxide

B- Intravenous sedation with midazolam

A 19-year-old woman reattends, having had a dental restoration completed an hour ago by a colleague. The notes record the administration of 2.2 mL of 4% Citanest®. She reports to be fit and well, with no known allergies. Clinically, the patient is cyanosed and struggling to breathe. She now reports a similar, less severe occurrence, following her previous restoration 6 weeks ago. From which single blood disorder is she most likely to be suffering? A- Haemophilia A B- Methaemoglobinaemia C - Pernicious anaemia D- Sickle-cell anaemia E- Thalassaemia A

B- Methaemoglobinaemia (too much methaemoglobin, triggered by LA)

A 42-year-old woman, who is non-verbal and has severe autism, attends for an examination with her brother, who is her carer. She requires three simple restorations and one dental extraction. She has accepted local anaesthesia in the past. You assess that she lacks capacity to consent for dental treatment. Regarding the treatment required, what is the single most appropriate next step? A- As the patient lacks capacity to consent, treatment should be delayed B- Complete the required treatment as planned C- Perform the restorations, and defer the extraction until the patient has capacity D- Discuss the options with the brother, and decide on treatment in her best interests E- Liaise with a colleague before arranging for general anaesthesia; two-doctor approval is required

D- Discuss the options with the brother, and decide on treatment in her best interests

A sedation-trained nurse is 8 weeks pregnant and informs her line manager on the morning of a nitrous oxide sedation list about her change in circumstances. What is the single most appropriate course of action? A- Advise the nurse that she is safe to continue normal duties B- Ask the nurse for proof of pregnancy C- Discuss the patient list with the clinical manager and cancel complex treatment D- Ensure active scavenging is used on all patients throughout the list E- Liaise with the clinical manager to reassign your nurse to alternative duties

E- Liaise with the clinical manager to reassign your nurse to alternative duties (Chronic exposure to NO2 increases the risk of miscarriage in the first trimester)

A 9-year-old boy has multiple retained deciduous teeth, a prominent brow, and a wide nasal bridge. Multiple supernumeraries are evident on the orthopantomogram (OPT), and the mother informs you that her son has recently seen a specialist regarding the lack of collarbones. Which single condition is this child most likely to have? A- Apert’s syndrome B- Cleidocranial dysostosis C- Melkerson–Rosenthal syndrome D- Pfeiffer syndrome E- Pierre–Robin sequence

B- Cleidocranial dysostosis

A 7-year-old girl attends with her mother for a routine examination. The patient’s mother has read that her child may have congenitally missing teeth and that they have an increased prevalence for periodontitis. You also note the girl has low-set ears, upward sloping palpebral fissures, brachycephaly, and a tendency for tongue protrusion. What is the single most likely diagnosis? A- 45,XO B- Trisomy 13 C- Trisomy 18 D- Trisomy 21 E- XXY

D- Trisomy 21 (Down syndrome)

A 27-year-old woman has marked mandibular prognathism and multiple basal cell carcinomas. She has previously been diagnosed with Gorlin–Goltz syndrome (naevoid basal cell carcinoma syndrome). An orthopantomogram (OPT) is taken to investigate cystic change in the mandible. Which single type of lesion are you most likely to identify? A- Ameloblastomas B- Dentigerous cysts C- Odontogenic keratocysts D- Radicular cysts E- Solitary bone cyst

C- Odontogenic keratocysts

A 17-year-old adolescent girl has multiple hard, bony lumps on her maxilla. She says that her mother had similar lumps and had a colectomy. Which is the single most likely diagnosis? A- Gardner’s syndrome B- Heerfordt syndrome C- Melkerson–Rosenthal syndrome D- Paterson–Brown-Kelly syndrome E- Peutz–Jeghers syndrome

A- Gardner’s syndrome

6-year-old girl has pronounced facial asymmetry and large unilateral café-au-lait spots on her skin. She has attended her dentist for regular examinations since the early loss of her primary central incisors, which exfoliated with her entire roots intact. She has recently recovered from a fractured right femur. What is the single most likely diagnosis? A- Crouzon syndrome B- Down’s syndrome C- Eagle’s syndrome D- Gardner’s syndrome E- McCune–Albright syndrome

E- McCune–Albright syndrome

An 8-year-old boy attends for a new patient consultation. He is under the care of the local Paediatric Maxillofacial Unit for a cleft palate. His appearance can be seen in Figure 13.2. Which is the single most likely diagnosis? A- Cherubism B- Ectodermal dysplasia C- Marfan’s syndrome D- Pierre–Robin sequence E- Treacher–Collins syndrome

E- Treacher–Collins syndrome (Wonder kid)

A 45-year-old woman has undergone post-operative radiotherapy following resection and selective neck dissection of a T2N1M0 squamous cell carcinoma of the right retromolar pad. At her 6-month review, she is showing signs of xerostomia. Which single physical interaction between radiation and tissue would predominantly explain the clinical signs? A- Attenuation B- Compton effect C- Ionisation D- Photoelectric effect E- Unmodified scatter

D- Photoelectric effect

A dental student has accidentally taken a right bitewing on an average-build 52-year-old man at 50 kV. The radiographer discusses the risk of low-energy photons and advises that a kilovoltage of 60–70 is generally advised. However, following the incident, the student is now confused why an even higher kilovoltage (80–90 kV) is not used to investigate for interproximal caries. What is the diagnostic disadvantage of using a kilovoltage of >70? A- Darkens the image B- Decreases the contrast C- Improves the resolution D- Increases the ionization E- Lightens the image

B- Decreases the contrast (70 is optimal and then it worsens)

The radiographer performing accidentally performed a panoramic radiograph instead of BWs, because that is what is usually performed in the department for periodontal bone-level assessment. The patient would now like to discuss any potential sequelae of this error. The risk of which single effect has been increased? A- Carcinogenic B- Deterministic C- Heritable D- Metastatic E- Stochastic

E- Stochastic (Random, by chance)

32-year-old woman attends for consultation in the local Restorative Dentistry Department where she is assessed by a specialty registrar (StR). She is subsequently sent to the Radiology Department for the radiographs to be carried out by a radiographer. Under the Ionising Radiation Medical Exposure) Regulations (IR(ME)R 2018), the StR is acting as which of the following agents? A- Operator B- Operator and practitioner C- Practitioner D- Referrer E- Referrer and practitioner

D- Referrer

A foundation dentist is updating their practice radiation folder. They notice that no radiation protection advisor (RPA) is recorded, and their foundation trainer wishes to know which single piece of documentation makes this mandatory. A- Health and Safety at Work etc. Act (HSW) 1974 B- Ionising Radiation Regulations (IRR) 2017 C- Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2018 D- Radiation and Health Protection (RHP) 1998 E- Royal College of Radiologists Guidelines (RCRG) 2008

B- Ionising Radiation Regulations 2017 (2018 is northern ireland!!)

A local Maxillofacial Unit are working on a clinical trial to develop a screening blood test which will help identify patients at risk of oral squamous cell carcinoma. The chief investigator informs the group that current tests available have a very low sensitivity and a high specificity. What single term is ‘sensitivity’ also commonly known as? A- False negatives B- False positives C- True negatives D- True positives E- Type I error

C- True negatives (Sensitivity- good at identifying patients with disease, true positive rate) (Specificity- good at identifying patients free from disease, true negative rate)

A study aiming to identify whether alcohol consumption and smoking during pregnancy increase the risk of the development of cleft lip and palate is being conducted. After selecting 50 newborn babies with cleft lip and palate from a local database, a questionnaire is provided to their parents to investigate the above health-related behaviours. A further 50 individuals born without cleft lip and palate are matched for age, sex, and social demographics and provided with the same questionnaire. Medical records are also examined. What single type of study design is being utilized in this scenario? A- Case-control B- Cross-sectional C- Prospective cohort D- Randomized controlled trial E- Retrospective cohort

A- Case-control

A local research group is conducting an observational study, as a randomized controlled trial was deemed unethical. The group uses the Bradford Hill criteria to help with its conclusions. What is the single core aspect of observational studies that these criteria were developed to evaluate? A- Bias B- Causation C- Incidence D- Randomization E- Selection

B- Causation

During hospital induction, a member of the clinical governance team discusses the importance of continually assessing standards to improve patient care. The Caldicott Principles are highlighted multiple times. Following the talk, a junior colleague asks to which single ‘pillar’ of clinical governance these principles relate. A- Audit B- Information governance C- Research D- Risk management E- Staff training

B- Information governance

A 22-year-old man attends for restoration of a large posterior class V cavity with glass-ionomer cement (GIC). Which single conditioning agent is the most appropriate to improve bond strength of this material to the tooth structure? A- Dentine bonding agent B- Fluorocarbonic acid C- Hydrofluoric acid D- Polyacrylic acid E- Resin-modified GIC

D- Polyacrylic acid (Dentine conditioner)

A 26-year-old man returns 1 week after having a deep amalgam restoration in his lower right first molar (LR6). The patient experienced shooting pain that lasted for a few seconds when drinking cold drinks. The restoration was removed by an emergency dentist and replaced with zinc oxide eugenol (ZOE). What is the primary benefit of using this material in this situation? A- Antimicrobial B- Less microleakage C- Fast setting D- High compressive strength E- Obtundent

E- Obtundent (Dulling the sensitivity - ZOE is a sedative)

A 45-year-old man is having his upper left lateral incisor (UL2) crowned. Prior to taking the impression with a monophase addition-cured polyvinylsiloxane (PVS) material, the tooth is thoroughly air-dried. What is the single main reason for this protocol? A- Absorption of residual surface moisture will lead to an inaccurate die B- Moisture acts as a separator between the light- and heavy-bodied PVS, leading to folds C- Moisture may cause air blows in the impression, as PVS materials are hydrophobic D- Moisture retards the polymerization of the material, potentially causing drags E- Moisture stops the material being placed in the correct place, as it slips off the teeth

C- Moisture may cause air blows in the impression, as PVS materials are hydrophobic (Alginate is hydrophilic, PVS hydrophobic)

A 47-year-old woman has received revision root canal treatment (ReRCT) on an upper central incisor. After chemomechanical preparation, which single irrigant would be the most appropriate for removing the residual inorganic matter from the root canal system? A- Acetone B- EDTA (ethylenediaminetetraacetic acid) C- MTAD (mixture of tetracycline, citric acid, and detergent) D- Saline E- Sodium hypochlorite

B- EDTA (ethylenediaminetetraacetic acid) (Disolves the smear layer)

A 15-year-old boy attends for root canal treatment on a recently traumatized upper central incisor. Following root canal treatment, a significant proportion of the crown is missing and a glass-fibre post is used to retain the restoration. Which single type of cement should be used when placing the post? A- Dual cured resin cement B- Flowable resin cement C- Light cured resin cement D- Resin-modified glass-ionomer cement E- Zinc phosphate cement

A- Dual cured resin cement Fibre posts should be bonded into the root canal system.

A 56-year-old man attends for construction of an upper partial cobalt-chromium (CoCr) denture. He has previously struggled to tolerate a full palatal coverage acrylic denture because of his gag reflex. The patient is a chemical engineer by trade and wishes to know what property of CoCr allows provision of a thinner and less extensive major connector. Which single property of CoCr can facilitate this design? A- Good corrosion resistance B- High fatigue resistance C- High yield strength D- Low mobility E- Low thermal resistance

C- High yield strength (Yield strength is the point at which permanent plastic deformation occurs within the material. CoCr has a highyield strength, giving it good flexural rigidity and allows denture bases of thin section.)

A 40-year-old woman attends for another amalgam filling with her new dentist. The dentist is a new graduate and, on a number of occasions, has been struggling to pack the amalgam sufficiently before it sets. Having spoken to their trainer, it is decided to order a lathe-cut amalgam instead—for which primary reason? A- Easier to condense B- Hardens slowly C- Has more shrinkage D- Less difficult to achieve tight contact points E- Smoother finish after polish

B- Hardens slowly

A 46-year-old man has had four permanent lower molars prepared for gold onlays to manage his generalized moderate toothwear. The preparations have minimal retention or resistance form. What single material is the most appropriate for cementation? A- Glass-ionomer cement B- Polycarboxylate cement C- Resin cement D- Resin-modified glass-ionomer cement E- Zinc phosphate

C- Resin cement (minimal retention or resistance form)

A 44-year-old woman requires a mesio-occlusal composite restoration in a lower first premolar. The supervising consultant recommends a ‘wet bonding’ approach, and the assisting dental care professional asks what this refers to. A- Bonding in low humidity conditions B- Isolating without a rubber dam C- Irrigating with saline prior to surface priming D- Not excessively drying the dentine E- Not setting the bonding agent prior to composite placement

D- Not excessively drying the dentine

A 26-year-old man with severe learning difficulties is having an amalgam restoration in his upper right first molar. Upon placement into the cavity, the amalgam appears crumbly and is unusable. What single procedural issue is most likely to have caused this to occur? A- Amalgam contraction B- Moisture contamination C- Out-of-date D- Over-burnished E- Under-triturated

E- Under-triturated - **not mixed fully**. (Over-triturated, exessively sticky Under-triturated, exessively crumbly)

A 64-year-old woman is having a new upper complete denture made. She has a hypermobile or ‘flabby’ anterior ridge, and a window technique is planned for the master impression. What primary property is desired of the impression material used in the flabby area? A- Dimensionally stable B- High elasticity C- High viscosity D- Low elasticity E- Low viscosity

E- Low viscosity (Low viscosity, means more runny and this means it can flow around the flabby tissues without moving or distorting them)

A 24-year-old woman requires a replacement crown on her upper right central incisor. as she dislikes the appearance, describing it as ‘too dark’. A Vita 3D shade guide™ is used to select the new shade. What element of colour needs to be adjusted, and in which component of the shade guide is this reflected? A- Chroma, the ‘M’ value B- Hue, numbers 1 to 5 C- Hue, the ‘M’ value D- Value, the ‘L/R’ value E- Value, numbers 1 to 5

E- Value, numbers 1 to 5 (light or dark)

A 72-year-old woman attends a few days after the fit of a replacement complete maxillary denture. She complains of a burning/itchy sensation of her palate. Following examination, it is believed to be a reaction to excess monomer. Which single processing error has most likely occurred? A- Curing temperature of 95°C not attained after an initial slow heating period B- Excess powder in the resin mixture C- Final temperature of 150°C reached too quickly D- Lack of compression during flasking E- Packing process occurred during the ‘wet sand’ stage

A- Curing temperature of 95°C not attained after an initial slow heating period (Should reach 100°C to remove any residual monomer)

A 21-year-old man has undergone endodontic treatment on an upper central incisor with an open apex. He returns after 12 months, with marked discoloration of the crown. Non-setting calcium hydroxide (CH) was used as an intracanal medicament between appointments, and sodium hypochlorite and ethylenediaminetetraacetic acid (EDTA) were used as irrigants. Finally, mineral trioxide aggregate (MTA) was placed as an apical barrier before completing the obturation with gutta percha and subsequently placing a coronal seal of resin-modified glass-ionomer cement (RMGIC). What is the single most likely cause of discoloration in this scenario? A- Interaction of sodium hypochlorite with residual EDTA B- Interaction of CH with residual sodium hypochlorite C- Residual gutta percha within the canal D- Staining of RMGIC E- Use of MTA

E- Use of MTA (bismuth oxide)

A 39-year-old woman requires replacement anterior maxillary crowns as part of a full arch rehabilitation. The crowns are to be placed at an increased occlusal vertical dimension (OVD), and following removal of the crowns, there is 1-mm space between the residual core and the desired incisal level. What is the minimum incisal reduction required for the provision of metallo-ceramic crowns in this situation? A- 0.5 mm B- 1 mm C- 1.5 mm D- 2 mm E- 2.5 mm

A- 0.5 mm (1mm is already there so 1+0.5= to the desired thickness of 1.5mm)

A 17-year-old woman with taurodontism requires a direct pulp cap, following an occlusal restoration on their lower right first permanent molar. The supervising consultant recommends using a new calcium silicate cement as pulp-capping material, rather than the conventionally used calcium hydroxide (CH). For which single biological reason is this most appropriate? A- Antibacterial B- Forms an ionic bond to the surrounding dentine C- High pH releases proteins and growth factors from the nearby dentine, leading to reparative dentine formation. D- Non-cytotoxic and induces odontoblast proliferation and activity E- Obtundent

D- Non-cytotoxic and induces odontoblast proliferation and activity

A 36-year-old man requires multiple composite restorations to restore his worn anterior maxillary teeth. The restorations are to be placed at an increased vertical dimension, using the Dahl approach. Which single type of composite is most appropriate for these restorations? A- Compomer B- Flowable composite C- Microfilled composite D- Nanohybrid composite E- Silorane composite

D- Nanohybrid composite (It's hard)

A 56-year-old man presents with mild asymptomatic erosion of the palatal aspects of his upper incisors, secondary to acid reflux. What single widely available active ingredient could be recommended in his toothpaste as part of a protective measure? A- Arginine 8% B- Casein phosphopeptides–amorphous calcium phosphates (CPP-ACP) 10% C- Sodium fluoride 0.31% D- Sodium lauryl sulfate 0.5% E- Stannous fluoride 0.45%

E- Stannous fluoride 0.45%

A 25-year-old man attends with a buccal swelling next to the lower right first molar. Incision and drainage of the abscess is planned. Which single branch of the external carotid artery should be avoided, whilst conducting this treatment? A- Ascending pharyngeal B- Facial C- Lingual D- Maxillary E- Parotid

B- Facial

A 33-year-old woman attends for extraction of the upper left second premolar. The clinical tutor asks the student to anaesthetize the patient using infiltrations prior to the procedure. Which nerves require anaesthetizing?. A- Anterior superior alveolar nerve + middle superior alveolar nerve B- Middle superior alveolar nerve + greater palatine nerve C- Middle superior alveolar nerve + nasopalatine nerve D- Posterior superior alveolar nerve + greater palatine nerve E- Posterior superior alveolar nerve + lesser palatine nerve

B- Middle superior alveolar nerve + greater palatine nerve

A 73-year-old man has Paget’s disease and develops trigeminal neuralgia in the lower jaw region. Compression of which single cranial foramen is most likely to be causing his neuralgia? A- Foramen lacernum B- Foramen ovale C- Foramen rotundum D- Foramen spinosum E- Stylomastoid foramen

B- Foramen ovale

A 45-year-old woman attends with localized right-sided facial pain of an aching nature and trismus. The pain has been present for 4 weeks and is localized to the pre-auricular region. It was preceded by recurrent clicking, with no restriction on opening. The patient is now unable to open her mouth beyond 20 mm. Which single component of condylar head movement is inhibited? A- Abduction B- Circumduction C- Protrusion D- Rotation E- Translation

E- Translation

The presence of the anatomical attachment of which single muscle visible in Figure 1.1may obscure radiographic assessment of the root apices? A- Buccinator B- Lateral pterygoid C- Medial pterygoid D- Mylohyoid E- Posterior belly of the digastric

D- Mylohyoid

An 18-year-old man attends the Maxillofacial Department, following an alleged assault to the right side of his head. He has pain, bruising, and depression of the right cheek, with limited opening. Radiographic assessment confirms a fracture of the right zygomatic arch. Entrapment of which single muscle is most likely responsible for the restricted opening? A- Buccinator B- Lateral pterygoid C- Medial pterygoid D- Masseter E- Temporalis

E- Temporalis

An 82-year-old woman fails to attend her review appointment at the dry mouth clinic. The consultant takes this opportunity to discuss the autonomic nerve supply to the parotid gland with junior staff. Parasympathetic nerve supply to the parotid gland is via the otic ganglion. Which single cranial nerve supplies pre-ganglionic parasympathetic nerve fibres to the otic ganglion? A- Accessory nerve B- Facial nerve C- Glossopharyngeal nerve D- Vagus nerve E- Vestibulocochlear nerve

C- Glossopharyngeal nerve

68-year-old woman with unilateral facial paralysis is assessed by a maxillofacial doctor in the Emergency Department (ED). Her mouth and cheek are drooping on the right-hand side, and she cannot bare her teeth or purse her lips on that side when asked. However, she can still wrinkle the skin of her forehead to command. What is the single most likely cause for the signs that have been described? A- Acoustic neuroma B- Bell’s palsy C- Otitis media D- Parotid tumour E- Stroke

E- Stroke

sba mega questions Flashcards

(305 cards)