Exam Revision

Question 1

What is the management of seizures?

Answer 1

If history of epilepsy or seisures is present - please use a bite block on the patient

1. Stop dental treatment
2. Ensure patient is not in danger
3. Turn the patient to the side
4. Avoid restrainning
5. Wait until seizure stops
6. Maintain airways
7. Assess the patient
8. If still unconscious, call 000 and maintain airways

Question 2

What are the oral consequences of kidney disease?

Answer 2

1. Greater bleeding tendency due to reduction in platalets
2. Hypertension due to extra blood volume

3.Anaemia

4.Drug intolerance - antibiotic and analgesics

5. Increased susceptibility to infections
6. Halitosis, burning sensation int eh mouth, uremic stomatitis, periodontal disease
7. Xerostomia
8. Impared healing

Please consider collaborating with a nephrologis

Question 3

Wht should be your general approach of managing a person of a general medical complication in the dental chair?

Answer 3

Consider

1. Time of day for appointment
2. Duration of the appointment
3. Positioning of the patient
4. Pre-procedure preparation/action plan - e.g. ask the patient to bring their medication
5. Use of local anaesthetics
6. Medications - contraindications, toxicities, interaction
7. Caries risk
8. Perio risk
9. Xerostomia

Question 4

How would you quickly assess the patients severity of COPD asthma?

Answer 4

1. If they are managed situational by an inhaler - they are probably okay
2. If they take medication - this may be a little more sus
3. If they have been hospitalised - maybe consult with tutor

Question 5

How does the diabetes damage the body?

Answer 5

Higher Blood glucose leads to advanced glycosylated end products (AGE) and free radicals which damage tissues - mostly on two levels

Microvascular damage - think perio

Macrovascular - think coronary artery disease and renal disease

Question 6

What would you mention to a patient who has periodontitis?

Answer 6

1. Periodontitis - a disease that destroys the bone underneath the tooth
2. Usually occurs from bacteria aggrevating the gums
3. Aggrevating the gums leads to inflammatory condition - gingivitis
4. When gingivitis is present with some underlying risk factors such as smoking, diabetes or immunuesupressed organism - periodontitis is caused
5. Periodontitis is caused by the immune system trying to fight off the bacteria in the plaque - but not bring very mindful of the surrounding tissue
6. Unfortunatley periodontitis is irreverisble - but if proper treatment - it can be slowed down or even arrested - thus we need to collaborate on this issure

Question 7

What are the Koch’s Postulates?

Answer 7

1) The microorganism must be found in diseased but not healthy individuals;

2) The microorganism must be cultured from the diseased individual;

3) Inoculation of a healthy individual with the cultured microorganism must recapitulated the disease;

4) The microorganism must be re-isolated from the inoculated, diseased individual and matched to the original microorganism.

Question 8

Why do microorganism preffer to reside in the biofilm?

Answer 8

1. 3D structure of the extra-cellular matrix provide a site for adhesion
2. Provides water and nutrient channels
3. Provides protection from desication
4. Provides protection from host defences - think B-Lactam aggregation

Question 9

What is the most common bacteria associated with fissure caries?

Answer 9

S. Mutants

Question 10

Give 5 differential diagnosis for a white lesion

Answer 10

1. Leukodema
2. Leukoplakia
3. Lichen Planus
4. Frictional keratosis
5. Oral squamous cell carcinoma

Question 11

Give 5 differential diagnosis for red lesions

Answer 11

1. Pyogenic granuloma
2. Haemangioma
3. Peripheral Giant Cell Granuloma
4. Erythroplakia
5. Oral squamous cell carcinoma

Question 12

Give 5 differential diagnosis for a pigmented lesion?

Answer 12

1. Oral melanotic macule
2. Mucosal melanocytic naevus
3. Amalgam tattoo
4. Malignant melanoma
5. Smokers melanosis

Question 13

Give 5 differential diagnosis for a gum lump?

Answer 13

1. Haemangioma

2.Fibroepithelial polyp

3. Pyogenic granuloma
4. Peripheral giant cell granuloma
5. Calcifying fibroblastic granuloma

Question 14

Give 5 differential diagnosis for an ulcer?

Answer 14

1. Herpetiform ampthous ulcer
2. Mild amthous ulcer
3. Major ampthous ulcer
4. Traumatic acute ulcer
5. Traumatic chronic ulcer

Question 15

Why are 5th and 7th generation of adhesive system kinda mid?

Answer 15

1. Because they are known to leave moisture bubles at the surface as well as water tress that impare bonding
2. Because there is an issue with the acid that is used with self etching. Essentially a special compound is used to neutraulise the acid over time so that self etching does not continue to destroy tooth structure - but unfortunaley that compound affect may be delayed thus the created resin tags are not formed properly - this reduced their effectiveness thus making the restoration last less time :(

Question 16

What is the process of activation and initiation of dental composite material?

Answer 16

1. Photo-initiator - in a form of specific frequency of light (light cure or UV light) initiates the creation of free radicals within the composite material
2. The free radicals with an extra electron will bind with monomers in order to create a polymer - at the end of this process an electron is loss thus another free radical can be initiated
3. This continues when around 80% of resin is polymerised and 20% is not - this is important to allow addition of other composite resin
4. Over time, free radicals will combine - creating a stable compound

Question 17

How would you explain to the patient the CR survival?

Answer 17

An average composite may last around 3-8 years but only if it is maintained. Give car analogy.

Question 18

Why do amalgams last more than composites?

Answer 18

Amalgams last longer due to the hardness of the material - but if they fail they fail spectacularly

Question 19

How do we treat hypersensitivity?

Answer 19

1. Block dentinal tubules - using restorations or protective coverings
2. Block nerve activity - stanous fluoride and potassium nitrate
3. Remove the cause - erosion and toothbrushing technique change

Question 20

How do we manage dentine hypersensitivity?

Answer 20

1. Occlude dentinal tubules to reduce impact of stimuli on fluid movement - can be done through chemical occlusion (fluorides) or physical occlusion (sealed resorations)
2. Reduce sensitivity of nerves - using potassium nitrate

Question 21

What are indications for indirect pulp capping?

Answer 21

1. Deep cavity
2. No pulpal exposure
3. Removal of all infected dentine may result in pulpal exposure
4. No signs or symptoms of irreversible pulpits

Question 22

What is the most important aspect of indirect pulp capping?

Answer 22

CORONAL SEAL IS VITAL.

Question 23

What happens to the pulp during direct pulp capping?

Answer 23

The varnish that is used is able to neutralise necrotic tissue and cause the deposition of tertiary dentine