Dental OSCE quiz 1

Is this impacted canine palatal or buccal to the centrals?

Is this impacted canine palatal or buccal to the arch?

Are these impacted canines palatal or buccal to the arch?

1. Gain [blank_start]consent[blank_end]. Check for [blank_start]latex[blank_end] allergies, explain to patient the procedure and why we need the rubber raincoat. 2. Select clamp - [blank_start]DW[blank_end] for primary molars and premolars, [blank_start]FW[blank_end] for partially erupted molars, [blank_start]BW[blank_end] for permanent molars. 3. Tie [blank_start]floss[blank_end] around clamp before application 4. Rubber dam must be pre-[blank_start]punched[blank_end]. 3 overlapping holes for [blank_start]single[blank_end] tooth, 5-6 overlapping holes for [blank_start]trough[blank_end] 5. Clamp applied [blank_start]first[blank_end] without rubber dam 6. Apply rubber dam when clamp is [blank_start]secure[blank_end] - rock [blank_start]lingually[blank_end], then [blank_start]buccally[blank_end]. 7. [blank_start]Frame[blank_end] attached to support dam 8. [blank_start]Trough[blank_end] isolation required dam to be stretched to include all required teeth 9. Apply wedget or wedge to [blank_start]mesial[blank_end] aspect of most mesial isolated tooth.

Label the image with different aspects required for an extra oral examination.

Label the correct lymph nodes for an EO exam from the dropdown menus

Label the image with muscles of mastication you should palpate during EO exam.

During a TMJ examination, you should stand behind the patient and palpate both joints [blank_start]simultaneously[blank_end]. The patient should be asked to [blank_start]open[blank_end] and close their mouth, and move their jaw [blank_start]laterally[blank_end]. You should note any clicking, [blank_start]locking[blank_end] (trismus), grinding or grating ([blank_start]crepitus[blank_end]), limited [blank_start]opening[blank_end], deviation, and pain.

For an ID block you should do the following: 1. Explain what you are going to do; gain [blank_start]consent[blank_end]. Numbness will last for around [blank_start]2[blank_end] or [blank_start]3[blank_end] hours and patient should avoid hot drinks and [blank_start]biting[blank_end] their lip 2. Check for any [blank_start]allergies[blank_end] or contraindications. LA contains [blank_start]vasoconstrictors[blank_end] and an additive called [blank_start]sodium[blank_end] metabisulphate that could cause a reaction. 3. Check the [blank_start]expiry date[blank_end] on the cartridge, check your choice of [blank_start]vasoconstrictor[blank_end], check it has no [blank_start]air bubbles[blank_end]. 4. Dry mucosa and apply [blank_start]topical[blank_end] anaesthetic - xylonor gel contains [blank_start]xylocaine[blank_end]. 5. Put the needle together - long needles are coloured [blank_start]yellow[blank_end] and short needles [blank_start]blue[blank_end]. 6. Check the [blank_start]bung[blank_end] is orientated correctly! 7. Patient should open their mouth [blank_start]wide[blank_end] so you can visualise anatomical landmarks. Ensure you have the operating [blank_start]light[blank_end] on to visualise tissues for the block. 8. Palpate the [blank_start]coronoid process[blank_end] with your thumb at the greatest depression - known as the coronoid [blank_start]notch[blank_end] 9. Slide your thumb [blank_start]posteriorly[blank_end] until you can palpate the [blank_start]internal oblique ridge[blank_end]. 10. The syringe is positioned between the [blank_start]premolars[blank_end] on the opposite side and needle inserted at the level of the thumb. 11. The injection site is 1cm above the [blank_start]occlusal[blank_end] plane of the molars and medial to the thumb, lateral to the [blank_start]pterygomandibular[blank_end] raphe. 12. The needle is advanced around 2.5cm. [blank_start]Bone[blank_end] should be contacted to ensure correct position. 13. When the needle meets the middle section of the rams, withdraw slightly by 1 or 2 mm so that the needle is not [blank_start]subperiosteal[blank_end] 14. Make sure you [blank_start]aspirate[blank_end] at this point. 15. Inject [blank_start]slowly[blank_end] - 1.5ml or 2/3rds of a cartridge. This improves patient comfort and you can assess any patient [blank_start]reactions[blank_end] to the solution before you inject too much. 16. The rest of the cartridge is injected as you [blank_start]withdraw[blank_end] the needle to block the [blank_start]lingual[blank_end] nerve. 17. Double click the syringe and dispose in the [blank_start]sharps bin[blank_end] 18. Remove gloves and apply alcohol gel.

What must you ensure you do after extracting a tooth? (check all that apply)

How long should a patient NORMALLY take to achieve haemostasis post-extraction?

How long should a patient wait before coming back to the LDI with a non healing socket or continued symptoms?

How many times daily should a patient carry out salty mouth rinses on the day after an extraction?

What is the correct secondary movement for extraction of an UL5?

What is the primary movement for all dental extractions?

What is the secondary movement for a LR2 extraction?

What movement is more likely to result in root fracture during extraction of upper molars?

Luxators are used to: (tick all that apply)

This is an example of a

This is an example of a:

Which forceps would you most likely use for a lower premolar extraction?

Which forceps would you use for an upper left lateral incisor extraction?

You've just given a patient a new set of dentures and are giving them some advice. You advise them: - Leave dentures in for at least [blank_start]24[blank_end] hours initially - Feeling of compaction and excess [blank_start]saliva[blank_end] will [blank_start]decrease[blank_end] with time - There may be [blank_start]sore[blank_end] spots to begin with - Their lips will [blank_start]relax[blank_end] with time - Eat [blank_start]small[blank_end] sized pieces of food and eat [blank_start]evenly[blank_end] on [blank_start]both[blank_end] sides of mouth - Avoid [blank_start]sticky[blank_end] foods - [blank_start]Muscles[blank_end] need to be re educated to accommodate dentures - [blank_start]Clean[blank_end] denture using a soft nylon brush with [blank_start]soap[blank_end] over the sink. They can use [blank_start]disclosing[blank_end] solutions to help them clean. - Soak dentures overnight in denture cleanser ([blank_start]hypochlorite[blank_end] solution) - Clean mouth with warm [blank_start]salt[blank_end] water [blank_start]twice[blank_end] daily

Unerupted incisors have several possible causes, these tend to be either [blank_start]hereditary[blank_end] or environmental in origin. Environmental causes include: 1. Trauma - [blank_start]avulsion[blank_end] or intrusion of the primary teeth that causes damage to the permanent tooth. This may include the root/crown axis to deviate, known as [blank_start]dilaceration[blank_end]. The permanent tooth may also become [blank_start]ankylosed[blank_end] to the bone. In these cases [blank_start]extraction[blank_end] may be required and tooth replacement options considered. 2. [blank_start]Retained[blank_end] primary teeth causing [blank_start]delayed[blank_end] eruption - this may cause a physical [blank_start]obstruction[blank_end] to the path of eruption of the permanent tooth. The most straightforward option here would be [blank_start]extraction[blank_end] of the primary tooth if there is no other obstruction and the teeth are close to [blank_start]eruption[blank_end]. Hereditary causes may include the presence of [blank_start]supernumerary[blank_end] teeth in the arch, [blank_start]cleft[blank_end] lip or palate, abnormal tooth/tissue ratio or other rarer conditions such as [blank_start]cleidocranial[blank_end] dysostosis. The other option is that the permanent teeth may be congenitally [blank_start]absent[blank_end]! According to the RCS guidelines, we should start monitoring unerupted incisors when: 1. [blank_start]Contralateral[blank_end] teeth erupted more than 6 months ago 2. Both centrals are unerupted and the lowers erupted more than [blank_start]12[blank_end] months ago 3. Deviation in the normal sequence of eruption During an intra oral examination, you may find that: - The primary teeth have been retained beyond normal [blank_start]exfoliation[blank_end] dates (which is [blank_start]6[blank_end] or [blank_start]7[blank_end] years for upper centrals, [blank_start]7[blank_end] or [blank_start]8[blank_end] years for upper laterals) - There may be buccal or palatal [blank_start]swellings[blank_end] on palpation - Note the space available for incisors - [blank_start]9[blank_end]mm for centrals and [blank_start]7[blank_end]mm for laterals You may wish to take some [blank_start]radiographs[blank_end] to determine the cause of the unerupted teeth. The [blank_start]parallax[blank_end] technique can locate the position of impacted teeth.

The upper canines usually erupt around [blank_start]11[blank_end] or [blank_start]12[blank_end] years of age. [blank_start]Congenitally[blank_end] absent canines is rare 0.3%. [blank_start]Impaction[blank_end] of canines is more common, and is usually bilateral. You should be able to [blank_start]palpate[blank_end] maxillary canines around 9 years of age in the buccal [blank_start]sulcus[blank_end]. Causes of impacted maxillary canines may be due to the: - [blank_start]Long[blank_end] path of eruption - [blank_start]Short[blank_end] rooted or [blank_start]absent[blank_end] upper lateral incisors ([blank_start]peg[blank_end] laterals) - Crowding - [blank_start]Retention[blank_end] of primary canine (an indicator rather than a cause!) - [blank_start]Genetic[blank_end] factors. It may run in the [blank_start]family[blank_end]. - It should also be noted that impacted canines is associated with other dental anomolies You should first assess the child [blank_start]clinically[blank_end] to see if you can tell where the tooth is displaced. If you suspect displacement you may wish to take some [blank_start]radiographs[blank_end]. The radiographs most commonly used for assessing ectopic canines are [blank_start]panoramic[blank_end] radiographs, upper [blank_start]occlusal[blank_end] radiographs, lateral [blank_start]cephalometric[blank_end] (for more accurate localisation), [blank_start]cone beam[blank_end] computerised tomography, and periodicals (useful for prognosis of retained deciduous canines). Management depends on wether the teeth are [blank_start]buccally[blank_end] or [blank_start]palatally[blank_end] displaced. Buccal displacements are usually due to [blank_start]crowding[blank_end], so relief of [blank_start]crowding[blank_end] is usually the option Palatal displacements may require surgical [blank_start]exposure[blank_end] with orthodontic [blank_start]alignment[blank_end], or surgical [blank_start]removal[blank_end] of the impacted canine. Occasionally unerupted canines can cause [blank_start]resorption[blank_end] of adjacent lateral incisor roots and possibly the centrals. In this case intervention should be done swiftly.