Dental OSCE Quiz 2

When taking a [blank_start]medical[blank_end] history from a medically compromised child you must ensure you get a definitive [blank_start]diagnosis[blank_end] from the parents, and ask them what it means for the child. The medical condition may affect [blank_start]dental[blank_end] visits and [blank_start]daily[blank_end] life. Ask the parents how they [blank_start]manage[blank_end] this condition daily. The child may require [blank_start]medication[blank_end] for a condition and you should be aware of the [blank_start]implications[blank_end] of this for dental treatment. It is important to gauge the [blank_start]severity[blank_end] of the condition. Is the condition [blank_start]stable[blank_end]? Get information about [blank_start]when[blank_end] the condition was diagnosed, and any [blank_start]history[blank_end] relating to the condition. Is the child under the care of a [blank_start]doctor[blank_end]? Does [blank_start]anyone else[blank_end] look after the child?

For an epileptic child the following information must be gathered: - What [blank_start]type[blank_end] of epilepsy? - How [blank_start]often[blank_end] do they fit? - How [blank_start]long[blank_end] do they usually fit for? - When was their [blank_start]last attack[blank_end]? - Do they take any [blank_start]medication[blank_end]? has there been any [blank_start]change[blank_end] to this? - What is the [blank_start]prognosis[blank_end]? - Are they under the care of a [blank_start]specialist[blank_end]?

For a child with a cardiac problem you must get the following information: - Definitive [blank_start]diagnosis[blank_end] - Is the child under the care of a [blank_start]cardiologist[blank_end]? - Does the child experience [blank_start]symptoms[blank_end] from their condition? - Does it have an effect on their [blank_start]lifestyle[blank_end]? - Have they ever had any [blank_start]operations[blank_end]? Do they have any planned?

A dentist treating a medically compromised child does not necessarily have to remain in correspondence with the child's specialist, if it is for routine treatment.

A child with congenital heart disease presents a few problems in the dental setting. Their [blank_start]caries[blank_end] risk is higher and they may have enamel [blank_start]defects[blank_end]. During treatment, these children may be more [blank_start]anxious[blank_end] than usual, may be on [blank_start]anticoagulant[blank_end] therapy or have [blank_start]thrombocytopaenia[blank_end] and there is an increased risk during procedures under [blank_start]general[blank_end] anaesthetic (you may need to liaise with the [blank_start]cardiologist[blank_end] and [blank_start]anaesthetist[blank_end] should this be required) In these children, [blank_start]pulp[blank_end] therapy is [blank_start]contraindicated[blank_end]. You should take caution with [blank_start]intraligamentary[blank_end] local anaesthetics Always be aware of ABC when assessing [blank_start]vital[blank_end] signs during treatment.

In asthmatic children, the effect of local [blank_start]steroid[blank_end] inhalers may increase their risk of [blank_start]thrush[blank_end] and dental [blank_start]erosion[blank_end]. In these children we would generally avoid [blank_start]general[blank_end] anaesthesia. Steroid therapy means the child is [blank_start]immunosuppressed[blank_end]. In practice, make sure the child brings their [blank_start]inhaler[blank_end] to appointments. Avoid prescribing [blank_start]aspirin[blank_end] to these children as it may precipitate an [blank_start]attack[blank_end], as well as [blank_start]anxiety[blank_end].

In children with cystic fibrosis, the following implications should be considered: - [blank_start]Enamel[blank_end] defects - Delayed [blank_start]eruption[blank_end] - [blank_start]General[blank_end] anaesthesia should be [blank_start]avoided[blank_end] - Narcotics or sedatives are avoided as these cause [blank_start]respiratory depression[blank_end] - Avoid [blank_start]long[blank_end] appointments

True or false: Cystic fibrosis patients have a decreased risk of dental caries?

True or false? Cystic fibrosis patients may have less plaque?

ID blocks are contraindicated in which patients?

True or false? Extractions for epileptics and asthmatics are indicated for hospital treatment?

Extractions for haemophiliacs should be undertaken in hospital

Diabetes, wether well controlled or not, ALWAYS has an impact on dental treatment

Which of the following are diabetic patients at greater risk of?

Patients undergoing treatment for cancer ([blank_start]radio[blank_end]therapy and [blank_start]chemo[blank_end]therapy) may experience the following problems in the dental setting: - Increased risk of thrush ([blank_start]candida[blank_end] infection) - Oral [blank_start]ulcer[blank_end]ation - Dry mouth ([blank_start]xerostomia[blank_end] from radiation of [blank_start]salivary glands[blank_end]) - Increased risk of [blank_start]periodontal[blank_end] disease - Destruction of bone from radiation - [blank_start]osteoradionecrosis[blank_end] or ORN

When you gain consent for an extraction (surgical or not) you need to make the patient aware of the following risks: - Post operative [blank_start]pain[blank_end] (pt to take analgesia) - Post operative [blank_start]swelling[blank_end], bleeding or bruising - [blank_start]Fracture[blank_end] of teeth - [blank_start]Dry socket[blank_end] or post operative infection of socket - Damage to [blank_start]soft tissues[blank_end] - Excessive [blank_start]bleeding[blank_end] - Damage to [blank_start]nerves[blank_end] - Creating an [blank_start]opening[blank_end] between oral cavity and maxillary [blank_start]sinus[blank_end] (oral-antral [blank_start]communication[blank_end] or oral-antral fistula) - [blank_start]Dislocation[blank_end] of the mandible - Fracture of maxillary [blank_start]tuberosity[blank_end]

What does the C stand for in the cage questions?

What does the A stand for in the CAGE questions?

What does the G stand for in the CAGE questions?

What does the E stand for in the CAGE questionnaire?

What is the NHS recommended level of drinking for an adult per week?

How many units of alcohol does a large glass of wine have?

True or false, a pint of beer always contains 3 units of alcohol

A patient has arrived with a failed crown you have to explain why this may have happened and what options they have. Why? - There may be [blank_start]decay[blank_end] under the crown margin, due to [blank_start]bacteria[blank_end]. The tooth or crown may have [blank_start]fractured[blank_end] as well. - We would need to [blank_start]replace[blank_end] the crown. This involves [blank_start]removing[blank_end] the existing crown and removing any [blank_start]decay[blank_end] on the tooth. We may need to [blank_start]prepare[blank_end] the tooth a little more and take some more [blank_start]impressions[blank_end] so a new crown can be made. This may take a few [blank_start]weeks[blank_end]. - If there is not much tooth left, we may need to place a [blank_start]post[blank_end] in the tooth and build up the tooth above the gum in order to place a [blank_start]crown[blank_end] on top. This procedure has a higher risk of [blank_start]failure[blank_end] however and may result in a root [blank_start]fracture[blank_end] in time. - Depending on the state of the tooth underneath, we may have to take an [blank_start]x-ray[blank_end] and possibly carry out [blank_start]root[blank_end] treatment on the tooth before we can place a crown on top. - If the tooth underneath is [blank_start]unrestorable[blank_end] we may have to [blank_start]extract[blank_end] it and replace it with a [blank_start]bridge[blank_end], partial [blank_start]denture[blank_end], or an implant.

The four principles of preventative advice are:

It is the amount of sugar in your diet rather than how often you eat sugar that makes the most impact on your dental health

You're giving a parent advice about their child's diet to prevent further decay as their child has white spot lesions. What are white spot lesions? - The beginning of [blank_start]decay[blank_end], where the tooth has been [blank_start]demineralised[blank_end] by sugar [blank_start]attacks[blank_end] from food. - Sugar is converted into [blank_start]acid[blank_end] by [blank_start]bacteria[blank_end] in our mouths - The less [blank_start]frequent[blank_end] we eat, the less attacks we have - Sugar attacks can cause a [blank_start]hole[blank_end] in the tooth Without oral hygiene improvement and diet changes, these white spot lesions may progress into [blank_start]decay[blank_end] and cause the child [blank_start]pain[blank_end]

What does ALARA stand for?

Who does ALARA aim to protect?

Which of the following techniques can achieve ALARA in practice? (tick all that apply)

True or false: patient positioning can have an effect on the dose of radiation they receive?

True or false? There are no readily-available precautions we can take to reduce radiation dose during DPTs