ORE Part 1 April 5-6th 2023 feedback (Group B)

Q. All muscles of mastication - origin & Insertion - do it well

Q. All muscles of tongue - origin & Insertion - do it well
Q. Pt. With aggressive periodontitis & allergic to Penicillin - Azithromycin + Doxycycline
Q. HBS serology - do it properly
Q. Effect of exercise on heart.. but this time tachy / bradycardia..
Q. Scenarios on effect of exercise on heart -
Q. Some Scenario related to Venous Return
Q. Cardiac output formula
Q. Mandibular nerve branches
Q. OPG labelling
Q. IOPAR labelling - mylohyoid , external oblique ridge
Q. LA - Which cause methhemoglobinema - prilocaine,
Q. Which LA is most cardiotoxic - Bupivacaine
Q. Cranial nerve scenarios, especially CN 3
Q. Coagulation Q’s - Plasminogen, Plasmin, Thrombin,
Q. Dry socket - anaerobic bacterial organism Treponema denticola is a pathogen in periodontal
disease and its fibrinolytic activity may be responsible for removing the blood clot..
Q. C. Difficult - Pesudomembranous colitis
Q. 2-digit classification very important - most of the Q’s were from it
Q. Doses were asked - Omeprazole side effect
Benzvdazimine dose
Sodium fusidate dose
Aciclovir dose
Midazolam dose
Fluconazole dose
Q. Geographic tongue diagram
Q. Lekuoplakia diagram
Q. BPE scores - emq
Q. Flouride - emq
Q. Salivary tumor which causes perineural invasion - Adenoid cystic carcinoma
Q. Pt came with dry mouth and dry eye.
Q. keneddy classification (Diagram) -
Q. Tooth & mucosa supported ((Diagram) -
Q. I-bar in RPI system (Diagram)
Q. Mobility classification
Q. Plaque classification
Q. Impression post (Diagram)
Q. Retractor (OS)
Q. Bisbiguanide (chlorhexidine) conc. as gel & mouthwash
Q Median rhomboid glosssitis
Q. Trauma guidelines - few Q’s
Q. Avulsed tooth Q’s
Q. Gingival retraction cord
Q. Few Ortho scenarios
Q. Cracked tooth syndrome
Q. Tooth wear
Q. Bleaching
So, I started with Samson’s notes
My main focus was on specific topics which were repeated in the last
exams so I could pass. I didn’t study books, I studied smart and
subject wise.

Anatomy (Samson notes/ google/ mental dental youtube channel)

It is important that you understand anatomy and see diagrams and
videos while you are studying, don’t only memorise as there are
diagrams for the arterial supply and skull foramen and its contents)
and these diagrams might sound hard to you if you only memorise!
Muscles of Mastication (almost 25 Q about origin- insertion learn the
two heads O/I in details and the action of each muscle precisely)
Cranial Nerves assessment (almost 15 Q)
Diagram of muscles of the tongue
Pharyngeal Arches and tongue development

Physiology (Samson notes/ Lots of youtube videos (Osmosis/ Alila

medical media) to have a general idea of the human body physiology)
Hypersensitivity (learn in details)
Heart physiology and histology (learn in details) and learn the changes
that happen during exercise! Heart valves
Respiratory physiology(learn in details)
Hepatic system (learn in brief)
Muscle histology and muscle contraction physiology (learn in details)
Action potential (learn in details)
Heart contraction physiology and type of junction between cells and
SA, AV nodes
Salivary glands and saliva content and how the saliva is formed is
extremely important, learn everything in detail, even learn the types of
enzymes in saliva and each enzyme job!! They asked about it ..EMQs
I personally had a look at it from Master Volume 3 but I think there
might be other good sources.
Also the development of Salivary glands timings

Speech physiology, learn the definitions (resonance, phonation and

and bla ) and their sequence and what parts of the oral and
pharyngeal contribute. Also I referred to Master Volume 3 it is good
but not brief so It took up my time.

Medical emergencies management (it comes as a clinical scenarios)

and CPR (learn everything about it)
Epilepsy scenario(midazolam)
Hypoglycemia emergency scenario
Glucagon
Case scenario: (Opioid overdose emergency) indirectly
Management: Naloxone
Choking w foreign body Ur Rx heimlich manoeuvre
Polycystic kidney disease
Oral Histology
This is really important as they focused on asking on Cementum and
PDL histology! It was surprising to me as I focused on Enamel and
Dentine!! They asked unfamiliar questions (to me) about the common
cells in these tissue like fibroblast, cementocytes and cementoblasts,
odontoblasts, specific enzymes and proteins in alveolar bone as well
and they were confusing to me so learn them in details from a good
source.
Tooth eruption timings and development learn them by heart and
calcification timings

Psychiatry is really important we had 5-10 Qs

I studied it form Samson and answered them

claustrophobia agoraphobia/ mania/ obsessive compulsive disorder/
bulimia and so on
Learn the difference. It will be a clinical scenarios and you have to pick
the disorder!
They asked to questions about bulimia (w/parotid bilateral swelling-
depapillation of tongue and erosion)

Oral pathology
I studied from Samson and pink oxford
But I don't remember that there were alot of questions but,
They focused on Cleft lip and palate
Learn the timing of the lip surgery and so on for those CLP patients in
detail and which processes failed to fuse.
They also focused on Cleidocranial dysplasia
They brought a question about dentigerous cyst but they wrote
follicular cyst

Prosthodontics
was the main focus
It was scenarios and you have to choose the best treatment (CR/BR-
Co-Cr- Maryland bridge- Implant and so on)

Impression materials techniques

Kennedy Classification

And learn the dental chart that is used in UK

As they asked questions on the UK dental chart and it was different
from the one I used in my country so I was confused!

Periodontics (Second Focus)

I studied it from uk guidelines
Gingival and bleeding and plaque indices (learn by heart)
BPE very very important many questions
Only one EmQ on the new periodontal classification
Probes types

Endodontics (Samson)
Case scenarios and you have to identify the diagnosis
(reversible/irreversible/ and so on)
A question about when to give antibiotic
I remember a question about Phoenix abscess?

Operative (Samson)
Amalgam (learn everything about it from Samson)
Over trituration in amalgam: porosities? (Samson notes)
No wedge - overhang

Sanitary pontic for rheumatoid patient

Probe parallel terminal shank to surface

Orthodontics (Samson)
Only one question (IOTN)
We didn’t have many questions as the first batch

Surgery (Samson)
Pharma (Scottish guidelines)
I remember only one question about Antibiotic indications
And Ampicillin question

Pediatrics
I don't recall questions
But few about dental trauma management
Splints timing
Prognosis after specific types of dental trauma
Cvek pulpotomy
Picture of rampant caries
They asked about intrusion : most common result is Pulpal necrosis

Preventive
Fluoride doses are of extreme importance
And toothpaste fluoride concentrations and indications (case
scenarios mention pt age and risk and u have to pick which toothpaste
conc)

Ethics
This was a little bit hard to me
I studied BDA sheets for only specific topics
And ethics chapter from oxford
But unfortunately they focused on different topics like 10 questions
about hand scrubbing/washing period and timing in seconds and it
was confusing to me
Antiseptic agent contains?
Also case scenarios with different committees names and u have to
choose which committee to refer to
I couldn’t remember and couldn’t find source after exam, if any of my
colleagues did, pls write in the comments to help others to study it in
the future exams
On the other hand, they asked about definitions that are covered in
oxfords ethics chapter which made me happy
Like neglect type definitions
Misconduct and so on
Disposal of wooden wedges
They brought these:
precontemplation, contemplation, preparation, action, and
maintenance with clinical scenarios and u have to pick the stage of
change I googled them after exam because I couldn’t know what is
it
Statistics
Also 3 questions about Prevalence calculation

I did pastest (online) 1-2 hours at night before I went to sleep! And I
did get a little feedback but I regret it as feedbacks are really very very
important!
I hope my feedback is helpful,
I got 73 in paper A
69 in paper B

It is doable, you need to study smart not hard, it is not about the
numbers of books you read!
So first have a view at feedbacks and it will guide you, the feedback
can really be repeated! This is a fact.

Good Luck everyone and pray to me!

-Please note, you don't need to waste ur money and go for courses in
part 1, save ur money for part two.
Self studying is enough.
April 2022
ORE PART 1 GUIDANCE – targeted for August 2022 attempt
Hi Everyone – this post is for those who are going for august
ORE attempt - so I sat the April exam with just 4 weeks prep
and managed to pass it. I also work 3 days a week so any
space between patients was used in studying. I wouldn’t say
this is an ideal situation but like we all know that there is so
much uncertainty with the booking and I was not one of those
who studies all around the year. The exam is do-able but only if
you smart study in the time left from now till august. If I can do it
so can you!

Main guidance:
Samson Notes – so important – the notes are a very good guide
to what comes up in the exam. It may seem like they’ve covered
everything but when you open a textbook you realise there’s so
much more. Samson notes are quite accurate to give you a
good start and guidance of what definitely needs to be covered.
Buy the subscription if you can as with the subscription comes a
huge bank of mcqs – broken down topic wise which also were
really helpful.
Link:
[https://www.samsoncourses.com/ot/users/register](https://www.
samsoncourses.com/ot/users/register)
Feedback Compiled documents – important – I wish someone
had told me to use this as a guide to the topics asked in the
exam. I admit there were some new and weird questions in the
exam that confused us all but if you take away those questions
– the main bulk of the questions are covered in feedback – they
may not be the exact question but the topics they picked on
were the same. These can be found in multiple places, esp
groups and dropbox links that have been shared.
Whatsapp/ Facebook Study Groups
They are many groups out there that are filled with lots of
documents to read through, it is worth saving important things
from those groups whether its BDA sheets/ Guidelines/ Law and
Ethics or any classification tables – it is extremely important to
have a folder where you save all these extra things that are
being shared esp guidelines and classification – these will
become your last minute flick throughs before the exam. Also a
small whatsapp group with people who are also serious about
the august exam is quite beneficial – if you get stuck or
confused – you can always drop a message and sometimes
someone understands it better and getting through questions
together – you learn a lot plus that whatsapp group can also be
used to share content.
BDA sheets and guidelines:
- Imp do them once properly, highlight and then revise – they
are also condensed documents that have people have put out
there where you can go through all of the guidelines in one go.
Text Books:
I have purposely written this after discussing the above because
you need to study smart and concisely. Once you have got a
good idea about the topics from the notes and feedback
questions. Now refer to your text book.
1) PINK book – you must at least cover it once properly and
second as a revision – having highlighted main points esp
tables and numericals.
2) Blue book – use for anatomy from the older edition and oral
histology – they were many questions on oral histology – esp
oral histo diagrams – so it is important to do oral histology well
and do images from a proper textbook such as tencates.
3) BRS PHYSIOLOGY – I used BRS physiology as I only had 4
weeks and BRS physiology is enough
4) Snell Review and Flash cards of netters – I did these for
anatomy – the diagrams from Netters are very useful – they
were a lot of anatomy based diagrams – you must be able to
identify foramina, nerves, arteries in different views and different
diagrams. Once you have made a concept of what attaches
where or what runs through where you will be able to identify
any diagram, they throw it at you.
5) Youtube pneumonics! – this is a lifesaver – there are
pneumonics and tricks on youtube for learning many things esp
ERUPTION DATES AND TIMES! – super important. Going
through feedback questions you will realise that they are certain
favourite topics they like and those you must get your head
around no matter how much you want to skip them – do not,
they will come in exam and you will wish you had gone through
that topic - some il state below.
6) MCQ BANKS – do as many as possible – use pastest books,
the app of pastest, samson bank mcqs, do mcqs everyday –
even if you get them wrong – keep going through as many
possible. There is also a telegram group with a quiz which is
useful and fun way of learning.
7) Master dentistry – I did use master dentistry but only to clear
my concepts in certain areas and ORAL PATHOLOGY is well
written in master dentistry. But it was a side book for me that I
used to check up things on.
Link of pastest:
[https://www.pastest.com/dentistry/online-revision/](https://www.
pastest.com/dentistry/online-revision/)
Link of telegram group:
[https://t.me/joinchat/AAAAAE6oOfPyPQT2mK1wOw](https://na
m12.safelinks.protection.outlook.com/...)
SOME OF THE IMP TOPICS that you must cover in your exam
prep
Anatomy:
1) Cranial nerves – all 12 – must know what areas they supply
and if there is a defect what would happen.
2) Muscles of mastication – attachments and supply
3) Muscles of tongue – attachments and supply
4) Hyoid bone – image,radiograph, attachments
5) External Carotid artery – branches – identify on diagram
6) Skull – foramens : ovale, spinosum, rotundum, magnum –
what passes through what and able to identify all foramens on
different views of skull
7) Sinuses – maxillary,frontal, sphenoidal, ethmoidal – identify
and label
8( Facial artery, Facial nerve
9) Branches of mandibular nerve
10) They love heart – Cardiology – do it very well! Cardiac
cycle, cardiac output, resistance – how resistance affects
different situations ie) exercise, elderly, different ventricles and
their function – basically all of cardiology!
11) Respiration – Tidal volumes – all of them! EMQ came up in
exam know the definition and volumes
12) Differences between different Hep and what's more
common, more infectious, more prevalent etc.
13) Hypersensitivity reactions know them all – learn the whole
table and make sure you know them well.
14) Hand signs – again use a table to learn all the hand
manifestations of diseases.
15) ERUPTION TIMES AND DATES for both primary and
permanent– cannot stress enough on this – if you skip this you
will lose easy marks at least 10!
16) Kennedy classification
17) Cleft lip and palate classification
18) Perio 2017 classification
19) BPE SCORES
20) LAW and ETHICS – pink book chapters are enough with
bda sheets
21) Negligence types
22) Gillicks competence – consent ages and scenarios
23) Pulpitis case scenarios – diff types and scenarios
24) Perio -endo lesions
25) Fluoride – although in 2022 exam – there wasn’t much on
fluoride but in feedbacks its in an imp topic
26) Blood diseases such as Haemophilia A,B, Thalassemia
27) Impression materials – when to use what impression
material – diff scenarios
28) Syndromes – crouzon, cleidocranial,osteogénesis
imperfecta,dentinogenesis imperfecta etc
29) Bell, Cap, Bud stages – histo diagrams – imp to see
diagrams for all of the stages and know how to label
30) Medical Emergencies
31) CPR/Basic life support questions
These are just a few topics that you MUST COVER in your
prep.
Moving on to a quick review of the actual APRIL EXAM 2022:
PAPER A
- Focussed mainly on anatomy, physiology and anything left
was oral histology.
- Here's a rough guide of what I wrote as I came out of exam:
- Anatomy - all of it mainly from cranial nerves and skull
- All 12 nerves
- All tongue muscles and supply
- External carotid artery and branches
- Lots of questions on eye movements
- Labelling of skull two different views
- Labelling of opg in particular hyoid bone and radiographic
artefact that I found difficult the rest were straight forward
- Muscles of mastication
- Anterior posterior fontanelles
- All sinuses labelling in different angles
- Side and front
- Physiology
- Heart - P wave, ventricles, cardiac cycle, different valves and
significance
- Cardiac output stroke volume and how resistance is affected
in different situations ie exercise, what happens to systole and
diastole in diff situations like eldery and exercise
- Respiratory - all tidal volumes significance and values
- Medicine!
- hand signs of different diseases like arthritis, liver disease,
peptic ulcer,bleeding
- all of emergency medicine like addisonian crisis, anaphylaxis
reaction, hypoglycemia, how to approach different scenarios
taking in consideration ABC - multiple scenarios
- Oral histology
- Bell stage, cap stage, bud stage
- Labelling diagrams of inner enamel epithelium outer enamel
epithelium, dental follicle etc
- Another diagram that was histology of dentine enamel pulp on
a tooth and was marked in diff areas and you had to identify a
histology picture of dentine, enamel, pulp, bone interseptal,
interradicular – these were the options given.
- Cleft lip and palate
- Embryo diagram of stomodeum showing maxillary process
frontal prominence etc etc
Hypersensitivity reactions – multiple mcqs
ERUPTION TIMES AND DATES
Paper B – the main bulk was from PROSTHO AND DENTAL
MATERIALS – a lot of questions on impression materials.
However, the other batch said they had a lot of endo – we didn’t
have any endo, maybe just 1-2 mcqs. One thing we all found is
whatever topic they liked they got stuck on it and generated
10-12 mcqs just on that topic either by giving EMQ or just
multiple single best answer questions – they didn’t really
distribute properly as I can't even remember doing a single
endo question properly – it is what it is – but be prepared that
you cannot leave any topic even if you do it superficially esp the
clinical PINK book ons.
Second an exam tip that I found helped me is the EMQ options
were extensive – try to attempt answering the question without
opening the drop down box because they had similar answer
and it would just confuse you further – I mentally had my
answer ready before I opened the drop down box menu then
explored other options incase there was a better answer to the
scenario.
Paper B rough idea:
Kennedy classification diff scenarios
Complete denture steps questions what you would do after so
and so step.
Impression materials in different scenarios
At Least 10 diff scenarios
Primary,secondary,resorbed ridge, need to record behind
tuberosity, diff scenarios and then what impression material
best in this case
Oral medicine SLE and MMP but common features we were
already told so like butterfly rash they already told asked for
additional minor feature symptoms
Syndromes - ectodermal hypoplasia, cleidocranial dysplasia
Osteogenesis Imperfecta, Dentinogenesis imperfecta,
Pictures of the above were given and u had to diagnose also
picture of tetracycline staining
Different scenarios of irreversible pulpitis, periodontal endo
lesion, periodontal abscess, apical abscess, diff scenarios and
same bank of answers where you had to diagnose what is what
Oral hygiene and basic hygiene, most effective handwashing
time, best Interproximal cleaning aid for implants, denture
stomatitis patient, first line of treatments in a lot of mouth related
diseases where i felt they were directing on u to choose the
removal of cause. Ie smoking,hygiene,
A Lot of questions on abrasion,erosion,abfraction and bulimia
erosion vs extrinsic erosion different pictures
Ortho few questions on treatment planning class 3 correction,
class 2 correction
A Lot of questions on best denture material for different
scenarios
Ie allergic to nickel whats the best denture to use
Pt wants lightweight dentures and what's the best material to
use.
Ethics quite abig.. about consent, different types of negligence,
different types of transtheoretical models scenarios and u had
to guess the phase, definition of affidavit, criminal negligence,
assault, diff scenarios about mental capacity.
Sickle cell anaemia scenario
Different dental committees – this was a hard one – read about
the different local dental committees on BDA and what they do
ie) which committee would you ask for referral, general
information, emergency information, applying for a job but gap
in clinical experience. There were diff committees and networks
given and you had to decide which one was for which.
The above breakdowns of paper A and B are very rough guides
but you can see some topics are bound to come!
It is a do-able exam, you just need to be extremely focussed on
what and where to study from. The main hurdle is the booking
system! Get through that and then give it your absolute best
shot. Remember a lot of the things from dental school will come
back to you in this exam! We passed dental school and with the
right amount of time and effort put into revision – you can pass
this exam too! August intake in my eyes is do-able if you start
from today and have a proper plan set out.
Best of luck,
If you have any questions – feel free to comment below or DM
me – however, I am overwhelmed with huge amounts of work
currently as I am due to get married in a month’s time but really
wanted to help the next candidates as all these groups and
reading people's feedback from exams helped me too!
Therefore, with the extensive feedback above, I will try to
answer everyone’s questions but they may be a few days late.
Also I think the groups have so much content and guidance you
can do it by yourself – I would save your money and spend it for
ORE PART 2 COURSES than ore part 1 ones. However, if you
really feel you need some guidance – then they are some good
ones out there too. Remember: YOU CAN and WILL get
through it!
Feedback
Anatomy (Samson notes/ google/ mental dental youtube channel)

It is important that u understand anatomy and see diagrams and

videos while you are studying, don’t only memorize as there

Muscles of Mastication (almost 25 Q about origin- insertion learn

the two heads O/I in details and the action of each muscle precisely)

Cranial Nerves assessment (almost 15 Q)

Diagram of muscles of the tongue

Pharyngeal Arches and tongue development

Physiology (Samson notes/ Lots of youtube videos (Osmosis/ Alila

medical media) to have a general idea of the human body
physiology)

Hypersensitivity (learn in details)

Heart physiology and histology (learn in details) and learn the
changes that happens during exercise! Heart valves
Respiratory physiology(learn in details)
Hepatic system (learn in brief)
Medical emergencies management (it comes as a clinical
scenarios) and CPR (learn everything about it)

Epilepsy scenario(midazolam)

Hypoglycemia emergency scenario

Glucagon

Case scenario: (Opioid overdose emergency) indirectly

Management:
Naloxone

Choking w foreign body

Ur Rx
heimlich maneuver

Polycystic kidney disease

Muscle histology and muscle contraction physiology (learn in
details)
Action potential (learn in details)
Heart contraction physiology and type of junction between cells and
SA, AV nodes

Oral Histology

This is really important as they focused on asking on Cementum

and PDL histology! It was surprising to me as I focused on Enamel
and Dentine!! They asked unfamiliar questions (to me) about the
common cells in these tissue like fibroblast, cementocytes and
cementoblasts, odontoblasts, specific enzymes and protiens in
alveolar bone as well and they were confusing to me so learn them
in details from a good source.

Tooth eruption timings and development learn them by heart and

calcification timings

Salivary glands and saliva content and how the saliva is formed is
extremely important, learn everything in details, even learn the
types of enzymes in saliva and each enzyme job!! They asked
about it ..EMQs
I personally had a look at it feom Master Volume 3 but I think there
might be another good sources.
Also the development of Salivary glands timings

Speech physiology, learn the definitions (resonance, phonation and

and bla ) and their sequence and what parts of the oral and
pharyngeal contribute. Also I referred to Master Volume 3 it is good
but not brief so It took from my time.

Psychiatry is really important we had 5-10 Qs

I studied it form Samson and answered them
claustrophobia agoraphobia/ mania/ obsessive compulsive disorder/
bulimia and so on
Learn the difference it will be a clinical scenarios and u have to pick
the disorder!
They asked to questions about bulimia (w/parotid bilateral swelling-
depapillation of tongue and erosin)

Oral pathology

I studied from Samson and pink oxford

But I dont remember that there were alot of questions but,
They focused on Cleft lip and palate
Learn the timing of the lip surgery and so on for those CLP patients
in details and which processes failed to fuse.
They also focused on Cleidocranial dysplasia
They brought a question about dentigerous cyst but they wrote
follicular cyst

Paper 1 was easier than paper 2 (to me)

Because I was more prepared for it

Paper 2 was more scenarios based

Long scenarios, so watch time.

-Prosthodontics was the main focus

It was scenarios and you have to choose the best treatment

(CR/BR- Co-Cr- Maryland bridge- Implant and so on)

Impression materials techniques

Kennedy Classification
And learn the dental chart that is used in UK
As they asked question on uk dental chart and it was different from
the one I used my country so I was confused!

- Periodontics (Second Focus)

I studied it from uk guidelines
Gingival and bleeding and plaque indices (learn by heart)
BPE very very much…
PAPER 1 - 21-04-2015

1. Which part of medial pterygoid muscle which originates from pterygoid plate
bone:
A. Superficial
B. Deep
C. Anterior
D. Posterior

2. Which part of medial pterygoid originates from medial part of lateral pterygoid
plate:
A. Superficial
B. Deep
C. Anterior
D. Posterior

3. Histological picture of bell stage: two questions asking to label the parts: one
was dental lamina giving rise to the bud and the other was internal enamel
epithelium

4. Normal glucose level in an adult

A. 0.5
B. 3.5-5.5
C. 5.5-7.5
D. 8.5

5. Hemoglobin level in a 6yr old

A. <8mg/dl
B. 11-13mg/dl
C. 13-15mg/dl
D. >18mg/dl

6. IOPA showing cone cut and asked to label:

A. Cone cut with round collimator
B. Cone cut with square collimator
It was square
7. Iopa showing blurred image: cause was asked (read OPG / IOPA faults in
detail )
A. Double exposure
B. Exposed to light before taking the x ray
C. Splashes of developer dark spots
D. Splashes of fixer white spots
E. Movement of patient

8. Iopa showing another blurred image: same options

9. Iopa shown… asked what was the problem: wrong placement of the film… (
we could see the lines of the silver film)

10. Bitewing pointing to some landmarks: asked to label them

One was inferior dental canal
Maxillary tuberosity
Calculus deposit on second molar (overhanging composite filling was also an
option)

Mylohyoid ridge/ external oblique ridge

10. Calculation of dosage of LA… in “x” amount of cartridges of 2.2ml in an adult

11. Questions on local anesthetics (there were 5)

A. Long acting LA - Bupivacaine

B. A child who is perfectly healthy and fit requiring a second molar extraction,
type
of LA?
12. A child comes to the clinic with a complaint of burning mucosa, on
examination the mouth is sore and red on one side of the oral cavity
A. Herpetic gingivostomatitis

13. Reactivated form of varicella zoster

A. Chicken pox
B. Shingles
C. Herpes simplex
14. An elderly female patient with irritation of the corners of the mouth and palatal
eryhtema. She is a denture wearer and admits wearing the denture at night. The
condition is?
A. Angular chelitis
B. Sjogren’s syndrome

15. A new edentulous patient comes to you for dentures. He has a history of
previous radiotherapy for tonsillar tumor. What is the long term complication that
would effect your treatment?
A. Oral mucositis
B. Osteoradionecrosis
C. Xerostomia

16. A patient with many swellings on the lateral side of the face - Gorlin goltz
syndrome

17. A pic showing arterial supply of face: (maxillary artery and its branches were
shown) and asked to label different braches

18. How do you dispose of used gloves?

a) Clinical waste
b) Domestic waste
c) Sharps container
d) Pharmacological waste
e) Yellow bag
f) Red bag

19. What do you do to a used 15 no. File after completion of treatment?

a) Autoclave
b) Dispose in sharps container
c) Disinfect and wash

20. How do you dispose of used impression materials?

a) Same options as for gloves, and- Pharmacological waste
21. A patient with a cardiac pacemaker. Which is most contraindicated?
a) Electrosurgery
b) Placement of implants
c) Extraction of teeth

22. Acute attack of asthma. Which drug would most treat the
bronchoconstriction?
a) Salbutamol
b) Theophylline

23. A patient with chronic inflammation and hypersensitivity of the respiratory

tract?
a) Asthma
b) Chronic bronchitis
c) Emphysema
d) Chronic obstructive pulmonary disease
e) Pulmonary embolism
f) Tuberculosis

24. A patient with a history of productive cough and night sweats for 3 years of 2
month episodes
a) Same options as above- TB

25. A patient's x-ray showing enlargement of alveolar spaces?

a) Same options- Emphysema (I think)

26. A patient with venous thrombosis which is dislodged?

a) Same options- embolism

27. Drug that is counteracted by beta lactamase inhibitors?

a) Penicillin V
b) Erythromycin
c) Clarithromycin
28. What is the common cause of a faint in a dental office?
a) Hypoglycemia
b) Myocardial infarction
c) Anaphylactic shock
d) Vasovagal

Hypoglycemia second most common

29. A patient comes late in the morning for a dental treatment. She missed her
morning breakfast and is feeling giddy and unwell. The treatment of choice?
a) Glucagon
b) Insulin
c) Adrenaline
d) Glucose
e) Oxygen

30. The exocrine glands are most?

a) Unicellular
b) Bicellular
c) Tricellular
d) Multicellular

31. Which of the following is exocrine?

a) Pituitary
b) Adrenal
c) Skin
d) Thyroid

32. A picture showing a girl with opposing clavicles

a) Cherubism
b) Cleidocranial dysplasia
c) Ectodermal dysplasia
33. Diagnosis of a child who has delayed eruption. On examination, the child can
bring her shoulders together
a) Cleidocranial dysplasia
b) Ectodermal dysplasia

34. A child having sparse hair and missing teeth

a) Ectodermal dysplasia

35. Embryo picture: asked to label - i think they were medial nasal process and
maxillary process

36. Which arch does the maxilla develop from

a) 1st arch
b) 2nd arch
c) 3rd arch....

37. Trigeminal nerve belongs to which pharyngeal arch?

a) Options all arches- 1st arch

38. A patient develops a fixed swelling of the parotid gland, which nerve is
affected?
a) Facial nerve
b) Trigeminal nerve
c) Auriculotemporal nerve
d) Glossopharyngeal nerve

39. A picture showing muscles attachments (extrinsic) to the tongue: asked to

label - 4 questions:
a) Styloglossus
b) Hyoglossus
c) Genioglossus and
d) Palatoglossus
40. Hyperventilation - about 5 questions: read in detail. It was a lil confusing.
a) What is the substance that is reduced - options were CO2, O2, N
b) Which levels remain the same - options were CO2, O2, N, metabolic alkalosis,
metabolic acidosis, respiratory alkalosis, respiratory acidosis
c) What does it cause - same options
d) What causes alkalosis - same options

In respiratory acidosis Co2 will increase

In metabolic acidosis it remains normal and HCO3 decreases
In respiratory alkalosis Co2 will decrease and HCo3 normal
In metabolic alkalosis co2 will be normal and HCo3 increased

Respiratory alkalosis occurs when high levels of carbon dioxide disrupt the blood's
acid-base balance

41. In hyperventilation, what is decreased, what is increased, what remains

same: options were:
a) Inspiratory reserve volume
b) Expiratory reserve volume
c) Residual volume
d) Tidal volume decreases

42. Cardiac output is most affected by

a) Stroke volume
b) End systolic volume

43. Same question as 41, different options:

a) Heart rate
b) End Systolic volume

44. What is the common cause of food poisoning in the UK?

a) campylobacter
45. What should you be most concerned about when extracting a tooth in a
patient who underwent radiotherapy previously?
a) Osteonecrosis
b) Osteomyelitis
c) Osteoradionecrosis
d) Osteoporosis

46. A person on bisphosphonate therapy, the most risk factor?

a) Similar options as 45, Osteonecrosis

47. Young patient underwent extraction of the mandibular third molar 2 months
back. The socket did not heal and recently developed 2 sinus tracts. The
treatment includes:
a) Clarythromycin
b) Tetracycline
c) Metronidazole

48. A patient has bleeding from the gingiva and halitosis. On examination, there
is generalized erythema of gingiva and plaque accumulation. How do you treat?
a) Amoxycillin
b) Tetracycline
c) Clarythromycin
d) Aciclovir
e) Valacyclovir
f) Chlorhexidine

49. A child has multiple ulcers in the oral cavity and fever since 3 days. He has
burning sensation of the mouth. Treatment of choice: Pls confirm
a) Aciclovir
b) Valaciclovir
c) Metronidazole
d) Ampicillin
50. A patient has recently received a graft and on examination has white plaque
on the tongue that reveals bleeding spots on removal. What is the treatment?
a) Aciclovir
b) Tetracycline
c) Nystatin cream
d) Metronidazole

51. Questions on hepatitis:

a) Which is most commonly transmitted through feco-oral route- Hep A/ E (either)
b) Which hepatitis depends on another virus- Hep D
c) Dentists require vaccination against which type? Hep B
d) Passive and active immunisation is available for which type

52. One question on glandular fever relating to Epstein Barr virus

53. Questions on cells:

a) Acute infection - neutrophils
b) Cells at the border of a healing minor aphthous ulcer (8 days old) - options:
macrophages, monocytes, neutrophils, lymphocytes
c) Granulomatous infection
d) Cells in periapical infection (acute)- Many questions regarding cells and
Inflammation

54. Non-caseous infection:

a) Tuberculosis
b) Sarcoidosis

55. Aspirin - what is the most likely action in a patient likely to have myocardial
infarction
a) Antiplatelet
b) Analgesic
c) Antipyretic

57. What is the enzyme most influenced by aspirin?

a) COX
b) Angiotensin converting enzyme
58. Immunoglobin in acute infection
a) IgM
b) IgG
c) IgE

59. A patient says he is allergic to penicillin. What is the most useful symptom
that confirms that he is truly allergic?
a) Diarrhoea
b) Vomiting
c) Cutaneous rash

60. What is the type of hypersensitivity in a patient who develops difficulty in

breathing and flushes of her face 3 hours after receiving amoxicillin?
a) Type 1
b) Type 2
c) Type 3
d) Type 4

61. Type of hypersensitivity in a patient who received a bone marrow transplant.

62. a membrane disorder of a rbc

62. Type of cell in Lichen Planus

a) Giant cell
b) Langans cell
c) Neutrophil
d) Lymphocyte
e) Macrophage
f) Monocyte

63. OPG showing some black space on either side of the left condyle, asked to
label it.

64. Same OPG, asked about a shadow just below the level of the mandibular
body hyoid bone
65. Same OPG, asked to label the floor of maxillary sinus
66. Parotid secretion is highest with what stimulus?
a) Taste
b) Sight
c) Chewing
d) Smell
e) Thought

67. Masseter functions:

a) Elevation of mandible with retrusion
b) Elevation of mandible without retrusion
c) Depression of mandible

68. Stenson’s duct - which gland?

a) Parotid
b) Submandibular
c) All secretions of the mouth
d) Sublingual

69. Most common bilateral swelling of the parotid?

a) Pleomorphic adenoma
b) Warthin's tumor
c) Adenoid carcinoma
70. An elderly patient complains of temporomandibular pain on once side which
goes on and off. The history reveals she has trouble sleeping and wakes up at 4
am every morning. What is the diagnosis?
a) Anxiety
b) Depression (depression is one of the etiological factor for tmj problems)
c) Trigeminal neuralgia
d) Temporal arteritis

71. Shooting pain which lasts for a very short time

a) Trigeminal neuralgia

72. Origin of masseter?

a) Zygomatic arch

73. What are the mediators for the following:

a) Sympathetic system adrenaline
b) Parasympathetic system Ach ((preganglionic)
c) Sensory system
d) Which effects Parkinson’s disease dopamine
The options: adrenaline, noradrenaline, Ach, dopamine, serotonin etc..

74. An elderly patient became forgetful and something ( dont really remember).
What is she most suffering from?
a) Alzhemeirs’
b) Myasthenia gravis
c) Parkinsons

75. Which affects the calcium the most?

a) Calcitonin
b) Adrenaline
76. What does the posterior pituitary secrete? - asked as two questions
a) ADH, Oxytocin

77. What middle pituitary secrete?

a) MSH
b) LH
c) Oxytocin
d) ADH

78. Which hormone influences the gland adjacent to the kidneys?

a) ACTH
b) Thyroxine

79. Which hormone is secreted by growth hormone?

a) Insulin derived growth factor
b) Transforming growth factor

80. What is secreted by the outer portion of the adrenal cortex?

a) Cortisol
b) aldosterone (mineralocorticoid)

81. Cells:
a) Which cell helps in deposition of dentin? - Odontoblast

b) Which cell helps in resorption of bone? - Osteoclast

c) Which cell is responsible for thickening of the root? - cementoblast or

cementocyte?
d) Which cell is lost after its function? - Ameloblast
82. Periodontal fibers are inserted into?
a) Enamel
b) Dentin
c) Cementum
d) Cancellous bone
83. Serology of an infected hep B patient will have: Hba Ag, Hbe Ag, anti Hba,
Anti Hbe

84. Structure of Hb- 2alpha, 2 beta

85. Heamarthrosis is caused in- sickle cell anemia

86. What is the main step before transporting of an impression- washing/

disinfection

87. Most economical way to disinfect/ sterilize an articulator- chemical

sterilization I think.

88. Pic shown with a lesion on lip, patient was with partner on holiday- looked like
herpes.

89. Questions on ANUG and herpetic gingivostomatitis

90. Question on mean, median, mode

In part B-
Many questions from law, ethics.- CPD hours, governing bodies of GDC,
consents, data protection act 1998, maintenance of clinical records etc ( all given
in pink book).

Treatment planning- eg what should be the best treatment plan for: a young
patient with MOD, and old patient etc etc… options like onlays, inlays etc

Questions on caries diagnosis (trans-illumination /bitewing/IOPA/probing etc etc)-

what method to use in different scenarios.

Questions on prosthetic rehabilitation- based on kennedy’s classification

Questions from oral medicine.

Question on IOTN
A ceph was shown and some landmarks were asked

A ceph was shown and was asked to determine the mal occlusion- it was skeletal
class 2.

Question related to eruption age of teeth (indirect question).

Question related to BPE index, debris index.

1-2 questions on statistics.

1. percentage of success of fissure sealants in children?

answer: 85% over 1 year

2. origin of masseter muscle?

answer zygomatic arch

3. tyre track appearance on radiograph. reason?

answer: film placed on the wrong side in the oral cavity

4. extrinsic muscles of tongue ( labelled on diagram)

answer: hyoglossus, genioglossus, styloglossus, palatoglossus
5. labelled on the diagram. ( embryo)
answer maxillary process and nasal placodes

6. which describes the origin of medial pterygoid muscle?

answer: deep head from medial part of lateral pterygoid plate

7. which describes the origin of lateral pterygoid muscle?

answer: inferior head from lateral part of lateral pterygoid plate

8. where to discard used impressions?

answer: clinical wastes

9. where to discard used reamers and files

answer: sharps waste

10. what is the sign for single use only?

answer circle with a 2 written in it with a slash across the 2.

11. What is the sign of orbital fracture?

answer: diplopia on upward gaze

12. What is the pathognomonic sign of lefort 1?

answer: maxillary alveolus with teeth moves as a single unit ( down fracture)

13. What is the most obvious sign of zygomatic arch fracture?

answer: infraorbital nerve paresthesia

14. most repeated statistical figure in a study of mean values?

answer: mode

15. a study in which you compare two groups for a future outcome one with a
group exposed to disease factor other not exposed?
answer: case control study

16. most suitable hand scrub?

answer: chlorhexidine gluconate 4%

17.radiograph with an elongated styloid process

answer: eagle's syndrome

18. what is important for cardiac output

answer: stroke volume and heart rate

19. when someone breathes from a sealed plastic bag which gas is inhaled?
answer: CO2

20.which gas is lost in hyperventilation?

answer: Co2

21. active marker of infectivity of hepatitis b?

answer: hepB e Ag

22. which virus needs another virus to survive:

answer : hep D

23. which virus cannot survive outside human body at all?

answer: HIV

24 which virus has no carrier stage?

answer: HEp E

25. Which virus is spread orofecal ?

answer: A and E

26. diagram of facial arteries ( identify labelling)

answer: superficial temporal artery, facial artery, maxillary artery and labial
inferior artery

27.picture of an ulcer next to an amalgam filling with an overhang?

answer : traumatic ulcer

28. picture of blue black discoloration next to an amalgam filling?

answer: lichenoid reaction

29: Slowly growing salivary tumour on palate rubbery in texture?

answer : pleomorphic adenoma

30. Subepithelial bullae and desquamative gingivitis?

answer: mucous membrane pemphigoid

31. Biliary cirrhosis dry eyes dry mouth?

answer: secondary sjogrens

32 Unilateral sudden pain in the submandibular area in a 10 year old child?

answer: salivary duct calculi

33. infection spreads from lower incisors to?

answer: submental space
34. infection spreads from lower premolars to?
answer: submandibular space

35. infection causing difficulty in swallowing with swelling in the neck under lower
borders of the mandible. most involved space is?
answer: parapharyngeal space
36. infection causing trismus?
answer: submasseteric space

37. infection spreads to cavernous sinus from which tooth?

answer: maxillary canine

38: a child with care order .Who decides he gets a specific dental treatment?
answer: specific order to the court

39.Retention for an over denture?

answer: precision attachment

40. pontic covering the entire ridge?

answer : saddle pontic

41. 2 retainers and 1 pontic , makes how many unit bridges?

answer: 3 unit bridge

42.what is the least amount of varnish of fluoride given to a high caries risk child?
answer: at least twice a year, usually 3-4 times a year

43.how to decrease stress on a tooth ?

answer: narrow occlusal table

44. How to decrease stresses on a denture?

answer: wide denture base area

45. What kind of extra strength is given to dentures?

answer: metallic copings

46. When to get expressed consent?

answer . when revealing patients info to insurance company

47: You discussed with the patient all the risks and benefits of a procedure. He
gave consent. What type of consent is this?
answer: verbal consent (informed consent)

48. What is not important for the consent process?

answer the patient can read and write

49 Why do we consent?
answer: to protect dentist from illegitimate accusation, for patient care

50. What do we do immediately after making an impression?

answer: disinfect it

51: picture of bright pink nodules in the vestibule?

answer fibroepithelial polyp (or fibroma depends on options)

52. picture of cobblestone appearance on buccal mucosa. ( identify)

answer: crohn's disease

53.red cell membrane disease?

answer pyruvate dehydrogenase deficiency
54. identify labelings on stages of tooth formation ( structures)
answer: cervical loop and IEE

55.which restoration is best for children after pulpectomies?

answer: SS crowns

56. Which cells carry oxygen?

answer erythrocytes

57. Which cells resorb root of tooth?

answer: odontoclasts

58: which cells resorb bone?

answer osteoclasts

59 Which cells lay down dentin?

answer odontoblasts

60. Which cells are responsible for synthesis and breakdown both?
answer: fibroblasts

61. Which cells are signal transducers?

answer : osteoblasts

62. Which anaesthesia is given to patients with arrhythmias?

answer prilocaine with felypressin

63. Which anaesthesia is given to pregnant women?

answer : lidocaine

64. Which anaesthesia is given to an anxious child?

answer : sedation inhalation plus local lignocaine

65. Which anaesthesia is given to epileptics?

answer: lignocaine with iv benzodiazepine

66. Which anaesthesia is best used topically?

answer: lignocaine

67: Which anaesthesia is flavoured?

answer: benzocaine

68. which anesthesia has longest duration of action?

answer : bupivacaine

69. which anesthesia given to a child with molar pulpectomy?

answer: lignocaine infiltration

70. which anesthesia prefered for multiple extractions in a child in all 4

quardrants?
answer; GA

71. Best radiograph for submandibular stones?

answer: lower standard occlusal

72 which radiograph best for new patient to asses crestal bone levels?
answer: bitewings

72. Which radiograph to assess bone quality before implants instalment?

answer: CBCT
73. which radiograph for parotid gland mass?
answer : ultrasound

74. which radiograph for tmj disc?

answer MRI

75. a radiograph shown with a defect:

answer cone cut

76. a radiograph shown with dark blotches?

answer: developer blotches
If light blotches then choose fixer

77. a radiograph showing tram lines in mandible?

answer inferior alveolar nerve canal

78. a radiograph showing 2 hazy outlines of all teeth. this defect is due to?
answer: patient movement while taking radiograph

79. who should not be registered with the gdc?

answer: dental educators

80. a lady with missing lateral incisor and good periodontal condition and sound
abutments. how to replace a tooth?
answer: implant

81. a man with missing upper 5. with tilted upper 4 and 6 teeth.moderately
carious . how to replace it?
answer: fixed movable
82. a lady with grossly carious lower first and 3rd molar. how to replace the
missing 2nd molar?
answer: fixed fixed

83: a radiograph showing a labelling of vertebra

answer: atlas vertebra

84. percentage of carbamide peroxide in walking bleach?

answer: 35%

85. crossbite of 1 to 2mm . which IOTN?

answer: grade 2

86. severe hypodontia. which IOTN?

answer: grade 5

87. cleft palate . which IOTN?

answer : grade 5
88. overjet more than 6mm and equal to 9mm . which IOTN?
answer: grade 4.
89. most common cyst in UK is:
answer: radicular cyst (most common site upper lateral incisor)

90. if a nurse has a blood borne virus she is?

answer : redeployed

91. a staff member is considered non responsive to hepatitis vaccine when level
is?
answer: is <10

92. aspirin given to MI patients as it is?

answer: an antiplatelet

93. a known diabetic patient feels agitated and swoony. What would you do?
answer: give glucose

94. Caries on enamel how to test?

answer: dry surface test with good light

95. Caries in dentine?

answer: wet test

96: occult caries?

answer: bitewing

97. proximal caries:

answer: bitewing
98: patient has halitosis and plaque problem what to give?
answer: chlorhexidine mouthwash

99. patient has spontaneous bleeding of gingiva and infections:

answer. leukaemia

100. patient has perio abscess what to give?

answer. amoxicillin

101. patient with multiple draining sinuses what to give?

answer : 500 mg amox or 100 mg doxcyline 4 to 6 weeks

102: banker with tight band headache:

answer: tension headache

103. pulseless temporal arteries?

answer: temporal arteritis

104. nsaids sulphonamides and cephalosporins can cause?

answer: glandular fever

105. man feels electric shock like pain when shaves?

answer trigeminal neuralgia

106. a student has enlarged red interdental papilla due to stress in exams . what
can it lead to?
answer: ANUG

107: treatment of anug?

answer metronidazole 400mg tds for 3 days.
108. bleeding on probing, calculus deposits and 6mm pockets, no furcation
which bpe?
anwer: bpe 4
Highlight answers in light blue please

If you have related info please highlight in orange

Mandible
• Muscles attachments
• Tongue muscles
• Tmj movements and muscles causing those movements
Synovial , ginglymoarthrodial
Lower compartment- hinge and upper gliding (0.9ml)
Intrinsic ligament- lateral ligament
Extrinsic ligament- sphenomandibular and stylomandibular

• Cranial nerve scenarios, there were about 6-8 questions on the tests that
we have to do to check which nerve is damaged like which nerve works in
blowing of mouth, shrugging of shoulders and so on

• Local anesthesia( what types of anesthesia would you give in different

scenarios eg asthmatic pt, child, old pt etc)

• Types of cells in periodontitis

• Types of organisms in periodontitis

• Scenarios of first-time patient comes to the dental clinic and is petrified,

how will you manage(tell,show,do)
• Behavioral management scenarios

• Questions from cardio (what happens to peripheral resistance, cardiac

output during exercise, valve between right atrium and right ventricle, which
vessels carry deoxygenated blood from heart)
• What happens to diastole during exercise
• Questions on membrane potentials
Action potential = all or non phenomenon = depolarization = -55 mv
rest = -70 mv
sodium influx = depolarization
K efflux (out) = hyperpolarization

• Radiographs given asked about impacted third molar, opg(had to mark

different structures)
• Tongue muscles too much.. innervation labeling everything in one form or
the other lot of questions
• Cleft lip and palate picture and many questions related were asked(failure
of closing of which structures causes cleft lip and palate, at which
embryological age) Cleft unilateral Lip One maxillary process fails to fuse
with the medial nasal process 4-6 weeks
palate 7-11 weeks
Oblique facial cleft >> When the maxillary process fails to fuse with the lateral
& medial nasal process
• Palate formation 2 palatine shelves

• Scenario of sialolithiasis stone during mealtime

• Audit definition Clinical audit is a quality improvement cycle that involves
measurement of the effectiveness of healthcare against agreed and proven
standards for high quality, and taking action to bring practice in line with
these standards so as to improve the quality of care and health outcomes.

• Dolichofacial profile scenarios

• Retromandibular pad
• Quinine side effects in mouth (in general deafness & tinnitus) is used to
treat malaria can cause
• Questions on antibodies igA igG igE
• What happens to periodontal ligament in old age decreases 0.18mm 32 to 52
yrs 0.15 52tp 67 yrs.
• Heparin acts on which factor?? Xa
• Rotary file p

rotaper

• Shaping files ( F1, F2, F3 ,S1etc)

• Mcqs on calcification curved canal…different scenarios EDTA
• Dental charts(asked to show which tooth should be extracted, which tooth
is missing)
Filling materials( basically everything about filling materials, different
scenarios were given of different age of people and asked about the
suitable filling materials for them)

• SS crowns for children band 2

• Bridges
• Angles classification and modifications around 5-6 mcqs ortho

• Patient came and had heart problems, diabetes, copd, veins were
thrombosed etc.. what type of sedation will you give for anesthesia…
Inhalation, nasal, i/v, venepuncture and local L.A? GA hospital admission

• Types of x rays for different conditions around 15-20 questions

• Loe and silness gingival index and plaque index(a lot of questions)
Quigley–Hain (Turesky) plaque index:

0: No plaque

1: Isolated flecks of plaque at the gingival margin

2: A continuous band of plaque up to 1mm at the gingival margin

3: Plaque greater than 1 mm in width and covering up to ⅓ of the tooth

surface

4: Plaque covering from ½ to ⅔ of the tooth surface

5: Plaque covering more than ⅔ of the tooth surface

• BPE
• Staging and grading of periodontium
https://www.bsperio.org.uk/assets/downloads/111_153050_bsp-flowchart-i
mplementing-the-2017-classification.pdf

• Osteogenesis imperfecta blue sclera

• Hand sign of rheumatoid arthritis

• 9 Principles of GDC
• Question about which one is not the developmental line of tooth
Perikymata (Ritzius), Hunter schreger
• Questions on CPR (how many inches 5 to 6cm (2 to 2.5 inches) should the
chest be pressed during cpr, recommended presses/breathing rate)
• Ideal INR normal 0.8-1.2, max to extract 4 it measures prothrombin time

Anatomy (Samson notes/ google/ mental dental youtube channel)

It is important that you understand anatomy and see diagrams and videos while you
are studying, don’t only memorize as there

Muscles of Mastication (almost 25 Q about origin- insertion learn the two heads O/I
in details and the action of each muscle precisely)

Cranial Nerves assessment (almost 15 Q)

Diagram of muscles of the tongue

Pharyngeal Arches and tongue development

Physiology (Samson notes/ Lots of youtube videos (Osmosis/ Alila medical media)
to have a general idea of the human body physiology)

Hypersensitivity (learn in details)

Heart physiology and histology (learn in details) and learn the changes that happens
during exercise! Heart valves
Respiratory physiology(learn in details)
Hepatic system (learn in brief)
Medical emergencies management (it comes as a clinical scenarios) and CPR (learn
everything about it)

Epilepsy scenario(midazolam)
Hypoglycemia emergency scenario
Glucagon

Case scenario: (Opioid overdose emergency) indirectly

Management:
Naloxone

Choking w foreign body

Ur Rx
heimlich maneuver

Polycystic kidney disease

Muscle histology and muscle contraction physiology (learn in details)
Action potential (learn in details)
Heart contraction physiology and type of junction between cells and SA, AV nodes

Oral Histology

This is really important as they focused on asking on Cementum and PDL histology!
It was surprising to me as I focused on Enamel and Dentine!! They asked unfamiliar
questions (to me) about the common cells in these tissue like fibroblast,
cementocytes and cementoblasts, odontoblasts, specific enzymes and protiens in
alveolar bone as well and they were confusing to me so learn them in details from a
good source.

Tooth eruption timings and development learn them by heart and calcification
timings

Salivary glands and saliva content and how the saliva is formed is extremely
important, learn everything in details, even learn the types of enzymes in saliva and
each enzyme job!! They asked about it ..EMQs
I personally had a look at it from Master Volume 3 but I think there might be another
good sources.
Also the development of Salivary glands timings
Speech physiology, learn the definitions (resonance, phonation and and bla ) and
their sequence and what parts of the oral and pharyngeal contribute. Also I referred
to Master Volume 3 it is good but not brief so It took from my time.

Psychiatry is really important we had 5-10 Qs

I studied it form Samson and answered them
claustrophobia agoraphobia/ mania/ obsessive compulsive disorder/ bulimia and so
on
Learn the difference it will be a clinical scenarios and u have to pick the disorder!
They asked to questions about bulimia (w/parotid bilateral swelling- depapillation of
tongue and erosin)

Oral pathology

I studied from Samson and pink oxford

But I dont remember that there were alot of questions but,
They focused on Cleft lip and palate
Learn the timing of the lip surgery and so on for those CLP patients in details and
which processes failed to fuse.
They also focused on Cleidocranial dysplasia
They brought a question about dentigerous cyst but they wrote follicular cyst

Paper 1 was easier than paper 2 (to me)

Because I was more prepared for it

Paper 2 was more scenarios based

Long scenarios, so watch time.

-Prosthodontics was the main focus

It was scenarios and you have to choose the best treatment (CR/BR- Co-Cr-
Maryland bridge- Implant and so on)
Impression materials techniques

Kennedy Classification

And learn the dental chart that is used in UK

As they asked question on uk dental chart and it was different from the one I used
my country so I was confused!

- Periodontics (Second Focus)

I studied it from uk guidelines
Gingival and bleeding and plaque indices (learn by heart)
BPE very very much…
Part 1 August 2017

Highlight answers in light blue please

If you have related info please highlight in orange

Dear all, these are some questions from ORE Part 1 August 2017,
contributed by a few people.

Don’t depend on answers in feedback - always double check!

Finally, happy studying and all the best :)

Paper A Group 1 (contributed by Radiqa)

● Cells present in lichen planus & Bacterial infections T- lymphocyte

● penicillins, tetracycline, benzodiazepines mode of action Cell wall

syn, 30s ribosome, GABA
● Functions of cells in enamel Inner enamel epithelium, Dentin and pulp
formation Dental papilla
● Remnants of epitheliums epithelial pearl
● Tongue innervation Lingual, chorda tympani, glossopharyngeal,
hypoglossal
● Parotid gland parasympathetic innervation glossopharyngeal and
facial secretion
● X ray showing palate, cervical vertebra, Floor of max sinus Lateral CT

Lateral cephalometric . Opg

● Bell's palsy upper of which motor neuron lesion -Loss of wrinkling on
the opposite side which neuron lesion
● Upper motor neuron lesion: deviation of the corner of his mouth when
he smiles but wrinkling of his forehead is normal
● Bell's palsy a lower motor neuron lesion
● Ramsay hunt syndrome features: lower motor neuron facial palsy of
geniculate ganglion
● Patient is unable to close his right eye and unable to smile? Lower
motor neuron lesion.
● Upper can wrinkle
● Upper motor neuron lesion If there's an injury it will affect the lower
face of the contralateral side.
● Lower cannot wrinkle

● Autoantibodies in myasthenia gravis IgG igm, hypersensitivity 5

● There were two questions on amalgam hypersensitivity one was due
to drugs lichenoid reaction
● Amalgam reaction, which hypersensitivity type IV
● blood transfusion, which hypersensitivity type II
● Epithelium present on hands but not on face ?
● Location of pyknotic nuclei in which epithelium ?(Pyknotic nuclei are
often found in the zona reticularis of the adrenal gland. They are also
found in the keratinocytes of the outermost layer in parakeratinized
epithelium.) from google .
● Caseating granules in which disease (TB)
● Streptococcal Pneumonia : pneumonia
● A few questions on hyperventilation Co2 decreases, O2 increases,
residual volume does not change
● Hand signs for infective endocarditis - splinter haemorrhages nails
● Rheumatoid arthritis - Ulnar deviation
● Anaesthesia 2 questions
● the diaphragm and position in relation to inspiration and expiration of
air and the effect on the thorax: inspiration - ribs move up and out,
diaphragm - flattens; expiration - ribs move down and in, diaphragm -
dommes up.
● Loss of gag reflex and dysphagia in which nerve Vagus nerve (X)
● A question on oculomotor and one on trochlear
● Types of nerves in muscle spindles Alpha B 1 B2 Gamma and delta
Alpha is muscle spindle,
● gamma-is motor to muscle spindle,
● Delta-is pain fast and cold.
● Cgroup-is pain slow and hot.

● Scenario for Crohn's (swelling of lips with ulcerations)

● RAS on tongue by Caeliac disease
● Increased ESR in what disease

Temporal arteritis(cranial arteritis), reiter syndrome (reactive

arteritis),Behcet disease, Sjogren's syndrome, Sarcoidosis,Rheumatic
fever, Multiple myeloma

● There were two questions on Which increases during exercise and

which decreases and options were stroke volume, systolic pressure.
Answer: diastolic remains the same, TPR decreases, everything else
increases( blood to the skin increases).
-End diastolic volume=?
-mitral valve location= left ventricle and left atrium
● Decreased: Visceral Blood Flow & Total Peripheral Resistance (TPR)
● Remain constant (unchanged) Blood Flow to Brain & Diastolic Arterial
Pressure remain unchanged

● Left lower quadrant abdominal pain what is it? Can't recall the rest of
the statement, options: Diverticula
● Pdl is narrowest in the middle third of the root
● Platelets are formed by Megakaryocytes
● Which nerve passes the stylomastoid foramen (Facial nerve)
●
There was a picture of the skull showing foramen ovale : 1) which
structure passes through - Mandibular nerve (V3); 2) is it motor,
sensory or mixed - Mixed Tongue is deviated to the right side on
which side is the lesion on the nerve? Right Hypoglossal(XII) tongue
deviates or points to the damaged side
● Q Function of glycogen in an unconscious hypoglycemic
patient--.glycogenolysis
● A lot of questions on Na/k channel pumps, absolute refractory,
relative refractory factor 4
 ● Which reacts with tissue to form a clot with thrombin (this one is
doubtful) -
● How much is the Normal tidal volume (500ml)
● A lot of questions on statistics. Mean, median, mode, standard
deviation, case control study, cohort study,

Paper B Group 1 (contributed by Rana)

● fever cells that rise and oral findings

● patient with rubbery mass on the side of his face that has slightly
increased in size and isn’t attached to underlying structures
pleomorphic adenoma
● patient with poorly defined lesion in the parotid gland which is not
soft-. Mucoepidermoid carcinoma
● patient who can't swallow and doesn’t have gag reflex
Glossopharyngeal + vagus Mainly cranial nerve IX
● patient with constipation and sudden urgency to use toilet with mucus
and blood in stool
● patient who feels pain in the lower left abdomen and feels better after
lying down Diverticula
● patient who deviates jaw to left when opening the mouth with clicking
but can close normally right lateral pterygoid
● patient who feels pain in joints and it gets worse with day progresses
osteoarthritis
● patient who feels pain in joints and can’t brush rheumatoid arthritis
● Sjogren syndrome with what’s rest flow rate of saliva <0.1ml/min
● Rest saliva 0.2ml-0.3ml/min
● stimulated 1-2ml/min
● Pilocarpine to increase salivary flow
● child who broke her upper central a complicated fracture in cervical
area how do you treat cvek pulpotomy
● patient who has upper lateral crossbite how to treat ( Z spring )
● many cases of dental pain pulpitis, abscess and acute and chronic
periodontitis
● patient with swelling in face with no pain with a rct treated tooth
● patient injured himself and lose sensation in right cheek and upper
lip, which nerve is damaged ..Maxillary branch of trigeminal nerve
● cells seen in TB Caseating granules, multiple myeloma,SLE,
Myasthenia gravis, HSV1
● cancers of GIT, layers of skin, lining of lungs pseudostratified columnar
ciliated epithelium and anatomical dead space no gas
exchange(150ml)
● patient with hyperventilation which gases rise and which is
responsible for apneic period after it- increasedO2
● patient feels pain on side of head with increased ESR- temporal
arteritis(cranial arteritis)(giant cell), reiter syndrome (reactive
arteritis),Behcet disease, Sjogren's syndrome, Sarcoidosis,Rheumatic
fever, Multiple myeloma
● secondary sjogren what rises ESR
● 10 year old gum appears higher than surrounding tooth why eruption
cyst
● what does amalgam creep and corrosion do microleakage &
secondary caries
● luting cement for all ceramic, pjc, gold crown resin cement,panavia
● Missing upper 5 and decayed 6 patient needs a bridge !?
● Down’s syndrome what do they have and how does it complicate
dental surgery 21 trisomy
● many patients with systemic disease what to expect after extraction
● what happens in IV bisphosphonates patients who get mandible
angle fracture- osteomyelitis
● Enzymes that elevate in MI but options were so unfamiliar- Troponin
● who has heart fibrillation there were option like addison disease,
angina, etc, irregular pulse
● pressure of lungs when increase and decrease
● function of diaphragm
● drugs mode of actions and post op complications: cyclosporin,
amoxicillin , ampicillin cell wall (polypeptide) synthesis, tetracycline 30
r, sulphonamides folate, ciproflox DNA-gyrase, bisphosphonates
osteomyelitis, benzodiazepines GABA
● What does midazolam cause IV sedation, GABA
● fractures in angle, tmj and zygoma how to detect them OPG, OPG+
lateral cephalic, OM,
● amount of LA in ml given in infiltration- 1ml .
● patient gets pain on bending - Sinusitis
● drug causes abdominal pain in high dose- codeine
● questions on different Hepatitis viruses types, envelope or not and
spread mode A oro-focal unenveloped, B DNA sex and blood, C
enveloped sex and blood
● BPE score 0,1,2,3,4,X,*
● mixed dentition patients with pain age 8, 9, 10
● evidence based dentistry 2 questions
● lots of dental pain questions 8-10, scenarios to choose diagnosis
● trauma management
● Instruments
● Calculation for lower facial height MMPA (maxillary to mandibular
plane angle) 27° +or- 4°
● Patient who hasn't seen a dentist for two years, what probe to use?
Williams, WHO, Nabers
● 15 year old girl in boarding school for consent her sister cannot
consent
● Drug that causes pseudomembranous colitis? Clindamycin
● Luting cements in different cases like porcelain crown, ceramic
crown, Nayyar core length 3mm and materials amalcore (amalgam)
● pain with 3 months peptic ulcer (means B12 anaemia) Ans:
koilonychia???
● pain in multiple sites with bruises and recurrent facial rash (means
SLE)
● patient with pain in joints and can’t use brush (rheumatoid arthritis)
Ans: ulnar deviation
Group 1 questions (contributed by Norah):

o Cells found in TB, infectious mononucleosis, multiple myeloma,

Myasthenia gravis, mumps, HIV
TB- multinucleated giant cells (caseating granules )
infectious mononucleosis(EBV)-lymphocytes
Multiple myeloma-plasma cells

o Patient with intermittent pain on biting, when taking x ray theres

widening of PDL apically and loss of lamina dura

o Patient with pain that wakes him in the middle of night-irreversible

pulpitis

o Best post used for anterior canine in a relatively healthy patient Fibre
post carbon fibre)

o Bridge for a patient with missing upper 6, the upper 7 has full crown and
upper five is sound, the patient is on oral bisphosphonates.

o Patient with osteosarcoma what is the postoperative complication

following extraction of lower 8 dry socket

o X Rays of various respiratory conditions like asthma, haemophilus

influenzae, pneumonia, TB. (NEED TO SEARCH IT)

o Mode of action of different drugs like penicillin, metronidazole DNA,

doxycycline, sulphonamides, vancomycin.

o Picture of skull base with 4 canals and an arrow on one of them, identify
and name the function of nerve that passes through it (I think it was
ovale)

o Hand signs weren't direct but I remember these

o Patient with chronic hepatitis (leukonychia)

o Patient with bruising, pain in multiple joints, organs

involvement and recurrent facial rash ( SLE and sign is
osler's node and same)

o Patient with valve replacement who was on antibiotics for 3

weeks due to infection (Rheumatic fever and sign is splinter
haemorrhage)

o Patient with skin disease that may involve the oral cavity
(psoriasis and nail pitting)

o Patient with normal MCV and pain with swelling in his small
fingers ( Sickle cell anaemia and sign is dactylitis )
o Many questions on GIT diseases can't remember all cases but they
included colon cancer, UC, peptic ulcer, diverticular disease lower left
quadrant of abdomin, acute pancreatitis.

o Patient who can't smile on the right side with ipsilateral inability to
wrinkle the forehead (lower right motor neuron lesions)

o Patient who deviates his tongue upon protruding towards the right side (
right hypoglossal damage)

o Lining of lungs pseudostratified columnar ciliated epithelium

o Skin layers (there were like 8 options and 4 layers)

o Hepatitis A virus what type is it, unenveloped, does it cause cirrhosis no

caused by C mainly , B sometimes

o Which patient is most likely to have atrial fibrillation and options were
DM, Addison disease, angina and thyrotoxicosis << the answer

o Pictures of oral lesions they included lichenoid reaction, sub epithelial

fibroma, TB ulcer

o Patient with a rubbery mass on the sides of his face which slightly
increased in size within three months, it's painless and unattached to
underlying structures.

o Patient with a firm mass on one side of the face, poorly defined on x ray
and hasn't changed in size.

o Patient experiences clicking on opening his mouth which deviates to the

left and there's no clicking on closing it and there's no pain.

o Patient with joint pain that gets worse throughout the day and can't open
their mouth.

o Patient with joint pain that is worse in the morning and can't brush teeth.
o Postoperative complications in patients with down syndrome.

o Patient was involved in a fight and received a blow on the face after
which he lost sensation in his upper lip, right cheek which nerve was
injured ( options involved buccal, infraorbital nerve, nasopalatine).

o Hepatitis surface findings like HbsAb, HbeAb, HbcAg and what each of
them meant.
o During hyperventilation breathing CO2 from a bag changes the levels of
what gas, which lung volume changes and which remains the same,
what gas has the highest concentration, and change in what gas results
in the apneic period after hyperventilation

o What is the most common byproduct options were (bicarbonate, urea,

co2 and glucose) kerb’s cycle

o Patient with increased level of ESR who feels severe pain when
brushing the side of his face (temporal arteritis).

o A 10 year old amalgam appears higher than the surrounding tooth

structure what's the cause, options were ( tooth wear from brushing,
creep in amalgam ) . amalgam proud

o Enzymes that elevate after MI attack and many options but the answer
was troponin.

o Function of diaphragm and how it affects breathing ( contraction and

relaxation ) .

o What's the most common postoperative effect of midazolam ( it was

amnesiac ) .

o Amount of LA given in buccal and palatal infiltrations, options were 0.25,

0.50, 0.75, 1, 1.25 ml ) .

o Intraligamentary injection is painful, does it require a special syringe,

does it require pressure, does it provide long duration, etc .

o Which X Ray is used to detect fracture in condyle PA mandible or

(reverse towne’s), fracture in zygoma OM (watery), abnormality in
condylar disc. MRI

o Many BPE examinations like patients with pocket depth of 5 mm in the

upper seven which is the only tooth in that quadrant what's the score (
 it's X because each quadrant must have two teeth at least to count as a
quadrant) .

o Patient with calculus, bleeding on probing and pocket depth of 3 mm

what score is it.

o Patient with pocket depth of 7 with gum recession what score is it.

o Overdose of codeine, paracetamol , aspirin, gentamicin.

o Opg with 5 marks which were floor of maxillary antrum, soft palate,
hyoid bone, condyle and hard palate.

o Cells that disappear before tooth eruption.???

o Too many questions on cells and structures origin I can't really

remember the names.

o Microorganisms in 2 cases of periodontitis, Hepatitis A virus type and if

there’s envelope and can it be acute or chronic, mode of spread
Group 1 questions (contributed by Aya)

1.Raised after myocardial infarction: Troponin and creatinine

phosphokinase (CPK)

2.Percentage of hazardous drinker 23%

3.Patient with a toothache on hot and cold pain on biting on a cotton:

cracked tooth

4.BPE of a sextant having only one tooth with pocket 7 and bleeding is (X)

5.BPE of a sextant having pocket 4 to 7mm score is 4

0. Combines with tissues factor in extrinsic pathway to

form thrombin burst

0. Picture of a red post from a tooth questions were

type of post? impression post duralay, type of crown needed depends on
tooth and length of post : 5 mm
 0. X-ray opg need to label hard palate, floor of sinus ,
hyoid bone

0. X ray showing rotated central asking for the

abnormality : Supernumerary

0. X ray occlusal showing post crown on left central

and lateral and PMF on right central and lateral asking type of crown

0. How many unit in pint of alcohol 1pint =2units

0. How many ml of LA needed for buccal infiltration 1

 0. % of OSMF oral sub mucous fibrosis malignant
8-10%

0. Primary impression for edentulous with large

undercut Alginate

0. Probe in BPE CPITN C or WHO

0. Picture of a primary tooth with abscess treatment of

choice pulpectomy

0. Best irrigant apart from NaOCl 2.5% & 0.1% in

primary, CHLHX .2%

0. Patient lost central the abutments have PFM with

black line visible cervically the saddle is concave and narrow restoration of
choice : options were : fixed fixed , implant, cr co denture, acrylic denture
 0. Patient 8 years old taking tetracycline discolouration
in which teeth options were : lower 5 , central, second molar,

0. Channel takes the longest time to return to normal

potential Potassium channel

0. Ion as second messenger calcium

0. Potential at which rapid depolarisation occurs Action

potential

0. Antibiotics cause rigor and abdominal cramp at high

dose Clindamycin

0. Gas remain same at hyperventilation: nitrogen

0. Reduced at hyperventilation co2

0. Vol remain same at hyperventilation: residual

volume

0. Vol after full inspiration Inspiratory capacity 3600

0. Hypersensitivity after amalgam type IV

0. Cell of hertwig sheath: epithelial HERS

0. Induce inner enamel epi to ameloblast :

predentin???

0. Induce differentiation of odontoblast : inner

enamel???

0. Responsible for nutrition during odontogenesis

0. Cell in acute inflammation Neutrophil, Immuno IgM

0. Cell in granuloma: giant cell

0. Cell in TB : multinucleated giant cell

 0. Ig as a dimer and monomer: IgA

0. Bacterial in aggressive periodontitis aggregatibacter

0. Picture of instrument to measure facial height Willis

gauge vertical dimension

0. Patient with avulsed tooth on 7 day follow up? RCT

The level of evidence of case series is 4.

0. Lowest Level of evidence expert opinion

0. Highest level of evidence meta & systematic review

0. Patient with root caries professional fluoride

application Varnish 2.26% 2.26mg NaF

0. Trauma on central tooth in a 7 years old child with

cervical root fracture treatment options pulpotomy pulpectomy ,cvek , RCT

0. % edentulous in England 6%

0. Neurotransmitter for increased salivation

acetylcholine… Parasympathetic

0. Fight or flight : sympathetic

0. Mechanism of penicillin: on peptidoglycan cell wall

synthesis

0. Mechanism of tetracycline Bacteriostatic, inhibit 30

R

0. Antibiotics causing pseudomembranous colitis

clindamycin
 0. Antibiotics causing rash in infectious mononucleosis
options: ampicillin pink book 436 amoxicillin penicillin g

0. EBV test : Paul bunnell or monospot

0. Questions on studies: mean median cross sectional

study , p value , t student test ??

0. How many times smoker and drinker get

periodontitis

0. Kennedy classification in pt lost lower left 345

Class III

0. decreased in exercise options cardiac output,

systolic pressure , end systolic vol, Visceral Blood Flow & Total Peripheral
Resistance (TPR)

0. Not reduced in exercise Blood Flow to Brain &

Diastolic Arterial Pressure remain unchanged

0. Concentration of topical anaesthetic 5% lidocaine

topical gel, 10% lidocaine spray, 20% benzocaine

0. What is true about diaphragm contraction ??

0. Most compliant fixed Ortho , removable Ortho ??

0. Patient with rheumatoid arthritis complain most :

difficulty in tooth brush according to options provided

0. Hand sign in rheumatoid arthritis ulnar deviation

0. Patient says he had an infection of childhood

required antibiotics: rheumatic fever according to options provided
 0. Hand sign in pt having Raynaud phenomenon and
telangiectasia : syndactyly (CREST syndrome)

0. Patient having fever unwell after extraction ( I.E.)

hand sign splinter hemorrhage

0. Patient pain in weight bearing joint hand sign:

heberden’s node

0. Patient complain with mucous bloody diarrhoea :

ulcerative colitis

0. Patient is having pain in the left quadrant relieved

by passing flatus options: Celiac , diverticular , colonic cancer, crohn’s
disease

0. Patient complain of multiple ulcer on ventral of

tongue the coalesce to form large ulcer same option as above Celiac not
sure

0. Patient with ulcer and full width gingivitis: orofacial

granulomatosis

Paper A Group 2 questions (Contributed by Amy, Dalia, Waraf and

Harjinder)

- Which muscle does the vagus nerve supply in the tongue?

Ans: Palatoglossus

- Pt is taking Rivaroxaban (anticoagulant), what will happen after

extraction?

Ans: Prolonged bleeding

- Amount (ml) of local anaesthetic needed for buccal injection? 1ml
(ref pocket dentistry)

- What nerve causes dysarthria (difficulty speaking caused by brain damage,

which results in an inability to control the muscles used in speech) and gag
reflex?

Ans: CN 9 or 10 ??
Cranial nerves that control the muscles relevant to dysarthria include the trigeminal
nerve's motor branch (V), the facial nerve (VII), the glossopharyngeal nerve (IX), the
vagus nerve (X), and the hypoglossal nerve (XII).

- Hypersensitivity

-Blood transfusion rejection? Type 2

-Patient had reaction to latex gloves or rubber dam, symptoms were

rashes, couldn’t breathe? Type 1

-Transplant rejection? Type 4

-Mantoux test (TB)? Type 4

- A 40 year old female patient taking Dabigatran will most likely suffer
from this condition after dental extraction?

Ans: prolonged bleeding, drug-induced osteonecrosis.

New anticoagulants alternative to warfarin and have less drug interaction:

Apixaban (Eliquis)
Dabigatran (Pradaxa) Asked in Group 2

Edoxaban (Savaysa)

Rivaroxaban (Xarelto) Asked in Group 1

- Penicillin mode of action

Ans: inhibit peptidoglycan synthesis, inhibit DNA synthesis, inhibit RNA

synthesis

(in the answers there was no “destroy cell wall synthesis”)

- What material to use for secondary impression of a flabby ridge with
window technique?

Ans: light body addition silicone, alginate, impression compound,

impression plaster

- How much root filling to leave for a post?

minimum 5mm of remaining GP(ref PB)

Ans: 4mm, 6mm.

- What is (?)% mineralised, and is more resilient than bone?

Ans: Cementum 45%

- Photo of child with red swollen gingiva, fever and ulceration

Ans: Herpes Simplex infection, pemphigoid, angioedema

- Patient with folate deficiency test? CBC

Schillings test for B12 deficiency

- Complication for Sjogren’s syndrome?

Ans: Non-Hodgkin Lymphoma not sure?

- Erythema multiforme which cells? cell mediated

- Patient requires extraction for upper right lateral incisor, how much LA to
give for effective palatal infiltration?

Ans: 0.25ml, 0.5ml, 0.75ml, 1ml

- Pleomorphic adenoma – choose the correct statement. Forgot all the
options, but there was something like C) soft and fluctuant swelling

- EMQ questions:

1) It was if the patient has weakness in one side of his face and his ability
to wrinkle the forehead is abolished-Answer is lower motor neuron facial
nerve palsy.

2) After a surgery to remove a pleomorphic adenoma from the parotid

gland, which might happen? Frey syndrome

Lower motor neuron facial nerve palsy

3) If the patient protrudes his tongue and it deviates to the right then he
would have a RIGHT hypoglossal nerve lesion.

- Metformin diabetes type 2

QRetraction cord, pH 1.2.Ans: Aluminium chloride

Q.Patient position. Why do we position patients?

Arm rest/support of dentist and to reduce the risk of syncope

Gigantism in children and adolescence

Acromegaly Adults
Q Free light chains are found in?

Ans: Myeloma up or down free light chains

If the amount of free light chains is higher or lower than normal, it can mean you
have a disorder of the plasma cells. These include multiple myeloma, a cancer of
plasma cells, and amyloidosis

Antibodies are: glycoproteins

**The antigen binding site on an antibody is called epitope is a part of an

Ag molecule to which an Ab attached

**Light chains and heavy chains of an antibody is joined by Disulfide Bond

- Sickle cell trait, choose the correct statement?

Ans: sickle cell trait is more common and less severe than disease, oxygen
issues… something haemoglobin.. (sorry can’t remember in more detail)

- 2 EMQ on blood coagulation/clotting. What forms the basis of clot???,

what dissolves/destroys fibrin (plasmin???)

Ans: Plasmin, Fibrin, Fibrinogen, Collagen and some other clotting factors
maybe VIII

??????

- What cells rise in infectious mononucleosis(glandular fever)?

Ans: Lymphocytes
- What group of cells do neutrophils belong to?

Ans: Granulocytes

- EMQ that mentioned what is missing in Parkinson? Dopamine, (drug to

treat : levodopa) What is found the most in
parasympathetic/sympathetic/free sensory endings
- Saliva, substance P

- Creatin C protein produced in? Liver

albumin (which controls blood volume) and globulin (largely made up of antibody
proteins).
- Which muscle has 2 innervations?

Ans: Digastric muscle (anterior by trigeminal, posterior by facial)

- Intracellular signalling, pick the right statement. Passive transport, ca,

excitable non-excitable EMQ physiology

- Membrane potential, cardio question about bundle of his, purkinje

The bundle of His is a heart muscle that takes part in electrical conduction in
the heart. Purkinje fibres are branched fibres that carry the electrical impulse
to the ventricles

- Baroreceptors location?

Ans: Carotid arch and aortic valve

What receptor transmits pain?

Ans: Nociceptor

- Which trait would most affect patient compliance?

Ans: Reticent, enthusiastic, energetic

not revealing one's thoughts or feelings readily i.e does not like to share

his thoughts
- Pain receptors, , thermal proprioceptors, chemotactic, biting (sorry don’t
remember the details)

Group A Alpha proprioceptors to muscles and golgi tendon

- Regulation of hormones

Paper B Group 2 questions (contributed by Amy, Dalia, Waraf and

Harjinder)

- Patient who hasn't seen a dentist for two years and has multiple small
occlusal caries lesions, what radiograph to take?

Ans: Horizontal bitewing, vertical bitewing, panoramic, periapicals

- Patient has pericoronitis, what medication do you prescribe?

Ans: Metronidazole 200mg

- Picture of an X-ray labelling..

Ans: I remember External oblique ridge (mylohyoid ridge was also an

option), maxillary tuberosity, cone cut from square collimation, cone cut
from round collimation Eric whites

- 10-year old child with a mobile and a cervical root fracture, treatment
options?

RCT/CAOH2/EXTRACT.

-Percentage of edentulous people in the UK and Wales or Scotland??

Ans: 6%, 13%, 17%,

- Most common cause for impacted teeth?

Ans: Supernumerary

- X ray of a radiopacity in between two teeth, identify.

Ans: Supernumerary

- Photo of teeth with gingival recession on 31 only. What is the cause?

It was localised to 31, other teeth and gingiva appeared normal, also not
much plaque, nor was it very erythematous in other regions

Ans: Self-induced (factitious injury)

- Picture of a crown on 21 with marginal inflammation, what is the most

probable cause?

Ans: Crown margin was extended subgingivally

- What is the main constituent/immune cell present in GCF?

Ans: B-lymphocyte

IgG, IgA , IgM

- Patient came and while you were assessing her plaque, you found a
continuous band of plaque of 1mm around the cervical margin of the
tooth. What is the score of that according to the Turesky index?

Ans: 2

Quigley–Hain (Turesky) plaque index:

0: No plaque

1: Isolated flecks of plaque at the gingival margin

2: A continuous band of plaque up to 1mm at the gingival margin

3: Plaque greater than 1 mm in width and covering up to ⅓ of the tooth

surface

4: Plaque covering from ½ to ⅔ of the tooth surface

5: Plaque covering more than ⅔ of the tooth surface

- Tooth mobile 2mm vertically, what is the mobility index?

Ans: Grade 3

- Picture of buccal mucosa with a huge ulcerated lesion with hyperkeratotic

margins and looked neoplastic.

Ans: Burn, Ulcer, Neoplasm

Q What material to repair root perforation?

Ans: MTA, GIC

- What is the likely cause?

Ans: Caries, hypoplasia, osteogenesis imperfecta, dentinogenesis

imperfecta

- 70 year old with a photo showing expansion of maxilla, and x rays one
lateral skull and one periapical

Ans: Fibrous dysplasia, Paget’s disease cotton wool appearance,

hypothyroidism, calcifying tumour, osteosarcoma

- Brown’s tumour(hyperparathyroidism), sarcoidosis (oral granulomatosis)

(EMQ)

- A dentist uses fine polishing bur to polish the palatal aspect of upper
teeth, does not use finger rest, patient sneezes and head jerks
backward, what will happen?

Ans: Mucosal burn, soft tissue injury, gingival trauma, mucosal trauma,
trauma to adjacent tooth

If electrosurgery Mucosal burn

- Dentist was doing electrocautery while doing soft tissue design?There is
a hairline crack / broken laser cord you didn’t notice and you rest it on
the patient's lip. What will happen?

Ans: Mucosal burn, soft tissue injury, gingival trauma, mucosal trauma,
trauma to adjacent tooth

- What would indicate that a patient with Ludwig’s Angina requires urgent
hospital admission?

Ans: Periorbital oedema, stridor, block airway

- What fracture has the highest tendency for meningitis?

Ans: LeFort 3, LeFort 1, LeFort 2, orbital

- EMQ about pulpotomy, pulpectomy for deciduous teeth

- EMQ diagnosing pulpal and periodontal conditions

- Iron deficiency sign.

Ans: Depapillated tongue

- Least important for consent taking?

Ans: Dentist has done the procedure before

- Highest amount of tooth decay found in?

Ans: Professional / skilled workers, semi-skilled, non-skilled / manual or

whatever

- Omeprazole (Proton pump inhibitor) side effects?

Ans: Xerostomia

Prolonged use causes erosion of teeth

- Best way to give oral health education?

Ans: one to one in dental chair, parent to child, leaflet, mass media, oral
health day at school

- EMQ on LA:

- Longest? Ans: Bupivacaine

- Shortest? Ans: Mepivacaine

- Penetrates bone? Ans: Articaine

- Causes methemoglobinemia: Prilocaine

- Commonly used as a topical: Lidocaine5% or benzocaine20%

- Cranial nerve EMQ:

- various symptoms with pain behind the ears, loss of balance? CN 8

- lost taste in the anterior ⅔ of tongue? CN 7 chorda tympani

- diplopia of the eye upon looking downwards and outwards? CN 3

 - various symptoms and voice affected?Larynx CN10

54. Behcet ..

- EMQ with 3 scenarios, 1 lady with some parotid swelling for 1-6 months
and dry mouth and eyes for 30 years or something Secondary Sjogren .
Second one also has dry mouth and eyes Primary Sjogren. 3rd one is a 5
year old child with dry mouth lips eyes and rampant caries mouth
breathing

Ans: Primary Sjogren, Secondary Sjogren, salivary gland aplasia, mouth

breathing, dehydration

- SLE patient, what is the oral manifestation?

Ans: Angular cheilitis, desquamative cheilitis

- Side effects of xerostomia due to radiotherapy?

Ans: Rampant caries

- EMQ about fluoride, concentration of toothpaste/fluoride varnish given

for:

- 15 year old child with high caries risk (2800ppm)

- 27 year old with high caries risk (5000ppm)

- 72 years with high caries risk (5000ppm)

- Sensitivity lesion / fluoride varnish (2.26%)

Ans: 1000ppm, 2800ppm, 5000ppm, 2.26%, 5%

- EMQ about fluoride, how much fluoride supplement should be given for:

- child with heart problem when the water fluoridation=1 ppm 0ppm

- how much for a child with high caries risk and water fluoridation= 0.3

- Optimum water fluoridation concentration? 1ppm

- 7 year old child in area with water fluoridation of 0.3pppm, but low caries
risk *

Ans: 0ppm, 0.25ppm, 1ppm

- EMQ on labelling parts of denture

Ans:

7:Fully circulating clasp

4-Occlusal Rest

There was an I-bar from the edentulous area to the premolar on the other
side and a cingulum rest on the canine, and lingual bar

- Alcohol calculation. What is equivalent to 3 units of alcohol? 10ml / 8 .

Ans: 250ml of 12% wine, ½ pint of medium strength beer, ½ pint of

premium beer,½ glass of wine

Calculation is 250 x 12 divided by 1000 = 3 pints

You can work out how many units there are in any drink by multiplying the total
volume of a drink (in ml) by its ABV (measured as a percentage) and dividing the
result by 1,000. For example, to work out the number of units in a pint (568ml) of
strong lager (ABV 5.2%): 5.2 (%) x 568 (ml) ÷ 1,000 = 2.95 units
- Blood test finding showing acantholysis and tzanck cells, what is the
disease?

Ans: Pemphigus vulgaris, pemphigoid, leukoplakia (acanthosis), lichen

planus/lichenoid reaction

- Most common bilateral parotid swelling?

Ans: Warthin’s tumour, adenoid cystic carcinoma

- EMQ on behavioural management. Refer to paedi

-pulling lip while giving LA

-raise hand to stop (control)

-repeated exposure to something (desensitisation)

- tell show do

- What probe to use for 6 point charting after BPE is done?

Ans: Nabers, Williams, WHO

- Draining sinus from the mandible, what microorganism is involved?

Ans: clostridium, actinomyces, fusobacterium, streptococcus,

staphylococcus
- Functional appliance for a child with anterior crossbite?

Ans: Z spring with cribs on upper 6 and E with molar capping, palatal
spring with cribs on upper 6 and E with molar capping

- Ortho: values given and asked to interpret whether max/man/incisors are

proclined/retroclined, facial height. SNA 81, SNB 74 (average value is
79), Upper 1 angle: 106, facial height/proportion 55%, SNA 74 is Class
2??

Ans: Mandible is retrognathic (SNB is 74 which is less than the average

value of 79, SNB refers to the relationship between the cranial base and
the mandible), other options: maxilla is prognathic, low facial height

- What are cuspless teeth used for?

Ans: Horizontal movement, create balanced occlusion, increase

masticatory efficiency
- 15 year old boy with malocclusion on Class 3 skeletal base, what to
advise?

Ans: Fixed appliance and surgery

- EMQ on prostho: group function, canine guidance, posterior discursion /

all posterior teeth in contact - Type of occlusion used for complete
denture construction?Bilaterally balanced

Ans: Retruded contact position, intercuspal, anterior

- Type of occlusion used for restoration?

Ans: Retruded contact position, intercuspal, anterior

Pink book 234

- Ortho: 18 year old patient with Class II incisor relationship on Class I

skeletal base, treatment?

Ans: Fixed appliance, fixed appliance with surgery, removable appliance,

functional appliance

- What does P stand for in the RPI system?

Ans: Proximal plate

- Picture of a denture, unilateral free end saddle on the left, with some
missing teeth and rests at the premolars on the right. What kind of
support is this?
Ans: Tooth and mucosa borne, tooth borne, mucosa borne

- Manual sterilisation of instruments. What kind of solutions to put in?

Ans: Chlorhexidine for hand washing, disinfection liquid, concentrated

washing liquid???????????

- Single use instruments: guidelines about endodontic files, how should

they be used? Prion

Ans: use once, multiple use for single patient within a day, multiple use
on same day

- Court orders you to disclose information about a child but the mother
does not consent. What do you do?

Ans: Give the specific requested information to the court, give all
patient’s dental records to the court

- Employer called the receptionist if his employee came for treatment, and
asked about details of treatment, what do you do?

Ans: Refuse the employers request, only tell him the appointment time
but offer no details about treatment, tell him everything

- EMQ about root canal morphology. Upper first molar, lower first molar, 2
upper premolars, lower first premolar

Ans: single root, mesiobuccal mesiolingual, distal, mesiobuccal distobuccal

palatal (upper six palatal diverts buccally)
- Extraction of right lower lateral incisor, inferior alveolar nerve block was
given. What is the most likely reason for LA to fail?

Ans: Midline crossover? Other options were hypoglossal nerve, facial nerve
not anaesthetised?

- A few questions on primary prevention (maybe 2), secondary prevention

(removal or restoration of severe caries or something), tertiary
prevention (rehabilitation)

- 70 year old woman who recently lost lower lateral which had a post and
crown before. She is fit and well, adjacent teeth are sound and unfilled,
what’s the best option for replacement?

Ans: minimal preparation bridge, conventional bridge, implant etc

- 30 year old woman who lost upper central incisor, adjacent teeth crowned
with stained defective margins, ridge has a good width but radiolucency
of 4mm or something crest. What is the best option for replacement?

Ans: bridge, implant

- Facial space infection going to mediastinum?

Ans: submasseteric, submandibular, lateral pharyngeal

- Patient with rheumatoid arthritis, best choice of pontics for posterior
bridge?

Ans: sanitary(hygienic), modified ridge lap etc

- EMQ about x rays, best view for:

- caries for 4 year old child (bimolar),

- bilateral canine identification for 12 year old occlusal (panoramic

- Visualising bilateral condyle fracture, (Reverse towne's)

- maxillary antrum/sinus lateral skull/DPT

- zygomatic bone fracture Occipitomental (Watery)

- vertical bone loss IOPA

- Most commonly used drug for IV sedation?

Ans: Midazolam

- Least likely to be contraindicated for IV sedation?

Ans:

- allergy to benzodiazepines

- patient attend without chaperone

- History of angina pectoris

- clinically significant / severe myasthenia gravis

- first trimester of pregnancy

CPR: position? heel of hand centre of chest 5cm, heel of hand left of
chest

- compression rate? 30, 60, 100- 120 per minute , 2 breaths

- What is used to eliminate the gamma 2 phase?

Ans: Copper, silver, mercury, tin, zinc

- What is the highest constituent in high copper amalgam?

Ans: Silver, copper, tin, zinc

- Concentration of sodium hypochlorite used as an irrigant in endodontics?

Ans: 0.1–1, 2–6?

Comments: 2.5% is used for adults but 0.1% is used for pulpectomy

2.5 sodium hypochlorite used in irrigation is bacreiocidal and dissolves

organic debris.

- Best type of imaging to examine TMJ

Ans: MRI, OPG

- What luting agent is used for provisional bridge cementation?

Ans: ZOE (ZOE cannot be used as a liner)

- What is the most important for diagnosis/to confirm before RCT?

Ans: Periapical radiograph, pulp vitality test

- Haemoglobin range in a 6 year old child

● 1-6 years: 9.5-14 g/dL

● 6-18 years: 10-15.5 g/dL
● Adult men: 14-18 g/dL
● Adult women: 12-16 g/dL

- EMQ on periodontal definitions.

Ans: clinical attachment level, pocket depth, clinical crown, anatomical

crown, true/false pocket refer to master dentistry perio

- Who benefits the most from fissure sealants?

Ans: child with medical conditions, adult with medical conditions

- Patient who coincidentally has glandular fever, what drug is

contraindicated?

Ans: Ampicillin, Amoxicillin, Penicillin V, Flucloxacillin

- Most important/effective/main component of mouthwash?

Ans: biguanide, quaternary ammonium compound

- Molar Class II DO restoration, matrix band is tightly placed at the bottom

of the box, no wedge, no adaptation of the matrix band :

Ans:

Open contact with straight interproximal wall

Open contact with well contoured interproximal wall

Overhang wedge

- Fixed-movable bridge. Choose the correct statement

Ans: abutment can be prepared independently

- Fixed-fixed bridge. Choose the correct statement

Ans: connectors/components must be rigid, abutments can be prepared

independently, connector placed between x and x, abutments cannot be
parallel, has flexion (sorry don’t remember exactly)

- EMQ about post:

- what kind of post is this? Impression post, fibre post

- ideal length of post / how much GP should you leave? 5mm

As a general guide the post should be at least equal to the anticipated

crown height- (pink book)

A minimum of 5mm of well condensed GP should be left.

- what is the most important factor to prevent post rotation? Remaining
post, remaining coronal crown, width??

Anti rotational grooves or parallel pins.

- what material would be used for the crown? PFM, ceramic, medium gold,

- Partially edentulous woman with missing upper right 5 to upper right 2,

what Kennedy classification is this?

Ans: Class 3

- Why is the labial flange given for lower denture?

Ans: mucosal retention, restoring lost mucosa

- Most common site for intraoral malignant melanoma?

Ans: Hard palate, buccal mucosa, lateral tongue, labial gingiva, floor of
mouth

- Abundant blood cells on PDL after 48 hours?

Ans: neutrophils, eosinophils, macrophages

- Haemoglobin structure?

Ans: 2 alpha chains 2 beta chains, 2 alpha chains 2 gamma chains

- Elderly woman on Salbutamol, with multiple mobile teeth and pockets
3-8mm upon BPE examination with 60% bone loss. What is the
diagnosis?

Ans: Generalised severe/chronic periodontitis, localised severe/chronic

periodontitis, generalised aggressive periodontitis, localised aggressive
periodontitis

-Vital tooth TTP with pus.

Ans: Lateral periodontal abscess

Q asymptomatic tooth requiring RCT and had a huge radiolucency, what

should you warn patients about?

Ans: Phoenix abscess / flare up

Q Young female patient about to undergo orthodontic treatment, during

consent taking what must you mention, or what is likely to happen?

Ans: Root resorption, loss of vitality, gingival recession

- Which condition is caused by herpes virus?

Ans: Herpes labialis, herpetiform recurrent aphthous ulcer, herpangina,

herpes zoster

- Salivary gland tumour that spreads along nerve sheaths?

Ans: Adenoid cystic carcinoma, swiss cheese

- EMQ on management of dental trauma.

- Child falls off bike, fractured tooth, comes after 48 hours (Cvek)

- crown fracture up to cervical/coronal portion (cervical pulpotomy)

- 8 year old child fell and subluxate her upper lateral 2 weeks ago, the
locum dentist did a splinting and now she came to you for check up,
what do you do? (reassurance and review)

Ans: Direct pulp capping, Cvek pulpotomy, cervical pulpotomy, review and
reassurance, extirpate pulp, temporary dressing with IRM or Ledermix

- EMQ about pulpal management of deciduous teeth

- large non carious pulpal exposure Ferric sulphate pulpotomy

- small carious pulpal exposure on vital tooth Ferric sulphate pulpotomy

- carious exposure with one necrotic pulp pulpectomy

- carious (did they say asymptomatic?) with sinus depends on age and
tooth - extraction

- asymptomatic tooth with buccal sinus on deciduous molar depends on

age and tooth - extraction

Ans: Ferric sulphate pulpotomy, formocresol pulpotomy, ledermix dressing,

IRM dressing, pulpectomy, extraction

- Epileptic man with hypertrophic gums, what drug is he most likely taking?

Ans: Phenytoin, nifedipine, metformin, cyclosporin

- What is present in gingiva 3-4 days after plaque??

Ans: Neutrophils

-12 year old boy with red lesions/crusting lips

Ans: erythema multiforme, herpes labialis, pemphigoid

- Stephan curve represents?

Ans: change in pH of plaque with time

- A few questions on effect of exercise on cardiac output, peripheral

resistance
PTR-decreases,Diastolic-remains same, everything else increases.

- Characteristic finding in erythema multiforme?

Ans: Target lesions

-2 EMQ on tooth development

Ans: IEE, REE, Hertwig, cervical loop

- EMQ about time of eruption/calcification:

- Calcification of first permanent molar? At birth

- Time of eruption of maxillary second premolar? 10-12 years old

-Which of the following has the best prognosis?

Ans:

- delayed presentation

-well differentiated/highly dysplastic epithelium

-tumor >4cm

-metastasis

-lymph node involvement

- A few EMQ and SBA about muscles of mastication. Origin attachment

and action. Superficial head deep head medial pterygoid, lateral
pterygoid, temporalis fan shaped, masseter origin zygomatic ramus or
angle of mandible

- Pre-eruptive effect of fluoride?

Ans: Rounded cusps/fissures

- Fusion of posterior fontanelle

Ans: Parietal and occipital, occipital and temporal

- Which bone fuses completely intramembranous?

Ans: Frontal, temporal, occipital, mandible, sphenoid

-2 questions about ingredients of toothpaste and their actions

Anticalculus? Sodium pyrophosphate

Desensitizing agent? Potassium chloride, sodium fluoride

- What is least likely to happen when you have a buried, impacted tooth?

Ans: Jaw fracture, neoplasm, cyst, infection

- Patient came, he didn't wear his removable ortho for a while and it
became ill-fitted. What type of plier would you use to adjust it?

Ans: Adam’s pliers

- Best way to make scaling least exhausting?

Ans: Sharp instruments

- Woman with malar rash, what is the oral feature?

Ans: Oral ulceration, desquamative gingivitis

- What fungal disease is primary erythematous?

Ans: Erosive candidiasis

- Dysplasia features, choose the incorrect one?

Ans: Hypochromatism, drop shaped rete pegs, loss of differentiation,

polarity

- Where do you get support for finger rest?

Ans: Tooth, palate, lip, cheek

- Chlorhexidine gluconate concentration as gel?

Ans: 1%

- Chlorhexidine gluconate concentration as mouthwash?

Ans: .06% 0.12%, .2%most common, if gel 1%

- Patient came to your clinic, his 10 year old amalgam filling is higher than
the rest of the teeth, why?

Ans: Bruxism, creep, attrition

- What is composition of GIC?

Ans: Aluminosilicate glass & polyacrylic acid, Fluoroaluminosilicate glass
& polyacrylic acid, Flouroaluminosilciate glass & polyalkenoate acid

- Which one of the following is a type of stochastic effect from radiation?

Ans: Carcinogenesis,

osteoradionecrosis,genetic effect,solid tumor induction

Deterministic effect

● skin erythema
● irreversible skin damage
● hair loss
● sterility
● cataracts
● lethality (whole body)
● fetal abnormality

- Highest level / best type of evidence / research?

Ans: meta analysis systematic review

- Patient with 8 mm overjet and proclined incisors, what's the incisor

relationship?

Ans: Class I, Class ll div 1, Class II div 2, Class lll

- At the jaw relation stage of denture, the patient's vertical dimension at rest
was 75mm, vertical dimension in occlusion was 77mm. What changes will
you make?

Ans: Reduce the occlusal rim to 72mm, no changes, add 2mm

- Best interdental cleaning method for a patient with a gingival recession?

Ans: Interdental brush, single tufted brush, small head toothbrush.

- Survival rate for SCC OF T1N0M0?

Ans: 85%

- Which is the least likely to have multilocular appearance on X-ray:

Ans: Osteopetrosis, keratocyst, ameloblastoma, aneurysmal cyst

- For extraction of lower molar, inferior alveolar and lingual nerve block
already given. What other nerve has to be anaesthetised?

Ans: Buccal branch of facial nerve

- How does erosion appear clinically?

Ans: Cup-shaped lesions

- Type of bacteria for chronic infection (or abscess) in the sinus / sinus
draining from the mandible?
Anaerobic gram positive cocci streptococcus milleri group and
peptostreptococuss.

Ans: S. Milleri

- Photo of white lesion next to large amalgam restoration, what is it?

Ans: Lichenoid reaction,

- Woman came after 3 months for check up after perio treatment, you did
6-point charting. What would you do next to know the disease is not active?

Ans: Bleeding on probing or absence of blood on probing

QFunction of GDC

Ans: To maintain dentists register and to supervise the standards of

dental education

- Verified CPD for dentists every 5 years?

Ans: 100 hours

- Cause of xerostomia: Woman with liver cirrhosis, dry mouth, positive

shimmer test? Which syndrome?
2018 questions by Rasha

Function of enamel knot? A lot of questions on Enamel knot

Which growth influence of enamel knot? Location, number of cusps

Primary maxilla formed from? 2 maxillary processes and 2 nasal processes

Which Ig find in GCF? IgG, IgE, secretory IgA, monomer IgA.

IgA more common in? Saliva> milk> tear> serum SMTS

Most stable virus outside the body? Hep A

Least stable virus outside the body? HIV

Virus transmitted by oro-facial route? Hep A

Which virus does not come on its own alone? Hep D

What is expected to see in the blood after hepatitis B immunization? HBsAb

Which gas results from carbohydrate metabolism? Co2

Which gas results from fat metabolism? Co2

Drug that is a mast cell stabilizer? Sodium cromolyn

Which drug is used to treat ischemic heart disease? Simvastatin note sure

Cells seen in chronic gingivitis? Neutrophil, lymphocyte, macrophage, blast cell,

…..

Cells in the late stage of periodontitis? Neutrophil, lymphocyte, macrophage,

blast cell, plasma cells

Cells in generalized periodontitis? Neutrophil, lymphocyte, macrophage, blast

cell, …
Which is considered primary prevention? Denture, restoration, scaling and
polishing, restoration of initial lesion

Which is best to describe primary prevention? Regular examination, dental

prophylaxis, extraction, filling, ..

Dental tissue which has 50% of its composition mineral, but harder than bone?
Cementum

Protein found in the enamel? Enamelin, amelogenin

Which view is this? Vertical bitewing

What is the age of the patient? Was 5-6 years

A point? Lower first premolar

B point? Lower second premolar

Cementoma or cementoblastoma common in which part of the jaw?

The mesiobuccal cusp of the upper first molar occludes with the mesiobuccal
groove of the lower first molar and upper incisors are proclined, what is the
incisors classification? Class II division 1
The mesiobuccal cusp of the lower first molar occludes between upper first molar
and upper second premolar, what is the molar relationship? Class I

The mesiobuccal cusp of the upper first molar occludes with the mesiobuccal
groove of the lower first molar and upper incisors are retroclined with increased
over jet, what is the incisors classification? Class II division 2

The mesiobuccal cusp of the upper first molar occludes with the mesiobuccal
cusp of the lower first molar and upper incisors are proclined, what is the molars
classification? Class II or class I

Which hormone affects the osteoblast activity the most? Thyroid, parathyroid,
growth, adrenaline, insulin

The most abundant Ig in the saliva? IgA

Stephan curve represents what? A) change in PH of saliva with time, B) change

in PH of plaque with time, C) change in PH of saliva with sugar intake

Iatrogenic increase in ACTH leads to? Cushing syndrome

In which color bag the magazine which was used in the waiting room, should be
through? Black bag

The personal protected gown that is contaminated with blood will be disposed of?
Orange bag

Symptoms due to damage of the lingual nerve during lower third molar
extraction?

Tongue deviated to the right side, which nerve is injured? Right hypoglossal
nerve
Which drug can cause xerostomia?

Which period represents the time before the bell stage of tooth development?
11-13 weeks

Parotid gland development? 4-6 wks

Eruption date of maxillary second molar? 12-13 years

Calcification time of first permanent molar? At birth

Calcification time of maxillary incisors? 3-4 months

Deep head of this muscle attach to the medial aspect of the lateral pterygoid
plate? Medial pterygoid

Muscles attach to inferior temporal lines? Temporalis muscle

This muscle runs from zygomatic arch to lateral surface of mandibular ramus?
Masseter muscle

Patient is unable to close his right eye and unable to smile? Lower motor neuron
lesion

Virus that causes hand , foot and mouth disease? Coxsackie virus

Virus in Kaposi’s sarcoma? Human herpes virus 8

What happens to peripheral vascular resistance during exercise? Decrease

What happens to systole during exercise? Increase

What happens to diastole during exercise? Decrease or stay the same note sure

What is the cause of tooth loss in girl with bulimia nervosa? Erosion of palate

Which type of patient cannot predict his or her behavior in response to dental
treatment? introvert

Which patient pain control with local anesthetic will be less effective? Child, adult,
teenager, pregnant women

Which complement acts as antigen presenting? C3a

Angioneurotic edema is characterized by which esterase

inhibitor? C1
complement component facilitate opsonization and phagocytosis? C3b

Patient came to the clinic , you noticed she lost a lot of weight from last visit, she
is more anxious and complaining of feeling hot and lost some of her hair and the
lateral third of her eyebrows? Hyperthyroidism

Hyperthyroidism more common with ? Hashimoto's disease, goiter, graves’

disease ….

Acellular cement found in which part of the tooth? Root dentin ….

How to treat blood spillage that covers less than 30ml? sodium hypochlorite 1%,
5%, 10%, 20% , 2%

Sterilization reduces the number of pathogens by ? 100 fold, 500, 1000, 2000

The most common site of malignant melanoma intar-orally? Hard palate

Patient has a jaw tumor of 2.5 cm in size, with no metastasis or lymph nodes
involvement. After surgical resection, malignant cells were seen histologically in
the cut line, what is the classification of this tumor? T1N1M0, , T2N0M0,
T2N0M1, T2N1M1

You recommended a company for your employer to buy new products, after a
few days the company owner sent to your home addressa basket full of
expensive goods as a thank you present. What shall you do? A) accept the
present and enjoy it with your family. B) refuse to take it. C) take it and share it
with your colleagues at work

Many question about law and ethics regarding these bodies: local area
committee, local dental committee, local professional committee, clinical
commission.. and another committee cannot remember

Laws expressed by parliament? Legislation

Question about pyogenic granuloma

Tumor spread through nerve sheath? Adenoid cystic carcinoma

Salivary gland tumor that can become bilaterally? Warthin’s tumour

The concentration of chlorhexidine gel used in the UK? 1%

The concentration of chlorhexidine mouthwash that is commonly used in the UK?

0.2%

Statistic, what in the prevalence of the disease , and the positive predictive value
to be calculated from a table
What does P stand for in the PRI system? Proximal plate

Label the following A, B, D, E A major connector, B minor connector,

D cingulum rest, E saddle

Which part provides indirect retention for part labelled e? D

What is the most common cause of rampant caries?

A) Low socioeconomic state, B) medical condition, C) poor oral hygiene

…..

What is this disease? Rampant caries

Which suture is not used in the UK? Catgut

Suture for border of the lip? Prolyene

The most important part of dentistry in relation to forensic science is? A) patient
history, B) periodontal examination, C) Dental chart ……..

The effect of fluoride on teeth before eruption? Round cusps and fissures

The recommended systemic fluoride for 7 years old in area with 0.8ppm water
fluoridation? None

What is this condition? Chronic atrophic candidosis

Which is the commonly found in it? Candida albicans

Which nerves provide parasympathetic supply to salivary glands? Facial and

glossopharynegeal nerves

Which muscle of mastication supplied by two nerves? Digastric muscle

In erythema multiform what will be seen? Target lesion

What is the cause of Belly’s palsy? A) stroke, B) Ramsy hunt syndrome, C)

Melkerson Rosenthal syndrome

Immunocompromised patient with elevated T lymphocytes and CD4, has purple

papules in his palate, what are they? Kaposi’s sarcoma

Which nerve to be anaesthetized for upper canine apicectomy ? infraorbital nerve

+ nasopalatine

Bleeding gum with teeth mobility? Vitamin C deficiency

Which factor decrease in Christmas disease? Factor IX

Which factor decrease in hemophilia A? Factor VIII

Which factor decrease in Von Willbrand disease? Factor VIII

Which factor decrease in DIC? All factors

Which factor reduce when using warfarin ? have to choose just 1 factor, Factor II

Patient with polydipsia, weight loss and diluted urine? Diabetes insipidus

a 10 year old boy has been brought to A and E after a road traffic accident, he
needs an urgent operation, his parents are abroad and he was looked after by
his uncle who cannot be reached through the phone, who can consent for him?
A) The A & E doctor , B) wait till get permission from his uncle, C) ….

Most common cause of dry mouth? A) Anti hypertensives B) Autoimmune

disorders C) Chemotherapy D)Radiotherapy

Most common cause of rampant caries ? A) Residence in north east B)

Residence in south east

C) Low socioeconomic status D) Low fluoride E)Disability

A child has been brought to the clinic by his neighbour, he has many caries teeth,
his clothes are dirty and doesn’t smell nice.. what do you consider this? A) child
abuse, B) negligence …..

The most common cause for salivary gland duct obstruction? A) mucous plug,
B) salivary gland calculi, C) duct constriction ….

Sialolithiasis commonly happens in which salivary gland? Submandibular salivary

gland stones

A father who looks drunk and agitated brings his son to the clinic, you notice
bruises on the child's neck of different colours, what is this called? A) sexual
abuse, B) physical abuse, C) negligence, D) psychological abuse .………

Patient with deviation of the corner of his mouth when he smiles but wrinkling of
his forehead is normal? upper motor neuron lesion
patient with deviation of the corner of his mouth when he smiles and cannot
wrinkle his forehead? Lower motor neuron lesion

Many questions on hypersensitivity and hepatitis

General medicine was mainly the endocrine section, not many questions from
physiology

A lot of questions in law and ethics, child abuse and negligence

August 2018 exam
File -A
Paper B: *BPE question E.g You are undergoing a second non surgical
treatment for a 32 year old women with penicillin allergy with plaque 10% and
class 1 molar and incisor relationship. She has the following BPE score 343
————- 212 What should you do? 1.chlorhexidine mouth wash 0.2%

Quigley–Hain (Turesky) plaque index:

0: No plaque

1: Isolated flecks of plaque at the gingival margin

2: A continuous band of plaque up to 1mm at the gingival margin

3: Plaque greater than 1 mm in width and covering up to ⅓ of the tooth

surface
4: Plaque covering from ½ to ⅔ of the tooth surface

5: Plaque covering more than ⅔ of the tooth surface

2.doxycycline and metronidazole

question with different readings and changes were;she is taking warfarin e
inr=3etc

*pathogens in chronic periodontitis Plasma cells

*pic of cobblestone mucosa,impression posts with related questions

*post and cores for different scenarios like aesthetics etc

*a pt wants to replace his fractured anterior incisor metal ceramic crown

which is fractured at the porcelain part only.You notice that it’s because of
increased occlusal loading.After taking face bow record,which articulator would
you articulate it on? Options were hanau articulator,semi adjustable,full
adjustable,hinge articulator.

*bridge question in which situation which For a 15 year old anterior teeth For a
60 year old lady’s central incisor.she already has crowns on the adjacent teeth
and mucogingival line not very good

*Pic of a child anterior teeth shown with enamel hypoplastic the treatment option

Radiograph for disc location in TMj Myofascial pain syndrome

Pain and clicking and deviation to the left side on opening the mouth but nothing
happens when closing the mouth.

Iotn for submerged tooth 5 iotn

Incisor and molar classification 4 questions

A patient wants his 3rd molar to be extracted under G.A Who would you
contact? Local dental committee Dental commissioner

A 12 year old child had RTA,is seriously injured and his parents are out of
country. He uncle is with him.who to give contest

Contraindication to I.V sedation

Who is least likely to benefit from local anaesthesia (acute infection)

Who is least likely to benefit from IV sedation e.g asa grade 4 hospitalbound
Pregnant
*asa classification

What to expect in Down syndrome patient Immune deficit

opg labelling

Primary secondary and tertiary prevention

A 70 years old male has root caries.what would you give 5000 ppm toothpaste
2.2 duraphat varnish 4 times yearly or 2 times yearly Life long CHX m/w

Some mcqs with similar concept Why is the texture in dentin caries soft or
less mineralised?

Stephens curve

What is increased in blood after myocardial infarction Ecg myosin

Carboxyhaemoglobin

Alcohol units 3 questions

Tumour that travels along nerve sheath 2 questions

Hand signs 4 questions divided 4 times Ulnar deviation,dupuytren contracture,

Parasympathetic supply of parotid Nerve affected by Glossopharyngeal nerve

masseter Facial nerve
1 question Lignocaine 1:80000 to give in Buccal and palatal infiltration Amount
given in Buccal side 1ml

Amalgam raises from the border of tooth with time due to the phenomenon of
Lichenoid reaction

Myasthenia gravis which neurotransmitter defect Saltatory conduction Ach

Function of neutrophils,eosinophils,which releases during allergic response

Blood transfusion type of hypersensitivity 2, Tb type of sensitivity 4

A few questions on primary passive immunisation

Clinical scenario on sjogren syndrome

Anti RO antibodies are positive in? Sjorgen’s syndrome (Sicca)
ANCA (antineutrophil cytoplasmic antibodies) antibodies positive in?
Wenger’s granulomatosis
Questions of type of hypersensitivity but they asked about the names instead
of no’s

Precursor of platelets A patient with normal PT high APTT

A patient with normal everything but high BT

Pathognomonic of infection mononucleosis Rashes caused by which drug in

infectious mononucleosis ampicillin

Schirmer test Sjorgen’s syndrome

A few questions on pathways of clotting E.g which factor binds to tissue factor

Which factor is calcium FEV1/FVC in obstructive lung disease and restrictive

lung disease

Function of ADH ,production and deficiency

Function of glucagon, Hyperparathyroidism clinical scenario

Which of the cyst is likely to be unilocular radicular

In a two visit implant,which is most imp for retention osseointegration

Alveolar osteitis one question

Which is the best for placing finger rest on tooth

During finishing of anterior teeth with fine bur,patient sneezes with head tilted
forward,what is most likely to occur

Inhalation of instruments,what to do? Search if not found, CXR

A patient collapses in the waiting room with only you present,what do you do?
Creutzfeldt jacobs disease occurs because of-blood transfusion or Dural graft

Which is more resistant to sterilisation-prion

What is the most commonly used before sterilisation-washer FWRTD,scrubbing

What is used in antibacterial hand wash

Sign for single used instruments

Pic of erythematous area opp to amalgam filling on the Buccal mucosa saying
patient has pain here for 6 months

Common site for myeloma bone marrow

Lymphoma in sjogren syndrome-a long scenario burkitt's lymphoma

A question on cheek retractor

P in RPI stands for

Kennedy class 3 in descriptive form Muscle attached to labial frenum

Midline crossover in anterior mandible teeth

Long Buccal nerve (which nerve to anaesthetise after IDB)

Impression for an edentulous patient with deep undercut posterior to the

vibrating line elastomers

Which material requires poly acrylic acid GIC

Bennet angle

Opportunistic pathogen
Posterior Pontic for RA patient Best aesthetic crown for a young patient with
missing central incisor Sanitary

What to do after removing splint of a 12 year old with perm teeth after avulsion
RCT

Which antibiotic to give after luxation injury no anti or amxo

Cervical root fracture with coronal pulp exposure in a permanent tooth of a
young 12 years old 4 months&rct
Deep caries Reversible ,irreversible pulpitis,chronic and acute periapical
abscess,lateral periodontal abscess

Luting of crown with GIC

Which layer has two layers (Inner enamel epithelium and outer enamel
Epithelium cuboidal )
Cells in that are cuboidal with a basement membrane in the skin tissue
Perikymata

Junctional epithelium origin

Dental papilla,dental follicle,

Cervical loop >> root

Stratum intermedium
Dental lamina
Cells present in pdl after degeneration of HERS rest of malassez
IEE induces differentiation of
Which of the following anomalies occurs during the initiation and
proliferation stages of tooth development
Oligodontia – initiation stage ( absence of single or multiple teeth)

Oligodontia, Anodontia, mesiodens and supernumerary teeth - initiation phase

(NUMBER)

Macrodontia and microdontia also peg laterals or peg molars is- bud stage
(SIZE)

Dens in dente,germination,fusion and tubercle- cap stage (EXTRA PIT)

Enamel hypoplasia, concrescence and enamel pearl is - defect in apposition and

maturation stage (SHAPE)

Reversal of polarity ameloblastoma

Features of dysplasia
Drug to give in pericoronitis metronidazole
Pain killer after extraction in asthmatic paracetamol
Clindamycin 50s R causes pseudomembranous colitis
Cephalosporin MOA like penicillin
Tetracycline 30s R,penicillin MOA(peptidoglycan chain)
In a patient whose condition has been treated with azathioprine? But angular
chelitis persists...which antifungal to give nystatin
Side effect of azathioprine Hepatotoxicity and bone marrow toxicity
The most common side effect of quinine is: Deafness.
Nicorandil Side effect fixed ulcer
Antihypertensive gum hyperplasia calcium channel blocker ipines
Class2 div2
What is least imp in fixed orthodontics appliance - patient compliance
A girls comes to you to cut the distal end of an extended arch wire Which
instrument will you do it with end cutting plier
Pic of a foramina in the base of the skull

Nerve in cavernous sinus-a scenario oculomotor nerve (CN III), trochlear nerve
(CN IV), ophthalmic nerve (V1), maxillary nerve (V2), abducens nerve (CN VI)
III, IV, V1, V2 , VI 3,4,5a,5b,6
Abnormality caused by in and out eye muscle movement Oculomotor
SO 4 nerve and it’s defect
Mylohyoid muscle
Chords tympani and glossopharyngeal
Loss of gag reflex
Ipratropium and Salbutamol in asthmatics
MOA Haemophilia B…. IX
influenza S/S Pneumonia

radiographic features S/S of asthma in a baby

Acromegaly insulin like growth hormone

A pt complaining of loose posterior teeth with horizontal movement of 1.5
mm..what is the score 2

A patient visits after two years with BPE grade 1 and small occlusal caries in
post teeth-which radiograph bitewings
Epinephrine for anaphylaxis in a 8 year old

In which condition chlorhexidine is not to be given and in which is the best

Option known allergy

Raised ESR IN temporal arteritis

Qs on mean median mode standard deviation incidence specificity

Case control study

%of. Edentulous in uk 6%
Cpd 2 questions
RIDDOR 1995,2013
HbeAg infective state most infectious
Floor impervious
Bag for blood soiled cotton Orange bag
<30ml spillage 1:1000 ppm or 1mg of sodium hypochlorite
>30ml contamination 1:10000 ppm or 10mg of sodium hypochlorite
Dose of fluoride in 4 year old with high caries risk and water fluoridation 1ppm no
need
Langhans cells seen in tb
Herpes virus disease lipshutz
Shingles pic unilateral not crossing midline
3 questions from delivering better health care
A child was given tetracycline abroad for an infection and now she is 8 years
years old....which of her teeth are affected depends on the given options.. 2nd
molar closest

Erosion cupped shaped teeth Bulimia diagnosis palatal erosion

Action potential definitions What is present inside What causes swelling of cell
Which ion act as second messenger calcium
What increases in exercise Hyperventilation(what increases,what decreases,
which gas is increased by cupped hands, Co2
which is not changed) Lung volumes definitions big file
Submucous fibrosis dysplasia 10% premalignant
What causes cushing disease pituitary adenoma , endogenous acth
A person is taking cimetidine and prednisolone and is here for 3 molar open
extraction,what is the likely consequence dry socket
Which la is neurotoxic at 4% cannot be given ID? Articaine

A child if 12 years is here for orthodontic treatment,before commencing the

treatment which complication should you inform them beforehand-options
like external root resorption etc
A patient taking carbamazepine 200 mg and is epileptic is here for
extraction,which ASA classification? II
A diabetic and hypertensive-which Asa classification if controlled too II if high
then III
A male 15years old child with oral ulceration for 2 years-behcet's disease
Orofacial granulomatosis Crohn’s disease, caelic disease, sarcoidosis
Acantholysis is seen in? Pemphigus
Acanthosis? leukoplakia
Ground glass is seen in fibrous dysplasia, hyperparathyroidism
Paget’s disease cotton wool
Tunnel prep in which defect class III furcation
Atrial fibrillation treated with digoxin is seen in tertiary syphilis
The use of vasoconstrictor especially epinephrine in L.A. may cause fatal
hypertension to patients taking Beta blockers olol
La allergy Methylparaben
Which LA for heart disease lidocaine without adrenaline, prilocaine with
felypressin
Which lA is long acting Bupivacaine
Which LA for a restorative treatment of a child duration of which is 40 mins
mepivacaine
Which type of neurons supply masticatory muscles Somatic motor gamma fibres

Done

First let’s discuss paper-A.

A lot of questions from immunology, allergic reaction and
hypersensitivity (as expected). From Anatomy couple of labelling,
questions from muscle of mastication origin insertion etc. From physio
a few questions- from endocrinology and respiration it was mixed. Yeah
good enough questions from general medicine and believe me those
who only did notes properly can easily attempt the mcqs- sign n
symptoms of diseases, their oral manifestation etc anaemia’s, couple of
hand signs. Then questions from oral histology that was only part bit
hard for me. I didn't study this properly.
Now Paper B, it was easy compared to paper A, which was quite
surprising.
Again many questions came from Oral pathology/oral medicine n
feedback (my mentor told me before so I was fully prepared).
Questions from radiology and law ethics few. Straight forward
questions from preventive dentistry-chlorhexidine etc.

As mentioned by other candidates and Ahmed Tareq lot of repeated

topics or I must say from pet topics. All you just need is proper
Guidance.

Tbh Paper was moderate as it should be, if it’s easy then everyone can
Pass. Either you get 50% or 99% it counts the same- Pass.

Coming to Paper A so many pet questions as expected- muscles of

mastication,cementum composition, dental lamina, muscles of facial
region, branchial arches and pouches derivative, bone ossification,
eruption dates, couple of other histology and embryology and anatomy
questions- as they are focusing more on these subjected- TO be honest
I wasn’t ready for this n nor planning to study them thoroughly however,
everyone here would agree with me esp those who took DrDavis course
they’ve categorically mentioned study these subjects meticulously for
August-exam.
Moreover, many questions from physio-hormones, nervous system,
depolarization,
action potentials, cardiac output, Stoke volumes, muscle
fibres, do all hormones related syndromes and condition plz, Scenrios
from-acromegaly, diabetes, Cushing, calcitonin, pituary gland, Gardner
syndrome. Then hand signs do it thoroughly( same as in notes),
haemoglobin,blood disorders, hemophilias, deficient cloting factors and
condition names, lungs volume, immunology( all time favourite),
complement system, immunity, straightforward Qs hypersensitivity,
some twisted questions from metabolites and enzymes.
Salivary glands, meningitis, lichenoid reaction, sojgren syn,
Amalgam compositions and phases, scenarios from composite and
GIC, so many questions (clinical conditions) from oral pathology don’t
miss this subject, again hand signs imp, signs and symptoms with
overdose of drugs, few questions from oral microbiology, perio (Bpe,
plaque index, periodontitis, gingivitis)

Ortho many questions- angles classifications, incisors, their treatments,

IOTN, Fixed and removable appliance, ceph values,

So many questions from trauma,

Peads- avulsion, luxation injuries, splinting timings, fluoride doses,
cholrhexidine, IV sedation, LA,
Law and ethics asked, some clinical pictures and labelling. Kennedy
classification, freeway space, rest seat, connectors, canals, syphilis,
access and cysts questions, post n core, temporary cements. Some
repeated questions too.
Overall exam was nor easy not very difficult. If you have studied
properly, you can do it.
Being a mother of one devil boy it was bit hard for me to cope with
studies, however I was a recent graduate so basics weren’t struggle for
me. I didn’t study BDA, law and ethics so that part was hard for me.
 feedback July 2019 Paper A

Highlight answers in light blue please

If you have related info please highlight in orange

Cardiac cycle and what increases and what decreases during exercise
All increase except ….Decreased: Visceral Blood Flow & Total Peripheral
Resistance (TPR)
● Remain constant (unchanged) Blood Flow to Brain & Diastolic Arterial
Pressure remain unchanged

Antibiotics clinical cases and you pick what antibiotic would you use
Hand signs of medical problems

Food poisoning bacteria in the UK campylobacter

Everything about tooth development histology a histological section and label
on ameloblasts, odontoblasts, dentin, IEE, OEE, dental papilla and so on
Diagram about hyoid bone

Diagram identify the muscles of the tongue extrinsic

X ray labels on maxillary sinus and zygomatic arch

X ray errors two questions i e two x rays with about five questions
Clinical cases about respiratory diseases and identify them and their
treatment
cleidocranial dysplasia picture and 4 questions about what are the features

Histology of the TMJ and every single component bone, muscles and the disc

identify
Anterior and posterior and middle pituitary glands and what they secrete
Diagram muscles of facial expression around the mouth the nose the eyes
identify
OPG and identify some normal and pathologic structures as well as errors
Some diseases and the which is the most likely one to transform into
malignant lesion
Action potentials what starts it which ion on which part the LA works and what
is the latest gate to close or the last ion to get to the normal state after
Least platelet count that you can perform extraction with
Scenario on Haemophilia A and another one on the Von Willebrand disease
Some acute infection and which Ig we can see IgM
Question on how we can detect a patient with HBV infectivity
Scenario about young boy ho started uni and then he came with acute HIV
infection symptoms
Which collagen present in PDL what is the main I 80% and what is the other
III 20%
Most predominant PDL fibres oblique
What is the difference between the PDL space in young and elderly Width
decrease with age
Where is the thinnest part middle of the root
What is the predominant cells in PDL fibroblasts
Patient had allergic reaction to perfume what Ig we can see IgE
Where do most of the PDL fibres attache cementum
Two ortho questions one about repairing removable appliance it was spring
coil something and which player you use to make it right and the other was
about which cutting instrument you use to cut an excess arch wire
-Ortho about the composition of 18/8 stainless steel which material is the 18
and which one is the 8 and the options were
Titanium
Aluminium
Chromium 18
Nickel 8
Silver
Three questions about amalgam
You wanna buy amalgam to your clinic and you want
Amalgam with increased strength:
Amalgam with increased working time

-Two questions about modulus of elasticity and plastic deformation between

two materials X and Y

-What is the test for infectious mononucleosis: monospot test or paul

bannel
-Where can we find EBV infection 6 options and chose the one that is not
related to EBV
-Picture of CLP and they need which classification it is? Class3
-Which probe we using when carrying out BPE: who probe
-Definition of Mode= the most frequent number example(4,2,4,3,2,2) it will
be Mode=2
-Two scenarios about behaviour management
1.tell show do
2.behaviour shaping
3.cognitive behavioural therapy
4.modelling
5.desensitisation

-You gave patient 3 cartilages of 2.2% lidocaine 1:8000 how much anaesthetic
did you give
132mg
6.6
66
1 cartridge in 2.2% is 44mg
44x3=132 mg

1.8% is 36mg
 Paper B

Few questions, diagrams, and clinical scenarios about tooth trauma quite a
few

Lower fully edentulous cast and they put arrows on the anatomical landmarks
few questions
Disinfection and sterilisation methods of different dental and none dental
surfaces and equipment
Adam’s clasp’s parts (the names)

1 arrow head
2 Retentive arm (tag)
3 Long one in front of the tooth is called bridge
Picture of spoon denture and name it

Scenarios about BPE

Picture of Cobblestone appearance of the buccal sulcus and where we see it

Loads of questions about prostho

Complete denture stages in very much details especially the bite registration
and face bow transfer and these stuff

What bacteria in arrested root caries A israeli

Picture of erosive lichen planus identify the lesion
Picture of lichenoid reaction adjacent to large amalgam restoration identify

The stages/process of sterilisation

CT scan and asking about different plans like sagittal, coronal, transverse,
and so on and then what is the lesion was vertical root #
A) Axial (transverse)
B) Coronal (frontal)
C) Sagittal (longitudinal)
Occlusal x ray with wrong preparation of post canal (something like this,
although nothing wrong with the below fig)
Double exposure x ray error
IOTN
Picture of Class 2 division 1 malocclusion

Pictures of Kennedy classification of partial denture 4 questions

Why we sandblast and acid etch implant surfaces answer to increase surface
area for osseointegration

What material we use to construct RPDs

Picture of dental lingual bar /plate major connector of lower RPD and few
questions about it

Questions about tooth restoration like:

What happens if we don’t use wedge overhang
What happens if we can’t put the matrix band properly around the tooth with
class 2 amalgam open contact
What happens if we do provide proper depth in occlusal-mesial cavity
What happens to inlay when we the walls are diverge occlusally

Occlusal interference during lateral excursions causes it was a scenario

Drugs that interfere with warfarin Vitamin K

Picture of fixed ortho and arrow on the band identify

Scenarios about different angel and incisal ortho classification

1. 'What is the lowest level of platelets that you can extract?
a. Regional LA blocks are given, if the platelets levels are above 30x109 b.
Haemostasis of dentoalveolar surgery is adequate if platelet levels are
above 50x109/L. c. Major surgery requires platelets level above 75x10^9/L.

3. When performing operative treatment in a patient's oral cavity, you put

you finger support on: 1- Tooth, 2- Gingiva, 3- Cheek, 4- Chin, 5- Lip

5. What is the dose of Amoxicillin oral suspension? 125-250 mg

6. What is the year of when RIDDOR regulation came out? 1995

7. What is the normal level of Glucose on a BM stick

9. A non synovial joint with dense connective tissue between two bony
surfaces 1 synchondrosis 2 syndesmosis 3 symphysis 4 suture

13. Suppuration is mainly the result of the combined action of four factors.
Which of the following is not one of them? 1 necrosis 2 presence of
lymphocytes 3 collection of neutrophils 4 accumulation of tissue fluid 5
autolysis by proteolytic enzymes

14. What would over trituration of silver and mercury cause and what would
under trituration cause?
 15. As a newly qualified dentist you are offered a contract in which
remuneration is on capitation basis. What is the most important and
well-recognized feature of this method of remuneration?
A. Tends to encourage under-prescribing
B. Tends to encourage high technical quality of work
C. Tends to encourage high output of procedures
D. Tends to encourage over-prescribing
E. Tends to encourage low technical quality of work

16. A patient on examination was found to have swollen gingiva around a

crown that had been present for several years. The papillae were
particularly enlarged. What is the most important feature of a crown that
may be responsible for this? A. Material of the Crown B. The occlusion C.
Proximal Contour D. Labial Contour E. Surface finish

17. It is best to retain dental radiographs for how many years?

adults should be kept for 11 years , for children 25 years of age or 11 years
from treatment whichever is longer

18. Which is the most important factor to reduce dental irradiation? (speed
of film or collimation

19. After crown placement, how many months will you review it radio
graphically? annually
21. A 50 year old male patient has a Class III jaw relationship with an
anterior open bite. It is planned to restore his lower right second molar,
which has suffered tooth wear and fracture, with an indirect restoration.
This tooth has approximately 2 mm of coronal height. What would be the
most suitable approach to restore this tooth?
A. Provide an adhesively retained gold onlay
B. Provide a conventional full crown
C. Increase the vertical dimension and provide a full crown
D. Surgically crown lengthen and provide gold crown
E. Provide an adhesively retained ceramic onlay

22. A patient presents with a history of a post-crown having fallen out. The
post-crown was originally placed fifteen years ago and had been successful
up until four months ago since when it has come out and been recemented
four times. At recementation there was no evidence of any caries.The
patient had been a regular attender and not needed any restorative
treatment for the last eight years. Which of the following is the most likely
cause for the failure of this crown? A. The post was to narrow B. The post
was to short. C. The root canal treatment was failing. D. A vertical root
fracture was present. E. There were excessive occlusal loads on the tooth.

23. In dental epidemiology, indices are used to measure the oral health of
a population. The DMF index is commonly used to measure the prevalence
and severity of dental caries

24. You want to evaluate the effectiveness of tetracycline as an adjunct to

scaling & root planning for the treatment of chronic periodontitis. What is
the primary study design most appropriate for addressing this topic? A.
Cohort B. Non randomised controlled trial C. Randomised controlled trial D.
Control case study E. Case series

24. Which LA is neurotoxic at 4%? articaine

25. The management of patients taking corticosteroid for a long time with
dental infection, abscess or high temperature , do we need to double the
dose of antibiotic or double the dose of cortisone ?

28. Why does a patient with heart failure bleed easily?

29. Which immunoglobulin exists as both a monomer and dimer or

J-chain? IgA

30. Appointment for asthmatic patients should be given in? A morning B

Afternoon C Evening D Anytime

30. According to the water regulations, all dental equipment must be

protected by back siphonage and between the water ingress and drainage
points there should be a a. “Type A” gap of 20mm b. “Type B” gap of 30mm
c. “Type C” gap of 40mm d. “Type D” gap of 50mm.

31. Fire certificates are only required for buildings with 20 people working in
them or if more than ten people work on floors other than ground floors
(same applies to dental practices). Fire risk assessment should be carried
out every a. 3 months b. 6 months c. 9 months d. one year

32. Discharge in vesiculo bullous lesion - serous or suppurative?

33. Rushton bodies are commonly seen in which of the following:

1.ultraviolet rays 2.ultrasonic vibrations 3.lichen planus 4.lupus
erythematosus 5. Radicular cyst

34. If a patient has a severe gag reflex which kind of sedation will you use?
Midazolam IV
36. Which immunoglobulin is associated with MALT (mucosa associated
lymphatic tissue?) IgA

37. What will be the answer? Stephan's curve represents a) change in pH

of saliva with time b) change in pH of plaque with time c) change in pH of
saliva with sugar intake.

40. Which antibiotic can we give to a patient who is on warfarin? Amxo

41. Which antibiotic can we give to a patient who is on warfarin? and if he

is also allergic to penicillin ? clindamycin

43. Which drug causes angioedema? ACE inhibitors

44) Which drug causes lichenoid reaction, ii.)Which drug causes dry
cough?ACE inhibitors
45. Which one of these is most benign? a) kaposi's sarcoma b)
adenolymphoma (Warthin’s tumour) c) burkitt's lymphoma

46. A curette may be inserted to the level of the attached gingiva with
minimal trauma to the tissues because of A. Has a round base B. Is easy to
sharpen C. Has rounded cutting edges D. Provides good tactile sensitivity
E. Has two cutting edges

47. What type of hypersensitivity reaction causes amalgam restoration?

Type 4
48. Kiwi causes anaphylaxis & urticaria? Type 1

48. As far as localised alveolar osteitis is concerned; which one of the

following is true 2.
A. The incidence in the mandible and maxilla is similar
B. The prophylactic prescription of antibiotics prior to extraction reduces the
incidence.
C. Excessive fibrinolysis is the likely aetiology
D. Purulent exudate must be seen for a diagnosis and irrigation is
mandatory
E. Zinc oxide eugenol and alvogyl dressing promote a rapid bone growth

49. How do you prepare the floor of the pulp chamber in molars?
A. Swab and dry with cotton wool and excavate B. Use round bur to flatten
the floor C. Under cut walls D. Use flat end fissure bur to make it levelled

50. Which immunoglobulin is the first to be found when the child is born?
For a newborn it's IgG and its IgG ( in utero)
IgA from the milk after
The elevation of the IgM at birth is suggestive of intra uterine infection

51. Distance of maxillary sinus from the first molar?

Volume of the upper compartment in TMJ is? 1.2 ml
Lower compartment? 0.9 ml

SERUM>TEARS>SALIVA>BREAST MILK

SERUM--40-400MG/TEARS--60-85MG/DL, SALIVA--6.2-14.5 MG/DL,

BREAST MILK--APPROX 0.708 MG/DL

52. Which of the following anomalies occurs during the initiation and
proliferation stages of tooth development
A. Amelogenesis imperfecta - histodifferentiation
B. Dentinogenesis imperfecta- histodifferentiation
C. Enamel hypoplasia – apposition stage
D. Oligodontia – initiation stage ( absence of single or multiple teeth)
E. Ankylosis Hypocalcified/hypomineralized – normal organic matrix but
defective mineralization.

Anodontia, mesiodens and Oligodontia - initiation phase (number)

Macrodontia and microdontia also peg laterals or peg molars is- bud stage
(Size)
Dens in dente,germination,fusion and tubercle- cap stage (Extra)
Supernumerary, eruption cyst, odontoma from epithelial pearl - bell stage
(variation) keratocytes from dental lamina , odontogenic cysts and tumors
from dental lamina
Enamel hypoplasia, concrescence and enamel pearl is - defect in
apposition and maturation stage

53. How to disinfect a bridge before sending it to the lab? 1:1000

hypochlorite 10 mins

54. Best treatment planning- to replace missing lateral incisor?

15yr old boy adhesive/spoon denture, 26year old Depends on age but
usually implants
with missing lateral, with good periodontium, bone levels, good oral
hygiene, absence of Dental Caries ?

56.Treatment for peg shaped laterals? With Hybrid composite or laminate

veneer the best option?
57.Type of crown placed after Nayyar core etc? Full metal/gold

58.Cement used for Temporary cementation? ZOE

59. How many mg of lidocaine in 3 cartridges of 2.2ml? 132 mg

60. What is the most toxic LA? Bupivacaine (cardiotoxic), articaine

(neurotoxic)

62. cells in acute and chronic infection? Neutrophils / macrophage

63. Cells in granulomatous infection?

1. Acute infection. Neutrophils
2. Border healing minor aphthous ulcer 8 days old t lymphocytes, mast cells
macrophages
3. Granulomatous infection macrophages
4. Periapical infection plasma cells
5. Lichen Planus T- lymphocytes

64. What is the concentration of lignocaine in a topical anaesthetic? 5%

topical gel, 10% spray

65. Best restoration material for class 5 in sjogrens? RMGIC

66. Cavity in post teeth in parkinson's patient,restorative material of choice?

RMGIC

66. What antibiotics and pain reliever would you prescribe for a patient who
has a prosthetic heart valve and is on Warfarin anticoagulant after having a
surgical extraction of an infected tooth? Paracetamol, amxo
67. What do we do with used files? are they disposed of in a sharps
container or are they sterilised ?

68. Which tooth if extracted can spread infection to cavernous sinus?

Upper canine

69. Patient, a known diabetic collapses in your dental chair, what wud is
your first line of treatment?

70. Which measurement is taken with a single record block in the mouth??
resting vertical dimension (Will’s gauge)

72. Cantilever Bridge?

73. Role of NaCl in saliva?taste salt 2: role of Hco3 in saliva? Buffering

76. Dental fee exemption?

You do not have to pay for NHS dental services if you're:

● under 18, or under 19 and in full-time education

● pregnant or have had a baby in the last 12 months
● being treated in an NHS hospital and your treatment is carried out by
the hospital dentist (but you may have to pay for any dentures or
bridges)
● receiving low income benefits, or you're under 20 and a dependant of
someone receiving low income benefits

Low income benefits

You're entitled to free NHS dental treatment if you or your spouse (including civil
partner) receive:
 ● Income Support
● Income-related Employment and Support Allowance
● Income-based Jobseeker's Allowance
● Pension Credit Guarantee Credit
● Universal Credit (in certain circumstances)

Certificates to help with health costs

You can receive free NHS dental treatment if you're entitled to or named on:

● a valid NHS tax credit exemption certificate

● a valid HC2 certificate – which is available for people on a low income
● a valid maternity exemption certificate

People named on an NHS certificate for partial help with health costs (HC3) may also
get help.

People on a low income can include some students and pensioners.

You'll be asked to show your dentist written proof that you do not have to pay for all or
part of your NHS treatment.

77. A 55 year old female patient is missing her upper right second premolar
and upper right first molar and also is missing the upper left second molar.
The upper right second molar is functional and has an amalgam restoration
(MOD and buccal wall) that requires replacing. The patient has no
functional or aesthetic concerns. What would be the treatment of choice in
this situation?
A. Provide an upper removable partial denture
B. Replace the amalgam in the upper right 7 only
C. Provide a full coverage crown in the upper right 7
D. Provide a fixed bridge in the upper right quadrant E. Provide a full
coverage crown in the upper right 7 with guide planes and occlusal rests.

1. The above scenario mentioned that UR7 has a defective MOD amalgam
and buccal wall " I take it that it means the buccal wall is defective too.
Therefore providing an amalgam restoration won't be adequate especially that
UR5 and the UR6 are missing.
2. The patient has no esthetic or functional concerns hence I won't select the
provision of a prosthesis to replace missing teeth ( fixed or removable)
I will only be stabilising a compromised tooth to increase its longivity, clinical I I
would go for a full gold crown " minimal prep"

78. A new filling material has been developed by the Dental School. After
publication of laboratory results, the researchers conducted a randomised
clinical trial in general dental practice where patients requiring one filling
were randomly allocated either to old or new filling material groups. After a
five year follow up, the mean survival time between two materials was
compared, and P-value of 0.125 was reported. Which answer is correct?

A. There are no important differences in the properties of the materials

B. There is no difference in restoration mean survival time between the two
materials
C. The difference between two materials is not clinically important
D. The difference between the materials is very small
E. The new material is useless

79. A 23 year old male presents to your surgery. He lost his upper lateral
incisors some 10 years ago in a swimming pool accident. Since then he
has been wearing a `spoon' denture which he now feels is aesthetically
unacceptable. He has sought an opinion on dental implants but has been
told that he would need bone grafting for this to be successful and he is not
prepared to undergo this. His dentition is excellent with no restorations and
a Class I occlusion. He wants some advice on what the best treatment
might be. Which option would you put first on your list of possibilities?

A. Two fixed resin bonded bridges using the central and canine teeth
B. Two cantilever resin bonded bridges from the central incisors and
canines.
C. Two conventional fixed bridges from the canine
D. Conventional cantilever bridges from the canines
E. Cobalt chrome partial denture

81. How to disinfect a bridge before sending it to the lab? Answer:

ultrasonic bath , disinfect in 1:1000 sodium hypochlorite bath for 10 minutes

82. Gingival enlargement due to phenytoin?

1. Affects males more than females
2. More in edentulous areas
3. Dose dependent
4. Occurs within 4-12 months after beginning of therapy

82. Which antibiotic causes diarrhoea and abdominal cramps at a high

dose? Clindamycin

83. Which anion is present in bone? Bicarbonate and phosphate

84. significance of surface markers in hep b? – indicates acute or chronic

infection, immunity etc.

3 Which virus is stable outside the body?Hep A

4 How to treat a spillage of less than 30 ml of blood? 1:1000ppm sodium

hypochlorite
QHow many units of pure alcohol is in 4 pints of 3% beer?
1 pint= 561ml
3% means 3 units in 1000ml
so 561ml = 561x3/1000=1.6 units
therefore 4 pints= 1.6x4=6.7 units

85 Which drug causes a fixed ulcer? Nicorandil

86. Which x-ray for implant? CBCT

87. What type of cells are seen in the early and later stages of
periodontitis? Neutrophils, plasma cells

89. Which area is more prone to develop cancer?

90. What is the pressure of a BPE probe? 20-25g/.2-.25 N

92. Do we need to change the antibiotic dose for patients with rheumatoid
arthritis taking 15 mg prednisolone for 6 months or 3 months had dental
abscess?

99. Fluoride in blood is carried by – Plasma

100. What is the extracranial cause of nerve palsy?

a. cerebral malignancy (Intracranial palsy)
b. stroke (Intracranial palsy)
c. MS (Intracranial palsy)
d. Ramsay hunt syndrome (Intracranial palsy)
e. Melkersson-Rosenthal syndrome

101. A young girl complains of swelling on both cheeks. On doing various

tests the salivary glands were found normal. What may be the reason?
Mumps
102. A 43year old patient is missing on the upper right first premolar and
molar. He has good oral hygiene and requests a fixed replacement for
these teeth. The other teeth on the same side are all moderately restored
with MOD amalgam restorations and are vital, except the canine, which has
a very large restoration and is root-filled. He has a group function.
Radiographs show a large sinus cavity and no periapical pathology. What
would be the restoration of choice for replacement of the missing teeth?

A. Implant supported crowns

B. A conventional fixed bridge using the 7 and 5 as abutments
C. Two conventional cantilever bridges, using the 7 and 3 as abutments
D. A resin-bonded bridge, using the 7 and 5 as abutments
E. A conventional fixed-moveable bridge using the 7 and 5 as abutments

103. An 80 year old patient presents with an ulcer in the floor of the mouth.
This has been present for several months and has not responded to
conventional treatment. An incisional biopsy is taken. Which of the
following histological changes in the epithelium confirm a diagnosis of
squamous cell carcinoma?
A. Hyperkeratosis
B. Acanthosis
C. Dysplasia
D. Invasion
E. Discontinuous epithelium
104. Cigarette smoking is considered to be the most important factor next
to microbial plaque in periodontal disease progression. Which of the
following is the most important factor in the disease progression in
smokers?
A. Smokers have drier mouths than non-smokers
B. Smokers have poorer oral hygiene than non-smokers.
C. Nicotine will impair the chemotactic and phagocytic properties of PMNs.
D. The gingival blood flow is reduced in smokers.
E. Smokers alter the oral environment encouraging the growth of anaerobic
bacteria.

105. A 35 year old male patient who admits to grinding his teeth at night
has a number of wedge shaped cervical (Class V) lesions on his upper
premolar teeth. These are causing some sensitivity and are approximately
3mm deep. What is the correct management option?

A. Provide tooth brushing instruction and fluoride

B. Restore the lesions with compomer
C. Restore the lesions with microfilled composite
D. Restore the lesions with a hybrid composite

106 Cells which are not present in healthy periodontium? Plasma cells
107. A patient gives a history of rheumatic fever. Which of the following
procedures require prophylactic antibiotic cover.
a. scale and polish
b. extraction of tooth
c. inferior dental nerve block
d. impression for a new lower complete denture
e. placing a class 1 amalgam restoration
f. None

108. Best method to diagnose below caries

1) caries half away through enamel on proximal surface - Briault
probe/transillumination
2) caries halfway through enamel on occlusal surface - Bitewing
3) caries half way through dentin not cavitated bitewing
4) stained fissure – blunt probe
5) hidden occlusal caries – bitewing

109. What is required to increase efficacy and reduce fatigue of universal

curettes? Sharpness

110. Ideal angle required for sub gingival curettage from universal curettes?
45 degrees

111. Suppuration is mainly the result of the combined action of four factors.
Which of the following is not one of them?
1. necrosis
2. presence of lymphocytes
3. collection of neutrophils
4. accumulation of tissue fluid
5. autolysis by proteolytic enzymes

112. What makes scaling easier and less exhausting? A. length of

instrument B. breadth C. grip D. Sharpness of instruments

113. Which immunoglobulin will increase in gingival inflammation? IgG

Most abundant immunoglobulin in saliva during infections? IgG

114. 8 year old, high caries rate prescribes fluoride content 500 ppm,
800ppm, 1000ppm, 1350 ppm.

116. What would over trituration of silver and mercury cause and what
would under trituration cause?

117. A patient on examination was found to have swollen gingiva around a

crown that had been present for several years. The papillae were
particularly enlarged. What is the most important feature of a crown that
may be responsible for this?
A. Material of the Crown
B. The occlusion
C. Proximal Contour
D. Labial Contour
E. Surface finish

118. What causes Amalgam expansion? Moist contamination and When the
saliva reacts with the zinc inside the restoration, hydrogen gas will be formed,
and this gas will cause the amalgam to slowly expand over time. This
phenomena is called DELAYED EXPANSION
What makes Amalgam black after some time? Corrosion
119. A patient presents with a history of a post-crown having fallen out. The
post-crown was originally placed fifteen years ago and had been successful
up until four months ago since when it has come out and been recemented
four times. At recementation there was no evidence of any caries. The
patient had been a regular attendee and not needed any restorative
treatment for the last eight years. Which of the following is the most likely
cause for the failure of this crown?
A. The post was to narrow
B. The post was to short.
C. The root canal treatment was failing.
D. A vertical root fracture was present.
E. There were excessive occlusal loads on the tooth.

120. A 50 year old male patient has a Class III jaw relationship with an
anterior open bite. It is planned to restore his lower right second molar,
which has suffered tooth wear and fracture, with an indirect restoration.
This tooth has approximately 2 mm of coronal height. What would be the
most suitable approach to restore this tooth?
A. Provide an adhesively retained gold onlay
B. Provide a conventional full crown
C. Increase the vertical dimension and provide a full crown
D. Surgically crown lengthen and provide a gold crown
E. Provide an adhesively retained ceramic onlay

122. You want to evaluate the effectiveness of tetracycline as an adjunct to

scaling & root planning for the treatment of chronic periodontitis What is the
primary study design most appreciated for addressing this topic?
A. Cohort
B. Non randomised controlled trial
C. Randomised controlled trial
D. Control case study
E. Case series
123. Which LA is neurotoxic at 4% ? articaine

124. Which LA will you use in a child to do a pulpotomy? lidocaine

125. Cyst in which white paste is seen? Odontogenic Keratocyte

126. What is the amount of gas in lungs at the end of the tidal volume? IC
3600 ml IC = IRV+TV

127. Anaesthetic for a patient with congenital heart disease in an

emergency appointment? Prilocaine

128. Pt. with dentures that don't fit? Paget’s disease, Gardner’s syndrome
depends on question
130. Cement used for cantilever with little preparation? Panavia resin
composite cement

131. % of fissure sealants that fail and get carious?

Success rate 1 year >85% -
>50% after 5 years

132. What is the % of transmission of these viruses? HBA 40% HBV 30%
HCV 3% HIV 0.3%

133. Which is the most stable virus outside the body? Hepatitis A Virus

133. Which has the most smooth muscle? arteries

135. A 30 year old man with an unknown allergy to latex goes into
anaphylactic shock whilst being treated in the dental surgery. Which drug
and route of administration is of most benefit in this situation?
A. Hydrocortisone - orally
B. Chlorphenamine – intramuscularly
C. Chlorphenamine - orally
D. Epinephrine - intravenously
E. Epinephrine – intramuscularly
136. What causes difficulty in pronouncing the letters? F, V – D,S,T – S
becomes ‘th’ - Whistling – Clicking teeth –

137. What is the irrigant that could be used in root canal irrigation? What
concentration? 2.5%

138. What combines irreversibly with Hb (haemoglobin)? Co carbon

monoxide

139. What is the success rate of first time RCT and the success rate of
Re-RCT? ???

140. BPE score * : furcation

141. What type of fluoride (topical or systemic) you will prescribe for a 6
year and a 12 year old living in an area with water fluoridation of less than
0.3 ppm. 0.7ppm
143. Iron def anaemia is: Microcytic anaemia

144. Last deciduous tooth to be replaced by permanent one: a.max canine

b.max 2nd molar c.mand canine

145. Elongation of pulp chamber seen in: a.gemination b.turner teeth

c.taurodontism d.dilaceration

146. Potassium sulphate is added to gypsum to a. increase setting

expansion b.decrease working time

147. The component of bacteria that attaches to the toll process: a. prop
ionic acid b. lipopolysaccharide

148. the maximum cartridges of lignocaine that can be given to a pt

a.7 b.14. C.6

149. Hb e antigen means: a. high risk infectious b. recent infection c.

immune to infection

150.question of candidiasis which is caused in particular group/races(don't

remember the exact ethnic group) a.c.tropicalis b.c.albicans

153.the amount of adrenaline used 1:X,X is a.100 b.1000 c.10000

155.pemphigus shows: a.acantholysis b..acanthosis

156. IgG and C3 are seen in: a. lichen planus b. pemphigoid c. erythema
multiforme d. pemphigus vulgaris

157. Commonly used treatment of candidiasis: a. fluconazole b.

miconazole c. nystatin
158. actinomycosis is differentiated from osteomyelitis by the presence of:
a. sequestrem b. involucrum c. sulphur granules d. Pain

159. Sulphur granules is seen in microscopic examination of

Osteomyelitis
Lemierre syndrome
Actinomycosis

162.histopath lesion closest to advancing edge in enamel caries: a. dark

zone b. surface zone c. translucent zone

163. pogonion,menton,and gonion are the bony landmarks in a. mandible

b. max c. bony chin

164. best method of fluoridation – water

165.Simplest way to correct a lateral incisor crossbite : a.removal appliance

b.fixed appliance

167. Case scenarios where one central incisor is missing in a child who has
had a previous history of trauma with an avulsed primary incisor, the cause
is a.scar tissue b.supernumerary teeth c.tubercle d.frenum

168. Based on ASA (American anaesthesia association) when you can

treat a dental pt: a. type /class 1 b. type 1 or 2 c.type 5 d.type 4 and 5

173.What is the concentration of chlorhexidine in a gel? 0.2%, 0.5%, 1%,

5%

174. A 46-year-old male smoker presents as a new patient complaining of

bleeding gums, bad breath and his BPE score is given as above: Select the
most appropriate initial radiographic examination. A. Bitewings B. Bitewings
and periapical views of selected teeth C. Full mouth periapicals D.
Periapicals of the lower incisors E. Vertical bitewings
175. Q2. A. 1 month B. 3 months C. 6 months D. 12 months E. 24 months
F. 36 months Choose from the options above the period of time which
should elapse before the next radiographic review in the scenarios below.
Each option may be used once, more than once, or not at all.

1. A 13-year-old patient designated as having a high caries risk. - 6months

2. A 15-year-old patient considered to be at moderate risk of future caries. -

12 months
3. A 32-year-old patient still considered as at high risk of future caries.
6months

4. A 9-year-old patient at low caries risk. 12-18months

5. A 25-year-old patient at moderate risk of future caries. 12 months

6. A 38-year-old patient who has had a full coverage crown placed. 12

months

7. A 27-year-old patient who has had orthograde endodontic treatment to

UL6. 6months

8. A 7-year-old who has had a vital pulpotomy following trauma to UL1.

3 months
176.Q3. A. Clubbing B. Erythematous palms C. Evidence of widespread
scratching D. Flattened nails (koilonychias) E. Keratotic striations F. Pitted
nails G. Purpura H. 'Target' lesions. For each of the following clinical
scenarios identify the most appropriate skin/nail condition from those
provided. Each option may be used once, more than once, or not at all

1. A 45 year old woman with known liver disease. - Erythematous palms

2. A 56-year-old psoriasis sufferer. Pitted nails
3. A woman with a hypochromic microcytic anaemia. - Flattened nails
(koilonychias)
4. A heavy smoker with haemoptysis. - Clubbing
5. A patient with a history of gallstones presenting with dark urine and
jaundice. - Evidence of widespread scratching

178. A mother brings her child to the after hours clinic suffering
spontaneous excess bleeding from his gingival, what is the expected
diagnosis? - acute leukaemia - injury - stress - survey

179. The most common type of injury caused by a Non accidental Injury is:
- burnt tip of tongue - ulcer on the gingiva - lacerated labial frenum

180. The most common scale used for diagnosing a brain injury is:
Glasgow coma scale

181. The most important feature to differentiate between an upper neuron

motor lesion and a lower neuron motor lesion is: - eye involvement - ear
involvement - forehead involvement - anaesthesia of the facial nerve

182. A supernumerary tooth next to the maxillary lateral incisor is called a: -

conical tooth - supplementary - tuberculate
183. A patient attends your clinic for swollen lymph nodes, after
examination, the diagnosis revealed T2N1M0, what does that mean? - A
tumor of 1 cm, with one lymph node involved and no metastasis. -
A tumor of 2 cm, with one lymph node of 1 cm involved and no metastasis.
- A tumor of 2-4 cm, with ipsilateral lymph nodes involved and no
metastasis.

184. You suspect the patient suffers hepatitis B symptoms, after

investigation, the test show HBe Ag antibodies, what does that indicate? -
the patient is getting better - the patient is in a transmitting state of the
disease

185. Peptic ulcers are caused by the following type of bacteria: -

mycobacterium tuberculosis - streptococcus oralis - helicobacter pylori

204. A man has diet-controlled type 2 diabetes. He consumes 30 glasses

of alcohol and smokes 40 cigarettes per day. He is otherwise healthy. What
may be the reason for dry mouth? Sjogren's syndrome, candidosis,
dehydration, drug-induced.

205. What colour bag for disposing waste in the waiting room of a clinic
Black

206 Which sealant is more likely to cause tissue damage if extruded –

A26H plus(resin based), grossman's sealer, tubliseal.

216. Muscle involved in snoring? Muscles of soft palate and Uvula

217. How many cpd hours do the nurses need from 1st August 2008
(started compulsory)

218.. How many cpd hrs does the dentist need? A. Background radiation
dose B. Threshold dose C. Equivalent dose D. Absorbed dose
MCQ 2018/April

1. What is the recommended daily sugar intake?

Ans ;60 g per day for adults and 33 g for children

2. CHILD WITH ULCERS ON SOFT PALATE, TONSILS,

FEVER, MALAISE WHAT IS THE DIAGNOSIS
Ans: herpangina, measles, herpes, hpv

3. Picture of child with underdeveloped clavicle, what is this

syndrome? What is the most common symptom associated –
Cleidocranial dysplasia Hypodontia, Supernumerary teeth

4. there was one emq from cleidocranial dysplasia too 5 marks

same clinical features

6. What kind of lichen planus is more likely to turn malignant?

a. Bullous
b. Erosive
c. Papillary

7. What antibiotic is used to manage a superinfected herpetic lip

lesion?
a. Ciprofloxacin
b. Metronidazole
c. Cefuroxime
 What is the extracranial cause of nerve palsy?

a. cerebral malignancy (Intracranial palsy)

b. stroke (Intracranial palsy)
c. MS (Intracranial palsy)
d. Ramsay hunt syndrome (Intracranial palsy)
e. Melkersson-Rosenthal syndrome

-- Most immunisable virus (mumps)

-- Most common site affected by sun to form scc (lower lip)

-- Vancomycin usage (antibiotic cover) MRSA

10. What area is present behind the mandibular third molars? –

ans- retromolar area
11. How often should routine radiographs be taken? emq

Posterior bitewing radiographs

High caries risk: 6 monthly interval
Moderate risk: Annually
Low risk: primary dentition: 12-18 month
Permanent dentition: 2 years

12. Tetracycline hydrochloride conditioning of root surface in

periodontal surgery is to:

a. Sterilise the root surface

b. May enhance binding of fibronectin and fibroblast & Aids in bone
regeneration
c. Aids in remineralising the root surface
d. Assist the biding of lamina dura
e. Prevents post operative infections
13. definition of sensitivity and specifity they asked it 4 times.

14. Which immunoglobin will increase in gingival inflammation?

Answer: IgG

15. Which immunoglobulin increase in periodontitis?

Answer: IgG

16. . A man who smokes 2 packets of cigarettes a day and drinks

would have an increase risk of developing oral cancer of
a. 11 times
b. 13 times
c. 47 times

17. There were at least 15-20 questions from immunology. Major

mcqs portion passing my paper-A

18. Angioneurotic edema is characterized by which esterase inhibitor?

ans : C1, c2 ,c3 ,c4

19. GIC and composites 5 sub questions – composite cure length

(2mm), GIC not need to be cured, others ( we covered in note)

20.
- EMQ about muscle fibres’, what is the A band made of, what
combines with , what protein has I,T and c subcomponents

A-band is made of myosin.

Calcium binds to Troponin C.
Troponin has 3 types...I.T.C
C: binds to Ca to bring conformational change in tropomysoin
 T: binds to Tropomyson to hold Troponin-Tropomysoin in place
I: binds to the site on actin in thin filaments to hold
Troponin-tropomyosin in place

MCQ April/2017

1-5 L.A emq on which local anastheic has

1. Longest duration of action a
2. Shortest duration of action mostly c
3. Causes methaemoglobinaemia in high doses b
4. Commonely Used as topical anaesthesia mostly d
5. Has best bone penetration mostly e

a. Bubivacaine
b. Prilocaine
c. Procaine
d. Lignocaine
e. Articaine

6- along with inf alveolar and lingual nerve block, which nerve block is also
needed for extraction of lower third molar
1. Buucal branch of facial nerve
2. Buccal nerve of trigeminal nerve
3. Mental nerve of trigmenial
4. Submandibular
5.
7-Radiograph for maxillary antrum
Occipito mental
Reverse town
Postero anterior
Lateral skull
OPG
8-sedations is least likely contra-indicated in patient with
Pregnancy
Angina
Benzodiazipines allergy
Asthma or COPD
Patient whithout his chaperone

9-13 Diagram of RPD in kennedy class 2 modification one with arrows to label
on :
i-bar
cingulum rest
aker's clasp
full encircling clasp(looks like circumferential but this option was not available)
lingual bar

14-if you performed basic periodontal examination for a patient and found pocket
depths from 3-8 mm , you will perform comprehensive 6-point probing for each
tooth, what is the probe u will is
bryauts probe
WHO probe (I did this but I think is mostly should be done by graduated
periodontal probe)
Williams

15-19 (5 questions were on different readings, interpretation of BPE)

a. one quadrant with tooth of 5 mm and furcation envolvement
b. one sextant with a tooth of 3 mm pocket and 4 mm gingival recession
c. In one quadrant ,patient had only remaining lower 6 with probing depth of 6
and furcation involvement

20—24 (5 questions of hand signs of systemic diseases)

Diseases were:
Infective endocarditis
Rheumatoid arthritis

25-picture of bleeding and crust lip and diagnosis was asked :mostly erythema
multiform
26-patient with biliary cirrhosis and dry mouth ,diagnosis:sjogren's syndrome

27- patient with joints pain, dry mouth and dry eyes, what hand sign do you
expect to find: ulnar deviation as in sjogren syndrome, rheumatoid arthritis is the
commonest autoimmune disease to accompany

28-patient on antihypertensive drugs has ulcer persistent for 3 months,which is

the probable causative drug
Amlodipine,nifidipine, nicorandil, isinopril

29-30
(2) questions about drugs causing xerostomia(important to know names of many
drugs not only one from each type)

31-pictures of severe gingival growth and question is which of the following drugs
caused this enlargement in this epileptic patient
Amldipine
Nifidipine
Cyclosporine
Phenytoin(all the options causes gingival enlargement but they mentioned the
patient is epileptic so phenytoin)

32-Best treatment option for a patient with mesiobuccal cusp of lower 6 occludes
with buccal groove of upper 6, has 9 mm over jet and proclined upper incisors on
a severe skeletal class II relation
a. Functional appliance
b. Head gear
c. Fixed appliance
d. Fixed appliance +surgery(this is the only correct option as "severe" skeletal
discrepancy is corrected only by surgery, also 9 mm overjet is usually too
much to be corrected by orthodontics alone)
e. Removable appliance
33- patient with class III incisor relationship,crowding,on class I skeletal relation
ship, what is the best management:
a. Fixed orthodontic treatment(as the patient is skeletal class I, so he doesn't
need any skeletal correction by other appliances)
b. Removable appliance
c. Chin cap
d. Head gear
e. Functional appliance

34-orthodontic patient with SNA:81, SNB74, MMP angle 27. Facial height ratio
55%, upper incisor angle 109, lower incisor angle 93.this patient had:
a. Reduced facial height
b. Protruded maxilla
c. Retruded mandible
d. Proclined upper incisors
e. Retroclined lower incisors

35-9 years old patient with anterior cross bite in the upper central incisors, what
is the best management:
a. Upper Removable appliance with finger springs
b. Upper Removable appliance with Z springs (finger and z spring both used to
correct this case ,while Z spring is more appropriate as ot procline the incisors
bodily,while finger springs produce rotation)
c. Functional appliances
d. Lower removable appliances with labial retractor

36-which of the following treatment options is the least dependent upon patient
compliance
a. Elastics
b. Removable appliance
c. Fixed appliance
d. Head gear
e. Functional appliance

37,38 (two questions on hierarchy of evidence :which of the following produce

the heighest
Evidence:
Randomized controlled study
Systematic review of randomized controlled studies
Case control study
Observational study
Expert opinion and panels
(Meta analysis and systematic reviews give the highest evidence followed by
randomized control trials,while expert opinion give the weakest evidence in the
hierarchy)

39-43(five questions on clinical indications of different radiographic views

44-the best imaging technique to evaluate disc position in TMJ problems :MRI

45-49 (5 questions about diagnosis from signs and symptoms )

a. with carious tooth with intermittent pain on hot and cold ,pain is not localized
,no radiographic signs of periapical lesion: irreversible pulpitis
b. intermittent pain on cold only: reversible
c. pain on mastication and the tooth has large restoration, pain increases with
tooth sloth:cracked tooth syndrome
d. pain on mastication in restored tooth and u notice movement of part of
tooth:fractured tooth

50-the court asked you to provide some informations from a child records , the
child mother called the clinic and asked not to release this information to the
court,what u should do
provide court with informations asked
provide court with all data and records of this child
ignore court request
 Feedbacks
Disclaimer !
Candidates after exam conditions tried their best to remember as many questions as
they could. However, some questions & answers are incorrect, but it will give a rough
idea how the exam will look like. Study smart and keep us in your prayers

What comes in paper A can be repeated in paper B

1
 Anatomy

Skull base landmarks (mastoid process, styloid process, lateral pterygoid plate etc) very
bad picture of the skull came in the exam, be ready to see ugly skull

2
- Intrinsic tongue muscles

3
- Labelling

1 Hamular notch

2 Glenoid fossa
3 Mastoid process
4 Styloid process
5 Medial pterygoid plate

Muscle attached medial pterygoid superior constrictor of pharynx?

- The Broca area is damaged. What will it cause? What are the main centres
involved?
a. Broca’s area for articulation: Broca’s area lies in the prefrontal and premotor
facial regions of the cortex, about 95% of the time in the left hemisphere. Skilled
motor patterns for the control of the larynx, lips, mouth, respiratory system and
other accessory muscles involved in speech, are all initiated from this area.
Damage of Broca’s area leads to the person being capable of deciding what he
or she wants to say but they cannot make the vocal system emit words instead of
incoherent noises. This is called motor aphasia.

- Vein exiting the parotid gland and dividing into anterior and posterior divisions.

4
 The retromandibular vein, also known as the posterior facial vein, is a deep vein
of the face that is formed by the merger of the superficial temporal vein
with the maxillary vein (check the answer)

- Nerve supplying palatoglossus muscle. You have to know that Vagus and
accessory nerves can supply that muscle

- Nerve supply that contributes to palatoglossus- accessory nerve (again in options

there were no Vagus)

Muscles of mastications not a lot of question

- Which part of medial pterygoid muscle which originates from pterygoid plate
- bone:
- A. Superficial head
- B. Deep head
- C. Anterior
- D. Posterior

- Secretion of all salivary glands serous, mucoserous and mucous secretions you
have to know all

- Innervation of salivary glands during secretion Facial and glossopharyngeal

nerves
- Parotid glosspharygneal
- Submandibular & sublingual facial

- Medial pterygoid trismus during LA

5
You had to identify hyoid bone, maxillary antrum and there was an artefact

- What separates the buccinator from sup constrictor of pharynx:

sphenomandibular raphe, pterygomandibular was not an option and found out it
is the same thing

- Which gland is above mylohyoid muscle (sublingual)

- Parasymphyseal fracture patient had mental nerve paralysis with lingual swelling
- Pt had denture with low labial ridge (absorbed) and denture not stable in the
labial aspect because of which muscle (mentalis, mylohyoid, buccinator)

6
- Which of the following muscles of muscation is innervated by facial nerve
Digastric (posterior)

- You ask patient to protrude his tongue which muscle is responsible for this action
Genioglossus

7
- This diagram came asking about sublingual gland and buccinator muscle-

8
-

9
- Branch of superficial temporal artery. (Transverse facial artery).

10
- Nerve supplying sensory anterior two third of tongue passes through which
foramen.

11
- Foramen spinosum in a diagram and what passes through it.

- Greater palatine nerve in a diagram showing palate.

12
 - Arterial supply of masseter muscle.
masseteric artery, a branch of the internal maxillary artery

- Direct questions of teeth innervation, which nerve to be anesthetised if you are

extracting UR2, and in the options were like anterior superior alveolar nerve
- Another scenario with same idea but they told you that you already had given
anterior superior so you choose nasopalatine (sphenopalatine is another name)

- Facial artery branches

13
14
- Picture of cephalometric x-ray and pointing to sinuses
1. Frontal sinus
2. Maxillary sinus
3. Ethmoid sinus
4. Oropharyngeal air space

15
 Physiology

Portal system questions

- Portal system (3-4 questions) (read it from a reliable source)

Nutrient rich blood? portal vein

Oxygenated blood? in hepatic artery
Connection of oxygenated and nutrient rich is: liver sinusoid

16
Go in the liver as portal vein and leaves the liver as hepatic vein ( so both veins in and
out)

Respiratory system questions

- Reason of decreased peripheral resistance in hyperventilation

- Heart rate increases in hyperventilation
- Hyperventilation which gas increases Oxygen,
- Decreases CO2 and what stay the same Residual volume
- Which gas does not take part in hyperventilation? Nitrogen
- When someone breathes from a sealed plastic bag, which gas is inhaled? CO2

- Questions on lung volumes all in below table ( you need to understand more than
memorise as they can twist words sometimes)

17
-

18
Cardiovascular & muscles
- What increases in exercise (cardiovascular system) was not as straightforward
as previous exams

19
Vessel that carries oxygenated blood to the heart. (Pulmonary vein)

20
- Positive chronotropic adrenaline

- Dromotropic and inotropic effect?

- Rapid filling?

- Stroke volume def ejected blood per min?

- Stroke volume depends on end systolic volume

- Positive inotropic def?

- First ion in heart sinus rhythm?

21
 - Muscles isotonic, isometric

- What is calculated by the difference between end systolic and end diastolic volume.
Stroke volume

-Baroreceptors are found in? carotid sinus

the wall of the bifurcation of the internal carotid arteries (carotid sinus) and in the wall of the
aortic arch

Something related to afferent and efferent lymphatics (Afferent towards, efferent away)

Vessels that release heat in the skin?

22
Nervous system

23
24
-Which fibres are responsible for rapid spreading of electric impulse throughout
ventricles?
Myelinated fibres
- First channel in depolarisation na influx
- Repolarization K efflux

25
-Pain receptors: Nociceptors are sensory receptors that detect signals from
damaged tissue or the threat of damage and indirectly also respond to chemicals
released from the damaged tissue

- Which neurotransmitter is secreted by vagus nerve Ach

- 4 questions on neurotransmitter pre/postganglionic/ in parasympathetic and

sympathetic Ach, Nor-adrenaline
- Constriction of which vessels is controlled by neurotransmitters?
constriction of blood vessels sympathetic

- Propagation definition

26
- Saltatory action

27
28
Endocrine & blood

- Cortisol causes osteoporosis

Elevated cortisol levels interfere with osteoblast formation and dramatically
decreases bone building—resulting in reduced bone density. Put simply—more bone
tissue is broken down than deposited. As a result, patients with chronically elevated
cortisol levels may be at an increased risk for osteoporosis.

- Maximum blood loss in which body can compensate and above which
transfusion is needed 5%,10%,20%?

- Outer part of the adrenal cortex corticosteroids and aldosterone

- Which hormone causes secretion from adrenal cortex ACTH

- Anabolic hormone is insulin from B-cells

Insulin is an anabolic hormone produced in the pancreas that is essential for
blood sugar control.

- Catabolic is glucagon from A-cells

- What ion acts as a second messenger? Calcium ion

- Factor IV in blood coagulation? Calcium

- Affected by renin from the kidney? Angiotensinogen I

- Affects RBCs scenario was given? Erythropoietin

- Anterior pituitary gland partially control the adrenal gland? ACTH

- Adrenal medulla secretes the adrenaline from? chromaffin cells

- Which hormone is secreted from the outer layer of adrenal cortex options were
indirect was basically asking about the function of the hormone (Aldosterone)

- Adrenaline secreted from medula

29
 - Noradrenaline for alpha 1 receptors vasoconstriction of skin

- 5 questions on clotting factors, what breaks the clot, what reacts with platelets to form
clot etc
Fibrin stabilising factor 13
Fibrinogen with platelet initiates the clot
Clot degreading factor Plasminogen
Pt having liver disease what test would you perform before undergoing surgery
INR and clotting factors or Inr and hepatitis

- Which ion decreases in tetanus? Calcium

- Which hormone is primarily responsible for calcium regulation in body calcitonin

from thyroid

Which hormone is secreted by chief cells that regulate calcium in the body
calcitonin again.

- Which vessels regulate temperature in skin (terminal arterioles)

30
- Long scenarios on hypo/hyper in thyroid and parathyroid

- Commonest cause of hyperthyroidism? (graves disease)

- Jaw pain, Teeth mobile and pt had some kidney disease what problem
hyperparathyroidism

31
 Embryology
- Cyst in the middle of the neck just above the thyroid gland. Thyroglossal beware
of dermoid cyst or branchial cyst
(Same in different patch) Soft neck swelling in a lady around 40 yrs old branchial
cyst, thyroglossal duct cyst

- Primary palate formed by fusion of what ? inter/premaxillary segments

- Trigeminal nerve of first arch

- Picture of embryo and label maxillary process and medial process

- When do the primary teeth start to develop? 5-6 weeks

- Internal auditory meatus and tympanic membrane rise from? 1st

branchial/pharyngeal pouch

32
 - All tooth structures rise from Neural crest cells except enamel
There were many options you had to choose the one that has no enamel

Histology

- Dentine caries enzyme? ENOLACE

- Enamel protein? Amelogen & Enamelin
- Calculus deposition enzyme?
- Odontoblasts differentiated from dental papilla cells
- Final cusp pattern enamel knot and cord? Make sure
- Dental lamina in bell stage identify
- Pdl width 0.2 mm
- St intermedium
- St reticulum most bulk of enamel organ that
- Tmj histology picture, needed to identify lateral pterygoid muscle and mandibular
fossa of temporal bone.
- Acellular cementum where? Coronal part of the root

33
Which gene is involved in degradation of enamel knot and cord? SH, FGF(samson
notes), BMP (google search and other references) you need to search for the right
answer

- Nutrition during odontogenesis (stellate reticulum, stratum intermedium) search

the answer
- Gingival sulcus
- Vestibular sulcus
- Dentine
- Enamel
- Pulp
- Cementum, alveolar bone, PDL

-Lip and cheek from vestibular lamina

34
 Study it by heart

Non-incremental hard tissue of the tooth?

-Perikymata
-Hunter Schreger bands
Search because there are non developmental and non incremental (could be the same
thing not sure)

35
 -Enamel knot few questions

- Which structure forms bulk of the enamel organ (stellate reticulum,Stratum

intermedium)

- Which structure has alkaline phosphatase activity? (Stratum intermedium,

stellate reticulum )

- From which structure cementum, pdl develops? (Dental follicle)

-Coronal part of dentine in which stage

Initiation
Bell (maybe)
Cap
Bud
Search for the answer

-Simple question about bone resorption? Osteoclast

-Simple question regarding apex of the root resorption? Options were like neural
crest to differentiate odonto something

36
 - Saliva know it by heart

Saliva is hypotonic with plasma

-To check for salivary flow rate which of the following do you measure
Submandibular
Sublingual
Submandibular + Sublingual
Parotid
Whole saliva of the mouth
Check answer

37
- Pt complaining of dry mouth , what to ask her?

Radiology

- There was an opg as well on which carious molars were visible

Few annoying questions (4qs) on Operator, referrer, practitioner IR(ME)R
In a Single-handed operated practice

- Radiographic fault: pale area: Fixer splash, double exposure, light streaks,
developer splash

- Vertical or horizontal bitewing you had to identify.

38
OPG showing gross caries in 6s

Xray for sublingual gland stone? (lower occlusal/lateral oblique) in the exam it came as
intra oral x-ray ,, other options were extra oral like
-Intra oral
-Occiptomental
-Posterior anterior

- Position of premolars in lower denture? On the middle of the ridge

- Bilateral black eyes, flattened zygomatic bone, which X Ray? OM

- Which x-ray you use for a 3 year old? Bimolar (2 lateral oblique)
- X-ray for 3rd molar evaluation with ID canal? Sectional DPT
- Zygomatic fracture? OM
- Upper occlusal angle options were, 50, 55, 60,70 (just know the angles because
not sure)
- Bilateral mandible fracture? Posterior anterior or DPT
- Bone around tooth IOPA
- When you do RCT to justify the dose Pre-operative + master cone +
post-operative.

39
- Lower occlusal showing post retained crown, was asked what crown is it?

- The same Xray was asked in the post? (Was incorrect post space preparation I
think). Same like 2019 exam just an example here

- Xray showing radiolucency under 6, 5 and 4. (ameloblastoma).

40
- Xray shown was asked for the error. (fixer splash I think)

41
- Double exposure

- Wrong film position

track tyre

42
-

43
 Medicine

- Microcytic anaemia in an African guy, normal ferritin, what other tests to do.
(Sickle cell test)

- Patient coughing green sputum, what condition? Lobar pneumonia (haemophilus

influenzae)
-Increased bleeding and yellow pigmentation liver disease

--Most common cause of renal failure in developing countries? Diabetic

nephropathy,hypertension check answer

- Scenario of Thrush : acute pseudomembranous candidiasis

- Picture of lips showing fordyce spots, what will you do (normal do nothing)

44
-Hand signs in scenarios
-Hand signs for ulcers in celiac disease (koilonychia)
-Alcoholic liver disease (dupuytren contracture),
-Small joints affected and morning stiffness (ulnar deviation)

45
-Picture a palate with denture stomatitis.

46
47
Drooling of mouth parkinson's disease sialorrhea
Patient has shuffle gait with drooling saliva and dysphagia? parkinson's disease

- Picture of cleidocranial dysplasia. What is the feature? (From the given options it
was frontal bossing and cleft palate) and came again in 2 different questions,
supernumerary and failure of eruption

Causes of angular cheilitis in denture wearers? Reduced vertical dimension/height

Inflammatory bowel disease?

Burning mouth associated with trigeminal neuralgia, chronic anxiety disorder,

glossopharyngeal neuralgia

48
Picture of ulcer or nodular, dysplasia, neoplasm not sure but it looked like this

Picture of smoker keratosis

49
 - Picture nursing bottle caries and asking what is this? Just answer caries (simple

as that)

Picture like this but the UR one is grey in colour and asking about the pathology and in
the options were like diastema or necrosis

50
And what would you do so if you choose diastema you might get confused and will
choose monitor or orthodontic interference , and if you choose extraction you might go
for monitor or extraction, the point I am trying to make is read the question very carefully
it was asking for the pathology not a condition

- X-ray like this and asking what's wrong with this

Options were like amelogenesis imperfecta and taurodontism

Frictional keratosis picture

51
ALL PICTURE THEY COME ALONE A SCENARIO SO DO NOT WORRY MUCH

-Scenario about measles and they say it is measles, How would it affect the teeth?
Hypoplasia

- Scenario about pt complaining of bla bla and it is also in Hand foot mouth
disease, Which virus? Coxsackievirus

- Pt with a rash in the abdominal area and has white spots in the buccal mucosa?
Measles

- Chicken pox scenario given and virus asked HZV

- Classic scenario for EBV and they give you all the signs and asking what is the
name of the virus, noting that there was a Paul-Bunnel test

52
-

- Scenario regarding this , cannot remember the exact question but I remember
seeing nocturia and anorexia

53
 - Questions on hand sign related to peptic ulcer? Not sure

- X-ray picture with shape of pointed tooth

-
- a) Cherubism
- b) Cleidocranial dysplasia
- c) Ectodermal dysplasia

Immunology

2-3 questions on immunoglobulins

- In chronic periodontitis which one will be the prominent IG in saliva of mouth? IgA
or IgG (search for the correct answer)
- Hypersensitivity scenario regarding a failure of bone transplant I,II,III,IV,V?
- Cells in MALT? lymphocyte
- Opsonisation question (phagocytosis/complement cascade)
- Contact dermatitis hypersensitivity? (Type 4)
- Organ transplant hypersensitivity type 4
- You applied for a new job and they wanted to make sure you are vaccinated
against Hep B, HbsAB (Surface antibody)

54
55
 Miscellaneous

- Fire extinguisher to set off fire caused by an electrical device, which colour band
on it? Black or blue we had an argument over this
- Fire extinguisher to set off fire of cardboards, which colour band on it? Foam or
blue we

had an argument over that too

56
- Fire exit sign colour? Silly question just look at the door during the exam and you
would know the answer is green

57
Radiation sign

58
-Pneumonia microorganism?

-Monosaccharides one was glucose

-Psychological preparation?
-Recall child low risk options were 3 months, 6 months , 12 months, 24 months

59
You need to know the definitions of bipolar, depression, schizophrenia…etc

60
61
Stats & evidence based dentistry

Evidence-based dentistry (EBD) integrates the dentist's clinical expertise, the patient's
needs and preferences, and the most current clinically relevant evidence.
Evidence based dentistry highest evidence
Evidence based depends on 3 things ????
Clinical audit def
Incidence
Prevalence
Something related to dmfs dmft?
-Consent is required for a study to be? ethical, valid
40 yr amalgam experience with mental problems can be generalised to population
reason?

Toothpaste ingredient that prevents sensitivity: potassium nitrate

62
Fluoride ppm in different scenarios

63
Law questions

-Definitions:

-Misconduct
-Professional negligence
-Local area and professional area , please refer to last few pages of this file

Dentist has been away from practice for 2.5 years (30 months) and would like to return,
whom should he contact?
-Clinical Commissioning Group
-Local professional network
-Local area team
Not sure

You want to refer a case whom would you contact

-local professional network
-Locall area team
Clinical professional network

Question on physical abuse

Question on a 7 compliant year old girl with dirty clothes and has hair lice, and missing
3 dental appointments, you suspect negligence, what would you do? Report, talk to the
mother, write it in your notes

64
 - a patient came to you and you told her that she has perio disease, she said she
was with a dentist for 18 years and never told her that, the last time she saw
dentist was 4 years ago
- can she claim negligence
- She cannot claim negligence

5 from precontemplation

65
NOTE: action is till 6 months
Maintenance from 6 months up to 5 years

Pharmacology

- Pt fit and well and which antibiotic would you prescribe for uncomplicated tooth
extraction amxo, metro, no antibiotic
- Pt pregnant has no allergy of any antibiotic and would like prescription for
pericoronitis metro, amoxicillin, clindamycin
- Pt on apixaban which is the most common complication after tooth extraction?
Post operative bleeding
- Came in 2017 A 40 year old female patient taking Dabigatran will most likely
suffer
- from this condition after dental extraction?

Medical Emergency

Straightforward questions

-100 compression Cpr per minute.

-Vaso vagal syncope pt feels fine spontaneously after 3 mins.
-Anaphylaxis .
-Hypoglycemia.
Pt suffers from chest pain, which travels from left arm to neck, shortness of breath,
sweating, nausea, vomiting, abnormal heart beating, anxiety, fatigue, weakness, stress,
depression, and other factors. Myocardial infarction

-Acute attack of asthma. Which drug would most treat the

bronchoconstriction?
a) Salbutamol
b) Theophylline

Sedation and LA

66
Different scenarios on sedation for different patients (one of them was a former drug
abuser having DVT in medical history). GA

EMQ options inhalation sedation, inhalation sedation + LA, GA, LA,Iv midazolam, IV
midazolam + LA

-Inhalation sedation for nervous child

-a 24 weeks anxious pregnant pt requires deep carious filling inhalation, GA, LA,Iv
midazolam

-3rd Trimester pregnant pt

-For a teenager who needs multiple molar extraction? Intravenous sedation/GA

-35 patient requires wisdom teeth surgical extraction IV sedation + LA

-Anxious child Inhalation + LA

-Anxious 65 old copd a lot of things contraindicate sedation so you had to choose
between in-day GA or inpatient GA

Patient came and had heart problems, diabetes, copd, veins were
thrombosed etc.. what type of sedation will you give for? anaesthesia…
Inhalation, nasal, i/v, venepuncture and local L.A? GA hospital admission

-Severely mental disabled, cannot move his head and needs multiple fillings?

-Regular attender crown preparation LA

- Anxious Pregnant 24 weeks Inhalation + LA (not sure)

-Gag reflex impression inhalation sedation

-Molar extraction nervous adult Iv sedation

67
-Who has less pain control under local anaesthesia medically compromised, elderly or
children

Periodontology

- probe for individual deep pocket and for 6 point probing williams

- For bpe who probe

- What brush to use under the bridge pontic? Superfloss

- And in pericoronitis(Single tufted brush for operculum cleaning)? Single

tufted toothbrush

- In periodontitis interdentally? interdental brush

- Pt with Parkinson's disease? Electric toothbrush

- Pt with orthodontic braces and cannot brush around the braces? Single
tufted toothbrush

- Pt with multiple proximal caries which is the best advice to show? Show
him how to floss

- For cleaning through the furcation area? Interdental brush

- Best way to teach patients oral hygiene? One to one at the dental setting
(dentist or nurse to talk directly with patient)

- Best way to teach patients oral hygiene? Let them try and correct their
mistakes and guide them (correct), to show them on a model (incorrect)

- Also what’s the best way to ask about pt brushing habits? How do you
look after your teeth

68
 BPE questions tricky make sure you read the question till the end be careful from
* and X

- Only one tooth present in a quadrant X

- Bleeding on probing, pocket depth 2 mm, 3mm gingival recession with calculus 2
- Bop with overhang 2
- BOP no pocket 1
- 2 teeth present in a quadrant with bland band partially visible and furcation
involved 3*
- Pockets in a sextant varying from 3-8 mm 4
- Disease activity best measured by bop

Radiographic followup for high risk caries 6 months

3-4Questions on perio surgery like which on you use in furcation involvement II

-Apically repositioned flap
-gingivectomy
-frenectomy
- Free tissue flap/graft

4-5 Questions on perio 6ppc asking for recession, inflammation

69
-From Cemento-enamel junction to pocket base (recession, CAL, clinical crown)
-From Cemento-enamel to gingival margin (recession, CAL, clinical crown)
-From gingival margin to incisal edge (recession, CAL, clinical crown)

Turskey plaque (Quigley and Hein) index

70
Restorative + Prosthesis

posselt's envelope you have to know it, watch a youtube video

71
72
 - Which structure shows the posterior limit of upper denture. (Fovea
palatini,vibrating lines)

- Picture of study models showing attrition, was asked what is the first line of
treatment Diagnostic wax up

- -Pt had recently extracted UR1 and has no maxillary molars, he has perio
problems and many other issues and would like to replace the upper central
incisor? spoon denture

- Walking technique concentration? Check bda

-5 EMQs on Burs picture you have to know each bur usage
One for gold proximal preparation in a crowded dentition
One for occlusal rest
One for replacing composite that had marginal defect

73
- Picture showing denture, identify rest?

- Many questions on the pulpitis are reversible and irreversible.

- Caries picture, needed to identify the stage?

74
-

75
-Questions on instruments (condenser, wards carver, WHO probe, Williams probe, etc)

76
 - A congenitally missing left maxillary lateral incisor tooth in a 13-year-old female.
The ridge is well rounded. There is minimal overbite and 6mm space between
the abutment teeth. The dentition is otherwise intact, unrestored, caries free and
periodontally stable
o Cantilever minimal preparation bridge
o Conventional cantilever bridge
o Conventional fixed-fixed bridge
o Conventional fixed-moveable bridge
o Dental implant
o Every partial denture
o Fixed-fixed minimal preparation bridge
o No restoration

- Missing mandibular second premolar and first molar teeth in a 35-year-old male.
The abutment teeth are restored with large MOD amalgam restorations. The
distal abutment is mesially tilted and drifted half a unit mesially
o Cantilever minimal preparation bridge
o Conventional cantilever bridge
o Conventional fixed-fixed bridge
o Conventional fixed-moveable bridge
o Dental implant
o Every partial denture
o Fixed-fixed minimal preparation bridge
o No restoration

- A missing maxillary central incisor lost 2-years ago in a 40-year-old male. There
is a rounded ridge, minimal overbite. The dentition is otherwise intact,
unrestored, caries free and periodontally stable. There is anterior spacing with
10mm span between the abutment teeth
o Cantilever minimal preparation bridge
o Conventional cantilever bridge
o Conventional fixed-fixed bridge
o Conventional fixed-moveable bridge
o Dental implant
o Every partial denture
o Fixed-fixed minimal preparation bridge
o No restoration

77
 - A maxillary left central incisor that was extracted following root fracture 6-months
ago in a 65-year-old male. The right central incisor is crowned with a defective
margin. The left lateral incisor abutment tooth is unsightly, with large mesial and
distal composite restorations. The abutment teeth are vital with a minimal
overbite
o Cantilever minimal preparation bridge
o Conventional cantilever bridge
o Conventional fixed-fixed bridge
o Conventional fixed-moveable bridge
o Dental implant
o Every partial denture
o Fixed-fixed minimal preparation bridge
o No restoration

- A maxillary second premolar that was extracted 2-years ago in a 55-year-old

female. The first molar tooth has an unaesthetic large recently replaced MOD
bonded- amalgam restoration. The first premolar is unrestored and caries free

o Cantilever minimal preparation bridge

o Conventional cantilever bridge
o Conventional fixed-fixed bridge
o Conventional fixed-moveable bridge
o Dental implant
o Every partial denture
o Fixed-fixed minimal preparation bridge
o No restoration

-Initial pH of alginate when start mixing?

a. 3
b. 5
c. 7
d. 9
You need to know the pH of alginate before and after mixing (non sense but you have
to)

78
- Deep undercut at tuberosity area, what impression material to use? Low viscosity
polyvinyl silicone

- Questions on articulator types and which to use in different scenarios

- Transfer the relation between maxilla and TMJ Facebow
- semi adjustable, non adjustable, fully adjustable

- Picture of willis gauge

- -Alma Gauge to determine incisive papilla and its relation to maxillary anterior teeth

- Image of bulbous crowns, identify what condition (dentinogenesis imperfecta)

- Preparation margins for metal ceramic crown? Buccally will be shoulder finish
line

79
 - Preparation margins for anterior all ceramic onlay? Labially will be chamfer
finish line

- Erosion index BEWES index

80
Affect teeth from Gastroesophageal reflux? erosion

81
Different alloys, which has shape memory? ( nickel titanium)
Flexible file Niti
What to add to an amalgam to increase working time? (tin)

- Stainless steel which one is 18% Chromium which one is 8% Nickel

- Tooth showing root fracture, was asked what factor affects the prognosis?

- After avulsion splint for how many days? 14 days

- Avulsion time for best prognosis 30 mins (the earlier the better)

- Picture of tooth fracture showing enamel and root fracture

-
- Best medium to restore an avulsed tooth no milk present, saliva

- Picture an upper denture with Adam’s cribs on the 6's. What kind of denture is it?
a. Spoon denture
b. Every denture
c. Tooth supported denture

Scenario with no picture (just for illustration of proud amalgam ), patient had amalgam
for 10 years and the amalgam is higher than rest of teeth structure options were
amalgam creep, or erosion

82
Also study amalgam ditching (came in another exam)

- Ductile and stiff material X more plastic deformation material y more stiff and
opposite? Creep? Definition of dental materials

83
 84

-
 - Luting Cement used for SS crown? Zinc phosphate, zinc polycarboxylate, zinc
oxide eugenol, GIC
-

Orthodontic

- Most important thing to inform patient about (root resorption) before ortho treatment
not sure

-Different scenarios crossbites on ortho removable appliances (z spring with crib on 4,6
etc)

- Porion definition
- Which point is close to the root of the upper lateral incisor? Point A

85
Which class is that? Class II

86
-Wire thickness used to construct palatal spring. 0.5mm

- Point involved in a plane in ceph used to assess mandibular rotation? MMPA not
sure

- Increases in inter incisal angle will cause. (Class 2 div 2)

- Midpoint of pituitary fossa? (Point S)

-

Xerostomia good oral hygiene no caries

Marginal gingivitis no caries
Child with too many cavities
Ohi, ohi with chlorhexidine, ohi with fluoride, longer term fluoride therapy, long time
chlorhexidine therapy, long time chx and fl therapy

2 abutment teeth only left and treatment option was asked Overdenture

Minimum GP to be left in post retained canine tooth 4 mm, 5mm, 6mm

- Balanced force technique in endo fills? 90,180 you have to know how the
technique works
- a)90 clockwise, 180 anticlockwise, then 90 clockwise with apical pressure
- b) 90 clockwise, 180 anticlockwise , then 180 clockwise with apical pressure

Gates glidden size 4 usage? search

87
Deep caries removed by step wise excavation

Instrument for placing ZnO2 eugenol ?

For refining the anatomy of amalgam- ward’s carver

Def of abutment, precision attachment, coping, Pontic

Post dam area guided by vibrating line

Surgery
-Infraorbital nerve paresthesia In zygomatic fracture

-African man with bulbous and divergent roots and wants to extract upper wisdom
common complications? Maxillary tuberosity fracture

-Pt requires lower wisdom extraction and the tooth is close to the lower border of the
mandible, common complications? Fracture, alveolar osteitis, lingual paresthesia (not
sure)

- Patients with blows to the chin and loss of sensation of lower lip. (Mental nerve
involved)

Questions about Mental nerve injury

- Parasymphyseal fracture
- Facial palsy nerve

88
 Paediatric

Calcification date of maxillary permanent incisor? 3-4 months

(they usually ask permanent ant and first molar [at birth])

- Pulp minor iatrogenic exposure Setting Caoh

- Perforation Mta

- lots of scenarios on pulpotomy and pulpectomy.

- Most important factor in determining prognosis of a reimplanted tooth? 30

minutes best prognosis

- Which teeth are present at 8.5 years old in each quadrant? 12DE6

89
90
Positive reinforcement
Tell show and do
Desensitisation

91
GOOD LUCK

92
To compare between triclosan and lestrin in treatment of periodontal disease systemic review and meta analysis

Cohort study
Cohort study is always about finding relation in between cause and disease.

Cohort prospective- linking cause to disease Like smoking causes lung disease Its forward future study in over a long period of time u study how
much the cause has effected people and diseased them Prospective Cohort The study groups follow a group of people who do not have the disease
for a period of time and see who develops the disease (new incidence).

Cohort retrospective- linking disease to cause backward study, in which disease has happened and u r linking it to the cause that was responsible
in the past

The effectiveness of dental floss and dental tape in reducing the development of plaque– ( this is cross over habiba)
Floss and future plaque relation Cohort study
Impact of smoking on the discoloration of teeth using patients arriving for their first appointment following registration at a practice
Cohort study
The study using data from entire population to compare between lung cancer deaths in relation to per capita cigarette consumption is:
a. Case report
b. Cohort study
c. Correlation studies
d. Cross-sectional studies

A random selection of 1200 adults agreed to participate in a study of the possible effects of drug X. They are followed prospectively for
a period of five years to see if there is an association between the incidence of cataract and the use of drug X. This type of study is a:
a. Case-control study.
b. Randomized controlled clinical trial.
c. Cross-sectional study.
d. Cohort study.
e. cross-ove
Case control study
Patients with a particular disease (case) are matched with Controls in the general population
A case-control study is always retrospective, because it starts with an outcome then traces back to investigate exposures using two
groups,
One with ideal conditions called control and other group with non ideal conditions called case.
When the subjects are enrolled in their respective groups, the outcome of each subject is already known by the investigator.

You are interested in finding out what the risk indicators are for a rare form of oral cancer and decide to undertake a study to
examine this. What type of study would be the most appropriate for addressing this issue?
a. Cohort
b. Prevalence study
c. Clinical trial
d. Case-control study

A study was conducted with the following objective, to determine the individual and combined effects of potential risk factors in relation
to the temporomandibular disorder, Pain Dysfunction Syndrome (PDS). The first group comprised new referrals between May 1997 and
August 1999 to the temporomandibular disorder clinic of the University Dental Hospital, diagnosed with PDS. The second group consisted
of patients without PDS randomly selected from twenty-four dental practices. Using a postal questionnaire information was collected on
socio-demographic, local mechanical, psychological factors, co-morbidities and illness behaviour.
What type of study is this?
a. Case series
b. Cross-sectional study ( this one is correct, final )
c. Case-control study
d. Case report
e. Randomised clinical trial
 Cross sectional study

Cross-sectional studies are carried out at one time point or over a short period for the purposes of public health planning. It provides a
snapshot of the frequency of a disease or other health related characteristics in a population at a given point in time.

Cross-sectional studies are used to assess the burden of disease or health needs of a population and are particularly useful in the planning
and allocation of health resources. For example a random sample of schools across London may be used to assess the prevalence of
asthma among 12-14 year olds.

1. Study health in proportion/cross section of subjects registered over period of time Cross sectional study
2. Proportion of people arriving for 1st appointment at a specific time period Cross sectional study
3. Proportion of adults in Glasgow registered with a dentist Cross sectional study

Cross over
A crossover study, also referred to as crossover trial, is a longitudinal study in which subjects receive a sequence of different treatments
(or exposures).
1. Wisdom teeth removal in adults during their 20s-30s. Cross over
2. longitudinal study in 20s n 30s Cross over

Double blind

A valuable research design, commonly used in clinical research, is the double-blind study. What does this expression means?
a. Neither the persons collecting the data nor the people participating as subjects know all of the details of the study

In a randomised double-blind single-centre clinical trial, the effect of pre-operative administration of Ibuprofen 600mg or Diclofenac
100mg tablets was compared for post-operative pain relief in 119 patients having day surgery under general anaesthesia for surgical
removal of impacted third molars. Pain was assessed using visual analogue scales (VAS) pre-operatively, 15minutes, 30 minutes, 1 and 3
hours post-operatively.
Which answer is correct? The trial was double-blind because ….
a. Each patient received both treatments
b. The patients could choose the treatment
c. The patients did not know they were in a trial
d. Both patients and the nurse assessing did not know treatment allocation
e. The nurse assessing the patients knew which treatment they have received

Sensitivity Specitivity

Bitewings in caries detection has

a. Moderate sensitivity & low specitivity
b. Moderate sensitivity & moderate specitivity
c. Moderate sensitivity & high specitivity
d. High sensitivity & moderate specitivity
e. High sensitivity & high specitivity

Mobility in peri-implantitis has

a. Moderate sensitivity (50%) & low specitivity (25%)
b. Moderate sensitivity & moderate specitivity
c. Moderate sensitivity & high specitivity
d. High sensitivity & moderate specitivity
e. High sensitivity & high specitivity

To diagnose peri implantitis

mobility checking is
- 50% sensitive ( meaning if there is implantitis, there are 50% chances of a positive mobility of the tooth)
-and only 25% chances that a mobile tooth is due to peri implantitis ( meaning mobilty is not a specific factor for determing periimplantitis)
What does the term "caries prevalence" mean?
a. The total number of carious areas affected and any
present caries
b. The individual risk for a patient to acquire caries

Care index

In studying the impact of dental caries on communities, Care index is used sometimes? What is the most appropriate interpretation of
care index?
a. Shows th eprevelance of decay in community
b. Shows the extent to which decay is prevented
c. Shows the extent to which decay is treated by extraction
d. It shows the extent to which decay is treated restoratively
e. Shows the incidence of new decay

DMFT Index
In dental epidemiology, indices are used to measure the oral health of a population. The DMF index is commonly used to measure the
prevalence and severity of dental caries. In dental epidemiology the main limitation of DMFT index is
a. It does not allow statistical analysis
b. It gives equal weight to decayed missing and filled teeth
c. It is difficult to calibrate examiners
d. It is reversible
e. It is not gold standard

A. Absolute Risk Reduction

B. Bias
C. Confounding Factor
D. Double Blind
E. Single Blind
F. Number Needed to Treat
G. Open Label
H. Real End Point
I. Relative Risk Reduction
J. Statistical Power
H. Subgroup Analysis
i. Surrogate end point
Choose the correct option:
a. Reanalysis of the trial to determine if treatment affects male more than female. Subgroup Analysis
b. A clinical trial in which neither patient nor investigator is aware of treatment allocation. Double Blind
c. Stroke In a trial investigating the effect of antihypertensive drugs on the cerebrovascular system Real End Point
d. Suppression of ventricular ectopic beats in a trial to evaluate the function of anti arrhythmic drugs after myocardial infarction
Surrogate end point
e. In a clinical trial investigating the treatment of MI, the percentage of patients with infarcts in the placebo group minus the
percentage of patients with infarcts in the treatment group. Absolute Risk Reduction
f. a measure of the likelihood that a positive result means a patient has the disease positive predictive value
g. Number of diseased people positive for a test/number of diseased people x 100 sensitivity
h. Number of disease-free people negative for the test/number of disease-free people x 100 specificity
i. A measure of the limits above and below mean value for a study population within which the true mean for the population lies
confidence interval
j. Number of patients who would have to take a particular drug in order for one patient to benefit from taking it number needed
to treat
NOTES:
a surrogate endpoint (or marker) is a measure of effect of a specific treatment that may correlate with a real clinical endpoint but does not necessarily have
a guaranteed relationship.

In a clinical research trial, a clinical endpoint generally refers to occurrence of a disease, symptom, sign or laboratory abnormality that constitutes one of
the target outcomes of the trial, but may also refer to any such disease or sign that strongly motivates the withdrawal of that individual or entity from the trial,
then often termed humane (clinical) endpoint
For example, a clinical trial investigating the ability of a medication to prevent heart attack might use chest pain as a clinical endpoint.

• Sensitivity-Proportion of diseased population with positive test

– Looks at patients with disease
– Independent of prevalence of disease
– Ex. The sensitivity of a CT scan in detecting disease X is 97%
– 97 % of pts. with disease X will have a positive CT scan (ability to detect when disease present)
formula: Number of disease people positive for the test/number of disease people x 100
•

Specificity-Proportion of pts. without disease with a negative test

• Looks at patients without disease
• Independent of prevalence of disease
• Ex. The specificity of a CT scan in detecting disease X is 97%
• Real words: 97% of pts. without disease X will have a negative CT scan (ability to detect when disease not present)
• formula: Number of disease-free people negative for the test/number of disease-free people x 100 specificity

• Positive Predictive Value (PPV)

– Looks at pts. with positive test
– Ex. The PPV of test X for detecting disease Y is 12%
– Real words: Of pts. with a positive test X, 12% actually have disease Y (true positive)
– Formula: TP/TP + FP
– Does reflect prevalence of disease
• Negative Predictive Value (NPV)
• Looks at pts. with negative test
• Ex. The NPV of test X for detecting disease Y is 12%
• Real words: Of pts. with a negative test X, 12% actually don’t have disease (True negative)
• Formula: TN/TN + FN
• Does reflect prevalence of disease

• P Value-significance of a finding
• Usually P values <0.05 are considered “statistically significant”
• Ex. The P value of high heels causing spurs on women’s feet is <0.05
• Real words: The likelihood that finding that high heels cause spurs on women’s feet by chance alone is less than 5%
• Let’s say in the above example the P value was <0.5
• Real words: The likelihood that finding that high heels cause spurs on women’s feet by chance alone is less than 50%
• That’s a pretty big likelihood that it’s chance alone, thus not statistically significant
•

Number needed to treat (NNT)

• Know this, it will be on your boards
• Real words: How many pts. do I need to treat with treatment X, to prevent one bad outcome
• Formula: 1/(rate in placebo-rate in treatment group) –or-
• 1/(absolute risk reduction)
• Ex. CHF plus drug X-10/50 that received drug died
• CHF plus Placebo-20/50 that received placebo died, what is the NNT?
• 1/(2/5-1/5) = 1/(.4 - .2) = 1/.2 = 5
• Real words: You must treat 5 pts. with CHF, with drug X, to prevent one bad outcome

95% Confidence Intervals-essentially same as saying P<0.05

• If the values do not cross zero, it is considered significant
• Ex. The 95% confidence interval is 0.5 to 1.9, that is considered significant
• If they say the 95% confidence interval is -0.7 to 1.6 that is non-significant
•
• Type 1 error-Concluding that there is a difference (reject null hypothesis) when there is no difference
• Type 2 error-Concluding that there is no difference (accept null hypothesis) when one exists
•

In statistical hypothesis testing,

a type I error is the incorrect rejection of a true null hypothesis (a "false positive"), while a
type II error is the failure to reject a false null hypothesis (a "false negative").
More simply stated, a type I error is detecting an effect that is not present, while a type II error is failing to detect an effect that is present
Type I error
A type I error, also known as an error of the first kind, occurs when the null hypothesis (H0) is true, but is rejected. It is asserting something that is
absent, a false hit. A type I error may be compared with a so-called false positive (a result that indicates that a given condition is present when it actually is
not present) in tests where a single condition is tested for. Type I errors are philosophically a focus of skepticism and Occam's razor. A Type I error occurs
when we believe a falsehood.[4] In terms of folk tales, an investigator may be "crying wolf" without a wolf in sight (raising a false alarm) (H0: no wolf).

The rate of the type I error is called the size of the test and denoted by the Greek letter α (alpha). It usually equals the significance level of a test, which is
the probability of rejecting the null hypothesis given that it is true.[5] In the case of a simple null hypothesis, α is the probability of a type I error. If the null
hypothesis is composite, α is the maximum (supremum) of the possible probabilities of a type I error.

Type II error
A type II error, also known as an error of the second kind, occurs when the null hypothesis is false, but erroneously fails to be rejected. It is failing to
assert what is present, amiss. A type II error may be compared with a so-called false negative (where an actual 'hit' was disregarded by the test and seen
as a 'miss') in a test checking for a single condition with a definitive result of true or false. A Type II error is committed when we fail to believe a truth.[4] In
terms of folk tales, an investigator may fail to see the wolf ("failing to raise an alarm"). Again, H0: no wolf.

The rate of the type II error is denoted by the Greek letter β (beta) and related to the power of a test (which equals 1−β).

What we actually call type I or type II error depends directly on the null hypothesis. Negation of the null hypothesis causes type I and type II errors to switch
roles.

The goal of the test is to determine if the null hypothesis can be rejected. A statistical test can either reject or fail to reject a null hypothesis, but never prove it
true.

Table of error types[edit]

Tabularised relations between truth/falseness of the null hypothesis and outcomes of the test:[1]

Null hypothesis (H0) is

Valid/True Invalid/False

Type I error Correct inference

Reject
False Positive True Positive

Judgement of Null Hypothesis (H0)

Correct inference Type II error

Accept (fail to reject)
True Negative False negative

Absolute risk reduction

From Wikipedia, the free encyclopedia

In epidemiology, the absolute risk reduction, risk difference or excess risk is the change in risk of a given activity or
treatment in relation to a control activity or treatment.[1] It is the inverse of the number needed to treat.[2]
In general, absolute risk reduction is the difference between the control group’s event rate (CER) and the experimental group’s
event rate (EER). The difference is usually calculated with respect to two treatments A and B, with A typically a drug
and B a placebo. For example, A could be a 5-year treatment with a hypothetical drug, and B is treatment with placebo, i.e. no
treatment. A defined endpoint has to be specified, such as a survival or a response rate. For example: the appearance of lung
cancer in a 5-year period. If the probabilities pAand pB of this endpoint under treatments A and B, respectively, are known, then
the absolute risk reduction is computed as (pB − pA).
The inverse of the absolute risk reduction, NNT, is an important measure in pharmacoeconomics. If a clinical endpoint is
devastating enough (e.g. death, heart attack), drugs with a low absolute risk reduction may still be indicated in particular
situations. If the endpoint is minor, health insurers may decline to reimburse drugs with a low absolute risk reduction.
Number needed to treat
From Wikipedia, the free encyclopedia

The number needed to treat (NNT) is an epidemiological measure used in communicating the
effectiveness of a health-care intervention, typically a treatment with medication. The NNT is the
average number of patients who need to be treated to prevent one additional bad outcome (e.g. the
number of patients that need to be treated for one to benefit compared with a control in a clinical trial).
It is defined as the inverse of the absolute risk reduction. The ideal NNT is 1, where everyone
improves with treatment and no one improves with control. The higher the NNT, the less effective is
the treatment

In statistics, a confidence interval (CI) is a type of interval estimate of a population parameter. It is an observed interval (i.e. it is calculated
from the observations), in principle different from sample to sample, that frequently includes the parameter of interest if the experiment is
repeated. How frequently the observed interval contains the parameter is determined by the confidence level or confidence coefficient. More
specifically, the meaning of the term "confidence level" is that, if confidence intervals are constructed across many separate data analyses of
repeated (and possibly different) experiments, the proportion of such intervals that contain the true value of the parameter will match the
confidence level; this is guaranteed by the reasoning underlying the construction of confidence intervals

Evidence based from systemic review of Randomised Control Trial, what the level of this evidence? Level 1a

a. What is the % lies between the 3 standard deviation of the mean? 99.7%
b. What is the % lies between the 2 standard deviation of the mean? 95%
c. What is the % lies between the 1 standard deviation of the mean? 68%
d. What is the % lies between the less than 1 standard deviation of the mean? 68.27%

Level Type of Evidence

Grade A

Ia Evidence obtained from meta-analysis or randomised control trials

Ib Evidence from at least one randomised control trial

Grade B

IIa Evidence obtained from at least one well designed control study without randomisation

IIb Evidence obtained from at least one other type of well designed quasi-experimental study
III Evidence obtained from well designed non experimental descriptive studies, such as comparative studies, correlation
studies and case control studies.

Grade C

IV Evidence from expert committee reports or opinions and/or clinical experience of respected authorities

Types of primary studies

• Descriptive studies

– describe occurrence of outcome

• Analytic studies

– describe association between exposure and outcome

Descriptive

1. Case report (detailed presentation of a single case or handful of cases, One case of unusual findings)
2. Case series (experience of a group of patients with a similar diagnosis, Multiple cases of findings)
3. Descriptive epidemiology

Analytic

1. Experimental Studies

a. Randomized controlled clinical trials

b. Community trials

2. Observational Studies (non experimental)

a. Group data
 Ecologic
b. Individual data
 Cross-sectional
 Cohort
 Case-control
 Case-crossover

Experimental studies

• treatment and exposures occur in a “controlled” environment

• planned research designs
• Clinical trials are the most well known experimental design. Clinical trials use randomly assigned
data.
• Community trials use nonrandom data

Observational studies

• non-experimental
• observational because there is no individual intervention
• treatment and exposures occur in a “non-controlled” environment
 • individuals can be observed prospectively, retrospectively, or currently

Cross-sectional

• An “observational” design that surveys exposures and disease status at a single point in time
• Often used to study conditions that are relatively frequent with long duration of expression
(nonfatal, chronic conditions)
• It measures prevalence, not incidence of disease
• Example: community surveys
• Not suitable for studying rare or highly fatal diseases or a disease with short duration of expression

Case-Crossover Studies

• Study of “triggers” within an individual

• ”Case" and "control" component, but information of both components will come from the same
individual
• ”Case component" = hazard period which is the time period right before the disease or event onset
• ”Control component" = control period which is a specified time interval other than the hazard
period

Randomized Controlled Trials (RCTs)

• a design with subjects randomly assigned to “treatment” and “comparison” groups

• provides most convincing evidence of relationship between exposure and effect
• not possible to use RCTs to test effects of exposures that are expected to be harmful, for
ethical reasons
• Randomized Controlled Trials (RCTs)
• the “gold standard” of research designs
• provides most convincing evidence of relationship between exposure and effect

The grades of evidence given are as follows:

Grade Strength of evidence

I Strong evidence from at least one systematic review of multiple well-designed

randomised control trial/s.

II Strong evidence from at least one properly designed randomised control trial of

appropriate size.

III Evidence from well-designed trials without randomisation, single group pre-post,

cohort, time series of matched case-control studies.

IV Evidence from well-designed non-experimental studies from more than one centre
or research group.

V Opinions of respected authorities, based on clinical evidence, descriptive studies

or reports of expert committees.

 SPEECH

1. The acquisition of language, together with its associated processes of writing and reading, is
probably the most complex sensorimotor developmental process in a person’s life. Indeed,
individuals can be readily recognised and distinguished by the distinctive features of their
voice, which, in turn, relate to the special anatomical and functional characteristics of that
person’s ‘vocal tract’ (the region from the larynx to the mouth).

Speech is initiated voluntarily and involves a complex set of muscles around the mouth, the
larynx and the throat. It also involves the interruption of breathing and the many muscles of
expiration. Sounds are produced during exhalation and initially within the larynx (‘voice box’),
a structure that has evolved from its original purpose of protecting the trachea from inhaling
food substances to enable the production of very complex sound patterns.

2. What is phonation? Process that involves the coordinated movements of abdominal, thoracic
and laryngeal muscles.

3. What involves the production of sound?

a. The usage of air pressure provided by the lungs to cause vocal cords to vibrate
b. The resulting sound is altered by variety of constrictions and openings in parts of the
vocal tract.

4. What is speech chain? The process of speech production, speech transmission and speech
perception. It is the configuration of the human vocal tract that gives rise to the acoustic
properties of speech.

5. What are the components of speech? Speech production has three components:

a. Vocalisation: The production of a particular frequency by expelling air between partly

closed vibrating vocal cords. The volume of the air expelled determines the loudness
of the sound. Length and tension of the cords gives the frequencies.
b. Phonation: The process of changing the size and shape of resonating chambers to
modify the frequency. The resonating champers are:
i. The larynx:
ii. Pharynx: which can be shortened by raising the larynx.
iii. Nose: which can be closed off by raising the soft palate.
iv. Mouth: Has two oral resonators:
1. Between palate and tongue.
2. Between lips and teeth, especially the incisors.
c. Articulation: Is the pattern of controlled release and stoppage of air flow that gives
intelligible speech. Modification of the laryngeal sound to generate meaningful
speech occurring principally within the resonating chambers of the pharyngeal, oral
and nasal cavities.
i. For vowels the crucial action is the formation of the oral resonator space.
 ii. For consonants the crucial action is the controlled release and stoppage of air.
This is achieved through the co-ordinated action of lips and tongue against
the palate and teeth.

The process is controlled from speech centres in the brain which are mostly on the non-dominant side.
(in left handed 70% will have it on the right side).

6. What are the main centres involved?

a. Broca’s area for articulation: Broca’s area lies in the prefrontal and premotor facial
regions of the cortex, about 95% of the time in the left hemisphere. Skilled motor
patterns for the control of the larynx, lips, mouth, respiratory system and other
accessory muscles involved in speech, are all initiated from this area. Damage of
Broca’s area leads to the person being capable of deciding what he or she wants to
say but they cannot make the vocal system emit words instead of incoherent noises.
This is called motor aphasia.
b. Whernicke’s area for understanding speech: The first stages of speech (the formation
in the mind of thoughts that need to be expressed as well as the choice of words to
be used) involve the functions of the sensory association area of the brain and, in
particular, an area called Wernicke’s area in the posterior part of the superior
temporal gyrus. If Wernicke’s area in the dominant hemisphere (the left hemisphere
for a right-handed person) is damaged or destroyed, the person has what is termed
Wernicke’s aphasia in which they are capable of understanding the spoken or written
word but are unable to interpret the thought that it expresses or formulate the
thoughts that are to be communicated.
c. Facial and laryngeal regions of the motor cortex activate the muscles involved in
articulation, and the cerebellum, basal ganglia and sensory cortex all help to control
the sequences and intensities of muscle contractions. Damage to any of these regions
can cause either partial or total inability to speak distinctly
7. How is the co-ordination of speech and language achieved? through integrated actions
between these centres all working together:
a. the auditory cortex (hearing)
b. visual cortex (sight)
c. hippocampus (memory)

However, several other parts of the brain, such as the cerebellum and the brain stem,
together with sensory feedback, can modify and regulate the descending nerve
impulses to the motor neurones that activate the various muscles involved in speech.
The motor neurones involved are to be found in the brain stem and their axons travel
to the muscles of the vocal apparatus. Speech also depends on the coordination of
the motor neurones in the cervical and thoracic parts of the spinal cord that innervate
the muscles that are involved in breathing.

8. The important nerves involved are:

a. X:
i. External laryngeal nerve branch which provides innervation for the
cricothyroid muscle which controls vocal cord length and tension and the
 crico-pharyneus which acts as a sphincter to keep the oesophagus closed off
except during swallowing.
ii. Recurrent laryngeal nerve supplies the vocalization muscles
b. VII: Facial musculature.

9. What is the classification of consonant sounds based upon place and matter of articulation?
10. What can go wrong with speech?

a. Dysphasia is an older term for impaired ability to speak (because dysphasia is so easily
confused with dysphagia, i.e. difficulty with swallowing, the term aphasia is
preferred).
b. Aphasia: partial and total language impairment caused by brain injury and stroke
c. Dysarthria: impaired articulation commonly caused by neuromuscular problems, e.g.
Bell’s palsy or ill-fitting dentures.

11. Clinical relevance of aphasia: may be one of the earlies signs of a stroke, it will be difficult to
obtain medical and dental history, explain treatment options and obtain valid consent.

12. How dental procedures affect speech?

a. Speech sounds are affected by alteration in the position of the anterior teeth and the
shape of the anterior palate.
i. The ‘th’ sound requires the tip of the tongue to momentarily contact the tip
of the central incisors.
ii. The ‘s’ sound requires the tip of the tongue to spread out against the anterior
palate but leaving a space for air escape.
 iii. The ‘f ’ and ‘v’ sounds are formed by the contact of the tips of the upper
incisors with the lower lip. Loss of anterior teeth particularly affects these ‘f ’
and ‘v’ sounds.

In constructing complete dentures, problems may arise with the shape of the anterior palate
and the position of the incisors. If the palate is too thin it may allow air to escape during speech
and result in a whistling sound. In the same way a large overjet may result in a lisp. A common
lisp is caused by mispronunciation of sibilants such as the ‘s’ sound, which may be pronounced
as a ‘th’ sound with the tongue thrusting between the teeth. Any intra-oral device, denture,
or appliance may affect speech in the short term but usually adaptation occurs within about
a month.

13. Cleft palate: Ideally, all this is prevented by early surgery at 3 months to repair the palatal
defect and allow normal development of speech. The speech and language therapist has a
crucial role in the multidisciplinary team caring for cleft patients and speech should be
formally assessed at 18 months. A common problem is poor contact between the soft palate
and posterior pharynx with incomplete closure of the nasal airway resulting in nasal vocal
intonations and further surgery may be needed to correct this.

14. Why is speech complex? That speech is probably the most complex movement in the body is
indicated by the range of muscles involved, by the great number of nerves implicated and by
the large areas of the cerebral hemispheres of the brain associated with speech. The muscles
involved include those in the chest that control breathing, the intrinsic muscles of the larynx
that are concerned with phonation (i.e., those required to close the rima glottidis between
the vocal cords to put tension in the cords, and to change the shape of the cords), the muscles
in the pharynx and soft palate that help in resonance, and the muscles of the tongue, palate,
jaws and facial musculature that produce meaningful speech. The nerves involved may include
the intercostals and phrenic nerves, the recurrent laryngeal and superior (external) laryngeal
branches of the vagus, nerves associated with the pharyngeal plexus, and the trigeminal, facial
and hypoglossal cranial nerves. The complexity of speech is further indicated by the fact that,
although meaningful speech results from the bringing together of very simple sounds so that
phonemes become syllables become words become whole sentences and concepts, the brain
has to work in the opposite manner, so that whole concepts and ideas, if not entirely coherent
sentences, have to be established before the physiological process of phonation and
articulation. In addition, speech occurs alongside other means of communication – facial
expression, hand movements, body posture – and requires feedback from the person(s) to
whom one is speaking so that visual and auditory signals must be coordinated with speech.
 HEALTH SERVICES

1. NHS: commonly sued to refer the UK’s publicly funded healthcare system, set
up in 1948.
a. In England: NHS England. Responsible to the UK government.
b. In Ireland: Health and Social Care in Northern Ireland (HSC) is
responsible to the Northern Ireland Executive.
c. In Scotland: NHS Scotland. Responsible to the Scottish Government.
d. In Wales: NHS Wales: Responsible to the Welsh Assembly.

The NHS is divided into two sections:

a. Primary care: Front line service and firs point of contact with the NHS
for most people. With the introduction of a National Commissioning
Board they will oversee new GP commissioning groups. The Care
Quality Commission (CQC) is the regulator and each area will have a
patient advocacy group- Healthwatch.
b. Secondary care: Also known as acute healthcare, can be either elective
or emergency care.

2. NICE: The UK government agency (National Institute for Health and Care
excellence) Responsible for deciding which treatment or investigations are
required most commonly and are the most cost effective.

NHS has to be run as cost-effectively as possible to avoid wasting resources

while delivering the best possible care to all patients irrespective of where they
live in the UK>

 In England and Wales: NICE

 In Scotland:
o NHS Quality Improvement Scotland.
o Scottish Intercollegiate Guidelines Network (SIGN)
o Scottish Medicines Consortium.

 In Northern Ireland: The department of health, social services and

public safety (DHSSPS) through its Commissioning Plan.

3. Healthcare-related government agencies and the National Patient Safety

alerting system.

4. The Care Quality Commission and the Care Commission: Independent

regulatory body that regulates and inspect health and social services in
England, the CQC oversees services provided by the National Health Service
(NHS), local authorities, private companies and the voluntary organisations.
 The aim is to ensure better care for everyone in hospital, in a care home and at
home.

In addition to standards set by GDC it is mandatory for dental practices to

register with CQC and comply with its Essential Standards of Quality and Safety
(Standards that outline the ideal outcome patients should experience when
using a service). Each practice will need to be able to demonstrate compliance
with regulations in the following areas:
- Care and welfare of service users
- Assessing and monitoring the quality of provision
- Safeguarding vulnerable service users
- Management of medicines and medical devices.
- Cleanliness and infection control
- Meeting nutritional needs
- Safety and suitability of premises
- Safety, availability and suitability of equipment
- Respecting and involving service suers
- Consent to care and treatment
- Complaints
- Records
- Competence and suitability of workers
- Staffing
- Effective management of workers
- Cooperating with other providers.

5. The health and Social Care act 2012: It is a major coalition government reform
that, in England, put clinicians at the centre of commissioning, freeing up
providers to innovate, empowering patients and giving a new focus to public
health. The provision in the Act were designed to make the NHS more
responsive, efficient and accountable.

The ACT puts clinicians in charge of shaping services with the aim of enabling
NHS funding to be spent more effectively. Supported by the NHS
Commissioning Board, new clinical commissioning groups (CCGs) now directly
commission services for their populations. These replace the former primary
care trusts (PCT’s)

6. Disclosure and Barring Service (DBS) (Formerly the Criminal Records

Bureau): The first rule to healthcare is ‘do no harm’.

In the UK, children and vulnerable people are offered formal protection via
criminal record checks. The criminal records bureau (CRB) and the
independent safeguarding authority (ISA) were merged following passage of
 the Protection of Freedoms Act 2012 to become the Disclosure and Barring
Service (DBS). These disclosure are either:
a. Standard DBS disclosures: Which reveals details of any convictions,
cautions, reprimands, and final warnings that the applicant has received,
regardless of the length of time since the incidents. They also reveal
details of whether that person is banned from working with children or
vulnerable adults (if these details have been requested). The DBS aims
to issue Standard Disclosures within 10 days of receipt of the application.
b. Enhanced DBS disclosures: These disclosures are for positions
involving greater contact with children or vulnerable adults (most health
professionals) and involve an additional check with the police.

7. The National Patient Safety Agency (NPSA): Leads and contributes to

improved, safe patient care in England and Wales. It does this by providing
information, support, and recommendations for safer practice to NHS
organisations. It has three divisions:
a. Reporting and Learning Service: This division aims to improve safety
by enabling NHS organisations to learn from patient safety incidents.
b. National Clinical Assessment Service: Provides confidential services
to help manage any concerns about the performance of healthcare
practitioners.
c. National Research Ethics Service: Protects the safety and dignity of
research participants by promoting ethical research.

8. Complaints: When a patient wishes to complain:

a. The service provider, Care Quality Commission or the Obdusman
for NHS care.
b. The Dental Complaints Service for private care. It is an independent
complains service funded by the GDC to help resolve complains about
private dental care. EPAs were replaced by LPAs in October
2007. However, if you made and signed an EPA before 1 October 2007,
it should still be valid. An EPA covers decisions about your property and
financial affairs, and it comes into effect if you lose mental capacity, or if
you want someone to act on your behalf.
c. The GDC
d. The Health and Safety Executive: The UK National independent
watchdog for work-related health, safety and illness.
e. The Advertising Standards Authority
f. The Office of Fair Trading/Trading Standards Officer.
g. The police.

9. Independent and government organisations in the UK that developed

healthcare guidelines for the use by doctors, dentists and other
healthcare professionals:
a. NICE
 b. SIGN
c. Royal college of Surgeons of England
d. British society for paediatric dentistry
e. British society for disability and oral health.

10. Local dental committees: Set up at the inception of the NHS. They represent
dentists with a General Dental Service contract and may represent dentists
working under a GDC contract or a Primary Dental Services (PDS) agreement.
Represent dentists who are members or who are on NHS performers List.
a. Ensure you are kept up to date with new regional guidance as it becomes
available.
b. Feedback your concerns to the local NHSE team
c. Feedback any local concerns to the BDA.
d. Offer advice if there is anything you need to know about what is
happening locally with dental services.
e. Support you with empathy if you need someone to talk to.
f. Signpost you to help if you are not sure where to turn.

11. The Equality and Human Right Commission (EHRC): Forbid direct or
indirect discrimination in employment, housing and social services. It is illegal
to discriminate by:
a. Refusing or omitting to provide services
b. Offering services of a lesser quality
c. Offering services in different ways or on different terms.

12. Health and Welfare Lasting Power of Attorney: Consent for adults without
capacity. No one can authorise treatment on behalf of an adult unless they are
that person’s named legal attorney under a Health and Welfare Lasting Power
of Attorney that has been lodged with the office of the Public Guardian.

a. Ordinary power of attorney: This covers decisions about your financial

affairs and is valid while you have mental capacity. It is suitable if you
need cover for a temporary period (hospital stay or holiday) or if you find
it hard to get out, or you want someone to act for you.
b. Lasting power of attorney (LPA): An LPA covers decisions about your
financial affairs, or your health and care. It comes into effect if you lose
mental capacity, or if you no longer want to make decisions for yourself.
You would set up an LPA if you want to make sure you're covered in the
future.
c. Enduring power of attorney (EPA): EPAs were replaced by LPAs in
October 2007. However, if you made and signed an EPA before 1
October 2007, it should still be valid. An EPA covers decisions about
your property and financial affairs, and it comes into effect if you lose
mental capacity, or if you want someone to act on your behalf.
Allows a person over the age of 18 to formally appoint one or more people
(attorneys) to look after their health decisions. Where appointed, the attorney
will be the decision-maker oncall matters relating to the patient’s care and
treatment and have a duty of care to the adult on whose behalf they act and to
abide by the general principles of the Mental Capacity Act 2005. To be valid,
an LPA must be registered with the Public Guardian. You must check
registration as an unregistered LPA cannot be used.

Before losing capacity people over 18 years can make advance decisions to
refuse particular medical treatments including dental treatment and explain the
circumstances when the refusal would apply. advanced decisions cannot be
made to request medical treatment. if you treat a patient who is unable to
consent, you must cheque for an advance decision that relates to dentistry;
generally it should be launched with their clinical records or the patient should
carry a card clearly setting out their wishes.

Individuals can make a written and verbal statement about their preferences for
future care treatment. is the individual subsequently loses capacity you must
consider the statement when determining what care and treatment is in the
patients best interest if your professional judgement refers from the patient
stated preferences you should keep a written record of this in the patient's
clinical records.

d. Adults with Incapacity (Scotland) Act 2000. Allows a competent adult

to nominate a person, known as a welfare attorney or proxy to make
medical decision on their behalf. Also provides for a general power to
treat a patient who is unable to consent to treatment in question. It is
Welfare power of Attorney.
e. The mental health (Care and treatment) Scotland Act 2003 Allows for
medical/dental intervention to prevent serious deterioration in patient’s
mental health condition or to prevent the patient from harming
themselves.
f. The mental capacity act (England and Wales) 2005. Central to
treating issues around treating patients over the age of 16 who lack
capacity to consent to treatment.
g. High Court: In Northern Ireland, the care of incapacitated adults is
governed by common law.

Statutory bodies: The following organisations may become involved in

cases of mentally incapacitated adults:
 a. The Court of Protection: Considers mental capacity issues and
decisions about healthcare and treatment. The court can appoint
deputies to have ongoing authority to make decisions for those who lack
capacity.
b. The Office of Public Guardian: Is an agency of the Ministry of Justice
and is responsible for maintaining a register of Lasting Powers of
Attorney. It protects people who lack capacity from abuse.
c. Independent Mental Capacity Advocates (IMCA): Assists those who
lack capacity and who do not have the support of close-family or friends
to help them make important decisions. The IMCA will only be involved
in certain circumstances, for example, if the decision is about serial
medical treatment provided by the NHS or moving to a hospital care
home.

The dental organisations:

d. Dental defence union: Advisory team. The DDU is the specialist

dental division of the MDU. The MDU is led and staffed by doctors and
dentists who have real-life experience of the pressures and challenges
you face every day. To represent the interests of dental professionals by
providing professional indemnity and access to expert dento-legal
advice and assistance.
e. Dental protection Limited:
f. Medical and Defence Union of Scotland (MDDUS):
When a health professional has a significant concern relating to decisions taken
under the authority of a Lasting Power of Attorney (LPA) about serious medical
treatment, the case can be referred for adjudication to the Court of Protection,
which is responsible for the proper functioning of the legislation

13. Caldicott guardian: Oversees access to patient-identifiable information. All

NHS organisations are now required to have a Caldicott guardian and lead
individual to coordinate a programme of work.

14. Advice on inoculation injuries: Get advice from occupational health services
or local hospital accident and emergency department. When local advice is not
available, you should contact your local health protection team.

a. England: Duty doctor at Public Health England.

b. Scotland: Scottish Centre for Infection and Environmental Health
(SCIEH)
c. Wales: Public Health Laboratory
 d. Northern Ireland: Director of Public Health at your local Health and Social
services Board.

15. Investigating Committee (IC): Meets in private and assesses all information
relating to an allegation including the registrant’s response. They can decide to:
a. Take no further action.
b. Issue advice or a warning either privately or public.
c. Retry to Fitness of practice committee.

16. Fitness to practice Committees:

a. The professional performance committee:
b. The health Committee:
c. Professional Conduct Committee (PCC)
BODIES OTHER THAN GDC PARTICULARLY RELEVANT TO DENTISTRY

1. British Dental Association: A national professional association for dentists.

2. British Association of Dental Nurses: National professional association for
dental nurses.
3. Royal College of Surgeons: Professional associations for dentists and DCP’s
which also offer education, examinations, and higher qualifications.
4. Specialty Advisory Committees: Are intercollegiate bodies which advise on
higher specialist training in the dental specialties.