a) Four causes of candidosis
- Prolonged use of broad-spectrum antibiotics
- Long term corticosteroid use
- Immunocompromised
- Diabetes
- Immunosuppressed
- Poorly fitting dentures
b)Name the organisation and virulence factor responsible for candidiasis
- C. Albicans
- Hyphae
c)What are the stages of biofilm formation
- Adhesion
- Colonisation
- Accumulation
- Complex community
- Dispersal
d) How would you test for this organism and suggest a lab identification method
- Swab/ oral rinse
- PCR for C. Albicans DNA and if positive present
Next gene sequencing
a) What is the gold standard study design method
- Systematic Review (and meta-analysis) of RCTs
e) Give the method of action for fluconazole and nystatin
Flucanzole= Affect the ergoserol and inhibit it to be synthesised leading to destabalising of cell membrane
Nystatin(polyene)=They bind to ergosterol in the cell membrane directly and lead to cell death
f) Name 3 other study designs and explain them
- Case control study: Takes a group of people with the disease and a group without and looks retrospectively at risk factor exposure
- Cohort Study: Take a group of people measure their exposure to risks following up after a period of time
- Cross sectional study: Take a group of people at a set point in time and determine their prior exposure to risks and current health status
a) Draw an audit flow chart
Plan for audit → Select criteria → Measure performance → Make improvements → Sustain improvements
b) What are the principles of waste disposal
- Segregation of waste
- Safe handling of sharps
- Safe storage of waste
- Use of appropriate disposal pathways
- Documentation
c) Name 3 regulations for waste disposal. (3 marks)
- Hazardous waste directive (2011)
- Health and safety at work act (1974)
- Environmental protection act (1990)
e) Name one agent that can be used to clean blood spillages (1 mark)
f) What concentration would they be used at and what is the active agent (2 marks)
- Sodium hypochlorite
- 10,000ppm
- Chloride
c) Short and long term consequences of overhanging restorations
- Food may become trapped between teeth
- Overhang acts as a plague retentive factor
- Secondary caries
- Gingivitis
- Food trap
- Difficulty cleaning
- Microleakage
b)Two reasons for mesial overhang of restoration of 46 + 47. (2 marks
-Poor adaptation of matrix band
-Excessive force used when condensing amalgam
two methods to correct overhang and preferred method
- By retreatment - replace restoration. Use wedges to ensure well adapted.
- Finishing strips interproximal
- Preferably replace restoration
a) Patient presents with EDP# and exposed RTC give 5 functions of a provisional restoration in this scenario (5 marks)
- Provide coronal seal for RCT
- Provides aesthetics
- Improve speech
- Improve masticatory function
- Maintain space
- Allow for optimum home care OH
b) Name three types of prefabricated crowns
- Polycarbonate
- Clear plastic crown filled with composite
- Preformed malleable composite crowns
a) How would you manage an ED# in an 8 year old boy. (2 marks
-Assess for soft tissue damage
-If patient has fragments rebond to tooth or place composite bandage
-Sensibility testing
-Definitive restoration
c) Four things included on trauma stamp. (4 marks
- Sinus
- Tender to percussion
- ECL
- EPT
- Mobility
- Colour
- Radiograph
- Percussion note
b) Explain the pattern of distribution seen in nursing bottle caries
- Nursing position of tongue protects lower incisors
- Upper incisors experience cariogenic environment due to bottle top resting against palate
- Upper incisors experience greater level of caries due to earlier eruption and therefore longer exposure
- If habit persist other present teeth will be affected
- Mainly upper anterior and upper/lower molars
c) Explain four causes of nursing bottle caries. (2 marks)
-Young children being given high sugar drinks
-Young children being given acidic drinks
-Children being put to bed with a nursing bottle
-Use of a bottle instead of feeding cup from 6 months
b) List four signs of late stage dementia. (2 marks)
- Inability to recognise familiar people
- Physical frailty
- Difficulty eating
- Incontinence
c) Name two cognitive tests for dementia. (2 marks)
Mini mental state examination (MMSE)
Blessed dementia scale
d) Three ways a dental practice can be made dementia friendly. (3 marks)
- Reception desk visible from the entrance
- Walls a different colour from floor
- Doors to staff only rooms should be same colour as walls
- Ensure there is good levels of natural lighting
a) What are the causes of malocclusion locally? (2 marks)
- Variation in tooth number
- Variation in tooth size or form
- Abnormalities of tooth position
- Soft tissue abnormalities
- Local pathology
