Candidate Guide

Question 1

True or false… pit and fissure occlusal, lingual, buccal, or facial restorations are not to be included unless there is an obvious cavitation on the photographs and/or radiolucency on the radiographs, or tactile evidence of caries is noted in the “clinical findings” section of the patient record.

Answer 1

True

Question 2

True or false… candidates must specify the material to be used for the restoration.

Answer 2

False. Howeve,r they must specify whether the restoration will be a direct or indirect restoration

Question 3

True or false… bases, build-ups, pins, and posts need not be specified in the treatment plan

Answer 3

True, they do not need to be specified. Direct or indirect is good enough

Question 4

True or false… OHI should be listed on the treatment plan

Answer 4

False.. it is assumed that OHI will be provided for every patient

Question 5

True or false… topical fluoride application is assumed in conjunction with dental prophylaxis.

Answer 5

False. Topical fluoride application is not included in the definition of dental prophylaxis. Therefore, if indicated, fluoride should be listed seperately.

Question 6

Following submission of the treatment plan, additional questions or tasks related to the case are presented. The first case will have ___ items. The second case will have ___. The third case will have___ items.

Answer 6

4-5

7-8

4-5

Question 7

True or false… answers to the supplemental questions should be answered in complete sentences

Answer 7

False. It is not necessary

Question 8

What is the definition of a critical error in the CTP exam?

Answer 8

Critical errors are those likely to cause life-threatening harm or severe morbidity that may require hospitalization

Question 9

What are some examples of critical errors?

Answer 9

Prescribing medications contrary to patient medical history and/or dosages exceeding safe guidelines

Question 10

What are the AAPD guidelines for maximum dosage for lidocaine?

Answer 10

2mg/lb

4.4 mg/kg

Question 11

how do you convert lbs to kg?

Answer 11

Lbs x 2.2

Question 12

What is the maximum dosage for mepivicaine (carbocaine)?

Answer 12

2 mg/lb

4.4 mg/kg

Question 13

What is the maximum total dosage for lidocaine and mepivicaine?

Answer 13

300mg

Question 14

What is the maximum dosage for articaine?

Answer 14

3.2mg/lb

7mg/kg

Question 15

What is the maximum total dosage for articaine?

Answer 15

500mg

Question 16

What is the maximum dosage for prilocaine?

Answer 16

2.7mg/lb

6mg/kg

Question 17

What is the maximum total dosage for prilocaine?

Answer 17

400mg

Question 18

What is the maximum dosage for bupivicaine? (Marcaine)

Answer 18

0. 6mg/lb

1. 3 mg/kg

Question 19

What is the maximum total dosage for bupivicaine?

Answer 19

90mg

Question 20

Define caries for CTP

Answer 20

Caries has definitive resistance to the perpendicular withdrawal of the explorer and may have a dry leathery apperance

Question 21

Define prophy for CTP

Answer 21

Removal of plaque, calculus, and stains, to control local irritation factors and frequently involves scaling of coronal and subgingival surfaces of the teeth

***application of fluoride is NOT included in the definition of dental prophylaxis

Question 22

How should periodontal treatment be stated? Give an example

Answer 22

By quadrant, including the number of teeth.

S/RP 4 quads of 4 or more teeth

Prophylaxis, S/RP: UR and LL 1-3 teeth

Prophylaxis, S/RP: UL 4 or more teeth

Question 23

A decision to treat perio should be based on ___, ___, and ____. What are the requirements for SRP?

Answer 23

CAL (clinical attachment loss)
Periodontal pocket depth (PD)
BOP

Teeth having CAL with pocket depths of 5 or greater

Or…..

Teeth having CAL with pocket depths 4 or greater WITH BOP

Question 24

Define periodontal “good”prognosis

Answer 24

Involves one or more of the following:
Health or slight CAL, adequate periodontal support, no mobility, no furcation involvement, and control of etiological factors to assure the tooth would be relatively easy to maintain, assuming full patient compliance

Question 25

Define “fair” periodontal prognosis

Answer 25

Involves one or more of the following: CAL to the point that the tooth could not be considered to have a good prognosis, which would include slight or moderate CAL and/or Class 1 mobility or furcation involvement. The location and depth of the furcation would allow proper maintenance with full patient compliance

Question 26

Define periodontal “poor” prognosis

Answer 26

Involves one or more of the following: severe CAL resulting in a poor crown to root ratio, poor root form, class 2 furcations not easily accessible to maintain, or class 3 furcations, class 2 or 3 mobility, significant root proximity

Question 27

Define “hopeless” perio prognosis

Answer 27

Involves one or more of the factors listed in poor prognosis with inadequate attachment to maintain the tooth in health, comfort, and function. Extraction is suggested, as active periodontal therapy (non-surgical or surgical) is unlikely to improve the current status of the tooth

Question 28

What is the antibiotic prophylaxis for an adult?

Answer 28

2 grams amoxicillin 30-60 minutes before procedure

Question 29

What is the antibiotic prophylaxis for children?

Answer 29

50mg per kilogram

Question 30

What is the antibiotic prophylaxis regimen for an adult who cannot take oral medication?

Answer 30

2g ampicillin IM or IV 50mg/kg IM or IV for children

Question 31

What is the antibiotic prophylaxis for an adult allergic to penicillins?

Answer 31

600mg clindamycin

Question 32

What is the antibiotic prophylaxis protocol for children allergic to penicillins?

Answer 32

20mg/kg clindamycin

Question 33

Name 4 cardiac conditions that require antibiotic prophylaxis

Answer 33

Prosthetic cardiac valve Previous infective endocarditis Congenital heart disease Cardiac transplantation recipients who develop cardiac valvuopathy

Question 34

True or false... as of 2015 (updated for CTP), the ADA guideline states “in general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infections”

Answer 34

True But, patients with a history of complications associated with their joint replacement surgery wo are undergoing dental procedures that include gingival or mucosal incision, prophylactic antibiotics should only be considered after consultation with the patient and orthopedic surgeon.

Question 35

For a simple tooth extraction, for patients on warfarin, treatment can be safely performed without high risk of bleeding, providing that the INR is equal to or less than ___ on the day of extraction

Answer 35

3.5

Question 36

What is the prescription for acetaminophen for adults and children 12 and older?

Answer 36

500mg every 4-6 hours | Maximum 4 grams per 24 hours

Question 37

What is the prescription for acetaminophen for children under the age of 12?

Answer 37

10mg/kg/dose every 4-6 hours | Max 75mg/kg/24 hours

Question 38

What is the prescription for ibuprofen for children less than 50kg?

Answer 38

10mg/kg/dose every 6-8 hours | Maximum single dose 400mg: 40mg/kg/24hours

Question 39

What is the prescription for children 12 or older for ibuprofen?

Answer 39

200mg every 4-6 hours (max 1.2grams/24 hours)

Question 40

What is the the prescription for ibuprofen for adults?

Answer 40

200-400mg/dose every 4-6hours | Max = 1.2g/24hours

Question 41

True or false... codeine and other opioid analgesics are not recommended for children by the AAP

Answer 41

True, it is NOT recommended

Question 42

What is the prescription for amoxicillin for children < 40kg?

Answer 42

20-40mg/kg/day in divided doses every 8 hours | Max 500mg/dose

Question 43

What is the prescription for amoxicillin for adults?

Answer 43

500mg every 8 hours

Question 44

What is the prescription for clindamycin for children?

Answer 44

8-20 mg/kg/day in 3-4 divided doses as hydrochloride (20mg/kg/day in 4 divided doses) Or 8-25mg/kg/day in 3-4 divided doses as palmitate

Question 45

What is the prescription for clindamycin for adults?

Answer 45

150-450mg every 6 hours (maximum 1.8g day) | 300mg every 6 hours

Question 46

What is the prescription for topical nystatin for angular cheilitis?

Answer 46

Ointment (100,000 units/g) For all ages: apply a thin layer to angles of mouth 4 times/day for 14 days or until complete healing

Question 47

What is the prescription for topical/transmucsoal agent for oral candidiasis? (Clotrimazole)

Answer 47

Lozenge 10mg (Do not use for patients under 3 years of age) Dissolve one troche 5 times a day for 14 days

Question 48

What is the nystatin topical prescription for oral candidiasis for infants (children under 3)

Answer 48

Suspension (100,000 units mL) 200,000-400,000 (2-4 mL) 4times/day; 1/2 of dose placed in each side of mouth

Question 49

What is the prescription for systemic acyclovir for primary herpetic gingivostomatitis? Children and adult

Answer 49

Children = 15mg/kg 5 times/day for 7 days Adults 400 mg 3-5times/day for 10 days

Question 50

What is the prescription for systemic agent for herpes labialis? Children and adults

Answer 50

Acyclovir Children 20mg/kg/dose 4 times/day 5 days (maximum 400mg/dose) Adults 400mg 3 times/day for 5 days

Question 51

What is the prescription for topical acyclovir for herpes labialis?

Answer 51

Acyclovir cream 5% Children over 12 and adults. Apply a thin layer on the lesion 5 times daily for 4 days

Question 52

What is the prescription for docosanol (abreva)?

Answer 52

Cream 10% Children over 12 and adults Apply a thin layer on the lesion 5 times a day for up to 10 days

Question 53

What is the prescription for chlorhexidine gluconate?

Answer 53

Dental solution 0.12% Children 8 and up and adults Rinse with 15 ml 2 times/day

Question 54

What is the prescription for topical corticosteroids for apthous ulcers?

Answer 54

Dexamethasone Form = elixir Adolescents and adults: rinse with 5ml 4 times/day for 2 minutes and expectorate. Do not exceed 7 day course

Question 55

You estimate a patient requiring amoxicillin prophylaxis requires 3-4 dental appointments. Write the prescription.

Answer 55

Amoxicllin 500mg tabs 16 capsules Take 4 tabs one hour prior to appointment

Question 56

What is the eruption phone number for maxillary teeth?

Answer 56

781-0062

Question 57

What is the eruption phone number for mandibular teeth?

Answer 57

679-0160

Question 58

Fluoride level of drinking water < 0.3PPM. Child is less than 6 months old. What is the recommended fluoride supplementation?

Answer 58

None

Question 59

Fluoride level of drinking water < 0.3PPM. Child is 6 months - 3 years old. What is the recommended fluoride supplementation?

Answer 59

0.25mg daily

Question 60

Fluoride level of drinking water < 0.3PPM. Child 3 years - 6 years old. What is the recommended fluoride supplementation?

Answer 60

0.5mg daily

Question 61

Fluoride level of drinking water < 0.3PPM. Child is 6 years to 16 years old. What is the recommended fluoride supplementation?

Answer 61

1mg daily

Question 62

Fluoride level of drinking water 0.3-0.6PPM. Child is less than 6 months old. What is the recommended fluoride supplementation?

Answer 62

None

Question 63

Fluoride level of drinking water 0.3-0.6PPM. Child is 6 months - 3 years old. What is the recommended fluoride supplementation?

Answer 63

None

Question 64

Fluoride level of drinking water 0.3-0.6PPM. Child is 3 years - 6 years old. What is the recommended fluoride supplementation?

Answer 64

0.25mg daily

Question 65

Fluoride level of drinking water 0.3-0.6PPM. Child is 6 years - 16 years old. What is the recommended fluoride supplementation?

Answer 65

0.5mg daily

Question 66

Fluoride level of drinking water is over 0.6PPM. What is the recommended fluoride supplementation for any age?

Answer 66

No supplementation

Question 67

When is azithromycin prescribed?

Answer 67

When patient is allergic to penicillins and clindamycin doesn’t work well.

Question 68

What is the typical dosage for azithromycin?

Answer 68

500mg every 24 hours for 3 days

Question 69

What is the eruption pattern for primary maxillary teeth? (In months)

Answer 69

``` 8 9 16 13 25 ```

Question 70

What is the eruption pattern for mandibular teeth in months?

Answer 70

``` 6 10 17 14 23 ```

Question 71

Pre diabetes has an HbA1C of what range?

Answer 71

5.7-6.3

Question 72

Diabetes is classified as an HbA1C of ___ and above. Anything over ___ is dangerous

Answer 72

6. 4 | 7. 6

Question 73

What do you prescribe a patient who is allergic to penicillins and is unable to take oral medication?

Answer 73

Clindamycin 600mg IM or IV

Question 74

If bone is to be manipulated and the patient is taking PO bisphosphonates, what should you do?

Answer 74

Obtain informed consent

Question 75

If bone is to be manipulated and patient is on IV bisphosphonates, what should you do?

Answer 75

Bone manipulation is to be avoided. Refer to OS if BRONJ is suspected

Question 76

Which anesthetic is the best to use if the patient is pregnant? Which class is it?

Answer 76

Lidocaine (category B)

Question 77

True or false... NO2 should be avoided in preganancy

Answer 77

True, especially avoid in first 2 trimesters

Question 78

True or false... aspirin and ibuprofen should be avoided in pregnancy

Answer 78

True. Stick to acetomenophen

Question 79

In patients with pace makers, what should you avoid?

Answer 79

Electronic pulp testers Apex locators Ultrasonic Electrosurgery Local anesthetics with epi

Question 80

How much epi is in a 1/200,000 cartridge?

Answer 80

0.009

Question 81

How much epi is in a 1/100,000 cartridge?

Answer 81

0.018mg

Question 82

How much epi is in a 1/50,000 cartridge?

Answer 82

0.036mg

Question 83

What class of drugs are the following? Warfarin Dabigatran Heparin Xeralto

Answer 83

Antiplatelet/anticoagulant

Question 84

Name 6 contraindications to vasoconstrictors (epi)

Answer 84

- Heart diseases (unstable angina, recent myocardial infarction, recent coronary bypass surgery, refractory arrhythmias, uncontrolled congestive heart failure, uncontrolled severe hypertension) - uncontrolled hyperthyroidism - uncontrolled diabetes - sulphite allergies - steroid-dependent asthma - pheochromocytoma Moderate to severe asthma

Question 85

Name some examples when you should take precautions in using epi.

Answer 85

Patients taking tricyclic antidepressants Pts taking phenothiazine compounds Pts taking monoamine oxidase inhibitors Pts taking beta-blockers Cocaine abusers Pts taking digioxin General anesthesia with halothane

Question 86

Define stage 1 hypertension

Answer 86

130-139 Over 80-89

Question 87

Define stage 2 hypertension (severe)

Answer 87

140 or higher Over 90 or higher

Question 88

In what case is it considered a hypertensive crisis?

Answer 88

>180 and/or over >120

Question 89

What drug may be used to give to an epileptic patient undergoing a prolonged seizure?

Answer 89

Midazolam 5 minutes or longer or 3 or more seizures in an hour

Question 90

What are some treatment modifications for patients on dialysis?

Answer 90

Best time for dental treatment is the day after dialysis (not day of due to anticoagulants given during dialysis) Don’t take blood pressure on same arm with the shunt Consult with physician about antibiotic prophylaxis

Question 91

What drug type is Norco and Lortab?

Answer 91

Hydrocodone

Question 92

What is the dosing for hydrocodone?

Answer 92

5mg every 6 hours for 24 - 48 hours