SmileWisdom Mock

A 34 year old female patient requires a bridge to replace t heir missing upper left central incisor.  The rest of her teeth are sound and healthy.  On discussion with the dentist, the patient opts for a bridge which requires little or no preparation and; therefore, causes minimal damage to the other teeth.  From the list below which bridge is the dentist likely to provide?

The Professional Conduct Committee of the General Dental Council (GDC) considers whether misconduct amounts to impairment of a registrant’s fitness to practice.  If impairment is found, which one of the following sanctions is outside the GDC’s powers?

A patient is to have an impacted lower  third molar removed under local anaesthesia as a surgical procedure.  Which nerve is most at risk of damage during this procedure?

The General Dental Council (GDC) sets out the ethical and professional principles expected of everyone on their registers.  To which publication would a registered dental nurse  refer to find these principles?

You are worried about a four year old who has attended the surgery (you notice that appears to be cigarette burns on the child’s arm  Which practice policy document would you consul for advice in this situation?

Registered dental nurses are required to comply with the General Dental Council’s (GDC’s) enhanced Continuing Professional Development (CPD) requirements.  Each dental nurse registrant must have a personal development plan and record at least 50 hours of verified CPD (vCPD) over a 5 year cycle.  Which one of the following statements is true in this respect?

A patient is having a root canal treatment carried out.  The dentist has asked you to help protect the patient’s airway.  You will need to assist in protecting the airway by passing which of the following?

A patient attends for the first stage of an endodontic treatment on the upper left  permanent first molar.  The  dentist decides to confirm that the tooth is not vital.  What is the most appropriate option below to confirm tooth vitality?

A 27 year old patient attends the for a new patient examination.  During a Basic Periodontal Examination (BPE) the dentist records scores of 4 in each sextant and diagnoses generalised periodontitis.  Which micro-organism is likely to have caused this?

Zinc oxide and Eugenol (ZOE) materials have many applications in dentistry.  For which one of the following applications would ZOE  be inappropriate?

An adult patient has collapsed in the waiting room of your dental surgery.  The dentist asks you to assist with cardiopulmonary resuscitation (CPR) using the emergency bag -valve- mask apparatus to deliver artificial ventilation (“breaths”).  What is the correct routine/ algorithm  you should adopt?

An elderly patient complains of a sore tongue and numerous mouth ulcers.  The dentist suggests the patient may be anaemic.  Anaemia is diagnosed when erythrocytes contain a low level of the protein necessary to transport oxygen around the body.  What protein is this?

A seven year old patient has a Bluish coloured swelling over an unerupted lower first permanent molar tooth.  The dentist diagnoses an eruption cyst.  What is a cyst?

A female patient is attending for some stitches (sutures) to close a cut on the upper lip.  The dentist administers the local anaesthetic and the patient reports that her upper lip is starting to tingle.  Which nerve will be responsible for this sensation.

A young adult attends as a new patient.  They are unhappy about chalky white areas of mottled enamel on their permanent incisor teeth present since the teeth erupted.  What is the most likely cause?

A patient requires a class IV restoration on the upper left permanent lateral incisor.  Select from the list the Zsigmondy-Palmer notation for this tooth:

Your patient is accompanied into the surgery by a qualified lip speaker who helps he patient to understand what is said during the appointment.  What special care group does this patient most likely belong to?

A patient with xerostomia is at increased risk of developing caries and periodontal disease.  Xerostomia can be caused by radiotherapy and is a side-effect of many drugs.  What is Xerostomia?

You have been asked to change the chemicals in the practice’s automatic X-Ray film processing machine.  There are three tanks and then the drier at the back.  Working from the front (where the unprocessed film is inserted), in what order are the tanks?

A 28 year old female patient presents for her routine dental check-up.  During the intra-oral examination the dentist asks you for the necessary probe to carry out the basic periodontal examination (BPE).  Which probe should you select?

A patient attends for this three monthly scale and polish procedure.  Following the treatment, how should the latch-grip polishing brush be managed?

A patient returns to the surgery with a high spot on the surface of an occlusal amalgam restoration that was placed in a premolar two days ago.  When correcting this, which item is the dentist most likely to ask you for?

During periodontal examination, the dentist will carry out a Basic Periodontal Examination (BPE) charting.  The BPE score 2 specifically indicates which of the following?

A 28 year old patient attends for a routine examination.  The dentist asks you to complete the dental charting.  A large number of restorations are required.  Which of the following risk factors is most likely to be associated with this?

The mandible forms the lower jaw of the oral cavity.  At which point does it articulate with the temporal bone to form the temporomandibular joint?

The dentist extracts several teeth and asks you to check whether an upper molar is one of the teeth that has been extracted.  You are able to answer yes because you know the anatomy of an upper molar.  Which of the teeth in the diagram is the upper molar?

The General Dental Council (GDC) expects dental nurses to be able to ‘give and receive feedback effectively to and from other members of the team’.  What is the most professional way to respond to critical feedback?

The dentist has asked you to deliver oral health advice to the mother of an 8 year old patient.  Using resources may help you to clarify the information you are giving.  A diagram showing Stephan’s Curve may be used to depict the effect of which of the following?

A 28 year old patient with no relevant medical history has just had their lower left first permanent molar tooth removed.  This was a difficult procedure where both roots had to be surgically extracted with bone removal and the placement of several sutures (stitches) after the procedure.  Which one of the following signs and symptoms would be of concern in the days following the extraction, so that the patient should contact the practice or out of hours services if they experience it

Any process that removes, kills or deactivates all forms of life, in particular microorganism such as fungi, bacteria, viruses and spores present on or in a specific surface or object’ is a definition of which important infection control process?

The British Society of Paediatric Dentistry suggests that ‘”the persistent failure to meet a child’s basic oral health needs, is likely to result in the serious impairment of a child’s oral or general health or development” is a safeguarding concern,  Which issue from the list below is this referring to?

In theory, if valid consent is not obtain for a dental procedure and harm occurs to the patient, this could give rise to claim of which offence?

The General Dental Council’s Scope of Practice’ document sets out additional skills for each registrant group.  Registered dental nurses who are trained, competent and indemnified may undertake these additional skills under prescription of other registrants.  Which one of the list is reserved for other registrant groups, and as such must never be carried out by a dental nurse?

Saliva is secreted by the salivary glands and is the watery fluid that is naturally present in the healthy oral cavity.  Which one of the following constituents of saliva acts to start the process of breaking down complex carbohydrates?

Any work related accident or incident which results in a person being absent from work for seven days or more should be reported.  To which one of the following organization must such an accident or incident be reported?

An adult patient attends for a mesial occlusal distal amalgam restoration.  After the treatment, you are asked to dispose of the matrix band.  Which receptacle would you use?

A patient attends for an amalgam restoration of the lower right second premolar.  The dentist removes the caries from the tooth and informs  you that there is a pin-point pulpal exposure.  Which material are you most likely to be asked to prepare?

A 58 year old patient attends the surgery complaining of pain and an ulcer.  The dentist finds that the labial flange of the new partial denture is over extended.  Which item from the list would be most appropriate to select to ease the denture?

During a tooth extraction, your patient starts to experience breathing problems and you fetch the emergency oxygen cylinder.  The cylinder displays the CLP warning symbol shown.  What does this mean?

A patient complains of feeling unwell during treatment.  You notice the face has fallen on one side, they are unable to raise both arms and keep them there and their speech has become slurred.  It is time to dial 999, administer oxygen and monitor the patient until the ambulance arrives.  What medical emergency is this?

Patient taking the medication warfarin may require a blood test prior to dental treatment.  What measurement would this blood test reveal?

According to document HTM 01-05 and is equivalents, when you have worn full Personal Protective Equipment (PPE) to assist with a procedure, which item should be removed first?

A 16 year old patient presents for a routine dental check-up.  On intraoral examination the dentist suspects an interproximal cavity arising at the contact point of the lower left permanent molars.  Which instrument is designed to be used to confirm this diagnosis?

During a routine examination of an 8  old child, caries is identified in the lower first permanent molars.  Select from the option list the type of bacteria most likely to be associated with the onset of dental caries.

Patient is undergoing treatment under inhalation sedation.  There are two different coloured cylinders on the relative analgesia machine.  Identify from the option list the colour of the nitrous oxide cylinder used during this procedure.

The dental therapist is giving an inferior dental nerve block injection.  You have learned that the inferior dental nerve supplies the lower teeth and enters the mandible at the mandibular  foramen.  What structure in front of the mandibular foramen protects the ID nerve from damage?

Patients taking certain drugs may be required to have a pre-treatment blood test to determine their INR.  The International Normalised Ratio (INR) is  a test of the pharmacological effectiveness of which group of drugs?

A 45 year old patient attends for a routine check-up appointment.  The dentist suspects that there may be caries affecting the occlusal and mesial surfaces of  the 6|.  Which radiographic view from the list below would be most appropriate to confirm this diagnosis?

The permanent dentition normally has eight teeth in each quadrant, assuming none are congenitally missing.  Which one of the following options is a tooth that which arrangement of roots are mesiobuccal, distobuccal and palatal?

Several diseases and disorders can affect the structures of the oral cavity so that they cannot perform their normal functions correctly.  Which one of the following options is the term used to describe the condition that causes drooling due to hypersalivation?

The cranium is made up of  eight bony plates that enclose the brain like a helmet and fit together tightly at the coronoid sutures.  Which one of the following options is the bone that  forms the base of the skull?

Many of the bones of the skull contain natural bony openings (foramina/ foramen) to allow the passage of nerves and blood vessels to the  tissues of the head and neck region.  Which one of the following options is the name of the foramen through which the anterior superior alveolar nerve and middle superior alveolar nerve subdivide?

Sodium fluoride is added to dental products to help reduce the risk of dental caries.  Which one of the following options is the recommended level of fluoride (in parts per million – ppm) in fluoride varnish that is applied by the dentist in the dental surgery.

One area considered during an oral health assessment is the occlusion of the patient’s teeth: the way the teeth bite together and whether this is normal or whether a malocclusion is present,  Which one of the following options is the term used during this assessment to describe a malocclusion where the maxilla is further forward than normal?

One area considered during an oral health assessment is the occlusion of the patient’s teeth: the way the teeth bite together and whether this is normal or whether a malocclusion is present,  Which one of the following options is the term used during this assessment where there is a reversed overjet present?

The periodontal tissues are those acting as the supporting structures of the teeth, and they are routinely assessed for signs of disease during an oral health assessment.  A basic periodontal examination (BPE) is carried out initially to identify areas requiring further periodontal investigation.  Which one of the following option is the BPE code that indicates a  crevice up to 3.5 mm and presence of calculus?

Completion of continuing professional development activities is a requirement by the General Dental  Council (GDC) for all registrants.  The previous ’core topics’ are now referred to as ‘highly recommended topics’ and have been identified  by the GDC as relevant to almost all registrant groups. Which one of the following is not a ’highly recommended topic’?

The requirement for the dental team to be appropriately trained and qualified is enshrined in the General Dental Council (GDC) Standards document.  Which one of the following options is the specific core ethical principle of professionalism in this document that deals with raising concerns if patient is at risk?

The human dentition consist of a set of both primary and secondary teeth that have no ability to grow once they are fully formed.  Which  part of the upper permanent first molar is the area where the Cusp of Carabelli is found?

The maxillary sinus also known as Antrum of Highmore is an empty space inside both sides of the maxilla bone.  The following are functions and facts of this sinus with the exception of:

The following is a list of materials used in the construction of dentures. 

For each of the scenarios described below select the ONE most appropriate material.

A 65 year old patient attends the surgery for the first stage in the provision of a partial upper denture.  Which of the materials listed is most likely to be used by the dentist when taking the primary impressions of the patient’s mouth?

A 58 year old patient attends for the occlusal registration (bite) stage in the provision of a complete upper denture.  The laboratory technician has constructed the bite rims from which one of the following materials listed?

A 65 year old patient attends the surgery for the first stage in the provision of a full upper denture.  Which of the materials listed is most likely to be used by the dentist when taking the second impressions of the patient’s mouth using the special trays?

A 65 year old patient is attending for the try-in stage of a complete upper denture.  They are happy with the fit and bite but ask for the teeth to be made a shade lighter.  The dentist indicates this to the technician on the laboratory sheet and asks the technician to return the denture for a retry.  What material are the prosthetic teeth on a denture made from at the try-in (and re-try) stage?

A 50 year old patient has returned for an examination six months after the fitting of a removable partial denture.  The patient is adamant that their oral hygiene measures are thorough, yet there is significant accumulation of plaque where the denture abuts the natural  teeth.  What is the most appropriate item in the list that would help the patient to see the plaque that is accumulating?

A fully dentate elderly patient has osteoarthritis, which has caused a mobility impairment.  The patient’s manual dexterity has declined so that brushing their teeth effectively using a manual toothbrush has become very difficult for them.   What is the most appropriate item in the list that this patient could use to improve plaque removal?

The dentist is about to prescribe an antifungal agent for a patient with oral thrush but first double checks that the patient is not taking warfarin.  They are not, so miconazole oral gel is prescribed as an antifungal agent.  Which microorganism in the list is susceptible to the effects of miconazole?

A 22 year old patient attends the surgery complaining of soreness at gingival level and halitosis.  On clinical examination the dentist can see the interdental papilla is  ulcerated and necrotic. Patient is diagnosed with ANUG.  Which microorganism in the list is the found in ANUG?

Squamous cell carcinoma is the most common oral cancer which is within the 10 most common cancers worldwide.  Its main signs and symptoms can be from an ulcer that does not heal in three weeks, pain when swallowing and the presence of a lump in the neck.  Which microorganism has been found in oral cancer ulcers?

Lead-in Statement:

For each of the following situations described, select the ONE most appropriate aspect of communication from the option list.

 Following the surgical extraction of the upper left first molar tooth, the dentist asks you to give verbal post-operative instructions to the patient.  You go over the main points verbally.  But the patient is keen to leave and isn’t listening properly.  Which one of the options is the most appropriate additional communication method you should use?

The dentist is explaining to the patient that they will require a tooth extraction and denture.  You notice that throughout the discussion the patient has their arms folded and legs crossed and that they are leaning away from the dentist.  After the discussion the dentist asks you to make the patient another appointment.  You are not surprised when the patient tells you they  do not want another appointment and are going elsewhere for a second opinion.  What type of communication was the patient exhibiting during the discussion with the dentist?

Lead-in Statement:

A patient attends for an examination and a charting of their dental health is recorded as follows.

For each treatment described, select the ONE most appropriate answer from the option list.

Each option may be used once, more than once, or not at all.

The patient is experiencing severe pain which commenced approximately four days following the extraction of a tooth.  Th dentist has diagnosed alveolar osteitis.  Which area is the dentist referring to?

The patient has attended the surgery with pericoronitis.  The patient complains of soreness around a partially erupted tooth.  The dentist decides to irrigate this area.  Which tooth requires irrigating?

Lead-in Statement:

A patient attends for an examination and a charting of their dental health is recorded as follows.

For each treatment described, select the ONE most appropriate answer from the option list.

Each option may be used once, more than once, or not at all

The patient has been experiencing pain for some time and the dentist decides to take a radiograph of the tooth which is due to be extracted.  Which tooth is to be x-rayed?

The dentist calls you in the dental surgery so that you can see how well the patient’s tooth-coloured crown matches the rest of the dentition.  You agree that the tooth looks very natural; it is very difficult to tell it has been crown, even up close.  Which tooth is the dentist showing you?

Lead-in Statement

For each situation described, select the ONE most appropriate FDI notation from the option list.

Each option may be used once, more than once, or not at all.

A patient attends the surgery complaining of pain the lower incisor region.  During examination the dentist observes swelling and a periapical radiograph confirms the presence of an acute periapical abscess.  The dentist suggests that root canal therapy is required on the patient’s lower right permanent central incisor.  From the option list, identify the correct FDI notation for this tooth.

A patient attends for a routine dental examination and tells the dentist that they are experiencing pain the upper left quadrant.  On inspection, the dentist sees that the upper left first premolar is carious.  What FDI notation would you use to chart this tooth?

An adult patient attends for a clinical examination and it is noted that the upper right deciduous canine is retained.  From the option list, identify the correct FDI notation for this tooth.

A child attends for their regular dental examination complaining of a mobile tooth.  Upon examination the dentist notes that the lower left primary (deciduous) first molar is mobile and will soon exfoliate.  From the option list, identify the correct FDI notation for this tooth.

Lead-in Statement

For each situation described, select the ONE most appropriate disease from the option list.

Each option may be used once, more than once, or not at all.

Patient M has large amalgam fillings and attends the surgery with a tongue piercing which has an over-length bar.  Patient M tells you that the piercing was placed a year ago.  Patient M has a habit of tapping the metal ball against their molar teeth with their tongue and of chewing the bar.  The dentist advises Patient M to have the bar changed to a shorter version and to replace the metal ball with a plastic ball.  The dentist is giving this advice to try to prevent the patient from experiencing tooth surface loss.  Which type of tooth surface loss is caused by contact of an external frictional force with a tooth surface – in this case the metal bar rubbing on the tooth surfaces?

There is another reason why the dentist has advised Patient M to replace the metal ball on the end of the tongue piercing with a plastic ball.  If the patient bites on to the metal ball what sudden dental problem may occur?

A patient is attending for an apicectomy on the upper left central incisor.  Following administration of the local anaesthetic, the dentist needs to make an incision in the upper gingiva to produce a flap.  Which instrument would you select or the dentist to make this incision?

The dentist has just surgically removed the lower left third molar tooth and is placing a suture.  You are asked to pass the instrument designed to grasp the soft tissue flap and hold it steady whilst the suture is inserted.  Which instrument will you pass which is designed to grasp the flap?

Lead-in Statement

For each situation described, select the ONE most appropriate disease from the option list.

Each option may be used once, more than once, or not at all.

The teeth are held in their sockets by the supporting structures of the periodontium – the alveolar bone, the periodontal ligament and the gingivae.  Which one of the options listed is the cell type that produces the alveolar bone of the jaws?

Teeth are made up of several different tissue layers that are laid down by various cell types during tooth development.  Which one of the options listed is the name of the tissue that covers the full surface of the root only, in a healthy tooth?

A normal healthy tooth is made up of different layers of specialized tissues which begin development before birth.  Which one of the options listed is the tissue layer that contains no nerve ending and cannot feel sensation?

A normal healthy tooth is made up of different layers of specialized tissues which begin development before birth.  Which one of the options listed is the tissue layer that contains 80% of inorganic tissue, mainly calcium hydroxyapatite crystals?

Because of Health and Safety (Sharp Instruments in Healthcare) regulations 2013 the practice has changed from using conventional dental local anaesthetic syringes to the safety type so that re-sheathing is no longer necessary.  Dentist A routinely re-covers the local anaesthetic (LA) needle with the safety guard after use but Dentist B leaves the needle exposed on the treatment tray.  You are concerned that Dentist B’s actions increase the risk of a sharps injury occurring.  Who would it be appropriate for you to speak to about this concern in the first instance?

Dentist A always wears safety glasses during treatment sessions but Dentist B rarely does.  You are concerned about this because it increases Dentist B’s risk of catching an infection throught the cornea of the eye or suffering eye damage.  Who would it be best to discuss this concern with in the first instance?

Theme: Medical Emergencies

Lead- In Statement: For each of the 5 scenarios described, select the ONE most appropriate answer form the option list

Each options may be used once, more than once or not at all.

You are assisting the dentist to carry out a routine scale and polish on a 39 year old patient.  With little warning, the patient becomes rigid and then their limbs start shaking and jerking violently.  What is the most likely medical emergency?

You are assisting the dentist during a restoration on a 49 year old patient.  The patient begins to stutter and is not behaving as they normally do.  The dentist asks you to retrieve the glucometer as they believe the patient is suffering from low blood sugar and is diabetic.  What medical emergency may be confirmed using this machine?

A patient is suddenly taken ill in the waiting room.  They complain of pain in their left arm and crushing pain in the chest.  You observe that they patient is having difficulty breathing, has cyanosed lips and their skin has become gray in colour.  What medical emergency is this patient likely to be suffering from?

A middle-aged patient has collapsed in the corridor and you are called to help.  When you examine the patient you discover that there is no pulse, capillary refill does not occur following pressure on the skin, indicating no circulation, and the patient is not breathing.  What is the most likely medical emergency?

Patient P is a regular attender whose last visit was six months ago, when endodontic treatment was carried out under rubber dam without incident.  When updating Patient P’s medical history, they mention that when they recently put on some rubber gloves to do the washing up their hands became red and itchy, then their face and neck began to swell up and turned red and they were struggling to breather.  Patient P explains that when this happened they were taken to hospital urgently where they were given oxygen and an injection.  Patient P is now undergoing tests because the doctor thinks they have become allergic to latex.   Which medical emergency did Patient P most likely experience?

Theme: GDC Standards

Lead- In Statement: For each of the  scenarios described, select the ONE most appropriate answer form the option list

Each options may be used once, more than once or not at all.

You must make sure the patients (or their representative) understand the decision they are being asked to make.  This applies whether you are the first member of your team to see the patient or whether you are involved after other team members have already seen them. 

You must only release patients’ information without their permission in exceptional circumstances.  You must understand and meet your responsibilities in relation to patient information in line with current legislation.   You must follow appropriate national advice on retaining, storing and disposing of patient records.

You must act promptly if patients or colleagues are at risk and take measures to protect them.  You should not have to prove your concern for it to be investigated.  If the investigation shows that there was no problem, the fact that you raised the concern should not be held against you as long as you were justified in raising the concern.

You must find out about laws and regulations that affect your work and follow them.  You must maintain appropriate boundaries in the relationships you have with patients.  You must not take advantage of your position as a dental professional in your relationships with patients.

Theme: Health and Safety

Lead- In Statement: For each of the  scenarios described, select the ONE most appropriate answer form the option list

Each options may be used once, more than once or not at all.

It is the law which seeks the welfare of all person while on the premises of the dental workplace and it is both an employer’s and an employee’s responsibility, at all times.  Many safety issues are simple a matter of common sense and not taking unnecessary risks, but some issues have legislation and regulation in place too.  Which one of the options listed is the legislation for ensuring the welfare of each and every individual while on the premises?

The provision of dental treatment in the surgery involves the effective use of specialist           equipment, instruments and materials.  Some of the materials used can be harmful to both patients and staff if they are handled or stored incorrectly.  Which of the options listed is the legislation that provides guidance on the health hazards associated with these materials?