OSCE prep questions

A 25-year-old man attends for review. He has clinical signs of Treacher-Collins syndrome, and the consultant is discussing the first and second pharyngeal arch syndromes. A junior dental student asks which cranial nerve develops with, and goes on to innervate the second pharyngeal arch. Which is the single most appropriate response?

The facial nerve (CN VII)

A 23-year-old woman returns to the surgery 5 days after surgical extraction of her lower right third molar. She reports loss of sensation from the floor of the mouth on the right-hand side. Which single nerve is most likely to have been damaged during her extraction?

The lingual nerve (a branch of CN V3)

A 45-year-old man is receiving an inferior alveolar nerve block for the restoration of a lower right first molar from a dental student, who is administering the injection for the first time. They are using a direct technique (over the contralateral premolar teeth), and their supervisor asks them which single muscle will the needle pass through?

Buccinator

A 18-year old mn is having a cranial nerve assessment performed after a traumatic incident. Upon protrusion of his tongue, the tongue deviates to the left-hand side. Which single nerve has been affected?

Hypoglossal nerve (CN XII)

A 33-year-old woman attends for extraction of the upper left second premolar. The clinical tutor asks the student to anaesthetize the patient using infiltrations prior to the procedure. Which nerves require anaesthetizing?

Middle superior alveolar nerve + greater palatine nerve

A 34-year-old woman requires root canal treatment on an asymptomatic lower left first permanent incisor (LL1), which has two canals. Having been given two buccal infiltrations for anaesthesia, she can still feel pain. Which single nerve is most likely to be providing accessory innervation to the tooth?

Right inferior alveolar

A 15-year-old boy attends your surgery for a routine examination. His upper right permanent canine is yet to erupt. His upper left permanent canine erupted at the appropriate age. At approximately what age would you expect this tooth to have erupted?

10-11

A 14-month-old girl is brought to the surgery y her mother. She is concerned that a gap is present between some of her child’s developing upper teeth. Which teeth would you expect to have erupted in the maxillary arch of this child?

A’s, B’s and D’s

The babysitter of a 4-year-old boy telephones the practice, as the child fell down a staircase and has knocked out his upper right deciduous central incisor. The boy was momentarily unconscious but appears normal now. which is the single most appropriate advice to give to the babysitter over the phone?

Do not re-implant and take the child to the ER

A 3-year-old girl attends, following a recent fall. The crown of the ULA is significantly displaced labially. The tooth is non-mobile. A radiograph confirms the clinical diagnosis of lateral luxation. Which is the single most appropriate treatment

Extract ULA

A 9-year-old girl attends for a single routine restoration with her father. When asked, the father says that he was not married to the child’s mother at birth, but that they subsequently married and that he is named on the birth certificate. Which single most appropriate option for obtaining consent for this procedure

Father only

A 13-year-old girl attends for a routine dental examination, and multiple white spot lesions are noted around the cervical region of the upper and lower incisors. She reports frequent intake of sugary carbonated beverages (2L/day). In this scenario the single most appropriate management to reduce her caries risk

Reducing the frequency of sugar attacks

A 10-year-old girl has marked plaque-induced gingivitis. A ‘simplified BPE’ is performed. This procedure involves assessment of selective teeth termed ‘index teeth’. These teeth include all permanent first molars. Which other teeth are included?

Upper right and lower left permanent central incisors

A subdued 5-year-old boy is seen in the practice. He has multiple injuries on his hands, knees, chin and back of the neck. The parents report that the patient recently feel in the park. Injury to which single region would raise the most suspicion of a non-accidental injury?

Behind the ears

A 7-year-old girl has has a pulpotomy performed on her lower right second primary molar. Which single coronal restoration is considered the most appropriate

PMC

A 7-year-old girl has been referred for extraction of all of her carious primary molars under GA. Extensive OHI and prevention were given to the child and her parents prior to the GA appointment. Which is the single most appropriate future management for this child

3/12 recall with FV and fissure sealants

A 8-year-old boy has occlusal caries in his lower right first permanent molar. He is an irregular attender. Clinically the caries is minimal and confined to the distal section of the fissure system. A bitewing shows the caries extends into the outer third of the dentine. Which is the single most appropriate restorative management strategy for this tooth

PRR

An 8-year-old boy has a routine examination, an the patient’s mother has brought a 3-year-old sibling with no dental experience to observe their first examination. Which is the single most appropriate definition of this non-pharmacological behaviour management strategy.

Live modelling

A 45-year-old man is being reviews, following a course of non-surgical periodontal therapy. His current full mouth plaque score is 15% and he has had a good response to the treatment. Following repeat periodontal indices, he still has a number of isolated probing depths of 5mm, which have reduced from 8mm. Additional recession is present in these areas, varying from 1-2mm. Which single clinical indicator would suggest these sites are stable.

Absence of bleeding on probing

What is the optimum angle for a graceys curette

70 degrees

A 28-year-old man present for a routine examination. He is a smoker but otherwise fit and well. His previous clinical notes report diagnosis of plaque-induced gingivitis. However, following clinical examination today, his diagnosis has changed to generalised stage I grade B periodontitis. Which clinical finding is fundamental in differentiating between these two diagnoses?

Loss of attachment

A 78-year-old man complains of loose teeth. he has not attended the dentist in many years, and a detailed examination reveals:
- Poor plaque control
- Widespread periodontal probing depths of >8mm
- Furcation involvement of a number of teeth
- Generalized horizontal bone loss of up to 70%
He is a smoker of 5/day for 15 years.
What is the most appropriate diagnosis?

Generalised stage IV grade B

A basic examination is performed on a 42-year-old woman. Her oral hygiene is generally good, but generalized recession of 2-3mm is noted. In the upper right posterior sextant, a 2* is recorded. What single meaning does * indicated in the context?

Furcation involvement

A 27-year-old man comes in complaining of loose teeth. He is medically fit and well and has never smoked. He reports rapid development of mobility, affecting all of his lower anterior teeth and lower right first permanent molar. Periapical radiographs provided by his GDP show progression on horizontal bone loss from 20%-50% in the last 12 months. His OH is good and he is aware that his father and paternal grandfather suffered from pyorrhoea. Which single bacteria is most commonly associated with the disease above?

aggregatibacter actinomycetemcomitans

A 56-year-old man has swollen gums. Despite suboptimal OH, the appearance of the gingiva is suggestive of gingival overgrowth. He has controlled Type II diabetes and hypertension which single common medication is most likely to be responsible for this clinical situation?

Amlodipine

A 22-year-old woman has bleeding gums and severe pain around her lower front teeth. She has Type I diabetes and is a heavy smoker. Her gingivae around the lower incisors are acutely tender and inflamed, and there is ulceration, combined with loss of the papilla. No significant probing depths or associated bone loss on the radiographs are noted, but there is an unpleasant odour. Which is the single most likely diagnosis?

Necrotizing gingivits

A 52-year-old man has generalised stage II grade B perio. OH instruction was instigated immediately, along with supra and sub PMPR. Upon 3 month review, he has demonstrated no improvement in oral hygiene and his lack of motivation is apparent; heavy plaque deposits are present on all teeth surfaces. What is the single most appropriate next step in his management

Re-address OHI