ADC - Australian Dental Council Minor Oral Surgery Questions and Answers

Question 1

A 65-year-old patient on long-term warfarin therapy for atrial fibrillation requires a simple extraction of tooth 36.
His recent INR reading is 2.8.
According to Australian Therapeutic Guidelines, what is the most appropriate management plan?

Accepted Answer

Proceed with the extraction using effective local haemostatic measures.

Answer

Defer the extraction and advise the patient to cease warfarin for 3 days prior.

Answer

Refer the patient to a hospital for the extraction under general anaesthesia.

Answer

Ask the patient to halve their warfarin dose for 24 hours before the procedure.

Question 2

A patient presents 3 days after the extraction of tooth 46 with severe, radiating pain and a foul taste. Clinical examination reveals an empty socket with exposed, sensitive bone. What is the primary goal in the management of this alveolar osteitis (dry socket)?

Accepted Answer

To provide symptomatic relief of pain while healing by secondary intention occurs.

Answer

To surgically debride the socket walls to induce fresh bleeding.

Answer

To prescribe a course of broad-spectrum systemic antibiotics.

Answer

To place a bone graft into the socket to accelerate tissue regeneration.

Question 3

During the extraction of a maxillary first molar (tooth 16), you suspect a small oroantral communication (OAC) of approximately 2mm has been created. There is no pre-existing sinus pathology. What is the most appropriate immediate management?

Accepted Answer

Promote and protect the blood clot with a haemostatic agent and a figure-of-eight suture.

Answer

Immediately refer the patient to an oral and maxillofacial surgeon for a buccal advancement flap.

Answer

Leave the socket open to drain and provide strict sinus precautions.

Answer

Prescribe a one-week course of antibiotics and nasal decongestants as the sole management.

Question 4

A 22-year-old patient presents with severe pain, trismus, and swelling associated with a partially erupted tooth 38. There is purulent discharge from under the operculum. Which of the following is the most appropriate initial management for this acute pericoronitis?

Accepted Answer

Gentle irrigation under the operculum and debridement, with antibiotics reserved for systemic signs.

Answer

Immediate surgical extraction of tooth 38 to remove the definitive cause.

Answer

Incision and drainage of the operculum without local anaesthesia to avoid spread of infection.

Answer

Prescribing a course of analgesics only and reviewing the patient in one week.

Question 5

A dentist identifies a 1.5 cm, indurated, non-healing ulcer on the lateral border of the tongue of a 60-year-old male smoker. The lesion is suspicious for malignancy. Which of the following is the most appropriate diagnostic step?

Accepted Answer

Perform an incisional biopsy taking a wedge of tissue from the lesion's border.

Answer

Perform an excisional biopsy to remove the entire lesion and a 2mm margin.

Answer

Use a cytological brush to scrape cells from the surface for analysis.

Answer

Review the patient in two weeks to see if the lesion has resolved on its own.

Question 6

Which of the following is a fundamental principle for designing a full-thickness mucoperiosteal flap for a surgical extraction?

Accepted Answer

The flap must be wide enough to allow for tension-free retraction and good visibility.

Answer

The base of the flap should be narrower than the free margin to minimise bleeding.

Answer

Releasing incisions, if used, should be placed over the mid-buccal of adjacent teeth.

Answer

The periosteum should be carefully left attached to the bone to accelerate healing.