AGD Clinical Skills & Patient Care in General Dentistry 5 — Questions and Answers
Question 1: A dentist notes a 4 mm × 4 mm white patch on the lateral border of the tongue that cannot be wiped off. It has been present for 3 months. The most appropriate initial management is:
- Prescribe antifungal therapy and recheck in 2 weeks
- Reassure the patient and recheck in 12 months
- Incisional biopsy for histopathologic evaluation (Correct answer)
- Apply topical corticosteroids and recheck in 1 month
Correct answer: Incisional biopsy for histopathologic evaluation
A persistent white lesion that cannot be wiped off and does not resolve within 2–3 weeks requires biopsy to rule out dysplasia or malignancy.
Question 2: Which principle of tooth preparation MOST directly prevents a full-coverage crown from rotating on the prepared tooth?
- Retention form
- Resistance form (Correct answer)
- Structural durability
- Marginal integrity
Correct answer: Resistance form
Resistance form prevents displacement of the restoration from oblique or lateral forces, including rotation, through features like flat occlusal planes and auxiliary grooves.
Question 3: A patient using a bisphosphonate for osteoporosis requires extraction of a mandibular molar. The MOST important factor in assessing risk for medication-related osteonecrosis of the jaw (MRONJ) is:
- The patient's current serum calcium level
- Duration of bisphosphonate use and route of administration (Correct answer)
- The patient's age and menopausal status
- Presence of periodontal disease
Correct answer: Duration of bisphosphonate use and route of administration
Intravenous bisphosphonates carry far greater MRONJ risk than oral agents, and risk increases significantly with cumulative duration of use (>4 years oral; any IV use).
Question 4: When using a rubber dam during endodontic treatment, the MAIN clinical benefit is:
- Improving radiographic visualization of canals
- Preventing aspiration/ingestion of instruments and providing a sterile field (Correct answer)
- Reducing post-operative pain
- Facilitating better access to posterior teeth
Correct answer: Preventing aspiration/ingestion of instruments and providing a sterile field
Rubber dam isolation prevents accidental swallowing or aspiration of files and irrigants while maintaining a clean, bacteria-reduced operating field.
Question 5: Which caries risk assessment model, widely used in the US, categorizes patients based on biological, protective, and clinical findings?
- CAMBRA (Caries Management by Risk Assessment) (Correct answer)
- DMFT Index scoring
- OHI-S (Oral Hygiene Index Simplified)
- BEWE (Basic Erosive Wear Examination)
Correct answer: CAMBRA (Caries Management by Risk Assessment)
CAMBRA is the evidence-based caries risk assessment system that integrates disease indicators, risk factors, and protective factors to guide personalized prevention and treatment.
Question 6: A patient refuses local anesthesia and demands extraction of a tooth without it. What is the MOST ethical course of action for the dentist?
- Proceed without anesthesia to respect patient autonomy
- Refuse to perform the extraction and refer the patient
- Explain the risks, document refusal, and proceed only if the patient provides informed refusal (Correct answer)
- Administer the anesthetic without consent for the patient's wellbeing
Correct answer: Explain the risks, document refusal, and proceed only if the patient provides informed refusal
After thorough explanation of risks including pain and physiologic stress, the dentist may proceed if the patient signs an informed refusal, as patient autonomy must be respected.
Question 7: In pediatric dentistry, which space maintainer is MOST appropriate following premature loss of a mandibular second primary molar in a 7-year-old with the first permanent molar erupted?
- Nance holding arch
- Distal shoe space maintainer
- Band-and-loop space maintainer (Correct answer)
- Transpalatal arch
Correct answer: Band-and-loop space maintainer
A band-and-loop space maintainer is indicated when the first permanent molar has erupted and an adjacent primary molar is lost, preventing mesial drift of the permanent molar.
AGD Clinical Skills & Patient Care in General Dentistry 5
A dentist notes a 4 mm × 4 mm white patch on the lateral border of the tongue that cannot be wiped off.
It has been present for 3 months.
The most appropriate initial management is: