DANB CDA DANB CDA Oral Pathology and Dental Emergencies 2 — Questions and Answers
Question 1: Dry socket (alveolar osteitis) most commonly occurs in which situation?
- After placement of a crown
- After mandibular molar extractions, especially in smokers (Correct answer)
- After a routine cleaning in a healthy patient
- After placement of a dental implant
Correct answer: After mandibular molar extractions, especially in smokers
Dry socket occurs when the blood clot is dislodged or fails to form, and it is most common after mandibular third molar extractions, particularly in tobacco users and women on oral contraceptives.
Question 2: What is the dental assistant's role during an anaphylactic reaction in the office?
- Administer antihistamine tablets orally
- Activate EMS, assist with epinephrine auto-injector (EpiPen), position patient supine, and monitor airway (Correct answer)
- Have the patient sit upright and breathe slowly
- Apply a cold compress to the injection site only
Correct answer: Activate EMS, assist with epinephrine auto-injector (EpiPen), position patient supine, and monitor airway
Anaphylaxis is life-threatening; the dental assistant must call 911, retrieve the emergency kit (epinephrine), help administer the EpiPen, position the patient supine, and maintain airway until EMS arrives.
Question 3: Erythroplakia is significant in oral pathology because it:
- Is always benign and self-limiting
- Has a higher rate of malignant transformation than leukoplakia (Correct answer)
- Only occurs in children
- Is caused exclusively by Candida albicans
Correct answer: Has a higher rate of malignant transformation than leukoplakia
Erythroplakia (red mucosal lesion) carries a significantly higher risk of dysplasia and malignant transformation than leukoplakia, making biopsy and immediate evaluation essential.
Question 4: A patient on warfarin (Coumadin) therapy presents for an extraction. The dental team should:
- Proceed without modification as warfarin has no effect on oral bleeding
- Consult with the patient's physician and assess INR levels before proceeding (Correct answer)
- Stop the warfarin 2 weeks before the appointment without consulting anyone
- Double the local anesthetic dose to ensure hemostasis
Correct answer: Consult with the patient's physician and assess INR levels before proceeding
Warfarin is an anticoagulant that increases bleeding risk; the dentist must consult the patient's physician and check the INR level (ideally ≤3.5) before performing extractions.
Question 5: Which oral lesion is most commonly associated with HIV infection and presents as white, corrugated plaques on the lateral borders of the tongue that cannot be wiped off?
- Oral candidiasis
- Hairy leukoplakia (Correct answer)
- Geographic tongue
- Linea alba
Correct answer: Hairy leukoplakia
Hairy leukoplakia, caused by Epstein-Barr virus, presents as white, corrugated (hairy) plaques on the lateral tongue borders and is strongly associated with immunosuppression, especially HIV.
Question 6: What is the emergency management of a patient experiencing a hypoglycemic episode (low blood sugar) in the dental office?
- Administer insulin immediately
- Provide a fast-acting carbohydrate (orange juice, glucose tablets) if the patient is conscious (Correct answer)
- Position the patient prone and monitor
- Administer epinephrine and call 911 immediately
Correct answer: Provide a fast-acting carbohydrate (orange juice, glucose tablets) if the patient is conscious
If the patient is conscious and can swallow, administer 15–20g of fast-acting carbohydrate (juice, glucose gel, candy); if unconscious, call 911 and administer glucagon per emergency protocol.
DANB CDA DANB CDA Oral Pathology and Dental Emergencies 2
Dry socket (alveolar osteitis) most commonly occurs in which situation?