FREE ADC Scenario-Based Questions and Answers

Question 1

Case scenario:
Alexander, a 64-year-old patient who is receiving warfarin as part of the management of his atrial fibrillation tells you that one of his lower right back teeth was restored three years ago by a dentist who has since retired from your practice.

The tooth is now occasionally sensitive to hot and cold. The clinical notes confirm the history and indicate that the tooth was restored using a resin composite material.

You obtain the periapical radiograph.

In addition to testing the pulp vitality with either a cold or an electric pulp tester, which of the following clinical tests or procedures would be the most appropriate to assist in making a diagnosis?

Accepted Answer

Percussion test

Answer

Orthopantomogram (OPG)

Answer

Bite-wing radiograph

Answer

Crack test

Answer

International normalized ratio (INR) test

Question 2

Case scenario:
Alexander, a 64-year-old patient who is receiving warfarin as part of the management of his atrial fibrillation tells you that one of his lower right back teeth was restored three years ago by a dentist who has since retired from your practice.

The tooth is now occasionally sensitive to hot and cold. The clinical notes confirm the history and indicate that the tooth was restored using a resin composite material.

You obtain the periapical radiograph.

In this case, what is most likely to cause the failure of the class II composite restorations of the posterior teeth?

Accepted Answer

The gingival margin on dentine because bonding under these conditions is unpredictable

Answer

Material is placed in increments because of the risk of leakage between the increments

Answer

Glass-ionomer lining is used because of the risk that the lining will leach out over time

Answer

Occlusal loads applied to the marginal ridge due to the flexure of the material

Answer

Extended curing time due to greater shrinkage of the material

Question 3

Case scenario:
Alexander, a 64-year-old patient who is receiving warfarin as part of the management of his atrial fibrillation tells you that one of his lower right back teeth was restored three years ago by a dentist who has since retired from your practice.

The tooth is now occasionally sensitive to hot and cold. The clinical notes confirm the history and indicate that the tooth was restored using a resin composite material.

You obtain the periapical radiograph.

Given the history and radiographic evidence, what is the best description of the sensitivity to hot and cold you would expect Alexander to report?

Accepted Answer

Dull and lingering for 1-2 minutes

Answer

Sharp, occurring once or twice per week and only with ice cream and hot coffee

Answer

Sharp and relieved on removal of the hot or cold stimulus

Answer

Always present but worse after a hot or cold stimulus

Answer

Worse in the morning

Question 4

Case scenario:
Alexander, a 64-year-old patient who is receiving warfarin as part of the management of his atrial fibrillation tells you that one of his lower right back teeth was restored three years ago by a dentist who has since retired from your practice.

The tooth is now occasionally sensitive to hot and cold. The clinical notes confirm the history and indicate that the tooth was restored using a resin composite material.

You obtain the periapical radiograph.

You decided to extract the tooth and in planning for the procedure you find that the patient’s International normalized ratio (INR) is 2.4. What is the most appropriate action to take at this time?

Accepted Answer

Proceed with the extraction and provide appropriate post-operative instructions

Answer

Proceed with the extraction and suggest that the patient stop their warfarin for 3 days

Answer

Suggest that the patient stop their warfarin and commence taking 125mg aspirin before returning in 3 days to have the tooth removed

Answer

Consult the patient’s cardiologist to discuss stopping their warfarin treatment

Answer

Refer to patient to a consultant Oral and Maxillofacial Surgeon who is best placed to manage complex surgical problems such as this

Question 5

Case scenario:
Alexander, a 64-year-old patient who is receiving warfarin as part of the management of his atrial fibrillation tells you that one of his lower right back teeth was restored three years ago by a dentist who has since retired from your practice.

The tooth is now occasionally sensitive to hot and cold. The clinical notes confirm the history and indicate that the tooth was restored using a resin composite material.

You obtain the periapical radiograph.

After the removal of the 46, which prosthodontic options would be most appropriate for Alexander?

Accepted Answer

No replacement until the patient has had an opportunity to assess their functional and aesthetic concerns

Answer

Immediate placement and immediate restoration with a dental implant

Answer

Replacement with an immediate removable partial denture

Answer

Replacement with a removable partial denture after the extraction site has healed

Answer

Replacement with a fixed bridge

Question 6

Case Scenario:
A patient presents with a fractured incisor tooth due to trauma. Which of the following is the most appropriate immediate management?

Accepted Answer

Assess for pulpal involvement and initiate root canal treatment if necessary.

Answer

Refer the patient to an orthodontist.

Answer

Administer antibiotics and schedule for extraction.

Answer

Apply fluoride varnish and advise the patient to return in a week.

Question 7

Case Scenario:
A patient complains of tooth sensitivity to colds and sweets. On examination, you notice a visible cavity in the tooth. What is the most appropriate initial treatment?

Accepted Answer

Restore the tooth with a filling.

Answer

Prescribe antibiotics.

Answer

Perform a tooth extraction.

Answer

Apply a desensitizing agent.

Question 8

Case Scenario:
During a routine dental examination, you notice redness and swelling around the gum line of a patient's tooth. What is the most likely diagnosis?

Accepted Answer

Gingivitis

Answer

Periodontitis

Answer

Dental caries

Answer

Abscess

Question 9

Case Scenario:
A patient presents with pain and swelling in the lower right jaw. On examination, you notice a draining sinus tract near the mandibular molars. What is the most likely diagnosis?

Accepted Answer

Periapical abscess

Answer

Periodontal abscess

Answer

Temporomandibular joint disorder (TMJ)

Answer

Mandibular fracture

Question 10

Case Scenario:
A patient reports a clicking sound and discomfort while opening their mouth. What is the most likely cause of this symptom?

Accepted Answer

Temporomandibular joint (TMJ) disorder

Answer

Dental caries

Answer

Periodontal disease

Answer

Bruxism