MFDS Part 1 - Membership of Faculty of Dental Surgery Oral Surgery and Exodontia Questions and Answers

Question 1

A 68-year-old patient taking apixaban for atrial fibrillation requires a routine extraction of a single molar tooth.
According to the Scottish Dental Clinical Effectiveness Programme (SDCEP) guidance, what is the most appropriate management plan?

Accepted Answer

Proceed with the extraction without altering the medication regimen, using local haemostatic measures.

Answer

Advise the patient to stop taking apixaban for 48 hours prior to the extraction.

Answer

Refer the patient to a hospital setting for the extraction under specialist care.

Answer

Proceed with the extraction but advise the patient to miss their morning dose of apixaban on the day of the procedure.

Question 2

According to the National Institute for Health and Care Excellence (NICE) Technology Appraisal Guidance [TA1], which of the following is an accepted indication for the surgical removal of an impacted third molar?

Accepted Answer

The presence of non-treatable pulpal pathology in the third molar.

Answer

To prevent potential future crowding of the anterior teeth.

Answer

A single, mild episode of pericoronitis that resolved with local measures.

Answer

The patient is asymptomatic but the tooth is horizontally impacted.

Question 3

During the extraction of a maxillary first molar, a 3mm oro-antral communication (OAC) is created. The sinus lining appears intact and the patient is healthy with no history of sinusitis. What is the most appropriate immediate management?

Accepted Answer

Provide post-operative instructions to avoid nose-blowing and allow healing by secondary intention.

Answer

Refer the patient immediately to an oral and maxillofacial surgery department for primary closure.

Answer

Surgically close the defect with a buccal advancement flap and prescribe antibiotics.

Answer

Pack the socket with antiseptic gauze and review the patient in one week.

Question 4

A 72-year-old patient has been taking oral alendronic acid for osteoporosis for seven years. They require extraction of a mandibular molar. According to SDCEP guidance on Medication-related Osteonecrosis of the Jaw (MRONJ), which factor places this patient in the 'higher risk' category?

Accepted Answer

The duration of bisphosphonate use is greater than 5 years.

Answer

The extraction is in the mandible.

Answer

The patient's age is over 70.

Answer

The patient has a diagnosis of osteoporosis.

Question 5

When raising a full-thickness mucoperiosteal flap for the surgical removal of an impacted mandibular third molar, which technical principle is most crucial for preventing iatrogenic injury to the lingual nerve?

Accepted Answer

Keeping the periosteal elevator in constant, firm contact with the lingual plate of bone during elevation.

Answer

Placing the initial incision deep in the lingual sulcus to be away from the surgical field.

Answer

Using a broad, flat retractor to actively pull the lingual tissues away from the mandible.

Answer

Making a large distal relieving incision that extends towards the buccal aspect.

Question 6

A patient presents three days after an extraction complaining of severe, radiating pain and a foul taste. The socket appears empty with exposed bone. Which of the following represents the most appropriate initial management for alveolar osteitis (dry socket)?

Accepted Answer

Gently irrigate the socket with warm saline and place an obtundent dressing.

Answer

Vigorously curette the socket to stimulate bleeding and prescribe a course of amoxicillin.

Answer

Take a radiograph to rule out a retained root and then suture the socket closed.

Answer

Prescribe a strong opioid analgesic and advise hourly hot salt water mouthwashes.

A 68-year-old patient taking apixaban for atrial fibrillation requires a routine extraction of a single molar tooth.According to the Scottish Dental Clinical Effectiveness Programme (SDCEP) guidance, what is the most appropriate management plan?

A 68-year-old patient taking apixaban for atrial fibrillation requires a routine extraction of a single molar tooth.
According to the Scottish Dental Clinical Effectiveness Programme (SDCEP) guidance, what is the most appropriate management plan?