MFDS Part 1 - Membership of Faculty of Dental Surgery Patient Assessment and Diagnosis Questions and Answers — Questions and Answers
Question 1: According to the National Institute for Health and Care Excellence (NICE) guidelines (CG19), what is the maximum recommended recall interval between oral health reviews for an adult patient aged 18 or over who has repeatedly demonstrated they can maintain good oral health?
- 6 months
- 12 months
- 24 months (Correct answer)
- 36 months
Correct answer: 24 months
NICE Clinical Guideline 19 (Dental checks: intervals between oral health reviews) states that the longest interval between oral health reviews for patients aged 18 years and older should be 24 months. This is based on a risk assessment approach, moving away from the traditional 6-month recall for all patients.
Question 2: A 55-year-old male patient attends for a routine examination. During the social history, he mentions he regularly drinks a large bottle of wine over two evenings. According to the 'Delivering Better Oral Health' toolkit, which of the following is the most appropriate initial screening tool to assess his level of risk from alcohol harm?
- CAGE questionnaire
- FAST (Fast Alcohol Screening Test)
- SAD-Q (Severity of Alcohol Dependence Questionnaire)
- AUDIT-C (Alcohol Use Disorders Identification Test - Consumption) (Correct answer)
Correct answer: AUDIT-C (Alcohol Use Disorders Identification Test - Consumption)
The 'Delivering Better Oral Health' toolkit, an evidence-based guide for dental teams in the UK, recommends using the AUDIT-C tool to assess a patient's level of risk of alcohol harm. It consists of three consumption questions and is a brief, effective screening method suitable for a primary care setting like dentistry.
Question 3: A new patient presents for their initial oral health assessment. Which of the following components is NOT considered a mandatory part of the extra-oral examination as per standard UK dental practice guidelines?
- Palpation of the cervical lymph nodes
- Assessment of the temporomandibular joint (TMJ)
- Auscultation of the carotid arteries for bruits (Correct answer)
- Visual inspection of the skin of the head and neck
Correct answer: Auscultation of the carotid arteries for bruits
A comprehensive extra-oral examination in UK dentistry includes visual inspection of the head and neck, palpation of salivary glands and cervical lymph nodes, and assessment of TMJ function. Auscultation of the carotid arteries for bruits is a specialised medical procedure not routinely performed during a dental assessment and is outside the scope of general dental practice.
Question 4: A dentist is completing the clinical records after an examination. According to the Faculty of General Dental Practice (UK) 'Clinical Examination and Record-Keeping' guidelines, which classification system should be used to describe recommendations?
- High, Medium, Low Priority
- Urgent, Necessary, Elective
- A (Aspirational), B (Basic), C (Conditional) (Correct answer)
- Grade I, Grade II, Grade III Evidence
Correct answer: A (Aspirational), B (Basic), C (Conditional)
The FGDP(UK) guidelines 'Clinical Examination and Record-Keeping' categorise recommendations as A (Aspirational - gold-standard practice), B (Basic - essential/baseline practice), and C (Conditional - dependent upon circumstances). This system provides clarity on the expected standards of care and record-keeping.
Question 5: A 28-year-old patient presents with concerns about tooth wear on her upper anterior teeth. On examination, you notice shallow, smooth, scooped-out lesions on the palatal surfaces of the maxillary incisors. Which diagnostic index, specifically recommended in UK guidance for monitoring tooth wear, should be recorded at baseline?
- Tooth Wear Index (TWI) by Smith and Knight
- Basic Erosive Wear Examination (BEWE) (Correct answer)
- Lussi Index for Dental Erosion
- Simplified Oral Hygiene Index (OHI-S)
Correct answer: Basic Erosive Wear Examination (BEWE)
The Basic Erosive Wear Examination (BEWE) is a simple and validated tool recommended by UK experts and in guidance documents like 'Delivering Better Oral Health' for screening and monitoring tooth wear, particularly erosive wear. It provides a cumulative score that helps in risk assessment and management planning.
Question 6: Which principle from the General Dental Council (GDC) 'Standards for the Dental Team' most directly relates to the process of conducting a thorough patient assessment and taking a holistic and preventative approach to care?
- Principle 2: Communicate effectively with patients
- Principle 3: Obtain valid consent
- Principle 7: Maintain, develop and work within your professional knowledge and skills
- Principle 1: Put patients' interests first (Correct answer)
Correct answer: Principle 1: Put patients' interests first
Principle 1, 'Put patients' interests first', encompasses the standard 1.4: 'Take a holistic and preventative approach to patient care which is appropriate to the individual patient.' This involves a full assessment of their overall health, needs, and desired outcomes to formulate the most appropriate care plan, which is the foundation of patient assessment and diagnosis.
