MJDF Pharmacology & Pain Control 4

Question 1

What is the mechanism by which tetracyclines are deposited in developing teeth?

Accepted Answer

Chelate with calcium ions in calcifying tissues forming tetracycline-calcium orthophosphate complexes — permanent staining

Answer

Tetracyclines chelate with calcium ions during mineralisation of dentine and enamel, forming permanent yellow-brown fluorescent complexes; contraindicated in children under 12 and during pregnancy.

Question 2

What drug is used to prevent dry socket (alveolar osteitis) in high-risk patients?

Accepted Answer

Chlorhexidine mouthwash pre- and post-operatively; oxidised cellulose or resorbable gelatin sponge intra-socket

Answer

Pre-operative chlorhexidine mouthwash (0.12–0.2%) and intra-socket placement of resorbable materials (oxidised cellulose, Alvogyl) reduce dry socket incidence in high-risk patients (smokers, previous dry socket, lower molars).

Question 3

What is the dental significance of patients taking bisphosphonates for osteoporosis?

Accepted Answer

Risk of medication-related osteonecrosis of jaw (MRONJ) after invasive dental procedures — requires risk assessment before extraction

Answer

Bisphosphonates (oral and particularly IV) impair bone remodelling; invasive dental procedures (extractions, implants, periodontal surgery) can trigger MRONJ, requiring MDT risk assessment and preventive strategies.

Question 4

What is the mechanism of action of fluoride in caries prevention?

Accepted Answer

Incorporates into hydroxyapatite as fluorapatite (more acid-resistant), inhibits bacterial enolase, and enhances remineralisation

Answer

Fluoride forms fluorapatite (less soluble at acid pH), inhibits bacterial glycolysis (enolase inhibition reducing acid production), and promotes remineralisation of early carious lesions.

Question 5

What drug class should be avoided in patients with aspirin-sensitive asthma (Samter's triad) requiring dental pain control?

Accepted Answer

All NSAIDs (cross-sensitivity is common)

Answer

Samter's triad (asthma, nasal polyps, aspirin sensitivity) involves COX-1 inhibition shifting arachidonic acid to leukotriene production; all NSAIDs carry cross-sensitivity risk and must be avoided, with paracetamol used instead.

MJDF Part 1 Practice Test

MJDF Part 1 Practice Test

MJDF Pharmacology & Pain Control 4