ORE Part 2 – Overseas Registration Examination (GDC) — Questions and Answers

Question 1: Which nerve is at risk of damage during extraction of a lower premolar?

Lingual nerve
Long buccal nerve
Mental nerve (Correct answer)
Inferior alveolar nerve

Correct answer: Mental nerve

The mental nerve emerges from the mental foramen near the apices of the lower premolars and is at risk during surgical procedures or overzealous elevation in this region.

Question 2: What is the maximum recommended dose of lidocaine with adrenaline for a 70 kg adult in the UK?

300 mg
700 mg
200 mg
500 mg (7 mg/kg) (Correct answer)

Correct answer: 500 mg (7 mg/kg)

The maximum safe dose of lidocaine with adrenaline is 7 mg/kg, equating to approximately 500 mg (about 14 cartridges of 2% lidocaine with 1:80,000 adrenaline) for a 70 kg adult.

Question 3: What is the difference between Type 1 and Type 2 respiratory failure in the context of a dental emergency?

Type 2 occurs only with cardiac arrest
Type 1: hypoxaemia with normal CO2 (e.g., acute asthma); Type 2: hypoxaemia with raised CO2 (e.g., COPD) (Correct answer)
Type 1 is more severe than Type 2
They are identical in management

Correct answer: Type 1: hypoxaemia with normal CO2 (e.g., acute asthma); Type 2: hypoxaemia with raised CO2 (e.g., COPD)

Type 1 respiratory failure (low O2, normal CO2) occurs in conditions like acute asthma; Type 2 (low O2, high CO2) occurs in COPD exacerbations — management differs, particularly oxygen dose in COPD.

Question 4: What drug and dose is used for an acute asthma attack not responding to a salbutamol inhaler in a dental practice?

Oral prednisolone tablet
Nebulised ipratropium as first line
Repeat salbutamol puffs (10 puffs via spacer), call 999, give oxygen, and consider IM adrenaline if severe (Correct answer)
IV aminophylline in the surgery

Correct answer: Repeat salbutamol puffs (10 puffs via spacer), call 999, give oxygen, and consider IM adrenaline if severe

For acute severe asthma: 10 puffs of salbutamol via spacer (100 mcg per puff), high-flow oxygen, call 999; if anaphylaxis-related or life-threatening, IM adrenaline is indicated.

Question 5: What is the recommended depth of chest compressions in adult CPR?

8–10 cm
2–3 cm
5–6 cm at a rate of 100–120 per minute (Correct answer)
3–4 cm at any rate

Correct answer: 5–6 cm at a rate of 100–120 per minute

Resuscitation Council UK guidelines specify chest compressions of 5–6 cm depth at a rate of 100–120 per minute, allowing full chest recoil between compressions.

Question 6: What is CBCT's primary advantage over conventional dental radiography?

Better for detecting interproximal caries
Lower radiation dose than bitewing radiographs
Three-dimensional imaging at lower dose than medical CT, showing structures in all planes without superimposition (Correct answer)
Equivalent to OPG in all situations

Correct answer: Three-dimensional imaging at lower dose than medical CT, showing structures in all planes without superimposition

CBCT provides volumetric 3D imaging, eliminating superimposition and allowing structures to be viewed in axial, coronal, and sagittal planes — invaluable for implant planning, impacted teeth, and jaw pathology.

Question 7: Smoking increases the risk of periodontal disease through which primary mechanism?

Direct chemical destruction of tooth enamel
Stimulation of osteoblast activity
Increased salivary flow causing plaque accumulation
Impaired neutrophil function and reduced gingival blood flow (Correct answer)

Correct answer: Impaired neutrophil function and reduced gingival blood flow

Smoking impairs the host immune response through multiple mechanisms: reduced neutrophil chemotaxis and phagocytosis, impaired antibody production, vasoconstriction reducing gingival blood flow (masking inflammation), and altered cytokine profiles favouring tissue destruction. Smokers also show reduced bleeding on probing despite active disease, making clinical assessment more challenging.

Question 8: What is the most appropriate local anaesthetic for a child undergoing extraction of a lower primary molar?

Articaine 4% alone
2% lidocaine with 1:80,000 adrenaline (IANB) (Correct answer)
Topical benzocaine only
Prilocaine without vasoconstrictor

Correct answer: 2% lidocaine with 1:80,000 adrenaline (IANB)

Inferior alveolar nerve block with 2% lidocaine and 1:80,000 adrenaline is the standard anaesthetic for lower primary molar extractions, ensuring complete anaesthesia for the procedure.

Question 9: What is the purpose of the NHS Dental Contract (2006) Unit of Dental Activity (UDA) system?

Measure patient satisfaction
Measure and remunerate dental practices based on the volume and complexity of NHS treatment delivered (Correct answer)
Calculate NHS staff salaries
Assess clinical quality of individual treatments

Correct answer: Measure and remunerate dental practices based on the volume and complexity of NHS treatment delivered

The UDA system allocates points (1, 3, or 12) to treatment bands, with practices contracted to deliver a specified number of UDAs per year; remuneration is based on UDA delivery against contract.

Question 10: Which flap design is most commonly used for surgical removal of a lower third molar?

Semilunar flap
Ward's (envelope) incision with a distal relieving incision (Correct answer)
Straight midcrestal incision only
Trapezoidal flap

Correct answer: Ward's (envelope) incision with a distal relieving incision

The most common approach involves a Ward's envelope incision along the external oblique ridge with a mesial relieving incision, providing adequate access while avoiding key anatomical structures.

Question 11: What is the Gustafson and Koch formula used for in oral surgery?

Calculating anaesthetic doses
Estimating age from dental features (root resorption, attrition, etc.) (Correct answer)
Assessing fracture risk
Grading impaction difficulty

Correct answer: Estimating age from dental features (root resorption, attrition, etc.)

The Gustafson method estimates age from histological and radiographic dental features including attrition, secondary dentine, cementum apposition, root resorption, and root translucency.

Question 12: What is 'Gillick competence' and how does it apply in dental practice?

Only applies to contraception, not dentistry
Children under 16 can never consent
A minor under 16 who fully understands the nature and implications of treatment can consent independently (Correct answer)
Parents must always consent for children under 18

Correct answer: A minor under 16 who fully understands the nature and implications of treatment can consent independently

Gillick competence allows children under 16 to consent to their own treatment if the clinician is satisfied they fully understand the treatment, its risks, and consequences without needing parental consent.

Question 13: What is the initial management of an anaphylactic reaction in a dental surgery?

Adrenaline 1:10,000 IV only
Call 999, administer IM adrenaline 0.5 mg (500 mcg) 1:1000, lie flat with legs elevated, give oxygen (Correct answer)
IV corticosteroids as first-line treatment
Give oral antihistamine and monitor

Correct answer: Call 999, administer IM adrenaline 0.5 mg (500 mcg) 1:1000, lie flat with legs elevated, give oxygen

Anaphylaxis management follows the Resuscitation Council algorithm: call 999, administer IM adrenaline 0.5 mg (1:1000) to the anterolateral thigh, position (supine/legs elevated unless breathing difficulty), and give high-flow oxygen.

Question 14: What is the Hall Technique for managing carious primary molars?

Extracting the tooth and placing a space maintainer
Using glass ionomer to seal caries only
Sealing caries under a preformed metal crown without caries removal (Correct answer)
Complete caries removal before crown placement

Correct answer: Sealing caries under a preformed metal crown without caries removal

The Hall Technique involves placing a preformed stainless steel crown (SSC) over a carious primary molar without caries removal or tooth preparation, sealing bacteria under the crown.

Question 15: What are the signs of a hypoadrenal (Addisonian) crisis in the dental surgery?

Chest pain and bradycardia
Only mild dizziness
Profound hypotension, collapse, confusion, pallor, and nausea in a patient on long-term steroids (Correct answer)
Hypertension and agitation

Correct answer: Profound hypotension, collapse, confusion, pallor, and nausea in a patient on long-term steroids

Addisonian crisis (acute adrenocortical insufficiency) presents with severe hypotension, collapse, confusion, and pallor, typically in patients on long-term corticosteroids who have not been steroid-covered.

Question 16: Which occlusal scheme is most commonly prescribed for complete dentures?

Mutually protected occlusion
Group function
Canine guidance
Balanced occlusion (Correct answer)

Correct answer: Balanced occlusion

Balanced occlusion (bilateral balanced articulation) is the most appropriate complete denture occlusal scheme, providing stability during excursive movements by maintaining contacts on both sides.

Question 17: What are the four domains of the GDC Standards for the Dental Team (2013)?

Clinical excellence, record keeping, infection control, prescribing
Patient-centred care, effective communication, maintaining knowledge, working with colleagues (Correct answer)
Ethics, law, training, assessment
Consent, complaints, CPD, referrals

Correct answer: Patient-centred care, effective communication, maintaining knowledge, working with colleagues

The GDC Standards are organised around four principles: putting patients first, effective communication, maintaining knowledge and skills (CPD), and working effectively with colleagues.

Question 18: Which instrument design is most effective for subgingival debridement in a narrow 5 mm pocket?

Ultrasonic scaler tip (standard beaver tail)
Universal curette only
Hand sickle scaler
Gracey curette (e.g., Gracey 11/12 for mesial surfaces) (Correct answer)

Correct answer: Gracey curette (e.g., Gracey 11/12 for mesial surfaces)

Area-specific Gracey curettes are designed to adapt to specific root surfaces, providing effective subgingival debridement in defined pocket depths.

Question 19: What is the most appropriate immediate management for an acute apical abscess with spreading cellulitis and systemic signs of infection?

Definitive root canal treatment in a single visit
Prescribe antibiotics alone without intraoral intervention
Drainage, systemic antibiotics, and definitive endodontic treatment or extraction (Correct answer)
Analgesics only and review in 48 hours

Correct answer: Drainage, systemic antibiotics, and definitive endodontic treatment or extraction

Spreading infection with systemic involvement requires both surgical drainage and systemic antibiotics; antibiotics alone are insufficient without addressing the source, and definitive treatment follows once acute symptoms resolve.

Question 20: Which cement is contraindicated for luting glass ceramic crowns?

Zinc phosphate cement (Correct answer)
Resin-modified glass ionomer
Dual-cure composite cement
Resin cement

Correct answer: Zinc phosphate cement

Zinc phosphate cement lacks adhesive bonding, reducing retention for all-ceramic crowns that rely on adhesive luting for strength and aesthetics.

Question 21: At what stage of periodontal treatment should definitive restorative work ideally be completed?

During active phase 1 treatment
Simultaneously with surgical treatment
After periodontal stability has been achieved and re-assessed (Correct answer)
Before any periodontal treatment

Correct answer: After periodontal stability has been achieved and re-assessed

Definitive restorations should be deferred until periodontal stability is confirmed at reassessment, ensuring tissue levels and margins are stable before final impressions.

Question 22: What is the primary purpose of the NHS Contract Compliance Framework for dental practices?

Replace CQC inspections
Monitor UDA delivery and ensure practices meet contractual obligations to deliver NHS care (Correct answer)
Determine NHS staff pay
Assess clinical quality of individual treatments only

Correct answer: Monitor UDA delivery and ensure practices meet contractual obligations to deliver NHS care

The NHS Contract Compliance Framework monitors whether dental practices deliver the contracted number of UDAs and comply with NHS contract terms, including access and reporting requirements.

Question 23: What is the recommended treatment for a child with severe early childhood caries (ECC) affecting multiple teeth requiring GA?

Comprehensive treatment under GA: restore restorable teeth, extract non-restorable, provide preventive care (Correct answer)
Extract all teeth under GA
Restore under GA without preventive plan
Antibiotics only until definitive treatment

Correct answer: Comprehensive treatment under GA: restore restorable teeth, extract non-restorable, provide preventive care

GA treatment for severe ECC should be comprehensive, addressing all teeth in one session; post-GA preventive care (fluoride, diet counselling) is essential to prevent recurrence.

Question 24: What is the purpose of indemnity insurance for dental professionals in the UK?

Provides financial protection and legal support in the event of a negligence claim or complaint (Correct answer)
Required only for NHS providers
Covers premises liability only
Covers equipment breakdown

Correct answer: Provides financial protection and legal support in the event of a negligence claim or complaint

Professional indemnity/insurance is a GDC registration requirement, providing financial and legal protection for dental professionals in the event of negligence claims, complaints, or fitness to practise proceedings.

Question 25: Under the GDC Standards, what is the minimum annual CPD requirement for a registered dentist in the UK?

No minimum — only verifiable CPD required
10 hours per year with 75 hours over a 5-year cycle, including mandatory topics (Correct answer)
20 hours per year
5 hours per year

Correct answer: 10 hours per year with 75 hours over a 5-year cycle, including mandatory topics

GDC requires dentists to complete at least 10 hours of verifiable CPD per year, totalling 75 hours over a 5-year cycle, including mandatory subjects such as medical emergencies and infection control.

Question 26: Which regulatory body is responsible for registering and regulating dental professionals in the UK?

Care Quality Commission (CQC)
NHS England
British Dental Association (BDA)
General Dental Council (GDC) (Correct answer)

Correct answer: General Dental Council (GDC)

The General Dental Council (GDC) is the statutory regulatory body for all dental professionals in the UK, responsible for registration, setting standards, and fitness to practise procedures.

Question 27: What is the GDC's definition of 'fitness to practise'?

Their CPD completion record
A registrant's physical health status
A registrant's ability to practise safely and effectively, encompassing competence, health, conduct, and honesty (Correct answer)
Only clinical skill level

Correct answer: A registrant's ability to practise safely and effectively, encompassing competence, health, conduct, and honesty

Fitness to practise encompasses clinical competence, health, character (conduct and behaviour), and probity (honesty), all of which the GDC monitors through its fitness to practise procedures.

Question 28: What are a dentist's obligations under the Children Act 1989 regarding safeguarding?

Only required if parents give consent to refer
The obligation is discretionary
Duty to refer to children's services if there are concerns about abuse or neglect; child's welfare is paramount (Correct answer)
Only if the dentist witnesses abuse directly

Correct answer: Duty to refer to children's services if there are concerns about abuse or neglect; child's welfare is paramount

Under the Children Act 1989 and related statutory guidance, dental professionals have a duty to act on safeguarding concerns; the child's welfare is the paramount consideration, overriding confidentiality.

Question 29: What is the clinical significance of the apical constriction in endodontic treatment?

It is the ideal terminus for both canal preparation and obturation (Correct answer)
It marks the external surface of the root at the anatomical apex
It identifies where coronal flaring should terminate
It represents the cemento-enamel junction of the root

Correct answer: It is the ideal terminus for both canal preparation and obturation

The apical constriction, located approximately 0.5–1 mm short of the radiographic apex, is the narrowest part of the canal and represents the ideal endpoint for preparation and obturation to preserve periapical tissues.

Question 30: How does internal root resorption appear on a periapical radiograph?

Irregular shortening and blunting of the root apex
Periapical radiolucency at the root tip
Well-defined oval or round radiolucent enlargement within the root canal (Correct answer)
Radiopaque deposit within the pulp chamber

Correct answer: Well-defined oval or round radiolucent enlargement within the root canal

Internal resorption appears as a well-defined, symmetrical, oval or round radiolucent widening of the root canal lumen caused by clastic activity originating from within the pulp.

ORE Part 2 – Overseas Registration Examination (GDC)

The GDC Overseas Registration Examination Part 2 is a clinical assessment for overseas-qualified dentists seeking registration in the UK, testing practical skills across OSCE stations, dental manikin operative procedures, diagnosis & treatment planning, and medical emergencies.

100

Questions

120 min

Time Limit

70%

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