A 13-year-old patient presented to your practice due to avulsion of 21 after trauma of his face. He attended your practice after he has received first aid in emergency department in hospital. At the hospital they already repositioned 21 with a rigid splint.
They also washed the tooth in water and then kept in the milk for 2 hours then
reimplemented. His tetanus immunisation status is up to date.

Q1. What will badly affect the prognosis of reimplanted tooth?

Q2. PA given, shows that tooth is a bit out of socket, the tooth fixed with rigid splint, what to do regarding the avulsed tooth?

Q3. He had injury to his forehead; a layer of his skin was torn/ peeled off and it was bleeding. What’s is appropriate term for this injury?

Q4. You prescribed 100mg of doxycycline, what’s the clinical significance of Doxycycline given in this case?

Q5. Patient cannot brush his tooth because the tooth is sore, why do you may choose chlorhexidine mouth wash?

Mary is A 60-year-old lady has been referred to you by her orthopaedic for an oral clearance after she has been diagnosed with Osteoporosis and she is on IV Denosumab. Mary has lots of badly decayed teeth and remaining roots.

Q1. What other medication/ dietary supplements would she be having to help this condition?

Q2. You educated her about post extraction complications that may happen due to Denosumab’s side effect, what is the most serious complication you will discuss with Haam bo her?

Q3. She has some root pieces that need to be extracted. You tell her the risks of the medication. She is now upset because the previous dentist whom she visited last month didn’t tell her about the post extraction complication. What will you do?

Q4. Giving that she will start the 1st dose of medication after 2 weeks and her second dose will be after 6 months. When will you advise her to perform the extraction?

Q5. What could be the safest dental treatment that can be done while she is on Denosumab?

59-year-old, MRs Susan, attended today with pain in the grossly destructed tooth #46 tooth as on x-ray. Patient was on warfarin recently changed to dabigatran a months ago. Patient has diabetes, previously had hep B changed his medication recently to dabigatran and needs extraction.

Q1. Based on the X-ray provided what is the cause of radiolucency in the furcation area?

Q2. What TEST you may advise to check on the blood anticoagulation in the patient before proceeding with extraction, if necessary?

Q3. How will you proceed with extraction?

Q4. What would be the MOST LIKELY complication after extraction?

Q5. Which post operative instruction you will advise the patient for ongoing bleeding after 24 hours?

Marry is a 50-year-old woman who owns a business of flowers, and she is on systemic corticosteroids for hay fever and asthma related to her profession and she is also suffering from rheumatoid arthritis. She presented to your practice with a fractured tooth #37, which was previously restored many times with amalgam and now the tooth needs to go.

Q1. Prednisolone, more than 5 mg-10 mg per day, for more than a few weeks can cause all the followings EXCEPT:

Q2. Which one of the following has the highest risk to cause adrenal crisis?

Q3. Dental treatment should be performed in:

Q4. As a part of management and before the extraction of the badly broken tooth, what precaution/s will you take?

Q5. If you decide to do extraction, so when will you advise the patient to increase their current dose?

Lila is a 71-year-old woman presented to you complaining of burning sensation on the tip and lateral border of tongue. She said the pain starts at morning and increases while day progresses. She is seeking your help to manage her concern. The medical history is clear.

Q1. In order to reach the provisional diagnosis what would be the most important information to ask her?

Q2. What is the most probable diagnosis of her symptoms?

Q3. What is the important investigation you need to do for your diagnosis?

Q4. What would you advise her about her condition?

Q5. She comes back to you after 12 months for her review appointment. She said that the symptoms are completely resolved now. But she complains of burning around her tonsillar area, back of head and says she is worried that this is something serious. Examination by an ENT specialist has ruled out any significant problem/ diseases/ ENT specialist ruled out any serious underlying cause. What could be the diagnosis in this case?