A 39-year-old male attends for root canal treatment on tooth 16, which has deep caries extending close to the pulp. The tooth is asymptomatic, with only mild occasional chewing discomfort and tender to percussion. His medical history is clear, and he reports occasional smoking and social drinking. He works full-time and has limited availability for dental appointments.

After about 45 minutes of treatment, with another patient waiting outside, you begin preparing to irrigate and temporise the tooth. While using the last file for today in the mesio-buccal canal during the final minutes of the appointment, the file separated inside the canal, a periapical x ray was taken then. The patient immediately says:

“Please finish everything today. I cannot come again this week.”

Q1. What is the most appropriate immediate management?

A 39-year-old male attends for root canal treatment on tooth 16, which has deep caries extending close to the pulp. The tooth is asymptomatic, with only mild occasional chewing discomfort and tender to percussion. His medical history is clear, and he reports occasional smoking and social drinking. He works full-time and has limited availability for dental appointments.

After about 45 minutes of treatment, with another patient waiting outside, you begin preparing to irrigate and temporise the tooth. While using the last file for today in the mesio-buccal canal during the final minutes of the appointment, the file separated inside the canal, a periapical x ray was taken then. The patient immediately says:

“Please finish everything today. I cannot come again this week.”

Q2. How should you handle the patient insisting that you finish today?

A 39-year-old male attends for root canal treatment on tooth 16, which has deep caries extending close to the pulp. The tooth is asymptomatic, with only mild occasional chewing discomfort and tender to percussion. His medical history is clear, and he reports occasional smoking and social drinking. He works full-time and has limited availability for dental appointments.

After about 45 minutes of treatment, with another patient waiting outside, you begin preparing to irrigate and temporise the tooth. While using the last file for today in the mesio-buccal canal during the final minutes of the appointment, the file separated inside the canal, a periapical x ray was taken then. The patient immediately says:

“Please finish everything today. I cannot come again this week.”

Q3. Which statement is the most appropriate communication?

A 39-year-old male attends for root canal treatment on tooth 16, which has deep caries extending close to the pulp. The tooth is asymptomatic, with only mild occasional chewing discomfort and tender to percussion. His medical history is clear, and he reports occasional smoking and social drinking. He works full-time and has limited availability for dental appointments.

After about 45 minutes of treatment, with another patient waiting outside, you begin preparing to irrigate and temporise the tooth. While using the last file for today in the mesio-buccal canal during the final minutes of the appointment, the file separated inside the canal, a periapical x ray was taken then. The patient immediately says:

“Please finish everything today. I cannot come again this week.”

Q4. What additional and significant measure you should take after the file separation?

A 39-year-old male attends for root canal treatment on tooth 16, which has deep caries extending close to the pulp. The tooth is asymptomatic, with only mild occasional chewing discomfort and tender to percussion. His medical history is clear, and he reports occasional smoking and social drinking. He works full-time and has limited availability for dental appointments.

After about 45 minutes of treatment, with another patient waiting outside, you begin preparing to irrigate and temporise the tooth. While using the last file for today in the mesio-buccal canal during the final minutes of the appointment, the file separated inside the canal, a periapical x ray was taken then. The patient immediately says:

“Please finish everything today. I cannot come again this week.”

Q5. Will you charge the patient for today’s treatment?

A 65-year-old carpenter attends your clinic complaining of gum bleeding and loose teeth. Clinical examination reveals generalised probing pocket depths between 5–10 mm. He does not smoke. His medical history shows an HbA1c of 10%. He reports significant financial limitations, making surgical periodontal treatment difficult to afford.

You perform a Basic Periodontal Examination (BPE) with the following scores:

BPE Scores

An OPG has been attached.

Nine months later, his HbA1c is <7%, and a follow-up periodontal assessment is performed.

Q1. What is TRUE regarding the Basic Periodontal Examination (BPE)?

A 65-year-old carpenter attends your clinic complaining of gum bleeding and loose teeth. Clinical examination reveals generalised probing pocket depths between 5–10 mm. He does not smoke. His medical history shows an HbA1c of 10%. He reports significant financial limitations, making surgical periodontal treatment difficult to afford.

You perform a Basic Periodontal Examination (BPE) with the following scores:

BPE Scores

An OPG has been attached.

Nine months later, his HbA1c is <7%, and a follow-up periodontal assessment is performed.

Q2. What is the correct periodontal stage for this patient?

A 65-year-old carpenter attends your clinic complaining of gum bleeding and loose teeth. Clinical examination reveals generalised probing pocket depths between 5–10 mm. He does not smoke. His medical history shows an HbA1c of 10%. He reports significant financial limitations, making surgical periodontal treatment difficult to afford.

You perform a Basic Periodontal Examination (BPE) with the following scores:

BPE Scores

An OPG has been attached.

Nine months later, his HbA1c is <7%, and a follow-up periodontal assessment is performed.

Q3. What is the correct periodontal grade for this patient?

A 65-year-old carpenter attends your clinic complaining of gum bleeding and loose teeth. Clinical examination reveals generalised probing pocket depths between 5–10 mm. He does not smoke. His medical history shows an HbA1c of 10%. He reports significant financial limitations, making surgical periodontal treatment difficult to afford.

You perform a Basic Periodontal Examination (BPE) with the following scores:

BPE Scores

An OPG has been attached.

Nine months later, his HbA1c is <7%, and a follow-up periodontal assessment is performed.

Q4. You decided to extract five hopeless teeth. What is the NEW periodontal stage?

A 65-year-old carpenter attends your clinic complaining of gum bleeding and loose teeth. Clinical examination reveals generalised probing pocket depths between 5–10 mm. He does not smoke. His medical history shows an HbA1c of 10%. He reports significant financial limitations, making surgical periodontal treatment difficult to afford.

You perform a Basic Periodontal Examination (BPE) with the following scores:

BPE Scores

An OPG has been attached.

Nine months later, his HbA1c is <7%, and a follow-up periodontal assessment is performed.

Q5. What is the updated periodontal grade for this patient after 9 months?

Evan is a 4-year-old boy brought to your clinic by his mother, Mrs. Susan, after falling yesterday and chipping his front teeth. Evan reports pain when biting, and his mother discarded the broken fragments thinking they were useless. Although she describes Evan as usually hyperactive, he appears unusually quiet today. On examination, you note chipped upper primary incisors (#51 and #61). You proceed with investigations and discuss management.

Q1. Which investigation will you perform?

Evan is a 4-year-old boy brought to your clinic by his mother, Mrs. Susan, after falling yesterday and chipping his front teeth. Evan reports pain when biting, and his mother discarded the broken fragments thinking they were useless. Although she describes Evan as usually hyperactive, he appears unusually quiet today. On examination, you note chipped upper primary incisors (#51 and #61). You proceed with investigations and discuss management.

Q2. The mother asks: “What are you going to do now for the chipped teeth?”

Evan is a 4-year-old boy brought to your clinic by his mother, Mrs. Susan, after falling yesterday and chipping his front teeth. Evan reports pain when biting, and his mother discarded the broken fragments thinking they were useless. Although she describes Evan as usually hyperactive, he appears unusually quiet today. On examination, you note chipped upper primary incisors (#51 and #61). You proceed with investigations and discuss management.

Q3. What age group is most prone to traumatic dental injuries?

Evan is a 4-year-old boy brought to your clinic by his mother, Mrs. Susan, after falling yesterday and chipping his front teeth. Evan reports pain when biting, and his mother discarded the broken fragments thinking they were useless. Although she describes Evan as usually hyperactive, he appears unusually quiet today. On examination, you note chipped upper primary incisors (#51 and #61). You proceed with investigations and discuss management.

Q4. You notice facial bruises and a healing scar on Evan’s arm. What will you do next?

Evan is a 4-year-old boy brought to your clinic by his mother, Mrs. Susan, after falling yesterday and chipping his front teeth. Evan reports pain when biting, and his mother discarded the broken fragments thinking they were useless. Although she describes Evan as usually hyperactive, he appears unusually quiet today. On examination, you note chipped upper primary incisors (#51 and #61). You proceed with investigations and discuss management.

Q5. The mother asks: “What should I do next to help Evan?” — All of the following are correct EXCEPT:

Mr. Harris, 87 years old, comes to your clinic with a complaint of mild pain and swelling in the lower right back tooth region for 2 days. Medical history shows the patient has been diagnosed with high blood pressure for the past 8 years and is controlled with medications Perindopril and Candesartan. The patient is allergic to penicillin. You diagnosed a periodontal abscess in relation to tooth no. 46 and the patient does not want any other treatment and consents for extraction only. You are happy to extract the tooth today.

Q1. Which statement is NOT correct regarding adrenaline as a vasoconstrictor in local anaesthetic solution?

Mr. Harris, 87 years old, comes to your clinic with a complaint of mild pain and swelling in the lower right back tooth region for 2 days. Medical history shows the patient has been diagnosed with high blood pressure for the past 8 years and is controlled with medications Perindopril and Candesartan. The patient is allergic to penicillin. You diagnosed a periodontal abscess in relation to tooth no. 46 and the patient does not want any other treatment and consents for extraction only. You are happy to extract the tooth today.

Q2. While administering LA, Mr. Harris becomes sweaty, clammy, dizzy, and loses consciousness. What will you do first?

Mr. Harris, 87 years old, comes to your clinic with a complaint of mild pain and swelling in the lower right back tooth region for 2 days. Medical history shows the patient has been diagnosed with high blood pressure for the past 8 years and is controlled with medications Perindopril and Candesartan. The patient is allergic to penicillin. You diagnosed a periodontal abscess in relation to tooth no. 46 and the patient does not want any other treatment and consents for extraction only. You are happy to extract the tooth today.

Q3. Mr. Harris regains consciousness after you recline the chair. What is your provisional diagnosis?

Mr. Harris, 87 years old, comes to your clinic with a complaint of mild pain and swelling in the lower right back tooth region for 2 days. Medical history shows the patient has been diagnosed with high blood pressure for the past 8 years and is controlled with medications Perindopril and Candesartan. The patient is allergic to penicillin. You diagnosed a periodontal abscess in relation to tooth no. 46 and the patient does not want any other treatment and consents for extraction only. You are happy to extract the tooth today.

Q4. Mr. Arnold says he feels okay now. How will you care for him today?

Mr. Harris, 87 years old, comes to your clinic with a complaint of mild pain and swelling in the lower right back tooth region for 2 days. Medical history shows the patient has been diagnosed with high blood pressure for the past 8 years and is controlled with medications Perindopril and Candesartan. The patient is allergic to penicillin. You diagnosed a periodontal abscess in relation to tooth no. 46 and the patient does not want any other treatment and consents for extraction only. You are happy to extract the tooth today.

Q5. Mr. Harris refuses extraction today and will return next week. What will you prescribe now?

Daniel, a 41-year-old man, presents to your practice requesting “porcelain veneers on all my teeth as soon as possible.” He reports ear pain that is worse in the morning and improves throughout the day. He uses an electric toothbrush three times daily. He is a smoker, drinks a lot of coffee, and states he has been feeling depressed since losing his wife 5 years ago.

Q1. What is the most appropriate first step for management?

Daniel, a 41-year-old man, presents to your practice requesting “porcelain veneers on all my teeth as soon as possible.” He reports ear pain that is worse in the morning and improves throughout the day. He uses an electric toothbrush three times daily. He is a smoker, drinks a lot of coffee, and states he has been feeling depressed since losing his wife 5 years ago.

Q2. Which ONE of the following diagnostic steps is MOST essential?

Daniel, a 41-year-old man, presents to your practice requesting “porcelain veneers on all my teeth as soon as possible.” He reports ear pain that is worse in the morning and improves throughout the day. He uses an electric toothbrush three times daily. He is a smoker, drinks a lot of coffee, and states he has been feeling depressed since losing his wife 5 years ago.

Q3. What is the diagnosis of the cervical lesion?

Daniel, a 41-year-old man, presents to your practice requesting “porcelain veneers on all my teeth as soon as possible.” He reports ear pain that is worse in the morning and improves throughout the day. He uses an electric toothbrush three times daily. He is a smoker, drinks a lot of coffee, and states he has been feeling depressed since losing his wife 5 years ago.

Q4. Which ONE of the following statements is NOT correct regarding botulinum toxin in dental practice?

Daniel, a 41-year-old man, presents to your practice requesting “porcelain veneers on all my teeth as soon as possible.” He reports ear pain that is worse in the morning and improves throughout the day. He uses an electric toothbrush three times daily. He is a smoker, drinks a lot of coffee, and states he has been feeling depressed since losing his wife 5 years ago.

Q5. What are the spots referred to by the arrows?