49 years old, Janice presented with pain on a lower second molar tooth. The patient had sensitivity for a long time but recently experienced pain with hot foods and drinks.
History reveals a restoration placed on the tooth 10 years ago.
Now it is so painful that she cannot bite on it.
The tooth was not mobile.

1. What test will you do to check pulp sensibility?-

49 years old, Janice presented with pain on a lower second molar tooth. The patient had sensitivity for a long time but recently experienced pain with hot foods and drinks.
History reveals a restoration placed on the tooth 10 years ago.
Now it is so painful that she cannot bite on it.
The tooth was not mobile.

2. You performed pulp testing and the pain lasted for more than 10 mins.
What is the pulpal diagnosis?-

49 years old, Janice presented with pain on a lower second molar tooth. The patient had sensitivity for a long time but recently experienced pain with hot foods and drinks.
History reveals a restoration placed on the tooth 10 years ago.
Now it is so painful that she cannot bite on it.
The tooth was not mobile.

3. There is no swelling, no pain on palpation. The tooth is tender on percussion.
What is the periapical diagnosis?-

49 years old, Janice presented with pain on a lower second molar tooth. The patient had sensitivity for a long time but recently experienced pain with hot foods and drinks.
History reveals a restoration placed on the tooth 10 years ago.
Now it is so painful that she cannot bite on it.
The tooth was not mobile.

4. The tooth restoration is not too deep.
What could be the reason for the patient’s complaint?-

49 years old, Janice presented with pain on a lower second molar tooth. The patient had sensitivity for a long time but recently experienced pain with hot foods and drinks.
History reveals a restoration placed on the tooth 10 years ago.
Now it is so painful that she cannot bite on it.
The tooth was not mobile.

5. What decides the prognosis for this tooth?-

Mandibular first molar has been hypersensitive to cold and sweets over the past few months but the symptoms have subsided.
Now there is tenderness in biting and pain to percussion.
Radiographically, there are diffuse radiopacities around the root apices.

6. What investigation will you do to diagnose tooth condition?-

Mandibular first molar has been hypersensitive to cold and sweets over the past few months but the symptoms have subsided.
Now there is tenderness in biting and pain to percussion.
Radiographically, there are diffuse radiopacities around the root apices.

7. After a clinical examination you found that the tooth is not responding to the pulp testing.
What is the pulp status?-

Mandibular first molar has been hypersensitive to cold and sweets over the past few months but the symptoms have subsided.
Now there is tenderness in biting and pain to percussion.
Radiographically, there are diffuse radiopacities around the root apices.

8. What is the periapical status if your examination revealed response to percussion and tenderness to biting?-

Mandibular first molar has been hypersensitive to cold and sweets over the past few months but the symptoms have subsided.
Now there is tenderness in biting and pain to percussion.
Radiographically, there are diffuse radiopacities around the root apices.

9. What is the diagnosis?-

Mandibular first molar has been hypersensitive to cold and sweets over the past few months but the symptoms have subsided.
Now there is tenderness in biting and pain to percussion.
Radiographically, there are diffuse radiopacities around the root apices.

10. What will be the treatment for the tooth?-

A 40-year-old aboriginal male who cannot understand much English presented at your clinic with his 14 years old son who can speak English. The patient complained of tooth pain which was excruciating in the lower right posterior region.
He has not been to a dentist for many years.
Intraoral examination showed a large polypoid lesion about 1.5cm x1.5cm wide with a 2 mm diameter stalk protruding from the carious cavity of 46.
Pulpal growth was pale pink in color and was covering the entire carious cavity in relation to 46.

11. How to proceed with investigation of the patient’s complaint?-

A 40-year-old aboriginal male who cannot understand much English presented at your clinic with his 14 years old son who can speak English. The patient complained of tooth pain which was excruciating in the lower right posterior region.
He has not been to a dentist for many years.
Intraoral examination showed a large polypoid lesion about 1.5cm x1.5cm wide with a 2 mm diameter stalk protruding from the carious cavity of 46.
Pulpal growth was pale pink in color and was covering the entire carious cavity in relation to 46.

12. You took a radiograph.
What is your diagnosis?-

A 40-year-old aboriginal male who cannot understand much English presented at your clinic with his 14 years old son who can speak English. The patient complained of tooth pain which was excruciating in the lower right posterior region.
He has not been to a dentist for many years.
Intraoral examination showed a large polypoid lesion about 1.5cm x1.5cm wide with a 2 mm diameter stalk protruding from the carious cavity of 46.
Pulpal growth was pale pink in color and was covering the entire carious cavity in relation to 46.

13. The patient has a history of Rheumatic heart disease.
What is the appropriate antibiotic prophylaxis if required?-

A 40-year-old aboriginal male who cannot understand much English presented at your clinic with his 14 years old son who can speak English. The patient complained of tooth pain which was excruciating in the lower right posterior region.
He has not been to a dentist for many years.
Intraoral examination showed a large polypoid lesion about 1.5cm x1.5cm wide with a 2 mm diameter stalk protruding from the carious cavity of 46.
Pulpal growth was pale pink in color and was covering the entire carious cavity in relation to 46.

14. What is the appropriate management?-

A 40-year-old aboriginal male who cannot understand much English presented at your clinic with his 14 years old son who can speak English. The patient complained of tooth pain which was excruciating in the lower right posterior region.
He has not been to a dentist for many years.
Intraoral examination showed a large polypoid lesion about 1.5cm x1.5cm wide with a 2 mm diameter stalk protruding from the carious cavity of 46.
Pulpal growth was pale pink in color and was covering the entire carious cavity in relation to 46.

15. You decided to do a biopsy of the lesion and the pathology lab is 3 hours away from your surgery, which medium you can use to transport the excised tissue?-

16. The most appropriate initial step in management of this case?-

17. Which of the following has the largest effect on caries risk?-

18. In caries diagnosis for children, the frequency of bitewing radiograph examination is?-

19. The parent has questions about the x-rays as it is mandatory and is concerned about radiation. Which of the following should be used to decrease radiation exposure?-

20. A protective drape for gonadal protection could only be regarded as prudent for?-

A 30-year-old man presented with various lesions on teeth.
He wants bleaching for his teeth because they “look weird over the last few years”.
The patient reported that he had a history of drinking cola as a favorite drink during work hours.
His main complaint is pain around the area of tooth # 16.
He has poor oral hygiene.
He has never visited a dentist in the past 5 years.

21. What could be the original etiology of the lesions on cervical thirds of upper and lower teeth?-

A 30-year-old man presented with various lesions on teeth.
He wants bleaching for his teeth because they “look weird over the last few years”.
The patient reported that he had a history of drinking cola as a favorite drink during work hours.
His main complaint is pain around the area of tooth # 16.
He has poor oral hygiene.
He has never visited a dentist in the past 5 years.

22. Clinical examination showed swollen interdental gingiva, while the radiograph showed two issues related to tooth#16 and tooth #17.
What could be the cause of the patient’s pain?-

A 30-year-old man presented with various lesions on teeth.
He wants bleaching for his teeth because they “look weird over the last few years”.
The patient reported that he had a history of drinking cola as a favorite drink during work hours.
His main complaint is pain around the area of tooth # 16.
He has poor oral hygiene.
He has never visited a dentist in the past 5 years.

23. How will you solve the problem?-

A 30-year-old man presented with various lesions on teeth.
He wants bleaching for his teeth because they “look weird over the last few years”.
The patient reported that he had a history of drinking cola as a favorite drink during work hours.
His main complaint is pain around the area of tooth # 16.
He has poor oral hygiene.
He has never visited a dentist in the past 5 years.

24. You are restoring tooth #16, in order to gain proper contact with the adjacent tooth. What will you do?-

A 30-year-old man presented with various lesions on teeth.
He wants bleaching for his teeth because they “look weird over the last few years”.
The patient reported that he had a history of drinking cola as a favorite drink during work hours.
His main complaint is pain around the area of tooth # 16.
He has poor oral hygiene.
He has never visited a dentist in the past 5 years.

25. If tooth 16 decay was extensive that required root canal treatment but the patient refused rubber dam. What will you do?-

26. How will you investigate?-

27. Why is it important to use control teeth during the clinical tests?-

28. Which of the methods of cold testing is preferred for pulp testing?-

29. You took a periapical radiograph.
The tooth has deep caries almost reaching the pulpal floor and a lot of secondary dentine is formed reducing the level of pulp chamber floor and there is a periapical radiolucency. Which anatomic structure will help you determine the floor level so that you don’t perforate it if RCT is required?-

30. The patient is diabetic. What significance does this hold for the patient and the treatment plan?-

31. Which period is considered to be safe to treat a pregnant woman?-

32. You are about to take an occlusal radiograph for her.
What can you do best to protect her from radiation?-

33. In the case of a pregnant dental operator, the fetus should be protected at what level?-

34. She asks “If I don’t get the proper periodontal treatment, am I more likely to deliver a pre-term, low-birth weight baby?”
Which type of study design would provide the best answer to her question?-

35. She comes back after 2 years and asks about tooth brushing and oral hygiene of her baby.
What toothpaste do you recommend for her baby?-

A patient from overseas presented at your clinic with a concern of discoloration and loss of tooth structure.
He is going to leave the country in a few days time and would like to have a ‘quick fix’ for his teeth.
Medical history is clear and no medications intake.

36. Based on the clinical picture, what do you think has happened?-

A patient from overseas presented at your clinic with a concern of discoloration and loss of tooth structure.
He is going to leave the country in a few days time and would like to have a ‘quick fix’ for his teeth.
Medical history is clear and no medications intake.

37. What treatment would you recommend for his condition?-

A patient from overseas presented at your clinic with a concern of discoloration and loss of tooth structure.
He is going to leave the country in a few days time and would like to have a ‘quick fix’ for his teeth.
Medical history is clear and no medications intake.

38. In order to restore the teeth, you would like to place a rubber dam.
Which one of the following is not a function of a rubber dam?-

A patient from overseas presented at your clinic with a concern of discoloration and loss of tooth structure.
He is going to leave the country in a few days time and would like to have a ‘quick fix’ for his teeth.
Medical history is clear and no medications intake.

39. You cannot manage to place a rubber dam on a tooth for endodontics.
Which one of the following solutions is unacceptable?-

A patient from overseas presented at your clinic with a concern of discoloration and loss of tooth structure.
He is going to leave the country in a few days time and would like to have a ‘quick fix’ for his teeth.
Medical history is clear and no medications intake.

40. One of his teeth required extraction. You decided to go for extraction, the root tip fractured.
Following extraction of teeth, root fragments can be left in place when?-

41. What is the cause of her root caries?-

42. What do you advise regarding water intake?-

43. What is the best management for her condition?-

44. Which toothpaste to recommend for her teeth sensitivity?-

45. She is looking for a natural toothpaste for sensitivity treatment. What will you tell her?-

Samantha, a 45-year-old patient is visiting your dental clinic with a complaint of sensitivity to hot and cold temperatures in her lower molar on the right side.
Additionally, she experiences pain that keeps her awake at night.
She says the pain has been there for a while now and needs a solution to fix it.

46. The pain after pulp testing lingered for a while.
You took a periapical radiograph, what would the patient most likely be suffering from?-

Samantha, a 45-year-old patient is visiting your dental clinic with a complaint of sensitivity to hot and cold temperatures in her lower molar on the right side.
Additionally, she experiences pain that keeps her awake at night.
She says the pain has been there for a while now and needs a solution to fix it.

47. What is the best means of differentiating endodontic lesions from periodontal lesions?-

Samantha, a 45-year-old patient is visiting your dental clinic with a complaint of sensitivity to hot and cold temperatures in her lower molar on the right side.
Additionally, she experiences pain that keeps her awake at night.
She says the pain has been there for a while now and needs a solution to fix it.

48. You have recommended root canal treatment (RCT) based on your diagnosis, but the patient is unwilling to undergo the procedure with a rubber dam.
Additionally, the patient mentions having a wedding to attend in three days. What to do?-

Samantha, a 45-year-old patient is visiting your dental clinic with a complaint of sensitivity to hot and cold temperatures in her lower molar on the right side.
Additionally, she experiences pain that keeps her awake at night.
She says the pain has been there for a while now and needs a solution to fix it.

49. While checking the patient’s dental records you noticed something abnormal related to lower left posterior molars. What complication has occurred?-

Samantha, a 45-year-old patient is visiting your dental clinic with a complaint of sensitivity to hot and cold temperatures in her lower molar on the right side.
Additionally, she experiences pain that keeps her awake at night.
She says the pain has been there for a while now and needs a solution to fix it.

50. What symptoms might the patient be experiencing or might have experienced?-

51. Her mother is concerned about her daughter’s interest in getting a mouth tattoo and tongue piercing.
She shares that some of her daughter’s friends of the same age had these procedures done and experienced infections.
The mother seeks your advice on the matter.-

52. Who is responsible for giving consent for her tongue piercing?-

53. You notice that the girl doesn’t care about her appearance. She brushes her teeth a few times a week and doesn’t floss. You need to give her oral hygiene instructions.
What will you base it on?-

54. The mother asks for advice about what to check out about tattoo shops?-

55. Mother asks you how long does it usually take the tattoo to heal?-

Jack a male patient 43 years of age, came with a chief complaint of sensitivity to cold food.
He also complained of discolored restorations in his upper and lower front teeth.
Patient’s medical history revealed that he is an asthmatic on medications
Inhaled corticosteroids
Salbutamol inhaler
20 mg Omeprazole
He has been suffering from this chronic inflammatory condition since 18 years and his asthmatic attacks are triggered by dust. Since then he has regularly been on medication.
When asked about his oral hygiene habits, it was understood that the patient brushes his teeth 2-3 times a day, immediately after the use of the inhaler.
Clinical examination revealed saucer shaped loss of tooth structure on labial surface of the teeth 23, 34, 35, 44 and 45. There were also discolored composite restorations on the labial surface of the teeth 22, 31, 32 and 33. Minimal attrition of posterior teeth was also seen.

56. The most probable cause for tooth structure loss in this patient could be due to?-

Jack a male patient 43 years of age, came with a chief complaint of sensitivity to cold food.
He also complained of discolored restorations in his upper and lower front teeth.
Patient’s medical history revealed that he is an asthmatic on medications
Inhaled corticosteroids
Salbutamol inhaler
20 mg Omeprazole
He has been suffering from this chronic inflammatory condition since 18 years and his asthmatic attacks are triggered by dust. Since then he has regularly been on medication.
When asked about his oral hygiene habits, it was understood that the patient brushes his teeth 2-3 times a day, immediately after the use of the inhaler.
Clinical examination revealed saucer shaped loss of tooth structure on labial surface of the teeth 23, 34, 35, 44 and 45. There were also discolored composite restorations on the labial surface of the teeth 22, 31, 32 and 33. Minimal attrition of posterior teeth was also seen.

57. Asthmatic medications can place the patient at increased risk of dental erosion by?-

Jack a male patient 43 years of age, came with a chief complaint of sensitivity to cold food.
He also complained of discolored restorations in his upper and lower front teeth.
Patient’s medical history revealed that he is an asthmatic on medications
Inhaled corticosteroids
Salbutamol inhaler
20 mg Omeprazole
He has been suffering from this chronic inflammatory condition since 18 years and his asthmatic attacks are triggered by dust. Since then he has regularly been on medication.
When asked about his oral hygiene habits, it was understood that the patient brushes his teeth 2-3 times a day, immediately after the use of the inhaler.
Clinical examination revealed saucer shaped loss of tooth structure on labial surface of the teeth 23, 34, 35, 44 and 45. There were also discolored composite restorations on the labial surface of the teeth 22, 31, 32 and 33. Minimal attrition of posterior teeth was also seen.

58. What advice will you give this patient?-

Jack a male patient 43 years of age, came with a chief complaint of sensitivity to cold food.
He also complained of discolored restorations in his upper and lower front teeth.
Patient’s medical history revealed that he is an asthmatic on medications
Inhaled corticosteroids
Salbutamol inhaler
20 mg Omeprazole
He has been suffering from this chronic inflammatory condition since 18 years and his asthmatic attacks are triggered by dust. Since then he has regularly been on medication.
When asked about his oral hygiene habits, it was understood that the patient brushes his teeth 2-3 times a day, immediately after the use of the inhaler.
Clinical examination revealed saucer shaped loss of tooth structure on labial surface of the teeth 23, 34, 35, 44 and 45. There were also discolored composite restorations on the labial surface of the teeth 22, 31, 32 and 33. Minimal attrition of posterior teeth was also seen.

59. Another simple measure to reduce tooth erosion is?-

Jack a male patient 43 years of age, came with a chief complaint of sensitivity to cold food.
He also complained of discolored restorations in his upper and lower front teeth.
Patient’s medical history revealed that he is an asthmatic on medications
Inhaled corticosteroids
Salbutamol inhaler
20 mg Omeprazole
He has been suffering from this chronic inflammatory condition since 18 years and his asthmatic attacks are triggered by dust. Since then he has regularly been on medication.
When asked about his oral hygiene habits, it was understood that the patient brushes his teeth 2-3 times a day, immediately after the use of the inhaler.
Clinical examination revealed saucer shaped loss of tooth structure on labial surface of the teeth 23, 34, 35, 44 and 45. There were also discolored composite restorations on the labial surface of the teeth 22, 31, 32 and 33. Minimal attrition of posterior teeth was also seen.

60. You provide the patient with an aspirin tablet.
The patient told you that he experienced wheezing 3 hours after the aspirin table that would raise your concern that he has?-

Jessica, a 44-year-old female patient, came to you complaining of pain and swelling caused by chewing on lower molar.
This tooth had a temporary filling which has been lost for weeks now.
Patient missed a few appointments with their dentist.
Radiographic examination showed a previous endodontic therapy with a silver cone in the mesial root of the tooth and a periapical lesion.

61. You did a percussion test which gave a positive result.
What other test is required now?-

Jessica, a 44-year-old female patient, came to you complaining of pain and swelling caused by chewing on lower molar.
This tooth had a temporary filling which has been lost for weeks now.
Patient missed a few appointments with their dentist.
Radiographic examination showed a previous endodontic therapy with a silver cone in the mesial root of the tooth and a periapical lesion.

62. The diagnosis was of chronic apical periodontitis.
How will you manage?-

Jessica, a 44-year-old female patient, came to you complaining of pain and swelling caused by chewing on lower molar.
This tooth had a temporary filling which has been lost for weeks now.
Patient missed a few appointments with their dentist.
Radiographic examination showed a previous endodontic therapy with a silver cone in the mesial root of the tooth and a periapical lesion.

63. Patient agrees to the treatment you suggested but she wants some time to think about the treatment options, for the meantime, how will you restore the tooth temporarily?-

Jessica, a 44-year-old female patient, came to you complaining of pain and swelling caused by chewing on lower molar.
This tooth had a temporary filling which has been lost for weeks now.
Patient missed a few appointments with their dentist.
Radiographic examination showed a previous endodontic therapy with a silver cone in the mesial root of the tooth and a periapical lesion.

64. You inform the patient that this would have not happened if they timely got their final restorations done and that final restorations are very important.
The patient said she was never told by the previous dentist about the crown and was upset that she was not informed. What would you advise?-

Jessica, a 44-year-old female patient, came to you complaining of pain and swelling caused by chewing on lower molar.
This tooth had a temporary filling which has been lost for weeks now.
Patient missed a few appointments with their dentist.
Radiographic examination showed a previous endodontic therapy with a silver cone in the mesial root of the tooth and a periapical lesion.

65. How will you prevent any misunderstanding during communication with the patient?-

A 24-year-old female bike riding athlete presented to you today who is not happy with the way her teeth look.
Examination reveals erosion and dental caries.
She mentions multiple years of drinking sports drinks.
She mentions she is a vegetarian.
Medical history is clear and she takes no medications.

66. What is the cause of the lesions?-

A 24-year-old female bike riding athlete presented to you today who is not happy with the way her teeth look.
Examination reveals erosion and dental caries.
She mentions multiple years of drinking sports drinks.
She mentions she is a vegetarian.
Medical history is clear and she takes no medications.

67. What is your advice to this patient?-

A 24-year-old female bike riding athlete presented to you today who is not happy with the way her teeth look.
Examination reveals erosion and dental caries.
She mentions multiple years of drinking sports drinks.
She mentions she is a vegetarian.
Medical history is clear and she takes no medications.

68. What alternative can you suggest?-

A 24-year-old female bike riding athlete presented to you today who is not happy with the way her teeth look.
Examination reveals erosion and dental caries.
She mentions multiple years of drinking sports drinks.
She mentions she is a vegetarian.
Medical history is clear and she takes no medications.

69. She asked for advice about a suitable mouth guard for her?-

A 24-year-old female bike riding athlete presented to you today who is not happy with the way her teeth look.
Examination reveals erosion and dental caries.
She mentions multiple years of drinking sports drinks.
She mentions she is a vegetarian.
Medical history is clear and she takes no medications.

70. What could happen if she uses a mouth guard and sports drink while riding the bike?-

A 29 year old lady complains of dry mouth recently.
She smokes, drinks a lot of alcohol with friends over the weekends.
She is very stressed in her job, drinks a lot of coffee and sugary snacks in every break, can’t sleep properly, has headaches, wakes up feeling tired.
She started taking antidepressant recently.
She is worried about her teeth, which are looking to change over time.

71. What is the reason for the appearance of her teeth?-

A 29 year old lady complains of dry mouth recently.
She smokes, drinks a lot of alcohol with friends over the weekends.
She is very stressed in her job, drinks a lot of coffee and sugary snacks in every break, can’t sleep properly, has headaches, wakes up feeling tired.
She started taking antidepressant recently.
She is worried about her teeth, which are looking to change over time.

72. What will you do for the above problem?-

A 29 year old lady complains of dry mouth recently.
She smokes, drinks a lot of alcohol with friends over the weekends.
She is very stressed in her job, drinks a lot of coffee and sugary snacks in every break, can’t sleep properly, has headaches, wakes up feeling tired.
She started taking antidepressant recently.
She is worried about her teeth, which are looking to change over time.

73. What is the cause of her dry mouth?-

A 29 year old lady complains of dry mouth recently.
She smokes, drinks a lot of alcohol with friends over the weekends.
She is very stressed in her job, drinks a lot of coffee and sugary snacks in every break, can’t sleep properly, has headaches, wakes up feeling tired.
She started taking antidepressant recently.
She is worried about her teeth, which are looking to change over time.

74. You did an oral examination and found multiple incipient caries.
What will you give her?-

A 29 year old lady complains of dry mouth recently.
She smokes, drinks a lot of alcohol with friends over the weekends.
She is very stressed in her job, drinks a lot of coffee and sugary snacks in every break, can’t sleep properly, has headaches, wakes up feeling tired.
She started taking antidepressant recently.
She is worried about her teeth, which are looking to change over time.

75. She has limited her alcohol, what will you do for the management of her dry mouth?-

Jessica had composite filling done 2 months ago at a local dental practice on one of her upper back teeth.
She feels soreness in between her upper molars region specially after she eats meat and the gums around the tooth bleed and there is a foul odor.
No other complaints.

76. What could be the cause of her soreness?-

Jessica had composite filling done 2 months ago at a local dental practice on one of her upper back teeth.
She feels soreness in between her upper molars region specially after she eats meat and the gums around the tooth bleed and there is a foul odor.
No other complaints.

77. What is the problem with the filling?-

Jessica had composite filling done 2 months ago at a local dental practice on one of her upper back teeth.
She feels soreness in between her upper molars region specially after she eats meat and the gums around the tooth bleed and there is a foul odor.
No other complaints.

78. Reason for the open contact after placement of the filling?-

Jessica had composite filling done 2 months ago at a local dental practice on one of her upper back teeth.
She feels soreness in between her upper molars region specially after she eats meat and the gums around the tooth bleed and there is a foul odor.
No other complaints.

79. The patient has multiple composite restorations.
What advice will you give her regarding her daily oral hygiene?-

Jessica had composite filling done 2 months ago at a local dental practice on one of her upper back teeth.
She feels soreness in between her upper molars region specially after she eats meat and the gums around the tooth bleed and there is a foul odor.
No other complaints.

80. You plan to replace the restoration.
Incremental building of composite restorations is not necessary?-

Patient has undergone an initial visit of root canal treatment 3 days ago and presents to you with pain.
The involved tooth is the lower right first molar.
She was not happy with the previous dentist who started the root canal treatment and came to you for further procedures.
On the initial periapical radiograph you took, you suspect a perforation of the pulp chamber floor.

81. Which of the following would not be an early sign or indication of a perforation?-

Patient has undergone an initial visit of root canal treatment 3 days ago and presents to you with pain.
The involved tooth is the lower right first molar.
She was not happy with the previous dentist who started the root canal treatment and came to you for further procedures.
On the initial periapical radiograph you took, you suspect a perforation of the pulp chamber floor.

82. What is the ideal time and material for nonsurgical repair of a furcation perforation?-

Patient has undergone an initial visit of root canal treatment 3 days ago and presents to you with pain.
The involved tooth is the lower right first molar.
She was not happy with the previous dentist who started the root canal treatment and came to you for further procedures.
On the initial periapical radiograph you took, you suspect a perforation of the pulp chamber floor.

83. Which type of perforation has the poorest long-term prognosis?-

Patient has undergone an initial visit of root canal treatment 3 days ago and presents to you with pain.
The involved tooth is the lower right first molar.
She was not happy with the previous dentist who started the root canal treatment and came to you for further procedures.
On the initial periapical radiograph you took, you suspect a perforation of the pulp chamber floor.

84. Which sequela is most likely to occur after minor extrusion of obturating materials into the periapical tissue?-

Patient has undergone an initial visit of root canal treatment 3 days ago and presents to you with pain.
The involved tooth is the lower right first molar.
She was not happy with the previous dentist who started the root canal treatment and came to you for further procedures.
On the initial periapical radiograph you took, you suspect a perforation of the pulp chamber floor.

85. Which of the following is more likely to cause extrusion of sodium hypochlorite irrigating solution into the periapical tissues?-

The patient complained of sensitivity to both hot and cold liquids following the placement of a full gold crown on the maxillary second molar, now the discomfort is spontaneous.
Upon application of Endo-Ice on this tooth, the patient experienced pain and upon removal of the stimulus, the discomfort lingered for 20 seconds.
Responses to both percussion and palpation were normal On IOPA, there was no evidence of osseous changes.

86. You believe it is an irreversible pulpitis.
What is irreversible pulpitis?-

The patient complained of sensitivity to both hot and cold liquids following the placement of a full gold crown on the maxillary second molar, now the discomfort is spontaneous.
Upon application of Endo-Ice on this tooth, the patient experienced pain and upon removal of the stimulus, the discomfort lingered for 20 seconds.
Responses to both percussion and palpation were normal On IOPA, there was no evidence of osseous changes.

87. Radiographically, there was no evidence of osseous changes. Which of the following is a characteristic of a periapical lesion of endodontic origin?-

The patient complained of sensitivity to both hot and cold liquids following the placement of a full gold crown on the maxillary second molar, now the discomfort is spontaneous.
Upon application of Endo-Ice on this tooth, the patient experienced pain and upon removal of the stimulus, the discomfort lingered for 20 seconds.
Responses to both percussion and palpation were normal On IOPA, there was no evidence of osseous changes.

88. What are the most difficult teeth to anesthetize with irreversible pulpitis?-

The patient complained of sensitivity to both hot and cold liquids following the placement of a full gold crown on the maxillary second molar, now the discomfort is spontaneous.
Upon application of Endo-Ice on this tooth, the patient experienced pain and upon removal of the stimulus, the discomfort lingered for 20 seconds.
Responses to both percussion and palpation were normal On IOPA, there was no evidence of osseous changes.

89. Your diagnosis of this case is “an exacerbation of a tooth with symptomatic irreversible pulpitis”.
What is a common presentation of a patient with this condition?-

The patient complained of sensitivity to both hot and cold liquids following the placement of a full gold crown on the maxillary second molar, now the discomfort is spontaneous.
Upon application of Endo-Ice on this tooth, the patient experienced pain and upon removal of the stimulus, the discomfort lingered for 20 seconds.
Responses to both percussion and palpation were normal On IOPA, there was no evidence of osseous changes.

90. If there was a developed, sizable radiolucency apically, what must the pulpal diagnosis be?-

Mr. Tran brings in his 18 month old son Henry for a well child visit.
You know the Tran family well, but see them only sporadically due to their lack of health insurance, mobility, and other life priorities.
Overall, the Tran family children are quite healthy. The only significant problems has been with Henry’s older sister who had extensive dental caries, primarily related to the family’s poor understanding of the role of preventive care and appropriate diet.
On examination you note several white lines on Henry’s teeth along with a small early cavity.
Henry also has a thumb sucking habit.

91. What is his caries risk?-

Mr. Tran brings in his 18 month old son Henry for a well child visit.
You know the Tran family well, but see them only sporadically due to their lack of health insurance, mobility, and other life priorities.
Overall, the Tran family children are quite healthy. The only significant problems has been with Henry’s older sister who had extensive dental caries, primarily related to the family’s poor understanding of the role of preventive care and appropriate diet.
On examination you note several white lines on Henry’s teeth along with a small early cavity.
Henry also has a thumb sucking habit.

92. Your decision to apply fluoride varnish should be based upon which of the following statements?-

Mr. Tran brings in his 18 month old son Henry for a well child visit.
You know the Tran family well, but see them only sporadically due to their lack of health insurance, mobility, and other life priorities.
Overall, the Tran family children are quite healthy. The only significant problems has been with Henry’s older sister who had extensive dental caries, primarily related to the family’s poor understanding of the role of preventive care and appropriate diet.
On examination you note several white lines on Henry’s teeth along with a small early cavity.
Henry also has a thumb sucking habit.

93. After consideration, you make the decision to apply fluoride varnish to Henry’s teeth.
While discussing Henry’s treatment plan and obtaining informed consent, Mr.Tran raises concerns about the safety of fluoride varnish.
Which of the following statements about the safety of fluoride varnish is most correct?-

Mr. Tran brings in his 18 month old son Henry for a well child visit.
You know the Tran family well, but see them only sporadically due to their lack of health insurance, mobility, and other life priorities.
Overall, the Tran family children are quite healthy. The only significant problems has been with Henry’s older sister who had extensive dental caries, primarily related to the family’s poor understanding of the role of preventive care and appropriate diet.
On examination you note several white lines on Henry’s teeth along with a small early cavity.
Henry also has a thumb sucking habit.

94. Once reassured as to the safety of fluoride varnish, Mr. Tran then inquires, “How does fluoride help to protect Henry’s teeth?” The most appropriate response to Mr. Tran’s question is?-

Mr. Tran brings in his 18 month old son Henry for a well child visit.
You know the Tran family well, but see them only sporadically due to their lack of health insurance, mobility, and other life priorities.
Overall, the Tran family children are quite healthy. The only significant problems has been with Henry’s older sister who had extensive dental caries, primarily related to the family’s poor understanding of the role of preventive care and appropriate diet.
On examination you note several white lines on Henry’s teeth along with a small early cavity.
Henry also has a thumb sucking habit.

95. The parent asked about what should be done to the thumb-sucking habit?-

96. What is your initial management of tooth 51?-

97. What home care instructions must be given?-

98. Tooth 51 requires a follow up within?-

99. Tooth 61 showed crown fracture with a small pulp exposure. What is your investigation?-

100. Treatment of tooth 61 should be?-