#MCQ 10 - In Orthodontics, Porcelain brackets have better esthetics as compared to stainless steel brackets. However, a major disadvantage is:

#MCQ 10 - In Orthodontics, Porcelain brackets have better esthetics as compared to stainless steel brackets. However, a major disadvantage is:

A. Stains over time

B. Require special debonding agents

C. Removing is difficult and causes enamel cracks

D. Channel microfraction while debonding

Answer: Removing is difficult and causes enamel cracks

"Ceramic brackets are more difficult to debond than steel brackets, and wing fractures may occur easily during debracketing." - Graber

Drawbacks of Ceramic Brackets:

1.  The frictional resistance between orthodontic wire and ceramic brackets is greater and less predictable than it is with steel brackets. This unpredictability makes determining optimal force levels and anchorage control difficult. Ceramic brackets with a steel slot insert to reduce friction are therefore more reliable for clinical purposes.

2. Ceramic brackets are not as durable as steel brackets and are brittle by nature. These brackets may break during orthodontic treatment, particularly when full size (or close to full size) stainless steel archwires are used for torquing purposes.

3. Ceramic brackets are harder than steel and rapidly induce enamel wear of any opposing teeth.

4. Ceramic brackets are more difficult to debond than steel brackets, and wing fractures may occur easily during debracketing. 

5. The added bulk required to provide adequate strength makes oral hygiene more difficult.

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#MCQ 9 - Treatment of Ludwig's Angina due to pericoronitis with respect to lower third molar?

#MCQ 9 - Treatment of Ludwig's Angina due to pericoronitis with respect to lower third molar :
A. Incision and Drainage, antibiotics and removal of third molar
B. Intubation prior to surgery
C. Incision and drainage, removal of third molar, antibiotics
D. Tracheostomy should be done before any treatment

Answer: D.  Tracheostomy should be done before any treatment

The dramatic reduction in the mortality of Ludwig's angina from 54% to 10% in only 3 years, afforded by Williams and Guralnick, was made possible by their changed surgical policy of immediate establishment of airway security by early intubation or tracheostomy, followed by aggressive and early surgical intervention. This dramatic reduction in mortality from 54 to 10 percent was not due to the first use of penicillin in the treatment of these infections.

Reference: Peterson's Principles of Oral and Maxillofacial Surgery, 3rd Edition, Page 841

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#MCQ 8 - A dental surgeon has recovered from Hepatitis B after a three months rest. His Laboratory Findings are Normal but he is not allowed to attend to the patients as per the medical board because he is:

#MCQ 8 - A dental surgeon has recovered from Hepatitis B after a three months rest. His Laboratory Findings are Normal but he is not allowed to attend to the patients as per the medical board because he is:
A. Healthy carrier
B. Active carrier
C. Convalescent carrier
D. Paradoxical carrier

Answer: C. Convalescent carrier

A carrier is a person who harbors the pathogenic microorganism without suffering from any ill effect because of it.

Healthy Carrier - One who harbors the pathogen but has never suffered from the disease caused by the pathogen
Convalescent carrier - One who has recovered from the disease and continue to harbor the pathogen in the body
Temporary carrier - This state lasts less than 6 months
Chronic carrier - This state lasts for several years and even rest of the life in some cases
Contact carrier - One who acquires pathogen from a patient
Paradoxical carrier - One who acquires pathogen from other carrier

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How to get rid of Toothache ?

Toothache is a lifetime experience for someone who has experienced the pain of acute pulpitis. Be it sharp, acute, transient pain for seconds or some dull aching, continuous vauge pain in the facial region, tooth pain is really intolerable to ignore. Getting rid of the toothache is the only  thing the sufferer thinks of at the time because, foods look painful, all parties are meaningless if you cannot eat anything, even water !

The type of pain you have is very important to know the condition you might be suffering with. For example, continuous pain that lasts for minutes to hours even after removal of an offending stimulus ( cold, heat, air or some acidic foods) or spontaneous pain without any stimulus often represents irreversible pulpitis, which mandates that you should have a root canal treatment rather than a simple tooth filling. The tooth may seem perfectly fine from outside but there may be a large decay between two teeth which can be seen only on radiographs. Or, your teeth may be without any decay but the pain may be from some periodontal problems (problems arising from gums and other supporting structures of tooth)  The decision of treatment plan whether you should get a root canal treatment or a simple restoration will be okay must be done by your dentist after listening to your history of illness, clinical examination and radiographic evaluation. There's no point asking a dentist over the phone about whether you need an RCT or not.

There is no any medication to reverse your tooth decay once a clinically visible cavitated lesion is formed, the only treatment is to remove the caries and then restore it. But for the immediate pain relief, you can avoid the stimulus causing pain. Warm water can be helpful to relieve pain in some tooth sensitivity cases. Lying down or sleeping aggravates the pain in irreversible pulpitis due to increased blood pressure in the pulpal tissues while sleeping or lying down, so, upright positioning provides relief relatively. Avoid taking too cold or too hot foods and acidic foods and beverages like carbonated soda drinks, citric fruits, sweets, ice cream, etc.

 If you cannot tolerate the dental pain, you may take over the counter medications such as Paracetamol 500mg or Ibuprofen 400mg for immediate pain relief. But that does not mean you can defer the dental treatment any further. You do not feel the pain doesn't mean that the underlying problem is cured, the bacteria doesn't die itself. You wouldn't want the disease progress further and come back again larger and stronger which causes more pain, loss of time and loss of money.

A stitch in time saves nine is very much applicable in the field of dentistry.

# MCQ 7 - Which of the following tests for tooth vitality assessment has the highest diagnostic accuracy?

# MCQ 7
# Which of the following tests for tooth vitality assessment has the highest diagnostic accuracy?
A. Electric Pulp Test
B. Heat Test
C. Cold Test
D. Anesthetic Test

Answer: C. Cold Test
The diagnostic accuracy of cold test is 86%, the heat test is 71 % and Electric pulp test is 81%.
So, a combination of cold test followed by Electric Pulp Test (EPT) is recommended in a clinical setting. Anesthetic test is done only in patients who are in pain at the time of the test and other tests have failed to identify the tooth causing pain.

Reference: Grossman's Endodontic Practice, 13th Edition, Page 72

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# MCQ 6 - Maximum use of Computers in the field of Dentistry is in the field of:

# Maximum use of Computers in the field of Dentistry is in the field of:
A. Periodontology
B. Prosthodontics
C. Community Dentistry
D. Operative Dentistry

Answer:
C. Community Dentistry
Other branches of dentistry may optionally use computers, but Community Dentistry uses computers extensively for data analysis, storage, transfer and presentation.

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#MCQ 5 - First Water Fluoridation was done in:

# First Water Fluoridation was done in:

A. Sweden
B. Canada
C. Michigan (USA)
D. California

Answer:
C. Michigan (USA)

To test the hypothesis that adding fluoride would prevent cavities, Dean and his colleagues conducted a controlled experiment by fluoridating the water in Grand Rapids, Michigan, starting 25 January 1945. The results, published in 1950, showed significant reduction of cavities.

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