DHA Dentist Exam cheat sheet

Syncope: supine position with legs elevated, loosen tight clothing, ammonia spirits; if no recovery in 1–2 minutes, assess airway and call for help.

Angina pectoris: stop treatment, sit patient upright, administer sublingual nitroglycerin 0.3–0.4 mg every 5 minutes up to 3 doses; if pain persists >15 minutes, treat as myocardial infarction and arrange emergency transfer.

Hypoglycemia in a conscious patient: give 15–20 g oral glucose; if unconscious, give glucagon 1 mg IM/SC or IV dextrose and call emergency services.

Anaphylaxis: epinephrine 0.3–0.5 mg IM (1:1000) in the anterolateral thigh, repeat every 5–15 minutes as needed; adjuncts include oxygen, IV fluids, and diphenhydramine.

Asthma attack: place patient upright, administer 2 puffs of a short-acting beta-2 agonist via spacer, repeat as needed; seek emergency care if no improvement or if lips/face turn blue.

Adrenal crisis prevention: patients with primary adrenal insufficiency or on long-term systemic corticosteroids may need doubled or supplemental corticosteroid coverage for stressful procedures.

Antibiotic prophylaxis is indicated before invasive dental procedures for patients with prosthetic heart valves, previous infective endocarditis, certain congenital heart defects, and cardiac transplant with valvulopathy.

Warfarin: do not stop routinely for routine dental care; check INR within 24 hours and proceed if INR is within therapeutic range (typically ≤3.5); use local hemostatic measures.

Metformin should be withheld on the day of a procedure using iodinated contrast or when the patient is unable to eat; restart after renal function is confirmed normal.

Recurrent aphthous stomatitis: minor ulcers <1 cm, heal in 7–14 days without scarring; major ulcers >1 cm, persist weeks, and may scar.

Oral lichen planus: bilateral white striae (Wickham striae), erosive areas; biopsy if unilateral, ulcerated, or nonresponsive to rule out dysplasia or malignancy.

Leukoplakia: white patch that cannot be rubbed off and cannot be classified clinically; biopsy to rule out dysplasia; annual follow-up for nonsmokers and 6-month for smokers.

Erythroplakia: red velvety patch; high risk of severe dysplasia or carcinoma in situ; biopsy is mandatory.

Squamous cell carcinoma of the lip: most common on the lower lip; actinic cheilitis is a precursor; any nonhealing ulcer >2 weeks requires biopsy.

Pleomorphic adenoma: most common benign salivary gland tumor, usually in the parotid; superficial parotidectomy with margin is treatment; recurrence risk if ruptured.

Mucoepidermoid carcinoma: most common malignant salivary gland tumor; low-grade tumors have cystic spaces and mucous cells; high-grade tumors show anaplasia and necrosis.

Trigeminal neuralgia: paroxysmal lancinating pain in V2/V3, triggered by touch, chewing, or cold; carbamazepine is first-line therapy.

Burning mouth syndrome: chronic oral burning without clinical lesions, often bilateral and in postmenopausal women; evaluate for anemia, diabetes, and vitamin deficiencies.

Working length determination: apex locator reading within 0.5 mm of the apical constriction; confirm with periapical radiograph.

Irrigation: 0.5–5.25% sodium hypochlorite dissolves organic tissue and is antimicrobial; 17% EDTA removes the smear layer; do not mix NaOCl and chlorhexidine due to precipitate formation.

Root canal obturation: warm vertical compaction or single-cone with bioceramic sealer; fill to 0.5–1 mm short of the radiographic apex.

C-shaped canals: most common in mandibular second molars; use rotary files with caution and copious irrigation because of complex anatomy.

Crown preparation: axial reduction 1.0–1.5 mm for metal-ceramic, 1.5–2.0 mm for all-ceramic; occlusal reduction 1.5–2.0 mm.

Dentin bonding: total-etch uses 32–37% phosphoric acid on enamel and dentin; self-etch does not require separate etching; avoid over-drying etched dentin to prevent collagen collapse.

Postoperative sensitivity after composite: often from polymerization shrinkage or inadequate dentin sealing; use a liner or self-etch adhesive in deep cavities.

Rubber dam isolation is standard for endodontic treatment and for adhesive restorations to control moisture and protect the airway.

Cracked tooth syndrome: sharp pain on release of biting force, often on a mandibular molar; transillumination and bite test aid diagnosis; cuspal coverage is often required.

Complete denture occlusion: bilaterally balanced occlusion in eccentric movements to stabilize dentures; arrange teeth over the residual ridge.

Posterior palatal seal: provides retention and seals the denture border; placed at the junction of the hard and soft palate, extending to the vibrating line.

Retention of complete dentures: adhesion, cohesion, surface tension, atmospheric pressure, and neuromuscular control; border seal is essential.

Implant overdenture: minimum of two implants in the anterior mandible between mental foramina; splinting improves stability and survival.

Fixed partial denture abutment selection: crown-to-root ratio ideally ≥1:1; avoid cantilevers longer than the length of the abutment-supported span.

Occlusal vertical dimension: loss of OVD manifests as angular cheilitis, reduced lower facial height, and increased freeway space; restore with a trial denture or occlusal splint.

Metal-ceramic crown: minimum 0.3–0.5 mm metal substructure and 1.0–1.5 mm porcelain for adequate esthetics and strength.

Denture stomatitis: most commonly Candida albicans; treat with topical antifungal, denture hygiene, and remove dentures at night.

Periodontal disease classification: staging (I–IV) based on severity and complexity; grading (A–C) based on progression rate and risk factors.

Pocket depth ≥4 mm with bleeding on probing indicates active periodontal disease requiring treatment; ≥5 mm often needs surgical or regenerative therapy.

Scaling and root planing: definitive nonsurgical therapy for chronic periodontitis; re-evaluate 6–8 weeks after completion.

Antibiotic adjunct: amoxicillin 500 mg plus metronidazole 400 mg three times daily for 7 days is used for aggressive periodontitis or necrotizing periodontal disease.

Gingival recession: Miller classification guides prognosis; Class I and II have good root coverage potential; Class III partial; Class IV poor.

Risk factors: smoking, diabetes mellitus, poor oral hygiene, genetic predisposition, and certain medications (phenytoin, nifedipine, cyclosporine) cause gingival enlargement.

Peri-implant mucositis: reversible inflammation without bone loss; peri-implantitis includes bone loss and requires surgical intervention.

Furcation involvement: Grade I (incipient), Grade II (partial), Grade III (through-and-through); Grade III often requires root resection or extraction.

Third molar extraction: indications include recurrent pericoronitis, caries, cyst formation, and orthodontic need; contraindications include uncontrolled systemic disease and acute infection.

Inferior alveolar nerve injury: most common after third molar surgery; assess with neurosensory testing; most paresthesias resolve within 6 months.

Dry socket (alveolar osteitis): severe pain 2–4 days post-extraction with empty socket; treat with socket irrigation and medicated dressing; avoid smoking.

Post-extraction bleeding: apply pressure with gauze for 20–30 minutes; if persistent, use hemostatic agents (oxidized cellulose, tranexamic acid mouthwash) and check for coagulopathy.

Odontogenic infection: spread to submandibular, sublingual, or buccal spaces; airway compromise (Ludwig's angina) requires urgent IV antibiotics and surgical drainage.

Orthognathic surgery: Le Fort I osteotomy for maxillary repositioning; bilateral sagittal split osteotomy (BSSO) for mandibular advancement or setback.

Mandibular fracture: most common in the angle and body; treat with closed reduction (maxillomandibular fixation) or open reduction and internal fixation (ORIF).

Biopsy principles: incisional biopsy for large or suspicious lesions; excisional biopsy for small benign lesions; always send specimen in formalin.

Eruption timeline: first primary tooth at 6 months; first permanent molar at 6 years; canine at 11–12 years; third molar at 17–21 years.

Class I malocclusion: normal anteroposterior relationship; Class II: mandibular retrognathia or maxillary prognathia; Class III: mandibular prognathia.

Cephalometric angles: SNA normal ~82°, SNB ~80°, ANB ~2°; ANB >4° suggests Class II skeletal pattern; ANB <0° suggests Class III.

Space maintenance: band-and-loop or crown-and-loop for premature loss of primary molars; space maintainers prevent arch length loss.

Fluoride varnish: 5% sodium fluoride (22,600 ppm) applied every 3–6 months for caries prevention in children.

Pulpotomy in primary molars: remove coronal pulp, apply medicament (formocresol or ferric sulfate), and place stainless steel crown.

Ectopic eruption of first permanent molar: often requires disimpaction with separators or orthodontic appliances to prevent impaction.

Digit sucking: stop before 4 years to prevent anterior open bite; habit appliances and positive reinforcement are effective.

DMFT index: Decayed, Missing, Filled Teeth; DMFS index: surfaces; used to measure caries prevalence in populations.

Community Periodontal Index (CPI): assesses periodontal status using a probe; scores 0–4; score 4 indicates pocket depth ≥6 mm.

Water fluoridation: optimal level 0.7–1.2 ppm depending on climate; reduces caries by 20–40%.

Hand hygiene: use alcohol-based hand rub for routine decontamination; wash with soap and water when hands are visibly soiled or after contact with blood/body fluids.

Sterilization: autoclave at 121°C for 15 minutes or 134°C for 3 minutes; monitor with biological indicators (Geobacillus stearothermophilus) weekly.

Surface disinfection: use EPA-registered hospital disinfectant with tuberculocidal activity for blood-contaminated surfaces; barriers for clinical contact surfaces.

Sharps safety: never recap needles; dispose in puncture-resistant sharps container; report needlestick injuries immediately and follow post-exposure prophylaxis protocol.

Personal protective equipment: gloves, mask, eye protection, and gown; change gloves between patients and after touching contaminated surfaces.

Maximum recommended dose of lidocaine with epinephrine: 7 mg/kg (up to 500 mg) for adults; 4.4 mg/kg for children; calculate based on body weight.

Epinephrine concentration: 1:100,000 = 0.01 mg/mL; 1:200,000 = 0.005 mg/mL; maximum epinephrine dose 0.2 mg per appointment for healthy adults.

Local anesthetic allergy: true allergy to amide anesthetics is rare; ester anesthetics (benzocaine) more commonly cause allergic reactions.

Aspirin: irreversible COX-1 inhibitor; avoid in children due to Reye's syndrome; used for antiplatelet therapy at low doses.

NSAIDs: ibuprofen 400–600 mg every 6–8 hours; contraindicated in peptic ulcer disease and renal impairment; caution with warfarin.

Opioid analgesics: codeine is a prodrug converted to morphine by CYP2D6; avoid in children and ultrarapid metabolizers due to respiratory depression risk.

Antibiotic prophylaxis for dental procedures: amoxicillin 2 g orally 30–60 minutes before procedure; clindamycin no longer recommended due to C. difficile risk; use cephalexin, azithromycin, or doxycycline for penicillin allergy.

Nitrous oxide/oxygen sedation: contraindicated in patients with upper respiratory infection, pregnancy (first trimester), and severe COPD; monitor oxygen saturation.

Inferior alveolar nerve block: target is the pterygomandibular space; complications include trismus, hematoma, and intravascular injection.

Informed consent: must include diagnosis, proposed treatment, risks, benefits, alternatives, and consequences of no treatment; document in the patient record.

Patient confidentiality: protected under UAE Federal Law No. 2 of 2019 (Health Insurance) and professional regulations; disclose only with consent or legal requirement.

Record keeping: maintain accurate, legible, and contemporaneous records; retain for at least 10 years or as required by UAE health authority regulations.

Scope of practice: dentists must practice within their licensed scope; refer complex cases to specialists when appropriate.

Infection control standards: follow UAE Ministry of Health and Prevention (MOHAP) and local health authority (DHA) guidelines for sterilization and PPE.

Adverse event reporting: report serious adverse events and near misses to the health authority; participate in root cause analysis.

Advertising: dental advertising must be truthful, not misleading, and comply with DHA regulations; avoid guarantees of results.

Continuing education: dentists must complete required CME hours for license renewal as specified by DHA.

Impaired practitioner: duty to report impaired colleagues to the health authority; patient safety takes precedence.