ADC Written Exam common mistakes
ADC Written Exam · Understand the traps and how to avoid them.
On a vignette describing a rapidly spreading submandibular swelling with dysphagia, trismus and systemic upset, selects 'prescribe oral amoxicillin and review in 48 hours' instead of urgent referral and airway assessment.
The stem uses descriptive language rather than the word 'emergency', so the overlearned 'dental infection equals antibiotics' script fires and the red flags are skimmed as background detail.
What to do instead
Build and rehearse a red-flag triage list (dysphagia, dyspnoea, floor-of-mouth elevation, trismus under about 20 mm, rapid progression, systemic upset) and apply it before considering any definitive treatment, so these findings override the routine script every time.
Answers a stem asking which option is NOT appropriate, or is the LEAST appropriate, by choosing the first option that is clinically correct, without going back to the negated qualifier.
Under time pressure the brain matches on the clinical content of the options and the negation drops out of working memory, so a correct-sounding option feels like the answer.
What to do instead
Circle or silently say the qualifier (NOT, LEAST, EXCEPT, FIRST, NEXT) before reading the options and re-check it after selecting; in practice sets, log every item lost to a missed qualifier and review the pattern weekly.
Calculates a child's antibiotic or local anaesthetic dose by scaling down an adult dose (for example half an adult tablet) instead of using mg/kg with an absolute maximum adult cap.
Adult dosing is overlearned and weight-based calculation is rarely performed after graduation, so the easier proportional shortcut feels adequate under exam pressure.
What to do instead
Memorise the mg/kg figures and maximum doses for the drugs on the ADC list, then practise ten weight-based calculations per week writing out weight, mg/kg, total mg, concentration and volume, explicitly noting where the adult maximum caps the dose.
Judges a diagnostic test from its sensitivity alone, concluding a highly sensitive test 'rules in' disease in a low-prevalence population, or treats prevalence as irrelevant to the answer.
Sensitivity and positive predictive value are conflated, and prevalence is read as a distractor rather than the driver of post-test probability.
What to do instead
Practise filling a 2x2 table with a stated prevalence, then compute PPV, NPV and likelihood ratios; state the rules explicitly (a sensitive test helps rule out, a specific test helps rule in) and check whether the low-prevalence setting flips the answer.
Gives a periodontal diagnosis in pre-2017 language such as 'generalised severe chronic periodontitis' with no stage or grade attached.
Notes and overseas training predate the 2017 World Workshop classification, and the older terms are still the ones that come to mind first.
What to do instead
Learn the current classification as a fixed template: stage from interdental clinical attachment loss and radiographic bone loss plus complexity factors, grade from progression rate and risk factors, then extent; write the full diagnosis out for twenty cases until the template is automatic.
Moves straight to a definitive restorative or surgical plan when the stem asked only for the next step in management.
A familiar case pattern triggers a full treatment plan, and the final sentence of the stem is read faster than the clinical details above it.
What to do instead
Before answering, restate the question in your own words (for example 'what do I do today?') and rank the options by immediacy, eliminating any option that answers a different question from the one actually asked.
Proposes extraction of a tooth with acute pericoronitis or an acute apical abscess at the first visit without first controlling the acute infection.
Definitive treatment feels like the 'real' answer, and the principle of treating the acute problem before elective care is under-rehearsed relative to procedure knowledge.
What to do instead
Apply a fixed sequence to every management vignette, acute control then reassessment then definitive care, and test each option against the question 'is this safe to do today?'
Plans an extraction or implant for a patient on denosumab or zoledronic acid, or with previous head and neck radiotherapy, without mentioning medication-related osteonecrosis risk, consent or specialist opinion.
The drug history appears as one line of background in the stem, and osteonecrosis is filed mentally as an oral medicine topic rather than a step in surgical planning.
What to do instead
Screen every surgical vignette for antiresorptive and antiangiogenic drugs, radiotherapy and diabetes; rehearse the risk-reduction conversation, the consent discussion and the indications for referral so they are triggered automatically.
Defers all dental treatment for a pregnant patient with acute pain until after delivery or until the second trimester, regardless of the urgency described.
An over-generalised 'avoid treating pregnant patients' rule is remembered, while the exception for urgent and emergency care is not.
What to do instead
Learn the actual framework as a set of rules: urgent and emergency care at any stage, elective care ideally in the second trimester, left lateral positioning in the third trimester, and the specific analgesic, antibiotic and radiographic considerations.
Describes reprocessing single-use items, or a sterilisation sequence that does not match AS/NZS 4187 and the current NHMRC infection control guidelines, such as omitting validation of the steriliser cycle.
Workplace habits from a previous practice or overseas setting are assumed to be compliant, so the answer reflects local custom rather than the current Australian standard.
What to do instead
Read the current NHMRC Australian Guidelines for the Prevention and Control of Infection in Healthcare and AS/NZS 4187, then write out the full reprocessing cycle (cleaning, inspection, packaging, sterilisation, validation, storage) with the rationale for each step until it can be reproduced from memory.