CRDTS Dental common mistakes
CRDTS Dental · Understand the traps and how to avoid them.
Starting a patient-based clinical task, such as a Class II cavity prep or scaling, without first confirming patient identity, consent, medical history, and the correct tooth/site against the chart, then proceeding once the examiner signals time.
Candidates rehearse the operative steps and treat the pre-procedure checklist as administrative padding, so under time pressure they skip verification and lose structured marks before the bur or scaler touches the tooth.
What to do instead
Build a fixed 60–90 second opening script: greet and identify patient, confirm written consent, state relevant medical history and any precautions, name the tooth and surface, and verbalise the planned procedure and local anaesthetic. Rehearse it aloud until it is automatic, and treat it as a scored station in its own right.
Losing control of instrument angulation and adaptation during scaling or root surface debridement, so the cutting edge is not kept adapted to the tooth and strokes become heavy, burnishing deposits or traumatising the gingiva.
Candidates focus on removing visible calculus quickly and grip the instrument like a pen under stress, which collapses the lateral pressure and angulation they practised on a manikin.
What to do instead
Practise on a periodontal manikin with a disclosing or pressure-sensitive surface, using controlled 1–2 mm overlapping strokes, a finger rest on a stable adjacent tooth, and light exploratory strokes before activating. Video your own hand position and check angulation against the tooth long axis before each sextant.
Preparing a cavity or crown without a clear, stated end-point for depth, width, and margin design, so the preparation is judged as over-extended, under-extended, or with unsupported enamel, and the candidate cannot justify the design when questioned.
Candidates memorise preparation 'recipes' without linking them to caries extent, remaining tooth structure, and material requirements, so they improvise once the tooth looks different from the textbook picture.
What to do instead
Before cutting, state the diagnosis, the design rationale, and the dimensions you are aiming for (e.g. isthmus width, pulpal floor depth, margin location). Check depth with a periodontal probe or marked bur at intervals rather than at the end, and practise explaining the design aloud in a mock viva.
Failing to achieve or verify moisture control and isolation before a restorative or endodontic step, then bonding or obturating into a contaminated field.
Candidates underestimate how much saliva and tongue movement compromise a manikin or patient field, and they rush isolation to save time for the 'real' procedure.
What to do instead
Treat isolation as a timed, scored sub-task: place rubber dam or effective suction and retraction, verify the field is dry, and only then proceed. Practise rubber dam application on a manikin until it is reliable within a set time, and state your isolation method and its verification out loud during the station.
In the written oral assessment OSCE, giving a disorganised stream-of-consciousness answer to a scenario question instead of a structured clinical response with diagnosis, justification, and management plan.
Candidates prepare content knowledge but not answer architecture, so under viva pressure they recall facts in the order they come to mind and the examiner cannot award marks for reasoning that was never stated.
What to do instead
Adopt a fixed scaffold for every scenario answer: findings and problem list, differential or diagnosis with reasoning, investigations, management options with risks and benefits, and follow-up. Practise with a timer and a peer who scores only whether each element was explicitly stated.
Answering a written oral station with confident but unqualified assertions and no acknowledgement of uncertainty, alternatives, or the limits of the evidence.
Candidates believe examiners reward certainty, so they overclaim on topics such as material choice, prognosis, or antibiotic use rather than stating indications, contraindications, and when to refer.
What to do instead
Train a habit of framing answers as 'first-line, alternatives, and when I would escalate or refer', citing the principle behind each choice. Rehearse phrases that show calibrated judgement, such as stating the main risk and how you would monitor for it.
Misreading or ignoring the specific wording of an OSCE station instruction, for example answering a 'what would you do next' question with a full treatment plan, or missing a stated constraint such as the patient declining a procedure.
Candidates skim the prompt because they recognise the clinical topic and start answering from memory of a similar case, so they answer a different question than the one asked.
What to do instead
Read the prompt twice and underline the task verb, the constraint, and the number of parts required. Before speaking, restate the question in one sentence and check it against your planned answer; if the station asks for the next step, give one step and its rationale before elaborating.
Failing to close the loop on patient communication in a simulated patient station: no check of the patient's understanding, no discussion of risks, alternatives, or costs, and no confirmation of consent at the end.
Candidates concentrate on delivering accurate clinical information and treat communication as a soft extra, so they explain well but never verify comprehension or invite questions.
What to do instead
Use a repeatable communication structure: explain, check understanding with a teach-back question, discuss alternatives and risks, confirm the patient's preference, and summarise the agreed plan. Practise with a simulated patient who is instructed to look confused, and score yourself on whether you detected and addressed it.
Poor time and sequence management across a multi-station circuit, so the candidate runs over on an early station and then rushes or abandons later stations, or performs steps out of clinical order.
Candidates do not rehearse under circuit conditions and underestimate transition and reset time, so they are surprised by the pace of a timed OSCE or patient-based session.
What to do instead
Run full mock circuits with the same station timing and no pauses, including equipment reset and movement between rooms. Allocate a mental budget per station, keep a visible clock, and practise a deliberate 30-second wrap-up so you finish with a stated summary rather than mid-sentence.
Failing to recognise and act on a safety-critical finding or red flag during a station, such as an unexplained ulcer, a suspicious soft tissue lesion, uncontrolled bleeding, or a medical condition requiring modification of treatment, and continuing with the planned procedure.
Candidates are anchored on completing the named task and have not rehearsed the decision point where the correct action is to stop, refer, or modify, so the finding is noted but not acted on.
What to do instead
Build a personal red-flag checklist covering medical history, soft tissue, bleeding, and anaesthetic risk, and rehearse the exact words for stopping and escalating. In every mock station, ask yourself explicitly whether anything found changes the plan, and state the referral or modification out loud so it is credited.