Internat en Odontologie common mistakes
Internat en Odontologie · Understand the traps and how to avoid them.
Confusing reversible pulpitis with irreversible pulpitis and choosing the wrong vital-pulp therapy, then selecting endodontic treatment when a protective restoration would have sufficed (or vice versa).
Candidates memorise diagnostic labels but do not systematically apply the cold test duration, lingering response, spontaneous pain history and periapical status together; they anchor on a single positive test.
What to do instead
Before answering, write out the four axes explicitly (spontaneous vs provoked pain, duration of response to cold, percussion sensitivity, periapical radiolucency) and let the combination drive the answer; rehearse the decision rule that lingering pain after stimulus removal points to irreversible disease.
Missing a second mesiobuccal canal in a maxillary first molar and declaring the tooth fully instrumented.
Candidates rely on the radiographic appearance of a single canal and do not apply the known anatomical prevalence or use magnification and troughing; time pressure discourages searching under the dentinal shelf.
What to do instead
Treat 'MB2 present' as the default assumption for maxillary first molars and describe the search sequence (troughing between MB1 and the palatal canal, ultrasonic tips, magnification) whenever the question probes canal anatomy.
Designing a fixed partial denture or crown with an inadequate ferrule or on a questionable abutment, ignoring the biomechanical requirements of the planned restoration.
Candidates focus on the material or aesthetics and neglect the preparation geometry, remaining coronal tissue and occlusal load distribution that determine long-term survival.
What to do instead
For any prosthesis question, first state the abutment's structural status and the ferrule/retention requirement, then justify material choice; treat insufficient ferrule as a contraindication to a single crown unless a core build-up restores it.
Confusing the indications and design principles of a removable partial denture (Kennedy classification, clasp selection, stress distribution) with those of a fixed or implant-supported solution.
Candidates learn classifications in isolation and cannot translate them into a treatment plan, so they pick the technically simplest option rather than the one matching the edentulous space and abutment prognosis.
What to do instead
Practise converting a Kennedy class plus abutment periodontal status into a concrete design (major connector, direct retainers, rests) before comparing it with implant options; always state what the classification implies for load transfer.
Underestimating or omitting the risk profile (smoking, uncontrolled diabetes, poor plaque control, history of periodontitis) when proposing implant placement or regenerative periodontal therapy.
Candidates treat the local defect as the whole problem and answer the technique question without integrating systemic and behavioural modifiers that change prognosis.
What to do instead
Build a standard pre-answer checklist of systemic and behavioural risk factors and explicitly state how each modifies prognosis or timing; if a risk factor is present, name the mitigation (smoking cessation, glycaemic control, supportive therapy) in the answer.
Misclassifying an odontogenic infection's anatomical spread and choosing inadequate drainage or antibiotic-only management for a collection that requires incision and drainage.
Candidates answer the pharmacology question (which antibiotic) instead of the surgical question (is there a drainable collection, which fascial space is involved, is the airway at risk).
What to do instead
For every infection scenario, answer in fixed order: airway risk, spread to fascial spaces, need for drainage, then adjunctive antibiotics; state that antibiotics never substitute for source control of a collection.
Failing to recognise red-flag oral mucosal lesions (non-healing ulcer, leukoplakia, erythroplakia) and defaulting to a benign diagnosis without biopsy referral.
Candidates pattern-match to common benign conditions and are uncomfortable committing to a malignancy suspicion; they also underestimate the significance of lesion duration.
What to do instead
Apply a hard rule: any ulcer persisting beyond two to three weeks or any unexplained red/white lesion warrants biopsy or specialist referral; state the referral explicitly rather than offering a benign label.
Mixing up the timing windows and skeletal-versus-dental indications for interceptive orthopaedic treatment versus fixed appliance therapy in a growing child.
Candidates memorise appliance names without linking them to the growth stage and the specific skeletal discrepancy they correct, so they propose treatment at the wrong age or for the wrong problem.
What to do instead
Anchor each answer to the patient's growth status (pre-pubertal, pubertal, post-pubertal) and state whether the problem is skeletal or dental; justify why the chosen appliance fits that stage and what happens if treatment is delayed.
Recommending restorative or endodontic treatment for primary teeth using permanent-tooth criteria, or extracting a primary tooth without considering space maintenance and the developing successor.
Candidates transfer adult protocols to paediatric cases and forget that pulpal therapy, materials and extraction decisions in primary teeth follow different rules and have different consequences for the permanent dentition.
What to do instead
Before answering any paediatric question, state the tooth's status (primary vs permanent), the successor's position, and the space-maintenance implication; use primary-specific pulpotomy/pulpectomy indications and never apply adult criteria reflexively.
Selecting or dosing a drug (antibiotic, analgesic, local anaesthetic with vasoconstrictor) without checking interactions, allergies, renal/hepatic status or the maximum safe dose by weight.
Candidates recall the drug class and indication but skip the safety calculation and the patient-specific contraindications, especially in children and polymedicated adults.
What to do instead
For every prescribing question, compute the weight-based maximum dose explicitly, list the relevant interactions and contraindications, and state the non-pharmacological alternative; treat the calculation as a mandatory step, not an optional check.