Primary Care Dentistry: Foundations of Person-Centred Care
Primary care dentistry is the first point of contact for most patients and the setting where prevention, diagnosis, and routine treatment are delivered over time. A candidate should be comfortable with the core concepts that underpin general practice: the oral health needs assessment of an individual and a population, risk-based recall rather than one-size-fits-all intervals, and minimally invasive philosophy (prevention first, restoration only when necessary). Understand the common risk factor approach - sugar, tobacco, alcohol, and poor plaque control drive caries, periodontal disease, and oral cancer together, so advice should target shared behaviours rather than isolated diseases.
Know the structure of a routine examination: history (including medical, social, and diet history), extra-oral and intra-oral soft tissue checks, periodontal assessment (BPE and, where indicated, full charting), caries assessment, occlusion, and review of radiographs justified by selection criteria (ALARA/IRMER principles). Record-keeping, valid consent, and safeguarding are examinable and often appear as scenario stems.
Traps in questions: confusing recall interval (risk-based, typically 3–24 months) with a fixed six-month rule; assuming a radiograph is routine rather than justified; and forgetting that consent is a process, not a signature. Another frequent trap is mixing primary prevention (fluoride, fissure sealants, diet advice) with secondary prevention (early detection and arrest of existing disease).
Rule of thumb: before any treatment, ask three questions - What is this patient's risk? What is the least invasive option that controls the disease? What evidence justifies any radiograph or intervention? If a question offers a treatment without a preventive or diagnostic rationale, it is usually the distractor.
Worked example: A 14-year-old with one incipient occlusal lesion and high sugar intake. Correct emphasis is dietary counselling, fluoride toothpaste at appropriate concentration, and sealant or monitoring - not immediate drilling of a sound surface.