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Question 1General Dental Surgery (domain structure not published in retrieved source)

Which permanent tooth typically erupts first into the oral cavity?

  1. Mandibular first molar Correct answer.
  2. Maxillary first molar
  3. Mandibular central incisor
  4. Maxillary central incisor

Explanation

The mandibular first molar usually erupts at around 6 years of age and is commonly the first permanent tooth to appear, often before any primary tooth is shed. It establishes the occlusal relationship for the developing dentition.

Question 2General Dental Surgery (domain structure not published in retrieved source)

Which nerve provides the main sensory supply to the mandibular teeth?

  1. Mylohyoid nerve
  2. Long buccal nerve
  3. Inferior alveolar nerve Correct answer.
  4. Chorda tympani nerve

Explanation

The inferior alveolar nerve, a branch of the mandibular division of the trigeminal nerve, supplies sensation to the mandibular teeth before exiting via the mental foramen as the mental nerve.

Question 3General Dental Surgery (domain structure not published in retrieved source)

Which local anaesthetic agent is most commonly associated with methemoglobinemia at high doses?

  1. Lidocaine
  2. Mepivacaine
  3. Prilocaine Correct answer.
  4. Articaine

Explanation

Prilocaine is metabolised to ortho-toluidine, which can oxidise haemoglobin to methaemoglobin. Excessive doses therefore risk methaemoglobinaemia, a recognised but uncommon adverse effect.

Question 4General Dental Surgery (domain structure not published in retrieved source)

A patient reports a sudden, sharp pain on drinking cold water that resolves within seconds of removing the stimulus. Which pulp diagnosis best fits?

  1. Reversible pulpitis Correct answer.
  2. Asymptomatic apical periodontitis
  3. Pulpal necrosis
  4. Irreversible pulpitis

Explanation

Pain that is provoked by thermal stimuli and subsides promptly once the stimulus is removed is characteristic of reversible pulpitis. Irreversible pulpitis typically produces lingering pain.

Question 5General Dental Surgery (domain structure not published in retrieved source)

Which radiographic feature most suggests a periapical cyst rather than a periapical granuloma?

  1. Widening of the periodontal ligament space only
  2. Well-defined corticated border Correct answer.
  3. Diffuse radiolucency with root resorption
  4. Ill-defined margins

Explanation

A periapical cyst tends to show a well-defined, corticated radiolucent border, whereas a granuloma often has less distinct margins. Definitive distinction requires histopathology.

Question 6General Dental Surgery (domain structure not published in retrieved source)

Which antibiotic is recommended first-line for a dentoalveolar infection in a patient with a penicillin allergy (non-anaphylactic)?

  1. Metronidazole alone
  2. Amoxicillin
  3. Clindamycin Correct answer.
  4. Co-amoxiclav

Explanation

Clindamycin is a recognised alternative for odontogenic infection when penicillin cannot be used, though local guidance varies. Amoxicillin and co-amoxiclav are penicillins and are contraindicated in true allergy.

Question 7General Dental Surgery (domain structure not published in retrieved source)

What is the most appropriate initial management of a dental avulsion where the tooth has been out of the socket for 30 minutes and the root appears intact?

  1. Discard the tooth and plan an implant
  2. Replant immediately after gentle rinsing Correct answer.
  3. Soak in bleach before replanting
  4. Store dry and refer the next day

Explanation

An avulsed permanent tooth with an intact root should be replanted as soon as possible, ideally within 60 minutes, after gentle handling and rinsing. Prompt replantation improves periodontal healing and survival.

Question 8General Dental Surgery (domain structure not published in retrieved source)

Which clinical sign is most characteristic of a mandibular fracture?

  1. Bilateral trismus only
  2. Increased salivary flow
  3. Step deformity in the occlusion Correct answer.
  4. Generalised gingival bleeding

Explanation

A step deformity or derangement of occlusion is a classic sign of a mandibular fracture because the segments displace. Other findings such as swelling and trismus support but do not confirm the diagnosis.

Question 9General Dental Surgery (domain structure not published in retrieved source)

Which tooth is most frequently impacted in the permanent dentition?

  1. Mandibular third molar Correct answer.
  2. Maxillary canine
  3. Mandibular second premolar
  4. Maxillary central incisor

Explanation

Mandibular third molars are the most commonly impacted teeth, largely due to insufficient space in the arch. Maxillary canines are the second most common.

Question 10General Dental Surgery (domain structure not published in retrieved source)

A patient has a history of infective endocarditis and requires a dental extraction. What is the standard prophylactic regimen?

  1. Amoxicillin 500 mg for five days after
  2. No prophylaxis is ever required
  3. Amoxicillin 2 g orally one hour before Correct answer.
  4. Metronidazole 400 mg one hour before

Explanation

For high-risk patients, a single 2 g oral dose of amoxicillin one hour before the procedure is the standard regimen where prophylaxis is indicated. Local guidelines should always be checked.

Question 11General Dental Surgery (domain structure not published in retrieved source)

Which periodontal parameter best reflects current disease activity rather than past destruction?

  1. Clinical attachment loss
  2. Bleeding on probing Correct answer.
  3. Recession
  4. Radiographic bone loss

Explanation

Bleeding on probing is a marker of current inflammation and disease activity. Attachment loss, bone loss and recession record cumulative destruction rather than present activity.

Question 12General Dental Surgery (domain structure not published in retrieved source)

Which is the principal mineral component of dental enamel?

  1. Collagen type I
  2. Calcium carbonate
  3. Dentin sialoprotein
  4. Hydroxyapatite Correct answer.

Explanation

Enamel is approximately 96% mineral by weight, predominantly in the form of hydroxyapatite crystals. This high mineral content gives it great hardness but little capacity for repair.

Question 13General Dental Surgery (domain structure not published in retrieved source)

What is the most appropriate management for a patient on warfarin with an INR of 3.2 requiring a simple extraction?

  1. Give vitamin K preoperatively
  2. Cancel extraction permanently
  3. Check INR and liaise with the physician before proceeding Correct answer.
  4. Withhold warfarin for three days

Explanation

An INR above the usual therapeutic range warrants discussion with the prescriber and possibly correction before elective extraction. Local haemostatic measures are used if the procedure proceeds.

Question 14General Dental Surgery (domain structure not published in retrieved source)

Which condition is characterised by recurrent aphthous ulcers with a yellow pseudomembrane and erythematous halo?

  1. Oral lichen planus
  2. Leukoplakia
  3. Oral candidiasis
  4. Recurrent aphthous stomatitis Correct answer.

Explanation

Recurrent aphthous stomatitis presents with painful, shallow ulcers with a yellow-grey centre and red halo, often recurring on non-keratinised mucosa.

Question 15General Dental Surgery (domain structure not published in retrieved source)

Which factor most increases the risk of osteoradionecrosis after extraction in a patient treated with head and neck radiotherapy?

  1. Use of local anaesthetic
  2. Maxillary tooth site
  3. Short duration since radiotherapy
  4. High radiation dose to the mandible Correct answer.

Explanation

Osteoradionecrosis risk rises with higher radiation dose, particularly to the mandible, and with the proximity of treatment to the planned extraction. Timing and site also matter.

Question 16General Dental Surgery (domain structure not published in retrieved source)

Which is the recommended first-line treatment for a child with early childhood caries affecting maxillary incisors?

  1. Systemic antibiotics alone
  2. Behavioural advice, fluoride and restorative care Correct answer.
  3. No intervention until the permanent teeth erupt
  4. Immediate full-mouth extraction

Explanation

Early childhood caries is managed with dietary and oral hygiene advice, fluoride application and restoration or extraction as needed. Comprehensive prevention underpins all treatment.

Question 17General Dental Surgery (domain structure not published in retrieved source)

Which material is most commonly used as a direct pulp capping agent to promote dentine bridge formation?

  1. Glass ionomer only
  2. Zinc phosphate cement
  3. Amalgam
  4. Calcium hydroxide Correct answer.

Explanation

Calcium hydroxide has a long-established role in direct pulp capping, stimulating a dentine bridge. Newer bioceramic materials are increasingly used but calcium hydroxide remains a classic choice.

Question 18General Dental Surgery (domain structure not published in retrieved source)

What is the working length in root canal treatment defined as?

  1. Length of the gutta-percha cone
  2. Distance from cusp tip to the furcation
  3. Distance from a coronal reference point to the apical constriction Correct answer.
  4. Length of the tooth crown only

Explanation

Working length is the distance from a stable coronal reference point to the apical constriction, usually 0.5 to 1 mm short of the radiographic apex. It guides instrumentation and obturation.

Question 19General Dental Surgery (domain structure not published in retrieved source)

Which best describes the purpose of a surgical flap in periodontal surgery?

  1. To increase pocket depth
  2. To avoid suturing
  3. To permanently remove all attached gingiva
  4. To provide access for debridement and allow repositioning of tissue Correct answer.

Explanation

A flap elevates tissue to give access to roots and bone for debridement and can be repositioned to improve contour. It preserves attached gingiva where possible.

Question 20General Dental Surgery (domain structure not published in retrieved source)

Which is the most appropriate initial investigation for a suspected temporomandibular joint disorder with clicking but no imaging abnormality expected?

  1. Panoramic radiograph to confirm disc position
  2. Clinical examination and history Correct answer.
  3. Immediate MRI for all patients
  4. CT with contrast

Explanation

Most temporomandibular disorders are diagnosed clinically; imaging is reserved for specific indications such as suspected disc displacement or pathology. A thorough history and examination come first.

Question 21General Dental Surgery (domain structure not published in retrieved source)

Which feature distinguishes a malignant ulcer from a traumatic ulcer?

  1. Induration and failure to heal after cause removal Correct answer.
  2. Presence of a yellow slough
  3. History of biting
  4. Pain on palpation

Explanation

Malignant ulcers are typically indurated and do not heal after the presumed cause is removed, prompting biopsy. Traumatic ulcers usually resolve once the cause is eliminated.

Question 22General Dental Surgery (domain structure not published in retrieved source)

Which is the primary aim of fissure sealants?

  1. Preventing caries in susceptible pits and fissures Correct answer.
  2. Remineralising existing dentine lesions
  3. Whitening the enamel
  4. Reducing gingival inflammation

Explanation

Sealants create a physical barrier in pits and fissures where plaque accumulates and caries risk is high. They are most effective when placed on caries-free or early non-cavitated surfaces.

Question 23General Dental Surgery (domain structure not published in retrieved source)

Which tooth surface is most commonly affected by caries in the primary dentition?

  1. Lingual surfaces of incisors
  2. Occlusal surfaces of molars Correct answer.
  3. Smooth surfaces of anterior teeth
  4. Cervical surfaces of canines

Explanation

Pits and fissures of primary molars are highly caries-susceptible because of their morphology and plaque retention. Smooth-surface caries also occurs but is less common in early childhood.

Question 24General Dental Surgery (domain structure not published in retrieved source)

What is the recommended management for a tooth with a horizontal root fracture in the middle third and a stable coronal segment?

  1. Root canal treatment regardless of vitality
  2. Reposition if displaced and splint flexibly Correct answer.
  3. Extract immediately
  4. Crown lengthening

Explanation

Mid-root horizontal fractures with a stable, vital fragment are managed by repositioning if needed and flexible splinting to allow healing. Pulp vitality is monitored.

Question 25General Dental Surgery (domain structure not published in retrieved source)

Which statement about fluoride varnish application is correct?

  1. It is applied to dried teeth and the patient avoids rinsing immediately Correct answer.
  2. It is contraindicated in all children
  3. It requires a full-mouth prophylaxis with pumice before every application
  4. It should be applied to wet teeth for best uptake

Explanation

Fluoride varnish is applied to dried tooth surfaces and patients are advised not to rinse or eat hard food immediately, allowing the fluoride to remain in contact with enamel.

Question 26General Dental Surgery (domain structure not published in retrieved source)

Which local anaesthetic is most appropriate for a patient with a documented allergy to ester-type local anaesthetics?

  1. Tetracaine
  2. Lidocaine Correct answer.
  3. Benzocaine
  4. Procaine

Explanation

Ester local anaesthetics include procaine, tetracaine, and benzocaine, whereas lidocaine is an amide. Allergy to esters does not preclude the use of amides, so lidocaine is the safe choice.

Question 27General Dental Surgery (domain structure not published in retrieved source)

Which instrument is most appropriate for removing supragingival calculus during a routine prophylaxis?

  1. Periodontal curette
  2. Periodontal probe
  3. Explorer
  4. Ultrasonic scaler Correct answer.

Explanation

Ultrasonic scalers use vibratory energy to efficiently remove supragingival calculus and stain. Curettes are designed for subgingival debridement, while explorers and probes are diagnostic instruments.

Question 28General Dental Surgery (domain structure not published in retrieved source)

Which radiographic view is most commonly used as the initial image for a patient with suspected impacted mandibular third molars?

  1. Cephalometric radiograph
  2. Panoramic radiograph Correct answer.
  3. Bitewing radiograph
  4. Periapical radiograph

Explanation

A panoramic radiograph provides a broad view of both jaws and is the standard initial image for assessing third molar position, angulation, and proximity to the inferior alveolar nerve. Periapical and bitewing views have limited field size, and cephalometric views are used for orthodontic assessment.

Question 29General Dental Surgery (domain structure not published in retrieved source)

Which tooth numbering system is used in the FDI World Dental Federation notation?

  1. Alphanumeric system
  2. Universal numbering
  3. Palmer notation
  4. FDI two-digit system Correct answer.

Explanation

The FDI system uses two digits: the first identifies the quadrant (1–4 for permanent, 5–8 for primary) and the second identifies the tooth within the quadrant (1–8). Universal and Palmer notations use different conventions.

Question 30General Dental Surgery (domain structure not published in retrieved source)

Which type of toothbrush bristle is generally recommended for most adults to avoid gingival trauma?

  1. Hard
  2. Soft Correct answer.
  3. Extra-hard
  4. Medium

Explanation

Soft-bristled toothbrushes are recommended because they effectively remove plaque while minimising the risk of gingival abrasion and recession. Hard and medium bristles are more likely to cause trauma.

Question 31General Dental Surgery (domain structure not published in retrieved source)

What is the most appropriate management for a primary tooth that has suffered a complicated crown-root fracture with pulp exposure and is not restorable?

  1. Extraction Correct answer.
  2. Fragment reattachment
  3. Direct pulp capping
  4. Pulpotomy

Explanation

A complicated crown-root fracture that is not restorable and involves the pulp of a primary tooth is best managed by extraction to prevent infection and preserve the developing permanent successor. Pulpotomy and pulp capping are intended for restorable teeth, and reattachment is not feasible when the fracture extends subgingivally.

Question 32General Dental Surgery (domain structure not published in retrieved source)

Which clinical finding best differentiates a periapical abscess from a periodontal abscess?

  1. Radiographic bone loss
  2. Tooth vitality Correct answer.
  3. Presence of a sinus tract
  4. Gingival swelling

Explanation

A periapical abscess arises from a necrotic pulp, so the tooth is non-vital, whereas a periodontal abscess typically occurs in a vital tooth with a deep periodontal pocket. Sinus tracts, swelling, and bone loss can occur in both conditions.

Question 33General Dental Surgery (domain structure not published in retrieved source)

Which analgesic is most appropriate for a patient with a history of peptic ulcer disease who requires post-extraction pain relief?

  1. Paracetamol Correct answer.
  2. Aspirin
  3. Naproxen
  4. Ibuprofen

Explanation

Paracetamol is not an NSAID and does not carry the same risk of gastrointestinal irritation and ulceration. Ibuprofen, aspirin, and naproxen are NSAIDs that can exacerbate peptic ulcer disease.

Question 34General Dental Surgery (domain structure not published in retrieved source)

Which condition is characterised by a chronic autoimmune destruction of salivary and lacrimal glands, leading to xerostomia and xerophthalmia?

  1. Mucous membrane pemphigoid
  2. Sjögren syndrome Correct answer.
  3. Lichen planus
  4. Pemphigus vulgaris

Explanation

Sjögren syndrome is an autoimmune exocrinopathy that primarily affects the salivary and lacrimal glands, producing dry mouth and dry eyes. Lichen planus, pemphigus, and pemphigoid are mucocutaneous disorders with different clinical presentations.

Question 35General Dental Surgery (domain structure not published in retrieved source)

Which is the most appropriate first-line treatment for a patient with chronic periodontitis and generalized pocket depths of 5–6 mm?

  1. Gingivectomy
  2. Subgingival scaling and root planing Correct answer.
  3. Systemic antibiotics alone
  4. Extraction of all affected teeth

Explanation

Non-surgical periodontal therapy with subgingival scaling and root planing is the cornerstone of initial treatment for chronic periodontitis. Antibiotics are adjunctive, surgery is considered after re-evaluation, and extraction is reserved for hopeless teeth.

Question 36General Dental Surgery (domain structure not published in retrieved source)

Which material is most commonly used for the fabrication of a provisional crown?

  1. Glass ionomer
  2. Amalgam
  3. Poly(methyl methacrylate) Correct answer.
  4. Composite resin

Explanation

Poly(methyl methacrylate) (PMMA) or bis-acryl composite resins are commonly used for provisional crowns because they are easy to manipulate and can be relined. Amalgam, composite, and glass ionomer are used for definitive restorations or fillings.

Question 37General Dental Surgery (domain structure not published in retrieved source)

Which is the most appropriate management for a tooth with a necrotic pulp and an open apex?

  1. Apexification with calcium hydroxide Correct answer.
  2. Immediate placement of a titanium post
  3. Extraction and implant placement
  4. Root canal treatment with a tapered gutta-percha cone

Explanation

Apexification using calcium hydroxide (or MTA) is the standard approach to induce a calcified barrier in a non-vital immature tooth with an open apex. Immediate post placement, extraction, or conventional gutta-percha obturation are inappropriate because the canal is too wide and the walls are thin.

Question 38General Dental Surgery (domain structure not published in retrieved source)

Which clinical feature is most characteristic of a dentigerous cyst?

  1. Presence of cholesterol clefts and giant cells
  2. Development from the rests of Malassez
  3. Occurrence in the periapical region of a vital tooth
  4. Association with the crown of an unerupted tooth Correct answer.

Explanation

A dentigerous cyst encloses the crown of an unerupted tooth and attaches at the cementoenamel junction. Periapical cysts are associated with non-vital teeth, and radicular cysts develop from the rests of Malassez.

Question 39General Dental Surgery (domain structure not published in retrieved source)

Which is the most appropriate initial management for a patient with a suspected mandibular fracture?

  1. Prescription of antibiotics alone
  2. Immediate open reduction and internal fixation
  3. Clinical assessment and imaging Correct answer.
  4. Application of a pressure bandage

Explanation

Initial management of a suspected mandibular fracture involves a thorough clinical examination and appropriate imaging to confirm the diagnosis and plan treatment. Definitive treatment such as open reduction is decided after assessment.

Question 40General Dental Surgery (domain structure not published in retrieved source)

Which statement about the use of fluoride varnish in caries prevention is correct?

  1. It is contraindicated in children under 6 years
  2. It should be applied only to cavitated lesions
  3. It is rinsed off immediately after application
  4. It is applied to dried teeth and left undisturbed Correct answer.

Explanation

Fluoride varnish is applied to clean, dried teeth and left in place to maximise fluoride uptake; patients are advised not to brush or eat hard food for a period afterwards. It is not rinsed off, is not contraindicated in young children, and is used on sound as well as early carious surfaces.

Question 41General Dental Surgery (domain structure not published in retrieved source)

Which is the most appropriate management for a patient with a bleeding disorder who requires a dental extraction?

  1. Prescribe aspirin post-operatively
  2. Consult with the patient's haematologist and plan appropriate cover Correct answer.
  3. Perform the extraction under general anaesthesia
  4. Proceed without any precautions

Explanation

Patients with bleeding disorders require liaison with their haematologist to ensure appropriate factor replacement or other cover before invasive dental procedures. Proceeding without precautions risks serious haemorrhage.

Question 42General Dental Surgery (domain structure not published in retrieved source)

Which local anaesthetic agent is most appropriate for a patient with severe liver disease?

  1. Mepivacaine
  2. Lidocaine
  3. Articaine
  4. Prilocaine Correct answer.

Explanation

Prilocaine has the lowest hepatic metabolism among the amide local anaesthetics and is therefore preferred in severe liver disease. Lidocaine, articaine, and mepivacaine are more reliant on hepatic metabolism.

Question 43General Dental Surgery (domain structure not published in retrieved source)

Which is the most appropriate choice of antibiotic for a patient with a severe penicillin allergy who requires prophylaxis for a dental procedure?

  1. Amoxicillin
  2. Azithromycin Correct answer.
  3. Cephalexin
  4. Clindamycin

Explanation

Azithromycin or clarithromycin are recommended alternatives for patients with severe penicillin allergy. Clindamycin is no longer recommended for prophylaxis due to the risk of Clostridioides difficile infection, and cephalexin may cross-react.

Question 44General Dental Surgery (domain structure not published in retrieved source)

Which is the most appropriate management for a patient with a suspected odontogenic infection causing dysphagia and elevation of the floor of the mouth?

  1. Immediate referral for hospital assessment Correct answer.
  2. Prescription of an analgesic only
  3. Incision and drainage in the dental chair
  4. Oral antibiotics and review in one week

Explanation

Dysphagia and elevation of the floor of the mouth suggest a spreading infection involving the sublingual and submandibular spaces (Ludwig's angina), which is a life-threatening emergency requiring immediate hospital assessment and airway management. Chair-side drainage or oral antibiotics alone are inadequate.

Question 45General Dental Surgery (domain structure not published in retrieved source)

Which is the most appropriate choice of radiograph for assessing bone loss in a patient with generalized chronic periodontitis?

  1. Cone beam computed tomography
  2. Bitewing radiographs
  3. Periapical radiographs Correct answer.
  4. Panoramic radiograph

Explanation

Periapical radiographs provide the detail needed to assess alveolar bone levels and are the standard imaging modality for periodontal assessment. Bitewings show crestal bone but not the full root length, panoramic images have lower resolution, and CBCT is not routinely indicated.

Question 46General Dental Surgery (domain structure not published in retrieved source)

Which is the most appropriate management for a patient with a suspected malignant transformation of an oral lichen planus lesion?

  1. Topical corticosteroid therapy alone
  2. Laser ablation without biopsy
  3. Reassurance and review in 12 months
  4. Incisional biopsy for histopathological examination Correct answer.

Explanation

Any suspicious change in a chronic oral lesion such as lichen planus warrants incisional biopsy to exclude malignancy. Reassurance, topical steroids alone, or ablation without histological diagnosis could delay detection of oral squamous cell carcinoma.

Question 47General Dental Surgery (domain structure not published in retrieved source)

Which is the most appropriate treatment for a patient with a fractured amalgam restoration on a molar with no pulpal involvement?

  1. Replace the restoration Correct answer.
  2. Perform root canal treatment
  3. Place a crown without replacing the restoration
  4. Extract the tooth

Explanation

A fractured amalgam restoration without pulpal involvement is managed by removing the existing restoration and placing a new one. Extraction, root canal treatment, or crowning over a defective restoration are not indicated.

Question 48General Dental Surgery (domain structure not published in retrieved source)

Which is the most appropriate advice for a patient who has just undergone a dental extraction?

  1. Rinse vigorously with mouthwash
  2. Exercise vigorously to promote healing
  3. Avoid smoking and hot drinks for 24 hours Correct answer.
  4. Probe the socket with a finger

Explanation

Patients should avoid smoking, hot drinks, and vigorous rinsing for at least 24 hours after extraction to prevent dislodgement of the blood clot and reduce the risk of dry socket. Vigorous rinsing, exercise, and probing the socket are discouraged.

Question 49General Dental Surgery (domain structure not published in retrieved source)

Which is the most appropriate initial management for a patient with a suspected temporomandibular joint dislocation?

  1. Immediate reduction of the dislocation Correct answer.
  2. Prescription of muscle relaxants
  3. Reassurance and soft diet
  4. Application of a heat pack

Explanation

A dislocated temporomandibular joint requires prompt reduction to relieve pain and restore function. Reassurance, heat, or muscle relaxants alone do not address the dislocation.

Question 50General Dental Surgery (domain structure not published in retrieved source)

Which is the most appropriate management for a patient with a retained root fragment in the maxillary sinus following extraction?

  1. Refer for surgical removal Correct answer.
  2. Leave it and review in 6 months
  3. Prescribe antibiotics and observe
  4. Attempt removal through the socket without imaging

Explanation

A retained root fragment in the maxillary sinus should be removed surgically to prevent sinusitis and other complications. Blind attempts through the socket without imaging risk further displacement.