Lebanon Dental Colloquium common mistakes
Lebanon Dental Colloquium · Understand the traps and how to avoid them.
Treating an ulcer or white patch as a diagnosis instead of a description: writing 'aphthous ulcer' or 'leukoplakia' as the final answer and stopping there, without listing a differential, the risk factors (tobacco, alcohol, sharp cusp, ill-fitting denture, betel use), and the next diagnostic step (incisional biopsy, referral, review interval).
Candidates memorise lesion names from textbooks and revise them as single-answer entities; the exam instead tests diagnostic reasoning, and Lebanese cases frequently involve water-pipe (argileh) smoking and denture-related trauma, so a one-word answer misses the point being examined.
What to do instead
For every mucosal lesion question, write a structured answer: description (site, size, duration, colour, induration), differential in order of seriousness, red flags that mandate urgent referral or biopsy (induration, fixation, >2 weeks, unexplained bleeding, cervical nodes), and a defined review or referral interval. Practise on 20 lesions until the structure is automatic.
Missing the systemic link: assessing a mucosal or salivary problem without asking about medication, diabetes, HIV, autoimmune disease or smoking, and without recording blood pressure, HbA1c or a drug history before prescribing or operating.
Training is compartmentalised into 'oral medicine' and 'general medicine', and candidates under time pressure jump to the local finding; oral medicine questions in this exam are usually written as a patient with a systemic condition presenting orally.
What to do instead
Use a fixed medical-history checklist (cardiovascular, endocrine, haematological, immunosuppression, medication, allergy, social history) and rehearse linking signs to systems: xerostomia to drugs and Sjögren, candidiasis to inhalers and immunosuppression, gingival enlargement to calcium channel blockers and phenytoin, delayed healing to diabetes.
Committing to a single diagnosis on a radiograph or vitality test before correlating with history, percussion, palpation and thermal testing, and failing to distinguish irreversible pulpitis, symptomatic apical periodontitis and a cracked tooth in the written justification.
Radiographs are visually seductive and candidates over-weight them; vitality testing is taught as a formality rather than as the discriminating test, and cracked-tooth presentations are under-rehearsed.
What to do instead
Follow a written sequence for every endodontic case: chief complaint and pain character (spontaneous vs provoked, lasting vs fleeting), pulp sensibility tests with control tooth, percussion and palpation, periodontal probing, then radiograph. State which test changed your mind and why. Practise distinguishing 'lingering pain to cold' from 'sharp pain that stops on removal'.
Planning a restoration or endodontic retreatment without assessing restorability and the biological width: ignoring ferrule, remaining coronal tissue, crown-root ratio, furcation involvement and post space, then proposing a crown on a tooth that should be extracted.
Candidates focus on the technique they know best rather than on the decision to treat; restorability criteria are rarely drilled as a checklist, and exam questions deliberately present borderline teeth.
What to do instead
Before any plan, write four numbers: remaining walls and ferrule (mm), periodontal support and mobility, endodontic prognosis, and opposing/shortened arch status. If ferrule is under about 1.5 mm circumferentially or the tooth is untreatable periodontally, justify extraction and replacement options explicitly.
Proposing a fixed prosthesis or implant without stating the diagnostic wax-up, occlusal scheme, interocclusal space, abutment prognosis and a maintenance plan; or designing a removable partial denture without surveying, rests, guide planes and a stated clasp design.
Prosthodontics is examined as a planning discipline, but candidates revise materials and tooth-preparation numbers and neglect the design logic that examiners are testing; surveyor and occlusal concepts are the least practised.
What to do instead
Answer in the order: assessment (ridge, occlusion, vertical dimension, abutment status) → design (surveyed path of insertion, rests, connectors, clasp type; or implant number, position, splinting) → material choice with a reason → maintenance and review. Draw the design in words if you cannot draw it.
Giving a stage and grade for periodontitis or an implant plan without the supporting data: no probing depths, no bleeding on probing percentage, no radiographic bone level, no plaque control status, and no discussion of risk factors such as smoking or uncontrolled diabetes.
The 2017 classification requires multidimensional data, and candidates quote a stage from memory instead of deriving it; implant questions tempt a purely surgical answer.
What to do instead
Always tabulate: worst probing depth, interdental CAL, bone loss percentage, number of teeth lost to periodontitis, BOP%, plaque score, smoking status, HbA1c. Then derive stage from severity and complexity and grade from progression and risk. For implants, state bone volume, soft tissue phenotype, and a maintenance interval.
Describing a surgical procedure without the pre-operative risk assessment and consent content: no mention of anticoagulant or antiplatelet management, bisphosphonate and MRONJ risk, diabetic control, smoking, airway assessment, or the specific risks the patient must be told.
Candidates treat surgery questions as technique recall and forget that examiners test judgement and documentation; medication-related osteonecrosis and anticoagulation are high-yield but under-revised.
What to do instead
For every surgical scenario, write a pre-op paragraph (medical status, drug history including antiresorptives and anticoagulants with INR or DOAC status, anaesthetic plan, consent items including nerve injury, bleeding, infection, dry socket) before the technique. Learn the local protocol for not stopping anticoagulants without medical advice.
Answering orthodontic questions with appliance names rather than a problem list and treatment objectives: no skeletal versus dental classification, no growth status, no anchorage and space analysis, no mention of retention.
Appliance familiarity dominates revision, while the exam asks for diagnosis and mechanotherapy reasoning; candidates also forget that timing relative to growth is the central decision in interceptive cases.
What to do instead
Structure every case as: problem list (skeletal class, dental class, overjet/overbite, crowding, midline, facial profile) → growth status → objectives → mechanics with anchorage → retention. Practise stating why treatment now, later, or not at all.
Managing a child's caries or behaviour as if the child were a small adult: no behaviour-management plan, no consideration of sedation or general anaesthesia criteria, no fluoride or sealant prevention plan, and no discussion with parents about diet, habits or trauma to primary teeth.
Paediatric content is often skimmed by candidates focusing on adult restorative work, and behavioural and preventive aspects feel less 'technical' to revise.
What to do instead
For each paediatric scenario, write three sections: behaviour and communication approach with alternatives, definitive and preventive treatment plan (including extraction versus pulpotomy decisions and space maintenance), and home care with parent counselling. Know the indications for referral for sedation or GA and the management of avulsed and intruded primary teeth.
Answering public health and ethics items with opinion instead of framework: no mention of study design or bias when interpreting an epidemiological statement, no sensitivity/specificity reasoning for a screening claim, and no reference to consent, confidentiality, scope of practice or mandatory reporting when resolving an ethical or legal dilemma.
These domains are perceived as 'common sense' and revised last; Lebanese health law and professional regulation are rarely covered in clinical textbooks, so candidates improvise.
What to do instead
Learn a short framework for each: for epidemiology, design, sampling, confounding, bias, and the difference between incidence and prevalence; for ethics, the four principles plus consent, capacity, confidentiality and referral obligation. Read the Lebanese dental practice regulations and the order's code of ethics once, and cite the principle you applied in every answer.
Prescribing or selecting drugs without checking dose, interaction and contraindication: giving a full adult NSAID dose to a child or an elderly patient with renal impairment, prescribing a macrolide with a statin or warfarin without comment, using adrenaline-containing local anaesthetic without considering cardiac status, and omitting the emergency drug protocol.
Pharmacology is revised as a list of drug classes, not as prescribing decisions; candidates rarely rehearse dose calculation by weight or the contents of an emergency kit.
What to do instead
For every prescribing question, state drug, dose in mg/kg or mg with maximum, frequency, duration, contraindications, interactions and alternatives. Memorise the emergency protocol for syncope, hypoglycaemia, asthma, anaphylaxis and local anaesthetic toxicity, including adrenaline doses and routes, and know the standard contents of a dental emergency kit.