SLMC ERPDS cheat sheet

Dental caries is a multifactorial, biofilm-mediated, diet-modulated disease; the operative restoration addresses the lesion, not the disease process, so caries-risk assessment and prevention must accompany restorative care.

Periodontal disease classification (2017 World Workshop) uses staging (I–IV, severity and complexity) plus grading (A–C, rate of progression) based on interdental clinical attachment loss, radiographic bone loss, and % bone loss/age.

Pulpitis is reversible when provoked pain is brief and resolves after stimulus removal; irreversible pulpitis shows spontaneous or lingering pain, and necrotic pulp typically presents as asymptomatic until periapical inflammation develops.

Percussion tenderness suggests periapical inflammation; cold test positivity with lingering response suggests irreversible pulpitis; a negative response to cold and EPT together indicates pulp necrosis.

Antibiotics are not indicated for uncomplicated pulpitis or localized dentoalveolar abscess without systemic involvement; they are adjuncts to drainage and source control when systemic signs (fever, swelling, trismus, malaise) are present.

The rule of thirds on a periapical radiograph divides the root into coronal, middle, and apical thirds; bone loss patterns and furcation involvement are graded by probing depth and radiographic bone level.

A 2 mm or greater probing depth change with bleeding on probing at the same site across visits suggests active periodontal disease and warrants re-evaluation and possible site-specific therapy.

Local anesthesia failure in irreversible pulpitis is common; supplemental techniques such as intraligamentary or intraosseous injection or a buccal infiltration with articaine may improve anesthesia success.

Crown preparation requires 1.0–1.5 mm axial reduction for metal-ceramic and 1.5–2.0 mm for all-ceramic; occlusal reduction is 1.5–2.0 mm to allow adequate material thickness.

A ferrule of at least 1.5–2.0 mm of circumferential dentin above the crown margin improves fracture resistance of endodontically treated teeth; lack of ferrule increases risk of vertical root fracture.

Post space preparation should preserve at least 4–5 mm of apical gutta-percha to maintain the apical seal; posts do not strengthen the root and are used only to retain the core.

Implant osseointegration requires primary stability; loading protocols vary from immediate to delayed (3–6 months in the maxilla, 2–4 months in the mandible) based on bone quality and implant stability.

Extraction socket preservation uses graft material and a barrier membrane to limit dimensional ridge change; without grafting, horizontal and vertical bone loss of several millimeters can occur within months.

Sinus lift (internal or lateral approach) is indicated when residual bone height is insufficient; a minimum of 4–5 mm residual bone is often needed for a lateral window approach without simultaneous implant placement.

Fixed partial denture abutment selection should consider crown-to-root ratio (ideally 1:1 or better), periodontal support, and the span length; cantilever designs increase stress on the terminal abutment.

Suturing after periodontal or implant surgery should be tension-free; non-resorbable sutures are removed at 7–14 days, while resorbable sutures degrade over several weeks depending on material.

Maximum recommended dose of lidocaine with 1:100,000 epinephrine is approximately 7 mg/kg (up to 500 mg); articaine is approximately 7 mg/kg (up to 500 mg); prilocaine is approximately 8 mg/kg.

One cartridge (1.8 mL) of 2% lidocaine contains 36 mg lidocaine; 1:100,000 epinephrine equals 0.018 mg per cartridge.

Epinephrine-containing local anesthetics are relatively contraindicated in uncontrolled hyperthyroidism, pheochromocytoma, and recent myocardial infarction; dose limitation and aspiration reduce risk.

Methemoglobinemia is associated with prilocaine and benzocaine overdose; treatment is methylene blue 1–2 mg/kg IV in severe cases.

Epinephrine reversal: for anaphylaxis, epinephrine 0.3–0.5 mg IM (1:1,000) in the anterolateral thigh is first-line; antihistamines and corticosteroids are adjuncts, not substitutes.

Syncope is the most common medical emergency in dental practice; management includes supine positioning, airway maintenance, and monitoring; recovery is typically rapid.

Antibiotic prophylaxis before dental procedures is indicated for patients with prosthetic heart valves, history of infective endocarditis, certain congenital heart disease, and cardiac transplant with valvulopathy, per current guidelines.

Local anesthetic systemic toxicity presents with CNS excitation (tinnitus, metallic taste, seizures) followed by CNS depression and cardiovascular collapse; lipid emulsion is the antidote for severe toxicity.

Standard precautions apply to all patients regardless of presumed infectious status; personal protective equipment includes gloves, mask, eye protection, and gown when splash risk exists.

Sterilization of critical and semicritical instruments uses autoclave (steam under pressure) at 121°C for 15–20 minutes or 134°C for 3–4 minutes; biological indicators (spore tests) verify efficacy.

Handpieces and other semicritical items require sterilization between patients; high-level disinfection is acceptable only for items that cannot withstand heat.

Informed consent requires disclosure of diagnosis, proposed treatment, alternatives, risks, benefits, and the opportunity to ask questions; documentation should reflect the discussion.

Patient records must be retained according to local regulations; in many jurisdictions, adult records are kept for at least 7–10 years after the last visit, and minors' records until they reach the age of majority plus a specified period.

Confidentiality is a core ethical duty; disclosure without consent is permitted only where required by law (e.g., reporting certain communicable diseases or suspected abuse) or to prevent serious harm.

Sharps injuries require immediate washing, reporting, source evaluation, and post-exposure prophylaxis consideration; HIV PEP should be initiated as soon as possible, ideally within hours.

Dental unit waterlines must be maintained to reduce biofilm; flushing and disinfectant treatment keep microbial counts within accepted limits.

Primary tooth eruption typically begins at 6 months; first permanent molar erupts around age 6; mixed dentition spans approximately 6–12 years.

Fluoride varnish (5% NaF) is applied to caries-risk children every 3–6 months; silver diamine fluoride arrests active dentinal caries and is an option for uncooperative or medically complex children.

Space maintenance is indicated when a primary molar is lost before the eruption of the succedaneous tooth; a band-and-loop or distal shoe maintains arch length.

Class II malocclusion with mandibular deficiency may be treated with functional appliances during growth; Class III with maxillary deficiency may benefit from protraction headgear or facemask.

Oral squamous cell carcinoma is the most common oral malignancy; risk factors include tobacco, alcohol, and betel quid; red or white lesions that do not resolve within 2 weeks warrant biopsy.

Odontogenic cysts include radicular (periapical) cyst, dentigerous cyst, and odontogenic keratocyst; the keratocyst has a high recurrence rate and requires careful follow-up.

Ameloblastoma is a locally aggressive odontogenic tumor often in the posterior mandible; treatment is wide resection with margin control due to recurrence risk.

Eruption cysts and hematomas in infants usually resolve spontaneously; intervention is needed only if they interfere with feeding or eruption.