Dentistry
The Dentistry domain of the MDC PQE tests safe oral healthcare: diagnosis of dental and mucosal disease, management of dental emergencies, infection control, local anaesthesia, prescribing, and appropriate referral. Vignettes often ask for the next safest step rather than a definitive histological diagnosis.
Core rules
- Take a focused history: pain character and duration, swelling, trauma, bleeding, medical conditions, medicines, allergies, and social factors.
- Examine extraorally and intraorally; palpate swelling, check mouth opening, floor of mouth, and airway.
- Use radiographs when they answer a clinical question, not as a substitute for examination.
- Apply infection prevention and control for every patient: hand hygiene, PPE, sterile instruments, safe sharps disposal.
- Prescribe antibiotics only for systemic involvement or specific indications; drainage or source control is usually essential.
Worked example
A 45-year-old man has a painful submandibular swelling, trismus, dysphagia, and an elevated floor of mouth after a lower molar ache. What is the priority? The reasoning is a spreading odontogenic infection with airway risk. Do not send him home on oral antibiotics. Arrange urgent airway assessment and referral for incision and drainage, start systemic antibiotics per protocol, and remove the dental source when safe. Document neurology, swallowing, and temperature. The key is recognising danger signs and escalating.
Traps
- Prescribing antibiotics without drainage or source control.
- Missing airway danger signs: dysphagia, drooling, voice change, raised floor of mouth.
- Failing to adjust for medical history such as anticoagulants, diabetes, or allergy.
- Taking inadequate radiographs or ignoring them in trauma.
- Poor record keeping of consent, anaesthesia, and postoperative instructions.