PMDC NLE Dental cheat sheet

PMDC NLE Dental - High-Yield Reference

• Tooth numbering: FDI/ISO two-digit system - first digit is the quadrant (1 upper right, 2 upper left, 3 lower left, 4 lower right in permanent; 5–8 same quadrants in primary), second digit counts from midline distally; universal system numbers permanent teeth 1–32 starting at maxillary right third molar.

• Eruption timing (permanent): first molars ~6 y, central incisors 7 y, lateral incisors 8 y, canines 11–12 y, premolars 10–12 y, second molars 12–13 y, third molars 17–21 y; primary dentition completes ~2.5–3 y.

• Local anesthesia maxima (adult, mg/kg and cartridge counts at 1.8 mL): lidocaine 2% with 1:100,000 epinephrine - 7 mg/kg, ~13 cartridges; articaine 4% - 7 mg/kg; mepivacaine 3% - 6.6 mg/kg; prilocaine 4% - 8 mg/kg; bupivacaine 0.5% - 1.3 mg/kg. One 1.8 mL cartridge of 2% lidocaine contains 36 mg drug and 0.018 mg epinephrine.

• Antibiotic prophylaxis before dental procedures with gingival manipulation: 2 g amoxicillin orally 30–60 min pre-op (or ampicillin/cefazolin/ceftriaxone IM/IV); penicillin allergy - cephalexin 2 g, azithromycin/clarithromycin 500 mg, or doxycycline 100 mg; no fluoroquinolones. Indicated for prosthetic valves, prior infective endocarditis, certain congenital heart disease, and cardiac transplant with valvulopathy.

• Periodontal disease classification uses staging (severity/extent, I–IV) and grading (progression rate, A–C); clinical attachment loss = probing depth + recession (or minus hyperplasia); bleeding on probing indicates active inflammation; calculus and plaque are the primary modifiable etiologic factors.

• Dental caries: Streptococcus mutans is the principal cariogenic organism; demineralization occurs below pH ~5.5 (critical pH for enamel); fluoride promotes remineralization as fluorapatite and inhibits enolase. White-spot lesions are reversible with remineralization therapy; cavitation requires restoration.

• Pulp diagnosis: reversible pulpitis = sharp provoked pain resolving after stimulus removal; irreversible pulpitis = spontaneous or lingering pain; necrotic pulp = no response to cold/EPT; apical periodontitis shows percussion tenderness and periapical radiolucency. Cold test assesses pulp vitality; EPT assesses nerve responsiveness.

• Fracture and trauma rules: Ellis Class I = enamel only; Class II = enamel + dentin (yellowish, sensitive); Class III = pulp exposure; avulsed permanent tooth - handle by crown, rinse, replant within 60 min, splint 2 weeks; avulsed primary tooth is not replanted.

• Radiographic interpretation: radiolucent = caries, pulp necrosis, cyst, granuloma; radiopaque = amalgam, enamel, calculus, foreign body, osteosclerosis. Panoramic radiograph shows entire dentition and jaws; periapical view shows 2–3 teeth with apex; bitewing best detects interproximal caries.