DSE UPDATED SCRIPT 2026 PRACTICE
SOLUTIONS GRADED A+
● 41-yo woman, pregnant; prev rheumatic fever with heart murmur (no
valvular abnormality); allergy to penicillin. Positive history of infective
endocarditis. Does she need to pre med?
- yes
- no. Answer: yes
- REVIEW HEALTH HISTORY - on my exam, this patient had a
previous history of infective endocarditis. Pre-med IS indicated
- many of the OSCE quizlets say no....
● Pre-med options for pregnant woman w/hx of infective endocarditis
and penicillin allergy
- amoxicillin
- cephalexin
- clarithromycin
- ciproflaxacin. Answer: *clarithromycin*
I may not be correct, the correct option may be cephalexin. however I
chose clarithromycin due to penicillin allergy, cross reaction with
cephalosporins, and since clindamycin/erythromycin/azthromycin were
not options. Ciproflaxacin is contraindicated in pregnancy. article for
reference https://www.parents.com/pregnancy/my-body/is-it-
safe/antibiotics-and-pregnancy/
,● What procedure can a dentist perform without consulting MD if a
patient is currently taking bisphosphonates?
- endo therapy
- prophy and scaling
- extraction
- occlusal restoration. Answer: *occlusal restoration*
although the main HELL NO is extraction, completing endo therapy
increases risk if the apex is compromised/damaged during therapy. I
teetered on prophy and scaling, but since it did not specify
supragingival, decided that the risk of scaling can negatively affect the
periosteum of a bisphosphanate patient. ADA recommendations:
http://www.centreoms.com/admin/storage/news/ADA%20Recommendat
ions%20for%20Treatment%20of%20Patients%20on%20Bisphosphon.p
df
● Pregnant person afraid of needles - stress management by putting
patient in what position when in your chair (BEFORE they even get to
the point of passing out)?
- supply oxygen
- place in Trendelenburg
- make patient sit up straight
- tell them to suck it up buttercup. Answer: place her in Trendelburg
position.
,- supine hypotension in 3rd trimester usually occurs (bc compression Inf
vena cava) => must prevent this in dental chair bc it can cause patient to
pass out.
- Best preventative treatment for supine hypotension is to turn the
patient, preferably to the left side, to displace the uterus away from the
inferior vena cava. The patient can also be placed in a sitting position
with the knees flexed.
● 6 months pregnant had bleeding gums and mobile teeth, how should
they be treated?
- immediate extractions
- do not treat until baby is born
- conservative debridement
- immediate endo. Answer: conservative debridement
.- pregnancy gingivitis: important to do ScRP (and stress good oral
hygiene) to prevent plaque growth. The plaque can enter blood stream
and stimulate patient's immune system to produce prostaglandins, which
can trigger uterine contraction leading to early labor, premature birth,
and a small baby.
● Pregnant lady with a diastema in between #8 and #9 with deep probing
depth and class 1 mobility on 8 and 9. What is the reason for diastema?
- chronic periodontitis
- distal drift
- normal during pregnancy. Answer: chronic perio
, - increased incidence of periodontal disease during pregnancy => must
emphasize good oral hygiene, and remove all their plaque so it doesn't
lead to premature birth / low birth weight
● Permanent staining as a result of tetracyline; did this happen?
- During development (as fetus)
- 0-5yrs
- 5-10 yrs
- 10-15 yrs. Answer: age 0-5 years
- remember that PERMANENT dentition does not begin calcification
until birth
● Pentobarbital (Nembutal) and Secobarbital (Seconal) are what type of
drugs?
- benzodiazepines
- NSAIDS
- barbituates
- atypical antipsychotic. Answer: barbituates
- used primarily evening BEFORE appointment
● A patient has an allergic reaction to a barbiturate, how do you treat?
- epinephrine
- diphenhydramine
SOLUTIONS GRADED A+
● 41-yo woman, pregnant; prev rheumatic fever with heart murmur (no
valvular abnormality); allergy to penicillin. Positive history of infective
endocarditis. Does she need to pre med?
- yes
- no. Answer: yes
- REVIEW HEALTH HISTORY - on my exam, this patient had a
previous history of infective endocarditis. Pre-med IS indicated
- many of the OSCE quizlets say no....
● Pre-med options for pregnant woman w/hx of infective endocarditis
and penicillin allergy
- amoxicillin
- cephalexin
- clarithromycin
- ciproflaxacin. Answer: *clarithromycin*
I may not be correct, the correct option may be cephalexin. however I
chose clarithromycin due to penicillin allergy, cross reaction with
cephalosporins, and since clindamycin/erythromycin/azthromycin were
not options. Ciproflaxacin is contraindicated in pregnancy. article for
reference https://www.parents.com/pregnancy/my-body/is-it-
safe/antibiotics-and-pregnancy/
,● What procedure can a dentist perform without consulting MD if a
patient is currently taking bisphosphonates?
- endo therapy
- prophy and scaling
- extraction
- occlusal restoration. Answer: *occlusal restoration*
although the main HELL NO is extraction, completing endo therapy
increases risk if the apex is compromised/damaged during therapy. I
teetered on prophy and scaling, but since it did not specify
supragingival, decided that the risk of scaling can negatively affect the
periosteum of a bisphosphanate patient. ADA recommendations:
http://www.centreoms.com/admin/storage/news/ADA%20Recommendat
ions%20for%20Treatment%20of%20Patients%20on%20Bisphosphon.p
df
● Pregnant person afraid of needles - stress management by putting
patient in what position when in your chair (BEFORE they even get to
the point of passing out)?
- supply oxygen
- place in Trendelenburg
- make patient sit up straight
- tell them to suck it up buttercup. Answer: place her in Trendelburg
position.
,- supine hypotension in 3rd trimester usually occurs (bc compression Inf
vena cava) => must prevent this in dental chair bc it can cause patient to
pass out.
- Best preventative treatment for supine hypotension is to turn the
patient, preferably to the left side, to displace the uterus away from the
inferior vena cava. The patient can also be placed in a sitting position
with the knees flexed.
● 6 months pregnant had bleeding gums and mobile teeth, how should
they be treated?
- immediate extractions
- do not treat until baby is born
- conservative debridement
- immediate endo. Answer: conservative debridement
.- pregnancy gingivitis: important to do ScRP (and stress good oral
hygiene) to prevent plaque growth. The plaque can enter blood stream
and stimulate patient's immune system to produce prostaglandins, which
can trigger uterine contraction leading to early labor, premature birth,
and a small baby.
● Pregnant lady with a diastema in between #8 and #9 with deep probing
depth and class 1 mobility on 8 and 9. What is the reason for diastema?
- chronic periodontitis
- distal drift
- normal during pregnancy. Answer: chronic perio
, - increased incidence of periodontal disease during pregnancy => must
emphasize good oral hygiene, and remove all their plaque so it doesn't
lead to premature birth / low birth weight
● Permanent staining as a result of tetracyline; did this happen?
- During development (as fetus)
- 0-5yrs
- 5-10 yrs
- 10-15 yrs. Answer: age 0-5 years
- remember that PERMANENT dentition does not begin calcification
until birth
● Pentobarbital (Nembutal) and Secobarbital (Seconal) are what type of
drugs?
- benzodiazepines
- NSAIDS
- barbituates
- atypical antipsychotic. Answer: barbituates
- used primarily evening BEFORE appointment
● A patient has an allergic reaction to a barbiturate, how do you treat?
- epinephrine
- diphenhydramine
