COMPLETE SOLUTIONS
Course
ADEX DSE OSCE
Question 1: Medical History Assessment
A 62-year-old patient presents for a routine dental hygiene appointment. During the medical
history review, they report taking warfarin for atrial fibrillation. The patient is scheduled for
periodontal scaling.
Question:
What is the dental hygienist's most appropriate initial action?
A. Proceed with scaling immediately
B. Confirm the patient's most recent INR and assess bleeding risk
C. Discontinue the patient's warfarin before treatment
D. Administer local anesthesia with epinephrine without further assessment
Answer:
B. Confirm the patient's most recent INR and assess bleeding risk
Rationale:
Patients taking warfarin have an increased bleeding risk. The hygienist should verify the patient's
current INR (International Normalized Ratio) and determine whether treatment is appropriate.
The hygienist should never advise discontinuation of anticoagulants independently. Most routine
periodontal procedures can safely proceed when the INR is within the therapeutic range.
Question 2: Infection Control
While removing your gloves after treating a patient, one glove tears and your bare finger contacts
contaminated saliva.
Question:
What is the FIRST action you should take?
A. Complete charting before washing
B. Wash the exposed area thoroughly with soap and water
C. Put on another glove
,D. Apply alcohol gel only
Answer:
B. Wash the exposed area thoroughly with soap and water
Rationale:
Exposure to potentially infectious material requires immediate washing with soap and water,
followed by reporting the exposure according to the office exposure control plan. Prompt action
reduces the risk of disease transmission.
Question 3: Instrument Identification
During periodontal instrumentation, the dentist asks you to pass a Gracey 11/12 curette.
Question:
What surface is this instrument primarily designed to scale?
A. Facial surfaces of anterior teeth
B. Mesial surfaces of posterior teeth
C. Distal surfaces of posterior teeth
D. Occlusal surfaces
Answer:
B. Mesial surfaces of posterior teeth
Rationale:
The Gracey 11/12 curette is area-specific and designed for the mesial surfaces of posterior teeth.
Correct instrument selection improves efficiency and minimizes tissue trauma.
Question 4: Periodontal Assessment
A patient has probing depths of 6 mm with bleeding on probing and radiographic evidence of
bone loss.
Question:
Which periodontal diagnosis is most appropriate?
A. Gingival health
B. Gingivitis
, C. Periodontitis
D. Dental fluorosis
Answer:
C. Periodontitis
Rationale:
Clinical attachment loss, deep periodontal pockets, and bone loss are diagnostic features of
periodontitis. Gingivitis involves inflammation without attachment or bone loss.
Question 5: Oral Cancer Screening
During an oral cancer examination, you observe a white lesion on the lateral border of the tongue
that does not wipe off.
Question:
What should the hygienist do?
A. Ignore the lesion
B. Document the lesion and recommend further evaluation
C. Attempt to scrape the lesion away
D. Prescribe antibiotics
Answer:
B. Document the lesion and recommend further evaluation
Rationale:
Persistent white lesions (leukoplakia) that cannot be wiped away require documentation and
referral for evaluation because they may represent premalignant or malignant changes.
Question 6: Dental Radiography
A patient requests dental radiographs but is pregnant.
Question:
What is the best response?
A. Never expose radiographs during pregnancy
B. Take radiographs only if clinically necessary while using appropriate protective measures