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DENTIN is the dental board preparation leader for dental students to easily pass the NBDE, NBDHE, ADEX, WREB, and FL Dental Laws. Our awesome study guides are used by thousands of dental students, dental hygiene students, and dentists globally. DENTIN study guides are "high yield" providing dental students and dentists with clear, concise, and current test preparation content to achieve scoring excellence on U.S. dental examinations and dental licensure boards.
The FIRST LINE analgesic therapy to treat acute (postoperative) nociceptive odontogenic or acute orofacial pain is to follow the “2-4-24” target dose (2 medications, 4 doses, within 24 hours). 600mg ibuprofen and 650mg acetaminophen every 6 hours for 24 hours for patients who can tolerate both medications. Maximum dose in a 24-hour period is 2,400mg ibuprofen and 3,000mg acetaminophen.
Potent synthetic opioid 50-100x more potent than morphine.
Mu-selective opioid agonist to produce analgesia.
Hepatically metabolized via the CYP450 enzyme system (CYP3A4) with a 3-7 hour 1/2 life.
Illegally produced and laced in cocaine, heroin and pills, fentanyl has killed 100,000+ people in the U.S. within the last 12 months.
An amount the size of a grain of salt is lethal.
Dental students are now taking the INBDE which replaced the NBDE I and NBDE II. JCNDE discontinued the NBDE I on December 31, 2020. Examinees may continue to take the NBDE II until December 31, 2022. The INBDE covers the same basic and biomedical science material contained in the NBDE I and II, but emphasizes clinical relevance and application using more case-based questions. There are 3 main sections of the INBDE:
Diagnosis and Treatment Planning (36.2%).
Oral Health Management (42%).
Practice and Profession (21.8%).
DENTIN’S INBDE STUDY GUIDE IS NOW AVAILABLE IN EBOOK OR PRINT FORMAT! The INBDE study guide covers 2,200+ past and potential INBDE questions organized by subject and converted into “success statements” with correct answers. You may also continue to use the comprehensive DENTIN NBDE II study guide and the DENTIN NBDE II 1,001+ High Speed Drills to prepare for the NBDE II until the exam is discontinued. Regardless of which dental board exam you take, DENTIN’s amazing study aids cover all of the critical INBDE and NBDE II exam material.
627. A 34-year old female presents to the dental clinic with a history of Crohn’s disease and chronic IBD. She complains of sore oral ulcerations with oral malodour for about one month. Upon intra-oral examination, you find multiple exophytic pustules with yellowish appearance on the tender erythematous base that covers the entire gingiva, buccal mucosa, and vestibular oral mucosa. The oral lesions resemble “SNAIL TRACKS”and appear histologically as intraepithelial clefting and acantholysis with eosinophil accumulation within the spinous layer. The underlying connective tissue shows mixed inflammatory cell infiltration. The diagnosis is PYOSTOMATITIS VEGETANS.
628. PYOSTOMATITIS VEGETANS (PV) most commonly affects the labial gingiva, soft and hard palate, and buccal and labial mucosa. PV rarely affects the tongue and mouth floor. BOTH TRUE.
The three CARDINAL symptoms of Burning Mouth Syndrome (BMS) are ORAL BURING PAIN, DYSGEUSIA, and XEROSTOMIA. BMS mainly affects menopausal or postmenopausal women between 50 and 70 years and is rarely diagnosed in patients younger than 30 years. BOTH STATEMENTS TRUE.
VITAL PULP EMERGENCY: patient may report spontaneous, sharp, or radiating pain. Classic chief complaint is sudden, intense, and prolonged painful response to COLD.
Vital Emergency Treatment: achieve profound anesthesia (can be tough), reduce occlusion if needed, prepare access cavity, and perform pulpotomy. If bleeding stops, place a dry cotton pellet and place a provisional restoration or complete definitive treatment if time permits. If bleeding persists from a specific canal after completing the pulpotomy, extirpate the pulp from the culprit canal.
NECROTIC PULP EMERGENCY: patient may report dull, throbbing ache, pain from biting pressure and/or intra/extra oral swelling. Classic chief complaint is severe pain to HEAT that is alleviated by a cold liquid.
Necrotic Emergency Treatment: anesthetize, isolate and perform pulpectomy then adjust occlusion. Complete RCT at next scheduled appointment.
Local anesthetics should NEVER be frozen while being shipped or stored. Frozen anesthetic can compromise the seal of the rubber plunger in the carpule and subsequently introduce AIR into the anesthetic solution and degrade the anesthetic. When administering local anesthetic ALWAYS aspirate to ensure that the needle is not entering a blood vessel. If a positive aspiration occurs (blood in the carpule), REDIRECT the syringe and re-aspirate until a negative aspiration is achieved.
Dentinal hypersensitivity is discomfort (sharp, shooting, or stabbing pain) caused by exposed dentin and open dentinal tubules (often due to gingival recession). The open dentinal tubules permit rapid fluid movement inside the tubules that subsequently stimulate pulpal mechanoreceptors. Dentinal hypersensitivity most commonly affects the buccal surfaces of premolars (but can occur on any tooth). Causes include overzealous toothbrushing, periodontal disease, acidic diet, GERD, and xerostomia. Treatment involves occluding (blocking) the open dentinal tubules orifices with glass ionomer or CPP-ACP varnish to physically prevent pulpal hyper-stimulation.
DENTIN's 2017 NBDHE Study Guide and 1,001+ HIGH SPEED DRILLS are MUST READS to prepare for the challenging dental hygiene boards. The study guides are clear, concise, and contain the precise material for thousands of prior NBDHE questions. DENTIN HAS THE ABSOLUTE BEST NBDHE STUDY GUIDE AVAILABLE! Authored by Ricky J. Rubin, D.M.D., M.P.A., Dr. Rubin has been preparing dental students for over a decade to pass the dental boards. Start studying today with DENTIN! visit www.dentin.co
Approximately 85% of TMJ and orofacial pain cases are MUSCLE-RELATED. Thus, non-surgical, minimally invasive TMJ and orofacial pain trigger-point muscle injections with botulinum toxin (Botox) may be highly effective for dentists to treat facial esthetics, TMJ/orofacial pain, and bruxism. Trigger-point injections often eliminate headaches caused by stress-induced clenching and grinding. While BOTOX treatment for these disorders is currently in the early stages, clinical evidence suggests that BOTOX is an extremely effective treatment. It is important that dentists expand their TMD treatment repertoire beyond occlusal splints (night guards) and NSAIDs, and consider alternative effective TMD treatment with trigger-point injections to treat orofacial pain.
HPV is a double-stranded DNA virus that infects epithelial cells of the skin and mucosa. There are over 200 HPV strains, but HPV-16 is the LEADING cause of oropharyngeal cancer. 80% of Americans will acquire HPV in their lifetime with 99% clearing the infection without consequence and without symptoms. White males, non-smokers 35-55 yrs are the highest risk population (4:1 females). The most effective way to screen for HPV related oral and oropharyngeal cancer is a visual and tactile exam by the dentist or dental hygienist. The most common areas orally are the uvula, tongue base, and tonsils.
After high demand and awesome dental hygiene reviews on DENTIN's 1,001+ High Speed Drills, DENTIN's 2017 NBDHE STUDY GUIDE is now available at www.dentin.co. DENTIN's 2017 NBDHE STUDY GUIDE has the high-yield exam information you need to easily prepare for and pass the NBDHE without feeling overwhelmed, or the need to purchase another study aid. DENTIN's NBDHE study guide is easy-to-read, comprehensive, and current, and is the best and only study guide you need to pass the NBDHE!
The immunoglobulin commonly found in HIGH CONCENTRATIONS in SALIVA, BREAST MILK, and MUCOSAL LININGS of the respiratory and GI tracts is IgA.
The HYOID BONE, MUSCLES OF FACIAL EXPRESSION, BUCCINATOR, and FACIAL NERVE all arise from the SECOND (2nd PHARYNGEAL ARCH).
The MANDIBLE, MAXILLA, MUSCLES OF MASTICATION, and TRIGEMINAL NERVE all arise from the FIRST (1st PHARYNGEAL ARCH).
WATER-SOLUBLE VITAMINS: (all vitamins B-complex and C). Dissolve in water, are NOT STORED BY THE BODY (low toxicity risk), and are easily absorbed then excreted by the kidneys. OBTAINED FROM DIET. Function to release energy (ATP) from consumed foods through the metabolism of fats, proteins, and carbohydrates. Involved in HEMOPOIESIS (RBC and platelet production in bone marrow). Water-soluble vitamin deficiencies often cause oral pathology (ex: petechaie, angular cheilitis, and glossitis).
FAT-SOLUBLE VITAMINS (A, D, E, K): absorbed through the intestinal tract and stored in the LIVER and adipose tissues for long periods, thus pose a greater toxicity risk due to accumulation (not readily excreted by the kidneys). Exccessive accumulation can lead to HYPERVITAMINOSIS.
The four pairs of muscles of mastication are innervated by the MANDIBULAR DIVISION (V3) of the TRIGEMINAL NERVE and receive blood supply from the PTERYGOID BRANCH OF THE MAXILLARY ARTERY (the larger terminal branch of the external carotid artery).
For more critical NBDE and NBDHE potential test material, please visit dentin.co
ALL TASTE SENSATIONS (BITTER, SWEET, SOUR, SALTY, UMAMI) come from ALL TONGUE REGIONS AND ARE PERCEIVED EQUALLY WELL. Different tongue regions are NOT exclusively responsible for the different basic tastes (the “tongue map” misconception was disproven by various PhD researchers). While different tongue regions are slightly more sensitive to certain tastes initially, all tongue regions equally convey the various five tastes. For example, the sides of the tongue are only slightly more sensitive to all tastes than the middle of the tongue, and the posterior tongue is more sensitive to BITTER as a defense mechanism to protect us from swallowing spoiled or poisonous substances.
The HYOID MUSCLES originate from above or below the U-shaped HYOID BONE in the anterior midline of the neck. The hyoid bone is NOT attached to any other bone, but is anchored by muscles and ligament to support the tongue during speech and swallowing.
SUPRAHYOID MUSCLES: elevate the hyoid bone to RETRACT and DEPRESS the mandible. Consists of DIGASTRIC, MYLOHYOID, GENIOHYOID and STYLOHYOID muscles. Innervated by CN VII, V3 and CN XII (C1).
INFRAHYOID MUSCLES: stabilize the hyoid bone when the suprahyoid muscles contract. Consists of TOSS (Thyrohyoid, Omohyoid, Sternohyoid, Sternothyroid) muscles. Innervated by ANSA CERVICALIS.
For more critical NBDE and NBDHE material, please visit dentin.co.
Of the 22 different amino acids in proteins, eight are ESSENTIAL AMINO ACIDS. ESSENTIAL AMINO ACIDS are NOT produced by the body, but must be obtained through DIET. Essential amino acids include:
Isoleucine, Leucine, Lysine, Methionine, Valine, Phenylalanine, Threonine, and TRYPTOPHAN
Since we are getting ready to celebrate Thanksgiving, it’s important to highlight TRYPTOPHAN. When TRYPTOPHAN reaches the CNS (crosses the blood-brain barrier), it is converted into SEROTONIN (affects mood) and MELATONIN (affects sleep-wake cycles). TRYPTOPHAN is also a biological precursor of NIACIN (vitamin B3). Tryptophan is found in most protein-based foods and egg whites, spinach, and cheese actually contain higher amounts of tryptophan than TURKEY. So if you feel tired after eating a big meal on Thanksgiving, it might simply be from the daily grind of dental school and not the turkey! Happy Thanksgiving from DENTIN.
TOBACCO is a drug that contains NICOTINE (a stimulant) used in cigarettes, cigars, pipes, chewing and dipping products and is the world’s #1 greatest cause of preventable disease or death.
Tobacco increases the risk of lung cancer, COPD, hypertension, heart disease, ORAL & NECK CANCER (squamous cell carcinoma), pancreatic cancer, spontaneous abortion, SIDS, and PERIODONTAL DISEASE (7-10 times greater risk due to reduced vascularity).
SMOKING DECREASES the PLAQUE ACCUMULATION RATE, GINGIVAL VASCULARITY, gingival inflammation and decreases BOP. Smokers are NOT at increased risk for caries (due to the decreased plaque accumulation rate).
In terms of dental management, ALWAYS perform a thorough comprehensive exam due to the increased risk for oral cancer and provide smoking cessation assistance. Apply the “5 A’s” to a smoking cessation program: (1st Ask, 2nd Advise, 3rd Assess, 4th Assist, and 5th Arrange). For more helpful practical NBDE & NBDHE information, please visit dentin.co.
