Diploma of the Faculty of Dental Surgery (MFDS) Clinical Dentistry and Patient Management Syllabus

Clinical Dentistry and Patient Management syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Clinical Dentistry and Patient Management in Diploma of the Faculty of Dental Surgery (MFDS), not a summary of it.

1. 1

   Comprehensive Oral Care and Treatment Planning

   5 topics

   • History taking and clinical examination
     • Presenting complaint, dental and social history
     • Extra-oral and intra-oral examination technique
     • Special investigations and their indications
   • Diagnosis and problem-based treatment planning
     • Sequencing of stabilisation, corrective and maintenance phases
     • Risk assessment and prognosis estimation
   • Shared decision making and consent
     • Capacity and the Mental Capacity Act
     • Discussing risks, benefits and alternatives
   • Holistic and multidisciplinary care
     • Liaison with medical and specialist colleagues
   • Recall intervals and risk-based maintenance
2. 2

   Restorative Dentistry

   5 topics

   • Dental caries diagnosis and management
     • Caries risk assessment and minimally invasive dentistry
     • Selective and stepwise caries removal
   • Direct and indirect restorations
     • Material selection: composite, glass ionomer, amalgam, ceramics
     • Cavity design and bonding principles
   • Tooth wear assessment and management
     • Erosion, attrition, abrasion and abfraction
     • Monitoring with study casts and indices (BEWE)
   • Management of the failing dentition
   • Aesthetic and shade matching considerations
3. 3

   Endodontics

   6 topics

   • Pulpal and periapical diagnosis
     • Pulp sensibility and vitality testing
     • Classification of pulpitis and apical periodontitis
   • Root canal anatomy and access
     • Working length determination and apex locators
   • Chemo-mechanical preparation and irrigation
   • Obturation and coronal seal
   • Management of endodontic complications
     • Instrument fracture, perforation and flare-ups
   • Vital pulp therapy and regenerative endodontics
4. 4

   Prosthodontics and Occlusion

   5 topics

   • Removable partial and complete dentures
     • Surveying, design and path of insertion
     • Retention, support and stability principles
   • Fixed prosthodontics
     • Crown and bridge preparation and provisionalisation
     • Impression techniques and digital workflows
   • Fundamentals of occlusion
     • Centric relation and intercuspal position
     • Articulators and facebow records
   • Introduction to dental implant restoration
   • Management of the edentulous and partially dentate patient
5. 5

   Periodontology

   5 topics

   • Periodontal examination and the BPE
     • 2017 classification of periodontal and peri-implant diseases
     • Staging and grading
   • Aetiology and risk factors
     • Plaque biofilm and the host response
     • Smoking, diabetes and genetic factors
   • Non-surgical periodontal therapy
     • Oral hygiene instruction and root surface debridement
   • Management of acute periodontal conditions
   • Maintenance and supportive periodontal care

Clinical Dentistry and Patient Management flashcards for Diploma of the Faculty of Dental Surgery (MFDS)

25 of 51 cards from the Clinical Dentistry and Patient Management deck — real questions with worked answers.

1. What are the four key components of a structured dental history?

   Presenting complaint and its history (HPC), past dental history, past medical history (including medications and allergies), and social history (smoking, alcohol, diet, occupation). Often summarised with the SOCRATES framework for pain.

2. What does the SOCRATES mnemonic stand for when assessing dental pain?

   Site, Onset, Character, Radiation, Associations, Time course, Exacerbating/relieving factors, and Severity.

3. List the standard sequence of a clinical extra-oral and intra-oral examination.

   Extra-oral: inspection of face/skin/asymmetry, TMJ and muscles of mastication, lymph nodes. Intra-oral: soft tissues (lips, cheeks, tongue, floor, palate, oropharynx), then hard tissues (teeth, periodontium, occlusion).

4. Define 'diagnosis' versus 'problem-based treatment planning' in dentistry.

   Diagnosis is the identification of disease(s) from history, examination and special tests. Problem-based treatment planning organises identified problems into a logical, phased plan: immediate/emergency, disease control (stabilisation), then reconstructive/definitive, and finally maintenance.

5. What are the standard phases of a dental treatment plan in order?

   1) Immediate/emergency (relief of pain/sepsis), 2) Initial/disease control (caries stabilisation, perio therapy, OHI, extractions), 3) Re-evaluation, 4) Reconstructive/definitive (restorative, prosthodontic), 5) Maintenance/recall.

6. What are the three core elements of valid consent?

   It must be given voluntarily, by a person with capacity, and after being adequately informed (material risks, benefits, alternatives, and the option of no treatment).

7. What legal case established the modern UK standard for informed consent (material risks)?

   Montgomery v Lanarkshire Health Board (2015), which established that clinicians must disclose any material risk to which a reasonable person in the patient's position would attach significance.

8. Define 'shared decision making' in clinical practice.

   A collaborative process where clinician and patient jointly make decisions, combining the clinician's evidence and expertise with the patient's values, preferences and circumstances.

9. What does 'holistic and multidisciplinary care' mean in dentistry?

   Treating the whole patient (medical, social, psychological context) rather than isolated teeth, and coordinating across disciplines/specialists (e.g. perio, endo, ortho, oral surgery, medicine) to deliver integrated care.

10. According to NICE guidance, what is the recommended range of recall intervals for dental check-ups?

    Between 3 and 12 months for adults (up to 24 months for low-risk adults), and between 3 and 12 months for those under 18, set individually according to caries/perio/disease risk.

11. What is meant by 'risk-based maintenance' for recall scheduling?

    Recall frequency is tailored to the patient's individual risk of disease (caries, periodontal, oral cancer) rather than a fixed 6-month interval; higher risk means shorter intervals.

12. How is dental caries diagnosed clinically and radiographically?

    Clinically by visual inspection (ICDAS criteria) of demineralisation, cavitation, and texture, with gentle probing; radiographically by bitewings showing radiolucency in enamel/dentine. Adjuncts include transillumination and laser fluorescence (DIAGNOdent).

13. What does the ICDAS scoring system measure, and what are its score extremes?

    ICDAS (International Caries Detection and Assessment System) scores visual caries severity from 0 (sound) to 6 (extensive cavitation with visible dentine), with intermediate scores for early enamel and dentine lesions.

14. Outline the principles of minimally invasive caries management.

    Prevention and remineralisation of early non-cavitated lesions (fluoride, diet, OHI), selective caries removal preserving pulpal dentine, and restoring only when cavitation/progression demands, maximising tooth tissue preservation.

15. Compare direct and indirect restorations.

    Direct restorations (amalgam, composite, GIC) are placed and set chairside in a single visit within the cavity. Indirect restorations (inlays, onlays, crowns) are fabricated outside the mouth (lab/CAD-CAM) from an impression and cemented at a later visit; they suit larger cavities needing greater strength.

16. What is the BEWE index used for, and what is its scoring range?

    The Basic Erosive Wear Examination grades the most affected surface per sextant from 0 (no wear) to 3 (hard tissue loss greater than 50% of surface area); cumulative score guides risk level and management.

17. Name the three principal mechanisms of tooth surface loss (tooth wear).

    Erosion (chemical/acid dissolution), attrition (tooth-to-tooth contact), and abrasion (mechanical wear from foreign objects e.g. toothbrushing); abfraction is sometimes added (cervical stress lesions).

18. What is the 'failing dentition' and what are management options?

    A dentition with widespread, advanced disease (caries, perio, tooth wear) of poor prognosis. Options range from intensive stabilisation and selective retention of key teeth, to strategic extractions with partial dentures/implants, to full clearance and complete dentures, guided by patient wishes and prognosis.

19. What is the 'shade matching' sequence and which guide is commonly used?

    Match shade early before tooth dehydration, under natural/colour-corrected light, against a moist tooth, using the VITA shade guide (or VITA 3D-Master ordered by value, chroma, hue). Assess value first, then chroma, then hue.

20. Define the dimensions of colour relevant to dental aesthetics.

    Hue (the colour itself, e.g. yellow/red), value (lightness/darkness — most important), and chroma (saturation/intensity of the hue).

21. What are the clinical features distinguishing reversible from irreversible pulpitis?

    Reversible pulpitis: short, sharp pain to stimulus (cold/sweet) that stops when stimulus removed; pulp can recover. Irreversible pulpitis: spontaneous, lingering, often throbbing pain, may be worse on lying down or to heat, relieved by cold in late stages; requires pulp removal.

22. List the periapical diagnoses commonly used in endodontics.

    Normal apical tissues, symptomatic apical periodontitis, asymptomatic apical periodontitis, acute (or chronic) apical abscess, and condensing osteitis.

23. What special tests are used to determine pulpal status?

    Thermal tests (cold e.g. Endo-Ice, heat), electric pulp test (EPT — assesses sensibility/nerve), percussion and palpation (periapical status), mobility, periodontal probing, and selective radiographs; pulp oximetry/laser Doppler assess true vitality (blood flow).

24. How many canals are typically found in maxillary first molars?

    Usually three roots with three to four canals: mesiobuccal (often two — MB1 and MB2), distobuccal, and palatal canals. MB2 is frequently missed.

25. What are the objectives of endodontic access cavity preparation?

    Achieve straight-line access to canal orifices, remove the entire pulp chamber roof, conserve sound tooth structure, locate all canals, and avoid gouging/perforation.

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