Diploma of the Faculty of Dental Surgery (MFDS) Oral Surgery, Oral Medicine and Pathology Syllabus

Oral Surgery, Oral Medicine and Pathology syllabus — full chapter and topic list

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

1. 1

   Exodontia and Minor Oral Surgery

   5 topics

   • Pre-operative assessment for extractions
     • Radiographic assessment and IDN/maxillary sinus proximity
   • Forceps and elevator technique
     • Principles of leverage and tooth sectioning
   • Surgical removal of teeth and roots
     • Flap design and bone removal
   • Management of impacted third molars
     • NICE guidance and coronectomy
   • Suturing and post-operative care
2. 2

   Surgical Complications and Emergencies

   5 topics

   • Management of haemorrhage
     • Local and systemic haemostatic measures
   • Dry socket (alveolar osteitis)
   • Oro-antral communication and fistula
   • Nerve injury and altered sensation
   • Displaced roots and foreign bodies
3. 3

   Oral and Maxillofacial Pathology

   4 topics

   • Odontogenic and non-odontogenic cysts
     • Radicular, dentigerous and odontogenic keratocyst
   • Benign and malignant tumours of the jaws
   • Salivary gland disease
     • Obstructive, inflammatory and neoplastic conditions
   • Biopsy techniques and histopathology request
4. 4

   Oral Medicine

   5 topics

   • Oral mucosal disease
     • Lichen planus, ulceration and vesiculobullous lesions
   • Oral manifestations of systemic disease
   • Orofacial pain
     • Trigeminal neuralgia and temporomandibular disorders
   • Dry mouth and salivary dysfunction
   • Burning mouth syndrome and management of chronic conditions
5. 5

   Oral Cancer and Potentially Malignant Disorders

   5 topics

   • Epidemiology and risk factors
     • Tobacco, alcohol, betel quid and HPV
   • Recognition of potentially malignant disorders
     • Leukoplakia, erythroplakia and oral submucous fibrosis
   • Urgent referral pathways (2-week wait)
   • Principles of staging and multidisciplinary management
   • Prevention and early detection in practice

Oral Surgery, Oral Medicine and Pathology flashcards for Diploma of the Faculty of Dental Surgery (MFDS)

23 of 57 cards from the Oral Surgery, Oral Medicine and Pathology deck — real questions with worked answers.

1. What key elements should be assessed during pre-operative assessment before a dental extraction?

   Medical history (bleeding disorders, anticoagulants, bisphosphonates, immunosuppression, cardiac/diabetic status), drug history and allergies, social history (smoking, alcohol), tooth-specific assessment clinically and radiographically (root morphology, ankylosis, proximity to vital structures), and assessment of access and difficulty.

2. What radiographic features predict a difficult extraction?

   Divergent, curved, hooked or bulbous roots; hypercementosis; ankylosis (loss of PDL space); root proximity to the inferior alveolar canal or maxillary antrum; dense/sclerotic bone; root caries with risk of fracture; and impaction.

3. What are the three primary movements/forces used in extraction with dental forceps?

   Apical force (to displace the tooth apically and expand the socket), buccolingual/buccopalatal rocking (to expand alveolar bone), and rotational force (for single conical-rooted teeth such as lower incisors and upper canines). Traction is applied only at the end.

4. On what mechanical principles do dental elevators work?

   Three principles: the lever (a force applied over a fulcrum to gain mechanical advantage), the wedge (forcing the tooth out along its path), and the wheel-and-axle (rotational force). They expand bone, sever PDL, and luxate teeth/roots.

5. What is the correct fulcrum point when using an elevator, and what should be avoided?

   Use alveolar bone (not an adjacent tooth) as the fulcrum to avoid damaging or luxating the neighbouring tooth. Controlled, supported force with the non-dominant hand protecting adjacent structures is essential.

6. List the main indications for surgical (transalveolar) removal of a tooth rather than simple forceps extraction.

   Grossly carious/broken-down crown, root fracture during simple extraction, impaction, ankylosis, hypercementosis, dilacerated or unfavourable roots, very dense bone, and retained roots inaccessible by forceps.

7. Describe the basic steps of a surgical extraction (transalveolar approach).

   Raise a mucoperiosteal flap to expose bone, remove buccal bone (bone removal/guttering) with a bur under irrigation, section the tooth/roots if needed, elevate and deliver the tooth, debride and irrigate the socket, achieve haemostasis, and suture the flap back.

8. What flap design principles minimise complications in surgical extraction?

   Broad base wider than the apex (to preserve blood supply), full-thickness mucoperiosteal flap, relieving incisions placed away from vital structures and over sound bone, avoid the lingual nerve and mental foramen, and ensure the flap can be closed over sound bone.

9. What is the Winter/Pell-Gregory classification used for, and what does Pell-Gregory assess?

   They classify mandibular third molar impactions. Pell-Gregory assesses depth (levels A, B, C relative to the occlusal/cervical line of the second molar) and the relationship to the anterior ramus (classes I, II, III for available space distal to the second molar). Winter classifies angulation.

10. List the angulations of impacted mandibular third molars (Winter classification).

    Mesioangular (most common, often easiest), horizontal, vertical, distoangular (often most difficult), and rarely buccal/lingual or inverted/transverse impactions.

11. According to NICE guidance, what are the indications for removal of impacted third molars?

    Removal is justified for pathology: two or more episodes of pericoronitis, unrestorable caries in the third molar or distal of the second molar, cysts/tumours, periapical infection, internal/external resorption, or fracture involving the tooth. Prophylactic removal of disease-free impacted teeth is not recommended.

12. What is coronectomy, and when is it indicated?

    Coronectomy (intentional partial odontectomy) is removal of the crown while deliberately leaving the roots in situ. It is indicated for mandibular third molars in close relationship to the inferior alveolar nerve to reduce the risk of permanent nerve injury, in the absence of root infection or mobility.

13. What are the main purposes of placing sutures after a dental surgical procedure?

    To reposition and approximate the flap, achieve primary or secondary haemostasis, cover bone and protect the clot, reduce dead space, and aid healing. Sutures do not by themselves stop brisk arterial bleeding.

14. Compare resorbable and non-resorbable suture materials with examples.

    Resorbable (e.g. Vicryl/polyglactin, plain or chromic catgut) are broken down by hydrolysis or enzymes and need no removal — used intra-orally. Non-resorbable (e.g. silk, polypropylene, nylon) require removal, typically at 5-7 days, and may be used where prolonged support is needed.

15. What standard post-operative instructions should be given after an extraction?

    Avoid rinsing for 24 hours then warm salt-water rinses, avoid hot food/drink, hard chewing and exercise on the day; do not smoke or drink alcohol; bite on a gauze pack if bleeding recurs; take analgesia (avoid disturbing the clot); and contact the practice if heavy bleeding, swelling or severe pain develops.

16. Classify post-extraction haemorrhage by timing.

    Primary (occurs at the time of surgery), reactionary/intermediate (within 24-48 hours, often as vasoconstriction/local anaesthetic effect wears off or vessels open), and secondary (typically 3-7 days later, usually due to infection breaking down the clot).

17. Outline the stepwise local measures to control post-extraction haemorrhage.

    Reassure and position the patient; apply firm pressure with a damp gauze pack (bite for 10-20 min); LA with adrenaline for vasoconstriction; pack the socket with a haemostatic agent (e.g. oxidised cellulose/Surgicel or collagen); suture the socket; and use diathermy or ligation for persistent vessel bleeding. Refer if uncontrolled.

18. Name local and systemic causes of prolonged post-extraction bleeding.

    Local: soft-tissue tears, bony bleeding, vascular lesions, infection, and patient interference with the clot. Systemic: anticoagulants/antiplatelets, liver disease, inherited coagulopathies (haemophilia, von Willebrand disease), thrombocytopenia and other bleeding disorders.

19. What is dry socket (alveolar osteitis), and when does it typically present?

    A localised osteitis where the blood clot is lost or fails to form, exposing bone. It typically presents 3-5 days after extraction with severe throbbing pain, often radiating, an empty socket with exposed bone, malodour/bad taste, but usually without pus, swelling or fever.

20. List the main risk factors for dry socket.

    Smoking, mandibular and posterior teeth (especially lower third molars), surgical/traumatic extraction, the oral contraceptive pill, female sex, excessive mouth-rinsing or spitting, a history of dry socket, local infection, and inadequate blood supply (e.g. dense bone).

21. How is dry socket managed?

    It is self-limiting; management is symptomatic: irrigate the socket with warm saline/chlorhexidine to remove debris, place a sedative obtundent dressing (e.g. Alvogyl/zinc oxide-eugenol or iodoform-based dressing), provide analgesia, and review. Antibiotics are not usually required.

22. What is an oro-antral communication (OAC), and how does it differ from an oro-antral fistula (OAF)?

    An OAC is an acute, unepithelialised opening between the mouth and the maxillary antrum (often after extraction of upper molars/premolars). An OAF is a chronic, epithelialised tract that has become a persistent established pathway lined by epithelium.

23. How is an oro-antral communication diagnosed clinically?

    Direct vision of the antral lining, bubbling of blood/air at the socket, a positive nose-blowing (Valsalva) test with air or fluid passing into the mouth, a bony defect on probing with a blunt instrument (gentle), and on radiograph a raised/disrupted antral floor. Avoid vigorous probing which may push roots in.

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