NEET MDS Preventive Dentistry Syllabus

What is the certainly lethal dose (CLD) of fluoride for an adult?

Approximately 32–64 mg F per kg body weight (commonly cited as 5–10 g of sodium fluoride for a 70 kg adult).

What is the first-aid management for acute fluoride toxicity?

Induce vomiting, give milk or calcium/magnesium-containing antacids to bind fluoride, and seek emergency medical care; calcium gluconate for severe cases.

What are pit and fissure sealants and on which surfaces are they used?

Resin or glass-ionomer materials placed in the pits and fissures of occlusal (and sometimes buccal/lingual) surfaces of teeth to provide a physical barrier against caries-causing bacteria and food.

What is the most important step ensuring retention of resin-based pit and fissure sealants?

Adequate acid etching and complete moisture control (isolation/dryness)—saliva contamination is the leading cause of sealant failure.

Which teeth and at what age are sealants most commonly indicated?

Newly erupted permanent first molars (~6 years) and second molars (~12 years); also premolars and caries-prone primary molars, ideally placed soon after eruption.

Differentiate resin-based sealants from glass-ionomer sealants.

Resin sealants have superior retention and are technique-sensitive (require dry field); glass-ionomer sealants release fluoride and tolerate moisture better but have lower retention—useful for partially erupted/uncooperative cases.

What is the Vipeholm study and its key finding?

A Swedish study (1945–1953) on institutionalized adults showing that the frequency and stickiness (retentiveness) of sugar consumption, especially between meals, is more cariogenic than the total amount.

Name the major dietary modifications recommended for caries prevention.

Reduce frequency and amount of fermentable sugars, avoid sticky/retentive sugars between meals, substitute non-cariogenic sweeteners (xylitol), and increase protective foods like cheese and fibrous fruits/vegetables.

How does xylitol help prevent caries?

Xylitol is a non-fermentable sugar alcohol that Streptococcus mutans cannot metabolize into acid; it reduces S. mutans levels, stimulates saliva, and aids remineralization.

What is the gold standard mechanical method of plaque control?

Toothbrushing combined with interdental cleaning (dental floss/interdental brushes)—mechanical plaque removal.

Which chemical agent is considered the gold standard anti-plaque mouthrinse and what is a key side effect?

Chlorhexidine gluconate (0.12–0.2%); a major side effect is extrinsic brown staining of teeth and tongue, altered taste, and increased calculus with prolonged use.

Name two indices used to measure plaque/oral hygiene.

Silness and Löe Plaque Index, Turesky modification of the Quigley-Hein Plaque Index, and the Oral Hygiene Index–Simplified (OHI-S, Greene and Vermillion).

What toothbrushing technique is most commonly recommended for plaque removal at the gingival margin?

The Modified Bass technique—bristles at 45° to the long axis directed toward the gingival sulcus, with small vibratory then sweeping motions.

What are the clinical signs of healthy gingiva?

Coral pink color, stippled firm consistency, knife-edge margins, scalloped contour, no bleeding on probing, and a sulcus depth of 1–3 mm.

What is the earliest clinical sign of gingival inflammation?

Bleeding on probing (often preceding visible color/contour changes).

Which index measures gingival inflammation?

The Gingival Index (GI) of Löe and Silness, and the Sulcus Bleeding Index.

What is the difference between gingivitis and periodontitis?

Gingivitis is reversible inflammation confined to the gingiva with no attachment/bone loss; periodontitis involves irreversible loss of periodontal attachment and alveolar bone, with pocket formation.

What is interceptive orthodontics?

Treatment carried out in the mixed dentition to recognize and eliminate developing malocclusions, intercepting problems before they fully establish (e.g., space maintenance, habit breaking).

Give three examples of interceptive orthodontic procedures.

Space maintenance after early tooth loss, serial extraction for crowding, correction of oral habits (e.g., thumb-sucking appliances), and treatment of anterior/posterior crossbites.

What is serial extraction?

A planned, sequential removal of certain primary and permanent teeth in cases of severe arch-length deficiency to guide eruption and relieve crowding, typically: primary canines, then primary first molars, then first premolars.

What is a space maintainer and why is it used?

An appliance used to preserve the space created by premature loss of a primary tooth, preventing adjacent teeth from drifting and ensuring eruption space for the permanent successor.

List the major risk factors for dental caries.

High/frequent fermentable sugar intake, poor oral hygiene/plaque, high S. mutans and Lactobacillus counts, reduced salivary flow (xerostomia), lack of fluoride exposure, deep pits/fissures, and low socioeconomic status.

List the major risk factors for periodontal disease.

Poor plaque control, smoking/tobacco, diabetes mellitus, genetic susceptibility, age, stress, hormonal changes, and local factors like calculus and overhanging restorations.

What is caries risk assessment (CRA) and name a common tool.

A systematic evaluation of factors to classify a patient's likelihood of developing caries (low/moderate/high) to guide preventive intervention; tools include CAMBRA (Caries Management By Risk Assessment) and the ADA Caries Risk Assessment form.

Which preventive strategy applies to a whole population rather than high-risk individuals, and who proposed it?

The whole-population (mass) strategy versus the high-risk strategy—proposed by Geoffrey Rose ('Rose's prevention paradox').

What is the prevention paradox (Rose)?

A preventive measure that brings large benefit to the population (whole-population approach) often offers little benefit to each participating individual, whereas high-risk strategies benefit individuals but have limited population impact.

What special preventive considerations apply to pediatric dentistry?

Anticipatory guidance, early dental visit by age 1, caries-risk assessment, fluoride and sealant use, diet/feeding counseling (avoid nursing bottle caries), and behavior management.

What is early childhood caries (ECC) and a key preventive measure?

ECC is the presence of one or more decayed/missing/filled tooth surfaces in a child under 6 years (severe ECC includes smooth-surface caries); prevention includes avoiding prolonged/nocturnal bottle feeding with sugary liquids and early fluoride exposure.

What are key preventive concerns in geriatric dentistry?

Root caries (due to gingival recession), xerostomia from polypharmacy, periodontal disease, denture care, reduced manual dexterity, and use of high-fluoride toothpaste/fluoride for root caries prevention.

What preventive approaches are important for patients with special needs?

Caregiver-assisted oral hygiene, modified/adaptive toothbrushes, frequent professional fluoride application, chlorhexidine use, dietary counseling, and more frequent recall visits due to higher disease risk and limited self-care ability.