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Oral pain, erythematous gingival tissues, blunted papillae spontaneous gingival bleeding, and no attachment loss

 # A 19 year old patient presents with oral pain, erythematous gingival tissues, blunted papillae spontaneous gingival bleeding, and no attachment loss. There is also a pseudomembrane covering the gingiva. Which of the following is the diagnosis for this patient?
A. Plaque associated gingivitis
B. Necrotizing ulcerative gingivitis
C. Aggressive periodontitis
D. Chronic periodontitis
E. Necrotizing ulcerative periodontitis





The correct answer is B. Necrotozing ulcerative gingivitis.

Necrotizing ulcerative gingivitis and periodontitis usually occurs
because of the predominance of the anaerobic fusobacteria and
spirochetes within the oral cavity, specifically underneath the gingiva.

This is a case of Necrotizing ulcerative gingivitis (NUG) NOT
necrotizing ulcerative periodontitis (NUP) because the patient is not
experiencing bone loss.

Debridement of the affected gingiva with an adjunctive prescription
of chlorhexidine 0.12 % rise will help stop the progression of
necrotizing ulcerative disease.

Acute necrotizing gingivitis signs/ symptoms:
  1. Pain
  2. Interproximal necrosis of the papilla (Blunting of papilla)
  3. Bleeding gingiva
  4. Fetid odor
  5. Low-grade fever
  6. Pseudomembrane

Acute necrotizing gingivitis risk factors:
  1. Poor oral hygiene
  2. Smoking
  3. Malnutrition
  4. Fatigue
  5. Stress
  6. Immunocompromised patients


Strongest indication for splinting

 # Which of the following patient conditions is the strongest indication for splinting?
A. Mobility with a unilateral shift from centric relation to centric occlusion
B. Mobility with discomfort
C. Presence of diastemas
D. Primary occlusal trauma



The correct answer is B. Mobility with discomfort.

Unstable teeth that cannot maintain normal position during centric occlusion need additional support to maintain position and therefore must be splinted to the adjacent teeth.

Presence of a diastema does not necessarily require splinting except when the diastema is caused by the movement of teeth due a periodontally compromised status.

Primary occlusal trauma can be resolved once the cause of trauma
is removed.

Discomfort associated with tooth mobility may:
• Be due to other periodontal conditions
• Be due to pulpal conditions
• NOT be a direct indication alone for splinting therapy


Peace Dental Care Pvt. Ltd., Bharatpur -10, Chitwan

 Name of Dental Clinic: Peace Dental Care Pvt. Ltd.
Address: Bharatpur-10, Hospital Road, Chitwan
Year of Establishment: 2076
Name of the chief Dental Surgeon: Dr. Binaya Subedi
CONTACT NUMBER: 056593325

Baishdhara Dental Clinic, Balaju, Kathmandu

 Name of Dental Clinic: Baishdhara Dental Clinic
Address : Near Tarun Ma Vi, Balaju, Kathmandu, Nepal
Year of Establishment: 2021
Name of the chief Dental Surgeon: Dr Bishwo Prachanda Sedhain
CONTACT NUMBER: 9851157949

Interruption of transmission of disease is called:

 # Interruption of transmission of disease is called:
A. Disease control 
B. Disease eradication
C. Disease elimination
D. Disability limitation



The correct answer is C. Disease elimination.

Concept of Control
A. Disease control : The term 'disease control' describes (ongoing) operations aimed at reducing incidence, duration, decrease effects of disease, etc. Control activities may focus on primary prevention or secondary prevention. The concept of tertiary prevention is comparatively less relevant to control efforts. In disease control, the disease agent is permitted to persist in the community at a level where it ceases to be a public health problem according to the tolerance level of local population.

B. Disease elimination: Between control and eradication, an intermediate goal has been described, called 'regional elimination'. The term elimination is used to describe interruption of transmission of disease, eg. elimination of measles, polio and diphtheria from large geographic region or areas. Regional elimination is now seen as an important precursor of eradication.

C. Disease eradication: Eradication literally means to 'tear out by roots'. It is the termination of all transmission of infection by extermination of the infectious agent through surveillance and containment. As the name implies, eradication is an absolute process, and not a relative goal. It is an all or none phenomenon. 

Phases of Public Health - Concept of risk factor

 # The new concept of risk factor came into existence during which phase?
A. Disease control phase
B. Health promotional phase
C. Social engineering phase
D. Health for all phase


The correct answer is C. Social engineering phase.

Four phases of public health have been recognized:
A. Phase one: Disease Control Phase (1880-1920)
The 19th century Public Health- matter of sanitary legislation and sanitary reform, safe water supply and waste disposal. 

B. Phase Two: Health promotional phase (1920-1960)
At the beginning of the 20th century, the concept of health promotion emerged. As a result, in addition to disease control activities, one more goal was initiated. e.g. Maternal and child health, School health, mental health, occupational health and rehabilitation services.

C. Phase Three: Social Engineering phase (1960-1980)
Chronic conditions such as cancer, Diabetes mellitus (DM), cardiovascular diseases (CVD), and alcoholism, drug addiction occurred. These chronic health problems could not be tackled by the traditional approaches to public health i.e. isolation, immunization, and disinfection) nor they can be explained on the basis of germ theory (biomedical) of disease. The concept of risk factors (social, environmental, genetic and lifestyle) came into action as determinants of disease. 

D. Phase four: Health for all phase (1980-2000)
Primary Health care, Health for all (HFA)- Health for all meant that every individual should have access to Primary Health Care 


Bhatbhateni Dental Care Pvt. Ltd., Thirbum Sadak, Bhatbhateni, Naxal

 Name of Dental Clinic: Bhatbhateni Dental Care Pvt. Ltd.
Address: Thirbum Sadak, Bhatbhateni, Naxal
Year of Establishment: 2017
Name of the chief Dental Surgeon: Dr. Sanjay Kumar Tiwari 
CONTACT NUMBER: 9863028098 

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