Thomas attends an emergency appointment complaining of severe pain in the upper right premolar region, on examination and radiographs, you determine that UR4 is unrestorable and needs extracting. Thomas consents for extraction however asks to be given antibiotics instead for the pain and to return for the extraction at a later date. What should you do?

You are going through treatment options with the parents of Lizzy during a paediatric examination. Her parents disagree with all of the options you have provided and are refusing treatment, even though the child has presented with extensive decay and pain. What should you do?

You notice that your colleague, Sid, has been quiet recently and ask him if he is ok. Sid breaks down and tells you that he was having an affair with a nurse. Despite several attempts to stop it, she won’t let him. He tries to avoid her throughout the day and is finding it increasingly difficult to work alongside her, he feels forced to continue the relationship. What should you do?

You’re a DFT on your second day at work. A patient, Gemma presents to you in pain with several large cavities in her molar teeth. She is shocked at why she wasn’t told about this in the past. You check the notes and see another associate Frank saw her 4 weeks ago but didn’t mention anything in his clinical records. What do you do?

One of the associate dentists, Jack has called in sick. You have come into work because your ES had called you to ask if you could come in to cover his list on your day off. Later on, as you check your social media pages you see a picture of Jack with his friends at a football match that you know is happening today. What do you do?

You are in a practice with 2 DFTs. Your fellow DFT, Tina has started arriving late to her shifts and it is resulting in you taking over for her until she arrives. This has happened on multiple occasions, often leading to you running behind or staying until late to write notes.
Tina is often disorganised and appears to be frazzled. What do you do?

You attended a party with your DFT colleague James last night. By the end of the party, he appears to be heavily intoxicated. When you get to work at 8am, you are surprised to see he is already there, making a coffee and talking to the nurses. You’re concerned he Is still under the influence of alcohol and has a full list of patients booked this morning. What do you do?

You are treating Violet, a 6-year-old girl who needs a deciduous molar taken out. You inform her mother that you’ll need to take a radiograph beforehand, but her mother is adamant she doesn’t want Violet to suffer from the ill effects of radiation and insists that you just take the tooth out as it is a “baby tooth” and the adult one will grow through. What do you do?

You have just finished treating Eddie, an 80-year-old male patient who attends regularly, has brilliant oral hygiene and is very compliant. You finish the appointment and as he is walking back to reception, he tells your nurse that he is beginning to forget things and has to leave himself notes and reminders throughout the house so that he doesn’t forget. Your nurse comes back after Eddie has left to tell you what he said. What do you do?

You are treating Andy, a 9-year-old boy who requires composite restorations on UR1 UL1 which have enamel-dentine fractures following trauma. Andy’s mother excuses herself during the appointment to visit the toilet and Andy is visibly upset, bursting into tears, telling you he feels his teeth look fine but his mother is forcing him to have treatment that he doesn’t wish to have. What do you do ?

You have just finished seeing Ellie, a 25-year-old patient for a routine check-up appointment. You discover she needs 2 fillings on her lower 6’s. After providing all the restorative options she opts for NHS amalgam fillings. After carrying out the fillings and showing the patient in the mirror, she informs you she thought she was having white fillings and that you explained the choices poorly. She tells you she’s not happy and that you need to replace them with white fillings for free. What do you do?

You are seeing Nikhil, a regular patient of yours who has told you that he has just read a paper online and has found that there is no evidence that flossing increases gingival health. He tells you that he plans to stop flossing from today. What do you do?

You are running late to work due to traffic issues, its already 8.30 am and your first patient is scheduled for 9 am and you are certain you won’t arrive at work until 10am. What do you do?

You have a patient who has presented to you after seeing a different dentist in the practice. She requires a large amount of work and you need to take a few radiographs in order to form a fully-rounded treatment plan. The patient is concerned as she had many radiographs with her previous dentist and is concerned about the radiation. What do you do?

You see an emergency patient, 25-year-old Rick, at your practice who was involved in a fight last night. He presents with his two central incisors in a pot of solution and tells you he would like them re-implanted. He then goes on to tell you he’s had headaches and migraines all of last night and has also been vomiting, however he is adamant on getting his teeth re-implanted. What do you do?

You notice a nurse, Candice is talking in the staff room with her fellow nurse colleagues about one of the associates, Yusef that she is working with. She is talking about him very loudly, stating that he is poor clinically and hasn’t got very good patient management. What do you do?

You are told by your TPD that your reflections in your e-portfolio are poor and clinically your progress isn’t where it’s expected to be. You feel overwhelmed, especially as your ES has been off on sick leave for 3 months- meaning you’ve often been left with little to no support. What do you do?

Mrs. Smith presents to you for an emergency appointment with facial pain and bruising under her cheek. She tells you she fell at home, and when you check over the notes, you note that she had also been in 3 weeks earlier and saw another dentist whom she told “she walked into a door”. She then tells you with an anxious expression that her husband is sitting outside in the waiting room. How do you proceed?

Lilly and her father present to you for a routine check-up. You notice that she has multiple teeth that have abscesses. Due to a lack of cooperation, you inform her father that the best option would be for these to be extracted under general anaesthetic in hospital. Her father declines on the basis that he has heard of people not waking up after having general anaesthetic. He asks if you can just prescribe antibiotics instead?

You are an DFT seeing a patient for restorative treatment. She presents with pain and swelling from her lower left molar which is unrestorable and fractured below the gum level. You tell the patient that the best option would be for her to have this tooth out. The patient reports to you that she is in considerable amounts of pain and would prefer you give her antibiotics today so that she can think about how to proceed in the future. The guidelines state patients don’t require antibiotics if they don’t have a fever. What do you do?

You are treating a patient for a colleague who is currently on holiday, you go to extract the decayed tooth (LR6) which is causing pain but looking at the consent and previous charting you realise the clinically sound (LL6) has been consented for extraction at a previous appointment. What do you do?

You are a foundation dentist doing an extraction of an upper molar in a patient, Anna. You notice upon removing the tooth that one of the roots has dislodged and has been pushed up near the sinus. Anna doesn’t seem to notice but you are concerned that leaving a root in place can lead to complications and infections. What do you do?

You have been booked a patient Mrs Sutton, under your ES’s guidance for a 2-hour appointment. When you check the diary, you notice there has been an admin error and the receptionist has booked 2 different one-hour appointments. Your next 2-hour appointment slot isn’t for another 3 months and you don’t want to risk overrunning into the next patient’s slot. What do you do?

You are a foundation dentist in a busy practice. You have just gotten home after a long day and recall you may have given a patient with a penicillin allergy a prescription for Amoxicillin. What do you do?

You see one of the associates, Ray taking a box of whitening gels from the supply fridge and putting it into his jacket before leaving the practice. What do you do?

You are 6 months into your DFT year, one of the nurses, Mike, approaches you and informs you that the other DFT in your practice, Luke whom he has been paired up with, has been extremely rude and made insulting comments to him in front of patients today. You don’t recall Luke having this demeanour as he has always been pleasant and polite to you. What do you do?

A patient whom you got on well with, messages you on a social networking website, offering to take you out for dinner and drinks as a thank you for all you’ve done for them. What do you do?

You are in the middle of a procedure and have left the room to ask your ES for advice. When you return, you notice your nurse, Adrian is extremely distant, distracted and appears visibly upset. He tells you that he cannot continue with the treatment and needs to leave. What do you do?

You are a foundation dentist, seeing a regular patient who has severe gum disease and has constantly ignored both your lifestyle and oral hygiene advice. Furthermore, the patient hasn’t booked in with the hygienist even after countless recommendations. The patient has now developed a few loose teeth and you are concerned that he is progressing in a way that will result in loss of most of his teeth. When you tell him this, he informs you that he feels like you never made the severity of his gum disease clear to him. What do you do?

You have just completed your case study and post pictures of some of your work on your social media account which is attracting a great response. One of your colleagues’ messages you privately and informs you the name of the patient is visible on the study model images. What do you do?

A 3-year-old patient with autism attends for his first dental appointment with his mother. The patient refuses to sit in the chair and appears very distressed in the environment. What do you do?

You are administering local anaesthetic for an extraction on the upper right side. After administration, the patient asks you why you gave the injection on the left side and not the right. You realise you have made a mistake. What do you do?

You catch your nurse taking pictures of patients notes on her phone. When she notices you watching, she jumps and explains she was checking her parents’ notes because she believes they aren’t receiving the correct treatment. What do you do?

A patient attends the practice demanding an appointment as they are in pain and couldn’t get an emergency slot over the phone. You can hear them being very rude and condescending to the receptionist and nurse while you are treating another patient. What do you do?

It is Sunday and you see one of your patients in the supermarket. She approaches you and begins discussing her father’s treatment with you. What do you do?

It is your first day of DFT and you are observing your ES with a patient. You notice that he leaves the surgery with gloves on and uses them to continue to examine the patient on returning. After the patient leaves, you notice that the surgery is not wiped down between patients and instruments are not changed. What do you do?

You receive a message request on social media from one of your patients asking if they can book an appointment with you as they don’t have the time to ring the surgery. What should you do?

Your friend has recently set up a dental Instagram to showcase their work. You notice that the radiographs of the patient still have identifiable information on them. What do you do?

A 5-year-old patient attends with her uncle for her first ever dental appointment reporting pain from her back teeth. On discussion with her uncle, you find that her parents were busy with work. As a result, he attended with the child but he has no parental responsibility. What do you do?

You are mid-way through root canal treatment of a UR6. When you remove the K file you realise the file has fractured within the canal. What do you do?

A crown for your patient has come back, your notes suggest you requested a porcelain bonded crown, but the lab has sent back a metal crown. Your patient is due to come see you tomorrow whilst your ES is supervising. What do you do?

You are a foundation dentist observing one of the associates Aaron, with an extraction of a lower premolar for a patient, Fatima. Fatima attends with her son as she lacks capacity and requires someone to consent on her behalf.
You notice upon delivering the local anaesthetic, Aaron appears to have pierced himself with the needle. Before you can say anything, Aaron has already delivered the anaesthetic. You are unsure whether he has acquired a sharps injury or not. What do you do?

Your fellow FD colleague Juan, tells you that he has been extremely stressed with both personal problems and managing e-portfolio and clinical care. He tells you that as a result of this, he has been drinking large amounts of alcohol every day. Additionally, at a recent DFT meeting with your fellow colleagues, when your TPD asked if anyone had any concerns or issues, Juan didn’t mention these issues. What do you do?

You are doing an audit with another FD, Riya, on patient satisfaction. When you ask Riya for the fifty completed forms back, you notice that the last 10 have the same handwriting. You ask Riya about this and she admits that she filled the rest of them out herself as she didn’t have time to speak to patients. What do you do?

You are treating Melanie alongside your nurse Billy, for an orthodontic extraction before her braces are fitted. The extraction went well, however at the end of the treatment, Billy takes you outside to tell you that he believes you have extracted the adjacent tooth to the one intended. You check the notes which confirms you have extracted the incorrect tooth. What do you do?

You have just finished a long day in practice. You notice you have your patient list in your jacket pocket, and make a note to remember not to keep patient information and to go home and destroy it. Once you get home, you notice the patient list in not in your jacket. You decide to check your bag and the list is nowhere to be found. You realise you must’ve lost it on the bus on the way home. What do you do?

You are halfway through your foundation year. Your ES, Dr.Shah asks to speak to you one morning and informs you that your last emergency of the day, Alisha, was admitted to the local hospital last night with worsening facial swelling from her infected tooth following the appointment with you. Your ES informs you that you shouldn’t have missed these clinical signs. What do you do?

Your ES informs you that your manner with difficult patients isn’t appropriate and that you have received a complaint from a patient you saw this week. You recall having a difficult week and seeing two extremely difficult patients. You do feel stressed with difficult patients, but feel that you generally handle them well. What do you do?

Your educational supervisor has to go home for a family emergency, and she has left her patient Katie under your care. Katie requires an extraction which she assures you is routine. Upon looking at the notes and preparing for the patient, you realise you will need assistance and the extraction is more complex than initially thought. As you are coming up with a plan, Katie looks visibly worried and asks if you everything is alright. What do you do?

You are seeing 23-year-old Aamir for a routine extraction which has been completed without issue. As you are awaiting for haemostasis you notice he seems to have lost consciousness. What do you do?