Home/Quiz/Free ORE Part 2 Practice Questions Free ORE Part 2 Practice Questions Welcome to your Free ORE Part 2 Practice Questions 1. A 58-year-old man with type 2 diabetes mellitus is undergoing a routine dental restoration. About 30 minutes into the procedure, he becomes confused, sweaty, pale, and increasingly aggressive. He is conscious, responsive to verbal commands, and able to swallow safely. The dentist suspects hypoglycaemia. What is the most appropriate immediate management? Give 15–20 g of fast-acting oral glucose, stop treatment, and reassess after 10–15 minutes. Administer 1 mg intramuscular glucagon immediately. Administer intravenous dextrose immediately. Continue dental treatment and observe the patient. Give insulin to correct the low blood sugar. None 2. An OSCE clinical examination station provides a full periodontal chart and radiographs for interpretation. The patient has generalised bleeding on probing, probing pocket depths of up to 7 mm, and radiographic bone loss extending to the apical third of the root on several teeth. There is no relevant medical history. Based on the 2018 Classification of Periodontal Diseases, how should this condition be best classified? Generalised Stage IV periodontitis Generalised Stage III periodontitis Generalised plaque-induced gingivitis Localised Stage II periodontitis Necrotising ulcerative periodontitis None 3. A 42-year-old patient attends your practice and asks that a copy of their dental records be sent to a solicitor handling a compensation claim. The solicitor later contacts the practice requesting the records. According to UK data protection legislation and GDC confidentiality principles, what must you generally obtain before releasing the patient's dental records to a third party? The patient's valid written consent (or other lawful authority to disclose). Verbal permission from a family member. Approval from the practice manager. Permission from the patient's general medical practitioner (GP). A request from the third party alone is sufficient. None 4. A 45-year-old patient attends a Diagnosis and Treatment Planning (DTP) station with intermittent discomfort associated with the lower left first molar. Clinical examination shows a large existing restoration. The tooth is non-vital, has no significant mobility, is periodontally sound, and is considered restorable. A periapical radiograph demonstrates a well-defined periapical radiolucency associated with the tooth. The patient is keen to retain the tooth. What is the most appropriate definitive treatment option to present? Non-surgical root canal treatment followed by an appropriate definitive cuspal coverage restoration. Extraction followed by replacement with a removable partial denture. Incision and drainage only, with no further treatment. Long-term antibiotics until the radiolucency resolves. Apicectomy as the first-line treatment. None 5. During an ORE Part 2 OSCE briefing, a candidate asks how the OSCE stations are organised so they can manage their time effectively. Approximately how long is each active OSCE station, and how is it typically structured? 5 minutes at each active station, with candidates rotating through a circuit of stations assessing communication, clinical reasoning, ethics, history taking, interpretation, and practical judgement. 15 minutes at each station with one examiner throughout the examination. 30 minutes at each station followed by a viva examination. 45 minutes at each station with a practical operative task. 60 minutes at each station with written answers only. None 6. A 32-year-old healthy patient undergoes a routine composite restoration under 2% lidocaine with 1:80,000 adrenaline (epinephrine). Within a few minutes of the injection, the patient reports feeling shaky, anxious, and aware of a rapid heartbeat. On examination, the patient is alert, normotensive, breathing comfortably, and has no rash, wheeze, facial swelling, or chest pain. What is the most likely explanation? Transient systemic effects of adrenaline (epinephrine) from the local anaesthetic Anaphylaxis to the local anaesthetic Acute myocardial infarction Local anaesthetic overdose (systemic toxicity) Hypoglycaemia None 7. A 68-year-old man with a known history of stable angina develops central crushing chest pain during a routine dental procedure. The pain is similar to his previous angina episodes. He remains conscious and has his own glyceryl trinitrate (GTN) spray with him. What is the most appropriate first action? Administer 300 mg aspirin immediately before giving GTN. Continue treatment while observing the patient. Administer intramuscular adrenaline. Begin cardiopulmonary resuscitation (CPR). Stop treatment, sit the patient comfortably, and assist them to use their own GTN spray. None 8. A 29-year-old patient returns 3 days after extraction of a mandibular first molar complaining of severe throbbing pain radiating to the ear. The pain started about 48 hours after the extraction and has progressively worsened. The patient also reports bad taste and halitosis. Clinical examination reveals an empty-looking socket with exposed bone, minimal surrounding erythema, and no facial swelling, pus, or fever. What is the most likely diagnosis and the appropriate first-line management? Acute odontogenic infection – Prescribe antibiotics only and review in one week. Osteomyelitis – Admit the patient for intravenous antibiotics immediately. Dry socket (alveolar osteitis) – Gently irrigate the socket, place a medicated dressing if indicated, provide analgesia, and reassure the patient. Normal postoperative healing – Reassure the patient and discharge without treatment. Retained root fragment – Re-open the socket surgically at the same visit. None 9. During the Dental Manikin Assessment in the ORE Part 2 examination, you are restoring a Class IV composite cavity using a total-etch (etch-and-rinse) adhesive technique. After isolation with rubber dam, you apply 37% phosphoric acid to the enamel margins. According to accepted adhesive dentistry principles, how long should enamel typically be etched, and what should you avoid? Etch enamel for 60 seconds and air-dry dentine until it is chalky white. Etch enamel for 5 seconds and immediately place composite without bonding. Etch enamel for 90 seconds and leave the acid on while placing the adhesive. Etch enamel for 15–30 seconds, then rinse thoroughly and avoid overdrying dentine before applying the bonding agent. Etch enamel for 30 seconds and deliberately desiccate both enamel and dentine completely before bonding. None 10. A 60-year-old man with type 2 diabetes mellitus attends for a routine dental extraction. Approximately 20 minutes into the procedure, he becomes confused, sweaty, pale, and increasingly aggressive. He is conscious, able to respond to questions, and can swallow safely. The dentist suspects hypoglycaemia. What is the most appropriate immediate management? Administer 1 mg intramuscular glucagon immediately. Give 15–20 g of fast-acting oral glucose, stop treatment, and reassess after 10–15 minutes. Administer intravenous dextrose immediately. Continue treatment and observe the patient for improvement. Give a rapid-acting insulin injection. None 11. During the ORE Part 2 Dental Manikin Assessment, you are restoring a Class I occlusal cavity on a mandibular first molar using composite resin. The examiner assesses the final restoration for anatomy, function, and occlusion. Which feature best reflects a clinically acceptable anatomical and functional restoration? A completely flat occlusal surface to eliminate any occlusal interference. Deep, exaggerated fissures with very high cusps to maximise aesthetics. Rounded occlusal anatomy with no identifiable cusps or fossae. Well-defined cusps, triangular ridges, fossae, and fissure pattern with harmonious occlusal contacts and no premature interference. An overfilled restoration with heavy occlusal contacts to compensate for future wear. None 12. During the ORE Part 2 Dental Manikin Assessment, you are asked to restore a Class V non-carious cervical lesion (NCCL) on the buccal surface of a premolar. The lesion extends onto the root surface, and the examiner notes that the cervical area is difficult to keep completely dry. Which restorative material is most commonly indicated because of its chemical adhesion to tooth structure and fluoride release in this moisture-prone area? Dental amalgam Zinc phosphate cement Resin-modified glass ionomer cement (RMGIC) Microfilled composite resin only Zinc oxide eugenol cement None 13. During the ORE Part 2 Medical Emergencies assessment, you are asked to perform adult cardiopulmonary resuscitation (CPR) on a resuscitation manikin. The examiner assesses the quality of your chest compressions according to current Resuscitation Council UK guidance. To what depth should the chest be compressed in an average adult? 2–3 cm 3–4 cm 7–8 cm At least 8 cm 5–6 cm None 14. A 55-year-old man attends a Diagnosis and Treatment Planning (DTP) station complaining of a painful ulcer on the right lateral border of the tongue that has been present for 3 weeks. He smokes 20 cigarettes daily and drinks alcohol regularly. Clinical examination reveals a 1.5 cm indurated ulcer with rolled margins. There is no obvious traumatic cause. What is the most appropriate immediate action? Prescribe topical corticosteroids and review in 2 weeks. Prescribe broad-spectrum antibiotics and review after completion of the course. Perform root canal treatment on the adjacent tooth. Urgently refer the patient via the Suspected Cancer (Two-Week Wait) pathway for specialist assessment and biopsy. Advise chlorhexidine mouthwash and review in one month. None 15. During the ORE Part 2 Structured Medical Emergencies Oral Examination, the examiner asks how frequently a UK dental practice should check its emergency drugs and emergency equipment to ensure they are ready for immediate use. What is the expected UK standard? Every 6 months during equipment servicing. At least once a week, with additional checks after every use and regular monitoring of expiry dates and oxygen supply. Once a month. Only when a medical emergency occurs. Once a year during the practice inspection. None 16. During the ORE Part 2 Medical Emergencies Manikin Assessment, you arrive at an adult patient who is unresponsive and not breathing normally. After confirming cardiac arrest, calling for help, and requesting an AED, you begin single-rescuer basic life support (BLS). Which chest compression-to-rescue breath ratio should you demonstrate according to current UK guidance? 15 compressions : 2 rescue breaths 5 compressions : 1 rescue breath 30 compressions : 1 rescue breath Continuous chest compressions without rescue breaths 30 compressions : 2 rescue breaths None 17. A 24-year-old healthy patient receives an inferior alveolar nerve block before a routine restoration. Within a minute, they become pale, complain of feeling faint and nauseated, and begin to sweat. They remain responsive but say they are about to "pass out." Their pulse is slow, and there are no signs of rash, wheeze, or facial swelling. What is the most appropriate immediate management? Administer 300 mg aspirin and call 999 immediately. Give intramuscular adrenaline (epinephrine) 500 micrograms. Sit the patient upright and encourage them to walk around. Place the patient in a supine position with the legs elevated, stop treatment, maintain the airway, and administer oxygen if indicated while monitoring recovery. Give oral glucose immediately. None 18. During the ORE Part 2 Dental Manikin Assessment, you are asked to perform an access cavity preparation on a maxillary first molar for root canal treatment. After gaining access, the examiner asks how many canals you would expect to identify in the majority of cases. What is the most appropriate answer? Two canals Three canals Five canals One canal Four canals None 19. A 30-year-old patient with a history of epilepsy develops a generalised tonic-clonic seizure during dental treatment. The seizure continues despite appropriate basic management and has now lasted more than 5 minutes. An ambulance has already been called. According to current UK guidance, which emergency drug and route is most appropriate while awaiting the ambulance? Intramuscular adrenaline (epinephrine) 500 micrograms Oral diazepam 10 mg Buccal midazolam 10 mg Intravenous glucose 75 mL of 20% dextrose Sublingual glyceryl trinitrate (GTN) spray None 20. A 28-year-old patient attends a Diagnosis and Treatment Planning (DTP) station requesting tooth whitening. The patient is medically fit, has no active caries or periodontal disease, and is over 18 years of age. The examiner asks about the legal concentration of whitening agent that may be used by a dental professional under current UK regulations. What is the maximum concentration of hydrogen peroxide (or equivalent) that may be used for tooth whitening in patients over 18 years of age? 0.1% hydrogen peroxide 12% hydrogen peroxide 35% hydrogen peroxide 6% hydrogen peroxide (or equivalent released from carbamide peroxide) 10% hydrogen peroxide None 21. A 48-year-old patient attends an ORE Part 2 OSCE station with a heavily worn dentition consistent with long-standing sleep bruxism. Several posterior teeth have recently been restored with composite, and the patient asks: "What can I wear at night to protect my teeth and these new fillings?" What is the most appropriate recommendation? Advise the patient to avoid chewing gum only. Prescribe a soft over-the-counter mouthguard. Recommend extraction of severely worn teeth before considering prevention. Prescribe muscle relaxants for long-term nightly use. Provide a custom-made hard acrylic occlusal splint (stabilisation splint/night guard). None 22. During an ORE Part 2 OSCE radiographic interpretation station, you are shown a bitewing radiograph of a 24-year-old patient with good oral hygiene. A radiolucency is visible on the proximal surface of a premolar, extending only into the outer half of the enamel. Clinical examination confirms the surface is non-cavitated. What is the most appropriate management? Prepare the tooth immediately and place a composite restoration. Place a glass ionomer restoration to release fluoride. Extract the tooth because proximal caries will inevitably progress. Manage non-operatively with preventive measures, including fluoride therapy, dietary advice, oral hygiene reinforcement, and radiographic review. Perform fissure sealing of the occlusal surface only. None 23. A 32-year-old woman who is 34 weeks pregnant attends for an urgent dental restoration. Shortly after being placed supine in the dental chair, she complains of feeling faint, dizzy, and short of breath. She appears pale and says she feels as though she might lose consciousness. What is the most likely cause and the most appropriate immediate management? Pulmonary embolism – Call 999 immediately and begin CPR. Hypoglycaemia – Give 15–20 g of oral glucose immediately. Supine hypotensive syndrome due to compression of the inferior vena cava – Turn the patient onto her left side (or tilt to the left by placing a wedge under the right hip), stop treatment, and monitor until symptoms resolve. Anaphylaxis – Administer intramuscular adrenaline (epinephrine) 500 micrograms. Hyperventilation – Encourage the patient to rebreathe into a paper bag. None 24. During the ORE Part 2 Dental Manikin Assessment, you are preparing a maxillary first premolar for a full-coverage all-ceramic crown. The examiner evaluates your preparation and asks why a well-defined finish line (such as a chamfer or shoulder) is an essential feature of the preparation. What is the best answer? It increases the retention of the crown by creating undercuts. It reduces the need for an impression by clearly marking the preparation margin. It provides a clear, continuous margin for accurate crown fabrication and marginal adaptation while ensuring adequate material thickness. It allows the crown to be cemented without any tooth preparation. It eliminates the need for temporary crown placement. None 25. During an ORE Part 2 History-Taking OSCE station, a 72-year-old patient requires a simple extraction of an upper premolar. The patient reports taking warfarin for atrial fibrillation and has had no recent bleeding complications. They ask whether they should stop taking their anticoagulant before the extraction. What is the most appropriate UK approach regarding their anticoagulation? Stop warfarin for 5 days before the extraction without consulting anyone. Admit the patient to hospital for all dental extractions. Replace warfarin with low-molecular-weight heparin (bridging therapy) before treatment. Proceed with the extraction regardless of the patient's INR. Check that the INR is within the therapeutic range (generally ≤4.0 and measured within the previous 24–72 hours according to stability), continue warfarin, and use appropriate local haemostatic measures. None 26. A 70-year-old edentulous patient returns 2 weeks after receiving a new maxillary complete denture. They report that the denture is comfortable at rest but drops or dislodges when they open their mouth widely, laugh, or yawn. The fit surface appears satisfactory, and the occlusion is acceptable. Which feature is most likely to require correction to improve denture retention? Increase the vertical dimension of occlusion. Shorten the posterior teeth. Increase the thickness of the palatal acrylic. Deepen the labial flange. Correct the posterior palatal seal (post dam). None 27. A 9-year-old child attends a Diagnosis and Treatment Planning (DTP) station with a deeply carious, unrestorable lower first permanent molar. Clinical and radiographic examination also shows developing crowding, and the second permanent molar is still unerupted. The examiner asks about planning the extraction and whether compensating or balancing extraction should be considered. What factor most influences the timing of any compensating or balancing extraction decision? The child's body weight. The degree of pain from the affected tooth. The stage of development of the second permanent molar, particularly early bifurcation formation. The eruption status of the third molar. The amount of plaque accumulation around the first permanent molar. None 28. During an ORE Part 2 OSCE station, a 52-year-old woman attends for a routine oral examination. She has no significant symptoms, although she occasionally notices mild sensitivity to spicy foods. On examination, there are bilateral white, lacy striations (Wickham's striae) on the buccal mucosa. The lesions cannot be wiped off and are symmetrical. What is the most likely diagnosis? Chronic hyperplastic candidiasis Oral leukoplakia Frictional keratosis Reticular oral lichen planus Oral hairy leukoplakia None 29. A 35-year-old patient presents at a Diagnosis and Treatment Planning (DTP) station complaining of increasing tooth sensitivity. Clinical examination shows generalised tooth surface loss, including cupping of the occlusal surfaces of posterior teeth and loss of palatal enamel on the maxillary incisors. The patient reports drinking several cans of fizzy drinks every day and has no history suggestive of gastro-oesophageal reflux or eating disorders. What is the most likely primary aetiology? Attrition due to nocturnal bruxism. Abrasion from aggressive toothbrushing. Abfraction due to occlusal loading. Developmental enamel hypoplasia. Dental erosion caused by frequent exposure to extrinsic dietary acids. None 30. During the ORE Part 2 OSCE briefing, a candidate asks how the OSCE circuit is organised to help with time management. What best describes the structure of each active OSCE station? Each active station consists of 1 minute to read the instructions followed by 5 minutes to complete the task. Candidates rotate through a circuit of up to 24 stations, including at least 15 active stations, with some rest and pilot stations. Each station lasts 10 minutes with no reading time before entry. Each station consists of 15 minutes with one examiner assessing all stations. Each station lasts 20 minutes and includes a written examination after the practical task. Each station consists of 30 minutes with multiple clinical tasks completed before moving on. None 31. A 31-year-old woman who is 35 weeks pregnant attends for emergency dental treatment. Shortly after being placed in the supine position, she complains of feeling faint, dizzy, and short of breath. She appears pale and says the symptoms improve slightly when she tries to turn onto her side. What is the most likely cause and the most appropriate immediate management? Pulmonary embolism – Administer oxygen and arrange immediate hospital transfer. Supine hypotensive syndrome caused by compression of the inferior vena cava – Reposition the patient into the left lateral position (or place a wedge under the right hip to tilt her to the left), stop treatment, and monitor. Hypoglycaemia – Give 15–20 g of oral glucose immediately. Vasovagal syncope – Place the patient flat with both legs elevated. Anaphylaxis – Administer 500 micrograms intramuscular adrenaline immediately. None 32. During the ORE Part 2 Medical Emergencies Manikin Assessment, you have confirmed an adult cardiac arrest, started high-quality CPR, and attached an automated external defibrillator (AED). The AED analyses the rhythm and announces, "Shock advised." What should you ensure immediately before delivering the shock? Continue chest compressions while pressing the shock button. Remove the AED pads before delivering the shock. Deliver two rescue breaths before shocking the patient. Ensure that no one is touching the patient, loudly announce "Stand clear!", perform a visual check, and then deliver the shock. Check the patient's pulse again before delivering the shock. None 33. A 62-year-old patient attends a Diagnosis and Treatment Planning (DTP) station requiring multiple simple dental extractions. They have well-controlled type 2 diabetes mellitus, with a recent HbA1c within the target range, take oral hypoglycaemic medication, and have no diabetic complications. How should the patient's diabetes most appropriately influence appointment planning? Delay all extractions until the patient is no longer taking diabetic medication. Prescribe prophylactic antibiotics before every extraction because of diabetes. Arrange treatment under general anaesthesia because diabetic patients should not undergo multiple extractions under local anaesthesia. Stop the patient's diabetic medication on the day of treatment to reduce the risk of hypoglycaemia. Schedule a morning appointment, ensure the patient has eaten normally and taken their usual diabetic medication, minimise fasting, and monitor for signs of hypoglycaemia during treatment. None 34. During the ORE Part 2 Dental Manikin Assessment, you are performing root canal treatment on a mandibular first premolar. After gaining access, the examiner asks why accurate working length determination is essential before canal instrumentation. What is the best reason? It allows larger files to be used more easily. It eliminates the need for irrigation during root canal treatment. It ensures the access cavity is wide enough for obturation. It determines the amount of local anaesthetic required. It allows complete cleaning, shaping, and obturation of the root canal system while minimising over-instrumentation or under-instrumentation beyond the apical constriction. None 35. During an ORE Part 2 OSCE station, you review a periapical radiograph showing a previously root-treated tooth with a separated endodontic instrument in the canal and a persistent apical radiolucency. The patient was unaware of the fractured instrument and asks why the tooth has not healed. According to GDC Standards and the professional duty of candour, what is the most appropriate response? Avoid mentioning the fractured instrument unless the patient specifically asks about it. Inform the patient honestly about the fractured instrument and the persistent pathology, explain the implications and available treatment options, apologise where appropriate, and document the discussion. Refer the patient to a specialist without discussing the fractured instrument. Reassure the patient that fractured instruments never affect treatment outcome and no further explanation is required. Remove the fractured instrument immediately without discussing the risks or obtaining consent. None 36. A 40-year-old patient receives a local anaesthetic injection for a dental procedure. Within minutes, they develop stridor, widespread urticaria, facial swelling, hypotension, and collapse. The patient is conscious but deteriorating rapidly. You diagnose anaphylaxis. According to Resuscitation Council UK guidance, what is the correct first-line drug, dose, and route for an adult? Chlorphenamine 10 mg IV. Hydrocortisone 200 mg IM. Adrenaline (epinephrine) 500 micrograms (0.5 mL of 1:1000 solution) administered intramuscularly into the anterolateral thigh. Salbutamol 5 mg nebulised as the first-line treatment. Adrenaline 1 mg IV immediately. None 37. During the ORE Part 2 Dental Manikin Assessment, you are preparing a maxillary central incisor for a metal-ceramic (PFM) crown. The examiner assesses the preparation and asks about the ideal total occlusal convergence (TOC) of the axial walls to provide adequate retention, resistance, and a single path of insertion. What is the typical recommended total occlusal/axial convergence (taper)? 20–30° 10–20° 2–4° 6–10° 30–40° None 38. During the ORE Part 2 Dental Manikin Assessment, you are preparing a maxillary first premolar for a full-coverage crown. After examining your preparation, the examiner asks why it is important to create a well-defined finish line (such as a chamfer or shoulder). What is the best answer? It increases crown retention by creating intentional undercuts. It allows the crown to be cemented without the need for a temporary restoration. It eliminates the need for an accurate impression. It provides a clear, continuous margin for accurate crown fabrication, ensures adequate restorative material thickness, and promotes optimal marginal adaptation. It prevents the need for occlusal reduction during tooth preparation. None 39. During an ORE Part 2 Clinical Examination OSCE station, you are asked to perform a Basic Periodontal Examination (BPE) on a model using a WHO/BPE probe. In one sextant, the probe's black band is completely submerged in the deepest pocket, and bleeding on probing is present. What does a BPE Code 4 indicate? Bleeding on probing only, with no plaque-retentive factors or pockets >3.5 mm. Pocket depths of 3.5–5.5 mm, with the black band partially visible. Furcation involvement requiring immediate extraction. Healthy periodontal tissues with no treatment required. Pocket depths greater than 5.5 mm in that sextant, requiring a comprehensive periodontal assessment and charting. None 40. During an ORE Part 2 OSCE station, a 46-year-old patient presents with generalised tooth wear consistent with sleep bruxism. Several posterior teeth have recently been restored with composite resin. The patient asks: "What can I wear at night to stop me grinding my teeth and protect these new fillings?" What is the most appropriate recommendation? Provide a custom-made hard acrylic stabilisation splint (occlusal splint/night guard) for nighttime wear. Recommend a soft over-the-counter sports mouthguard for long-term use. Prescribe long-term muscle relaxants before bedtime. Advise extraction of the worn teeth before considering preventive treatment. Recommend avoiding chewing gum only, with no appliance required. None 41. During the ORE Part 2 OSCE Referral-Writing Station, you are asked to write a referral for a complex surgical extraction of an impacted mandibular third molar to the Oral and Maxillofacial Surgery department. Which set of information is essential to include in the referral? Patient's occupation, marital status, and preferred appointment time only. The patient's name and radiograph only. Patient details, presenting complaint, relevant history, diagnosis, justification for referral, clinical findings, relevant radiographs, medical history, medications/allergies, and the specific treatment requested. A copy of the patient's previous dental records without a clinical summary. The estimated cost of treatment and the patient's insurance details. None 42. During an ORE Part 2 Radiology OSCE station, a patient asks: "Why do you only take dental X-rays when you think they're really necessary? Why not take them routinely?" Which UK principle governs this practice? The justification principle under the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R), requiring every exposure to do more good than harm. The ALARP principle under the Health and Safety at Work Act only. The GDC Standards for the Dental Team only. The COSHH Regulations for hazardous substances. HTM 01-05 decontamination guidance. None 43. A 30-year-old anxious patient attends a Diagnosis and Treatment Planning (DTP) station requesting help to cope with dental treatment. They ask if they can be "put to sleep" because they are very nervous. They have no significant medical history and have not previously attempted any anxiety management techniques. According to UK good practice, what should be tried first before considering conscious sedation? Arrange treatment under general anaesthesia. Prescribe diazepam for every dental appointment. Extract the tooth without discussing anxiety management options. Refer immediately for intravenous sedation. Use behavioural management techniques, including effective communication, reassurance, tell-show-do (where appropriate), acclimatisation, and local anaesthesia before considering conscious sedation. None 44. During an ORE Part 2 OSCE station, a 34-year-old patient complains of severe spontaneous toothache. They report that cold drinks trigger intense pain that lingers for several minutes after the stimulus is removed. The pain is difficult to localise and occasionally wakes them at night. There is no facial swelling, and the tooth is restorable. What is the most likely diagnosis, and what is the clinical implication? Reversible pulpitis – Place a sedative dressing only, as the pulp is expected to recover. Dentine hypersensitivity – Recommend desensitising toothpaste and review. Symptomatic irreversible pulpitis – The pulp is irreversibly inflamed and requires root canal treatment or extraction. Acute apical abscess – Immediate incision and drainage with antibiotics is indicated. Pulp necrosis – No endodontic treatment is required unless swelling develops. None 45. During the ORE Part 2 Medical Emergencies Assessment, the examiner asks you to demonstrate the use of the practice oxygen cylinder. They specifically ask what flow rate the oxygen supply should be capable of delivering for an adult medical emergency. What is the expected UK standard? 2 L/min 4 L/min 6 L/min 15 L/min 25 L/min None 46. During the ORE Part 2 Medical Emergencies Assessment, you are asked to demonstrate single-rescuer adult Basic Life Support (BLS) on a resuscitation manikin. The examiner asks what chest compression rate should be maintained according to current Resuscitation Council UK guidance. What is the correct compression rate? 60–80 compressions per minute. 80–100 compressions per minute. 120–140 compressions per minute. 140–160 compressions per minute. 100–120 compressions per minute. None 47. During an ORE Part 2 orientation session, a candidate asks where the Dental Manikin (DM) operative test is physically conducted. Where is the Dental Manikin component of the ORE Part 2 currently held? The Royal College of Surgeons of England, Lincoln's Inn Fields Pearson VUE Test Centre UCL Eastman Dental Institute, Rockefeller Building, London General Dental Council Headquarters Any NHS Dental Hospital in the UK None 48. A 55-year-old man attends a Diagnosis and Treatment Planning (DTP) station with a 3-week history of a non-healing ulcer on the lateral border of the tongue. He is a long-term smoker and drinks alcohol regularly. Clinical examination reveals a 1.5 cm indurated ulcer with rolled margins. There is no obvious traumatic cause. What is the most appropriate immediate action? Prescribe topical corticosteroids and review in 2 weeks. Prescribe broad-spectrum antibiotics and review after one week. Smooth the adjacent tooth and review after one month. Perform an incisional biopsy in general dental practice. Arrange an urgent suspected cancer (Two-Week Wait) referral to an Oral and Maxillofacial Surgery or Oral Medicine service for specialist assessment and biopsy. None 49. At a Diagnosis and Treatment Planning (DTP) station, you are shown a periapical radiograph of a non-vital mandibular first molar with a large existing restoration and a well-defined periapical radiolucency. Clinical examination confirms the tooth is restorable, and the patient wishes to retain it. What is the most appropriate definitive treatment option to present? Prescribe antibiotics and review in 6 weeks. Extract the tooth because all teeth with periapical radiolucencies have a poor prognosis. Perform incision and drainage only. Replace the restoration without endodontic treatment. Perform non-surgical root canal treatment (or root canal retreatment if the tooth has previously been root-filled), followed by an appropriate definitive coronal restoration. None 50. A 35-year-old patient presents with a dental abscess associated with facial swelling and spreading infection. Drainage of the source of infection is carried out, but adjunctive antibiotics are indicated because of the spreading infection. The patient reports a true penicillin allergy. According to current UK guidance, which is the most appropriate first-choice alternative antibiotic? Ciprofloxacin Clarithromycin Metronidazole Doxycycline Co-amoxiclav None 51. During the ORE Part 2 Dental Manikin (DM) examination briefing, a candidate asks about the format of the operative test. How many procedures must candidates complete, and over what period? Four procedures in 4 hours. Two procedures in 2 hours. Three procedures in 2 hours. Five procedures in 3 hours. Three procedures in 3 hours. None 52. At an ORE Part 2 Diagnosis and Treatment Planning (DTP) station, a 45-year-old patient requires extraction of an impacted mandibular third molar. The panoramic radiograph shows the roots are closely related to the inferior alveolar canal. The patient asks: "What is the main risk I need to know about before the extraction?" What is the most relevant complication that should be discussed during the consent process? Fracture of the maxillary tuberosity. Perforation of the maxillary sinus. Permanent facial nerve paralysis. Injury to the inferior alveolar nerve, causing altered or loss of sensation (numbness) of the lower lip, chin, and lower teeth, which may be temporary or permanent. Blindness due to optic nerve injury. None 53. During an ORE Part 2 OSCE station, you are assessed on clinical record keeping. The examiner asks which statement best reflects the standard expected of clinical records in UK dental practice. Which is the best answer? Clinical notes only need to record the treatment carried out if there were no complications. Records should be completed at the end of the week to allow time for reflection. Records should be brief and omit discussions of risks and consent to maintain confidentiality. Records should include only positive findings to avoid unnecessary detail. Clinical records should be clear, accurate, contemporaneous, legible, and include relevant history, examination findings, diagnosis, treatment options, consent, treatment provided, advice given, and any follow-up arrangements. None 54. During the ORE Part 2 Dental Manikin Assessment, you have completed cleaning and shaping of a root canal and are ready to obturate the canal using gutta-percha and root canal sealer. The examiner asks about the principal aim of obturation. What is the primary objective? To strengthen the root and prevent future root fractures. To whiten the tooth from within. To enlarge the apical foramen and improve drainage. To create a radiopaque filling that is easy to identify on radiographs only. To achieve a three-dimensional fluid-tight seal of the cleaned and shaped root canal system, preventing reinfection by eliminating pathways for bacterial ingress or egress. None 55. A 7-year-old child attends a Diagnosis and Treatment Planning (DTP) station. Clinical examination reveals newly erupted first permanent molars with deep occlusal fissures. The child has a high caries risk due to frequent sugar intake and previous caries experience. What is the most appropriate preventive intervention for these teeth? Place amalgam restorations prophylactically. Apply resin-based fissure sealants. Prescribe oral antibiotics. Extract the first permanent molars. Review after 12 months without treatment. None 56. A 9-year-old child attends a Diagnosis and Treatment Planning (DTP) station in the mixed dentition. Clinical examination shows a single maxillary central incisor in anterior crossbite with an otherwise Class I occlusion and adequate space. There is no underlying skeletal discrepancy. What is the most appropriate interceptive treatment option? Delay treatment until all permanent teeth have erupted. Extract the upper central incisor. Correct the crossbite using a removable appliance with a Z-spring (or an equivalent simple anterior crossbite appliance). Commence comprehensive fixed orthodontic treatment immediately. Refer for orthognathic surgery. None 57. During the ORE Part 2 Medical Emergencies Assessment, you are asked to demonstrate airway management on an unconscious adult manikin. There is no suspicion of cervical spine injury. Which simple manoeuvre should be used to open the airway? Jaw thrust only. Head tilt–chin lift. Recovery position. Finger sweep of the mouth. Neck flexion. None 58. An OSCE patient attends for a simple dental extraction. During history taking, they report taking long-term oral corticosteroids for rheumatoid arthritis. Why is this medical history particularly relevant? It increases the risk of infective endocarditis. It commonly causes severe thrombocytopenia. It may cause adrenal suppression, increasing the risk of adrenal crisis during significant physiological stress. It is an absolute contraindication to local anaesthesia. It always requires prophylactic antibiotics before extraction. None 59. During the ORE Part 2 Medical Emergencies Assessment, the examiner asks you to identify the correct adrenaline preparation kept in the dental emergency drug kit for the intramuscular treatment of anaphylaxis. Which concentration is correct? 1:10,000 1:100,000 1:1,000 1:10,000,000 1:100 None 60. During an ORE Part 2 OSCE Infection Control Station, the examiner asks about the correct decontamination process for reusable dental instruments in primary care. Which statement best reflects UK decontamination guidance? Reusable instruments should be wiped with alcohol and stored for the next patient. Instruments should be immersed in disinfectant only before reuse. Sterilisation alone is sufficient, even if instruments are visibly contaminated. Reusable instruments should be cleaned, inspected, packaged (where appropriate), and sterilised in a validated steam autoclave before reuse. Instruments used on healthy patients do not require sterilisation if no blood is visible. None 61. A Diagnosis and Treatment Planning (DTP) station presents a 28-year-old patient with an impacted mandibular third molar. The patient has experienced several episodes of pericoronitis over the past year. A panoramic radiograph confirms the impacted tooth. According to NICE guidance on wisdom teeth, what justifies surgical removal of this tooth? The tooth is impacted but asymptomatic. The patient requests removal to prevent future problems. The tooth is associated with recurrent pericoronitis. The tooth is partially erupted without symptoms. The patient is over 25 years of age. None 62. An OSCE patient presents with a facial swelling, raised floor of the mouth, difficulty swallowing, and trismus following an infection associated with a lower molar. What is the most appropriate action? Prescribe oral antibiotics and review in one week. Perform root canal treatment immediately. Arrange an urgent same-day referral to hospital for assessment and management. Incise the swelling in general practice and discharge the patient. Advise warm saltwater mouth rinses and analgesics. None 63. An OSCE station presents a 16-year-old patient who attends alone requesting dental treatment. The patient appears mature, understands the proposed treatment, and is able to discuss the risks, benefits, and alternatives. In England, how should you assess their capacity to consent? A parent or guardian must always provide consent for anyone under 18 years of age. Treatment should be postponed until a parent is present. The patient can only consent to emergency treatment. Assess whether the patient is Gillick competent and, if so, they may provide valid consent. Obtain consent from both the patient and a parent before proceeding. None 64. During the ORE Part 2 Medical Emergencies Assessment, you are performing adult CPR on a resuscitation manikin. The examiner asks about the recommended chest compression depth for an average adult according to Resuscitation Council UK guidance. What is the correct depth? 2–3 cm 3–4 cm 4–5 cm 5–6 cm 6–7 cm None 65. During an ORE Part 2 Professionalism OSCE, the examiner asks about the professional duty of candour. Which scenario best demonstrates compliance with the duty of candour? A dentist notices a small file separation during root canal treatment but decides not to tell the patient because the treatment appears successful. A dentist informs the patient that a procedural error has occurred, explains its implications, apologises, discusses the available management options, and documents the conversation. A dentist waits until the patient develops symptoms before mentioning a complication. A dentist informs only the practice manager and makes no entry in the patient's records. A dentist refers the patient to a specialist without explaining why. None 66. During an ORE Part 2 Diagnosis and Treatment Planning (DTP) station, you are provided with study models, clinical photographs, and radiographs. An actor is present to provide the patient's history and answer your questions. What is the actor's primary role in this station? To assess the candidate's operative skills. To perform the clinical examination. To provide the patient's history and respond consistently to questions as the simulated patient. To decide whether the treatment plan is correct. To mark the candidate's communication skills independently. None 67. During an ORE Part 2 OSCE station, a patient asks you to send a copy of their dental records to a third party, such as a solicitor or insurance company. Under UK data protection and GDC confidentiality principles, what must you generally obtain first? Verbal approval from the practice manager. Permission from the patient's family member. Approval from the General Dental Council. Written consent from the patient's general medical practitioner. The patient's valid consent (usually written) before disclosing the records. None 68. A 7-year-old child presents with a traumatically avulsed permanent maxillary central incisor. The tooth has been stored in milk for approximately 30 minutes and the child is otherwise fit and well. What is the most appropriate emergency management? Discard the tooth and provide a removable partial denture. Store the tooth in saline and review after one week. Refer for extraction of the adjacent incisor. Replant the tooth immediately, splint it with a flexible splint, and arrange appropriate follow-up. Delay replantation until the socket has completely healed. None 69. During the ORE Part 2 Dental Manikin Assessment, you over-prepare a Class II cavity for an amalgam restoration and leave a sharp internal line angle. Why is this a concern? It increases stress concentration and weakens the tooth. It improves retention of the amalgam. It reduces polymerisation shrinkage. It enhances marginal adaptation. It increases fluoride release. None 70. A Diagnosis and Treatment Planning (DTP) station presents a patient with a heart murmur who requires a dental extraction. The patient asks whether they need antibiotics to prevent infective endocarditis before the procedure. According to current NICE guidance, what is the most appropriate advice for most patients? Prescribe amoxicillin before all invasive dental procedures. Prescribe antibiotics only before extractions. Routine antibiotic prophylaxis is not recommended solely to prevent infective endocarditis. Prescribe clindamycin if the patient is allergic to penicillin. Antibiotic prophylaxis is required for all patients with a heart murmur. None 71. A 35-year-old patient attends a Prevention OSCE station. They have multiple active carious lesions and are assessed as being at high caries risk. They ask which fluoride toothpaste would be most appropriate. According to Delivering Better Oral Health (DBOH), what fluoride concentration toothpaste may be recommended for a high-risk adult? 500 ppm fluoride toothpaste. 1,000 ppm fluoride toothpaste. 1,450 ppm fluoride toothpaste. 2,800 ppm fluoride toothpaste 5,000 ppm fluoride toothpaste. None 72. During an ORE Part 2 OSCE station, a patient refuses a recommended periapical radiograph that you consider necessary to establish a diagnosis and provide safe treatment. The patient understands your explanation but still declines. What is the most appropriate professional course of action? Take the radiograph without the patient's consent. Proceed with irreversible treatment without the radiograph. Discharge the patient immediately from the practice. Respect the patient's decision, explain the consequences, document the refusal, and reassess whether treatment can be provided safely. Ask a family member to consent on the patient's behalf. None 73. A dentist is planning to apply for the Overseas Registration Examination (ORE) Part 2 and asks about the eligibility requirements. What must a candidate have already achieved before sitting ORE Part 2? Completed one year of NHS dental practice. Passed ORE Part 1. Obtained a UK foundation training certificate. Registered with the General Dental Council. Completed a postgraduate dental qualification in the UK. None 74. During the ORE Part 2 Dental Manikin Assessment, you are restoring a Class V non-carious cervical lesion located close to the gingival margin. Moisture control is challenging, and the examiner asks which restorative material is most commonly indicated because of its chemical adhesion and fluoride release. Composite resin Dental amalgam Resin-modified glass ionomer cement (RMGIC) Compomer Zinc phosphate cement None 75. During the ORE Part 2 Dental Manikin Assessment, you are removing caries from a deep cavity in a vital tooth. The lesion extends close to the pulp, and the examiner asks about the preferred management to minimise the risk of pulpal exposure. What is the recommended approach? Remove all caries regardless of pulp exposure. Leave all carious dentine untouched. Perform immediate root canal treatment. Selective caries removal, leaving soft dentine only over the pulpal wall if necessary. Extract the tooth. None 76. A Diagnosis and Treatment Planning (DTP) station presents a patient with multiple active carious lesions, poor oral hygiene, and a high-sugar diet. You are asked to formulate an appropriate treatment plan. Which preventive advice should take priority? Advise the patient to brush immediately after every meal. Recommend whitening toothpaste. Advise six-monthly scaling only. Recommend alcohol-free mouthwash as the main preventive measure. Provide dietary advice to reduce the frequency of free sugar intake and reinforce effective fluoride toothbrushing. None 77. A patient presents at a Diagnosis and Treatment Planning (DTP) station with crushing central chest pain radiating to the left arm for 20 minutes. The pain has not been relieved by their own GTN spray. You suspect an acute myocardial infarction. In addition to calling 999 and administering oxygen if the patient is hypoxic, which drug from the dental emergency kit should you give? Salbutamol inhaler Aspirin 300 mg (to chew) Adrenaline 1:1,000 IM Oral glucose gel Midazolam buccally None 78. A patient requires a removable partial denture (RPD). During the ORE Part 2 DTP station, you are asked about the design of the metal framework. What is the primary purpose of a rest seat prepared on an abutment tooth? Improve denture aesthetics. Increase clasp flexibility. Prevent food packing. Provide vertical support and prevent tissueward movement of the denture. Reduce plaque accumulation. None 79. An OSCE station presents a periapical radiograph showing a fractured endodontic instrument in a previously treated root canal with a persistent apical radiolucency. The examiner asks what professionalism requires when discussing this finding with the patient. What is the most appropriate action? Reassure the patient that the fractured instrument is insignificant and requires no discussion. Remove the fractured instrument without informing the patient. Wait until the patient develops symptoms before mentioning the finding. Refer the patient without explaining the reason. Explain the finding honestly, discuss its implications and management options, and document the discussion. None 80. A Diagnosis and Treatment Planning (DTP) station presents a patient with generalised Stage III, Grade B periodontitis. Several teeth have a poor prognosis, but the patient wishes to retain as many teeth as possible. After completing initial periodontal therapy, what is the correct sequencing principle for the overall treatment plan? Place definitive crowns before reassessing the periodontal condition. Begin orthodontic treatment immediately after scaling. Extract all questionable teeth before initial therapy. Reassess the periodontal response, remove teeth with hopeless prognosis if indicated, then proceed with definitive restorative/prosthodontic treatment and supportive periodontal care. Provide removable dentures before periodontal reassessment. None 81. During the ORE Part 2 Dental Manikin Assessment, you are restoring a Class II composite restoration. The examiner asks about the purpose of using a sectional matrix system with a separating ring. What is its principal function? Reduce polymerisation shrinkage. Increase the depth of the cavity. Improve the shade match of the restoration. Create a tight anatomical proximal contact. Prevent postoperative sensitivity. None 82. A patient attending an ORE Part 2 OSCE station has limited English proficiency and requires dental treatment. You need to obtain valid informed consent. Which approach best supports valid consent and effective communication? Ask a child accompanying the patient to interpret. Proceed with treatment using simple gestures only. Obtain verbal consent without checking the patient's understanding. Use a professional interpreter where possible, explain the treatment, and confirm the patient's understanding before obtaining consent. Ask the patient to sign the consent form without further discussion. None 83. During an ORE Part 2 OSCE station, you examine a 7-year-old child accompanied by a parent. You notice injuries and signs that raise concerns about possible non-accidental injury and dental neglect. What is the most appropriate first course of action? Confront the parent with your suspicions immediately. Report the parent directly to the police. Discharge the child from the practice. Ignore the findings unless the child confirms abuse. Document your findings carefully and follow local safeguarding procedures by discussing your concerns with the practice safeguarding lead or appropriate safeguarding services. None 84. During the ORE Part 2 Medical Emergencies Assessment, you assess a collapsed adult patient. After opening the airway, you find the patient is unresponsive and has no normal breathing. Which finding confirms you should begin chest compressions? Weak radial pulse with normal breathing. Unresponsive with no normal breathing (or only agonal gasps). Chest pain with normal breathing. Unconscious but breathing normally. Slow pulse with dizziness. None 85. During a history-taking OSCE station, a patient reports they take warfarin for atrial fibrillation and requires a simple dental extraction. What is the most appropriate UK approach regarding their anticoagulation? Stop warfarin 5 days before the extraction. Switch the patient to low-molecular-weight heparin. Continue warfarin, check the INR is ≤4.0 (ideally within 24 hours), and use local haemostatic measures. Delay treatment until the patient is no longer taking warfarin. Prescribe prophylactic vitamin K before the extraction. None 86. During an ORE Part 2 OSCE station, you are asked about the technique for administering an inferior alveolar nerve block (IANB). The examiner asks why aspiration before injecting is an important step. Because of the proximity of which structure should aspiration always be performed? Facial artery Inferior alveolar artery and vein Lingual gland Maxillary artery Submandibular duct None 87. During an ORE Part 2 OSCE station, you are required to obtain a focused pain history from a patient presenting with dental pain. Which structured framework is most appropriate for characterising the patient's pain? ABCDE SBAR SOAP SAMPLE SOCRATES None 88. Throughout the ORE Part 2 OSCE, candidates are assessed on ethics, communication, consent, confidentiality, and professionalism. Which professional standards document underpins these assessments in the UK? Good Medical Practice (GMC) Standards for the Dental Team (GDC) Delivering Better Oral Health (DBOH) Health Technical Memorandum (HTM) 01-05 NICE Guideline NG12 None 89. A candidate has just completed the ORE Part 2 examination and asks when they can expect to receive their results. According to the General Dental Council (GDC), within what timeframe are candidates typically informed of their results? Within 5 working days Within 10 working days Within 15 working days Within 20 working days Within 30 working days None 90. A Diagnosis and Treatment Planning (DTP) station presents an upper first molar requiring extraction. The radiograph shows the roots are closely related to the maxillary antrum. Which complication should specifically be included during the consent process? Inferior alveolar nerve injury. Mandibular fracture. Oroantral communication. Lingual nerve injury. Temporomandibular joint dislocation. None 91. During an ORE Part 2 OSCE prescribing station, you assess a patient with a localised dental abscess. There is no facial swelling, no pyrexia, and no systemic involvement. What is the single most important principle of antimicrobial stewardship in this situation? Prescribe broad-spectrum antibiotics immediately. Prescribe antibiotics for 7 days before definitive treatment. Refer all patients to hospital. Perform definitive local treatment and avoid antibiotics unless clinically indicated. Prescribe antibiotics to prevent the infection from spreading. None 92. During the ORE Part 2 Dental Manikin Assessment, you are taking a final impression for a full-coverage crown. To accurately record the finish line, soft tissue management is required. Which technique is most commonly used to displace the gingival sulcus atraumatically? Electrosurgery in all cases. Gingivectomy with a scalpel. Placement of a gingival retraction cord. Removal of the interdental papilla. Periodontal curettage. None 93. A dentist has successfully passed ORE Part 1 and is preparing for ORE Part 2. They ask how many attempts they are normally permitted for Part 2. How many attempts is a candidate normally allowed at ORE Part 2? Two attempts Three attempts Four attempts Five attempts Unlimited attempts within 5 years None 94. A patient receives a dental local anaesthetic containing adrenaline. Within a few minutes, they become shaky and complain of palpitations. They remain alert, normotensive, and have no rash, wheeze, or respiratory distress. What is the most likely explanation? Anaphylaxis Adrenaline effect following local anaesthetic administration Vasovagal syncope Hypoglycaemia Local anaesthetic toxicity None Time's up
