NATIONAL EXAMINING BOARD FOR DENTAL NURSES

NATIONAL CERTIFICATE EXAMINATION

DENTAL CHARTING

108-110 LONDON STREET

FLEETWOOD
LANCASHIRE
FY76EU

NEBDN is a limited company registered in England & Wales No. 5580200

Registered with the Charity Commisioners No. 1112331

www.nebdn.org.uk
TEL: 01253 778417
FAX: 01253 777268

Charting contributes to the Part A section of the examination for the National Certificate for
Dental Nurses, and Part C of the Independent Assessment. In order to standardise training
and assessment the following information indicates to candidates the notations they will
need to know in order to complete these sections. Therefore, in the same way that there is a
definitive list of items for the spotter, the notations below will become a definitive list.
There are different charting systems available, this document will cover:
a.

United Kingdom (UK)

b.

International Dental Federation (FDI)

c.

Basic Periodontal Examination (BPE)

As the chart is probably the most important dental record of a patient's condition, it is vital
that dental nurses know how to chart. NEBDN acknowledges that there are a number of
systems and software used to record charting. It also recognises that there are local and
regional differences in registering patient details. The following notations are to be used when
completing a written chart for the National Certificate Examination, and interpreting
a
charting in the Independent Assessment.
A chart is a diagrammatic representation of the teeth showing all the surfaces of the teeth.
The charts in the examination will be used to show:

Teeth present

Teeth missing

Work to be carried out

Work completed

Surfaces with cavities and restorations etc.

When charting, the mouth is looked on as being a flat line. The diagram is viewed, as you
would examine the patient's mouth.

8 7 6 543

234

8 7 6 543

2 345

5 6 7 8

678

abCde

b C d

Most charts have an inner and outer grid. NEBDN has introduced a new grid, which will make clear the work that
has been completed in the mouth and the work which needs to be done.
An example of the grid is given below.

:1 :
:

'"

r'[ r ,f

';----------(

.:

-~

.;.

-:..... :

'.

---

Present Dental Status

and work completed

Present Dental Status

and work completed

:.:

r---------r

'_-.-.-.-.-.-_-._]

r-.-.-.-

:-,

.:

.-;

r-.-.- .. '-.]

";
----.----.~::. ..

':

.:~

.;.

.t._- ----~

.;.

.:

.;.

.:

:;.-.-.- .-.-.]:

'

1:

:-_.. __. __.~:

"

.:._--------.:..

';----------r

'"

'-....----- --:
.... \'"

.:

.;.

.:

'----------r

r-------r

:----------...

:----------...

:--_._-_ ...

.'----------...

::

]"'-------[
:---_ ........

.,----------r

..----------.

'1"---- .... [

:----_........

:............

:............

-.---- ----- -.

..-- ----- -- r

:--

:-------_......

.:

"

1". - ---. -- -~::'

------...

r-r

,,---------,

................. ::.".... :_._._._-_._-_-_._-_-;;----------;

....

-------f
:.~

i i

;f

.:

The inner grid is for present dental status and work already present in the mouth. The outer grid is for work to be
carried out.

Present Dental Status

and work completed

Present Dental Status

and work completed

In order to complete the chart accurately candidates should be able to identify and note the
correct surfaces of teeth. These are:

I
I
I
I
I
I
I
I
I
I
I
I
I
I

---------------------------~--------------------------I
I
I
I
I
I
I
I
I
I
I
I
I
I

------------~.

-..------------Mesial Direction

ACCEPTED NOTATIONS
Incisor Teeth

Upper Right

Upper Left
Fracture

Labial Cavity

Midline

Palatal Cavity

5j

Work to be carried out

I
I

Porcelain Veneer

Porcelain
Bonded Crown

~
Artificial Tooth
Present

Canine Present
Retained C

Palatal
Restoration

ta

B B
B

Tooth Rotated
Distally

Mesial
Restoration

Distal
Cavity

Labial
Restoration

Ej

Root Filled
Palatal Restoration

Porcelain
Jacket Crown

Present status and

work completed

-;-

I
I

B B 8
B

Distal
Restoration

Tooth Rotated
Mesially

Present status and

work completed

Crown

Work to be carried out

Mesial
Cavity

I
Lower Right

Midline

Lower Left

ACCEPTED NOTATIONS
Premolar and Molar Teeth

Mesial-Occlusal-Distal
Cavity

Upper Right

Upper Left
Buccal Cavity

Midline

Work to be carried out

~
Mesial Occlusal Distal
Restoration with a
Buccal Extension
Present status and
work completed

Present status and

work completed

~
Occlusal
Restoration

Tooth
Instanding

aTI
~
Distal-Occlusal
Restoration

Palatal
Restoration

Implant

Fissure
Sealant

Tooth Missing
Space Closed

~
ID

[Jd

~
Mesial-Occlusal
Porcelain Inlay

Lingual
Restoration

aTI

Tooth
Outstanding

~
Roots
Retained

Work to be carried out

~
Tooth
Fractured

Disto-Occlusal
Restoration
to be replaced
I

Lower Right

Midline

Lower Left

ACCEPTED NOTATIONS
Premolar and Molar Teeth

Upper Right

Upper Left
Tooth to be extracted

Midline

[g(]

Work to be carried out

Preventive Resin
Restoration

Tooth Drifting
Distally

Bridge
Pontic

Bridge Abutment

Tooth Drifting
Mesially

Full Gold
Crown Present

Present status and

work completed

Present status and

work completed

~
Distal-Occlusal
Temporary Dressing

Mesial
Restoration

Distal
Restoration

Distal-Occlusal
Gold Inlay

<0

~
Tooth
Partially erupted

Tooth recently
Extracted

Work to be carried out

~
Mesial
Cavity

Occlusal
Buccal Cavity

Lower Right

Midline

Lower Left

a.

Upper right second molar has a mesio-occlusal

cavity

b.

Upper right first molar has a disto-occlusal

c.

Upper right first premolar is for extraction

d.

Upper right canine has a buccal restoration

e.

Upper right central incisor is an abutment for a cantilever Maryland bridge

f.

Upper left central incisor is a Maryland bridge pontic

g.

Upper left lateral incisor has a fracture on the incisal edge

h.

Upper left second premolar needs a root filling

i.

Upper left second molar has preventive resin restoration (PRR) occlusally

j.

Upper left third molar has a fissure sealant restoration

k.

Lower left third molar has been recently extracted

I.

Lower left first molar has a lingual restoration to be replaced

m.

Lower left first premolar has a bonded porcelain crown

n.

Lower right lateral incisor has a mesial restoration and a separate distal cavity

o.

Lower right first premolar is missing

p.

Lower right second premolar has rotated mesially

q.

Lower right first molar has an MOD porcelain inlay

r.

Lower right second molar has a full restoration gold crown

s.

Lower right third molar is partially erupted

temporary dressing

FEDERATION DENTAIRE INTERNATIONAL NOTATION (FDIl

TWO DIGIT CHARTING SYSTEM

In this system the quadrant symbol is replaced by a number. The quadrant number is the first
digit while the second number identifies the individual tooth.

a.

18 is partially erupted

b.

17 has an occlusal restoration

c.

16 has an occluso-palatal

d.

14 is missing and the gap has closed

e.

13 has a porcelain jacket crown in place

f.

12 has a fracture of the incisal edge

g.

21 needs distal and palatal restorations

h.

24 is root filled with an occlusal restoration

I.

25 has a mesial-occlusal

j.

26 to be extracted

k.

28 is unerupted

I.

38 is missing

m.

37 has an occlusal cavity

n.

34 has a full gold crown

o.

32 has a distal and labial restorations

p.

41 has mesial and lingual cavities

q.

44 has a mesial-occulsal-buccal

r.

48 has been recently extracted

filling

restoration present

cavity

This index is used with the BPE probe formerly known as the CPITN. The periodontal probe is
introduced into the gingival sulcus and a light probing pressure is used around the buccal and
then lingual/palatal surfaces.
The mouth is divided into sextant (no 8's) represented by a single box chart for each sextant.
17-14
47 - 44

13 - 23
43 - 33

24 - 27
34 - 37

BPE
Code

Criteria

Healthy periodontal tissues

No bleeding after gentle probing

Bleeding after gentle probing

Black band remains completely visible (probing depth up to 3.5mm)
No calculus or defective margins detected

Black band remains completely visible (probing depth up to 3.5mm)

Calculus or other plaque retention factor detected

Black band partially visible in deepest pocket (shallow pocket up to 5mm)

Black band not visible in pocket (deep pocket of more than 5.5mm)

Furcation involvement
Gingival recession added to probing gives depth of 7mm or more

PERIODONTAL DIAGNOSIS
AND TREATMENT PLAN

POCKET
DEPTH

POCKET
DEPTH

POCKET
DEPTH

POCKET
DEPTH

ERUPTION DATES

Letter

Upper eruption date months

Lower eruption date months

Central incisor

10

Lateral incisor

11

13

Canine

19

20

First molar

16

16

Second molar

29

27

Letter

Upper eruption date years

Lower eruption date years

Tooth

Tooth

Central incisor

7 to 8

6 to 7

Lateral incisor

8 to 9

7 to 8

Canine

10 to 12

9 to 10

First premolar

9 to 11

9 to 11

Second premolar

10 to 11

9 to 11

First molar

6 to 7

6 to 7

Second molar

12 to 13

11 to 12

Third molar

18 to 25

18 to 25

Each question is followed by 4 alternatives of which one is correct. Please mark with a cross in the box
at the right hand side, the answer which you consider to be the best one, for example:The colour of a Nitrous Oxide cylinder is:-

(a) red

(a)

(b) blue

(b) ~

(c) white

(c)

(d) black

(d)

(a) haemostasis

(a)

(b) immunity

(b)

(c) transport of oxygen

(c)

(d) removal of bacteria from the blood stream

(d)

D
D
D

(a) take radiographs

(a)

(b) solidify fissure sealants

(b)

(c) sterilise instruments and materials

(c)

(d) cure composite resins

(d)

~~

~'(~~
Please note: More than one cross
to each question will invalidate
your answer.

1. What are blood platelets concerned with?

2. What is gamma irradiation used to do?

D
D
D

3. What may rheumatic fever cause damage to?

(a) the cardiac septum

(a)

(b) the heart valves

(b)

(c) the coronary arteries

(c)

(d) the cardiac sphincter

(d)

(a) Indicators

(a)

(b) Ionising

(b)

(c) Injuries

(c)

(d) Indicating

(d)

D
D
D

D
D
D
D

5. What is a pontic?
(a) a type of orthodontic bracket

(a)

(b) a suspended unit of a bridge

(b)

(c) an artificial tooth on a denture

(c)

(d) a type of crown

(d)

(a) aorta

(a)

(b) pulmonary artery

(b)

(c) pulmonary vein

(c)

(d) vena cava

(d)

D
D
D
D

0
0
0
0

7. What may an occlusal radiograph be used to assess?

(a) interproximal

caries

(a)

(b) root canal length

(b)

(c) a periapical abscess

(c)

(d) an impacted canine tooth

(d)

D
D
D

8. What may aggresive tooth brushipg cause?

(a) erosion

(a)

(b) hyperplasia

(b)

(c) attrition

(c)

(d) abrasion

(d)

(a) cellulose matrix

(a)

(b) siqveland matrix

(b)

(c) tofflemire matrix

(c)

(d) ivory matrix

(d)

D
D

D
D
D
D

10. At what age does a lower permanent central incisor normally erupt?
(a) 5 years

(a)

(b) 7 years

(b)

(c) 9 years

(c)

(d) 11 years

(d)

(a) reactionary haemorrhage

(a)

(b) secondary haemorrhage

(b)

(c) regressive haemorrhage

(c)

(d) primary haemorrhage

(d)

D
D
D

D
D
D
D

12. What were Adams Universal pliers designed to do?

(a) cut an arch wire

(a)

(b) hold an orthodontic bracket

(b)

(c) shape an arch wire

(c)

(d) place a separator

(d)

D
D
D
D

(a) metronidazole

(a)

(b) iodine

(b)

(c) penicillin

(c)

(d) nystatin

(d)

(a) pulpectomy

(a)

(b) alveolectomy

(b)

(c) apicectomy

(c)

(d) gingivectomy

(d)

(a) gold

(a)

(b) cobalt chromium alloy

(b)

(c) stainless steel

(c)

(d) none of these

(d)

D
D
D
D

D
D
D
D

D
D
D
D

1.

At what age does the tooth marked 'A' normally erupt?

2.

What is tooth marked 'A' in the FDI charting system?

3.

How many roots does tooth '1\ normally have?

4.

How many root canals does tooth 'A' normally have?

5.

Occasionally

8.

Which tooth does the tooth marked

an extra tooth may be present in the area marked 'B'. What is this extra tooth called?

'c'

replace?

At what age does that tooth normally erupt?

9.

Sometimes the tooth marked

'c'

is not present; this condition is called:

.
.

4. Fissure sealants are placed on the

of posterior teeth.

6. When used as a lining

dentine formation.

surfaces

promotes secondary

Record all the following information on the chart below.

All teeth are present unless otherwise stated.

NB

Treatment completed should be charted in the inner grid

Treatment to be carried out should be charted on the outer grid

NATIONAL EXAMINING BOARD FOR DENTAL NURSES

NATIONAL CERTIFICATE

PART B
This part contains 5 questions.You ~
answer .E.Q.!J.B of these questions in
the answer book provided.
All questions carry equal marks.

1. Define 'chronic gingivitis'.

How does dental plaque contribute to this condition?
Describe the ways in which plaque is controlled.

2. The following are all basic first aid procedures.

Write short notes on how the dental nurse would:
(a)
(b)
(c)

check a pulse
clear and open an airway
deal with a fainting patient

3. List the reasons why a tooth may require root filling.

Outline the stages involved in a root canal treatment on an upper incisor
tooth with a periapical abscess.

4. Describe how the following materials may be used in the dental surgery:
(a)
(b)
(c)

alginate
glass ionomer
gutta percha

5. A grossly carious upper first permanent molar tooth is to be surgically extracted.

(a) list the nerves that will need to be anaesthetised
(b) outline the role of the dental nurse during this procedure
(c) what post-operative instructions should be given to the patient?

NATIONAL EXAMINING BOARD FOR DENTAL NURSES

NATIONAL CERTIFICATE

This part contains 5 questions.You nmst answer FOUR of these questions in

the answer book provided.

1. Write short notes on each of the following:

a)

fire precautions in the dental practice

b)

reasons for root filling a tooth

c)

bitewing radiographs

2. What factors should the dentist take into consideration when assessing a patient
for the construction of a chromium cobalt partial denture?
List the surgery stages in the construction of such a denture.

3. Why is moisture control important in dental procedures?

Describe the techniques used by the dental nurse and the dentist in achieving moisture
control during dental procedures.

4. Write short notes on each of the following:

a)

systemic fluoride

b)

oral health instruction for patient undergoing fixed orthodontic treatment

c)

dental plaque

5. List the different ways the airway may be obstructed in an unconscious patient.
Assume you are alone and describe in detail the basic life support procedures
to be carried out on an adult patient who has a suspected cardiac arrest in the
dental surgery.

NATIONAL EXAMINING BOARD FOR DENTAL NURSES

NATIONAL CERTIFICATE

This part contains 5 questions.You musi answer FOUR of these questions in

the answer book provided.

1. Describe the process by which dental caries takes place and outline its progression from the
enamel through to the pulp.
Discuss the factors which would have an effect on how fast this process could take place in an
individual.

2. List 3 filling materials available to restore a permanent tooth.

Indicate the advantages and disadvantages of one of these materials.
Describe the role of the dental nurse during the placement of a permanent restoration.

3. Write short notes on:

(a) enamel
(b) bitewing radiographs
(c) denture stomatitis

4. List the general contents of atypical local anaesthetic cartridge.

State the methods of injection that can be used to gain dental local anaesthesia.
Describe how the anaesthetic equipment should be handled and disposed of after use.

5. Define the term 'sterilisation'.

Explain in detail how you would ensure that the risk of cross-infection in the dental surgery
is reduced to a minimum.

NATIONAL EXAMINING BOARD FOR DENTAL NURSES

NATIONAL CERTIFICATE

This part contains 5 questions. Please answer ONLY FOUR of these questions in
the answer book provided.

1. Define 'chronic gingivitis'

How does dental plaque contribute to this condition?
Describe the ways in which plaque is controlled.

2. List 5 types of dental radiograph and explain when each may be used.
What faults could occur during the taking and processing of the film, and how may
these faults have been caused?

3. List the different ways the airway may be obstructed in an unconscious patient.
Describe in detail the basic life support procedures to be carried out on an adult patient
who has a suspected cardiac arrest in the dental surgery.

4. Write notes, including the advantages and disadvantages of each method, on:
(a) autoclave sterilisation
(b) sodium hypochlorite disinfection
Give examples of their uses.

5. A grossly carious upper first permanent molar tooth is to be surgically extracted.

List the instruments to be set out by the dental nurse.
What advice should be given to a patient for post operative care?

NATIONAL EXAMINING BOARD FOR DENTAL NURSES

NATIONAL CERTIFICATE

This part contains 5 questions. Please answer ONLY FOUR of these questions in
the answer book provided.

1. Describe the procedure of, and the role of the dental nurse in, restoring an anterior tooth
with a light cured composite.
What precautions should be taken to protect the patient and the dental team during
this procedure?

2. Outline how, in the dental workplace, the following health & safety issues should be managed:
a) fire safety
b) a patient who has slipped on a wet floor
c) disposal of clinical waste

3. List the instruments for a routine root filling procedure.

A dentist drops a hand file whilst undertaking endodontic treatment on a patient, and its
location is not immediately obvious.
a) What action would the dental team take immediately at the time of and after the event?
b) How could this be avoided?

4. Define the term 'infection control' .

Describe the importance of hand and eye protection for the oral health care team within
the dental surgery.

5. Write short notes on:

a) types of dentures
b) calculus
c) an angina attack

NATIONAL EXAMINING BOARD FOR DENTAL NURSES

NATIONAL CERTIFICATE

This part contains 5 questions. Please answer ONLY FOUR of these questions in
the answer book provided.

1. Briefly outline the clinical stages in the construction of full/full (complete) dentures.
At the fit stage what instructions would you give a patient about the care of full/full
dentures?

2. Write short notes on the following:

a)
b)
c)

the main differences between primary (deciduous) and secondary (permanent) teeth
dentine
dental handpiece maintenance

3. List the reasons for root filling a tooth.

What is meant by the term apicectomy
procedure on a tooth?

and why may it become necessary to perform this

Describe the chairside role of the dental nurse during an apicectomy.

4. List the signs and symptoms of the following medical emergencies and explain the actions
a First Aider should take in the management of the conditions:
a)
b)
c)

simple faint
asthmatic attack
epileptic seizure

5. Write short notes on dental caries under the following headings:

a)
b)
c)

cause
diagnosis
prevention

The Spotter Test in the National Certificate Examination ensures that a qualified dental nurse is able to
identify items commonly used in dental practice. The 20 items will be selected from the list below and
the candidate will be expected to use the precise terminology indicated in order to gain the available
marks.
Where the description of an item has two words separated by an oblique line (eg
clear/transparent) either is acceptable.
The list has been compiled from a list of requirements for a vocational training practice, as described in
four of the major dental catalogues. Items which can vary in appearance have been omitted .

Dentate
Edentulous

. Disposable
Metal

Burs

Round
Flat fissure
Tapered fissure
Flame
Pear
Bud
Inverted cone

Steel
Diamond
Tun,gsten Carbide/TC

Friction grip/FG
Latch griplLG
Strai,ght hand piece/HP

Fin er s reader
Flat lastic instrument
Forceps:
Lower molar
Lower molar, childrens
Lower roots
Upper incisor/straight
Upper left molar
Upper right molar
U er roots
Cou lands chisel
Crown form:
polycarbonate
acetate/clear/transparent
aluminium
stainless steel
C ers elevator
Curette scaler

Acrylic
Pear
Bud

Le Cron carver
Luxator
Matrix strip, clear/transparent
Mauns wire cutters
Mitchells trimmer
Modelling wax
Molar orthodontic band
Molar rubber dam clamp
Moore's mandrel
Mouth prop

Radiation monitoring badge

Red ribbon wax
Root canal hand file
Rubber cup, latch griplLG
Rubber dam clamp forceps
Rubber dam frame
Rubber dam punch
Sickle probe
Siqveland matrix retainer
Stainless steel mixing spatula
Suture needle and silk

Needle holders
Occlusal x-ray film packet
Orthodontic bracket
Paper point
Paste filler, rotary/spiral
Periapical x-ray film packet
Periodontal hoe
Periosteal elevator
Plastic wedge
Pocket mask
Polishing/finishing strip
Pop-on mandrel
Push scaler

Teeth:
Lower deciduous molar
Lower permanent molar
Lower permanent incisor
Upper first premolar
Upper deciduous molar
Upper permanent molar
Tissue dissecting forceps
Toftlemire matrix retainer
Wards carver
Warwick James elevator
Wax knife
Willis bite gauge
Wooden wedge