1. The OSCE expects logic, not a full treatment plan
ADEX does NOT ask for multi-visit detailed plans. It asks whether you understand clinical priority and sequencing.
Every treatment planning question can be solved using one rule:
Golden Rule
Urgency → Disease control → Definitive care → Maintenance.
The exam checks if you stabilise the patient before choosing elective or complex treatment.
2. The ADEX “Next Best Step” algorithm
- Is there pain, swelling, or infection? → Treat that first.
- Is there uncontrolled perio? → Control inflammation.
- Is caries active or severe? → Remove disease before prosthetics.
- Is the tooth non-restorable? → Extract before planning.
- Is the patient medically unstable? → Defer elective care.
- Is the case beyond general dentist scope? → Refer.
These patterns appear in every ADEX OSCE form in slightly different cases and are often paired with radiographic findings. For a deeper look at how images drive these decisions, see the ADEX Radiographic Interpretation guide.
3. Common scenario 1 – Tooth pain & radiolucency
Radiograph: periapical radiolucency, symptoms of irreversible pulpitis or necrosis.
Next best step:- Initiate endodontic treatment or refer for root canal.
Wrong answers usually involve: “crown”, “post”, “bridge”, or elective prosthodontics.
4. Common scenario 2 – Severe gingival inflammation
Patient presents with bleeding, deep pockets, inflammation.
Next best step:- Perform periodontal therapy (scaling + OHI).
NOT crown, NOT veneer, NOT implant. Perio always comes before definitive restorative.
5. Common scenario 3 – Caries under existing restoration
Exam shows caries progression under an old filling.
Next best step:- Replace the restoration or remove caries and restore.
Not RCT unless pulp is involved. Not full crown unless tooth structure is severely compromised.
6. Common scenario 4 – Tooth fractured to gingival margin
Unrestorable crown length or fracture far subgingival.
Next best step:- Extract the tooth → then consider replacement options.
ADEX penalizes attempts to restore clearly non-restorable teeth.
7. Common scenario 5 – Medically complex patient
Uncontrolled diabetes, high BP, angina history, recent MI.
Next best step:- Defer elective treatment.
- Consult physician if needed.
Elective restorative or surgery is NEVER the answer here.
8. Referral decisions
Referral is correct when:
- Root morphology too complex for general dentist
- Severe periodontitis
- Impacted teeth with surgical difficulty
- Medically unstable patients
The safest choice is usually the correct choice.
9. How to score high on Treatment Planning OSCE
- Identify the most urgent problem.
- Choose the simplest and safest next step.
- Do not skip stages (e.g., perio → prostho).
- Do not jump into definitive care too early.
- Always consider patient’s medical status.
Many of these decision patterns also appear in viva-style questions. For short sample answers you can rehearse, review the ADEX Common Viva Questions guide.
10. How DentAIstudy strengthens OSCE logic
DentAIstudy can generate:
- OSCE-style “Next Best Step” cases
- Flashcards on perio vs caries vs emergency prioritization
- Checklists for fast decision-making
- Short notes linking radiology → diagnosis → treatment action
References
- ADEX OSCE Candidate Manual – Treatment Planning Section
- Standard dental sequencing and emergency guidelines
- Common case patterns observed across ADEX administrations