Exam 2 DW Practice Questions
When inserting a curet into a periodontal pocket, what is the ideal angle between the cutting edge of the blade of the instrument and the tooth? A. 100 to 110 degrees B. 45 to 90 degrees C. 35 to 40 degrees D. 0 to 10 degrees
D. 0 to 10 degrees Insertion of a bladed instrument into subgingival areas involves closing the angle of the cutting edge of the blade relative to the tooth to avoid tissue trauma with the opposite side of the blade, and to reach the base of the pocket on the down stroke of insertion. A 0- to 10-degree angle is ideal for inserting the working end of a curet into a sulcus or pocket.
All of the following statements about oral biofilm are false except one. Which one is the exception? A. A biofilm is easily influenced by host-mediating factors. B. Biofilm-associated bacteria are vulnerable and unlikely to survive past the steady-state stage. C. Biofilm-associated bacteria are dependent on the host for survival, much like a parasite. D. Biofilm-associated bacteria are resistant to antibiotics and antimicrobial agents.
D. Biofilm-associated bacteria are resistant to antibiotics and antimicrobial agents. The clinical significance of the biofilm is that it creates its own renewing source of lipopolysaccharide and protective slime layer for the long-term survival of microorganisms. The biofilm lends protective properties to the associated bacteria, such as resistance to antimicrobial agents (0.12% chlorhexidine gluconate). Because of these characteristics, biofilm-associated bacteria are more likely to survive within the mouth.
Which of the following represents early childhood caries? A. Progresses slowly over time B. Usually remineralizes and becomes arrested C. Occurs at the margins of restorations D. Commonly affects maxillary anterior teeth
D. Commonly affects maxillary anterior teeth Early childhood caries is most associated with prolonged use of the baby bottle while sleeping. This type of caries occurs rapidly and commonly affects the maxillary anterior teeth, particularly the facial surface.
All of the following are valuable uses of the perioscope except one. Which one is the exception? A. Visualize deep narrow pocket areas. B. Educate clients about their disease. C. Magnify the interior walls of periodontal pockets. D. Deliver chemotherapeutic agents.
D. Deliver chemotherapeutic agents. The perioscope is used for magnification and visualization for both the practitioner and to teach the client about the disease process. It is not a chemotherapeutic delivery system or vehicle.
A high-risk profile in the United States for oral cancer includes which characteristic? A. Betel nut chewer B. Female gender C. Age under 40 D. Excessive sun exposure
D. Excessive sun exposure A typical high-risk profile in the United States for oral cancer is man over age 40 who uses tobacco and/or abuses alcohol and has extensive sun exposure. Other forms of tobacco such as betel use may be implicated in many parts of the world. However, this is changing as younger persons are getting oral cancer, possibly because of human papillomavirus.
All of the following factors support the daily growth and retention of oral biofilm except which one? A. Calculus B. Orthodontic band C. Mouth breathing D. Frequent continued-care intervals
D. Frequent continued-care intervals Plaque formation begins immediately after a tooth surface is cleansed. Therefore routine continued-care visits to the dentist or dental hygienist do very little to control plaque formation and retention. What the client does at home daily to control plaque in his or her mouth is the critical factor in managing plaque formation and retention.
Overjet is which of the following? A. Horizontal overlap between the buccal surfaces of the maxillary incisors and the labial surfaces of the mandibular incisors B. Vertical overlap between the maxillary and mandibular incisors C. Molars erupted into an end-to-end position D. Horizontal overlap between the lingual surfaces of the maxillary incisors and the labial surfaces of the mandibular incisors
D. Horizontal overlap between the lingual surfaces of the maxillary incisors and the labial surfaces of the mandibular incisors
Which of the following terms is used to describe an area that faces away from the head and toward the feet? A. Anterior B. Posterior C. Superior D. Inferior
D. Inferior An area that faces away from the head and toward the feet is its inferior portion. An area that faces toward the head and away from the feet is its superior portion. The front of an area in relationship to the entire body is its anterior portion. The back of an area is its posterior portion.
All of the following are characteristics of the ideal disclosing agent except one. Which one is the exception? A. Provides a distinct staining of deposits that does not rinse off immediately B. Has a pleasant taste C. Is nonirritating to the oral tissues D. Is antibacterial
D. Is antibacterial A disclosant allows the dental hygienist and client to visualize oral biofilm accumulation in the oral cavity. Disclosants are not antibacterial agents.
Which of the following is the most common site in the oral cavity for oral cancer? A. Attached gingiva B. Hard palate C. Dorsal surface of the tongue D. Lower lip
D. Lower lip Although cancer may arise at any site in the oral cavity, the most common sites in order are the lateral border of the tongue, soft-palate complex (posterior soft palate, uvula, and faucial arches), floor of the mouth, and lower lip.
In advancing periodontal disease, subgingival oral biofilm is characterized by all of the following except one. Which one is the exception? A. A zone of gram-positive organisms attached to the tooth B. A loosely adherent zone of gram-negative species attached to the pocket wall C. Predominance of bacteria such as Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythensis, Treponema denticola, and others D. Mutans streptococci
D. Mutans streptococci Mutans streptococci are associated with caries activity, not advancing periodontal disease. These bacteria do occur in early plaque formation.
Oral cancer when detected early has a cure rate of _____ %. A. Under 20 B. 90 C. Under 30 D. Over 90
D. Over 90
What is the specific reason that a lymph node feels tender to the client when palpated after it has undergone lymphadenopathy? A. Change in consistency B. Mobility in tissue C. Attachment to underlying tissues D. Pressure on area nerves
D. Pressure on area nerves The lymph node can also feel tender to the client when palpated owing to the pressure on the area nerves from the node enlargement.
All of the following may cause brown tooth stain if used for a long enough period of time except one. Which one is the exception? A. 0.12% Chlorhexidine gluconate mouth rinses B. Stannous fluoride dentifrices (some formulations) C. 0.07% Cetylpyridinium chloride mouth rinses D. Sodium fluoride mouth rinses and dentifrices
D. Sodium fluoride mouth rinses and dentifrices Sodium fluoride mouth rinses and dentifrices are not known to cause extrinsic tooth stain. Oral care products with substantivity that are used regularly for several months tend to cause extrinsic stain. Extrinsic stain does not cause oral disease and can be removed.
Which of the following tissues is limited to the upper surface or dorsum of the tongue? A. Epidermis B. Dermis C. Masticatory mucosa D. Specialized mucosa
D. Specialized mucosa Specialized mucosa is limited to the upper surface or dorsum of the tongue. This tissue is keratinized because it is also used for mastication and, in addition, plays a role in taste sensation. The masticatory mucosa covers the hard palate and gingiva with its rubbery surface texture and resiliency and is attached firmly to the tissue underneath.
Bacterial species associated with dental-plaque-induced gingival disease include all of the following except one. Which one is the exception? A. Fusobacterium nucleatum B. Prevotella intermedia C. Campylobacter rectus D. Streptococcus mitis
D. Streptococcus mitis Streptococcus mitis is associated with periodontal health, not gingivitis.
Root planing a root surface that is normal and healthy can contribute to which of the following? A. The prevention of clinical attachment loss B. The prevention of gingival recession C. The prevention of bone loss D. The development of gingival recession
D. The development of gingival recession Root planing a tooth that is normal and healthy can contribute to gingival recession.
An area-specific curet has two straight flat blades that are not easily adapted to a curved tooth or root surface. The rounded smooth back of the working end of the area-specific curet aids in the placement of the instrument without trauma to the tissues. A. Both statements are true. B. Both statements are false. C. The first statement is true, and the second statement is false. D. The first statement is false, and the second statement is true.
D. The first statement is false, and the second statement is true. The area-specific curet has two curved blades, but only one is used in periodontal debridement and root planing. The correct cutting edge is determined by examining the curvature of the blades. The blade of an area-specific curet is not only bent in a curve, but it is also bent so that one cutting edge is elongated. The longer curved blade is the designated cutting edge. The curved back of any curet is designed to minimize trauma during insertion of the working end into the subgingival area.
All of the following are uses of the mouth mirror except one. Which one is the exception? A. Indirect vision B. Retraction to the tongue and tissues C. Transillumination D. Tongue depression to assess the oral pharynx
D. Tongue depression to assess the oral pharynx A mirror is not used for tongue depression because the head of the mirror can become disjoined from the handle. A wooden tongue depressor should be used to assess the oral pharynx.
All of the following are advantages of electronic charting except one. Which one is the exception? A. paperless saves space B. electronic charts are readily retrievable chair side C. they allow for incorporation of digital and radiographs images into the patient record D. electronic charts are expensive to implement and often require a steep learning curve
D. electronic charts are expensive to implement and often require a steep learning curve Electronic charts that are expensive to implement and often require a steep learning curve are disadvantages and not advantages.
Match the working ends of dental instruments. Sickle scaler Dental explorer Curet or curette Hoe scaler File scaler 33. Pointed toe and pointed back 34. Rounded toe and rounded back 35. Excellent for crushing large tenacious calculus deposits 36. Triangular in cross-section 37. Fine, wirelike working end with a sharp point
33. Pointed toe and pointed back : Sickle scaler 34. Rounded toe and rounded back : Curet or curette 35. Excellent for crushing large tenacious calculus deposits : File scaler 36. Triangular in cross-section : Sickle scaler 37. Fine, wirelike working end with a sharp point : Dental explorer
What is the recommended pressure when a periodontal probe is used? A. 1 to 2 g B. 10 to 20 g C. 100 to 200 g D. 1 to 2 mg
A. 10 to 20 g A pressure of about 10 to 20 g provides a good balance among client comfort, ability to reach the epithelial junction, and an accurate probe reading.
Enamel hypoplasia is the result of a disturbance in which cells and formation period? A. Ameloblasts during matrix formation B. Ameloblasts during mineralization C. Fibroblasts during matrix formation D. Fibroblasts during mineralization
A. Ameloblasts during matrix formation Enamel hypoplasia is the result of a disturbance of the ameloblasts during matrix formation.
What type of bacteria is associated primarily with advancing periodontal disease? A. Anaerobic B. Aerobic C. Anaerobic and aerobic D. Facultative
A. Anaerobic The bacteria associated with advancing periodontal disease must be able to live in deep pockets within the dense oral biofilm where there is no oxygen. Therefore anaerobic bacteria will thrive.
Which of the following instrument designs is best used for accessing a deep periodontal pocket on the proximal surface of a maxillary permanent first molar? A. Angled shank with complex bends B. Angled shank with a single bend C. Straight shank with complex bends D. Straight shank with a single bend
A. Angled shank with complex bends An instrument with an angled shank and complex bends is designed for accessing deep periodontal pockets on posterior teeth. In terms of the instrument shank, the smaller the angle and the lower the number of bends, the more suitable the instrument is for use on anterior teeth. The more acute the angle and the greater the number of bends, the more suitable the instrument is for use on posterior teeth.
A firm grasp is used when calculus is removed. A light grasp is used during exploration to find calculus. A. Both statements are true. B. Both statements are false. C. The first statement is true, and the second statement is false. D. The first statement in false, and the second statement is true.
A. Both statements are true. A firm grasp is needed during working strokes so that the appropriate lateral pressure and force can be exerted to remove calculus. When one is exploring calculus (exploratory stroke), a light grasp is used to maximize tactile sensitivity.
The surface texture of the instrument handle can be knurled or smooth. The amount and type of texture helps provide a firm grasp on the instrument and prevents slipping in a wet environment. A. Both statements are true. B. The first statement is true, and the second statement is false. C. Both statement are false. D. The first statement is false, and the second statement is true.
A. Both statements are true. Instrument handles come in a variety of knurled and smooth surface textures. Textured handles are preferred so that the clinician can maintain a firm grasp on the instrument when necessary.
The host's normal response to injury (inflammation) and to foreign bodies (the immune response) is activated in the presence of a microbial challenge. It is the effects of proinflammatory mediators produced during chronic inflammation and inability of the immune system to reach the site of injury or infection that cause the connective tissue and bone destruction in periodontal disease. A. Both statements are true. B. The first statement is true, and the second statement is false. C. The first statement is false, and the second statement is true. D. Both statements are false.
A. Both statements are true. The sentences in the stem of the question succinctly explain the human body's response to injury and attack by foreign bodies. Proinflammatory mediators encourage the inflammatory process to continue and accelerate; in high enough concentrations, they cause the soft- and hard-tissue destruction that is observed in periodontitis.
The lymph nodes in a healthy client: A. Cannot be visualized B. Can be visualized C. Can vary in size but are never small D. Are soft and attached to underlying tissues
A. Cannot be visualized In healthy clients, lymph nodes are usually small, soft, and free or mobile in the surrounding tissue and cannot be visualized or palpated.
All of the following are used at home by the client for self-monitoring oral biofilm accumulation except one. Which one is the exception? A. Dental explorer B. Bleeding points or areas C. Disclosant D. Senses of smell, feel, and sight
A. Dental explorer The dental explorer would be a dangerous and very difficult instrument for the client to use at home. All of the other "tools" can be safely and easily used by the client for self-assessment of oral biofilm.
Which of the following are secondary lymph nodes for the occipital lymph nodes? A. Inferior deep cervical lymph nodes B. Superior deep cervical lymph nodes C. Auricular lymph nodes D. Submental lymph nodes
A. Inferior deep cervical lymph nodes The occipital nodes empty into the inferior deep cervical nodes of the neck.
What is the first stage in oral biofilm formation? A. Initial adherence B. Lag phase C. Rapid growth bacterial D. Steady state
A. Initial adherence Immediately after cleansing of the tooth surfaces, the pellicle begins to form on exposed oral surfaces. Therefore, initial adherence of the acquired pellicle, a tenacious, acellular protein film composed of glycoproteins found within saliva, occurs in the first stage of plaque formation.
Which of the following lymph nodes in the oral pharyngeal area can specifically become enlarged in a child client with tonsillitis? A. Jugulodigastric lymph nodes B. Submental lymph nodes C. Posterior auricular lymph nodes D. Jugulo-omohyoid lymph nodes
A. Jugulodigastric lymph nodes The jugulodigastric (tonsillar node) is located below the posterior belly of the digastric muscle and is associated with the drainage of the palatine tonsils and/or pharynx.
What do the maxillary sinuses drain into? A. Nasal cavity B. Facial sinuses C. Lacrimal gland D. Occipital lymph node
A. Nasal cavity The paired maxillary sinuses are each located in the body of the maxilla, just posterior to the maxillary canine and premolars, and they drain into the nasal cavity.
Oral hygiene assessment conducted by a dental hygienist includes observation and measurement of hard and soft deposits on the teeth using all of the following except one. Which one is the exception? A. Severity B. Location C. Degree (amount) D. Extent
A. Severity Severity is a criterion that is used by the dental hygienist to assess gingival and periodontal disease, not hard and soft deposits.
A client comes into the dental office exhibiting injury from excessive occlusal forces on a periodontium that has not been altered by disease. There is no attachment loss, apical migration of the junctional epithelium or any loss of connective tissue. The client is in manageable pain, radiographs indicate a widened periodontal ligament space. These signs and symptoms are indicative of: A. Secondary trauma from occulsion B. Primary trauma from occlusion C. Tertiary trauma from occlusion D. None of the above
B. Primary trauma from occlusion Primary trauma from occlusion injury to excessive occlusal forces on a periodontium that has not been altered by disease. There is no attachment loss, apical migration of the junctional epithelium or any loss of connective tissue. The client is in manageable pain, and radiographs indicate a widened periodontal ligament.
The distance between the gingival margin and the junctional epithelium at the base of the sulcus or periodontal pocket is known as which of the following? A. Mucogingival junction B. Probing depth C. Relative attachment level D. Infrabony pocket
B. Probing depth When a dental hygienist uses a periodontal probe to measure the distance between the gingival margin and the junctional epithelium, the distance is known as the pocket depth. If a dental hygienist is measuring from a fixed reference point on a tooth to the junctional epithelium, the distance is known as the relative attachment level.
Persons who are low calculus formers may have which of the following chemical or minerals in their saliva that inhibit calculus formation? A. Octocalcium B. Pyrophosphate C. Calcium and phosphorous D. Whitlockite and brushite
B. Pyrophosphate Pyrophosphate is a known inhibitor of calcification used in anticalculus dentifrices. Higher concentrations of pyrophosphate are found in light calculus formers as compared with high calculus formers.
All of the following are uses of the dental mirror except one. Which one is the exception? A. Indirect vision B. Retention C. Illumination D. Transillumination
B. Retention Retention has nothing to do with a mouth mirror. A mouth mirror is used for retraction of soft tissue.
All of the following are extrinsic tooth stains except one. Which one is the exception? A. Black line B. Tetracycline stain C. Wine D. Tobacco
B. Tetracycline stain Tetracycline stain (a yellow, brown, gray, or orange discoloration) is a result of fetal exposure to tetracycline antibiotic during tooth development or ingestion of tetracycline by a child during tooth development. The stain therefore is within the tooth structure and cannot be removed by selective polishing.
In the modified pen grasp, where is the second finger positioned on the instrument? A. Side of the finger rests on the handle B. Tip (pad of the finger) on the instrument shank C. Side of the finger on the instrument shank D. Tip (pad of the finger) on the instrument handle
B. Tip (pad of the finger) on the instrument shank In a modified pen grasp the pad of the thumb must be placed on the instrument handle and the joint bent slightly, depending on the area being scaled. The pad of the index finger should be on the instrument at a point slightly higher on the handle than the thumb, and the first joint should be slightly bent downward with the second joint cocked upward. The side of the second finger (middle finger) near the nailbed should be placed opposing the thumb and farther down the instrument on the shank near the working end.
Which of the following instruments is the best choice for light to moderate subgingival calculus removal? A. Area-specific curet B. Universal curet C. Sickle scaler D. Chisel scaler
B. Universal curet A universal curet is designed for light to moderate subgingival and supragingival calculus removal, and root planing in all areas of the mouth.
Enamel hypocalcification produces which of the following? A. Hard pitted surface B. White spotted appearance C. Brownish stained surface D. White flecking near the incisal edge
B. White spotted appearance Enamel hypocalcification is a defect occurring in the enamel as a result of a disturbance during mineralization. Enamel hypocalcification produces a white spotted appearance of the enamel surface.
A dental hygienist is assessing the periodontium around tooth 3. Four millimeters of visible recession is present on the facial surface of the tooth. The probing depth in the same area is 1 mm. What is the clinical attachment level of this tooth? A. 3 mm B. 4 mm C. 5 mm D. 6 mm
C. 5 mm Clinical attachment level is the measurement from the cementoenamel junction (CEJ) to the junctional epithelium. The hygienist would measure the amount of recession from the CEJ to the gingival margin (4 mm), then measure the pocket depth (1 mm), and finally add those readings together (5 mm).
What percent of the population shows clinical evidence of some type of periodontal disease (including gingivitis)? A. 10% to 20% B. 20% to 50 % C. 50% to 90% D. 60% to 70 %
C. 50% to 90% Depending on the specific study, population sampled, and types of periodontal diseases measured, anywhere from 50% to 90% of the population has some type of periodontal disease, including gingival diseases.
What degree of angulation should be established between the tooth surface and the cutting edge of the instrument blade when calculus is removed? A. 0 to 10 degrees B. 35 to 45 degrees C. 60 to 80 degrees D. 100 to 110 degrees
C. 60 to 80 degrees A 60- to 80-degree angle is ideal for removing calculus and planing roots. The closer the angulation is to 90 degrees, the more the instrument cuts or bites into the tooth surface. The closer to 45 degrees, the more the instrument slides over the tooth surface. An angulation close to 60 degrees is recommended for root planing strokes; an angulation close to 80 degrees is recommended for heavy calculus deposits.
The dental hygienist is scaling a sextant, teeth 28 through 31. The areas have generalized 5- to 6-mm pockets with light subgingival calculus and bleeding on probing. Which of the following would be the best instrument to use to debride the pockets in this area? A. Sickle scaler B. Universal scaler C. Area-specific curet D. Chisel scaler
C. Area-specific curet Area-specific curets are particularly effective for instrumenting teeth with slight to severe periodontitis in clients who require therapeutic scaling and root planing by quadrant or sextant.
Regarding oral lesions, which of the following is usually true? A. Unilateral structures are most likely normal anatomic structures. B. The majority of lesions occur as multiple lesions. C. Benign lesions have well-defined borders. D. Lesions fixed to both overlying and underlying tissues are benign.
C. Benign lesions have well-defined borders.
Middle-aged women with good oral hygiene are the most likely population to have which of the following? A. Chromogenic stain B. Intrinsic stain C. Black-line stain D. Brown stain
C. Black-line stain Black-line stain can occur in clients with meticulous oral hygiene. These stains are found on the tooth surface near the gingival margin and are associated with iron in the saliva. Middle-aged women with good oral hygiene are the most likely population to have black-line stain.
Instruments with short shanks are used in restricted areas, for example, posterior teeth, whereas instruments with long shanks are used in unrestricted areas of the mouth. A. Both statements are true. B. The first statement is true, and the second statement is false. C. Both statement are false. D. The first statement is false, and the second statement is true.
C. Both statement are false. Short shanks are designed for use on teeth with normal sulcus depth, whereas long shanks are specifically designed for access into periodontal pockets.
Shanks with thin diameters are considered rigid in nature and therefore are capable of removing heavy calculus deposits. In contrast, shanks with thick diameters are considered flexible for the removal of light calculus. A. Both statements are true. B. The first statement is true, and the second statement is false. C. Both statements are false. D. The first statement is false, and the second statement is true.
C. Both statements are false. Although rigid instruments are designed for removing heavy calculus deposits, a thin shank is flexible and not rigid. Thick shanks fall into the rigid and extra-rigid categories and are designed for heavy calculus removal.
Where is a type of tissue that is nonkeratinized and has a softer surface texture, moist surface, and ability to stretch and be compressed, acting as a cushion for the underlying structures, located in the oral cavity? A. Dorsal surface of tongue B. Hard palate C. Floor of the mouth D. Gingiva
C. Floor of the mouth Lining mucosa, which is nonkeratinized and has a softer surface texture, moist surface, and ability to stretch and be compressed, acts as a cushion for the underlying structures. Lining mucosa covers the inner surfaces of the cheeks and lips, the floor of the mouth, the ventral surface (undersurface) of the tongue, the soft palate, and the pharynx (throat). The masticatory mucosa covers the hard palate and gingiva with its rubbery surface texture and resiliency and is attached firmly to the tissue underneath. Because these areas are directly exposed to masticatory forces, they are keratinized, having a callused surface.
The small bulge of tissue at the most anterior portion of the hard palate, lingual to the anterior teeth, is the: A. Palatine rugae B. Median palatine raphe C. Incisive papilla D. Greater palatine foramen
C. Incisive papilla A small bulge of tissue at the most anterior portion, lingual to the anterior teeth, is the incisive papilla.
All of the following tooth stains can be removed by scaling or selective polishing except one. Which one is the exception? A. Chromogenic bacteria stain B. Extrinsic tooth stain C. Intrinsic tooth stain D. Chlorhexidine gluconate and cetylpyridinium chloride stain
C. Intrinsic tooth stain Intrinsic stains are incorporated into the tooth structure and cannot be removed by scaling or selective polishing. They are best managed using dental techniques such as cosmetic tooth whitening (bleaching), veneers, or crowns.
The slime layers that form to protect the biofilm community of microorganisms predominately contain which of the following? A. Neutrophils B. Macrophages C. Lipopolysaccharides D. Polymorphonuclear leukocytes
C. Lipopolysaccharides The slime layer is made of lipopolysaccharides that are produced by bacteria in the biofilm in response to stress on the bacterial colonies. It is one of the self-protective strategies of a biofilm.
What is the term for a loosely attached collection of oral debris, desquamated epithelial cells, leukocytes, salivary proteins and lipids, and bacteria that is seen as a whitish to yellowish to grayish mass on the teeth or overlying oral biofilm? A. Bacterial plaque B. Food debris C. Materia alba D. Calculus
C. Materia alba
Which of the following teeth are known as the Ramfjord teeth? A. All eight central incisors from both maxillary and mandibular arches B. All four first molars and all four central incisors from both maxillary and mandibular arches C. Maxillary right and mandibular left first molars, maxillary left and mandibular right first premolars, and maxillary left and mandibular right central incisors D. One of each from the maxillary and mandibular arch: central, canine, premolar, and molar
C. Maxillary right and mandibular left first molars, maxillary left and mandibular right first premolars, and maxillary left and mandibular right central incisors Maxillary right and mandibular left first molars, maxillary left and mandibular right first premolars, and maxillary left and mandibular right central incisors are referred to as the Ramfjord teeth. These six teeth are used as a sample in many dental indexes to represent the entire mouth.
All of the following may cause subgingival calculus to be dark in color (dark tan, brown, or black) except one. Which one is the exception? A. Type of bacteria it is made of B. Absorption of blood products C. Melanin pigmentation D. Foods and drinks that can cause extrinsic tooth stain
C. Melanin pigmentation Melanin is in the skin and does not affect the color of the calculus. Unlike supragingival calculus, subgingival calculus is more likely to have a dark color because of the adsorption of blood products from the epithelial lining of the gingival sulcus or periodontal pocket. Pigmentation can also come from certain bacteria.
How should the client best move his or her head to allow for the increased prominence of the large strap muscle that divides the neck into regions? A. Move head up and down. B. Lie supine in the chair. C. Move head side to side. D. Point the chin down.
C. Move head side to side. The large strap muscle, the sternocleidomastoid muscle (SCM), divides each side of the neck diagonally into two triangular regions. When the client moves the head to the side, the SCM is more prominent.
Which of the following microorganisms is the primary causative agent in the dental caries process? A. Lactobacillus B. Prevotella intermedia C. Mutans streptococci D. Porphyromonas gingivalis
C. Mutans streptococci Mutans streptococci are the primary microorganisms initiating the dental caries process. Lactobacillus is believed to also be involved in the caries process but is a secondary bacterial agent that is involved later in the process.
Which of the following tissues lines the oral cavity? A. Epidermis B. Dermis C. Oral mucosa D. Connective tissue
C. Oral mucosa The oral mucosa, or the lining of the oral cavity, is a mucous membrane composed of stratified squamous epithelium covering connective tissue or lamina propria. The skin is composed of a surface layer of keratinized stratified squamous epithelium forming the epidermis, overlying a layer of connective tissue or dermis.
Referring to the case in question 8, what is the recommended treatment appropriate to Jason's caries risk status? A. Reinforce flossing, and schedule his next recall appointment for 6 months. B. Reinforce flossing, and schedule his next recall appointment for 12 months. C. Reinforce flossing, apply sealants, recommend a home fluoride product, and schedule his next recall appointment for 6 months. D. Reinforce flossing, apply sealants, monitor mutans streptococcus levels, recommend an antimicrobial agent, and schedule his next recall appointment for 3 to 6 months.
C. Reinforce flossing, apply sealants, recommend a home fluoride product, and schedule his next recall appointment for 6 months. An appropriate preventive plan for Jason includes reinforcing flossing, applying sealants, recommending a home fluoride product, and scheduling his next recall appointment for 6 months. At this time he has no caries, and therefore Jason is not classified being at high risk, so monitoring his mutans streptococcus levels and recommending an antimicrobial agent are not necessary.
Why are clinicians advised to use "sharp eyes and blunt explorers" when conducting a clinical examination? A. Many clinicians fail to see caries. B. Blunt explorers remove bacteria better. C. Sharp explorers may cause cavitation of the lesion. D. Blunt explorers prevent the spread of the microorganisms from one tooth to another.
C. Sharp explorers may cause cavitation of the lesion. The expression "sharp eyes and blunt explorers" refers to the finding that exploring may cause early carious lesions to become cavitated due to rupture of the remineralizing enamel crystals by the explorer.
All of the following are true about instrument shanks except one. Which one is the exception? A. Instrument shanks vary in diameter, curvature, and length. B. Shanks with many deviations are used in treatment areas with restricted access such as posterior areas of the mouth. C. Short functional shanks are used to reach tooth surfaces that are hard to access. D. The length of the shank is measured from the first bend and away from the handles to the beginning of the working end.
C. Short functional shanks are used to reach tooth surfaces that are hard to access. Short functional shanks are used to access normal sulcus areas. Long shanks are used to access deep pockets that are hard to access.
Which of the following instruments is the best choice for moderate supragingival calculus removal? A. Area-specific curet B. Universal curet C. Sickle scaler D. Chisel scaler
C. Sickle scaler Sickle scalers are designed for moderate to heavy supragingival calculus removal. Only in situations of moderate to heavy subgingival calculus and very loose tissue may a sickle scaler be used subgingivally.
Which of the following can be noted of a client during initial appraisal that gives an indication of drug abuse? A. Wearing long pants B. Increased weight gain C. Slurred speech D. Wearing clear glasses
C. Slurred speech The quality of speech may be indicative of drug abuse if slurred. Drug abuse may be indicated by wearing sunglasses inappropriately to conceal dilated or constricted pupils or redness or because of eye sensitivity. It may also be indicated by dramatic weight loss, long sleeves to conceal needle marks, and small bloodstains on clothes.
Which is the most common malignant neoplasm of the oral cavity? A. Verrucous carcinoma B. Basal cell carcinoma C. Squamous cell carcinoma D. Malignant melanoma
C. Squamous cell carcinoma Squamous cell carcinoma makes up 90% of all malignant neoplasms of the oral cavity.
Which of the following describes Class II malocclusion? A. The molar relationship is such that the mandibular first permanent molar is situated mesially to the maxillary first permanent molar. B. The molar relationship is such that the mandibular first permanent molar is situated mesially to the maxillary first permanent molar and may include crowded alignment of the anterior teeth. C. The buccal groove of the mandibular first permanent molar is situated distally to the mesiobuccal cusp of the maxillary first permanent molar by at least the width of a premolar. D. The buccal groove of the mandibular first permanent molar is situated mesial to the mesiobuccal cusp of the maxillary first permanent molar by at least the width of a premolar.
C. The buccal groove of the mandibular first permanent molar is situated distally to the mesiobuccal cusp of the maxillary first permanent molar by at least the width of a premolar Class II malocclusion is characterized by the buccal groove of the mandibular first permanent molar being situated distally to the mesiobuccal cusp of the maxillary first permanent molar by at least the width of a premolar.
About 20% of the oral cavity is occupied by teeth, and about 80% is occupied by soft tissue. Oral biofilm grows only on teeth. A. Both statements are true. B. Both statements are false. C. The first statement is true, and the second statement is false. D. The first statement is false, and the second statement is true.
C. The first statement is true, and the second statement is false. About 20% of the oral cavity is occupied by teeth, and about 80% is occupied by soft tissue. Oral biofilm grows on teeth, soft tissue, and dental appliances and in saliva. Oral biofilm needs to be controlled in the entire mouth, not just on the teeth.
The shape of the shank will influence the use of the instrument. An instrument with a ridged shank is for the removal of light subgingival calculus. A. Both statements are true. B. Both statements are false. C. The first statement is true, and the second statement is false. D. The first statement in false, and the second statement is true.
C. The first statement is true, and the second statement is false. The shape of the shank influences the use of the instrument. For example, a straight shank is designed for anterior teeth, whereas an angled shank is designed for posterior teeth. A ridged shank is best used for the removal of heavy tenacious calculus. In fact, tactile sensitivity is limited with ridged shanks, making it difficult to detect light to moderate calculus.
Which of the following conditions is necessary for effective extraoral assessment? A. Subdued lighting B. Supine patient C. Upright patient D. Tight collar and tie
C. Upright patient The client should be seated in an upright position for the extraoral assessment, and later supine for the intraoral assessment. Good lighting and exposure of the area being assessed are essential (e.g., collar and tie loosened).
The temporal region is known for: A. Only large areas of the scalp B. Presence of the external ear C. Location of the glabella D. Placement of the facial sinuses
B. Presence of the external ear Within the temporal region is the external ear, which is composed of an auricle or oval flap of the ear and the external acoustic meatus.
What bacteria predominate in early bacterial plaque that is 1 to 2 days old? A. Anaerobic gram-positive cocci B. Aerobic gram-positive cocci C. Aerobic gram-negative cocci D. Anaerobic gram-negative cocci
B. Aerobic gram-positive cocci Aerobic, gram-positive cocci, such as mutans streptococci and Streptococcus sanguis, are found in early plaque.
Which of the following bacteria primarily are associated with periodontal health? A. Anaerobic gram-positive rods and cocci B. Aerobic gram-positive rods and cocci C. Aerobic gram-negative rods and cocci D. Anaerobic gram-negative rods and cocci
B. Aerobic gram-positive rods and cocci Aerobic rods and cocci such as Streptococcus mitis, Actinomyces species, and Streptococcus oralis (sanguis) are associated with nonpathologic dental plaque.
What is defined as a host-associated biofilm, as well as a dense, nonmineralized mass of bacterial colonies enclosed in a slime matrix and attached to a moist environment? A. Materia alba B. Bacterial plaque C. Food debris D. Calculus
B. Bacterial plaque The description provided is that of bacterial plaque, also known as oral biofilm, dental biofilm, dental plaque, and microbial plaque.
Which of the following tests can be used in the dental office setting and consists of a transepithelial specimen spread on a slide? A. Exfoliative cytology B. Brush test C. Toluidine blue test D. Chemiluminescent light
B. Brush test Unlike exfoliative cytology, which uses a smear of the tissue and allows only the surface cells to be captured as a specimen, the Brush test captures a full and more complete transepithelial specimen of all three layers of epithelium.
Attrition is the gradual wearing of the tooth caused by which action? A. Chemical agents B. Bruxism or grinding C. Cervical stress D. Traumatic toothbrushing
B. Bruxism or grinding Attrition is the tooth-to-tooth wear of the dentition. Grinding bruxism or clenching may cause excessive wear of the teeth.
Because disclosants can _____ clinical signs of disease, disclosing agents should be applied after the oral and periodontal assessment and after the client sees the oral findings in his or her own mouth. A. Aggravate B. Camouflage C. Allay D. Mimic
B. Camouflage Because disclosants will stain soft tissue, subtle color changes associated with gingival inflammation can be masked and therefore missed during the assessment and evaluation phases of the dental hygiene process.
The outer corner where the upper and lower eyelids meet is the outer or lateral: A. Commissure B. Canthus C. Supraorbital ridge D. Nasion
B. Canthus The outer corner where the upper and lower eyelids meet is the lateral or outer canthus.
Dental caries found in the interproximal surface of a posterior tooth are classified as which of the following? A. Class I B. Class II C. Class III D. Class IV
B. Class II Dental caries found in the proximal surface are classified as Class II caries.
Which of the following scaling instruments is designed for subgingival calculus removal? A. Sickle B. Curet C. Chisel D. Hoe
B. Curet The rounded back and toe of the working end of the curet makes it appropriate for subgingival scaling.
A dental hygienist is scaling the posterior, mandibular right quadrant. Suddenly the tip of the working end of the instrument (13/14 area-specific curet) breaks. Which of the following is not an appropriate part of the initial tip-retrieval procedure? A. Reinstrument the area with another curet. B. Dry the area with compressed air. C. Inform the client about the breakage. D. Use a magnetic-tip instrument to retrieve the broken tip, such as a Periotriever.
B. Dry the area with compressed air. Drying the area with compressed air may move the broken tip from the area or into the client's oral pharynx (where it can be easily swallowed or aspirated) and may make finding it more difficult.
A dental hygienist records a periodontal probe reading of 6-6-6 on the facial surface of tooth 8 and a clinical attachment level of 3-3-3. What would a competent dental hygienist conclude from these assessment data? A. Normal readings B. Gingival pocket C. Periodontal pocket D. Not enough information
B. Gingival pocket The client has an attachment level that is within the range of normal, but the gingival tissue is enlarged to the point of an abnormal pocket depth. The client has a gingival pocket, also known as a pseudopocket. The hygienist needs to now look for factors that may place the client at risk for gingival enlargement.
All of the following are true about an instrument handle except one. Which one is the exception? A. Instrument handles can be narrow and solid, or wide and hollow. B. Instruments with narrow handles are lighter in weight. C. Instruments handles can be made with silicone grasps. D. Instruments with hollow handles are more efficient at transmitting tactile sensitivity.
B. Instruments with narrow handles are lighter in weight. The narrow diameter of the handle is not related to the weight of the instrument. Instrument weight is related to whether the handle is hollow or solid. Most wide-handled instruments are lighter in weight.
What term is used to describe structures on the same side of the body? A. Medial B. Ipsilateral C. Lateral D. Contralateral
B. Ipsilateral Structures on the same side of the body are considered ipsilateral. Structures on the opposite side of the body are considered contralateral. Structures toward the midline of the body are medial, and those away from the midline are lateral.
Tonsillar tissue consists of _____ of _____ tissue. A. Layers; connective B. Masses; lymphoid C. Layers; muscular D. Masses; nerve
B. Masses; lymphoid Tonsillar tissue consists of masses of lymphoid tissue located in the oral cavity and pharynx.
Jason is 12 years old and is undergoing orthodontic treatment. At his last recall examination he was found to have no caries but was found to be sporadic in flossing his teeth. What caries risk is he classified as? A. Low B. Moderate C. High D. Very high
B. Moderate Jason is classified as being at moderate risk. Although he does not have any current carious lesions, he is undergoing orthodontic treatment, which puts him at moderate risk because of the difficulty in removing all plaque from around the brackets and wires. He is also not flossing, and this factor should be considered in making the risk determination.
Which of the following instruments is best designed for assessment of furcation involvement? A. PSR screening probe B. Nabers probe C. Williams probe D. Marquis color-coded probe
B. Nabers probe The Nabers probe is a specialized probe used for the detection and classification of furcations. Because classification of furcation involvement is based on the degree of penetration of a probe between the roots of multirooted teeth, the Nabers probe, with its curved shank, shaded markings, and blunted tip, is well-suited for subgingival insertion and furcation classification.
What type of tests are used to identify, evaluate and monitor oral mucosal abnormalities in clients who are at an increased risk for oral cancer? This test includes a handheld device. A. Tissue reflectance and tissue autofluorescence B. Toluidine Blue Dye and chemiluminescent light C. Tissue autofluorescence and Toluidine Blue Dye D. Chemiluminescent light and tissue reflectance
A. Tissue reflectance and tissue autofluorescence Both tissue reflectance and tissue autofluorescence utilize handheld devices and are used to identify, evaluate, and monitor oral mucosal abnormalities in clients who are at an increased risk for oral cancer.
What is the most effective method for identifying supragingival calculus? A. Use of compressed air and direct observation B. Use of disclosing tablets C. Use of a periodontal explorer D. Use of a periodontal probe
A. Use of compressed air and direct observation Supragingival calculus is similar in color to a tooth. Making supragingival calculus clinically visible with the use of compressed air is the most effective method for its identification, particularly when it is light in accumulation.
