DHY 101 Final Exam Review

Prevention of calculus

several methods to manage and minimized calculus formation: -effective daily biofilm removal -professional clinical nonsurgical periodontal therapy -chemotherapeutic agents (antitartar and antimicrobial products)

It is well documented that _________________ results in superior health outcomes.

shared decision making

Objectives of health communication:

shared decision-making between patients & providers; personalized, targeted, accurate, accessible, & actionable information, self-management tools, & resources; increasing health literacy skills

What is hypersensitivity characterized by?

short, sharp pain arising from exposed dentin that occurs in response to stimuli

What is the principle objective of a quick reference?

include symptoms, equipment needed, and management of common emergencies

What does the term bleaching refer to?

involves free radicals and the breakdown of pigment which occurs in the tooth bleaching procedures

Family decision making:

involving key family members in decision making may be expected & necessary; use special sensitivity when family members are involved in discussion

Free gingiva

is closely adapted around each tooth. It connects with the attached gingiva at the free gingival groove and attaches to the tooth at the coronal portion of the junctional epithelium (JE)

what are some cosmetic effects of dentifrices?

it removes extrinsic stains left behind by foods, tobacco, or chemical agents, and it reduces oral malodor (halitosis)(via chlorhexidine, cetylpyridinium chloride, and zinc formation)

What is the walking bleach method?

it was introduced in 1961 which sealed a mixture of sodium perborate and water into the pulp chamber and retained it in between visits then later modified with 30-35% hydrogen peroxide

body language or physical movement

kinesics

Dental caries prevalent in some populations due to ______ Remains major problem

lack of access to care

refers to providing cultural appropriate oral and written health information for persons with limited proficiency in English

linguistic competence

nonkeratinzed mucosa

lining mucosa in which the stratified squamous epithelial cells retain their nuclei and cytoplasm

What is auscultation?

listening through a stethoscope

When classifying chronic periodontitis, it is further classified as

localized/ generalized

Gingival sulcus (crevice)

location, boundaries, sulcular epithelium, depth of sulcus, and gingival sulcus fluid

use of technology to convey information; directed to individual recipient or wider audience

media communication

systemic fluoride issues

need to have water supplies tested and monitored, swallowing of topical preparations such as toothpaste

additional transmission-based precautions: sharps

needles or other sharp objects

the study of the causes and effects of language disorders and how to communicate with individuals with language disorders

neurolinguistics

Oral Lesions Strongly Associated with HIV Infection

oral candidiasis oral hairy leukoplakia non-hodgkin lymphoma kaposi's sarcoma gingival/periodontal infections necrotizing periodontal disease

significant differences in oral health status and/or access to oral health services between one population and another; populations affected by disparities include racial and ethnic minorities, the elderly, and persons with disabilities

oral health disparities

HIV: indicators

oral lesions

sharpey's fibers

penetrating connective tissue fibers by which the tooth is attached to the adjacent alveolar bone; the fiber bundles penetrate cementum on one side and alveolar bone on the other

Infectious process #1: essential features for disease transmission: reservoir

people, equipment, instruments, water(from tubing)

Where is the patient's physician listed?

permanent record in standard convenient place

Changes in biofilm microorganisms (Days 6-10)

-Increase in filaments and mixed flora appears including rods, filamentous forms, and fusobacteria -heavy accumulation of leukocytes -Gram negative bacteria form (porphyromonas gingival, spirochetes, and vibrios proliferate) -EPS helps form 3D structure of biofilm

What is used when burnishing?

A wooden toothpick

describe the burnishing process

A wooden toothpick is repeatedly rubbed over the root surface with moderate pressure. The burnishing process will form a smear layer over dentin and occlude the dentinal tubule.

Dry heat sterilizers

-Achieve sterilization by oxidation of molecules Ex: static air sterilizers- chamber uses heating coils to bring unit up to temperature Forced air sterilizers- heated forced air is circulate at high velocity

Tetracycline stain

-Antibiotic was easily absorbed by bones and teeth. Could also be transferred through the placenta during 3rd trimester -believed that tetracycline bonds with calcified tooth structure during development -appears light green to dark yellow or gray-brown

What are the Categories for Care plan Centered goals?

-Cognitive goal -Psychomotor goal -Affective goal -Oral health status goal

Name the characteristics of a well-written dental hygiene care plan

-Consistent with patient needs and readiness to change -Reflects goals of care -Identifies a relationship among the dental hygiene diagnoses, patient goals and interventions -Is compatible with the dental treatment plan prepared by the dentist -Identifies the dental hygienists responsibilities, if any, for fulfilling components of the dental treatment plan or interdisciplinary healthcare plan _Reflects current standards of evidence-based care -Meets the patients psychosociocultural and physical needs -Reflects the dental hygienists role as a clinician, educatior, administrator or manager, researcher, and advocate -Esablishes priorities of care

Oral epithelium (outer gingival epithelium)

-Covers the free gingiva from the gingival groove over the gingival margin. -Composed of keratinized stratified squamous epithelium

Causes for changes: Position of gingival margin

-Edematous or fibrotic -junctional epithelium has migrated along the root; gingival margin follows

Causes for Changes: Size

-Edematous: inflammatory fluid, cellular exudate, vascular engorgement, hemorrhage -Fibrotic: new collagen fibers

Changes in disease: Position of gingival marign

-Enlarged gingiva: margin is higher on the tooth, above normal, pocket deepened -Recession: margin is more apical; root surface is exposed

What are injectable drugs in the emergency kit or cart?

-Epinephrine via autoinjector -Diphenhydramine -Cortisone -Glucagon -Midazolam -Atropine

In regards to the Components of the Overall Dental Care Plan, name the components in "Restorative Phase: Phase III Therapy"

-Final restorative care -Fixed and removable prosthodontic appliances -Evaluation of response to restorative procedures

Why will a root surface demineralize quicker than enamel?

Because of the lower critical pH

How are interventions like goals?

Both are linked to the dental hygiene diagnosis or problem

The only portions of the dentinal tubules that innervated with nerve fiber endings from the pulp chamber are those closest to the pulp. The tubules in sensitive areas are wider and more numerous and are open. True/False?

Both sentences are true

Gingival infections are confined to the gingiva. Periodontal infections include all parts of the periodontium.

Both statements are true.

Malocclusion may be a predisposing factor in the retention of plaque biofilm. Plaque biofilm retention is a causative factor in dental caries disease and in periodontal disease.

Both statements are true.

Periodontitis can be associated with an endodontic lesion. Root fractures are classified as an acquired deformity or condition, according the Classification of Periodontal Diseases and Conditions.

Both statements are true.

What is a heartbeat under 50 BMP called?

Bradycardia

Chemical disinfectant categories

By their biocidal activity as high, intermediate, or low level

Key components of Motivational Interviewing:

Expressing empathy, acceptance, & respect for patient; recognizing inconsistencies between current actions/behaviors & patient's own health-related goals; recognizing, understanding, & exploring resistance to change; eliciting self-motivation discussion; supporting self-efficacy.

Tests for sterilization

External chemical indicator Internal chemical indicator Biologic monitor

What is a complete examination?

Extra and Oral examination

Which of the following is considered a congenital abnormality?

Extra or missing cusps

If a tooth is missing, which of the following is most likely to occur due to the position of remaining teeth?

Extrusion of opposing tooth

Who regulates "clears" sterilization equipment?

FDA (food and drug administration)

fluoride varnishes

FDA approved these products for use only as cavity liners and for hypersensitivity, 5% sodium fluoride from tube: discard any clear varnish bc ingredients have separated from packet: mix varnish, then apply

Care of sterile instruments

Instruments stored with sealed wrappers are only momentarily sterile because of airborne contamination Labeled, sterilized and sealed packages are stored unopened in clean dry cabinets or drawers Packages wrapped and sealed in paper may not need resterilizing for several months to 1 years

Cleaning procedures

Instruments washer/thermal disinfector Ultrasonic processing Manual cleaning

Boundaries of gingival sulcus

Inner: tooth surface. may be the enamel, cementum, or part of each, depending on the position of the JE Outer: sulcular epithelium Base: "probing depth", "depth of the sulcus", "bottom of the pocket"

How is having an automated informed consent document linked to the dental hygiene care plan helpful?

It ensures that this step will not be overlooked

Moist heat: steam under pressure Use

May be used for all materials except oils, waxes and powders that are impervious to steam for materials that cannot be subjected to hight temperatures

Which of the following describes Class IV furcation?

Severe involvement, probe can be passed between the roots through the entire furcation with exposure resulting from gingival recession.

Which of the following describes Class III furcation?

Severe involvement, probe can be passed between the roots through the entire furcation.

What is the purpose of planning?

To develop a strategy of care that results in the resolution of an oral health problem open to dental hygiene care, the prevention of a problem, or the promotion of oral health and well-being

Packaging purposes

To prevent contamination of newly sterilized instruments as soon as they are removed from the sterilizer To provide means of storing instruments to keep them in sets for individual appointment use and sterilized and ready for immediate use on opening

External chemical indicator

To seal the package and change color to show the autoclave temperature has been reached

What is the function of respiration?

To supply oxygen to the tissues and to eliminate carbon dioxide

When designing a strategy for the prevention of oral pain in patients with poor oral status, which strategy applies? Recommend use of non-sucrose-containing candies and gum Encourage use of over the counter saliva substitutes Review medications Monitor patients for symptoms of abuse Train caregivers to provide regular oral inspections

Train caregivers to provide regular oral inspections

The clientele of the dental hygienist who visits the homebound represent all of the following except which of the following? Well elderly. Developmentally disabled. Critically ill. Frail elderly. Physically disabled.

Well elderly

What are biopsychosocial variables in dental hygiene diagnosis?

Traditional biologic variables, such as medical history and dental history, combined with the psychosocial variables to develop a dental hygiene diagnosis and care plan

Health

a state of complete physical, mental, and social well-being and not just the absence of disease and infirmity

How does the WHO describe health?

a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity

A dental hygiene diagnosis includes:

a statement of the problem that may be addressed within the scope of dental hygiene practice, evidence or risk indicators, and etiology of the problem

Infectious process #2: prevention of transmission: Maintain Infection Control Protocols

cdc guidelines are available

fluoride in foods

certain foods contain fluoride, meat, eggs, vegetables, cereals, fruit, tea and fish

additional transmission-based precautions: contact

direct and indirect contact

refers to making an effort to understand the language, culture, and behaviors of diverse individuals and groups

cultural sensitivity

refers to a dynamic relationship between provider and patient that results in culturally relevant and culturally specific oral healthcare recommendations, delivery of oral healthcare services in a way that is respectful of and responsive to the cultural norms and linguistic needs of individual patients

culturally effective oral health care

refers to a learned set of beliefs, values, attitudes, convictions, and behaviors that are common to a group of people and usually passed down from generation to generation

culture

3 methods for self-application

custom-made or disposable tray, rinsing, toothbrushing

the reverse process of encoding; the receiver takes the words, gestures, or other signs to recreate the thought

decoding

What does low BP indicate?

decreased cerebral blood flow

Infectious process #1: essential features for disease transmission: transmission

direct/indirect contact, inhalation, coughing, sneezing

Stain in dentin

discoloration resulting from a carious lesion -arrested decay or secondary dentin present as a black stain on teeth. Surface is hard and glossy

refers to one-on-one communication between two people; in contrast to communication among a group or from one person toward a group of individuals

diadic

What should you do when a care plan includes multiple dental hygiene diagnoses?

discuss all the elements of ONE dental hygiene diagnosis before introducing a subsequent condition

Dental caries

disease of dental calcified structures characterized by demineralization of mineral components and dissolution of organic matrix

distribution and retention

distributed to all tissues and organs, stored as part of teeth and bones, once enamel is matured its fluoride is deposited during development can be altered by various processes

Language proficiency:

simplify language; eliminate professional jargon; use pictures; provide "plain language" health info publications

What are Korotkoff sounds?

sounds heard when taking blood pressure

fluoride metabolism

sources of intake: drinking water, dietary supplements, foods, beverages prepared at home or commercially using fluoridated water, varying amounts ingested from dentifrices, mouthrinses, supplements and other fluoride products used by the individual

•General health conditions

special healthcare needs, eating disorders, medication (xerostomia), drug/alcohol abuse, chemo/radiation therapy

Diffuse

spread out, dispersed; affects gingival margin, attached gingiva, interdental papillae, and alveolar mucoasa. frequently localized, rarely generalized

Disturbances in tooth development can cause?

staining ex: amelogenesis imperfecta. Dentinogenesis imperfecta

interventions to break chain of disease transmission: break chain of port of entry

standard precautions, immunization

Intervention strategies must be selected carefully to ensure what?

the care plan addresses the fundamental causative factor

attachment apparatus

the cementum, periodontal ligament, and the alveolar bone

EBP

the conscientious use of current best evidence in making decisions about patient care

Sulcular epthelium of gingivial sulcus

the continuation of the oral epithelium covering the free gingiva. not keratinized

Location of gingival sulcus

the crevice or groove between the free gingiva and the tooth

Generalized

the ginigva is involved about all or nearly all of the teeth throughout the mouth, also throughout a single arch, maxillary or mandibular

How many times stronger is hydrogen peroxide than carbimide peroxide?

three times stronger

periodontium

tissues surrounding and supporting the teeth

Why is the term "continued-care" used rather than "recare or recall visit"?

to emphasize the supportive role of the dental hygienist in the patient-clinician relationship

benefits of fluoride dentifrice

twice daily > once daily, use of dentifrice with fluoride concentration of 1,000 ppm has been shown to reduce caries rate by 23% when compared to dentifrice without fluoride

How should you position a patient that has high blood pressure in a emergency situation?

upright

HAART (highly active antiretroviral therapy)

use of combinations of drugs to treat AIDS

Standard precautions: syring needles

use safe recapping and disposal methods to prevent accidental needle stick

communication with school-aged children

use third-person statements to overcome anxieties; assess child's knowledge & misconceptions

What is external tooth bleaching used for?

used for both vital and nonvital teeth

topical fluoride products

used intraorally for variable amounts of time, provide fluoride to exposed crown and root surfaces

HBV: preventions

vaccine available edu standard precautions prenatal testing enforced blood bank rules sharps safety

HCV: preventions

vaccine available edu standard precautions prenatal testing enforced blood bank rules sharps safety

HPV: prevention

vaccine for children 11-12, women thru 26, men thru 21, young men who have sex with men up to 26, transgender to 26, immunocompromised thru 26

infant formula

variable, may be reconstituted with fluoridated water, formula packing should be consulted to determine fluoride level (0.11-0.57 ppm), fluoride level are low in breast milk

What are the uses of the medical emergency report form?

-evaluation for planning appointments so future emergencies for patient can be avoided -provide reference in the event legal questions arise

At the continued-care visit, identify and document the following:

-evidence of the patients long-term commitment to continued health and wellness -reoccurrence and etiology of a previous need or conditions -occurrence and etiology o fa new condition or problem that may be present

Changes in biofilm microorganisms (Days 10-21)

-gingivitis is clinically evident

Changes in disease: Exudate

-white fluid, pus, visible on digital pressure -amount not related to pocket depth

If a patient has difficulty in describing or localizing the pain, what diagnostic tests or techniques will you use to determine the problem?

Ask trigger questions to elicit detailed information to characterize the pain and assist in the dental hygiene diagnosis

Information about the immediate problem, chief complaint, cause of present pain, or discomfort of any kind in the oral cavity can be found in the ________________. A. medical history B. dental history C. personal history

B. dental history

Information about the personal daily care exercised by the patient can be found in the: A. medical history B. dental history C. personal history

B. dental history

Which of the following are disadvantages of a questionnaire? A. inconsistent B. inflexible C. time-saving D. broad in scope E. impersonal

B. inflexible E. impersonal

Which communication theory is based on perception of personal control over issues related to health and includes an internal orientation and an external orientation? A) Health Belief Model B) Theory of Reasoned Action C) Self-Efficacy D) Locus of Control

D) Locus of Control

For standard general prophylaxis, which prophylaxis agent(s) can be used? A. Ampicillin B. Cephalexin C. Azithromycin D. Amoxicillin E. Cefazolin F. Clindamycin

D. Amoxicillin

All except one of the following are good communication techniques to obtain accurate and complete information. Which is the EXCEPTION? A. Express genuine interest and willingness to listen B. Be aware of nonverbal communication issues when interviewing a patient from a different culture C. Show self-confidence and gentle efficiency D. Ask more personal questions first to get out of the way E. Be friendly, understanding, reassuring, and accepting

D. Ask more personal questions first to get out of the way

Previous infective endocarditis is an example of which of the following categories? A. Diseases and drugs with manifestations in the mouth B. Allergic or untoward reactions C. Gender or ethnic/racial influences that increase risk for systemic and oral disease D. Conditions or diseases that require premedication before treatment E. Communicable diseases that endanger the dental personnel

D. Conditions or diseases that require premedication before treatment

Gingiva is made up of?

free gingiva, gingival sulcus, JE, interdental gingiva, attached gingiva, mucogingival junction, alveolar mucosa,

Interradicular fibers

from cementum between the roots of multirooted teeth to the adjacent bone to resist vertical and lateral forces

Alveolar crest fibers

from the alveolar crest to the cementum just below the cementoenamel junction to resist intrusive forces

Horizontal fibers

from the cementum in the middle of each root to adjacent alveolar bone to resist tipping of the tooth

Transseptal fibers

from the cervical area of one tooth across to an adjacent tooth (on mesial or distal only) to provide resistance to separation of teeth

Oblique fibers

from the root above the apical fibers obliquely toward the occlusal to resist vertical and unexpected strong forces

Apical fibers

from the root apex to adjacent surrounding bone to resist vertical forces

Signs of health: Position of gingival margin

fully erupted tooth; margin is 1-2 mm above cementoenamel junction, at or slightly below the enamel contour

tray technique

gel or foam select proper tray size/fit, design of trays (multiple), no more than 2 mL of gel placed in each tray for children, no more than 5 mL placed in each tray for adults, thin ribbon in each arch

HHV-1: Herpes labialis (cold sore, fever blister)

genital and oral facial infection that can't be distinguished clinically

Steam autoclave microorganism spore test

geobacillus stearothermophilus vials, ampules, or strips

Evaluation methods must reflect the intent of the ______________________.

goal statement

black line stain

gram positive bacteria; located 1mm from gingival margin contour. Common of facial and lingual surfaces -no definitive etiology

What is a bulla?

greater than 1 cm, contains serum or blood

touch as a form or component of communication

haptics

The periodontium

is the functional unit of tissues that surrounds and supports the tooth. consists of periodontal ligament, cementum, and bone

Why does the nature of the smear layer constantly change?

it is subject to effects such as mechanical disruption from ultrasonic debridement, or dissolution from acid exposure

based on perception of personal control over issues related to health: internal (personal actions determine health status) vs. external (external factors determine health status)

locus of control

chronic toxicity

long-term ingestion of fluoride in amounts exceeding approves therapeutic levels

What diseases are contraindicated from high concentration of oxygen?

lung diseases such as, emphysema

Oral Lesions Strongly Associated with HIV Infection: Kaposi's sarcoma

main type of cancer to affect HIV patient and is oral malignancy co-existing with HHV-8

fluoride excretion

mainly excreted through the kidneys (small amounts by sweat glands and in feces), limited transfer/excretion through breast milk

Describe how fluoride varnish works

maintains prolonged contact with the tooth surface by serving as a reservoir to release fluoride ions in response to pH changes in saliva and biofilm

Signs of health: Mucogingival junctions

make clear demarcation between the pink, stippled, attached gingiva and the darker alveolar mucosa with smooth shiny surface

communication form one source intended to reach a large group of individuals

mass communication

methods of communication that uses technology to reach a large, diverse audience

mass media

dentin

may have higher levels of fluoride in dentin than enamel, inner surface has higher concentration

ADHA standard 5, Evaluation

measurement of the extent to which the patient has achieved the goals defined in the dental hygiene care plan, continuous process

pre-eruptive

mineralization stage; fluoride deposited during formation of enamel, hydroxyapatite become fluorapatite (less soluble)

HHV-4: preventions

minimize contact with saliva by hand washing, not drinking after others, standard precautions

community water fluoridation

most common systemic fluoride delivery is via the community water supply, in 2010 - approximately 66% of the US population received fluoridated water

fluoride

most effective method for caries prevention/control, naturally occurring salt of hydrofluoric acid, as a preventative agent may be delivered systemically or topically

Type 2 embrasure

there is slight to moderate recession of the interdental gingiva

Oral prophylactic premedication is required ______ subgingival instrumentation begins. A. 1 hour after B. immediately after C. immediately prior to D. 2 hours prior to E. 1 hour prior to

E. 1 hour prior to

What should the dental hygienist do if a patient requests care that is unwarranted, inappropriate, or dangerous?

the dental hygienist should refuse to provide the care and encourage the patient to seek a second professional opinion

What part of the toot is primarily color changed?

the dentin

What happens to the dentinal tubule orifice in the presence of biofilm?

the dentinal tubule orifices increase to three times the original size

probing depth

the distance from the gingival margin to the location of the periodontal probe tip inserted for gentle probing and the attachment

Localized

the gingiva is involved about a single tooth or a specific group of teeth

Type 1 embrasure

the gingival tissue fills the area

What makes calculus easy or difficult to remove?

the manner of attachment of calculus to the tooth surface

does assessment in continuing care follow the same procedures as for new patients?

yes

are vital signs and extra/intra oral exams documented?

yes, they are documented

Supplemental recommendations:

• clean exposed areas of face • smoking and eating/drinking are banned in treatment rooms • reception area toys and other items need to be cleaned/disinfected. Provide hand sanitizer in waiting room • sterilization monitoring- keep written record of dates when processing tests/biological monitoring. Mark dates for next testing on calendar. Perform tests weekly on same day to ensure compliance • office policy manual should outline standard precautions and emergency procedures

ADA Caries Risk Assessment ( low, moderate, high risk)

•Contributing conditions •General health conditions •Clinical conditions

Tooth position can be a factor in disease development. Which of the following is NOT considered a factor due to *tooth position*?

Missing cusps

Both correct

Pre-procedural rinsing and other oral hygiene measures help to prevent the spread of communicable diseases. Pre-procedural rinsing and other oral hygiene measures decrease the number of microorganisms in the oral cavity

Manual cleaning

Precautions needed when only alternative Heavy duty gloves, eyewear and mask Use detergent and scrub Brush stokes away from body Rinse Dry on paper towels

Clinician's chair

Smooth, plactic seat cover that is easily disinfected and has a minimum of seams and creases Set (before gloving) at correct height for individual clinician

Calculus formation time

Soft deposit to change to mature mineralized deposit is 12 days -mineralization can begin as early as 24-48 hours

Materia alba

Soft white tooth deposit that is clinically visible. Cottage cheese-like texture and appearance -unorganized accumulation of living and dead bacteria, desquamated epithelial cells, disintegrative leukocytes, salivary proteins, and food debris

person-centered care

a way of thinking and doing things that sees the people using health and social services as equal partners in planning, developing, and monitoring care to make sure it meets their needs

Chronic periodontitis is classified using which of the following?

a, b, and c only

List some action verbs that can be used to denote patient behavior expected in the goal..

affirm, attend, choose, communicate, complete, define, demonstrate, decrease, eliminate, increase, perfome, replace, etc.

food debris

after eating food, remnants may collect near cervical 3rd of teeth and in proximal embrasures -vertical food impaction occurs during mastication if patient has open contacts. If left unattended, food accumulation can contribute to dental caries and oral malodor

HHV-3: Shingles (herpes zoster)

after infection it remains latent in dorsal root and cranial ganglia

When does secondary dentin form?

after the tooth is completely formed

additional transmission-based precautions: airborne

air ventilation is required

The dental hygiene care plan identifies:

all supportive dental hygiene intervention strategies, facilitates the monitoring of patient progress, ensures continuity of care, serves as a vehicle for communication between the IPC team, and increases the likelihood of high quality care

What does the community drug take back program do?

allow public to bring unused drugs to a central location for disposal

Psychomotor Goal

focuses on patient skill development and skill mastery

What is blood pressure?

force of blood against arterial walls

suppuration

formation of pus

Internal chemical indicator

Color change assesses instruments exposure to temperature and steam for the required time

Instrument washer

Uses high-velocity hot water and a detergent to clean instruments (some are equipped to dry)

Molar Relation of Normal Occlusion

- Mesiobuccal cusp of maxillary 1st permanent molar occludes with buccal groove of mandibular 1st molar - Occlusal force is greater on posterior teeth than anterior

Appearance of Dentin Defects

- Opalescent brown discoloration - Progressive pulp obliteration

CDT means?

Current Dental Terminology

What is HN?

Human Needs (method)

What is a blisterform lesion?

Fluid filled, transparent lesion

What does dentin exposure lead to?

Hypersensitivity

What is an autoclave

It is sterilization achieved by steam under pressure

Transmission takes place soon after tooth eruption

Most likely from mother

How is pulpal pain characterized?

Severe, intermittent, throbbing

Dry heat

The action of dry heat is oxidation

hyperkeratosis

abnormal thickening of the keratin layer of the epithelium

Fluoride varnish 5% is

bactericidal

study of the meaning of language

semantics

HHV-2: antiviral therapy

to suppress disease

Infectious process #2: prevention of transmission: Inteuption of Transmission

rubber dam high-volume evacuation manual instrumentation air control infection control protocols

HHV-4: transmission

saliva even when no symptoms of disease

What does the pulp chamber look like as aging occurs?

secondary dentin accumulates, resulting in a smaller pulp chamber with fewer nerve endings and less sensitivity

based on belief that actions will affect outcome; gained by experiencing success, learning from success of others, & verbal persuasion; low self-efficacy in one area can offset high self-efficacy in another

self-efficacy

How should you position a patient that has low blood pressure in a emergency situation?

semi-spine

Communication process:

sender encodes & transmits message to receiver, who decodes message; receiver then becomes sender of return message; effectiveness of message depends on compatibility of encoding & decoding

What is the first steps in preparing for managing emergencies?

setting up the emergency equipment and a systematic protocol

Attrition

Wearing away of a tooth as a result of tooth-to-tooth contact

The term iatrogenic refers to

a result of treatment by a professional person.

Etiology

cause of disease

organisms of microorganisms of the oral cavity: origin

in utero the oral cavity is sterile but few hours after birth, simple oral flora develops

Intermediate level disinfectant

inactivate all forms of microorganisms but do not destroy spores

High level disinfectant

inactivate spores and all forms of bacteria, fungi, and viruses. Either a disinfectant or a sterilant.

Low level disinfectant

inactivate vegetative bacteria and certain lipid-type viruses but do not destroy spores, tubercle bacilli, or nonlipid viruses.

Why is oxygen not indicated in the presence of hyperventilation?

patient is receiving increased amounts of oxygen in air inhaled and is in need of carbon dioxide

indications for professional topical application

patients at elevated risk of developing caries, 5% NaF varnish at least every 3-6 months, 1.23% APF gel 4 minutes trays at least every 3-6 months, patients at low caries risk may not benefit from addition treatment

Subsurface initial caries lesion is formed and appears

white spot lesion

Dentoperiosteal fibers

(alveolar crest) from the cervical cementum over the alveolar crest to blend with fibers of the periosteum of the bone

Alveologingival fibers

(attached gingiva) from the alveolar crest into the free and attached gingiva to provide support

Circumferential fibers

(circular) continous around the neck of the tooth to help to maintain the tooth in position

Dentogingival fibers

(free gingiva) from the cementum in the cervical region into the free gingvial to give support to the gingival

Describe a procedure manual?

- can be paper but electronic format is currently excepted -needs to be accessible from a computer located in the clinic -reviewed and updated 3 to 4 times a year -useful during orientation of a new member -contains work assignments and checklists for equipment and resources -provides reference info concerning specific emergencies organized in color-coded sections and alphabetical order to outline signs, symptoms, and initial treatment -members of team are given assignments to update the manual by conducting a critical review of the scientific literature for quality assurance and evidence based patient centered care -all updates are referenced in the index of the manual

Biofilm Significance

-biofilm initiates and progresses dental caries and periodontal disease caused by pathogenic microorganisms -biofilm forms dental calculus!

Biofilm heaviest and lightest locations

-biofilm is heavily seen on lingual, postural, and proximal surfaces -anterior surfaces have the least biofilm

Detection of biofilm: use of explorer or probe

-biofilm may be disturbed passing side of probe or explorer over the suspected tooth surface

Unit water lines

-biofilm of microorganisms can form on the inside of the tubings after overnight standing -purging lines reduces microbial counts -contaminated water cannot be used for surgical purposes or during the irrigation of pocket areas

What disorders can be suspected or discovered from extra oral palpation, skin color changes, abnormalities of the eyes, and asymmetry of the face or neck?

-blood disorders and endocrine disorders

Before injection of anesthetic

-microorgansims can be carried into tissue when administering anesthetic. Applying topical antiseptic can decrease this risk

Presentation of the dental hygiene care plan will include:

-nature of condition -proposed care plan -risks involved (if any) -potential for failure -alternative treatment options

A normal saliva pH is ______ which in neutral, when sugar is broken down inducing acids, it will cause an acidic environment in the mouth to critical pH 5.5 to demineralize. It takes at least _____ min or more for the saliva pH to buffer.

- 7 -30

Professional and Prescribed Applications

- Chlorhexidine 0.12% - Neutral sodium fluoride 1.1% Rx - Fluoride varnish 5% (strongest)

Occurrence of Abrasion

- Exposed root surfaces - Incisal edge or on occlusal surface

Causes of Erosion

- Extrinsic acids: occupational, food, drugs - Intrinsic acids: eating disorders, acid reflux, alcohol abuse

Bruxism

- Grinding teeth - Sleep and awake - Predisposing factors: stress, occlusal interferences, foods, tobacco use - Sleep in children may be related to secondhand smoke

Normal Occlusion

- Ideal mechanical relationship between teeth of the maxillary arch and mandibular arch - Even bilateral distribution of occlusal forces between arches is symmetrical

Occurrence of Attrition

- Location: occlusal, incisal, proximal surfaces - Cumulative over time: increased age=increased attrition - More seen in men than women of comparable age

Posterior Crossbite

- Maxillary or mandibular posterior teeth are either facial or lingual to their normal position - May occur bilaterally or unilaterally

Underjet

- Maxillary teeth are lingual to mandibular teeth - Measurable horizontal distance between the labioincisal surfaces of the maxillary incisors and the linguoincisal surfaces of the mandibular incisors

Facial Profile of Normal Occlusion

- Mesognathic: slightly protruded jaw, flat appearance

Causes of Abfraction

- Multifactorial - Dentin demineralization may increase risk of abfraction

Assessments of Occlusion

- Normal occlusion - Malocclusion - Malrelations of groups of teeth - Malpositions of individual teeth - Dynamic (functional) occlusion - Traumatic occlusion

Causes of Abrasion

- Originates from mechanical abrasion and cervical areas are most commonly affected tooth surface - Abrasiveness of dentifrice, stiffness of toothbrush bristles, and area where patient first begins brushing - Occupational causes: cement factories, granite workers

Occurrence of Abfraction

- Primarily on buccal surfaces - Wedge or V-shaped lesions with sharp angles

Saliva is a ____ for ____. This aids in remineralization.

- Reservoir - Fluoride

Initial Lesion of Attrition

- Small shiny, flat, worn spot on surface of tooth known as a facet - Found on cusp tip or ridge, slight flattening of an incisal edge

Appearance of Erosion

- Smooth, shallow, hard, shiny (dental caries contrast this and are soft and discolored) - Shape varies - May progress to involve dentin and stimulate secondary dentin - May occur in combo with caries, calculus, or restorations

Saliva also

- Supply minerals to replace Calcium and Phosphates ions - Hyposalivation or xerostomia reduces buffering capacity - Derived fluoride from all sources - Help with speech, and lubrication

Local insults to developing tooth may include:

- Trauma - Periapical inflammation of primary tooth may injure the developing permanent tooth

Appearance of Abfraction

- V or wedge shaped with hard, smooth, shiny surface and clearly defined margins - Initially on exposed cementum, then extend to dentin - SHARP ANGLES

Appearance of Abrasion

- V or wedge-shaped with hard, smooth, shiny surface and clearly defined margins - Initially on exposed cementum, then extend to dentin

Overbite

- Vertical overlap - Vertical distance by which maxillary incisors overlap the mandibular incisors - Normal, moderate, deep (severe), very deep

Deep (Severe) Overbite

- When the incisal edges of the maxillary teeth are within the cervical third of the mandibular teeth. - VERY DEEP: When in addition, the incisal edges of the mandibular teeth are in contact with the maxillary

what other types of aids are used for flossing?

- floss threader (flexible plastic needle with thread attached)(used for biofilm removal form M to D abutments and under prosthesis). - tuft dental floss (regular floss with thickened tuft portion)(used for biofilm removal form M to D abutments and under prosthesis). - floss holder (helpful for people with disabilities, parents, or caregivers). - gauze strip (for proximal surfaces of widely spaced teeth. surfaces of teeth next to edentulous areas) - power flossers (battery operated)

Charters method

- indications - loosens debris and biofilm, stimulates marginal and interdental gingiva. good for PTs with incisive papilla loss, fixed prosthetics. - procedure: bristles at 90°, press bristles gently between the teeth being careful not to injure the gingiva. - limitations: brush ends do no engage tthe gingival sulcus to disturb subgingival bacterial accumulations.

Fones method

- indications: best for small children. - procedure: 90° to long axis of teeth, press brush gently against teeth, circular motions - limitations: efficiency of plaque removal was the lowest.

Stillman method

- indications: massages and stimulation and cleaning cervical areas. - procedure: angle bristles 45° toward the apex with 1/2 of bristles placed on tooth, the other half on the gingiva, use slight rotary motion - limitations: light pressure is needed, right placement is necessary to prevent laceration.

Rolling Method

- indications: removing biofilm, materia alba, food debris (without emphasis on gingiva). used in conjunction with bass, charters, and stillman. - procedure: filaments apically, roll brush slowly over teeth. - limitations: brushing too hard can lacerate alveolar mucosa, minimal plaque removal.

Bass method

- indicatiton: biofilm removal. most commonly accepted brushing technique - procedure: bristles directed apically into sulcus @ 45°, vibratory strokes (at least 10 strokes). - limiation: aggressive brusher may tturn intot vigorous horizonttal and injure the gingiva.

factors that are considered when making a mouthrinse recommendation:

- is PT currently able to control biofilm through other methods? - does PT consider rinsing a substitute for other mechanical procedures such as brushing and interproximal biofilm removal? - does the PTs substance abuse contraindicate recommending alcohol -containing mouthrinses? - could PTs xerostomia worsen by drying effect of alcohol?

Infection control objectives

- reduction of pathogenic microorganisms to a level at which normal resistance mechanisms of the body can prevent infection -elimination of cross contamination by breaking the chain of infection -application of standard precautions by treating each patient as if all human blood and body fluids are infectious

what types of interdental brushes are there?

- small insert brushes with reusable handle - travel interdental brush (stainless steel plastic-coated wire) - rubber interdental cleaners (soft-pick is effective at biofilm removal) (it is suggested that interdental brushes should be the first choice for interproximal cleaning)

Steam under pressure: principles of action

- sterilization is achieved by heat. Pressure helps attain high temperature -sterilization depends on penetrating ability of steam -Air must be excluded -space between objects is essential -air discharged in downward direction to bottom of autoclave

For a low likelihood patient

- toothbrushing 2x/day with fluoride toothpaste (>1,000 ppm - Motivational engagement, maintain dental visits at risk-based intervals

Moderate Likelihood

- toothbrushing 2x/day with higher efficacy fluoride toothpaste (>1,450 ppm F) or High F prescription - general behavior modification in oral health - prescribed F mouth rinse - Motivational engagement, maintain dental visits at risk-based intervals - sealants - F varnish 2x/year -F gels or solution (2% NaF) -Recalls up to three months - Motivational interviewing - One-to-one dietary intake interventions - Altering medication-induced hyposalivation - Reducing the use of recreational drugs

what are the inactive ingredients of mouthwash?

- water (largest percent of volume) - alcohol (increases the solubility of some active ingredients) - flavoring (essential oils and derivatives)

How many liters per minute is started in supplemental oxygen?

-4 to 6 liters per minute

What manual is updated regularly to reflect the most current information and procedures to follow when responding to an emergency situation?

-AHA BLS for Healthcare Providers Manual

How should you handle a patient that has stress/ anxiety about dental visits?

-Initial appointment for consultation and assessment -Stress reduction can be built into treatment appointments -Plan the time of appt according to personal health requirements -Make a first morning appointment so patient does not have to wait all day -Take patient into treatment room immediately and starting treatment promptly -identify usual mealtime -ask about previous meal eaten to prevent stress or hypoglycemia -limit length of appointment to patient's tolerance

Selecting a realistic time frame for each goal will allow the patient ample time to do what?

-Internalize information -Practice new skills -Experience physical and attitudinal changes related to oral health and wellness -Assess the importance of these changes to their lifestyle -Adopt the new behavior

What are advantages of assignments?

-Keeps personnel is well organized -Relieves pressure by sharing responsibilities -Duties can be carried out quietly -Necessary work gets done without duplication and without omissions

Signs of health: Shape

-Marginal gingiva: knife-edged, flat, follows a curved line about the tooth -Papillae: 1.normal contact: papilla is pointed and pyramidal: fills the interproximal area 2.space (diastema) between teeth; gingiva is flat or saddle shaped

What is listed when recording a drug?

-Name -Dosage -Date purchased -Address of source if different from usual pharmacy -Itemized record, signed by the staff member responsible -Specific entry as each drug is used -Expiration dates checked at routine intervals -Instructions for disposal

The appointment schedule specifies the following:

-Number of visits -Time needed for each visit -Interventions to be implemented at each visit

In regards to the Components of the Overall Dental Care Plan, name the components in "Nonsurgical Phase: Phase I Therapy"

-Patient education and self-care instruction -Dietary guidance (caries risk management & prevention, tissue healing) -Smoking cessation counseling -Fluoride and remineralization therapy -Placement of pit and fissure sealants -Therapeutic periodontal debridement -Hard-tissue desensitization -Correction of restorative and prosthetic irritation factors, excavation of caries and restorations -Antimicrobial therapy -Occlusal therapy, minor orthodontic movement -Coronal polishing

Procedures following exposure

-Perform basic first aid to clean area affected. Immediately wash wound or flush nose, mouth, eyes, skin -report to designated official -complete incident report -follow required posted procedures of individual practice setting -immediately seek medical evaluation -pt may be present and agree to accompany dental provider for medical evaluation/testing -if baseline test is negative, post 6-week testing may be recommended -obtain counseling services if necessary -report signs and symptoms associated with heptatitis of HIV -obtain further medical evaluation if ill involving rash etc

In regards to the Components of the Overall Dental Care Plan, name the components in "Maintenance Phase: Phase IV Therapy"

-Periodic reassessment of oral health -Supportive, preventive, and therapeutic periodontal maintenance therapy -Self-care education -Evaluation and recommendation for scheduling continued-care interval

In regards to the Components of the Overall Dental Care Plan, name the components in "Surgical Phase: Phase II Therapy"

-Periodontal therapy, including placement of dental implants' -Endodontic therapy

In regards to the Components of the Overall Dental Care Plan, name the components in "Phase I: Evaluation of Response to Nonsurgical Therapy"

-Reassess gingival inflammation, bleeding and pocket depth, hard and soft deposits, host response, and caries risk factors -Review and reinforcement of self-care -Debridement of residual hard and soft deposits -Recommend a schedule for Phase IV Maintenance Therapy

Goals of Successful Periodontium Treatment

-Recognize normal, healthy tissue -Educate, monitor daily oral selfcare -Apply periodontal and preventive care knowledge to treatment

In regards to the Components of the Overall Dental Care Plan, name the components in "Preliminary Phase: Emergency Care"

-Relief of pain -Laboratory tests for suspected pathological conditions -Emergency needs -Extraction of hopeless teeth (some cases postponed to later phases of care) -Provisional replacement to restore function, as needed (may also be postponed) -Referral for suspected undiagnosed medical condition or risk

Remove the Nidus of Infection

-Restorations of all carious lesions -Well-placed and well-seal restorations -Sealants

What are the required equipment in the emergency kit or cart?

-Series E portable oxygen tank -Automated external defibrillator (AED) -Oro- and nasopharyngeal and airways -Sphgmomanometer -Magils forceps -Syringes -Medical Emergency Report forms -Criothyrotomy equipment -Intravenous equipment

Sterilization methods

-Steam under pressure (autoclave) -Dry heat -Chemical vapor -Immediate-use steam sterilization (flash) -Chemical (cold) sterilization-NOT RECOMMENDED

Periodontal Ligament

-The fibrous connective tissue that surrounds and attaches the alveolar bone to the cementum -composed of connective tissue cells and intracellular substance -sharpey's fibers -2 groups: gingvial and principal fiber

What is compensating?

-When patients experience a fight or flight reaction -vitals are elevated above base line findings

What is decompensating?

-When vital signs have fallen below base line findings

Stain removal of stains incorporated within the tooth

-Whitening procedures may be used to remove intrinsic staining

Each goal should have each of the following:

-a subject -a verb -a criterion for measurement -a time dimension for evaluation

Biofilm formation: Stage 1- Formation

-biofilm forms with initial attachment of planktonic bacterial cells to the pellicle on the tooth surface -stage is reversible if cells are disrupted with oral self care activities

What should be noted during the first contact with the patient?

-abnormalities of patients voice on telephone during scheduling -handwriting on medical history can indicate steadiness, ability to communicate, and education -assess overall appearance and gait when patient enters office -document findings in record

pH of biofilm

-acid formation begins immediately once cariogenic substance is taken into biofilm causing a drop in pH of biofilm -enamel demineralizes at 5.5 pH and lower -root surface demineralization is higher at 6.2-6.4 due to lower mineral content

Name some Clinician actions if a patient refuses care

-acknowledge patients concerns -clarify proposed plan of care -discuss consequences of not receiving recommended care -recommend alternative treatment options, when appropriate

What type of drugs may be associated with photosensitivity and hyperpigmentation when light activated whitening agents are used?

-acne meds -anticancer -antidepressants -antiparasitics -antipsychotics -diuretics -hypoglycemic -NSAIDS

Changes in disease: Surface texture

-acute condition: smooth, shiny gingiva -chronic: hard, firm, with stippling, sometimes heavier than normal

Causes for changes: Consistency

-acute: edematous: fluid between cells in connective tissue -chronic: fibrotic: collage fibers

Causes for Changes: Color

-acute: inflammation, capillary dilation, increased blood flow -chronic: vessels engorged, blood flow sluggish, venous return impaired, anoxemia, increased fibrosis -attached ginigiva: deepening of pocket, mucoginigival involvement

Causes for changes: Surface texture

-acute: inflammatory changes in the connective tissue; edema, cellular infiltration -chronic: fibrosis

Selection of sterilization methods:

-all items are sterilized in different ways -sterilization method used my destroy all miroorganisms, viruses, and spores but not damage the instruments

What should be in a comprehensive recording keeping?

-all medical findings and changes -treatments provided such as, type and amount of local anesthesia, general anesthesia, nitrous oxide, or other types of sedation -regimens of medications prescribed for patients

Preliminary planning of prepping treatment room

-all surfaces/items used during appointment is categorized as critical, semi-critical, or noncritical -all surfaces should be cleaned at end of every work day -use efficient procedural system to prepare treatment room with limited time

Principal fiber groups

-also called the dentoalveolar fiber groups -apical fibers, oblique fibers, horizontal fibers, alveolar crest fibers, intrerradicular fibers

What are some drugs used in dentistry?

-anesthesia (local, general, conscious sedation) -Tranquilizers -Pain medications (CNS depressants) -Antibiotics

What are non-injectable in a emergency kit or cart?

-antiplatelet: (aspirin) -respiratory stimulant (ammonia vaporoles) -Bronchodilator (albuterol) -Anti-hypoglycemic (glucose gel, glucagon paste) -Vasodilator (nitroglycerine tablets, nitrolingual spray) -Diphenhydramine tabets

what do you need to take notes on while reviewing the patients history?

-any new conditions, medications, hospitalizations and illnesses

Causes for change: Mucogingival junctions

-apical migration of the JE -attached gingiva decreases with pocket deepening -inflammation extends into alveolar mucosa

How do you use supplemental oxygen in a emergency situation?

-apply full face clear mask or nasal cannula -supplemental oxygen is started at 4 to 6 liters per minute -monitor breathing; if breathing stops, proceed with positive pressure oxygen

How do you use positive pressure oxygen?

-apply full face mask so that tight seal is formed -one dental team member may need to apply pressure to face mask to maintain complete seal -adjust oxygen flow so that the positive pressure bag remains filled -compress the bag manually, one ventilation every 5 to 6 seconds to provide 10 to 12 respirations per minute for adult -for a child, 1 ventilation for every 3 seconds -watch chest rise -when chest does not rise, recheck airway for obstruction -proceed with airway obstruction management -Call EMS

Gingival fiber groups

-around the cervical area within the gingival tissues -dentogingival fibers, alevologingival fibers, circumferential fibers, dentoperiosteal fibers, and transseptal fibers

Position of JE

-as the tooth erupts, the attachment is on the enamel; during eruption it migrates to the CEJ -at full eruption, attachment is on the cementum where it becomes fully attached

How do you turn on the laminate and affix to the oxygen tank?

-attach oxygen delivery system to tank -turn key on top of tank in counterclockwise direction to open flow of oxygen -read low flow regulator knob -to increase oxygen flow: turn knob in direction arrow indicates (many regulators are opposite of sink faucets and open clockwise instead of counterclockwise) -attach oxygen delivery system from patient

How do you turn on the oxygen tank?

-attach oxygen delivery system to tank -turn the key on top of tank in a counter clockwise direct to open flow of oxygen -read low flow regulator knob turn in direction of arrow indicates to increase or open; many regulators are opposite of sink faucets and open clockwise instead of counterclockwise -attach oxygen delivery system to patient

Attrition stain

-attrition of occlusal surfaces results in loss of enamel showing a yellow or brown outline of dentin showing through

Benefits of using barriers and surface covers

-barriers/surface covers eliminate contact time required by disinfectants -chemical free, efficient, and safe

Detection of biofilm: clinical record

-biofilm control record should be used to document initial biofilm accumulation as well as changes over treatment and follow up appointments -document location and biofilm thickness. Biofilm index score may be used

Name the items to document in the event of a patients informed refusal

-brief explanation of recommended care -identify specific treatment procedure being declined -list risks and consequences to patients health without treatment -indicate date of informed refusal -include signatures of patient, dentist, and witness

Mechanism of mineralization

-calculus formation is affected by salivary flow, salivary supersaturation with calcium phosphate salts, and inhibitors/promoters of calculus formation -Inhibitors include pyrophosphate and zinc salts -Promotors include urea and silicon

Calculus attachment by means of acquire pellicle

-calculus is superficial with no interlocking or penetration present -EASILY REMOVED

Calculus and Periodontal Disease

-calculus may not cause periodontal disease but the microorganisms in the biofilm layer certainly cause inflamation -calculus acts as a reservoir for endotoxins and tissue breakdown products -pocket lining irritation stimulates more flow of GCF

Enlargement From Drug Therapy

-certain drugs used for specific systemic therapy cause gingival enlargement as a side effect -drugs including phenytoin, cyclosporine, and nifedipine

Antimicrobial agents stain reaction

-chlorhexidine, alexidine, essential oils etc are using in mouthrinses and are affective against biofilm formation -chromogenic polyphenols (tea, coffee, wine) interact with chlorehexidine and worsen staining -brown stain on tongue and teeth

Preparation of treatment room

-cleanliness/neatness of treatment room reflects character and conscientiousness of dental team -orderliness and cleanliness of treatment rooms is essential to minimizing cross contamination -occasionally view operators from patients perspective

Changes in biofilm microorganisms (Days 2-4)

-cocci dominate with increasing numbers of leukocytes -Stage when bacteria secretes EPS -biofilm matures by 72 hours and can initiate inflammatory response

Standard procedures: Patient factors

-comprehensive patient medical/dental history and make necessary referrals -ask pt to rinse with antimicrobial mouthrinse -provide protective eyewear for patient -avoid elective procedures for patients suffering from communicable conditions (ex: respiratory infection or open lesion of lips/oral tissues)

GOALS of continuing care:

-continue the healthy state attained during ACTIVE treatment -prevent reoccurrence of infection -prevent initiation of new disease -monitor educational and behavioral changes (are they doing what you taught them) -monitor risks and clinical signs of health and disease -provide specialized instructions of new restorations/appliances -offer encouragement

Name some patient reasons for refusal of care

-cost of service -fear of pain -lack of understanding -low value placed on dental care -lack of dental insurance coverage

types of calculus deposits

-crusty, spiny, or nodular -ledge or ring formation -thin, smooth veneers -finger and fernlike formations -Individual calculus islands/ spots -supragingival on subgingival deposits

Subgingical calculus examination

-dark edges of calculus (dark shadow) may be seen at or just beneath the gingival margin -air can deflect tissue from tooth to gain some visibility -use transillumination to determine if a dark, opaque, or shadow like calculus area is present -Identify calculus interference with probing subgingivally -use subgingival explorer to determine calculus present on teeth -use radiographs to detect large deposits -use endoscope to assess deep pockets and furcations

Causes for changes: Bleeding

-degeneration of the sulcular epithelium with the formation of pocket epithelium -blood vessels engorged -tissue edematous

What does the dental hygiene care plan specify?

-dental hygiene diagnosis -goals -dental hygiene interventions -appointment schedule

Supragingival calculus examination

-deposits may be seen directly or indirectly using mouth mirror -may use air and light to clinically view small deposits

Oral manifestations and lesions can be indications of many disease states, such as?

-diabetes -anemia -leukemia -lupus erythematosus -human immunodeficiency virus/acquired immune deficiency syndrome

Chemical disinfectants: Principles of action

-disinfection is achieved by coagulation, precipitation, or oxidation of protein of microbial cells and denaturation of enzymes of the cells -Disinfection depends on: contact of solution at effective concentration for optimum time period

What is the normal respiratory rate?

12-20 breaths per minute

Disinfecting environmental surfaces: Agent

-disinfection is effective because of the physical rubbing and removal of contaminate material as well as the chemical inactivation of living microorganisms -surface disinfectants are concentrated, premixed solutions, sprays, foams, impregnated wipes, and dissolves tablets

Guidelines for disposal of waste

-disposable materials (gloves, masks, wipes) contaminated with blood or body fluids are disposed in sturdy, impervious plastic bags -blood, suctioned fluids, or other liquid waste can be poured into a drain connect to sanitary sewer system -Sharp items go in the leak-proof biohazard container -human tissue, extracted teeth are disposed according to local/state environmental regulatory agencies

Relation of Crest of Alveolar Bone to the Attached Gingivial Tissue: JE

-distance b/w the base of the attachment and the crest of the alveolar bone is approximately 1-1.5mm -the distance is maintained in diesase when the epithelium moves along the root surface and bone loss occurs

What should be documented when consulting with the patients doctor?

-document telephone and written responses of consultation with doctors in patients record

Signs of health: Position of JE

-during eruption along the enamel surface -fully erupted tooth; it is at the CEJ

Instrument arrangement

-each package is dated and marked for ID of contents (ex: adult prophy, exam). May use clear packages the permit the ID of instruments without labelling -Instruments can be organized into tray systems, dental storage containers, or cassettes

Changes in Biofilm Microorganisms (Days 1-2)

-early biofilm consists of gram positive cocci ex: streptococcus mutans and streptococcus sanguinis

Regular professional continuing care

-ensure patient maintains appointments on a regular basis in addition to daily oral self care -emphasize good oral hygiene and routine professional removal to maintain low levels of supra and subgingival calculus

Significance of dental stains

-esthetics -thick deposits of stain can provide a rough surface for biofilm to collect

What do you do with the medical emergency report form?

-filed,scanned, and stored in the computerized patient record control system to include in patient's permanent record -place pad of forms comprised of non-carbon replication paper on clipboard on emergency cart -copy of emergency report is given to EMS personnel to present to ER or medical facility

How does a dental team member dispose of drugs?

-follow specific instructions on the drug label or patient info sheet -do not flush prescription drugs down toilet -take advantage of community drug take back program

Signs of health: Surface texture

-free gingiva: smooth -attached gingiva: stippled (pebbled or orange peel surface)

Where is the medical alert box located?

-front page of medical history to alert the dental team of information that may predispose the patient to a medical emergency before, during , or post dental treatment

Markers for inflammation examination

-gingival tissue changes (color, size, shape, surface texture, position) -mucogingival involvement (adequate width of attached gingiva) -probind depths; pocket formation (attachment levels) -bleeding and exudates -furcation involvement -dental biofilm and calculus present -mobility of teeth -radiographic evidence

Each goal set is evaluated to determine the degree to which it has been achieved, the dental hygienist determines one of the following outcomes:

-goal met -goal partially met -goal not met

What are traits of hydrogen peroxide?

-has a lower ph -takes less times a day but more days to color -high acidic changes

What are the traits for carbamide peroxide?

-has a slow release -has a neutral ph

What type of affects could bleaching chemicals containing hydrogen peroxide have?

-have a negative affect on restorations due to lower ph increase mercury release from amalgams -increase solubility from dental cements

Standard procedures: Factors for dental team

-have annual physical for updated medical examination and up to date immunizations -Always use appropriate PPE -Utilize thorough hand hygiene and cleansing before and after wearing gloves -develop habits to minimize contact with switches and other parts of dental unit, chair, light, stools, and avoid all environmental contacts unrelated to current procedure

Depth of suclus of gingival sulcus

-healthy sulci are shallow and may be only 0.5 mm -the average depth of the healthy sulcus is about 1.8 mm

What may happen if a patient tries to repress their fears?

-hyperventilate or experience syncopal episodes

Monthly reminder method:

-if appointment is not made at the current appointment -mail out postcards to inform patient to make appointment -list of patient recalls-from computer system

Changes in Disease: Color

-in chronic inflammation: dark red, bluish red, magenta, or deep blue -in acute inflammation: bright red -attached gingivaa: color change may extend to the mucogingival line

Benefits of ultrasonic and instrument washer vs manual scrubbing instrument

-increased efficiency with high degree of cleanliness for improved disinfection -reduced danger to clinician -elimination of possible release of microorganisms (aerosols, droplets) which occur while scrubbing

What are some factors that contribute to emergencies?

-increased number of older patients with natural teeth and dental diseases that require invasive procedures -medications that interact adversely with drugs used in dentistry -more complex dental procedures require longer appointments -increased use of drugs in dentistry

periodontal scaling and debridement:

-need for scaling/periodontal debridement -plan appropriate pain control -# of appointments -local delivery of antimicrobials -check areas of bleeding on probing, endoscopic examination or evaluation for surgical therapy

List the Rationale for Developing a Formal Dental Hygiene Care plan?

-individual care -focus care on priorities -facilitate communication and collaboration among the members of the interdisciplinary patient care team -establish patient-centered goals -provide foundation on which an evaluation of patient care outcomes is based -developing roadmap for implementing planned interventions that will achieve the desired outcomes -promote professional practice

Causes for changes: Exudate

-inflammation in the connective tissue -excessive accumulation of white blood cells with serum and tissue makes up the exudate (pus)

Before scaling and other dental hygiene instrumentation

-instrumentation can create breaks in tissue where bacteria can enter -use .2% preprocedural chlorhexidine rinse prior to services -subgingival instrumentation with broken down sulcular epithelium contributes to entrance of bacteria

Care of Sterile Instruments

-instruments should be stored with sealed wrappers. Will be contaminated if exposed to air (airborne contamination) -labeled, sterilized, and sealed packages are stored unopened in clean, dry cabinets or drawers -All stored packages are dated and used in rotation

Junctional Epithelium

-is a cufflike band of stratified squamous epithelium that is continuous with the sulcular epithelium and completely encircles the tooth -triangular in cross section, is widest at the junction with the sulcular epithelium, and narrows down to the width of a few cells at the apical end -is not keratinized

Free gingival groove

-is a shallow linear groove demarcating the free from the attached gingiva. about one-third of the teeth may show a visible gingival groove. -In the absence of inflammation and pocket formation, the gingival groove runs slightly parallel with and about 0.5-1.5 mm from the gingival margin. The gingival groove is approximately at the level of the bottom of the gingival sulcus.

Attached gingiva

-is continuous with the oral epithelium of the free gingiva and is covered with keratinized stratified squamous epithelium -firmly bound to the underlying cementum and alveolar bone -follows the depressions between the eminences of the roots of the teeth

How is the nonvital tooth bleaching procedure preformed?

-it is preformed by the dentist after root canal therapy using a rubber dam or other type of isolation -the bleaching agents are introduced in the pulp chamber

Possible patient-centered barriers to personal health and wellness..

-lack of knowledge about the disease process or its infectious, chronic nature -lack of knowledge about importance of the prevention of oral disease -lack of knowledge of the oral-systemic link -lack of protective factors -skill deficit in in oral self care -low value on oral health -low self-esteem -inadequate financial resources -culture as a barrier to professional care -presence of other unidentified risk factors

Stannous fluoride

-light brown/yellowish stain formed on the teeth in the pellicle -stain is a result of formation of stannous sulfide or brown tin oxide from the reaction of tin ion in fluoride compound

Complete steps of Dental Hygiene Care Planning

-link care plan to dental hygiene diagnoses -establish priorities -set patient-centered goals/select evidence-based interventions -establish an appointment schedule -present the dental hygiene care plan to patient -ask patient to sign an informed consent statement for teh care plan -document the completion of this service to the patients dental record

Enamel erosion stain

-loss of hard tissue by chemical means like acidic foods, eating disorders, reflux -results in thinner enamel which allows yellower dentin to show through

prebook or preschedule method:

-make next apt before the patient leaves the office -give patient appt. card -remind the patient of the appointmetn (postcard, call or text)

Causes for changes: Shape

-marginal gingiva: inflammatory changes; edematous or fibrous -Papillae: bulbous with gingival enlargement -cratered in necrotizing ulcerative gingivitis

Changes in disease: Shape

-marginal gingiva: rounded rolled -papillae: bulbous flattened blunted created

3 divisions or categories of oral mucosa

-masticatory mucosa -lining mucosa -specialized mucosa

Size of JE

-may be up to 15 or 20 cells in thickness where it joins the sulcular epithelium and tapers down to 1 or 2 cells in thickness at the apical end -length ranged from 0.25 to 1.35 mm

Assessment at each appointment:

-medical history -vital signs/exams -radiographs as needed -periodontal examination -teeth examination -oral hygiene evaluation (how are they doing at home care) -examination of areas that have had problems

What are some patient assessment techniques?

-medical history questionnaires at every appointment -documentation of vital signs -documentation of findings on Medical Alert Tags; wrist or ankle bracelet or necklace that provides info on patient medical condition -completion of a physical assessment begins with first interaction with patient -incorporation of proper risk management and stress reduction protocols into the patient care plan -careful review and update of patient record before each appointment so that preparatory steps can be taken

Chemical vapor sterilizer: Principles of action

-microbial and viral destruction from the penetration of formaldehyde and alcohol -tightly wrapped/sealed packages do not permit the penetration of vapors

Changes in biofilm microorganisms

-microbial density increases as biofilm ages and matures -caries and gingivitis risk increase with more microorganisms -undisrupted biofilm (7 days old) negative anaerobic bacteria forms

Early calculus formation

-microorganisms adhere to pellicle layer coated tooth surface -colonies form and by the 5th day, biofilm is made up of filamentous organisms which provide the matrix for deposition of minerals -underneath layer of microorganisms, areas of mineralization foci form -undisturbed for 24-72 hours allows for more mineralization centers to develop -with age, calcium phosphate crystals of calculus directly bond to enamel and cementum apatite crystals. This is what makes tenacious calculus

How does a dental office care for the equipment for use of emergency?

-needs to be emergency kit or cart -everyone in office is familiar with contents -organized -contents are replenished -outdated materials replaced as needed -portable -well-maintained -kept in a place readily accessible to all treatment rooms -materials are marked -materials are kept separate from other office supplies -Materials are selected to accomplish emergency treatment by current methods -Items in kit imply proper training in their use

Pulpess/traumatized teeth Stain

-not all purples teeth discolor but traumatized teeth not treated endodontically do -can be slate gray, dark brown, bluish black etc -pigments from decomposed hemoglobin and pulp tissue penetrates and discolors the dentinal tubules

Location of Interdental Gingiva

-occupies the interporximal area between adjacent teeth that are in contact -tip and lateral borders are continuous with free gingiva -also called an embrasure

Calculus composition

-organic and inorganic components and water -% of composition depends on age, hardness of deposit, location of deposit etc.

What is the purpose of a medical emergency report form?

-organize data collected during the emergency -serve as a time reference during the monitoring of vital signs -Prepare a record from which the medical personnel can interpret the patient's condition at the time of transfer from the dental facility

The dental hygiene prognosis is contingent on what?

-overall appraisal of the evaluative statements -patients continued adherence to recommended self-care -level of optimal oral health achieved

What are the parts of the oxygen reuscitation equipment?

-oxygen tank -reducing valve -flow meter -tubing -mask -positive pressure bag

Signs of health: Color

-pale pink or coral pink -Variations in pigmentation related to complextion, race

Oral hygiene instruction motivation:

-patient is responsible for their care as well as the clinician -stress the importance of home oral hygiene

What are the factors influencing how priorities are established?

-patient values, beliefs, attitudes -healtchare provider philosophy -collaborating dentists goals -patient health status -whether the patient is experiencing infection, discomfort, anxiety, or pain

Significant clinician exposures:

-percutaneous or permucosal stick/wound with blood, saliva, or other body fluids -contamination of open wounds, non intact skin, or mucous membrane -exposure of pt body fluids to unbroken skin IS NOT A SIGNIFICANT EXPOSURE

What are the measures that increase emergency preparedness?

-periodic review of literature to update drills -equipment well maintained and kept in a convenient place -quick reference readily available

Risks and clinical signs of health and disease:

-periodontal infection -oral mucosa lesions -dental cares (demineralization)

Special appointment requirements:

-periodontitis (2-3 months) -cognitive/physical disabilities -diabetes -cardiovascular disease -patient undergoing extensive dental care -rampant dental caries -sealants (free-flowing) -orthodontic appliance

What the parts of the assessment?

-physical assessment (signs and symptoms) -comprehensive medical history -vital signs -extra and intra oral exam -comprehensive documentation of findings

What may the medical alert box contain?

-physical conditions that may lead to emergencies -diseases the patient has or had -previous surgeries -medical emergencies the patient experienced -medications the patient has taken within the past 2 years -allergies and adverse drug reactions -previous adverse reactions to dental treatments

What type of oxygen would you use if a patient is not breathing?

-positive pressure oxgen

When should regular reviews and rehearsal for each type of emergency be conducted?

-preferably surprise basis and at least once a month

What are the contraindications for whitening?

-pregnant and lactating women -photosensitive meds

Preparation of emergencies requires ?

-preparedness -alertness -anticipation

Dental caries control:

-prevention education to address caries risk factors -minimize sugars and carbs -limit the exposure causing caries

Instrument packing and management system should:

-provide a means of organizing instrument packets for different procedures -assure instruments are sterilized and ready for immediate use on opening -proved a means of storing instrument packets

Attachment of the Epithelium to the Tooth Surface: JE

-provides a seal at the base of the sulcus -accomplished by hemidesmosomes and the basal lamina

What are the vital signs taken in a dental office?

-pulse -blood pressure -respirations -temperature -height -weight -information from the patients personal Medical Alert Tag (necklace, bracelet, or anklet)

What is found on a drug container?

-purpose and method of administration - Replacement date appears clearly on each item that has a limited shelf life

Intermediate use steam sterilizer (flash sterilizer)

-rapid steam heat sterilization is used to sterilize unwrapped instruments for immediate use. Rapid contact w/ steam allows for shorter sterilization times -monitors and indicators should be used/checked for every cycle -caution must be used in transport of instruments to avoid contamination -Items meant for IMMEDIATE USE. DO NOT STORE

Chemical vapor sterilizer: Care of sterilizer

-refilling depends on use. Refill needed at least every 30 cycles -condensate tray should be removed and cleaned, exhausted solution emptied

Why does sterilization fail?

-remaining debris on instruments or packaging -overloading, timing, or temperature errors of sterilizer -inadequate maintenance of sterilizer

How do you turn off the oxygen tank?

-remove oxygen delivery system from patient -turn key on top of tank in a clockwise direction to shut off flow of oxygen -turn the low flow regulator knob in open position to bleed oxygen from system -after bleeding, gently close the low flow regulator knob

How do you turn off a laminate and affix to the oxygen tank?

-remove oxygen delivery system from patient -turn key on top of tank in clockwise direction to shut off flow of oxygen -turn the low flow regulator knob to open position to bleed oxygen from the system -after bleeding, gently close the low flow regulator knob

What hydrogen peroxide at a percent greater than 30 do?

-remove the enamel matrix -create microscopic voids that scatter light -increase in whiteness until mineralization

How to prevent material alba

-remove using water spray, oral irrigator, tongue action -requires basic biofilm control procedures (brush and floss)

What type of medical aid should be posted to call?

-rescue squads with paramedics -Ambulance -Nearest hospital emergency department -Posion information center -Physicians

What are new entries in the patients record?

-response to treatment: patients reactions and responses to treatment regardless if they are unremarkable or remarkable -previous appointment review: comprehensive review of previous appts documentation before providing additional treatment at sequential appts -current information: patients health status -emergency documentation: include copy of Medical Emergency Report Form -Progress notes

Calculus formation

-results from deposition of minerals into a biofilm organic matrix -3 steps: pellicle formation, biofilm formation, and mineralization

Factors to consider for appointment intervals:

-risk for periodontal disease -risk for dental caries -risk for oral cancer -predisposing factors for perio and other conditions -patient compliance -previous treatment -local factors (calculus formation/biofilm) -restorative complications (implants, prosthetic replacements)

Standard procedures: clinic preparation

-run water through all lines, handpicks, and ultrasonic unit for 2 minutes at start and end of day and 30 seconds between patients -disinfect all environmental surfaces that may be "touch surfaces" during appointment. Use orderly sequence for cleaning and disinfection. Apply barriers -Sterilize instruments and other equipment. Maintain close sterilized packages until ready for use

Gingivial sulcus fluid of gingival sulcus

-serum like fluid the seeps from the connective tissue through the epithelial lining of the sulcus or pocket -part of the local defense mechanism and is able to transport many substances, including endotoxins, enzymes, antibodies, and certain systemically administered drugs

Characteristics of healthy gingiva

-shade of pale or coral pink varied by complexion and pigmentation -a knife-edged gingival margin that adapts closely around the teeth -stippling, firmness, and minimal sulcus depth with no bleeding when probed

Follow MSDS for all manufacturer products. MSDS for chemical disinfectants will be labeled with:

-shelf life (expiration date of unopened container) -Use life (life expectancy of solution once activated) -Reuse life (amount of time a solution can be used and reused) -directions for activation (mixing directions) -type of container for use and storage -storage directions -directions for use (precleaning/drying, time/temp ratio) -instructions for disposal of used solution -warnings

Sterilization room

-should be centrally located -clean and dirty side -used to clean, package, sterilize, and store instruments

Supplemental procedures:

-smoking cessation -desensitizing of sensitive areas (fixing it) -special care for implants and fixed prosthesis -referral for retreatment evaluation (retreat area thats not doing well)

Change in disease: Consistency

-soft, spongy: dents readily when pressed with probe (acute inflammation) -associated with red color, smooth shiny surface, loss of stippling, bleeding on probing -firm, hard: resists probe pressure (chronic inflammation with fibrosis) -associated with pink color, stippling, bleeding only in depth of pocket

Accidental ingestion of small amounts of the white products may cause what?

-sore throat -nausea -vomiting -abdominal distention -ulcerations

Changes in disease: Bleeding

-spontaneous bleeding -bleeding on probing; bleeding near margin in acute condition; bleeding deep in pocket in chronic condition

Stain removal directly on tooth surface

-stains directly associated with biofilm on enamel or exposed cementum should be removed through toothbrushing and interdental cleaning -some stains could use debridement or polishing If stains are tenacious, avoid excessive polishing using minimal abrasive polishing agent

Stain removal of stains incorporated within deposits

-stains included in the deposit of calculus can be removed with the deposit

Brown pellicle

-stains of various colors resulting from chemical alteration of the pellicle -tannins in tea, coffee, soy sauce results in brown stain -seen on buccal of maxillary molars and linguals of mandibular anteriors

What is shock?

-state of lack of perfusion (saturation) of oxygenated blood to all cells of the brain and body -when brain cells are deprived of oxygenated blood, they cease to provide respiratory and circulatory function

Dry heat sterilizers: principles of action

-sterilization achieved by heat conducted from exterior surface to interior of the object -sterilization results when material is treated for sufficient length of time at required temperature. Heat penetration time varies with different materials.

What are some supplementary equipment in a emergency cart or kit?

-thermometer -blood glucose meter, lancets, and test strips -pen flashlight -stopwatch -razor -scissors -cotton pliers -emesis basin -blanket -pillow -inflatable splints -backboard -quick activated cold packs -betadine wipes -sterile packages of gauze and adhesive tape

What would one do if they are not trained in the use of a bag valve mask or positive pressure delivery?

-they use mouth to mouth procedure

Characteristics of Cementum

-thickness is 50 to 200 um about the apex; 30 to 60 um about the cervical area -vascular and nerve connections are missing; therefore, it is insensitive -in 10% of the instances ,they do not meet and there can be small area of exposed dentin; in 30% they meet edge to edge; and in 60% the cementum overlaps the enamel

Givgival margin (gingival crest, margin of the gingiva, or free margin)

-this is the edge of the gingiva nearest the incisal or occlusal surface -marks the opening of the gingival sulcus

Priorities are based on the degree to which the dental hygiene diagnosis does the following:

-threaten the patients well-being -can be addressed simultaneously with other diagnoses -is a patients priority (chief complaint)

When to use chemical disinfectants?

-to clean treatment area after each patient -to disinfect impressions and patient appliances

Function of Cementum

-to seal the tubules of the root dentin -to provide attachment for the periodontal fiber groups

What is the five point plan to prevent emergencies?

-use careful, routine patient assessment procedures -document and update accurate comprehensive patient records -implement stress reduction protocols -recognize early signs of emergency distress -organize team management plan for emergency preparedness

Standard precautions: posttreatment

-use utility gloves to handle contaminated instruments -follow routines to disinfect, clean, and prepare instruments for sterilization -contaminated waste goes in plastic bag and infectious waste in a container with secure lid -disinfect all safety eyewear (pt and dental team)

Use for dry heat sterilizers

-used for materials that cannot be steamed under pressure -for small metal instruments enclosed in special containers or that may be corroded/rusted by moisture

Shape of Interdental Gingiva

-varies with spacing or overlapping of the teeth: may be flat or saddle-shaped when wide spaces are between the teeth, may be tapered and narrow when the teeth are crowded or overlaped. -between anterior teeth: pointed, pyramidal -between posterior teeth: flatter, two papillae, one facial and one lingual

Standard precautions: removable oral prostheses

-wear gloves to receive oral prosthesis from pt -place prosthesis in disposable cup or ziplock bag -cover with disinfectant (.05% iodophor in water or 1:5 dilution of 5% sodium hypochlorite) -place in ultrasonic cleaner

What are health-related risk factors?

1. History of previous cancer 2. Family history of squamous cell 3. Tobacco 4. Alcohol use 5. Cultural and genetic 6. Sun exposure and lack of sunscreen 7. Diet 8. Certain surgeries such as organ or bone marrow transplant

What is a vesicle?

1 cm or less contains serum

What is the sequence for developing a care plan using the OHRQL model?

1) Link the dental hygiene care plan to the dental hygiene diagnosis 2) Establish priorities 3) Select evidence-based interventions 4) Set Goals 5) Establish an appointment schedule

What is the sequence for developing a care plan using the HN model?

1) Link the dental hygiene care plan to the dental hygiene diagnosis 2) Establish priorities 3) Set Goals 4) Select evidence-based interventions 5) Establish an appointment schedule

What are the Critical Foundational Skills Needed to Formlate an Effective Dental Hygiene Care Plan?

1) Use of parameters or standards of dental hygiene care 2) collect, analyze, and interpret comprehensive patient findings 3)collaborate with dentists and other IPCs when needed 4) integrate evidence-based knowledge and theory, professional judgement, and the patients values 5) develop dental hygiene diagnosis 6) formulate patient-centered goals, and select dental hygiene interventions that support the defined dental hygiene diagnosis 7) synthesize the aforementioned information into a written plan 8) communicate oral health needs to patients 9) position the dental hygiene care plan within the context of the total dental treatment plan

When does the dental hygienist use evaluation findings to make evidence-based decisions?

1)During the implementation of planned interventions 2)At the completion of planned dental hygiene care 3)At the subsequent cycle of the process of care

Guidelines for the Presentation of Care Plan:

1)define and discuss the dental hygiene diagnosis 2)present and explain the proposed treatment 3)discuss the prognosis of No Treatment 4)Discuss Care Plan Goals 5)Discuss the Appointment Schedule 6)Discuss Fee Schedule 7)Secure Patient Consent

How many months does nicotine stain usually require?

1-3 months

What is the poison information center number in the US?

1-800-222-1222

What are some dentrifices to recommend for at home sensitivity control?

1. 5% Potassium Nitrate 2. Sodium Fluoride 3. Stannous Fluoride 4. Tartar Control

What are some examples of chemical stimuli?

1. Acids in food/drinks - Citrus fruits - Condiments - Spices - Wine - Carbonated beverages 2. Acids produced by acidogenic bacteria after carbohydrate exposure 3. Acids from purging

What are the two types of calcium phosphate used in desensitivity?

1. Amorphous Calcium Phosphate (ACP) 2. Casein Phosphopeptide-amorphous calcium phosphate (CPP-ACP)

What are the sources of traumatic stimuli?

1. Attrition 2. Dental caries

What are the four basic vital signs?

1. Body temperature 2. Pulse 3. Respiratory rates 4. Blood pressure

What are some recommendations for toothbrushing to help with hypersensitivity?

1. Brush 1-2 teeth at a time with a ultra-soft/soft toothbrush 2. Start in the least sensitive areas and finish in the most sensitive 3. Brushing with the non dominant hand (if able) will help reduce pressure 4. Investigate current toothbrush grip and adjust to reduce the amount of pressure applied 5. suggest a power toothbrush

What are some parafunctional habits and how are they managed?

1. Bruxing/Clenching = may need additional treatment 2. May need occlusal adjustments 3. Monitor levels of stress = stress reduction may be needed

What are some examples of thermal stimuli?

1. Hot or Cold food/drinks 2. Cold air

What are some factors that contribute to the loss of enamel and cementum?

1. Cementum at CEJ is thin and abrades easy when exposed 2. Enamel and cementum do not MEET at the CEJ in about 10% of teeth leaving an area of exposed dentin 3. Attrition and abrasion 4. Erosion from dietary acids 5. Brushing with dentifrice after consuming acids, after gastric reflux, morning sickness, self-induced vomiting 6. Abfraction (stresses from tooth flexure resulting in tooth structure) appearing as a "V" shaped wedge or cervical notch 7. Crown preparations that expose dentin at cervical area 8. Instrumentation 9. Frequent or improper stain removal techniques Root surface caries

What does the RDH do if the temperature is 99.6-104?

1. Check for possible temporary causes (Smoking, drinking hot beverage) 2. Review dental history 3. Postpone care

What are some oral conditions that could be confused with hypersensitivity?

1. Chipped tooth 2. Fractures 3. Pulpal pathology 4. Leaking restorations

What are some examples of tactile/mechanical stimuli?

1. Contact with toothbrush/hygiene devices 2. Eating utensils 3. Dental instruments 4. Friction from prosthetic devices

What are some examples of evaporative stimuli?

1. Dehydration of oral fluids via high-volume evacuation 2. Air to dry teeth

What are the main etiologies of hypersensitive dentin?

1. Dentinal tubules are open to the oral cavity 2. Large and numerous dentinal tubules 3. Thin, poorly calcified/breached smear layer 4. 3 nerve fibers extending from the pulp to DEJ

What are some treatment options for keeping the patient comfortable?

1. Desensitizing agents that are marketed for immediate relief from severe hypersensitivity can be used 2. local anesthetics and/or nitrous oxide analgesia can be utilized

What are the steps for hypersensitivity management?

1. Determine the extent and severity of pain 2. Provide education regarding the etiology and contributing factors 3. Apply treatment goals 4. Reassessment

What are some of the important treatment considerations for fluoride varnish?

1. Does not require a dry tooth surface 2. patient should avoid oral hygiene self-care for several hours to allow the fluoride to stay in contact with the tooth surface for as long as possible

What activities cause a temporary increase in temperature?

1. Exercise 2. Drinking hot drinks 3. smoking 4. Application of external heat

What are some factors that increase blood pressure?

1. Exercise 2. Eating Stimulants 3. Emotional disturbance

What causes increased respirations?

1. Exercise 2. Excitement 3. Nervousness 4. Strong emotions 5. Pain 6. Hemorrhage 7. Shock

What increases pulse?

1. Exercise 2. Stimulants 3. Eating 4. Strong emotions 5. Extreme heat or cold 6. Some forms of heart disease

What are the steps for preparing the patient to take blood pressure?

1. Explain procedure to patient 2. Seat patient 3. Use either arm (Unless handicap, mastectomy, or vascular surgery) 4. Take pressure on bare arm not over clothing 5. Select cuff size (2 fingers between)

What are some factors that decrease blood pressure?

1. Fasting 2. Rest 3. Depressants 4. Fainting 5. Blood loss 6. Shock 7. Quiet moods

When should temperature be taken?

1. For the new patient's initial permanent record 2. When oral infection is present 3. Prior to local anesthesia 4. When the patient reports illness or there is a suspected infection

Blood pressure is dependent on what factors?

1. Force of the heartbeat 2. Peripheral resistance (Condition of arteries) 3. Volume of blood in the circulatory system

What are some gels to recommend for at home sensitivity control?

1. Gels containing 5,000 ppm fluoride 2. Gels with no abrasives/provide stain control

How can dentin become exposed?

1. Gingival recession 2. Loss of cementum 3. Loss of enamel

What are 2 polymerizing agents?

1. Glass ionomer cements (GIC) 2. Adhesive Resin Primers

What are some factors that contribute to gingival recession and cause root exposure?

1. Improper self-care (medium/hard toothbrush, aggressive brushing) 2. Narrow zone of attached gingiva 3. Facial version of one or more teeth 4. Tight and short labial frenums 5. Scaling and root planing with shrinkage of tissues 6. Surgical periodontal surgery to reduce pocket 7. Orthodontic treatment that results in loss of periodontal attachment 8. Crown preparation that can abrade gingival tissue 9. Oral piercings

what data do you need to collect from patient?

1. Location 2. Degree of Pain 3. Onset/Duration 4. Source of Stimulus 5. Intensity 6. Alleviating Factors related to painful response

What should be written down when describing a lesion?

1. Location as related to adjunct structures 2. Extent 3. Size 4. Color 5. Surface texture 6. Consistency 7. Morphology 8. History

Precleaning procedures of instruments

1. Manual scrubbing -not recommended -wear heavy duty gloves, eyewear, and mask -use detergent and scrub one instrument at a time. Stroke away from body 2. Instrument washer -uses high velocity hot water and detergent to clean instruments. High degree of temperature to disinfect instruments. Handle with gloves while packaging cassettes 3. Ultrasonic -removes debris using acoustic energy waves transmitted in liquid. Do not overload; solution must contact all surfaces and instruments need to be immersed. Drain, rinse, then dry

What is the sequence of examination?

1. Overall appearance 2. Face 3. Skin 4. Eyes 5. Nodes (Palpate) 6. Glands (Palpate) 7. Temporomandibular joint 8. Lips 9. Breath odor 10. Labial and buccal mucosa 11. Tongue 12. Floor of mouth 13. Saliva 14. Hard palate 15. Soft palate, uvula 16. Tonsillar region, throat

What are 2 approaches to treatment goals of hypersensitivity?

1. Pain relief 2. Modification/elimination of contributing factors

What are three methods of examination?

1. Palpation 2. Transillumination 3. Instrumentation

What are the non-blisterform lesion types?

1. Papule- Smooth surface, less than 5 sm 2. Nodule- solid tissue, less than 1 cm 3. Tumor- solid tissue, greater than 2 cm

What are some desensitizing agents?

1. Potassium Nitrate 2. Fluorides 3. Oxalates 4. Gluteraldehye 5. 6. Calcium Phosphate Technology

What do you do post-procedure for a patient?

1. Professionally applied desensitization agents can be used. 2. Patient is instructed in daily oral health behavior changes and use of self-applied desensitizing agents

What are the eight human needs assessed in the HN model?

1. Protection from health risks 2. Freedom from fear/stress 3. Freedom from pain 4. Wholesome facial image 5. Skin and mucous membrane integrity of the head and neck 6. Biologically sound and functional dentition 7. Conceptualization and problem solving 8. Responsibility for oral health

Where can a pulse be taken?

1. Radial 2. Temporal 3. Carotid artery 4. Brachial

What are variation in respirations?

1. Rate 2. Rhythm 3. Depth 4. Quality

What are some natural mechanisms that reduce hypersensitivity?

1. Sclerosis 2. Secondary Dentin 3. Smear Layer

How do you prepare the patient to take vitals?

1. Seat patient in upright position at eye level for instruction 2. Explain the vital signs and obtain consent 3. Explain how vitals can affect dental hygiene 4. During the process explain each step as needed by the individual patient

What causes decreased pulse?

1. Sleep 2. Depressants 3. Fasting 4. Quiet emotions 5. Low vitality from prolonged illness

how do you determine the extent and severity of pain?

1. Solicit a self-report of symptoms, including the eliciting stimuli 2. Quantify and record the baseline pain intensity using objective measures such as the visual analog scale (VAS) and/or the verbal rating scale (VRS)

What are variables of subjective pain?

1. Stress 2. Fatigue 3. Health Benefits

What are types of stimuli than can cause a pain reaction?

1. Tactile/Mechanical 2. Thermal 3. Evaporative 4. Osmotic 5. Chemical

How do you prepare the patient to have their blood pressure taken?

1. Tell the patient you are going to take their blood pressure 2. Have patient assume a comfortable position with arm and hand supported (palm down) 3. Locate radial pulse on thumb side of wrist with the tips of three fingers (NOT THUMB BC PULSE)

In what order are vitals taken?

1. Temperature 2. Pulse 3. Respiration 4. Blood pressure

acidulated phosphate fluoride (APF)

1.23% gel or foam

what are some recommendations to ease tooth whitening induced sensitivity?

1. Use potassium nitrate/fluoride/other desensitization item before/during whitening 2. use a gel that incorporates 5% potassium nitrate/fluoride/ACP 3. Use an at-home product = less hypersensitivity risk than in office products 4. Allow for a "recovery period" between whitening sessions 5. Decrease frequency of use by whitening every second or third day.

name some typical commercial mouthrinse ingredients:

1. alcohol - enhances to flavor impact 2. flavor - adds pleasantness/freshness and makes breathe temporarily fresh 3. humectant - adds "body" 4. surfactant - solubilizes the flavor and proves foaming action 5. water - major vehicle to carry other ingredients 6. preservative - preserves aqueous formulation 7. dyes - add color 8. sweeteners - contributes to flavor 9. flavor - makes pleasant 10. active or functional ingredients - provides therapeutic and/or benefits

What are some examples of Osmotic stimuli?

1. alteration of pressure in dentinal tubules through a selective membrane

What does Team member 3 in a emergency situation do?

1. calls for medical aid 2. monitors vitals 3. records data 4. assists team lead 5. suctions 6. loosens tight clothing 7. relieves others in CPR

Changes in disease: Mucogingival junctions

1. color changes may extend full height of the gingvia; mucogingival line obliterated 2. probing reveals that the bottom of the pocket extends into the alveolar mucosa 3. frenal pull may displace the gingival margin from the tooth

what are the preventive and therapeutic agents of mouthrinses?

1. fluoride - stannous and sodium; prevents demineralization, reduces hypersensitivity, and gingivitis 2. chlorhexidine - binds to oral hard and soft tissues, binds to pellicle and salivary mucins to prevent biofilm accumulation, MOST effective for: antimicrobial and antigingivitis agent. available by RX, great for PT at high risk for caries *CONSIDERATION* staining of teeth, increases supragingival calculus formation, minor irritation 3. triclusan - effective against both gram (-) and gram (+) bacteria, antimicrobial and antigingivitis agent, can reduce biofilm and bleeding on probing 4. phenolic-related essential oils - decreases pathogenicity of biofilm, combination of thymol, eucalyptol, menthol and methyl salicylate. recommended for PT unable to perform adequate brushing and flossing. *CONSIDERATION* burning sensation, bitter taste, poor substantivity 5. quaternary ammonium compounds - cationic agents that bind to oral tissues, most common is CPC and is recommended to reduce biofilm accumulation, *CONSIDERATION* stains teeth and tongue, burning sensation 6. oxygenating agents - common agents 10% carbomide peroxide and 1.5% hydrogen peroxide, recommended for short term use to reduce symptoms of pericoronitis *CONSIDERATION* does not always prevent plaque biofilm accumulation, occasional erosive change in mucosa 7. oxidizing agents - common agents are chlorinedioxide, mainly for management of halitosis

When does the smear layer accumulate?

1. following scaling and root instrumentation 2. use of toothpaste (abrasive particles) 3. cutting with a bur 4. attrition 5. abrasion (burnishing with a toothbrush or toothpick, or other device)

How does Calcium phosphate work with desensitivity?

1. may plug tubules 2. Enhances fluoride delivery = remineralization and reduced sensitivity

What does team leader 1 do in a emergency situation?

1. provides basic life support 2. evaluates vital signs 3. initiates CPR 4. positions patient 5. manages airway 6. directs emergency care 7. administers oxygen 8. administers drugs

What are the dietary modification suggestions to help with dentinal sensitivity?

1. review acidic food/beverage habits 2. Counsel patient on changing diet 3. Advise not brushing immediately after eating/drinking 4. Suggest non-acidic mouth rinses 5. Provide profession treatment referrals for patient's with eating disorders 6. Suggest eliminating hot or cold food/drinks to avoid discomfort

What does Team Member 2 do in a emergency situation?

1. starts stop watch 2. brings cart and oxygen 3. assists with oxygen 4. prepares medications 5. assists team leader 6. assists with CPR

Chemical disinfects include:

1. surface disinfectants 2. Immersion disinfectants, immersion sterilants 3. Hand antimicrobial agent

name the ingredients and function of commercially available dentifrices:

1. surfactant/detergent - foaming and cleaning, penetrates and loosens surface deposits 2. abrasive - cleaning and polishing, cleans without damage to tooth surface 3. binder - thickening agent, stabilizes the formulation 4. humectant - prevents water loss/hardening of dentifrice, retains moisture and prevents exposure to air 5. preservative - prevents microorganisms from destroying the dentifrice (examples: alcohol) 6. flavoring - sweetener 7. water - maintains the ingredient in formulation

What are steps in every emergency?

1. terminate dental treatment and remove all items from patients mouth 2. Tell patient there will be no more dental treatment today 3. If patient is unconscious check pulse and breathing 4. If pulse and breathing: assess rate and quality 5. -Monitor blood pressure, pulse and respiration -Position patient to improve circulation 6. -If vital signs are below or above baseline, call EMS 7. Administer oxygen in every emergency except hyperventilation. 8. assess patient symptoms question medications food intake illnesses If patient has no pulse and breathing: 1. begin BLS following the CAB steps 2. Call EMS

Disinfecting environmental surfaces: Procedure

1. wear PPE 2. determine degree of disinfection required 3. Ensure produce is prepared correctly and not expired 4. check label to ensure disinfectant is compatible with surfaces it will be used on 5. clean blood with low or intermediate level disinfectant effective against HBV and HIV 6. clean and scrub surfaces with soap and water, EPS registered detergent, or low level disinfectant 7. Disinfectant must be used with vigorous scrubbing 8. when cleaned, spray surface again to leave disinfectant for recommended amount of time 9. scrub disinfectant over entire surface where inconsistencies are seen 10. Use products according to manufacturers directions. Leave surfaces wet for recommended time 11. Wipe surfaces dry

How much percent of hydrogen peroxide product is in a bleaching product?

15-35%

HIV: stages of infection: stage 2 CD4+ count

200-499

HHV-3: Chickenpox (varicella): vaccine

1st: 12-15 months 2nd: 4-6 years

Continued-care appointments are scheduled at ______ to _____ month intervals

2 to 12, based on patient need

How should restoration work be delayed to allow the bleaching to stabilize?

2 weeks

neutral sodium fluoride

2%; replaces acidulated phosphate formula when low pH in contradicted, research does not support the same effectiveness as APF, comes in foam as well

How much time is needed for reassessment?

2-4 weeks to evaluate effectiveness of treatment

sodium fluoride (NaF)

2.0% gel of foam, 5% varnish

How often do patients with a history of periodontal disease need to be seen a year to decrease the risk for progression of the disease?

3-4 month recall

How long does it take for decreased hypersensitivity?

4 - 6 weeks

In how many minutes does the bleaching products reach the enamel and dentin?

5-15 minutes

What is the average temperature in older adults?

96.8

What is the average temperature for an adult?

98.6 (Range is 97-99)

If a tooth has furcation involvement, the clinical attachment level has extended into the furcation area.

A Nabors probe is used to assess furcations.

What MUST be done when ruling out oral conditions?

A Radiographic exam

What is a symptom?

A change in body function that is felt by a patient as a result of disease

What is the first step in diagnosis?

A comprehensive assessment and analysis of all the data collected

General Dentist or Dental Specialists develop...

A comprehensive dental treatment plan for the patient

How does the dental diagnosis differ from the dental hygiene diagnosis?

A dental diagnosis is more problem oriented, a dental hygiene diagnosis seeks to prevent oral disease and then proceeds to minimize the risk of oral disease, and promote wellness.

What is transillumination?

A strong light directed through a soft issuer or tooth to enhance examination, used for detecting irregularities, and calculus

Sclerosis deposits peritubular dentin - what does this mean?

A thicker, highly mineralized layer is deposited within the periphery of the tubules

Labioversion

A tooth that has assumed a position labial to normal

What is a limited examination

A type of brief examination made for an emergency or management of acute condition

What fibers are responsible for evoking the sharp, short pain responsible for dentinal hypersensitivity?

A-delta fibers

The birthplace and residence in early years provides information to make which consideration for appointment procedures? A. Determine effects of fluoride on teeth B. Obtain informed consent of parent or gaurdian C. Consult with physician D. Determine need for interpreter

A. Determine effects of fluoride on teeth

A structured form with places to check and fill in is only used for the questionnaire method. Recording on a blank sheet from questions created from a guide list of essential topics is only used for an interview method. A. First statement is FALSE; second statement is TRUE. B. First statement is TRUE; second statement is FALSE. C. Both statements are TRUE. D. Both statements are FALSE.

A. First statement is FALSE; second statement is TRUE.

According to the American Society of Anesthesiologists Physician Status Classification System, a patient with mild systemic disease is classified as _______. A. ASA II B. ASA I C. ASA IV D. ASA V E. ASA III

A. ASA II

According to the American Society of Anesthesiologists Physician Status Classification System, a patient with severe systemic disease that limits activity but is not incapacitating is classified as _______. A. ASA III B. ASA IV C. ASA V D. ASA I E. ASA II

A. ASA III

Latex hypersensitivity is an example of which of the following categories? A. Allergic or untoward reactions B. Communicable diseases that endanger the dental personnel C. Gender or ethnic/racial influences that increase risk for systemic and oral disease D. Physiologic state of the patient E. Conditions or diseases that require premedication before treatment

A. Allergic or untoward reactions

When the patient is unable to take oral medications and is not allergic to Penicillins, the following prophylaxis agent(s) can be used: Select all that apply. A. Ampicillin B. Azithromycin C. Clindamycin D. Amoxicillin E. Cephalexin F. Cefazolin

A. Ampicillin F. Cefazolin

The rapport established at the time of the interview contributes to the continued cooperation of the patient. The history is never to be taken in a reception area when other patients are present. A. Both statements are TRUE. B. Both statements are FALSE. C. First statement is FALSE; second statement is TRUE. D. First statement is TRUE; second statement is FALSE.

A. Both statements are TRUE.

The birthplace and residence in early years provides information to make which consideration for appointment procedures? A. Determine effects of fluoride on teeth B. Determine need for interpreter C. Obtain informed consent of parent or gaurdian D. Consult with physician

A. Determine effects of fluoride on teeth

Which of the following should be considered when documenting the patient's health history? Select all that apply. A. Handwritten records should be in ink B. Date all records C. Patient signature must be on the health history form D. Maintain all information obtained for a patient history in strictest privacy E. Completed history by a minor is signed by a parent or guardian

A. Handwritten records should be in ink B. Date all records C. Patient signature must be on the health history form D. Maintain all information obtained for a patient history in strictest privacy E. Completed history by a minor is signed by a parent or guardian

Which of the following should be recorded in the notes when bleeding is indicated in the medical history? A. Laboratory tests for bleeding time B. Joint pain C. Previous history of bisphosphonate prescription D. History of disorder with coagulation problem E. History of transfusions or other blood products

A. Laboratory tests for bleeding time D. History of disorder with coagulation problem E. History of transfusions or other blood products

Which of the following are considerations for appointment procedures when kidney is indicated in the medical history? A. Limited stress tolerance B. Bleeding tendency C. Monitor blood pressure D. No aerosol agents E. Poor healing F. Susceptibility to infection

A. Limited stress tolerance B. Bleeding tendency C. Monitor blood pressure E. Poor healing F. Susceptibility to infection

Characteristics of an adequate basic history form include which of the following? A. Permits quick identification of special needs of a patient when the history is reviewed before each appointment B. Provided, whenever possible, in a version that has been translated to the patient's primary language C. Ample space to record the patient's own words whenever possible in the interview method, or for self-expression by the patient on a questionnaire, and space for notes about attitudes and knowledge stated by the patient D. The more items or questions included, the better the form E. Conventional notation of important details in a logical sequence

A. Permits quick identification of special needs of a patient when the history is reviewed before each appointment B. Provided, whenever possible, in a version that has been translated to the patient's primary language C. Ample space to record the patient's own words whenever possible in the interview method, or for self-expression by the patient on a questionnaire, and space for notes about attitudes and knowledge stated by the patient E. Conventional notation of important details in a logical sequence

Which of the following systems for obtaining the history does not use a questionnaire? A. Preappointment Information B. Complete History C. Brief History D. Self-History

A. Preappointment Information

Which of the following types of correspondence for medical consultation occurs when signs of a possible disease condition are apparent? A. Referrals B. Written request C. Telephone or personal contact

A. Referrals

All except one of the following are considered systems for obtaining the history. Which is the EXCEPTION? A. Supplementary forms B. Preappointment information C. Complete history D. Self-history E. Brief history

A. Supplementary forms

The American Dental Association (ADA) and other organizations have basic history forms that have been translated into a variety of languages. History forms provided by the ADA and other organizations must be used in practice. A. The first statement is TRUE; second statement is FALSE. B. The first statement is FALSE; second statement is TRUE. C. Both statements are FALSE. D. Both statements are TRUE.

A. The first statement is TRUE; second statement is FALSE.

Dentolegal science is the relation and application of dental facts to legal problems, as in using the teeth for identifying the dead. It is also called ____________. A. forensic dentistry B. over the counter C. informed consent D. premedication E. immunocompromised

A. forensic dentistry

Response, cooperation, and attitude to expect during appointments can be determined by the information recorded under ___________________ in the medical history? A. general health and appearance B. medical examination C. age factors D. medications prescribed by physician E. major illnesses, hospitalizations, surgeries

A. general health and appearance

Information that identifies the need for approval for care of a minor patient and/or legal requirements is found in the _______________. A. personal history B. dental history C. medical history

A. personal history

Antibiotic premedication can be described as: A. the provision of an effective antibiotic before invasive clinical procedures that can create a transient bacteremia, which, in turn, can cause infective endocarditis or other serious infection. B. a change in the effect of one drug when a second drug is introduced concomitantly; the change may be desirable, adverse, or inconsequential. C. a state of abnormal and individual hypersensitivity acquired through exposure to a particular allergen. D. the presence of microorganisms in the bloodstream. E. produced or derived from blood; disseminated through the bloodstream.

A. the provision of an effective antibiotic before invasive clinical procedures that can create a transient bacteremia, which, in turn, can cause infective endocarditis or other serious infection.

Which of the following are disadvantages of an interview? A. time-consuming B. flexibility for individual needs C. patient may be embarrassed to talk about personal conditions D. personal contact to develop rapport E. items of importance may be ommitted

A. time-consuming C. patient may be embarrassed to talk about personal conditions E. items of importance may be ommitted

Which of the following are advantages of a questionnaire? A. time-saving B. personal contact to develop rapport C. flexibility for individual needs D. patient has time to think over the answers; not under pressure, nor under the eyes of the interviewer E. consistent; all selected questions are included

A. time-saving D. patient has time to think over the answers; not under pressure, nor under the eyes of the interviewer E. consistent; all selected questions are included

The dental hygiene care plain is written immediately following...

ADHA Standard 2 diagnosis

Why can a dental hygienist be comfortable using the ADHA Standards year to year?

ADHA Standards are put through a rigorous validation process to ensure that they are based on emerging scientific evidence, federal and state regulations, policy development, and changing disease patterns

Chemical liquid sterilizer

AKA cold sterile -Biological monitoring to verify sterility with this method is not possible -NOT RECOMMENDED

When designing a strategy for the treatment of xerostomia in patients with poor oral status, which strategy applies? Identify medications with potential of causing xerostomia Eliminate lemon Eliminate glycerin Eliminate alcohol All of the above apply

ALL

Chemical vapor sterilizer: Advantages and Disadvantages

Advantages: -corrosion and rust free for carbon steel instruments -short sterilizing cycle -ease of operation and care of equipment Disadvantages: -adequate ventilation required. DO NOT USE IN SMALL ROOM -slight odor

Evaluation of steam under pressure

Advantages: All microorganisms, spores and viruses are destroyed quickly and efficiently Wide variety of material can be treated Disadvantages: May corrode carbon steel instruments if precautions are not taken Unsuitable for oils, powders that are impervious to heat

Advantages and disadvantages of stem under pressure sterilizers

Advantages: -all microorganisms, spores, and viruses are destroyed quickly and efficiently -wide variety of materials can be treated Disadvantages: -carbon steel instruments may corrode

Occupational post-exposure management

Accident happen even to the most skillful clinician. Accidental percutaneous (laceration, needle stick) or premucosal (splash to the eye) exposure to blood other body fluids requires prompt action

Following acids are in the metabolic process

Acetic, lactic, formic, propionic

______ are formed that demineralize the enamel, cementum, and dentin and lead to cavity formation

Acids

Which of the following types of periodontitis presents as a manifestation of a systemic disease?

Acquired neutropenia Leukemia Chediak-Higashi syndrome Histiocytosis syndrome

What educational materials should the dental hygienist have for the homebound patient? Adaptive aids Napkin Disposable items Gauze Cotton rolls

Adaptive aids

Oral Health Status Goals

Addresses the signs and symptoms of oral disease and reflects a desire oral health or clinical outcome

Dry heat sterilizers: advantages and disadvantages

Advantages: -Used for materials that cannot be steamed under pressure (ex: burs, plastics) -Best for sharp instruments -no corrosion Disadvantages: -long exposure time required; penetration slow and uneven -high temperature critical to some materials

What is the first step in the Dental Hygiene Process of Care?

Assessment

Chemical vapor sterilizer evaluation

Advantages: Corrosion and rust free operation for carbon steel instruments Ability to sterilize in short total cycle Ease of operation Disadvantages: Adequate ventilation is needed, cannot use in a small room Slight odor, which is rarely objectionable

Evaluation of dry heat

Advantages: Useful for materials that cannot be subjected to steam under pressure With correct temperature, this method is well suited for sharp instruments No corrosion compared with steam under pressure Disadvantages: Long exposure time required, penetration slow and uneven High temperature critical to certain materials

as used by mental health professionals, refers to an expressed or observed emotional response or lack of expression of emotional response (flat or restricted affect)

Affect

What is the meaning of palliative? State of unconsciousness Affording relief Affected with coma Cure Brain death

Affording relief

What is continuing care/ reevaluation?

After a specific period of time following the completion of the care plan and the anticipated restoration to health

Clean and disinfect environmental surfaces

Agent: effectiveness of disinfection procedure is the result of physical rubbing and removal and chemical inactivation of the living microorganisms Procedure: wear heavy duty gloves and mask, use several large gauze sponges or papertowels

Infectious process #2: prevention of transmission

Airborne Infection Can Be Controlled Pre-procedural Oral Hygiene Measures Inteuption of Transmission Clean Water Protection of the Clinician Protection of the Patient Maintain Infection Control Protocols

What does AUDIT stand for?

Alcohol Use Disorders Identification Test

Sterilization selection of method

All materials and items cannot be treated by the same system of sterilization Disposable single-use products sterilization cannot be done Sterilization method provides complete destruction of all microorganisms, viruses, and spores Manufacturers specifications is necessary

Complicating factors for disease development may be which of the following?

All of the above

Which of the following are necessary as part of the permanent record of a patient who has a need for periodontal therapy?

All of the above

When the gingiva over the furcation has not receded, which of the following can be seen?

All of the above.

Which of the following is true regarding the periodontal pocket?

All of the above.

Supplies

All sterilizable or disposable

What does AAP stand for?

American Academy of Periodontology

What does AHA stand for?

American Heart Association

Who provides guidelines and training for healthcare professionals?

American Heart Association (AHA)

What is a sign?

An objective or observable symptom

What are the six parts of the Dental Hygiene Process of Care?

Assessment, DH Diagnosis, Planning, Implementation, Evaluation, Documentation

Distribution of tissue changes may include all of the following EXCEPT one. Which one is the EXCEPTION?

Attached

What is a peduncuated lesion?

Attached by a narrow stalk

Malocclusion

Any deviation from the normal positioning of the maxillary teeth against the mandibular teeth

Orange/red stains

Appear at cervical 3rd Seen commonly on anterior teeth Possible chromogenic bacteria

Silver amalgam stain

Appears as a gray or black discoloration around a restoration. Caused when metallic ions from the amalgam penetrate into the dentin and enamel.

Factors of disease development due to tooth contour...

Areas of abrasion Erosion Incomplete eruption Overcontoured or undercontoured restorations Areas of attrition

Tooth position can be a factor in disease development. Which of the following is NOT considered a factor due to tooth position?

Areas of abrasion/erosion

Cultural competence & process of care: Assessment Diagnosis Planning Implementation Evaluation

Assessment: use culturally effective nonverbal communication & listening skills to build trust & patient rapport; use skillful, nonjudgmental questioning to elicit culturally specific data such as health beliefs & values and to avoid misunderstandings; ask permission before touching a patient. Diagnosis: take into consideration the patient's culture-specific health risks related to oral status & cultural practices that may impact the patient's oral health status. Planning: consider patient's current health practices & beliefs; devise plan to accept, modify, or eliminate current culturally relevant healthcare practices; be sensitive to practices, products, or substances that patient's culture prohibits; communicate plan in a culturally & linguistically sensitive way. Implementation: recognize culturally determined expressions of pain & discomfort during treatment; use language-appropriate instructions; use "plain language" oral health materials. Evaluation: provide feedback to the patient that respects culturally diverse beliefs & values related to oral health.

What is the first step in the DHCP?

Assessment

To facilitate oral care of the homebound, the dental hygienist provides cleansing that the patient will allow versus that which is recommended. What ethical principle supports respecting the patient's choice? Veracity Beneficence Paternalism Autonomy Confidentiality

Autonomy

Patients at risk for infective endocarditis already taking an antibiotic for other health conditions may need which of the following before dental hygiene instrumentation? A. Increase dosage of the currently taken antibiotic B. A different class of antibiotic C. Discontinue antibiotic D. Nothing additional is required to prevent overuse

B. A different class of antibiotic

According to the American Society of Anesthesiologists Physician Status Classification System, a patient with severe systemic disease that limits activity but is not incapacitating is classified as _______. A. ASA V B. ASA III C. ASA II D. ASA I E. ASA IV

B. ASA III

According to the American Society of Anesthesiologists Physician Status Classification System, a patient with an incapacitating systemic disease that is a constant threat to life is classified as ______. A. ASA II B. ASA IV C. ASA V D. ASA I E. ASA III

B. ASA IV

Which of the following are considerations for appointment procedures when pregnancy is indicated in the medical history? A. Bleeding problems B. Adjust physical position for comfort C. Xerostomia D. Frequent appointments to maintain high level of oral hygiene E. Ultrasonic and air-powder polisher are contraindicated

B. Adjust physical position for comfort D. Frequent appointments to maintain high level of oral hygiene

Antibiotic prophylaxis is recommended for certain cardiac conditions associated with highest risk of adverse outcomes from endocarditis. Antibiotic prophylaxis should also be considered for all total joint replacement patients before any invasive procedure that may cause bacteremia. A. Both statements are FALSE. B. Both statements are TRUE. C. First statement is FALSE; second statement is TRUE. D. First statement is TRUE; second statement is FALSE.

B. Both statements are TRUE.

The rapport established at the time of the interview contributes to the continued cooperation of the patient. The history is never to be taken in a reception area when other patients are present. A. Both statements are FALSE. B. Both statements are TRUE. C. First statement is TRUE; second statement is FALSE. D. First statement is FALSE; second statement is TRUE.

B. Both statements are TRUE.

Which of the following are advantages of a questionnaire? A. Flexible; provides for additional questioning in areas of specific importance to an individual patient B. Broad in scope C. Time-saving D. Consistent; all selected questions are included, and none is omitted E. Provides opportunity to build rapport

B. Broad in scope C. Time-saving D. Consistent; all selected questions are included, and none is omitted

Which of the following dental hygiene procedures is withheld until the risk for infective endocarditis is determined? Select all that apply. A. Extra and intra-oral examination B. Calculus detection C. Hand scaling D. Dentition assessment E. Periodontal assessment, including measurement of pocket depths F. Power scaling

B. Calculus detection C. Hand scaling E. Periodontal assessment, including measurement of pocket depths F. Power scaling

The hygienist is preparing to perform a stain removal procedure for a patient who is required to take prophylactic antibiotics prior to having dental treatment done. The patient has taken the correct medication as noted at the beginning of the appointment. Which of the following should be considered? A. Avoid flossing after the procedure to avoid forcing abrasive particles into the sulci/pockets B. Check the time the medication was taken to be sure the optimal level of circulating medication has not passed C. Perform a "toothbrush" prophy to avoid creating a bacteremia D. Stain removal procedures do not require prophylactic antibiotic premedication

B. Check the time the medication was taken to be sure the optimal level of circulating medication has not passed

When the patient is allergic to Penicillins or Ampicillin and able to take oral medications, the following prophylaxis agent(s) can be used: Select all that apply. A. Amoxicillin B. Clindamycin C. Cefazolin D. Azithromycin E. Cephalexin F. Ampicillin

B. Clindamycin D. Azithromycin E. Cephalexin

Which of the following systems for obtaining the history is conducted at the initial visit and combines interview and questionnaire? A. Brief History B. Complete History C. Preappointment Information D. Self-History

B. Complete History

Uncontrolled hypertension is an example of which of the following categories? A. Communicable diseases that endanger the dental personnel B. Conditions that may complicate certain kinds of dental and dental hygiene treatment C. Allergic or untoward reactions D. Gender or ethnic/racial influences that increase risk for systemic and oral disease E. Conditions or diseases that require premedication before treatment

B. Conditions that may complicate certain kinds of dental and dental hygiene treatment

Uncontrolled hypertension is an example of which of the following categories? A. Communicable diseases that endanger the dental personnel B. Conditions that may complicate certain kinds of dental and dental hygiene treatment C. Conditions or diseases that require premedication before treatment D. Allergic or untoward reactions E. Gender or ethnic/racial influences that increase risk for systemic and oral disease

B. Conditions that may complicate certain kinds of dental and dental hygiene treatment

Coagulation disorder requiring anticoagulant therapy is an example of which of the following categories? A. Gender or ethnic/racial influences that increase risk for systemic and oral disease B. Conditions under treatment by a physician that require medicating drugs that may influence or contraindicate certain procedures C. Conditions or diseases that require premedication before treatment D. Communicable diseases that endanger the dental personnel E. Allergic or untoward reactions

B. Conditions under treatment by a physician that require medicating drugs that may influence or contraindicate certain procedures

Which of the following are considerations for appointment procedures when respiration is indicated in the medical history? A. Poor healing B. Contraindication of nitrous oxide C. No aerosol agents D. Dental chair position E. Xerostomia

B. Contraindication of nitrous oxide C. No aerosol agents D. Dental chair position

Herpes virus is an example of which of the following categories? A. Conditions or diseases that require premedication before treatment B. Diseases and drugs with manifestations in the mouth C. Gender or ethnic/racial influences that increase risk for systemic and oral disease D. Physiologic state of the patient E. Allergic or untoward reactions

B. Diseases and drugs with manifestations in the mouth

Information from the histories does not influence aspects of total patient care and dental hygiene care planning. Immediate evaluation of histories is necessary before proceeding to complete the assessment. A. Both statements are FALSE. B. First statement is FALSE; second statement is TRUE. C. First statement is TRUE; second statement is FALSE. D. Both statements are TRUE.

B. First statement is FALSE; second statement is TRUE.

Which of the following are possible medications and treatment modalities for diabetes mellitus? A. Estrogen/progestin B. Hypoglycemics C. Insulin D. Isoniazid E. Diet control

B. Hypoglycemics C. Insulin E. Diet control

Information that identifies the need for approval for care of a minor patient and/or legal requirements is found in the _______________. A. dental history B. personal history C. medical history

B. personal history

Information to determine culturally appropriate communication measures is found in the: A. medical history B. personal history C. dental history

B. personal history

Which of the following are considerations when endocrine is indicated in the medical history? A. Minimize stress B. Monitoring blood pressure C. Antibiotic premedication if taking steroids D. Emphasis on high level of biofilm control E. Oral lesions

B. Monitoring blood pressure C. Antibiotic premedication if taking steroids D. Emphasis on high level of biofilm control

Which of the following are advantages of an interview? A. Items of importance may be ommitted B. Personal contact C. Flexibility for individual needs D. Time consuming E. Patient may hold back significant information due to embarrassment

B. Personal contact C. Flexibility for individual needs

Patients at high risk for infective endocarditis do NOT need prophylaxis for which of the following procedures? A. Coronal polishing B. Placement of removable prosthodontic or orthodontic appliances C. Bleeding from trauma to the lips or oral mucosa D. Routine anesthetic injections through noninfected tissue E. Taking dental radiographs F. Shedding of primary teeth

B. Placement of removable prosthodontic or orthodontic appliances C. Bleeding from trauma to the lips or oral mucosa D. Routine anesthetic injections through noninfected tissue E. Taking dental radiographs F. Shedding of primary teeth

Based on the 2007 revision to the American Heart Association guidelines, which of the following conditions require antibiotic premedication before dental and dental hygiene treatment? Select all that apply. A. Rheumatic heart disease B. Previous endocarditis C. Cardiac transplantation recipient with cardiac valvular disease D. All congenital heart disease E. Prosthetic cardiac valve F. Mitral valve prolapse

B. Previous endocarditis C. Cardiac transplantation recipient with cardiac valvular disease E. Prosthetic cardiac valve

Which of the following are the general methods in current use for obtaining a health history? A. Combination of interview and survey B. Questionnaire C. Survey D. Combination of interview and questionnaire E. Interview

B. Questionnaire D. Combination of interview and questionnaire E. Interview

The need for immediate treatment can be determined from which information in the dental history? A. Previous treamtent B. Reason for present appointment C. Previous dental appointments D. Radiation history

B. Reason for present appointment

Question 12 of 20 Which type of medical consultation may be needed so that urgent treatment may proceed? A. Referrals B. Telephone or personal contact C. Written request

B. Telephone or personal contact

Overuse of antibiotics can induce which of the following? Select all that apply. A. Dependence B. Toxicity C. Allergy D. Microbial resistance E. Infection

B. Toxicity C. Allergy D. Microbial resistance

Which of the following types of correspondence is preferred for medical consultation? A. Telephone or personal contact B. Written request C. Referrals

B. Written request

A crowded reception area may prevent accuracy or completeness of a health history related to A. how the questions are worded. B. insufficient privacy. C. a patient's inability to read or a language barrier. D. patient fear of refusal of treatment. E. withheld information because it may seem irrelevant.

B. insufficient privacy.

Information to determine conditions that may complicate certain kinds of dental and dental hygiene treatment can be found in the _________________. A. dental distory B. medical history C. personal history

B. medical history

Information to determine the physiologic state of the patient can be found in the: A. dental distory B. medical history C. personal history

B. medical history

Information to determine whether the patient has or has had allergic or untoward reactions can be found in the: A. dental distory B. medical history C. personal history

B. medical history

Information to determine whether the patient has or has had communicable diseases that endanger the dental personnel can be found in the: A. dental distory B. medical history C. personal history

B. medical history

Information to determine whether the patient has or has had diseases and drugs with manifestations in the mouth can be found in the: A. dental distory B. medical history C. personal history

B. medical history

Information about culturally related health practices that may impact the patient's oral health can be found in the: A. medical history B. personal history C. dental history

B. personal history

Information about the patient's current beliefs and attitudes about health, illness and oral health can be found in the: A. dental history B. personal history C. medical history

B. personal history

A preliminary medication that may be for the purpose of allaying apprehension, preventing bacteremia, or otherwise facilitating the clinical procedure is called: A. immunocompromised B. premedication C. informed consent D. over the counter E. forensic dentistry

B. premedication

"Does your mouth frequently become dry?" is which type of question? A. system oriented B. symptom oriented C. culture oriented D. disease oriented

B. symptom oriented

What certification do all hygienist need to have?

BLS/CPR certification

Dry heat oven microorganism spore test

Bacillus atrophaeus strips

Fluoride can be

Bacterial Static Bactericidal

Smoking and eating

Banned in treatment areas

Preparation of treatment room Items that may be covered

Barrier coverings prevent contamination from reaching surfaces. Covers for light handles, counter tops, x-ray machine parts, and water faucets are examples. Care is taken when removing covers not to contaminate object beneath

What is a sessile lesion?

Base of the lesion is broad or flat

Before and after treatment using barriers

Before Treatment: -identify where barriers/covers can be used -apply barriers prior to patient visit -ensure barriers are secure and will not fall off during patient treatment After treatment: -wear PPE when removing barriers -Do not contaminate surfaces with gloves or unclean barriers -clean and disinfect contaminated surfaces -discard used barriers and covers in trash -remove contaminated gloves, perform hand hygiene, and apply fresh covers/barriers

Patient preparation Application of surface antiseptic

Before injection of anesthetic: a needle introduced into the mucosa for penetration to deeper tissue, microorganisms on the surface can be carried into the tissue Before scaling and other dental hygiene instrumentation: dry surface and swab the area before instrumentation

How do composite/glass ionomers work in terms of sensitivity?

Blocks tubules with an added benefit of fluoride release

When exploring a pocket, the clinician may detect a variety of different surfaces. Which of the following are commonly detected?

Biofilm accumulation Calculus formation Demineralization

Unit water lines

Biofilm microorganisms can form on the inside of the waterline tubings overnight standing Water lines flushed for 2 minutes at the beginning of each day microbial counts were reduced Run water through water tubing for 230 seconds before and 30 minutes after each patient

What is a follow-up?

Brief follow-up examination to check healing following. a treatment

What is a screening?

Brief, preliminary examination to determine priorities for treatment

Which teeth are most often affected by hypersensitivity?

Buccal and cervical regions of: 1. Canines 2. First Premolars 3. Incisors 4. Second Premolars 5. Molars

Molar Relation of Mesiocclusion

Buccal groove of mandibular 1st molar is mesial to mesiobuccal cusp of maxillary 1st molar by at least the width of a premolar

Main role of saliva

Buffer the acids and clearance of food debris

Which of the following is a characteristic of motivational interviewing? A) Clinician is in the power role B) Patient resistance is not addressed C) Patient and clinician have dialogue D) Motivation is by guilt or intimidation

C) Patient and clinician have dialogue

The hygienist is preparing to perform a stain removal procedure for a patient who is required to take prophylactic antibiotics prior to having dental treatment done. The patient has taken the correct medication as noted at the beginning of the appointment. Which of the following should be considered? A. Stain removal procedures do not require prophylactic antibiotic premedication B. Avoid flossing after the procedure to avoid forcing abrasive particles into the sulci/pockets C. Check the time the medication was taken to be sure the optimal level of circulating medication has not passed D. Perform a "toothbrush" prophy to avoid creating a bacteremia

C. Check the time the medication was taken to be sure the optimal level of circulating medication has not passed

When the patient is allergic to penicillins and unable to take oral medications, the following prophylaxis agent(s) can be used: Select all that apply. A. Azithromycin B. Amoxicillin C. Clindamycin D. Cephalexin E. Cefazolin F. Ampicillin

C. Clindamycin E. Cefazolin

Which of the following are possible medications and treatment modalities for arthritis? A. Antineoplastic drugs B. Vitamins C. Corticosteroids D. Nonsteroidal anti-inflammatory drugs E. Aspirin

C. Corticosteroids D. Nonsteroidal anti-inflammatory drugs E. Aspirin

A questionnaire by itself can satisfy the overall purposes of the history as long as the questions are comprehensive. Positive findings on a questionnaire are explained further in a personal interview. A. Both statements are FALSE. B. First statement is TRUE; second statement is FALSE. C. First statement is FALSE; second statement is TRUE. D. Both statements are TRUE.

C. First statement is FALSE; second statement is TRUE.

Patients who have had radiation therapy to the area surrounding a proposed implant site are considered poor risks for which one of the following reasons? A. Radiation permanently affects growth of the oral soft tissues B. Radiation causes excessive bleeding C. Radiation affects the bone's ability to heal D. Radiation causes a compromised immune system E. Radiation destroys the bone

C. Radiation affects the bone's ability to heal

Permitting children to participate in their history preparation allows for A. no need for parent or legal guardian to sign the record. B. the parent or legal guardian to leave the office. C. building rapport. D. getting the most accurate information.

C. building rapport.

Information about the personal daily care exercised by the patient can be found in the: A. personal history B. medical history C. dental history

C. dental history

When the immune response is attenuated by administration of immunosuppressive drugs, by irradiation, by malnutrition, or by certain disease processes, it is called: A. forensic dentistry B. informed consent C. immunocompromised D. over the counter E. premedication

C. immunocompromised

Which of the following are disadvantages of a questionnaire? A. broad in scope B. time-consuming C. inflexible D. impersonal E. items of importance may be ommitted

C. inflexible D. impersonal

Information to determine gender or ethnic/racial influences that increase risk for systemic and oral disease can be found in the: A. personal history B. dental distory C. medical history

C. medical history

A health condition that may be embarrassing, such as an infectious or communicable disease, may prevent accuracy or completeness of a health history related to: A. how the questions are worded. B. a patient's inability to read or language barrier. C. patient fear of refusal of treatment. D. withheld information because it may seem irrelevant. E. insufficient privacy.

C. patient fear of refusal of treatment.

Which of the following are disadvantages of an interview? A. inflexible; no provision for additional questioning in areas of specific importance to an individual patient B. impersonal; no opportunity to develop rapport C. patient may be embarrassed to talk about personal conditions and may hold back significant information D. time-consuming when not prefaced with questionnaire E. unless a list is consulted, items of importance may be ommitted

C. patient may be embarrassed to talk about personal conditions and may hold back significant information D. time-consuming when not prefaced with questionnaire E. unless a list is consulted, items of importance may be ommitted

Bacteremia can be defined as: A. produced or derived from blood; disseminated through the bloodstream. B. the provision of an effective antibiotic before invasive clinical procedures that can create a transient bacteremia, which, in turn, can cause infective endocarditis or other serious infection. C. the presence of microorganisms in the bloodstream. D. a state of abnormal and individual hypersensitivity acquired through exposure to a particular allergen. E. a change in the effect of one drug when a second drug is introduced concomitantly; the change may be desirable, adverse, or inconsequential.

C. the presence of microorganisms in the bloodstream.

Chemical vapor sterilizer use

Cannot be used for materials or objects that can be altered by the chemicals that make vapor or that cannot withstand the high temperature Examples: low melting plastics, liquids or heat sensitive hand pieces

What are the necessary foundational skills of a dental hygienist in contemporary clinical practice?

Care planning, evaluation, and documentation

organisms of microorganisms of the oral cavity: infection potential

Carriers Transient organisms Inappropriate work practices

Instrument processing center

Center for care, cleaning, packaging, sterilizing, and storing instruments is located definitely apart from the treatment rooms

What does the smear layer cover?

Dentinal surface and tubules

Cleaning the face

Check and clean the exposed parts of the face not covered by mask or protective eyewear Cleaning face several times a day and washing before eating is personal hygiene and safety

Select all of the following that are considered a traumatic lesion according to the Classification of Periodontal Diseases and Conditions, Gingival Diseases.

Chemical injury Physical injury Thermal injury

What are the four general classes of furcations?

Class I, II, III, IV

Supplemental recommendations

Cleaning the face Smoking and eating Reception area Sterilization monitoring Office policy manual

How does gluteraldehyde work with desensitivity?

Coagulates proteins and amino acids within the dentinal tubule to decrease the dentinal tubule lumen diameter.

What is the most common stimulus for pain?

Cold

The dental hygienist who collaborates autonomously with members of interdisciplinary teams to provide dental hygiene services in a variety of settings is using which type of practice model? Dependent Model Collaborative Practice Model Mid-level Model Public Health Model Web-based Communication Model

Collaborative Practice Model

Critical items

Come into contact with body tissue and bone -highest risk of disease transition -items should be disposable or sterilized with heat sterilizer ex: surgical instruments, probes, needles, scalpel blades

What does CODA stand for?

Commission on Dental Accreditation

Communication with caregivers:

Communicate w. caregiver & patient Keep focus on patient (eye contact) Assess patient needs & caregiver relationships Encourage caregiver to allow patient independence when possible

a process of defining the meaning of a message shared between a sender and one or more intended recipients

Communication

Bactericidal

Completely destroy (kill) bacteria

Standard procedures Patient factors

Comprehensive patient history -Assessment history, prepare patient history, medical consultation and refer patients suspected of carrying infectious disease for medical evaluation Ask patients to rinse with antimicrobial mouth rinse to reduce oral microorganisms Provide protective eyewear Treat every patient as if they are infected , patient with communicable condition avoid elective procedures

Which ethical principle dictates that the dental hygienist respect the patient's private information in the home, hospital, or nursing home setting? Beneficience Confidentiality Nonmaleficence Veracity Autonomy

Confidentiality

What is an example of interprofessional collabortation?

Consultation to support the planning of dental hygiene care, referral for medical evaluation of a suspected undiagnosed condition, or care planning and delivery of dental hygiene service in an integrated healthcare setting

What is a pustule?

Contains pus

What do United States federal regulations mandate of residential facilities, such as nursing homes, that receive Medicaid or Medicare funding? Contract with qualified dental personnel Payment for dental crowns Contract with the State for services Payment for dental services Payment for extractions

Contract with qualified dental personnel

What is exposed after calculus is removed and why is this important to patient treatment?

Dentinal tubules can become exposed = postdebridement sensitivity

Chemical vapor sterilizer care of sterilizer

Depending on the amount of use, refilling is needed at least every 30 cycles. Manufacturers instruction; condensate tray is removed, the exhausted solution emptied and the tray cleaned

How do unfilled/partially filled resins work in terms of sensitivity?

Covers dentinal tubules

How does fluoride work with desensitivity?

Create a barrier by precipitating CaF2 at the exposed dentin surface, to block open dental tubules

How does secondary dentin insulate the pulp?

Creates a "walling off" effect between the dentinal tubules and the pulp

Preparation of treatment room Sterilizable items

Critical and semicritial items are sterilized or disposed of

Barriers to Effective Communication Include:

Cultural Interpersonal Attitudinal Physical Physiological Psychological Insufficient knowledge Lack of access to knowledge Lack of interest Information overload Poor communication skills

the ability of healthcare providers & organizations to understand & respond to needs of culturally diverse populations for whom they provide care. It requires commitment to cultural awareness, motivation to engage in cultural encounters, & ongoing acquisition of cultural knowledge & communication skills.

Cultural & linguistic competence

What valuable services does a Dental Hygienist provide?

Current knowledge, skills to formulate a dental hygiene care plan, communicate the plan to the patient, as well as monitor, measure, and professionally document patient care outcomes

whta is another name for a Dental procedure code?

Customized electronic note

Which of the following medications is an immunosuppressive drug for patients with organ transplants to prevent rejection?

Cyclosporine

Anticonvulsants and sedatives are possible medications and treatment modalities when which of the following is indicated in the medical history? A. Gastrointestinal B. Endocrine C. Diabetes mellitus D. Epilepsy E. Mental, psychiatric

D. Epilepsy

When a patient is receiving or recently received radiation therapy, the physician or oncologist should be consulted to determine the quantity of radiation to be received from any necessary dental radiographs. A dental radiographic examination should be limited if there is any history of radiation therapy. A. First statement is FALSE; second statement is TRUE. B. Both statements are FALSE. C. Both statements are TRUE. D. First statement is TRUE; second statement is FALSE.

D. First statement is TRUE; second statement is FALSE.

Postural hypotension, xerosomia, and gingival enlargement are considerations when which of the following is indicated in the medical history? A. Cerebrovascular accident B. Congenital heart disease C. Angina pectoris D. Hypertension E. Previous history of infective endocarditis

D. Hypertension

The purposes of carefully prepared personal, medical, and dental histories used in comprehensive patient care include all except one of the following. Which is the EXCEPTION? A. Reveal conditions that necessitate precautions, modifications, or adaptations during appointments to ensure patient safety B. Permit appraisal of the general health and nutritional status, which, in turn, contributes to the prognosis of success in patient care and instruction C. Identify cultural beliefs and practices that affect risk for oral disease D. Provide legal record of the comprehensive patient history, which should never be updated E. Provide information pertinent to the etiology and diagnosis of oral conditions and the total patient care plan

D. Provide legal record of the comprehensive patient history, which should never be updated

Patients who have had radiation therapy to the area surrounding a proposed implant site are considered poor risks for which one of the following reasons? A. Radiation destroys the bone B. Radiation permanently affects growth of the oral soft tissues C. Radiation causes a compromised immune system D. Radiation affects the bone's ability to heal E. Radiation causes excessive bleeding

D. Radiation affects the bone's ability to heal

The Dental Hygiene Process of Care components include:

Documentation of assessment, dental hygiene diagnosis, dental hygiene care plan, recording of interventions, and the required process for evaluation

Drug interaction can be described as: A. a state of abnormal and individual hypersensitivity acquired through exposure to a particular allergen. B. produced or derived from blood; disseminated through the bloodstream. C. the presence of microorganisms in the bloodstream. D. a change in the effect of one drug when a second drug is introduced concomitantly; the change may be desirable, adverse, or inconsequential. E. the provision of an effective antibiotic before invasive clinical procedures that can create a transient bacteremia, which, in turn, can cause infective endocarditis or other serious infection.

D. a change in the effect of one drug when a second drug is introduced concomitantly; the change may be desirable, adverse, or inconsequential.

Review and update of a patient's health history must be done ___________________. A. every 6 months B. when a patient gets a medical physical C. at least once a year D. at each appointment

D. at each appointment

Toothbrushing and other cleansing devices and frequency of use is recorded for _______________________in the dental history? A. fluorides B. previous treatment C. family dental history D. biofilm control procedures E. previous dental appointments

D. biofilm control procedures

Questions that identify ethnic or gender-related increase risk for systemic or oral disease are which type of questions? A. disease oriented B. symptom oriented C. system oriented D. culture oriented

D. culture oriented

Which of the following are advantages of an interview? A. consistent B. time-saving C. patient has time to think over the answers D. development of rapport E. flexibility for individual needs

D. development of rapport E. flexibility for individual needs

Questions that contain items such as diabetes or asthma are which type of questions? A. system oriented B. culture oriented C. symptom oriented D. disease oriented

D. disease oriented

Which of the following are disadvantages of a questionnaire? A. broad in scope B. items of importance may be ommitted C. time-consuming D. inflexible E. impersonal

D. inflexible E. impersonal

A medicolegal document that holds providers responsible for enduring that patients understand the risks and benefits of a procedure or dedication before it is administered is called: A. premedication B. forensic dentistry C. over the counter D. informed consent E. immunocompromised

D. informed consent

Questions that check whether the patient has had a disease of the digestive system are ___________ oriented questions. A. disease B. culture C. symptom D. system

D. system

Questions that check whether the patient has had a disease of the digestive system are ___________ oriented questions. A. disease B. culture C. symptom D. system

D. system

The patient's limited knowledge about the relationship between certain diseases or conditions and dental treatment may prevent accuracy or completeness of a health history related to: A. how the questions are worded. B. patient fear of refusal of treatment. C. insufficient privacy. D. withheld information because it may seem irrelevant. E. a patient's inability to read or language barrier.

D. withheld information because it may seem irrelevant.

On the tooth surface, continuous process of ____ and _____ is CONSTANTLY occurring

Demineralization Remineralization

If you are constantly eating, your teeth will be in acid enviroment or ____ But if you back up with water, toothpaste and buffering of your saliva. your teeth will _____

Demineralized Remineralized

What is best practice when teaching care to a patient with a caregiver? Demonstrate current methods to the caregiver Avoid tiring the patient Socialize with the patient Avoid distraction Tell the patient what the caregiver should do

Demonstrate current methods to the caregiver

Components of Care Plan Goal: Time Dimension

Denotes when the patient is to achieve a goal and Target time may be a specific date or statement

What does the ADHA Code of Ethics state under "basic belief" regarding Dental Hygiene?

Dental Hygiene is an essential component of overall healthcare and Dental Hygienists function interdependently with other healthcare providers

A comprehensive dental treatment plan for the patient includes:

Dental diagnosis; all essential phases of therapy to be carried out by the dentist, dental hygienist, and patient to eliminate and manage disease or to promote health; and the prognosis

Treatment room features

Dental unit Dental chair Light Clinician's chair Floor Sink Supplies Waste

What is the difference between dental hypersensitivity and pulpal caries?

Dentinal hypersensitivity is sharp, sudden but transient. Pulpal caries creates severe, intermittent or throbbing pain

Dental unit

Designed for easy cleaning and disinfection Removable hoses that can be cleaned & disinfected Syringes with autoclavable tips or fitted disposable tips Handpieces with with valves that can be autoclaved Use of barrier covers where possible

Moist heat: Steam under pressure

Destruction of microorganisms by heat takes place because pf inactivation of essential cellular proteins or enzymes, causes coagulation of protein

What important step is utilized in every part of the Dental Hygiene Process of Care?

Documentation

Instrument washer/thermal disinfector

Differs from the plain washer by having a degree of temperature so that it disinfects as well as clean the instruments Disinfection means that the instruments in cassettes can be handled while packaging

Extrinsic stain categories

Direct -caused by compounds, organic chromogens, attached to the pellicle producing a stain Indirect -result from chemical interaction with tooth surface

Select all that apply to surface irregularities on the cementoenamel junction surfaces.

Diseased altered cementum Cemental resorption Root caries Abrasion Calculus Deficient or overhanging filling Grooves from residual deposits (all options)

Intermediate chemical disinfectant

Disinfectants inactivate all forms of microorganisms but do not destroy spores

High level chemical disinfectant

Disinfectants inactivate spores and all forms of bacteria, fungi and viruses

Chemical disinfectant principles of action

Disinfection is achieved by coagulation, precipitations, or oxidation of protein of microbial cells or denaturation of the enzymes of the cells

Preparation of treatment room Disposable items

Disposable items are used wherever possible

Acids can ?

Dissolve enamel crystals into calcium & phosphate ions

Canine Relation of Mesiocclusion

Distal surface of mandibular canine is mesial to mesial surface of maxillary canine at least the width of a premolar

Yellow stain

Dull, yellowish discoloration of dental biofilm

When the patient is allergic to penicillins and unable to take oral medications, the following prophylaxis agent(s) can be used: Select all that apply. A. Amoxicillin B. Cephalexin C. Ampicillin D. Azithromycin E. Clindamycin F. Cefazolin

E. Clindamycin F. Cefazolin

Active tuberculosis is an example of which of the following categories? A. Gender or ethnic/racial influences that increase risk for systemic and oral disease B. Physiologic state of the patient C. Allergic or untoward reactions D. Diseases and drugs with manifestations in the mouth E. Communicable diseases that endanger the dental personnel

E. Communicable diseases that endanger the dental personnel

Where should vitals be recorded?

In the patient record

African Americans having an increased risk for diabetes and a related increased risk for periodontal disease is an example of which of the following categories? A. Allergic or untoward reactions B. Physiologic state of the patient C. Conditions under treatment by a physician that require medicating drugs that may influence or contraindicate certain procedures D. Conditions or diseases that require premedication before treatment E. Gender or ethnic/racial influences that increase risk for systemic and oral disease

E. Gender or ethnic/racial influences that increase risk for systemic and oral disease

History of jaundice should be recorded when which of the following is indicated in the medical history? A. Kidney B. Mental, psychiatric C. Respiration D. Pregnancy E. Liver

E. Liver

Which one of the following would be recommended prior to having a tooth polishing procedure done if the patient has a history of mitral valve prolapse? A. Erythromycin 800 mg B. Azithromycin 500 mg C. Amoxicillin 2.0 g D. Clindamycin 600 mg E. No prophylactic antibiotics

E. No prophylactic antibiotics

The purposes of carefully prepared personal, medical, and dental histories used in comprehensive patient care include all except one of the following. Which is the EXCEPTION? A. Permit appraisal of the general health and nutritional status, which, in turn, contributes to the prognosis of success in patient care and instruction B. Reveal conditions that necessitate precautions, modifications, or adaptations during appointments to ensure patient safety C. Identify cultural beliefs and practices that affect risk for oral disease D. Provide information pertinent to the etiology and diagnosis of oral conditions and the total patient care plan E. Provide legal record of the comprehensive patient history, which should never be updated

E. Provide legal record of the comprehensive patient history, which should never be updated

Which one of the following systems for obtaining the history can be prepared at home by the patient? A. Complete History B. Brief History C. Preappointment D. Information E. Self-History

E. Self-History

ADHA standards serve as a resource for dental hygiene practitioners who seek to provide ______________ and _______________.

EBP , person-centered care

HHV-4: Oral hairy leukoplakia

EBV replicates within epithelial cells

Which of the following describes Class I furcation?

Early, beginning involvement

When designing a strategy for the treatment of increased risk of caries in patients with poor oral status, which strategy applies? Educate regarding oral status and potential for compromised nutritional status Educate about emergency care for oral injury Educate about the signs and symptoms of mucosal infections Educate about reducing intake of fermentable carbohydrates Educate regarding sips of water or ice chips

Educate about reducing intake of fermentable carbohydrates

When designing a strategy for the treatment of inadequate biofilm removal in patients with poor oral status, which strategy applies? Educate regarding the role of biofilm in the oral cavity Educate about reducing intake of fermentable carbohydrates Educate about the signs and symptoms of mucosal infections Educate about the effects of oral disease on systemic health Educate regarding sips of water or ice chips

Educate regarding the role of biofilm in the oral cavity

Preparation of the treatment room

Effective care of instruments and equipment contributes to: Control of disease transmitted of environmental surfaces An increase in the working efficiency of the office personnel Atmosphere of cleanliness and orderliness that contribute to patients and clinicians well-being Increase in patients confidence in the ability of dental personnel Maintenance of working efficiency of equipment and instruments A decrease in of unpleasant orders in office

What is palpation?

Examination of the body using touch

If your patient has sensitivity and is having periodontal debridement what do you need to do preprocedural?

Explain potential for sensitivity resulting from calculus removal and/or instrumentation of teeth with areas of exposed cementum or dentin

Chemical disinfectant uses

Environmental surfaces disinfection: following each appointment, the treatment area is cleaned and disinfected Dental laboratory impressions and prostheses: impression can be carries of infectious material to a dental laboratory. Completed prostheses must be disinfected before delivery to a patient

Permanent colonization of a child's teeth with the mutans streptococci group can take place soon after ____

Eruption

Characteristics of effective technique using motivational interviewing:

Establish rapport; acknowledge patient's concerns, priorities, & arguments against change; express empathy & acceptance rather than scold; avoid confrontation; assess readiness for change; tailor interventions to facilitate movement along the continuum; provide feedback; use reflective listening skills & paraphrase patient statements to evaluate accuracy; ask open-ended questions; support self-efficacy; shift responsibility to patient.

Components of Care Plan Goal: Criterion of Measurement

Establishes the observable behavior or tangible outcome deisre of the patient

True or False: A dental hygiene diagnosis is problem and disease oriented

False A dental diagnosis is problem and disease oriented

True or False Dental hygienists should rely on their employer's liability insurance

False! It is critical for a dental hygienist to carry their own liability insurance and not simply rely on the employer's insurance

Dental caries is not a major problem in the health and welfare of adults, adolescents, and children. True or False

False. It still remains a major problem.

There is no protocols to address caries. True or False

False. There is prevention and management at various stages of lesion development; goal is to halt and control disease.

True or False: Informed consent is a one-time activity

False; informed consent is an ongoing process

Why would a patient feel acute hypersensitivity with sudden dentin exposure and not gradual exposure?

Gradual dentin exposure allows for natural healing, like forming a smear layer or sclerosis. Secondary or tertiary dentin may also form to protect the pulp.

Housekeeping surfaces

Floors, walls, sinks -pose no risk of disease transmission Floor: no carpeting. Smooth floor covering, easily cleaned, nonabsorbent Sink: wide and deep for effective hand washing. No splashing or touching sides. Automatic water faucet, soap dispenser, knee or foot-operated controls Waste: receptacle with opening large enough to prevent contact with sides when material is deposited. Heavy-duty plastic bag liner. Separate sharps disposal. Smal biohazard receptacle near treatment area for contaminated gauze and other waste

What creates a pressure on the nerve endings within the tubule which transmits the pain impulse by stimulating the nerves in the pulp?

Fluid movement

What to use on white spot lesion?

Fluoride to reverse meticulous biofilm removal or prescription paste.

Dental chair

Foot-operated controls Surface and seamless finish of easily cleaned plastic material that withstand chemical disinfection with out damage or discoloring; cloth upholstery to be avoided

Chemical vapor sterilizer operation

From 132 C (270 F) with 20-40 pounds of pressure in accord with the manufacturers directions Minimum of 20 minutes after the correct temperature and pressure have been attained, extended for a large load Instruments are, need a short period for cooling

fluoride absoprtion

GI tracts (absorbed as hydrogen fluoride in stomach), blood stream (travels in plasma, reacted within 30 min of intake)

Chemical vapor microorganism spore test

Geobacillus stearothermophilus strips

Autoclave types

Gravity displacement High-speed prevacuum

Appointment schedule

Guide for implementing the proposed interventions

hepatitis: types

HBV HCV HDV

human herpes viruses

HHV-1 HHV-2 HHV-3 HHV-4

Standard procedures Factors for the dental team

Have medical examinations, keep immunizations up (DHCP medical status) Always use a mask, protective eye wear, gloves and a clean closed front gown with fitted wrist cuff (PPE) Meticulous hand wash Aseptic technique

Folders are required for confidentiality and what act?

Health Insurance and Portability and Accountability Act

informed people will make good health-related decisions; limitation of this model is that information alone is not usually sufficient to change behaviors, & behavior change does not follow a logical series of step-wise changes

Health belief model

Which one of the following gingival lesions are of genetic origin?

Hereditary gingival fibromatosis

HHV-1: Herpetic whitlow

Herpes of the finger entering through skin abrasions around fingernail

Both correct

High-level disinfectants, inactive sport and all forms of bacteria, fungi and viruses. Intermediate-level disinfectants inactivate all for of microorganisms but do not destroy spores

Which of the following is considered a gingival disease of fungal origin?

Histoplasmosis

In the development of gingival and periodontal infections, there are 4 stages of development. Select the four stages.

Initial, early, established, and advanced lesion

What is the pulse measuring?

How often the heart beats in 1 minute

Standard procedures Treatment factors

Hypodermic needles: use a safe recapping method, place used needle into puncture resistant sharps, dispose Removable oral prostheses: routinely, gloves are not to receive a septic prostheses from a patients, place in disposable cup (zip lock with disinfectant)

What are the five aspects outlined in Standard 2 of the ADHA Standards for Clinical Dental Hygiene Practice of the dental hygiene diagnostic?

I. Analyze and interpret all assessment data II. Formulate the dental hygiene diagnosis III. Communicate the dental hygiene diagnosis with patients IV. Determine patient needs that can be improved through the delivery of dental hygiene care V. Identify referrals needed within dentistry and other healthcare disciplines based on dental hygiene diagnosis

Components of Care Plan Goal: Subject

Identifies the patient or patietns caregiver as the person responsible for achieving the goal

Components of Care Plan Goal: Verb

Identifies the patients action desired to achieve the goal

Procedure following exposure

Immediately wash would with soap and water, rinse Flush nose, mouth, eyes or skin with clear water, saline or sterile irrigant First aid procedures Report Complete incident report, document Follow required predetermine procedures

Gingival pockets have a tooth surface wall (enamel).

In periodontal pockets, the tooth surface wall is either cementum or a combination of cementum and enamel.

Where do cancers of the head and neck begin?

In the the squamous cell that line moist mucosal surfaces of the mouth, nose, and throat

Low level chemical disinfectant

Inactivate vegerative bacteria certain lipid-type viruses but do not destory spores, tubercle bacilli or nonlipid viruses

Moderate Overbite

Incisal edges of maxillary teeth appear within the middle third of the mandibular teeth

Normal Overbite

Incisal edges of the maxillary teeth are within the incisal third of the facial surfaces of the mandibular teeth

Edge-to-Edge Bite

Incisal surfaces of the maxillary anterior teeth occlude with the incisal surfaces of the mandibular anterior teeth, instead of overlapping like in normal occlusion

Office policy manual

Include in clinic or office policy manual outline of procedures for standard precautions address for sources of various materials can be kept in manual Emergency procedures to follow when accidentally exposed

Tooth contour can be a factor in disease development. Which of the following is NOT considered a factor due to tooth contour?

Incomplete eruption

Interdisciplinary patient care team

Integrated providers from across the planning of dental hygiene care, referral for medical evaluation of a suspected undiagnosed condition, or care planning and delivery of dental hygiene services in an integrated healthcare setting

How do interventions differentiate from goals?

Interventions address the specific barriers to the patient achieving oral health and wellness

Metallic substances contained in drugs- Staining

Iron- black or brown Manganese- black Generalized staining -Drug enters biofilm and imparts color to biofilm and calculus -Take medications through a straw or in tablet/capsule form to prevent contact with teeth

Define the hydrodynamic theory

It's an explanation for transmission of stimuli from the outer surface of the dentin to the pulp

Noncritical items

Items that come in contact with intact skin. Pose lowest risk of disease transmission ex: blood pressure cuff

Open Bite

Lack of occlusal or incisal contact between certain maxillary and mandibular teeth because either/both have failed to reach the line of occlusion

Sterilization monitoring

Keep written record of dates Indicate advance dates for next testing Perform tests made weekly on the same day to simplify remembering

What infectious organism is active during the progression of dental biofilm?

Lactobacillus (Join party)

Dental Hygiene Management

Legal and Psychosocial Considerations (DHCP legally obligated to treat) Maintain OH Pain and oral manifestations Adverse effects of medications (nausea and dental caries)

Which of the following is considered a gingival manifestation of systemic conditions?

Lichen planus

Tobacco stain

Light brown to black discolorations of the teeth caused by coal tar combustion in cigarettes, and pigments from chewing tobacco, penetrating the pits and fissures on the enamel and dentin surface

Tips for establishing rapport with patients of all ages:

Listen more than talk Practice attentive listening Sit eye-to-eye Convey nonjudgmental attitude Maintain a calm demeanor Use normal tone appropriate vocabulary Look for clues, share thoughts, ask questions Don't jump to conclusions Link info to activities of daily living

What is localized and generalized?

Localized- Limited to a small area Generalized- Involves most or all of an area

Subgingival calculus

Location: -clinical crown apical to margin of gingiva extending towards the clinical attachment on root surface -also on dental implants Distribution: -can be generalized or localized -heavier deposits are found in areas where pt has difficulty accessing during personal oral care -calculus usually forms at CEJ with recession and pocket formation

Supragingival calculus

Location: -clinical crowns coronal to margin of gingiva Distribution: -lingual surfaces of mandibular anterior teeth -facial surfaces of maxillary 1st and 2nd molars (near parotid ducts) -crowns of teeth out of occlusion; neglected teeth not being brushed -on dentures, implants, oral piercings, dental prostheses

Erosion

Loss of tooth substance by chemical process that does not involve known bacterial action

What is the diastole phase?

Lowest pressure, effect of ventricular relaxation. Normal for adults is less than 80

Division 2 of Distocclusion

Mandible is retruded and 1 or more maxillary incisors are retruded

Division 1 of Distocclusion

Mandible is retruded and all maxillary incisors are protruded

Classes describe the relationship of the ____ to the _____

Mandible to the maxilla - Because mandible is moveable and maxilla is stationary

Class III - Mesiocclusion

Mandibular teeth are anterior to normal position in relation to maxillary

Why do we need a differential diagnosis?

Many oral conditions exhibit similar symptoms to dentinal hypersensitivity

Canine Relation of Normal Occlusion

Maxillary permanent canine occludes with distal half of mandibular canines and mesial half of mandibular 1st premolar

Preparation

Materials: Each method of sterilization has specific requirements and manufacturers recommendations are followed Study wrapping is necessary to prevent punctures or tears The wrap permits steam or chemical vapor to pas through contents Seal: Indicator tape is used. Pins, paper clips or other types of metal are not used Chemical indicator tape is also used to seal Change of color means the autoclave reached temp. Striped tape is left on sealed packages to identify ready

Anterior Crossbite

Maxillary incisors are lingual to the mandibular incisors

Abrasion

Mechanical wearing away of tooth substance by forces other than mastication

Chemical vapor sterilizer principles of action

Microbial and viral destruction results from permeation of the heated formaldehyde and alcohol

Tooth position can be a factor in disease development. Which of the following is NOT considered a factor due to tooth position?

Missing cusps

Which of the following describes Class II furcation?

Moderate involvement, bone has been destroyed to permit probe to enter furcation but not pass freely through.

What is OHRQL?

Oral Health-Related Quality of LIfe

a well-accepted, patient-centered communication alternative that can help increase a patient's engagement in his or her own oral care & strengthen commitment to health-related behavior changes

Motivational interviewing

What infectious organism colonize the teeth and help to form the dental biofilm, creating a sticky environment?

Mutans Streptocci (They start the party!)

What does OHRQL stand for?

Oral health-related quality of life

What does the smear layer consist of?

Organic and inorganic debris

What does NPDB stand for?

National Practitioner Data Base

How do lasers work?

Nd:YAG laser treatment can obliterate dentinal tubules through a process called "melting and resolidification." When used with an appropriate protocol, there is no resulting damage to the pulp or dentin surface cracking

Which of the following is a medication that is used in the treatment of angina and ventricular arrhythmias?

Nifedipine

What is the average pulse in adults?

No absolute normal. 60-100 beats per minute

What chemical agents should be used to disinfect housekeeping surfaces?

No blood: Use EPA registered hospital disinfectant or detergent and water Blood: Use EPA registered hospital disinfectant plus tuberculocidal activity

What chemical agents should be used to disinfect clinical contact surfaces?

No blood: Use EPA registered hospital grade disinfectant plus HBV and HIV kill claim or tuberculocidal activity Blood: Use EPA registered hospital disinfectant plus tuberculocidal activity

Floor

No cloth carpeting Smooth floor covering, easily cleaned, nonabsorbent

sending and receiving wordless messages; usually refers to body language, gestures, facial expressions, eye contact, and verbal elements such as rhythm and intonation

Nonverbal Communication

Size and contour of the gingiva can provide retentive areas for biofilm. Which of the following IS NOT contributory to disease development?

Normal gingiva

What is direct observation?

Notes color, contour, size

Anticalculus Dentifrice and Mouthrinse

Objective: -aim to inhibit calculus crystal growth -do not effect existing calculus deposits but prevent formation of future deposits Chemotherpeutic anticalculus agents: -used in "tartar control" mouthiness -ex: pyrophosphates, zinc citrate, pyrophosphates plus triclosan

Personal dental biofilm control

Objective: -to remove biofilm by selecting appropriate brushing, interdental care, and supplementary methods Patient education: -Identify and use hands on demos of oral hygiene aids based on the patients needs -follow up at continuing care appointments to evaluate success and review/refine techniques -Identify dietary behaviors related to biofilm growth

Preparation of treatment room Items that require chemical disinfection

Objects and surfaces that cannot be included in of the the preparation of treatment room categories are treated with a chemical disinfectant, a substitute item which is either disposable or coverable will be needed

what does the smear layer do for the dentinal tubules?

Occludes the tubules, forming a "smear plug" or "bandage" to block stimuli

What is the systole phase?

Occurs during ventricular contraction, peak or highest pressure exerted by heart during contraction. Normal for adults is less than 120

Dental stains and discolorations of teeth and restorations

Occurs in 3 general ways: -adherence directly to surfaces -contained within calculus and soft deposits -incorporated within tooth structure or restorative material

Preparation of treatment room Hand contacts

Only contacts essential to the service to be preformed are made. Planning ahead to have materials ready so that cabinets knobs and drawers do not have to be contacted

Dental fluorosis

Originally called brown stain but known as mottled enamel today -results from excessive fluoride ion ingestion during mineralization period of teeth. Caused toxic damage to ameloblasts -appears chalky white spots to brown depending on severity. May also produce cracks or pitting

Infectious process #2: prevention of transmission: Protection of the Clinician

PPE immunizations

What happens when stimulus is removed?

Pain subsides

In this type of reaction (pulpal pain) will pain persist or subside after stimulus is removed?

Pain will persist, even if the stimulus is removed

HHV-1: Primary herpetic gingivostomatitis

Painful oral ulcers are asymptomatic and isolated to marginal and attached gingiva

HIV: transmission

Parenteral Sexual Less Common Routes: making out, saliva, sweat, lesions, insect bites

Informed refusal

Patient declining all or part of the proposed care plan after they have been given all information necessary for them to make an informed decision

_____________________ clarify what the patient needs to do to promote, maintain, and achieve oral health and wellness.

Patient goals

When determining case diagnosis for a patient, which of the following assist in the classification of gingival and/or periodontal diseases?

Patient health history dental history and social history Clinical examination Radiographs Data from assessment

Name the criteria for Informed Consent of Planned Care?

Patient must: -be knowledgeable about what the healthcare provider plans to do -have enough info to make a rational choice -give oral or written permission for plan to be carried out -give consent for specific treatment -give consent for legal procedure -give consent under truthful conditions -be legally competent to give consent to care

Documentation

Patient name, record #, address, phone and email Medical history of HBV, HCV, HIV For HIV+ source patients: -current medication and effectiveness -viral load and current CD4 if known

Documentation should include:

Patient's age, gender, & ethnicity Observations about health literacy level Cultural factors affecting communication or care Disabilities affecting communication

Factors to teach the patient:

Patient's willingness & ability to communicate affects DH's ability to provide care Patient-client rapport affects patient's motivation to follow oral health recommendations

Preprocedural oral hygiene measures

Patients should brush/floss prior to dental appointment -biofilm removal from teeth, tongue, and gingiva contributes to lowering microbial count Patients should perform a preprocedural antiseptic mouthrinse -reduces bacteria on gingival and mucosal surfaces -.2% chlorhexiding provides lower bacterial count for more than 60 minutes -preprocedural rinsing is recommended before injections

Packaging instrument arrangement

Preset cassettes or packages can be preplanned to contain all the item usually needed for appointments Each packaged dated and marked for identification of contents Clear packages with self-seal permit instrument identification without special labeling

Dental hygiene services include:

Preventative, therapeutic, supportive, and referral interventions.

Select all that are classified as mucocutaneous disorders resulting in gingival manifestations of systemic diseases.

Pemphigoid Erythema multiforme Lupus erythematosus Pemphigus vulgaris

Significant exposures

Percutaneous or premucosal stick or wound with needle or sharp instrument with blood, saliva, or other body fluids Contamination of any obviously open wound, non intact skin, or mucous membrane with blood, saliva, or a combination Exposure of patient;s body fluids to unbroken skin is not considered a significant exposure

Gingival infections are confined to the gingiva.

Periodontal infections include all parts of the periodontium.

What is a soft tissue graft also referred to?

Periodontal plastic surgery

What is formed as a result of disease degeneration that caused the junctional epithelium to migrate apically along the cementum?

Periodontal pocket

organisms of microorganisms of the oral cavity: cross-contamination

Person to person Person to inanimate object Inanimate object to another person

Which of the following is a medication that is used in the treatment of seizures?

Phenytoin

Which of the following medications can lead to gingival enlargement?

Phenytoin Nifedipine Cyclosporine

Communication with older adults:

Physical and cognitive changes: cognitive disabilities, communication disorders (dysarthria & aphasia), sensory loss (hearing loss), & physiologic changes in speech patterns (voice tremor, pitch, loudness, speaking rate). Communication predicament: avoid inappropriately modifying your speech & language when addressing older patients; this includes accommodative speech (high-pitched tone, sing-song cadence, simplistic language), terms of endearment (honey, sweetie, dearie, nicknames), use of plural pronouns ("we"), baby talk, & elderspeak.

Infection control: clinical procedures

Prevention of cross-contamination Keep yourself and patient healthy Infection control Reduce pathogenic organisms Standard precautions

All of the items below are functions of the attached gingiva EXCEPT one. Which one is the EXCEPTION?

Prevents mucogingival defects

Affective Goal

Pinpoints desired changes in patient values, beliefs, and attitudes

Malocclusion may be a predisposing factor in the retention of plaque biofilm.

Plaque biofilm retention is a causative factor in dental caries disease and in periodontal disease.

Psychosocial factors may contribute to the risk of periodontal disease. Select the psychosocial factors that are risk factors.

Poor nutrition Antisocial behavior Generalized anxiety disorder

The significance of oral health to overall general health for people that are homebound is which of the following? Limited regulations prevent individuals from accessing oral care. Limited Medicaid and Medicare coverage for the adult in care facilities for oral health. Regulations for oral health vary greatly state by state for oral health. Some states require nursing homes to contract with dental personnel. Poor oral heath affects general health and poor general health affects oral health.

Poor oral heath affects general health and poor general health affects oral health

Use of dry heat

Primarily for materials that cannot be safely sterilized with steam under pressure For oils and powders when they are thermostable at the required temperatures For small metal instruments enclosed in special containers or that might be corroded or rusted by moisture

pellicle composition

Primarily glycoproteins which are selectively absorbed by the hydroxyapatite of the tooth surface. -material becomes insoluble coating on teeth, existing calculus, dental prostheses etc.

What equipment is essential to deliver dental hygiene care for the homebound patient who has defective swallowing? Hospital bed Portable dental unit Hand held x-ray Ultrasonic scaler Autoclave

Portable dental unit

Components of Transtheoretical Model and Stages of Change

Precontemplation Contemplation Preparation Action Maintenance Termination

Preliminary planning of preparation of treatment room

Preparation of the treatment room when time between appointments is limited requires an efficient procedural system Hand contacts Sterilizable items Disposable items Items that may be covered Items that require chemical disinfection

Which of the following is considered a gingival disease of viral origin?

Primary herpetic gingivostomatitis

Top priority for low risk patient?

Primary prevention remains top priority

What do you use to measure the size of a lesion?

Probe

Define the ADHA Standard 3, Planning

Process in which diagnosed patient needs are prioritized, patient goals and evaluative measures established. Intervention strategies are determined, and an appointment schedule is proposed

Iatrogenic causes are created by professionals during patient treatment or neglect of treatment.

Professionals are obligated to inform patients of risk factors should they occur iatrogenically.

Facial Profile of Mesiocclusion

Prognathic with prominent, protruded mandible and lower lip and normal maxilla

What is the most important objective of care for the homebound patient who has a shortened life span due to a terminal illness? Triage the patient's needs. Provide educational intervention for caries prevention. Contribute to patient's general well being. Provide palliative care. Coordinate periodontal treatment.

Provide palliative care.

HIV: testing for diagnosis

Serological Tests -lab test -rapid/home test -CD4+ lymphocyte and viral load count

When designing a strategy for the treatment of periodontal infection in patients with poor oral status, which strategy applies? Provide dietary analysis Facilitate the reline or replacement of poor fitting dentures Evaluate inadequate chewing function Eliminate the use of products with alcohol Provide periodontal therapy

Provide periodontal therapy

What objective of care is not the focus for the patient who has a terminal illness? Provide care that emphasizes patient comfort Provide clean mouth environment to reduce odor Provide relief of painful or aggravating symptoms Provide preventive and restorative aspects of care Prevent aspiration of debris and oral microorganisms

Provide preventive and restorative aspects of care

What does calculus provide for exposed dentin?

Provides a protective coating to shield dentin from stimuli

Which part of the tooth contains highly innervated cell fiber endings? - Pulp - Cementum - Dentin - Enamel

Pulp

What is occlusal pressure indicative of?

Pulpal Pathology

High-speed prevacuum

Pump removes the air from the chamber and allows faster penetration of the steam for sterilizing

Which of the following are necessary as part of the permanent record of a patient who has a need for periodontal therapy?

Radiographs Physician's approvals for therapy Other correspondence of record

Position of the gingiva can provide retentive areas for biofilm. Which of the following gingival positions are contributory to disease development?

Receded Enlarged Periodontal pocket Blunted papilla (All are contributory)

Waste

Receptacle with opening large enough to prevent contact with sides when material is dropped in; heavy duty plastic bag liner to be sealed tightly for disposal Separate sharps disposal Small biohazard receptacle near treatment area

Bacterial Static

Reduce bacteria growth

Disposal of waste

Regulation: investigate the regulations of each town of city sanitation division for rules concerning disposal of contaminated waste Guidelines: Disposable materials (gloves, masks, wipes, barriers) that are contaminated are discarded in sturdy impervious bag Blood, suctioned fluid or other liquid waster carefully poured into a drain that is connected to a sanitary fluid system Sharp items placed into a puncture resistant leak proof container Human tissue, infectious medical waste, liquid/solid chemical contaminated solid wastes disposed of according to requirements

is the natural repair process of moving minerlas back into the subsurface of the intact enamel

Remineralization

Light

Removable handle for sterilization or disposable barrier

Follow-up

Report signs and symptoms associated with HIV seroconversion Obtain medical evaluation of any illness involving fever, rash or lymphadenopathy Pursue counseling and further testing

How to recognize and identify factors causing stains/discoloration of a patients dentition?

Review medical and dental history -do they smoke? What kind of medications do they take? Fluoride use? Food Diary -Do they drink tea, coffee, dark-colored juices, wine? Oral hygiene habits -Review history of personal biofilm removal routines

Before the dental hygienist visits alternative sites to provide care, the hygienist needs to be aware of which legal concern? Review reimbursement mechanisms Review supervision laws Adopt a new model of oral health delivery Receive additional education Join public health programs

Review supervision laws

What should you observe when taking pulse?

Rhythm- regular, irregular Volume and. strength- full, strong, weak, thready

All of the following are mucogingival deformities around teeth EXCEPT one. Which one is the EXCEPTION?

Root fracture

An example of an iatrogenic factor would be which of the following?

Rough or grooved surfaces left after scaling

Standard procedures Clinic preparation

Run water through lines -2 minutes in the morning, 30 minutes between patients Disinfect all environmental surface Sterilize instruments all other equipment that be be sterilized

Different factors can influence appointment times for the homebound patient. Which of the following are the most appropriate guidelines for appointment scheduling? Schedule late in the afternoon. Schedule when the patient is awake. Schedule to coincide with regular mealtimes. Schedule first thing in the morning. Schedule in relation to nursing care.

Schedule in relation to nursing care. Schedule when the patient is awake.

What does SBIRT stand for?

Screening, Brief Intervention, and Referral to Treatment

Reception area

Select items that can be cleaned and disinfected Provide hand sanitizer gel

Gravity displacement

Self-generation of steam forces out the air; steam enters to penetrate through the cassettes or packages

Chronic periodontitis is classified using which of the following?

Severity of slight, moderate, or severe Distribution of localized or generalized Marginal and/or papillary

What is the objective of care for the terminally patient? Select all that apply. Palliative Care Preventive Care Health Care Short-term care Long-term Care

Short-term care Palliative Care

What is a plaque?

Slightly raised with a broad flat top

Cigarette smokers have increased bone loss compared with nonsmokers.

Smokeless tobacco users are high risk for root exposure in the areas where the quid is held.

Sink

Smooth material (stainless steel) Wide and deep enough for effect handwashing Automatic water faucets and soap dispensers with electric controls Separate room or area for contaminated instrument care

What device is used to take blood pressure?

Sphygmomanometer

HIV: stages of infection

Stage 1: acute HIV infection Stage 2: clinical latency Stage 3: AIDS

Extrinsic stains

Stains that occur on the external surfaces of the teeth that may be removed by toothbrushing, scaling, or polishing

Intrinsic stains

Stains that occur within the tooth surface. Cannot be removed by scaling or polishing. May be improved by WHITENING

Factors to teach patient

Standard precautions Medical, dental and social histories Sterilization and biologic monitoring Normal oral flora and disease etiology Personal oral infection control methods

Sterilization approved methods

Steam under pressure 15-30min 250 F 3.5-10min 132 F Dry heat 120 min 320 F Chemical vapor 20 min 270 F

Moist heat: steam under pressure Principles of action

Sterilization is achieved by action of heat, depends on the temperature ability of steam, air must be excluded, space between objects is essential to ensure access for the steam, materials must be cleaned and air dried before

Dry heat principles of action

Sterilization is achieved by heat Timing for sterilization must start when the entire contents of the sterilizer have reached the peak temperature needed for that load Oil, grease or organic debris on instruments insulates and protect microorganisms from the sterilizing effect

What exactly affects the pain response?

Stimuli that affect the fluid flow within the dentinal tubules

The following are fermentable carbohydrates

Sucrose, glucose, fructose, and cooked starch

What is continuing care?

System of appointments for the long-term maintenance phase of patient care

True or false: There is no evidence that bloodborne infections can be transmitted through housekeeping surfaces

TRUE

True or false Oral procedures that penetrate tissue, such as giving anesthesia, can introduce bacteria into tissues and into the bloodstream

TRUE -organisms injects into tissue can multiply causing an abscess -natural resistance helps body handle and destroy invading microorganisms

What is a heartbeat over 100 BMP called?

Tachycardia

_______________ is the model of health care delivery that uses web-based technology to send electronic information such as digital radiographs and patient history between on-site and off-site dental practitioners. Teledentistry Model Public Health Model Interdisciplinary Team Model Collaborative Practice Model Mid-level Model

Teledentistry Model

Dry heat operation

Temperature: 160 C (320 F) maintained for 2 hours 170 C (430 F) for 1 hour, timing starts after the desired temperature has been reached Penetration time: heat penetration varies with different materials, and the nature and properties of various materials is considered Care: care is taken not to overheat because certain materials can be affected

Chemical vapor sterilizer: Operation

Temperature: 270 degrees F w/ 20-40lbs of pressure Time: minimum of 20 minutes after correct temperature and pressure have been attained. Time extended for large load Cooling at completion of cycle: instruments are dry. Only short cooling period needed

Dry heat sterilizers operation

Temperature: 320 degrees F for 2 hours. 340 degrees F for 1 hour. Timing starts after desired temperature is reached Care: care taken to prevent overheating materials.

When the distance is less than the width of a premolar, what can it be classified as?

Tendency toward Class II or III

Which of the following are used during an assessment of the mucogingival area?

Tension test Probe measurements Color changes

Biologic monitor

Tests that the autoclave is functioning properly

What is the Human Needs (HN) Conceptual Model?

The HN model is a dental hygiene diagnostic process that uses eight human needs related to dental hygiene care as its foundation

What is responsible for depolarizing the nerve as potassium leaves the nerve cell and sodium enters?

The Sodium Potassium Pump

Interproximal space

The area between adjacent tooth surfaces

What does the ADHA Diagnosis White Paper expressly state about the dental diagnosis and the dental hygiene diagnosis?

The dental hygiene diagnosis is to be complementary to the dental diagnosis and promote collaboration within dentistry and with other healthcare professionals

Col

The depression under the contact area that is most susceptible to infection is known as the ______ area. most periodontal infection begins here

Dental hygiene interventions

The evidence-based strategies, preventative services, treatment, products, and referrals, that when applied, reduce, eliminate, or prevent a diagnosed need or problem

Acidogenic and aciduric bacteria produce acid as a result of what?

The fermentable carbohydrates consumed by the individual

The ameloblasts are dentin producing cells. The odontoblastic process has its cell body in the pulp tissue True/False?

The first sentence is false: odontoblasts produce dentin The second sentence is true

If a patient needs non-surgical periodontal therapy, discussion of the etiology of caries and periodontal disease should be discussed with the patient.

The first statement is false; the second statement is true.

If a patient needs non-surgical periodontal therapy, discussion of the etiology of caries and periodontal disease should be discussed with the patient. The prevention of biofilm accumulation affects both caries and periodontal disease progression.

The first statement is false; the second statement is true.

Diabetes increases the risk for periodontal infections. A well controlled diabetic is at increased risk for periodontal infections.

The first statement is true; the second statement is false.

If a patient needs oral hygiene instructions, the specifics of these needs should be documented in the patient's health record. The specific types of toothbrush and interdental aids are not necessary as part of the documentation.

The first statement is true; the second statement is false.

One person may have chronic periodontitis with very little destruction to the periodontium, whereas another may have very destructive pathogenic micoorganisms that greatly affect the host response. The virulence of the microorgansims has no role in the destruction of the periodontium.

The first statement is true; the second statement is false.

Smokeless tobacco is a risk factor for periodontal disease. Those who use smokeless tobacco are at lower risk than smokers for acquiring periodontal disease.

The first statement is true; the second statement is false.

Overjet

The horizontal distance between the labioincisal surfaces of the mandibular incisors and the linguoincisal surfaces of the maxillary incisors (measure with probe)

Chemical disinfectant criteria for agent selection

The objective is to select a product that is effective in the control of microorganisms and practical to use

Etiology is not a priority for patient education if the patient has low caries risk.

The prevention of biofilm accumulation affects both caries and periodontal disease progression.

If a patient needs oral hygiene instructions, the specifics of these needs should be documented in the patient's health record.

The specific types of toothbrushes and interdental aids should be documented in the patient's record so that other recommendations can be made at subsequent appointments if necessary.

What is digital palpation?

The use of a single finger

What is bidigital palpation?

The use of finger and thumb of same heand

What is bimanual?

The use of finger or gingers an thumb from each hand

What is radiographic examination?

The use of radiographs can reveal deviation from the normal not observable to by direct vision

people form an intention to make health-related changes on basis of knowledge, personal values, & two types of belief: behavioral beliefs (risk/benefit/outcome) & normative beliefs (community/social norms & expectations)

Theory of reasoned action

Let say you have an older patient who is taking a wide variety of medication and complains of having a dry mouth. He/she is most likely to develop what?

They are at most risk to develop caries since the medications might be causing him/her to have xerostomia.

Detection of biofilm: Direct vision

Thin biofilm: -can be translucent and not visible without disclosing agent Stained biofilm: -extrinsic stains make biofilm for visible ex: tobacco staines Thick biofilm: -tooth may appear dull and dingy with a matted fur like surface. Materia alba and food debris collects over biofilm

Ultrasonic processing

This cleaning before sterilization is safer that manual cleaning Maintained and used according to manufacturer's guidelines Not a substitute for sterilization; it is only a cleaning process (do not put scaler in here)

When examining the mucogingival area, the clinician should locate the base of the pocket but the tip of the probe is at the MGJ. What is the significance of this?

This suggests a possible mucogingival defect in the future. The clinician should record this and evaluate at all subsequent appointments. The patient should be advised of the finding and the necessity for meticulous oral hygiene in this area. (all of the above)

Why is it called dental hygiene care plan, rather than dental hygiene treatment plan?

To denote the broad range of preventative, educational, therapeutic, and support services within the scope of dental hygiene practice

What is the responsibiltiy of dental hygienists?

To advise and refer for further evaluation

Abfraction

To break away and results from microfractures in the hydroxyapatite crystals of enamel and dentin

Manual toothbrush

Tooth brush powered by human hands. Includes head, shank and handle. conforms to individual patient requirements in size, shape, and texture. consists of tufts and bristles. most current toothbrushes have nylon filaments.

Buccoversion

Tooth position is buccal to normal

Linguoversion

Tooth position is buccal to normal

Patient preparation Pre procedural or hygiene measures

Toothbrushing: disturbs a removes microorganisms Rinsing: numbers of bacteria on the gingival or mucosal surface can be reduced by the use of antiseptic mouth rinse

When treating patients in alternative settings, the procedure for the safe handling of instruments includes which of the following? Use instruments directly from sterile packs or cassettes Transport sterile instruments in sealed packages Open sterile packets in front of the patient Transport dirty instruments in a tub labeled for contaminated instruments Place sterile instruments on a small tra

Transport dirty instruments in a tub labeled for contaminated instruments

people move along a continuum of predictable steps to change health-related behaviors; healthcare providers must assess where patient is on continuum & provide individualized interventions based on patient's readiness to change; motivational interviewing

Transtheoretical model and stages of change

Dental caries an infectious, transmissible disease. It is also PREVENTIBLE True or False?

True

Dentinal hypersensitivity is more prevalent in females than in males probably due to more frequent oral care and therefore, more exposed dentin True/False?

True

The nerve fiber endings that extend just beyond the dentinopulpal junction that wind around the odontoblastic processes react via the same neural depolarization mechanism (sodium potassium pump) which characterizes the response of any nerve to a stimulus True/False?

True

True or False: A care plan may include a single or multiple dental hygiene diagnoses

True

True or False: A dental hygiene diagnosis should be considered complimentary to the dental diagnosis

True

True or False: A dental hygiene diagnosis will have one or more defined goals

True

True or False: A process of care provides a systematic approach for practitioners to follow in the provision of care to patients

True

True or False: Adopting a format for writing care plan goals simplifies the plan

True

True or False: Dental hygiene diagnosis should always be based on a cluster of significant information rather than on a single sign or symptom

True

True or False: Direct access allows for the dental hygienist to treat the patient without the presence of a dentist

True

True or False: Evaluation is a critical component to the successful outcome of dental hygiene care

True

True or False: Evaluation is linked inherently to each step o fthe process of care

True

True or False: Goals evaluated too early restrict the clinicians and the patients ability to determine the impact of the care provided

True

True or False: Informed consent may be given verbally or in written form

True

True or False: Planning care is contingent on the dental hygiene diagnosis

True

True or False: Pyschosocial variables are collected using the OHRQL questionnaire

True

True or False: Use of dental hygiene diagnoses appears promising for the development of a computerized system of dental hygiene diagnosis and care planning

True

True or False: the ADHA is dedicated to revising standards as an ongoing commitment to dental hygiene practitioners and the public that they serve

True

True or False: the dental hygiene diagnosis provides the foundation for the dental hygiene care plan

True

True or False: the dental hygienist can be held liable for untreated periodontal disease

True

True or False: Dental hygienist providing direct patient care without dentist supervision do not necessarily have access to a dental treatment plan or collaboration with a dentist during care planning

True

True or False: The dental hygiene care plan supports the overall dental plan

True

True or False: A shared decision-making process between providers and patients results in superior outcomes

True

pathogens transmissible from the oral cavity

Tuberculosis Viral hepatitis Herpetic infections AIDS

Following the initial appointment, and at subsequent dental hygiene appointment intervals, the health record should include which of the following?

Updated health history Current symptoms Current complaint or problem Clinical examination with periodontal findings Summary of prognosis and diagnosis (all options)

What is bilateral palpation?

Two hands used at the same time

updated in april 2015

US department of health and human services updated the recommendation from a range of 0.7-1.2 ppm to recommending all fluoridated water be at 0.7 ppm regardless of climate

Chemical vapor sterilizer

Unsaturated chemical vapor sterilizer. Combination of alcohols, formaldehyde, ketone, water and acetone heated under pressure produces a gas that is effected as a sterilizing agent

Standard procedures Post treatment

Use heavy puncture resistant gloves to handle instruments Follow routines to disinfect; disinfect, clean and prepare instruments Contaminated waste is secured in plastic disposal bags Disinfect safety eyewear for patients and dental team members

Autoclave types

Use steam under pressure to achieve sterilization 2 types: 1. Gravity displacement: self-generation of steam forces out the air. Steam enters and penetrates through cassettes or packages 2. High speed prevacuum: pump removes air from chamber and allows faster penetration of steam for sterilizing

Chemical disinfectants

Used in several forms, including as surface disinfectants, immersion disinfectants, immersion sterilants and hand antimicrobials

Chemical vapor sterilizer

Uses a combination of alcohols, formaldehyde, ketone, water, and acetone heated under pressure to produce a gas sterilizing agent -cannot be used for objects that can be ruined by chemicals or high temperature (ex: plastics, liquids, heat sensitive handpicks)

Attaining Cultural Competence

Value diversity Conduct honest self-assessment Learn patients' beliefs, behaviors, norms Be nonjudgmental about culture Avoid stereotypes Adapt delivery of dental hygiene

Factors to Teach the Patient

Virus survival Health history updated Oral health to overall systemic health Preparation prior to appointment

How do you take a pulse?

When pulse is felt, exert light pressure watch clock for one minute and count beats

pellicle formation

When saliva touches a tooth surface -fully formed within 30-90 minutes

HPV: testing

available for women undergoing cervical cancer treatment

How do you measure lesions? And what characteristics do you record?

With a probe 1. Size and shape 2. Color 3. Surface texture 4. Consistency

With biofilm accumulation on the cervical surface adjacent to the gingival margin, the initial lesion occurs:

Within 2-4 days

What does WHO stand for?

World Health Organization

Papillary

a change that involves a papilla but not the rest of the free gingiva around a tooth, may be localized or generalized

Marginal

a change that is confined to the free or marginal gingiva, specified as either localized or generalized

Motivational Interviewing (MI)

a collaborative, person-centered form of guiding to elicit and strengthen motivation for change

remineralization

a demineralized area readily takes up available fluoride

What is the foundation for care plan development?

a dental hygiene diagnosis

The definition of a local factor is

a factor in the immediate environment of the oral cavity, or specifically in the environment of the teeth or periodontium

The definition of a local factor is

a factor in the immediate environment of the oral cavity, or specifically in the environment of the teeth or periodontium.

The definition of an etiologic factor is

a factor that is the actual cause of a disease or condition.

The definition of a contributing factor is

a factor that lends assistance to, supplements, or adds to a condition or disease.

The definition of a predisposing factor is

a factor that renders a person susceptible to a disease or condition

The definition of a predisposing factor is

a factor that renders a person susceptible to a disease or condition.

How long can tooth whitening induced sensitivity last?

a few day to several months

pus

a fluid product of inflammation that contains leukocytes, degenerated tissue elements, tissue fluids, and microorganisms

What is glycerin used for in bleaching products?

a gel to thicken and control the flow of the bleaching agent to prevent overextending onto gingival tissues

Once the patient agrees, the care plan becomes ______________________ between the dental hygienist and the patient

a legal contract

Mucogingival junction

a line that marks the connection between the attached gingiva and the alveolar mucosa

The width of attached gingiva should be

a minimum of 1-2 mm.

What is formed as a result of disease degeneration that causes the junctional epithelium to migrate apically along the cementum is known as

a periodontal pocket.

Acquired pellicle

a thin acellular tenacious film formed of proteins, carbohydrates, and lipids

What is carbopol used for in bleaching products?

a water soluble resin uses as am thickening agents that prolongs the release of hydrogen peroxide from the carbmide peroxide and promotes quicker results

brush-on gel

adjunctive method to daily application of fluoride dentifrice, can help control demineralization around orthodontic appliances, provides protection against postirridation caries

Of all the factors that influence health, what percentage does social determinants of health account for?

about 75%

Basic caries process starts with certain ____ bacteria in the dental biofilm acting to metabolize the fermentable carbohydrates ingested by the patient.

acidogenic

fluoridation

adjustment of nature fluoride ion content in a municipal water supply to the optimum concentration that will maximize caries prevention and limit fluorosis

Why is ongoing monitoring of the patient important?

allows the clinician to: - modify the care plan if the patient is having a difficulty achieving the goals -modify the care plan if the patient is not ready to achieve the goal -continue the care plan because the patient needs more time to achieve the goal and/or -terminate the care plan because the patient has achieved the goal

HHV-4

also called epstein barr virus mono Infectious mononucleosis (IM) Oral hairy leukoplakia

HHV-2

also called genital herpes neonatal herpes antiviral therapy

HHV-3

also called varicella zoster virus Chickenpox (varicella) Shingles (herpes zoster)

The definition of 'risk factor' is

an exposure that increases the probability that disease will occur.

What are additional benefits of using hydrogen peroxide?

an antimicrobial action that may lead to a reduction I biofilm and improved gingival health

Dental Hygiene Prognosis

an evidence-based prediction of the patients continued health and wellness

Causes for changes: JE

apical migration of the epithelium along the root

effects/benefits of fluoridation

appearance of teeth (possible fluorosis), dental caries: permanent teeth, root caries, dental caries: primary teeth, tooth loss, adults, periodontal health (indirect effect)

communication with toddlers and preschoolers

approach directly; offer encouragement & gentle hints; demonstrate by parallel actions; calmly distract or direct toward alternative behavior to counter defiance; state specifically what child is to do; ask simple, focused questions; give brief, truthful, & simple instructions; be patient as child speaks; speak on child's level

Each continued-care visit begins with _______________ and __________________ .

assessment and evalution

What are additional benefits of carbamide peroxide?

assist with caries control due to its high ph and has also shown to be bacteriocidal

Green stain

associated with poor oral hygiene, chromogenic bacteria, fungi, and gingival hemorrhage -primarily found in children

preparation of teeth for topical application

at routine care appointment, rubber cup polishing is not necessary prior to application of fluoride

Where can you find the accepted standards of practice for periodontal care?

at the American Academy of Periodontology (AAP)

At what time will a color stabilize from bleaching?

at two weeks

Fluoride available in biofilm and saliva flow into the enamel diffusion channels and root surface

attaches as hydrogen fluoride (HF). Inhibiting demineralization

HIV/AIDS infection

attacks bodies immune sys and last stage is AIDS

Why are microorganisms destroyed by heat?

because of inactivation and coagulation of essential cellular proteins or enzymes

Infectious process #1: essential features for disease transmission: infectious agent

bacteria, fungi, viruses, protozoa, rickettsiae

When does primary dentin form?

before tooth eruption

HIV: stages of infection: stage 3 CD4+ count

below 200 cell/mm3

Infectious process #2: prevention of transmission: Pre-procedural Oral Hygiene Measures

biofilm removal with toothbrush and flossing antiseptic mouth rinse

Signs and symptoms of disease

bleeding gingiva while brushing teeth, sensitivity to hot and cold, tenderness or discomfort while eating or pain after eating, food retained between the teeth, unpleasent mouth odors, chronic bad taste, or a feeling that the teeth are loose

How do oxalates work with desensitivity?

blocks open dental tubules

HBV: transmission

blood and body fluids contaminated needle contact with blood sexual exposure sharing toothbrushes and razors

hepatitis: transmission

blood-borne route

Infectious process #1: essential features for disease transmission: port of entry

body fluids, skin & mucous membranes, droplets and spatter, needle stick

Infectious process #1: essential features for disease transmission: port of exit

body fluids, skin and mucous membranes, droplets and spatter

fluoride in biofilm and saliva

both are reservoirs for fluoride, enhances remin. by forming a condensed layer on the crystal surface, high concentration of fluoride can interfere with the growth and metabolism of bacteria, may contain 5-50 ppm

Active oral lesions are cared for in the terminally ill. The reason for this is the lesions may cause extreme discomfort when talking or eating, and can present an opportunity for secondary infection. The first statement is true and the second is false. Both statements are true. The first statement is false and the second is true. Both statements are false. The topic does not apply.

both are true

Patients who are home bound typically have an ASA classification of III or higher; and an ASA of III can correlate one or more systemic health conditions. The first part of the statement is false and the second is true. Both parts of the statement are true. Both parts of the statement are false. The topic does not apply. The first part of the statement is true and the second is false.

both are true

Regional studies indicate that individuals residing in nursing homes generally have poor oral health status, and they do not receive adequate care. The first statement is true and the second statement is false. Both statements are true. The first statement is false and the second statement is true. Both statements are false. The statements do not apply.

both are true

bottled water and water filters

bottled water typically does not contain optimal fluoride, water filters depend on system

interventions to break chain of disease transmission

break chain of infectious agent break chain of reservoirs break chain of port of exit break chain of mode of transmission break chain of port of entry break chain of susceptible host

how are oxalates applied?

burnished to a dried tooth surface

How do nonvital teeth become intrinsically stained?

by blood breakdown products or agents from root canal therapy

How should the presentation of the dental hygiene care plan be accomplished?

by establishing a collaborative, co-therapeutic relationship with the patient

How is pain registered?

by the depolarization neural discharge that characterizes all nerve activity

Which of the following is not a part of Dental Hygiene Process of Care? a) Assessment b) Planning c) Research d) Documentation

c) Research

HHV-1

can occur in the lips, fingers, and eyes Primary herpetic gingivostomatitis Herpes labialis (cold sore, fever blister) Herpetic whitlow Ocular/ophthalmic herpes

Infectious process #2: prevention of transmission: Airborne Infection Can Be Controlled

carefully monitor procedure

Cassettes

can be wrapped or packaged -package material permits steam/chemical vapor to pass through contents and maintains sterility during transport and storage -sturdy wrapping= prevents punctures/tears that break the chain of asepsis -use chemical indicator tape (black striped) -cassettes are kept completely sealed until unwrapped in front of the patient

Infectious process #1: essential features for disease transmission: airborne infection: aerosol & spatter

classified by size found in the air or on an object

interventions to break chain of disease transmission: break chain of infectious agent

clinical identification of lesions, standard precautions

What step should be taken by the clinician if the patient makes an informed refusal?

clinician should have the patient sign a declaration of informed refusal that remains part of the patients dental record

Infectious process #1: essential features for disease transmission: airborne infection: dust-borne organisms

clostridium tetani (tetanus bacillus) staphylococcus aureus enteric bacteria

A care plan goal may address the following:

cognitive, psychomotor, affective, or oral health status needs

Examination of gingiva includes?

color, size, shape, consistency, surface texture, position, mucogingival junctions, bleeding, and exudate

Semi critical items

come into contact with mucous membranes/non intact skin -lower risk of transmitting disease compared to critical items -items should be disposable or sterilized with heat sterilizer -if head sensitive, use high level disinfectant ex: mirrors, impression trays

adolescents have intense, extreme feelings, are strongly independent, and have a tendency to withdraw or become hostile if misunderstood; use straightforward approach, explaining & soliciting input; build rapport & establish trust; be aware of confidentiality laws in your state; address adolescent directly, even in presence of parent; allow adolescent to ask questions privately, as well as in presence of parents/guardians

communication with adolescents

ADHA standard 6, Documentation

complete and accurate recording of all collected data, care plan, patient consent for treatment, treatment outcomes, continued-care recommendations, and other interactions and information relevant to patient care

Dental biofilm matrix

composed of polysaccharides, proteins, and other compounds which protect the biofilm from the host's immune system and antimicrobial agents

post-eruptive

concentration of fluoride on outermost surface of enamel dependent on topical sources, fluoride on outermost surface inhibits demin. and enhances remin. as needed, during 1st year of eruption - fluoride uptake is quicker (tooth continues to take up fluoride on surface of external sources)

interventions to break chain of disease transmission: break chain of transmission

control aerosols, standard precautions

Interprofessional collaboration (IPC)

coordinated care of a patient by an interdisciplinary patient care team

Specialized mucosa

cover the upper surface of the tongue, 4 types of papillae; filiform, fungiform, circumvallate, and foliate

Masticatory mucosa

covers the gingiva and the hard palate, firmly attached to underlying tissues, keratinized

Lining mucosa

covers the inner surfaces of the lips and checks, the floor of the mouth, the underside of the tongue, the soft palate, and the alveolar mucosa , not firmly attached to underlying tissue, not keratinized

Floss Cleft

created by incorrect floss positioning appears as a vertical linear or V-shaped fissure in the marginal gingiva

What is potassium nitrate used for in bleaching products?

creates a calming affect on pulp by affecting the transmission of nerve impulses

Factors influencing biofilm accumulation

crowded teeth, rough surfaces, out of occlusion during mastication -Toothbrushing and interdental cleaning are needed daily for mechanical disruption of biofilm

Crystal formation

crystals form in the intercellular matrix and on the surface of bacteria and finally within the bacteria

a set of congruent attitudes, skills, behaviors, and policies that enable effective cross-cultural communication for delivery of oral health services

cultural competence

Mouthbreathing can contribute to disease development by

dehydrating tissues

Mouthbreathing can contribute to disease development by

dehydrating tissues.

HHV-2: neonatal herpes

delays development, blindness, neurological problems, and death to newborn C section

Dental Procedure Code

denotes standardized assessment and treatment codes used y the dental profession to indicate services as defined by the ADA Current Dental Terminology (CDT)

what is a primary risk factor for gingivitis, periodontal disease, and dental caries?

dental biofilm

Dental calculus

dental biofilm that has been mineralized by crystals of calcium phosphate mineral salts -calculus is covered by non mineralized dental biofilm containing live bacteria -calculus is classified by its location (supragingival and subgingival)

The ___________________________________ includes assessment, dental hygiene diagnosis, planning, implementation, evaluation, and documentation.

dental hygiene process of care

Within the dentinal tubules are ______, and the ________ process which only extend a short distance into the tubule

dentinal fluid odontoblastic

Within the dentin are ______ that run from root surface to nerves in pulp tissue, they extend from the ______ to the DEJ

dentinal tubules Pulp

Exogenous Stains

develop or originate from sources outside the tooth.

Endogenous Stains

develop or originate from within the tooth

keratinization

development of a horny layer of flattened epithelial cells containing keratin

What does the reduction of stress include?

development of patient rapport through effective communication between the dental team and the patient

additional transmission-based precautions

droplets contact airborne sharps

HHV-3: Chickenpox (varicella): transmission

droplets direct contact

prescription supplements

drops, tablets and lozenges, developed as vehicles for providing systemic fluoride to children residing in non-fluoridated communities

Infectious process #1: essential features for disease transmission: airborne infection

dust-borne organisms aerosol & spatter

demineralization

early stage of dental caries with an intact surface enamel and subsurface demineralization area

Dental caries shift from ____ balance of dental plaque to a more ______ flora

ecologic cariogenic

Social determinants of health

economic and social conditions that influence the health of people and communities

acid formed passes freely into tiny diffusion channels between the

enamel rods or into the exposed root surfaces

refers to the translation of a thought into words, gestures, or other linguistic signs that will allow thoughts to be expressed in some understandable way to another; encoding can be verbal or nonverbal, oral, visual, or tactile

encode

Changes in Disease: Size

enlarged

demineralization and remineralization are constantly happening to maintain

equilibrium

What does EBP stand for?

evidence based practice

Attributes of effective health information:

evidence-based, accurate, balanced, & reliable; consistent with information from other sources; culturally & linguistically appropriate; delivered in an easily understood & accessible way; provided when the patient is most ready to receive it; repeated & reinforced over time

Skills and attributes of effective health communicators:

expertise & knowledge in health & prevention; understanding of learning/behavior change theories & principles of good communication; relationship building skills; interview & role modeling skills; assessment for readiness to change behaviors; attention to the patient's attitudes & beliefs; personal attributes of confidence & flexibility

How can vital teeth be stained?

exstrinsicinly and intrinsically

Infectious process #2: prevention of transmission: Protection of the Patient

eyewear

True or false: patients who comply with regular maintenance intervals have more attachment loss and tooth loss

false: they have LESS attachment loss and tooth loss

the receiver's direct response to a communicated message

feedback

The definition of cicatrix is

fibrous tissue left after healing of a wound

Signs of health: Consistency

firm, attached gingiva firmly bound down

When are assignments of duties and practice for the new member addressed?

first working day's orentation

Signs of health: Size

flat, not enlarged; fits snugly around the tooth

Contributing conditions

fluoride exposure, consumption of sugar foods/drinks, gov programs, dental home, and family caries experience (0-6)

Infectious process #2: prevention of transmission: clean water

flush waterlines 20-30 sec between each patient

How should drills be recorded?

in diary of dates, procedures practiced, and names of those present

What can provide the team with efficiency, composure, and freedom from fear at the time of crisis?

group planning and individual acceptance of responsibility

What is a soft tissue graft?

guided tissue regeneration, tissue engineering (fibroblasts), sub-epithelial connective tissue graft (tissue is harvested from palate) for Class I and II defects

summary of action

having fluoride available topically to the tooth post-eruption is key to effectiveness, 3 basic topical effects

Effects of culture on oral health status:

health disparities related to cultural & ethnic backgrounds exist; don't ignore culture; culture & language can influence: beliefs & behaviors related to health, healing, & wellness; perceptions of illness, diseases, & their causes; attitudes of patients toward accessing health services or toward healthcare providers; attitudes & behaviors of providers who may have learned a set of values that are different from those of their patients

What do surfactancts in bleaching products help to do?

help to lift and remove extrinsic stain

What does the AAP do?

helps to develop a dental hygiene diagnosis that will guide the appropriate dental hygiene care

HBV

hepatitis B virus

HCV

hepatitis C virus

HDV

hepatitis D virus; delta hepatitis

human herpes viruses: relation to periodontal infection

herpes positive-periodontal lesions involving cytomegalovirus (CMV) and EBV have higher levels of perio bacteria

cariogenic foods

high cariogenic diet allows biofilm to increase its pH lowering ability

HPV

human papillomavirus

Cariogenic microorganisms in biofilm

in severe/long term acidic environments, streptococci and lactobacilli initiate and progress carious lesions -xerostomia with fermentable carb exposure creates a more acidic environment by growing nonmetals streptococci

What is caramide peroxide broken down into?

hydrogen peroxide and urea

enamel

hypomineralized enamel absorbs more fluoride that sound enamel, outer surface has higher concentration

dental hygiene diagnosis

identification of patient's health behaviors, attitudes, and oral health care needs for which a dental hygienist is qualified and licensed to provide

Detection of biofilm: disclosing agent

if disclosing agent is used, biofilm takes on the color and becomes visible

interventions to break chain of disease transmission: break chain of reservoirs

immunizations, standard precautions

Infectious process #1: essential features for disease transmission: susceptible host

immunosuppressed, medically compromised, elderly pre-existing transmissible disease

What is malocclusion?

imperfect positioning of the teeth when the jaws are closed

What does a high BP indicate?

increased cerebral blood flow

tray technique: home application

indications for use, gels used (Rx only), precautions, patient instructions

Select caries management strategy to meet needs of each ______

individual patient

Assess and address health literacy:

individualized approach for each patient, user-friendly clinic, encourage patients to ask questions, use plain language in forms, build on patient's current knowledge base, written patient education materials, visual aids, monitoring patient's understanding, use "teach-back" method

Infectious process #1: essential features for disease transmission

infectious agent reservoir port of exit mode of transmission port of entry susceptible host

hepatitis: definition

inflammation of the liver

What information can provide crucial information in a medical emergency or post-treatment complication?

info about patient, treatments, reactions, healing and comments by the patient

What legal concern needs to be addressed before beginning care with the nursing home patient? Comfort Care Informed Consent Autonomy Medicaid Rules Treatment Plan

informed consent

systemic fluoride products

ingested and delivered to the oral cavity via the bloodstream

tuberculosis: transmission

inhalation of droplet nuclei to infect the lungs

Which one is a Reversible stages a Moderate Stage b Extensive Stage Caries c. Initial Stage Caries

initial stage without cavitation (incipient, white spot lesion)

tray application

instruct patient not to rinse, eat, drink, brush, or floss until at least 30 minutes after gel or foam is applied

varnish application

instruct patient to avoid hot drinks and alcoholic beverages, hard, sticky, crunchy, brushing/flossing for at least 4-6 hours

communication with infants

interact playfully by mimicking facial expressions, rocking, & talking softly or singing; encourage adult who is familiar to infant to distract & comfort the child; wait until the infant is calm to approach closely

A pocket in which the base of the pocket is below or apical to the crest of the alveolar bone is known as a

intrabony pocket.

Oral Mucosa

is a mucous membrane composed of connective tissue covered with stratified squamous epithelium, 3 divisions or categories

Cementum

is a thin layer of calcified connective tissue that covers the tooth from the cementoenamel junction to and around the apical foramen

human herpes viruses: general characteristics

latent, recurrent. malignant

Nonverbal communication:

learn the significance that different cultures attach to facial expressions, gestures, head movements & physical postures, personal space & touching, & eye contact; follow patient's lead for touching or personal space; use hand & arm gestures with caution; be careful in interpreting facial expressions; follow patient's lead for making eye contact

HHV-1: Ocular/ophthalmic herpes

lesions in the eye that can occur from splash or saliva infected with herpes

Oral Lesions Strongly Associated with HIV Infection: non-hodgkin lymphoma

lesions present as growths and ulcers affecting the gingiva, palatal tissues, and alveolar mucosa

Sclerosis results in smaller diameter tubule - what does this mean?

less able to transmit stimuli through the dentinal fluid to the nerve fibers at the dentinopulpal interface

HIV: stages of infection: stage 1 CD4+ count

less than 500 cell/mm3

cementum

level is high and increases with exposure

Culturally effective oral care:

meet each patient's individual oral care needs; assess, be sensitive to, & respect each patient's cultural differences; include each patient's health beliefs, practices, values, customs, & traditions in plan for dental hygiene care

During an intervention, a person-centered discussion using __________________________ concepts to raise awareness and enhance motivation to change behavior is used.

motivational interviewing (MI)

Oral health-related quality of life

multidimensional construct that reflects people's comfort when eating, sleeping, and engaging in social interactions, with self-esteem, and with the satisfaction in their oral health

HDV: transmission

multiple exposures from B by direct contact to contaminated blood and fluids needles sexual contact perinatal transfe

Where are telephone numbers for medical aid posted?

near each extension rom which outside calls can be made

Metallic stains

nickel-green, copper-bluish green, Iron brown to green, cadmium-yellow -anterior teeth at cervical 1/3 are commonly affected -Industrial workers inhale the dust through mouth. Metal imparts color to pellicle. Workers should wear a mask

Should you mention code when calling a specific emergency ?

no -only the number

Signs of health: Exudate

no exudate expressed on pressure

Signs of health: Bleeding

no spontaneous bleeding or upon probing

HHV-4: vaccine

no vaccine

What stimulus elicits hypersensitivity pain?

non-noxious stimulus EX: Cold Water

Treatment room contact surfaces

noncritical items that come into contact with intact skin. -can be contaminated from spray/splatter or hand contact by DHCP -use environmental protection agency (EPA) hospital disinfectant -cover with barriers when possible ex:light switches, drawer handles, pens, pencils, doorknobs

body position (posture, use of social space), movement of body parts, eye movements & facial expression, appearance (grooming & dress), vocal qualifiers (volume, pitch, tempo, & cadence), vocal characterizers (crying, laughing)

nonverbal communication

What stimulus elicits oral condition pain?

noxious stimulus EX: Cavitated dental caries

How does arginine and calcium carbonate work with desensitivity?

occludes tubules

eye behavior, such as direct or indirect eye contact, during communication

occulesics

Nerves are wrapped around the __________ and nerve endings from the pulp wrap themselves around the odontoblastic process in the dentin

odontoblast cell body

The body portions of the ________ located next to the pulp extend their processes form the dentinopulpal junction a short way into each dentinal tubule

odontoblasts

HHV-3: Shingles (herpes zoster): risk factors

old age, HIV, trauma or surgery, cancer, transplants, immunosuppressive meds

Dental biofilm

oral microbiome is composed of microorganisms, their genetic makeup, and environments in oral cavity -Biofilm is a dynamic, structured community of microorganisms, encapsulated in extracellular polymeric substance (EPS) forming a matrix around colonies -3D structure allows for communication with each other, adaptation, and response to environment

What is the key concept in emergency preparedness?

organization

Care plan goal

outcome desired to be achieved through specific dental hygiene intervention strategies to satisfy an identified need or problem

HPV details

over 150 types known to cause various cancers 13 types of human papillomavirus are oncogenic 63% of oropharyngeal cancers associated with HPV

What released from the bleaching products changes the optical qualities of the tooth color?

oxygen being released

What is the minimum size of oxygen recommended in the E cylinder?

oxygen for 30 mins

Define hypersensitivity

pain that is elicited by a stimulus that leads to a pain response in patients with exposed dentin

HCV: transmission

parenteral

additional transmission-based precautions: droplets

particles of liquids that are sprayed from the nose or mouth

In clinic, you will doing a gingival assessment on every patient and recording your findings in the hygiene assessments autonote. Which of the following would be descriptive of gingival tissue in a given sextant?

pink, pointed, firm, stippled

written health information that uses simplified terminology, pictures, or any other method that can enhance understanding for patients with limited language proficiency

plain language publication

What does the term tooth whitening refer to?

refers to the use of abrasive agents contained in a dentifrice to remove extrinsic stain

Changes in disease: JE

position determined by use of probe, is on the root surface

What type of oxygen is needed when the patient is not breathing?

positive pressure oxygen (demand valve reusecitator)

human herpes viruses: clinical management for herpes

postpone appointment if patient has an active lesion

study of the impact of language and how people use language

pragmatics

HDV: preventions

prevent hepatitis B

what are the preventive and therapeutic benefits of dentifrice?

prevents dental caries, can remineralize early noncavitated dental caries (influenced by fluoride), it reduces biofilm formation (via triclosan, zinc citrate, stannous fluoride), it can reduce gingivitis and inflammation (tricluson is primary agent that has show efficient reduction in inflammation), it can reduce hypersensitivity (via potassium nitrate and sodium fluroide), and it can reduce supragingival calculus formation

HHV-3: Chickenpox (varicella)

primary infection, with latency occurring; extremely contagious childhood disease

maturation stage

prior to eruption, fluoride is taken up from tissue fluids around the crown

The health professions rely on a ________________ as a method for providing practitioners with a systematic approach to follow in their care of patients.

process of care

Ongoing Monitoring

process of continual review and reinforcement of patient progress toward achieving the goals

Informed consent

process of providing a patient with the information needed to make a decision about treatment

Using an interpreter:

professional interpreters are more likely to be proficient in both languages, objective, & able to communicate accurately; avoid asking children to interpret sensitive health information; focus on & direct all communication to patient, with pauses to allow interpreter to translate

HPV-16

progress to 95% of head and neck cancers

Significance of pellicle

protective against acids, lubrication, nidus (origin) for bacteria, attachment for calculus

standard precautions of transmissible diseases

protects all DHCPs and patients; treat everyone as if they have a transmissible dieases

What is the purpose of the ADHA Diagnosis White Paper?

provides understanding, clarity, and guidance on the issue of dental hygiene diagnosis and scope of practice

refers to the component or dimension of physical space or distance in the context of human communication

proxemics

What is noted when bleaching products is combined with excessive heat or trauma?

pulpal necrosis

•Clinical conditions

radiographic caries lesions, missing teeth, noncavitated lesions, visible plaque biofilm, inter-proximal restorations, exposed root surfaces, fixed or removable prosthetic/ortho appliances

How should you position a patient if the face is red?

raise the head

How should you position the patient if the face is pale?

raise the tail

What is an elevated lesion?

raised above the surface

acute toxicity

rapid intake of excess dose over short time

Health learning capacity:

reading level, cognitive (info processing ability, attention, memory capacity, reasoning ability), combined cognitive/psychosocial (numeracy, verbal ability, reading), & psychosocial (self-efficiency, communication ability, previous health-related experience)

what is continuing care also called?

recare or maintenance

taste bud

receptor of taste on tongue and oropharynx: goblet-shaped cells oriented at right angles to the surface of the epithelium

HHV-3: Shingles (herpes zoster): vaccine

recommended for all adults 50 yr plus

Xylitol

reduce level of mutans streptococci and promote remin (do not give to dog or they will go to heaven)

How does potassium nitrate work with desinsitivity?

reduces depolarization of the nerve cell membrane and transmission of the nerve impulse

Biocidal activity of chemical disinfectants meaning?

refers to ability of chemical disinfectant to destroy or inactivate living organisms

tuberculosis: clinical management

risk assessment, referral to facility with airborne isolation rooms

an attitude or judgment made about people that is usually not based on personal experience but rather on what has been learned from other sources; seeing individuals from a population group as having no individuality as though all have the same characteristics

stereotype

All critical and semi critical supplies should be...

sterilizable or disposable

What is the basis for many of the common emergencies that occur in a dental office?

stress and anxiety

The resulting fluorapatite bond is ______ less acid soluble than the hydroxyapatite bond, resulting in a stronger tooth surface

stronger

Continued-care

subsequent cycle of the process of care to monitor and support the continued health of a patient

What oxygen do you use if the patient is breathing ?

supplemental oxygen

A pocket in which the base of the pocket is coronal to the crest of the alveolar bone is known as a

suprabony pocket

A pocket in which the base of the pocket is coronal to the crest of the alveolar bone is known as a

suprabony pocket.

HHV-4: Infectious mononucleosis (IM)

symptomatic disease caused by infection with EBV

Cognitive Goal

targets an increase in patient knowledge and understanding

How is a pain response activated?

terminal nerve endings near to or surrounding the dentinal tubules are activated by stimuli

water testing

test should be done on primary water source before any supplement is prescribed

How and what two antibiotics can cause staining of the teeth ?

tetracycline and minocycline; their particles incorporate into the dentin calcium during mineralization of un erupted teeth; may require 1-12 months of whitening

Accepted standards for blood pressure can be found by referring to?

the AHA guidelines

The development of a dental hygiene care plan can be guided through the use of theoretical models such as.....??

the HN conceputal model and the OHRQL model

What are the two theoretical models developed specifically for dental hygiene?

the Human Needs (HN) Conceptual Model and the Oral Health-Related Quality of Life (OHRQL) Model

What is the diagnostic process for OHRQL?

the Oral Health-Related Quality of Life Model dental hygiene diagnostic process revolves around the assessment of biopsychosocial variables

direct access

the ability of a dental hygienist to initiate treatment based on the assessment of the patient's needs without the specific authorization of a dentist

The dental hygiene care plan is written in conjunction with..

the overall dental treatment plan or interdisciplinary healthcare plan

Clinical crown

the part of the tooth above the attached periodontal tissues, considered the part of the tooth where clinical treatment procedures are applied

what are the intervals of appointments dictated by?

the patients needs

stippling

the pitted, orange-peel appearance frequently seen on the surface of the attached gingiva

clinical attachment level

the probing depth measured from a fixed point, such as the CEJ

irrigation

the purpose is to reduce the bacteria and inflammatory mediators that lead to the initiation or progression of periodontal infection.

Clinical examination

the recognition of normal gingiva, gingival infections, and deeper periodontal involvement

What should a dental hygienist do if there is a medical or dental healthcare need that is urgent?

they would refer the patient for assessment and treatment proir to, or in conjunction with dental hygiene services

What does the dental hygiene diagnosis clarify?

the role of the dental hygienist and allows for a defined scope and domain of the dental hygiene practice

What is the color of teeth influenced by?

the thickness of enamel and underlying color of dentin

dental floss and tape

the types of floss are waxed or unwaxed floss (nylon); waxed helps the floss slide through the contact areas; unwaxed helps with tight areas; indications of unwaxed floss - may become frayed due to irregular tooth surface, rough surface or calculus deposit.

Inflammatory response means?

there is an increased blood flow, increased permeability of capillaries, and increased collection of defense cells and tissue fluid

Type 3 embrasure

there is extensive recession or complete loss of the papilla

Once the interventions are selected, what is next?

they are put into action with planned appointments

How does the 35% HEMA (hydroxyethyl methacrylate) work with the gluteraldehyde?

they can be combined and seal tubules

Why is it important for the care plan to be presented to the patient before preventive and therapeutic services are implemented?

to ensure the patient: -understands and supports the planned services -recognizes the importance of self-responsibility to the plan -has realistic expectations of the care plan

What are the goals of documentation?

to maintain continuity of care, provide a means of communication among the patients interdisciplinary care providers and minimize practitioner risk of malpractice claims

The dental hygiene care plan is personalized to support:

to support the individual's unique oral health needs, general health status, values, expectations, and abilities

high likelihood

toothbrushing 2x/day with higher efficacy fluoride toothpaste (>1,450 ppm F) or High F prescription - general behavior modification in oral health - prescribed F mouth rinse - Motivational engagement, maintain dental visits at risk-based intervals - sealants - F varnish 2x/year -F gels or solution (2% NaF) -Recalls up to three months - Motivational interviewing - One-to-one dietary intake interventions - Altering medication-induced hypo-salivation - Reducing the use of recreational drugs - Increase F-varnish 4x/year - Topical F application, counseling

Exposure to _______ can increase available salivary levels of fluoride

topical fluoride

interventions to break chain of disease transmission: break chain of susceptible host

treatment of secondary infection, standard precautions

Healthy tissue does NOT bleed during periodontal probing.

true

The clinical crown may consist of some root surface.

true

based on language or words; vocal = spoken; nonvocal = based on signs or signals (writing, Braille, sign language)

verbal communication

sending and receiving messages using words; usually defined as spoken or written communication

verbal communication

What are essential to assess a patient's overall health status and evaluate the severity of a medical emergency by comparison with baseline findings?

vital signs

cues, such as accent, loudness, tempo, pitch, cadence, and tone, that occur during verbal communication

vocalics

interventions to break chain of disease transmission: break chain of port of exit

waste disposal, standard precautions

Fluoride accumulation is salvia comes from

water, dentifrice, mouthrinse, and professionally applied therapies

What is the NPDB?

web-based repository of reports on malpractice payments and adverse actions related to healthcare practitioners, providers, and suppliers

What is a syncopal episode?

when someone faints

how is 5% Gluteraldehyde (HEMA) applied?

with a microbrush

How does sclerosis begin?

with traumatic stimuli

Dental Hygiene Care plan

written blueprint that directs the dental hygienist and patient as they work together to meet the patient's desired oral health outcomes

Tests for sterilization

• external chemical indicator - tape or pouches - change color from steam and temperature • internal chemical indicator - placed inside the kit - change color from steam and temperature • biological monitor (spore test) - miroorganisms put through regular cycle of sterilization then cultured. No growth= sterilizer is functioning properly WEEKLY TESTED IS RECOMMENDED