NBDHE 2022
Interview data collection
- speak with population directly one-on-one - time consuming, not cost effective for large groups - uses a questionnaire
Unhealthy gingiva
- spongy, swollen - red, bleeds upon probing - bulbous, festooned - probing depths may increase due to swelling of the gingiva
The infrahyoid muscles
- stabilize the hyoid bone - thyrohyoid - sternothyroid - sternohyoid (sternum, or breastbone) - omohyoid (shoulder) *Common junction, thyroid area
Quaternary Ammonium Compound mouthrinse side effects:
- staining of teeth/tongue - burning sensation - increased supragingival calculus formation
Higher kVp results in
higher quality and better penetration of x-rays
Zinc Properties
highest concentration found in bones
Overjet
horizontal distance between linguals of maxillary anterior incisors and facials of mandibular anterior incisors
Frequency Distribution
how often (frequently) each data point shows up in the data matrix; tally the number of times the data points appear based on the type of frequency distribution
Mode of transmission
how the agent is carried from one place to another - direct transmission - indirect transmission
What is the most medial bone of the orbit?
lacrimal
G.V. Black Classification for Caries and Restorations Class II
proximal surface of posterior teeth; commonly involves occlusal surfaces
depressor
pulls down
Maxillary Incisors Innervation:
pulp: anterior superior alveolar nerve facial gingiva: anterior superior alveolar nerve (and infraorbital nerve) palatal gingiva: nasopalatine nerve
Maxillary Premolars Innervation:
pulp: middle superior alveolar nerve buccal gingiva: middle superior alveolar nerve (and infraorbital nerve) palatal gingiva: greater palatine nerve
Clinical findings for necrotizing periodontal disease:
punched out papillae, pseudomembrane, BAD odor, pain and severe inflammation
Types of Data
qualitative and quantitative
What is the most common cyst of the oral cavity?
radicular/periapical cyst
Composite without barium or strontium will appear ______ in a radiograph:
radiolucent, seems like decay
Condensing osteitis (focal sclerosing osteomyelitis)
radiopaque lesion at apex of inflamed or necrotic tooth
Eminence
raised or elevated
Measures of Dispersion
range, variance, standard deviation
Ordinal
ranked in order by criteria, but not equal in value
Tachypnea
rapid respirations; most common form in hyperventilation
Simplified or Modifed
rather than looking at every tooth, only select a few teeth used to represent the entire dentition - common modification: Ramfjord teeth: 3,9,12,19,25,28
Circumpulpal dentin
remaining dentin, adjacent to the pulp
Polishing with a rubber cup indication for use
remove extrinsic stain not accomplished with hand scaling or with toothbrush and toothpaste - use light pressure
What kind of deposits to curets remove?
removes deposits supra- and subgingivally
What kind of deposits do scalers remove?
removes deposits supragingivally and up to 2 mm subgingivally
Standard Deviation
represents the square root of the sample variance - most commonly used to measure of dispersion and reflect the range within the matrix
Snowball Sampling
select a member of the population and ask them to refer more members to be in the sample; the sample size keeps growing
Air/Powder Polishing
slurry formed by forced air, water and powder (sodium bicarbonate, aluminum trihydroxide, glycine, calcium carbonate, or calcium sodium phosphosilicate)
Hydrolysis
water is broken into free radicals, which are unstable and highly reactive. Free radicals can create toxins (hydrogen peroxide, etc.) in cells
Hydrophilic
water loving water soluble
cytoplasm
watery gel enclosed by the membrane
Sampling
ways to come up with a workable study population representing the target population
When does the face begin to develop?
week 3
Perceived barriers
what obstacles do they believe stands in their way from doing the behavior
Skew
when central tendency scores are not uniform; the graphed data will demonstrate an asymmetrical appearance said to be "skewed"
Reservoir
where the agent can live, grow, and multiple (environment, humans, animals)
Entry portal
where the agent enters a new host
Exit Portal
where the agent leaves the reservoir
Maximum response
where the curve plateaus (flattens out)
Therapeutic range
where the dose is increasing sharply
When does lactic acid attacks begin?
within the first minute of exposure
Sjogren Syndrome
autoimmune disease with dry eyes & mouth from inflammation
Variance
average distance of each data point to the mean: squared and then averaged
G.V. Black Classification for Caries and Restorations Class V
cervical (gingival) 1/3 of the facial or lingual surfaces of any tooth (root caries)
Civil Law (Contracts)
Implied and express
Sensory Only Cranial Nerves
- (I) Olfactory - (II) Optic - (VIII) Vestibulocochlear
Motor Only Cranial Nerves
- (III) Oculomotor - (IV) Trochlear - (VI) Abducens - (XI) Accessory - (XII) Hypoglossal
Both sensory and motor cranial nerves
- (V) Trigeminal - (VII) Facial - (IX) Glossopharyngeal - (X) Vagus
Oxygenated blood flow of the heart:
- (from lungs) pulmonary vein - left atrium - bicuspid (mitral) valve - left ventricle - aorta (to body)
Stage I (Initial Stage)
- 1-2 mm of CAL, bone loss in coronal 1/3 only, no loss of teeth due to periodontitis - probing depths of 4 mm or less, slight horizontal bone loss - treatment includes NSPT (scaling/root planning)
Safely Tolerated Dose (STD)
- 1/4 of CLD - Acute fluoride toxicity (flu like symptoms)
Dietary Requirements and Nutrient Sources for Carboydrates
- 130 grams per day
Stage II (established or moderate periodontitis)
- 3-4 mm of CAL, bone loss in coronal third only, no loss of teeth due to periodontitis - probing depths of up to 5mm, mostly horizontal bone loss - treatment includes NSPT (scaling/root planning)
Dry Heat Sterilization
- 320 degrees F for 2 hours - Recommended for metal instruments - Avoid paper products - May damage rubber and plastic items - not recommended for handpieces - Spore test= Bacillus atrophaeus
Stage IV (advanced periodontitis)
- 5+ mm of CAL, bone loss into middle third of root, 5 or more teeth lost due to periodontitis - same as Stage III, Plus occlusal/masticatory dysfunction, secondary occlusal trauma, etc. - treatment includes surgical intervention, teeth replacement and complex oral rehabilitation
Stage III (severe periodontitis)
- 5+ mm of CAL, bone loss into middle third of root, up to 4 teeth lost due to periodontitis - Probing depths of 6+ mm, vertical bone loss, class II/III furcation involvement - treatment often includes surgical intervention and replacement of teeth
Cementum
- 50% mineralized (like bone), found on the root surface - produced by cementoblasts located in the PDL - Contains cementocytes (trapped cementoblasts) in lacunae - Thinnest at the cervical portion of the tooth, thickest at the apex - acellular found at the CEJ; cellular at the apex - nourished by the periodontal ligament
Dentin
- 70% mineralized, tubular structure, forms greatest bulk of tooth - Produced by odontoblasts from the dental papilla - Primary dentin is deposited before completion of the root (mantle dentin, circumpulpal dentin) - Secondary dentin develops after the tooth is in occlusion - Odontoblastic processes are found in the dentinal tubules
Enamel
- 96% mineralized, hardest tissue of the body - Produced by ameloblasts from the inner enamel epithelium - Lines of Retzius are incremental lines from mineralization - Enamel spindles are ends of odontoblastic process which cross the DEJ
Fat-Soluble Vitamins
- A, D, E, K - stored in liver and fatty tissues - not readily excreted and therefore can build up to toxic levels
Sucralose
- active ingredient in Splenda - Stable in heat - used in several products
Acesulfame-K
- active ingredient in Sunette and Sweet One - Stable in heat - Used in chewing gums, nondairy creamers, and gelatin puddings
Saccharin
- active ingredient in Sweet'N Low - used in soft drinks and table sweeteners
Tartar control formula toothpastes
- active ingredient: pyrophosphate - leading cause of dentinal hypersensitivity
Vital beach or tooth-whitening
- active ingredients: carbamide peroxide or hydrogen peroxide - Carbamide peroxide breaks down into hydrogen peroxide and urea
Natural Killer Cells
- active without prior exposure to an antigen - kill viral and tumor cells - non-specific (indiscriminate killers)
Modification of working time:
- add borax to slow set - add potassium sulfate to accelerate set
Functional (Soluble) Fibers
- added to foods during manufacturing process; dissolve in water to form a gel - Sources include pectin, such as apples, citrus fruits, and berries
Addison's disease
- adrenal cortical insufficiency - too little steroid production - diffuse pigmentation ("bronzing") of skin and mucosa; may be described as tanned, bronzed, or tinted
Tertiary Prevention
- advanced disease status - disease present with significant loss of tissue or function; severe or advanced stage of disease - reduce symptoms of existing disease; replace lost tissues to restore function and improve quality of life - preventing complications; replace lost tissues through rehabilitation - implants, bridges, dentures
Cumulative effect
- adverse reactions of the body to x-radiation never return exactly to original state, therefore, accumulating to some degree over a lifetime
Faculative anaerobes:
- aerobic, but can grow in the absence of oxygen via fermentation bacteria in this classification include: Staphylococcus, Listeria, Actinomyces
Gingival recession
- age - plaque - iatrogenic - tooth malposition - occlusion - frenum pull -trauma - inadequate - attachment - improper flossing technique
Bulimia Behavior Profile
- age of onset 20-24 - weight is at or slightly above normal - turns toward food for comfort - aware behavior is abnormal - low self- esteem and impulsive behavior
At- home rinses
- aid in oral cleaning - saline rinse: after nonsurgical periodontal therapy - fluoride rinse: to prevent dental caries
How to minimize air bubbles in gypsum mixtures?
- air incorporated into the mix will result in surface voids - add gypsum to the water
Streptococcus: s. mitis, s. oralis, s. sanguis, s. mutans
- all Gram+ Bacteria - Early "healthy" plaque, able to attach to the acquired pellicle
Diestone, Type IV Gypsum
- alpha- calcium sulfate hemi-hydrate - contains a chemical additive to make it more durable and wear resistant - also called improved stone
Non-adherent plaque
- also known as planktonic plaque - mostly motile rods and spirochetes - increase during acute infection/inflammation - the oral hygiene aid most suited for removal of loose or non-adherent plaque is an oral irrigator
Hand-foot-mouth disease
- caused by coxsackie virus - vesicles or ulcers of mouth, hand and feet - flu-like symptoms
Tannerella forsythia
another important pathogen in adult periodontitis
Gracey 5/6 are used for which surface(s)?
anterior and premolars; buccal/lingual of posterior teeth
Vitamin E (Tocopherol) Function
antioxidant; stimulates immune response
antigen
any agent foreign to the body
What materials will totally block the x-ray beam and will, therefore, appear "white" radiographically?
any metal (silver amalgam, cast metal restoration, metal endo post, retention pin, etc.)
Primary data
data you collect yourself/original research
Autonomy
deals with the Patient, not the practitioner
Nonmalefience
deals with the practioner (do no harm)
deft
decay, extraction needed, filled, teeth (20 teeth/88 surfaces) - measures observable caries in primary teeth - does not take into account teeth that have been exfoliated naturally - calculate: count up the number of teeth with def
dft
decayed, filled, teeth - does not measure missing due to difficulty knowing why primary teeth are missing
increasing the filtration will
decrease the density of a film
Increasing filtration will
decrease the number of photons
increasing the distance will
decrease the number or photons, will decrease the density of the film
Ectodermal dysplasia
syndrome with hypodontia; conical teeth
Radiographic localization
taking two radiographs of an object from two different angels can determine if the object is buccal or lingual to the other teeth in the arch
Herpangina
- caused by coxsackie virus - vesicles or ulcers of posterior oral cavity - flu-like symptoms
Buccinator Muscle
- cheek muscle - muscle of facial expression - keeps food on chewing surface of the teeth
Methods of Sterilzation:
- chemical or heat
Power-assisted Toothbrushes indications for use include:
- children - physically and mentally challenged - elderly - arthritic patients - poorly motivated individuals - implant care
Prospective Study
- cohort study - a cohort is classified by exposure to one or more specific risk factors observed into the future to determine the rate at which the diseases develops
Type I Examination Method
- complete exam or comprehensive exam - complete set of radiographs - light source, radiography, study models, tests - mouth mirror and all instruments
Polysaccharides
- complex carbohydrates: composed of more than 10 sugar units - starch, glycogen, fibers
Mylohyoid muscle
- comprises floor of the mouth - attaches to the mylohyoid ridge (internal oblique extension)
Complete (High-quality) proteins
- contain all 9 essential amino acids in sufficient amounts - predominately animal sources (e.g., fish, meat, eggs, cheese, milk) and soy protein
Monounsaturated Fatty Acids
- contain point of unsaturated linkage (double bond) with no hydrogen atoms - viscous in form - maintain serum cholesterol levels - sources include canola and olive oils
Acetaminophen effects
-Analgesic (pain reducer) -Antipyretic (fever reducer) -NOT ANTI-INFLAMMATORY
Iron Deficiency
-Anemia -Oral lesions -Patchy tongue -Brittle bones -Fatigue
Adrenergic Drugs Adverse effects
-CNS (anxiety, fear, tremor, headache) -Cardiac arrhythmia -Hypertension -Xerostomia
Examples of Cephalosporins
-Cephalexin (Keflex) -Cefaclor (Ceclor) -Cefuroxime (Ceftin)
Tissue rebuilding
-Fibroblasts synthesize & deposit fibronectin, collagen & proteoglycans -Granulation tissue: is the initial tissue formed in the connective tissue after injury - Granulation tissue: an immature tissue with many capillaries and fibroblasts
Iodine Function
-Helps regulate BMR (thyroid gland)
Acetaminophen adverse effects
-Hepatotoxicity -Liver necrosis (both at high doses)
The typical oral infection, known as candidiasis can present as:
-Pseudomembranous candidiasis ("thrush"), white plaques that wipe off - Erythematous candidiasis, red ulcerative lesions, which are painful
Pica Treatment
-Psychosocial -Environmental -Family guidance
Osseous surgery
-Requires a gingival flap (incision) -Bone recountoured (osteoplasty) -Bone removal (osteoectomy) - Bone and soft tissue grafts -Sutures are required, since an incision is performed -Sutures are used for tissue apposition -Sutures may be bioabsorbable (gut) or non-absorbable (silk) -Sutures decrease the distance cells need to migrate in the wound-healing process
FDA approved artificial sweeteners
-Saccharin -Aspartame -Acesulfame-K -Sucralose -Neotame
Copper Sources
-Shellfish -Oysters -Crab -Liver -Legumes
Anorexia nervosa Behavior Profile
-Usually female; occurs after puberty -Highest rate of occurrence is between the ages 15-19 -Competitive & obsessive behavior -Rigid relationships with over-protective parents -Fear of gaining weight
Taurodontism (Bull's Teeth)
- large pulp chamber with furcation close to the apex - common in Down Syndrome
V3 Mandibular (Both Sensory and Motor)
- leaves the skull through the Foramen Ovale of the Sphenoid bone - enters the mandible through the Mandibular Foramen - Includes the muscles of mastication (motor) and lower teeth (sensory)
V2 Maxillary (Sensory)
- leaves the skull through the Foramen Rotundum of the sphenoid bone - Includes the upper teeth, nose, palate, mouth, cheek, and temporal region: Zygomatic (skin of cheek), Infraorbital (maxillary sinus, anterior and middle max teeth), Pterygopalatine (pharyngeal, greater, lesser, and nasopalatine), Posterior Superior Alveolar (molars, except MB of 1st molar), Middle Superior Alveolar (bicuspids, and MB of 1st molar), Anterior Superior Alveolar (incisors and cuspids), Palatine Greater and Lesser (hard and soft palate), Nasopalatine (palatal gingiva of incisors)
V1 Ophthalmic (Sensory)
- leaves the skull through the Superior Orbital Fissure of the Sphenoid bone - includes tip of nose (nasociliary), eyes (lacrimal), and forehead (frontal)
Grade B (moderate rate of progression)
- less than 2 mm of bone loss/CAL over a 5 year period - up to 1.0% bone loss/age - amount of plaque is commensurate with amount of periodontal destruction (common presentation) - patient is a light smoker, or has controlled diabetes (A1c less than 7%)
Staphylococcus aureus produces:
- leukocidins, which destroy leukocytes (contributing to pus formation) - Hyaluronidase ("spreading factor"), which degrades the hyaluronic acid in collagen, and allows bacteria to spread through subcutaneous tissue, contributing to cellulitis - Coagulase, which converts fibrinogen to fibrin, leading to clot formation
Polymerization
- light activated polymerization allows flexible working time - photo-initiators typically include benzoyl peroxide or a tertiary amine
Abnormal gingival color:
- light, coral pink: normal - erythema: redness associated with inflammation - cyanosis: bluish, highly vascular- often found around crowns - pallor: lighter than normal, associated with anemia, leukemia, fibrotic tissue, etc.
HIV Infection Periodontal Characteristics
- linear gingival erythema (LGE): band of redness of the marginal gingiva - Necrotizing periodontitis: necrosis of gingiva and alveolar bone - Kaposi's sarcoma
Blood clotting
- local tissue injury results in hemorrhage from damage blood vessels - the initial clot is composed of fibrin, fibronectin and platelets - the clot fills the wound, serving as a scaffolding for PMNs and macrophages
alveolar crest fibers
- located apical to the junctional epithelium - resists tilting and horizontal forces
Peripheral giant cell granuloma
- looks clinically similar to pyogenic granuloma - multinucleated giant cells present
Hypoglycemia
- low blood glucose levels - less than 70 mg/dl
Mucocele
- lower lip most common site - bluish/pink fluid-filled nodule - caused by traumatic severance of salivary gland duct - treatment: excision including the associated gland - recurrence: if feeder salivary gland is not removed
Wound cleansing
- macrophages ingest debris and degrade the clot - PMNs attack bacteria - New capillaries and fibroblasts move in as debris is removed
filtration
- made from aluminum - absorbs weak long wavelength x-rays - improves the quality/penetration of the x-rays
Maltose (plant sugar)
- made up of 2 glucose molecules - By-product from the breakdown of polysaccharides - found in beer and malt beverages
Lactose (milk sugar)
- made up of glucose and galactose - found in milk products
Glucose (dextrose/blood sugar)
- main fuel for brain and need for WBC's and RBC's - most abundant carbohydrate found in nature - found naturally in fruits and vegetables
multiple myeloma
- malignancy of plasma cells - bone pain - "punched-out" radiolucencies - Bence-Jones proteins: light chain immunoglobulins found in urine
Personal Protective Equipment (PPE) Include
- mask - examination gloves - protective eyewear: face shield; eyewear with side shield such as goggles, and loupes - Protective clothing (gowns/jackets worn over clinical attire) made of impervious material
Minocycline
"Arestin" adjunct to SCRP procedures for pocket depth reduction in patients with adult periodontitis. Direct placement of powder (microspheres) to base of pocket
Sonic scalers work through?
driven by compressed air; less powerful
Direct transmission
droplet spread or direct contract between susceptible host and reservoir full of the agent
Interpersonal level
influence between individuals that causes someone to do a behavior
Societal level
influence of broad societal factors or social norms
Community level
influence of settings on behavior choices
Intrapersonal level
influence within a person that shapes their behavior
Attrition
physiologic loss of tooth structure from tooth to tooth contact
Chlorhexidine
"Periochip" placed subgingivally, Perioguard and Peridex oral rise
High kVp equals a
"low contrast/long scale" radiograph
Marasmus
- "to waste away" (chronic form, body's adaptation to starvation) - head is large, and you can see all of the bones of the person - inadequate food intake (protein and calorie deficiency) over a long period of time - common in children 6-18 months in impoverished nations; impairs brain development and learning - muscles, including heart, waste and weaken (no edema)- skin and bones - poor growth, if any
developer
(Elon and Hydroquinone) turns only exposed crystals to metallic silver (black)
Silicone rubber
(condensation reaction silicone - putty-like, rarely used
fixer
(sodium thiosulfate) removes undeveloped (including unexposed) crystals
How often does the HIPPA form need to be signed
***ONE TIME*** Unless: - Changes are made: patient wants to add or remove an individual from a previous form - The government makes changes to HIPPA policy - Office must provide the patient a copy of HIPPA policy every three years
Oblique fibers
**most numerous type of fiber - resists "intrusive" or "vertical" masticatory forces - prevents the tooth from being "jammed" into the bony socket
Perfect positive correlation
+1
Ranula
- "Mucocele of the floor of the mouth" - usually associated with sublingual gland - floor of mouth swelling
Kwashiorkor
- "evil spirit infects first child when second child is born" (acute form) - fluid retention and big belly - Severe protein deficiency - Begins at approximately 18 months to 2 years of age - edema in legs, abdomen, and face - failure to grow and gain weight - delayed tooth eruption and hypoplasia
Epulis fissuratum (Inflammatory fibrous hyperplasia)
- "fibroma" around denture flange, especially poor fitting denture - excise tissue and remake denture
transseptal fibers
- "interdental ligament" - extend interproximal over the alveolar crest - hold teeth in interproximal contact with each other
Recommended drug regimen for premedication:
- Amoxicillin 2000mg (2g) one hour prior to procedure Allergy to penicillin: - Clindamycin 600 mg one hour prior to procedure - Cephalexin (Kelfex) 2000 mg (2g) one hour prior to procedure - Azithromycin or clarithromycin 500 mg one hour prior to procedure
Gram + Rods
- Bacillus (causative organism for anthrax and food poisoning) - Clostridium (causative organism for tetanus, botulism, gangrene, food poisoning and antibiotic-resistant pseudomembranous colitis) - Corynebacterium (causative organism for diphtheria) - Listeria (causative organism for meningitis and sepsis) - Lactobacillus (associated with advanced caries, producing lactic acid and lexans) - Actinomyces (associated with root caries)
Energy needs of body include:
- Basal Metabolism Rate (BMR) - Degree of physical activity - Thermic effect of food
Caners of the skin
- Basal cell carcinoma: sun exposed skin - Squamous cell carcinoma: sun exposed skin - Melanoma: pigmented tumor
Types of streptococcus are differentiated by the ability to hemolyze red blood cells (using hemolysins)
- Beta-hemolytic strep completely lyses red blood cells - Alpha-hemolytic strep only partially lyses red blood cells - Gamma-hemolytic strep is unable to lyse red blood cells
Liners Include:
- Calcium Hydroxide - Zinc-oxide/eugenol - Resin-modified glass ionomer - Bonding agents
Varicella-zoster virus
- Chicken pox (occurs in crops- erythema, vesicles, pustules, crusted lesions) - Shingles in adults (unilateral erythema, vesicles, ulcers & pain)
Fluoride safety
- Children six years of age and under should not use fluoride rinses because they may swallow it (use pea size amount of toothpaste when brushing) -Instruct patients on how to correctly use self-applied topical fluoride products - Know potential toxicity and be prepared to administer emergency procedures
Therapeutic Mouthrinse Agents:
- Chlorhexidine Gluconate - Essential Oil (includes Listerine Antiseptic) - Quaternary Ammonium Compounds (Cetylpyridinium Chloride [CPC]- examples include Scope, Cepacol, and Crest Pro- Health Rinse) -Fluoride Rinses
Types of Disinfecting Agents
- Chlorine- based compounds - Iodophors - Phenols (water or alcohol based) - Quaternary compounds
Zinc-oxide/eugenol cement
- Commonly used for temporary cement - Orange solvent typically used to clean ZOE- contaminated instruments
T-cell Lymphocytes
- Comprise 65-80% of lymphocytes - Precursors from bone marrow migrate to , and mature into the thymus - regulate the production of antibodies and play a role in the suppression of certain immune responses (regulatory functions) - directly involved in tissues graft destruction and delayed hypersensitivity
Blistering Disease
- may be termed vesiculobullous disease - Autoimmune disorders (body attacks itself) - Treatment: steroids
Sodium Fluoride Varnish
- Contain 5% NaF (22,600 ppm) - Used for desensitizing exposed roots and caries prevention - 0.3-0.5 mL/ application, which is a small volume/low dose - Retained for 24-48 hours during which time the fluoride is released for reaction with the underlying enamel (substantivity) - recommended applications repeated 2-4 times per year - more effective in caries reduction than traditional professional topical fluorides- 14% more effective than topical gels - Effective for use on infants and small children with significantly less fluoride ingested than with APF gel; also easy application - Not for home use- professional application only
Measurement of Dental Caries- Irreversible
- DMFT/DMFS - deft - dft - RCI
Anorexia Nervosa Treatment
- Dietary: increase food intake to raise metabolic rate back to normal - Psychological: therapist determines underlying issues for eating disorder
Examples of Marcolides
- Erythromycin - Azithromycin (Zithromax) - Clarithromycin (Biaxin)
Infectious mononucleosus
- Etiology: Epstein-Barr virus (EBV) - Fever, lymphadenopathy, pharyngitis, rhinitis, hepatosplenomegaly, palatal petechiae
Oral hairy leukoplakia
- Etiology: Epstein-Barr virus (EBV) - white, furrowed vertical lines on lateral surface of tongue - may be 1st manifestation of HIV infection
Ways to detect calculus?
- Explorers: 11/12, pigtail for posterior teeth, orban for anteriors and cervical 1/3 of posterior theeth - Compressed air to dry the teeth - Radiographs
Toothpick Holder (Peiro aid) use in/for:
- Exposed Class IV furcations - interdental cleaning: concave proximal surfaces - gingival margins above orthodontic appliances
Dentifrices Active Ingredients (Therapeutic)
- Fluoride for caries - Pyrophosphates for tartar control - Potassium nitrate, sodium fluoride, stannous fluoride for antihypersensitivity - Triclosan for antimicrobial - Carbamide or hydrogen peroxide for whitening
Plaque formation
- Glycoproteins from saliva are absorbed to the tooth surface, forming the acquired pellicle - bacteria then adhere (attach) to the acquired pellicle - bacteria multiply to form colonies on the tooth, creating a biofilm - As plaque grows, bacteria detach from the biofilm and become "planktonic" bacteria (free) - later, calculus forms from the mineralized plaque biofilm
Health Bacteria
- Gram + - Aerobic - Cocci - Nonmobile
Disease Bacteria
- Gram - - Anaerobic - Bacilli/Spirochete - Mobile
Wound remodeling
- Granulation tissue: is eventually remodeled into a scar composed of dense collagen interspersed with cells and blood vessels
RNA Viruses include:
- Hepatitis A, C, D, E - Rhinovirus - Influenza - Mumps - Measles - Rabies - HIV - COVID-19
Levels of surface disinfectants include:
- High: capable of killing bacterial spores - Intermediate: must kill TB organisms - Low: includes simple phenol
DNA Viruses include:
- Human papilloma virus - Herpes Simplex I and II - Varicella-Zoster - Cytomegalovirus - Epstein-Barr - Smallpox
Principles of good teaching
- Identify the learner's needs - Establish learning foals and objectives for each lesson - Design learning experiences and methodology based on objectives - Teach the way skills are to be used: Hands on (tell-show-do) - plan an evaluation mechanism - Deliver the information through formal delivery or informal delivery
Treatment for Acute Fluoride Toxicity:
- Induce vomiting (mechanical) - call 911 - Administer fluoride-binding agent (patient needs to not be vomiting) Some examples: milk and Milk of Magnesia
Levels of government
- International - Federal - State - Local
Social Ecological model
- Intrapersonal Level - Interpersonal Level - Community Level - Societal Level
B12 Cobalamin (Cyanocobalamin) Properties
- Intrinsic Factor: protein made in stomach needed for absorption of B12 - Extrinsic Factor: must be obtained through diet
Bacterial Growth Phases:
- Lag Phase - Logarithmic Phase - Stationary Phase - Death Phase
Type II Examination Method
- Limited exam - limited radiographs - light sources, radiography - mouth mirror and all instruments
Leukocytes (WBC) are the cells of the immune system. They include:
- Lymphocytes (B-cells, T-cells, natural killer cells) - Monocytes (which differentiate into macrophages) - Granulocytes (neutrophils, eosinophils, basophils) (aka polymorphonuclear leukocytes) - Dendritic cells (antigen-presenting cells)
Grading of periodontitis
- based upon the risk of future disease and the anticipated outcome of treatment - takes age of the patient into account, and includes the risk factors of smoking and diabetes
First Branchial Arch
- Maxillary process (lateral palatine processes [palatal shelves], upper parts of cheek, sides of upper lip) - Mandibular process (lower jaw, lower parts of the face and lower lip, anterior 2/3 of the tongue)
B9 Folate Deficiency
- Megaloblastic anemia - glossitis - diarrhea - birth defects (spina bifada)
What can be used to assess furcations:
- Nabers probe - evaluate furcation before recommending oral physiotherapy aids
Grade A (slow rate of progression)
- No CAL or radiographic bone loss over a 5 year period - 0.25% bone loss/age - Patient may have heavy plaque, but low levels of periodontal destruction - non-smoker, and patient does not have diabetes
Scales/ Levels of Measurment
- Nominal - Ordinal - Interval - Ratio
Ibuprofen
- Nonopiod, NSAID, brand name= Motrin, Advil
Antifungal Medications
- Nystatin (mycostatin) - Clotrimazole (mycelex) - Fluconazole (Diflucan)
Measurement of Oral Hygiene Care- Reversible
- OHI-S - PLI - PHP - VMI
Measure of Periodontal Conditions- Irreversible
- PI - PDI - PSR - CPITN
Aphthous ulceration (Canker sore)
- Painful, recurring, well-circumscribed ulcers with erythematous halo - Only on moveable non-keratinized mucosa (never on hard palate or attached gingiva - decreased incidence in smokers
Examples of Penecillin
- Penicillin VK - Penicillin G - Amoxicillin - Ampicillin - Augmentin (amoxicillin and clavulanic acid)
Drugs that increase the risk of gingival enlargement:
- Phenytoin (Dilantin): anticonvulsant, 50% have hyperplasia - Nifedipine (Procardia): antihypertensive calcium channel blocker - Cyclosporine: immunosuppressive drug, 30% have hyperplasia
Water-insoluble impression materials include:
- Polysulfide rubber - Polyether rubber - Silicone rubber - Vinylpolysiloxane * except for hydrocolloid, these materials set by polymerization
Bacterial species associated with disease
- Porphyromonas gingivalis (p. gingivalis) - Treponema denticola (t. denticola) - Tannerella forsythia - Fusobacterium nucleatum (f. nucleatum) - Campylobacter retus (c. rectus) - Prevotella intermedia (p. intermedia) - Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) (A.a.)
Gram - Rods
- Prevotella (associated with "pregnancy" ginigvitis, cellulitis, and NP/GP) - Porphyromonas gingivalis (associated with periodontal disease and connective tissue destruction through the production of collagenase)
Sources of Data
- Primary data - Secondary data - Tertiary data
Sublingual gland
- Produces 10% of total saliva - Bartholin's duct empties under the tongue - Multiple Ducts of Rivinus (8-20) open unto sublingual fold - Mixed secretion (mostly mucous) - Located in floor of mouth near midline - Parasympathetic innervation by cranial nerve VII
Parotid gland
- Produces 25% of total saliva - Stenson's duct empties opposite the maxillary molars - Serous secretion only (contains amylase to break down starches [amylase]) - Located in front of and below the ears - Parasympathetic innervation by cranial nerve IX - Inflammation is called parotitis; common site of pleomorphic adenoma
Glass ionomer cement
- binds to dentin - releases fluoride - coefficient of thermal expansion approximates tooth structure - can be used as a Class V restorative material
Disinfectant properties include:
- Rapid, broad-spectrum antimicrobial: bactericidal, fungicidal, tuberculocidal, virucidal - Odorless, easy to use, fast acting, and economical - Compatible to environment and surface - Residual effect- continues to work after it dries - Non toxic to touch or inhalation - EPA registered - Cleans and disinfects
High sensitivity to radiation
- Reproductive tissues (#1 high) - lymphoid tissue - bone marrow (hematopoietic) - intestines - mucous membranes
Vitamin A Sources
- Retinols (preformed Vitamin A)- include animal foods such as liver, fish, and fortified milk - Carotenoids (vitamin precursors)- include orange-yellow and dark green vegetables and fruits
Vitamin D Deficiency
- Rickets - Osteomalacia - Osteoporosis - Colon Cancer
Types of Lipids
- Saturated fatty acids - Monounsaturated fatty acids - Polyunsaturated fatty acids
Chronic Fluoride Toxicity
- Skeletal Fluorosis: results after long-term exposure (10+ years) of water containing 8-10 ppm fluoride - Dental fluorosis: hypomineralization results from excessive ingestion of fluoride (2 ppm+) during amelogenesis
Types of professionally applied topical fluorides are:
- Sodium Fluoride - Sodium Fluoride Varnish - Acidulated Phosphate Fluoride - Silver Diamine Fluoride (SDF)
Compounds used to fluoridate water include:
- Sodium fluoride - Sodium silicofluoride - Hydrofluorosilicic acid (liquid solution)
Muscles of the neck
- Sternocleidomastoid - trapezius
Early Healthy plaque species
- Streptococcus, Actinomyces
Bacterial species associated with necrotizing disease:
- Treponema denticola (t. denticola) - Treponema/Barrelia vincentii - Prevotella intermedia (p. intermedia) - Porphyromonas gingivalis (p.gingivalis) - fusobacterium nucleatum
Hypersensitivity Reactions
- Type I- Anaphylactic - Type II- Cytoxic - Type III- Immune Complex - Type IV- Delayed
Type IV Delayed Hypersensitivity Reaction
- Typically occur 48-72 hours after antigen exposure - Associated with transplant reaction (like Type II) - Cell-mediated, Helper T cells become sensitized to the antigen - Cytokines are released upon a subsequent exposure to that antigen - inflammation chemotactically attracts macrophages leading to antigen destruction - Examples: contact dermatitis (poison ivy), tuberculin test ( Mantoux reaction)
Stages of Learning Theory
- Unawareness - Awareness - Self-interest - Involvement - Action - Habit
Ultrasonic (Piezoelectric) Scaler
- Uses ceramic rod to produce mechanical vibrations - Produces rapid linear motion; new piezos have elliptical/linear motion - lateral sides of tip are active
Trigeminal Nerve (V) Three major branches:
- V1 Ophthalmic (sensory) - V2 Maxillary (sensory) - V3 Mandibular (both sensory and motor)
bulimia characteristics
- binges/vomits at least 2 times per week - Eats 15,000 or more calories in a binge - Calluses form on knuckles from digital purging (vomiting) - often clinically depressed
Adrenergic drug medications
- Ventolin (albuterol) inhaler to treat asthma (bronchodilator) - epinephrine to treat anaphylactic reaction - epinephrine also used in local anesthetic solutions as vasoconstrictor - epinephrin also used in cardiac arrest to stimulate heart muscle - dopamine used to treat shock, low blood pressure and Parkison's
Civil Offence (Lawsuit)
- Wrongful offence against a person - satisfaction is sought (money) - Common lawsuits: dental injections, adverse drug reactions, failure to diagnose
Tongue innervation:
- XII (motor nerve to muscles, except palatoglossus) - V3 (sensory to anterior 2/3) (mandibular division, trigeminal - VII (taste to anterior 2/3) (Chorda tympani) - IX (taste, sensory to posterior 1/3)
Types of Cements
- Zinc phosphate cement - Polycarboxylate cement - Glass ionomer cement - Resin cement - Hybrid cement - Zinc-oxide/eugenol cement
Xylitol
- a 5-carbon sugar alcohol (polyol)--sucrose is a 6 carbon sugar - absorbed slowly and completely by small intestine- little or non insulin is metabolized during the absorption process so there is not a sudden increase in blood glucose level - antimicrobial- S. mutans are attracted to xylitol over other sugars; however, bacteria cannot metabolize xylitol and, therefore, die
Candida albicans
- a component of our normal oral flora, which suppresses its growth - also present in the digestive, respiratory, and urogenital tracts, and can lead to systemic infection
Periodontal ligament (PDL)
- a connective tissue complex, made up of fiber bundles and cells - all fibers attach to the tooth's cementum
Odontogenic Cysts
- a cyst in which the lining of the lumen is derived from epithelium produced during tooth development - Epithelial rests of serres: remnants of the dental lamina - Epithelial Rest of Malassez: remnants of Hertwig's root sheath
Orthostatic hypotension
- a decrease in blood pressure due to a sudden change of posture - can be caused by fetal pressure on the inferior vena cava
Longitudinal Study
- a group is observed over a long period of time - any study over a long time; long depends on what you're studying - data collected at 2 or more intervals for the same group
Lymphatic system
- a network of tiny channels and nodes - plays a key role in our immune system - helps the venous circulation return interstitial fluid to the bloodstream (via the subclavian veins near the junction of the internal jugular vein)
Cross-sectional Study
- a single point in time; each person studied only once
Antibodies
- a subclass of gamma globulins, immunoglobulins (antibodies) react specifically with antigens (agents foreign to the body) - chemically, they feature disulfide bonds
Dilacceration
- abnormal bend or curve in a tooth - maxillary incisors ma be induced from trauma
Microdont
- abnormally small tooth - maxillary lateral incisors most common ("peg lateral")
Healthy ginigva
- absence of clinically- detectable inflammation - may include stable, previous periodontal bone loss - firm - light pink (coral pink) - fills interproximal spaces, knife-edged - gingival margin on enamel - no bleeding upon probing or very minimal BOP - 1-3 mm gingival sulcus
Aluminum filtration
- absorbs weak/"soft" long wavelength x-rays - much have at least 1.5 mm of total aluminum filtration for up to and including 70 kVp. Requires 2.5 mm if machine can function about 70 kVp
subgingival plaque
- accumulates after supragingival plaque - contains more motile, gram -, anaerobic than supragingival plaque - there are also free-floating or loosely adherent plaque is the pocket/sulcus
Dental Plaque
- accumulations of microbes on the surface of the teeth - not readily removed by rinsing - plaque is the major etiological factor (cause) in the initiation and progression of inflammatory periodontal diseases - plaque is a "biofilm"- bacteria forming on tooth surfaces
What must an objective contain?
- action or performance verb: what are they going to do - conditions: under which the action will occur and deadline - criterion: measurement to know that the objective was met
Cephalosporins
- action s similar to penicillin - 10% of patients allergic to penicillin are also allergic to Keflex (cross-allergenicity)
IgG
- active as the primary responder to a subsequent exposure to a previously encountered antigen - most abundant antibody - highly effective at targeting and destroying an antigen through phagocytosis ("opsonizing") - the only antibody able to cross the placenta
IgM
- active as the primary responder to the initial encounter of a new antigen - it is the largest antibody, shaped like a pentameter (five sided) - With ten binding sites, it has the strongest "avidity" or bond strength to an antigen - J-chain component aids antigen agglutination, or "clumping"
Aspartame
- active ingredient in NutraSweet and Equal - Composed of amino acids, phenylalanine and aspartic acid, and methanol - not stable in heat therefore not suitable for cooking; used in beverages and chewing gum - Adverse effects- headaches, dizziness, and seizures - Provide calories, but little is needed for sweetening - Must carry phenylketonuria (PKU) warning
Erythema multiforme
- an acute ulcerative condition of skin and mucous membranes - an immunologic response to foods, chemicals, drugs, or microbial infection - recurrent HSV is a common trigger for recurrent EM - Hemorrhagic crusting of lips - large erosions & ulcerations - 50% have skin lesions: Bull's eye or target lesions - Stevens-Johnson Syndrome
Effects of Aspirin
- analgesic (pain reducer) - antipyretic (fever reducer) - through action of - hypothalamus - anti-inflammatory - anti-platelet (blood thinning)
Silver Diamine Fluoride (SDF)
- antimicrobial effects- inhibits growth of S. mutans and Actinomyces; use microbrush to apply a thin layer; then rinse with water - Contraindications: stains tooth black; possible metallic taste post application and irritated gingival margins
Blood flow from the heart to the head:
- aorta - right side: brachiocephalic artery, branching to the common carotid - left side: common carotid - right and left common carotids branch: internal carotid: skull, eye, brain external carotid: everything else (teeth, muscles of mastication, tongue, face, lips)
Radicular cyst (periapical cyst, apical periodontal cyst)
- apex of necrotic tooth - well-circumscribed unilocular radiolucency - treatment: tooth extraction or endodontic treatment
Neotame
- approved in 2022 by the FDA; often blended with other sweeteners - No amino acids are absorbed, therefore does not need to carry PKU warning - Stable in heat
Viruses
- are genetic material (RNA or DNA) surrounded by a protein shell called a capsid. - They are extremely small (0.05-0.2 microns) in size - inanimate and require a host cell for energy and replication. Viral mRNA utilizes the host cell's ribosomes for protein production and replication and diseases (envelope destroyed by soap)
Lancefield Group A streptococcus
- are the most pathogenic, attach to the pharyngeal epithelium, and can cause: - Streptococcal pharyngitis (Strep Throat) - Tonsilitis - Scarlet and Rheumatic Fever - Pyogenic (pus-producing) infections
Conditions requiring premedication for prophylaxis procedures:
- artificial heart valves - history of infective endocarditis - specific congenital heart defects - unrepaired or incomplete repair of cyanotic heart disease - heart defect repaired with prosthetic patch or device - cardiac transplant with valve problems - renal dialysis shunt - ventriculoatrial hydrocephalic shunt
Intentional torts
- assault - battery - deceit and misrepresentation - defamation - invasion of property
Vitamin D Function
- assist in absorbing calcium and phosphorus - assist in providing bone health and immune function
endotoxins
- associated with gram- bacteria - stimulate osteoclast - inhibit fibroblasts and may harm neutrophils (PMNs)
Prevotella intermedia (p. intermedia)
- associated with periodontal disease - anaerobe most often associated with inflammation during pregnancy
Chlorhexidine Gluconate (CHX) Mechanism of Action
- bactericidal - possesses high substantivity (8-10 hours)- binds to tooth, pellicle, plaque and mucous membrane and then slowly released
Macrolide antibiotics
- bacteriostatic drugs - may be used for premedication in dentistry
Nonprecious alloys contain base metals
- base metals are subject to tarnish and corrosion - may be allergenic (gingival inflammation) - base metals used in dentistry include: silver copper, nickel, tin and zinc
Systemic hypoplasia
- birth related trauma - malnutrition (hypocalcemia- low calcium levels in blood) - Chemicals (fluorosis: >0.7 ppm of fluoride in drinking water) - Systemic infection (Congenital syphilis: Hutchinson's incisors & mulberry molars) - Idiopathic (unknown)
Healing
- blood clotting - wound cleansing - tissue rebuilding - wound remodeling
Essential (Indispensable) amino acids
- body cannot synthesize - must obtain from diet - 9 are essential
Galactose (component of milk sugar)
- body converts glucose to galactose in mammary tissue during lactation; makes lactose in breast milk - found in dairy products and some legumes
mandibular tori
- bony, bilateral, radiopaque mass lingual mandible - Females 2:1
palatal torus
- bony, radiopaque mass midline hard palate - females 2:1
Tetracyclines
- broad spectrum, bacteriostatic antibiotics that inhibit bacterial protein synthesis - used in the treatment of acne and penicillin resistant periodontal infections, such as NG - should not be taken during pregnancy/early childhood due to tooth discoloration - should not be taken with dairy products, antacids or iron, which bind with tetrcycline - concentrates in gingival crevicular fluid
Digestion of Disaccharides
- broken down by following enzymes - Sucrase breaks down sucrose into glucose and fructose - Lactase breaks down lactose into glucose and galactose - maltase breaks down maltose into 2 molecules of glucose
Physiologic pigmentation (racial pigmentation, normal pigmentation)
- brown from melanin pigment - variable in dark skin individuals
Essential Oils mouthrinse side effects:
- burning sensation associated with alcohol content (most common) - bitter taste - slight extrinsic staining - contraindicated for current or recovering alcoholics
Parenteral drug administration
- bypasses the GI tract - IV, IM, SG, intradermal - inhalation, topical sublingual
Sialolithiasis (salivary stones)
- calcification within gland or duct - Wharton's (submandibular) duct most common site - may cause obstruction - swelling when eating with partial obstruction
Environmental Hypoplasia of Teeth
- can affect primary or permanent teeth - site of defect based on stage of tooth development - can be multifocal or solitary (Focal enamel hypoplasia)
Microaerophilic
- can tolerate oxygen, but produce energy via fermentation bacteria in this classification include: Streptococcus, Spirochetes
Intrinsic (endogenous) Stain
- cannot be removed by scaling and polishing - possible causes include pulpal necrosis, internal resorption, excessive systemic fluoride and/or tetracycline use during tooth development
Six classes of nutrients
- carbohydrates - proteins - lipids - vitamins - minerals - water
Saturated Fatty Acid
- carry maximum number of hydrogen atoms (hydrogenation) - remain solid at room temperature (e.g., stick of butter) - increase serum cholesterol levels - sources include beef, lard, and animal fats
Retrospective study
- case control study - seeks to compare those diagnosed with a disease with those who do not have the disease
What are the 6 links of infection?
- causative agent - reservoir - exit portal - mode of transmission - entry portal - susceptible host
Prostaglandins
- cause swelling, pain and inflammation - are inhibited by NSAIDs (ibuprofen) and aspirin
Kaposi sarcoma
- caused by HHV-8 (Kaposi sarcoma associated herpes virus) - vascular neoplasm - multiple bluish-purple macules and plaques - seen with HIV-infection
Polyunsaturated Fatty Acids
- contain two or more points of unsaturation (double bond) - liquid in consistency - decrease serum cholesterol levels - sources include vegetable oils - Essential fatty acids
Acidulated Phosphate Fluoride
- contraindicated in presence of tooth-colored restorations and porcelain- acid in fluoride etches glass components in the restoration, causing surface roughening or pitting over time - application- tray (2.5 ml for adult) or by painting with cotton-tip applicator; available in foams or thixotropic (gel-like) form
Healthy radiographs
- crest of the alveolar bone should be 1-2 mm apical to the CEJ - contour of the alveolar bone should follow the contour of the CEJ - intact, distinct radiopaque lamina dura should be present - PDL space should be visible and uniform in width
Dentigerous cyst (follicular cyst)
- cyst around the crown of an impacted tooth - mandibular 3rd molars most common site - unilocular, pericoronal radiolucency
Dens invaginatus (dens in dente)
- deep surface invagination of the crown or root that is lined by enamel - maxillary lateral incisors most common (also most common to have a lingual pit) - teeth may become necrotic/infected
Contraindications for Power-driven scalers (sonic and ultrasonic)
- demineralized areas - exposed dentinal surfaces - thermal injury to pulp and gingiva - titanium implants (unless a specially designed tip is used) - restorations (e.g., composites, amalgam and/or porcelain) - children with primary and newly erupted permanent teeth - dentures - communicable diseases (e.g., TB) - respiratory conditions (e.g., cystic fibrosis, asthma, emphysema); microorganisms can be aspirated into lungs, which complicates breathing - difficulty swallowing - susceptible to infection (e.g., immunosuppression from disease, organ transplant, chemotherapy)
Adherent plaque
- densely interconnected - contains non-motile bacteria - may mineralize and become calculus
Alpha-hemolytic streptococcus can cause:
- dental caries (strep. mutans creates acid and dextrans from sucrose) - Endocarditis (Strep. mitis) - Abscesses and cellulitis - Pneumonia (S. pneumoniae, encapsulated and resistance to destruction - Cerebral stroke (Strep viridans) - Strep salivarius is associated with the tongue (principle bacteria of the tongue)
Classified by the disease or condition being measures by:
- dental caries indices - gingival indices - periodontal indices - oral hygiene indices - dental fluorosis - tooth wear
Bulimia oral manifestations
- dental erosion (perimolysis) found on lingual surfaces of maxillary teeth due to constant exposure to acid - erosion (restorative): restorations appears 'raised' from adjacent teeth - thermal tooth sensitivity - enlarged parotid glands can occur unilaterally or bilaterally from gorging food and purging - Cheilosis associated from loss of moisture and protective qualities of saliva - Pharyngeal tears and erythema of palate, pharynx, and posterior tongue can result from objects or fingers used to induce gagging/regurgitation
Epidemiology is used in dental hygiene to:
- describe normal biological processes - describe patterns of disease in a population - understand the natural history of disease - identify the determinants of disease - test hypothesis for prevention and control of disease through studies in populations - Evaluate health care systems and how care is provided
Amperes (mA)
- describes the number of electrons flowing through the machine - also measures current of electricity
Quantity of the beam
- describes the number of x-ray photons given off in a period of time - affected by mA, kVp, time, distance and filtration
Quality of the beam
- describes the penetrating ability of x-rays - affected by kVp and filtration only - shorter wavelengths= more energy= better penetration
Voltage (kVp)
- describes the potential difference between the cathode (-) and the anode (+), or the speed of the electron moving toward the anode
B-Cell Lymphocytes
- develop in bone marrow, but do not migrate to the thymus - key components of the humoral immune system - Differentiate into plasma cells which produce antibodies - are antigen-presenting cells
Calcium Sources
- diary products, broccoli, and soy sources - calcium-fortified fruit drinks; calcium supplements
Varicosities (Varix, Varices)
- dilated superficial veins - prominent on ventral tongue (lingual varices)
Enteral drug administration
- directly in to the GI tract - oral route - rectal route
Lichen planus
- disease of the skin that can affect oral mucosa - Middle-aged adult women - Wickham's striae: fine, lace-like network of white lines - Reticular type: lace-like - Erosive type: red areas with blasters & ulceration
Secondary Prevention
- display risk factors or early phase of disease - disease present with no significant loss of structure or impact; early phases of disease; often asymptomatic disease - try to detect disease early and precent form getting worse; return back to as normal as possible - control of risk factors; screenings of at risk individuals, early intervention - periodontal debridement; fluoride varnish on demineralized areas; simple restorations; educational program about nutrition and physical activity for mildly obese kids; screening for early disease detection
Survey data collection
- distributes a written questionnaire (paper or electronic) - best choice for large groups, must be well written - cross-sectional (looks at a single point in time)
Obligate anaerobes
- do not tolerate oxygen - bacteria in this classification include: Prevotella (hormonal gingivitis, facial cellulitis, NP/NG), Porphyromonas ginivalis (produces collagenase, destroys collagen
Disaccharides
- double sugars; made up of two monosaccharides - sucrose, lactose, maltose
Superior and Inferior Deep cervical nodes
- drains the submandibular nodes, 3rd molars, and the wall of the throat (includes the retropharyngeal nodes) - structures of the oropharynx, drained by superior deep cervical nodes - superior deep cervical drained by inferior deep cervical nodes
Submandibular nodes
- drains the submental nodes and remaining teeth - may (or may not) include 3rd molars due to anatomical variation
Topical route of administration
- drug applied to a body surface (skin, mucosa) - most effective in non-keratinized area - used when local effect is desired - topical drugs require an increased concentration of the drug - contraindicated in ulcerated, burned or abraded surfaces
Xerostomia
- dry mouth - Etiology: drugs, head & neck radiation, Sjogren syndrome Can cause loss of tongue papillae & discomfort (similar appearance in severe deficiencies of: riboflavin, niacin, folic acid, cobalamin, or iron)
What can be used on an implant?
- electric toothbrush - air polisher HuFriedy has a titanium alloy scaler on the market, but Teflon is preferred
Hairy Tongue
- elongation of the filiform papillae - heavy smoking, antibiotic therapy, poor oral hygiene, etc.
Cyst
- epithelial lined pathologic cavity - often filled with straw-colored fluid
Bulimia Differential Diagnosis
- erosion on maxillary anteriors can be attributed to a dietary source, such as sucking on lemons or drinking wine, soft drinks and fruit juices - erosion on occlusal and palatal surfaces of maxillary molars, without involving anterior teeth, is most often secondary to (regurgitation of stomach acid from hiatal hernia, gastroesophageal reflux (GERD), nausea related to disease or mediation)
Stevens-Johnson Syndrome
- erythema multiforme major - more sever with skin involvement - usually triggered by a drug
Papilloma
- pedunculated (on stalk), wart-like, soft lesion - caused by human papilloma virus (HPV)
Chronic hyperplastic pulpitis (Pulp polyp, pulp granuloma)
- exophytic lesion from the pulp of carious teeth in children - composed of granulation tissue - not painful - Treatment: endodontics or extraction
Pulp Tester
- explain procedure to patient - dry teeth: isolate area with cotton rolls - apply toothpaste (conducting agent) to tip of tester - Apply tester tip: tooth in question and another tooth and do not place on same tooth more than twice; on middle or gingival 1/3 with no pressure, avoiding contact with soft tissue or metallic restorations
Apical fibers
- extend form apical area of the tooth to base of the tooth socket - resists "extrusive" forces - prevents the tooth from being lifted out of the bony socket
Pyogenic granuloma
- exuberant tissue response to local irritation or trauma - composed of granulation tissue (young connective tissue, blood vessels, inflammation) - vascular appearance - most common in kids and young adults on gingiva - hormonal influence - "Pregnancy Tumor": often seen during pregnancy
Articular disc part of the TMJ
- fibrous pad dense collagen tissue - prevents bone to bone contact - divides joints into upper and lower synovial cavities - thickest at the posterior, thinner in the center - moves with condyle under normal funnction
Sympathetic (SANS)
- fight or flight - emergency/crisis situations - increased blood pressure through vasoconstriction - increased heart rate - dilates bronchioles for improved breathing dilates pupils - may reduce saliva flow - preganglionic neurotransmitter: acetylcholine - postganglionic neurotransmitter: norepinephrine - adrenergic drugs (sympathomimetics)
Clindamycin
- first alternative for premedication if patient is allergic to amoxicillin - use limited due to rare adverse reaction called pseudomembranous colitis
Melanotic macule (oral focal melanosis, oral freckle)
- flat, brown lesion - not dependent on sun exposure - lower lip, intraoral - no treatment necessary
Gastrointestinal symptoms of acute fluoride toxicity:
- fluoride in stomach reacts with hydrochloric acid to form hydrofluoric acid, causing irritation to stomach lining, resulting in: nausea, vomiting, diarrhea, abdominal pain, increased salivation and thirst
International level of Government
- focuses on health problems of international status - WHO - IFDH
Federal Level of Government
- focuses on health problems the national population - DHHS - CDC - HRSA - NIH - FDA - IHS
Foliate
- folds of tissues at the posterior, lateral border - contain taste buds - common site of oral cancer, lateral border of the tongue
Frontal Process
- forehead and frontal bones - mean nasal process (center and tip of nose, nasal septum, globular process [philtrum, premaxillary palate]) - Lateral nasal process (sides of nose, infraorbital area)
Calcium function:
- forms and maintains bones/teeth - coagulates blood
Pterygoid plexus:
- found near the pterygoid muscles, maxillary tuberosity, and sphenoid bone - drains to form the maxillary vein - structures which drain into the plexus include the teeth, muscles of mastication, buccinator, nose, and palate - this plexus may be pierced through improper angulation of the needle during the administration of a PSA block. Hematoma may develop as a result
Interradicular fibers
- found only in multi-rooted teeth - located in tooth furcations - stabilizes tooth root
lack of keratinized gingiva
- frenum position/pulling of tissue - gingival excess
Diet Survey- Evaluate
- frequency of intake (most important) (worse times are between meals) - consistency of food (physical form) - amount of sugar added to foods - total intake
Bones of the cranium (8)
- frontal - parietal (paired) - occipital - temporal (paired) - sphenoid - ethmoid
Orbital bones
- frontal - Sphenoid - Ethmoid - Maxilla - Zygomatic - Lacrimal - Palatine
Oral cavity is developed from two embryonic processes:
- frontal process - 1st branchial arch
Autonomic nervous system
- functions without conscious effort - controls BP, pulse, respiration, body temperature, salivary gland secretion
Sucrose (table sugar)
- furnishes almost 16% of calorie intake in the average Western diet - made up of glucose and fructose - found abundantly in fruits and vegetables
Streptococcus
- generally arranged in chains or pairs - Catalase negative (an enzyme which protects bacteria from harmful metabolic byproducts, specifically, oxidative radicals)
Staphylococcus
- generally arranged in grape-like clusters - catalase positive - typically associated with pus and abscess formation
Antinomyces: a. viscous
- gram + rod - early colonizer in plaque formation
Porphyromonas gingivalis (p.gingivalis)
- gram- - rod-shaped anaerobic bacteria - important periodontal pathogen
Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) (A.a.)
- gram- - rod-shaped - associated with aggressive periodontal disease
Sphenoid Bone Landmarks
- greater and lesser wings - medial and lateral pterygoid plates (project off the greater wing) (origin of medial and lateral pterygoid muscles, Lateral Pterygoid Plate) - Hamulus (projects from the Medial Pterygoid Plate)
Grade C (rapid rate of progression)
- greater than or equal to 2 mm of bone loss/CAL over a 5 year period - Greater than 1.0% bone loss/age - Periodontal destruction exceeds expected amount due to amount of plaque - patient is a heavier smoker, or less-controlled diabetic
Amalgam tattoo (Focal argyrosis)
- grey, blue-black, flat lesion - amalgam particles in soft tissues - if particles large enough, may see radiographic radiopacities
anaerobic
- grow in the absence of oxygen - found in the periodontal pockets and gingival sulcus
Medium sensitivity to radiation
- growing cartilage - growing bone - salivary glands - fine blood vessels - lungs - kidneys - liver
Logarithmic Phase
- growth occurs exponentially, with increased metabolic activity - bacterial organisms most susceptible to antimicrobial agents in this phase
Bruxism
- habitual grinding of teeth - pathologic form of attrition
Antiviral medications treatment of HIV/AIDS
- have many adverse effects, including bone marrow depression, leading to anemia and thrombocytopenia. This results in oral effects of bleeding gingiva and oral ulcers - ex: Zidovudine (Retrovir, AZT), Didanosine (Videx, ddl) and Zalcitabine (ddC)
Primary Prevention
- healthy - no disease - prevent getting a disease - health promotion, educating about risk factors & genetic factors - Dietary restriction of sucrose; fluoride treatments for bactericidal properties, immunizations; educational program about healthy habits
Leukotrenes
- help WBCs to exit vessels and move into connective tissue - cause bronchoconstriction, cellular infiltration, cytokine release and inflammation - are inhibited by asthma drugs, such as Singulair (montelukast)
Dendritic cells
- help regulate the immune system - at as antigen presenting cells, capable of activating both T and B cells
Beta-hemolytic streptococcus
- hemolytic ability due to the production of hemolysins (cell-wall destroying agents) - Classified by Lancefield groups (A-U), based upon cell wall antigens - generally resistant to phagocytosis
Dentiogenesis imperfecta (Hereditary opalescent dentin)
- hereditary defect of dentin - obliterated pulp chambers and canals - may be associated with osteogenesis imperfecta (Brittle bone disease)
Amelogenesis imperfecta
- hereditary defect of enamel formation - enamel hypoplasia, pits and/or grooves in teeth - teeth often discolored - different subtypes and modes of inheritance
Bacterial metabolism of fluoride:
- high concentrations (professional application) of fluoride is bactericidal (destructive to bacteria) - low concentrations (daily home application) of fluoride is bacteriostatic (inhibits growth or multiplication of bacteria) - Provides substantivity (has ability to bind to pellicle, plaque and tooth surface and be released over a period of time with retention of potency; therefore, do not polish teeth prior to application)
Cardiovascular considerations
- history & severity of disease - evaluate functional status/extent of limitations - if surgery: date/type - review medications- may be taking antiplatelet (aspirin) or anticoagulant (warfarin/Coumadin) - MD consult may be needed
Contrast
- how sharply the dark and light areas on a film/image are differentiated, or how the density of one point on a film compares to another point on a film - affected by kVp and filtration only
Signs and Symptoms of Diabetes Mellitus
- hyperglycemia - acetone breath - ketonemia/ketonuria - polydipsia/polyuria/polyphagia
Temporal bone includes:
- mastoid process - styloid process - articular fossa and eminence - stylomastoid foramen (VII) - petrous portion (houses hearing components
Important Concept of the Muscles of Facial Expression:
- if the muscle of facial expression inserts into the mouth, an origin above the mouth will contribute to a smile - similarly, an origin below the mouth will contribute to a frown - therefore, the zygomaticus (arises from the cheekbone), levator anguli oris (arises from the canine fossa), and risorius help us smile
Type I Anaphylactic Hypersensitivity Reaction
- immediate (within minutes) and can lead to death - Requires previous exposure to the antigen - mediated by IgE, which indices the release of histamine from mast cells and basophils - examples: allergen of penicillin, bee sting, shellfish
Contra-indications to implant placement:
- inadequate bone - uncontrolled periodontal disease or diabetes - smoking - infection - bisphosphonates (contributes to osteonecrosis)
Phenylketonuria (PKU)
- inborn error of metabolism - liver cannot metabolize essential amino acid phenylalanine into nonessential amino acid tyrosine - must restrict phenylalanine in diet (need just enough to support normal growth); avoid aspartame (NutraSweet/Equal)
Down Syndrome (Trisomy 21)
- incidence increased with maternal age - mentally challenged, heart defects, altered immune system, risk of leukemia - fissured tongues, macroglossia (also seen in acromegaly- excess growth hormone), mouth breathing, hypodontia or hyperdontia - Taurodontism, periodontal disease, decreased caries
Water- Soluble Vitamins
- include all B vitamins and C - easily absorbed and excreted; therefore, unlikely to reach toxic levels - main functions include energy metabolism and blood formation (hemopoiesis) - deficiency of these vitamins affects the mouth (e.g., cheilosis and glossitis)
Dietary (Insoluble) Fibers
- include cellulose and hemicellulose - source of indigestible (insoluble in water) carbohydrates - increases peristalsis - sources include bran, fruits, legumes, and all vegetables
Chronic Complications of DM
- increase in periodontal disease (3 times more likely to develop periodontal disease; overall an increase in decay) - Xerostomia, therefore an increase in decay - loss of sight an kidney function - poor circulation - heart disease- most frequent cause of diabetes- related death
Gingival Hyperplasia
- increase number of cells - most related to medications - phenytoin (Dilantin): seizure medication - Calcium channel blockers (nefedipine/Procardia, others): hypertension medication - Cyclosporine: transplant medication
Smoking Periodontal Characteristics
- increased risk of developing periodontal disease, due to vasoconstriction and impaired neutrophil response of periodontal pathogens - are not a an increased risk of developing caries - deeper pockets, more bone loss, and take longer to heal after periodontal surgery/ treatment - may develop "black hairy tongue"
V3 Mandibular Posterior Division
- inferior alveolar (lower teeth) (called incisive after the mental foramen) - mental (buccal gingiva from mental foramen forward, chin, and lower lip) - lingual (floor of the mouth, lingual gingiva, anterior 2/3 tongue)
Bones of the face (14):
- maxillae (paired) - mandible - zygomatic (paired) - palatine (paired) - nasal (paired) - vomer - inferior nasal conchae (paired) Lacrimal (paired)
Periodontitis
- inflammation of the periodontal tissues, and loss of connective tissue attachment to the tooth - characterized by bone resorption that usually progresses (slowly and horizontally) - characterized by the "apical (downward) migration of the junctional epithelium" - the rate of destruction varies due to the virulence of bacteria and the host response - documented by clinical attachment loss (CAL) over time.
Tetracycline staining
- ingestion of tetracycline during tooth development - endogenous or intrinsic stain
Antiviral medications treatment of oral herpes
- inhibit viral DNA synthesis - ex: Acyclovir (Zovirax), Penciclovir (Denavir), and Valacycovir (Valtrex)
Digestion of polysaccharides (starch):
- initial digestion (chemical) begins in mouth with enzyme salivary amylase (breaks down into maltose) - continues in small intestine with release of enzyme pancreatic amylase
Intradermal route of administration
- injection into the dermis of the skin - EX: TB skin test aka Mantoux test
V3 Mandibular Anterior Division
- innervates temporalis, masseter, medial pterygoid, lateral pterygoid muscles - buccal (aka long buccal) (buccal gingiva to the mental foramen and cheek)
Type I Diabetes Mellitus (T1DM)
- insulin dependent - involves minority of diabetes cases-- 5%-10% - Onset occurs primarily in children and young adults- usually between ages 10 and 14 - Islets of Langerhans in pancreas cannot synthesize insulin - onset associated with a viral infection or genetic - Characterized by weight loss with increased appetite
Ibuprofen adverse reactions
- interferes with clotting - GI irritation
Adverse reactions of aspirin:
- interferes with clotting (contraindicated with Coumadin (warfarin)) - GI irritation (contraindicated with gastric ulcers) - Hypersensitivity (15% of patients experience allergic reaction to aspirin, asthma patients at higher risk) - association with Reye's Syndrome (a potentially severe reaction in children with either chicken pox or influenza. Reye's Syndrome may result in liver toxicity and brain damage. Avoid aspirin in children (acetaminophen is the drug of choice)) - Tinnitus (ringing in the ears-usually at higher doses only
Fordyce Granules
- intraoral sebaceous (oil) glands - small, bilateral, yellow nodules of buccal mucosa & vermilion after puberty
Diet Counseling: Motivation
- involving him/her in the decision making process - allowing him/her to choose what should be eliminated from the diet - allowing him/her to be accountable for changing own behavior
May require premedication (consult with orthopedic surgeon or physician)
- joint replacements less than 2 years ago - previous prosthetic joint infection - multiple joint replacements - immunocompromised patients (IV drug abusers, uncontrolled diabetes, patients with AIDS)
Filiform Papillae
- keratinized papillae protect the tongue, but contain no taste buds - most numerous papillae, give tongue its velvet appearance - randomly changing pattern known as "geographic tongue" (also known as "benign migratory glossitis") - Elongation known as "hairy tongue"
Leading cause of failure of an implant is Mobility:
- lack of osseo-intergration - Inadequate bone - peri-implantitis (a Swedish study conducted in 2021, indicated that 42% of implant patients develop peri-implantitis within nine years)
Disease/Periodontitis radiographs
- lamina dura becomes less distinct - may see loss of bone in furcation areas - bone loss may be horizontal or vertical - best evaluated on bitewing radiographs
Internal resorption (Pink tooth of Mummery)
- may occur after tooth trauma - enlargement of chamber or canal - if in pulp chamber, tooth may look "pink" - treatment: endodontic therapy before perforation into periodontal membrane
If there is gingival enlargement/hyperplasia, how do you measure CAL?
- measure the pocket depth first - next, measure how much enlargement is present (from CAL) - then subtract the amount of enlargement from the pocket depth
To measure CAL:
- measure the pocket depth first - next, measure how much recession is present - then, add these two numbers together
CAL
- measures from the CEJ to the base of the pocket - CAL is the best indicator of damage to the periodontium - and increase in CAL means that there is disease progession
IgE
- mediates anaphylactic hypersensitivity by binding to mast cells and basophils (massive release of histamine)
What cannot be used on an implant?
- metal instrument - probing is controversial
Periapical cemental dysplasia (Periapical cemento-osseous dysplasia, false cementoma)
- middle-age black females - periapical regions mandibular anterior teeth - involved teeth are vital - no cortical bone expansion - mixed radiolucent/radiopaque lesion- starts RL & becomes more RO - Treatment: none
Leukoedema
- milky white lesions of buccal mucosa that disappear when stretched - more prominent in dark skin individuals
Fluoride mouthrinse indications:
- moderate-to-high risk for caries - undergoing orthodontia or wearing prosthetic appliances - experiencing xerostomia, have recession, and/or demineralization
Salivary Gland Functions
- moistens the mouth (xerostomia-dry mouth) - helps cleanse the teeth - lubricates the oral tissues - buffers the oral pH
Ultrasonic (Magnetostrictive) Scaler
- more powerful than sonic scalers: uses stack of metal strips in insert to convert energy from handpiece to insert tip - produces elliptical motion - all sides of tip are active
Narcotics/Opioid drugs examples
- morphine (schedule 2 drug) - Tylenol #3 (acetaminophen and codeine- Schedule 3 drug) - Codeine is most commonly used in dentistry, in combination with acetaminophen - Demerol (meperidine), Dilaudid (hydromorphone), Fentanyl (Schedule 2 drugs - Vicoidn (acetaminophen and hydrocodone- Schedule 2 drug)
Fungi Characteristics
- most are obligates aerobes - eukaryotic (have membrane-bond organelles and a nucleus) - antibiotic resistant
Squamous cell carcinoma (Epidermoid carcinoma)
- most common form of oral cancer - smoking & alcohol consumption major risk factors; HPV for oropharyngeal tumors - often starts as a leukoplakia: white plaque that cannot be rubbed off - dysplasia & Carcinoma-in-situ: premalignant lesions, not invasive yet - lateral tongue & floor of mouth most common sites - lip common site, but many do not consider this "oral" - primary risk is sun exposure - Metastasize: 1st to cervical (neck) lymph nodes - Treatment: surgery, radiation, chemotherapy, combination - Radiation effects: erythema, xerostomia, radiation caries, osteoradionecrosis
Candida albicans
- most common fungal infection - local factors: xerostomia, complete dentures/RPD's, steroid inhalers - systemic factors: antibiotic therapy, immunosuppression (HIV), uncontrolled diabetes - several different presentations - all can present with burning
Odontoma
- most common odontogenic "tumor" - composed of enamel/dentin: can look like teeth (compound) or less organized (complex) - treatment: conservation excision
Benign mixed tumor (Pleomorphic adenoma)
- most common salivary gland tumor - parotid gland most common location (Major) - hard palate (posterior) most common intraoral/minor gland location (minor) - painless, well-circumscribed soft tissue swelling
Porphyromonas gingivalis (p. gingivalis)
- most common/ most important periodontal pathogen - anaerobic - gram- - rod-shaped bacteria
Penicillin
- most commonly prescribed antibiotic in dentistry - Bactericidal= destroys the bacterial cell wall - the most likely antibiotic to produce an anaphylactic allergic reaction - most common side effect/allergy sign is a rash - safe for pregnant patients
Neutrophils
- most numerous of all white blood cells (40-75%) - represent first line of defense - Migrate in response to chemotactic factors - able to squeeze through the endothelial lining of capillaries (diapedesis) - capable of phagocytosis
Unhealthy state of bacteria
- motile - gram- - anaerobic bacteria - bacilli bacteria (rod-shaped)
Material selection dependent upon strength and dimensional accuracy desired:
- mount model on articulator with plaster so that it can be easily removed - use stone for a study or opposing model due to its improved dimensional accuracy - use improved stone or diestone for crown and bridge since it's the most accurate and wear resistant of all gypsum products
Other causes of gingival enlargement:
- mouth breathing - periodontal inflammation - genetic/hereditary factors - systemic conditions, including leukemia and hormonal imbalance
Chronic discoid (cutaneous) lupus erythematosus
- mucosa and skin ulcerations - "Butterfly" rash
Waxes
- multiple uses, comprised primarily of paraffin - various modifiers change hardness, plasticity, melting point, color
Buccinator
- muscle of facial expression - compresses the cheek, enlarged with bruxism, originates from the pterygomandibular raphe and inserts in the muscles of the lip
Levator labii superioris
- muscle of facial expression - lift upper lip
Levator labii superioris aleque nasii
- muscle of facial expression - lift upper lip, flare nostrils
Platysma
- muscle of facial expression - neck webbing
Mentalis
- muscle of facial expression - pout- hyperactivity makes lower lip retraction difficult
Orbicularis oris muscle
- muscle of facial expression - pucker
Depressor anguli oris
- muscle of facial expression - pull down corner of mouth
Depressor labii inferioris
- muscle of facial expression - pull down lower lip
Orbicularis oculi
- muscle of facial expression - squint
Circumvallate
- mushroom like - 8-12 in number, just anterior to the sulcus terminalis - contain taste buds & gland of Von Ebner (minor salivary glands, serous)
Complementary Proteins
- need to combine two or more proteins to compensate for deficiencies in amino acid content - intake of whole grains in important
Events for a community program
- needs assessment: gather data to create a community profile - planning: prioritize needs, come up with a plan, gather supplies - implementation: carry out the plan - evaluation: continuously look at baseline data to determine if goal and objective were met
Genetic conditions
- neutropenia: lack deficiency of neutrophils (polymorphonuclear leukocytes) - down syndrome (no increased risk for caries) - Papillon-LaFevre syndrome (severe periodontal destruction, premature tooth loss,-hyperkeratosis of the palms of hands and soles of feet) - Chediak-Higashi syndrome (inherited disease of the immune and nervous systems, impairment neutrophils) - aggressive periodontitis associated with this condition
Vitamin A deficiencies
- night blindness - stunning of bones
Peri-Implant Health
- no clinical signs of inflammation - no increase in probing depth compared to previous visits (generally 5 mm of less) - no bone loss beyond initial remodeling
Precious alloys contain noble metals
- noble metals resist tarnish and corrosion - noble metals used in dentistry include: gold, platinum and palladium
Type II Diabetes Mellitus (T2DM)
- non-insulin dependent - most common type of diabetes- approximately 90-95% -usually develops in those over 40 and is associated with obesity - results from insufficient or improper insulin use - characterized by weight gain with increased appetite
Healthy state of bacteria
- non-motile - gram+ - aerobic - cocci (round)
Natural immunity
- non-specific, and does not require exposure to an antigen - it is not strengthened by repeated exposure, nor is it "remembered" by the body - aided by barriers (skin, mucous membranes), natural killer cells, phagocytosis, inflammation (release of histamine or arachidonic acid) - certain circulating proteins (complement) which assist other defensive mechanisms
Artificial Sweeteners
- nonmutritive sweeteners; non-carbohydrate and non-caloric
Alpha- hemolytic streptococcus
- not classified via the Lancefield groups A-U - Normal inhabitants of the nasopharynx and gingival crevices - includes the Viridans group (which produce a greenish tint when cultured)
Lining mucosa
- not keratinized - includes alveolar, vestibular, and buccal mucosa, as well as the floor of the mouth
Gingival fibers
- not part of the PDL - this group includes circular fibers within the marginal gingiva
Classification based upon oxygen metabolism:
- obligate aerobes - facultative anaerobes - microaerophilic - obligate anaerobes
Primordial cyst
- occurs in place of a tooth - unilocular radiolucency
Nasolabial cyst (Nasolacrimal cyst)
- soft tissue cyst - often lifts ala (wing) of the nose
Recurrent intraoral HSV
- occurs only on "bound-down" keratinized mucosa (hard palate & attached gingiva) - immunosuppressed patients-- can be anywhere - vesicles rarely seen - healing in 7-10 days
Type III Immune Complex Hypersensitivity Reaction
- occurs when an accumulation of antibody-antigen complexes have not been cleared - associated with autoimmune disorders - this inflammatory state attracts neutrophils - Lysosomal enzymes released by the neutrophils lead to tissue destruction - IgG and IgM are the principal antibodies involved - Examples: rheumatoid arthritis, systemic lupus erythematosus, and serum sickness
First-pass effect
- occurs when orally-administered drugs initially pass through the hepatic-portal circulation (liver), which reduces the amount of effective drug - drugs with a high first-pass effect have a large oral to parental dose ratio. This means they require a large oral dose
Linolenic fatty acid
- omega-3 - sources include fish, such as mackerel, tuna, and salmon, and certain plants oils, such as canola, olive, and peanut
Linoleic fatty acid
- omega-6 - sources include vegetable oils, such as sunflower and safflower
Half-life
- one measure of duration - the amount of time necessary for a drug to fall to 1/2 of its original blood level
Area-specific curets (Graceys) Characteristics:
- only one cutting edge per working end - face of blade offset 60⁰ - 70⁰ to terminal shank
Interdental Brush use in/for:
- open embrasures - exposed Class IV furcations - Orthodontic appliances, fixed prostheses, and implants *** inner wire must be plastic coated to prevent scratching cementum
Tufted Brush use in/for:
- open proximal spaces - hard to access areas, such as 3rd molars, crowded teeth and areas around missing teeth - Fixed prostheses, such as under fixed partial dentures, pontics, and orthodontic appliances
Suprahyoid muscles
- open the mouth (depress the mandible) - mylohyoid (floor of the mouth) - geniohyoid (genial tubercles - digastric (support slings, from mastoid process to mandible) - stylohyoid (styloid process)
Narcon
- opioid antagonist that reverses the effects of opioid drugs - used to treat opioid overdose (heroin) - found in dental emergency kits
Proteins
- organic compounds made up of amino acids - contain carbon, hydrogen, oxygen, and nitrogen (and sometimes sulfur) - main function is to repair/build tissues/cells - yield 4 Kilocalories/gram
Carbohydrates
- organic compounds made up of carbon, hydrogen, and oxygen - Provide source of energy - Yield 4 kilocalories/gram - include monosaccharides, disaccharides, and complex polysaccharides
Extrinsic muscles
- originate elsewhere and insert into the tongue - control the position of the tongue - hyoglossus, styloglossus, and genioglossus - palatoglossus (innervated by X, XI)
Nasopalatine duct cyst (incisive canal cyst)
- oval radiolucency of midline anterior maxilla - may appear "heat-shaped" on PA radiograph due to superimposed anterior nasal spine - occlusal radiograph shows well
What does malocclusion include?
- overbite - overjet - openbite - cross bite - midline shift (deviation) - edge-to-edge - end-to-end
Traumatic ulcer
- painful ulcer(s) at site of trauma (usually from biting) - tongue, lips, buccal mucosa - usually heals in a few days, but if deep may take weeks
Papillary hyperplasia of the palate
- papillary lesions under maxillary denture, especially if denture never removed - excise tissue & remove denture regularly
What does HPV cause?
- papilloma - cutaneous or skin warts (verruca vulgaris) - genital warts (condyloma acuminatum) - cervical cancer - and is a risk factor for oral cancer (oropharyngeal) - 5% of all cancers come from HPV
Lymph node groups
- parotid nodes - buccal nodes - post-auricular - occipital nodes - submental nodes - submandibular nodes - anterior cervical nodes - superficial cervical nodes - deep cervical nodes (superior and inferior)
Erosion
- pathologic loss of tooth structure due to a chemical process - chromic vomiting (lingual surfaces), bulimia, acidic foods, etc. - Perimolysis: erosion from gastric secretions
ibuprofen contraindications
- patients with gastric ulcers - can decrease the effect of many drugs, including ACE inhibitors, aspirin, beta blockers, steroids, loop diuretics and lithium
supraginigival plaque
- pellicle formation is derived from salivary glycoproteins - this pellicle is a sticky matrix that allows for bacterial attachment to the tooth - attachment begins mostly with gram + cocci - as plaque matures, more facultative anaerobic bacteria are present
Tissues of the periodontium
- periodontal ligament - gingiva - cementum - alveolar bone
Starch (amylose and amylopectin)
- plant storage form of glucose - nutritionally most important carbohydrate - stores energy - digestible; breaks down at a slow rate - sources include rice, potatoes, pasta, and legumes
plaque zones
- plaque-retentive zones include pits and fissures, irregular tooth surfaces, and interproximal areas - plaque includes bacteria and the extracellular matrix - this sticky extracellular matrix makes up the bulk of the plaque biofilm, and functions to hold the bacteria together, and allow for the exchange of nutrients between bacteria, and for the removal of waste products
Rectal route of administrtion
- poor patient acceptance - suppositories, creams, enema - may be used if a patient is vomiting or unconscious - poor and irregular absorption rectally
Chlorhexidine Gluconate (CHX) Clinical uses
- preprocedural rinse: use prior to aerosol-generating procedures - is an antimicrobial and antigingivitis agent - Enhances wound healing post-surgery - suppresses Strptococcus mutans for those at risk for dental caries
Informed Consent includes:
- presented in understandable language - nature and need of procedure - benefits/risk of procedure - prognosis - alternatives to procedure - patient is allowed to ask questions
MRSA ( Methicillin Resistant Staphylococcus Aureus
- presently the most drug- resistant disease-causing organism known - treated with Vancomycin and Bactrim
Vitamin A Functions
- prevent night blindness (forms visual purple= rhodopsin) - maintain bone health and immune function
Submandibular gland
- produces 65% of total saliva - Wharton's duct empties under the tongue - mixed secretion (mostly serous) - located near the angle/body of the mandible (Stafne's Defect) - Parasympathetic innervation by cranial nerve VII
T-helper cell (CD4-T cell)
- produces cytokines (chemical messengers), which stimulate other immune cells- including macrophages, natural killer and dendritic cells- to move to the site of infection, trauma, or inflammation
Function of Lipids
- provide concentrated source of energy-- 9 kilocalories/grams - carry fat-soluble vitamins A, D, E, K - provide satiety (fullness) - Provide flavor and texture to foods - provide insulation to maintain body temperature and protect organs
function of carbohydrates
- provide energy (4 kilocalories/gram) - fuel brain and needed for RBC's and WBC's - Spare Proteins- protein can supply energy; however, its main function is to build tissue and replace cells (e.g., growth) - aid in oxidation (burning) of fats to prevent ketosis - provide fiber for normal peristalsis
Glycogen
- provides a carbohydrate storage form of energy (12-24 hours) in animals/humans (glycogenesis) - in liver-regulates blood sugar for the brain - in muscle- serves as an energy source for muscle contraction - not significant as a food source
Self-applied topical fluorides
- provides additional forms of frequent, low concentration fluoride to promote remineralization (bacteriostatic effect); examples are: - rinses: contain 0.05% NaF daily; 225 ppm - Dentifrices: depending on fluoride compound, they contain anywhere between 400 and 1500 ppm
Inhalation route of administration
- provides rabid delivery across large surface area of respiratory mucosa - asthma inhalers and nitrous oxide/oxygen sedation
Steps to placing a sealant
- pumice or prophyjet to remove oils, bacteria, and debris - etch 15-20 seconds and rinse - re-etch is enamel lacks frosty appearance - apply sealant material, wick off excess before curing - Cure for 10-20 seconds (depending on the product) - Retention is mechanical; check success with explorer after polymerization
Residual cyst
- radicular cyst that was "left behind" - treatment: removal
Biological sensitivity to radiation
- rapid turnover of mitosis rate of cells increases tissue damage - undifferentiated cells have increased damage
Stannous Fluoride
- rarely used - potential side effects of use is brown staining and occasionally gingival reaction
Role of the Dental Hygienist with special needs patients
- recognize physical, medical, mental, social, dental needs - communicate appropriately to patient, caregiver & other health professionals - know all medical conditions, medications, vital signs - adapt an appropriate treatment plan
Steam Sterilization
- recommended minimum sterilization parameter 250 degrees F with 15 to 20 lbs per square inch (psi) for 30 minutes - Corrodes non-stainless (carbon) steel instruments - Dulls instruments and burs - OK for some plastics; cotton rolls/gauze (cloth goods) - paper packages come out wet and tear - Spore Test= Geobacillus (formerly Bacillus) stearothermophilus
Chemical Vapor Sterilzation
- recommended minimum temperature 270 degrees F for 20 minutes with a pressure of kPa/25 psi - Ventilation is necessary - may damage rubber and plastic items - spore test= Geobacillus (formerly Bacillus) stearothermophilus
Herpes labialis (Cold sores, fever blisters, secondary herpes)
- recurrent lesions of HSV on the lips - vesicles that ulcerate - prodromal symptoms: burning, tingling, itching, or erythema before a lesion
Median rhomboid glossitis (Central papillary artophy)
- red, atrophic area, midline dorsal tongue - often seen in immunocompetent individuals
Polyether rubber
- relatively rigid, good tissue detail - unstable in presence of moisture (will distort if left wet)
Indications for use of air/powder polishing
- remove stain and biofilm - detoxify roots (performed by periodontist) - prepare tooth for sealant - remove soft debris around orthodontic appliances
Oblique aerobes
- require oxygen - produce catalase, peroxidase, and superioxide dismutase (enzymes which protect the organism from oxidative radicals) produce energy via the Krebs cycle and glycolysis bacteria in this classification include: Neisseria, Pseudomonas, Mycobacterium
Hybrid cements
- resin-modified glass ionomers - seals dentin effectively to minimize sensitivity (unfilled resin/bonding agent) - releases fluoride (glass ionomer)
Monocytes (Macrophages)
- responsible for phagocytosis - production of cytokines - antigen transportation and presentation to T-cells
Parasympathetic (PANS)
- rest and digest - normal, resting activity - increased blood flow to digestive organs - accelerates peristalsis - constricts bronchioles - constricts pupils - increases saliva flow - acetylcholine - cholinergic drugs (parasympathomimetics)
Diabetes Mellitus Periodontal Characteristics
- results in an increased risk of periodontal disease - xerostomia and increased caries risk - candidiasis - delayed wound healing
Gingivitis
- reversible inflammation of the gingiva - directly related to the accumulation of plaque - most gingivitis is "plaque-associated gingivitis" - gingivitis is not seen on a radiograph - may be modified by systemic factors, nutrition and medications
Endoplasmic Reticulum
- ribosome-filled membranous network (rough endoplasmic reticulum) - site of cellular protein synthesis (translation of mRNA to protein)
Oral route of administration
- safest, least expensive and most convenient - large area for absorption (small intestine) - less predictable blood levels - drug inactivation by acid, enzymes or first pass effect
Treatment of periodontal disease:
- scaling and root planing; non-surgical periodontal therapy - antimicrobials/antibiotics - gingivectomy - osseous surgery
Dental Treatment for Diabetes Mellitus
- schedule early in day, following breakfast - keep rapidly absorbed sugar, such as glucose gel, readily available - use stress reduction protocol
Type IV Examination Method
- screening - no radiographs - Light source may be provided - tongue depressor
Type III Examination Method
- screening - no radiographs - light source - mouth mirror, may instruments
Zinc Sources
- seafood - tofu - milk - eggs - whole-grain breads
Signs and symptoms of occlusal trauma
- sensitivity: increased tooth mobility and tooth migration - wear facets: widening of the PDL space on a radiograph
Symptoms of hypoglycemia
- shakiness - dizziness - sweating - headaches - irritability - hunger - lightheadedness - palpitations (not lowered heart rate)
Ankyloglossia (Tongue-tie)
- short lingual frenum resulting in limitation of tongue movement - 3 males: 1 female - May have associated feeding problems in infancy, speech difficulty, periodontal issues
Stress reduction
- short, morning procedures - decrease time for procedure (may need to increase time for appointment) - good communication & encourage patients to ask questions - use relaxation techiques - make procedures as "pain-free" as possible
Biologic Monitor (Spore Testing)
- should be conducted weekly - test for proper function of autoclave- determines if the sterilization cycle is reaching proper temperature, time, and pressure to kill all microorganisms
Fibers
- should consume 25-38 grams daily - Dietary, functional, total fiber
Glutaraldehydes
- should not be used as a surface disinfectant because of toxic effects of fumes; also is corrosive - can be used as an immersion sterilant for 10 or more hours
Most common fillers for composites
- silicates - quartz - glass
Monosaccharides
- single sugars (simplest carbohydrates) - Glucose, Fructose, Galactose
Reduce Penumbra
- small focal spot increases sharpness - short object-to-film (sensor) distance decreases magnification - large target-to-film (sensor) distance decreases magnification - film (sensor) and tooth parallel decreases distortion of the image - beam perpendicular to film (sensor) decreases distortion
Fibroma
- smooth, pink, firm, elevated nodule - reactive hyperplasia of fibrous connective tissue in response to irritation/trauma - most common "tumor" of the oral cavity
Contraindications for use of air/powder polishing
- sodium-restricted diets (hypertension)- can use a sodium- free formula, such as aluminum trihydroxide - spongy/soft gingiva - respiratory conditions - restorative materials (e.g., composites, glass ionomers, porcelain veneers, and luting agents) - exposed root surfaces; avoid prolonged use - immunocompromised: increases infections - taking potassium, anti-diuretics, or steroid therapy
Chlorhexidine Gluconate (CHX) Side Effects
- stains teeth, tongue, and tooth-colored restorations - alters taste sensation (dysgeusia), including a bitter taste - can irritate and burn oral mucosa - increases supragingival calculus formation- related to the dead bacteria that remain as a result of the bactericidal action - wait 30 minutes after brushing before rinsing with CHX- inactivated by sodium lauryl sulfate
Intrinsic tongue muscles
- start and end within the tongue - determine the shape of the tongue - superior and inferior longitudinal, transverse and vertical groups
Lymphocytes are derived from what?
- stem cells in the bone marrow - present in lymph nodes (T cells mature in the thymus) - respond to foreign antigens in the tissue fluids
What type of cells is oral mucosa composed of?
- stratifies squamous epithelial layer and a connective tissue lamina propria, separated by a basement membrane. - squamous cell carcinoma will metastasize to the cervical lymph nodes
Appointment modifications for Cardiovascular Disease:
- stress reduction - frequent maintenance appointments - chair position- may not tolerate supine position - may need to limit epinephrine - xerostomia (medication related) - if condition is uncontrolled, postpone treatment -refer to MD if undiagnosed chest pains
Common appointment modifications for special needs patients:
- stress reduction - xerostomia management - frequent maintenance appointments - modification of chair position (CVA, CHF, COPD, pregnancy) - nutritional counseling - simple written & verbal home care instructions (Tell, show, do) - involve/educate caregiver - positive reinforcement - may need physician (MD) consult - if uncontrolled condition, do not treat
Alternative Sweeteners
- sugar alcohols and artificial sweeteners
Vitamin D Sources
- sunlight- body makes its own vitamin D through exposure to sunlight (90%) - fortified foods, including milk-- human milk has no vitamin D - Fatty fish (salmon, tuna, sardines)
Deoxygenated blood flow of the heart:
- superior and inferior vena cava (from body) - right atrium - tricuspid valve - right ventricle - pulmonary artery (to lungs)
Periodontal Ligament
- suspensatory ligament attaching tooth to alveolar socket - composed of dense collagen and fibroblasts - attached to cementum by Sharpy's Fibers - Oblique fibers most numerous (resist intrusive and rotational forces)
Fructose (levulose/fruit sugar)
- sweetest of the monosaccharides - found in many fruits and honey
Systemic Involvement of acute fluoride toxicity results in:
- symptoms of hypocalcemia - hyperreflexia, convulsions, paresthesia - cardiac failure or respiratory paralysis
Both forms of hydrocolloids (agar and alginate) are susceptible to:
- syneresis - imbibition *both issues lead to a distorted and inaccurate impression
Nonessential (Dispensable) amino acids
- synthesized in liver or derived from diet - 11 are nonessential
Parts of the temporal bone
- temporal bone - mandible - articular disc - capsule
Examples of Tetracylines
- tetracycline - minocycline - doxycycline
Type II Cytotoxic Hypersensitivity Reaction
- the body attacks its own tissues - associated with transplant rejection - mediated by the complement system of proteins - IgG and IgM are the principal antibodies involved - Examples: hemolytic anemia, thrombocytopenia
Metabolism
- the breaking down of a drug for its removal from the body - also known as biotransformation - liver is the most important site for metabolism of drugs
Maximum Permissible Dose (MPD)
- the maximum does that a body is permitted to receive in a specific time period with no injury - measured in "Does equivalent in man" for dosimetry: old units= Rem S.I. units= Sieverts (S.I. stands for International System of Units)
Gingivectomy
- the most common surgical procedure to reduce pocket depths - removes soft tissue only - treatment for gingival hyperplasia and pseudopockets
Density
- the overall blackness of a film or x-ray image - more photons generated= higher density - affected by mA, kVp, exposure time, distance, and filtration
Potency
- the pharmacological activity of a drug, related to dose - the amount of drug necessary to produce an effect - potency is greater when dose is smaller
IgA
- the primary immunoglobulin present in saliva - prevents the attachment of antigens to mucous membranes - J-chain component aids antigen agglutination, or "clumping"
Distribution
- the process by which a drug leaves the blood stream and enters the body systems - drugs are distributed to organs with highest blood flow - oral does to the liver, sublingual dose to the heart - drugs may be bound to proteins in the blood, especially plasma albumin
Elimination
- the removal of the drug from the body - drug elimination terminates drug effects - kidney is the most important organ (renal excretion) - other routes include liver, lungs, bile, GI, sweat, milk, saliva and crevicular fluid
Water-soluble impression materials are the hydrocolloids and include:
- the reversible form, known as agar - the irreversible form, known as alginate
Absorption
- the transfer of drug from the site of administration to blood stream - rate and efficiency is dependent upon the route of administration - IV administered drugs bypass this step - Lipid soluble drugs move across most biological membranes by diffusion, and may pass the blood-brain barrier - small intestine is most important for absorption of oral drugs
Specific bacterial species
- there are over 700 species of bacteria capable of joining a dental biofilm - formation of plaque is not random - each species attach to a limited number of others, in order
Capsule part of the TMJ
- thick, fibrous tissue surrounding joint - reinforced by the temporomandibular ligament - inner lining secretes synovial fluid (lubricates joint)
Paget's disease (Osteitis deformans)
- thickening and enlargement of the bones - Men 2: 1, usually > 50 years - "cotton-wool" radiopacities - increased alkaline phosphatase in blood & increase risk for osteosarcoma
Periodontal Biotype:
- thin scalloped - thick flat - thick scalloped
Gram + Cocci
- this classification includes Streptococcus and Staphylococcus - these organisms are non-mobile and spread via the enzyme, hyaluronidase (also known as "spreading factor"), which breaks down collagen by degrading hyaluronic acid
Floss holder recommended for:
- those who are physically challenged - caregivers providing oral hygiene care
Blood flow to oral and facial structures:
- three major branches of the external carotid artery: Maxillary: teeth, muscles of mastication, ear Lingual: tongue, floor of mouth Facial: muscles of facial expression, lips, eyelids, soft palate, throat
PDL Functions
- tooth anchorage (attaches teeth to bone) - Transmits occlusal forces to the bone, and resists impact of these forces - supplies nutrients to periodontal structures - sensory functions include tooth, pressure and pain - acts as a shock absorber for the teeth, nerves and blood vessels
Resin cement
- tooth colored to attach esthetic restorations like porcelain laminate veneers and tooth- colored inlays, onlays, or crowns, and clear orthodontic brackets - also used for luting etched metal retainers such as resin-bonded bridges and prefabricated endodontic posts
Factors that affect the prognosis after treatment:
- tooth mobility - endodontic status - Characteristics of periodontal defect (depth of pockets, width of defects, the more bony walls present, the better the prognosis - the 3-walled defect has a better prognosis than a 1-wall defect
Fiber groups of the PDL
- transseptal fibers - alveolar crest fibers - oblique fibers - horizontal fibers - apical fibers - interradicular fibers
Nystatin (mycostatin)
- treatment of oral candidiasis - comes in tablets or aqueous suspension - oral dose in 5 ml QID for 2 weeks
Thin Scalloped Biotype
- triangle-shaped tooth crowns - mild cervical scalloping - interproximal contacts close to incisal edge - narrow zone of keratinized tissue with clear, thin, delicate gingiva and thin alveolar bone
Primary herpes simplex virus (Primary HSV)
- typically occurs at a young age (1-5 years old) - Flu-like symptoms-- fever, lymphadenopathy, malaise, etc. - mouth vesicles then ulcers-- any oral location including gingiva - erythema (redness) especially of gingiva (Acute herpetic gingivostomatitis)
Epidemic
- unexpectedly large number of cases of a disease in a particular place and time
Odontogenic Keratocyst (OKC)
- unilocular or multilocular radiolucency - usually posterior mandible - high recurrence rate - unique epithelial lining - can be associated with Basal Cell Carcinoma Syndrome (Gorlin syndrome) - Some classifications now refer to OKC as a tumor (Keratocystic odontogenic tumor or KCOT)
Globulomaxillary cyst
- unilocular radiolucency - between maxillary lateral incisor and canine
Lateral periodontal cyst
- unilocular radiolucency of mandibular premolar region - cannot probe as it is a cyst in the bone
Sodium Fluoride
- use in presence of tooth-colored and porcelain restorations - application: tray method is most effective delivery system for individuals with rampant caries - 4 minute application for maximum efficacy; 1 minute applications are not recommended due to lack of efficacy data - greatest uptake is within first minute - instruct patient not to eat, drink, or smoke for 30 minutes post application - Recommended for bulimics
intensifying screens
- used in extraoral radiography - panoramic intensifying screens reduce the amount of radiation the patient receives - dose of one panoramic radiograph is about the same as 4BW
Methadone
- used in the treatment of narcotic dependence and withdrawal - taken once daily, it suppresses the need for narcotics for 24-36 hours
Subcutaneous route of administration
- used to administer protein products - insulin is administered subcutaneously- it is inactivated by the GI acid/enzymes - local anesthesia in dentistry is delivered subcutaneously - side effects may include sterile abscess or hematoma
Casting alloys
- used to fabricate inlays, onlays, crowns, and bridges - properties determined by components
Metronidazole (Flagyl)
- used to treat anaerobic infections - treatment of periodontal infections and ANUG - do not use alcohol with metronidazole (antabuse effect)
Sonic Scaler
- uses compressed air to create vibrations - produces elliptical motion - all sides of tip are active
How to avoid overhang formation:
- using a properly placed band and wedge(s) - wedge forces bas of band against tooth structure and separates the teeth to compensate for the thickness of the band (which prevents an open contact) - detect an overhang with an explorer
Abfraction
- usually 1 or 2 teeth (localized area) - pathologic loss of tooth structure from tooth flexure during mastication - wedge-shaped defects limited to the cervical area
Ibuprofen effects
-Analgesic (pain reducer) -Antipyretic (fever reducer) -Anti-inflammatory
Cushing's syndrome (Hypercortisolism)
- usually from prescribed corticosteroid therapy - Cushing's disease if caused from excess pituitary gland ACTH production - Can lead to weight gain, stretch marks (striae), bone fractures, poor healing - "Moon facies"- fat accumulation in the face - "Buffalo Hump"- fat accumulation in the upper back
Ameloblastoma
- usually multilocular radiolucency (soap-bubble or honey-combed radiolucency) - usually posterior mandible - high recurrence rate
Gingival Disease-non-dental biofilm induced
- viral, fungal or bacterial disease that affect the gingiva - examples include herpes and aphthous ulcers
Mumps (Epidemic parotitis)
- virus transmitted through saliva or respiratory secretions - bilateral parotid enlargement - flu-like symptoms
Pulp
- vital, sensory, responsive portion of the tooth, contains: blood vessels, nerve fibers, fibroblasts, odontoblasts, histiocytes, pulp stones
Direct observation data collection
- watch with your eyes - time consuming, not cost effective for large groups; requires manpower
Systemic or pre-eruptive forms of fluoride:
- water - supplements - food
Topical or post eruptive forms of fluoride
- water - toothpaste - rinses - fluoride tx
Optimal mix of gypsum
- water should be measured - gypsum should be weighed
X-rays
- weightless bundles of energy (photons) with no charge - travel in waves, and are a type of electromagnetic radiation - produce ionization - the shorter the wavelength of radiation, the shorter the energy
Neutrophils
- white blood cells significant in the development and progression of disease - most prevalent cell in acute inflammation - most active cell in the periodontal pocket - main function is phagocytosis
Nicotinic stomatitis (smoker's palate)
- white, hyperkeratotic, coarse, nodular, wrinkled appearance to hard palate in smokers - scattered red "dots" are the orifices of inflamed minor salivary glands - not precancerous
Smokeless tobacco keratosis (Snuff dipper's lesion)
- wrinkled, corrugated white lesion at site of placement - may also have gingival recession, tooth staining, & decay
Polishing with a rubber cup contraindications for use
- xerostomia - demineralized areas or dental decay - tooth sensitivity - newly erupted teeth - severe gingivitis- irritates free gingiva - lack of extrinsic stain and/or plaque - exposed root surfaces - respiratory conditions (e.g., asthma, emphysema, cystic fibrosis)
Cancer patients may present with
- xerostomia: dry mouth - mucositis: inflammation of oral tissues - Dysgeusia: loss of taste or altered taste - Increased risk of fungal and viral infections - bone loss due to malignancy
Perfect negative correlation is:
-1
Anorexia Nervosa Characteristics
-dramatic weight loss: 20-40% below desirable weight -excessive exercise -aversion to food and altered eating habits: eats 300-600 kcal/day -amenorrhea: absence of menstrual cycle caused by hormonal changes -lanugo (hirsutism): fine, soft hair -decreased heart rate caused by slowing of metabolism
Masticatory mucosal tissue
-keratinizes - protects the attached gingiva and hard palate - keratinization of the attached gingiva ends at the mucogingival junction
Local Hypoplasia
-local infection or trauma - Turner's environmental hypoplasia or tooth: enamel defect of permanent tooth from trauma or infection in 1 degree tooth - electrical burn, irradiation, etc.
Low sensitivity to radiation
-nerve tissue (#1 low) -skeletal muscle -heart -optic lens -mature bone -mature cartilage
Thick Flat Biotype
-square shaped tooth crowns -pronounced tissue scalloping - narrow zone of keratinized tissue with thick fibrotic gingiva
Xerostomia management
-things patients can do (hydrate, humidify bedroom) -saliva substitutes -saliva stimulants (cholinergics such as pilocarpine mimic acetylcholine) -caries prevention (frequent recalls, home fluoride, other products)
Adrenergic-Blocking Drugs
-used to treat cardiac arrhythmia, angina pectoris, glaucoma, myocardial infarction -may block alpha or beta (adrenergic) receptors
What is the cardiac dose for epi?
0.04mg per appointment per pt
What % is approved in the US for Chlorhexidine Gluconate (CHX)?
0.12%
MPD for pregnant dental personnel
0.5 mSv per month during pregnancy months
What is the optimal fluoride level?
0.7 ppm mg/L
Dental Hygiene Process of Care
1) Assess: review history of the patient 2) Diagnosis: current disease state 3) Plan: create plana to get the patient as healthy as possible 4) Implement: carry out the plan 5) Evaluate: check to maker sure what you did worked 6) Document
Community Program Planning 4 Phases
1) Need assessment 2) Planning 3) Program implementation 4) Program evaluation
Dental Practice Process of Care
1) Oral examination 2) Treatment planning 3) Carrying out treatment 4) Evaluate treatment outcomes
Health Belief Model
1) Perceived susceptibility 2) Perceived severity 3) Perceived benefit 4) Perceived barriers 5) Self-efficacy 6) Cute to action
Transtheoretical Model
1) Pre-contemplation 2) Contemplation 3) Preparation 4) Action 5) Maintenance 6) Termination
Crucial steps in Community Oral Health Assessment
1) Recruit key partnerships with stakeholders and community members 2) Create a community profile 3) Implement self-assessment and prioritize goals for the actual oral health assessment 4) Collect data from existing sources about the population 5) Collect primary data from the population 6) Analyze the data collected 7) Prioritize identified needs and concerns 8) Share assessment findings with the key partners
Characteristics of an Ideal index
1) Simple/clear 2) Valid 3) Reliable 4) Sensitive 5) Quantifiable 6) Objective 7) Accepted
Community Dental Health Program Planning
1) Survey/data collection 2) Program planning 3) Program operation 4) Evaluation/apprasial
After periodontal therapy
1) a re-evaluation appointment 4-6 weeks after therapy is necessary to determine effectiveness 2) the first factor to assess at this appointment is the degree of inflammation of the tissues
Goals of periodontal surgery
1. Allow for easier cleaning for the patient (cleans-ability) 2. Replace lost tissue 3. Gain new attachment
Objectives of periodontal therapy
1. Identify the disease 2. Control inflammation 3. Deal with defects resulting from the disease
IV (intravascular) route of administration
1. MOST RADIP drug response, best for emergency situations 2. More predictable blood levels 3. Absorption phase bypasses 4. Disadvantages: phlebitis (inflammation of blood vessel), irretrievability and allergy
SLOB Rule
1. Same Lingual 2. Opposite Buccal 3. Lingual objects move in same direction as the tube head 4. Buccal objects move in the opposite direction as the tube head
IM (intramuscular) route of administration
1. provides sustained effect 2. Absorption due to high blood flow in skeletal muscles 3. Massaging muscles will increase the drugs absorption 4. Deltoid or gluteal muscles common injection sites
If the x-ray source moves 2 times farther away, the patient receives only _____ of the original radiation.
1/4
If the x-ray sources moves 3 times farther away, the patient only receives ______ of the original radiation.
1/9
Normal Pulse Range for Infants
100-160 bpm
Normal Respiration for Adults
12-20 bpm
Elevated Blood Pressure
120-129/ <80 mmHg
Stage I Hypertension
130-139/89 mmHg
Normal Respiration for Children
14-26 bpm
Stage II Hypertension
140+/90+ mmHg
How long can a patient keep their insurance on COBRA?
18 months
What is the ideal length of time for diet counseling?
4-7 days
How much more Vitamin C do smokers need?
35%
Mantel dentin
1st layer of dentin immediately adjacent to the DEJ
How many bones are in the skull?
22 - 8 are cranial - 14 are facial
When do symptoms of acute fluoride toxicity begin?
30 minutes of ingestion and may last as long as 24 hours
Normal Respiration for an Infant
30-60 bpm
If the x-ray source moves 2 times closer, the patient receives _______ times more radiation.
4
Normal Pulse Range for Well trained Athletes
45-60 bpm
What is the critical pH for enamel?
5.5
When does the palate develop?
6-12 weeks
When is the upper lip complete?
6-8 weeks
What is the critical pH for dentin?
6.0
What is the critical pH for cementum?
6.7
Normal Pulse Range for Adolescents (11)- Adult
60-100 bpm
Normal Pulse Range for Children
70-120 bpm
How much Vitamin C do women need?
75 mg
If the x-ray source moves 3 times closer, the patient receives ________ times more radiation.
9
How much Vitamin C do men need?
90 mg
Sodium Source
90% consumed is table salt form
Normal Blood pressure
< 120/80 mmHg
Statistically significant p-value
<0.5
ASA I
A normal, healthy patient; no apparent disease is evident; requires no dental management modifications
ASA II
A patient with mild systemic disease; may or may not need dental management modifications ex: well-controlled NIDDM, asthma, epilepsy, Stage I hypertension, healthy pregnancy
ASA III
A patient with moderate-to-severe systemic disease, but not incapacitating; may have drug concerns and require special care will most likely require dental management modifications ex: well-controlled IDDM, stage II hypertension, CHF, AIDS, Chronic COPD
ASA IV
A patient with sever systemic disease that is incapacitating and life threatening; requires dental treatment modifications, often in a special facility ex: severe CHF or COPD, Kidney or liver failure
Electrons
A tiny, negatively charged particle that moves around the nucleus of an atom. - travel from the negative cathode to the positive anode
Lead apron
Absorbs 90% of the scatter that would have reached the reproductive tissues. Lead equivalent of 0.25mm
What is the active ingredient in Sunette and Sweet One?
Acesulfame-K
ATP
Adenosine TriPhosphate, generated via the Krebs Cycle
Narcotics/Opioid drugs effects
Analgesic (pain reducer) Antitussive (cough suppressant) Sedation Euphoria
ANOVA
Analysis of Variance - used when comparing the statistical differences between three or more mean scores
Avoid Adrenergic drugs with:
Angina, uncontrolled hypertension, uncontrolled hyperthyroidism
ALARA principle
As Low As Reasonably Achievable
What is the active ingredient in NutraSweet and Equal?
Aspartame
What is the most widely used artificial sweetener in the world?
Aspartame
What is the hardest material in the body?
Enamel - 96% mineralized and smooth. It's surface area increased (roughened) by demineralizing it with phosphoric acid
B Vitamins
B1: thiamine B2: riboflavin B3: niacin B5: pantothenic acid B6: pyridoxal phosphate B7: biotin B9: folic acid, folate B12: cyanocobalamin, cobalamin
What are antibiotics used to treat?
Bacterial infections NOT viral infections
B1 Thiamine Deficiency
Beriberi: damages nervous and cardiovascular systems
Measurement of Gingival Conditions- Reversible
Bleeding - GBI - SBI Inflammation - GI
Narcotics/Opioid drugs
Block pain receptors in the brain
Which types of Hepatitis is a blood-borne pathogens?
B, C, and D
What vegetable has the most Vitamin C?
Broccolii
How do clinical setting hygienists prevent disease?
By educating and motivating patients about the epidemiology of disease
Black-line
Composed primarily from gram-positive bacteria; typically located on cervical 1/3 of facials and lingual
CDC
Central for Disease Control - Monitors and maintains national health sciences - Federal level of Government
CDC
Central for Disease Control - Recommends infection control protocol - Provides guidelines for disease prevention and disease transmission - Located in Atlanta, GA
What type of reaction does irreversible form, alginate, undergo?
Chemical reaction - once initiated by adding water to the powder, the process cannot be reversed
What should you address first in an appointment?
Chief complaint
Dietary Fluoride Supplements are recommended to who?
Children who live in areas with inadequate water fluoridation
How do you disinfect a surface area?
Clean-wipe- disinfect
CPITN
Community Periodontal Index of Treatment Needs - Developed by WHO - Determines periodontal needs in community versus periodontal status of aperson - requires a special probe
COBRA
Consolidated Omnibus Budget Reconciliation Act - Gives individuals the right to keep the group health insurance benefits for 18 months - Applies if the person has reduced work hours, quits or loses job (voluntary or involuntary) - provides coverage for spouse and dependent children
COBRA
Consolidated Omnibus Budget Reconciliation Act - offers insurance to workers when they no longer work - last up to 18 months
What metal is added to an amalgam minimize corrosion?
Copper (Cu)
What is not included in informed consent?
Cost of the procedure
Gracey 13/14 are used for which surface(s)?
Distal surfaces of posterior teeth
Ownership of dental records
Dentist owns hard copy on which records are printed Patient owns information It is okay for dentist to charge a reasonable fee to transfer records, even if there is a balance on the account
DHHS
Department of Health and Human Services - Maintains Healthy People 2020 - Federal level of Government
Defamation
Damaging a person's reputation - Libel: written defamation - Slander: spoken, verbal defamation
DMFT/DMFS
Decayed, Missing, Filled Teeth/Decayed, Missing, Filled Surfaces (28 teeth/128 surfaces) - Permanent teeth only - cumulative measurement (past and present) - Calculate: count up the number of Teeth or surfaces DMFT/s 1 or more= caries experience DMFT/S 0= caries free
What are the 4 D's?
Dementia, Diarrhea, Dermatitis, Death
Furcation Classification Class I
Early evidence of bone loss; instrument can enter depression leading to furcation
Who monitors the concentration level of fluoride in the community drinking water?
Environmental Protection Agency (EPA)
Geographic tongue
Erythema migrans Benign migratory glossitis - areas of erythema (atrophy of filiform papillae) surrounded by raised, white border - etiology: idiopathic; symptoms: possible burning
Who monitors the concentration level of fluoride in bottled water?
FDA
Muscle of facial expression nerve innervation:
Facial Nerve (VII)
partial anadontia
Fewer than normal teeth. 3rd molars, 2nd premolars, lateral incisors.
FDA
Food and Drug Administration - Federal level of Government
Where does the V2 Maxillary trigeminal nerve leave the skull?
Foramen Rotundum of the Sphenoid Bone
GBI
Gingival Bleeding Index - measures the presence or absence of bleeding from interproximal sulcus - Calculate: floss interproximal area and evaluate for bleeding after 30 seconds, count the number of sites
Subgingival Calculus Nutrient Source:
Gingival Crevicular Fluid and Exudate
GI
Gingival Inflammation - measures severity of inflammation and identifies location based on color, consistency, and bleeding - Calculate: insert probe, press to determine firmness, move probe circumferentially: score 0-3. Must divide by 4 (# of surfaces possible) Normal (0), Mild (1), Moderate (2), Severe (3)
Carcinoma in situ
Has not penetrated the basement membrane
HIPPA
Health Insurance Portability and Accountability Act - Maintains patient confidentiality - All health care entities that electronically process, store, transmit or receive medical forms, claims, or remittance
HRSA
Health Resources and Services Administration - Federal level of Government
When does the EPA recommend deflouridation of fluoride level in community water source?
If water source of fluoride level is between 2 and 4 mg F/L of water
G.V. Black Classification for Caries and Restorations Class VI
Incisal edge of anterior and/or cusp tips of posterior teeth
IHS
Indian Health Service - Federal level of Government
Inferential
Infer (predict) what may happen with a population based on the data collected from the smaller pop
Trapezius
Innervation: accessory nerve (XI) Origin: occipital and vertebral bones Insertion: scapula (shoulder blade) and clavicle (collarbone) Function: rotate and elevate the shoulder
Sternocleidomastoid
Innervation: accessory nerve (XI) Origin: sternum (breastbone) and clavicle (collarbone) Insertion: mastoid process of the temporal bone Function: tilts and rotates the head
What do the external indicators indicate?
Instruments have been heat processed, does not guarantee sterilization of instruments
Civil Law (Torts)
Intentional torts and unintentional torts
IFDH
International Federation of Dental Hygienist - international level of government
Human Herpes Virus-8 (HHV-8)
Kaposi sarcoma associated herpes virus
Candida albicans systemic treatment
Ketoconazole and Fluconazole
What is the most fragile bone of the skull?
Lacrimal
Collimation
Lead washer sized beam reduces scatter Beam size at patient's face can be no larger than 2.75" Reduces patient's dose Rectangular are better than round
Where does the V3 Mandibular trigeminal nerve leave and enter the skull?
Leaves: Foramen Ovale of the Sphenoid Bone Enter: Mandibular Foramen
Long vs short cone (xrays)
Less volume of tissue is irradiated if long cone is used * rectangular long is the best*
Maslow's Hierarchy of Needs
Level 1: Physiological needs Level 2: Safety needs Level 3: Belongingness and love Level 4: Need for self-esteem Level 5: self actualization
Muscles of Mastication Innervation:
Mandibular Division of the Trigeminal Nerve (V3)
What two muscles of the muscles of mastication are parallel to each other?
Masseter and Medial pterygoid Masseter is external Medial Pterygoid is internal
Muscles of Mastication Blood Supply:
Maxillary artery (branch of the external carotid artery)
Measures of Central Tendancy
Mean, median, mode
Class I Occlusion (Mesognathic)
Molar Relationship: Normal; mesiobuccal cusp of the maxillary first molar; malposition of individual teeth or groups of teeth Canine Relationship: Maxillary canine occludes with distal half of the mandibular canine and mesial half of mandibular first premolar
Class II Division II Occlusion (Retrognathic)
Molar Relationship: buccal grove of mandibular first permanent molar is distal to mesiobuccal cusp of maxillary first permanent molar by at least the width of a premolar Canine Relationship: Distal portion of maxillary canine is mesial to mesial portion of mandibular canine by at least the width of a premolar *** Retruded mandible with one or more maxillary anterior teeth inclined lingually
Class II Division I Occlusion (Retrognathic)
Molar Relationship: buccal grove of mandibular first permanent molar is distal to mesiobuccal cusp of maxillary first permanent molar by at least the width of a premolar Canine Relationship: Distal portion of maxillary canine is mesial to mesial portion of mandibular canine by at least the width of a premolar *** Retruded mandible with one or more maxillary anterior teeth protruded facially
Class III Occlusion (Prognathic)
Molar relationship: buccal groove of mandibular first permanent molar is mesial to mesiobuccal cusp of maxillary first permanent molar by at least the width of a premolar Canine Relationship: Mesial portion of the maxillary canine is distal to the distal surface of the mandibular canine by the width of a premolar
Oculomotor
Motor Eye Muscles, pupil, lens
Hypoglossal (XII)
Motor Muscles of the tongue (except Palatoglossus (X, XI)
Abducens (VI)
Motor eye muscles
Trochlear (IV)
Motor eye muscles
Accessory (XI)
Motor Trapezius, Sternocleidomastoid, pharynx, and larynx
AC Electricity
Movement of electrons (-) along a wire toward a (+) charge which changes direction 60 times per second
Does aging cause xerostomia?
NO, medications and etiology
NIH
National Institute of Health - Federal level of Government
Unintentional Torts
Negligence and malpractice
Gram - Cocci
Neisseria (causative organism for meningitis and gonorrhea) (sometimes referred to as meningococcus)
Acetaminophen
Nonopiod, Brand name Tylenol
aspirin
Nonopioid, Mechanism of action is the inhibition of prostaglandin synthesis
Candida albicans topical treatment
Nystatin and Clotrimazole
What fibers are the most numberous?
Oblique fibers
OSHA
Occupational Safety and Health Administration - Responsible for developing universal/standard precaution protocols for employees to prevent them from contracting disease through blood and/or other body fluids
MPD: Occupational
Old/ Traditional units: 5 rem/ year (5000 mrem) SI Units: 0.05 Sv/year (50 mSv)
MPD: Non-occupational
Old/Traditional units: 0.1 rem/year (100 mrem) SI Units: 0.001 Sv/year (1 mSv)
OHI-S
Oral Hygiene Index- Simplified - measures oral hygiene status for cleanliness- from excellent (0) to poor - involves scores for the debris (soft) and calculus (hard) deposits
Lateral Pterygoid Muscle
Origin: lateral surface of the lateral pterygoid plate (sphenoid bone) and infratemporal surface of the sphenoid bone Insertion: TMJ disc and neck of the mandibular condyle Function: protrude and/or depress the mandible (working with the hyoid muscles), and allow the side to side (lateral) shift of the mandible
Medial Pterygoid Muscle
Origin: medical surface of the lateral pterygoid plate (sphenoid bone) and maxillary tuberosity Insertion: inner surface of the angle of the mandible Function: elevate and protrude the mandible
Temporalis Muscle
Origin: temporal fossa (temple) Insertion: coronoid process (and the mandible posterior to third molars) Function: retract and elevate the mandible
Masseter Musle
Origin: zygomatic arch (cheekbone) Insertion: outer surface of the mandible (and angle of the mandible) Function: elevate the mandible
PHP
Patient Hygiene Performance - assess the individual's performance in removing debris after toothbrush instruction
B3 Niacin deficiency
Pellagra (4 D's: Dementia, Diarrhea, Dermatitis, Death)
PDI
Periodontal Disease Index - Measures periodontal disease that uses Ramfjord teeth (3, 9, 12, 19, 25, 28) - Calculate: score teeth based on conditions of surrounding tissue: higher the score the more disease (0-6) 0= healthy 1= mild gingivitis on parts of the tooth 2= mild gingivitis surrounding tooth 3= severe gingivitis with bleeding 4= up to 3 mm bone loss 5= more than 3 less than 6 mm bone loss 6= more than 6 mm of bone loss
PI
Periodontal Index - measure periodontal disease - calculate: score each tooth based on the condition of the surrounding tissue: higher the score the more disease (0-8) 0= no bone loss 1= early gingivitis 2= gingivitis 4= early periodontitis (cannot detect visually) 6= mild periodontitis (up to 50% bone loss) 8= advanced periodontitis (more than 50% bone loss)
PSR
Periodontal Screening and Recording - rapidly assessment periodontal health in sextants - requires a special ball probe - preliminary screening in large population - Calculate: probe sextant assign score based on results for each sextant score 0-4 with * (*= there is a furcation, mobility, recession or mucogingival defect
How is the model base trimmed?
Perpendicular to the midline between the central incisors
What kind of reaction does reversible form, agar, undergo?
Physical reaction
PLI
Plaque Index aka Biofilm Index - measures differences in thickness of soft deposits at the gingival margin - Calculate: no biofilm=0; little bit= 1; visible to the naked eye/moderate= 2; significant amount=3 then find the average scores collected
Implant safe curets and scalers include:
Plastic, nylon, graphite, or gold-tipped
What is the most common periodontal pathogen?
Porphyromonas gingivalis (p. gingivalis)
Who do you not recommend dietary fluoride supplements to?
Pregnant women
p-value
Probability value - tells you the probability (how likely) it is that you came to a false conclusion from your research; the smaller the p-value the more significant the results, because most likely didn't happen by chance
Mandibular Premolar Innervation:
Pulp: Inferior alveolar nerve Buccal gingiva: buccal nerve, or mental nerve (mental nerve, forward of mental foramen, also lip and chin) Lingual gingival: lingual nerve
Maxillary Cuspids Innervation:
Pulp: anterior superior alveolar nerve Facial gingiva: anterior superior alveolar nerve (and infraorbital nerve) Palatal gingiva: nasopalatine nerve (and greater palatine nerve)
Mandibular Molar innervation:
Pulp: inferior alveolar nerve Buccal gingiva: buccal nerve Lingual gingiva: lingual nerve
Mandibular Cuspids/Incisors Innervation:
Pulp: inferior alveolar nerve (incisive nerve, forward of mental foramen) Facial gingiva: mental nerve Lingual gingiva: lingual nerve
Maxillary Third and Second Molar Innervation:
Pulp: posterior superior alveolar nerve Buccal gingiva: posterior superior alveolar nerve Palatal gingiva: greater palatine nerve
Maxillary First Molars Innervation:
Pulp: posterior superior alveolar nerve, middle superior alveolar nerve (MB root) (28% of the time) Buccal gingiva: posterior superior alveolar nerve Palatal gingiva: greater palatine nerve
Antibiotics used to treat tuberculosis
RIPE -Rifampin -Isoniazid -Pyrazinamide -Ethambutol - all 4 used together to treat active TB - Rifampin/Isoniazid only most likely for prevention
Frequency of films:
Radiographs should be ordered on an individual basis after a historical and clinical examination of the patient
Tachycardia
Rapid pulse rate; over 100 beats per minute
Orange
Rare occurrence. possibly associated with chromogenic bacteria; more frequently located on anterior teeth
RCI
Root Caries Index - attempt to assess the extent of root caries experience within the context of individuals at risk for the disease - Must have exposed roots - Calculate: Count the number of teeth with visible exposed roots, count the number of root caries on root restorations. Divide the number of caries and restorations by the number of teeth with recession
What is the active ingredient in Sweet'N Low?
Saccharin
Supragingival Calculus Nutrient Source:
Saliva
What instrument(s) have the face of the blade at 90⁰ to the terminal shank?
Scaler and curet
Vitamin C (Ascorbic Acid) Deficiency
Scurvy: ruptured blood vessels, swollen and bleeding gingiva, delayed wound healing
Vestibulocochlear
Sensory Sense of Balance and Hearing
Optic (II)
Sensory Sense of Sight
Olfactory (I)
Sensory sense of smell
Facial (VII)
Sensory and Motor muscles of facial expression, taste (anterior 2/3 of tongue via chorda tympani), sublingual and submandibular salivary glands (parasympathetic)
Trigeminal (V)
Sensory and Motor ophthalmic (V1), Maxillary (V2), Mandibular division (V3)
Vagus (X)
Sensory and Motor smooth muscles and glands of the body, cardiac muscle
Glossopharyngeal (IX)
Sensory and Motor taste and sensation for the poster 1/3 of tongue, and parasympathetic innervation to the parotid gland
What is the base metal in an amalgam?
Silver (Ag), susceptible to corrosion
film emulsion
Silver halide (Bromide) crystals on both sides of film
Gram- Spiral-Shaped Organisms
Spriochetes (causative organisms for syphilis and Lyme disease) - closely associated with NP and NG (Treponema denticola)
What is the active ingredient in Splenda?
Sucralose
SBI
Sulcus Bleeding Index - measures the presence or absence of bleeding MDFL surfaces - used in short term trails because detects early signs of gingivitis - Calculate: probe areas and observe after 30 seconds before bleeding, count the number of sites, score 0-5
Where does the V1 Ophthalmic trigeminal nerve leave the skull?
Superior Orbital Fissure of the Sphenoid Bone
B12 Cobalamin (Cyanocobalamin) Sources
animal products; vegans can get sources from sea vegetables and fortified soy milk
Latent period
Time between exposure to ionizing radiation and appearance of symptoms
Nerve innervation of hyoid muscle
Trigeminal Nerve (V) Facial Nerve (VII)
Foramen Ovale
Trigeminal nerve (V3), Third Division (mandibular)
Sulcus terminalis
V-shaped line separating the anterior 2/3 and posterior1/3 of the tongue.
Social trust
Values patient trust based on our actions and behavior
What vitamin can cause gingival bleeding?
Vitamin E
VMI
Volpe-Manhold Index - used to test agents for plaque control and calculus inhibition following prophylaxis - calculate: scores supragingival calculus formation after prophy
Pavementing
WBCs line the wall of the vessel
Barriers
Wall is mandatory if operator cannot stand at least 6 feet from the scatter source. Walls do not necessarily require lead lining. Operator should stand 90-135 degrees to the beam
When does the EPA mandate defluoridation of fluoride level in community water source?
When water source exceeds 4 mg F/L or water
Calcium Deficiency
Women are most likely to be at risk - Rickets - Osteomalacia -Osteoporosis
WHO
World Health Organization - international level of government
Summative
at the end (summary) outcome evaluation; measure impact of the program
Causative agent
a biological agent (pathogen) that causes a disease
endotoxin
a gram- bacterial cell wall toxin released when the bacterial cell is disrupted
Elasticity
a material's ability to recover its initial shape after undergoing a force
Malleability
a material's capacity to be shaped by force or pressure
Zirconium
a metal, is oxidized to create the "all-ceramic" material, zirconia. It's crystalline structure will block x-ray penetration, and will therefore appear "white", just like a cast gold crown
gamma globulin
a protein component of blood serum
prokaryotic
a single-celled organism lacking a membrane-bound nucleus or organelles
Cavernous sinus:
a sinus containing venous blood located on each side of the body of the sphenoid bone, near the base of the brain, behind the bridge of the nose. An infection of this space is life threatening.
coagulase
a staphylococcal enzyme that leads tot he coagulation of blood or plasma
Health
a state of complete physical, mental and social well-being
t-test
a statistical hypothesis test used when comparing the statistical difference between two mean scores
Odontogenic tumors
a tumor (almost always benign) derived from elements of tooth development
Specificity
ability to correctly identify the absence of disease; can say with confidence you do not have the disease, because the positive cases are truly positive
Sensitivity
ability to correctly identify the presence of a disease; picks up disease
T-cytotxic cells (CD8-T cell)
able to directly attack and destroy diseased cells
Macrodont
abnormal large tooth; rare
Hyperglycemia
abnormally high blood glucose concentration
Superior
above
Imbibition
absorption of a solvent by a gel
ADME
absorption, distribution, metabolism, excretion
Desensitization toothpaste
active ingredients: potassium nitrate, sodium citrate, or strontium chloride
Action
act of putting the motivation into action/ begun changing/ started within the last 6 months
Utilization
action use of services available by the population
Gum care toothpaste
active ingredient: triclosan (antimicrobial agent)
Water fluoridation
adjustment of fluoride ion content of a domestic water supply to the optimum physiologic concentration that provides maximum protection against dental caries with a minimal possibility of producing objectionable enamel fluorosis
Termination
adopted behavior and isn't considering changing, lifelong commitment
Perceived benefit
adopting the new behavior do they think the plan will work
Necrotizing gingivitis
affects gingiva only
gelation
agar is solidified into its gel form through chilling
hemolysins
agent that destroy the membrane of red blood cells (causing lysis or hemolysis)
cytokines
agents secreted by cells of the immune system to impact other cell activity
Vitamin K Function
aids in formation of blood-clotting factor prothrombin; bone health
Indirect transmission
airborne, vehicleborne (inanimate objects), vectorborne (animal objects)
Gracey 1/2 are used for which surface(s)?
all anterior teeth
Pacemakers and ultrasonic scalers
all pacemakers manufactured are shielded. Medtronic states there are no known risk in using ultrasonics on patients with pacemakers. Despite this finding, it is still suggested to contact the patient's physician for medical clearance
Amalgam
alloy of mercury with silver, copper, tin, and zinc
Which has less expansion and higher strength, alpha (stone) or beta (plaster)?
alpha! Remember: A>B
Heated to refine material, which drives off some of the water, resulting in either:
alpha- calcium sulfate hemi-hydrate or beta-calcium sulfate hemi-hydrate
Stone, Type III Gypsum
alpha-calcium sulfate hemi-hydrate
Secondary data
already existing data= collected by someone else
digital radiography systems
always faster than film
B3 Niacin Properties
amino acid tryptophan can be converted to niacin equivalents
Certainly Lethal Dose (CLD)
amount of a drug likely to cause death if not intercepted by antidotal therapy
Implied Contract
an agreement made through inference by signs, inaction or silence
lysozymes
an anti-bacterial enzyme that catalyzes cell wall destruction of certain bacteria
Galvanism
an electrical current generated by dissimilar metals in an acidic environment
"-ase" is a suffix for what:
an enzyme
catalase
an enzyme that breaks down hydrogen peroxide
peroxidase
an enzyme that breaks down hydrogen peroxide
collagenase
an enzyme that breaks sown collagen, especially in damage or diseased tissue
Hyaluronidase
an enzyme that degrades hyaluronic acid, also known as "spreading factor"
replicase
an enzyme that helps synthesize complementary RNA using an RNA template
Superoxide dismutase
an enzyme that reduces cellular damage caused by superoxides
Composite
an esthetic restorative material composed of a bonding agent and tooth-colored filler particles of various sizes
hyperemia
an excess of blood in the vessels in the tissues
Coefficient of thermal expansion
an index which indicates how one material reacts to temperature extremes in relation to another
Analytical Studies
analyze information to test a hypothesis to determine causative factors; types depend on how you are analyzing the information you have or will have
Origin is the
anchor
anguli
angle
Bass Method (Sulcular brushing/ perio)
angle bristles 45⁰ toward apex at gingival 1/3, placing bristles into sulcus
Stillman Method
angle bristles 45⁰ toward apex with 1/2 of bristles placed on teeth and other half on gingiva
Penumbra
area of unsharpness or lack of detail
When should a patient start flossing?
as soon as contacts are present (approximately 2 years old for a child- deciduous molars)
B9 Folate function
assist in forming DNA/RNA and RBC's
Campylobacter retus (c. rectus)
associated with periodontal disease - gram - - anaerobe associated with inflammation during pregnancy
Brown
associated with poor oral hygiene and/or drinking dark-colored beverages such as tea, coffee, fruit juices, and red wine
Green
associated with poor oral hygiene; composed of chromogenic bacteria and gingival hemorrhage
Light to dark brown
associated with tobacco use
When do you learn that you have PKU?
at birth in the hospital
Posterior
back
Death Phase
bacterial organisms die off
exotoxins
bacterial waste products that cause direct tissue injury - examples include hydrogen sulfite, uric acid and fatty acids
What are usually added to composites to make radiopacity?
barium or strontium
Sealant
barrier used to protect the occlusal surfaces of teeth from bacterial assault by sealing anatomically unprotected tooth structure with resin
Sticky wax
becomes sticky when heated, used to attach models
Where to you begin a stroke for Area-specific curets (Graceys)?
begin stroke coronal to edge of junctional epithelium
Mesiodens
between the maxillary central incisors; 4th molars
Interior
below
Plaster, Type II Gypsum
beta-calcium sulfate hemi-hydrate
Pica causes
biochemical or iron/zinc deficiency
Implants
biocompatible titanium alloy prosthesis used to replace missing teeth
Agent
biological, chemical, physical/mechanical cause of disease or injury (what is causing it) - flu virus, chemicals, radiation, toothbrush bristles
What color is the nitrous oxide tank?
blue
osteo-
bone
Fossa
bony depression
exostoses
bony protuberances that arise from the cortical palate
Double blindness
both (double) the researcher and the subjects are unaware of who is in the treatment and control group- removes bias
Hyaluronidase
breaks down the extracellular matrix, allowing bacteria to detach "spreading factor"
Goals
broad statements of what changes will occur in the population over time
Gracey 9/10 are used for which surface(s)?
buccal/lingual surfaces of molars
Awareness
correct information, but lacks personal meaning
What is the most abundant mineral in the body?
calcium
What does Vitamin D help absorb?
calcium and phosphorus
Weight control
calories from food should equal energy needs of body
Yellow-brown and brown
can be associated with Chlorhexidine (other ingredients in mouthrinses) and stannous fluoride use (stannous fluoride stain results from the reaction of the tin ion in the fluoride
True need
can be seen through the eye of the planner; data driven
Perceived need
can be seen through the eye of the population; wants; can be the same as true need; similar to the chief complaint for the individual patient treatment
Iodophors
can discolor some surfaces yellow
Facultative anaerobic
can grow in the presence or absence of oxygen
Tufted floss
can place under pontic(s) of bridges or with orthodontic appliances
chondro-
cartilage
Battery
causing bodily harm ex: placing sealants on a child's teeth without parental consent or taking radiographs without permission
Ultrasonic scalers work through?
cavitation
emigration
cells move into the tissues from the blood vessel
Mitochondria
center of energy production (ATP) and cellular respiration
Peri-implantitis
characterized by inflammation of tissues around the implant and progressive bone loss, often with probing depths >/= to 6 mm
Varicella-zoster virus (VZV)
chickenpox & shingles
Acetaminophen is the drug of choice for:
children and patients on anticoagulants (Coumadin) or ulcers
Chlorine- based compounds
corrosive to metals; strong odor
COPD
chronic obstructive pulmonary disease
arbicularis
circular
Strong correlation
closer to +/- 1
Weak correlation
closer to 0
B3 Niacin function
coenzyme in energy metabolism
B2 Riboflavin function
coenzyme in energy metabolism; prevents cheilosis and glossitis
B1: Thiamine Function
coenzyme needed for nerve function and energy metabolism
Macrophages
come after neutrophils (PMNs), characterized chronic inflammation Phagocytosis
Spirochetes
comma-, S-, or spiral shaped bacteria
Tetracycline
concentrates in the gingival crevicular fluid
Mandible part of the TMJ
condyle
Rotation
condyle rotates in the fossa
Translation
condyle slides forward along the articular fossa to the articular eminence (disc moves with condyle in health)
CHF
congestive heart failure
Interdental Tip
conical is shape; cleans debris form interdental area and gingival margins
fibro-
connective tissue
Interexaminer reliability
consistent between examiners
Intraexaminer reliability
consistent performance by the same examiner
Pica Charateristics
consumes non-nutritive substances (e.g., soil, paper, coal, paint chips) or has an abnormal appetite for some things (e.g., raw potatoes, ice cubes, flour)
Bonding failures are commonly due to:
contamination by saliva or oils
Continuous
continuous distinct separate units (weight, height, periodontal pocket measurement)
Syneresis
contraction due to loss of water to the atmosphere
Syneresis
contraction of a gel due to the loss of a solvent
Sodium properties
contributes to high blood pressure, which can lead to heart disease and stroke; hypertension is not caused by excess sodium, but aggravates it
membrane
controls the passage of materials into and out of the cell
Transcription
conversion of DNA into mRNA
Cumulative Frequency
count the number of scores below and including any given value in a set
End-to-end
cusp-to-cusp relationship of posterior teeth
Categorical
data that has no numerical value and results can only be in one category (socioeconomic status)
B9 Folate Sources
dark green leafy vegetables, enriched pasta, rice and breads, and citrus fruits
ungrouped frequency distribution
data presented in ascending or descending order along with the frequency of each score
Validity
degree that a study measures the variable it is designed to measure
Dependent variable
depends on the independent variable; depends on what you are doing; outcome of interest - what symptoms or results do you hope to see changed using the product or procedure you are testing; should change in response to intervention
Susceptible host
described above in host factors
Discriptive Studies
describes an epidemic with respect to person, place, and time. - helps to determine who is getting the disease, where the disease is occurring, when the disease occurs
Confidence Interval
describes how confident that you are correct
Descriptive statistics
describes, organizes, and classifies the dataset you currently have
planning
designing health promotion activities and programs
Bulimia Treatment
dietary: establish regular eating patterns -sodium fluoride rinses to aid with remineralization -sodium bicarbonate (baking soda) rinses to help neutralize acids -chewing sugar free gum to stimulates saliva
Range
difference between the highest and lowest score of a data set; affected by extremely high or low scores; smaller the range, the more precise the results
Need
difference between what is and what ought to be; type of care or education necessary
Physiology
digestion begins in stomach
Strong Correlation
direct association between two variable; score on one scale predicts the corresponding score on the other scale
Gracey 7/8 are used for which surface(s)?
direct facials and lingual of posterior teeth
Collagenase
directly breaks down connective tissues
Protease
directly breaks down tissues
Endemic
disease occurring regularly in a population as a matter of course; expected normal rate of disease; predictable; steady rate, but do not disappear from the population
Abandonment
dismissal of patient without ample and proper notice (patient)
Oral Irrigator
disrupts loosely adherent plaque and flushes debris and food particles around orthodontic appliances
Gracey 17/18 are used for which surface(s)?
distal surfaces of posterior teeth
Discrete
distinct separate units, but cannot have parts of a unit (number of people, number BOP)
Stratified Sampling
divide the population into groups (strata/subgroups) based on certain characteristics: select the sample population by picking from each group
median
divides the distribution of scores into two equal parts; exact middle
Self-efficacy
do they believe they have the ability to change, self-confidence
Perceived susceptibility
do they think they can get the disease
What is the best way to avoid a lawsuit?
documentation, charting and communication
Submental nodes
drain fluid from the mandibular incisors, tip of tongue, midline of lip, chin, and floor of mouth
Internal jugular vein
drains brain, facial vein, and superficial temporal vein (facial vein also empties in cavernous sinus)
Facial vein:
drains facial structures (nose, lips, eyes, submental and submandibular areas)
Formative
during the program (while its forming); allows planners to make adjustments
Random Sampling
each element of the population has an equal chance of being selected - reduces bias
Convenience Sampling
easiest to do; sample group chosen based solely on being readily available/ convenient
Vitamin E Properties
easily destroyed by heat and exposure to air; overconsumption interferes with blood coagulation
Adrenergic Drugs
effects mimic the sympathetic nervous system
Circular fibers
encircle the tooth, helping to maintain gingival integrity like pulling on the strings of a purse
Thermic effect of food
energy required to digest and absorb food
Fusion
enlarged tooth in which the tooth count reveals a missing tooth
Digestion of Monosaccharides
enter capillaries and glucose goes directly into blood to be used as energy
Bulimia
episodes of binge eating followed by purging (e.g., vomiting, use of laxatives, excessive exercise, enemas and purgatives or diuretic abuse) to prevent weight gain
Interval
equal ordered units around an arbitrary zero (can go into negative numbers)
Radiation exposure for the average complete mouth series
equal to 3 days to one week of normal background whole body radiation
Amino acids
essential (indispensable) amino acids nonessential (dispensable) amino acids
Primary occlusal trauma
excessive force on a tooth with normal bone support
discolored film
exhausted fixer or poor replenishment, after time, problem is poor wash
What type of salivary glands have ducts?
exocrine glands
Zinc phosphate cement
exothermic (heat generating) reaction on mixing (use cool glass slab)
Imbibition
expansion due to absorption of water
oculi
eye
Host
factors about the person; relates to susceptibility and resistance to disease through immunity, knowledge, behavior, and cultural practice - age, sex, genes, immune status, occupation, family background, previous illnesses
Neglagence
failure to do what a reasonable person would do
Acid staining techniques
fast, used to identify Mycobacterium tuberculosis
hypodontia
fewer than normal teeth
Fungiform
fewer, larger (appear as red bumps), contain taste buds
Sharpey's fibers
fiber bundles that are attached and embedded in cementum and bone
Foramen caecum
found at the center or point of the sulcus terminalis and is the site of the embryonic origin of the thyroid gland
Beta 2
found in many areas, increasing BP, dilate smooth muscle, other actions
Dark staining techniques
field Microscopy, used to identify spirochetes
Primary node
first node affected by a disease process
Which trimester of pregnancy are most abnormalities occuring?
first trimester
angular cheilitis
fissured areas at corner of the mouth - can see similar appearance with severe riboflavin (Vitamin B12) deficiency
Fissured tongue (furrowed tongue, scrotal tongue)
fissures and grooves on dorsal tongue surface
Vitamin A Properties
found in preformed (active) vitamin A and provitamin A
B12 Cobalamin (Cyanocobalamin) Deficiency
found in strict vegetarians; pernicious anemia causing weakness, sore tongue, and apathy
Elastometric
flexible
What muscles make the floor of the mouth?
floor of the mouth
Local Level of Government
focuses on health problems of small local populations (city or county)
State Level of Government
focuses on health problems of state population
Internal motivation
focuses on reward from inside
External motivation
focuses on reward from outside
Copper Function
formation of hemoglobin
Anterior
front
Acetone breath
fruity odor on breath (as a result of ketosis)
How is the palate formed?
fusion of the globular process with the left and right palatal shelves. It separates the stomodeum into and upper (nasal) and lower (oral) cavity
How is the upper lip formed?
fusion of the median nasal process and right and left maxillary processes
Growth of fungi
generally opportunistic, and accelerates when the immune system is depressed, or the normal flors (which suppresses fungal growth) is reduced through antibiotic therapy
Herpes simplex virus (HSV-2)
genital herpes
Vitamin K deficiency
hemorrhaging
Hyperplasia
gingival enlargement due to an increase in cell numbers
Hypertrophy
gingival enlargement due to an increase in cell size
Iodine Deficiency
goiter
Gold foil
gold in color, small in size, gum-line, anterior tooth
Extra-orally
gold may be polished with rouge in the lab
Intra-orally
gold may be polished with tin oxide
Adeno-
grandular (glands are epithelial)
What color is the oxygen tank?
green
Vitamin K Sources
green leafy vegetables and canola and soybeans
What is the cross section of a curet?
half-moon or semi-circle
Tetracycline (Doxycycline)
has anti-collagenase properties, and is found in crevicular fluid. It is for the reason, that low - "subclinical"- does routinely taken may be an effective "non-surgical" periodontal therapy (Periostat)
Maintenace
have changed the behavior for more than 6 months and is adopting the new normal
Medicare
health insurance for elderly and disabled
Medicaid
health insurance for the poor
B12 Cobalamin (Cyanocobalamin) Function
helps build tissues, maintains nerve cells, and essential RBC development; also needed for folate metabolism
Iron Function
helps manufacture amino acids and hormones
IgD
helps protect the respiratory system from foreign bodies entering through the lungs
Most common mechanism of damage (radiation) in humans:
hydrolysis
Linea alba
hyperkeratotic white line of buccal mucosa along plane of occlusion
Trismus
hypomobility from trauma, disease, bruxism
Cleidocranial dysostosis (dysplasia)
hypoplastic clavicles
Bacteria
identified by their morphology or metabolic differences
Passive immunity
immediate, short-lived
Endosteal
implant within bone
Osteomalacia
in adults, calcium is taken from bones to make up for insufficient absorption in intestine; symptoms include bowed legs, bent posture and pain in ribs, pelvis, and legs - Predominately in women
Rickets
in children, softening of bones due to failure to calcify normally; symptoms include bowed legs, enlarged head, joints, and rib cage, and deformed pelvis
Edge-to-edge
incisal edge to incisal edge of maxillary anterior to mandibular anterior teeth, respectively
Vitamin E (Tocopherol) Sources
include vegetable oils (corn and safflower oils) and green leafy vegetables
Beneficence
includes the well-being of individuals and the public
increasing the kVp will
increase the density of the film/image
increasing the mA will
increase the density of the film/image
increase the exposure time will
increase the number of photons and increase the density of the film
increasing the kvp will
increase the number of photons generated
increasing the mA will
increase the number of photons generated
Interleukins (ILs)
increase vascular permeability, attract PMNs, fever, etc.
Hyperdontia
increased number of teeth
polydipsia/polyuria/polyphagia
increased thirst/urination/appetite
Reversible Indices
index measures conditions that can be reversed or resolved - gingivitis and plaque indices
Tender and/or enlarged lymph nodes can indicates what?
infection and/or malignancy -detected by palpation
Ibuprofen mechanism of action
inhibits prostaglandin synthesis (similar to aspirin)
Secondary occlusal trauma
injury as the result of forces applied to a tooth that has previously experienced bone or attachment loss. Rapid bone loss/pocket formation may result from excessive occlusal forces on a tooth that has bone/attachment loss previously - trauma from orthodontic forces now under this category
What is the choice for removal of stain that is located on the cementum?
instrumentation
IDDM
insulin-dependent diabetes mellitus
Negative Correlation
inverse association; the score on one scale predicts an opposite score on the other scale closer to 0
Preparation
investing in motivation to change/decided to change and is getting ready to change in next 30 days
Mobility Class 2 or II
involves moderate horizontal mobility- greater than 1 mm- with no vertical displacement
Mobility Class 3 or III
involves severe mobility with possible combined horizontal and vertical movement
Mobility Class 1 or I
involves slight horizontal mobility
Stafne's Duct
is a developmental concavity of the mandibular cortical plate, and is associated with the submandibular gland
Prevotella intermedia (p. intermedia)
is a gram - - rod-shaped anaerobic bacteria - also associated with pregnancy gingivits
Treponema/Barrelia vincentii
is a gram - anaerobic spirochete
Treponema denticola (t. denticola)
is a spirochete
Active immunity
is delayed, but long-lasting
Perceived severity
is the disease severe enough to worry about
cell
is the fundamental function unit of the body
Rubber dam
isolates field and prevents salivary contamination
Crepitus
joint noise, generally indicates joint damage (disc tear, and/or bone to bone contact), may be associated with pain/pathology
Systemic Treatment for Angular Cheilitis
ketoconazole, fluconazole (Diflucan)
ketonemia/ketonuria
ketones in blood/urine
Disinfectionts
kill or inactivate most pathogenic microbes, not spores
Sterilization
kills all pathogenic microbes, including spores
Incomplete (Low-quality) protiens
lack one or more essential amino acids (e.g., plant proteins)
What muscles open the mouth?
lateral pterygoid with hyoid muscles
B3 Niacin Sources
lean meats, fish, enriched and fortified grains and cereals, whole grains and sweet potatoes
Habit
learner begins to experience gratification and self-satisfaction; behavior is modifies long term
Unawerness
learner has incomplete or inaccurate information
Self-Interest
learner personalizes the information; realizes there is a personal preoblem
Action
learner test new concepts based on perceived needs
When contractions of the right lateral pterygoid muscles happens the jaw will shift?
left
Copper Deficiency
lesions within connective tissues and bone that results in failure to grow
Levator
lifts
Blood supply for the tongue
lingual artery
Essential (polyunsaturated) fatty acids
linoleic acid (omega 6) and linolenic acid (omega 3) - must be obtained through diet
labii
lip
Points of Reference for Palpation of Carotid Artery
located along outer edge of trachea; often used in emergency situations
Sublingual caruncle
located in the midline under the tongue, contains the duct openings for both submandibular and sublingual salivary glands
Points of Reference for Palpation of Brachial Artey
located on inside of upper arm; best point for taking a pulse on toddlers and infants
Points of Reference for Palpation of Radial Artery
located on the thumb side of the wrist; most common point for taking a pulse
Necrotizing periodontitis
loss of clinical attachment and bone
inferioris
lower
Nominal
lowest level; categories/no rank in order or values
Block grant
lump sum of $ given to a group to use at their discretion
What is the second most important WBCs?
macrophages
Macrominerals
major minerals present in amounts greater than 5 grams in the body
Naturally acquired passive immunity
occurs during pregnancy (maternal antibodies) IgG
leukemia
malignancy of leukocytes (white blood cells)
lymphoma
malignancy of lymph tissue or nodes
melanoma
malignancy of melanocyted
Kaposi's sarcoma
malignancy of vessels, presents as a blue/purple macule
Carcinoma
malignant neoplasm of epithelial tissue
Sarcoma
malignant neoplasm of mesenchymal tissue (muscle, bone, connective tissue, etc.)
Temporal bone part of the TMJ
mandibular fossa, glenoid fossa, or articular fossa (articular eminence, just anterior to the fossa)
A Long scale of contrast
many shares of gray (low visual contrast) - results from more kVp and aluminum
Anterior Crossbite
maxillary incisors are positioned lingual to mandibular incisors
Posterior Crossbite
maxillary or mandibular teeth are lingual or facial to normal position (can be bilateral or unilateral)
Efficacy
maximum response of a drug, regardless of the dose
Phenols (water or alcohol based)
may leave a film or residue on surfaces
What is the most common measure of central tendency?
mean
Negative Skew
mean < mode mean < median when more scores fall in the higher range tail goes to the left
Positive Skew
mean > mode mean > median when more scores fall in the lower range tail goes to the right
Normal (Bell) Curve
mean, median and mode or equal
Basal Metabolism Rate (BMR)
measure of energy needed to maintain life at rest (breathing, heart beating, circulation, muscle tone, and body temperature)
Cumulative Indices
measures all evidence of a condition, past and present - caries and restorations
Irreversible Indices
measures conditions that cannot be reversed; measures a lifetime of disease - caries or periodontal disease
Gracey 15/16 are used for which surface(s)?
mesial surfaces of posterior teeth
Gracey 11/12 are used for which surface(s)?
mesial, facial, and lingual surfaces of posterior teeth
Polysulfide rubber
messy, smelly, must be poured same day
Diabetes Mellitus
metabolic disorder characterized by high blood glucose levels due to insufficient or ineffective insulin function. When glucose levels are elevated in the blood and cells, tissue damage results. (normal [random] glucose levels are between 70 and 125 mg/dl)
fermentation
metabolic process that converts sugar to acid/alcohol when oxygen is scarce
Midline shift (deviation)
midline of maxillary central incisors does not align with midline of mandibular central incisors
B2 Riboflavin Sources
milk, enriched and fortified grains, and whole grains
Gypsum is made of
mineral, calcium sulfate di-hydrate
Calculus
mineralized plaque; provides an irritant to ginigva
Oligodontia
missing 6 or more teeth
How can a chemical reaction be slowed?
mixing chemical with cold water
How can a chemical reaction be accelerated?
mixing chemical with hot water
Furcation Classification Class II
moderate bone loss; instrument can enter furcation, but cannot pass between the roots
Epstein-Barr virus (EBV)
mono, oral hairy leukoplakia, Burkitt's lymphoma
Children (radiology)
more sensitive to radiation due to rapid cell mitosis associated with child growth
Fibroblast
most common cell of the PDL, important in collagen synthesis, and fiber production - "Primary cell of the PDL"
Film Speed
most effective method of protection.
mode
most frequently occurring score
Inflammatory biochemical mediators: released by WBCs (leukocytes)
most important mediators include interleukins, prostaglandins and leukotrienes
Materials will allow some x-ray penetration, they will appear somewhat radiopaque, but not "white":
most non-metal restorative materials (sealants, composites, cements, liners, bases, gutta percha, etc.) have been made partially radiopaque by the addition of barium or strontium
Ratio
most precise level; zero determined by nature and means absence of something; equal ordered units (height, weight)
A short scale of contrast
mostly blacks and whites (high visual contrast) - results from less kVp and Aluminum
Involvement
motivated to act/become involved in learning process; desire for more info
oris
mouth
Insertion
movable part the movable part moves toward the anchor when the muscles contracts
chemotaxis
movement in the direction of a changing chemical gradient
What is the most common white blood cell?
neutrophils
What is the most important WBCs?
neutrophils
DNA Viruses
must be transcribed into mRNA before protein synthesis can occur. The host cell's ribosomes then translate the mRNA into amino acid chains, or polypeptides (protein)
What is the best instrument to detect a furcation?
nabers probe
Necrotizing stomatitis
necrosis extending beyond gingiva (tongue, cheeks, palate, etc.)
Cathode
negative electrode that supplies the electrons necessary to generate x-rays - made of tungsten filament and molybdenum cup
-oma
neoplasm
neuro-
nerve
Control groups
no experimental treatment and provides the baseline to compare the treatment group results to; the group that has the experimental treatment (intervention) withheld; Often receive the placebo
Vitamin C ( Ascorbic Acid) Properties
no extensive storage; smokers have and increased need
Stationary Phase
no growth, as available nutrients have been utilized and waste products accumulate
No Correlation
no relationship is seen between the variables on the x-y axis
Anadontia
no teeth
Terminating patients
non-compliance and failure to pay (practitioner)
NIDDM
non-insulin dependent diabetes mellitus
Hyoid bone
nonarticulated horseshoe shaped bone in the midline, inferior to the mandible
Mobility Class N
normal
nasii
nose
Quaternary compounds
not corrosive, but have a lower kill spectrum; limited efficacy
Pre-contemplation
not motivated to change/not thinking about changing
Rate
number of events that occur in a given population in a given period
Natality
number of live births
Sugar Alcohols
nutritive sweeteners; carbohydrate-like, sugar-like compounds that provide calories; do not promote tooth decay because they metabolize at a slower rate; not readily absorbed by small intestine, therefore can cause diarrhea if too much is consumed - Sorbitol - Mannitol - Xylitol
Topical Treatment for Angular cheilitis
nystatin, clotrimazole
Barriers
obstacles which interfere with care to be provided
Traumatic occlusal forces
occlusal trauma does not cause periodontal disease, but can make periodontal disease worse
Acquired Immunity
occurs after exposure to an antigen, and improves with repeated exposures. Because it is mediated by antibodies and T-cells, it is "remembered".
bacterial products
often contribute to tissue destruction
Dichotomous
one or the other (yes/no; true/false)
Foramen
opening or passage
Express Contract
oral and written
Herpes simplex virus (HSV-1)
oral herpes
Which oral hygiene aid is most suited for removal of loose or non-adherent plaque?
oral irrigator
Iron Sources
organ meats (liver), dried beans, and nuts (not found in milk)
Lipids (Fats)
organic compounds composed of carbon, hydrogen, and oxygen
Vitamins
organic nutrients needed in small quantities
eukaryotic
organisms whose cells are membrane- bond, with a nucleus and organelles
Data Matrix
organization/arrangement of data scores from lowest to highest (basically an ordered list of data points) in a table format
Pandemic
outbreak of disease over a wide geographical area such as a continent or across boarders
Hypertensive Crisis
over 180/120 mmHg
Vitamin E (Tocopherol) Overcomsumption
overconsumption from supplements can interfere with blood coagulation-- function of vitamin K; also can cause gingival bleeding, especially if a patient is taking aspirin
Abrasion
pathologic loss of tooth structure from a mechanical process
Confidentiatlity
patient information and relationships
Golgi Bodies
packages cellular protein product for secretion
What stimulates the flow of saliva?
parasympathetic nervous system
Three major salivary glands
parotid, submandibular, sublingual
diapedesis
passage of leukocytes through the intact capillary wall
Microleakage (percolation)
passage of oral fluids/bacteria into and out of tooth structure due to a marginal gap or failure to the marginal (restorative) seal
Alternative sweeteners are made for what kind of people?
people who have diabetes
porin channel
permeable membrane channel found in gram - bacteria
G.V. Black Classification for Caries and Restorations Class I
pits and fissures on lingual surfaces of anterior and on occlusal, buccal, and lingual surfaces of posterior teeth
Charters (Ortho)
place bristles 45⁰ towards occlusal/ incisal plane; move bristles in several small rotary motions keeping contact with gingival margin
How do you sharpen a curet?
place stone between 100⁰-110⁰ against blade (internal angle should be 70⁰-80⁰)
How do you sharpen a scaler?
place stone between 100⁰-110⁰ against blade (internal angle should be 70⁰-80⁰)
Fusobacterium nucleatum (f. nucleatum)
plays a critical role in biofilm formation - anaerobic - gram - - rod-shaped bacteria
Bacilli bacteria
rod-shaped bacteria, most common type found in periodontal disease
B1 Thiamine Sources
pork, whole grains, and enriched and fortified foods
Fones (Pedo)
position bristles perpendicular to crowns of teeth; brush in circular motion
Anode
positive electrode that converts electrons in to x-ray photons - made of a tungsten target and copper stem
2nd and 3rd branchial arches develop:
posterior 1/3 tongue and hyoid bone
Polycarboxylate cement
powder mixed with polyacrylic acid
Quota Sampling
predetermined number of participants; once reach that size no more participants are recruited
Gardner syndrome
premalignant colon polyps, osteomas, epidermoid cysts
In-office rinses:
preprocedural rinse to reduce microorganisms and aerosol contamination before using ultrasonic scalers as well as air and rubber cup polishing
Sodium bicarbonate
primary ingredient in denture cleaners
Total fiber
sum of dietary and functional fibers
Diapidesis
process by which neutrophils squeeze between endothelial cells in the vessel wall
Calibration
process of establishing a relationship between measuring device and units of measure; helps to increase interexaminer reliability
Osteoblast
production of bone
Cementoblast
production of cementum
Process
projection or extension
Vitamin C (Ascorbic Acid) Function
promotes synthesis of protein collagen (connective tissue); antioxidant
When contraction of both lateral pterygoid muscles happens the jaw will?
protrude
Filaments and tubules
provide structural support
What is the purpose of PPE?
provides barriers to minimize exposure to aerosols, spatter, and splash
G.V. Black Classification for Caries and Restorations Class III
proximal surface of anterior teeth; does not involve incisal edge
G.V. Black Classification for Caries and Restorations Class IV
proximal surface of anterior teeth; involves incisal edge
Recommended antimicrobial for plaque-induced gingivitis, slight-to-moderate chronic periodontitis, NG/NP and periodontal maintenance patients
recommend chlorhexidine 2x/day
Recommended antimicrobial for patient with alcohol condition
recommend non-alcohol containing rinses- rinses containing alcohol are contraindicated in patients being treated with Antabuse (disulfiram) because, in combination, they may induce nausea and vomiting
Herpetic whitlow
recurrent HSV on finger
Erythematous candidiasis
red areas
Sodium Recommendation
reduce intake and increase cooking with spices
Specialized mucosa
refers to the papillae of the tongue
Environment
relates to outside forces influencing health (where the agent and the person are that helps spread or prevent the disease) - water sources, temperature, altitude, radiation, pollution, noise
Reliability
reproducible: the extent to which the method of measurement performs consistently; if something is reliable you know it will perform the same way every time
Microminerals
required in the diet in amounts of < or = to 100 mg/day
aerobic
requires oxygen to grow - not found in periodontal pockets
Epidemiologic Surveys data collection
research in controlled environment
Single blindness
researcher remains uninformed and unaware of a the identities of treatment and control groups to prevent bias
Horizontal fibers
resist horizontal and tilting forces
Viscosity
resistance to flow (the higher the viscosity, the lower the flow)
Osteoclast
resorption (break down) of bone
Cementoclast
resorption (break down) of cementum
Narcotics/Opioid drugs adverse effects
respiratory depression/sedation nausea/vomiting (emesis) constipation addiction
Lysosomes
responsible for phagocytosis and digestion
Naturally Acquired Active Immunity
results from infection (measles, chicken pox)
When contraction of the left lateral pterygoid muscles happens the jaw will shift?
right
Recommended antimicrobial for cancer patient with mucositis
rinse with baking soda or saline solution followed by plain water rinse
Bacilli
rod shaped bacteria
Cocci bacteria
round/spherical-shaped bacteria found in early plaque formation
Iodine Source
salt
Furcation Classification Class IV
same as Class III, but with evidence of recession
What are liners generally used for?
seal dentin or medicate the dental pulp
Bonding Agents
seals dentinal tubules
Resin-modifies glass ionomer
seals tubules and releases fluoride
Anorexia nervosa
self-starvation due to a distorted body image
B2 Riboflavin Properties
sensitive to light (mild should be stored in cardboard/opaque containers)
Furcation Classification Class III
severe bone loss; instrument can pass between roots
Pleomorphic
shapeless bacteria
increasing the kVp =
shorter wavelengths= more penetration
aleque
side (also talks about the ala of the nose)
Central giant cell granuloma
similar microscopically but different condition; presents as unilocular or multilocular bony radiolucency ("central" designates within bone)
Peri-Implant Mucositis
similar to gingivitis: bleeding upon probing, possibly increased probing depths due to inflammation. No loss of supporting bone
Germination (twinning)
single enlarged tooth in which the tooth count is normal
rhabdomyo-
skeletal muscle
Zinc Deficiency
skin disorders
Creep
slow dimensional change caused by compression
Lag Phase
slow growth, with routine metabolic activity
Bradypnea
slow repirations
Bradycardia
slow respirations
leiomyo-
smooth muscle
Area-specific curets (Graceys) are designed to do what?
smooth surfaces during root planing
Peri-Implant soft and hard tissue defficiencies
soft tissue/alveolar bone deficiencies may be caused by healing, extraction trauma, infections, etc.
Judgement Sampling
some familiar with the population selects the sample; using personal judgement to select - use this when not worried about bias jest need right kind of people
Zinc-oxide/eugenol Liner
soothes the pulp, oily, contra-indicated with composite
Sinus
space
Line Item grants
specifies where monies are to be used and only used
Cocci
spherical bacteria
Spirochetes bacteria
spiral/shaped bacteria, often associated with necrotizing disease
Splinting
splinting of mobile teeth to stronger adjacent teeth can give stability for potential reattachment, improve comfort, function and esthetics, and improve prognosis
Staging of periodontitis
staging is based upon severity of the disease and the complexity of the treatment/management
Gram - organisms stain
stain pink
Gram + organisms stain
stain purple
Calcium Hydroxide Liner
stimulates reparative dentin formation/pulp exposure
Beta 1
stimulates the heart's cardiac output, increasing BP
Alpha
stimulation constricts arteries, increasing BP
Tertiary data
summary or overview of already existing data
nucleus
stores DNA and directs all cellular activities
What type of cells make salivary glands?
stratified cuboidal epithelial cells
Vitamin C (Ascorbic Acid) Source
strawberries, BROCCOLII, cantaloupe, citrus fruits, potatoes, and tomatoes
Formal delivery
structured and planned with goals
Experimental studies
studies carried out under controlled situations in a LAB; trying to find the effectiveness of altering risk factors or treatment options
Epidemiology
study of the cause, pattern of occurrence, and determinates of disease in populations
Nutrients
substances obtained from food and used by the body to promote growth, maintenance or repair
Outbreak
sudden appearance of a disease
Vinylpolysiloxane
tasteless, odorless, capable of multiple pours, most popular
What foods contain larger amounts of fluoride than meat, eggs and fruit?
tea and fish
Bulimia Psychological
team approach; easier to treat because bulimic is aware of normal behavior
Openbite
teeth not in occlusion between maxillary and mandibular teeth or arches
Veracity
telling the truth and expecting it of others
What is known as freeway space?
temporalis
What muscles elevate the mandible?
temporalis, medial pterygoid and masseter muscles
What is the drug of choice for necrotizing periodontal disease?
tetracycline because it concentrates in gingival crevicular fluid
Ductility
the ability to undergo change of form without breaking
Width of attached gingiva:
the attached gingiva is connected to the tooth cementum and the periosteum of the alveolar bone - widest in the anterior teeth - narrowest in premolar areas - width of attached gingiva is not calculated for palatal surfaces
avidity
the bond strength between an antigen and an antibody
glycolysis
the breakdown of glucose for the extraction of energy in the absence of oxygen
Cohesion
the chemical attraction between like molecules
Adhesion
the chemical attraction between unlike molecules
agglutination
the clumping of particles, as in an antigen-antibody reaction
Grouped frequency distribution
the count of data points grouped into class intervals (groupings)
Translation
the decoding of mRNA
Host range refers to
the different kinds of organisms the virus can infect (man, horse, cow)
Ionization
the ejection of an electron from an atom. Produces charge ion pairs or free radicals
Independent variable
the experimental treatment option; controlled/manipulated by the researcher; researcher creates the change directly - what product concentration or procedure are you testing
Supernumerary
the extra teeth
Muscle of facial expression blood supply:
the facial artery (a branch of the External Carotid Artery)
Compressive strength
the force at which a material breaks under pressure
Proportional limit
the force at which a material cannot return to its original shape
Tensile strength
the force needed to stretch a material to the point of fracture
Kreb's cycle
the mitochondrial process by which cellular energy is aerobically produced
Cue to action
the motivation to act; encourages them to adopt the behavior or participate
Margination
the movement of WBCs to the periphery of vessel walls
chemotaxis
the movement of cells to the site of inflammation
Treatment groups
the group that receives the experimental treatment
inverse square law
the intensity of radiations inversely proportional to the square of the distance from the source of the radiation
Exposure time
the interval of time during which x-rays are produced 1 sec= 60 impluses 1/4 of a second= 15 impulses, 1/2 of a second= 30 impluses
Specificity refers to
the kinds of cells a virus can infect (blood, liver, lungs)
Duration
the length of time that a drug has an effect
Polymerization
the linking, branching, or cross-linking of smaller molecules to generate a larger molecule, as seen with composite bonding and impression setting
Secondary node
the next set of nodes affected by a disease process
Mortality
the number of deaths in a population
Incidence
the number of new cases of a disease in a population during a period of time
opsonization
the process by which a pathogen is marked by an antibody for phagocytosis
transcription
the process by which genetic information is passed from DNA to mRNA
Translation
the process by which mRNA directs protein synthesis
Gelation
the process of gelling (solidification by cold)
Morbidity
the rate of an illness in a population
Pharmacokinetics
the study of how a drug enters the body, circulates the body, and leaves the body
Periodontology
the study of the diagnosis, treatment and prevention of diseases affecting the periodontium
Tertiary node
the third nodal set affected by a disease process
Onset
the time it takes for the drug to have and effect
Prevalence
the total number of new and old cases of a disease in a population during a period of time
RNA Viruses
the viral genome is similar to the host cell's mRNA, it is referred to as a positive strand since there is minimal delay in viral replication
distance
the x-ray beam spread as the distance from the unit increases
Hyoid muscles
these muscles originate from the hyoid bone, and are important for chewing, swallowing and speaking since they comprise the floor of the mouth, and work with the lateral pterygoid muscles to open the mouth
Contemplation
thinking about being motivated/considering changing
Assult
threatening bodily harm ex: person raising his hand to threaten to hit someone who actually doesn't do it
Enamel Peral (Ectopic enamel)
tooth enamel on the root surface
How are extrinsic (exogenous) stains removes?
toothbrushing, scaling and/or polishing
leukocidins
toxins, produced by staphylococci and strepticocci, that destroys leukocytes
Doxycycline
treatment of chronic adult periodontitis. "Atridox" applied by filling the pocket with a solution after mixing 2 syringes. Can also be prescribed as oral medication
What is the cross section of a scaler?
triangular
Superior Orbital Fissure
trigeminal nerve (V1), First Division (ophthalmic)
Foramen Rotundum
trigeminal nerve (V2), Second division (Maxillary)
Demand
type of care or services desired
Yellow stain
typically associated with dietary sources
Artificially Acquired Passive Immunity
typically results from an injection (gamma globulin)
Artificially Acquired Active Immunity
typically results from vaccination (Hep B vaccine)
Bonding agents
unfilled organic resins which establish micro-mechanical rection with enamel and dentin by adapting to roughened areas created by conditioning with phosphoric acid
Nerve blocks are bilateral or unilateral?
unilateral
Concrescence
union of teeth by cementum
Landmark
unique feature
Informal delivery
unstructured, self-directed
superioris
upper
Wooden (Wedge) Interdental Cleaner
use in interdental areas with exposed root surfaces (recession)
Floss threader
use under pontics and with orthodontic appliances
Inlay and casting wax
used for cast restorative patterns
Polymethylmethacrylate and Bis-Acryl Composite Resins
used for making temporary restorations for crown and bridge
Boxing wax
used in pouring models (vertical wall around impression)
Cements
used to attach a restoration to tooth structure, or as a base
Thermoplastic polymer
used to fabricate athletic mouthguards
Utility wax
used to modify the shape of impression trays and cushion braces
Bases
used to provide thermal insulation or mechanical protection for the dental pulp (insulate/protect) - includes all cements, because cements are poor thermal conductors, and have adequate compressive strength
Baseplate wax
useful in removable prosthetic procedures
Bite registration wax
useful to obtain occlusal records
How do you check for mobility?
using two instrument with hard handles (not fingers)
Uncontrolled variable
variable not related to the purpose of the study, but might impact the outcomes of the study
Overbite
vertical overlap of maxillary incisors to mandibular incisors
objective
very specific measurable statement of changes that will occur as a result of the program; small step to achieve goals
Degree of physical activity
voluntary component of energy, which varies from sedentary to strenuous activity
Hydrophobic
water fearing water insoluble
Pseudomembranous candidiasis (Thrush)
white plaques that wipe off
Zinc Function
wound healing; aids in cell and immune system function
Systematic Sampling
you have a system for selecting; select every Nth participant
Florid cemento-osseous dysplasia
• Middle age black females • Multiple quadrants: bilateral and symmetric involvement • Both dentulous and edentulous areas may be affected • Radiographically like periapical cemental dysplasia (mixed radiolucent/radiopaque)