Clinic Theory Exam 2 Study Guide

CORRECT WORKING END

1. Lower shank is parallel to the distal surface 2. Functional shank goes up and over the tooth

What 4 features of restorations and dentures (partial or full) make them at risk for biofilm accumulation?

1. Metal Clasps, 2. areas underneath the dentures, 3. irregularities in seating/faulty margins, 4. scratches in the material

- The actual cause of the disease or condition

Etiologic factor

Denture-induced Frictional hyperplasia

White patches caused by prolonged mild abrasion of the mucosa from rubbing of the denture "Sore-spots"

Define Removable partial denture (RPD)

Removable appliance replacing missing teeth

- something that is PARTLY RESPONSIBLE for the development of a condition or disease

contributing factor

5 reasons Why it is important to place denture patients on dental hygiene recall/recare

1 . Evaluation of the oral tissues and potentially pathology screening. 2. Frequency of appointments is determined by individual needs and risk factors 3. Seek care at any time if discomfort or concerns arise 4. A patient may be unaware of chronic mucosal lesions, which are often asymptomatic 5. Tissue changes can be important indicators of serious disease, like oral cancer, the intraoral examination must be conducted thoroughly with good illumination

Immediate denture

1. A denture fabricated for placement immediately following the removal of a natural tooth or teeth. 2. An immediate or interim denture tends to loosen after the significant remodeling of bone and soft tissue that follows surgery. 3. Temporarily, the denture may be relined with a soft liner or a tissue conditioning material. 4. The patient may use a denture adhesive until the majority of healing occurs. 5. After approximately 6 months, dentures are remade, relined, or rebased.

Interim denture

1. A provisional prosthesis designed for use over a limited period of time, after which it is to be replaced by a more definitive restoration 2. Used to assist in the determination of the therapeutic effectiveness of a specific treatment plan or in determining the form and function of the planned definitive prosthesis. 3. Also called a provisional prosthesis.

Denture Chemical solution cleaners ingredients: Immersion (A.D.E.D.)

1. Alkaline peroxide (with sodium perforate or percarbonate), most common, Efferdent and Polydent 2. Dilute agents (with inorganic acids) 3. Enzymes 4. Disinfectants

4 things to know about the India stone (AAIM)

1. Artificial stone 2. Aluminum oxide crystals 3. Impregnated with oil 4. Medium grit

3 steps when using sickle scalers for Posterior Teeth: Begin, Reposition, Insert

1. Begin at DF line angle of the posterior tooth and work toward the D surface 2. Reposition at the DF line angle and complete the F/L and M surfaces of tooth working toward the front of the mouth 3. Insert at 0 degrees and tilt instrument to 70-80 degrees so the face of the working end is perpendicular to the lower shank.

The condition of the mucous membranes, salivary glands and alveolar bone is influenced by dietary and nutritional deficiencies, age, and various chronic diseases. List the 4 denture-related changes mentioned in class (B.O.X.S.)

1. Bone 2. Oral Mucosal 3. Effect of Xerostomia 4. Sensory Changes

What 3 signs and symptoms should denture patients be watching for when they are wearing a denture?

1. Bone remodeling - pathologic changes of the mucosa and attached gingiva 2. Sore spots - areas of discomfort from rubbing or loose denture 3. Food traps

Denture Abrasive Cleaner Ingredients: Brushing

1. Denture pastes and powders, toothpastes and powders (calcium carbonate) 2. Household agents (detergent and/or abrasive agent) 3. Professional Denture Cleaner: dilute, inorganic acids (i.e. 3% to 5% hydrochloric acid with phosphoric acid) in the ultrasonic

6 uses and 1 "no-no" for posterior sickle scalers

1. Designed for posterior teeth originally 2. Can be used anteriorly 3. Removes medium to large size calculus 4. Removes calculus deposits from crowns of posterior teeth 5. Debridement of ENAMEL surfaces 6. Used to access interproximally below the contact 7. NOT recommended for use on root surfaces

3 characteristics of denture stomatitis

1. Erythematous mucosa of covered tissues by a full or partial denture 2. Most common on the palate and maxillary alveolar ridge 3. Usually asymptomatic

8 other things to know about the Area-Specific-Posterior Curets

1. Face is tilted 70° in relation to the lower shank making it Self Angulated 2. Causes one cutting edge to be lower than the other on each working-end 3. ONLY the lower cutting edge is used for calculus removal. 4. Since the lower cutting edge is used, it is called the working cutting edge. 5. The other cutting edge--that is not used--is called the nonworking cutting edge. 6. Cutting edges are curved. 7. Different from a universal curet that has parallel cutting edges 8. Remove light to moderate calculus deposits from the crowns and roots of teeth

Describe the 3 features of a full denture

1. Flesh-colored acrylic base that fits over your gums. 2. The base of the upper denture covers the palate (roof of your mouth) 3. The lower denture is horseshoe shaped to accommodate the tongue.

What 7 findings on a CAMBRA would identify an individual as being at HIGH risk for caries?

1. Frequent or prolonged exposure to sugary drinks and foods between meals 2. Carious lesions in the last 6 months 3. Special needs ages 6-14 4. Chemo or radiation therapy 5. 3+ carious lesions or restorations in the last 36 months 6. Missing teeth due to caries in the past 36 months 7. Severe dry mouth

How do you identify a dull cutting edge in preparation for instrument sharpening?

1. Glare test- a dull blade will reflect light 2. Acrylic test stick- apply cutting edge to test stick at a 45-90 degree angle to determine if it catches or bites into the test stick; if it "shaves" the surface the instrument is in need of sharpening.

4 things to know about the Artificial stones like ceramic

1. Hard, dense stone 2. Fine or medium grit 3. Routine sharpening 4. Water lubricant

3 STEPS TO IDENTIFYING THE CORRECT WORKING END:

1. Hold instrument so that you are looking directly at the toe 2. Raise or lower instrument handle until the lower shank is perpendicular to the floor 3. Look closely at the working-end. One cutting edge is lower (closer to the floor)

Describe the first 5 steps in the technique of instrument sharpening

1. Identify cutting edge to be sharpened 2. Lubricate stone with water 3. Grasp instrument using a palm grasp 4. Stabilize arm against body 5. Align terminal shank and stone to proper position

3 types of a Full denture

1. Immediate Denture: Delivered at the time of extractions; relined needed after 6 months due to remodeling of the bone 2. Interim Denture: Temporary, used for diagnosis and treatment 3. Conventional Denture: Long-term "complete" denture prosthesis

Papillary hyperplasia Appearance

1. Inflammatory papillary hyperplasia is located on the palate, rarely outside the confines of the bony ridges 2. The overall lesion appears as a group of closely arranged, "pebble-shaped", red, edematous projections

What are 13 common oral features seen in older adults?

1. Lips: dry, purse-string openings from dehydration, Angular cheilitis 2. Oral Mucosa: Atrophic changes, Hyperkeratosis, Capillary fragility 3. Tongue: Atrophic glossitis (burning tongue), Sublingual varicosities 4. Xerostomia: Dry mouth, medications 5. Oral Candidiasis: Denture stomatitis and angular cheilitis 6. Tooth Color: Darkening or yellowing 7. Dental Pulp: Narrowing of pulp chambers and root canals due to secondary & tertiary dentin 8. Attrition: Signs of wear (mainly anteriors) due to diet, bruxing, occupational factors 9. Abrasion: At the cervical third of a tooth due to aggressive toothbrushing 10. Root Caries: Exposed root surfaces due to recession & bone loss 11. Bone: Osteoporosis 12. Cementum: Cementum at 20 years of age was 0.095 mm; cementum from 60-year-old persons measured 0.215 mm 13. Gingiva: Gingival changes, recession, predisposing factors

3 things to know about Denture Irritation Hyperplasia

1. Long-standing chronic inflammatory tissue appears as tissue growth over the alveolar ridges. 2. The etiology is often multifactorial and may include poor oral hygiene, smoking, and ill-fitting dentures. 3. It may be treated by surgical removal by scalpel or laser.

3 Things to know about instrument sharpening stones

1. Made with crystals that are harder than the metal of the instrument. 2. Size, shape and hardness of crystals determine grit of stone. Course, medium, fine, or ultra-fine 3. Fine grit = routine sharpening

4 Things to know about an RPD

1. Metal framework is made of chrome cobalt 2. The framework engages abutment teeth or an abutment implant with a wide variety of clasp assemblies and rest seats or precision attachments. 3. Depending on the location and number of remaining natural teeth, a partial denture may receive all its support from the teeth, or it may be partially tooth-borne, partially implant-borne, and partially tissue borne. 4. The base is made of plastic acrylic resin. The teeth are made of porcelain, plastic resin, or metal.

4 things to know about Lateral Pressure for Calculus removal

1. Moderate to firm pressure 2. Short stroke length, 3. Controlled calculus removal stroke (vertical, horizontal, oblique) that is made AWAY from the soft tissue 4. ALWAYS use the minimum number of strokes

4 things to know about the Arkansas stone (NNSW)

1. Natural stone with fine grit 2. Nonvaculite- Hard, compact silica crystals 3. Scalers or curettes 4. Water or oil lubricant

The 2 basic reasons for daily self-care/cleaning of removable prosthesis

1. Remove all loose debris and attached biofilm. 2. Disinfect the appliance to eliminate potential irritants to the teeth and oral tissues that may cause malodor.

2 uses and 1 "no-no" for Sickle Scalers

1. Remove med-lg size calculus deposits from the crowns of teeth 2. Pointed tip provides good access to proximal surfaces apical to the contact areas of teeth 3. NOT recommended for use on root surfaces

What type of education should be provided to a patient that wears a denture?

1. Self exam of oral tissues 2. Evaluate denture and clean more than 1 time per day 3. How to handle the denture while cleaning it 4. Oral hygiene aids and cleaners 5. Tongue cleaning 6. Maintaining regular Oral cancer/hygiene appointments 7. Discuss risks associated with not replacing missing teeth 8. Importance of seeking professional evaluation 9. Never adjust or repair your denture

What 3 things are contained in professional cleaning agents for dentures/appliances?

1. Sodium perborate or percarbonate, 2. hydrogen peroxide, 3. enzymes (Wilkins pg 526)

What 3 things are contained in professional cleaning agents for dentures/appliances? (SP,HP,E)

1. Sodium perborate or percarbonate, 2. hydrogen peroxide, 3. enzymes (Wilkins pg 526)

Use of Sickle Scalers 4 Basic Concepts (T.A.A.R.)

1. Tilt lower shank toward tooth surface to establish correct angulation: operator MUST force the instrument into a 70-80 angle 2. Adapt TIP 1/3 of cutting edge of tooth 3. Activate calculus removal stroke using wrist motion activation 4. Relax your fingers between each calculus removal stroke

3 Stroke directions

1. Vertical strokes are most common on anteriors and mesial or distals of posteriors 2. Oblique strokes on facial and linguals of posteriors 3. Horizontal strokes at the line angles of posteriors and midlines of facial or linguals of anteriors

What 7 findings on a CAMBRA would identify an individual as being at MODERATE-HIGH risk for caries?

1. Visible plaque = High levels of S. Mutans and Lactobaccilus 2. Frequent snacking or sipping on sugary beverages 3. Deeps pits and fissures 4. Drug use 5. Xerostomia 6. Exposed roots 7. Orthodontic work 0- indicates low risk 1-10- indicates moderate risk 10 or above high risk

Describe the last 3 steps in the technique of instrument sharpening

12. Evaluate sharpness 13. Evaluate contour 14. Continue sharpening if needed

Describe the next 5 steps in the technique of instrument sharpening

6. Move the stone in an up and down motion at 1mm intervals from heel to toe 7. Moderate, consistent pressure 8. Overlap strokes 9. Round toe of the curette 10. Remove wire edge

Implant supported denture

A complete dental prosthesis that is supported in part or whole by one or more dental implants. The denture itself is not an implantable device.

Papillary hyperplasia of the palate

A pink, granular or "cobblestone" like appearance of the hard palate under a denture A form of Denture stomatitis - superficial infection of Candida albicans

Tissue-supported complete denture

A removable dental prosthesis that replaces the entire dentition and associated structures of the maxilla or the mandible and rests on the denture foundation area, the mucosal-covered alveolar ridge.

Overdenture

A removable prosthesis that rests on one or more remaining natural teeth that are shaved down and/or dental implants Also called an overlay prosthesis

What are the active ingredients in the OTC and at home agents (abrasive cleaners) for denture cleaning?

Calcium carbonate in "Denture pastes and powders" Detergent and or abrasive agent like salt and bicarbonate of soda in 'Household agents"

Cause of Denture-induced fibrous hyperplasia (Epulis fissuratum or Denture-associated inflammatory hyperplasia) and location

Caused by an ill-fitting denture Located in vestibule along the denture flange

Describe the features of a fixed partial denture

Commonly called dental bridges, are composed of the following: • Abutments • Connectors • Pontics

What 7 findings on a CAMBRA would identify an individual as being at LOW risk for caries?

Fluoride exposure Mouth rinses containing fluoride Rx or regular fluoride toothpaste Fluoride varnish treatments Adequate salivary flow Sealants Healthy low-sugar diet

What is the primary etiologic agent of an oral infection in a denture wearer?

Gingival stomatitis- a fungal infection that is normally painless and limited to where the denture rests.

Inner and outer cutting edges of posterior scalers are used on what tooth surfaces?

Inner = distal surfaces Outer = facial, lingual, and mesial surfaces

To achieve a sharp cutting-edge during instrument sharpening, what is happening to the instrument cutting edge?

It's being slowly shaved down or away

Denture Stomatitis (Chronic Atrophic Candidiasis)

Most common type of candidiasis that effects the mouth -The mucosa covered by a full or partial denture is erythematous -Most common on the palate and maxillary alveolar ridge -Usually asymptomatic

- Renders a person SUSCEPTIBLE to disease - Genetic, attitudinal, personality, and environmental factors that are associated with health, or lack of it, in a person.

Predisposing factor

- Increases the PROBABILITY that disease will occur

Risk factor

Some things to know about Contributing factors of Papillary hyperplasia

The cause is unknown. Associated with: 1. Poor denture hygiene, 2. Ill-fitting dentures, 3. Possible C. albicans infection.

Area-Specific-Posterior Curets are used to remove __________ calculus deposits from the ___________ and _________ of teeth

light crowns and roots

What 3 visual clues can you use to identify the correct working end and cutting edge for the posterior sickle scaler and the posterior area specific curets?

lower shank is parallel to the distal surface. The functional shank should go up and over the tooth. You can achieve the CORRECT angulation by tilting the lower shank slightly towards the tooth surface

What methods can be used to test an instrument for sharpness?

• Glare test- a dull blade will reflect light • Acrylic test stick- apply cutting edge to test stick at a 45-90 degree angle to determine if it catches or bites into the test stick; if it "shaves" the surface the instrument is in need of sharpening.