Dental Hygiene CE Update on Demineralization/Remineralization

Leake, in an evidence-based review on root caries, stated that "Severity reaches over one lesion by age fifty, two lesions by age seventy, and just over _____ lesions for those seventy-five and older. A. Four B. Five C. Three D. Six

c

Radiographically, an early lesion of enamel caries appears as _______________. A. a break in the outer layer of enamel B. an opaque area C. a demineralized zone beneath the intact surface layer D. All of the above.

c

The paradigm shift from a surgical model to a medical model for caries control as described by Steinberg includes: A. Bacterial control B. Reduction of risk levels for at-risk patients C. Reversal of active sites by remineralization D. Follow-up and maintenance E. B and C F. All of the above.

f

A remineralized area of enamel is actually stronger than it was prior to acid attack due to which of the following? A. The incorporation of fluoride into the teeth with calcium and phosphate makes enamel more resistant to acid demineralization than it was originally B. Remineralized enamel has fewer bacteria C. The pellicle is removed during remineralization D. Amalgam is acid resistant

a

A remineralized area of enamel is actually stronger than it was prior to acid attack. A. True B. False

a

Human dentin (root surface) is approximately ____% (by volume) of mineral. A. 45 B. 55 C. 65 D. 76

a

One published study on digital radiography reports: A. A significantly improved accuracy of caries diagnosis while reducing observer variability B. Lower reliability for digital radiographs compared to conventional films C. There is a greater ease of storage for conventional films compared to digital images. D. It takes more time to take digital images than conventional films.

a

The earliest clinical evidence of an enamel lesion of dental caries is _______________. A. a white spot lesion B. a roughened surface C. an explorer "stick" D. a darkened appearance

a

According to the most recent National Health and Nutritional Examination Survey, caries has been essentially eliminated as a childhood disease. A. True B. False

b

Caries activity usually begins _______________. A. at the outer-most surface of the enamel B. along the rod margins below the outer tooth surface C. mostly on smooth surfaces D. within 1 to 2 microns of the outer tooth surface

b

Dental caries became a matter of national concern in the ____________. A. 1930s B. 1940s C. 1950s D. 1960s

b

Duggal et al used a human intra-oral model to examine carbohydrate frequencies and the use of non-fluoride and fluoride toothpaste and found when a F-free toothpaste was used and carbohydrate frequency exceeded 3 times per day, significant demineralization occurred. When subjects used a fluoride-containing toothpaste, however, net demineralization was only seen when carbohydrate consumption exceeded _______________. A. 3 times per day B. 5 times per day C. 10 times per day D. 15 times per day E. more than 19 times per day

c

The process of evidence-based dentistry includes: A. Following a strict protocol written only for dental patients. B. Consultation with an attorney. C. Incorporate the best scientific evidence (evidence that is critically appraised in systematic reviews) with clinical experience and their patients' preferences for treatment outcomes. D. A and B E. A and C F. All of the above.

c

Which of the following statements regarding remineralization and demineralization processes is false? A. The processes of remineralization and demineralization are similar on any tooth surface upon which they are occurring (enamel pits, fissures, smooth surfaces). B. Some tooth surfaces tend to have higher incidence of lesion formation compared to others. C. The reason for differences in caries incidence on different tooth surfaces is related to the hardness of the enamel on each surface D. Pit and fissure, along with interproximal sites, experience the highest rates of lesion formation.

c

According to the most recent National Health and Nutritional Examination Survey (NHANES; 1999-2004), the following statement(s) is(are) correct. A. Caries has been essentially eliminated as a childhood disease B. Overall, dental caries in deciduous (baby) teeth of children ages 2 to 11 declined from the early 1970s until the mid-1990s. C. From the mid-1990s until the most recent survey, the trend has actually reversed: a small but significant increase in primary decay was found, with the trend being more severe in younger children. D. B and C

d

Saliva is important for caries protection because it__________________. A. neutralizes acids formed by plaque bacteria B. contributes the needed calcium and phosphate for preventing caries and allowing remineralization to occur. C. naturally contains a high level of fluoride D. A and B

d

The "Cochrane Review" on fluoride toothpaste that indicated it is clearly efficacious in preventing caries included studies on more than ___________ children. A. 1,200 B. 7,600 C. 10,500 D. 73,000 E. 100,000

d

The elements that dissociate during demineralization are _______________. A. fluorapatite B. calcium hydroxide and phosphorous C. calcium citrate and pyrophosphate D. calcium and phosphate

d

Which of the following statements about enamel caries and root caries is true? A. Coronal caries is plaque related, while root caries is related to both plaque and recession B. During enamel caries, acids demineralize and create subsurface lesions, while in root caries, the surface can become sticky and change in contour C. Until cavitation occurs, remineralization is possible with enamel caries; with collagen still in place, root caries remineralization is also possible D. All of the above

d

Fluoride plays a key role in the remineralization process by _______________. A. speeding up the remineralization process B. inhibiting demineralization at the crystal surfaces C. enhancing crystal growth D. enhancing the transformation through the mineral phases E. All of the above. F. None of the above.

e

The "Cochrane Review" on Fluoride in Orthodontic Patients reported: A. There is some evidence that the use of topical fluoride or fluoride-containing bonding materials during orthodontic treatment reduces the occurrence and severity of white spot lesions, however there is little evidence as to which method or combination of methods to deliver the fluoride is the most effective B. Based on current best practice in other areas of dentistry, for which there is evidence, the daily use of a 0.05% sodium fluoride mouthrinse is recommended C. More high quality, clinical research is required into the different modes of delivering fluoride to the orthodontic patient D. Although the level of evidence as to which fluoride therapy is best to use during orthodontic treatments, it is clear that fluoride therapy is an essential component of successful treatment. E. All of the above

e

The NIH Caries Consensus Conference in 2001 reached which of the following conclusions? A. The research data on fluorides in water and dentifrice support their efficacy B. The use of pit and fissure sealants is supported by the data. C. Research data showing the effectiveness of chlorhexidine is strong. D. Calcium is highly effective as an anticaries agent when delivered from toothpaste. E. A and B

e