Wake up memory
How many images are in an FMX?
14 PAs, 4 BWX
How often do you apply fluoride varnish on high caries risk vs. mod caries risk?
3 mo for high, 6 mo for mod
About half of adults within the US are affected by root surface caries by age ___. The percentage increases to 70% by age __.
50, 60
If neutrophil count is less than ____/mm3, preprocedural prophylactic antibiotics should be administered. If platelet count is less than __,____/mm3, postpone treatment.
500 50,000
How many Americans are affected by periodontal disease?
67 million
If you mix tobacco and alcohol, your chance of getting oral cancer is ____ times higher.
7
What percent of smokers start smoking before age 18?
80%
What is a circuit?
route the electrical current takes. A high-voltage circuit uses 65,000 to 100,000 volts that will provide high energy to produce x-rays.
Define: Analytic Studies. What are the 3 subtypes under this?
Quantifies the relationship between an intervention (exposure) on an outcome. Includes case control studies, cohort studies, and some cross-sectional studies. Prospective studies Longitudinal studies Retrospective studies
Max Rocks
Rotundum = Maxillary division of CN V
What is a tubercle?
Rounded elevation (tubercle of upper lip)
Side effects of corticosteroids include all of the following except? (and why?) Super infection Peptic ulcer Delayed wound healing Osteoporosis Xerostomia
Xerostomia. Causes INCREASE in saliva production.
What are 2 to divisions of the autonomic nervous system?
Sympathetic (SANS) and parasympathetic (PANS) nervous systems
What are the 2 divisions of the autonomic nervous system?
Sympathetic (fight or flight) Parasympathetic (rest and digest)
Where is the nasal maxillary sinus?
hollow spaces in bone superior to molar and premolar.
What is a root fracture?
horizontal or vertical crack.
AP Revealed Structures - Muscles Quiz
https://docs.google.com/presentation/d/1Jh3O9B1I7-Qn9ORDu1_S0vMyK2_1JhJiZI-sQJrjL7Q/edit?usp=sharing
Inflammation flash cards DO THESE
https://quizlet.com/347499803/inflammation-flash-cards/
DO THIS IMMUNOLOGY SET
https://quizlet.com/347511077/immunology-flash-cards/
Lower pH on the tooth surfaces dissolves ___ and ___
hydroxyapatite, phosphates
Oral conditions of Stroke?
Xerostomia
What does IA innervate?
innervates all the lower teeth.
What does the NP innervate?
innervates the anterior palate and lingual tissue of that region.
What does the GP innervate? Which foramen does it pass through?
innervates the hard palate, palatal root, and related tissue. Passes through the greater palatine foramen.
What is direct superivision?
licensed dentist diagnoses the condition to be treated, authorizes procedures to be performed, and remains on premises while work is being performed
Where is the external oblique ridge?
linear area of bone on external surface of mandible. Radiopaque line running anterior from the ramus across the molars.
Articaine: Is this brand or generic name? What's the other name? Where is this drug metabolized? What types of patients do you use this on? Higher chance of what complication?
Arti=generic (Brand: Septocaine) HINT: Art=made with blood. Processed in blood (and liver) + Mostly metabolized by the plasma and some in the liver. Used for patients with liver diseases. + Higher chance for paresthesia compared to other local anesthetics.
How many nephrons are in 1 kidney? What are nephrons?
1 million. Microscopic units that filter blood and produce urine.
In general, the CEJ is more prominent on which surface: mesial or distal?
Mesial
Mandible: What is its purpose?
articulates with the temporal bone at the mandibular condyle
What's fremitus?
palpable or visible movement of a tooth when in function. Can be assessed by gently placing a gloved index finger against the facial aspect of the tooth as the patient taps the teeth together.
Pharmacological Abbreviation: tid
three times a day (ter in die)
Define: Periapical Cyst. AKA? What does it look like radiographically? What causes it? Symptoms? Where is it? How common is it? How do you differentiate it from a periapical granuloma or abscess based on radiographic appearance alone?
Radicular cyst Caused by pulpal necrosis secondary to dental caries or trauma. Condition is usually asymptomatic as the tooth is non-vital. Appears as a radiolucency around the apex of a tooth or at the site of tooth extraction. Most common cyst in the oral region. Epithelial rests of malassez, which are remnants of tooth forming tissue often present in the cyst. Not possible to differentiate a periapical cyst from a periapical granuloma or abscess based on the radiographic appearance alone.
Define: Experimental Studies. What does each group receive? What must be done afterward? What's the most valid study of all studies?
Researchers manipulate the exposure by allocating subjects to the treatment or control group. + Control group receives placebo or is withheld from the intervention (exposure). + Treatment group receives the intervention (exposure). Include randomized controlled trials (RCTs). Require pre/post-test data of both the treatment (experimental) and control group. A double-blind study is the most valid of all studies. Neither the examiner nor the participant knows which is the control group or the treatment group (whoever created the study DOES know, though).
Difference between localized and generalized when describing gingiva?
Local: disease affects 30% or less of all sites Gen: 30% or more of all sites
Define: Regional Odontodysplasia. What look like radiographically? What causes it?
Localized developmental abnormality of the dental tissues. One or several teeth in the same quadrant radiographically exhibit a marked reduction in radiodensity described as "ghostlike" appearance. The enamel and dentin are very thin.
Define: Periapical Granuloma. What does it look like radiographically vs. visually? Symptoms? Where?
Localized mass of chronically inflamed granulation tissue at the apex of a non-vital tooth. Most cases are asymptomatic. Tooth may appear slightly extruded from its socket. Radiographic appearance may vary from a slight thickening of the periodontal ligament space to a distinct radiolucency at the root apex.
Which maxillary premolar has 2 roots? How many cusps does it have? What special feature does it have?
Maxillary 1st premolar. 2 cusps. Distinct mesial root concavity.
What's synovial fluid?
clear, viscous liquid in the joint that reduces friction.
What types of parafunctional habits can put stress on the periodontium and weaken it?
clenching, grinding, tongue thrust
What's a ganglion?
collection of nerve cells outside the CNS.
What does it look like on x-rays: Gold
completely radiopaque, even in crown, inlay, and onlay.
Stannous fluoride: What does it do? What does prolonged use cause?
anti-gingivitis, anti-plaque (e.g., Crest Pro-Health, GelKam). Prolonged used of stannous fluoride can create tooth staining.
What's the latent image?
image formed by the x-rays on the film, but is not visible yet.
Processing: What does it mean if fogged films?
improper safelight, light leaking into darkroom, outdated film.
Corticosteroid: How does it work? Examples?
improves symptoms by suppressing allergy-related inflammation. + Fluticasone (Flonase), hydrocortisone cream, etc.
What's an ameloblastoma?
multilocular radiolucent bone destruction of "soap bubble" appearance.
What are tricyclic antidepressants? More or less targeted? How do they work? Examples?
older-generation antidepressants so LESS targeted. Increase synaptic concentration of neurotransmitters serotonin and norepinephrine. Amitriptyline (Elavil), etc.
Pharmacological Abbreviation: qd
once a day (quaque die)
Where is the mental foramen?
opening for mental nerve and vessels inferior to mandibular premolar apices. Round radiolucent area sometimes mistook for periapical disease.
What is a condyle?
oval prominence which usually involves the joints (e.g., condyle of the mandible articulates with the temporal bone and forms the TMJ).
The facial nerve pierces through the ___ ___ after emerging from the ____ foramen, but doesn't innervate that. It's innervated by the ____.
parotid gland, stylomastoid, glossopharyngeal (9th)
What's condensing osteitis?
radiopaque area attached to apex of a non-vital tooth with a low-grade infection.
What does it look like on x-rays: Composite
radiopaque, the density of opacity varies with the composition of the material.
What does it look like on x-rays: Silver point
radiopaque, used to obliterate canals during endodontic therapy.
What does it look like on x-rays: Retention Pins
radiopaque, used to stabilize the restoration.
What does meth mouth look like?
rampant caries, burned mucosa, and severe attrition.
What's Gingival Curettage?
removes the soft tissue lining of the periodontal pockets in order to eliminate bacteria and diseased tissue. It may be used along with scaling and root planing.
What's Gingivoplasty?
reshaping of the gingiva to obtain better contours (e.g., eliminating tissue crater from NUG).
The Hyoid muscles can be divided into...
• Suprahyoid muscles (above the hyoid bone) • Infrahyoid muscles (below the hyoid bone)
What's Gingivectomy?
pocket reduction by excision of the soft tissue pocket wall. Reduced pocket depth allows the patient to remove plaque more easily, therefore treating and preventing periodontal diseases.
Pharmacological Abbreviation: bid
twice a day (bis in die)
What's the most common pigmentation in the oral cavity?
Amalgam Tattoo
What is an oblique ridge?
(/ or \ shape) are found on the occlusal surface of maxillary molars formed by the union of two triangular ridges. An oblique ridge extends from the mesiolingual cusp to the distobuccal cusp.
What's MRI stand for? What do you use it for?
(magnetic resonance imaging): used for images of the soft tissue, TMJ, etc.
What's Paget's disease?
"cotton-wool" appearance of bone, patchy opacities.
Define: Alveolar Osteitis. AKA? What causes it? What does it look like visually? Symptoms? Where?
"dry socket." Post-operative complication of tooth extraction. Occurs when the blood clot breaks down and is lost before healing has taken place (clot is essential for healing). Patient complains of pain, bad odor, and taste.
What's fibrous displasia?
"ground glass" appearance of bone.
What's multiple myeloma?
"punched-out" lesions of bone.
How do you get a plaque score?
(# of teeth surfaces with plaque/total # of teeth surfaces) x 100 = percentage score. The lower the score the less plaque.
What is a transverse ridge?
(< or > shape) are formed by the union of two triangular ridges on posterior teeth meeting on a faciolingual line.
What does Gingival Crevicular Fluid contain?
(GCF) flows into the sulcus from the gingival connective tissue. The amount of flow increases with diseases. This can be explained by the fact that GCF contains collagenase (an enzyme that breaks down collagen), prostaglandin, and arachidonic acid, which are involved in inflammatory reactions such as those seen in periodontal disease.
Do stents usually require premedication? What is a stent?
(Mesh tube that prevents narrowing of the arteries) Usually do not require premedication.
What are the pharyngeal tonsils? AKA?
(also called adenoids): are located on the nasopharynx, behind the nasal cavity.
What is Percocet?
+ Oxycodone + acetaminophen
Four types of paranasal sinuses
-Frontal -Ethmoidal -Sphenoidal -Maxillary
Which bone forms the superior and middle nasal conchae? Is it a facial or cranial bone?
-Inferior nasal concha (forms itself). Facial.
Which bones form the floor and lateral wall of the nasal cavity?
-Lateral: ethmoid, inferior nasal concha. -Floor: Palatine, maxilla.
What are the muscles of the soft palate?
-Palatoglossus (ant faucial pillar/Anterior tonsillar pillar) -Palatopharyngeus (post faucial pillar/Posterior tonsillar pillar )-Levator veli palatini -Tensor veli palatini -Uvula muscle
Which bones form the walls of the orbit? In areas where multiple bones form that section, say which bone is largest
-Roof/superior wall: FRONTAL -Medial wall: ETHMOID and lacrimal (maxillary and sphenoid) -Lateral wall: ZYGOMATIC and sphenoid -Apex/base: SPHENOID and palatine bones -Floor: MAXILLARY, zygomatic (palatine)
How long do you fix for?
10 minutes, or twice developing time.
How much pressure do you use when probing (in grams)?
10-20
When the jaw is in resting position, how many mm of space is present between teeth?
2-4 mm, resting position
All anterior teeth are formed from _ centers of development, referred to as ___. ___ are on the facial, ___ on the lingual.
4, lobes. 3, 1.
How long do you develop for and at what temp?
5 minutes at 68° F (the higher the temperature the faster the process).
Earliest age you can have permanent premolars?
9-10 (max 1st).
What's a normal range for body temperature?
97-99 °F (36-37 °C), with the most common temperature of 98.6 °F.
Define: Pustule
< or > 5 mm, contains yellow pus
Which analgesic is a contraindication for asthma?
Acetaminophen (Tylenol)
Define: Longitudinal studies. Which main type of study does this fall under?
Analytic Studies observation over a long period of time (often decades). (e.g., Framingham Heart Study, which began in 1948, is now following the third generation of participants).
Aneurysmal Bone Cyst: Is it benign or malignant? What does it look similar to? What does it look like radiographically?
Appears as a radiolucent lesion with a multilocular appearance, often described as "honeycomb" or "soap bubble." Not to be confused with ameloblastoma which can also be described as "soap bubble." Characterized by expansion of the involved bone.
Which anti-platelet medications should you remember, especially in relation to angioplasty/stent?
Aspirin HINT: was Playing and cut finger on Vics vaporub, now bleeding a lot. clopidogrel (Plavix) Both meds increase patient's risk of prolonged bleeding
Lupus: What is it? Triggers? Symptoms?
Autoimmune disease causing damage to the joints, skin, kidneys, heart, lungs, blood vessels, and brain. The condition can be triggered by ultraviolet rays, medications, viruses, stress, etc. A BUTTERFLY-SHAPED RASH ON THE NOSE UNFOLDING ACROSS BOTH CHEEKS occurs in many, but not all cases.
What does it look like on x-rays: Amalgams
Completely radiopaque
What can cause impaction?
Dense bone, tooth malpositioning, and inadequate space for eruption.
Patients with ____ are more likely to have periodontal disease?
Diabetes
What does rotation allow the jaw to do?
Elevate and depress
Another name for coronal plane?
Frontal, divides into front and back.
The ___ the tungsten target is, the ___ the quality
Larger, Lesser
Which muscles are involved in protrusion (moving forward)?
Lateral pterygoid
What's first permanent tooth to erupt?
Mand 1st molar
Which carbohydrates are the most cariogenic?
Mono & saccharides
What's a fistula?
Opening for drainage of infection, may be visible as small bulge on gingiva
What's the leading cause of tooth loss for adults 45+?
Periodontal disease
Pharmacological Abbreviation: prn
as needed (pro re nata)
Define: Fissured Tongue. What causes it? How is it treated?
The dorsal surface of the tongue is cracked and dry. Can be related to dry Advise the patient to clean the tongue regularly to remove food debris caught in the grooves.
All muscles of mastication are derived from which arch?
The embryonic Pharyngeal Arch I (Mandibular Arch) - Table 3-2 p.50 in Embryology Text
All muscles of facial expression are derived from which arch?
The embryonic Pharyngeal Arch II (Hyoid Arch) - Table 3-2 p. 50 in Embryology Text
What do corticosteroids do? Examples of meds?
Used for long-term asthma attacks. Fluticasone (Flovent), etc.
What is the primary site for drug metabolism? What are other sites?
The liver. Other sites: Blood, lungs
What is quality?
The penetrating power of the x-ray beam
How does an electrical impulse travel through the heart?
The sinoatrial node (SA) triggers the electrical impulse, causing the atria (upper chambers) to contract. The signal travels through the atrioventricular (AV) node to the atrioventricular (AV) bundle, which divides into Purkinje fibers that carry the signal and cause the ventricles (lower chambers) to contract.
What does kVp determine?
The speed at which the electron is propelled from the cathode
What are platelets? What do they do?
Thrombocytes, clot the blood.
Examples of exogenous extrinsic stain
Yellow: Heavy biofilm Green: Poor oral hygiene, or Nasmyth's membrane (thin tissue on newly erupted teeth which brushes off) Black: Iron compounds embedded in dental biofilm. In clean mouths. Brown-black: Tobacco use. Orange: Chromogenic bacteria Tan-dark brown: Red wine, tea, coffee Yellow, brown or gray stain: Chlorhexidine Gray-green stain: Marijuana
What is Turner's tooth? What causes it?
a hypocalcification of a single tooth, usually a permanent maxillary incisor, can occur when a developing permanent tooth is affected by a local infection or trauma. The ameloblastic layer becomes disturbed by an event, typically bacterial or traumatic in nature, resulting in hypoplasia of the enamel.
What's a canal?
a long narrow tube-like opening in the bone (e.g., mandibular canal is a horizontal tubular opening in the mandible that contains the inferior alveolar nerves, arteries, and veins).
If assistance is required for holding tube head or film, who does it?
a parent or guardian should be shielded and allows to help the patient. Clinician never holds tube head or film!
What is a ridge?
a raised margin (e.g., internal oblique ridge runs along the inside of the mandible).
What is a tuberosity?
a rough prominence which usually attaches muscles and tendons (e.g., the medial pterygoid muscle attaches to the maxillary tuberosity).
What is a meatus?
a type of canal (e.g., external acoustic meatus runs from the outer ear to the middle ear).
What are recurrent caries?
appear under restorations.
What's the 5A intervention model for tobacco cessation?
ask about tobacco use at every visit advise all tobacco users to quit assess willingness to quit assist the patient in quitting arrange follow-up contact.
Pharmacological Abbreviation: hs
at bedtime (hora somni)
What is a Cephalosporin: Bactericidal or static? If static or cidal, how? What is it used for? Examples of drugs?
bactericidal agent, weaken the bacterial wall resulting in lysis and death of the bacterial cell. + Premedication of choice for patients with hip or joint replacement. HINT: Cephalon=Tephalon. + Cephalexin (Keflex), etc.
What is a Tetracycline: Bactericidal or static? If static, how? Side effects/contraindications? Examples of drugs?
bacteriostatic agent, interferes with bacterial protein synthesis. + Causes discoloration of unerupted teeth, therefore should not be prescribed for children under 9 years of age, pregnant women, or nursing mothers. + Milk or antacids inhibit tetracycline absorption. Atridox, Arestin, Periostat
What is a Macrolide: Bactericidal or static? If static, how? Side effects? Examples of drugs?
bacteriostatic agent, interferes with bacterial protein synthesis. + Gastrointestinal cramps and nausea are very common. + Erythromycin, clarithromycin, and azithromycin.
Pharmacological Abbreviation: ac
before meals (ante cebum)
What's cerubism?
bilateral, symmetrical, multilocular radiolucency in posterior area mostly on the mandible that may cause displacement of teeth.
What do antiadrenergic drugs do? Example?
block adrenergic receptors, produce opposite effect of the SANS, and decrease blood pressure. e.g., beta-blockers (suffix "-olol") slow the heart rate and lower blood pressure.
What do anticholinergic drugs do? Example?
block the cholinergic receptors and produce the opposite effect of rest and digest. e.g., atropine decreases salivation.
Maxillary molars are larger ___ - ____ than ___ - ____
bucco-lingually, mesio-distally
Premolars are larger ___ - ____ than ___ - ____
bucco-lingually, mesio-distally
Pharmacological Abbreviation: po
by mouth (per os)
Quality control techniques: What is a coin test used for?
check light leaks in the dark room.
What's a fissure?
deep clefts between adjoining cusps on posterior teeth.
What's the central fossa?
deep depression in the central portion of the occlusal surfaces of posterior teeth.
Define: Skew
describes a curve that is NOT symmetrical.
Processing: What does it mean if there's a straight white border?
developer cutoff caused by incomplete immersion of film into developer.
Processing: What does it mean if there are darker areas?
developing solution touches film before processing procedure.
Where is the maxillary tuberosity?
distal portion of alveolar process. Rounded, radiopaque elevation distal to third molar regions.
Define: Range.
distance between the highest and lowest score (e.g., range is 40 when scores range from 10 to 50).
Submental lymph nodes: Where do they drain? Empty?
drain the mandibular incisors and associated tissue located inferior to the chin. + Empty into the submandibular nodes or directly into the deep cervical nodes.
How does inhalation administration work? Example?
drug is absorbed through the lungs (e.g., nitrous oxide, albuterol).
How does intradermal administration work? Example of when it's used?
drug is injected into the dermal layer (e.g., allergy testing, TB skin test).
Casein phosphopeptide (CPP-ACP): What does it do?
helps remineralization (e.g., MI paste, MI paste plus products).
What's Crown Lengthening?
excess gum and bone tissue are reshaped to expose more of the natural tooth. Crown lengthening can also be recommended to make restorative or cosmetic dental procedure possible as there may be decay below the gum line, or the tooth structure is insufficient for a restoration.
Processing: What does it mean if there are yellow/brown stains?
exhausted solutions or insufficient washing.
Where is the lingual foramen?
exit for incisive vessel branches. Radiolucent circle inside the opaque genial tubercles on the mandibular anteriors.
Where is the hamulus?
extension of medial pterygoid plate of sphenoid bone. Radiopaque hook-like protrusion posterior to maxillary tuberosity.
What is the joint capsule?
fibrous joint capsule completely encloses the TMJ, wrapping around the temporal bone's articular eminence, articular fossa, and the mandibular condyle.
Processing: What does it mean if outline border of another film?
films stuck together in solutions.
Processing: What does it mean if there's a straight black border?
fixer cutoff caused by incomplete immersion of film into fixer.
Processing: What does it mean if there are lighter areas?
fixer solution touches film before processing procedure.
Where are the genial tubercles?
four bony spines used for muscle attachment of the genioglossus and geniohyoid muscles. Circular radiopacities inferior to central incisor apices.
Pharmacological Abbreviation: qid
four times a day (quarter in die)
What does the PSA innervate? What's the exception and what innervates that?
innervates the maxillary molars (exception of the mesiobuccal root of the 1st molar), periodontium and buccal tissues.
What does the MSA innervate? What percent of people don't have this nerve, and if they don't have it, what innervates that area?
innervates the maxillary premolars and mesiobuccal root of the first molar, periodontium, and buccal gingiva. Only 28% have MSA. If don't, ASA does.
What does the LP innervate? Which foramen does it pass through?
innervates the soft palate and tonsils. Passes through the lesser palatine foramen.
Which muscles are involved in lateral deviation? What's a power stroke?
involves the masseter, lateral pterygoid, medial pterygoid, and temporalis on one side. Power stroke: movement from a laterally deviated position back to the midline during mastication.
What's a synapse?
junction between two neurons, or between a neuron and an organ.
Where is the inverted Y?
junction where the nasal fossa and the maxillary sinus meet. Most commonly found superior to the maxillary canine apex.
What's hypodontia?
lack of one or more teeth in the primary or permanent dentition. The permanent dentition is most commonly affected. The maxillary and mandibular third molars, maxillary lateral incisors are most often missing.
Where is the nasal cavity/fossae?
large air-filled space above and behind the nose in the middle of the face. Radiolucent oval shapes superior to central incisors.
The faster the film, the ____ the silver halide crystals, the ___ the quality of the image.
larger, lower.
Pano errors: How do you fix a V or shark's fin?
lead collar above line → lower collar position.
Types of caries: Incipient
lesion that extends less than halfway through the enamel
Types of caries: Moderate
lesion that extends more than halfway through enamel but does not involve the dentino-enamel junction (DEJ)
Types of caries: Severe
lesion that extends through enamel, through dentin, and more than half the distance to the pulp
Types of caries: Advanced
lesion that extends to or through the DEJ but does not extend more than half the distance to the pulp
What is no supervision?
licensed dental hygienist may perform services without the supervision of a licensed dentist.
Deep cervical lymph nodes: Where are they located?
located along the neck deep to the SCM. Unlike the deep nodes of the head, the deep nodes of the neck can be palpated under the anterior and posterior aspects of the SCM.
Anterior jugular lymph nodes: Where are they located?
located anterior to the larynx, trachea, and SCM. More easily palpated if the patient turns the head to the opposite side making the SCM more prominent.
Inferior deep cervical lymph nodes: Where are they located? Where do they empty?
located around the armpits, can be involved with breast cancer. Drain the superior deep cervical lymph nodes.
Submandibular lymph nodes: Where do they drain? Empty?
located at the border of the mandible. + Drain all teeth, except mandibular incisors and maxillary third molars. Maxillary third molars drain directly into superior deep cervical nodes. + More easily palpated if the patient lifts the chin and the tip of the tongue up.
What is the joint disc?
located between the temporal bone and mandibular condyle, the disk divides the TMJ into two compartments or synovial cavities: upper and lower. With aging or trauma to the area, the disc can become thinner, perforated, or calcified.
Superior deep cervical lymph nodes: Where are they located? Where do they empty?
located deep beneath the SCM. + Empty into the inferior deep cervical nodes or directly into the jugular trunk. + All nodes of the head and neck drain to the superior deep cervical lymph node, except for the occipital node. + The occipital node drains directly into the inferior deep cervical nodes. + Maxillary third molars drain directly into superior deep cervical nodes.
External jugular lymph nodes: Where are they located?
located on each side of the neck superficial to the SMC.
Quality control techniques: What kind of bulb for safe light? What color is its filter? How far away should it be from working surface? How often is the light checked?
low voltage bulb (7 ½ or 15 watts) covered with red filter, 4 feet away from working surface. Light should be checked every 6 months.
What does the ASA innervate? What does it also innervate in what percent of people?
maxillary anteriors (including canines), periodontium and buccal gingiva. In 72%, also premolars and mesiobuccal (MB) root of first molar
Define and give an example: Reversible index
measures a dental condition that can be reversed (e.g., gingival index).
Define and give an example: Irreversible index
measures a dental condition that cannot be reversed (e.g., dental caries index).
Define and give an example: Cumulative index
measures all evidence of past occurrences (e.g., dental caries).
What are values?
principles used to define that which is right, good, and just. Values provide guidance to determine right versus wrong and good versus bad. Typical values include honesty, integrity, compassion, courage, honor, responsibility, patriotism, respect, fairness, etc.
What is a triangular ridge?
project from the cusp tips to the central groove (this is "inside" of the occlusal surface vs. the marginal ridge that is on the distal and mesial border). They create "half" of the oblique ridge or transverse ridge.
What's veracity?
provide only truthful information.
What's autonomy?
provide patient the freedom of choice to make medical/dental decisions based on the medical/dental assessment given by the healthcare professional.
Peroxide: What does it do?
provides whitening effect and helps remove intrinsic and extrinsic stains.
What is a periapical granuloma?
radiolucent area at the apex of a non-vital, usually asymptomatic tooth.
What is a periapical abscess?
radiolucent area located at the end of a symptomatic tooth with infected pulp.
What is a periodontal abscess?
radiolucent area located at the end or lateral part of the root.
Define: Convenience sampling. Do all members of a population have the same chance of being selected?
selection based on availability, what is "easiest." No, can form biased results (e.g., patients who visited the office this Saturday will form the sample).
What are ethics?
set of rules which are explicitly adopted by a group of people. When one acts in ways which are consistent with our beliefs (whether secular or derived from a moral authority), we characterize that as acting ethically.
What's a lingual fossa? What's the deepest part called?
shallow depressions on the lingual surfaces of anterior teeth. The deepest part of the lingual fossa is the developmental pit (sharp depression).
Quality control techniques: How often should cassette intensifying screens be inspected and cleaned?
should be inspected and cleaned monthly.
What does it look like on x-rays: Gutta-percha
slightly radiopaque, substance that fills tooth canals.
What does it look like on x-rays: Base material
slightly radiopaque, used to protect the pulp.
Pano errors: How do you fix White straight opacity in middle of image (Washington monument)?
slumping causing ghost image of the spine → move patient's feet forward, straighten the spine and lean backward.
What's a pit? On which teeth are they commonly? Name 2 pits.
small pinpoint depression at the junction of developmental grooves. + Commonly present on the mandibular first molar, and facilitates biofilm retention. + Buccal pit: depression on the buccal aspect of the tooth. + Central pit: depression on the occlusal aspect of the occlusal surface.
Developing: What is the alkalizer? What does it do?
sodium carbonate - softens film emulsion and speeds up action.
Developing: What is the preservative? What does it do?
sodium sulfite - a preservative that prevents oxidation.
Fixing: What is the preservative? What does it do?
sodium sulfite - prevents oxidation.
What's Guided Tissue Regeneration?
specialized piece of fabric is sewn around the tooth to cover the crater in the bone. The gum is then sewn over the fabric. The fabric prevents the gum tissue from growing down into the bone defect and allows the bone and the attachment to the root to regenerate.
Define: Dispersion.
spread of scores around the mean, median, and mode.
Processing: What does it mean if thin, black, branchlike lines?
static lines caused by low humidity and opening film packet too quickly.
What do cholinergic drugs do? Example? Contraindications?
stimulate cholinergic receptors and produce the effects of the PANS. e.g., pilocarpine is used in the treatment of xerostomia. +Contraindicated for patients with asthma because the drugs constrict the bronchi. +Also contraindicated for cardiac conditions because the drugs decrease heart rate.
What's the lymph drainage of the teeth?
submental (incisors) node → submandibular node (the rest of teeth except third molars) → superior deep cervical node (third molars) → inferior deep cervical node.
Processing: What does it mean if the emulsion is cracked?
sudden temperature change between developer and fixer.
What's a full mouth disinfection?
term used for complete mouth debridement (all four quadrants) within 24-48 hours.
Oxygenating compounds: What is it? Long-term use side fx?
used short-term for wound cleansing and soothing (e.g., Amosan, Orthoflur, hydrogen peroxide). Long-term use side effects include tissue damage, mucosal ulcerations, and black hairy tongue.
What is a supernumerary tooth? Where is it usually found
usually found in between the maxillary central incisors and behind the third molars.
What is moral?
values that are attributed to a system of beliefs, typically a religion.
Where is the median palatal suture?
vertical radiolucent thin line in the middle of the palate. Should not be mistaken for a fracture.
Where are the nutrient canals?
vertical thin radiolucent lines near the teeth, may be mistaken for bone fractures.
When should infants see the dentist?
within 6 months of the eruption of the first tooth or before 1 year of age.
What's tort law?
wrongful conduct against a person.
What are the four (4) Suprahyoid muscles?
• Digastric • Mylohyoid • Stylohyoid • Geniohyoid
What are the four (4) Infrahyoid muscles?
• Omohyoid • Sternothyroid • Sternohyoid • Thyrohyoid
The mastoid process is part of which cranial bone?
Temporal
Fluoride Varnish: Percentage?
+ Concentration of fluoride varies from 1-5%.
What is Oxycodone?
+ Semi-synthetic opioid.
Cementum contains what percent minerals?
50%
What is mesiodens?
Extra tooth between central incisors.
Define: macule
Flattened skin patch that's altered in color
What does pale yellow puss while probing mean?
Infection
Which is more moveable, origin or insertion?
Insertion
What's the mode?
Most FREQUENTLY occurring value.
Oh Man
Ovale = Mandibular division of CN V
What's Foreshortening? How do you fix it?
Too much vertical angulation → decrease angulation.
Are there lymphatic vessels in tooth pulp?
Yes
Pyrophosphate: What does it do?
Anti-calculus (e.g., Crest Tartar Protection)
What's the most common medical emergency?
Syncope
Pharmacological Abbreviation: pc
after meals (post cebum)
What is electricity?
Power source of x-ray machines. With a direct current (DC), electrons flow in one direction. With an alternating current (AC), electrons flow in two directions.
What are X-rays? What type of radiation are they? How long are their wavelengths?
Powerful electromagnetic energy capable of penetrating substances. Travels at speed of light, has no mass or charge. Electromagnetic. High-frequency short wavelength
Sodium fluoride: What does it do? OTC percentage NaF/ppm? Prescription strength percentage?
Prevents caries and remineralizes surfaces. + OTC product: NaF 0.24%/1100 ppm. + Prescription strength: NaF 1.1%/5000 ppm (e.g., Prevident 5000, Fluoridex).
Prilocaine: Is this brand or generic name? What's the other name? Where is this drug metabolized? Is it available with epi? Without epi?
Pri=generic (Brand: Citanest) HINT: PILOT, lung, kidney. Pilot is LUCKY to have survived the crash. Lung, kidney, and liver for this drug. + Metabolized in the liver, lungs, and kidneys. + Formula also available with no epinephrine (used when epinephrine is contraindicated).
deft/defs, dmft/dmfs, dft/dfs indices=primary or perm? What does the e, m stand for? What does it measure? Which teeth does it apply to? What if mixed dentition?
Primary e=extraction is NEEDED m=tooth was missing before exfoliation time Measures: Dental Caries Applies to: 20 teeth. If mixed dentition, do DMF & def/dft indices separate (DONT ADD THEM) Score: If both carious lesions and restorations present, record as decay
What is a transformer?
mechanism used in an electrical circuit to increase or decrease the voltage. It may be a step-up, step-down, or autotransformer type.
Which type of caries show up most on radiographs?
mostly interproximal caries, must be accompanied by clinical detection.
What's a risk factor?
Condition that increases possibility of a disease
Basic Life Support Sequence?
C: Circulation, Cardiac compression A: Airway, Clear airway B: Breathing, Respiration through rescue breathing
Bone loss pattern is measured from the ___ to the ____ ___.
CEJ, alveolar crest
Quality control techniques: What is the stepwedge used for? What's it made out of?
(aluminum layers): used for evaluating density on a daily basis.
What are toxic reactions (which organs do they target? Are they dose related?)
(e.g., high concentration of barbiturate produces coma or death). + Intense effect on the target organs. + Dose-related.
How do you decide between 3 and 6 month-1 year maintenance for a perio maintenance patient?
+ 3 months: patients who completed NSPT, patients who have poor oral hygiene. + 6 months - 1 year: patients who maintain good home care and have stabilized oral health.
Pulse: What's the normal rate for adults vs. kids vs. infants? What's a slow rate called and what can cause it? A fast rate called and what can cause it? Where can you measure the pulse?
+ Adult: 60-100 beats/minute (bpm). + Child: 80-120 BPM + Infant: 100-160 BPM Bradycardia is a slow heart rate, below the normal rate. + β-blockers, resting, and fasting can slow the heart rate. Tachycardia is a fast heart rate, above the normal rate. Exercise, stress, drugs, etc. can elevate the heart rate. Record beats per minute, quality (weak or strong), and rhythm (regular or irregular). Radial artery: lateral and ventral aspects of the patient's wrist. + Brachial artery: medial aspect of the antecubital fossa (depression at the bend of the elbow). + Carotid pulse: lateral to the sternocleidomastoid muscle. In an emergency, the carotid is the best artery for assessing the pulse. + Femoral pulse: medial aspect of the upper thigh. If no pulse can be palpated after 10 seconds, assume that this is a cardiac arrest and begin chest compressions at a rate of 100-120 compressions per minute.
Vagus: Afferent or Efferent? What does it do?
+ Afferent and efferent. + Innervates the pharynx region and organs in the chest and abdomen.
Glossopharyngeal: Afferent or Efferent? What does it do?
+ Afferent and efferent. + Innervates the posterior third of the tongue, parotid gland, and pharynx.
Trigeminal: Afferent or Efferent? How big is it? What are its three branches and are they afferent or efferent? Which branch is the largest?
+ Afferent and efferent. + Largest cranial nerve. + Ophthalmic (V1): afferent. + Maxillary (V2): afferent. + Mandibular (V3): afferent and efferent. Largest branch.
Facial: Afferent or Efferent? What does it do? Which muscles does it innervate?
+ Afferent and efferent. + Provides special taste sensation to the anterior 2/3 of the tongue. + Innervates the muscles of facial expression.
Optic: Afferent or Efferent? What does it do?
+ Afferent. + Carries visual information from the eye to the brain.
Vestibulocochlear: Afferent or Efferent? What does it do?
+ Afferent. + Provides hearing and balance.
What are agonists vs. antagonists? Examples?
+ Agonist: receptor activator that stimulates an action (e.g., Parkinson's disease can be treated by dopamine agonist drugs that bind to the receptors in the brain). + Antagonist: receptor blocker that prevents or cancels the action (e.g., naloxone competes with and blocks the opiate receptors to counteract morphine or opiate effects).
Types of bone grafts & where they come from?
+ Allograft: from human cadavers. + Alloplastic: synthetic material. + Xenograft: from another species, usually bovine (cow).
What are the two types of cells in the pancreas and what do they do?
+ Alpha cells: produce glucagon that stores glycogen in the liver if the blood glucose levels are too low. + Beta cells: produce insulin to allow glucose to enter into cells.
What's an intentional tort?
+ Battery or technical assault: offensive bodily contact with the intent to harm. Wrongful act that is NOT consented to; includes performing a procedure that patient has NOT been agreed to have done. + g., placing sealants or performing fluoride treatment on a minor without consent of parent or guardian. + Assault: threat of bodily harm that reasonably causes fear of harm in the victim. + Defamation: action of damaging the good reputation of someone. + Slander: spoken defamation (e.g., insulting an employee in front of a patient). + Libel: written defamation (e.g., notes in the patient's chart judging his/her character).
What are dendrites? What do they do?
+ Branch off the body, act like tiny antennae picking up signals from other cells.
What are some medical complications of diabetes mellitus? Difference between hyper and hypoglycmeia, their symptoms, and which is the most common adverse reaction of diabetes meds?
+ Cardiovascular problems including atherosclerosis (thickening of the blood vessel wall from fatty plaque), high blood pressure, and stroke. + Retinopathy: vision problems, cataracts, blindness. + Nephropathy: renal failure. + Neuropathy: loss of sensation in the extremities. + Gangrene of the feet: death of body tissue from lack of blood flow or bacterial infection. + Slow healing. HINT: Hyper means too much sugar in blood, too little insulin, makes you drowsy, thirsty, fruit breath. Hypo=not enough sugar in blood, too much insulin, increased heart rate, fast breathing, dizzy, shaky, numb. + Hyperglycemia (diabetic coma): too much sugar in the blood (above 240 mg/dL), too little insulin. Symptoms include drowsiness, thirst, and fruity breath. + Hypoglycemia (insulin shock): not enough sugar (below 70 mg/dL) in the blood, too much insulin. Symptoms include increased heart rate, fast breathing, dizziness, shakiness, numbness. Most common adverse reaction of diabetes medication; why you'd give them glucose under lip.
How do the Pregnancy Categories work?
+ Category A: best, failed to demonstrate a risk to the human fetus in the first trimester of pregnancy. + Category B: animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women. Amoxicillin, lidocaine, prilocaine, etc. + Category C: animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans. Rifampin (anti-TB), mepivacaine, septocaine, etc. + Category D: positive evidence of human fetal risk. Potential benefits may warrant use of the drug in pregnant women despite potential risks. Aspirin, phenytoin (anti-seizure), tetracycline (antibacterial), etc. + Category X: studies in animals or humans have demonstrated fetal abnormalities. Temazepam (anti-anxiety), etc.
At 4-6 week tissue check, at non-responsive sites, what do you do?
+ Check for residual calculus deposits or roughness. + Determine other factors that can affect the condition such as systemic diseases, use of tobacco, etc.
Types of furcations
+ Class 1 (V): curvature of the concavity can be detected with the probe tip but it cannot enter the space; no radiolucency on radiographs. + Class 2 (∇): probe penetrates into the furcation, but does not completely pass through to the other side; slight radiolucency on radiographs. + Class 3 (black∇): probe passes completely through the furcation; radiolucency usually visible from radiographs. + Class 4 (black∇): entrance to the furca is clinically visible because of gingival recession and probe passes through the furcation; larger radiolucency on radiographs.
What is a glomerulus? What structure surrounds it?
+ Each nephron contains a glomerulus, a network of capillaries that performs the first step in filtering. + The glomerulus is surrounded by a thin-walled, bowl-shaped structure called the Bowman capsule.
Hypoglossal: Afferent or Efferent? What does it do?
+ Efferent. + Motor supply for intrinsic and extrinsic muscles of the tongue (with the exception of the palatoglossus which is innervated by the vagus nerve X).
Oculomotor: Afferent or Efferent? What does it do?
+ Efferent. + Contracts muscles of the eyes.
Trochlear: Afferent or Efferent? What does it do?
+ Efferent. + Contracts the superior oblique muscle of the eye.
Abducens: Afferent or Efferent? What does it do?
+ Efferent. + Moves the lateral muscle of the eyeballs.
Accessory: Afferent or Efferent? What does it do?
+ Efferent. + Provides the trapezius, SCM, etc.
Dental contraindications if cocaine was used within the past 24 hours? Why?
+ Epinephrine is contraindicated if cocaine was used within the past 24 hours. Cocaine and epinephrine are both vasoconstrictors.
What is Morphine used for?
+ First natural opiate used for acute or severe pain.
What is the focal trough? With panos, objects in the focal trough are ___, and those outside of it are ___
+ Horseshoe-shaped, narrow, curved space where the structure is captured. Inside=clear, outside=blurred.
What are the 6 steps to solving an ethical dilemma?
+ Identify the ethical dilemma or problem: clearly state the ethical question considering all pertinent aspects of the problem. This is the most critical step in the process. + Collect information: the decision maker must gather information to make an informed decision from all sources that are available. + Formulate options: the decision maker must use all the information gathered to formulate as many alternatives or options as possible. + Apply ethical principles to the options: this step involves stating how each alternative will affect the ethical principle by developing a list of pros and cons for each option. In the "pro" column, alternatives that protect or hold each principle are listed. The "con" column states how each alternative could violate the principle or value. This process will clarify which ethical principles are in conflict in a particular situation. + Choose an option: choose the option that has the most "pros" and is a solution to solving the problem. + Implement the decision: the final step involves acting on the decision that has been made.
What assessment methods are available in public health? Pros/cons?
+ Interview: time-consuming and not adequate for large groups. + Direct observation: best method for detailed assessment unbiased by the subject, but time-consuming and not cost-effective for large groups. + Other methods include questionnaires, reviewing existing documents, etc.
Maxillary: Which hole does it leave the skull through? What are 7 nerves that come out of it?
+ Leaves the skull through the foramen rotundum. + Infraorbital + Anterior superior alveolar + Middle superior alveolar + Posterior superior alveolar + Greater palatine + Lesser palatine + Nasopalatine
What's an unintentional tort?
+ Malpractice (= negligence): carelessness without the intent to harm a patient. Occurs when the appropriate standard of care is not met and damage results. + Malpractice cannot be claimed simply because the desired result was not achieved or the procedure resulted in some injury. It must be shown that the provider acted negligently under the circumstances. + E.g., failure to diagnose and treat periodontal diseases, which is against the standard of care. + E.g., trauma to the soft tissue because an instrument slipped during a procedure. This alone does not constitute negligence. Only if the clinician admits to having done something wrong to cause the instrument to slip that the case becomes malpractice (negligence). + Elements of negligence or malpractice: harm must be done. + Supervised neglect: patient needs further professional care but is discharged from care (e.g., failure to refer to a specialist). Patient should be referred to a specialist when "average" dentist knows that procedure is complex.
Schedule II controlled substance: What does this classification mean? Potential for addiction? Examples?
+ Medical use (e.g., cocaine, oxycodone, amphetamines, morphine, etc.) + Potential for Addiction: Abusing the drug can cause severe physical and mental addiction
Mandibular: Which muscles does it innervate? What part of the tongue does it innervate? Which hole does it leave the skull through? What about enter the skull through? What are 5 nerves that come out of it?
+ Muscles of mastication (masseter, temporalis, medial pterygoid, and lateral pterygoid). Also innervates anterior 2/3 of tongue. + Leaves the skull through the foramen ovale. + Enters the mandible through the mandibular foramen and travels through the mandibular canal. + Buccal + Incisive + Mental + Lingual + Inferior alveolar
How does the Hierarchy of Needs work (5 levels, from most basic needs to least basic):
+ Physiological need: food, water, and shelter. + Safety and security: personal security, financial security, health. + Love and belonging: social need, friendship, family, intimacy. + Self-esteem: feeling of worth, achievement. + Self-actualization: growth, self-development
What's the difference between primary and secondary trauma from occlusion? How does this damage the periodontium?
+ Primary: excessive occlusal forces on a healthy periodontium (e.g., high restoration that places excessive force on the periodontium). + Secondary trauma: normal or excessive occlusal forces on an unhealthy periodontium.
Which intensifying screens are green? Which are blue? Which type of film does each go with? Do the screen and film go in a hard or soft cassette?
+ Rare earth intensifying screens are green and paired with green film. Calcium tungstate intensifying screens are blue and paired with blue film. + Screen and film are placed inside a soft or hard cassette.
What is Tylenol 3 used for? What is it made up of?
+ Tylenol + codeine = Tylenol 3 or Tylenol with Codeine, provides greater pain relief.
What side effects of therapy do cancer patients experience related to periodontal disease?
+ Xerostomia, mucositis, infections, and loss of taste (dysgeusia), necrosis of the bone, etc.
Which heart conditions DO NOT require antibiotic premed prior to dental care?
+Mitral valve prolapses. +Rheumatic heart disease. +Bicuspid valve disease. +Calcified aortic stenosis. +Congenital heart conditions such as ventricular septal defect, atrial septal defect, and hypertrophic cardiomyopathy.
What is a sphygmomanometer? What does it measure? What does a stethoscope do? How do you use both? What's the systolic vs. diastolic pressure when you use both during the process?
+Sphygmomanometer measures the pressure, and stethoscope enables the hearing of the sound of blood passing through the arteries. (Automated devices are not as accurate as the standard cuff). + Place the cuff snugly around the upper arm, but not too tight. + Inflate the cuff until the pulse disappears, and inflate another 20-30 mmHg. + Slowly deflate at a rate of 2-3 mmHg per second, until the pulse reappears. This is the systolic pressure. + Keep deflating until the pulse disappears. The last sound before silence is the diastolic pressure.
What's the resting potential (in mV)? Is the inside of the axon negative or positive vs. outside? Where is Na vs. K? How permeable is the membrane
-70 mV Inside: negative Na+ mostly outside K+ mostly inside Slightly permeable to Na+
What are the muscles of facial expression? (15) Which nerve innervates them?
-Epicranial (frontal belly & occipital) -Obicularis oculi (around eye--squints, closes) -Corrugator supercilii (medial part of eyebrow--frowning) -Orbicularis oris (around mouth--kissing muscle) -Buccinator (between max & mand in cheek area--chew, compress cheek, suck. NOT a muscle of mastication, though.) HINT: BUX like deep pockets, deep to masseter. -Risorius (horiz muscle around parotid gland/corner of mouth--stretches lips laterally, real smile involves this) -Levator labii superioris (between nostrils & upper lip--elevates upper lip) -Levator labii superioris alaeque nasi (around nostrils--elevates upper lip, dilates nostrils) -Zygomaticus major (attaches to corner of mouth--smile) HINT: BELOW minor, like with the sphenoid bone, how greater is below lesser wing -Zygomaticus minor (attaches to lip--smile) HINT: ABOVE major, like with the sphenoid bone, how lesser wing is above greater wing -Levator anguli oris (vertical muscle between eye & upper lip--lifts corner mouth) -Depressor anguli oris (between lower lip & chin--frown) HINT: Inserts at corner of mouth, runs at an angle. -Depressor labii inferioris (between lower lip & chin--pulls down lower lip to expose mand. incisors) HINT: UNDER lower lip, inserts into skin -Mentalis (central pair of muscles from lower lip to chin--wrinkles skin of chin, protrudes lower lip) -Platysma (large superficial muscle on front of neck, face, chest, raises skin of neck, lowers corners of mouth) HINT: Say platysma, emphasize T, it sticks out as do this. CN VII (Facial)
What are the muscles of the pharynx?
-Stylopharyngeus muscle -Pharyngeal constrictor muscles: Superior, middle and inferior pharyngeal constrictor muscl -Soft palate muscles
What's the recommended level of fluoride? What was it before?
0.7 ppm. 0.7-1.2 ppm in past
Only ____% of energy is emitted as x-rays, ____% is emitted as heat.
1%, 99%
Where should intact gingival margin be positioned in relation to CEJ?
1-2 mm coronal
Universal system
1-32 for permanent, A-T for primary Count from Max right 3rd molar to mand. right third molar. Used in US
Types of strokes
1. Ischemic stroke: Blood vessel obstructed. Most strokes are this type. Subtypes of ischemic: HINT: Trombone close to BRAIN (thrombotic), ball travels far (embolic) +Thrombotic stroke: blood clot (thrombus) forms in one of the arteries of the brain. +Embolic stroke: blood clot or debris in the body travels through the blood stream, ends in a narrower brain artery and blocks it. 2. Hemorrhagic stroke: blood vessel is ruptured in brain.
A periodontist should be involved in the success of periodontal treatments in what cases (pocket depths)?
3-5 mm pockets are a challenge for subgingival plaque removal 6+ pockets can't be treated successfully with NSPT (residual calculus will be left most of time)
Define: Photoelectric effect. Responsible for ___% of interactions with the matter in dental x-rays.
30% A photon interacts with an inner shell electron. The photon is absorbed and the electron is ejected. Ionization occurs.
What is the antibiotic premedication regimen for adults? What about if allergic to penicillin? What about pediatric doseage?
2 g amoxicillin 1 hour prior to appointment. If the patient is allergic to penicillin, use: + 600 mg clindamycin 1 hour prior to appointment. + 500 mg azithromycin 1 hour prior to appointment. + 500 mg clarithromycin 1 hour prior to appointment. Pediatric dosage is 50 mg/kg (maximum 2 g) amoxicillin 1 hour prior to appointment.
Perio destruction is how many x higher in smokers vs. non-smokers?
2-6 times. Related to number of cigarettes smoked & how many years they've smoked
Plasma is what percent water and what percent protein?
70% H2O, 10% protein
What are the ADHA core values?
Confidentiality, societal trust, nonmaleficence, beneficence, justice, veracity, autonomy
Enamel contains what percent minerals? What is it primarily made out of? Where is it hardest? Is it living tissue or not?
96% minerals (consists predominantly of apatite crystals containing calcium and phosphate). It is hardest at the biting edges or cusps. NOT living, doesn't contain nerves.
Define: Vesicle
<5 mm, contains serum or mucin
Define: papule
<5 mm, contains tissue
Define: Bulla
>5 mm, contains serum or mucin
Define: nodule
>5 mm, contains tissue
What bacteria is associated with localized aggressive periodontitis?
A. actinomycetemcomitans
8 Cranial Bones?
HINT: Ethan's Fried Spanish Pasta Tempts Octavia Ethmoid Frontal Sphenoid Parietal (2) Temporal (2) Occipital
Which heart conditions require antibiotic premed prior to dental care?
As of 2012: HINT: Transplant, unrepaired/partly unrepaired, prosthetic, residual defect, artificial valve, IE (infective endocarditis) +A cardiac transplant that develops cardiac valvulopathy. +Unrepaired or incompletely-repaired cyanotic congenital heart disease, including people with palliative shunts and conduits. +Defects repaired with a prosthetic material during the first six months after the procedure. +Cases in which a heart defect has been repaired, but a residual defect remains at the site or adjacent to the site. +Artificial heart valves. +History of infective endocarditis.
Pano errors: How do you fix maxillary incisor roots are blurred?
chin tipped too far up → reposition the chin.
Crohn's Disease: What is it? Cause? Symptoms? Oral Conditions? Tx mods? Who had it?
Autoimmune inflammatory bowel disease (IBD) that causes inflammation of any part of the digestive tract. (Although this condition is an immune-related disease, it is not an autoimmune disease). Symptoms include diarrhea, weight loss, fatigue, and malnutrition. Oral conditions: angular cheilitis, fissured lips, and "cobblestone" buccal mucosa. Schedule appointments during remission. HINT: Who had it--Eisenhower, cobblestones laid on highways (on cheeks), angular cheilitis (corners of mouth)
Myasthenia Gravis: What it is, Causes, Symptoms, Oral Manifestations, Management
Autoimmune neuromuscular disease - weakness of skeletal muscles Cause: Autoimmune - defect in nerve impulse transmission at neuromuscular junction. Symptoms: Weakness in voluntary muscles of body, drooping eyelids, slurred speech, difficulty breathing and walking. ^DONT USE ANYTHING ON THEM THAT COULD AFFECT BREATHING, like Cavitron, etc. Oral: Masticatory muscle weakness, food retention, increased caries, increased perio Manage: Muscle weakness can affect breathing muscles - myasthenic crisis
What nervous system controls the salivary glands?
Autonomic
Obstructed airway: What do? What if pass out?
A foreign body falling into the pharynx can lead to partial or complete airway obstruction. If the condition is not relieved immediately, respiratory arrest will lead to cardiac arrest within minutes. The patient may cough, stop breathing, and become cyanotic (turns blue). + The patient may also use the universal choking signal (hands around the throat). If coughing--LET THEM COUGH. If conscious but can't breathe, Heimlich maneuver (abdominal thrust) on adults, infants face down then 5 back throws If lose consciousness, move to floor, call 911, tilt head & lift chin so tongue doesn't block pharynx=more air Don't reach in mouth to fish for object if don't see it. If see it, cna take it out. + Continue CPR.
Cleidocranial Dysplasia: What is it? What causes it? Characteristics (body and orally?)
A genetic disorder that affects the development of the bones and teeth. The cranium develops into a mushroom shape and the clavicles are underdeveloped. Characterized by many supernumerary teeth, sometimes even simulating a third dentition. Interference with the eruption of normal teeth results in pseudo anodontia.
Can a dental hygienist write a prescription? Can they sign it? If not, who can?
A healthcare professional such as a dental hygienist may write the prescription but the doctor must review and sign in ink.
What's a cornu?
A horn-like process as seen with the hyoid bone.
Who signs and dates forms if the patient is a minor?
A parent or legal guardian
Who signs and dates forms if a patient is mentally incompetent?
A parent or legal guardian.
Define: Cyst.
A pathologic cavity with an epithelium liner and connective tissue capsule. Usually fluid-filled lumen (however with OKC it's filled with keratin). Can be deeper in CT. Needs microscopic exam to determine it's a cyst.
What's an ion pair?
A positive ion (atom missing an electron) and negative ion (ejected electron).
What do anti-coagulation agents do? AKA? When used? Examples of drugs and how they work? What's an INR test and how do the values work? What values are safe for dental procedures? Which OTC drugs can cause even ore bleeding during a dental procedure? What alternatives do you recommend for analgesia?
AKA Blood thinners. Reduce ability of the blood to clot. Used after MI events, strokes, etc. HINT: Bleed a lot during WAR, hurt a lot during coma. Warfarin (Coumadin) Clopidogrel=clumpy; Plavix=plaque. Reduce clumpy plaque. Clopidogrel (Plavix). Warfarin (Coumadin): Interferes with production of vitamin K needed for clotting. Aspirin: Anti-platelet agent. Baby aspirin (81 mg) is commonly used to prevent MI and DOES NOT cause excessive bleeding. Clopidogrel (Plavex) INR: International Normalized Ratio test performed in labs to check blood clotting time. The higher the number, the longer it takes for coagulation. +Value of 1 is normal. Patients on blood thinners have higher values. Any value of 3 or less is safe for dental procedures. Aspirin or NSAID can cause even more bleeding during dental procedures. Use acetaminophen for analgesia.
What's dens in dente? AKA? Most commonly where?
AKA Dens invaginatus. Enamel organ invaginates (goes into) the crown of a tooth before mineralization. Radiographically, a tooth-like structure appears within the crown. Tooth is more vulnerable to caries and infections including periapical lesions. Most commonly seen in maxillary lateral incisors.
Syncope: AKA? What is it? Who has it? What causes it? What symptoms precede it? How resolve it?
AKA Fainting. Temporary partial or complete loss of consciousness. + Can occur in healthy individuals, but is more common in elderly patients. Caused by a temporary reduction in blood pressure which decreases the blood flow and oxygen to the brain (cerebral hypoxia). This sudden change can result from: + Postural (orthostatic) hypotension: drop in blood pressure due to changing body position to a more vertical position after lying or sitting + Dehydration: causing a decrease in blood volume + Abnormalities of the heart valves or heart rhythms + Stroke + Anxiety + Low blood sugar + Anemia (deficiency in healthy oxygen-carrying blood cells) Usually is preceded by a sense of warmth, nausea, lightheadedness, and visual disturbance. Put patient in a Trendelenburg position with feet higher than the head. Also, use an ammonia capsule, crush and brush it under the patient's nose. The strong odor will help wake the patient up. Patient may be pale, weak, and lightheaded before the event of syncope. Episodes of syncope usually last less than 5 minutes. Pulse should return to normal after syncope, but allow patient to rest in a supine position.
Where is the internal oblique ridge? AKA?
AKA Mylohyoid. elevated long area on the internal surface of mandible. Radiopaque line running along the premolar and molar apices. It is usually positioned below the external oblique ridge on radiographs.
What's Orthostatic Hypotension? AKA? Why does it happen? Tx mods?
AKA Postural. a decrease in the supine-to-standing blood pressure of levels above 20 mmHg (systolic) or 10 mmHg (diastolic). + Caused by blood collecting in the lower body from gravity, which leads to a drop in blood pressure. + Can occur when a patient sits up too fast after long hours in the dental chair. Advise the patient to stay in the chair seated for a few minutes before standing up. + In North America, about 18% of medical emergencies in the dental office are related to postural hypotension. + Patients taking antihypertensive medications are at higher risk for postural hypotension. It is advised to schedule appointments with those patients 30-60 minutes after the ingestion of medications and meals. + In the case of dizziness or fainting, put the patient back into a supine position, and monitor vital signs, and later raise the patient slowly again. Allow patient first to sit for two minutes, then stand for two minutes. + Oxygen may need to be administered in some cases.
What is the therapeutic index? How is this abbreviated? How do you get this value? The ___ the TI number, the ___ the drug. On a graph, what does this look like?
AKA TI. Number that determines the safety of a drug. Lethal dose (LD 50) / Effective Dose (ED 50) Bigger, safer. More space between the two therapeutic effect and toxic effect dose-response curves=safer drug. Less space between those two curves=less of a difference between the doses that are therapeutic vs. lethal=more dangerous drug.
Is Acetaminophen an NSAID? Why or why not? Brand name? How does it work? What type of patient should use this drug?
AKA Tylenol. + Antipyretic and analgesic, but not anti-inflammatory, so NOT an NSAID. + Has no effect on blood coagulation. Drug of choice if the patient is on blood thinners.
What is the height of contour? AKA? What is its function?
AKA crest of curvature, it is the greatest bulge farthest from the center of the crown of the tooth. + It prevents the food from accumulating on the tooth and protects the gingiva. + Height of contour in the mesial and distal surfaces is the contact area.
Types of antibodies (AKA WHAT?) & what they do & what type of cells produce them.
AKA immunogloblins Produced by plasma cells and lymphocytes. HINT: IgG=General=most common type IgA=Allie has a lot of salivA, teArs, respiratory tract. IgM=Moves fast=1st type made in response to infection IgE=Allergic to eggs=allergic rxn IgD=Detect=recognizes antigens IgG: Most common type of antibody. IgA: Lines body surfaces, provides protection from microorganisms. In saliva, tears, respiratory tract. IgM: First type of antibody made in response to infection. Stimulates production of IgG IgE: Causes body to have allergic rxn IgD: Recognizes antigens
Gingival hyperplasia is common in about how many % of people who are on Dilantin? What is that med used for and also known as?
AKA phenytoin for seizures Rate ranges from 3-93%, but 50% of patients on long-term therapy are prone to develop it. So say 50%
The mean of the correlation between geographic location and plaque scores was compared with the mean of the correlation between gender and plaque scores. What type of research analysis does this exemplify?
ANOVA or one-way analysis of variance analyzes the effects of two or more independent variables simultaneously and determines interactions among the variables in multiple sample groups. Note that calculations of ANOVA include dispersion scores around the mean value. A similar statistical tool, the Student's t-test is another statistical measurement that compares two sample groups when one or two independent variables are tested. However, because the t-test assumes a normal distribution bell-shaped curve, it is not applicable when mean values require analysis. Standard deviation SD, which measures the variance of spread of scores around the mean, is not applicable in this case because it does not compare or correlate information between two variables. Also not applicable is a chi-square test which compares observed frequencies to expected frequencies
What causes sickle cell anemia? Who is more likely to have it? What does it look like on radiographs? Symptoms of it? Oral conditions?
Abnormal (sickle-shaped) red blood cells. These abnormal cells can get stuck in small blood vessels and slow/block blood flow and oxygen to the body. + Condition affects African-Americans more commonly. + Bone loses trabeculae and appears to have irregular and large bone marrow spaces on radiographs + The change in the skull is described as a hair-on-end pattern because the trabeculae radiate outward. Weakness, pallor, impaired memory, paresthesia of the hands and feet, and fatigue. Paleness of the oral tissues, ulcerations, glossitis (swollen, red, smooth tongue), etc. + Loss of papillae on the dorsum of the tongue (filiform papillae disappear first because they have the highest metabolic requirements).
What's an idiosyncratic reaction? Is it dose-related?
Abnormal reaction to a drug, and is usually genetically-related. + The reaction cannot be predicted by the clinician. + Not dose-related.
What is absorbed dose? How is it measured? Units?
Absorbed dose: amount of radiation absorbed by an object. Depending on the material, the amount of radiation absorbed will vary. + Dose (absorbed dose) measurement: Rad (Standard system), Gray (Gy) (SI system)
What's a talon cusp? Where is it usually? Do you need to remove it or not?
Accessory cusp located in the area of the cingulum of a maxillary or mandibular permanent incisor. Removal of the talon cusp is often indicated because it can interfere with occlusion.
What's dens evaginatus? Where most often seen?
Accessory enamel cusp found on the occlusal tooth surface. Most often seen on the mandibular premolars. A pulp horn may extend into this extra cusp.
When should the antibiotic premed be given? Is it given in a single dose or multiple? If it's not given at that time, when else can it be given?
According to the ADA guidelines, the antibiotic should be given in a single dose 30-60 minutes before treatment. If the antibiotic is not administered at that time, the dose may be given 2 hours after the procedure.
In the PANS, what is the neurotransmitter that mediates a response? What kind of receptor does it act as?
Acetylcholine Cholinergic receptor
What's AIDS & HIV? Full names? Cause? How does HIV progress to AIDS? How long does someone with AIDS usually live and if they die, what causes it?
Acquired Immune Deficiency Syndrome, Human Immunodeficiency virus The human immunodeficiency viruses invade T lymphocyte cells (called CD4 helper cells), inject their RNA, and take over the replication stage to produce new viruses. Eventually the CD4 cell count falls below 200 cells/mm3 of blood (normal CD4 is 500-1,600 cells/mm3). When the body becomes weak, HIV infection leads to AIDS. People who are diagnosed with AIDS typically survive for 3 years and more. Death usually occurs due to opportunistic infections (infections that happen when the body is abnormally weak).
Define: Ankyloglossia. What other oral conditions can it cause? How is it treated?
Adhesion of the tongue to the floor of the mouth often referred to as "tongu Can cause problems with speech, gingival recession, and bone loss (if the frenum is attached too high on the lingual alveolar ridge). Frenectomy: surgical removal of a portion of the frenum.
How do cell bodies differ in afferent vs. efferent neurons? Is it involved in impulse transmission?
Afferent (sensory): cell body is a small distance away from the axon. Not involved in impulse transmission Efferent (motor): ncell body between the dendritic zone and axon. Involved in impulse transmission
In the SANS, what are the 2 agonist neurotransmitters that mediate responses? What kind of receptors do they act as.
Agonists: Epinephrine & norepinephrine Adrenergic receptors
Respiration: How do you measure it? What's the normal rate for adults vs. kids? What's a slow rate called? A fast rate?
Allow the patient to rest for at least 5 minutes before recording any vital signs. Monitor the respiratory rate by watching the chest rise and fall. + Adult: 12-20 breaths/minute. + Child: 18-22 breaths/minute. Bradypnea is a slow respiratory rate, below the normal rate. Tachypnea is a rapid respiratory rate, above the normal rate. Also, monitor the quality of the breath, sound, depth, and rhythm.
ALS (Amyotrophic Lateral Sclerosis): What is it? Results in one? Who? Symptoms?
Also called Lou Gehrig's disease, it is a progressive neurodegenerative disease that affects motor neurons from the brain to the spinal cord. Eventually leads to death. Most commonly occur in ages 40-60. Symptoms include muscle weakness, twitching, shortness of breath, etc. Mental ability remains mostly the same as before the onset of ALS.
Define: Pulpitis. AKA? What look like visually? What causes it? Where? Symptoms?
Also called pulp polyp, the inflamed pink dental pulp tissue protrudes from the pulp chamber. Occurs in teeth with large, open carious lesions. Primary and permanent molars are often affected. Conditions are usually asymptomatic.
Infectious Mononucleosis: What is it? AKA? Symptoms? Who gets it? Transmission? Treatment?
Also called the "kissing disease," is caused by the Epstein-Barr virus. Symptoms: sore throat, fever, extreme fatigue, lymphadenopathy, etc. can appear 4-6 weeks after the infection. Common among teenagers and young adults. Spread through bodily fluids, especially saliva. Maintain good hydration during illness.
What is the drug of choice for premed if a patient doesn't have a penicillin allergy? Is it bactericidal or static? If static, how?
Amoxicillin. Bactericidal.
What is Papillon-Lefevre syndrome? Must both parents have it or just one? Oral manifestations?
Autosomal recessive inherited disease. Both parents must have it (if only one does, you may be a carrier). Condition leads to early and severe periodontal disease of both dentitions, as well as hyperkeratosis of the palms of the hands and soles of the feet.
What is a notch?
An INDENTATION (mandibular notch between coronoid process and condyle process)
What is autoimmune disease?
An abnormal immune response of the body against substances and tissues that are normally present in the body.
What's an implant? Types of implants?
An artificial tooth root is placed into the jaw to hold a replacement tooth or bridge. Dental implants may be an option for people who have lost a tooth or teeth due to periodontal disease, an injury, or some other reason. + Endosteal (in the bone): screws, cylinders or blades surgically placed into the jawbone. This is the most commonly used type of implant. + Subperiosteal (on the bone): placed on top of the jaw with the metal framework's posts protruding through the gum to hold the prosthesis. These types of implants are used for patients who cannot wear conventional dentures and have minimal bone height.
Define: Sjogren's Syndrome. What causes it? Symptoms? How do you diagnose this? What are these patients at higher risk for?
An autoimmune disease in which the white blood cells attack moisture-producing glands, including the salivary and lacrimal glands. Biopsy of the minor salivary glands is often performed to confirm Sjögren syndrome. Causes xerostomi) and dry eyes (xerophthalmia). xerostomia + xerophthalmia = sicca syndrome. Patients are at high risk for caries, periodontal disease, and oral candidiasis. Bilateral parotid gland enlargement is seen in about 50% of the patients. 90% of patients with Sjögren syndrome have a positive reaction to rheumatoid factor, also an autoimmune disease.
Ellis-Van Creveld Syndrome: What is it? What causes it? Characteristics (body and orally?)
An inherited disorder characterized by abnormal bone growth resulting in dwarfism. Patients can be mildly mentally handicapped. Characterized by polydactyly (VERY spread thumb and pinky, like horizontal), hypoplastic fingernails, and toenails. Fusion of the anterior portion of the maxillary gingiva to the upper lip from canine to canine (anterior maxillary vestibular sulcus is lacking). Lack of central incisors on both the maxilla and mandible. The area is replaced by a centrally located abnormal tooth. More than half of newborns with this syndrome have natal teeth.
Define: Retrospective studies. Which main type of study does this fall under?
Analytic Studies studies are formed after some people have developed the outcomes of interest. Investigators jump back in time to identify the cause (e.g., patients with lung cancer are compared to their smoking habits).
Define: Prospective studies. Which main type of study does this fall under?
Analytic Studies subjects are observed over time to determine how certain factors affect rates of a certain outcome (e.g., school water fluoridation and number of caries found in those school children).
Which type of studies utilize hypothesis?
Analytic studies (Prospective, Retrospective, Longitudinal)
Oral conditions of Alzheimer's? Side effects?
Angular cheilitis, glossitis (soreness of tongue with inflammation and loss of dorsal papillae=smooth tongue), loss of taste, root caries, and periodontal disease. Fx: xerostomia.
Eating Disorders: Types (3)? Who affects? Tx? Med complications? Oral Findings? Tx mods?
Anorexia - self starvation (weigh at least 15% less than normal healthy weight), distorted body image, misuse of laxatives, diuretics, enemas - lanugo, sensitive to cold, low vital signs, amenorrhea (no period), excessive exercise Bulimia - binge eating/purging, perimylolysis Bulimarexia Who: Adolescent girls Tx - interdisciplinary team, cognitive behavioral therapy, antidepressants. Medical complications: dehydration, electrolyte imbalance, cardiac arrhythmia Oral findings: glossitis, angular cheilitis, bleeding gingival due to nutritional deficiency. Perimylolysis (tooth erosion) esp on lingual surfaces of max anterior teeth from stomach acid, raised restorations, xerostomia, hypersensitivity, parotid gland enlargement Tx mod - Rinse with water after purging (don't brush right after); rinse with pH neutral solution if can; nonthreatening, preventive program, fluoride plan (since xerostomia and enlarged parotid glands in bulimia)
What's a sinus in cardiovascular system?
Another term related to veins. i.e. Cavernous venous sinus is behind eyes--infection from pterygoid plexus can spread here and become VERY dangerous.
Order of the following from anterior to posterior: Maxillary vein, Pterygoid plexus, Cavernous venous sinus?
Anterior to posterior: Pterygoid Plexus, Maxillary, Cavernous Venous sinus
Which medications cause xerostomia?
Anti-hypertensive drugs (e.g., hydrochlorothiazide). Anti-histamine drugs (e.g., Benadryl). Anti-depressant drugs (e.g., citalopram - Celexa). Anti-psychotic drugs (e.g., clozapine - Clozaril). Anti-emetic drugs (e.g., AlkaSeltzer). Anti-Parkinson's drugs (e.g., Levodopa). Chemotherapy and radiation therapy can also cause dry mouth.
Immune system components
Antibodies, WBC, chemicals, and proteins, tonsils, thymus
What's a process?
Any prominence on a bony surface (coronoid process of mandible)
Aorta vs. veins? Exception to this rule?
Aorta=carry OXYGENATED blood AWAY from heart TO the body. Aorta like AWAY from heart. Veins=carry DEOXYGENATED blood TOWARD the heart, AWAY from the body. Vein TOWARD heart. More numerous, vary in location, anastomose (communicate) with eachother freely (come together). Exception: Pulmonary arteries carry DEOXYGENATED blood from R ventricle to the lungs for oxygenation. Pulmonary veins carry OXYGENATED blood from the lungs to the L atrium of the heart.
Primary herpetic gingivostomatitis: What causes it? Who gets it? Symptoms? When does it heal? How infectious?
Appears as painful, erythematous and swollen gingiva or vesicles on the oral mucosa. + Affects children under age 6. + Fever, malaise and cervical lymphadenopathy generally occur before oral signs. Heals spontaneously in 1 to 2 week.
How much of the US population is prevented by periodontal diseases? What about if 65+ years old?
Approximately half of the population in the United States. 70% of patients 65+ have periodontitis
What is the function of premolars? AKA?
Assist molars in grinding food, assist canines in piercing and tearing food. Bicuspids.
What are axons? What do they do? What other components are there of them (what's around them? What cells makeup that part around them? What are the spaces between the cells? Does the part that goes around speed up nerve impulses or slow it down and how?)
Axon is a thin long fiber that carries the signal. + Insulated by a myelin sheath (fat tissue). +Schwann cells: Make up segments of the myelin sheath. +Nodes of Ranvier: Gap between adjacent Schwann cells. With sheath=faster conduction because impulse jumps from node to node vs. entire length of the nerve.
When should you bring a child for a dental visit? What education is provided to parents?
At the eruption of the first tooth or no later than 12 months. Parents and caregivers should be educated regarding the risk of milk causing decay and proper oral hygiene practice.
What is the Position-indication device?
Attaches to the tube head and directs the x-ray beams to the object and film. Can be in the shape of a cylinder or a rectangle (reduces exposure).
Types of lymphocytes?
B-lymphocytes (plasma cells): humoral immunity (antibody-mediated specific immunity). Bind to, fragment, engulf antigens. Secrete antibodies (AKA immunoglobulins) that neutralize & recognize a microorganism. Antibodies are specific to each foreign substance. T-lymphocytes: Cell-mediated immune response, intensify response of other immune cells.
What's a Herringbone or waffle pattern? How do you fix it?
Backward placement of film → place the film with the smooth, white side next to the tooth and bumpy side away (there is lead foil on the backside of the film packet to prevent backscatter).
What's the primary cause of perio disease?
Bacteria
Dental Decay Process formulas
Bacteria + Food = Acid Tooth + Acid = Decay
What's the primary etiology for Perio Disease?
Bacteria in dental plaque
Define: Strep Throat. What does it look like visually? Which bacteria is it associated with (1 type)? Symptoms? Who does it usually affect?
Bacterial infection caused by streptococcus pyogenes (Group A Streptococcus). It is highly contagious and usually affects children from 5-15 years. Symptoms: sore throat, fever, white patches on tonsils, red spots on palate, etc. Tonsillitis and pharyngitis describe the inflammation of the tonsils and pharynx. Scarlet fever can occur and features bright red rash throughout the body. Rheumatic fever: inflammatory disease following streptococcal infection that can cause permanent damage to the heart, joints, and central nervous system. In addition, petechiae (small, round purplish-red spots on the soft palate), and strawberry tongue (red bumpy appearance) can appear.
What's Tuberculosis (TB)? Cause? How does it spread? How do you test for it (and name of test)? What does a positive result mean? Treatment modifications? Requirements for healthcare professionals?
Bacterial infection of the lungs caused by the bacterium Mycobacterium tuberculosis. Spread through AIRBORNE particles, when an infectious patient coughs, sneezes, talks, etc. Lasts in air for HOURS. PPD (purified protein derivative), also known as the Mantoux skin test is an antigen used to test for tuberculosis. The swelling is read after 48-72 hours after the antigen is injected. A positive sign does not mean that the patient has active TB, but confirms exposure to the disease at some point in patient's life. Elective non-emergency dental treatment should be postponed for patients who have active TB or who are suspected to have TB. Health care professionals should be regularly checked. Positive PPD test means that the individual was exposed to the disease, but does not mean that the clinician has active TB or is contagious
What is a Metronidazole: Bactericidal or static? If static or cidal, how? What is it used for? Side effects?
Bactericidal agent, effective against amoebae. + Effective in treating periodontitis (anaerobic infection). + More commonly used than tetracycline for periodontal diseases. HINT: Metro=subway. Subway is made of metal=metallic taste. Subway has hairy wheels. Black hairy tongue. + Side effects include black hairy tongue and metallic taste.
What is Penicillin: Bactericidal or bacteriostatic? Examples?
Bactericidal. Amoxicillin, penicillin V, penicillin G, penicillin VK, etc.
The bisecting technique is based on what rule? What does it require? At what angle does the beam hit the line? Does it cause more or less distortion vs. paralleling and why?
Based on rule of isometry (two triangles are equal when they share one complete side and have two equal angles). + Requires bisection of the angles formed by the film and long axis of the tooth. + Primary beam hits at 90° to the bisected line. + Generally produces more distortion than paralleling technique because of the position of the palate, and the difficulty of visualizing the bisecting line.
Why are joint sounds NOT a reliable indicator of TMD? Which radiography could help with diagnosis?
Because they can change over time. MRI or pano
What a lymphangioma? Who usually gets them? Benign or malignant? Where are they? What do they look like?
Benign Vascular lesions typically present at birth and most frequently occurring on the tongue, appear as an ill-defined pebbly mass.
Define: Odontoma. Benign or malignant? 2 subtypes and difference between them? What look like radiographically? Where seen? Symptoms?
Benign mass composed of mature enamel, dentin, cementum, and pulp tissue. Compound odontoma: cluster of numerous small teeth surrounded by a radiolucent halo. Usually located in the anterior maxilla. Complex odontoma: mass of enamel, dentin, cementum, and pulp that does not resemble a normal tooth. Most commonly occurs in the posterior mandible. Appears as a radiopaque mass surrounded by a thin radiolucent halo. Can cause swelling and displacement of the erupted teeth.
Define: Condyloma Acuminatum. Benign or malignant? Which virus causes it? How transmitted? Where? What looks like? How does it differ from papilloma or verruca vulgaris?
Benign papillary lesion that is caused by the papilloma virus. Transmitted mostly through sexual contact. Appear as finger-like (papillary) projections of the epithelium. Lesions occur on the tongue, buccal mucosa, palate, gingiva, and alveolar ridge. More diffuse than the papilloma or verruca vulgaris. Pink in color whereas verruca vulgaris is usually white.
Neurofibroma and Schwannoma: Is it benign or malignant? What disease is it associated with? What does it look like visually? Where do they occur?
Benign tumors derived from the nerve. Von Recklinghausen's disease is a genetic disorder that causes neurofibroma. Tongue is the most common intraoral location. Papules of various sizes develop on the facial skin, especially the eyelids. Café au lait pigmentation presents from the first decade of life, before the development of neurofibromas.
What causes a Mark across film? How do you fix it?
Bent film → store film properly.
What is metabolism? AKA?
Biotransformation. Process by which the body breaks down and converts medication into other chemical substances.
What is the function of incisors?
Bite & cut food
Anti-histamine: How does it work? Side effects? Examples? When used?
Blocks histamine produced by mast cells during allergic reactions. + Side effects: drowsiness and xerostomia. + Diphenhydramine (Benadryl), loratadine (Claritin), etc. + Mild reactions can be treated with antihistamines.
How does LA work (pharmacodynamics)? Most local anesthetics are (vasoconstrictors/vasodilators).
Blocks the transmission of electrical nerve impulses by inhibiting the influx of sodium ions through the sodium channels. The action potential is not propagated because the threshold level is never attained. Vasodilators.
Post-Perio Surgery Care
Blood seeping is normal. Do not forcefully spit or rinse the mouth on the first day because this may disturb the blood clotting process. After the first day, rinse gently with warm water and salt, or prescribed anti-microbial agents. Brush gently avoiding the area of surgery. Massage with ice to control inflammation. Periodontal dressing (periodontal pack): bandage placed on area of treatment. Used to provide comfort, maintain blood clot, inhibit food impaction, and protect the wound. The bandage itself does not have any wound healing property. + Some dressings contain eugenol for its obtundent (soothing effect) but may irritate the tissue. + The dressing should be soft to be molded onto the tissue (not higher than the height of contour, do not apply near the occlusal surface), and hardens within hours. Smooth the surface when the dressing is still soft. + Be sure that sutures are not embedded in the dressing. + Remove dressing within 5-7 days. Use Charter's method of tooth brushing (bristles directed towards the occlusal surface, not the gingiva) if needed. + White patches of dead cells and bleeding can be common upon the removal of periodontal dressings. Chlorhexidine rinse may be prescribed. Use 15 ml twice daily for 30 seconds, or for the prescribed duration. + Chlorhexidine has high substantivity (released slowly over a long period of time). Can be used for gram-positive, gram-negative bacteria, and fungus.
Which drugs can cause prolonged bleeding?
Blood thinners (anti-coagulants) such as Warfarin
Define: Eruption Cyst. What look like visually? What causes it? Where? How treated?
Blue/green layer of soft tissue around the crown of an erupting tooth. Condition can happen in both deciduous and permanent teeth, especially around the permanent first molars and incisors. The condition does not require treatment as teeth usually erupt through the cyst.
Type II diabetes: How does it work? What meds and/or devices are needed? Side effects?
Body cannot produce enough insulin or cannot use insulin properly. + Medication can be prescribed. Some cases can be controlled with diet and exercise (obesity is a risk factor for type II diabetes). + Drugs: repaglinide (Prandin), metformin (Fortamet), etc. Side fx: hypoglycemia (most common), poor wound healing, weight gain, and infections including periodontal diseases.
Type I diabetes: How does it work? What meds and/or devices are needed? Side effects?
Body cannot produce insulin. + Injections of insulin are needed. +Symlin (pramlintide) is a man-made form of a hormone. + Device that monitors and controls the release of insulin can be implanted in the body. Side fx: hypoglycemia (most common), poor wound healing, weight gain, and infections including periodontal diseases.
Before entering the oral cavity, the parotid duct pierces which muscle?
Buccinator. The parotid gland is located in the cheek area. Its duct travels through the buccinators before it opens into the oral cavity at the parotid papilla, opposite of the maxillary first molar. The buccinator is a thin muscle between the maxilla and mandible on the cheek area. It keeps the food pushed back when chewing, helps the sucking action, and expels air (also called the trumpet muscle).
What are inherent filtrations? How thick are they? What are added filtrations? How thick are they?
Built into the machine and include glass tube, oil, and 0.5-2 mm aluminum. Depends on kVp used (below 70 kVp=1.5 mm thickness of aluminum, at or above 70 kVp=2.5 mm thickness).
What's a nerve?
Bundle of neurons that connect the body parts to the central nervous system.
Bupivacaine: Is this brand or generic name? What's the other name? Where is this drug metabolized? What is this used for?
Bupi=generic (Brand: Marcaine) + Mostly metabolized in the liver. + Provides long (up to 12 hours) relief. Useful for surgeries.
Multiple Sclerosis: What it is, Who, When have symptoms, Causes, Symptoms, Oral Manifestations, DH Management
CNS degenerative disease - myelin of nerves is destroyed by immune system, disrupts communication between body and brain. Who: Mostly young adults When: Moments of symptoms followed by periods of remission, treat pt during remission Cause: Idiopathic Symptoms: Fatigue, slurred speech, muscle spasms, short-term memory loss Oral: Xerostomia from medications Manage: Muscle spasms
What causes Parkinson's?
CNS disorder caused by the death (or impairment) of dopamine-producing neurons in the basal ganglia of the brain. Dopamine and acetylcholine imbalance. + Dopamine: neurotransmitter that sends signals to places in the brain that are related to muscle control. Idiopathic
What's in the CNS vs. PNS? What types of nerves are in the PNS?
CNS=Brain & spinal cord PNS=all nerves outside of CNS. Communication between CNS & body PNS: + Motor (efferent): sends information to muscles and glands. + Sensory (afferent): gathers information from peripheral parts and sends them to the CNS.
What's a CCT, CAT, or CBCT? What does CBCT stand for? What do you use it for?
Cone beam computed tomography. Used for implant planning and soft tissue lesions, especially in salivary glands. Can provide a 3D image.
Community Periodontal Index of Treatment Needs: AKA? What does it measure? Used with what tool? Which teeth does it apply to? How do scores work? How do treatment needs correspond to score?
CPITN, Periodontal Screening and Recording (PSR) Measures: Pockets, bleeding, & dental biofilm retention factors Used with: CPITN-E probe (0.4 mm ball tip with a black band between 3.5-5.5 mm) Applies to: Divide mouth into 6 sextants; only evaluate a sextant if there are 2 or more teeth present and not indicated for extraction. Only highest reading in the sextant is recorded. Score: +0=Band is completely visible in the deepest pocket. Pocket depths < 3.5 mm; no calc or defective margins present; gingival tissues healthy w/no BOP + Code 1: Band is completely visible in the deepest pocket. No calc or defective margins; there is BOP. + Code 2: Band is completely visible in the deepest pocket; supra or sub calc present and/or defective margins . + Code 3: Band is partially visible in the deepest pocket, thus indicating a pocket that is > than 3.5 mm. + Code 4: Band is NOT visible in the deepest pocket of the sextant, thus indicating a pocket > 5.5 mm. Treatment needs: + 0 or 1: preventative care, biofilm control.+ + 2: preventative care and calculus removal, biofilm control. + 3: comprehensive periodontal assessment and treatment plan, counseling, biofilm control. + 4: comprehensive periodontal assessment and treatment plan for non-surgical periodontal therapy, counseling biofilm control.
Dentin contains what percent minerals? Which part of the tooth consists of mostly dentin?
Calcified tissue around the pulp under the enamel comprising approximately 70% minerals. Bulk of the crown
What is Leukemia? What's the difference between the 2 types? Recommended treatment? Symptoms (including oral conditions)?
Cancer of the body's blood-forming tissues, including the bone marrow and the lymphatic system. Results in an excessive number of abnormal white blood cells. + Acute leukemia: primarily affects children and young adults. Has good prognosis. + Chronic leukemia: primarily affects middle-aged adults. Progression is slow. Eliminate all infections and dental caries before cancer therapy. Fatigue, unexplained bruising, infections, paleness, weight loss. Oral conditions: gingival enlargement, necrotizing ulcerative gingivitis, bleeding gums, pallor of the lips and gingiva, petechiae and ecchymosis of the palate. + Cancer therapy can cause mucositis, xerostomia, ulcers, oral candidiasis, erosion (from vomit), etc. Advise the patient to sip water regularly, rinse after vomiting, and use fluoride to control caries. + If the radiation damages the major salivary glands, severe xerostomia will occur. + Patients can develop necrosis of bone from radiation therapy and are prone to rampant caries and oral candidiasis.
Define: Kaposi's Sarcoma. What is it associated with? What does it look like clinically? What causes it? Where is it?
Cancer of the lymph or the blood vessels. Caused by the human herpes virus (HHV-8) or Kaposi sarcoma-associated herpes virus (KSHV). Appears as a red/purple, flat, or raised lesion. Most commonly appear on the palate and gingiva.
Oral Pathology Related to HIV/AIDS: What 6 conditions?
Candidiasis Kaposi's Sarcoma. Herpes Major Aphthous Ulcers Hairy Leukoplakia Linear Gingival Erythema (LGE)
What is sharpness? What's penumbra? How can you increase sharpness? Smaller crystals produce (sharper or less sharp?) images. What causes fuzziness?
Capacity to produce details and distinct outlines. Blurring at the edges of a structure on a radiograph. Sharpness can be increased when: + Tungsten target of anode (focal spot) is small. + Object to film distance is short. HINT: want film NEXT to tooth + Tube (target) to film distance is long. HINT: Tube is long and far from film. Smaller crystals produce sharper images. Patient and tube head movements are the most important reasons for fuzziness.
What structures do occlusal films capture? What are they useful for?
Captures bone surrounding the teeth, floor of the mouth, sialolith (stone), supernumerary teeth, etc. + Useful when patient has limited jaw opening.
What does cocaine do the body? Symptoms of Cocaine Addiction? Treatment modifications?
Categorized as a psychoSTIMULANT and vasoconstrictor. HINT: Dilute your coke with water. Dilated pupils. dilated pupils, increased blood pressure, respiration, body temperature, and heartbeat. Avoid epinephrine if cocaine is used within 24 hours, as both are vasoconstrictors.
Pathology associated with Systemic Lupus Erythematosus? Who does it occur in? What causes it? Where is it?
Chronic inflammatory disease that can worsen when exposed to sunlight. Occurs three times more frequently in black women than in white women. "Butterfly" rash over the bridge of the nose that spreads to the cheeks, and erythematous lesions on the fingertips can occur.
What's a Circular white border? How do you fix it
Cone cut → PID should cover the entire surface of the film.
What does Methamphetamine do the body? Symptoms of Meth Addiction?
Categorized as a psychoSTIMULANT, more addictive and effects last longer than other drugs. Made of highly acidic ingredients, softens tooth enamel. Also increases anxiety so more likely to grind teeth. Arrhythmia, high blood pressure, and other CNS/heart conditions. Meth mouth: term for damaged teeth and oral health. Teeth are described as "blackened, stained, rotting, crumbling or falling apart." + Caused by dry mouth and longer periods of poor oral hygiene. While patients are under the influence of the drug, they often crave high-calorie, carbonated, sugary beverages. Teeth grinding and clenching are often noted.
Define: Mucous Membrane Pemphigoid. What causes it? What does it look like after healing? More or less severe vs. pemphigus vulgaris? Where is it? Who does it affect? Treatment? How do you determine if Pemphigoid vs. Pemphigus?
Caused by chronic autoimmune disease causing erosive skin lesions of the mucous membrane in various parts of the body. Not as severe as pemphigus vulgaris. Redness, tenderness of gum. Desquamative/sluffing gingivitis. Lesions heal with scarring. Most common site is the gingiva. Gingival lesions are called desquamative gingivitis. Would need biopsy to determine if GUS or GOID because with GOID, epithelium separates from CT border (basal layer) so about defective hemidesmosomes. Antibodies against hemidesmosomes. So sluffing occurs there--autoantibodies against basement membrane. Age : 40-55 years Gender: Females (2:1) Treatment: Corticosteroids
What's a pseudopocket?
Caused by gingival inflammation without loss of attachment. Also called a gingival pocket. A true pocket shows apical movement of the epithelial attachment.
Define: Peripheral and Central Giant Cell Granuloma. What is it caused by? Where does it occur? What does it look like clinically? Symptoms?
Caused by irritating factors such as dental implants. Occurs both on the gingiva (peripheral giant cell granuloma) and within the bone (central giant cell granuloma). The red/blue lesion may resemble a pyogenic granuloma and cause pain.
What does the periodontium consist of?
Cementum, alveolar bone, gingiva and PDL (perio fibers)
Who is the CDC (full name!)? What do they do?
Center for Disease Control and Prevention: federal organization that protects the nation from health, safety, and security threats.
The Infrahyoid muscles are innervated by which nerve(s)?
Cervical Nerves II and III - See Table 3 in Canvas (all are innervated by both C2 & C3)
Define: Focal Sclerosing Osteomyelitis. What does it look like radiographically? Symptoms? Where? How common is it?
Change in bone near the apex of teeth from a low grade infection from periodontal diseases, caries, etc. Lesion is usually asymptomatic because it is associated with pulpal death. Radiopaque area extends below the roots of the tooth and may expand the bone. Condensing osteitis is the most common tooth associated radiopacity viewed on dental radiographs.
What does LA do to the Threshold Potential? Also which type of LA blocks sodium channels?
Changes threshold potential so need more than 15 mV change (need to be positive more than 15 mV) to fire off an impulse. RNH+ (Nikki Honey) AKA amide
What is white coat hypertension?
Characterized by transient elevation of blood pressure by 10-20 mmHg, which is precipitated by a vigorous sympathetic response to the medical or dental setting. + This type of hypertension is estimated to occur in 12-50% of the population. + When abnormally high blood pressure is present, give the patient a chance to rest, and retake the blood pressure.
Who can't have fluoride toothpaste? How much do you use for what ages?
Children under 2-3 years old If using for those under 3, use smear layer or rice-size amount Pea-size amount for kids 3-6 years old
What's Periochip? What issues may you run into using it? How does it work? OHI?
Chlorhexidine chip is inserted into the periodontal pocket. + Chip may not properly fit into the pocket, especially if the pocket is shallow (less than 5 mm). + Chip is dissolved, no need to remove anything from the pocket. + Do not floss at sites for 10 days.
What do bronchodilators, short acting beta-agonists do? Examples of meds?
Choice for acute asthma. Albuterol (Ventolin, Proventil), etc.
Pathology associated with Papillon-Lefevre Syndrome? What causes it? What does it look like (in body and mouth)? Who gets it?
Chromosomal disturbance marked by destruction of the periodontal tissues and palmar/plantar hyperkeratosis (hyperkeratosis of the palms of the hands and soles of the feet). The condition occurs at a very young age. Permanent dentition erupts at the proper time, but all permanent teeth are lost before age 14.
Asthma: What is it? Who? Symptoms? Meds? Oral Conditions? Treatment mods? Can you use nitrous?
Chronic inflammatory respiratory disease in which the airways narrow, swell, and produce extra mucus. Can be triggered by stress, allergies, or exercise. Mostly diagnosed in childhood/adolescence and shows intermittent symptoms. Symptoms: difficulty breathing, tightening of chest, wheezing, and cyanosis. Meds: Albuterol (Ventolin, Proventil) is often used for quick relief. Oral conditions: oral candidiasis and xerostomia from inhaler use. Advise patients to rinse with water after use of inhalants. Avoid ultrasonic scalers and air polishers. Schedule appointments in the late morning or late afternoon, and maintain a less stressful environment. IT IS WORSE IN EARLY MORNING AND AT NIGHT (AND SLEEPING) Asthma is the only respiratory disease where nitrous oxide is recommended.
What's the most frequent form of periodontitis? Which bacteria are associated with it? Does the same condition with an implant count?
Chronic periodontitis. HINT: PG, TF, TD. Pig and toad sandwich with toffee in the middle. P. gingivalis, T. forsythia, T. denticola of red complex. YES, peri-implantitis=chronic periodontitis in tissues surrounding a dental implant
Criteria of an ideal index?
Clarity: the index rules are easy to understand by the examiner. Simplicity: the index is easy to apply. Objectivity: the index criteria are not ambiguous. Validity: the index measures what it is intended to measure. Reliability: the index measures consistently regardless of different conditions and examiners. Quantifiability: the data can be expressed in numbers. Sensitivity: the index detects small changes. Acceptability: the index is not harmful to the subject.
What is used if the patient has a penicillin allergy? Is it bactericidal or static? If static, how? Side effects?
Clindamycin. Bacteriostatic, interferes with bacterial protein synthesis. + Gastrointestinal cramps and nausea are very common. Discontinue if side effects are severe.
What what angle should a clinician stand while taking x-rays if no protective wall, and how far away?
Clinician should stand behind a protective wall. If a wall is not available, stand at least 6 feet from the source of radiation, at a 90-135° angle from the beam.
Define: Fordyce Granule. Who do you see it on?
Clusters of ectopic sebaceous (oil) glands. Ectopic=occurring in an abnormal position or pattern. Observed on lips & buccal mucosa. Clusters of tiny yellow lobules. 80% of adults have them
What's the Pterygoid plexus of veins?
Collect small blood vessels (PSA, IA, IO, facial, retromandibular, middle meningeal, etc.). +Plexus: large network of blood vessels. + Located behind the molars and nose towards the middle of the skull. + Its flexibility protects the maxillary arteries from being compressed during mastication (accommodate the movement of the mandible). + Improper administration of the PSA block can injure the plexus and cause a hematoma. + Infection in the plexus can spread to the cavernous sinus, which can become dangerous.
Herpangina and hand-foot-mouth disease: What virus causes it? Differences in location between the two? Treatment?
Common childhood diseases caused by the Coxsackie virus. In herpangina, ulcers appear on the soft palate, tongue, and throat accompanied by flu-like symptoms. In hand-foot-mouth disease, the painful rash can appear on the hands, feet, and mouth. Maintain good hydration during illness.
Define: Verruca Vulgaris. AKA? Which virus causes it? How transmitted? Where? What looks like? How treated?
Common wart A papillary oral lesion caused by one of the many types of the human papilloma virus (a wart is a painless growth on the skin). Virus is transmitted through direct contact. Lips are one of the most common intraoral sites. Appears as white, papillary, exophytic lesion. Need surgical excision at the base of the lesion.
What is the single most effective public health measure for preventing tooth decay? How expensive is it?
Community water fluoridation. 1 of the 10 greatest public health achievements of 20th century, as per CDC Water fluoridation is very inexpensive ($0.12 to $1.16 per individual/year) and saves money. + A lifetime of fluoridated water for an individual is less than the cost of a dental filling.
Define: Systematic Review. What level of statistical power does it have in research?
Comprehensive review of all relevant studies of a particular topic. More reliable and accurate than individual studies (RCT, cohort, case control & case series/report). For example, a literature search resulted in 30 studies on ultraviolet-blocking sunscreen and melanoma. The 30 studies were reviewed and the majority showed a strong positive relationship between daily use of sunscreen and a reduced appearance of melanoma.
What is color not a reliable indicator in the presence or severity of periodontitis?
Consistency: edematous tissue (spongy tissue), or smooth with a shiny appearance. In chronic conditions, the tissue is usually fibrotic (leathery).
Quaternary ammonium compound: What is it? What percentage alcohol? Substantivity?
Contains most commonly cetylpyridinium chloride (e.g., Pro-Health, Scope, Cepacol, Oral B Rembrandt, etc.). + May contain as much as 20% alcohol. + Very low substantivity, does not have the ADA Seal of Acceptance.
What's contract law? What are the two types of contracts? How can a contract be terminated?
Contract: agreement between two or more parties. + Implied contract: assumed agreement made in silence or with no action. + Expressed contract: oral or written agreement. Termination can be made by the client and/or the practitioner (after giving notice and chance to seek other options).
What do anti-GERD and anti-ulcer agents do? Side effects? Examples of drugs?
Control acid production. Side effects: halitosis, xerostomia, and taste alteration. Drugs + Histamine-2 receptors blockers: tagamet (Cimetidine), ranitidine (Zantac), etc. + Proton pump inhibitors: omeprazole (Prilosec), etc.
Which muscle draws the eyebrows medially and down?
Corrugator supercilli
In a lymph node: What's the cortex? Medulla? Lobules? ____ lymph vessels bring content into the node , ____ take it out.
Cortex is the outer layer of the organ and medulla is the inner core. Lobules are small divisions of the organ separated by connective tissue. Afferent vessels bring the content into the node and efferent vessels let the content out. Hilus is a depression where the vessels exit.
The Suprahyoid muscles have variable innervation by which nerve(s)?
Cranial nerves V, VII and XII and Cervical nerve I - See Table 3 in Canvas -Digastric - Anterior Belly, and Mylohyoid: Cranial nerve V - mylohyoid. -Stylohyoid : Cranial nerve VII - stylohyoid. -Digastric - Posterior Belly: Cranial nerve VII - posterior digastric. -Geniohyoid: XII & C1.
Prognosis (prediction of duration, course & outcome of a disease) for someone with perio disease (what's the McGuire Scale?)
Created in 1991: + Very good: less than 25% attachment loss. + Good: less than 25% attachment loss and/or class I furcation involvement. + Fair: 25-50% attachment loss and/or class I furcation. + Poor: 50-75% attachment loss and/or class II or III furcation, class II mobility. + Hopeless: over 75% attachment loss, class III mobility.
Criminal vs. civil law?
Criminal law: crime against the society (e.g., individual practicing dental hygiene without a license). + The case is filed by the government, and a guilty defendant is subject to custodial (imprisonment) or non-custodial punishment (fines or community service); and in exceptional cases, the death penalty. + E.g., theft, trafficking controlled substances, murder, etc. Civil law: crime against an individual. Includes contract and tort law. + The case is filed by a private party, and claimant must give proof. + Punishments include compensation (usually financial) for injuries or damages or an injunction in nuisance. + E.g., property dispute, personal injury, etc.
Recurrent vs. refractory disease?
Cur: News signs of destruction reappear after periodontal therapy caused by inadequate professional care or self-care. Frac: destruction despite appropriate professional care and self-care.
What are mores?
Customs of a group
Which drugs cause gingival enlargement?
Cyclosporine such as Sandimmune used to prevent organ rejection can cause gingival hyperplasia. Calcium channel blocker (end in -pine) such as nifedipine used for hypertension can cause gingival hyperplasia. Phenytoin (Dilantin) used as anti-seizure medication can cause gingival hyperplasia.
Spinal cord injuries: What it is, level of damage, types, where damage, Causes, Management
Damage to the spinal cord--the lower the site of injury, the less disability (further up=more limited movement everywhere and ventilator) Level of damage (cervical, thoracic, lumbar) Injury to: +C-2/C3: Limited head/neck movement, patient needs ventilator +C-4: Arm & leg paralysis, possible respiratory problems +C-5: Limited shoulder control, patient can eat +C-7: Hand, wrist, elbow, shoulder movement, can do self care +T-1 to T-12: Normal motor function of head, neck, shoulders, arms, hands and fingers with increased use of rib, abdominal, trunk. May use wheelchairs, crutches, or other aids. Types: Paraplegia, Quadriplegia Cause: Trauma Manage: Wheelchair, Loss of movement, Loss of sensation, Loss of bladder/bowel control - catheters, Skin pressure sores (decubitus ulcers).
Which teeth are most often ankylosed? What's another sign of it being ankylosed aside from what's seen radiographically?
Deciduous molars are most often affected by ankyloses. The ankylosed tooth is not exfoliated. Extraction of ankylosed deciduous teeth is necessary to allow eruption of the underlying permanent tooth. Appears submerged and has a different, more solid sound when percussed.
What do asthma drugs do? Examples of drugs (3 types)? Side fx?
Decrease swelling and mucous production in the lungs while relaxing the muscles of the airways. Drugs: + Bronchodilator, short-acting beta-agonist: choice for acute asthma. Albuterol (Ventolin, Proventil), etc. + Long-acting bronchodilators: relieve asthma symptoms for a long period of time. Salmeterol (Serevent), etc. + Corticosteroids: used for long-term asthma attacks. Fluticasone (Flovent), etc. Side effects: xerostomia and oral candidiasis.
What does an AED do? When do you use it? How do you use it?
Delivers electric shocks to the heart during a cardiac arrest, and helps the heart get back to its natural rhythm. Use as early as possible in CPR cycle (but start CPR while waiting for someone to grab AED), but only if a second person can go grab it--don't leave the patient to go grab it. +Use if patient is unconscious AND doesn't have a pulse + Secure a firm surface before providing AED shocks or CPR. + Place a board under the patient, or move the patient to a stable surface if necessary. + Turn on the power. + Attach the electrodes to the bare chest. + Clear the surrounding area. + Press, "analyze" and wait for instructions. "Shock" may be announced or continue CPR. + Remember to begin CPR before turning on the AED and start CPR again after the shock if CPR is still needed.
What are the primary factors (2) in the initiation and progression of caries and periodontal disease?
Dental biofilm & bacteria
What is the most common chronic childhood disease? How much more common is it vs. asthma?
Dental caries is the most common chronic childhood disease (five times more common than asthma) one of the major reasons for children to miss school days.
Who is the DHHS and what do they do?
Department of Health and Human Services: federal agency responsible for improving the health, safety, and well-being of Americans. + Generates the Surgeon General's reports. Healthy People 2020 (1,200 objectives in 42 topics, oral health is one of them).
Of the below, which are depressants and which are stimulants? Alcohol Amphetamines (Meth) Cocaine Opioids (Morphine, Heroin, Codeine) Nicotine
Depressants: alcohol, opioids (morphine, heroin, codeine), etc. Stimulants: amphetamines (methamphetamine), cocaine, nicotine, etc.
Contraindications for levonordefrin (Mepivacaine)?
Depression: If patient is on tricyclic antidepressant.
What's the difference between descriptive and inferential statistics?
Descriptive statistics: description of the data as is. Data is not used to make any further conclusions (e.g., test scores of 100 students are described). Inferential statistics: data is used to reach conclusions that extend beyond the immediate data alone. "Inferential" means to be expected, to be presumed (e.g., the test scores of 100 students are used to represent the school district's population).
What is the therapeutic action?
Desired result of a drug
Define: Case Report. What level of statistical power does it have in research?
Detailed description of an event, and a patient's profile. +For example, case report of Ebola by hospitals. Lowest level of statistical power (not much, if any)
What's sialography used for?
Detects salivary stones and other blockages.
What is the manual process for image processing?
Develop, wash, fix, wash, dry
What is the automatic process for image processing? How does it differ from manual?
Developer, fixer, water, and drying chamber. NO FIRST WASH like with manual processing. Developing solution works at higher temperatures and more rapidly.
Define: Lateral Periodontal Cyst. Difference in naming between if it's in the bone vs. soft tissue? What causes it? What look like radiographically and visually? Where seen? Symptoms?
Develops from the dental lamina, reduced enamel epithelium, or epithelial rests of Malassez. Appears as a radiolucent lesion located on the lateral aspect of a tooth root. If the cyst is located in the bone, it is called a lateral periodontal cyst; if the cyst is located in the soft tissue, it is called a gingival cyst. Appears as a small bulge or swelling of the attached gingiva or interdental papillae. Most often found in the mandibular cuspid (canine) and premolar areas. Cysts may be asymptomatic.
Which drug can exacerbate gag reflex?
Digitalis (digoxin) used for heart disorders
Define: Syphilis. What does it look like visually? Stages (3) and symptoms associated with each one? Which bacteria is it associated with (1 type)? How transmitted?
Disease caused by the spirochete bacterium Treponema pallidum. Usually transmitted through sexual contact (direct contact). Stages/symptoms: + Chancre: lesion of the primary stage, highly infectious. Heals spontaneously after several weeks without treatment. + Mucous patches: secondary stage lesions occurring about 6 weeks after the primary lesions. Appear as multiple painless grayish-white plaques covering ulcerated mucosa. The lesions of secondary syphilis are the most infectious. + Gumma: tertiary lesions occurring years after the initial infection if the disease is not treated. Non-infectious stage.
Celiac Sprue: What is it? Symptoms? Oral Conditions?
Disorder characterized by sensitivity to dietary gluten, a protein found in wheat. Gluten ingestion causes injury to the intestinal mucosa causing malabsorption of other nutrients. Symptoms include diarrhea and paresthesia of the extremities. Oral conditions: painful burning tongue (glossitis--smooth red tongue because no villi to absorb nutrients) and atrophy of the papillae of the tongue.
What causes hemophilia? What are the 2 types and which is more common? Oral conditions? OHI for patient?
Disorder in blood coagulation that results in prolonged bleeding. Plasma proteins involved in the coagulation cascade necessary for the conversion of fibrinogen to fibrin are insufficient. HINT: A sounds like 8. Type 8 has to do with Factor 8 def. B sounds like benign. Type B has to do with Factor 9 def. + Type A hemophilia: plasma thromboplastinogen (or factor VIII) deficiency. Most common type. + Type B hemophilia (Christmas disease): plasma thromboplastin (or factor IX) deficiency. Spontaneous gingival bleeding, hematoma, and ecchymosis. Patient should maintain healthy soft tissues to prevent gingival bleeding. Prolonged bleeding and hemorrhage after dental procedures may happen.
What does the control panel do?
Displays on-off switches & milliamperage/time/kilovoltage settings
What is dilaceration?
Distortion of root
What is dose equivalent? Units?
Dose equivalent: absorbed dose "adjusted" to the biological damage potential of the particular type of radiation. Some types of radiation produce greater effects than others. + Dose equivalent: Rem (Roentgen equivalent in man) (Standard system), Sievert (Sv) (SI system)
What is the LD 50?
Dose that is lethal in 50% of participants
Where is dose vs. response on an dose-response graph?
Dose=x Response=y
What's Darker film with outlines of many teeth? How do you fix it?
Double exposure → use film only once.
In terms of genetics, give an example of a genetic syndrome that causes patients to develop severe, aggressive periodontitis?
Down Syndrome
What is Periostat? What type of antibiotic?
Doxycycline capsules. Tetracycline.
What's Atridox? How does it work? OHI?
Doxycycline gel (derivative of tetracycline) is inserted into the pocket (by cannula tip). + Gel dissolves - no need to remove anything from the pocket. + Do not brush or floss at sites for 7 days.
What is Atridox? What type of antibiotic?
Doxycycline gel. Tetracycline.
How does mouth breathing put you at increased risk for perio disease?
Dries out gingival tissues
What causes anemia?
Drop in oxygen-carrying hemoglobin in red blood cells.
Who is in charge of enforcing laws and setting the abuse potential (controlled substances) in the US?
Drug Enforcement Agency (DEA)
How does subcutaneous administration work? When is it used?
Drug is injected under the skin but not into the muscles. + Useful for protein products such as insulin that would otherwise be digested in the intestines.
What is the first-pass effect? Which methods of enteral administration avoid this effect?
Drug metabolizes in the GI and liver before it reaches the systemic circulation) - significantly reduces the amount of drug available. +Sublingual +Rectal
Where do opiates come from? How do they work? What are they used for? Side effects? Drugs used to treat opioid overdose (opioid antagonist)? Examples of opioids?
Drugs from the plant opium poppy (Papaver somniferum). HINT: SLOPI=Slow Opioids. Makes things slow (bowel, breathing, thinking). Depress the central nervous system (CNS) and suppress pain pathways by binding to opioid receptors mu (μ) and kappa (ƙ). Used as analgesics and for sedation. Side effects include euphoria, sleep, respiratory depression, constipation, and miosis (pinpoint pupil). + Cocaine abusers exhibit dilated pupils (mydriasis). + Opioid triad: coma, respiratory depression, miosis. Naloxone (Narcan) is an opioid antagonist and used to treat opioid overdose. Drugs Codeine + Tylenol + codeine = Tylenol 3 Oxycodone +Morphine + Oxycodone + acetaminophen = Percocet. + Oxycodone + aspirin = Percodan.
Side fx of Ecstasy?
Dry mouth that causes cavities and gum disease. Bruxism
How does film duplication work?
Duplicating film is coated only on one side. Used for insurance, referral, etc. Place original film next to the light source and duplicate film on top of it.
What is pharmacodynamics? What is pharmacokinetics?
Dynamics: What the drug does to the body (kill you, side effects, effective). Study of effects of drugs and their mechanisms of actions (MOA). Kinetics: What your body does to the drug (metabolize, absorb, excrete).
Early Childhood Caries Index: AKA? What does it measure?
ECC Measures: Presence of 1 or more decayed surfaces in a child younger than 6 years.
Eastman Interdental Bleeding Index: AKA? What does it measure? What product do you use with it? How do scores work?
EIBI Measures: Presence of gingival disease by assessing bleeding. Use: Insert triangular wooden interdental cleaner into IP area and record if bleeding after 15 sec. Score: 0=no bleeding, 1=bleeding
What's a teratogenic effect? Example?
Effect of drugs on fetus development. Tetracycline staining on child's teeth
What is the ED 50?
Effective dose that produces desired response in 50% of the participants
At what age do patients have the highest rate of perio disease? Why?
Elderly patients. Factors RELATED to old age (not just age itself), such as lack of dexterity, soft diet, or medication contribute to the disease.
What is electromagnetic radiation?
Electric and magnetic fields of energy that move through space in a wave-like motion. Includes radio waves, microwaves, visible light, UV rays, x-rays, and gamma rays (from low to high energy). Only high-energy waves have ionizing capability.
What is Characteristic Radiation?
Electrons from the cathode dislodge electrons from the inner orbital K/L shell of the tungsten atoms. When the electrons of the inner shells are dislodged, electrons from other orbits fill the empty space left by the ejected electron. During this process, energy is produced. Not as significant a source of x-rays as braking radiation.
Endemic vs. Epidemic vs. Pandemic?
Endemic: disease occurring frequently and at a predictable rate in a specific location or population (e.g., malaria in many African countries, chicken pox in North America). Epidemic: disease unexpectedly large in number that spreads rapidly through particular segments of the population (e.g., in 1952, polio spread nationwide in the U.S.). Pandemic: disease that occurs throughout the population of a country, people, or the world (e.g., Black Death of the 14th century killed between 75 and 200 million people in Europe).
What's the safest, slowest, and most variable route for administration of a drug? What 3 ways can drugs be taken?
Enteral administration. Uses GI tract. Drug can be: +Taken orally (swallowed) +Placed under tongue (capillaries under tongue speed up absorption--commonly used for nitrates, relieves cardiac conditions) +Inserted in rectum
What's an example of intramuscular administration of a medication? How quickly is the drug absorbed? How can you speed up absorption?
Epi pen. Drug is injected into muscles because of the high volume of blood flow in those areas + Absorption is rapid and is increased when massaging the area.
Which muscle raises the eyebrows?
Epicranial
Oral Pathology Related to Oral Appliances: What 3 conditions?
Epilus Fissuratum Papillary Hyperplasia of the Palate Denture Stomatitis
When is the permanent dentition complete?
Eruption of third molars at 17-21 years.
What is the most numerous type of cell present in blood? What does it contain that transports O2 through the body?
Erythrocytes (RBC) 5000-10K/mm3 present in blood. Hemoglobin
Esters vs. Amides: Naming conventions
Esters have one "i", Amides have 2 "i"s. Benzocaine=ester Lidocaine=amide
What bone forms the anterior part of the nasal septum?
Ethmoid
What is a lateral jaw exposure? What do you use it for?
Evaluates the posterior portion of the mandible or lateral areas that are too large to capture for periapical films.
Define: Simple Random sampling. Whose bias does it prevent, if any (researcher, examiner, etc)? Is this the least bias way to sample?
Every member of the population has an equal chance of being selected. Prevents researcher bias (e.g., picking a name out of a phone book). YES, least bias way to sample.
What's Hyperpituitarism? Type in childhood vs. adulthood? Oral Conditions?
Excessive hormone production by the anterior pituitary gland (pea-sized organ found at the base of the brain that produces hormones including growth hormone). Gigantism: increase in growth hormone production during childhood. Acromegaly: increase in growth hormone production during adulthood. Oral conditions: enlargement of the maxilla and mandible causing SEPARATION OF TEETH and malocclusion, thickened lips and macroglossia (enlarged tongue).
Are major and minor salivary glands exocrine or endocrine glands?
Exocrine
What's the ALARA concept?
Exposure should be kept to a minimum and benefits should outweigh the risks for the patient.
Saliva contains what three inorganic components that help with remineralization?
Fluoride, calcium, & phosphate
External vs. internal resorption?
External: part of the external surface of the tooth is lost. Can be related to orthodontics. Missing apex of root, for instance. Internal: Internal part of the tooth structure is lost. Can be related to pulpal injury. Radioluscency within root that is round-shaped, for instance.
What's Abandonment?
Failure to provide services after contract.
T/F: Absence of bleeding guarantees complete absence of perio disease.
False. It's a good predictor of stability, though.
Pathology associated with Gardner Syndrome? AKA? What causes it? What does it look like (in body and mouth)? Who gets it? Radiographically?
Familial Colorectal Polyposis HINT: COLO=o=odontoma & osteoma=radiOpaque=polyps are round like an o Radiographic: Radiopacities in pano Microscopic: Odontomas and Osteomas in jaw, polyps in intestine, malignant epilthelial growths (carcinomas) Caused by a chromosomal disturbance, and characterized by the presence of osteomas in bones. Teeth can exhibit hypercementosis and fail to erupt. Related to intestinal polyps that can become malignant at age 30 and after.
3 components for the formation of caries?
Fermentable carbohydrate, bacteria, and tooth structure
What does the gingiva look like in someone with chronic gingivitis (consistency?) and why?
Fibrotic because after having gingivitis for months or years, the body may attempt to repair the tissue by forming new collagen fibers, which gives the gingiva its leathery appearance. Excess collagen fibers mask the redness, making the tissue appear healthier than it actually is.
What kind of response does SANS create? What does the response look like (bronchi/pupils, heart rate/respiration, perspiration/arterial blood pressure, digestive activity)?
Fight or flight Bronchi/pupils: Dilate (let more light in) HR & Respiration: Accelerate Perspiration & Arterial BP: Increase Digestive activity: Decreases
What's a dosimeter?
Film badge that measures exposure to radiation. Worn at waist
What do lymph nodes do? What type of cells do they contain? In a healthy patient, are they big or small? Hard or soft? Mobile or immobile?
Filter lymph fluid, trap infectious agents, and prevent them from entering the bloodstream. Composed of organized lymphoid tissue and contain lymphocytes that remove toxins. Small, soft, mobile in healthy patient. Large and hard if diseases present
What is plaque-induced gingivitis vs. non-plaque induced?
First type: food impaction under the margins of restorations causing plaque accumulation Second type: gingival inflammation as a manifestation of systemic diseases
The ___ soft palate muscles (part of muscles of the pharynx) are?
Five. • Palatoglossus • Palatopharyngeus • Levator veli palatini • Tensor veli palatini • Uvula muscle
Examples of endogenous intrinsic stain
Fluorosis, tetracycline stain During tooth development, within tooth
Define: Dentigerous Cyst. AKA? What causes it? What does it look like radiographically and visually? How common? Where?
Follicular cyst Formed from the accumulation of fluid between the reduced enamel epithelium and the crown of an unerupted or impacted tooth. Commonly appears around the crown of an impacted mandibular third molar as a well-defined unilocular radiolucency. Second most common ODONTOGENIC (has to do with tooth development) cyst after a periapical cyst. When enlarged, it is capable of displacing teeth or causing fractures in the affected area.
Blood Pressure: What is it? Normal vs. Elevated vs. Stage 1 vs. Stage 2 vs. Hypertensive crisis? When should you retake BP (which level of the above) after 5 min? What should you do if patient has a BP in Stage 2 or Crisis? What's the Systolic BP? What's the Diastolic BP?
Force against the walls of the blood vessels during contraction and relaxation of the heart. + Normal: Less than 120/80 mm Hg + Elevated: Systolic between 120-129 AND Diastolic less than 80 mm Hg + Stage 1: Systolic between 130-139 OR Diastolic between 80-89 mm Hg; + Stage 2 (retake after 5 min): Systolic at least 140 OR Diastolic at least 90 mm Hg <Get Med consult, but not a medical emergency + Hypertensive crisis (retake after 5 min): Systolic over 180 AND/OR Diastolic over 120 mm Hg. <IMMEDIATE Medical Attention is needed OLD VERSION: Normal: <120 & <80 Prehypertension: 120-139 or 80-89 Hypertension Stage 1: 140-159 or 90-99 Hypertension Stage 2: >=160 or .=100 Hypertensive Crisis >180 / >110 Systolic BP: force exerted during ventricular contraction. "Korotkoff sounds" are the sounds made by the vibrations of an artery under pressure. Diastolic BP: resting pressure with ventricular relaxation.
How is patient positioned for pano?
Frankfort plane should be parallel to the floor (Frankfort plane: line from the bottom of the orbit and the top of the auditory meatus). Lead apron is worn with the open side to the front to protect the back and shoulders. No thyroid collar, causes "shark's fin" artifact. All jewelry (tongue ring, earrings, necklaces, etc.), glasses, and removable oral appliances should be taken out as ghost images can occur. Chin is tipped slightly down, and patient should look forward and down towards the floor (this elevates the posterior palate so it does not overlap with the apices of the maxillary teeth). Midsagittal plane should be perpendicular to the floor. Avoid slumping of the neck by bringing the patient forward to bite the block. Patient holds onto the handle and leans back. Right before the exposure, patient should swallow and lift the tip of the tongue up to the roof of the mouth. Failure to do this will result in shadows over the maxillary teeth.
How long does primary dentition last? When does last primary tooth erupt (and which tooth)?
From 6 months to 6 years. Ends when first perm tooth (mand 1st molar) erupts. Max. second molar at 25-33 months (2-3 years old).
Developer vs. fixer: Which turns it black vs. white?
HINT: BD, FW. Developer black (changes crystal color). Fixer white (removes crystals).
Limitation of radiographs for perio eval
Furcation involvement cannot be exactly identified because the buccal and lingual alveolar bones are superimposed and angles of the roots can mask bone defects. For bone loss to be diagnosed from a radiograph, 40% bone loss must have already occurred. Therefore, radiographs may not detect early signs of periodontitis. Shape of the bony defect (irregular shape of the bone) cannot be accurately identified. The dental professional may need to "open" the area to evaluate the shape and severity of bone loss. Radiographs do not reveal soft tissue margins (periodontal pockets) and tooth mobility.
What's the difference between a gingival, periodontal, and periapical abscess? Which is most common, then second most common type?
G: Infection of the surface gingiva and interdental papillae without affecting the tooth or PDL. PD: Infection on the lateral aspect of tooth that begins in periodontal pockets. May develop after periodontal debridement. + Second most common type of dental abscess. + Fistula (opening to the outside) can develop. Tooth is vital and patient can experience acute or dull pain (if infection is chronic). PA: Results from pulp infection, commonly related to deep tooth decay. + Most common type of dental abscess.
Gingival Bleeding Index: AKA? What does it measure? What product do you use with it? How do scores work?
GBI Measures: Presence of gingival disease by assessing bleeding. Use: Floss inserted into IP areas below gingival margin & observe if bleeding after 30 sec. Score: 0=no bleeding, 1=bleeding
Gingival Index: AKA? How often is it used? What does it measure? Which teeth does it apply to? How do scores work? What is it typically used for?
GI Most freq. used to evaluate gingivitis Measures: Color, consistency, & bleeding of gingiva Applies to: Used on all or 6 teeth. Divide teeth into 4 areas (disto-facial, facial, mesio-facial, lingual) Score: 0=normal; 1=mild inflammation, sl. color change or edema, no BOP; 2= mod. inflam, redness, edema, glazing, BOP, 3=severe inflam, marked redness and edema, ulceration, tendency to spontan bleed. 0.1-1=mild gingivits 1.1-2=mod gingivits 2.1-3=severe gingivitis Used for: Individual or group studies
What's a diastema? Causes?
Gap between 2 teeth. Can be congenital or caused by changes in the oral environment such as high frenum pull or loss of teeth.
Define: Leukoedema. Who do you see it on?
Generalized gray opalescence on the oral tissues, especially the buccal mucosa. Cannot be rubbed off but disappears when the tissue is stretched. Most commonly observed in black adults and smokers.
What is Von Willebrand Disease? Symptoms? What can it be confused for?
Genetic condition causes extended or excessive bleeding. Von Willebrand factor is a protein for blood clotting. Red/blue discoloration of the skin or mucosa, excessive bleeding, frequent nosebleed, easy bruising, etc. Patients may have prolonged bleeding and hemorrhage after dental procedures. When patients present with bruise-like marks, before suspecting abuse, review medical history.
Marfan Syndrome: What is it? Symptoms? Oral conditions?
Genetic disorder that affects the body's connective tissue. Patients are usually very thin, tall, and often have heart problems. Oral conditions: high palate, narrow jaw, crowding of teeth, and malocclusion.
Oral conditions of epileptic (seizure) patient.
Gingival hyperplasia from seizure medications such as phenytoin (Dilantin). Trauma to tissues during seizure activity. Avoid light in patient's eyes--can trigger seizure
How do you measure attached gigiva?
Gingival margin measurement outside pocket to mucogingival junction - probing depth
What is the thyroid? What does the thyroid do? Where is it in relation to the thymus?
Gland of the neck. Largest endocrine gland (ductless) that has 2 lobes. Located below thyroid cartilage at junction between larynx and trachea. Secretes thyroxin, hormone that stimulates metabolic rate. If enlarged, firm, and tender=goiter (hypothyroidism) Above the thymus
What is the thymus? What does it do? Where is it in relation to the thyroid?
Glands of the neck. 2 identical sized lobes Located behind sternum and way below thyroid gland. Allows T-lymphocytes to mature. Shrinks after puberty
What is the parathyroid? What does it do? Where is it in relation to the thyroid?
Glands of the neck. 4 tiny glands, located behind thyroid gland, secretes regulatory hormones
Articular fossa: AKA? which bone is it on? What is its purpose? Where is the articular eminence in relation to it?
Glenoid or mandibular fossa. Temporal bone location of articulation Articular eminence is anterior to the articular fossa.
Nevoid Basal Cell Carcinoma Syndrome: AKA? What causes it? Characteristics visually and radiographically? What are these patients prone to?
Gorlin Syndrome HINT: Neil Gorchich is pale=Nevoid, Gorlin, radioLUCENT because he lives in Oklahoma, OKC Clinical: Basal cell carcinomas on skin Radiographic: Radiolucencies in pano, bifid ribs. Microscopic: OKC in mandible, basal cell carcinomas Inherited condition that causes abnormalities in the skin, nervous system, bones, etc. Nevus (plural nevi): congenital lesion characterized by pale brown skin pigmentation. Palms of hands and soles of feet show small dark pits that can easily get filled with dirt. People with this syndrome are particularly prone to skin cancers. Patients may have multiple cysts of the jaw that are odontogenic keratocysts.
Which types of bacteria (+ or -, and shape) are prevalent within 2 days of plaque accumulation?
Gram + cocci
Which types of bacteria (+ or -, and shape) are prevalent within 2-4 days of plaque accumulation? Which are there more of?
Gram + cocci: More of these Gram + rods (bacillus) appear
Streptococcus bacteria are gram + or -? Motile or non-motile? Shape?
Gram + non-motile cocci
Gram + vs. -: Number of walls, and what the bacteria release?
Gram +: 1 thick, single-cell wall, release exotoxin Gram -: Double-cell walls, release endo and exotoxin.
Which types of bacteria (+ or -, and shape) are prevalent within 4-7 days of plaque accumulation?
Gram - spirochetes (spirals) and vibrios (comma shaped) appear
What type of bacteria (+ or -, motile or non, ana or aero, shape) are associated with periodontitis?
Gram -, motile, anaerobic, rod-shaped
Which types of bacteria (+ or -, and aerobic or ana) are prevalent within 14-21 days of plaque accumulation (and what do they do)? What is visible.
Gram -/anaerobic bacteria are prevalent, gingivitis is visible
Which types of bacteria (+ or -, and aerobic or ana) are prevalent within 7-14 days of plaque accumulation (and what do they do)? What begins?
Gram -/anaerobic bacteria duplicate, inflammation begins
What is the function of molars?
Grind food, assisted by premolars
COPD (Chronic Obstructive Pulmonary Disease): What is it? Types? Cause? Who? Symptoms? Oral Conditions? Treatment mods? Can you use nitrous?
Group of lung diseases that block airflow in the lungs. Types: HINT: Blue bloater=Chronic bronchitis=I got bronchitis as a kid.=inflamed bronchial tree so secretes more mucous. Pink puffer=emphysema=air sacs (alveoli) at end of smallest air passages (bronchioles) in lungs are destroyed. Barrel chest. Cause: smoking. Who: Most common in adults and conditions are chronic. Symptoms" shortness of breath, cough, sputum, and wheezing (asthma-like symptoms). Oral conditions: oral candidiasis and xerostomia from inhaler use. Advise patients to rinse with water after use of inhalants. Avoid ultrasonic scalers and air polishers. Patients may not be able to breathe easily in a supine position, may need supplemental oxygen. Avoid nitrous oxide.
What is Osseous/Flap Surgery? Also Perio Flap Surgery?
Gums are lifted away from the tooth and surrounding bone to allow access for deep cleaning of the root surface, removal of diseased tissue, and repositioning/shaping of the bones/gum/tissues supporting the teeth. The diseased root surfaces are cleaned and curetted (scraped) to remove deposit. Gum tissue is replaced into position to minimize pocket depth.
Herpes: Types?
HHV-1 through HHV-8 HHV-1 & 2: Herpes simplex virus (HSV) - cause oral symptoms like skin, lip & mucosal tingling followed by ulcerative and eruptive lesions. Varicella-zoster: human herpes virus three HHV-3 - causes chickenpox and shingles.
What COPD medication is used? What is it used for?
HINT: A, COPD. A COP. A=Atrovent. COPD. Ipratropium (Atrovent) prevents wheezing, shortness of breath, coughing, and chest tightness.
Define: Meta-analysis. What level of statistical power does it have in research?
HINT: Mindy's System is Random, so her Cohort tries to Control her Report. Meta-analysis, Systematic Reviews, RCT, Cohort, Case control, Case report Has the highest statistical power in research. Comprehensive review of all relevant studies of a particular topic. Researcher pools populations from all of them. The total numbers of subjects are treated as one large study population. For example, a MEDLINE search resulted in 8 randomized controlled studies, each with 100 to 120 subjects. The subjects from all eight studies (total: 860 subjects) were pooled and statistically analyzed to determine the relationship between sunscreen and melanoma.
Olfactory: Afferent or Efferent? What does it do?
HINT: Some Say Marry Money, But My Brother Says Big Brains Matter More + Afferent. + Carries odor from the nose to the brain.
Developing: What is the reducing agent? What does it do?
HINT: Elon Reduced the price of HYDRO-planes. Hydroquinone or elon - reduces exposed silver halide crystals into black metallic silver.
Types of oral health examination: Difference between Type 1 (complete examination) & IV (screening)? Instruments/tools needed for each one? Which is used in public health surveys?
HINT: Type I=all in ONE. Everything. Type III=only 3 things. Mirror, explorer and light. Remember it's explorer because would never PROBE a young child. Type IV=For=forward, stick your tongue forward. Tongue depressor and light only. + Type I: complete examination. Need mouth mirror, explorer, light, radiographs, study models, and tests. Seldom used in a public health setting. + Type II: limited examination. Need mouth mirror, explorer, light, bitewings, and selected periapicals. + Type III: inspection. Need mouth mirror, explorer, and light only. Most used method in public health surveys. + Type IV: screening. Need light and tongue depressor only. Too unreliable for public health surveys.
14 Facial Bones?
HINT: Veronica (Vomer) Never (Nasal) Makes (Maxillary) My (Mandibular) Nice (Nasal Conchae--Inferior) Pet (Palatine) Zebra (Zygomatic) Laugh (Lacrimal). Why? Because she wears fur (think of Veronica from Riverdale) Mandible (1) Vomer (1) Maxillary (2) Nasal (2) Inferior Nasal Conchae (2) Zygomatic (2) Lacrimal (2) Palatine (2)
What do calcium channel blockers do? Oral side fx? Drugs?
HINT: -Pine. California has a lot of PINE trees. California=calcium channel blockers REMINDER: Ca2+ has to ENTER the cell in order to start process of muscle contraction. Relax the blood vessels by inhibiting calcium (needed for muscle contraction) from entering cells of the heart and blood vessel walls. Can cause gingival hyperplasia. Drugs: nifedipine (Procardia), diltiazem (Cardizem), amlodipine (Norvasc), verapamil (Isoptin), etc. ~PINE.
What do ACE inhibitors do? How do they do it? What does ACE stand for? Side fx? Drugs?
HINT: -Pril, add an A to get April. A also starts out ACE. April ACED the test. HINT: In April there are a lot of allergies which can cause a cough. Angiotensin Converting Enzyme Reduce the constriction of blood vessels by INHIBITING THE ENZYME THAT PRODUCES angiotensin II, a substance that narrows the blood vessels. Can cause dry cough. Drugs: enalapril (Vasotec), lisinopril (Zestril, Prinivil), etc. ~PRIL.
What do ARB receptor blockers do? How do they do it? What does ARB stand for? Drugs?
HINT: -Tan. Arm is tan. ARB. HINT: B for blocking the action. BLOCKING THE ACTION OF angiotensin II (natural substance that narrows blood vessels). Drugs: losartan (Cozaar), etc. ~TAN.
What do diuretics do? How do they do it? Is this a first, second, or third line therapeutic agent for hypertension? Examples of this drug?
HINT: -ide if you get rid of the e, just have id, and if you flip that you get di. One type of drug starts with di, and that's diuretics. Remove water and reduce blood pressure. Block the sodium reuptake in the nephrons (loop of Henle) in the kidneys. As a result, more water is excreted from the body, decreasing the blood volume and peripheral resistance. Also called "water pills." + Loop of Henle's main function is to recover water and sodium chloride from the urine to limit the amount of water intake needed for survival. +First line of therapeutic agents for hypertension. Drugs: hydrochlorothiazide (HCTZ), furosemide (Lasix), etc.
What do beta blockers do? How do they do it? Which receptors do they target and what do those 2 receptors do? Examples of drugs? Contraindications? Local anesthetic MRD (in carps and mg of epi) for those taking ___-____ beta blockers? Other uses of beta blockers?
HINT: -olol is like 2 ds next to eachother but mirrored makes 2 bs. dd=bb for beta blocker Reduce cardiac output by slowing down the heartbeat and decreasing the force of contraction. + Target the beta-adrenergic receptors of the heart responsible for increasing the cardiac output. HINT: 1 heart=beta 1, 2 lungs=beta 2. Heart contracts and turns to stone, lungs dilate and melt + Beta 1 receptors increase heart muscle contraction. + Beta 2 receptors relax bronchial smooth muscles. Drugs + Selective beta blockers: target beta 1 receptors. E.g. Atenolol (Ternormin), metoprolol (Lopressor), etc. ~OLOL. + Non-selective beta blockers: affect both beta 1 and beta 2 receptors. The cardiac output decreases, but the bronchi constrict. E.g. Propanolol (Inderal), timolol (Timoptol) etc. ~OLOL. + Contraindicated for patients with asthma. + MRD (Maximum Recommended Dose) for local anesthesia is two cartridges or 0.04 mg of epinephrine for patients taking non-selective beta blockers. Beta blockers are also used for cardiac arrhythmia, angina pectoris, myocardial infarction, and anxiety management.
What causes Pernicious anemia?
HINT: 12 like December when holidays are which is harmful for wallet. Pernicious=harmful. B-12. B-12 (cobalamin) deficiency triggered by a lack of intrinsic factor (which is secreted by parietal cells of stomach, helps absorption of B-12 in small intestine)
Which bones form the rim of the orbit?
HINT: 3 Frontal, Maxilla, Zygomatic
What is a maximum permissible dose (MPD)? What is it for an occupational person (in rem, mrem, msv)? A non-occupational person? How do you calculate it?
HINT: 5 rams are in my living room. Occupational dose=5 rems/yr. Dose of radiation not expected to produce any significant radiation effects. MPD for an occupational person: 5 rem/year (5000 mrem), or 50 msv/year. MPD for a non-occupational person: 10% of worker amount, or 0.5 rem (500 mrem), or 5 mSv/year. Maximum accumulated dose = 5 rem x N - 18 (N = age) For pregnant patients, use non-occupational dose.
In ADPIED with community health, what are the first two steps?
HINT: ADPIED. A=Assessment in private practice, but Surveying in community health. D=Diagnose in priv pract, but Analysis and prioritizing needs in comm health
Lipoma: Is it benign or malignant? What does it look like visually? Where do they occur?
HINT: Appearance is like fat, which is yellow. Where is there fat in our mouth? In your cheeks (buccal mucosa) and nearby vestibule. Benign tumor of mature fat cells that appears as a yellow mass. Buccal mucosa and vestibule are most common intraoral locations.
Define: Denture Stomatitis. AKA? What does it look like clinically? What causes it? Where is it? Treatment?
HINT: Appearance? itis->inflammation->red Location? Area in contact with appliance. Commonly affects the palate and maxillary alveolar ridge. Also called chronic atrophic candidiasis, it is an inflammatory response to irritation from oral appliances (usually removable dentures). Asymptomatic and is usually discovered by the dental professional during oral examination. Remind patient to remove the prosthetic at night, clean the denture and the mucosal area in contact with the denture.
What is (Nizatidine) Axid® treat?
HINT: Axid like acid. Nizatidine like DINE (help with stomach) Stomach conditions
What is Agranulocytosis? How many granulocytes are there usually per microliter of blood? What about with Granulocytopenia and Agranulocytosis? Oral conditions?
HINT: BEN joined the Navy. All WBC are military, subdivides into navy and airborne. BEN=basophils, eosinophils, neutrophils. Navy defends, with not enough defenders get chronic infections. Significant reduction in circulating granulocytes (neutrophils, eosinophils, and basophils) which play an important role in the immune system. + Normally there are at least 1500 per microliter of blood. + Granulocytopenia: the level is between 100-1500 per microliter of blood. + Agranulocytosis: the level drops below 100 per microliter of blood. These conditions lead to the development of chronic infections and can be life-threatening. Oral conditions: necrotizing ulcerations, bleeding gingiva, and rapid destruction of the periodontium.
Pano errors: How do you fix anterior teeth thicker & wider?
HINT: Back=fat chin placed behind the focal trough → reposition the chin forward, bite at the notch of the stick.
Basal Cell Carcinoma: Is it benign or malignant? How common is it? What does it look like visually? Where do they occur? What causes them?
HINT: Basil leaf that's round -> rolled. You hate basil, don't want to eat it --> doesn't occur in oral cavity. Basil needs a lot of sun to grow --> assoc. with sun exposure Malignancy of basal cells (deepest layer in epidermis; melanocytes are found in this layer). Associated with excessive sun exposure. Most common type of skin cancer. Doesn't occur in oral cavity. Characterized by non-healing ulcers with rolled borders.
Abfraction vs. Abrasion?
HINT: Brasion=bra=caused by something else Fraction=fract=tooth on tooth causing it to fracture. Fract: Biomechanical destruction related to fatigue, flexure, and deformation of tooth structure. Can appear as a WEDGE-shaped lesion at the cervical third of the tooth. Bras: Mechanical destruction of the teeth. Results from forces of friction between teeth or external objects. Can happen from improper brushing technique, parafunctional habits such as using a toothpick or pipe. V-SHAPE NOTCH in the gingival portion of the facial aspect of the teeth is the most common example of abrasion by tooth brushing.
What's contrast? What's it dependent on? What does increasing that do? Which setting is best for bone abnormalities vs. detecting caries?
HINT: C in contrast sounds like K. Contrast is controlled by kVp. The difference between lighter and darker shades of grays on a radiograph. Dependent on kVp. HINT: High kVp means LOTS of shades of gray, but considered low contrast because there's not much difference between each shade of grey. Low kVp means FEW shades of gray, but considered high contrast because there's a BIG difference between each shade of gray. Increased kVp (long-scale contrast, low contrast) results in many shades of gray (long-scale contrast, low contrast), which is best for detecting bone abnormalities. Decreased kVp (short-scale contrast, high contrast) results in more black and white areas (short-scale contrast, high contrast), best for detecting caries.
What is concrescence?
HINT: C=Cementum. two adjacent teeth are united by cementum only.
What causes gingival hyperplasia?
HINT: CIA Calcium Channel BLockers (nifedipine AKA Procardia) Immunosuppresive medications (cyclosporine AKA Sandimmune) Anti-seizure medications (phenytoin AKA Dilantin)
Define: Compton Scatter. Responsible for ___ interactions with the matter in dental x-rays (around ___%).
HINT: COMMON. Compton is more COMmon. Ionization occurs. A photon interacts with an outer shell electron of a matter. Photon loses energy but continues to travel, and the electron is ejected. It is always easier to hit the outer shells than it is to hit the inner shells because the outer shell is bigger and contains more electrons. Photoelectric scatter, on the other hand, interacts with the inner shells, and is, therefore, less common. Most, 60%
Define: Cherubism. Who does it effect? What does it look like? What is it associated with? How does it affect oral cavity?
HINT: Cheru->cherry->Child (under 20) likes cherries, stuffs them in his mouth and cheeks->expansion of mandible and maxilla. Cherry is fibrous (as a fruit)->bone is replaced by fibrous tissue. Kid bites on the seed in the cherry and it causes their tooth to break and fall out->Premature loss of teeth. Hereditary condition where the bone in the mandible is replaced by excessive fibrous tissues. Often affects individuals under the age of 20. Characterized by bilateral mandibular and maxillary expansion. Also causes premature loss of the primary teeth and non-eruption of the permanent teeth.
What's fenestration?
HINT: Chuckie Finster looking out the window. Window of bone loss on facial or lingual. "Window" of bone loss on the facial or lingual aspect of a tooth that places the exposed root surface directly in contact with gingiva or alveolar mucosa. It can be distinguished from the dehiscence in that the fenestration is bordered by alveolar bone along its coronal aspect.
Define: Coherent Scatter/Thompson Scatter. Responsible for ___% of interactions with the matter in dental x-rays.
HINT: Coherent, stable, not changing. So NO ionization. 8% Photons interact with an outer shell electron but the matter is not altered. Photons continue to travel with no loss of energy. Ionization does not occur.
Condylar Process vs. Coronoid Process?
HINT: Dialing an old school phone=condylar Condylar articulates with Temporal Coronoid is anterior
For CHF, what drugs should you remember?
HINT: Dig a Lane digoxin (Lanoxin) HINT: Digital phone with a Crystal case digitalis (Crystodigin)
Nasopalatine Canal Cyst: What does it look like visually vs. radiographically? Where do they occur?
HINT: Dog's NOSE is heart-shaped and bulging->heart-shaped radiolucency that's bulging. Located within the nasopalatine canal (contains nerves and blood vessels) or the incisive papilla. Appears as a radiolucent heart-shaped lesion. A small pink bulge may appear near the apices of the maxillary central incisors on the palate. The condition is asymptomatic, and the adjacent teeth are usually vital.
Define: Epilus Fissuratum. What does it look like clinically? What causes it? Where is it? Treatment?
HINT: E like enormous, PIL like PILE=protrusion. Location? Get a Pile of cash through INVESTment->In vestibule. Inflammatory hyperplasia caused by prosthetics, such as removable dentures. Usually appears in the vestibule along the denture border from ill-fitting appliances. Affected surfaces can be ulcerated. Excess tissue may need to be surgically removed.
What is cyclic neutropenia? How long is the "cycle"? Symptoms? Oral conditions?
HINT: Every 21-27 days, you have 2-3 bad days Inherited disorder with repeated decrease in the number of neutrophils for a short period (2-3 days). + Events occur usually at intervals of 21 to 27 days. Neutrophils makeup 60-70% of the circulating white blood cells and serve as the primary defense against infections. The normal neutrophil count is 1500-8000 per microliter of blood. Symptoms include fever, malaise, sore throat, and occasional cutaneous infections. Periodontal diseases are initiated and worsened in those periods. When neutrophils return to normal, the oral lesions tend to improve. Over time, episodes of neutropenia will lead to severe periodontal disease (inflamed gingiva, attachment loss, bone loss, tooth mobility, and tooth loss) and ulceration. Preventive antibiotic therapy can protect against secondary opportunistic infections. Dental treatment should be initiated when the circulating neutrophil count is normal.
Sulcus Bleeding Index: AKA? What does it measure? How do scores work?
HINT: Extra part is being looked at separately, sulcus=Scores go up through 4 SBI Measures: Presence of gingival disease via probing Score: 0=healthy papillary & margina gingiva, no BOP; 1=apparently healthy no change in color no swelling, but BOP; 2=BOP, color change, sl. edema; 3=BOP, obvious swelling, color change; 4=BOP, spontan. bleed, color change, marked swelling w/ or w/out ulceration
Define: Fibrous dysplasia. What does it look like visually and radiographically? What is it associated with? How does it affect oral cavity vs. body?
HINT: Fibr->Fiberglass->Glasses->Ground-glass appearance. Glasses sit on your nose and cheeks->Maxilla. Glasses->On a sunny day, you get a TAN with sunGLASS marks->Brown->Cafe au lait spots. Bone is replaced by abnormal, fibrous, connective tissue with varying amounts of calcification. Characterized by "café au lait" spots (light brown skin lesions). Polyostotic fibrous dysplasia (polyostotic: involving or relating to many bones): painless enlargement of the bones of the skull, clavicles, and long bones. Craniofacial fibrous dysplasia: fibrous dysplasia that involves the maxilla. Peculiar radiopacities are described as "ground glass."
What is a fissure?
HINT: Fissure synonym for cleft. narrow cleft-like uneven opening in the bone (e.g., superior orbital fissure on the top part of the orbit allows nerves and blood vessels to pass through).
What causes folate deficiency anemia?
HINT: Foliage comes out in September (9). B-9. B-9 (folic acid) deficiency
Pano errors: How do you fix skinny anterior teeth?
HINT: Front=skinny chin placed too far forward → reposition the chin back, bite at the notch of the stick.
Globulomaxillary cyst: Is it benign or malignant? What does it look like radiographically? Where do they occur?
HINT: GLOB->Gold color->Pears->Pear-shaped radiolucency. Pears are long, like the maxillary canine (longest tooth in mouth)-->appears between roots of canine and lateral Located between the roots of the maxillary lateral incisor and canine. Appears as a well-defined, pear-shaped radiolucensy. When the cyst is large enough, the roots can diverge.
Define: Pemphigus Vulgaris. What causes it (which cells involved)? What does it look like clinically? Symptoms? Who gets it? Treatment?
HINT: GUS doesn't want neighbors. Defective desmosomes=acantholysis (intraepithelial blister formation that separates epithelial cells). Nikolsky's sign. Autoimmune disease that causes chronic blistering of the skin that is fragile and painful. Severe and progressive. Acantholysis: intraepithelial blister formation that separates the epithelial cells. Defective desmosomes=autoimmune rxn against them, but hemidesmosomes are fine. Under basal layer, lots of lymphocytes. Nikolsky's sign: cleavage produced by gentle finger pressure. One of the first signs of pemphigus vulgaris is lesions in the oral cavity. Red, ulcerated lesions on labial mucosa, alveolar ridge. White lesions present too on phlange. On edentulous patient. Age: 40-50 years Gender and ethnicity: More common in white females, Ashkenazis Treatment: Corticosteroids
Gemination vs. fusion? Where most common?
HINT: Gemination has right number of crowns in entire dentition but 1 fewer root (count all of them), fusion has 1 fewer crown and 2 roots. Gemination: Single tooth germ attempts to divide and results in incomplete formation of 2 teeth. Crown is divided by notched area and has 1 root. Most commonly in deciduous mandibular incisors & permanent maxillary incisors. Fusion: Union of 2 normally separated adjacent teeth. 2 crowns appear as 1 large crown, but roots are separated and fused.
What is Medicare vs. Medicaid? Who do they help? Do either cover oral health services?
HINT: Give the kids, disabled, poor AND grandparents a bandAID. You clean the kids teeth, and maybe adults. Governmental programs that provide health-related services to specific groups of people in the United States. + Medicaid: Low-income, needy individuals (seniors, kids, disabled). Oral health coverage mandatory for kids, optional for adults. Varies by state what coverage looks like. + Medicare: At or 65+ years old, disabled, and/or kidney failure patients. DOES NOT cover oral health.
Define: Median Rhomboid Glossitis. What causes them? What does it look like? Where is it? How is it treated?
HINT: Gloss like shiny->hardwood floors don't have carpet->carpet=texture of filiform papillae. Missing that texture. Flat or slightly raised erythematous area in the midline of the dorsal surface of the tongue in a rhomboid (diamond) shape. May be associated with a chronic fungal infection by candida albicans. The texture of the area is smooth because of the loss of filiform papillae. No specific treatment is indicated.
Define: Hairy Tongue. What causes it? What does it look like? Where is it? How is it treated? What papilla are involved?
HINT: Hairy->Long dark hair. Solution? Wash your hair->Wash tongue. Dark staining of the accumulated keratin on the filiform papillae. Stain is caused by chromogenic bacteria, tobacco, alcohol, etc. Related to poor oral hygiene and use of antibiotics (metronidozole), corticosteroid, and some other drugs. Harmless, but advise patient to clean tongue regularly.
Which premolar has 2 roots? Which has 3 cusps?
HINT: Head is heavier than legs. So 3 cusps is on mandible, and it's mand. second PM because Jamie is stubborn (heavy-headed, second child). I'm the maxillary 1st PM (older, up, 2 roots).
Pano errors: How do you fix an Exaggerated smile?
HINT: Think of smiling clow, has chin tipped down, creepy smile. chin tipped too far down → reposition the chin.
Define: Descriptive Studies. AKA?
HINT: I am now describing what I observe right now. Observational Describes a situation without predictions, causes, or effects. "Snap shot" of an existing situation. No manipulation is used, cause and effect relationship is not determined (e.g., measurement of cholesterol level across two age groups, over 40 and under 40). Usually based on events that have already happened and are "retrospective."
Define: Cohort Studies. Pros/cons? What level of statistical power does it have in research? When is it used?
HINT: Identify the GROUP first & observe them Cohort: any group of people who are linked in some way and followed over time. Subjects are observed until they develop an outcome of interest. Researchers make no allocation or manipulation of exposure. Useful to research risk factors to disease. Expensive to conduct, and requires follow-up. +For example, researchers recruited a group of smokers and a group of non-smokers to follow for a period of time. Later, the incidence of lung cancers in the two groups is evaluated. Falls under RCT in terms of statistical power
Define: Case Control Studies. Pros/cons? What level of statistical power does it have in research?
HINT: Identify the PROBLEM first. +Collect data on someone with lung cancer and someone without, but there are smokers in each group. Look at if smokers are likely to be diagnosed with cancer. Researchers use existing records to identify people with a certain problem (case) and people without the problem (control). Researchers then look back retrospectively to compare the exposure to a risk factor. +For example, researchers collect data about patients with lung cancer (case) and patients without lung cancer (control). Smokers are present in each group. If a larger portion of patients with lung cancer (case) smokes, this shows that smokers are more likely to be diagnosed with cancer. Falls under cohort studies.
Define: P-value. What does it measure? What's statistical significance? Which p-value indicates stat sig vs. insignificance vs. chance?
HINT: If I pee less than a tiny bit (0.05), means something is wrong (I need to drink more water!). If I pee more than a tiny bit 0.05, doesn't matter (drinking enough water). If I pee EXACTLY 0.05, it occurred by chance that I peed EXACTLY the right amount. Measures results that occurred by chance during an experiment. Stat sig: results are not happening by chance (coincidence) but because of the independent variable. + If the p-value is <0.05, the results are statistically significant. + If the p-value is >0.05, the results are statistically insignificant. + If the p-value is 0.05, the difference occurred by chance.
Define: Tertiary preventions
HINT: Indirect restorations replace lost tissues and rehabilitate them to near normal function (e.g., dental implants, bridges, etc.).
Define: Positive skew. What does this mean for order of mean, median and mode (which is larger/smaller than the other?)
HINT: It's a good thing to be tall. The y axis is tall. Positive skew=closer to y axis. To be tall, you need 2 tall people (mode=closer to Y axis so smallest). Median means middle. Mean is furthest from Y axis (short mean guy). scores are gathered in a lower range (e.g., in a clinical exam, 20 students scored below 70, except for 2 students who scored 100). Closer to Y axis. + Mean > median > mode
Gram + vs. - & how they stain? Why?
HINT: Keep your Ps together Positive & Purple Gram + = purple. Thicker peptidoglycan wall retains the stain Gram - = red. Thinner peptidoglycan walls
Leukoplakia: Is it benign or malignant? What does it look like visually? Where do they occur?
HINT: LAKE->Lake is flat. I jogged to the side of the lake (ventrolateral tongue), swam to the bottom (FOM), and biked in the loops (lips). Depends. Can range from hyperkeratosis to squamous cell carcinoma. White plaque-like flat lesion of oral mucosa that can't be diagnosed with a specific disease microscopically. If found on FOM, ventrolateral tongue, or lips, higher potential to be squamous cell carcinoma vs. leukoplakia occurring in other parts of oral cavity.
Define: Hairy Leukoplakia. What causes it? What does it look like? What is it mistaken for and how does it differ from that? Benign or Malignant? How is it treated?
HINT: Leuko=white. Hairy=hairy, fluffy (texture) white rabbit. Where are the Easter bunnies hiding? On the side of the house->With ridges on side of the tongue. Cause? Easter Bunny Virus=Epstein-Barr Virus Lesions caused by the Epstein-Barr virus (EBV). Infectious mononucleosis is also caused by this virus. Most cases of hairy leukoplakia are an oral manifestation of HIV infection. Appears as white patches that resemble folds or ridges on the sides of the tongue. Often mistaken for oral thrush, which can be wiped off, whereas this cannot be done with hairy leukoplakia. Usually does not lead to malignant conditions, but proper treatment is indicated.
Define: Lichen Planus. Benign or malignant? Symptoms? What does it look like clinically? Where is it?
HINT: Lichen Planus-> Like a plant with branches->Branches are striations->Wickham's striae. Having a plant at home is normal->Benign condition. Benign inflammatory condition of the skin. Severe forms of lichen planus can cause painful sores and ulcers in the mouth. Characterized by white, lacy lines called Wickham's striae in the oral cavity. Most common location is the buccal mucosa, frequently distributed symmetrically.
10% of saliva comes from which gland and duct? What about opening? It's the smallest and only ___-___ major salivary gland. Mostly serous or mucous? Innervated by which CN? Where in relation to submandibular glands?
HINT: Ling=line. Bart hates standing in line. Lingual=Bartholin. Sublingual - Bartholin Sublingual caruncle Non-encapsulated Mucous 7th & 9th CN Anterior to Submand glands
Define: Sialolith. What causes them? Symptoms? Where are they? What do they look like? How are they treated?
HINT: Lith means stone->Stone is a radiopacity. Stones sink to the bottom of the ocean->Affect SUBmandibular gland. Solution? Need more saliva->Lemon can cause more saliva. Calcified mass or stone in the major and minor salivary glands. The majority of stones affect the submandibular glands (compared to the parotid gland or sublingual gland) because of its long and complex duct. Can cause inflammation and pain on the floor of the mouth. For the removal of small stones, stimulating saliva flow by sucking on a lemon or sour candies may help.
65% of saliva comes from which gland and duct? What bout opening? Mostly serous or mucous? What is this gland related to? Which nerve is this gland near? Innervated by which CN?
HINT: M flip to W=Wharton. Submandibular -Wharton's. Sublingual caruncle Serous Salivary stone formation. Duct is longer and more complex vs. others, but can remove stones with minimal discomfort (suck on acid). Lingual nerve (branch of trigeminal) 7th CN
Eruption patterns permanent teeth?
HINT: MAN. For permanent. Grown man. Eruption pattern spells out Man (just leave out all 1st molars since it's first to erupt. at 6-7 years old) So M=man central, max central, man lateral, max lateral, man canine A=man 1st premolar, max 1st premolar, max 2nd premolar, man 2nd premolar., max canine. N=man 2nd molar, max 2nd molar, man 3rd molar, max 3rd molar Remember: 6-7 years old for man. central and max. 1st molar, 11-12 years old for max. canine., 12-13 for max. 2nd molar.
Classes of occlusion? What part (bone) is moving?
HINT: MANDIBLE is moving forward or backward. Mandible moves back=Cl. II=Retrognathic Mandible moves forward=Cl. III=Prognathic REMEMBER: Max. 1st molar mesiobuccal cusp in mandibular 1st molar mesiobuccal groove. Normal: MB cusp of max 1st molar fits in buccal groove of mand. 1st molar. Normal overbite & overjet. Cl. I: Same as normal, but crowding, crossbite, etc. present. Cl II: MB cusp of max 1st molar is in front of buccal groove of mand. 1st. + Div 1: Upper incisors protruded (out) + Div 2: Upper incisors retruded (in) Cl III: MB cusp of max 1st molar is behind the buccal groove of mand. 1st molar.
What nervous systems fall under the efferent division? What does each one do?
HINT: ME Motor=efferent Autonomic: Controls involuntary responses Somatic: Controls voluntary responses
Define: Major aphthous ulcers. How common and in who? Size? How long do they last? What do they look like after they heal?
HINT: Major=larger than half the size of a penny (>1 cm). Larger than 1 cm in diameter and last longer than minor aphthous ulcers. + Can take several weeks to heal and frequently result in scarring. + Occur more commonly with immunodeficient conditions such as HIV.
Melanocytic Nevus: AKA? Is it benign or malignant? What does it look like visually? Where do they occur? Who is predisposed to them?
HINT: Melanin=dark. Drop of coffee dripping from your hard palate. Mole. Benign tumor of melanocytes (melanin-producing cells). Presents as dark macule or papule. Most commonly on hard palate, or buccal mucosa. Genetic predisposition is related to this condition.
Define: Smoker's Melanosis. What does it look like clinically? How does it develop? Where is it? What is severity determined by?
HINT: Melanosis->Melanin makes the skin dark->Dark areas. Hold the cigarette between lips->Labial gingiva (location) Dark pigmentation of the oral tissue caused by stimulation of melanin production (by melanocytes) due to chemical substances in cigarette smoke. The anterior labial gingiva is the most commonly affected site. Severity of the lesion is related to the frequency and duration of smoking.
Define: Minor aphthous ulcers. How common? Size? What do they look like clinically? Where are they? How long do they last?
HINT: Minor=half the size of a penny (<1 cm). Most common type, comprise 70-90% off aphthous ulcers. Less than 1 cm in diameter. + Exhibit a yellowish-white surface surrounded by a red halo. + Only present on movable parts of the oral cavity and occasionally extend onto the gingiva. + Prodromal period of 1 to 2 days precedes the appearance of ulcers. + Heal spontaneously in 7 to 10 days.
Where is there a Cusp of Carabelli?
HINT: MoP the caramel. Mesio-palatal Carabelli.
4 muscles of mastication? Which nerve innervates them (be specific)? What actions can each do?
HINT: Mom Makes Tasty Lasagna CHEWING the lasagna Cranial nerve 5 (high five mom for her tasty lasagna!) Masseter (Elevates mandible, clenching muscle, superficial muscle). If clenching, can see that muscle protruding. Temporalis (Elevates & retractions mandible w/posterior portion of the muscle, superficial muscle) Medial pterygoid (Elevates mandible--runs VERTICAL like SIDES OF AN M vs. lateral pterygoid, deep muscle) HINT: Letter M Lateral pterygoid (Depresses mandible, RUNS HORIZONTAL like SHAPE OF AN L vs. medial pterygoid, deep muscle) HINT: Say "me"=closing jaw=medial Say "la"=opening jaw=lateral Mandibular division of CN V (Trigeminal)
Define: Mucocele vs. Ranula. What causes them? Symptoms? Where are they? What do they look like? How are they treated? Who gets them? How do they differ in size?
HINT: Mucocele->M like mini->Small. Cele=seal the lips. Small lesions on lower lip. Ranula->Means frog in Latin->Frong uses tongue to capture its prey->Lesion UNDER the tongue. Swelling caused by the spilling of fluids into the tissues due to blocked or damaged salivary glands. Both appear as dome-shaped, soft, movable. They have a bluish hue and painless. Mucocele: commonly present on the lower lip. May also appear on the palate, top of the tongue or other areas of accessory gland ducts. Smaller than ranula, usually ranges from a few millimeters and stay under 1.5 cm. Ranula: appears as a larger, dark lesion on the floor of the mouth. Affected by the sublingual and submandibular glands. Surgical removal may or may not be needed. May occur at all ages.
Eruption patterns primary teeth?
HINT: NXI Mand. central, max central, max. lateral, mand lateral, max 1st molar, mand 1st molar, max canine, mand canine, mand 2nd molar, max 2nd molar. Remember: 6-10 months mand central, 17-23 months mand canine, 13-19 months max 1st, 25-33 months max 2nd.
What are the 12 Cranial Nerves?
HINT: Oh, Oh, Oh, To Touch and Feel Very Good Velvet, Ah Heaven Olefactory (I) Optic (II) Oculomotor (III) Trochlear (IV) Trigeminal (V) Abducens (VI) Facial (VII) Vestibulocochlear (VIII) Glossopharyngeal (IV) Vagus (X) Accessory (XI) Hypoglossal (XII)
Osteosarcoma: Is it benign or malignant? What does it look like radiographically? Where do they occur? Who is most commonly affected?
HINT: OsteosARComa->Arc like a rainbow->near the sun->Sunburst pattern. Malignant tumor of bone-forming tissue. Some patients initially present with a toothache or exhibit tooth mobility. Sunburst pattern may be seen radiographically. Teens and elderly patients are more commonly affected.
Define: Primary preventions
HINT: P for prevention prevent the onset of a disease, reverse the initial stages of a disease, or arrest the progress of a disease before treatment is needed (e.g., oral prophylaxis, fluoride treatments, dietary counseling, vaccinations, etc.).
Plaque index: AKA? What does it measure? What other index is it used commonly with? Which teeth does it apply to? How do scores work? What is it typically used for?
HINT: PII=Pie=thick pie PII, Silness, & Loe Measures: Thickness of dental biofilm at gingival margin (cervical third) ONLY Used with: Gingival Index (looks at severity of gingivitis). Applies to: Specific teeth and/or entire dentition. Score: 0-3, higher=thicker plaque Used for: Clinical Studies
Incidence vs. Prevalence? Which is the snapshot and which is the video? How do they relate to proportions vs. counts?
HINT: PPS=Prevalence, proportion, snapshot Incidence (rates): number of NEW cases over a PERIOD OF TIME (e.g., new cases of the latest flu). VIDEO. Prevalence (proportions): total number of ALL cases of a disease in a GIVEN POPULATION at a GIVEN TIME (e.g., about 20% of Americans are affected by diabetes). SNAPSHOT.
Define: Paget Disease. AKA? Who does it effect? What does it look like clinically vs. radiographically? Who gets it? How does it affect oral cavity? How diagnosed?
HINT: Paget->Page->Crunch it up and it looks like a cotton ball->Cotton-wool like appearance. Put cotton roll between the patient's 2 teeth->Increased spacing of teeth, pain Osteitis Deformans A chronic metabolic bone disease characterized by resorption, osteoblastic repair, and remineralization of the involved bone. Most common in men older than 50 years. Pain and enlargement of the bones are usually present. This can result in the increased spacing of the teeth. Elevated serum alkaline phosphatase level occurs (blood or urine sample to diagnose) Edentulous patients may complain that their dentures no longer fit. Appears as a radiopacity referred to as "cotton-wool" appearance.
Define: Papillary Hyperplasia of the Palate. What does it look like clinically? What causes it? Where is it?
HINT: Papillae=small, round, raised structure->Cobblestones. Location? Areas in contact with appliance. Associated with removable dentures, or orthodontic appliances. Usually appears in the vault Covered by multiple erythematous papillary projections, giving the area a granular or "cobblestone" appearance.
25% of saliva comes from which gland and duct? What about opening? It's the largest ____ major salivary gland. Mostly serous or mucous? Innervated by which CN? Which nerve is this gland near?
HINT: Par=parrot can stand=Stensen Parotid - Stensen's Parotid Papillae Encapsulated Serous 9th CN Can be pierced when the inferior alveolar nerve block is incorrectly administered. This may cause damage to the seventh (VII) cranial nerve.
Define: Nicotine Stomatitis. What causes it? What does it look like clinically? Benign or malignant?
HINT: Pieces of tobacco in a cigarette->Put them on the palate->red dots on palate Benign lesion on the hard palate caused in response to heat. With time, increase in keratinization makes the surface appear opalescent with raised red dots, which are the openings of the ducts of the minor salivary glands on the palatal surface. May develop into malignancy.
What's hyperthyroidism? Symptoms? What's Grave's disease? Oral Conditions?
HINT: Pugsley is hyper due to excessive production of thyroid hormone from the gland. Symptoms below. Hyperthyroidism: excessive production of thyroid hormone from thyroid gland. + The body's metabolism increases. Patient can experience exophthalmos (bulging of the eyes), heat intolerance, fatigue, insomnia, dyspnea (shortness of breath), tachycardia, weight loss, muscle weakness, etc. + Grave's disease: autoimmune disease caused by antibodies that attach to specific sites of the thyroid gland and causes an overproduction of hormones. + A thyroid storm (thyrotoxic crisis) may occur if hyperthyroidism is left untreated. Call Emergency. + Oral conditions: EARLY loss of deciduous teeth, early eruption of permanent teeth, large mandible, osteoporosis of alveolar bone causing more progressive periodontal disease.
What is Codeine used for (2 uses)?
HINT: Put the code in the chart and billing. Codeine in dentistry. Most commonly used opioid in dentistry. Can also be used as cough suppressants in subanalgesic doses.
Define: Geographic tongue. What causes it? What does it look like? Where is it? How is it treated? What kind of papilla are involved? Symptoms? What is it mistaken for?
HINT: Red and shiny inside a blood orange with red inside, yellow outside. Erythematous patches surrounded by a white or yellow border on the dorsal and lateral borders of the tongue. Also called erythema migrans or benign migratory glossitis. The cause of the condition is unknown. No specific treatment is indicated. Patches can disappear and reappear in a different location. Filiform papillae are lost on the affected areas and the condition can cause a burning sensation. Differs from ulcer: YELLOW border, red inside with geographic tongue; yellow inside and red border with ulcer.
Define: Aphthous Ulcer. AKA? What does it look like clinically? Where is it? Who gets it/what causes it and can it recur? Sub-types (3)?
HINT: Red delicious apple has red outside, yellow inside->yellow with red borders. APHTH->Path->A path is for moving vs. bench to sit->Movable parts. Painful oral ulcers also known as canker sores or traumatic ulcers. Only seen in movable parts of the oral cavity (labial and buccal mucosa, maxillary and mandibular vestibular mucosa, ventral and lateral borders of the tongue, soft palate, and nasopharynx). Recur in episodes. Affect largely professional population or individual with high level of stress. Ulcers resulting from various stimuli (e.g., biting the cheek, ill-fitting dentures, sharp edges of food, etc.) Can occur after dental procedures (e.g., in the area of the film placement or at the site of local anesthetic injection). Minor, major, and herpetiform aphthous ulcers.
Characteristics of x-rays
HINT: Remember characteristics of sunlight Invisible Travel at speed of light Travel in waves High-frequency short wavelength Can penetrate objects Can cause changes in cells Can cause ionization
Difference between 1, 2 & 3 wall infrabony defects? Which has best prognosis?
HINT: Remember to replace "defect" with "left" because 3-wall defect=3 walls left. + Three-wall defect: bordered by three osseous surfaces and one tooth surface. Has the best prognosis among the three bone defects. + Two-wall defect: bordered by two osseous surfaces and two tooth surfaces. + One-wall defect: bordered by one osseous surface and three tooth surfaces.
Developing: What is the restrainer? What does it do?
HINT: Restrain (inhibit) yourself from eating too much Peanut Butter! potassium bromide - inhibits development of unexposed silver halide crystals.
What does Risedronate sodium (Actonel) treat?
HINT: Rise and sodium=taking chewable in the morning like as a kid=osteoporosis Osteoporosis.
Define: Negative skew. What does this mean for order of mean, median and mode (which is larger/smaller than the other?)
HINT: Think of positive skew (good to be tall by y axis, to be tall need 2 tall people AKA mode closest to y-axis). Opposite of it (so now mode is furthest from y axis) scores are gathered in a higher range (e.g., in a clinical exam, 20 students scored above 90, except for 5 students who scored below 70). + Mean < median < mode.
What causes depression? Side fx of anti-depressants? What are examples of anti-depression drugs and how do they work?
HINT: SEratonin + NORepinephrine. Senor=seniors are depressed. Low levels of norepinephrine and serotonin in CNS. Side fx: Xerostomia. Drugs + Selective serotonin reuptake inhibitors (SSRIs): newer-generation antidepressants. Inhibit the reuptake of serotonin from the synapses. Fluoxetine (Prozac), citalopram (Celexa), etc. + Tricyclic antidepressants: older-generation antidepressants. Increase synaptic concentration of neurotransmitters serotonin and norepinephrine. Amitriptyline (Elavil), etc. + Monoamine oxidase inhibitors (MAOs): older-generation antidepressants. Phenelzine (Nardil), etc. + Norepinephrine and dopamine reuptake inhibitors (NDRIs): bupropion (Wellbutrin), etc.
Syphilis: What is it? How is it transmitted? Stages & how long they last?
HINT: SIP (like syphilis) TEA (like Treponema) Palace (like pallidum) Disease caused by the spirochete bacterium Treponema pallidum. Usually transmitted through sexual contact (direct contact). Condition develops in stages, and symptoms vary with each stage. HINT for stages: First, I went on my PC=personal computer; then, I SMP=ShaMPoo my hair; later, I will do nothing; tomorrow I will play TaG +Primary syphilis: highly infectious lesions appear about 3 weeks after exposure. Lesions are called chancres, and heal spontaneously in about 6 weeks without treatment. +Secondary syphilis: occurs about 6 weeks after the primary lesions. Lesions are called mucous patches, and are multiple, painless with gray/white plaques covering the ulcerated mucosa. Mucous patches are MOST infectious. +Latent syphilis: period of no symptoms. If the condition is not treated, symptoms may reappear or can develop to tertiary This stage can last years. +Tertiary syphilis: if the condition is not treated, the disease may damage the brain, nerves, heart, etc. Lesions are called gumma and are non-infectious.
What's the buccal object rule?
HINT: SLOB. Same lingual, opposite buccal. Shows whether an artifact is lingual or buccal. Radiograph is a two-dimensional image of a three-dimensional space. Therefore, a bitewing or PA only shows the anteroposterior location of the artifact. Two images needed, whether they are PA or BWX. Second image is taken from a different horizontal or vertical angulation. Compare the two images to see if the artifact moves towards the same or opposite direction compared to the change in the tube head position. + Tube head and object moved in the same direction: object is located lingually. + Tube head and object moved in the opposite direction: object is located bucally.
What are the 6 beliefs that influence behaviors in the Health Belief Model? Purpose?
HINT: SSBBCS Susceptibility and Severity Benefit when Barriers Can Stand. Related to perio disease=you're susceptible (first you get it) and severity increases (benefits) when calculus (barriers) can stand (is attached). Useful to PREDICT patient's actions. Looking at beliefs. Perceived susceptibility: if they believe they are susceptible to the condition. Perceived severity: if they believe that the condition has serious consequences. Perceived benefits: if they believe taking action would reduce their susceptibility to the condition or its severity. Perceived barriers: if they believe costs of taking action are outweighed by the benefits. Cue to action: if they are exposed to factors that prompt action. Self-efficacy: if they are confident that their ability to successfully perform an action.
Define: Secondary preventions
HINT: STOP the disease. INCLUDES FILLINGS terminate a disease and restore tissues to near normal function (e.g., drilling and filling a cavity, periodontal therapy, etc.). + Also includes early detection of a disease (e.g., periodontal screening, breast cancer screening, etc.).
Where is the nasal septum?
HINT: Septum 4th letter=T. T is thinner than N. Thin wall that divides the nasal cavity into two. Radiopaque vertical strip.
Define: Solar Cheilitis. AKA? What does it look like? Benign or malignant? Who gets it? Where is it?
HINT: Solar->Sun causes dryness->Cracks. Sun is a bright light->BL->Bottom lip. Fair-skinned people are less protected from the sun. Actinic Chelitis. a pre-cancerous condition related to sun exposure. Most commonly occurs in fair-skinned individuals. Affected mucosa is pale, crusted, and fissured. Lower lip and vermillion borders are usually more severely involved than the upper lip. The interface of the lips and skin is indistinct.
Define: Validity. What's the difference between sensitivity vs. specificity? AKA?
HINT: Someone would be sensitive if they had a positive HIV result. Sensitive=have disease. True positive. Specificity is opposite of that. Research measures what it is intended to measure. + Sensitivity: probability of a positive test among patients with disease. True Positive. + Specificity: probability of a negative test among patients without disease. True Negative.
What's the Alternative Hypothesis? How is it denoted?
HINT: Something you think is causational, like treatment has an effect on disease (denoted by Ha or H1): reflects that there will be an observed effect in the experiment (e.g., dental hygiene therapy lowers the severity of periodontal diseases).
What's the Null Hypothesis? How is it denoted?
HINT: Something you want to prove is wrong, like treatment has no effect on disease. (denoted by H0): hypothesis which the researcher tries to reject (e.g., dental hygiene therapy does not lower the severity of periodontal diseases)
Where is the nasal spine?
HINT: Spine 4th letter is N. N is triangular shaped vs. T. Pointy spine. projection of bone anteriorly. Radiopaque triangle shape at median palatal suture where nasal septum and fossae meet.
What's the difference between a summative and formative evaluation?
HINT: Sum=total at END Form=processing=during the program Summative evaluation: conducted after the program (e.g., final examination). Formative evaluation: conducted during the program. This allows the program to be re-evaluated and modified during its progress (e.g., weekly examination).
What's a T-test? Who does it compare? What does it compare them on?
HINT: T for TWO. compares two different groups on some variable of interest (e.g., male/female, undergrad/grad) (e.g., Do males and females differ in the number of hours spent shopping in a given month?)
Define: Aspirin Burn. What does it look like clinically? Symptoms? What causes it? How long does it last?
HINT: Take an aspirin to make a headache disappear->Buy aspirin at 7/11->lasts 7-21 days. Caused by an aspirin tablet placed directly on the pain area instead of being swallowed. Affected tissues appear white with necrotic tissue that may slough off. The lesion is painful and usually heals spontaneously in 7 to 21 days.
Define: Tobacco Pouch Keratosis. Where is it? Can it disappear? Benign or Malignant?
HINT: Tobacco pouch->White, flat and raised. Where do you put the pouch? In the mucobuccal fold. Raised, flat area. Most common location is the mucobuccal fold. Often disappears when tobacco is no longer placed in the area. May develop into malignancy.
What are the 6 steps of the Learning Ladder? Purpose?
HINT: UASIAH. See where patient is standing and create custom plan for an effective program. Unawareness: patient lacks information and/or has incorrect information about a problem. Awareness: patient knows about a problem but does not take action. Self-interest: patient knows about the problem and shows interest in taking action. Involvement: patient wants more knowledge and wants to participate. e.g. wants a coupon Action: patient acts to resolve the problem. NEW BEHAVIORS are FORMED. Habit: lifestyle has changed.
What is the cathode electrode controlled by? Is it positive or negative? What are its 2 components and what do they do?
HINT: Want grade to go from a C- to an A+ (electrons travel from negative cathode to positive anode) Negative . Controlled by milliAmperage (mA) settings. Tungsten filament: emits electrons when heated. An electron cloud forms around it. Molybdenum cup: focuses the direction of electrons towards the anode.
What is the anode electrode controlled by? Is it positive or negative? What are its 3 components and what do they do?
HINT: Want grade to go from a C- to an A+ (electrons travel from negative cathode to positive anode) Positive. Controlled by kVp settings. Tungsten target: spot where the electrons hit to produce x-rays. Focal spot (target): small area on the target on the anode toward which the electrons from the focusing cup of the cathode are directed. X-rays originate at the focal spot. Copper stem: dissipates excessive heat. X-ray production results in the generation of x-rays (1%) and heat (99%).
What is Arestin? What type of antibiotic?
HINT: arrest a MINOr. Arestin=minocycline Minocycline microspheres. Tetracycline.
What is collimation? What is filtration?
HINT: column like the architectural structure, big size and shape. Metal barrier with an opening in the middle that restricts size and shape of the x-ray beam. Reduces film fog, improves image quality, restricts patient exposure (primary and scattered) Metal sheet placed in an x-ray beam between the window and patient. Usually aluminum discs that filter out longer, nonproductive wavelengths (low-energy soft x-ray photons that don't contribute to image quality).
What are the extrinsic tongue muscles (from superior to inferior)? Actions? Endings for tongue muscle names?
HINT: for movements -Sty=emphasize St=retracts tongue, moves it upward. -Gen=emphasize Ge=sticks tongue out, moves it down Ends in -glossus Styloglossus (Retracts tongue, moves it superiorly) Genioglossus (stick tongue out, depresses part of it) Hyoglossus (Depresses tongue)
What is Percodan?
HINT: percoDAN, aSPIRIn=SPIRIT. Dan has a good spirit. + Oxycodone + aspirin
+1 Sv = +1 Gy= + 1000 mrem =
HINT: the A in rad combines with Gy to form a word, Gay. 100 rem, 100 rad, 1 rem
Which is associated with HPV: Hairy leukoplakia or white hairy tongue?
Hairy leukoplakia. On sides of tongue/underneath.
Examples of pxychedelics? What do they do?
Hallucinogens. marijuana (cannabis), LSD, etc.
How should patient's head be positioned for intraoral imaging?
Head against the headrest. Maxillary arch parallel to the floor. Do not ask the patient to hold the film in their mouth.
What's Cross-sectional mandibular occlusal technique?
Head tilted backward until the ala-tragus ("ala" meaning side of nose, "tragus" meaning flap in ear) line is almost perpendicular to the floor. Beams are perpendicular to the receptor and directed inferior to the chin.
What's Mandibular occlusal technique?
Head tilted backward, negative 55° vertical angulation. Central rays are directed through the chin.
When was HIPAA created? Why? By who? What does it stand for?
Health Insurance Portability and Accountability Act Enacted by U.S. Congress in 1996. Designed to improve the efficiency of the healthcare industry and ensure that patient-identifiable information remains confidential. A dental office is not allowed to disclose information to family members including the spouse and employer (even if the party pays for the insurance). Only the patient and insurance carrier are allowed access to the information. Also protects workers and families in cases of unemployment or change of work. Group health plans cannot deny a patient's application for coverage based solely on the patient's health status. Patient owns the dental records and has the right to request dental records (office can charge a reasonable fee). Physical safeguards should be installed to prevent information from being stolen (e.g., lock patients' charts). A privacy officer and contact person should be designated for the office. Patients are required to sign the written policy that describes how the office will be compliant with HIPAA.
How does bacterial composition differ between health, gingivitis, and periodontitis?
Health: Gram +, non-motile bacterial are prevalent Gingivitis: equal ratio of gram + & gram - Perio: gram - & motile bacteria (red complex) are prevalent.
What a hemangioma? Who usually gets them? Benign or malignant? Where are they? What do they look like? What condition can they develop into?
Hemangiomas are very common vascular lesions frequently involving the tongue and often lead to macroglossia enlarged tongue. Benign. Although typically present at birth and more frequent in girls, hemangiomas occur in adults as a result of trauma. They vary in size, are deep-red or blue and frequently blanch with pressure.
Recommended immunizations for healthcare professionals?
Hep B (3 shots, at 0, 1, and 6 months, then 1-2 months later a blood test) Influenza Mumps Measles Rubella Varicella-zoster
What is hyperbilirubinemia? Signs/symptoms?
High level of bilirubin, a yellow-orange bile pigment which is formed from breakdown of RBC. Signs/symptoms: Fever, Chills, Abdominal pain, Flu-like symptoms, Change in skin color and sclera color (JAUNDICE).
Schedule I controlled substance: What does this classification mean in terms of abuse? Potential for addiction? Examples of these drugs?
High potential for abuse. + No medical use (e.g., heroin, hallucinogens, opium derivatives, etc.) + Potential for Addiction: Drug is not safe to use, even under medical supervision
How do hormonal changes put you at higher risk for periodontal disease? What's a pregnancy example of this? What medication that alters hormones can increase your chance for a type of gingivitis, and which type?
Higher levels of hormones can increase sensitivity to local irritants, such as bacterial plaque. + Pregnancy-associated pyogenic granuloma (pregnancy tumor) is commonly related to P. intermedia. + Oral contraceptives: may increase the chance for plaque-induced gingivitis. + Menopause: can cause dry mouth, burning sensations or altered taste. + Puberty: can be affected by aggressive periodontitis.
Define: Impetigo. What does it look like visually? Which bacteria is it associated with (2 types)? Who gets it? Any systemic manifestations?
Highly contagious superficial skin infection generally caused by one of two bacteria: Staphylococcus aureus or Streptococcus pyogenes. Characterized by vesicles or bullae resembling recurrent herpes virus that rupture and crust around the nose and mouth. The condition is usually seen in young children, and the infection is transmitted from direct contact with the microorganism. Systematic manifestations such as fever and malaise generally do not occur.
Ameloblastoma: Is it benign or malignant? What does it look like visually and radiographically? Where do they occur? Likely to recur or no?
Hint: I AM have a BLAST on New Years while drinking champagne. Benign, slow-growing, and aggressive odontogenic tumor (tissue involved in tooth formation--produces dentin) Characterized by soap bubble-like or honeycombed radiolucencies 80% of them develop in the mandible, usually in ramus area. Can cause expansion of bone. Recurrence is common.
What are the 3 domains involved in the Learning Domain model?
Hint: I put my thinking CAP on when I'm in the Learning Room (Domain). C=Cognitive, A=Affective, P=Psychomotor Cognitive domain: knowledge, intellectual ability (e.g., clinician provides brochure with different brushing techniques to be reviewed). Affective domain: interest, attitude, values (e.g., teacher informs parents of the benefits of fluoride). Psychomotor domain: motor skills, performance (e.g., hands-on learning of brushing techniques demonstrated by dental hygienists).
Melanoma: Is it benign or malignant? What does it look like visually? Where do they occur? What causes them?
Hint: Melanoma= MEAN = mood goes up and down= irregular borders. Malignant tumor that develops in the melanocytes (in basal layer of the epidermis, produces melanin to give color to the skin). Presents as rapidly enlarging blue-to-black asymmetrical lesion with irregular borders. Most serious type of skin cancer. Condition is related to UV radiation exposure from the sun.
Difference between positive and negative correlation in terms of x and y?
Hint: Negative means opposite relationship, positive means same relationship Negative correlation: when x increases, y decreases or the opposite (e.g., the more the patient brushes his/her teeth, the less risk for caries). Positive correlation: when x increases, y also increases; or when x decreases, y also decreases (e.g., the more candies a patient eats, the more risk for caries).
Papilloma: Is it benign or malignant? What does it look like? What does it resemble in appearance?
Hint: Papillo -> Papillon (french word for butterfly) dancing on a cauliflower -> cauliflower-like Benign tumor of squamous epithelium. Can be white due to thickened layer of keratin, has cauliflower-like appearance. Verruca vulgaris (common wart) and condyloma acuminatum resemble papilloma in appearance.
What is a foramen?
Hint: See Eamon through the window. Small window-like opening a small window-like opening (e.g., mental foramen is the opening for the nerves and blood vessels that supply the anterior teeth).
Squamous Cell Carcinoma: Is it benign or malignant? How common is it? What does it look like visually? Where do they occur? What causes them?
Hint: Squa=Square=Canadian flag with red and white. Canadians are softer (known to be nice)=on softer areas so under and side of tongue, FOM, soft palate, etc. Malignant tumor of the squamous cells - compose most of epidermis (skin's upper layer). Most common primary malignancy of oral cavity. Infiltrate adjacent tissues & spread to distant sites. On the ventrolateral tongue, floor of mouth, soft palate, tonsillar pillar, and retromolar areas. Early tumors can be leukoplakia, erythroplakia, or speckled (white & red). Alcohol consumption & tobacco use
Which type of bone loss is more common? What type of pocket does it produce?
Horizontal is more common. Suprabony pocket is produced. Vertical is less common, would produce an infrabony pocket.W
Bone reduction is ____ to the CEJ in horizontal bone loss, vs. vertical bone loss goes in an ___ ___.
Horizontal, oblique direction
Define: Standard deviation. What does a larger standard deviation mean in terms of range? What percent of scores fall between +1 & -1 standard deviation regardless of the values of the scores?
How much scores deviate from the mean, positive square root of variance. The bigger the standard deviation the wider the range. + 68.2 %
Difference between humoral and cell-mediated immunity?
Humoral: Involves substances found in body fluids (secreted antibodies, complement proteins, antimicrobial peptides) Cell-mediated: NO antibodies, involves activation of phagocytes, natural killer cells (NK), antigen-specific cytotoxic T-lymphocytes, and various cytokines.
What's Cushing's syndrome? AKA? Symptoms?
Hypercortisolism. Hypersecretion of cortisol by the adrenal glands. HINT: Cushings=cushion=weight gain, fatty deposits in face, hypersecrete hormones. + Symptoms include weight gain, fatty tissue deposits in the face and body creating a "moon face" and "buffalo hump."
Periodontal disease process occurs in an ___ manner.
Intermittent, so alternating periods of inactivity and destruction.
Define: Frictional Keratosis. AKA? What does it look like? Benign or malignant?
Hyperkeratosis, a thickening of the keratin on the surface of the epithelium caused by friction against tissues. Appears white and is not associated with malignancy.
Define: Erythema Multiforme. What is it caused by? Where does it occur? What does it look like clinically (on body and in mouth)? How quick is onset? What's the most severe form of it?
Hypersensitivity reaction to an infection, or medication. Characterized by target, iris, or bull's eye lesions that consist of concentric rings of erythema alternating with normal skin color. The color is darkest at the center. Can also present as ulcers on the lateral borders of the tongue, or crusted and bleeding lips. Onset is usually explosive. Most severe form of it is Stevens-Johnson Syndrome.
Respiration alkalosis: What is it? What's it tied to? Symptoms? How do you treat it?
Hyperventilation is typically the underlying cause of the rise in blood pH called respiratory alkalosis (caused by the low CO2 levels). + Respiratory alkalosis leads to narrowing of the blood vessels that supply blood to the brain and in severe cases can lead to loss of consciousness. Symptoms can last 20-30 minutes. The goal of treatment during an episode is to increase CO2 levels in the body and to slow down the breathing rate. + Try to help the patient stay calm. + Seat upright. This helps the patient use the diaphragm more efficiently. + Breathe through pursed lips (as blowing out a candle). + Cup the hands over the nose and breathe into them slowly (the use of a paper bag is no longer recommended). + Advise the patient to breathe into the diaphragm (belly) rather than the chest. + Hold the breath for a short period of time + Alternate nostril breathing (close one nostril at a time). DO NOT ADMINISTER OXYGEN
What's Addison's Disease? AKA? Symptoms? Oral Conditions? What can this lead to if left untreated?
Hypocortisolism. Hyposecretion of cortisol and aldosterone by the adrenal glands. Caused by the destruction of the adrenal cortex (outer layer). HINT: Addisons=add pigment, hyposecrete hormones. + Symptoms include SKIN PIGMENTATION, weakness and fatigue, low tolerance for stress, low blood pressure, and susceptibility to infections, rapid heart, and respiratory rates. + Oral conditions: pigmentation on oral tissues. + Adrenal crisis: sudden appearance of symptoms triggered by excessive stress.
The intrinsic and extrinsic tongue muscles are innervated by which nerve(s)?
Hypoglossal nerve (Cranial nerve XII) - See Table 4 in Canvas
How do you know someone has amelogenesis imperfecta?
Hypoplastic type: the enamel layer did NOT develop to a normal thickness. Caused by the failure of the ameloblasts to lay down enamel matrix properly. May show pitting, smoothness, or roughness. Hypocalcified type: the enamel has a normal thickness but is poorly calcified. May appear yellow and is soft in texture, leading to the exposure of dentin. Hypomaturation type: the enamel has a normal thickness but chips and abrades easily. May appear mottled (uneven) and feature softer than normal enamel. With pressure, the tip of an explorer can penetrate the enamel and the enamel chips easily.
What is hypothyroidism? Symptoms? What's hypothyroidism in kids vs. adults called? What can kids type cause if left untreated? Symptoms of adult type? Oral Conditions?
Hypothyroidism: insufficient production of thyroid hormones. + As a result, the pituitary gland produces MORE TSH in order to stimulate the thyroid. The extra production of TSH then forms a GOITER (abnormal enlargement of the thyroid gland). + Cretinism in kids, can result in serious damages in the physical and mental development if left untreated. + Myxedema in adults. Characterized by lethargy, fatigue, cold intolerance, and bradycardia. + Oral conditions: enlarged tongue (macroglossia), DELAYED tooth eruption, small jaw development, and malocclusion.
What's Type I diabetes (AKA?) Cause? More or less common? Who has it? Symptoms? What can it progress to? Treatment?
IDDM or insulin-dependent. The body CANNOT produce insulin. Autoimmune destruction of pancreatic Beta cells. Affects 5% of the population, and usually peaks at the age of 20 years. HINT: polyDIPsia=Tipsy/dip when drunk=drink + Patient can experience 3 Ps: polydipsia (excessive thirst), polyuria (excessive urination), and polyphagia (excessive appetite). + Ketoacidosis: when the body cells do not get the glucose needed for energy, the body burns fat, which produces ketones. Ketones are acids that circulate in the blood. This lowers the pH of the blood, and lead to coma or death. (Normal blood pH is around 7.4 but can lower to pH 7 with ketoacidosis). + Ketoacidosis can be obvious by the smell of a person's breath, referred to as fruity breath. + Treatment: insulin injections or pump therapy, proper diet, and exercise.
International Standard Organization Designation System AKA?
ISO or FDI System 2-digit number First digit=quad. 1=R max, 2=L max, 3=L mand, 4=R mand/ Second digit=tooth. Start at midline. Central=1, 3rd molar=8. Primary teeth use numbers too, just goes 1-5 for second digit. Used in Canada, Europe, etc. Accepted by WHO
Which cells are more radiosensitive: Immature or mature? Quickly dividing or slowly dividing? Younger person's cells or highly specialized cells?
Immature, quickly dividing, younger person's
4 types of hypersensitivities?
Immediate (type I): IgE‐mediated, begins within minutes of exposure, rxns include sneezing, itchy eyes, hives, burning skin sensations, etc. (e.g., asthma, and anaphylaxis attacks). Antibody-mediated (type II): antibodies produced by the immune response bind to antigens on the patient's own cell surfaces. Immune complex-mediated (type III): aggregations of antigens to IgG and IgM antibodies form in the blood and are deposited in various tissues. + Cell-mediated (type IV): has a delayed response. Usually symptoms from exposure take hours to days to occur (e.g., contact dermatitis).
What is hypersensitivity?
Immune rxn caused by immune response to repeated exposure to antigen
The lymphatic system is part of what system? Think of it as what?
Immune. Think of it as security/
Fungal infections occur more in patients who are ____. What drugs are used to treat thrush (aka fungal infections) and how taken?
Immunosuppressed. HINT: Statin=mushroom Mushroom with flu. Drugs end with -statin & contain flu=antifungals Drugs + Nystatin (Mycostatin) is usually applied topically. + Fluconazole (Diflucan) and ketoconazole are usually taken orally.
Implied vs. expressed consent?
Implied by actions of patient (if patient comes to dental office, agreeing to receive dental exam and consult. Expressed is agreement given verbally or in writing.
Which cell types are most sensitive to radiation? Least sensitive? What's the most sensitive part of a cell?
In order of most sensitive to least sensitive cell types: + Blood-forming (bone marrow), reproductive, intestines. + Blood, skin, immature bone, thyroid, kidney, liver, connective tissue. + Adult bone, muscle, nerve. Most sensitive part of a cell is the DNA and chromosomes.
What's overlap? How do you fix it?
Inappropriate horizontal angulation → direct beams through contacts.
Side fx of Marijuana?
Increased risk for cavities, gum disease, oral cancer 60% more likely to have gum disease vs. those who don't smoke, as per ADA study in 2008
What do congestive heart failure agents do? Examples of drug? Side effects? What can a high dose of epinephrine do to these patients?
Increases force of cardiac contraction. HINT: Dig a lane Digoxin is generic, (Lanoxin is brand). Side fx: Gag reflex, salivation High dose of epi can increase risk of heart dysrhythmia.
How does diabetes mellitus make patients more susceptible to periodontal disease?
Increases the level of glucose present in the gingival crevicular fluid that serves as nutrition for bacteria. Can cause: + Delayed wound healing. + Increased risk for infections including candidiasis and periodontal disease. + Diminished sensation, burning mouth, parotid gland enlargement.
Cri du chat: What is it? Any oral manifestations? What other syndrome that's similar has which oral manifestations?
Individuals make a cat-like cry at birth and are mentally retarded. HINT: CAT and the WOLF No oral manifestations; however, individuals afflicted with the closely-related Wolf-Hirschhorn syndrome almost always have cleft lip and very low intelligence levels.
What's pericoronitis? Symptoms? Tx?
Infection of tissue flap (operculum) surrounding the crown of a partially erupted tooth caused by accumulation of food debris and bacteria under the tissue. Third molars are most affected. Patients can experience pain (radiating to the ear), foul taste, difficulty closing the jaw. + Clean the area and drain exudates. Excision of the soft tissue and/or extraction of tooth may be needed.
Define: Congenital Syphilis. Which bacteria causes it? How transmitted? 2 Oral visual/radiographic signs?
Infectious disease caused by Treponema pallidum spread from the mother who has syphilis to the infant through the placenta or during birth. Hutchinson incisors: screwdriver-shaped incisors (broad, cervically and narrow incisally) with a notched incisal edge. Mulberry molars: multiple tiny globules form on the molars instead of cusps.
Define: Pericoronitis. What causes it? Where does it occur?
Inflammation and infection of the tissue between the tooth and its overlying flap of gingiva (operculum). Usually occurs in an erupting mandibular third molar.
Arthritis: What it is, types (2--which more common?), Who, Symptoms (includes Oral), Medications and side fx
Inflammation of one or more joints. Types: +Osteoarthritis: damage to the cartilage of the joints (the hard, slick coating on the ends of bones). Enough damage can result in bone grinding directly on bone. Most common type of arthritis in the United States. +Rheumatoid arthritis: damage to the lining of the joint capsule (a tough membrane that encloses all the joint parts). Can eventually destroy cartilage and bone within the joint. Who: Arthritis is more common in women than in men. Symptoms" joint tenderness, swelling, and stiffness that worsen with age. Patients may have TMJ problems. Meds: the use of aspirin for inflammation can cause prolonged bleeding (aspirin is an anticoagulant). Corticosteroids can suppress the immune system.
What's Hepatitis? Causes? What can it progress to? Types? Which one should healthcare workers get a vaccine for? Which one has no cure? How long can the virus live outside the body for? Symptoms?
Inflammation of the LIVER caused by the hepatitis viruses, toxic substances (e.g., alcohol, certain drugs), and autoimmune diseases. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer. HINT: B-Blood & C-Caca (other fluids like saliva). NOTE: Hep B doesn't transmit through saliva, but C transmits through blood & saliva. ATE=A and E with food and water D-dizzy, piggyback on your Boyfriend (hep B) 5 viruses, types A-E. + Hepatitis B and C are transmitted through blood or other body fluids. + Hepatitis A and E are transmitted indirectly through contaminated food and water. + Hepatitis D is a piggyback virus that is linked to hepatitis B. Dental health care workers should be vaccinated against hepatitis B. No vaccine for hep C. Hepatitis virus can live outside the body for at least 7 days. Symptoms: fatigue, dark urine, and jaundice.
Define: Contact Dermatitis. What is it caused by? Where does it occur? What does it look like clinically? Classifications?
Inflammation of the skin caused by direct contact of an allergen with the skin. Hypersensitivity is the undesirable reaction produced by the normal immune system. Swelling, itching, and change in color may occur. The skin surface may also become smooth and shiny. Classified as a T cell-mediated immune response (Type IV hypersensitivity). + Type I: immediate reaction within minutes, can be fatal (e.g., anaphylactic shock). + Type IV: delayed response, T-cells mediated (e.g., Mantoux skin test for TB).
Define: Thalassemia. What does it look like radiographically?
Inherited disorders that cause damage to the red blood cells. Shows a peculiar trabecular pattern called "salt and pepper" effect on radiographs.
What do organ transplant agents do? Examples? Side fx?
Inhibit inflammation and prevent the transplanted organ(s) from being rejected. Drugs: cyclosporine (Sandimmune), etc. + Cyclosporine can cause gingival hyperplasia.
What does lingual innervate?
Innervates the floor of the mouth, lingual gingiva, and anterior portion of the tongue (sensory).
What does the IO innervate? What foramen does it pass through? Which teeth does this nerve block numb?
Innervates the upper lip, portion of the cheek, lower eyelid, side of nose. Passes through the infraorbital foramen. Infraorbital nerve block will numb maxillary anteriors and premolars.
Mental "Retardation" (Disability): What is it? Types (4)? Risk factors? Prenatal causes? Perinatal causes? Postnatal causes?
Intellectual function Mild (9-12 mental age) Moderate (6-9) Severe (3-6 ) Profound (3) Risk factors: biomedical, social, behavioral, educational (Table 59-1 p.972) - most prenatal Prenatal: genetic, developmental, poverty, malnutrition, violence, lack of care, drugs, alcohol, smoking Perinatal: birth injury, lack of care, abandonment Postnatal: traumatic brain injury, malnutrition, meningoencephalitis, fetal alcohol syndrome, poverty, neglect, abuse, violence, social deprivation, lack of care
What do pano films use that intraoral images don't use?
Intensifying screens! The film is sandwiched between the 2 screens.
What is the inverse square law? How does it work? + If cone length changed from 8 to 16 inches, how did the intensity change?
Intensity of radiation is inversely proportional to the square of the distance from the source of radiation. + Step 1: simply note how much shorter or longer the distance is (2 times farther → write 2, 3 times shorter → write 3). + Step 2: square the number (2 times farther or shorter → 2 squared = 4; 3 times farther or shorter → 3 squared = 9). + Invert the number only if the source is farther (2 times farther → 4 → ¼, this means the beam is ¼ intense) (3 times shorter → 9 → do not inverse, this means the beam is 9 times more intense). Example: 2 times further → 2, 2 squared = 4, further therefore inverse = ¼. Reduced by 4 times, or ¼ the original intensity.
Which cytokines play role in destruction of periodontium?
Interleukin-1, interleukin-6, interleukin-8 & tumor necrosis factor-alpha
What are the 2 locuses of control involved in the Motivation Theories model?
Internal locus of control: patients believe that they have control over their life. External locus of control: patients believe that their decisions are controlled by environmental factors, such as fate.
Which parenteral administration method allows for 100% instant and complete availability of a drug in the bloodstream? It's also the best option to control the level of drugs. When is this method used?
Intravenous. Used in emergency situations & chemotherapy
The tongue muscles can be divided into ___ and ___.
Intrinsic, Extrinsic
What is particulate radiation?
Involves particles that have mass and travel in straight lines at high speeds. Cannot reach speed of light. May have a charge (except neutrons). Include neutrons, protons, electrons, Beta particles, Gamma particles
What's breach of contract?
Involves the breaking of a contract by either party involved.
What causes Iron-deficiency anemia? When is it worse?
Iron deficiency. Menstraution and pregnancy.
If something has MORE contrast what does that mean?
It has more shades of grey (like in a pano). IT IS NOT DARKER. Darker=density.
What causes Herpes Simplex Infection? Type 1 causes which type of infections vs. type 2? What are the names of the 2 types?
It is caused by a group of viruses called human herpes viruses (HHVs). Oral infections are generally caused by type 1, and genital infections by type 2 herpes. Primary herpetic gingivostomatitis Recurrent herpes simplex infection
What is density? How do you maintain it? What decreases it? + 15mA, 90kVp, 10 sec is changed to 10mA, 90 kVp. To keep the same density, how long should the exposure be?
It's darkness. It's proportional to amperes, kVp and time. It's also decreased if the target structure is dense. Milliampere-seconds (mA-s): Combo of milliamperes and seconds. If increase time, decrease milliamerage. 15 sec
What affects beam intensity? What is intensity? How do you increase intensity?
It's total energy contained in the beam. Affected by mA, kVp, distance, exposure time. Increase intensity: Increase mA, kVp, and time, decrease the distance.
Pano errors: How do you fix ghost image?
Jewelry not removed → remove all jewelry and removable dentures.
What is Deontology? Who came up with it?
Kant. a person should act right regardless of consequence. Determines that morality, principles, and actions are unconditional.
Which health promotion model can be used for implementing positive behaviors, such as flossing? Learning Ladder Health belief model Maslow's Heirarchy of Needs Learning Domain
Key word: Implementing. Health Belief Model
Which organ is usually involved in excretion (elimination) of drugs and their metabolites from the body? What other sites are involved in excretion?
Kidneys excrete, urine flushes them and their metabolites out of the body. Other: intestines, saliva, gingival crevicular fluid, sweat, tears, breast milk, and lungs.
Labial vs. lingual mounting: Where should the raised dot be? What is orientation of the viewer?
Labial: Raised dot toward viewer, viewer is reading radiograph as if standing in front of and facing the patient. Lingual: raised dot is away from viewer, viewer is reading radiograph as if standing behind patient.
Incas made Lace
Lacerum = Internal Corotid
How does obesity or poor nutrition put someone at increased risk for perio disease?
Lack of nutrients can compromise the body's immune system and make it harder for the body to preserve the oral tissues. + Vitamin C is important for wound healing and collagen production. + Protein is important in the repair process.
What type of bacteria are found in deep carious lesions? What kind are they (+ or - & shape?)
Lactobacillus, gram + rods
What's a Cephalometric projection? What do you use it for?
Lateral view of the skull and evaluates trauma, and facial growth.
What's the smear layer?
Layer of debris that closes up the tubules. Prevents hypersensitivity.
Schedule V controlled substance: What does this classification mean? Potential for addiction? Examples?
Least potential for abuse, limited dependence. + Medical use (e.g., codeine cough syrup, etc.) + Potential for Addiction: Abusing the drug may lead to mild mental or physical addiction.
Define: Sessile
Lesion has an attachment larger than the top
Define: Pedunculated
Lesion has an attachment smaller than the top. The base is called stalk or pedicle. It's mushroom-shaped
Define: Primordial Cyst. What look like radiographically? What causes it? Where? Symptoms?
Lesion that develops in place of a tooth. Appears as a well-defined radiolucency. Most commonly found in place of a third molar or posterior to an erupted third molar. Usually asymptomatic.
Define: Pyogenic Granuloma. AKA? What does it look like? Benign or malignant? Who gets it? Where is it? When does it go away? What does pyogenic mean?
Lesion usually associated with pregnancy and is commonly called the pregnancy tumor. Usually heals after delivery. Appears as a raised, soft, red/purple lesion that bleeds easily. Gingiva is the most common location, but the lesion can occur in other areas. Men and non-pregnant women can also be affected by pyogenic granuloma. Pyogenic=you can squeeze it and there's pus.
Schedule IV controlled substance: What does this classification mean? Potential for addiction? Examples?
Less potential for abuse, limited dependence. + Medical use (e.g., diazepam (Valium), etc.) + Potential for Addiction: Abusing the drug may lead to moderate mental or physical addiction.
Schedule III controlled substance: What does this classification mean? Potential for addiction? Examples?
Less potential for abuse, moderate dependence. + Medical use (e.g., Tylenol #3, etc.) + Potential for Addiction: Abusing the drug can cause severe mental addiction, or moderate physical addiction
Bottled water usually contains how much fluoride?
Less than 0.3 ppm
What type of cells in the blood defend against infections? Name the 3 subtypes and which is the most numerous type, second most numerous type,
Leukocytes (WBC) 5000-10,000/mm3 present in blood. + Neutrophils: most numerous, 1st line of defense during infection by phagocytosis. + Lymphocytes: 2nd largest component of white blood cells, provide immune response. Comprise 30-40% of all leukocytes. + Monocytes: arrive at site after the neutrophils during inflammatory response. Comprise 7% of all leukocytes.
Lidocaine: Is this brand or generic name? What's the other name? Where is this drug metabolized? What is it also used for?
Lido=generic name (Brand: Xylocaine) + Mostly metabolized in the liver. + Also used for cardiac arrhythmia.
Which local anesthetics are safer to use on pregnant patients? What pregnancy category are they in? Can you use nitrous? When is best time to do dental procedures?
Lidocaine & Prilocaine. Category B. No nitrous Second trimester
Names of amide drugs (generic then brand)? How is each metabolized?
Lidocaine (Brand: Xylocaine) + Mostly metabolized in the liver. + Also used for cardiac arrhythmia. Mepivacaine (Brand: Carbocaine) + Mostly metabolized in the liver. + Weaker vasodilators. + Formula also available with no epinephrine (used when epinephrine is contraindicated). Articaine (Septocaine) + Mostly metabolized by the plasma and some in the liver. Used for patients with liver diseases. + Higher chance for paresthesia compared to other local anesthetics. Prilocaine (Citanest) + Metabolized in the liver, lungs, and kidneys. + Formula also available with no epinephrine (used when epinephrine is contraindicated). Bupivacaine (Marcaine) + Mostly metabolized in the liver. + Provides long (up to 12 hours) relief. Useful for surgeries.
Median Palatine cyst: What does it look like radiographically? Where do they occur?
Located in the midline of the hard palate, more posterior than the nasopalatine canal cyst. Appears as a well-defined unilocular radiolucency.
What can you teach patients who smoke to look for in their own mouths?
Look for pigmentation such as smoker's melanosis (examine under and on the lateral sides of the tongue as those areas are more susceptible to lesions).
What's dehiscence?
Loss of alveolar bone on the facial (rarely lingual) aspect of a tooth that leaves a characteristic oval, root-exposed defect from the cementoenamel junction apically. The defect may be one or two millimeters long or extend the full length of the root. The three features of dehiscence include gingival recession, alveolar bone loss, and root exposure.
Verrucous Carcinoma: Is it benign or malignant? What does it look like visually? Prognosis? Who is most commonly affected? Risk factors?
Low-grade Squamous Cell Carcinoma. Has a much better prognosis than squamous cell carcinomas, and represents about 5% of oral cancers. Presents as a slow-growing exophytic tumor with a pebbly white/red surface or cauliflower-like papillary form. Risk factors include irritation, human papilloma virus (HPV) infection, and smoking.
Cystic Fibrosis: What is it? Symptoms?
Lungs produce abnormally thick and sticky mucous that blocks the alveoli and can become infected. Symptoms include persistent coughing or wheezing, and weight loss.
What is bacterial rupture called?
Lysis
Is a virus bigger or smaller than a fungus or bacterium? How does it replicate? How do antiviral agents work? How do they differ from antibiotics? Examples of antiviral drugs and what they treat?
MUCH smaller. Must invade a living cell and release its DNA or RNA in order to reproduce. Antiviral agents interfere with the viral replication process. Unlike antibiotics, specific antivirals are used for specific viruses. Drugs + Acyclovir (Zovirax): treats herpes simplex 1 (HSV1), herpes simplex 2 (HSV2), mononucleosis (Epstein-Barr virus), and shingles (varicella-zoster). + Docosanol (Abreva): treats oral herpes labialis (cold sores). + Zidovudine (AZT, Retrovir): treats HIV infections.
What is end-stage renal disease? Cause? Treatment and how often for how long? What will patient eventually need? Tx mods? Oral conditions?
Main filtration system, the glomerulus in the kidney, becomes damaged and cannot properly remove excretions. As a result, uremia (build-up of excretions in the blood) causes toxicity. Patients with end-stage renal diseases undergo dialysis. + Hemodialysis machine is hooked up to the patient for 3-5 hours 2-3 times a week. Eventually, the patient will need a transplant. Treatment mod: Schedule dental visits the day after dialysis due to complications with anticoagulants (heparin) given during dialysis. Cyclosporine (Sandimmune), an anti-rejection agent for transplants can cause gingival hyperplasia. Oral conditions: candidiasis, metallic taste from urea in saliva, xerostomia, stomatitis, bleeding gingiva.
Schizophrenia: What is it? Who affects? Cause? Symptoms? How to treat? Medications for each type of symptom (+ and -)? ADR? Treatment modific.
Major psychotic illness - patient has different reality, delusions, hallucinations Who: Onset 15-24 in males, 25-35 in women, genetics Cause: excess dopamine in specific brain synapses Treat: Exaggerated (positive symptoms) or absence of behaviors (negative symptoms), neglect; needs antipsychotic meds HINT: Hal wants a throat losenge for cough (Haldol, Thorazine, + symptoms) Meds Effective for + symptoms: Thorazine, Haldol Meds Effective for - symptoms: Risperdal ADR - agranulocytosis, infection, candidiasis, tardive dyskinesia, alcohol and drug use (smoking), xerostomia Tx Mod - plan a simple routine, establish competence for informed consent
What is Bremsstrahlung (Braking) Radiation?
Major source of x-rays produced in dentistry (70%). Results when high-energy electrons come close to the nuclei of the tungsten atoms. The electrons move towards the nucleus (since they have opposite charges) and then slow down (this is why the name "braking" is used). When the electrons brake, energy is released (photons).
Define: Carcinoma in situ
Malignant tumor that has not metastasized into deeper layers
What do patients who have alcohol dependency usually suffer from? Oral conditions? Things to avoid? Symptoms?
Malnutrition, especially thiamine (B-1) and folate (B-9) deficiency. Symptom: Red, bulbous nose (subtype of rosacea: rhinophyma) Alcohol and tobacco used in combination significantly increase the risk of oral cancer. + Teach patients to perform self-oral cancer exam. Avoid alcohol-containing mouthwashes and nitrous oxide.
Corticosteroids: What do they do? When used? Side effects? Examples of drugs and how to take them?
Man-made drugs that closely resemble cortisol, a hormone produced by the cortex of the adrenal glands. Often called glucosteroids. Decrease inflammation, allergic reactions, and treat autoimmune disorders such as Addison's disease. Side effects: increased risk for infections, peptic ulcers, delays in healing, and osteoporosis. +Buffalo hump and moon face are caused by the deposition of fat in those areas. (Cushing Syndrome, side effect of meds they are taking too). HINT: -asone, As one. CT CT=corticosteroid, corticosteroid. Drugs: prednisone (Deltasone), methylprednisolone (Medrol), etc. Consume the drug with food or milk to prevent stomach upset.
Reichert's cartilage is in which pharyngeal arch? What parts of the ear does it form?
Mandibular (2) Stapes
Which tooth is usually the 1st to erupt in permanent dentition?
Mandibular 1st molar
Of the mandibular molars, which has 5 cusps? How many roots? What special features does it have?
Mandibular 1st molar: 2 roots, 5 cusps (3 facial, 2 lingual). + Wider mesio-distally than bucco-lingually. + Most complex developmental groove of all permanent mandibular molars. + Largest tooth in arch and in permanent dentition.
Of the mandibular premolars, which has 2 cusps? How many roots?
Mandibular 1st premolar. 1 root.
Of the mandibular molars, which has 4 cusps? How many roots?
Mandibular 2nd molar: 2 roots, 4 cusps.
Of the mandibular premolars, which has 3 cusps? How many roots? What special features does it have?
Mandibular 2nd premolar. 1 root, 1 buccal cusp and 2 lingual. + Y-shape grooves with a central pit on the occlusal surface. + Larger than the mandibular 1st premolar.
Of the mandibular molars, which usually has fused roots? Is the crown larger or smaller vs. the other molars on that arch? What else does it have?
Mandibular 3rd molar: usually fused roots. + Smaller crown than the 1st and 2nd molar, more supplemental grooves.
Describe the movements of the temporomandibular joint and their relationship with the muscles in the head and neck region.
Mandibular Movements=TMJ Movements=Associated Muscles Protrusion of mandible/moving lower jaw forward=Gliding in both upper synovial cavities (lateral deviation)=Lateral pterygoid, bilateral contraction Retraction of mandible/moving lower jaw backward=Gliding in both upper synovial cavities=posterior portion of temporalis, bilateral contraction Depression and protrusion of mandible/opening jaws=Gliding in both upper synovial cavities and rotation in both lower synovial cavities=Suprahyoids and inferior heads of lateral pterygoid, bilateral contraction Lateral deviation of mandible/to shift lower jaw to opposite side=Gliding in one upper synovial cavity and rotation in opposite upper synovial cavity=Lateral pterygoid, unilateral contraction
Which tooth is the smallest and most symmetrical in the entire dentition?
Mandibular central incisor
Which primary tooth erupts first? When?
Mandibular central incisor. 6-10 months on avg.
Which type of molars are bifurcated vs. trifurcated? Which type of premolar can have bifurcated roots?
Mandibular molars are usually bifurcated (mesial and distal roots), with potential furcation involvement on both the facial and lingual aspects of the tooth. Maxillary premolars can have bifurcated roots (bucal and palatal) with potential furcation invovlemen ton mesial and distal aspects of the tooth. Maxillary molars are usually trifurcated (mesiobuccal, distobuccal, and palatal roots) with potential furcation involvement on the facial, mesial, and distal aspects of the tooth.
Bipolar: What is it? Treat with what type of meds? ADR? Tx mods?
Mania and depression Tx: +manic phase: sedation (benzodiazepine) anticonvulsants (valproic acid) antipsychotics (olazapine, risperidone) lithium +depressive phase: antidepressants ADR - xerostomia, dysgeusia (lithium), neglect, stomatitis, glossitis Tx mod - simplify, no rush
Which types of enzymes play a role in breakdown of connective tissue?
Matrix metalloproteinases (MMPs)
Which teeth are the most likely to develop lingual caries? Why?
Max Lateral Incisors because of deep lingual fossae
Which anterior teeth have a larger, well-developed teeth--max or mand? Which anterior teeth have smoother and rounded cingulum?
Max, mand.
Which has more pronounced lingual anatomy for anterior teeth: Maxillary or mandibular?
Maxillary
Meckel's cartilage is in which pharyngeal arch? What parts of the ear does it form?
Maxillary (1). Malleus & Incus
Of the maxillary molars, which has 4-5 cusps? How many roots? What special features does it have?
Maxillary 1st molar, 3 roots (2 buccal, 1 lingual), 5th cusp is Cusp of Carabelli on ML.
Which teeth can have root concavities that are a predisposing factor for perio diseases? What is the good thing about these concavities?
Maxillary 1st premolar, mesial surface Increase the attachment area to provide more retention
Of the maxillary molars, which has 3-4 cusps? How many roots? What special features does it have?
Maxillary 2nd molar. 3 roots (2 buccal, 1 lingual), 3 or 4 cusps. + Rhomboidal or heart-shaped crown.
Which maxillary premolar has 1 roots? How many cusps does it have? What special feature does it have?
Maxillary 2nd premolar. 2 cusps. Concavity on root not as pronounced as 1st premolar.
Of the maxillary molars, which usually has fused roots? Is the crown larger or smaller vs. the other molars on that arch? What else does it have?
Maxillary 3rd molar: usually fused roots. + Smaller crown than the 1st or 2nd molar, more supplemental grooves.
What's the last primary tooth to be lost usually?
Maxillary canine or 2nd molar
Which tooth is the longest in the dentition? How many lingual fossae dos it have? How many lingual ridges?
Maxillary canine: longest tooth in the dentition.
Which tooth is most likely to be congenitally missing?
Maxillary lateral
Which teeth are most likely to provoke gag reflex?
Maxillary molars
What is efficacy? Where does a more effective drug show up on a graph? Is there a relationship between potency and efficacy? Will administering more drugs increase the efficacy of a drug?
Maximal response obtained by a drug (Emax). + The drug with the highest point on the graph has the greatest efficacy. + There is no relationship between potency and efficacy. Administering more drugs will not increase the efficacy of the drug, but will create more adverse reactions.
Can intrinsic stain be affected by whitening?
May be reduced by it/
Which teeth are succedaneous? Which are nonsuccedaneous?
Means have primary predecessors. So anterior and premolar teeth. Molars are non.
What's Chi-square test? What does it stand for? What does it compare? How does it compare them?
Measures the difference between two or more qualitative data (e.g., Is the distribution of sex and voting behavior due to chance or is there a difference between the sexes on voting behavior?)
Define and give an example: Simple index
Measures the presence or absence of a condition (e.g., plaque control record).
Dean's Fluorosis Index: What does it measure? Which teeth does it apply to? How do scores work?
Measures: Result of excessive ingestion of fluoride during tooth formation Applies to: Most severe form of fluorosis found on 2 or more teeth Score: + Normal (0): translucent, pale color. + Questionable (0.5): few white flecks. + Very mild (1): opaque, paper-white areas, < 25% of dentition affected. + Mild (2): white opacities, < 50% of dentition affected. + Moderate (3): brown stains. + Severe (4): pitted areas, brown stains.
Vertical linear radiolucency observed in maxillary central incisor radiographs?
Median palatine suture
Mepivacaine: Is this brand or generic name? What's the other name? Where is this drug metabolized? Is this a stronger or weaker vasodilator? Is it available with epi? Without epi?
Mepi=generic (Brand: Carbocaine) + Mostly metabolized in the liver. + Weaker vasodilators. + Formula also available with no epinephrine (used when epinephrine is contraindicated).
What is the most common supernumerary tooth? Where is it located? What about the second most ocmmon? Do supernumerary teeth usually erupt?
Mesiodens, between maxillary central incisors. Second most: Maxillary 4th molar (AKA distomolar) Smaller and don't usually erupt.
Diabetes Mellitus: What is it? What's insulin?
Metabolic disease related to insulin that is produced in the pancreas. + Insulin: hormone needed to convert sugar, starches, and other food into energy for daily life.
How are esters metabolized? Are they stable or unstable in solution? Are they more likely to cause allergies than amides? Examples of drugs?
Metabolized in the plasma via pseudocholinesterases. Unstable in solution. Much more likely to cause allergies than amino amides. Procaine, cocaine, propoxycaine, tetracaine, benzocaine, etc. (have one "i" in name).
Which drugs can cause black hairy tongue and metallic tase?
Metronidazole (antibiotic AKA Flagyl)
What's Arestin? How does it work? How long is it effective for? OHI?
Microspheres of minocycline (derivative of tetracycline) are inserted into the pocket (by cannula tip). + Microspheres dissolve - no need to remove anything from the pocket. + Bacteriostatic for up to 14 days. + Do not brush for 12 hours and do not floss at sites for 10 days.
Mild vs. moderate vs. severe periodontitis
Mild: 4-5 mm probe depth, 1-2 mm CAL. Moderate: 6-7 mm probe depth, 3-4 mm CAL, Cl 1 or 2 tooth mobility, Cl 1 furcation. Severe: 7+ mm probe depth, 5+ mm CAL, Cl. 2 or 3 mobility, Cl. 2 3 or 4 furcation.
What is Utilitarianism? Who came up with it?
Mill. The greatest good for the greatest number of individuals is the right action. Right and wrong of an action are based on its usefulness.
Types of tooth mobility
Miller classification + Class I: up to 1 mm horizontal displacement in a facial-lingual direction. + Class II: 1-2 mm horizontal displacement in a facial-lingual direction. + Class III: greater than 2 mm horizontal displacement and/or presence of vertical depression.
What is the only measure of central tendency that can be used when measuring nominal data?
Mode The three measures of central tendency are mode, median, and means. Since mode measures the frequency of distribution or the value that occurs most often, it is the only measure of central tendency that can be used on nominal data. Nominal data is data that is categorized by way of a distinct characteristic but one that cannot be measured or ranked. Examples of nominal data include gender and SES socioeconomic status. The other measures of central tendency, namely median and mean, both use rank order or value to determine central tendency. Median is the mid-point of the data where half of the values are above and half are below. The mean is measured as the arithmetic average for a set of data.
What does MAO stand for? More or less targeted? What are they? How do they work? Examples?
Monoamine oxidase inhibitors. Older-generation antidepressants so LESS targeted. Phenelzine (Nardil), etc.
Morbidity vs. mortality?
Morbidity rate: number of actual diseases divided by number of possible diseases. Mortality rate: number of actual deaths divided by number of possible deaths.
What's CAL? How measured?
More accurate indicator of the periodontal support around a tooth than probing depth. CAL is measured from a fixed point on the tooth that does not change, the CEJ. HINT: If too high gingiva (inflammed), take away (subtract). Two measurements needed: Gingival margin to the CEJ, and probing depth. + In recession, probing depth + gingival margin to the CEJ (add). + In tissue overgrowth, probing depth - gingival margin to the CEJ (subtract).
How do you treat TMD?
Most cases improve over time with relaxation therapy, stress management, habit control, muscle exercises, etc. (e.g., avoid eating hard foods and chewing gum). + Occlusal adjustment, jaw repositioning, and orthodontic treatment may be needed. + Stabilization splint is helpful in controlling bruxism and to take stress off the TMJ, although some individuals may bite harder on it and worsen the problem.
Spina bifida: What it is, types, Causes, Symptoms Management
Neural tube defect caused by the failure of the spine to develop and close properly during the first month of pregnancy. Results in the incomplete development of the brain and spinal cord. Caused by folic acid (B-9) deficiency. Parapelgia. Different degrees of permanent paralysis exist. Types: +Meningocele (protrusion of meninges and cerebrospinal fluid from open bony defect of spinal column) +Meningomyelocele (most severe type--usually experience hydrocephalus so fluid buildup around brain that puts pressure on brain) Cause: Genetic or environmental -prenatal folic acid can prevent Manage: Wheelchair, usually latex allergy
Sensitivity in the area of the parotid glands is most closely associated with which illness? What causes this illness? Symptoms of it? Oral manifestations?
Mumps: Caused by Paramyxovirus. A classic symptom of mumps is tenderness and swelling of the parotid glands, ranging from very slight to severe. Although all salivary glands can be involved, the parotid glands are most frequently affected. Fever, headache, and anorexia are also symptoms. Orally, mumps can cause dry mouth, sore face and/or ears, and occasionally in more serious cases, loss of voice.
What is Mydriasis vs. Miosis?
Mydriasis=pupil dilation Miosis=pupil constriction
What's Type II diabetes (AKA?) Cause? More or less common? Who has it? Treatment?
NIDDM or non-insulin dependent: the body cannot produce ENOUGH insulin or cannot use insulin properly. This type is more common (90% of cases) + Obesity is a common finding in people with type 2 diabetes and therefore may be preventable. + Treatment: insulin therapy, proper diet, and exercise.
Is the presence of bacteria alone sufficient to cause perio disease?
NO
If a patient is allergic to Penicillins, could you prescribe Keflex?
NO, effect and side effects of Keflex are similar to penicillins.
Is stain a risk factor for development of caries?
NO, regardless of if it's intrinsic or extrinsic. REVIEW the 3 components of caries (carbs, bacteria, tooth structure)
Is pulp calcified? What's it mainly composed of?
NO. Composed mainly of fibroblasts & water.
What type of fluoride is the active ingredient in fluoride (dietary) supplementation? What are the amounts of <0.3, 0.3-0.6, and >0.6 PPM in drinking water recommended for birth-6 mo, 6 mo-3 years, 3-6 years, and 6-16 years? What about if pregnant?
NaF Birth-6 mo: All 3=none 6 mo-3 years: <0.3 PPM=0.25 mg/day; 0.3-0.6 PPM=None; >0.6 PPM=None 3-6 years: <0.3 PPM=0.50 mg/day; 0.3-0.6 PPM=0.25 mg/day; >0.6 PPM=None 6-16 years: <0.3 PPM=1.0 mg/day; 0.3-0.6 PPM=0.50 mg/day; >0.6 PPM=None No proven benefit for unborn child if taken while mom is pregnant
What type of probe should be use to assess presence and extend of a furcation?
Naber's probe (aka furcation probe)
Who is the NIH? What do they do?
National Institutes of Health: conducts research, prevention, planning, and development programs related to health.
What are NK cells? How do they work?
Natural Killer cells. Body has special protein on surface called MCH1. When body is infected, won't make MCH1 proteins. NK detects the abnormality, pokes it then kills it through apoptosis.
What's Necrotizing Ulcerative Periodontitis (NUP)? Who experiences it most? Characteristics? Tx?
Necrosis of the gingival tissues combined with loss of attachment and alveolar bone. + Patients present with symptoms similar to NUG accompanied by loosening of teeth, rapid loss of bone and soft tissue. + Occurs most commonly in immunocompromised patients with diseases such as HIV/AIDS.
What is a neuron? What are its 4 parts?
Nerve cell. Nucleus, dendrite, body, axon.
Autistic Spectrum Disorder: What is it? Etiology? When does it occur and in who? How does it impact them? Symptoms? Types? Manage? Oral conditions?
Neurological disorder that results in developmental disabilities. Unknown etiology. Occurs within the first 3 years of life and is more prevalent in boys than girls. Affects ability to understand and communicate Spectrum of symptoms from mild to severe. Speech difficulties, lack of social skills, and learning disabilities. Asperger: High-functioning type of autism. Rett: Rare, in baby girls, growth slows at 12-18 months, wring and then can't use hands, no language skills, struggle with coordination and breathing. Provide a dental routine in a quiet atmosphere and avoid direct eye contact. Oral Conditions: higher risk for caries if caregiver reinforces behavior with cariogenic foods. Possible self-abuse behavior can lead to trauma.
What's cerebral palsy? Types?
Neuromuscular condition resulting from brain damage, congenital or acquired (prenatal, natal or postnatal). Movement disorders. Seizures. +Spastic: Most common type of CP (70-80%). Damaged cerebral cortex (outer layer of brain) at birth or when young. Increased muscle tone because muscles always in tension. +Athetosis: 10-25%. Damage to basal ganglia (midbrain). Involuntary slow and writhing movements in extremities, facial grimacing/drooling. Mixed muscle tone: some muscles tense, others not. Symptoms lessen during sleep. +Ataxia: 5-10%. Damage to cerebellum (base of brain). Difficulty with balance and coordination, low muscle tone, gait problems (wide walk), tremors when trying to complete a voluntary fine motor movement (tie shoe, brush teeth). Affects all 4 limbs and trunk
The majority of white blood cells are: Lymphocytes Erythrocytes Monocytes Neutrophils
Neutrophils (1st line of defense) Followed by: Lymphocytes: B cells, T cells, NK cells -second largest component of WBC + Monocytes: arrive at site after the neutrophils during inflammatory response. Once leave blood and enter tissue, differentiate into macrophages.
Oral Pathology Related to Tobacco Use: What 3 conditions?
Nicotine Stomatitis Tobacco Pouch Keratosis Smoker's Melanosis
Do lymphatic vessels have valves?
No
How often is health history gathered?
No specific rules apply to how often health history should be gathered. Patient's health information should be updated at every appointment.
Do artificial joints require premed?
No, UNLESS patient is immunocompromised and/or has an infection. As per Journal of American Dental Association, January 2015 update. If pt has hx of complications associated with their joint replacement surgery & are undergoing dental procedures that include gingival manipulation or mucosal incision, prophylactic antibiotics should only be considered after consultation with the patient and orthopedic surgeon; in cases where antibiotics are deemed necessary. Previous guidelines recommended the use of antibiotics for two years after surgery. Premedication for life was also included in even earlier guidelines.
If a patient is a smoker and wants an implant, should a periodontist give him one? Why or why not?
No, because smokers are more likely to have implant failure. Should educate them on quitting first.
Do local factors initial periodontal diseases? Examples?
No, but they contribute to plaque retention. Overhangs, calculus, furcation, cavities, irregular tooth morphology like grooves, concavities
Are allergic effects dose-related?
No, unpredictable and NOT dose-related.
Does perio dressing adhere to teeth? Does it speed up wound healing process?
No. The periodontal dressing does not automatically adhere to the teeth or gingiva; it is retained by the material that is interlocked around the neck of the teeth through the embrasure space. It also doesn't have any wound-healing property.
What does NSAID/NAID stand for? How do they work? When are they most effective? What actions do they have (HINT: 3 anti-s)? What conditions are they commonly used for? Contraindications? Examples of NSAIDs? Which example can a small percentage of patients be allergic to?
Non-Steroidal Anti-Inflammatory Drugs. Act by blocking the formation of pain mediators in the peripheral nervous system. + More effective if taken before pain. + Antipyretic (fever-reducing--affect hypothalamus which controls body temp), anti-inflammatory (inflammation reducing), and analgesic (pain-relieving). + Commonly used for arthritis because of its anti-inflammatory benefits. Contraindications: +When taking blood thinners like warfarin (Coumadin) because it can interfere with blood's ability to clot. +When have peptic ulcer because it can cause GI irritation. Drugs: + Aspirin: small percentage of patients can be allergic to aspirin. Aspirin is also used as an antiplatelet agent. + Ibuprofen (Advil, Motrin), naproxen (Aleve), etc.
Side effects act on the (target/non-target) organs. They are (predictable/not predictable) and (dose-related/not dose related)
Non-target, predictable, dose-related
What does NDRI stand for? What are they? How do they work? Examples?
Norepinephrine and dopamine reuptake inhibitors. Bupropion (Wellbutrin), etc.
What is the: Normal pH of mouth Critical pH for enamel demin? Critical pH for root demin? Which demineralizes easier: enamel or roots? What's the pH of toothpaste?
Normal: 6.7-7 Enamel: 4.5-5.5 Root: 6.6-7 (so they demineralize easier vs. enamel) Toothpaste: 9
Is a tumor cancerous? What suffix (ending) indicates it's a tumor?
Not necessarily. It just means swelling or growing. -oma
What is an ampere? What does an increase in them mean? How does this apply to dental machines?
Number of electrons per second. An increase in amperage increases the number of electrons that "work." Dental machines operate with 5-15 mA.
Oral Hygiene Index - Simplified: AKA? What does it measure? Which teeth does it apply to? How do scores work? What is it typically used for?
OHI-S Measures: Presence of plaque and debris on tooth surfaces. Applies to: ONLY 6 teeth (3, 8, 14, 24 & 30). Explorer is passed over buccal and lingual surfaces of teeth Score: 0=no calc or plaque; 1=supra calc or plaque cover <1/3 of tooth surface; 2=supra calc or plaque covering 1/3-<2/3 of tooth surface OR individual sub calc flecks; 3=supra calc or plaque covering >2/3 or heavy band of sub calc Used for: Small and large population studies, NOT individual eval
Which type of caries are harder to detect and why?
Occlusal caries because of the superimposed structures of the tooth.
What's Maxillary occlusal technique?
Occlusal plane parallel to floor, positive 65° vertical angulation. Central rays are directed through the tip of the nose.
What's Cross-sectional maxillary occlusal technique?
Occlusal plane parallel to floor. Beams are perpendicular to the receptor and directed between the eyebrows.
What is Klinefelter syndrome? Cause? Symptoms? Oral signs?
Occurs when a male has an extra X chromosome. Cause: nondisjunction defective chromosomal separation during meiosis, primarily associated with increased maternal age. Abnormal sexual features become apparent at puberty. Orally, the maxilla is slightly underdeveloped.
Define: Odontogenic Keratocyst. What causes it? What look like radiographically? Where seen? What can it do to oral cavity? What condition is it associated with?
Odontogenic tumor that is thought to arise from the dental lamina (band of epithelial cells covering the embryonic jaw that grows down into the tissue to form a tooth). Appears as a well-defined, multilocular, radiolucent lesion. Most often seen in the mandibular posterior region. Lesions can move teeth and resorb tooth structure, but do not usually cause expansion of the bone. Associated with nevoid basal cell carcinoma syndrome (Gorlin syndrome).
What does heroin do once it is in the brain (convert to, then what does)? Symptoms of Heroin/Morphine Addiction?
Once in brain, converts to morphine & binds to opiate receptors REMEMBER: Pinpoint pupils, think person moves slower than usual Pinpoint pupils (all narcotics: heroin, morphine, codeine, fentanyl, methadone can cause pupil constriction), decreased blood pressure/respiration/body temperature/heartbeat.
What is macrodontia? Is it more common to have 1 tooth affected or all? what is facial hemihypertrophy?
One or more teeth in a dentition are larger than normal. It's uncommon for it to just affect one tooth--usually more generalized. Localized macrodontia affecting one side of the dental arch.
What is microdontia? Is it more common to have 1 tooth affected or all? Which two teeth are most often affected?
One or more teeth in the dentition are smaller than normal. More commonly involving single tooth The maxillary lateral incisor, called peg lateral, and the maxillary third molar are the teeth most often affected.
Open bite vs. crossbite?
Open: No vertical overlap of lower incisors by upper incisors (or can occur with posteriors too). Usually due to tongue thrust. Cross: form of malocclusion where a tooth (or teeth) has a more buccal or lingual position than its corresponding antagonist tooth in the opposite arch. In other words, it refers to cases in which the maxillary teeth fall inside the mandibular teeth on one side. + An anterior crossbite will show maxillary anterior teeth falling behind the mandibular anteriors.
What are Local Contributing Factors? Example?
Oral conditions that increase an individual's susceptibility to periodontal infection in individual teeth or surfaces of a tooth. Calculus
Diabetes patients: Oral conditions & treatment mods?
Oral conditions: patients are susceptible to infection (periodontal disease and oral candidiasis), and show poor wound healing. Xerostomia, parotid gland enlargement, loss of taste, burning mouth symptoms are also common. Patients with uncontrolled diabetes should not be treated until their diabetes is under control.
Cerebral palsy Oral manifestations? Dental hygiene management issues?
Oral man: +Bruxism +Gingival enlargement/hyperplasia if on Dilantin/phenytoin for seizures +Broken teeth (due to trauma from freq. falls) + Drooling, gag reflex, difficulty opening mouth. + Mouth breathing, tongue thrusting. + High risk for caries and periodontal diseases. Manage: Wheelchair, communication, involuntary movements, drooling.
HIV/AIDS: Oral Conditions? Treatment modifications?
Oral: + Candidiasis (most common intraoral manifestation for HIV). + Linear gingival erythema: darker color band along the gingival margin. + Hairy leukoplakia: white lesion on the lateral border of tongue. + Kaposi's sarcoma: red/purple, flat/raised lesion on the hard palate, tongue, and gingiva. + NUG/NUP: ulceration and necrosis of gingiva with or without periodontal attachment loss. + Herpes: vesicles are widespread, and persist for months. STANDARD PRECAUTION must be used for all patients. Prophylactic antibiotic is recommended for invasive procedure (CD4 cell count below 200/mm3, neutrophil lower than 500/mm3) because the patient is susceptible to opportunistic infection.
What is the origin and insertion of the mentalis muscle?
Origin: Incisive fossa of mandible Insertion: Skin of the chin
Sanguinarine: What is it? What percentage alcohol? How use>?
Originates from bloodroot Sanguinaria Canadensis plant (e.g., Viadent dentifrice). + Contains around 15% alcohol. + Minimal Use toothpaste and rinse in combination for effect.
What is a common side effect of anti-hypertensive agents?
Orthostatic (postural) hypotension
Define: Exostosis
Overgrowth of normal compact bone on the buccal aspect of the maxilla or mandible. No treatment is indicated unless it interferes with a prosthetic appliance.
What's overlap caused by? What about elongation and foreshortening? How do you fix them?
Overlap: caused by improper horizontal angulation. HINT: Helicopter above a building will make tooth look small (like a max. tooth), so to fix the foreshortening, bring tube down or decrease angulation. If helicopter is on the ground, building is tall (like a max. tooth), so to fix the elongation, bring tube up or increase angulation. Elongation and foreshortening: caused by improper vertical angulation. + Elongation: caused by underangulation. Therefore, increase angulation. + Foreshortening: caused by overangulation. Therefore, decrease angulation. In paralleling technique, the film and long axis of the tooth must be parallel to each other to prevent distortion.
What 3 bacteria are associated with chronic periodontitis?
P. gingivalis T. forsynthia T. denticola
Pregnancy-induced gingivitis or periodontitis is characterized by what type of bacteria?
P. intermedia
What bacteria is associated with pregnancy-induced gingivitis or periodontitis?
P. intermedia
Plaque Control Record: AKA? What does it measure? What product is it used with? Which teeth does it apply to? How do scores work? What is it typically used for?
PCR Measures: % of teeth with supra plaque Used with: Disclosing agent Applies to: entire dentition Score: # of surfaces with plaque/# of tooth surfaces x 100=PCR %. Lower percent=better plaque control Used for: Individual performance and monitoring oral self-care progress
Periodontal Disease Index: AKA? How often is it used? What does it measure? Which teeth does it apply to? What is it typically used for?
PDI but AKA Ramfjord's periodontal disease index No longer used Measures: Presence and severity of perio disease. Gingival health, probe depths, dental biofilm, calc deposits. Applies to: 6 teeth (3, 9, 12, 19, 25, 28)
Plaque Free Score: AKA? What does it measure? What product is it used with? Which teeth does it apply to? How do scores work? What is it typically used for?
PFS Measures: % of teeth with no plaque Used with: Disclosing agent Applies to: entire dentition, divide teeth into 4-6 surfaces Score: # of surfaces with NO plaque/# of tooth surfaces x 100=PFS %. Higher percent=better control. 100% would be best score. Used for: Good for patient to use as follow-up at home
Which type of prostaglandins play an important role in bond destruction?
PGE
Which nerves innervate which parts of the tongue?
Posterior 1/3 of tongue and pharynx: Glossopharyngeal (IX) Anterior 2/3: Trigeminal (V) Hearing & balance: Vestibulocochlear (VIII) Motor muscles: Hypoglossal (XII)
Personal Hygiene Performance index - Modified: AKA? What does it measure? What product is it used with? Which teeth does it apply to? How do scores work? What is it typically used for?
PHP-M Measures: Presence of plaque and debris on tooth surfaces. Used with: Disclosing agent Applies to: ONLY 6 teeth (3, 8, 14, 24 & 30). Divide each tooth into 5 sections. Score: 0-5 score per section, add them all up then divide by number of teeth. Used for: Assessing groups rather than individual performance
Types of phagocytes?
PMN (neutrophils)--first line of defense, most prevalent cells in acute inflammation (accounts for 60% of all WBCs), contain lysosomes with bactericidal and digestive enzymes. Pus=dead PNMs. Called macrophages if located in tissue, monocytes if in bloodstream. Also ingest & digest. Slower to arrive vs. PMNs, more numerous in chronic inflammation (accounts for 5% of all WBCs)
Recurrent herpes simplex infection: What causes it (which nerve does it stay dormant in)? Who gets it? Symptoms? When does it heal? How infectious? What infection can it cause? Treatment?
Painful clusters of tiny vesicles or ulcers. + Most infectious during the vesicle stage. The virus stays dormant in the nerve tissue of the trigeminal ganglion. Lesions on the vermilion border of the lips are called herpes labialis (also called cold sores or fever blisters). Stimuli such as sunlight, menstruation, fatigue, fever, and stress can trigger the reaction. Occurs on keratinized mucosa that is fixed to bone (hard palate and gingiva). Therefore, if the lesion is on the soft palate, floor of the mouth, etc., it is not herpes. Prodromal symptoms such as pain, burning or tingling precede the vesicles. Heals without scarring in 1 to 2 weeks. Acyclovir can help with the treatment. Herpes simplex virus can cause a painful infection of the fingers called herpetic whitlow or can spread to the eye.
What bones forms the posterior part of the hard palate and lateral walls of the nasal cavity and orbit?
Palatine
Anxiety: What is it? Types? How to treat? Medications? ADR? Treatment modific? Goals?
Panic attack and disorder - impending doom, agoraphobia, +PTSD - trauma, flashbacks +Generalized anxiety disorder Tx - eliminate caffeine and alcohol, exercise, sleep Medications - benzodiazepines, antidepressants ADR - drowsiness, xerostomia TX Mod - help patient feel in control, effective pain control, dental dam? Goals - avoid panic attack
The paralleling technique: More or less distortion vs. bisecting? What does it require? Angle of primary beam to long axis of tooth & film?
Paralleling technique (long-cone technique): provides more accurate image with less distortion than bisecting technique. Requires a film holder. + Long axis of the tooth and the film are parallel to each other. + Primary beam hits at 90° to the long axis of the tooth and film. + Film holder (receptor) is positioned farther from the tooth surface, therefore can create magnification, but this can be compensated by an increased tube-to-tooth distance.
Which method of administration allows drugs to bypass the GI tract? What 6 ways can they be taken?
Parenteral administration. +Intravenous +Intramuscular +Subcutaneous +Intradermal +Topical/transdermal +Inhalation
What are the lingual tonsils? What are they part of?
Part of lymphatic system. rounded masses of lymphatic tissues on the base of the tongue posterior to the circumvallate papillae. (Do not confuse this with lingual thyroid, which are masses of thyroid tissue on the tongue caused by the migration of the thyroid gland.)
What are the palatine tonsils? What are they part of?
Part of lymphatic system. Rounded masses of lymphatic tissues located in the oral cavity between the anterior and posterior faucial pillars on each side.
What two types of radiation are formed because of an ionizing process?
Particulate and electromagnetic
Define: Linear Gingival Erythema (LGE). What does it look like clinically? Is it associated with plaque? Who has it?
Periodontal disorder characterized by a 2-3mm width band near the free gingival margin. Condition is not associated with dental plaque, and are occasionally seen in immunocompromised patients.
Is recession a sign of gingivitis or periodontitis?
Periodontitis
The autonomic nervous system is part of the ____ nervous system that controls _____ actions such as _______.
Peripheral, involuntary, beating of the heart
What is under primary molars?
Permanent premolars
DMFT/DMFS indices=primary or perm and what's the difference between T & S? What do D, M & F stand for? What does it measure? Which teeth does it apply to? What if a carious lesion and restoration are present--how score?
Permanent, T=teeth, S=surfaces D=decayed M=is already missing because of caries F=is already filled because of caries Measures: Dental Caries Applies to: 28 teeth (NOT thirds, no congenitally unerupted or supernumerary teeth, teeth removed for reasons other than caries such as ortho or cosmetics). Score: If both carious lesions and restorations present, record as decay
First line of defense in immune system?
Phagocytes: ingest & digest.
Four (4) soft palate muscles are innervated by the ____ group of nerves, and one (1) - Tensor veli palatini - is innervated by the _____
Pharyngeal plexus Trigeminal nerve (Cranial nerve V) - See Table 4 in Canvas
Essential oils: AKA? What is it? What percentage alcohol? Contraindications? Substantivity? Indications? Side fx?
Phenolic compounds +thymol, menthol, eucalyptol, etc. (e.g., Listerine). INTERFERES WITH INFLAMMATORY PROCESS (bad for diabetic patients, for instance) + Contain around 25% alcohol unless noted differently. Contraindicated for patients with alcohol dependency, and xerostomia. + Low-substantivity. Effective against gingivitis but not periodontitis. + Side effects include dryness of mucosa, burning sensation, and loss of taste.
What happens if there's no interaction between x-rays and matter?
Photons pass through the atom unchanged (dodging the bullets). Produces densities in dental radiographs. If all photons passed through the matter (patient) and reach the receptor (film), the image will be fully exposed (dark).
What is the function of canines? AKA?
Pierce or tear food. Cuspids.
With ADPIED and community health, when do you come up with the goal and objective? What's the difference between the two in terms of definition?
Planning HINT: Objective has details, measurable outcomes, and is time-limited. + Goal: general statement that describes the major purpose of the plan (e.g., improve oral home care of children at Orange elementary school). + Objective: statement that describes specific details to achieve a goal (e.g., children will demonstrate circular motion brushing technique by the end of the program). An objective statement should be specific (provides details), measurable (outcomes can be compared), and time-limited (endpoint is stated).
What's the difference between enamel hypoplasia vs. hypocalcificiation?
Plasia: Mild fluorosis appears as white flecks and more severe cases may have brown or black staining with severe pitting. On perm teeth (can affect primary too), caused by infection of primary tooth, fluoride ingestion (mottling), & systemic diseases. Calcification: Localized, chalky white or dark spots w/underlying enamel that's soft & sensitive to caries.
Define: Pleomorphic Adenoma. Where? Benign or malignant?
Pleomorphic means that the size and shape of cells vary. Adenoma is a benign tumor formed from glandular structures in epithelial tissues. Pleomorphic adenoma is a benign tumor of the salivary gland.
If a patient has inflammation, why does probing cause BOP?
Pocket is ulcerated, more blood flow to area.
Define: Periapical Abscess. What does it look like radiographically vs. visually? What causes it? Symptoms? Where is it? What can form and should that be treated/how?
Pocket of pus caused by a bacterial infection (caries, periodontal diseases, trauma, etc.). Can cause severe pain as the inflammatory exudate puts pressure on the nerves. Fever, swelling of the face, and tender lymph nodes may also occur. If the abscess ruptures, the patient may sense a foul taste. Pus may seek a path of least resistance, create a channel (fistula) out of the tissue, and spread to surrounding tissues. The DENTIST may drain the abscess. Tooth may appear slightly extruded from its socket. Radiographic appearance may vary from slight thickening of the apical periodontal ligament space to distinct radiolucency at the root apex.
Define: Stratified Random sampling. Whose bias does it prevent, if any (researcher, examiner, etc)? Is this the least bias way to sample?
Population is divided into subgroups before selection to ensure that all subgroups are sampled. Goal may be to have statistically sufficient numbers of every age, gender, race or socioeconomic group Prevents examiner bias (e.g., split into males and females, then do computer randpmly picking numbers). No, simple random is least bias way.
What is Primary Radiation? How is it produced?
Primary Radiation=X-Rays Filament is heated when switch is activated. At the cathode, an electron cloud forms around the molybdenum cup by thermionic emission. Electrons are expelled at a high speed toward the anode's focal spot within the tungsten target. Electrons hit the tungsten target at the anode and transform kinetic energy into x-rays. When the electrons hit the tungsten, heat is formed but is dissipated through the copper stem. Photons leave the x-ray tube (photon: bundle of energy) as primary radiation (photons has not interacted with the patient's body or any other objects). X-rays are formed at the tube, mainly by two mechanisms - braking radiation and characteristic radiation.
Differences between primary and permanent dentition?
Primary: Teeth are smaller and whiter Enamel is thinner Crowns have more constricted cervical area (shorter) Cuspal anatomy is smoother Pulp chambers larger so less dentin Roots are slimmer and more divergent May have no mamelons on incisal edges and pits on lingual surfaces May have spacing between teeth (spacing makes oral care easier)
What is a crest?
Projecting structure (crest at the alveolar bone between teeth)
Which drugs increase the chance of oral candidiasis?
Prolonged use of antibiotics, immunosuppressants, or corticosteroids
What is the tube head?
Protective metal covering that contains the x-ray tube, high/low-voltage transformers, and insulating oil (oil helps dissipate the heat).
How do you measure blood clotting time? What's the normal range for Prothombin vs. Partial thromboplastin time? How do doctors classify patients? What's a "healthy patient"
Prothrombin (PT) is a blood test used to evaluate clotting function and monitor anticoagulant therapy with warfarin (Coumadin). Normal PT range is 11-16 seconds. Partial thromboplastin time (PTT) also evaluates blood clotting ability of the body. The normal range for PTT is 25-35 seconds. HINT: We stop bleeding in 1 second; INR doesn't indicate seconds, that's just a way to remember that lower INR value means you stop bleeding faster which is good. So INR of 3.5 or higher is bad. Most physicians use the international normalized ratio (INR), which is the ratio of a patient's PT in comparison to a normal (control) sample. + The INR value is 0.8-1.1 in healthy patients. + Patients on warfarin are often treated with a therapeutic INR goal of 2.0-3.5. + Patients with INR value of 3.5 and higher are at particularly high risk for prolonged bleeding.
What's Water's projection?
Provides images of the maxillary sinus.
Examples of exogenous intrinsic stain
Pulp necrosis (dark teeth) Pulpitis (pink discoloration due to inflammation and internal bleeding in pulp chamber) Occurred after tooth eruption, but within tooth
Define: Lingual Varicosity. Who do you see it on?
Purple/blue enlarged vessels observed on the ventral and lateral surfaces of the tongue. Usually seen in elderly patients
What is exposure? How is it measured? Units?
Quantity of ionization in air. The measurement is taken at the skin surface before radiation penetrates the tissues. + Exposure measurement: Roentgen (Standard system), Coulomb (C/kg) (SI system)
Anti-hypothyroidism agents: How do they work? Examples of drugs? Other names for hypothyroidism in kids vs. adults.
Replace the insufficient levels of thyroid hormones. Drugs: levothyroxine (Synthroid), etc. HINT: That kid is a creature. Cretinism=kids. MyxEDEMA in adults=adults have edema.
With CHF, which side of heart failing causes which effects: L or R side Fluids from blood leaking into lungs Extremities swell Which side fails first?
R side fails, body swells (deoxygenated blood comes from the body to this side before going to lungs to be oxygenated) HINT: Left=lungs L side fails, fluids leak into lungs (oxygenated blood comes from lungs before goes to the body to deliver oxygen) Left side usually fails first (lung side)
Define: Randomized Controlled Clinical Trials. AKA? Pros/cons? What level of statistical power does it have in research? What are Controlled Clinical trials and how do they differ from these?
RCC or RCCT A study design that randomly assigns participants to an experimental group or a control group. This can reduce any population bias, but is time and money intensive. Considered the gold standard for producing reliable evidence. Falls under systematic review in terms of statistical power. For example, 40 trial participants were randomly separated into equal groups of 20: an experimental group and a control group. The experimental group wore a UVA-blocking sunscreen daily and the control group did not wear any sunscreen. All participants' skin health was then evaluated. Controlled clinical trials (CCT): similar to RCT, except that subjects are not randomly assigned to treatment and control groups. This increases the chance for bias.
Root Caries Index: AKA? What does it measure? How score?
RCI Measures: Risk & extent of root caries (with gingival recession) Score: (Decayed and filled root surfaces/total number of exposed surfaces) x 100=RCI %
What does it look like on x-rays: Orthodontics
Radiopaque
What does it look like on x-rays: Implants
Radiopaque, resembles a screw
What is the therapeutic range?
Range between the dose causing the minimum effect and dose causing the minimum adverse effect
What's aggressive periodontitis? AKA? Characterized by what type of bacteria? Tx goal? How control infection? 2 types of aggressive periodontitis (define and explain)?
Rapid destruction of the periodontium with no obvious signs of systemic diseases. Relatively small amounts of bacterial plaque are present. Previously known as juvenile periodontitis because it mostly affects patients under 30 years of age. This term is not used anymore. Characterized by A. actinomycetemcomitans. Pts are high risk for tooth loss. Reasonable treatment goal is slow the progression of disease. Tetracycline, metronidazole, and chlorhexidine are used to control the condition. Localized aggressive periodontitis: rapid tissue destruction around the permanent first molars and incisors. Onset of disease is around puberty. Generalized aggressive periodontitis: rapid tissue destruction around most teeth.
Pathology associated with Behcet Syndrome? What causes it? Characteristics? Who does it occur in? What does it look similar to? Symptoms?
Rare disorder that causes inflammation in the blood vessels throughout the body. Characterized by oral ulcers, genital ulcers, and ocular inflammation. Increased prevalence in individuals from the Mediterranean region and Asia. Oral ulcers are very similar in appearance to aphthous ulcers and are painful and recurrent.
How long are records kept for an inactive patient?
Records are typically kept for length of time required by the Statute of Limitations and/or State Dental Practice Act.
Which is better: round or rectangular PID? Short (8 inch) or long (16 inch) PID? Why?
Rectangular, 60% less tissue exposure vs. round. Long produces more parallel rays so less radiation exposure.
Erythroplakia: What does it look like visually?
Red patches. Speckled leukoplakia is a clinical description of a mixture of red and white areas.
What do anti-hyperlipidemic agents do? How do they work? Contraindications for these medications? Examples of these medications?
Reduce abnormally high levels of lipids; therefore lower the risk for atherosclerosis (fat build up inside the blood vessels). Drugs lower the level of low-density lipoprotein cholesterol (LDL), reduce triglyceride, or cholesterol levels. Can also help raise the level of high-density lipoprotein cholesterol (HDL). Should not be taken with grapefruit juice (it interacts with all medications metabolized by the body). HINT: Quest-RAN to reduce fat. Drugs: cholestyramine (Questran), atorvastatin (Lipitor), etc.
What are anti-anxiety drugs used to treat? Side effects of anti-anxiety drugs? Examples of drugs?
Reduce anxiety, treat seizures, and induce sleep. Treat neurosis such as obsessive-compulsive disorder. Side fx: Xerostomia HINT: The anxious lamb's name is Pam--> ZPAM, ZOLAM Drugs + Benzodiazepines: act on the CNS by enhancing the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) which has a calming effect + Also act as anticonvulsants and muscle relaxants. + Diazepam (Valium), lorazepam (Ativan), alprazolam (Xanax), etc. ~ZEPAM, ZOLAM + Hypnotics: zolpidem (Ambien), eszopiclone (Lunesta) etc.
Potassium nitration, sodium citrate, strontium chloride: What do they do?
Reduce dentinal hypersensitivity (e.g., Sensodyne). + Concentrations of fluoride in OTC toothpaste are not strong enough to have an impact RAPIDLY on dentinal hypersensitivity.
Anti-diabetic reaction agents: What do they do?
Reduction of blood glucose is essential to control diabetes.
Define: Correlation. What indicates the direction of the correlation? What indicates strength of the relationship? Variables closest to ___ (whether they are ___ or ___) have the ____ correlation.
Relationship between two variables. Direction: (-) and (+) Strength: number Variables closest to 1 (whether they are positive or negative) have the STRONGEST correlation (e.g., +0.95 or -0.95 is a stronger correlation compared to +0.3 or -0.3).
What do long-acting bronchodilators do? Examples of meds?
Relieve asthma symptoms for a long period of time. HINT: Severus Snape fishes for Salmon for a long time. Long acting=Serevent=Salmeterol. Salmeterol (Serevent), etc.
If the MPD for an occupational person is 5 rem/year, how many mrems is that? What about msV?
Remember: 1 sV=100 rem 1 Gy=100 ram 1000 mrem=1 rem 5 rem/x mrem = 1 rem/1000 mrem 1000 x 5 / 1 = 5000 mrem <ANSWER 100 rem/1 sV=5 rem/x sV=0.05 sV 0.05 sV x 1000 = 50 msV <ANSWER
What's Osseous surgery?
Reshaping of alveolar bone to produce better contour. Flap surgery is indicated to access the roots and clean the surfaces before the bone is recontoured. Sometimes a bone graft may be needed for large defects. The gums are placed back and stitched into place.
What kind of response does PANS create? What does the response look like (bronchi/pupils, heart rate/respiration, perspiration/arterial blood pressure, digestive activity)?
Rest & digest Bronchi/pupils: Constrict (let less light in) HR & Respiration: Slows Perspiration & Arterial BP: Decrease Digestive activity: Peristalsis accelerates due to blood vessels leading to GI tract dilating and increasing blood flow for digestion Salivary gland: Stimulates secretion
Define: Reliability. What's the difference between inter vs intraexaminer reliability?
Results can be reproduced with the same experiment. + Inter: consistency performed by DIFFERENT examiners. + Intra: consistency performed by the SAME examiner.
A real smile involves which muscles?
Risorius, Zygomaticus major & minor, Levator anguli oris
What is hypercementosis?
Root deposited more cementum to compensate for trauma.
When do roots of third molars develop?
Roots of the third molars develop about 6 years before the eruption (18-21 years of age).
Which muscles are involved in opening? Which motions involve opening?
Rotation, depression, protrusion Lateral pterygoid
Which muscles are involved in closing? Which motions involve closing?
Rotation, elevation, retraction Medial pterygoid, masseter, temporalis
What's a head?
Rounded surface projected by a neck (head of humerus is rounded part of the bone forming the shoulder joint)
Chlorhexidine digluconate: What is it? What percentage concentration? How often do you use and how much? Long or short term use? When Indicated? Side fx?
Rx needed, 0.12% concentration (e.g., Peridex, PerioGard). + Contains around 11% alcohol unless noted. + Rinse with 15 ml twice daily for 30 seconds (some sources suggest 1 minute). Indicated for short-term use only. + High substantivity. (ability of agent to be retained and released slowly over time with continued effect) Bactericidal for gram-positive, gram-negative bacteria, and fungi; therefore most effective anti-microbial agent. + Indicated for the treatment of gingivitis, periodontitis, candidiasis, and post-surgery care. + Side effects include extrinsic (brown) staining, increased supragingival calculus, altered taste, and dryness of mucosa.
Severe-Early Childhood Caries Index: AKA? What does it measure?
S-ECC Measures: Presence of decay in child younger than 3 yo
Which 2 bacteria are involved in the early stages of tooth demineralization? But then which one dominates with further progression?
S. mutans and S. sanguis. S. mutans dominates.
How to tell from the tumor name if it's benign or malignant?
SAME CAR Malignant if it starts with an Sa (Serious - Sarcoma), Me (Mean - Malignant), or Car (Cancer - Carcinoma).
Difference between Scaling and Root Planing and Periodontal Debridement?
SRP: procedure designed to remove cementum or surface dentin that is rough, impregnated with calculus to produce "glassy smooth" surfaces. New practice in dentistry is moving away from the "glassy smooth" surfaces (definition by the ADA). PD: removal of bacterial plaque, its by-products, and calculus deposits from coronal surfaces, root surfaces, and within pocket space and tissue wall to the extent needed to re-establish periodontal health and restore a balance between the bacterial flora and the host's immune responses. Does not include aggressive removal of cementum.
Irritation Fibroma: Is it benign or malignant? What does it look like visually? Where do they occur?
Scar tissue from localized irritation and trauma. Appears as a small, elevated lesion of light color. Most frequently appears on buccal mucosa due to cheek biting. Resembles lipoma (but more white, not yellow), so assess patient's diet and habits.
Where are minor salivary glands located (vs. the 3 majors listed)? Do they secrete serous (enzymes) or mucous (carbs) saliva? Which nerve innervates them? What are Von Ebner's glands?
Scattered in all areas of the oral cavity including the buccal/labial/lingual mucosa, soft palate, lateral parts of the hard plate, etc. More numerous than major glands but smaller. Minor salivary glands are innervated by the seventh cranial (VII, or facial) nerve. Von Ebner's glands are located at the base (back) of the tongue with the circumvallate lingual papillae and secrete serous type of saliva to cleanse the taste buds.
How are controlled substances classified?
Schedule I-V
What's a suprabony vs. infrabony pocket?
Supra: base of the pocket is above (coronal) the alveolar crest. Created by horizontal bone loss. Infra: base of the pocket is below (apical) to the alveolar crest. Created by vertical bone loss. May exhibit various forms.
What's the safest trimester during pregnancy for dental treatment? Should radiographs be avoided? Tx modifications? Good position? What can periodontal disease and caries do to developing child? What oral conditions can it cause?
Second. Need to avoid radiographs unless necessary for the provision of dental care. Short appointments due to discomfort sitting/lying in chair for long periods. Tilt to left side to prevent orthostatic hypotension (so put pillow under R hip) Periodontal disease and caries may increase the risk of a premature low-birth-weight infant. Studies show that oral pathogens may stimulate uterine contractions and cause premature labor. Pregnancy gingivitis: elevated hormonal influences of estrogens and progesterone can exaggerate gingival response to microorganisms. Frequently associated with Prevotella intermedia. Pyogenic granuloma (pregnancy tumor): localized area of gingival enlargement, typically involving interdental papillae. Usually diminishes after delivery.
What is a superinfection? Example of one?
Secondary infection superimposed on an earlier one, especially by a different microbial agent that is resistant to the treatment used against the first infection. e.g., candidiasis (fungal infection) may happen with the use of antibiotics.
Scatter radiation is also known as ___. Are there waves shorter or longer than primary? How do they effect an image. What are the 3 types of scatter radiation?
Secondary radiation. Longer. Can cause fogging of image. Compton, Photoelectric Effect, Coherent.
Define: Judgment sampling. Do all members of a population have the same chance of being selected?
Selection based on the familiarity with the subject to the researcher. Most chance for bias (e.g., researcher asks co-workers to fill out a questionnaire).
Define: Systematic sampling. Do all members of a population have the same chance of being selected?
Selection of every Nth member on a list (e.g., selecting every 10th number in the phone book). All members of a population DO NOT have the same chance of being selected.
What does SSRI stand for? What are they? More or less targeted? How do they work? Examples?
Selective serotonin reuptake inhibitor. Newer-generation antidepressants so MORE targeted. Inhibit the reuptake of serotonin from the synapses. Fluoxetine (Prozac), citalopram (Celexa), etc.
What does serous fluid contain? Mucous fluid?
Serous=enzymes Mucous=carbohydrates
Epinephrine: How does it work? When used? Examples?
Shots are given to treat anaphylaxis (e.g., EpiPen). + Provides vasoconstriction to counteract vasodilation (hypotension) associated with anaphylaxis.
Receptor film sizes: Which size for kids? Which size for kids and adult anteriors? Which size for adult BWX & PAs? Which size for longer version of BWX, where you take only 1 image on each side? Which size is used for occlusal techniques?
Size 0: used for children. Size 1: used for children, and adult anteriors. Size 2: used for adult bitewings and periapicals. Size 3: longer version of the bitewing, only one image is taken on each side. Size 4: used for occlusal techniqu
Muscular Dystrophies: What it is, types, Causes, Oral Manifestations
Skeletal muscle disease - degenerated muscle cells. Several types, including Duchenne's: affects infants and young children (ages 3-5), especially male. Weakness starts with the lower body, then spreads through the whole body. Children are unable to walk by the age of 12, and life expectancy is around 25. Genetic Muscular weakness and decreased biting force
Define: Actinomycosis. What does it look like visually? Which bacteria is it associated with (1 type)?
Swelling of lower cheek (seen outside). Infection caused by a filamentous bacteria species Actinomyces. Abscesses drain through the formation of small holes leaking pus
Define: Urticaria and Angioedema. AKA? What is it caused by? Where does it occur? What does it look like clinically? Symptoms?
Skin reactions that appear as a result of allergies. Urticaria, also called hives, appears as multiple areas of well-demarcated swelling of the skin, usually accompanied by itching (pruritus). Angioedema is similar to hives, but the swelling occurs beneath the skin instead of the surface and is not accompanied by itching.
Difference between sl., mod, & sev. bone loss
Slight bone loss: loss of 20% or approximately 1-2 mm of normal supporting bone. Moderate bone loss: loss of 20-50% of normal supporting bone. Severe bone loss: loss of over 50% of normal supporting bone.
What does it look like on x-rays: Porcelain
Slightly radiopaque
Define: Plaque
Slightly raised, non-blister-form lesion with broad flat top
Difference in mv between slow & rapid depolarization? What's the threshold potential? mV values associated with each? What happens during each?
Slow depolarization -50 to -60 mV. Sodium starts to come in, membrane a bit more permeable. Inside of axon negative. Threshold potential (usually 15 mV from -70, so at -55): Firing threshold that initiates the impulse. Rapid depolarization + 40 mV. Membrane permeability to Na+ increased. Na+ rushes into axon. Inside of axon positive.
Anti-hyperthyroidism agents: How do they work? Examples of drugs? When in dentistry should you use caution in relation to patients who take these meds? Why may surgery or radioactive iodine be needed?
Slow the production of thyroid hormones. Drugs: propylthiouracil (PTU), methimazole (Tapazole), etc. Use caution with local anesthetics containing epinephrine. Surgery may be needed to remove all or parts of the thyroid gland, or radioactive iodine can be used to shrink the gland.
What are the adrenal glands? Where are they located? What do they do? Difference between the outer (cortex) vs. inner (medulla)?
Small, triangular glands located on top of both kidneys and produce hormones important to all parts of the body. + Outer organ (adrenal cortex): secretes corticosteroid and aldosterone that regulate the level of sodium and potassium, maintain blood volume and blood pressure. + Inner organ (adrenal medulla): produces epinephrine (also called adrenaline) and norepinephrine to help the body respond to a stressful situation by increasing the heart rate and the force of heart contractions.
Risk factors for perio diseases?
Smoking Gender (men) Rural living Low socioeconomic status Low education level
Major risk factors for oral cancer?
Smoking & alcohol consumption
Fixing: What is the fixing agent? What does it do?
Sodium thiosulfate - clears unexposed silver halide crystals.
The enamel of primary teeth is (softer or harder) and (thicker or thinner) than the enamel of permanent teeth.
Softer, thinner
Curve of Wilson vs. Spee?
Spee is as viewed from buccal aspect, Wilson is from frontal view. Wilson involves the buccal and lingual cusp tips because buccal cusps are higher than lingual cusps on mandibular teeth Wilson=mesiolateral curve Spee=anteroposterior curve. Both are upward smile lines
What bone helps form the base and sides of the skull, and the floor and walls of the orbits?
Sphenoid
Which TMJ ligament may act as a barrier to the IA injection?
Sphenomandibular ligament The sphenomandibular ligament connects the sphenoid bone and the mandibular foramen on the inner side of the mandible. This ligament prevents the mandible from moving too far forward. Because of its placement, this ligament may act as a barrier to needle penetration during the inferior alveolar block injection. If the needle does not penetrate the tissue to the desired length, only the lingual nerve will be anesthetized.
MMA fighters love spinach
Spinosum = Middle Meningeal Artery
Static Bone Cyst: AKA? Is it benign or malignant? What is it? What does it look like radiographically? Where do they occur?
Stafne Defect A pseudocyst with no epithelial lining. (Cyst is a pocket-like, closed structure filled with a substance.) Appears as a well-defined radiolucency in the posterior region of the mandible, inferior to the mandibular canal.
HIV/AIDS: Symptoms? Medications? How is it transmitted?
Symptom: flu-like symptoms and chronic infection. Antiretroviral therapy (ART) can dramatically prolong the lives of people infected with HIV and lower their chances of infection. Transmitted only through certain fluids: BLOOD, SEMEN, VAGINAL FLUIDS, RECTAL FLUIDS, BREAST MILK; NOT SALIVA!!! Must come in contact with the mucous membrane or damaged tissue, or be directly injected into the bloodstream. The virus is NOT spread by air, water, saliva, or sweat.
Cerebral palsy Symptoms? Causes?
Symptoms: lack of controlled muscle movements and involuntary muscle movements. + Intellectual disability only affects less than half of the patients and learning disability is usually caused by sensory impairment. Causes: Anoxia, Infections, Trauma
What do adrenergic drugs do? Example? Adverse effects and contraindications?
Stimulate adrenergic receptors and produce the effects of the SANS. e.g., albuterol treats asthma as a bronchodilator. +Adverse effects include cardiac arrhythmia, increased headaches/anxiety, etc. +Contraindicated for angina, uncontrolled hypertension, and uncontrolled hyperthyroidism.
Which bacteria is mainly responsible for caries formation?
Streptocococcus mutans
What's another name for a cerebrovascular accident?
Stroke
Most teeth drain into the ____ lymph nodes, except for maxillary third molars which drain into the _____ lymph nodes, and the mandibular incisors which drain into the ____ lymph nodes.
Submandibular, superior deep cervical nodes, submental
Which structure divides the tongue into the body and the base?
Sulcus terminalis
What's total filtration?
Sum of inherent and added
Which bone forms the superior and middle nasal conchae? Which bone forms the inferior nasal conchae?
Superior & middle: ethmoid Inferior: Maxilla
Signs of Fetal Alcohol Syndrome and associated oral conditions?
Symptoms: mental, behavioral, and/or learning disabilities (hyperactivitiy), seizures, poor muscle coordination. Abnormal muscle tone, small eyes, neuro disorders. Facial deformities include: + Abnormally narrow eyes with epicanthal folds (elongated fold of the upper eyelid on the inner corner). + Smooth philtrum: lack of a groove from the upper lip to the nose. + Flat face and micrognathia (small jaw). Oral conditions: tooth malformation, malocclusion, gingivitis, cleft palate, and lip.
What's Periostat?
Systemic delivery of a 20 mg capsule of doxycycline hyclate (oral administration).
Periodontitis can occur as a result of ___ ___, ___ ___, or ___ ___.
Systemic disease (leukemia), genetic disorder (Down Syndrome, Papillon-Lefevre Syndrome, Cyclic Neutropenia), or hormonal changes (Puberty, pregnancy).
T/F: Medical history must be updated at every visit and signed by the patient and clinician.
T
T/F: Every calculus surface is covered in plaque? Why/why not?
T. Because of its porous structure.
What is TMD? Where do symptoms originate from?
TEMPOROMANDIBULAR DISORDER (TMD) Chronic joint tenderness, swelling, and muscle spasms in the TMJ area. Most symptoms originate from the muscles supporting the joint (not the joint itself).
What type of cytokine contributes to bone destruction?
TNF
How do you know someone has dentinogenesis imperfecta?
Teeth are opalescent & brown/blue in color. Primary teeth are usually more severely affected vs. permanent. Weak dentin can cause chipping of enamel. Radiographically, no pulp chambers or root canals are seen.
What's taurodontism? Generalized or localized? What is is associated with?
Teeth exhibit elongated, large pulp chambers, and short roots. Usually affects a single molar or several molars in the same quadrant. Associated with amelogenesis imperfecta (especially hypomaturation type) and Down Syndrome.
Which muscles are involved in retrusion (moving back)?
Temporalis
What are Tetracycline HCL fibers? What issues may you run into using them? How does it work?
Tetracycline soaked cord is packed inside the pocket and retained with adhesive. + Time-consuming and can be uncomfortable for the patient. + Periodontal surgeries may be necessary to treat the conditions properly.
What's endogenous staining?
Tetracycline stain (yellow-green discoloration from ingestion of tetracycline during tooth development). Teeth fluoresce under ultraviolet light when first erupt, but as age, they won't fluoresce anymore.
Fluoride Gel (office application) or foam: How long? How long do you need to wait before eat, drink, or smoke? Types? What shouldn't it be used on?
The 4-minute application is common, read the manufacturer's label for application time. + Do not eat, drink, or smoke for at least 30 minutes after application. + Most popular types are 1.23% Acidulated Phosphate Fluoride, and 2.0% Neutral Sodium Fluoride. + Acidulated phosphate fluoride (APF): do not use on composite, porcelain, and sealant materials as it causes pitting and roughening.
When is school water fluoridation helpful? What concentration is used? Do you need parent consent?
When community water fluoridation is not available Concentration is 4-5x higher than recommended community water fluoridation levels Yes
What's paternalism?
act as a parent would on behalf of a child. Sometimes can override the decisions and opinions of an individual (not included in the ADHA core values).
Processing: What does it mean if white spots?
air bubbles trapped during processing.
Bell's Palsy: What it is, Causes, Oral Manifestations, DH Management. Who had it?
Unilateral paralysis of facial muscles innervated by the facial nerve (Cranial Nerve VII) Cause: Idiopathic, Infections, Trauma Oral: Food retention, increased caries, increased perio disease, drooling, inability to close eye on side affected. Manage: Spontaneous remission (2-8 weeks; up to 6 months) or Permanent paralysis. Wait until in remission if possible before treating. HINT: Who had it: Angelina Jolie
Depression: What is it? Who affects? Type of risk associated with it? Treat with what type of meds? ADR? Tx mods?
Unipolar Onset mid-20's Suicide risk Modified issues by age Tx - antidepressants: serotonin (SSRI) Serotonin and noraderenergic (SNRI), tricyclic, monoamine oxidase (MAOI) ADR - xerostomia, neglect Tx mod - positive reinforcement and reassurance
How many tablets of nitroglycerine can you give a patient experiencing angina?
Up to 3 tablets in 15 minutes
What's the standard of care?
all patients should be granted the same level of attentiveness.
X-ray reminders for edentulous patients
Use cotton rolls to stabilize the film/receptors. Bisecting technique may be easier to achieve than paralleling technique. Occlusal and panoramic images may be used. Radiographs are still important for edentulous patients, as the images can detect bone level, lesions, fractures, root tips, etc.
What's distortion? What's magnification? What happens if you increase target to film distance?
Variation of size and shape of the actual object. Magnification: enlargement of the object. + Increased tube (target)-to-film distance: allows more parallel rays and produces less magnification. + Object-film distance: shorter distance produces less magnification.
What does the thyroid do? What do iodine and tyrosine do? What stimulates the thyroid gland?
Thyroid gland plays an important role in regulating the body's metabolism and calcium balance. + Iodine and tyrosine are used to produce thyroxine (T4) and triiodothyronine (T3) in the thyroid gland. + Thyroid gland is stimulated by thyroid stimulating hormone (TSH) from the pituitary gland (pea-sized gland located in brain stem).
What is half-life? How many half-lives does it usually take?
Time it takes for the body to eliminate half of the drug present in the body. It usually takes 6 half-lives for the drugs to be completely eliminated. + 1 half-life: 50% clearance, 50% remains in the body. + 2 half-lives: 75% (50% + 25%) clearance, 25% remains in the body. + 3 half-lives: 87.5% (50% + 25% + 12.5%) clearance, 12.5 % remains in the body. + 4 half-lives: 93.75% (50% + 25% + 12.5% + 6.25%) clearance, 6.25% remains in the body. + 5 half-lives: 96.875 % (50% + 25% + 12.5% + 6.25% + 3.125%) clearance, 3.125% remains in the body. + 6 half-lives: 98.4375% (50% + 25% + 12.5% + 6.25% + 3.125% + 1.5625%) clearance, 1.5625% remains in the body.
Define: Herpetiform aphthous ulcers. What do they look like? Size? Treatment that differentiates them from TRUE herpes vesicles? Where are they?
Tiny (1 to 2 mm) in size and resemble clusters of herpes vesicles. + Unlike true herpes vesicles, aphthous ulcers respond to topical application of liquid tetracycline. May develop anywhere in the oral cavity.
Define: Herpes. What does it look like clinically? Where is it? Symptoms? How long are they visible? Is it infectious or not?
Tiny vesicles on keratinized mucosa fixed to bone (hard palate and gingiva). If the lesion is on non-keratinized tissue (soft palate, floor of the mouth etc.), it is not herpes. Prodromal symptoms such as pain, burning or tingling precede the appearance of vesicles. Lesions disappear without scarring in 7 to 14 days. Herpes virus is infectious, therefore dental treatment should be delayed.
What's Gum/Connective Tissue Graft?
Tissue is harvested from a donor site, such as the palate, and then placed on the desired area to provide strength and cover exposed root surfaces. This can be done for one tooth or several teeth to even the gum line and reduce sensitivity.
Types of embrasures
Type I: Interdental papilla fills space, can be cleaned with floss. Type II: Interdental papilla does not fill space, can be cleaned with tufted dental floss, interdental brush, wooden interdental cleaner, and toothpick Type III: Interdental papilla is missing. can be cleaned with tufted dental floss, interdental brush, wooden interdental cleaner, end tufted brush, and toothpick
Where is the zygomatic process?
U-shaped radiopaque band superior to molar apices.
What can cause hypersensitivity?
Thermal, chemical, tactile or evaporative stimuli. Examples: thermal (cold/heat), evaporative (bloACwing air), osmotic (sweet or sour/acid), tactile (toothbrushes, flossing, toothpick, dental instruments), and whitening solution.
Define: Candidiasis. AKA? What causes it? Characteristics? How common? How does it differ from leukoplakia? What is it associated with?
Thrush. Overgrowth of the fungus candida albicans. This fungus is part of the normal oral microflora, but becomes more dominant with a weak immune system (infant, elderly, and immunosuppressed patient) or with medication. One of the most common oral lesions that occur in association with immunodeficiencies such as HIV or diabetes. Can also occur in patients with prosthetics if it is not cleaned properly. Usually appears as white creamy lesions that can be wiped with a cloth. Angular cheilitis is associated with the fungus candida, nutritional deficiency (especially B-2), dry mouth, drooling, etc. You CANT wipe leukoplakia off.
What's Necrotizing Ulcerative Gingivitis (NUG)? What causes it? Who experiences it most? Characteristics? Tx?
Tissue necrosis limited to the gingiva. + Stress-related, and seen in young adults (college students or soldiers on the front line). Characteristics: + Crater-like depression at the interdental papillae, also described as "punched out." + Gray necrotized slough surrounded by red halo. + Strong fetid odor, spontaneous bleeding. + Pain, fever, malaise, and swollen lymph nodes. + Spirochetes. Tx: debridement of plaque and debris using ultrasonic scaler. Reappointment in 1-2 days for a complete periodontal treatment. + Advise patient to avoid irritating food (hot, spicy, alcohol, etc.).
Why is epinephrine added to local anesthetics? What's the MRD of epi for healthy patients vs. cardiovascular disease patients? What side effect can epi have? What adverse rxns can occur?
To provide vasoconstriction to increase the duration of the anesthetics, reduce bleeding in the area, and decrease the potential for adverse reactions. + Healthy: 0.2 mg of epinephrine (5.5 cartridges in 1:50,000 concentration; 11.1 cartridges in 1:100,000 concentration; 22.2 cartridges in 1:200,000 concentration). + Cardio: 0.04 mg of (1.1 cartridges in 1:50,000 concentration; 2.2 cartridges in 1:100,000 concentration; 4.4. cartridges in 1:200,000 concentration). + Decreases local tissue pH, therefore creates a burning sensation. +Adverse reactions to local anesthetics include excitation, depression, seizures, etc.
What is the greatest single risk factor for oral and pharyngeal cancer?
Tobacco
What's one of the most significant risk factors for perio disease? How does it affect the periodontium? Does it increase caries risk?
Tobacco + Inhibition of collagen production and slow healing after therapy is seen in tobacco users. + Gingiva can appear healthy due to impaired vascularization (diseased gingiva usually looks dark and swollen due to increased vascularization). + Smoking does not increase the risk of caries.
Name some risk factors of perio disease?
Tobacco Genetics Educational level/socioeconomic status Parafunctional habits Mouth breathing Occlusal trauma Impingement on biological width Furcations, calc, restorations, overhangs, pits, caries Obesity/poor nutrition Age Stress Systemic diseases Hormonal changes
Where are antibodies produces?
Tonsils & thymus
What's Elongation? How do you fix it?
Too little vertical angulation → increase vertical angulation.
What is dentin dysplasia?
Too much dentin was formed in the tooth structure. Affected teeth have normal crowns and feature normal colors, but show abnormally short roots that exfoliate prematurely. Total or partial lack of pulp, half-moon, thistle, or bow-tie shaped chambers or root canals can be seen radiographically.
What is ankylosis?
Tooth is fused with adjacent bone which prevents the tooth from erupting fully. Hollow sound detected when tapped
What happens during repolarization? mV value assocaited with it? Where do sodium/potassium go? What pump balances the ions and how does the pump run (what type of
Transmembrane potential changed from +40 back to -70 mV (anywhere between -60 to -90) Sodium moves back outside, Potassium moves back inside Sodium-Potassium pump to balance the ions. Active transport (uses energy from hydrolysis of ATP to pump 3 Na+ out and 2 K+ in)
Another name for horizontal plane?
Transverse plane, divides top and bottom of body
Simple bone Cyst: AKA? Is it benign or malignant? What causes it? What does it look like radiographically? Where do they occur?
Traumatic bone cyst, related to trauma. Appears as a well-defined radiolucent lesion characterized by scalloping around the roots.
Mandibulofacial Dysostosis: AKA? What causes it? Characteristics (body and orally?)
Treacher Collins Syndrome Genetic disorder that affects the development of the facial structure. Characterized by a fish-like mouth (high palate, downward sloping of the lip commissures, and an open-bite). Deafness results from a lack of otic ossicles.
What do anti-arrhythmia agents do? Examples of drug? Two devices that are related to this?
Treat irregular heart rhythms which include tachycardia (>100 beats per minute), bradycardia (<60 beats per minute), and atrial fibrillation. Hint: BCL=Be silly=arrhythmia is a silly heart rate. Beta blockers, Calcium Channel blockers, Lidoctain (BCL). Beta blockers, calcium channel blockers, lidocaine. Defibrillator and pacemaker: Devices that are placed under the skin in the chest area to send electrical signals that regulate the heartbeat.
What are anti-psychotics used to treat? Side effects of anti-psychotic drugs? Examples of drugs?
Treat psychosis such as schizophrenia (characterized by disordered thoughts and behaviors). Side fx: xerostomia. HINT: A crazy person bought a magazine made out of pines. -Zine, -apine ending=schizophrenia Drugs: chlorpromazine (Thoracine), clozapine (Clozaril), etc. ~ZINE, ~APINE.
What are anti-convulsant drugs used to treat? Side effects? Examples of drugs?
Treat seizures (events of abnormal brain activity). Drugs: phenytoin (Dilantin), phenobarbital (Phenobarbital), carbamazepine (Tegretol), etc. + Phenytoin can cause gingival enlargement.
What are examples of anti-tuberculosis agents? What do they treat? How long are they used for? How do you test for TB (test type) and what does a positive result mean?
Treat the microbe Mycobacterium tuberculosis. HINT: Isolate Tom Brady. Isoniazid TB. Drugs: isoniazid (INH), rifampin (Rifadin), pyrazinamide (Pyrazinamide), etc. medications are used for long periods of time (3-9 months). PPD (purified protein derivative), also known as the Mantoux skin test is an antigen used to test for tuberculosis. + The swelling is read 48-72 hours after the antigen is injected. + A positive sign does not mean that the patient has active TB, but confirms exposure to the disease at some point in the patient's life.
Down Syndrome: Cause (how many chromosomes do they have and which one is affected)? Symptoms? How does it affect systemic health? Oral manifestations? Tx modifications? Meds?
Trisomy 21 Chromosomal Abnormality. Has 47 chromosomes instead of 26. Symptoms: Physical characteristics of patients include small stature and head, slanted eyelids (epicanthic fold at eye corners), depressed nasal bridge, small mouth, stubby fingers, small hands and feet. Mental retardation is also common. Systemic health: heart abnormalities, altered immune response Oral manifestations: large tongue (macroglossia) Higher risk for periodontal disease Tooth anomalies (delayed exfoliation and development, microdontia, missing teeth, anomalies in eruption). Caries risk: Lower in kids and young adults because of delayed primary/perm tooth eruption, missing perm teeth, small-size teeth, wider interprox spaces. Higher in adults because of poor oral hygiene and cariogenic foods. Clefting. Prognathic mandible with Cl. III malocclusion and open bite because of tongue thrust Fissured tongue, cracked lips (mouth breather because has small airways). Use "tell-show-do" approach with positive reinforcement. Patients may be taking medications related to congenital heart defects. Consult physician for details.
T/F: Perio diseases can be affected by numerous factors?
True. Although plaque and bacteria associated are main causes, other things play a role too (host response, systemic factors, etc.)
Define: Multiple Myeloma. Where does it originate? Symptoms? Who does it affect? What does it look like radiographically?
Tumor originating in the bone marrow. Lesion is painful and more common in elderly patients. Appears as radiolucency in a "punched out" pattern.
What's an ethical dilemma?
Two or more ethical principles that are in conflict but each principle can be morally justifiable (e.g., patient refuses x-rays for the fourth visit in a row because of costs, leaving the hygienist and dentist unable to provide a complete oral evaluation).
How should PSR (Periodontal Screening & Recording) measurements be recorded?
Use most severe reading in the quad. Use WHO probe with colored band located between 3.5-5.5 mm. Code 0: color-coded reference band is completely visible in deepest pocket in the sextant. Pocket depths are less than 3.5 mm; no calculus or defective margins present in the sextant; gingival tissues are healthy with no visible bleeding upon gentle probing Code 1: color-coded reference band is completely visible in deepest pocket in the sextant; no calculus or defective margins present in the sextant; there is bleeding on probing. Code 2: color-coded reference band is completely visible in deepest pocket in the sextant; supra or subgingival calculus and/or defective margins are present in the sextant. Code 3: color-coded reference band is partially visible in the deepest pocket, thus indicating a pocket is deeper than 3.5 mm. Code 4: color-coded reference band is NOT visible in the deepest pocket of the sextant, thus indicating a pocket deeper than 5.5 mm.
Palmer System
Use right-angle symbol to indicate quad, tooth number inside that. Used in ortho Graphical map of dentition
What are adjunct therapies? When can you use them? When shouldn't you?
Used only after other periodontal therapy has been tried with unsuccessful results. Studies show that adjunct therapy alone does not improve periodontal health. + Ingestion of tetracycline during pregnancy or nursing may cause permanent discoloration of the teeth of the infant.
What is Nitrous Oxide used for? What level of anesthesia does it offer (stage 1, 2, 3, or 4?) and what does this mean? How does biotransformation work? Level of nitrous oxide not to exceed? Contraindications? Color of tank compared to oxygen tank?
Used to alleviate anxiety in patients. Can also help relax the skeletal muscles, as in a patient affected by cerebral palsy. Provides stage 1 anesthesia (stage 1 is the lowest and stage 4 is the highest level of anesthesia). Patient can hear and respond to any request or direction given by the dentist. No biotransformation occurs in the body; the gas is easily excreted through exhalation. Effect wears off soon after the mask is removed. + Introduction of 100% oxygen for 1-2 minutes followed by titration of nitrous oxide in intervals is recommended. During this process, the concentration of nitrous oxide should not routinely exceed 50%. Once nitrous oxide flow is terminated, 100% oxygen should be delivered for 5 minutes. Contraindications + Respiratory issues such as COPD or airways congestion (obstructions reduce the amount of gas reaching the lungs and the brain). OK WITH ASTHMA though. + Pregnancy. + Hepatitis, cystic fibrosis, infections. + Emotional illness (depression, manic behavior, etc.). + History of substance abuse. Nitrous oxide tank is blue; oxygen tank is green.
What's the school fluoride rinse concentration? How often do you rinse? How long do you rinse? Why is/is this not a recommended way to get fluoride? Who is this contraindicated for?
Useful in areas where community water fluoridation is not available. Not widely used anymore and not as cost-effective. Administrators require parents' consent. 0.2%. Rinse for 60 seconds once a week. Rinse not advised for children under age 5, or until the child can properly spit the rinse.
The data collection instrument chosen to measure the effect of the desensitizing agent on root sensitivity has been used successfully before and published in the Journal of Dental Hygiene. This indicates that the instrument is: Reliable Valid Systematic Correctional
Valid Validity is the ability of a measurement to measure what it is intended to measure. This instrument is considered valid if it has been tested before, utilized and statistical inferences made based on the instrument. A study is considered reliable if other researchers are able to consistently measure the same level of disease at different times whereas systematic describes the continual process of repeating an action. Correctional is a term that describes undoing, or correcting, mistakes.
____ are often absent in the veins of the head and neck, which allows a _____-____ flow of blood that can spread facial/dental infections.
Valves, two-way + Facial vein is valveless - blood can reverse direction and flow from the facial vein to the cavernous sinus. This provides a potential pathway by which infection of the face can spread to the venous sinuses.
Chickenpox and Shingles: What virus causes it? Who gets it? Symptoms? When does it heal? Preventative measures? How contagious?
Varicella-zoster virus (VZV) causes both chickenpox (varicella) and shingles (herpes zoster). Vaccine is available to prevent varicella-zoster infections. Chickenpox occurs mostly in children and is highly contagious. Itchy lesions throughout the body and flu-like symptoms will appear. Herpes zoster usually occurs with anyone who has had chickenpox. The virus remains inactive in the nerve cells near the spinal cord. + Characterized by unilateral, painful vesicles along the sensory nerves. Lesions can last for several weeks to several months.
What do anti-anginal agents do? What causes angina? Examples of drugs? How taken?
Vasodilate the blood vessels to allow for better flow of oxygen to the heart muscles. Agngina results from heart being overworked because oxygen isn't reaching the heart properly. Nitroglycerin (NTG) and nitrates Taken sublingually for faster absorption (avoids GI tract)
What is a volt? What's KiloVoltage peak? What does KiloVoltage peak determine?
Volt: Force that moves electrons. KiloVoltage peak (kVp): peak voltage of an alternating current. + kVp determines the speed at which the electron is propelled from the cathode. + kVp also determines the penetrating power of the x-ray beam, called quality.
What bone forms the posterior part of the nasal septum?
Vomer
What are lymphocytes?
WBCs that recognize & control foreign invaders (antigens). Accounts for 20-40% of all WBC.
End a meal with ___. What type of food can be consumed after acidic foods to raise the pH?
Water. Cheese.
What determines the energy of radiation?
Wavelength: distance between the peaks or crests of one wave to another. Longer wavelength=lower frequency=less energy=less ability to penetrate stuff Shorter wavelength=high frequency=more energy=more ability to penetrate things, cause changes in cells, and ionization
After calculating the results of the correlation test between geographic location and plaque scores, the correlation coefficient r-value was 0.26. This relationship between these two variables is: Weak Moderate Strong Very Strong
Weak 0.0 to 0.2 Very weak to negligible correlation 0.2 to 0.4 Weak, low correlation 0.4 to 0.7 Moderate correlation 0.7 to 0.9 Strong, high correlation 0.9 to 1.0 Very strong correlation Further, a correlation coefficient is a statistical measure of the degree to which changes to the value of one variable predict change to the value of another. Expressed as an r-value, correlation coefficient values range between +1 and -1. A coefficient of +1 indicates a perfect positive correlation: A change in the value of one variable will predict a change in the same direction in the second variable. A coefficient of -1 indicates a perfect negative correlation: A change in the value of one variable predicts a change in the opposite direction in the second variable. Lesser degrees of correlation is expressed as non-zero decimals. A coefficient of zero indicates there is no discernible relationship between fluctuations of the variables.
What is jaundice? What's it caused by? What diseases is jaundice associated with?
When the skin, sclera (whites of the eyes) and mucous membranes turn yellow. This yellow color is due to a high level of bilirubin, a yellow-orange bile pigment which is formed from the breakdown of red blood cells. Caused by hyperbilirubinemia. Liver diseases: Chronic hepatitis, Pyoderma gangrenosum (skin disease), acute hep B or C, Polyarthralgias (joint inflammation).
Define: Lingual Thyroid Nodule.
When the thyroid gland descends to its normal location in the neck, the tissues can become entrapped in the tongue. Appears as a mass in the midline of the dorsal surface of the tongue, posterior to the circumvallate papillae in the area of the foramen cecum.
Define: Linea Alba. Who do you see it on?
White line of hyperkeratosis (thickening of the corneum, outermost layer of the epidermis) that extends horizontally on the buccal mucosa along the occlusal plane. More prominent in patients with clenching, bruxing, or grinding habits.
Difference in life support response if patient is not breathing but has a plus vs. if they're not breathing and don't have a pulse?
With pulse (check carotid near neck/chin): Open airways, provide rescue breathing at 10-12 breaths/min. Tilt head back for rescue breathes and observe chest rising. Use pocket masks or resuscitation bags if possible. Without pulse: Begin chest compression AND rescue breaths. +CPR: Cardiopulmonary resuscitation. Goal: Provide oxygen to brain, heart and organs until help arrives +Put hands on lower half of patient's sternum between nipples. Push down using heel of one hand on top of the other, place shoulders above hand and use body weight. +100-120 compressions/minute, at least 2 inches deep. Let chest fully recoil. +Compression to breath ratio: +Adults: 30:2 +Kids: if one person CPR on a child, 30:2. If two person CPR on a child, 15:2. ONLY GO 1/3-1/2 DEPTH OF CHEST. USE 2 FINGERS, NOT HEEL OF HAND.
Who is the WHO and what do they do?
World Health Organization: specialized agency of the United Nations (UN) that is concerned with international public health. Gather data.
Side fx of Parkinson's meds? Tips for patients?
Xerostomia is a common side effect of drugs (e.g., Levodopa). Protect airways to prevent choking, and stabilize patient's hands using aids to prevent injuries that can be caused by patient's tremor. May have rigidity. It is best to treat patients a few hours after they take medication, and use short appointments.
Are there more lymphatic vessels than blood vessels?
Yes
If a patient is unconscious and needs emergency treatment, is it legal to treat the patient without the patient's or guardian's consent?
Yes
Is bleeding a sign of early gingivitis?
Yes.
What is a fossa?
a DEEPER depression (mandibular fossa of the temporal bone articulates with the mandibular condyle at the TMJ)
What is a sulcus?
a SHALLOW depression that houses arteries and nerves
What is a spine?
a blunt sharp pointed projection (e.g., anterior nasal spine in the midline of the maxilla).
To avoid triggering gag reflex, slide the receptor ____ ___ ____ then firmly bring receptor to the ____
along the teeth, palate.
Fixing: What is the acidifier? What does it do?
acetic acid - keeps medium acidic and stops additional development.
What is potency? The ____ amount needed, the ___ potent the drug. Where does a more potent drug show up on a graph?
amount needed to achieve the desired effect. + Useful in comparing drugs. The less the amount needed, the more potent the drug. + The drug showing a curve closest to the left side of the graph (y-axis) is the most potent.
What's ANOVA? What does it stand for? Who does it compare? What does it compare them on?
analysis of variance compares three or more groups for statistical significance (e.g., Do SAT scored differ for low-, middle-, and high-income families?)
Where is the coronoid process?
anterior portion of ramus. Radiopaque triangular projection usually superimposed over maxillary tuberosity.
Triclosan: What does it do?
anti-gingivitis, anti-plaque (e.g., Colgate Total).
Pano errors: How do you fix mandibular incisor roots are blurred?
chin tipped too far down → reposition the chin.
Pano errors: How do you fix a flat smile?
chin tipped too far up → reposition the chin.
If the heads of the ___ move too far ___ on the ___ ___, the muscles become spastic and prevent the jaw from being repositioned. How does a clinician fix this?
condyle, anterior, articular eminence HINT: Think of pushing condyle down and back (under then behind hump, like a tunnel in Ori) Press down and back on occlusal surface (with thumbs protected and 4 fingers wrapping around angle of mandible
What's anodontia?
congenital lack of all primary or permanent teeth.
Sphenomandibular ligament: Where does it connect? What does it do? Which nerve block can it be in the way of?
connects the sphenoid bone and the mandibular foramen on the inner side of the mandible. Can be in the way of the inferior alveolar block. Prevents the mandible from moving too far forward.
Stylomandibular ligament: Where does it connect? What does it do?
connects the styloid process of the temporal bone and the angle of the mandible. Prevents the mandible from moving too far forward.
Temporomandibular ligament: Where does it connect? What does it do?
connects the zygomatic process of the temporal bone and the lateral/posterior surface of the mandible. Prevents the mandible from moving too far back.
What is the lead glass vacuum housing's purpose?
contains two types of electrodes - the cathode and anode.
How does topical/transdermal administration work? How long do effects last? How effective are effects on keratinized vs. nonkeratinzed skin? Are topical drugs more or less concentrated - does this cause problems with toxicity?
drug is applied to the body surface and absorbed slowly by capillaries under the skin (e.g., hydrocortisone, nicotine patches). + Effects last a long time through slow absorption but are less effective on keratinized tissue. + Topical drugs are more concentrated, and therefore, toxicity should be carefully monitored.
What does buccal innervate?
innervates the buccal gingiva from the mental foramen to the posterior region.
What is general supervision?
licensed dentist diagnoses the condition to be treated and authorizes procedures to be performed, but the dentist does not have to be physically present when the procedures are performed.
What is indirect supervision?
licensed dentist diagnoses the condition to be treated, authorizes procedures to be performed, and remains in the dental facility while procedures are being performed.
Define: Hyperplasia
normal cell proliferates in response to tissue damage. The proliferation stops when the stimulus is removed (e.g., denture-related hyperplasia occurs from ill-fitting dentures that put excessive mechanical pressure on the mucosa).
Processing: What does it mean if the film is too light?
not enough development time. Temperature too low. Exhausted developing solution.
What does Mental innervate? What is it part of?
part of the IA, innervates the buccal gingiva (lower lip, chin, anterior labial mucosa) anterior to the mental foramen (around the second premolar).
What does Incisive innervate? What is it part of?
part of the IA, innervates the lower incisors and canines.
Where is the incisive foramen?
passageway for nasopalatine nerves. Small radiolucent oval between roots of maxillary central incisors. Should not be confused with periapical disease.
What's informed consent?
patient agrees to the procedure presented and will follow treatment.
What's informed refusal?
patient declines treatment after it is presented. Consent valid only if the following requirements are present and met. + Includes the procedure, complications, and alternative choices. + Includes the prognosis (benefits and risks) and results of not treating the condition. + Presented in a language the patient understands. + Patient is legally competent to provide consent. If mentally challenged or underage, caregiver may provide consent. Legal age will depend on State/Province. + Patient is allowed to ask questions. + Consent must not be obtained through deceit.
Pano errors: How do you fix one side shows larger teeth/condyle?
patient head is twisted → reposition the head, midsagittal plane perpendicular to the floor (the larger side is the distant side).
Pano errors: How do you fix dark shadow on anteriors?
patient not closing lips → close lips around the biting block.
Fixing: What is the hardener? What does it do?
potassium alum - shrinks and hardens emulsion.
Where is the submandibular fossa?
radiolucent band that runs inferior to the mylohyoid line and apices of molars.
Where is the mandibular canal?
radiolucent horizontal band outlined with a thin line of cortical bone. Inferior alveolar nerve and arteries pass inside the canal. Stretches from the mandibular foramen to the mental foramen.
Where is the mental ridge?
ridge of bone located on the anterior surface of mandible. Bilateral radiopaque lines, starting inferior to premolar apices and extending anteriorly to the midline.
What is virtue ethics? Who came up with it?
right actions are based on the actions of a virtuous person.
What is external resorption?
root surface can be lost with trauma such as orthodontic therapy.
What are pulp stones?
round, radiopaque calcifications in the pulp commonly seen in molars.
What's an enamel pearl?
round, radiopaque calcifications most commonly seen in the furcations of multi-rooted teeth.
What's a cementicle?
round, radiopaque calcifications on the root surface within the PDL space.
What is the cingulum? What's above it?
rounded elevation (convexity) on the lingual surface at the cervical third (near CEJ) of anterior teeth. + V-shaped ridge is identifiable above the cingulum. + Major lingual fossa is noticeable above the cingulum.
What's a Sinus Lift (Augmentation?)
the sinus floor is raised to allow sufficient quantity and quality of bone for the placement of dental implants. More commonly performed in the maxillary posterior area due to the close proximity to the sinus.
Pano errors: How do you fix an airway shadow in an arch shape?
tongue not touching the roof of the mouth → have the patient swallow and reposition the tongue.
Pano errors: How do you fix shadow over maxillary teeth?
tongue not touching the roof of the mouth → have the patient swallow and reposition the tongue.
Processing: What does it mean if the film is too dark?
too much development time. Temperature too high.
What's nonmaleficence?
treat patients in a way that minimizes harm.
What's beneficence?
treat patients with a commitment to provide the highest standard of care.
What's justice?
treat patients with fairness, regardless of all factors.