Chapter 26- 29 Study Set

The use of nylon for toothbrush bristles began in 1938. World War I complications prevented Australian export of wild boar bristles so synthetic materials were substituted.

The statement is true and the reason is false

The horizontal brushing method is not recommended for all of the following reasons except one. Which one is the exception?

This method allows greater coverage in a short amount of time.

Your patient presents with a definitive carious lesion diagnosed by the dentist. What is the treatment plan for a cavitated carious lesion?

Appoint for a restoration

A patient has asked you for advice in using a particular model of power toothbrush given to her as a gift. You have never heard of this type of power toothbrush. She has an appointment with the doctor for restorative work the following week. What should you recommend to this patient?

Ask the patient to bring the brush in at her next visit and research the manufacturers' instructions prior to her return

Case Study 1Mr. Larsen, a 52-year-old, has just moved into town and is new to this dental office. In completing initial oral assessments, Eric, the dental hygienist, noted straight line cuts on the anterior facial and lingual surfaces in the middle of the interdental gingiva. Mr. Larsen had periodontal probe depths from 1 to 3 mm, and his gingiva was stippled, pink, and firm. He also had moderate biofilm accumulations around his bridge in the lower left quadrant and minimal bleeding upon probing. Mr. Larsen reports brushing two or three times a day and flossing one to two times every day. When Eric asked him to demonstrate brushing and flossing, he noticed that Mr. Larsen used a 24-inch piece of floss and snapped it between the contact areas. He also noticed Mr. Larsen used a scrubbing technique when brushing. When Eric commented on his brushing and flossing technique, Mr. Larsen stated that he has always done it this way and no one has ever said anything about it before. Open and read the attached case to answer the following question. What are straight-line cuts on Mr. Larsen's gingiva?

Floss cuts

All of the following are mechanisms of action of fluoride in the prevention of caries except one. Which of the following actions of fluoride is not associated with the prevention of caries?

Passes through diffusion channels to increase acid level

Acids are a byproduct of metabolic processes. All of the following acids are produced during metabolic processes except one. Which acid is not a byproduct of metabolic processes?

Phosphoric acid

All of the following are uses for a toothbrush except one. Which of the following is not an accepted use of the toothbrush for oral health care?

Polishing of restorations

An individual can be in the "high-risk" or "low-risk" category for development of dental caries. All of the following factors are low-risk factors in the development of dental caries for adults except one. Which one of the following factors is not low risk?

Poor manual dexterity

All of the following statements regarding power toothbrushes are true except one. Which statement is the exception?

Power brushes do not offer a great variety in the manner in which the bristles/head moves.

Which one of the following reasons for occlusal brushing would be the leastdesirable reason for this technique?

Remove biofilm deposits from the maxillary tuberosity

Which of the following recommendations would you least likely give to a patient experiencing toothbrush abrasion?

Suggest that the patient spend a longer time brushing his or her teeth

Sealants are recommended for patients with low risk factors. Properly placed sealants close off the pits and fissures where microorganisms can live.

The first statement is false and the second statement is true.

Which of the following statements is true about the interdental anatomy?

The papillae are connected by a col.

According to the video MI can inspire people/patients to change?

True

According to the video MI is about working collaboratively?

True

Archaeologists discovered cavities in 15000 year old human remains?

True

Cavities surged after the industrial revolution?

True

MI is designed to strengthen personal motivation?

True

The spirit of MI is an attitude of acceptance of what the patient brings?

True

A wooden interdental cleaner would be appropriate for biofilm removal with a patient who has what type of embrasures?

Type III

Which of the following is not a suggestion to tell your patient regarding the care of toothbrushes?

Use only one brush for home and work to prevent cross-contamination

What is the best way to use a tongue cleaner? heavy, firm stroke, light soft stroke, light firm stroke, heavy and light stroke? Why?

When using a tongue cleaner you are suppose to use light pressure, drawing the brush forward and over the tip of the tongue. Repeating it 3 to 4 times. You are not suppose to scrub the papilla.

Which of the following interdental aids would not work well for a patient with fixed prostheses?

Wooden interdental cleaner

All of the following are considered fermentable carbohydrates except one. Which of the following is not a fermentable carbohydrate?

Xylitol

Case Study 1You have been hired as a dental hygienist at the Health Department dental clinic in your county. The patient population in this facility is predominately low income. There is no community water fluoridation in the area. Most of your patients do not follow a healthy lifestyle through diet and exercise. Open and read the attached case to answer the following question. Your employer has decided to send the caries risk "Oral Health Check Sheet" to his patients and ask that they fill it out and bring it to their next appointment. This checkoff sheet lists 10 questions associated with a patient's caries risk. Is this a good choice by your employer and why?

Yes. This will be convenient for patients to complete at home and bring in.

Using the acronym PACE with MI the "A" stands for ____________.

acceptance

When is toothbrush damage most likely to occur?

after the initial instruction in a new method of brushing

An interdental tip is indicated for a patient who has:

biofilm accumulations at the gingival margin

What tools will you use to identify dental caries at very early stages during an oral examination of your patient?

blunt probe with no pressure

In your own words describe affirmation?

validate or confirm commending a patients effort toward change

The core skills for MI include?

Open Ended Questions Affirmations Reflective Listening Summary

Mr. Larsen, a 52-year-old, has just moved into town and is new to this dental office. In completing initial oral assessments, Eric, the dental hygienist, noted straight line cuts on the anterior facial and lingual surfaces in the middle of the interdental gingiva. Mr. Larsen had periodontal probe depths from 1 to 3 mm, and his gingiva was stippled, pink, and firm. He also had moderate biofilm accumulations around his bridge in the lower left quadrant and minimal bleeding upon probing. Mr. Larsen reports brushing two or three times a day and flossing one to two times every day. When Eric asked him to demonstrate brushing and flossing, he noticed that Mr. Larsen used a 24-inch piece of floss and snapped it between the contact areas. He also noticed Mr. Larsen used a scrubbing technique when brushing. When Eric commented on his brushing and flossing technique, Mr. Larsen stated that he has always done it this way and no one has ever said anything about it before. Open and read the attached case to answer the following question. In order to better remove biofilm from the pontic and around the abutments, Mr. Larsen should use what interdental aid?

"Super floss"

What are desirable characteristics in a toothbrush?

- conforms to individual patient requirements in size, shape, and texture -easily and efficiently manipulated readily cleaned and aerated; impervious to moisture -durable and inexpensive -functional -end-rounded filaments -designed for utility, efficiency, and cleanliness

What are some desirable reasons for recommending occlusal brushing?

- to loosen biofilm microorganisms packed in pits and fissures - remove biofilm deposits from occlusal surface of teeth -remove biofilm from the margins of restorations -clean pits and fissures for sealants

What recommendations would you give your patient regarding the care of toothbrushes?

-clean toothbrushes after each use -tap handle on edge of sink to remove remaining particles -use one toothbrush to clean another brush -rinse completely and tap out excess water

List the four CAMBRA risk levels.

1. Low risk 2. Moderate risk 3. High risk 4. Extreme Risk

List the three considerations for toothbrushing with ANUG

1. Oral tissues are sensitive to touch during acute stage 2. Careful brush placement 3. extra soft brush 4. lack of oral cleanliness

Name at least four uses for a toothbrush?

1. dental biofilm removal 2. application of preventative agents 3. contibute to halitosis control 4. sanitation of oral cavity

List the five risk factor categories associated with the CAMBRA guidelines for caries management.

1. social history 2. medical history 3. use of fluoride 4. dietary habits 5. clinical/oral

Identify two methods for cleaning the tongue

1. tooth brush 2. tongue scraper

List the four interrelated elements of the spirit of MI. (PACE)

1.P- Partnership 2. A- Acceptance 3. C- Compassion 4. E- Evocation

Outline a protocol for remineralization you can initiate when your patient has evidence of early carious lesions that do not yet require restoration.

1.Remove the nidus of infection -restoration of all carious lesions 2.Initiate Daily preventive measures -personal fluoride use -dietary modifications -chew sugar-free gum at ends of meals 3. Professional and Prescribed Applications

Bitewing radiographs should be recommended every _________ for the moderate risk patient.

18 to 24 months

There has been a reduction in caries in the United States since 1945, attributed to the fluoridation of the water supplies in certain communities. Which of the following is the percentage reduction in caries found?

40%

List in order the stages of dental caries on a tooth surface?

A. Initial Infection: Invisible Lesion B. White Area Lesion: Early Stage C. White Area: Later Stage (white spot lesion) D Cavitated Lesion

When is toothbrush damage mostlikely going to occur?

After the initial instruction in a new method of brushing

What is the order of steps in a prevention program?

Assess the patients needs

What is the most widely accepted method of toothbrushing intended to remove dental biofilm adjacent to and directly beneath the gingival margin?

Bass method

You have been hired as a dental hygienist at the Health Department dental clinic in your county. The patient population in this facility is predominately low income. There is no community water fluoridation in the area. Most of your patients do not follow a healthy lifestyle through diet and exercise. Open and read the attached case to answer the following question. When a patient presents with no dental caries, which of the following treatment options would not be recommended

Be glad that the patient is caries free and leave well enough alone

A child can be at risk for dental caries as soon as tooth eruption begins. Why?

Because sugars and fermentable carbs are introduced into the mouth Important to note they are at risk for caries because they have bacteria present already in the oral cavity

Which of the following radiographs is the best choice to detect caries on proximal tooth surfaces?

Bitewing radiograph

When making suggestions regarding toothbrush selection, the dental hygienist should consider all of the following except one. Which one is the exception?

Bleeding of the gingiva during brushing

Remineralizing tooth surfaces should not be scratched or altered in any way. Which of the following techniques would be the most acceptable way to detect coronal caries on a demineralized surface?

Blunt probe

The fluorapatite bond is stronger than the hydroxyapatite bonds. In the biofilm, the HF diffuses through the cell membrane of acidgenic bacteria.

Both statements are true.

Which one of the following characteristics would be least desirable in a toothbrush?

Bristle or filament height of 21 mm

Saliva has many protective functions in the oral cavity. Which of the following is the most important protective property of saliva in the caries process?

Buffering of acids

All of the following statements regarding dental caries are true exceptone. Which of the following statements is incorrect?

Caries is an eradicated disease

Mr. Larsen, a 52-year-old, has just moved into town and is new to this dental office. In completing initial oral assessments, Eric, the dental hygienist, noted straight line cuts on the anterior facial and lingual surfaces in the middle of the interdental gingiva. Mr. Larsen had periodontal probe depths from 1 to 3 mm, and his gingiva was stippled, pink, and firm. He also had moderate biofilm accumulations around his bridge in the lower left quadrant and minimal bleeding upon probing. Mr. Larsen reports brushing two or three times a day and flossing one to two times every day. When Eric asked him to demonstrate brushing and flossing, he noticed that Mr. Larsen used a 24-inch piece of floss and snapped it between the contact areas. He also noticed Mr. Larsen used a scrubbing technique when brushing. When Eric commented on his brushing and flossing technique, Mr. Larsen stated that he has always done it this way and no one has ever said anything about it before. Open and read the attached case to answer the following question. Excess pressure used when flossing is especially harmful to whom?

Children who have a mixed dentition

Which of the following is not an effect of cleaning the tongue?

Contributes to increased xerostomia

Tooth abrasion results from mechanical removal of the surface epithelium?

False

Case Study 1You have been hired as a dental hygienist at the Health Department dental clinic in your county. The patient population in this facility is predominately low income. There is no community water fluoridation in the area. Most of your patients do not follow a healthy lifestyle through diet and exercise. Open and read the attached case to answer the following question. You have been asked by your employer to develop a caries management strategy that covers all of the patients' needs. Which of the following is not an objective for this caries management strategy?

Determine the patients' financial situation

What is the first step in Motivational Interviewing?

Engaging

According to the power point presentation slide #9 Focusing is the first step in the process of MI?

False

Who was issued the first patent for a toothbrush in the United States around the middle of the 19th century?

H. N. Wadsworth

Writings in 300 B.C. include descriptions of diseased gums related to calculus and of complex preparations for the treatment of unhealthy mouths. Who was the author of these writings?

Hippocrates

What recommendations would you give a patient experiencing toothbrush abrasion?

I would explain to the patient the problem and what is it doing to their teeth, then i would advice the use of a toothbrush with end-rounded filaments, and recommend a less abrasive paste, and to use a smaller amount. And try to locate the area in the mouth wear the patient accumulates calculus and then tell them to start brushing first in that area.

The incidence of gingivitis is greatest in what area?

Interdental tissues

Which one of the following is true concerning the readiness ruler?

It can elicit change talk.

In a patient with advanced periodontitis, which teeth may have furcation areas on the proximal surface, making interdental biofilm removal difficult?

Maxillary first premolars

Identify the acids produced during the metabolic process of the bacteria in dental biofilm?

Mutans streptococci and the lactobacillas species (PG. 437)

A habit, behavior, lifestyle, or condition that when present increases the probability of a disease occurring is a term often used in medical research. Which of the following best fits this definition?

Risk factor

Which one of the following is NOT a factor in contributing to demineralization?

Salivary calcium

When using the oral irrigator which one of the following is true?

Set unit pressure at lowest setting

Which interdental aid would be best to recommend to a patient with orthodontic appliances?

Soft picks

In the example of how not to do a MI the dentist assumed the patient had been?

a methamphetamine user

Where are microorganisms in the saliva primarily from?

dorsal surface of the tongue

The four steps in MI are:

engaging focusing evoking planning

The sequence in brushing for any method used should:

ensure complete coverage for each tooth surface.

Sustain talk is the ___________ own argument for not changing.

individual

The col area becomes deeper when:

inflammation leads to edema.

Dental floss is most effective when a patient has:

interdental papillae and no loss of attachment

The tongue cleaner is pressed over the tongue with a ______________.

light and firm stroke

Planning patient interdental care begins with patient assessment, which provides all of the following information except:

motivation to perform the patient's oral care routine.

All of the following statements are true about ANUG except:

oral tissues usually have a smell and thus toothbrushing is increased.

Traumatic toothbrush lesions are frequently found:

over canines and premolars.

Tooth brushing adequately removes biofilm from all surfaces of the teeth except:

proximal

When teaching a patient to use floss, all of the following instructions should be given except:

snap floss through the contact area.

Mr. Larsen, a 52-year-old, has just moved into town and is new to this dental office. In completing initial oral assessments, Eric, the dental hygienist, noted straight line cuts on the anterior facial and lingual surfaces in the middle of the interdental gingiva. Mr. Larsen had periodontal probe depths from 1 to 3 mm, and his gingiva was stippled, pink, and firm. He also had moderate biofilm accumulations around his bridge in the lower left quadrant and minimal bleeding upon probing. Mr. Larsen reports brushing two or three times a day and flossing one to two times every day. When Eric asked him to demonstrate brushing and flossing, he noticed that Mr. Larsen used a 24-inch piece of floss and snapped it between the contact areas. He also noticed Mr. Larsen used a scrubbing technique when brushing. When Eric commented on his brushing and flossing technique, Mr. Larsen stated that he has always done it this way and no one has ever said anything about it before. Open and read the attached case to answer the following question. The reason the straight-line cuts appear are because Mr. Larsen:

snaps floss through the contact area.

Properties of unwaxed floss include:

squeaking sound when floss moves over clean tooth surface

MI is designed to ____________ personal motivation?

strengthen

Sustain talk means:

the individual's own arguments for not changing.

Microorganisms in saliva are principally from the _______.

tongue

Define toothbrush abrasion

toothbrush abrasion is the wearing away of tooth structure that results from a repetitive mechanical habit. It can happen from brushing with an abrasive agent in the dentifrice, horizontal brushing with excessive pressure, form of filament ends; abrasion is less frequent when filament ends are rounded.

Mr. Larsen, a 52-year-old, has just moved into town and is new to this dental office. In completing initial oral assessments, Eric, the dental hygienist, noted straight line cuts on the anterior facial and lingual surfaces in the middle of the interdental gingiva. Mr. Larsen had periodontal probe depths from 1 to 3 mm, and his gingiva was stippled, pink, and firm. He also had moderate biofilm accumulations around his bridge in the lower left quadrant and minimal bleeding upon probing. Mr. Larsen reports brushing two or three times a day and flossing one to two times every day. When Eric asked him to demonstrate brushing and flossing, he noticed that Mr. Larsen used a 24-inch piece of floss and snapped it between the contact areas. He also noticed Mr. Larsen used a scrubbing technique when brushing. When Eric commented on his brushing and flossing technique, Mr. Larsen stated that he has always done it this way and no one has ever said anything about it before. Open and read the attached case to answer the following question. Mr. Larsen asks Eric what type of floss he should use to prevent further floss cuts. Eric should recommend:

waxed floss.

Floss is made of the following materials except:

wood filaments