Ch. 7: The Complete Prophy Flashcards
What is the “Prophylaxis” definition? - “Prophy” (shortened for veterinary use) or “dental” are incorrect terms
Prevention of or protective treatment for disease
Sometimes confused with “prophylactic” or “condom”
What is the first step in prepping for a prophylaxis?
Getting consent and giving an estimate to the client, describe to them what will be done, and ask what they would like to happen if something unexpected happens
What is the difference between a prophylaxis and periodontal therapy?
A prophylaxis is performed for patients with healthy, stage 1, or stage 2 periodontal disease. Periodontal therapy is performed for patients with stage 3 or stage 4 periodontal disease
What equipment/instruments do you need for a prophylaxis?
Sickle scaler, curette, calculus removing forces, periodontal probe/explorer, pigtail explorer, ultrasonic scaler, low-speed hand piece, prophy angle, prophy cup, prophy paste, sharpening tools, and chlorhexidine rinse
How many steps are there to a complete prophy?
11 steps
Antibiotics are indicated for what kind of patients?
Patients with periodontal disease who are compromised by health conditions (liver, kidney, or heart disease) or viral infections (FELV or FIV)
What is step 1 to a complete prophy?
Preliminary Exam and Evaluation; done prior to anesthetic induction
What is step 2 to a complete prophy?
Supragingival Gross Calculus Removal
What are the different instruments that can be used for step 2: supragingival gross calculus removal?
Hand scalers, calculus removal forceps, and ultrasonic scalers
Hand scalers are safe to be used under the gumline.
True or False?
False
What stroke technique is used to remove calculus?
The pull stroke (a stroke pulling the calculus toward the coronal (crown) aspect)
What are ultrasonic scalers used for?
They are used to quickly remove the smaller deposits of supragingival calculus
It is okay to use ultrasonic scalers supragingivally and subgingivally.
True or False?
True
What is an important component of an ultrasonic scaler that must be provided?
Water flow! An ample supply of water is necessary for irrigation. Less water may be required to cool smaller scaler tips and water amount can be adjusted to even just a drip
What can be done for ease of insertion with an ultrasonic scaler subgingivally?
Turning on the handpick before insertion provides a water supply and thereby eases the insertion of the tip in the sulcus
What are a straight shank and a curved shank used for?
A straight shank can be used when working straight down the tooth and a curved shank will allow working around a crown or in a furcation
What is a good ultrasonic technique? Including tips used and where
- Start out with sweeping cross strokes
- Next, work in various directions (coronal to apical, oblique, circumferential)
- To reach furcations, use oblique or corkscrew tips
- Avoid pressing the scaler tip on the tooth surface too hard (thermal damage and render equipment tie ineffective)
What is an abbreviation helpful in ultrasonic technique?
DENTAL; Digits, Engage, Neutral, Technique, Adaptation, and Light Touch
What scaler is controversial in veterinary medicine and why?
The rotary scaler because it can easily damage teeth and requires a great deal of training and practice for safe use. Rather than scaling, this bur frequently ends up burnishing the calculus which can lead to a periodontal abscess
What is step 3 to a complete prophy?
Periodontal Probing & Charting
What is the recommended starting order to have a consistent charting/evaluation method?
Right posterior maxilla (100), left posterior maxilla (200), left posterior mandible (300), and then right posterior mandible (400)
What is step 4 to a complete prophy?
Subgingival calculus removal
What 2 instruments should be used for subgingival calculus removal?
A curette or ultrasonic scaler
What happens if all subgingival calculus is not removed?
Bacterial plaque will continue to destroy the periodontium, leading first to bone deterioration and eventually to tooth loss
What is the preferred hand method for holding hand instruments?
The modified pen grasp
What is step 5 to a complete prophy?
Detection of missed plaque and calculus
What instrument is used in step 5 to detect any missed plaque/calculus?
An explorer
What can be done to aid or applied in finding any missed plaque/calculus?
A disclosing solution that applies a pigment to the tooth surface may be used and will attach to any missed plaque/calculus. You can also let the tooth air dry or use compressed air to dry the tooth an any missed plaque/calculus turns chalky white when dry
What is a consideration when using compressed air to dry the tooth?
This technique should not be used if the integrity of the periodontium is in question because air could be blown into tissues, resulting in air being trapped in the subq tissues or possibly entering the bloodstream
What is step 6 to a complete prophy?
Mechanical polishing or air polishing
What is mechanical polishing?
The use of a prophy angle and abrasive paste
What is the purpose of polishing?
To remove any plaque that may have been missed and smooths the tooth surface
What is a concern with polishing?
It generates considerable heat so a liberal amount of prophy paste should be used and little time should be spent on each tooth
Some researchers believe excessive polishing could cause enamel loss. This is really only a concern with humans as animals don’t get their teeth cleaned that often
What is a disadvantage to circular prophy units?
Hair can get wrapped in the prophy angle
How is a sealed non-rotary prophy angle different from a traditional unit?
They oscillate back and forth at 90 degrees and do not rotate a full 360 degrees (hair can’t get trapped)
What is the most economic means of making prophy paste?
Mix flour pumice with a slight amount of water
It is acceptable to substitute prophy paste containing fluoride for the final irrigation.
True or False?
False
What are the different uses for fine vs. coarse paste?
Fine paste is used to smooth down the tooth surface. Coarse paste is used to remove stains and should be followed up with fine prophy paste
What is air polishing?
Uses air, water, and a powder projection method on the dental surface
What are the advantages to air polishing?
Faster and less demanding for operator, less abrasive, doesn’t produce any heat, and gives better access to the teeth and no direct contact with the dental surface treated
What are the disadvantages to air polishing?
More expensive and can be messier
What is step 7 to a complete prophy?
Sulcus irrigation and fluoride treatment
What is the purpose of sulcus irrigation?
To flush out debris and oxygenates the intrasulculuar fluid
It is appropriate to use pure chlorhexidine to flush the sulcus.
True or False?
False; full-strength disinfectant chlorhexidine which is commonly found in vet hospitals should never be used as a disinfectant without proper dilution
What is a fluoride gel used for?
Slows the reattachment of plaque after the prophy; it is then wiped (not washed) from the tooth surface
What solutions are used for step 7 of a complete prophy?
Saline fluoride or dilute chlorhexidine solution
What is step 8 to a complete prophy?
Application of a sealer
What are the types of sealers available?
Sanos, OraVet (most common), AH plus, and sealaplex
How long is the antimicrobial activity with sanos?
6 months
Sanos can be used in combination with fluoride, doxirobe, or other products.
True or False?
False; it shouldn’t be used with other products and is the last product applied
What is step 9 to a complete prophy?
Periodontal diagnostics
What is included in step 9 to a complete prophy?
Probing and intraoral radiographs
What is step 10 to a complete prophy?
Final charting
What is step 11 to a complete prophy?
Home care
