Clinical dental hygiene Flashcards
Used to penetrate soft tissue or bone; should always be sterilized using heat
critical items
come in contact with mucous membranes and non-intact skin (skin that is chapped, abraded, dermatitis); should be sterilized using heat or disposable alternative
semi-critical
only contact intact skin (radiograph conehead, blood pressure cuff); clean with EPA registered hospital disinfectant and/or protect with barrier
non-critical items
Regulated or biohazard waste
can squeeze the blood out
non-regulated waste or household waste
regular waste can be thrown out
Direct touching saliva, blood or OPIM
Direct contact
touching something that is already contaminated
indirect contact
inanimate objects that when contaminated with infectious agents can transfer disease to a new host
Fomite
visible particles containing microorganisms generated from infected person, such as coughing, sneezing or talking
droplet
particles of respirable size commonly generated by handpicks, ultrasonic scalers, air/water syringe; can remain airborne and viable for extended period of time
Aerosol
Disinfection
kills MOST microorganisms
Sterilization
kills ALL microorganisms, including spores
What are the qualites of an ideal disinfectant
broad spectrum fast acting non-toxic compatible with different types of surfaces easy to use substantivity odorless
High level of disinfectant
used in hospitals
Medium level of disinfectant
commonly used in dental offices; kills mycobacterium tuberculosis
low level of disinfectant
unacceptable in dental offices; kills HIV and hep B
Spore test for steam autoclave
Geobacillus stearothermophilus
15-30 min @ 250 degrees (varies if insturments are wrapped or unwrapped)
Steam autoclave
Can be used with packaged items
Can process a wide variety of materials
Do not use closed containers
Corrosion of non-stainless steel
Steam autoclave
20 minutes at 270 degrees
unsaturated chemical vapor
spore test for unsaturated chemical vapor
geobacillus stearothermophilus
Do not use closed containers
May damage plastic and rubber items
Cannot sterilize liquids
unsaturated chemical vapor
60-120 mins at 320 degrees
Dry heat
Do not use paper products in chamber
Appropriate for closed containers
Dry heat
spore test for dry heat
bacillus atrophaeus
12 min @ 375 degrees
Forced air
spore test for forced air (convection)
bacillus atrophaeus
Demineralization
loss of calcium, phosphate, and carbonate
occurs when pH drops below critical levels
critical levels for ename and cementum
enamel 4.5-5.5; cementum 6.0-6.7
Acidogenic
acid producing
aciduric
acid tolerant
Streptococcus mutans
main species involved in caries process
gram +
mainly produces lactic acid
new carious lesion
Lactobacillus species
Gram +
incapable of producing the range of pH values required for caries
found in large numbers
old carious lesion
Actinomyces viscosis
associated with root/cervical caries
calcium, phosphate and other ions are redeposited into previously demineralized areas
remineralization
Fluoride
halts the caries process as it has substantivity; it interferes with bacterial metabolism - bactericidal or bacteriostatic
Maxillary and mandibular teeth do not occlude
openbite
maxillary teeth are positioned lingual to the mandibular teeth
crossbite
vertical overlap of maxillary and mandibular incisors
overbite
horizontal overlap of maxillary and mandibular incisors
overjet
relationship of the interproximal surfaces of the maxillary central incisors and the inter proximal surfaces of the mandibular central incisors
midline deviation
1st sign of gingivitis
bleeding on probing
Early bone loss; instrument can enter the depression leading to the furca
class I
moderate bone loss; instrument can enter the fulcra but cannot pass between roots
class II
severe bone loss; instrument can pass between roots through entire furca
class III
severe bone and soft tissue loss; instrument can pass between roots through entire furca
class IV
extrinsic stain
external source
brown stain
poor oral hygiene; drinking dark colored beverages, coffee, tea, fruit juices, wine
dark brown and black stain
tobacco products
yellow brown stain
CHX and stannous fluoride; may not be able to remove
black stain
often found in healthy mouths; may be seen as thin lines on the cervical third of tooth; possibly caused by consumption of iron and insoluble ferric sulfide; also associated with gram positive bacteria
green and yellow stain
poor oral hygiene chromogenic bacteria
orange stain
chromogenic bacteria
bluish green stain
occupational exposure of metallic dust
Alterations to tooth during tooth development; may be from extrinsic source if in area of demineralization
intrinsic stain
types of intrinsic stain
fluorosis
tetracycline
usually appears on incisal/occlusal third of tooth; opaque or brownish discoloration depending on severity
fluorosis
shapes of yellow to brown to orange to gray
tetracycline staining
automatic (powered) toothbrush
arthritic hands, caregivers, manually-dexterity challenges, implant care
interdental brush (proxy brush)
metal wire or plastic wire; open embrasure spaces, exposed class III or IV furcations, mild arthritis, diastema, orthodontia
tufted brushes (end tuft)
rotated teeth, hard to access third molars, exposed class III or IV furcations
toothpick in holder
accessible furcations, shallow pockets, normal sulcus depths, someone who already uses toothpick
oral irrigator
delivery of liquid antimicrobial agents; gingival inflammation and bleeding, disrupt loosely-adherent plaque, orthodontia. LEAST EFFECTIVE ORAL PHYSIOTHERAPY FOR REMOVING PLAQUE
Floss (bridge) threader
orthodontia, bridges
Floss holder
physically challenged, large hands, poor manual dexterity
Dental floss
aids in minimizing interproximal decay
toothbrush
cleans teeth, gums and tongue
Anti-caries ingredient
fluoride
tartar control ingredient
pyrophosphates
antihypersensitivity ingredients
potassium nitrate, strontium chloride, or sodium citrate
antibacterial ingredient
triclosan
whitening ingredients
carbamide peroxide or hydrogen peroxide
Absorbed through the bloodstream of developing bone and teeth; can cause skeletal and dental fluorosis
systemic fluoride
Rapidly absorbs fluoride
stomach and small intestines
Compounds added in water fluoridation
sodium fluoride
sodium silicofluoride
hydrofluorosilic acid
Community drinking water is monitored by
EPA
Opimum fluoride level
0.7 ppm
What is the enamel maturation period
period of up to two years after eruption of tooth
In office fluoride
Bactericidal effect (high concentration;low exposure)
1.23% APF
2% NaF
5% NaF
Home fluoride gels
bacteriostatic effect (low concentration; routine exposure)
- 4% stannous; 1,000 ppm
- 1% NaF; 5,000 ppm
Mechanism of action for chlorhexidine
bactericidal
gracey 1-2
all anterior surfaces
gracey 7-8
direct facial and lingual of posterior teeth
gracey 11-12
mesial surface of posterior teeth
gracey 13-14
distal surface of posterior teeth
gracey 15-16
mesial surface posterior teeth
gracey 17-18
distal surface posterior teeth
Most effective for rampant decay and recommended for bulimics
Sodium fluoride gels (2% NaF)
Use for desensitizing exposed roots and caries prevention 0.3-0.5 mL application
Sodium fluoride varnish (5% NaF)
Possible gingival sloughing and discoloration of tooth colored restoration
stannous fluoride
Use 2.5mL on adults and 2.0mL for kids
Acidulated phosphate fluoride (1.23% APF)
What is the certainly lethel dose of fluoride
5-10 gram of NaF at one time for adult
What is the safely tolerated dose of fluoride
1/4 of certainly lethal dose
symptoms begin withint 30 minutes of ingestion and may persist for as long as 24 hours
acute fluoride toxicity
What is the primary purpose of the material safety data sheet
Provides detailed information about specific products used in the dental office
A simple phenol is inappropriate for use for disinfecting the dental operatory. A complex phenol is appropriate for use for disinfecting the dental operatory. What category is a complex phenol
mid-level disinfectant
Which of the following is best to sterilize a dental handpiece
steam autoclave
Using G.V blacks classification for restorations and carious lesions determine the class for a porcelain inlay on the disco-occlusal surface of #14
Class 2
Sterility of instuments is determined by
biological testing monitors
dentinal hypersensitivtiy
movement of fluid within the dentinal tubules
a firm pull stroke with proper lateral pressure isolated to the area of the deposit describes what type of instrumentation stroke
scaling stroke
Which gracey curet is best for use on the maxillary second molar
gracey 17-18
Must be changed to achieve long term success with oral home care
behavior
In what percentage is professional strength, in office sodium fluoride gel
2%
This sterilization technique is least appropriate for paper products
dry heat