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board review > Clinical DH > Flashcards

Clinical DH Flashcards

1
Q

Examples of regulated waste?

A

Sharps, items w/saturated blood and/or saliva and hard or soft tissues removed from the patient’a mouth.

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2
Q

Provides the employee with info regarding hazards of chemicals and how to protect themselves from these hazards.

A

Safety Data Sheets

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3
Q

What is PPE?

A

Personal protective equipment (mask, examination gloves, protective eye wear, and protective clothing). Minimizes exposure to aerosol, spatter, direct transmission, and indirect transmission.

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4
Q

Invisible airborne particles that remain in the air for awhile?

A

Aerosol

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5
Q

Visible airborne particles of blood and/or saliva.

A

Spatter

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6
Q

Direct transmission

A

Occurs through touching of infectious agent, saliva, or blood.

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7
Q

Occurs through a contaminated object.

A

Indirect transmission

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8
Q

What are the qualities of a disinfectant?

A

Rapid, broad-spectrum antimicrobial, bactericidal, tuberculocidal, virucidal. Odorless, compatible, residual effect, non toxic, EPA registered, cleans and disinfects.

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9
Q

Types of Disinfecting agents?

A

Chlorine-based compounds; corrosive to metals and strong odor.
Iodophors-discolor surfaces yellow.
Phenols-leave film or residue on surface.
Quaternary-not corrosive, lower kill spectrum, and limited efficacy.

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10
Q

Why should Glutaraldehydes NOT be used as a surface disinfectant?

A

Toxic effects of fumes and also corrosive.

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11
Q

What are the levels of disinfectants?

A

High-surgical areas
Intermediate-dental offices, must kill TB.
Low-used at home

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12
Q

What kills ALL pathogenic microbes, including spores?

A

Sterilization

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13
Q

Chemical Sterilization

A

273 degrees for 20mins w/ kPa 25 psi.
Spore test= geo bacillus stearothermophilus
Requires ventilation

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14
Q

340 degrees for 1 hour or 320 degrees for 2 hours.
Metal instruments.
NOT for handpieces.
Spore test= bacillus atrophaeus.

A

Dry Heat

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15
Q

Steam

A

250 degrees with 15 or 20 lbs psi for 30 mins.
Corrodes non stainless steel instruments.
Fills instruments and burs.
Spore test= geobacillus stearothermophilus.

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16
Q

What does NOT guarantee sterility?

A

External indicators that change color only indicate instruments have been heat processed.

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17
Q

When should Spore testing be completed?

A

Weekly.

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18
Q

What’s always addressed with the patient first?

A

Chief complaint

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19
Q

Pits/fissures on lingual of ant teeth and occlusal, buccal, and lingual surfaces of post teeth.

A

Class 1 GV Black

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20
Q

Class 2 GV Black

A

Proximal surface of post teeth; commonly occlusal surfaceS.

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21
Q

Proximal surface of ant teeth; does not involve incisal edge.

A

Class 3 GV Black

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22
Q

Class 4 GV Black

A

Proximal surface ant teeth; involves incisal edge.

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23
Q

Cervical (gingival) 1/3 facial or lingual surfaces of any tooth. Root caries.

A

Class 5 GV Black

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24
Q

Class 6 GV Black

A

Incisal edge of ant and/or cusp tips of post teeth.

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25
Q

Class 1 Occlusion (mesognathic)

A

Molar: Mesiobuccal cusp of max 1st molar positioned in buccal groove of mand 1st molar.
Canine: max canine occluded w/distal half of mand canine and mesial half of mand 1st premolar.

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26
Q

Class 2 occlusion (Retrognathic)

A

Molar: buccal groove mand 1st molar distal to mesiobuccal cusp of max 1st molar by at least a width of a premolar.
Canine: distal portion of max canine is mesial to mesial portion of mand canine by at least width of a premolar.

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27
Q

Class 2, Division 1 Occlusion

A

Retruded mandible w/max ant teeth protruded facially.

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28
Q

Class 2, Division 2 Occlusion

A

Retruded mandible w/max ant teeth inclined lingually.

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29
Q

Class 3 Occlusion (prognathic)

A

Molar: buccal groove mand 1st molar mesial to mesibuccal cusp of max first permanent molar by width of a premolar.
Canine: mesial portion of max canine is distal to distal surface of mand canine by width of a premolar.
Usually have cross bite.

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30
Q

Class 1 Furcation

A

Early bone loss; instrument enters depression leading to the furcation.

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31
Q

Moderate bone loss; instrument can enter furcation, but cannot pass between roots.

A

Class 2 Furcation.

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32
Q

Class 3 Furcation

A

Severe bone loss; instrument can pass between roots.

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33
Q

Same as Class 3, but with evidence of recession.

A

Class 4 Furcation.

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34
Q

How do you assess a Furcation?

A

Naber probe

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35
Q

Mobility

A

Class 1: slight horizontal mobility
Class 2: moderate horizontal mobility, greater than 1 mm- no vertical displacement.
Class 3: severe mobility w/possible combined horizontal and vertical movement.

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36
Q

What is Calculus?

A

Mineralized plaque, provides an irritant to gingiva.

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37
Q

What’s the nutrient source for supragingival calculus?

A

Saliva

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38
Q

What’s the nutrient source for subgingival calculus?

A

Crevicular fluid and inflammatory exudate.

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39
Q

How can you detect calculus?

A

11/12 and pigtail for posteriors; orban-type for anteriors and cervical 1/3s of posterior teeth.
Compressed air and radiographs.

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40
Q

What causes Extrinsic stain (exogenous)-removable?

A

Certain bacteria or other sources, such as food, beverages, and tobacco.

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41
Q

Gram positive bacteria; located on cervical 1/3 facials and linguals

A

Black line extrinsic stain

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42
Q

Associated w/poor oral hygiene and dark colored beverages.

A

Brown extrinsic stain

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43
Q

Associated with tobacco use

A

Dark brown or black extrinsic stain

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44
Q

Chromogenic bacteria in plaque; poor oral hygiene located on anterior teeth.

A

Orange extrinsic stain

45
Q

Standouts fluoride/chlorhexidine use. Standouts Fluoride stain results from reaction of tin ion in the fluoride.

A

Yellow-brown and brown extrinsic stain

46
Q

Associated poor oral hygiene, chromogenic bacteria, fungi, and gingival hemorrhage.

A

Green extrinsic stain.

47
Q

What’s the choice of removal if stain is located on the cementum?

A

Instrumentation

48
Q

What causes Intrinsic (endogenous) stain?

A

Pulpal necrosis, internal resorption, excessive systemic fluoride and/or tetracycline use during tooth development.

49
Q

When does Demineralization occur?

A

When the pH drops below 4.5 to 5.5 for enamel and 6.0 to 6.7 for cementum-known as critical pH levels.

50
Q

When is fluoride bactericidal?

A

In high concentrations, professional application.

51
Q

When is fluoride bacteriostatic (inhibits growth or multiplication of bacteria)?

A

In low concentrations, daily at home application.

52
Q

Ability to bind to pellicle, plaque, and tooth surface and be released over a period of time with retention of potency.

A

Substantivity o

53
Q

Where is fluoride rapidly absorbed?

A

Stomach and small intestine

54
Q

The amount of fluoride no used is excreted through?

A

Kidneys

55
Q

What’s the most cost-effective and efficient method of delivering the benefits of fluoride to a community?

A

Water Fluoridation

56
Q

What’s the optimal fluoride level?

A

0.7 ppm mg/L

57
Q

What monitors the concentration level in community drinking water?

A

EPA

58
Q

What sets limits in bottled water?

A

FDA

59
Q

What compounds are used to fluoridate water?

A

Sodium fluoride
Sodium silicofluoride
Hydrofluorosilic acid

60
Q

When is defluoridation recommended by the EPA?

A

If F levels is between 2 and 4 mg F/L of water.

61
Q

What foods contain large amounts of fluoride?

A

Tea and fish

62
Q

Used in presence of tooth-colored and porcelain restorations. Tray method, most effective for rampant caries, 4 minute application, recommended for bulimics.

A

Sodium fluoride

63
Q

Contain 5% NaF, sensitizing exposes roots and caries prevention, retained for 24-48 hours, repeat applications 2-4 times per year, 14% more effective than topical gels, not for home use-professional application only.

A

Sodium Fluoride Varnishes

64
Q

Contraindicated in presence of tooth-colored restorations and porcelain-acid in fluoride etches the glass components in restoration, causing surface roughening or pitting over time.

A

Acidulated Phosphate Fluoride

65
Q

Must be mixed right before use, unpleasant taste due to tin ion in compound, stains demineralized areas and margins of tooth-colored restorations due to tin ion, causes possible gingival sloughing.

A

Stannous Fluoride

66
Q

Certainly Lethal Dose

A

Amount of drug likely to cause death if not intercepted by antidotal therapy.

67
Q

Safely Tolerated Dose

A

One fourth of CLD

68
Q

Acute fluoride toxicity

A

Symptoms begins within 30 minutes of ingestion and may persist for as long as 24 hours. GI symptoms: nausea, vomiting, diarrhea, abdominal pain, increased salivation and thirst.
Systemic Involvement: hypocalcemia, hyperreflexi, convulsions, paresthesia, cardiac failure.

69
Q

What’s the TX for Acute Fluoride Toxicity?

A

Administer fluoride binding agent
Induce vomiting (emesis)
Seek medical treatment
Cardiac monitoring

70
Q

Long-term exposure (10+ years) of water containing 8-10 PPM fluoride.

A

Skeletal fluorosis

71
Q

Hypomineralization results from excessive ingestion of fluoride (2ppm+) during amelogenesis, typically between ages 1-4.

A

Dental fluorosis

72
Q

Indications for use of power-assisted toothbrushes?

A 
Children
Physically/mentally challenged
Elderly 
Arthritic patients
Poorly motivated individuals
Implant care
73
Q

Angle bristles 45 degree toward apex at gingival 1/3, placing bristles into the sulcus ( Perio patient)

A

Bass

74
Q

Stillman

A

Angle bristles 45 degree toward the apex with 1/2 of bristles placed on tooth, other half on the gingiva.

75
Q

Position bristles perpendicular to crown of teeth; brush in circular motion (pedo patient).

A

Fones

76
Q

Charters

A

bristles 45 degrees towards occlusal/incisal plane; move bristles in small rotary motions keep in contact with gingival margin. (ortho patient).

77
Q

What is an Interdental brush used for?

A

open embrasures, exposed class IV furcations, orthodontic appliances, fixed prostheses, dental implants. Inner wire must be plastic coated to avoid scratching the cementum.

78
Q

What is a tufted brush used for?

A

open proximal spaces, hard to assess areas, fixed dental partials, poetics, and orthodontic appliances.

79
Q

What is a toothpick holder (per aid) used for?

A

Exposed class IV furcations and interdental cleaning.

80
Q

When is a floss holder recommended?

A

people who are physically challenged and caregivers providing oral hygiene care.

81
Q

What dentrifices prevent caries?

A

Fluoride

82
Q

What denitrifices prevent tartar-control?

A

Pyrophosphates.

83
Q

What denitrifies are in anti hypersensitivity agents?

A

Potassium nitrate, strontium chloride, and sodium citrate.

84
Q

What dentrifice is in antibacterial agents?

A

Triclosan.

85
Q

What denitrifies are in whitening agents?

A

Carbamide peroxide or hydrogen peroxide.

86
Q

What is an area-specific curet (Graceys)?

A

Only has one cutting edge per working end, begin stroke coronal to edge of junctional epithelium.

87
Q

What areas does a Gracey 1-2 clean?

A

All anterior teeth

88
Q

What areas does a Gracey 11-12 clean?

A

Mesial, facial, and lingual surfaces of posterior teeth.

89
Q

What areas does a Gracey 13-14 clean?

A

Distal surfaces of posterior teeth.

90
Q

What areas does a Gracey 15-16 clean?

A

Mesial surfaces of posterior teeth.

91
Q

What areas does a Gracey 17-18 clean?

A

Distal surfaces of posterior teeth.

92
Q

How do Ultrasonic scalers work?

A

Through cavitation.

93
Q

How do Sonic scalers work?

A

Use compressed air; less power.

94
Q

Operates 18,000 to 45,000 CPS, uses stack of metal strips, elliptical or orbital, all sides of tip are active w/the most active being the point.

A

Ultrasonic Magnetostrictive.

95
Q

Operates 25,000 to 50,000 CPS, uses ceramic rod, rapid linear strokes, lateral sides of tip most active.

A

Ultrasonic Piezoelectric.

96
Q

Operates 2,500 to 7,000 CPS, uses compressed air, elliptical or orbital, all sides of tip are active.

A

Sonic.

97
Q

What are the indications for use of Rubber cup polishing?

A

Removes extrinsic stain not accomplished with hand scaling or with toothbrush and toothpaste. Use light and consistent pressure.

98
Q

When is polishing avoided?

A

Xerostomia, demin/decay, tooth sensitivity, newly erupted teeth, severe gingivitis, lack of extrinsic stain/plaque, exposed root surfaces, and respiratory conditions.

99
Q

What is Air Polishing?

A

Slurry formed by forced air, water and powder (sodium bicarbonate, aluminum trihydroxide, glycine, calcium carbonate, or calcium sodium phosphosilicate).

100
Q

When is air polishing indicated?

A

Stain/biofilm removal, root detoxification, sealant prep, and soft debris removal around orthodontic appliances.

101
Q

Contraindications for use of air polishing?

A

HTN, spongy gingiva, respiratory conditions, restorative materials, exposed root surfaces, immunocompromised, and patients taking potassium, anti-diuretics, or steroid therapy.

102
Q

What color is the Nitrous Oxide tank?

A

Blue.

103
Q

What color is the oxygen tank?

A

Green.

104
Q

When should a saline be used?

A

after nonsurgical periodontal therapy.

105
Q

When should a fluoride rinse be used?

A

To prevent dental caries.

106
Q

What’s the mechanism of action of Chlorhexidine Gluconate?

A

(0.12%). Bactericidal and high substantivity.

107
Q

Whats the clinical use of Chlorhexidine?

A

Preprocedural rinse, decreases supragingival bacterial plaque formation, short-term adjunctive therapy following surgical treatment, implants, and suppresses Streptococcus mutants.

108
Q

Side effects of chlorhexidine?

A

Stains teeth, tongue, and tooth-colored restorations. Alters taste sensation (dysgeusia) including a bitter taste. Increase in supra gingival calculus formation.

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