Final: Exam1, Exam2, Exam3 Flashcards

1
Q

Which of the following descriptions best characterizes orthofunction?

a. ordinary masticatory forces
b. adaptive capacity of the orofacial complex
c. proper arch form in a Class 1 occlusal relationship
d. few or no occlusal interferences

A

adaptive capacity of the orofacial complex

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2
Q

The etiology of tempromandibular disorders is described as:

a. behavorial
b multifactorial
c. neurologic
d. psychologic

A

multifactorial

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3
Q

The normal jaw should achieve an opening distance of at least:

A

40 mm

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4
Q

The first step in the dental hygiene process of patient care is:

a. planning
b. assessment
c. diagnosis
d. implementation

A

assessment

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5
Q

All of the following are methods of recording the presence of plaque biofilm on tooth surfaces EXCEPT one. Which one is the EXCEPTION?

a. O Leary INdex
b. Gingival Index of Loe and Silness
c. Plaque Index of Silness and Loe
d. Simplified Oral Hygiene Index

A

Gingival INdex of Loe and Silness

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6
Q

The periodontal probe can be used to quantify all of the following EXCEPT one. Which one is the EXCEPTION?

a. pocket depth
b. gingival recession
c. furcation involvement
d. clinical attachment loss
e. stain and plaque biofilm

A

stain and plaque biofilm

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7
Q

Which phase of treatment describes the procedures designed to control or eliminate the etiologic factors of disease?

a. Phase 3 therapy
b. Phase 2 therapy
c. Phase 1 therapy
d. Preliminary phase
e. Phase 4 (IV)

A

Phase 1 therapy

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8
Q

The term describing the basis for the legal relationship between the health care provider and the patient is:

a. treatment plan
b. prognosis
c. informed consent
d. phase of therapy

A

INformed consent

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9
Q

All of the following factors infulence the number and length of treatment visits for dental hygiene care EXCEPT one. Which one is the EXCEPTION?

a. amount of calculus
b. willingness of patient to cooperate
c. height of patient
d. severity of periodontal pockets

A

height of patient

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10
Q

The term for heavy occlusal forces that have caused injury to tissues and bone in a normal periodontium is:

a. physiologic occlusion
b. secondary traumatic occlusion
c. primary traumatic occlusion
d. dysfunctional occlusion

A

primary traumatic occlusion

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11
Q

An oral habit such as bruxism can result in all of the follwoing EXCEPT one. Which one is the exception?

a muscular hypertrophy

b. periodontal tissue injury
c. change in microflora
d. muscular pain and tenderness

A

Change in microflora

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12
Q

Myalgia is best described as:

a pain in the muscles

b. clicking in the joint
c. crepitus in the joint
d. incoordination of the jaw

A

pain in muslces

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13
Q

What are the four primary symptoms of tempporomandibular disorders?

A

muscle pain, jaw pain, clicking, and limitation of motion

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14
Q

The goals of treatment planning are to eliminate and control factors of disease and to prevent recurrence of disease. The dental hygienist can use treatment planning as an opportunity to explain problems to patients in understandable terms.

A

both statements are true

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15
Q

Which phase of treatment describes the procedures for restoration or replacement of teeth?

a. Phase IV
b. Phase III
c. Phase II
d. Phase I
e. Preliminary phase

A

Phase III

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16
Q

The term for swelling at the gingival margin that has an inner tube like appearance is:

a. festoon
b. frenum
c. tumor
d. cleft

A

festoon

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17
Q

A type of stain that occurs as a thin black line on the facial and lingual surfaces of the teeth of individuals who have excellent oral hygiene is called:

a. tobacco stain
b. orange stain
c. chlorexidine stain
d. black stain

A

black stain

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18
Q

The medical history aids the clinician in the evaluation of oral manifestations of systemic diseases. The medical history is not important when evaluating only the periodontium.

A

the first statement is TRUE, and the second is FALSE

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19
Q

The lining mucosa covers all of the follwoing EXCEPT one. Which one is the EXCEPTION?

a. floor of mouth
b. ventral of tongue
c. inner lips
d. cheeks
e. dorsum of tongue

A

dorsum of tongue

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20
Q

Which of the following is TRUE concerning Green Stains?

a. associated with adults
b. associated with elderly
c. associated with women
d. none are TRUE

A

none are TRUE

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21
Q

Informed consent is permission granted by the patient for the health care provider to proceed with treatment. A patient has the right to refuse any or all treatment if not in their best interest.

A

both statements are TRUE

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22
Q

The dentist is NOT responsible for the dental hygienist under General Supervision because the hygienist is working alone. A hygienist can still be found neglient in legal proceeding if malpractice has been established.

A

first statement is FLASE, and the second is TRUE

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23
Q

Occlusion is a static state and not dynamic in nature. Malocclusion may not be ideal, therefore it cannot be physiologic occlusion.

A

both statements are FALSE

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24
Q

Clenching or grinding of the teeth when the individual is not chewing is known as:

a. bruxism
b. orthognathic function
c. orthodontic nocturnalism
d. none of the above

A

bruxism

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25
Q

Secondary symptoms in temporomandibular dysfunction include all of the follwoing EXCEPT one. Which one is the EXCEPTION?

a. uncomfortable bite
b. dyskinesia
c tinnitus
d. pain the ocular nares

A

pain in the ocular nares

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26
Q

There are 4 types of oral mucosa

A

False

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27
Q

Oral Hygiene Assessment aids in treatment planning the patients as well as designing patient education strategy.

A

True

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28
Q

The Oleary Plaque Control Record is scored by subtracting the number of surfaces with recorded plaque biofilm from the number of surfaces in the assessment and this gives you a percentage total.

A

False

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29
Q

Brown stain is the least common of the stains because it only caused by chlorexidine.

A

False

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30
Q

Orange stain is the most common type stain.

A

False

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31
Q

Tetracycline stains are due to antibiotic therapy and has occurred during tooth development.

A

True

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32
Q

A two rooted tooth has a bifurcation and a three rooted tooth has a trifurcation.

A

True

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33
Q

All teeth have a slight degree of physiologic mobility because they are supported by the periodontal ligament.

A

True

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34
Q

Pathologic mobility is horizontal movement of a tooth beyond its physiological limits, it must not contain any vertical movement to be considered pathologic mobilty.

A

False

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35
Q

The Periodontal Screening and Recording system (PSR) is a periodontal disease detection system endorsed by the ADA and the AARP.

A

False

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36
Q

Slight Periodontal Disease

A

1-2 mm of clinical attachment loss

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37
Q

Moderate Periodontal Disease

A

3-4 mm of clinical attachemtn loss

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38
Q

Severe Periodontal Disease

A

5mm or greater clinical attachemtn losss

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39
Q

Parafunctional Activity

A

clinching or grinding activity

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40
Q

Dyskinesia

A

incoordination of jaw

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41
Q

Tinnitus

A

ringing in ears

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42
Q

Arthralgia

A

tenderness or pain in the TMJ

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43
Q

Myaligia

A

pain in the masticatory muscles

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44
Q

Crepitus

A

grating sound in TMJ

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45
Q

Phase 1

A

control and eliminate predisposing factors of disease

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46
Q

PHase 2

A

surgical phase

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47
Q

Phase 3

A

restorations and replacing missing teeth phase

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48
Q

Phase 4

A

maintenance phase

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49
Q

Subclass A Furcation

A

0-3 mm from the roof of the furca

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50
Q

Subclass B Furcation

A

4-6 mm from the roof of the furca

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51
Q

What should be the maximal intercuspal distance of occlusion, this is known as centric occlusion or Vertical Dimension of Occlusion. Answer must be in millimeters.

A

Freaking 0 mm ………

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52
Q

Relics used for dental care were found in Iraq. They were estimated to have been used about 3000 BCE.

A

both statements are TRUE

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53
Q

Anton van Leeuwenhock was the father of dentistry. He discovered dentinal tubules, examined tartar, and identified microbes of the mouth.

A

both statements are unrelated but TRUE

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54
Q

Names for periodontal lesions include all the following EXCEPT one. Which is the EXCEPTION?

a. pockets
b. periodontal lesions
c. periodontal pockets
d. periodontal disease
e. probe measurements

A

probe measurements

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55
Q

There is growing concern about the increase in population and the need for health care for all. This has resulted in a decrease in the number of dental hygiene programs in the United States.

A

The first statement is True the second statement is False

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56
Q

The red complex bacteria are:

A

T. denticola, T. forythensis, P. gingivalis

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57
Q

______ is the study of health and disease with associated factors associated with it in a population in reference to heredity, biology, environment, society, and behavior.

a. epidemiology
b. incidence
c. prevalence
d. tracology
e. none of above

A

epidemiology

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58
Q

The Americal Dental Hygienists’ Association was first established for dental hygienist. The Association has helped define the roles of the dental hygienist in dentistry.

A

both statements are TRUE

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59
Q

Risk factors for periodontal disease include alcohol consumption, obesity, tobacco use, and insulin dependence. HIV is never associated with any type of periodontal problems.

A

The first statement is True and the second statement is False

60
Q

Approximately what percentage of the US adult population suffers from MILD to MODERATE periodontal disease?

a. 35%
b. 45%
c. 5 to 20%
d. 5 to 45%

A

35%`

61
Q

Capilouto and Douglas concluded that the prevalence and severity of gingivitis over the last two decades has:

a. remained the same
b. decrease over time
c. increased over time

A

increased over time

62
Q

All of the following are assoicated with greater incidence of periodontal disease except one. Which is the exception?

a. race
b. sex
c. smoking
d. economic status

A

race

63
Q

Which group is greatest risk for localized aggressive periodontitis?

a. blacks
b. hispanics
c. caucasians
d. pacific islanders

A

blacks

64
Q

The attachment apparatus is made up of:

a. lamina dura and alveoli
b. periodontal ligament fiber bundles
c. elements of the junctional epithelium
d. periodontal ligament, cementum, and alveolar bone
e. sharpey’s fibers, cementum, periodontal ligament fiber bundles

A

sharpey’s fibers, cementum, periodontal ligament fiber bundles

65
Q

The window of bone in healthy bone structure covering the surface of the root is called a dehiscence. The dehiscence is a significant structure in periodontal disease.

A

The first statement is Flase and the second is True

66
Q

Cells attracted to areas of the body by stimuli such as microbial influence or trauma are referred to as:

a. cytokines
b. blood cells
c. chemotactic cells
d. inflammatory cells

A

inflammatory cells

67
Q

Inflammatory cells perform all of the following functions Except one. Which one is the exception?

a. lyse cells
b. phagocytize bacteria
c. remove damaged tissue
d. reduce osteoclastic activity

A

reduce osteoclastic activity

68
Q

B lymphocytes come from the liver, spleen, and bone marrow. B Lymphocytes are important in the antigen antibody response.

A

both statements are TRUE

69
Q

Plaque biofilm microbiota produces enzymes. Some of the enzymes produced by the biofilm organisms protect the tissues from destruction.

A

The first statement is TRUE and the second is FLASE.

70
Q

The scientific rationale for the dental hygienist to teach patients good plaque biofilm control is to:

a. keep plaque in a mature state
b. keep plaque in an immature state
c. enhance self-cleansing mechanisms in the mouth
d. remove pellicle from teeth so that bacteria cannot adhere

A

keep plaque in a immature state

71
Q

Plaque biofilm should be removed by the patient at a miniumum every:

a. 6 hours
b. 24 hours
c. 48 hours
d. 2 to 5 days

A

24 hours

72
Q

Understanding that plaquw is a biofilm is significant because:

A

plaque biofilms are protective of the gingiva

73
Q

Gingivitis, which is considered to be a nonspecific infection, is a disease process that is unlikely to progressive. Chronic periodontitis is thought to be caused by a limited number of organisms and is a disease process that is likely to progress.

A

both statements are TRUE

74
Q

The first dental school was opened in what year in the US?

A

1840

75
Q

All of the following is true concerning the gingiva EXCEPT: Which is the exception?

a. the visible component
b. coral pink in color
c. lighter when melanin is present
d. distinguished from the oral mucosa at the mucogingival

A

lighter when melanin is present

76
Q

All of the following is true concerning cementum EXCEPT: Which is the exception?

a. covers the root surface and coronal between the dentin and enamel
b. aids in anchoring the teeth
c. contains Sharpey’s fibers
d. has no vascular or nerve fibers

A

has no vascular or nerve fibers

77
Q

Means “in chains”

A

Cocci

78
Q

Rods

A

bacilli

79
Q

Prefers carbon dioxide

A

Canophiles

80
Q

Cannot tolerate oxygen environment

A

Obligate Anaerobes

81
Q

Spiral

A

Spirochetes

82
Q

Crystal violet stain

A

Gram +

83
Q

Safranin counterstain

A

Gram -

84
Q

Requires oxygen

A

Aerobes

85
Q

Does not require oxygen

A

Anaerobes

86
Q

Can use oxygen or fermentation

A

Faculative anerobic organisms

87
Q

The majority of organisms on the dorsum of the tongue are gram positive.

A

True

88
Q

Disclosing liquids detect biofilm on the teeth.

A

True

89
Q

S. mutans is not a bacteria of the oral cavity.

A

False

90
Q

IgA is not secreted in the saliva by salvary glands

A

Flase

91
Q

P. gingivalis seems to be the most important periodontal pathogen.

A

True

92
Q

NUG is referred to as NUP when it invades deeper tissues.

A

True

93
Q

Virulence means the ability to cause disease.

A

True

94
Q

Edentulism is increasing in the Untied States.

A

False

95
Q

2/3 of all adutls have calculus and it decreases with age

A

Flase

96
Q

The MIller Index determines the amount of material alba.

A

False

97
Q

Gingival bleeding is assocaited with inflammation.

A

True

98
Q

Human immunoglobulins are divided in to 9classes.

A

True

99
Q

Macrophages are scavengers that pahgocytize bacteria.

A

True

100
Q

Polymorphonuclear Leukocytes are referred to as neutrophils

A

True

101
Q

Anaphylaxis is a Type II hypersensitivity reaction caused by cellular breakdown.

A

False

102
Q

How long does it take for plaque biofilm to begin to minerlize?

A

less than 24 hours

103
Q

Each of the following characteristics is related to increased rates of calculus formation EXCEPT one. Which one is the exception?

a. elevated pH
b. higher individual inhibitory factors
c. concentration of salivary bacterial protein and lipid
d. concentration of calcium

A

higher individual inhibitory factors

104
Q

Light calculus formers have a higher level of:

a. ductal calcium
b. salivary phosphotasis
c. stenotic pyrophosphates
d. none of the above
e. all of the above

A

none of the above

105
Q

Healing of gingivitis results in the deposition and maturation of new collagen fibers. The redness and swelling remain.

A

The first statement is TRUE, the second is FALSE

106
Q

Which factor facilitates the early growth of subgingival plaque?

a. predominance of filamentous bacteria
b. greater production of fermentation end products
c. presence of hemin-containing proteins in cervicular fluid
d. formation of highly branched extracellular polysaccharides

A

Presence of hemin-containing proteins in crevicular fluid

107
Q

Clinical signs of inflammation will appear approximately how many days after all plaque control measures are discontinued?

A

10 to 21 days

108
Q

Calculus becomes firmly attached to the tooth surfaces through which mechanism(s)?

a. serum attachment
b. pellicle attachment
c. mechanical attachment
d. mechanical and pellicle attachment

A

mechanical and pellicle attachment

109
Q

Anti-calculus forming agents work by decreasing the ____ formation

a. crystal
b. pellicle
c. matrix glycocalyx
d. biofilm

A

crystal

110
Q

Hormone induced gingivitis is characterized by both cellular proliferation and vascular proliferation and fragilty. This form of gingivits does not respond to improved plaque biofilm control.

A

The first statement is TRUE, and the second is FALSE

111
Q

The significnce of the clinical attachment loss measurement is that it provides:

a. millimeter amount of recession
b. millimeter depth of the gingival pocket
c. millimeter depth of the periodontal pocket
d. millimeter amount of loss of support for the tooth

A

the millimeter amount of loss of support for the tooth

112
Q

Systemic antibiotic therapy should be used in the treatment of periodontal diseases when:

a. specific organisms have been identified
b. dental hygiene treatment has been successful and specific organisms can be identified
c. dental hygiene treatment has been successful and specific organisms cannot be identified
d. dental hygiene treatment has been unsuccessful and specific organisms have been identified.

A

dental hygiene treatment has been unsuccessful and specific organisms have been identified

113
Q

Dental plaque biofilm associated with chronic periodontitis is predominantly:

a. spirochetal
b. gram-positive
c. gram-negative
d. gram positive and gram negative
e. actinobacillus actinomycetemcomitans

A

gram negative

114
Q

All of the following are features of the micorflora of chronic periodontitis EXCEPT one. Which one is EXCEPTION?

a. microflora varies among patients
b. biofilm is similar to that gingivitis
c. biofilm can altered with debridement
d. biofilm commonly contains P. gingivalis

A

biofilm is similar to that gingivitis

115
Q

Subgingival calculus is made up of crystals that can grow into cemental irregularities and bond to tooth structure. These qualities are important to understand because they explain why:

A

Subgingival calculus is often more tenacious than supragingival calculus

116
Q

The risk of severe periodontal disease is increased for those who smoke tobacco products? The patient is less likely to recognize the disease process since many of the symptoms are masked by the tobacco

A

Both statements are true

117
Q

The hyginenic pontic should have what characteristics:

a. saddle shape that is overlapping the gingival on both buccal and lingual
b. spherical and away from the gingiva enough for ease in cleaning
c. spherical and tightly adapted to the gingival causing blanching of the tissue
d. saddle shaped and 3 mm away from the gingiva
e. saddle shaped and tightly adapted to the gingiva

A

spherical and away from the gingiva enough for ease in cleaning

118
Q

When the gingival swells causing an increase in the pocket depth but a los of bone, this is known as psedupocket. Probing in this case gives a false CAL.

A

Both statements are true

119
Q

Connective tissue hyperplasia in transplant patients is related to taking which of the following:

a. hormones
b. antibiotics
c. cyclosporine
d. antiviral medicatons

A

cyclosporine

120
Q

Primary herpetic gingivostomatis is significant to the dental hygienist because:

a. it resembles aggressive forms of gingival and periodontal disease
b. the disease resembles NUG and presents with punched out papillae
c. herpesvirus is contagious at this stage, and treatment should be deferred
d. herpesvirus is not contagious at this stage, so the patient can now treated

A

herpesvirus is contagious at this stage, and treatment should be deferred

121
Q

The first step in calculus formation is:

a. formation of pellicle
b. formation of colonies of bacteria
c. deposition of minerals from saliva
d. deposition of minerals from serum

A

formation of pellicle

122
Q

Which drug that is not a calcium channel blocker can cause excessive growth of gingival tissue?

a. nifedipine
b. phenytoin
c. cyclosporine
d. corticosteroid

A

cyclosporine

123
Q

Which gingival conditon is characterized by pain, pseudomembrane, burning mouth, and the…?

a. acute leukemia
b. phenytoin hyperplasia
c. necrotizing ulcerative gingivitis
d. primary herpetic gingivostomatitis

A

necrotizing ulcerative gingivitis

124
Q

The most important host factor in determining the progression of periodontitis and bone loss is:

a. effective scaling and root planning
b. corrosive factors in dental calculus
c. bacteria acid eroding the crestal alveolar bone
d. direct tissue damage by the bacteria in plaque
e. inflammation from the host response to plaque antigens

A

inflammation from the hose response to plaque antigens

125
Q

Virulence (pathogenicity) of periodontal pathogens is related to all of the following EXCEPT one. Which is the exception?

a. proximity to oral tissues
b. ability to destroy oral tissues
c. gram positive cell membrane
d. ability to evade host defenses

A

Gram positive cell membrane

126
Q

Which stage of gingival inflammation begins within 4 to 7 days after plaque has accumulated sulcus and may be seen as slightly red and swollen?

a. inital stage (Stage I)
b. Early stage (Stage II)
c. Established stage (Stage III)
d. Advance stage (Stage IV)

A

early stage (stage I)

127
Q

The dental hygienist should consider recommending a thorough medical evaluation for:

a. all patients with heavy plaque and calculus
b. all patients with moderate plaque and calculus
c. patients whose gingiva does not bleed when probed
d. patients with plaque and calculus levels consistent with the amount of periodontal destruction
e. patients with plaque and calculus levels not consistent with the amount of periodontal destruction

A

patients with plaque and calculus levels not consistent with the amount of periodontal destruction

128
Q

All of the following treatment options are useful in treating moderate chronic periodontitis EXCEPT one. Which one is the exception?

a. systemic antibiotic therapy
b. assisting the patient with a smoking cessation program
c. removal of local factors such as overhanging restorations
d. educating the patient in improved personal plaque biofilm control
e. complete removal of plaque biofilm and calculus from the root surfaces

A

systemic antibiotic therapy

129
Q

Which type of calculus is tightly adherent to the tooth and found near opening of the salivary ducts?

a. serumal
b. subgingival
c. submarginal
d. supragingival

A

supragingival

130
Q

The risk of periodontal disease is increased for moderate drinkers. The protective effects of alcohol consumption and presence of social habits must be considered when discussing these risks with patients.

A

Both statements are TRUE

131
Q

Subgingival calculus is associated with which of the following?

a. attachment loss
b. attachment gain
c. first molar loss syndrome
d. nonaggressive forms of periodontal disease

A

attachment loss

132
Q

Gingivitis and periodontitis share all of the following characteristics EXCEPT one. Which on is the exception?

a. pocket formation
b. alveolar bone loss
c. tissue inflammation
d. collagen fiber destruction

A

alveolar bone loss

133
Q

Necrotizing ulcerative gingivitis NUG is a gingival disease associated with specific organisms. It is accurately considered a form of aggressive periodontal periodontal disease.

A

Both statements are TRUE

134
Q

What is the principal etiologic agent of periodontitis?

a subgingival calculus

b. neutrophil deficiency
c. dental plaque biofilm
d. antigen antibody reaction

A

dental plaque biofilm

135
Q

Gingivitis may occur when the patient is under going stressful situations. Treatment by the dental hygienist improve the clinical situations, but it may not heal completely until the stressful situation…

A

Both statements are true

136
Q

Clinical probing depths increase in stage II gingivitis because:

a. the tissues become engaged with inflammatory cells
b. the probe penetrates more deeply into the junctional epithelium
c. the margin of the gingival moves coronally as a result of swelling in the gingiva
d. the tissue becomes engaged with inflammatory cells and the probe penetrates more deeply
e. the tissue becomes engaged with inflammatory cells, and the margin of the gingiva moves cornally

A

the tissue becomes engaged with inflammatory cellls, the probe penetrates more deeply, and the margin of the gingiva moves cornallly

137
Q

Chronic periodontitis is:

a not treatable with antibiotics

b. usually significant before age 35 years
c. a rare disease
d. neither localized nor generalized

A

usually significant before age 35 years

138
Q

The plaque biofilm associated with juvenile periodontitis is present in small amounts considering the severity of the periodontal defects because:

a. all the plaque biofilm is supragingival
b. the primary pathogen in the biofilm does not create much extracellular matrix
c. the primary pathogen creates extracellular matrix that forces the bacteria out of the pocket
d. the primary pathogen creates a great deal of extracellular matrix, leaving no space for bacteria to grow

A

the primary pathogen in the biofilm does not create much extracellular matrix

139
Q

Bone is an active characterized by continuous formation and resorption. It is possible to determine the precise time that bone loss caused by peridontal disease begins.

A

The first statement is true, and the second is false

140
Q

All of the following treatment options are useful in treating moderate chronic periodontitis EXCEPT one. Which one is the exception?

a. systemic antibiotic therpay
b. assisting the patient with a smoking cessation program
c. removal of local factors such as overhanging restorations
d. educating the patient in improved personal plaque biofilm control
e. complete removal of plaque biofilm and calculus from the root surfaces

A

systemic antibiotic therapy

141
Q

The toxic effects of tobacco are caused by:

a. changes in gingival epithelium and muscosal cells
b. decreases in vascular reaction to inflammation
c. reduced ability of PMNs to phagocytize substances
d. all of the above

A

all of the above

142
Q

Recession is the significance to the patient for all of the following reasons EXCEPT one. Which one is the exception?

a. exposed root surfaces can decay
b. exposed root surfaces can become sensitive
c. exposed root surfaces can lead to peridontitis
d. exposed root surfaces can be harder for the patient to clean

A

exposed root surfaces can decay

143
Q

A pregnancy tumor is a localized area of pyogenic granulation tissue. The pregnancy tumor is neoplastic lesion.

A

The first statement is TRUE, and the second is FALSE

144
Q

Healing of gingivitis results in the deposition and maturation of new collagen fibers. The redness and

A

The first statement is TRUE, and the second is FALSE

145
Q

The mineral content of subgingival calculus is derived from:

a. saliva
b. food particles
c. salivary ducts
d. crevicular fluid

A

crevicular fluid

146
Q

All of the following affect periodontal health EXCEPT one. Which one is the exception?

a. orthodontic appliances
b. antibiotic therapy
c. malocclusion
d. missing teeth
e. none are correct, all affect periodontal health

A

none are correct, all affect periodontal health