final for prin 2 Flashcards
If an individual is suspected of acute fluoride toxicity in the dental chair, what should the clinician do immediately?
Induce vomiting
Which of the following best describes enamel?
Acid-soluble
Fluoride uptake is greatest in soft tissues of the body.
False
Dental caries is a multifactorial disease that may be caused by all of the following except:
Excess consumption of acidic beverages
What is the goal of dental caries management?
To restore and maintain a balance between protective factors and pathologic factors
1.23% APF gel contains _______ ppm of fluoride.
12,300 ppm
12,300 ppmFluoride is excreted from the body from which major organ?
Kidneys
A Caries risk factor that immediatley places an individual at severe risk for dental caries
Radiation therapy
Root surface deminerlization occurs at what PH
6-6.7
All of the following bacteria are related to caries develeopment Except Streptococuss sobrinus Lactobacillus Streptococcus mutan Pseudomonas aeruginosa
Pseudomonas aeruginosa
All are examples of clinical caries disease indicators except
White spots
Restoration placed in 6m
Decay into dentin
Xerostomia
Xerostomia
In caries risk assesment heavy biofilm formation is example of
Caries risk Factor
Biologic/ therputic influences that can collectevly offset the challenge presented by caries risk are known as
Caries protective factors
Optimal fluoride concentration for community water fluoridation is 1.2ppm.
False
Optimal fluoride concentration for community water fluoridation is 1.2ppm.
False
optimal= .7ppm
5% NaF varnish contains 1000-1100ppm in one unit dose
False
22,600ppm
Which of the following types of flouride hardens on the tooth structure in prescence of saliva
5% NaF varnish
Flouride :
Inhibits demineralization
Inhibition of biofilm:
Enhance remineralization:
Dose not
Enhance Biofil formation
Dental cares are reversable in the intial phase
True
Biological influences/factors that contribute to developing new caries are known as
Caries risk factors
Which professional used topical fluoride formulation has a PH of 3.5
1.23 APF
Slowly dissolving foods are able to clear the oral cavity easily and contribute minimally to caries development.
False
contribute alot to caries
Acid formation begins immediately when a cariogenic substance is taken into the biofilm.
Food particles are not needed for biofilm to form.
Both statements are true.
Sodium bicarbonate as a caries preventive agent is most effective for reducing acids in a toothpaste formulation.
False
SB= good for Xerostomia
Neutralizes acids produced by acidogenic bacteria
Severe caries risk patients with xerostomia benefit from sodium bicarbonate rinse
Sodium Bicarbonate
Example of low potency/ high frequency flouride mouth rinse for caries prevention?
0.05% NaF: 230ppm
Fluoride varnish is the primary source of fluoride for PTs of all level of caries risk.
False
All maybe used as desensitizing agents for dental hypersensitivity except : 5% NaF varnish Products containing potassium salts Dentifrice with added CPP-ACP .12% CHX Gluconate
.12% CHX Gluconate
Naturally occurring 5-carbon sugar alcohol
Enhances remineralization and assists stimulate saliva
○ Xylitol should be listed as first ingredient : • Inhibits attachment and transmission of bacteria
Helps prevent erosion
Xylitol
- 0.12% ….rinse 1x/daily for 1 week each month shown to reduce levels of caries causing bacteria
- Cons: alters taste, stains teeth, increases calculus formation :High and severe caries risk patients
Chlorohexidine
According to the hydrodynamic theory, dentinal hypersensitivity is related to pressure from fluid movement across dental tubules to the pulp
True
Remineralization therapy is contraindicated for those with milk allergies
CPP-ACP
The most effective prevention for occlusion pit and fissure dental caries is use of 5% NaF varnish
False
Purpose of dental sealants
• To provide a physical barrier to “seal off” pit or fissure
• To prevent oral bacteria from collecting in the pit or fissure
To fill the pit or fissure as deep as possible and with a tight junction to the surface of the enamel
what Fluoride with concentration of 22,600ppm and is the fluoride choice for treating hypersensitivity
5% NaF Varnish
Type of sealant that doesn’t need occlusion adjustment
Unfilled
The best description on use of acid etch prior to sealants
To enhance penetration and retention of sealants
Naturally occurring 5- carbon sugar alcohol that inhibits biofilm attachment
Xylitol
Presence of white spots demineralization is a contraindication for the use of CPP-ACP
Flase
Milk allergies is
Age and eruption patterns must be considered when choosing remineralization therapy
True
For scute fluoride toxicity liquid that maybe used
Milk, lime water
CHX Gluconate for prevention of caries is recommended
Once daily, for a week, every month
Remineralization therapy solution that has the ability to stabilize calcium and phosphate in a solution to increase their levels in dental biofilm
CPP-ACP
Xylitol is more effective at remineralization the fluoride.
Xytol must be the first active ingredient
False
True
All Pt would benefit from using rinsing with .20 NaF; 905ppm BUT
PT with localized demineralization
PT with generalized demineralization
High caries risk
PT with orthodontic brackets/ moderate biofilm
PT with localized demineralization
Pain subsides or is alleviated with removal of the stimuli
Characteristic of dental hypersensitivity
Contraindication for sealant
Interproximal decay- on xray
Presence of pit and fissure with deep and irregular grooves on a tooth surface is
Caries risk
Preventive agent toothpaste clinically effective for reduction of root caries
Brushing daily with toothpaste 1.1% NaF 5,000ppm
Hypersensitivity is often difficult to diagnose because the presenting symptoms can be confused with other types of dental pain and different etiology
True
- Teeth with clear cavitation or radiographic lesions that penetrate into dentin
- Approximal radiographic lesions confined to enamel only
- Visual white spots on smooth surfaces
- ANY restorations placed in the last 3 years for a new patient OR in the last 12 months for a patient of record
Caries Disease Indicators
YOU CAN SEE IT
PAST/PRESENT
Tobacco use, mod-heavy biofilm deep pits/ fissures exposed roots frequent snacks/ sugar bevs radiation therapy* drug use oral appliances
Caries Risk Factors
Factors of New desisaes that hasn’t happened yet!
contributes to progression of carious lesion
Lactobacilli
•what potency/ frequency for PT with
High caries rinse adolescents
• Generalized demineralization
• Patients with oral appliances contributing to biofilm accumulation
• Patients with significant root exposure
High Potency/Low frequency
- Moderate caries risk patients
- Newly erupted teeth
- Adolescents and preteens
- Areas of demineralizations
Patients with xerostomia*
Low potency/high frequency
Best describes fluorides mechanism of action in caries prevention
It is able to inhibit biofilm growth / deminerlization
Best describes S.Mutans and their ability to thrive in the oral cavity?
Have the ability to produce acid and live in low PH
may be used to arrest and remineralize caries
Best discription of 38% SDF
Flouride concentration of a 1.1% NaF prescription gel for at home use
5000ppm
Kaposi’s sarcoma is a fungal infection common in HIV patients.
True
An individual with uncontrolled HIV is classified as:
Asa 3
Acute infection
The initial exposure to the HIV virus prior to diagnosis is known as
What is the most common oral side effect related to the use of highly active antiretroviral therapy?
Xerostomia
The call HIV uses to replicate within the body
T lymphocytes
High viral load and CD4+ T cell count <200cells/mm
Which of the following best describes an individual with AIDS?
All of the following may present as opportunistic infections in uncontrolled HIV patients except:
Dental Caries
The period of time after exposure to HIV where the blood changes from negative to positive for the serum marker is known as:
Seroconversion
Infection disease that take advantage of a weakend immune system are known as
Opportunistic infection
Infection disease that take advantage of a weakend immune system are known as
Opportunistic infection
Asubstance capable of inducing a specific immune response and of reacting with the products of that specific antibody is known as
Antigen
Protects individuals with HIV from discrimination based on HIV status
ADA; Amaericans with disabilities
Protects individuals with HIV from discrimination based on HIV status
Viral supression
Low levels of HIV RNA copies making the virus undetctable
viral load count less than 200 copies of HIV/mm so it is undetectable in blood test
Hairy leukoplakia often presents as curd like patches that may be wiped off
False
cant not be wiped off
A viral load of less than 200 copies of HIV/mm indicates AIDS.
False
Positive HIV Test + Very low CD4 count (<200 cells) OR presence of specific cancers or infections = AIDS
healthy immune system normally has a CD4 count ranging from 500 to 1,600 cells per cubic millimeter of blood (cells/mm3),
The ability of HIV to insert itself in the DNA of the CD4+ T cell is known as reverese transcription.
false.
Integration:
Integration:
Exposure to HIV is immediately detectable by blood tests.
true.
Which of the following best describes thrombocytopenia?
Blood platelets less than 20,000 mcL
Viral load
The amount of HIV RNA copies per millleter of blood
Has roughness , not smooth
Can be bilateral, unilateral
-Asymptomatic, vertically corrugated, hyperkeratotic patches on lateral borders of tongue
-Cannot be wiped off!
-More common in male HIV patients than females
-More commonly associated with low CD4+ T cell count (<200)
Hairy Leukoplakia
- Most common HIV associated oral malignancy
- Red, bluish, or purplish macular lesion often asymptomatic until ulceration
- Most often occur on palate of gingiva
- Caused by HHV-8
- Can be unrelated to CD4+ T cell or viral load
- Often establishes diagnosis of AIDS
Kaposi’s Sarcoma
-Fungal infection
-Typically presents as pseudomembranous candidiasis (thrush), erythematous candidiasis, or radiating fissures at the corner of the mouth w/ angular cheilitis
-Candida albicans most common type with HIV
Can be wiped off
Oral Candidiasis
A patient with an A1C of 9% indicates which ASA classification:
ASA III
Emergencies involving diabetic patients occur most frequently with which type of diabetes?
Type 1
Uncontrolled diabetes is an example of a caries disease indicator.
False
well controlled= not a risk
uncontrolled = risk
Individuals with poorly controlled diabetes are at low risk for poor wound healing and infection.
False
high risk*
A1c from 5.7 to 6.4%
8% or higher
Healthy is less then 5.7
Prediabetes= 5.7 to 6.4%
• Diabetes diagnosis greater than or equal to 6.5%
8/higher = uncontrolled
Happens over days :
underlying infection, disruption of insulin treatment, and new onset of diabetes.
Ketoacidosis
body’s response to loss of excess glucose
Polyuria= excess frequent urination Polydipsia= excess thirst Polyphagia= excess hunger
sudden, confusion, drowsy, lack of coordination, weakness, sweaty skin, blurry vision, dilated pupils, normal or slightly elevated blood pressure
More common!
Insulin Shock/Hypoglycemia
WHAT TO DO: GIVE SUGAR (juice, frosting, glucose tablets), revival is prompt if not, then IV glucose
develops slowly, flushed skin, abdominal pain, dry mouth, fruity smelling breath, low blood pressure, rapid but weak pulse
Ketoacidosis
Only type 1
• WHAT TO DO: activate EMS, monitor vital signs, keep patient warm, insulin injection AFTER medical assessment
DO NOT GIVE SUGAR
The most common condition of coronary artherosclerotic heart disease is:
Angina pectoris
Which of the following is not a congenital heart disease Pulmonary stenosis Ventricular septal defect Myocardial infraction Patent ductus arteriosus
Myocardial infraction
The chronic condition related to abnormal cardiac fundtion that may result from ischemic heart disease is known as:
Congestive heart failure
What is the recommendation for use of the ultrasonic for a patient with an implantable cardiac pacemaker?
It is necessary to consult with the cardiologist
A patient is taking the medication warfarin. What adverse reaction would the clinician consider with tis patient
Excessive bleeding
Which of the following os an example of a medication used as part of antiplatelet therapy?
Plavix
Secondary hypertension may result from sedentary lifestyle and poor diet.
Diet and lifestyle are modifiable risk factors for hypertension.
The first statement is false.
The second statement is true.
diet= primary
Secound= underlying conditions
sleep apnea, renal , drug/ alcohol
Most congenital anomalies originate between the fifth and eighth week of life.
True
A semi-supine position is contraindicated for a patient with congestive heart failure
False
it is good
Atrial fibrillation is a type of cardiac arrhythmia
True
Gingival enlargement, xerostomia, and poor diet in the cardiac patient are example of
Caries risk factors
What medications is used to treat a patient experiencing symptoms of angina pectoris
nitroglycerin
medications for cardiac conditions may relate to gingival enlargement due to
Calcium channel blockers
The eithology of rhemuatic fever is related to what cells
Beta- hemolytic group A streptococci
coronary artery disease
Conditions arising from reduction or arrest of blood flow to myocrdium
What is the target INR value for a patient taking anticoagulant therapy
2.0-3.0
A myocardial infraction results from
Sudden arest of coronary blood flow
Chew tobacco users are at an increased risk for root caries due to:
Fermentable carbohydrates contained in smokeless tobacco
Type of tobacco cessation provided should be based on a patients readines to quit.
True
Tobacco use decreases the risk of peri implantitis after implant placement.
False
Nicotine replacement therapy comes in all of the following forms except:
Injection
What is the purpose of nicotine replacement therapy?
to provide some blood concentration of nicotine to reduce withdrawal
Which of the following best describes the relationship between the pH of a tobacco product and the availability of free nicotine?
The more alkaline the pH the more available free nicotine
Tobacco users are at greater risk for increased bleeding during dental hygiene treatment then non tobacco users.
False
FalseAll of the following are complications related to tobacco use and periodontal conditions EXCEPT: Increased tissue vascularity Alteration of IgG production Decreased host immune response Decreassed vascularization of tissue
Increased tissue vascularity
After completing nonsurgical periodontal therapy on an individual who is daily smoker, what is a necessary part of patient education
The patients healing and progression of clinical attachment loss is related to continued smoking and tobacco use
Which of the following chemicals is not released from the brainwith exposure to nicotine
Arsenic
Vaping as a form of tobacco use in an example of what caries factor
Caries risk factor
Term carcinogenic means caner causing
true
Nicotine withdrwal may present as all symptoms Except
Depression
Increased irritability
Decreased hunger
insomia
Decreased hunger
Hookah smoking is less harmful use of tobacco because there is no metabolism of nicotine
False
1 session = 100 cigs
Which of the following is an example of a pharmacotherapy used for tobacco cessation?
Bupropion
All of the following are potential intraoral manifestations associated with tobacco use except:
Apthous ulcer
The most common oral manifestation associated with pregnancy is:
Pregnancy gingivitis
Which of the following antimicrobials is contraindicated during pregnancy?
Phenolic-based essential oils
Preclampsia during pregnancy indicates:
An increase in maternal blood pressure
A patient with uncontrolled preclampsia during pregnancy is an ASA II.
False
FalseReccomended amount of flouridated toothpaste for an infant 12 months of age for daily brushing.
A grain of rice sized amount
Preagnant women with gestational diabetes are at higher risk of developing type 2 diabetes
True
Goal of PT education for the pregnant pt
Educate on the risk of biofilm from mother to infact
Risk factor that increases an infants risk for early childhood caries
Frequent exposure to cariogenic beverages
Osteopina, the precursor to osteoporosis, is a risk factor for periodontal disease for
Post menopause women
Use of anesthetics for pain control are dontradicted during pregnancy
False
What age is the first infamt dental appointment recommended
12 months
Which antibiotics is contraindicting during pregnancy
Tetracyclyin
What teeth are offten effected by ECC in an infant PT
Maxialry anteriors
Oral sympom that is the highest complaint by women in menopause
Xerstomia
To relive pressure of uterus on the vena cave. Its recommended the PT rolls on the right side for DH treatment
False= right side LEFT!!= True
Oral pyogenic granulomas are a malignant condition associated with pregnancy
True
Women who have gingivitis before pregnancy are more prone to exacerbation during pregnancy
True
Educateing the care givers on the infant care and what to expect from the childs current and net development stage is known as
Anticipatory guidance
Medicationd that would be recommended for a pregnant women for pain management following an SRP
Acetaminophen
The fluoride concentration for OTC childrens toothpaste is 1000-1100 ppm.
TRUE
Which of the following steps is necessary to increase retentiveness on the surface of the enamel during sealant placement and orthodontic bracket placement?
Acid etch
At what age is it recommended to begin cessation of nonnutritive sucking habits like thumb sucking?
3 years
Best describes caries risk in the adolescent population.
Caries risk increases due to increased need for nutritional intake and frequent consumption of cariogenic substances
Improper use of fluoridated toothpaste may result in mild fluorosis
TRUE
Which preventive flouride treatment is recommended for the pediatric patient under the age of 6?
5% NaF Varnish
What is best form patient education for a 5 year- old pt
Show, Tell, Do
The first primary teeth to erupt into the oral cavity are:
Mandibular anterior central incisors
Ultrasonic scaling is the most effective instrumentation for calculus removal on primary teeth.
False
A tooth structure is most likely to be damaged during which stage of orthodontics.
During the debonding of bracketrs
The shape of the interdental papilla of the primary dentition usually presents.
Flat or saddle shaped
At which age is a pea- sized amount of toothpaste reccomended for twice daily use
3-6 years
“Risk taking behavior” is a characteristic of which patient population
Adolescents
Primary herpetic gingivostomatitis is associated with which of the following communcable diseases
HSV-1
All are childhood caries risk factors EXCEPT
Heavy biofilm and poor oral hygiene of parent caregiver
Prolonged bottle feeding with out cleaning tooth surface
Low socioeconomic status
Thumb sucking
Thumb sucking
White lesions on primary teeth are an example of a caries risk factor for ECC
false
disease indicators
Dental sealants may not be placed on permanent teeth until the child reaches 12 years of age
False
6 years
period of time between conseption and birth
gestation
40 weeks
