GD Exam 1 Flashcards
1
Q
Primary dentition consists of ________
A
20 teeth total: 10 upper and 10 lower
2
Q
Primary teeth erupt at about age _______ and remain until age _____
A
6 and remain until age 6 approx
3
Q
What is the mixed dentition period
A
Both deciduous and permanent teeth
4
Q
What is permanent dentition composed of?
A
32 teeth total. 16 upper and 16 lower
5
Q
What are successional teeth
A
Permanent teeth that replace deciduous teeth
*Permanent molars, which replace nothing, are called accessional teeth
6
Q
Humans have what two types of dentition? Define them
A
Diphyodont: develop two sets of teeth
Heterodont: distinctive classes of teeth that are regionally specialized
7
Q
What are the two classes of anterior teeth?
A
Incisors and canines
8
Q
What teeth are known as the cornerstones of dental arch
A
Canines
9
Q
What are the two classes of posterior teeth?
A
- Premolars
- Molars
10
Q
Premolars are also known as ________
A
Bicuspids
11
Q
Premolars are designated as first or second bicuspid by ________
A
their position in the dental arch
12
Q
How many molars are there?
A
SIx upper and six lower
13
Q
Review this
A
14
Q
Arch Form is what shaped
A
U-shaped
*The maxilla is bigger than the mandible
15
Q
The arch form is determined mostly by
A
underlying basal bones
16
Q
Compare overjet vs overbite
A
Overjet is horizontal overlap
Overbite is vertical overlap
17
Q
Define curve of spee
A
cusp tips follow an upwards curve in lateral view
18
Q
Define curve of wilson
A
curvature of the mandibular teeth is concave
curvature of the maxillary teeth is convex in frontal view
19
Q
What is the anatomical and clinical crown?
A
Anatomical: covered with ENAMEL
Clinical: portion of anatomical crown that is visible clinically
20
Q
What is anatomical root and clinical root?
A
Anatomical: portion of the tooth that is covered with cementum
Clinical: port of the root that is embedded in the jaw
21
Q
Define cervical line
A
Line that separates the anatomic crown from the anatomic root
-junction between enamel and cementum (CEJ)
22
Q
Define pulp cavity
A
space in the tooth that contains the pulp or “nerve” of the tooth
- it has a coronal (crown) portion and a radicular (root) portion, usually called the root canal
23
Q
What are the 4 types of tooth tissue
A
- Enamel
- Dentin
- Cementum
- Pulp
24
Q
The protective outer surface of the anatomic crown.
It is 96% mineral and is the hardest tissue in the body
A
ENAMEL
25
Located in both crown and root, it makes up the bulk of the tooth beneath the enamel and cementum.
Dentin
26
What lines the pulp cavity
Dentin
27
-This substance covers the surface of the anatomic root
-It facilitates anchorage of the tooth in its bony socket (the alveolus)
Cementum
28
-The central, innermost portion of the tooth
-It has formative, sensory, nutritive, and reparative functions during the life of the tooth
Pulp
29
Define midline
An imaginary line on the plane that bisects the dental arch at the center
30
Define Mesial
toward the center midline of the dental arch
31
Define distal
Away from the center midline of the dental arch
32
Define proximal
the surface of a tooth that is toward another tooth in the arch
33
Define facial
toward the cheeks or lips `
34
Define labial
facial surface of anterior teeth (toward the lips)
35
Define Buccal
facial surface of posterior teeth (towards the cheeks)
36
Define Lingual
Toward the tongue
37
Define Occlusal
The biting surface; that surface that articulates with an antagonist tooth in an opposing arch
38
Define Inciscal
The cutting edge of anterior teeth
39
Define apical
toward the apex, the tip of the root
40
Define contact
a point or area where one tooth is in contact with its neighbor
41
Know this well
42
Define cusp
A point or peak on the occlusal surface of MOLAR and premolar teeth and on the inciscal ridges of canines
43
a bulge or elevation on the lingual surface of incisors or canines. It makes up the bulk of the cervical third of the lingual surface
the cingulum
44
Define Lobe
primary centers of formation in the development of the crown of the tooth
-cusps and mamelons are represented of lobes
45
define mamelons
lobes seen on anterior teeth; any of the three rounded protuberances seen on the unworn surfaces of an incisor
46
What are the four types of ridges?
1. Marginal ridges
2. Triangular ridges
3. Transverse ridges
4. Oblique ridges
47
Define marginal ridge and where its located
round borders of enamel that form the margins of the surfaces of premolars and molars, mesially and distally, and the mesial and distal margins of the incisors and canines lingually
okay so
1. Incisors and canines: lingual outer border
2. Molars and premolars: mesially and distally
48
Where are TRIANGULAR ridges found
Ridges that descend from the tips of molars and premolars towards the central groove of the occlusal surface
*remember molar and premolar only
49
Where are TRANSVERSE ridges found and how are they created
created when a buccal and a lingual triangular ridge join
* it is the union of two triangular ridges crossing transversely across the surface of a posterior tooth
50
Where are OBLIQUE ridges found
-Seen on maxillary molars and are a companion feature to the distal oblique groove
51
Location of central fossa
found on the occlusal surface of a molar. Formed by the converging of ridges terminating at a central point in the bottom of a depression where there is a junction of developmental grooves
52
what is the lingual fossa
sulcus on the lingual surface of INCISORS
53
Where are triangular fossae found
found on molars and premolars on the occlusal surfaces mesial or distal to marginal ridges
54
A ______ is often the site of the onset of dental decay
a pit.
*a pit is a small pinpoint depression located at the junction of developmental grooves or at the terminals of these groups
55
A sharply defined, narrow and linear depression formed during tooth development and usually separates lobes or major portions of a tooth.
developmental groove
56
Describe the odontogram and explain its use
its a digital representation of the patient's mouth, including existing restoration, pathology, and planned treatment
57
How do you add a treatment note to a procedure
Select "Add Tx Note"
58
The college of dentistry mostly uses _____ formatting
AMA
59
T or F: "And" in searches means within a concept
False.
And means both between 2 concepts
Or will always give you more (within a concept)
60
List 3 clinical tools you can use when doing research
1. Dynamed
2. Lexicomp/ clinical pharmacology
3. medline Plus
61
What is a wildcard in database searches
a character that substitutes for another character or string of characters when searching a database.
Example: Dent* =dentistry, dental, dentin, dented
62
What are the 4 personality styles
1. Analytical
2. Driving
3. Amiable
4. Expressive
63
What personality type
Emphasis is on working conscientiously within existing circumstances to insure quality and accuracy
*want all the info
*dont like changes to the routine
*withdraws and avoids conflict when under stress
Analytical
64
what personality type
Emphasis is on shaping the environment by overcoming opposition to accomplish results
*more task oriented when under stress
*few details
Driver
65
What personality type
Emphasis is on cooperating with others within existing circumstances to carry out the task
*Cry but bottle up anger when under stress
Amiable
66
what personality type
emphasis is on shaping the environment by influencing or persuading others
*thrive on uniqueness, recognition
*Future oriented
*Under stress: let you know their opinion, sometimes forcefully
Expressive
67
What is the goal of cultural competence?
Cultural humility
*cultural humilty is a goal, not a destination
68
Name two ways dentistry is a culture
1. Shared power and norms
2. Shared language
69
What are the three roles medical interpreters can play
1. neutral: translation only
2. Conduit: advocate
3. Cultural broker: will facilitate intended cultural meaning
70
What are the 3 types of empathy?
1. Cognitive (perspective taking)
2. Personal distress (feeling another person's pain)
3. Empathetic concern (recognize the emotional state, tune in, and then respond)
71
Two types of trust
residual
specific
72
define residual trust
1. formed in milliseconds
2. largely based on non-verbal behavior
73
define specific trust
based on conscious processing of the situation
74
What is important to know on a medical and dental history
1. chief complaint
2. relevant medical history
3. social history
4. risk factors
75
Components to a comprehensive examination
1. obtain patient history
2. chief concern
3. radiographic examination
4. clinical evaluation of extraoral and intraoral soft and hard tissues
5. gathering diagnostic information to assist in treatment planning process
76
What is a periodic examination
performed on a returning and regular basis
update of patient history
77
What is a problem-focused examination
limited to a specific problem
78
What is Protected Health Information (PHI) and what is it used for?
HIPAA
-requires health care providers to prevent unnecessary use and release of PHI
- PHI can be used for treatment purposes, obtaining payment for services, quality assurance or assisting legal authorities
-Include demogrpahic data, medical data, or diagnoses or treatment notes
79
T or F: De-Identified Data can be used without restriction by removing 18 identifiers
True
80
What vital signs are measured at UIC COD
1. Blood pressure
2. Pulse
81
When should blood pressure and pulse be obtained (4 times)
1. During COE
2. Periodic exams
3. Prior to administering local anesthesia
4. At ALL visits for patients with HTN, thyroid disease or cardiac disease
82
The first sound (Korotkoff) when measuring blood pressure is the ______ pressure
Systolic
83
__________ pressure is when Korotkoff sounds completely disappear
Diastolic pressure
84
Reading blood pressure by ______ is considered the gold standard
auscultation
85
Top number in blood pressure is the ____ and what does it represent
systolic blood pressure
-represents how much pressure your blood flow is exerting against the artery walls when the heart CONTRACTS
86
the bottom or second number in blood pressure is the ______ and what does it represent
diastolic blood pressure
-represents how much pressure your blood flow is exerting against the artery walls when the heart is at REST
87
What is
1. normal
2. elevated
3. hypertension stage 1 and 2
Systolic blood pressure?
1. Less than 120 is normal
2. 120-129 is elevated
3. stage 1: 130-139
stage 2: greater than or equal to 140
88
What is
1. normal
2. elevated
3. hypertension stage 1 and 2
Systolic and Diastolic blood pressure combined?
1. Less than 120/80 is normal (together)
2.120-129/ less than 80 is elevated (together)
3. 130-139/ OR 80-89 (if one or the other is present patient is stage 1 hypertension)
more than or equal to 140/ OR more than 90 (if one or the other is present patient is stage 2 hypertension)
89
How do you measure pulse?
1. Find radial artery thumb side of the hand
2. Palpate for 30 seconds then multiply your count by 2
90
What is normal pulse range
Normal 60-80 bpm
91
1. What is high pulse range
2. What is tachycardia range
3. What is bradycardia range
1. High: 80-100
2. More than 100 is tachycardia
3. Less than 60 is bradycardia
92
What is the normal oral temperature measuremnt?
Oral temperature of 98.6 degrees and can vary as much as 1 degree throughout the day
93
What is the normal rate of respiration?
12-16
94
How might height and weight be useful for treatment?
Can be helpful for pediatric patients when determining medication dosage
95
Normal blood glucose level range is
70-99 mg/dL
96
Define ASA I classification and give example
a normal and healthy patient with no evidence of systemic disease
*example not applicable
97
Define ASA II classification and give examples
A patient with mild systemic disease or significant health risk factor. Patient is able to walk up a flight of stairs without difficulty
*Ex: Controlled diabetes, controlled hypertension, asthma history, mild obesity, pregnant, smoker, dental anxiety or fear
98
Define ASA III classification and give examples
Patient with moderate to severe systemic disease that limits activity, not incapacitated though. Pt can walk up ONE flight or stairs or two city blocks but stops
*Ex: stable angina, postmyocardial infarction, uncontrolled hypertension, massive obesity, symptomatic respiratory disease
99
Define ASA IV classification and give examples
Patient with severe systemic disease that IS LIFE THREATENING. Pt is unable to walk up a flight of stairs, cant walk two blocks, and is distress at rest
*UNSTABLE angina, liver failure, severe congestive heart failure, end stage renal disease
100
What dental procedures are little to no risk (ASA I)?
-oral examination
-radiographs
-study models
101
What dental procedures have LOW risk
-local anesthesia
-simple restorations
-prophylaxis
-asymptomatic endodontic therapy
-simple extractions
-orthodontic treatment
102
What dental procedures have MEDIUM risk
-symptomatic endodontic therapy
-multiple extractions
-single implant placement
-deep scaling
-root planing
103
what dental procedures have HIGH risk
-Extensive surgical procedures
-Mulitlpe implants
-general anesthesia
104
Describe diagnostic process of treatment planning
-gather information about patient
-create patient database that will serve as the basis for all future patient care decisions
-takes place during dental examination
105
Diagnostic information sources include (3)
1. patient history
2. clinical and radiographic examination
3. Other diagnostic sources
106
Describe the process of developing a diagnoses
1. Information gathering
2. Evaluation of findings
3. Significant findings
4. Comprehensive diagnosis list
107
Define risk assessment
Determining the likelihood of a patient's acquiring a specific disease or condition
108
Define outcome assessment
The results that a patient and practitioner anticipate receiving as a result of treatment
109
Define prognosis
Prognosis is a prediction. prediction based on present circumstances of the patient's future condition.
Prognosis is the likely outcome or course of a disease; the chance of recovery or recurrence
The prospect recovering from injury or disease, or a prediction of the course and outcome of a medical condition
*generally express as excellent, good, favorable, unfavorable, fair, poor, etc
110
List the 5 phases of a treatment plan
1. Systemic phase
2. Acute phase
3. Disease control phase
4. Definitive treatment plan
5. Maintenance care phase
SADicDetM
111
What phase of treatment is this?
Thorough evaluation of the patients health history and any procedures necessary to manage the patient's general and psychological health before or during dental treatment Eg: Consult with other provider, antibiotic prophylaxis, stress and fear management
Systemic
SADicDetM
112
What phase of treatment is this?
Resolve any symptomatic problems with which a patient may present
Treatment addressing patients CC should be rendered in this phase
Eg: pain, swelling, infection, broken teeth, missing restoration
Acute
SADicDetM
113
What phase of treatment is this?
Control active oral disease and INFECTION stop occlusal and esthetic deterioration and manage any risk factors that cause ORAL PROBLEMS Eg: controlling caries, arresting periodontal disease
Disease control phase
SADicDetM
114
What phase of treatment is this?
Rehabilitate patient's oral condition and includes procedures that improves appearance and function. Eg: periodontal surgery, orthodontic treatment, elective extractions, cosmetic procedures
Definitive treatment phase
SADicDetM
115
What phase of treatment is this?
Individualized plan that strives to maintain the patient in optimum oral health
Maintenance care phase
SADicDetM
116
Memorize this
117
T or F
Treatment planning at UIC COD
1. Treatment plan expires after 24 months
2. Not every phase needs a re-evaluation
3. Existing treatment plans need to be revised, updated and put under the current provider's name
1. F After 12 months
2. F Every phase needs a re-eval
3. T
118
SOAP notes are used for
new patient exam, recall patient, or when a patient has a new dental problem
119
Progress notes are used for
middle of treatment updates, used for periodic visits
120
Components of SOAP note
Subjective: Cheif complaint, hx of present illness
Objective: findings gathered during the clinical exam
Assessment: Diagnosis
Plan: Care plan for the patient and documentation of informed consent
121
Open ended questions are questions that usually start with
How or What
122
Treatment addressing patient's CC should be rendered in which phase of the treatment plan?
Acute phase
123
Describe dental caries as a disease
1. 1889 Chemico-parasitic theory of Miller: local phenomenon associated with carb retention and acidogenic bacteria
2. Specific Plaque Hypothesis proposed by Leosche
At the tooth level, localized destruction of susceptible hard tissues by acidic byproducts from bacterial fermentation of dietary habits
124
What are the components of the multifactorial model of caries process
Host, time, biofilm, carbohydrates, education, saliva, social factors, behavior are all related to dental caries
125
Multifactorial model of caries process
Components of the HOST/TOOTH
1. Tooth resistance
2. Anatomic factors
3. Salivary flow
126
Multifactorial model of caries process
HOST/TOOTH --> list saliva protective functions
1. control growth of flora and prevents bacteria adherence by
-clears acid metabolites
-saliva buffering system
-helps remineralization with calcium, phosphate, and fluoride ions
-antibacterial activity
127
Multifactorial model of caries process
Name the two organisms (micro) that initiate enamel caries
1. Strepcoccus mutans
2. Streptocossus sobrinus
128
Multifactorial model of caries process
CARIOGENIC BIOFILM/BACTERIA
Name the organism important in the progression of dentinal caries
Lactobacillus species
129
Multifactorial model of caries process
FERMENTABLE CARBS
list the factors
-Consumption of sucrose
-fermantation of glucose and fructose (leads to lactic acid formation)
-Levels of mutans strep (MS) increases by sucrose consumption
-frequency
130
Describe demineralization/remineralization process of dental caries
DEMIN:
acidogenic bacteria--> metabolized fermentable carbs to produce acid--> lactic acid dissociates releasing hydrogen ions--> decrease pH--> acids diffuse into underlying tooth structure-->dissolving of minerals---> calcium and phosphate diffuse out of tooth= cavity
REMIN:
1. saliva provides calcium, phosphate, and proteins that neutralize acid
2. promote remineralization
3. flouride can also enhance remineralization
131
What do incipient carious lesions look like on clinically smooth surfaces?
earliest manifestations usually seen beneath plaque is a WHITE SPOT LESION
132
Radiographic appearance of incipient enamel caries (best diagnosed via bitewing)
133
Protective factors --> No caries
Salivary flow and its components
Proteins, calcium phosphate, immunoglobins
flouride
good OH
If protective factors outweigh pathologic factors, no caries will result
134
Carie classification system by anatomical site? the anatomical sites caries can be found on
1. Pit/fissures
2. Smooth surfaces
3. Root
135
Carie classification system by activity?
1. Active
2. Arrested
3. Inactive
136
Carie classification system by stage?
1. Incipient (white spot lesion is the first sign of caries seen with the naked eye)
2. Non-cavitated lesion
3. Cavitated lesion
137
List all smooth-surface caries location
1. Buccal surfaces
2. Lingual surfaces
3. Interproximal surfaces
4. All of the above
SS-BLIA
138
Signs of ACTIVE carious lesions
1. Whitish
2. Soft
3. Dull
4. chalky
5. Opaque
139
Signs of inactive/arrested carious lesions
1. stained
2. Hard
3. dark
4. glossy
140
Review this
141
Limitations of GV Black classification system?
1. classifies carious lesions at an advanced stage
2. Does not different stage of diseases (cavitated vs non cavitated)
3. No allowance for activity of disease (active vs arrested)
4. Early stages of caries are not classified
142
Bacteria isolated from dental unit water include
1. pseudomonas
2. Legionella
3. non TB mycobacterium
143
Four models of Dental Practice
Normative:
1. Service or interactive: Both dentist and patient bring values and expertise to the decision making process of dental treatment
Non Normative:
2. Guild model: Dentist decides what is best. Patient either accepts or declines
3. Commercial model: Dentist goal is to make a profit
4. Consumerist/ agent model: Dentist does as directed by the customer
144
Define Caries Risk:
The probability that
1. a specific number of new lesion will develop
2. A specific number of existing lesions will progress over a specified period of time
145
What is CaMBRA
Caries management by risk assessment
146
Caries non-modifiable risk factors
1. presence of numerous restorations or past caries
2. radiation or chemo
3. xerostomia
4. Dexterity limitations
5. malformed teeth
6. exposed root surfaces
7. presence of dentures or ortho treatment
8. Age
9. Economic and educational status
147
Caries modifiable risk factors
-fluoride exposure
-meds causing reduced salivary flow
-oral hygiene habits
-deep pits and fissures
-dietary habits
-S. Mutans/Lactobacillus prevalence
-pH of saliva
148
List 4 Caries protective factors
1. saliva and sealants
2. antibacterials
3. flouride
4. effective diet
149
Caries risk reduction is based on
1. risk factors modification
2. reduce the bacterial level
3. neutralize the pH
4. facilitate mineral exchange
150
Hyposalivation is associated with increase in the number of _______ and increase ________ activity
increase in number of cariogenic bacteria and increase caries activity
151
Ranking of caries predictors
1. past and present caries activty (the strongest predictor)
2. primary surfaces with incipient caries
3. Recent placement of restoration
4. High sugar intake
152
Caries follow-up times
1. high/extreme risk
2. Moderate risk
3. low risk
1. 3 month
2. 6 months
3. 1 year
153
Hyposalivation vs Xerostomia
hyposalivation is a condition where the flow rates of saliva are abnormally low
xerostomia is a SUBJECTIVE feeling of daily oral dryness
154
Minimum salivary flow rate necessary to maintain oral health is
0.1 to 0.2 mL/min unstimulated flow
155
Daily production of saliva for a healthy individual is
0.5-1 L daily
156
What is an armamentarium
a watch, tube, graduated pipette, 1 gr. paraffin for saliva stimulation
157
Frequency of fermentable carbohydrate consumption, and conditions of low pH will favor the proliferation of ____________
Acid-tolerating (and acidogenic) bacteria
158
T or F
Patients with high level of S. mutans in saliva (greater than 10^5 CFU/mL) are potentially at risk for developing dental caries
T
159
Define line angle
Angle formed by the junction of two walls
160
Define point angle
angle formed by the junction of three walls, or three line angles
161
Most common patient-operator positioning
ALMOST supine
knees and feet at same level
head is slightly elevated
162
4 positions for right handed operator
1. right front 7 oclock
2. right 9 oclock
3. right rear 11 oclock
4. direct rear, 12oclock
163
Name
Dental explorer
164
Name
11/12 explorer
*it has lots od different angles
165
name
Nabers probe
*it curls
166
Name
Periodontal probe
167
Radiopacities are
White areas where x-rays were stopped (attenuated)
168
Xray Short wavelength =. ________ frequency
short wavelength = high frequency = high energy
169
Direct effects of X-rays
-direct collision with biological macromolecules
-result in altered structure and function
170
Indirect effect of X-rays
-ionization (break up) of water molcules
-Formation of H and OH ions
-production of hydroperoxide H2O2
171
kVp controls
QUALITY
as kVp is raised, the penetrating power of the beam is increased
172
mA controls
QUANTITY
as mA is raised, more x-rays are produced per unit time
173
exposure time controls
QUANTITY
as time is increased, x rays are produced for a longer period of time so more x-rays reach the film
174
What type of image
periapical
175
review this
176
A radiographic examination is ______ in order to answer a specific disgnostic question needed to establish, maintain, or promote the patients health
prescribes
177
Radiolucent is
relatively dark, air space on a radiograph ex: the sinus
178
parts of intraoral exam
lips, buccal mucosa, gingiva, lateral, base ventral and dorsal tongue, floor of mouth, salivary glands
179
Most common sites for oral cancer
1. lateral tongue
2. Then floor of mouth
180
Explain sensitivity vs specificity
Sensitivity is the ability of a diagnostic method to identify correctly individuals with disease.
*the probability that a diagnostic method will detect caries when caries is present
Specificity is the proportion of those without disease who are correctly identified as not having disease.
*the probability that the test will indicate no caries when caries is not present
181
Caries diagnosis for pit and fissure caries
Tactile: _______
List potential problems
Use of dental explorer
-possible cavitation of an incipient lesion
-poor sensitivity
182
Caries diagnosis for pit and fissure surfaces
Radiographs
-less efficient as a diagnostic method for occlusal surfaces
-enamel lesions will not be visible
183
T or F Stain within a fissure is indicative of carious dentin at the base of the fissure
F. stain within fissure is not indicative of carious dentine
184
What does the non-cavitated initial/incipient lesion look like in enamel?
light or dark brown discoloration at the base of the pit with or without demineralization. No breakdown but area is soft
185
What does the non-cavitated initial/incipient lesion look like in dentin?
shows signs of enamel undermining
opacity or discoloration inside the surface
186
An active cavity should have _____ (hard/soft) walls or floors
Soft walls or floors
187
When there is contact between proximal surfaces, _______ radiographs are the most effective evaluation methods
bitewing
188
Visual, tactile, and radiographic detection of recurrent caries
Visual: discoloration of the margins, open margins
tactile: margin discrepancy between the tooth and restoration
radiograph: radiolucent area surrounding a radiopaque restoration
189
5 steps of EBD
1. Formulating a searchable question
2. Search the literature efficiently
3. Critically appraising the literature
4. Apply the results to clinical practice
5. Evaluate the outcomes
190
What is PICO
When formulating a searchable question
P: population/patient/problem
I: Intervention
C: Comparison
O: Outcome
191
What are MeSH terms?
Medical Subject Headings
