Hard things Flashcards
Discuss and inform the patient about a health diet with particular reference to vitamins and minerals that may influence both a healthy and unhealthy periodontium
- Vitamin D and Calcium deficiencies
- Vitamin C (Ascorbic Acid) deficiency: associated with changes in the periodontium
- Protein deficiency: affects hosts immune response to periodontitis
- Antioxidant deficiency: increases perio risk
- Omega 3 Polyunsaturated Fatty Acid deficiency: inflammation
List the correct sequence in performing a periodontal charting
- Recession
- Probing depths
- Bleeding and suppuration
- Mobility
- Furcation
- LOA
Briefly describe the cleaning, disinfection, sterilisation and maintenance of the air-powder polisher
- After use and within 30 minutes, disconnect the air-flow handpiece from the body of the polisher
- Using air and water from the triplex to clean the triplex
- Empty powder from chamber (at end of day), via suctioning
- Clean thread of powder chamber with alcohol
- Disinfect body and handpiece of polisher with alcohol-based disinfectant
- Place handpiece in sterilisation bag to autoclave
Discuss the benefits of ultrasonic instrumentation
• Slim diameter tips offer greater access and effective instrumentation options for deep periodontal pockets and furcations
• Ultrasonic instrumentation removes less cementum
1. Irrigation flushes toxins and biofilm from the periodontal pocket and has been shown to increase tissue rate of healing
2. Cavitation destroys bacteria and disrupts biofilm colonization
3. Acoustic micro-streaming is thought to impede biofilm adherence
What are causes of tooth mobility?
• Occlusal Trauma
• Periodontal Disease
• Pathologic Disease of the Jaw
Spread of infection from a necrotic tooth to the surrounding periodontium
• Periapical Periodontitis or interradicular periodontitis
What is the name and mixture of the ice thermal testing?
• Ethyl chloride: a propane/butane/isobutane gas mixture stored in a pressurised can
What are the types of palpation techniques?
- Digital
- Bidigital
- Bimanual
- Bilateral
Define the following palpation techniques Digital Bidigital Bimanual Bilateral
Digital:
Using only one finger
Bidigital:
Using two fingers of the same hand
Bimanual:
Using fingers from two different hands
Bilateral:
Using two hands at the same time to palpate
List the effects of incorrect brushing
Lacerations
Recessions
Toothbrush abrasion
List the factors you need to consider when personalising an oral hygiene regime for your patient
Factors to consider 1. Patient factors ○ Motivation ○ Dexterity ○ Compliance ○ Periodontal disease status
2. Local factors ○ Crowding, tooth inclination ○ Furcation involvement ○ Inflammation if present ○ Access (gag reflex, mouth size, tongue size)
- Type Embrasure/Interdental Space
Explain the post treatment care instructions that should be given to patients after air-powder polishing
- Rinse
- Fluoride
- Don’t eat/ drink or smoke for 3 HOURS
Describe the energy of the
- Magnetostrictive
- Piezoelectric
Magnetostrictive
20 - 42 kHz
Piezoelectric
29 - 32 kHz
Describe in detail the 5 steps to performing a GC Saliva test
- Time saliva by holding down lower lip
- Look at the consistency of saliva: watery, bubbly or frothy/ sticky
- Spit and measure pH
- Measure quantity of saliva
- 5 ml - 5 ml
- Record buffering capacity of stimulated saliva 3 drops
List and describe the ideal procedure for an “Overall appraisal” of the Head and Neck
- Asymmetry
- Hair loss
- Eyes
- Ears
- Facial movements
- Colour
- Lesions on the skin
State the location of the Tempro-mandibular joint
- It is the joint where the mandible and maxilla meet
How would you record a significant finding?
- Palpable
- Elevated
- Solid mass
- Fluid filled
- Loss of skin or mucosal surface
What are notable findings for lymph nodes?
- Fixed and/ or freely moveable
- Warm
- Firm
- Tender
- Swollen bilaterally
What are notable findings for salivary glands?
- Swollen, enlarged and tender glands
- Cysts or inflammation
- Firm and fixed
What are notable findings for TMJ?
- Deviation upon opening and or closing
- Sounds- clicking, grinding and or popping
- Limited movements
- Pain or tenderness
Discuss the rationale for conducting an intra oral examination
- Early detection for oral diseases and abnormalities
- Insight into the general oral health of a patient
- Detect life- threatening malignancies early on
How big are erythritol particles? What are things does it contain?
- 14 μm
* 0.3% Chlorhexidine
What are advantages for erythritol?
- Requires less time
- Generates no heat
- Improved ergonomics
- Less abrasive than prophylaxis paste
- Removes heavy extrinsic stains
- More effective around orthodontic appliances
What are disadvantages for erythritol?
- Production of aerosols
- Use of mirror for indirect vision
- Spray may be uncomfortable
- Contraindicated for some patients
When is air-powder polishing contra- indicated?
- Respiratory diseases/conditions (E.g. asthma, emphysema, cystic fibrosis, cold)
- Patients with end-stage renal disease, Addison’s or Cushing’s diseas
- Patients with communicable infection
- Immunocompromised
- Allergy
- Diabetes
- Hemophilia
- History of endocarditis
What is the supra- gingival technique for air-powder polishing? (ANGULATION AND DISTANCE)
- Distance of 3 to 5mm away
- At an angle of 30 - 60 degrees
- constant small horizontal or circular motions (never stay in one place for more than 5 seconds)
What is the sub- gingival technique for air-powder polishing? (ANGULATION AND DISTANCE)
- Distance of 3 to 5mm away
- At an angle of 30 - 60 degrees
- Maximum of 5 seconds using short vertical motions of the nozzle
What are the types of malocclusions?
Class 1
Class 2:
- Division 1
- Division 2
Class 3
How do you measure tooth mobility?
- Grade I: Slight mobility, up to 1mm of horizontal displacement in a facial-lingual direction
- Grade II: Moderate mobility, greater than 1 mm but less then 2 mm of horizontal displacement in a facial-lingual direction
- Grade III: Severe mobility: greater then 2 mm of displacement in a facial-lingual direction or vertical displacement (tooth depressible in the socket)
Describe the role of ultrasonic use
- Arrest infection and maintain a healthy periodontium by removing bacteria
- Remove calculus and plaque from the sulcus
- Produce a biologically acceptable tooth/root surface
How much pressure does the air and water need in air- polishing?
- Air pressure: 40 – 100 psi
* Water pressure: 20 – 60 psi
