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Dental > HMCS Dental review > Flashcards

HMCS Dental review Flashcards

1
Q

What are the two line of defenses?

A

-Salivary amylase initiates the breakdown of starch.
-Lingual lipase breaks down triglycerides into fatty acids.

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2
Q

Is the hard palate keratinized or non-keratinized?

A

Keratinized

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3
Q

What are examples of non-keratinized areas of the mouth?

A

-Soft palate
-Floor of mouth
-Cheeks (buccal)

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4
Q

What are the three regions of the tooth?

A

-Crown
-Neck
-Root

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5
Q

What is the most visible region of the tooth?

A

-The crown

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6
Q

What is the area on the neck of the tooth where the enamel and cementum meet?

A

-Cementumal Enamel Junction (CEJ)

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7
Q

What is the hard white outer layer of the tooth?

A

-Enamel

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8
Q

What part of the tooth gives it basic shape and rigidity?

A

-Dentin

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9
Q

The pulp contains what?

A

-Connective tissue containing blood vessels, nerves, and lymphatic vessels

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10
Q

What is contained within the Attachment Apparatus?

A

-Cementum
-Periodontal ligaments
-The alveolar process

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11
Q

How many different types of teeth do we have and what are they?

A

-1.Incisors
-2.Canines
-3.Premolars
-4.Molars

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12
Q

What are the most posterior molars called?

A

-Wisdom teeth

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13
Q

How many teeth does an adult with all their teeth have?

A

-32

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14
Q

Most people in the military have how many teeth?

A

28

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15
Q

What tooth is tooth number one?

A

-Maxillary right third molar

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16
Q

What tooth is tooth number seventeen?

A

-Mandibular left third molar

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17
Q

What tooth is tooth number thirty-two?

A

-Mandibular right third molar

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18
Q

What is the only movable skull bone?

A

-Mandible

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19
Q

What is the only nerve associated with dental?

A

-Cranial Nerve V: Trigeminal

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20
Q

The cranial nerve comprises of what?

A

The lingual nerve

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21
Q

What does medial mean?

A

-Towards the midline

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22
Q

What does distal mean?

A

-Away from the midline

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23
Q

What anesthetic do you use for someone in pain on the ship and why?

A

-0.5% Bupivacaine /Marcaine because it lasts longer

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24
Q

Local infiltration is deposited where?

A

-At or near small terminal nerve endings in the immediate area of treatment. (The tooth that affected)

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25
Q

A regional block is deposited where?

A

-Near a major nerve trunk at a greater distance from the area of treatment, which provides wider areas of anesthesia.

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26
Q

Why do you use the tooth block (oral nerve block)?

A

-It reduces the need for oral analgesics

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27
Q

What are indications for an IA block?

A

-Fracture repair
-Removal of teeth
-Pain control
-NOT POSTOPERATIVE CARE

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28
Q

When you’re giving an IA block your target site is called what?

A

Lingula (a small bony bump about halfway back on the inner ramus of the mandible, where the inferior alveolar nerve enters the jaw)

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29
Q

When placing the barrel you place it opposite of what?

A

-Place barrel of syringe in commissure of mouth opposite to the site of injection. (Over the bicuspid on the opposite side)

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30
Q

What is the treatment for a tooth concussion?

A

Usually no treatment is required.

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31
Q

What is the most common cause of subluxation?

A

-Trauma

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32
Q

What is subluxation?

A

-Loose tooth

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33
Q

What is the treatment for subluxation?

A

-Gentle manipulation to make sure tooth is all the way in socket.
-Splint if necessary

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34
Q

Pt complains of pain and mobility after playing basketball, no visible displacement, what is the diagnosis?

A

-Subluxation

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35
Q

Avulsion is what?

A

-A traumatic injury where the tooth has been removed from the socket

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36
Q

What is the time frame to replace a tooth back in the socket?

A

-30 minutes to 1 hour

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37
Q

If re-implantation is unsuccessful what do you place the tooth in?

A

-Hank’s solution, milk, saline, or saliva (the patient’s mouth)

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38
Q

What do you not want to put a tooth in?

A

-Water

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39
Q

If your patient has an avulsed tooth what are you going to do for the patient?

A

Give them an IA (intraoral nerve block)

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40
Q

What anesthetic is used for an IA?

A

Bupivacaine /Marcaine

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41
Q

What are indications for an intraoral nerve block?

A

-Whenever anesthesia is desired in a fairly small anatomic area
-For laceration repair
-For incision and draining
-For oral pain management
-For repositioning/inserting traumatized teeth
-For teeth extraction

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42
Q

What are the different types of tooth fractures?

A

-Affect only the enamel (superficial)
-Expose the dentin
-Expose the pulp
-Include the root

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43
Q

If the fracture involves only the enamel what does the patient notice? What do you do for the patient?

A

-Patients notice rough or sharp edges but are asymptomatic.
-Treatment involves smoothing out the edges

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44
Q

If dentin is exposed but not the dental pulp, patients usually exhibit sensitivity to what?

A

-Cold air and water

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45
Q

What it the treatment for exposed dentin?

A

Drill and fill. Treatment consists of restoration of the tooth by a composite (white filling) or, if the fracture is extensive, a dental crown, to cover the exposed dentin

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46
Q

Is SIQ required for a dentin fracture?

A

-No

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47
Q

How can you tell if the pulp is exposed?

A

-Bleeding from the tooth

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48
Q

What is the treatment for pulp exposure?

A

-Root canal

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49
Q

Is SIQ needed for any tooth fractures?

A

-No

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50
Q

What do you do for a mandibular fracture?

A

Immobilize jaw and refer to dental

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51
Q

Inflammation of the dental pulp is called what?

A

-Pulpitis

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52
Q

What is pulpitis caused by?

A

-Carries/cavities not taken care of or carries/cavities redone multiple times (multiple restorations)
-Trauma

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53
Q

What is the treatment for pulpitis?

A

-Removing the decay
-Restoring the damaged tooth
-Sometimes performing root canal therapy or extracting tooth (last resort)

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54
Q

What is the primary symptom of pulpitis?

A

-Pain

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55
Q

In reversible pulpitis, pain occurs when what is applied to the tooth?

A

-Cold, sweets, or percussion

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56
Q

In reversible pulpitis when stimulus is removed how long does it take pain to cease?

A

he pain ceases within 1 to 2 seconds.

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57
Q

If the pain is longer than 1 to 2 seconds after stimulus is removed what is it?

A

-Irreversible pulpitis
-The pain may then cease for several days because of pulpal necrosis.

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58
Q

In irreversible pulpitis the tooth is sensitive to what?

A

-As infection develops and extends through the apical foramen, the tooth becomes exquisitely sensitive to pressure and percussion.

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59
Q

What is the most appropriate action for the IDC to take for pulpitis?

A

-Refer

60
Q

Infectious sequelae of pulpitis includes what (most sever to least)?

A

-Osteomyelitis of the jaw
-Apical periodontitis
-Periapical abscess

61
Q

Spread from mandibular teeth may cause what?

A

-Ludwig’s angina

62
Q

If the patient has an infected molar and the floor of the mouth is nice and firm what does the patient have?

A

-Ludwig’s angina

63
Q

Every time root canal therapy is done what should also be done?

A

-Put a crown on that tooth

64
Q

What is a periapical abscess also known as?

A

-Apical abscess

65
Q

Where is a periapical abscess located?

A

-At the apex of the tooth

66
Q

What does a patient present with if they has a periapical abscess?

A

-Fluctuant swelling of the mucuosa that extends to the cheek but more severe.

67
Q

What does this picture represent

A

Periapical/apical abscess

68
Q

Where is a periodontal abscess located?

A

-Around the tooth

69
Q

The initial treatment plan for a periapical abscess is what?

A

-Drainage via I & D
-Refer to dental for a root canal therapy or tooth extraction (last resort)

70
Q

What do you see on a patient the presents with gingivitis?

A

-Swelling, redness, plaque (typically), bleeding of gums when touching, discomfort
-(Discomfort from the superficial gingival pain)

71
Q

How does normal gingiva present?

A

-Firm, tightly adapted to the teeth, and contoured to a point. Keratinized gingiva near the crown is pink stippled tissue.

72
Q

What is the main cause of gingivitis?

A

-Poor oral hygiene

73
Q

Periodontal pockets contain what?

A

Bacteria that may cause both gingivitis and root caries

74
Q

What is a secondary role to gingivitis?

A

-Faulty dental restorations and xerostomia

75
Q

Chronic gingivitis will lead to what?

A

-Periodontitis.

76
Q

What is Primary Herpetic Gingivostomatitis?

A

-A common, mild, self-limiting, viral infection of the mouth.

77
Q

A viral infection has was intervention?

A

-Has no intervention

78
Q

What are the prodromal symptoms of Herpatic gingivostomatitis?

A

Fever, cervical lymphadenopathy, and malaise

79
Q

How does Herpatic gingivostomatitis present?

A

Numerous pin-head vesicles which rupture and ulcer on the perioral skin
-Severe and painful gingivitis with difficulty eating.

80
Q

What is the treatment?

A

-Self limiting
-Heals spontaneously in 7-14 days

81
Q

What can be prescribed for severe cases to speed up recover time?

A

-Acyclovir 200-800 mg five times daily for 7-14 days

82
Q

What is the ratio for magic mouth wash?

A

-1:1:1
-2% viscous lidocaine (most important part and numbs the mouth)
-Liquid diphenhydramine
-Kaopectate or Maalox

83
Q

What is Recurrent Herpes Simplex?

A

Common, mild, self-limiting re-manifestation

84
Q

What is Herpes Labialis also known as?

A

-“cold sores” or “fever blisters”

85
Q

What are the prodromal symptoms for recurrent?

A

Pain, burning, tingling, itching in areas where vesicles develop.

86
Q

Where are herpes labialis normally found?

A

-Vermillion border and/or commissure of lips.

87
Q

What is the treatment for recurrent herpes?

A

-Topical antivirals

88
Q

NUG is also known as what?

A

trench mouth” and “Vincent’s Angina.”

89
Q

How does NUG present?

A

-Acute, painful infection of the gums brought on by opportunistic Fusobacteria.
-Immunosuppression causes low WBC count

90
Q

NUG appears as what?

A

-Punched-out appearance
-Foul breath
-Rapid onset

91
Q

What is the treatment for NUG?

A

-Magic mouth wash
-Then a gentle debridement 24-48hrs after using magic mouthwash

92
Q

What’s another name for Oral Candidiasis?

A

-Thrush

93
Q

What is thrush caused by?

A

-Yeast and fungus

94
Q

What is the treatment of thrush

A

-Fluconazole 100 mg x 7 days

95
Q

How does thrush present?

A

-White “curdled milk” or “cottage cheese” like build up on dorsum of tongue, soft palate, or oropharynx.

96
Q

Aphthous ulcers are also known as what?

A

-“canker sores”
-Recurrent Aphthous Stomatitis (RAS)

97
Q

What may a patient with Aphthous ulcers complain of?

A

-Prodromal burning or itching.

98
Q

How do Aphthous ulcers present?

A

-¼ to 6mm round ulcerations with yellow-gray fibrinoid centers surrounded by red halos (caused by erythema).

99
Q

What is the treatment Aphthous ulcers

A

-Self healing, 10-14 days
-Topical corticosteroids

100
Q

Temporomandibular disorders (TMD) is an umbrella term for what?

A

-Conditions producing dysfunction of the jaw joint or pain in the jaw and face

101
Q

What is Internal Joint derangement?

A

Anterior misalignment of the articular disk above the condyle.

102
Q

What is Infectious arthritis?

A

Traumatic arthritis, osteoarthritis, RA, and secondary degenerative arthritis can affect the TMJ.

103
Q

What is Condylar Hyperplasia?

A

A disorder of unknown etiology characterized by persistent accelerated growth of the condyle.

104
Q

What is Condylar Hypoplasia?

A

A facial deformity caused by a short mandibular ramus.

105
Q

What is the treatment for TMD?

A

-NSAIDS
-Splint
-Refer to dental

106
Q

Benign migratory glossitis is also known as what?

A

-Geographic Tongue

107
Q

Where is geographic tongue found

A

-Migrates and doesn’t always look the same
-Dorsum and edges of tongue.

108
Q

How does geographic tongue present?

A

-Often resembles a map
-Usually asymptomatic but may be associated with burning when eating spicy or acidic food.

109
Q

What is Hairy Tongue?

A

-Dark, elongated filiform papillae, stained by chromeogenic microorganisms

110
Q

How do you treat hairy tongue?

A

-Good oral hygiene

111
Q

Mucus retention cyst is also known as what?

A

-“mucocele”

112
Q

What causes a mucocele?

A

Occurs as a result of a ruptured or obstructed minor salivary gland.

113
Q

Caries is also known as what?

A

-Cavities

114
Q

What is the most common source of tooth pain?

A

-Dental caries

115
Q

Pulpitis can results from what?

A

Untreated dental caries

116
Q

Focal erythema, swelling, and fluctuance, with a possible sinus tract (fistula) would suggest what?

A

A periapical abscess or periodontal abcess

117
Q

What is Pericoronitis?

A

-infected gingiva that results as bacteria is trapped over a partially erupted tooth, usually 3rd molars.

118
Q

A patient presents after a dental extraction and it keeps bleeding what do you do?

A

-Apply direct pressure

119
Q

What is the primary treatment of caries?

A

-Drill and fill

120
Q

How long can temporary fills be left in place?

A

Filling may be left in place 6 to 10 weeks

121
Q

What is the most common material used for fillings?

A

Silver amalgam

122
Q

How long do silver amalgam fillings last?

A

-Average of 14 years
-However, with good oral hygiene and if placed with use of a rubber dam for isolation from saliva, many amalgam fillings last > 40 yr.

123
Q

Why do we like using amalgam?

A

-Because composite shrinks (white filling) and amalgam (silver) does not

124
Q

Glass Ionomers provide the same aesthetics as what?

A

As composites, but without shrinkage.

125
Q

What do Glass Ionomers release into the tooth?

A

Slowly release Fluoride

126
Q

Intermediate Restorative Material (IRM) contains what?

A

-Eugenol to relieve pain
-Also easy to remove or re-contour

127
Q

Glass ionomers also known as Fuji are good for what

A

Bonding splints

128
Q

What is Dycal used for?

A

-Used to temporarily re-bond a prosthetic.

129
Q

If you have a patient that keeps coming in and getting cavities what are you going to promote?

A

Oral hygiene

130
Q

If a patient is dental class 2 what is the status?

A

-Current Dental Exam (within 12 months)
-Routine treatment needs that can be delayed for 12 months
-Worldwide deployable

131
Q

Intrinsic teeth staining (yellow) is a result of what?

A

Necrotic pulp, certain medications, or high fever during tooth development

132
Q

Extrinsic staining (brown/black) is a result of what?

A

Tobacco, wine, beetle nut

133
Q

Tobacco can also cause what?

A

Xerostomia, or lack of saliva production which leads to higher caries.

134
Q

What can vasoconstriction lead to?

A

Gingival recession and eventual tooth loss.

135
Q

What is a primary cause of gingival recession?

A

vasoconstriction

136
Q

Throat, mouth, and lip cancer can be caused by what?

A

Tobacco

137
Q

BUMEDINST 6200.12A is what?

A

Tobacco Cessation

138
Q

When can calculus occur?

A

Can occur in as little as 24 hours, or several days/weeks.

139
Q

How long is tooth brushing recommended for?

A

-2 minutes

140
Q

Halitosis is a result from what?

A

An underlying medical condition such as liver failure or ketoacidosis.

141
Q

What is the treatment for halitosis?

A

Most halitosis can be reversed with good oral hygiene to include flossing. Mouth rinses and sugar-free chewing gum can assist. Halitosis may take up to 48 hours to resolve.

142
Q

What the purpose for an emergency dental exam?

A

-The patient is having pain
-IDC should examine the area of pain

143
Q

A patient presents with white sores and redness the redness cannot be scraped off, what do you do?

A

-Refer

144
Q

Is dental class 3 deployable?

A

-No

145
Q

If a patient presents with pain and clicking in jaw what do you do?

A

-Refer to dental

Dental (3 decks)

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