Midterm Exam Review (Week 1 - 6) Flashcards
1
Q
Chpt 19:
What is acquired immunity?
A
immunity that is developed during a persons lifetime
2
Q
What is an acute infection?
A
infection of a short duration that is often severe
3
Q
What is artificially acquired immunity?
A
Immunity that results from a vaccination
4
Q
What is a blood borne disease?
A
a disease that is caused by microoganims such as viruses or bacteria carried in blood
5
Q
What is blood borne pathogens?
A
disease causing organisms transferred through contat with blood or other body fluids
6
Q
What is the chain of infection?
A
Conditions that must be present for infection to occur
7
Q
What is a chronic infection?
A
an infection of long duration
8
Q
What is a communicable disease?
A
condition caused by an infection that can spread from person to person or through contact with bodily fluids
9
Q
What is direct contact?
A
touching or contact with a patients blood or saliva
10
Q
What is indirect contact?
A
Touching or contact with a contaminated surface or instrument
11
Q
What is inherited immunity?
A
Immunity present at birth
12
Q
What is a latent infection?
A
persistent infection with recurrent symptoms that “come and go”
13
Q
What is naturally acquired immunity?
A
immunity that occurs when a person has contracted and is recovering from a disease
14
Q
What is OSHA BBP guidelines?
A
designed to protect employees against occupational exposure to blood borne pathogens
15
Q
What is a pathogen?
A
Disease causing organism
16
Q
What is percutaneous?
A
through the skin (ex. needle stick)
17
Q
What is permucosal?
A
contact with mucous membrane’s such as eyes or mouth
18
Q
What is a standard precaution?
A
standard of care designed to protect healthcare providers from pathogens that can be spread by blood or any other body fluids via excretion or excretion
19
Q
What is a universal precaution?
A
guidelines based on treating all human blood and body fluids as potentially infectious
20
Q
What is virulence?
A
strength of pathogens ability to cause disease also known as pathogenicity
21
Q
What is the order in the chain of infection?
A
- Infectious agent
- Reservoir
- Portal of exit
- Transmission
- Portal of entry
- Host susceptibility
22
Q
What is bioburden?
A
organic materials such as blood and saliva
23
Q
What is used to help minimize the number of microorganisms in the aerosol?
A
dental dam and high volume evacuation
24
Q
True or false: aerosols are visible to the naked eye
A
false, they often cant be seen
25
What is food and water transmission?
disease spread through contaminated food or water (not cooked or is contaminated by other means ex poop)
26
What is fecal-oral transmission?
transmitted by improper sanitation after coming in contact with fecal matter (ex. poor hand hygiene)
27
What is the most common reason patient to dental team disease transmission occurs?
direct contact with patient blood or saliva
28
What are the 3 ways patient to dental team transmission can occur?
1. Direct contact
2. Droplet infection (aerosols)
3. indirect contact ( cross contamination)
29
How does dental team to patient disease transmission occur?
unlikely to happen but could if the dental team member has open cuts on hand
30
How does patient to patient disease transmission occur?
contaminated instruments from one patient used on another patient
31
How does dental office to community disease transmission occur?
microorganisms leave the dental office and enter the community ex. worker leaving the office in their contaminated scrubs or an impression going to lab
32
How does community to dental office to patient disease transmission occur?
microorganisms enter the dental office through municipal water that supplies the dental unit
33
Is the CDC a regulatory agency? What is their role?
No they are not, they give specific recommendations
34
Is OSHA a regulatory agency? What is their role?
Yes, issue specific standards designed to protect the health of employees
35
When do we use hand rubs?
When our hands are not visibly soiled
36
What is more effective hand rubs or hand washing?
Hand rubs
37
What is irritant dermatitis?
chemical irritation to the skin, does not involve the bodies immune system
38
What is a type IV allergic reaction?
delayed contact reaction that involves the immune system may take 48 to 72 hours for symptoms to show ex. latex
39
What is a Type I allergic reaction?
can result in death, occurs in 2-3 minutes and can cause anaphylaxis (closing of airways)
40
What is general waste?
consists of all non hazardous waste (ex. paper towls, paper mixing pads)
41
What is contaminated waste?
Waste that has been in contact with blood or other body fluids (ex. barriers)
42
What is hazardous waste?
poses a risk to humans and to the environment ex. toxic materials such as extracted teeth with amalgam restorations
43
What is infectious or regulated waste? 3 types
waste that is capable of transmitting an infectious disease
1. blood and blood soaked materials (blood or saliva can be squeezed out)
2. pathologic waste ( soft tissues and teeth)
3. sharps
44
Why should teeth with amalgam never be disposed of with regulated medical waste?
amalgam contains mercury and regulated medical waste is incinerated
45
Chpt 20:
What is an antiseptic?
substance for killing microorganisms on the skin
46
What is a disinfectant?
Chemical used to reduce or lower the numbers of microorganisms on inanimate objects
47
What is a fungicidal
product capable of killing fungi
48
What is glutaraldehyde
enviromental protection agency (EPA) registered high level disinfectant
49
What is a high level disinfectant?
hospital disinfectant with tuberculocidal activity kills all microorganisms except spores
50
What is an intermediate level disinfectant
liquid disinfectant with EPA registration as a hospital disinfectant used for operatory surfaces
51
What is a liquid sterilant?
chemical used at room temp for items that are damaged by heat sterilization
52
What is a low level disinfectant?
destroys certain viruses and fungi, used for general housecleaning
53
What is precleaning?
used to remove bioburden before disinfection
54
What is residual activity?
action that continues long after initial application as with disinfectants
55
what is a sporadical
capable of killing bacterial spores
56
What is a surface barrier
fluid resistant material used to cover surfaces likely to be contaminated
57
what is tuberculocidal?
capable of inactivating tuberculosis causing microorganisms
58
What are touch surfaces and examples?
direct touch and contaminated during treatment
ex. unit controls and drawer handles
59
What are transfer surfaces?
not directly touched but often are touched by contaminated instruments ex. trays and hand piece holders
60
Chpt 21:
How does the autoclave sterilize instruments?
sterilization works by moist heat under pressure
61
What are biological indicators?
vials or strips (spore tests) that contain harmless bacterial spores used to determine whether sterilization has occurred
62
What is biological monitoring?
verifies sterilization by confirming that all spore forming microorganisms have been destroyed
63
What is a critical instrument? example
one that has been used to penetrate soft tissue or bone
- scalpels, chisels, scalers and burs
64
How does a dry heat sterilizer sterilize?
sterilized by heated air
65
What is an endospore?
resistant, dormant structure formed inside some bacteria that can withstand adverse conditions
66
What is a multiparameter indicator?
strip placed in packages that change color when exposed to to a combination of heat, temp and time
67
What is another term for multiparameter indicators?
process integrators
68
What is a noncirtical instrument? Example
item that comes in contact with intact skin only
- PID of xray tubehead, lead apron, curing light
69
What is a safety data sheet?
OSHA: required for each hazardous chemical in facility
70
What is a semi critical instrument? example
item that comes in contact with tissues but foes not penetrate soft tissue or bone
- HVE Tips, X ray holders, amalgam carriers
71
How does the ultrasonic cleaner work?
instrument that loosens and removes debris by sound waves traveling through a liquid
72
Seven Steps To Instrument Reprocessing:
Step 1: Transport
- How do we do it and why?
Transport instruments to the processing area in a manner that minimized the risk for exposure to person and the environment
- proper PPE
- Leakproof container
73
Seven Steps To Instrument Reprocessing:
Step 2: Cleaning
- What do we use?
handsfree mechanical process such as an ultrasonic cleaner
74
Seven Steps To Instrument Reprocessing:
Step 3: Packaging
- What do we use? How
Wrap instruments in appropriate manner ( wrap cassettes pouches for loose items) place a indicator strip into or on the outside of the package
75
Seven Steps To Instrument Reprocessing:
Step 4: Sterilization
Load items into the sterilizer as per manufacture directions, allow items to cool before removing them from the sterilizer
76
Seven Steps To Instrument Reprocessing:
Step 5: Storage
- where do we store?
store instruments in a clean, dry environment in a-manner that maintains the integrity of the package, rotate so the oldest packages will be used first
77
Seven Steps To Instrument Reprocessing:
Step 6: Delivery
deliver packages to point of use in a manner that maintains sterility of the instruments until they are used, inspect each package for damage and open package aseptically
78
Seven Steps To Instrument Reprocessing:
Step 7: Quality
record keeping, maintenance and the use of biologic indicators
79
Where should the instrument processing room be located? why?
away from easy access to patient care areas this minimizes the need to carry contaminated instruments around patients and "clean" areas
80
What are two ways instruments can be precleaned?
1. ultasonic cleaning
2. Instrument washing machine (miele)
81
If instruments can not be cleaned immediately after a procedure what should they be placed in?
Holding solution
82
What is the holding solution usually?
any non corrosive liquid
- usually an enzymatic solution that partially dissolved organic debris
83
Is a holding solution ideal?
no its neither cost effective or desirable as a disinfectant alone
84
What is hand scrubbing and when is it used?
removes all visible dirt and debris prior to ultrasonic and miele cleaning
85
When is the best time to remove visible dirt and debris from instuments?
Chairside
86
How do we hand scrub?
Place instruments fully under the water to avoid splashing and use a brush to clean the debris off
87
How often do we clean the ultrasonic cleaner solution?
Once a day atleast or if it becomes cloudy
88
What is the foil test used for? How is it used?
used to determine if the ultrasonic is working properly
place the tinfoil into the ultrasonic and run for 20 seconds, small pebbling and holes should effect the entire surface if an area has no pebbling (1/2 or more) there is a problem with the unit
89
How does the miele work?
very hot recirculating water and detergents that remove the organic material
90
What is flash sterilization? is it adequate?
method for sterilizing unwrapped items for immediate use, not recommended by public health
91
What does sterilization kill?
All microbial forms including bacterial spores
92
What are the three common forms of heat sterilization?
1. steam
2. chemical vapour
3. dry heat
93
How does the Steam Autoclave Sterilizer work?
steam under pressure, involves heating water to generate steam producing a moist heat that rapidly kills microorganisms.
94
Is it heat or pressure that kills the microorganisms in the autoclave?
Heat
95
What are the 4 cycles of the autclave?
1. heat up cycle
2. sterilizing cycle
3. depressurization cycle
4. drying cycle
96
what is a disadvantage of the autoclave?
may cause corrosion due to moisture
97
What is chemical vapour sterilization?
similar to autoclaving, but a combination of chemicals is used instead of water to create a vapour for sterilization
98
What are some advantages to chemical vapour sterilization?
does not rust, dull or corrode dry metal instruments
short time cycle
99
What are some disadvantages to chemical vapour sterilization?
adequate ventilation is necessary because of the chemicals used and released from the chamber they can be very irritating
100
What is dry heat sterilization?
operates by heating air and transferring that heat from the air to the instruments
101
Do instruments rust while in the dry heat sterilizer?
no (as long as they are dried before packaging)
102
What are two types of dry heat sterilizers?
1. static air
2. forced air
103
What is/ how does the static air sterilizer work?
similar to an oven
- hot air rises from the botto, and heat is transferred from the static (nonmoving) air to the instruments in 1-2 hours
104
What is a disadvantage of the static air sterilizer?
time - takes a-lot of time and error due to incorrect processing time
105
What is/ how does the forced air sterilizer work?
circulate the hot air throughout the chamber at a high velocity, permits rapid transfer of heat energy from the air to the instruments
106
What is the average time for the forced air sterilizer?
6 mins for unpackaged 12 minutes for packaged
107
What are liquid chemical sterilants? why are they used? how?
a liquid sterilant such as 3% glutaraldhyde
- instruments placed in solution for 10 hours to become sterilized
- used for instruments or items that can not withstands heat sterilization
108
True or False: Liquid Chemical Sterilants are highly recommended by public health
False: not recommended by public health
109
What are three forms of sterilization monitoring?
1. physical
2. chemical
3. biological
110
What is physical monitoring?
looking at the gauges, readings on the sterilizer and recording temp, pressure and exposure time
111
Does physical monitoring guarantee sterilization?
No but an incorrect reading gives a signal there is a problem
112
What is chemical monitoring?
involves the use of heat sensitive chemical that changes colour when exposed to certain conditions
113
What are two types of chemical monitoring?
process indicator
process integrators
114
What are process indicators? How do they work? examples
places external
example: autoclave tape or color change marking on a package
115
Do process indicators show if something has been sterilized?
No, it shows that the instrument pack have been exposed to a certain temp
116
T or F: Process indictors are useful in distinguishing between packages that have been processed and those that have not
True
117
What is process integrators?
Placed inside packages
respond to a combination of pressure, temperature and time
All sterilization factors are integrated. ( sterility is not confirmed tho)
118
What is Biological Monitoring?
Test done to confirm sterility
119
What is the only way to determine whether sterilization has occured?
Biological monitoring
120
What is the least desirable method of cleaning instruments? why
hand scrubbing, because it risks poke
121
How do we "pre clean" handpieces?
We flush them with a pressurized machine
122
What two sterilization techniques are acceptable for dental hand pieces?
chemical vapour and steam sterilizers
123
Chapter 23:
What is acute exposure?
high levels of exposure over a short period
124
What is the GHS?
Global Harmonized System of Classification and Labelling of Chemicals
125
What does the GHS do?
its an organization that defines and classifies the hazards of products and communicates health and safety information on labels and SDS's
126
What is a hazard class?
classification that provides a number or name of hazardous properties that present a potential hazard to human health and safety
127
What is a hazard classification?
Systemic standardization statement that divides health and physical hazards into seperate classifications
128
What is the Hazard Communication Standard (HCS)
Standard set in place by OSHA to ensure that the hazards of all chemicals are evaluated and details provided to employers regarding the right to know about hazardous chemicals in workplace
129
What is a health hazard?
evidence of a chemical that acute or chronic health effects may occur when an employee is exposed
130
What is a physical hazard?
chemicals that can be combustible liquid, a compressed gas and explosive material or water reactive and is a health hazard
131
What 4 characteristics makes a chemical hazardous?
1. if it can ignite (catch fire)
2. if it can react or explode when mixed with other substances
3. if it is corrosive
4. if it is toxic
132
What are the 3 primary methods of chemical exposure?
inhalation, skin contact, ingestion
133
What is acute chemical toxicity? What are the symptoms
high levels of exposure over a short period
- symptoms are very sudden
- dizziness, vomiting, head ache
134
What is chromic chemical toxicity? what are the symptoms?
repeated exposure over a long period of time
- liver disease, brain disorder, cancer, infertility
135
What gloves should we wear while handling chemicals?
utility gloves
136
Why should latex gloves never be used while handiling chemicals
latex creates a wicking or sucking action that will actually pull the chemicals into the glove and onto your hand
137
True or False: Chemical spills are a common occurrence in the dental field
False. they should be avoided
138
What spill kit should every dental office have? what is included and why?
mercury spill kit
it includes mercury spill powder, sponge and disposal bag
its important because mercury can be dangerous even in small amounts
139
What are 4 ways we can practise good storing of chemcials?
1. follow manufacturer instructions
2. avoid exposure to light
3. check expiration date
4. rotate inventory
140
How can empty chemical containers be considered hazardous?
they often hold residues that can burn or explode
141
A chemical is considered corrosive if it has a pH less than ___ (highly acidic) or a pH of more than ____ ( basic)
2.0 - acidic
12.5 basic
142
What does a reactive chemical react with?
explosive and toxic when mixed with water
143
What must a chemical contain to be considered toxic?
arsenic, barium, chromium, mercury, lead, silver, and certain pesticides
144
What is found on all chemical labels?
1. signal word
2. pictogram
3. hazard statement
145
When must employee training take place (3)
1. when a new employee is hired
2. when a new chemical product is introduced
3. once a year for all continuing employees
146
When a chemical is transfered to a secondary container what must we ensure be done?
the secondary container must also be labelled
147
The National Fire Protection Association (NFPA) has a labelling system:
what does the blue diamond represent?
health hazard
148
The National Fire Protection Association (NFPA) has a labelling system:
what does the red diamond represent?
flammability
149
The National Fire Protection Association (NFPA) has a labelling system:
what does the yellow diamond represent?
reactivity
150
The National Fire Protection Association (NFPA) has a labelling system:
what does the white diamond represent?
oxidizers
151
The National Fire Protection Association (NFPA) has a labelling system:
what are the numbers inside of the diamond?
0-4 numeric ratings
152
What is regulated waste?
waste that includes items that can be potentially contaminated with infectious material also referred to as regulated medical waste, infectious waste, or biomedical waste
153
What is toxic waste?
waste that can have a poisonous effect
154
Extracted teeth that do not contain amalgam must be _____ ______ before being used for educational purposes
heat sterilized
155
Why must be never heat sterilize teeth that contain amalgam?
high temperatures can create mercury vapours
156
What type of waste is extracted teeth considered?
regulated waste
157
How should scrap amalgam be dealt with?
collected and stored in an airtight container. Never dump any liquid from the container down the sink
158
Disinfectants that contain less than 2% glutaraldehyde should be disposed of by?
Dumping down the sink
159
Disinfectants that contain more than 2% glutaraldehyde should be disposed of by?
managed as hazardous waste
160
Chpt 24: Dental Unit Waterlines
What is an anti-retraction device?
mechanism that prevents entry of fluids and microorganisms into waterlines as a result of negative water pressure. also called "suck back"
161
What is biofilm?
slime producing bacterial communities that can harbour fungi, algae, and protozoa
162
What is colony forming units (CFU)
number of separable cells on the surface of a semisolid agar medium that create a visible colony
163
What is dental unit waterline (DUWL)
small bore tubing usually made of plastic, used to deliver water through a dental unit during dental treatment
164
What is heterotrophic bacteria?
bacteria that use organic carbon as food: protozoa fungi and most bacteria fall into this catergory
165
What is planktonic?
describes small organisms that float or drift in bodies of salt and fresh water
166
True or False: bacteria found in dental waterlines are the same as in community water just higher
True
167
What bacteria are dental healthcare workers expose to at a much higher rate than the general public
legionella
168
Where does biofilm exist?
in all places in which moisture an a suitable solid surface are found
169
which is a more resistant bacterial to chemicals, biofilm or planktonic bacteria
Biofilm is 1500 times more resistant to chemicals
170
What are 4 ways we can minimize bacterial contamination in water lines
1. use self contain water reservoirs
2. chemical treamtent regimens
3. microfiltration
4. daily draining and drying of lines
171
What are two advantages of self container water reservoirs
1. dental personelle can select the quality of water to be used (distilled, tap etc)
2. maintenance of the water system is under the control of the dentist and staff
172
What are microfiltration cartridges?
dramatically reduces bacterial contamination in dental unit waterline
- inserted as close to the hand-piece on air water syringe as possible
173
How can chemicals help control biofilm (2)
1. periodic or "shock" treatment with biocidal levels (levels that will kill microorganisms) of chemicals
2. continuous application of chemicals to the system that will kill the microorganisms but not harm human beings
174
What type of water should only be used during surgery (exposure to bone)
only sterile water
175
T or F: flushing dental waterlines removed biofilm and temporarily reduces microbial count in the water?
F: flushing waterlines does not remove biofilm
176
What are two options when testing the water quality?
1. use commercial testing service ( send sample off to lab and results are mailed back)
2. use in office test kit
177
What should we use when minimizing aerosols while using the high speed hand-piece, ultrasonic scaler and air water syringe?
HVE
178
How does a dental dam reduce direct contact?
reduces aerosols and spattering of the patients microorganisms
179
What is important to advise patients of when using saliva ejectors?
not to close their lips lightly around the ejector
180
What do we clean the waterlines with at the end of each day at NC
Biopure for 2-3 seconds leaving it in the lines overnight
181
How does biopure work?
chemicals and enzymes break down and dissolve the organics as they flush down the system, eats away the waste
182
Chpt 27: Vital Signs
What does vital signs consist of taking?
- temperature
- pulse
- respiration
- blood pressure
183
What two factors impact vital signs?
Emotional Factors- stress, fear, white coat syndrome
Physical Factors- illness, drinking or eating, exercise
184
What is a persons temperature?
the degree of hotness or coldness of the bodys internal enviorment
185
What is the process of physical and chemical changes that takes place in the production of the body heat?
metabolism
186
How does temperature play a role during illness?
metabolism increases causing the elevation in the bodys temperature this occurs because your body is defending off the bacteria and viruses that can not survive in excess heat
187
What is the average temperature of a resting person
97.6 - 99 F
188
What is a digital thermometer?
battery operated, shows digital reading after 30 seconds
189
What is a tympanic thermometer?
infrared signal is bounced off the eardrum, accurate reading provided after 2 seconds
190
What is a temporal scanner thermometer?
uses surface temperature of the artery on the forehead to determine the presence of fever
191
What is a glass thermometer?
contains mercury, which can cause health hazards it is banned in many provinces
192
What is the pulse?
the pulse is the rhythmic expansion of an artery each time the hear beats
193
Where are the 3 areas pulse can be taken?
Radial Artery- inner surface of wrist
Brachial Artery- Inner fold of the upper arm
Carotid Artery- alongside the larynx
194
What is the rate of pulse?
the number of beats that occurs during the counting period
195
What is the rhythm of pulse?
the pattern of the beats, such as an occasional skipping, speeding up, or slowing down
196
What is the volume of pulse?
the force of the beat, such as a strong or a weak beat
197
What is the normal pulse rate in an adult?
60 -100 BPM
198
What is the normal pulse rate in children?
70-120 BPM
199
What is tachycardia
abnormally rapid resting pulse rate
200
What is bradycardia
abnormally slow resting pulse rate
201
What is respiration?
the process of inhaling and exhaling, or breathing
202
What is rate in respiration?
total number of breaths per minute
203
What is rhythm in respiration?
breathing pattern
204
what is depth in respiration?
amount of air inhaled and exhaled
205
What is the normal adult respiration reading?
10-20 breaths per minute
206
What is the normal children and teenager respiration reading?
18-30 breaths per minute
207
What is blood pressure?
the amount of work the heart has to do to pump blood throughout the body
208
What are the two pressures of the heart?
systolic and diastolic
209
What does the systolic number in BP represent?
reflects the amount of pressure it takes for the left ventricle of the heart to compress or push oxygenated blood out into the blood vessels
210
What does the diastolic number in BP represent?
the heart muscle at rest when it is allowing the heart to take in blood to be oxygenated before the next contraction
211
What two pieces of equipment do we need to take blood pressure?
Sphygmomanometer and stethoscope
212
What sound does the stethoscope amplify?
Korotkoff sounds
213
What do the korotkoff sounds represent?
blood rushing back into the brachial artery
214
What is the pulse oximetry?
measuring the concentration of oxygen in the blood
215
What color is oxygenated blood?
bright red
216
what color is deoxygenated blood?
more blue-purple
217
what is the normal reading from the pulse oximetry?
95-99% oxygen saturation level
218
Chpt 36: Moisture Control
What is a saliva ejector?
small straw shaped oral evacuator used during less invasive dental procedures
219
What are the 4 indication for use of the saliva ejector?
1. preventive procedures such as prophylaxis and fluoride treatments
2. control of saliva and moisture accumulation under the dental dam
3. cementation of a crown or bridge
4. orthodontic bonding procedures
220
Where do you place the saliva ejector in the patients mouth?
under the tongue where most fluids accumulate opposite to the side the dentist is working
221
What are the indication for use of the HVE
- keeps the mouth free of saliva, blood, water, and debris
- retracts the tongue and cheek away from the field of operation
- reduces bacterial aresol caused by the high speed hand-piece
222
What is the operative suction tip?
desinged with a straight or slight angle in the middle
beveled working end
223
what is the surgical suction tips?
smaller in circumference
made of plastic or stainless steel
224
What two grasp are used when operating the HVE
1. thumb to nose
2. pen grasp
225
What are 4 key things when positioning the HVE
1. position the HVE on the surface closest to you
2. position the tip as close as possible to the tooth being worked on
3. position the bevel of the tip so it is parallel to the tooth surface
4. keep the edge of the tip slightly beyond the occlusal surface or incisor edge
226
What are the two types of rinsing procedures
1. limited area rinsing
2. full mouth rinsing
227
What is a limited-area rinse?
- performed frequently throughout a procedure
- accomplished quickly and efficiently
228
What is a full mouth rinse?
freshens the patients entire mouth completed at the end of a procedure
229
What is the air water syringe used for
convenience and accuracy to complete the rinsing process
230
What is cotton roll isolation? advantages and disadvantages
- easy application
- no additional equipment required
- flexible, permitting adaptation to different areas of mouth
disadvantage: does not provide complete isolation, may stick to oral mucosa, must be replaced frequently
231
What are cotton roll holders?
designed to hold multiple cotton rolls in a. more secure manner for the mandibular quadrant
- metal or plastic prong is slid into each cotton roll
232
What is dry angle isolation?
isolate posterior areas and is placed over stensens duct (opposite to max second molar)
the pad block the flow of saliva and protect the tissues in this area, replace pads id they become soaked before the procedure
233
Chpt 25- Ergonomics
What are musculoskeletal disorders?
Headache, neck and shoulder pain, back pain, and carpal tunnel syndrome due to work habits, posture and equipment
234
Why do we care about ergonomics in the dental field?
back, shoulder and joint pain, can result in more serious damage overtime
235
What does the early onset of paint alert you to?
an imbalence
236
what 3 interrelated factors contribute to job related injuries
- posture
- repetition
- force
237
what is the neutral position
sitting upright with your weight distributed evenly
238
how do ambidextrous gloves affect ergonomics?
can exert tension on the hypothenar eminence (fleshy elevation of the palm side of hand) forcing the hand to work against the vertical alignment
239
What is the most important factor in preventing CTS
resting hands frequently
240
What eye exercise can you do to relief eye sprain
look up from the task and focus your eyes at a distance for approx. 20 seconds
241
Chpt 48: General Dentistry
What is restorative dentistry?
when teeth need to be restored to the original from and shape through the use of direct and indirect restorative material
242
What is esthetic dentistry?
improving the appearance of teeth by repairing imperfections, with direct and indirect restorative materials, or by using whitening techniques
243
What must be considered during cavity preparation?
consideration of enamel thickness, body of dentin, size and position of pulp
244
what is cavity preparation?
process of removing diseased tooth structure while leaving healthy tooth structure for the tooth to maintain a restoration
245
Initial cavity preparation: what is the outline form?
design and initial depth of sounds tooth structure
- framework for filling, removal of carious lesion, defective resto
246
Initial cavity preparation: what is the resistance form
primary shape and placement of cavity walls
- strength and durability
247
Initial cavity preparation: what is retention form
to resist displacement or removal
- how well the cavity pre is able to retain the restoration
248
Initial cavity preparation: what is convenience form
accessibility in preparing and restoring the tooth
249
What is the final cavity preparation
removes any enamel, diseased dentin, or old restorative materal
insert additional resistance and retention notches and grooves
placing protective dental materials (lining agents, bases, desensitizing or bonding agents)
250
What are class I caries?
occlusal caries in pits and fissues of molar/ pre molar: facial/ lingual surfaces of molars: lingual surfaces of max incisors
251
What are Class II caries?
caries on proximal surfaces of posteriors
252
What are class III caries?
caries on proximal surfaces of anteriors that do not involve the incisal angle
253
What are class IV Caries?
caries on proximal surfaces of anteriors that involve the incisal edge
254
What are class V caries?
caries on incisal edges/ cusps
255
What are class VI caries?
incisal (anterior) and occlusal cusps (posterior)
256
What is a direct restoration and ex.
placed directly in office
- amalgam
- resin based composites
- glass ionomers
257
what is an indirect restoration and ex
fabricate in lab and inserted at a later time
- crown, inlays on-lays
veneers
258
What are retention pins
used to support the restoration. usually one pin for each missing cusp
259
why is it important to use a dental dam while preparing and placing pins
pins are small so they can easily be dropped or misplaced
260
what are intermediate restorations?
restoration placed for a short time
261
Chpt 34: Dental Instruments
What is a instrument number?
manufacture assigns number to most instruments
262
What instrument is often referred to by their number rather than their name?
pliers and forceps
263
Parts of Instruments: Handle
portion of the instrument that the operator grasps
264
Parts of Instruments: Shank
part of the instrument that connects the working end to the handle
265
Parts of Instruments: Working End
portion of the instrument designed for a specific function
266
What is blacks instrument formula?
formula that describes the angulations and dimensions of the working end of a hand instrument
267
in blacks instrument formula what do the three sets of numbers repersent?
- width of blade
- length of blade
- angle of blade
268
What are the 4 instrument classification?
examination
hand cutting
restorative
acessory
269
What is the function of a periodontal probe?
to measure sulcus and pocked depth of the periodontium of each tooth
270
What is the function of locking and non locking pliers
retrieve small items like pinchers
271
What are the 3 types of chisels?
1. straight
2. wedelstaeft
3. bi-angle
272
What is the characteristics of hatchets (4)
- beveled on one side
- blade on one side
- refines cavity walls
- obtain retention in cavity
273
What is the function of a hoe?
smoothes and shapes floor of cavity prep
274
What is the function of gingival margin trimmers?
curved blade, angled cutting edge, bevel gingival margin wall of cavity prep
275
What is the characteristics of an angle former?
define point angles
sharpen line angles
276
What is the function of an excavator?
- blade or spoon
removal of carious materials and excess cement
277
What is the most commonly used excavator?
spoon excavator
278
What is the definition of a restorative instrument?
an instrument used to place, condense, and carve the restorative dental material back to reflect the normal anatomy
279
What is a plastic filling instrument used for?
placing and condensing restorative materials
280
What is a composite instrument used for?
placing, condensing, carving, contouring and burnishing
281
What is the function of a amalgam carrier?
carry and dispense amalgam
282
What is the function of a amalgam condenser?
pack amalgam into cavity preparation
283
What is the function of a carver?
to remove excess restorative material, carve wax inlays and onlays
284
What is the function of a burnisher?
to smooth restorations and shape matrix bands
285
What is found in an armamentarium? (amalgam filling set up)
- triturator
- amalgam well
- amalgam carrier
- condensing instrument
- carving
- tofflemire matrix system or sectional
286
What the 5 steps of amalgam manipulation
1. dispensing
2. trituration
3. condensation
4. carving
5. polishing
287
What is the first step in a composite filling preparation
etched, rinsed and dried
288
What is the second step in a composite filling procedure
prime and bond is applied, light cured
289
What is the third step in a composite filling procedure
composite is places and condensed, shaped with PFI and then light cured
290
What is the fourth step in a composite filling procedure
matrix is removed and finishing burs are used to shape and polish
291
What is the last step in a composite filling procedure
occlusion is checked with articulating paper, reduced if needed
292
What is the first step in an amalgam filling procedures
triturator- amalgam capsule is placed into the triturator
293
What is the second step in an amalgam filling procedures?
place amalgam into the amalgam well then amalgam is placed in small increment (starting with proximal areas)
294
What is the third step of an amalgam filling
condensing: packing amalgam into prep cavity and each portion is condensed with a condensing instrument
295
What is the fourth step in an amalgam filling
carving and burnishing- carving shapes amalgam into anatomic form to restore function, sharp cutting instrument's
burnishing is used to burnish overpacked amalgam
a explorer is used to contour marginal ridge heigh and outer contours of tooth
296
What is the fifth step in an amalgam filling?
wedge is removed, tofflemire is now loosened from band
297
What is the purpose of a pre procedural rinse?
to reduct the amount of microorganisms introduced in the form of areosol or splatter/spray `
298
What is the name of the PPR we use during aerosol procedures
Denticare Chlorohexidine 0.12%
299
What age do we use PPR on?
children over the age of 12
300
What must we be aware of for some patients when using a PPR
for alcohol dependent patients some PPR contain alcohol therefore we must avoid those
301
what is sloughing?
shedding of the oral mucosa, grey/white strips of oral epithelium which peels off the soft tissue
302
can your client rinse with water after doing a PPR?
no it dilutes the active ingredients
303
What indication is used on cassette to ensure proper colour change indications have occurred?
black lines
304
what is the final colour of a properly sterilized internal integrator
black
305
what colour will the pouch change to in order to confirm the item went through sterilization
pink to black
306
Chpt 33: Delivering Dental Care
What is the operator zone for a right handed clinician?
7-12 oclock
307
what is the transfer zone for right handed clinician
4-7 o clock
308
what is the assistant zone for a right handed clinician?
2 to 4 o clock
309
what is the static zone for a right handed clinician?
12 to 2 o clock
310
what is the operator zone for a left handed dentist
12 to 5 oclock
311
what is the transfer zone for a left handed dentist
5 to 8 o clock
312
what is the assistant zone for a left handed dentist
8 to 10 o clock
313
What hand does the assistant use to pass and receive instruments with a right handed dentist
left hand
314
How is the mirror and explorer transfered?
mirror in the right hand and the explorer in the left hand
315
how are dental hand-pieces transferred
behind the patients head
316
Chpt 49- Matrix systems
What is a matrix systems function?
provides a temporary wall for the restoration process in class II, III, and IV
317
What posterior matrix system is most common?
universal retainer or tofflemire
318
what is a matrix band?
thin flexible stainless steel material
319
what two designs are often used for matrix bands
1. universal band
2. extension band
320
what is a universal matrix band? what type of restoration is it used for
selected for class II preparation when the proximal box is prepared to a minimum depth and width and the cusps are intact
321
what is an extension matrix band? why is it used
selected for deeper class II preparations requiring gingival extensions
- has two lumps
322
When placing a matrix band what end should the small circumference be placed?
towards the gingiva
323
when placing a matrix band what end should the larger circumference be placed?
occlusal edge is always positioned facing toward the occlusal part of tooth
324
why is a wedge used with a matrix band
when inserted into the gingival margin area it provides and acts like additonal support to the wall
325
What shapes do wedges come in
triangular or round
326
what instrument do we use to place wedges
cotton pliers
327
for posterior restorations what side is the wedge placed in
lingual
328
what is another term for a clear plastic matrix
celluloid strip or mylar strip
329
what is a clear plastic matrix used for
anterior composite resin or glass ionomer materials
330
what class of tooth restoration is a clear plastic matrix used for?
class III or Class IV when the proximal wall of an anterior tooth is missing
331
T OR F a retainer is needed to hold the clear plastic matrix in place
false no retainer is needed
332
is the clear plastic matrix placed inter proximally before or after etching and bonding of the tooth? why
before to protect the adjacent teeth from these materials
333
t or f: the clear plastic matrix allows for the curing light to penetrate
true
334
what is an automatrix system?
alternative to a universal retainer and band, no retainer is needed to hold the band in place instead a coil like autolock loop and tightening wrench hold the band in place
335
What type of matrix is used for posterior composite restorations?
palodent-type matrix band and tension ring
336
what two types of matrix system are used for primary teeth
t band a spot welded band `
337
Chpt 28: Oral Diagnosis
Blacks Classification: Class I
Pits and fissures
338
Blacks Classification: Class II
interproximal of posteriors only
339
Blacks Classification: Class III
Interproximals of anteriors only
340
Blacks Classification: Class IV
inter-proximal and incisal edges
341
Blacks Classification: Class V
Cervical areas of the tooth (near gum)
342
Blacks Classification: Class VI
cusps
343
What are we feeling for when palpation
texture
size
consistency of the hard and soft
344
What is palpation used to detect in dental
detecting swollen lymph nodes
345
What are we examining when looking at the TMJ
- noises
- tenderness
- pain
- limited function
346
What types of instruments are used to examine teeth?
mouth mirror and explorer
347
What does the dentist use to detect imperfections in the teeth
explorer
348
What is a Level I Treatment Plan
emergency care, relieves immediate discomfort
349
What is a Level II Treatment Plan
standard care, restores the patients to normal function
350
What is a Level III Treatment Plan?
optimum care, restores the patient to maximum function
351
chpt 37: anesthesia and pain control
What does topical anesthetic do
numbs a particular area, used prior to local anesthetic and desensitizes oral mucosa
352
what are indications for topical anesthetic?
- subginginval scaling
- root planning
- seating crowns
- placing matrix bands
- periodontal probing
- preparing for local anesthesia
- repressing gag reflex
353
what are contradictions for use in topical anesthetic
- allergic reaction to anesthesia
- allergic to flavour (ex. bannana)
354
what must you do before placing topical anesthetic
dry the area
355
what must be included on a topical anestetic documentation
- brand
- dosage
- flavour
- site applied
- time applied
- if there was a reaction
356
what is oraqix and what is its details?
topical anesthetic
- not a vasoconstrictor, quick onset, 5 cartridges can be used at one appt
357
what are indications for oraqix?
localized anaesthesia in periodontal pockets
- scaling, root planning, probing
358
What are contraindications for oraqix?
- allergic to amide type local anesthetics
- traumatized mucosa
- certain blood disorders
359
how would you document oraqix?
- amount used
- medications in it
- where it was applied
- to what teeth
- was there a reaction
360
What does local anesthesia do?
produces deadened or pain free area, sensory impulses temp blocked affects nerve fibers carrying messages to brain
361
what is a short duration local anesthetic?
30 minutes
362
what is a intermediate duration local anesthetic?
60 minutes
363
what is a long duration local anesthetic?
90 minutes
364
what is a vasoconstrictor?
contricts blood vessels to reduce blood flow to the area of injection site
365
what is the most common vasoconstrictor?
epinephrine
366
when should vasoconstrictors never be used?
clients with heart conditions
367
what is parethesia?
pricking or tingling sensation that could last few days or a few weeks caused by nerve damage during injection
368
When should we never use a anesthetic cartridge?
if it is damages in any way, discoloured or cloudy or has passed the expiration date
369
The larger the gauge of the needle the ____ the needle
thinner
370
When is a short needle used?
to administer anesethic by infiltration injection on maxillary arch
371
when is a long needle used?
to administer anesthetic by block injection on mandibular arch
372
what is the maximum amount of penetrations you can do with a needle?
four
373
How do you document local anesthetic
amount of carpules (how many in each carp) what was used what amount, what size, what needle, was there a reaction
374
How should we always re cap needles?
using the single handed school technique
375
What is the name of the IO site for target topical
Infraorbital
376
Where is the IO topical placement
muccobuccal fold of the 4's
377
What is the name of the ASA site for target topical
anterior superior alveolar
378
What teeth are effected in the infraorbital?
buccal tissues and pulp of 1-5
379
What teeth are effected in the ASA?
buccal tissues and pulp of 1,2 and 3
380
where is the placement for the ASA?
topical is placed at the muccobuccal fold of the 3s
381
What is the name of the MSA site for target topical
middle superior alveolar
382
Where is the topical placement put for the MSA?
muccobucal fold of the 5s
383
What teeth are effected by the MSA
buccal tissues and 4,5 and MB root of 6
384
What is the name of the PSA site for target topical
Posterior superior alveolar
385
Where is the topical placement for PSA
placed at muccobuccal fold of 5s
386
What teeth are effected in the PSA
buccal tissue and pulp of 6,7,8
387
What is the name of the NP site for target topical
Nasopalatine
388
Where is the topical placement put for PSA
topical is placed at midline next to incisive papilla
389
What teeth are effected in NP
palatal tissue of 3 to 3
390
What is the name of the GP site for target topical
Greater Palatine
391
Where is topical placed in GP
near depression of greater palatine foramen (by 7)
392
What are the maxillary injections? (6)
IO, ASA, MSA, PSA, NP, GP
393
What teeth are effected in the GP
palatal tissues of 4-8
394
What are the mandibular injections?
B, IA, IN
395
What is the name of the B site for target topical
Buccal Block
396
Where is topical placed on the buccal block
topical placed on buccal of 7
397
What teeth are effected in the buccal block
buccal tissue of 6,7 and 8
398
What is the name of the IA site for target topical
inferior alveolar
399
Where is topical placed in the inferior alveolar
distal to the last molar ( ptygomandibular space)
400
What teeth are affected in the inferior alveolar
pupal 8-1, tongue , lip, lingual tissue
401
What is the name of the IN site for target topical
Incisive
402
Where is the topical placed in the IN
mental foramen
