Midterm Review (OEQ) Flashcards
What is the definition of pocket/probing depth (PD)?
Gingival margin to the bottoms of the pocket
What is the definition of attachment loss?
From CEJ to base of the pocket
CEJ is required for the measurement of:
attachment loss
-Gingival pocket (false pocket)
Pseudopocket
A pseudopocket is caused by:
Hyperplasia; coronal movement of the gingival margin
A pseudopocket involves no _____ of _____
apical migration; junctional epithelium
Describe the bone loss seen with a pseudopcoket:
No bone loss (all psuedopockets are suprabony)
What is the ppm of in-office fluoride:
Greater than 9000 ppm
(our slide gives 22,600 ppm as an example)
What is the fluoride concentration of Prevident?
5000 ppm (1.1% NaF)
Do you use toothpaste prior to applying foam or gel fluorides?
Yes, you should brush the patients teeth & then apply
If a patient overdoses on fluoride, what should you give them?
Also what is considered “overdosing”?
Calcium, aluminum or magnesium products
(>5mg/kg)
EMERGENT Situation= >15mg/kg (9-1-1)
What is the current fluoride standard in water?
0.7 ppm
What do we mean by “optimal” fluoride levels in water:
Optimal means minimal caries with minimal fluorosis
What is the optimal RANGE of fluorination of water?
0.6-1.2 ppm (though 0.7 is optimal LEVEL)
0.7 ppm fluoride in water will decrease caries with _____ % of the population experiencing fluorosis
less than 10%
What is the definition of plaque?
An organized mass of bacteria in gel matrix
Which of the following is NOT true concerning the acquired pellicle?
a) it is a glycoprotein from saliva
b) it is a mode of attachment for calculus
c) if it is removed, it immediately reforms
d) it is primarily composed of bacteria
d) it is primarily composed of bacteria is false
Describe the composition of the acquired pellicle:
- polysaccharides
- proteins
- glycoproteins
- lipid material
- DNA
The pellicle forms first on the tooth…
providing bacteria a surface to attach to
When does bacteria colonization occur?
As soon as acquired pellicle is introduced/forms in the mouth
Within the first 4 hours of bacterial colonization of plaque, 47-85% of the organisms are:
streptococcus
When an energy source is introduced, microorganisms produce:
a) acid
b) intracellular polysaccharides
c) extracellular polysaccharides
d) acid & intracellular polysccharide
e) all of the above
e) all of the above
(True/False):
The optimal level of water fluoridation is 70 ppm. Optimal levels mean minimal caries with minimal fluorosis.
Statement 1- false
Statement 2- true
(True/False):
After fluoride deposition, the concentration of fluoride is highest in the surface enamel & decreases as you approach the surface dentin.
True
After fluoride deposition, where is the concentration of fluoride the highest?
Surface enamel
In office fluorides are ______ ppm
9000-28000 ppm
Which of the following is used for in office fluoride treatments?
2.0% neutral sodium fluoride- 9000ppm (rarely used)
1.23% acidulated phosphate fluoride- 12,300 ppm (rarely used)
5.0% NaF- 22,600 ppm (varnish) (commonly used)
If a patient is 40 kg, what is their probably toxic does (PTD)?
200 mg
(calculated using 5mg/kg rule) (40mg x 5mg/kg =200kg)
Why is brushing your teeth before using a prescription gel indicated?
The prescription gel does not have abrasive systems
One can decrease fluorosis by:
Decreasing the amount of fluoride accidentally ingested in children during tooth development
Which of the following is false concerning cementum?
The acellular portion is towards the apex of the root
Which is false regarding gingival fibers?
Unites marginal gingiva with PDL
Which structure is also termed the lamina dura and cribiform plate?
Alveolar bone proper
Which is the least likely determinant of unhealthy gingiva?
-color
-consistency
-stippling
stippling
The consistency of healthy gingiva should be:
Firm & resilient
In smokers, gingiva will have ______ likelihood of bleeding during probing
lesser
List the parts of the periodontium: (4)
- gingiva
- PDL
- Cementum
- Alveolar bone
(NOT- alveolar mucosa, enamel)
The attached gingiva and alveolar mucosa are separated by the:
Mucogingival junction
Which of the following are non-keratinized: (3)
- gingival col
- junctional epithelium
- alveolar mucosa
Color of gingiva is determined by:
Vascularity of the gingiva
To measure the amount of attached gingiva:
Subtract the pocket depth from the keratinized gingiva
The least amount of attached gingiva is found:
facial of mandibular premolars
What is the basis of branstrom’s theory of hydrodynamics?
Fluid movement in the dentinal tubules produces sensitivity & pain
Gingivitis (Class I) is characterized by:
No bone loss
Periodontitis is characterized by:
- bone loss
- apical migration of the JE
What bacteria is associated with periodontal disease: (5)
- aggregatibacter actinomysetemcomitan (Aa)
- Treponema denicola (T. denticola or Td)
- Porphyromonas gingivalis (P. gingivalis or Pg)
- Prevotella intermedia (P. intermedia or Pi)
- Tanerella forsythia (T. forsythia or Tf)
Gingivitis is characterized by:
- BOP
- increased GCF
- Edema
What is the response when a patient informs you that they bleed during flossing?
Tell the patient that they have gingivitis
Fluoride varnish ppm is approximately:
22,000 ppm
Recession occurs from the:
CEJ to the gingival margin
Major component of plaque biofilm:
Pellicle
What is the main role of calculus?
Keeps plaque in contact with the gingiva
T/F: You use your middle finger to roll the instrument
False- you use your thumb
Angling 45-90 degrees with the instrument allows for:
Proper removal of calculus
What is the fluoride concentration of an over the counter mouthwash?
225 ppm
What is the fluoride concentration of prescription toothpaste?
5000 ppm
Where would you sit to see the facial of second molars with direct vision:
9 o’clock
True and false pockets have what in common?
Bleeding & hyperplasia
If the gingival portion of the tooth is white and chalky what is wrong?
Decalcification
After applying fluoride varnish, what is the patient instruction?
Can eat and drink immediately - (but no chips/hard stuff)
How long does SDF take to remineralize (arrest caries)?
1 week
What is indication for use of SDF?
Caries present on posterior dentition
SDF allows for:
formation of hydroxyapatite & fluorapatite (treated surfaces will be less susceptible to caries)
What is the fluoride content of kids toothpaste?
1000 ppm
The acquired pellicle is mainly composed of:
Glycoproteins
Plaque is formed by salive/exudate and:
Bacteria & acquired pellicle
T/F: Secondary colonizers do not colonize on clean teeth
True
(Primary colonizers work on clean teeth, secondary colonizers work on pellicle)
One fluoride that is NOT used in a dental office is:
Stannous fluoride
To measure the attached gingiva use:
keratinized gingiva - sulcus depth
Anchors tooth to bone by PDL:
Cementum
Mouthwash is beneficial for communities:
with or without fluoridated water
What is the fluoride content of over the counter toothpaste?
1000 ppm
How do you adapt the line angles?
Roll instrument between thumb and forefinger
Bleeding on probing is due to: (2)
- ulceration is sulcular epithelium
- presence of inflammation
T/F:
APF is a more effective form of fluoride so we want to use it.
Enamel that has fluoride is less susceptible to caries.
First statement- false
Second statement- true
T/F: Neutral fluoride has a metallic taste
False- SDF does
Psuedopockets and true pockets have what in common: (3)
- gingival inflammation
- BOP
- increased pocket depth
What is the distinct difference between natural tooth and natural periodontium vs. dental implant and peridontium?
- dental implant will have ______ vascularity
- dental implant will NOT have a _____
- dental implant will have ____ gingival fibers
- dental implant will have collagen fibers ____ to the implant
- Less
- PDL
- Fewer
- Parallel
What are the components of a dental implant? (3)
- implant body
- abutment
- fabricated crown
(made of titanium)
What is the seating position for the anterior area of the mandibular arch when working on toward surface?
8-9 o’clock for RH
What is the seating position for the anterior surfaces of the maxillary arch when working on toward surfaces?
8-9 o’clock for RH
What is the seating position for the anterior area of the mandibular arch when working on away surfaces?
12 o’clock
What is the seating position for the anterior surfaces of the maxillary arch when working on away surfaces?
12 o’clock
What is the seating position for the posterior aspects of the mandibular arch using direct vision?
9 o’clock for RH
What is the seating position for the posterior aspects of the maxillary arch using direct vision?
9 o’clock for RH
What is the seating position for the posterior aspects of the mandibular arch using indirect vision?
10-11 o’clock for RH
What is the seating position for the posterior aspects of the maxillary arch using indirect vision?
10-11 o’clock for RH
Where can universal curettes be used?
All surfaces of the mouth
How many cutting edges does a sickle scaler have?
two
How many cutting edges does a universal curette have?
two
What is the shape of a sickle scaler?
Pointed toe (tip?)
What is the shape of a universal curette?
rounded toe
Where is a posterior sickle scaler used?
interproximal surface ONLY
Which part of a periodontal instrument is the working end?
a) toe
b) middle
c) heel
a) toe
What is the angulation for sickle scalers and universal curretes?
90 degrees for both
What is the cross section of a sickle scaler?
Triangular
What is the cross section of a universal curette?
Half elliptical
What is the blade for a sickle scaler?
straight
What is the blade for a universal curette?
straight
Describe a sickle scaler:
- end:
- cutting edge:
- angulation:
- cross section:
- blade:
- pointed toe (tip)
- two
- 90 degrees
- triangular
- straight
Describe a universal curette:
- end:
- cutting edge:
- angulation:
- cross section:
- blade:
- rounded toe
- two
- 90 degrees
- half-elliptical
- straight
Which of the following is NOT a component of the periodontium?
a) cementum
b) dentin
c) alveolar bone
d) gingiva
b) dentin
The allowed seating position for both right & left-handed clinicians working on the facial aspect of the maxillary anterior teeth is:
RH: 12 o’clock
LH: 12 o’clock
Which best describes the reddish color of diseased gingival tissues?
erythema
Which aspect of the periodontium is NOT present around a dental implant?
cementum
Which is the most common CEJ relationship found in the patient population?
Overlap
Mineralization of calculus is composed mostly of:
Inorganic components (70-90%)
How many days does it take an acquired pellicle to develop?
7 days
T/F: Organisms in a biofilm are 100-150x more resistant to antibiotics
False- they are actually 1000-1500 x. more resistant
Which surface would require an offset position?
28 DB (any posterior distal surface would require offset)
What is the difference between the anterior and posterior sickle scaler?
Design of the shank (posterior sickle scaler will have a bend in the shank)
Where should the light be positioned when viewing the mandibular arch?
Directly above the patient
Where should the light be positioned when viewing the maxillary arch?
45 degree angle pointing down
SDF percentage to be effective against caries?
38%
Erythema occurs in what stage of gingivitis?
II
Established gingivitis lesion is characterized by:
Color change
Where would you sit for indirect vision of the posterior sextant?
11 o’clock
Where would you sit for direct vision of the posterior sextant?
9 o’clock
The terminal shank should be held _____ to the long axis of the tooth
parallel
What is the light grasp used for?
Tactile sensitivity
What is NOT a function of the PDL?
Strengthening
A true pseudopocket is caused by:
Hyperplasia
Over-angulation of sickel scalers could result in:
Burnished calculus
Principle fibers that have masticatory stresses:
Oblique fibers
A valley-like depression in the portion of the interdental gingiva that lies directly apical to the contact area of two adjacent teeth & connects the facial & lingual papillae:
Gingival col
What is the most likely reason that gingivitis does NOT progress to periodontitis
Patient is not susceptible
What is easily displaced with water?
Materia albla
What best describes a periodontal explorer?
Used for caries detection & subgingival calculus removal
What instrument would you use to remove supragingival calculus off a posterior molar?
Posterior sickle scaler
What instrument is most likely to hurt the gingiva when used incorrectly?
Sickle scaler
When probing how many measurements per tooth?
6- (DF, F, MF, ML, L, DL)
Anaerobic glycolysis does what to the oral cavity?
Decreases pH
What is NOT a function of the periodontal probe?
a) measure size of lesion
b) removal of calculus
c) test for BOP
d) measure overbite/overjet
b) removal of calculus
When is SDF contraindicated? (2)
- pulpal exposure
- silver allergy
Which gingival fibers connect to cementum?
Dentoperiosteal & dentogingival
T/F: pointed or peaked papilla is seen in disease
False- rounded papilla seen in disease
T/F: you would NOT use the mm in the nabers probes when determining furcation involvement
True
Mrs. Smith has red, inflamed gums, probing reads 2-4mm with mandibular molars reading 5 mm. What is your diagnosis?
Gingivitis
Why can you go subgingival with a curette?
Rounded back/rounded cutting edge
T/F: Bacteria release noxious substances. The primary role of the noxious agent is to make an inflammatory response.
Both statements true
What does NOT contribute to periodontitis?
Longitudinal growth
If calculus is subgingival on the root, why would it need to be removed?
Calculus keeps the plaque in contact
Inflammatory processes extending to affect the PDL and alveolar bone, resulting in:
attachment loss
CEJ to base of pocket:
attachment loss
Where is the light supposed to be when viewing the mandibular arch?
directly above
what happens when bacteria shift apical from primary to mature?
Co-adhesion of bacteria
Silver diamine fluoride percentage to be effective against caries:
38%
Erythema occurs at what stage of gingivitis?
Stage II
Established gingivitis lesion will show:
color change
What are four essential oils?
- thymol
- eucalyptol
- methyl sialicylate
- menthol
True about fluoride:
Fluoride > 9000 ppm over calcium fluoride
Mirror used for indirect vision of mandibular lingual:
Retract tongue
Where do you sit for indirect vision of a posterior sextant?
11:00
Where do you sit for direct vision?
9:00
The terminal shank is held:
parallel to the tooth
What bacteria below is NOT involved with periodontitis?
Porphyromas intermedium
Pellicle is mainly composed of:
Glycoproteins
What does it mean if you have bleeding on probing?
Ulceration of sulcular epithelium
Light grasp of instrument allows for:
increase in tactile sensitivity
Functions of the PDL include:
- formative
- supportive
- nutritive
- sensory
What is NOT a function of the PDL?
Strengthening
All plaque has been removed from the teeth. After 4 hours which of the following makes up 47-85% of bacteria present?
Streptococci
Why does CHX not have an ADA seal?
ADA seals are for consumer products OTC (not prescriptions)
Alcohol is used as a:
solvent
Which of the following are not a secondary, local causative factor of periodontal disease?
Stress
(xerostomia and medication are!!)
Which of the following is NOT a risk factor for caries?
Smoking
(snacking and drug use are!!)
Which of the following is a disease indicator of caries?
Restorations within 3 years
A true pseudopocket is caused by:
Hyperplasia
Overangulation of sickles scalers:
Weill result in burnished calculus
T/F: The middle finger is used to roll an instrument
False
Describe when cementum is deposited:
Continuously deposited apically throughout life
Alveolar mucosa is NOT:
a) thick, nonkeratinized
b) movable tissue
c) separate from attached gingiva at MGJ
d) darker shade of red
a) thick, non-keratinized
(alveolar mucosa is thin and non-keratinized)
What is false about gingival fiber groups:
a) around the cervical area with gingival tissues
b) includes dentogingival, alveologinigval, circumferential, dentoperiosteal & transeptal fibers
c)
These are both true - we dont know the actual answer
Soft, sponge, dense, BOP is used to describe:
Consistency
Principle fibers that have masticatory stresses:
Oblique fibers
Principle fiber group from the root apex to adjacent surrounding bone to resist vertical forces:
apical fibers
Principle fibers from the root above the apical fibers obliquely toward the occlusal to resist vertical and unexpected strong forces:
Oblique fibers
Principle fibers from the cementum in the middle of each root to adjacent alveolar bone to resist tipping of the tooth:
Horizontal fibers
Principle fiber group from the alveolar crest to the cementum just below the CEJ to resist intrusive forces:
alveolar crest fibers
Principle fibers from the cementum between the roots of multi-rooted teeth to the adjacent bone to resist vertical and lateral forces:
interradicular fibers
Transeptal fibers provide resistance to:
the separation of teeth
Circumferential fibers help maintain the tooth:
in position
Most coronal to teeth:
a) attached gingiva
b) MGJ
c) free gingiva
free gingiva
Valley-like depression of interproximal contact areas:
Gingival col
Most likely reason that gingivitis doesn’t progress to periodontitis:
Patient NOT susceptible
OTC fluoride = _____ ppm
1000
Saliva and gingival crevicular fluid make an intracellular matrix, what else contributes to it:
bacteria
Saliva, GCF, and bacteria all contribute to:
Intracellular matrix
Easily displaced with water:
Materia alba
T/F: Bacteria attaches to the acquired pellicle
True???
Used for caries detection & subgingival calculus detection:
Periodontal explorer
What instrument would you use to remove supragingival calculus off a posterior molar?
Posterior sickles scaler
What instrument is most likely to hurt the gingiva if used wrong?
Sickle scaler
When probing, how many measurements should you record per tooth?
6
Anaerobic glycolysis does what to the oral cavity?
Decreases the pH
What causes calculus to start forming subgingivally?
A patient had gingivitis and it did not turn to periodontitis, why is this?
Not a susceptible host
What is true about the free gingival groove?
Occurs in 50% of the population & something else
What has 12,300 ppm?
Acidulated phosphate fluoride
What tool would you use for generalized supragingival calculus, posterior maxillary sextant?
Posterior sickle scaler
Why does the color of the gingiva play a key role in evaluating the health of the gingiva?
vascular changes
What is NOT a function of the periodontal ligament fibers?
Attachment of cementum to the tooth
Cementum is NOT:
a) calcified connective tissue covering roots of teeth
b) continuously deposited in apical area of root throughout life
c) attach PDL to tooth
d) most mineralized of calcified tissues
d) most mineralized of calcified tissues
Not a function of the periodontal probe:
a) measure size of lesion
b) removal of calculus
c) bleeding on probe
d) overjet/overbite
b) removal of calculus
