Patient Management Flashcards
A patient is sitting in the chair immediately
following an extraction. She says, “Thank you.
That wasn’t as bad as I expected, but my sister
told me that the first night after having a tooth
pulled is very painful. What if the medication
you’re giving me isn’t strong enough?” Choose
the most appropriate response.
A. “Did she make you feel worried about that?”
B. “It sounds like you’re worried that you might not
have enough pain relief when you’re home.”
C. “I understand your concern.”
D. “Don’t worry. I’ll give you plenty of pain
medicine.”
E. “It sounds like your sister had a unusually bad
experience. Don’t believe what others tell you,
and certainly don’t let that worry you. You’ll be
fine.”
B. Of the options given, the best response would be
to interpret what the patient is trying to commu-
nicate and reflect the communication back to
him or her. This will gently encourage the patient
to openly express and discuss the concern with
the clinician. It also serves to establish an envi-
ronment of openness and acceptance.
During admission, a patient interrupts you on
a number of occasions with stories about past
dental experiences while you are attempting to
take a complete medical history. Your best
response would be _____.
A. Say nothing, listen to the patient, and finish your
intake as best you can.
B. Say, “I’d like to focus on your present
experience and right now I need to know your
medical history.”
C. Say, “It seems like you’ve had some important
experiences and I would like to hear more
about them, but first, let’s discuss this health
questionnaire before we address it, okay?”
D. Say, “I don’t need to know the details of your
dental history. Please inform me of the
experiences asked about in the questionnaire.”
E. Say, “We have about 30 minutes to complete
this questionnaire and get started in your
examination, so let’s focus on that.”
C. Of the options given, it is best to acknowledge
that the patient is trying to convey information that
is important to him or her and establish that there
will be a time to talk about those issues, while
gently redirecting him or her to the task at hand.
A 7-year-old child has a history of recurrent
pain and discomfort in a second molar, which
has a necrotic pulp. You present the treatment
options to the parents. “There are several ways
in which we can treat this problem. We could
do a pulpectomy in which we . . . . We could
do something called a pulpotomy, which
involves. . . . We could apply a pulp cap which
is . . . . We could remove the tooth. Or we could
leave the tooth untreated for now and see how
things go.” You have phrased the options so
that they are in what you believe to be the order
of descending desirability and you have
indicated that to the patient. Which option is
most likely to be chosen by the parents?
A. Pulpectomy
B. Pulpotomy
C. Pulp cap
D. Extraction
E. No treatment
A. When a number of alternatives are presented
and the first on the list is more desirable, there is
a tendency for individuals to select the first
option and view the successive options as less
desirable.
Which statement is false regarding motivation?
A. Motivation is strengthened when a person
succeeds and is weakened when a person fails
to achieve his/her goals.
B. Motivation is increased when the patient
focuses on long-term goals.
C. Motivating a patient can be achieved by
generating interest, showing your concern, and
providing information.
D. Encourage a sense of personal acceptance in
the face of the inevitable difficulties involved in
breaking old habits and establishing new ones.
E. Help a patient cope with relapses by
emphasizing the knowledge gained.
B. Focusing on long-term goals is not only a poor
motivator, it is often a pitfall in the effort to change
behavior, as patients are less motivated when goals
seem too big, impossible, or far from their current
circumstances.
Which statement is false about behavioral con-
tracts?
A. It is a legal and binding agreement between
health care professional and patient.
B. It helps solidify an agreement with a patient.
C. It should always be open to modification.
D. It helps clarify agreements.
E. The clinician should give a copy to thepatient
and keep one for himself or herself.
A. Although the behavioral contract is not a legal
document, it can be a useful approach in solidi-
fying behavioral strategies and goals.
A 6-year-old patient likes to tell you stories
about school. Each time he begins a story, you
stop working to listen. After three long sessions,
you realize that the child is attempting to avoid
or delay the dental work by telling stories. You
decide that from this point on you are going to
continue working while engaged in conversation
with the patient. At first, the child tells you more
stories about school and, further, tries other
strategies to get your attention and stop your
work. He eventually settles down and allows
you to work, whether or not you are engaged in
conversation. This is an example of _____.
A. Shaping
B. Extinction
C. Modeling
D. Stimulus control
E. Power
B. Extinction is the process of identifying all positive
reinforcements (in this case, the dentist ceasing
work on the child’s teeth) that maintain a behavior
and ceasing or withholding these.
Which of the following is not a factor in the
appraisal of stress?
A. Familiarity—how familiar the situation is; the
less familiar, the more stressful it may seem.
B. Predictability—how predictable the situation is;
the less predictable, the more stressful it may
seem.
C. Controllability—how controllable the situation
seems to be; the less controllable, the more
stressful it may seem.
D. Imminence—the more imminent the situation
is, the more stressful it may seem.
E. Positive or negative valence—whether the
situation is positive or negative; positive
situations (e.g., a wedding) are typically
experienced as less stressful than are negative
situations (e.g., a divorce).
E. Both positive and negative events or situations
are experienced as stress.
The substitution of a relaxation response for
an anxiety response (using a relaxation strat-
egy such as diaphragmatic breathing) when
one is exposed to a hierarchy of feared stimuli is called \_\_\_\_\_. A. Progressive muscle relaxation B. Habituation C. Flooding D. Systematic desensitization E. Biofeedback
D. Systematic desensitization is the process of sys-
tematically pairing a relaxation response with a
hierarchy of feared stimuli.
Which statement is false regarding the relation-
ship between pain and fear?
A. Fear initially inhibits pain due to a release of
endorphins from the pituitary, resulting in an
analgesic effect.
B. Although muscle tension contributes to the
experience of anxiety, it does not contribute to
the perception of pain.
C. Any autonomic activation causes one to have a
lower pain threshold.
D. Catastrophic thinking and a perceived lack of
control are common factors that influence pain
perceptions.
E. Misattribution occurs when patients identify an
event as painful because they can identify a
fearful stimulus.
B. Muscle tension is associated with the experience
of anxiety. Heightened anxiety contributes to
lower pain thresholds/sensitivity to the percep-
tion of pain.
Which of the following is an example of a cog-
nitive strategy that may be useful in pain man-
agement?
A. Address expectations by providing information
and addressing any questions and/or concerns.
B. Suggest to patients that they learn to identify,
evaluate, and eliminate maladaptive thinking.
C. Encourage patient efforts to address their
anxiety and pain management.
D. Suggest to patients that they learn to generate,
evaluate, and apply more realistic thinking.
E. All of the above.
E. All of the strategies listed may be considered
appropriate cognitive interventions in pain man-
agement.
- Which of the following scenarios is an example
of classical conditioning?
A. You teach a dentally-anxious patient
diaphragmatic breathing unconditional stimulus
(US), which naturally induces the physiological
relaxation response unconditional response
(UR). You seat that anxious patient in the dental
chair for an examination conditional stimulus
(CS) and ask them to use their breathing skills
during the exam (US). While using the breathing
skills, the patient will feel more relaxed
conditional response (CR).
B. You teach a dentally-anxious patient
diaphragmatic breathing (US), which naturally
induces the physiological relaxation response
(UR). You ask the patient to practice that
technique at home (CS) and also use it during
procedures to reduce the subjective experience
of anxiety (CR).
C. You teach a dentally-anxious patient
diaphragmatic breathing (US), which naturally
induces the physiological relaxation response
(UR). You seat that anxious patient in the dental
chair for an examination (CS) and ask them to
use their breathing skills during the exam (US).
The focus on breathing serves as a distraction
(US) from what the patient feels is threatening
and fearful (CR), and, therefore reports less
anxiety (CR).
D. You teach a dentally-anxious patient
diaphragmatic breathing (US), which naturally
induces the physiological relaxation response
(UR). You seat that anxious patient in the dental
chair for an examination (CS) and ask them to
use their breathing skills during the exam (US).
After a number of these experiences, the patient
will feel relaxed during the exam while using
the breathing technique (UR) and without using
it at all (CR).
E. None of the above.
D. Classical conditioning (also known as respondent
or Pavlovian conditioning) occurs when a neutral
stimulus, one that is not associated with a particular
response, is paired with an unconditioned stimulus
([US]; one that naturally elicits a particular
response [UR]). After a number of pairings, the
neutral stimulus (CS) elicits a conditioned response
(CR), which is essentially a weaker form of the UR)
without the presence of the US.
The best strategy for addressing dental fear
that is based upon distrust of the dentist is to
_____.
A. Use distraction techniques
B. Use cognitive coping strategies
C. Enhance informational and behavioral control
D. Teach diaphragmatic breathing
E. Reassure the patient that he or she can trust
you
C. Providing the patient with information and
control over his or her environment is likely to
contribute to increased trust over time. Avoiding
the issue of trust or providing reassurance that
the patient can trust you without evidence is
likely to maintain poor trust.
What behavior can you typically expect from
an anxious patient in the dental chair?
A. He or she is more likely to sit still, hands clasped
together.
B. He or she is more likely to sit casually, legs
crossed, reading a magazine.
C. He or she is more likely to keep to himself or
herself and not speak unless spoken to.
D. He or she is more likely to fidget in the chair,
moving his or her hands and feet.
E. Both A and C.
E. Contrary to their behavior in the waiting room,
anxious patients are typically more likely to sit
very still, often holding onto the arms of the den-
tal chair, and engage in minimal verbal commu-
nication unless encouraged by the clinician.
With no other intervention or instruction,
which is most likely to trigger a physiological
relaxation response?
A. Observing one’s own physiological responses
(e.g., heart rate, blood pressure)
B. Muscle tensing
C. Reassurance
D. Thought stopping
E. Diaphragmatic breathing
E. Diaphragmatic breathing naturally activates the
parasympathetic nervous system, producing a
relaxation response.
A 32-year-old male patient is fearful of receiv-
ing injections. You decide to use a cognitive
behavioral strategy with him to help him
through an injection. You have already
instructed him in diaphragmatic breathing and
ask him to practice this skill throughout the
procedure. First, you show him the syringe. You
talk about the characteristics of the needle.
You then place the needle in his mouth with the
cap on. Then, you simulate the procedure with
the cap on. You then simulate the procedure
with the cap off. Eventually, you proceed with
the injection. What does this procedure exem-
plify?
A. Habituation B. Cognitive control C. Flooding D. Systematic desensitization E. Behavior modification
D. Systematic desensitization is the systematic
process of exposing the patient to a hierarchy of
increasingly anxiety-provoking stimuli while the
patient uses relaxation skills such as diaphragmatic
breathing exercises.
Principles of operant conditioning teach us
that _____.
A. If you praise your 5-year-old patient and reward
him for keeping his legs still while you are
drilling, this will make the child happy and more
likely to like you and less likely to resist your
requests.
B. If you praise your 5-year-old patient and reward
him for keeping his legs still while you are
drilling, this will increase the likelihood that he
will remain still in similar situations in the future.
C. If you make the dental environment a child-
friendly place, your young patient will be more
comfortable.
D. If you pair the dental chair with having a parent
present, the child will be less likely to be
anxious.
E. None of the above.
B. Operant conditioning posits that behavior is
largely influenced by the consequences associ-
ated with the particular behavior.
According to anxiety disorders research, it has
been suggested that which of the following is
the most important component of systematic
desensitization?
A. Cognitive restructuring
B. Progressive muscle relaxation
C. Diaphragmatic breathing
D. Exposure
E. Psychoeducation
D. Research suggests that the most integral compo-
nent of the treatment of anxiety is exposure to
the feared stimulus.
Sarah S. is a young child who consistently pres-
ents as anxious, hypervigilant, and upset during
dental visits. Sarah is often accompanied by her
parent, who appears to be very concerned about
the child and wants to be involved at all times in
her evaluation and treatment. During this visit,
Sarah’s treatment requires an injection and a
rubber dam application, which you anticipate
may lead to increased anxiety. Which strategy
would be the least effective in completing the
rubber dam application?
A. Tell-Show-Do
B. Distraction
C. Ask the child to be a helper
D. Structure time
E. Rehearsals
B. Of the choices, distraction would most likely be
the least effective approach—the attention of a
very anxious individual cannot typically be easily
diverted. In such cases, distraction can have
detrimental effects such as compromising rap-
port and/or increasing anxiety by failing to pro-
vide a positive coping experience. Providing
education and coping strategies—increasing pre-
dictability, familiarity, and controllability—are
typically more effective strategies in working with
anxious patients.
Which of the following factors are involved in
the cognitive appraisal of a threat?
A. Interference, adaptability, longevity, and reactance
B. Adaptability, preventability, inevitability, and
constancy
C. Controllability, familiarity, predictability, and
imminence
D. Validity, reliability, adaptability, and predictability
E. Accountability, reliability, validity, and familiarity
C. Controllability, familiarity, predictability, and
imminence are significant factors influencing the
cognitive appraisal of stress.
A patient has difficulty inhibiting the gag reflex
during x-ray procedures. You suggest that the
patient take several x-ray packets home and pra-
ctice holding the packets in his or her mouth for
increasingly longer periods of time. Which of the
following techniques does this best exemplify?
A. Reinforcement
B. Graded exposure
C. Modeling
D. Behavioral control
E. Systematic desensitization
B. Graded exposure is the systematic process of
exposing the patient to a hierarchy of increas-
ingly anxiety-provoking stimuli.
When faced with a frightened child patient,
which would be the most appropriate or most
effective response?
A. Ask the child about his or her fears.
B. Reschedule the appointment for a later date.
C. Reassure the child.
D. Tell the child that dentistry shouldn’t be frightening.
E. Chastise the child.
A. Asking the child about his or her fears will create
an environment in which the child is encouraged
to discuss any worries or concerns and to ask
questions. This will also serve to alleviate anxiety,
provide an opportunity to correct any mispercep-
tions regarding dentistry, and to further establish
or maintain trust and rapport.
Research suggests that life events and per-
ceived stress/distress _____ predictors of self-
reported health concerns.
A. Are B. Are not C. Are sometimes D. Have little to do with E. None of the above
A. Perceived stress and distress in one’s life has
been demonstrated to be a significant predictor
(positively correlated) with self-reported health
concerns.
Patients experiencing stress and anxiety typi-
cally require _____ interpersonal distance for
comfortable interaction. A. Greater B. Less C. The same as patients who are not experiencing stress and anxiety D. Individualized E. Behaviorally controlled
A. Patients who are experiencing stress and anxiety
typically feel more comfortable in having greater
interpersonal space than they normally would
when not experiencing stress and anxiety.
Which statement is true about the use of
silence as an interviewing technique?
A. It permits and encourages patient participation.
B. It is a nonverbal technique for showing interest
in the patient.
C. It is a nonverbal technique for encouraging the
patient to speak.
D. It is done by silently attending to the patient,
while maintaining eye contact.
E. All of the above.
E. The use of silence can be a useful technique to
encourage patient comment following a state-
ment or question posed to the patient.
How do people typically respond to stress?
A. Physiologically (fight-or-flight response; i.e.,
autonomic arousal)
B. Cognitively (beliefs of self-efficacy, stress
appraisal)
C. Behaviorally (e.g., disturbed sleep/appetite,
impaired attention, acting out)
D. Emotionally (e.g., anxiety, anger, fear)
E. All of the above
E. Individuals respond to stress physiologically,
behaviorally, cognitively, and emotionally.
Which of the following indices is not reversible? A. DMFT B. GI C. PI D. OHI-S E. None of the above
A. Periodontal disease (measured by the PI) and
gingival disease, measured by the GI, are
reversible processes. The amount of the debris
and calculus, measured by the OHI-S, can
decrease too. Caries is not a reversible process.
The recommended level of fluoride for commu-
nity water supply systems in the United States
ranges from \_\_\_\_\_. A. 0.2–0.5 ppm B. 0.7–1.2 mL C. 1.2–1.5 ppm D. 0.2–0.5 mL E. 0.7–1.2 ppm
E. The recommended level of fluoride for a com-
munity water supply in the United States ranges
from 0.7 to 1.2 ppm of fluoride, depending on the
mean maximum daily air temperature over a
5-year period. Thus, in a warm climate the fluo-
ride level would be lower and in a cold climate it
would be higher. In the United States, most com-
munities are fluoridated at approximately 1 ppm,
which is equivalent to 1.0 mg of fluoride per liter
of water.
The supplemental fluoride daily dosage sched-
ule for a 5-year-old child who lives in a commu-
nity where the concentration of fluoride in the
drinking water is less than 0.3 ppm is \_\_\_\_\_. A. 0 mg B. 0.10 mg C. 0.25 mg D. 0.50 mg E. 1 mg
D. Physicians and dentists can help prevent fluorosis
by prescribing dietary fluoride supplements
according to the Supplemental Fluoride Dosage
Schedule recommended by the ADA Council on
Scientific Affairs.
What type of epidemiology is primarily used in intervention studies? A. Descriptive B. Analytical C. Observational D. Experimental E. None of the above
D. Experimental epidemiology is used primarily in
intervention studies. Once etiology for a particu-
lar disease has been determined, the researchers will try to establish the effectiveness of a particu-
lar program of prevention or therapy. Descriptive
epidemiology is used to quantify disease status in
a community. Analytical epidemiology, also
called observational epidemiology, is used to
determine the etiology of a disease.
A researcher follows a group of individuals in
a population over 10 years to determine who
develops cancer, and then evaluates the factors
that affected the group. What type of study is
this?
A. Cross-sectional
B. Case control
C. Randomized
D. Prospective cohort
E. Retrospective cohort
D. In this case, the investigator chooses or defines a
sample of subjects who do not yet have the out-
come of interest: cancer. He or she measures risk
factors in each subject (such as habits that may
predict the subsequent outcome) and follows
these subjects with periodic surveys or examina-
tions to detect the outcome(s) of interest.
A group of researchers undertook a study to
assess the relationship between squamous cell
carcinoma and chewing tobacco. The resear-
chers determined past exposure records among
subjects who had been diagnosed with the dis-
ease. This type of study was a _____.
A. Clinical trial B. Community trial C. Retrospective cohort study D. Case control study E. Randomized clinical trial
C. In a retrospective cohort study, the investigator
chooses a sample of individuals who have the
outcome of interest (in this case, squamous cell
carcinoma) and then look into the past for possi-
ble variables that may have caused the disease
(e.g., chewing tobacco).
The following part of a scientific article sum-
marizes the background and focus of the study,
the population sampled, and the experimental design, findings, and conclusion. A. Introduction B. Background C. Literature review D. Methods E. Abstract
E. The abstract allows the reader to determine
whether the study is of interest. The abstract usu-
ally appears at the head of the article and is
reproduced in the literature database.
In this section of a scientific article, the resear-
cher interprets and explains the results obtained.
A. Summary and conclusion B. Results C. Discussion D. Abstract E. None of the above
C. In the results section the researcher describes the
specific findings and actual outcomes of the project
but does not interpret them. The interpretation and
analysis of the results are part of the discussion,
where the researcher attempts to explain his
results.
The following were the scores for six dental stu-
dents in their Restorative Dentistry exam: 56, 64,
68, 46, 82, 86. Therefore, the median is \_\_\_\_\_. A. 68 B. 64 C. 67 D. 40 E. 66
E. The median is the middle of a distribution: half the
scores are above the median and half are below
the median. The median is less sensitive to
extreme scores than the mean, making it a better
measure than the mean for highly skewed
distributions. For instance, the median income of
a population is usually more informative than the
mean income.
When there is an even number of numbers,
the median is the mean of the two middle num-
bers. Thus, in this case the median is (64 + 68)/2
= 66.
A correlation analysis shows that as the income
of the population increases, the number of deca-
yed teeth decreases. Therefore, an expected value
for this correlation coefficient (r) would be \_\_\_\_\_. A. 0 B. 1 C. −1 D. 2 E. −2
C. The correlation coefficient (r) quantifies the rela-
tionship between variables (x and y). A positive
correlation coefficient indicates that the variables
increase in the same direction; a negative correla-
tion coefficient indicates that the variables vary in
opposite directions. The correlation coefficient
ranges from −1 to +1.
A test result that erroneously excludes an indi-
vidual from a specific diagnostic or reference
group is called \_\_\_\_\_. A. Erroneous B. False positive C. False negative D. Mistaken E. None of the above
C. A false positive test is a test result which erro-
neously assigns an individual to a specific diag-
nostic or reference group.
Which of the following statements about trans-
missible diseases is false?
A. The risk of transmission after percutaneous
injury is higher for HBV than for HIV.
B. HCV and HIV are both caused by an RNA virus.
C. A vaccine to immunize against HBV is available.
D. The average risk of infection for HBV after a
needlestick injury falls between HCV and HIV.
E. All of the above.
D. The average risk of infection for HBV after a
needlestick injury does not fall between HCV and
HIV. For HBV, the risk of transmission after
percutaneous injury is 30%; this figure is 1.8% for
HCV and 0.3% for HIV.
In HIV diagnosis, the Western blot assay is
used to confirm the results of a positive ELISA
test. Therefore, we can say that the Western
blot test will confirm a _____.
A. True-positive result
B. True-negative result
C. False-positive result
D. False-negative result
E. None of the above
A. Very specific tests are appropriate for confirming
the existence of a disease. If the result of a highly
specific test is positive, the disease is almost cer-
tain. High specificity is required in situations where the consequences of a false-positive
diagnosis are serious or unduly alarming (e.g.,
HIV positivity).
Which of the following statement(s) about the
hepatitis B vaccination is(are) true?
A. HBV vaccine must be offered to all potentially
exposed dental workers.
B. The HBV vaccine must be free to all potentially
exposed dental workers.
C. At the time of employment, each person should
be asked to provide documentation of previous
immunizations.
D. Three doses are given to confer immunity.
E. All of the above.
E. All of these measures help ensure the safety of
dental personnel.
Which of the following terms refers specifically
to the process where an antimicrobial agent
destroys (germicide) or avoids the growth
(microbiostatic) of pathogenic microorganisms
on inanimate surfaces?
A. Antisepsis
B. Microbacterial control
C. Sterilization
D. Disinfection
E. Asepsis
D. Disinfection refers only to the inhibition or destru-
ction of pathogens. Spores are not killed during
disinfection procedures. By custom, the term
disinfection is reserved for chemicals applied to
inanimate surfaces, and the word antiseptic is
used for antimicrobial agents that are applied to
living tissues.
Which of the following is the most common method of sterilization? A. Dry heat B. Ethylene oxide C. Glutaraldehyde at 2% D. Autoclave E. Chemi-clave
D. The proper time and temperature for autoclaving is
250 ̊ F (121 ̊ C) for 15 to 20 minutes, which
yields 15 pounds pressure of steam, or 270 ̊ F
(134 ̊ C) for a minimum of 3 minutes, which
yields 30 pounds pressure of steam. Moist heat
destroys bacteria—denaturation of the high-
protein-containing bacteria.
A set of precautions designed to prevent trans-
mission of HIV, HBV, and other bloodborne
pathogens when providing first aid or health care is known as \_\_\_\_\_. A. Asepsis B. Infection control C. Sterilization D. Disinfection E. Standard infection control procedures
E. A thorough medical history, physical examination,
and laboratory tests will not always detect patients
who are carriers of infectious diseases. Therefore,
you must assume that all patients are infected with
HIV, HBV, or other bloodborne pathogens. Similar
infection control procedures must be used for all
patients, regardless of their medical history or the
type of treatment to be performed.
Which of the following chemical agents is not a disinfectant? A. Iodophors B. Sodium hypochlorite C. Synthetic phenol D. Isopropyl alcohol E. Glutaraldehyde
D. Alcohol is not an accepted disinfectant. Alcohol
evaporates too quickly to be an effective disin-
fectant. The term disinfection is reserved for
chemicals applied to inanimate surfaces, and
the word antiseptic is used for antimicrobial agents
(such as alcohol) that are applied to living tissues.
Which of the following recommendations must
be followed when handling mercury?
A. Train personnel involved in the handling of
mercury
B. Work in properly ventilated areas
C. Use high-volume evacuation systems when
finishing or removing amalgams
D. Avoid direct skin contact with the metal
E. All of the above
E. Mercury can be absorbed through the skin as
well as absorbed by inhalation. Safe handling,
resulting in part from proper training, helps
reduce the risk of exposure.
According to the CDC, the acceptable water
quality in a dental office should be _____.
A. < 125 CFU/mL
B. < 250 CFU/mL
C. < 500 CFU/mL
D. < 750 CFU/mL
E. < 1000 CFU/mL
C. The CDC recommends, at a minimum to meet
nationally recognized drinking water standards,
less than 500 colony-forming units (CFUs) of het-
erotrophic bacteria per milliliter. In 1995, the ADA
addressed the dental water concern by asking
manufacturers to provide equipment with the
ability to deliver treatment water with < 200
CFU/ml of unfiltered output from waterlines.
Which of the following ADA’s Principles of
Ethics states that a dentist has a duty to
respect the patient’s right to self-determination
and confidentiality?
A. Patient Autonomy
B. Nonmaleficence
C. Beneficence
D. Justice
E. Veracity
A. There are five principles in the ADA Principles of
Ethics:
● Patient Autonomy (“self-governance”). The
dentist has a duty to respect the patient’s rights to
self-determination and confidentiality.
● Nonmaleficence (“do no harm”). The dentist
has a duty to refrain from harming the patient.
● Beneficence (“do good”). The dentist has a
duty to promote the patient’s welfare.
● Justice (“fairness”). The dentist has a duty to
treat people fairly.
● Veracity (“truthfulness”). The dentist has a duty
to communicate truthfully.
Which of the following are characteristics of proper documentation in a dental record? A. Specific B. Objective C. Complete D. Timely E. All of the above
E. Being specific helps to avoid misinterpretation of
reports. Being objective provides the basis for
accuracy in describing events. Being complete
provides the basis for a thorough review of the facts
when reviewing the report. Being timely ensures
the best opportunity to recall all relevant events.
Which of the following is an arrangement
between a plan and a group of dentists
whereby the providers agree to accept certain
payments (usually less than their usual fees) in
anticipation of a higher volume of patients?
A. PPO
B. Capitation
C. HMO
D. IPA
E. None of the above
A. Capitation is a payment mechanism whereby the
dentist is paid a fixed amount irrespective of the
number of patients seen or services provided.
Health Maintenance Organizations (HMOs) are
also called capitation plans because of the pay-
ment mechanism they use. An Individual Practice
Association is a type of plan that combines the risk
of capitation with fee for service reimbursement.
Which of the following agencies monitors and
prevents disease outbreaks, implements dis-
ease prevention strategies, and maintains
national health statistics? A. CDC B. FDA C. DEA D. IHS E. None of the above
A. CDC is correct. The U.S. Food and Drug
Administration (FDA) is responsible for protecting
the health of the nation against impure and unsafe
foods, drugs, cosmetics, and other potential
hazards. The Drug Enforcement Administration
(DEA) determines the levels of controlled
substances that have abuse potential. The Indian
Health Services (IHS) focuses on the goal of raising
the health status of Native Americans and Native
Alaskans.
Which of the following federal agencies is the
U.S. government’s principal agency for protect-
ing the health of all Americans and providing
essential human services? A. DHHS B. NIH C. HRSA D. AHRQ E. None of the above
A. The DHHS is the U.S. government’s principal
agency for protecting the health of all Americans
and providing essential human services. DHHS
includes 11 agencies and more than 300 pro-
grams. The agencies listed in the answers are
part of the DHHS. The National Institutes of
Health (NIH) is the world’s premier medical
research organization. The Health Resources and
Services Administration (HRSA) provides access
to essential health care services for people who
are low-income, uninsured, or who live in rural
areas or urban neighborhoods where health care
is scarce. The Agency for Healthcare Research
and Quality (AHRQ) supports research on health
care systems, health care quality and cost issues,
access to health care, and effectiveness of med-
ical treatments.
Empathic understanding reflects which of the
following characteristics?
A. It accurately reflects others’ feelings.
B. It connects the feelings to concrete circumstances
that are likely to be causing the feelings.
C. It accepts the feelings as real and important.
D. It is nonjudgmental: it does not compromise the
listener’s objectivity.
E. All of the above.
E. The use of empathy serves a number of purposes,
including all of the choices given.
A 14-year-old male patient has significant plaque
build-up and one cavity. Upon inquiry, the
patient tells you that he brushes his teeth about
once a day and does not floss because it is
difficult and too time-consuming. Which of the
following would likely be the least effective way
to address his oral hygiene practices and get
him to improve his oral self-care?
A. Educate him regarding the ways in which he can
improve his oral hygiene and avoid dental
problems in the future.
B. Use a collaborative relationship to arrange for
modification of consequences.
C. Use the Premack principle.
D. Set up a behavioral contract.
E. Set up a system of positive reinforcers.
A. Although education is an essential component of
patient care overall, research indicates that, in an
effort to influence behavior change, education
alone is not nearly as effective as behavioral
intervention.
A 20-year-old woman has significant plaque
build-up. Upon inquiry, she tells you that she
brushes twice daily and flosses daily. You
determine that the patient should be educated
about optimal brushing procedures. Which
strategy might you first use in a series of steps
for improving her brushing skills?
A. Demonstrate your recommended brushing
practices.
B. Explain to her good brushing technique.
C. Tell her you don’t believe she brushes twice daily.
D. Ask her to demonstrate her teeth brushing.
E. Clean her teeth.
D. In order to initiate behavior change, one must
first fully assess the behavior. In this case, in
order to address the patient’s inadequate brush-
ing technique one should observe the patient
engaging in the behavior in order to identify the
strengths and weaknesses of the process.
Which of the following statements is false
regarding behavior change?
A. Goals are long-term targets, whereas objectives
are reachable steps/goals along the way.
B. Shaping is a behavior change strategy in which
the patient learns though the dental professional’s
demonstration of the desired behavior.
C. The basic behavioral model consists of
antecedents, behaviors, and consequences.
D. Some consequences will strengthen a behavior
whereas others will weaken it.
E. Generally, the consequences of today’s behavior
will affect the way in which we behave tomorrow.
B. This is an example of modeling. Shaping is the
process of achieving successive approximations
toward a desired behavior.
You need to inject a local anesthetic for a
10-year-old patient. You note that this patient
appears to be very anxious and frequently asks
what you are doing or are about to do. To which
technique is the patient least likely to respond
well?
A. Distraction.
B. Taking a few deep breaths.
C. Bringing his mother in the room for reassurance.
D. Provide him with age-appropriate information
about the injection.
E. Give the patient an amount of time (how long it
will take) and ask him to count.
A. Distraction is not typically a very effective tech-
nique for very anxious patients.
Which statement is false regarding child pain
management?
A. It is recommended that a dentist provide specific
direction and praise for cooperation.
B. Children do not have a fully developed sense of
time; therefore, it is recommended that one use
more concrete measures of time such as counting
or a visible timer (e.g., egg timer).
C. The Tell-Show-Do technique is no longer
recommended since it has been demonstrated to
increase anxiety and reports of pain during
treatments.
D. In order to enhance the sense of control, it is
recommended that one establish a hand signal
signifying distress and a desire for the dentist to
stop or take a break.
E. Once a child begins to complain about poor pain
control, the chances of having a successful visit
drop dramatically.
C. The Tell-Show-Do method, in which the clinician
explains, demonstrates, and allows a child (or an
adult patient) to learn and understand what will
be happening before proceeding, contributes to
decreased self-reports of anxiety and pain.
What behavior can you typically expect from an
anxious patient in the waiting room?
A. He or she is more likely to sit still, hands clasped
together.
B. He or she is more likely to sit casually, legs
crossed, reading a magazine.
C. He or she is more likely to keep to himself or
herself and not speak unless spoken to.
D. He or she is more likely to fidget in the chair,
moving his or her hands and feet.
E. Both A and C.
D. Anxious patients are typically more likely to fidget
in their chairs, unable to focus on a task such as
reading or relaxing in the waiting room.
What is the most likely consequence of the
avoidance of a feared stimulus?
A. Reinforcement of the associated anxiety.
B. Habituation to the stimulus.
C. Decreased anxiety in response to the stimulus.
D. Learned helplessness.
E. Increased coping resources.
A. Avoidance of a feared stimulus inadvertently rein-
forces the anxiety reaction, thereby maintaining
the associated anxiety.
The first time you perform a complicated dental
procedure, you feel uncomfortable and nervous.
At one point, you even think for a moment that
you will not be able to complete the procedure.
However, you stay with it, and near the end of
the procedure you feel much better. Which
concept does this best exemplify?
A. Covert conditioning
B. Systematic desensitization
C. Habituation
D. Cognitive restructuring
E. Psychoeducation
C. Habituation is the decrease in response that
occurs as a result of repeated or prolonged expo-
sure to a conditioned stimulus.
During a previous dental visit, you assisted a
patient by generating his statement, “Even if
there is some pain, it will be brief. I have ways
to cope and I’ve done well using them.” The
patient will remind himself of this during future
dental procedures. This patient’s statement
exemplifies which of the following strategies?
A. Rational response
B. Self-efficacy induction
C. Relaxation statement
D. Imagery
E. Systematic desensitization
A. A rational response is a cognitive therapy tech-
nique in which the patient develops (with or
without assistance) a more adaptive thought or
statement as a means of coping.
In clinical practice, you frequently see young
patients who are nervous about seeing the
dentist. Knowing which factors are important
influences on young patients’ comfort, you
consider which of the following to help your
patients to feel more comfortable?
A. Inviting a parent into the operatory for support.
B. Placing toys and children’s books in the waiting
room.
C. Hanging child-friendly décor in the operatory.
D. Talking to the child about his or her interests
before beginning your work.
E. All of the above.
E. Creating a child-oriented environment (e.g., hav-
ing toys and books in the waiting room, hanging
pictures on the wall and/or ceiling that a child
would find interesting), conveying interest in the
child by asking about their interests, and having
the parent present are all variables that may put
child patients more at ease.
Dental intervention studies suggest that educating patients regarding dental care (patient education) is more effective than behavioral modification (behavioral intervention) in increasing compliance. A. True. B. False. C. Sometimes. D. Both are equally effective. E. Cannot be determined.
B. Research has demonstrated that behavioral inter-
vention is typically more effective than patient
education alone. A combination of the two is
considered the most effective approach to
increasing patient compliance.
Which technique is typically not useful in
treating the anxious patient?
A. Using less structure in establishing rapport.
B. Reassuring the patient by telling the patient not to
worry.
C. Providing reasons before asking for sensitive
information.
D. Using empathy.
E. Making expectations clear.
B. Clinicians should use caution in providing pre-
mature reassurance because, if the outcomes
are inconsistent with what the clinician asserted,
trust and rapport may be compromised.
The most common site for oral cancers in the oral cavity is \_\_\_\_\_. A. Lip B. Soft palate C. Hard palate D. Tongue E. Tonsils
D. The tongue is the most common place for inci-
dent cancers in the oral cavity.
The most effective method to prevent caries on the occlusal surfaces among school-age children is \_\_\_\_\_. A. Sealants B. Community water fluoridation C. School dietary fluoride D. School fluoride mouth rinse E. School fluoridation
A. Sealants. Community water fluoridation is the
most cost-effective and economical method to
prevent dental caries. However, fluoride is
believed to be the least effective on the occlusal
surface. Most decay among school children
occurs on the chewing surfaces’ pits and surfaces.
In this type of study design, neither the subject nor the investigator knows to which group a subject belongs. A. Matching studies B. Randomized C. Double-blind D. Single-blind E. None of the above
C. Double-blind designs help prevent the potential
for a biased interpretation of a treatment effect
that might occur if either the investigator or sub-
jects know to which group the latter belong.
The following component of a scientific article provides the reader with detailed information regarding the study design. A. Introduction B. Background C. Literature review D. Methods E. Abstract
D. The Methods section organizes the research
paper and allows the reader to assess the validity
of the study and the reliability of the measures.
This section should provide the reader with spe-
cific and detailed information regarding how the
study was conducted. Based on this information,
the reader should be able to replicate the study.
The variance for data set A is 25 and for data
set B is 9. Therefore, we can conclude _____.
A. There are more items in data set A than data set B
B. The mean of data set B is smaller than the mean
for data set A
C. The items in data set A are more widely spread
about the mean value than in data set B
D. The standard deviation for data set B is larger
than for data set A
E. None of the above
C. The variance determines the way individual val-
ues are located around the mean. The larger
the variance, the more widely the data items
are spread about the mean value. Variance is
measured in squared units (s2).
The standard deviation is the square root of the
variance. The mean is expressed in the same units as the data items, but the variance is
expressed in squared units. Thus, the standard
deviation measures the average deviation from
the mean in the same units as the mean.
What route of transmission is a needlestick injury of infectious disease? A. Direct contact B. Indirect contact C. Accidental contact D. Parenteral contact E. Droplets
D. Parenteral contact is defined as the transmission
of pathogenic microorganisms by piercing the
skin or mucous membrane (e.g., intravenous,
subcutaneous, intramuscular) by an accidental
or intentional stick with a needle or other sharp
instrument that is contaminated with blood or
other body fluid.
Which of the following is/are recommendations
for the use of masks?
A. Use whenever aerosols or spatter may be
generated.
B. A new mask should be worn for each patient.
C. Masks should be changed at least once every
hour.
D. Masks should be changed more frequently in the
presence of heavy aerosol contamination.
E. All of the above.
E. Masks that cover the mouth and nose reduce
inhalation of potentially infectious aerosol parti-
cles. They also protect the mucous membranes
of the mouth and nose from direct contamina-
tion. Masks should be worn whenever aerosols
or spatter may be generated.
If a mask is worn longer than 20 minutes in an
aerosol environment, the outside surface of the
mask becomes a nidus of pathogenic bacteria
rather than a barrier. It is recommended that a
new mask be worn for each patient and that
masks be changed routinely at least once every
hour and more often in the presence of heavy
aerosol contamination.
The following definition refers specifically to the
process in which an antimicrobial agent
destroys (germicide) or inhibits the growth
(microbiostatic) of pathogenic microorganisms
on inanimate surfaces.
A. Antisepsis
B. Microbacterial control
C. Sterilization
D. Disinfection
E. Asepsis
D. Disinfection refers only to the inhibition or
destruction of pathogens. Spores are not killed
during disinfection procedures. By custom, the
term disinfection is reserved for chemicals
applied to inanimate surfaces, and the term anti-
septic is used for antimicrobial agents that are
applied to living tissues.
The following biological test is used to check the
effectiveness of the sterilization process.
A. Spore test
B. Total bacterial count test
C. Aseptic test
D. EPA test
E. Disinfection test
A. The spore test is a biological monitor. The
process consists of placing into the autoclave
bacterial spores on strips or in envelopes along
with a normal instrument load. If the autoclave is
working properly, the autoclave reaches the tem-
perature and pressure to kill the spores. Spore
testing must be conducted weekly.
Which of the following are guidelines for disinfectants used in dental practice? A. Have an EPA registration number. B. Kill the Mycobacterium tuberculosis. C. Have an ADA seal of approval. D. Must be used according to guidelines. E. All of the above.
E. A disinfectant should be able to kill the
Mycobacterium tuberculosis. This is the bench-
mark organism for disinfectants. It is much
harder to kill than most bacteria, viruses, fungi,
and protozoa. This resistance is partially due to
the waxy cell wall of Mycobacterium.
Which of the following statements about material
safety data sheets (MSDSs) is/are correct?
A. Employees have the right to know about on-
the-job hazards.
B. The MSDSs help to protect employees.
C. An MSDS contains information on hazardous
materials, substance, and wastes.
D. The MSDS describes chemical hazards and how
to work with the chemical safely.
E. All of the above.
E. The Material Safety Data Sheet (MSDS) is an easy
reference for information on hazardous sub-
stances. The MSDS must be “readily accessible”
to workers exposed to hazardous substances.
The MSDS provides information on hazardous
materials, substances, and wastes. Chemical
manufacturers develop and provide an MSDS for
each hazardous product. The distributor is
responsible for getting MSDSs to employers. At
least one copy of the MSDS should be maintained
with the chemical.
Some dental plans allow the dentist to charge
the patient any difference between what the plan
agrees to pay and the dentist’s UCR (usual,
customary, reasonable) fees. This arrangement
is called _____.
A. Payment differential
B. Balance billing
C. Prospective reimbursement
D. Managed care
E. None of the above
B. Balance billing. Prospective reimbursement is a
mechanism in which the dentist is compen-
sated before treatment is provided (i.e., in capi-
tation systems). Managed Care is an
arrangement in which a third party mediates
between providers and patients negotiating
reimbursement for certain services and over-
seeing the treatments delivered.
when is recommended to fluoridate public water?
when levels < 0.7 mg/dL
what can fluorine inhibit
enzyme phosphatase at 20-40mg/day (Ca metabolism)
what can fluorine do at higher doses
40-70 heartburn and pain in extremities
tx for F toxicity
Ca
which surfaces benefit most from F
proximal and smooth
gretatest concentration of F
outer enamel
concentration of F in school water
~1ppm (4.5x city level)
excretion of F
kidney, urine, sweat, up to 3mg/day
optimal water F
0.7-1.2 ppm
cariostatic effect of F at which stage
calcification
toothpaste F concentration
1100 ppm
F toxicity
adults 4-5g
child lethal dose 15 mg/kg
How many mg of fluoride in 1 L of water at 1 ppm:
1 mg
Patient has 1 ppm fluoride in water. What is that equal to in mg/L?
1mg/L
What ion gets replaced in hydroxyapatite by fluoride?
Hydroxyl
least soluble -
fluorapatite
F- on collagen
breaks it down
is bacteriocidal, fluoroapetite is more resistant to acid attack, decreases solubility of enamel,
excreted by kidneys, helps remineralize
Fluoride helps prevent caries in all ways except?
lower pH of the oral cavity
Where does fluoride localize/accumulates?
Outer enamel
Fluorosis does what?
Inhibits remineralization
Fluorosis does what –
inhibits remineralization (irreversible) - Fluoride induces enamel hypoplasia (hypocalification), which is a characteristic of fluorosis that is caries resistant.
fluoride on dental plaque
no effect
How do you determine the severity of fluorosis?
Look at the two worst teeth?
- Higher the fluoride level, greater degree of enamel change
ADA recommends to apply in-office fluoride foam for how long?
4 minutes
How many minutes do you place neutral sodium fluoride tray on teeth?
4 minutes
Floride supplementation is effective in: everybody, only kids, anyone but most beneficial to children.
anyone but most beneficial to children.
At what age should supplemental fluoride be started?
6 months
Minimum fluoride age?
6 months
What age does fluoride get incorporate into primary dentition?
4 months in utero
At what age does fluorosis of anterior permanent teeth occur? 4-6mo, 0-4mo, 1year, 2years and 6 years)
4-6mo
Fluoride is given to children in schools usually by rinse with what concentration? 0.05 daily, 0.2 daily, 0.05 weekly, 0.2 weekly
0.2 weekly
How do they administer Fluoride in schools?
0.2% Fluoride rinse 1x week
What happens when a kid with primary teeth ingests fluoride?
It affects their permanent teeth.
The drinking water supply of a community has a natural F level of 0.6 ppm. The F level is raised by 0.4ppm. Tooth decay is expected
to decrease by what % after 7 years?
40%
The usual metabolic path of ingested fluoride primarily involves urinary excretion with remaining portion in?
skeletal tissue
Where is the biggest storage of fluoride in tissues?
Skeletal tissues
Where does fluoride work the best?
interproximal and smooth surfaces
What is least likely to cause baby bottle caries?
a. Breast milk at night
b. Formula made with fluoridated water
c. Water with no fluoride
d. juice
c. Water with no fluoride
Early Childhood Caries (ECC) are cause by all at night except?
- bottle feeding with formula with fluoridated water
- breast feeding
- sippy cup with OJ
- bottle feeding with processed water with no fluoride
bottle feeding with processed water with no fluoride
ECC (early childhood caries) is usually in what location?
a. Max incisors and molars
b. Man incisor and molars
c. Max canine
d. Man canine and molar
a. Max incisors and molars
- Primary max incisors (B&L), then primary molars, mandibular unaffected bc tongue blocks
What determines fluoride supplementation for a city -
temperature
Usual/recommended water fluoridation-
0.7 ppm
The appropriate/optimal amount of fluoride in the community water:
0.75-1.2 ppm
What percentage of Americans have public fluoride in water: 66%, 85%,
66
- CDC 2010 reports Americans have 79.6% water fluoridation
What is percentage of community water fluoridation- 67, 85, 35
67
Fluoridation for water: effectiveness: early studies showed that it prevents 50%-70% of caries in permanent teeth, however
currently the effectiveness is
20%-40%
Effectiveness of Water fluoridation in the U.S. is
20%-40%
Fluoridation: daily use of tablet cause __ in new carious lesions
30% reduction
Pt has a white discoloration with no sensitivity near cervical region of #29, what do you do? fill, 5% fluoride, do nothing
5% fluoride
What type of fluoride is in water? fluorosilicic acid, sodium fluorosilicate, and sodium
fluoride
fluorosilicic acid,
(hydrofluorosilicate) – most commonly used
Types of Fluoride used in toothpaste: sodium fluoride, Stannous fluoride, sodium monofluorophosphate
Stannous fluoride (most effective) - Stannous fluoride may stain.
What mouthwash is good for children with caries to rinse with?
Sodium Fluoride (NaF)
What rinse is used at home for developmental disabled child to reduce of plaque? NaF, stannous fluoride, chlorohexidine
chlorohexidine
Which type of fluoride is not in toothpaste?
Acidulated fluoride
What fluoride toothpaste should not be used in a patient with multiple porcelain crowns?
Acidulated
What’s the concentration of acidulated phosphate fluoride is used in the dental office?
1.23%
Dentist places sodium fluoride on patient with GI fillings rather than acidulated fluoride because
– acid of fluoride will wear away
at GI.
What fluoride tx would you used in a pt with amalgams, PFM’s, composite restorations, implants?
1.1% NaF
Which one is not useful in managing caries in elderly?
Use of 1.1% fluoride as a standard of care
2.2 mg NaF how much F-
1 mg
A 2 y/o child has injested 20mg fluoride pill. What will likely happen? coma, nausea, renal failure, cardiac arrest
nausea
How much fluoridation supplement would you give to a 5 y/o drinking 0.75ppm F in their water?
0 ppm
3 y/o patient lives in area with 0.4 ppm fluoride. How much do you supplement?
0 ppm
4 yrs old patient lives in community w/ 0.25 ppm fluoride intake, what do you give? Give her systemic fluoride (0.5 mg/day) Apply fluoride Change diet to more fluoride intake Prescription fluoride rinse
Give her systemic fluoride (0.5 mg/day)
4 y/o pt with 0.4 ppm fluoride Supplement?
0.25mg/day
4.5 y/o child with 0.75ppm fluoride in their water requires how much fluoride to be supplement?
0 mg
7-year-old patient has no fluoride in drinking water. What do you give them systemically…? 5 mg, 1 mg, 0.25 mg
1 mg
7-year-old child lives in area with 0.2 ppm fluoridated water, what do you supplement?
1.0 mg/day
Supplementation for 10-year-old with no other fluoride source? 1 mg/day or 1 mg/week?
1 mg/day
Diabetes, can you place implant if HbA1c = 8:
No, refer to physician
Pt with hemoglobin A1C of 12%. Pt just visited the MD, what kind of TX we can do?
Consult with an MD prior to tx
Time management of diabetic patient:
Treat diabetic patient 2 hours after eating & taking insulin.
Kidney dialysis: best to do tx when
day after dialysis or inbtwn days of dialysis
give OJ
Do NOT give more insulin, blood sugar is already low enough. Give OJ.
Pt is a child and is diabetic undergoes hypoglycemia in the chair
if conscious give him orange juice (unconscious give him 50%
dextrose IV)
Child goes into insulin shock in the chair (hypoglycemia)
a. gives OJ
b. ask parent to give kid insulin shot
gives OJ
Unconscious diabetic is treated with:
50% dextrose in IV.
IV sedation for DIABETICS:
Schedule in the morning.
- If insulin-dependent, have them not eat, not take short acting insulin and take half dose of long acting insulin.
- If not dependent, no food and no meds until after the surgery.
Patient is a non-insulin dependent diabetic & needs minor oral surgery w/ IV sedation. What should he do?
clear-liquids and regular
dose of diabetes meds.
- Minor surgery: normal as long as procedure occurs within 2 hours of eating and taking meds.
Pt with insulin dependent diabetes & having sedation IV and LA. Ask the pt to take: high calorie food with insulin, low calorie food
with insulin
low calorie food with insulin (reduce dose of insulin and no food)
5 principles of ethics
Beneficence- “Do good”.
- Patient Autonomy- “Self-governance”.
- Nonmaleficence- “Do no harm”. Dentists are to keep skills and knowledge up-to-date and practice within their limits in order to protect
the pt from harm. - Justice- “Fairness”.
- Veracity- “Truthfulness”.
Pt presents with amalgam restorations in good shape and the dentist suggest to change them for composites due to systemic
toxicity of the amalgam. What ethic principle is the dentist is violating?
Veracity
What principle has to do with a patient’s self-governance & privacy?
Autonomy
Dentist keeps on current dental medicine to provide current standard of care. What part of the ethical code does this relate to?
Non-maleficence
Dentist refers a difficult case to a specialist, what ethic principle is this?
Non maleficence
- Having non-maleficence is knowing your limitations and referring patients out to specialist
QUESTION: Informed consent which ethics principle
à autonomy*
Dentist lets the patient sign informed consent -
autonomy
What you do first before getting informed consent? make sure patient can sign or has guardian, consult physician, discuss options
with relatives, etc
make sure patient can sign or has guardian,
90-year-old patient comes in with son, who has a document mentioning the guardian of the patient -
must have consent from them
to treat the patient
QUESTION: The 16 yr. old can take the decisions for the elder pts if: If the elders are deaf and dumb, if the boy makes the payment, if the
elders are over 60yrs, if the kid has the power of an attorney
if the kid has the power of an attorney
When should patient sign informed consent forms for surgery?
AFTER there has been a discussion w/ the dentist about the
surgery
Inform consent most contain all except:
cost of Tx
QUESTION: If you don’t obtain informed consent, what kind of offense is this?
Battery
What happen when patient doesn’t sign the consent?
Battery
- health care provider commits a battery if the provider performs a procedure for which the patient has not given consent.
Emancipated minor: if the kid is under 18, know exceptions of how they become emancipated minor
- Emancipated minor assumes most adult responsibilities before reaching the age of majority (usually 18). If she/he graduated from
high school, has been married, has been pregnant, or responsible for his or her own welfare and is living independently of parental
control and support.
How is FACT witness is different from expert specialist?
- fact witness = individual, who has personal knowledge of events pertaining to the case & can testify as to things they have
personally observed or witnessed. They may not offer opinions, which are the province of the expert witness - Expert witnesses offer opinions, unlike a fact witness, that may assist the judge in understanding technical knowledge in order to
support their ability to make a sound ruling in a case. An expert witness can be a credentialed specialist in fields.
Child came with a history of aggressive behavior and is crying, then should the dentist show empathy or sympathy or control
sympathy
Rapport best with: empathy; sympathy, compassion
empathy
What best characterizes rapport?
Understanding patient’s feeling and talking with patient
Definition of rapport?
mutual openness / harmonious relationship
- Rapport = mutual sense of trust and openness between individuals that, if neglected, compromises communication.
