Patient Management

Question 1

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.”

Answer 1

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.

Question 2

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.”

Answer 2

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.

Question 3

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

Answer 3

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.

Question 4

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.

Answer 4

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.

Question 5

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.

Answer 5

A. Although the behavioral contract is not a legal

document, it can be a useful approach in solidi-
fying behavioral strategies and goals.

Question 6

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

Answer 6

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.

Question 7

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).

Answer 7

E. Both positive and negative events or situations

are experienced as stress.

Question 8

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

Answer 8

D. Systematic desensitization is the process of sys-
tematically pairing a relaxation response with a

hierarchy of feared stimuli.

Question 9

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.

Answer 9

B. Muscle tension is associated with the experience
of anxiety. Heightened anxiety contributes to

lower pain thresholds/sensitivity to the percep-
tion of pain.

Question 10

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.

Answer 10

E. All of the strategies listed may be considered

appropriate cognitive interventions in pain man-
agement.

Question 11

11. 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.

Answer 11

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.

Question 12

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

Answer 12

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.

Question 13

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.

Answer 13

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.

Question 14

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

Answer 14

E. Diaphragmatic breathing naturally activates the
parasympathetic nervous system, producing a
relaxation response.

Question 15

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

Answer 15

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.

Question 16

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.

Answer 16

B. Operant conditioning posits that behavior is

largely influenced by the consequences associ-
ated with the particular behavior.

Question 17

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

Answer 17

D. Research suggests that the most integral compo-
nent of the treatment of anxiety is exposure to

the feared stimulus.

Question 18

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

Answer 18

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.

Question 19

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

Answer 19

C. Controllability, familiarity, predictability, and
imminence are significant factors influencing the
cognitive appraisal of stress.

Question 20

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

Answer 20

B. Graded exposure is the systematic process of

exposing the patient to a hierarchy of increas-
ingly anxiety-provoking stimuli.

Question 21

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.

Answer 21

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.

Question 22

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

Answer 22

A. Perceived stress and distress in one’s life has
been demonstrated to be a significant predictor
(positively correlated) with self-reported health
concerns.

Question 23

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

Answer 23

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.

Question 24

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.

Answer 24

E. The use of silence can be a useful technique to

encourage patient comment following a state-
ment or question posed to the patient.

Question 25

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

Answer 25

E. Individuals respond to stress physiologically, | behaviorally, cognitively, and emotionally.

Question 26

``` Which of the following indices is not reversible? A. DMFT B. GI C. PI D. OHI-S E. None of the above ```

Answer 26

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.

Question 27

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 ```

Answer 27

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.

Question 28

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 ```

Answer 28

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.

Question 29

``` What type of epidemiology is primarily used in intervention studies? A. Descriptive B. Analytical C. Observational D. Experimental E. None of the above ```

Answer 29

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.

Question 30

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

Answer 30

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.

Question 31

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 ```

Answer 31

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).

Question 32

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 ```

Answer 32

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.

Question 33

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 ```

Answer 33

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.

Question 34

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 ```

Answer 34

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.

Question 35

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 ```

Answer 35

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.

Question 36

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 ```

Answer 36

C. A false positive test is a test result which erro- neously assigns an individual to a specific diag- nostic or reference group.

Question 37

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.

Answer 37

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.

Question 38

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

Answer 38

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).

Question 39

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.

Answer 39

E. All of these measures help ensure the safety of | dental personnel.

Question 40

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

Answer 40

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.

Question 41

``` 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 ```

Answer 41

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.

Question 42

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 ```

Answer 42

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.

Question 43

``` Which of the following chemical agents is not a disinfectant? A. Iodophors B. Sodium hypochlorite C. Synthetic phenol D. Isopropyl alcohol E. Glutaraldehyde ```

Answer 43

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.

Question 44

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

Answer 44

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.

Question 45

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

Answer 45

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.

Question 46

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

Answer 46

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.

Question 47

``` 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 ```

Answer 47

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.

Question 48

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

Answer 48

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.

Question 49

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 ```

Answer 49

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.

Question 50

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 ```

Answer 50

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.

Question 51

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.

Answer 51

E. The use of empathy serves a number of purposes, | including all of the choices given.

Question 52

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.

Answer 52

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.

Question 53

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.

Answer 53

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.

Question 54

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.

Answer 54

B. This is an example of modeling. Shaping is the process of achieving successive approximations toward a desired behavior.

Question 55

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.

Answer 55

A. Distraction is not typically a very effective tech- | nique for very anxious patients.

Question 56

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.

Answer 56

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.

Question 57

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.

Answer 57

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.

Question 58

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.

Answer 58

A. Avoidance of a feared stimulus inadvertently rein- forces the anxiety reaction, thereby maintaining the associated anxiety.

Question 59

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

Answer 59

C. Habituation is the decrease in response that occurs as a result of repeated or prolonged expo- sure to a conditioned stimulus.

Question 60

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

Answer 60

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.

Question 61

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.

Answer 61

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.

Question 62

``` 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. ```

Answer 62

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.

Question 63

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.

Answer 63

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.

Question 64

``` The most common site for oral cancers in the oral cavity is _____. A. Lip B. Soft palate C. Hard palate D. Tongue E. Tonsils ```

Answer 64

D. The tongue is the most common place for inci- | dent cancers in the oral cavity.

Question 65

``` 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 ```

Answer 65

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.

Question 66

``` 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 ```

Answer 66

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.

Question 67

``` 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 ```

Answer 67

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.

Question 68

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

Answer 68

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.

Question 69

``` 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 ```

Answer 69

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.

Question 70

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.

Answer 70

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.

Question 71

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

Answer 71

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.

Question 72

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

Answer 72

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.

Question 73

``` 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. ```

Answer 73

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.

Question 74

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.

Answer 74

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.

Question 75

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

Answer 75

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.

Question 76

when is recommended to fluoridate public water?

Answer 76

when levels < 0.7 mg/dL

Question 77

what can fluorine inhibit

Answer 77

enzyme phosphatase at 20-40mg/day (Ca metabolism)

Question 78

what can fluorine do at higher doses

Answer 78

40-70 heartburn and pain in extremities

Question 79

tx for F toxicity

Answer 79

Ca

Question 80

which surfaces benefit most from F

Answer 80

proximal and smooth

Question 81

gretatest concentration of F

Answer 81

outer enamel

Question 82

concentration of F in school water

Answer 82

~1ppm (4.5x city level)

Question 83

excretion of F

Answer 83

kidney, urine, sweat, up to 3mg/day

Question 84

optimal water F

Answer 84

0.7-1.2 ppm

Question 85

cariostatic effect of F at which stage

Answer 85

calcification

Question 86

toothpaste F concentration

Answer 86

1100 ppm

Question 87

F toxicity

Answer 87

adults 4-5g | child lethal dose 15 mg/kg

Question 88

How many mg of fluoride in 1 L of water at 1 ppm:

Answer 88

1 mg

Question 89

Patient has 1 ppm fluoride in water. What is that equal to in mg/L?

Answer 89

1mg/L

Question 90

What ion gets replaced in hydroxyapatite by fluoride?

Answer 90

Hydroxyl

Question 91

least soluble -

Answer 91

fluorapatite

Question 92

F- on collagen

Answer 92

breaks it down is bacteriocidal, fluoroapetite is more resistant to acid attack, decreases solubility of enamel, excreted by kidneys, helps remineralize

Question 93

Fluoride helps prevent caries in all ways except?

Answer 93

lower pH of the oral cavity

Question 94

Where does fluoride localize/accumulates?

Answer 94

Outer enamel

Question 95

Fluorosis does what?

Answer 95

Inhibits remineralization

Question 96

Fluorosis does what –

Answer 96

``` inhibits remineralization (irreversible) - Fluoride induces enamel hypoplasia (hypocalification), which is a characteristic of fluorosis that is caries resistant. ```

Question 97

fluoride on dental plaque

Answer 97

no effect

Question 98

How do you determine the severity of fluorosis?

Answer 98

Look at the two worst teeth? | - Higher the fluoride level, greater degree of enamel change

Question 99

ADA recommends to apply in-office fluoride foam for how long?

Answer 99

4 minutes

Question 100

How many minutes do you place neutral sodium fluoride tray on teeth?

Answer 100

4 minutes

Question 101

Floride supplementation is effective in: everybody, only kids, anyone but most beneficial to children.

Answer 101

anyone but most beneficial to children.

Question 102

At what age should supplemental fluoride be started?

Answer 102

6 months

Question 103

Minimum fluoride age?

Answer 103

6 months

Question 104

What age does fluoride get incorporate into primary dentition?

Answer 104

4 months in utero

Question 105

At what age does fluorosis of anterior permanent teeth occur? 4-6mo, 0-4mo, 1year, 2years and 6 years)

Answer 105

4-6mo

Question 106

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

Answer 106

0.2 weekly

Question 107

How do they administer Fluoride in schools?

Answer 107

0.2% Fluoride rinse 1x week

Question 108

What happens when a kid with primary teeth ingests fluoride?

Answer 108

It affects their permanent teeth.

Question 109

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?

Answer 109

40%

Question 110

The usual metabolic path of ingested fluoride primarily involves urinary excretion with remaining portion in?

Answer 110

skeletal tissue

Question 111

Where is the biggest storage of fluoride in tissues?

Answer 111

Skeletal tissues

Question 112

Where does fluoride work the best?

Answer 112

interproximal and smooth surfaces

Question 113

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

Answer 113

c. Water with no fluoride

Question 114

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

Answer 114

bottle feeding with processed water with no fluoride

Question 115

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

Answer 115

a. Max incisors and molars | - Primary max incisors (B&L), then primary molars, mandibular unaffected bc tongue blocks

Question 116

What determines fluoride supplementation for a city -

Answer 116

temperature

Question 117

Usual/recommended water fluoridation-

Answer 117

0.7 ppm

Question 118

The appropriate/optimal amount of fluoride in the community water:

Answer 118

0.75-1.2 ppm

Question 119

What percentage of Americans have public fluoride in water: 66%, 85%,

Answer 119

66 | - CDC 2010 reports Americans have 79.6% water fluoridation

Question 120

What is percentage of community water fluoridation- 67, 85, 35

Answer 120

67

Question 121

Fluoridation for water: effectiveness: early studies showed that it prevents 50%-70% of caries in permanent teeth, however currently the effectiveness is

Answer 121

20%-40%

Question 122

Effectiveness of Water fluoridation in the U.S. is

Answer 122

20%-40%

Question 123

Fluoridation: daily use of tablet cause __ in new carious lesions

Answer 123

30% reduction

Question 124

Pt has a white discoloration with no sensitivity near cervical region of #29, what do you do? fill, 5% fluoride, do nothing

Answer 124

5% fluoride

Question 125

What type of fluoride is in water? fluorosilicic acid, sodium fluorosilicate, and sodium fluoride

Answer 125

fluorosilicic acid, | (hydrofluorosilicate) – most commonly used

Question 126

Types of Fluoride used in toothpaste: sodium fluoride, Stannous fluoride, sodium monofluorophosphate

Answer 126

``` Stannous fluoride (most effective) - Stannous fluoride may stain. ```

Question 127

What mouthwash is good for children with caries to rinse with?

Answer 127

Sodium Fluoride (NaF)

Question 128

What rinse is used at home for developmental disabled child to reduce of plaque? NaF, stannous fluoride, chlorohexidine

Answer 128

chlorohexidine

Question 129

Which type of fluoride is not in toothpaste?

Answer 129

Acidulated fluoride

Question 130

What fluoride toothpaste should not be used in a patient with multiple porcelain crowns?

Answer 130

Acidulated

Question 131

What’s the concentration of acidulated phosphate fluoride is used in the dental office?

Answer 131

1.23%

Question 132

Dentist places sodium fluoride on patient with GI fillings rather than acidulated fluoride because

Answer 132

– acid of fluoride will wear away | at GI.

Question 133

What fluoride tx would you used in a pt with amalgams, PFM's, composite restorations, implants?

Answer 133

1.1% NaF

Question 134

Which one is not useful in managing caries in elderly?

Answer 134

Use of 1.1% fluoride as a standard of care

Question 135

2.2 mg NaF how much F-

Answer 135

1 mg

Question 136

A 2 y/o child has injested 20mg fluoride pill. What will likely happen? coma, nausea, renal failure, cardiac arrest

Answer 136

nausea

Question 137

How much fluoridation supplement would you give to a 5 y/o drinking 0.75ppm F in their water?

Answer 137

0 ppm

Question 138

3 y/o patient lives in area with 0.4 ppm fluoride. How much do you supplement?

Answer 138

0 ppm

Question 139

``` 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 ```

Answer 139

Give her systemic fluoride (0.5 mg/day)

Question 140

4 y/o pt with 0.4 ppm fluoride Supplement?

Answer 140

0.25mg/day

Question 141

4.5 y/o child with 0.75ppm fluoride in their water requires how much fluoride to be supplement?

Answer 141

0 mg

Question 142

7-year-old patient has no fluoride in drinking water. What do you give them systemically...? 5 mg, 1 mg, 0.25 mg

Answer 142

1 mg

Question 143

7-year-old child lives in area with 0.2 ppm fluoridated water, what do you supplement?

Answer 143

1.0 mg/day

Question 144

Supplementation for 10-year-old with no other fluoride source? 1 mg/day or 1 mg/week?

Answer 144

1 mg/day

Question 145

Diabetes, can you place implant if HbA1c = 8:

Answer 145

No, refer to physician

Question 146

Pt with hemoglobin A1C of 12%. Pt just visited the MD, what kind of TX we can do?

Answer 146

Consult with an MD prior to tx

Question 147

Time management of diabetic patient:

Answer 147

Treat diabetic patient 2 hours after eating & taking insulin.

Question 148

Kidney dialysis: best to do tx when

Answer 148

day after dialysis or inbtwn days of dialysis

Question 149

Insulin shock, what do you give? give insulin, give OJ, give oral sucrose -

Answer 149

give OJ Do NOT give more insulin, blood sugar is already low enough. Give OJ.

Question 150

Pt is a child and is diabetic undergoes hypoglycemia in the chair

Answer 150

if conscious give him orange juice (unconscious give him 50% | dextrose IV)

Question 151

Child goes into insulin shock in the chair (hypoglycemia) a. gives OJ b. ask parent to give kid insulin shot

Answer 151

gives OJ

Question 152

Unconscious diabetic is treated with:

Answer 152

50% dextrose in IV.

Question 153

IV sedation for DIABETICS:

Answer 153

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.

Question 154

Patient is a non-insulin dependent diabetic & needs minor oral surgery w/ IV sedation. What should he do?

Answer 154

clear-liquids and regular dose of diabetes meds. - Minor surgery: normal as long as procedure occurs within 2 hours of eating and taking meds.

Question 155

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

Answer 155

``` low calorie food with insulin (reduce dose of insulin and no food) ```

Question 156

5 principles of ethics

Answer 156

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”.

Question 157

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?

Answer 157

Veracity

Question 158

What principle has to do with a patient’s self-governance & privacy?

Answer 158

Autonomy

Question 159

Dentist keeps on current dental medicine to provide current standard of care. What part of the ethical code does this relate to?

Answer 159

Non-maleficence

Question 160

Dentist refers a difficult case to a specialist, what ethic principle is this?

Answer 160

Non maleficence | - Having non-maleficence is knowing your limitations and referring patients out to specialist

Question 161

QUESTION: Informed consent which ethics principle

Answer 161

à autonomy*

Question 162

Dentist lets the patient sign informed consent -

Answer 162

autonomy

Question 163

What you do first before getting informed consent? make sure patient can sign or has guardian, consult physician, discuss options with relatives, etc

Answer 163

make sure patient can sign or has guardian,

Question 164

90-year-old patient comes in with son, who has a document mentioning the guardian of the patient -

Answer 164

must have consent from them | to treat the patient

Question 165

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

Answer 165

if the kid has the power of an attorney

Question 166

When should patient sign informed consent forms for surgery?

Answer 166

AFTER there has been a discussion w/ the dentist about the | surgery

Question 167

Inform consent most contain all except:

Answer 167

cost of Tx

Question 168

QUESTION: If you don’t obtain informed consent, what kind of offense is this?

Answer 168

Battery

Question 169

What happen when patient doesn't sign the consent?

Answer 169

Battery - health care provider commits a battery if the provider performs a procedure for which the patient has not given consent.

Question 170

Emancipated minor: if the kid is under 18, know exceptions of how they become emancipated minor

Answer 170

- 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.

Question 171

How is FACT witness is different from expert specialist?

Answer 171

- 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.

Question 172

Child came with a history of aggressive behavior and is crying, then should the dentist show empathy or sympathy or control

Answer 172

sympathy

Question 173

Rapport best with: empathy; sympathy, compassion

Answer 173

empathy

Question 174

What best characterizes rapport?

Answer 174

Understanding patient’s feeling and talking with patient

Question 175

Definition of rapport?

Answer 175

mutual openness / harmonious relationship | - Rapport = mutual sense of trust and openness between individuals that, if neglected, compromises communication.

Question 176

A successful practice is built on -

Answer 176

Good clinician-patient relationship

Question 177

Empathy is not: shared personal experiences, Imagination, understanding

Answer 177

shared personal experiences

Question 178

Which do you not need to show empathy to the patient? a. open-mindedness b. sharing personal experiences c. reflection and showing understanding

Answer 178

b. sharing personal experiences

Question 179

When should the dentist NOT use para-phrasing? a. When trying to speak to a patient in his second language b. When the dentist is upset with what patient says c. when giving factual values

Answer 179

c. when giving factual values

Question 180

Finding out whether a pt is listening:

Answer 180

Eye contact

Question 181

Patient complains of pain in relation to a particular tooth. The best answer/reply of the dentist would be: If you came here earlier things would not be bad If you took more care this would not have happened I will take care of everything

Answer 181

I will take care of everything

Question 182

While the dentist is preparing a large carious lesion in Tooth #30 for a restoration, a pulp exposure occurs. The patient angrily shouts at the dentist, "Your incompetent 'creep'- -you're responsible for this problem!"- Of the following possible responses the dentist could make, which one is the most emphatic? A. Calm down, I can still restore your tooth adequately. B. Not when I'm preparing a tooth with caries like you had. C. I can see that you're very upset. You thought the tooth could be restored and now this problem has occurred. D. If you took care of your mouth the way you should, I wouldn't have been close to the pulp. E. I'm sorry this happened, but we must get on with the procedure.

Answer 182

C. I can see that you're very upset. You thought the tooth could be restored and now this problem has occurred.

Question 183

When the dentist enters the operatory, the patient, who is new to the office, stands close to the wall, has his arms folded, and is looking at the floor. The dentist should initiate communication by saying which of the following? A. Let's get going; I've got a lot to do. B. What are you angry about? C. Didn't my assistant get you seated? D. You seem uncomfortable; did you have a bad dental experience? E. Hi, I'm Doctor Wilson, what brings you here today?

Answer 183

Hi, I'm Doctor Wilson, what brings you here today?

Question 184

Pt complains of high fees of dentist, how should the dentist answer? Fee is fine according to the geographic area, it is fair and reasonable, I have to make a living too

Answer 184

Fee is fine according to the geographic area

Question 185

QUESTION: The closest a dentist should get to their patient is?

Answer 185

Tap their shoulder

Question 186

Reason to not have parent in room with dentist and kid? communication barrier between dentist and child, OSHA violation, HIPAA violation,

Answer 186

communication barrier between dentist and child

Question 187

Precontemplation stage of change

Answer 187

are not even thinking about changing their drinking behavior. They may not see it as a problem, or they think that others who point out the problem are exaggerating.

Question 188

Contenplation:

Answer 188

Individuals in this stage of change are willing to consider the possibility that they have a problem, and the possibility offers hope for change. However, people who are contemplating change are often highly ambivalent. They are on the fence. Contemplation is not a commitment, not a decision to change.

Question 189

Pt. says, “I do not have time to quit smoking.” What stage is s/he in? A: Precontemplation, contemplation, action, denial

Answer 189

Precontemplation

Question 190

over the counter nicotine replacement therapy

Answer 190

patches, gum, lozenges inhaler and spray are prescription

Question 191

buproprion uses

Answer 191

aka Zyban, Wellbutrin reduce nictoine withdrawal, also depression can be used safely with nicotine replacement

Question 192

buproprion contraindications

Answer 192

seizure disorder, current or prior diagnosis of anorexia nervosa or bulimia, or undergoing abrupt discontinuation of alcohol, benzodiazepines, barbiturates, and antiepileptic drugs.

Question 193

varenicline use

Answer 193

aka chantix | reduce nictoine withdrawal, blocks effect of nicotine if starts smoking again

Question 194

varenicline contraidications

Answer 194

Alcohol Intoxication, Depression, Increased Cardiovascular Event Risk, Coronary Artery Bypass Graft, Heart Attack, Acute Syndrome of the Heart, Angina, Transient Ischemic Attack, Stroke, Peripheral Vascular Disease, Severe Renal Impairment, Seizures, Feel Like Throwing Up, Schizophrenia, Manic-Depression, Having Thoughts of Suicide, Habit of Drinking Too Much Alcohol. DON’T COMBINE WITH PATCHES

Question 195

which non-nictoine replacement can be combined with nictoine replacement

Answer 195

buproprion only | NOT VARENICLINE

Question 196

positive reinforcement

Answer 196

Positive consequence that increases behavior § you brush, you get sticker

Question 197

negative reinforcement

Answer 197

Removal of negative consequence that increases behavior § Stop pain from toothache, pt realizes he should brush

Question 198

positive punishment

Answer 198

aversive Conditioning, negative consequence that decreases negative behavior § everytime you don’t brush, you have to clean your room

Question 199

negative punishment

Answer 199

Removal of positive stimulus in order to decrease an undesirable behavior § don’t brush, no allowance

Question 200

operant extinction

Answer 200

child cries, don’t give attention

Question 201

what is more effective, reinforcement or punishment

Answer 201

reinforcement is more effective than punishment because in punishment, you have resentment, you avoid the punisher, and you are not taught positive behavior.

Question 202

Most important component of systematic desensitization is

Answer 202

exposure to fearful stimulus

Question 203

During the child's first visit, the dentist requested that the parents wait in the reception room. The child cries moderately, but tearfully, throughout the dental examination and prophylaxis. The dentist "gave her permission" to cry while he/she worked and then took no notice of her crying. Her crying diminished in intensity over time and then stopped. With respect ONLY to the crying behavior, the dentist has A. used positive reinforcement. B. used negative reinforcement. C. extinguished the behavior. D. ignored the problem.

Answer 203

C. extinguished the behavior.

Question 204

Definition of Operant extinction?

Answer 204

removal of reinforcements that decrease a behavior | - disappearance of a previously learned behavior when the behavior is not reinforced.

Question 205

Behavior shaping:

Answer 205

providing positive reinforcement for approximation of behavior you are desiring

Question 206

A behavior modification device (ie thumb sucking deterrent) is an example of:

Answer 206

``` POSITIVE PUNISHMENT (negative consequence that decreases negative behavior) ```

Question 207

Patient is given oral habit reducing appliance to prevent an oral habit, what is this considered?

Answer 207

POSITIVE PUNISHMENT

Question 208

Providing reward for desired behavior:

Answer 208

positive reinforcement

Question 209

Eye contact, smiling, and telling pt doing good job (praising) is what type?

Answer 209

social reinforcement

Question 210

Desensitization works if the base of the behavior problem is

Answer 210

fear

Question 211

Main disadvantage to desensitization?

Answer 211

Time

Question 212

classic conditioning in how a patient sees a dentist

Answer 212

sees dentist (stimulus) -- assumes pain is coming

Question 213

Conditioned stimulus? a. Dental chair b. High blood pressure c. Fear d. Anxiety

Answer 213

a. Dental chair

Question 214

How to deal with angry patient? Listen and validate emotion, agree with patient, ignore anger then investigate after

Answer 214

Listen and validate emotion

Question 215

How to reduce stress & dental anxiety in peds?

Answer 215

Tell-show-do

Question 216

Based on Frank behavioral rating scale, what is the rate that indicates positive rapport with dentist?

Answer 216

rating 4

Question 217

6-year-old int. disabled child. Treatment is a recall. Would you give sedation, antianxiolytic, voice control or positive reinforcement?

Answer 217

positive reinforcement? - with ID, you want to be short and brief, explain things, tell-show-do, and REWARD. Positive reinforcement.

Question 218

What is the best way to treat a developmentally disabled patient?

Answer 218

Consistency | - Disabled pt, should be treated by flatterness, permissible, consistency

Question 219

Autistic kids have what characteristic?

Answer 219

Repetitive behavior

Question 220

Disable patient comes in and not cooperative, how should you act?

Answer 220

Permissiveness (give patient freedom & treat in the way patient feel comfortable)

Question 221

Patients with autism will usually show? a. decreased rate of caries b. heightened sense of lights and sounds c. the compassion to interact with people

Answer 221

b. heightened sense of lights and sounds - Children with autism are easily overwhelmed by sensory overload, which can cause “stimming” (flapping of arms, rocking, screaming, etc). - Autistic children are hypersensitive to loud noises, sudden movement, and things that are felt.

Question 222

Child patient – you smile, tell him good job, and pat him on the shoulder. These are examples of negative reinforcement, social reinforcement, or token reinforcement.

Answer 222

social | reinforcement

Question 223

If kid complained and whined in the beginning but at the end, is very good: you

Answer 223

compliment how well they were at the end of the | procedure.

Question 224

QUESTION: Voice control method used with children’s -

Answer 224

Aversive conditioning (punishment to deter unwanted behavior, ex. hand over mouth)

Question 225

What is the purpose of the voice control technique?

Answer 225

Sets boundaries à Aversive conditioning

Question 226

QUESTION: 8-year-old patient, 1st dental visit ever, scared of dentist? What’s the most likely answer? a. Television b. Parents c. Peers

Answer 226

b. Parents

Question 227

If a child is afraid,

Answer 227

allow the child to express fears

Question 228

How do you treat a fearful child? use sedation, let him watch another patient,

Answer 228

let him watch another patient,

Question 229

Young patient is scared b/c he has no control what to do?

Answer 229

tell him to raise his hand if he needs a break/ you to stop

Question 230

A kid is on recall appointment and is not cooperative. You should do voice control followed by?

Answer 230

v

Question 231

Patient is very young and fearful first time you meet them –

Answer 231

try to talk to them, go down at their height.

Question 232

Patient 2 yrs old and scared, who do you ask to help position the patient? ask parent to position patient for you get assistant to do it you do it yourself

Answer 232

ask parent to position patient for you

Question 233

The restraining of uncooperative 2 yr. child should be done by. Dentist, Assistant, Parent

Answer 233

Parent

Question 234

4-year-old kid, best position? Knee to knee with head on dentist lap Knee to knee with head on parent’s lap

Answer 234

Knee to knee with head on dentist lap

Question 235

Patient comes in with 1-year-old child, how do you do exam?

Answer 235

parent and dentist are knee to knee, baby's head is in dentist's lap

Question 236

8-year-old boy, when will he behave better? Mom inside the dental office Dad inside the dental office Nobody inside

Answer 236

Nobody inside

Question 237

What is a 2 yr. old most afraid of? 4 yr. old?

Answer 237

• 1-3 yr. old: SEPARATION • 4-6 yr. old: UNKNOWN - pediatric fears correlated with age

Question 238

QUESTION: Uncooperative 2-year-old, what are they scared of?

Answer 238

separation anxiety

Question 239

4-5-year boy is scared of?

Answer 239

Unknown

Question 240

You help a child help recognize what they are afraid of and make outward positive connection:

Answer 240

``` cognitive restructuring (psychotherapeutic process of learning to identify and dispute irrational or maladaptive thoughts) ```

Question 241

Behavior Modeling:

Answer 241

when the kid is afraid and you use a sibling or someone older to show how they should behave

Question 242

QUESTION: A 4 yr. old child management?

Answer 242

empathy and respect

Question 243

Replacing words like LA with sleepy juice is called as

Answer 243

Euphemism (relabeling)

Question 244

``` Pedo 1st visit. Multiple carious teeth on anteriors. During anesthesia is well cooperative and doesn’t cry or move. Once begin tx, begins to cry. What do. • Keep working • Voice control • More anesthesia • Oral sed • N20 ```

Answer 244

• Voice control

Question 245

Fear vs anxiety:

Answer 245

Fear: results from anticipation of a threat arising from an external origin. Anxiety: results from anticipation of a threat arising from an unknown or unrecognized origin. - Anxious patients are the most difficult patients as they often cause the dentist to become anxious as well.

Question 246

fear increases or decreases pain?

Answer 246

increases

Question 247

Dental anxiety can be caused by patient’s helplessness. What would reduce it?

Answer 247

Telling the patient to raise her/his hand when feels | pain

Question 248

``` A patient is going to the dentist and has never had local anesthetic. He recently got a flu vaccine and is now afraid of needles. The fear is due to what? Location Generalization Translation ```

Answer 248

Generalization

Question 249

Define anxiety according to Freud and K:

Answer 249

aversive inner state that people seek to avoid or escape.

Question 250

What do Freud and Erikson say about anxiety?

Answer 250

Inability to overcome a conflict in a particular stage that will lead to anxiety. Inadequate resolution becomes anxiety - An inadequate resolution would indicate a child's insecurity and anxiety. - An Adequate Resolution would mean that a child was able to overcome the conflict in each stage and develop properly. This applies similarly to the other 8 stages.

Question 251

Patient has dental fear, what is most likely due to?

Answer 251

previous traumatic dental procedure

Question 252

What would most cause a man to have anxiety? traumatic past experience, or finances, peers, unpleasant staff

Answer 252

traumatic past experience

Question 253

Constantly exposing the pt to get from the fear factor is .

Answer 253

desensitation

Question 254

Systematic desensitization- 3 steps:

Answer 254

Construct a hierarchy, relaxation exercises, associate components of hierarchy with relaxation state

Question 255

Panic attacks usually produce a sense of unreality, a fear of impending doom, or a fear of losing control.

Answer 255

a fear of impending doom

Question 256

``` What is not included in the ADA code of ethics? • Licensure by credential • Advertising • patient values • Fees ```

Answer 256

• Fees

Question 257

What cannot be advertised by a general dentist? a. Cost b. Specialty c. License agreement

Answer 257

What cannot be advertised by a general dentist? a. Cost b. Specialty c. License agreement

Question 258

A dentist has an ethical obligation to report a colleague in all these situations except? a. working under substance abuse b. advertising on electronic media c. abusing patients

Answer 258

b. advertising on electronic media

Question 259

if you find problems with a medical conditions occurring with a certain drug, who do you contact? OSHA, FDA, EPA

Answer 259

FDA

Question 260

If there is an adverse reaction to a medication in the office, who do you notify? a) FDA b) CDC c) HIPPA d) OSHA e) EPA.

Answer 260

FDA

Question 261

Asked which statement was correct for HIPPA?

Answer 261

Must give privacy form to pt but you don’t need confirmation of receipt, fax and email standard, etc.

Question 262

What’s not the reason for rising dental costs?

Answer 262

number of dental students in dental schools

Question 263

medicaid vs medicare

Answer 263

medicaid is income based | medicare is age-based (>65 yo)

Question 264

insurance pays a flat fee - patient pays the rest

Answer 264

co-pay

Question 265

provider paid per patient not per procedure

Answer 265

capitation

Question 266

HMO

Answer 266

limited to selection – dentists are paid a fixed rate for each individual per month. Dentist is paid regardless patient was seen or not. If value of services exceeds payments, dentist’s loss. If payment exceeds value of services, dentists gain.

Question 267

PPO

Answer 267

group of dentists agree on certain lower fees in hopes o attract more patients

Question 268

who decides how dentists are reimbursed

Answer 268

each state has discretion

Question 269

QUESTION: What does Medicaid cover?

Answer 269

Extractions, one-time denture, children until 18.

Question 270

What sector of government provides funding for dental care? Medicaid, Medicare, grant, HMO

Answer 270

Medicaid

Question 271

Who pays for Medicare:

Answer 271

federal program that pays for covered health services for most people 65 years old and older and for most permanently disabled individuals under the age of 65.

Question 272

Government spends most of the money in Medicare, Medicaid, HMO.

Answer 272

Medicare

Question 273

Medicare is a federal program that provide health care for elderly. It does not cover dental.

Answer 273

Answer: Both statements | are true

Question 274

Most aid for finance: Medicaid, Medicare, and hmo

Answer 274

Medicaid

Question 275

Most dental procedures for the elderly are paid for by

Answer 275

out of pocket cash.

Question 276

Which of the following is the leading payer for dental treatment? Insurance or self-pay

Answer 276

self-pay

Question 277

Who pay for most of dental care? a. government b. insurance c. cash

Answer 277

cash

Question 278

Majority of health service in USA:

Answer 278

private insurance.

Question 279

QUESTION: who pays most of dental Tx:

Answer 279

56% patients, 33% third parties private insurance

Question 280

73yo woman makes $23,000/year. how should she receive dental care? * Medicaid * Medicare * Private insurance

Answer 280

• Private insurance

Question 281

A 65 yr. old lady living on 40k pension per year, wants to get dental treatment. She does not have any other physical abnormality besides tooth pain in her molars. From where does the money covered for her treatment come from? a. Medicaid b. Medicare. c. Private Insurance d. Others insurance.

Answer 281

c. Private Insurance - private dental IF she has it\ medicaid does not cover dental for adults medicare does not cover dental for elders

Question 282

What is the name of the federal funded medical care for the elderly and its coverage? a. Medicare wI dental coverage b. Medicare w/o dental coverage c. Medicaid wI dental coverage d. Medicaid w/o dental coverage

Answer 282

b. Medicare w/o dental coverage

Question 283

``` Insurance question about adverse selection • only take pt with high risk • only take pt with low risk • take both • something about taking pt of all ages ```

Answer 283

(adverse selection deals with the idea that those at higher risk are more likely to buy an insurance policy. If the price for the policy is the same for nonsmokers and smokers, it is more likely that smokers will buy the insurance, because it is more “worth it” to them—because they are at higher risk for disease. This is averse to the insurance. So the prices need to be different. • only take pt with high risk

Question 284

Know about capitation:

Answer 284

Dentist is paid a fixed fee to see patients enrolled in program; HMO = capitation dental plan

Question 285

which is the capitation dental plan

Answer 285

HMO

Question 286

most common dental plan

Answer 286

HMO

Question 287

who's usually at risk with HMO

Answer 287

dentist

Question 288

Insurance allows pt to only see certain set of providers.... PPO, HMO, Closed panel

Answer 288

Closed panel

Question 289

Company offers dental insurance to its employees that can go to selected dentist, what is this example of?

Answer 289

Closed panel

Question 290

``` On a prepayment basis, dental patients receive care at specified facilities from a limited number of dentists. This practice plan is classified as which of the following? A. Closed panel B. Open panel C. Group practice D. Solo practice ```

Answer 290

A. Closed panel

Question 291

Direct Reimbursement:

Answer 291

self-funded group dental plan in which the employee is reimbursed based on a percentage of dollars spent for dental care provided, and which allows employees to seek treatment from the dentist of their choice.

Question 292

If you are an employer and you provide your employee with reimbursements for dental care they received from a dentist of their choice it is called:

Answer 292

direct reimbursement,

Question 293

patient goes to the dentist and needs to pay something before seen:

Answer 293

Copayment

Question 294

What happened in 1997:

Answer 294

SCHIP (state children insurance health program) - SCHIP (State Children's Health Insurance Program) provides matching funds to states for health insurance to families with children. It covers uninsured children in families with incomes that are modest but too high to qualify for Medicaid.

Question 295

1997 law passed that

Answer 295

state must look after children that cannot afford healthcare - State Children's Health Insurance Program (SCHIP) AKA Children's Health Insurance Program (CHIP)

Question 296

Unbundling -

Answer 296

separating of a dental procedure into component parts with each part having a charge so that the cumulative charge of the components is greater than the total charge to patients who are not beneficiaries of a dental benefit plan for the same procedure.

Question 297

Bundling -

Answer 297

opposite of unbundling & can occur on the insurance carrier end. It’s the systematic combining of distinct dental procedures by third-party payers that results in a reduced benefit for the patient/beneficiary.

Question 298

Upcoding or overcoding is defined by the ADA as

Answer 298

"reporting a more complex and/or higher cost procedure than was actually performed."

Question 299

Downcoding is defined by the ADA as

Answer 299

"a practice of third-party payers in which the benefit code has been changed to a less complex and/or lower cost procedure than was reported except where delineated in contract agreements."

Question 300

Dentist did not accept a copayment and did not report it to the 3rd party (insurance)?

Answer 300

Overbilling

Question 301

Dentist charge for $500 for a crown. insurance only covers $400. Dentist waves copayment ($100) but still let insurance knows that he charges $500 for crown, what’s this action called? a. Down coding b. Overbilling c.Price fixing d.Unbundling

Answer 301

Overbilling

Question 302

The dentist charges separately for core build up and the crown but the insurance company says that the core builds up is part of crown. What is this called?

Answer 302

Bundling

Question 303

Doctor billed insurance couple of procedures, when actually there is a global procedure that combines them all, what did he commit?

Answer 303

Unbundling

Question 304

Dentist does the treatment for 2 crowns but the insurance company paid for one crown, what is it?

Answer 304

Downcoding

Question 305

You performed a two surface restoration and coded it that way. Insurance came back with coding it as only one surface restoration. What is this called? Downcoding or upcoding

Answer 305

Downcoding

Question 306

What is it called when a dentist charges several procedures instead of one? a. upcoding b. downcoding c. unbundling d. bundling

Answer 306

unbundling

Question 307

The patient retires & loses health benefits. The treatment is done on the next day. The pt requests that the dentist enter the previous day’s date and the dentist does so. What is this called?

Answer 307

Fraud

Question 308

Child abuse sign:

Answer 308

- multiple untreated injuries - lag time bt injury and tx - comminuted facial fractures - parents with different stories - Most common in children under 3

Question 309

abuse most common in which children

Answer 309

<3

Question 310

Abuses that have to be reported to authorities -

Answer 310

colleague practicing with chemical impairment, colleague advertising falsely on media, child abuse, domestic violence, elderly abuse

Question 311

When treating elderly patients what should be your concern?

Answer 311

Health of patient

Question 312

How often will you see child abuse

Answer 312

at least twice a year

Question 313

It is required mandatory to report all except: child abuse, reaction to drug

Answer 313

reaction to drug

Question 314

You suspect child abuse. Who do you call?

Answer 314

Social services

Question 315

If there is an elderly woman in your chair & you think there might be abuse. What do you have to do? Tell family or tell human health services

Answer 315

tell human | health services

Question 316

Which is not true of elder abuse: Most of the elder abuse is at victims home Mostly it is by the victim’s relative elder’s abuse is often over reported and exaggerated

Answer 316

elder’s abuse is often over reported and exaggerated

Question 317

Unauthorized use of elderly’s ATM card is not a sign of abuse but in some situation, it is under consideration.

Answer 317

(Both are true)

Question 318

Elderly abuse is often:

Answer 318

underreported

Question 319

Dentist potential for abuse not likely due to a. Vulnerability b. Pressure of being perfect c. Knowledge and access to drugs d. Stress

Answer 319

Vulnerability

Question 320

When opening a dental practice, what makes it more successful?

Answer 320

Better communication

Question 321

What do general dentists report as being their biggest issue? fearful patients, business/financial issues, staff training

Answer 321

fearful patients

Question 322

Patient is bothering the dentist, dentist got upset. The assistant drops instruments in the floor & the dentist was so piss that he had it out with the assistant. What you you call that reaction ?

Answer 322

Transference | - Transference is a unconscious redirection of feelings from one person to another

Question 323

Most eye injury in practice happens to who: dentist, dental assistant, hygienist, custodian

Answer 323

dentist

Question 324

Least chance of needle injury? Setting up, Cleaning up, Recap

Answer 324

Setting up

Question 325

When do you most likely get a puncture wound: pre procedure, during, post-proceduring cleanup, needle recapping

Answer 325

post-proceduring cleanup,

Question 326

Most injury/percutaneous cuts happen when

Answer 326

recapping needles

Question 327

What test for every year?

Answer 327

Hep B

Question 328

Dentist can diagnose which of the following?

Answer 328

Bulimia (reflected in oral condition)

Question 329

A patient comes in with rampant decay. What is the primary responsibility of the dentist?

Answer 329

figure out etiology of decay FIRST

Question 330

Patient is in your office for a treatment plan, all of the following should be done when you explain the proposed treatment to the patient, except? Use professional terminology explain risk of not getting a procedure done, inform on the fee of the procedure

Answer 330

Use professional terminology

Question 331

QUESTION: First step before/in treatment planning: make sure patient doesn't need translator, consult with physician about pre-existing medical conditions

Answer 331

make sure patient doesn't need translator

Question 332

Patient is ready to hear your treatment plan, all of the following are true except?

Answer 332

Guarantee the success of treatment!

Question 333

First step in tx planning is?

Answer 333

treat the initial pain and discomfort of the pt. Other choices were see how you can make a preventitive plan, treat all restorations.

Question 334

Proper order for treatment planning –

Answer 334

emergency care, disease control, reevaluation, definitive treatment, maintenance care

Question 335

Which are the two most imp. steps for diagnosis:

Answer 335

History and clinical examination

Question 336

Patient comes to your office, complains about how other dentists did really bad job, and tells you how you are the best dentist in the world. What mental condition is she suffering from?

Answer 336

Borderline Personality Disorder

Question 337

Pt comes in saying she’s been to 5 different dentists the last 6 months. A few minutes later, she’s telling you how great of a dentist you are and that she’ll refer all of her friends to you. This example of:

Answer 337

Borderline. Other choices were paranoia & schizoid. - Borderline personality disorder (BPD) is a serious mental illness marked by unstable moods, behavior, and relationships.

Question 338

Patient with bipolar disease comes in for dental care, choses not to take his medication and states he is in the “manic phase,” what do you expect from treating this patient?: he will have unpredictable reactions during the treatment, he is will be obsessed about is esthetics

Answer 338

he will have unpredictable reactions during the treatment,

Question 339

When trying to change person, what is most important?

Answer 339

trying to determine whether they are willing to change

Question 340

Patient who has a complex medical history that is not debilitating but will require medical management and dental modifications –

Answer 340

ASA 3

Question 341

You have a test that is not accurate but gives consistent result: this means test is

Answer 341

reliable

Question 342

Which of the following are necessary for a test to be accurate: Specificity, reliability, validity

Answer 342

validity

Question 343

is verbal or nonverbal communication more reliable

Answer 343

verbal

Question 344

Dentists have to have proper accommodations for disable people. Dentists have to treat HIV people the same as others.

Answer 344

Both | statements are true

Question 345

American disabilities act does not include HIV:

Answer 345

False

Question 346

One patient left, and before getting another patient, how would you clean your operatory?

Answer 346

Use disinfecting spray à let it sit for 10 | minutes and then wipe off

Question 347

Disinfection?

Answer 347

Destroy majority of microorganisms but not bacterial spores. | - Bacterial spores = benchmark organism for sterilization

Question 348

QUESTION: Benchmark for sterilization:

Answer 348

bacillus spores | - I think it’s Clostriduim Botulinium

Question 349

Mycobacterium is the benchmark for

Answer 349

disinfection

Question 350

Definition of disinfectants –

Answer 350

Inanimate objects (non-living)

Question 351

Antiseptic: can be safely applied to

Answer 351

tissues, but will kill most living organisms

Question 352

Denaturation of the proteins - _______; Coagulation of proteins - ________

Answer 352

QUESTION: Denaturation of the proteins - alcohol and autoclave; Coagulation of proteins - dry heat

Question 353

QUESTION: Steam Autoclave:

Answer 353

20 minutes at 1210C & 15 psi.

Question 354

Which method of sterilization needs higher temperature: steam dry heat oxide pressure

Answer 354

dry heat – 160 C or 3200 F

Question 355

Temperatures for autoclaves is governed by:

Answer 355

FDA

Question 356

Which method of sterilization does not corrode instruments/burs? – Dry Heat, Ethylene oxide

Answer 356

Dry Heat

Question 357

Which method of sterilization does not dull carbide instruments?

Answer 357

Dry heat

Question 358

Sterilization most destructive to burs & causes rusts: Steam heat, dry heat, unsaturated vapor, chemical, ethylene oxide

Answer 358

Steam heat

Question 359

What is best to sterlize carbide burs?

Answer 359

DRY HEAT or unsaturated chemical vapor --> no corrode or dull - Ethylene oxide is for heat-sensitive instruments

Question 360

Anti-retraction valves -

Answer 360

used to prevent aspiration of patient materials into some dental handpieces and waterlines – prevent patient to patient cross-contamination.

Question 361

What’s not found on the OSHA poster?

Answer 361

How many days each employee is allowed to work with that chemicals

Question 362

How often should OSHA be updated

Answer 362

once a year

Question 363

What are the hep B vaccine rules by OSHA?

Answer 363

all must always be offered and able to get the vaccine

Question 364

Once a year, you have to check for one of the following: HIV HEP B HEP C

Answer 364

HEP B

Question 365

If worker didn’t get Hep B vaccine because he is more concerned about HIV?

Answer 365

Tell him it’s easier to get hep B à must sign that they | legally don’t want

Question 366

Who is at least risk for HEP B infection? a) food servers b) Down syndrome c) drugs addicts

Answer 366

a) food servers

Question 367

Who is in control of writing the material safety data sheet (MSDS):

Answer 367

Manufacturer

Question 368

Hazard Communication Standard:

Answer 368

created by OSHA to make sure employees know about hazardous/toxic materials

Question 369

Hazard Communication Standard states –

Answer 369

every chemical hazard has to be evaluated then reported to employer & employees

Question 370

HAZARD COMMUNICATION LAW created by? | what does it control: amalgam, sharps, blood

Answer 370

a) created by OSHA controls, among others, amalgam

Question 371

hazardous communication regulation

Answer 371

train worker right after you hire; train worker when new hazardwhether the means of 2 groups are statistically different—assume that standard deviation is unknown. Small sample sizeous material is in office

Question 372

T test: used to compare

Answer 372

whether the means of 2 groups are statistically different—assume that standard deviation is unknown. Small sample size

Question 373

Z test: used to compare the

Answer 373

means of 2 groups are statistically different if the variances like standard deviation are known. Large sample size.

Question 374

Chi-square test:

Answer 374

tests correlation b/w two independent variables

Question 375

Case control study —

Answer 375

RETROSPECT study that compares people that have the disease to people that do not have the disease. Also, looks back to see how the risk for the disease is compared to actually getting that disease. - start with disease and look backwards for exposure - ex. How did people react to the new mouthwash vs nonusers

Question 376

Cohort study —

Answer 376

PROSPECTIVE study where there is more than one sample/cohort and evaluations are done to see how certain risk factors the groups have are related to developing a certain disease. - look forward from exposure to disease development, through time to see how develops disease, then looks at various factors (no one has diease yet) - ex. how will/does people react to using new mouthwash vs nonusers

Question 377

Cross sectional study —

Answer 377

EPIDEMIOLOGICAL study that looks at the entire population. Not like case control, that only studies a certain group with a specific characteristic. - all variables measures simultaneously at one point in time - Example: It was observed that there was less caries in certain geographic areas. Higher fluoride in water supplies was suspected as the probable cause

Question 378

Longitudinal Study —

Answer 378

TIMED study that looks at a certain set of people (same people) over a long period of time.

Question 379

gold standard for establishing cause and effect

Answer 379

clinical trial

Question 380

If a dentist is reading an article, where should he look for the definition of dependent and independent variables? method , introduction, discussion, results, summary

Answer 380

method

Question 381

``` Where would you look in a scientific journal to find the dependent and independent variables • Intro • Materials • Methods • Conclusion • Summary ```

Answer 381

Methods

Question 382

What section states the purpose of the research?

Answer 382

INTRO (ABSTRACT)

Question 383

Researcher wants to find incidence of oral cancer in nursing home what study?

Answer 383

Cross-sectional

Question 384

Which type of study determines relative risk ratio:

Answer 384

Cohort

Question 385

QUESTION: What parameter study lets you have a risk quotient?

Answer 385

Cohort

Question 386

Efficacy, what study would you do?

Answer 386

CASE CONTROL

Question 387

Study among smokers & nonsmokers in a period of 6 years (2000-2006) to develop disease? Cohort, cross sectional

Answer 387

Cohort - By: disease/non-disease: case control; by time: cohort

Question 388

What type of studylets you find causation- analytical, cross-sectional, case-control, cohort

Answer 388

analytical

Question 389

Myestena Gravis patients are involved in a study. The doctor is conducting a study and is trying to find out how many of these patients has periodontitis. What study is he conducting?

Answer 389

Case control study

Question 390

``` Dentist is doing research on 5 unrelated patient with different background. He record data ......etc. Dentist is doing what kind of research? a. clinical trial b. cohort c. sectional ```

Answer 390

a. clinical trial

Question 391

Study group A and B give some agents for plaque control then compare which agent is more effective. Which study is that?

Answer 391

Clinical | trial

Question 392

A study is done to determine the affectiveness of a new antihistamine .To do this, 25 allergic pt‟s are assigned to one of the two groups ,the new drug (13 pt’s) , placebo (12 pt’s) . The pts are followed for 6 months . This study is called: Cohort, Cross-sectional, Case controlled, historical cohort, clinical trial.

Answer 392

clinical trial. ( assigned or give is the clue )

Question 393

A study is designed to determine the relationship between emotional stress and ulcers. To do this, the researchers used hospital records of pt's diagnosed with peptic ulcer disease and pt. diagnosed with other disorders over the period of time from july 1988 to july 1998 . The amount of emotional stress each pt. is exposed to was determined from these records. This study is: A) Cohort B)Cross-sectional C) Case-study D)Historical Cohort E)Clinical Trial

Answer 393

C) Case-study

Question 394

A researcher conducting a research between students self studying and those attending lectures what is the independent variable? students participating in research, material studied, Students results, Lecture of self study

Answer 394

- ATTENDING LECTURE or SELF STUDY (INDEPENDENT VARIABLE) | - STUDENTS RESULT (DEPENDENT VARIABLE)

Question 395

QUESTION: Analyze statistical difference between two means?

Answer 395

T-test

Question 396

Crossover study advantages:

Answer 396

influence of confounding covariates is reduced because each crossover patient serves as his or her own control and are statistically efficient and so require fewer subjects than do non-crossover designs (even other repeated measures designs).

Question 397

Means of caries risk assessment for 3 groups: white, black, Hispanic what test do u use to compare? A) chi square b) variance c) t-test

Answer 397

c) t-test

Question 398

How do you compare between 2 constant variables? Chi square, regression analysis

Answer 398

regression analysis

Question 399

QUESTION: Two groups of 100 ppl, gave them different foods & asked how they felt afterwards. which test to compare the 2 groups answers à

Answer 399

chi squared test

Question 400

Want to compare 2 groups of people, male and female for something, what test do you look at? Multiple regression, Chi square Test, T-test

Answer 400

Chi square

Question 401

QUESTION: What test measures 2 nonparametric data? Chi-square, normal distrubition, spearman, wilcoxin, kruskal wallis

Answer 401

Chi-square

Question 402

Two common VARIABLE..what statistical test would you use? Chi-test, T-test, correlation analysis, or standard deviance

Answer 402

Chi-test,

Question 403

QUESTION: If you have a study of confounding variable

Answer 403

– minimize confounding variables by randomizing - minimize confounding variables by randomizing groups, utilizing strict controls, and sound operationalization practice all contribute to eliminating potential third variables.

Question 404

QUESTION: confounding variants

Answer 404

- a third variable or a mediator variable, can adversely affect the relation between the independent variable and dependent variable. This may cause the researcher to analyze the results incorrectly. The results may show a false correlation between the dependent and independent variables, leading to an incorrect rejectionof the null hypothesis.

Question 405

- Type I Error with null hypothesis-

Answer 405

rejecting the null hypothesis when it is true. This is an alpha error. Another way to say this is, to reject a null that should be accepted. false positive

Question 406

Type II Error with null hypothesis-

Answer 406

accepting a false null hypothesis. This is a beta error. Another way to say this is, to accept a null that should be rejected. false negative

Question 407

what should observed probability be to reject null hypothesis

Answer 407

<= 0.05 (5%) -- outcome is judged as no effect

Question 408

when accept null hypothesos

Answer 408

when probability >5% --> accept null, results not statistically significant

Question 409

sensitivity

Answer 409

people with disease correctly classified as having disease true positive/(true positive + false negative [these have it but not recognized])

Question 410

specificity

Answer 410

people without disease correctly classified as not having it true negative/(true negative + false positive)

Question 411

incidence

Answer 411

new cases

Question 412

Experiment was done and error = 0.05 was the goal but when completed it was 0.01. The question asks what type of error was it? a. Type I b. TYPE 2 c. no error:

Answer 412

no error: Error of less or equal of 0.5 no statistical significance..

Question 413

P-significant value is equal to 0.01, your theory should be right, so you you will ______ null hypothesis

Answer 413

reject

Question 414

Type I – and Type II –

Answer 414

1 is false rejection of null hypothesis (false negative/incorrect regection) = less dangerous in terms of research 2 is false acceptance of null hypothesis (false positive/failure to regect) – less problematic bc no conclusion is made from a rejected null. But type 2 is more dangerous medically bc a patient is diagnosised as HEALTHY when they actually have the HIV.

Question 415

The power of a statistical analysis is ultimately to:

Answer 415

reject the null

Question 416

QUESTION: Incidence is when

Answer 416

number of people like to get disease in given time

Question 417

QUESTION: Dentist in his clinic notices a new diseases this is?

Answer 417

incidence

Question 418

What is the statistical measure for the total number of cases per population, regardless of time of onset?

Answer 418

prevalence

Question 419

``` For a population, the research divides the number of disease cases by the number of people. By so doing, this investigator will have calculated which of the following rates? a. incidence b. odds ratio c. prevalence d. specificity ```

Answer 419

c. prevalence

Question 420

Specificity:

Answer 420

Proportion of truly nondiseased persons who are so identified by a screening test (measures “how good a test is at correctly identifying nondiseased persons). Sensitivity tests identifying diseased persons.

Question 421

Dentist finds a group of individuals are free of (do not have the) dental disease:

Answer 421

specificity | - Specificity (without disease) and sensitivity (with disease)

Question 422

If a dentist was able to correctly ID disease free patients w/ the diagnostic study, it has?

Answer 422

high specificity.

Question 423

Study says 95 out of 100 people had the disease what is lab value:

Answer 423

95% sensitivity

Question 424

A study failed to report 5 cases of caries. What is this called? 1. True Positive, 2. True Negative, 3. False Positive, 4. False Negative

Answer 424

False Negative

Question 425

QUESTION: Incidence of caries in your office this year is 300 out of 1000, last year it was 200, so what is it for this year?

Answer 425

10% | - Incidence refers to NEW cases so the answer is (300-200)/1000 = 100/1000 = 0.1

Question 426

Dentist has 300/1000 patients with periodontitis; last year only 200 had periodontitis, what is the incidence for this year:

Answer 426

10%

Question 427

mean, median, mode

Answer 427

mean (average) median (middle number) mode (number that shows up the most)

Question 428

Which does not describe the spread of data? median, range, variance, standard deviation, standard error

Answer 428

median

Question 429

What do you use for average Q? Mean, median, mode

Answer 429

Mean

Question 430

``` Which of the following represents the variability about the mean-value of a group of observations? A. Sensitivity B. Standard deviation C. t-Statistic D. Specificity ```

Answer 430

B. Standard deviation

Question 431

Histogram is used to show : mean, correlation of 2 variables, variance

Answer 431

variance | standard deviation

Question 432

Outliers control: a. mean b. median c. mode d. standard deviation

Answer 432

d. standard deviation

Question 433

An outlier has the biggest effect on which of the following?

Answer 433

Standard deviation

Question 434

Your office uses perio scale 1= gingivitis 2= mild perio 3= moderate/severe etc, what type of scale is this? Nominal, ordinal, ratio, cardinal

Answer 434

ordinal

Question 435

mild, moderate, severe: what type of scale?

Answer 435

ordinal

Question 436

kelvin temperature what type of scale

Answer 436

ratio

Question 437

celsius temperature what type of ratio

Answer 437

interval

Question 438

Best scale for gingival index? a. ratio b. nominal c. interval

Answer 438

b. nominal