Preventive FINAL

Question 1

Oral irrigation removes the biofilm on the tooth structure.

Supragingival irrigation improves and prevents gingivitis.

A) Both statements are true.

B) Both statements are false.

C) First statement is true, second statement is false.

D) First statement is false, second statement is true.

Answer 1

D) First statement is false,

second statement is true.

Irrigation is recommended as an adjunct to daily oral hygiene, which includes toothbrushing, dental flossing, and the use of other aids as needed. It is NOT the best method to disrupt or remove biofilm, is NOT effective without toothbrushing, and should NOT be used as a substitute for mechanical plaque removal.

Question 2

An example of how a dental practitioner might determine what information is relevant to the patient is _______________.

A. Tell me how you think flossing daily will affect the gum bleeding that you have been noticing?

B. You will lose teeth if you don’t floss.

C. You are going to have to floss even if you have a hard time.

D. Why didn’t you come in 3 months ago like I told you?

Answer 2

A. Tell me how you think flossing daily will affect the gum bleeding

that you have been noticing?

Question 3

Abrasives usually do NOT damage enamel, but they may dull the tooth luster. To compensate for this, polishing agents are added to the dentifrice formulation.

A) First statement is true, second statement is false.

B) First statement is false, second statement is true.

C) Both statements are true.

D) Both statements are false.

Answer 3

C) Both statements are true.

Abrasives usually do NOT damage enamel, but they may dull the tooth luster. To compensate for this, polishing agents are added to the dentifrice formulation.

Question 4

Fluoride ingredients allowed by the FDA for use in US dentifrices include which of the following?

A. Stannous fluoride

B. Sodium fluoride

C. Sodium monofluorophosphate

D. Only B and C.

E. A, B and C.

Answer 4

E. A, B and C.

A. Stannous fluoride

B. Sodium fluoride

C. Sodium monofluorophosphate

Question 5

Which of the following is NOT a personal factor when planning interdental care?

a) A Patient’s work environment
b) None of the above
c) Appreciation for interdental oral care
d) Disability that limits ability to carry out personal oral hygiene

Answer 5

a) A Patient’s work environment

Question 6

The interdental tip is used:

a) Above the margin
b) Beneath the margin
c) At the facial cervical third
d) All of the above

Answer 6

b) Beneath the margin

Question 7

The statement, “You’re very determined, even in the face of discouragement. This change must really be important to you.” is an example of _______________.

A. an open-ended question

B. a reflection

C. affirmation

D. change talk

Answer 7

C. affirmation

Question 8

Sodium fluoride can be formulated with almost any of the available dentifrice abrasives.

A. True, sodium fluoride is easily formulated with almost any abrasive.

B. False, only compatible abrasive systems can be used, due to the high reactivity of sodium fluoride.

Answer 8

B. False, only compatible abrasive systems can be used,

due to the high reactivity of sodium fluoride.

Question 9

The maximum allowable fluoride in a NaF-containing OTC dentifrice is __________ ppm.

A. 500

B. 1150

C. 2500

D. 5000

Answer 9

B. 1150ppm

Question 10

Which of the following affects the rate of caries formation?

a) Increased frequency of dietary carbohydrates only
b) Decreased salivary flow (xerostomia), increased frequency of dietary carbohydrates, and presence of Streptococcus mutans
c) Decreased salivary flow (xerostomia only)
d) Presence of mutants streptococci only

Answer 10

b) Decreased salivary flow (xerostomia),

increased frequency of dietary carbohydrates,

and

presence of Streptococcus mutans

Question 11

The clinician will increase the likelihood of engaging patients if he/she clearly demonstrates respect for patients and recognizes they are autonomous individuals.

A. True

B. False

Answer 11

A. True

Question 12

Which of the following is not an acceptable property of a disclosing agent?

1. Short duration
2. Antiseptic
3. Pleasant taste
4. Distinct color contrast

Answer 12

1. Short duration

A disclosing agent that has a short duration would rinse off quickly and not allow enough time to complete instructions or clinical services. (Page 371)

Question 13

Stannous fluoride adheres to the surface of tooth enamel and forms a protective layer that is able to shield enamel from the effects of erosive acids.

A. True

B. False

Answer 13

A. True

Question 14

It is important to assess the patient’s readiness for change for all of the following reasons EXCEPT one. Which one is the EXCEPTION?

A. Knowing the patient’s readiness to change impacts the effectiveness of the oral health intervention.

B. Knowing the patient’s readiness to change affects the handouts you may give the patient.

C. Knowing the patient’s readiness to change affects the kind of debridement that will be planned.

D. Knowing the patient’s readiness to change affects the recommendations made for oral healthcare.

Answer 14

C. Knowing the patient’s readiness to change

affects the kind of debridement that will be planned.

Question 15

What bacteria are most likely responsible for caries that are present?

1. Streptococcus mutans
2. Bacteroides forsythus
3. Prevotella intermedia
4. Streptococcus intermedius complex
5. Treponema denticola

Answer 15

1. Streptococcus mutans

Streptococcus mutans are the primary acidogenic bacteria responsible for dental caries. The other bacteria are microorganisms implicated in destructive periodontal infections. (Page 378)

Question 16

All of the following extrinsic factors may interfere with pellicle formation and maturation except:

a) Intake of acidic foods and beverages
b) Whitening products
c) Abrasive toothpaste
d) Water

Answer 16

d) Water

Question 17

When should oral hygiene instructions take place?

1. At each appointment
2. Only at the last appointment
3. Only at the first appointment
4. Only when time allows

Answer 17

1. At each appointment

Oral hygiene instructions should be given and reviewed at each appointment. An overload of information at one appointment can be overwhelming for a patient, so instruction should be divided over several appointments. (Page 367)

Question 18

All of the following have been added to enhance dental floss except:

a) Whitening agent
b) Color
c) Fluoride
d) Chlorhexidine

Answer 18

d) Chlorhexidine

(Rx only)

Question 19

Triclosan is a broad-spectrum antibacterial agent.

A. True

B. False, triclosan is a chemical whitening agent.

C. False, triclosan is a tubule-occluding agent.

Answer 19

A. True

Question 20

How can a subgingival biofilm formation protect periodontal pathogens from locally delivered antimicrobial agents?

A. The biofilm prevents the antimicrobial agent from entering the periodontal pocket.

B. The biofilm matrix serves as a protective barrier.

C. The biofilm fluid channels direct the antimicrobial agent out of the pocket.

D. The biofilm changes the pH of the antimicrobial agent and inactivates the agent.

Answer 20

B. The biofilm matrix serves as a protective barrier.

Question 21

What does learning consist of?

A) Motivation

B) Retention of knowledge

C) Reinforcement of knowledge

D) All of the above

Answer 21

D) All of the above

Learning is a dynamic process that involves motivation to learn, retention of knowledge, reinforcement of knowledge, and transference.

Question 22

Which of the following best represents the goal of reflective listening?

A. repeating what the patient says

B. informing using directive advice

C. keeping the patient talking

D. warning the patient

Answer 22

C. keeping the patient talking

Question 23

Which of the following is a key point in learning?

A) Self-efficacy

B) Relevance

C) Stressors

D) Determination

Answer 23

B) Relevance

A key point of adult learning is relevance. This concept means adults must understand WHY new information or a changed behavior is needed before true learning will take place.

Question 24

A positive use of biofilm is _______________.

A. detoxification of human waste products

B. lining on indwelling catheters

C. coating in fish tanks

D. layer in dental unit water lines

Answer 24

A. detoxification of human waste products

Question 25

All of the following are reasons **why oral hygiene instructions** should be **given before any clinical treatment** _*except*:_ 1. instruction time should be limited to 5 to 10 minutes 2. healing is more favorable if not immediately disturbed by practicing oral hygiene 3. techniques emphasis is placed on the importance of self-care 4. the patient's gingiva are not sensitive from instrumentation

Answer 25

1. instruction time should be **limited to 5 to 10 minutes** ## Footnote Instruction time **should not be limited** and therefore should be **completed before clinical treatment,** so the **appointment time does not determine how long can be spent on oral hygiene instructions**. ***(Page 366)***

Question 26

**Potassium nitrate** is a commonly used, FDA-approved, OTC **desensitization agent**. It **reduces the reaction** of nerves in the teeth to **stimuli such as heat and cold.** A) First statement is true, second statement is false. B) First statement is false, second statement is true. C) Both statements are true. D) Both statements are false.

Answer 26

C) **Both statements are true.** ## Footnote *Potassium nitrate is a commonly used, FDA-approved, OTC desensitization agent and reduces hypersensitivity.*

Question 27

The step in the **transtheoretical** model during which **return** to **old behavior** is highly **unlikely** is which of the following? a. Termination b. Contemplation c. Maintenance d. Preparation

Answer 27

a.**Termination**

Question 28

Xerostomia increases a patient's caries susceptibility. All of the following are benefits of saliva in the prevention of caries except one. Which one of the following *is **not*** **a benefit** of saliva with respect to caries prevention? 1. Is a carrier of antibodies 2. Buffers acids that demineralize teeth 3. Supplies minerals lost in demineralization 4. Provides fluoride transport to tooth

Answer 28

**Is a carrier of antibodies** *Saliva is a carrier of antibodies, but this **does not affect caries formation.*** ***(******Pages 378 to 379)***

Question 29

The foundation of MI is built on \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. A. specific strategies the clinician teaches to the patient B. a sincere "spirit" of mutual respect and collaboration between the clinician and patient C. clinicians solving problems for patients D. patients’ fear of losing their teeth

Answer 29

B. **a sincere "spirit" of mutual respect and** ## Footnote **collaboration between the clinician and patient**

Question 30

The **ADA Seal of Acceptance program** is a **required** process to market a fluoride dentifrice in the US. A. True B. False, the ADA Seal of Acceptance program is a voluntary process to provide assurance to consumers of the safety and efficacy of a product. C. False, the ADA Seal of Acceptance program is a voluntary program to monitor the efficacy of dentifrices.

Answer 30

B. **False**, the **ADA Seal of Acceptance program i**s a **voluntary** process to provide assurance to **consumers of the safety and efficacy of a product.**

Question 31

Which of the following is **a thin, acellular, homogenous layer** positioned between the **calculus** and the **tooth surface**? a) Enamel b) Dentin c) Plaque d) Pellicle

Answer 31

d) **Pellicle**

Question 32

You have just seated your 1:00pm patient. It is a 12 year-old male full of braces. He has a **high plaque score,** particularly at the **gingival margins**. When you ask the patient to demonstrate brushing for you, he does not appear to spend any time around the **orthodontic brackets**. Which toothbrushing method would be most advantageous for this patient to access the plaque on the gingival side of the orthodontic bracket? a) Charters method b) Bass method c) Smith method d) Leonard method e) Horizontal method

Answer 32

a) Charters method

Question 33

What theory states that **changes take place bidirectional; environment, information, and behavior all affect one another?** A) Locus of control B) Sense of coherence C) Social Learning Theory D) Theory of Reasoned Action

Answer 33

C) **Social Learning Theory** ***Social Learning Theory states individuals do NOT learn or change behavior in a linear fashion.** Rather, changes take place bidirectional; environment, information, and behavior all affect one another.*

Question 34

Effective **anti calculus agents** work by **binding calcium and inhibiting plaque calcification.** A. True B. False

Answer 34

A. **True**

Question 35

A patient presents with generalized **3 to 4 mm of recession** and **flat interdental papillae**. It is also noted that this patient has several **open interproximal areas** and an **implant replacing tooth # 20**. The dental hygienist notes in the biofilm score that the lingual surfaces of the **mandibular molars** and the **proximal surfaces** have retained a **large amount of biofilm.** Which **interdental aid** would be appropriate to recommend for this patient? a) Toothpick in holder b) Interdental brush with wire handle c) Single-tuft brush d) Interdental rubber tip

Answer 35

c) **Single-tuft brush**

Question 36

What focuses on the patients' **readiness to learn and change**, and helps **engage patients** to **motivate them** to progress along the stages of the model? A) Motivation B) Motivational interviewing C) Personal opinion D) Values

Answer 36

B) **Motivational interviewing** *Motivational interviewing is defined as **patient-centered counseling that helps the patient resolve conflicts and ambivalence.** Behavioral changes are aided by encouraging patients to set personal goals as negotiated with the health care provider.*

Question 37

Root surface **demineralization** can occur if the **pH drops** to: a) 3.5 to 4.0 b) 6.2 to 7.0 c) 6.0 to 6.7 d) 4.5 to 5.5

Answer 37

c) **6.0 to 6.7** **7.2 = normal**

Question 38

The ________ is MOST appropriate for **children whose dexterity is NOT sufficient** to **master the Bass technique.** A) Rolling technique B) Bass technique C) Horizontal technique D) Stillman method

Answer 38

A) **Rolling technique** ## Footnote *The rolling technique is most appropriate for children whose dexterity is NOT sufficient to master the Bass technique.*

Question 39

In which step of the **preventative program** would you use a **dietary record**? 1. Assessment of the patient's needs 2. Plan for intervention 3. Plan for short- and long-term maintenance 4. Implementation

Answer 39

1. **Assessment of the patient's needs** ## Footnote Using indices such as a biofilm score or a dietary record is part of the assessment phase of a preventative program. ***(Page 364)***

Question 40

Researchers currently believe that all of the following **bacteria** play a role as **periodontal pathogens** EXCEPT: A. T. pallidum B. P. gingivalis C. A. actinomycetemcomitans D. B. forsythus

Answer 40

A. ## Footnote **T. pallidum**

Question 41

Your patient Mrs. Schneider came in for a **prophylaxis** for the first time in **3 years.** After you complete the assessment, you explain to her that she has a lot of calculus and the **start of periodontal disease.** Mrs. Schneider is very surprised; she states that she has **never had any pain or discomfort** and she has been using an **anticalculus dentifrice for 6 months**. She asks you how can this be and you explain: 1. dental calculus formation and deposits often cause no pain or discomfort 2. the anticalculus dentifrice should have prevented the calculus formation 3. the anticalculus dentifrice usage may have prevented any pain or discomfort 4. you may have a high tolerance for pain

Answer 41

1. dental calculus formation and deposits **often cause no pain or discomfort** ## Footnote *Dental calculus can be a serious periodontal health problem without the patient suffering pain or discomfort. Calculus-control dentifrices do not have an effect on existing calculus deposits and are offered as a preventive measure against the formation of new calculus formation; these dentifrices do not have any effect on prevention of pain. **(Page 303)***

Question 42

**Streptococcus mutans** is responsible for **caries.** Which of the following is **not a mechanism of action** in the **caries process** involving **Streptococcus mutans**? 1. It can diffuse over the cell membrane of the _acidogenic_ bacteria 2. It can cling to the smooth surface of the tooth 3. It can create a biofilm 4. It can produce acid from available fermentable carbohydrates

Answer 42

**It can diffuse over the cell membrane of the acidogenic bacteria** *Diffusion over the cell membrane of the **acidogenic bacteria is the mechanism of action** of **fluoride** in inhibiting bacteria in the biofilm, not the mechanism of action of Streptococcus mutans. (Page 379)*

Question 43

Patients in the **Preparation stage** of change are ready to set a target date within \_\_\_\_\_\_\_\_\_\_\_\_. A. 1 month B. 2 months C. 3 months D. 6 months

Answer 43

A. **1 month**

Question 44

A 45-year-old female with **diabetes** presents to the dental office. In the dental hygienist's initial assessments he notes that the patient has **heavy biofilm** accumulation on the **lingual surfaces** of the teeth. In order to show this to the patient he decides to apply a two-tone **disclosing agent**. When the patient uses a hand mirror to look at the result, she notices blue- and red-stained areas on the lingual surfaces. **What do the red- and blue-stained areas indicate?** 1. Red areas are newly formed and thinner biofilm; blue areas are older and thicker biofilm 2. Blue areas are newly formed and thinner biofilm; red areas are older and thicker biofilm 3. Red areas are free of biofilm; blue areas have biofilm accumulation 4. There is no difference in the two colors; both red and blue areas indicate similar biofilm accumulation

Answer 44

**a. Red** areas are **newly formed** and **thinner biofilm**; **blue** areas are **older** and **thicker biofilm** *When using a two-tone disclosing agent the blue areas are older, thicker, more tenacious areas of biofilm. Red areas are thinner and newer areas of biofilm accumulation. **(Page 372)***

Question 45

It is recommended that **bulimics do which of the following after vomiting**? A) Rinse with water B) Brush teeth C) Floss D) Rinse with chlorhexidine

Answer 45

A) **Rinse with water** ## Footnote *It is recommended that patients with bulimia **rinse with plain water or bicarbonate of soda in water immediately after vomiting.***

Question 46

With fluoride treatment, a **noncavitated lesion** can be **remineralized with fluorapatite** and have **greater resistance to subsequent demineralization than hydroxyapatite.** A. True B. False

Answer 46

A. **True**

Question 47

Which of the following characteristics is **typical of a bacteria in a biofilm**? A. Bacteria communicate with each other by sending out chemical signals. B. Bacteria are dispersed more or less evenly through the plaque. C. The environment surrounding bacteria consists of the same or similar pHs. D. Bacteria exist in isolation from each other.

Answer 47

A. **Bacteria communicate with each other** ## Footnote **by sending out chemical signals.**

Question 48

Your patient Mrs. Jacobs is in for her **6-month recare** appointment. Mrs. Jacobs only has her lower dentition and a complete upper denture. You ask Mrs. Jacobs if she would like to remove her upper denture, and she replies, **"I have no teeth; why do I need to remove my denture?"** You explain: 1. it is important to clean your denture and examine your soft tissue 2. cleaning your denture will help prevent periodontal infection 3. I respect your wishes; you can keep the denture in 4. I understand; calculus will not form on dentures

Answer 48

1. **it is important to clean your denture and examine your soft tissue** ## Footnote *Calculus is a tenacious mass that forms on the clinical crowns of the natural teeth, dental implants, dentures, and other dental prostheses. **(Page 296)***

Question 49

An **external locus of control** refers to a patient flossing daily because it will make their **dental hygienist happy**. An **internal locus of control** refers to a patient who **dictates their treatment** even when it is **not in their best interest.** A. Both statements are TRUE. B. Both statements are FALSE. C. The first statement is TRUE; the second statement is FALSE. D. The first statement is FALSE; the second statement is TRUE.

Answer 49

B. Both statements are **FALSE.**

Question 50

Which of the following ingredients **reduce(s) plaque and gingivitis**? A. Stannous fluoride B. Potassium nitrate C. Triclosan D. A and C. E. A and B.

Answer 50

D. **A and C.** **A. Stannous fluoride** **C. Triclosan**

Question 51

Which statement is **NOT true** about **disclosing agents, or disclosants**? A) They may be in either a liquid or a tablet form. B) They allow the patient to see plaque in the mouth before or after brushing. C) These agents can give patients a literal road map to remove the plaque. D) The chewable tablet or the liquid disclosant chewed and swallowed.

Answer 51

D) The chewable tablet or the liquid disclosant **chewed and swallowed.** ## Footnote *They may be in either a liquid or a tablet form, may allow the patient to see plaque in the mouth before or after brushing and importantly, can give patients a literal road map to remove the plaque.*

Question 52

Which of the following statements is ***true* about xerostomia**? a. Can be pharmacologically induced b. Is a disease that causes dry mouth c. Is always a permanent condition d. Cannot be treated

Answer 52

a. Can be **pharmacologically induced** ## Footnote *Xerostomia can be induced by several types of medications. Xerostomia, or dry mouth, is not a disease but a symptom. It can be temporary and can be treated in several ways. **(Page 373)***

Question 53

What occurs when **individuals think their personal actions determine health status**? A) External locus of control B) Multidimensional locus of control C) Internal locus of control D) Locus of control

Answer 53

C) **Internal locus of control** *Locus of control deals with the **perception of personal control over pertinent health issues**. Internal LOC occurs when **individuals think their personal actions determine health status**.*

Question 54

Dentifrice ingredients with **antibacterial activity** can help reduce all of the following EXCEPT \_\_\_\_\_\_\_\_\_\_. A. gingivitis B. intrinsic stain C. oral malodor D. plaque biofilm

Answer 54

B. **intrinsic stain**

Question 55

All of the following are true regarding the **benefits** of **removing loosely connected biofilm** with the use of an **oral irrigator** EXCEPT a) Provided subgingival delivery of antimicrobial agents b) There is alteration of subgingival dental biofilm c) Provided subgingival access to pathogenic microorganisms d) There is no improvement in gingivitis and bleeding

Answer 55

d) **There is no improvement in gingivitis and bleeding**

Question 56

All of the following are examples of **open-ended questions** except one. Which is the exception? A. "Can you tell me about your normal oral home care routine?" B. "What concerns you most about your oral condition?" C. "Are you satisfied with the information provided you today?" D. "How do you think this is affecting your overall health?"

Answer 56

C. **"Are you satisfied with the information provided you today?"**

Question 57

**Ambivalence** refers to \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. A. simultaneous and contradictory feelings about something B. the state of readiness for change C. a strong conviction about something D. understanding without confusion or uncertainty

Answer 57

A. **simultaneous and contradictory feelings about something**

Question 58

A collaborative, person-centered approach to communication aimed at eliciting and strengthening motivation for change is known as \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. A. active listening B. clear and direct communication C. motivational interviewing D. learning ladder

Answer 58

C. **motivational interviewing**

Question 59

Which of the following is the more **acid-resistant** form of **tooth mineral**? A. Fluorapatite B. Hydroxyapatite

Answer 59

A. **Fluorapatite**

Question 60

Which one of the following **recommendations** should be given to a patient with **halitosis**? 1. Brush the tongue daily 2. Use a mouthrinse containing alcohol 3. Purchase a Halimeter to monitor breath 4. Use an oxidizing agent daily

Answer 60

1. **Brush the tongue daily** ## Footnote The **dorsal surface of the tongue is a major source of microorganisms that produce VSCs**. Mouthrinses containing alcohol or oxidizing agents **should not be used** and can be detrimental to the oral tissues if used extensively. ***(Page 375)***

Question 61

Scientists have had **difficulty in identifying specific periodontal pathogens because** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. A. periodontal pockets contain both pathogens and non-pathogens B. the different bacteria in periodontal pockets require different culture media C. periodontal disease goes through active and quiescent periods D. All of the above.

Answer 61

D. All of the above.

Question 62

**Calculus formation time** depends on the **individual tendency**, but it is strongly influenced by **roughness of the tooth surface** a) True b) False

Answer 62

a) **True**

Question 63

Which of the following statements is true about the **col**? a) Is easily accessed for biofilm removal with a toothbrush b) Connects the papillae c) Is convex area that follows the gingival margin d) Is Highly keratinized and thick

Answer 63

b) **Connects the papillae**

Question 64

The specific **plaque hypothesis** would support the following belief: A. "Where there is more plaque, there is more disease." B. "All bacteria in plaque contribute to gingivitis and periodontitis." C. "Calculus plays a major role in causing periodontitis." D. "The presence of bacterial plaque is necessary to develop periodontal disease, but not sufficient to guarantee disease."

Answer 64

D. **"The presence of bacterial plaque is necessary to develop periodontal disease, but not sufficient to guarantee disease."**

Question 65

A biofilm is \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. A. a loose collection of free-floating bacteria B. a calcified collection of bacteria that cannot be easily removed C. an acellular translucent, homogeneous film covering moist surfaces D. a well-organized, cooperating community of microorganisms

Answer 65

D. a **well-organized, cooperating community of microorganisms**

Question 66

Wooden interdental cleaners should be used: a) Even when wood has splayed b) On healthy patients with light biofilm c) On proximal surfaces with adequate space d) With all patients

Answer 66

c) **On proximal surfaces with adequate space**

Question 67

Which one of the following would be considered the **least important feature** for a **toothbrush handle** to have? a) Easily fits into toothbrush holder b) Is easy to grasp c) Does not slip or rotate during use d) Is lightweight e) Has no sharp corners or projections

Answer 67

a) **Easily fits into toothbrush holder**

Question 68

Given the nature of bacteria in biofilm, which techniques may be helpful in controlling oral biofilms? A. Keep bacteria from communicating with each other. B. Prevent fluid flow between microcolonies of bacteria in a biofilm. C. Change the oxygen concentration with the biofilm microenvironments. D. All of the above.

Answer 68

D. **All of the above.**

Question 69

**Stannous fluoride,** specifically the stannous ion, has reported activity against: A) Caries B) Plaque C) Gingivitis D) All the above

Answer 69

D) **All the above** ## Footnote *Stannous fluoride is often touted to have uses NOT only in the reduction in caries and plaque, but also improving gingival health.*

Question 70

Radiographs cannot **positively identify all calculus** deposits because: a) Mineralized tooth structure becomes superimposed over calculus deposits b) Calculus is more mineralized than enamel c) Calculus is more opaque than enamel d) Enamel is more radiolucent than calculus

Answer 70

a) **Mineralized tooth structure becomes** ## Footnote **_superimposed_ over calculus deposits**

Question 71

The **Bass** method is **NOT acceptable for all patients**. However, this method is effective at **removing plaque at the gingival margin** and directly below it. A) First statement is true, second statement is false. B) First statement is false, second statement is true. C) Both statements are true. D) Both statements are false.

Answer 71

B) First statement is **false,** second statement is **true.** ***The Bass method is acceptable for all patients,** although it is always important to individualize patient education. However, this method is effective at removing plaque at the gingival margin and directly below it.*

Question 72

What oral-hygiene aid is used primarily for **gingival massage** and **recontouring of gingival papilla after periodontal therapy**? A) End-tuft brush B) Toothpick holder C) Sulca brush D) Rubber tip stimulator

Answer 72

D) **Rubber tip stimulator** ## Footnote *Rubber tip stimulators are used primarily for gingival massage and recontouring of gingival papilla after periodontal therapy.*

Question 73

Important characteristics that **lead to public acceptance of a dentifrice** are: A) Flavor, smell, color, and consistency B) Flavor, smell, and texture C) Smell, color, and consistency D) Flavor, smell, texture, and consistency

Answer 73

A) **Flavor,** **smell,** **color,** and **consistency** *Flavor, smell, color, and consistency are all characteristics that lead for public acceptance of a dentifrice.*

Question 74

Which one of the following is **NOT a mode of attachment for calculus**? a) Attachment to minute irregularities in the tooth surface by mechanical locking into undercuts b) Attachment by indirect contact between calcified intercellular matrix and the tooth surface c) Attachment by means of an acquired pellicle d) None of the above

Answer 74

b) Attachment by **indirect contact between calcified intercellular matrix** and the tooth surface

Question 75

What is the first thing you should do prior to sharing information with a patient? A. provide background knowledge B. ask permission C. remove personal protective mask D. remind patient that you are the authority

Answer 75

B. **ask permission**

Question 76

The process in which a person, known as the **receiver**, takes the words, gestures, or other **signs of the sender** and **recreates** the **thought intended by the sender** of the message is known as which of the following? a. Decoding b. Encoding c. Coding d. Translating

Answer 76

a**.Decoding** ## Footnote *Decoding is the process in which a person, known as the receiver, takes the words, gestures, or other signs of the sender and recreates the thought intended by the sender of the message. Encoding refers to the translation of a thought into words, gestures, or other linguistic signs that will allow thoughts to be expressed to another. Coding and translating are more associated with encoding than with decoding.*

Question 77

**Antibacterial** approaches can **provide substantially longer-term breath efficacy** than that provided by **odor masking agents.** A. True B. False

Answer 77

A. **True**

Question 78

The **key therapeutic** areas for **dentifrices** are \_\_\_\_\_\_\_\_\_\_. A. caries B. gingivitis C. sensitivity D. whitening E. A, B and C

Answer 78

E. A, B and C **A. caries** **B. gingivitis** **C. sensitivity**

Question 79

What oral hygiene product is recommended for **Type II and III embrasures**? A) Floss threaders B) Floss picks C) Interdental brushes D) Rubber tip stimulator

Answer 79

C) Interdental brushes ## Footnote *Interdental brushes are recommended for interproximal areas where the papilla is missing or shortened (Type II and III embrasures) and root concavities.*

Question 80

The purpose of **irrigation** is to **reduce the bacteria** and inflammatory mediators that lead to the **initiation** or progression of **periodontal infections**. For the patient, irrigation can be part of **routine self-care**. a) Both statements are false b) Both statements are true c) The first statement is true, and the second statement is false. d) The first statement is false, and the second statement is true.

Answer 80

b) **Both statements are true**

Question 81

**Stannous fluoride** is the only fluoride that delivers **anticaries, antiplaque/gingivitis, enamel protection and anti-hypersensitivity benefits from one ingredient.** A. True B. False

Answer 81

A. **True**

Question 82

Which of the following is the **strongest motivating factor** for most dental patients? 1. Peer group approval 2. Ability to chew food 3. Good oral health 4. Lack of disease and infection

Answer 82

1. **Peer group approval** ## Footnote Peer group approval and the need to conform to group standards are frequently much stronger motivating factors than is a health reason. ***(Page 365)***

Question 83

Which of the following **bacteria** plays a major role in **caries development** and progress? a) Spirochetes b) Fusobacteria c) Streptococcus mutans d) Filamentous bacteria e) Leucocyte

Answer 83

c) **Streptococcus mutans**

Question 84

The theory of **reasoned action** is more effective with which of the following? A) A collective community B) An individual C) A small group setting D) None of the above

Answer 84

A) **A collective community** ## Footnote *Social norms and community expectations are powerful predictors of individual behavior, according to this theory. Used in community intervention, the **theory may be better able to predict the behavior of the collective community than the individual.***

Question 85

**Interdental gingival filling** the interproximal area and **under the contact of adjacent teeth** describes what type of embrasure. a) Type II b) PTFE embrasure c) Type I d) Type III

Answer 85

c) **Type I**

Question 86

Most **gingival disease starts** in what area? a) Under the fixed dental prostheses b) Gingival margin c) Col area d) Concavities of root surfaces

Answer 86

c) **Col area**

Question 87

Which fluoride active is unique in its ability to provide **significantly greater levels of erosion protection** compared to other fluoride sources? A. Sodium fluoride B. Sodium monofluorophosphate C. Stannous fluoride

Answer 87

C. **Stannous fluoride**

Question 88

The **scrub toothbrushing technique** uses which movements? A) Horizontal strokes B) Vertical strokes C) Circular strokes D) All of the above

Answer 88

D) **All of the above** ## Footnote *The scrub toothbrushing technique is a combination of horizontal, vertical, and circular strokes. It also incorporates vibration movements in certain areas. Care should be taken with this technique to avoid excessive pressure.*

Question 89

Patients **prefer to be told** which home care aids to use. The patient and the dental professional **should work together** to decide the most immediate problem to address. A. Both statements are TRUE. B. Both statements are FALSE. C. The first statement is TRUE; the second statement is FALSE. D. The first statement is FALSE; the second statement is TRUE.

Answer 89

D. The first statement is **FALSE;** the second statement is **TRUE**.

Question 90

**Potassium nitrate** is the **most commonly** used **tubule-occluding** agent used to treat **dentinal hypersensitivity**. A. True B. False

Answer 90

B. **False** **Stannous fluoride** is also a tubule-occluding agent that can treat dentinal hypersensitivity.

Question 91

Most patients should be instructed to use **dental floss before toothbrushing** because of all of the following **except:** a) If brushing is done first the mouth may feel clean and flossing may not be completed b) Patients who are in a hurry will skip flossing if it is done second to brushing c) Patients who floss before brushing are less likely to complete brushing d) Fluoride in the dentifrice can be reach the proximal surfaces if biofilm is removed.

Answer 91

c) **Patients who floss before brushing are less likely to complete brushing** ***Flossing before brushing allows the dentifrice to each proximal surfaces and patients are more likely to not floss if brushing is completed first** (page 434)*

Question 92

An **incipient carious lesion** begins as: a) A brown discoloration on the surface of the tooth b) An area of decalcification on the surface of the tooth c) A subsurface demineralization d) A white spot on the surface of the tooth

Answer 92

a) A **brown discoloration** on the **surface** of the **tooth**

Question 93

**Calculus forms in layers** that are more or less **perpendicular with the tooth surface.** The layers are **separated by lines** that appear to be pellicle deposited over the **previously formed calculus**, and as **mineralization progressed,** the **pellicle imbedded.** a) Both are true b) The first statement is true, and the second statement is false c) The first statement is false, and the second statement is true d) Both are false

Answer 93

c) The first statement is **false**, and the second statement is **true**

Question 94

**Smaller particle**s (1 mm) have an **abrasive** action, and **larger particles** (20 mm) have a **polishing** action. A) First statement is true, second statement is false. B) First statement is false, second statement is true. C) Both statements are true. D) Both statements are false.

Answer 94

D) **Both statements are false.** ## Footnote *All sizes of particles may be used for polishing and abrasion; however larger particles are better used for abrasion and smaller particles are better used for polishing.*

Question 95

When are **floss holders NOT recommended**? A) Poor dexterity B) Small hands C) Strong gag reflex D) Physical disabilities

Answer 95

B) **Small hands** *A dental floss holder is a device that holds floss and eliminates the need for placing fingers in the mouth. It is **recommended** for those with **physical disabilities, poor dexterity, large hands, limited mouth opening, or a strong gag reflex.***

Question 96

Which of the following is not a part of the **four key principles of motivational interviewing?** A. resist the righting reflex B. listen to your patient C. design goals for patient D. empower your patient

Answer 96

C. **design goals for patient** **R.U.L.E.** **Resist** **Understand patient's motivation** **Listen to patient** **Empower patient**

Question 97

A patient’s **verbal expression** of their **desire, reason, ability or need to make a change in oral health behaviors** is referred to as: A. motivational ruler B. empathy C. change talk D. resistance

Answer 97

C. ## Footnote **change talk**

Question 98

Floss should be guided past each contact area with what type of motion? a) Horizontal only b) A snap c) Sawing d) Vertical only

Answer 98

c) **Sawing**

Question 99

Which is **NOT** a **source of motivation**? A) Religious beliefs B) External expectations C) Social relationships D) Social welfare

Answer 99

A) **Religious beliefs** *When presenting education to adults, motivating the adult learner requires certain considerations. **Six sources of adult motivation** are: **social relationships, external expectations, social welfare, personal advancement, escape stimulation, and cognitive interests.***

Question 100

The **initial care plan** should include: a) Minimum frequency of use for interdental aids b) Complex and detailed procedures c) A strict daily oral care regimen d) Several interdental aids

Answer 100

a) **Minimum frequency of use for interdental aids**

Question 101

**Andragogy** refers to the **art and science of helping** ____________ learn. A. children B. everyone C. adults D. adolescents

Answer 101

C. **adults**

Question 102

The degree of **dentifrice abrasiveness** depends on: A) The inherent hardness of the abrasive B) The size of the abrasive particle C) The shape of the particle D) All of the above

Answer 102

D) **All of the above** ## Footnote *Dentifrice abrasiveness is dependent upon the hardness, size and shape of the particle.*

Question 103

The active ingredient in the **first dentifrice** to receive the **ADA Seal of Acceptance** was \_\_\_\_\_\_\_\_\_\_. A. sodium fluoride B. sodium monofluorophosphate C. stannous fluoride

Answer 103

C. **stannous fluoride**

Question 104

Which of the following is a **systemic factor** contributing to **halitosis?** Cirrhosis of the liver Fetor ex ore Xerostomia Cleft palate

Answer 104

1. **Cirrhosis of the liver** * Cirrhosis of the liver can be a systemic factor contributing to halitosis. **Fetor ex ore is another name for halitosis.** Xerostomia and cleft palate are **oral factors** that **can contribute to halitosis. (Page 374)***

Question 105

Which **disclosing agent** requires **ultraviolet light** to make areas of **biofilm retention visible?** 1. Fluorescein 2. Fast green 3. Erythrosin 4. Mercurochrome

Answer 105

1. **Fluorescein** Fluorescein made with **F.D. & C. Yellow No. 8 requires the use of an ultraviolet light in order to make the agent visible within the oral cavity.** *(Page 372)*

Question 106

A patient constantly **looks at the floor i**nstead of making eye when communicating with the dental hygienist. Which type of **communication** is his looking at the floor? a. Nonverbal b. Nonverbal, vocal c. Verbal, vocal d. Verbal, nonvocal

Answer 106

a**.Nonverbal**

Question 107

Why would it be important to **replace the restorations** that have recurrent decay or are lacking marginal seal? 1. To help decrease the bacterial count in the oral cavity 2. To improve the esthetic appearance 3. To make sure the dentist meets his monthly production goal 4. All restorations should be replaced every few years

Answer 107

1. **To help decrease the bacterial count in the oral cavity** ## Footnote *Well-placed restorations with a marginal seal will lower the bacterial counts in the oral cavity. This is thought to decrease the person's chance of getting caries. **(Page 383)***

Question 108

Which of the following is **true r**egarding the **pellicle**? a) Is soluble b) Is readily visible c) Protein components are derived from water d) Primarily comprised of glycoproteins

Answer 108

d) Primarily comprised of **glycoproteins**

Question 109

Which of the following correctly describes the anatomy of the **posterior interdental area?** a) Between adjacent teeth there is a single papilla, which forms a col under the contact area b) The col area is thick and keratinized c) The single papilla has a pyramidal shape d) Between adjacent teeth there are two papillae, one facial and one lingual

Answer 109

d) **Between adjacent teeth there are two papillae,** ## Footnote **one facial and one lingual**

Question 110

The **primary mechanism of action** for **fluoride** includes \_\_\_\_\_\_\_\_\_\_. A. promotion of remineralization B. inhibition of demineralization C. Both A and B. D. None of the above.

Answer 110

C. BOTH ## Footnote **A. promotion of remineralization** **AND** **B. inhibition of demineralization**

Question 111

The **lines between the layers of calculus** can be called: a) Sharpey lines b) Enamel lines c) Lines of demarcation d) Incremental lines

Answer 111

d) **Incremental lines**

Question 112

The MOST **common types of abrasives** used are: A) Carbonates B) Phosphates C) Silicas D) All the above

Answer 112

D) **All the above** ## Footnote *All of the answers are commonly used abrasives.*

Question 113

At any one point in time, **80% of patients are** at which of the following **stages of change** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. A. Precontemplation B. Preparation C. Action D. Relapse/Maintenance

Answer 113

A. **Precontemplation**

Question 114

When using the **oral irrigator** a standard delivery **tip is directed** ________ to the long axis of the tooth.

Answer 114

**Perpendicular**

Question 115

**Abrasion** can occur from toothbrushing. Toothbrush abrasion usually appears as a **V-shaped notch** in the **cementum apical to the cementoenamel junction.** A) First statement is true, second statement is false. B) First statement is false, second statement is true. C) Both statements are true. D) Both statements are false.

Answer 115

C) **Both statements are true**. ## Footnote *When toothbrush abrasion damage does occur, it usually appears as a V-shaped notch in the cementum apical to the cementoenamel junction and is termed toothbrush abrasion.*

Question 116

Which of the following is an example of an **open-ended question**? A. Do you have any concerns about your mouth? B. Tell me what you have used to clean between your teeth? C. Did you floss your teeth today? D. How often do you brush your teeth each day?

Answer 116

B. **Tell me what you have used to clean between your teeth?**

Question 117

What is the most common **nerve depolarizing agent** used in **sensitivity dentifrice**? A. Amine fluoride B. Potassium nitrate C. Sodium hexametaphosphate D. Strontium chloride

Answer 117

B. **Potassium nitrate**

Question 118

What is defined as an **unpleasant breath emanating from the oral cavity**, regardless of its origin? A) Periodontal disease B) Sour breath C) Halitosis D) Sweet breath

Answer 118

C) **Halitosis** ## Footnote *Halitosis is defined as an unpleasant breath emanating from the oral cavity. Although this occurs in the oral cavity, the originating source of malodor can be nasal, nasopharyngeal, sinus, or oropharyngeal areas.*

Question 119

Which of the following is a key component of **motivational interviewing**? a. Expressing empathy, acceptance, and respect for the patient b. Using a similar motivational approach for all patients c. Clinician does most of the talking d. Clinician instills knowledge, insight, and motivation

Answer 119

a. **Expressing empathy,** **acceptance,** and **respect for the patient**

Question 120

What is defined as **bacteria-induced inflammation** or **infection of the heart and its valves?** A) Bacterial endocarditis B) Cardia allergic response C) Bacteremia D) Pulmonary embolism

Answer 120

A) **Bacterial endocarditis** ## Footnote *Although the occurrence is uncommon, bacterial endocarditis (bacteria-induced inflammation or infection of the heart and its valves) has occasionally been reported.*

Question 121

Components of **establishing an adult teacher-learner relationship** include all of the following EXCEPT one. Which one is the **EXCEPTION**? A. Trust B. Mutual respect C. Authenticity D. Offering opinions

Answer 121

D. **Offering opinions**

Question 122

What is defined as the formation of a **V-shaped slit in the gingiva that extends apically from the gingival margin?** A) Recession B) Clefting C) Abfraction D) Floss cut

Answer 122

B) **Clefting** ## Footnote *Clefting is the formation of a V-shaped slit in the gingiva that extends apically from the gingival margin. **If flossing trauma is evident, further instruction should be given until the individual has become adept.***

Question 123

The **tongue** is anatomically perfect for **harboring bacteria**. A patient with a **fissured tongue** (deep grooves on the tongue's surface) is **more prone to accumulate bacterial plaque and debris.** A) First statement is true, second statement is false. B) First statement is false, second statement is true. C) Both statements are true. D) Both statements are false.

Answer 123

C) **Both statements are true.** ## Footnote *The tongue is anatomically perfect for harboring bacteria. A patient with a fissured tongue (deep grooves on the tongue's surface) is more prone to accumulate bacterial plaque and debris.*

Question 124

Which of the following can be used to **elicit the extent to which a person feels compelled to change**? A. motivational ruler B. expressing empathy C. righting reflex D. rolling with resistance

Answer 124

A. **motivational ruler** **Scale of 1 to 10**

Question 125

The **precontemplation stage** of change is most consistent with \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. A. being aware of a problem and thinking of ways to solve it B. learning new coping methods to sustain change C. substituting healthy responses for problem behaviors D. demonstrating denial and/or active resistance to change

Answer 125

D. **demonstrating denial and/or active resistance to change**

Question 126

The **outer layer** of **subgingival calculus** is **completely calcified** a) True b) False (the outer layer of subgingival calculus is only partly calcified)

Answer 126

b) **False** ## Footnote **(the outer layer of subgingival calculus is only _partly_ calcified)**

Question 127

Possible **new strategies to control oral biofilms** include all of the following **EXCEPT:** A. Control of biofilm nutrient sources. B. Alteration of pH within biofilm microcolonies. C. Varying the oxygen concentration within biofilm. D. Addition of systemic antibiotics.

Answer 127

D. **Addition of systemic antibiotics.**

Question 128

All of the following are true of studies of **patient autonomy** EXCEPT one. Which one is the **EXCEPTION**? A. Autonomy is not relevant to a patient’s health. B. Patients are more motivated to manage their health. C. Patients feel more confident about managing their health. D. Patients showed improvement in health outcomes.

Answer 128

A. **Autonomy is not relevant to a patient’s health.**

Question 129

When motivation is **imposed from an external source** (e.g., persuasion), patients’ behavior change is often \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. A. sustained over time B. transient and guilt-induced C. successful D. None of the above.

Answer 129

B. **transient and guilt-induced**

Question 130

A **communication theory** that is based on the individual's **belief that actions** will **affect the outcome** is known as which of the following? a. Self-efficacy b. Transtheoretical model c. Locus of control d. Theory of reasoned action

Answer 130

a.**Self-efficacy**

Question 131

"Resisting the righting reflex" means the clinician ____________ resistance expressed by the patient. A. minimizes B. acknowledges C. tries to resolve D. ignores

Answer 131

B. **acknowledges**

Question 132

The purpose of toothbrushing includes: A) Removal of plaque biofilm and disturbance of its reformation B) Removal of food, debris, and stain from the oral cavity C) Application of a dentifrice containing specific ingredients to address D) All of the above

Answer 132

D) **All of the above** ## Footnote *All of the aforementioned are purposes of brushing of the teeth.*

Question 133

When you try to **communicate the importance** of proper brushing to a patient who is having difficulty removing all of the plaque from his teeth, he **becomes defensive** and tells you that he already knows how to brush his teeth. Which **barrier to communication** do you face with this patient? a. Attitudinal b. Psychological c. Cultural d. Physical

Answer 133

a.**Attitudinal**

Question 134

Traditional patient education \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. A. is clinician-centered B. often causes the patient to passively accept, or resist, unsolicited advice C. attempts to persuade patients to change behaviors D. All of the above.

Answer 134

D. **All of the above.**

Question 135

Suggest the **sequence be varied** at least once each day so that the **same areas are not always brushed last** when time may be limited and biofilm removal may be less complete. Encourage the patient to begin by brushing one of the **areas of greatest** individual **needs** as shown by **disclosing agent.** a) Both statements are true b) Both statements are false c) The first statement is false, and the second statement is true d) The first statement is true, and the second statement is false

Answer 135

a) Both statements are **true**

Question 136

**Chlorhexidine** is **highly effective** against **Streptococcus mutans** infections. **Chlorhexidine** is often **prescribed** for the **long-term** control of dental caries. 1. The first statement is true and the second statement is false 2. The first statement is false and the second statement is true 3. Both statements are true 4. Both statements are false

Answer 136

The first statement is **true** and the second statement is **false** ***Chlorhexidine** is **highly effective** against **Streptococcus mutans**. It is prescribed for **short-term,** not long-term, control of dental caries. (Page 384)*

Question 137

What is the BEST oral-hygiene aid that helps **reduce malodor**? A) Tongue cleaner B) Chlorhexidine C) Listerine D) Interdental brushes

Answer 137

A) **Tongue cleaner** ## Footnote *The bacteria that collect on the surface of the tongue contribute to oral malodor, compromised wound healing, and oral diseases. Tongue cleaning helps control oral diseases and oral malodor.*

Question 138

**A.** Gingivitis develops in _1 week_ when biofilm is left undisturbed on the tooth surface. **B.** Most _gingivitis is_ _reversible_, with mechanical biofilm disruption; healthy gingiva can return within a few days a) Statement A is false, and statement B is true b) Both statements are false c) Statement A is true, and statement B is false d) Both statements are true

Answer 138

a) Statement A is **false (2 weeks)** and statement B is **true**

Question 139

**Halitosis**, or bad breath, can be caused by which of the following? A. Dry mouth B. Bacteria C. Oral debris D. Oral diseases E. All of the above.

Answer 139

E. **All of the above.**

Question 140

**Baking soda** (sodium bicarbonate) has had a long history of use as an oral-hygiene aid. The uses for these oral-hygiene aids include **fighting plaque, gingivitis reduction, stain-removal, and odor-reducing efficacy.** A) First statement is true, second statement is false. B) First statement is false, second statement is true. C) Both statements are true. D) Both statements are false.

Answer 140

C) **Both statements are true.** ## Footnote *Sodium bicarbonate has had a long history of use as an oral-hygiene aid, which includes fighting plaque, gingivitis reduction, stain-removal, and odor-reducing efficacy.*

Question 141

For **acid formation** to occur, which of the following must be taken up into the **biofilm**? a) Acquired pellicle b) White blood cells c) Calcium d) Cariogenic substance

Answer 141

d) **Cariogenic substance** **Cariogenic = causing tooth decay**

Question 142

Dental **calculus control, tooth whitening** and **reduction of bad breath** are considered by the FDA to be what type of benefits? A. Therapeutic B. Cosmetic C. Either cosmetic or therapeutic, depending on the product.

Answer 142

B. **Cosmetic**

Question 143

What can be used in the **anterior** of the mouth to help **differentiate** between **enamel** that is **translucent** and **calculus that is opaque?** a) Direct vision b) Radiographs c) Moth mirror and transillumination d) Disclosing solution

Answer 143

c) **Moth mirror** ## Footnote **and** **transillumination**

Question 144

In order to appeal to different learning styles, which of the following is appropriate? A. Give the patient a handout on tooth brushing. B. Demonstrate tooth brushing in the patient’s mouth. C. Give the patient internet resources to learn more information. D. All of the above.

Answer 144

D. **All of the above.**

Question 145

**Mild** to **moderate fluorosis** occurs at which of the following parts per million (**ppm**) **levels**? A \< 1 ppm B \> 2 ppm C \> 5 ppm D \> 10 ppm

Answer 145

B **\> 2 ppm** * **Mild to moderate fluorosis** occurs at levels of **greater** than **2 ppm**. The **ideal level** of fluoride in **community water supplies is 0.7 ppm** for all geographic locations in the United States. The Environmental Protection Agency (EPA) recommends * *defluoridation** if water supplies have a fluoride level **greater than 2 ppm.***

Question 146

Which of the following statements describes the **incorporation** of **chemotherapeutic agents** in the **control of bacterial** components of **plaque biofilm**? A Replaces brushing and flossing B Supplements brushing and flossing C Recommended for use by all patients D No antibacterial role in plaque biofilm control

Answer 146

B **Supplements brushing and flossing**

Question 147

Which of the following **fluoride** compounds is **NOT** used in **professionally administered fluoride** products to **prevent dental caries**? A Sodium fluoride (NaF) B Stannous fluoride (SnF2) C Acidulated phosphate fluoride (APF) D Sodium monofluorophosphate (MFP)

Answer 147

D **Sodium monofluorophosphate (MFP)**

Question 149

Which of the following **additives** has been shown to **control dental caries**by**preventing the transmission**of**cariogenic bacteria** from **mother to infant**? A Xylitol B Sorbitol C Triclosan D Stannous fluoride E Hydrogen peroxide

Answer 149

A **Xylitol** *Chewing **xylitol gum** in adequate amounts by **mothers** of **young children**in the**first 2 years**of the children’s lives**prevented** the **vertical transmission of cariogenic bacteria f**rom **caregivers to infants.***

Question 150

Which of the following **OTC mouthrinses** has been **accepted** by the **ADA** and **approved** by the **FDA** to **control and treat plaque biofilm and gingivitis**? A Chlorine dioxide B Chlorhexidine gluconate (Peridex) C Essential oils (Listerine and generic versions) D Cetylpridinium chloride (CPC), Crest Pro-Health, Scope

Answer 150

C **Essential oils** (Listerine and generic versions) ***Listerine** and its generic versions are the only **ADA-accepted,** **OTC mouth rinses** used to treat **plaque biofilm, gingivitis, and volatile sulfur compounds producing organisms** that cause **malodor.***

Question 151

All the following are **effective ways** to control **volatile sulfur compounds (VSC)**–producing**organisms**that**cause breath malodor** EXCEPT one. Which one is the **EXCEPTION**? A Using breath mints B Brushing the tongue C Rinsing with Listerine D Using a tongue scraper

Answer 151

A **Using breath mints** *Breath mints will **help to mask breath malodor** but will not impact the **VSCs.** Research indicates that **80% to 90%** of oral **malodor originates** from the oral cavity. Oral malodor is caused by **VSCs, which are byproducts of bacterial metabolism.***

Question 152

**Chlorhexidine** has been shown to be **effective** as an **antimicrobial** to **control dental caries** in patients who are at **high risk** for caries. The recommended **protocol** is the **same** as that used to **control gingivitis.** A Both statements are true. B Both statements are false. C The first statement is true, and the second statement is false. D The first statement is false, and the second statement is true.

Answer 152

The **first** statement is **true,** and the **second** statement is **false**

Question 153

Which of the following is considered the **major mechanism of action** of **fluoride** in the **inhibition** of **dental caries progression**? A Antimicrobial effect on acidogenic bacteria B Enhancement of remineralization in the demineralization– remineralization cycle C Formation of fluorapatite during the development of enamel prior to eruption D Inhibition of demineralization through fluoride adsorption by enamel mineral crystals

Answer 153

B **Enhancement** of **remineralization** in the **demineralization** – **remineralization cycle** ***Fluorides enhance** the **remineralization of enamel** in the **continual demineralization–remineralization cycle**and this **posteruptive remineralization** is believed to be the **major mechanism of action**of**fluorid**e in the**inhibition of dental caries progression.***

Question 154

Which of the following **dentifrice** ingredients should be **avoided** if a **nonabrasive dentifrice is recommended**? A Triclosan B Baking soda C Stannous fluoride D Carbamide peroxide

Answer 154

B **Baking soda** ***Baking sod**a as a **dentifrice** ingredient in **whitening toothpastes** and should be **avoided** if a **nonabrasive** dentifrice is **recommended.***

Question 155

The **emphasis** in **toothbrushing instruction** to **prevent and control gingivitis a**nd **mild to moderate periodontitis** should be on **developing and maintaining** an effective technique. The emphasis on toothbrushing to prevent and **control dental caries** should be on **increasing the frequency** and **duration of brushing** with **fluoride toothpaste.** A Both statements are true. B Both statements are false. C The first statement is true, and the second statement is false. D The first statement is false, and the second statement is true.

Answer 155

**A. Both the statement and the reason are correct and related.** ***Sealants** are directed toward the **prevention of pit and fissure caries**.* ***Fluorides** have the **greatest effect** in the **prevention of smooth surface caries.** **Combining** both **preventive measures** provides a **comprehensive approach** for **prevention** of **tooth decay.***

Question 156

Which of the following **foods naturally** contains the **MOST fluoride**? A Fish and tea B Meats and eggs C Milk and cheese D Fruits and vegetables

Answer 156

A **Fish** and **tea** ***Fish from the sea** naturally contains **1 ppm** and **black tea** contains from **1 to 6 ppm** of **fluoride**. Fluoride is a naturally occurring compound in water and soil, so **all foods contain some fluoride**, especially those grown in soil that is* ***irrigated with fluoridated water.***

Question 157

**Fluoride** is **stored** in the **body** in which of the following **two locations?** A Blood B Liver C Saliva D Teeth E Bones

Answer 157

D **Teeth** E **Bones** * **Excess fluoride** is stored in the hard tissues of **bones** and the * *developing enamel of teeth***

Question 158

**Ingested fluoride** is **excreted** primarily through **saliva.** * *Excretion of fluoride** through **saliva i**s the reason that **water fluoridation** has * *posteruptive caries reduction benefits** in both **children and adults.** A Both statements are true. B Both statements are false. C The first statement is true, and the second statement is false. D The first statement is false, and the second statement is true.

Answer 158

D The **first** statement is **false**, and the **second** statement is **true.** * The **primary excretion** of excess **fluoride is in urine**, not saliva. **Saliva is a secondary means** by which **fluoride is excreted,** providing topical benefits. **The second statement is true**. When * *fluoride** is **consumed regularly** through **water, food, supplements**, or all of these, **saliva provides** continual **intraoral bioavailability of fluoride** for **enhanced remineralization,** **prevention of demineralization**, and an **antimicrobial** effect.*

Question 159

**Fluoride supplements** are **recommended** by the **FDA** because research has shown them to be **safe** to the **developing fetus.** Research has demonstrated that **fetal plasma fluoride** levels **increase** as a result of **prenatal fluoride supplementation,** but the **benefit** of prenatal fluoride to the **child is minimal.** A Both statements are true. B Both statements are false. C The first statement is true, and the second statement is false. D The first statement is false, and the second statement is true.

Answer 159

D The **first** statement is **false**, and the **second** statement is **true.** The FDA **does not recommend fluoride supplements** because the **benefit** to the **developing fetus is minimal,** not because of any safety concerns. This is because enamel formation of **permanent teeth occurs after birth** and the **primary benefits** of **fluoride** occur after **teeth erupt** following birth. There are **no ill effects** of **optimal fluoride consumption** by the **mother** on the **development of the fetus.**

Question 160

Which of the following **first aid steps** should be taken **FIRST** if a **child swallows** a **toxic dose** of **fluoride**? A Have the child drink milk B Induce vomiting C Administer cardiopulmonary resuscitation (CPR) D Administer oxygen

Answer 160

B **Induce vomiting** *The **first step** in the administration of **first aid** if a **child swallows** a **toxic dose of fluoride** is to **empty the stomach** of **excess fluoride** by **inducing vomiting***

Question 161

When the **fluoride ion replaces** the **hydroxyl ion** in the **enamel** structure, which of the following is the **MOST stable result**? A Fluorapatite B Hydroxyapatite C Carbonated apatite

Answer 161

A **Fluorapatite** **fluorapatite** crystal becomes **more stable** and **less soluble**. **Fluorapatite** is **very resistant** to **dissolution** by **acid.**

Question 162

Which of the following statements is **MOST** correct regarding the **benefits of water fluoridation**? A. The benefits of water fluoridation continue even after it is discontinued. B Water fluoridation does not benefit adults because their teeth have already erupted. C Partial exposure to water fluoridation provides benefits in proportion to the amount of fluoride in the water. D Because of current multiple exposures to fluorides, water fluoridation is no longer considered cost effective and is not recommended by public health experts.

Answer 162

C **Partial exposure** to **water fluoridation** provides **benefits** in proportion to the **amount of fluoride in the water.** *Even in **suboptimal levels of water fluoridation,** there are **still benefits** in **proportion** to the **amount of fluoride** in the **water***

Question 163

Which of the following is the **MOST commonly** used **fluoride** compound in **water fluoridation**? A Sodium fluoride B Stannous fluoride C Hydrofluosilicic acid D Sodium silicofluoride

Answer 163

D **Sodium silicofluoride** ***Sodium silicofluoride** is the **most commonly used** compound in **community water fluoridation**, and the **least expensive** because it is a **byproduct of fertilizer** production. **Three fluoride compounds** are **used for water fluoridation**:* ***sodium fluoride** (A), **hydrofluosilicic acid** (C).* *and **sodium silicofluoride** (D).*

Question 164

Which of the following are **benefits of water fluoridation**? (Selectall that apply.) A Greater overall oral health B Reduction of childhood caries C Savings in dental treatment costs D Reduction in cases of oral cancer E Lower rates of coronal and root caries in adults

Answer 164

A **Greater** overall oral **health** B **Reduction** of childhood **caries** C **Savings** in dental treatment **costs** E **Lower rates** of **coronal and root caries** in adults

Question 165

There are **greater caries reduction** benefits from **combining** several methods of **self-administered topical fluoride** products with **water fluoridation** rather than **one method alone**. Combining **several methods** of **topical fluorides** and **water fluoridation** will cause **fluorosis** in the **adult** patient. A Both statements are true. B Both statements are false. C The first statement is true, and the second statement is false. D The first statement is false, and the second statement is true.

Answer 165

C The **first** statement is **true**, and the **second** statement is **false.**

Question 166

A **5-year-old** child presents to the dental office in a **community** in which the **_water is not fluoridated_** and the natural level of fluoride in the water is **0.2 ppm**. Which of the following daily **dosages** of **sodium fluoride (NaF) supplement tablets** should be **prescribed** for this **child**? A No supplement B 0.25 mg NaF C 0.50 mg NaF D 1.0 mg NaF

Answer 166

C. **0.50 mg NaF**

Question 167

**School water fluoridation** requires **adjustment** of the **amount of fluoride** to **4-5 times** the **optimal level** that is required to **fluoridate the community** water supply. School water fluoridation is **no longer recommended** by the CDC. A Both statements are true. B Both statements are false. C The first statement is true, and the second statement is false. D The first statement is false, and the second statement is true.

Answer 167

A. **Both statements are true.**

Question 169

Which of the following is the **LOWEST** probable **toxic dose (PTD)** of **fluoride** for a **child** who weighs **20 kilograms**? A 100 mg fluoride or 640 g NaF B 200 mg fluoride or 1280 g NaF C 640 mg fluoride or 100 g NaF D 1280 mg fluoride or 200 g NaF

Answer 169

A **100 mg** fluoride or **640 g NaF** * At the low end of this range for a child who weighs **20 kg**,* * the PTD would be **640 mg** fluoride or **100 g NaF** (**32 × 20 = 640; 5 × 20 = 100**).* *The PTD is **32 to 64 mg** fluoride or **5 to 10 g (50 to 100 mg) NaF/kg** body weight **(1 kg= 2.20 pounds**)*

Question 170

All of the following statements are **true** EXCEPT one. Which one is the **EXCEPTION**? A Fluorosis can be controlled in the population by controlling the risk factors. B The trend in the United States is an increase in the prevalence of slight fluorosis in children. C The new CDC recommendation to reduce fluoride levels in water supplies indicates that some public health care professionals consider the level of fluorosis to be a public health problem. D The rate of fluorosis is continuing to increase because of the high level of fluoride in children’s toothpaste.

Answer 170

D The **rate of fluorosis** is continuing to **increase** because of the **high leve**l of **fluoride in children’s toothpaste.** *The concern about increasing **fluorosis** has **led** to the **recent** development of **children’s dentifrices** with **lower** or **no fluoride**, **_not high levels_***

Question 171

**Detergent** ingredients in **dentifrices help loosen debris** through their **foaming action**. An example of a **detergent** is **sodium lauryl sulfate**. A Both statements are true. B Both statements are false. C The first statement is true, and the second statement is false. D The first statement is false, and the second statement is true.

Answer 171

A. **Both** statements are **true.** *The purpose o**f adding a detergent agent** to a dentifrice is to **help loosen debris,** produce a **foaming action**, and act as a **surfactant.*** ***Sodium lauryl sulfate** is the **most commonly utilized** detergent for **dentifrices.***

Question 172

Your patient has just concluded **orthodontics therapy** and is **upset about the white areas** in the former **location** of the **brackets**. Which of the following would be the **BEST dentifrice recommendation** for this patient? A Anticaries dentifrice with fluoride B Antiplaque dentifrice with triclosan C Whitening dentifrice to even out enamel coloration D Remineralization dentifrice with fluoride and calcium phosphate

Answer 172

D. **Remineralization** dentifrice with **fluoride** and **calcium phosphate** *A **remineralizing dentifrice** with **fluoride** and **calcium phosphate** will **promote reversal of incipient carious** or **“white spot lesions”** by **enhancing the uptake** of **fluoride and minerals** into the **enamel surface.***

Question 173

All of the following are **important considerations** for a **mouth rinse** marketed for **xerostomia** EXCEPT one. Which one is the **EXCEPTION**? A Is nonstaining B Contains fluoride C Has lubricating properties D Has moisturizing qualities

Answer 173

A. Is **nonstaining** *A **stain** is a **cosmetic concer**n and holds **no pathologic effects**; if a xerostomia mouth rinse causes staining, the **stain is easily removed** during a patient’s routine **oral prophylactic treatment.***

Question 174

One **suitable option** for an **antiplaque mouth rinse** recommendation is **chlorhexidine**. **Chlorhexidine** is readily **available** as an **OTC medication.** A Both statements are true. B Both statements are false. C The first statement is true, and the second statement is false. D The first statement is false, and the second statement is true.

Answer 174

C The **first** statement is **true**, and the **second** statement is **false.** ***Chlorhexidine** is used as an **antimicrobial agent** to **destroy bacterial cell membranes; controlling microbial levels** in patients at **high risk for caries** or **periodontal disease**. It is recommended as a **prescription** antiplaque agent (**not available OTC**) for high-risk patients because it **inhibits bacterial colonization**and**prevents pellicle formation.***

Question 175

Which of the following characteristics represent **ideal properties** of an **antimicrobial mouth rinse**? (Select all that apply.) A Substantivity B No adverse reactions C Promotes microbial resistance D Targets pathogenic microflora

Answer 175

A **Substantivity** B **No** adverse **reactions** D Targets **pathogenic microflora**

Question 176

Which of the following **products** are **commonly associated** with **staining of teeth, tongue,** and **tooth-colored restorations**? (Select all that apply.) A Listerine B Chlorhexidine C Stannous fluoride D Crest Pro-Health

Answer 176

B **Chlorhexidine** C **Stannous fluoride** D **Crest Pro-Health**

Question 177

**Sugar-free gums** primarily use **xylitol or sorbitol** for their **sweetening agents. Chewing gum** may be a **useful home care** recommendation to **stimulate saliva.** A Both statements are true. B Both statements are false. C The first statement is true, and the second statement is false. D The first statement is false, and the second statement is true.

Answer 177

A. **Both** statements are **true.** * **Xylitol, sorbitol, mannitol, and erythritol** are useful **sweeteners for chewing gum** because they are **not metabolized** by **oral bacteria**, **nor can** they be used to * *produce acid byproducts**. Chewing gum **stimulates saliva** that **buffers acids** in the mouth and **enhances remineralization**. Research indicates that **chewing xylitol gum** specifically additionally **reduces the population of cariogenic bacteria.***

Question 178

Which of the following **concentrations of neutral sodium fluoride NaF** is considered a **professionally applied fluoride** (in-office administration) agent? A 0.1% B 0.5% C 0.2% D 2.0%

Answer 178

D. **2.0% NaF** ***Neutral sodium fluoride 2.0% gel or foam** is a **professionally applied** agent available by **prescription** and used **twice annually** or as **caries incidence requires**.*

Question 179

Which of the following formulations are **considered professionally applied fluoride** products and have been **approved** by the **FDA** for **in-office use**? (Select all that apply.) A 2.0 % sodium fluoride B 1.1% sodium fluoride C 5% sodium fluoride varnish D 8.0% stannous fluoride solution E 1.23% acidulated phosphate fluoride

Answer 179

The 4 **high-potency topical fluoride systems** that have been **approved** by the **FDA** for **in-office use:** are **1.23% acidulated phosphate fluoride** **2.0% sodium fluoride,** **5% sodium fluoride varnish,** **8.0% stannous fluoride**, **1.1% sodium fluoride** is for **home care** and is available **OTC** or in the **dental office.**

Question 180

When **fluoride** **reacts with stomach acid**, the reaction product is **hydrogen fluoride.** The **initial symptoms** of **chronic fluoride toxicity** are **nausea, gastrointestinal pain,** and **vomiting.** A Both statements are true. B Both statements are false. C The first statement is true, and the second statement is false. D The first statement is false, and the second statement is true.

Answer 180

C The **first** statement is **true**, and the **second** statement is **false.** *When **fluoride** is **swallowed,** it reacts with **acids present** in the **stomach;** the **reaction** product is **hydrogen fluoride,** and this is considered **acute fluoride toxicity,** which produces **initial symptoms** of **nausea, gastrointestinal pain,** and **vomiting.***

Question 181

.The purpose of **converting neutral sodium fluoride NaF** into **acidulated phosphate fluoride** **APF** is to **lower the pH** of the product. Evidence-based research indicates that a **pH** of **4 or lower enhances fluoride uptake.** A Both statements are true. B Both statements are false. C The first statement is true, and the second statement is false. D The first statement is false, and the second statement is true.

Answer 181

A. **Both** statements are **true.** *The **primary purpose** of converting n**eutral sodium fluoride** to **acidulated phosphate fluoride** is to **lower the pH** of the product, which **increases fluoride uptake** into the enamel surface. **Neutral sodium fluoride** has a **pH** of around **7,** and **acidulation drops** the **pH to 3 to 5***

Question 182

Which of the following items are considered **antibacterial agents** for **dental caries**? (Select all that apply.) A Xylitol B Chlorhexidine C Dental sealants D Sodium bicarbonate E Carbamide peroxide

Answer 182

A **Xylitol** B **Chlorhexidine** D **Sodium bicarbonate** E **Carbamide peroxide**

Question 183

**Topically applied fluorides** are **most effective** for **prevention** of **dental caries** formation in the **pits** and **fissures** of teeth. Dental **sealants should be the primary** **preventive consideration** by the dental hygienist for the **reduction** in **pit and fissure caries** of teeth. A Both statements are true. B Both statements are false. C The first statement is true, and the second statement is false. D The first statement is false, and the second statement is true.

Answer 183

D The **first** statement is **false**, and the **second** statement is **true.** ***Topically applied fluorides** are **most effective** for **preventing dental caries** formation on the **smooth surfaces** of teeth and **least effective** in **pits and fissures.***

Question 184

**Continuous use** of **fluoridated water** from **birth** may result in **40% to 65% fewer carious lesions**. Anterior teeth, particularly **maxillary anterior teeth**, **receive more protection** from **fluoride** compared with **posterior teeth** because of the **direct contact of drinking water** as it **passes into** the **mouth** and **earlier eruption dates.** A Both statements are true. B Both statements are false. C The first statement is true, and the second statement is false. D The first statement is false, and the second statement is true.

Answer 184

A. **Both** statements are **true.**

Question 185

**Fluoride** is **added** to the **surface of enamel before** tooth **eruption.** The **uptake of fluoride** depends on the **level of fluoride** in the oral environment and the **length of time** of **exposure.** A Both statements are true. B Both statements are false. C The first statement is true, and the second statement is false. D The first statement is false, and the second statement is true.

Answer 185

D The **first** statement is **false**, and the **second** statement is **true.** ***Fluoride** is **added** to the **surface** of the **enamel after tooth eruption.***

Question 186

Which of the following is the **best practice** for the use of an **oral irrigator**? A Flush gingival sulcular areas directly. B Gradually increase the intensity of the stream to high. C Direct the stream perpendicular to the long axis of the tooth. D Use in limited access areas without soft-tissue inflammation.

Answer 186

C **Direct the stream perpendicular to the long axis of the tooth.**

Question 187

**Communication** can be considered a **preventive agent** when a dental professional **identifies harmful habits** and **encourages changes** in patient **behavior**; therefore, the dental professional should **avoid discussing** a patient’s **recreational drug use**. A Both the statement and the reason are correct and related. B Both the statement and the reason are correct but NOT related. C The statement is correct, but the reason is not. D The statement is NOT correct, but the reason is correct. E NEITHER the statement NOR the reason is correct.

Answer 187

C The **statement is correct**, but the **reason is not.** * the dental professional **SHOULD** **discuss** **all conditions** and observations,* * including **drug use, related** to the **patient and behaviors.***

Question 188

Which of the following self-care **devices** is **most appropriate** for **plaque biofilm removal** from **proximal tooth surfaces** and **shallow pockets**? A Dental floss B Toothpicks C End-tuft brushes D Powered toothbrush

Answer 188

A. **Dental floss**

Question 189

Use of a properly fitted **mouthguard**, while an individual plays sports, helps to **protect against** all the following conditions EXCEPT one. Which one is the **EXCEPTION**? A Bruxism B Clenching C Head injuries D Mouth breathing

Answer 189

D Mouth breathing *Use of a **properly fitted mouthguard,** while an individual is **playing sports,** is **not designed** to **prevent mouth breathing***

Question 190

* *Education** for a patient who wears an **obturator** should include * *all the following** teaching points EXCEPT one. Which one is the **EXCEPTION**? A Food takes longer to clear the oral cavity. B Soft-food consumption increases caries risk. C Tenacious nature of nasal fluids promotes biofilm retention. D Systemic fluorides are contraindicated due to risk of choking

Answer 190

D. **Systemic fluorides** are **contraindicated** due to **risk of choking** *Due to the **increased risk** of **caries** development, **topical and systemic fluorides,** along with **dental sealants** and use of **therapeutic doses** of* ***xylitol-**containing products **are indicated.***

Question 191

The **first course of action** in the dental hygiene **process of care** is to" A. recognize any deviations or abnormalities. B. identify the presence of plaque deposits. C. obtain medical and dental histories. D. classify the extent of periodontal disease.

Answer 191

C. obtain **medical** and **dental histories.** *Obtaining **comprehensive medical and dental histories** is the **first part** of **assessment,** and the **assessment phase** is the **first component** of the dental hygiene process.*

Question 192

The **highest pH level** at which **demineralization occurs** in **enamel** is between: A. 2.5 and 3.5. B. 3.5 and 4.5. C. 4.5 and 5.5. D. 6.0 and 6.7. E. 7.0 and 7.2.

Answer 192

C. **4.5 and 5.5.** The **highest pH** at which **demineralization occurs** for **enamel** is between **4.5 and 5.5;** demineralization will also **occur at any pH value lower than 4.5.**

Question 193

A caries management by **risk assessment (CAMBRA)** protocol for **enamel remineralization** involves **chewing of xylitol gum or mints** because **xylitol reduces** the levels of **Streptococcus mutans** and **promotes remineralization.** A. Both the statement and reason are correct and related. B. Both the statement and reason are correct and NOT related. C. The statement is correct, but the reason is NOT. D. The statement is NOT correct, but the reason is correct. E. NEITHER the statement NOR the reason is correct.

Answer 193

A.. **Both** the **statement and reason** are **correct and related.**

Question 194

**Dental caries** is a(n) A hereditary disease. B autoimmune disease. C communicable disease. D nontransmissible disease.

Answer 194

C **communicable disease**. Dental caries is an **infectious, transmissible, communicable** disease.

Question 195

For a patient who is classified as being at **moderate to extreme risk** for **caries**, **all of the following** are recommended **risk-reduction** and treatment **strategies** EXCEPT one. Which one is the **EXCEPTION**? A Topical and systemic fluoride use B Chewing an antacid before bedtime C Using a 0.12% chlorhexidine gluconate rinse D Substituting xylitol mints for sugared mints E Brushing with a calcium phosphate paste daily

Answer 195

B. **Chewing an antacid before bedtime**

Question 196

**Hyposalivation** may develop into **all of these** oral conditions EXCEPT one. Which one is the **EXCEPTION**? A Dysgeusia B Dysphagia C Xerostomia D Rampant caries E Periodontal disease

Answer 196

E. **Periodontal disease** * *Periodontal disease** is a **multifactorial disease** that has its * *primary etiology** in oral **biofilm**, **_not_ hyposalivation.**

Question 197

**Parents of** **infants** with **high caries risk** should use a **xylitol-containing gum** **4-5 times daily**. Use of xylitol gum by the parent will **reduce the transfer of caries causing bacteria to the infant.** A. Both statements are true. B. Both statements are false. C. The first statement is true, and the second statement is false. D. The first statement is false, and the second statement is true.

Answer 197

A. **Both** statements are **true.**

Question 198

To **control high levels** of **Streptococcus mutans** in an individual with **existing decay** and **high caries activity**, which of the following **protocols is recommended** to **control the microorganisms**? A Daily lidocaine oral rinse for 1 week B Daily chlorhexidine rinse for 2 weeks C Daily dose of amoxicillin for 1 week D Weekly debridement appointments

Answer 198

B Daily **chlorhexidine** rinse for **2 weeks** *Use of **0.12% chlorhexidine** rinse for **1 minute per day** for a **2-week** period every* ***2 to 3 months** will **eliminate the microorganisms** that **initiate the caries process***

Question 199

**Chlorhexidine gluconate rinse** is effective in the **reduction of caries-causing** **bacteria** along with the pathogens associated with **periodontal disease. Chlorhexidine gluconate** is a **broad-spectrum antibacterial agent**. A. Both statements are true. B. Both statements are false. C. The first statement is true, and the second statement is false. D. The first statement is false, and the second statement is true.

Answer 199

A. **Both** statements are **true.**

Question 200

Which of the following items **can be adapted** to aid in **oral care** for a patient who has **difficulty holding objects** because of **severe arthritis**? (Choose all that apply.) A Bicycle grip B Mouth sticks C Universal cuff D Soft rubber ball E Quick-cure acrylic molds

Answer 200

A **Bicycle grip** D **Soft rubber ball** E **Quick-cure acrylic molds** ***Bicycle grips, soft rubber balls**, and **quick-cure acrylic molds** may be used to **build up the handle of a device**, making it **easier f**or the **patient to grip.***

Question 201

Which of the following options is **MOST appropriate** for a patient **experiencing severe dentinal hypersensitivity** during **instrumentation** at the **prophylaxis appointment**? A Fluoride varnish B Local anesthesia C Home fluoride trays D Desensitizing toothpaste

Answer 201

A. **Fluoride varnish**

Question 202

Each of the following **agents** may be effective in **relieving dentinal hypersensitivity** EXCEPT one. Which one is the **EXCEPTION**? A Stannous fluoride B Potassium oxalate C Potassium nitrate D Sodium bicarbonate E Amorphous calcium phosphate (ACP)

Answer 202

D **Sodium bicarbonate** ***Sodium bicarbonate** has **antibacterial properties** and is used with individuals who are at **high risk for caries** and **dry mouth**. It **_does not relieve hypersensitivity._***

Question 203

A patient with **orthodontic appliances** should be instructed to use an **interdental aid** to **clean around the appliances**. The patient should be instructed to use a **chlorhexidine rinse** and a **fluoride treatment together within 15 minutes.** A. Both statements are true. B Both statements are false. C The first statement is true, and the second statement is false. D The first statement is false, and the second statement is true.

Answer 203

C The **first** statement is **true**, and the **second** statement is **false.**

Question 204

In which of the following **toothbrushing methods** are the **bristles directed away** from the **gingiva toward** the **occlusal** or **incisal edge**? A Bass B Charters C Stillman D Roll stroke

Answer 204

B. **Charters**

Question 205

A score on a **plaque index (PI)** of a **1.0 to 1.9** **(53%**) means that the patient has **which type** of **oral hygiene**? A Poor B Fair C Good D Excellent

Answer 205

B. **Fair** When scoring the PI, a score of **1.0 to 1.9 (53%)** means the patient has **fair** A score of **0.0 (0%)** means **excellent** oral hygiene **0.1 to 0.9 (11%)** means **good** oral hygiene and **2.0 to 3.0 (63%)** means **poor**

Question 206

What is the patient’s score on the **O’Leary’s Plaque Control Record** if he or she has **plaque** at the **gingival margin** of **40 surfaces** and a total of **28 teeth**? A 28% B 40% C 60% D 100%

Answer 206

A. **28%** ***(28 × 4 = 112)**, with **112** available **tooth surfaces**. **40** of those **surfaces** are* ***covered in plaque** **(112 ÷ 40 = 28%)***

Question 207

Which of the following is the **MOST effective tool** for cleaning the **embrasure space i**n a patient with **missing interdental papillae**? A Floss B Toothpicks C Proxy brush D Oral irrigator E Rubber tip stimulator

Answer 207

C. **Proxy brush**

Question 208

The **MOST effective** method for a dental hygienist to **assess the patient’s ability** to **perform daily self-care** is to: A. ask the patient to explain how he or she brushes and flosses. B ask the patient to explain why he or she brushes and flosses. C ask the patient to demonstrate brushing and flossing on self. D ask the patient to demonstrate brushing and flossing on a mannequin.

Answer 208

C. ask the **patient to demonstrate** **brushing and flossing on self.**

Question 209

Which **recommendation** should the dental hygienist make to a **patient who continuously drinks energy drinks throughout the day**? A Completely avoid energy drinks. B Sip the energy drink throughout the day. C Drink all of the energy drink at one time. D Drink half the energy drink in the morning and half in the afternoon.

Answer 209

C. **Drink all of the energy drinks at one time.**

Question 210

**Excessive consumption** of **diet soda** may **lower plaque biofilm pH** and be a **factor** in **dental erosion**. Erosion makes the tooth **more susceptible to dental decay.** A. Both statements are true. B Both statements are false. C The first statement is true, and the second statement is false. D The first statement is false, and the second statement is true.

Answer 210

A.. **Both** statements are **true.**

Question 211

Which of the following **four zones** of **demineralizatio**n is the **largest**? A Dark zone B Surface zone C Translucent zone D Body of the lesion

Answer 211

D. **Body of the lesion** *The **body of the lesion** is the **largest portion** of the **incipient lesion.** This **V-shaped zone** is the **most demineralized** of **all the zones.***

Question 212

Which of the following **statements** about the **white spot lesion** is the **MOST correct**? A. The area is hypermineralized. B The area may be remineralized. C The area should be examined with a sharp explorer. D The area roughness indicates beginning of surface breakdown.

Answer 212

B The **area may be remineralized.** *The **white spot lesion** may be **remineralized** with **adequate saliva** and **increased fluoride** as long as the **surface** is **not compromised.***

Question 213

**Early childhood caries (ECC)** often presents as **carious lesions** on **maxillary anterior** teeth. Early **carious lesions** are **caused by sleeping** with a **bottle** of **milk or other sugar-containing liquids.** A. Both statements are true. B. Both statements are false. C. The first statement is true, and the second statement is false. D. The first statement is false, and the second statement is true.

Answer 213

A. **Both** statements are **true.**

Question 214

Which of the following **foods** has an **anticariogenic effect** and the potential to **reduce demineralization** and **enhance remineralization**? A Raisins B Cheddar cheese C Meat of any kind D Green leafy vegetables

Answer 214

B **Cheddar cheese** ***Milk** and certain **kinds of cheese** such as **cheddar cheese** have been found to have an anticariogenic effect, with the potential to reduce demineralization and enhance remineralization of enamel.*

Question 215

Patients with **xerostomia** do not have **enough saliva** for the A buffering process. B diffusion process. C ionization process. D demineralization process.

Answer 215

A **buffering process**. ***Saliva** causes **neutralization of acid**, which is called the **buffering process***

Question 216

**Chlorhexidine gluconate** is used in the **treatment of dental caries** as a **cavity cleanser,** in preparation for restoration. It also **reduces** the **number of bacteria** in patients with **dental caries** and **high bacterial challenges.** A. Both statements are true. B Both statements are false. C The first statement is true, and the second statement is false. D The first statement is false, and the second statement is true.

Answer 216

A. **Both** statements are **true.**

Question 217

Which of the following **fluorides** is **MOST appropriate** for delivery in a **custom tray** for a patient undergoing **head and neck radiation**? A. Stannous fluoride B Neutral sodium fluoride C Acidulated phosphate fluoride D Sodium monofluorophosphate fluoride

Answer 217

B. **Neutral sodium fluoride (NaF)** ***Mucositis** is common during **radiation** therapy, and **neutral sodium fluoride** is **nonirritating to ulcerated tissue.***

Question 218

Which of the following **supportive measures** is **MOST effective** for the **prevention** of **occlusal dental caries** on **newly erupted permanent posterior teeth (kids)**? A. Dietary counseling B Oral hygiene instruction C Use of fluoride toothpaste D Application of pit and fissure sealants

Answer 218

D **Application** of **pit** and **fissure sealants** *The **application** of **pit and fissure sealants** on n**ewly erupted permanent teeth** is the **most effective** for the **prevention** of **dental caries** because it **does not involve patient motivation** or **compliance** for **long-term effectiveness.***

Question 219

Which of the following **dental conditions** could be **mistaken** for **amelogenesis imperfecta**? A. Fluorosis B Tetracycline stain C Osteogenesis imperfecta D Dentinogenesis imperfecta

Answer 219

A.. **Fluorosis** ***Fluorosis** appears as **change** in the **enamel** that range from barely **noticeable white spots** to staining to d**ark brown staining and pitting**. **Amelogenesis imperfecta** is a group of **genetic autosomal defects** in **enamel formation,** resulting in a variety of **clinical manifestations**. The **white mottled appearance** of the “**snow-capped”** variety of **amelogenesis imperfecta** resembles the **white spots** often seen in **fluorosis.***

Question 220

What is the **role** of **subgingival calculus** in the development of **periodontal disease**? A Prime etiologic factor B Environmental factor C Local contributing factor D Systemic contributing factor

Answer 220

C. **Local contributing factor** ***Subgingival calculus** is a **local contributing factor** to the **etiology** of **periodontal disease** because of its **role** in **harboring plaque biofilm.***

Question 221

Which of the following **should be avoided** when the dental hygienist is **preparing** a dental hygiene **diagnosis statement**? A. Unmet need B Etiology of disease C Signs and symptoms D Attitudes or judgments

Answer 221

D. **Attitudes or judgments** *The dental hygiene **diagnostic statement** should not include words that **express attitudes or judgments***

Question 222

The dental hygiene **care plan** is a **blueprint** that should be **developed** between **which individuals**? A. Dentist and patient B Dental hygienist and patient C Dental hygienist and dentist D Dental hygienist independently

Answer 222

B. **Dental hygienist** and **patient** *The dental hygienist should **work in collaboration** with the **patient to encourage participation** of the patient in **identifying goals, priorities, and unmet needs** for the **care plan.***

Question 223

**Oral irrigation** is an **adjunctive method** to periodontal therapy for the r**emoval of oral biofilm.** Oral irrigation **effectively targets attached oral biofilm,** **unattached oral biofilm,** and **loosely adherent oral biofilm.** A. Both statements are true. B Both statements are false. C The first statement is true, and the second statement is false. D The first statement is false, and the second statement is true.

Answer 223

C The **first** statement is **true**, and the **second** statement is **false.** The **second** statement is **false** because **oral irrigation** is **most effective** in **removal** of **unattached and loosely adherent oral biofilm** but **does not** effectively remove **attached oral biofilm**, which requires **mechanical removal.**

Question 224

Which is the **FIRST clinical feature** of **plaque-induced gingivitis**? A. Edema B Redness C Exudate D Loss of function E Bleeding on probing

Answer 224

E. **Bleeding on probing**

Question 225

“**A desired end result**, in terms of **knowledge** that the **client is to achieve** through **specific** dental hygiene **actions**” describes what type of **patient-centered goal**? A. Affective B. Cognitive C. Psychomotor D. Oral health status

Answer 225

B.. **Cognitive** ***Cognitive** goals aim to **increase** the **client’s knowledge** to **achieve a desired*** ***end result** through **specific** dental hygiene **actions.***

Question 226

**Periodontal disease** is associated with the following **obligate, anaerobic,** **gram-negative bacteria** EXCEPT one. Which one is the EXCEPTION? A Streptococcus mutans B Tannerella forsythensis C Porphyromonas gingivalis D Aggregatibacter actinomycetemcomitans

Answer 226

A. **Streptococcus mutans** ***S. mutans** is a **gram-positive**, _not a gram-negative_, **facultative** **anaerobic bacterium** associated with **dental caries. T. forsythensis, P. gingivalis,** and **A. actinomycetemcomitans** are all **gram-negative**, obligate, **anaerobic bacteria** that have strong links to **periodontal disease.***

Question 227

Which feature **differentiate**s **periodontitis** from **gingivitis**? ' A. Bleeding on probing B Clinical attachment loss C Fibrotic gingival consistency D Probe depth greater than 3 mm

Answer 227

B **Clinical attachment loss** *A **diagnosis** of **periodontitis** requires **clinical attachment loss**, with **apical migration** of the **junctional epithelium, bone loss,** or **both.***

Question 228

**Cratered** and **missing gingival papillae** are **indicative** of **all of the following**EXCEPT one. Which one is the**EXCEPTION**? A Loss of col B Necrotizing ulcerative gingivitis (NUG) C Proximal infrabony osseous defect D Chronic use of toothpicks

Answer 228

B **Necrotizing ulcerative gingivitis (NUG)** *Although individuals with **chronic NUG** may have **cratered papillae**, **not all cases of NUG result in this defect.***

Question 229

When a **patient is identified** as being at **high risk** for **caries** during oral examination, which of the following **strategy is NOT recommended** by the American Dental Association (ADA) for **primary prevention of caries**? A Sealants B Fluoride varnish C Nutritional counseling D Xylitol gum chewed after meals

Answer 229

D **Xylitol gum chewed after meals**

Question 230

**Which teeth** are **generally affected** first in **early childhood caries**? A Maxillary molars B Mandibular anterior teeth C Mandibular molars and maxillary anterior teeth

Answer 230

C **Mandibular molars** and **maxillary anterior teeth**

Question 231

Identify this **CDT code:** ## Footnote **D1206**

Answer 231

D1206 – **Topical application** of **fluoride varnish** and gave **post‐operative instructions**

Question 232

Identify this **CDT code:** ## Footnote **D1120**

Answer 232

D1120 – **Prophylaxis – child (under 14 years of age)**

Question 233

Which health **behavior model** addresses the dental hygiene **focus** of **creating** and **increasing awareness** of **healthy choices** through a **process of change over time** as individuals **cycle through stages of awareness and readiness**? A Locus of Control B Health Belief Model C Social Cognitive Theory D Stages of Change: Transtheoretical Model

Answer 233

D. **Stages of Change**: **Transtheoretical Model** *This model proposes the theory that **change must develop**as a process**over time**while individuals**cycle** through **different stages of awareness and readiness.** The cycle starts by **raising awareness of a problem, progresses to contemplating** **change, deciding to change, acting on a specific plan, and finally follows up**with**the maintenance**of that**desired action**or**behavior.***