Preventive Procedures - Midterm Review Flashcards
What does oral prophylaxis include
scaling, root planning, gingival curettage, polish & fluoride
This type of deposit forms within mintues after eruption of the tooth or after the removal of hard and soft deposits
acquired pellicle
Makes up the composition of Materia alba
Living and dead bacteria
Gram positive aerobic bacteria is typically found..
Supragingivally
Calculus is..
mineralized plaque biofilm
Mineralization of plaque biofilm can occur
24 to 72 hours
Supragingival calculus can occur most frequently on
buccal surfaces of maxillary molar
Dental stains can…
Provide a rough surface where biofilm can develop
mainly an aesthetic concern
means of evaluation of oral hygiene practices
Intrinsic stains..
occur on the inside of the tooth and cannot be removed by scaling or polishing
Black line stains can be caused by…
tobacco product
chromogenic bacteria
hydrogen sulfide reaction with iron in the saliva
The extension of inflammation into the connective tissues and bone surrounding the teeth describes…
periodontitis
The 3 essential criteria for the formation of dental caries includes
Susceptible Tooth: Any tooth can get cavities, but teeth with fluoride are less likely to decay.
Acid-Producing Bacteria: Bacteria like Streptococcus mutans produce acid from sugar and contribute to decay.
Cariogenic Foods: Foods high in sugar that bacteria can ferment into acids increase the risk of cavities.
If acid attacks are infrequent and short or _____ can help repair the damage by neutralizing acid and suppyling
saliva
Contributing factors for early childhood caries..
bacteria present in caregivers mouth passed on to child
fermentable carbohydrates
milk
The quality of the saliva describes the…
consistency or viscosity
Antibiotic premedication is recommended for patients with..
cardiac conditions associated with adverse outcomes from endocarditis
Dental stains cause caries - true of false?
False
Dental fluorosis is an example of ____ staining.
Instrinsic & Exogenous
Dental stain is classified by…
location & source
All dental stains can be removed - true or false?
false
Dental assistants remove stains from teeth and perform preventive services?
false
Dental stains contribute to the disease process - true or false?
false
What type of dental stains cannot be removed?
intrinsic stains
What is an example of extrinsic dental stains?
staining from food
from tobacco or wine
Gingivitis is a disease of what body part?
Gums
Gingivitis is inflammation of the ______
GUMS
What causes gingivitis?
not brushing your teeth
An instrument with incremental marks to measure the periodontal pockets
periorprobe
Periodontal disease is best measured by..
clinical exam
periodontal probing
radiographic exam
Measuring the periodontal pocket is called..
probing
Periodontal disease is infectious… True or false?
TRUE
What type of pocket is formed as a result of disease or degeneration that causes the tissue to migrate apically
Periodontal pocket
For healthy sulcus, the probing depth should be between…
1-3mm
When completing a comprehensive periodontal examination, there are __ readings taken per tooth.
6
What kind of tooth brush bristle is usually recommended?
nylon, soft rounded bristles
As a dental professional you will recommended what type of brush
Soft, rounded nylon
Home care methods used - preventive?
flossing
brushing
mouth wash
Modification of the different tooth brushing methods would involve?
The rolling stroke
Which tooth brushing methods would you recommended to 6 year old brushing on their own?
Fones or Bass Method
what type of fluoride is ingested in water, food, beverages or supplements?
Systemic fluoride
Using the heel or toe of the brush is helpful for cleaning which tooth surfaces?
lingual surfaces of anterior teeth
When brushing the lingual surfaces of the anterior teeth, the head of the tooth brush is placed…
vertically
To avoid abrasive effects, what is the recommended amount of time to spend polishing each tooth?
3 to 5 seconds
What is the purpose of flossing?
to aid in removale of bacteria
You should only use the square types of tooth picks - true or false?
false
The type of tooth brush that is recommended is…
nylon
What sign indicates incorrect flossing?
cleft gingiva
What is the arrangement of bristles called?
tuft
Embrasure types: fills interproximal space?
Class 1
What is the purpose of an astringent in a mouth wash?
Shrink tissue
Type 1 embrasures will respond well to which type of floss?
teflon coated floss
The space between the tooth and the free gingiva is….
the sulcus
Which toothbrush method is most popular?
Bass or Modified Bass
The recommended time to properly brush your teeth is…
2-3 minutes
Why should a bristle brush and abrasive NOT be used on the cementum
it is soft and easily grooved
An interdental brush can be used for all of the following cases except…
crowded teeth
Toothbrushing method that is acceptable for all patients
Modified bass
Toothbrushing method that is most appropriate for children
Rolling Method
Toothbrushing method for Small children
fones
Bristle brush attachments should NOT be used near the gingival margin - true or false?
True
Calculus ____ be removed by brushing and other plaque control methods
CANNOT
Define “Preventive Dentistry” and list 3 procedures that would be considered a
preventive procedure.
Preventive dentistry is a type of dentistry that involves procedures and services aimed at preventing the occurrences of oral diseases. Preventive procedures are done to help individuals of all ages obtain optimal oral health.
Preventive procedures include:
-Scaling
-Root Planing
-Curettage
-Coronal Polishing
-Topical fluoride application
List 4 types of soft deposits - 1. Dental Plaque/Biofilm
Dental Plaque/Biofilm
- dense organized bacterial communities embedded in extracellular substance matrix that adheres to the teeth, calculus, restorations and other surfaces in the oral cavity
-microorganisms and EPS comprise 20% (inorganic and organic solids) the other 80% is water
- Calcium, phosphorus and magnesium
-Organic - carbs & proteins
-colonization of oral microorganisms
-major role in the initiation and progression of dental caries and periodontal disease
- contains pathogenic microorganisms
-Can be removed with toothbrush and interdental aid (floss)
List 4 types of soft deposits - 2. Materia Alba
Materia Alba
-white or grayish white with a cottage cheese texture & appearance
-unorganized accumulation of living and dead bacteria, desquamated epithelial cells, disintegrating leukocytes, salivary proteins & possibly particles of food debris
-incidental accumulation
-contributes to gingival inflammation and tooth demineralization
-can remove with vigorous rinsing, water irrigation
List 4 types of soft deposits - 3. Food Debris
Food Debris
-Unstructured, loosely attached particulate matter
- loose particles of food
- food retention following consumption
-cariogenic foods contribute to dental caries
- self cleansing action of the tongue & saliva.. rinsing, toothbrushing, and other oral hygiene aids
List 4 types of soft deposits - 4. Acquired Pellicle
Acquired Pellicle
-Translucent, homogenous, unstructured thin film that covers and adheres tothe tooth surfaces, restorations, calculus, and other surfaces
- primarily glycoproteins that are selectively absorbed by the hydroxyapatite of the tooth surface
-Supragingival: saliva, oral mucosa, and microorganisms
-Subgingival - gingival sulcus fluid
-Protective lubrication, nidus for bacteria, attachment for calculus
- can be removed with abrasive toothpastes, whitening products, intake of acidic foods & beverages
Describe the difference between dental plaque biofilm and dental calculus
Dental plaque biofilm is the sticky film of bacterial colonies that constantly forms on the surface of teeth. Dental calculus is oral biofilm that has been mineralized by calcium and phosphate salts from saliva. When dental plaque biofilm is not removed form the teeth, it will hard and create dental calculus.
List the sequence for dental plaque biofilm formation.
The first stage is the deposition of salivary components, know as the acquired pellicle. Although the acquired pellicle has a protective function, acting as a barrier to acids, it also serves as an initial site of attachment for bacteria
Bacteria such as gram-positive cocci, are the first microorganisms to adhere to and colonize on teeth. Early plaque consists primarily of aerobic, gram positive cocci such as steptococcus mutans.
Once bacteria have adhered to the tooth surface, they colonize & multiply. As the growth process continues, an intermicrobial matrix forms and connects the bacterial colonies. The biofilm is now a fully functioning community of different species.
List 3 criteria required for dental caries to occur
- Susceptible tooth - any tooth that has erupted into the oral cavity, a tooth with optimum fluoride content is less susceptible to the process of dental caries
- Acidogenic microorganisms - bacteria that produces acids through the metabolism of fermentable carbohydrates, streptococcus mutans and lactobacillus are consistently associated with dental decay
- Cariogenic food source - a food source that is associated with the development of dental caries, sugars that are easily fermented and breakdown into simple sugars (glucose, fructose, maltose & lactose)
Acidogenic bacteria will ferment these carbohydrates and produce acid, which will begin to demineralize the tooth
Define demineralization
The process that occurs when acids produced in the oral cavity diffuse into the tooth and dissolve the calcium and phosphate minerals. If the acid attacks are infrequent and of short duration, saliva can assist in the repairing of damage by neutralizing the acid and replacing minerals lost from the tooth. If however, the flow of saliva is low, the bacterial level is high, and the frequency of client snacking is high, remineralization cannot take place and the start of dental caries may occur.
How does saliva serve as protectant against decay?
- Physical protection: assists in the removal of sugars from the mouth
- Chemical protection: Neutralizes and buffers acids in bacterial plaque
- Antibacterial protection: contains antibacterial properties
An unorganized accumulation of living and dead bacteria, desquamated epithelial
cells and disintegrating leukocytes make up the composition of:
Materia Alba
Which of the following is an example of an intrinsic stain?
- Initial tobacco stain
- Black line stain
- fluorosis stain
d. Green stain
- Fluorosis stain
Xylitol can be used to…
Xylitol can be used to reduce caries risk because it cannot be metabolized by cariogenic microorganisms
Which of the following factors increases an individual’s risk for dental caries?
a. Malpositioned teeth
b. Sipping water after meals
c. Increased salivary flow
d. Fluoride treatment
a. Malpositioned teeth
Xerostomia is..
Dry mouth
When calcium and phosphate dissolve from a tooth it is known as:
demineralization
Which structures are a part of the periodontium?
gingiva, periodontal ligament, cementum, alveolar bone
Gingivitis differentiates into periodontitis when…
when the infection progresses causing
attachment loss.
What is Chronic Periodontitis?
Results in inflammation within the tissues supporting the teeth and progressive attachment loss that generally occurs slowly
Which of the following is not considered a risk factor for periodontal disease:
a. Tobacco use
b. Osteoporosis
c. Hormone alterations
d. Abundance of vitamins A, B, C
d. Abundance of vitamins A, B, C
What can be done to reverse gingivitis
Improve brushing and flossing techniques
What systemic diseases are related to periodontal disease?
-respiratory diseases
-preterm low birthweight
-cardiovascular disease
How many recordings are taken for a periodontal screening and recording (PSR) assessment?
1 recording per sextant
In which situation would you use a plastic probe?
during comprehensive (full mouth) probing where there is a dental implant
The ability to feel whilst exploring is known as:
Tactile sensation
What is the main purpose of using a disclosing agent?
Valuable visual aid for patient education and instruction
Which toothbrushing method is indicated for young children and people who do not
have sufficient dexterity?
Fones Method
What is the purpose of explorers in periodontal treatment?
To provide tactile information & to locate calculus
Dental carious lesions are best classified as:
Life long, transmissible , an infection
This periodontal disease is often associated with pain, halitosis and a suppressed
immune system:
Necrotizing periodontal disease
Some drugs used to treat hypertension and epilepsy can cause:
Gingival overgrowth
Aggressive brushing can lead to:
Gum recession, abrasion and root caries
Chromogenic bacteria is associated with
Green stains, orange stains and black stains
Tetracycline stains are:
Endogenous intrinsic
Extrinsic stains are best described as?
Occurring on the external surface of a tooth
Tetracycline stain on a tooth is an example of what type of stain?
Endogenous
The two basic forms of periodontal disease are:
gingivitis and periodontitis
The bacteria found in dental _________cause inflammation by producing enzymes and toxins that destroy periodontal tissues and lower host defenses.
plaque biofilm
The leading cause of tooth loss in adults is:
periodontal disease
Dental caries is a __________caused by acids from bacterial metabolism which leaches into enamel and dentin, dissolving the mineral content of these tooth tissues.
bacterial disease process
Periodontal pockets can best be described as:
a diseased gingival sulcus
A periodontal probe cannot be used to:
remove calculus
Comprehensive (full mouth) probing depth measurements are taken on how many “sites” of each tooth?
6 sites
What is the primary contraindication to using a disclosing solution?
allergy
Charlie, a 9-year-old boy, presents to your dental office and the dentist asks you to assess Charlie’s home care by completing a plaque indices that indicates the precentage of Charlie’s teeth that are covered with plaque. You complete which of the following plaque indices?
Plaque Control Record
Dental professionals should recommend _______________toothbrushes to their patients.
soft bristled nylon
Which of the following factors does not influence the stiffnes of the toothbrush filament?
end rounding of the filaments
Define Acquired Pellicle
Organic film covering the surfaces of the teeth
Define food debris
particles of food in the mouth
define dental plaque
a sticky colourless or yellow film that forms on teeth
define material alba
soft accumulations of bacteria and tissues that are not organized and can be removed with water spray
Define root planing
used to smooth the tooth root and remove residual calculus and toxins
define fluoride
aids in the prevention of tooth decay and sensitivy
define oral prophylaxis
the removal of calculus, debris, stain and plaque from the teeth
define coronal polishing
used to remove extrinsic stains from the enamel surfaces of the teeth
List 3 basic steps in calculus formation
PELLICLE FORMATION-deposit of salivary components, the acquired pellicle
BIOFILM MATURATION-bacteria adheres to the acquired pellicle & colonizes creating dental plaque biofilm
MINERALIZATION-if the dental plaque is not thoroughly removed, it can harden and mineralize into calculus
List 3 protective mechanisms of saliva that prevents against dental caries
PHYSICAL -washes sugars from mouth
CHEMICAL-neutralizes acids
ANTIBACTERIAL-antibacterial protection
When the number of caries causing bacteria in the mouth increases, the risk for developing dental caries also increases. True of False?
True
Dental caries is a(n)
infections disease
communicable disease
highest disease reported in history
untreated disease in children with a higher prevalence rate than asthma
The term for dental caries that occurs under or adjacent to existing restorations is
recurrent
During remineralization __, found in saliva, work together to replace some of the minerals that have been lost.
calcium, fluoride, and phosphate
If a patient has incipient caries, it __ possible for remineralization to reverse the decay process.
IS POSSIBLE
Prevention of dental caries includes
-the use of fluoride
-an antimicrobial oral rinse
-decreasing fermentable carbohydrates in the diet
-increasing salivary flow
Decay that develops rapidly and is widespread throughout the mouth is ?
rampant caries
Loss of minerals from the tooth surface is called
demineralization
Mutans streptococci are transmitted through saliva, most commonly the mother’s, to the infant. True or False?
True
Early childhood caries is (ECC)
-Preventable
-Transmissible
-More common in children with special needs
The most highly mineralized tissue in the body is
Enamel
The oral cavity of newborn children does not contain any mutans streptococci. True or false?
True
The earliest stage of dental caries is
Incipient
Colonies of bacteria embedded in an adhesive layer are called
plaque
What is a Dull, yellowish discoloration of dental biofilm occurrence and Etiology?
All ages and usually diet
What colour stain is usually found in children?
GREEN
What is usually Continuous or interrupted fine line that follows the contour of the gingival margin – may appear black at the bases of pits and grooves
black line stain
What type of stain is typically found in patients who smoke?
Tobacco stain
Exogenous stains are stains found within the tooth ? true of false?
false
Exogenous stains can be removed - true or false?
true
Tetracycline stain is a endogenous stain - true or false?
true
How many periodontal probing measurements are taken for each tooth?
6
A gingival pocket that is present due to disease and loss of attachment is?
Periodontal pocket
The procedure that removes calculus, soft deposits, and stain from all unattached tooth surfaces is known as
dental prophylaxis
The accuracy of dental radiographs is not as important in periodontics as it is in detecting dental caries. True or False?
FALSE
Curettes that are designed with two cutting edges are
Universal
The procedure in which the gingival wall of the pocket is scraped is called
gingival curettage
During an examination, the bleeding index is based on the principle that
healthy gingiva does not bleed
If a patient has a loss of attachment of the gingiva and deep pockets, they have?
Periodontitis
What can you tell a patient that has gingivitis?
it is reversible
Mothers who go into early labour often have?
increase in toxins that can induce labour
It is safe to give Xylitol to children, pregnant women, seniors and adults as it helps to reduce the oral bacteria. True or False?
True
Curettage is when ?
the RDH removes roughness on cementum below the gumline
PSR is a Screening tool ONLY, determining the need for a more comprehensive periodontal evaluation. True or false?
True
If you get a code 4 you must stop probing that sextant and move on to the next. True of False
True
Healthy Pockets are ?
1 mm to 3 mm
Calculus removal, plaque control measures and correction of defective margins on restorations if noted fall under which code?
4??
Home care instructions, plaque control and preventive care measures can be given if a patient has code ?
Code 1
Because dental plaque biofilm is not easily seen; it can be difficult for patients to realize it is there. What can you use to make your oral hygiene instructions more effective?
a disclosing agent
This method is useful for all types of dental conditions, especially periodontal diseases. With bristles. Pointed at a 45-degre angle into the gingival sulcus, the brush is vibrated gently back and forth about 10 times. The brush is then moved forward and the vibrations repeated.
Bass Method
This method is useful for removing biofilm without reaching the sulcus. The brush is placed above the free gingiva with the bristles pointed toward the apices. Light pressure is exerted and the brush is drawn toward the occlusal surface using a rolling stroke.
Rolling Stroke Method
This method is useful for patients with severe loss of interdental papilla height, fixed prosthetic appliances and previous gingival surgery. The rolling stroke method is completed first. Then the bristle tips are directed toward the occlusal or incisal surface. The handle is rotated, flexing the bristles and bringing them into contact with the interdental tissue and exposed proximal surfaces. The handle of the brush is vibrated with a slow, circular motion.
Charters
This method is useful for patients for cleaning cervical areas, and for stimulation and massage of the gingiva. It works well in areas of recession and proximal surfaces. The brush ends are placed partly on the ginigva and partly on the cervical area of the tooth and directed slightly apically and angled 45 degrees. The bristles are vibrated in a rotary motion over the gingiva and rolled over the tooth making some bristles reach interproximally
Modified Stillman
This method is useful for small children or others with poor manual dexterity. The teeth are occluded.
Then, lightly press the bristles against the posterior teeth and the gingiva. The brush is moved in a
circular motion, using circles of large diameter. The circular motion is continued, and the brush is
slowly motioned toward the anterior until all facial surfaces have been brushed. With the mouth open,
use an in and out stroke on the maxillary and mandibular lingual surfaces.
Fones
