Preventive Procedures - PP week 2

Question 1

Dental Prophylaxis

Answer 1

Dental Prophylaxis, also known as a “prophy” or a “cleaning,” involves the thorough removal of calculus (a hard, mineralized deposit on the teeth), plaque, and stains using hand instruments, ultrasonic scalers, and coronal polishing. This procedure is performed by a dentist or a registered dental hygienist.

Question 2

Purpose of Dental Prophylaxis

Answer 2

It aims to prevent dental problems like cavities, gum disease, and tooth decay by ensuring a deep clean of the teeth and gums

Question 3

Why is prevention important?

Answer 3

To prevent dental problems, patients and the dental healthcare team need to work together.
1. As a dental assistant, your first job is to help patients learn what causes dental problems and how to avoid them.
2. The next step is to encourage patients to change their habits and actively participate in preventing dental issues for themselves and their families (Robinson, 2024).
3. Helping patients understand what causes dental disease and how to prevent it.

Question 4

Scaling (non-surgical)

Answer 4

This is the process of removing plaque and tartar (hardened plaque) from the surface of your teeth, especially below the gum
line. It’s usually done with special instruments or ultrasonic devices to clean the teeth thoroughly

Question 5

root planing (non-surgical)

Answer 5

This involves smoothing the roots of the teeth after scaling. The goal is to remove any remaining tartar and to make the root
surfaces less rough, which helps the gums to reattach properly. It’s often done for patients with gum disease.

Question 6

Gingival Curettage

Answer 6

This is a procedure where a small instrument is used to scrape
away infected tissue from the gum lining. The goal is to remove
diseased tissue and help the gums heal. It’s typically used in more
severe cases of gum disease.

Question 7

Coronal Polishing

Answer 7

Coronal Polishing is a procedure aimed at cleaning the surfaces of the teeth above the gum line. It involves:
Removing Plaque and Stains: It helps get rid of any remaining plaque and stains from the teeth’s outer surfaces after a routine cleaning.
Smoothing Surfaces: It polishes the teeth to make them smooth and shiny, which can help prevent plaque from accumulating.
Typically, it’s done using a rotating brush or rubber cup with a special polishing paste. This procedure is often part of a regular
dental check-up and cleaning

Question 8

Fluoride

Answer 8

Fluoride is a mineral that helps to protect and strengthen tooth enamel, making teeth more resistant to decay. It is commonly
used in various dental products and treatments to prevent cavities and maintain oral health. In Alberta, dental assistants can apply fluoride treatments, but
they must adhere to specific guidelines and regulations set by the College Alberta Dental Assistants Association (CADA) and
Alberta’s health regulations. These guidelines include proper training and certification to perform such procedures. The dental assistant typically works under the supervision of a dentist or dental hygienist and follows protocols to ensure the fluoride application is done safely and effectively.

Question 9

What are soft deposits?

Answer 9

Soft deposits are materials that accumulate on the teeth and are not yet hardened like tartar.

They include:
1. Plaque: A sticky, colorless film of bacteria that forms on teeth and gums.
If not removed, plaque can lead to tooth decay and gum disease.
2. Food Debris: Small bits of food that get stuck between teeth or around
the gum line. This can contribute to plaque formation if not cleaned properly.
3. Cellular Debris: Dead cells and other microscopic particles that accumulate in the mouth.

The soft deposits are referred to as acquired pellicle, dental biofilm, materia
alba, and food debris

1. Acquired Pellicle: A thin, protein-based film that quickly forms on teeth.
   It can be removed through coronal polishing with an abrasive agent like
   “prophy” paste.
2. Materia Alba: A soft, white mixture of bacteria and salivary proteins,
   often visible without a disclosing agent. It commonly accumulates in individuals with poor oral hygiene.
3. Food Debris: Particles of food that get stuck between the teeth after
   eating. While food debris itself doesn’t turn into biofilm, it can contribute to dental caries if it contains fermentable carbohydrates.
4. Dento-biofilm, or simply biofilm, is a thick, sticky layer of bacteria that builds up on the teeth and gums.

Question 10

Significance of Soft Deposits

Answer 10

1. Cavity Formation: Plaque contains bacteria that produce acids when they digest sugars from food. These acids can erode tooth enamel, leading to cavities.
2. Gum Disease: Plaque buildup along the gum line can cause gum inflammation (gingivitis) and, if not managed, progress to more severe gum disease (periodontitis), which can lead to gum recession and tooth loss.
3. Bad Breath: Accumulated food debris and bacteria in plaque can contribute to bad breath.
4. Tartar Formation: If plaque is not removed regularly, it can harden into tartar (calculus), which is more difficult to clean and requires professional dental treatment.

Question 11

acquired pellicle

Answer 11

The acquired pellicle is a thin, clear layer of proteins that quickly forms
on your teeth within minutes after you clean them. It’s made from proteins in your saliva and provides a surface where
bacteria can stick and start forming plaque.
Although the pellicle itself is not harmful and helps protect teeth, if not cleaned properly, it can lead to plaque and stains.

Question 12

Significance of Pellicle

Answer 12

The acquired pellicle has several significant roles in oral health:
1. Protective Layer: It acts as a protective barrier for the tooth enamel against
acidic attacks from food and bacteria, which can help prevent enamel erosion.
2. Foundation for Plaque Formation: The pellicle provides a surface for
bacteria to adhere to, which can lead to the formation of plaque if not regularly
cleaned. Plaque buildup can eventually contribute to dental issues like
cavities and gum disease.
3. Aids in Remineralization: The pellicle can help in the process of
remineralization by attracting calcium and phosphate ions from saliva, which
can aid in repairing early damage to the enamel.
4. Helps in Salivary Exchange: It allows for the exchange of substances between the tooth surface and saliva, which can help in maintaining the overall health of the enamel.
Maintaining good oral hygiene is important to manage the pellicle and minimize its
role in plaque formation and dental issues.

Question 13

Removal of Pellicle

Answer 13

The acquired pellicle can be removed through the following methods:
1. Brushing: Regular brushing with a fluoride toothpaste helps to remove
the pellicle and prevent plaque buildup. It’s important to brush at least twice a day for effective cleaning.
2. Flossing: Daily flossing helps clean between the teeth and along the gum line, removing any pellicle and plaque that brushing might miss.
3. Coronal Polishing: During a professional dental cleaning, a dental hygienist or assistant may use an abrasive polishing paste (such as “prophy” paste) to remove the pellicle and surface stains.
4. Professional Cleanings: Regular dental cleanings by a professional ensure thorough removal of pellicle, plaque, and tartar that has formed on the teeth.
These methods help to maintain oral health by preventing the buildup of plaque and reducing the risk of dental issues.

Question 14

materia alba

Answer 14

Materia Alba is a soft, white, or pale-coloured substance that can accumulate on the teeth. It is a mixture of:
Bacteria: Various types of bacteria that thrive in the mouth.
Salivary Proteins: Proteins from saliva that combine with bacteria and food particles.
Materia alba appears as a white or grayish film and can be visible without a disclosing agent. It is commonly found in individuals with poor oral hygiene and can contribute to plaque development if not removed

Question 15

Composition of Materia Alba

Answer 15

Materia Alba is composed of:
1. Bacteria: Various strains of bacteria naturally present in the oral cavity. These bacteria can contribute to the formation of
plaque if not managed properly.
2. Salivary Proteins: Proteins from saliva that combine with bacteria and food particles. These proteins can create a
medium for bacterial growth.
3. Food Particles: Small bits of food that become trapped in the mouth and contribute to the accumulation of materia alba.
4. Cellular Debris: Dead cells and other microscopic particles from the oral tissues.
Materia alba is generally a soft, non-mineralized substance that can be easily removed through regular oral hygiene practices such as brushing and flossing.

Question 16

Removal of Materia Alba

Answer 16

Materia alba can be removed using the following methods:
1. Brushing: Use a toothbrush with fluoride toothpaste to brush all surfaces of your teeth, including along the gum line, to remove materia alba.
2. Flossing: Daily flossing helps to clean between the teeth and remove any materia alba and food particles that brushing alone
might miss.
3. Rinsing: Using an antimicrobial mouthwash can help reduce bacteria in the mouth and assist in removing materia alba.
4. Professional Cleaning: Regular dental cleanings by a dental hygienist will remove materia alba, plaque, and tartar that may
have accumulated.
Maintaining a consistent oral hygiene routine is key to preventing the buildup of materia alba and promoting overall oral health.

Question 17

Food Debris

Answer 17

Food debris refers to small particles of food that get trapped between teeth, around the gum line, or in other areas of the mouth after eating. It consists of:
1. Food Particles: Tiny bits of food that are left in the mouth after meals.
2. Saliva: Can mix with food particles to form a semi-solid substance.
Food debris can contribute to oral health issues if not cleaned properly. It can lead to:
1. Plaque Formation: Food debris provides a source of nourishment for bacteria, which can lead to plaque buildup if not removed.
2. Bad Breath: Food particles can contribute to unpleasant odours if they remain in the mouth.
3. Cavities and Gum Disease: If food debris is not removed, it can contribute to the development of cavities and gum disease.

Question 18

Dental Biofilm

Answer 18

Dento-biofilm, or simply biofilm, is a thick, sticky layer of bacteria that builds up on the teeth and gums.
* How It Forms: It starts with a thin film called the pellicle that forms on your teeth. Bacteria then stick to this film and start to grow. They create a sticky layer that becomes the biofilm.
* What It Looks Like: The biofilm is a dense, sticky coating that can be hard to remove. It’s often seen as plaque on the teeth.
* Types of Bacteria: The biofilm includes many different types of bacteria, some of which can be harmful and some that are harmless. What’s in the biofilm can change based on how well you care for your teeth, what you eat, and other factors.
* Health Effects: If you don’t clean your teeth well, the biofilm can lead to problems like cavities, gum disease, and bad breath. The bacteria in the biofilm produce acids that can damage tooth enamel.
* To keep biofilm under control, it’s important to brush and floss regularly and visit the dentist for cleanings.

Question 19

The development of dento-biofilm typically
occurs in five stages:

Answer 19

1.Pellicle Formation: Within minutes after cleaning, a thin, protein-based film called the acquired pellicle forms on the tooth surface. This film serves as a foundation for bacterial adhesion.
2.Initial Bacterial Adhesion: Bacteria begin to adhere to the pellicle. These are mostly early colonizers that attach to the pellicle using specific receptors.
3.Early Biofilm Formation: Over the next few hours to days, bacteria multiply and form a thin, loosely organized biofilm. The biofilm starts to accumulate and create a more structured layer.
4.Mature Biofilm: Within a few days, the biofilm becomes more organized and complex. The bacteria produce extracellular matrix materials that hold the biofilm together. This stage features a diverse community of bacteria and is more resistant to removal.
5.Biofilm Maturation and Growth: As time progresses, the biofilm continues to mature. It becomes thicker and more structured, with layers of different types of bacteria. The mature biofilm can lead to significant oral health issues if not properly managed.

Question 20

Composition of Dental Biofilm

Answer 20

Microorganisms and EPS comprise 20% of the biofilm that are organic and inorganic solids.
The other 80% is water.

Question 21

Detecting Dental Plaque Biofilm

Answer 21

Detecting plaque biofilm involves identifying its presence on the teeth, which can be done through several methods:
1. Visual Inspection: Look for visible signs of plaque, such as a thin, sticky film on the teeth. It may appear as a cloudy or discolored layer, especially around the gum line.
2. Disclosing Agents: These are special dyes or solutions that can be applied to the teeth. They stain the plaque biofilm, making it more visible. This method helps identify areas that need more thorough cleaning.
3. Exploring: The explorer helps in identifying plaque, tartar, and areas where
these deposits may be building up.
4. Plaque Index Systems: The use of specific scoring systems to measure plaque accumulation. These systems help in assessing the amount and distribution of plaque

Question 22

Calculus - Hard Deposit

Answer 22

Dental calculus is dental biofilm mineralized. The calculus is covered with a layer of nonmineralized dental biofilm
containing live bacteria. The hard, tenacious mass forms on the clinical crowns of natural teeth, dental implants, dentures, and other dental prostheses.
It cannot be removed by the patient and must be removed by the dentist or
the dental hygienist with the use of scaling instruments. Regular, effective plaque/biofilm control measures can minimize or eliminate the buildup of calculus

Question 23

Supragingival Calculus (above)

Answer 23

Located on clinical crowns coronal to the margin of the gingiva. On implants,
complete and partial dentures.
On the crowns of teeth out of occlusion; nonfunctioning teeth; or teeth that are
neglected during daily biofilm removal (toothbrushing, flossing, or other personal
care). On surfaces of dentures, dental prostheses, and oral piercings. Mostly found on the lingual surfaces of mandibular anterior teeth and the facial surfaces of maxillary first and second molars, opposite the openings of the ducts of the submandibular and parotid salivary glands.

Question 24

Subgingival Calculus - below

Answer 24

Found on the clinical crown apical to the margin of the gingiva and extends toward the clinical attachment on the root surface. May be generalized or localized on single teeth or a group of teeth. Heaviest deposits are related to areas most difficult for the patient to access during personal oral biofilm removal procedures.

Question 25

significance of calculus

Answer 25

The surface of calculus is porous and rough
and provides an excellent surface on which
additional plaque can grow. Calculus can
penetrate into the cementum on root surfaces. Contributing to periodontal disease.

Question 26

Significance of dental stains

Answer 26

A tooth stain is a discolored deposit or area on a tooth that is in contrast with the
rest of the tooth color. Stains are classified as exogenous or endogenous, depending on their source, and as intrinsic or extrinsic, based on their location. Identification of the stain origins and locations are needed to develop an appropriate treatment plan.

Question 27

Exogenous stains

Answer 27

Exogenous stains originate from sources outside of the tooth such as food, beverages, tobacco products, or chromogenic bacteria (color-producing bacteria).

Question 28

Endogenous stains

Answer 28

Endogenous stains are always intrinsic and usually are discolorations of the dentin reflected through the enamel.
When stain is intrinsic, whether exogenous or endogenous, it cannot be removed by scaling or polishing

Question 29

Extrinsic stains

Answer 29

Extrinsic (on the outside of the tooth)
Extrinsic stains occur on the external surface of the tooth and may be removed by procedures of toothbrushing, scaling, and/or polishing.
Extrinsic stains develop because of the
presence of chromogenic bacteria and
substances such as tobacco, red wine, tea,
coffee, soda, blueberries, certain drugs, and
exposure to metallic compounds. Over time, extrinsic stains may become intrinsic

Question 30

intrinsic stains

Answer 30

Intrinsic stains are incorporated within the tooth structure and cannot be removed by scaling or polishing; alternative
methods can be used to improve the appearance

Such stains are the result of alterations during tooth development and are
associated with antibiotic use, fever, trauma, infection, and ingestion of high
amounts of systemic fluoride

Question 31

What is the most common non-surgical way to treat periodontal
disease?

Answer 31

Scaling and root planing

Question 32

Which of the following is characterized by a thin, translucent,
unstructured film adherent to the surfaces of the teeth?

Answer 32

Acquired pellicle

Question 33

Calculus is…

Answer 33

Mineralized dental biofilm that is hard and often tenacious or
difficult to remove

Question 34

Extrinsic staining is…

Answer 34

Occurs outside the tooth and can be removed by scaling or polishing