Steps to the Complete Prophy

Question 1

What are the steps to complete a prophy?

Answer 1

The oral cavity is evaluated
Large pieces of calculus are removed
The periodontal area is probed for pocket depth
Subgingival calculus removal
Detection of missed plaque & calculus
Polishing
Sulcus irrigation & fluoride treatment
Application of a sealer
Periodontal diagnostics
Final charting
Home care

Question 2

Who makes the decision to administer antibiotics?

Answer 2

The veterinarian

Question 3

Are antibiotics indicated for healthy patients with periodontal disease?

Answer 3

No

Question 4

When are antibiotics indicated?

Answer 4

For patients with compromised health conditions

Question 5

Why are mouth gags not used for more than a few minutes?

Answer 5

It causes overextension of the mandible. Which may lead to stretching and tearing of the ligaments & muscles of the jaw

Question 6

What should be used instead of a mouth gag?

Answer 6

The mouth should be propped open with the nonworking hand

Question 7

Why is the first step in a prophy a complete evaluation of the oral cavity?

Answer 7

Some patients may not allow this examination at all or only for a brief time

Question 8

What are hand scalers used for?

Answer 8

Supragingival removal of calculus

Question 9

Where should hand scalers not be inserted?

Answer 9

Below the gumline

Question 10

What are scalers particularly effective in removing?

Answer 10

The calculus from the developmental groove of the fourth premolar

Question 11

What stroke is used to remove calculus?

Answer 11

A pull stroke

A stroke pulling the calculus toward the coronal aspect

Question 12

What is a fairly quick method for removing supragingival calculus?

Answer 12

Calculus removal forceps

Question 13

What part of the calculus removal forceps is placed over the crown, and which part is placed under the calculus?

Answer 13

The longer tip is over the crown & the shorter under the calculus

Question 14

When is the calculus is cleaved off the tooth?

Answer 14

When the tips are brought together

Question 15

When using the calculus removal forceps, the operator should be extremely careful not to do what?

Answer 15

Damage the gingiva

Create an iatrogenic slab fracture

Question 16

Ultrasonic or sonic scalers are used to quickly remove what?

Answer 16

The smaller deposits of the supragingival calculus

Question 17

What do the ultrasonic scalers vibrate in the range of?

Answer 17

18,000 to 45,000 cycles per second

Question 18

What should be used for supragingival scaling?

Answer 18

The side of a beavertail tip rather than the tip

Question 19

How should the ultrasonic instrument be grasped?

Answer 19

Lightly, not tightly

Feel balanced with minimal pull from the handpiece cord

Question 20

What must be allowed to do the work?

Answer 20

The handpiece, not the hands

Question 21

Where is the handpiece is balanced?

Answer 21

On the index or middle finger

Question 22

Where may the handpiece cord be looped to decrease stress on the hand from its pull?

Answer 22

Over the little finger

Question 23

What is required to prevent overheating of the teeth and damage to the pulp?

Answer 23

Water flow

Question 24

With what tip is an ample supply of water irrigation necessary for irrigation?

Answer 24

The board-based, beaver-type inserts

Question 25

What helps provide a water supply and thereby ease the insertion of the tip in the sulcus?

Answer 25

Turning on the handpiece before insertion

Question 26

How much pressure should the operator use when using ultrasonic or sonic instruments?

Answer 26

A light touch Keep the tip moving while traveling around the circumference of the tooth Not stopping in any area

Question 27

Do ultrasonic and sonic instruments need cutting edges?

Answer 27

No, unlike hand instruments

Question 28

What part of the tip should be held parallel to the tooth surface, what should not be pointed at the tooth surface?

Answer 28

The side should be held parallel, the tip should not be pointed at the tooth surface

Question 29

What does a curved shank allow for?

Answer 29

Working around a crown or in a furcation

Question 30

What steps does the ultrasonic technique include?

Answer 30

Sweeping cross strokes Work in various directions Use oblique or corkscrew tips to reach furcations Avoid pressing the scaler tip on the tooth surface too hard

Question 31

DENTAL

Answer 31

``` Digits Engage Neutral Technique Adaptation Light touch ```

Question 32

What position is useful for maxillary posterior teeth?

Answer 32

An extraoral finger rest Fingers should rest on the teeth for maxillary anterior & mandibular areas A stable fulcrum is not always necessary

Question 33

Engage

Answer 33

Activate the tip of the instrument & direct the tip subgingivally Water lavage will facilitate a comfortable entry into the sulcus

Question 34

Neutral

Answer 34

A balanced instrument grasp The instrument should feel balanced in the hand with no pull from the cord Use a light pen or modified pen grasp

Question 35

Technique

Answer 35

Brush away the calculus | Using sweeping cross strokes

Question 36

Adaptation

Answer 36

Ultrasonic & sonic instruments are active on at least two sides when in contact with the tooth surface The side of the tip is held parallel to the tooth surface The end of the tip should not be adapted to the tooth surface at a 90-degree angle

Question 37

Light touch

Answer 37

Apply extremely light pressure

Question 38

What settings should be used for the broad-based, beavertail-type tips?

Answer 38

Higher power settings

Question 39

What should the power setting be decreased to when thin subgingival tips are used?

Answer 39

Lower settings

Question 40

What does failure to decrease the power setting cause?

Answer 40

Fracturing of the tip or render it ineffective because the tips are manufactured to operate in optimal frequency ranges

Question 41

Rather than scaling teeth, rotary scaler burs, end up doing what to calculus, and leading to a periodontal abscess?

Answer 41

Burnishing calculus

Question 42

What should be used to measure the depth of the sulcus or pocket?

Answer 42

A periodontal probe

Question 43

How should the periodontal probe be held for an accurate reading?

Answer 43

Parallel to the long axis

Question 44

What does holding the probe at an angle result in?

Answer 44

An inaccurate measurement

Question 45

If the marginal gingiva is at the normal cementoenamel junction, the probed depth will correspond with what?

Answer 45

Attachment loss

Question 46

If a previous recession of the gingiva has occurred and the marginal gingiva has moved apically, the pocket depth will be less than what?

Answer 46

The actual loss of attached gingiva

Question 47

What happens if gingival hyperplasia and a pseudopocket are present, the probed depth will be what?

Answer 47

Greater than the actual attachment loss

Question 48

When charting, what is the recommended order?

Answer 48

Buccal of right posterior maxilla Lingual of the left posterior maxilla Lingual of left posterior mandible Buccal of the right posterior mandible

Question 49

What should be used to remove the calculus below the gumline?

Answer 49

A curette or select ultrasonic scaler

Question 50

What should be used to scale and remove calculus below the gumline?

Answer 50

Ultrasonic scalers with subgingival tips

Question 51

What is an extremely important part of the dental procedure?

Answer 51

The removal of subgingival calculus

Question 52

What is the preferred method for holding hand instruments?

Answer 52

The modified pen grasp

Question 53

Where are the thumb and forefinger placed on the instrument with a modified pen grasp?

Answer 53

At the junction of the handle and shank of the instrument

Question 54

When using a modified pen grasp, where is the ring finger placed?

Answer 54

Held straight and placed on the surface closest to the tooth being worked on.

Question 55

What is adapted to the tooth root surface?

Answer 55

The curette

Question 56

What happens if the instrument does not fit the curvature of the tooth?

Answer 56

The opposite end of the instrument is adapted

Question 57

What position is the closed position?

Answer 57

The face of the curette should face the root surface as it is inserted into the pocket

Question 58

What position is the open position?

Answer 58

The instrument is moved over the calculus and then repositioned so that the cutting surface is under the calculus ledge

Question 59

What is used to evaluate the tooth surface while checking for subgingival calculus?

Answer 59

An explorer

Question 60

What are two techniques used to detect plaque and calculus?

Answer 60

Air-drying | Application of disclosing solution

Question 61

Why should air-drying not be used if the integrity of the periodontium is in question?

Answer 61

Because air being blown into tissues can be trapped in the subcutaneous tissues or possibly enter the bloodstream

Question 62

What are the use of a proxy angle and abrasive paste?

Answer 62

Mechanical polishing

Question 63

What does polishing with an electric or air-powered polisher do?

Answer 63

Removes any plaque that may have been missed and smooths the tooth surface

Question 64

What is the most economic means of making prophy paste?

Answer 64

To mix flour pumice with a slight amount of water

Question 65

What speed are teeth polished with?

Answer 65

3000 to 8000 rpm

Question 66

What does air polish use?

Answer 66

Air, water, powder projection

Question 67

What are the advantages of air polishing when compared to a mechanical polisher?

Answer 67

``` Faster and less demanding Reducing the operator’s hand fatigue Less abrasive than abrasive pastes No production of heat Gives better access to the teeth No direct contact with the dental surface ```

Question 68

What are the disadvantages of air polishing when compared to a mechanical polisher?

Answer 68

More expensive | Can be messier

Question 69

What flushes out trapped debris and oxygenates the intrasulcular fluids?

Answer 69

Gentle irrigation

Question 70

Should the full-strength disinfectant chlorhexidine that is commonly found in veterinary hospitals be used?

Answer 70

No

Question 71

What are the two types of sealers available?

Answer 71

Sanos | OraVet

Question 72

Why should radiographs be taken?

Answer 72

To evaluate the dental and bony structures for periodontal bone loss, root canal disease, other conditions

Question 73

What is the last step to complete prophy?

Answer 73

Home-care instruction