Test 3 Flashcards
Where does the alveolar ridge sit in health?
1.5 - 2mm apical to the CEJ
What does the aveolar ride look like on a radiograph of the anterior in health?
Pointed
Sharp
Very radiopaque
What does the alveolar ridge look like on radiographs of the posterior in health?
Flat
Smooth
Parallel to the CEJ
Less radiopaque than anterior
What does the alveolar ridge look like on radiographs in disease?
More than 2mm apical to the CEJ
Indistinct
What does the PDL space look like on radiographs?
The thin radiolucent line between the tooth and the lamina dura
What does the lamina dura look like on a radiograph?
Radiopaque line around the outside of the PDL space
What types of radiographs should you use to diagnose bone loss?
PA using paralleling technique (RINN)
Vertical BW for posterior
What type of radiographs should you not use to diagnose bone loss?
Any type using the bisecting technique
Horizontal BWs alone
Why don’t you use the bisecting technique for bone loss assessment?
Dimesntional distortion due to vertial angulation
Why shouldn’t you use horizontal BW alone to diagnose disease?
Limited vision of interproximal bone loss
What areas of bone are difficult to see on radiographs?
Buccal and / or lingual
Furcation
What type of bone loss is parallel to the CEJ?
Horizontal
What type of bone loss is not parallel to the CEJ?
Vertical / angular
What early signs can indicate bone change?
Fuzziness at the crest
Widened PDL space
Finger-like radiolucent projections
What are the predisposing factors to periodontal disease?
Calculus
Overhangs
Inadequate / uneven margins
Open / loose contacts
Poor contour
How do overhangs contribute to periodontal disease?
Food / bacteria gets trapped
What does calculus look like on radiographs?
Pointed, irregulat radiopaque projections
Nodular radiopaque projections
Smooth radiopacity
What is a one wall bony defect?
One wall remaining
What is a two wall bony defect?
Two walls remaining
What is a two wall bony defect also known as?
Osseous crater
What is a three wall bony defect?
Three walls remaining
What is a four wall bony defect?
Circumferential defect surrounds the tooth, no wall remaining
What type of radiograph is used to diagnose mandibular fractures?
Panoramic
What are the signs of a fracture on a radiograph?
Sharpe defined radiolucent lines within the bone
Change in anatomic outline
Asymmetrical mandible
Loss of continuity of outer border
Increase in radiopacity due to overlapping of fragments
Horizontal fractures can be directionally
Horizontal or oblique
Where are horizontal fractures more common?
Maxillary centrals
What causes a horizontal fracture?
Direct application of force
What type of fracture is lengthwise from the crown to the apex?
Vertical fracture
True or False: vertical fractures are usually through facial and lingual surfaces
True
Where are vertical fractures more common?
With molars
What is a tooth concussion?
When a tooth has been hit but not knocked out or broken
Symptoms of tooth concussions
Crush injury
Inflammatory edema results
No displacement
Minimal loosening
Widening of the PDL space
True to False: Tooth concussion can cause minor avulsion resulting in premature tooth contact.
True
What is a long term effect of tooth concussion?
Pulp chamber size changes
What is a dislocation of a tooth from it’s socket but is still present in the mouth?
Luxation
Symptoms of tooth luxation
Abnormally mobile teeth due to severing of the PDL attachment
Apical portion of the PDL space is widened
In which teeth is luxation most common?
Central incisors
What is tooth displacement into the alveolar process?
Intrusive luxation
What is partial displacement externally?
Extrusive luxation
What is the movement of a tooth other than intrusive or extrusive?
Lateral luxation
What is the complete displacement of a tooth?
Avulsion
What is the number one cause for permanent tooth loss?
Fights
What is the number one cause for primary tooth loss?
Falls
What teeth are most commonly lost through avulsion?
Maxillary centrals
What is the process of reimplantation dependent on?
Condition of the tooth outisde the mouth
Time spent outside the mouth
Viability of the residual PDL
Will endodontic therapy be needed on a reimplanted avulsed tooth?
Possibly
What is physiological resorption?
Roots of primary teeth are resorbed as permanent teeth move in
What is pathological resporption?
Roots are resorbed due to regressive alteration of tooth structure under abnormal stimuli.
Where does external resporption occur?
Along the periphery of the root surface, at the apex
What is external resorption often associated with?
Reimplanted teeth
Impacted teeth
Trauma
Chronic inflammation
What does a tooth with external resporption look like on a radiograph?
Blunted apex
Shortened length
Where does internal resorption occur?
Within the root and / or crown
What tooth structures are involved with interal root resporption?
Pulp
Dentin
What causes internal root resorption?
Trauma
Pulp capping
Pulp polyps
How does internal resorption appear on a radiograph?
Round / oval radiolucency
What is the treatment for external resorption?
None
What is the treatment for internal resorption?
Extraction if tooth is weakened
Endo if the tooth is not weakened
What is pulpal sclerosis?
Diffused, calcification of the pulp chamber and canals
True or False: pulpal sclerosis causes an increase in canal size
False. Pulpal sclerosis causes a decease in canal size
What is pulpal obliteration?
The tooth does not have a pulp chamber or canals due to the formation of secondary dentin
Is a tooth with pulpal obliteration vital or non-vital?
Non-vital
What are round / ovoid / cylindrical calcifications within the pulp chamber?
Pulp stones
Do pulp stones cause the person any problems?
No
What are common periapical radiolucencies?
Granulomas
Cysts
Abscesses
What is a localized mass of chronically inflammed granulation tissue?
Periapical granuloma
Is a tooth with a periapical granuloma vital or non-vital?
Non-vital
What causes periapical granuloma?
Pulpal necrosis
What commonly follows pulpitis?
Periapical granuloma
True or False: periapical granulomas are asymptomatic but the clients commonly have a history of sensitivity to sweets
False. Periapical granulomas are asymptomatic but the clients commonly have a history of sensitivity to temperature
What is the appearance of a periapical granuloma on radiographs?
Widened PDL space at the apex that enlarges with time
No lamina dura
What is a periapical cyst also known as?
Radicular cyst
What are periapical cysts caused by?
Pulpal necrosis
True or False: periapical cysts are the most common.
True
Are periapical cysts symptomatic or asymptomatic?
Asymptomatic
What is the appearance of a periapical cyst on a radiograph?
Similar to a periapical granuloma but has a lamina dura
What is an infection in the pulp of a tooth, causing a collection of pus a the apex?
Periapical abscess
What are the characteristics of an acute periapical abscess?
Painful
Non-vital tooth
No change in the PDL space widening
What are the characteristics of a chronic periapical abscess?
Asymptomatic due to draining
Appears round / ovoid with poorly defined margins and no lamina dura on an x-ray
What is a periodontal abscess?
A bacterial infection within the walls that results from a pre-existing periodontal condition
Characteristics of a peridontal abscess?
Painful
Rapidly progressing
Destruction
What is the treatment of a periodontal abscess
Scaling
Conditions that appear as periapical radiopacities?
Condensing osteitis
Sclerotic bone
Hypercementosis
What is condensing osteitis?
Well-defined radiopacity that is apical to the apex of a non-vital tooth from a proliferation of periapical bone in response to pulpal necrosis
Does condensing osteitis appear attached to the root on a radiograph?
No
What is the most common radiopacity?
Condensing osteitis
Where is condensing osteitis most commonly found?
Mandibular first molars
Where else is condensing osteitis commonly found?
Teeth with large carious lesions or restorations
What does sclerotic bone look like in a radiograph?
Well-defined radiopacity apical of vital, non-carious teeth
True or False: sclerotic bone is idiopathic
True
Is sclerotic bone associtated with inflammation?
No
Is sclerotic bone attached to the tooth?
No
Is scelrotic bone symptomatic or asymptomatic?
Asymptomatic
What is extra deposition of cementum on all surfaces of the root?
Hypercementosis
What causes hypercementosis?
Supra-eruption
Inflammation
Trauma
True or False: hypercementosis is large and bulbous.
True
What is the law?
A system of rules
What are statutes?
Laws passed by legislature (Acts)
What are regulations?
Rules that set out to detail the practical application made under the authority of statutes
What are moral principals that govern behaviour?
Ethics
What governs hygienists?
HARP
RHPA
DHA
What does HARP govern for hygienists?
Safety involving the use of x-rays
How does the RHPA govern hygienists?
Outlines controlled acts
How does the DHA govern hygienists?
Under the RHPA that dictates the scope of practice and authorized acts
What are the five ethical principles?
Beneficence
Autonomy
Privacy and confidentiality
Accountability
Professionalism
What is beneficence?
Promoting the good of another
What is autonomy?
The right to make decisions
What is privacy and confidentiality?
Controlling the collection, use, and disclosure of personal information and the right to expect that information is kept secure
What is accountability?
Answering for one’s actions
What is professionalism?
Commitment to use and advance skills and knowledge. As well as being honest, competent, and fair
What are DH examples of benefience?
Scaling effectively / completely
Education
What are DH examples of autonomy?
Informed consent
Involvement in treatment planning
What is DH example of privacy and confidentiality?
Not sharing any information
What are DH examples of accountability?
Meeting clients’ needs
Infection control
What are DH examples of professionalism?
Client-centered care
QA program
Continuing education
What is providing high-quality services every time called?
Competence
What is truthful in actions and statements?
Honesty
What happens if legal obligations are not followed?
Legal action, fines, or imprisonment
What is fairness?
Balancing competing interests
What happens legally when violating ethical principles?
May or may not have legal consequences
What is the failure to meet the bare minimum of legal requirements?
Professional misconduct
What follows professional misconduct?
Disciplinary proceedings
What is an ethical dilemma?
When two or more eithical principles are in conflict
What are the decision-making model steps?
- Identify the problem
- Gather information
- Clarify the problem
- Identify options
- Assess options
- Choose an option
- Implement option
- Evaluate outcome (consequences and benefits)
True or False: DH are mandatory sexual abuse reporters.
True
What can failure to report sexual abuse lead to?
Severe penalties
When must a report of suspected sexual abuse be reported?
Within 30 days
True or False: if the client does not want you to report, you still have to and it is not a breach of confidentiality.
True
Sexual abuse in inacteractions with clients include
Sexual relations
Touching of a sexual nature
Behaviour / remarks of a sexual nature
Treatment of someone you have been intimate with
What happens to a hygienist guilty of sexual abuse of a client?
Mandatory penalty and removal of certificate
Who is a client?
A person receiving services from the registrant
Person who has has an entry in their health record by the registrant
Person who consented to a service provided by the registrant
Had a drug prescribed to them by the registrant
When is a person no longer considered a client?
If one full year has passed
When of the treatment of spouses allowed?
Person is defined by the Family Law Act (married)
Person has lived with the registrant outside of marriage continuously for 3 year or more (common law)
The treatment is an emergency situation
How to maintain firm boundaries with clients
Avoid sexual behaviour and put a stop to it
Avoid misinterpretation
Do not comment on body or sex life
Never date a client
Do not treat spouses / partners
Detect and deflect emotionally attached clients
What does the Child, Youth, and Family Services Act dictate?
Responsibility for the welfare of children
Mandatory report for anyone under the age of 16
