Dental Hygiene National Board Exam Questions and Answers, Exams of Nursing

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HOSMERIT

DENTAL HYGIENE NATIONAL BOARD NEW EXAM

QUESTIONS AND ANSWERS (A+)

What are some examples of bio-hazard waste? - ANSWER Sharps, items that drip of blood and/or saliva, and hard and soft tissues removed from patient The bio-hazard waste or regulated true or false? - ANSWER True When should we change our mask? - ANSWER When it becomes wet or soiled with every patient. That includes your fluids as well. PPE What for? - ANSWER Is to minimize the exposure to Aerosol, Spatter, Direct transmission, and Indirect transmission (ASDI) Do disinfectants kill spores? - ANSWER NO Name some kind of disinfectants - ANSWER Chlorine-based compounds, iodophors, phenols, quaternary compounds What are some bad qualities of chlorine-based compounds? - ANSWER corrosive to metals and strong odor What are some poor qualities of phenols? - ANSWER may leave a film or residue on surfaces What are some poor qualities of iodophors? - ANSWER can discolor some surfaces yellow

What are some poor qualities of quaternary compounds? - ANSWER not corrosive, but have a lower kill spectrum What would be some good qualities of disinfectants? - ANSWER rapid, broad spectrum antimicrobial, bacteriocidal, fungicidal, tuberculocidal, virucidal, odorless, easy to use, fast acting, economical, residual effect which it continues to work after it dries, not toxic to touch or inhalation, EPA registered, and disinfects and cleans. Is a spatter invisible to the eye? - ANSWER NO, can see it when airborne Is aerosol invisible to the eye? - ANSWER yes, remain in the air for a while What sheet provides an employee with information regarding the hazards of chemicals utilized in the office and how to protect themself? - ANSWER MSDS (Material Safety Data Sheet) What disinfectant should not be used as a surface disinfectant in the office and why? - ANSWER Glutaraldehydes, toxic effects of fumes; also corrosive What kind of disinfectants are used in the dental office? - ANSWER Intermediate What are some forms of sterilization? - ANSWER Chemical, Dry, and Steam In chemical sterilization how long at what degree and pressure does it use? - ANSWER 20 min @ 270 degree F @ 20-40 lbs psi In Dry sterilization how long at what degree does it use? - ANSWER 60 - 120 min @ 320 degree F

HOW LONG AT WHAT DEGREE AND PRESSURE USED DURING STEAM

STERILIZATION? ANSWER 20 - 30 min @ 250 degree F @ 15 - 30lb psi What method of sterilization involves the least temperature? ANSWER Steam at 250 degree F What considerations are there when using chemical method? ANSWER ventilation is necessary, may damage rubber and plastic items What are some things you need to watch out for when using the dry method? - ANSWER recommended for metal instruments avoid paper products, may damage rubber and plastic items, and should not be used on handpieces. What are some things to consider when using the steam method? - ANSWER corrodes non- stainless steel instruments, dulls instruments and burs, ok for some plastics; cotton rolls and gauze, paper packages come out wet and tear. What is the only way to know if the instruments are sterilized? - ANSWER A weekly spore test Does indicator tape always guarantee sterility? - ANSWER NO, only spore test What spore test is used with chemical sterilization? - ANSWER Geobacillus (formerly Bacillus) stearothermophilus What spore test is used with dry sterilization (static air)? - ANSWER Bacillus atrophaeus/ subtilis What spore test is used with steam sterilization? - ANSWER Geobacillus (formerly Bacillus) Stearothermophilus

What 2 sterilization methods use the spore test Geobacillus (Bacillus)? - ANSWER Chemical and Steam What is another name for spore testing? - ANSWER Biological Indicators What should the Dental Hygienist do if there are any questions regarding the patients medical hx? - ANSWER Always contact the patient's physician first What is the systolic pressure? - ANSWER ventricles of the heart contract sending blood into circulation What is the diastolic pressure? - ANSWER ventricles of the heart relax to fill with blood returned by circulation What is tachycardia? - ANSWER rapid pulse rate; over 100 beats per min. What is bradycardia? - ANSWER slow pulse rate; below 50 beats per min. What is the normal HR for children (1-10yrs)? - ANSWER 70 - 120 beats per min. What is the normal HR for adults? - ANSWER 60 - 100 beats per min. What is normal HR for infants? - ANS 100 - 160 beats per min. What is normal for adult blood pressure? - ANS > 120/

What is considered stage 1 hypertension (mild)? - ANS 140/90 - 159/ What is considered stage 2 hypertension (moderate)? - ANS 160/100 + What is normal respiration rate for a child? - ANS 14 - 26 breaths per min. What is the normal respiration rate for an adult? - ANSWER 12 - 20 breaths per min. What is the normal respiration rate for an infant? - ANSWER 30 - 60 breaths per min. Where do we place the cuff on an adult for blood pressure? - ANSWER over the brachial artery Is high blood pressure in African Americans very common? - ANSWER YES When we are going over a patient what are some things we look at? - ANSWER treated by a doctor, hospitalized in the last 5 yrs, meds, smokers, pregnant, medical history, social history, and chief complaint What is one kind of social history? - ANSWER If a pt likes to drink red wine socially all the time (ESPECIALLY when asking about anesthesia) What may a smokers chief complaint be, and what do we respond? - ANSWER Whiter teeth, we respond that bleaching would work What conditions may fall into an ASA II? - ANSWER noninsulin-dependent diabetes melliturs, asthma, epilepsy, stage 1 hypertension, health pregnacy

What conditions may fall into an ASA III? - ANSWER insulin-dependent diabetes mellitus, congestive heart failure, state 2 hypertension, Aids, chronic COPD What conditions may fall into an ASA IV? - ANSWER severe congestive heart failure or COPD, and kidney or liver failure During class 1(mesognathic) occlusal relationships, where are the teeth positioned for molar to molar? - ANSWER MB cusp of the max. 1st molar is in the buccal groove of the mand. 1st molar What is the canine relationship for class 1? - ANSWER max. Canine occludes with the distal half of the mand. Canine and the mesial half of the mand 1st molar What is the molar relationship with class 2 (retrognathic) - ANSWER buccal groove of the mand. 1st molar is distal to MB cusp of the max 1st molar what is the canine relationship with class 2? - ANSWER distal portion of the mx. canine is mesial to the mesial portion of the mand. canine what is the molar relationship with class 3 (prognathic)? - ANSWER buccal groove of the mand 1st molar is mesial to the MB cusp of the max 1st molar What is the canine relationship with class 3? - ANSWER mesial portion of the max. canine is distal the distal surface of the mandbular canine What can cause class 2 occlusal relationship (retrognathic)? - ANSWER tongue thrusters, and thumb sucking What is a class 1 restortation? - ANSWER Pits and fissures on lingual surfaces of anterior and on occlussal, buccal, and lingual surfaces of posterior teeth

What is a class 2 restoration? - ANSWER proximal surfaces of posterior teeth; commonly involves occlusal surfaces. What is a class 3 restoration? - ANSWER proximal surfaces of anterior teeth; does not include incisal edges What is a class 4 restoration? - ANSWER proximal surfaces of anterior teeth; involves the incisal edges What is a class 5 restoration? - ANSWER cervical gingiva 1/3 of the facial and lingual surfaces of any tooth. (root caries) What is a class 6 restoration? - ANSWER Incisal edge of anterior or cusp tips of posterior teeth When looking for midline deviation, what are we looking at in the mouth? - ANSWER We are going to be looking at the mandible in relation to the maxillary. Do not align the maxillary with the mandibular arch. Which bacteria are capable of producing more acid from sugars than other bacterial types, predominantly lactic acid? ANSWER Streptococcus mutans What kind of microorganism is streptococcus mutans? ANSWER gram-positive What would be a complication of having a diastema? - ANSWER food impaction occurs What bacteria is associated with root caries? - ANSWER Actinomyces viscosis

What bacteria is found in large numbers after cavitation of tooth has occurred and is incapable of producing the range of pH values required for caries initiation? - ANSWER Lactobacillus species= gram-positive What are some requirements to encourage remineralization? - ANSWER good plaque control, vigorous fluoride therapy, and restricted sugar intake What is the nutrient source for supragingival calculus? - ANSWER saliva What is the nutrient source for subgingival calculus? - ANSWER crevicular fluid What is calculus? - ANSWER Mineralized plaque, which is an irritant for the gingiva Supra and Subgingival Calculus What is the color of supra-and sub-gingival calculus? - ANSWER supra= white, yellow, or gray sub = dark brown, dark green or black Which of the following explorers can be used to detect calculus? - ANSWER 11/12 and pigtail for posteriors; orban-type for anteriors and cervical 1/3s of posterior teeth What are some reasons for extrinsic (exogenous) stain? Certain bacteria, food, beverages, and tobacco What are some causes of Intrinsic (endogenous) stain? - ANSWER pulpal necrosis, internal resorption, excessive systemic fluoride, and tetracycline use during development

Where is black line stain usually located? - ANSWER on the cervical 1/3rd of facial and linguals What is black line stain associated with? - ANSWER iron, insoluble ferric sulfide, and gram- positive bacteria What is bluish-green stain associated with? - ANSWER inhalation of metallic dust, probably occupational exposure What is triclosan in some toothpaste? - ANSWER It is a antibacterial What is the shape of the cross section of a scaler? - ANSWER triangular cross section What is the shape of a curet's cross section? - ANSWER half-moon cross section With an area-specific curet, what is the position of the face of the blade relative to the terminal shank? - ANSWER its offset at 60-70 degree to the terminal shank Which area-specific curets are used for the distal surface of posterior teeth? - ANSWER 13- 14 and 17- 18 What area specif curet is used for the mesial surfaces of posterior teeth? - ANSWER 11-12 and 15 - 16 The 11 - 12 is also used in what other areas besides the mesial surfaces of posterior teeth? - ANSWER facial,and linguals of posterior teeth

What is brown stain associated with? - ANSWER poor oral hygiene or consumption of dark- coloured beverages ( red wine, coffee) What is dark- brown and black stain associated with? - ANSWER tobacco product use What is orange stain associated with? - ANSWER chromogenic bacteria in plaque, poor oral hygiene Where is orange stain typically found? - ANSWER anterior teeth, cervical 3rd What is yellow-brown and brown stain associated with? - ANSWER chlorhexidine use or stannous flluoride ( which is from tin ion in fluoride) What is green stain associated with? - ANSWER poor oral hygiene, chromogenic bacteria, fungi, and gingival hemorrhage What governmental regulatory agency is responsible for enforcement of MSDS to also enforce compliance with Bloodborne Pathogen Standard in the dental office setting? ANSWER Occupational Safety and Health Administration Who would be best to refer a floss holder? - ANSWER patient with large hands, physically challenged, and for a caregiver proving oral hygiene care What would be some excellent areas to use tufted floss on? - ANSWER under pontic of bridge What is the active ingredient in tartar control toothpaste? - ANSWER pyrophosphates

What is the active ingredient in antihypersensitivity toothpaste? - ANSWER potassium nitrate, strontium chloride, or sodium citrate What is the active ingredient in whitening toothpaste? - ANSWER carbamide peroxide or hydrogen peroxide What is most active, to the least active on an ultrasonic magnetostrictive tip? - ANSWER point, concave face, convex back, and then lateral sides What is most active part of the ultrasonic piezoelectric? ANSWER Lateral sides of tip are most active What is most active for the sonic? ANSWER all sides of tip are active, same as magnetostrictive What types of ultrasonic produce elliptical or orbital strokes? ANSWER magnetostrictive and sonic The piezoelectric produce what type of stroke? ANSWER produce rapid linear strokes; newer piezos have ellipitical/linear motion What considerations should we evaluate before using a type of ultrasonic? ANSWER demininalised areas, hypersensitivity, titanium implants, and those with communicable diseases or respiratory conditions, and dentures Should we always instrument first before polishing? ANSWER YES

When would a fomite be created? ANSWER during dental charting when the hygienist touches the keyboard with contaminated gloves What working stoke is being used when the face of the blade is perpendicular to the long axis of the tooth during instrumentation? - ANSWER veritcal stoke What must happen in order to gain proper adaptation during instrumentation? - ANSWER The instrument must be rolled between the finger and thumb What percent and ppm of a home use of stannous fluoride? - ANSWER .4% Stannous; 1000 ppm What is neutral sodium good for in home use? - ANSWER porcelain or composite restorations, those that can not have acidic fluorides such as bulimics, rampant caries, ortho patients, decalcification, and home whitening What is the percent and ppm of home use of neutral sodium? - ANSWER 1.1% and 5,000ppm What is the landmark to initiate the root planing stroke? - ANSWER coronal edge of the junctional epithelium What are the stains that were involved with poor oral hygiene? - ANSWER brown, orange, and green What area specific curet is used in the anterior region? - ANSWER 1 - 2 What area specific curet is used in the premolar regions? - ANSWER 5 - 6

how do we initiate our stroke with the area-specific curetes? - ANSWER beginning coronal to edge of junctional epithilium What are some other materials implants are made of? - ANSWER plastic, nylon, graphite, or gold-tipped How do ultrasonic scalers work?ca - ANSWER through cavitation If stain is on cementum what is choice for removal? ANSWER Instrumentation What are two ways that we remove stain? ANSWER Instrumentation and polishing What can be some obstacles for probing? ANSWER calculus, over hanging restorations, caries and bleeding What is the first sign of gingivitis? ANSWER Bleeding What is a class 1 furcation? - ANSWER early evidence of bone loss; instrument can enter the depression leading to the furcation What is a class 2 furcation? - ANSWER moderate bone loss; instrument can enter furcation, but cannot pass between the roots What is a class 3 furcation? - ANSWER severe bone loss; instrument can pass between roots What is a class 4 furcation? - ANSWER same as class 3 except w/ evidence of recession

What is class 1 mobility? - ANSWER involves slight horizontal mobility What is class 2 mobility? - ANSWER involves moderate horizontal mobility; greater than 1mm- w/ no vertical displacement What is class 3 mobility? - ANSWER involves severe mobility w/ possible combined horizontal and vertical movement What is the PH for enamel and cementum when demineralization (critical PH levels) is involved? - ANSWER enamel= below 4.5 to 5. cementum= 6 to 6. What are the 3 components of saliva that remineralize the teeth? - ANSWER calcium, phosphate, and fluoride What does it mean when fluoride is bactericidal? - ANSWER destructive to bacteria; this is only is professional application What is to be considered before polishing with a rubber cup? - ANSWER xerostomia, demineralized areas or dental decay, tooth sensitivity, newly erupted teeth, severe gingivitis, lack of extrinsic stain or plaque, exposed roots surfaces, and respiratory disorders What is to be considered before polishing with an air polisher? - ANSWER active periodontal conditions, soft spongy conditions, respiratory conditions, sodium restricted diets, people with composits, glass ionomer, and luting agents

What are some indications for use of the air polisher? ANSWER removal of stain, possible preparation of tooth for sealants, removal of soft debris around ortho appliances Where do we place a pulp vitality test on a tooth? ANSWER middle or gingival 1/3 with no pressure, avoiding contact w/ soft tissue, or metallic restorations What does it mean when fluoride is bacteriostatic? - ANSWER it can inhibit the growth or multiplication of bacteria; this occurs each day with at-home application An industrial worker comes to the dental office with bluish-green stain on the teeth. The inhalation of what type of metallic dust form occupational exposure caused this stain? - ANSWER copper Which of the following methods of sterilization is most appropriate for heat sensitive items? - ANSWER Ethylene oxide The fluoride concentration in saliva ranges from? - ANSWER .01 to .04 ppm Hydroquinone and phenidone are examples of what? - ANSWER Reducing Agents Does the hygienist have to polish the teeth prior to the application of fluoride? - ANSWER No, fluoride will penetrate through pellicle and plaque A patient returns for a 4 - week reevaluation appointment showing bleeding in certain areas. What is the most appropriate treatment for this patient? - ANSWER periodontal debridement of affected areas A furcation where the probe goes completely through the opening is? ANSWER Type III, not type IV because it does not mention recession

What are some of the requirements to prevent demineralization? ANSWER good plaque control, fluoride therapy, and restricted sugar intake What is the major species involved in the caries process? ANSWER Streptococcus mutans What does it mean by acidogenic and aciduric bacteria? ANSWER acidogenic= acid producing and aciduric= acid tolerant What is the etiology of black-line stain? - ANSWER unknown Is it ok to place a vitality test on a tooth more than two times? - ANSWER NO approved fluoride components found in over the counter deftrifices include? - ANSWER sodium fluoride, stannous fluoride, and sodium monofluorophosphate Demineralization occurs when the pH of enamel drops below 4.5-5.5. This is known as the critical pH level? true or false on both - ANSWER Both statements are true Does saliva affect the digestion of protein? ANSWER NO Does saliva affect carbohydrates? ANSWER YES; it breaks them down What is the objective of periodontal debridement? - ANSWER to produce a root surface that is biologically compatible with the surrounding tissues Which of the fluoride regimes is best to minimize dental caries? - ANSWER low

concentration with high frequency What is the role of fluoride in the caries process? - ANSWER reacts with hydroxyapatite to form fluorapatite, and fluoride interferes with bacterial metabolism When should we start flossing children teeth? - ANSWER When proximal surfaces contact each other When 3 compounds are added to a water supply to limit fluorosis and provide maximum protection against caries? - ANSWER sodium fluoride, sodium silicofluoride, and hydrofluorosilic acid What is stannous fluoride for home use good for? - ANSWER caries control and plaque reduction, ortho and perio patients, and dentinal hypersensitivity Does fluoride have substantivity and what is it? - ANWER yes, which is the ability to bind to pellicle and tooth surface and be released over a period of time with retention of potency. What is another name for systemic fluoride? - ANWER pre-eruptive What is another name for topical fluoride? - ANWER post- eruptive When systemic fluoride is involved, where is it absorbed? - ANWER in stomach and small intestine With systemic fluoride where is it excreted?- ANSWER through the kidney

Who does the systemic fluoride effect?- ANSWER 6 months to 14 years of age What is the optimal fluoride level since 2011?- ANSWER .7 ppm Does the climate matter with fluoride concentration?- ANSWER Yes; warmer climate-= .7 ppm and colder climate= 1.2ppm What agency monitors the concentration in community drinking water?- ANSWER Evironmental Protection Agency (EPA) What agency set the limits in the bottled water? - ANSWER FDA What are the 3 compounds used to fluoridate the water? - ANSWER Sodium fluoride, Sodium silicofluoride, and hydrofluorosilicic acid Does the ADA of scientific affairs of 1994 recommend supplemental fluoride to birth to 6 months? - ANSWER NO What do they recomend for children 6 months to 3 yrs? - ANSWER < or equal to .3 ppm, .25 mg/ day What type of food contained a lot of fluoride? - ANSWER tea and fish What is the most useful tray method for rampant caries and bulimia? - ANSWER Sodium Fluoride applied with the tray method for 4 minutes for optimum effect. What do we advise the patient after the application of the fluoride tray method? - ANSWER not to eat, drink, or smoke for 30 minutes post application.

What percent is Sodium Fluoride Varnish? - ANSWER 5% NAF (20,600 ppm) What is Sodium Fluoride Varnish main uses? - ANSWER desensitizing exposed roots and caries prevention What is another name for vomiting? - ANSWER emesis If an individual ingest less than 5 mg/kg of fluoride what should we do? - ANSWER administer fluoride-binding agents if an individual ingest more than 5 mg/kg, what should we do (toxic dose)? - ANSWER induce vomiting (emesis), administer fluoride-binding agent, and seek medical treatment;if an individual ingest greater than 15 mg/kg (lethal dose), what should we do?

• ANSWER seek medical treatment, induce vomiting, and cardiac monitoring What are the symptoms of acute fluoride toxicity? - ANSWER 1) gastrointestinal symptoms which includes nausea, vomiting, diarrhea, abdominal pain, and increased salivation and thirst.

2. systemic involvment which includes hypocalcemia, hyperflexia, convulsions, parenthesis, cardiac failure or respiratory paralysis What is the CLD stand for and mean? - ANSWER Certainly lethal dose; amount of a drug likely to cause death if not intercepted by antidotal therapy What does STD stand for and what does it mean? - ANSWER Safely Tolerated Dose; one fourth of CLD

how old should you be before you start giving fluoride rinses and why? - ANSWER greater than 7 years because they are more likely not to swallow the fluoride rinse What are some side effects of Stannous Fluoride? - ANSWER Susceptible solution; must be mixed up fresh and causes possible gingival sloughing, unpleasant taste, and brown staining What is a contraindication to Acidulated Phosphate Fluoride? - ANSWER Is to use on or near tooth colored restorations and porcelain Acidulated phosphate fluoride. How is it available? ANSWER tray, paint on; and available in thixotropic Gel-like, and foams What is the best fluoride for recession? - ANSWER NaF varnish (fluoride varnish) What percentage Sodium NaF gels are? - ANSWER 2% What percent is acidulated phosphate APF? - ANSWER 1.23% What is the percent of Stannous F SnF2? - ANSWER 8% In order what has the least to highest concentration and ppm in fluorides? - ANSWER Sodium (NaF), acciduated phosphate, and Stannous (SnF2) how many times a year can you apply Fluoride varnish? - ANSWER 4 times per year how many times a year can you apply acciduated, and stannous fluoride? - ANSWER 1 to 2 times per year

What are some ways of application for home use? - ANSWER tray, rinses, and toothbrushing The home fluorides are considered bacteriostatic true or false? - ANSWER True, will inhibit bacteria formation What is the concentration of Sodium fluoride rinse that is used at home? - ANSWER .05% daily; 225ppm What causes dental fluorosis? - ANSWER Hypermineralization caused by excessive ingestion of fluoride (2 ppm+) during the post-secretory maturation phase of amelogenesis. At what stage in a person's life would dental fluorosis likely be observed? - ANSWER ages 12- 16 or when the crowns of the permanent third molars are complete What might some indications of mild flurosis be? - ANSWER bilateral distribution, slightly more opaque than normal enamel, resembles shading in a line drawing. What type of toothbrushing technique is recommended for periodontal patients? - ANSWER Bass method What toothbrushing method is angled at 45 degree while half the bristles are on the gingiva and the other half is on the tooth surface? - ANSWER Stillman method With the interdental brush why should the inner wire be plastic? - ANSWER to avoid scratching cementum

What is the best location to use a tufted brush on? - ANSWER irregular gingival margins of rotated anterior teeth Best area to place the use of toothpick holder? - ANSWER apply to visible furcations, such as class 4 furcations