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Reports of randomized controlled trials A dental hygienist has been asked to provide information to clients about a new tooth whitening procedure. The dental hygienist did not study this procedure at school. Which of the following sources of information should the dental hygienist consult before providing information to clients about this procedure? A. The employer regarding the new technique B. Reports of randomized controlled trials C. Colleagues regarding technique and efficacy D. Dental supply companies regarding product available Have the interpreter explain the procedure by telephone Mrs. Sandhu, 58 years old, is a recent immigrant. She does not speak english or french; however, she is accompanied by an interpreter for assessment and treatment planning. At the follow-up appointment, Mrs. Sandhu arrives alone. During periodontal debridement, the dental hygienist determines that Mrs. Sandhu needs local anesthetic. What should the dental hygienist do next? A. Explain the action of local anesthetic using gestures B. Have the interpreter explain the procedure by telephone C. Use pictures to explain the need for this procedure D. Proceed with the treatment without the local anesthetic 20 seconds Following a client's appointment, the dental hygienist is preparing the operatory for the next client. What is the recommended minimum time that water should be run through the water lines before the next appointment?
A. 20 seconds B. 60 seconds C. 90 seconds D. 120 seconds Encourage him to express his concerns regarding today's appt Mr. Kehoe, a 24 year old informs the dental hygienist that the reason he missed his previous periodontal debridement appointment was due to a fear of being hurt. Today, he appears anxious. Clinical findings who dental biofilm- induced gingivitis localized to the papillae with light interproximal calculus. What is the best action for the dental hygienist to take next? A. Encourage him to express his concerns regarding today's appt. B. Complete his periodontal debridement during one session C. Suggest that he consider using an anti-anxiety medication D. Advise that some discomfort is possible and topical anesthetic can be used if necessary 4 vertical bitewings Mr. Ungle, 35 years old, presents for his continuing care appointment. The dental hygienist records generalized posterior periodontal probing depths of 5-6mm. He reports some sensitivity on the max left quad. What radiographic views would be most appropriate to take to assess this area? A. 4 vertical bitewings B. 4 horizontal bitewings C. 2 vertical bitewings D. 2 horizontal bitewings No signs of gingival infammation Which one of the following factors is most reliable indicator that oral self-care procedures are effective? A. Reduction of dental biofilm B. Change in tissue color C. No signs of gingival inflammation D. Absence of calculus A client with recently diagnosed type 2 diabetes
Who would benefit more from shorter continuing care appointments? A. A client who just completed tobacco use cessation program B. A client who is starting an at-home whitening program C. A client with recently diagnosed type 2 diabetes D. A client with a diagnosis of hyperthyroidism Mepivicaine (Carbocaine, Polocaine) 3% and the inferior alveolar nerve block, the lingual and long buccal nerve injections Joey, 11 years old, needs LA for periodontal debridement in Q3. The procedures will take approximately 30 minutes to complete once anesthetized. What anesthetic agent and injection(s) would be ideal for this situation? A. Mepivicaine 3% and the inferior alveolar nerve block, the lingual and long buccal nerve injections B. Lidocaine 2% and buccal infiltration(s) C. Articaine 4% with epinephrine 1:200,000 and the inferior alveolar nerve block and long buccal nerve injections D. Prilocaine 4% with epinephrine 1:200,000 and the inferior alveolar nerve block and long buccal nerve injections Pseudomembranous Candidiasis Don, an 18-year-old athlete, has been taking penicillin for pericoronitis of tooth 38. He presents for repair of a clasp on an ill-fitting maxillary partial denture. Don reports a metallic taste and a burning sensation in the palatal area. The clinical assessment reveals a lesion under the partial denture. There is a white, curd-like material with underlying erythematous mucosa. What condition should the dental hygienist suspect? A. Denture stomatitis B. Erosive lichen planus C. Necrotizing periodontitis D. Pseudomembranous candidiasis Heat therapy, warm saline mouth rinses and analgesics Ms. Katerinova, 32 years old, has recently received local anesthetic for periodontal debridement by the dental hygienist. She reports pain and some difficulty opening her mouth the day after treatment. What post care recommendations should the dental hygienist consider?
A. Heat therapy, warm saline mouth rinse and analgesics B. Cold therapy, antimicrobial mouth rinse and analgesics C. Antibiotic therapy and warm saline rinses D. Analgesics and referral for physiotherapy Candida albicans. Which one of the following oral microorganisms may overgrow with the use of broad-spectrum antibiotics? A. Porphyromonas gingivalis. B. Streptoccocus mutans. C. Actinomyces viscosus. D. Candida albicans. Generalized periodontitis stage II, grade A The periodontal assessment of Mr. Stevens, 30 years, includes a dental biofilm score of 60%, a BOP score of 30% and generalized clinical attachment loss of 3 mm with no gingival recession. The radiographs indicate generalized horizontal bone that account for a % of bone loss/age of 0.20. What is Mr. Stevens's periodontal classification? A. Generalized periodontitis stage I, grade B B. Generalized periodontitis stage III, grade B C. Generalized dental biofilm-induced gingivitis on an intact periodontium D. Generalized periodontitis stage II, grade A Elder abuse Mrs. Ridley, 81 years old, is now living with her daughter's family. When she presents for her 9- month continuing care appointment, she appears withdrawn and anxious even though she has been a longstanding client in the practice. During the intraoral assessment, the dental hygienist notes poor oral hygiene, a fractured upper denture, and bruising of the edentulous ridge. What should the dental hygienist suspect? A. Iron deficiency B. Dementia C. Self-neglect D. Elder abuse
Fluoride varnish Mr. Applebaum, 29 years old, presents for his annual continuing care appointment. He reports extreme sensitivity to cold in the mandibular right quadrant. Intraoral findings reveal localized gingival recession of 4 mm on teeth 43 and 44. What should the dental hygienist recommend for Mr. Applebaum? A. Acidulated phosphate fluoride B. Fluoride varnish C. Composite restorations D. Gingival graft Hallow handle Which one of the following design features provides the best tactile sensitivity in a hand instrument? A. Long functional shank B. Serrated handle texture C. Paired working ends D. Hallow handle The correlation between dental biofilm and gingivitis is much stronger than the correlation between calculus and gingivitis. Which one of the following statements about the clinical significance of calculus is true? A. The surface texture of subgingival calculus causes gingivitis B. Lactobacillus microorganisms are essential for the formation of calculus C. The correlation between dental biofilm and gingivitis is much stronger than the correlation between calculus and gingivitis. D. When calculus becomes embedded in the connective tissue, it results in an inflammatory resonse Sodium fluoride varnish Mrs. Savage, 73 years old, presents for her 6-month continuing care appointment. She presents with generalized periodontitis stage II grade B, generalized gingival recession of 2 mm on the facial surfaces of sextant 5 and porcelain crowns on teeth 13 to 23. The dental hygienist notices the presence of carious lesions on the roots of the maxillary premolars. What fluoride agent should the dental hygienist select for Mrs. Savage? A. Acidulated phosphate fluoride gel
B. Sodium monofluorophosphate dentifrice C. Stannous fluoride solution D. Sodium fluoride varnish A reduction in salivary flow due to fluid loss. Shamir, 17 years old, has uncontrolled type 1 diabetes. In spite of good oral self care, Shamir is at increased risk for dental caries. What is the best explanation for this conclusion? A. A wide fluctuation in blood glucose levels B. A high carbohydrate diet to control hypoglycemia C. A reduction in phagocytic activity due to hyperglycermia D. A reduction in salivary flow due to fluid loss. Provide information regarding resource agencies Mr. Roznowski, 33 years old, has multiple sclerosis. He is now living with his mother and is unhappy with his loss of autonomy. How should the dental hygienist proceed? A. Assist with only his dental hygiene needs B. Contact a social worker on his behalf C. Provide information regarding resource agencies D. Consult with his mother A tonque barbell. Todd, 18 years old, presents to his continuing care appointment with fractures of the lingual surfaces of teeth 41 and 31. What most likely caused these fractures? A. A parafunctional habit B. Bulimia nervosa C. A tonque barbell. D. Pencil chewing Replace the currently used toothbrush. What oral self-care strategy should be recommended in the recovery phase of oral candidiasis? A. Rinse with warm salt water B. Avoid the use of sodium lauryl sulfate
C. Replace the currently used toothbrush. D. Rinse with chlorhexidine Retained first primary molars. A panoramic radiograph taken on David, 14 years old, reveals teeth 14 and 24 are morphologically complete but unerupted. What is the most probable cause? A. A congenitally missing teeth B. Retained first primary molars C. Impacted canines D. Normal eruption She was caries free but now requires restorative work CLIENT PROFILE: Ms. Kane, 48 years old, presents regularly for her continuing care appointments. CHIEF CONCERN: She reports a toothache on the upper right, and dry mouth. HEALTH HISTORY: She has just completed 2 years of chemotherapy and radiation treatments for breast cancer. She is taking sertraline (Zoloft) for depression and is very worried about her health. DENTAL HISTORY: She is motivated to control her periodontal condition. She has not required restorations for the past 6 years. INTRAORAL ASSESSMENT: The gingiva is soft and spongy and the buccal mucosa is atrophic. She has generalized periodontitis stage III, grade B, with generalized 2 mm of gingival recession on the buccal surfaces of teeth 35, 34, 44, 45. Periodontal probing depths have remained stable over the past 3 years. There are CI. V carious lesions on teeth 34, 44, and 45. RADIOGRAPHIC FINDINGS: Today's radiographs have signs of carious lesions on teeth 16M and 15D. What conclusion can be drawn based on a comparison of the previous treatment record with the current assessment findings? A. She was caries free but now required restorative work B. Periodontal tissues are inflamed and aggressive periodontal therapy is required C. Large doses of radiation were recently received, so radiographs should be limited D. Her depression is responsible for the changes in her oral hygiene The use of antidepressants can contribute to xerostomia CLIENT PROFILE: Ms. Kane, 48 years old, presents regularly for her continuing care appointments. CHIEF CONCERN: She reports a toothache on the upper right, and dry mouth.
HEALTH HISTORY: She has just completed 2 years of chemotherapy and radiation treatments for breast cancer. She is taking sertraline (Zoloft) for depression and is very worried about her health. DENTAL HISTORY: She is motivated to control her periodontal condition. She has not required restorations for the past 6 years. INTRAORAL ASSESSMENT: The gingiva is soft and spongy and the buccal mucosa is atrophic. She has generalized periodontitis stage III, grade B, with generalized 2 mm of gingival recession on the buccal surfaces of teeth 35, 34, 44, 45. Periodontal probing depths have remained stable over the past 3 years. There are CI. V carious lesions on teeth 34, 44, and 45. RADIOGRAPHIC FINDINGS: Today's radiographs have signs of carious lesions on teeth 16M and 15D. Which one of the following topics is the most important for the dental hygienist to discuss with Mrs. Kane? A. The use of antidepressants can contribute to xerostomia B. Dental biofilm-induced tissue edema requires home antimicrobial mouth rinses C. The relationship between diet and dental caries D. Composite and amalgam restorations are restorative options Developing common themes PROFILE: Central College City Campus offers students basic education and literacy programs. Eighty percent (80%) of the students are enrolled in English as a Second Language (ESL) classes. Sixty percent (60%) of the students enrolled in ESL classes are also taking literacy skills training. CHIEF CONCERN: The dental hygienist is working with a health team and college administration to assess barriers to accessing oral health care. Results of this study will be used by local health departments for program planning purposes. The information gathered from the student population includes written transcripts of their feelings and beliefs about oral health care. How should this information be analyzed? A. Mean, median, and mode B. T-Test analysis C. Statistical significance D. Developing common themes Hold a meeting for the people interested to discuss it PROFILE: Central College City Campus offers students basic education and literacy programs. Eighty percent (80%) of the students are enrolled in English as a Second Language (ESL) classes. Sixty
percent (60%) of the students enrolled in ESL classes are also taking literacy skills training. CHIEF CONCERN: The dental hygienist is working with a health team and college administration to assess barriers to accessing oral health care. Results of this study will be used by local health departments for program planning purposes. Once the health team has developed an initial plan for the study, how should this initial plan be communicated to ensure the success of the project? A. Send copies of the plan to the student council B. Hold a meeting for the people interested to discuss it C. Develop a newsletter for distribution D. Speak to the president of the college Refer to a reference text CLIENT PROFILE: Mr. Gaudet, 72 years old, presents for his continuing care appointment. CHIEF CONCERN: He reports blue areas under his tongue. HEALTH HISTORY: No significant findings. He presents intermittently for dental hygiene care and has a history of intraoral verrucous carcinoma. DENTAL HISTORY: There is generalized gingival inflammation with papillae that appear edematous. INTRAORAL: The periodontal probing depths are 4 to 6 mm in the molar area accompanied with bleeding on probing. Teeth 33 to 43 present with gingival recession of 1 to 2 mm on the facial and lingual surfaces, that are sensitive to cold. RADIOGRAPHIC FINDINGS: There is evidence of interproximal calculus and slight horizontal bone loss. During the review of the health history, Mr. Gaudet reports that he has been seeing a herbalogist because of his history of cancer. What is the most effective strategy for the dental hygienist to obtain further information on herbal remedies? A. Refer to a reference text. B. Ask the client questions C. Contact the dental hygiene association D. Consult with colleagues Assure him that the condition is normal CLIENT PROFILE: Mr. Gaudet, 72 years old, presents for his continuing care appointment. CHIEF CONCERN: He reports blue areas under his tongue.
HEALTH HISTORY: No significant findings. He presents intermittently for dental hygiene care and has a history of intraoral verrucous carcinoma. DENTAL HISTORY: There is generalized gingival inflammation with papillae that appear edematous. INTRAORAL: The periodontal probing depths are 4 to 6 mm in the molar area accompanied with bleeding on probing. Teeth 33 to 43 present with gingival recession of 1 to 2 mm on the facial and lingual surfaces, that are sensitive to cold. RADIOGRAPHIC FINDINGS: There is evidence of interproximal calculus and slight horizontal bone loss. How should the dental hygienist address his chief concern? A. Assure him that the condition is normal B. Send him to cytologic smear to the lab for analysis C. Refer him to an oncologist for further assessment D. Prepare in office brush biopsy Local anesthetic Mr. Pothier, 65 years old, presents with localized 6 mm periodontal probing depths. Calculus can be seen interproximally in the same areas on a radiograph. The client terminated his previous dental hygiene appointment early due to sensitivity. Which one of the following interventions would best contribute to effective periodontal debridement for Mr. Pothier? A) Local anesthetic. B) Ultrasonic scaler. C) Hand instruments. D) Relaxation techniques. Share with her the findings that are consistent with her condition Lara, 14 years old, presents for her continuing care appointment with signs of an eating disorder, but has not indicated this in her health history. What action should the dental hygienist take? A) Confront her with the suspected condition. B) Ask her if she has sought medical help for her condition. C) Discuss the signs of her condition with her parents. D) Share with her the findings that are consistent with her condition. Provide information on the oral manifestations that may occur during chemotherapy and develop specific preventive strategies with Mrs. Meltzer.
Mrs. Meltzer, 72 years old, presents for periodontal therapy. She is scheduled for chemotherapy for breast cancer in 4 weeks. The dental hygienist will need several appointments to complete the dental hygiene therapy. In addition to treating the current periodontal condition, what action should the dental hygienist take when developing the dental hygiene care plan? A) Reassure Mrs. Meltzer that oral manifestations are rare with chemotherapy and recommend she continue her current oral self-care regimen. B) Provide information on the oral manifestations that may occur during chemotherapy and develop specific preventive strategies with Mrs. Meltzer. C) Explain to Mrs. Meltzer that oral self-care practices will help prevent the oral manifestations associated with chemotherapy. D) Refer Mrs. Meltzer to a periodontist for further treatment and recommend use of an oral irrigator. His delayed response to healing Mr. Stephans, 52 years old, is a new client. He presents with generalized Stage III Grade B periodontitis and is in need of extensive periodontal debridement. He confirms a long history of alcohol abuse and that he has recently begun alcohol cessation counseling. What is the most important information for the dental hygienist to provide to Mr. Stephans regarding his treatment? A) His delayed response to healing. B) The benefits of a phenol-based mouthrinse. C) His need for a prescription for a post-operative analgesic. D) The advantages of him taking tetracycline. Physician for a health assessment The initial assessment of Mr. Parker, 40 years old, reveals tenderness in the temporomandibular joint area, bilateral lymphadenopathy, white folded plaques on the lateral borders of the tongue, linear gingival erythema, and generalized 7 - 9 mm periodontal probing depths. Which one of the following referrals would be most important for Mr. Parker? A) Counselor for a tobacco use cessation intervention. B) Radiologist for temporomandibular joint pain. C) Physician for a health assessment. D) Periodontist for the periodontal condition.
Increased bleeding on probing Mrs. Guay, 73 years old, presents to her continuing care appointment with a recently placed mandibular canine-to-canine periodontal splint. During the assessment, the dental hygienist notices changes in her periodontium arising from ineffective dental biofilm control methods. What should the dental hygienist expect to observe? A) Narrower embrasures preventing dental biofilm removal. B) A wider periodontal ligament space. C) Radiographic evidence of bone loss. D) Increased bleeding on probing. Collaboration After consultation between a group of dental hygienists and public health nurses, a kit for new parents was created to reduce the incidence of early childhood caries. The nurses will use the kit in their prenatal classes. This is an example of which one of the following health promotion strategies? A) Collaboration. B) Health education. C) Community organization. D) Advocacy. Asthma The air-powder abrasive system is CONTRAINDICATED for clients with which one of the following conditions? A) Mild gingivitis. B) Asthma. C) Hypothyroidism. D) Hypoglycemia. Review all treatment options with the client and document the discussion in his dental chart. Mr. Cook, 82 years old, presents for periodontal therapy. The dental hygiene care plan includes periodontal debridement with local anesthesia. Mr. Cook says, "I really don't know why it is so important to have this treatment". The client record indicates that he has consented to having the periodontal debridement. Before proceeding with treatment, what action would be most appropriate for the dental hygienist to take?
A) Review all treatment options with the client and document the discussion in his dental chart. B) Reassure the client that this treatment is beneficial and necessary if he wants to save his teeth. C) Contact the client's children to determine if they understand the need for the periodontal treatment. D) Advise the client that he must have understood the process when he consented to the treatment. Less lateral pressure is used How does powered instrumentation differ from hand instrumentation? A) The tissue healing time is slower. B) Less lateral pressure is used. C) There is a greater risk of musculoskeletal disorders. D) The use of an intraoral fulcrum is critical. Bacterial invasion of the junctional epithelium What is the initiating factor in the histopathological sequence of inflammation in periodontal disease? A) Loss of clinical attachment. B) Resorption of alveolar bone. C) Apical migration of the gingival margin. D) Bacterial invasion of the junctional epithelium. Nausea, gastrointestinal pain, and vomiting. What are the initial symptoms of an acute fluoride toxicity reaction? A) Nausea, gastrointestinal pain, and vomiting. B) Vomiting, coughing, and headache. C) Urticaria, nausea, and itching. D) Rash, vomiting, and wheezing. Modified by systemic factors. A pyogenic granuloma is found under which section of the classification of gingival diseases? A) Viral origin. B) Modified by medications. C) Allergy related. D) Modified by systemic factors.
Curvature of the occlusal plane in an anterior to posterior direction. Which one of the following choices best describes the "curve of Spee"? A) Curvature of the occlusal plane in a medial to lateral direction. B) Curvature of the occlusal plane in an anterior to posterior direction. C) Curvature of the line from the ala to the tragus. D) Curvature of a root affected by dilaceration. The packet was folded. A periapical radiograph of the teeth in sextant 5 presents with dark vertical lines along the edges of the film running parallel to the long axis of teeth 32 and 42. What factor is the most likely cause of these lines on the film? A) The packet was folded. B) The processing temperature too high. C) The emulsion was scratched. D) The film was exposed twice. Hypoglycemia Mrs. Bernard, 48 years old, is running late for her 9:00 am continuing care appointment. In the past, there have been no significant findings on her health history except for gestational diabetes. Today she reports that she missed her yearly physical examination and she is on a diet to lose 10 kg. As the dental hygienist begins treatment, she becomes anxious and irritable. Her skin is moist and sweaty. What type of medical emergency is Mrs. Bernard exhibiting? A) Angina pectoris. B) Myocardial infarction. C) Hypoglycemia. D) Hypotension. A sudden change from the supine to the upright position What would most likely induce orthostatic hypotension in a client? A) Lying in the dental chair for a prolonged period of time. B) A high level of fear and anxiety. C) The level of the client's feet is higher than his or her head. D) A sudden change from the supine to the upright position.
The dental hygienist is analyzing a client's food diary. Findings suggest the client has eaten 15 fermentable carbohydrates. Three of these foods were consumed with breakfast, one was consumed mid morning, two were consumed with lunch and four were consumed with dinner. The remaining five foods were consumed during the evening at greater than 20-minute intervals. What was the client's total number of acid exposures? A) 8. B) 9. C) 10. D) 15. Enlarged thyroid gland Mrs. Berg, 69 years old, presents with an immobile, soft tissue mass on the anterior midline of the lower neck. What is the most likely explanation for this finding? A) Enlarged thyroid gland. B) Enlarged submandibular salivary gland. C) Enlarged superficial cervical lymph nodes. D) Enlarged deep cervical lymph nodes. Nail biting Which one of the following is an example of a parafunctional habit? A) Mouth breathing. B) Nail biting. C) Cigarette smoking. D) Sucking on lemons. A reduction in gingival bleeding Mrs. Lysiuk, 73 years old, presents with generalized Stage II Grade B periodontitis and moderate dental biofilm. She asks the dental hygienist for professional advice because her "gums bleed" each time she brushes. What would be a realistic goal for Mrs. Lysiuk during the next 6 weeks? A) A reduction in periodontal probing depths. B) Elimination of bleeding on probing.
C) A reduction in gingival bleeding. D) Removal of all dental biofilm. Mobility of M Which one of the following clinical findings would suggest that a single tooth implant was failing? A) 1 mm of bone loss. B) Gingival bleeding. C) 5 mm periodontal probing depth. D) Mobility of M2. Sodium flouoride Mr. Kell, 54 years old, is at moderate risk for root caries due to medication-induced xerostomia. What oral self-care mouthrinse should the dental hygienist recommend to Mr. Kell? A) Sanguinarine. B) Essential oils. C) Sodium fluoride. D) Chlorhexidine. Perceived need for change Which one of the following factors is most likely to enable clients to learn new oral hygiene behaviours? A) Perceived need for change. B) Level of manual dexterity. C) Need for social acceptance. D) Presence of oral disease. Confirm that she understands that this treatment may not extend the life of her teeth. Mrs. Attwell, 65 years old, has been diagnosed with Stage IV Grade C periodontal disease. She understands that her condition is severe, but is currently unable to accept the loss of her teeth and refuses to consider complete dentures. When she presents for her initial periodontal debridement appointment, what should the dental hygienist do first? A) Suggest that she consider the placement of a periodontal splint. B) Begin periodontal debridement focusing on her areas of suppuration.
C Refer her to a prosthodontist to discuss the possibility of partial dentures. D) Confirm that she understands that this treatment may not extend the life of her teeth. Clinical attachment levels What is the most reliable indicator of periodontal disease stability over time? A) Periodontal probing depths. B) Classification of mobility. C) Periodontal Screening and Recording scores. D) Clinical attachment levels. To facilitate accurate conclusions When designing a community-based program, why is it important to plan the evaluation phase? A) To facilitate accurate conclusions. B) To increase the cost-benefit ratio. C) To produce qualitative data. D) To improve time management. Thorough dental biofilm removal Ms. May, 32 years old, is interested in learning how to properly care for her dental implants that replace teeth 33 to 43. What strategy would be most important for Ms. May to learn to prevent peri- implantitis? A) Daily use of a chlorhexidine mouthrinse. B) Twice daily home irrigation. C) Thorough dental biofilm removal. D) Use of a powered toothbrush. Roll the handle What action must be taken in order to maintain proper adaptation of the instrument blade when debriding the distobuccal line angle of tooth 37? A) Use a vertical rocking motion. B) Roll the handle. C) Close the angle of the blade. D) Apply a horizontal stroke.
Sodium bicarbonate Joanna, 17 years old, is diagnosed with necrotizing ulcerative periodontitis. She receives periodontal debridement and oral self-care instructions on her first of several appointments scheduled. What mouthrinse should the dental hygienist recommend Joanna use for 3 days following the first treatment rendered? A) Sodium bicarbonate. B) Diluted hydrogen peroxide. C) Hypertonic saline. D) Sodium fluoride. Hard tissue manifestations such as mandibular tori Mr. Mandel, 74 years old, requires a complete lower denture. He is worried because he overheard the dentist's concern about seating the mandibular dental impression tray. Mr. Mandel asks the dental hygienist about the dentist's concern. Which one of the following factors should the dental hygienist assess prior to answering Mr. Mandel's question? A) Pathological deposits such as sialoliths. B) Hard tissue manifestations such as mandibular tori. C) Pathological condition such as periodontal abscess. D) Atypical soft tissue anatomy such as herniated lingual veins. Empathy Malachi, 12 years old, is anxious about having his first premolars removed prior to orthodontic treatment. What would allow the dental hygienist to sense Malachi's fear? A) Empathy. B) Kinesic behaviour. C) Paraphrasing. D) Locus of control. Radiographic evidence of osseointegration. Mrs. Edgar, 57 years old, has multiple mandibular dental implants with a fixed dental prosthesis. Which one of the following criteria indicates a successful implant? A) Slight surrounding bone loss. B) Radiographic evidence of osseointegration.
C) Attachment of Sharpey's fibres to the implants. D) Minimal bleeding on probing. Bacillus stearothermophilus. What type of biological monitoring strips should be used to verify the effectiveness of a steam sterilizer? A) Bacillus stearothermophilus. B) Clostridium tetani. C) Bacillus subtilis. D) Clostridium botulinum. Comprehensive documentation What is the best indicator that a client has received the planned services? A) Resolved inflammation. B) Comprehensive documentation. C) Client satisfaction. D) Care plan revisions. Erosion and decalcification on the palatal surfaces. CLIENT PROFILE: Ms. Porter, 31 years old, is a new client to the dental office. She is 10 weeks pregnant with her second child. CHIEF CONCERN: "My gums bleed when I brush and I think I have a few cavities." HEALTH HISTORY: She is experiencing morning sickness with daily vomiting. Her first pregnancy resulted in the premature birth of a healthy baby. DENTAL HISTORY: It has been 4 years since her last dental hygiene appointment. INTRAORAL: She presents with generalized severe gingival inflammation, bleeding on probing, and moderate dental biofilm accumulation. An enlarged papilla between teeth 13 and 14 is noted. Teeth 16, 25, and 26 have incipient carious lesions. No restorations are present. What hard tissue finding might the dental hygienist expect as a result of the morning sickness? A) Rampant dental caries on the posterior buccal surfaces. B) Interproximal carious lesions on the anterior facial surfaces.
C) Abfraction on the facial surfaces of the mandibular canines. D) Erosion and decalcification on the palatal surfaces. The impact of dental biofilm and hormonal changes on gingival tissues. CLIENT PROFILE: Ms. Porter, 31 years old, is a new client to the dental office. She is 10 weeks pregnant with her second child. CHIEF CONCERN: "My gums bleed when I brush and I think I have a few cavities." HEALTH HISTORY: She is experiencing morning sickness with daily vomiting. Her first pregnancy resulted in the premature birth of a healthy baby. DENTAL HISTORY: It has been 4 years since her last dental hygiene appointment. INTRAORAL: She presents with generalized severe gingival inflammation, bleeding on probing, and moderate dental biofilm accumulation. An enlarged papilla between teeth 13 and 14 is noted. Teeth 16, 25, and 26 have incipient carious lesions. No restorations are present. Based on Ms. Porter's periodontal assessment, what information should the dental hygienist discuss with her? A) The impact of dental biofilm and hormonal changes on gingival tissues. B) That dental biofilm is a predisposing factor for periodontal disease. C) That gingivitis causes gestational diabetes. D) The relationship between morning sickness and plaque-induced gingivitis. Pyogenic granuloma CLIENT PROFILE: Ms. Porter, 31 years old, is a new client to the dental office. She is 10 weeks pregnant with her second child. CHIEF CONCERN: "My gums bleed when I brush and I think I have a few cavities." HEALTH HISTORY: She is experiencing morning sickness with daily vomiting. Her first pregnancy resulted in the premature birth of a healthy baby. DENTAL HISTORY: It has been 4 years since her last dental hygiene appointment. INTRAORAL: She presents with generalized severe gingival inflammation, bleeding on probing, and moderate dental biofilm accumulation. An enlarged papilla between teeth 13 and 14 is noted. Teeth 16, 25, and 26 have incipient carious lesions. No restorations are present.
What is the most probable gingival condition affecting the papilla between teeth 13 and 14? A) Aphthous ulcer. B) Traumatic lesion. C) Pyogenic granuloma. D) Apical abscess. Monitor adherence to the established program activities PROFILE: Beaver Creek School is located in a remote, northern community. There are 50 male and female students ranging from 6-16 years of age, enrolled in grades 1-9. CHIEF CONCERN: The school-aged children exhibit a high incidence of dental caries. There is a lack of accessibility to regular dental care. A dental hygienist has been contracted to help the community address its concern about the children's oral health. DENTAL HISTORY: The drinking water is obtained from individual wells. Several tests have shown that the natural fluoride in water is less than 0.30 pm. Once the dental caries reduction program has been implemented, which one of the following actions should the dental hygienist take as part of a formative evaluation? A) Monitor adherence to the established program activities. B) Perform a community Plaque Index. C) Establish short-term objectives for the program. D) Conduct a diet survey for each student. Consult with the oncologist regarding the ASA solution and discuss the resulting oral effects. CLIENT PROFILE: Mr. Fox, 65 years old, quit smoking 10 years ago. CHIEF CONCERN: He is presenting for dental hygiene care prior to radiation therapy. HEALTH HISTORY: Mr. Fox has recently been diagnosed with squamous cell carcinoma on the tongue, and is scheduled for surgery and radiation therapy. INTRAORAL: There is an 8 mm by 3 mm, irregular, indurated, cratered and primarily white lesion with areas of erythema on the right lateral border of the tongue. There is a rough amalgam restoration on the lingual surface of tooth 46. Several teeth are scheduled for extraction. Following several sessions of radiation therapy, Mr. Fox is experiencing soft tissue sensitivity. He is gargling with an acetylsalicylic acid (ASA) and water solution that he said was recommended by his oncologist. What should the dental hygienist do?
A) Recommend Mr. Fox stop rinsing with the ASA solution and use an antimicrobial mouthrinse. B) Consult with the oncologist regarding the ASA solution and discuss the resulting oral effects. C) Instruct Mr. Fox to follow the recommendations of his oncologist and rinse his mouth with water following the ASA solution. D) Write a letter to the oncologist outlining the sensitivity Mr. Fox has reported and suggest it may be due to the ASA solution. Reduced salivary glow may result in increased food retention CLIENT PROFILE: Mr. Fox, 65 years old, quit smoking 10 years ago. CHIEF CONCERN: He is presenting for dental hygiene care prior to radiation therapy. HEALTH HISTORY: Mr. Fox has recently been diagnosed with squamous cell carcinoma on the tongue, and is scheduled for surgery and radiation therapy. INTRAORAL: There is an 8 mm by 3 mm, irregular, indurated, cratered and primarily white lesion with areas of erythema on the right lateral border of the tongue. There is a rough amalgam restoration on the lingual surface of tooth 46. Several teeth are scheduled for extraction. Following radiation therapy, Mr. Fox experiences xerostomia, loss of taste sensation, and some difficulty swallowing. What information should the dental hygienist give Mr. Fox regarding his increased risk for dental caries? A) Radiation therapy weakens dental enamel. B) Difficulty in swallowing may result in a higher intake of sweet foods. C) Reduced salivary flow may result in increased food retention. D) Radiation therapy lessens the effect of fluoride. Rinse with water and use a saliva subsitute CLIENT PROFILE: Mr. Fox, 65 years old, quit smoking 10 years ago. CHIEF CONCERN: He is presenting for dental hygiene care prior to radiation therapy. HEALTH HISTORY: Mr. Fox has recently been diagnosed with squamous cell carcinoma on the tongue, and is scheduled for surgery and radiation therapy. INTRAORAL: There is an 8 mm by 3 mm, irregular, indurated, cratered and primarily white lesion with areas of erythema on the right lateral border of the tongue. There is a rough amalgam restoration on the lingual surface of tooth 46. Several teeth are scheduled for extraction.
What should the dental hygienist suggest to Mr. Fox to relieve the xerostomia, loss of taste sensation, and difficulty swallowing that he will be experiencing post radiation therapy? A) Rinse with a warm hypotonic saline solution. B) Rinse regularly with a hydrogen peroxide solution. C) Rinse frequently with an antimicrobial mouthrinse. D) Rinse with water and use saliva substitutes. 2 g of amoxicillin (Amoxil) at 9:00 a.m. PROFILE: Mrs. Blackler is 70 years old. CHIEF CONCERN: "During the night my tongue sticks to the roof of my mouth." HEALTH HISTORY: Mrs. Blackler had her hip surgically repaired 3 years ago and underwent heart valve replacement surgery 18 months ago. She takes nifedipine (Adalat) to control her hypertension, and the over-the-counter antihistamine chloropheniramine maleate (Chlor-Tripolon) for seasonal hay fever. She has no known drug allergies. DENTAL HISTORY: Mrs. Blackler has been a client of the practice for 10 years and usually presents for annual continuing care appointments. She wears a mandibular partial denture and a complete maxillary denture. INTRAORAL: Teeth 44 to 34 are present. There is a carious lesion on the distal root surface of tooth
fever. She has no known drug allergies. DENTAL HISTORY: Mrs. Blackler has been a client of the practice for 10 years and usually presents for annual continuing care appointments. She wears a mandibular partial denture and a complete maxillary denture. INTRAORAL: Teeth 44 to 34 are present. There is a carious lesion on the distal root surface of tooth
C) advise the client that the hematoma will most likely be present for 2-3 days D) place an icepack on the area to minimize the size of the hematoma Position Ms. Romani so her head is even with the upper edge of the headrest. During periodontal debridement for Ms. Romani, 34 years old, the dental hygienist experiences lower back discomfort from balancing on the edge of the clinician's stool to obtain optimal visibility. Ms. Romani is 1.52 m tall and of average weight. What initial adjustment should the dental hygienist make to avoid lower back strain? A) Ensure Ms. Romani's head is positioned straight ahead. B) Position the dental hygienist's elbows above waist level and away from the body. C) Position Ms. Romani so her head is even with the upper edge of the headrest. D) Obtain a clinician's stool that provides effective lumbar support. Pulpal and buccal soft tissue anesthesia of the mandibular anteriors and premolars on one side. The incisive nerve block is known to provide complete anesthesia of which of the following areas? A) Pulpal and buccal soft tissue anesthesia of the mandibular anteriors and premolars on one side. B) Pulpal, buccal and lingual soft tissue anesthesia of the maxillary centrals, laterals and canines. C) Buccal soft tissue and pulpal anesthesia of the mandibular premolar teeth. D) Buccal and lingual soft tissue and pulpal anesthesia of the mandibular central, lateral, canine and premolars on one side. Erosive Lichen Planus Mrs. Jorgenson, 67 years old, presents to the dental office for an oral health assessment. The intraoral assessment reveals that the buccal mucosa has a lace-like pattern of intersecting angular white striations with irregular, bilateral, painful ulcers. She is taking furosemide (Lasix to relieve the edema associated with a heart failure condition. What pathology should the dental hygienist suspect? A) Erythematous candidiasis. B) Reticular lichen planus. C) Systemic lupus erythematosus. D) Erosive lichen planus. Allergic reaction to a topical anesthetic