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Clin Tech Quiz 1
Study Guide & Notes
| Question | Answer |
|---|---|
| What are the three types of microorganisms of concern in the dental environment | Bacteria Viruses Fungi |
| What varies between individuals, reflecting the degree of health of each person | Host resistance to infection |
| Fomite | An inanimate object that carries bacteria in a medical setting |
| What 3 things carry potentially harmful microorganisms? | Patients Dental healthcare workers! Dental equipment |
| True or False: If someone looks normal, they can not be infectious | FALSE! Asymptomatic carriers & Pre-symptomatic spreaders |
| What are the 7 Universal Precautions | Treat all patients as potentially infectious Use personal protective equipment (PPE) Handle sharps safely Clean and disinfect surfaces Wash hands frequently Follow safe work practices Use disposable equipment |
| What is the Mode of Transmission? | The specific method by which an infectious agent (pathogen) spreads from one host to another |
| What are some modes of transmission for microorganisms? | Surface Skin Oral Tissues Saliva |
| True or False: Saliva only contains harmful microorganisms. | FALSE! Saliva contains healthy microorganisms too that aid in digestion, support the immune system, maintain PH of the oral cavity and compete with harmful/infectious microorganisms. |
| Examples of 2 oral situations that harbor disease producing organisms? | Periodontal disease Tooth decay |
| How can bloodborne microorganisms be transmitted? | By contact In saliva In the form of droplets, spatter or aerosols |
| What are the 3 modes of disease transmission? | Direct Contact Indirect Contact Droplet Transmission |
| Describe direct contact (mode of disease transmission) | The immediate, physical transfer of an infectious agent from a reservoir to a new host, occurring through actions like touching, kissing, or sexual intercourse. |
| Describe indirect contact (mode of disease transmission) | occurs when a person contracts a pathogen from a contaminated intermediate object, substance, or surface (a "vehicle") or by an organism that transmits the disease from one host to another AKA mosquito (a "vector") |
| Describe droplet transmission | Mode of disease spread where infectious microorganisms are transmitted through respiratory droplets produced by an infected individual. |
| Direct Contact Example in dental setting | Patient's Mouth (saliva) |
| Indirect Contact Example | Contaminated surfaces, hands, sharps equipment |
| Droplet Transmission Example | Aerosols, sprays, splashes, spatter |
| 2 ways that microorganisms leave the host? | Naturally & Artificially |
| How does a microorganism naturally escape the host? | Speech, cough, oral cavity |
| How does a microorganism artificially escape the host? | Carried on hands, instruments, equipment (handpieces, ultrasonics) Aerosols and spatter |
| What are the Primary Routes of Microbial Entry? | Inhalation – breathe in droplet aerosols Ingestion – swallow Breaks in skin – direct touch Mucous membranes – droplet of saliva/blood to eyes, nose and/or mouth |
| 1ml of saliva has how many bacteria | 10-100 million! |
| 1 mg of plaque has? | 200 million organsims |
| What 3 things impact chances of being infected with disease from pathogen? | Virulence, dose, host resistance |
| Define Virulence | the severity of the disease caused by a pathogen |
| Define Dose | How many microorganisms are being spread |
| Define Host Resistance | How susceptible person is to developing illness from pathogen |
| How is chance of infection is calculated? | Virulence times the # of organisms / host resistance = infection |
| 6 Steps to the Chain of Infection | Infectious Agent Reservoir Portal of Exit Mode of Transmission Portal of Entry Susceptible Host |
| What are some MHx questions that prevent spread of disease by patient? | Have you recently traveled? If so, where and for how long? Have you had close contact with anyone who has been sick? |
| Modes of Transmission for HIV | Unprotected sex w/ infected partner Sharing needles w/ infected person Transmission from mom to fetus Infection from blood products |
| What is the primary mode of transmission for TB | Inhalation |
| Are new TB cases rising or becoming less common? | Rising due to bacteria becoming antibiotic resistant and increased travel. |
| Two Modes of Transmission for Hep B | Hematogenous and sexually |
| What type of infection is Hep B? | Bloodborne |
| Two Modes of Transmission for Hep C | Hematogenous and sexually |
| Is there a vaccine for Hep C? | Nope |
| Mechanisms of Action for Cars-CoV-2? | Virus enters nasal passage or oral cavity, activates immune response, inflammatory mediators are released. |
| Three modes of transmission for Sars-CoV-2 (3) | Aerosols, Droplet, Fomites |
| How are aerosols created in dentistry? | Ultrasonics, High speed handpieces, air polishing, rubber cup polishing |
| What Mode of transmission spreads the most bacteria? | Aerosols |
| Examples of ASEPTIC Patient Treatment Techniques in dentistry | Toothbrushing – decrease pathogenic M/Os Mouthrinse – pts. rinse w/ H2O2 High vacuum evacuation(HVE) Rubber dam Barriers – face shields, various filtration masks specific to the task (levels) |
| Function of surface barriers? | Cover hard to clean equipment instead of using surface disinfectant |
| What does OSHA stand for? | Occupational Safety and Health Administration |
| What is the general purpose of OSHA? | To enforce a healthy and safe work environment. |
| What does ADA stand for? | American Dental Association |
| What is the general purpose of the ADA? | To set national guidelines and recommendations for dentistry. |
| What does WISHA stand for? | Washington Industrial Safety and Health Act |
| General purpose of WISHA? | Enforce healthy and safe work environment specifically in WA |
| What does CDC stand for? | Center for Disease Control |
| General purpose of the CDC? | Conducts and supports health promotion, prevention, and preparedness activities in the U.S. |
| What is the goal of the CDC? | To. improve overall public health. |
| What does EPA stand for? | Environmental Protection Agency |
| Purpose of the EPA? | To coordinate programs that reduce pollution and protect the environment. |
| What does FDA stand for? | Food and Drug Administration |
| What is the FDA responsible for? | Determining if a food or drug is safe and effective enough to be sold to the public. |
| What does DOSH stand for? | Division of Occupational Safety and Health |
| General goal of DOSH? | To protect and improve the health and safety of workers. |
| Who does DOSH cover? | State workers, not federal workers. |
| Difference between disinfection and sterilization? | Disinfection kills all disease-producing microorganisms, except endospores. Sterilization kills all disease-producing microorganisms including endospores. |
| What is the normal range of respiration and pulse for an adult? | 12-20 breaths per minute 60-100 beats per minute |
| In the autoclave, how should instrument packages be arranged? | Side by side, space between each cassette, and not stacked. |
| Which agency under federal jurisdiction registers chemicals for disinfection and sterilization? | Sterilizing materials in clinic are approved by EPA |
| What is the most effective solution for disinfecting your cart after a patient? | Cavi wipes |
| Who is the father of dental hygiene? | Afred C. Fones |
| Who was the first dental hygienist? | Irene Newman |
| When was Irene Newman trained? | 1913 in Philedelphia |
| When did the 1st DH class graduate? | 1914 |
| What years started the promotion of fluoride? | 1940s-1950s |
| What years did DH learn about ergonomics? | 1980s-1990s |
| Who was Ester M. Wilkins? | Founder of U. of WA DH school in 1950. |
| What services does the RDH provide? | Preventative, educational, therapeutic |
| Define primary preventative | No disease, only preventative care. Includes placing sealants, fluoride, education, removing debris. |
| Define secondary preventative | Treatment of early disease to stop it from progressing. (scaling, SRP, irrigating) |
| Define tertiary preventative | Replacement of lost tissues and rehabilitation of oral cavity to near normal as possible after secondary prevention fails. (crowns, dentures) |
| How does educating patient prevent disease? | The better the patient understands, the better care they take of oral cavity, the better the success rate. |
| What are the 6 types of supervision a RDH can work under? | Direct Supervision Indirect Supervision General Supervision Direct Access Supervision Remote Supervision Independant Practice |
| What is direct supervision? | Dentist must diagnose patient and be present while RDH works. Dentist approves work before patient leaves. |
| What is indirect supervision? | Dentist must authorize work by RDH, dentist must be in office where RDH is giving treatment. |
| What is general supervision? | Dentist authorizes treatment for patient, but doesn't need to be there for treatment. |
| What is direct access supervision? | RDH can initiate treatment based on their assessment w/o authorization or presence of dentist. Have a provider-patient relationship. |
| What is remote supervision? | Dentist is not on site, communication is done with current technology. |
| What is the term for remote supervision? | Teledentistry |
| What is independent practice? | RDH can provide services in any scope of RDH practice in any setting without the dentist. |
| What are the 6 steps to the DH Process of Care? | 1.) asses 2.) diagnose 3.) plan 4.) implement 5.) evaluate 6.) document |
| Describe the assessment phase of the DH process of care | The 1st phase, systematic collection of comprehensive data, provides foundation for care, documented in patients record |
| What is subjective data? | Observation that includes interaction, chief complaints, perception of healthcare, MHx and DHx. |
| What is objective data? | Physical and oral assessment, clinical and radiographic findings to show evidence of disease in teeth and periodontal tissues, oral exams. |
| What is the purpose of a diagnosis? | Basis for treatment plan |
| What is a care plan? | Strategies developed to meet individual needs that were identified by the diagnosis. |
| What are the steps to the RDH care plan? | Establish priorities, set goals, determine interventions, define expected outcomes. |
| How are priorities established? | By the severity of the condition and resources. |
| Describe implementation | Putting the care plan into action. |
| Define evaluation | Comparison of current health status with baseline data, assess the progress made toward the goal, determine needed changes in care plan. |
| Define documentation | RDH details all assessment data, diagnosis, care plan, treatments, and patient education into electronic health record in condensed and consistent format. |
| Function of the RDH process of care? | To guide the RDH decision making and the education and treatment of the patient. |
| What is the code of ethics? | It describes professional conduct, and outlines responsibilities and duties to patients, colleagues and society. |
| What are the DH core values (7) | Individual autonomy, confidentiality, societal trust, nonmalificence, beneficence, justice, and veracity (truthfulness) |
| What causes an ethical dilemma? | When there are 2 morally correct choices or courses of action |
| How to solve an ethical dilemma? | Follow logical steps to provide a reasonable approach, reach conclusions and take action. |
| Why is it important to keep up with state law? | It is always changing. |
| Proper placement of a blood pressure cuff around the arm and what artery is inflated | On bare upper arm leveled to heart. Brachial artery |
| Normal blood pressure reading is? | Less than 120/less than 80 |
| Elevated blood pressure reading is? | 120-129/less than 80 |
| What is a stage 1 blood pressure reading? | 130-139/80-89 |
| What is a stage 2 blood pressure reading? | 140 or higher/90 or higher |
| What is a critical blood pressure reading? | Higher than 180/higher than 120 |
| What effect does a very tight grasp on instrument have? | Blanching and overexertion of hand. Strains, carpel tunnel, etc |
| Maxillary arch position | Pt chin is up, light is pushed away and angled up |
| Mandibular arch position | Pt chin is down, light directly over pt mouth |
| Function of thumb and index finger during modified pen grasp? | Holds instrument |
| Function of the middle finger during modified pen grasp? | Helps guide working end and provides extra support |
| Function of the ring finger during modified pen grasp? | Fulcrum on tooth surface (incisal or occlusal). Stabilizes |
| When measuring blood pressure, how is the max pressure to which the cuff should be inflated determined? | BP cuff should be inflated 20-30mmHg above point when pulse is no longer felt |
| A decreased pulse rate can be caused by? (2) | Heart conditions, medications |
| An increased pulse rate can be caused by? (3) | Anxiety, medications, exercise, caffeine |
| Mirror indirect vision | Using mirrors reflection to view a tooth surface or structure that cannot be seen with naked eye. |
| Retraction | Using mirror to pull back tongue, cheek, or lip for a better view |
| Indirect illumination | Use of mirror surface to reflect light onto a dark area of mouth |
| Transillumination | Use of mirror to reflect light through teeth to find margins or fillings |
| What are the awesome things about using the modified pen grasp? (4) | Allows precision, strength, reduces fatigue and disorders. |
| Function of chemical indicator tape? | Changes color when the autoclave has reached the designated temp, this does not mean it is sterile |
| What is an SDS? | Safety data sheet |
| Incubation period of Covid-19? | 2-14 days |
| What is Individual autonomy? | The right to be treated respectfully, give informed consent, and be given disclosure to any relevant info |
| How does a DH demonstrate Confidentiality? | Protecting patients information and respecting HIPPA |
| How does a DH demonstrate Societal Trust? | valuing client trust and understanding that public trust in our profession is based on our actions and behavior |
| Non-maleficence | do no harm |
| Purpose of beneficience? | Encourages well being for the patient. |
| How does the DH demonstrate Justice/fairness? | Providing equal treatment no matter the patient |
| How does the DH demonstrate veracity? | Always being honest and telling truth |
| What is the purpose of the Universal Precautions? | Outline the actions needed to prevent the spread of disease through blood and other body fluids when providing first aid or health care |
| Which two organizations do not have authority? | CDC and ADA, they can only make recommendations. |
| SDS's are developed and maintained by who? | The SDS are developed and maintained by the individual manufacturer. OSHA oversees it to make sure all the appropriate information is included, but does not have a universal format that is followed |
| How far can you angle your body away from being ergonomic? | 20 degrees |
| Where should the handle rest when working on mandibular teeth? | Between the first and second knuckle of the index finger |
| Where should the handle rest when working on maxillary teeth? | Between base of thumb to second knuckle. |
| Where to sit for surfaces toward? | 8:00-9:00 |
| Where to sit for surfaces away? | 12:00 |
| Where should the fulcrum be positioned in relation to the tooth being scaled? | on a tooth or facial tissue adjacent to the tooth being scaled and as close to the working area as possible to ensure the lower shank of the instrument remains parallel to the tooth's surface for effective strokes. |
| When is the incubation period for COVID? | 2-14 days |
| What are the different methods of sterilization in dentistry? | Autoclave, Dry heat sterilizer, and Chemical vapor sterilizer |
| Preferably, what is the initial method of cleaning instruments after they are used on a patient? | The automated method (Ultrasonic cleaners, instrument washers) because this method limits contact with contaminated materials and therefore decreases risk of exposure. |
| What clock positions do right handed clinicians sit at? | 8-1 o'clock |
| What clock positions do left handed clinicians sit at? | 11-4 o'clock |
| Where is patients head on the clock? | 12 o'clock |
| Where are patients feet on the clock? | 6 o'clock |
| Why is it necessary to sit in a specific position? (2) | Reduces musculoskeletal stress because the clinician can maintain neutral positioning. Provides optimal vision of the tooth surfaces during instrumentation. |
| How are anterior teeth divided? | At midline |
| How are surfaces described/named on the anteriors? | Surfaces away and surfaces towards midline. |
| At eight or four o'clock, what surfaces are worked on? | anterior surfaces toward |
| Where should right hand person sit to clean anterior surfaces toward? | 8-9 |
| From 11 to 12 o'clock what surfaces are worked on? | Anterior surfaces away |
| What two aspects should the posteriors be divided into? | Facial and lingual aspect |
| For Posterior Aspects facing TOWARD, what position should right handed clinician sit at? | 9 o'clock |
| For Posterior Aspects facing TOWARD, what position should left handed clinician sit at? | 3 o'clock |
| For posterior aspects facing away, what position should right handed clinician sit at? | 10-11 o'clock |
| For posterior aspects facing away, what position should left handed clinician sit at? | 1-2 o'clock |
| When should a Clinician Stand? (3) | When there is difficulty accessing treatment area. When patient cannot be placed in supine position due to medical or physical limitations. For mandibular treatment areas. |
| How far can head tilt in neutral positioning? | 15 degrees |
| How do chemical vapor sterilizers work? | Uses chemicals, such as liquid ethylene oxide or hydrogen peroxide, instead of heat to kill microbes. |
| How does moist heat sterilization work? | Utilizes high-temperature steam, often under pressure, generated in autoclaves. |
| How does dry heat sterilization work? | Uses high-temperature dry air to sterilize items. |
| What does chemical indicator tape do? Does this mean it is sterile> | Changes color when autoclave has reached needed temp. NO. |
| How must instruments be packed after sterilization? | Rinsed or soaked with water or enzymatic solution, then cleaned in ultrasonic before sterilization. |
| What is taping in sterilization process? | Put on outside of packages, labeled with date of sterilization, contents, and the sterilizer cycle and initials of person who did it. |
| 3 Disadvantages of the autoclave? | Rusting, dulling, not usable for heat sensitive materials. |
| What is involved in neutral positioning? | Head, neck, shoulders, upper arm position, forearm position, back, adjusting stool, maintaining low back curve while sitting. |
| What is chemical vapor sterilization and what temp and time is it sterilized at? | Heating a special chemical in a closed chamber, producing hot chemical vapors that kill microorganisms. 20 minutes at 132.2 C (120 F) |
| What is moist heat sterilization and what temp and time is it sterilized at? | Heating water to create steam in a closed chamber to produce a moist heat that kills all microorganisms including endospores. 20-30 min at 121 C (250 F) |
| What is dry heat sterilization and what temp and time is it sterilized at? | Heating the air, transfers heat energy to instruments. Requires higher temps than other two methods 60-120 minutes at 160 C (320 F) |
| Where should fulcrum be positioned in relation to too that's being scaled? | No more than 4 teeth away. |
| What verifies that sterilization was reached for the instruments? | Internal Chemical Indicators found inside the packages. |
| What are biological indicators? | Spore tests done weekly to confirm effectiveness of sterilization. |
| Disadvantages to dry heat sterilizer? | Long cycles, heat sensitive damage, poor penetration |
| Disadvantages to vapor sterilizer? | Odor, ventilation required, chemical damage, cost. |
| Disadvantages to gas sterilizer? | Long cycle, toxic, flammable expensive. |
| Disadvantages of chemical sterilizer? | Has to soak, chemical residue, less reliable. |
Created by:
Saylorlee5