HPDP Exam I
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| what is health | state of complete physical, mental and social well-being and not merely the absence of disease or infirmity
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| what is health promotion? | the process of enabling people to increase control and improve their health through self care, mutual aid and the creation of healthy environments
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| what is disease? | an impairment of health or a condition of abnormal functioning
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| what is the dental hygiene process of care? | ADPIE
assessment, dental hygiene diagnosis, planning, implementation, evaluation
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| what is meant by assessment in dental hygiene process of care? | collection of objective and subjective date
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| what is meant by dental hygiene diagnosis in dental hygiene process of care? | incorporate risk from assessment
basis on which treatment plan is designed
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| what is meant by planning in dental hygiene process of care? | establish priorities, set goals, interventions, prognosis
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| what is meant by implementation in dental hygiene process of care? | put plan into action
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| what is meant by evaluation in dental hygiene process of care? | determine if outcomes were successful, retreat or referral
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| what are preventive serves categorized in? | primary services, secondary services, tertiary services
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| what is primary services | person does not have disease, prevent disease
fluoride, sealant, education, oral cancer screening, tobacco cessation
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| what is secondary services | patient has problems but is not big, can fix and get patient back to health
desensitizing for sensitive teeth, one fluoride treatment for incipient lesions, instructions to reverse early gingivitis
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| what is tertiary services? | patient has a problem that we cannot heal and doesn't take problem away
scaling, root planing for periodontal disease, for DDS more restorative, prosthodontics and reconstructive
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| what are the two branches of periodontal disease | gingivitis and periodontitis
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| what is attached gingiva | covers the alveolar bone
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| what is gingivitis? | inflammation/ infection of the gingival tissue in the absence of clinical attachment loss or bone loss
NO BONE LOSS, CAN CURE IT
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| what are the signs of gingivitis? | edema/ swelling, erythema/ redness, increase gingival temperature, occasional pain, bleeding, no bone loss and reversible
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| what is periodontitis? | inflammation/infection that affects and destroys the supporting structures of the teeth (periodontial ligaments and alveolar bone)
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| what are the signs of periodontitis | pocket formation, bleeding, mobility, recession, furcations, bone loss and is irreversible
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| what are the primary factors of periodontal disease? | bacterial plaque or biofilm
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| what is the contributing factors of periodontal disease? | local factors, systemic factors, dysfunctional factors
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| what are the local factors of periodontal disease? | calculus, crowded teeth, dental appliances, tooth anatomy, overhanging restorations, food impaction/open contacts
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| what are the systemic factors of periodontal disease? | smoking, diabetes, HIV/AIDS, immune system, hormonal imbalance, genetics
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| what are the dysfunctional factors of periodontal disease? | trauma from occlusion
injurious habits
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| what is dental plaque induced gingivitis? | most common type of gingivitis
associated with plaque with or without local factors
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| what is dental plaque induced gingivitis modified by systemic factors? | endocrine factors, blood dyscasias, medications, malnutrition
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| what is non plaque induced gingival lesion | bacterial, fungal, viral, genetic, systemic, traumatic, foreign body reactions
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| what is chronic periodontitis? | most common, slow progression, localized and generalized, horizontal bone loss
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| what is aggressive periodontitis | periodontitis as a manifestation of systemic disease
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| what is case type I gingivitis/periodontitis | gingivitis or healthy
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| what is case type II gingivitis/periodontitis | early, mild periodontitis
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| what is case type III gingivitis/periodontitis | moderate periodontitis
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| case type IV gingivitis/periodontitis | advanced/ severe periodontitis
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| case type V gingivitis/periodontitis | refractory
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| what is pellicle? | tenacious membranous layer, originates from glycoproteins found in saliva and gingival fluids, first stage of plaque development
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| what is pellicle made of? | serum glycoproteins from the saliva and gingival sulcus fluid
supra- glycoproteins in saliva
sub- glycoproteins in gingival sulcus
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| what does pellicle look like? | clear, translucent, invisible to naked eye may become visible if plaque or stain accumulates on it
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| where do we find pellicle? | all tooth surfaces, thickest point at gingival margin
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| how do we find pellicle? | disclosing solution
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| what is the significance of pellicle? | protective- an acid barrier
lubrication- keeps surface moist/ prevents drying
nidus for bacteria plaque colonization
attachment of calculus
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| how do we get rid of pellicle? | polishing, toothbrushing
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| what is plaque/biofilm? | dense, non-mineralized complex mass of colonies in a gel-like inter-microbial matrix
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| what does plaque or biofilm look like? | invisible, transparent, white film accumulated on the tooth surface
sticky like peanut butter
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| how does pellicle form | pellicle formation
bacterial colonization
plaque maturation
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| where do you find plaque or biofilm? | supra and sub, proximal, occlusal, appliances
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| how do we find plaque or biofilm? | disclosing solution, air water, explorer, probe
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| what is wrong with plaque or biofilm? | primary etiological factor
causes periodontal disease, oral infections, causes dental caries
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| what is calculus? | calcified bacterial biofilm
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| what does calculus look like? supra and sub | supra- white or yellowish
sub- brown/ green /black
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| what is the range of time that calculus forms? | 10-20 days
deposition of minerals into the biofilm organic matrix
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| where do we find calculus supra gingival? | lingual mandibular anteriors
buccal maxillary molars
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| what is wrong with calculus? | rough surface attracts plaque
may prevent full healing
may hinder self care
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| what is materia alba | white material
loosely adherent complex of bacteria and cellular debris formed on top of biofilm
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| what is materia alba made of | bacteria, epithelial cells, leukocytes, salivary proteins and food particles
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| where do we find materia alba? | along the gingival margin
between teeth
around crowded teeth
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| what is wrong with materia alba? | unsanitary mouth
halitosis- bad breath
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| what is extrinsic stain? | on external surface
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| what is intrinsic stain? | within the tooth surface
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| what is exogenous stain? | caused by factors from outside the tooth
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| what is endogenous stain? | stain originates within tooth
incorporated within the tooth structure
may be related to period of tooth development
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| what is extrinsic yellow stain? | food pigment common to all ages
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| what is extrinsic black line stain | continuous 1 mm line along gingival 1/3
black at base of pits and sealants, low tendency for dental decay
predominately female healthy mouths
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| what is extrinsic green stain? | chromogenic fungi/bacteria
drugs
DO NOT SCALE
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| what is the bass method used for? | only effective method for sulcular cleaning
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| what are the indications for bass method? | open interproximal areas, exposed root surfaces, abutment, periodontal surgery patients
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| what are the strokes of bass method? | 10 strokes each area, press lightly without flexing, vibrate the brush
direct bristles into the sulcus at 45 degree angle
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| what is the rolling stroke method used for? | children
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| what are the indications for rolling stroke method? | emphasis not on gingival sulcus, children with healthy gingiva
sulcular technique too difficult, hold toothbrush and roll down
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| what do you use the rolling stroke method in conjunction with? | bass, stillman, charters
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| what do we use modified stillman method for? | gingiva massage
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| what are the indications for stillman's method? | minimize gingival trauma
massage of gingival tissue
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| what is the stroke for stillman method? | press to flex filaments, angel filaments, activate brush, roll and vibrate the brush
starting with all bristles on top of the gingiva then you move to a 45 degree angle and roll down
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| charters Method is good for | othro, braces, pontics
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| charters method indications | orthodontic appliances, pontiffs, post perio surgery, stimulate marginal and interdental gingiva
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| what are the strokes of charters method | brush pointed towards occlusal, accomplish rolling stroke first, press lightly, vibrate brush, 45 degree angle
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| what are the indications of circular or fones method | easy to learn for young children or elderly
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| what is the procedure of circular or fones method | teeth closed, circular motion
fast wide sweeping maxillary to mandibular gingiva
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| what is gingival recession | margin moves apically
root surface exposed
vigorous pressured brushing with abrasive dentifrice and worn brush
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| what is gingival celfting or stillman's cleft | narrow groove or slit
extends from crest of gingiva to the attached gingiva
looks like a bracket or a slit
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| what is gingival festooning or McCall's festoon? | rolled bulbous hard, firm gingiva
melted rubber tire, rolled tissue around tooth
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| what is embrasure type I? | filled with papilla
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| what is embrasure type II? | still a little papilla, open space with blunted papilla
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| what is embrasure type III? | no papilla, large space in between teeth
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| what is waxed floss used for? what is unwaxed floss used for? | waxed- tight proximal contracts
unwaxed- normal tooth contracts
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| what is dental tape and what is it used for? | wider, flatter and waxed
preferred if surface area is large
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| what is PTFE or polytetrafluoroethylene or glide | waxed, resists fraying, coated with teflon
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| braided floss is used for | dental implants
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| what is tufted floss used for? | fixed partial dentals or ortho
embrasure type II and III
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| What are the two flossing methods? | spool method
loop method
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| what is spool method? | wrap floss around middle finger, thumb and index finger guide it
seesaw to get it into the contact, wrap C shape and up and down motion once in
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| what is loop method used for? | children and patients with limited dexterity
2 ends tied together but works like spool
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| what are the pieces of tufted floss? | waxed and unwaxed floss
cylindrical nylon meshwork
rigid nylon needle
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| what is the floss threader used for | under fixed partial denture
orthodontics
under implant bars
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| what is the perio-aid or toothpick holder used for | periodontitis and gingivitis, tooth concavities/furcations
crowns and bridges, orthodontics, patients who won't floss but like toothpicks, fluoride desensitizing agents deliver
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| when should the perio aid should not be used | healthy gingiva or type I embrasures
limited manual dexterity
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| what is the technique to use the perio aid | 90 degree angle and follow the gingival margin
insert at the sulcus at 45 degree angle
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| what is a sulcus bush? | used for patients who need to get into the sulcus and clean
bass method
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| what is a sulca brush? | one tuft, cut to a point, used for crowded area
end tuft brush/ tooth pick holder/ proxy brush
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| what is the interdental brush or proxy brush used for? | Furcation area
good for ortho
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| what are the contradictions of interdental brush or proxy brush? | healthy gingiva
limited manual dexterity
intact papilla
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| what is the technique for the interdental brush or proxy brush? | should come from both the facial and the lingual
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| what is an end tuft brush? | single tuft, nylon bristles, flat or tapered with a plastic handle
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| What are the indications for the interdental brush or proxy brush? | interdental areas, fixed dental prosthesis, difficult to reach area, lack of manual dexterity, orthodontic appliance, crowded areas and third molars
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| what is the technique for interdental brush or proxy brush? | 45 degree angle, bristles towards apical circular pattern
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| what is the rubber tip stimulator used for? | interproximal/ embrasures, re-shape gingiva after periodontal surgery
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| what is the technique for rubber tip stimulator? | 45 to 90 degree angle, follow the contour of gingiva, rotary motion, intermittent pressure
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| what do we use wooden interdental cleaners or stim-u-dents for? | orthodontics, proximal spaces/ embrasures
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| when do we use knitting yarn? | type III furcations, open furcations, abutments on implants, diastemas, isolated teeth
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| when do we use gauze strips? | widely spaced teeth, abutment of implants
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| what is the hypochlorite solution made up of? | 1 tablespoon bleach
2 teaspoons of calgon or water softener
1.2 cup water
ONLY USE PLASTIC NO METAL
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| demineralization is... | loss
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| remineralization is... | gain
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| what are the plaque bacteria? | strep mutans, lactobacillus
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| demineralization can occur at a pH of... | 5.5 which is called the critical level for enamel
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| the acidic state lasts for about how many minutes before it returns to normal | 40 minutes
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| class I caries | pits and fissures
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| class II caries | smooth surfaces, in between posterior teeth
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| class III caries | smooth surfaces between anterior teeth
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| where are the largest percent of caries found on teeth? | fissures on occlusal
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| what are the roles of saliva? | cleansing, buffering, remineralizing, antibacterial
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| how does saliva cleanse? | dilutes and removes acid concentrations of plaque
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| how does saliva buffer? | sodium bicarbonate neutralize acids of plaque
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| how does saliva remineralize? | calcium and phosphate prevents demineralization and repairs through remineralization
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| how is saliva antibacterial? | substances from both salivary glands and immune system negatively affect caries bacteria
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| class V | smooth surfaces in cervical third
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| what microflora cause cavities in smooth surfaces? | S. mutans
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| what microflora cause cavities in root surfaces | actinomyces naeslundii and viscosus, S. mutans and lactobacillus
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| what is the primary agent that promotes plaque formation and flavors colonization of cariogenic microorganisms | sucrose
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| what do detergent foods do | may have an effect on thickness of plaque
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| amount of sugar is not as important as the... | frequency
form it is in (whether it clears easily)
when the sugar is consumed (meals or in between meals)
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| what is an incipient lesion? | demineralization going on
surface is intact though
no bacterial penetration
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| what is an established lesion? | surface layer breaks down, clinically detectable
attack on dentin which is soft, infected tubules
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| what is the critical pH for cementum? | 6.0
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| what does water do? | maintain ingredients in formation
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| what does sodium fluoride do? | prevent decay
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| what does hydrated silica do? | abrasive
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| what does sorbitol do? | humectant and sweetener, anti-cavitiy
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| what does dichlorinated phenol do? | preservative
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| what does sodium lauryl sulfate do? | detergent, for the bubbles
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| what does xantheam gum do? | binder, prevent separation
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| what does calcium carbonate do? | abrasive
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| what does alcohol do? | preservative
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| what does xylitol do? | humectant and sweetener
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| what is the definition of dentifrices? | substances use with a toothbrush or other applicator for removal of soft tooth deposits
application of therapeutic agents
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| what are the preventive and therapeutic benefits of dentifrices? | caries prevention, remineralization, reduction of biofilm formation, reduction of gingivitis/ inflammation, sensitivity and supragingival calculus
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| what are the cosmetic effects of dentifrices? | removal of extrinsic stain, reduction of oral malodor
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| what are the basic components of inactive ingredients in dentifrices | detergent, abrasive, binder, humectant, preservative, flavoring, water
did amy's binder hit peter's frikken wall
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| what is the purpose of detergent? | lower surface tension, penetrate and loosen surface deposits, foaming action
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| what are the substances of detergents? | sodium lauryl sulfate or lauryl sarcosinate
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| what is the purpose of abrasive? | polishes/ cleans to produce smooth surface without damage to tooth surface
smooth surface prevents re-accumulation of deposits
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| what are the substances of abrasives? | calcium carbonate, phosphate salts, silica, silicates, dehydrated silica gels, hydrate aluminum oxide
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| what are the purpose of binders? | stabilize the formulation
prevents separation of ingredients during storage
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| what are the types of binders used? | mineral colloids, natural gums, seaweed colloids, synthetic celluloses
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| what is the purpose of the humectant? | retain moisture
prevent hardening when exposed to air
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| what are the substances used for humectant? | xylitol, glycerol, sorbitol
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| what is the purpose of preservative? | prevent bacterial growth
prolong shelf life
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| what are the substances used for preservatives? | alcohol, benzoates, dichlorinated phenols
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| what is the purpose of flavoring? | sweetener for patients acceptance
masks other ingredients
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| what is the substances used for flavoring? | essential oils (peppermind, cinnamon, wintergreen)
artificial noncariogenic sweeteners (xylitol, glycerol, sorbitol)
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| what are therapeutic active components? | anti-biofilm/ antigingivitis
anti-calculus
desensitizer
oral malodor
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| how much tooth paste should a toddler get? | 1/2 pea size
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| how much tooth paste should a older child (4-5) get? | pea sized
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| how much tooth paste should an adult used? | 1/2 inch
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| what does astringent do? | shrinks tissues
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| what does anodynes do? | alleviate pain
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| what does oxygenating do? | cleansing
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| what are the functions of chemotherapeutic agents | remineralization, antimicrobial, astringent, anodyne, duffering, deoderizing, oxygenating
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| what are the therapeutic compounds in Listerine? | phenolic compounds, essential oil
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| chorhexidine is used for | preprocedural rinse, before during and after periodontal debridement, high risk for dental caries, immunocompromised individuals prone to infection, post surgery for wound healing
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| chorhexidine interacts with | sodium lauryl sulfate when rinsing is performed immediately after brushing
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| what fluoride rinse do you use for gingivitis and periodontitis? | stannous fluoride
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| sodium fluoride low potency/ high frequency number | .05%/ 250 ppm
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| stannous fluoride low potency/ high frequency number | .63%/ 250 ppm
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| sodium fluoride high potency/ low frequency number | .2%/ 900 ppm
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| essential oils is a combination of... | thymol, eucalyptol, menthol, menthyl salicylate
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