HPDP Final Exam
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| What is the dental hygiene process of care? | ADPIE
A: assessment D: dental hygiene diagnosis P: planning I: Implementation E: evaluation
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| what is a primary service? | person does not have a disease
examples: fluorides, sealants, education, oral cancer screenings, tobacco cessation
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| what is a secondary service? | patient has a problem but it is not big, try to fix and get them back to health
examples: desensitizing for sensitive teeth, home fluoride, instructions to reverse early gingivitis
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| what is tertiary service? | patient has a problem that we can't heal and doesn't take the problem away
examples: scaling/root planing for periodontal disease, restorative DDS, prosthodontics
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| what is a normal sulcus depth? | 1-3 mm
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| what is gingivitis? | inflammation or infection of the gingival tissue in the absence of clinical attachment loss or bone loss
NO BONE LOSS, REVERSIBLE
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| What is periodontitis? | inflammation or infection that affects and destroys the supporting structures of the teeth
BONE LOSS, IRREVERSIBLE
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| what are local factors of gingivitis or periodontitis? | calculus, crowded teeth, dental appliances, tooth anatomy, overhanging restorations, food impaction or open contacts
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| what are systemic factors of gingivitis or periodontitis? | smoking, diabetes, HIV, AIDS, immune system, hormonal imbalance, genetics
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| what are dysfunctional factors of gingivitis or periodontitis? | trauma from occlusion, injurious habits such as toothpicks or nails, bruxism
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| what it the most common gingival disease? | dental plaque induced gingivitis
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| what is the most common periodontal disease? | chronic periodontitis
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| what is case type I periodontitis | gingivitis or healthy
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| what is case type II periodontitis | early/mild periodontitis
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| what is case type III periodontitis | moderate periodontitis
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| what is case type IV periodontitis | advanced/ severe periodontitis
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| what is case type V periodontitis | refractory
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| what is supra gingival pellicle made of? | glycoproteins in saliva
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| what is sub gingival pellicle made of? | glycoproteins in gingival sulcus
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| what is the first stage of plaque development? | pellicle-->plaque biofilm-->calculus
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| what is the significance of the pellicle? | protective as an acid barrier
lubrication to keep surfaces moist and prevent drying
nidus for bacteria plaque colonization
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| what is extrinsic stain? | on external surface
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| what is intrinsic stain? | within tooth surface
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| what is an exogenous source for stain? | caused by factors from outside the tooth
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| what is an endogenous source for stain? | stain originates within tooth, incorporated within tooth structure, may be related to period of tooth development
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| examples of extrinsic stain? | yellow stain, black line stain, green stain, tobacco stain, betel leaf
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| what is the type of extrinsic stain that you do not scale? | Green stain
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| what are some examples of intrinsic stain? | tetracycline, fluorosis, restorative, endodontic treatment
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| what is important about bass method? | only effective method for sulcular cleaning
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| how does one perform bass method? | 10 strokes each area, press lightly without flexing bristles, 45 degree intrasulcular position
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| what is important about rolling stroke method? | children with healthy gingiva or sulcular technique is too difficult for patient
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| hoe does one perform rolling stroke method? | holds toothbrush and rolls bristles down
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| what is important about modified stillmans method? | minimize gingival trauma and massages gingival tissue
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| how does one perform modified stillmans method? | start with bristles on top of the gingiva then you move to a 45 degree angle and vibrate until you hit the tooth then roll down
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| what is important about charter's method? | orthodontic appliances, braces, or pontics, post perio surgery
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| how does one perform charter's method? | brush towards incisal and occlusal edge and vibrate brush using rotary motion of handle
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| what is important about circular or Fones method? | easy to learn for young children or elderly patients
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| how does one perform circular or Fones method? | teeth closed and circular motion sweeping from maxillary to mandibular gingiva
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| what is gingiva recession? | margin moves apically and root surface exposed
caused by vigorous pressured brushing with abrasive dentifrice and worn brush
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| what is gingival clefting or Stillman's cleft? | narrow groove or slit that looks like a bracket
extends from crest of gingiva to the attached gingiva
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| what is gingival festooning or McCall's festoon? | rolled, bulbous, hard, firm gingiva
looks like a melted rubber tire rolled 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, space in between teeth
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| what are the two flossing techniques? | spool method and loop method
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| how should you tell someone to floss? | seesaw to get through contact, up and down motion and wrap in C-shape
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| What are the minerals in saliva? | Calcium and phosphate
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| What is loss called in dental caries? | Demineralization
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| What is gain called in dental caries? | Remineralization
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| What is in plaque bacteria? | Strep mutans and lactobacillus
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| What is the critical level for enamel | 5.5
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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 neutralizes acids of plaque
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| How does saliva remineralize? | Supersaturation of calcium and phosphate prevents demineralization and repairs through remineralization
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| What happens to a remineralized tooth? | Becomes less susceptible to caries
Happens before the surface layer with a. White spot lesion
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| What is the primary agent of a cariogenic diet? | Sucrose
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| How long does it take the tooth to recover from a pH drop? | 40 minutes
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| Amount of sugar is not as important as what? | Frequency, form it is in, and when sugar is eaten
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| What is happening during incipient lesions? | Demineralization is going on, surface is intact, no bacterial penetration
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| What is happening for an established lesion? | Surface layer breaks down, clinically detectable, attack on dentin
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| What is the critical pH level for root caries? | 6.0
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| What are the basic inactive components of dentifrices? | Detergent, abrasives, binder, humectant, preservative, flavoring, water
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| What are the preventative and therapeutic benefits of dentifrices? | Caries prevention, remineralization, reduction of biofilm, reduction of gingivitis/periodontitis, dentin hypersensitivity, supra gingival calculus
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| What are the cosmetic effects of dentifrice? | Removal of extrinsic stain, reduction of malodor
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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 is an example of detergent? | Sodium laurel sulfate
Lauryl sulfate
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| What is the purpose of abrasive? | Polishes cleans to produce smooth surface without damage to tooth surface
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| What is an example of abrasive? | Calcium carbonate, phosphate salts, silica, hydrated aluminum oxide
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| What is the purpose of binder? | Stabilizes the formula, prevents separation of ingredients during storage
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| What is an example of a binder? | Mineral colloids, natural gums, seaweed colloids, synthetic cellulose
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| What is the purpose of a humectant? | Retain moisture, prevent hardening when exposed to air
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| What is an example of a humectant? | Xylitol, glycerol, sorbitol
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| What is the purpose of a preservative? | Prevent bacterial growth, prolong shelf life
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| What are examples of a preservative? | Alcohol, benzoates, dichlorinated phenols
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| What is the purpose of flavoring? | Sweetener for patient acceptance, masks other ingredients
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| What are examples of flavorings? | Essential oils such as peppermint, cinnamon, wintergreen and clove
Xylitol, glycerol, and sorbitol
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| What are the therapeutic active components? | Anti biofilm, anti gingivitis, desensitizer, oral malodor
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| What is an example of antibiofilm and antigingivitis agents? | Triclosan, stannous fluoride, zinc citrate
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| What is an example of anti calculus agents? | tetra potassium, tetra sodium, triclosan
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| what is pellicle made of? | glycoproteins from the saliva and gingival sulcus fluids
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| what is calculus made of? | 70-80% inorganic materials and trace elements such as Ca, P, Mg Na Co and F
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| what is materia alba made of?? | bacteria, epithelial cells, leukocytes, salivary proteins and food particles
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| what is a de sensitizer agent? | potassium nitrate, potassium citrate, potassium chloride, stannous fluoride
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| what is an agent to get rid of malodor? | essential oils, triclosan, stannous fluoride
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| what size of toothpaste should you give a toddler aged 2? | 1/2 pea size
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| what size of toothpaste should you give an older child of 4-5 | pea size
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| what size toothpaste should you give an adult? | 1/2 inch
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| what is an astringent? | shrinks tissues
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| what is an anodyne? | alleviate pain
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| what is oxygenating? | cleansing
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| what are the functions of chemotherapeautic agents of mouthwashes? | remineralization, antimicrobial, astringent, anodyne, buffering, deoderizing, oxygenating
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| what is the substantivity for chlorhexidine? | 8-12 hours
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| what is important about chlorhexidine? | most effective antimicrobial/ anti gingivitis agent
both bactericidal and bacteriostatic
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| what is bactericidal? | attaches to cell membrane causing lysis and death
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| what is bacteriostatic? | interferes with cell wall transport system, doesn't kill just stops division
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| what are the recommended uses for chlorhexidine? | preprocedural rinse, before during or after periodontal debridement, high risk for dental caries, immunocompromised individuals, post surgery for wound healing
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| what is chlorhexidine inactivated by? | sodium lauryl surf ate when rinsing is performed immediately after brushing
wait 30 minutes after brushing
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| what is the effect of stannous fluoride? | antimicrobial effect due to run ion from stannous fluoride interfering with cell metabolism, reduction of gingivitis and periodontitis
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| what is the effect of sodium fluoride? | cariostatic effect due to inhibition of demineralization and enhancement of remineralization
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| what are the uses of fluoride rinses? | prevention of dental caries, reduction of hypersensitivity and gingivitis
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| which fluoride rinse is low potency, high frequency? | sodium fluoride (NaF)
stannus fluoride (SnF)
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| what are the ppm for sodium fluoride? | .05/ 250 ppm
or high potency of .2%/900 ppm
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| what are the ppm for stannous fluoride? | .63%
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| what are the mechanisms of action for essential oil rinses? | bacterial static- disrupts cell walls and inhibits bacterial enzymes
poor substantivity, ant microbial and anti gingivitis agent
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| what is in essential oil rinses? | thymol, eucalyptol, menthol, menthyl salicylate
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| what is the mechanisms of action of quaternary ammonium compounds? | ruptures cell wall and alters cytoplasm, low substantivity
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| what are the mechanisms of action for oxygenating rinses? | alteras bacterial cell membrane increasing permeability
poor substantivity, reduces symptoms of pericoronitis and NUG
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| what is in an isotonic solution? | 1/4 tsp salt
1/2 tsp baking soda
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| what is in a hypersonic solution? | 1/2 tsp salt
1 tsp baking soda
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| what are the 2 ways fluoride gets into the body? | gastrointestinal tract and blood stream
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| when does the teeth take up the most fluoride? | 2 years prior to eruption
rapid uptake into enamel for 2 years
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| where is the highest amount of fluoride in the enamel? | enamel
dentin pulpal surface second
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| what is enolase? | enzyme needed by bacteria to metabolize carbohydrates
fluoride inhibits this
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| what are the three protective effects of fluoride? | inhibits demineralization, enhance remineralization and inhibit bacterial activity (enolase)
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| what is the optimum level of fluoridation in water? | .7-1.2 ppm
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| what is the halo effect? | commercially processed foods/ beverages in optimally fluoridated cities can be distributed and consumed in non fluoridated communities
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| professionally apply fluoride after what services? | scaling and root planning, policing with prophy paste, air polishing, sealant placement, amalgam polishing, protect restorations from second caries
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| what is the ppm for sodium or neutral fluoride and how often should you use it? | 9050 ppm
ever 3 months or twice a year
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| what is important about sodium fluoride? | will not etch restorations
high potency/low frequency
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