Clinic Theory Final Review Pt 1

Front 1

If you're seeing a child Pt, what must be signed prior to treatment and by whom?

Back 1

CCD consent form. Must be signed by parent or guardian.

*There is a separate form if Parent/guardian won't be present for Tx*

Front 2

What must be obtained in addition to the consent form if the Parent/Guardian won't be there for Tx?

Back 2

A Phone Number where they can be reached.

Front 3

When can a parent come into the Tx room?

Back 3

If they don't have other young children

*Can't leave them alone in waiting room, unless they are old enough*

Front 4

What do we need to be asking of parents prior to child Tx?

Back 4

Has child been to dentist in past?
What is childs oral education level?
What do you do to help child clean their teeth?
How do you help your child make good nutrition choices?

Front 5

What are some barriers to dental care?

Back 5

Education
Financial
Transportation

Front 6

What do you not put on a toddler when treating?

Back 6

Avoid goggles and bibs.

Front 7

What type of exam do we perform on a child before taking any X-Rays?

Back 7

A clinical exam.

Front 8

What part of the occlusal evaluation can we perform every child?

Back 8

Open Bite,
Cross Bite,
Over jet

Front 9

Do we "measure" for Angle's Classification of Occlusion?

Back 9

Not until the child as both 1st & 2nd molars

Front 10

In the dental caries evaluation what part of the exam happens first? Second?

Back 10

Clinical Exam 1st
Radiographic Exam 2nd

Front 11

When conversing with the parent what questions do you want to ask about diet?

Back 11

Questions about their sugar intake.

Front 12

When should you take X-rays on a child

Back 12

If you can't see the interproximal area and if the child is cooperative

Front 13

Which occlusal evaluation do we not perform on a child until their permanent molars are in?

Back 13

Angle's classification

Front 14

What fluoride treatment is best to use on a child?

Back 14

Varnish.

Child won't understand "don't swallow" and they are too squirly for 4 minutes.

Front 15

What is a good way to teach the child about oral health care?

Back 15

Show and tell.

Front 16

What is a good way to have "child management" in your chair?

Back 16

Establish a rapport,
Show, Tell, Do
Positive reinforcement.
*Remember you will constantly have to re-direct their attention.*

Front 17

When should I use the I/O camera?

Back 17

With every new patient.
Take 1-4 images.
Use as part of Tx Plan
Use to Educate Pt
Show a returning Pt the changes.

Front 18

When should I print I/O pictures?

Back 18

Only with faculty approval as needed.

Front 19

How is the camera "wand" cleaned?

Back 19

With a Caviwipe.

Front 20

What are examples of some Area-Specific Curets?

Back 20

Any of the Gracey's 1/2 11/12 13/14 etc.

Front 21

What is the area specific curet used for?

Back 21

Specific surfaces of the tooth and to remove light calculus deposits from crown/roots.

*Can be used supra & sub.*

Front 22

How is the cutting edge on an area specific curet different from a universal curet?

Back 22

The area specific curet has a curved cutting edge. Universal curet has parallel cutting edges.

*Remember you only use one cutting edge on either side of the area specific curet. You have to flip it to use the other edge.*

Front 23

What is the angulation of a "self" angulated Gracey?

Back 23

Face is tilted 70 degrees.

Front 24

Which edge do you work with on the Gracy?

Back 24

The lower cutting edge.

Front 25

Why do we like self angulation instruments?

Back 25

Its easier to adapt to the tooth

Front 26

What is the term for the "lower" cutting edge?

Back 26

The Working cutting edge.
The other edge is the Non-working edge.

Front 27

When is the lower cutting edge of a Gracey automatically at a 70 degree angle to the tooth surface?

Back 27

When the lower shank is parallel to the tooth!

Front 28

How is a area specific curet used?
(When would you use it?)

Back 28

Its used as a finishing instrument for lighter deposits or after having used the ultra sonic.

*Its to go back and get what might be left over.*

Front 29

How do you hold the Gracey to tell if where the lower cutting edge is at?

Back 29

Hold it so you're looking directly at the toe.

Front 30

What surface does the Gracy 11/12 adapt to?

Back 30

The Mesial Surfaces

Front 31

Where do you start working with the Gracey 11/12?

Back 31

On the distal line angle and work anteriorly.

Front 32

What type of stroke do you use on the direct lingual or buccal surface for the Gracey 11/12?

Back 32

Oblique strokes.

Front 33

What stroke do you use on the direct mesial surface for the Gracey 11/12?

Back 33

Vertical Strokes

Front 34

What type of motion do you use for either Gracey 11/12 or 13/14?

Back 34

A rocking wrist motion.
Not digitallis.

Front 35

What surface is the Gracey 13/14 intended for>

Back 35

Distal surfaces only

Front 36

What type of stroke do you use for the Gracey 13/14?

Back 36

Vertical Strokes (No oblique)

Front 37

When do you use the Caries Risk Assessment form?

Back 37

On all new patients
Any returning Pt with 1 or more carious lesion

Front 38

On the Caries Risk Assesment form, what score represents a Low risk, Moderate risk and High risk?

Back 38

Low = 0
Moderate = 1-9
High = 10 or more

Front 39

Where do you save the Tx plan to?

Back 39

Document Center

*Patient can have a copy if they would like.*

Front 40

Who signs the completed Tx plan?

Back 40

Patient Faculty and Me

Front 41

What is important to include in each section?

Back 41

Depends on the patient

Front 42

What is included in Sec 1 of the Tx Plan?

Back 42

The Pt's overall health
Any Medications
Systemic Disease
Tobacco Use

Front 43

What is included in Sec 2 of the Tx Plan?

Back 43

Previous Tx Plan What worked?
Recommendations on Past interventions

Front 44

What is included in Sec 3 of the Tx Plan?

Back 44

Caries Risk-->CAMBRA (new Pt) Plaque Index

Front 45

What is included in Sec 4 of the Tx Plan?

Back 45

Perio Risk..if a returning Pt, why did you perform the perio risk assessment again today?

Front 46

What is included in Sec 5 of the Tx Plan?

Back 46

Anything Else about the Pt that is important about their Tx?
Social History?

Front 47

What is included in Sec 6 of the Tx Plan?

Back 47

Sequence of Appt?
What will you perform & What topics will you discuss with Pt

Front 48

What is included in Sec 7 of the Tx Plan?

Back 48

Maintenance schedule and rationale

Front 49

What is in all 7 sections of the Tx Plan?

Back 49

1) Overall Health
2) Previous Tx Plan
3) Caries Risk
4) Perio Risk
5) Addn'l things learned about Pt
6) Sequence of Appt
7) Maintenance schedule/Rationale

Front 50

What are 5 stimuli which contribute to pain?

Back 50

1) Tactile/mechanical
2) Thermal
3) Evaporative (air on teeth)
4) Osmotic (theory)
5) Chemicals

Front 51

What is actually the source of the pain for sensitive teeth?

Back 51

The MX & MN brances of the Trigeminal nerve!

Front 52

What are some characteristics of pain?

Back 52

1) Sharp, short, with rapid onset
2) Cessation of pain when stimuli is removed
3) chronic condition w/acute episodes..Pt will avoid certain things
4) Pain from stimulus that wouldn't normall cause pain..the explorer going over the surface of the tooth.

Front 53

What might be some dental conditions associated with pain?

Back 53

Cracked Tooth syndrome
Dental Caries
Defective restorations, leakage
Sensitivity after restorative Tx--> newly placed restorations
Incomplete polymerization of restorative materials-->not fully hardened or cured.

Front 54

What are some factors in the mouth that contribute to sensitivity? (5)

Back 54

1)Loss of Gingiva-->Recession
2) Loss of Cementum-->Abraision
3) Loss of Enamel-->Fracture or Caries
4)Role of the smear layer-->when removed by a polisher 5)Pathologic causes

Front 55

What are some factors that cause the loss of gingiva? (Just list a bunch)

Back 55

Perio Infection
DH instrumentation-->oops
Aggressive brushing
Short frenum attachment
Oral Piercings
Ortho Procedures
"Facial" orientation of one or more teeth

Front 56

What does the smear layer actually do?

Back 56

Acts as a natural band-aid.
It tends bo block dentinal tubules and insulate nerve endings. Its constantly changing and blocks stimuli

Front 57

What are 3 pathologic causes of sensitivity?

Back 57

1) Dentinal Hypersensitivity
2) Acute Pulpal Pain
3) Chronic Pulpitis

Front 58

What is the most common dental pain?

Back 58

Dentinal Hypersensitivity is most common!

Front 59

What are 3 theories concering the Conduction of the Pain Impulse?

Back 59

1) Direct Innervaton-->Nerve fivers penetrate but only a short distance
2) Odontoblast Extension in the Tubule
3) Hydrodynamic Theory-->Stimuli can cause an increase of fluid flow/pressure change within the dentin.

Front 60

What 3 things can we do to help the patient manage the hypersensitivity?

Back 60

1) Educate-->possible etiology, realisitc self care
2) Treatment mild pain-->try sensitive toothpaste sever pain--> may need restorations or custom fluoride trays
3) Reassess after 2-4 weeks

Front 61

What naturally occuring things contribute to having less sensitivity?

Back 61

Formation of secondary dentin
Sclerosis of dentin (from trauma)
Deposition of the smear layer
Formation of calculus
Dietary changes-->removing acidic foods/beverages

Front 62

Acceptable desensitizing agents should be…(list a bunch)

Back 62

Fast Acting
Easy to Use
Long Lasting,
Biologically acceptable to the tissues
No Bad Side Effects
Taste Good
No Pain

Front 63

What are some actual products you can recommend to a PT to reduce sensitivity?

Back 63

Sensitive toothpastes MI Paste Preseription Gels

Front 64

For a professional application to reduce sensitivy what might be involved?

Back 64

1) May require local anesthesia
2) Fluoride varnish or tray
3) Metallic Salts (old school)
4) Bonding adhesives or resins..usually more plastic restoration than metallic.

Front 65

If I have a Pt who is very sensitive what can I do before I even begin the oral exam?

Back 65

Use the polisher to apply the Colgate Sensitive pro-Relief before I do any instrumentation

Front 66

After the exam what can I do to reduce sensitivity?

Back 66

Apply fluoride try or varnish.

Front 67

For a patient who is very sensitive, how should I handle the compressed air during the exam?

Back 67

Avoid direct compressed air and adivse the Pt to utilize desensitizing therapies BEFORE the appointment
(about a week or 2 ahead of time).

Front 68

Concerning aging, what does ADL stand for?

Back 68

Activities of Daily Living

Front 69

What is level 0 of ADL?

Back 69

Person is able to perform the task w/o assistance

Front 70

What is level 1 of ADL?

Back 70

Ability to perform task w/some human assistance, may need a device or mechanical auid but still independent

Front 71

What is level 2 of ADL?

Back 71

Ability to perform task with partial assistance

Front 72

What is level 3 of ADL?

Back 72

Requires full assistance to perform the task…Totally Dependent!

Front 73

What is Chronologic Age?

Back 73

The actual measure of TIME elapsed since a person's birth.

Front 74

What is Bilolgic Age?

Back 74

The (physiologic) age of a person as determined by changes in organismic structure and function.

(Takes into account posture, skin texture, strength,speed & sensory acuity.)

Front 75

What kind of changes are part of physiologic aging? (Name off a few)

Back 75

Musculoskeletal
Skin
Respiratory
GI
CNS PNS
Senses
Endocrine Immune

Front 76

What age is considered the "Older Population"?

Back 76

55+

Front 77

What age is considered the "Elderly Population"?

Back 77

65+

Front 78

What age is considered the "Aged Population"?

Back 78

75+

Front 79

Alzheimer's Disease is ______________. The etiology is ____________.

Back 79

Non Reversible
Unknown

Front 80

What age is considered early onset of Alzheimer's?

Back 80

30-40 year olds

Front 81

What age is considered late onset of Alzheimer's?

Back 81

Over 65.

Front 82

When working with a Pt who has Alzheimer's, who do you need to involve in the Tx? How often should recare appts be?

Back 82

The care giver In the early stages recare should be 3 months.

*Be sure you're getting Fluoride into the Pt.*

Front 83

What may be involved in treating a later stage Pt with Alzheimer's?

Back 83

Possible Sedation,
Use of a mouth prop

*The Pt/care giver may need to utilize a power tooth brush. Again, involve the care giver!*

Front 84

How many stages is Alzheimer's broken down into?

Back 84

7 Each stage has different symptoms

Front 85

Does Stage 1 show any symptoms?

Back 85

No!

Front 86

Which stage has very mild cognitive decline and can be age related?

Back 86

Stage 2

Front 87

Which stage is Alzheimer's Disease usually diagnosed?

Back 87

Stage 3

Front 88

Which stage of Alzheimer's is characterized by forgetfulness of recent events (mild or early stage Alzheimer's)?

Back 88

Stage 4

Front 89

Forgetting one's address or phone us usually part of what stage of Alzheimer's?

Back 89

Stage 5

Front 90

Stage 6 of Alzheimer's is associated with…..

Back 90

Severe cognative decline….remember own name but difficulty with personal history.

Front 91

What is common with Stage 7 Alzheimer's in terms of care for the Pt?

Back 91

Pt needs assistance w/much of their daily personel care including using the toilet
(Very Severe Cognative decline)

Front 92

What factors influence overall health status? (4 items)

Back 92

Biologic
Environmental
Psychosocial (Communication & Socialization)
Lifestyle

Front 93

What are the 5 most comon chronic conditions of the aging?

Back 93

1) Arthritis
2) Visual Impairments
3) Hearing Impairments
4) Hypertension (may not be able to Tx Pt)
5) Caradiovascular Disease

Front 94

What are some Conditions of Significance?
(They may determine if or how we Tx a Pt, and we may have to approach Tx differently.)

Back 94

COPD
Depression
Diabetes
Alzheimer's (Dementia)
Osteoarthritis
Osteoporosis
Stroke Alcoholism (can delay healilng)

Front 95

What kind of soft tissue changes might you observe in an aging patient?

Back 95

Xerstomia--may be from meds or radiation therapy
Loss of elasticity
Capillary fragility-->more petachia
Sublingual varicosities (more often and more pronounced)
Oral candidiasis--due to antibiotics, radiation or chemo therapy.

Front 96

How do the teeth change in an aging patient?

Back 96

Change color (intrinsic)
Pulpal change (secondary dentin)
Attrition/abraision (due to wear n tear)
Root caries (due to recession)

Front 97

In the periodontium, what chanages might you see in the aging?

Back 97

More Bone Loss
Recession w/sensitivity
minimal attached gingiva (gets fragile)

*Remember some patients can ve very healthy, involved and well maintained.*

Front 98

What are 6 common oral conditions found in the elderly Pt?

Back 98

1)Angular chelitis
2)Glossitis
3) Attrition
4) Xerostomia
5) Periodontitis (R/T xerostomia)
6) Caries (R/T xerostomia

Front 99

What is osteoporosis?

Back 99

Gradual loss of bone…loss of mineral & bone mass

*Effects men and women but is more common in post menopausal women.*

Front 100

What do you need to be aware of in the edentulus patient if they are osteoporosis?

Back 100

The oral ridge that holds the dentures may be shrinking.

Front 101

In the edentulous mouth be sure to observe what parts of the Bone and Mucus Membranes?

Back 101

Bone: Residual Ridges or Tori

Mucus Membranes: attached tissue, lining mucosa, frenal attachments

Front 102

What part of the mocosa may create a problem with a denture wearer?

Back 102

The frenal attachment…could be pinched by dentures.

Front 103

Anodontia

Back 103

The absense of teeth..could be born this way which is rare,

Front 104

Denture Adhesive

Back 104

material used to adhere a denture to the oral mucosa

Front 105

Denture Characterization

Back 105

modification of the form & color of the denture base & teeth to produce a more life-like appearance.

Front 106

Prosthesis

Back 106

An artificial replacement of an absent part of the body…A therapeutic device to improve or alter function.

Front 107

A prosthesis may be __________ or ___________.

Back 107

Fixed or Removable

Front 108

A denture may be a _____________ or ____________.

Back 108

partial or complete

Front 109

Overdenture

Back 109

A removeable prosthesis that tests on one or more remaining natural teeth, roots and/or dental implants.

Front 110

Immediate Denture

Back 110

A complete denture fabricated for placement immediately following the removal of natural teeth (and/or other surgical preparation of the dental arches.)

Front 111

Obturator

Back 111

A prosthesis used to close a congenital or aquired opening such as for a cleft palate.
(Could also be due to other trauma)

Front 112

Space Maintainer

Back 112

prosthetic replacement for prematurally lost primary teeth..to prevent closure of the space before the eruption of the permanent tooth

Front 113

Hawley (retainer)

Back 113

A removable plastic & wire appliance used to stabilize teeth; may be modified for special applications during/after ortho treatment.