Clinic Theory Final Review Pt 2

Front 1

What are some causes of denture induced oral lesions? (4)

Back 1

1) ill fitting dentures
2) Lack of oral hygiene
3) Continuous wearing of the dentures
4) Some medications if the Pt is imunocompromised

**Pt's often feel DDS exams are no longer needed if they wear dentures…this is not true.**

Front 2

What does the typical appointment for a denture Pt look like? (describe what you would do)

Back 2

Review HH / Vitals
Inquire on fit of dentures/have Pt remove
Perform IO/EO
Examine dentures in front of PT (don't want to be accused of breaking them)
Cleanse Dentures
Identify homecare needs/education
DDS Tx as needed

Front 3

Why does a denture Pt still need to brush the soft tissues?

Back 3

To remove plaque and stiumlate the tissue.

*Always use a very soft brush.*

Front 4

A bridge is a __________ or _________ denture.

Back 4

Fixed or Partial

Front 5

What does the metal framework do with regard to the partial denture or bridge?

Back 5

Makes it more stable

Front 6

What does a "rest" sit on?

Back 6

Existing structure to add support

Front 7

What does a "clasp" do with regard to partials?

Back 7

Wraps around a tooth to add stability

Front 8

What are the 4 parts of a Complete Removable Denture?

Back 8

1) Impression Surface (where the existing soft tissue lies) 2) Denture Border(rests in the vestibule)
3) Polished Surface (the pink polished surface)
4) Occlusal Surface

Front 9

An implant supported denture is a more/less common type of denture?

Back 9

More Common!
It uses actual implants in the edentulous Pt to hold the denture in place

Front 10

An over denture is often used for a patient with….

Back 10

Remaining tooth structure.
(could be existing teeth or roots remaining)

Front 11

If a patient has an over denture what sill needs to be done with the remaining tooth structure?

Back 11

Still needs to be probed and examined for health.

Still need to scale those remaing structures too!

Front 12

What is the purpose for cleaning a prosthesis? (4)

Back 12

1) Prevent irritation of oral tissue
2) Control Infection
3) Prevent Mouth Odor
4) Maintain Appearance (they will stain)

Front 13

What 3 deposits will show up on dentures?

Back 13

Plaque, Calculus and Saliva!

(All of this will be on both sides of a denture. Calc especially so on the lower denture.)

Front 14

What types of things do I need to tell a Pt concerning the cleaning of their dentures?

Back 14

Remove and brush after each meal. (if can't brush then rinse off)
Use denture cleaning products--Immersion is best w/denture detergent (avoid abrasives)
Use a specially designed denture brush
There are commercially available ultrasonic devices the Pt can purchase.

Front 15

Denture Cleansers need to be: (5 things)

Back 15

Easy to use
Reasonably priced
Effective at removing deposits
Non-toxic
Harmless to dental materials

Front 16

What can be the purpose of denture adhesive?

Back 16

To fill the space when the tissues shrink as a result of healing.

*Be aware that food & plaque will stick to the adhesive and if not cleaned…will stink!*

Front 17

What is the procedure for a professional cleaning etc of complete/partial dentures?

Back 17

1) Have Pt remove (unless they are unable then I should do it.)
2) Inspect for debris
3) Immerse in an ultrasonic cleaning solution
4) Rinse, inspect & polish-->just like typodont teeth
5) deliver to Pt

Front 18

What should always be done to avoid breakage of dentures when cleaning?

Back 18

Fill the sink with water to avoid breakage in case you drop them. Also, always transport in a cup.

Front 19

What are the advantages of cleaning by immersion? (5)

Back 19

1) Solution reaches all surfaces
2) Minimize danger of dropping the appliance
3) Offers safe storage when not in the mouth
4) Aids person with limited dexterity
5) Immersion involves the least amount of handling/observation when distasteful!

Front 20

Salivary glands are classifed by their_________.

Back 20

Location (Major or Minor)

Front 21

In additional to their location, how else are salivary glands classified by?

Back 21

The type of secretion…Serous, mucous or mixed.

Front 22

What is the compositon of serous saliva?

Back 22

Water, Enzymes, Salts & Organic Ions

Front 23

What is the composition of Mucous Saliva?

Back 23

Mucin

(Mucin is a glycoprotein constituent of mucus.)

Front 24

What are the major salivary glands?

Back 24

Parotid Submandibular & Sublingual

*They give the most saliva and you want to check for any tenderness when palpating during the IOEO.*

Front 25

What duct is assocatted with the Parotid gland?

Back 25

Stenson's duct

Front 26

Which gland(s) is the Wharton's duct associated with?

Back 26

Submandibular & Sublingual

Front 27

Where is the Wharton's duct located?

Back 27

Under the tongue on the floor of the mouth.

Front 28

What portion of the total saliva comes from the Parotid gland? What is this fluid primarly comprised of?

Back 28

25%

Serous fluid

Front 29

Which cranial nerve intervates the Parotid gland?

Back 29

Glosopharyngeal (IX Nine)

Front 30

Which gland produces 60% of the total salivary secretions? What is the fluid comprised primarly of?

Back 30

Submandibular
The fluid is mixed but is predominatly serous

Front 31

What part of the facial cranial nerve impacts the submandibular gland?

Back 31

The Chorda tympani of the facial nerve (VII 7)

Front 32

What excreets the submandibular fluid?

Back 32

The Wharton's duct.

Front 33

How much of the total saliva output is released by the Sublingual gland?
What is the fluid primarly made up of?

Back 33

5%
Mixed secretions but primarily mucus.

Front 34

Which cranial nerve intervates the Sublingual Gland?

Back 34

VII Facial Nerve….The same Chorda Tympani of the facial nerve intervates both the Sublingual & Submandibular glands.

Front 35

What are the 3 locations of the minor salivary glands?

Back 35

Labial minor Buccal minor & Palatal minor mucosas

Front 36

What is primarily secreted from the minor salivary glands?

Back 36

Mucous Secretions?

Front 37

What is one other minor salivary gland, where is it located and what does it secrete?

Back 37

von Ebner's gland, Located at the posterior of the tonge by the circumvalate papilla

Secetes ONLY Serous fluid!

Front 38

What causes the formation of the calcified stones which block the ducts?

Back 38

The salts in the saliva

Front 39

Since a blocked gland/duct causes pain and swelling; what is causing any infection that arrises?

Back 39

An abundance of natural bacteria since the duct is backed up.

*It can cause infection or even a tumor could form.*

Front 40

How are salivary stones gotten rid of?

Back 40

They either work themselves out OR they need to be excised.

**You could suggest the Pt increase the intake of fluids to flush it out, the Pt may also need antibiotics in response to any infection.*

Front 41

Mucositis is a condition associated w/radiation therapy. What is mucositis?

Back 41

Inflammation & ulceration of the mucus membranes.
(aka apthous ulcer…everywhere)

Front 42

What is dyspgagia?

Back 42

Difficulty swallowing…possibly due to a lack of saliva

Front 43

Is Sjogren's (Show grens) Syndrome an autoimmune disease? If so, what is causing it?

Back 43

Yes There is an abnormal # of antibodies in the blood

Front 44

What is the difference between Primary Sjogrens & Secondary Sjogrens?

Back 44

Primary: Inflammation of tear and salivary glands

Secondary: Inflamation of tear, salivary glands AND connective tissues

Front 45

What are some additional symptoms of Secondary Sjogren's Syndrome?

Back 45

Rheumatoid arthritis, lupus & scleroderma

Front 46

How is Sjogren's transmitted and who is most likely to "receive" it?

Back 46

Its GENETIC in nature and 90% of those who get it are FEMALE

Front 47

What can Sjogren's sometimes be associated with?

Back 47

Juvenile diabetes
Thyroid disease

Front 48

What are some non oral symptoms of Sjorgen's?

Back 48

Frequent Dry Cough
Difficulty Swalling
Blurred vision or the sensation of burning
Constipation
Dry Skin
Nasal Dryness

Front 49

What types of physicians might be included in the Tx of Sjogren's? Why?

Back 49

Opthalmologist-->Dry Eyes
Rheumatologist-->Connective tissue disorder, arthritis

Front 50

What are some products to recommend for the Pt w/Xerostomia?

Back 50

Biotene
Salivart (little pump spray that goes in the mouth)
No alcohol
Chewing gum (xylitol) or sugar free candy

Front 51

What meds might you see for a Pt with hyposalivation?

Back 51

Pilocarpine 5-10 mg BID or Evoxac 30mg BID

(effects are 2-4 hours for each)

Front 52

What is an extrinsic stain? (Stain by locatin)

Back 52

A stain that is outside the tooth surface

Front 53

What is an intrinsic stain? (Stain by location)

Back 53

A stain from within the tooth surface

Front 54

Where does an Exogenous stain orginate?

Back 54

Outside of the tooth

Front 55

What is an exogenous stain the result of?

Back 55

Exposure to environmental agents..the stain may be on the outside surface of the tooth (extrinsic) or become incorporated within the tooth structure (intrinsic).

Front 56

What is an example of an exogenous stain source?

Back 56

Coffee Tea Wine Smoking

Front 57

Where is an endogenous stain orginate?

Back 57

Comes from within the tooth

Front 58

In terms of location (intrinsic or extrinsic) and by source; what would a metallic stain be classified as?

Back 58

Exogenous (from outside of the body) &
Intrinsic (as it can stain dentinal tubules)

Front 59

What causes Orange/Yellow stain? What would be the classification?

Back 59

Chromogenic Bacteria
Exogenous extrinsic-->comes from outside source & can be cleaned off.

Front 60

Where is Orange/Yellow stain usually located on the tooth surface?

Back 60

Cervical 1/3 of anteriors-->adheres to the gingival margin.

Front 61

What is Orange/Yellow stain associated with?

Back 61

Poor Oral hygiene.

*Remember incisors get "self" cleaned by the act of eating. If this stain is present then Pt isn't cleaning very well.*

Front 62

What are Green Stains usually associated with?

Back 62

An environmental metal-->metallic industry dust, perhaps from the work place

Front 63

Where on the mouth is Green Stain usually found?
What is the classification of green stain?

Back 63

MX anteriors

Exogenous/Extrinsic

Front 64

Teeth with green stain are often ____________ (condition.)
In addition to the metallic dust, what is causing the green stain?

Back 64

Demineralized

Chromogenic bacteria, fungi and gingival hemorrhage.

*Fungi has a higher acidity, since teeth become demineralized they are a "magnet" for this type of staining.

Front 65

Where is Black Line Stain usually located?
Which sex is more likely to experience it?

Back 65

Posterior linguals, along the gingival margin…often found in clean mouths.

Females

Front 66

What is often the cause of Black line stain?

Back 66

Exposure to iron (ferric sulfide).
Can come from Pre-natal vitamins perhaps, or well water

Front 67

Since Black stain can come from well water or vitamins and can be polished right off, what is the stain classification?

Back 67

Exogenous/ Extrinsic

**Remember the iron is constantly coming throug the saliva so the stain is "always" there.**

Front 68

How difficult is it to remove Black stain?

Back 68

Very Easy-->remove with polishing cup.

**But because it flows through the saliva the stain will return right away.**

Front 69

What specificially causes the intrinsic stain of smoking tobacco?

Back 69

The HEAT!

The heat is actually baking the enamel causing it to become yellow.

Front 70

What tool is good at removing the tar of tobacco stain?

Back 70

Ultra Sonic!

*Otherwise, keep your instruments sharp!*

Front 71

What are 3 "reasons" to see endogenous intrinsic stains?

Back 71

1) Pulpless teeth
2) Tetracycline Stain (Drug induced in offspring)
3) Developmental imperfections

Front 72

Review Nabors Probe on your own

Back 72

Didn't have time to make questions

Front 73

What is a Class 1 Furcation?

Back 73

Slight root indention

Front 74

What is a Class 2 Furcation?

Back 74

1/2 way through

Front 75

What is a Class 3 Furcation?

Back 75

All the way through…but covered by Gingiva

Front 76

What is a Class 4 Furcation?

Back 76

All the way through & EXPOSED!

Front 77

What constitutes a Class 1 perio Pt
(Like Class1 Lt or Class 2 Lt etc)

Back 77

No Attachment Loss

No bone loss (bone is 1.5-2.0mm from CEJ)

Front 78

What constitutes Class 2 perio Pt
(Like Class1 Lt or Class 2 Lt etc)

Back 78

10 places w/ 1-2 mm attachment loss

*Bone measures 1-2mm beyond the normal 2mm level**

Front 79

What constitutes a Class 3 perio Pt
(Like Class1 Lt or Class 2 Lt etc)

Back 79

10 places w/ 3-4 mm attachment loss

**Bone measures 3-4mm beyond the normal 2mm level**

Front 80

What constitutes a Class 4 perio Pt
(Like Class1 Lt or Class 2 Lt etc)

Back 80

10 places w/5-6 mm attachment loss

**Bone measures 5-6mm beyond the normal 2mm level**

Front 81

Review your Process Evals

Back 81

Review the process Evals for:
Graceys
Polishing
Fluoride Tray vs Varnish
Cleaning Prosthetic