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117 Cards in this Set
- Front
- Back
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What is considered a normal BP? |
*120/80 mmHg used to be normal.
*Health risks for HTN begin at 115/75 mmHg |
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What is prehypertension? |
120-139/80-89 mmHg |
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What is stage 1 hypertension? |
140-159/90-99 mmHg |
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What is stage 2 hypertension? |
>160/>100 mmHg |
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How many BP readings are necessary to diagnose hypertension? |
>2 seated measurements at >2 visits |
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A BP cuff that is too small will give a reading that is... |
High |
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A BP cuff that is too large will give a reading that is... |
Low |
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The arrow on the cuff should be aligned with what artery? |
*Brachial Artery, 1" above fossa, with Pt arm resting at level of the heart. |
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What is the Auscultatory Gap? |
A space of time in which sound disappears, then reappears. This may lead to misreading the systolic and diastolic sounds. |
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True or False:
It is ok to record values and a round number (5's or 10's) |
False, record everything accurately. |
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What systemic conditions are important in regards to taking a pulse? (5) |
1. Hypovolemia 2. Stress 3. Heart Block 4. Medications 5. Fibrillation |
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Why should you avoid using the thumb when taking a pulse? |
The clinician may feel their own pulse, rather than the pulse of the Pt |
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What is a normal pulse value? |
60-100
If Pt is arrhythmic, count one full minute |
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What can irregular breathing indicate? (4) |
1. Dental Anxiety 2. Systemic Problems 3. Medications 4. Reaction to pain |
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When is temperature an important vital sign to record in the dental office? |
If the Pt may have an infection, or appears febrile. |
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what equipment is necessary to do an intraoral examination? |
*Mirror *Tissue retractor (tongue blade) *Dry gauze |
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What drugs can cause a reaction in the gingiva? |
1. Anti-epileptic 2. Calcium Channel Blockers 3. Immunosuppressant |
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What 2 areas are the most common places for oral cancer to occur? |
1. Lateral Border of the Tongue 2. Floor of Mouth |
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How long should you wait to re-evaluate any suspicious lesions? |
2 weeks (if still there do a biopsy) |
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How often should a systemic oral examination be done? |
*At initial exam, and any recall appointments.
*All areas of the oral cavity must be visualized! |
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What are the boundaries of the anterior triangle? |
1. Anterior border SCM 2. Lower border mandible 3. Midline |
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What are the boundaries of the submental triangle? |
1. Anterior Belly Digastric 2. Body of Hyoid 3. Midline
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What are the boundaries of the digastric triangle? |
1. Anterior Belly Digastric 2. Posterior Belly Digastric 3. Lower border Mandible |
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What are the boundaries of the muscular triangle? |
1. Anterior border SCM 2. Superior Belly Omohyoid 3. Midline |
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What are the boundaries of the carotid triangle? |
1. Anterior border SCM 2. Posterior Belly Digastric 3. Superior Belly Omohyoid |
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What are the 3 parts to a hand instrument? |
1. Handle 2. Shank 3. Working End |
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What is an unpaired hand instrument? |
An instrument with 2 dissimilar working ends |
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What is a paired hand instrument? |
An instrument with working ends that are mirror images of each other |
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What does the number orientation on the handle of a hand instrument tell you about the working ends? |
*1st number on the left identifies the working-end at the top.
*The 2nd number indicates the working-end at the lower end of the handle. |
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What are the recommended qualities of a good handle for hand instruments? (3) |
1. Large Diameter 2. Lightweight Handle 3. Bumpy Texturing |
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What is balanced instrument? |
An instrument where the working ends are centered with the midline of the handle. |
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A simple shank (one with limited bends) is best for what area of the mouth? |
Anterior Teeth |
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A complex shank (one with side-to-side bends) is best for what area of the mouth? |
Posterior Teeth |
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What is the portion of the shank that allows for adaptation to the tooth surface? (working end to last bend in shank) |
Functional Shank |
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What is the portion of the shanks that is nearest to the working end? |
Terminal Shank |
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What are the uses of a dental mirror? (4) |
1. Indirect Vision 2. Retraction 3. Indirect Illumination 4. Transillumination |
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Reflecting light off the mirror onto a specific tooth or part of the mouth to brighten the areas for easier viewing is called what? |
Indirect Illumination |
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What is the correct position for lower arch buccal surfaces towards you? (same for upper arch) |
RH: 9:00
LH: 3:00 |
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What is the correct position for lower arch lingual surfaces towards you? (same for upper arch) |
RH: 9:00
LH: 3:00 |
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What is the correct position for lower arch buccal surfaces away? (same for upper arch) |
RH: 11-12:00
LH: 12-1:00 |
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What is the correct position for lower arch lingual surfaces away? (same for upper arch) |
RH: 11-12:00
LH: 12-1:00 |
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What are the advantages given by using the modified pen grasp? (5) |
1. Allows for precise control 2. Permits easy movement 3. Permits easy rolling 4. Good tactile sensitivity 5. Reduces fatigue |
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Where should the middle finger be placed when using the modified pen grasp? |
*It should rest lightly on the shank
*It should NEVER rest on the handle |
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Where should the handle sit when using the modified pen grasp? |
The handle should rest against the hand in order to stabilize the instrument. |
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What is the ring fingers main objective when using the modified pen grasp? |
*Fulcrum
*Allows for stability, good control, and power |
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True or False:
The fulcrum (ring finger) and middle finger should be in contact during the modified pen grasp. |
True, this allows a stronger grasp and less stress for the hand muscles. |
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Why is operator positioning important? (4) |
1. Prevents fatigue 2. Clear viewing area 3. Easy access to work area and to mouth 4. Time efficient |
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What is the ideal head tilt? (in degrees) |
0 to 15 degrees |
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How is neutral back position obtained? |
Leaning forward slightly from the waist or the hips. Ideal tilt is 0 to 20 degrees. |
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True or False:
It is proper positioning to have your shoulders hunched up towards your ears? |
False, your shoulders should be even |
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What is the ideal position for your elbows? |
Elbows should be at waist level held slightly away from the body. |
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What is considered a neutral forearm position? |
A good position would be forearms parallel to the floor, but anywhere between 60-100 degrees is ok. |
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What is considered a neutral hand position? |
The side of your palm with the little finger should be slightly lower than the side of your palm with the thumb. |
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True or False:
It is ok to place your legs under the headrest of the patient chair. |
True, however it is important to avoid placing legs under the back of the patients chair. |
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Which probe has black bands between 4-5mm and 9-10mm? |
UNC probe |
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What are the Shepard's Hook 23 and Hook 17 explorers used for? |
Caries Detection |
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Which of the probes is curved and used to measure furcations? |
Nabers Probe |
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What is the OD 11/12 used for? |
Root surfaces (calculus deposit detection) |
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What is a walking stroke and why is it important? |
*A series of bobbing movements made within the sulcus to make sure the entire circumference of the tooth is covered.
*The probe should not be removed from the sulcus with each stroke
*The Junctional Epithelium is not always a uniform depth. |
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How many numbers are recorded for each tooth when performing probing? |
6 (the deepest reading of each surface should be recorded) |
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What is the proper method for interproximal probing? |
*Slanting the probe so that the tip reaches under the contact. |
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What are the 2 types of movements used to activate a hand instrument? |
1. Wrist Activation (used for calculus removal)
2. Finger Motion Activation (used for calculus removal with ultrasonic) |
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What is pivoting? |
*A slight swinging motion of the hand and arm carried out by balancing on the fulcrum finger.
*Changes the angulation of blade on the tooth. |
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True or False:
Teeth are usually vertical in the arch. |
False, This is a misconception, and teeth are actually tilted in the arch.
*Maxillary angulation |
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What is adaptation? |
*The positioning of the first 1-2mm of the working-end of a hand instrument in contact with the tooth.
*The toe 1/3 or tip 1/3 is always in contact with the tooth surface. |
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What is the instrumentation stroke? |
*The act of moving the working-end of a hand instrument against the tooth surface.
*exploratory or calculus removal strokes |
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What is the proper direction of the instrumentation stroke? |
*Made in the coronal direction.
*Away from the Junctional Epithelium
*Apical --> Coronal (vertical, horizontal, oblique) |
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Where are vertical strokes used? |
*All surfaces of anterior teeth
*Mesial and Distal surfaces of posterior teeth |
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Where are oblique strokes used? |
*Facial and LIngual surfaces of posterior teeth |
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Where are horizontal strokes used? |
*Narrow root surfaces of anterior teeth |
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What are the uses of an explorer? (4) |
1. Locate calculus 2. Detect surface irregularities 3. Detect margins of restorations 4. Detect demineralized areas & caries |
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True or False:
Shepard's Hook explorers are recommended for subgingival exploration. |
False, not recommended subgingival |
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What 2 explorers are recommended for caries detection? |
1. Shepard's Hook 2. #17 (+ narrow anterior pockets) |
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What is the main use of the ODU 11/12 paired explorer? |
Calculus Detection
(curved "pigtail" used on root surfaces) |
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What are the 2 basic principles of explorer functional use? |
1. Terminal shank is parallel to the long axis of the tooth.
2. 1-2 mm of side tip should be adapted to the tooth. |
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What are the purposes of scaler use? |
1. Removal of supra-gingival calculus.
2. Removal of sub-gingival calculus, IF it is continuous with supra-gingival calculus, AND only right below gingival margin.
3. Calculus removal immediately below contact. |
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True or False:
Scalers should be used sub-gingival. |
False,
*Tissue trauma if too large. *Avoid use on root surfaces. |
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What are the qualities that a scaler has? |
*Anterior scalers have a straight blade. *Posterior scalers have curved blade? *Cross-section is triangular *lateral edges meet face at 70-80 degrees. *Pointed toe |
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Where is a H5/6 Sickle Scaler used? |
*In the anterior *Used with a pull stroke *Used supra-gingival |
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Angulation of a scaler? |
*Adapted at 70-80 degrees *Place blade below deposit and apply lateral pressure. *Apply snap pulling stroke with firm fulcrum
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True or False:
Posterior scalers can be used in the anterior. |
True |
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What are of the mouth is the 204 S Scaler used? |
Posterior |
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What are the 4 steps in the instrumentation that is repeated on each tooth when scaling? |
Step 1: distal facial line angle to proximal Step 2: distal facial line angle to buccal Step 3: buccal into mesio facial proximal
*Repeat |
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What is Junctional Epithelium? |
The soft epithelial tissue forming the base of a gingival sulcus.
*Sharp cutting edges of instruments could injure JE. |
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What is the working-end design of a Graceys Curet? |
*The lower blade is the working blade. *Rounded back toe *Face tilted at 60-70 degrees to lower shank. |
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How many Curets did Dr. Clayton Gracey make? |
*14 single-ended area specific curets |
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Where are Graceys 1-2 and 3-4 used? |
Anteriors |
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Where is Graceys 5-6 used? |
Anteriors and Premolars |
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Where are Graceys 7-8 and 9-10 used? |
Facial and Lingual of Posteriors |
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Where is Graceys 11-12 used? |
Buccal, Lingual, and Mesials only of posteriors |
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Where is Graceys 13-14 used? |
Distal only of posteriors |
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Where is Gracey 15-16 used? |
Buccal, lingual and mesial of posteriors |
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Where is Gracey 17-18 used? |
Distals only of posteriors |
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What Gracey Curets can be used on the posterior teeth, surfaces buccal, lingual, and mesial? |
*Gracey 11-12
*Gracey 15-16 |
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What Gracey Curets can be used on the posterior teeth, distal surface only? |
*Gracey 13-14
*Gracey 17-18 |
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How can you identify the cutting edge of a Gracey Curet? |
Put lower shank perpendicular to floor, and the lower blade is the cutting edge used for instrumentation. |
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How many Gracey Curets are necessary to appropriately clean one tooth? |
*2 different curettes -11-12 for B, L, M surfaces -13-14 for D surface
*4 different working-ends. |
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What are the important qualities of universal curets? |
1. Works in all areas 2. Works supra-gingival and sub-gingival 3. Used on crown and root surfaces 4. Used with vertical, oblique, and horizontal pull stroke. |
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Universal design qualities: |
1. Paired (mirror image) 2. 2 parallel cutting blades (both used) 3. Rounded toe |
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Of the Barnhart and Columbia universal curets, which one is used for deep periodontal pockets? |
*Barnhart 1/2 |
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What is phase 1 periodontal therapy? |
*Initiate daily plaque control regimen *Removal of calculus and microbial plaque (SRP) *Correct restorations *Treatment of carious lesions |
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Phase 1 therapy includes the management of what factors? |
1. Complete calculus removal 2. Correction of restorations and prosthetic devices. 3. Restore carious lesions 4. Orthodontic tooth movement 5. Treatment of food impaction areas 6. Treatment of occlusal trauma 7. Extraction of hopeless teeth |
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Type 1 Gingivitis: |
*no loss of attachment *BOP *Shallow pockets (1-3) *No bone loss |
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Type 2 Early Periodontitis: |
*Pocket depth 3-4 *BOP *Localized gingival recession *Possible grade 1 furcation *Mild to moderate bone loss (1-2) |
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Type 3 Moderate Periodontitis: |
*Pocket depth 4-6 *BOP *Grade 1 or 2 furcation *Class 1 mobility *Exudate possible |
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Type 4 Advanced Periodontitis: |
*Pocket depths >6 *BOP *Grade 2 or 3 furcation *Class 2 or 3 mobility *Exudate present *Severe bone loss |
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Type 5 Aggressive Periodontitis: |
*Early and rapid loss of bone *Usually associated with puberty aged, but can affect everyone. *Localized or generalized |
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Type 1 Gingivitis Treatment/Recall: |
Prophy (1110)
6 month reevaluation |
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Type 2 Early Periodontitis Treatment/Recall: |
SRP (4341 or 4342)
4-6 week evaluation 6 month reevaluation |
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Type 3 Moderate Periodontitis Treatment/Recall: |
SRP (4341 or 4342)
4-6 week evaluation 6 month reevaluation |
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Type 4 Advanced Periodontitis Treatment/Recall: |
SRP (4341 or 4342) or Referral to specialist
4-6 week reevaluation |
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Type 5 Aggressive Periodontitis Treatment/Recall: |
Refer to specialist |
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What is the treatment code for SRP of 4 or more teeth? |
4341 |
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What is the treatment code for SRP of 1-3 teeth? |
4342 |
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True or False:
Adult Prophy (1110) should be added to treatment plan when you plan SRP (4341 or 4342). |
False, Adult Prophylaxis is included in SRP treatment (4241 or 4342) |
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When should 4910 (periodontal maintenance) be used? (2 circumstances) |
1. When at least 1 quadrant of 4341 is treatment planned.
2. When 2 or more quadrants of 4342 is treatment planned
*4910 indicates 3 month SRP recall |
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What is code 4355 for? |
*Gross Debridement or Full Mouth Debridement
*used when excess calculus allows for probing
*1-2 week recall after 4355 for re-probing. |
