What is the first step in the dental hygiene process of patient care?
Assessment
The assessment provides the foundation for the subsequent diagnosis, planning, implrementation, and evaluation of dental and dental hygiene care, and is therefore, a __________ part of the overall quality of care delivered to every patient.
critical
Assessment must be accompanied by the ____________ of information gatehered during the assessment process.
documentation
Name 4 essential information/procedures to the assessment of a patient's periodontal status.
chief complaint
medical and dental histories
clinical exam
radiographic exam
Which portion of the assessment protocol includes medical history and dental history?
Interview
Which portion of the assessment protocol includes head and neck exam, and oral mucosa assessment?
extraoral and intraoral assessment
Which portion of the assessment protocol includes plaque biofilm, calculus, and stain?
oral hygiene assessment
Which portion of the assessment protocol includes probe depth, clinical attachment loss, bleeding and suppuration, furcation detection and measurment, tooth mobility, tooth migration, and implications of implants?
periodontal assessment
Which portion of the assessment protocol includes caries, restorations, overhanging margins, proximal contact relationships, tooth abnormalities, parafunctional habits, tooth wear, sensitivity or hypersensitivity?
dentition assessment
Which portion of the assessment protocol includes interdental septa, bone destruction, furcation areas, and dental implants?
radiographic assessment
The medical history obtained at the initial appointment helps ensure patient safety, health, and well-being by aiding the clinician in what 3 things?
evaluation of oral manifestations of systemic disease
detection of systemic conditions that affects tissue response
special precautions and modifications in tx procedures
true or false. The medical history of the patient must include vitals. It needs to be signed by the RDH only to validate responses.
first statement is true
second statement is FALSE. must be signed by RDH, and the PATIENT
What 4 items of information should be included in DENTAL history?
chief complaint
previous dental experience
current OH
attitudes toward dentistry to help design a plan to meet pt needs
The clinical examination should include what 6 assessments?
extraoral
intraoral
oral mucosa
oral hygiene
periodontal
dentition
What are the 3 types of oral mucosa in the oral cavity?
masticatory
specialized
lining
Which type of mucosa covers the gingiva and hard palate?
masticatory mucosa
Masticatory mucosa is attached to underlying tissue except with what?
margingal/unattached gingiva
Is masticatory mucosa movable or immovable?
immovable
is masticatory mucosa keratinized or nonkeratinized?
keratinized
Which type of mucosa covers the dorsum of the tongue?
specialezed mucosa
specialized mucosa contains ___________ and ___________
tastebuds
papillae
list 6 areas that are covered by the lining mucosa.
floor of mouth
ventral surface of tongue
inner lips
inner cheeks
vestibule
soft palate
is lining mucosa movable or immovable?
movable
is lining mucosa keratinized or nonkeratinized?
nonkeratinized
How would you describe the contour of healthy gingiva?
pointed, knife-like papillae
tissue fills embrasure
How would you describe the color of healthy gingiva?
pale coral pink
What are 5 terms used to describe the contour of inflammed gingiva/tissue?
blunted
bulbous
cratered
festoon-tube like
Stillman's cleft - slit like depression
Assessment of periodontal health includes: description and ______ of oral mucosa features; ________ for planning tx and outcome; consistent _________ between providers; and make sure to use ________ recognized descriptions
documentation
baseline
evaluation
universal
The oral Hygiene assessment is a clinical evaluation of what 3 things?
biofilm
calculus
stain
List ways to detect each of the following types of calculus:
supra
sub
heavy
supra: seen when dried with air
sub: light careful exploring
heavy: can be seen on radiographs
What is the most commonly occuring stain?
brown stain
Which type of stain is a thin, translucent, acquired, usually bacteria-free, pigmented pellicle?
Brown stain
true or false. Brown stain is frequently associated with insufficient oral hygiene
true
Where dows brown stain occur?
gingival margin
interproximal
Brown stain is often caused by _______; which has a denaturing effect on pellicle proteins.
tannin
name 4 things that tannin is found in.
coffee
tea
fruit
wine
Is black stain firmly or loosely attached?
firmly
is black stain more common in women or men?
women
true or false. Black stain is only found in people with poor oral hygiene.
FALSE. It can be found in people with excellent hygiene
Black stain found in children is typically associated with a ____ incidence of caries
low
The microflora of black stain is dominated by ____________ bacteria; which may be the cause of the black pigmentation
chromogenic
Is green stain thin or thick?
thick
Is green stain usually associated with children or adults?
children
true or false. Green stain is associated with poor oral hygiene
true
Where on the teeth does green stain usually occur?
gingival half of facial surfaces of anterior teeth
The discoloration of green stain has been attributed to fluorescent bacteria and fungi such as what? (2)
penicillium - (kids have to tak lots of penicillin because they are always sick)
aspergillus - (asperigus is green)
true or false. Orange stain is very common
FALSE. it is uncommon
On what surfaces of teeth is orange stain usually found?
facial and lingual of anterior teeth
true or false. Orange stain is associated with poor oral hygiene
true
Orange stain forms on loosely attached ___________
debris
Name 2 chromogenic organisms that have been suggested as the responsible organisms for orange stain.
serratia murcescens - (use a serrated knife to cut murcy's oranges)
flavobacterium lutescens - (oranges have "luts" of flavor)
*oranges have a strong "scent" (for scens)
Periodontal includes assessment of what 5 aspects?
probe depths
clinical attachment levels
assessing gingival bleeding
furcations
mobility
Increased bleeding is not always an absolute predictor of actie disease. increased bleeding may be present in patients taking what?
aspirin
anticoagulant therapy
The absence of bleeding generally indicates current __________ of the periodontium
stability
The presence of suppuration or purulent exudate in combination with periodontal pockets and bleeding on probing can indicate what?
That the site is subject to periodontal disease progression
Which grade of furcation has pocket formation into the flute of the furca, but the interradicular bone is intact?
Grade I
Which grade of furcation hs loss of interradicular bone, with pocket formation of varying depths into the furca but not completely through to the opposite side of the tooth?
Grade II
Which grade of furcation has complete loss of interradicular bone, with pocket formation that is completely probable to the opposite side of the tooth?
Grade III
Which grade of furcation has loss of attachment and gingival recession making the furca clearly visible on clinical examination?
Grade IV
The following assessments are important in which area?
investigate slightest change
radiodensity suggests involvment in the area
assume it is boneloss on one root of a molar
furcatino involvment
Which grade of mobility is physiologic mobility only?
Grade 0
Which grade of mobility is clinical mobility that is slightly greater than physiologic mobility but less than 1 mm buccolingually?
Grade 1/2
Which grade of mobility is slight pathologic mobility, approximately 1 mm buccolingually?
Grade 1
Which grade of mobility is moderate pathologic mobility approximately 2 mm buccolingually, but no vertical displacement?
Grade 2
Which grade of mobility is severe pathologic mobility greater than 2 mm buccolingually or mesiodistally combined with vertical displacement?
Grade 3
Which type of mobility is normal or expected mobility of a tooth? And at what time of day is it greatest?
physiologic
morning
Which type of mobility is caused by factors affecting periodontal ligament space?
pathological
What are 2 factors that affect the periodontal ligament space that may cause pathologic mobility?
loss of alveolar bone
horizontal or vertical bone loss
true or false. Pathological mobility of teeth depends on the severity and distribution of the bone loss.
true
What occurs when periodontal disease disturbs that balance among the factors that maintain physiologic tooth position?
Pathologic migration of teeth
true or false. In pathologic tooth migration, teeth only migrate mesially.
FALSE. they can move in any direction
true or false. Tooth migration may occur from unreplaced missing teeth and tongue thrust.
true
Dentition assessment is a clinical evaluation of what 6 things?
teeth for caries
restoration status
proximal contacts
anomalies
sensitivity
habits
Which G.V. class is pit and fissure cavities; occlusal surfaces of premolars and molars; occlusal two thirds of facials and linguals on molars; and lingual surface of maxillary incisors?
Class 1
Which G.V. class is proximal cavities in premolars and molars?
Class 2
Which G.V. class is proximal cavities in incisors and canines (no incisal edge)
Class 3
Which G.V. class is proximal cavities in incisors and canines and involves the incisal edge?
Class 4
Which G.V. class is gingival third cavities? (not including pit and fissure cavities)
Class 5
Which G.V. class is incisal edge and cusp tip cavities?
Class 6
What type of root caries is the surface texture soft and can be penetrated with a dental explorer? No surface defect or cavitation? And pigmentation is light tan to brown?
Grade I
incipient
Which type of root caries is the surface textrue soft, irregular, and rough, and can be penetrated by a dental explorer? Surface defect is less than 0.5 mm deep? And pigmentation is from tan to dark brown?
Grade II
Shallow
Which type of root careis is the surface texture soft and can be penetrated with a dental explorer? Penetrating lesion with cavitation that is greater than 0.5 mm deep; no pulpal involvement? Pigmentation is brown to dark brown?
Grade III
cavitation
Which type of root caries is deeply penetrating lesion with pulpal involvement? Pigmentation is from brown to dark brown?
Grade IV
pulpal
What is tooth wear caused by mecanical process of foreign objects such as a tooth brush, or other personal habits?
abrasion
What tooth wear appears as a "V" shaped defect or notch on buccal surfaces; and a ditch, notch, or indentation on the incisal and occlusal surfaces?
Abrasion
Which tooth wear is caused by mechanical process involving tooth flexure by eccentric occlusal forces?
abfraction
What appears as a V or wedge shape with sharp edges at the cervical surface of teeth?
abfraction
Which tooth wear is caused by tooth-to-tooth contact?
attrition
Which form of tooth wear is caused by chemical acids?
erosion
Where is dietary erosion most often seen?
cervical and buccal surfaces of maxillary teeth and occlusal and buccal surfaces of mandibular teeth
Where is gastric erosion most commonly seen?
lingual surfaces of anterior and posterior maxillary teeth, buccal surfaces of mandibular posterioro teeth, and occlusal surfaces of mandibular and maxillary posterior teeth
Which type of examination is an essential adjunct to clincal examination, assesses bone destruction, and can be used to compare changes over time?
radiographic examination
true or false. Radiographic examination indicates the presence of active disease.
FALSE. it does NOT
Bone changes are noted based on the appearance of what on a radiograph?
the interdental septa
The interdental septum normally has a thin radiopaque border adjacent to the PDL space, this is called what?