What is the first step in the dental hygiene process of patient care?
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.
Assessment must be accompanied by the ____________ of information gatehered during the assessment process.
Name 4 essential information/procedures to the assessment of a patient's periodontal status.
medical and dental histories
Which portion of the assessment protocol includes medical history and dental history?
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?
Which portion of the assessment protocol includes caries, restorations, overhanging margins, proximal contact relationships, tooth abnormalities, parafunctional habits, tooth wear, sensitivity or hypersensitivity?
Which portion of the assessment protocol includes interdental septa, bone destruction, furcation areas, and dental implants?
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?
previous dental experience
attitudes toward dentistry to help design a plan to meet pt needs
The clinical examination should include what 6 assessments?
What are the 3 types of oral mucosa in the oral cavity?
Which type of mucosa covers the gingiva and hard palate?
Masticatory mucosa is attached to underlying tissue except with what?
Is masticatory mucosa movable or immovable?
is masticatory mucosa keratinized or nonkeratinized?
Which type of mucosa covers the dorsum of the tongue?
specialized mucosa contains ___________ and ___________
list 6 areas that are covered by the lining mucosa.
floor of mouth
ventral surface of tongue
is lining mucosa movable or immovable?
is lining mucosa keratinized or 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?
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
The oral Hygiene assessment is a clinical evaluation of what 3 things?
List ways to detect each of the following types of calculus:
supra: seen when dried with air
sub: light careful exploring
heavy: can be seen on radiographs
What is the most commonly occuring stain?
Which type of stain is a thin, translucent, acquired, usually bacteria-free, pigmented pellicle?
true or false. Brown stain is frequently associated with insufficient oral hygiene
Where dows brown stain occur?
Brown stain is often caused by _______; which has a denaturing effect on pellicle proteins.
name 4 things that tannin is found in.
Is black stain firmly or loosely attached?
is black stain more common in women or men?
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
The microflora of black stain is dominated by ____________ bacteria; which may be the cause of the black pigmentation
Is green stain thin or thick?
Is green stain usually associated with children or adults?
true or false. Green stain is associated with poor oral hygiene
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
Orange stain forms on loosely attached ___________
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?
clinical attachment levels
assessing gingival bleeding
Increased bleeding is not always an absolute predictor of actie disease. increased bleeding may be present in patients taking what?
The absence of bleeding generally indicates current __________ of the periodontium
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?
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?
Which grade of furcation has complete loss of interradicular bone, with pocket formation that is completely probable to the opposite side of the tooth?
Which grade of furcation has loss of attachment and gingival recession making the furca clearly visible on clinical examination?
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
Which grade of mobility is physiologic mobility only?
Which grade of mobility is clinical mobility that is slightly greater than physiologic mobility but less than 1 mm buccolingually?
Which grade of mobility is slight pathologic mobility, approximately 1 mm buccolingually?
Which grade of mobility is moderate pathologic mobility approximately 2 mm buccolingually, but no vertical displacement?
Which grade of mobility is severe pathologic mobility greater than 2 mm buccolingually or mesiodistally combined with vertical displacement?
Which type of mobility is normal or expected mobility of a tooth? And at what time of day is it greatest?
Which type of mobility is caused by factors affecting periodontal ligament space?
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.
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.
Dentition assessment is a clinical evaluation of what 6 things?
teeth for caries
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?
Which G.V. class is proximal cavities in premolars and molars?
Which G.V. class is proximal cavities in incisors and canines (no incisal edge)
Which G.V. class is proximal cavities in incisors and canines and involves the incisal edge?
Which G.V. class is gingival third cavities? (not including pit and fissure cavities)
Which G.V. class is incisal edge and cusp tip cavities?
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?
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?
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?
Which type of root caries is deeply penetrating lesion with pulpal involvement? Pigmentation is from brown to dark brown?
What is tooth wear caused by mecanical process of foreign objects such as a tooth brush, or other personal habits?
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?
Which tooth wear is caused by mechanical process involving tooth flexure by eccentric occlusal forces?
What appears as a V or wedge shape with sharp edges at the cervical surface of teeth?
Which tooth wear is caused by tooth-to-tooth contact?
Which form of tooth wear is caused by chemical acids?
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?
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?