Dental Hygiene Techniques Midterm

midterm

The three parts of the gingiva

interdental papillae, marginal gingiva, attached gingiva

Part of the gingiva with stippled appearance

attached gingiva

Pseudopockets

pocket that is 4mm or less, formed by gingival enlargement without apical migration of junctional epithelium

Periopockets

pocket that is 4mm or more, formed as a result of disease or degeneration causing apical migration of the junctional epithelium along the cementum

Immunization required by OSDB for Licensure

Hepatitis B vaccine

Normal respiration rate for adults

12 to 20 per minute

Normal pulse rate for adults

60bpm

Tachycardia

Pulse rate over 100bpm

Bradycardia

Pulse rate less than 50bpm

160/100

Patients will be dismissed and referred to their PCP

Bimanual palpation

palpating with two/both hands

Bidigital palpation

palpating with two fingers, typically one finger and the thumb

Bilateral palpation

palpating with both hands, one on either side of the patient’s head/neck

Auscultation

use of sound, used to assess the TMJ

The lymph node under chin

submental lymph node

Documentation of lesions should include

history, location/extent, size/shape, color, surface texture, and consistency

Goal of IO/EO exam

detect deviations from normal

Routine handwashing

water and nonantimicrobial soap, removes debris and transient microorganisms

Antiseptic handwash

Water and antimicrobial soap, removes/destroys transient microbes, reduce flora

Antiseptic handrub

Alcohol based handrub, removes/destroys transient microbes, reduce flora

Surgical Antisepsis

Water and antimicrobial soap, removes/destroys transient microbes, reduce flora, persistent effect

Low Level Disinfectant

Inactivates vegetative bacteria and certain liquid type viruses, but NOT spores, tubercle, bacilli, or non-lipid viruses.

Intermediate Level Disinfectant

Inactivates all microbes but NOT spores

High Level Disinfectant

Inactivates spores and all bacteria, fungi, viruses. Either disinfectant or sterilant

Purulent

containing, forming, or discharging pus

Idiopathic

unknown origin

Verracous

wart like

Wrist rocking motion

-motion using larger arm muscles

-moves working end

-used for scaling

Digital motion activation

-push and pull motion with just fingers

-used for assessing and ultrasonic

-physical strength NOT needed

Simple shank

straight shank, used on anterior teeth

Complex shank

curvy shank, used on posterior teeth

Rigid shank

Higher diameter, stronger metal, used to remove heavy deposits

Flexible shank

Smaller diameter, weaker metal, used on small to medium deposits. Good for tactile information like detecting calculus and vibrations

Functional shank

region of shank below working end, extends to last bend by handle

Lower shank

portion of functional shank that is nearest to working end

Short Functional shank

functional shank used for SUPRAgingival areas

Long Functional shank

functional shank used for SUBgingival areas

Extended Lower shank

shank used for middle and apical thirds of root

Filiform papillae

threadlike & keratinized, most numerous, found on dorsum

Fungiform papillae

mushroom shaped & red, on tip and sides of tongue, has taste buds

Circumvallate papillae

10-14 large & round, in V formation at posterior, has taste buds

Foliate papillae

vertical grooves on lateral posterior tongue, has taste buds

Sharpey’s fibers

Inserted into cementum on one side and alveolar bone on the other side

*Initial lesion

Inflammatory response to dental biofilm bacteria occurs within 2 to 4 days

*Established lesion

Marked by formation of pocket epithelium

*Williams probe

Probe in standard cassette case

*How to measure CAL

-Measure the distance from the GM to CEJ

-Measure pocket depth

-Add the two measurements

*Which is NOT used for furcation involvement

Perio probe

*Benefits of clock positions

Optimal vision and less musculoskeletal stress

Ergonomics definition

applied science concerned with the “fit” between people and technological tools and environment

Four ergonomic hazards for dental hygienists

awkward posture, static posture, repetitive movements, force

Ergonomic “do’s”

assume neutral position, make adjustments to pt chair and equipment

Musculoskeletal disorder (MSD)

is a condition muscles, tendons, and nerves are injured over time

Position yourself first!

What should be adjusted first, you or your patient?

Supine position

Position where patient is flat on their back facing the ceiling

Ancillary equipment

magnifications loupes and light on loupes (coaxial illumination)

Dental health care provider should aim to

protect patients and workers from infection

Within hours/day

how long after birth does a baby’s oral cavity become unsterile and develop flora

Standard precautions apply to

apply to blood, saliva, all body fluids, secretions, excretions, nonintact skin, mucous membranes

Standard precations

minimum standard of care, applies to everyone

Aerosols

small particles, invisible, suspended in air for a long time, can be solid or liquid

Spatter

heavy/large particles, visible on people/surfaces, suspended in air for short time

2 minutes

how long to run lines at the start of the day

30 seconds

how long to run lines between patients

HBV, HCV, and HIV

the 3 most concerning bloodborne pathogens in dental offices

Kaposi Sarcoma

caused by HHV 8, most common HIV associated oral malignancy (cancer)

Type I hypersensitivity

immediate reaction: hives, rash, sneezing, watery eyes, difficulty breathing, drop in blood pressure, anaphylaxis

Type IV hypersensitivity

delayed reaction: contact dermatitis develops 8 hrs to 5 days after contact

DOCUMENT IT

If somebody has an allergy, (latex specifically) you should proooobably…

UVGI

Ultraviolet Germicidal Irradiation

This should be done WEEKLY!!!

Spore testing should be done how often

Autoclave (hows it work?)

moist heat/steam under pressure

Gravity displacement

TYPE of autoclave, forces out the air and steam penetrates the packages

High-speed pre-vacuum

TYPE of autoclave, pump removes the air allowing for faster penetration of steam

Autoclaves are cool because…

economic, kills ALL microbes QUICKly, works with variety of materials

Autoclave disadvantages

can cause corrosion of carbon steel instruments without precautions

Dry heat

Oxidation of molecules kill organisms. Mostly used for stuff that cant be autoclaved. NO corrosion potential

Dry heat disadvantages

cycles are super long, penetration is slow and uneven

Chemical Vapor Sterilizer

Alcohols, formaldehyde, ketone, water, and acetone heated under pressure kill organisms, requires ventilation and is stinky

Flash sterilization

rapid steam heat sterilization used with UNWRAPPED instruments for IMMEDIATE use. Rapid contact with steam allows for short cycles

Chemical Liquid Sterilization

AKA Cold sterile, items are soaked in chemicals. Impossible to verify sterility. CDC recommends this only when other methods cannot be used

Most common sites for oral cancer (4)

Lateral borders of tongue, floor of mouth, lips, soft palate

3 rules for progress note

each entry is dated and signed, only use standard dental abbreviations, always be OBJECTIVE

Dental History

includes dates of last radiographs, exam, prophylaxis. History or orthodontics or oral surgery. Also personal oral self care habits.

Medical History

includes current physician with contact info, all current conditions/diseases as well as history of disease, do they need a premed?, all current meds, medical clearance if appropriate, allergies, ASA category, vitals

ASA I

normal healthy patient, no acute/chronic disease, normal BMI

ASA II

presence of mild systemic disease that is well controlled like diabetes or hypertension. Any patient who uses tobacco. Any patient age 60 and older.

ASA III

1 or more moderate to severe systemic disease with functional limitations, like renal failure with dialysis, poorly controlled DM, history of stroke or heart attack (>3mo), morbid obesity

ASA IV

severe systemic disease with constant threat to life; i.e. CHF, advanced cancer, recent heart attack (

ASA V

patient not expected to survive beyond 24hrs without medical care

ASA VI

patient is brain dead

Radial artery

artery used to determine a patient’s pulse

Systole Phase

during ventricular contraction, highest pressure exerted

Systolic blood pressure

the number on the top of a blood pressure reading, the first sound

Diastolic blood pressure

the number on the bottom of a blood pressure reading, the last number sound

Diastole Phase

the effect of ventricular relaxation, lowest pressure

Hypotension

low blood pressure, less than 90/60

Hypertension

high blood pressure, more than 130/80

Pathognomonic sign/symptom

unique to a disease, used to distinguish between disease and variants of normal

Sign

is any objective (NOT influenced by personal feelings) abnormality found using things such as probe or radiograph. Includes changes in color, size, shape, consistency (something YOU report)