dthy 205 midterm

supine position of the dental chair

all the way flat

what is the trendelenburg position of the dental chair used for

if patients get dizzy

with the dental mirror, illumination (reflecting light off of mirror) can show what

can show caries between front teeth

proper ergonomics include having feet, thighs, and chair at what positions

feet- flat on floor

thighs- flat or slightly angled down

chair- between reclined and supine and at waist level

___ is the federal agency that protects the employee not the patient

OSHA

___ is the federal agency that protects the environment

EPA

___ sets the guidelines for infection control in the dental office

CDC

standard precautions state that all patients must be treated as if they are ___

infectious

Asepsis

absence of all microbes including viruses and spores

HAVE TO STERILIZE TO GET

Sterilization

destruction of all forms of microbes (physical or chemical)

HOW YOU GET ASEPSIS

disinfection

kills some microorganisms, but not all

sanitization

removes visible contaminants

cross contamination

spread of microbes from one source to another

airborne infection

Infection through inhalation of microbes. gets into mucosal surface

critical items of sterilization and disinfection

penetrate soft tissue or bone

semi-critical items of sterilization and disinfection

contacts mucosal membranes or nonintact skin

non-critical items of sterilization and disinfection

contact intact skin

heat sterilization of critical items: steam under pressure

autoclave: 250-260 F for 15-20 minutes

flash sterilization: 275 F for 6-9 minutes UNWRAPPED or 275 F for 14-17.5 min WRAPPED

heat sterilization of critical items: dry heat

higher temp, can dull instruments

320 F for 2 hours

key board infection control procedure

- cover with plastic barriers

- only touch top plastic cover WITH GLOVES

- only touch actual keys UNGLOVED

after taking an impression, you must ___ before sending it anywhere

spray it with disinfectant

handwashing only gets ___ off

bioburden

non-surgical hand washing

- plain soap or antimicrobial and water

- 15 seconds pre covid, 20 seconds now

surgical handwashing

- antimicrobial cleanser and water

- 2-6 minutes

hand sanitizer is a ___ second procedure

20

order of donning

1. gown 2. mask 3. eye wear 4. gloves

how often should you change gown

daily, or when visibly soiled

order of doffing

1. gloves 2. eyewear 3. gown 4. mask

post exposure management steps

1. immediate washing area

2. report incident

3. discuss incident with patient

4. refer patient to get treated and tested

___ solution cleans water

iodine

you must flush waterline for ___ seconds

20

does cross contamination occur directly or indirectly

both

regulated waste can contain: (3)

sharps, SOAKED blood, body tissue

items that directly or indirectly contact the oral cavity must be

heat sterilized

items like rubber or plastic cannot be heat sterilized so they must be sterilized by a ___ solution for ___ hours

gluteraldehyde for 10 hours

gloves and gown are disposed via

regular trash. NOT regulated

___ is a legal document used to get information about patient

health history

health histories may aid in identification of

dead/missing person

social history contains

info on tobacco, alcohol, drugs

dental health history ALWAYS has patients ___ written in quotes, in the patients words

chief complaint

ASA physical status classification: ASA physical status 1

a normal, healthy patient

ASA physical status classification: ASA physical status 2

patient with MILD systemic disease

ex. smoking but with no other diseases

ASA physical status classification: ASA physical status 3

a patient with MODERATE to SEVERE systemic disease

ASA physical status classification: ASA physical status 4

a patient with SEVERE systemic disease that is a constant threat to life

ASA physical status classification: ASA physical status 5

a patient who will die without an operation

ASA physical status classification: ASA physical status 6

a brain dead patient

when patient is taking meds, what should you know (5)

-medication

-dosage and freq.

-what it treats

-are there side effects

-any interactions with a drug you plan to prescribe

with health history, the ___ owns it, but patient can request it

dentist

when you make a mistake on the health history, you should...

mark one line through the error and initial it

only ___ of the US population has access to fluoridated water

2/3

dental caries is the most common chronic disease in ___

children

dental caries are caused

bacteria

___, ___, and ___ are affected by perio disease

gingiva, bone, and ligaments

process of caring for a patient (5)

assessment

diagnosis

planning

implementation

evaluation

process of caring for a patient: assessment

bp, pulse, etc

process of caring for a patient: diagnosis

problem/disease

process of caring for a patient: planning

developing realistic goals

process of caring for a patient: implementation

carrying out the plan

process of caring for a patient: evaluation

measure of achieving goals

scaling

using instruments to remove plaque above and below gums

chronic periodontitis

inflammation and attachment loss

Calcium and phosphate ions are found in the___ and cause ____

Saliva, causes plaque to be mineralized

normal probing depths

1-3 mm

cej

cemento

enamel

junction

cmj is where ___ ends

enamel

dental plaque

acquired bacterial biofilm

soft, removed with brushing and flossing

___+___= plaque

bacteria + cells,food,etc

___ appears when the tooth becomes covered with a thin, microscopic coating of saliva and it is the FIRST thing that goes onto clean tooth

acquired pellicle

acquired pellicle takes ___ hours to appear

2

earliest bacteria to colonize of the teeth

gram + streptococci

the thicker the plaque becomes, its harder for O2 to reach and ___ develop in later phases

gram - anaerobes

gram + aerobic requires ___

oxygen

gram - develops ___

later

plaque is ___ and ___ (texture)

soft and fuzzy

plaque is removed by ___

flossing, brushing

Ca+ and phosphate hardens above gum plaque and forms ___

calculus

calculus is located where

above and below gums

calculus below the gum is ___ and is ___ to remove

dark and harder to remove

calculus itself is not pathogenic, ___ on calculus is

active bacteria

formation of calculus may be increased by

- smoking

- cystic fibrosis

- asthma

- tube feeding

first stage of plaque disease of the tooth

demineralization, is a white spot lesion that is white, chalky, and hard

second stage of plaque disease of the tooth

cavitates and becomes soft and flaky

___ is first step of perio disease

gingivitis

plaque score

use disclosing agent to see how much is properly cleaned (stain shows plaque)

can restorations also have calculus and plaque

yes

___ in toothpaste helps prevent calculus

pyrophosphate

critical pH in the mouth

5.5

why is 5.5 the critical pH

when the pH gets this low, the tooth will begin to dissolve. Demineralization will occur

remineralization occurs above ___ and is when

5.5 and above, this is when minerals (phosphate, calcium, fluoride) are added which hardens the tooth

fluoroappetite

hardens the tooth, hard to break down

Active vs inactive caries: darker caries and their consistency

Inactive, leather feeling

levels of prevention

primary- promotion of good health

secondary- treating early diseases

tertiary- treating more advanced diseases

caries start on ___ and spread once it reaches ___

smooth surfaces, dentin

sugar + bacteria=___ + tooth=___

acid, caries process

dental caries def

chemical dissolution of the tooth surface

non specific biofilm hypothesis

no diagnosis required

Treat all population the same

Remove all plaque

HAS NOT BEEN SUCCESSFUL

specific biofilm hypothesis

target specific microorganisms involved with caries

how does caries development begins

plaque/bacteria

the longer the plaque is there the ___ it becomes (texture)

fuzzier

when plaque is calcified, ___ forms

calculus