Preventive Test 2

Dental caries is caused by:

Mutans streptococci and lactobacilli

Demineralization is the:

Dissolution of calcium and phosphate minerals from the tooth when acids diffuse into the tooth

The white spot lesion is:

A demineralized area that appears white due to the loss of mineral in the subsurface zone of the enamel

When the junctional epithelium has migrated below the cementoenamel junction (CEJ) but remains above the crest of the alveolar bone, what type of pockets results?

Suprabony pockets

The client exhibits a periodontal pocket of 6 mm. The amount of recession is 2 mm, and the distance from the gingival margin to the mucogingival junction is 10 mm. The amount of attached gingiva present is _____ mm.

4

In which lesion stage of the Page and Shroeder Model of Inflammation would acute disease be found?

Early lesion

A cufflike band of squamous cell epithelium that completely encircles the tooth is:

Junctional epithelium

Bleeding on probing is indicative of periodontal breakdown because bleeding indicates active inflammation.

The first statement is false, and the second statement is true.

In a healthy dentition, how many millimeters will the free gingiva be coronal to the CEJ?

2

The space between the marginal gingiva and the tooth is the:

Gingival sulcus

Jane Jones, age 28, is a new client. Oral assessment findings reveal generalized gingival inflammation, bleeding on probing in all molars and mandibular anterior teeth, localized 4-mm pockets, and no gingival recession. Light marginal plaque biofilm is generalized, and calculus deposits are detected in the mandibular anterior teeth, maxillary molars, and lingual surfaces of the mandibular posterior teeth. Which of the following toothbrushing methods should be recommended?

A. Modified Bass

B. Circular

C. Charter's

D. Horizontal scrub

Modified Bass

Susie Smith, age 5, has an appointment for an oral prophylaxis. On examination the dental hygienist notes moderate plaque biofilm and gingival inflammation generalized throughout the mouth. Which of the following toothbrushing methods should be recommended to most effectively improve Susie's oral hygiene?

A. Modified Bass

B. Stillman's

C. Charter's

D. Horizontal scrub

E. Circular

Circular

Current understanding indicates that abfractions and abrasions both share the term noncarious cervical lesions because these lesions are indistinguishable and have multifactorial causes.

Both the statement and the reason are correct, and they are related.

___________________ is not a predictor of future attachment loss; however, ______________ on probing in combination with increasing pocket depths does increase risk for continued periodontal destruction.

bleeding

Masticatory oral mucosa that covers the alveolar process and the surrounding cervical portion of the teeth.

gingiva

Gingiva is divided into four anatomic areas:

free or unattached gingiva

gingival sulcus

attached gingiva

interdental gingiva or interdental papilla

Gingival tissue closest to the crown. (0.5 to 3mm)

free or unattached gingiva

The space between the free gingiva and the tooth. (0.5 to 3mm)

gingival sulcus

Boundaries of the gingival sulcus are:

the sulcular epithelium and the tooth

The nonkeratinized continuation of the keratinized epithelium covering the marginal gingiva. It is a permeable membrane.

sulcular epithelium

Continuous with the free gingiva and is covered with stratified squamous epithelium.

attached gingiva

Located in the interdental space between two adjacent teeth. Can be flat or saddle shaped in wide spaces or points or pyramidal and narrow spaces.

interdental or gingival papilla

Movable tissue loosely attached to underlying alveolar bone. Appears smooth and shiny and composed of thin, nonkeratinized epithelium.

alveolar mucosa

The alveolar mucosa is separated from the alveolar gingiva at the ____________.

MGJ

A cufflike band of squamous epithelium that completely encircles the tooth and is attached to the tooth. The base of the sulcus is formed by this.

junctional epithelium

The innermost part of the JE that attaches to the tooth by hemidesmosomes and the basal lamina.

epithelial attachment

The fibrous connective tissue that surrounds and attaches the tooth roots to the alveolar bone.

PDL

The PDL is connected to cementum and bone by collagen fibers called:

Sharpey's fibers

Where PDL fibers are anchored and where rich vascular supply penetrates. Composed of compact or cortical bone and spongy bone.

alveolar process or bone

Gingival diseases have two classifications:

plaque-induced gingivitis

non-plaque-induced gingivitis

plaque-induced gingivitis includes:

1. Gingival diseases modified by systemic factors

2. Gingival diseases modified by medications

3. Gingival diseases modified by malnutrition

4. Dental plaque causing only

Non-plaque−induced gingivitis includes:

1. Gingival diseases of viral, bacterial, fungal, and genetic origin

2. Gingival manifestations of systemic conditions

If less than 30% of sites in the mouth are affected, the disease is:

localized

If more than 30% of the sites in the mouth are affected, the disease is:

generalized

Disease severity is determined by the amount of clinical attachment loss as:

slight or early

moderate

severe or advanced

Signs of Gingival Infection:

Changes in color

BOP

Swelling or edema

presence of exudate from the gingival sulcus

In gingivitis, gingival texture becomes __________ and __________ from loss of stippling and presence of edema.

smooth and shiny

In gingivitis, marginal gingiva becomes:

rounded or rolled

When the col area is inflamed, epithelial and connective tissue layer degeneration can result in a:

blunted papilla

a split interdental papilla

cratered papilla.

_________ rarely is found in healthy gingiva.

exudate

GCF is called __________ when it is a clear, serous liquid.

suppuration (pus)

The distance from the gingival margin to the base of the sulcus or pocket.

probing depth

When the JE has migrated below the CEJ but remains above the crest of the alveolar bone. Horizontal bone loss.

Suprabony periodontal pocket

A reduction of the height of the marginal gingival to a location apical to the CEJ. Signifies attachment loss.

gingival recession

Common mucogingival conditions:

-recession

-absence of attached gingiva

-probing depths that reach and extend beyond the MGJ resulting in no attached gingiva

Areas with limited zone of attached gingiva

inadequate attached gingiva (IAG)

No bone loss.

gingivitis

used to assess gingival inflammation based on color, consistency, and bleeding on probing. It is based on the assumption that a slight color change is indicative of gingival inflammation.

Gingival Index (GI)

A demineralized area of enamel that usually has an intact surface remaining over the body of the demineralized early carious lesions.

white spot lesion

Four caries disease indicators for caries risk assessment:

1. Teeth with frank cavitations or lesions that radiographically show penetration into dentin

2. Approximal radiographic lesions confined to enamel only

3. Visual white spots on smooth surfaces

4. Any restorations placed in the last three years

Caries risk factors:

-Medium or high S. mutans and lactobacilli counts

-Visible heavy plaque biofilm on teeth

-Frequent snacking between meals

-Deep pits and fissures

-Recreational drug use

-Inadequate salivary flow

-Saliva-reducing factors

-Exposed roots

Biologic or therapeutic factors that collectively can offset the challenge presented by the caries risk factors.

caries protective factors

Caries protective factors:

-Lives, works, and attends school in fluoridated community

-Uses fluoride toothpaste at least once daily

-Uses fluoride toothpaste at least twice daily

-Uses fluoride mouth rinse daily

-Uses 5000 ppm fluoride toothpaste daily

-Had fluoride varnish applied in the last 6 months

-Had an office fluoride topical application in the last 6 months

-Used prescribed chlorhexidine daily for 1 week during each of the last 6 months

-Used xylitol gum or lozenges four to five times daily for the last 6 months

-Used calcium and phosphate supplement paste during last 6 months

-Has adequate salivary flow

Caries management involves:

-Suppressing the bacteria that cause the infection

-Remineralizing early noncavitated carious lesions (increasing salivary flow, fluoride, and use of calcium and phosphate paste products)

-Protecting tooth surfaces with the use of sealants and fluorides

-Decreasing the frequency of sugar intake

-Surgically removing carious lesions and restoring

the teeth