HOSA Dental Science Written Exam

Hesi-Re

First recognized figure in dentistry, practiced in 3000

Egyptians

Excavations of their pyramids shows that they paid great attention to dental care. In burial remains, mummies of the time had their teeth filled with gold restorations.

Methods of early times

Dentistry consisted primarily of removing teeth, holes were drilled in the skull near roots to allow infections to drain and most problems came from tooth preparation techniques

Hippocrates (460-377 B.C.)

Father of medicine who attempted to explain health and disease. He was the first to teach an educated method of medical care. He felt it was important to keep teeth in good condition and he developed his own toothpaste and mouth rinse. He wrote about formation, eruption, diseases of teeth, and methods of treatment. He designed some extraction instruments to make removal easier and safer. He advocated for physicians to have confidentiality with their patients and founded his Hippocratic Oath which is a basic code for ethics for medical and dental professionals to “do no harm” **SHORTEN**

Diocles of Carystus (384-322B.C.)

Athenian physician and pupil of Aristotle who stated that oral hygiene should get proper attention and gave instructions to this end.

Grit

Caused severe wear of the occlusal bite in the surface of the tooth and possible pulp exposure this is because pieces of stone were mixed into the grain.

Guy de Chauliac (1300-1368)

French surgeon who wrote the “Hygienic Rules for Oral Hygiene” and became one of the 14th century’s most influential authors on surgery. Not all the information is entirely accurate, but much is still used today such as sweet foods increase decay.

Leonardo da Vinci (1452-1519)

Artist who dissected the human skull and was the first to differentiate between molars and premolars which would further define tooth morphology.

Pierre Fauchard (1678-1761)

French dentist who wrote “Le Chirurgien Dentiste” about step-by-step procedures with pictures. He rejected the tooth worm theory and claimed “caries” were caused by hormonal imbalance and advocated for treating diseased gingival tissue. He noticed that he could straighten teeth by using braces. He also developed a manual drill and believed once decay was removed, something should replace the missing structure, a technique still used today. His findings were extremely beneficial and he is referred to as the “Founder of Modern Dentistry”.

Wilhelm Conrad Roentgen (1845-1923)

German physicist who discovered x-rays in 1895

Robert Woofendale

One of the first dentists to arrive in the U.S. who placed an advertisement in November 17,1766 stating that he performs all operations upon the teeth

John Baker

Advertised in the Boston area and wrote about fillings and artificial teeth. He was also well known for treating George Washington.

John Greenwood (1760-1819)

George Washington’s favorite dentist who had little formal education, but was proficient. He advocated for children’s dental care and believed that tartar should be regularly removed for good oral health.

Paul Revere (1735-1818)

Silversmith and dentist who made surgical instruments and artificial teeth. He was also the first to use dental forensics to identify remains and trained Josiah Flagg.

Josiah Flagg

Skilled surgeon who was accomplished in several procedures, but his largest contribution was the construction of the dental chair. The chair had an extension on the arm and an adjustable headrest.

James B. Morrison

Created the first dental engine with a functioning handpiece, motor, and foot treadle.

Horace H. Hayden (1769-1844)

Sought dental care from John Greenwood, practiced dentistry in Baltimore and helped open the first dental college, the Baltimore College of Dental Surgery with Harris on March 6, 1840.

Chapin A. Harris (1806-1860)

Studied with Hayden and wrote dental literature such as his own, “The Dental Art: A Practical Treatise on Dental Surgery” and published the first dental dictionary. He helped open the first dental college with Hayden and was a main founder of the American Society of Dental Surgeons in 1840 which later became the ADA.

Baltimore College of Dental Surgery

Founded on March 6, 1840 and is now called the School of Dentistry at the University of Maryland and is home to the Dr. Samuel Harris National Museum of Dentistry.

Dr. Greene Vardiman Black (1836-1915)

Referred to as the “grand old man of dentistry”, he taught at dental schools and became a dean who invented several machines for testing alloys and instruments to refine cavity preparations. He conducted research on amalgam formulation and cavity prevention and his contributions are still used today.

Arthur D. Black

Son of G.V. Black who developed the Index to Dental Periodical Literature which allowed general dentists to improve their skills.

Lucy Beaman Hobbs Taylor

The first woman to graduate from a dental college in 1866.

Dr. Robert Tanner Freeman

The first African-American to earn a dental degree in 1869 from Harvard.

Ida Gray

First African-American woman to earn a dental degree in 1890 from University of Michigan.

George Franklin Grant

African-American who graduated in 1870 at Harvard who is credited as an authority on the cleft palate.

American Society of Dental Surgeons

Formed in 1840, but dissolved in 1856. Chapin A. Harris was instrumental in finding it and had a journal called the American Journal of Dental Science.

American Dental Association (ADA)

Founded by 25 delegates in New York in 1859. There are national, state, and local organizations that report to each other for bylaws. It’s official publication is the “Journal of the American Dental Association”.

Sterilization Assistant

Dental assistants that sterilize treatment rooms and instruments. They must monitor sterilizers, water lines, ultrasonic units, cold chemical solutions, and biohazard material and stay informed on chemicals and PPE.

American Dental Assistants Association (ADAA)

Founded in 1924 by Juliette Southard on the principles of education, efficiency, service, and loyalty. Members have a voice in national affairs, opportunities to continue education, professional liability insurance, and interaction with other professionals. It’s official publication is “The Dental Assistant, Journal of the ADAA”.

High-Speed Handpiece

A foot treadle was developed by James Morrison in 1871, by the late 1800s, the electric drill was invented. The Airotor handpiece developed in 1957 was the most proficient of these.

Dr. Ignaz Semmelweis

A Vienna physician who demonstrated that routine hand washing could prevent the spread of disease in the 1850s starting the revolution of stopping disease in the workplace.

Florence Nightingale (1820-1910)

English nurse who researched hospital sanitary and formalized standard cleanliness and sanitation in hospitals and the military.

Joseph Lister

Advocated for disinfection with chemicals in 1867 and believed the “germ theory” would infect wounds, so he introduced disinfection in the operating room and the use of gloves.

Center for Disease Control (CDC)

This organization began infection control in the 1970s and expanded from a center of epidemiology to the prevention and control of infection spread. Universal precautions were developed in 1987 to prevent spreading bloodborne pathogens such as gloves, PPE, eyewear, and masks.

Occupational Saftey and Health Administration (OSHA)

Organization that created standards that protected the nation’s healthcare workers exposure to pathogens. The standard included exposure control measures and the use of PPE.

Nitrous Oxide

Gas that makes patients not feel pain when injured that was introduced to dentistry in 1844 by Horace Wells. It is still used today to reduce patient anxiety associated with dental care.

Local Anesthesia

Localized medicine was sought after the introduction of Nitrous oxide, so Lidocaine to ease pain during dental procedures.

Dr. C. Edmund Kells

First to use x-rays in the dental field after reading Roentgen’s work. He developed a film and holder to fit into the patient’s mouth and the use of dental x-rays was born in 1895.

Silicate Cement

First used in 1908 as an esthetic restorative material for anterior teeth, but it didn’t last long due to its solubility.

Ultraviolet Light Curing

First used in 1973 and changed how esthetic dentistry was performed because dentists could cure from the inside out in layers.

Cross-Training

Being skilled in part art, part science, and part business. As a dental assistant, having these skills will make your services more valuable.

Direct Care Dental Team

Hands on work with a patient present in the dental chair.

Dentist (DDS or DMD)

Leader of the dental team who is the only member who diagnoses oral disease and can perform irreversible procedures. They must complete undergrad, dental school, and pass a national and state recognized exam to earn a Doctor of Dental Medicine degree or a Doctor of Dental Surgery degree.

Forensic Dentistry

Area of dentistry that requires additional training, but is not regarded as a dental specialty. They deal with identifying bite marks on the body, identifying an individual through tooth restoration and morphology using dental records.

Dr. Alfred Civilon Fones

Stated that dentists can't be surgeons and clean teeth. He established first dental hygiene school in 1913, Fones School of Dental Hygiene and trained Irene Newman.

American Dental Hygiene Association (ADHA)

Formed in 1923 in Cleveland in conjunction with the ADA meeting. In 1927, the "Journal of the ADHA" became its official publication.

Dental Hygienist (RDH or LDH)

Specialty that focuses on preventative treatment, evaluates periodontal health, removes calculus, and provides clean tooth surfaces below the gingiva, prophylaxis, and patient education. Some states allow them to apply sealants, mount dental radiographs, chart conditions in the oral cavity, inject local anesthetics, or administer nitrous oxide. They must complete one year of dental hygiene prerequisites before being accepted into an accredited program so they can pass the national and state written and clinical exam.

Dr. C. Edmund Kells

He hired a woman to replace men in chairside assisting to be “quick, quiet, gentle, and attentive”. He employed Malvina Cueria who was the first dental assistant in modern history and women in the office was accepted quickly.

Malvina Cueria (1893-1991)

First dental assistant in modern dental history hired by Dr. C. Edmund Kells. By 1911, it was common for dentists to employ assistants.

Dental Assistant

Graduates from an ADA accredited institution with one year of training before the state exam. They may perform intraoral procedures such as placing retraction cord, dental dams, and patient education. They may also do task such as instrument setup and patient seating and dismissing.

Dental Assisting National Board (DANB)

National certification board for dental assistants recognized by 39 states, each with different requirements. DA’s with this certification get increased pay, and they have 3 years to pass the 3 exams: RHS, ICE, and GC.

Expanded Functions Dental Assistant (EFDA):

Dental assistants who may perform more abilities such as placing sealants, nitrous oxide administration, removing sutures, etc. Their knowledge makes them the most desirable dental assistant.

Dental Business Assistant

Works in the front office of a dental practice and is the first person a patient contacts. They schedule appointments, communicate with patients, and handle financial issues.

Certified Dental Laboratory Technician (CDT)

Person who works with models of a patient’s mouth and makes prostheses such as crowns, bridges, and veneers, and sometimes retainers and dentures.They work with precious metals like gold or lifelike materials like porcelain and may work in the dental office, or a private dental lab. They may get trained on the job or graduate from a CODA-accredited program.

American Dental Laboratory Technician Association (ADLTA)

Membership for dental laboratory technicians.

Commission on Dental Accreditation (CODA)

National program accrediting agency for dental and dental-related education programs at the post-secondary level.

Dental Products Salesperson

Person who brings product expertise to the dental practice by being aware of the latest dental products to allow dentists to provide optimal patient experience.

Dental Educator

Person who uses real-world experience to teach others. They must ensure students understand material to past credentialing exam and instill skills they will need to use in their careers.

Dental Service Technician

Person who maintains dental equipment and works with the dental assistant to identify equipment problems and make service calls.

Dental Representative

Person who demonstrates how to use new materials and is typically trained beforehand on the materials they represent.

Dental Supply Company

Gives information about new materials and helps the dental assistant order supplies by making weekly calls to the office.

Dental Public Health

Specialty concerned with the prevention of dental disease; they work with the community to promote dental health.

Periodontics

Specialty concerned with the diagnosis, treatment, and prevention of diseases of the supporting tissues of the tooth. Patients who have plaque and calculus buildup and patients who have lost some of the bone around the tooth would be referred to them for further evaluation and treatment.

Endodontics

Specialty concerned with the pathology and morphology of the dental pulp and surrounding tissues due to injury and disease; patients referred with root canals typically see them.

Prosthodontics

Specialty concerned with the diagnosis, restoration, and maintenance of oral functions. This specialty is also concerned with the replacement of missing teeth through artificial means.

Orthodontics

Specialty concerned with the diagnosis, supervision, guidance, and correction of malocclusion in the dentofacial structures; braces for straightening teeth are placed by them.

Pediatric Dentistry

Specialty concerned with the prevention of oral disease and the diagnosis and treatment of oral disease in children, from birth through adolescence; other patients requiring special care due to emotional, mental, or physical problems are referred to them.

Oral and Maxillofacial Radiology

Specialty of dentistry and radiology concerned with the production and interpretation of images and data produced by all modalities of radiant energy that are used for the diagnosis and management of diseases, disorders, and conditions of the oral and maxillofacial region.

Oral and Maxillofacial Pathology

Specialty concerned with the diagnosis and nature of the diseases affecting the oral cavity; a patient with a lesion unknown to the general dentist may be referred to them for further treatment and diagnosis.

Oral and Maxillofacial Surgery

Specialty concerned with the diagnosis and surgical treatment of the oral and maxillofacial region due to injury, disease, or defects; a patient having third molars (wisdom teeth) removed may be referred to them.

Dental Home

Relationship between the dentist and the patient inclusive of all aspects of oral health care. Establishing this at a young age gives the child an environment to grow and develop while the pediatric dentist can provide information and preventative care.

Caregiver’s Importance

It is important to involve the caregiver in every aspect of the child’s treatment and for the dentist to keep them educated about the child’s needs, including treatment of primary teeth to start a habit of good oral health.

Function of Primary Teeth

Mastication, nutrition, speech, and appearance are their functions, and neglect of them can result in pain, infection, and malocclusion. Early treatment/ proper care is less costly than waiting to get treatments such as orthodontics and endodontics.

Pediatric Patient

Needs at least one parent at their appointment, and their family’s attitude affects theirs. Their behavior may be based on emotional and environmental and they should be evaluated individually regardless of their physical develop and maturity.

Children with Special Needs:

Pediatric dentists are trained to treat patients with ADHD, down syndrome, autism, asthma, cystic fibrosis, etc. A complete medical history is important to prepare to address these needs.

Pediatric Dental Assistant

Person who is trained to engage the child during appointments to establish trust during a procedure. The procedures are similar to those for adults, but they must also monitor the child’s behavior.

Child Abuse and Dental Neglect

Something that must be reported with confidentiality by dentist and dental assistant in order for the child to have adequate function of the mouth without pain and infection.

Dental Caries

Infectious and communicable disease with multiple factors that progress the disease, but is preventable. S. mutans can cause these at an early age, and reducing sweets and increasing cleaning can delay the decay, and lack of these can add decay to newly erupting teeth. Left untreated, these may need extraction.

Early Childhood Caries (ECC)

Presence of one or more decayed, missing, or filled tooth surfaces in a child 71 months or younger. The front teeth are usually affected first before slight decay in the posterior teeth.

Infant Oral Exam

Visit to dentist when first tooth erupts, usually before first birthday before caries process to begin early oral hygiene and dietary habits.

Pediatric Charting

Children normally develop 20 teeth, universally labeled A through T where A-J are found on the upper arch, and K-T are on the lower arch, the first to erupt are usually lower central incisors. They are then replaced by succedaneous, or permanent teeth. The teeth that erupt not replacing primary teeth are nonsuccedaneous and are numbered 1-32.

Charting Present and Missing Teeth

Charting mixed dentition can identify primary teeth by size, shape, enamel composition, shallow pulp chamber, and root resorption on radiographs.

Pediatric Conditions and Abnormalities

Pediatric dentists will look for conditions both clinically and radiographically such as crowding which may indicate future orthodontic treatment. They can also find that thumb sucking leads to an open bite and skeletal problems and encourage the patient to stop habit.

Common Abnormalities

Short Frenum attachments on lips or tongue, enamel hypoplasia, primary and permanent supernumerary teeth, congenitally missing teeth, over retained and early loss of primary teeth, cysts and impacted teeth that cause tissue damage all of which affect the child’s developing permanent dentition.

Prevention

Includes five major points such as oral hygiene, dietary instructions, fluoride, sealants, and routine dental checkups.

Oral Hygiene Instructions

The pediatric dentist or assistant will demonstrate techniques for cleaning the mouth and erupting teeth, and the caregiver must do this daily to help with discomfort such as massaging gums and cleaning them with a soft washcloth. As more teeth erupt, a toothbrush may be used.

Sequelae

Consequences of a disease. Caries and its sequelae are among the most prevalent problems in children.

Pediatric Dietary Guidelines

Avoid frequent ingestion of sugars and carbohydrates and have a balanced diet of milk, meat, vegetables, fruit, and grain.

Infant over one year

Should be weaned off bottle/breast and be introduced healthy foods to learn to stimulate dentition. Sippy cups should be only used at meals, not bedtime to avoid decay.

Fluoride Varnish

Recommended for preschoolers and high risk caries patients and is an application of 5% sodium fluoride with resin base that causes varnish to remain on teeth and be brushed away the next day. Can be applied every three to four months from birth - adolescence.

Fluoride Application

2-5 year olds should get a pea-sized amount to brush teeth and avoid fluorosis from excess ingestion of fluoride. When applied by professionals, it has more concentrated solutions and gets delivered in a tray.

Dental Sealants

Thin coating of unfilled resin applied to pits and fissures of posterior permanent molars and premolars. Seals out germs and food particles from fissures in chewing surface of tooth and lasts up to 5-10 years.

Regular Checkups

Reinforces the need for good oral health from infancy to adulthood and monitors growth and development of dentitions. Also provides early intervention to dental decay by taking routine radiographs which can also see abnormalities.

Frankl Behavorial Rating Scale

A way to classify a child’s behavior during treatment by using four categories including definitely positive where the child enjoys the situation (4), positive where the child is willing to comply(3), negative where the child is reluctant and uncooperative(2), and definitely negative where the child refuses and is forceful(1).

Pediatric Communication

Number one tool in pediatric dental team for both caregiver and child during procedure. Positive approach should be taken by being truthful, making eye contact, maintaining control, and praising child at the appointment.

Communication

The act of passing along a message, transmitting an idea, or providing feedback

Components of Communication Process

Sender, message, channel through which the message is delivered, receiver, feedback

Sender

The individual who begins the communicative process by generating a message.

Stimuli to begin communication

The senses of taste, smell, touch, feelings of delight, hunger, fatigue, anger, or others.

Encoding

The use of specific signs, symbols, interpersonal communication, or language in sending a message.