Chapter 29: Radiographic Techniques for Specific Oral Conditions

a

Which of these statements is false?

A) Not all patients have gag reflexes.

B) Gagging is an involuntary effort to free the airway.

C) A hypersensitive gag reflex is the most troublesome problem a dental radiographer encounters.

D) A gag reflex can be stimulated by the suggestion of gagging.

d

Which of the following statements regarding the gag reflex is correct?

A) Tactile stimuli result from the suggestion of gagging.

B) Psychogenic stimuli are a physical reaction to a feeling of the airway being blocked.

C) The radiographer should ask the patient, "Are you a gagger?"

D) Unless the patient brings up the problem of gagging, the radiographer should not mention it.

d

Each of the following statements regarding the gag reflex is correct except one. Which one is the exception?

A) The radiographer should not dismiss patient concerns about gagging as "all in the mind."

B) The radiographer should inform the patient that there are techniques to help minimize the gag reflex.

C) Most gagging patients are embarrassed by their involuntary reaction of gagging.

D) The radiographer should let the patient place the image receptor in his or her own mouth to help control the gag reflex.

b

Each of the following statements regarding the gag reflex is correct except one. Which one is the exception?

A) Some patients have a heightened gag reflex due to chronic sinus problems.

B) Mucus and saliva in the nasopharynx minimize the gag reflex.

C) A gag reflex may originate in the mind.

D) A gag reflex may be a response to physical stimuli.

a

Each of the following will help to reduce a gag reflex except one. Which one is the exception?

A) Exposing the maxillary molar projection first

B) Using the bisecting technique

C) Having the patient rinse with cold water prior to placement of the image receptor

D) Placing salt on the tip of the patient's tongue

a

Which of the following would be most likely to assist in controlling a tactile stimulated gag response?

A) Place a commercial edge-covering product over the image receptor.

B) Direct the patient to press the back of the head against the headrest.

C) Ask the patient to breathe deeply through the nose.

D) Project confidence while maintaining an empathetic attitude.

d

Each of the following management techniques will help avoid a gag response except one. Which one is the exception?

A) An empathetic response from the radiographer when the patient mentions a fear of gagging during the procedure

B) Using the power of suggestion to explain the tips and tricks the radiographer will apply for the patient to help avoid exciting the gag reflex

C) Asking for the patient's cooperation with performing distraction techniques during the procedure

D) Questioning the patient about his or her past history with a gag reflex prior to beginning the procedure

c

Which of the following is the best recommendation when it becomes impossible to place an intraoral image receptor because of an exaggerated gag reflex?

A) Substitute a size 0 image receptor.

B) Use topical anesthetic to numb the oral cavity.

C) Substitute an extraoral radiograph.

b

Each of the following will aid in minimizing a hypersensitive gag reflex during the radiographic procedure except one. Which one is the exception?

A) Avoid scraping the palate with the edge of the image receptor.

B) Begin the exposure in the posterior region.

C) Convey a confident attitude.

D) Suggest breathing exercises.

a

Which of these statements regarding acceptable alterations of radiographic technique is false?

A) Position the image receptor with the posterior edge a greater distance from the lingual surfaces of the teeth.

B) Position the image receptor perpendicular to the embrasures of the teeth of interest.

C) Expose two radiographs utilizing two different horizontal angles in the same region.

D) Redirect the horizontal angle to intersect the image receptor from the distal to avoid canine-premolar overlap.

c

Which of the following is correct when encountering a shallow palatal vault?

A) Absolute parallelism between the image receptor and long axes of the teeth is easier to achieve.

B) The cusp tips are most likely to be cut off of the image.

C) The vertical angulation can be increased up to 15 degrees and still produce a reasonably acceptable image.

D) The horizontal angulation will be more difficult to visualize.

b

Each of the following requires a decrease in exposure settings except one. Which one is the exception?

A) Children

B) Older adults

C) Edentulous regions

D) Mandibular incisor region

b

Which of the following statements regarding tori is correct?

A) A torus palatinus is located along the lingual surface of the mandible.

B) Tori are common bony protuberances in the oral cavity.

C) The oral mucosa overlying tori is thick and calloused.

D) The correct image receptor position should be on top of the torus.

b

Which of the following is not a reason to expose radiographs on an edentulous patient?

A) To establish the position of anatomical structures prior to implants

B) To assess the density of tori

C) To determine the quality and condition of alveolar bone

D) To detect retained root tips or impactions

d

Anatomical limitations may require that the radiographer knowledgably alter which of the following to obtain a diagnostic image?

A) Horizontal angulation

B) Vertical angulation

C) Positioning of the image receptor

D) All of the above

b

Positioning the image receptor slightly diagonally, with the front edge a greater distance from the lingual surfaces of molars than the back edge, will aid in

A) using the bisecting technique.

B) avoiding overlap of the contacts between adjacent teeth.

C) aligning the image receptor perpendicular to the embrasures.

D) eliminating patient discomfort.

b

Due to anatomy a premolar bitewing radiograph will almost always exhibit overlap between the

A) distal of the lateral incisor and the mesial of the canine.

B) distal of the canine and the mesial of the first premolar.

C) distal of the first premolar and mesial of the second premolar.

D) distal of the second premolar and mesial of the first molar.

c

To clearly image the proximal surfaces of malaligned or crowded teeth, which of the following may be necessary?

A) A smaller image receptor positioned lower in the oral cavity

B) A smaller image receptor positioned higher in the oral cavity

C) Additional radiographs varying the horizontal angulation

D) Additional radiographs varying the vertical angulation

d

Disto-oblique periapical radiographs are indicated for each of the following except one. Which one is the exception?

A) Suspected pathology located in the tuberosity area

B) Imaging impacted third molars

C) A patient who cannot tolerate posterior placement of the image receptor

D) Detection of interproximal caries

a

For a maxillary molar disto-oblique periapical radiograph, the vertical angulation is ________ that used for the standard paralleling technique.

A) increased by 5 degrees over

B) increased by 10 degrees over

C) decreased by 5 degrees from

D) decreased by 10 degrees from

b

Before starting the procedure, the radiographer should ask the patient, "Are you a gagger?"

a. True

b. False

b

If the patient mentions gagging, the radiographer should dismiss his or her concern as all in the mind.

a. True

b. False

a

To minimize a patient's gag reflex, the radiographer can apply distraction techniques.

a. True

b. False

a

Placing the image receptor to expose the anterior regions first can help avoid exciting a gag reflex.

a. True

b. False

a

In a patient with a strong gag reflex, the image receptor placement for the bisecting technique may be easier to achieve.

a. True

b. False

b

Patients with a large oral cavity and a high palatal vault do not have a gag reflex.

a. True

b. False

b

Stimuli that excites a gag reflex originating from a physical reaction to a feeling of the airway being blocked is called "psychogenic stimuli."

a. True

b. False

a

Using a distraction technique would produce the best results of suppressing a gag reflex that originates from psychogenic stimuli.

a. True

b. False

a

Placing table salt on the middle or tip of the patient's tongue has been shown to be effective at reducing the gag reflex.

a. True

b. False

a

Because the edentulous ridge is less dense, the amount of radiation needed to produce a diagnostic image is less.

a. True

b. False

b

To avoid overlap of contact areas on a molar bitewing radiograph, the image receptor should be positioned perpendicularly to the midpoint of the maxillary first molar.

a. True

b. False

b

Precise positioning of the image receptor and accurate angulation will eliminate overlap between the canine and first premolar on a canine periapical radiograph.

a. True

b. False

a

In patients with a low palatal vault, the vertical angulation can be increased up to 15 degrees to compensate for the lack of parallelism without noticeable distortion.

a. True

b. False

b

Bony outgrowths on the palate and lingual surfaces of the mandible are called "nodules."

a. True

b. False

b

he mucosa over tori is thick and calloused, so an image receptor can usually be comfortably placed on top of tori.

a. True

b. False

b

Periapical radiographs of an edentulous ridge should be exposed with the bisecting technique.

a. True

b. False

b

The external aiming device on an image receptor holder is the dictator of where the x-ray beam must be aimed.

a. True

b. False

a

The exposure settings for the maxillary molar region should be higher than those used in the mandibular anterior region.

a. True

b. False

a

In the totally edentulous patient, a fair amount of leeway in horizontal angulation is permissible.

a. True

b. False

a

Disto-oblique periapical radiographs are valuable in detecting impacted third molars.

a. True

b. False