Dental Hygiene National Board

What are some examples of bio-hazard waste?

Sharps, items that drip of blood and/or saliva, and hard and soft tissues removed from patient

The bio-hazard waste or regulated true or false?

True

When should we change our mask?

When it becomes wet or soiled with every patient. That includes your fluids as well.

What is the purpose of PPE?

Is to minimize the exposure to Aerosol, Spatter, Direct transmission, and Indirect transmission (ASDI)

Do disinfectants kill spores?

NO

What are some types of disinfectants?

Chlorine-based compounds, iodophors, phenols, quaternary compounds

What are some bad qualities of chlorine-based compounds?

corrosive to metals and strong odor

What are some bad qualities of phenols?

may leave a film or residue on surfaces

What are some bad qualities of iodophors?

can discolor some surfaces yellow

What are some bad qualities of quaternary compounds?

not corrosive, but have a lower kill spectrum

What would be some good qualities of disinfectants?

rapid, broad spectrum antimicrobial, bacteriocidal, fungicidal, tuberculocidal, virucidal, odorless, easy to use, fast acting, economical, residual effect which it continues to work after it dries, not toxic to touch or inhalation, EPA registered, and disinfects and cleans.

Is a spatter invisible to the eye?

NO, can see it when airborne

Is aerosol invisible to the eye?

yes, remain in the air for a while

What sheet provides an employee with information regarding the hazards of chemicals utilized in the office and how to protect themself?

MSDS (Material Safety Data Sheet)

What disinfectant should not be used as a surface disinfectant in the office and why?

Glutaraldehydes, toxic effects of fumes; also corrosive

What kind of disinfectants are used in the dental office?

Intermediate

What are some methods of sterilization?

Chemical, Dry, and Steam

During chemical sterilization, how long at what degree and pressure are used?

20 min @ 270 degree F @ 20-40 lbs psi

During Dry sterilization, how long at what degree are used?

60-120 min @ 320 degree F

During Steam sterilization, how long at what degree and pressure are used?

20-30 min @ 250 degree F @ 15-30lb psi

What method of sterilization involves the least temperature?

Steam at 250 degree F

What are some considerations when using the chemical method?

ventilation is necessary, may damage rubber and plastic items

What are some considerations when using the dry method?

recommended for metal instruments, avoid paper products, may damage, rubber and plastic items, and not recommended for handpieces.

What are some considerations when using the steam method?

corrodes non-stainless steel instruments, dulls instruments and burs, ok for some plastics; cotton rolls and gauze, paper packages come out wet and tear.

What is the only way to tell if the instruments are sterilized?

A weekly spore test

Does indicator tape always guarantee sterility?

NO, only spore test

What spore test is used with chemical sterilization?

Geobacillus (formerly Bacillus) stearothermophilus

What spore test is used with dry sterilization (static air)?

Bacillus atrophaeus/ subtilis

What spore test is used with steam sterilization?

Geobacillus (formerly Bacillus) Stearothermophilus

What 2 sterilization methods use the spore test Geobacillus (Bacillus)?

Chemical and Steam

What is another name for spore testing?

Biological Indicators

What should the Dental Hygienist do if there are any questions regarding the patients medical hx?

Always contact the patient's physician first

What is the systolic pressure?

ventricles of the heart contract sending blood into circulation

What is the diastolic pressure?

ventricles of the heart relax to fill with blood returned by circulation

What is tachycardia?

rapid pulse rate; over 100 beats per min.

What is bradycardia?

slow pulse rate; below 50 beats per min.

What is the normal HR for children (1-10yrs)?

70-120 beats per min.

What is the normal HR for adults?

60-100 beats per min.

What is the normal HR for infants?

100-160 beats per min.

What is the normal blood pressure for adults?

> 120/80

What is stage 1 hypertension (mild) considered?

140/90 - 159/99

What is stage 2 hypertension (moderate) considered?

160/100 +

What is the normal respiration rate for a child?

14-26 breaths per min.

What is the normal respiration rate for an adult?

12-20 breaths per min.

What is the normal respiration rate for an infant?

30-60 breaths per min.

Where do we place the cuff on an adult for blood pressure?

over the brachial artery

Is high blood pressure in African Americans very common?

YES

When assessing a patient what are some areas we look at?

under care of a physician, hospitalized in last 5 yrs, medications, smokers, pregnant, medical hx, social hx, and chief complaint

What is an example of social hx?

If a patient likes to drink red wine socially all the time (particularly for anesthesia)

What may a smokers chief complaint be, and what do we respond?

Whiter teeth, we respond that bleaching would work

What conditions may fall into an ASA II?

noninsulin-dependent diabetes melliturs, asthma, epilepsy, stage 1 hypertension, health pregnacy

What conditions may fall into an ASA III?

insulin-dependent diabetes mellitus, congestive heart failure, state 2 hypertension, Aids, chronic COPD

What conditions may fall into an ASA IV?

severe congestive heart failure or COPD, and kidney or liver failure

During class 1(mesognathic) occlusal relationships, where are the teeth positioned for molar to molar?

MB cusp of the max. 1st molar is in the buccal groove of the mand. 1st molar

What is the canine relationship for class 1?

max. canine occludes with the distal half of the mand. canine and the mesial half of the mand 1st molar

What is the molar relationship with class 2 (retrognathic)

buccal groove of the mand. 1st molar is distal to MB cusp of the max 1st molar

What is the canine relationship with class 2?

distal portion of the mx. canine is mesial to the mesial portion of the mand. canine

What is the molar relationship with class 3 (prognathic)?

buccal groove of the mand 1st molar is mesial to the MB cusp of the max 1st molar

What is the canine relationship with class 3?

mesial portion of the max. canine is distal the distal surface of the mandbular canine

What can cause class 2 occlusal relationship (retrognathic)?

tongue thrusters, and thumb sucking

What is a class 1 restortation?

Pits and fissures on lingual surfaces of anterior and on occlussal, buccal, and lingual surfaces of posterior teeth

What is a class 2 restoration?

proximal surfaces of posterior teeth; commonly involves occlusal surfaces.

What is a class 3 restoration?

proximal surfaces of anterior teeth; does not include incisal edges

What is a class 4 restoration?

proximal surfaces of anterior teeth; involves the incisal edges

What is a class 5 restoration?

cervical gingiva 1/3 of the facial and lingual surfaces of any tooth. (root caries)

What is a class 6 restoration?

Incisal edge of anterior or cusp tips of posterior teeth

When finding midline deviation, what part of the mouth are we looking at?

We will look at the mandible in accordance with the maxillary. Do not aline the maxillary with the mandibular arch.

What is the nutrient source for supragingival calculus?

saliva

What is the nutrient source for subgingival calculus?

crevicular fluid

What is calculus?

mineralized plaque, which is an irritant for the gingiva

What is the color of supragingival and subgingival calculus?

supra= white, yellow, or gray

sub=dark brown, dark green, or black

What are some calculus detecting explorers?

11/12 and pigtail for posteriors; orban-type for anteriors and cervical 1/3s of posterior teeth

What are some causes of extrinsic (exogenous) stain?

certain bacteria, food, beverages, and tobacco

What are some causes of Intrinsic (endogenous) stain?

pulpal necrosis, internal resorption, excessive systemic fluoride, and tetracycline use during development

Where is black line stain usually located?

on the cervical 1/3rd of facial and linguals

What is black line stain associated with?

iron, insoluble ferric sulfide, and gram- positive bacteria

What is bluish-green stain associated with?

inhaling metallic dust, most likely for an occupational exposure

What is brown stain associated with?

poor oral hygiene or drinking dark- colored beverages ( red wine, coffee)

What is dark- brown and black stain associated with?

tobacco product use

What is orange stain associated with?

chromogenic bacteria in plaque, poor oral hygiene

Where is orange stain typically found?

anterior teeth, cervical 3rd

What is yellow-brown and brown stain associated with?

chlorhexidine use or stannous flluoride ( which is from tin ion in fluoride)

What is green stain associated with?

poor oral hygiene, chromogenic bacteria,fungi, and gingival hemorrhage

What are the stains that were involved with poor oral hygiene?

brown, orange, and green

If stain is located on cementum, what is the choice of removal?

Instrumentation

What are the two ways we get rid of stain?

Instrumentation, and polishing

What can be some obstacles for probing?

calculus, over hanging restorations, caries, and bleeding

What is the first sign of gingivitis?

Bleeding

What is a class 1 furcation?

early evidence of bone loss; instrument can enter the depression leading to the furcation

What is a class 2 furcation?

moderate bone loss; instrument can enter furcation, but cannot pass between the roots

What is a class 3 furcation?

severe bone loss; instrument can pass between roots

What is a class 4 furcation?

same as class 3 except with evidence of recession

What is class 1 mobility?

involves slight horizontal mobility

What is class 2 mobility?

involves moderate horizontal mobility; greater than 1mm- with no vertical displacement

What is class 3 mobility?

involves severe mobility with possible combined horizontal and vertical movement

What is the PH for enamel and cementum when demineralization (critical PH levels) is involved?

enamel= below 4.5 to 5.5

cementum= 6 to 6.7

What are the 3 components of saliva that remineralize the teeth?

calcium, phosphate, and fluoride

What does it mean when fluoride is bactericidal?

destructive to bacteria; this is only is professional application

What does it mean when fluoride is bacteriostatic?

inhibits growth or multiplication of bacteria; this occurs daily with at home application

Does the hygienist need to polish the teeth before the application of fluoride?

No, fluoride will penetrate through pellicle and plaque