Pre-clinical dental hygiene Exam 1 review

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75 Terms

1
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individual autonomy and respect for human beings

People have the right to be treated with respect. They have the right to informed consent prior to treatment, and they have the right to full disclosure of all relevant information so that they can make informed choices about their care.

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confidentiality

respect the confidentiality of client information and relationships as a demonstration of the value we place on individual autonomy. We acknowledge our obligation to justify any violation of confidence

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societal trust

We value client trust and understand that public trust in our profession is based on our actions and behavior.

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non-maleficience

We accept our fundamental obligation to provide services in a manner that protects all clients and minimizes harm to them, and others involved in their treatment.

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beneficence

We have a primary role in promoting the well-being of individuals and the public by engaging in health promotion/disease prevention activities.

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justice and fairness

We value justice and support the fair and equitable distribution of health care resources. We believe all people should have access to high-quality, affordable oral healthcare.

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veracity

We accept our obligation to tell the truth and expect that others will do the same. We value self-knowledge and seek truth and honesty in all relationships

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standard precautions

protects DHCP dental health care professional and patients from transission agents such as

  • blood

  • saliva

  • all bodily fluids except sweat

  • nonintact skin

  • mucous membranes

Body fluids of ALL patients are
treated as if they were infectious.
● Exposure Control Plan
● Consistency between HCP’s to
prevent Cross-Contamination

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universal precautions

most emphasis on bloodboorne pathogens

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cross contamination

  • spread of microorganisms from one source to another

    • person to person

    • person to inatimate object and then to another person

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factors that influence infection

  • number of organisms

  • virulence

  • immune status of the host

  • general physical health and nutritional stauts

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classification of aerosols

  • small 3-5 microns

  • breathed into lings

  • cavitron

    • larger remain airborne a short time visible

    • greater than 50 microns

    • particle from cavity prep or daliva

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tuberculosis

Transmission: Inhalation of tubercle bacilli
○ Mycobacterium tuberculosis
● Symptoms:
○ Low-grade fever
○ Loss of appetite
○ Weight loss
○ Tires easily
● May have reactivation tuberculosis
● Clinical examination: look for lymphadenopathy

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hep a transmission

fecal oral

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hep b transmission

All body fluids carry the virus
■ Blood, saliva, semen, and vaginal fluids are infectious
■ Percutaneous
● Needle sticks
■ Sexual exposure
■ Blood transfusions or blood products

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hep c transmission

Percutaneous
○ Parenterally
○ Blood
○ Found in saliva
● 4 million infected in the US*
○ Upgraded from 3.2 million
● 80% develop chronic infection
● Baby Boomers!
○ Born 1946 - 1964
○ Sex, Drugs, Rock & Roll

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hep b prevention

Immunizations
■ 95% effective
■ After 15 year check status
○ Safe use of disposable syringes and needles

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The vaccine for Hepatitis B protects
against?

Hepatitis D

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human herpesviruses

Highly infectious
● Produce latent, recurrent tendencies
● Immunosuppressed patients are at risk - opportunistic

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HPV

Over 200 Types
○ 40 can infect genital and oral areas
● Types 16 & 18
○ 80% of cervical cancer
○ Type 16 is most likely oncogenic HPV to
progress to cancer and is attributed to
95% of head and neck cancers
● Vaccination
○ 3 Step
○ Children 11-12 years
○ Up to age 26

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HIV Infection

HIV-1 is the virus
HIV attacks the immune system
● CD4 T Lymphocytes
● Unable to fight off
● infection, disease, cancer
● Opportunistic infections – AIDS
● Antiretroviral Therapy
● Strict ART regimen can achieve viral suppression.
● Preexposure Propholaxis - PrEP
● Prevents HIV infection in high-risk indivisuals

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MRSA

Found on healthy human skin
● Causes serious infection when
enters the bloodstream or
subcutaneous tissues
● Transmitted by direct and indirect
contant
● Resistant to antibiotic therapies

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reccomended vaccines

Hep. B, Influenza, Measles, Mumps, Rubella, Varicella, COVID-19

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critical items

instruments anything the comes in contact with blood or tissues

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semi critical items

items that go in the mouth but no blood

mirror impression xcp

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noncritical items

items that are contact with the the pt but not the mouth ]

bp cuff and dental chair

27
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modified pen grasp index and thumb

  • on the instrument handle

  • holds instrument

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modified pen grasp middle finger

  • rest lightly against the shank

  • helps guide working end

  • feels vibrations transmitted from working end to shank

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modified pen grasp ring finger

on oral structure often tooth

advances ahead of the other fingers in the grasp

stabilizes and supports the hand for control and strength

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modified pen grasp pinky

near ring finger held in a naural relaxed manner

has no function in the grasp

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work related ergonomic risk factors

Repetitive motion
● Frequent resisted hand/finger motion
● Use of vibrating instruments
● Forceful pinching & gripping of small
diameter instruments
● Static posture

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workplace related risk factors ergonomics

Patient & operator's chair
● Placement & design of delivery unit
● Scheduling
● # of patients
● Work hours

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worker related risk factors ergonomics

Work style
● Stress level
● Posture
● Attitude
● Fitness

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what is ergonomics 

Science of fitting physical & psychosocial work and work environment
to the individual
● Term coined in 1950
● Greek
○ "Ergon" – work
○ "Nomos" – natural laws

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WMD

work-related musculoskeltal disorder

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CTD

Cumulatative trauma disorder

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RSI

repetitive Strain Injury

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neutral posture 

Appendages are neither away nor
toward the body's midline
● Shoulders are not abducted,
overextended, hunched
● Trunk is not flexed forward or
extended backwards, twisted or
laterally bent
● When seated – buttocks, thighs, legs
are evenly supported; arches behind
knees are open for free circulation;
lumbar region is supported

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risk reduction 

Instrument handle design
● Use only enough force to get job done
● Alternate using hand and vibratory instruments
(power scalers, handpieces)
● Wear proper fitting gloves
● Avoid excessive finger motion
● USE A MIRROR FOR INDIRECT VISION

Integrate stretches into daily routine

Stretch regularly - 3 minutes every hour

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masticatory mucosa

  • Masticatory mucosa 

    • Surrounds the necks of the teeth 

      • Free

      •  Interdental 

      • Attached

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alveaolar mucosa

  • Mucogingival Junction

  •  Alveolar mucosa, 

  • Frenum

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the three Cs

-color

contour

consistency

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color 

  • Usually pink

  • Color will vary depending on

    •  Thickness of tissue

    •  Keratinization

    •  Pigmentation

    • Vascularity

    •  Presence of disease

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contour

  • Flat and knife-like

  • Snugly adapted to the tooth

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consistency

  • Texture/ smooth

  • Density:  firm and resilient

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Col

  • Central depression or concave area that is non-keratinized

  • Between buccal & lingual papillae

  • Conforming to interproximal bone

  • Inflammation starts here

  • looks like sagging tent

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attached gingiva 

  • Continuous with the free gingiva

  • Keratinized Stratified squamous epithelium

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gingival fiber groups

Bundles of Gingival Fibers connect the gingiva to the bone and/or the tooth to provide support during chewing

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alveolar mucosa

  • Thin, 

    • Non-keratinized stratified squamous epithelium

  • Movable 

    • Loosely attached to bone

  • Continuous

    • Different from the free & attached gingiva

    • the color is redder and highly vascular

    • indefinite contour smooth and shiny texture

    • soft and thin

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uses of the perio probe

  1. Assess the Periodontal Status for Preparation of a Treatment Plan

  2. Determine Clinical Attachment 

  3. Conduct Mucogingival Examination

  4. Make Other Gingival Determinations

  5. Guide Treatment

  6. Evaluate Success and Completeness of Treatment

  7. Evaluation at Continuing Care and Periodontal Maintenance Appointments

  8. Measure Oral Lesions for Clinical Documentation


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gingival sulcus or crevice

  • crevice or groove between the free gingiva and the tooth

  • 1-3mm in health

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gingival pocket or pseudopocket

  • formed by gingival enlargement without apical migration of the junctional epithelium

  • >3mm

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periodontal pocket

  • pockets form from disease or degeneration

  • causing apical migration of junctional epithelium/epithelial attachment

  • >3mm

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<p>parts of the probe&nbsp;</p><p></p>

parts of the probe 

  • Handle

  • Angled shank

  • Working end

    • Blunt end

    • Calibrations

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marquis

round; color-coded; calibrations at 3, 6, 9, 12 mm

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williams

  • round or flat; calibrations at 1, 2, 3, 5, 7, 8, 9, 10 mm

57
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who

  • round; ball tip; calibrations at 3.5, 5.5 mm

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nabors

  • round; curved, color-coded; calibrations at 3, 6, 9, 12

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unc 15

  • round – calibrations at 1,2,3,4,5,6,7,8,9,10, 11,12,14, 15

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working end of probe

  • Slender, rod-like working ends

    • Cross-sections

      • Round 

        •  easy to adapt

        • may puncture epithelial attachment

      • Oval

      • Flat 

        •  less likely to puncture

        • difficult to adapt interproximally

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probe selection criteria

  • Adaptability

    • Should adapt to the circumference of tooth

  • Markings

    • Easy to read

  • Length

    • Healthy mouth v. disease

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assess the periodontal status

Preparation of treatment plan

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perform a sulcus 

perform a sulcus  an pocket survey 

  • Shape, 

  • Topography 

  • Dimensions

  • Measure depths 

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perform a muco gingval exam

  • Determine width of attached gingiva

  • Mucogingival involvement

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make other gingival determinations

  • Bleeding upon probing – indicates disease

  • Recession

  • Plaque control

  • Any measurement :  crown length, diastema, pathology, overbite, overjet, lesions, etc)

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guide to treatment

  • Detect anatomical configurations (roots)

  • Detect submarginal deposits

  • Determine depth of pocket &  instrument selection


  • Evaluate success of treatment

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pocket characteristics

  • depth vries on each area of very tooth

  • location of margin

  • location of attachment

  • pockets tend to be deepest in the col area

  • anatomical features of the tooth influences prob direction (crown and root shape)

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Dental Hygiene Process of care

ADPIED

Asses, Dagnose Plan Implement Evaluate Document

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Diagnose

Problem Identification

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Plan 

selection of interventions

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implement

activating the plan

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evaluate

feedback on effectivness

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document

comprehensive record-keeping

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assess

data colection