Dental Assist

Who issues the Dental Assistant Certificate of Registration?

▰ The Texas Dental Association

▰ The American Dental Association

▰ The Texas State Board of Dental Examiners

▰ The Bureau of Radiation Safety

The Texas State Board of Dental Examiners

The Texas State Board consists of:

▰ 11 members

▰ 2 hygienists and 4 dentists

▰ 6 dentists, 3 hygienists, and 1 member of the public

▰ 2 dentists, 2 hygienists, 2 dental assistants, and 2 members of the public

▰ 11 members

What are the TSBDE Rules and Regulations?

▰ The codes of ethics

▰ The rules pertaining to dentistry in the state of Texas

▰ The rules pertaining to the Texas Dental Association code of conduct

▰ All of the above

▰ The rules pertaining to dentistry in the state of Texas

All of the following are required to obtain a Dental Assistant Radiology Certificate, except:

▰ A High School Diploma or GED certificate

▰ Successful completion of a current course in Basic Life Support (CPR)

▰ Completion of a dental assisting externship

▰ Paying all application, examination and licensing fees

▰ Completion of a dental assisting externship

What is the maximum amount of time a dental assistant may work in a dental office and take X-rays before being required to register with the Texas State Board of Dental Examiners?

▰ 12 months

▰ 9 months

▰ 2 years

▰ 6 months

▰ 12 months

Your registered dental assistant certificate must be displayed in each office where you work.

▰ True

▰ False

▰ True

Renewal for certificate holders:

▰ Is yearly

▰ Requires completion of 6 hours Continuing Education annually – OR – 12 hours per biannual registration period

▰ Requires proof of employment in a dental office

▰ Has to be paid for by the dentist you work for

▰ Requires completion of 6 hours Continuing Education annually – OR – 12 hours per biannual registration period

The following are actions permitted only for a licensed dentist, except:

▰ Taking an impression for a final permanent prothesis

▰ Owning an office with employees or another person to practice dentistry

▰ Allowing patients to believe you are a dentist

▰ Performing a visual dental screening using gloves, a tongue depressor, and a light

▰ Performing a visual dental screening using gloves, a tongue depressor, and a light

When a dental assistant performs a duty which he/she is not allowed to perform under the rules of the TSBDE, they are “practicing dentistry without a license.” In this situation, the following is true:

▰ The dentist who the assistant works for is fined $10,000

▰ It is a 3rd degree felony

▰ It is a class-A misdemeanor

▰ The person who asked the assistant to perform the duty will lose their license

▰ It is a 3rd degree felony

What activities are dental assistants permitted to perform under the Dental Practice Act?

▰ Take impressions of crowns

▰ Give anesthetic

▰ Take radiographs after successfully registering with the TSBDE

▰ Adjust dentures

▰ Take radiographs after successfully registering with the TSBDE

What qualifications must a dental assistant meet in order to place pit and fissure sealants?

▰ Cannot first polish the teeth to which sealant is applied

▰ Must work under the supervision of a Medicaid-licensed dentist

▰ Must have 4 years of experience as a dental assistant

▰ Completion of an 8-hour class in the placement of pit and fissure sealant

▰ Completion of an 8-hour class in the placement of pit and fissure sealant

True or False: In Texas, a dental assistant may not induce (initiate) nitrous oxide sedation, even if they hold nitrous oxide monitoring certification.

▰ True

▰ False

▰ True

A patient’s dental record:

▰ Is classified as privileged information and cannot be disclosed without signed authorization from the patient or the patient’s legal guardian

▰ Is owned by the dental office in which the dentist is employed

▰ The treating dentist is required to maintain these records for 20 years.

▰ Must be provided within five days upon the patient’s request.

▰ Is classified as privileged information and cannot be disclosed without signed authorization from the patient or the patient’s legal guardian

Duties that can be performed under general supervision can be performed with or without the dentist present in the office. The patient must be a patient of record, and the patient must have had an exam performed by the dentist in the last 12 months.

▰ True

▰ False

▰ True

Which of the following duties can a dental assistant perform under general supervision?

▰ The application of pit and fissure sealant, if the assistant has completed a pit and fissure course

▰ Coronal polishing, if the assistant has taken a coronal polishing course

▰ Interim treatment of a minor emergency, if the patient is a patient of record and has been examined by the dentist in the last 12 months

▰ Taking an impression for a permanent denture

▰ Interim treatment of a minor emergency, if the patient is a patient of record and has been examined by the dentist in the last 12 months

The following is privileged dental information, except:

▰ Dental x-rays

▰ The patient’s name, phone number, and social security number

▰ Information that is more than 7 years old

▰ Any information in the patient’s dental record

▰ Information that is more than 7 years old

The following are requirements of OSHA’s Blood Borne Pathogens Standard, except:

▰ Implementing universal precautions

▰ Flu vaccines

▰ Medical records on each exposed employee

▰ Recapping needles

▰ Flu vaccines

What is the correct sequence to put on Personal Protective Equipment (PPE)?

▰ Gloves only

▰ Gown, mask, eye protection, gloves

▰ Gloves, mask, eye protection, gown

▰ Gloves, eye protection, gown

▰ Gown, mask, eye protection, gloves

How is Hepatitis B transmitted?

▰ Hereditary

▰ Direct Contact

▰ Airborne

▰ Bloodborne

▰ Bloodborne

Which of the following is false?

▰ Protective gowns must be worn for all dental procedures

▰ Protective gowns do not need to be worn for all dental procedures

▰ Protective gowns must be worn for all dental procedures

After an accidental needlestick injury:

▰ The puncture wound must immediately be washed with soap and water

▰ The employee must be offered a medical evaluation, but the employee is not required to go

▰ After an explanation of what happened, the dental office must ask the patient to go for blood testing

▰ The blood tests are HIV, Hepatitis B, and Hepatitis C

▰ All of the above

▰ All of the above

The Center for Disease Control (CDC) recommends the following vaccines for dental assistants, except:

▰ Hepatitis B

▰ Flu

▰ Measles

▰ HIV

▰ HIV

Handwashing:

▰ Is the most important way to prevent the transmission of disease

▰ Is not important if you are wearing gloves

▰ Should be done for 5 seconds

▰ Can be done with hand sanitizer if you are assisting with a surgical procedure

▰ Is the most important way to prevent the transmission of disease

Methods to prevent cross contamination and disease transmission include all of the following, except:

▰ Proper hand washing

▰ Using reusable items wherever possible

▰ Following the Unit Dose concept

▰ Using barrier techniques

▰ Using reusable items wherever possible

Utility gloves:

▰ Are the same as silicone dishwashing gloves

▰ Are not necessary to clean small burs because small burs are difficult to handle with these gloves

▰ Must be worn when decontaminating the operatory

▰ Do not need to be puncture resistant

▰ Must be worn when decontaminating the operatory

Which chemical can you use to disinfect surfaces in a dental office?

▰ An iodophor

▰ Alcohol

▰ Glutaraldehyde

▰ Antimicrobial soap

▰ An iodophor

Which of the following is true about the sterilization of instruments?

▰ It is never okay to sterilize unwrapped instruments

▰ Sterilization cannot use dry heat

▰ If we use wraps with indicators that turn brown, we know the instruments are sterile

▰ It is important to label the packages with the date

▰ It is important to label the packages with the date

Handpieces:

▰ Are fragile instruments and should never be sterilized

▰ Must go in an ultrasonic bath before you put them in a sterilizer

▰ Must be flushed for 20-30 seconds before and after patient use

▰ Can be wiped down with disinfecting wipes between patients

▰ Must be flushed for 20-30 seconds before and after patient use

Bio-hazardous waste:

▰ Is any waste tainted with any amount of saliva or blood

▰ Must be removed from the dental office by a biohazardous waste service

▰ Includes patient bibs, disposable items, and gloves

▰ Can be disposed of in the regular trash if it is wrapped and sterilized

▰ Can be disposed of in the regular trash if it is wrapped and sterilized

Impressions and prostheses going into the lab:

▰ Need to be rinsed off with water

▰ May cause cross contamination

▰ Should be placed in a plastic bag immediately

▰ Cannot be sprayed with any disinfectant because it will distort the impression

▰ May cause cross contamination

The infection control quality assurance program consists of the following, except:

▰ Regular inspections by an infection control consultant

▰ A written quality control manual

▰ A checklist for infection control procedures

▰ Yearly review and training for employees

▰ Regular inspections by an infection control consultant

Which of the following is not considered as a sharp?

▰ Orthodontic wires

▰ Anesthetic carpules

▰ Scalpel blades

▰ Needles

▰ Anesthetic carpules

Which is true about herpes?

▰ It is not found in dental patients

▰ It is spread by direct contact

▰ It is airborne

▰ It is bloodborne

▰ It is spread by direct contact

As a dental assistant, I can….

▰ reuse a disposable item on another patient

▰ not reuse a disposable item on another patient

▰ not reuse a disposable item on another patient

A face mask should be changed (Pick 2):

▰ When it is visibly soiled with blood

▰ At the end of the day

▰ After every patient

▰ After lunch

▰ When it is visibly soiled with blood

▰ After every patient

Which is true for a radiograph?

▰ A bitewing is used to diagnose lesions at the end of the root

▰ A periapical is the ideal x-ray for the diagnosis of interproximal caries

▰ A CBCT is an extraoral x-ray ideally used to screen for pathology

▰ A bitewing is used to diagnose caries and early stage bone loss from periodontal disease

▰ A bitewing is used to diagnose caries and early stage bone loss from periodontal disease

Which of the following statements is true for vertical and horizontal angulation?

▰ Overlapped contacts are the result of incorrect horizontal angulation

▰ Foreshortening is the result of under-angulation of the x-ray beam

▰ To correct elongation, the operator must decrease the vertical angulation

▰ Overlapped contacts are the result of incorrect vertical angulation

▰ Overlapped contacts are the result of incorrect horizontal angulation

X-ray production is affected by all of the following, except:

▰ Kilovolts (kV)

▰ A timer

▰ Resistance or Ohms

▰ Milliamps (mA)

▰ Resistance or Ohms

Safety measures for patient protection include:

▰ Using a short beam indicating device

▰ Avoiding digital whenever possible

▰ Using a sensor or film holding device

▰ Sight developing film

▰ Using a sensor or film holding device

Which of the following is true about collimation and filtration?

▰ Restrict the size and shape of the x-ray beam and reduce patient exposure

▰ It requires a spot size of no more than 2.75 inches (7 cm) at the patient’s skin

▰ The filter is an aluminum disk that removes the long wavelengths of the beam, allowing only the short wavelengths through

▰ All of the above

▰ All of the above

The inverse square law is:

▰ Intensity = d²

▰ Intensity = 2d

▰ Intensity = 1/d²

▰ Intensity = 2x/d²

▰ Intensity = 1/d²

Which is true about the effects of radiation to cells and tissues?

▰ After low-level radiation exposure, there is an immediate visible effect on cells and tissues

▰ The effects of radiation are cumulative

▰ Cells and DNA cannot repair radiation damage

▰ All cells and tissues are equally sensitive to radiation exposure

▰ The effects of radiation are cumulative

What is the most important concept for radiation safety?

▰ Caries Management by Risk Assessment (C.A.M.B.R.A)

▰ As Intense As Reasonably Achievable

▰ As Low As Reasonably Achievable (A.L.A.R.A)

▰ The Texas Department of Radiation Safety

▰ As Low As Reasonably Achievable (A.L.A.R.A)

Safety measures for operator protection include:

▰ The operator should stand behind an appropriate barrier

▰ The operator is safe if the distance from the x-ray tube is at least 4 feet

▰ It is safe to hold the film for a small child

▰ You should position yourself at a 10º angle to the x-ray beam

▰ The operator should stand behind an appropriate barrier

Which of the following statements is true about infection control in radiography?

▰ You must always wear gloves, a mask, eye protection, and a protective gown when exposing radiographs

▰ When processing film, it is important to wear gloves to put film in the processor

▰ When using a digital sensor, use a barrier before inserting the sensor in the patient’s mouth

▰ The spray wipe spray method is the best way to handle infection control of the x-ray head and beam indicating device (BID)

▰ When using a digital sensor, use a barrier before inserting the sensor in the patient’s mouth

During x-ray procedures, you should:

▰ Obtain informed consent

▰ Place the film or sensor in the patient’s mouth before making adjustments to the machine

▰ Start exposures in the molar area

▰ Treat the patient without taking x-rays first, if the patient is afraid of x-rays

▰ Obtain informed consent

Which one of the following statements is true about radiation exposure?

▰ The benefits of x-rays do not outweigh the risk of radiation

▰ The radiation exposure from a digital full mouth series (FMX) is equal to 14 hours of background radiation

▰ A panoramic x-ray has more radiation exposure than a mammogram

▰ X-rays have a low perceived risk but a high actual risk

▰ The radiation exposure from a digital full mouth series (FMX) is equal to 14 hours of background radiation

Which statement is true about the techniques for intraoral radiography?

▰ The preferred technique is the bisecting angle technique

▰ The bisecting angle technique is better at showing tooth decay

▰ The preferred technique is the paralleling technique

▰ The position of the film or sensor is more comfortable for the patient in the paralleling technique

▰ The preferred technique is the paralleling technique

Which is true when using the periapical technique?

▰ Use the film holder to position the sensor or film parallel to the teeth

▰ The central ray is directed perpendicular to the sensor and parallel to the long axis of the tooth

▰ Place the sensor as close to the tooth as possible

▰ Direct the central ray through the mid facial areas of the teeth to avoid overlapped contacts

▰ Use the film holder to position the sensor or film parallel to the teeth

Which statement is true about the bitewing technique?

▰ Place the film at a 30º angle to the crowns of the teeth

▰ Use +10 degrees of vertical angulation

▰ Direct the central ray through the mesiobuccal cusps of the teeth to open the contacts

▰ Check the x-ray beam to ensure that it fully covers the sensor to prevent “elongation”

▰ Use +10 degrees of vertical angulation

X-ray exposure settings:

▰ Can be found in your office radiation safety manual

▰ Should not be changed for optimum quality control

▰ Must be posted next to the control panel of the x-ray unit

▰ Must be set at higher settings for digital x-rays than for film x-rays

▰ Must be posted next to the control panel of the x-ray unit

Which is true about film speed:

▰ Refers to how the film responds to the timer

▰ Is designated in letter codes from A-F

▰ Speed “A” is the most sensitive. It is fast film

▰ Speed “F” is the least sensitive. It is slow film

▰ Is designated in letter codes from A-F

Which of the following statements is true about radiographs?

▰ The dot on the film packet should be placed toward the apical aspect of the tooth

▰ The plastic cover will filter the x-ray beam

▰ The side of the sensor that the cord is attached to should face the tongue

▰ The side of the film with the V-shaped flap should face out

▰ The side of the sensor that the cord is attached to should face the tongue

Which of the following statements is true about storing film, except?

▰ Film should not be stored under heavy objects

▰ Film should not be stacked too high

▰ Film is not affected by the temperature at which it is stored

▰ Film should be stored in a cool, dry place

▰ Film is not affected by the temperature at which it is stored

Which of the following is true about fixing solution?

▰ Fixing solution removes developed silver halide crystals

▰ Fixing solution shrinks and re-hardens the emulsion to prevent scratching

▰ Under-fixing results in a lighter washed out film

▰ Over-fixing produces a brown stain on the film, when wet reading

▰ Fixing solution shrinks and re-hardens the emulsion to prevent scratching

It is important to correctly prepare and maintain x-ray solutions. All of the following are true, except:

▰ When mixing or placing solutions in the processor, do not contaminate the solutions by splashing

▰ As films are processed, the solution levels decrease or are depleted. As a result, the films will be lighter and lighter

▰ You should increase the exposure time when x-ray solution levels decrease

▰ One way to evaluate the state of the solutions is to make an x-ray checker film using a step wedge

▰ You should increase the exposure time when x-ray solution levels decrease

How should x-rays be mounted?

▰ The dot should be facing inward

▰ As if we are looking at the patient facing us

▰ We should mount the posterior teeth first

▰ The film representing the right side of the patient should be on our right side

▰ As if we are looking at the patient facing us

Which of the following is true about the landmarks that help us to mount our xrays?

▰ You can see the sinus in the mandibular molar films

▰ You can see the maxillary tuberosity in the maxillary premolar films

▰ You can see the mental foramen in bitewing films

▰ You can see the ramus of the mandible in lower molar films and sometimes in the posterior bitewings

▰ You can see the ramus of the mandible in lower molar films and sometimes in the posterior bitewings

Which of the following are necessary criteria for an acceptable periapical radiograph?

▰ As long as the entire root shows on the periapical x-ray, it is diagnostic

▰ You need a 2-4mm margin between the crown and the edge of the film

▰ Periapical x-rays are ideal for diagnosing interproximal decayBitewing x-rays should record 5mm of crestal bone

▰ Periapical x-rays should show the entire root as well as 4mm of the surrounding bone

▰ Periapical x-rays should show the entire root as well as 4mm of the surrounding bone

All of the following are true for bitewingx-rays, except:

▰ It is okay to overlap the crowns in order to be able to see the alveolar bone

▰ There should be no overlapping of contacts from the distal of the canine to the distal of the last tooth in the mouth

▰ The image should show equal amounts of the maxillary and mandibular arch

▰ It is not acceptable to have distortion from film bending

▰ It is okay to overlap the crowns in order to be able to see the alveolar bone

Which of the following is a reason that your images might be too light?

▰ Keeping your finger on the timer too long

▰ The kilovoltage peak (kVp) is set too high

▰ The beam-indicating device (BID) is too close to the face

▰ The exposure timer is set too short

▰ The exposure timer is set too short

Which of the following is a reason that your images might be too dark?

▰ Taking your finger off the exposure switch too soon

▰ The milliamperage (mA) is set too low

▰ The kilovoltage peak (kVp) is set too high

▰ Using the digital exposure time for a film exposure

▰ The kilovoltage peak (kVp) is set too high

What is the best way to prevent cone cutting?

▰ Use a snap-a-ray film holder

▰ Use a cone-shaped beam-indicating device (BID)

▰ Increase the milliamperage (mA) setting

▰ Use a Rinn film holder and align the BID with the aiming ring

▰ Use a Rinn film holder and align the BID with the aiming ring

All of the following are true about panoramic radiography, except:

▰ Film requires intensifying screens

▰ It rotates a narrow beam of radiation

▰ The film quality shows significantly more detail than a periapical radiograph

▰ The “object to film” distance can vary

▰ The film quality shows significantly more detail than a periapical radiograph

When the palatal plate creates a line over the apices of the maxillary teeth, and the teeth are blurred:

▰ The chin is tilted too low

▰ The chin is tilted too high

▰ The patient is positioned too far forward

▰ The patient is positioned too far backward

▰ The chin is tilted too high

Which of the following is true about CBCT?

▰ A larger field of view results in less radiation

▰ The amount of radiation emitted is less than it is for a panoramic radiograph

▰ The smaller the field of view (FOV), the more intense the radiation

▰ CBCT is best used for situations where details are important for treatment

▰ CBCT is best used for situations where details are important for treatment

Which of the following is true about digital radiography?

▰ You must print the x-rays to view them

▰ The system requires a special digital x-ray tube head

▰ The system must be capable of very short exposures

▰ There are three types of digital systems: wireless, wired, and cloud systems

▰ The system must be capable of very short exposures

Which radiograph error is unique to digital systems?

▰ Cone cutting

▰ Leaving in oral appliances

▰ Elongation

▰ Taking radiographs in the wrong patient‘s chart

▰ Taking radiographs in the wrong patient‘s chart

All of the following are true about radiographs, except:

▰ Radiographs are part of the dental record

▰ Radiographs are part of a legal document

▰ The dentist must keep the original radiographs. If we need to send x-rays to other providers or insurance companies, the radiographs must be duplicated.

▰ In Texas, dentists must keep radiographs for 10 years

▰ In Texas, dentists must keep radiographs for 10 years

Which is not an identifier of health information?

▰ Names

▰ Social security numbers

▰ Telephone numbers

▰ Front desk sign in sheets

▰ Front desk sign in sheets

All of the following are responsibilities the dental office has regarding HIPAA, except:

▰ The dental office must have soundproof operatories so patients cannot overhear private information.

▰ The dental office must make reasonable efforts to limit their use of protected health information (PHI). Only use the patient’s PHI that is necessary to accomplish the intended purpose.

▰ The dental office must provide training to employees. In Texas, both HIPAA and HB 300 training is required.

▰ The dental office must “make a good faith effort” to get the patient to sign an acknowledgement of the dental office’s privacy practices.

▰ The dental office must have soundproof operatories so patients cannot overhear private information.

When the anterior teeth in a panoramic film are blurred and show a diminished width:

▰ The patient is positioned too far back

▰ The patient is positioned too far forward

▰ The chin is tilted too low

▰ The chin is tilted too high

▰ The patient is positioned too far forward