Dental Hygiene Comprehensive Clinical Review: Examinations, Periodontal Structures, Infection Control, Charting, and Occlusion

Comprehensive vocabulary flashcards covering Extraoral and Intraoral Examination techniques, Oral Hygiene Infection Control and OPT aids, Periodontal Structures and AAP/EFP Classifications, Dental Charting and G.V. Black classifications, and Dental Occlusion.

ABCDT Rule

A systematic mnemonic used for descriptive charting of oral lesions: A = Anatomic location, B = Border, C = Color change, D = Diameter/dimension, and T = Type.

Bidigital Palpation

An examination technique using the fingers and thumb of one hand to move or compress the tissue of a structure with a rolling motion.

Bimanual Palpation

An examination technique using the index finger of one hand and the fingers and thumb of the other hand simultaneously to move or compress tissue.

Bilateral Palpation

An examination technique using a finger or fingers of both hands simultaneously to move or press tissue on contralateral (opposite) sides of the head or body.

Circular Compression

A palpation method consisting of moving fingertips in a deliberate, rotating fashion over tissues to be examined while exerting pressure against underlying structures.

Lymphadenopathy

Enlargement of lymph nodes due to infection; nodes typically swell to $\frac{1}{2}\text{ to }1\text{ inch}$ across with a viral infection, can enlarge over $1\text{ inch}$ with a bacterial infection, and are typically painless with cancer.

Malignant Lymph Node

A lymph node characterized by being enlarged, firm, nontender, matted (stuck to each other), fixed (stuck to underlying tissue), and unilateral.

Fordyce Granules

Normal developmental variations appearing on the mucosal surfaces, consisting of clusters of ectopic sebaceous glands.

Ankyloglossia

A developmental abnormality characterized by an unusually short, thick, or tight lingual frenulum that restricts tongue mobility ("tongue-tie").

Mallampati Score

A clinical scoring system evaluating the visibility of the oral pharyngeal structures: Class I (complete visualization of soft palate), Class II (complete visualization of uvula), Class III (visualization of only the base of the uvula), and Class IV (soft palate not visible at all).

ADA Seal of Acceptance

A designation established in 1931 requiring laboratory and clinical evidence over a 5-year period to verify the safety and efficacy of commercial oral care products.

Bass Method

A sulcular toothbrushing technique where bristles are directed apically at a $45^{\circ}$ angle to the long axis of the tooth into the gingival sulcus and vibrated back and forth with short strokes.

Stillman Method

A toothbrushing method designed for gingival massage and stimulation where bristles are placed partly on the cervical area of the tooth and partly on the gingiva at a $45^{\circ}$ angle, with pressure applied to blanch the tissue.

Charters Method

A toothbrushing method indicated for orthodontics, fixed bridges, and post-periodontal surgery where bristles are directed toward the occlusal or incisal plane at a $45^{\circ}$ angle to the long axis of the tooth and activated with short vibratory strokes.

Fones Method

A circular toothbrushing technique where teeth are closed in occlusion and the facial surfaces of both arches are brushed simultaneously in large sweeping circles; recommended as an easy-to-learn first method for children.

Rolling Stroke

A brushing technique where bristle filaments are placed with the side of the brush on the attached gingiva pointing apically and rolled slowly over the tooth crowns toward the incisal or occlusal surface.

Gingival Embrasure Types

Classification of interproximal spaces based on papilla height: Type I (embrasures totally occupied by interdental papilla), Type II (slight to moderate recession of papilla), and Type III (extensive recession or complete loss of papilla).

Tufted Dental Floss (Super Floss)

A specialized variable-diameter floss containing three segments—a stiffened rigid end threader, a mesh/yarn cylindrical tufted portion, and regular dental floss—indicated for Type II and III embrasures, under pontics, and around orthodontic appliances.

Floss Threader

A blunt-ended, needle-like flexible plastic device used to thread dental floss under tight contacts, orthodontic wires, and fixed bridge pontics in Type I embrasures.

Wedge Stimulator (Stim-U-Dent)

A triangular balsa wood device pressed against the proximal tooth surface with the base toward the gingiva, moved in and out to remove supragingival plaque and stimulate gingiva in Type II and III embrasures.

Substantivity

The ability of oral tissues to absorb an active therapeutic agent and permit its slow, sustained release in active form over an extended period of time (e.g., $8\text{--}12\text{ hours}$ for chlorhexidine).

Chlorhexidine Gluconate (CHX)

A broad-spectrum antimicrobial agent that binds to hydroxyapatite and oral tissues to inhibit bacterial colonization; common side effects include brown staining of teeth and restorations, bitter taste alteration, and slight increase in supragingival calculus.

Cetylpyridinium Chloride (CPC)

A quaternary ammonium compound with low substantivity that reduces surface tension to decrease the adherence of bacterial plaque to the acquired pellicle.

Col

A depression or saddle of nonkeratinized interdental gingival tissue connecting the facial and lingual aspects of the interdental papillae beneath a tooth contact; the site where most periodontal disease begins.

Junctional Epithelium (JE)

A cuff-like band of nonkeratinized stratified squamous epithelium consisting of two layers that completely encircles the tooth, forms the base of the sulcus, and attaches to the tooth surface via hemidesmosomes.

Gingival Crevicular Fluid (GCF)

A serum-like fluid that seeps from connective tissue through the sulcular epithelium into the sulcus or periodontal pocket, carrying immune components and increasing significantly in the presence of inflammation.

Clinical Attachment Loss (CAL)

The distance from the cementoenamel junction (CEJ) to the junctional epithelium (base of the sulcus/pocket), calculated by adding the probing depth to the measurement of gingival recession (or subtracting margin height if coronal to the CEJ).

Bleeding on Probing (BOP)

The most reliable early clinical indicator of gingival inflammation; evaluated 1–2 seconds after probing and measured at up to 6 sites per tooth.

Gingivitis

A reversible inflammation of the marginal gingival tissue characterized by bleeding, edema, and redness, without apical migration of the junctional epithelium beyond the CEJ and without alveolar bone loss.

Periodontitis

An irreversible, chronic inflammatory disease affecting all structures of the periodontium characterized by apical migration of the junctional epithelium, clinical attachment loss, and alveolar bone destruction.

Periodontitis Staging

A multidimensional classification of the severity and complexity of periodontitis based on interdental CAL, radiographic bone loss (RBL), tooth loss, and complexity factors (ranging from Stage I: Mild to Stage IV: Advanced).

Periodontitis Grading

An assessment of the biological rate of periodontitis progression, responsiveness to therapy, and systemic health impact, classified as Grade A (slow, $\text{\%RBL}/\text{age} < 0.25$), Grade B (moderate, $0.25\text{ to }1.0$), or Grade C (rapid, $> 1.0$).

Peri-implant Mucositis

An inflammatory lesion confined to the peri-implant mucosal soft tissue characterized by erythema, edema, and bleeding on gentle probing without progressive marginal bone loss.

Peri-implantitis

A plaque-associated pathological condition occurring in tissues around dental implants characterized by inflammation in the peri-implant mucosa and progressive loss of supporting peri-implant alveolar bone.

Stillman's Cleft

A localized area of gingival recession forming a narrow, straight or "V"-shaped slit in the marginal gingiva extending toward the mucogingival junction.

McCall's Festoon

A rolled, thickened, lifesaver-shaped enlargement of the marginal gingiva most frequently observed adjacent to canine and premolar teeth.

Tooth Mobility Classification

Clinical grading of tooth movement: Class I ($\le 1\text{ mm}$ movement in any horizontal direction), Class II ($> 1\text{ mm}$ in any horizontal direction without vertical depressibility), and Class III (buccolingual movement with vertical depressibility in the socket).

Furcation Involvement Classification

Assessment of bone loss between multi-rooted teeth: Class I (concavity detected with probe, cannot enter), Class II (probe enters partially up to $\frac{1}{3}$ tooth width), Class III (through-and-through probe penetration covered by soft tissue), and Class IV (through-and-through opening clinically visible due to recession).

Universal Numbering System

The standard tooth numbering system adopted by the ADA that designates permanent teeth with numbers 1 through 32 (starting with maxillary right third molar) and primary teeth with sequential uppercase letters A through T.

Dental Charting Color Coding

Standard documentation colors on odontograms where blue ink represents existing restorations or conditions and red ink indicates proposed/treatment-planned procedures or active pathology.

G.V. Black Class I Caries

Caries or restorations affecting structural pits and fissures on the occlusal surfaces of molars and premolars, facial/buccal or lingual pits of molars, and lingual pits of maxillary incisors.

G.V. Black Class II Caries

Caries or restorations affecting the proximal (mesial or distal) surfaces of posterior teeth (premolars and molars), typically involving two or more surfaces.

G.V. Black Class III Caries

Caries or restorations on the proximal surfaces of anterior teeth (incisors and canines) that do not involve the incisal angle.

G.V. Black Class IV Caries

Caries or restorations on the proximal surfaces of anterior teeth (incisors and canines) that involve or remove the incisal edge/angle.

G.V. Black Class V Caries

Caries or restorations located on the gingival (cervical) third of the facial/labial or lingual surfaces of any anterior or posterior tooth.

G.V. Black Class VI Caries

Caries or restorations located on the incisal edges of anterior teeth or the cusp tips of posterior teeth.

Pontic

The artificial prosthetic tooth on a fixed partial denture (bridge) that replaces a missing natural tooth and fills the edentulous space.

Abutment

A natural tooth, root, or dental implant post that serves to attach, support, and retain a fixed bridge or prosthetic restoration.

Endosteal Implant

The most common surgical implant type, consisting of a biocompatible titanium fixture anchored directly into alveolar bone to support a single crown, bridge, or overdenture.

Centric Occlusion

The maximal intercuspation or contact relationship of opposing occlusal surfaces when the mandibular arch occludes fully with the maxillary arch.

Mesognathic Profile

A balanced facial profile characterized by slightly protruded jaws with a relatively flat, straight profile line; typically associated with Class I normal occlusion.

Retrognathic Profile

A facial profile characterized by a prominent maxilla and a retruded mandible positioned posterior to its normal relationship; typically associated with Class II malocclusion.

Prognathic Profile

A facial profile characterized by a prominent, protruded mandible that extends anterior to its normal relationship with the maxilla; typically associated with Class III malocclusion.

Angle's Class I Occlusion (Neutroclusion)

A molar relationship where the mesiobuccal cusp of the maxillary first permanent molar articulates directly with the buccal groove of the mandibular first permanent molar.

Angle's Class II Malocclusion (Distoclusion)

A molar relationship where the buccal groove of the mandibular first permanent molar is positioned distal to the mesiobuccal cusp of the maxillary first permanent molar by at least the width of a premolar.

Class II, Division 1 Malocclusion

A Class II molar relationship characterized by a retruded mandible with facial protrusion (labioversion) of all maxillary incisors and a deep overbite.

Class II, Division 2 Malocclusion

A Class II molar relationship where the mandible is retruded, maxillary central incisors are upright or retruded (linguoversion), and maxillary lateral incisors tip labially or overlap the centrals.

Angle's Class III Malocclusion (Mesioclusion)

A molar relationship where the buccal groove of the mandibular first permanent molar is positioned mesial to the mesiobuccal cusp of the maxillary first permanent molar by at least the width of a premolar.

Overbite

The vertical overlap of the maxillary incisors over the incisal edges of the mandibular incisors in centric occlusion; graded as normal (incisal third), moderate (middle third), or severe/deep (cervical third).

Overjet

The horizontal distance between the labial surfaces of the mandibular incisors and the incisal edge of the maxillary incisors in centric occlusion, measured in millimeters using a periodontal probe.

Underjet

A horizontal relationship where maxillary anterior teeth occlude lingual to the mandibular anterior teeth, measured horizontally with a periodontal probe.

Crossbite

An abnormal occlusal relationship where mandibular teeth are located facial to opposing maxillary teeth, occurring either anteriorly or posteriorly (unilaterally or bilaterally).

Open Bite

A lack of incisal or occlusal contact between opposing teeth when the posterior dentition is fully intercuspated in centric occlusion.

Primary Occlusal Trauma

Injury resulting in tissue changes caused by excessive occlusal forces exerted on a tooth with healthy, normal bone and periodontal attachment levels.

Secondary Occlusal Trauma

Injury caused when normal or excessive occlusal forces are applied to a tooth with compromised, reduced, or inadequate periodontal attachment and bone support.

Tongue Thrusting

An infantile swallowing habit where the tongue is forcefully pushed forward against or between the anterior teeth during swallowing ($1{,}200\text{ to }2{,}000\text{ times per day}$ with approximately $4\text{ pounds}$ of force), resulting in anterior open bite or malalignment.