Clinic Chapter 26 and 27

Which of the following is not an accepted use of the toothbrush for oral health care?

a) Biofilm removal

b) Application of treatment or preventive agents

c) Polishing of restorations

d) Halitosis control

e) Sanitation of the oral cavity

c) Polishing of restorations

Evidence points to toothbrush origins around 3500 BC. Where did the toothbrush originate?

a) China

b) Babylonia

c) Africa

d) Turkey

e) None of these are correct.

b) Babylonia

Who was issued the first patent for a toothbrush in the United States around the middle of the 19th century?

a) Pierre Fauchard

b) William Addis

c) Lawrence Koecker

d) H. N. Wadsworth

e) Ebert Papyrus

d) H. N. Wadsworth

1. The use of nylon for toothbrush bristles began in 1938.

2. World War I complications prevented Australian export of wild boar bristles so synthetic materials were substituted.

a) Statement A is true and statement B is false.

b) Statement A is false and statement B is true.

c) Both statements are true.

d) Both statements are false.

a) Statement A is true and statement B is false.

Which of the following characteristics would be least desirable in a toothbrush?

a) Conforms to individual patient in size, shape, and texture

b) Readily cleaned and aerated, impervious to moisture

c) Bristle or filament height of 21 mm

d) End-rounded filaments

e) Durable and inexpensive

c) Bristle or filament height of 21 mm

When making suggestions regarding toothbrush selection, the dental hygienist should consider all of the following, except:

a) the ability of the patient to use the toothbrush.

b) the status of the gingival or periodontal health.

c) bleeding of the gingiva during brushing.

d) positioning of the teeth.

e) personal preferences of the patient.

c) bleeding of the gingiva during brushing.

The sequence in brushing for any method used should:

a) ensure complete coverage for each tooth surface.

b) begin in the anterior region of the oral cavity and work posterior.

c) begin in the same place each time you brush.

d) ensure that you brush the areas that are easiest first.

e) It is not necessary to worry about any particular sequence.

a) ensure complete coverage for each tooth surface.

Which of the following is the most widely accepted method of toothbrushing intended to remove dental biofilm adjacent to and directly beneath the gingival margin?

a) Roll technique

b) Bass method

c) Charters method

d) Stillman method

e) Fones technique

b) Bass method

The horizontal brushing method is not recommended for all of the following reasons except one. Which one is the exception?

a) This method bears pressure on teeth that are most facially inclined or prominent.

b) With use of an abrasive dentifrice, this method may produce tooth abrasion.

c) This method does not allow access to the interdental areas.

d) This method allows greater coverage in a short amount of time.

d) This method allows greater coverage in a short amount of time.

Which of the following is not true regarding power toothbrushes?

a) Current power brushes move in speeds and motions that cannot be duplicated by manual brushes.

b) Research has consistently shown that power brushes are more effective than manual brushes.

c) Power brushes have evolved through time due to improved designs and features.

d) Power brushes are evaluated by the ADA Council on Scientific Affairs.

e) Power brushes do not offer a great variety in the manner in which the bristles/head moves.

e) Power brushes do not offer a great variety in the manner in which the bristles/head moves.

A patient has asked you for advice in using a particular model of power toothbrush given to her as a gift. You have never heard of this type of power toothbrush. She has an appointment with the doctor for restorative work the following week. What should you recommend to this patient?

a) Tell the patient to go ahead and give the brush a try and let you know if she likes it.

b) Try to provide a demonstration of the brushing technique on a model with a regular brush.

c) Tell the patient that you do not recommend this brush because you have never heard of it.

d) Ask the patient to bring the brush in at her next visit and research the manufacturers' instructions prior to her return.

e) Tell the patient to return the gift and buy the brush your employer sells in his office.

d) Ask the patient to bring the brush in at her next visit and research the manufacturers' instructions prior to her return.

Which of the following would be the least desirable reason for using the occlusal brushing technique?

a) Loosen biofilm microorganisms packed in pits and fissures.

b) Remove biofilm deposits from occlusal surfaces of teeth out of occlusion.

c) Remove biofilm deposits from the margins of restorations.

d) Remove biofilm deposits from the maxillary tuberosity.

e) Clean pits and fissures to prepare for sealants.

d) Remove biofilm deposits from the maxillary tuberosity.

Which of the following is not an effect of cleaning the tongue?

a) It retards dental biofilm formation.

b) It contributes to overall oral cleanliness.

c) It contributes to increased xerostomia.

d) It reduces the number of microorganisms.

e) It reduces the potential for halitosis.

c) It contributes to increased xerostomia.

When is toothbrush damage most likely to occur?

a) After the removal of wisdom teeth

b) After the placement of a new restoration

c) After the initial instruction in a new method of brushing

d) After the patient becomes concerned with the color of his or her teeth

e) After the purchase of a new toothbrush

c) After the initial instruction in a new method of brushing

Which of the following is generally not a recommendation you would give to a patient experiencing toothbrush abrasion?

a) Change or correct the tooth brushing procedure.

b) Recommend a less abrasive dentifrice.

c) Suggest that the patient spend a longer time brushing his or her teeth.

d) Advise use of a specific brush with end-rounded filaments.

e) Explain the problem to the patient to ensure full cooperation.

c) Suggest that the patient spend a longer time brushing his or her teeth.

Which of the following is not a suggestion to tell your patients regarding the care of toothbrushes?

a) Replace your brush frequently, at least every 2 to 3 months.

b) Replace your brush before the filaments become splayed or frayed.

c) If you have a known infection, replace or disinfect your brush.

d) Use only one brush for home and work to prevent cross-contamination.

e) Brushes should be kept in open air with head in an upright position.

d) Use only one brush for home and work to prevent cross-contamination.

Microorganisms in saliva are typically the same as those in the:

a) sulcus.

b) buccomucosal folds.

c) teeth.

d) tongue.

d) tongue

The tongue cleaner is pressed over the tongue with a:

a) heavy and firm stroke.

b) light and soft stroke.

c) light and firm stroke.

d) heavy and light stoke.

c) light and firm stroke.

Traumatic toothbrush lesions are frequently found:

a) over molars.

b) over canines and premolars.

c) around the anterior frenum.

d) around the mandibular frenum.

b) over canines and premolars.

Which of the following is not true about bacteremia?

a) There is no clear association with infective endocarditis.

b) Oral tissues usually have a smell, and thus tooth brushing is increased.

c) Incidence is higher in patients with gingival inflammation.

d) All of these are correct.

b) Oral tissues usually have a smell, and thus tooth brushing is increased.

Most current toothbrushes have __________ filaments.

a) natural

b) polyester

c) boar

d) nylon

d) nylon

The most effective power toothbrush moves in a(n) __________ motion.

a) oscillating

b) side-to-side

c) orbital

d) All of these are correct.

a) oscillating

Which interdental aid would be best to recommend to a patient with orthodontic appliances?

a) Knitting yarn

b) Gauze strips

c) Soft picks

d) Wooden interdental cleaner

c) Soft picks

A wooden interdental cleaner would be appropriate for biofilm removal with a patient who has what type of embrasures?

a) Type III

b) Type II

c) Anterior

d) Posterior

a) Type III

Tooth brushing adequately removes biofilm from all surfaces of the teeth, except:

a) lingual.

b) facial.

c) palatal.

d) proximal.

d) proximal.

Which of the following statements is true about the interdental anatomy?

a) Between adjacent anterior teeth there are two papillae.

b) The papillae are connected by a col.

c) Col epithelium is thick and keratinized.

d) The col epithelium is very resistant to infection.

e) Between adjacent posterior teeth there is a single papillae and no col area.

b) The papillae are connected by a col.

The col area becomes deeper when:

a) there is severe recession.

b) antimicrobial mouthrinses are used.

c) it follows the shape of the apical border of the contact area.

d) inflammation leads to edema.

e) flossing too vigorously.

d) inflammation leads to edema.

An interdental tip is indicated for a patient who has:

a) biofilm accumulations at the gingival margin.

b) difficulty using a toothpick in holder.

c) biofilm accumulation on the distal of the last molars.

d) large embrasure spaces.

a) biofilm accumulations at the gingival margin.

The incidence of gingivitis is greatest in what area?

a) Posterior palatal tissues

b) Anterior facial tissues

c) Gingival margin

d) Interdental tissues

d) Interdental tissues

In a patient with advanced periodontitis, which teeth may have furcation areas on the proximal surface, making interdental biofilm removal difficult?

a) Maxillary first premolars

b) Mandibular molars

c) Mandibular central incisors

d) Maxillary lateral incisors

a) Maxillary first premolars

Planning patient interdental care begins with patient assessment, which provides all of the following information, except:

a) periodontal condition.

b) history of personal oral care.

c) position of teeth.

d) types of embrasures.

e) motivation to perform the patient's oral care routine.

e) motivation to perform the patient's oral care routine.

Dental floss is most effective when a patient has:

a) inflammation in the col area.

b) wide embrasure spaces.

c) interdental papillae and no loss of attachment.

d) fixed prostheses.

e) orthodontic appliances.

c) interdental papillae and no loss of attachment.

Floss is made of all of the following materials, except:

a) silk.

b) waxed nylon.

c) unwaxed nylon.

d) expanded PTFE.

e) wood filaments.

e) wood filaments.

When teaching a patient to use floss, all of the following instructions should be given, except:

a) use a 12- to 15-inch piece.

b) snap floss through the contact area.

c) grasp with only a half-inch of floss between fingertips.

d) pass floss below the gingival margin.

b) snap floss through the contact area.

Features of unwaxed floss include:

a) smooth surface.

b) thinner that waxed floss.

c) slides through contact area with ease

d) resists breakage or shredding

b) thinner that waxed floss.

Which of the following interdental aids would not work well for a patient with fixed prostheses?

a) Wooden interdental cleaner

b) Interdental brush

c) Super Floss

d) Single-tuft brush

a) Wooden interdental cleaner

When using the oral irrigator, which of the following is true?

a) Direct the tip above the gingival margin.

b) Use continuous flow from tooth to tooth.

c) Set the unit pressure at the lowest setting.

d) None of these are true.

c) Set the unit pressure at the lowest setting.

The power flosser tip is:

a) inflexible.

b) permanent.

c) nylon.

d) All these are correct.

c) nylon.

Power flossers remove __________ of interproximal biofilm.

a) 30%

b) 48%

c) 57%

d) 62%

b) 48%

Mr. Larsen, a 52-year-old, has just moved into town and is new to this dental office. In completing initial oral assessments, Eric, the dental hygienist, noted straight line cuts on the anterior facial and lingual surfaces in the middle of the interdental gingiva. Mr. Larsen had periodontal probe depths from 1 to 3 mm, and his gingiva was stippled, pink, and firm. He also had moderate biofilm accumulations around his bridge in the lower left quadrant and minimal bleeding upon probing. Mr. Larsen reports brushing two or three times a day and flossing one to two times every day. When Eric asked him to demonstrate brushing and flossing, he noticed that Mr. Larsen used a 24-inch piece of floss and snapped it between the contact areas. He also noticed Mr. Larsen used a scrubbing technique when brushing. When Eric commented on his brushing and flossing technique, Mr. Larsen stated that he has always done it this way and no one has ever said anything about it before. What are straight-line cuts on Mr. Larsen's gingiva?

a) Recession caused by malocclusion

b) Gingival inflammation

c) Floss cuts

d) Trauma from vigorous brushing

c) Floss cuts

Mr. Larsen, a 52-year-old, has just moved into town and is new to this dental office. In completing initial oral assessments, Eric, the dental hygienist, noted straight line cuts on the anterior facial and lingual surfaces in the middle of the interdental gingiva. Mr. Larsen had periodontal probe depths from 1 to 3 mm, and his gingiva was stippled, pink, and firm. He also had moderate biofilm accumulations around his bridge in the lower left quadrant and minimal bleeding upon probing. Mr. Larsen reports brushing two or three times a day and flossing one to two times every day. When Eric asked him to demonstrate brushing and flossing, he noticed that Mr. Larsen used a 24-inch piece of floss and snapped it between the contact areas. He also noticed Mr. Larsen used a scrubbing technique when brushing. When Eric commented on his brushing and flossing technique, Mr. Larsen stated that he has always done it this way and no one has ever said anything about it before. The reason the straight-line cuts appear are because Mr. Larsen:

a) snaps floss through the contact area.

b) uses a sawing motion to floss through the contact area.

c) does not use a sulcular brushing technique.

d) flosses too frequently.

a) snaps floss through the contact area.

Mr. Larsen, a 52-year-old, has just moved into town and is new to this dental office. In completing initial oral assessments, Eric, the dental hygienist, noted straight line cuts on the anterior facial and lingual surfaces in the middle of the interdental gingiva. Mr. Larsen had periodontal probe depths from 1 to 3 mm, and his gingiva was stippled, pink, and firm. He also had moderate biofilm accumulations around his bridge in the lower left quadrant and minimal bleeding upon probing. Mr. Larsen reports brushing two or three times a day and flossing one to two times every day. When Eric asked him to demonstrate brushing and flossing, he noticed that Mr. Larsen used a 24-inch piece of floss and snapped it between the contact areas. He also noticed Mr. Larsen used a scrubbing technique when brushing. When Eric commented on his brushing and flossing technique, Mr. Larsen stated that he has always done it this way and no one has ever said anything about it before. Excess pressure used when flossing is especially harmful to which group?

a) Patients with recession

b) Children who have a mixed dentition

c) Patients with fixed prostheses

d) Patients who have periodontal disease

b) Children who have a mixed dentition

Mr. Larsen, a 52-year-old, has just moved into town and is new to this dental office. In completing initial oral assessments, Eric, the dental hygienist, noted straight line cuts on the anterior facial and lingual surfaces in the middle of the interdental gingiva. Mr. Larsen had periodontal probe depths from 1 to 3 mm, and his gingiva was stippled, pink, and firm. He also had moderate biofilm accumulations around his bridge in the lower left quadrant and minimal bleeding upon probing. Mr. Larsen reports brushing two or three times a day and flossing one to two times every day. When Eric asked him to demonstrate brushing and flossing, he noticed that Mr. Larsen used a 24-inch piece of floss and snapped it between the contact areas. He also noticed Mr. Larsen used a scrubbing technique when brushing. When Eric commented on his brushing and flossing technique, Mr. Larsen stated that he has always done it this way and no one has ever said anything about it before. Mr. Larsen asks Eric what type of floss he should use to prevent further floss cuts. Eric should recommend:

a) limiting flossing.

b) unwaxed floss.

c) waxed floss.

d) gauze strips.

c) waxed floss.

Mr. Larsen, a 52-year-old, has just moved into town and is new to this dental office. In completing initial oral assessments, Eric, the dental hygienist, noted straight line cuts on the anterior facial and lingual surfaces in the middle of the interdental gingiva. Mr. Larsen had periodontal probe depths from 1 to 3 mm, and his gingiva was stippled, pink, and firm. He also had moderate biofilm accumulations around his bridge in the lower left quadrant and minimal bleeding upon probing. Mr. Larsen reports brushing two or three times a day and flossing one to two times every day. When Eric asked him to demonstrate brushing and flossing, he noticed that Mr. Larsen used a 24-inch piece of floss and snapped it between the contact areas. He also noticed Mr. Larsen used a scrubbing technique when brushing. When Eric commented on his brushing and flossing technique, Mr. Larsen stated that he has always done it this way and no one has ever said anything about it before. In order to better remove biofilm from the pontic and around the abutments, Mr. Larsen should use what interdental aid?

a) Interdental tip

b) Super Floss

c) Toothpick in holder

d) Wooden interdental cleaner

b) Super Floss