California RDA Exam Review and Clinical Dental Assisting Study Guide
Patient Records and Professional Conduct
Patient Record Ownership and Status:
The patient record is considered a permanent document belonging to the dental practice.
Dental radiographs (X-rays) are legally owned by the dentist, regardless of who paid for them.
Purpose of Dental History:
The dental history section of a patient record provides the dental team with essential information regarding the patient's previous dental care and treatment.
Patient Management:
To remain approachable and supportive to an anxious patient, the dental professional should encourage the patient to ask questions about their procedures and care.
Dental Charting and Initial Assessment
Visual Charting Symbols:
A tooth that is not visible in the mouth (missing or unerupted) is typically indicated on a dental chart by placing an "X" through the tooth.
Dental Materials: Bases, Liners, and Cements
Bases:
Placement and Purpose: A base is placed on the floor of the tooth preparation. It serves as a measure of protection for the pulp, typically used when decay or trauma has occurred close to the pulp chamber.
Legal Regulations (California): Both the Dentist and the Registered Dental Assistant (RDA) are legally permitted to place a base during a restorative procedure.
Liners:
Calcium Hydroxide: Used in dentistry as a liner. A common brand-name product containing calcium hydroxide is Dycal.
Legal Regulations (California): Both the Dentist and the RDA are legally allowed to place a liner during restorative procedures.
Temporary Sedative Dressings:
Definition: A temporary sedative dressing is classified as a temporary filling.
Materials: Common materials used for temporary sedative dressings include (Intermediate Restorative Material) and Cavit.
Zinc Oxide and Eugenol (ZOE): This material is utilized as a temporary cement/dressing.
Luting Agents and Permanent Cement:
Definition: A luting agent is an adhesive, such as a cement, designed to hold two separate structures together.
Removal: Once a permanent restoration has been cemented in place with permanent cement, the only method for removal is using a handpiece and bur.
Zinc Phosphate Cement (ZPC): This material should always be mixed on a cool, glass slab. The mixing technique involves incorporating the powder into the liquid in small but steady increments.
Mixing Guidelines:
It is a standard clinical requirement to ensure all powder is fully incorporated into the liquid before adding more powder during the mixing process.
Restorative Procedures: Etching and Bonding
Etchant (Acid Etch):
Composition: Etchant material is typically composed of phosphoric acid.
Physical Characteristics: It is typically electric blue in color and has a very bitter taste.
Function: The primary benefit of etchant is that it roughens the enamel and/or dentinal layers of the tooth to prepare the structure for bonding.
Application Timing: Etchant is generally left on the tooth structure for .
Legal Regulations (California): The Dentist and the RDA are legally allowed to place etchant on tooth structure for restorations or dental sealants.
Bonding and Adhesives:
Smear Layer: This is a layer of debris (often described in the context of being a protective secretion or remaining material) that must be managed during bonding.
Self-Etching Adhesives: These products streamline the procedure by eliminating the need to rinse the etchant from the tooth.
Restoration Setting and Polymerization
Polymerization: This term refers to the process of a material being cured, set, or hardened.
Types of Curing:
Dual Cure: If a material is labeled as "dual cure," the material will begin the initial setting phase on its own (chemical cure) but requires the use of a curing light to complete the setting process.
Commonality: The dual cure method is not the most commonly used method of polymerization (the statement that it is most common is False).
Provisional Restorations and Temporary Coverage
Terminology: Provisional coverage is also referred to as a temporary restoration.
Types of Temporary Crowns:
The two primary types of temporary crowns are custom and preformed.
Custom Temporary Crowns: These are typically fabricated from acrylic material.
Stainless Steel Crowns (SSC): These can be used as provisional coverage for adult patients and as a permanent restoration for pediatric patients.
Procedures and Tools:
Festooning: This term refers to the process of trimming a restoration.
Trimming Tools: Crown and bridge scissors are used specifically to trim around the margin of a stainless steel crown.
Clinical Protocol: It is strictly False that it is acceptable or customary to trim a provisional restoration intraorally; this should be done extraorally.
Quality Check: When fabricating a provisional, it is essential to check the mesial and distal contacts.
Legal Regulations (California): Both the Dentist and the RDA are legally allowed to fabricate and cement a provisional restoration.
Laboratory Procedures and Specialized Materials
Digital Impressions: A digital impression is defined as a picture or image of the prepared tooth.
Pressure Indicator Paste (PIP): This material is placed in a denture to pinpoint specific sore spots on the patient's oral mucosa.
Tooth Whitening: The main effective ingredient in tooth whitening material is Carbamide peroxide.
Examination Standards: On the California RDA Written examination, materials are referred to by their clinical names rather than brand names.
Infection Control and Sterilization Protocols
Record Keeping: According to Dental Board regulations, sterilization monitoring records must be kept for a period of from the date the load was originally processed.
Pre-Sterilization Cleaning:
Before sterilization, loose contaminated instruments must be processed in an ultrasonic cleaner.
Purpose: The purpose of the ultrasonic cleaner is to remove debris and bioburden via a mechanical device.
Decontamination of Materials:
Before sending impressions to a dental laboratory, they must be cleaned and disinfected using an intermediate-level disinfectant.
Institutional Precautions:
Standard Precautions: This set of precautions is intended to prevent exposure to all body fluids.
Microbiology and Hygiene:
Handwashing: Routine handwashing is designed to remove most transient microbes and some resident microbes.
Aerosols and Spray: The majority of the spray produced by dental handpieces during use consists of spatter.
Personal Protective Equipment (PPE) and Clinical Safety
Face Masks: The primary reason a dental health care professional (DHCP) must wear a surgical face mask is to protect them from exposure to splatter, spray, or splash during procedures.
Instrument Handling: Instrument cassettes should be wrapped after cleaning but before they undergo the sterilization process.
Air/Water Syringe Requirements: When using the air/water syringe during treatment, Dental Board regulations require the use of gloves, a mask, a gown, and eye protection.