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Perio Module 11
Chapters 20, 22, 24, 25
| Question | Answer |
|---|---|
| If the periodontal chart indicates that all the probing depths are between 1 and 3 mm but does not indicate the position of the gingival margin or any CAL readings, can the dental hygienist assume that this patient has a healthy periodontium? | No, because the chart provides no way to tell if the patient has attachment loss |
| What are the components of a comprehensive periodontal assessment? | Level of mucogingival junction, level of free gingival margin, fremitus, gingival conditions, probe depths, bleeding on probing |
| What class of mobility would a patient have if a molar has an 8-mm attachment loss and the hygienist is able to depress the tooth in its socket by applying downward pressure? | class 3 |
| If the hygienist applies pressure with a gloved finger against the facial gingival tissue of a tooth and observes a pale yellow material oozing from the orifice of the pocket, what is the substance? | exudate |
| If the dental hygienist inserts a Nabers furcation probe into the pocket and tries to move the tip between the mesial and distal roots of the tooth, what is he or she assessing for? | Furcation involvement |
| If moderate alternating pressure in a facial--lingual direction is applied against the tooth, first against the facial surface of the tooth, then from the lingual surface of the tooth, what is the hygienist assessing the tooth for? | Horizontal tooth mobility |
| If moderate pressure against the occlusal surface is applied in an upward direction, what is the hygienist assessing the tooth for? | Vertical tooth mobility |
| What does bleeding on gentle probing represent? | bleeding from the soft tissue wall of the periodontal pocket where the wall of the pocket is ulcerated due to disease |
| How should a hygienist assess for bleeding? | observe each site for a few seconds before moving on to the next site |
| What measurement is being obtained when the hygienist uses a probe to measure the distance from the CEJ to the base of a pocket? | Clinical attachment level |
| In what conditions can inflammation not always be clinically visible in the tissues? | both gingivitis and periodontitis |
| What condition is being assessed for if the hygienist places his gloved index finger against the facial surface of the crown and asks the patient to tap her teeth together? | Fremitus |
| What is it called if the dental hygienist performs an efficient periodontal screening to determine IF she needs to complete a comprehensive periodontal assessment on a patient? | Periodontal screening and recording (PSR) |
| What is it called if the hygienist begins a new patient to the practice with a fact-gathering process designed to provide the hygienist with a comprehensive picture of the patient's periodontal health status? | comprehensive periodontal assessment |
| If the furcation probe passes completely through the furcation between the mesial and distal roots but the entrance to the furca is not visible clinically, what is the level of furcation involvement? | III |
| What is the importance of assessing calculus deposits on teeth during a comprehensive periodontal assessment? | Calculus deposits must be removed during nonsurgical therapy, and calculus is a local contributing factor in disease |
| What is the biggest difference between periodontal screening and recording (PSR) and a comprehensive periodontal charting? | PSR records one code for each sextant, and comprehensive periodontal charting records six readings for each tooth |
| Why is thorough documentation of periodontal assessment findings in the patient chart or computerized record important? | To serve as baseline data, to measure treatment outcomes, and to monitor periodontal health over time |
| When assessing for furcation involvement on a maxillary first molar, what could be a reason that the probe penetrated into the furcation but did not go through to the lingual? | The lingual root stopped the probe |
| What is the proper way to calculate the width of the attached gingiva? | subtract the probing depth from the total width of gingiva |
| According to the Center for Evidence-Based Medicine (CEBM), when searching for clinically relevant information, what are the steps in the process? | search primary sources, such as PubMed for systemic reviews, search secondary sources, such as the ADA systematic reviews, and formulate a PICO question |
| What are the goals of best practice? | measurable, consistent and reproducible outcomes |
| What is included in best practice for dental hygiene? | research, expert opinion, and personal experience |
| What resources used for systematic reviews? | American Dental Association Center for Evidence-Based Dentistry, Cochrane Collaboration, PubMed, and evidence-based journals |
| What is the second step of the PICO process? | intervention |
| What is the first step of the PICO process? | patient or problem |
| What is most important part of interpreting a professional journal article? | Evaluating presented information to facilitate informed decisions about patient care |
| What type of study provides the lowest level of evidence for evidence-based decision making? | Case-controlled studies |
| What term is used to define the act of "removing rough cementum or dentin that is impregnated with calculus or toxins?" | Root planning |
| What are some examples of patients who might benefit from co-management by the referring general dentist and the periodontist? | A pregnant patient with periodontal inflammation, patient with Stage III and Stage IV periodontitis, a patient who smokes |
| What are some examples of patients who only should be treated by a periodontist? | A patient with furcation involvement, a patient with rapidly progressing periodontitis, or a patient with vertical (angular) bony defects of the alveolar bone |
| What percentage of exposed dentin is hypersensitive until it is desensitized? | Approximately half of patients experience post-scaling dentinal hypersensitivity |
| What action by the dental hygienist can result in dentinal hypersensitivity? | Instrumentation of root surfaces |
| What are the goals of nonsurgical therapy? | Eliminate or control local risk factors for periodontal disease, minimize the bacterial challenge and the impact of systemic risk factors for periodontal disease, and stabilize attachment levels |
| What are the steps in the re-evaluation appointment? | Update the medical history, perform periodontal clinical assessment, compare results, and decide on next steps |
| What are common triggers of dentinal hypersensitivity? | touching the area with the bristles of a toothbrush, eating ice cream, and eating acidic foods |
| What is an odontoblastic process? | A living part of an odontoblast |
| What would you do at a re-evaluation appointment if the assessment findings show a moderate amount of generalized supragingival plaque biofilm and inadequate daily oral self-care? | Retrain the patient in oral self-care procedures |
| Why is it not necessary to remove the cementum during periodontal instrumentation? | Bacteria and toxins are not firmly embedded in cementum |
| What type of instrumentation is needed to convert a root surface from a site of disease to one of health? | Periodontal instrumentation using the minimum amount of strokes and just enough pressure to completely remove the calculus and biofilm |
| What is the cause of dental hypersensitivity? | Exposed dentin |
| At the re-evaluation appointment for a patient who had gingivitis, the patient continues to have clinical signs of gingivitis. What would you recommend for this patient? | retrain the patient in oral self-care procedures |
| How long does the natural process of blocking open dentinal tubules on exposed (open) dentinal tubules usually take? | A few weeks |
| After the completion of nonsurgical periodontal therapy, when should the re-evaluation appointment be scheduled? | 4-6 weeks |
| What is the gold standard treatment for all patients with dental biofilm-associated gingivitis and Stage I and Stage II periodontitis? | Nonsurgical therapy |
| If you suspect that your patient will require periodontal surgical therapy, what should you do first? | try nonsurgical therapy first. |
| What is the goal of periodontal instrumentation? | Render root surface and pocket space acceptable to tissue so healing occurs |
| What is the hydrodynamic theory for the origin of dentinal hypersensitivity? | Fluid movement within the tubules stimulates nerve endings associated with the odontoblastic processes |
| Who carries out the measures for nonsurgical therapy? | dentist, hygienist, and patient |
| What are the goals of nonsurgical therapy? | Eliminate or control bacteria and local risk factors for periodontal disease, minimize the impact of systemic risk factors for periodontal disease, and stabilize attachment levels |
| What is the minimum amount of time the hygienist should wait before reassessing tissue response and healing after periodontal instrumentation? | 1 month |
| What is the primary pattern of healing after periodontal instrumentation? | Formation of a long junctional epithelium |
| What are the reasons to brush the tongue? | A coated tongue may contribute to periodontal disease, reducing bacteria on the tongue reduces the number of pathogens in the saliva, and periodontal pathogens that produce methyl mercaptan accumulate within filiform papillae on the back of the tongue |
| What are some situations where an end-tufted brush would clean effectively? | Distal surface of last tooth in the arch, lingual surface of crowded mandibular anterior teeth, and exposed furcation areas |
| A pipe cleaner or interdental brush can be recommended to clean in which type of embrasure space? | Type III |
| Where is tufted dental floss effective at removing plaque? | Type II embrasures, under the pontic of a fixed bridge, and distal surface of the last tooth in the arch |
| Which auxiliary cleaning aids would be useful for cleaning furcation areas? | Toothpick in a holder (Perio-aid), End-tufted brush, interdental brush |
| Which interdental cleaning devices is effective in a type I embrasure space? | dental floss |
| Which interdental cleaning device would be the most effective in removing plaque biofilm from an interproximal root concavity? | Interdental brush |
| What is the most frequently used aid for biofilm removal? | toothbrush |
| Your patient flosses daily, but the posterior proximal surfaces are experiencing continued attachment loss and clinically, you see heavy plaque in these areas. What could be the cause of these problem areas? | Floss will not disrupt plaque biofilm in root concavities |
Created by:
BrendaAlberts