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54 Cards in this Set
- Front
- Back
areas of recession may be sensitive. Why?
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exposed cementum and dentine. Sensitivity via fluid movement in the dentine tubules
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three causes of hypersensitivity
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mechanical abrasion or attrition
chemical erosion thermal stimulation lesion or decay in tooth |
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2 common causes of gingival recession
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traumatic OH proceedures
perio |
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3 possible causes of tooth mobility
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1. inflammation
2. LOA 3. occlusal or other trauma |
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2 possible causes of gingival hyperplasia
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1. Inflammation
2. Medication such as phenytoin (anti-convulsant for epilepsy) or Ca2 blockers (hypertension) |
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what are the definitive signs of gingivitis
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1. bleeding
2. rolled contour, swelling 3. erythema 4. spongy consistency of gingiva |
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on what criterion is the diagnosis of perio made
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LOA
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what 2 measures are combined to calculate LOA
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1. recession
2. pocket depth |
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describe in histopathological terms what is occuring when there is erythema of the gingiva
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red indicateds acute inflammation and increased vacularity in the area
blue indicates venous congestion in the CT as the result of chronic inflammation |
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what is furcation involvement and why must it be evaluated?
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LOA between the roots of multirooted teeth. Furcation must be evaluated because of its role in the progression of perio
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Liast important oral conditions that can be seen on BW's
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1. caries
2. Perio 3. bony pathology 4. unerupted and impacted teeth |
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3 uses of the mouth mirror
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1. indirect vision
2. retraction 3. transillumination 4. illumination |
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which instruments can be used to remove subgingival calculus
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for heavy deposits = sickle scaler or ultra sonic
for light deposits = gracy or universal curettes |
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what does the term root planning or debridement mean
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to remove soft and hard deposits from root surface to leave a smooth hard root surface. Recently, however there is evidence to suggest that a more conservative approach in which the cementum is cleaned with an ultra sonic scaler but isn't removed is now seen as a better option
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advantages of using an ultrasonic scaler
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1. generally good patient acceptance
2. improved subgingival access 3. improved vision due to washed field 4. good access to furcation areas 5. efficient 6. improved operator comfort |
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what are the goals of instrument sharpening
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1. maintain cutting edge
2. preserve shape and proportional dimensions of the instrument 3. increase the working efficiency |
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what are the benefits of a shap instrument
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1. allow to apply appropriate amount of pressure to remove deposits
2. will remove all deposits 3. increases tactile sensitivity thereby increasing efficiency and effectiveness 4. decrease operator fatigue 5.reduce burnishing of calculus |
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name the uses of expanded dental floss (superfloss)
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1. cleans proximal surfaces of abutment teeth
2. cleans under bridges 3. cleaning around implants 4. cleaning around ortho appliances |
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what to consider when selecting an appropriate interdental cleaning device for your patient
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1. size of space
2. manual dexterity 3. patient preference 4. cost 5. compliance |
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what are three consequences of overzealous brushing
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1. gingival recession
2. abrasion lesion on gingival region of the tooth 3. hypersensitivity caused by exposed root or dentine 4. infection 5. ulceration of the gingiva |
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name a disadvantage of using stannous fluoride
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subsurface staining of demineralised enamel
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What are the benefits of root planning
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- way to be certain that the root is free of inflammation causing plaque deposits
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what are three different vehicles for delivering topical fluoride in the clinic
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- liquid = 10% stannous fluoride.
- gels = acidulated phospho-fluoride with 1-2% NaF (oral B minute APF, colgate phos-flur). Contraindicated for glass based restoratives - varnish = duraphat 5% NaF |
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what factors should be considered when recommending the "best" toothpaste for a patient.
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1. age: risk of fluorosis
2. benefits of fluoride 3. desensitising? 4. benefits of baking soda and tricolsan as antibacterials 5. calculus reduction in toothpastes with Zn chloride and pyrophosphate toothpastes |
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is fluoride more beneficial in small or large doses
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benefits are derived from ongoing presesnce of small amounts of F in the saliva and plaque.
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name 6 situations in which additional sources of F are advisable for home care
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1. high risk caries
2. high risk tooth wear (erosion) 3. ortho 4. partial dentures 5. hypersensitivity 6. reduced saliva flow 7. medically compromised 8. newly erupted teeth 9. root caries |
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6 factors for determining a suitable fluoride regime
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1. fluoride Hx
2. current use 3. brushing technique 4. risk of swallowing paste 5. frequency of brushing 6. weight of patient 7. compliance 8. cost |
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3 stratagies for enhancing saliva flow
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1. hydration
2. sugar free gum (xylitol) 3. reduce caffine intake 4. reduce / eliminate nicotine intake 5. reduce etOH 6. medications that stimulate flow |
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3 reasons why fluoride reduces caries
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1. it is incorporated into the enamel crystals as fluoroapatite which is more resistant to demineralisation because it has a critical point of 4.5pH where as hydroxiapatite has a critical pH of 5.5
2. F binds with Ca ions to increase the rate of remineralisation 3. F interferes with bacterial enzymes making it bacteriocidal |
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give 5 possible causes of xerostomia
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1. dehydration
2. too much caffine 3. alcohol 4. medications 5. radiation therapy 6. drugs 7. hormonal changes 8. diabetes 9. auto immune disease |
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5 signs or symptoms that a patient with xerostomia may report
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1. needing to sip liquid
2. waking up with dry mouth 3. commissures cracked 4. altered sense of taste and smell 5. difficulty chewing and swallowing 6. food remaining on teeth between meals 7. recurrent oral thrush 8. frothy or bubbly saliva at corners of mouth 9. sensitive mucosa 10. dentine hypersensitivity 11. denture problems 12. chronic sinitis 13. halitosis |
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name 4 functions of saliva
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1. lubricates oral mucosa, assisting in speech and swallowing
2. buffers capacity to neutralise oral environment 3. immune functions. IgA 4. facilitates tasting 5. clearance of food and debris 6. ion sink 7. provides ions for remineralisation |
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what are the two basic types of tooth staining. Explain.
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Intrinsic staining:
stains that are incorporated into the enamel and cant be removed by scaling or polishing. Usually occur during the tooths development. Tetracycline, fluorosis Extrinsic: staining of the salivary pellicle by substances such as tannins in red wine, coffee and tobacco. Can be removed with polishing |
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Name the different acquired deposits on oral structures and approprite methods for their removal
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1. Food debris: toothbrush, toothpick, rinse away
2. material alba: soft loose layer of cellular and broken down food debris: toothbrushing 3. Acquired pellicle: organic membrane that forms over the tooth that is made up of glycoproteins from saliva and crevicular fluid - removed with professional polishing 4. Bacterial plaque: biofilm made up of micro-organisms and their products. removed via self care and scaling 5. Calculus: mineralised bacterial plaque. removed with professional instrumentation |
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Name three statagies for reducing the cariogenicity of a patients diet
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1. awareness
2. education 3. reduce sugar intake and frequency 4. encourage protective foods 5. encourage water drinking between meals 6. reduce acidic foods |
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Name 3 reasons why preventative advice should include information about quitting smoking
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- major risk of oral and pharyngeal cancer
- risk for periodontitis - increased severity of perio - reduced effectivnes of perio Tx - reduced resting saliva flow and associated problems |
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which teeth are most commonly injured? which gender is most commonly involved?
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83% are upper central incisors
male to female ratio 3:1 |
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how do dental injuries occur
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direct
indirect intrinsic extrinsic |
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how should avulsed teeth be transported
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in milk or a tooth basket
persons own saliva Not in water |
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what are the three main factors determining mouthguard protection
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1. thickness min 3mm
2. stiffness 3. material base |
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why is pressure adaptation superior to vacuum formd
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superior adaption
no elastic memory 5 times greater forming power better comfort and fit max protection long term dimensional stability |
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which sites on the mandible are most prone to fracture
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- angle
- neck of condyle - canine region |
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2l/2r universal curette
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used for anterior teeth
2 cutting edges face of blade 90 degrees to shank |
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1/2 gracey curette
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one cutting edge
curved in 2 planes face of blade beveled at 60 degrees to the shank |
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gracy 11/12 and 13/14
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both are used on specific sites on posterior teeth - root debridement
curved in 2 planes face of blade beveled at 60 degrees to the shank 11/12 = mesial surfaces 13/14 = distal surface |
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reason for the ball on the WHO probe
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tactile feedback for detection of calculus
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what is irriversible pulpitis
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severe inflammation of the pulp that will not resolve even if the cause is removed. often more sensitive to heat and pain lasts longer. sensitive to percussion
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what are the mechanisms of dentinal sensitivity
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mechanical, thermal, chemical
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3 stages of plaque formation
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1. protein + tooth = pellicle
2. pellicle + micro-organisms = early plaque formation 3. plaque + time = mature plaque. Gram anaerobic filamentous form and fusobacteria followed by spirochetes 4. |
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care for dentures
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clean over sink filled with water
cool water use paste and denture brush |
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causes of gingivitis
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- plaque
- smoking - trauma - infection - poorly fitted dentures - dental appliances - puberty - pregnancy - diabetes - leukemia - malnutrition - |
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how is mobility graded
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grade 1 = up to 1mm horizontal movement
grade 2 = > than 1mm horizontal movement grade 3 = horizontal and vertical movement |
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reasons that gingiva can be different colours
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pigmentation
keratinisation inflammation staining bruising drug reaction underlying pathology |
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uses for an end tuft brush
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interproximal cleaning
hard to reach places orthodontic appliances root surface cleaning |