OSHA
organization concerned with clinics being compliance with the Bloodborne Pathogen Standard
MSDS
contain information about each product used in the clinic
High
Level of surface disinfection commonly used in surgical areas
Intermediate
Level of surface disinfection commonly used in dental offices
NO
Is a Low level of surface disinfection acceptable in the dental office?
Disinfection
kills MOST microorganisms
Sterilization
designed to kill ALL microorganisms including spores
Spores
What is the hardest form of life to kill?
Bacillus stearothermaphilus
Type of spore, used for autoclave & chemical vapor
Bacillus subtilis
Type of spore, used for dry heat & ethylene oxide
Steam Autoclave
Corrosion of non-stainless steel may occur, don't use closed containers, 20 min at 250 degrees & 15-30psi
Unsaturated Chemical Vapor
Do not use closed containers, may damage plastic & rubber items, provide adequate ventilation
does not corrode instruments, affective for oils & powders, any instrument that cannot be autoclaved.
Advantages of Dry Heat
long sterilization cycle, not good for plastics or hand pieces, do not stay sterile b/c instruments are not wrapped
Disadvantages of Dry Heat
Sterilizes by oxidation. Substances combine with oxygen. Timing starts when contents reach peak temperature
How does dry heat work?
Unsuitable for oils & powders & waxes, can corrode instruments.
What are the disadvantages of moist heat?
very economical, useful for all instruments that are able to stand high temperatures
What are the advantages of moist heat: .
ASA Classification I
Notmal healthy patient, no dental management alterations required
ASA Classification II
A patient with mild systemic disease; may or may not need dental management alterations
ASA Classification III
A patient with moderate to severe systemic disease; would generally require dental managment alterations
ASA Classification IV
A patient with severe systemic disease; requires dental management alterations, best treated in special facility
Blood Pressure
The force exerted by blood against arterial walls when the heart contracts
Primary Hypertension
Most common form of hypertension, no obvious cause
Secondary Hypertension
Hypertension that is secondary to another disease
Malignant Hypertension
Most severe form of hypertension
Radial Artery
Most common point to take pulse
Brachial Artery
Best place to take pulse on a toddler or infant
Carotid Artery
Point to take pulse in emergency situations; unconscious patient
Tachycardia
Rapid pulse: 100+ beats/min
Brachycardia
Slow pulse: below 50 beats/min
60-100
Normal adult pulse rate
Tachypnea
Rapid respiration (hyperventilation)
Bradypnea
Slow respiration
12-20
Normal adult respiration rate
Attrition
Tooth to tooth wear
Abrasion
Pathologic wear due to a foreign substance
Erosion
Loss of tooth structure due to a chemical agent
Hypoplasia
Caused by a disturbance of ameloblasts during enamel formation; pitted enamel, striations, white spots
Class I
GV Black Class I--Pits and fissures of anterior & posterior teeth
Class II
GV Black Class--Proximal surface of posterior teeth, commonly involves occlusal surface
Class III
GV Black Class--Proximal surface of anterior teeth NOT involving the incisal edge
Class IV
GV Black Class --Proximal surface of anterior teeth involving the incisal edge
Class V
GV Black Class--Cervical 1/3 of facial or lingual surface
Class VI
GV Black Class--Incisal edge of anterior teeth or cusp tips of posterior teeth
Angle's Class I
The mesiobuccal cusp of the maxillary first molar is aligned with the buccal groove of the mandibular first molar. There is alignment of the teeth, normal overbite and overjet and coincident maxillary and mandibular midlines
Angle's Class II
A malocclusion where the molar relationship shows the buccal groove of the mandibular first molar distally positioned when in occlusion with the mesiobuccal cusp of the maxillary first molar
Angle's Class II Div. I
__________ is when the maxillary anterior teeth are proclined and a large overjet is present
Angle's Class II Div. II
__________ is where the maxillary anterior teeth are retroclined and a deep overbite exists
Angle's Class III
A malocclusion where the molar relationship shows the buccal groove of the mandibular first molar mesially positioned to the mesiobuccal cusp of the maxillary first molar when the teeth are in occlusion
Openbite
MX and MN teeth do not occluse
Crossbite
MX teeth are positioned lingual to the MN teeth
Overbite
Vertical overlap of MX and MN incisors
Overjet
Horizontal overlap of MX and MN incisors
Class I Furcation
Evidence of early bone loss in furca area; instrument can enter
Class II Furcation
Evidence of moderate bone loss in furca; instrument can enter but not pass between roots
Class III Furcation
Evidence of severe bone loss in furca; intstrument can pass through entire furca
Class IV Furcation
Same as Class III with exposure resulting from gingival recession
Nabors
Probe used to measure furcation involvement
Marginal Gingiva
Marks opening into sulcus
1.5 to 2.0mm
In health gingival margin is ________ coronal to crest of bone
Keratinized Gingiva
The gingiva from GM to MGJ
Attached Gingiva
The gingiva from the base of the gingival sulcus to MGJ
Interdental Gingiva
Located between adjacent teeth
(1) Presence of Bacterial Plaque (2) Ingestion of certain drugs
2 causes of gingival enlargment
Aquired Pellicle
1st stage of Plaque Formation
Selective Bacterial Adhesion
2nd stage of Plaque Formation
Bacterial Colonization
3rd stage of Plaque Formation
Gram Positive, Streptococcus
Dominant bacteria in Inital Plaque
Gram Negative, motile rods & spirochetes
Dominant bacteria in Established Plaque
Saliva
Source of nutrition of Supragingival Plaque and Calculus
Crevicular Fluid (pl & cal), Gingival Crevicular Fluid (cal)
Source of nutrition of Supragingival Plaque and Calculus
Provides a rough, irritating surface for bacteria to exist; a physical irritant for gingiva
Function of Calculus
Pyrophosphates
_______ from saliva affect calculus formation
Bacterial Plaque
a non-mineralied mass, that is attached firmly to acquired pellicle
Proximal or Gingival 1/3
What tooth surfaces have the most involvement in plaque formation?
Palatal Surfaces of MX teeth
What tooth surfaces have the least involvement in plaque formation?
4.5-5.5
pH for enamel demineralization
6.0-6.7
pH for root surface demineralization
Increased
People with heavy calculus have (increased or decreased) levels of calcium phosphorous in their saliva.
Smooth bottom layer of calculus
What is burnished calculus?
Incorrect Angulation or Dull Instruments
2 causes of burnished calculus
Change it immediately!
What if your mast gets moist?
Lingual of MN anteriors & Buccal of MX molars
Most common site for supragingival calculus
Proximal Surfaces (when plaque is left undisturbed)
Most common site for subgingival calculus
Chlorhexidine
Active ingredient in Peridex
Essential Oils
Active ingredient in Listerine
Quaternary Ammonium Compounds
Active ingredient in Scope & Cepacol
True
True/False- Indicator tape indicates temperature has been reached, NOT sterility
80
Plaque is ________% water
Yes
Does subgingival calculus have more inorganic compound than dentin?
Intrinsic
_____(location) stain within the tooth surface (Meds)
Extrinsic
_____(location) stain that occurs from an outside source (Tea, Coffee)
Endogenous
Stain originating from within the tooth (Trauma, Tetracycline)
Exogenous
Stain that originates from sources outside the tooth (Cigarettes)
Yes
Can some extrinsic stains (green or tobacco) become embedded & become intrinsic?
Black Line Stain
Usually teeth are clean, iron compounds in saliva
Green, Yellow, Orange
Chromogenic bacteria can cause stains in what 3 colors?
Yellow-Brown
What color stain does Chlorhexidine cause?
Blue/Green; Copper
An industrial worker may have what color stain on his teeth? What causes this stain?
True
True/False- The amount of sugar is not as important as the frequency & form.
Adaptation
Rolling the explorer between the thumb & index finger will promote better ________
Tissue Trauma
Scaling with greater than 90� angulation may cause:
Tufted Brush
_______would be used on: rotated teeth, hard to access 3rd molars, Type III & IV furcations
Interdental Brush
_______would be used on: open embrasures, root concavities, proximal surfaces, III & IV furcations
Periostat
An example of a Collagenase Inhibitor
Arestin
Minocycline in the form of a powder, controlled delivery system
Periochip
Subgingival sustained release delivery system, containing Chlorhexidine
Atridox
Doxycycline subgingival treatment
20 min @ 121�C/250� & 15-30 psi
Cycle for Steam Autoclave
20 min @ 132�C/270� & 20-40 psi
Cycle for Unsaturated Chemical Vapor
60-120 min @ 160�C/320�
Cycle for Dry Heat
10-16 hours @ 61�C
Cycle for Ethylene Oxide
Chief Complaint
Always address the pt's ___________ first.
Pseudopocket
Produced by edematous gingival, no migration of JE
Periodontal Pocket
Produced by apical migration of JE
Bleeding on Probing
1st sign of gingivitis; microulcerations of sulcular epithelium
Direct Facial, Distofacial, Mesiolingual
Access MX Molars furcations from ______, ______, & ______
Bass Method
Most commonly accepted brushing technique; bristles directed apically into sulcus @ 45�
Toothpick
Indications for _______ use is: accessible furcations, shallow pockets & normal sulcus depths
Pyrophosphate
Active ingredient in anti-calculus toothpaste
Sensitivity
Potassium nitrate, strontium chloride, or sodium citrate are all added to toothpastes to treat what?
Dentinal Hypersensitivity
Caused by movement of fluid within dentinal tubules
Effervescent
Oxygenating agents cleanse via what kind of action?
Hydrogen Peroxide
Continued use of __________ can lead to: sponginess of gingiva, hairy tongue, root hypersensitivity, & demineralization
Streptococcus mutans
0.12% Chlorhexidine suppresses growth of ________
No
Should an ultrasonic scaler be used on implants, dentures or in areas of demineralization?
True
True/False-Gracey curets are designed as "finishing" curets
2
Universal curets have ________ cutting edges per working end
during Instrumentation
When should stain be removed ideally?
False
The size of the polishing cup influences the ability of the polishing agent.
Occlusal
Polishing is LEAST effective on _________ surfaces.
Moist Heat
Sterilizes by coagulation of proteins
No
Are standard precautions patient specific?
Clinician
The purpose of PPE is to protect the clinician or the patient?
10 Hours
To sterilize instruments through liquid chemical solutions, the recommended immersion time is _______
HIPAA
Who is concerned with patient confidentiality?
Yes
Is a toothpick in holder effective in furcation plaque removal?
Therapeutic
If a mouthrinse is _________, it has the ability to kill all bacteria in the mouth
True
True/False- The type of subgingival bacteria most likely to be found at the base of a 7mm pocket would be RODS.
No
Does a classification of II for mobility involve vertical movement?
Angle's Class I
Canine relationship: the MX canine occludes with the distal 1/2 of the MN canine & mesial 1/2 of MN 1st premolar
True
True/False- The facial profile of Class I Occlusion is mesognathic.
Angle's Class II
Canine relationship: Distal of MN canine is distal to mesial surface of MX canine by at least the width of a premolar.
1
Class II, Div ______ is often associated with deep overbite, excessive overjet, abnormal lip muscle function, short mandible &/or short upper lip.
Retrognathic
The facial profile of Class II occlusion is ________
Angle's Class III
Canine relationship: distal of MN canine is mesial to the mesial surface of the MX canine
Prognathic
The facial profile of Class III occlusion is ________
2
Class II, Div ______: one or more MX incisors are retruded
Within Minutes
How long does it take acquired pellicle to form after polishing?
1-2 Days
How long does it take Gram Positive cocci to enter bacterial biofilm?
<120 / <80
What is normal blood pressure?
120-139
Systolic for "Prehypertension
80-89
Diastolic for "Prehypertension
140-159
Systolic for "Stage I Hypertension
90-99
Disastolic for "Stage I Hypertension
160 or above
Systolic for "Stage II Hypertension
100 or above
Diastolic for "Stage II Hypertension
Stage II Hypertension
Mr. Thats Whatshesaid came in with BP of 190/102. What stage hypertension is that?
True
True/False- Definitive emergency care only if blood pressure is <180/110.
Morning
Patients who are ASA Class II should be scheduled for appointments when?
No
Ms. Ophelia Dingdong presents with blood glucose level of 248. Should she be treated?
I/E Exam
The purpose of _______ is to assess & recognize deviations from normal conditions significant to the patient's health.
Stage I Hypertension
A blood pressure of 162/95 would be considered_________.
Class II
An MOD on #4 would best be described as a __________ restoration.