First Exam Flashcards
(190 cards)
1
Q
Form is the morphology of the teeth bone and tmj whereas function includes the jaw muscles and neuromuscular system
A
True
2
Q
A complex apparatus that has an amazing adaptive capacity to function.
A
Masticory system
3
Q
When the masticory systems adaptive capacity is exceeded l, dysfunction can range from
A
Discomfort to debilitating pain
4
Q
Good oral health requires the functional harmony of the
A
Teeth muscles and tmj
5
Q
Causative factor in perio disease is
A
Plaque biofilm
6
Q
The role of the hygienist is to recognize the signs and symptoms of pain and dysfunction
Record the parameters of these signs and symptoms and refer the patient for diagnosis and treatment
A
True
7
Q
The Oral cavity is in what state of function when talking chewing and swallowing
In occlusal and I
A
Is dynamic
8
Q
State of morphofuncitonal harmony in which the forces developed during function are within an adaptive physiologic range
A
Orthofunction
9
Q
Orthofunction means — and — for patient
A
Health and comfort
10
Q
This term indicates physiologic and physical comfort for thre patient a normal adaptive situation
A
Physiologic occlusion
11
Q
An occlusal relationship that functions for the patient is considefed —- and does not follow a particular occlusal configuration
A
Optimum
12
Q
A malocclusion can still be in orthofunction
A
True
13
Q
State of morphofunctional disharmony in which the forces developed during function cause pathological changes in the tissues
A
Dysfunction
14
Q
—- forces directed along the tooth and periodontium usually meet the demands necessary for normal function
A
axial
15
Q
Such as grinding or clenching can stress the system if axial forces
A
Parafunctional activity
16
Q
Antiaxial forces directed along the tooth and periodontium can cause —- or a —- response
A
Resorption
Hypertrophic response
17
Q
Certain factors effect response of teeth
A
Size shape of roots
Quantity quality of alveolar bone
Presence of biofilm
18
Q
An occlusal contact relationship that is harmonious does not produce a painful response in the masticory system
A
True
19
Q
When the condyles of the tmj rest in the normal closed super anterior position and the mandible has a well distributed even contact with the maxilla the max system is in a stable relationship
A
True
20
Q
Occlusion that has caused injury to the teeth muscles or tmj
A
Traumatic occlusion
21
Q
Heavy occlusal forces exceed the adaptive range in normal periodontium causing injuries to tissues and bone
A
Primary traumatic occlusion
22
Q
when normal occlusal force exceed the capabiltiy of a periodontium that is already affected by perio disease
A
secondary traum. occl
23
Q
trauma from occlusion does not initate gingiviis and perio
A
true
24
Q
traumatic occlusion does not refer to a maloclusion as described by angles three classifications
A
true
25
1,2,3 classify and describe the skeletal relationship of the max and man teeth.
angles classes 1-3
26
the occlusal relationship of the teeth is not a predictor of pain or problems in the tmj
true
27
pain in a joint structure
arthralgia
28
puncture of a joint space with a needle and removal of fluid
arthrocentesis
29
grinding or gnashing of the teeht usualy during sleep
bruxism
30
clamping and forcing the teeth togehter without grinding
clenching
31
cracking or snapping noise in the tempromandibular joint because of disk and condyle incoordination can occur in one or both joints
clicking
32
grating noise in the temporomandibular joint becayse of damage to the disk and articulation joint surfaces
crepitus
33
abnormal movement can describe masticory muscle incoordination or spasm
dyskinesia
34
mandible in movement from side to side and forward movement away from the intercuspal position.
excursive movement
35
vibration or movement of a tooth when in function can be observed or felt by placing a finger over the tooth
fremitus
36
enlargement
hypertrophyq
37
the maximum intrercuspation of the mandibular and max teeth also called centric occlusion and habitual occlusion
intercuspal position
38
tooth contact that does not allow the teeth to achieve stable interdigitation also called supra contact
interference
39
mandibular movement away from the midline the laterotrusive side moves away from the midline infunction
laterotrusion
40
mandibular movement toward the midline the mediotrusive side moves toward the midline in function
meditrusion
41
relationship of form and function
morpho function
42
pain in a muscle
myalgia
43
inflammation in a muscle
myositis
44
treatment that alters the occlusal contacts or mandibular position of the jaw
occlusal therapy
45
pathologic changes in the oral cavity as a result of occlusal forces an occlusion producing injury
occlusal trauma
46
a state of morphofunction harmony in which the forces developed during function are within an adaptive physiologic range
orthofunction
47
movement of the mandible outside the range of function
parafunction
48
an occlusion that is free of disease and dysfunction and has adpated to some physiologic changes
phyisologic occlusion
49
the mandible in the end point of the terminal hinge closure also called centric relation position
retruded contact position
50
involuntary contract of a muscle or muscles usually painful and interefring with function
spasm
51
spasm in the masticory muscles associated with a disturbance in the trigeminal nerve
trismus
52
it is now widely accepted that in the absense of marginal gingival irritation trauma from occlusion does not produce gingival inflammation
true
53
trauma associated with orthodontic movement of teeth is
self limiting
54
when an individual can attain and maintain good oral hyg. ----- is of no perio significance
maloclusion
55
most patients have difficult with------- making maloclusion a fator to be considered in perio
biofilm
56
the normal position of the teeth in max intercuspation is called
centric occlusion
57
in the intercuspal position the anterior teeth may have only
light or no contact
58
normal movement of the jaw with the teeth in contact should be smooth symmetric and able to achieve about ----mm
8
59
area on a tooth that may prevent well distribute stable contact between max and mand
supracontact
60
occlusal interferences are
supracontacts
61
latermal movement is examined starting from the ---
intercuspal position
62
slight mobiliity of the teeth especially the lower incisors is normal
true
63
occurs because the conical roots of a single rooted teeth are suspendied in the perio ligament which allows them to mve very slightly
physiologic mobility
64
wear caused by tooth to tooth contact is called
attrition
65
is a otth surface worn by attrition from functional or parafunctional causes
facet
66
a facet that is shiny is known as
active facet
| non shiny is passive
67
when the facet is angular the occlusal forces are directed --- and increase the risk of perio injury
laterally
68
the widening of the perio ligament is caused by
resoprtion of bony support from the excessive occlusal forces
69
osteosclerosis and hypercementosis are ---- responces to the occlusal forces
hypertrophic
70
physcial exam for this expanded evaluation include
```
examing man motion in all planes
palpating the tmj
palpatin the masticory muscles
examining and listening to joint sounds
palpating the cervical musculature
determing the stability of the dentition and skeleton
```
71
the goal of treatment of tmd is to reduce pain and improve jaw system functionality
true
72
Clarks three criteria
based on correct differential diagnoses
selected with reason and purpose
directed toward eliminating or neturalixzzing the cause of the symptoms
73
tmd treatement is conservative and
reversible
74
conseritive approach use simple non invasive methods rather than irreversible methods
true
75
the most frequent approach for tmd tx is
physical medice with a strong behavior educational component.
76
the first step in the treatment of patient with a tmd is to recommend
initail therapy
77
inital therapy
soft diet
limited movement of jaw
moist heat
non narcotic analgesic
improve after 2-3 weeks
78
set of simple noninvasive steps that can provideimmediate comfort and relief of symptomsthe first step is to instruct the patient to eat soft foods only
initial therapy
79
include ultrasound massage electrical stimulation of the muscles soft tissue manipulation and exercise progroams
physical therapy
80
made of hard acrylic resin and fit over the occlusal and incisal surfaces of the max or mad teeth they are usually called splint nightguards or biteguard
occlusal applicance
81
counseling for stress or anxiety depression
behavioral therapy
82
meds prescribed as paharmacologic treatment of tmd
pharmcologic therapy
83
pharm therapy can be used to help trigger pain which is a painful hypersensitive band of muscle tissue
true
| ex carbocaine
84
partial removal
condylotomy
85
any surgical procedure should be completed only after a careful diagnosis and the consideration ofa second or third opinion
true
86
cause and effect relationship between accumlulation of plaque and gingivitis in adults is within
21 days
87
gingivitis was reversible within --- days when proper plawur control was initatied
7
88
supra ging plauque becomes dominated by ---- --- microbial species as it ages
gram negative
89
these gram - bacteria are resp. for the develop. of subging biot asso with
perio disesase
90
mature plaque biofilm is
heterogeneous mass with open fluid filled channels used for the movement of nutrients and waste products.
91
most challenging aspect of plaque control for perio pt is
motivation to initate and continue a life long process of improved daily biofilm removal.
92
first brushes were made of hog bristile often with bone or ivory ahnes
true
93
because of the work of pioneers usch as arnim barclay and dr. bass soft bristled brushes used with a controlled bioilm removal tech have become the standard
true
94
ideal tooth brush
straight 6 inches long 7/16 wide
three evenly spaced rows with 6 tufts each
80 nylon bristles per tuft .007 inches in diameter 13/32 inches llong and rounded finish
95
the oldest tooth brush method
scrub
96
most popular method taught today
bass method 1948 it provides mechanical plaque removal at the ging margin and minimizes trauma
97
simplest brushing techniques consisting of placing the brsitles on teeth and moving them backand forth, snearly everyone including kids can become adept at this tec.
it can lead to trauma and recession
scrub
98
brushing teeth the way grow bristles placed on gingica
roll
99
requires placement of the brush at a 45 egree angle to the tooth surface with the bristle ends pointing away from the gingiva but toward the interproximal surfaces of the teeht.
charter
100
charter also recommended the use of metal or wooden toothpicks for interproximal stimulatoion. dental floss was to be used only to remove fibrous food caught between fualt contacts
true
101
placement of the bristles pointing apically but not at right angles to the gingiva to minimize puncture. pressure is placed on the bristle cause them to flex and the tissue to blanch. brush is rinsed several times with a salt water sodium bicarbonate solution. this techinique may result in plaque removal although its effectigvness around the ging margin is questionable
stillamn
102
soft multitufted toothbrush to be place at 45 degree angle to the long axis of teeth. the vibratory motion is used to force the bristles intol sulci and between the teeth effect as possible
bass
103
headed portion of powered brush is
```
vibrating
osciallation
rotary
counter roatery
soncic vibtration feature
```
104
rotating oscilliating is the best powered toothbrush
true
105
designed spec. for access to prximal areas have shaped tips and can readily be applied to both the interproximal surfaces when there is sufficient space and the gingival margin
rotary powered same as convenetional
106
most accepted
bass
107
--- will clean interproximal surfaces of the teeth extending under ging margin often to junctional epithelim where a toothbrush cannot reach, however it is likely to miss plaque in root surface grooves and cannot clean furcations
floss
108
proper flossing requires a piece of floss about ---- incles long both hands. a small portion one inch is held between thumb and fingers
18
109
dental floss can be used to clean under the pontic of fixed partial dentures and around abutement teeth when it is threaded under the soldered joints of fixed restorations.
true
110
needle like deice called a --- or ----. threaded through the eye of device and theen inserted under contact areas of bridge
floss threader
111
reusable floos tools have -- or --- shaped working ends
c u
112
c shaped
anterior areas
113
u shaped
posterior
114
disposable floss helper tools are convenient when
traveling and for kids
115
ideas to clean large interproximal spaces facester and easier to grasp
yarn or gauze
116
facilitate the mechanical cleaning of proximal root surfaces and provide improved access into develiping grooves and furcations. useful for perio patient who have attachment loss long exposed root surfaces and complex root arch.
interdental brushes
117
usually include a reusable handle and a dispoable brush tip. tip is inserted in the end of the handle. secured at 90 degree angle to handle and used to brush interproximally in spaces that are large enough to permit access
interdental brush.
118
some practictinoers recommend soaking the tip before use to soften it so that it frays slightly and covers more surface area
the tooth pick
119
gingival masasge
interdental stimulation
120
popular concept in plaqe control until the 0s
rubber tip stimulator
121
inflammation starts in the
sulcus
122
rubber tip stimulators are
convenitnat inexpensive devices that can be useful to perio patients
123
tip is a conical piece of firm rubber or plastic tht is several mm long. placed proximally resting the dsde of the cone on the gingiva and worked in small circular motion.
rubber tip stimulator
| thoughtt to increase keratinixtion clean the surface of gingiva stimulate blood flow and sqeeze fluid from sulcus
124
patients who never floss or are afraid to floss suggest
rubber tip
125
---- -- is a good tool for perio patients but is rarely the only interproxiam aid needed
dental floss
126
studies show that 40 percent of americans report using floss only 10 percent floss daily and another 10 floss one or twice a week.
true
127
forcing water between the teeth with a single jet or multiple jet of pulsed beads of water
supragingival irrigation
128
studies showed that irrigation really only helped reduce
calculaus formation
129
plaque scores were not always reduced by irrigation corroborating the results of the earlier work but bleeding of the gingiva was reduce significatnly
true
130
oral irrigation is associated with ------ occurng in as many as --- of patients with perio
bactermia
50 percent
131
if irrigation is recommended for perio patients after perio surgary it should be postponed for atleast
1 month longer in case of regenerative surgery to permit healing of tissues
132
subgingival irrigation can be accomplished with the use of a special soft rubber tib that permits the irrigant to be directed under the gingiva. tip is slipped gently under the gingiva in areas with deep pockets and irrigant is flushed into pickets
true
133
pressure for irrigation should be set on -----
| this tech extends the cleansing action of irigation beyond the generally accepted --- mm depth reached with standard tec
low
3mm
134
irrigation is good for people who really have no interest in flossing etc
true
135
chemical agents can clearly assist in plaque control programs but they are not a sub for good oral hyg practices
true
136
chemical antiplaque agents should have these properties
`.antiplaque action
substantivity
low toxicity and nonirriating
low permeability
137
abiliity to adhere to structure in the oral environment and be realease slowly over time
substantivity
138
low permeability allows
retention in the oral cavity
139
most efective anti bacterial agent available today is
chlorohexidine mouthwash containg .12 of active ingredeient
140
1989 chlorex. reduced plaque and givetis by
60 in short term studies and 55 and 45 respective in seperate long term
141
chrlohexidine highly substantive not being cleared from the mouth for several hours
true
142
chlorexidine availbe in
gelatin chip
toothpastes
mouthwash
143
side effects of chlor
```
brown staining
increased supra ging calc formation
reversible desquaation of oral tissue.
taste bitter a
alter taste sensation
```
144
chlorexidine containt ---- alchol.
11.6
145
the dental hygenist should recommend the use of chloredine as a mouth rinse full strenth .12 twice daily for 30 seconds using 15 ml of rinse
true
146
chlorexidine reduces gingivits when used once daily in supragingival irrigation with an oral irrigator in a 1:1 dilution with water .06
true
147
mouthwashes containing essential oils thymol eucaluptol menthol and methy salicylate have been shown to reduce plaque and gingivist by about
30
| alters cell walls
148
essential oil mouthwash contain a subtantial percent of alchol up to
26.4 have a strong flavor can cause staining
149
__ toothpastes with either zinc citrate or a copolymer of methoxyethylene and maleic acid asthe active agent have been shown in numerous studies to reduce plawue by about 25 and ging by 20
triclosan
150
quaternary ammonium compounds have limited substantivity and are not accepted by the ADA because there ability to reduce ging as not been adequately documented in long term studies
true
151
alters bacteria cell metabolism and cell adhesion prioperties in addition to reacting with tooth surace for caries prevention
stannous fl
152
the usual strengeth for daily home use is .... stannous flu delivered in gel or toothpaste
.4
153
stannous fl. negative
staining
154
there is no single agent that is recommend for sub irrigation and no compelling evidence that the procedeure provides sign benefits
true
155
clinical studies show approx a -- to ---- reduction in supra calculys formation wen anticalculus toothpastes are used
20-40
156
all of the following are charcterisitc of chlorhexidine except
anticalculus agent
157
irrigation is auseful component of home care for the perio patient. bactermia has bee nshown to be asso with orig.
both are true
158
which of the following oral hy aaid are best suited to areas of furcation onvolvement
tooth picks
159
toothbrush focused on ging margin
bass
160
technical skill of the dental hygi is critcal element in succlssful
non surgical perio therapy
161
achieving root smoothness is important for evalutatin short term goals during treatment appointments.
true
162
---- sense is used to determine the amount of caluclus presenti n the untreated pt the existanece of irriating factors such as overhands and the point at which thouroug hinstrumentation is finised at each app
tactile
163
glassy smooth root surfaces are not end poitns in treatemetn
true
164
smooth surfaces are easier to clean
smooth surfaces rerard plaque formation
rough surfaces mechanically irriate gingival tissue
smooth surfaces promote ginigival healing
true
165
no exp evidence indicated that rough root surfaces are mech irriatnt woule dtherefore delay healing
true
166
roughness has no effect on wound healing
true
167
----- do not pentrate deeply into cemental surfaces and that retained toxins are associated with missed calculus and plaqure rather than diseased cementum
endotoxins
168
the thinning is an example of over instrumentation or rootplaning without rationale.
true
169
other termss used to describe non surgical perio therapy include
intial therapy
phase 1
eitotropic phase
perio debridement
170
goals
remove plaque to restore perio health
slow/stop perio
prepare tissue for surgical therapy
171
```
emergency care
oral hyg instruct
nutrition counseling
perio debride
anti microb therapy
fluoride application
smoking cessation
extraction
```
phase one
172
surgical abcess if patient does not respond to one than do this
2
173
restorative and prsthetic care
phase 3
174
evaluation of patients oral hyg
smoking cessation
tx depends on con
phase 4
175
nonsurgical procedures
```
scaling
hand instruments
root planing
gingival curettage
polsihing
```
176
instrumentation of the crown adn rooth srufaces of teeth to remove plaque calculus and stains from surfaces
scaling
177
treatment designed to remove cementum or surface dentin that is rough imprenated with calculus or contaminted with toxins
root plaingn
178
polishing agents can scratch amalgom compositie resin and gold
true
179
air polishing works by mechanical abrasion using slurry of
sodium bicarbonate and water
180
polishing has
no therapeutic value
181
scraping or cleaning the walls of a cavity or surface by meeans
curettage
182
invovles the removal of inflamed soft tissue laeral to pocket wall
gingival curettage
183
traditionaly gingival curettage was called closed curettage or nonsurgical gingial curettage and was performed to remove inflamed pocket lining
true
184
curettage no longer considered standard tx
true
no longer method of tx
185
short term go of non surgical
promote plaque biofilm control and to instrument hte tooth surface until clean and smooth
186
long term goal
restore gingival health
187
actinobacillus actinomycetemocimtinas have been associated with agress perio
true
188
calculus adheres to tooth surfaces through pellicle attachment mechanical locking and intercrystalline forces.
truew
189
calculus is an inert substance plaque biofilm retention
true
190
studies show that --- do not pentrate deeply into cemental surfaces
endotoxins
