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Flashcards in Module 1 Deck (72):
1

What can ignoring someones culture lead to?

negave health concequences or poor clinical outcomes

2

how is cross culture communication enhanced

when the DH develops a knowledge about adn aviods stereotyping

3

What are some successful nonverbal communication examples

-follow pts lead about touching or personal space
-use hand gestures with caution
-be careful interpreting facial expressions
-follow pt. lead for eye contact

4

The DH who strives to become adept to providing culturally effecive care:

-values diversity
-actively aquires knowledge
-nonjudgemental
-avoids sterotypes

5

What does periodontal debridement include?

scaling, root planing, root debridement

6

what is scaling?

manual and power driven to remove calc and all soft deposits sub and supra

7

what is root planing?

to elimiate subgingival calculus and smooth the tooth surface

8

what is root debridement

to elimiate subgingival biofilm and mineralized deposits

9

gingival inflammation and periodontal destruction result from what

the action of pathogenic microorganisms in dental biofilm

10

What is another name for an endotoxin?

lipopolysachcharides

11

what are endotoxins derived from?

the cell walls of gram negative organisms

12

What is an endotoxin?

toxic to human tissue and leas to inflammation and destruction of perio attachment

13

where do endotoxins exist?

in the biofilm

14

Removal of cementum during instrumentation is

inevitable

15

Is calculus a direct cause of gingival inflammation

no

16

what does calculus provide in inflammation

a nidus for bacteria

17

what must be removed to create a healing environment for perio tissue

calculus

18

what are the aims and expected outcomes of perio therapy?

-interrupt of stop the progress of disease
-create an environment that encourages healing
-induce changes in quantity and quality of bacteria
-tissue conditioning for advanced disease
-educate and motivate patient

19

when is a single appointment adequate for a patient

gingivitis or ealy perio with small deposits, reasonable personal care, few teeth present

20

When may you need multiple appointments for a patient?

extent of deposits, probe measurements,lack of oral care

21

When would you schedule patients for quadrant scaling appointments?

in a patient who is severely diseased, at 1 week intervals with anesthesia

22

In quadrant scaling when can you scale 2 quads in the same appointment?

when they have less severe perio

23

after quadrant scaling is completed what will be needed?

a follow up appt for evaluation

24

what is introduced after quadrant scaling is completed?

periodic maintenance

25

how long should you wait to evaluate a paitent after the scaling series?

2 weeks

26

What is full mouth disinfection?

scaling in 2 long appointments completed within a 24 hour period

27

what is the rationale for full mouth disinfection

perio disease are infections ridding the mouth of as many pathogens at one time can encourage healing and no reinfection

28

what are the limitations of full mouth disinfection?

- pt cant stand such intense tx
-not as may opportunities for pt instruction
-revaluation

29

what is preliminary partial scaling?

"inital full mouth debridement" "gross scaling"

30

what is usually used in partial scaling?

an ultrasonic

31

what are potential problems for imcomplete scaling?

Healing at the margin:limited access
potential for abcess formation
patient instruction
roughened calculus
patient misunderstanding

32

What happens to gingival tissues in gross scaling?

-tightens around tooth
-tissue appears normal
-probing and bleeding hasnt changed
-makes instrumentation difficult

33

What is the potential for abcess formation?

predisposing factors
sequence: tissue tightens, pocket closes, microorganisms multiply abcess develops

34

What are the problems of incomplete scaling in the category of patient instruction?

-visible lesson taken away
-swelling and discomfort taken away, less motivation
- when you scale quads the patient cant compare them

35

What are the problems of incomplete scaling as far as roughened calculus?

calculus is roughened thus providing more areas for infection

36

What are the probems of incomplete scaling as far as patient misunderstanding?

it looks and feels good so they may not see need to return for appointments, if perio develops they may claim incomplete tx was given

37

In scaling to completion what is the segmental approach?

quad or sextant treatments and reevaluating quads each time the patient comes back for the remaining quads

38

What are factors to consider in scaling to completion?

access, deposit on tooth surface, root anatomy, patient factors (LA, n20, limited opening)

39

What do you do to prepare for instrumentation?

Review patients assessment record
review radiographic findings
review care plan and tx records
patient preparation
supra and sub gingival exam
formulate a strategy

40

What factors are included in patient preparation?

premedication, preprocedural bactericial Rinse, prep for anesthesia

41

What factors are included in a suprogingival visual examination?

-gross deposits and irregularites
-dry off teeth observe calculus

42

What factors are included in a tacile supragingival examination?

-look for smooth surface
-explorer meets resistance to calc

43

what sound is heard when an explorer encounters a deposit?

scratchy or audible click

44

What factors are involved in a visual subgingival examination of the gingiva?

-spongy, red tissue over proximal calc
-dark color beneath translucent marginal gingiva

45

what factors are involved in a visual subgingival examination of calculus?

-loose resilient pocket wall deflected
-dark calc can be seen within the pocket

46

what factors are involved in a tactile subgingival exam with perio charting?

-depths recorded as a baseline
-study soft tissue attach for effective procedures

47

what factors are involved in a tactile subgingival exam with identifying shallow pockets

-scaling in pockets less than 3 mm can lead to loss of attachment
-repeated use of curet when no calc is present can result in loss of attachment

48

what factors are involved in a tactile subgingival exam with determining the extent of the pockets?

use an explorer for distinction of fine hard deposits

49

what is involved in tactile subgingival exam with examining tooth topography?

detect grooves and furcations using a horizontal stroke

50

what factors are involved in a tactile subgingival exam when evaluating restorative margins?

-detect overhangs
-detect marginal irregularities

51

How do you formulate a strategy for instrumentation?

-combine clinical findings with info in chart
-check tx objectives
-formulate a strategy

52

WHat are the 3 prerequisites for calculus removal?

-position of clinician to prevent trauma
-visibility and lighting
-sharp instruments

53

What is periodontal debridement?

removal of all residual calc and toxic materials from the root to produce a clean smooth surface

54

what are the other names for periodontal debridement?

root planing, root detoxification, root preparation

55

What is the instrumentation zone?

areas where instrumentation is preformed for scaling and root planing

56

where is the instrumentation zone?

above the clinical attachment of perio fibers, extends the height and width of the deposits to be removed

57

What are the steps in systematic deposit removal?

1-tooth to tooth
2-section to section of deposit
3-strokes overlap
4-instrument in instrumentation zone
5-nature of the deposit

58

What is the nature of a deposit?

the oldest calc is located next to the tooth and is the hardest

59

What are some special subgingival anatomy considerations?

-tooth surface pocket wall- thin or no cementum
-soft tissue pocket wall- bleeding inevitable
-variations in probing depths- guides insertion

60

What is instrumentation dependent on?

almost entirely on tactile sensitivity

61

what limits the freedom of movement of an instrument?

soft tissue pocket wall

62

What is the location of subgingival calc?

enamel root or both

63

how does calculus attach to the cementum?

in minute irregularities and in areas of enamel resorbtion

64

calculus is more______ than on enamel and requires a different technique for removal

tenacious

65

What forms does subgingival calc occur in?

nodules, ledge, smooth veneer, and other forms

66

What are the steps in manual subgingival scaling?

-instrument grasp
-stabilization: establish finger rest
-select correct cutting edge
-adaptation of cutting edge
-angulation
-lateral pressure
-activation stroke
-channels of strokes
-plane the root surface
-evaluation

67

What do you do during an activation stroke?

-tighten grasp
-maintain cutting edge evenly
-control motion
-overlapping strokes
-stay in instrumentation zone

68

What are channels of strokes?

moving the instrument slightly laterally to ensure overlap

69

What is the purpose of the finishing techniques in root planing?

to smooth the surface to lesson the immediate recolonization of bacteria

70

Where do do plane the root surface

only where deemed necessary after exploration

71

What strokes should be used in the finishing techniques of root planing?

multidirectional, vertical then oblique, be careful with horizontal

72

How should the explorer be applied in evaluation?

vertical and diagonal strokes