PATIENT MANAGEMENT

Question 1

___ is defined as the science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. it is that form of dental practice which serves the community as a patient rather than the individual. it is concerned with the dental education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis

Answer 1

dental public health

Question 2

what is a gingival index?

Answer 2

• loe and silness
• scoring of gingival inflammation from 0-3, with 0 being normal and 3 being ulcerated tissue with a tendency toward spontaneous bleeding

Question 3

why are periodontal indices not considered the best methods to measure periodontal disease?

Answer 3

because they both (periodontal index and periodontal disease index) combine gingivitis and periodontitis measure into a common score

Question 4

the community periodontal index of treatment needs (CPITN) combines an assessment of what 3 things?

Answer 4

• gingival health
• pocket depth
• presence of supragingival and subgingival calculus

Question 5

which index sets forth a method of quantifying the amount of plaque and calculus in its two components, the debris index and the calculus index

Answer 5

simplified oral hygiene index (OHI-S)

Question 6

the prevalence of caries in the US declined substantially from the early 1970s until the mid 1990s as a result of ___

Answer 6

fluoridation, the use of fluorides, and other preventive measures

Question 7

from the mid 1990s until the most recent NHANES survey (2004), among children 2-11 years old, what happened to the incidence of caries?

Answer 7

it increased slightly

Question 8

the current best estimate of early childhood caries prevalence in the US is approximately ___% nationwide

Answer 8

• 5%

- in 2005, 28% of preschool aged children had experienced tooth decay (4 million children affected nationwide)

Question 9

has the prevalence of coronal caries increased or decreased in recent decades among US adults?

Answer 9

decreased

Question 10

more than ___% of US adults over 20 years old have at least one decayed or filled tooth

Answer 10

90%

Question 11

the prevalence of caries among dentate adults 20 years or older increases with age until ___ years old, after which it plateaus at approximately ___ decayed and filled surfaces

Answer 11

• 59 years old

- 30

Question 12

T or F:

it has been determined that nonwhites have significantly higher coronal DFS (decayed/filled surfaces) than whites

Answer 12

• false (opposite)

- whites have a mean coronal DFS twice as high as african americans

Question 13

approximately ___% of dentate adults older than 20 have root caries

Answer 13

18%

Question 14

although the prevalence of root caries has decreased compared with previous national surveys, root surface caries is 3x higher among adults ___ years and older compared with adults younger than ___ years old.

Answer 14

• 60
• 40
• this prevalence is lower for whites compared with other racial groups

Question 15

the prevalence of gingivitis among school age children has been reported to be ___%. the prevalence among the US population 20 years and older is ___%

Answer 15

• 40-60%

- 53%

Question 16

what is the most common form of periodontitis?

Answer 16

chronic

Question 17

the prevalence of periodontitis in adults 30 and older is about ___%

Answer 17

• 47%

- 64.7 million adults

Question 18

according to the national cancer institute, how many new cases of oral cancer would be diagnosed, and how many people would die of cancer of the oral cavity and pharynx in 2013? most of these oral cancers are ___ and ___

Answer 18

• 41,380 (M:F 2:1) would be diagnosed
• 7890 would die
• epidermoid carcinomas and squamous cell carcinomas

Question 19

in the US, oral cancer represents about ___% of all cancers, and about ___% of all cancer deaths

Answer 19

• 4%

- 2.2%

Question 20

the incidence of oral and pharyngeal cancers increases with age and alcohol or tobacco use, and is uncommon before age ___

Answer 20

40

Question 21

cancers of the ___ and ___ account for approximately 2/3 of all new oral and pharyngeal cancers, with the ___ being the most common site of incident cancers of the oral cavity

Answer 21

• lip and oral cavity

- tongue

Question 22

which population has a higher incidence of oral and pharyngeal cancers compared to other racial groups?

Answer 22

whites

Question 23

overall, the 5-year survival rate for oral and pharyngeal cancers is approximately ___%

Answer 23

63%

Question 24

what is the recommended level of fluoride for a community water supply in the US?

Answer 24

0.7-1.2ppm

Question 25

1ppm of fluoride is equivalent to ___mg of fluoride per liter of water

Answer 25

1

Question 26

studies demonstrate that water fluoridation prevents ___% of caries in the permanent teeth of children without the addition of other fluoride products (toothpaste, rinses, etc), and is ___% with the fluoride products

Answer 26

- 50-70% | - 20-40%

Question 27

what is the major difference between community water fluoridation and school water fluoridation?

Answer 27

the recommended concentration for school water fluoridation is 4.5x the concentration of fluoride recommended for community water supplies in the respective geographic area

Question 28

school water fluoridation has shown a ___% reduction in caries when children have consumed school water fluoridation for 12 years

Answer 28

20-30%

Question 29

since the early 1960s, ___ has become the most widely used fluoride compound for professional application. it has a pH of ___

Answer 29

- acidulated phosphate fluoride - pH is about 3.0 (acidic) - experimental work showed that the topical uptake of fluoride by enamel is greater in an acidic environment

Question 30

___ indicates what proportion of a given population is affected by a condition at a given point in time

Answer 30

- prevalence | - number of people with the disease divided by the total number of people at risk

Question 31

___ indicates the number of new cases that are expected to occur within a population over a period of time

Answer 31

- incidence | - number of new cases of the disease divided by the total number of people at risk

Question 32

___ is a study in which the health conditions in a group of people who are, or are assumed to be, a sample of a particular population is assessed at one time

Answer 32

cross-sectional study

Question 33

___ is a study in which people with a condition are compared to people without it, but who are similar in other characteristics

Answer 33

case-control study

Question 34

___ is a study where a general population is followed through time to see who develops the disease, and the various exposure factors that affected the group are evaluated

Answer 34

prospective cohort study

Question 35

___ is a study used to evaluate the effect that a specific exposure has had on a population

Answer 35

retrospective cohort study

Question 36

the ___ is a method of ascertaining the way individual values are located around the mean

Answer 36

- variance (s^2) - the larger the variance, the more widely the data items are spread around the mean - the smaller the variance, the closer the data items are spread around the mean - a variance of zero indicates no spread at all

Question 37

the ___ measures the typical or average deviation from the mean

Answer 37

standard deviation

Question 38

if p < 0.5, so you reject or accept the null? what about if p > 0.5?

Answer 38

- reject if p < 0.5 - accept if p > 0.5 - p is the statistical significance

Question 39

the ___ quantifies the relationship between variables (x and y)

Answer 39

correlation coefficient (r)

Question 40

a ___ provides a mathematical model of linear relationship between a dependent and two or more independent or predictor variables

Answer 40

multiple regression

Question 41

the ___ measures the association between two categorical variables

Answer 41

chi-square test

Question 42

the ___ is used to analyze the statistical difference between two means

Answer 42

t-test

Question 43

the ___ analyzes whether or not the means of several groups are equal and generalizes a t-test to more than two groups

Answer 43

analysis of variance (ANOVA) test

Question 44

___ is defined as the percent of persons WITH the disease who are correctly classified as having the disease. ___ is defined as the percent of persons WITHOUT the disease who are correctly classified as not having the disease.

Answer 44

- sensitivity | - specificity

Question 45

what are the transmissible diseases of greatest concern to the dental professional?

Answer 45

hepatitis B, HIV, hepatitis C, and tuberculosis

Question 46

what is the etiology of hepatitis B (HBV)?

Answer 46

- the disease is produced by a highly infective virus known as the Dane particle - the intact virus consists of an inner core antigen (hepatitis B core antigen) and an outer coat surface antigen (hepatitis B surface antigen)

Question 47

what is the risk of transmission of HBV after percutaneous injury from an infected patient?

Answer 47

30%

Question 48

how is HBV diagnosed?

Answer 48

- physical exam, medical history, and blood tests - blood tests include hepatitis B antigens and antibodies and hepatitis B viral DNA (HBV DNA), which detects genetic material from the HBV

Question 49

is there a vaccine for hepatitis B?

Answer 49

- yes - three doses - initial dose, a second dose 1 month later, and a third dose 6 months after the first

Question 50

what is the etiology of hepatitis C (HCV)?

Answer 50

caused by hepatitis C virus, a single stranded RNA virus that appears to have cytopathic activity

Question 51

the risk of transmission of HCV after a needle stick or sharps exposure is ___%

Answer 51

1.8%

Question 52

how is HCV diagnosed?

Answer 52

- med history, physical exam, and blood tests | - blood test detects antibodies or genetic material (RNA) of the virus

Question 53

is there a vaccine against HCV?

Answer 53

- no | - prevention is vital

Question 54

what is the etiology of HIV?

Answer 54

HIV is caused by an RNA virus

Question 55

the risk of transmission of HIV from percutaneous exposures is ___% and from mucous membrane exposures is ___%

Answer 55

- 0.3% | - 0.09%

Question 56

how is HIV diagnosed?

Answer 56

- diagnosed when antibodies to HIV are detected in the blood - two primary blood tests are used: enzyme linked immunosorbent assay (ELISA) and western blot assay, which is used to confirm the result of a positive ELISA test - HIV is diagnosed only after two or more positive ELISA tests are confirmed by western blot assay

Question 57

is there a vaccine for HIV?

Answer 57

- no - prevention is vital - postexposure prophylaxis consists of antiviral drugs similar to drugs given to patients with AIDS

Question 58

what is the etiology of tuberculosis?

Answer 58

caused by mycobacterium tuberculosis, a slow-growing bacterium that thrives in areas of the body that are rich in blood and oxygen, such as the lungs

Question 59

what is the most common mode of transmission of tuberculosis?

Answer 59

- inhalation of infected droplet nuclei | - a rare mod of transmission is by infected urine

Question 60

how is tuberculosis diagnosed?

Answer 60

-pulmonary tuberculosis is diagnosed based on a med history, physical exam, and sputum cultures and chest x-rays

Question 61

___ is absence of all life forms

Answer 61

- sterilization | - this is the most important component of an infection control program

Question 62

by custom, the term ___ is reserved for chemicals applied to inanimate surfaces, whereas ___ is used for antimicrobial agents that are applied to living tissues

Answer 62

- disinfection | - antiseptic

Question 63

a major distinction between high-level disinfection and sterilization is the ability of sterilization to kill ___

Answer 63

- spores of spore-forming bacteria (bacillus and clostridium) - bacillus spores are the benchmark organisms for sterilization - if a process kills bacillus spores, it will also kill easier-to-kill bacteria, fungi, viruses, and protozoa

Question 64

what is the proper time and temperature for autoclaving?

Answer 64

250*F (121*C) for 15-20 minutes (15lb pressure of steam) or 270*F (134*C) for a minimum of 3 minutes (30lb pressure of steam)

Question 65

how does moist heat destroy bacteria?

Answer 65

by denaturation of the high-protein-containing bacteria

Question 66

how often should spore testing be conducted?

Answer 66

weekly

Question 67

do process indicators demonstrate that microoorganisms have been eliminated?

Answer 67

- no, they only demonstrate that certain physical conditions have been reached - biologic monitors (spore tests) can indicate elimination of microorganisms

Question 68

compare dry-heat sterilization to autoclaving

Answer 68

- dry-heat sterilization requires a higher temperature and longer time (320*F [160*C] for 1-2 hours) than steam autoclaving - only glass or metal objects can be sterilized by dry heat

Question 69

what is ethylene oxide (chemiclave)?

Answer 69

- a chemical used to sterilize medical devices | - ethylene oxide gas achieves sterilization in 2-3 hours at 120*F (48.9*C) followed by a lengthy aeration time

Question 70

describe chemical (cold) sterilization

Answer 70

- used for instruments and other items that are heat-sensitive - items are soaked in a 2% solution of gluteraldehyde for 10 hours followed by rinsing in sterile water - does not destroy spores or hepatitis viruses

Question 71

___ is a process in which an antimicrobial agent destroys (germicide) or avoids the growth of (microbiostatic) pathogenic microogranisms

Answer 71

disinfection

Question 72

what is the benchmark organism for disinfectants?

Answer 72

mycobacterium tuberculosis

Question 73

what is the most commonly used antiseptic to reduce the number of pathogenic microorganisms on the skin surface?

Answer 73

alcohol

Question 74

noise-induced hearing loss is caused by any exposure regularly exceeding a daily average of ___ dB

Answer 74

90

Question 75

the national fire protection association color and number method is used to identify information about various hazardous chemicals easily on MSDS sheets and product labels. what do the following colors correspond to: blue, red, yellow, and white

Answer 75

- blue = health hazard - red = fire hazard - yellow = reactivity or stability of a chemical - white = required PPE when using the chemical - the level risk for each category is indicated by the use of numbers 0-4 (the higher the number, the greater the danger)

Question 76

which principle of ethics states that the dentist has a duty to respect the patient's rights to self-determination and confidentiality?

Answer 76

patient autonomy

Question 77

which principle of ethics states that the dentist has a duty to refrain from harming the patient?

Answer 77

nonmaleficence

Question 78

which principle of ethics states that the dentist has a duty to promote the patient's welfare?

Answer 78

beneficence

Question 79

which principle of ethics states that the dentist has a duty to treat people fairly?

Answer 79

justice

Question 80

which principle of ethics states that the dentist has a duty to communicate truthfully?

Answer 80

veracity

Question 81

which principle of ethics is "self-governance"?

Answer 81

patient autonomy

Question 82

which principle of ethics is "do not harm"?

Answer 82

nonmaleficance

Question 83

which principle of ethics is "do good"?

Answer 83

beneficence

Question 84

which principle of ethics is "fairness"?

Answer 84

justice

Question 85

which principle of ethics is "truthfulness"?

Answer 85

veracity

Question 86

informed consent is based on which ethical principal?

Answer 86

patient autonomy