Test 2

Question 1

What is the single greatest contributor to behavior change? 2nd greatest?

Answer 1

Patient’s own self-change efforts. The relationship between parent and care provider.

Question 2

What is health promotion?

Answer 2

Any process enabling individuals or communities to increase control over the determinants of their health. Multiple determinants of health.

Question 3

What are the social determinants of health?

Answer 3

Knowledge, health belifs and attitudes. Patterns of behavior and psychosocial factors.

Question 4

Salutogenic Model

Answer 4

Focus on health and well being, not the disease. In oral health, it focuses on factors associated with children and caregivers who ave avoided oral disease rather than on the more more common pathogenic approach, which describes factors associated with dental caries. “This is what you can do/are doing that’s right. Rather than, this is what you are doing that’s wrong.

Question 5

Locus of Control

Answer 5

A belief about outcomes of our actions being contingent on what we do (internal LOC) or events outside our personal control (external LOC). Where we put the blame. Most are in between the two extremes. Inner LOC patients are much better.

Question 6

What is the central concept of MI?

Answer 6

Identify, examine and resolve ambivalence about changing behavior.

Question 7

What is ambivalence?

Answer 7

Feeling two ways (love-hate) about behavior change.

Question 8

What are the 3 essential elements of MI?

Answer 8

Specific form of conversation about change.
Collaborative, person-centered, honors autonomy.
Evocative, brings forth the person’s own motivation and commitment.

Question 9

What are the 4 fundamental processes of MI?

Answer 9

Engaging: the relational foundation.
Focusing: Strategic centering.
Evoking: recognizing, eliciting, responding to change.
Planning: bridge to change.

Question 10

What is OARS?

Answer 10

Core communication strategies.

Open-ended questions.
Affirmations
Reflection (most common response)
Summaries

Question 11

If importance is low, how do you talk to the parent?

Answer 11

Do not give advice. Ask the person about their values, goals. Ask what they want their life to be like.

Question 12

If confidence is low, how do you talk to the parent?

Answer 12

Provide info, advice. Ask about what will help to change. Ask about past success, challenges/strategies used. Ask about strengths, abilities.

Question 13

What’s the most effective way to control caries in pit and fissure?

Answer 13

Restorations. Fluoride is less effective.

Question 14

What’s the most effective way to control caries on smooth surface?

Answer 14

Fluoride, oral hygiene and dietary modification.

Question 15

What’s the earliest clinical sign of dental caries?

Answer 15

White spot.

Question 16

What are the 4 classical zones of a white spot lesion?

Answer 16

1. Surface Zone: High concentration of mineral.
2. Body of lesion. Principal area of demineralization.
3. Dark zone:
4. Translucent Zone: Furthest away.

Question 17

What constitutes as ECC?

Answer 17

A child less than 6 years or 71 months with 1 or more decayed, missing (from caries) or filled tooth surface in any primary tooth.

Question 18

What constitutes as severe ECC?

Answer 18

Child less than 3 with any sign of smooth surface caries.

Or chlide 3-5 yr with 1 or more cavitated, missing, or filled smooth surfaces in MX anterior teeth or DMFS score, greater than 4 at age 3, 5 at age 4 and 6 at age 5.

Question 19

Why are primary teeth at greater risk for caries?

Answer 19

Thinner enamel and dentin. Larger pulp, closer to surface, reached more rapidly. Flat broad contacts that are harder to clean.

Question 20

Summary of Hopewood House

Answer 20

Children lived there and had limited oral hygiene and dental care, but had a lacto-vegetarian diet without refined foods. Extremely low caries prevalence.

Question 21

Summary of Vipeholm Study

Answer 21

Swedish government used long term controlled conditions and extreme carbohydrate consumption to induce caries. Increased caries in consumption between meals and highest caries in retentive or sticky candies. But also found that it varies. Some people just don’t get caries.

Question 22

How much juice intake does the AAP recommend per day?

Answer 22

4-6 oz.

Question 23

What is in the preop evaluation for exodontia?

Answer 23

Med and dental history. Physical exam. Imaging. Diagnosis.

Question 24

What are some med history contraindications?

Answer 24

Systemic disorders (blood, heart, leukemia, bisphosphate therapy, etc)

Question 25

What are some med history considerations?

Answer 25

Systemic disorders (premature birth, genetic disorders and syndromes, pulmonary problems such as asthma and cystic fibrosis, growth and development, obesity, endocrinology disorders, etc), local factors (radiation, cancer, teeth and tumor association, abscess, infection, chemo, etc)

Question 26

Where is the Cow Horn is contraindicated?

Answer 26

MN Molars.

Question 27

What forceps do you use for MN molars?

Answer 27

151 (S-K)

Question 28

Why would you maybe need to section primary MN 2nd molars.

Answer 28

The diverging mesial and distal roots on the primary 2nd molars. Prevents damage to developing tooth bud.

Question 29

What forceps do you use on anterior teeth?

Answer 29

1, 150 (S-K) or 151 (S-K)

Question 30

What type of forces do you use on anterior teeth?

Answer 30

Rotational force on conical roots.

Question 31

What is the purpose of apical pressure?

Answer 31

Expansion of the tooth socket, moves center of rotation apically.

Question 32

What is the purpose of buccal pressure?

Answer 32

Expansion of buccal plate.

Question 33

What is the purpose of lingual pressure?

Answer 33

Expansion of linguo-crestal bone.

Question 34

What is the purpose of rotational forces?

Answer 34

Internal expansion of socket.

Question 35

What are the purposes of tractional forces?

Answer 35

Gentle and limited to the final portion of the extraction process.

Question 36

1st step in extraction procedure?

Answer 36

Loosening of the ST attachment. Reassurance of profound anesthesia. Push tissue away to allow forceps to be positioned as apically as possible.

Question 37

2nd step in extraction procedure?

Answer 37

Luxation of tooth with dental elevator. Expansion of alveolar bone and tearing of PDL.

Question 38

Step 3 in extraction procedure?

Answer 38

Firm adaption of forceps to tooth. Beaks should grasp underneath loosened soft tissue. Luxation of tooth with combination of all motions.

Question 39

Step 5 in extraction procedure?

Answer 39

Removal of tooth with forceps. Compression of socket.

Question 40

What is the primary tooth treatment for reversible pulpitis?

Answer 40

Indirect pulp treatment: Deep caries with no pulp exposure. Objective is to completely seal the involved dentin from the oral environment and stimulate dentin healing and repair. Calcium hydroxide, zinc oxide and eugenol, glass ionomer cement then tooth restored with material that seals the tooth from microleakage. A direct pulp cap is not recommended for carious pulp exposure in primary tooth.

Question 41

When do you use a pulpotomy and what is it's objective?

Answer 41

Reversible pulpitis. A deep carious lesion adjacent to the pulp, a carious pulp exposure in a tooth with a normal pulp or reversible pulpitis, large traumatic pulp exposure. Objective is to amputate coronal pulp tissue and reat remaining radicular pulp surface with a medicament to preserve health. Fill coronal pulp chamber with a suitable base, then restoration that seals from microleakage.

Question 42

When do you perform a pulpectomy and what are it's objectives?

Answer 42

Irreversible pulpitis or necrotic pulp. Pulp tissue is infected or necrotic due to caries or trauma. Indications include: Irreversible pulpitis or necrotic pulp, tooth planned for pulpotomy in which radicular pulp exhibits clinical sings of pulp necrosis such as excessive hemorrhage. Objectives: Maintain tooth and resolution of the infectious process radiographically in 6 months. Root canals are debrided, enlarged, disinfected and filled with a resorbable material such as zinc oxide/eugenol.

Question 43

When would you extract a tooth?

Answer 43

Irreversible pulpitis or necrotic pulp. Tooth is non restorable due to insufficient tooth structure for restoration. Tooth is within 1 year of exfoliation or shows root resorption.

Question 44

What is a sedative restoration and when do you do it?

Answer 44

On reversible pulpitis on young permanent teeth. You place a protective base on the pulpal surface of cavity preparation, covers the dental tubules, acts as a protective barrier between restorative material or cement tooth's pulp.

Question 45

When do you use indirect pulp treatment on a young permanent tooth?

Answer 45

Reversible pulpitis, deep caries with no pulp exposure. You want to completely seal dentin from the oral environment and stimulate dentin healing and repair. Calcium hydroxide, zinc oxide and eugenol, glass ionomer, then restored with material that seals from microleakage.

Question 46

When do you do a direct pulp cap?

Answer 46

NOT ON PRIMARY TEETH. Only on young permanent teeth. Small, mechanical pulp exposure during cavity preparation, small carious exposure or following traumatic injury. Maintain tooth's vitality with pulp healing and reparative dentin formation resulting. After hemorrhage control completed, cap the exposed pulp. Put material in direct contact with the exposed pulp tissue, then restoration that seals tooth from microleakage.

Question 47

When are partial pulpotomy carious exposures indicated? Objective?

Answer 47

Young permanent tooth for small carious exposure in which pulp bleeding is controlled in 1-2 minutes. Inflamed pulp tissue beneath carious exposure is removed to depth of 1-3 mm or, in some cases, deeper to reach healthy pulp tissue. Control bleeding, cover.

Question 48

How do you do a partial pulpotomy for traumatic exposures?

Answer 48

Inflamed pulp tissue beneath exposure is removed to depth of 1-3 mm to reach the deeper, healthy tissue. Bleeding is controlled using bactericidal irrigants. covered. Vital, traumatically exposed, young permanent teeth. Especially with incompletely formed apex. Bleeding must be controlled. Must amputate to healthy pulp. Maintain vital pulp. NO symptoms, no radiographic signs of resorption or pulp calcification or periapical radiolucency. Immature root shows continued normal root development.

Question 49

How do you treat a non-reversible/nonvital pulp of permanent tooth?

Answer 49

PULPECTOMY. Rootcanal.

Question 50

Infraction

Answer 50

Incomplete fracture (crack) of the enamel with no loss of tooth structure. Craze lines and normal radiographic appearance. For treatment, you want to maintain structural integrity and pulp vitality. Complications are unusual.

Question 51

Uncomplicated Crown Fracture

Answer 51

An enamel fracture or enamel-dentin fracture that doesn't involve the pulp. Diagnosis: Clinical and/or x ray findings reveal the loss of tooth structure confined to enamel or both enamel and dentin. Treatment: Maintain vitality and restore to normal esthetics and function. Prognosis: dependent on concominant injury to PDL and secondarily to extent of dentin exposed. Improved prognosis with timely care.

Question 52

Complicated Crown Fracture

Answer 52

An enamel/dentin fracture with pulp exposure. Diagnosis through clinical and x ray findings reveal a loss of tooth structure with pulp exposure. Treatment: Maintain pulp vitality and restore normal esthetics and function. Primary teeth: Decision is based on life expectancy of traumatized tooth and vitality. Pulpotomy/ectomy or extraction. Permanent: Direct pulp cap, pulpotomy (partial or full) and pulpectomy. Prognosis is dependant on pdl, age of exposure, dtent of dentin and root develoupment.

Question 53

Crown-Root Fracture

Answer 53

An enamel, dentin and cementum fracture with or without pulp exposure. Diagnosis: Mobile coronal fragment attached to gingiva with or without pulp exposure. Radiolucent oblique line on xray, usually vertical. Primary: Remove tooth and apical shit, unless you will result in damage to succedaneous tooth. Permanent: Stabalize coronal fragment. Remove cronoal fragment and restore. Prepare for subgingival restoratuon by fingivectomy, osteotomy or extruson. Pulp treatement. Most permanent can be restored with complex treaatment.

Question 54

Root fracture

Answer 54

Dentin and cementum fracture involving pulp. Primay: extract coronoal fragment. Permanent; Reposition and stabliilze cornoal fragment. Pulp necroses. Should preserve in cervical third. Yong teeth, immature roots, high pulp senstivity and disolatoin within 1 mm are good at healing.

Question 55

Concussion

Answer 55

Injury to tooth-supporting structures without abnormal loosening or displacement of the tooth. PDL absorbs injury and is inflamed. Tender. No radiographic abnormalities. You want to help it heal and maintain vitality. Unless infection, do nothing. Minimal risk for necrosis. Perm teeth may undergo.

Question 56

Subluxation

Answer 56

Injury to tooth with loosening. Mobile tooth without displacement. Can have sulcular bleeding. No radiographic abnormalities. Watch primary teeth for pathology. Permanent teeth: stabilize, releive occlusion, flexible stint. Favorable prognosis. Primary teeth will return to normal within 2 weeks, but often discolors. Need to follow permanent teeth closely for pulpal necrosis.

Question 57

Lateral Luxation

Answer 57

Displacement of tooth in a direction otther than axially. PDL is torn and contusion or fracture of spporting bone occurs. Tooth displaced laterally. Normally palatal or lingual (crown). Not moble. X ray shows increased PDL space. Primary: Allow passive repositioning if no occlusion. Gently reposition if minor interference. Extract if severe. Permanent: Reposition and stablility with splint and monitor vitality. Primary teeth have risk of pulp necrosis if repositioned. Permanent teeth: necrossis and canal obliteration are common.

Question 58

Intrusion

Answer 58

Apical displacement of bone into alveolar bone. Driven into socket. Compressing PDL. Crushing fracture. Tooth is shortened or missing. Apex is usually labial in primary teeth and driven into alveolar process in permenant. Not moble or tender. PDL noot continuous on radiograph. Primary: Allow re eruption with successor then take out. Permanent: passive reposition. Or with traction. Or surgically. If immature: spontaneous. If mature: reposition and treat with endo within 3 weeks. Primary teeth, most will re-erupt within 2-6 month. Ankylosis can occur. Permanent teeth: Mature with closed apex: high risk for bad stuff. root resorption. Immature: allow to reposition. low risk for complication.s Adjacent intrudet teeth is bad.

Question 59

Extrusion:

Answer 59

Displacement axially, PDL normally torn. Elongated and mobile. Increased PDL apically. Primary: Allow to reposition spontaneously. Severe,, near exfoliation, fully formed, then extract. Permanent: reposition as soon as possible, then stabilize in anatomically correct osition. Splint. Not that good of a prognosis.

Question 60

Avulsion

Answer 60

Complete displacement. Tooth is gone. Reimplant immediately, less than 5 min. Do not wait. drying of cells is bad. Use milk or packed ice if can't reimplant. Water damages. Primary teeth, don't replant. Don't want to damage developing tooth. Permantnt: Reimplant and stabilize. Tetanus and abx. Prognosis is dependent upon formation of tooth development and extra orald dry time. You want an immature tooth. No chance for PDL if its been out for more than 60 min. ankylosis is a risk.