Dental Hygiene III Final Review - Part I

A) A first dental visit is recommended at the eruption of the first tooth, and no later than at 6 months of age. B) One of the major reasons for this first visit is to establish a dental home.

Mary presents for her dental hygiene appointment. Her previous dental cleaning appointment was 2 years ago. She announces that she is 5 months pregnant. She reports taking the drug valerian, an herbal supplement taken for insomnia and also a multivitamin. She reports that her gums bleed when she brushes and flosses her teeth. Upon examination you notice she has a round swelling, purplish in color, located in the papilla area between the premolar teeth. Mary reports that the swelling appeared in the past month and she is concerned about it. The most probable reason that Mary's gums bleed when she brushes and flosses her teeth is due to:

Use of fluoride supplementation can begin at:

During the third trimester of pregnancy, lying in the supine position can be uncomfortable for the pregnant woman due to the weight of the fetus pressing on circulatory vessels. Patient positioning should be adjusted by doing the following?

The safest time for providing dental care to a pregnant patient is during the:

A smear layer of fluoridated toothpaste is advised for an infant and children up to the age of:

Ryan is a 3-year-old child who presents for his first dental appointment. His mother accompanies him to the operatory room. He willingly climbs into the dental chair sporting a big smile. You observe that he has an open bite and his maxillary right central incisor is dark in appearance. He is very cooperative as you begin the dental hygiene appointment. The examination reveals several teeth with caries on the occlusal surfaces. Appropriate anticipatory guidance for the parent should focus on all of the following risk factors, except:

The microorganism most commonly found in the saliva of children who present with early childhood caries is:

For fluorosis to develop in primary teeth, excessive fluoride intake occurs:

The best type of fluoride application for treating white spot lesions on primary teeth is:

A) Children younger than 6 years of age should use mouthrinse. B) Parent/main caregiver of the child may rinse at bedtime with a 0.12% chlorhexidine gluconate for 1 week per month to decrease risk of transferring cariogenic bacteria.

White-spot lesions along the cervical areas and on proximal tooth surfaces indicates which of the following?

All of the following would be important treatment considerations with Alzheimer patients except one. Which one is the exception?

Common oral changes associated with aging include all the following, except:

Communication with the older adult patient includes all the following, except:

The older population has more of which type of caries than any other age group?

All of the following are physiologic changes that occur in the musculoskeletal system due to the normal aging process except one. Which one is the exception?

Mrs. Jones is a new patient in your office. She explains that she does not want to have radiographs or a dental examination, just a cleaning. She goes on to say: “I do not want to spend all of that extra money because I am old. You know that people lose their teeth because they get old.” What would be the best response for Mrs. Jones?

All of the following are oral manifestations of cleft palate, except:

Paul, who is 8 years old, is a patient who had cleft palate surgery completed at an early age to repair a Class VI cleft. He has malpositioned teeth in the maxillary arch that have contributed to speech problems, poor oral hygiene, and several carious teeth. His parents ask for guidance on what can be done to improve his speech and his smile. Paul cares for his teeth on his own and brushes once a day. He is apprehensive about dental treatment. The appropriate time to begin orthodontic treatment for realigning the teeth of a child with a cleft is:

A child with a cleft palate is at greater risk for all of the following, except:

All of the following are appointment considerations for patients with cleft palate, except:

Paul, who is 8 years old, is a patient who had cleft palate surgery completed at an early age to repair a Class VI cleft. He has malpositioned teeth in the maxillary arch that have contributed to speech problems, poor oral hygiene, and several carious teeth. His parents ask for guidance on what can be done to improve his speech and his smile. Paul cares for his teeth on his own and brushes once a day. He is apprehensive about dental treatment. The first priority to address in providing treatment for Paul is:

A) A child with a cleft palate is more likely to have a mental disability. B) A child with a cleft palate is more prone to ear infections.

Which of the following is not a physical characteristic of fragile X syndrome?

Intellectual disorder is characterized by which of the following?

The purpose of cognitive-behavioral therapy for people with autism is:

Which of the following oral features are frequently associated with Down syndrome?

John, a 13-year-old male, presents to the dental office for the first time. John comes with his mother and a caregiver. John's medical history indicates that he has autism and is nonverbal. The dental hygienist completes initial assessments and notes that John has moderate gingivitis and has heavy biofilm accumulation on the buccal surfaces of posterior teeth. Tooth #7 is congenitally missing. John has eight carious lesions. His caregiver reports that his favorite food is gummy bears and that they are often used as a reward when he behaves well. When questioned about fluoride use, his mother reports that they drink the city water, which is optimally fluoridated. What technique should be used to show John and his caregiver how to reach the posterior teeth?

An adult who can conform to a daily routine, do small household tasks, but is likely to be in need of supervised support has what level of intellectual disorder?

If a patient with a disability has a legal guardian, the legal guardian must:

When doing a sliding board transfer, the seat of the dental chair should be positioned:

Jim, a 14-year-old patient, presents to the dental office with his mother, complaining of bleeding gums and sensitivity. His mother reports on his medical history that he has muscular dystrophy and has had epilepsy since he was 3. A few years ago, he had to start using a wheelchair. He has difficulty bending his arm at the elbow and has limitations in raising his arms. The dental hygienist notes that Jim has moderate gingival overgrowth and generalized heavy biofilm accumulation. Jim's mother states that she tries to help him brush his teeth, but he still wants to be as independent as possible and does not like to have help. She knows he probably cannot reach his back teeth by himself. She is also concerned that he may have several cavities because he eats a lot of candy when he is with his caregiver before and after school, but he does drink a lot of bottled water each day. The gingival overgrowth indicated may be caused by which of the following medications?

Jim, a 14-year-old patient, presents to the dental office with his mother, complaining of bleeding gums and sensitivity. His mother reports on his medical history that he has muscular dystrophy and has had epilepsy since he was 3. A few years ago, he had to start using a wheelchair. He has difficulty bending his arm at the elbow and has limitations in raising his arms. The dental hygienist notes that Jim has moderate gingival overgrowth and generalized heavy biofilm accumulation. Jim's mother states that she tries to help him brush his teeth, but he still wants to be as independent as possible and does not like to have help. She knows he probably cannot reach his back teeth by himself. She is also concerned that he may have several cavities because he eats a lot of candy when he is with his caregiver before and after school, but he does drink a lot of bottled water each day. What could be done to Jim's toothbrush to enable him to brush more effectively?

Which of the following is not true of a disability?

A patient who is unable to complete brushing and flossing on his or her own and depends on someone else to attend to his or her oral care would be classified as:

Which factor should a hygienist consider when planning dental hygiene care for the patient with multiple sclerosis?

A) Many diseases of the neuromuscular system leave the patient with a physical impairment. B) Most patients with a physical impairment also have mental impairment.

Andrew is a 26-year-old patient who presents to the dental office for routine dental hygiene therapy. Andrew was in a car accident 2 years ago. He now uses a wheelchair because he cannot use his legs. He does have normal arm function and some hand weakness. Andrew has good oral hygiene, as he uses a power toothbrush and flosses with a floss holder. The first visit Andrew had at the office was very long, as he had neglected his oral hygiene after his accident. He developed a pressure sore and this time has brought some padding to place under him in the dental chair. In addition to the padding, how can a decubitus ulcer be prevented during the dental hygiene appointment?

Another term for cerebrovascular accident is:

How can osteoarthritis affect the temporomandibular joint?

Parkinson's disease:

Which condition requires antibiotic premedication before dental and dental hygiene treatment?

A thyroid storm:

The absence of spontaneous menstrual periods in a female of reproductive age is:

Diabetes is a disease of metabolism with inadequate production of the hormone insulin. Which endocrine gland is responsible for diabetes?

Which of the following is the master endocrine gland that regulates the output of hormones by other glands?

Cushing's syndrome:

Symptoms of adrenal crisis include all the following, except:

Ann, age 53, presents for her 6-month recall appointment and appears anxious and flushed in the face. She reports that she has recently been prescribed Actonel by her gynecologist and that she has been feeling depressed during the past few months. Her oral tissue appears to be more inflamed at this visit than in the past. She reports no changes in her diet or her oral hygiene habits but reports that she has a burning sensation in her mouth and everything tastes salty to her. She also complains of having a dry mouth. The patient's general symptoms are primarily related to the decline of what hormone?

Dental hygiene treatment should be postponed during chemotherapy treatment when the platelet count is less than:

A 55-year-old man with Stage III squamous cell carcinoma of the left retromolar area and left lateral tongue, with metastasis to the left neck, presents for a cleaning appointment prior to his continuing radiation therapy. The radiation field includes the entire neck, mandible, TMJ, and posterior of the maxilla. The examination reveals multiple teeth with cervical caries. The patient has a well-fitting maxillary partial denture, replacing teeth #1 to #5 and #12 to #15. Periodontal involvement includes pocketing ranging from 5 to 7 mm on the maxillary anterior teeth and generalized on the mandibular arch. The plaque level is moderate, with heavy calculus and stain. The patient drinks occasionally and smokes two packages of cigarettes daily. He brushes his teeth twice daily and rinses with Listerine once each day. During assessment of your patient, you notice signs of severe xerostomia. You would expect him to have all of the following other symptoms of radiation therapy, except:

All of the following are systemic side effects of chemotherapy, except:

For the first 6 months after head and neck radiation therapy, recall the patient every __________ as needed for nonsurgical periodontal therapy.

Suggestions for the dental hygiene care plan for patients with cancer include all of the following, except:

The type of bone marrow transplant when the tissue comes from one's own body is:

Which of the following is NOT an objective of dental hygiene care and instruction before oral and maxillofacial surgery?

Maxillary fractures are easier to manage because of the fixation of the associated anatomy.

Which one of the following is not a suggested mouth rinse after surgery?

Which of the following is not an objective in planning the diet of a patient with a fractured jaw?

Mandibular fractures are described by the location and include all of the following, except:

Which of the following instructions should a dental hygienist give to a patient regarding postsurgical care?

Bill, a 30-year-old patient, presents to the office for routine dental hygiene therapy. Bill has always reported that he has had seizures. This visit he indicates that he has been having a seizure about once a week. Since his seizures have been happening more frequently, his doctor has put him on phenytoin. The dental hygienist asks Bill about his seizures and he states that he usually notices very strong smells before his seizures. His seizures usually last about 10 seconds, he loses consciousness, and usually his eyelids twitch. He comes out of it quickly and usually does not remember what has happened. During the intraoral exam the dental hygienist notes that the gingiva in the upper anterior interdental area is enlarged and is somewhat fibrotic. Bill says he has noticed it but it is not painful. Gingival hyperplasia is caused by:

A seizure is a:

When a seizure occurs, the dental hygienist should:

A) A partial seizure affects the entire brain at the same time. B) A generalized seizure involves only a part of the brain.

Bill, a 30-year-old patient, presents to the office for routine dental hygiene therapy. Bill has always reported that he has had seizures. This visit he indicates that he has been having a seizure about once a week. Since his seizures have been happening more frequently, his doctor has put him on phenytoin. The dental hygienist asks Bill about his seizures and he states that he usually notices very strong smells before his seizures. His seizures usually last about 10 seconds, he loses consciousness, and usually his eyelids twitch. He comes out of it quickly and usually does not remember what has happened. During the intraoral exam the dental hygienist notes that the gingiva in the upper anterior interdental area is enlarged and is somewhat fibrotic. Bill says he has noticed it but it is not painful. What determines the severity of phenytoin-induced gingival enlargement?

Beth, a 16-year-old teenager, comes into the office complaining of tooth sensitivity. She has not been seen in the office for 3 years. When asked about her medical history she states that she has been diagnosed with an eating disorder and has had a lot of trouble with it over the past few months. Beth is of normal weight and the dental hygienist questions her further about the disorder. She states that she goes through phases of uncontrollable binge eating and then uses laxatives or self-induces vomiting after the binges. She says she thinks she is obese. Upon further assessment the dental hygienist notes that several teeth have been worn down and are very translucent. She also notes that the right parotid gland is swollen. Which surface of teeth most often shows signs of perimylolysis in a patient who has bulimia?

The major oral problem associated with antidepressive medications is:

Dental hygiene therapy should be completed at what time for a patient with schizophrenia?

Beth, a 16-year-old teenager, comes into the office complaining of tooth sensitivity. She has not been seen in the office for 3 years. When asked about her medical history she states that she has been diagnosed with an eating disorder and has had a lot of trouble with it over the past few months. Beth is of normal weight and the dental hygienist questions her further about the disorder. She states that she goes through phases of uncontrollable binge eating and then uses laxatives or self-induces vomiting after the binges. She says she thinks she is obese. Upon further assessment the dental hygienist notes that several teeth have been worn down and are very translucent. She also notes that the right parotid gland is swollen. Beth indicates that she is seeing a doctor for her eating disorder. What dental advice should the hygienist give her?

A patient with photosensitivity should be given __________ during dental hygiene therapy.

The need for higher doses of a drug to achieve the same effects is called:

Snorting of cocaine can result in perforation of the:

A) Alcohol abuse is associated with an increased risk of cancer of the gastrointestinal and respiratory tracts. B) Alcohol abuse combined with tobacco abuse increases risk for oral cancer.

Which of the following has the side effect of trismus?

A) Oral candidiasis can be present with substance abuse due to immunosuppression. B) Due to immunosuppression and inadequate nutrition, tissue healing is good.

Which of the following is not true of oral manifestations of TB?

The dental chair position should be __________ for patients with respiratory disease.

Mr. Patton presents in your office for a tooth extraction. His dental chart indicates that he has asthma. He uses an albuterol (Ventolin) inhaler four times per day to treat the asthma. Mr. Patton reports that his cardiologist's office has recently prescribed captopril (Capoten) because his blood pressure has been high. The dentist plans on using a local anesthetic containing epinephrine. An oral manifestation from the use of an inhaler is:

All of the following are considered upper respiratory tract diseases, except:

A) Tuberculosis is an infectious communicable disease caused by Mycobacterium tuberculosis. B) A positive Mantoux skin test provides definitive diagnosis of clinically active tuberculosis.

Which of the following is an example of a genetic cause of a congenital heart defect?

A) The dental patient who is experiencing heart failure is usually unconscious. B) The patient should be placed in a supine position to prepare for initiation of emergency response procedures.

All of the following are signs and symptoms of right heart failure, except:

A) Coumarin derivatives, such as warfarin (Coumadin), are used in anticoagulant therapy to prevent blood clots. B) Dental patients on Coumadin should have their prothrombin time checked no more than 1 hour before their dental appointment to determine blood clotting time.

Use of antibiotic prophylaxis is limited to those at highest risk for:

Mrs. Jones is a new patient in your office. She explains that she does not want to have radiographs or a dental examination, just a cleaning. She goes on to say: “I do not want to spend all of that extra money because I am old. You know that people lose their teeth because they get old.” What would be the best response for Mrs. Jones?

The older population has more of which type of caries than any other age group?

All of the following would be important treatment considerations with Alzheimer patients except one. Which one is the exception?

Common oral changes associated with aging include all the following, except:

Communication with the older adult patient includes all the following, except:

All of the following are physiologic changes that occur in the musculoskeletal system due to the normal aging process except one. Which one is the exception?

All of the following are oral manifestations of cleft palate, except:

Paul, who is 8 years old, is a patient who had cleft palate surgery completed at an early age to repair a Class VI cleft. He has malpositioned teeth in the maxillary arch that have contributed to speech problems, poor oral hygiene, and several carious teeth. His parents ask for guidance on what can be done to improve his speech and his smile. Paul cares for his teeth on his own and brushes once a day. He is apprehensive about dental treatment. The first priority to address in providing treatment for Paul is:

A) A child with a cleft palate is more likely to have a mental disability. B) A child with a cleft palate is more prone to ear infections.

Paul, who is 8 years old, is a patient who had cleft palate surgery completed at an early age to repair a Class VI cleft. He has malpositioned teeth in the maxillary arch that have contributed to speech problems, poor oral hygiene, and several carious teeth. His parents ask for guidance on what can be done to improve his speech and his smile. Paul cares for his teeth on his own and brushes once a day. He is apprehensive about dental treatment. The appropriate time to begin orthodontic treatment for realigning the teeth of a child with a cleft is: