Preventive Dentistry Exam 1

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A licensed primary healthcare professional, oral health educator, and clinician who provides preventive, educational, and therapeutic services supporting total health for the control of oral diseases and the promotion of oral health

dental hygienist

Professional roles of the dental hygienist

Educator
Researcher
Administrator/Manager
Advocate
Clinician

All professional roles of the dental hygienist are interconnected through their common application to ___________.

public health

The science and practice of the prevention of oral diseases and the integrated preventive and treatment services administered for a patient by a dental hygienist

dental hygiene care

Services of dental hygiene care

preventive

educational

therapeutic

Types of preventive services

primary

secondary

tertiary

Measures carried out so that disease does not occur

primary prevention

Treatment of early disease to prevent further progression of potentially irreversible conditions that, if not arrested, can lead eventually to extensive rehabilitative treatment or even loss of teeth

secondary prevention

What type of preventive service includes fluoridation of water supplies?

primary prevention

What type of preventive service includes removal of all calculus and dental biofilm while debriding a root surface in a relatively shallow periodontal pocket

secondary prevention

Uses methods to replace lost tissues and to rehabilitate the oral cavity to a level where function is as near normal as possible

tertiary prevention

What type of preventive service involves the replacement of a missing tooth using a fixed partial denture or implant and therefore restoring function?

tertiary prevention

strategies developed for an individual or a group to elicit behaviors directed toward health and permeates the entire patient care system

educational services

clinical treatments designed to arrest or control disease and maintain oral tissues in health

therapeutic services

What type of service involves all scaling and root debridement along with the steps in posttreatment care?

therapeutic service

What type of service involves the placement of a pit and fissure sealant?

preventive and therapeutic service

A framework within which individualized needs of the patient can be met; also, to identify the causative agents and risk factors of a condition that can be reduced, eliminated, or prevented by the services of a dental hygienist

purposes of the dental hygiene process of care

What are the elements of the dental hygiene process of care?

ADPIED

Assessment
Diagnosis
Planning
Implementation
Evaluation
Documentation

Which of the following is secondary prevention?
A) When disease does not occur
B) The treatment of early disease
C) The progression of disease
D) True prevention

B) The treatment of early disease

Which of the following may be influenced by a person's culture and language?
A) Their beliefs and behaviors about health and wellness
B) Their perceptions about the causes of illnesses
C) Attitudes of a patient about accessing healthcare
D) A person's beliefs, behaviors, perceptions, and attitudes may all be influenced by a person's culture or language

D) A person's beliefs, behaviors, perceptions, and attitudes may all be influenced by a person's culture or language

All are correct, but D is the BEST answer

ADA-recognized dental specialities

D-E-4O-3P

Dental Public Health
Endodontics
Oral (and Maxillofacial) Pathology
Oral (and Maxillofacial) Surgery
Orthodontics (and Dentofacial Orthopedics)
Oral (and Maxillofacial) Radiology
Pediatric Dentistry
Periodontics
Prosthodontics

Dental hygiene specialty practices

orthodontics
pediatric dentistry
periodontics

Objectives for professional practice

Overall goals

Personal goals

The professional dental hygienist carefully documents all aspects of patient care in the patient's permanent record to provide that is:

comprehensive
accurate
ongoing
ethical and legal
objective and facutal

The co-therapist role of the DH is:

-moral/ethical
-within scope of DH care
-combined educational and clinical services
-patient's oral wellness status/maintenance

Steps in a Preventive Program

Assess the patient's needs
Plan for intervention
Implementation
Perform clinical preventive services
Evaluate progressive changes
Plan short- and long-term maintenance

True or False: The clinician sets the patient's goals

False

Patient sets goals; RDH guides them to set goals

What may be factors to assess the patient's needs?

data:
x-rays; looking at past and comparing
PASS, PSR, and PI scores
infection present

What step in a preventive program involves a patient's learning factors, oral status, oral homecare, dexterity, and comprehension as well as outlines procedures and goals and explains outcomes?

plan for intervention

What step in a preventative program involves providing a demonstration, methods for self-evaluation?

implementation

What step in a preventive program involves scaling for complete calculus and biofilm removal as well as application of caries-preventive agents (fluoride & sealants)?

perform clinical preventive services

What step in a preventive program involves assessing the patient's compliance, recording their dental biofilm score, noting improvement in probing findings, and providing preventive counseling for corrective action when goals are not met?

evaluate progressive changes

What step in a preventive program involves determining appropriate intervals, reevaluating to monitor preventive practices, and providing supplemental care

plan for maintenance

What step in a preventive program involves personalized instructions, risk factors that can be controlled, prevention of oral accidents, and encouragement of action toward prevention?

patient counseling

The stimulus to act or think

Stimulation of behavior directed towards fulfilling a recognized goal

motivation

What are two theories of motivation

Maslow's hierarchy of human needs

behavior modification

What are Maslow's hierarchy of human needs?

Biological, physiological, or physical needs

Safety and security needs

Social needs-belongingness and love needs

Esteem-ego

Self-actualization

What are the two levels of Maslow's hierarchy that have potential as long-term motivators?

Social and Esteem levels

This theory involves breaking the change that is necessary into small steps and positively achieving one step at a time.

behavior modification

When people modify their ________, they take charge through ________ of the problem

behavior

"ownership"

What are the factors of motivation?

action toward behavioral change

value of oral health

factors of psychosocial change

peer group factors

What are the three types of learning?

Cognitive

Affective

Psychomotor

This type of learning pertains to the recall or recognition of facts and the development of intellectual skill and abilities; ex: Orofacial Anatomy

cognitive

This type of learning pertains to interests, attitudes, and values, as well as the development of appreciations and adequate adjustments; ex: Preventive Dentistry

affective

This kind of learning pertains to the manipulative or motor skill areas; ex: Preclinic Lab

psychomotor

What are the 4 steps to keep in mind for actual patient instruction?

small step size (small increments of info)

active participation

immediate feedback

self-pacing

What are the principles of learning?

Readiness to learn

Motivation to learn

Transfer of learning

Evaluation after instruction

Learning occurs when individuals:
A) understand the concepts presented to them
B) change their beliefs and attitudes about oral health
C) are motivated to practice good oral health habits
D) have received thorough oral hygiene instructions
E) change behavior and incorporate the changes into everyday living

E) change behavior and incorporate the changes into EVERYDAY living

What are the steps of the Learning Ladder?

1. Unawareness

2. Awareness

3. Self-interest

4. Involvement

5. Action

6. Habit

Involves when to teach, the setting of teaching, and the presentation with demonstration and practice

Individual patient planning

What patient education lesson number involves orientation to dental biofilm removal (do they know what it is?), description of biofilm, evaluation of patient's tissues with a mirror, demonstration, application of a disclosing agent, instruction, and summary?

first lesson

What is involved in the summary of the first lesson with a patient?

need for specific toothbrushing method

use of disclosing agent

need for regular cleaning

counsel regarding toothbrush selection and use

What patient education lesson number involves evaluating the patient's success to date, review and extension of knowledge, continuous instruction (relationship to gingival health, maintenance)

second lesson

What is involved in instruction adaptability?

methods adapted to any age level

awareness of motivation factors ("what are the benefits to you")

instruction for caregivers

What adaptions do you need to make to the instruction of preschool-aged children?

establish oral health habits

parental preventive education

risk factors and prevention

What are the components of The Teaching System?

Approach
-Content and goals

Outcomes of learning
-treatment outcomes
-prevention of recurrence

What are the criteria for teaching aides?

Simplicity

Content (relevant, practical, evidence-based)

Cultural and linguistic appropriateness

Level of orientation (appropriate)

Durability (reusable?)

Cost

Objectives (clear, educate not entertain)

Reading material for the patient must be

appropriately selected

"taught" by the dental hygienist

What kinds of models can be used as teaching aides?

patient's study cast

commercially available models

demonstration in patient's mouth

A person-centered, goal-directed method of communication for eliciting and strengthening intrinsic motivation for positive change

motivational interviewing

What are the levels in the MI pyramid?

Strategies (top)

Principles

Spirit (bottom)

What are the principles of motivational interviewing?

Express Empathy

Develop Discrepancies

Roll with Resistance

Support Self-efficacy

How would you express empathy to a patient?

through acceptance ("I hear you")

affirmation

open-ended questions

reflective listening

How would you develop discrepancies with the patient?

between current behavior vs. important goals/values

what their teeth are vs. what they think is healthy

How can you support self-efficacy with in a patient?

optimism (Spirit)

thank your patient for coming ("I'm so glad you're here")

What are the key components of brief MI which can be applied for the delivery of oral health information and advice?

Ask Permission

Elicit, Provide, Elicit

Explore Options and Affirm Commitment

What sets the collaborative spirit of MI right from the start and provides the patient with the autonomy?

Asking permission

What communication skills are used for Elicit-Provide-Elicit?

OARS

Open-ended questions (asking)

Affirmation (informing)

Reflection (listening)

Summaries

What term refers to a conflicted feeling or uncertainty about something?

ambivalence

There is empirical evidence that the skillful use of MI:
A) can be learned by dentists and dental hygienists.
B) reduces plaque and improves gingival health.
C) enhances internal motivation for regular brushing.
D) Only B and C.
E) All of the above.

E) All of the above.

The acquired or innate tendency for health professionals to "fix" a patient's problems by offering prescriptive advice is referred to as ________.

righting reflex

The clinician reflects back what he/she perceives the patient has communicated

reflective listening

The statement, "You're very determined, even in the face of discouragement. This change must really be important to you." is an example of ___________.

affirmation

What can be used to elicit the extent to which a person feels compelled to change?

motivational ruler

"Rolling with resistance" means the clinician ____________ resistance expressed by the patient.

acknowledges

True/False: The clinician will increase the likelihood of engaging patients if he/she clearly demonstrates respect for patients and recognizes they are autonomous individuals.

true

The foundation of MI is built on:
A) specific strategies the clinician teaches to the patient.
B) a sincere "spirit" of mutual respect and collaboration between the clinician and patient.
C) clinicians solving problems for patients.
D) patients' fear of losing their teeth.

B) a sincere "spirit" of mutual respect and collaboration between the clinician and patient.

Research has shown the average health care provider _________ a patient disclosure.

quickly interrupts

MI has been shown to positively affect health behavior change related to:
A) Smoking
B) Diabetes management
C) Oral health
D) All of the above

D) All of the above

A patient's verbal expression of their desire, reason, ability, or need to make a change in oral health behaviors

change talk

Andragogy refers to "the art and science of helping _____ learn."

adults

What are principles of good practice in andragogy

prior experience

readiness for learning

relevance

internal locus of control

Components of establishing an adult teacher-learner relationship include:

trust

mutual respect

authenticity (and non-possessive warmth)

accurate empathy

What are the stages of change?

Precontemplation

Contemplation

Preparation

Action

Maintenance/Relapse

What stage of change is this: the individual is not willing to change oral health habits in the next 6 months and may not even recognize there is a problem

precontemplation

What stage of change is this: the individual is considering change, undergoing a process of evaluating the pros/cons, and is ready to change current behavior within 6 months

contemplation

What stage of change is this: the individual is ready to make a commitment to change oral health habits in the next 30 days and to set a target date.

preparation

What stage of change is this: change or modification of behaviors actually takes place

action

What stage of change is this: this individual has had 3-6 months of successful behavior change and is focusing on lifestyle modifications in order to avoid relapse and stabilize behavior change

maintenance

What stage of change is this: individual and clinician asses the reason & discuss how the patient might handle the situation differently the next time.

relapse

a patient believes some force from the environment is in control of their behavior

external locus of control

the belief a person is in control of his/her own behavior

internal locus of control

Demonstrating denial and/or active resistance to change is consistant with the ___________ stage of change.

precontemplative

Patients in the preparation stage of change are ready to set a target date within ______ month(s).

1

What part of an appointment would this fall under?

examine tissues for signs of inflammation

assessment

What part of an appointment would this fall under?

examine teeth for carious lesions

assessment

What part of an appointment would this fall under?

utilize radiographs for signs of periodontal disease or carious areas

assessment

What part of an appointment would this fall under?

perform PASS

assessment

What part of an appointment would this fall under?

perform PSR and periodontal probing if necessary

assessment

What part of an appointment would this fall under?

disclose the patient and perform a plaque index if necessary

assessment

What part of an appointment would this fall under?

allow the patient to perform his/her usual cleaning routine

assessment

What part of an appointment would this fall under?

Engage the patient in conversation regarding the frequency of brushing and use of other aids, floss, etc. Seek additional information on the patient's general awareness and concert for oral conditions

assessment

What part of an appointment would this fall under?

Idendify some short- and long-term goals

planning

What part of an appointment would this fall under?

Share the plan with the patient - are the goals acceptable? What goals does the patient have? Is the patient committed to the plan?

implementation

Accepted steps to keep in mind for patient instruction

small step size

active participation

immediate feedback

self-pacing

What part of an appointment would this fall under?

Measures progress toward attaining the goals that have been set

evaluation

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