Clinical Dental Hygiene

sharps, items that drip of saturated blood and/or saliva, and hard and soft tissues removed from the patients mouth
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residual effectcontinues to work after it is driedrapid, broad-spectrum antimicrobial-bactericidal, fungicidal, tuberculocidal, virucidal, odorless, easy to use, fast acting, environmental and surface compatible, has residual effect, nontoxic to touch or inhalation, EPA registered cleans and disinfectsqualities of disinfectants include whatGlutaraldehydewhat should not be used as a surface disinfectant because of toxic effects of fumes; also corrosive (immersion sterilant for 10 or more hours)high (used in surgical areas), intermediate (used in dental offices; must kill TB organism), low (generally used at home; not acceptable for use in a. dental office (simple phenols)levels of surface disinfectantssimple phenolswhat are used in homessterilizationkills ALL pathogenic microbes, including sporesrecommended minimum temperatures - 273F for 20 mins with a pressure of kPa/25 psiconditions for chemicalventilation is necessary. may damager rubber and plastic items. Spore test = geobacillus (formerly bacillus) stearothermophilusconsiderations for chemicalgeobacillus (formerly bacillus) stearothermophiluswhat is the spore test for chemical340F for one hour or 320F for two hoursconditions for dry heatrecommended for metal instruments. avoid paper products. may damage rubber and plastic items. not recommended for hand pieces. spore test = bacillus atrophaeusconsiderations for dry heatbacillus atrophaeusspore test for dry heatrecommended minimum sterilization parameters 250F with 15 or 20libs per square inch (psi) for 30 minsconditions for steamcorrodes non-stainless (carbon) steel instruments. dulls instruments and burs. OK for some plastics; cotton rolls/gauze (cloth goods). paper packages come out wet and tear. spore test = geobacillus (formerly bacillus) sterothermophilusconsiderations for steamgeobacillus (formerly bacillus) sterothermophilusspore test for steamfalse. indicate have been heat processedtrue or false external indicators that change color indicate sterilityspore testing. determine if the sterilization cycle is reaching proper temperature, time and pressure to kill all microorganismsbiological indicatorsconducted weeklywhen should spore testing been donechief complaintalways address what firstpits and fissures on lingual surfaces of anterior and on occlusal, buccal and lingual surfaces of posterior teethClass 1 cavityproximal surface of posterior teeth, commonly involved occlusal surfacesClass 2 cavityproximal surfaces of anterior teeth, does not involved the uncial edgeClass 3 cavityProximal surface of anterior teeth; involves the incisal edgeClass 4 cavityCervical (gingival) 1/3 of the facial or lingual surfaces of any tooth (root caries)Class 5 cavityincised edge of anterior and/or cusp tips of posterior teethClass 6 cavityclass 1mesognathic is known asclass 1 occlusionclass 2 occlusionclass 3 occlusionclass 2retrognathic is also known as whatclass 3prognathic is also known as whatvertical______ overlap of the maxillary incisors to the mandibular incisorsmidline shiftdeviationedge to edgeanterior teeth edge to edgeend to endposterior teeth cusp to cuspClass 3 furcationsevere bone loss; instruments can pass between roots. (closed triangle)Class 1 furcationearly evidence of bone loss; instrument can enter the depression leading to the furcation. (open triangle)Class 2 furcationmoderate bone loss; instrument can enter furcation, but cannot pass between the roots (open triangle)class 4 furcationsame as class II but with evidence of recession (closed triangle)Nabers probeuse what probe to assess furcationsangles classification of occlusionNnormal mobility1slight horizontal mobility2involved moderate horizontal mobility greater than 1mm without vertical displacement3involved severe mobility with possible combined horizontal and vertical movementsalivanutrient source for supra gingival calculusCrevicular fluid and inflammatory exudatenutrient course for sub gingival calculus11/12 explorer and pigtail for posteriors. orban-type for anterior and cervical 1/3s of posterior teeth. dry teeth with compressed air. radiographswhat do you use for detecting calculusremovable.exogenous stainblack line, brown, dark-brown and black, orange, yellow-brown and brown, greentypes of exogenous stainnot removable, possible causes include pupal necrosis, internal resorption, excessive systemic fluoride and or/tetracycline use during tooth development.causes of endogenous staininggram positive bacteria. typically located on cervical 1/3 of facial and line stain is caused by whatpoor oral hygiene and/or drinking dark-colors beverages-tea, coffee, fruit, juices and red wine.brown stain is associated with whattobacco usedark brown and black staining is caused by whatchromogenic bacteria in plaque; associated with poor oral hygiene; typically located on anterior teethorange staining is caused by whatcan be associated with chlorhexidine or stannous fluoride use; stannous fluoride stain results from the reaction of the tin ion in the fluorideyellow-brown and brown stain is caused by whatassociated with poor oral hygiene, chormiogenic bacteria, fungi, and gingival hemorrhage (bleeding gums).green stain is caused by whatblack linewhat type of stain is associated with ironpotassium nitrate, sodium citrate, strontium chloridewhat is added to toothpaste to prevent dental hypersensitiytEPAwhich agency monitors water fluoridationtachycardiaabornomally high heart rate usually above 150 beats per minutebradycardiaslow heart ratethe pH drops below 4.5 to 5.5 for enamel an 6.0 to 6.7 cementum--known as critical pH levelsdemineralization occurs whenbacterial metabolismfluoride interferes withbactericidal (destrutiva to bacteria)in high concentrations (professional application), fluoride is whatbacteriostatic (inhibits growth or multiplication of bacteria)in low concentrations (daily at home application) fluoride is whatthe ability to bind to pellicle, plaque and tooth surface and be released over a period of time with retention of potency; therefore DO NOT need to polish teeth prior to applicationfluoride has substantivity which means whatwater, toothpaste, rinses, fluoride Txtopical fluoride therapy exampleswater, supplements, foodsystemic pre-eruptive fluoridestomach and small intestines. amount not used is excreted though kidneyssystemic fluoride is rapidly whereadjustment of the fluoride ion content of a domestic water supply to the optimum physiologic concentrations that will provide maximum protection against dental caries. Most cost-effective and efficient methodwater fluoridation$0.13-5.48/person/year, depending on the size of the communityaverage cost of water fluoridation0.7 ppm mg/Lwhat is the optimal fluoride levelEnvironmental Protection Agency (EPA)who monitors the concentration level in community drinking water?FDAwho monitors the concentration level in bottled watersodium fluoride, sodium silicofluoride, hydrofluorosilicic acidwhat compounds are used to fluoridate water4 mgEPA MANDATES defluoridation if fluoride level in community water source exceeds whatbetween 2 and 4mg of waterEPA RECOMMENDS defluoridation if levels arechildren who live in areas with inadequate water fluoridation, not recommended for pregnant womendietary fluoride supplements are recommended for whopregnant womendietary fluoride supplements are not recommended for who0.25 mg/day of <0.3ppmhow much fluoride should 6 months to three years old of age get in drinking water0.50 mghow much fluoride should 3-6 year old get in drinking water when it is <0.3 ppm0.50-1.00mg/dayhow much fluoride should 6-16 years old get in drinking watertea and fishwhat foods contain fluoridesodium, acidulated phosphate, stannoustypes of professionally applied topical fluoridesSodium Fluroideused in the presence of tooth-colored and porcelain restorationsSodium Fluroidetray method most effective delivery system for individuals with ramparts rant caries. 4 minute application for maximum efficiency; 1 minute applications are not recommended due to lack of efficacy data.first minutegreatest uptake of sodium fluoride using tray method is whensodium fluoride trayswhat is recommended for bulimics.contains 5% NaF 22,600ppmsodium fluoride varnish contains how much fluoridesodium fluoride varnishused for desensitizing exposed roots and caries preventionsodium fluoride varnishuse 0.3-0.5mL application, which is a small volume/low dosesodium fluoride varnishretained for 24-48 hours during which time the fluroide is released for reaction with he underlying enamel (substantivity)2-4 times a yearsodium fluoride varnish is recommended how oftenmore effective in caries reduction than traditional professional topical fluorides - 14% more effective than topical gels. effective for use on infants and small children with significantly less fluoride ingested than with APF gel. NOT for home usedescribe sodium fluoride varnishtray 2.5 ml for adult. or by painting with cotton-tip applicator; available in foams or thixotropic (gel-like) formapplication for phosphate fluoridedue to tin ion in compoundwhy does stannous fluoride have metallic tastestannous fluoridestains demineralized areas and margins of tooth-colored restorations due to the reaction of the fluoride tin ion in the compoundstannous fluoridecauses possible gingival sloughing2%percentage concentration of sodium fluoride9,050ppm of fluoride in sodium fluoride22,600ppm of fluoride in sodium fluoride varnish12,300ppm of fluoride in acidulated phosphate (APF)1.23%concentration of fluoride in acidulated phosphate8%concentration of stannous fluoride19,360ppm of stannous fluoride0.05% and 225 ppmat home rinses contain how much fluoride400 and 1500ppmhow much fluoride is in dentifricespea sizechildren under the age of six uses how much toothpastesafety tolerated dose (STD)one fourth of CLD; acute fluoride toxicitywithin 30 minutes of ingestion and may persist for as long as 24 HorusSTD begins whengastrointestinal symptoms - fluoride in the stomach reacts with hydrochloric acid to form hydrofluoric acid, causing irritation to the stomach lining; results in: nausea, vomiting diarrhea, abdominal pain, increased salivation and thirstgastrointestinal symptoms of too much fluoridesymptoms of hypocalcemia, hyperreflexia, convulsions, paresthesia, cardiac failure or respiratory paralysissystemic involvement of too much fluorideadminister fluoride-binding agent (calcium)if patient has <5mg/kg of fluoride what do u doinduce vomiting (emesis), administer fluoride-binding agent, seek medical treatment.if patient has >5mg/kg (TOXIC DOSE) of fluoride what do u doseek medical treatment, induce vomiting, cardiac monitoringif patient has >15mg/kg (LETHAL DOSE) of fluoride what do u dohypo mineralization results from excessive ingestion of fluoride (2ppm+) during amelogensis, typically between ages 1-4 yearsdental fluorosis happens whenresults after long-term exposure (10+ years) of water containing 8-10 ppm fluoridedescribe skeletal fluorosisstillmanThis brushing technique angles the bristles at 45* to the gingival margin and 1/2 the bristles are placed on the tooth and the other 1/2 on the gingivaBass brushing techniqueangle bristles 45 degrees toward the apex at gingival 1/3 placing bristles into the sulcus; recommended for periodontal patientsFones Brushing Techniqueposition bristles perpendicular to crown of teeth; brush in circular motion (Pedo patient)Charters brushing techniqueplace bristles 45 towards occlusal/incisal plane; move bristles in several small rotary motions keeping in contact with gingival margin (oath patient)when contacts are evident (approximately 2 years old for a child)when do patients start flossingopen embrasures, exposed class IV furcations, orthodontic appliances, fixed prostheses and dental implants. (Caution: inner wire must be plastic coasted to avoid scratching cementum)uses for interdental brushopen proximal spaces, hard to access areas, such as 3rd molars and crowded teeth. fixed prostheses such as under sized partial dentures, pontics and orthodontic appliancesuses of tufted brushtufted brushtoothpick holderexposed class IV furcations. interdental cleaning - concave proximal surfaces. gingival margins above orthodontic appliances.toothpick holder useswedge stimulatorwedge stimulatorused in interdental areas with exposed rootsPontictufted flosssuper floss is also known as whatglycerinwhich ingredient is added to dentifrices as a humectant to retain moisture and ensure chemically and physical stable product25what is the average number of days required for the primary soft deposits to change to calculusmarquis probemarquis probewhat probe contains 3,6,9,12 mm markingspyrophosphatesactive ingredient for tartar-controlpotassium nitrate, strontium chloride, sodium citrateactive ingredient in antihypersensiivtytriclosanactive ingredient in antibacterialcabamide peroxide or hydrogen peroxideactive ingredient in whitening60-70 degreeswhat angulation of the blade is graceysgracey 5-6anterior and premolars; buccal/linguals of posterior teethgracey 7-8direct facials and linguals of posterior teeth9-10buccal/lingual surfaces of molars11-12messiah, facial, and lingual surfaces of posterior teeth13-14distal surfaces of posterior teeth15-16messiah surfaces of posterior teeth17-18distal surfaces of posterior teethplastic, nylon, graphite, or gold tippedimplant safe curets and scalers include what18,000 to 45,000ultrasonic magnetostricitve operates at how many cycles her second25,000 to 50,000ultrasonic piezoelectric operates @ how many cps per second2,500 to 7,000sonic scaler operates at how many cps per secondultrasonic magnetosrtictiveuses stack of metal strips in inset to convert energy from handpiece to inset tipultrasonic magnetosrtictiveproduces elliptical or orbital strokesultrasonic magnetosrtictiveall sides of tip are active - most active is the point followed by concave face, convex back, then lateral side =sultrasonic piezoelectricuses ceramic rod to produce mechanical vibrationsUltrasonic Piezoelectric scalerlateral sides of tip are most active. produces linear strokes.sonicuses compressed air to create vibrationssonicproduces elliptical or orbital strokessonicall sides of tip are activeultrasonic scalerswork through cavitationxerostomia, demineralized areas or dental decay, tooth sensitivity, newly erupted teeth, severe gingivitis-irriates free gingiva, lack of extrinsic stain and/or plaque, exposed root surfaces, respiratory conditionsyou should avoid polishing with the use of a rubber cup when?stain and biofilm removal, root detoxification (performed by periodontist), sealant preparation, soft debris removal around orthodontic appliances.air polishing is used whenaluminum trihydroxidewhat can be used instead of sodium bicarbonate when air polishing if the patient has high blood pressurespongy gingiva, respiratory conditions, restorative materials, exposed root surfaces, imunocmpromised, patients taking potassium, anti-diuretics, or steroid therapycontraindications for air polishingorgan transplant and chemotherapysystemic health conditions for ultrasonicexplain procedure to patient, dry teeth, isolate area, apply toothpaste conducting agent) to tip of tester, apply tester tip to tooth in question and another tooth and do not place on same tooth more than twice, on middle or gingival 1/3 with no pressure avoiding contact with soft tissue or metallic restorationspulp vitality test proceduregreenoxygen cylinder is what colorbluenitrous oxide cylinder is what colorsaline rinsewhat mouthwash can be used after nonsurgical periodontal therapybactericidal - inhibits bacterial colonization and prevents pellicle formation. high substantivity - binds to tooth, pellicle, plaque and mucous membrane and then slowly releasedmechanism of action of CHXpreprcedural rinse, decreases supraginival bacterial plaque formation inhibits development of gingivitis, short term adjective therapy following surgical treatment, impactsclinical uses of CHXdyspepsiaalters taste sensationrelated to the dead bacteria that remain as a result of the bactericidal actionhow does CHX cause more calculus to build upsodium laurel sulfateCHX is inactivated by whatpatients who are moderate to high risk for caries. undergoing orthodontia or wearing prosthetic applicable, experiencing xerostomia, have recession, and or demineralizationfluoride rinses are recommended for whobaking soda or saline solution followed by plain water rinsecancer patients with oral mucositis should be recommended what mouthwashChlorhexidine 2x/dayplaque induced gingivitis, slight to moderate chronic periodontitis, NUG, NUP, and periodontal maintenance should be recommended what mouthwashtriangularscalers have what kind of cross sectionhalf mooncurets have what kind of cross section90 degreescurets and scalers face of blade is what to the terminal shankplace stone between 100-110 degrees against blade. (internal angle should be 70-80 degrees)how do u sharpen curets and scalersdirect supervisiondentist authorizes procedure dentist physically present on premises dentist approves work after completion ***indirect supervisiondentist authrozes procedure dentist physically present on premises ***general supervisiondentist authorizes procedure dentist not physically present ***unsupervisedno authorization or supervision ***incipient bleedingless than 10%localized bleeding10-29%perio stability in reduced periodontiumbleeding cant be in 4s+periodontitisCALoss on 2+ non adjacent teeth not from traumaDMFS/DMFT 3rd molarsoptinalposterior teeth surfaces DMFT5anterior teeth surfaces DMFT4high Dtreatment programs neededhigh findicates utilization of surfaceshigh mindicates need for earlier intervention and education, money is a barrier1:200,000 cardio limits4 carps1:100,000 cardio limit2 carpsMI time limit30 daysCVA time limit6 monthsminimize vaso in patients withhyperglacemia (insulin agonist= increase BG)anesthetics for pregnantlodocaine and procainepregnancy sidelay on left, prop up right side