DHE 112 Exam 2 Review

  1. What are recommendations for patients with cancer w/ mucositis?
    Palliative care: topical solutions such as a mixture of lidocaine, cough syrup, and a coating agent (milk of magnesia). Cryotheraphy such as chewing on ice chips, and bland rinses of sodium bicarbonate or salt. Systemic prednisone or narcotics such as morphine.

    • Topical solutions (mixture of lidocaine, cough syrup and a coating agent)
    • Cryotherapy(chewing ice)
    • rinse w/ sodium bicarbonate or salt
    • narcotics
    • chlorhexidine
    • inflammation of mucous membranes (meaning oral and GI are affected)
  2. What are things patients w/ mucositis should avoid?
    • Mouth rinses containing alcohol and foods and beverages with high sugar content. Also, Chlorhexidine, sucralfate, and antimicrobial lozenges.
    • A brief interruption in radiation and/or chemotherapy is necessary when mucositis is severe.
  3. What is grading?
    • -(determined by histologic subtype)
    • -Determining the degree of differentiation from normal(of the cells)
    • Grade 1: low grade: well differentiated, keratin, resembles normal tissue, grows less aggressively, metastasize later
    • Grade 2: moderately differentiated: little/no keratin, still recognizable as epi
    • Grade 3: high grade: poor differentiation, no keratin, lack normal architecture, grows aggressively, metastasizes early
  4. What is staging?
    • (determining the clinical extent)
    • -Based on the size and extent of metastatic spread
    • -TNM (tumor-node-metastasis) system used
    • -Size of the tumor (T) in centimeters
    • -Involvement of local lymph nodes (N)
    • -Presence / absence of distant metastasis (M)
  5. How is the stage of cancer determined?
    Tumor-node-metastasis (TNM) system
  6. How do healthcare providers diagnose oral cancers
    Usually detected by clinical examination and confirmed by surgical or fine-needle biopsy.
  7. How do we tx primary avulsed dentition?
    Avulsed primary teeth are seldom reimplanted.
  8. How should we tx permanent avulsed teeth?
    • Recommendations for reimplanting avulsed teeth with open apices are questionable
    • The international association of dental trauma = does not recommend reimplanting
    • ○If possible perform RCT prior to reimplantation for good seal of apex
    • ○Treatment should be aseptically and minimal trauma to PDL for best prognosis
  9. Discolored primary teeth is caused by?
  10. What are possible recommended tx for primary discolored teeth?
    Teeth often will naturally exfoliate w/o treatment and need only conservative monitoring.
  11. Where should you store avulsed teeth in?
    • ▪Hanks balanced salt solution (HBSS)
    • ▪Milk
    • ▪Saline
    • ▪Patient's saliva proved beneficial
    • ▪Viaspan, a storage medium used for transport of transplant organs has also been effective for avulsed teeth
  12. Is dry media as good as wet media for avulsed teeth?
    Matching the osmolarity of the storage medium to the tissue fluids will preserve the PDL
  13. Why is water not the best media to store avulsed teeth?
    ▪Tap water is often used for storage because of its ready availability, but it is a very poor storage media. In fact, water's low osmolality results in cell death of the periodontal ligament. Storage of avulsed teeth on ice is a low alternative if none of the approved storage media are available.
  14. Who should be knowledgeable about handling avulsed teeth?
    • educators
    • health providers
    • public
  15. What are the defense system of the human body?
    • Anatomic barriers
    • normal oral flora
    • immune system
    • saliva
  16. Anatomic barriers functions?
    • (epithelium and normal dentition)
    • Epithelium is a formidable barrier to microbial invasion
    • Oral epithelium does not differ from that of the rest of the body, except that it is wet
    • Majority of the oral epi = keratinized (fibrous, sulfur containing protein which cannot be penetrated even by gastric acids)
    • Ideal dentition includes anatomic barrier of tooth enamel
    • -Enamel is the hardest substance in the human body
    • -It is more mineralized than bone or dentin (96% inorganic)
    • -Hydroxyl group is substituted for fluoride once teeth are erupted
    • -Teeth constantly undergoing demin-remin
  17. Normal Oral flora functions?
    • (bacteria that discourage colonization)
    • Saliva pH
    • Water content in saliva
    • Saliva as a buffer
    • probiotics
  18. Immune system functions?
    • (cellular and humoral)
    • The components of the immune system all monitor the body and distinguish it from anything that is foreign.
  19. Saliva functions?
    • (immunoglobulins)
    • Saliva is important for host defense of homestasis
    • Disease only starts if the bacteria exceed the bodys capabilities and/or pt lacks self care
    • Saliva helps modulate and augment the major body defense systems
  20. What is the epithelium and what is its function?
    • Epithelium is a formidable barrier to microbial invasion
    • Majority of the oral epi = keratinized (fibrous, sulfur containing protein which cannot be penetrated even by gastric acids)
  21. What are the components of a tooth?
    • enamel 
    • dentin 
    • pulp
  22. Which bacteria causes dental decay?
    • Streptococcus mutans
    • Lactobacillus
  23. What is cellular immunity and its components?
    • a.From T cells of the thymus
    • b.T cells are formed by precursor cells from bone marrow
    • c.But the thymus is where they mature to full function
    • d.From the thymus they migrate to the lymph nodes, spleen and blood
  24. What is humoral immunity and its components?
    • a.From B cells of the bone marrow
    • b.Tonsils contain many b cells
  25. What does saliva provide?
    • Lubrication
    • Flushing/rinsing
    • Chemical
    • Antimicrobial (including antibacterial, antifungal, and antiviral)
    • Maintenance of supersaturation of calcium and phosphate ions bathing the enamel, and helping to buffer demineralization and aid remineralization of tooth surfaces.
    • Saliva is important for host defense of homestasis
    • Saliva helps modulate and augment the major body defense systems
  26. What are granulocytes and what are some examples of them?
    • Their function is to find and attack foreign invaders
    • They include:
    • ○Eosinophils
    • ○Neutrophils
    • ○Basophils
    • ○Macrophages
    • They enter the mouth through the gingival sulcus and the tonsils
  27. What are immunoglobulins? How many are there?
    • Antibodies made of protein
    • Defend the body against all types of infection and, sometimes, even when there is no infection
  28. Which immunoglobulins are most important to dentistry?
    • 1.IgA
    • a.Has two subgroups: serum IgA and secretory IgA (dentists most concerned with)
    • All exocrine glands secrete IgA, also in tears, saliva, vaginal fluid, and colostrum
    • Secretory IgA initiates the inflammatory process
    • prevents bacteria and viruses from adhering to mucous membranesLack of IgA = autoimmune disorders like rheumatoid arthritis and lupus
  29. What does saliva provide for the human mouth?
    • missing minerals
    • Acellular protein
  30. What is it called when tooth brush bristles are heat treated?
    End rounding
  31. What are the components of a toothbrush?
    head with bristles and a handle
  32. What are most toothbrush handles made of? What are advantages of such materials they use nowadays?
    • Plastic handle
    • ▪ Water resistant/durable 
    • ▪ Inexpensive
    • comfort
    • • Easy to hold
    • ▪ Dexterity
    • ▪ Children/elderly
    • • Curves and twist allow for
    • hard to reach areas
  33. What are is the purpose of brushing?
    • ▪ Removal of plaque biofilm and disturbance of its re-formation
    • ▪ Removal of food, debris, and stain from the oral cavity
    • ▪ Stimulation of the gingival tissues
    • ▪ Application of a dentifrice containing specific ingredients
    • to address caries, periodontal disease, or sensitivity
  34. What is the Bass method?
    • Acceptable for all patients (perio involvement)
    • Removes plaque at gingival margin
    • • The toothbrush bristles are angled
    • apically at a 45-degree angle to
    • the long axis of the tooth
    • • Filaments subgingival
    • • Jiggle with short horizontal strokes
    • • 2–3 teeth at a time
  35. What is the rolling technique for brushing?
    • • Most appropriate for
    • children cannot master Bass
    • • The bristles are positioned
    • apically along the long
    • axis of the tooth.
    • • Bristles are rolled against
    • the tooth from the apical
    • position toward the
    • occlusal plane.
    • • Repeat several times.
  36. What are some benefits of an electric toothbrush? Who is it typically recommended for?
    • vibration, ionic, oscillation, reciprocation, rotational
    • • Helpful for parents who brush their children's teeth
    • • Larger handle is easier to grasp.
    • Powered toothbrushes are especially helpful for people who
    • are physically handicapped, developmentally disabled,
    • elderly, or arthritic, or who have dexterity issues.
  37. What are disclosing tablets? What are they used for?
    • Disclosing agents;
    • Evaluating the thoroughness of cleaning the teeth.
    • allow the patient to see plaque in the mouth before and after brushing. Give literal road map to remove plaque.
    • self-evaluation and plaque control
  38. What is toothbrush wear? How is it caused by? What influences its progress?
    • (splayed, bent, broken bristles)
    • influenced by brushing method than by the length of time or number of tooth brushing per day. 
    • brushing habits
  39. What anatomy in the mouth harbors the most bacteria?
  40. What is fissured tongue?
    • deep grooves on the tongue surface
    • can transmit organisms during tooth brushing and infection or reinfection of a periodontal pocket
  41. Dentifrice(toothpaste) abrasives are influenced by what factors?
    • depends on the inherent hardness of the abrasive, the size of the abrasive
    • particle, and the shape of the particle.
  42. What are the most common dentifrice abrasives?
    carbonates (calcium carbonate, sodium carbonate*baking soda), phosphates, and silicas.
  43. What is the difference between particle size of abrasive and polishing particles?
    polishing agents are usually small-sized particles of aluminum, calcium, tin, magnesium, zirconium compensate for abrasives that dull the tooth luster.
  44. What is abrasion? What does it typically appear like on a tooth?
    • dull tooth luster
    • v-shaped notches
  45. What are humectants?
    • maintain the moisture and
    • prevent hardening. (*used in toothpaste)
  46. What are common examples of humectants?
    sorbitol, mannitol, glycerol, propylene glycol
  47. What are characteristics of dentifrice for public acceptance?
    • flavor 
    • smell
    • color
    • consistency
  48. How is baking soda used in dentistry? What does it do for oral hygiene?
    • toothpaste, brush with baking soda
    • reduce plaque , gingivitis 
    • remove extrinsic stains
    • reduce malodor
  49. What is an activity of stannous fluoride?
    • Anticaries agent
    • specifically the stannous ion, has reported activity against caries, plaque, and gingivitis.
  50. What are examples of desensitizing agents? What is their mechanism?
    • (Potassium nitrate) it reduces the reaction of nerves in the teeth to stimuli such as heat and cold
    • Known to desensitize the nerve by penetrating through the length of the dentinal tubules and to depolarize sensory nerve endings located at the dentin–pulpal interface.
  51. What is clefting? How does it appear in the gingiva?
    • damage from flossing; signs of incorrect use of dental floss
    • gingival cut and cleft
  52. What is bacterial endocarditis?
    bacterial infection of the heart
  53. When are floss holders not recommended?
    • difficult loading and threading
    • tension of floss
    • decrease of C-shape
  54. What are the different embrasure types?
    • Type I; papilla fills interproximal space
    • Type II; slight to moderate recession of papilla
    • Type III; extensive recession or complete loss of papilla
  55. What are recommendations for hygiene of each type of embrasure?
    • Type I; waxed floss, unwaxed round, 
    • Type II; waxed dental tape, Tufted super floss
    • Type III; waxed dental tape, Tufted super floss
  56. What is a recommendation for bulimics for oral hygiene?
    • Rinsing with 0.05% sodium fluoride, slightly alkaline mineral water, sodium bicarbonate, magnesium hydroxide solution to neutralize the gastric acids following each vomiting episode. 
    • Use of fluoride trays for 5 min/day, rinse w/ 1 teaspoon baking soda mixed with 8 ounces of water. Over-the-counter 0.05% fluoride rinse is helpful in diminishing enamel loss. Don't brush the teeth for at least an hour after vomiting. The enamel becomes soft due to stomach acid. Using a tongue cleaner to remove acid from the papillae is crucial. Limiting nonabrasive dental products for maintenance appointments is important and the use of enamel promoting dentifrices is optimal.
  57. What is halitosis?
    • bad breath
    • malodor
  58. How does someone address halitosis?
    • mechanical cleaning of tongue and maintain oral health even in healthy patients.
    • professional debridement and irrigation of soft tissues as needed, increasing salivary flow, and removal of plaque
  59. What are implant success rate dependent on?
    daily oral hygiene self-care.
  60. What are some contraindications for patients health history prior to any surgery?
    systemic conditions
  61. What is the difference between peri-implantitis and peri-mucositis?
    • peri-implantitis is implant failure irreversible bone loss caused by inflammation.
    • peri-mucositis is precursor to peri-implantitis which is plaque induced reversible inflammation of surroundings soft tissues.
  62. What are implants made of? Why is it important to keep them clean and not scratch their surface?
    use of uncoated metal on the implant surface can scratch the titanium surface
  63. What are some contraindications for implant hygiene?
    • use of abrasive toothpaste 
    • flat ended bristles 
    • flossing aggressively
  64. What is stomatitis? How is it caused by?
    patches of erythema on the oral mucosa caused by poor hygiene, trauma, physical irritation, irritants, allergies, infections, systemic disorders from failure to adequately clean dentures.
  65. What are some hygiene care for denture wearers and their overall health?
    • remove dentures after every meal
    • soak daily antimicrobial chemical
    • rinse and brush
    • massage oral tissue
    • keep safe
    • adjustments diet
    • no self repair
Card Set
DHE 112 Exam 2 Review
DHE 112 Exam 2 Review