Deck 16: Strategies for Oral Health Promotion and Disease Prevention and Control

Question 1

Which one of the following antimicrobial mouthrinses is available only as a prescription in the United States?

A)0.12% chlorhexidine gluconate mouthrinse
B)0.0 5% sodium fluoride mouthrinse
C)Essential oils mouthrinse
D)Cetylpyridinium chloride mouthrinse

Answer 1

0.12% chlorhexidine gluconate mouthrinse

Question 2

An interdental brush can be used to effectively remove plaque biofilm in all of the following situations EXCEPT one. Which one is the EXCEPTION?

A)Teeth with large diastemas
B)Teeth with enamel erosion
C)Type II embrasure space
D)Fixed orthodontic appliances

Answer 2

Teeth with enamel erosion

Question 3

Which of the following ingredient in a dentifrice would a dental hygienist recommend to a client struggling to minimize supragingival calculus formation?

A)Potassium nitrate
B)Pyrophosphate
C)Hydrogen peroxide
D)Triclosan

Answer 3

Pyrophosphate

Question 4

Which of the following professional fluoride agents is known for both its efficacy in caries prevention and control of dentinal hypersensitivity because of its high concentration of fluoride?

A)Acidulated phosphate fluoride gel
B)Stannous fluoride
C)Sodium fluoride varnish
D)Neutral sodium fluoride foam

Question 5

A dental hygienists should recommend all of the following to a client struggling to control oral malodor EXCEPT one. Which one is the EXCEPTION?

A)Refraining from using tobacco products
B)Rinsing with antimicrobial mouthrinse
C)Chewing on sugar-free gums or candies
D)Drinking coffee without sugar

Question 6

Power toothbrushing should be recommended to clients with all of the following EXCEPT one. Which one is the EXCEPTION?

A)Meticulous oral hygiene
B)Gingivitis
C)Orthodontic appliances
D)Abrasion

Question 7

Floss holders should be recommended for clients with which one of the following?

A)Manual dexterity problems
B)Excellent home oral care
C)Dentinal hypersensitivity
D)Inadequate exposure to fluoride

Question 8

A dry field is necessary for the long-term success of resin-based pit-and-fissure dental sealants; therefore, glass ionomer pit-and-fissure dental sealant material should be applied on the teeth of clients when moisture control is an issue.

A)Both statements are TRUE
B)Both statements are FALSE
C)The first statement is TRUE; the second statement is FALSE
D)The first statement is FALSE; the second statement is TRUE

Question 9

What is the MOST commonly used product to control plaque biofilm?

A)Antimicrobial mouthrinses
B)Dental floss
C)Power toothbrush
D)Toothbrush

Question 10

Which of the following categories of prevention within the agent-host-environment theory is exemplified by scaling and root planing for a client with periodontal disease?

A)Primary
B)Secondary
C)Tertiary
D)Action

Question 11

Use Case A to answer The Following questions
CASE A
Ms. Ivory is a 45-year-old female who has just arrived for her first dental hygiene care visit in 11 years. Ms. Ivory recently acquired dental insurance and is interested in improving her oral health. Her physician is treating her for anxiety, hypertension, type 2 diabetes, and seasonal allergies. She takes Xanax (alprazolam) for anxiety and migraines; Atenolol (tenormin) for hypertension; Glucotrol (glipizide) for diabetes and an over-the-counter antihistamine product for seasonal allergy relief. She occasionally experiences dry mouth; she reports brushing twice per day, flossing occasionally, and using Parodontax toothpaste without fluoride. In addition, she states that her gums bleed every time she brushes and flosses her teeth. Ms. Ivory has moderate levels of cervical plaque biofilm. She reports using a soft toothbrush but cannot remember the brand name. She also experiences sensitivity to cold, sweets, and pressure in the mandibular right posterior quadrant. She is missing teeth #1, #3, #14, #16, #17, and #32. A class I furcation involvement is present on the buccal surface of tooth #19, and generalized 2- to 3-mm recession throughout her mouth, with class II embrasure spaces. Radiographs show moderate horizontal bone loss and moderate subgingival and supragingival calculus, especially in the interproximal areas. She has three new class I and two class II and IV carious lesions. In five previously restored teeth, recurrent caries can be seen.
To address this client's dentinal hypersensitivity to cold, sweets, and pressure, all of the following would be appropriate recommendations EXCEPT one. Which one is the EXCEPTION?

A)Recommend an ADA-accepted or CDA-recognized dentifrice containing potassium nitrate and fluoride
B)Evaluate the tooth vitality of the mandibular right molar and premolars
C)Refer to a dental practitioner
D)Obtain periapical radiographs of the mandibular molars and premolars

Question 12

Desensitizing agents for dentinal hypersensitivity disrupt pain transmission by preventing nerve depolarization or by blocking dentinal tubules; over-the-counter dentinal hypersensitivity products which occlude dentinal tubules contain potassium salts and products which affect nerve depolarization contain fluoride.

A)Both statements are TRUE
B)Both statements are FALSE
C)The first statement is TRUE; the second statement is FALSE
D)The first statement is FALSE; the second statement is TRUE

Question 13

Which of the following should be recommended for a client at high to moderate caries risk?

A)Fluoride varnish
B)Products containing amorphous calcium phosphate
C)Xylitol-containing chewing gum
D)All of the above

Question 14

Effective oral health education programs should include all of the following EXCEPT one. Which one is the EXCEPTION?

A)Assess the client's risk for oral disease
B)Include strategies for effective control of plaque biofilm
C)Address current disease activity
D)Unwillingness of patient to practice preventive behaviour

Question 15

Use Case A to answer The Following questions
CASE A
Ms. Ivory is a 45-year-old female who has just arrived for her first dental hygiene care visit in 11 years. Ms. Ivory recently acquired dental insurance and is interested in improving her oral health. Her physician is treating her for anxiety, hypertension, type 2 diabetes, and seasonal allergies. She takes Xanax (alprazolam) for anxiety and migraines; Atenolol (tenormin) for hypertension; Glucotrol (glipizide) for diabetes and an over-the-counter antihistamine product for seasonal allergy relief. She occasionally experiences dry mouth; she reports brushing twice per day, flossing occasionally, and using Parodontax toothpaste without fluoride. In addition, she states that her gums bleed every time she brushes and flosses her teeth. Ms. Ivory has moderate levels of cervical plaque biofilm. She reports using a soft toothbrush but cannot remember the brand name. She also experiences sensitivity to cold, sweets, and pressure in the mandibular right posterior quadrant. She is missing teeth #1, #3, #14, #16, #17, and #32. A class I furcation involvement is present on the buccal surface of tooth #19, and generalized 2- to 3-mm recession throughout her mouth, with class II embrasure spaces. Radiographs show moderate horizontal bone loss and moderate subgingival and supragingival calculus, especially in the interproximal areas. She has three new class I and two class II and IV carious lesions. In five previously restored teeth, recurrent caries can be seen.
To assist Ms. Ivory modify her current oral health behaviors and improve her oral health, it is important to determine her level on the learning ladder. What step of the learning ladder is Ms. Ivory currently on?

A)Unawareness
B)Awareness
C)Action
D)Habit

Question 16

Which of the following dentifrice ingredients prevent separation by increasing the consistency of the mixture of liquid and solid ingredients?

A)Humectants
B)Flavoring agents
C)Preservatives
D)Binding agents

Question 17

Which of the following methods would be MOST appropriate to disinfect a toothbrush for a client with candidiasis?

A)Rinse thoroughly with water, and allow to air-dry
B)Spray liberally with chlorine bleach
C)Soak in 0.12% chlorhexidine
D)Coat with a slurry of hydrogen peroxide and baking soda

Question 18

All of the following are true statements about 5% fluoride varnish EXCEPT one. Which one is the EXCEPTION?

A)Approved for caries control
B)Can be applied to both children and adults' teeth
C)Recommended for clients with high caries risk
D)Available over the counter for caries prevention

Question 19

All of the following are true regarding oral irrig?ation devices EXCEPT one. Which one is this EXCEPTION?

A)Recommended for clients with fixed prosthetics
B)Can be effectively used to treat periodontitis
C)Helps reduce gingivitis
D)Used for the delivery of antimicrobial agents subgingivally

Question 20

What behavioral theory explains that clients with the internal desire to change a behavior strive to accomplish it and the behavior usually lasts longer?

A)Attribution
B)Locus of control
C)Motivation
D)Self-efficacy

Question 21

Use Case A to answer The Following questions
CASE A
Ms. Ivory is a 45-year-old female who has just arrived for her first dental hygiene care visit in 11 years. Ms. Ivory recently acquired dental insurance and is interested in improving her oral health. Her physician is treating her for anxiety, hypertension, type 2 diabetes, and seasonal allergies. She takes Xanax (alprazolam) for anxiety and migraines; Atenolol (tenormin) for hypertension; Glucotrol (glipizide) for diabetes and an over-the-counter antihistamine product for seasonal allergy relief. She occasionally experiences dry mouth; she reports brushing twice per day, flossing occasionally, and using Parodontax toothpaste without fluoride. In addition, she states that her gums bleed every time she brushes and flosses her teeth. Ms. Ivory has moderate levels of cervical plaque biofilm. She reports using a soft toothbrush but cannot remember the brand name. She also experiences sensitivity to cold, sweets, and pressure in the mandibular right posterior quadrant. She is missing teeth #1, #3, #14, #16, #17, and #32. A class I furcation involvement is present on the buccal surface of tooth #19, and generalized 2- to 3-mm recession throughout her mouth, with class II embrasure spaces. Radiographs show moderate horizontal bone loss and moderate subgingival and supragingival calculus, especially in the interproximal areas. She has three new class I and two class II and IV carious lesions. In five previously restored teeth, recurrent caries can be seen.
Ms. Ivory can benefit from all of the following educational resources EXCEPT one. Which one is the EXCEPTION?

A)Pamphlet explaining the value of oral products carrying the ADA Seal of Acceptance
B)Pamphlet on the role of fluoride in dental caries prevention
C)Methods to reduce dentinal hypersensitivity
D)Tooth whitening methods

Question 22

Use Case A to answer The Following questions
CASE A
Ms. Ivory is a 45-year-old female who has just arrived for her first dental hygiene care visit in 11 years. Ms. Ivory recently acquired dental insurance and is interested in improving her oral health. Her physician is treating her for anxiety, hypertension, type 2 diabetes, and seasonal allergies. She takes Xanax (alprazolam) for anxiety and migraines; Atenolol (tenormin) for hypertension; Glucotrol (glipizide) for diabetes and an over-the-counter antihistamine product for seasonal allergy relief. She occasionally experiences dry mouth; she reports brushing twice per day, flossing occasionally, and using Parodontax toothpaste without fluoride. In addition, she states that her gums bleed every time she brushes and flosses her teeth. Ms. Ivory has moderate levels of cervical plaque biofilm. She reports using a soft toothbrush but cannot remember the brand name. She also experiences sensitivity to cold, sweets, and pressure in the mandibular right posterior quadrant. She is missing teeth #1, #3, #14, #16, #17, and #32. A class I furcation involvement is present on the buccal surface of tooth #19, and generalized 2- to 3-mm recession throughout her mouth, with class II embrasure spaces. Radiographs show moderate horizontal bone loss and moderate subgingival and supragingival calculus, especially in the interproximal areas. She has three new class I and two class II and IV carious lesions. In five previously restored teeth, recurrent caries can be seen.
Reduction of future cervical plaque is best accomplished by the:

A)Introduction of 0.12% chlorhexidine rinse
B)Introduction of a soft bristle toothbrush
C)Modification of the client's toothbrushing technique
D)Modification of the client's flossing technique

Question 23

Use Case A to answer The Following questions
CASE A
Ms. Ivory is a 45-year-old female who has just arrived for her first dental hygiene care visit in 11 years. Ms. Ivory recently acquired dental insurance and is interested in improving her oral health. Her physician is treating her for anxiety, hypertension, type 2 diabetes, and seasonal allergies. She takes Xanax (alprazolam) for anxiety and migraines; Atenolol (tenormin) for hypertension; Glucotrol (glipizide) for diabetes and an over-the-counter antihistamine product for seasonal allergy relief. She occasionally experiences dry mouth; she reports brushing twice per day, flossing occasionally, and using Parodontax toothpaste without fluoride. In addition, she states that her gums bleed every time she brushes and flosses her teeth. Ms. Ivory has moderate levels of cervical plaque biofilm. She reports using a soft toothbrush but cannot remember the brand name. She also experiences sensitivity to cold, sweets, and pressure in the mandibular right posterior quadrant. She is missing teeth #1, #3, #14, #16, #17, and #32. A class I furcation involvement is present on the buccal surface of tooth #19, and generalized 2- to 3-mm recession throughout her mouth, with class II embrasure spaces. Radiographs show moderate horizontal bone loss and moderate subgingival and supragingival calculus, especially in the interproximal areas. She has three new class I and two class II and IV carious lesions. In five previously restored teeth, recurrent caries can be seen.
When making recommendations regarding future caries control, the dental hygienist should consider all of the following EXCEPT one. Which one is the EXCEPTION?

A)Plaque control behavior
B)Xerostomia management
C)Bleeding during toothbrushing
D)Current fluoride exposure

Question 24

Use Case B to answer The Following questions
CASE B
Mr. Jones, a 30-year old male, presents for his 6-month continued-care appointment. His health and pharmacologic histories reveal that he is taking an antidepressant drug. He has very tight contacts between his teeth and reports that flossing frustrates him. He smokes one-half pack of cigarettes daily. Intraoral assessment findings reveal a coated tongue, generalized brown extrinsic stains covering most of the lingual surfaces, generalized moderate gingivitis, and light interproximal calculus. Periodontal probe readings and radiographs reveal healthy teeth and periodontium with no bone loss. Recently separated from his long-time girlfriend, Mr. Jones is concerned about his self-image and wonders if he has "bad breath." He is interested in having his teeth whitened to improve his appearance and has requested your guidance in making his oral health care decisions.
All of the following are true regarding oral cancer diagnostic tools EXCEPT one. Which one is the EXCEPTION?

A)Exfoliative cytology collects surface cells for microscopic evaluation
B)Brush biopsy is indicated for unexplained clinically detectable lesions
C)Brush biopsy is as effective as scalpel biopsy
D)Use of topical anesthesia is contraindicated for brush biopsy

Question 25

Use Case A to answer The Following questions
CASE A
Ms. Ivory is a 45-year-old female who has just arrived for her first dental hygiene care visit in 11 years. Ms. Ivory recently acquired dental insurance and is interested in improving her oral health. Her physician is treating her for anxiety, hypertension, type 2 diabetes, and seasonal allergies. She takes Xanax (alprazolam) for anxiety and migraines; Atenolol (tenormin) for hypertension; Glucotrol (glipizide) for diabetes and an over-the-counter antihistamine product for seasonal allergy relief. She occasionally experiences dry mouth; she reports brushing twice per day, flossing occasionally, and using Parodontax toothpaste without fluoride. In addition, she states that her gums bleed every time she brushes and flosses her teeth. Ms. Ivory has moderate levels of cervical plaque biofilm. She reports using a soft toothbrush but cannot remember the brand name. She also experiences sensitivity to cold, sweets, and pressure in the mandibular right posterior quadrant. She is missing teeth #1, #3, #14, #16, #17, and #32. A class I furcation involvement is present on the buccal surface of tooth #19, and generalized 2- to 3-mm recession throughout her mouth, with class II embrasure spaces. Radiographs show moderate horizontal bone loss and moderate subgingival and supragingival calculus, especially in the interproximal areas. She has three new class I and two class II and IV carious lesions. In five previously restored teeth, recurrent caries can be seen.
To help Ms. Ivory prevent future dental caries, the dental hygienist may suggest all of the following EXCEPT one. Which one is the EXCEPTION?

A)An ADA-approved or CDA-recognized dentifrice containing fluoride
B)Dental sealants on all permanent molars and premolars
C)Xylitol-containing gums or candies
D)Interdental brushing once per day

Question 26

Use Case B to answer The Following questions
CASE B
Mr. Jones, a 30-year old male, presents for his 6-month continued-care appointment. His health and pharmacologic histories reveal that he is taking an antidepressant drug. He has very tight contacts between his teeth and reports that flossing frustrates him. He smokes one-half pack of cigarettes daily. Intraoral assessment findings reveal a coated tongue, generalized brown extrinsic stains covering most of the lingual surfaces, generalized moderate gingivitis, and light interproximal calculus. Periodontal probe readings and radiographs reveal healthy teeth and periodontium with no bone loss. Recently separated from his long-time girlfriend, Mr. Jones is concerned about his self-image and wonders if he has "bad breath." He is interested in having his teeth whitened to improve his appearance and has requested your guidance in making his oral health care decisions.
All of the following statements are true regarding oral cancer self-examination EXCEPT one. Which one is the EXCEPTION?

A)All clients can potentially benefit from it
B)A mirror and an adequate light source are essential for the procedure
C)It is a substitute for professional evaluation
D)Asymmetric, irregular lumps and sores indicate the need for professional evaluation

Question 27

Use Case A to answer The Following questions
CASE A
Ms. Ivory is a 45-year-old female who has just arrived for her first dental hygiene care visit in 11 years. Ms. Ivory recently acquired dental insurance and is interested in improving her oral health. Her physician is treating her for anxiety, hypertension, type 2 diabetes, and seasonal allergies. She takes Xanax (alprazolam) for anxiety and migraines; Atenolol (tenormin) for hypertension; Glucotrol (glipizide) for diabetes and an over-the-counter antihistamine product for seasonal allergy relief. She occasionally experiences dry mouth; she reports brushing twice per day, flossing occasionally, and using Parodontax toothpaste without fluoride. In addition, she states that her gums bleed every time she brushes and flosses her teeth. Ms. Ivory has moderate levels of cervical plaque biofilm. She reports using a soft toothbrush but cannot remember the brand name. She also experiences sensitivity to cold, sweets, and pressure in the mandibular right posterior quadrant. She is missing teeth #1, #3, #14, #16, #17, and #32. A class I furcation involvement is present on the buccal surface of tooth #19, and generalized 2- to 3-mm recession throughout her mouth, with class II embrasure spaces. Radiographs show moderate horizontal bone loss and moderate subgingival and supragingival calculus, especially in the interproximal areas. She has three new class I and two class II and IV carious lesions. In five previously restored teeth, recurrent caries can be seen.
All of the following oral hygiene product ingredients can benefit Ms. Ivory's oral health EXCEPT one. Which one is the EXCEPTION?

A)Triclosan
B)Sodium lauryl sulfate
C)Stannous fluoride
D)Zinc chloride

Question 28

Use Case B to answer The Following questions
CASE B
Mr. Jones, a 30-year old male, presents for his 6-month continued-care appointment. His health and pharmacologic histories reveal that he is taking an antidepressant drug. He has very tight contacts between his teeth and reports that flossing frustrates him. He smokes one-half pack of cigarettes daily. Intraoral assessment findings reveal a coated tongue, generalized brown extrinsic stains covering most of the lingual surfaces, generalized moderate gingivitis, and light interproximal calculus. Periodontal probe readings and radiographs reveal healthy teeth and periodontium with no bone loss. Recently separated from his long-time girlfriend, Mr. Jones is concerned about his self-image and wonders if he has "bad breath." He is interested in having his teeth whitened to improve his appearance and has requested your guidance in making his oral health care decisions.
To help Mr. Jones remove interproximal plaque biofilm, what should the hygienist recommend?

A)Smoking cessation
B)Power toothbrush
C)Floss threader
D)Floss holder

Question 29

Use Case B to answer The Following questions
CASE B
Mr. Jones, a 30-year old male, presents for his 6-month continued-care appointment. His health and pharmacologic histories reveal that he is taking an antidepressant drug. He has very tight contacts between his teeth and reports that flossing frustrates him. He smokes one-half pack of cigarettes daily. Intraoral assessment findings reveal a coated tongue, generalized brown extrinsic stains covering most of the lingual surfaces, generalized moderate gingivitis, and light interproximal calculus. Periodontal probe readings and radiographs reveal healthy teeth and periodontium with no bone loss. Recently separated from his long-time girlfriend, Mr. Jones is concerned about his self-image and wonders if he has "bad breath." He is interested in having his teeth whitened to improve his appearance and has requested your guidance in making his oral health care decisions.
All of the following may contribute to oral malodor EXCEPT one. Which one is the EXCEPTION?

A)Active periodontal disease
B)Aphthous ulcer
C)Use of tobacco products
D)Lack of tongue brushing

Question 30

Use Case B to answer The Following questions
CASE B
Mr. Jones, a 30-year old male, presents for his 6-month continued-care appointment. His health and pharmacologic histories reveal that he is taking an antidepressant drug. He has very tight contacts between his teeth and reports that flossing frustrates him. He smokes one-half pack of cigarettes daily. Intraoral assessment findings reveal a coated tongue, generalized brown extrinsic stains covering most of the lingual surfaces, generalized moderate gingivitis, and light interproximal calculus. Periodontal probe readings and radiographs reveal healthy teeth and periodontium with no bone loss. Recently separated from his long-time girlfriend, Mr. Jones is concerned about his self-image and wonders if he has "bad breath." He is interested in having his teeth whitened to improve his appearance and has requested your guidance in making his oral health care decisions.
Which of the following is important for Mr. Jones to be aware of before a professional whitening procedure?

A)Tobacco decreases the longevity of tooth whitening
B)Professional tooth whitening will remove brown extrinsic stains
C)Professional tooth whitening may cause dental erosion
D)None of the above; clients who smoke should not have their teeth bleached

Question 31

Use Case A to answer The Following questions
CASE A
Ms. Ivory is a 45-year-old female who has just arrived for her first dental hygiene care visit in 11 years. Ms. Ivory recently acquired dental insurance and is interested in improving her oral health. Her physician is treating her for anxiety, hypertension, type 2 diabetes, and seasonal allergies. She takes Xanax (alprazolam) for anxiety and migraines; Atenolol (tenormin) for hypertension; Glucotrol (glipizide) for diabetes and an over-the-counter antihistamine product for seasonal allergy relief. She occasionally experiences dry mouth; she reports brushing twice per day, flossing occasionally, and using Parodontax toothpaste without fluoride. In addition, she states that her gums bleed every time she brushes and flosses her teeth. Ms. Ivory has moderate levels of cervical plaque biofilm. She reports using a soft toothbrush but cannot remember the brand name. She also experiences sensitivity to cold, sweets, and pressure in the mandibular right posterior quadrant. She is missing teeth #1, #3, #14, #16, #17, and #32. A class I furcation involvement is present on the buccal surface of tooth #19, and generalized 2- to 3-mm recession throughout her mouth, with class II embrasure spaces. Radiographs show moderate horizontal bone loss and moderate subgingival and supragingival calculus, especially in the interproximal areas. She has three new class I and two class II and IV carious lesions. In five previously restored teeth, recurrent caries can be seen.
What follow-up questions will the dental hygienist ask regarding Ms. Ivory's type 2 diabetes?

A)What was your most recent A1c (HbA1c) test result?
B)When did you last eat?
C)Is your diabetes controlled or uncontrolled?
D)All of the above

Question 32

Use Case B to answer The Following questions
CASE B
Mr. Jones, a 30-year old male, presents for his 6-month continued-care appointment. His health and pharmacologic histories reveal that he is taking an antidepressant drug. He has very tight contacts between his teeth and reports that flossing frustrates him. He smokes one-half pack of cigarettes daily. Intraoral assessment findings reveal a coated tongue, generalized brown extrinsic stains covering most of the lingual surfaces, generalized moderate gingivitis, and light interproximal calculus. Periodontal probe readings and radiographs reveal healthy teeth and periodontium with no bone loss. Recently separated from his long-time girlfriend, Mr. Jones is concerned about his self-image and wonders if he has "bad breath." He is interested in having his teeth whitened to improve his appearance and has requested your guidance in making his oral health care decisions.
All of the following may be contributing to Mr. Jones's halitosis EXCEPT one. Which one is the EXCEPTION?

A)Tight tooth contacts
B)Coated tongue
C)Necrotizing ulcerative gingivitis
D)Smoking one-half pack of cigarettes daily

Question 33

Use Case A to answer The Following questions
CASE A
Ms. Ivory is a 45-year-old female who has just arrived for her first dental hygiene care visit in 11 years. Ms. Ivory recently acquired dental insurance and is interested in improving her oral health. Her physician is treating her for anxiety, hypertension, type 2 diabetes, and seasonal allergies. She takes Xanax (alprazolam) for anxiety and migraines; Atenolol (tenormin) for hypertension; Glucotrol (glipizide) for diabetes and an over-the-counter antihistamine product for seasonal allergy relief. She occasionally experiences dry mouth; she reports brushing twice per day, flossing occasionally, and using Parodontax toothpaste without fluoride. In addition, she states that her gums bleed every time she brushes and flosses her teeth. Ms. Ivory has moderate levels of cervical plaque biofilm. She reports using a soft toothbrush but cannot remember the brand name. She also experiences sensitivity to cold, sweets, and pressure in the mandibular right posterior quadrant. She is missing teeth #1, #3, #14, #16, #17, and #32. A class I furcation involvement is present on the buccal surface of tooth #19, and generalized 2- to 3-mm recession throughout her mouth, with class II embrasure spaces. Radiographs show moderate horizontal bone loss and moderate subgingival and supragingival calculus, especially in the interproximal areas. She has three new class I and two class II and IV carious lesions. In five previously restored teeth, recurrent caries can be seen.
All of the following factors may have contributed to Ms. Ivory's periodontal disease EXCEPT one. Which one is the EXCEPTION?

A)Infrequent flossing
B)Inclusion of fluoride in dentifrice
C)Subgingival calculus
D)Uncontrolled diabetes

Question 34

Use Case A to answer The Following questions
CASE A
Ms. Ivory is a 45-year-old female who has just arrived for her first dental hygiene care visit in 11 years. Ms. Ivory recently acquired dental insurance and is interested in improving her oral health. Her physician is treating her for anxiety, hypertension, type 2 diabetes, and seasonal allergies. She takes Xanax (alprazolam) for anxiety and migraines; Atenolol (tenormin) for hypertension; Glucotrol (glipizide) for diabetes and an over-the-counter antihistamine product for seasonal allergy relief. She occasionally experiences dry mouth; she reports brushing twice per day, flossing occasionally, and using Parodontax toothpaste without fluoride. In addition, she states that her gums bleed every time she brushes and flosses her teeth. Ms. Ivory has moderate levels of cervical plaque biofilm. She reports using a soft toothbrush but cannot remember the brand name. She also experiences sensitivity to cold, sweets, and pressure in the mandibular right posterior quadrant. She is missing teeth #1, #3, #14, #16, #17, and #32. A class I furcation involvement is present on the buccal surface of tooth #19, and generalized 2- to 3-mm recession throughout her mouth, with class II embrasure spaces. Radiographs show moderate horizontal bone loss and moderate subgingival and supragingival calculus, especially in the interproximal areas. She has three new class I and two class II and IV carious lesions. In five previously restored teeth, recurrent caries can be seen.
Given this client's high caries incidence, systemic health issues, periodontal condition, and pharmacologic history, the inclusion of dietary analysis and counseling in the care plan would be appropriate:

A)Both statements are TRUE
B)The first part of the statement is TRUE, and the second part is FALSE
C)The first part of the statement is FALSE, and the second part is TRUE
D)Both statements are FALSE

Question 35

Use Case B to answer The Following questions
CASE B
Mr. Jones, a 30-year old male, presents for his 6-month continued-care appointment. His health and pharmacologic histories reveal that he is taking an antidepressant drug. He has very tight contacts between his teeth and reports that flossing frustrates him. He smokes one-half pack of cigarettes daily. Intraoral assessment findings reveal a coated tongue, generalized brown extrinsic stains covering most of the lingual surfaces, generalized moderate gingivitis, and light interproximal calculus. Periodontal probe readings and radiographs reveal healthy teeth and periodontium with no bone loss. Recently separated from his long-time girlfriend, Mr. Jones is concerned about his self-image and wonders if he has "bad breath." He is interested in having his teeth whitened to improve his appearance and has requested your guidance in making his oral health care decisions.
Clients need to be educated on mutable and nonmutable risk factors for oral cancer; alcohol and tobacco use falls under nonmutable risk factor.

A)Both parts of the statement are TRUE
B)The first part of the statement is TRUE; the second part is FALSE
C)The first part of the statement is FALSE; the second part is TRUE
D)Both parts of the statement are FALSE

Question 36

Use Case A to answer The Following questions
CASE A
Ms. Ivory is a 45-year-old female who has just arrived for her first dental hygiene care visit in 11 years. Ms. Ivory recently acquired dental insurance and is interested in improving her oral health. Her physician is treating her for anxiety, hypertension, type 2 diabetes, and seasonal allergies. She takes Xanax (alprazolam) for anxiety and migraines; Atenolol (tenormin) for hypertension; Glucotrol (glipizide) for diabetes and an over-the-counter antihistamine product for seasonal allergy relief. She occasionally experiences dry mouth; she reports brushing twice per day, flossing occasionally, and using Parodontax toothpaste without fluoride. In addition, she states that her gums bleed every time she brushes and flosses her teeth. Ms. Ivory has moderate levels of cervical plaque biofilm. She reports using a soft toothbrush but cannot remember the brand name. She also experiences sensitivity to cold, sweets, and pressure in the mandibular right posterior quadrant. She is missing teeth #1, #3, #14, #16, #17, and #32. A class I furcation involvement is present on the buccal surface of tooth #19, and generalized 2- to 3-mm recession throughout her mouth, with class II embrasure spaces. Radiographs show moderate horizontal bone loss and moderate subgingival and supragingival calculus, especially in the interproximal areas. She has three new class I and two class II and IV carious lesions. In five previously restored teeth, recurrent caries can be seen.
Which of the following interdental aids would be MOST appropriate for this client's moderate horizontal bone loss?

A)Power toothbrush
B)Interdental brush
C)Unwaxed floss
D)Uni-tufted brush

Question 37

Use Case B to answer The Following questions
CASE B
Mr. Jones, a 30-year old male, presents for his 6-month continued-care appointment. His health and pharmacologic histories reveal that he is taking an antidepressant drug. He has very tight contacts between his teeth and reports that flossing frustrates him. He smokes one-half pack of cigarettes daily. Intraoral assessment findings reveal a coated tongue, generalized brown extrinsic stains covering most of the lingual surfaces, generalized moderate gingivitis, and light interproximal calculus. Periodontal probe readings and radiographs reveal healthy teeth and periodontium with no bone loss. Recently separated from his long-time girlfriend, Mr. Jones is concerned about his self-image and wonders if he has "bad breath." He is interested in having his teeth whitened to improve his appearance and has requested your guidance in making his oral health care decisions.
To assist Mr. Jones abstain from cigarette smoking, the dental hygienist should take all of the following actions EXCEPT one. Which one is the EXCEPTION?

A)Recommend the use of pharmacologic adjuncts
B)Refer him to a local tobacco cessation program
C)Demonstrate interproximal cleaning
D)Educate him on the consequences of smoking

Question 38

Use Case B to answer The Following questions
CASE B
Mr. Jones, a 30-year old male, presents for his 6-month continued-care appointment. His health and pharmacologic histories reveal that he is taking an antidepressant drug. He has very tight contacts between his teeth and reports that flossing frustrates him. He smokes one-half pack of cigarettes daily. Intraoral assessment findings reveal a coated tongue, generalized brown extrinsic stains covering most of the lingual surfaces, generalized moderate gingivitis, and light interproximal calculus. Periodontal probe readings and radiographs reveal healthy teeth and periodontium with no bone loss. Recently separated from his long-time girlfriend, Mr. Jones is concerned about his self-image and wonders if he has "bad breath." He is interested in having his teeth whitened to improve his appearance and has requested your guidance in making his oral health care decisions.
Which of the following will help clients manage their nicotine withdrawal symptoms?

A)Nicotine transdermal patch
B)Referral to a tobacco cessation program
C)Non-nicotine agent (e.g., SR bupropion HCl)
D)All of the above

Question 39

Use Case B to answer The Following questions
CASE B
Mr. Jones, a 30-year old male, presents for his 6-month continued-care appointment. His health and pharmacologic histories reveal that he is taking an antidepressant drug. He has very tight contacts between his teeth and reports that flossing frustrates him. He smokes one-half pack of cigarettes daily. Intraoral assessment findings reveal a coated tongue, generalized brown extrinsic stains covering most of the lingual surfaces, generalized moderate gingivitis, and light interproximal calculus. Periodontal probe readings and radiographs reveal healthy teeth and periodontium with no bone loss. Recently separated from his long-time girlfriend, Mr. Jones is concerned about his self-image and wonders if he has "bad breath." He is interested in having his teeth whitened to improve his appearance and has requested your guidance in making his oral health care decisions.
All of the following can be recommend to Mr. Jones for his halitosis EXCEPT one. Which one is the EXCEPTION?

A)Tobacco cessation
B)Tongue brushing
C)Use of an ADA-accepted or CDA-recognized antimicrobial mouthrinse
D)Daily fluoride mouthrinse

Question 40

Use Case B to answer The Following questions
CASE B
Mr. Jones, a 30-year old male, presents for his 6-month continued-care appointment. His health and pharmacologic histories reveal that he is taking an antidepressant drug. He has very tight contacts between his teeth and reports that flossing frustrates him. He smokes one-half pack of cigarettes daily. Intraoral assessment findings reveal a coated tongue, generalized brown extrinsic stains covering most of the lingual surfaces, generalized moderate gingivitis, and light interproximal calculus. Periodontal probe readings and radiographs reveal healthy teeth and periodontium with no bone loss. Recently separated from his long-time girlfriend, Mr. Jones is concerned about his self-image and wonders if he has "bad breath." He is interested in having his teeth whitened to improve his appearance and has requested your guidance in making his oral health care decisions.
Recommendations to a client at high risk for oral cancer will include all of the following EXCEPT one. Which one is the EXCEPTION?

A)Abstinence from tobacco products
B)Abstinence from smoking
C)Abstinence from excessive alcohol consumption
D)Abstinence from essential oil mouthrinse

Question 41

Use Case C to answer The Following questions
CASE C
Mr. Wilson, 28-years old, is a new patient at your dental office. His chief complaint is: "I have pinpoint white spots on my palate, and my front tooth is getting darker in color." Mr. Wilson smokes one pack of cigarettes per day. He has no known allergies. He has three 7-year-old implants with porcelain-fused-to-metal crowns on #5, #19, and #30. The gingiva around the implants are erythematous, with moderate plaque biofilm adhering to the implant fixtures. He has light calculus and stain accumulations on the linguals of mandibular and maxillary anterior teeth.
All of the following should be initiated to assess the discoloration of the front tooth EXCEPT one. Which one is the EXCEPTION?

A)Take a periapical radiograph
B)Obtain periodontal measurements
C)Check for a widened periodontal ligament
D)Conduct pulp vitality testing

Question 42

Use Case C to answer The Following questions
CASE C
Mr. Wilson, 28-years old, is a new patient at your dental office. His chief complaint is: "I have pinpoint white spots on my palate, and my front tooth is getting darker in color." Mr. Wilson smokes one pack of cigarettes per day. He has no known allergies. He has three 7-year-old implants with porcelain-fused-to-metal crowns on #5, #19, and #30. The gingiva around the implants are erythematous, with moderate plaque biofilm adhering to the implant fixtures. He has light calculus and stain accumulations on the linguals of mandibular and maxillary anterior teeth.
What is the most widely used method for oral cancer detection and screening?

A)Visual examination and palpation
B)Brush biopsy and exfoliative cytology
C)ViziLite
D)VELscope

Question 43

Use Case C to answer The Following questions
CASE C
Mr. Wilson, 28-years old, is a new patient at your dental office. His chief complaint is: "I have pinpoint white spots on my palate, and my front tooth is getting darker in color." Mr. Wilson smokes one pack of cigarettes per day. He has no known allergies. He has three 7-year-old implants with porcelain-fused-to-metal crowns on #5, #19, and #30. The gingiva around the implants are erythematous, with moderate plaque biofilm adhering to the implant fixtures. He has light calculus and stain accumulations on the linguals of mandibular and maxillary anterior teeth.
Which one of the following statements is FALSE about the use of tobacco products?

A)Increase collagenase production
B)Decrease collagen production
C)Increase vascularity
D)Impair helper lymphocytes

Question 44

Use Case C to answer The Following questions
CASE C
Mr. Wilson, 28-years old, is a new patient at your dental office. His chief complaint is: "I have pinpoint white spots on my palate, and my front tooth is getting darker in color." Mr. Wilson smokes one pack of cigarettes per day. He has no known allergies. He has three 7-year-old implants with porcelain-fused-to-metal crowns on #5, #19, and #30. The gingiva around the implants are erythematous, with moderate plaque biofilm adhering to the implant fixtures. He has light calculus and stain accumulations on the linguals of mandibular and maxillary anterior teeth.
Mr. Wilson should be informed of all of the following EXCEPT one. Which one is the EXCEPTION?

A)Plaque biofilm, if left uncontrolled, will cause implant failure
B)Smoking contributes to implant failure
C)The reddish pinpoint lesions on his palate are caused by smoking
D)A biopsy will be needed for his whitish pinpoint lesions on his palate

Question 45

Use Case B to answer The Following questions
CASE B
Mr. Jones, a 30-year old male, presents for his 6-month continued-care appointment. His health and pharmacologic histories reveal that he is taking an antidepressant drug. He has very tight contacts between his teeth and reports that flossing frustrates him. He smokes one-half pack of cigarettes daily. Intraoral assessment findings reveal a coated tongue, generalized brown extrinsic stains covering most of the lingual surfaces, generalized moderate gingivitis, and light interproximal calculus. Periodontal probe readings and radiographs reveal healthy teeth and periodontium with no bone loss. Recently separated from his long-time girlfriend, Mr. Jones is concerned about his self-image and wonders if he has "bad breath." He is interested in having his teeth whitened to improve his appearance and has requested your guidance in making his oral health care decisions.
Which toothbrushing method should be recommended for a client with plaque biofilm control problems around the cervical areas of the teeth?

A)Stillman's method
B)Charter method
C)Bass method
D)Leonard method

Question 46

Use Case C to answer The Following questions
CASE C
Mr. Wilson, 28-years old, is a new patient at your dental office. His chief complaint is: "I have pinpoint white spots on my palate, and my front tooth is getting darker in color." Mr. Wilson smokes one pack of cigarettes per day. He has no known allergies. He has three 7-year-old implants with porcelain-fused-to-metal crowns on #5, #19, and #30. The gingiva around the implants are erythematous, with moderate plaque biofilm adhering to the implant fixtures. He has light calculus and stain accumulations on the linguals of mandibular and maxillary anterior teeth.
Mr. Wilson's chief complaint is most likely caused by:

A)Candidiasis
B)Allergy
C)Smoking
D)Implants

Question 47

Use Case B to answer The Following questions
CASE B
Mr. Jones, a 30-year old male, presents for his 6-month continued-care appointment. His health and pharmacologic histories reveal that he is taking an antidepressant drug. He has very tight contacts between his teeth and reports that flossing frustrates him. He smokes one-half pack of cigarettes daily. Intraoral assessment findings reveal a coated tongue, generalized brown extrinsic stains covering most of the lingual surfaces, generalized moderate gingivitis, and light interproximal calculus. Periodontal probe readings and radiographs reveal healthy teeth and periodontium with no bone loss. Recently separated from his long-time girlfriend, Mr. Jones is concerned about his self-image and wonders if he has "bad breath." He is interested in having his teeth whitened to improve his appearance and has requested your guidance in making his oral health care decisions.
All of the following should be recommended to a person with a dental implant EXCEPT one. Which one is the EXCEPTION?

A)Soft-bristled, multiple-tufted nylon toothbrush
B)Interdental brushes with metal wire cores
C)Floss containing a soft filament brush
D)Flat and tapered end-tuft brush

Question 48

Use Case C to answer The Following questions
CASE C
Mr. Wilson, 28-years old, is a new patient at your dental office. His chief complaint is: "I have pinpoint white spots on my palate, and my front tooth is getting darker in color." Mr. Wilson smokes one pack of cigarettes per day. He has no known allergies. He has three 7-year-old implants with porcelain-fused-to-metal crowns on #5, #19, and #30. The gingiva around the implants are erythematous, with moderate plaque biofilm adhering to the implant fixtures. He has light calculus and stain accumulations on the linguals of mandibular and maxillary anterior teeth.
For Mr. Wilson's dental implant maintenance, abrasive dentifrices should be avoided. Oral irrigation should also be avoided around the dental implants.

A)Both statements are TRUE
B)The first statement is TRUE; the second statement is FALSE
C)The first statement is FALSE; the second statement is TRUE
D)Both statements are FALSE

Question 49

Use Case B to answer The Following questions
CASE B
Mr. Jones, a 30-year old male, presents for his 6-month continued-care appointment. His health and pharmacologic histories reveal that he is taking an antidepressant drug. He has very tight contacts between his teeth and reports that flossing frustrates him. He smokes one-half pack of cigarettes daily. Intraoral assessment findings reveal a coated tongue, generalized brown extrinsic stains covering most of the lingual surfaces, generalized moderate gingivitis, and light interproximal calculus. Periodontal probe readings and radiographs reveal healthy teeth and periodontium with no bone loss. Recently separated from his long-time girlfriend, Mr. Jones is concerned about his self-image and wonders if he has "bad breath." He is interested in having his teeth whitened to improve his appearance and has requested your guidance in making his oral health care decisions.
All of the following are true regarding the use of the oral irrigator EXCEPT one. Which one is the EXCEPTION?

A)Used with cannula to irrigate to the base of the pocket
B)Can be used as an adjunct to mechanical root debridement
C)Delivers the antimicrobial mouthrinse subgingivally
D)Eliminates the need for controlled release drug therapy

Question 50

Use Case C to answer The Following questions
CASE C
Mr. Wilson, 28-years old, is a new patient at your dental office. His chief complaint is: "I have pinpoint white spots on my palate, and my front tooth is getting darker in color." Mr. Wilson smokes one pack of cigarettes per day. He has no known allergies. He has three 7-year-old implants with porcelain-fused-to-metal crowns on #5, #19, and #30. The gingiva around the implants are erythematous, with moderate plaque biofilm adhering to the implant fixtures. He has light calculus and stain accumulations on the linguals of mandibular and maxillary anterior teeth.
Oral effects of tobacco use include all of the following EXCEPT one. Which one is the EXCEPTION?

A)Impaired healing
B)Dental abrasion
C)Migratory glossitis
D)Nicotine stomatitis