TEST BANK for Newman and Carranzas Clinical Periodontology for the Dental Hygienist 1st Edition by N

Newman and Carranzas Clinical Periodontology for the Dental Hygienist 1st Edition Newman Test Bank Chapter 01: The Historical Background of Periodontology Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. What was the most common of all diseases found in the embalmed bodies of the ancient

Egyptians? a. Heart disease b. Tonsillitis c. Periodontal disease d. Throat cancer ANS: C

Periodontal disease was the most common of all diseases found in the embalmed bodies of the ancient Egyptians.

DIF: Recall REF: p. 1 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 2. Which classical historical figure wrote about tartar deposits, and about how they must be

removed with scraper or a small file? a. Hippocrates of Cos b. Paul of Aegina c. Albucasis d. Avicenna ANS: B

Paul of Aegina (625–690 AD) wrote that tartar deposits must be removed with either scrapers or a small file and that the teeth should be carefully cleaned after the last meal of the day.

DIF: Comprehension REF: p. 1 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 3. Who developed the doctrine of calculus? a. Paracelsus b. Albucasis c. Andreas Veslius d. John Hunter ANS: A

Paracelsus (1493–1541) developed an interesting and unusual theory of disease: the doctrine of calculus. He recognized the extensive formation of tartar on the teeth and related this to toothache. He considered toothaches to be comparable to pain produced by calculus in other organs, such as the kidneys.

DIF: Recall REF: p. 2 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 4. Which one of these historical figures was a big 19th century influence in the field of

periodontology? a. Ambroise Pare

b. John Hunter c. Hippocrates of Cos d. Leonard Koecker ANS: D

Leonard Koecker (1785–1850) was a German-born dentist who recommended that oral hygiene was performed in the morning and after every meal with the use of an astringent powder and a toothbrush. He was also an early advocate of the “odontogenic focal infection” theory.

DIF: Comprehension REF: p. 3 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 5. Who is considered the father of oral hygiene and the inventor of dental floss? a. Levi Spear Parmly b. John W. Riggs c. Leonard Koecker d. Adolph Witzel ANS: A

Levi Spear Parmly (1790–1859) was a dentist from New Orleans, Louisiana, and is considered the father of oral hygiene and the inventor of dental floss.

DIF: Recall REF: p. 4 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 6. Who was the first individual to identify bacteria as the cause of periodontal disease? a. Levi Spear Parmly b. Adolph Witzel c. Horace Wells d. William Morton ANS: B

The first individual to identify bacteria as the cause of periodontal disease appears to have been the German dentist Adolph Witzel (1847–1906).

DIF: Recall REF: p. 4 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 7. During the first third of the 20th century, periodontics flourished in central Europe, with which

two major cities as its center of excellence? a. Budapest and Prague b. Prague and Krakow c. Vienna and Berlin d. Berlin and Munich ANS: C

During the first third of the 20th century, periodontics flourished in central Europe, with two major centers of excellence: Vienna and Berlin.

DIF: Comprehension REF: p. 5 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases

8. In what year was periodontics recognized as a specialty of dentistry? a. 1962 b. 1940 c. 1959 d. 1947 ANS: D

Periodontics was recognized as a specialty of dentistry by the American Dental Association in 1947.

DIF: Recall REF: p. 8 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 9. Which ancient civilization wrote about gingival disease on Ebers papyrus? a. Egyptians b. Babylonians c. Sumerians d. Assyrians ANS: A

The Ebers papyrus contains many references to gingival disease and offers a number of prescriptions for strengthening the teeth and gums.

DIF: Recall REF: p. 1 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 10. Who wrote Canon, a compTreEhS enTsB ivA eN trK eaStiE seLoLnEmRe. diCciOnM e, which was in continuous use for

almost 600 years? a. Albucasis b. Avicenna c. Cornelius Celsus d. Paracelsus ANS: B

Avicenna (980–1037) was possibly the greatest of the Persian physicians. His Canon, a comprehensive treatise on medicine, was in continuous use for almost 600 years.

DIF: Recall REF: p. 1 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 11. Who wrote the first original book about teeth, titled Libellus de Dentibus (“A Little Treatise

on the Teeth”)? a. Albucasis b. Andreas Vesalius c. Bartholomeus Eustachius d. Serefeddin Sabuncuoglu ANS: C

Bartholomeus Eustachius (1520–1574) of Rome was another outstanding anatomist who wrote a small book about dentistry, Libellus de Dentibus (“A Little Treatise on the Teeth”), which contained 30 chapters. This was the first original book about the teeth, and it included a description of the periodontal tissues as well as information about the diseases of the mouth, their treatment modalities, and the rationale for treatment.

DIF: Comprehension REF: p. 2 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 12. Who appears to have been the first to differentiate among the types of periodontal disease? a. Girolamo Cardano b. Anton van Leewenhoek c. Pierre Fauchard d. Andreas Vesalius ANS: A

The Italian physician, mathematician, and philosopher Girolamo Cardano (1501–1576) appears to have been the first to differentiate among the types of periodontal disease. In a publication dated 1562, he mentions one type of disease that occurs with advancing age and leads to progressive loosening and loss of teeth as well as a second very aggressive type that occurs in younger patients.

DIF: Recall REF: p. 3 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 13. In the 18th century, what were the two European countries who witnessed the most growth for

modern dentistry? a. France and England b. Germany and Italy c. Poland and Switzerland d. Greece and Sweden ANS: A

Modern dentistry essentially developed in 18th century Europe, particularly France and England. Notable names include Pierre Fauchard, John Hunter, and Thomas Berdmore.

DIF: Comprehension REF: p. 3 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 14. Who is credited for the discovery of radiographs? a. Wilhelm Rontgen b. Rudolph Virchow c. John W. Riggs d. Louis Pasteur ANS: A

German physicist Wilhelm Rontgen (1845–1923) discovered radiographs in 1895 at the University of Wurzburg. It is considered to be a crucial development in periodontics and many other areas of medicine and dentistry.

DIF: Recall REF: p. 4 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases

15. Who is considered to be the first true oral microbiologist? a. John W. Riggs b. W. J. Younger c. Carl Koller d. Willoughby D. Miller ANS: D

The first true microbiologist was the American Willoughby D. Miller (1853–1907), whose professional activities took place in Berlin, where he embarked on a research career that introduced modern bacteriology principles to dentistry. He also wrote the book The Microorganisms of the Human Mouth, which was published in 1890.

DIF: Recall REF: p. 4 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 16. Who described the principles of periodontal flap surgery, including osseous recontouring as it

is currently known, in a book published in 1912? a. Oskar Weski b. Horace Wells c. Robert Neumann d. Julius Cohnein ANS: C

Neumann (1882–1958), in a book published in 1912 (with new editions in 1915, 1920, and 1924), described the principles of periodontal flap surgery, including osseous recontouring as it is currently known.

DIF: Recall REF: p. 6 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 17. Who coined the term “gelatinus microbic plaque?” a. Salomon Robicsek b. G.V. Black c. Moritz Karolyi d. Hyacinthe Jean Vincent ANS: B

Bacterial plaque was described by J. Leon Williams (1852–1932), an American dentist who practiced in London and who, in 1897, described a gelatinous accumulation of bacteria adherent to the enamel surface in relation to caries. In 1899, G.V. Black (1836–1915) coined the term gelatinous microbic plaque.

DIF: Recall REF: p. 5 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 18. What school developed the basic histopathologic concepts on which modern periodontics was

built? a. The Berlin School b. Oxford University c. The Vienna School d. Harvard University

ANS: C

The Vienna school developed the basic histopathologic concepts on which modern periodontics was built.

DIF: Comprehension REF: p. 5 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 19. During the 1950s, which Swedish orthopedic surgeon developed a technique that involved the

use of titanium screw-shaped intraosseous implants? a. A. E. Strock b. Isadore Hirschfeld c. A. Schroeder d. Per-Ingvar Bränemark ANS: D

During the 1950s, the Swedish orthopedic surgeon Per-Ingvar Bränemark developed a technique that involved the use of titanium screw-shaped intraosseous implants. This proved to be quite successful, and it was gradually adopted by the dental profession after the 1982 international conference in Toronto, Ontario, Canada. Numerous variations of the Bränemark concept were presented by A. Kirsch, G.A. Niznick, A. Schroeder, and others, and they are widely used at present.

DIF: Recall REF: p. 7 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 20. Which two periodontists founded The American Academy of Periodontology? a. Henry M. Goldman anT dE JoShT nB PrAicNhK arSdELLER.COM b. Grace Rogers Spalding and Gillette Hayden c. Irving Glickman and Saul Schluger d. Leonard Koecker and William Hunter ANS: B

The American Academy of Periodontology, which was founded in 1914 by two female periodontists, Grace Rogers Spalding (1881–1953) and Gillette Hayden (1880–1929), has become the leader in organized periodontics. The association publishes a monthly scientific publication called the Journal of Periodontology, which presents all current advances in the discipline.

DIF: Recall REF: p. 8 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases

Chapter 02: Evidence-Based Decision Making Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Using evidence from medical literature to answer questions, direct clinical action, and guide

practice was pioneered by what university in the 1980s? a. Stanford University b. Oxford University c. McMaster University d. McGill University ANS: C

Using evidence from the medical literature to answer questions, direct clinical action, and guide practice was pioneered at McMaster University in Ontario, Canada, in the 1980s.

DIF: Recall REF: p. 10 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 2. What word can be defined as “the synthesis of all valid research that answers a specific

question and that, in most cases, distinguishes it from a single research study?” a. Theory b. Evidence c. Hypothesis d. Conclusion ANS: B

Evidence is considered the synthesis of all valid research that answers a specific question and that, in most cases, distinguishes it from a single research study.

DIF: Comprehension REF: p. 10 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 3. Which of the following is one of the two fundamental principles of evidence-based decision

making (EBDM)? a. Evidence alone is never sufficient to make a clinical decision. b. Always critically apply the results of evidence in clinical practice. c. Rely on previously discovered information to formulate hypotheses. d. Evaluate processes and performance throughout the process.

ANS: A

The two fundamental principles of evidence-based decision making (EBDM) are: (1) evidence alone is never sufficient to make a clinical decision, and (2) hierarchies of quality and applicability of evidence exist to guide clinical decision making.

DIF: Comprehension REF: p. 10 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 4. Which of the following is an example of a skill or ability that is needed to apply an

evidence-based decision-making process? a. Conduct a computerized or manual search with ample efficiency for finding

evidence with which to answer the question. b. Keep the results applicable only to the question at hand. c. Convert information needs and problems into theories. d. Critically appraise the evidence for its validity and usefulness.

ANS: D

The skills and abilities needed to apply an evidence-based decision-making process can be found in 2.1 of the textbook, and are also listed here: (1) convert information needs and problems into clinical questions so that they can be answered, (2) conduct a computerized search with maximum efficiency for finding the best external evidence with which to answer the question, (3) critically appraise the evidence for its validity and usefulness (clinical applicability), (4) apply the results of the appraisal, or evidence, in clinical practice, and (5) evaluate the process and your performance.

DIF: Comprehension REF: p. 11 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 5. PICO stands for four components of a well-built question. What does the “I” stand for? a. Intervention b. Information c. Intuition d. Inclusion ANS: A

PICO stands for Population, Intervention, Comparison, and Outcomes.

DIF: Recall REF: p. 11 TOP: NBDHE; 4.1 EtiologyTaE ndSpTaB thA ogNeK neS siE sL ofLpE erR io. doCnO taM l diseases 6. A controlled trial is a methodology of choice that can be used to answer what type of

question? a. Etiology, causation, harm b. Diagnosis c. Therapy, prevention d. Prognosis ANS: B

A controlled trial can be used to answer a question related to a diagnosis because it measures the reliability of a particular diagnostic measure for a disease against the “gold standard” diagnostic measure for the same disease. Refer to Table 2.1 in the textbook for more information.

DIF: Comprehension REF: p. 14 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 7. Evidence-based article reviews are an example of which type of source of evidence? a. Primary source b. Expert source c. Secondary source d. Highest source ANS: C

Primary sources are original research studies and publications that have not been filtered or synthesized, such as an RCT or cohort study. Secondary sources are synthesized studies and publications of the already-conducted primary research, which include clinical practice questions (CPGs), SRs, MAs, and evidence-based article reviews and protocols.

DIF: Comprehension REF: p. 12 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 8. Clinical practice guidelines are considered a secondary source of evidence and are at which

level of evidence? a. The lowest level of evidence b. The second lowest level of evidence c. The second highest level of evidence d. The highest level of evidence ANS: D

Clinical practice guidelines are a secondary source of evidence and is at the top of the hierarchy of evidence. CPGs should be based on the best available scientific evidence, typically from MAs and SRs, which put together all that is known about a topic in an objective manner.

DIF: Application REF: p. 15 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 9. Which of the following is the National Library of Medicine’s premier bibliographic database

covering the fields of medicine, nursing, dentistry, veterinary medicine, the health care system, and the preclinical sciences? a. MEDLINE b. DOCLINE c. LOVELINE d. PUBLINE ANS: A

MEDLINE is the National Library of Medicine’s premier bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the health care system, and the preclinical sciences. It contains bibliographic citations and author abstracts from more than 5200 biomedical journals published in the United States and 80 other countries.

DIF: Recall REF: p. 16 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 10. Although the use of evidence to help guide clinical decisions is not new, which of the

following aspects of EBM are considered new? a. The methods of generating high-quality evidence, such as nonrandomized trials (NRTs) and other methods b. The statistical tools for synthesizing and analyzing the evidence (systematic reviews [SRs] and meta-analyses [MA]) c. The way in which dental care professionals use evidence to steer patient decisions toward a common goal d. The usage of current best evidence to sometimes replace clinical expertise or input from the patient

ANS: B

The use of evidence to help guide clinical decisions is not new. However, the following aspects of EBM are new: (1) the methods of generating high-quality evidence, such as randomized controlled trials (RCTs) and other well-designed methods, (2) the statistical tools for synthesizing and analyzing the evidence (systematic reviews [SRs] and meta-analyses [MA]); and (3) the ways of accessing evidence (electronic databases) and applying it (evidence-based decision making [EBDM] and practice guidelines).

DIF: Comprehension REF: p. 10 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 11. Which of the following is the definition for evidence-based dentistry? a. The synthesis of all valid research that answers a specific question and that, in

most cases, distinguishes it from a single research study. b. The integration of the best research evidence with our clinical expertise and our patient’s unique values and circumstances. c. An approach to oral health care that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the patient’s oral and medical condition and history, with the dentist’s clinical expertise and the patient’s treatment needs and preferences. d. A structured process that incorporates a formal set of rules for interpreting the results of clinical research and places a lower value on authority or custom.

ANS: C

Evidence can be defined as “the synthesis of all valid research that answers a specific question and that, in most cases, distinguishes it from a single research study.” Evidence-based medicine can be defined asT“EthSeTinBteAgN raKtiS onEoLfLthEeRb.esCt O reMsearch evidence with our clinical expertise and our patient’s unique values and circumstances.” Evidence-based dentistry can be defined as “an approach to oral health care that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the patient’s oral and medical condition and history, with the dentist’s clinical expertise and the patient’s treatment needs and preferences.” Evidence-based decision making is “a structured process that incorporates a formal set of rules for interpreting the results of clinical research and places a lower value on authority or custom.”

DIF: Comprehension REF: p. 10 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 12. The first step in evidence-based decision making (EBDM) is: a. asking the right question. b. conducting computerized research. c. searching for and acquiring evidence. d. appraising the evidence.

ANS: A

The first step in evidence-based decision making (EBDM) is asking the right question.

DIF: Recall REF: p. 11 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases

13. The combination of

and good evidence allows health care professionals to apply the benefits from clinical research to patient care. a. technology b. good doctors c. practice d. teamwork ANS: A

The combination of technology and good evidence allows health care professionals to apply the benefits from clinical research to patient care.

DIF: Recall REF: p. 11 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 14. What can be a challenge when using EBDM? a. When only one research study is available on a particular topic. b. The fact that technology has not caught up to the needs of the process. c. When the clinician is forced to focus on what he or she and the patient believe to

be the most important single issue and outcome. d. The fact that hierarchies of the types of evidence exist.

ANS: A

The challenge in using EBDM arises when only one research study is available on a particular topic, or when limited research is available (and it is weak in quality or poorly conducted).

DIF: Comprehension REF: p. 12 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 15. Which of the following is true about guidelines in the dental industry? a. Guidelines need to be strictly followed and never questioned. b. Guidelines are important to have in place so that dental care professionals do not

veer from the course or goal. c. Guidelines are meant to be followed only by the dentist, not by the support staff. d. Guidelines will change over time as evidence evolves.

ANS: D

Guidelines will change over time as evidence evolves, thereby underscoring the importance of keeping current with scientific literature.

DIF: Comprehension REF: p. 15 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 16. Which of the following can be defined as “a statistical process used when the data from the

individual studies in the systematic review can be combined into one analysis?” a. Clinical practice guidelines b. Case reports c. Meta-analysis d. Scientific process ANS: C

Meta-analysis (MA) is a statistical process used when the data from the individual studies in the systematic review (SR) can be combined into one analysis. When data from these studies are pooled, the sample size and power usually increase.

DIF: Comprehension REF: p. 16 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 17. The highest level of evidence associated with questions about therapy or prevention is from: a. CPGs based on MAs and/or SRs of inception cohort studies. b. CPGs based on MAs and/or SRs of RCT studies. c. CPGs based on MAs and/or SRs about case reports. d. CPGs based on MAs and/or SRs about editorials.

ANS: B

The highest level of evidence associated with questions about therapy or prevention is from CPGs based on MAs and/or SRs of RCT studies. The highest level of evidence associated with questions about prognosis is from CPGs based on MAs and/or SRs of inception cohort studies.

DIF: Comprehension REF: p. 16 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 18. International evidence-based groups have made appraising evidence easier by developing

appraisal forms and checklists that guide the user through a structured series of what types of questions? a. Open-ended questions b. Specific and measurable questions c. YES/NO questions d. PICO questions ANS: C

International evidence-based groups have made appraising evidence easier by developing appraisal forms and checklists that guide the user through a structured series of “YES/NO” questions to determine the validity of the individual study or SR. Refer to Table 2.4 in the textbook.

DIF: Comprehension REF: p. 17 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases 19. What does CASP stand for? a. Continuous Advancement Skills Program b. Critical Analysis Skills Program c. Continuous Allocation Skills Program d. Critical Appraisal Skills Program ANS: D

CASP, which is an example of a critical analysis guide, stands for “Critical Appraisal Skills Program.”

DIF: Recall REF: p. 17 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases

20. Which of the following is an example of a question that can be used to evaluate the

effectiveness of the EBDM process? a. Would more people want to have participated in this process? b. Did the selected intervention or treatment achieve the desired result? c. Do we want to continue this process at a later date? d. Did the hypothesis turn out to be the actual outcome of the process?

ANS: B

The final steps in the EBDM process are to evaluate the effectiveness of the intervention and clinical outcomes and to determine how effectively the EBDM process was applied. For example, one question to ask in evaluating the effectiveness of the intervention is, “Did the selected intervention or treatment achieve the desired result?”

DIF: Application REF: p. 18 TOP: NBDHE; 4.1 Etiology and pathogenesis of periodontal diseases

Chapter 03: Critical Thinking: Assessing Scientific Evidence Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following is one of the three systematic experimental designs that are now

routine in clinical research? a. The cohort study b. The case study c. The control study d. The exposure study ANS: A

Three systematic experiments are now routine in clinical research: the case-control study, the cohort study, and the RCT. A cohort study is when exposed individuals are compared with nonexposed individuals and monitored longitudinally for the occurrence of the primary endpoint of interest.

DIF: Recall REF: p. 21 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 2. All three systematic experimental designs that have become routine in clinical research permit

us to study the association between the a. hypothesis b. evidence c. exposure d. facts

and the endpoint.

ANS: C

All three study designs permit us to study the association between the exposure and the endpoint. An important challenge in the assessment of controlled evidence is determining whether the associated identified is casual.

DIF: Comprehension REF: p. 21 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 3. Usually, clinically relevant questions share four important characteristics of the pretrial

hypothesis. Which of the following is an example of such? a. A research team that is big enough to make a difference. b. Previous research related to the endpoint. c. A study sample that is big enough to be relevant. d. A clinically relevant endpoint.

ANS: D

Usually, clinically relevant questions share four important characteristics of the pretrial hypothesis: (1) a clinically relevant endpoint (referred to as the Outcome in the PICO question), (2) relevant exposure comparisons (referred to as the Intervention and the Control in the PICO question, (3) a study sample representative of real-world clinical patients (should be representative of the Patient defined in the PICO question), and (4) small error rates.

DIF: Comprehension REF: p. 22 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 4. How do you calculate an odds ratio? a. Create a multiplication equation and convert the byproducts. b. Create a two-by-two table and cross-tabulate. c. Create a realistic scenario and form a hypothesis. d. Critically appraise the evidence for its validity and usefulness.

ANS: B

An odds ratio is a ratio of odds. To calculate an odds ratio, a two-by-two (2 2) table is constructed in which the outcome is cross-tabulated with the exposure. Odds ratios can be calculated for data from RCTs, cohort studies, and case-control studies.

DIF: Application REF: p. 23.e1 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 5. For a factor to explain away an observed association, two criteria need to be fulfilled. Which

of the following is one of those criteria? a. The factor must be cauT saEllS yT reBlaAteNdKtoStEhL eL ouEtcRo. mCeOanMd must not be in the causal pathway. b. The factor must be related to the exposure in a causal way. c. The factor must be associated to the outcome but not directly linked. d. The factor must be unrelated to the exposure.

ANS: A

For a factor (i.e., a potential confounder) to explain away an observed association, two criteria need to be fulfilled. First, the factor must be related to the exposure but not necessarily in a causal way. Second, the factor must be causally related to the outcome and must not be in the causal pathway.

DIF: Comprehension REF: p. 24 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 6. Why can randomization be a counterintuitive process? a. It can create research bias. b. It takes control over treatment assignment away from the physician. c. It can lead to patient frustration. d. It can contribute to the patients feeling neglected and ignored.

ANS: B

Randomization can be a counterintuitive process because it: (1) creates heterogeneity, (2) takes control over treatment assignment away from the physician, and (3) leads to apparently illogical situations in which patients who are randomly assigned to a treatment but are refusing compliance are still analyzed as if they received the treatment.

DIF: Comprehension REF: p. 24 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 7. What kind of study is considered the gold standard design in clinical research? a. Cohort study b. Case-control study c. Secondary study d. Randomized control trial ANS: D

RCTs are considered the “gold standard” in clinical research. When properly executed, they are referred to as level 1 evidence and the highest (best) level of evidence available.

DIF: Recall REF: p. 21 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 8. What kind of study is the most challenging study design to use for obtaining reliable

evidence? a. Cohort study b. Case-control study c. Secondary study d. Randomized control trial ANS: B

The case-control study is the most challenging study design to use for obtaining reliable evidence. As a result, in evidence-based medicine, case-control studies, when properly executed, are considered the lowest level of evidence.

DIF: Recall REF: p. 21 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 9. What kind of study is often considered the optimal study design in nonexperimental clinical

research? a. Cohort study b. Case-control study c. Secondary study d. Randomized controlled trial ANS: A

A cohort study is often considered the optimal study design in nonexperimental clinical research (i.e., for those study designs where randomization may not be feasible). In evidence-based medicine, cohort studies, when properly executed, are referred to as level 2 evidence.

DIF: Recall REF: p. 21 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 10. When properly executed, what level of evidence are randomized controlled trials (RCTs)

considered? a. Level 1 b. Level 2 c. Level 3 d. Level 4 ANS: A

RCTs, when properly executed, are referred to as level 1 evidence and the highest (best) level of evidence available.

DIF: Comprehension REF: p. 21 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 11. What is the lowest classification level of evidence available? a. Level 1 b. Level 2 c. Level 4 d. Level 5 ANS: D

The lowest classification level of evidence is level 5.

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DIF: Recall REF: p. 20 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 12. Which of the following is a measurement related to a disease process or condition and is used

to assess the exposure effect? a. Endpoint b. Hypothesis c. Evidence d. PICO ANS: A

The endpoint is a measurement related to a disease process or condition and is used to assess the exposure effect.

DIF: Recall REF: p. 22 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 13. Who purportedly said that “his own major scientific talent was his ability to look at an

enormous number of experiments and journal articles, select the very few that were both correct and important, ignore the rest, and build a theory on the right ones?” a. Galileo b. Twain

c. Einstein d. Newton ANS: C

Albert Einstein purportedly said that “his own major scientific talent was his ability to look at an enormous number of experiments and journal articles, select the very few that were both correct and important, ignore the rest, and build a theory on the right ones.”

DIF: Recall REF: p. 20 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 14. What is the first step in a proper randomization? a. Subjects are enrolled into a study before randomization. b. A third-party organization randomly assigns subjects to treatments. c. The randomization process needs to be effectively hidden from the clinicians. d. Clinicians and subjects need to have an interview.

ANS: A

The first step in a proper randomization is that the subjects need to be enrolled into a study before the randomization can occur. This is so that important baseline disease characteristics are recorded and provided to an independent person or organization.

DIF: Comprehension REF: p. 24.e1 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 15. Which of the following is tThE eS naTmBeAfN orKthSeEbLraLnE chRo.fCmOeM dicine which deals with the incidence,

distribution, and possible control of senses and other factors relating to health? a. Dentistry b. Oral health c. Evidence-based research d. Epidemiology ANS: D

Epidemiology is the branch of medicine which deals with the incidence, distribution, and possible control of diseases and other factors relating to health.

DIF: Comprehension REF: p. 24 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 16. Which of the following is the term that is a foundational concept for causal analysis because

causal relationships unfold over time? a. Time-lapse research b. Temporality c. Meta-analysis d. Scientific process ANS: B

Temporality is a foundational concept for causal analysis because causal relationships unfold over time—and become observable only after a certain lapse of time.

DIF: Application REF: p. 21 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 17. Which of the following is the term that is the application of statistical methods in studies in

biology? a. Biologic epidemiology b. Biostatistics c. Biocentricity d. Biologic evidence ANS: B

Biostatistics is the application of statistical methods in studies in biology, and encompasses the design of experiments, the collection of data from them, and the analysis and interpretation of data.

DIF: Comprehension REF: p. 21 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 18. Why might the use of deductive reasoning for clinical decisions be dangerous? a. Because clinicians must draw their own conclusions. b. Because clinicians should never be skeptical of research. c. Because of an incomplete understanding of biology. d. Because of confusion surrounding how to build a hypothesis.

ANS: C

Because of an incomplete understanding of biology, the use of deductive reasoning for clinical decisions may be dangerous.

DIF: Recall REF: p. 20 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 19. Which of the following is another phrase for “systematic experiments”? a. Biologic plausibility b. Inductive reasoning c. Causal relationship d. Deductive reasoning ANS: B

Rational thought requires reliance on either deductive reasoning (biologic plausibility) or systematic experiments. Systematic experiments are sometimes referred to as “inductive reasoning.”

DIF: Comprehension REF: p. 21 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 20. What is the only criterion that needs to be satisfied for claiming causality? a. Timeliness

b. Deductive reasoning c. Inference d. Temporality ANS: D

Temporality is the only criterion that needs to be satisfied for claiming causality; the cause needs to precede the effect.

DIF: Application REF: p. 21 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results

Chapter 04: Anatomy, Structure, and Function of the Periodontium Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following is one of the three zones of the oral mucosa? a. The oral mucous membrane b. The gingiva and covering of soft palate c. The teeth and gums d. The bottom surface of the tongue ANS: A

The oral mucosa consists of the following three zones: (1) the gingiva and the covering of the hard palate (the masticatory mucosa), (2) the dorsum of the tongue, covered by the specialized mucosa, and (3) the oral mucous membrane lining the remainder of the oral cavity.

DIF: Recall

REF: p. 29

TOP: NBDHE; 1.1.2 Dental anatomy

2. There are four principal components of the normal periodontium: the gingiva, the periodontal

ligament, the alveolar bone, and what other component? a. Lips b. Oral mucosa c. Cementum d. Dorsum of the tongue ANS: C

The normal periodontium T prE ovSiT deBs A thNeKsuSpEpL orL tE neRce.sC saOryMto maintain teeth in function. It consists of four principal components: gingiva, periodontal ligament, cementum, and alveolar bone.

DIF: Comprehension TOP: NBDHE; 1.1.2 Dental anatomy

REF: p. 29

3. The gingiva is divided anatomically into three areas: marginal, attached, and what other area? a. Unilateral b. Unattached c. Alveolar d. Interdental ANS: D

The gingiva is divided anatomically into marginal, attached, and interdental areas.

DIF: Recall

REF: p. 29

TOP: NBDHE; 1.1.2 Dental anatomy

4. What is the principal cell type of the gingival epithelium? a. Langerhans cells b. Keratinocytes c. Melanocytes d. Merkel cells ANS: B

The principal cell types of the gingival epithelium are keratinocytes. Other cell types found in the epithelium are the clear cells or nonkeratinocytes, which include the Langerhans cells, the Merkel cells, and the melanocytes.

DIF: Comprehension TOP: NBDHE; 1.1.2 Dental anatomy

REF: p. 32

5. What is the main function of the gingival epithelium? a. To protect the deep structures while allowing for a selective interchange with the

oral environment b. To differentiate and supply the cells necessary for the keratinization process c. To produce various types of cells, as well as replace any damaged cells d. To provide a healthy environment for the strategic exchange of processes and cells

within the oral cavity ANS: A

The main function of the gingival epithelium is to protect the deep structures while allowing for a selective interchange with the oral environment. This is achieved via the proliferation and differentiation of the keratinocytes.

DIF: Recall

REF: p. 32

TOP: NBDHE; 1.1.2 Dental anatomy

6. Which of the following are dendritic cells located among keratinocytes at all suprabasal

levels? a. Langerhans cells b. Merkel cells c. Melanocytes d. Non-Langerhans cells ANS: A

Langerhans cells are dendritic cells located among keratinocytes at all suprabasal levels. They belong to the mononuclear phagocyte system as modified monocytes derived from the bone marrow.

DIF: Recall

REF: p. 34

TOP: NBDHE; 1.1.2 Dental anatomy

7. The degree of gingival keratinization diminishes as what progresses? a. Tartar buildup b. Stress c. Pregnancy d. Age ANS: D

The degree of gingival keratinization diminishes with age and the onset of menopause, but it is not necessarily related to the different phases of the menstrual cycle.

DIF: Comprehension TOP: NBDHE; 1.1.2 Dental anatomy

REF: p. 34

8. Which kind of epithelium lines the gingival sulcus? a. Oral epithelium b. Sulcular epithelium

c. Gingival epithelium d. Junctional epithelium ANS: B

The sulcular epithelium lines the gingival sulcus. It is a thin, nonkeratinized stratified squamous epithelium without rete pegs, and it extends from the coronal limit of the junctional epithelium to the crest of the gingival margin. It usually shows many cells with hydropic degeneration.

DIF: Recall

REF: p. 35

TOP: NBDHE; 1.1.2 Dental anatomy

9. What kind of epithelium consists of a collar-like band of stratified squamous nonkeratinizing

epithelium and is formed by the confluence of the oral epithelium and the reduced enamel epithelium (REE) during tooth eruption? a. Oral epithelium b. Sulcular epithelium c. Gingival epithelium d. Junctional epithelium ANS: D

The junctional epithelium consists of a collar-like band of stratified squamous nonkeratinizing epithelium. It is 3 to 4 layers thick in early life, but that number increases with age to 10 to even 20 layers. The junctional epithelium is formed by the confluence of the oral epithelium and the reduced enamel epithelium (REE) during tooth eruption.

DIF: Recall

REF: p. 36

TOP: NBDHE; 1.1.2 Dental anatomy

naSmTeB l aAfN teK r eSnE am elEfoRr. mC atO ioMn is complete?

10. What substance covers theTeE LL a. Reduced enamel epithelium b. Gingival fluid c. Gingival sulcus d. Cuticular structures ANS: A

After enamel formation is complete, the enamel is covered with reduced enamel epithelium (REE), which is attached to the tooth by a basal lamina and hemidesmosomes. When the tooth penetrates the oral mucosa, the REE unites with the oral epithelium and transforms into the junctional epithelium.

DIF: Recall

REF: p. 37

TOP: NBDHE; 1.1.2 Dental anatomy

11. Which of the following is one of the main components of gingival connective tissue? a. Collagen fibers b. Gingival fluid c. Langerhans cells d. Dental follicles ANS: A

The major components of the gingival connective tissue are collagen fibers (approximately 60% by volume), fibroblasts (5%), and vessels, nerves, and matrix (approximately 35%).

DIF: Recall

REF: p. 38

TOP: NBDHE; 1.1.2 Dental anatomy

12. The three types of connective tissue fibers are collagen, reticular, and what other type? a. Elastic fibers b. Gingival fibers c. Circular fibers d. Junctional fibers ANS: A

The three types of connective tissue fibers are collagen, reticular, and elastic.

DIF: Recall

REF: p. 38

TOP: NBDHE; 1.1.2 Dental anatomy

13. Gingival fibers consist of what type of collagen? a. Type I b. Type II c. Type III d. Type IV ANS: A

Gingival fibers consist of type I collagen.

DIF: Recall

REF: p. 38

TOP: NBDHE; 1.1.2 Dental anatomy

14. Why does the connective tissue of the gingiva have remarkably good healing and regenerative

capacity? a. Because of the amount of tissue involved b. Because of the cleanliness of the tissue c. Because of the high turT nE ovSeT r rBaA teNKSELLER.COM d. Because of the placement on the body ANS: C

Because of the high turnover rate, the connective tissue of the gingiva has remarkably good healing and regenerative capacity.

DIF: Comprehension TOP: NBDHE; 1.1.2 Dental anatomy

REF: p. 39

15. The three sources of blood supply to the gingiva are arterioles, vessels of the periodontal

ligament, and what other source? a. Gingival crevicular areas b. Supraperiosteal arterioles c. Alveolar bones d. Gingival connective tissues ANS: B

Three sources of blood supply to the gingiva are supraperiosteal arterioles along the facial and lingual surfaces of the alveolar bone, vessels of the periodontal ligament, and arterioles that emerge from the crest of the interdental septa and extend parallel to the crest of the bone to anastomose with vessels of the periodontal ligament.

DIF: Comprehension TOP: NBDHE; 1.1.2 Dental anatomy

REF: p. 39

16. What color is typically used to describe the color of the attached and marginal gingiva? a. Salmon pink b. Magenta c. Coral pink d. Blush pink ANS: C

The color of the attached and marginal gingiva is generally described as “coral pink”; it is produced by the vascular supply, the thickness and degree of keratinization of the epithelium, and the presence of pigment-containing cells.

DIF: Recall

REF: p. 41

TOP: NBDHE; 1.1.2 Dental anatomy

17. Which of the following terms is a non-hemoglobin–derived brown pigment that provides

physiologic pigmentation? a. Melatonin b. Melanin c. Melasma d. Mucosa ANS: B

Melanin is a non-hemoglobin–derived brown pigment that provides physiologic pigmentation.

DIF: Recall

REF: p. 41

TOP: NBDHE; 1.1.2 Dental anatomy

18. Which of the following can best describe the surface texture of the gingiva? a. Smooth b. Mountainous c. Textured d. Bumpy ANS: C

The gingiva presents a textured surface similar to that of an orange peel and is referred to as “stippled.”

DIF: Comprehension TOP: NBDHE; 1.1.2 Dental anatomy

REF: p. 42

19. During which stage of passive eruption is the entire junctional epithelium on the cementum? a. Stage 1 b. Stage 2 c. Stage 3 d. Stage 4 ANS: C

The teeth reach the line of occlusion in Stage 1 of passive eruption. In Stage 2, the junctional epithelium proliferates so that part is on the cementum and part is on the enamel. In Stage 3, the entire junctional epithelium is on the cementum, and the base of the sulcus is at the cementoenamel junction. In Stage 4, the junctional epithelium has proliferated farther on the cementum.

DIF: Application

REF: p. 43

TOP: NBDHE; 1.1.2 Dental anatomy

20. Which of the following is the correct order of how the principal fibers of the periodontal

ligament develop sequentially in the developing root? a. Transseptal, alveolar crest, oblique, apical, horizontal, interradicular b. Transseptal, alveolar crest, horizontal, oblique, apical, interradicular c. Transseptal, apical, horizontal, alveolar crest, oblique, interradicular d. Transseptal, horizontal, apical, oblique, alveolar crest, interradicular ANS: B

The principal fibers of the periodontal ligament are arranged in six groups that develop sequentially in the developing root: the transseptal, alveolar crest, horizontal, oblique, apical, and interradicular fibers.

DIF: Comprehension TOP: NBDHE; 1.1.2 Dental anatomy

REF: p. 45

21. What are the two main types of cementum? a. Typical and atypical b. Cellular and acellular c. Differentiated and undifferentiated d. Rapid and slow ANS: B

The two main types of cementum are acellular (primary) and cellular (secondary) cementum.

Both consist of a calcified interfibrillar matrix and collagen fibrils.

DIF: Recall

REF: TpE . 4S9TBANKS TE OL P:LE NR BD .HCEO; M1.1.2 Dental anatomy

22. What process involves the portion of the maxilla and the mandible? a. Alveolar process b. Cementum process c. Intercellular process d. Interdental septum process ANS: A

The alveolar process is the portion of the maxilla and the mandible that forms and supports the tooth sockets (alveoli). It forms when the tooth erupts to provide the osseous attachment to the forming periodontal ligament, and it disappears gradually after the tooth is lost.

DIF: Comprehension TOP: NBDHE; 1.1.2 Dental anatomy

REF: p. 53

23. What types of cells produce the organic matrix of bone? a. Osteoclasts b. Osteoblasts c. Chondroblasts d. Fibroblasts ANS: B

Osteoblasts are cells that produce organic matrix of bone.

DIF: Recall

REF: p. 55

TOP: NBDHE; 1.1.2 Dental anatomy

24. What type of bone develops around each tooth follicle during odontogenesis? a. Basal bone b. Bone marrow c. Alveolar bone d. Periodontal ligament ANS: C

The alveolar bone develops around each tooth follicle during odontogenesis. When a deciduous tooth is shed, its alveolar bone is resorbed.

DIF: Comprehension TOP: NBDHE; 1.1.2 Dental anatomy

REF: p. 59

25. What is the term used to describe teeth movement that occurs with time and wear? a. Physiologic mesial displacement b. Physiologic mesial development c. Physiologic mesial mobility d. Physiologic mesial migration ANS: D

Tooth movement does not end when active eruption is completed, and the tooth is in functional occlusion. With time and wear, the proximal contact areas of the teeth are flattened, and the teeth tend to move mesially. This is referred to as “physiologic mesial migration.”

DIF: Comprehension REF: p. 59 TOP: NBDHE; 1.1.2 DentalTaE naStoTmByANKSELLER.COM

Chapter 05: Aging and the Periodontium Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. It has been reported that what part of the periodontium thins and has decreased keratinization

with age? a. Gingival epithelium b. Periodontal ligament c. Alveolar bone d. Cementum ANS: A

Thinning and decreased keratinization of the gingival epithelium have been reported with age.

DIF: Recall

REF: p. 62

TOP: NBDHE; 1.1.2 Dental anatomy

2. Gingival recession is a consequence of which of the following? a. Hormone levels b. The way the body processes sugar c. Cumulative effects of inflammation or trauma d. The aging process ANS: C

The consensus is that gingival recession is not an inevitable physiologic process of aging, but rather that it can be explained by the cumulative effects of inflammation or trauma on the periodontium.

DIF: Comprehension TOP: NBDHE; 1.1.2 Dental anatomy

REF: p. 63

3. What part of the periodontium becomes coarser and denser with age? a. Gingival epithelium b. Periodontal ligament c. Cementum d. Gingival connective tissue ANS: D

Increasing age results in coarser and denser gingival connective tissues. Qualitative and quantitative changes have been reported.

DIF: Recall

REF: p. 63

TOP: NBDHE; 1.1.2 Dental anatomy

4. What part of the periodontium shows decreased numbers of fibroblasts and a more irregular

structure as aging progresses? a. Gingival epithelium b. Periodontal ligament c. Cementum d. Alveolar bone ANS: B

Changes in the periodontal ligament that have been reported with aging include decreased numbers of fibroblasts and a more irregular structure, thereby paralleling the changes seen in the gingival connective tissues.

DIF: Recall

REF: p. 63

TOP: NBDHE; 1.1.2 Dental anatomy

5. Which mediator of bone homeostasis is widely recognized for its role in activating

osteoclasts? a. RANKL b. OPG c. ORGA d. IL-4 ANS: A

B ligand (RANKL) and osteoprotegerin (OPG) are both mediators of bone homeostasis.

RANKL is widely recognized for its role in activating osteoclasts, whereas OPG antagonizes RANKL binding, thereby helping to maintain balance.

DIF: Comprehension TOP: NBDHE; 1.1.2 Dental anatomy

REF: p. 63

6. What part of the periodontium may increase 5 to 10 times in width as age progresses? a. Alveolar bone b. Cementum c. Gingival epithelium d. Periodontal ligament ANS: B

An increase in cemental width is a common finding in the aging process; this increase may be 5 to 10 times wider than in those of younger age.

DIF: Comprehension TOP: NBDHE; 1.1.2 Dental anatomy

REF: p. 64

7. Which of these processes seems to be unaffected by increasing age? a. Morphologic changes in the alveolar bone b. The widening of the cementum c. The changing in structure of the periodontal ligament d. Healing rate of bone in extraction sockets ANS: D

Although age is a risk factor for the bone mass reductions in individuals with osteoporosis, it is not causative and, therefore, should be distinguished from physiologic aging processes.

Also, the healing rate of bone in extraction sockets appears to be unaffected by increasing age.

The success of osseointegrated dental implants, which relies on intact bone healing processes, does not appear to be age-related.

DIF: Application

REF: p. 64

TOP: NBDHE; 1.1.2 Dental anatomy

8. It has been suggested that dental plaque biofilm accumulation tends to do what as age

progresses? a. Decrease

b. Change in texture c. Increase d. Stay the same ANS: C

Dental plaque biofilm accumulation has been suggested to increase with age. This may be explained by the increase in hard tissue surface area as a result of gingival recession and the surface characteristics of the exposed root surface as a substrate for plaque formation as compared with enamel.

DIF: Comprehension TOP: NBDHE; 1.1.2 Dental anatomy

REF: p. 65

9. Which of the following is an acute phase protein that is widely regarded as a marker of

inflammatory burden and response to bacterial infection? a. C-reactive protein b. D-reactive protein c. B-reactive protein d. E-reactive protein ANS: A

C-reactive protein (CRP) is an acute phase protein that is widely regarded as a marker of inflammatory burden and response to bacterial infection.

DIF: Recall

REF: p. 65

TOP: NBDHE; 1.1.2 Dental anatomy

10. Which of the following terms can be defined as “any characteristic, behavior, or exposure

with an association of a paT rtE icS ulT arBdAisN eaKsS e”E?LLER.COM a. Diagnosis b. Health issue c. Biologic indicator d. Risk factor ANS: D

A risk factor can be defined as “any characteristic, behavior, or exposure with an association to a particular disease.” The relationship is not necessarily causal in nature, however.

DIF: Recall

REF: p. 66

TOP: NBDHE; 1.1.2 Dental anatomy

11. Which of the following is the most significant risk factor for loss of periodontal support? a. Increased age b. Smoking c. Lack of flossing d. Poor nutrition ANS: B

Smoking is the most significant risk factor for loss of periodontal support.

DIF: Recall

REF: p. 66

TOP: NBDHE; 1.1.2 Dental anatomy

12. Which of the following structures is not considered part of the periodontium? a. Cementum

b. Periodontal bridge c. Alveolar bone d. Gingiva ANS: B

The periodontium is composed of the gingiva, alveolar mucosa, cementum, periodontal ligament, and alveolar bone.

DIF: Comprehension TOP: NBDHE; 1.1.2 Dental anatomy

REF: p. 62

13. Lower intake levels of what nutrients in adults over age 60 are associated with greater levels

of periodontitis? a. Vitamin D b. Serum folate c. Calcium d. Zinc ANS: B

Lower intake levels of serum folate in adults over age 60 are associated with greater levels of periodontitis.

DIF: Recall

REF: p. 65

TOP: NBDHE; 1.1.2 Dental anatomy

14. Which of the following factors related to aging may actually pay a larger role in periodontal

health than age alone? a. Cognitive and motor function skills b. Growth of cancer cells c. Hypertension and heart-related issues d. Loss of bone density ANS: A

The biologic effects of aging have either no impact or minimal impact on an individual’s response to periodontal treatment. However, other factors may have a profound impact, including cognitive and motor skills, as well as medical history.

DIF: Comprehension TOP: NBDHE; 1.1.2 Dental anatomy

REF: p. 66

15. The older population tends to present other comorbidities along with periodontitis. Which of

the following are examples of these types of comorbidities that occur with age? a. Rapid gene formation b. Cardiovascular disease c. Growth of brain cells d. Skin cancer ANS: B

Older people, especially those with periodontitis, tend to present with multiple other comorbidities, such as diabetes, dementia, cardiovascular disease, and polypharmacy.

DIF: Comprehension TOP: NBDHE; 1.1.2 Dental anatomy

REF: p. 62

16. What are two key factors that have led to decreasing tooth loss for all age-groups? a. Extensive research and increased patient appointments b. Increased health awareness and improvements in preventive dentistry c. Steady incline in the age of dentists and better dental insurance coverage options d. Fewer cavities and an improved patient-dentist relationship ANS: B

Increased health awareness and improvements in preventive dentistry have led to decreasing tooth loss of all age-groups. The effects of this shift in tooth retention need to be considered carefully.

DIF: Recall

REF: p. 62

TOP: NBDHE; 1.1.2 Dental anatomy

17. What are two key factors that must be considered in relation to possible changes in demand

from older individuals for periodontal treatment? a. Increased life expectancy and greater health expectations b. Increased reliance on dentures and the decline of flossing c. Decreased brain function and improvements in preventive dentistry d. Patient compliance and lower health expectations ANS: A

Increased life expectancy and greater health expectations may lead to changes in demand from older individuals for periodontal treatment and potentially a substantial increase in supportive periodontal therapy.

DIF: Application

REF: p. 62

TOP: NBDHE; 1.1.2 Dental anatomy

18. Which of the following is a change that is seen in the periodontal ligament as age progresses? a. Increased organic matrix production b. Increased epithelial cell rests c. Increased amounts of elastic fiber d. Increased numbers of fibroblasts ANS: C

Changes in the periodontal ligament that have been reported with aging include decreased numbers of fibroblasts and a more irregular structure, thereby paralleling the changes seen in the gingival connective tissues. Other findings include decreased organic matrix production, decreased epithelial cell rests, and increased amounts of elastic fiber.

DIF: Comprehension TOP: NBDHE; 1.1.2 Dental anatomy

REF: p. 63

19. The interplay of cytokines has been extensively researched in periodontal pathogenesis.

Which one of the following interleukins is potent mediators of inflammation? a. IL-4 b. IL-1 c. IL-8 d. IL-10 ANS: B

The interplay of cytokines—and, in particular, the interleukin family—has been extensively researched in periodontal pathogenesis. Some of the interleukins (e.g., IL-1) are potent mediators of inflammation, whereas others have been shown to downregulate the process (e.g., IL-4, IL-10).

DIF: Recall

REF: p. 64

TOP: NBDHE; 1.1.2 Dental anatomy

20. What is the correct term for inflammation of the gums? a. Dental biofilm b. Oral cancer c. Periodontitis d. Gingivitis ANS: D

Gingivitis is the inflammation of the gums. Periodontitis is the inflammation of the tissue around the teeth, often causing shrinkage of the gums and loosening of the teeth.

DIF: Recall

REF: p. 65

TOP: NBDHE; 1.1.2 Dental anatomy

Chapter 06: Classification of Diseases and Conditions Affecting the Periodontium Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. What two 1999 descriptors of rate of progression of periodontitis were grouped together in

2018 under the single category of “periodontitis”? a. Mild and severe b. Young and age-progressed c. Chronic and aggressive d. Gingival and dental ANS: C

Chronic and aggressive periodontitis, which were previously separated into their own diagnostic categories, are now grouped together under the single category of “periodontitis.”

DIF: Comprehension REF: p. 69 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 2. Which of the following 2018 periodontal classifications now encompasses the 1999 diagnostic

category of “Necrotizing Periodontal Diseases”? a. Periodontal health, gingival diseases and conditions b. Periodontitis c. Peri-implant diseases and conditions d. Other conditions affecting the periodontium

TESTBANKSELLER.COM

ANS: B

“Necrotizing Periodontal Diseases” falls under the new 2018 periodontal classification of “Periodontitis.”

DIF: Recall REF: p. 68 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 3. Which of the following 2018 periodontal classifications now encompasses the 1999 diagnostic

category of “Abscesses of the Periodontium”? a. Periodontal health, gingival diseases and conditions b. Periodontitis c. Peri-implant diseases and conditions d. Other conditions affecting the periodontium ANS: D

“Abscesses of the Periodontium” falls under the new 2018 periodontal classification of “other conditions affecting the periodontium.”

DIF: Recall REF: p. 68 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results

4. Staging describes the complexity of each case and incorporates which of the following

elements? a. Severity of disease b. Association of gum recession c. Diagnosis of the problem d. Grading of the periodontitis ANS: A

Staging and grading are not diagnoses. A diagnosis of periodontitis is determined first, with staging and grading providing supplemental information that helps to determine treatment complexity and prognosis. Staging incorporates the severity of the disease, tooth loss due to periodontitis, management complexity of the patient’s periodontal condition, and the overall oral rehabilitation needs.

DIF: Comprehension REF: p. 69 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Which stage of periodontitis requires nonsurgical treatment with the possibility of surgical

treatment? a. Stage I b. Stage II c. Stage III d. Stage IV ANS: B

Stage I requires nonsurgical treatment. Stage II will require nonsurgical treatment and may also require surgical treatment. Stage III will require initial nonsurgical treatment followed TeBnAtsN LEwRil. most probably by surgical T trE eaStm . SKtS agEeLIV l rC eqOuMire initial nonsurgical treatment followed by advanced surgical treatment and/or regenerative therapy, including augmentation treatment to facilitate implant therapy.

DIF: Application REF: p. 69 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Which stage of periodontitis has the potential for tooth loss of five or more teeth? a. Stage I b. Stage II c. Stage III d. Stage IV ANS: D

Stages I and II have no expected posttreatment tooth loss. Stage III has the potential for tooth loss from 0 to 4 teeth. Stage IV has the potential for tooth loss of five or more teeth.

DIF: Application REF: p. 70 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Which of the following is the term that provides the likelihood of posttreatment disease

progression? a. Staging b. Grading c. Diagnosing

d. Treatment planning ANS: B

Grading provides the likelihood of posttreatment disease progression, and it can change along the way because it depends on the state of the patient at the time of examination.

DIF: Comprehension REF: p. 70 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. Which grading designation would be used for a patient who smokes 5 cigarettes a day and has

had a 1 mm rate of periodontitis progression over 5 years? a. Grade A b. Grade B c. Grade C d. Grade D ANS: B

Grade A is used for people who are nonsmokers and who have no periodontitis progression over 5 years. Grade B is used for people who smoke less than 10 cigarettes a day and who have less than 2 mm rate of periodontitis progression over 5 years. Grade C is used for people who smoke 10 or more cigarettes a day and have had 2 mm or more millimeter rate of periodontitis progression over 5 years. Grade D is not part of the grading system.

DIF: Application REF: p. 71 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following periodontal classification is a newly established category not

previously covered in the 1T9E 99ST clB asA siN fiK caStiE onLsLyE stR em .?COM a. Periodontal health, gingival diseases and conditions b. Periodontitis c. Other conditions affecting the periodontium d. Peri-implant diseases and conditions ANS: D

Peri-implant diseases and conditions is a newly established category in the periodontal classification system. This category was introduced in response to the overwhelming evidence that peri-implantitis is a prevalent entity worldwide.

DIF: Recall REF: p. 71 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 10. What is the distinctive difference between a diagnosis of peri-implant mucositis and

peri-implantitis? a. The amount of dental biofilm b. The progression of gum disease c. The presence of bone loss d. The depth of probing needed ANS: C

The distinctive difference between a diagnosis of peri-implant mucositis and peri-implantitis is the presence of bone loss in peri-implantitis.

DIF: Recall REF: p. 72 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Which of the following is part of the peri-implant evaluation? a. Visual inspection b. Diagnosis c. Treatment planning d. Flossing ANS: A

The three parts of the peri-implant evaluation are probing, radiographs, and a visual inspection.

DIF: Recall

REF: p. 72

TOP: NBDHE; 1.3 Periodontal evaluation

12. Which recession type would be used to describe gingival recession where the amount of

interproximal attachment loss is less than or equal to the buccal attachment loss? a. Recession Type 1 b. Recession Type 2 c. Recession Type 3 d. Recession Type 4 ANS: B

Recession Type 1 (RT1) is when gingival recession has no loss of interproximal attachment and the interproximal CEJ is clinically not detectable at both mesial and distal aspects of the tooth. Recession Type 2 (RT2) is when gingival recession is associated with loss of interproximal attachment aTnE dS thT eB am t oEfLinLteErR pr. oxCiO mM al attachment loss is less than or equal AoNuKnS to the buccal attachment los. Recession Type 3 (RT3) is when gingival recession is associated with loss of interproximal attachment and the amount of interproximal attachment loss is higher than the buccal attachment loss.

DIF: Recall REF: p. 73 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Which of the following is a systemic factor that can contribute to gingivitis? a. Diabetes b. Aging c. Weight gain d. Weight loss ANS: A

Systemic factors that contribute to gingivitis include endocrine changes associated with puberty, the menstrual cycle, pregnancy, and diabetes.

DIF: Recall

REF: p. 74

TOP: NBDHE; 1.1 Medical and dental history

14. Which of the following medications can modify gingival diseases (i.e., gingival overgrowth)? a. Calcium channel blockers and anticonvulsants b. Antidepressants and NSAIDs c. Diuretics and alpha blockers d. Beta-blockers and ACE inhibitors

ANS: A

Gingival diseases that are modified by medications include gingival overgrowth due to anticonvulsant drugs such as phenytoin, immunosuppressive drugs such as cyclosporine, and calcium channel blockers such as nifedipine, verapamil, diltiazem, and sodium valproate.

DIF: Comprehension REF: p. 75 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Which of the following types of gingival diseases may be caused by a variety of

deoxyribonucleic acid and ribonucleic acid viruses? a. Gingival diseases of specified bacterial origin b. Gingival diseases of fungal origin c. Gingival diseases of genetic origin d. Gingival disease of viral origin ANS: D

Gingival disease of viral origin may be caused by a variety of deoxyribonucleic acid and ribonucleic acid viruses, with the most common being the herpesvirus.

DIF: Recall REF: p. 76 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Which of the following is the term used for when trauma is induced by the dentist or health

professional? a. Dental trauma b. Iatrogenic trauma c. Spontaneous trauma d. Inflicted trauma ANS: B

Iatrogenic trauma is trauma that is induced by the dentist or health professional.

DIF: Recall REF: p. 78 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. What is the most common form of periodontitis? a. Acute b. Chronic c. Localized d. Aggressive ANS: B

Chronic periodontitis is the most common form of periodontitis. It is most prevalent in adults, but it can also be observed in children.

DIF: Recall REF: p. 82 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. Which of the following is considered the primary etiologic factor for gingivitis? a. Pregnancy b. Aging

c. Microbial plaque d. Medications ANS: C

Microbial plaque is considered the primary etiologic factor for gingivitis.

DIF: Comprehension REF: p. 74 TOP: NBDHE; 1.1 Medical and dental history 19. Which form of periodontitis differs from the chronic form primarily because of the rapid rate

of disease progression seen in an otherwise healthy individual? a. Aggressive b. Passive c. Localized d. Generalized ANS: A

Aggressive periodontitis differs from the chronic form primarily by the rapid rate of disease progression seen in an otherwise healthy individual.

DIF: Recall

REF: p. 83

TOP: NBDHE; 1.3 Periodontal evaluation

20. What is the correct term now used to replace the phrase “bisphosphonate-related osteonecrosis

of the jaw”? a. Gingivitis-related osteonecrosis of the jaw b. Drug-related osteonecrosis of the jaw c. Medication-related osteonecrosis of the jaw d. Osteoporosis-related oT steEoSnT ecB roAsN is KoS f tE heLjLaE wR.COM ANS: C

Medication-related osteonecrosis of the jaw (MRONJ) is an updated term that has replaced the phrase bisphosphonate-related osteonecrosis of the jaw (BRONJ).

DIF: Recall REF: p. 86 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 21. How does necrotizing ulcerative periodontitis (NUP) differ from necrotizing ulcerative

gingivitis (NUG)? a. With NUP, the loss of clinical attachment and alveolar bone is a consistent feature originating from the proximal region. b. With NUG, the loss of clinical attachment and alveolar bone is a consistent feature originating from the proximal region. c. With NUP, the malnutrition may be a contributing factor, whereas that is not an issue with NUG. d. With NUP, patients often have spontaneous bleeding and severe pain, whereas that is not an issue with NUG. ANS: A

NUP differs from NUG in that the loss of clinical attachment and alveolar bone is a consistent feature originating from the proximal region.

DIF: Recall

REF: p. 88

TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 22. Which of the following is the most common viral origin of gingival diseases? a. HIV b. Influenza c. Adenoviruses d. Herpesviruses ANS: D

The most common viral origin of gingival diseases is herpesvirus.

DIF: Recall REF: p. 76 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 23. Which of the following nutrients have been found to have immunomodulatory properties, and

thus perhaps contributing to gingival diseases modified by malnutrition? a. Long-chain omega-3 fatty acids b. Non-essential fatty acids c. Vitamin B12 d. Soluble carbohydrates ANS: A

Various nutrients, such as long-chain omega-3 fatty acids, have been found to have immunomodulatory properties, whereas others act to ameliorate the destructive effects of reactive oxygen species (ROS) functioning as ROS scavengers.

DIF: Comprehension REF: p. 75 TOP: NBDHE; 3.3 IndividuT alE izS edTpBatA ieN ntKeS duEcL atL ioE n R.COM 24. What is the most common oral fungal infection? a. Candidiasis—Candida albicans b. Cryptococcosis—Cryptococcus neoformans c. Histoplasmosis—Histoplasma capsulatum d. Blastomycosis—Blastomyces dermatitidis ANS: A

The most common oral fungal infection is candidiasis. Candida albicans is often indicated.

DIF: Recall REF: p. 78 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 25. Which of the following is a dimension to the new classification system that enables clinicians

to incorporate individual characteristics into the diagnosis and related treatment plans? a. Staging b. Grading c. Diagnosing d. Prioritizing ANS: B

Grading provides the likelihood of posttreatment disease progression. It is the dimension of the new classification system that enables clinicians to incorporate individual characteristics into the diagnosis and related treatment plans.

DIF: Comprehension REF: p. 70 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results

Chapter 07: Fundamentals in the Methods of Periodontal Disease Epidemiology Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. What are the two broad categories that epidemiologic study designs fall within? a. Observational and interventional b. Blind and nonblind c. Randomized and nonrandomized d. Cross-sectional and case-control ANS: A

Epidemiologic study designs fall within two broad categories: observational and interventional. Examples of interventional studies in oral health research are randomized clinical trials and nonrandomized clinical trials. Examples of observational studies are cross-sectional studies, cohort studies, and case-control studies.

DIF: Recall REF: p. 94 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 2. What word is defined by the World Health Organization (WHO) as “the study of the

distribution and determinants of health-related states or events (including disease), and the application of this study to the control of disease and other health problems?” a. Pathology b. Periodontology c. Epidemiology d. Dentistry ANS: C

Epidemiology is defined by the World Health Organization (WHO) as “the study of the distribution and determinants of health-related states or events (including disease), and the application of this study to the control of disease and other health problems.”

DIF: Recall REF: p. 94 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 3. Which of the following is an example of an interventional study? a. Randomized clinical trial b. Case-control study c. Cross-sectional study d. Cohort study ANS: A

Examples of interventional studies in oral health research are randomized clinical trials and nonrandomized clinical trials.

DIF: Recall REF: p. 94 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results

4. Which of the following is considered a form of secondary research that aims to screen the

entire breadth of information on a selected topic, identify relevant research studies, and summarize their findings? a. Expert opinion review b. Systematic review c. Cross-sectional review d. Analytical review ANS: B

A systematic review is considered a form of secondary research that aims to screen the entire breadth of information on a selected topic, identify relevant research studies, and summarized their findings.

DIF: Recall REF: p. 94 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 5. When measuring the occurrence of conditions or diseases, the sum of all examined individuals

or sites that exhibit the condition or disease of interest divided by the sum of the number of individuals or sites examined is known as which of the following? a. Prevalence b. Risk c. Probability d. Odds ANS: A

The prevalence is the sum T ofEaSllTeB xaAmNiK neSdEinLdL ivEidRu. alC sO orMsites that exhibit the condition or disease of interest divided by the sum of the number of individuals or sites examined.

DIF: Recall REF: p. 95 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 6. When measuring the occurrence of conditions or diseases, the risk is without dimension and

ranges between what two numbers? a. 0 and 1 b. 1 and 10 c. 0 and 5 d. 0 and infinity ANS: A

Because the risk is estimated as a proportion, it is without dimension, and it ranges between 0 and 1.

DIF: Comprehension REF: p. 95 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 7. When measuring the occurrence of conditions or diseases, what term is used when discussing

the probability that an event occurred divided by the probability that an event did not occur? a. Prevalence

b. Risk c. Incidence rates d. Odds ANS: D

The odds for an event is the probability that an event occurred divided by the probability that an event did not occur. Odds values can range from 0 to infinity.

DIF: Comprehension REF: p. 95 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 8. Which of the following is expressed as a value between 0 and infinity? a. Incidence b. Odds c. Risk d. Prevalence ANS: B

Odds values can range from 0 to infinity. If the probability for observing an event is small, then the odds and the probability are almost identical.

DIF: Comprehension REF: p. 95 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 9. Incidence rates imply an element of which of the following? a. Time b. Risk c. Probability d. Prevalence ANS: A

Incidence rates imply an element of time. The denominator in the incidence rate has time as the dimension. Thus, the dimension of incidence rate is 1/time.

DIF: Recall REF: p. 95 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 10. Which of the following is defined as the number of diseased patients who are correctly

identified as having disease? a. Specificity b. Branded c. Odds d. Sensitivity ANS: D

Sensitivity is defined as the number of diseased patients who are correctly identified as having disease. Specificity is defined as the number of healthy persons who are correctly determined to not have the disease.

DIF: Recall REF: p. 96 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 11. Which of the following is a common measure of gingival inflammation where only gingival

tissues are assessed? a. Gingival index b. Mean probing depth c. Bleeding on flossing d. Mean recession level ANS: A

The gingival index is a common measure of gingival inflammation where only gingival tissues are assessed.

DIF: Comprehension REF: p. 96 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 12. Which of the following is the term used to describe tangible outcomes that directly measure

how a patient feels, functions, or survives? a. End diagnosis b. True endpoints c. Diagnostic planning d. Valid outcomes ANS: B

True endpoints are tangibleToEuStcToB mA esNtK haSt E diLreLcE tlyR. mC eaOsuMre how a patient feels, functions, or survives. True endpoints include oral health-related quality-of-life measurements and self-reported problems.

DIF: Recall REF: p. 96 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 13. Which of the following is another term for cohort studies? a. Geographical study designs b. Nonrandomized study designs c. Companion study designs d. Exposure-based study designs ANS: D

Cohort studies can also be referred to as exposure-based study designs.

DIF: Recall REF: p. 97 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 14. Which of the following is an example of a true endpoint? a. Tooth loss b. Bleeding upon probing c. Widening of cementum

d. Aging ANS: A

True endpoints are tangible outcomes that directly measure how a patient feels, functions, or survives. Tooth loss is an example of a true endpoint.

DIF: Application REF: p. 97 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 15. What is the term used for the type of endpoints that are intangible to the patient? a. Abstract endpoints b. Surrogate endpoints c. Phantom endpoints d. Nonphysical endpoints ANS: B

Surrogate endpoints are intangible to the patient and include anatomic measures, measures of inflammation, and immunologic measures. They are often objective.

DIF: Recall REF: p. 97 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 16. Case-control studies are typically referred to as what type of study design? a. Exposure-based study design b. Outcome-based study design c. Prognosis-based study design TESTBANKSELLER.COM d. Diagnosis-based study design ANS: B

Case-control studies are typically referred to as outcome-based study designs. Persons with a condition or outcome of interest are compared with persons without a condition of interest with respect to the history of the suspected causal factors.

DIF: Recall REF: p. 98 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 17. Which of the following is defined as “an attribute or a characteristic of a person”? a. Disease b. Condition c. Diagnosis d. Prognosis ANS: A

Disease is defined as an attribute or a characteristic of a person, and diagnosis is the clinician’s belief that the person has the attribute.

DIF: Recall REF: p. 99 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results

18. Which type of study design is considered the least reliable? a. Randomized control study b. Cohort study c. Nonrandomized control study d. Case-control study ANS: D

A case-control study is considered the least reliable of the epidemiologic study design options.

DIF: Comprehension REF: p. 97 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 19. Which of the following terms is used to describe the relationship between cause and effect? a. Relatability b. Causality c. Dependability d. Consequent ANS: B

Causality describes the relationship between cause and effect.

DIF: Comprehension REF: p. 98.e1 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 20. Which of the following terms refers to the set of causes that initiate a chronic disease? a. Necessary cause b. Component cause c. Sufficient cause d. Reliable cause ANS: C

The terms necessary cause, component cause, and sufficient cause help to define the challenges of determining the cause of a disease and of verbalizing the complexity of chronic disease causes. The set of causes that initiate a chronic disease is referred to as a sufficient cause. Different elements of a sufficient cause are referred to as a component clause. A component clause, which is an element of all the sufficient cause for a given disease, is referred to as a necessary clause.

DIF: Recall REF: p. 98.e1 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results

Chapter 08: Periodontal Disease Pathogenesis and Genetics Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following is a unique epithelial structure that has surface cells specialized for the

purpose of the attachment to the tooth? a. Gingival epithelium b. Sulcular epithelium c. Junctional epithelium d. Dentogingival junction ANS: C

The junctional epithelium is a unique epithelial structure because the surface cells are specialized for the purpose of attachment to the tooth.

DIF: Recall REF: p. 103.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Which type of lesion roughly corresponds to what clinicians would refer to as “chronic

gingivitis?” a. The initial lesion b. The early lesion c. The established lesion d. The advanced lesion ANS: D

The advanced lesion roughly corresponds to what clinicians would refer to as “chronic gingivitis.”

DIF: Comprehension REF: p. 103.e2 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. Which of the following epithelial components of the dentogingival unit forms the soft tissue

lining of the gingival sulcus or the periodontal pocket? a. Junctional epithelium b. Dentogingival junction c. Sulcular epithelium d. Gingival epithelium ANS: C

The sulcular epithelium forms the soft tissue lining of the sulcus or the periodontal pocket.

DIF: Recall REF: p. 103 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Which of the following key types of inflammatory mediators in periodontitis binds to cell

surface receptors to trigger production of protein by the cell? a. Cytokines b. Prostaglandins c. Matrix metalloproteinases

d. Chemokines ANS: A

Cytokines are a key inflammatory mediator that bind to cell surface receptors in order to trigger production of protein by the cell.

DIF: Comprehension REF: p. 107 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Which of the following matrix metalloproteinase types relevant to periodontal disease digests

ECM molecules, activates pro-MMPs, increases cell invasion, and disrupts cell aggregation? a. Collageneases b. Gelatinases c. Stromelysins d. Matrilysins ANS: C

Stromelysins digest ECM molecules, activate pro-MMPs, disrupt cell aggregation, and increase cell invasion.

DIF: Comprehension REF: p. 110.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Which stage type of immunity refers to antigen-specific immune responses? a. Innate immunity b. Automatic immunity c. Innovative immunity d. Adaptive immunity ANS: D

Adaptive immunity refers to antigen-specific immune responses.

DIF: Recall REF: p. 113 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Which constituent of saliva inhibits bacterial adherence and promotes agglutination? a. Antibodies b. Histatins c. Cystatins d. Lysozyme ANS: A

Antibodies, as well as mucins, inhibit bacterial adherence and promotes agglutination.

DIF: Recall REF: p. 114 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. Which of the following words can be defined as “the origination and development of a

disease?” a. Genetics b. Pathogenesis c. Causal factor

d. Diagnosis ANS: B

According to Merriam Webster’s Collegiate Dictionary, the word pathogenesis is defined as “the origination and development of a disease.”

DIF: Recall REF: p. 101 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which type of lesion develops after about 1 week of continued plaque accumulation? a. Initial lesion b. Early lesion c. Established lesion d. Advanced lesion ANS: B

The early lesion was said to develop after about 1 week of continued plaque accumulation and corresponds to the early clinical signs of gingivitis.

DIF: Recall REF: p. 103.e2 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which of the following is the term for cytokine-like molecules that are characterized by their

chemotactic activity? a. Chemistry cytokines b. Chemical cytokines c. Chemokines d. Cytochems ANS: C

Chemokines are cytokine-like molecules that are characterized by their chemotactic activity.

DIF: Recall REF: p. 110 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Advanced forms of periodontal disease are characterized by tooth mobility, tooth loss, and

tooth . a. migration b. disintegration c. removal d. sinking ANS: A

Advanced forms of periodontal disease are characterized by the symptoms of tooth mobility, tooth loss, and tooth migration.

DIF: Application REF: p. 111 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. Which of the following is another term for antimicrobial peptides? a. Epithelial cells b. Defensins

c. Neutrophils d. Chemokines ANS: B

Antimicrobial peptides, which are also called defensins, are expressed by epithelial cells.

DIF: Recall REF: p. 111 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Which of the following is the generic term for cytokines produced by leukocytes that are

grouped into families on the basis of functional and structural similarities? a. Interleukin (IL) b. Lipopolysaccharide (LPS) c. Intercellular adhesion molecule-1 (ICAM-1) d. Leukemia-inhibitory factor (LIF) ANS: A

Interleukin (IL) is the generic term for cytokines produced by leukocytes that are grouped into families on the basis of functional and structural similarities.

DIF: Recall REF: p. 115.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Which of the following is a growth factor that functions as a cytokine and has

immunoregulatory roles? a. TGF- b. MMP-7 c. IL-10 d. TNF- ANS: A

TGF- is a growth factor that functions as a cytokine and has immunoregulatory roles, such as the regulation of T-cell subsets and the action of Treg cells, and it also plays a role in repair and regeneration.

DIF: Comprehension REF: p. 111 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Histologic studies have confirmed that the bone resorbs so that a width of noninfiltrated

connective tissue of about a. 0.1 to 1.0 b. 0.5 to 1.5 c. 0.1 to 0.5 d. 0.5 to 1.0

mm overlying the bone is always present.

ANS: D

Histologic studies have confirmed that the bone resorbs so that a width of noninfiltrated connective tissue of about 0.5 to 1.0 mm overlying the bone is always present.

DIF: Recall REF: p. 112 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

16. Which type of cells are the key infiltrating cells in periodontitis that accumulate in large

numbers in inflamed periodontal tissues? a. Neutrophils b. Microphages c. Osteoblasts d. Fibroblasts ANS: A

Neutrophils are the key infiltrating cells in periodontitis that accumulate in large numbers in inflamed periodontal tissues.

DIF: Recall REF: p. 110.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Which of the following is not one of three major salivary glands? a. Parotid b. Submaxillary c. Submandibular d. Sublingual ANS: B

The three major salivary glands that secrete saliva are the parotid, submandibular, and sublingual glands.

DIF: Recall REF: p. 113 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. What kind of fluid originatT esEfSroTmBA thN eK poSsE tcL apLilE laRry.vCeO nuMles of the gingival plexus? a. Gingival activating fluid b. Antimicrobial peptide fluid c. Gingival crevicular fluid d. Epithelial fluid ANS: C

Gingival crevicular fluid (GCF) originates from the postcapillary venules of the gingival plexus.

DIF: Recall REF: p. 114 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. Which of the following are known as the “professional” phagocytes that are critical to the

defense of bacteria that invade host tissues? a. Neutrophils b. Eosinophils c. Pathogens d. Basophils ANS: A

Neutrophils are the “professional” phagocytes that are critical to the clearance of bacteria that invade host tissues.

DIF: Recall

REF: p. 115

TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. Which of the following U.S. populations experience a higher rate of both localized and

generalized forms of early-onset aggressive periodontitis? a. Caucasian b. Asian c. African American d. Hispanic ANS: C

African Americans experience a higher rate of both localized and generalized forms of early-onset aggressive periodontitis.

DIF: Recall REF: p. 121 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 09: Biofilm and Periodontal Microbiology and Molecular Biology Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. When does the colonization of the oral cavity start to close? a. At time of conception b. At time of birth c. At preschool age d. At teenager age ANS: B

The colonization of the oral cavity starts to close at the time of birth.

DIF: Recall

REF: p. 125

TOP: NBDHE; 1.1.2 Dental anatomy

2. Which of the following are the first and most dominant oral microbes to colonize the oral

cavity of newborn infants? a. Veillonella and Streptococcus gordonii b. S. gordonii and Streptococcus anginosus c. Streptococcus salivarius and Streptococcus mitis d. Streptococcus sobrinus and Streptococcus oralis ANS: C

Streptococcus salivarius and S. mitis have been identified as the first and most dominant oral microbes to colonize the oral cavity of newborn infants.

DIF: Comprehension REF: p. 125 TOP: NBDHE; 3.5 Recognition and management of compromised patients 3. Based on physical and morphologic criteria, into how many ecosystems is the oral cavity

divided? a. 2 b. 4 c. 6 d. 8 ANS: C

On the basis of physical and morphologic criteria, the oral cavity can be divided into six major ecosystems.

DIF: Recall REF: p. 129 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Clinical evidence now shows that Streptococcus mutans can be detected in the mouths of

predentate children before what event? a. The eruption of the first tooth b. The first bite of solid food c. The hormone irregularities of adolescence d. The first cavity

ANS: A

Clinical evidence now shows that S. mutans can be detected in the mouths of predentate children before the eruption of the first tooth.

DIF: Recall REF: p. 132 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Which of the following is composed of microbial cells within a matrix of extracellular

polymeric substances? a. Bacteroidetes b. Nucleic acids c. Biomes d. Biofilm ANS: D

Biofilm is composed of microbial cells within a matrix of extracellular polymeric substances, such as polysaccharides, proteins, and nucleic acids.

DIF: Comprehension REF: p. 133 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Which of the following is an inorganic component of plaque? a. Calcium b. Proteins c. DNA d. Lipid material ANS: A

Organic constituents of the matrix include polysaccharides, proteins, glycoproteins, lipid material, and DNA. Inorganic components of plaque are predominantly calcium and phosphorus, with trace amounts of other minerals such as sodium, potassium, and fluoride.

DIF: Comprehension REF: p. 134 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Which of the following terms refers to soft accumulation of bacteria, food matter, and tissue

cells that lack the organized structure of dental plaque and that are easily displaced with a water spray? a. Calculus b. Materia alba c. Supragingival plaque d. Protozoa ANS: B

Materia alba refers to the soft accumulations of bacteria, food matter, and tissue cells that lack the organized structure of dental plaque and that are easily displaced with a water spray.

Calculus is a hard deposit that forms via the mineralization of dental plaque and that is generally covered by a layer of unmineralized plaque.

DIF: Comprehension REF: p. 135 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

8. Which type of plaque is found at or above the gingival margin? a. Subgingival plaque b. Supergingival plaque c. Supragingival plaque d. Soft gingival plaque ANS: C

The two broad classifications of dental plaque are supragingival plaque and subgingival plaque. Supragingival plaque is found at or above the gingival margin; when in direct contact with the gingival margin, it is referred to as marginal plaque.

DIF: Recall REF: p. 135 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. The specific microbial composition and structure of dental biofilms are highly dependent on

which of the following parameters? a. The amount of sugar eaten and how many cavities exist b. The region of the tooth and the local environmental parameters c. The mouth temperature and the BMI of the patient d. The flossing habits of the patient and the type of toothpaste used ANS: B

The specific microbial composition and structure of dental biofilms are highly dependent on the region of the tooth and the local environmental parameters.

DIF: Recall REF: p. 136 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which of the following is not one of the phases of plaque formation? a. The formation of the pellicle on the tooth surface b. The initial adhesion/attachment of bacteria c. The spread of pathogens between teeth d. The colonization/plaque maturation ANS: C

The process of plaque formation can be divided into several phases: (1) the formation of the pellicle on the tooth surface, (2) the initial adhesion/attachment of bacteria, and (3) colonization/plaque maturation.

DIF: Comprehension REF: p. 138 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Colonizing bacteria can be detected within how many minutes after the introduction of sterile

enamel into the mouth? a. 1 b. 2 c. 3 d. 5 ANS: C

Colonizing bacteria can be detected within 3 minutes after the introduction of sterile enamel into the mouth.

DIF: Recall REF: p. 138 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. During which phase of colonization of teeth by bacteria does the initial reversible adhesion

occur? a. Phase 1 b. Phase 2 c. Phase 3 d. Phase 4 ANS: B

The initial steps in colonization of teeth by bacteria occur in three phases. Phase 1 is transport to the surface, phase 2 is initial reversible adhesion, and phase 3 is strong attachment.

DIF: Recall REF: p. 138 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. The bacteria within biofilms are often up to how many times more resistant to antimicrobial

agents than their planktonic counterparts? a. 10 b. 100 c. 1000 d. 10,000 ANS: C

The bacteria within biofilms are often up to 1000 times more resistant to antimicrobial agents than their planktonic countT erEpS arT tsB . ANKSELLER.COM DIF: Recall REF: p. 146 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Which of the following is the most prevalent species of Candida in the oral cavity? a. Candida albicans b. Candida glabrata c. Candida tropicalis d. Candida parapsilosis ANS: A

Many fungal species have been isolated from the oral cavity. Most isolates are Candida, and the most prevalent species is C. albicans.

DIF: Recall REF: p. 148 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Which of the following are single-celled organisms that are as distinct from bacteria as they

are from eukaryotes, and their role in oral diseases is only just beginning to be explored? a. Biomes b. Archaea c. Protozoa d. Fungi

ANS: B

Archaea are single-celled organisms that are as distinct from bacteria as they are from eukaryotes. The role of archaea in oral diseases is only just beginning to be explored.

DIF: Recall REF: p. 149 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Which hypothesis indicates that certain low-abundance microbial pathogens can orchestrate

inflammatory disease by remodeling a normally benign microbiota into a dysbiotic one? a. The ecologic plaque hypothesis b. The microbiota action hypothesis c. The keystone pathogen hypothesis d. The inflammatory disease remodel hypothesis ANS: C

The keystone pathogen hypothesis indicates that certain low-abundance microbial pathogens can orchestrate inflammatory disease by remodeling a normally benign microbiota into a dysbiotic one.

DIF: Recall REF: p. 150 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Which of the following seems especially important for patients with the so-called early-onset

periodontitis? a. Environmental factors b. Genetic factors c. Behavioral factors d. Miscellaneous factors ANS: B

The susceptibility of the host is determined by genetic factors, as well as by environmental and behavioral factors. Genetic factors seem important for patients with the so-called early-onset periodontitis, which is now referred to as aggressive periodontitis.

DIF: Comprehension REF: p. 153 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. Which of the following is considered a behavioral factor and eventually an environmental

factor? a. Family history b. Exercise regime c. Smoking d. Viral infections ANS: C

Smoking is considered a behavioral factor and eventually an environmental factor. It dramatically increases host susceptibility to periodontal breakdown.

DIF: Comprehension REF: p. 153 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. Which form of periodontitis is also known as early-onset periodontitis?

a. b. c. d.

Aggressive periodontitis Necrotizing periodontal disease Localized periodontitis Nonaggressive periodontitis

ANS: A

Aggressive periodontitis, which is also known as generalized aggressive periodontitis, early-onset periodontitis, and rapidly progressive periodontitis, is a severe form of periodontitis that occurs at a relatively young age.

DIF: Recall REF: p. 159.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. Virulence factors of periodontal microorganisms can be subdivided into three categories.

Which of the following is not one of those three categories? a. Factors that promote colonization. b. Toxins and enzymes that degrade host tissues. c. Mechanisms that protect pathogenic bacteria from the host. d. Factors that serve to protect the tooth surface.

ANS: D

Virulence factors of periodontal microorganisms can be subdivided as follows: (1) factors that promote colonization (adhesions), (2) toxins and enzymes that degrade host tissues, and (3) mechanisms that protect pathogenic bacteria from the host.

DIF: Comprehension REF: p. 160 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 21. What does the acronym MAMP stand for? a. Microbe-associated molecular patterns b. Microbial and molecular patterns c. Molecular-associated microbe patterns d. Molecule and microbial patterns ANS: A

MAMP, which are evolutionary-conserved molecular motifs present in microorganisms, stands for “microbe-associated molecular patterns.

DIF: Recall REF: p. 161.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 22. What does the acronym PRR stand for? a. Periodontology rapid release b. Pattern-recognition receptor c. Periodontitis receptor response d. Periodontal rampant recognition ANS: B

PRR stands for “pattern-recognition receptor,” and it is effectively modulated to regulate the oral commensal microbiota (tolerance) and protect against periopathogenic bacteria (vigilance), thus supporting periodontal tissues homeostasis.

DIF: Recall REF: p. 161.e2 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 23. The TLR (toll-like receptors) consist of how many known functional TLRs in humans? a. 5 b. 10 c. 15 d. 20 ANS: B

The TLR family currently consists of 10 known functional TLRs in humans, of which TLR-10 is the only member having an unclear biologic role.

DIF: Recall REF: p. 161.e2 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 24. Currently, how many family members comprise the intracellularly expressed NLRs

(nucleotide-binding oligomerization domain-like receptors) in humans? a. 22 b. 28 c. 37 d. 49 ANS: A

Currently, 22 family members comprise the intracellularly expressed NLRs in humans. NLRs are localized to the cytosol, and they play a critical role in sensing invading microorganisms and prompting the immune response.

DIF: Recall REF: p. 161.e5 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 25. Which of the following is not one of the major ecosystems that the oral cavity is divided into

based on physical and morphologic criteria? a. The dorsum of the tongue b. The saliva c. The lips d. The intraoral and supragingival hard surfaces ANS: C

On the basis of physical and morphologic criteria, the oral cavity can be divided into six major ecosystems: (1) the intraoral and supragingival hard surfaces (teeth, implants, restorations, and prostheses), (2) subgingival regions adjacent to a hard surface, (3) the buccal palatal epithelium and the epithelium of the floor of the mouth, (4) the dorsum of the tongue, (5) the tonsils, and (6) the saliva.

DIF: Comprehension REF: p. 129 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 10: Resolution of Inflammation Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. The first description of a localized response to injury and infection that resembled signs of

inflammation was recorded by what two ancient cultures? a. English and Scottish b. Egyptian and Greek c. French and Swedish d. Italian and Spanish ANS: B

The first description of a localized response to injury and infection that resembled signs of inflammation was recorded by the ancient Egyptian and Greek cultures.

DIF: Recall

REF: p. 162

TOP: NBDHE; 5.1 General Pathology

2. Inflammation is characterized by which of the following? a. Decreased blood flow, vascular dilation, and increased vascular permeability b. Decreased blood flow, vascular dilation, and decreased vascular permeability c. Increased blood flow, vascular dilation, and increased vascular permeability d. Increased blood flow, vascular reduction, and increased vascular permeability ANS: C

Inflammation is characterized by increased blood flow, vascular dilation, increased vascular BeAnN permeability, and cellular rTeE crS uiT tm t. KSELLER.COM DIF: Recall

REF: p. 162

TOP: NBDHE; 5.1 General Pathology

3. The type and degree of an inflammatory response are dependent on the nature of the trigger as

well as what other factor? a. The color of the infected area b. Temperature c. Its duration d. The age of the patient ANS: C

The type and degree of an inflammatory response are dependent on the nature of the trigger (e.g., bacterial, viral, parasitic, or chemical) and its duration.

DIF: Recall REF: p. 162 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Which of the following is a tissue response of pro-resolution? a. Vasoconstriction b. Vasodilation c. Pain d. Swelling ANS: A

Vasoconstriction is a tissue response of pro-resolution, as are nonfever, analgesic, and return to homeostasis.

DIF: Comprehension REF: p. 163 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Which of the following is a cellular function of pro-inflammation? a. Decrease chemotaxis b. Efferocytosis c. Phagocytosis d. Apoptosis ANS: D

Apoptosis is a cellular function of pro-inflammation, as are chemotaxis, diapedesis, NF-B activation, and cytokine production.

DIF: Comprehension REF: p. 163 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Which of the following is a tissue response of pro-inflammation? a. Vasodilation b. Analgesic c. Vasoconstriction d. Nonfever ANS: A

Vasodilation is a tissue response of pro-inflammation, as are swelling, heat, and pain.

DIF: Comprehension REF: p. 163 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Pro-resolution signals are activated mostly by resolvins, lipoxins, maresins, and a. prostaglandins b. protectins c. lipid mediators d. SPMs

.

ANS: B

Pro-resolution signals are activated mostly by resolvins, lipoxins, maresins, and protectins.

DIF: Recall REF: p. 164 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. Which of the following is endogenous lipid mediators induced during the resolution phase of

inflammation? a. Lipoxins b. ALX receptors c. Resolvins d. COX-2 ANS: C

Resolvins are endogenous lipid mediators induced during the resolution phase of inflammation.

DIF: Recall REF: p. 165 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following is the term used to describe the active process that occurs when

inflammation terminates? a. Finale b. Resolution c. Endpoint d. Exit ANS: B

For many years, our understanding of inflammation was that initiation was an active process, whereas termination (a.k.a. resolution) was thought to be passive process. However, Drs. Charles Serhan and Thomas Van Dyke showed that resolution is an active process and can only be initiated when enzymes produce bioactive pro-resolution lipids.

DIF: Comprehension REF: p. 163 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. When speaking about inflammation, what does the acronym SPM stand for? a. Sequence of palate-resolving mediators b. Solid plaque-resolving mediators c. Specialized pro-resolving mediators d. Sporadic periodontal mediators ANS: C

When speaking about inflammation, the acronym SPM stands for “specialized pro-resolving mediators.”

DIF: Recall REF: p. 163 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. What are the two primary groups of the resolving family? a. A-series and B-series b. C-series and D-series c. D-series and E-series d. E-series and F-series ANS: C

The two primary groups of the resolving family have distinct chemical structures: E-series, obtained from EPA, and D-series, derived from DHA. DIF: Recall REF: p. 165 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. In the case of gingivitis, acute inflammation is a. widespread; irreversible b. self-limited; reversible c. widespread; reversible

and

.

d. self-limited; irreversible ANS: B

In the case of gingivitis, acute inflammation is self-limited and reversible. When the etiologic factor and modifiers are “removed,” the host returns to health.

DIF: Comprehension REF: p. 165 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. What type of inflammation in periodontitis has a failure of signals that activate resolution and

return to homeostasis? a. Initial b. Acute c. Chronic d. Self-acting ANS: C

Chronic inflammation in periodontitis has a failure of signals that activate resolution and return to homeostasis.

DIF: Recall REF: p. 166 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. In type 2 diabetes, which of the following is a therapeutic action of the lipid mediator

Resolvin E1? a. Increases monocyte recruitment. b. Increases cell counts. c. Decreases severe colitiT s.ESTBANKSELLER.COM d. Decreases inflammation in adipocytes.

ANS: B

In type 2 diabetes, Resolvin E1 increases cell counts, increases chemotaxis, and rescues phagocytosis.

DIF: Comprehension REF: p. 166 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. In periodontitis, which of the following is a therapeutic action of Lipoxin A4/ATL? a. Ceases infiltration of neutrophils. b. Decreases severe colitis. c. Lowers number of osteoclasts. d. Increases cell counts.

ANS: A

In periodontitis, Lipoxin A4/ATL rescues attachment loss, enhances tissue healing, promotes periodontal regeneration, and ceases infiltration of neutrophils.

DIF: Comprehension REF: p. 166 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. In colitis, which of the following is a therapeutic action of Resolvin E1? a. Protects against neovascularization.

b. Increases monocyte recruitment. c. Reduces weight loss. d. Reduces colonic PMN infiltration.

ANS: C

In colitis, Resolvin E1 improves animal survival rate, reduces weight loss, activates LPS detoxification, and inhibits neutrophil recruitment.

DIF: Comprehension REF: p. 167 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. The fate of inflammation is influenced by what four key components in order to resolve the

acute process and reestablish homeostasis? a. Biomes, muscles, gums, and teeth b. Cells, mediators, tissues, and scaffolds c. Age, gender, temperature, and environment d. Plaque, vasculature, genetics, and culture ANS: B

The fate of inflammation is influenced by endogenous mediators, cells, tissue, and scaffolds to resolve the acute process and reestablish homeostasis, thereby promoting tissue healing and regeneration.

DIF: Recall REF: p. 167 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. Which of the following is part of the cellular arm of the first line of defense in the innate

immune system? a. Pro-inflammatory mediators b. Interleukins c. Polymorphonuclear leukocytes d. Interleukins ANS: C

Polymorphonuclear leukocytes (PMLs) are also neutrophils, and they constitute the cellular arm of the first line of defense of the innate immune system.

DIF: Recall REF: p. 162 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. What happens if acute inflammation goes unresolved? a. Chronic inflammation and disease will establish. b. The inflammation will automatically diminish and return to its normal state. c. The site will become infected and antibiotics will be necessary. d. A dentist will need to perform a deep cleaning of the site.

ANS: A

If acute inflammation is unresolved, chronic inflammation and disease will establish.

DIF: Comprehension REF: p. 163 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

20. Which of the following is a mediator for pro-resolution? a. Leukotrienes b. IL-6 c. Histamine d. Maresins ANS: D

Mediators of pro-resolution include TGF-, IL-1r, IL-10, CWCR4, lipoxins, protectins, and maresins.

DIF: Recall REF: p. 163 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 11: Smoking and Periodontal Disease Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. How many million people does tobacco kill each year? a. 2 b. 4 c. 6 d. 8 ANS: C

Tobacco kills 6 million people each year.

DIF: Recall REF: p. 168 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. In 2012, the overall daily smoking prevalence rates for the United States were what

percentage for men and what percentage for women? a. 17.2% (males); 14.3% (females) b. 23.1% (males); 11.9% (females) c. 13% (males); 18.2% (females) d. 16.8% (males); 19.2% (females) ANS: A

The overall daily smoking prevalence rates for the United States were 15.5% in 2012 (17.2% for males; 14.3% for femalTeE s)S . TBANKSELLER.COM DIF: Recall REF: p. 168 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. Which of the following diseases is not associated with smoking? a. Emphysema b. Breast cancer c. Kidney cancer d. Stroke ANS: B

Diseases associated with smoking include lung cancer, heart disease, stroke, emphysema, bronchitis, and cancers of the oral cavity, bladder, kidney, stomach, liver, and cervix.

DIF: Recall REF: p. 168 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Approximately half of long-term smokers will die early as a result of smoking, and those who

die before the age of 70 will lose an average of how many years of life? a. 5 b. 10 c. 15 d. 20

ANS: D

Approximately half of long-term smokers will die early as a result of smoking, and those who die before the age of 70 years will lose an average of 20 years of life.

DIF: Recall REF: p. 168 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Which of the following is part of the gaseous phase of tobacco smoke? a. Carbon monoxide b. Nicotine c. Benzene d. Benzoapyrene ANS: A

The gas phase of tobacco smoke contains carbon monoxide, ammonia, formaldehyde, hydrogen cyanide, and many other toxic and irritant compounds. The particulate phase includes nicotine, “tar,” benzene, and benzoapyrene.

DIF: Comprehension REF: p. 168 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Which of the following is not a direct result of nicotine consumption? a. Increased heart rate b. Decreased respiratory rate c. Peripheral vasoconstriction d. Rise in blood pressure ANS: B

Nicotine is highly addictive. It causes a rise in blood pressure, increased heart and respiratory rates, and peripheral vasoconstriction.

DIF: Comprehension REF: p. 168 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Which of the following is the term used for a special type of smokeless tobacco that is popular

in Sweden and becoming increasingly popular in the United States? a. Snus b. Sniff c. Snill d. Snare ANS: A

Snus (or Swedish snuff) is a special type of smokeless tobacco that is popular in Sweden and increasingly popular in the United States. It is banned across the rest of Europe. The manufacturers claim to use a special process to lower the levels of carcinogens in the product.

DIF: Recall REF: p. 169 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. A smoker who has smoked 20 cigarettes per day for 20 years has how many pack-years of

smoking? a. 5

b. 10 c. 20 d. 40 ANS: C

Pack-years = Number of packs smoked per day  the number of years of smoking. So, a smoker who has smoked 20 cigarettes per day for 20 years has 20 pack-years of smoking.

DIF: Application REF: p. 169 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following is considered a nonsmoker? a. People who smoke at least 100 cigarettes in their lifetime but are trying to cut

back. b. People who have smoked at least 100 cigarettes in their lifetime but do not currently smoke. c. People who have smoked less than 100 cigarettes in their life but have just recently started smoking. d. People who have smoked less than 100 cigarettes in their life and do not currently smoke.

ANS: D

Nonsmokers are those who have not smoked over 100 cigarettes in their lifetime and do not currently smoke.

DIF: Application REF: p. 169 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Periodontitis is defined as one or more sites with clinical attachment loss of _

greater and a pocket depth of a. 4; 4 b. 4; 2 c. 2; 2 d. 2; 4

mm or

mm or greater.

ANS: A

Periodontitis is defined as one or more sites with clinical attachment loss of 4 mm or greater and a pocket depth of 4 mm or greater.

DIF: Recall REF: p. 170 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Which of the following is an effect of smoking on periodontitis? a. Decreased gingival inflammation and bleeding on probing b. Decreased rate of tooth loss c. Increased prevalence of severity of periodontal destruction d. Increased prevalence of periodontitis with decreased number of cigarettes smoked

per day ANS: C

Decreased gingival inflammation and bleeding on probing is related to gingivitis, not periodontitis. In relation to periodontitis, smoking increases the prevalence and severity of periodontal destruction, the rate of periodontal destruction, tooth loss, pocket depth, attachment loss, and bone loss. The prevalence and severity of periodontitis increases with the number of cigarettes smoked in a day.

DIF: Comprehension REF: p. 170 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. The odds ratio for periodontitis in current smokers has been estimated to range from as low as

to as high as periodontitis. a. 1.5 to 7.3 b. 0.5 to 3.4 c. 5.5 to 10.3 d. 7.3 to 15.2

compared to nonsmokers, depending on the observed severity of

ANS: A

The odds ratio for periodontitis in current smokers has been estimated to range from as low as 1.5 to as high as 7.3 compared to nonsmokers, depending on the observed severity of periodontitis.

DIF: Recall REF: p. 170 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Longitudinal studies have demonstrated that young individuals who smoke more than how

many cigarettes per day show the highest risk for tooth loss? a. 10 b. 15 c. 20 d. 25 ANS: B

Longitudinal studies have demonstrated that young individuals who smoke more than 15 cigarettes per day showed the highest risk for tooth loss.

DIF: Recall REF: p. 170 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Which of the following can be a barrier against smoking cessation? a. No reimbursement from health care system b. Self-belief c. Task delegation d. Positive attitude ANS: A

A lack of reimbursement from the health care system can be considered a barrier against smoking cessation. The other options listed are actually all considered stimuli for smoking cessation. Refer to Table 11.2 in the textbook.

DIF: Comprehension REF: p. 171 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

15. Which of the following is not one of the 5 A’s, a brief intervention program sometimes used

for smoking cessation? a. Advocate b. Advise c. Assist d. Arrange ANS: A

The 5 A’s are Ask, Advise, Assess, Assist, and Arrange.

DIF: Recall REF: p. 171 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Which of the following is the least effective method of smoking cessation? a. Self-help materials b. Brief intervention program c. Willpower d. Nicotine replacement therapy ANS: C

The least effective method of smoking cessation, with only 3% of smokers managing to quit after 12 months, is willpower alone.

DIF: Recall REF: p. 172 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. What are the three main coTmEpS onTeB ntAs N ofKeS-lEiqLuL idEiR n. elC ecOtrMonic cigarettes? a. Nicotine, tar, and flavorings b. Diluents, nicotine, and flavorings c. Water, nicotine, and diluents d. Diluents, flavorings, and tar ANS: B

The e-liquid usually comprises three main components: diluent, nicotine, and flavorings.

DIF: Recall REF: p. 173 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. Which of the following is an effect of smoking in relation to maintenance oral health care? a. Decreased risk of implant failure in smokers b. Decreased risk of disease recurrence in smokers c. Increases the need of retreatment in smokers d. Increased gain in clinical attachment level in smokers ANS: C

In relation to maintenance care of periodontal therapy and oral health, there is an increase in need for retreatment in smokers. Refer to Table 11.4 in the textbook.

DIF: Comprehension REF: p. 175 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

19. Which of the following methods of smoking cessation involves a dental team member giving

advice to a smoking patient? a. Brief intervention program b. Nicotine replacement therapy c. Interview therapy d. Guided study therapy ANS: A

A brief advice intervention delivered by a physician or dentist can increase the rate of quitting (12 months) by 40% to 90%.

DIF: Comprehension REF: p. 172 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. Which of the following can be administered to smokers because it aims to reduce nicotine

withdrawal symptoms and the pleasure people usually experience when they smoke? a. Oxycodone b. Diluents c. Bupropion d. Varenicline ANS: D

A course of varenicline, at standard dose, can increase the rate of quitting (12 months) by 100% to 150%. Varenicline is a nicotine receptor partial agonist, and it aims to reduce both withdrawal symptoms and the pleasure people usually experience when they smoke.

DIF: Recall REF: p. 172 TOP: NBDHE; 3.3.2 ProvisT ioE nS ofTinBsA truNcK tioSnEfoLrLpE reR ve. ntC ioO nM and management of oral diseases

Chapter 12: The Role of Dental Calculus and Other Local Predisposing Factors Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. What is the primary cause of gingiva inflammation? a. Age b. Tooth loss c. Bacterial plaque biofilm d. Tobacco use ANS: C

The primary cause of gingival inflammation is bacterial plaque biofilm.

DIF: Recall REF: p. 177 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. What is the primary source of mineralization for supragingival calculus? a. Saliva b. Tobacco use c. Bacterial plaque biofilm d. Protein ANS: A

The primary source of mineralization for supragingival calculus is saliva. . 1S7T 7 BANKSELLER.COM DIF: Recall REF: TpE TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. What color is supragingival calculus? a. Red or reddish pink b. White or whitish yellow c. Grey or greyish white d. Black or blackish gray ANS: B

Supragingival calculus is usually white or whitish yellow in color.

DIF: Recall REF: p. 177 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Where is subgingival calculus located? a. Coronal to the gingival margin b. Below the crest of the marginal gingiva c. Between teeth d. On the surfaces of natural teeth and dental prostheses ANS: B

Subgingival calculus is located below the crest of the marginal gingiva and is not visible on routine clinical examination.

DIF: Comprehension REF: p. 177 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. What percentage of dental calculus is primarily composed of inorganic components? a. 10% to 30% b. 20% to 40% c. 50% to 70% d. 70% to 90% ANS: D

Dental calculus is primarily composed of inorganic components (70% to 90%) and the organic components constitute the rest.

DIF: Recall REF: p. 178 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Which of the following is the term used to describe an accumulation of microorganisms,

desquamated epithelial cells, leukocytes, and a mixture of salivary proteins and lipids, with few or no food particles? a. Calculus b. Materia alba c. Bacterial plaque biofilm d. Saliva ANS: B

Materia alba is an accumulation of microorganisms, desquamated epithelial cells, leukocytes, and a mixture of salivary proteins and lipids, with few or no food particles; it lacks the regular internal pattern observed inTpElS aqTuB e.ANKSELLER.COM DIF: Comprehension REF: p. 182 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. What is the term used to describe pigmented deposits on the tooth surface? a. Dental stains b. Bacterial plaque biofilm c. Calculus d. Teeth marks ANS: A

Pigmented deposits on the tooth surface are called dental stains. Stains are generally an esthetic problem and do not cause inflammation of the gingiva.

DIF: Recall REF: p. 183 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. Which of the following is the term used to describe a reversible inflammatory change of soft

tissues around implants without bone loss? a. Periodontitis b. Peri-implantitis c. Peri-implant mucositis d. Gingivitis

ANS: C

Peri-implantitis is an inflammatory disease of the tissues around dental implants resulting in progressive bone loss, whereas peri-implant mucositis is a reversible inflammatory change of the soft tissues around implants without bone loss.

DIF: Application REF: p. 184 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following is a direct correlation to how a deep a subgingival crown margin is

located? a. The deeper a subgingival crown margin is located, the lower the likelihood of poorer marginal integrity with accompanying gingival inflammation. b. The shallower a subgingival crown margin is located, the higher the likelihood of poorer marginal integrity with accompanying gingival inflammation. c. The shallower a subgingival crown margin is located, the lower the likelihood of greater marginal integrity with accompanying gingival inflammation. d. The deeper a subgingival crown margin is located, the higher the likelihood of poorer marginal integrity with accompanying gingival inflammation.

ANS: D

The deeper a subgingival crown is located, the higher the likelihood of poorer marginal integrity with accompanying gingival inflammation.

DIF: Application REF: p. 186 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. In general, restorative materials are not in themselves injurious to the periodontal tissues. One

exception to this may be: a. self-curing acrylics. b. crowns. c. dentures. d. braces.

ANS: A

In general, restorative materials are not in themselves injurious to the periodontal tissues. One exception to this may be self-curing acrylics.

DIF: Recall REF: p. 187 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Excessive orthodontic forces and too-rapid tooth movement during orthodontic treatment

increase the risk of which of the following? a. Buildup of dental plaque biofilm b. Root caries c. Apical root resorption d. Peri-implantitis ANS: C

It is important to avoid excessive force and too-rapid tooth movement during orthodontic treatment because they increase the risk of apical root resorption.

DIF: Application

REF: p. 189

TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. The improper use of dental floss may result in what? a. Lacerations of the interdental papilla b. Chronic toothbrush trauma c. Attachment loss d. Acute gingival abscess ANS: A

The improper use of dental floss may result in lacerations of the interdental papilla.

DIF: Comprehension REF: p. 193 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. A typical dose of radiation for head and neck tumors is in the range of how many centigray

(cGy)? a. 200 to 800 cGy b. 1000 to 4000 cGy c. 5000 to 8000 cGy d. 10,000 to 15,000 cGy ANS: C

Radiation therapy has cytotoxic effects on both normal cells and malignant cells. A typical total dose of radiation for head and neck tumors is in the range of 5000 to 8000 cGy. DIF: Recall REF: p. 194 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. What is the term for how a total dose of radiation is divided into partial incremental doses? a. Fractionation b. Radiation division c. Treatment decision making d. Incremental division ANS: A

The total dose of radiation is usually given in partial incremental doses, and this is referred to as fractionation.

DIF: Recall REF: p. 194 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. What are the two most common locations for the development of supragingival calculus? a. Buccal surfaces of the maxillary molars and the lingual surfaces of the mandibular

anterior teeth b. Lingual surfaces of the mandibular molars and the buccal surfaces of the maxillary molars c. Buccal surfaces of the mandibular molars and the lingual surfaces of the maxillary molars d. Lingual surfaces of the maxillary molars and the buccal surfaces of the mandibular anterior teeth ANS: A

The two most common locations for the development of supragingival calculus are the buccal surfaces of the maxillary molars.

DIF: Recall REF: p. 177 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Which of the following is an accurate description of subgingival calculus? a. Soft and brittle b. Soft and smooth c. Hard and dense d. Hard and porous ANS: C

Subgingival calculus is typically hard and dense.

DIF: Recall REF: p. 177 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Which of the following terms can be defined as “mineralized dental plaque”? a. Biofilm b. Calculus c. Cavity d. Saliva ANS: B

Calculus is mineralized dental plaque. . 1S8T 0 BANKSELLER.COM DIF: Recall REF: TpE TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. Which of the following is the term used for the decline from maximal calculus accumulation? a. Production decline b. Reverse calculus c. Reversal phenomenon d. Maximal decline ANS: C

The decline from maximal calculus accumulation, which is referred to as the reversal phenomenon, may be explained by the vulnerability of bulky calculus to mechanical wear from food and from the cheeks, lips, and tongue movement.

DIF: Comprehension REF: p. 181 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. Which of the following is an example of an iatrogenic factor? a. Inadequate dental procedures b. Lack of dental hygiene c. Age d. Cultural predisposition ANS: A

Inadequate dental procedures that contribute to the deterioration of the periodontal tissues are referred to as iatrogenic factors.

DIF: Application REF: p. 183 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. The use of smokeless tobacco has been associated with localized gingival leukoplakia,

recession, clinical attachment loss, and what else? a. Tears in the gums b. Decreased need for routine dental health visits c. Bleeding upon probing d. Increased susceptibility to severe periodontitis ANS: D

Use of smokeless tobacco has been associated with localized gingival leukoplakia, recession, clinical attachment loss, and increased susceptibility to severe periodontitis.

DIF: Comprehension REF: p. 195 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 13: Influence of Systemic Conditions Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following is a complex metabolic disorder characterized by chronic

hyperglycemia? a. Periodontitis b. Lyme disease c. Diabetes d. Pregnancy ANS: C

Diabetes mellitus is an extremely important disease to study from a periodontal standpoint. It is a complex metabolic disorder characterized by hyperglycemia.

DIF: Recall REF: p. 198 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Which of the following was formerly known as insulin-dependent diabetes mellitus? a. Type 1 diabetes b. Type A diabetes c. Type 2 diabetes d. Type B diabetes ANS: A

There are two major types T oE f dSiaTbBetAesN: K tySpE eL 1L anEdRty.pCeO2M . Type 1 diabetes mellitus was formerly known as insulin-dependent diabetes mellitus.

DIF: Recall REF: p. 198 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. What is perhaps the most striking periodontal change in patients with uncontrolled diabetes? a. Reductions in tooth loss and increased gum inflammation b. Reductions in defense mechanisms and increased susceptibility to infections c. Increase in salivary flow and reduction in plaque formation d. Increase in gingival polyps and reduction in rate of dental caries ANS: B

Numerous oral changes have been described in patients with diabetes, including cheilosis, mucosal drying and cracking, burning mouth and tongue, diminished salivary flow, and alterations in the flora of the oral cavity. But perhaps the most striking changes in patients with uncontrolled diabetes are the reductions in defense mechanisms and the increased susceptibility to infections, which lead to destructive periodontal disease.

DIF: Comprehension REF: p. 198 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. The glucose content of gingival fluid and blood is

in individuals with diabetes than in those without diabetes with similar plaque and gingival index scores. a. lower

b. higher c. darker in color d. lighter in color ANS: B

The glucose content of gingival fluid and blood is higher in individuals with diabetes than in those without diabetes with similar plaque and gingival index scores.

DIF: Comprehension REF: p. 200 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Chronic hyperglycemia causes proteins and matrix molecules to undergo a nonenzymatic

glycosylation, thereby resulting in . a. accumulated glycolysis complications b. decreased efficiency of immune response c. accumulated glycation end-products (AGE) d. increased polymorphonuclear (PMN) leukocyte function ANS: C

Chronic hyperglycemia impairs collagen structure and function. It causes proteins and matrix molecules to undergo a nonenzymatic glycosylation, thereby resulting in accumulated glycation end-products (AGEs). AGEs and RAGEs play a central role in the classic complications of diabetes, and they most likely play a significant role in the progression of periodontal disease as well.

DIF: Comprehension REF: p. 202 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Oral changes during menopause may include which of the following? a. Thickening of the oral mucosa, gingival recession, and xerostomia b. Thinning of the oral mucosa, gingival recession, and xerostomia c. Thinning of the oral mucosa, burning mouth, and excessive saliva d. Thickening of the oral mucosa, burning mouth, and altered taste ANS: B

Oral changes during menopause may include thinning of the oral mucosa, gingival recession, xerostomia, altered taste, and burning mouth.

DIF: Comprehension REF: p. 202 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Which of the following is responsible for gas exchange and nutrient supply to the periodontal

tissues and platelets? a. Red blood cells (RBCs) b. Leukocytes c. White blood cells (WBCs) d. Thrombocytes ANS: A

Red blood cells (RBCs) are responsible for gas exchange and nutrient supply to the periodontal tissues and platelets, and they are necessary for normal homeostasis as well as for the recruitment of cells during inflammation and wound healing.

DIF: Recall REF: p. 202 TOP: NBDHE; 2.0 Scientific Basis for Dental Hygiene Practice: Physiology 8. Which of the following oral changes may suggest the existence of a blood dyscrasia? a. Bleeding upon probing b. Peri-implantitis c. Increase in bacterial plaque biofilm d. Gingivitis ANS: C

Certain oral changes (e.g., hemorrhage) may suggest the existence of a blood dyscrasia.

However, a specific diagnosis requires a complete physical examination and a thorough hematologic study.

DIF: Application REF: p. 202 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. During menstrual period, the prevalence of gingivitis a. is unchanged b. is preexisting c. decreases d. increases

.

ANS: D

During the menstrual period, the prevalence of gingivitis increases. Some patients may complain of bleeding gums or a bloated, tense feeling in the gums during the day preceding menstrual flow.

DIF: Comprehension REF: p. 202 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which of the following statements is true when discussing the correlation of pregnancy to

gingivitis? a. The hormonal changes of pregnancy accentuate the gingival response. b. Pregnancy makes women less susceptible to gingivitis because of altered immune responses. c. The hormonal changes of pregnancy cause more bacterial plaque to form. d. Pregnancy itself can cause gingivitis.

ANS: A

Pregnancy itself does not cause gingivitis. The hormonal changes of pregnancy accentuate the gingival response to plaque and modify the resultant clinical picture, but no notable changes occur in the gingiva during pregnancy in the absence of local factors.

DIF: Comprehension REF: p. 202 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. A patient comes into the office with ecchymosis. Which of the following should occur? a. The patient should be given a prescription for the bleeding. b. The clinician should assess the problem as solely an oral issue. c. The patient should be referred to a medical doctor for a comprehensive checkup.

d. The clinician should provide feedback on what he or she believes the proper

associated medical diagnosis is.

ANS: C

Clinicians must be aware that certain oral manifestations (e.g., hemorrhage; ecchymosis) can suggest the existence of a systemic disorder. Determining a specific systemic diagnosis requires a complete physical examination and a thorough hematologic study. Patients should be referred to a medical doctor for a comprehensive workup.

DIF: Application REF: p. 203 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. Which of the following is an example of a leukocyte (neutrophil) disorder? a. Agranulocytosis b. Leukemia c. Periodontitis d. Gingivitis ANS: A

Agranulocytosis is a severe neutropenia that involves not only neutrophils but also basophils and eosinophils. It is characterized by a reduction in the number of circulating granulocytes, and it results in severe infections.

DIF: Recall REF: p. 203 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. What does the term “myelogenous” indicate, in relation to leukemia? a. That the certain kind oT f lE euSkTem iaNisKrS apEidLlL yE faR ta.l.COM BA b. That the malignant change occurs in cells that normally form lymphocytes. c. That the malignant change occurs in cells that normally form RBCs, some types of

WBCs, and platelets. d. That the white blood cell count is rapidly diminished because of an infection.

ANS: C

According to the cell type involved, leukemias are classified as lymphocytic or myelogenous.

The term lymphocytic indicates that the malignant change occurs in cells that normally form lymphocytes. The term myelogenous indicates that the malignant change occurs in cells that normally form RBCs, WBCs, and platelets.

DIF: Recall REF: p. 203 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Which of the following is a common finding in leukemic patients? a. Gingival hemorrhage b. Tooth loss c. Buildup of bacterial plaque biofilm d. Gingival infection ANS: A

Gingival hemorrhage is a common finding in leukemic patients, even in the absence of clinically detectable gingivitis.

DIF: Recall REF: p. 205 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Which of the following is an example of a long-term constant pressure that may exacerbate

periodontal destruction in susceptible individuals? a. Financial stress b. Social anxiety c. Aging d. Bleeding upon probing ANS: A

Financial stress is an example of a long-term constant pressure that may exacerbate periodontal destruction in susceptible individuals.

DIF: Recall REF: p. 208 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Which of the following is a term that is used to describe the condition of a reduced platelet

count that results from either a lack of platelet production or an increased loss of platelets? a. Leukemia b. Anemia c. Thrombocytopenia d. Lazy Leukocyte Syndrome ANS: C

Thrombocytopenia is a term that is used to describe the condition of a reduced platelet count that results from either a lack of platelet production or an increased loss of platelets. It is characterized by a low platTelEeS t cToB unAt,NaKpSroEloLnLgE edRc.loCt O reMtraction and bleeding time, and a normal or slightly prolonged clotting time.

DIF: Recall REF: p. 208 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Which of the following is a rare disease that affects the production of organelles found in

almost every cell? a. Lazy Leukocyte Syndrome b. Chédiak-Higashi Syndrome c. Papillon-Lefévre Syndrome d. Down Syndrome ANS: B

Chédiak-Higashi Syndrome is a rare disease that affects the production of organelles found in almost every cell. It affects mostly the melanocytes, platelets, and phagocytes.

DIF: Recall REF: p. 208.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. Which of the following is a very rare inherited condition that appears to follow an

autosomal-recessive pattern? a. Lazy Leukocyte Syndrome b. Chédiak-Higashi Syndrome c. Papillon-Lefévre Syndrome

d. Down Syndrome ANS: C

Papillon-Lefévre Syndrome is a very rare condition that appears to follow an autosomal-recessive pattern. Parents are not affected, and both must carry the autosomal genes for the syndrome to appear in their offspring.

DIF: Recall REF: p. 208.e2 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. Which of the following is a congenital disease caused by a chromosomal abnormality and is

characterized by mental deficiency and growth retardation? a. Lazy Leukocyte Syndrome b. Chédiak-Higashi Syndrome c. Papillon-Lefévre Syndrome d. Down Syndrome ANS: D

Down syndrome (mongolism, trisomy 21) is a congenital disease caused by a chromosomal abnormality and is characterized by mental deficiency and growth retardation.

DIF: Recall REF: p. 208.e3 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. Which of the following is widely held as a truth when discussing the relationship of nutrition

with periodontal disease? a. There are nutritional deficiencies that by themselves can cause gingivitis or periodontitis. b. Nutrition does not play a role in periodontal disease. c. There are no nutritional deficiencies that produce changes in the oral cavity. d. There are nutritional deficiencies that produce changes in the oral cavity.

ANS: D

The majority of opinions and research findings regarding the effects of nutrition on oral and periodontal tissues point to the fact that there are no nutritional deficiencies that by themselves can cause gingivitis or periodontitis and there are nutritional deficiencies that produce changes in the oral cavity.

DIF: Comprehension REF: p. 210 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 21. What are two types of medication that are prescribed to cure, manage, or prevent diseases that

may have adverse effects on periodontal tissues? a. Bisphosphonates and corticosteroids b. Bisphosphonates and NSAIDs c. Corticosteroids and NSAIDs d. Antidepressants and anti-inflammatories ANS: A

Bisphosphonates are a class of medication widely prescribed for the treatment of osteoporosis and various types of cancer. Corticosteroids have long been prescribed to suppress the immune system for the control and management of autoimmune disease. Both of these types of medications may have adverse effects on periodontal tissues.

DIF: Comprehension REF: p. 210 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 22. Which of the following vitamins serves as an antioxidant to limit free-radical reactions and to

protect cells from lipid peroxidation? a. Vitamin A b. Vitamin C c. Vitamin D d. Vitamin E ANS: D

Vitamin E serves as an antioxidant to limit free-radical reactions and to protect cells from lipid peroxidation.

DIF: Recall REF: p. 210.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 23. Which of the following is an example of a water-soluble vitamin? a. Vitamin A b. Vitamin B c. Vitamin D d. Vitamin E ANS: B

Vitamins A, D, and E are fat-soluble vitamins. Vitamins B and C are water-soluble vitamins.

DIF: Recall REF: p. 210.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 24. Which of the following vitamins can result in scurvy when there is a severe deficiency? a. Vitamin A b. Vitamin B c. Vitamin C d. Vitamin D ANS: C

Severe vitamin C (ascorbic acid) deficiency in humans results in scurvy, a disease that is characterized by hemorrhagic diathesis and delayed wound healing.

DIF: Recall REF: p. 210.e2 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 25. Which of the following is the generic name for Boniva? a. Etidronate b. Ibandronate c. Zoledronate d. Pamidronate

ANS: B

Ibandronate is the generic name for Boniva. Refer to Table 13.1 in the textbook.

DIF: Recall REF: p. 211 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 14: Impact of Periodontal Infection on Systemic Health Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following is an example of a condition that affects the endocrine system and

could possibly influence periodontal infection? a. Angina b. Dementia c. Metabolic syndrome d. Anemia ANS: C

Metabolic syndrome is a condition that affects the endocrine system and could possibly influence periodontal infection.

DIF: Recall REF: p. 216 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Which of the following is an example of a condition that affects cognitive function and could

possibly influence periodontal infection? a. Dementia b. Myocardial infarction c. Pancreatic cancer d. Coronary heart disease ANS: A

Dementia is a condition that affects cognitive function and could possibly influence periodontal infection.

DIF: Recall REF: p. 216 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. Which of the following is an example of a condition that affects the cardiovascular system and

could possibly influence periodontal infection? a. Renal insufficiency b. Myocardial infarction c. Metabolic syndrome d. Ankylosing spondylitis ANS: B

Myocardial infarction is an example of a condition that affects the cardiovascular system and could possibly influence periodontal infection.

DIF: Recall REF: p. 216 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Which of the following types of evidence follows groups of subjects over time? a. Case report b. Cross-sectional study c. Longitudinal study

d. Systematic review ANS: C

A longitudinal study follows groups of subjects over time. It is stronger than a cross-sectional study but more difficult and expensive to conduct.

DIF: Comprehension REF: p. 217 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 5. Which of the following types of evidence stronger than a case report but not as strong as a

longitudinal study? a. Cross-sectional study b. Intervention trial c. Systematic review d. Hypothesis convention ANS: A

A cross-sectional study compares groups of subjects at a single point in time. It is stronger than a case report but not as strong as a longitudinal study.

DIF: Comprehension REF: p. 217 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 6. Which of the following types of evidence is the weakest form of evidence? a. Cross-sectional study b. Systematic review c. Case report d. Intervention trial ANS: C

Case reports provide relatively weak retrospective anecdotal evidence and may suggest that further study is needed.

DIF: Comprehension REF: p. 217 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 7. Which of the following types of evidence is the highest/strongest level? a. Cross-sectional study b. Intervention trial c. Longitudinal study d. Systematic review ANS: D

Systematic review is the highest/strongest level of evidence. It systematically evaluates evidence from multiple studies, especially randomized controlled trials. It uses clearly defined guidelines for the selection of evidence to be included or excluded from the review.

DIF: Recall REF: p. 217 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results

8. Which of the following is on the acute pathway to ischemic heart disease? a. Atherosclerosis b. Thromboembolism c. Narrowing of coronary arteries d. Gingivitis ANS: B

Thromboembolism is on the acute pathway to ischemic heart disease. Refer to Figure 14.1 in the textbook.

DIF: Comprehension REF: p. 220 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. What is the ultimate medical outcome measure? a. Mortality b. Preexisting conditions c. Age and gender d. Gingivitis and oral health ANS: A

The ultimate medical outcome measure is mortality.

DIF: Recall REF: p. 218 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which of the following factors does not affect blood viscosity in health? a. Plasma fibrinogen b. Plasma lipoproteins c. White blood cell count d. Red blood cell count ANS: D

Plasma fibrinogen, plasma lipoproteins (LDL/VLDL), and white blood cell count affects blood viscosity in health. Refer to Figure 14.2 in the textbook.

DIF: Comprehension REF: p. 221 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Which of the following is an effect of infection? a. Decreased white blood cell count b. Increased white blood cell count c. Decreased blood viscosity d. Decreased von Willebrand factor ANS: B

Systematic or periodontal infection causes an increase in fibrinogen, blood viscosity, white blood cell count, and the von Willebrand factor.

DIF: Comprehension REF: p. 221 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

12. Subjects with generalized gingival bleeding after brushing showed an almost

increase in their incidence bacteremia as compared with those with minimal gingival bleeding. a. twofold b. fourfold c. eightfold d. 10-fold ANS: C

Subjects with generalized gingival bleeding after brushing showed an almost eightfold increase in their incidence bacteremia as compared with those with minimal gingival bleeding.

DIF: Recall REF: p. 221 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. What plays a major role in thrombogenesis? a. Platelet aggregation b. White blood cell count c. Presence of bacterial plaque biofilm d. Red blood cell count ANS: A

Platelet aggregation plays a major role in thrombogenesis, and most cases of acute MI are precipitated by thromboembolism.

DIF: Recall REF: p. 221 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Which of the following is aTfEoS caTl B thAicNkK enSinEgLoL fE thR e. arCteOriM al intima and media? a. Thrombogenesis b. Leukemia c. Atherosclerosis d. Gingival infection ANS: C

Atherosclerosis is a focal thickening of the arterial intima, the innermost layer lining of the vessel lumen, and the media, the thick layer under the intima that consists of smooth muscle.

DIF: Recall REF: p. 221 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Which of the following is an example of periodontal infection on atherosclerosis? a. Gram-positive bacteremia/LPS b. Vessel wall thinning c. Thromboembolic events d. Exothelial damage ANS: C

Periodontal infection can influence the following in relation to atherosclerosis: gram-negative bacteremia/LPS, endothelial damage, platelet adhesion/aggregation, monocyte infiltration/proliferation, cytokine/growth factor production, thrombus formation, atheroma formation, vessel wall thickening, and thromboembolic events. Refer to Figure 14.5 in the textbook.

DIF: Comprehension REF: p. 223 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. In combination with other risk factors, the monocyte/macrophage phenotype predisposes

individuals to: a. atherosclerosis and periodontitis. b. periodontitis and gingivitis. c. thrombocytopenia and atherosclerosis. d. gingivitis and thrombocytopenia.

ANS: A

In combination with other risk factors, the monocyte/macrophage phenotype predisposes individuals to atherosclerosis and periodontitis.

DIF: Recall REF: p. 223 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. What condition is associated with endothelial dysfunction and elevated levels of oxidative

stress and systemic inflammation, and thus, may have a relationship with periodontitis? a. Pregnancy b. Eating disorder c. Erectile dysfunction d. Menopause ANS: C

Erectile dysfunction (ED) is associated with endothelial dysfunction, and elevated levels of oxidative stress and systemTicEiSnT flaBmAm eE coRm.mCoOnMto both periodontal disease and ED. NaKtiSonEaLrL Preliminary studies suggest a relationship between periodontitis and ED, but more research is needed to understand the mechanisms of interaction.

DIF: Comprehension REF: p. 224 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. Stroke is categorized as either: a. chronic or acute. b. early or advanced. c. minor or major. d. hemorrhagic or nonhemorrhagic.

ANS: D

Stroke is classified as either hemorrhagic or nonhemorrhagic.

DIF: Recall REF: p. 224 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. Which of the following is not a complication of diabetes mellitus? a. Nephropathy b. Allergies c. Altered wound healing d. Retinopathy

ANS: B

Retinopathy, nephropathy, neuropathy, macrovascular disease, altered wound healing, and periodontal disease are all complications of diabetes mellitus.

DIF: Comprehension REF: p. 228.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. Low-birth-weight (LBW) infants are how many more times likely to die during the neonatal

period than normal-birthweight (NBW) infants? a. 10 b. 20 c. 40 d. 60 ANS: C

LBW infants are 40 times more likely to die during the neonatal period than normal-birthweight (NBW) infants.

DIF: Comprehension REF: p. 226.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 21. What is the most common vaginal disorder in women of reproductive age? a. Pelvic pain b. Bacterial vaginosis c. Trichomoniasis d. Viral vaginosis ANS: B

Bacterial vaginosis is the most common vaginal disorder in women of reproductive age.

DIF: Recall REF: p. 226.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 22. Which of the following is characterized by airflow obstruction that results from chronic

bronchitis or emphysema? a. Periodontal disease b. Acute respiratory infections c. Chronic respiratory infections d. Chronic obstructive pulmonary disease ANS: D

Chronic obstructive pulmonary disease (COPD) is characterized by airflow obstruction that results from chronic bronchitis or emphysema.

DIF: Recall REF: p. 226.e4 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 23. The most reliable origin of information about oral health should be: a. newspapers. b. magazines. c. online articles. d. dental and medical professionals.

ANS: D

Enhanced community awareness may be derived from newspapers, magazines, and other lay sources. However, the most reliable origin of information should be dental and medical professionals, through daily contact with patients.

DIF: Comprehension REF: p. 227 TOP: NBDHE; 1.0 Promoting health and preventing disease within groups

theory of the early 20th century was widely and appropriately discredited when treatment based on the theory had no effect on the underlying diseases that oral sepsis supposedly caused. a. focal infection b. oral health c. biome production d. focused oral intervention

24. The

ANS: A

The focal infection theory of the early 20th century was widely and appropriately discredited when treatment based on the theory, which consisted almost solely of tooth extraction, had no effect on the underlying diseases that oral sepsis supposedly caused.

DIF: Recall REF: p. 227 TOP: NBDHE; 3.0 Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results 25. Which of the following is an infection of the lungs that is caused by bacteria, viruses, fungi, or

mycoplasma and is broadlyTcEaS teT gor ithLeE rR co.mCmOuMnity-acquired or hospital-acquired?

BAizNedKaSsEeL a. Chronic obstructive pulmonary disease (COPD) b. Bronchitis c. Pneumonia d. Whooping cough ANS: C

Pneumonia is an infection of the lungs that is caused by bacteria, viruses, fungi, or mycoplasma and is broadly categorized as either community-acquired or hospital-acquired.

DIF: Recall REF: p. 226.e4 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 15: Defense Mechanisms of the Gingiva Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. What is another term for sulcular fluid? a. Gingival crevicular fluid b. Saliva c. Oral biofilm fluid d. Gingival tissue ANS: A

Sulcular fluid is otherwise known as gingival crevicular fluid (GCF).

DIF: Recall

REF: p. 229

TOP: NBDHE; 5.2 Oral pathology

2. What is the most difficult hurdle to overcome when collecting sulcular fluid? a. The density of material that can be obtained from the sulcus. b. The thickness of material that can be obtained from the sulcus. c. The scarcity of material that can be obtained from the sulcus. d. The color of material that can be obtained from the sulcus.

ANS: C

The most difficult hurdle to overcome when collecting sulcular fluid is the scarcity of the material that can be obtained from the sulcus.

DIF: Recall

. 2S2T 9 BANKS TE OL P:LE NR BD REF: TpE .HCEO; M5.2 Oral pathology

3. Which of the following is not a limitation when it comes to collecting sulcular fluid? a. Collection time b. Prediction rate c. Flow rate d. Contamination ANS: B

There are limitations to sulcular fluid collection techniques including fluid collection, collection time, flow rate, contamination, and reproducibility.

DIF: Recall

REF: p. 229

TOP: NBDHE; 5.2 Oral pathology

4. The amount of sulcular fluid collected on a paper strip can be studied in multiple ways. The

wetted area can be made more visible by staining with a. nitrogen b. sulcular epithelia c. Ninhydrin d. epithelial cells

.

ANS: C

The amount of sulcular fluid collected on a paper strip can be studied in multiple ways. The wetted area can be made more visible by staining with Ninhydrin; it is then measured planimetrically on an enlarged photograph or with a magnifying glass or a microscope.

DIF: Comprehension

REF: p. 230

TOP: NBDHE; 5.2 Oral pathology

5. Which of the following is not a cellular element found in sulcular fluid? a. Plaque b. Bacteria c. Leukocytes d. Desquamated epithelial cells ANS: A

Cellular elements found in sulcular fluid include bacteria, desquamated epithelial cells, and leukocytes (i.e., PMNs, lymphocytes, and monocytes/macrophages), which migrate through the sulcular epithelium.

DIF: Comprehension

REF: p. 231

TOP: NBDHE; 5.2 Oral pathology

6. What is the target for the Periocheck diagnostic test? a. Elastase b. MMPs c. Proteinases d. Bacterial toxins ANS: C

The target for the Periocheck diagnostic test of gingival crevicular fluid is Proteinases.

DIF: Recall

REF: p. 230

TOP: NBDHE; 5.2 Oral pathology

7. What is the target for the PT roEgS noTsB tiA kN diK agSnE osLtiLc EteRst. ? COM a. Elastase b. MMPs c. Proteinases d. Bacterial toxins ANS: A

The target for the Prognostik diagnostic test is elastase.

DIF: Recall

REF: p. 230

TOP: NBDHE; 5.2 Oral pathology

8. What is the target for the pocket watch diagnostic test? a. Elastase b. Bacterial toxins c. MMPs d. AST ANS: D

The target for the pocket watch diagnostic test is AST. DIF: Recall

REF: p. 230

TOP: NBDHE; 5.2 Oral pathology

9. Both and have been investigated as organic compound within the GCF. a. Carbohydrates; proteins b. Fats; oils

c. Leukocytes; thrombocytes d. Saliva; plaque ANS: A

Both carbohydrates and proteins have been investigated as organic compounds within the GCF. DIF: Recall 10.

REF: p. 231

TOP: NBDHE; 5.2 Oral pathology

and are biologic fluids that can provide information on human genomics and metagenomics. a. Carbohydrates; proteins b. Potassium; sodium c. Gingival fluid; saliva d. Blood; plaque ANS: C

Gingival fluid and saliva are biologic fluids that can provide information on human genomics and metagenomics (microbiome, transcriptome, metabolome, and proteome).

DIF: Comprehension 11. The amount of GCF is a. lesser b. greater c. unchanged d. zero

REF: p. 231

TOP: NBDHE; 5.2 Oral pathology

when inflammation is present.

ANS: C

The amount of GCF is greater when inflammation is present and is sometimes proportional to the severity of inflammation.

DIF: Recall REF: p. 231 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. Female sex organs a. decrease b. do not affect c. increase d. attack

GCF flow.

ANS: C

Female sex hormones increase GCF flow, probably because they enhance vascular permeability.

DIF: Comprehension REF: p. 231 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Which of the following is a probable mechanism of the cleansing function of saliva? a. Coating similar to gastric mucin b. Clearance of debris and bacteria c. Remineralization

d. Mechanical protection ANS: B

The cleansing function of saliva allows for the clearance of debris and bacteria.

DIF: Comprehension REF: p. 233 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Which of the following is a probable mechanism of the tooth integrity maintenance function

of saliva? a. Coating similar to gastric mucin b. Antacids c. Clearance of debris and bacteria d. Mechanical protection ANS: D

The tooth integrity maintenance function of saliva allows for maturation, remineralization, and mechanical protection.

DIF: Comprehension REF: p. 233 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Which of the following is a salivary component related to the buffering function of saliva? a. Bicarbonate b. Glycoproteins c. Lysozyme d. Immunoglobin A ANS: A

Bicarbonate and phosphate are the salivary components of the buffering function of saliva.

DIF: Comprehension REF: p. 233 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Which of the following is a hallmark of xerostomia? a. Salivary flow rate of 1 to 2 mL b. Salivary flow rate of <0.1 mg/mL c. Salivary flow rate of 0 to 1 mL d. Salivary flow rate of <1 mL ANS: B

Xerostomia is characterized by a flow rate of <0.1 mg/mL, dry mouth, and erythematous and sticky saliva.

DIF: Application REF: p. 234 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Which of the following is a probable mechanism of the antibacterial action function of saliva? a. Clearance of debris and bacteria b. Remineralization c. Breaking of bacterial cell walls d. Mechanical protection

ANS: C

The antibacterial action function of saliva has probable mechanisms of controlling bacterial colonization, breaking of bacterial cell walls, and oxidization of susceptible bacteria.

DIF: Comprehension REF: p. 233 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. Which of the following is not true of saliva? a. Saliva has several important properties, including mechanical, chemical, biologic,

and immunologic. b. Saliva is a viscous, thick, gray fluid secreted from salivary glands. c. Saliva is a major biologic fluid for diagnosis and “omics” research. d. Diagnosing local and systemic conditions is possible through salivary markers.

ANS: B

Saliva has several important properties, including mechanical, chemical, biologic, and immunologic. Saliva is a viscous, clear, watery fluid secreted from salivary glands and is a major biologic fluid for diagnosis and “omics” research. Diagnosing local and systemic conditions is possible through salivary markers.

DIF: Comprehension REF: p. 234 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. Saliva contains all forms of leukocytes, and the most principal ones are a. PMNs b. erythrocytes c. monocytes d. basophils

.

ANS: B

In addition to desquamated epithelial cells, saliva contains all forms of leukocytes, of which the principal cells are PMNs. DIF: Recall REF: p. 234 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. There is a(n)

in GCF production during the healing period after periodontal

surgery. a. decrease b. increase c. stoppage d. possible downshift ANS: B

There is an increase in GCF production during the healing period after periodontal surgery.

DIF: Recall REF: p. 232 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 16: Gingival Inflammation Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following is a component from the innate immune response? a. Mucins b. Collagen c. Plasma cells d. T-cells ANS: A

Components from the innate immune response include epithelial cells and nonspecific cells within the epithelium, mucins, lysozyme, lactoferrin, lactoperoxidase, and various antimicrobial peptides such as histatins, beta-defensins, and protease inhibitors.

DIF: Recall

REF: p. 235

TOP: NBDHE; 5.2 Oral pathology

2. The sequence of events that culminates in clinically apparent gingivitis is categorized into

what three stages of disease? a. Beginning, middle, diseased b. Onset, central, end c. Initial, early, and established d. Genesis, established, resolution ANS: C

TB The sequence of events thaTt E cuSlm inA atN esKiS nE clL inLicEalRly.aCpO paMrent gingivitis is categorized as the initial, early, and established stages of disease, with periodontitis designated as the advanced stage.

DIF: Recall REF: p. 235 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. What is the first manifestation of gingival inflammation? a. Vascular changes consisting of enlarged capillaries and increased blood flow b. Vascular changes consisting of dilated capillaries and increased blood flow c. Vascular changes consisting of enlarged capillaries and decreased blood flow d. Vascular changes consisting of dilated capillaries and decreased blood flow ANS: B

The first manifestations of gingival inflammation are vascular changes consisting of dilated capillaries and increased blood flow.

DIF: Comprehension REF: p. 235 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. After plaque has accumulated, when does the adherence of neutrophils to vessel wall

(margination) occur? a. 0 to 12 hours b. 1 to 3 days c. 2 to 7 days

d. 14 to 20 days ANS: C

Changes in blood vessel morphologic features and the adherence of neutrophils to vessel walls (margination) occur within 1 week, and sometimes as early as 2 days, after plaque has accumulated.

DIF: Comprehension REF: p. 235 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Which of the following is a clinical finding of an initial lesion of gingivitis? a. Changes in color, size, and texture b. Gingival fluid flow c. Erythema d. Bleeding on probing ANS: B

With an initial lesion, gingival fluid flow is found.

DIF: Comprehension REF: p. 236 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. The early lesion evolves from the initial lesion within about

after the beginning of

plaque accumulation. a. 24 hours b. 7 days c. 2 weeks d. 1 month ANS: B

The early lesion evolves from the initial lesion within about 1 week after the beginning of plaque accumulation.

DIF: Recall REF: p. 236 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Bleeding upon probing may be evident with what stage of gingivitis? a. Initial b. Beginning c. Early d. Middle ANS: C

Bleeding upon probing may be evident with the early lesion stage of gingivitis.

DIF: Recall REF: p. 236 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. As gingivitis progresses, the amount of collagen destruction a. decreases b. stays the same c. increases

.

d. accelerates ANS: C

As gingivitis progresses, the amount of collagen destruction increases.

DIF: Recall REF: p. 236 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. In the early lesion stage of gingivitis, what are PMNs attracted to? a. Plaque b. Gums c. Bacteria d. Saliva ANS: C

In the early lesion stage of gingivitis, PMNs are attracted to bacteria and engulf them during the process of phagocytosis.

DIF: Comprehension REF: p. 236 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. What stage of gingivitis is characterized by a predominance of plasma cells and B

lymphocytes and is probably in conjunction with the creation of a small gingival pocket lined with a pocket epithelium? a. Initial b. Early c. Middle d. Established ANS: D

The established lesion is characterized by a predominance of plasma cells and B lymphocytes and is probably in conjunction with the creation of a small gingival pocket lined with a pocket epithelium.

DIF: Recall REF: p. 237 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Chronic gingivitis tends to occur within how many weeks of plaque accumulation? a. 0 to 1 week b. 1 to 2 weeks c. 2 to 3 weeks d. 3 to 4 weeks ANS: C

Chronic gingivitis occurs 2 to 3 weeks after the beginning of plaque accumulation.

DIF: Recall REF: p. 239 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. What is the name for the fourth stage of gingival inflammation, where the lesion has extended

into the alveolar bone? a. Advanced lesion

b. Ending lesion c. Diseased lesion d. Hopeless lesion ANS: A

The extension of the lesion into alveolar bone characterizes the fourth stage of gingival inflammation: the advanced lesion.

DIF: Comprehension REF: p. 239 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. What is true of how gingivitis progresses into periodontitis? a. Gingivitis will always progress to periodontitis. b. Gingivitis will progress to periodontitis only in individuals who are susceptible. c. Age and gender definitely play a role if gingivitis progresses into periodontitis. d. Periodontitis and gingivitis are synonymous terms so one always occurs with the

other.

ANS: B

Gingivitis will progress to periodontitis only in individuals who are susceptible.

DIF: Comprehension REF: p. 240 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Which of the following is the predominant immune cells of an established lesion of gingivitis? a. PMNs b. Neutrophils c. Lymphocytes d. Plasma cells ANS: D

Plasma cells are the predominant immune cells of an established lesion of gingivitis.

DIF: Recall REF: p. 236 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Which of the following is the predominant immune cell for an initial lesion of gingivitis? a. PMNs b. Eosinophils c. Lymphocytes d. Plasma cells ANS: A

PMNs are the predominant immune cells of an established lesion of gingivitis.

DIF: Recall REF: p. 236 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Which of the following stages of gingivitis is associated with changes in color, size, and

texture? a. Initial b. Early

c. Established d. Advanced ANS: C

An established lesion of gingivitis is associated with changes in color, size, and texture.

DIF: Recall REF: p. 236 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Which of the following stages of gingivitis is characterized by blood stasis in the blood

vessels? a. Initial b. Early c. Established d. Advanced ANS: C

Blood stasis in the blood vessels is seen in the established lesion stage of gingivitis.

DIF: Comprehension REF: p. 236 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. In the established lesion phase of gingivitis, a(n)

relationship appears to exist between the number of intact collagen bundles and the number of inflammatory cells. a. symbiotic b. inverse c. direct d. coefficient ANS: B

In the established lesion phase of gingivitis, an inverse relationship appears to exist between the number of intact collagen bundles and the number of inflammatory cells.

DIF: Comprehension REF: p. 239 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. At the advanced lesion phase of gingivitis, the presence of

connective tissue, and a. leukocytes; plasma cells b. plasma cells; neutrophils c. neutrophils; plasma cells d. plasma cells; leukocytes

dominates the continue dominating the junctional epithelium.

ANS: B

At the advanced lesion phase of gingivitis, the presence of plasma cells dominates the connective tissue, and neutrophils continue dominating the junctional epithelium.

DIF: Recall REF: p. 239 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. What determines whether an initial lesion of gingivitis resolves rapidly or evolves into a

chronic inflammatory lesion?

a. b. c. d.

Predisposing genetic factors The amount of collagen present and when PMNs are released Character and intensity of the host response Plaque buildup and age

ANS: C

The character and intensity of the host response determine whether an initial lesion resolves rapidly or evolves into a chronic inflammatory lesion.

DIF: Comprehension REF: p. 236 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 17: Clinical Features of Gingivitis Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Epidemiologic studies indicate that more than

% of adolescents in the United States

have gingivitis and signs of gingival bleeding. a. 10% b. 27% c. 59% d. 82% ANS: D

Epidemiologic studies indicate that more than 82% of adolescents in the United States have gingivitis and signs of gingival bleeding.

DIF: Recall REF: p. 241 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Which of the following is not a clinical feature of gingivitis? a. Presence of calculus or plaque with no radiographic evidence of crestal bone loss b. Bleeding on provocation c. Pinkness and nonsponginess of the gingival tissue d. Changes in contour ANS: C

Clinical features of gingiviT tiE sS caT nBbA eN chKaS raE ctL erL izE edR. byCaOnM y of the following clinical signs: redness and sponginess of the gingival tissue, bleeding on provocation, changes in contour, and the presence of calculus or plaque with no radiographic evidence of crestal bone loss.

DIF: Comprehension REF: p. 241 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. Which of the following is a term for the type of gingivitis that develops slowly and has a long

duration? a. Localized gingivitis b. Chronic gingivitis c. Recurrent gingivitis d. Diffuse gingivitis ANS: B

Chronic gingivitis develops slowly and has a long duration. It is painless, unless it is complicated by acute or subacute exacerbations, and it is the type that is most often encountered.

DIF: Comprehension REF: p. 241 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Which of the following is a term for the type of gingivitis that is confined to the gingiva of a

single tooth or group of teeth and affects less than 30% of the remaining teeth? a. Localized gingivitis

b. Chronic gingivitis c. Diffuse gingivitis d. Marginal gingivitis ANS: A

Localized gingivitis is confined to the gingiva of a single tooth or group of teeth and affects less than 30% of the remaining teeth.

DIF: Recall REF: p. 241 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Which of the following is a term for the type of gingivitis that involves the interdental

papillae? a. Localized gingivitis b. Marginal gingivitis c. Papillary gingivitis d. Diffuse gingivitis ANS: C

Papillary gingivitis involves the interdental papillae, and it often extends into the adjacent portion of the gingival margin.

DIF: Recall REF: p. 241 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Which of the following is the term for the type of gingivitis that affects the gingival margin,

the attached gingiva, and the interdental papillae? a. Marginal gingivitis b. Diffuse gingivitis c. Localized gingivitis d. Generalized gingivitis ANS: B

Diffuse gingivitis affects the gingival margin, the attached gingiva, and the interdental papillae.

DIF: Recall REF: p. 241 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Which of the following is the term for the type of gingivitis that involves more than 30% of

teeth? a. Marginal gingivitis b. Localized gingivitis c. Chronic gingivitis d. Generalized gingivitis ANS: D

Generalized gingivitis involves more than 30% of teeth.

DIF: Recall REF: p. 241 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

8. Which type of gingivitis extends from the margin to the mucobuccal fold in a limited area? a. Localized marginal gingivitis b. Localized diffuse gingivitis c. Localized papillary gingivitis d. Localized generalized gingivitis ANS: B

Localized diffuse gingivitis extends from the margin to the mucobuccal fold in a limited area.

DIF: Recall REF: p. 241 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following types of gingivitis involves the entire gingiva? a. Localized marginal gingivitis b. Localized diffuse gingivitis c. Generalized diffuse gingivitis d. Generalized marginal gingivitis ANS: C

Generalized diffuse gingivitis involves the entire gingiva. Because the alveolar mucosa and attached gingiva are affected, the mucogingival junction and attached gingiva are affected, the mucogingival junction is sometimes obliterated.

DIF: Recall REF: p. 242 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. What are the two earliest signs of gingival inflammation that precede gingivitis? a. Plaque buildup and bleT edEinSgTfB roAmNtK hS eE giL ngLivEaR l. suC lcOuM s on deep probing b. Decreased gingival crevicular fluid production and bleeding from the gingival

sulcus on deep probing c. Plaque buildup and bleeding from the gingival sulcus on gentle probing d. Increased gingival crevicular fluid production and bleeding from the gingival sulcus on gentle probing ANS: D

The two earliest signs of gingival inflammation that precede established gingivitis are increased gingival crevicular fluid production and bleeding from the gingival sulcus on gentle probing.

DIF: Comprehension REF: p. 243 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Which of the following is an easily detected issue that can be used for early diagnosis and

prevention of more advanced gingivitis? a. Plaque biofilm buildup b. Cavities c. Bleeding on probing d. Pinkish color of gums ANS: C

Bleeding on probing (BOP) is easily detected clinically and, therefore, is of value for early diagnosis and for prevention of more advanced gingivitis.

DIF: Application REF: p. 243 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. What is the most common cause of abnormal gingival bleeding on probing (BOP)? a. Chronic inflammation b. Plaque biofilm buildup c. Fever and malaise d. Advanced age ANS: A

The most common cause of abnormal gingival BOP is chronic inflammation.

DIF: Recall REF: p. 243 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Which of the following populations are significantly more prone to gingivitis? a. Men and women taking daily multivitamins b. Women taking oral contraceptives c. Men and women of advancing age d. Men taking erectile dysfunction drugs ANS: B

Women taking oral contraceptives are significantly more prone to gingivitis and, therefore, to gingival bleeding.

DIF: Comprehension REF: p. 244 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

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14. What is the primary cause of pregnancy gingivitis? a. The existence of two heartbeats b. Rising body temperature c. Lack of menstrual period d. Hormonal imbalances ANS: D

Pregnancy gingivitis affects many pregnant women and is primarily caused by the hormonal imbalances associated with pregnancy.

DIF: Comprehension REF: p. 244 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Which of the following is an important clinical sign of gingival disease? a. Change of color in the gingiva b. Thinning of epithelial lining of the gingiva c. The rise of white blood cells d. Cavities on more than one tooth ANS: A

Change in color is an important clinical sign of gingival disease.

DIF: Recall REF: p. 245 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

16. What could make the gingiva have a bluish hue? a. High white blood cell count b. Plaque biofilm buildup c. Venous stasis d. Formation of new veins ANS: C

Chronic inflammation intensifies the red or bluish red color due to vascular proliferation and a reduction of keratinization. Venous stasis contributes a bluish hue.

DIF: Comprehension REF: p. 245 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Which of the following stages of gingivitis is characterized by blood stasis in the blood

vessels? a. Initial b. Early c. Established d. Advanced ANS: C

Blood stasis in the blood vessels is seen in the established lesion stage of gingivitis.

DIF: Comprehension REF: p. 236 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. With severe acute inflammTatio thN eK giSnE giL vaL, E thRe.reCdOcM olor gradually becomes what color?

ESnToBf A a. Reddish pink b. Dull, whitish gray c. Bright white d. Deep purple ANS: B

Color changes vary with the intensity of inflammation. With severe acute inflammation, the red color gradually becomes a dull, whitish gray. The gray discoloration produced by tissue necrosis is demarcated from the adjacent gingiva by a thin, sharply defined erythematous zone.

DIF: Comprehension REF: p. 246 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. In chronic gingivitis, which of the following is the underlying microscopic feature that relates

to the soggy puffiness that pits on pressure? a. Fibrosis and epithelial proliferation b. Infiltration by fluid and cells of inflammatory exudate c. Necrosis with formation of pseudomembrane d. Diffuse edema of acute inflammatory origin ANS: B

In chronic gingivitis, soggy puffiness that pits on pressure relates to infiltration by fluid and cells by inflammatory exudate.

DIF: Comprehension REF: p. 246 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. The prevalence, extent, and severity of which of the following can increase with age? a. Periodontitis b. Cavities c. Gingival recession d. Gingivitis ANS: C

The prevalence, extent, and severity of gingival recession can increase with age, and this condition is more prevalent among males.

DIF: Comprehension REF: p. 247 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 18: Gingival Enlargement Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. A change in the dimensions of gingival tissue is always a(n) a. age-related b. fatal c. destructive d. pathologic

event.

ANS: D

A change in the dimensions of gingival tissue is always a pathologic event.

DIF: Recall REF: p. 249 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Which of the following is the term for a component of the defense mechanism where

fibroblasts play a major role by generating excessive amounts of collagen and noncollagenous proteins of the extracellular matrix? a. Fibroblastitis b. Fibrolocosis c. Fibrosis d. Fibrolytics ANS: C

R. Fibrosis is a component ofTthEeSdTefBeA nsNe K mSeE chLanLiE sm wC heOreMfibroblasts play a major role by generating excessive amounts of collagen and noncollagenous proteins of the extracellular matrix.

DIF: Comprehension REF: p. 249 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. Which of the following is the term used to describe an increase in the number of cells in

tissues that result in increased tissue volume? a. Hypertrophy b. Hyperplasia c. Hypoplasia d. Hypotrophy ANS: B

Hyperplasia is an increase in the number of cells in tissues that results in increased tissue volume.

DIF: Comprehension REF: p. 249 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Which of the following is not one of the three families of drugs that can lead to drug-induced

gingival overgrowth? a. NSAIDs b. Anticonvulsants

c. Calcium channel blockers d. Immunosuppressants ANS: A

Three families of drugs can lead to drug-induced gingival overgrowth (DIGO): anticonvulsants, calcium channel blockers, and immunosuppressants.

DIF: Recall REF: p. 250 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Gingival enlargement is distinguished as what two types? a. Acute or chronic b. Beginning or advanced c. Localized or generalized d. Red or pink ANS: C

Gingival enlargement is distinguished as localized or generalized.

DIF: Recall REF: p. 250 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Which grade of gingival enlargement involves papilla and marginal gingiva? a. Grade 0 b. Grade I c. Grade II d. Grade III ANS: C

Grade II enlargement involves the papilla and the marginal gingiva.

DIF: Recall REF: p. 250 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. What is the main etiologic factor for acute inflammatory gingival enlargement? a. Gender b. Red color c. Bacteria d. Trauma ANS: D

The main etiologic factor for acute inflammatory gingival enlargement is trauma.

DIF: Comprehension REF: p. 251 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. A gingival abscess is a localized, painful, and a. slowly expanding b. rapidly expanding c. smooth d. sharp ANS: B

lesion.

A gingival abscess is a localized, painful, and rapidly expanding lesion.

DIF: Comprehension REF: p. 251 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following is a common habit of patients who have gingivitis and gingival

enlargement? a. Drinking coffee b. Bike riding c. Mouth breathing d. Running ANS: C

Gingivitis and gingival enlargement are often seen in patients who are mouth breathers.

DIF: Recall REF: p. 251 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which of the following drugs is not associated with drug-induced overgrowth of gingiva? a. Phenytoin b. Nifedipine c. Cyclosporine d. Fentanyl ANS: D

Three drugs associated with DGIO are phenytoin, nifedipine, and cyclosporine. . 2S5T 2 BANKSELLER.COM DIF: Recall REF: TpE TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Which of the following is the most effective treatment for drug-induced overgrowth of

gingiva? a. Good oral hygiene habits b. Pulling teeth that have cavities c. Withdrawal or substitution of the medication d. Probing ANS: C

The most effective treatment for DIGO is withdrawal or substitution of the medication.

DIF: Application REF: p. 255 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. Which two hormone levels increase 10 to 30 times by the end of the third trimester as

compared with the menstrual cycle? a. Progesterone and estrogen b. Progesterone and testosterone c. Estrogen and testosterone d. Insulin and progesterone ANS: A

Hormonal changes are linked to pathology in periodontal tissues. For example, progesterone and estrogen levels increase 10 to 30 times by the end of the third trimester compared with the menstrual cycle.

DIF: Recall REF: p. 256 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Which of the following is the term used to describe gingival enlargement in pregnancy? a. Pyogenic granuloma b. Angiogranuloma c. Facial gingivae d. Prevotella ANS: B

Gingival enlargement in pregnancy is known as angiogranuloma.

DIF: Comprehension REF: p. 256 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Which of the following rare disease that is characterized by acute granulomatous necrotizing

lesions of the respiratory tract, including nasal and oral defects? a. Polymorphonuclear granulomatosis b. Gingival fibromatosis c. Sarcoidosis d. Wegener granulomatosis ANS: D

Wegener granulomatosis isTaErSarTeBdA isN eaKseStE haLtLisEcRh. arC acOteMrized by acute granulomatous necrotizing lesions of the respiratory tract, including nasal and oral defects.

DIF: Recall REF: p. 257 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Which of the following is a granulomatous disease of unknown etiology that predominantly

affects blacks and can involve almost any organ? a. Polymorphonuclear granulomatosis b. Gingival fibromatosis c. Sarcoidosis d. Wegener granulomatosis ANS: C

Sarcoidosis is a granulomatous disease of unknown etiology. It starts in individuals during their 20s or 30s, and it predominantly affects blacks. It can involve almost any organ, including the gingiva.

DIF: Recall REF: p. 258 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. What is the most common form of gingival fibromatosis? a. Accumulated gingival fibromatosis b. Acquired gingival fibromatosis c. Hereditary gingival fibromatosis

d. Idiopathic gingival fibromatosis ANS: C

Heredity gingival fibromatosis is the most common form of gingival fibromatosis, and it has been linked to several genetic loci.

DIF: Comprehension REF: p. 258 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. What is the term used for gingiva that is enlarged due to increases in the size of underlying

osseous and dental tissues? a. Acquired enlargements b. Resistant enlargements c. False enlargements d. Advanced enlargements ANS: C

The gingiva can be enlarged due to increases in the size of underlying osseous and dental tissues. These false enlargements usually have no abnormal clinical features except for the massive increase in the size of the area.

DIF: Comprehension REF: p. 259 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. Which of the following is a generic term that is used to clinically designate all discrete tumors

and tumor-like masses of the gingiva? a. Formation b. Epulis c. Fibroma d. Gingival enlargement ANS: B

Epulis is a generic term that is used to clinically designate all discrete tumors and tumor-like masses of the gingiva. It serves to locate the tumor but does not describe it.

DIF: Recall REF: p. 259 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. What is it the term for a giant cell fibroma where mineralized tissue is found? a. Mineralized fibroma b. Peripheral ossifying fibroma c. Enhanced ossifying fibroma d. Advanced cellular fibroma ANS: B

Histopathologic review of fibromas demonstrates bundles of well-formed collagen fibers with scattered fibrocytes and various degrees of vascularity. The so-called giant cell fibroma contains multinucleated fibroblasts and another variant includes mineralized tissue. This variant is known as peripheral ossifying fibroma.

DIF: Comprehension REF: p. 259 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

20. When squamous cell carcinoma appears as a flat, erosive lesion, it is known as what? a. Ulcerative b. Stagnant c. Exophytic d. Malignant ANS: A

Squamous cell carcinoma is the most common malignant tumor of the gingiva. It may be exophytic, manifesting as an irregular growth, or ulcerative, appearing as a flat, erosive lesion.

DIF: Comprehension REF: p. 260 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 19: Acute Gingival Infections Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following is the term used to describe a microbial disease of the gingiva that

most often occurs in an impaired host and has characteristic clinical signs of necrosis and sloughing of the gingival tissues? a. Primary herpetic gingivostomatitis b. Pericoronitis c. Localized gingivitis d. Necrotizing ulcerative gingivitis ANS: D

Necrotizing ulcerative gingivitis (NUG) is a microbial disease of the gingiva that most often occurs in an impaired host. It manifests with the characteristic clinical signs of necrosis and sloughing of the gingival tissues and may be accompanied by systemic symptoms.

DIF: Recall REF: p. 262 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. What is the condition called when periodontal attachment loss and bone loss occurs? a. Pericoronitis b. Primary herpetic gingivostomatitis c. Necrotizing ulcerative periodontitis d. Necrotizing ulcerative gingivitis

TESTBANKSELLER.COM

ANS: C

When periodontal attachment loss and bone loss occurs, the condition is called necrotizing ulcerative periodontitis.

DIF: Comprehension REF: p. 262 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. In necrotizing ulcerative gingivitis, what color is the pseudomembranous slough that covered

the surface of the gingival crater? a. White b. Gray c. Red d. Black ANS: B

The surface of the gingival crater is covered by a gray, pseudomembranous slough that is demarcated from the remainder of the gingival mucosa by a pronounce linear erythema.

DIF: Comprehension REF: p. 262 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Which of the following is not true about necrotizing ulcerative gingivitis? a. It usually leads to pocket formation. b. It can occur in otherwise disease-free mouths.

c. It can super-imposed on chronic gingivitis or periodontitis with periodontal

pockets. d. It always leads to necrotizing ulcerative periodontitis.

ANS: A

NUG can occur in otherwise disease-free mouths, or it can be superimposed on chronic gingivitis or periodontitis with periodontal pockets. However, NUG does not usually lead to periodontal pocket formation because the necrotic changes involve the gingival and junctional epithelium; healthy epithelium is needed for periodontal pocket deepening.

DIF: Comprehension REF: p. 262 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Which of the following is not true about oral symptoms of necrotizing ulcerative gingivitis? a. The lesions are extremely sensitive to touch. b. The patient often complains of a constant radiating, gnawing pain. c. The pain is intensified by eating spicy or hot foods and chewing. d. There is a sour taste in the mouth.

ANS: D

The lesions are extremely sensitive to touch, and the patient often complains of a constant radiating, gnawing pain that is intensified by eating spicy or hot foods and chewing. There is a metallic foul taste, and the patient is conscious of an excessive amount of pasty saliva.

DIF: Comprehension REF: p. 262 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. The microscopic appearanT ceEoSf T tiB ssA ueNsKinSaEN is LU LG ERle.siConOM a. traumatic b. full of leukocytes c. nonspecific d. irritated

.

ANS: C

The microscopic appearance of tissues in a NUG lesion is nonspecific.

DIF: Recall REF: p. 263 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Which of the following methods have been used to study the relationship of bacteria and the

characteristic lesion of NUG? a. Guessing game b. Probing and comparing results c. Dark and electron microscopy d. Light and electron microscopy ANS: D

Light and electron microscopy have been used to study the relationship of bacteria and the characteristic lesion of NUG. DIF: Recall REF: p. 264 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

8. On what is a diagnosis of necrotizing ulcerative gingivitis based? a. Clinical findings of inflammation, plaque buildup, and teeth spacing b. Clinical findings of gingival pain, ulceration, and bleeding c. Clinical findings of gingival pain, plaque buildup, and bleeding d. Clinical findings of inflammation, gingival pain, and teeth spacing ANS: B

Diagnosis of NUG is based on clinical findings of gingival pain, ulceration, and bleeding.

DIF: Comprehension REF: p. 264 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following is not true about the microscopic examination of a biopsy specimen

being tested for necrotizing ulcerative gingivitis? a. It can be used to differentiate NUG from specific infections. b. It can be used to differentiate NUG from neoplastic disease. c. It is sufficiently specific to be diagnostic. d. It does not differentiate NUG from other necrotizing conditions of nonspecific origin.

ANS: C

The microscopic examination of a biopsy specimen is not sufficiently specific to be diagnostic. It can be used to differentiate NUG from specific infections or from neoplastic disease, but it does not differentiate NUG from other necrotizing conditions of nonspecific origin, such as those products by trauma or caustic medications. p.R2.

64COM DIF: Comprehension TESTBANKSREFL:LE TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which of the following is true of primary herpetic gingivostomatitis? a. It has no definite duration. b. It has no demonstrated immunity. c. It is caused by the interaction between host and bacteria. d. It occurs more frequently in children.

ANS: D

Necrotizing ulcerative gingivitis is caused by interaction between host and bacteria, most often fusospirochetes, is uncommon in children, and has no definite duration. Primary herpetic gingivostomatitis is caused by a specific viral infection, occurs more frequently in children, and lasts 7 to 10 days.

DIF: Comprehension REF: p. 267 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Which of the following is true of desquamative gingivitis? a. It is associated with an acute history. b. Bacterial smears reveal numerous epithelial cells and abundant bacterial forms. c. There is no odor. d. It most often affects children.

ANS: C

Desquamative gingivitis has no odor, is associated with a chronic history, and most often affects adults (usually women). Bacterial smears reveal numerous epithelial cells and few bacterial forms.

DIF: Application REF: p. 265 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. Which of the following is a rare condition that is characterized by a diffuse erythema of the

gingiva and other areas of the oral mucosa? a. Streptococcal gingivostomatitis b. Necrotizing ulcerative gingivitis c. Diphtheria d. Chronic destructive periodontal disease ANS: A

Streptococcal gingivostomatitis is a rare condition that is characterized by a diffuse erythema of the gingiva and other areas of the oral mucosa.

DIF: Comprehension REF: p. 265 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Which of the following is true of the secondary stage of syphilis? a. It affects the marginal gingiva. b. It is caused by Treponema pallidum. c. Serologic findings are normal. d. It is not at all contagious.

ANS: B

The secondary stage of syphilis is caused by T. pallidum, rarely affects the marginal gingiva, is contagious with direct contact, and has abnormal serologic findings.

DIF: Comprehension REF: p. 265 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Which of the following is true of necrotizing ulcerative gingivitis? a. Membrane removal is difficult. b. Marginal gingivae is unaffected. c. Immunity is conferred by an attack. d. It is a painful condition.

ANS: D

Necrotizing ulcerative gingivitis affects the marginal gingiva, is a painful condition, and immunity is not conferred. Also, with necrotizing ulcerative gingivitis, marginal gingivae is affected.

DIF: Recall REF: p. 265 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Which of the following is true of chronic destructive periodontal disease? a. Marginal gingiva is unaffected. b. It is painful even when uncomplicated. c. It is associated with a chronic history.

d. It is typically found in children.

ANS: C

Chronic destructive periodontal disease affects the marginal gingiva, is associated with a chronic history, is painless if uncomplicated, and is typically found in adults, but occasionally found in children.

DIF: Recall REF: p. 265 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Which of the following is true of diphtheria? a. Serologic findings are abnormal. b. It is caused by T. pallidum. c. The throat, fauces, and tonsils are affected. d. Membrane removal is easy.

ANS: C

Diphtheria is caused by Corynebacterium diphtheriae and has normal serologic findings. The throat, fauces, and tonsils are affected, and membrane removal is difficult.

DIF: Comprehension REF: p. 265 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Which of the following is an infection of the oral cavity caused by the herpes simplex virus

(HSV) type 1? a. Diphtheria b. Necrotizing ulcerative gingivitis c. Primary herpetic gingiv mB atA itiNs KSELLER.COM ToEstSoT d. Desquamative gingivitis ANS: C

Primary herpetic gingivostomatitis is an infection of the oral cavity caused by herpes simplex virus (HSV) type 1.

DIF: Recall REF: p. 267 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. Treatment of

medications can dramatically alter the course of primary herpetic

gingivostomatitis. a. antibiotic b. antiviral c. NSAIDs d. antifungal ANS: B

Treatment of antiviral medications can dramatically alter the course of primary herpetic gingivostomatitis.

DIF: Comprehension REF: p. 269 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

19. Which of the following terms refers to the inflammation of the gingiva in relation to the

crown of an incompletely erupted tooth? a. Periodontitis b. Pericoronitis c. Enhanced ossifying fibroma d. Advanced cellular fibroma ANS: B

The term pericoronitis refers to inflammation of the gingiva in relation to the crown of an incompletely erupted tooth.

DIF: Recall REF: p. 270 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. Primary herpetic gingivostomatitis occurs most often in what age-group? a. Infants and children who are younger than 6 years of age b. School-age children c. Young adults d. Older adults ANS: A

Primary herpetic gingivostomatitis is an infection of the oral cavity caused by herpes simplex virus (HSV) type 1 and it occurs most often among infants and children who are younger than 6 years of age, but it is also seen in adolescents and adults.

DIF: Recall REF: p. 267 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 20: Gingival Disease in Childhood Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Stippling appears at about how many years of age? a. 1 b. 2 c. 3 d. 4 ANS: C

Stippling appears at about 3 years of age and has been reported for 56% of children between 3 and 10 years of age.

DIF: Recall REF: p. 271 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. What is the term used for a fluctuant mass that usually manifests itself as a bluish or deep red

enlargement of the gingiva over the erupting tooth? a. Eruption cyst b. Eruption mass c. Eruption tumor d. Eruption formation ANS: A

An eruption cyst occasionaTllE ySisTeB viAdN enKt S wE heLnLtE eeRth.cCoO mM e in. It is a fluctuant mass that can be filled with blood, and it usually manifests itself over the erupting tooth.

DIF: Recall REF: p. 271 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. Which of the following is not a common symptom associated with teething that has been

proved or confirmed by scientific studies? a. Drooling b. Increased appetite c. Irritability d. Gum rubbing ANS: B

The most common symptoms associated with teething that have been proved or confirmed by scientific studies are drooling, irritability, decreased appetite, and gum rubbing.

DIF: Comprehension REF: p. 272 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. What is the time period associated with the eruption of primary incisors in infants? a. 5 to 12 months of age b. 0 to 3 months of age c. 12 to 18 months of age d. 3 to 6 months of age

ANS: A

The period associated with the eruption of primary teeth in infants can be difficult and stressful for the child and the parents; primary incisor eruption (i.e., 5 to 12 months of age) coincides with diminution of the passive humoral immunity conferred by the transfer of maternal antibodies through the placenta and establishment of the child’s own immunity.

DIF: Recall REF: p. 272 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. The prevalence of mucogingival problems and recession in children ranges from

,

depending on the criteria used to assess the condition. a. 1% to 19% b. 10% to 29% c. 30% to 49% d. 50% to 69% ANS: A

The prevalence of mucogingival problems and recession in children ranges from 1% to 19%, depending on the criteria used to assess the condition.

DIF: Recall REF: p. 273 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Gingivitis affects up to a. 20 b. 40 c. 50 d. 70

% of children who are more than 7 years old.

ANS: D

Gingivitis affects up to 70% of children who are more than 7 years old.

DIF: Recall REF: p. 274 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. As children age, their tendency to develop gingivitis a. decreases b. stays the same c. is completely dependent on oral health d. increases

.

ANS: D

As children age, their tendency to develop gingivitis increases.

DIF: Comprehension REF: p. 274 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. What is the most prevalent type of gingival disease in childhood? a. Acute gingivitis b. Chronic marginal gingivitis c. Localized gingivitis

d. Abnormal marginal gingivitis ANS: B

The most prevalent type of gingival disease in childhood is chronic marginal gingivitis.

DIF: Recall REF: p. 274 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following is true when comparing chronic marginal gingivitis in children with

chronic marginal gingivitis in adults? a. Children with a nonsignificant medical history have more severe gingival bleeding as seen in healthy adults. b. Gingivitis in children always escalates to periodontitis. c. The response of gingivitis in children is dominated by T lymphocytes. d. Children and adults with chronic marginal gingivitis will have a lower life span.

ANS: C

Children with a nonsignificant medical history have less severe gingival bleeding and very seldom have increased pocket depth, as seen in healthy adults. Gingivitis in children is also different from than in adults because the response is dominated by T lymphocytes, with few B lymphocytes and plasma cells in the infiltrate, and it rarely progresses to periodontitis.

DIF: Comprehension REF: p. 274 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which of the following populations has a higher incidence of calcium deposits caused by

increased calcium and phosphate concentrations in saliva? a. Children with Down syTnE drSoT mB e ANKSELLER.COM b. Children who are breastfed c. Children who have cancer d. Children with cystic fibrosis or chronic kidney disease ANS: D

Children with cystic fibrosis or chronic kidney disease have a higher incidence of calculus deposits, which can be caused by increased calcium and phosphate concentrations in saliva.

DIF: Comprehension REF: p. 274 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Which of the following is an immunosuppressant drug used by patients who have undergone

organ transplantation? a. Phenytoin b. Epinephrine c. Cyclosporine d. Anti-inflammatories ANS: C

Cyclosporine is an immunosuppressant drug used by patients who have undergone organ transplantation.

DIF: Application REF: p. 275 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

12. What is the term used to describe when mouth breathing and lip incompetence occur together? a. Mouth incompetence b. Open mouth posture c. Mouth and lip dysfunction d. Agape demarcation ANS: B

Mouth breathing and lip incompetence, which are together referred to as an open mouth posture, are often associated with increased plaque and gingival inflammation.

DIF: Recall REF: p. 276 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Which of the following is the name of a condition that appears to be unrelated to plaque

accumulation and is characterized by localized patches on the attached gingiva that manifest as bright red, raised overgrowths? a. Localized juvenile spongiotic gingival hyperplasia b. Generalized childhood gingival lesions c. Localized childhood spongiotic gingival hypoplasia d. Generalized gingival patchioma ANS: B

Localized juvenile spongiotic gingival hyperplasia appears to be unrelated to plaque accumulation. Lesions are localized patches on the attached gingiva that manifest as bright red, raised overgrowths and are usually painless and associated with easy bleeding. . 2S7T 6 BANKSELLER.COM DIF: Recall REF: TpE TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Which of the following types of gingivitis occurs most often in children and adolescents? a. Acute periodontitis b. Chronic periodontitis c. Nonaggressive periodontitis d. Aggressive periodontitis ANS: D

Of the various manifestations of periodontal disease, chronic periodontitis is more prevalent among adults, and aggressive periodontitis is more common among children and adolescents.

DIF: Comprehension REF: p. 277 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. The generalized form of aggressive periodontitis includes at least

molars or incisors, and is rare among children. a. 1 b. 2 c. 3 d. 4 ANS: C

teeth that are not first

The generalized form of aggressive periodontitis, which is defined as a generalized interproximal attachment loss, including at least three teeth that are not first molars or incisors, is rare among children.

DIF: Comprehension REF: p. 277 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Systemic diseases that result in periodontitis occur a. less frequently b. with similar frequency c. more frequently d. with less fervor

in children than in adults.

ANS: C

Systemic diseases that result in periodontitis occur more frequently in children than in adults.

DIF: Recall REF: p. 279 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. When do periodontal indices need to be recorded during the primary dentition of a child? a. At every appointment b. When a child exhibits signs of poor oral hygiene habits c. When a child exhibits signs of aggressive periodontitis or other unusual disease

processes d. Never ANS: C

Periodontal indices do not T neEeS dTtoBbAeNreKcS orEdL edLdEuR ri. ngCtOhM e primary dentition unless a child exhibits signs of aggressive periodontitis or other unusual disease processes.

DIF: Recall REF: p. 280 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. In children, which of the following is the part of the periodontium that varies in width

anteroposteriorly with a range of 3 to 6 mm? a. Interdental gingiva b. Attached gingiva c. Gingival sulcular depth d. Junctional epithelium ANS: B

The attached gingiva varies in width anteroposteriorly, with a range of 3 to 6 mm. On the buccal surfaces, the width decreases from anterior to posterior, with some data indicating a narrowing over the canines. The lingual attached gingiva shows an inverse relationship, with an increase in width from anterior to posterior.

DIF: Comprehension REF: p. 271 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. The incidence of calcium deposits a. decreases b. increases

with age.

c. stays relatively the same d. never happens ANS: B

Calculus deposits are uncommon in infants and toddlers, but they can increase with age.

About 9% of 4- to 6-year-old children exhibit calculus deposits. By the age of 7 to 9 years, 18% of children have calculus deposits, and by the age of 10 to 15 years, 33% to 43% have some calculus formation.

DIF: Recall REF: p. 275 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. Which of the following can occur after a course of antibiotics as a result of congenital or

acquired immunodeficiency? a. Primary herpetic gingivostomatitis b. Localized gingival hyperplasia c. Candidiasis d. Mouth breathing ANS: C

Candidiasis results from an overgrowth of Candida albicans, usually after a course of antibiotics or as a result of congenital or acquired immunodeficiency. It is far less common in children than in adults, and it rarely occurs in a healthy child.

DIF: Comprehension REF: p. 276 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 21: Desquamative Gingivitis Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. In what year was the term “chronic desquamative gingivitis” coined by Prinz? a. 1894 b. 1902 c. 1932 d. 1975 ANS: C

Although the condition was first recognized and reported in 1894, the term chronic desquamative gingivitis (DG) was not coined by Prinz until 1932.

DIF: Recall

REF: p. 281

TOP: NBDHE; 5.2 Oral pathology

2. Approximately what percentage of cases of desquamative gingivitis are localized to the

gingiva? a. 10% b. 25% c. 50% d. 75% ANS: C

Approximately 50% of DG cases are localized to the gingiva, although patients can have involvement of the gingivaTpEluSsToB thAerNiK ntS raEoL raL l aEnRd.eC xtO raM oral sites.

DIF: Recall

REF: p. 281

TOP: NBDHE; 5.2 Oral pathology

3. Approximately what percentage of cases of desquamative gingivitis have a dermatologic

genesis? a. 10% b. 25% c. 50% d. 75% ANS: D

The use of clinical and laboratory parameters has revealed that approximately 75% of DG cases have a dermatologic genesis.

DIF: Recall REF: p. 281 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Which of the following conditions do not sometimes clinically manifest as desquamative

gingivitis? a. Diabetes b. Lupus erythematosus c. Crohn disease d. Dermatomyositis

ANS: A

Lupus erythematosus and dermatomyositis are two mucocutaneous autoimmune conditions that can manifest as DG. Crohn disease, although less common, has also been reported to manifest clinically as DG. DIF: Comprehension REF: p. 281 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. After desquamative gingivitis is identified, what should be used to arrive at a final diagnosis? a. Oral and physical examination b. A series of laboratory procedures c. CBC blood draw d. X-ray ANS: B

After the condition is identified, a series of laboratory procedures should be used to arrive at a final diagnosis. The success of any therapeutic approach depends on the establishment of an accurate final diagnosis.

DIF: Comprehension REF: p. 281 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Which of the following is the correct term for a simple clinical maneuver that can offer insight

into the plausibility of a vesiculobullous disorder? a. Spitz sign b. Hesy-Re sign c. Fauchard sign d. Nikolsky sign ANS: D

A simple clinical maneuver such as the Nikolsky sign offers insight into the plausibility of a vesiculobullous disorder. The Nikolsky sign is characterized by blister formation or peeling of skin or mucosa when horizontal tangential pressure is applied to the skin or mucosa in patients with vesiculobullous disorders.

DIF: Comprehension REF: p. 282 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Which of the following is not one of the factors on which the management approach of

desquamative gingivitis should be based? a. The practitioner’s experience b. The patient’s experience c. The systemic impact of the disease d. The systemic complications of the medications ANS: B

The approach depends on the practitioner’s experience, the systemic impact of the disease, and the systemic complications of the medications.

DIF: Comprehension REF: p. 282 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

8. If a patient has been diagnosed with symptomatic lichen planus and tests positive for

superimposed candidiasis, what is the correct course of action? a. Antifungals b. Antivirals c. Antibacterials d. Antacids ANS: A

If a patient has been diagnosed with symptomatic lichen planus and tests positive for superimposed candidiasis, antifungals should be used. Refer to Figure 21.3 in the textbook.

DIF: Application REF: p. 282 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. If a patient has been diagnosed with symptomatic lichen planus and their prescribed

intralesional steroids have provided resolution for their intralesional steroids, what is the correct next course of action? a. Refer the patient to an ophthalmologist. b. Refer the patient to a dermatologist. c. Wean off the steroids and monitor the patient. d. Continue taking the steroids long-term.

ANS: C

If a patient has been diagnosed with symptomatic lichen planus and their prescribed intralesional steroids have provided resolution for their intralesional steroids, the patient should be weaned off the medication and monitored. Refer to Figure 21.3 in the textbook.

DIF: Application REF: TpE . 2S8T 2 BANKSELLER.COM TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which of the following terms applies to several cutaneous, immune-mediated, subepithelial

bullous diseases that are characterized by a separation of the basement membrane zone? a. Bullosa b. Erythematosus c. Lichen planus d. Pemphigoid ANS: D

The term pemphigoid applies to several cutaneous, immune-mediated, subepithelial bullous diseases that are characterized by a separation of the basement membrane zone, including bullous pemphigoid, mucous membrane pemphigoid (MMP), and pemphigoid (herpes) gestations.

DIF: Comprehension REF: p. 284 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Which of the following is a chronic vesiculobullous autoimmune disorder of unknown cause

that predominantly affects women during the fifth decade of life? a. Lichen planus b. Pemphigoid c. Mucous membrane pemphigoid d. Pemphigus vulgaris

ANS: C

Mucous membrane pemphigoid is a chronic vesiculobullous autoimmune disorder of unknown cause that predominantly affects women during the fifth decade of life.

DIF: Recall REF: p. 284 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. Which of the following is a mucocutaneous disorder that classically manifests with bilateral,

white striae on the buccal mucosae? a. Mucous membrane pemphigoid b. Lichen planus c. Pemphigoid d. Pemphigus vulgaris ANS: B

Lichen planus is a mucocutaneous disorder that classically manifests with bilateral, white striae on the buccal mucosae.

DIF: Recall REF: p. 284 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Which of the following is a chronic condition in young adults between the ages of 20 and 30

years, with a slight predilection for men? a. Dermatitis herpetiformis b. Chronic ulcerative stomatitis c. Linear IgA dermatosis d. Subacute cutaneous lupTuE sS erTyB thA em NaKtoSsEusLLER.COM ANS: A

Dermatitis herpetiformis is a chronic condition that usually develops in young adults between the ages of 20 and 30 years, and it has a slight predilection for men. Evidence indicates that dermatitis herpetiformis is a cutaneous manifestation of celiac disease.

DIF: Recall REF: p. 286 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Chronic ulcerative stomatitis typically manifests with chronic oral ulcerations and has a

predilection for which of the following groups? a. Men during their third decade of life b. Men during their fourth decade of life c. Women during their third decade of life d. Women during their fourth decade of life ANS: D

Chronic ulcerative stomatitis, which was first reported in 1990, manifests with chronic oral ulcerations and has a predilection for women during their fourth decade of life.

DIF: Recall REF: p. 286 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

15. Which of the following is the correct term for eruptions in the oral cavity that result from

sensitivity to drugs that have been taken orally or parenterally? a. Medical stomatitis b. Contact stomatitis c. Stomatitis medicamentosa d. Stomatitis medicamentality ANS: C

Eruptions in the oral cavity that result from sensitivity to drugs that have been taken orally or parenterally are called stomatitis medicamentosa.

DIF: Recall REF: p. 286 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Most drug eruptions in the oral cavity are a. lethal b. multiform c. short term d. fungal

.

ANS: B

Most drug eruptions in the oral cavity are multiform.

DIF: Comprehension REF: p. 286 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. What is the next step after diagnosing a patient with pemphigus vulgaris? a. Refer patient to a dermT atE oS loT giB stA . NKSELLER.COM b. Refer patient to an ophthalmologist. c. Prescribe antifungals. d. Prescribe topical steroids.

ANS: A

After diagnosing a patient with pemphigus vulgaris, a referral to a dermatologist should occur.

Refer to Figure 21.5 in the textbook.

DIF: Application REF: p. 284 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. When a patient has severe cicatricial pemphigoid, which of the following is the first two

options for treatment? a. Methotrexate or azathioprine b. Prednisone or dapsone c. Cyclosporine or dapsone d. Cyclophosphamide or methotrexate ANS: B

When a patient has severe cicatricial pemphigoid, prednisone or dapsone is the first two options for treatment. Refer to Figure 21.4 in the textbook.

DIF: Comprehension REF: p. 284 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

19. What is the mortality rate for pemphigus vulgaris? a. 1% b. 10% c. 25% d. 50% ANS: B

Pemphigus vulgaris is a potentially lethal chronic condition with a 10% mortality rate and a worldwide annual incidence of 0.1 to 0.5 cases per 100,000 individuals.

DIF: Recall REF: p. 285 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. Which of the following is an uncommon mucocutaneous disorder with a predilection for

women? a. Primary herpetic gingivostomatitis b. Lichen planus c. Linear immunoglobulin disease d. Subacute cutaneous lupus erythematosus ANS: C

Linear IgA dermatosis (LAD) is an uncommon mucocutaneous disorder with a predilection for women. The etiopathogenic aspects of LAD are not fully understood, although drug-induced LAD triggered by angiotensin-converting enzyme inhibitors has been reported.

DIF: Recall REF: p. 286 TOP: NBDHE; 3.3.2 ProvisT ioE nS ofTinBsA truNcK tioSnEfoLrLpE reR ve. ntC ioO nM and management of oral diseases

Chapter 22: The Periodontal Pocket and Associated Pathologies Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following is also known as a “pseudo-pocket?” a. Orthodontic pocket b. Periodontal pocket c. Gingival pocket d. Clinical pocket ANS: C

A gingival pocket is also called a “pseudo-pocket.”

DIF: Recall REF: p. 289 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Which of the following is not one of the types of periodontal pockets? a. Suprabony b. Supracrestal c. Interbony d. Intrabony ANS: C

Periodontal pockets can be classified as suprabony (supracrestal or supra-alveolar) or intrabony (infrabony, subcrestal, or intraalveolar).

DIF: Recall REF: p. 289 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. Which of the following is not a clinical sign that suggests the presence of periodontal pockets? a. Bluish red thinned marginal gingiva b. Tooth mobility c. Localized pain d. Gingival bleeding and suppuration ANS: A

Clinical signs that suggest the presence of periodontal pockets include a bluish red thickened marginal gingiva, a bluish red vertical zone from the gingival margin to the alveolar mucosa, gingival bleeding and suppuration, tooth mobility, diastema formation, and symptoms such as localized pain or pain “deep in the bone.”

DIF: Comprehension REF: p. 289 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. It is often difficult to differentiate between a deep normal sulcus and a shallow periodontal

pocket. What is the distinct characteristic that can distinguish between the two? a. Pathologic changes in the gingiva b. Color of the area c. The consistency of saliva d. Depth of the area

ANS: A

On the basis of depth alone, it is sometimes difficult to differentiate between a deep normal sulcus and a shallow periodontal pocket. In such borderline cases, pathologic changes in the gingiva distinguish the two conditions.

DIF: Comprehension REF: p. 290 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Which of the following are proteins secreted by cells that interact with other cells and

eventually lead to a specific cellular response? a. Amino acids b. Cytokines c. Collagen d. T-cells ANS: B

Cytokines are proteins secreted by cells that interact with other cells and eventually lead to a specific cellular response.

DIF: Comprehension REF: p. 291 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. What causes the discoloration of the gingival wall of a periodontal pocket? a. Destruction of gingival fibers b. Blood pressure c. The lack of air flow d. Circulatory stagnation ANS: D

The discoloration (various degrees of bluish red discoloration) is caused by circulatory stagnation.

DIF: Comprehension REF: p. 291 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Where do the most severe degenerative changes in the periodontal pocket occur? a. Along the lateral wall b. Surface level c. At the deepest point of the fissure d. Where the majority of the damage is located ANS: A

The most severe degenerative changes in the periodontal pocket occur along the lateral wall.

DIF: Comprehension REF: p. 292 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. Which of the following is not a feature of junctional epithelium? a. It acts as a physical barrier against plaque bacteria. b. It has a lower rate of cellular proliferation and turnover. c. It exhibits higher permeability to cells, gingival fluid, and host-defense molecules

to flow through. d. It is attached to the tooth by internal basal lamina.

ANS: B

Junctional epithelium, acts a physical barrier against plaque bacteria, is stratified squamous nonkeratinized in nature, is attached to the tooth by internal basal lamina, is attached to the connective tissue by external basal lamina, exhibits higher permeability to cells, gingival fluid, and host-defense molecules to flow through, and has a higher rate of cellular proliferation and turnover.

DIF: Recall REF: p. 293 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following is an ultrafiltrate of blood, present in the gingival sulcus space, that

contains several molecular components such as bacterial degradation products, host tissue degradation products, and inflammatory mediators? a. Periodontal fluid b. Saliva c. Gingival crevicular fluid d. Gingival filtrate ANS: C

Gingival crevicular fluid (GCF) is an ultrafiltrate of blood, present in the gingival sulcus space, that contains several molecular components such as bacterial degradation products, host tissue degradation products, and inflammatory mediators.

DIF: Recall REF: p. 296 TOP: NBDHE; 3.3.2 ProvisT ioE nS ofTinBsA truNcK tioSnEfoLrLpE reR ve. ntC ioO nM and management of oral diseases 10. As a periodontal pocket deepens,

fibers embedded in the cementum are destroyed, and becomes exposed to the oral environment. a. Oral; gingiva b. Oral; the pocket c. Collagen; the pocket d. Collagen; cementum ANS: D

As the pocket deepens, collagen fibers embedded in the cementum are destroyed, and cementum becomes exposed to the oral environment.

DIF: Comprehension REF: p. 297 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Which of the following is the dominant microorganism in root surface caries? a. Actinomyces viscosus b. Actinomyces naeslundii c. Streptococcus mutans d. Streptococcus salivarius ANS: A

The dominant microorganism in root surface caries is A. viscosus.

DIF: Recall REF: p. 297 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. Which of the following is not a zone that can be found in the bottom of a periodontal pocket? a. Cementum covered by calculus b. Zone of unattached plaque c. Zone of attachment of the junctional epithelium to the gumline d. Zone of semidestroyed connective tissue fibers ANS: C

The following zones can be found in the bottom of a periodontal pocket: cementum covered by calculus, attached plaque, the zone of unattached plaque, the zone of attachment of the junctional epithelium to the tooth, and the zone of semidestroyed connective tissue fibers.

DIF: Comprehension REF: p. 298 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Periodontal pockets may go through periods of exacerbation and dormancy as a result of

episodic bursts of activity followed by periods of remission. What is the term for these periods? a. Periods of dormancy b. Periods of sleepiness c. Periods of quiescence d. Periods of calm ANS: C

These periods are called periods of quiescence and they are characterized by a reduced inflammatory response andTlE itS tleToBrAnN oK loSssEoLf L boEnRe.aC ndOcMonnective tissue attachment.

DIF: Recall REF: p. 298 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Periodontal destruction does not most often occur in all parts of the mouth at the same time;

rather, it occurs on a few teeth at a time or even only on some aspects of some teeth at any given time. What is the term for this? a. Spread-out sites b. Site attachment c. Onsite exposure d. Site specificity ANS: D

Periodontal destruction does not most often occur in all parts of the mouth at the same time; rather, it occurs on a few teeth at a time or even only on some aspects of some teeth at any given time. This is referred to as the site specificity of periodontal disease.

DIF: Recall REF: p. 298 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. The severity of the attachment loss in pocket formation is generally but not always correlated

with the a. color b. location

of the pocket.

c. depth d. age ANS: C

The severity of the attachment loss in pocket formation is generally but not always correlated with the depth of the pocket.

DIF: Comprehension REF: p. 298 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. The distance from attached plaque to bone is never less than a. b. c. d.

mm and never more than

mm.

0.1; 2.0 0.5; 2.7 0.7; 3.1 1.0; 3.4

ANS: B

The distance from attached plaque to bone is never less than 0.5 mm and never more than 2.7 mm.

DIF: Recall REF: p. 299 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Which of the following is another term for a periodontal abscess? a. Lateral abscess b. Dental abscess c. Medial abscess d. Orthodontic abscess ANS: A

A periodontal abscess is a localized purulent inflammation in the periodontal tissues and is also known as a lateral abscess or a parietal abscess.

DIF: Recall REF: p. 299 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. The base of this time of periodontal pocket is coronal to the level of the alveolar bone. a. Intrabony b. Interbony c. Suprabony d. Superbony ANS: C

The base of a suprabony pocket is coronal to the level of the alveolar bone.

DIF: Comprehension REF: p. 300 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. A periodontal cyst is usually a. fatal b. related to gender

.

c. asymptomatic d. indented ANS: C

A periodontal cyst is usually asymptomatic, without grossly detectable changes, but it may present as a localized, tender swelling.

DIF: Recall REF: p. 302 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. The pattern of bone destruction on this type of periodontal pocket is vertical. a. Suprabony b. Interbony c. Intrabony d. Superbony ANS: C

The pattern of bone destruction in an intrabony pocket is vertical.

DIF: Recall REF: p. 300 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 23: Bone Loss and Patterns of Bone Destruction Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following is a true statement? a. Gingivitis is always preceded by periodontitis, but not all periodontitis progresses

to gingivitis. b. Periodontitis is always preceded by gingivitis, and all gingivitis progresses to

periodontitis. c. Periodontitis is always preceded by gingivitis, but not all gingivitis progresses to periodontitis. d. Gingivitis is always preceded by periodontitis, and all periodontitis progresses to gingivitis.

ANS: C

Periodontitis is always preceded by gingivitis, but not all gingivitis progresses to periodontitis.

DIF: Comprehension REF: p. 303 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. In advanced stages of periodontitis, the number of motile organisms and spirochetes a. b. c. d.

and the number of coccoid and straight rods increases; decreases increases; increases decreases, increases decreases, decreases

.

ANS: A

In advanced stages of periodontitis, the number of motile organisms and spirochetes increases, whereas the number of coccoid and straight rods decreases.

DIF: Comprehension REF: p. 303 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. Page and Schroeder postulated a range of about

to

mm in which bacterial biofilm

can induce loss of bone. a. 0.5; 1.5 b. 1.0; 2.0 c. 1.5; 2.5 d. 2.0; 3.0 ANS: C

Page and Schroeder, on the basis of Waerhaug’s measurements made on human autopsy specimens, postulated a range of about 1.5 to 2.5 mm in which bacterial biofilm can induce loss of bone. Beyond 2.5 mm, there is little or no effect; interproximal angular defects can appear only in spaces that are wider than 2.5 mm, because narrowed spaces would end up with horizontal bone loss.

DIF: Recall REF: p. 306 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

4. Large defects that greatly exceed a distance of

mm from the tooth surface may be

caused by the presence of bacteria in the tissues. a. 1.5 b. 2.0 c. 2.5 d. 3.0 ANS: C

Large defects that greatly exceed a distance of 2.5 mm from the tooth surface (as described in aggressive types of periodontitis) may be caused by the presence of bacteria in the tissues.

DIF: Recall REF: p. 307 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. In a study of Sri Lanken tea laborers with no oral hygiene and no dental care, Loe and

colleagues found the rate of bone loss averages about mm per year for facial surfaces and about mm per year for proximal surfaces when periodontal disease was allowed to progress untreated. a. 0.1; 0.2 b. 0.2; 0.3 c. 0.3; 0.4 d. 0.4; 0.5 ANS: B

In a study of Sri Lanken tea laborers with no oral hygiene and no dental care, Loe and colleagues found the rate of bone loss averages about 0.2 mm per year for facial surfaces and LhEeR about 0.3 mm per year for T prEoS xiT mBalAsN uK rfaScE esLw n. peCrO ioM dontal disease was allowed to progress untreated.

DIF: Recall REF: p. 307 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Periodontal destruction often occurs in a(n) a. episodic, intermittent b. flowing, continuous c. fast-progressing, traumatic d. predictable, ever-present

manner.

ANS: A

Periodontal destruction often occurs in an episodic, intermittent manner, with periods of inactivity or quiescent that alternate with destructive periods that result in the loss of collagen and alveolar bone and the deepening of the periodontal pocket.

DIF: Comprehension REF: p. 307 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. The factors involved in bone destruction in periodontal disease are

mediated. a. viral b. fungal c. parasitic

and host

d. bacterial ANS: D

The factors involved in bone destruction in periodontal disease are bacterial and host mediated.

DIF: Recall REF: p. 307 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. In the absence of inflammation, the localized bone loss caused by trauma from occlusion is a. b. c. d.

if the offending forces are removed. irreversible reversible continual intermittent

ANS: B

In the absence of inflammation, the localized bone loss caused by trauma from occlusion is reversible (can be repaired) if the offending forces are removed.

DIF: Recall REF: p. 307 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following is not an anatomic feature that substantially affects the

bone-destructive pattern of periodontal disease? a. Alignment of the teeth b. Root and trunk anatomy c. Elongation of tooth surT faEcS e TBANKSELLER.COM d. Proximity with another tooth surface ANS: C

The anatomic features that substantially affect the bone-destructive pattern of periodontal disease include the following: thickness, width, and crestal angulation of the interdental septa, the thickness of the facial and lingual alveolar plates, the presence of fenestrations and dehiscences, the alignment of the teeth, the root and root trunk anatomy, the root position within the alveolar process, and the proximity with another tooth surface.

DIF: Comprehension REF: p. 308 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which of the following terms can be defined as “outgrowths of bone of varied size and

shape?” a. Endostoses b. Exostoses c. Bone formation d. Collagen ANS: B

Exostoses are outgrowths of bone of varied size and shape.

DIF: Recall REF: p. 308 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

11. Why can angular osseous defect not form in thin radicular, facial, or lingual alveolar bone? a. These areas have little or no cancellous bone between the outer and inner cortical

layers. b. These areas are too thick to allow anything to form. c. These areas have far too much bacteria buildup to allow any defect to form. d. These areas often have an overgrowth of cancellous bone, which does not allow

the space for anything else to form.

ANS: A

Angular osseous defects—as often seen in the interdental areas of the posterior dentition— cannot form in the thin radicular, facial, or lingual alveolar bone. These areas havelittle or no cancellous bone between the outer and inner cortical layers. In these anatomic areas, the entire crest of the plate is destroyed, and the height of the bone is reduced in a horizontal fashion.

DIF: Comprehension REF: p. 308 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. What is the term used when bone formation occurs within the jaw? a. Central buttressing bone formation b. Medial buttressing bone formation c. Peripheral buttressing bone formation d. Automatic buttressing bone formation ANS: A

When bone formation occurs within the jaw, it is termed central buttressing bone formation.

DIF: Recall REF: p. 309 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. When bone formation occurs on the external surface, what is the term used? a. External buttressing bone formation b. Central buttressing bone formation c. Peripheral buttressing bone formation d. Surface level buttressing bone formation ANS: C

When bone formation occurs on the external surface, it is referred to as peripheral buttressing bone formation.

DIF: Recall REF: p. 309 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Rapid localized periodontitis usually results in attachment and bone loss around the

and a. b. c. d.

, particularly in cases where the disease is observed in teenagers. incisors; first molars incisors; premolars cuspids; first molars premolars; cuspids

ANS: A

Rapid localized periodontitis usually results in attachment and bone loss around the incisors and first molars, particularly in cases where the disease is observed in teenagers.

DIF: Recall REF: p. 309 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. What is the most common pattern of bone loss in periodontal disease? a. Vertical b. Horizontal c. Widespread d. Lateral ANS: B

Horizontal bone loss is the most common pattern of bone loss in periodontal disease.

DIF: Comprehension REF: p. 309 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Goldman and Cohen classified angular defects on the basis of what? a. The size of the defects b. The number of osseous walls c. How widespread the defects are? d. The shape of the defects ANS: B

Goldman and Cohen classified angular defects on the basis of the number of osseous walls.

Angular defects may have one, two, or three walls.

DIF: Recall REF: p. 310 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Which of the following terms can be defined as “a specific type of 2-wall defect that present

as concavities in the crest of the interdental bone that is confined within the facial and lingual walls”? a. Osseous craters b. Ledges c. Bulbous bone contours d. Lingual crests ANS: A

Osseous craters are a specific type of 2-wall defect; they present as concavities in the crest of the interdental bone that is confined within the facial and lingual walls.

DIF: Recall REF: p. 312 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. Which of the following terms can be defined as “plateau-like margins that are caused by the

resorption of thickened bony plates”? a. Osseous craters b. Ledges c. Bulbous bone contours d. Lingual crests

ANS: B

Ledges are plateau-like bone margins that are caused by the resorption of thickened bony plates.

DIF: Recall REF: p. 312 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. Which grade of furcation involvement involves incipient bone loss? a. Grade I b. Grade II c. Grade III d. Grade IV ANS: A

Furcation involvements have been classified as grades I through IV according to the amount of tissue destruction. Grade I involves incipient bone loss; grave II involves partial bone loss; and grade III involves total bone loss with a through-and-through opening of the furcation, but the opening of the furcation is not visible due to the gingiva, which covers the orifice. Grade IV is similar to grade III but includes gingival recession that exposes the furcation to view.

DIF: Recall REF: p. 313 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. What is another term for “reversed architecture”? a. Positive architecture b. Normal architecture c. Negative architecture d. Abnormal architecture ANS: C

Reverse (or negative) alveolar bone architecture is the result of a loss of interdental bone, without a concomitant loss of radicular bone, thereby reversing the normal (or positive) architecture.

DIF: Recall REF: p. 312 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 24: Masticatory System Disorders That Influence the Periodontium Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following is not a part of the masticatory system? a. Masticatory muscles b. Teeth in occlusion c. Lips d. Temporomandibular joints (TMJs) ANS: C

The masticatory system consists of the temporomandibular joints (TMJs), masticatory muscles, the teeth in occlusion, and the neurologic and vascular supplies that support all of these structures.

DIF: Recall REF: p. 315 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. The temporomandibular joint is capable of providing which two types of movements? a. Hinging and gliding b. Gliding and ball-and-socket c. Rotational and hinging d. Hinging and ball-and-socket ANS: A

The TMJ is capable of proT viE diS nT gB boAthNhKiS ngEinLgL(E roRta.tiC onO)Mand gliding (translation) movements and is able to resist incredible forces of mastication.

DIF: Comprehension REF: p. 315 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. The understanding of mandibular movement beings with an initial reference point for each

condyle, which is usually referred to as a. condyle relation b. central relation c. centric relation d. centrifugal relation

.

ANS: C

The understanding of mandibular movement begins with an initial reference point for each condyle, which is usually referred to as centric relation.

DIF: Recall REF: p. 315 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. What is the clinical term for grinding of the teeth? a. Xerostomia b. Sialorrhea c. Bruxism d. Clenching

ANS: C

Bruxism means “grinding of the teeth.”

DIF: Recall REF: p. 315 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. What is the term used when a person holds the teeth firmly together with significant force? a. Xerostomia b. Sialorrhea c. Bruxism d. Clenching ANS: D

Clenching is when a person holds the teeth firmly together with significant force.

DIF: Recall REF: p. 315 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Which of the following can be classified as an intracranial pain disorder? a. Neoplasm b. Migraine c. Carotidynia d. Temporomandibular joint pain ANS: A

A neoplasm is a type of intracranial pain disorder.

DIF: Recall REF: TpE . 3S1T 6 BANKSELLER.COM TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Which of the following can be classified as a primary headache disorder? a. Edema b. Hemorrhage c. Posttraumatic neuralgia d. Paroxysmal hemicrania ANS: D

Paroxysmal hemicrania is a type of primary headache disorder.

DIF: Recall REF: p. 316 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. Which of the following can be classified as a paroxysmal neuralgia? a. Superior laryngeal neuralgia b. Posttraumatic neuralgia c. Postsurgical neuralgia d. Neuralgia-inducing cavitational osteonecrosis ANS: A

Superior laryngeal neuralgia is a type of paroxysmal neuralgia.

DIF: Recall

REF: p. 316

TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following is a type of intraoral pain disorder? a. Dental pulp pain b. Masticatory muscle pain c. Temporomandibular joint pain d. Salivary gland pain ANS: A

Dental pulp pain is a type of intraoral pain disorder.

DIF: Recall REF: p. 316 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which of the following is not considered an associated structure related to orofacial pain? a. Ears b. Lungs c. Eyes d. Neck ANS: B

Ears, eyes, nose, paranasal sinuses, throat, lymph nodes, salivary glands, and the neck are all considered associated structures related to orofacial pain.

DIF: Recall REF: p. 316 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Which of the following can beScTlaBssAifNieKdSaE s aLcLoEnR tin.uCoO usMpain disorder?

TE a. Trigeminal nerve pain b. Hemorrhage c. Peripheral neuritis d. Somatoform disorders ANS: C

Peripheral neuritis is a type of continuous pain disorder.

DIF: Recall REF: p. 316 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. Pain associated with TMJ dysfunction is most frequently a. skeletal b. muscular c. bacterial d. cardiovascular

in origin.

ANS: B

Pain associated with TMJ dysfunction is most frequently muscular in origin.

DIF: Comprehension REF: p. 316 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Sources of dental or periodontal pain should be identified by clinical, radiographic, and

information.

a. b. c. d.

blood-related hypothetical historic sleep-related

ANS: C

Sources of dental or periodontal pain should be identified by clinical, radiographic, and historic information.

DIF: Comprehension REF: p. 316 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Headache is perceived primarily within the a. trigeminal b. cranial c. cervical d. neural

nerve pathways.

ANS: A

Headache is perceived primarily within the trigeminal nerve pathways, although other cranial and cervical nerves may offer painful sensory input.

DIF: Comprehension REF: p. 317 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. What forms the temporomandibular joint? a. The articulation of the mandible and the temporal bone of the cranium b. The upper jawbone andTtE hS eT teB mA poNrK alSbE onLeLoE fR th. eC crOaM nium c. The articulation of the mandible and the occipital bone of the cranium d. The upper jawbone and the occipital bone of the cranium ANS: A

The temporomandibular joint is formed by the articulation of the mandible and the temporal bone of the cranium.

DIF: Comprehension REF: p. 315 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Which of the following can be classified as an Axis II mental disorder? a. Peripheral neuritis b. Somatoform disorders c. Migraines d. Sympathetically maintained pain ANS: B

Somatoform disorders are classified as Axis II mental disorders.

DIF: Recall REF: p. 316 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Which of the following is not a primary headache disorder? a. Hematoma

b. Migraine c. Cluster headache d. Tension-type headache ANS: A

Migraines, migraine variants, cluster headaches, paroxysmal hemicrania, cranial arteritis, carotidynia, and tension-type headaches are all considered primary headache disorders.

DIF: Recall REF: p. 316 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. Which of the following is another term for “primary headache disorders”? a. Somatoform disorders b. Neurovascular disorders c. Intraoral pain disorders d. Neurogenic pain disorders ANS: B

Primary headache disorders are also called “neurovascular disorders.”

DIF: Recall REF: p. 316 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. During what stage of sleep does sleep bruxism primarily appear? a. Stages 1 and 2 b. Stages 2 and 3 c. Stage 3 and REM sleep d. Stage 1 and REM sleep ANS: A

Sleep bruxism may include both tooth grinding and clenching and it appears to occur primarily during Stages 1 and 2 (i.e., non-rapid eye movement) sleep.

DIF: Comprehension REF: p. 316 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. Discomfort associated with masticatory system disorders falls under the larger umbrella of

what type of pain? a. Chronic b. Neuropathic c. Orofacial d. Phantom ANS: C

Discomfort associated with masticatory system disorders falls under the larger umbrella of orofacial pain.

DIF: Recall REF: p. 316 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 25: Chronic Periodontitis Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. What is the most prevalent form of periodontitis? a. Acute periodontitis b. Mild periodontitis c. Chronic periodontitis d. Localized periodontitis ANS: C

Chronic periodontitis is the most prevalent form of periodontitis.

DIF: Recall REF: p. 318 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Periodontitis affects approximately what percentage of the world’s population? a. 5% to 9.5% b. 10.5% to 12% c. 15% to 19.5% d. 20.5% to 23% ANS: B

Periodontitis is a highly prevalent progressing disease, and it affects approximately 10.5% to 12% of the world’s population.

DIF: Recall REF: p. 318 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. Which of the following is not a characteristic clinical finding in patients with untreated

chronic periodontitis? a. Decreased tooth mobility b. Supragingival and subgingival plaque c. Tooth loss d. Bleeding on probing ANS: A

Characteristic clinical findings in patients with untreated chronic periodontitis include the following symptoms: supragingival and subgingival plaque (and calculus), gingival swelling, redness, and loss of gingival stippling, pocket formation, altered gingival margins, bone loss, bleeding on probing, root furcation involvement, tooth loss, increased tooth mobility, and change in tooth position.

DIF: Comprehension REF: p. 318 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Which of the following types of periodontitis means that 30% or more of the teeth show

attachment and bone loss? a. Localized chronic periodontitis b. Acute chronic periodontitis

c. Generalized chronic periodontitis d. Widespread chronic periodontitis ANS: C

Generalized chronic periodontitis affects 30% or more of the teeth.

DIF: Recall REF: p. 322 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Peri-implant mucositis is the dental implant counterpart of what kind of dental issue? a. Plaque-induced gingivitis b. Chronic periodontitis c. Localized periodontitis d. Bleeding on probing ANS: A

Peri-implant mucositis is the dental implant counterpart of plaque-induced gingivitis.

DIF: Comprehension REF: p. 322 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Which of the following is true for plaque-induced gingivitis? a. There is inflammation of the periodontal apparatus with attachment and bone loss. b. There is inflammation of the gingiva without attachment or bone loss. c. All patients with plaque-induced gingivitis will experience chronic periodontitis. d. Plaque-induced gingivitis is irreversible.

ANS: B

EaRti.onCO With plaque-induced gingiT viEtiS s,TthBeA reNiK s iSnE flaLmLm ofMthe gingiva without attachment or bone loss, and the condition can be completely reversed with optimal oral hygiene.

DIF: Comprehension REF: p. 322 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Which of the following stages of periodontitis is associated with a clinical attachment loss of

3 to 4 mm? a. Mild chronic periodontitis b. Moderate chronic periodontitis c. Severe chronic periodontitis d. Acute chronic periodontitis ANS: B

Moderate chronic periodontitis is associated with a clinical attachment loss of 3 to 4 mm.

DIF: Recall REF: p. 322 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. Which of the following statements about chronic periodontitis is not true? a. Chronic periodontitis may develop at any time in life. b. Chronic periodontitis is commonly a slowly progressing complex disorder without

a pain experience. c. Chronic periodontitis is considered to be one of the most common chronic diseases

in humans. d. Women are far more likely to have chronic periodontitis.

ANS: C

Chronic periodontitis may develop at any time in life. Chronic periodontitis is commonly a slowly progressing complex disorder without a pain experience and is considered to be one of the most common chronic diseases in humans. The prevalence of the disease increases with age equally in both genders.

DIF: Comprehension REF: p. 324 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following is considered to be the most important plaque-retentive factor because

of its ability to retain and harbor plaque bacteria on its rough surface as well as inside? a. Calculus b. Gums c. Enamel d. Saliva ANS: A

Calculus is considered the most important plaque-retentive factor because of its ability to retain and harbor plaque bacteria on its rough surface as well as inside.

DIF: Recall REF: p. 326 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which of the following is not a systemic disorder sometimes associated with chronic

periodontitis? a. Ehlers-Danlos syndrome b. Cohen syndrome c. Crohn’s disease d. Kindler syndrome ANS: C

Periodontitis can be associated with systemic disorders such as Haim-Munk syndrome, Papillon-Lefevre syndrome, Ehlers-Danlos syndrome, Kindler syndrome, and Cohen syndrome.

DIF: Recall REF: p. 326 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. What is the term used when a person holds their teeth firmly together with significant force? a. Bruxism b. Xerostomia c. Mastication d. Clenching ANS: D

Clenching is when a person holds the teeth firmly together with significant force.

DIF: Recall REF: p. 315 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

12. Chronic periodontitis occurs most frequently in what population? a. Toddlers b. School-aged children c. Teenagers d. Adults ANS: D

Chronic periodontitis occurs most frequently in adults but it may also be diagnosed in children and adolescents when associated with chronic plaque and calculus accumulation.

DIF: Recall REF: p. 318 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. What type of chronic periodontitis occurs when less than 30% of teeth show attachment and

bone loss? a. Generalized b. Acute c. Localized d. Specific ANS: C

Localized chronic periodontitis is when less than 30% of teeth show attachment and bone loss.

DIF: Comprehension REF: p. 322 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Which of the following is no ueBfA orNcKhS roEnL icLpE erR io.dC onOtiMtis?

TEt StrT a. The attachment loss is irreversible. b. All patients with chronic periodontitis must have experienced prior gingivitis. c. Inflammation of the gingiva occurs without attachment/bone loss. d. The dental implant counterpart is peri-implantitis.

ANS: C

With chronic periodontitis, attachment loss is irreversible, all patients with chronic periodontitis must have experienced prior gingivitis, the inflammation of the periodontal apparatus occurs with attachment/bone loss, and the dental implant counterpart of periodontitis is peri-implantitis.

DIF: Comprehension REF: p. 322 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Vertical bone loss is associated with a. intrabony b. interbony c. suprabony d. superbony

pocket formation.

ANS: A

Vertical bone loss is associated with intrabony pocket formation.

DIF: Recall

REF: p. 322

TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Horizontal bone loss is associated with a. intrabony b. interbony c. suprabony d. superbony

pocket formation.

ANS: C

Horizontal bone loss is associated with suprabony (supraalveolar) pockets.

DIF: Recall REF: p. 322 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. The severity of chronic periodontitis can be described in how many stages? a. 2 b. 3 c. 4 d. 5 ANS: C

Relative to the degree of attachment and bone loss, disease severity can be described in four stages as initial (Stage I), moderate (Stage II), severe with potential for further tooth loss (Stage III), and severe with potential for loss of dentition (Stage IV).

DIF: Comprehension REF: p. 322 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. As a result of gingival recession, patients with chronic periodontitis may notice black a. b. c. d.

between teeth. polka dots triangles squares stripes

ANS: B

As a result of gingival recession, patients may notice black triangles between teeth or tooth sensitivity in response to temperature changes.

DIF: Comprehension REF: p. 323 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. In general, what percentage of patients aged 65 years or older show signs of mild-to-moderate

periodontal destruction? a. 10% b. 33% c. 50% d. 75% ANS: C

In general, 40% of patients aged 50 years or older and almost 50% of patients aged 65 years or older show signs of mild-to-moderate periodontal destruction.

DIF: Recall REF: p. 324 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. Which of the following is not a feature found in smokers (as compared to nonsmokers)? a. More recessions b. Increased tooth loss c. Less recessions d. Fewer signs of gingivitis ANS: D

Compared to nonsmokers, the following features are found in smokers: increased periodontal pocket depth with more than 3 mm, increased attachment loss, more recessions, increased loss of alveolar bone, increased tooth loss, fewer signs of gingivitis (less bleeding upon probing), and a greater incidence of furcation involvement.

DIF: Comprehension REF: p. 328 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 26: Aggressive Periodontitis (Periodontitis Grade C) Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following is not one of the primary features of aggressive periodontitis? a. Rapid loss of attachment and tooth-supporting bone b. Subject is otherwise healthy c. Subject has systemic diseases that contribute to the problem d. Familiar aggregation ANS: C

Periodontitis Grade C (aggressive periodontitis) is characterized by three primary features: rapid loss of attachment and tooth-supporting bone, subject is otherwise healthy (i.e., does not have any systemic disease or condition that could be responsible for the present periodontitis), and familiar aggregation.

DIF: Recall REF: p. 329 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. The colonization of which of the following is a secondary feature of aggressive periodontitis? a. Streptococcus pneumoniae b. Aggregatibacter actinomycetemcomitans c. Moraxella catarrhalis d. Streptoccous mutans ANS: B

Strong colonization by A. actinomycetemcomitans is a secondary feature of aggressive periodontitis.

DIF: Recall REF: p. 329 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. Which of the following is a feature of aggressive periodontitis? a. Rapid rate of progression b. Slow rate of progression c. Often in older patients d. Clinical inflammation signs are commensurate with etiologic factors ANS: A

Aggressive periodontitis has a rapid rate of progression.

DIF: Comprehension REF: p. 329 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Which of the following is not a diagnostic criterion for aggressive periodontitis? a. Typical familiar aggregation b. Often minimal presence of etiologic factors c. Often seen in young patients but can be found in all age-groups d. Clinical inflammation signs are commensurate with etiologic factors

ANS: D

Aggressive periodontitis has a rapid rate of progression, a typical familiar aggregation, often minimal presence of etiologic factors, is often seen in young pages but can be found in all age-groups, and is sometimes lacking in clinical inflammation signs (especially with localized aggressive periodontitis).

DIF: Comprehension REF: p. 330 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Which subgroup of aggressive periodontitis is the one that is characterized by the highest

severity and extent of disease (Stage III and Stage IV)? a. Generalized aggressive periodontitis b. Acute aggressive periodontitis c. Localized aggressive periodontitis d. Widespread aggressive periodontitis ANS: A

Generalized aggressive periodontitis (GAP) is the subgroup of periodontal disease characterized by the highest severity and extend of disease, Stage III and IV, but also by its large heterogeneity.

DIF: Comprehension REF: p. 330 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. What are the two subgroups of aggressive periodontitis? a. Mild and severe b. Generalized and localized c. Acute and chronic d. Painful and pain-free ANS: B

Aggressive periodontitis can be subclassified by extent and distribution into a localized and generalized form.

DIF: Comprehension REF: p. 330 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Why is it difficult to diagnose aggressive periodontitis in epidemiologic studies? a. All three primary criteria are difficult to assess reliably. b. There doesn’t exist enough evidence to prove that aggressive periodontitis is a

valid diagnosis. c. Aggressive periodontitis is extremely rare. d. The rate of progression of aggressive periodontitis is too drawn out.

ANS: A

The diagnosis of aggressive periodontitis in epidemiologic studies is difficult because all three primary criteria for the disease are difficult to assess reliably in the setting of such a study.

DIF: Comprehension REF: p. 331 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. What is the prevalence of aggressive periodontitis in subjects 35 years of age or younger?

a. 1% to 8% b. 1% to 15% c. 10% to 19% d. 10% to 22% ANS: B

The prevalence of aggressive periodontitis is approximately 1% to 15% in subjects 35 years of age or younger.

DIF: Recall REF: p. 333 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. In the subgingival biofilm, up to

bacterial species have been identified, some of which

were identified to be causative. a. 150 b. 300 c. 500 d. 700 ANS: D

Periodontitis is caused by specific microorganisms in a susceptible host. In the subgingival biofilm, up to 700 bacterial species have been identified, some of which were identified to be causative.

DIF: Recall REF: p. 335 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which type of periodontitiT sE prS im TaBriAlyNaKffSecEtsLfLirEstRm.oClaOrsMand incisor teeth in adolescents? a. Localized aggressive periodontitis b. Generalized aggressive periodontitis c. Minimally aggressive periodontitis d. Acutely aggressive periodontitis ANS: A

Localized aggressive periodontitis (LAP) primarily affects first molars and incisor teeth in adolescents with deep pockets and advanced bone loss.

DIF: Recall REF: p. 336 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. What type of therapy appears to benefit patients with aggressive periodontitis? a. Antibacterial therapy b. Antifungal therapy c. Antiviral therapy d. Anti-infective therapy ANS: D

Anti-infective therapy in patients with aggressive periodontitis appears to benefit strongly from the adjunctive use of systemic antibiotics.

DIF: Recall REF: p. 336 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

12. Which of the following is an inflammatory condition of dental implants with parallels to

periodontal disease? a. Peri-implantitis b. Implantitis c. Oral implantitis d. Inflammatory implantitis ANS: A

Peri-implantitis is an inflammatory condition of dental implants with parallels to periodontal disease for which no defined, predictable treatment protocols exist to date.

DIF: Comprehension REF: p. 337 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Which of the following terms can be defined as “the pathologic manifestation of the host

response against bacterial challenge that stems from a polymicrobial biofilm at the biofilm-gingival interface?” a. Gingivitis b. Susceptibility c. Periodontitis d. Diagnosis ANS: C

Periodontitis is the pathologic manifestation of the host response against bacterial challenge that stems from a polymicrobial biofilm at the biofilm-gingival interface. . 3S2T 9 BANKSELLER.COM DIF: Recall REF: TpE TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Which of the following types of periodontitis has an episodic nature of attachment loss? a. Generalized aggressive periodontitis b. Localized aggressive periodontitis c. Chronic periodontitis d. Juvenile periodontitis ANS: A

Generalized aggressive periodontitis has an episodic nature of attachment loss.

DIF: Comprehension REF: p. 330 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. In aggressive periodontitis, as compared with the more common chronic periodontitis, the loss

of attachment progresses a. slightly faster b. significantly faster c. slightly slower d. significantly slower

.

ANS: B

In aggressive periodontitis, as compared with the more common chronic periodontitis, the loss of attachment progresses significantly faster.

DIF: Comprehension REF: p. 330 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. How is familiar aggregation of aggressive periodontitis evaluated? a. By hypothesizing the familial history of the patient and interviewing the patient b. By medical/dental history questionnaires and blood work of the patient c. By medical/dental history questionnaires and interviewing the patient d. By hypothesizing the familial history of the patient and blood work of the patient ANS: C

Familiar aggregation of aggressive periodontitis cases is a feature that can be evaluated by medical/dental history questionnaires and interviewing the patient.

DIF: Comprehension REF: p. 329 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Which of the following is not a secondary feature that can be generally found in periodontitis

cases? a. Consistency of the low amounts of present etiologic factors and the observed pronounced tissue destruction b. Strong colonization by bacterium c. Immunologic differences that do not entail the diagnosis “periodontitis as a manifestation of systemic disease” d. Self-limiting disease ANS: A

Several secondary featuresTcE anSbTeBgAeN neKraSllE y LfoLuE ndRi.nCpO erMiodontitis cases that are not universally necessary to diagnose the disease entity: inconsistency of the low amounts of present etiologic factors and the observed pronounced tissue destruction, strong colonization

by A. actinomycetemcomitans (and, in some populations, Porphyromonas gingivalis), immunologic differences that to not entail the diagnosis “periodontitis as a manifestation of systemic disease,” and self-limiting disease.

DIF: Comprehension REF: p. 329 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. What is the age generalized aggressive periodontitis is most often diagnosed? a. Toddler-aged b. Adolescents c. Under 30 years of age d. Over 55 years of age ANS: C

Generalized aggressive periodontitis is most often diagnosed in patients who are under 30 years of age, but it can occur in older individuals as well.

DIF: Comprehension REF: p. 330 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. Which of the following statements is true regarding aggressive periodontitis? a. The rate of progression is rapid.

b. It is most often seen in older patients but can occur at any age. c. It is always seen in conjunction with a coordinating systemic disease. d. 75% of adults will encounter aggressive periodontitis at some point of their lives.

ANS: A

Aggressive periodontitis is rapidly progressing.

DIF: Recall REF: p. 330 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. Aggressive periodontitis is what Grade of periodontitis? a. Grade A b. Grade B c. Grade C d. Grade D ANS: C

Aggressive periodontitis is Periodontitis Grade C. DIF: Recall REF: p. 329 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 27: Necrotizing Ulcerative Periodontitis Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Necrotizing ulcerative periodontitis is often an extension of what other disease? a. Necrotizing ulcerative gingivitis b. Necrotizing ulcerative syndrome c. Generalized aggressive periodontitis d. Localized aggressive periodontitis ANS: A

Necrotizing ulcerative periodontitis is often an extension of necrotizing ulcerative gingivitis (NUG) into the periodontal structures, leading to the loss of periodontal attachment and bone.

DIF: Recall REF: p. 338 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. What is the distinguishing feature of necrotizing ulcerative periodontitis? a. Existence in conjunction with other systemic diseases b. Destructive progression of the disease c. Buildup of calculus and bacterial plaque biofilm on 50% of teeth d. Severe headache to accompany other features of the disease ANS: B

The distinguishing feature of NUP is the destructive progression of the disease, which include periodontal attachment andTbEoS nT e lBoA ssN . KSELLER.COM DIF: Recall REF: p. 338 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. With necrotizing ulcerative periodontitis, gingival margins are generally described as what? a. Bright red and bleed easily b. Dull pink and bleed easily c. Murky grey and bleed easily d. Dark red and bleed easily ANS: A

With NUP, gingival margins are bright red and bleed easily.

DIF: Comprehension REF: p. 338 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Gingival and periodontal lesions with distinctive features are frequently found in patients with a. b. c. d.

. family history of bad teeth seizure disorders type 1 and type 2 diabetes HIV infection and AIDS

ANS: D

Gingival and periodontal lesions with distinctive features are frequently found in patients with HIV infection and AIDS. DIF: Comprehension REF: p. 339 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Which of the following statement is true regarding the etiology of necrotizing ulcerative

periodontitis? a. The etiology of NUP has not been determined, although a mixed fusiform-spirochete bacterial flora appears to play a key role. b. The etiology of NUP has been determined, and a mixed fusiform-spirochete bacterial flora definitely plays a key role. c. The etiology of NUP has not been determined, although it seems fairly certain that there is a link that involves both genetics and susceptibility to infection. d. The etiology of NUP has been determined, and there is definitely a link that involves both genetics and susceptibility to infection.

ANS: A

The etiology of NUP has not been determined, although a mixed fusiform-spirochete bacterial flora appears to play a key role.

DIF: Recall REF: p. 339 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Which of the following do not increase the risk of necrotizing ulcerative periodontitis? a. Smoking b. Malnutrition c. Alcohol d. High plaque levels ANS: C

Smoking, malnutrition, and high plaque levels all increase the risk of NUG and must be changed to achieve successful treatment.

DIF: Comprehension REF: p. 339 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Which of the following statements is true regarding necrotizing ulcerative periodontitis? a. Patients with NUP are less likely to be immunocompromised. b. Bacterial pathogens are solely responsible for NUP. c. Predisposing “host” factors appear to be necessary. d. Malnutrition is not linked to necrotizing ulcerative periodontitis.

ANS: C

Patients with NUP are more likely to be immunocompromised. Although a mixed fusiform-spirochete bacterial infection appears to play a key role in the etiology of NUP, bacterial pathogens are not solely responsible. Predisposing “host” factors appear to be necessary. Factors that have been attributed to NUG include poor oral hygiene, preexisting periodontal disease, smoking, viral infections, immunocompromised status, psychosocial stress, and malnutrition.

DIF: Comprehension

REF: p. 339

TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. Patients with NUG have been found to have significantly more of which of the following? a. Positive life events b. Anxiety c. Brain cells d. Headaches ANS: B

Patients with NUG have been found to have had significantly more anxiety, higher depression sores, a greater magnitude of recent stressful events, more overall distress and adjustments related to these events, and more negative life events.

DIF: Comprehension REF: p. 340 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Lesions that resemble NUG but that progress to become

have been described in

children with severe malnutrition in underdeveloped countries. a. streptococcus infection b. streptococcus stomatitis c. gangrenous infection d. gangrenous stomatitis ANS: D

Lesions that resemble NUG but that progress to become gangrenous stomatitis or noma have been described in children with severe malnutrition in underdeveloped countries. . 3S4T 0 BANKSELLER.COM DIF: Recall REF: TpE TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which of the following is reasonable to conclude about malnutrition? a. Malnutrition can predispose an individual to opportunistic infections or intensify

the severity of existing oral infections. b. Malnutrition cannot predispose an individual to opportunistic infections, but it can intensify the severity of existing oral infections. c. Malnutrition can predispose an individual to opportunistic infections, but it cannot intensify the severity of existing oral infections. d. Malnutrition cannot predispose an individual to opportunistic infections, nor can it intensify the severity of existing oral infections.

ANS: A

Malnutrition can predispose an individual to opportunistic infections or intensify the severity of existing oral infections.

DIF: Application REF: p. 340 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Perhaps the best example of an immunocompromised host with a predisposition for

necrotizing ulcerative periodontitis is: a. A patient who has previously had gingivitis b. A patient with plaque buildup c. A patient with poor oral health habits

d. A patient infected with human immunodeficiency virus ANS: D

Perhaps the best example of an immunocompromised host with a predisposition for necrotizing ulcerative periodontitis is a patient infected with human immunodeficiency virus or diagnosed with acquired immunodeficiency syndrome.

DIF: Recall REF: p. 340 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. Which of the following is true about the relationship between necrotizing ulcerative

periodontitis and necrotizing ulcerative gingivitis? a. Necrotizing ulcerative periodontitis and necrotizing ulcerative gingivitis can be used interchangeably. b. To date, there is little evidence to support the progression of NUG to NUP or to establish a relationship between the two conditions as a single entity. c. The lesions of NUP are confined to the gingiva. d. Necrotizing ulcerative gingivitis is often an extension of necrotizing ulcerative periodontitis.

ANS: B

To date, there is little evidence to support the progression of NUG to NUP or to establish a relationship between the two conditions as a single entity.

DIF: Comprehension REF: p. 338 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Why are “conventional” peTrE ioS doTnB taAl N poKcS keEtsLw epOpMrobing depth not found in patients LiEthRd.eC

with necrotizing ulcerative periodontitis? a. The ulcerative and necrotizing gingival lesion expands the marginal epithelium and connective tissue, resulting in swollen gingiva. b. The ulcerative and necrotizing gingival lesion destroys the marginal epithelium and surrounding tissues, resulting in swollen gingiva and bleeding upon probing. c. The ulcerative and necrotizing gingival lesion destroys the marginal epithelium and connective tissue, resulting in gingival recession. d. The necrotizing and ulcerative gingival lesion expands the marginal epithelium and surrounding tissues, resulting in craters and tooth loss.

ANS: C

The ulcerative and necrotizing gingival lesion destroys the marginal epithelium and connective tissue, resulting in gingival recession.

DIF: Comprehension REF: p. 338 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. In necrotizing ulcerative periodontitis, lesions are a. nonexistent b. predictable c. pain-free d. painful ANS: D

.

In NUP, lesions are painful.

DIF: Recall REF: p. 338 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Murray and colleagues reported that cases of NUP in HIV-positive patients demonstrated

significantly greater numbers of the opportunistic fungus a. Clostridium difficile b. Candida albicans c. Aspergillus d. Geomyces destructans

.

ANS: B

Murray and colleagues reported that cases of NUP in HIV-positive patients demonstrated significantly greater numbers of the opportunistic fungus C. albicans.

DIF: Recall REF: p. 339 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Necrotizing ulcerative gingivitis (NUG) has been recognized and described in literature for a. b. c. d.

.

Less than 15 years Decades Centuries Millennium

ANS: C

NUG has been recognizedTanEdSdTeB scAriN beKdSinEL litL erEatRu. reCfO orMcenturies.

DIF: Comprehension REF: p. 338 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. What does NUP stand for? a. Necrotizing ulcerative periodontitis b. Necrotizing ultimate periodontitis c. Neurogenic ulcerative periodontitis d. Neurogenic ultimate periodontitis ANS: A

NUP stands for “necrotizing ulcerative periodontitis.”

DIF: Recall REF: p. 338 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. Which of the following symptoms is not known to be a manifestation associated with

advanced lesions of NUP? a. Tooth mobility b. Severe bone loss c. Malnutrition d. Fever ANS: C

Advanced lesions of NUP lead to severe bone loss and tooth mobility, may ultimately leading to tooth loss. In addition to these manifestations, as previously mentioned, patients with NUP may present with oral malodor, fever, malaise, or lymphadenopathy.

DIF: Recall REF: p. 338 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. Why is early diagnosis and treatment of NUP crucial? a. Osseous defects that occur during the late stages of the disease are extremely

difficult to resolve. b. Without proper diagnosis, NUP can easily progress into NUG. c. Calcium buildup associated with NUP becomes harder to rectify as the patient

ages. d. Without proper diagnosis, NUP can easily progress into HIV, which then progresses into AIDS. ANS: A

The early diagnosis and treatment of NUP are crucial because the osseous defects that occur during the late stages of the disease are extremely difficult to resolve.

DIF: Comprehension REF: p. 339 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. Patients with NUG have been found to have higher what? a. Happiness levels b. Incidence of HIV c. Depression scores d. IQs ANS: C

Patients with NUG have been found to have had significantly more anxiety, higher depression scores, a greater magnitude of recent stressful events, more overall distress and adjustments related to these events, and more negative life events.

DIF: Recall REF: p. 340 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 28: Pathology and Management of Periodontal Problems in Patients With Human Immunodeficiency Virus Infection Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Acquired immunodeficiency syndrome (AIDS) is characterized by profound impairment of

what body system? a. Immune b. Skeletal c. Muscular d. Cardiovascular ANS: A

Acquired immunodeficiency syndrome (AIDS) is characterized by profound impairment of the immune system.

DIF: Recall REF: p. 342 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 2. HIV has a strong affinity for cells of the immune system, most specifically those that carry the

cell surface receptor molecule. a. b. c. d.

CD2 CD3 CD4 CD5

ANS: C

HIV has a strong affinity for cells of the immune system, most specifically those that carry the CD4 cell surface receptor molecule.

DIF: Recall REF: p. 342 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 3. What is the main difference between HIV-1 and HIV-2? a. HIV-1 appears to be less virulent and causes AIDS much more slowly. b. HIV-2 appears to be less virulent and causes AIDS much more slowly. c. HIV-1 is directly linked to type 1 diabetes. d. HIV-2 is directly linked to type 2 diabetes.

ANS: B

HIV-2 is very similar to HIV-1 but appears to be less virulent and causes AIDS much more slowly.

DIF: Comprehension REF: p. 342 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 4. What are the three named subgroups of HIV-1? a. M, N, and O b. A, B, and C c. N, O, and P

d. B, C, and D ANS: A

HIV-1 consists of three named subgroups: M (main or major), N (new or non-M), and O (outlier).

DIF: Comprehension REF: p. 342 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 5. Which HIV-1 subgroup is primarily responsible for the worldwide HIV epidemic? a. M b. B c. N d. D ANS: A

HIV-1 subgroup M is primarily responsible for the worldwide HIV epidemic.

DIF: Recall REF: p. 342 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 6. How many known HIV-2 subgroups are there? a. Five b. Eight c. Ten d. Twelve ANS: B

T-E2 SsuTbBgrAoNupKsS There are eight known HIV . ELLER.COM DIF: Recall REF: p. 342 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 7. Most patients with AIDS have lesions on what part of their body? a. Legs and feet b. Arms and hands c. Mouth and face d. Head and neck ANS: D

Most patients with AIDS have head and neck lesions, whereas oral lesions are common among HIV-positive individuals who do not yet have AIDS. DIF: Comprehension REF: p. 343 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 8. Most oral candida infections are associated with what type? a. Candida glabrata b. Candida albicans c. Candida parapsilosis d. Candida tropicalis ANS: B

More oral candidal infections (i.e., 85% to 95%) are associated with C. albicans, but other species of Candida may also be involved.

DIF: Recall REF: p. 343 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 9. Which of the following is the most common oral lesion associated with HIV disease? a. Superficial mucosal lesions b. Lichen planus c. Erythema migrans d. Candidiasis ANS: D

Candidiasis is the most common oral lesion associated with HIV disease; it has been found in approximately 90% of patients with AIDS. DIF: Recall REF: p. 343 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which of the following is the clinical term for oral thrush? a. Pseudomembranous candidiasis b. Erythematous candidiasis c. Hyperplastic lichen planus d. Angular cheilitis ANS: A

Pseudomembranous candidiasis is also known as oral thrush.

DIF: Recall REF: p. 343 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Which stage of HIV infection involves advanced symptoms such as severe weight loss,

chronic diarrhea, persistent intermittent or constant fever, pulmonary tuberculosis, and neutropenia? a. Clinical Stage 1 b. Clinical Stage 2 c. Clinical Stage 3 d. Clinical Stage 4 ANS: C

Clinical Stage 3 of HIV infection involves advanced symptoms such as severe weight loss, chronic diarrhea, persistent intermittent or constant fever, pulmonary tuberculosis, severe bacterial infections, unexplained anemia, neutropenia, chronic thrombocytopenia persistent oral candidiasis, oral hairy leukoplakia, acute necrotizing stomatitis, gingivitis, and periodontitis.

DIF: Comprehension REF: p. 343.e1 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 12. Which two organizations have published guidelines regarding the definition of HIV infection

and HIV disease staging? a. World Health Organization and the U.S. Food and Drug Administration

b. World Health Organization and the Centers for Disease Control and Prevention c. U.S. Food and Drug Administration and the Centers for Disease Control and

Prevention d. National Institutes of Health and the U.S. Food and Drug Administration ANS: B

The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have published guidelines regarding the definition of HIV infection and HIV disease staging.

DIF: Comprehension REF: p. 343.e1 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 13. A CD4 cell count of less than

is considered diagnostic for AIDS in adults and

children who are 5 years old or older. a. 150 mm3 b. 250 mm3 c. 350 mm3 d. 450 mm3 ANS: C

A CD4 cell count of less than 350 mm3 is considered diagnostic for AIDS in adults and children who are 5 years of age or older.

DIF: Comprehension REF: p. 343.e1 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 14. Which of the following areTtE heStTwBoAgN olK d SstE anLdLarEdRte.sC tsOuM sed to confirm human

immunodeficiency virus infection? a. ELISA and Western blot (WB) test b. CBC and thyroid panel c. ELISA and CBC d. Western blot (WB) test and thyroid panel ANS: A

The enzyme-linked immunosorbent assay (ELISA) and Western blot (WB) tests were the original methods for determining the presence of HIV-1 and HIV-2 antibodies in serum or plasma, and they are still considered the gold standard of confirmatory testing.

DIF: Recall REF: p. 343.e2 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 15. A patient with symptomatic AIDS conditions such as oropharyngeal or vulvovaginal

candidiasis would fall under what category/classification of AIDS grouping? a. Category A b. Category B c. Category C d. Category D ANS: B

Category B patients have symptomatic conditions such as oropharyngeal or vulvovaginal candidiasis, herpes zoster, oral hairy leukoplakia, or idiopathic thrombocytopenia, or constitutional symptoms of fever, diarrhea, or weight loss.

DIF: Application REF: p. 343.e2 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 16. Which type of antiviral therapy approved for treatment of HIV and AIDS infection were the

first class of antiretrovirals to be developed? a. Nucleoside reverse transcriptase inhibitors (NRTIs) b. Nonnucleoside reverse transcriptase inhibitors (NNRTIs) c. Protease inhibitors (PIs) d. Fusion inhibitors (FIs) ANS: A

Nucleoside reverse transcriptase inhibitors (NRTIs) were the first class of antiretrovirals to be developed for the treatment of HIV and AIDS infection.

DIF: Recall REF: p. 343.e3 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 17. Which of the following is caused by the Epstein-Barr virus (EBV) and is the only EBV lesion

with which viral shedding in saliva is common? a. Oral hairy leukoplakia (OHL) b. Kaposi sarcoma (KS) c. Non-Hodgkin lymphoma (NHL) d. Oral hyperpigmentation ANS: A

Oral hairy leukoplakia (OHL) primarily occurs in persons with HIV infection and is caused by the Epstein-Barr virus (EBV). It is the only EBV lesion with which viral shedding in saliva is common and the lesion is characterized by an asymptomatic, poorly demarcated keratotic area that ranges in size from a few millimeters to several centimeters.

DIF: Recall REF: p. 344 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. What is the most common oral malignancy associated with AIDS? a. Oral hairy leukoplakia (OHL) b. Kaposi sarcoma (KS) c. Non-Hodgkin lymphoma (NHL) d. Oral hyperpigmentation ANS: B

Kaposi sarcoma (KS) is the most common oral malignancy associated with AIDS. DIF: Recall REF: p. 344 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. Which of the following is an infectious vascular proliferative disease with clinical and

histologic features similar to those of Kaposi sarcoma? a. Oral hairy leukoplakia (OHL)

b. Bacillary (epithelioid) angiomatosis c. Non-Hodgkin lymphoma d. Oral hyperpigmentation ANS: B

Bacillary (epithelioid) angiomatosis (BA) is an infectious vascular proliferative disease with clinical and histologic features similar to those of KS. It is caused by facultative intracellular gram-negative mobile bacilli of the genus Bartonella and the order of Rickettsia.

DIF: Recall REF: p. 346 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 20. Which of the following may be most common among HIV-infected men during both the early

and advanced stages of HIV infection and immunosuppression? a. Atypical ulcers and xerostomia b. Atypical ulcers and salivary gland hyperfunction c. Salivary gland hypofunction and xerostomia d. Basal cell carcinoma and salivary gland hypofunction ANS: C

Salivary gland hypofunction and xerostomia may be most common among HIV-infected men during both the early and advanced stages of HIV infection and immunosuppression.

DIF: Recall REF: p. 347 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 21. Which of the following HIV medications has been recognized to occasionally induce oral

ulcerations? a. Interferon b. Ditiocarb c. Ganciclovir d. HAART drugs ANS: A

Foscarnet, interferon, and 2-3-dideoxycytidine occasionally induce oral ulcerations, and erythema multiforme has been reported with the use of didanosine. Zidovudine and ganciclovir may induce leukopenia, and xerostomia and altered taste sensation have been described in conjunction with Ditiocarb.

DIF: Comprehension REF: p. 348.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 22. The diagnosis of linear gingival erythema (LGE) may be difficult because it can easily be

mistaken for what? a. HIV b. Localized gingivitis c. Necrotizing ulcerative gingivitis d. Conventional marginal gingivitis ANS: D

The diagnosis of LGE may be difficult because it can be mistaken for conventional marginal gingivitis.

DIF: Comprehension REF: p. 348.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 23. It is important for dental care staff to display a. concern and understanding b. sympathy and condolences c. judgment and tough love d. pity and disappointment

for a patient with HIV or AIDS.

ANS: A

It is important for dental care staff to display concern and understanding for a patient with HIV or AIDS. Coping with a life-threatening disease may elicit depression, anxiety, and anger in patients, and it is important that dental care staff provide a calm, relaxed atmosphere, and stress to the patient must be minimized.

DIF: Application REF: p. 351 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 24. What type of antiretroviral drug is Ritonavir? a. Nucleoside reverse transcriptase inhibitors (NRTI) b. Nonnucleoside reverse transcriptase inhibitors (NNRTI) c. Protease inhibitor d. Fusion inhibitor ANS: C

Ritonavir is a protease inhibitor (PI).

DIF: Recall REF: p. 343.e3 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 25. Which of the following is a customized antiretroviral combination of different classes of

medications that a physician can prescribe in an effort to block HIV replication and plasma load and to restore immune function? a. Combination antiretroviral therapy b. Protease inhibitor therapy c. Multiclass combination product therapy d. HAART therapy ANS: D

HAART therapy is a customized antiretroviral combination of different classes of medications that a physician can prescribe in an effort to block HIV replication and plasma load and to restore immune function while minimizing antiretroviral drug resistance and adverse drug effects.

DIF: Application REF: p. 343.e4 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology

Chapter 29: Levels of Clinical Significance Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following terms can be defined as “treatment outcomes that reflect how a patient

feels, functions, or survives?” a. Tangible benefits b. Intangible benefits c. Measurable benefits d. Psychosomatic benefits ANS: A

Tangible benefits are treatment outcomes that reflect how a patient feels, functions, or survives.

DIF: Recall

REF: p. 355

TOP: NBDHE; 5.1 General Pathology

2. Which of the following is an example of an intangible benefit? a. Improved oral health-related quality of life b. Decrease in self-reported symptoms c. Changes in probing attachment level as a result of scaling d. Elimination of a painful periodontal abscess ANS: C

Intangible benefits cannot be realized or perceived by the patient’s mind. Changes in probing attachment level as a resulT t oEfSscTaB linAgNaKreSaEnLeL xaEmRp.leCoOf M an intangible benefit.

DIF: Application REF: p. 355 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. True endpoints are a. tangible outcome b. intangible outcome c. surrogate outcome d. interrelated outcome

measures.

ANS: A

True endpoints are tangible outcome measures.

DIF: Comprehension REF: p. 356 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Randomized controlled trials conducted in periodontics have primarily focused on what type

of endpoints? a. True endpoints b. Surrogate endpoints c. Hypothesized endpoints d. Deconstructed endpoints ANS: B

As in medicine, randomized controlled trials conducted in periodontics have primarily focused on surrogate endpoints. Having true endpoints in future randomized controlled trials will enhance the clinical applicability and relevance of their results.

DIF: Comprehension REF: p. 356 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. How many levels of clinical significance exist based on the nature of the benefit and the size

of the treatment effect? a. 3 b. 4 c. 5 d. 6 ANS: B

Based on the nature of the benefit (tangible/intangible) and the size of the treatment effect (large/small), four levels of clinical significance can be defined.

DIF: Recall REF: p. 356 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. What level of clinical significance are treatments that are considered “magic bullets” or

“miracle cures”? a. Level 1 b. Level 2 c. Level 3 d. Level 4 ANS: A

Treatments of clinical significance level 1 are the “magic bullets” or “miracle cures” in which the treatment provides a tangible benefit and a large treatment effect.

DIF: Comprehension REF: p. 356 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. What type of benefit is defined as one that can reliably be identified using epidemiologic

methodology? a. Small benefit b. Tangible benefit c. Intangible benefit d. Large benefit ANS: D

A large benefit is defined as one that can reliably be defined using epidemiologic methodology.

DIF: Comprehension REF: p. 356 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. Highly active antiretroviral therapy (HAART) in patients with AIDS is an example of what

level of clinical significance? a. Level 1

b. Level 2 c. Level 3 d. Level 4 ANS: C

Treatments of level 3 clinical significance are the magic bullets or miracle cures in the surrogate world, where the beneficial but intangible effects seem to be so convincing that the implementation of RCTs may appear to be unethical. HAART in patients with AIDS is considered an example.

DIF: Application REF: p. 357 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 9. Treatments of

clinical significance are those that have demonstrated a tangible benefit but for which the likelihood of obtaining the benefit from treatment is small. a. level 1 b. level 2 c. level 3 d. level 4 ANS: B

Treatments of level 2 clinical significance are those that have demonstrated a tangible benefit but for which the likelihood of obtaining the benefit from treatment is small.

DIF: Recall REF: p. 357 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 10. Clofibrate, when used to loTwEeS r lTipBidAlNevKeSlsE , iLs L anEeRx.am plM e of a drug of what level of clinical CO

significance? a. Level 1 b. Level 2 c. Level 3 d. Level 4 ANS: D

Treatments of level 4 clinical significance are those that have reliable evidence on small, intangible benefits. Clofibrate, used to lower lipid levels, is an example of a drug of level 4 clinical significance.

DIF: Comprehension REF: p. 358 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 11. What type of benefits can also be referred to as “clinically relevant” or “clinically

meaningful” benefits? a. Intangible benefits b. Tangible benefits c. Clinical benefits d. Oral-related benefits ANS: B

Tangible benefits can also be referred to as “clinically relevant” or “clinically meaningful” benefits.

DIF: Recall REF: p. 355 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 12. Which of the following statements is true? a. Tangible benefits are treatment outcomes that cannot be realized or perceived by

the patient’s mind. b. Intangible benefits can be realized or perceived by the patient’s mind. c. Intangible benefits always translate to tangible benefits. d. Intangible benefits often do not translate to tangible benefits.

ANS: D

Tangible benefits are treatment outcomes that reflect how a patient feels, functions, or survives. Intangible benefits cannot be realized or perceived by the patient’s mind. Intangible benefits often to not translate into tangible benefits.

DIF: Comprehension REF: p. 355 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 13. What are the two criteria on which the levels of clinical significance are based? a. The hypothesis of the diagnosis and the breadth of the treatment effect b. The size of the benefit and the nature of the treatment effect c. The nature of the benefit and the size of the treatment effect d. The hypothesis of the diagnosis and tangibility of the treatment effect ANS: C

Based on the nature of the benefit (tangible/intangible) and the size of the treatment effect (large/small), four levels oT f cEliSnT icB alAsN igK niS fiE caLnL ceEcRa. nC beOdMefined.

DIF: Comprehension REF: p. 356 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 14. The

the treatment effect, the recruited. a. smaller; smaller b. larger; larger c. smaller; larger d. larger; smaller

the number of patients who will need to be

ANS: C

The size of the anticipated treatment effect has a profound impact on the planning of randomized clinical trials. The smaller the treatment effect, the larger the number of patients who will need to be recruited.

DIF: Comprehension REF: p. 357 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology 15. Treatments that provide a tangible patient benefit fall into what two levels of clinical

significance? a. Levels 1 and 2 b. Levels 2 and 3 c. Levels 3 and 4

d. Levels 1 and 4 ANS: A

Treatments that provide a tangible patient benefit (levels 1 and 2) are of greater value and should correspond to a higher level of clinical significance than treatments with evidence of only intangible benefits (levels 3 and 4).

DIF: Comprehension REF: p. 356 TOP: NBDHE; 4.0 Scientific Basis for Dental Hygiene Practice: Microbiology and immunology

Chapter 30: Periodontal Examination and Diagnosis Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following is generally not included in a clinician’s overall appraisal of the

patient? a. Consideration of the patient’s mental and emotional status b. Consideration of the patient’s commute to the office c. Consideration of the patient’s preference toward care d. Consideration of the patient’s attitude ANS: B

From the first meeting, the clinician should attempt an overall appraisal of the patient. This includes consideration of the patient’s mental and emotional status, temperament, attitude, and physiologic age, as well as individual preferences toward care, and important aspects of life context that will impact treatment decisions.

DIF: Comprehension REF: p. 359 TOP: NBDHE; 1.3 Periodontal evaluation 2. Which of the following should not be included in a patient’s health history? a. The date of the last physical exam b. A family history c. Patient’s allergy history d. Patient’s birth weight ANS: D

The health history should include the date of the last physical exam and the frequency of physical examinations, details regarding hospitalizations and operations, all medical problems, abnormal bleeding tendencies, information about the onset of puberty and menstrual disorders, a list of all medications, the patient’s allergy history, a family history, and detailed information on current and history of alcohol, recreational drugs, and tobacco use.

DIF: Comprehension REF: p. 359 TOP: NBDHE; 1.3 Periodontal evaluation 3. A patient’s history with hay fever would fall under what category of a patient’s health history? a. Surgical information b. Dental information c. Familial history information d. Allergy information ANS: D

A patient’s history with hay fever would fall under the allergy information category of a patient’s health history.

DIF: Comprehension REF: p. 362 TOP: NBDHE; 1.3 Periodontal evaluation

4. A patient’s dental history needs to include all of the following except: a. patient’s oral hygiene regimen. b. patient’s exercise regimen. c. patient’s orthodontic treatment. d. patient’s gingival bleeding tendencies.

ANS: B

The dental history should include reference to: visits to the dentist, the patient’s oral hygiene regimen, the patient’s past or current orthodontic treatment, if the patient is experiencing any tooth pain, gingival bleeding, or a bad taste in his/her mouth, if the patient has any “loose” teeth, the patient’s general dental habits, the patient’s history of previous periodontal problems, and if the patient wears a removable prosthesis.

DIF: Comprehension REF: p. 362 TOP: NBDHE; 1.3 Periodontal evaluation 5. When should initial photographs be taken? a. Before the tissue is probed and manipulated. b. At the same time the tissue is probed and manipulated. c. Directly after the tissue is probed and manipulated. d. 5 to 10 minutes after the tissue is probed and manipulated.

ANS: A

Initial photographs should be taken before the tissue is probed and manipulated to obtain an undisturbed baseline of the patient’s mouth with gingiva and biofilm intact.

DIF: Application

REF: p. 363

TOP: NBDHE; 1.3 Periodontal evaluation

6. Clinical evaluation should begin with an evaluation of what? a. Extraoral structures b. Oral cavity c. Periodontium d. Plaque level ANS: A

Clinical examination should begin with an evaluation of the extraoral structures for abnormalities.

DIF: Comprehension REF: p. 363 TOP: NBDHE; 1.3 Periodontal evaluation 7. During the clinical examination, the temporomandibular joint should be assessed for what? a. Size and shape b. Color c. Pain and range of motion d. Temperature and width ANS: C

During the clinical examination, the temporomandibular joint should be assessed for pain, crepitus, clicking, and range of motion.

DIF: Comprehension

REF: p. 363

TOP: NBDHE; 1.3 Periodontal evaluation 8. What is the term used for a foul or offensive odor that emanates from the oral cavity? a. Xerostomia b. Sialorrhea c. Halitosis d. Periodontitis ANS: C

Oral malador, which is also termed fetor ex ore, fetor oris, or halitosis, is a foul or offensive odor that emanates from the oral cavity.

DIF: Recall

REF: p. 363

TOP: NBDHE; 1.3 Periodontal evaluation

9. Which statement is true regarding the examination of the periodontium? a. The periodontal examination should be generalized. b. The periodontal examination should begin with the insertion of the periodontal

probe. c. The periodontal examination should begin with a thorough and careful visual

evaluation of the gingival margin. d. The periodontal examination is the part of a standard medical doctor appointment.

ANS: C

The periodontal examination should be systematic and should not immediately begin with the insertion of the periodontal probe into the gingival crevice. It should begin with a thorough and careful visual evaluation of the gingival margin to assess biofilm and calculus accumulation a well as inflammatory changes in the soft tissue.

DIF: Comprehension REF: p. 364 TOP: NBDHE; 1.3 Periodontal evaluation 10. What are the two parts of the examination of the periodontium? a. Visual examination and tactile examination b. Verbal explanation and visual examination c. Tactile examination and verbal explanation d. Probing examination and tactile examination ANS: A

Examination of the periodontium consists of two parts: visual examination and tactile examination.

DIF: Recall

REF: p. 364

TOP: NBDHE; 1.3 Periodontal evaluation

11. Which of the following statements is true in relation to the visual examination of biofilm and

calculus? a. The presence of subgingival calculus is easily detected. b. The presence of biofilm and supragingival calculus can be observed directly. c. Radiographs provide complete information about calculus detection. d. The amount and location of biofilm and supragingival calculus do not provide any insight into the effectiveness of the patient’s biofilm control.

ANS: B

The presence of subgingival calculus may not be easily detected. The presence of biofilm and supragingival calculus can be observed directly. Although radiographs may sometimes reveal heavy calculus deposits interproximally and even on the facial and lingual surfaces, they cannot be relied on for thorough detection of calculus. The amount and location of biofilm and supragingival calculus may provide insights into the effectiveness of the patient’s biofilm control as well as possible inflammatory changes in the tissue.

DIF: Comprehension REF: p. 365 TOP: NBDHE; 1.3 Periodontal evaluation 12. The is the keratinized collar of the masticatory mucosa around the teeth. a. temporomandibular joint b. oral mucosa c. gingiva d. periodontium ANS: C

The gingiva is the keratinized collar of masticatory mucosa around the teeth.

DIF: Recall

REF: p. 365

TOP: NBDHE; 1.3 Periodontal evaluation

13. Why does the evaluation of the gingiva require the tissue to be dried before accurate

observation can be made? a. The presence of saliva can obscure details. b. The presence of saliva helps to show the extent of inflammation. c. The presence of saliva can help make a definitive diagnosis. d. The presence of saliva proves the patient is healthy.

ANS: A

The presence of saliva can obscure details. Once the gingiva is thoroughly dried with gauze, it is evaluated and assessed for inflammatory changes.

DIF: Comprehension REF: p. 365 TOP: NBDHE; 1.3 Periodontal evaluation 14. What is the consistency of healthy gingiva? a. Firm b. Edematous c. Spongy d. Loosely adapted ANS: A

The consistency of healthy gingiva is firm, tight, and well-adapted.

DIF: Recall

REF: p. 366

TOP: NBDHE; 1.3 Periodontal evaluation

15. What is the probing depth of inflamed gingiva? a. 0 to 1 mm b. 1 to 2 mm c. 2 to 3 mm d. Over 3 mm

ANS: D

The probing depth of healthy gingiva is 2 to 3 mm and the probing depth of inflamed gingiva is over 3 mm.

DIF: Recall

REF: p. 366

TOP: NBDHE; 1.3 Periodontal evaluation

16. Which of the following is the term used to describe the distance between the gingival margin

and the base of the gingival crevice? a. Probing depth b. Biologic depth c. Penetration depth d. Gingival depth ANS: B

Biologic depth is the distance between the gingival margin and the base of the gingival crevice.

DIF: Recall

REF: p. 368

TOP: NBDHE; 1.3 Periodontal evaluation

17. The biologic/histologic pocket depth is always

the clinical/probing pocket

depth. a. deeper than b. equal to c. shallower d. unrelated to ANS: C

The biologic/histologic poT ckEeS t dTeB ptA hN isKaS lwEaL ysLsEhR al. loCwOerMthan the clinical/probing pocket depth.

DIF: Comprehension REF: p. 369 TOP: NBDHE; 1.3 Periodontal evaluation 18. Which of the following is the term used to describe the location where the dentogingival

junction begins coronally on a tooth? a. Attachment loss b. Attachment level c. Probe angulation d. Probe depth ANS: B

Attachment level describes the location where the dentogingival junction begins coronally on a tooth.

DIF: Recall

REF: p. 370

TOP: NBDHE; 1.3 Periodontal evaluation

19. Which of the following is not a form of wasting? a. Erosion b. Abrasion c. Attrition d. Fraction

ANS: C

The forms of wasting are erosion, abrasion, attrition, and abfraction.

DIF: Recall

REF: p. 370

TOP: NBDHE; 1.3 Periodontal evaluation

20. Which of the following terms refers to the loss of tooth substance that is induced by

mechanical wear other than that of mastication? a. Erosion b. Abrasion c. Attrition d. Fraction ANS: B

Abrasion refers to the loss of tooth substance that is induced by mechanical wear other than that of mastication.

DIF: Recall

REF: p. 371

TOP: NBDHE; 1.3 Periodontal evaluation

Chapter 31: Radiographic Aids in the Diagnosis of Periodontal Disease Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following is true about radiographs? a. Radiographs are an adjunct to the clinical examination, not a substitute for it. b. Radiographs are not valuable in the diagnosis of periodontal disease. c. Radiographs can be used as a substitute for a clinical examination. d. Radiographs provide a moving view of the currently available periodontal bone.

ANS: A

Radiographs are an adjunct to the clinical examination, not a substitute for it. Radiographs are valuable for the diagnosis of periodontal disease, estimation of severity, determination of prognosis, and evaluation of treatment outcome. Radiographs provide a static view of the currently available periodontal bone.

DIF: Comprehension REF: p. 379 TOP: NBDHE; 2.0 Provision of Clinical Dental Hygiene Services: Obtaining and interpreting radiographs 2. The angulation of the crest of the interdental septum is generally

to a line between the

CEJs of the approximating teeth. a. adjacent b. perpendicular c. attached d. parallel ANS: D

The angulation of the crest of the interdental septum is generally parallel to a line between the CEJs and the approximating teeth.

DIF: Recall REF: p. 379 TOP: NBDHE; 2.0 Provision of Clinical Dental Hygiene Services: Obtaining and interpreting radiographs 3. What two types of dental radiography provide the most diagnostic information? a. Bitewing and occlusal projections b. Periapical and bitewing projections c. Occlusal and panoramic projections d. Panoramic and bitewing projections ANS: B

In conventional radiographs, periapical and bitewing projections offer the most diagnostic information and are most commonly used in the evaluation of periodontal disease.

DIF: Comprehension REF: p. 379 TOP: NBDHE; 2.0 Provision of Clinical Dental Hygiene Services: Obtaining and interpreting radiographs 4. For periapical radiographs, which technique most accurately projects the alveolar bone level?

a. b. c. d.

The short-cone paralleling technique Bisecting angle technique The long-cone paralleling technique The angular technique

ANS: C

For periapical radiographs, the long-cone paralleling technique most accurately projects the alveolar bone level.

DIF: Comprehension REF: p. 379 TOP: NBDHE; 2.0 Provision of Clinical Dental Hygiene Services: Obtaining and interpreting radiographs 5. What is the preferred imaging technique to depict interproximal periodontal bone levels in the

posterior dentition? a. Bitewing radiography b. Occlusal radiography c. Panoramic radiography d. Periapical radiography ANS: A

Bitewing radiography is the preferred imaging technique to depict interproximal periodontal bone levels in the posterior dentition.

DIF: Application REF: p. 380 TOP: NBDHE; 2.0 Provision of Clinical Dental Hygiene Services: Obtaining and interpreting radiographs 6. In general, the radiographic imagine tends to a. underestimate b. exactly predict c. overestimate d. provide no information about

the severity of bone loss.

ANS: A

In general, the radiographic imagine tends to underestimate the severity of bone loss.

DIF: Comprehension REF: p. 380 TOP: NBDHE; 2.0 Provision of Clinical Dental Hygiene Services: Obtaining and interpreting radiographs 7. In periodontal disease, what happens to the height of the interdental bone? a. It may be lengthened. b. It is typically unaffected. c. It may be reduced. d. It goes away completely.

ANS: C

In periodontal disease, the height of the interdental bone may be reduced, with the crest perpendicular to the long axis of the adjacent teeth.

DIF: Comprehension REF: p. 384 TOP: NBDHE; 2.0 Provision of Clinical Dental Hygiene Services: Obtaining and interpreting

radiographs 8. What is the earliest radiographic change in periodontitis? a. Bacterial biofilm buildup b. Fuzziness and disruption of lamina dura c. The existence of calculus d. Continued periodontal bone loss and widening of the periodontal space ANS: B

Fuzziness and disruption of lamina dura crestal cortication continuity is the earliest radiographic change in periodontitis.

DIF: Recall REF: p. 383 TOP: NBDHE; 2.0 Provision of Clinical Dental Hygiene Services: Obtaining and interpreting radiographs 9. Which statement is true about interdental craters? a. Craters generally blend with the rest of the bone. b. Craters are generally sharply demarcated. c. Interdental craters are seen as irregular areas of higher density on the alveolar bone

crests. d. Conventional radiographs accurately depict the morphology or depth of interdental

craters.

ANS: A

Interdental craters are seen as irregular areas of reduced density on the alveolar bone crests.

Craters are generally not sharply demarcated but gradually blend with the rest of the bone.

Conventional radiographs T doEnSoTt B acAcuNrK atS elE yL dL epEicRt . thC eO mMorphology or depth of interdental craters, with sometimes appear as vertical defects.

DIF: Comprehension REF: p. 384 TOP: NBDHE; 2.0 Provision of Clinical Dental Hygiene Services: Obtaining and interpreting radiographs 10. The and of the interdental bone and the angle of the crest normally vary according to the convexity of the proximal tooth surfaces and the level of the cementoenamel junction (CEJ) of the approximating teeth. a. Length; height b. Width; shape c. Length; width d. Height; shape ANS: B The width and shape of the interdental bone and the angle of the crest normally vary according to the convexity of the proximal tooth surfaces and the level of the cementoenamel junction (CEJ) of the approximating teeth.

DIF: Comprehension REF: p. 379 TOP: NBDHE; 2.0 Provision of Clinical Dental Hygiene Services: Obtaining and interpreting radiographs 11. Which of the following statements is true? a. The slightest radiographic change in furcation area does not need to be

investigated. b. Even a large, clearly defined radiolucency in the furcation area is difficult to

identify. c. Diminished radiodensity in the furcation area in which outlines of bone trabeculae

are visible suggests furcation involvement. d. Whenever there is a marked bone loss in relation to a single molar root, it should

not be assumed that furcation is also involved.

ANS: C

The slightest radiographic change in the furcation area should be investigated. A large, clearly defined radiolucency in the furcation area is easy to identify. Diminished radiodensity in the furcation area in which outlines of bone trabeculae are visible suggests furcation involvement.

Whenever there is marked bone loss in relation to a single molar root, it may be assumed that furcation is also involved.

DIF: Comprehension REF: p. 385 TOP: NBDHE; 2.0 Provision of Clinical Dental Hygiene Services: Obtaining and interpreting radiographs 12. The typical radiographic appearance of a periodontal abscess is a discrete area of radiolucency

along the a. lateral b. longitudinal c. medial d. central

aspect of the root.

ANS: A

The typical radiographic apTpEeS arT anBcA eN ofKaSpEerLioLdEoR nt. alCaO bsMcess is a discrete area of radiolucency along the lateral aspect of the root.

DIF: Recall REF: p. 386 TOP: NBDHE; 2.0 Provision of Clinical Dental Hygiene Services: Obtaining and interpreting radiographs 13. Which of the following is not a reason why a radiographic picture is often not characteristic of

a periodontal abscess? a. The stage of the lesion b. The color of the lesion c. The extent of bone destruction and the morphologic changes of the bone d. The location of the abscess ANS: B

The typical appearance of a periodontal abscess is often not captured by radiographs because of the stage of the lesion, the extent of bone destruction and the morphologic changes of the bone, and the location of the abscess.

DIF: Comprehension REF: p. 386 TOP: NBDHE; 2.0 Provision of Clinical Dental Hygiene Services: Obtaining and interpreting radiographs 14. The

phase of trauma from occlusion produces a loss of the lamina dura that may be noted in apices, furcations, and marginal areas.

a. b. c. d.

onset endpoint injury repair

ANS: C

The injury phase of trauma from occlusion produces a loss of the lamina dura that may be noted in apices, furcations, and marginal areas.

DIF: Recall REF: p. 387 TOP: NBDHE; 2.0 Provision of Clinical Dental Hygiene Services: Obtaining and interpreting radiographs 15. The

phase of trauma from occlusion results in an attempt to strengthen the periodontal structures to better support the increased loads. a. onset b. endpoint c. injury d. repair ANS: D

The repair phase of trauma from occlusion results in an attempt to strengthen the periodontal structures to better support the increased loads.

DIF: Recall REF: p. 387 TOP: NBDHE; 2.0 Provision of Clinical Dental Hygiene Services: Obtaining and interpreting radiographs 16. Digital intraoral radiographic systems use either a. spongy; radiographic b. solid-state; photostimulable phosphor c. electronically charged; semiautomatic d. wireless; cone-beam

detectors or

plates.

ANS: B

Digital intraoral radiographic systems use either solid-state detectors or photostimulable phosphor (PSP) plates.

DIF: Recall REF: p. 389 TOP: NBDHE; 2.0 Provision of Clinical Dental Hygiene Services: Obtaining and interpreting radiographs 17. Which of the following is said to have revolutionized the field of oral and maxillofacial

imaging? a. Digital sensors b. Digital panoramic and cephalometric x-rays c. Cone-beam computed tomography (CBCT) d. Protective x-ray aprons ANS: C

Cone-beam computed tomography (CBCT) has revolutionized the field of oral and maxillofacial imaging.

DIF: Comprehension REF: p. 389 TOP: NBDHE; 2.0 Provision of Clinical Dental Hygiene Services: Obtaining and interpreting radiographs 18. Which of the following is a disadvantage to CBCT imaging? a. It only provides two-dimensional information. b. It uses a higher-dose radiation procedure relative to bitewing radiography. c. CBCT imaging is less expensive than bitewing radiography. d. CBCT is only recommended for the routine evaluation of periodontal bone loss.

ANS: B

CBCT imaging provides three-dimensional information and overcomes many of the limitations of conventional two-dimensional radiography. However, CBCT imaging is a higher-dose radiation procedure relative to bitewing radiography. CBCT is not recommended for the routine evaluation of periodontal bone loss.

DIF: Recall REF: p. 391 TOP: NBDHE; 2.0 Provision of Clinical Dental Hygiene Services: Obtaining and interpreting radiographs 19. Radiographs are a(n)

method for determining the amount of bone loss in periodontal

disease. a. Direct b. Indirect c. Outdated d. Optional ANS: B

Radiographs are a valuable tool in the assessment of the periodontal osseous structures and are offered in various two- and three-dimensional imaging modalities.

DIF: Comprehension TOP: NBDHE; 2.0 Provision of Clinical Dental Hygiene Services: Obtaining and interpreting radiographs 20. The interdental bone is normally outlined by a thin radiopaque line adjacent to the periodontal

ligament (PDL) and at the alveolar crest, referred to as the a. lamina dura b. periodontium c. gingival crest d. interdental septum

.

ANS: A

The interdental bone is normally outlined by a thin radiopaque line adjacent to the periodontal ligament (PDL) and at the alveolar crest, referred to as the lamina dura.

DIF: Recall REF: p. 379 TOP: NBDHE; 2.0 Provision of Clinical Dental Hygiene Services: Obtaining and interpreting radiographs

Chapter 32: Clinical Risk Assessment Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following terms can be defined as “the probability that an individual will

develop a specific disease in a given period?” a. Disease risk b. Risk factor c. Risk assessment d. Risk indicator ANS: A

Disease risk is the probability that an individual will develop a specific disease in a given period.

DIF: Recall REF: p. 393 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Which of the following terms can be defined as “environmental, behavioral, or biologic

factors that, when present, increase the likelihood that an individual will develop a disease”? a. Disease risk b. Risk factor c. Risk assessment d. Risk indicator ANS: B

Risk factors may be environmental, behavioral, or biologic factors that, when present, increase the likelihood that an individual will develop the disease.

DIF: Recall REF: p. 393 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. Risk factors are identified through what type of study? a. Cohort b. Cross-sectional c. Longitudinal d. Case-control ANS: C

Risk factors are identified through longitudinal studies of patients with the disease of interest.

DIF: Comprehension REF: p. 393 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. To be identified as a risk factor, exposure must occur a. before b. at the same time as c. after d. significantly after

disease onset.

ANS: A

To be identified as a risk factor, exposure must occur before disease onset.

DIF: Comprehension REF: p. 393 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Which of the following terms can sometimes be substituted for the term “risk factor”? a. Risk assessment b. Disease risk c. Risk determinant d. Characteristic risk ANS: C

The term “risk determinant/background characteristic” can sometimes be substituted for the term “risk factor.” It should be reserved for risk factors that cannot be modified.

DIF: Comprehension REF: p. 393 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Which of the following are probable or putative risk factors that have been identified in

cross-sectional studies but not confirmed through longitudinal studies? a. Risk predictors b. Risk determinants c. Risk indicators d. Risk assessment ANS: C

Risk indicators are probablTeEoS r pTuBtaAtiN veKrSisE kLfaLcE toR rs.tC haOt M have been identified in cross-sectional studies but not confirmed through longitudinal studies.

DIF: Recall REF: p. 393 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Which of the following is associated with increased risk for disease but do not actually cause

the disease? a. Risk markers b. Risk determinants c. Risk indicators d. Risk assessment ANS: A

Risk predictors/markers, although associated with increased risk for disease, do not cause the disease.

DIF: Comprehension REF: p. 393 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. Which of the following is not a risk factor for periodontal disease? a. Tobacco smoking b. Age c. Diabetes d. Pathogenic bacteria and microbial tooth deposits

ANS: B

Tobacco smoking, diabetes, and pathogenic bacteria and microbial tooth deposits are risk factors for periodontal disease. Age is a risk determinant/background characteristic for periodontal disease.

DIF: Comprehension REF: p. 393 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following is not a risk determinant for periodontal disease? a. Gender b. Stress c. Infrequent dental visits d. Socioeconomic status ANS: C

Genetic factors, age, gender, socioeconomic status, and stress are all risk determinants/background characteristics for periodontal disease. Infrequent dental visits are a risk indicator.

DIF: Comprehension REF: p. 394 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which of the following is not a risk indicator for periodontal disease? a. Previous history of periodontal disease b. Osteoporosis c. Infrequent dental visits d. HIV/AIDS ANS: A

HIV/AIDS, osteoporosis, and infrequent dental visits are all risk indicators for periodontal disease. Previous history of periodontal disease is a risk marker/predictor.

DIF: Recall REF: p. 395.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Which of the following terms could safely be substituted for “risk markers”? a. Risk indicators b. Risk factors c. Risk determinants d. Risk predictors ANS: D

Risk markers are also known as risk predictors.

DIF: Comprehension REF: p. 393 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. Which of the following is an example of a risk marker? a. Previous history of periodontal disease b. Pathogenic bacteria and microbial tooth deposits c. Socioeconomic status

d. Osteoporosis ANS: A

Risk markers include previous history of periodontal disease and bleeding on probing.

Pathogenic bacteria and microbial tooth deposits is a risk factor, socioeconomic status is a risk determinant, and osteoporosis is a risk indicator.

DIF: Recall REF: p. 395.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. What is the ultimate goal of performing a periodontal risk assessment? a. To give a clear diagnosis to the patient b. To develop a personalized treatment plan c. To find the right specialist to refer the patient to d. To set up frequent dental visits ANS: B

The ultimate goal of performing periodontal risk assessments is to develop a personalized treatment plan for a specific patient, taking into account that patient’s periodontal risk profile.

DIF: Comprehension REF: p. 395 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Immunologic alterations are an example of what type of risk determinant for periodontal

disease? a. Age b. Socioeconomic status c. Genetic factors d. Stress ANS: C

Immunologic alternations are an example of a genetic factor that serves as a risk determinant for periodontal disease. An example is neutrophil abnormalities.

DIF: Recall REF: p. 395 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Which of the following is an example of a risk factor for periodontal disease? a. Tobacco smoking b. Cancer c. Exercise addiction d. Stress ANS: A

Tobacco smoking, diabetes, and pathogenic bacteria and microbial tooth deposits are examples of risk factors for periodontal disease.

DIF: Recall REF: p. 393 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Which of the following is an example of a risk determinant for periodontal disease? a. Diabetes

b. Cancer c. HIV/AIDS d. Socioeconomic status ANS: B

Risk determinants for periodontal disease include age, genetic factors, gender, socioeconomic status, and stress.

DIF: Recall REF: p. 394 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Which of the following is not one of the three specific bacteria that have been identified as

etiologic agents for periodontitis? a. Aggregatibacter actinomycetemcomitans b. Porphyromonas gingivalis c. Tannerella forsythia d. Streptococci mutans ANS: D

Aggregatibacter actinomycetemcomitans, P. gingivalis, and T. forsythia are the three specific bacteria that have been identified as etiologic agents for periodontitis.

DIF: Recall REF: p. 394 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. Although not clearly defined as risk factors for periodontitis,

and factors that influence plaque accumulation may play a role in disease susceptibility for specific teeth. a. anatomic; restorative b. gender; age-specific c. CBCT imaging is less expensive than bitewing radiography d. CBCT is only recommended for the routine evaluation of periodontal bone loss ANS: A

Although not clearly defined as risk factors for periodontitis, anatomic and restorative facts that influence plaque accumulation may play a role in disease susceptibility for specific teeth.

DIF: Recall REF: p. 394 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. The presence of

, which serves as a reservoir for bacterial plaque, has been suggested as a risk factor for periodontitis. a. saliva b. calculus c. biofilm d. inflammation ANS: B

The presence of calculus, which serves as a reservoir for bacterial plaque, has been suggested as a risk factor for periodontitis.

DIF: Recall

REF: p. 394

TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. Which of the following socioeconomic populations is more at risk for periodontal disease? a. Lower socioeconomic status b. Middle socioeconomic status c. Middle-upper socioeconomic status d. Upper socioeconomic status ANS: A

Gingivitis and poor oral hygiene can be related to lower socioeconomic status. This more likely can be attributed to less dental awareness and fewer dental visits compared with more educated individuals with a higher socioeconomic status.

DIF: Application REF: p. 395 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 33: Determination of Prognosis Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following terms can be defined as “a prediction of the probable course, duration,

and outcome of a disease based on a general knowledge of the pathogenesis of the disease and the presence of risk factors for the disease?” a. Predictability b. Determination c. Prognosis d. Risk ANS: C

A prognosis is a prediction of the probable course, duration, and outcome of a disease based on a general knowledge of the pathogenesis of the disease and the presence of risk factors for the disease.

DIF: Recall REF: p. 396 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Determination of a prognosis is a(n) a. worthless b. dynamic c. one-step d. simple

process.

ANS: B

Determination of a prognosis is a dynamic process.

DIF: Recall REF: p. 396 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. Which of the following terms can be defined as “the likelihood that an individual will develop

a disease in a specified period?” a. Risk b. Prognosis c. Determinant d. Prognostic factors ANS: A

Risk generally deals with the likelihood that an individual will develop a disease in a specified period.

DIF: Recall REF: p. 396 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Which of the following can be defined as “characteristics that predict the outcome once the

disease is present”? a. Risk factors b. Risk determinants

c. Prognostic factors d. Prognosis indicators ANS: C

Prognostic factors are characteristics that predict the outcome once the disease is present.

DIF: Recall REF: p. 396 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Which of the following would be considered a fair prognosis? a. Control of etiologic factors that adequate periodontal support b. Approximately 25% attachment loss or grade I furcation invasion c. Approximately 50% attachment loss or grade II furcation invasion d. More than 50% attachment loss or grade II/grade III furcation invasion ANS: B

A fair prognosis occurs when approximately 25% of attachment loss or grade I furcation invasion exists. The location and depth allow proper maintenance with good patient compliance.

DIF: Application REF: p. 396 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. When there is an inadequate attachment to maintain health, comfort, and function, what

prognosis is given to a patient? a. Good b. Poor c. Questionable d. Hopeless ANS: D

A hopeless prognosis occurs when there is inadequate attachment to maintain health, comfort, and function.

DIF: Application REF: p. 396 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Which of the following is considered a systemic/environmental factor to consider when

determining a prognosis? a. Stress b. Age c. Biofilm control d. Patient compliance ANS: A

Smoking, stress, genetic factors, and an existing systemic disease/condition are all considered systemic and environmental factors to consider when determining a prognosis.

DIF: Comprehension REF: p. 397 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. Which of the following is not an anatomic factor to consider when determining a prognosis?

a. b. c. d.

Caries Tooth vitality Abutment selection Root concavities

ANS: C

Abutment selection is considered a prosthetic and restorative factor to consider when determining a prognosis.

DIF: Comprehension REF: p. 397 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following is not a local factor to consider when determining a prognosis? a. Biofilm b. Calculus c. Subgingival restorations d. Systemic disease ANS: D

Biofilm, calculus, and subgingival restorations are all local factors to consider when determining a prognosis. Systemic disease is considered a systemic/environmental factor.

DIF: Comprehension REF: p. 397 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which of the following is considered an overall clinical factor to consider when determining a

prognosis? a. Biofilm control b. Smoking c. Root concavities d. Stress ANS: A

Overall clinical factors to consider when determining a prognosis include the patient’s age, the disease severity, biofilm control, and patient compliance.

DIF: Recall REF: p. 397 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. For two patients with comparable levels of remaining connective tissue attachment and

alveolar bone, the prognosis is generally better for the a. younger b. older c. more stressed d. more attractive

of the two patients.

ANS: B

For two patients with comparable levels of remaining connective tissue attachment and alveolar bone, the prognosis is generally better for the older of the two patients.

DIF: Comprehension REF: p. 397 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

12. Which of the following is not a variable that needs to be recorded when documenting the

patient’s past history of periodontal disease? a. Probing pocket depth b. Level of attachment c. Amount of bone growth d. Type of bony defect ANS: C

The following variables need to be recorded when documenting the patient’s past history of periodontal disease: probing pocket depth, level of attachment, amount of bone loss, and type of bony defect.

DIF: Recall REF: p. 397 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Epidemiologic evidence suggests that which of the following may be the most important

environmental risk factor impacting the development and progression of periodontal disease? a. Smoking b. Stress c. Age d. Patient compliance ANS: A

Epidemiologic evidence suggests that smoking may be the most important environmental risk factor impacting the development and progression of periodontal disease. p.R3.

99COM DIF: Comprehension TESTBANKSREFL:LE TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Which of the following is the primary etiologic factor associated with periodontal disease? a. Stress b. Bacterial biofilm c. Tooth loss d. Smoking ANS: B

Bacterial biofilm is the primary etiologic factor associated with periodontal disease.

DIF: Recall REF: p. 398 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Which of the following is an example of an anatomic factor that may predispose the

periodontium to disease? a. Root concavities b. Biofilm control c. Abutment selection d. Subgingival restorations ANS: A

Root concavities are an example of an anatomic factor that may predispose the periodontium to disease.

DIF: Recall REF: p. 401 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Which of the following is an example of a prosthetic/restorative factor to consider when

determining a prognosis? a. Bifurcation ridges b. Tooth mobility c. Root resorption d. Abutment selection ANS: D

Bifurcation ridges, tooth mobility, and root resorption are all examples of anatomic factors to consider when determining a prognosis. A prosthetic/restorative factor to consider is abutment selection.

DIF: Recall REF: p. 397 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Prognosis is less favorable for teeth with

, tapered roots and relatively

crowns. a. short; large b. large; large c. large; short d. short; short ANS: A

Prognosis is less favorableTfoErSteTeB thAwNiK thSsE hoLrtL, E taR pe.reCdOrM oots and relatively large crowns.

DIF: Recall REF: p. 401 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18.

What are the principal causes of tooth mobility?

The buildup of calculus and bacterial biofilm The gender and age of the patient, combined with disease susceptibility Loss of alveolar bone and inflammatory changes in the periodontium Malocclusion caused by genetics and improperly placed prosthetics

a. b. c. d.

ANS: C

The principal causes of tooth mobility are loss of alveolar bone, inflammatory changes in the periodontium, and trauma from occlusion.

DIF: Recall REF: p. 403 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. Teeth that serve as abutments are subjected to a. decreased b. increased c. minimal d. unpredictable ANS: B

functional demands.

Teeth that serve as abutments are subjected to increased functional demands.

DIF: Recall REF: p. 404 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. Although most clinical studies have not shown a relationship between malnutrition and

gingival diseases, what severe vitamin deficiency could be the one possible exception? a. Vitamin A b. Vitamin B c. Vitamin C d. Vitamin D ANS: C

Although malnutrition has been suspected to play a role in the development of gingival diseases, most clinical studies have not shown a relationship between the two. One possible exception is severe vitamin C deficiency.

DIF: Comprehension REF: p. 405 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 21. Aggressive periodontitis can be present in what two forms? a. Chronic and acute b. Localized and generalized c. Stage I and Stage II d. Mild and moderate ANS: B

Aggressive periodontitis caTnEpSreTsB enAt N inKaSloEcLalLizEeR d. orCgOenMeralized form.

DIF: Recall REF: p. 405 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 22. An accurate prognosis cannot be made without an accurate a. diagnosis b. BMI measurement c. CBC panel d. teeth cleaning

.

ANS: A

An accurate prognosis cannot be made without an accurate diagnosis.

DIF: Comprehension REF: p. 406 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 23. Which of the following is the proper progression? a. Diagnosis > Examination > Treatment > Prognosis b. Prognosis > Examination > Diagnosis > Treatment c. Examination > Diagnosis > Prognosis > Treatment d. Examination > Prognosis > Treatment > Diagnosis ANS: C

Examination occurs first, then diagnosis, then prognosis, and then treatment.

DIF: Comprehension REF: p. 407 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 24. Genetic factors are considered what type of factors to consider when determining a prognosis? a. Overall clinical factor b. Systemic and environmental factor c. Local factor d. Anatomic factor ANS: B

Genetic factors are considered a type of systemic and environmental factor to consider when determining a prognosis.

DIF: Comprehension REF: p. 397 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 25. Which of the following is the term used when a prognosis is made until phase I therapy is

completed and reevaluated? a. Hypothetical prognosis b. Testing prognosis c. Provisional prognosis d. Ongoing prognosis ANS: C

A provisional prognosis is sometimes used until phase I therapy is completed and reevaluated.

The provisional prognosis allows the clinician to initiate treatment of teeth that have a doubtful outlook in the hopTeEthSaTt B aA faN voKrS abEleLrL esEpR on.sC eO mM ay tip the balance and allow the teeth to be retained.

DIF: Comprehension REF: p. 397 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 34: Treatment Planning and the Rationale for Periodontal Treatment Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. A treatment plan should include what three types of goals? a. Immediate, intermediate, and long-term b. Short-term, intermediate, and long-term c. Unlikely, possible, and probable d. Easy, medium, and hard ANS: A

A treatment plan should encompass immediate, intermediate, and long-term goals.

DIF: Recall REF: p. 408 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. If a goal eliminates all infectious and inflammatory processes that cause periodontal and other

oral problems that may hinder the patient’s general health, what type of goal is it? a. Short-term b. Immediate c. Intermediate d. Emergency ANS: B

The immediate goals are the elimination of all infectious and inflammatory processes that EaRy.hCinOdM cause periodontal and otheT rE orS alTpBroAbN leK mSs E thLaL tm er the patient’s general health.

DIF: Recall REF: p. 408 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. Which of the following types of goals aims to reconstruct healthy dentition that not only

fulfills all functional and esthetic requirements but also lasts many years? a. Possible b. Immediate c. Long-term d. Intermediate ANS: D

Intermediate goals are the reconstruction of a healthy dentition that not only fulfills all functional and esthetic requirements but also lasts many years.

DIF: Recall REF: p. 408 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Which of the following types of goals aims to maintain health through prevention and

professional maintenance therapy? a. Short-term b. Immediate c. Intermediate d. Long-term

ANS: D

Long-term goals aim to maintain health through prevention and professional maintenance therapy.

DIF: Recall REF: p. 408 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. The is the blueprint for case management. a. diagnosis b. prognosis c. treatment plan d. research ANS: C

The treatment plan is the blueprint for case management.

DIF: Comprehension REF: p. 408 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. The is established based on the a. diagnosis; prognosis b. examination; prognosis c. prognosis; diagnosis d. diagnosis; treatment

.

ANS: C

The prognosis is based on the diagnosis.

DIF: Application REF: p. 409 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Which of the following statements is true? a. The diagnosis is based on the prognosis. b. Diagnosis and prognosis will change with treatment. c. Treatment decisions are made directly after the examination. d. The terms diagnosis and prognosis can be used interchangeably.

ANS: B

Diagnosis and prognosis will change with treatment.

DIF: Comprehension REF: p. 409 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. Treatment decisions are made based on a. diagnosis; diagnosis b. diagnosis; prognosis c. prognosis; diagnosis d. prognosis; prognosis

and to improve

ANS: D

Treatment decisions are made based on prognosis and to improve prognosis.

.

DIF: Comprehension REF: p. 409 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following is part of the initial periodontal evaluation? a. Comprehensive periodontal examination b. Inquiry of new concerns or problems c. Extraction of hopeless teeth d. Assessment of outcome of nonsurgical therapy ANS: A

A comprehensive periodontal examination is part of an initial periodontal evaluation.

DIF: Recall REF: p. 410 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Periodontal reevaluation is typically performed

weeks after nonsurgical periodontal

therapy. a. 2 to 6 b. 4 to 8 c. 6 to 10 d. 8 to 12 ANS: B

Periodontal reevaluation is typically performed 4 to 8 weeks after nonsurgical periodontal therapy (in the form of scaling and root planing).

DIF: Recall REF: p. 411 TOP: NBDHE; 3.3.2 ProvisT ioE nS ofTinBsA truNcK tioSnEfoLrLpE reR ve. ntC ioO nM and management of oral diseases 11. Which of the following should not be a part of discussing the treatment plan with a patient? a. Speak in general terms. b. Begin your discussion on a positive note. c. Present the entire treatment plan as a unit. d. Be clear in your directions.

ANS: A

Always be specific when talking to your patients about treatment plans.

DIF: Comprehension REF: p. 411 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. Which of the following is a good example of how to speak to a patient about their treatment

plan? a. “You are having some trouble with your gums.” b. “You can have the gums treated now and then take care of the necessary restorations later.” c. “It’s okay to do nothing now, but we should have a follow-up soon.” d. “Every effort will be made to retain as many teeth as possible.”

ANS: D

“You are having some trouble with your gums” is too general—be specific. Avoid creating the impression that treatment consists of separate procedures. Explain that “doing nothing” or holding onto hopelessly diseased teeth as long as possible is inadvisable. Be positive.

DIF: Application REF: p. 411 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Periodontal disease is a(n) a. bacterial b. viral c. microbial d. fungal

infection.

ANS: C

Periodontal disease is a microbial infection.

DIF: Recall REF: p. 412 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Which of the following statements is true? a. It is feasible to place restorations or fixed bridges on teeth with untreated

periodontal disease. b. Failure to eliminate periodontal disease results in the loss of teeth severely

involved but has no impact on the life span of other teeth. c. The dentist/dental hygienist should make it clear to the patient that if the

periodontal condition is treatable, the best results are obtained by prompt treatment. d. It is the patient’s respoT nsEibSilT itB yA toNrK esS eaErL chLtE heRi. mCpO orM tance of periodontal treatment.

ANS: C

It is not feasible to place restorations or fixed bridges on teeth with untreated periodontal disease. Failure to eliminate periodontal disease results in the loss of teeth severely involved, but also shortens the life span of other teeth. The dentist/dental hygienist should make it clear to the patient that if the periodontal condition is treatable, the best results are obtained by prompt treatment. It is the dental professional’s responsibility to advise the patient of the importance of periodontal treatment.

DIF: Comprehension REF: p. 412 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Diagnosis requires a thorough and careful a. prognosis b. treatment plan c. hypothesis d. examination

.

ANS: D

Diagnosis requires a thorough and careful examination.

DIF: Recall REF: p. 412 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

16. Treatment decisions are based on the a. examination b. prognosis c. diagnosis d. patient’s wishes

.

ANS: B

Treatment decisions are based on the prognosis.

DIF: Recall REF: p. 412 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Treatment decisions are made to improve the a. examination b. treatment plan c. diagnosis d. prognosis

.

ANS: D

Treatment decisions are made to improve the prognosis.

DIF: Recall REF: p. 412 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. Reevaluation exam allows the dental hygienist to assess changes in periodontal parameters

such as what? a. Body temperature b. Tooth decay c. Probing depths d. Gum disease ANS: C

Reevaluation exam allows dental hygienists to assess changes in periodontal parameters such as probing depths and make appropriate treatment recommendations.

DIF: Recall REF: p. 411 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. Maintenance of health depends on all of the following except: a. disease prevention. b. meticulous daily patient home care. c. patient adherence to professional recall maintenance. d. finding an accountability partner.

ANS: D

Maintenance of health depends on disease prevention, meticulous daily patient home care, and patient adherence to professional recall maintenance at a regular interval.

DIF: Comprehension REF: p. 408 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

20. What is Phase III of the sequence of periodontal therapy? a. Nonsurgical phase b. Maintenance phase c. Restorative phase d. Surgical phase ANS: C

Phase III is the restorative phase of treatment.

DIF: Recall REF: p. 409 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 35: Electronic Dental Records and Decision Support Systems Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following is not a standard component of an electronic dental record (EDR)? a. Patient registration b. Medical history c. Ophthalmology history d. Treatment planning ANS: C

An EDR typically includes components such as patient registration, medical and medication history, extraoral and intraoral exams, hard and soft tissue charting, treatment planning, patient education, visit documentation, imaging, and scheduling.

DIF: Recall REF: p. 413 TOP: NBDHE; 7.3 Patient and professional communication

include the patient’s name, gender, birth date, identification numbers, and address and contact information. a. patient registration b. medical history c. treatment planning d. imaging

2. The data captured in

ANS: A

The data captured in patient registration include the patient’s name, gender, birth date, identification numbers (such as Social Security and driver’s license numbers), and address and contact information.

DIF: Recall

REF: p. 413

TOP: NBDHE; 1.1 Medical and dental history

3. Which of the following is the identifier that links together all parts of the electronic record for

a particular patient? a. Phone number b. Password c. Social security number d. Chart number ANS: D

The chart number is a number that a patient is assigned automatically as soon as the record is saved. It is the identifier that links together all parts of the electronic record for a particular patient.

DIF: Recall

REF: p. 413

TOP: NBDHE; 1.1 Medical and dental history

4. Most information on the registration screen of an EDR is stored in separate fields. What is this

known as? a. Structured fields

b. Separation of information c. Moving parts d. Disconnected fields ANS: A

Most information on the registration screen is stored in separate fields, called “structured data.”

DIF: Recall

REF: p. 413

TOP: NBDHE; 1.1 Medical and dental history

5. The graphical presentation of a periodontal chart is much

in electronic form than it

is with paper form. a. harder to read b. difficult to set up c. more detailed d. less detailed ANS: C

The graphical presentation of a periodontal chart is much more detailed in electronic form than it is with paper form.

DIF: Comprehension REF: p. 413 TOP: NBDHE; 1.1 Medical and dental history 6. In what decade did a large growth of electronic dental records (EDRs) take place? a. 1960s b. 1970s c. 1980s d. 1990s ANS: D

Since the late 1990s, the use of EDRs in dental practices has risen significantly worldwide, especially in the United States.

DIF: Application

REF: p. 413

TOP: NBDHE; 1.1 Medical and dental history

7. Early on, dental practices used computerized systems primarily for a. clinical b. administrative c. treatment planning d. surgery

functions.

ANS: B

Early on, dental practices used computerized systems primarily for administration functions, such as patient accounting and billing, insurance processing, and patient scheduling.

DIF: Comprehension REF: p. 413 TOP: NBDHE; 1.1 Medical and dental history 8. Which of the following is an example of an electronic dental record (EDR) software system? a. NextGen b. Epic

c. Cerner d. Eaglesoft ANS: D

Eaglesoft is an example of an electronic dental record (EDR) software system. The others listed are examples of electronic health record software systems.

DIF: Application

REF: p. 414

TOP: NBDHE; 1.1 Medical and dental history

9. Which company makes the Dentrix Dental System software? a. Patterson Dental b. Carestream c. Henry Schein d. Dental Suite ANS: C

Henry Schein makes Dentrix Dental System software.

DIF: Recall

REF: p. 414

TOP: NBDHE; 1.1 Medical and dental history

10. Which of the following is a Windows-based electronic dental record (EDR) system? a. MOGO b. Curve Dental c. Dental Symphony d. United Dental ANS: A

MOGO is a Windows-based electronic dental record (EDR) system.

TESTBANKSELLER.COM

DIF: Recall

REF: p. 414

TOP: NBDHE; 1.1 Medical and dental history

11. Which of the following is not a barrier to using electronic dental records (EDRs)? a. Limited functionality b. Cost c. Steep learning curve d. Patient care ANS: D

Several barriers exist to using electronic dental records: limited functionality, suboptimal usability and a steep learning curve, insufficient operational reliability, and cost and infection control issues.

DIF: Comprehension REF: p. 414 TOP: NBDHE; 1.1 Medical and dental history 12. Which of the following is an example of usability problems with electronic dental records

(EDRs)? a. Separation of patient information across multiple screens b. Cost to implement the system c. Training of employees d. The lack of security within the system ANS: A

Two examples of usability problems are the separation of patient information across multiple screens and the frequent mismatch between system design and task flow.

DIF: Comprehension REF: p. 415 TOP: NBDHE; 1.1 Medical and dental history 13. Which of the following is an example of insufficient reliability of electronic dental records? a. Infection control issues b. System crashes c. Lack of congruity in the system d. Communication issues among the staff ANS: B

System crashes during patient care that lead to loss of patient data and time are an example of the insufficient operational reliability of EDRs. DIF: Recall 14. Currently, a. no b. minimal c. specific d. measurable

REF: p. 415

TOP: NBDHE; 1.1 Medical and dental history

standards exist on what clinical information dental records must contain.

ANS: A

Currently, no standards exist on what clinical information dental records should or must contain.

DIF: Comprehension REF: p. 416 TOP: NBDHE; 1.1 Medical and dental history 15. Which of the following is an example of a terminology that is being developed and evaluated

to serve as standard diagnostic codes for dentistry? a. ICD-10 b. HIPAA c. HCPCS d. SNODENT ANS: D

Several terminologies, such as the Systematized Nomenclature of Dentistry (SNODENT) and EZCodes, are being developed and evaluated as standard diagnostic codes for dentistry.

DIF: Recall

REF: p. 416

TOP: NBDHE; 1.1 Medical and dental history

16. Which of the following is not a benefit of using electronic dental records? a. The immense amount of time it takes to train staff. b. The ability to track their patient’s treatment progress. c. The amount of money it takes to get the system up and running. d. The standard terminology used.

ANS: B

EDRs can provide significant benefits for clinicians and researchers. One of these major benefits is that clinicians can track their patients’ treatment progress and risks for various diseases.

DIF: Comprehension REF: p. 416 TOP: NBDHE; 1.1 Medical and dental history 17. Which of the following is not an example of an advantage to using an EDR for dental

research? a. The ability to conduct studies with large sample sizes b. The ability to obtain well-matched controls c. The ability to have a delay in collecting data d. The ability to identify patients with rare diseases ANS: C

Advantages of using EDR data for research include the ability to conduct studies of significant statistical power due to large sample sizes, obtain well-matched controls, ascertain important potential confounders, identify patients with rate diseases, save study time, collect data in real time, and generate systematic data documentation.

DIF: Comprehension REF: p. 416 TOP: NBDHE; 1.1 Medical and dental history 18. In periodontology, a. theory-based b. risk-based c. disease-based

decision support systems are the most common type of CDSS.

d. diagnosis-based ANS: B

In periodontology, risk-based decision support systems are the most common type of CDSS. DIF: Recall

REF: p. 417

TOP: NBDHE; 1.1 Medical and dental history

19. Which of the following is an example of risk assessment tools for periodontal disease? a. PreViser Risk Calculator b. ReNovation Risk Calculator c. United Risk Calculator d. DentalWeb Risk Calculator ANS: A

The PreViser Risk Calculator (PRC) is an example of a risk assessment tool for periodontal disease.

DIF: Recall 20.

REF: p. 417

TOP: NBDHE; 1.1 Medical and dental history

is an interdisciplinary field that applies computer and information science knowledge and methods to improve information management during clinical care, research, and dental education. a. Dental information services b. Dental information science c. Dental informatics

d. Dental informatory processing ANS: C

Dental informatics is an interdisciplinary field that applies computer and information science knowledge and methods to improve information management during clinical care, research, and dental education.

DIF: Recall

REF: p. 417

TOP: NBDHE; 1.1 Medical and dental history

Chapter 36: Periodontal Treatment of Medically Compromised Patients Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1.

diseases are the most prevalent category of systemic disease in the United States and many other countries. a. Renal b. Endocrine c. Cardiovascular d. Pulmonary ANS: C

Cardiovascular diseases are the most prevalent category of systemic disease in the United States and many other countries, and they become more common with increasing age.

DIF: Recall REF: p. 419 TOP: NBDHE; 3.5 Recognition and management of compromised patients 2. Which of the following is an example of a cardiovascular issue? a. Myocardial infarction b. Liver failure c. Glomerulonephritis d. Blood dyscrasias ANS: A

NpKlS Myocardial infarction (MIT ) iE sS anTeBxA am eE ofLaLcE arRd. ioC vaOsM cular disease.

DIF: Recall REF: p. 419 TOP: NBDHE; 3.5 Recognition and management of compromised patients 3. Which of the following is the most common cardiovascular disease? a. Congestive heart failure (CHF) b. Cerebrovascular accident (CVA) c. Hypotension d. Hypertension ANS: D

Hypertension is the most common cardiovascular disease. It affects more than 50 million American adults, many of whom are undiagnosed.

DIF: Recall REF: p. 419 TOP: NBDHE; 3.5 Recognition and management of compromised patients 4. Systolic blood pressure greater than

cardiovascular disease. a. 120 b. 130 c. 140 d. 150

mm Hg is considered a greater risk for

ANS: B

Systolic blood pressure greater than 130 mm Hg is considered a greater risk factor for cardiovascular disease.

DIF: Recall REF: p. 419 TOP: NBDHE; 3.5 Recognition and management of compromised patients 5. If a patient has a systolic blood pressure if 135 and a diastolic blood pressure of 85, what stage

of hypertension should they be classified as? a. Stage 1 b. Stage 2 c. Stage 3 d. Hypertensive urgency ANS: A

Stage 1 hypertension includes a systolic blood pressure between 130 and 139 and a diastolic blood pressure of between 80 and 89.

DIF: Application REF: p. 419 TOP: NBDHE; 3.5 Recognition and management of compromised patients 6. Dental treatment for hypertensive patients is safe as long as a. probing b. stress c. medication d. talking

is minimized.

ANS: B

Dental treatment for hypertensive patients is safe as long as stress is minimized.

DIF: Recall REF: p. 420 TOP: NBDHE; 3.5 Recognition and management of compromised patients 7. Which of the following is typically used to treat hypertension? a. NSAIDs b. Beta blockers c. Corticosteroids d. Insulin ANS: B

Typically, beta blockers are used to treat hypertension.

DIF: Comprehension REF: p. 420 TOP: NBDHE; 3.5 Recognition and management of compromised patients 8. Which of the following is a condition in which the pump function of the heart is unable to

supply sufficient amounts of oxygenated blood to meet the body’s needs? a. Cerebrovascular accident b. Hypertension c. Congestive heart failure d. Ischemic heart disease

ANS: C

Congestive heart failure is a condition in which the pump function of the heart is unable to supply sufficient amounts of oxygenated blood to meet the body’s needs.

DIF: Recall REF: p. 422 TOP: NBDHE; 3.5 Recognition and management of compromised patients 9. Which of the following is a disease in which microorganisms colonize damaged endocardium

or heart valves? a. Bacterial endocarditis b. Infective endocarditis c. Fungal endocarditis d. Viral endocarditis ANS: B

Infective endocarditis is a disease in which microorganisms colonize damaged endocardium or heart valves. The term “infective endocarditis” is preferred to “bacterial endocarditis” because the disease can also be caused by fungi and viruses.

DIF: Recall REF: p. 422 TOP: NBDHE; 3.5 Recognition and management of compromised patients 10. What is the recommended antibiotic prophylaxis regimen for patients unable to take oral

medications? a. Ampicillin b. Cefazolin c. Amoxicillin d. Cephalexin ANS: A

Ampicillin is the recommended antibiotic prophylaxis regimen for patients unable to take oral medications.

DIF: Application REF: p. 424 TOP: NBDHE; 3.5 Recognition and management of compromised patients 11. How many months after a stroke can periodontal therapy be performed during short

appointments? a. 2 b. 3 c. 4 d. 6 ANS: B

Periodontal therapy can be performed during short appointments for 3 months after a stroke.

DIF: Comprehension REF: p. 424 TOP: NBDHE; 3.5 Recognition and management of compromised patients 12. Which of the following is not a classic sign of diabetes? a. Polythemia b. Polydipsia

c. Polyuria d. Polyphagia ANS: A

The classic signs of diabetes include polydipsia (excessive third), polyuria (excessive urination), and polyphagia (excessive hunger).

DIF: Comprehension REF: p. 425 TOP: NBDHE; 3.5 Recognition and management of compromised patients 13. The therapeutic goal for many diabetic patients is to achieve and maintain an HbA1c below

%. a. b. c. d.

2 6 8 12

ANS: C

The therapeutic goal for many diabetic patients is to achieve and maintain an HbA1c below 8%.

DIF: Recall REF: p. 426 TOP: NBDHE; 3.5 Recognition and management of compromised patients 14. Which of the following is not a sign/symptom of hypoglycemia? a. Confusion b. Xerostomia c. Seizures d. Dizziness ANS: B

Signs and symptoms of hypoglycemia include shakiness or tremors, confusion, agitation and anxiety, sweating, tachycardia, dizziness, feeling of impending doom, unconsciousness, and seizures.

DIF: Comprehension REF: p. 426 TOP: NBDHE; 3.5 Recognition and management of compromised patients 15. The most common dental office complication seen in diabetic patients taking insulin is a. b. c. d.

. hypersalivation seizures hyperglycemia hypoglycemia

ANS: D

The most common dental office complication seen in diabetic patients taking insulin is a symptomatic low blood glucose level, or hypoglycemia.

DIF: Recall REF: p. 426 TOP: NBDHE; 3.5 Recognition and management of compromised patients

16. Which of the following is an example of a long-acting type of insulin? a. Lispro (Humalog) b. Glargine (Lantus) c. Humulin N d. Glulisine (Apidra) ANS: B

Glargine (Lantus) is an example of a long-acting type of insulin.

DIF: Recall REF: p. 427 TOP: NBDHE; 3.5 Recognition and management of compromised patients 17.

is/are associated with significant morbidity and mortality rates as a result of a peripheral vascular collapse and cardiac arrest. a. Thyroid disorders b. Diabetes c. Adrenal insufficiency d. Coagulation disorders ANS: C

Acute adrenal insufficiency is associated with significant morbidity and mortality rates as a result of peripheral vascular collapse and cardiac arrest.

DIF: Comprehension REF: p. 427 TOP: NBDHE; 3.5 Recognition and management of compromised patients 18. Periodontal treatment can be performed in patients with coagulation disorders provided that a. b. c. d.

. scaling is not performed appropriate precautions are taken the patient gives consent NSAIDs are given

ANS: B

Periodontal treatment can be performed in patients with coagulation disorders provided that appropriate precautions are taken.

DIF: Comprehension REF: p. 429 TOP: NBDHE; 3.5 Recognition and management of compromised patients 19. During the acute phases of leukemia, patients . a. should receive only emergency periodontal care b. can receive all types of periodontal care c. should receive no periodontal care d. can receive all types of periodontal care, except emergency periodontal care ANS: A

During the acute phases of leukemia, patients should receive only emergency periodontal care.

DIF: Recall REF: p. 430 TOP: NBDHE; 3.5 Recognition and management of compromised patients

20. Major causes of liver disease include all of the following except: a. cirrhosis. b. viral infections. c. drug toxicity. d. bacterial infections.

ANS: D

Major causes of liver disease include drug toxicity, cirrhosis, viral infections, neoplasms, and biliary tract disorders.

DIF: Recall REF: p. 430.e2 TOP: NBDHE; 3.5 Recognition and management of compromised patients 21. Which of the following is not a pulmonary disease? a. Hepatitis C b. Asthma c. Bronchitis d. Emphysema ANS: A

Pulmonary diseases range from obstructive lung diseases (e.g., asthma, emphysema, bronchitis, acute obstruction) to restrictive ventilatory disorders caused by muscle weakness, scarring, obesity, or any condition that can interfere with effective lung ventilation.

DIF: Recall REF: p. 430.e2 TOP: NBDHE; 3.5 Recognition and management of compromised patients 22. Clinical studies of patientsToE nS anTtB icA oaNgK ulS anEt LthLeE raR py.uCnOdM ergoing extractions and other oral

surgical procedures have demonstrated continued. a. zero b. minimal c. significant d. almost uncontrollable

bleeding problems when therapy is

ANS: B

Clinical studies of patients on anticoagulant therapy undergoing extractions and other oral surgical procedures have demonstrated minimal bleeding problems when therapy is continued.

DIF: Comprehension REF: p. 432 TOP: NBDHE; 3.5 Recognition and management of compromised patients 23. Patients scheduled to receive head and neck radiation therapy require dental consultation a. b. c. d.

. at the earliest possible time at the convenience of the patient at the time the therapy is performed after the therapy is performed

ANS: A

Patients scheduled to receive head and neck radiation therapy require dental consultation at the earliest possible time to reduce the morbidity of known perioral side effects.

DIF: Comprehension REF: p. 433 TOP: NBDHE; 3.5 Recognition and management of compromised patients 24. During radiation therapy, patients should receive

prophylaxis, oral hygiene

instruction, and professionally applied fluoride treatments. a. daily b. weekly c. biweekly d. monthly ANS: B

During radiation therapy, patients should receive weekly prophylaxis, oral hygiene instruction, and professionally applied fluoride treatments, unless mucositis prevents treatment.

DIF: Recall REF: p. 434 TOP: NBDHE; 3.5 Recognition and management of compromised patients 25. Which of the following statements is true about patients with prosthetic joint replacements? a. The AAOM, ADA, AAOS, and BSAC advise for the universal use of antibiotic

prophylaxis before dental procedures for the prevention of prosthetic joint infections. b. The main treatment consideration for patients with prosthetic joint replacement is the potential need for antibiotic prophylaxis before periodontal therapy. c. Prophylactic antibiotics are recommended before dental procedures for patients with prosthetic joint implants.

CeOeMn dental treatment and joint d. There is a clear cause-aTnE d-SeT ffB ecA tN reK laS tioEnLshLiE pR be.tw infection.

ANS: B

Given the lack of evidence to support the need for prophylactic antibiotics, the AAOM, ADA, AAOS, and BSAC advise against universal use of antibiotic prophylaxis before dental procedures for the prevention of prosthetic joint infections. The main treatment consideration for patients with prosthetic joint replacement is the potential need for antibiotic prophylaxis before periodontal therapy. The clinical practice guideline states that prophylactic antibiotics are not recommended before dental procedures for patients with prosthetic joint implants to prevent prosthetic joint infections. Although dental-induced bacteremia can theoretically cause prosthetic joint infection, scant reports demonstrate dental treatment as a source of joint infection, and none actually documents a cause-and-effect relationship.

DIF: Comprehension REF: p. 434 TOP: NBDHE; 3.5 Recognition and management of compromised patients

Chapter 37: Periodontal Therapy in the Female Patient Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. On average, puberty occurs between the ages of a. 7 and 10 b. 11 and 14 c. 13 and 17 d. 15 and 19

in most females.

ANS: B

On average, puberty occurs between the ages of 11 and 14 in most females.

DIF: Recall

REF: p. 435

TOP: NBDHE; 3.3 Individualized patient education

2. Which of the following is an example of a female sex hormone? a. Estrogen b. Testosterone c. Prolactin d. Peptides ANS: A

Two examples of female sex hormones are estrogen and progesterone.

DIF: Recall

REF: p. 435

TOP: NBDHE; 3.3 Individualized patient education

3. During the reproductive years, females tend to have a a. less active b. weaker c. more vigorous d. zero-tolerance

immune response.

ANS: C

During the reproductive years, females tend to have a more vigorous immune response.

DIF: Recall

REF: p. 435

TOP: NBDHE; 3.3 Individualized patient education

4. Which of the following statements is true about puberty? a. Sex steroids have little effect on immune function and bone metabolism. b. In puberty, the prevalence of gingivitis and plaque increases. c. During puberty, periodontal tissues can have an exaggerated response to local

factors. d. Allergy, sensitivity, and asthma occur more often in young females.

ANS: C

Sex functions exert profound biologic effects on immune function and bone metabolism. The prevalence of gingivitis increases without an increase in the amount of plaque. During puberty, periodontal tissues can have an exaggerated response to local factors. Allergy, sensitivity, and asthma occur more often in young males, but after puberty females become more susceptible than their male counterparts.

DIF: Comprehension REF: p. 435 TOP: NBDHE; 3.3 Individualized patient education 5. During the reproductive years, the ovarian cycle is controlled by the a. anterior pituitary gland b. posterior adrenal gland c. posterior pituitary gland d. anterior adrenal gland

.

ANS: A

During the reproductive years, the ovarian cycle is controlled by the anterior pituitary gland.

DIF: Recall

REF: p. 436

TOP: NBDHE; 3.3 Individualized patient education

6. What two hormones are produced by the anterior posterior gland during the reproductive

years? a. Estrogen and progesterone b. Follicle-stimulating hormone and luteinizing hormone c. Estrogen and testosterone d. Progesterone and luteinizing hormone ANS: B

Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are produced by the anterior posterior gland. Estrogen and progesterone are steroid hormones produced by the ovaries during the menstrual cycle.

DIF: Recall

REF: TpE . 4S3T 6 BANKS TE OL P:LE NR BD .HCEO; M3.3 Individualized patient education

7. During what phase of the reproductive cycle does the estrogen level peak? a. Phase 1 b. Phase 2 c. Phase 3 d. Phase 4 ANS: B

Estrogen levels are stimulated in phase 1 of the monthly reproductive cycle, and peak in phase 2.

DIF: Comprehension REF: p. 436 TOP: NBDHE; 3.3 Individualized patient education 8. What is another term for the first phase of the monthly reproductive cycle? a. Follicular phase b. Synthesis phase c. Luteal phase d. Implantation phase ANS: A

The first phase of the monthly reproductive cycle is referred to as the follicular phase.

DIF: Recall

REF: p. 436

TOP: NBDHE; 3.3 Individualized patient education

9. During a standard 28-day menstrual cycle, at what day does the progesterone level peak? a. 5 b. 8 c. 10 d. 14 ANS: C

During menses, progesterone increases from the second week, peaks at approximately 10 days, and dramatically drops before menstruation.

DIF: Recall

REF: p. 437

TOP: NBDHE; 3.3 Individualized patient education

10. Which of the following statements is true about PMS? a. Many females exhibit physical symptoms like food cravings, abdominal bloating,

headaches, and breast tenderness. b. PMS is often treated with NSAIDs. c. The PMS patient is often easier to treat because the lack of emotion and sensitivity. d. Among menstruating women, 50% have PMS symptoms and meet the strict

diagnostic criteria.

ANS: A

During PMS, many females exhibit physical symptoms like fatigue, cravings for sweet and salty foods, abdominal bloating, swollen hands or feet, headaches, breast tenderness, nausea, and gastrointestinal upset. PMS is often treated with antidepressants, not NSAIDs. The PMS patient may be difficult to treat because of her emotional and physiologic sensitivity. Among menstruating women, 70% have PMS symptoms but only 5% meet the strict diagnostic criteria.

DIF: Comprehension REF: p. 437 TOP: NBDHE; 3.3 Individualized patient education 11. Which of the following statements is false? a. Epidemiologic studies indicate a relationship between the level of home care and

the severity of gingival inflammation. b. Current opinion suggests no association between periodontal disease and preterm

low-birth-weight infants. c. A systematic review of preeclampsia and periodontitis indicated a decreased risk

during pregnancy. d. Gram-positive bacteria in periodontal diseases may permit their selective

overgrowth or invasion within the genitourinary tract.

ANS: B

Epidemiologic studies indicate a relationship between the level of home care and the severity of gingival inflammation. Current opinion suggests a possible association between periodontal disease and preterm low-birth-weight infants. A systematic review of preeclampsia and periodontitis indicated an increased risk during pregnancy. Gram-negative bacteria in periodontal diseases may permit their selective overgrowth or invasion within the genitourinary tract.

DIF: Comprehension

REF: p. 439

TOP: NBDHE; 3.3 Individualized patient education 12. Which of the following is an example of a gingival response to elevated estrogen during

pregnancy? a. Decreases cellular proliferation in blood vessels. b. Decreases keratinization while increasing epithelial glycogen. c. Decreases vascular dilation and increases permeability. d. Alters rate and pattern of collagen production.

ANS: B

Elevated estrogen during pregnancy decreases keratinization while increasing epithelial glycogen and increases cellular proliferation in blood vessels. Increased levels of progesterone decrease vascular dilation and increases permeability and alters rate and pattern of collagen production.

DIF: Comprehension REF: p. 440 TOP: NBDHE; 3.3 Individualized patient education 13. What pregnancy hormone influences the permeability of the microvasculature, alters the rate

and pattern of collagen production, and increases the metabolic breakdown of folate? a. Estrogen b. Progesterone c. Testosterone d. Prolactin ANS: B

Progesterone influences the permeability of the microvasculature, alters the rate and pattern of collagen production, and inTcE reSasTeB sA thN eK mS etE abLoLliE cR br.eaCkOdM own of folate.

DIF: Recall

REF: p. 440

TOP: NBDHE; 3.3 Individualized patient education

14. Which of the following is a typical oral manifestation of pregnancy? a. Sialorrhea b. Xerostomia c. Tooth loss d. Dizziness ANS: B

Xerostomia is a frequent complaint among pregnant women. Sialorrhea (ptyalism) is a rare finding in pregnancy.

DIF: Comprehension REF: p. 441 TOP: NBDHE; 3.5 Recognition and management of compromised patients 15. Which of the following statements is true regarding fluoride treatments while pregnant? a. The American Dental Association recommends getting a second opinion from a

medical doctor about the use of prenatal fluoride. b. The prescription of prenatal fluoride supplements has never been an area of

controversy. c. The American Dental Association highly recommends the use of prenatal fluoride

because its efficacy has been demonstrated in many controlled studies. d. The American Dental Association does not recommend the use of prenatal fluoride

because its efficacy has not been demonstrated.

ANS: D

The American Dental Association (ADA) does not recommend the use of prenatal fluoride because its efficacy has not been demonstrated.

DIF: Recall REF: p. 441 TOP: NBDHE; 3.5 Recognition and management of compromised patients 16. Which of the following is the safest period during pregnancy for providing routine dental

care? a. Anytime in the first trimester b. Early in the second trimester c. Between months 6 and 7 of pregnancy d. Toward the end of the pregnancy ANS: B

Early in the second trimester is the safest period for providing routine dental care.

DIF: Recall REF: p. 441 TOP: NBDHE; 3.5 Recognition and management of compromised patients 17. Which of the following oral medication is safe to use during pregnancy? a. Lidocaine b. Codeine c. Aspirin d. Barbiturates ANS: A

Lidocaine is safe to use during pregnancy. Refer to Table 37.1 in the textbook.

DIF: Recall REF: p. 443 TOP: NBDHE; 3.5 Recognition and management of compromised patients 18. Which of the following is a risk of using penicillin during pregnancy? a. Seizures b. Low-birth-weight c. Diarrhea d. Gestational diabetes ANS: C

Diarrhea is a risk of using penicillin during pregnancy. Refer to Table 37.2 in the textbook.

DIF: Recall REF: p. 443 TOP: NBDHE; 3.5 Recognition and management of compromised patients 19. Which of the following analgesics should be avoided while breastfeeding? a. Procaine b. Aspirin c. Ibuprofen d. Mepivacaine ANS: B

Procaine and mepivacaine are local anesthetics. Ibuprofen is an analgesic and can be used during breastfeeding. Aspirin is an analgesic and should be avoided while breastfeeding.

DIF: Recall REF: p. 443 TOP: NBDHE; 3.5 Recognition and management of compromised patients 20. Which of the following antibiotics should be avoided during breastfeeding? a. Ciprofloxacin b. Erythromycin c. Nitrous oxide d. Cephalosporins ANS: A

Ciprofloxacin is an antibiotic that should be avoided during breastfeeding.

DIF: Recall REF: p. 443 TOP: NBDHE; 3.5 Recognition and management of compromised patients 21. Which of the following is not an oral change that occurs during menopause? a. Thinning of the oral mucosa b. Oral discomfort c. Altered taste sensation d. Sialorrhea ANS: D

Oral changes in menopause include thinning of the oral mucosa, oral discomfort (i.e., burning mouth), gingival recession, xerostomia, altered taste sensation, alveolar bone loss, and alveolar ridge resorption.

DIF: Comprehension REF: p. 444.e1 TOP: NBDHE; 3.5 Recognition and management of compromised patients 22. Which of the following terms is used to describe a reduction in bone mass caused by an

imbalance between bone resorption and formation? a. Osteoclasts b. Osteoporosis c. Osteopenia d. Osteomania ANS: C

Osteopenia is a reduction in bone mass caused by an imbalance between bone resorption and formation, favoring resorption and resulting in demineralization and osteoporosis.

DIF: Recall REF: p. 444.e1 TOP: NBDHE; 3.5 Recognition and management of compromised patients 23. Many females live a. 40 b. 50 c. 60 d. 70

% of their lives in menopause.

ANS: A

Female life expectancy is 80+ years and many live 40% of their lives in menopause.

DIF: Recall REF: p. 444.e1 TOP: NBDHE; 3.5 Recognition and management of compromised patients 24. Which of the following antibiotics should be avoided during pregnancy because of the risk of

depression of bone growth, enamel hypoplasia, and gray-brown tooth discoloration? a. Tetracycline b. Cephalosporins c. Erythromycin d. Gentamicin ANS: A

Tetracycline is an FDA category D and should be avoided during pregnancy because of the risk of depression of bone growth, enamel hypoplasia, and gray-brown tooth discoloration.

DIF: Recall REF: p. 443 TOP: NBDHE; 3.5 Recognition and management of compromised patients 25. Which of the following sedative-hypnotic drug does not have an assigned FDA category and

should be avoided in the first trimester of pregnancy but otherwise could be used with caution, as long as a physician is consulted? a. Benzodiazepines b. Nitrous oxide c. Barbiturates d. Oxycodone ANS: B

Nitrous oxide does not have an assigned FDA category and should be avoided in the first trimester in pregnancy, but otherwise could be used with caution, as long as a physician is consulted.

DIF: Comprehension REF: p. 443 TOP: NBDHE; 3.5 Recognition and management of compromised patients

Chapter 38: Periodontal Treatment for Older Adults Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Almost a. 30 b. 50 c. 70 d. 90

% of older adults in the United States have natural teeth.

ANS: C

Almost 70% of older adults in the United States have natural teeth.

DIF: Recall

REF: p. 446

TOP: NBDHE; 3.3 Individualized patient education

2. Which of the following statements is true about the aging periodontium? a. Normal aging of the periodontium is a result of cellular aging. b. The aging process affects every tissue in the same way. c. With aging, stem cells undergo invigoration. d. In the aging process, cell renewal takes place at a faster rate.

ANS: A

Normal aging of the periodontium is a result of cellular aging, which is the basis for the intrinsic changes seen in oral tissues over time. The aging process does not affect every tissue in the same way. With aging, stem cells undergo exhaustion; this affects the regenerative potential of the organism. T InEthSeTaB giAnN gK prSoE ceLssL, E ceRll.rC enOeM wal takes place at a slower rate and with fewer cells.

DIF: Comprehension REF: p. 446 TOP: NBDHE; 3.3 Individualized patient education 3. Which one of the following periodontal changes does not occur with aging? a. Thickening of oral epithelium b. Gingival recession c. Thickening of cementum d. Reduction or loss of periodontal ligament tissue elasticity ANS: A

Key periodontal changes with aging include the thinning of the oral epithelium and reduced keratinization, reduction or loss of periodontal ligament tissue elasticity, gingival recession, attachment and bone loss, and thickening of cementum.

DIF: Comprehension REF: p. 447 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Periodontal disease in older adults is usually referred to as a. acute b. chronic c. advanced d. aging

periodontitis.

ANS: B

Periodontal disease in older adults is usually referred to as chronic periodontitis.

DIF: Recall REF: p. 447 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Which of the following statements is true about older adults and periodontitis? a. The advanced stages of periodontitis are less prevalent than the moderate stages in

the older adult population. b. The moderate stages of periodontitis are more prevalent than the advanced stages of periodontitis in the older adult population. c. Older adults who have periodontitis are more likely to experience tooth loss and a thickening in the gingiva. d. Older adults who have periodontitis are less likely to experience tooth loss and a thinning in the gingiva.

ANS: A

The advanced stages of periodontitis are less prevalent than the moderate stages in the older adult population.

DIF: Comprehension REF: p. 447 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. In 2014, average life expectancy (at birth) was projected to be a. 62.4 b. 70.1 c. 78.8 d. 86.2

years.

ANS: C

In 2014, average life expectancy (at birth) was projected to be 78.8 years.

DIF: Recall REF: p. 449.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. From 2010 to 2050, the number of people 65 years or older is expected to increase from 560

million, or 8% of the world’s population, to the world’s population. a. 0.5; 14 b. 1.0; 15 c. 1.5; 16 d. 2.0; 17

billion, which is projected to be

% of

ANS: C

From 2010 to 2050, the number of people 65 years or older is expected to increase from 560 million, or 8% of the world’s population, to 1.5 billion, which is projected to be 16% of the world’s population.

DIF: Recall REF: p. 449.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

8. Which of the following is an example of an economic factor that could affect an older adult’s

eating patterns? a. Isolation b. Loneliness c. Dementia d. Death of a spouse ANS: D

Social factors include isolation, loneliness, and the effects of dementia or depression.

Economic factors include a lower economic status resulting from retirement, failing health, living on a fixed income, or death of a spouse.

DIF: Recall REF: p. 449.e3 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following terms refers to the consumption of types and varieties of food

resources? a. Diet b. Health c. Nutrition d. Eating pattern ANS: A

Diet refers to the consumption of types and varieties of food resources, and nutrition is the process by which food is used to provide energy and sustain, restore, and maintain tissue of living organisms.

DIF: Recall REF: TpE . 4S4T 9.B e3ANKSELLER.COM TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which of the following statements is not true when discussing psychosocial factors related to

the aging process? a. Older adults with a positive attitude about oral health have predictably better dental behaviors that translate into higher utilization rates of dental services. b. Positive attitude is highly associated with educational level. c. Dental diseases have their greatest effect on behaviors and mental and social well-being. d. On average, older adults use more dental services.

ANS: D

On average, older adults use fewer dental services, perhaps because of conflicting economic priorities between medical and dental needs.

DIF: Comprehension REF: p. 449.e3 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Which of the following is a function of protein? a. Energy metabolism b. Cellular differentiation and proliferation c. Integrity of immune system d. Coenzymes in metabolic processes

ANS: A

Protein helps with DNA/RNA synthesis and energy metabolism.

DIF: Recall REF: p. 449.e4 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. Which of the following nutrients is involved in hemoglobin, myoglobin, and cytochrome

systems? a. Protein b. Vitamin C c. Zinc d. Iron ANS: D

Iron is involved in hemoglobin, myoglobin, and cytochrome systems.

DIF: Recall REF: p. 449.e4 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Depression is a common public health problem among elderly people, affecting

% of

adults older than age 65 in the United States. a. 5 b. 15 c. 30 d. 50 ANS: B

Depression is a common pT ubEliScThB eaA ltN hK prSoE blL em onCgOeM lderly people, affecting 15% of adults LEam R. older than age 65 in the United States.

DIF: Recall REF: p. 449.e5 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. The current model of periodontal disease indicates all of the following except: a. the prevalence of periodontal disease is low and possibly decreasing. b. the process of periodontal disease is episodic and infrequent. c. most of the reported cases of periodontal disease occur in a small high-risk

population of older adults. d. active and inactive disease sites cannot coexist.

ANS: D

The prevalence of periodontal disease is low and possibly decreasing. The process of periodontal disease is episodic and infrequent. Most of the reported cases of periodontal disease occur in a small high-risk population of older adults. There is a continued effort to identify risk factors for periodontal disease. Active and inactive disease sites coexist.

DIF: Comprehension REF: p. 449.e6 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Candidiasis is caused by an overproliferation of a. Candida albicans b. Candida glabrata

.

c. Candida tropicalis d. Candida parapsilosis ANS: A

Candidiasis is caused by an overproliferation of C. albicans.

DIF: Recall REF: p. 449.e8 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Which of the following does not need to be included in the dental interview for older adults? a. Medical (physical) history b. Social history c. Economic history d. Behavior history ANS: C

The dental interview with the older adult includes the medical (physical) history, behavior history, and social history.

DIF: Comprehension REF: p. 449.e9 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. It is estimated that by 2060, the U.S. population of adults aged 65 years or older will rise to approximately million people. a. 24 b. 48 c. 68 d. 85 ANS: C It is estimated that by 2060, the U.S. population of adults aged 65 years or older will rise to approximately 68 million people.

DIF: Recall REF: p. 449.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. Which of the following is not an effect of fluoride? a. It reduces enamel solubility. b. It is bactericidal for bacterial plaque. c. It is effective at preventing plaque buildup, but not effective at preventing caries. d. It promotes remineralization of early carious lesions.

ANS: C

Fluoride reduces enamel solubility, is bactericidal for bacterial plaque, promotes remineralization of early carious lesions, and is an effective caries-preventive agent.

DIF: Comprehension REF: p. 449 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. Which of the following is a cationic bisbiguanide that has been used as a broad-spectrum

antiseptic in medicine since the 1950s? a. Tetracycline b. Chlorhexidine

c. Ibuprofen d. Mepivacaine ANS: B

Chlorhexidine is a cationic bisbiguanide that has been used as a broad-spectrum antiseptic in medicine since the 1950s.

DIF: Recall REF: p. 449 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. Which of the following is true about gingival overgrowth? a. Gingival overgrowth always occurs in direct correlation with periodontal disease. b. Gingival overgrowth can be induced by certain medications. c. Gingival overgrowth has no relation to a person’s ability to maintain good oral

hygiene. d. Gingival overgrowth is caused by the decrease in the number of collagen fibers.

ANS: B

Gingival overgrowth can be induced by certain medications such as cyclosporine, calcium channel blockers, and anticonvulsants.

DIF: Comprehension REF: p. 447 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 39: Treatment of Aggressive and Atypical Forms of Periodontitis Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. The overall prognosis for patients with aggressive periodontitis is

for patients with

chronic periodontitis. a. equal b. poorer than c. better than d. substantially better than ANS: B

The overall prognosis for patients with aggressive periodontitis is poorer than for patients with chronic periodontitis.

DIF: Recall REF: p. 451 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Which kind of periodontitis rarely undergoes spontaneous remission? a. Localized aggressive periodontitis b. Necrotizing ulcerative periodontitis c. Generalized aggressive periodontitis d. Acute aggressive periodontitis ANS: C

Generalized aggressive perTioEdS onTtB itiA sN raK reSlyEuLnL deErR go.eC sO spMontaneous remission, whereas localized forms of the disease have been known to arrest spontaneously.

DIF: Comprehension REF: p. 451 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. The prognosis for patients with aggressive periodontitis depends on all of the following

except: a. whether the disease is generalized or localized. b. the degree of destruction present at the time of diagnosis. c. the ability to control future progression. d. the elasticity of the gums.

ANS: D

The prognosis for patients with aggressive periodontitis depends on all of the following: whether the disease is generalized or localized, the degree of destruction present at the time of diagnosis, and the ability to control future progression.

DIF: Comprehension REF: p. 451 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Family members, especially

of the patient diagnosed with aggressive periodontitis, should be examined for signs of disease, educated about preventative measures, and monitored closely. a. younger siblings

b. parents c. spouses d. children ANS: A

Family members, especially younger siblings of the patient diagnosed with aggressive periodontitis, should be examined for signs of disease, educated about preventative measures, and monitored closely.

DIF: Recall REF: p. 452 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Aggressive periodontitis is primarily a. viral b. parasitic c. bacterial d. fungal

of origin.

ANS: C

Aggressive periodontitis is primarily bacterial of origin.

DIF: Recall REF: p. 452 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. In general, the

therapy and the more a. earlier; predictable b. later; predictable c. earlier; worse d. later; better

aggressive periodontitis is diagnosed, the more conservative the the outcome.

ANS: A

In general, the earlier aggressive periodontitis is diagnosed, the more conservative the therapy and the more predictable the outcome.

DIF: Recall REF: p. 452 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. In a patient with severe horizontal bone loss, why might a nonsurgical approach be

preferable? a. Surgical resective therapy may result in plaque buildup. b. Surgical resective therapy may result in increased tooth mobility. c. Nonsurgical approaches provide a better outcome for the patient. d. Nonsurgical approaches provide no downside for the patient.

ANS: B

In a patient with severe horizontal bone loss, surgical resective therapy may result in increased tooth mobility that is difficult to manage, and a nonsurgical approach may be preferable.

DIF: Application REF: p. 452 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

8. The presence of periodontal pathogens, specifically

has been implicated as the reason aggressive periodontitis does not respond to conventional therapy alone. a. Actinobacillus actinomycetemcomitans b. Porphyromonas gingivalis c. Fusobacterium nucleatum d. Aggregatibacter actinomycetemcomitans ANS: D

Aggregatibacter acinomycetemcomitans has been implicated as the reason aggressive periodontitis does not respond to conventional therapy alone.

DIF: Recall REF: p. 452 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following is an example of a regenerative material used in dentistry? a. Bone grafts b. Crown c. Sealant d. Probing device ANS: A

Regenerative materials, including bone grafts, barrier membranes, and wound-healing agents, are often employed, and their use is well-documented.

DIF: Recall REF: p. 452.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. When utilizing periodontalTrE egSeT neBraAtiNoK n,SitEiL s iLmEpR or.taCnO t tMo control a. local b. all c. systemic d. defective

factors.

ANS: A

When utilizing periodontal regeneration, it is important to control local factors.

DIF: Comprehension REF: p. 452.e2 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. What is the antibiotic of choice for P. gingivalis? a. Tetracycline b. Ciprofloxacin c. Amoxicillin d. Azithromycin ANS: D

Azithromycin is the antibiotic of choice for P. gingivalis.

DIF: Recall REF: p. 456.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

12. Amoxicillin-clavulanate potassium (Augmentin) is the antibiotic of choice for which of the

following associated microflora? a. Gram-positive organisms b. Gram-negative organisms c. Staphylococci d. Black-pigmented bacteria and spirochetes ANS: A

Amoxicillin-clavulanate potassium is the antibiotic of choice for gram-positive organisms.

DIF: Recall REF: p. 456.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. The use of amoxicillin and

as an adjunctive therapy to scaling and root planing for the treatment of aggressive periodontitis has been shown to significantly improve clinical attachment gain and pocket depth reduction when compared with scaling and root planing alone. a. tetracycline b. metronidazole c. clindamycin d. ciprofloxacin ANS: B

The use of amoxicillin and metronidazole as an adjunctive therapy to scaling and root planing for the treatment of aggressive periodontitis has been shown to significantly improve clinical attachment gain and pocket depth reduction when compared with scaling and root planing alone.

DIF: Comprehension REF: p. 455 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. What is the primary advantage to local therapy when it comes to treating aggressive

periodontitis? a. The exposure of the target microorganism is decreased. b. Side effects of systemic antibacterial agents are multiplied. c. Smaller total dosages of topical agents can be delivered to the pocket. d. There is only one form of local delivery agents.

ANS: C

The primary advantage of local therapy is that smaller total dosages of topical agents can be delivered inside the pocket, avoiding the side effects of systemic antibacterial agents while increasing the exposure of the target microorganisms to higher concentrations and therefore more therapeutic levels of the medication.

DIF: Comprehension REF: p. 455 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. In the patient with aggressive periodontitis, the approach to restorative treatment should be

chosen based on a single premise: a. extract severely compromised teeth early, and plan treatment to accommodate future tooth loss. b. focus treatment on the severely compromised teeth first and hold treatment on the

rest of the teeth until those teeth are healthy. c. plan treatment to accommodate the entire mouth as a single unit and treat every

tooth the same. d. focus treatment on the healthiest teeth first to ensure that they remain healthy

throughout the process.

ANS: A

In the patient with aggressive periodontitis, the approach to restorative treatment should be chosen based on a single premise: extract severely compromised teeth early, and plan treatment to accommodate future tooth loss.

DIF: Recall REF: p. 455 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Which of the following statements is true regarding periodontal maintenance? a. If oral hygiene is not good, patients may benefit most from a review of oral

hygiene instructions and a stern scolding about their oral health future if they continue down the same path. b. Frequent maintenance visits are not that important in the control of the disease. c. When patients with periodontitis are transferred to maintenance care, their periodontal condition must be stable. d. Each maintenance visit should include only an oral examination.

ANS: C

When patients with periodontitis are transferred to maintenance care, their periodontal condition must be stable. Each maintenance visit should consist of a medical history review, an inquiry about any recent periodontal problems, an assessment of risk factors, a SiEnaLtL comprehensive periodontaT l aEnS dT orBaA l eNxK am ioE n,Rth.oCroOuMgh root debridement, and prophylaxis, followed by a review of oral hygiene instructions. If oral hygiene is not good, patients may benefit most from a review of oral hygiene instructions and visualization of plaque in their own mouth before debridement and prophylaxis. Frequent maintenance visits appear to be one of the most important factors in the control of disease and the success of treatment in patients with aggressive periodontitis.

DIF: Comprehension REF: p. 455 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Patients who fail to respond to conventional therapy for aggressive periodontitis are

considered to have . a. failure to thrive b. fatal periodontitis c. periodontitis refractory to treatment d. treatment refusal periodontitis ANS: C

Patients who fail to respond to conventional therapy for aggressive periodontitis are considered to have periodontitis refractory to treatment.

DIF: Recall REF: p. 456 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. Which of the following is the antibiotic of choice for gram-negative organisms?

a. b. c. d.

Metronidazole Clindamycin Tetracycline Azithromycin

ANS: B

The antibiotic of choice for gram-negative organisms is clindamycin.

DIF: Recall REF: p. 453.e2 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. Aggressive periodontitis, by definition, causes

of the periodontal attachment

apparatus and the supporting alveolar bone. a. minor movement b. slow-moving destruction c. rapid destruction d. spontaneous detachment ANS: C

Aggressive periodontitis, by definition, causes rapid destruction of the periodontal attachment apparatus and the supporting alveolar bone.

DIF: Recall REF: p. 451 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. Conventional periodontal therapy for aggressive periodontitis always includes all of the

following except: a. patient education. b. oral hygiene improvement. c. regular recall maintenance. d. periodontal flap surgery.

ANS: D

Conventional periodontal therapy for aggressive periodontitis always includes patient education, oral hygiene improvement, regular recall maintenance, and scaling and root planing. It may or may not include periodontal flap surgery.

DIF: Comprehension REF: p. 452 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 40: Treatment of Acute Gingival Disease Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following statements about necrotizing ulcerative gingivitis (NUG) is true? a. NUG results from an impaired host response to a potentially pathogenic

microflora. b. NUG always occurs alongside chronic gingival disease. c. Treatment of NUG should ignore any acute inflammation and focus solely on the

underlying chronic gingival periodontal disease. d. Treatment of NUG should follow an orderly sequence, according to specific steps,

at five clinical visits.

ANS: A

NUG results from an impaired host response to a potentially pathogenic microflora. NUG may occur in a mouth essentially free of other gingival involvement or superimposed on underlying chronic gingival involvement or superimposed on underlying chronic gingival or periodontal disease. Treatment of NUG should include alleviation of the acute symptoms and correction of the underlying chronic gingival or periodontal disease. Treatment of NUG should follow an orderly sequence, according to specific steps, at three clinical visits.

DIF: Comprehension REF: p. 459 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Which of the following is a good example of a question to ask at the first visit of a patient

with necrotizing ulcerative gingivitis? a. Are you married? b. How many hours of sleep did you get last night? c. Has there been any previous treatment? d. Did you have braces when you were younger?

ANS: C

It is important to figure out if there has been any previous treatment for the disease and, if so, what it was and how long it lasted.

DIF: Comprehension REF: p. 459 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. All of the following should occur at the first visit of a patient with necrotizing ulcerative

gingivitis except: a. A comprehensive evaluation of the patient, including a thorough medical history b. An examination of the oral cavity c. An initial physical examination, including an assessment of general appearance d. Periodontal probing of the NUG lesions ANS: D

Periodontal probing of NUG lesions is likely to be very painful, will not aid in the primary diagnosis, and may need to be deferred until after the lesions are resolved.

DIF: Comprehension REF: p. 459 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Which of the following statements summarized the goals of initial therapy for necrotizing

ulcerative gingivitis? a. The goals of initial therapy for NUG are reduction of the microbial load and removal of necrotic tissue. b. The goals of initial therapy for NUG are minimizing plaque buildup and minimizing tooth loss. c. The goals of initial therapy for NUG are stabilizing the patient’s mental state and removing plaque buildup on the teeth’s surface. d. The goals of initial therapy for NUG are reduction of gingival inflammation and establishing good oral health routines.

ANS: A

The goals of initial therapy for NUG are reduction of the microbial load and removal of necrotic tissue to facilitate the healing process of repair and regeneration so that the normal tissue barriers are reestablished.

DIF: Recall REF: p. 460 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. When dealing with a patient with necrotizing ulcerative gingivitis, how many days after the

first visit should the second visit occur? a. 1 to 2 b. 2 to 3 c. 3 to 5 d. 5 to 7 ANS: A

The second visit should occur 1 to 2 days after the first visit.

DIF: Recall REF: p. 460 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Which of the following statements is not true about the second visit for necrotizing ulcerative

gingivitis? a. The patient is evaluated for amelioration of signs and symptoms. b. The patient’s condition is usually the same as the first visit. c. Scaling is performed if necessary and if sensitivity permits. d. Instructions to the patient are the same as those given previously.

ANS: B

The patient’s condition is usually improved from the first visit; the pain is diminished or is no longer present.

DIF: Comprehension REF: p. 460 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. In a patient with necrotizing ulcerative gingivitis, approximately how many days after the

second visit should the third visit occur? a. 2

b. 3 c. 5 d. 7 ANS: C

The third visit is approximately 5 days after the second visit.

DIF: Recall REF: p. 460 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. Which of the following statement is not true about the third visit for necrotizing ulcerative

gingivitis? a. The patient is evaluated for resolution of symptoms. b. A comprehensive plan for management of the patient’s periodontal condition is formulated. c. The patient is instructed in biofilm procedures. d. The patient continues with the hydrogen peroxide rinses.

ANS: D

The hydrogen peroxide rinses are discontinued, but chlorhexidine rinses may be maintained for an additional 2 to 3 weeks.

DIF: Comprehension REF: p. 460 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Approximately how long after the third appointment for necrotizing ulcerative gingivitis

should the patient be reevaluated? a. 4 to 6 weeks b. 6 to 8 weeks c. 2 to 3 months d. 4 to 6 months ANS: A

The patient should be reevaluated approximately 4 to 6 weeks after treatment to determine compliance with oral hygiene, health habits, psychosocial factors, the potential need for reconstructive or esthetic surgery, and the interval of subsequent recall visits.

DIF: Recall REF: p. 460 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which of the following does not occur in the final stage of the healing of a NUG lesion? a. The normal gingival color may be restored. b. The normal consistency of the gingiva may be restored. c. None of the root exposed of the acute disease may be covered by healthy gingiva. d. The surface texture of the gingiva may be restored to normalcy.

ANS: C

Portions of the root exposed by the acute disease may be covered by healthy gingiva.

DIF: Comprehension REF: p. 461 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

11. Which of the following statements is true about the role of drugs when it comes to a patient

with necrotizing ulcerative gingivitis? a. Only a few drugs have been used for treatment of NUG. b. Topical drug therapy is only an adjunctive measure. c. Only certain drugs, when used alone, can be considered complete treatment of NUG. d. Escharotic drugs should be used to help treat NUG. ANS: B

A large variety of drugs have been used for topical treatment of NUG. Topical drug therapy is only an adjunctive measure. No drug, when use alone, can be considered complete treatment.

Escharotic drugs, such as phenol, silver nitrate, chromic acid, or potassium bichromate, should not be used.

DIF: Comprehension REF: p. 462 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. If a case of necrotizing ulcerative gingivitis persists despite therapy or if it recurs, the patient

should be reevaluated with a focus on all of the following factors except: a. inadequate follow-up. b. reassessment of differential diagnosis to rule out diseases that resemble NUG. c. underlying systemic disease causing immunosuppression. d. inadequate compliance.

ANS: A

If a case of NUG persists despite therapy or if it recurs, the patient should be reevaluated, with a focus on reassessment of differential diagnosis to rule out diseases that resemble NUG, underlying systemic diseasTeEcaSuTsiB ngAN imKmSuEnL osLuE ppRre.sC siO onM, inadequate local therapy, and inadequate compliance.

DIF: Comprehension REF: p. 462 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Primary herpetic gingivostomatitis is an infection that primarily occurs in what group of

people? a. Men b. Women c. Children d. Adults ANS: C

This infection typically occurs in children but can occur in adults as well.

DIF: Recall REF: p. 462 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Primary herpetic gingivostomatitis typically runs a a. 3 to 5 b. 5 to 7 c. 7 to 10 d. 10 to 14

course.

ANS: C

Primary herpetic gingivostomatitis typically runs a 7- to 10-day course and usually heals without scarring.

DIF: Recall REF: p. 462 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Treatment of primary herpetic gingivostomatitis consists of early diagnosis and immediate

initiation of a. antibacterial b. antiviral c. antifungal d. antiparasitic

therapy.

ANS: B

Treatment of primary herpetic gingivostomatitis consists of early diagnosis and immediate initiation of antiviral therapy.

DIF: Recall REF: p. 463 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. If primary herpetic gingivostomatitis is diagnosed within 3 days of onset,

should be prescribed. a. NSAID suspension b. acyclovir suspension c. tetracycline suspension d. aminoglycoside suspension ANS: B

If primary herpetic gingivostomatitis is diagnosed within 3 days of onset, acyclovir suspension should be prescribed: 15 mg/kg five times daily for 7 days. If diagnosis occurs more than 3 days after onset in an immunocompetent patient, acyclovir therapy may have limited value.

DIF: Comprehension REF: p. 463 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. If primary herpetic gingivostomatitis does not resolve within

week(s), the patient should

be referred to a physician for medical consultation. a. 1 b. 2 c. 3 d. 4 ANS: B

If primary herpetic gingivostomatitis does not resolve within 2 weeks, the patients should be referred to a physician for medical consultation.

DIF: Recall REF: p. 463 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

18. Which of the following refers to inflammation of the excess flap of soft tissue that overlies the

crown of an incompletely erupted tooth? a. Pericoronitis b. Peri-implantitis c. Periodontitis d. Perimucositis ANS: A

Pericoronitis refers to inflammation of the excess flap of soft tissue that overlies the crown of an incompletely erupted tooth.

DIF: Recall REF: p. 463 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. Which of the following statements is true about the initial treatment of pericoronitis? a. Antibiotics are always prescribed. b. The area should be gently flushed with cold water to remove debris. c. The area should be swabbed with antiseptic after the pericoronal flap has been

lifted gently away from the tooth with an instrument. d. If the pericoronal flap is swollen and fluctuant, an incision should not be made.

ANS: C

Antibiotics can be prescribed in severe cases and in patients who have clinical evidence of diffuse microbial infiltration of the tissue. The area should be gently flushed with warm water to remove debris and exudate. The area should be swabbed with an antiseptic after the pericoronal flap has been lifted gently away from the tooth with an instrument. If the pericoronal flap is swollen and fluctuant, an incision and drainage procedure may be indicated to establish drainage and reTliEeS veTpBreAsN suKreS. ELLER.COM DIF: Comprehension REF: p. 464 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. All of the following are examples of instructions you would give to a patient with necrotizing

ulcerative gingivitis except: a. rinse with a glassful of an equal mixture of 3% hydrogen peroxide and warm water every 12 hours and/or 0.12% chlorhexidine solution every 2 hours. b. avoid tobacco, alcohol, and condiments. c. get adequate rest. d. pursue usual activities but avoid excessive physical exertion or prolonged exposure to the sun.

ANS: A

Rinse with a glassful of an equal mixture of 3% hydrogen peroxide and warm water every 2 hours and/or 0.12% chlorhexidine solution twice daily.

DIF: Comprehension REF: p. 460 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 41: Treatment of Periodontal Abscess Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. How many classifications (diagnostic groups) are there for periodontal abscesses? a. 2 b. 3 c. 4 d. 5 ANS: B

There are three diagnostic groups of periodontal abscesses: gingival, periodontal, and pericoronal.

DIF: Recall REF: p. 465 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Which type of periodontal abscess involves the marginal gingival and interdental tissues? a. Gingival abscess b. Periodontal abscess c. Pericoronal abscess d. Interdental abscess ANS: A

The gingival abscess involves the marginal gingival and interdental tissues.

DIF: Recall REF: p. 465 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. Which type of periodontal abscess is an infection located contiguous to the periodontal

pocket? a. Gingival abscess b. Periodontal abscess c. Pericoronal abscess d. Interdental abscess ANS: B

The periodontal abscess is an infection located contiguous to the periodontal pocket and may result in destruction of the periodontal ligament and alveolar bone.

DIF: Recall REF: p. 465 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Which of the following structures could be destroyed by a periodontal abscess? a. Gingival tissues b. Alveolar bone c. Periodontium d. Teeth ANS: B

The periodontal abscess is an infection located contiguous to the periodontal pocket and may result in destruction of the periodontal ligament and alveolar bone.

DIF: Comprehension REF: p. 465 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. What kind of periodontal abscess is associated with the crown of a partially erupted tooth? a. Gingival abscess b. Periodontal abscess c. Pericoronal abscess d. Interdental abscess ANS: C

The pericoronal abscess is associated with the crown of a partially erupted tooth.

DIF: Recall REF: p. 466 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Which type of periodontal abscess is typically found in patients with untreated periodontitis? a. Gingival abscess b. Periodontal abscess c. Pericoronal abscess d. Interdental abscess ANS: B

Periodontal abscesses are typically found in patients with untreated periodontitis and in association with moderate to deep periodontal pockets.

DIF: Comprehension REF: p. 465 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Which of the following options is not a clinical situation that periodontal abscesses have been

linked to? a. Patients after periodontal surgery b. Patients after preventive maintenance c. Patients after systemic antibiotic therapy d. Patients after gingivitis diagnosis ANS: D

Periodontal abscesses have been clinically linked to patients after periodontal surgery, after preventive maintenance, after systemic antibiotic therapy, and as a result of a recurrent disease.

DIF: Recall REF: p. 465 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. Which of the following diseases, when poorly controlled, is considered a predisposing factor

for periodontal abscess formation? a. Diabetes b. HIV c. Lupus d. Epilepsy

ANS: A

Poorly controlled diabetes mellitus has been considered a predisposing factor for periodontal abscess formation.

DIF: Recall REF: p. 465 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following is not considered a common cause for gingival abscesses? a. Microbial plaque infection b. Trauma c. Probing d. Foreign body impaction ANS: C

Gingival abscesses are a localized acute inflammatory lesion that may arise from a variety of sources, including microbial plaque infection, trauma, and foreign body impaction.

DIF: Comprehension REF: p. 465 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which of the following is not a clinical feature of a gingival abscess? a. Red b. Bumpy c. Often fluctuant swelling d. Sometimes painful ANS: B

OoMoth, sometimes painful, often Clinical features of gingivaTl E abSsT ceBsA seN sK inS clE udLeLaErR ed., C sm fluctuant swelling.

DIF: Comprehension REF: p. 465 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Pericoronal abscesses are most often observed around what kind of teeth? a. Incisors b. Mandibular third molars c. Mandibular second molars d. Bicuspids ANS: B

Pericoronal abscesses are most often observed around mandibular third molars.

DIF: Recall REF: p. 466 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. Abscesses are typically categorized as a. Acute; chronic b. Mild; moderate c. Infected; noninfected d. Latent; active ANS: A

or

.

Abscesses are categorized as acute or chronic.

DIF: Recall REF: p. 466 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. What type of abscess is often an exacerbation of a chronic inflammatory periodontal lesion? a. Moderate b. Latent c. Acute d. Chronic ANS: C

The acute abscess is often an exacerbation of a chronic inflammatory periodontal lesion.

DIF: Recall REF: p. 466 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. What type of abscess forms after the spreading infection has been controlled by spontaneous

drainage, host response, or therapy? a. Moderate b. Active c. Acute d. Chronic ANS: D

The chronic abscess forms after the spreading infection has been controlled by spontaneous drainage, host response, or therapy.

DIF: Recall REF: p. 466 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. How many phases are involved in the treatment of the periodontal abscess? a. 2 b. 3 c. 4 d. 5 ANS: A

Treatment of the periodontal abscess includes two phases: resolving the acute lesion, then managing the resulting chronic condition.

DIF: Recall REF: p. 466 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Which type of abscess has intermittent exudation and slight tooth elevation? a. Acute b. Active c. Moderate d. Chronic ANS: D

A chronic abscess has no pain (or dull pain), slight tooth elevation, intermittent exudation, and usually exists without systemic involvement.

DIF: Comprehension REF: p. 467 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Which type of abscess has mild to severe discomfort and tenderness to percussion or biting? a. Chronic b. Acute c. Active d. Moderate ANS: B

Acute abscesses have mild to severe discomfort, mobility, exudation, elevated temperature, and tenderness to percussion or biting.

DIF: Comprehension REF: p. 467 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. When performing a differential diagnosis to determine the cause of an abscess, what would

most probably be the correct diagnosis for a patient with an abscess whose radiographs show periodontal angular bone loss and furcation radiolucency? a. Periodontal abscess b. Gingival inflammation c. Pulpal abscess d. Periodontitis ANS: A

Periodontal abscesses often show periodontal angular bone loss and furcation radiolucency on radiographs.

DIF: Application REF: p. 467 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. When performing a differential diagnosis to determine the cause of an abscess, what would

most probably be the correct diagnosis for a patient whose tests show nonvital pulp and whose abscess pain is often severe and difficult to localize? a. Periodontal abscess b. Gingival inflammation c. Pulpal abscess d. Periodontitis ANS: C

Pulpal abscesses often show nonvital pulp on tests and pain is often severe and difficult to localize.

DIF: Application REF: p. 467 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. Which of the following is not a treatment option for a periodontal abscess? a. Drainage through pocket retraction or incision b. Local antibiotics

c. Periodontal surgery d. Tooth removal ANS: B

Treatment options for periodontal abscesses include drainage through pocket retraction or incision, scaling and root planing, periodontal surgery, systemic antibiotics, and tooth removal.

DIF: Comprehension REF: p. 468 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 21. Which of the following is not an indication for antibiotic therapy in patients with an acute

abscess? a. Fever b. Cellulitis c. Regional lymphadenopathy d. Shallow, accessible pocket ANS: D

Indications for antibiotic therapy in patients with an acute abscess include cellulitis (nonlocalized, spreading infection), a deep, inaccessibly pocket, fever, regional lymphadenopathy, and immunocompromised status.

DIF: Comprehension REF: p. 468 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 22. When using amoxicillin to help treat a periodontal infection, how soon after starting the drugs

should the patient be reevaT luEaS teT d?BANKSELLER.COM a. 1 day b. 2 days c. 3 days d. 1 week ANS: C

The patient should take the amoxicillin three times a day for 3 days and should be reevaluated after 3 days to determine the need for continued or adjusted antibiotic therapy.

DIF: Recall REF: p. 468 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 23. When using clindamycin to help treat a periodontal infection, how much more is the loading

dose than the following doses? a. The loading dose is twice as much as the following doses. b. The loading dose is three times as much as the following doses. c. The loading dose is four times as much as the following doses. d. The loading dose is five times as much as the following doses.

ANS: A

The loading dose of clindamycin is 600 mg, and the following doses are 300 mg four times a day for 3 days.

DIF: Comprehension

REF: p. 468

TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 24. When using azithromycin or clarithromycin to help treat a periodontal infection, what is the

amount of the loading dose? a. 500 mg b. 750 mg c. 1.0 g d. 1.5 mg ANS: C

The loading dose is 1.0 g, following by 500 mg four times a day for 3 days.

DIF: Recall REF: p. 468 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 25. Which of the following is often required when a periodontal abscess exists due to a deep

periodontal pocket? a. A surgical flap b. Deep probing c. Periodontal surgery d. Tooth removal ANS: A

Periodontal abscess due to a deep periodontal pocket often requires a surgical flap to access the subgingival calculus. This also allows the clinician to reduce the pocket at the same surgical appointment.

EF p.R4.

69COM DIF: Comprehension TESTBANKSRE L:LE TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 42: Phase I Periodontal Therapy Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. What is the objective to phase I periodontal therapy? a. To alter or eliminate the microbial etiology and factors that contribute to gingival

and periodontal diseases to the greatest extent possible b. To eliminate the systemic diseases and related causes of the initial periodontal

issues c. To change the scope of the periodontal problem so that the clinician can solve the smallest problem first and work toward the bigger, more complex, issues d. To alleviate the bacterial plaque biofilm buildup that may stand in the way of having a completely clean slate with which to continue the oral examination ANS: A

The objective of phase I periodontal therapy is to alter or eliminate the microbial etiology and factors that contribute to gingival and periodontal diseases to the greatest extent possible, thereby halting the progression of disease and returning the dentition to a state of health and comfort.

DIF: Comprehension REF: p. 471 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Which of the following is not another term for phase I periodontal therapy? a. Initial therapy b. Cause-related therapy c. Starter therapy d. Nonsurgical periodontal therapy ANS: C

Phase I therapy is referred to by a number of names, including initial therapy, nonsurgical periodontal therapy, and cause-related therapy.

DIF: Recall REF: p. 471 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. Which of the following is the definition of phase I therapy according to the American

Association of Periodontology? a. The initiation of a complete treatment plan that shall allow each patient to have an individualized, comprehensive oral health plan. b. The initiation of oral therapy that shall allow the patient and the clinician to form a bond in which they can carry out the treatment plan together, each person holding up their end of the bargain. c. The initiation of an all-encompassing daily ritual of oral health, management of systemic diseases that may be interrelated to oral health, and absolute removal of all bacterial biofilm. d. The initiation of a comprehensive daily plaque or biofilm control regimen, management of periodontal-systemic interrelationships as needed, and thorough removal of supragingival and subgingival bacterial plaque or biofilm and calculus.

ANS: D

Phase I therapy is defined by the evidence-based American Association of Periodontology practice guidelines as “the initiation of a comprehensive daily plaque or biofilm control regimen, management of periodontal-systemic interrelationships as needed, and thorough removal of supragingival and subgingival bacterial plaque or biofilm and calculus.”

DIF: Recall REF: p. 471 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Which of the following statements is true? a. Long-term success of periodontal surgical treatment is dependent on maintaining

the plaque or biofilm control results achieved with phase I therapy. b. One specific aim of phase I therapy is to achieve plaque or biofilm removal when the patient is at the dentist office. c. Management of all contributing local factors is not required in phase I therapy. d. Patients who do not have adequate plaque or biofilm control will not continue to lose attachment if surgical procedures are performed.

ANS: A

Long-term success of periodontal surgical treatment is dependent on maintaining the plaque or biofilm control results achieved with phase I therapy. One specific aim of phase I therapy for every patient is effective daily plaque or biofilm removal at home. Management of all contributing local factors is required in phase I therapy. Patients who do not have adequate plaque or biofilm control will continue to lose attachment regardless of what surgical procedures are performed. p.R4.

71COM DIF: Comprehension TESTBANKSREFL:LE TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Which of the following elements is not a component of phase I therapy? a. Patient education b. Orthodontic tooth movement c. Extraction of hopeless teeth d. Possible use of antibacterial agents ANS: D

The following list of elements makes up phase I therapy: patient education and oral hygiene instruction, complete removal of supragingival calculus, correction or replacement of poorly fitting restorations and other prosthetic devices, restoration or temporization of carious lesions, orthodontic tooth movement, treatment of food impaction areas, treatment of occlusal trauma, extraction of hopeless teeth, and the possible use of microbial agents.

DIF: Comprehension REF: p. 471 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. When should home care instruction begin? a. At the first treatment appointment b. At the second treatment appointment, where the dentist and patient have

established a rapport c. At the third treatment appointment, where the dentist and the patient can formulate a treatment plan together

d. After the completion of phase 1 therapy ANS: A

Home care instructions should begin at the first treatment appointment and be included in every appointment going forward.

DIF: Comprehension REF: p. 473 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. When instructing the patient on the correct technique to remove plaque or biofilm, it is

important to focus on applying the bristles at the gingival third of the clinical crowns. This technique is known as: a. gingival cleaning. b. gingival margin hygiene. c. targeted oral hygiene. d. localized oral hygiene.

ANS: C

This technique is known as targeted oral hygiene.

DIF: Recall REF: p. 473 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. Why do many clinicians prefer the multiple appointment approach to phase I therapy? a. It allows the clinicians to spread out the charges and get the most money out of

their patients. b. It permits time to evaluate, reinforce, and improve the patient’s oral hygiene skills. c. It allows the patient to T geEtSmToB reApNlaKqS ueEbLuL ildEuRp.bC etO wM een appointments, so the

clinician can help then remove the buildup every time. d. Multiple appointments allow the clinician multiple opportunities to try to upsell the

patient on supplementary services that could be provided in the office.

ANS: B

The use of the multiple appointment approach to phase I therapy is favored by many clinicians because it permits the use of numerous appointments to evaluate, reinforce, and improve the patient’s oral hygiene skills.

DIF: Comprehension REF: p. 473 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following is not a valid way to get rid of calculus? a. Sickles b. Ultrasonic instruments c. Portable flosser d. Curettes ANS: C

Calculus is removed using sickles, curettes, ultrasonic instrumentation, or a combination of these devices during one or more appointments.

DIF: Comprehension REF: p. 473 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

10. Which of the following is a type of therapy that uses lasers has been presented as an adjunct to

scaling and root planing? a. Radiographic therapy b. Photodynamic therapy c. Photography therapy d. Radiodynamic therapy ANS: B

Photodynamic therapy uses lasers at specific wavelengths to target microorganisms treated with a photosensitizer.

DIF: Recall REF: p. 473 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. How are corrections of restorative defects accomplished? a. Extracting hopeless teeth and making room for any future replacements b. By smoothing the rough surfaces and removing overhangs from the faulty

restorations with burs or hand instruments c. By probing at the surface and pushing the sides of the gingival margin aside d. By instructing the patient on proper oral hygiene at-home skills ANS: B

Corrections of restorative defects, which are plaque or biofilm retentive areas, are accomplished by smoothing the rough surfaces and removing overhangs from the faulty restorations with burs or hand instruments, or complete replacement of the failing restorations may be necessary.

DIF: Recall REF: p. 473 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. Healing of the periodontal tissues is

by removing the reservoir of bacteria in these lesions so that they cannot repopulate the microbial plaque. a. minimized b. maximized c. unaffected d. accomplished ANS: B

Healing of the periodontal tissues is maximized by removing the reservoir of bacteria in these lesions so that they cannot repopulate the microbial plaque.

DIF: Recall REF: p. 473 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. After scaling, root planing, and other phase I procedures, approximately how long do the

periodontal tissues need to heal? a. 2 weeks b. 3 weeks c. 4 weeks d. 2 months

ANS: C

After scaling, root planing, and other phase I procedures, the periodontal tissues require approximately 4 weeks to heal.

DIF: Recall REF: p. 473 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Additional improvement from periodontal surgical procedures can be expected only if the

patient has adopted effective daily plaque or biofilm control procedures and . a. phase 1 therapy results in gingival tissues that are free of significant inflammation b. phase 1 therapy results in gingival tissues that are mostly free of significant inflammation c. phase 1 therapy was spread out into as many appointments as possible d. phase 1 therapy was treated as an interdisciplinary approach that was discussed with the patient’s medical doctor ANS: A

Additional improvement from periodontal surgical procedures can be expected only if the patient has adopted effective daily plaque or biofilm control procedures and phase I therapy results in gingival tissues that are free of significant inflammation.

DIF: Recall REF: p. 474 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Studies related to scaling and root planing ranging from 1 month to 2 years in length

demonstrated up to a. 30 b. 50 c. 70 d. 80

% reduction in bleeding on probing.

ANS: D

Studies related to scaling and root planing ranging from 1 month to 2 years in length demonstrated up to 80% reduction in bleeding on probing and mean probing depth reductions of 2 to 3 mm.

DIF: Recall REF: p. 474 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Healing of the gingival epithelium consists of which of the following? a. Formation of a long junctional epithelium b. New connective tissue attachment to the root surfaces c. Formation of a short junctional epithelium d. The rejuvenation of old connective tissues that attach to root surfaces ANS: A

Healing of the gingival epithelium consists of the formation of a long junctional epithelium rather than new connective tissue attachment to the root surfaces.

DIF: Recall REF: p. 474 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

17. When should you refer a patient to a specialist? a. After phase 1 is completed and has been successful. b. After phase 2 is completed and has been successful. c. If the case is advanced or complicated. d. If the case seems genetic and the patient has a big family.

ANS: C

A patient should be referred to a specialist if the case is advanced or complicated. It is fortunate that many periodontally involved cases do not require further therapy beyond phase I therapy.

DIF: Comprehension REF: p. 475 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. The concept of the critical probing depth of

mm is used to assist in making the

determination to proceed to surgical intervention. a. 2.3 b. 3.7 c. 4.2 d. 5.4 ANS: D

The concept of the critical probing depth of 5.4 mm is used to assist in making the determination to proceed to surgical intervention.

DIF: Recall REF: p. 475 TOP: NBDHE; 3.3.2 ProvisT ioE nS ofTinBsA truNcK tioSnEfoLrLpE reR ve. ntC ioO nM and management of oral diseases 19. What is the standard that has been commonly used as a guideline for identifying candidates

for surgical referral? a. 3-mm standard b. 4-mm standard c. 5-mm standard d. 6-mm standard ANS: C

A 5-mm standard has been commonly used as a guidelines for identifying candidates for surgical referral based on the understanding that the typical root length is about 13 mm and the crest of the alveolar bone is at a level approximately 2 mm apical to the bottom of the pocket.

DIF: Recall REF: p. 475 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. In addition to the clinical attachment loss criterion, which of the following is not a factor to

consider in the decision to refer to a periodontal specialist? a. Root length b. Age of patient c. Gender of patient d. Mobility

ANS: C

In addition to the 5-mm clinical attachment loss criterion, other factors are considered in the decision to refer to a periodontal specialist: extent of the disease and generalized or localized periodontal involvement, root length, mobility, difficulty of scaling and root planing, restorability and importance of particular teeth for reconstruction, age of the patient, and lack of resolution of inflammation after thorough plaque or biofilm removal and excellent scaling and root planing.

DIF: Comprehension REF: p. 475 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 43: Plaque Biofilm Control for the Periodontal Patient Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following is another term that can be used interchangeably for “biofilm

control”? a. Periodontal self-care b. Oral health c. Dental hygiene d. Plaque resistance ANS: A

Biofilm control is also referred to as periodontal self-care.

DIF: Recall REF: p. 477 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Microbial biofilm growth occurs within hours, and it must be completely removed at least

once every hours in the experimental setting with periodontally healthy subjects to prevent inflammation. a. 24 b. 36 c. 48 d. 96 ANS: C

Microbial biofilm growth occurs within hours, and it must be completely removed at least once every 48 hours in the experimental setting with periodontally healthy subjects to prevent inflammation.

DIF: Recall REF: p. 477 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. The American Dental Association (ADA) recommends that individuals should brush how

many times a day? a. Once b. Twice c. Three d. After every meal ANS: B

The ADA recommends that individuals should brush their teeth twice per day and use floss or other interdental cleaners once per day to effectively remove microbial plaque biofilms and prevent gingivitis.

DIF: Recall REF: p. 477 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Which of the following statements is true? a. Toothbrushing alone is sufficient in controlling gingival and periodontal diseases.

b. Plaque biofilm tends to begin on easy-to-reach surfaces. c. Patients consistently leave more plaque biofilm on the anterior teeth than the

posterior teeth. d. Periodontal lesions are predominantly found in interdental locations.

ANS: D

Toothbrushing alone is not sufficient to control gingival and periodontal diseases. Plaque biofilm tends to begin on interproximal surfaces, where the toothbrush does not reach.

Patients consistently leave more plaque biofilm on posterior teeth than anterior teeth.

Periodontal lesions are predominantly found in interdental lesions.

DIF: Comprehension REF: p. 477 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Cessation of plaque control practices for 7 to 21 days results in all of the following except: a. reddened gingiva that bleeds easily. b. accumulation of thick plaque on tooth surfaces. c. shift to more virulent gram-positive flora. d. changes that are completely reversed in about 7 days when plaque control practices

are resumed.

ANS: C

Cessation of plaque control practices for 7 to 21 days results in accumulation of thick plaque on tooth surfaces, reddened gingiva that bleeds easily, shift to more virulent gram-negative flora, and changes that are completely reversed in about 7 days when plaque control practices are resumed.

DIF: Comprehension EF p.R47.8COM TESTBANKSRE L:LE TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. What were early toothbrushes mostly made of? a. Hog bristles b. Horsehair c. Sandpaper d. Paper ANS: A

Early toothbrushes were mostly made of hog bristles and were very stiff and hard.

DIF: Recall REF: p. 479 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Which of the following factors do not contribute to the problem of toothbrush abrasion? a. The use of hard toothbrushes b. Vigorous horizontal brushing c. The use of electronic toothbrushes d. The use of extremely abrasive dentifrices ANS: C

It has been shown that several factors contribute to the problem of abrasion: the use of hard toothbrushes, vigorous horizontal brushing, and the use of extremely abrasive dentifrices.

DIF: Recall REF: p. 479 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. How often should toothbrushes be replaced? a. Every 1 to 2 months b. Every 3 to 4 months c. Every 6 months d. Annually ANS: B

Toothbrushes become worn due to wear and should be replaced every 3 to 4 months.

DIF: Recall REF: p. 479 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following is not true about the amount of force to use when toothbrushing? a. The amount of force used is not critical for effective plaque biofilm removal. b. Vigorous brushing is necessary. c. Vigorous brushing can lead to gingival recession. d. The manner in which a brush is used and the abrasiveness of the dentifrice affect

abrasion to a greater degree than the bristle hardness itself.

ANS: B

The amount of force used is not critical for effective plaque biofilm removal. Vigorous brushing is not necessary and can lead to gingival recession, wedge-shaped defects in the cervical area of root surfaces, and painful ulceration of the gingiva. The manner in which a brush is used and the abrasiveness of the dentifrice affect abrasion to a greater degree than the bristle hardness itself.

DIF: Comprehension REF: p. 479 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which of the following is not true about powered toothbrushes? a. Powered toothbrushes with oscillating and rotating motions remove plaque. b. Patients who want to use powered toothbrushes should be encouraged to do so. c. Powered toothbrushes are self-explanatory. d. Patients who lack dexterity may particularly benefit from using powered

toothbrushes.

ANS: C

Powered toothbrushes with oscillating and rotating motions remove plaque. Patients who want to use powered toothbrushes should be encouraged to do so. Patients need to be instructed in the proper use of powered devices. Patients who lack dexterity, children, and caregivers may particularly benefit from using powered toothbrushes.

DIF: Comprehension REF: p. 481 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Which of the following abrasive ingredients is not commonly found in dentifrices? a. Silicon oxides b. Hydrogen peroxide c. Aluminum oxides

d. Granular polyvinyl chlorides ANS: B

The contents of dentifrices are abrasives (e.g., silicon oxides, aluminum oxides, and granular polyvinyl chlorides), water, humectants, soap or detergent, flavoring and sweetening agents, therapeutic agents, coloring agents, and preservatives.

DIF: Recall REF: p. 480 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. “Calculus control” toothpastes contain

and have been shown to reduce the

deposition of new calculus on teeth as it forms. a. coloring agents b. pyrophosphates c. fluoride d. preservatives ANS: B

“Calculus control” toothpastes contain pyrophosphates and have been shown to reduce the deposition of new calculus on teeth as it forms.

DIF: Recall REF: p. 480 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. What is another term for the horizontal method of toothbrushing? a. Stillman technique b. Fones technique c. Leonard technique d. Scrub technique ANS: D

Horizontal brushing is also known as the Scrub technique.

DIF: Recall REF: p. 481 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. The Fones technique of toothbrushing is also known as a. circular b. vibratory c. roll d. vertical

toothbrushing.

ANS: A

The Fones technique of toothbrushing is also known as circular toothbrushing.

DIF: Recall REF: p. 481 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. What is the most widely recommended tool for removing biofilm from proximal tooth

surfaces? a. Toothbrush b. Dental floss

c. Probe d. Toothpick ANS: B

Dental floss is the most widely recommended tool for removing biofilm from proximal tooth surfaces.

DIF: Recall REF: p. 483 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. When flossing, what is the general recommendation for how long the piece of floss should be? a. 6 to 12 inches b. 12 to 18 inches c. 18 to 24 inches d. 24 to 36 inches ANS: B

The piece of floss should be long enough to grasp securely; 12 to 18 inches is usually sufficient.

DIF: Recall REF: p. 483 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Massaging the gingiva with a toothbrush or an interdental cleaning device does all of the

following except: a. produces epithelial thickening. b. decreased keratinization. c. increased mitotic activT ityEiS nTthBeAeN piK thSelEiuLmL. ER.COM d. increased mitotic activity in the connective tissue.

ANS: B

Massaging the gingiva with a toothbrush or an interdental cleaning device produces epithelial thickening, increased keratinization, and increased mitotic activity in the epithelium and connective tissue.

DIF: Comprehension REF: p. 486 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. What is the term used when discussing solutions or wafers that stain bacterial biofilm on the

surfaces of the teeth, tongue, and gingiva? a. Biofilm attack agents b. Plaque control agents c. Bacterial agents d. Disclosing agents ANS: D

Disclosing agents are solutions or wafers that stain bacterial biofilm on the surfaces of the teeth, tongue, and gingiva.

DIF: Recall REF: p. 486 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

19. Many nonprescription essential oil rinses contain

, which must be a consideration for

some patients. a. codeine b. fluoride c. alcohol d. NSAIDs ANS: C

Many nonprescription essential oil rinses contain alcohol, which must be a consideration for some patients not to use these products.

DIF: Recall REF: p. 486.e3 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. When using the plaque biofilm control record (O’Leary Index), what is a reasonable goal for

percentages of teeth with plaque biofilm? a. 5% or fewer surfaces with plaque biofilm b. 10% or fewer surfaces with plaque biofilm c. 15% or fewer surfaces with plaque biofilm d. 20% or fewer surfaces with plaque biofilm ANS: B

A reasonable goal is 10% or fewer surfaces with plaque biofilm.

DIF: Comprehension REF: p. 487 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 21. Which of the following is tThE eS teT rmBA usNedKS toEdL esLcE ribRe.tC heOeMmphasis on cleaning the area of the

dentogingival junction? a. Target hygiene b. Systemic hygiene c. Local hygiene d. Gingival hygiene ANS: A

The emphasis to clean the area of the dentogingival junction is referred to as target hygiene.

DIF: Recall REF: p. 481 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 22. What is the toothbrushing method that is most often recommended? a. Roll technique b. Vigorous technique c. Leonard technique d. Bass technique ANS: D

The method most often recommended is the Bass technique because it emphasizes the placement of the bristles at the dentogingival junction, which is the most important area.

DIF: Recall REF: p. 481 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

23.

is shown to disrupt and detoxify subgingival plaque biofilm and can be useful in delivering antimicrobial agents to periodontal pockets. a. Fluoride rinsing b. Oral irrigation c. Flossing d. Toothbrushing ANS: B

Oral irrigation is shown to disrupt and detoxify subgingival plaque biofilm and can be useful in delivering antimicrobial agents to periodontal pockets.

DIF: Comprehension REF: p. 486.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 24.

rinses can be used to improve plaque biofilm control during phase I therapy, for patients with recurrent disease, after periodontal or oral surgery, and for caries management. a. Chlorhexidine b. Essential oil c. Fluoride d. Cosmetic oil ANS: A

Chlorhexidine rinses can be used to improve plaque biofilm control during phase I therapy, for patients with recurrent disease, after periodontal or oral surgery, and for caries management. . 4S8T 6.B e3ANKSELLER.COM DIF: Recall REF: TpE TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 25.

rinses are effective as irrigants, have fewer side effects than other rinses, and are available without a prescription. a. Chlorhexidine b. Essential oil c. Fluoride d. Cosmetic oil ANS: B

Essential oil rinses are effective as irrigants, have fewer side effects than other rinses, and are available without a prescription.

DIF: Comprehension REF: p. 486.e3 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 44: Breath Malodor Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE

people are reported to have bad breath at a given time in his/her life.

1. a. b. c. d.

1 in 2 1 in 3 1 in 4 1 in 5

ANS: C

1 in 4 people are reported to have bad breath at a given time in his/her life.

DIF: Recall REF: p. 490 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Which of the following is the term used for halitosis that can be diagnosed organoleptically or

by measurement of the responsible compounds? a. Genuine halitosis b. Pseudo-halitosis c. Halitophobia d. Physiologic halitosis ANS: A

Genuine halitosis is the term that is used when the breath malodor really exists and can be EeLnLt E diagnosed organolepticallyToEr S bT yB mA eaNsK urS em ofRth.eCrO esMponsible compounds.

DIF: Recall REF: p. 490 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. Which of the following is the term used for halitosis that is transient and caused by

physiologic factors, such as food intake or smoking? a. Genuine halitosis b. Physiologic halitosis c. Halitophobia d. Extraoral halitosis ANS: B

Physiologic halitosis is malodor that is transient and caused by physiologic factors, such as food intake or smoking.

DIF: Recall REF: p. 490 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Which of the following is the term used for halitosis that cannot be perceived objectively and

can be improved by oral hygiene instruction and counseling? a. Physiologic halitosis b. Halitophobia c. Intraoral halitosis d. Pseudo-halitosis

ANS: D

Pseudo-halitosis is malodor that cannot be perceived objectively even though the patient complains of its existence. This condition can be improved by oral hygiene instruction and counseling.

DIF: Recall REF: p. 490 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. In most patients, breath malodor originates from the a. throat b. plaque buildup on teeth surfaces c. oral cavity d. taste buds

.

ANS: C

In most patients, breath malodor originates from the oral cavity.

DIF: Comprehension REF: p. 491 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Which of the following is the term used for a hairy tongue? a. Lingua villosa b. Lingua plicata c. Scrotal tongue d. Tongue mucosa ANS: A

A hairy tongue is known aT sE linSgT uaBA viN lloKsS a.ELLER.COM DIF: Recall REF: p. 491 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. What is the influence of bad breath in patients with periodontitis? a. The bacterial cause of bad breath has a direct correlation with certain types of

periodontitis. b. All patients with bad breath also have an issue with periodontitis, because the

causal factors match up. c. The increased production of VSCs in people with bad breath may accelerate the

progression of periodontal disease. d. The increased inflammation of the taste buds on the tongue that occurs with bad

breath is in direct correlation to the acceleration of periodontal disease.

ANS: C

The increased production of VSCs in people with bad breath may accelerate the progression of periodontal disease.

DIF: Comprehension REF: p. 492 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. Which of the following is not a common cause of xerostomia? a. Medication

b. Diet c. Diabetes d. Alcohol abuse ANS: B

Xerostomia (dry mouth) can be caused by medication, alcohol abuse, Sjogren syndrome, and diabetes.

DIF: Comprehension REF: p. 493 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Extraoral halitosis can be divided into what two types? a. Common and uncommon b. Non-blood-borne halitosis and blood-borne halitosis c. Bacterial halitosis and viral halitosis d. Xerostomic halitosis and saliva halitosis ANS: B

Extraoral halitosis can be subdivided into two types: non-blood-borne halitosis and blood-borne halitosis.

DIF: Recall REF: p. 493 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. What is the most important cause of halitosis? a. Smoking b. Underlying disease c. Tongue coating d. Plaque buildup ANS: C

Tongue coating is the most important cause of halitosis. The innumerable depressions in the tongue surface are ideal niches for bacterial adhesion and growth; additionally; desquamated cells and food remnants also remain trapped in these retention sites.

DIF: Comprehension REF: p. 493 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. For proper diagnosis of malodor, it is recommended that a patient does not eat garlic, onions,

or spices for a. 1 b. 2 c. 3 d. 5

day(s) before the consultation.

ANS: B

For proper diagnosis of malodor, it is recommended that a patient does not eat garlic, onions, or spices for 2 days before the consultation.

DIF: Recall REF: p. 493 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

12.

is a hereditary metabolic disorder that leads to a typical fishy odor of the breath, urine, sweat, and other bodily secretions. a. Zenker diverticulum b. Trimethylaminuria c. Anamnesis d. Glomerulonephritis ANS: B

Trimethylaminuria is a hereditary metabolic disorder that leads to a typical fishy odor of the breath, urine, sweat, and other bodily secretions.

DIF: Recall REF: p. 493.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. What is the easiest and least expensive way to examine the breath? a. Smell the breath. b. Perform an organoleptic rating. c. Consult a loved one. d. Investigate the olfactory response.

ANS: A

The easiest and least expensive way to examine the breath is to smell the breath.

DIF: Recall REF: p. 494 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. The patient’s account of their own medical and social history is known as a. preconsultation b. oropharyngeal examination c. anamnesis d. patient analysis

.

ANS: C

The patient’s account of their own medical and social history is known as anamnesis.

DIF: Recall REF: p. 493 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Which of the following is not part of an organoleptic rating? a. Nasal breath odor b. Oral cavity odor c. Tongue coating d. Plaque buildup ANS: D

An organoleptic rating includes an examination of the nasal breath odor, oral cavity odor, and tongue coating.

DIF: Comprehension REF: p. 494 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Which of the following is considered the gold standard in the examination of breath malodor?

a. b. c. d.

Organoleptic assessment by a judge Physical examination by a clinician Oropharyngeal examination by a judge Anamnesis by a patient and a clinician

ANS: A

Even though devices are available, organoleptic assessment by a judge is still the gold standard in the examination of breath malodor.

DIF: Comprehension REF: p. 494 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Which of the following is an inexpensive electronic device that detects the presence of VSCs? a. Chroma Data Manager b. Halimeter c. Halitosis monitor d. OralChroma ANS: B

The Halimeter is an electronic device that detects the presence of VSCs. It is easy to use as a chairside test and is relatively inexpensive.

DIF: Comprehension REF: p. 496 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. When one of your patients complains of bad breath and he or she is periodontally healthy but

has a thick tongue coating, what can you do? a. You immediately start T toEpSeT rfB orA mNpKhS asEe LI L thE erRap.yCoOf Mperiodontitis. b. You request to speak to a loved one so that you can get a second opinion on the level of halitosis. c. You refer the patient to a specialist. d. You give the patient oral hygiene instructions and stress the importance of a tongue scraper.

ANS: D

You give the patient oral hygiene instruction and stress the importance of using a tongue scraper. Optionally, a mouthrinse can be advised, with active ingredients of proven efficacy such as chlorhexidine, cetylpyridinium chloride, or a zinc formulation.

DIF: Application REF: p. 497 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. Tongue cleaning using a tongue scraper reduces halitosis levels by a. 50% b. 60% c. 75% d. 90%

after 1 week.

ANS: C

Tongue cleaning using a tongue scraper reduces halitosis levels by 75% after 1 week.

DIF: Recall

REF: p. 498

TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. Which of the following is considered the most effective antiplaque and antigingivitis agent? a. Amine fluoride b. Chlorhexidine c. Baking soda d. Chloride dioxide ANS: B

Chlorhexidine is considered the most effective antiplaque and antigingivitis agent.

DIF: Comprehension REF: p. 499 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 21. Which of the following is a broad-spectrum antibacterial agent that has been found to be

effective against oral bacteria and has good compatibility with other compounds used for oral home care? a. Triclosan b. Oxidizing lozenges c. Essential oils d. Stannous fluoride ANS: A

Triclosan is a broad-spectrum antibacterial agent that has been found to be effective against oral bacteria and has good compatibility with other compounds used for oral home care.

DIF: Recall REF: p. 499 TOP: NBDHE; 3.3.2 ProvisT ioE nS ofTinBsA truNcK tioSnEfoLrLpE reR ve. ntC ioOnMand management of oral diseases 22.

is an ion with two positive charges that will bind to the twice-negatively loaded sulfur radicals and thus reduce the expression of VSCs. a. Aluminum sulfide b. Chlorine dioxide c. Chlorhexidine d. Zinc ANS: D

Zinc is an ion with two positive charges that will bind to the twice-negatively loaded sulfur radicals and thus reduce the expression of VSCs. DIF: Comprehension REF: p. 499 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 23. Which of the following is the term used for bad breath originating from pathologic conditions

outside the oral cavity? a. Extraoral halitosis b. Intraoral halitosis c. Genuine halitosis d. Oral malodor ANS: A

Extraoral halitosis is bad breath originating from pathologic conditions outside the oral cavity.

DIF: Recall REF: p. 490 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 24. Gastrointestinal disorders are responsible for a. less than 1% b. 5% c. 10% d. more than 15%

of malodor cases.

ANS: A

Contrary to common public opinion, even among medical physicians, gastrointestinal disorders are rarely responsible for bad breath. In fact, gastrointestinal disorders are responsible for less than 1% of malodor cases.

DIF: Recall REF: p. 493.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 25. When discussing cases of halitosis, the

is the concentration that is necessary to

increase the odor score by one unit. a. threshold concentration b. odor power c. volatility d. olfactory response ANS: B

When discussing cases of halitosis, the odor power is the concentration that is necessary to increase the odor score by T onEeSuTnB it.ANKSELLER.COM DIF: Comprehension REF: p. 493.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 45: Scaling and Root Planing Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following is used to locate and measure the depth of pockets, as well as

determine their pattern on individual tooth surfaces? a. Periodontal probes b. Explorers c. Periodontal endoscopes d. Curettes ANS: A

Periodontal probes are used to locate and measure the depth of pockets, as well as determine their pattern on individual tooth surfaces.

DIF: Recall REF: p. 501 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Which of the following is used to locate calculus deposits, surface irregularities, overhanging

restorations, and caries? a. Periodontal probes b. Explorers c. Periodontal endoscopes d. Curettes ANS: B

Explorers are used to locate calculus deposits, surface irregularities, overhanging restorations, and caries.

DIF: Recall REF: p. 501 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. Which of the following is heavy instruments used to remove supragingival calculus? a. Periodontal endoscopes b. Sickle scalers c. Dental tape d. Curettes ANS: B

Sickle scalers are heavy instruments used to remove supragingival calculus.

DIF: Recall REF: p. 501 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Which of the following is used for subgingival scaling and root planing? a. Periodontal endoscopes b. Periodontal probes c. Curettes d. File scalers

ANS: C

Curettes are instruments used for subgingival scaling and root planing.

DIF: Recall REF: p. 501 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Which of the following is plastic or titanium scalers and curettes designed for use on implants

and implant restorations? a. Ultrasonic and sonic instruments b. Periodontal endoscopes c. Cleansing and polishing instruments d. Implant instruments ANS: D

Implant instruments are plastic or titanium scalers and curettes designed for use on implants and implant restorations.

DIF: Recall REF: p. 501 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Which of the following is used to remove tenacious calculus and altered cementum? a. Curettes b. File scalers c. Periodontal endoscopes d. Explorers ANS: B

Hoe, chisel, and file scalerT s ar eT usBeA dN toKrS em s calculus and altered cementum.

ES EoLvLe EteRna.cCioOuM Their use is limited compared with that of curettes.

DIF: Recall REF: p. 501 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Which of the following is used for scaling and cleansing tooth surfaces and curetting the soft

tissue wall of the periodontal pocket? a. Periodontal probes b. Explorers c. Cleansing and polishing instruments d. Ultrasonic and sonic instruments ANS: D

Ultrasonic and sonic instruments are used for scaling and cleansing tooth surfaces and curetting the soft tissue wall of the periodontal pocket.

DIF: Recall REF: p. 501 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. Which of the following is used for deep visualization into subgingival pockets and furcations,

thereby allowing the detection of deposits? a. Periodontal probes b. Periodontal endoscopes c. Implant instruments

d. Explorers ANS: B

Periodontal endoscopes are used for deep visualization into subgingival pockets and furcations, thereby allowing the detection of deposits.

DIF: Recall REF: p. 501 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Dental tape is an example of what type of instrument? a. Implant instruments b. Ultrasonic and sonic instruments c. Cleansing and polishing instruments d. Scaling, root planing, and curettage instruments ANS: C

Rubber cups, brushes, and dental tape are examples of cleansing and polishing instruments and are used to clean and polish tooth surfaces.

DIF: Comprehension REF: p. 501 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which of the following is used to remove tenacious calculus and altered cementum? a. Hoe, chisel, and file scalers b. Ultrasonic and sonic instruments c. Cleansing and polishing instruments d. Periodontal endoscopes ANS: A

Hoe, chisel, and file scalers are used to remove tenacious calculus and altered cementum.

Their use is limited compared with that of curettes.

DIF: Comprehension REF: p. 501 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. What type of curettes is representative of the area-specific curette and are designed and angled

to adapt to specific anatomic areas of dentition? a. Gracey curettes b. Gray curettes c. Universal curettes d. Blade angle curettes ANS: A

Gracey curettes are representative of the area-specific curette and are designed and angled to adapt to specific anatomic areas of dentition.

DIF: Comprehension REF: p. 505 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. Which of the following is the most recent category of Gracey curette innovation? a. Extended shank b. Mini-blade

c. Periodontal maintenance d. Micro mini five ANS: C

The most recent Gracey curette innovation is a category called periodontal maintenance Gracey curettes, introduced in November 2015.

DIF: Recall REF: p. 507 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Which of the following is comprised of a set of two double-ended, highly magnetized

instruments designed for retrieval of a broken instrument tip from the periodontal pocket? a. Periodontal maintenance curette b. Schwartz Periotriever c. Micro Mini Five Gracey curette d. Mini-Langer curette ANS: B

Schwartz Periotrievers comprise a set of two double-ended, highly magnetized instruments designed for retrieval of a broken instrument tip from the periodontal pocket.

DIF: Comprehension REF: p. 509 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. The blade of a hoe scaler is bent at a

-degree angle to be used for scaling of ledges or

rings of calculus. a. 30 b. 45 c. 75 d. 99 ANS: D

Hoe scalers are used for scaling of ledges or rings of calculus. The blade is bent at a 99-degree angle, and the cutting edge is formed by the junction of the flattened terminal surface with the inner aspect of the blade.

DIF: Recall REF: p. 510 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Which of the following is designed for the proximal surfaces of teeth too closely spaced to

permit the use of other scalers, and is usually used in the anterior part of the mouth? a. Files b. Chisel scalers c. Hoe scalers d. Diamond-coated files ANS: B

The chisel scaler is designed for the proximal surfaces of teeth too closely spaced to permit the use of other scalers and is usually used in the anterior part of the mouth.

DIF: Comprehension REF: p. 511 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

16. Which of the following is particularly effective in revealing residual deposits when used with

the dental endoscope? a. Quetin furcation curettes b. Periodontal probe c. Chisel scalers d. Diamond-coated files ANS: D

Diamond files are particularly effective in revealing deposits when used with the dental endoscope.

DIF: Recall REF: p. 512 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. The

system consists of a 0.99-mm-diameter reusable fiberoptic endoscope over which is fitted a disposable sterile sheath. a. Perioscopy b. Fiberoptic c. Periodontal d. Quentin Furcation ANS: A

The Perioscopy system consists of a 0.99-mm diameter reusable fiberoptic endoscope over which is fitted a disposable sterile sheath.

DIF: Comprehension REF: p. 513 TOP: NBDHE; 3.3.2 ProvisT ioE nS ofTinBsA truNcK tioSnEfoLrLpE reR ve. ntC ioO nM and management of oral diseases 18. Both supragingival and subgingival air polishing with

powder are safe and very effective for removal of biofilm from titanium implant surfaces and restorative materials. a. Glycine and zinc b. Glycine and erythritol c. Zinc and chlorhexidine d. Chlorhexidine and erythritol ANS: B

Both supragingival and subgingival air polishing with glycine and erythritol powder are safe and very effective for removal of biofilm from titanium implant surfaces and restorative materials.

DIF: Comprehension REF: p. 514 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. a. b. c. d.

provides visibility, accessibility, and illumination.

Direct vision Direct illumination Retraction Indirect vision

ANS: C

Retraction provides visibility, accessibility, and illumination.

DIF: Comprehension REF: p. 515.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. Whenever possible,

vision with

illumination from the dental light is most

desirable. a. Direct; indirect b. Direct; direct c. Indirect; direct d. Indirect; indirect ANS: B

Whenever possible, direct vision with direct illumination from the dental light is most desirable.

DIF: Recall REF: p. 515.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 21.

refers to the manner in which the working end of a periodontal instrument is placed against the surface of a tooth. a. Angulation b. Retraction c. Vision d. Adaptation ANS: D

Adaptation refers to the maTnE nS erTinBw chStE heLw ki. ngCeOnMd of a periodontal instrument is AhNiK LoErR placed against the surface of a tooth.

DIF: Recall REF: p. 515.e6 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 22. a. b. c. d.

refers to the angle between the face of a bladed instrument and the tooth surface.

Angulation Retraction Vision Adaptation

ANS: A

Angulation refers to the angle between the face of a bladed instrument and the tooth surface. It may also be called the tooth-blade relationship.

DIF: Comprehension REF: p. 515.e6 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 23. For subgingival insertion of a bladed instrument such as a curette, angulation should be as

close to a. 0 b. 15 c. 45 d. 90

degrees as possible.

ANS: A

For subgingival insertion of a bladed instrument such as a curette, angulation should be as close to 0 degrees as possible.

DIF: Comprehension REF: p. 515.e6 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 24. Which of the following is a short, powerful pull stroke that is used with sharp bladed

instruments for the removal of both supragingival and subgingival calculus? a. Exploratory stroke b. Powering stroke c. Scaling stroke d. Root-planing stoke ANS: C

The scaling stroke is a short, powerful pull stroke that is used with sharp bladed instruments for the removal of both supragingival and subgingival calculus.

DIF: Comprehension REF: p. 515.e7 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 25. Which of the following can be defined as the process by which residual embedded calculus

and portions of cementum are removed from the roots to produce a smooth, hard, clean surface? a. Scaling b. Root planing c. Calculus removal d. Subgingival scaling ANS: B

Root planing is the process by which residual embedded calculus and portions of cementum are removed from the roots to produce a smooth, hard, clean surface.

DIF: Comprehension REF: p. 515.e11 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 46: Sonic and Ultrasonic Instrumentation and Irrigation Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following is true about power-driven instruments? a. Power instruments and hand instruments have similar outcomes. b. Power instruments are always used alone. c. Power instruments can make scaling less demanding. d. Power instrumentation has no potential hazards.

ANS: C

Power instruments and hand instruments have similar outcomes. Power instruments are useful tools used alone or in combination with hand instruments. Power instruments can make scaling less demanding. Potential hazards from using power-driven devices include rough root surfaces, production of bioaerosols, and interference with cardiac pacemakers.

DIF: Comprehension REF: p. 516 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Which of the following can be described as unidirectional fluid flow caused by ultrasound

waves? a. Acoustic streaming b. Acoustic turbulence c. Cavitation d. Cavitational flow ANS: A

Acoustic streaming is unidirectional fluid flow caused by ultrasound waves.

DIF: Comprehension REF: p. 516 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. Which of the following is created when the movement of the tip causes the coolant to

accelerate? a. Acoustic turbulence b. Acoustic streaming c. Cavitation d. Cavitational flow ANS: A

Acoustic turbulence is created when the movement of the tip causes the coolant to accelerate, producing an intensified swirling effect.

DIF: Comprehension REF: p. 516 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Which of the following can be defined as the formation of bubbles in water caused by high

turbulence? a. Acoustic streaming b. Acoustic turbulence

c. Cavitation d. Cavitational flow ANS: C

Cavitation is the formation of bubbles in water caused by the high turbulence. The bubbles implode and produce shock waves in the liquid, thus creating further shock waves throughout the water.

DIF: Comprehension REF: p. 516 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Sonic units work at a frequency of a. 1000 to 3000 b. 2000 to 6500 c. 4000 to 8000 d. 5000 to 8500

cycles per second.

ANS: B

Sonic units work at a frequency of 2000 to 6500 cycles per second and use a high- or low-speed air source from the dental unit.

DIF: Recall REF: p. 516 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. What type of devices work in a frequency range of 18,000 to 50,000 cycles per second and

have metal stacks that change dimension when electrical energy is applied? a. Sonic b. Supersonic c. Magnetostrictive ultrasonic d. Piezoelectric ultrasonic ANS: C

Magnetostrictive ultrasonic devices work in a frequency range of 18,000 to 50,000 cycles per second.

DIF: Comprehension REF: p. 516 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Which of the following statements is a disadvantage of mechanized instruments compared

with manual instruments? a. No need to sharpen b. Noise c. More tactile sensation d. Enhanced visibility ANS: B

Disadvantages of mechanized instruments compared with manual instruments include client comfort, aerosol production, temporary hearing shifts, noise, less tactile sensation, and reduced visibility.

DIF: Comprehension REF: p. 517 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

8. Which type of tip design would be ideal for a patient with gingivitis? a. Large-diameter tip b. Straight-tip c. Bent-tip d. Deactivated tip ANS: B

The straight-tip design is ideal for use in treating patients with gingivitis and periodontal maintenance patients.

DIF: Application REF: p. 517 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following is not an advantage of mechanized instruments as compared with

manual instruments? a. Reduced visibility b. No need to sharpen c. Large handpiece size d. Acoustic microstreaming ANS: A

Advantages of mechanized instruments as compared with manual instruments are multiple surfaces of tip, no need to sharpen, less chance of repetitive stress injuries, large handpiece, reduced lateral pressure, less tissue distention, water, lavage, irritation, and acoustic microstreaming. p.R5.

17COM DIF: Comprehension TESTBANKSREFL:LE TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Which type of tip design is indicated for the removal or large, tenacious deposits? a. Large-diameter tips b. Straight-tips c. Activated tips d. Thinner-diameter tips ANS: A

Large-diameter tips are created with a universal design and are indicated for the removal of large, tenacious deposits.

DIF: Comprehension REF: p. 517 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Which of the following statements is not true about power-driven instruments? a. Power-driven instruments are just for heavy calculus removal. b. Power-driven instruments are beneficial for supragingival calculus removal. c. Power-driven instruments are beneficial for general biofilm removal. d. Power-driven instruments are not useful for subgingival debridement.

ANS: D

Power-driven instruments are not just for heavy calculus removal. Depending on tip design and size, they are beneficial for supragingival calculus removal, subgingival debridement, and general plaque biofilm removal.

DIF: Comprehension REF: p. 518 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. What are the primary expected clinical outcomes from scaling and root planing? a. Reductions in bleeding and probing depth and reductions in tooth loss b. Reductions in bleeding and probing depth and a gain in clinical attachment c. Reductions in tooth loss and a gain in clinical attachment d. Gain in clinical attachment and reductions in tooth pain ANS: B

The primary expected clinical outcomes from scaling and root planing are reductions in bleeding and probing depth and a gain in clinical attachment.

DIF: Recall REF: p. 518 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Power-driven devices produce bioaerosols and splatter that can contaminate the operator and

remain in the air for up to how many minutes? a. 15 b. 30 c. 45 d. 60 ANS: B

Power-driven devices produce bioaerosols and splatter, which can contaminate the operator and remain in the air for up to 30 minutes.

DIF: Recall REF: p. 519 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Which of the following is a contraindication for the use of mechanized instruments? a. Diabetes b. Periodontitis c. Swallowing difficulty d. Cancer ANS: C

Contraindications for the use of mechanized instruments include chronic pulmonary disease, cardiovascular disease, and swallowing difficulty.

DIF: Comprehension REF: p. 519 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. What kind of pressure should be used with a power instrument? a. None b. Light c. Medium d. Deep

ANS: B

Light pressure is used with a power instrument.

DIF: Recall REF: p. 519 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. For coronal deposits located in the embrasure area, a

or

tip

orientation is recommended. a. horizontal; transverse b. vertical; transverse c. parallel; accessible d. perpendicular; deactivated ANS: A

For coronal deposits located in the embrasure area, a horizontal or transverse tip orientation is recommended.

DIF: Recall REF: p. 519 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Which of the following is not a physical factor that plays a role in the mechanism of action of

power scalers? a. Weight of power scaler b. Frequency c. Stroke d. Water flow ANS: A

Various physical factors play a role in the mechanism of action of power scalers. These factors include frequency, stroke, and water flow.

DIF: Recall REF: p. 516 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. What are located in the handpiece of piezoelectric ultrasonic units that change in dimension as

electric energy is applied? a. Metal stacks b. Metal sticks c. Ceramic disks d. Ceramic sticks ANS: C

Ceramic disks are located in the handpiece of piezoelectric ultrasonic units that change in dimension as electric energy is applied.

DIF: Comprehension REF: p. 516 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. Newer, slimmer designs of power scalers operate effectively at a. lower b. medium

power settings.

c. high d. inconsistent ANS: A

Newer, slimmer designs operate effectively at lower power settings, thus improving patients’ comfort.

DIF: Recall REF: p. 516 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. Which of the following is a precaution for the use of mechanized instruments? a. Shielded pacemakers b. Controlled diabetes c. Children d. Gingivitis ANS: C

Precautions for the use of mechanized instruments include unshielded pacemakers, infectious diseases, demineralized tooth surface, exposed dentin, restorative materials, titanium implant abutments, immunosuppression, uncontrolled diabetes mellitus, and children.

DIF: Comprehension REF: p. 519 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 47: Systemic and Local Anti-Infective Therapy for Periodontal Diseases Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Pharmacologic agents that prevent the growth of bacteria are known as a. bacteriostatic b. bacterial c. bactericidal d. bacteriocentric

antibiotics.

ANS: A

Pharmacologic agents that prevent the growth of bacteria are bacteriostatic antibiotics, whereas pharmacologic agents that actually kill the bacteria are bactericidal antibiotics.

DIF: Recall REF: p. 522 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Which one of the following is an example of a bacteriostatic antibiotic? a. Penicillin b. Metronidazole c. Tetracycline d. Macrolides ANS: C

Examples of bacteriostatic antibiotics include tetracycline and clindamycin, and penicillin and EpSlT metronidazole are good exT am esBoA fN baKcS teE ricLiL daEl R an.tiC biOoM tics.

DIF: Recall REF: p. 522 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. Which one of the following is an example of a bactericidal antibiotic? a. Tetracycline b. Macrolides c. Penicillin d. Ciprofloxacin ANS: C

Examples of bacteriostatic antibiotics include tetracycline and clindamycin, and penicillin and metronidazole are good examples of bactericidal antibiotics.

DIF: Recall REF: p. 522 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. An anti-infective agent is a

present. a. antibacterial b. chemotherapeutic c. antiseptic d. antimicrobial

agent that acts by reducing the number of bacteria

ANS: B

An anti-infective agent is a chemotherapeutic agent that acts by reducing the number of bacteria present.

DIF: Comprehension REF: p. 522 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5.

are antimicrobial agents that are generally applied to inanimate surfaces to destroy microorganisms. a. Disinfectants b. Antibacterials c. Chemotherapeutics d. Antiseptics ANS: A

Disinfectants are antimicrobial agents that are generally applied to inanimate surfaces to destroy microorganisms.

DIF: Recall REF: p. 522 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Which of the following categories of agents is effective against gram-negative rods and

promotes health-associated microflora? a. Tetracyclines b. Penicillins c. Macrolides d. Quinolones ANS: D

Quinolones are effective against gram-negative rods and promotes health-associated microflora.

DIF: Comprehension REF: p. 522 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Which of the following categories of agents is effective against anerobic bacteria and are used

systematically and applied locally as gel? a. Tetracyclines b. Macrolides c. Quinolines d. Nitroimidazoles ANS: D

Nitroimidazoles are effective against anerobic bacteria and are used systematically and applied locally as gel.

DIF: Comprehension REF: p. 522 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. What is the general dosage and duration for azithromycin? a. 500 mg three times a day for 8 days b. 500 mg once daily for 4 to 7 days

c. 500 mg twice daily for 10 days d. 500 mg once daily for 2 to 5 days ANS: B

The general dosage and duration for azithromycin is 500 mg once daily for 4 to 7 days.

DIF: Recall REF: p. 523 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following microorganisms is frequently associated with localized aggressive

periodontitis? a. Actinomycetemcomitans b. Peptococcus c. Selenomonas d. Bifidobacterium ANS: A

Actinomycetemcomitans is a microorganism that is frequently associated with LAP, and it invades tissue.

DIF: Recall REF: p. 523 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Tetracyclines are effective for the treatment of periodontal diseases in part because their

concentration in the gingival crevice is a. 1 to 3 b. 1 to 7 c. 2 to 5 d. 2 to 10

times that found in serum.

ANS: D

Tetracyclines are effective for the treatment of periodontal diseases in part because their concentration in the gingival crevice is 2 to 10 times that found in serum.

DIF: Recall REF: p. 523 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Which of the following agents is not a semisynthetic member of the tetracycline group that

has been used in periodontal therapy? a. Duocycline b. Tetracycline c. Minocycline d. Doxycycline ANS: A

Tetracycline, minocycline, and doxycycline are semisynthetic members of the tetracycline group that have been used in periodontal therapy.

DIF: Comprehension REF: p. 523 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. Which of the following is not a possible side effect of tetracycline?

a. b. c. d.

Gastrointestinal disturbances Photosensitivity Reduced blood urea nitrogen levels Dizziness

ANS: B

Side effects of tetracyclines include gastrointestinal disturbances, photosensitivity, hypersensitivity, increased blood urea nitrogen levels, blood dyscrasias, dizziness, and headache.

DIF: Comprehension REF: p. 525 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Which of the following is the only tetracycline that can permanently discolor erupted teeth

and gingival tissue when administered orally? a. Metronidazole b. Doxycycline c. Duocycline d. Minocycline ANS: D

Minocycline is the only tetracycline that can permanently discolor erupted teeth and gingival tissue when administered orally.

DIF: Recall REF: p. 525 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. When using doxycycline aT sE anSaTnB ti-AinNfeKcS tiE veLaLgE enRt,.wChOatMis the recommended dose/duration? a. 200 mg twice daily for the first day, then 100 mg daily b. 100 mg three times daily for the first day, then 100 mg twice a day c. 100 mg twice daily for the first day, then 100 mg daily d. 200 mg three times daily for the first day, then 100 mg twice a day ANS: C

The recommended dosage when doxycycline is used as an anti-infective agent is 100 mg twice daily the first day, which is then reduced to 100 mg daily.

DIF: Comprehension REF: p. 526 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Which of the following is a nitroimidazole compound that was first developed in France to

treat protozoal infections? a. Tetracycline b. Metronidazole c. Amoxicillin d. Cephalosporins ANS: B

Metronidazole is a nitroimidazole compound that was first developed in France to treat protozoal infections.

DIF: Recall

REF: p. 525

TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Up to a. 5 b. 10 c. 15 d. 20

% of patients may be allergic to penicillin.

ANS: B

Up to 10% of patients may be allergic to penicillin.

DIF: Recall REF: p. 526 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Which of the following types of medication is effective for situations in which the patient is

allergic to penicillin? a. Clindamycin b. Amoxicillin c. Ciprofloxacin d. Macrolides ANS: A

Clindamycin is effective against anaerobic bacteria and is effective for situations in which the patient is allergic to penicillin.

DIF: Comprehension REF: p. 526 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. Which of the following statements is not true? a. No single antibiotic is effective against all putative pathogens. b. The clinical diagnosis and situation dictate the need for possible antibiotic therapy. c. Antibiotic use is recommended for gingival diseases. d. Antibiotic use is not recommended for a periodontal abscess.

ANS: C

Because periodontal infections may contain a wide variety of bacteria, no single antibiotic is effective against all putative pathogens. The clinical diagnosis and situation dictate the need for possible antibiotic therapy as an adjunct for controlling active periodontal disease.

Antibiotic use is not recommended for gingival diseases. Antibiotic use is not recommended for a periodontal abscess.

DIF: Comprehension REF: p. 527 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. Which of the following statements is true about adjunctive therapy? a. Adjunctive therapy has no effect on scaling and root planing. b. Only slightly more patients show large pocket depth reductions with adjunctive

therapy. c. Mean changes are modest when all pockets are included. d. Clinical responses related to adjunctive therapy are evident immediately.

ANS: C

Adjunctive therapy makes scaling and root planing (SRP) more effective. Significantly more patients show large pocket depth reductions with adjunctive therapy. Because most pockets are quiescent, mean changes are modest when all pockets are included. Clinical responses related to adjunctive therapy are evident only after time and with clinical pocket measurements.

DIF: Comprehension REF: p. 530 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 20. What is the antimicrobial agent in Arestin? a. Minocycline b. Chlorhexidine c. Doxycycline d. Tetracycline ANS: A

The antimicrobial agent in Arestin is minocycline.

DIF: Recall REF: p. 530 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 21. Which of the following is indicated as an adjunct to SRP procedures for the reduction of

pocket depth in adults with periodontitis? a. Doxycycline chip b. Minocycline microspheres c. Chlorhexidine chip d. Doxycycline gel ANS: C

The chlorhexidine chip is indicated as an adjunct to SRP procedures for the reduction of pocket depth in adults with periodontitis, and it can be used as part of a periodontal maintenance program, which includes good oral hygiene and SRP. DIF: Comprehension REF: p. 531 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 22. Which of the following is not a locally delivered, controlled-release antimicrobial product

available for dental use in the United States? a. Doxycycline gel b. Doxycycline chip c. Chlorhexidine chip d. Minocycline microspheres ANS: D

Three locally delivered, controlled-release antimicrobial products available for dental use in the United States is a chlorhexidine-containing chip (PerioChip), a doxycycline gel (Atridox), and minocycline microspheres (Arestin).

DIF: Recall REF: p. 530 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

23. In which of the following situations would systemic antimicrobial agents possibly be a good

option? a. When a patient has gingival disease. b. When a patient with chronic periodontitis gets dizzy. c. When a patient with necrotizing ulcerative gingivitis has swollen lymph nodes. d. When a patient with aggressive periodontitis has gastrointestinal issues.

ANS: C

Antibiotic use is not recommended for a patient with necrotizing ulcerative gingivitis unless there are systemic complications like a fever or swollen lymph nodes.

DIF: Application REF: p. 528 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 24. Which of the following antibiotics is the only antibiotic in periodontal therapy to which all

strains of Aggregatibacter actinomycetemcomitans are susceptible? a. Penicillins b. Cephalosporins c. Ciprofloxacin d. Clindamycin ANS: C

Ciprofloxacin is the only antibiotic in periodontal therapy to which all strains of A. actinomycetemcomitans are susceptible.

DIF: Comprehension REF: p. 527 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 25. Which of the following need not be avoided during and directly after treatment with

minocycline microspheres? a. Hard or sticky foods b. Excessive heat c. Brushing teeth d. Interproximal cleaning devices ANS: C

Patients should avoid hard or sticky foods, excessive heat, and interproximal cleaning devices.

Regular oral hygiene such as brushing one’s teeth should continue.

DIF: Comprehension REF: p. 532 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 48: Occlusal and Orthodontic Therapy Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following terms can be defined as “the position of the mandible when both

condyle-disc assemblies are in their most superior positions in their respective glenoid fossae and against the slope of the articular eminences of each respective temporal bone”? a. Centric relation b. Medial relation c. Excursive movement d. Initial contact ANS: A

Centric relation can be defined as “the position of the mandible when both condyle-disc assemblies are in their most superior positions in their respective glenoid fossae and against the slope of the articular eminences of each respective temporal bone.”

DIF: Recall REF: p. 541 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Which of the following terms can be defined as “any movement of the mandible away from

maximum intercuspation”? a. Excursive movement b. Exterior movement c. Lateral excursion d. Maximal intercuspation ANS: A

Excursive movement can be defined as “any movement of the mandible away from maximum intercuspation.”

DIF: Recall REF: p. 541 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. Which of the following terms can be defined as “position of the mandible when there is

maximal interdigitation and occlusal contact between the maxillary and mandibular teeth”? a. Excursive movement b. Protrusion c. Retrustion d. Maximal intercuspation ANS: D

Maximal intercuspation can be defined as “position of the mandible when there is maximal interdigitation and occlusal contact between the maxillary and mandibular teeth.”

DIF: Recall REF: p. 541 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. Which of the following terms can be defined as “movement of the mandible anteriorly from

maximal intercuspation”?

a. b. c. d.

Minimal intercuspation Protrusion Retrusion Excursive movement

ANS: B

Protrusion can be defined as “movement of the mandible anteriorly from maximal intercuspation.”

DIF: Recall REF: p. 542 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Which of the following terms can be defined as “the side of either dental arch that corresponds

with the side of the mandible moving away from the midline during a lateral excursion?” a. Nonworking side b. Disclusion c. Working side d. Interference ANS: C

Working side can be defined as “the side of either dental arch that corresponds with the side of the mandible moving away from the midline during a lateral excursion.”

DIF: Recall REF: p. 542 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. If the mandible can move posteriorly, it is called a. retrusion b. protrusion c. excursion d. occlusal

.

ANS: A

If the mandible can move posteriorly, it is called retrusion.

DIF: Comprehension REF: p. 542 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. What is the clinical term for teeth grinding? a. Bruxism b. Xerostomia c. Sialorrhea d. Ptyalism ANS: A

Bruxism is the clinical term for teeth grinding.

DIF: Recall REF: p. 542 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. During a lateral excursion, posterior teeth that make contact on the same side as the direction

of mandibular movement are described as having a

.

a. b. c. d.

nonworking contact working contact disclusion interference

ANS: B

During a lateral excursion, posterior teeth that make contact on the same side as the direction of mandibular movement are described as having a working contact.

DIF: Comprehension REF: p. 542 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Contacts that are disruptive to mandibular movement or stressful to individual teeth are called a. b. c. d.

. centrically related malocclusal references occlusal interferences disturbances

ANS: C

Contacts that are disruptive to mandibular movement or stressful to individual teeth are called occlusal interferences or discrepancies.

DIF: Recall REF: p. 542 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. When performing a temporomandibular disorder screening evaluation, what is the reference

range of lateral and protrusTivEeSeT xcBuA rsN ioKnS s?ELLER.COM a. 1 to 3 mm b. 2 to 4 mm c. 3 to 5 mm d. 7 to 9 mm ANS: D

When performing a temporomandibular disorder screening evaluation, the reference range of lateral and protrusive excursions is 7 to 9 mm.

DIF: Comprehension REF: p. 543 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Which of the following is an interproximal, two-fall defect that does not improve with

orthodontic treatment? a. Periapical abscess b. Osseous crater c. Gingival inflammation d. Hemiseptal defect ANS: B

An osseous crater is an interproximal, two-fall defect that does not improve with orthodontic treatment.

DIF: Comprehension

REF: p. 547.e1

TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. Which of the following is a one- or two-wall osseous defect that often is found around

mesially tipped teeth? a. Hemiseptal defect b. Osseous crater c. Periapical abscess d. Intrabony defect ANS: A

A hemiseptal defect is a one- or two-wall osseous defect that often is found around mesially tipped teeth.

DIF: Comprehension REF: p. 547.e1 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. What are the three classifications of furcation defects? a. Incipient, medium, and advanced b. Starter, middle, and comprehensive c. Incipient, moderate, and advanced d. Acute, mild, and chronic ANS: C

Furcation defects can be classified as incipient (class I), moderate (class II), or advanced (class III).

DIF: Recall REF: p. 547.e3 TOP: NBDHE; 3.3.2 ProvisT ioE nS ofTinBsA truNcK tioSnEfoLrLpE reR ve. ntC ioO nM and management of oral diseases 14. If a patient with a class III furcation defect will be undergoing orthodontic treatment, what is a

possible method for treating the furcation? a. Using the tooth as an anchor and placing a splint across the top b. Moving the roots apart and using a bridge c. Extracting the tooth and placing an implant d. Hemisecting the crown and root of the tooth ANS: D

If a patient with a class III furcation defect will be undergoing orthodontic treatment, a possible method for treating the furcation is to eliminate it by hemisecting the crown and root of the tooth. However, this procedure requires endodontic, periodontal, and restorative treatment.

DIF: Application REF: p. 547.e5 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Which of the following terms can be defined as “the separation of certain teeth caused by the

guidance provided by other teeth during an excursion”? a. Excursion b. Disclusion c. Guidance d. Interference

ANS: B

Disclusion can be defined as the “separation of certain teeth caused by the guidance provided by other teeth during an excursion.”

DIF: Comprehension REF: p. 541 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Which of the following is another term for “maximal intercuspation”? a. Abundant occlusion b. Centric occlusion c. Intercuspal occlusion d. Intracuspal occlusion ANS: B

“Maximal intercuspation” is also known as “centric occlusion” and “intercuspal occlusion.”

DIF: Recall REF: p. 541 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Examination of which of the following is not included in a temporomandibular disorder

screening evaluation? a. Range of retrusions b. Maximal interincisal opening c. Auscultation for temporomandibular joint sounds d. Load testing of the patient’s temporomandibular joints ANS: A

A temporomandibular disoTrdEeS r sc ngSeEvL alL uaEtiRo. nC inO clM udes examination of maximal TBreAenNiK interincisal opening, opening or closing pathway, range of lateral and protrusive excursions, auscultation for temporomandibular joint sounds, palpation for temporomandibular joint tenderness or tissue displacement, palpation for muscle tenderness, and load testing of the patient’s temporomandibular joints.

DIF: Comprehension REF: p. 543 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. Teeth that are opposing an appliance should be loaded as close as possible to their a. b. c. d.

. counterparts gumline long axis maxillary appliance

ANS: C

Teeth that are opposing an appliance should be loaded as close as possible to their long axis.

DIF: Comprehension REF: p. 544 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. Implants can be used to facilitate orthodontic mechanotherapy by providing

orthodontic treatment can facilitate implant therapy by providing a. occlusion; cleanliness

, and .

b. site development; esthetics c. anchorage; site development d. therapy; treatment planning ANS: C

Implants can be used to facilitate orthodontic mechanotherapy by providing anchorage, and orthodontic treatment can facilitate implant therapy by providing site development.

DIF: Comprehension REF: p. 548 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 20. Occlusal trauma can a. amplify b. decrease c. cause d. have no effect on

localized loss of attachment from inflammatory bone damage.

ANS: A

Occlusal trauma can amplify (not cause) localized loss of attachment from inflammatory bone damage.

DIF: Comprehension REF: p. 541 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 49: Phase II Periodontal Therapy Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following is not an objective of phase II therapy? a. To remove biofilm b. To improve the prognosis for teeth and their replacements c. To improve esthetics d. To alter defects of the gingival and mucosal tissues that predispose these areas to

disease ANS: A

The surgical phase of periodontal therapy aims to improve the prognosis for teeth and their replacements, to improve esthetics, and to alter defects of the gingival and mucosal tissues that predispose these areas to disease.

DIF: Comprehension REF: p. 551 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. What type of techniques is used to create or widen the attached keratinized gingiva by placing

grafts of various types? a. Plastic surgery b. Esthetic surgery c. Preprosthetic techniques d. Implant surgery ANS: A

Plastic surgery techniques are used to create or widen the attached keratinized gingiva by placing grafts of various types.

DIF: Comprehension REF: p. 551 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. What type of techniques is used to cover denuded root surfaces resulting from recession and

to recreate lost papillae? a. Plastic surgery b. Esthetic surgery c. Preprosthetic techniques d. Implant surgery ANS: B

Esthetic surgery techniques are used to cover denuded root surfaces resulting from recession and to recreate lost papillae.

DIF: Comprehension REF: p. 551 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 4. What type of techniques is used to modify the periodontal and neighboring tissues to receive

prosthetic replacements? a. Plastic surgery

b. Esthetic surgery c. Preprosthetic techniques d. Implant surgery ANS: C

Preprosthetic techniques are used to modify the periodontal and neighboring tissues to receive prosthetic replacements.

DIF: Comprehension REF: p. 551 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Crown lengthening is an example of what type of technique? a. Plastic surgery b. Esthetic surgery c. Preprosthetic techniques d. Implant surgery ANS: C

Examples of preprosthetic techniques include crown lengthening, ridge augmentation, and vestibular deepening.

DIF: Recall REF: p. 551 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. What type of surgery consists or resective and regenerative procedures? a. Pocket reduction surgery b. Periodontal plastic surgery c. Preprosthetic surgery d. Periodontal pressure surgery ANS: A

Pocket reduction surgery consists of resective and regenerative procedures.

DIF: Recall REF: p. 551 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. What type of surgery consists of esthetic and gingival augmentation (anatomic) procedures? a. Pocket reduction surgery b. Periodontal plastic surgery c. Preprosthetic surgery d. Periodontal pressure surgery ANS: B

Periodontal plastic surgery includes esthetic and gingival augmentation (anatomic) procedures.

DIF: Recall REF: p. 551 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. Root coverage is an example of what type of surgery? a. Pocket reduction surgery b. Esthetic surgery

c. Plastic surgery d. Implant surgery ANS: B

Root coverage is an example of esthetic surgery.

DIF: Comprehension REF: p. 552 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Which of the following can be used to gain access to the diseased root surface to ensure the

removal of calculus located subgingivally before surgery and to eliminate or reduce the depth of the periodontal pocket? a. Esthetic surgery techniques b. Periodontal plastic surgery c. Surgical pocket therapy d. Preprosthetic surgery ANS: C

Surgical pocket therapy can be used to gain access to the diseased root surface to ensure the removal of calculus located subgingivally before surgery and to eliminate or reduce the depth of the periodontal pocket.

DIF: Recall REF: p. 552 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Gingivectomy is an example of what type of pocket reduction surgery? a. Regenerative b. Resective c. Dissective d. Degenerative ANS: B

Resective pocket reduction surgery includes gingivectomy, an apically displaced flap, an undisplaced flap with or without osseous resection.

DIF: Comprehension REF: p. 552 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. When a periodontal pocket is in an active state, what is happening to the underlying bone? a. It remains unchanged. b. It is being lost. c. It is changing color. d. It is expanding.

ANS: B

When a periodontal pocket is in an active state, the underlying bone is being lost.

DIF: Comprehension REF: p. 552 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. Inactive pockets sometimes heal with a long a. junctional epithelium

.

b. dose of therapy c. healthy sulcus d. coronal plane ANS: A

Inactive pockets sometimes heal with a long junctional epithelium.

DIF: Comprehension REF: p. 553 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Reevaluation after phase I therapy is typically made no less than

months after

phase I therapy has been completed. a. 1 to 3 b. 2 to 5 c. 3 to 6 d. 6 to 8 ANS: A

Reevaluating after phase I therapy typically is made no less than 1 to 3 months and sometimes as much as 9 months after the completion of phase I therapy.

DIF: Recall REF: p. 553 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Which of the following is not an indication for the need for surgical phase of therapy? a. Areas with irregular bony contours, deep craters, and other defects b. Furcation involvement of grade I or grade II c. Intrabony pockets distaTl E toStT heBlA asNt K mS olEarLsLER.COM d. Persistent inflammation in areas after past procedures ANS: B

The following findings can indicate the need for a surgical phase of therapy: areas with irregular bony contours, deep craters, and other defects; pockets around teeth where access to the root surface for complete removal of root irritants is not clinically possible; furcation involvement of grade II or grade III; intrabony pockets distal to the last molars; and persistent inflammation in areas after past procedures that have moderate to deep pockets.

DIF: Application REF: p. 554 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. What is the most common method of pocket therapy? a. Regeneration of bone b. Removal of the pocket wall c. Removal of the tooth side of the pocket d. Regeneration of cementum ANS: B

The most common method of pocket therapy is the removal of the pocket wall.

DIF: Recall REF: p. 554 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

16. Which of the following is considered a new attachment technique for pocket therapy? a. Regeneration of bone b. Removal of pocket wall c. Removal of the tooth side of the pocket d. Retraction of the gingival tissue ANS: A

New attachment techniques for pocket therapy include regeneration of bone, connective tissue, periodontal ligament, and cementum.

DIF: Comprehension REF: p. 554 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Selection of what type of pocket therapy technique is based on all of the following

considerations except: a. response to phase III therapy. b. previous periodontal treatments. c. patient cooperation. d. existence of mucogingival problems.

ANS: A

Selection of a technique for treating a particular periodontal lesion is based on the following considerations: characteristics of the pocket depth, relation to bone, and configuration, accessibility to instrumentation, including furcation involvement, existence of mucogingival problems, response to phase I therapy, patient cooperation, age and general health of the patient, overall diagnosis, esthetic considerations, and previous periodontal treatments.

DIF: Comprehension EF p.R55.4COM TESTBANKSRE L:LE TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. What type of tissue shrinks after the elimination of local factors, which reduces or totally

eliminates pocket depth? a. Edematous b. Epithelial c. Spongy d. Connective ANS: A

Edematous tissue shrinks after the elimination of local factors, which reduces or totally eliminates pocket depth.

DIF: Comprehension REF: p. 554 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. Criteria for the selection of a surgical technique for pocket therapy are based on the clinical

findings in all of the following except: a. soft-tissue pocket wall. b. tooth surface. c. underlying bone. d. unattached gingiva.

ANS: D

Criteria for the selection of a surgical technique for pocket therapy are based on clinical findings in the soft-tissue pocket wall, tooth surface, underlying bone, and attached gingiva.

DIF: Comprehension REF: p. 554.e1 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 20. Ridge augmentation is considered what type of periodontal surgery? a. Resective pocket reduction b. Regenerative pocket reduction c. Preprosthetic d. Esthetic ANS: C

Preprosthetic techniques include crown lengthening, ridge augmentation, and vestibular deepening.

DIF: Comprehension REF: p. 551 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 50: General Principles and Types of Periodontal Surgery Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. What is the most common emergency that occurs during dental surgery? a. Syncope b. Heart attack c. Seizure d. Choking ANS: A

The most common emergency that occurs during dental surgery is syncope.

DIF: Recall REF: p. 557 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 2. Which of the following may be administered to a patient about 1 hour before a dental surgery? a. Fluoride b. Sedative c. Ibuprofen d. Anti-seizure medication ANS: C

An NSAID such as Ibuprofen (e.g., Motrin) could be administered to a patient about 1 hour before a dental procedure.

DIF: Comprehension REF: p. 556 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 3. Which of the following is the most important objective of periodontal pocket reduction

surgery? a. To gain access to the surrounding tissues to access the damage b. To gain access to the root surface for scaling and root planing c. To discuss the patient’s long-term therapy plans d. To remove all saliva from the mouth and get a clear view of the entire pocket ANS: B

The most important objective of periodontal pocket reduction surgery is to gain access to the root surface for scaling and root planing.

DIF: Comprehension REF: p. 558 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 4. Which of the following is an example of a hemostatic agent? a. CollaBorg b. Gelpads c. Oxycel

d. Hemoplug ANS: C

Various hemostatic agents exist like absorbable gelatin sponges (Gelfoam), oxidized cellulose (Oxycel), oxidized regenerated cellulose (Surgicel Absorbable Hemostat), and microfibrillar collagen hemostat (Avitene, CollaCote, CollaTape, and CollaPlug).

DIF: Recall REF: p. 558 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 5. Which of the following hemostatic agents could cause an allergic reaction in patients with

known sensitivity to bovine materials? a. Absorbable gelatin sponge b. Oxidized cellulose c. Microfibrillar collagen d. Thrombin ANS: D

Thrombin (Thrombostat) may be applied topically to bleeding surface but could cause an allergic reaction in patients with known sensitivity to bovine materials.

DIF: Recall REF: p. 558.e1 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 6. Which of the following is a word use in periodontics to describe the scraping of the gingival

wall of a periodontal pockeTtEtoSrT em ovNeKthSeEcL hrLoE niR ca.llC y OinMflamed tissue?

BA a. Curettage b. Surgery c. Probing d. Excision ANS: A

The word curettage is used in periodontics to describe the scraping of the gingival wall of a periodontal pocket to remove the chronically inflamed tissue.

DIF: Recall REF: p. 559 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 7. Which of the following words or phrases means “excision of the gingiva”? a. Gingivitis b. Gingivectomy c. Gingival restoration d. Gingivoplasty ANS: B

The word gingivectomy means “excision of the gingiva.”

DIF: Recall REF: p. 559 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures

8. Which of the following words or phrases can be defined as “recontouring of the gingiva in the

absence of pockets”? a. Gingivitis b. Gingivectomy c. Gingival restoration d. Gingivoplasty ANS: D

Gingivoplasty can be defined as “recontouring of the gingiva in the absence of pockets.”

DIF: Comprehension REF: p. 559 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 9. The Orban knife and the Merrifield knife are examples of what types of instruments used in

dental surgery? a. Surgical chisels b. Periodontal knives c. Interdental knives d. Surgical curettes ANS: C

The Orban knife and the Merrifield knife are examples of interdental knives.

DIF: Recall REF: p. 559.e1 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 10. Which of the following tools is used to hold the flap during the suturing of dental surgery? a. Surgical chisels b. Periosteal elevators c. Tissue forceps d. Surgical sickles ANS: C

The tissue forceps are used to hold the flap during suturing of dental surgery. They are also used to position and displace the flap after the flap has been reflected.

DIF: Comprehension REF: p. 559.e3 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 11. Which of the following tools is used to suture the flap at the desired position after the surgical

procedure has been completed? a. Periosteal elevators b. Tissue forceps c. Surgical curettes d. Needleholders ANS: D

Needleholders are used to suture the flap at the desired position after the surgical procedure has been completed.

DIF: Comprehension REF: p. 559.e4 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 12. What type of flap surgery facilitates root instrumentation, does not attempt to reduce pocket

depth, but does eliminate the pocket lining? a. Undisplaced flap b. Modified Widman flap c. Distal terminal molar flap d. Apically displaced flap ANS: B

The modified Widman flap facilitates root instrumentation, does not attempt to reduce pocket depth, but does eliminate the pocket lining.

DIF: Comprehension REF: p. 561 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 13. What type of flap surgery may be the most frequently performed type of periodontal surgery? a. Undisplaced flap b. Modified Widman flap c. Distal terminal molar flap d. Apically displaced flap ANS: A

Currently, the undisplaced flap may be the most frequently performed type of periodontal surgery.

DIF: Recall REF: p. 561 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 14. What type of mouthrinse should patients use immediately after a surgical procedure and twice

daily thereafter until normal biofilm control can be resumed? a. Salt water b. 0.12% chlorhexidine gluconate c. 0.12% cetylpyridinium chloride d. Hydrogen peroxide ANS: B

Patients should be instructed to rinse with 0.12% chlorhexidine gluconate immediately after the procedure and twice daily thereafter until normal biofilm control can be resumed.

DIF: Recall REF: p. 568 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 15. Which of the following is not true about periodontal dressings?

a. b. c. d.

Periodontal dressings provide no curative properties.

Periodontal dressings assist healing by protecting the tissue.

Periodontal dressings prevent surface trauma.

Periodontal dressings assist healing by providing “healing factors.”

ANS: D

Periodontal dressings have no curative properties but assist healing by protecting the tissue rather than providing “healing factors.” The dressing facilitates healing by preventing surface trauma during mastication and protects the patient from pain induced by contact of the wound with food or with the tongue during mastication.

DIF: Comprehension REF: p. 569 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 16. Which of the following is not a usual finding when the dressing is removed at a return visit? a. After a flap operation, the areas that correspond to the incisions are epithelialized,

but they may bleed readily if irritated. b. The facial and lingual mucosa may be covered with a red layer of debris that has

entered under the dressing. c. Fragments of calculus could delay healing, so each root surface should be checked. d. If gingivectomy has been performed, the incised surface is covered with a friable

meshwork of new epithelium.

ANS: B

After a flap operation, the areas that correspond to the incisions are epithelized, but they may bleed readily if irritated. The facial and lingual mucosa may be covered with a grayish-yellow or white granular layer of dTeE brSisTtB haAt N haKsSeE ntL erLedER th. eC drOesMsing. Fragments of calculus could delay healing, so each root surface should be carefully checked. If a gingivectomy has been performed, the incised surface is covered with a friable meshwork of new epithelium.

DIF: Comprehension REF: p. 570 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 17. Tooth mobility usually a. slightly decreases b. increases c. stays the same d. moderately decreases

immediately after surgery.

ANS: B

Tooth mobility usually increases immediately after surgery.

DIF: Recall REF: p. 569 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 18. Which of the following can prevent bleeding or hemorrhage at the initial entry into soft tissue,

but cannot stop bleeding after that blood is present? a. Electrosection b. Electrocoagulation

c. Electrotomy d. Radiosurgery ANS: B

Electrocoagulation can prevent bleeding or hemorrhage at the initial entry into soft tissue but cannot stop bleeding after that blood is present.

DIF: Comprehension REF: p. 559.e2 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 19. What is the most important basic role of the use of electrosurgery? a. Always keep the tip moving. b. Hold the tip still. c. Eliminate the heat buildup. d. Maximize the amount of tissue destruction.

ANS: A

The most important basic rule of the use of electrosurgery is to always keep the tip moving.

DIF: Recall REF: p. 559.e3 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 20. Which of the following tools is needed to reflect and move the flap after the incision has been

made for flap surgery? a. Tissue forceps b. Surgical chisels c. Periosteal elevators d. Surgical sickles ANS: C

The periosteal elevators are needed to reflect and move the flap after the incision has been made for flap surgery.

DIF: Recall REF: p. 559.e3 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures

Chapter 51: Preparation of the Periodontium for Restorative Dentistry Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Generally, the preparation of the periodontium can be divided into what two phases? a. Control of periodontal inflammation with nonsurgical and surgical approaches and

pre-prosthetic periodontal surgery b. Control of plaque biofilm and control of periodontal inflammation with

nonsurgical and surgical approaches c. Control of oral hygiene procedures and pre-prosthetic periodontal surgery d. Control of plaque biofilm with nonsurgical and surgical approaches and control of periodontal inflammation with nonsurgical and surgical approaches ANS: A

Generally, the preparation of the periodontium for restorative dentistry can be divided into two phases: control of periodontal inflammation with nonsurgical and surgical approaches and pre-prosthetic periodontal surgery.

DIF: Recall REF: p. 574 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 2. Which of the following contains the correct sequence of treatment for pre-prosthetic surgery

in restorative dentistry? a. Emergency treatment, extraction of hopeless teeth, reevaluation, and periodontal TESTBANKSELLER.COM surgery b. Emergency treatment, oral hygiene instructions, preservation of ridge morphology, and management of mucogingival problems c. Management of mucogingival problems, preservation of ridge morphology after tooth extraction, crown-lengthening procedures, alveolar ridge reconstruction d. Alveolar ridge reconstruction, preservation of ridge morphology after tooth extraction, adjunctive orthodontic therapy, extraction of hopeless teeth ANS: C

The correct sequence of treatment for pre-prosthetic surgery in restorative dentistry is management of mucogingival problems, preservation of ridge morphology after tooth extraction, crown-lengthening procedures, and alveolar ridge reconstruction.

DIF: Comprehension REF: p. 574 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 3. Periodontal therapy should a. occur concurrently with b. antecede c. follow d. be unrelated to ANS: B

definitive restorative care.

Periodontal therapy should antecede definitive restorative care.

DIF: Recall REF: p. 573 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 4. Tissues that

during restorative manipulation allow for a more predictable

restorative and esthetic result. a. change color b. expand c. do not bleed d. shrink ANS: C

Tissues that do not bleed during restorative manipulation allow for a more predictable restorative and esthetic result.

DIF: Recall REF: p. 573.e1 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 5. If periodontal involvement is also coupled with rampant decay, the rampant caries must be

addressed periodontal disease. a. right before b. concurrently with c. after d. at least 6 months prior ANS: B

If periodontal involvement is also coupled with rampant decay, the rampant caries must also be addressed concurrently with periodontal disease.

DIF: Recall REF: p. 574 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 6. Emergency treatment is undertaken to alleviate symptoms and a. stabilize b. solve c. prolong d. exacerbate

acute infection.

ANS: A

Emergency treatment is undertaken to alleviate symptoms and stabilize acute infection.

DIF: Recall REF: p. 574 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 7. In patients with deep periodontal pockets (more than

mm), plaque biofilm control measures alone are insufficient for resolving subgingival infection and inflammation. a. 2

b. 3 c. 5 d. 7 ANS: C

In patients with deep periodontal pockets (more than 5 mm), plaque biofilm control measures alone are insufficient for resolving subgingival infection and inflammation.

DIF: Recall REF: p. 574 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 8.

weeks after periodontal surgery, the gingival tissues are evaluated to determine oral hygiene adequacy, soft tissue response, and pocket depth changes. a. 2 b. 4 c. 6 d. 8 ANS: B

Four weeks after periodontal surgery, the gingival tissues are evaluated to determine oral hygiene adequacy, soft tissue response, and pocket depth changes.

DIF: Recall REF: p. 575 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 9. At least

months of hTeE alS inT g BisArN ecKoS mE mL enLdEedR. afC teO rM soft-tissue grafting procedures before initiating restorative procedures. a. 2 b. 4 c. 6 d. 8 ANS: A

At least 2 months of healing is recommended after soft-tissue grafting procedures before initiating restorative procedures.

DIF: Recall REF: p. 575.e1 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 10. Which of the following terms is defined as the “physiologic dimension of the junctional

epithelium and connective tissue attachment”? a. Biologic width b. Attachment width c. Epithelial width d. Connective width ANS: A

The biologic width is defined as the physiologic dimension of the junctional epithelium and connective tissue attachment.

DIF: Recall REF: p. 575.e2 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 11. The healthy gingival sulcus has an average depth of a. 0.24 mm b. 0.48 mm c. 0.69 mm d. 0.82 mm

mm.

ANS: C

The healthy gingival sulcus has an average depth of 0.69 mm.

DIF: Recall REF: p. 575.e2 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 12. It is recommended that there be at least

mm between the gingival margin and the bone

crest. a. 1 mm b. 2 mm c. 3 mm d. 4 mm ANS: C

It is recommended that there be at least 3 mm between the gingival margin and bone crest.

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DIF: Recall REF: p. 575.e2 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 13. Which of the following would be considered a contraindication for surgical crown

lengthening? a. Subgingival caries or fracture b. Unequal clinical crown length for retention c. Unusual or unesthetic gingival heights d. Tooth is a poor restorative risk ANS: D

Indications for surgical crown lengthening are subgingival caries or fracture, inadequate clinical crown length for retention, and unequal or unesthetic gingival heights.

Contraindications include an unesthetic outcome, deep caries or fracture that would require excessive bone removal on contiguous teeth, and if the tooth is a poor restorative risk.

DIF: Comprehension REF: p. 575.e4 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 14. Emergency treatment is considered part of what phase of restorative dentistry? a. Control of active disease b. Pre-prosthetic surgery

c. Active restorative surgery d. Post-prosthetic surgery ANS: A

Emergency treatment is considered part of the control of active disease.

DIF: Recall REF: p. 574 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 15. Retention of hopeless teeth without periodontal involvement may result in a. inflammation of gingival tissue throughout the entire mouth b. buildup of plaque in unassociated teeth c. trauma to the junctional epithelium d. bone loss around the adjacent teeth ANS: D

Retention of hopeless teeth without periodontal involvement may result in bone loss around the adjacent teeth.

DIF: Comprehension REF: p. 574 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures

.

Chapter 52: Restorative Interrelationships Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. The gingiva and highly scalloped papilla are a. more highly prone to recession b. not as prone to recession c. more highly prone to inflammation d. not as prone to inflammation

after normal procedures.

ANS: A

The gingiva and highly scalloped papilla are more highly prone to recession after normal restorative procedures.

DIF: Comprehension REF: p. 576 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 2. A clinician is presented with three options for margin placement: a. supragingival, gingival, and subgingival. b. supragingival, equigingival, and subgingival. c. subgingival, medigingival, and supergingival. d. subgingival, equigingival, and supergingival.

ANS: B

A clinician is presented wiT thEtS hrT eeBoApN tiK onSsEfoLrLmEaR rg.inCpOlaMcement: supragingival, equigingival, and subgingival.

DIF: Recall REF: p. 576 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 3. What kind of margin has the least impact on the periodontium? a. Subgingival b. Supergingival c. Supragingival d. Equigingival ANS: C

The supragingival margin has the least impact on the periodontium.

DIF: Comprehension REF: p. 576 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 4. When measuring the distance between the bone and the restoration margin using a sterile

periodontal probe, if the distance is less than mm at one or more locations, a diagnosis of supracrestal attached tissue violation can be confirmed. a. 1 b. 2

c. 3 d. 4 ANS: B

When measuring the distance between the bone and the restoration margin using a sterile periodontal probe, if the distance is less than 2 mm at one or more locations, a diagnosis of supracrestal attached tissue violation can be confirmed.

DIF: Recall REF: p. 576 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 5. The first step in using sulcus depth as a guide in margin placement is to a. measure the depth of the sulcus b. manage gingival health c. locate the edges of the sulcus d. discuss treatment options with the patient

.

ANS: B

The first step in using sulcus depth as a guide in margin placement is to manage gingival health.

DIF: Recall REF: p. 578.e1 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 6. It has been shown that the level of gingival inflammation can

corresponding with the

level of marginal opening. a. decrease b. be proportional c. increase d. make no difference ANS: C

It has been shown that the level of gingival inflammation can increase corresponding with the level of marginal opening.

DIF: Recall REF: p. 579 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 7. Which of the following situations occurs more frequently in the dentist office? a. The clinician confronts a normal or shallow sulcus with a papilla that appears too

short. b. The clinician confronts a normal or shallow sulcus with a papilla that appears too tall. c. The clinician confronts a normal or deep sulcus with a papilla that appears too tall. d. The clinician confronts a normal or deep sulcus with a papilla that appears too short.

ANS: A

The clinician most frequently confronts a normal or shallow sulcus with a papilla that appears too short rather than a tall papilla with a deep sulcus.

DIF: Recall REF: p. 579 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 8. Which of the following can identify interproximal violations of supracrestal attached tissue

evaluation (SAT)? a. Probing b. Radiographic examination c. Vital signs d. Medical examination ANS: B

Radiographic interpretation can identify interproximal violations of SAT. DIF: Recall REF: p. 577 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 9. Which of the following is the four classic options to consider when evaluating pontic design? a. Hygienic, ridge lap, ovate, and modified ovate b. Ovate, hygienic, modified hygienic, and ridge lap c. Hygienic, ridge lap, modified ridge lap, and ovate d. Hygienic, hygienic ridge lap, ridge lap, and hygienic ovate ANS: C

Classically, there are four options to consider in evaluating pontic design: hygienic, ridge lap, modified ridge lap, and ovate designs.

DIF: Recall REF: p. 579 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 10. A mutually protective occlusion is created when all the teeth touch at the same time in a

normal closing arc, but when the mandible moves, all contacts are on the a. anterior b. posterior c. cuspid d. canine

teeth.

ANS: A

A mutually protective occlusion is created when all the teeth touch at the same time in a normal closing arc, but when the mandible moves, all contacts are on the anterior teeth.

DIF: Comprehension REF: p. 580 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 11. The greatest biologic risk occurs when placing a. supravingival

margins.

b. supergingival c. subgingival d. supracrestal ANS: C

The greatest biologic risk occurs when placing subgingival margins.

DIF: Recall REF: p. 576 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 12. Which of the following reasons is not a restorative consideration that could dictate the

placement of restoration margins beneath the gingival tissue crest? a. To create adequate resistance and retentive form in the preparation b. To make significant contour alterations because of other caries or other tooth deficiencies c. To mask the tooth-restoration interface by locating it subgingivally d. To shorten the tooth for esthetic reasons ANS: D

Restorative considerations frequently dictate the placement of restoration margins beneath the gingival tissue crest. Restorations may need to be extended gingivally to create adequate resistance and retentive form in the preparation, to make significant contour alterations because of caries or other tooth deficiencies, to mask the tooth-restoration interface by locating it subgingivally, or to lengthen the tooth for esthetic reasons.

DIF: Comprehension REF: p. 576.e1 TOP: NBDHE; 4.0 ProvisioT nE ofSCTliB niA caNl K DS enE taL lH neCSOeM rvices: Performing periodontal LyEgRie. procedures 13. When determining where to place restorative margins relative to the periodontal attachment, it

is recommended that the patient’s SAT requirement for that patient. a. goal sulcular depth b. current level of gingival inflammation c. goal level of gingival inflammation d. existing sulcular depth

be used as a guideline in assessing the

ANS: D

When determining where to place restorative margins relative to the periodontal attachment, it is recommended that the patient’s existing sulcular depth be used as a guideline in assessing the SAT requirement for that patient.

DIF: Comprehension REF: p. 577 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 14. There is a potential risk of a. gingival recession b. gingival inflammation c. tooth loss d. loss of tissue elasticity

after removal of bone.

ANS: A

There is a potential risk of gingival recession after removal of bone.

DIF: Recall REF: p. 577 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures 15. If the sulcus probes more than 1.5 mm, where should the margin be placed? a. No more than 0.5 mm below the gingival tissue crest b. No more than of the depth of the sulcus below the tissue crest c. No more than of the depth of the sulcus below the tissue crest d. No more than 1 mm below the gingival tissue crest ANS: C

If the sulcus probes more than 1.5 mm, place the margin no more than half of the depth of the sulcus below the tissue crest.

DIF: Comprehension REF: p. 578.e1 TOP: NBDHE; 4.0 Provision of Clinical Dental Hygiene Services: Performing periodontal procedures

Chapter 53: Supportive Periodontal Treatment Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following statements is not true? a. The long-term preservation of the dentition is closely associated with the

frequency and quality of recall maintenance. b. After phase I therapy is completed, patients are placed on a schedule of periodic

recall visits for maintenance care. c. Patients who are not maintained in a supervised recall program subsequent to active treatment show obvious signs of recurrent periodontitis. d. Transferring a patient from active treatment status to a maintenance program requires little time and effort on the part of the dentist and staff.

ANS: D

The long-term preservation of the dentition is closely associated with the frequency and quality of recall maintenance. After phase I therapy is completed, patients are placed on a schedule of periodic recall visits for maintenance care to prevent the recurrence of the disease.

Transferring a patient from active treatment status to a maintenance program is a definitive step in total patient care that requires time and effort on the part of the dentist and staff.

DIF: Comprehension REF: p. 581 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Patients who do not return to the office for supportive periodontal treatment lose how many

more teeth than compliant patients? a. 1 to 2 more times b. 2 to 3 more times c. 5 to 6 more times d. 8 to 9 more times ANS: C

Patients who do not return for SPT lose five to six times more teeth than compliant patients.

DIF: Recall REF: p. 581 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. When does the maintenance phase of periodontal treatment start? a. Immediately after the completion of phase I therapy b. 2 weeks after completion of phase I therapy c. 4 weeks after completion of phase I therapy d. 2 months after completion of phase I therapy ANS: A

The maintenance phase of periodontal treatment starts immediately after the completion of phase I therapy.

DIF: Recall REF: p. 581 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

4. What happens to subgingival biofilm if it is left behind during scaling? a. It changes color. b. It becomes minimized with good oral hygiene. c. It regrows within the pocket. d. It expands across tooth surfaces.

ANS: C

If subgingival biofilm is left behind during scaling, it regrows within the pocket.

DIF: Comprehension REF: p. 582 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. What phase is known as the maintenance phase of periodontal treatment? a. Phase I b. Phase II c. Phase III d. Phase IV ANS: D

Phase IV is known as the maintenance phase of periodontal treatment.

DIF: Recall REF: p. 582 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Scaling and root planing are not always effective at sites with probing depths of

mm or

greater. a. 5 b. 6 c. 7 d. 8 ANS: B

Scaling and root planing are not always effective at sites with probing depths of 6 mm or greater.

DIF: Recall REF: p. 582 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. Periodic recall visits form the foundation of a meaningful long-term prevention program. The

but may vary according to the patient’s

interval between visits is initially set at needs. a. 2 weeks b. 1 month c. 3 months d. 6 months ANS: C

Periodic recall visits form the foundation of a meaningful long-term prevention program. The interval between visits is initially set at 3 months but may vary according to the patient’s needs.

DIF: Comprehension

REF: p. 583

TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. Which of the following is not one of the main three parts of a maintenance recall visit? a. Examination b. Probing c. Treatment d. Report and scheduling ANS: B

The three parts to an SPT appointment are: examination, treatment, and report and scheduling.

While probing is done at the recall appointment, it is not one of the three main parts of the appointment.

DIF: Recall REF: p. 583 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. Approximately how much time should be allotted for a recall visit for a patient with multiple

teeth in both arches? a. 30 minutes b. 45 minutes c. 60 minutes d. 90 minutes ANS: C

The time required for a recall visit for patients with multiple teeth in both arches is approximately 60 minutes (1 hour). . 5S8T 3 BANKSELLER.COM DIF: Application REF: TpE TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. For a patient with no clinical caries and no high-risk factors for caries, what radiographic

examination should be scheduled? a. Posterior bitewing examination at 6- to 18-month intervals b. Posterior bitewing examination at 24- to 36-month intervals c. Bitewing examination every 24 to 36 months d. Periapical or vertical bitewing radiographs of problem areas every 12 to 24 months ANS: B

For a patient with no clinical caries and no high-risk factors for caries, a posterior bitewing examination should occur at 24- to 36-month intervals.

DIF: Comprehension REF: p. 586 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. For a patient with a history of periodontal treatment with disease under good control, what

radiographic examination should be scheduled? a. Posterior bitewing examination at 6- to 18-month intervals b. Posterior bitewing examination at 24- to 36-month intervals c. Bitewing examination every 24 to 36 months d. Periapical or vertical bitewing radiographs of problem areas every 12 to 24 months ANS: C

For a patient with a history of periodontal treatment with disease under good control, bitewing examination should occur every 24 to 36 months.

DIF: Comprehension REF: p. 586 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. For a patient with clinical caries or who has high-risk factors for caries, what radiographic

examination should be scheduled? a. Posterior bitewing examination at 6- to 18-month intervals b. Posterior bitewing examination at 24- to 36-month intervals c. Bitewing examination every 24 to 36 months d. Periapical or vertical bitewing radiographs of problem areas every 12 to 24 months ANS: A

For a patient with clinical caries or who has high-risk factors for caries, posterior bitewing examination should occur at 6- to 18-month intervals.

DIF: Comprehension REF: p. 586 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. For a patient who does not have good control over their periodontal disease, what type of

radiographic examination should be scheduled? a. Posterior bitewing examination at 6- to 18-month intervals b. Posterior bitewing examination at 24- to 36-month intervals c. Bitewing examination every 24 to 36 months d. Periapical or vertical bitewing radiographs of problem areas every 12 to 24 months ANS: D

For a patient who does not have good control over their periodontal disease, periapical or vertical bitewing examination of problem areas should occur every 12 to 24 months.

DIF: Comprehension REF: p. 586 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. To assess the effectiveness of their plaque control, when should patients perform their hygiene

regimen in relation to the recall appointment? a. Immediately before or at the recall appointment b. At least 2 to 4 hours before the recall appointment c. Over 12 hours before the recall appointment d. Immediately after the recall appointment ANS: A

To assess the effectiveness of their plaque control, patients should perform their hygiene regimen immediately before or at the recall appointment.

DIF: Comprehension REF: p. 586 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. It is the responsibility of

oral hygiene techniques. a. the receptionist b. the dental hygienist

to educate and motivate patients to improve their

c. the spouse of the patient d. the dentist ANS: B

It is the responsibility of the dental hygienist to educate and motivate patients to improve their oral hygiene techniques.

DIF: Recall REF: p. 588 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 16. Which of the following is considered a possible cause of increased mobility? a. Toothbrush abrasion b. Occlusal trauma c. Cracked teeth d. Inadequate restorations ANS: D

Possible causes of increased mobility include increased inflammation, poor oral hygiene, subgingival calculus, inadequate restorations, deteriorating or poorly designed prostheses, and systemic disease-modifying host response to plaque.

DIF: Comprehension REF: p. 588 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 17. Which of the following is considered a possible cause for recession? a. Orthodontic therapy b. Poor oral hygiene c. Grooves in teeth d. Increased inflammation ANS: A

Possible causes of recession include toothbrush abrasion, inadequate keratinized gingiva, frenum pull, and orthodontic therapy.

DIF: Comprehension REF: p. 588 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 18. When should the decision be made about when to retreat a periodontal patient? a. Immediately at the first preventive maintenance appointment b. 1 to 2 weeks after the first preventive maintenance appointment c. At the second preventive maintenance appointment d. After a follow-up appointment with a periodontist ANS: B

The decision to retreat a periodontal patient should not be made at the preventive maintenance appointment but should be postponed for about 1 to 2 weeks.

DIF: Comprehension REF: p. 588 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 19. What is the recall interval for a Class A recall patient? a. Every 1 to 2 months

b. Every 3 to 4 months c. Every 6 months to 1 year d. Every 1 year ANS: C

The recall interval for a Class A recall patient is 6 months to 1 year.

DIF: Recall REF: p. 589 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 20. Who should maintain a Class C recall patient? a. General practitioner b. General practitioner-dental hygienist team c. A specialist d. Dental hygienist ANS: C

Class C patients should be maintained by a specialist.

DIF: Application REF: p. 589 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 54: Results of Periodontal Treatment Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following statements is not true? a. Gingivitis is irreversible. b. Gingivitis is reversible with regular maintenance visits and good oral hygiene. c. Gingival health can be maintained by a combination of effective oral hygiene

maintenance and scaling procedures. d. Gingivitis is a common occurrence.

ANS: A

Gingivitis is reversible, common, and can be maintained by a combination of effective oral hygiene maintenance and scaling procedures.

DIF: Comprehension REF: p. 592 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 2. Which of the following statements is accurate? a. Gingivitis is often produced by good oral hygiene and reduced by improved oral

hygiene. b. Gingivitis is often produced by good oral hygiene and improved by reduced oral

hygiene. c. Gingivitis is often produced by a lack of oral hygiene and reduced by improved

oral hygiene. d. Gingivitis is often produced by a lack of oral hygiene and improved by reduced

oral hygiene.

ANS: C

Gingivitis is often produced by a lack of oral hygiene and reduced by improved oral hygiene.

DIF: Comprehension REF: p. 592 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 3. In the 2018 Classification of Periodontal and Peri-implant Diseases and Conditions, what two

disease categories were grouped under a single category called “periodontitis”? a. Chronic periodontitis and aggressive periodontitis b. Mild periodontitis and moderate periodontitis c. Localized periodontitis and generalized periodontitis d. Stage 1 periodontitis and Stage 2 periodontitis ANS: A

In the 2018 Classification of Periodontal and Peri-implant Diseases and Conditions, “chronic periodontitis” and “aggressive periodontitis” disease categories are grouped under a single category called “periodontitis.”

DIF: Recall REF: p. 592 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

4. Although periodontal therapy has been utilized for more than 100 years, it is only since the

that a number of studies have been conducted to determine the effect of treatment on reducing the progressive loss of periodontal support for the natural dentition. a. mid-1960s b. mid-1970s c. mid-1980s d. mid-1990s ANS: B

Although periodontal therapy has been utilized for more than 100 years, it is only since the mid-1970s that a number of studies have been conducted to determine the effect of treatment on reducing the progressive loss of periodontal support for the natural dentition.

DIF: Recall REF: p. 593 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 5. Loe and coworkers conducted a longitudinal investigation to study the natural development

and progression of periodontal disease and the first study group was in what country? a. Iceland b. Sweden c. Finland d. Norway ANS: D

Loe and coworkers conducted a longitudinal investigation to study the natural development and progression of periodontal disease and the first study group was in Norway.

DIF: Recall REF: TpE . 5S9T 3 BANKSELLER.COM TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 6. Patient ability for regular, thorough biofilm removal by the patient with periodic maintenance

therapy can predictably do what? a. Stop ongoing attachment loss. b. Cure gingivitis. c. Change the color of the gums. d. Add years to the life of the patient.

ANS: A

Patient ability for regular, thorough biofilm removal by the patient with periodic maintenance therapy can predictably stop ongoing attachment loss.

DIF: Comprehension REF: p. 594 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 7. What is the ultimate test for the effectiveness of periodontal treatment? a. Whether or not biofilm control can be kept at minimum. b. Whether or not a patient is nervous to come to the appointment. c. Whether or not tooth loss can be prevented. d. Whether or not gingival inflammation worsens.

ANS: C

The ultimate test for the effectiveness of periodontal treatment is whether tooth loss can be prevented.

DIF: Comprehension REF: p. 594 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 8. What was a takeaway from a study that was performed in Oslo that looked at the combined

effect of subgingival scaling every 3 to 6 months and controlled oral hygiene? a. In order to prevent tooth loss, it is imperative to have frequent subgingival scaling and impeccable oral hygiene. b. Impeccable oral hygiene can reduce tooth loss even when subgingival scaling isn’t a regular occurrence. c. Frequent subgingival scaling reduces tooth loss even when oral hygiene is “not good.” d. Neither frequent subgingival scaling nor good oral hygiene can reduce tooth loss.

ANS: C

This Oslo study showed that frequent subgingival scaling reduces tooth loss even when oral hygiene is “not good.”

DIF: Recall REF: p. 595 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 9. University-based studies on the treatment of moderate-to-severe periodontitis continue to

show therapy. a. zero b. minimal c. moderate d. advanced

tooth loss in patients who are able to comply with periodontal maintenance

ANS: B

University-based studies on the treatment of moderate-to-severe periodontitis continue to show minimal tooth loss in patients who are able to comply with periodontal maintenance therapy.

DIF: Comprehension REF: p. 596 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 10. Numerous studies indicate the possibility of maintaining teeth in patients with aggressive

periodontitis if the patient can perform supportive periodontal care. a. minimal b. adequate c. moderate d. excellent

biofilm removal along with regular

ANS: D

Numerous studies indicate the possibility of maintaining teeth in patients with aggressive periodontitis if the patient can perform excellent biofilm removal alone with regular supportive periodontal care.

DIF: Comprehension REF: p. 598 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 11. Clinical studies have indicated a(n)

rate of tooth loss in patients who are involved in a supportive periodontal maintenance program. a. nonexistent b. extremely low c. relatively low d. moderate ANS: C

Clinical studies have indicated a relatively low rate of tooth loss in patients who are involved in a supportive periodontal maintenance program.

DIF: Recall REF: p. 598 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 12. Strong evidence now indicates that periodontal disease can contribute to numerous health

problems, including all of the following except: a. throat cancer. b. pregnancy complications. c. stroke. d. diabetes.

ANS: A

Strong evidence now indicates that periodontal disease can contribute to numerous health problems, including pregnancy complications, heart disease, stroke, and diabetes.

DIF: Comprehension REF: p. 599 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 13. Where did a study of male tea laborers take place in order to study the loss of attachment in

untreated workers? a. India b. Nepal c. Sri Lanka d. Bangladesh ANS: C

In 1970, Sri Lankan male tea laborers were studied in order to look further into the loss of attachment in untreated workers.

DIF: Recall REF: p. 593 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 14. Sufficient studies from both

and

reduces or prevents loss of teeth. a. Dentists; physicians b. Private practice; research institutions c. 2-year colleges; 4-year universities d. Practicing dentists; retired dentists

are now available to document that oral therapy

ANS: B

Sufficient studies from both private practice and research institutions are now available to document that therapy reduces or prevents loss of teeth.

DIF: Recall REF: p. 594 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases 15. Which of the following statements is not true? a. Population studies have shown that marginal gingivitis can be controlled with good

oral hygiene and dental prophylaxis. b. Overwhelming evidence suggests that periodontal therapy greatly reduces tooth

mortality. c. Treated smokers lose about four times as many teeth as nonsmokers. d. Failure to diagnose and treat periodontal disease or to make periodontal treatment

available to patients causes unnecessary dental problems and tooth loss.

ANS: C

Population studies have shown that marginal gingivitis can be controlled with good oral hygiene and dental prophylaxis. Overwhelming evidence suggests that periodontal therapy greatly reduces tooth mortality. Treated smokers lose about twice as many teeth as nonsmokers. Failure to diagnose and treat periodontal disease or to make periodontal treatment available to patients causes unnecessary dental problems and tooth loss and places the patient at risk for systemic health problems.

DIF: Comprehension REF: p. 592 TOP: NBDHE; 3.3.2 Provision of instruction for prevention and management of oral diseases

Chapter 55: Peri-Implant Anatomy, Biology, and Function Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Who was the Swedish professor of anatomy who had a serendipitous finding while studying

blood circulation in bone that lead to developing an implant system with a specific protocol? a. Per-Ingvar Branemark b. John Greenwood c. Pierre Fauchard d. Etienne Bourdet ANS: A

In the 1950s, Per-Ingvar Branemark, a Swedish professor of anatomy, had a serendipitous finding while studying blood circulation in bone that became a historical breakthrough in medicine. He discovered an intimate bone-to-implant apposition with titanium that offered sufficient strength to cope with load transfer. He called that phenomenon osseointegration and developed an implant system with a specific protocol to predictably achieve it.

DIF: Recall REF: p. 603 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 2. What is the primary goal of implant installation? a. Bone formation at the implant surface b. Immobility of surrounding teeth c. Osseointegration d. Enhancement of smile esthetics ANS: C

The primary goal of implant installation is to achieve and maintain a stable bone-to-implant connection (i.e., osseointegration).

DIF: Comprehension REF: p. 604 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 3. What is the critical temperature for bone cells that should not be exceeded at an exposure time

of 1 minute? a. 32°C b. 47°C c. 58°C d. 62°C ANS: B

The critical temperature for bone cells that should not be exceeded is 47°C (116.6°F) at an exposure time of 1 minute.

DIF: Recall REF: p. 605 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 4. Which of the following statements is true about bone remodeling and function of an implant? a. Clinically, neither primary stability nor secondary stability of an implant is critical

to success. b. Clinically, only primary stability of an implant is critical to success. c. Clinically, only secondary stability of an implant is critical to success. d. Clinically, both primary stability and secondary stability of an implant are critical

to success.

ANS: D

Clinically, both primary stability and secondary stability of an implant are critical to success.

DIF: Recall REF: p. 606 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 5. The apical edge of the epithelial attachment is approximately

to

mm above the

bone margin. a. 1 to 2 b. 1.5 to 2 c. 2 to 2.5 d. 2 to 3 ANS: B

The apical edge of the epithelial attachment is approximately 1.5 to 2 mm above the bone margin.

DIF: Recall REF: p. 606 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 6.

fibers are bundles of collagenous fibers in the periodontal ligament that pass into the outer circumferential laTmEeS llaTeBoAf N alK veSoE laL rL boEnR e. anCdOtM he cementum of teeth. a. Sharpey b. Mucosal c. Type II d. Branemark ANS: A

Sharpey fibers are bundles of collagenous fibers in the periodontal ligament that pass into the outer circumferential lamellae of alveolar bone and the cementum of teeth.

DIF: Recall REF: p. 606 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 7. In the absence of cementum and inserting connective tissue fibers, most peri-implant

connective tissue fibers run in a direction more or less a. perpendicular b. adjacent c. parallel d. on top of

to the implant surface.

ANS: C

In the absence of cementum and inserting connective tissue fibers (i.e., as in a natural tooth), most peri-implant connective tissue fibers run in a direction more or less parallel to the implant surface.

DIF: Comprehension REF: p. 607 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 8. Prospective and cross-sectional studies have evaluated screw-shaped implants with a

machined surface and found that keratinized gingiva has what effect on long-term stability of the implant? a. The presence of keratinized gingiva is imperative for long-term stability. b. The presence or absence of keratinized gingiva is not a prerequisite for long-term stability. c. The absence of keratinized gingiva is important for long-term stability of the implant. d. Long-term stability of the implant is directly impacted by how much keratinized gingiva is located around the implant.

ANS: B

Prospective and cross-sectional studies, evaluating screw-shaped implants with a machined surface, suggest that the presence or absence of keratinized gingiva is not a prerequisite for long-term stability.

DIF: Comprehension REF: p. 610 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 9. If a patient with an implant complains about pain and discomfort while performing oral

hygiene procedures, which of the following is a good course of action? a. Give the patient a round of pain medication before starting oral hygiene procedures. b. Increase the amount of keratinized tissue around the implant via soft-tissue grafting. c. Deeply probe around the site of the implant in order to find the cause of the pain. d. Tell the patient to take deep breaths and go to their happy place.

ANS: B

If a patient with an implant complains about pain and discomfort while performing oral hygiene procedures, it is usually due to the lack of keratinized tissue, and the symptoms are alleviated by increasing the amount of keratinized (firmly bound) tissue around the implant(s) via soft-tissue grafting.

DIF: Application REF: p. 610 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 10. Emerging knowledge indicates that the morphology of peri-implant gingival or alveolar

mucosa corresponds in what way to the morphology of the corresponding tissues around teeth? a. Emerging knowledge indicates that the peri-implant gingival or alveolar mucosa has drastically different morphology than that of the corresponding tissues around teeth. b. Emerging knowledge indicates that the peri-implant gingival or alveolar mucosa has slightly different morphology than that of the corresponding tissues around teeth. c. Emerging knowledge indicates that much more testing needs to be done on the morphology of peri-implant gingival or alveolar mucosa in comparison to the

morphology of the corresponding tissues around teeth. d. Emerging knowledge indicates that the peri-implant gingival or alveolar mucosa

has the same morphology as the corresponding tissues around teeth.

ANS: D

Emerging knowledge indicates that the peri-implant gingival or alveolar mucosa has the same morphology as the corresponding tissues around teeth.

DIF: Comprehension REF: p. 610 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 11. What is the most striking difference when comparing the soft tissue-to-implant (abutment)

interface with the natural dentition? a. The amount of fibers involved b. The growth of gingiva around the implant c. The lack of a periodontal ligament d. The esthetic and color comparisons ANS: C

At the bone level, the lack of a periodontal ligament is the most striking difference.

DIF: Comprehension REF: p. 611 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 12. Proprioception in the natural dentition comes from a. the periodontal ligament b. the mandible c. where the gums meet tT heEtS eeTthBANKSELLER.COM d. the maxillary teeth

.

ANS: A

Proprioception in the natural dentition comes from the periodontal ligament.

DIF: Recall REF: p. 611 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 13. The osseointegration process observed after implant insertion can be compared with

. a. b. c. d.

scar healing recovering from major surgery bone fracture healing headaches

ANS: C

The osseointegration process observed after implant insertion can be compared with bone fracture healing.

DIF: Comprehension REF: p. 604 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 14. What is the effect of mild inflammation surrounding an implant? a. A mild inflammation drastically enhances the ability for the implant to move

around. b. A mild inflammation actually enhances the bone healing. c. A mild inflammation allows micromovements to begin to occur. d. A mild inflammation has zero effect on bone healing with an implant.

ANS: B

A mild inflammation actually enhances the bone healing.

DIF: Comprehension REF: p. 604 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 15. The interface between blade vent implant and bone was called a. implant connectivity b. blade-bone interconnection c. fibro-osseous integration d. cartilage-ossein migration

.

ANS: C

The interface between blade vent implant and bone was called fibro-osseous integration.

DIF: Recall REF: p. 604.e1 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 16. What type of implants is customized according to a plaster model derived from an impression

of the exposed jawbone? a. Subperiosteal implants b. Blade-disk implants c. Transmandibular implaTnE tsSTBANKSELLER.COM d. Root form (cylindric) implants ANS: A

Subperiosteal implants are customized according to a plaster model derived from an impression of the exposed jawbone, before the surgery planned for implant insertion.

DIF: Comprehension REF: p. 604.e2 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 17. Which of the following is another word for “implant surface characteristics”? a. Macrodesign b. Microdesign c. Implant geometry d. Implant processes ANS: B

Implant surface characteristics are known as its microdesign; implant geometry is known as its macrodesign.

DIF: Recall REF: p. 606 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 18. What type of implant processes modifies the microstructure and chemical nature of the

implant surface by removing or altering the existing surface?

a. b. c. d.

Microprocess Combination process Additive process Subtractive process

ANS: D

The subtractive process modifies the microstructure and chemical nature of the implant surface by removing or altering the existing surface.

DIF: Comprehension REF: p. 604.e4 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 19. Currently, the majority of oral implants are made of what type of material? a. Carbon b. Hydroxyapatite c. Titanium or titanium alloys d. Ceramic or porcelain ANS: C

Currently, the majority of oral implants are made of commercially pure (CP) titanium or titanium alloys.

DIF: Comprehension REF: p. 604.e5 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 20. Which of the following is the most common implant design currently being used? a. Screw-shaped or threaded cylindric implant b. Blade vents c. Press-fit cylindric d. Transmandibular long rods ANS: A

The most common implant design being currently used is the screw-shaped or threaded cylindric implant. A threaded implant design is preferred because it engages bone well and is able to achieve good primary stabilization.

DIF: Comprehension REF: p. 603 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care

Chapter 56: Clinical Evaluation and Imaging of the Implant Patient Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Currently, the long-term success of dental implants used to replace single and multiple

missing teeth in the partially edentulous patient is a. abysmal b. not very good c. good d. very good

.

ANS: D

Currently, the long-term success of dental implants used to replace single and multiple missing teeth in the partially edentulous patient is very good.

DIF: Recall REF: p. 612 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 2. Which of the following is the name of the classification system for an edentulous jaw and

partial dentures? a. The Kennedy Classification b. The Branemark Classification c. The Piedmont Classification d. The Jefferson Classification ANS: A

The Kennedy Classification refers to a system developed by Dr. Edward Kennedy for the classification of an edentulous jaw and partial dentures.

DIF: Recall REF: p. 614 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 3. What is the greatest challenge with a single-tooth implant restoration? a. The juxtaposition of the implant with the natural teeth b. Screw loosening and implant or component fracture c. The jaw relationship and amount of lip support d. The upper arch and its connectivity ANS: B

The greatest challenge with a single-tooth implant restoration is screw loosening and implant or component fracture.

DIF: Recall REF: p. 615 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 4. Which of the following is not an esthetic challenge for a single-tooth implant restoration? a. High smile line b. Inadequate hard or soft tissues c. Loosening screws d. Patient’s high expectations

ANS: C

Replacing a single tooth with an implant-supported crown in a patient with a high smile line, compromised or thin periodontium, inadequate hard or soft tissues, and high expectations is probably one of the most difficult challenges in implant dentistry and should not be attempted by novice clinicians. Loosening screws are a challenge, but they are not an esthetic challenge.

DIF: Comprehension REF: p. 616 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 5. A

evaluation is indicated for any patient who is being considered for dental

implant therapy. a. comprehensive b. simple c. psychologic d. cardiac ANS: A

A comprehensive evaluation is indicated for any patient who is being considered for dental implant therapy.

DIF: Recall REF: p. 616 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 6. What is the medical term used to describe the primary problem of the patient that led the

patient to seek dental/medical attention? a. Diagnosis b. Chief complaint c. Prognosis d. Symptom ANS: B

The chief complaint is a patient’s primary problem that led the patient to seek dental/medical attention.

DIF: Recall REF: p. 617 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 7. Which of the following is an example of the type of question that would be answered in the

dental history portion of the pretreatment evaluation? a. “Does the patient have any other disorder that may impair the normal wound-healing process?” b. “Does the patient have many restorations?” c. “How does the patient feel about their weight?” d. “What kind of medication is this patient currently taking?”

ANS: B

“Does the patient have many restorations?” is an example of a question that would be answered in the dental history portion of the pretreatment evaluation.

DIF: Comprehension REF: p. 617 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care

8. Assuming an implant is 4 mm in diameter and 10-mm long, what is the minimal width of the

jawbone for the implant to comfortably fit? a. 3 to 4 mm b. 4 to 5 mm c. 5 to 6 mm d. 6 to 7 mm ANS: D

Assuming an implant is 4 mm in diameter and 10-mm long, the minimal width of the jawbone needs to be 6 to 7 mm, and the minimal height should be 10 mm.

DIF: Application REF: p. 618 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 9. The minimum mesial-distal space required for a standard diameter implant is a. 6 b. 7 c. 8 d. 9

mm.

ANS: B

The minimum mesial-distal space required for a standard diameter implant is 7 mm.

DIF: Recall REF: p. 618 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 10. Which of the following is aTnEaS bT soBluAteNcKoS ntE raLinLdE icR at. ioCnOfoMr dental implant therapy? a. Diabetes b. Mental instability c. Bisphosphonate therapy d. Periodontal disease ANS: B

Mental instability is an absolute contraindication for dental implant therapy.

DIF: Comprehension REF: p. 622 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 11. Which of the following is a risk factor for dental implant therapy? a. Psychiatric syndromes b. Irrational fears c. Tobacco use d. Unrealistic expectations ANS: C

Tobacco use is a risk factor for dental implant therapy.

DIF: Comprehension REF: p. 622 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 12. Which of the following is a relative contraindication for dental implant therapy?

a. b. c. d.

Atrophic maxilla Substance abuse Mental instability Psychiatric syndromes

ANS: A

Atrophic maxilla is a relative contraindication for dental implant therapy.

DIF: Comprehension REF: p. 622 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 13. Which of the following could possibly be a risk factor for dental implant therapy? a. Radiation therapy b. Phobias c. Current infection d. Periodontal disease ANS: D

Periodontal disease could possibly be a risk factor for dental implant therapy. Radiation therapy and current infections are risk factors and phobias are not.

DIF: Comprehension REF: p. 622 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 14. Which of the following is an example of a parafunctional habit of a patient that may be

associated with an increased rate of implant failure? a. Smoking b. Clenching of teeth c. Substance abuse d. Radiation therapy ANS: B

Parafunctional habits, such as clenching or grinding of teeth (consciously or unconsciously) have been associated with an increased rate of implant failure.

DIF: Comprehension REF: p. 622 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 15. Which of the following is not considered a standard projection routinely available in dental

offices? a. Occlusal radiographs b. Panoramic radiographs c. Cone-beam computed tomography d. Lateral cephalometric ANS: C

Standard projections include intraoral (periapical, occlusal) and extraoral (panoramic, lateral cephalometric) radiographs. More complex techniques include cone-beam computed tomography (CBCT) and multislice computed tomography (MSCT).

DIF: Recall REF: p. 622 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care

16. Which of the following is considered a disadvantage of lateral cephalometric radiography? a. Unpredictable magnification b. Requires special equipment c. Low radiation dose d. 2D representation of anatomy ANS: D

Lateral cephalometric radiography is easy to acquire, has predictable magnification, is relatively inexpensive, and has a low radiation dose. Its disadvantages include limited use in an area of midline and a 2D representation of anatomy.

DIF: Comprehension REF: p. 623 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 17. Which of the following is considered an advantage of panoramic radiography? a. Predictable magnification b. 3D representation of anatomy c. Easy to acquire d. Relatively expensive ANS: C

Panoramic radiography is easy to acquire, images the full dentoalveolar ridge, has a low radiation dose, and is relatively inexpensive. Its disadvantages include unpredictable magnification, unequal magnification in vertical and horizontal dimensions, and a 2D representation of anatomy. p.R6.

23COM DIF: Comprehension TESTBANKSREFL:LE TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 18. The objectives for any radiographic evaluation should include an evaluation to do all of the

following except: a. measure the quality of the bone. b. measure the quantity of the bone. c. identify anatomic structures. d. include pathology.

ANS: D

The objectives for any radiographic evaluation should include an evaluation to exclude pathology, identify anatomic structures, and measure the quality, quantity, and location of available bone.

DIF: Comprehension REF: p. 624 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 19. Which of the following radiographic methods is an excellent choice for evaluation of the

implant patient if CBCT scanning is not available? a. Periapical and occlusal radiography b. Lateral cephalometric radiography c. Multislice computed tomography d. Panoramic imaging

ANS: C

MSCT is an excellent choice for evaluation of the implant patient if CBCT scanning is not available.

DIF: Comprehension REF: p. 624.e1 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 20. Which of the following anatomic structures is not considered pertinent to treatment planning

of the implant patient? a. Foramen magnum b. Incisive foramen c. Retromolar canal d. Nasal cavity ANS: A

Anatomic structures pertinent to treatment planning of the implant patient include maxillary sinus, nasal cavity, incisive foramen, canine fossa, canalis sinuosus, mandibular canal, anterior loop of the mandibular canal, anterior extension of the mandibular canal, mental foramen, submandibular fossa, retromolar canal, and the lingual inclination of the alveolar ridge.

DIF: Comprehension REF: p. 625 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care

Chapter 57: Basic Implant Surgical Procedures Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following statements about patient preparation before implant surgery is not

true? a. Most implant surgical procedures must be done at a specialist’s office. b. Conscious sedation may be indicated for some patients. c. The risks and benefits of implant surgery specific to the patient’s situation and needs should be thoroughly explained prior to surgery. d. A written, informed consent should be obtained for the procedure.

ANS: A

Most implant surgical procedures can be done in the office using local anesthesia. Conscious sedation may be indicated for some patients. The risks and the benefits of implant surgery specific to the patient’s situation and needs should be thoroughly explained prior to surgery. A written, informed consent should be obtained for the procedure.

DIF: Comprehension REF: p. 633 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 2. Which of the following is not one of the basic principles of implant therapy to achieve

osseointegration? a. Implants must be sterile and made of a biocompatible material. b. Implant site should be prepared under sterile conditions. c. Implant site should be prepared with an atraumatic surgical technique that specifically focuses on attempting to overheat the bone during preparation of the recipient site. d. Implants should be placed with good initial stability.

ANS: C

Implants must be sterile and made of a biocompatible material. Implant site should be prepared under sterile conditions. Implant site should be prepared with an atraumatic surgical technique that avoids overheating of the bone during preparation of the recipient site. Implants should be placed with good initial stability. Implants should be allowed to heal without loading or micromovement for 2 to 4 or 4 to 6 months, depending on the bone density, bone maturation, and implant stability.

DIF: Comprehension REF: p. 634 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 3. What happens if a clinician drills a bone without adequate cooling? a. The tooth closest to the site will most likely fall out. b. The bone would be injured and there is a risk of implant failure. c. The bone would burn, which would cause the implant to smoke. d. The jaw would become locked.

ANS: B

Drilling of the bone without adequate cooling generates excessive heat, which injures bone and increases the risk of failure.

DIF: Recall REF: p. 634 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 4. Currently, most threaded endosseous implants can be placed using either a a. b. c. d.

protocol. one-stage or two-stage two-stage of three-stage three-stage or four-stage four-stage or five-stage

ANS: A

Currently, most threaded endosseous implants can be placed using either a one-stage (nonsubmerged) or a two-stage (submerged) protocol.

DIF: Recall REF: p. 635 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 5. Which of the following is the correct term used for an implant that is specifically designed

with the coronal portion of the implant positioned above the crest of the bone? a. Bone level b. Tooth level c. Tissue level d. Gum level ANS: C

Some implants, referred to as “tissue level,” are specifically designed with the coronal portion of the implant positioned above the crest of the bone and extending through the gingival tissues at the time of placement in a one-stage protocol.

DIF: Recall REF: p. 634 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 6. Which of the following is the correct term used for an implant that is designed to be placed at

the level of bone and requires a healing abutment to be placed to the implant at the time of placement? a. Bone level b. Tooth level c. Tissue level d. Gum level ANS: A

Some implants, referred to as “bone level,” are designed to be placed at the level of bone and require a healing abutment to be attached to the implant at the time of placement to be used in a one-stage approach.

DIF: Recall REF: p. 634 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care

7. In areas with dense cortical bone and good initial implant support, the implants are left to heal

undisturbed for how many months? a. 1 to 2 months b. 2 to 4 months c. 3 to 5 months d. 4 to 6 months ANS: B

In areas with dense cortical bone and good initial implant support, the implants are left to heal undisturbed for a period of 2 to 4 months.

DIF: Comprehension REF: p. 634 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 8. What type of incision is typically preferred for implant surgery? a. A remote incision b. A specified incision c. A crestal incision d. A mucogingival incision ANS: D

The crestal incision is preferred in most cases, because closure is easier to manage and typically results in less bleeding, less edema, and faster healing.

DIF: Comprehension REF: p. 635 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 9. What is the diameter, in mT illE im stEdR r i. ll C thO atMcan be performed to establish the SeTteBr,AoNf KthSe EtwLiL

depth and align the long axis of the implant recipient site? a. 2 mm b. 3 mm c. 4 mm d. 5 mm ANS: A

A small twist drill, usually 2 mm in diameter and marked to indicate various lengths, is used to establish the depth and align the long axis of the implant recipient site.

DIF: Recall REF: p. 635 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 10. When multiple implants are being placed next to one another, what should be placed in the

prepared sites? a. A measured piece of dental floss b. A full-thickness flap c. A guide pin d. A finger ANS: C

When multiple implants are being placed next to one another, a guide pin should be placed in the prepared sites to check alignment, parallelism, and proper prosthetic spacing throughout the preparation process.

DIF: Recall REF: p. 635 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 11. When using a series of drills to prepare osteotomy sites, it is essential to prepare sites with

copious a. fanning b. airflow c. irrigation d. fluoride

to prevent overheating of the bone.

ANS: C

A series of drills will be used (speeds determined by manufacturer) sequentially to prepare osteotomy sites. It is essential to prepare sites with copious irrigation to prevent overheating of the bone.

DIF: Comprehension REF: p. 637 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 12. What is the final drill in the osteotomy site preparation for a standard-diameter (4 mm)

implant? a. The 2-mm drill b. The pilot drill c. The 3-mm drill d. The 4-mm drill ANS: C

The final drill in the osteotT om yT siB teApN reK paSrE atL ioL n EfoRr.aCstO anMdard diameter (4 mm) implant is the ES 3-mm twist drill.

DIF: Comprehension REF: p. 638 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 13. How are implants inserted? a. With a handpiece rotating at slow speeds or by hand with a wrench b. With a handpiece rotating at high speeds or by hand with a wrench c. With a wrench rotating at slow speeds or by hand with a handpiece d. With a wrench rotating at high speeds or by hand with a handpiece ANS: A

Implants are inserted with a handpiece rotating at slow speeds or by hand with a wrench.

DIF: Recall REF: p. 639 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 14. When moderate-to-severe postoperative swelling is anticipated, what type of suture is

recommended? a. A resorbable suture b. A nonresorbable suture c. No suture d. Permanent suture

ANS: B

When moderate-to-severe postoperative swelling is anticipated, a nonresorbable suture is recommended to maintain a longer closure period.

DIF: Comprehension REF: p. 638 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 15. Patients should be instructed to maintain a relatively a. mild b. warm c. salty d. soft

diet after implant surgery.

ANS: D

Patients should be instructed to maintain a relatively soft diet after implant surgery.

DIF: Recall REF: p. 638 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 16. What type of drilling is used when it is desirable to place the cover screw at or slightly below

the crestal bone, in order to shape or flare the crestal aspect of the osteotomy site? a. Bone tap drill b. Crestal drill c. Pilot drill d. Countersink drill ANS: D

When it is desirable to placTeEthSeTcB ovAeNr K scSreEwLaLt E orRs.liC ghOtlMy below the crestal bone, countersink drilling is used to shape or flare the crestal aspect of the osteotomy site allowing the coronal flare of the implant head and cover screw to fit within the osteotomy site.

DIF: Recall REF: p. 637.e1 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 17. Which of the following steps may be necessary as the final step in preparing the osteotomy

site in dense cortical bone? a. Probing procedure b. Incision procedure c. Tapping procedure d. Repositioning procedure ANS: C

As the final step in preparing the osteotomy site in dense cortical bone, a tapping procedure may be necessary.

DIF: Recall REF: p. 637.e1 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 18. If a minimal zone of keratinized tissue exists at the implant site, a

flap technique can be used to fulfill the objective of the second-stage surgery (exposing the implant) while increasing the width of keratinized tissue. a. full-thickness

b. partial c. repositioning d. partial-thickness ANS: D

If a minimal zone of keratinized tissue exists at the implant site, a partial-thickness flap technique can be used to fulfill the objective of the second-stage surgery (exposing the implant) while increasing the width of keratinized tissue.

DIF: Comprehension REF: p. 637.e1 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 19. Which of the following should be avoided during postoperative care of an implant? a. Direct pressure on the implant b. Brushing c. Flossing d. Oral examination ANS: A

Direct pressure or movement directed toward the soft tissue from a provisional prosthesis can delay healing and should be avoided.

DIF: Comprehension REF: p. 637.e2 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 20. The postoperative care for the one-stage surgical approach is similar to that for the two-stage

surgical approach except that: a. the surrounding teeth teTnEdStoTm ovNeKaSbE it L mLoE reR . .COM BA b. the cover screw or healing abutment is exposed to the oral cavity. c. direct chewing forces do not impact the implant. d. pain medication is necessary for all patients.

ANS: B

The postoperative care for the one-stage surgical approach is similar to that for the two-stage surgical approach except that the cover screw or healing abutment is exposed to the oral cavity.

DIF: Comprehension REF: p. 639 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care

Chapter 58: Implant-Related Complications and Failures Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following terms can be defined as “problems or adverse outcomes that result

from surgery”? a. Surgical complications b. Mechanical complications c. Biologic complications d. Esthetic complications ANS: A

Surgical complications are those problems or adverse outcomes that result from surgery, including procedures used for implant site development, implant placement, implant exposure, and tissue augmentation.

DIF: Recall REF: p. 640 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 2. Which of the following terms can be defined as “problems that involve the hard and soft

tissues that support the implant”? a. Surgical complications b. Mechanical complications c. Biologic complications d. Esthetic complications ANS: C

Biologic complications involve the hard and soft tissues that support the implant.

DIF: Recall REF: p. 640 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 3. Which of the following terms can be defined as “problems that typically occur in the form of

material failure, such as abutment and prosthetic screw loosening”? a. Surgical complications b. Mechanical complications c. Biologic complications d. Esthetic complications ANS: B

Prosthetic or mechanical complications and failures typically occur in the form of material failure, such as abutment and prosthetic screw loosening or fractures.

DIF: Recall REF: p. 640 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 4. Which of the following terms can be defined as “an implant that remains in place at the time

of evaluation, regardless of any untoward signs, symptoms, or history of problems”? a. Implant success b. Living implant

c. Implant review d. Implant survival ANS: D

Implant survival is defined as an implant that remains in place at the time of evaluation, regardless of any untoward signs, symptoms, or history of problems.

DIF: Recall REF: p. 641 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 5. Which of the following terms is defined by the criteria evaluating the condition and function

of the implant? a. Implant success b. Implant review c. Living implant d. Implant survival ANS: A

Implant success is defined by the presence of the implant and the criteria evaluating its condition and function at the time of the examination.

DIF: Recall REF: p. 641 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 6. Which of the following is not considered a possible postoperative complication with implant

surgery? a. Bleeding b. Hematoma c. Iatrogenic jaw fracture d. Infection ANS: C

Postoperative complications include bleeding, hematoma, and infection. An iatrogenic jaw fracture is a possible surgical complication.

DIF: Comprehension REF: p. 642 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 7. Which of the following terms is neuropathy defined by impaired sensory function that is

sometimes associated with phantom pain? a. Hyperesthesia b. Hypoesthesia c. Hyperstomia d. Hypostomia ANS: B

Hypoesthesia is a neuropathy defined by impaired sensory function that is sometimes associated with phantom pain.

DIF: Recall REF: p. 642 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care

8. The implant should be placed with reference to the

dimension(s) dictated by the position of the final restoration and not by the availability of the bone. a. 1 b. 2 c. 3 d. 4 ANS: C

The implant should be placed with reference to the three dimensions dictated by the position of the final restoration and not by the availability of the bone.

DIF: Comprehension REF: p. 643 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 9. Ideally, an implant should be placed buccolingually so there is at least

mm of bone

circumferentially around it. a. 1 b. 2 c. 3 d. 4 ANS: B

Ideally, an implant should be placed buccolingually so there is at least 2 mm of bone circumferentially around it.

DIF: Recall REF: p. 644 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 10. A misangulation of 30 degrees is considered what type? a. Minor misangulation b. Moderate misangulation c. Severe misangulation d. Extreme misangulation ANS: B

Minor misangulations (15 to 20 degrees) can be corrected with prefabricated or customized angled abutments; moderate misangulations (20 to 35 degrees) can usually be managed with customized UCLA-type abutments.

DIF: Recall REF: p. 643 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 11. Which of the following is an inflammatory process that affects the tissues around an

osseointegrated implant and results in the loss of supporting bone? a. Osseointegratitis b. Peri-implantitits c. Periodontitis d. Implantitis ANS: B

Peri-implantitis is an inflammatory process that affects the tissues around an osseointegrated implant and results in the loss of supporting bone.

DIF: Recall REF: p. 645 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 12. If an implant failure occurs after the implant has been restored, what type of failure is that

considered? a. Early implant failure b. Moderate implant failure c. Late implant failure d. Delayed implant failure ANS: C

Late implant failures occur after the implant has been restored.

DIF: Comprehension REF: p. 648 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 13. Which one of the following is considered the ultimate mechanical failure? a. Fracture of restorative materials b. Implant fracture c. Screw loosening d. Abutment failure ANS: B

The ultimate mechanical failure is implant fracture because it results in loss of the implant and possibly of the prosthesis. . 6S4T 8 BANKSELLER.COM DIF: Recall REF: TpE TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 14. Which of the following is the most common extraoral donor sites? a. Ilium and tibia b. Fibula and clavicle c. Humerus and femur d. Tarsals and carpals ANS: A

The two most common extraoral donor sites are the ilium and the tibia.

DIF: Recall REF: p. 648.e1 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 15. Which of the following is a procedure that uses a barrier membrane to isolate an area for bone

growth? a. Autogenous bone harvesting b. Guided bone regeneration c. Bone ontogenesis d. Maturation of bone ANS: B

GBR is a procedure that uses a barrier membrane to isolate an area for bone growth.

DIF: Recall

REF: p. 648.e1

TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 16. What type of complications occurs when a patient’s expectations are not met? a. Biologic b. Mechanical c. Esthetic d. Surgical ANS: C

Esthetic complications occur when a patient’s expectations are not met.

DIF: Comprehension REF: p. 649 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 17. Implant prostheses that are fabricated with unusual palatal contours or that have spaces under

and around the superstructure can create a. fabricated b. abutment c. biologic d. phonetic

problems for the patient.

ANS: D

Implant prostheses that are fabricated with unusual palatal contours or that have spaces under and around the superstructure can create phonetic problems for the patient.

DIF: Comprehension REF: p. 650.e1 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 18. Implant loss or failure is considered what type of complication? a. Mechanical b. Surgical c. Biologic d. Esthetic ANS: C

Implant loss or failure is considered the ultimate biologic complication.

DIF: Comprehension REF: p. 640 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 19. A patient with a high smile line is at risk for a. esthetic b. biologic c. surgical d. mechanical

complications.

ANS: A

A patient with a high smile line is at risk for esthetic complications.

DIF: Comprehension REF: p. 640 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 20. Malpositioned implants can be avoided by all of the following except:

a. b. c. d.

proper planning. good communication. meticulous surgical skills. pain medication.

ANS: D

Malpositioned implants can be avoided by proper planning, good communication, and meticulous surgical skills.

DIF: Comprehension REF: p. 644 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care

Chapter 59: Supportive Implant Treatment Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. When does peri-implant maintenance begin? a. Before the implant is placed. b. As the implant becomes exposed to the oral cavity. c. 2 weeks after the implant is placed. d. When the implant begins to have mechanical complications.

ANS: B

Peri-implant maintenance begins as the implant becomes exposed to the oral cavity and continues at regular intervals during the life of the implant.

DIF: Comprehension REF: p. 651 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 2. Which of the following is not an important risk factor for peri-implant diseases? a. Genuine halitosis b. Diabetes mellitus c. Poor oral hygiene d. Cigarette smoking ANS: A

Poor oral hygiene, residual cement, current or history of periodontitis, cigarette smoking, and CpOlM diabetes mellitus are imporTtaEnS t rTisBkAfaNcK toSrsEfL orLpEeR ri-.im ant diseases.

DIF: Comprehension REF: p. 651 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 3. The relationship between peri-implant mucositis and peri-implantitis is similar to that between a. b. c. d.

. plaque buildup and gingivitis gingivitis and periodontitis xerostomia and halitosis periodontitis and cavities

ANS: B

The relationship between peri-implant mucositis and peri-implantitis is similar to that between gingivitis and periodontitis.

DIF: Comprehension REF: p. 651 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 4. Which of the following statements is not true about dental implants? a. Dental implants are susceptible to dental caries. b. Dental implants are susceptible to mechanical complications. c. Dental implants are susceptible to biofilm-induced inflammatory tissue changes. d. Dental implant therapy does not end with the final prosthetic restoration of the

implant.

ANS: A

Although dental implants are not vulnerable to dental caries, they are susceptible to mechanical complications and peri-implant, biofilm-induced inflammatory tissue changes.

Dental implant therapy does not end with the final prosthetic restoration of the implant.

DIF: Comprehension REF: p. 651 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 5. Why should clinicians use caution when evaluating peri-implant probing? a. Probing of implants can give inaccurate information. b. Probing of implants should be done with heavy force to ensure the same effects of

probing teeth, and the force can cause damage to surrounding tissues. c. These measures cannot be interpreted the same as probing depths around the teeth. d. The clinician must use a different probe than the traditional steel probe used on teeth.

ANS: C

Clinicians should use caution when evaluating peri-implant probing because these measures cannot be interpreted the same as probing depths around teeth.

DIF: Application REF: p. 652 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 6. Which of the following sounds indicates osseointegration of an implant? a. Solid resonating sound b. Dull ringing sound c. Hollow sound d. Deep vibrating sound ANS: A

Tapping an implant’s healing abutment or restoration with an instrument produces a sound that can help determine osseointegration. A solid resonating sound and the absence of pain usually indicate osseointegration.

DIF: Recall REF: p. 654 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 7. Which of the following is one of the objectives of radiographic examination of an implant? a. To detect the level of plaque buildup on the surrounding teeth b. To measure the level of gingival inflammation adjacent to the implant c. To measure the height of the bone adjacent to the implant d. To rule out any related diseases ANS: C

The objective of the radiographic examination is to measure the height of the bone adjacent to the implant, evaluate the quality of bone along the length of the implant, and detect peri-implant radiolucencies.

DIF: Comprehension REF: p. 654 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care

8. Peri-implant health is characterized by which of the following? a. Erythema, edema, and loss of tissue tightness around the implant b. Pink, firm, and well-adapted peri-implant mucosa c. Red, spongy, and well-adapted peri-implant mucosa d. Nonkeratinized and keratinized peri-implant mucosa ANS: B

Peri-implant health is characterized by pink, firm, and well-adapted peri-implant mucosa.

Peri-implant disease is associated with erythema, edema, and loss of tissue tightness around the implant.

DIF: Comprehension REF: p. 655 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 9. Which of the following terms could be defined as “the firm anchoring of a surgical implant by

the growth of the bone around it without fibrous tissue formation at the interface”? a. Peri-implant monitoring b. Osseointegration c. Implantation d. Peri-implant evaluation ANS: B

Osseointegration could be defined as the firm anchoring of a surgical implant by the growth of the bone around it without fibrous tissue formation at the interface.

DIF: Recall REF: p. 654 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 10. Which of the following should not be used to gently remove biofilm from healing abutments

or provisional restorations during the early postoperative phase of healing? a. Cotton tip b. Cotton gauze c. Powered toothbrush d. Soft toothbrush ANS: C

A cotton tip, cotton gauze, or soft toothbrush can be used to gently remove biofilm from healing abutments or provisional restorations during the early postoperative phase of healing.

Before implant osseointegration, the use of powered toothbrushes should be avoided.

DIF: Comprehension REF: p. 656 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 11. Most implant prostheses are made with a. silver amalgam b. gold alloys c. composite resin d. porcelain

or ceramic materials.

ANS: B

Most implant prostheses are made with gold alloys or ceramic materials.

DIF: Recall REF: p. 657 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 12. What is a disadvantage of using Teflon-coated curettes? a. Teflon-coated curettes could damage the implant surface. b. Teflon-coated curettes don’t work as well as metal instruments. c. Teflon-coated curettes contain damaging materials that could contaminate the

implant. d. Teflon-coated curettes cannot be sharpened.

ANS: D

Teflon-coated curettes cannot be sharpened.

DIF: Recall REF: p. 657 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 13. During delivery, radiographs

the implant should be obtained for baseline documentation and to verify complete seating of the restorations. a. perpendicular to b. parallel to c. across from d. next to ANS: A

During delivery, radiographs perpendicular to the implant should be obtained for baseline documentation and to verify complete seating of the restorations. . 6S5T 6 BANKSELLER.COM DIF: Recall REF: TpE TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 14. Which of the following statements is true? a. Treatment of both peri-implant mucositis and peri-implantitis is effective. b. Treatment of both peri-implant mucositis and peri-implantitis is unpredictable. c. Treatment of peri-implant mucositis is effective, whereas treatment of

peri-implantitis is unpredictable. d. Treatment of peri-implantitis is effective, whereas treatment of peri-implant

mucositis is unpredictable.

ANS: C

Treatment of peri-implant mucositis is effective, whereas treatment of peri-implantitis is unpredictable.

DIF: Comprehension REF: p. 658 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 15. What is the main etiologic factor for peri-implant diseases? a. Systemic disease b. Local issues c. Viral d. Bacteria ANS: D

Although bacteria are the main etiologic factor of peri-implant diseases, systemic and local factors should be identified and modified.

DIF: Comprehension REF: p. 658 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 16. Which of the following can be used with mechanical debridement to enhance the treatment

outcome of peri-implant mucositis? a. Antimicrobials b. Antibacterials c. NSAIDs d. Fluoride ANS: A

Antimicrobials (e.g., chlorhexidine irrigation, mouthrinse) can be used with mechanical debridement to enhance the treatment outcome of peri-implant mucositis.

DIF: Recall REF: p. 658 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 17. Which of the following is not a nonsurgical intervention that can be used for peri-implantitis? a. Local antibiotics b. Bone augmentation c. Laser therapy d. Mechanical debridement with air-abrasive devices ANS: B

Nonsurgical interventions T coEnS siT stBoA f aNnKtiS mE icL roLbE iaR l r.inCsO eM and irrigation, local antibiotics, ultrasonic debridement, mechanical debridement with air-abrasive devices, and laser therapy.

Bone augmentation is a surgical option.

DIF: Comprehension REF: p. 658 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 18. Which of the following is not a surgical treatment that can be used for peri-implantitis? a. Full-thickness flap elevation for access, followed by degranulation b. Surface debridement by laser or mechanical instruments c. Surface decontamination with laser or antimicrobials d. Ultrasonic debridement ANS: D

Surgical treatment for peri-implantitis includes full-thickness flap elevation for access, followed by degranulation, surface debridement by laser or mechanical instruments, surface decontamination with laser or antimicrobials, and bone augmentation. Ultrasonic debridement is a nonsurgical option.

DIF: Comprehension REF: p. 658 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 19. Long-term success of dental implants requires all of the following except: a. precise surgical and restorative execution. b. sound treatment planning.

c. continual examinations to check for caries. d. impeccable long-term maintenance.

ANS: C

Long-term success of dental implants requires precise surgical and restorative execution, sound treatment planning, and impeccable long-term maintenance.

DIF: Recall REF: p. 651 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 20. Which of the following is a true statement regarding bleeding on peri-implant probing? a. There is a potential for false-positive bleeding. b. Bleeding on probing at implant sites does not indicate inflammation in the

peri-implant mucosa. c. The use of marginal bleeding is more likely to elicit false-positive bleeding. d. Probing of implants cannot be accomplished using a traditional sleep probe.

ANS: A

There is a potential for false-positive bleeding with probing. Bleeding on probing at implant sites indicates inflammation in the peri-implant mucosa. The use of marginal bleeding is less likely to elicit false-positive bleeding. Probing of implants can be accomplished with a traditional steel probe.

DIF: Comprehension REF: p. 653 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care

Chapter 60: Results of Implant Treatment Newman: Clinical Periodontology for the Dental Hygienist, 1st Edition MULTIPLE CHOICE 1. Which of the following was a landmark study that supported expectations for the success and

predictability of root-form dental implants? a. Bohrmann study b. Gateway study c. Goteborg study d. Boswhig study ANS: C

The landmark Goteborg study and the replica study at the University of Toronto supported expectations for the success and predictability of root-form dental implants.

DIF: Recall REF: p. 660 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care

is/are defined by specific criteria used to evaluate the condition and function

2.

of the implant. a. Implant success b. Implant outcomes c. Implant procedures d. Implant survival ANS: A

Implant success is defined by specific criteria used to evaluate the condition and function of the implant.

DIF: Recall REF: p. 660 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 3. When implant outcomes are reported as the presence or absence of the implant at the time of

the last examination, regardless of whether the implant was functional, suffered from bone loss, or had other problems, this time of assessment is a measure of implant . a. success b. survival c. predictability d. procedures ANS: B

When implant outcomes are reported as the presence or absence of the implant at the time of the last examination, regardless of whether the implant was functional, suffered from bone loss, or had other problems, this time of assessment is a measure of implant survival.

DIF: Comprehension REF: p. 662 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 4. Which of the following statements is true in regard to implant outcomes? a. Criteria for implant success are used consistently across literature.

b. A universally accepted definition of implant success has not been established. c. It is easy to compare reported data between studies. d. Criteria for implant success may vary, but when comparing studies, rates of

implant success only vary slightly.

ANS: B

Criteria for implant success have been proposed in literature but have not been used consistently. A universally accepted definition of implant success has not been established. It is challenging to compare reported data between studies because different criteria for success are used. Depending on the criteria used, the rates of implant success reported in studies can vary substantially.

DIF: Comprehension REF: p. 660 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 5. Which of the following is defined as “an implant that remains in place at the time of

evaluation, regardless of untoward signs and symptoms or a history of problems”? a. Implant results b. Implant success c. Implant survival d. Implant outcomes ANS: C

Implant survival is defined as an implant that remains in place at the time of evaluation, regardless of untoward signs and symptoms or a history of problems.

DIF: Comprehension REF: p. 662 TOP: NBDHE; 4.3 ReassesT smEeS ntTaB ndAm ceE , eR.g..,Cim NaKinSteEnaLnL OpMlant care 6. Implants placed in the posterior maxilla are

compared with implants

placed in the anterior mandible. a. less well supported b. supported equally c. more supported d. much more supported ANS: A

Implants placed in the posterior maxilla are less well supported compared with implants placed in the anterior mandible.

DIF: Comprehension REF: p. 663 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 7. Which of the following statements is false? a. Anatomic location has a significant effect on implant outcome. b. Implant design influences outcome. c. Defining implant results can be done in absolute terms. d. Many issues influence implant outcomes.

ANS: C

Many issues influence implant outcomes, including anatomic location and implant design.

Defining implant results in absolute terms can be difficult and confusing.

DIF: Comprehension REF: p. 663 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 8. Who established the concept of osseointegrated dental implant as a predictable treatment

modality for the edentulous patient on the empirically based requirement that the implant remain submerged and unloaded for a healing period of 3 to 6 months? a. Goteborg b. Branemark c. Schulte d. Clark ANS: B

Branemark established the concept of osseointegrated dental implant as a predictable treatment modality for the edentulous patient on the empirically based requirement that the implant remain submerged and unloaded for a healing period of 3 to 6 months.

DIF: Recall REF: p. 664 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 9. For most cases with alveolar ridge resorption,

is/are required before or

simultaneously with implant placement. a. a complete and thorough physical examination b. bone regenerative procedures c. consultation with a specialist d. radiographic analysis ANS: B

For most cases with alveolar ridge resorption, bone regenerative procedures are required to correct the defects before or simultaneously with implant placement.

DIF: Recall REF: p. 664 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 10. Which of the following statements is true regarding implant failure? a. Only a few patients experience implant failure. b. Implant failure occurs frequently. c. Implants fail more often than they are successful. d. Implant failure is difficult to track.

ANS: A

Only a few patients experience implant failure.

DIF: Recall REF: p. 664 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 11. Above all other risk factors,

and success. a. diabetes b. smoking c. HIV d. alcohol

has a significant negative impact on implant survival

ANS: B

Above all other risk factors, smoking has a significant negative impact on implant survival and success.

DIF: Recall REF: p. 664 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 12. Which of the following statement is true about periodontitis and implant treatment? a. Many studies have assessed the prognosis of implant treatment in patients with a

history of periodontitis. b. Implant survival in patients with a history of periodontitis appears to be highly

predictable. c. Many long-term studies show that implant survival in patients with aggressive

periodontitis is poor. d. Most studies indicated that implants are less successful in patients with a history of chronic periodontitis.

ANS: B

A limited number of studies have assessed the prognosis of implant treatment in patients with a history of periodontitis. Implant survival in patients with a history of periodontitis appears to be highly predictable. There is a lack of long-term studies to support implant survival in patients treated for aggressive periodontitis, which leaves the prognosis for these patients open to question. Most studies indicate that implants are equally successful in patients with a history of chronic periodontitis.

DIF: Recall REF: p. 665 TOP: NBDHE; 4.3 ReassesT smEeS ntTaB ndAm ceE , eR.g..,Cim NaKinSteEnaLnL OpMlant care 13. Peri-implant problems may be attributed to a continuous increase in the percentage of

implants exhibiting PPDs of a. 2 b. 3 c. 4 d. 5

mm or deeper over time.

ANS: C

Peri-implant problems may be attributed to a continuous increase in the percentage of implants exhibiting PPDs of 4 mm or deeper over time.

DIF: Recall REF: p. 665 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 14. Which of the following is not a risk factor that can adversely affect implant outcomes? a. Smoking b. Periodontitis c. Diabetes d. Cancer ANS: D

Smoking, diabetes, and periodontitis are risk factors that can adversely affect implant outcomes.

DIF: Comprehension REF: p. 665 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 15. In a survey of patient satisfaction, more than

% of patients were completely satisfied in

terms of function and esthetics. a. 33 b. 60 c. 75 d. 90 ANS: D

In a survey of patient satisfaction, more than 90% of patients were completely satisfied in terms of function and esthetics.

DIF: Recall REF: p. 665 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 16. The traditional placement protocol for implants included a nonloading period after implant

placement of a. 1 to 2 b. 2 to 3 c. 3 to 4 d. 4 to 5

months in the mandible and 6 months in the maxilla.

ANS: C

The traditional placement protocol for implants included a nonloading period of 3 to 4 months in the mandible and 6 monT thEs S inTtB heAm laL . LER.COM NaKxSilE DIF: Recall REF: p. 663 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 17.

of companies manufacture and market dental implants worldwide, and the number . a. Dozens; is growing b. Hundreds; is growing c. Dozens; is declining d. Hundreds; is declining ANS: B

Hundreds of companies manufacture and market dental implants worldwide, and the number continues to grow.

DIF: Recall REF: p. 663 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 18. Anatomic location has a significant effect on implant outcome, particularly for the a. b. c. d.

. posterior mandible posterior maxilla anterior mandible anterior maxilla

ANS: B

Anatomic location has a significant effect on implant outcome, particularly for the posterior maxilla.

DIF: Comprehension REF: p. 663 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 19. Defining implant results in absolute terms is a. uncomplicated and simple b. predictable and consistent c. difficult and confusing d. easy and categorized

.

ANS: C

Defining implant results in absolute terms is difficult and confusing.

DIF: Recall REF: p. 663 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care 20. Implant survival can good implant outcomes. a. underestimate b. be a good predictor for c. be used interchangeably with d. overestimate ANS: D

Implant survival, which is typically reported in studies, can overestimate good implant EhSiT outcomes. Implant successT ,w chBiA sN ofK teSnEleLssLrEepRo.rtC edO,Mcould offer a better measure if specific success criteria were universally defined, accepted, and used.

DIF: Comprehension REF: p. 662 TOP: NBDHE; 4.3 Reassessment and maintenance, e.g., implant care