NBDHE case studies 17 – 29 All Answers Correct
1. Best choice of anesthetic agent for debriding teeth with furcations and deeper pockets:
- A. Lidocaine HCL 2% with epinephrine 1:100,000
2. Classification of the patient's periodontal condition based on the 2018 AAP Classification:
- B. Stage III, Grade B
3. Classification of the patient's blood pressure based on the new AHA/ACC Guidelines:
- D. Stage 2
4. Medication responsible for the patient's current blood pressure reading:
- C. Amlodipine and Ramipril should not be taken with Ibuprofen
5. Best approach for a dental hygiene care plan based on deposit, pocket depths, and bleeding index:
- D. Local anesthesia for #2 & #31, ultrasonic scaling of all areas of the mouth followed by hand scaling
if necessary
6. Description of the patient's centric occlusion based on study models:
- B. Overjet
7. Technique error observed in the posterior bitewing radiographs on the right side:
- C. Film packet placement
8. Likely cause of the facial characteristics observed at the gingival margins of teeth #8 and #9:
- B. Sucking on acidic lozengesThe patient indicated that he has been getting recurrent painful ulcers
in his mouth since he quit smoking, what do you suspect these ulcers might be?
A. Herpetic lesions
B. Traumatic ulcers
C. Apthous ulcers
,D. Acid reflux
C
After discussing his brushing and flossing technique with him, what other home care
recommendations would you make for him?
A. Purchase a power toothbrush; use a toothpaste with stannous fluoride; use a proxabrush between
the posterior teeth
B. Use an air flosser; sodium fluoride toothpaste; and an alcohol-based mouthrinse
C. Switch to a soft bristled toothbrush; a desensitizing toothpaste; and use a toothpick in the deeper
pockets and furcations
D. Use a stannous fluoride toothpaste; an essential oils mouthrinse; and a floss threader
A
Case 18
The patient is a 68-year old Caucasian male who is semi-retired from farming. He has been a smoker for
almost 40 years and has had a few health issues. He is reluctant to totally quit farming as he is helping
his son take over the farm. He is 5'10" tall and weighs 185 lbs.
Despite being on an antihypertensive medication, this patient's blood pressure is still in Stage II. What is
the most likely explanation for this occurrence?
A. The combination of Diltiazem and Aleve elevates blood pressure
B. BMI falls within the "obese" category
C. The combination of aspirin and Aleve elevates blood pressure
D. He is overweight and smokes
A
The patient's daily use of NSAIDs and aspirin can increase his risk for:
A. Xerostomia
B. GI side effects
C. Kidney problems
D. Bleeding problems
B
What BEST identifies the cause for loss of tooth structure observed in the maxillary occlusal intraoral
image?
A. Abrasion
B. Erosion
C. Attrition
, D. Abfraction
C
Based on the clinical, radiographic and historical findings, how would you classify the periodontal
status of this patient according to the 2018 AAP Classification of Periodontal and Peri-implant
diseases?
A. Stage 1, Grade B
B. Stage II, Grade B
C. Stage III, Grade C
D. Stage IV, Grade C
C
What was the main reason for your selection of the “Grade” category in the above question?
A. Pocket depths
B. Clinical attachment loss
C. Bone loss
D. Presence of risk factors
D
After making adjustments to his scrub-brushing technique, what other oral hygiene home care
recommendations would you make for this patient?
A. Whitening toothpaste; power toothbrush; interdental brush; floss threader
B. Stannous fluoride toothpaste with whitening agent; power toothbrush; floss wand; toothpick for
furcation
C. Professional in-office whitening; use of a more abrasive toothpaste; flossing; tongue cleaner
D. Over-the-counter whitening agents; interdental brush; tongue cleaner; fluoridated toothpaste
B
What is the radiopaque U-shaped formation observed on the maxillary left molar periapical radiograph?
A. Wall of the maxillary sinus
B. Hyoid bone
C. Zygomatic process of maxilla
D. Air space
C
The patient's medical history findings indicate risk for all of the following EXCEPT:
A. Cardiovascular disease
1. Best choice of anesthetic agent for debriding teeth with furcations and deeper pockets:
- A. Lidocaine HCL 2% with epinephrine 1:100,000
2. Classification of the patient's periodontal condition based on the 2018 AAP Classification:
- B. Stage III, Grade B
3. Classification of the patient's blood pressure based on the new AHA/ACC Guidelines:
- D. Stage 2
4. Medication responsible for the patient's current blood pressure reading:
- C. Amlodipine and Ramipril should not be taken with Ibuprofen
5. Best approach for a dental hygiene care plan based on deposit, pocket depths, and bleeding index:
- D. Local anesthesia for #2 & #31, ultrasonic scaling of all areas of the mouth followed by hand scaling
if necessary
6. Description of the patient's centric occlusion based on study models:
- B. Overjet
7. Technique error observed in the posterior bitewing radiographs on the right side:
- C. Film packet placement
8. Likely cause of the facial characteristics observed at the gingival margins of teeth #8 and #9:
- B. Sucking on acidic lozengesThe patient indicated that he has been getting recurrent painful ulcers
in his mouth since he quit smoking, what do you suspect these ulcers might be?
A. Herpetic lesions
B. Traumatic ulcers
C. Apthous ulcers
,D. Acid reflux
C
After discussing his brushing and flossing technique with him, what other home care
recommendations would you make for him?
A. Purchase a power toothbrush; use a toothpaste with stannous fluoride; use a proxabrush between
the posterior teeth
B. Use an air flosser; sodium fluoride toothpaste; and an alcohol-based mouthrinse
C. Switch to a soft bristled toothbrush; a desensitizing toothpaste; and use a toothpick in the deeper
pockets and furcations
D. Use a stannous fluoride toothpaste; an essential oils mouthrinse; and a floss threader
A
Case 18
The patient is a 68-year old Caucasian male who is semi-retired from farming. He has been a smoker for
almost 40 years and has had a few health issues. He is reluctant to totally quit farming as he is helping
his son take over the farm. He is 5'10" tall and weighs 185 lbs.
Despite being on an antihypertensive medication, this patient's blood pressure is still in Stage II. What is
the most likely explanation for this occurrence?
A. The combination of Diltiazem and Aleve elevates blood pressure
B. BMI falls within the "obese" category
C. The combination of aspirin and Aleve elevates blood pressure
D. He is overweight and smokes
A
The patient's daily use of NSAIDs and aspirin can increase his risk for:
A. Xerostomia
B. GI side effects
C. Kidney problems
D. Bleeding problems
B
What BEST identifies the cause for loss of tooth structure observed in the maxillary occlusal intraoral
image?
A. Abrasion
B. Erosion
C. Attrition
, D. Abfraction
C
Based on the clinical, radiographic and historical findings, how would you classify the periodontal
status of this patient according to the 2018 AAP Classification of Periodontal and Peri-implant
diseases?
A. Stage 1, Grade B
B. Stage II, Grade B
C. Stage III, Grade C
D. Stage IV, Grade C
C
What was the main reason for your selection of the “Grade” category in the above question?
A. Pocket depths
B. Clinical attachment loss
C. Bone loss
D. Presence of risk factors
D
After making adjustments to his scrub-brushing technique, what other oral hygiene home care
recommendations would you make for this patient?
A. Whitening toothpaste; power toothbrush; interdental brush; floss threader
B. Stannous fluoride toothpaste with whitening agent; power toothbrush; floss wand; toothpick for
furcation
C. Professional in-office whitening; use of a more abrasive toothpaste; flossing; tongue cleaner
D. Over-the-counter whitening agents; interdental brush; tongue cleaner; fluoridated toothpaste
B
What is the radiopaque U-shaped formation observed on the maxillary left molar periapical radiograph?
A. Wall of the maxillary sinus
B. Hyoid bone
C. Zygomatic process of maxilla
D. Air space
C
The patient's medical history findings indicate risk for all of the following EXCEPT:
A. Cardiovascular disease
