DHG 161 Final Exam
What is the usual dosage and time sequence of prophylactic premedications? -
✔️✔️30-60 min before procedure
Standard
Amoxicillin
- adult: 2 g orally
- child: 50 mg/kg orally
Unable to take oral medications
Ampicillin
- adult: 2 g IM or IV
- child: 50 mg/kg IM or IV
Cefazolin or celtriaxone
- adult: 1 g IM or IV
- child: 50 mg/kg IM or IV
Allergic to penicillins of ampicillin - oral
Cephalexin
- adult: 2 g orally
- child: 50 mg/kg orally
Clindomycin
- adult: 600 mg orally
- child: 20 mg/kg orally
Azithromycin or Clarithromycin
- adult: 500 mg orally
- child: 15 mg/kg orally
Allergic to penicillins and unable to take oral medications
Cefazolin or ceftriazone
- adult: 1 g IM or IV
- child: 50 mg/kg IM or IV
Clindomycin
- adult: 600 mg IM or IV
- child: 25 mg/kg IM or IV
ASA Classifications - ✔️✔️*American Society of Anesthesiologists (ASA) Physical
Status Classification System*
- An overall estimate of medical risk of a patient
*ASA I*
- a patient without apparent systemic disease: a normal healthy patient
*ASA II*
- a patient with mild systemic disease
,*ASA III*
- a patient with severe systemic disease that limits activity but is not incapacitating
*ASA IV*
- a patient with an incapacitating systemic disease that is a constant threat to life
*ASA V*
- a moribund patient not expected to survive 24 hours with ot without care
Purpose of a periodontal probe - ✔️✔️1. Periodontal instrument marked in millimeter
increments that is used to evaluate the health of the periodontal tissue
2. Used to determine health or disease
- classify as gingivitis for periodontitis by determing if bone loss has occured and if the
pocket is gingival or periodontal
3. Used to measure
- sulci depth
- attachment level
- recession level
- width of attachment
- presence of bleeding
- measure oral lesions
4. Uses
- assess the periodontal status for preparation of a treatment plan
- make a sulcus and pocket survey
- determine CAL
- bleeding on probing
- measure gingival recession
- determine consistency of gingival tissue
- guide treatment
- evaluate success and completeness of treatment
- evaluation of continuing care and periodontal maintenance appointments
Purpose of a Nabor's probe - ✔️✔️Preferred to assess the extent of furcation
involvement over standard periodontal probes for accuracy
1. Mandibular molars (bifurcated)
- furcation accessible from the facial and lingual aspects
2. Mandibular first premolars (bifurcated)
- furcation accessible from the mesial and distal aspects; under the contact area
3. Maxillary primary molars
- widespread roots
4. Maxillary molars (trifurcated)
- access for probing is from the mesiolingual, buccal, and distolingual surfaces
Purpose of an explorer - ✔️✔️1. Detect, by tactile sense, the texture and character of
the tooth structure
- for calculus defects or irregularities in the surfaces and margins of restorations, and
other irregularities not apparent to direct observation
, - used to confirm direct observation
- avoid using on white spots (areas that have been remineralized)
2. Define the extent of instrumentation needed and guide techniques
- for scaling and root planning
- removing an overhanging filling
3. Evaluate the completeness of treatment
- for periodontal nonsurgical treatment as shown by the smooth tooth surface
- for removal of an overhanging filling by the smooth margins of the restoration
Correct exploring technique - ✔️✔️1. Uses tactile sensitivity
2. Must have a light grasp
3. Explorer: instrument of choice for:
- initial location of deposits
- re-evaluation
4. During instrumentation, the curet is used for detection once the area feels smooth
with curet, re-evaluate with explorer
*Grasp*
relaxed, light modified pen grasp; middle finger rests lightly on the shank
*Adaptation*
1-2 mm of the side of the tip
*Lateral pressure*
Light pressure against the tooth
*Activation*
Rocking motion (digital allowed with the use of an explorer)
*Stroke characteristics*
Fluid, sweeping stroke
*Stroke number*
Many overlapping strokes
*Common errors*
- avoid "death grip"
- avoid too much pressure
1. Adapt instrument and gently slide subgingivally
2. Keep tip in contact with root surface, slide tip apically until you feel the base of the
pocket
3. Use a vertical or oblique stroke to move instrument up root
4. DO NOT remove the instrument from the pocket
5. Walk around tooth
6. Short strokes, about 2-3 mm (overlapping)
7. Lead with the tip into the interproximals
Correct probing technique - ✔️✔️1. Act of walking the tip of the probe along the
junctional epithelium within the sulcus or pocket for the purpose of assessing the health
status of the periodontal tissue
- walking stroke: a series of bobbing strokes that are made within the sulcus or pocket
while keeping the probe tip against the tooth surface
What is the usual dosage and time sequence of prophylactic premedications? -
✔️✔️30-60 min before procedure
Standard
Amoxicillin
- adult: 2 g orally
- child: 50 mg/kg orally
Unable to take oral medications
Ampicillin
- adult: 2 g IM or IV
- child: 50 mg/kg IM or IV
Cefazolin or celtriaxone
- adult: 1 g IM or IV
- child: 50 mg/kg IM or IV
Allergic to penicillins of ampicillin - oral
Cephalexin
- adult: 2 g orally
- child: 50 mg/kg orally
Clindomycin
- adult: 600 mg orally
- child: 20 mg/kg orally
Azithromycin or Clarithromycin
- adult: 500 mg orally
- child: 15 mg/kg orally
Allergic to penicillins and unable to take oral medications
Cefazolin or ceftriazone
- adult: 1 g IM or IV
- child: 50 mg/kg IM or IV
Clindomycin
- adult: 600 mg IM or IV
- child: 25 mg/kg IM or IV
ASA Classifications - ✔️✔️*American Society of Anesthesiologists (ASA) Physical
Status Classification System*
- An overall estimate of medical risk of a patient
*ASA I*
- a patient without apparent systemic disease: a normal healthy patient
*ASA II*
- a patient with mild systemic disease
,*ASA III*
- a patient with severe systemic disease that limits activity but is not incapacitating
*ASA IV*
- a patient with an incapacitating systemic disease that is a constant threat to life
*ASA V*
- a moribund patient not expected to survive 24 hours with ot without care
Purpose of a periodontal probe - ✔️✔️1. Periodontal instrument marked in millimeter
increments that is used to evaluate the health of the periodontal tissue
2. Used to determine health or disease
- classify as gingivitis for periodontitis by determing if bone loss has occured and if the
pocket is gingival or periodontal
3. Used to measure
- sulci depth
- attachment level
- recession level
- width of attachment
- presence of bleeding
- measure oral lesions
4. Uses
- assess the periodontal status for preparation of a treatment plan
- make a sulcus and pocket survey
- determine CAL
- bleeding on probing
- measure gingival recession
- determine consistency of gingival tissue
- guide treatment
- evaluate success and completeness of treatment
- evaluation of continuing care and periodontal maintenance appointments
Purpose of a Nabor's probe - ✔️✔️Preferred to assess the extent of furcation
involvement over standard periodontal probes for accuracy
1. Mandibular molars (bifurcated)
- furcation accessible from the facial and lingual aspects
2. Mandibular first premolars (bifurcated)
- furcation accessible from the mesial and distal aspects; under the contact area
3. Maxillary primary molars
- widespread roots
4. Maxillary molars (trifurcated)
- access for probing is from the mesiolingual, buccal, and distolingual surfaces
Purpose of an explorer - ✔️✔️1. Detect, by tactile sense, the texture and character of
the tooth structure
- for calculus defects or irregularities in the surfaces and margins of restorations, and
other irregularities not apparent to direct observation
, - used to confirm direct observation
- avoid using on white spots (areas that have been remineralized)
2. Define the extent of instrumentation needed and guide techniques
- for scaling and root planning
- removing an overhanging filling
3. Evaluate the completeness of treatment
- for periodontal nonsurgical treatment as shown by the smooth tooth surface
- for removal of an overhanging filling by the smooth margins of the restoration
Correct exploring technique - ✔️✔️1. Uses tactile sensitivity
2. Must have a light grasp
3. Explorer: instrument of choice for:
- initial location of deposits
- re-evaluation
4. During instrumentation, the curet is used for detection once the area feels smooth
with curet, re-evaluate with explorer
*Grasp*
relaxed, light modified pen grasp; middle finger rests lightly on the shank
*Adaptation*
1-2 mm of the side of the tip
*Lateral pressure*
Light pressure against the tooth
*Activation*
Rocking motion (digital allowed with the use of an explorer)
*Stroke characteristics*
Fluid, sweeping stroke
*Stroke number*
Many overlapping strokes
*Common errors*
- avoid "death grip"
- avoid too much pressure
1. Adapt instrument and gently slide subgingivally
2. Keep tip in contact with root surface, slide tip apically until you feel the base of the
3. Use a vertical or oblique stroke to move instrument up root
4. DO NOT remove the instrument from the pocket
5. Walk around tooth
6. Short strokes, about 2-3 mm (overlapping)
7. Lead with the tip into the interproximals
Correct probing technique - ✔️✔️1. Act of walking the tip of the probe along the
junctional epithelium within the sulcus or pocket for the purpose of assessing the health
status of the periodontal tissue
- walking stroke: a series of bobbing strokes that are made within the sulcus or pocket
while keeping the probe tip against the tooth surface
