MICROBIOLOGY FINAL EXAM REVIEW

MICROBIOLOGY FINAL EXAM REVIEW aseptic techniques control - Correct Answers: - touch as few surfaces as possible - over gloves or removal of gloves when leaving operatory aerosols - Correct Answers: small, invisible bacteria spatter - Correct Answers: particles larger than 50 um high volume evacuation - Correct Answers: reduces the escape of salivary aerosols and spatting saliva ejector - Correct Answers: 1/5 cases say fluids might be retracted into the clients mouth when a seal around the saliva ejector is created rubber dam - Correct Answers: can result in 100% reduction in MOs escaping pre-procedural mouth rinses - Correct Answers: lowers the # of MOs that may escape a clients mouth during dental care - chlorhexidine - iodophors - essential oils disposables - Correct Answers: single use only preventing sharps injuries - Correct Answers: - can occur @ any time - one handed scoop - dispose of needles as soon as possible after use - use tongs or liners to pick up sharps that feel on the floor - look before reaching for a sharp instrument or instrument package lymphatic system - Correct Answers: group of organs and vessels distributed within the body which acts as a human defence against infectious diseases lymph nodes - Correct Answers: filter lymph fluid of invading MOs spleen - Correct Answers: filters blood thymus - Correct Answers: process and develop mature lymphocytes peters patches - Correct Answers: individual lymphatic modules concentrated in the ileum tonsils - Correct Answers: trap inhaled faring material and cells antigens - Correct Answers: proteins or other components on cell surface of pathogen - stimulate B and T lymphocytes - degraded macrophages - bacteria, viruses, fungi, protozoa antibodies - Correct Answers: specialized proteins produced by the cells of the immune system that counterpart a specific foreign substance immunoglobins - Correct Answers: a class of blood proteins which are responsible for immunity to specific infections erythrocyte - Correct Answers: transport oxygen and some carbon dioxide leukocyte (WBC) - Correct Answers: immune responsible neutrophil (WBC) - Correct Answers: phagocytosis of bacteria eosinophil (WBC) - Correct Answers: counterpart histamine in allergy; destroy parasitic worms basophil (WBC) - Correct Answers: release histamine and heparin; known as the mast cell lymphocytes - Correct Answers: made up of B and T cells B cells produce antibodies T cells function in cellular immunity monocytes - Correct Answers: phagocytosis; tissue forms if the macrophage thrombocyte (platelets) - Correct Answers: blood clotting non specific response (innate response) - Correct Answers: present at birth composed of: - physical barriers - mechanical barriers - antimicrobial chemicals - cellular barrier phagocytosis - Correct Answers: destroys MOs - neutrophils and macrophages inflammation - Correct Answers: process to isolate the pathogen and stimulate the speedy arrival of a large number of immune cels neutrophils - Correct Answers: earliest cells to arrive specific response (acquired immunity) - Correct Answers: lymphatic system where the T and B lymphocytes cells are found cell mediated response (T lymphocytes) - Correct Answers: - regulate antibody - destroy viruses - produce lymphokines - destroy nonmicroblal cells B-lymphocytes - Correct Answers: produced in the bone marrow T-cells - Correct Answers: leave the bone marrow via bloodstream and move to the thymus - helper T cells - killer T cells helper T-cells - Correct Answers: activate B cells and killer T cells killer T-cells - Correct Answers: attacking cells that are infected primary response - Correct Answers: 7-9th day secondary response - Correct Answers: specific antibodies appear within 1-2days and the antigen is rapidly eliminated after the body encounters the same antigen naturally acquired passive immunity - Correct Answers: molecules pass across from mother to placenta naturally acquired active immunity - Correct Answers: when a person is sick and then recovers artificially acquired passive immunity - Correct Answers: antibodies are injected into an individual who is very ill artificially acquired active immunity - Correct Answers: administration of a weakened products of a MO which will cause an active immune response immediate hypersen - Correct Answers: mild - ones such as seen in Hay fever or hives systemic - affecting multiple organ systems simultaneously leading to shock, circulatory collapse and even death delayed hypersensitivity - Correct Answers: occurs when there has been a second exposure to the appropriate antigen ELISA - Correct Answers: uses antibodies and colour change to identify a substance agglutination - Correct Answers: "grouping" 'clumping" antigen is mixed with its corresponding antibody precipitation - Correct Answers: when sufficient antigen and antibody molecules interact they precipitate out of solution complement-fixation - Correct Answers: detect specific antigen or specific antibody serum fluorescent antibodies - Correct Answers: antigen with a tagged antibody preparation of vaccines - Correct Answers: - antigen is generated (grown) - antigen is isolated - vaccine is made by adding adjuvant, stabilizers and preservatives human herpes virus type 1 - Correct Answers: - may cause infections of the mouth, skin, eyes and genitals - initial infection may be asymptomatic or may be characterized by vesicles on the lips out mouth - recurrent disease - cold sores - fever blisters - spread through direct contact - saliva, infected skin (herpetic whitlow), sprays/aerosols of saliva - occur in children under 2 years old through contact herpetic whitlow - Correct Answers: - enters through breaks in the skin - contact with kerpes virus - affects fingers or thumb - painful herpes type 2 - Correct Answers: - causes 90% genital herpes infection - can spread of be contagious - more commonly the cause of lesions on the genital organs through sexual contact tuberculosis - Correct Answers: - bacteria called mycobacterium tuberculosis - spread by aerosols from person with active TB - respiratory aerosols - do not treat clients with active TB early stages of TB - Correct Answers: individuals may be asymptomatic or may only have a low grade fever later stages of TB - Correct Answers: may include a higher temperature, cough, fatigue, lack of appetite, weight loss and pulmonary hemorrhage 4 to 12 weeks after exposure of TB - Correct Answers: lesions of the lungs become visible screening for TB - Correct Answers: - skin tests - chest x-rays treatment for TB - Correct Answers: - isolation - drugs SARS - severe acute respiratory syndrome - Correct Answers: - coronavirus TRANSMISSION - close person-person contact - droplet infection TREATMENT - steroids - oxygen therapy CONTROL MEASURES - isolation - clients to be quarantined - masks and eye wear - protective clothing HIV virus - Human Immunodeficiency Virus - Correct Answers: - retroviruses - destruction of the body immune system, making an individual susceptible to life threatening infections or diseases - infects T4 lymphocytes - cells that regulate the immune response SYMPTOMS - after 4 weeks - sore throat - fever and swollen glands - diarrhea - joint pain and fatigue DIAGNOSIS - 6 to 12 weeks after initial infection - ELISA test - capable of detecting antibodies in blood TREATMENT - drugs cant cure the disease but prolong periods of wellness AIDS - Acquired Immunodeficiency Syndrome - Correct Answers: - as the HIV virus replicates and destroys the T4 lymphocytes the immune system becomes progressively weaker - allowing for opportunistic diseases to occur which eventually cause disease DIAGNOSIS - when CD4T cells counts under 200/mL ORAL MANIFESTATIONS - candidiasis - hairy leukoplakia - herpes type 1 - rapidly progressing periodontal disease - kaposis sarcoma TRANSMISSION - sexual contact - blood exposure - perinatal contact - low-risk of transmission through saliva Ebola (acute viral) - Correct Answers: - hemorrhagic fever - severe - fatal TRANSMISSION - infected wild animals - burial ceremonies - men who have recovered from the disease can still transmit the virus through semen up to 7 weeks after recovery - health-care workers while treating patients DIAGNOSIS - other disease that should be ruled out before a diagnosis of EVD - can be diagnosed definitively in a lab - tests TREATMENT - no vaccine or medicine - maintaining oxygen and blood pressure - providing fluids oral candidiasis - Correct Answers: - yeast in mouth - opportunistic pathogen - white lesions - red areas CAUSES - HIV, leukemia - antibacterial therapy - poorly fitted dentures - poor mouth resistance TREATMENT - anti fungal agents oral syphilis - Correct Answers: - painless lesions - occurs in mouth -forms 21 days after exposure CAUSES - treponema pallidum, gram (-) spirochete bacterium gonorrhea - Correct Answers: - neisseari gonorrhoea (gram - bacteria) - STD that can spread in mouth - inflammation of throat area herpangina 'mouth blisters' - Correct Answers: - painful mouth infection - caused by "coxsackievirus" (hand-foot and mouth disease) - severe, sore throat headache - no specific treatment chicken pox/shingles - Correct Answers: - herpes type 3 - varicella-zoster virus - highly contagious - respiratory disease - droplet infection - spreads by saliva, nasal secretions, skin contact - vaccine developed 1996 infectious mononucleosis - Correct Answers: - herpes virus type 4 - 'kissing disease' - adolescents & young adults - spread through saliva and blood - fever, malaise, anorexia, fatigue, sore throat, oral ulcers, enlarged cervical nodes strep throat 'streptococcal pharyngitis' - Correct Answers: - streptococcal pyogenes - droplet infection from mouth to mouth - penicillin therapy influenza 'flu' - Correct Answers: - respiratory disease - type A and B virus - fever, cough, sore throat, headache, chills, body ached, vomitting, diarrhea, runny or stuffy nose, nausea, fatigue - droplet exposure, respiratory secretions, sneezing, coughing, hands waterborne disease agents - Correct Answers: - enter through dental units and attach to inside walls of water lines - 30-40 different types - 2 main types 1. legionella pneunophila - legionnaires disease 2. pseudomonas aeruginosa - harmful infections legionnaires disease - Correct Answers: - pneumonia - lung infections - legionella pneumophila - gram (-) rod-shaped bacterium - flu-like - fever, chills, muscle aches, headache, cough/sore throat TREATMENT - erythromycin pseudomonas infection - Correct Answers: - p. aeruginosa - opportunistic pathogen - individual is in a weakened state - found in dental water lines MRSA - Methicillin Resistant Staphylococcus Aureus - Correct Answers: - bacterium resistant to certain antibiotics - skin infections - boils and pustules - can be present on dental surfaces PREVENTION - hand hygiene - PPE - disinfection - sterilization H1N1 'swine flu' - Correct Answers: - 2009 flu pandemic - influenza A virus - "flu" like symptoms - vaccine - spread by cough/sneeze, air droplets TREATMENT - antiviral blood borne pathogens - Correct Answers: - disease-producing MOs that are spread by contact with blood or other body fluids from an infected person - infect blood cells or the other tissues of the body - contact of bodily fluids - enter the mouth during dental procedures that induce bleeding - contact with saliva during procedures may result in exposure to pathogens if present blood borne diseases - Correct Answers: - infectious diseases that are spread through contact with infected blood and other body fluids hepatitis - Correct Answers: inflammation of the live - can be virally related & acquired through blood, infected body fluids such as saliva, food and water - 6 strains of hepatitis: A-E, G Hepatitis A - Correct Answers: BIOLOGY - spherical, non-enveloped single-stranded RNA virus TRANSMISSION - usually by the fecal-oral route (poor hygiene); contaminated food/water CLINICAL FEATURES - incubation period 2-6 weeks - fever - nausea - abdominal discomfort - jaundice DIAGNOSIS - demonstration of HAV antigen in feces or serology of antigen HAV VACCINATION - available TREATMENT - rest - no alcohol and substances that are toxic to the liver Hepatitis B - Correct Answers: 1. a person will develop acute HBV and recover completely and develop antibodies that give them life-long immunity 2. small percentage become carriers 3. 25% of chronic carriers will develop chronic HBV BIOLOGY - circular, enveloped double stranded DNA TRANSMISSION - parenteral route @ birth - sexual activity - contaminated needles SYMPTOMS - nausea - vomitting - anorexia - fatigue - skin rash - sometimes arthritis - jaundice DIAGNOSIS - serological tests - no cute Hepatitis C - Correct Answers: BIOLOGY - blood borne virus - enveloped, single stranded RNA virus TREATMENT - pegylated interferon and ribavirin TRANSMISSIOON - intravenous drug use - blood and blood products - sexual transmission - organ and tissue transplantation - mother to child - needle-stick injury DIAGNOSIS - serological Hepatitis D - Correct Answers: BIOLOGY - non-enveloped single-stranded RNA TRANSMISSION - primarily parenteral OUTCOMES - it will increase the severity of HBV infection PREVENTION - treat the same Hep B Hepatitis E - Correct Answers: BIOLOGY - spherical, non-enveloped single-stranded RNA virus - similar to Hep A - liver disease - spread by fecal contaminated drinking water not a threat to personnel microbiology of caries - Correct Answers: infectious disease caused by dimeralization of a tooth structure by acids produced during metabolism of dietary sugars by bacteria associated with the tooth surfaces types of caries - Correct Answers: - occlusal carries - smooth surface carries - inter proximal carries - root carries 4 factors are necessary for dental carries to occur - Correct Answers: - susceptible host - MOs - substrate - time susceptible host - Correct Answers: for dental carries to occur the person must be susceptible to the disease microorganisms - Correct Answers: bacteria capable of causing carries must be present in the mouth and must be closely associated with the teeth - impaction of bacteria/food, poor oral hygiene substrate - Correct Answers: diet is a substance that is metabolized by oral bacteria through catabolic fermentation to produce acids - sucrose is the most carries-constructive component of our diet and can be fermented by bacteria and contributes to the disease time - Correct Answers: with any infectious disease, time is needed for the disease to become recognized - incubation period - 6 month recare mutans streptococci - Correct Answers: carries-conductive bacteria found in the mouth - most important bacteria initiating carries - have 3 pathogenic properties important for carries formation - plaque formers 1. streptococci mutans 2. streptococci sobrinus mutans streptococci pathogenic properties - Correct Answers: 1. producing acids from carbohydrates (being acidogenic) 2. surviving at low pH (acidic) 3. accumulating on teeth - rapidly accumulate in plaque in the presence of sucros - responsible in the initial attack on teeth lactobacilus - Correct Answers: species: L. acidophilus and L. casei highly acidogenic and acidic - responsible for progression of carious lesions (following the initial demineralization by streptococci mutant - DO NOT have effective attachment mechanisms to allow them to accumulate in plaque that develops over non-carious teeth - thrive best within the highly acidic carious lesion - produce the acids for demineralization and thrive in acidic environments actinomycetes naeslundii - Correct Answers: - good plaque formers and can accumulate to high numbers in plaque - not as carries conductive as the mutans streptococci because it is only slightly acidogenic and not acirduric - root carries formation formation of dental carries - Correct Answers: 1. acidogenic bacteria on teeth ferment sugars in the diet to acids (produce lactic acid) 2. acids accumulate on tooth surface, lowering pH to critical level of 5.2 3. minerals in the tooth start to dissolve, causing loss of tooth structure (demineralization) 4. natural body defines mechanism (remineralization) attempts to restore lost calcium and phosphate in the tooth, which will appear as a spot on the tooth 5. if remineralization occurs more slowly than demineralization - dental carries occurs periodontal disease - Correct Answers: infectious disease caused by members of the normal oral microbiota that have been allowed to accumulate in the gingival sulcus - as bacteria multiply in the gingival sulcus, these bacteria produce enzymes, toxic metabolites, immunosuppressive factors - inflammation accumulation of bacteria - Correct Answers: 1. direct damage to the gingiva and bone 2. inflammation 3. interference with some host defence mechanisms 4. stimulation of immune response in periodontal tissues, which can cause damage developed of plaque associated periodontal disease - Correct Answers: 1. plaque accumulates in gingival crevice/sulcus 2. bacteria multiply and produce harmful products (endotoxins, enzymes) which destroy tissue 3. direct damage to periodontal tissue occurs and immune system is stimulated MOs in Periodontal disease - Correct Answers: bacteria found in periodontal disease are gram-negative with the exception of peptostrptoccus, streptococcus, actinomycetes types of periodontal disease - Correct Answers: 1. gingivitis 2. chronic periodontitis 3. necrotizing ulcerative gingivitis (NUG) gingivitis - Correct Answers: effects only gingival tissue, results in an inflammatory response swelling, redness and maybe spontaneous bleeding - reversible when the plaque is removed - diagnosed through colour of gingiva and presence of bleeding periodontitis - Correct Answers: affects alveolar bone and results in loss or loosening of the teeth - development of periodontal pockets around the teeth where the gingival tissue has separated from the teeth - pockets are filled with plaque bacteria and limit access to cleaning - NOT REVERSIBLE - removal and control of plaque can stop further progression of the disease chronic periodontitis - Correct Answers: - continuous presence of plaque in individuals with normal body defence mechanisms - SLOW progression of destruction - usually occurs age 35 and older rapidly progressive periodontitis - Correct Answers: - defective body defence, bone destruction is rapid - 35 years and older juvenile periodontitis (defective body defence) - Correct Answers: most common in early teen years prepubertal periodontitis (defective body defence) - Correct Answers: occurring in those with primary teeth necrotizing ulcerative gingivitis (NUG) - Correct Answers: - another form of gingivitis - "trench mouth" - associated with plaque accumulation and predisposing factors such as stress - receivable if the predisposing factors are eliminated and plaque is controlled - often linked with a systemic disease prevention of plaque-associated diseases - Correct Answers: 1. regular brushing and flossing 2. fluoride 3. pit and fissure sealants 4. antimicrobials mechanisms of fluoride - Correct Answers: 1. inhibit bacterial metabolism after diffusing into the bacteria as hydrogen fluoride 2. inhibiting demineralization 3. enhance remineralization pulpitis - Correct Answers: inflammation of the tooth pulp periapical infection - Correct Answers: infection of the tooth apex cellulitis - Correct Answers: infection of the facial tissues endodontic treatment - Correct Answers: - removing necrotic (dead) pulp tissue - killing and removing the remaining bacteria in the root canals - fill the canals with inert material to prevent bacterial colonization of periodical tissue - antibiotic treatment - oral bacteria from carious lesions can cause acute dental infections transient bacteremia - Correct Answers: - members of the normal oral microbiota enter the blood stream subacute bacterial endocarditis - Correct Answers: - certain oral bacteria in the blood may induce damage to heart valves in someone who has previous damage to the heart valves, such as in rheumatic heart disease - inflammation inside the heart - pre-med with antibiotics pandemic illness - Correct Answers: worldwide outbreak of a specific disease that spreads easily and rapidly through many countries CCOHS - Correct Answers: Canadian Centre for Occupational Health and Safety TCDHA Pandemic illness - Correct Answers: 1. once TCDHA has been notified of a possible pandemic a. all students, faculty and support stats will be notified through email, in class discussion and the TCDHA website b. signs and symptoms will be posted 2. all incoming clients to TCDHA will be screened 3. all faculty, staff and students are advised to stay home if they are ill 4. TCDHA will continue to monitor the situation and provide everyone with daily updates regarding the pandemic 5. TCDHA will follow all provincial guidelines for pandemics TCDHA infection control protocols - Correct Answers: 1. cleaning and disinfecting unit 2. PPE and student responsibilities 3. protection of the client set-up - Correct Answers: 1. perform a long hand wash 2. Don PPE 3. flush each type of water and handpick for 2-3 minutes 4. obtain 1 litre of prepared evacuator solution and run solution through the high volume, saliva ejector and cuspidor 5. cleaning with optim (high tuberculocidal cleaner) 6. disinfect high risk areas 7. wash and disinfect utility gloves 8. perform hand hygiene barrier - Correct Answers: - chair control on tray - saliva and high volume suction couplings - sleeves on both A/W syringes - saran wrap on the computer keyboard supplies - Correct Answers: - bibs - gauze - paper tray liner - dixie cup - saliva ejectors - cotton rolls - overgloves - fluoride trays tear down - Correct Answers: - hand hygiene and PPE - 1 litre of evacuator solution - remove barriers - run evacuator solution - flush air/water lines for 20-30 seconds - clean bracket table, controls, switches, handpiece supports, a/w syringe, couplings, hosing - cuspidor cleaned - clean dental chair, light, base, foot controls, operator and assistant stoold - remove PPE, disinfect utility glove instrument care prior to sterilization - Correct Answers: - wear heavy utility gloves - closed when transpoting - no scrubbing - cassette in ultrasonic for 10 mins - rinse cassette with running water, let drain/dry for a few mins - place sterilizer monitoring strip in cassette and wrap with blue wrap and tape and label - disposable bags for handpieces - return all items to be sterilized to the dispensary for 15 mins prior to end of clinic equipment maintenance - Correct Answers: - follow infection control - keep cabinets stocked - spore testing - clean and lubricate handpieces - cuspidor traps are cleaned every clinic protecting our client - Correct Answers: - signage at door asking clients to notify us of any flu-like symptoms - medical history - vital signs - clients must wear safety glassses - pre-procedural rinse with 5ml of antibacterial mouth rinse for 30 secondary before intramural treatment sharps - Correct Answers: needles, syringes with needles must be separated and collected in a yellow puncture resistant, link proof container and labeled with a biohazard sticker on it blood soaked materials - Correct Answers: release liquid when compressed place into yellow liner bag marked biohazards general waste - Correct Answers: - garbage containers should be waterproof - out of reach from small children - use plastic bags to line garbage cans - do not overfill or place sharps or heavy items in bags puncture wound protocol - Correct Answers: - remain calm - excuse yourself from the client and speak to a faculty member immediately - throughly wash the wound with an anti-microbial hand wash solution - if the eyes, nose or mouth are involved, flush the area well with large amounts of water. primary closure of the wound should be performed, apply a band air or dressing - the faculty member will complete an "exposure to body fluids" form - after reviewing the report, you and the faculty member will sign it and submit to the safety officer review - a faculty member will speak to your client explaining the situation - post exposure assessment at a medical health facility post exposure prophylaxis for HIV exposure - Correct Answers: - should be administered ideally ihtin the first 1-2 hours - can be administered up to 72 hours after the exposure - length of treatment is 4 weeks - don't panic; chance of transmission in dental environment is extremely lo - dont rush with clients while working to prevent possible exposure to HIV, Hep A, B, C hep a - Correct Answers: does not lead to chronic infection hep b - Correct Answers: immunization, check antigens yearly hep c - Correct Answers: if contracted - testing takes several weeks as it does not show up immediately conjunctivityis - Correct Answers: unless they have been started on antibiotic eye drops, they are not to be seen in the clinic, very contagious herpes - Correct Answers: active lesions - do not treat clients until healed going green - Correct Answers: to use products and procedures that have lower adverse impacts on health and the environment than regular products and procedures disinfectant wipes - Correct Answers: - instead of spraying disinfectants - reduce amount of chemicals in environment and exposure to clients and practitioners hand hygiene - Correct Answers: - reduce use of paper towels could use a cloth towel once and then wash it instrument processing - Correct Answers: make sure sterilizer is fully loaded for each run if possible radiology - Correct Answers: digital radiology personal protective barriers - Correct Answers: wash scrubs and clinic gowns regulated medical waste - Correct Answers: biodegradable or recycled environmental asepsis - Correct Answers: - limit amount of physical barriers, dont waste - disinfectant wipes release less chemicals into the environment use of paper - Correct Answers: recycle paper, paperless offices WHMIS - Correct Answers: - Workplace Hazardous Materials Information System - canada-wide system to provide information on hazardous materials used in the workplace - employees need, and have the right to know about the chemicals they work with - 3 times more death every year from exposure to chemicals goals of WHMIS - Correct Answers: - to provide employers and employees information about hazardous materials used in the workplace - to prevent accidents and injury occurring in the course of employment acute - Correct Answers: intense chronic - Correct Answers: prolonger or long term latent period - Correct Answers: time between exposure and disease routes of entry - Correct Answers: - inhalation - ingestion - absorption - injection WHMIS- principles of prevention - Correct Answers: Avoid hazards Recognize hazards Assess hazards that cannot be avoided Control hazards Evaluate controls = ARACE 3 key elements of WHMIS - Correct Answers: 1. labels 2. safety data sheet 3. training labels - Correct Answers: containers must have labels that alert employees to the dangers and basic safety precautions - supplier label - workplace label who are suppliers - Correct Answers: - manufacturers - processors - packager - importer - sellers no label - Correct Answers: - employers duty to request from supplier - employer can store an unlabeled controlled product but not use it - if unable to obtain label-contact ministry of labour workplace labels must be on - Correct Answers: - all secondary containers of products - product where original supplier label is lost or becomes illegiblle - products produced and used at the workplace safety data sheets - Correct Answers: provide detailed information about a product - hazards - how to protect yourself - safe handling and emergency measure - 16 categories important: 2, 4, 7, 8, 15 consumer products - Correct Answers: a product packaged in a size appropriate for public use training - Correct Answers: education and training is required for workers who are exposed, or are likely to be exposed, to a hazardous product due to their work activities employee education - Correct Answers: - to ensure workers understand the hazards of the materials they are exposed to and the measure they should take to protect themselves - program in place for training new workers and retraining - program review annually employees responsibilities - Correct Answers: employees are expected to handle hazardous material according to the directions: - labels - sds - education and training employees rights - Correct Answers: - know about hazardous materials - information labels and (M) SDS - education in the workplace - actively involved in WHMIS program implementation dental hygienest and WHMIS - Correct Answers: - you - your client - your practice - the environment dental hygienists - Correct Answers: Implement WHMIS Know WHMIS Educate others about WHMIS Advoate for WHMIS = IKEA