Clinical Theory I Midterm Exam Questions and Answers Solved Correctly Latest Update 2025-2026
Bacterial Plaque Biofilm - Answers Dense, transparent nonmineralized mass of bacterial colonies in a gel-
like, intermicrobial, enclosed matrix (slime layer) that is attached to a moist environmental surface
When does the pellicle begin to form after teeth cleaning? - Answers immediately
When is gingivitis clinically evident? - Answers Days 14-24
Materia Alba - Answers •Loosely attached collection of oral debris, desquamated epithelial cells,
leukocytes, salivary proteins & lipids, microorganisms
•White/yellow/gray
•Cottage cheese like appearance
•Found in areas of poor oral hygiene
•Removed with vigorous rinsing and water irrigation
Exogenous stain - Answers a stain that was acquired after a tooth has erupted; can be extrinsic or
intrinsic
Endogenous stain - Answers intrinsic stain acquired during tooth development
Intrinsic stain - Answers - incorporated into the tooth structure
- cannot be removed by scaling or polishing
- •Alterations during the development of the tooth ( associated with antibiotic use, trauma, infection,
high amounts of fluoride during tooth development)
Extrinsic stain - Answers - staining that is found on the external surfaces of the teeth
- over time can turn into intrinsic stain
- Attracts Bacterial Plaque
- can be removed by scaling or polishing
What is a key feature of biofilm induced gingivitis? - Answers bleeding on probing
Why is BOP reduced in smokers? - Answers vasoconstriction and altered immune response. Thick
fibrotic gingiva with minimal redness. Not an indication of gingival health
BOP less than 10% - Answers Gingival health on an intact or reduced periodontium
BOP greater than or equal to 10 % - Answers Gingivitis on an intact periodontium, Gingivitis on a
reduced periodontium, or Stage I-IV periodontitis
,True or false: Smooth and shiny gingival texture is a sign of healthy gingival tissue. - Answers FALSE,
Healthy tissue should be stippled like an orange peel, : Firm, resilient tissue
Clinical signs of periodontal disease include firm, stippled, uniformly pink gingival tissue. Firm, stippled,
uniformly pink gingiva is likely to produce bleeding on probing. - Answers The first statement is false, the
second is true
Disclosing solution can camouflage the clinical signs of disease. It should be applied before the oral and
periodontal assessment. - Answers The first statement is true, the second is false
- disclosing solution should be applied AFTER periodontal assesment
What is the correct order of oral biofilm formation? - Answers Pellicle, colonization, maturation,
dispersion
An explorer is the most accurate method of detecting subgingival calculus. Subgingival calculus is always
visible on dental radiographs - Answers The first statement is true, the second is false
What is the number one cause of tooth loss in adults? - Answers periodontitis
-47% of adults over 30
-Can have onset of any age, but more common over age of 35
CAL - Answers Clinical Attachment Loss
Can occur in one site of a single tooth or several teeth or entire dentition:
•Apical migration of the JE to the tooth root
•Destruction of fibers of the gingiva
•Destruction of periodontal ligament fibers
Localized - Answers •may involve one site on a single tooth or several sites on several teeth
•Involves 30% or less of the teeth
Generalized - Answers •may involve most or entire dentition
, •Involves more than 30% of teeth
When is a patient a periodontitis case? - Answers -Interdental clinical attachment loss detectible at two
or more nonadjacent teeth
OR:
-Facial or lingual clinical attachment loss of 3 mm or more with pocketing greater than 3 mm detectible
at 2 or more teeth
What are some causes of attachment loss that are NOT due to periodontitis? - Answers -Gingival
recession of traumatic origin
-Dental caries extending to or apical to CEJ
-Presence of CAL on the distal aspect of a second molar associated with extraction of a third molar
-Endodontic lesion draining through marginal gingiva
-Vertical root fracture
Stage I Periodontitis (Initial Stage) - Answers •Severity:
-Interdental CAL of 1-2 mm at site of greatest loss
-Radiographic bone loss extending to coronal one-third of root
-No tooth loss due to periodontitis
•Complexity of management:
-Maximum probing depths of 4 mm or less
-Mostly horizontal bone loss
Stage II Periodontitis(Established Periodontitis) - Answers •Disease Severity:
-Interdental CAL of 3-4 mm at site of greatest loss
-Radiographic bone loss extending to coronal one-third of root
-No tooth loss due to periodontitis
•Complexity of Management:
-Maximum probing depths of 5 mm or less (not CAL, only proving depth)
-Mostly horizontal bone loss
Stage III Periodontitis(Severe Periodontitis) - Answers •Severity:
Bacterial Plaque Biofilm - Answers Dense, transparent nonmineralized mass of bacterial colonies in a gel-
like, intermicrobial, enclosed matrix (slime layer) that is attached to a moist environmental surface
When does the pellicle begin to form after teeth cleaning? - Answers immediately
When is gingivitis clinically evident? - Answers Days 14-24
Materia Alba - Answers •Loosely attached collection of oral debris, desquamated epithelial cells,
leukocytes, salivary proteins & lipids, microorganisms
•White/yellow/gray
•Cottage cheese like appearance
•Found in areas of poor oral hygiene
•Removed with vigorous rinsing and water irrigation
Exogenous stain - Answers a stain that was acquired after a tooth has erupted; can be extrinsic or
intrinsic
Endogenous stain - Answers intrinsic stain acquired during tooth development
Intrinsic stain - Answers - incorporated into the tooth structure
- cannot be removed by scaling or polishing
- •Alterations during the development of the tooth ( associated with antibiotic use, trauma, infection,
high amounts of fluoride during tooth development)
Extrinsic stain - Answers - staining that is found on the external surfaces of the teeth
- over time can turn into intrinsic stain
- Attracts Bacterial Plaque
- can be removed by scaling or polishing
What is a key feature of biofilm induced gingivitis? - Answers bleeding on probing
Why is BOP reduced in smokers? - Answers vasoconstriction and altered immune response. Thick
fibrotic gingiva with minimal redness. Not an indication of gingival health
BOP less than 10% - Answers Gingival health on an intact or reduced periodontium
BOP greater than or equal to 10 % - Answers Gingivitis on an intact periodontium, Gingivitis on a
reduced periodontium, or Stage I-IV periodontitis
,True or false: Smooth and shiny gingival texture is a sign of healthy gingival tissue. - Answers FALSE,
Healthy tissue should be stippled like an orange peel, : Firm, resilient tissue
Clinical signs of periodontal disease include firm, stippled, uniformly pink gingival tissue. Firm, stippled,
uniformly pink gingiva is likely to produce bleeding on probing. - Answers The first statement is false, the
second is true
Disclosing solution can camouflage the clinical signs of disease. It should be applied before the oral and
periodontal assessment. - Answers The first statement is true, the second is false
- disclosing solution should be applied AFTER periodontal assesment
What is the correct order of oral biofilm formation? - Answers Pellicle, colonization, maturation,
dispersion
An explorer is the most accurate method of detecting subgingival calculus. Subgingival calculus is always
visible on dental radiographs - Answers The first statement is true, the second is false
What is the number one cause of tooth loss in adults? - Answers periodontitis
-47% of adults over 30
-Can have onset of any age, but more common over age of 35
CAL - Answers Clinical Attachment Loss
Can occur in one site of a single tooth or several teeth or entire dentition:
•Apical migration of the JE to the tooth root
•Destruction of fibers of the gingiva
•Destruction of periodontal ligament fibers
Localized - Answers •may involve one site on a single tooth or several sites on several teeth
•Involves 30% or less of the teeth
Generalized - Answers •may involve most or entire dentition
, •Involves more than 30% of teeth
When is a patient a periodontitis case? - Answers -Interdental clinical attachment loss detectible at two
or more nonadjacent teeth
OR:
-Facial or lingual clinical attachment loss of 3 mm or more with pocketing greater than 3 mm detectible
at 2 or more teeth
What are some causes of attachment loss that are NOT due to periodontitis? - Answers -Gingival
recession of traumatic origin
-Dental caries extending to or apical to CEJ
-Presence of CAL on the distal aspect of a second molar associated with extraction of a third molar
-Endodontic lesion draining through marginal gingiva
-Vertical root fracture
Stage I Periodontitis (Initial Stage) - Answers •Severity:
-Interdental CAL of 1-2 mm at site of greatest loss
-Radiographic bone loss extending to coronal one-third of root
-No tooth loss due to periodontitis
•Complexity of management:
-Maximum probing depths of 4 mm or less
-Mostly horizontal bone loss
Stage II Periodontitis(Established Periodontitis) - Answers •Disease Severity:
-Interdental CAL of 3-4 mm at site of greatest loss
-Radiographic bone loss extending to coronal one-third of root
-No tooth loss due to periodontitis
•Complexity of Management:
-Maximum probing depths of 5 mm or less (not CAL, only proving depth)
-Mostly horizontal bone loss
Stage III Periodontitis(Severe Periodontitis) - Answers •Severity:
