Test Bank Darby & Walsh Dental Hygiene Theory and Practice, 4th Edition
Table of Contents
Chapter 01: The Dental Hygiene Profession ........................................................................................ 3 Chapter 02: Human Needs Theory and Dental Hygiene Care ............................................................ 12 Chapter 03: Evidence-Based Decision Making .................................................................................. 21 Chapter 04: Health and Health Promotion .......................................................................................... 28 Chapter 05: Changing Behaviors ....................................................................................................... 37 Chapter 06: Cultural Competence ...................................................................................................... 44 Chapter 08: The Dental Hygiene Care Environment ........................................................................... 49 Chapter 10: Medical Emergencies ..................................................................................................... 55 Chapter 11: Ergonomics .................................................................................................................... 63 Chapter 12: The Health History .......................................................................................................... 66 Chapter 13: Vital Signs ...................................................................................................................... 73 Chapter 14: Pharmacologic History .................................................................................................... 79 Chapter 15: Extraoral and Intraoral Clinical Assessment .................................................................... 89 Chapter 16: Dentition Assessment ..................................................................................................... 95 Chapter 17: Oral Hygiene Assessment: Soft and Hard Deposits ..................................................... 103 Chapter 18: Dental Caries Management by Risk Assessment ......................................................... 108 Chapter 19: Periodontal and Risk Assessment ................................................................................. 112 Chapter 20: Potential Impact of Periodontal Infections on Overall General Health ........................... 120 Chapter 21: Dental Hygiene Diagnosis ............................................................................................ 130 Chapter 22: Dental Hygiene Care Plan, Evaluation, and Documentation .......................................... 139 Chapter 23: Toothbrushing ............................................................................................................... 149 Chapter 24: Mechanical Oral Biofilm Control: Interdental and Supplemental Self-Care Devices ........ 155 Chapter 25: Dentifrices .................................................................................................................... 167 Chapter 26: Hand-Activated Instrumentation .................................................................................... 173 Chapter 27: Ultrasonic Instrumentation ............................................................................................ 182 Chapter 28: Root Morphology and Instrumentation Implications ...................................................... 188 Chapter 29: Stain Management and Tooth Whitening ...................................................................... 195 Chapter 30: Decision Making Related to Nonsurgical Periodontal Therapy ...................................... 202 Chapter 31: Chemotherapy for the Control of Periodontal Disease .................................................. 214
Chapter 32: Acute Gingival and Periodontal Conditions, Lesions of Endodontic Origin, and Avulsed Teeth ............................................................................................................................................... 220 Chapter 33: Fluorides, Chlorhexidine, Amorphous Calcium Phosphate, and Xylitol ......................... 222 Chapter 34: Pit and Fissure Sealants ............................................................................................... 229 Chapter 35: Nutritional Counseling .................................................................................................. 232 Chapter 36: Tobacco Cessation ....................................................................................................... 239 Chapter 37: Impressions, Study Casts, and Oral Appliances ........................................................... 247 Chapter 38: Restorative Therapy ..................................................................................................... 252
1 | P a g eChapter 39: Dentinal Hypersensitivity Management ......................................................................... 260
Chapter 40: Local Anesthesia .......................................................................................................... 267
Chapter 41: Nitrous Oxide–Oxygen Analgesia ................................................................................. 274
Chapter 42: Persons with Disabilities ............................................................................................... 280
Chapter 43: Cardiovascular Disease ................................................................................................ 288
Chapter 44: Diabetes Mellitus .......................................................................................................... 297
Chapter 45: Oral Care of Persons with Cancer ................................................................................ 305
Chapter 46: Human Immunodeficiency Virus Infection ..................................................................... 313
Chapter 47: Persons with Neurologic and Sensory Deficits .............................................................. 322
Chapter 48: Persons with Autoimmune Diseases ............................................................................. 329
Chapter 49: Renal Disease and Organ Transplantation.................................................................... 338
Chapter 50: Respiratory Diseases ................................................................................................... 346
Chapter 51: Cognitively and Developmentally Challenged Persons ................................................. 353
Chapter 52: Alcohol and Substance Abuse Problems ...................................................................... 360
Chapter 53: Eating Disorders ........................................................................................................... 365
Chapter 54: Women’s Health and the Health of Their Children ........................................................ 372
Chapter 55: The Older Adult ............................................................................................................. 381
Chapter 56: Persons with Fixed and Removable Dental Prostheses ............................................... 389
Chapter 57: Orofacial Clefts and Fractured Jaw ............................................................................... 396
Chapter 58: Osseointegrated Dental Implants .................................................................................. 402
Chapter 59: Persons with Orthodontic Appliances ............................................................................ 409
Chapter 60: Abuse and Neglect ....................................................................................................... 418
Chapter 61: Palliative Oral Care ....................................................................................................... 426
Chapter 62: Practice Management ................................................................................................... 433
Chapter 63: Career Planning and Job Searching ............................................................................. 441
2 | P a g eChapter 01: The Dental Hygiene Profession
MULTIPLE CHOICE
1. What is the discipline of dental hygiene?
a. The study of teeth and their supporting structures
b. Brushing and flossing one’s teeth and rinsing with an antimicrobial mouth rinse
twice a day, morning and night
c. The study of preventive oral healthcare, including the management of behavior
to prevent oral disease and promote health
d. The study of those procedures that dental hygienists provide to clients
ANS: C
The study of teeth and their supporting structures. This answer is wrong because the
discipline of dental hygiene covers much more information than the study of teeth and
supporting structures. Dental hygiene focuses on the preventive measures that the teeth and
supporting structures must receive, in addition to other oral healthcare steps that must be
taken to promote one’s health.
Brushing and flossing one’s teeth and rinsing with an antimicrobial mouth rinse twice a day,
morning and night. This answer is wrong because this statement describes only one procedure
within the discipline of dental hygiene. Dental hygiene is a much larger and general field of
study than this simple preventive action.
The study of preventive oral healthcare including the management of behavior to prevent
oral disease and promote health. This answer is correct because this is the direct definition
of dental hygiene. The definition can be broken down into smaller, specified divisions to
further develop the discipline of dental hygiene.
The study of those procedures that dental hygienists provide to clients. This answer is wrong
because dental hygienists play many interrelated roles, such as clinician, educator,
administrator or manager, advocate, and researcher. Although each of these roles is created
to assist in dental hygiene, the discipline is not centered on the actions and procedures of the
dental hygienist.
REF: What is Dental Hygiene? | 1
2. Who is the professional dental hygienist?
a. A licensed preventive oral health professional who has graduated from a
Commission on Dental Accreditation, accredited, entry level dental hygiene
program
b. A licensed person who has learned on the job via a preceptorship program, such
as the Alabama Dental Hygienists Program
c. A dentist who has graduated from a Commission on Dental
Accreditation, accredited, dental school program
d. A person who has graduated from a Commission on Dental
Accreditation, accredited, dental assisting program
ANS: A
A licensed preventive oral health professional who has graduated from a Commission on
Dental Accreditation, accredited, entry level dental hygiene program. This answer is correct
because to be eligible as a professional dental hygienist, the person must have graduated
from an accredited dental hygiene program.
A licensed person who has learned on the job via a preceptorship program, such as the
Alabama Dental Hygienists Program. This answer is wrong because a dental hygienist
cannot learn on the job to become a professional. Rather, they must pass written
examinations and graduate from an accredited dental hygiene program.
A dentist who has graduated from a Commission on Dental Accreditation, accredited,
3 | P a g edental school program. This answer is wrong because a dentist has a higher degree than a
dental hygienist and therefore, generally, works above a dental hygienist. It is not
necessary for a dental hygienist to receive an education from a dental school.
A person who has graduated from a Commission on Dental Accreditation, accredited,
dental assisting program. This answer is wrong because a person graduating from an
accredited dental assisting program would only be licensed as a dental assistant.
REF: Who Is the Dental Hygienist? | 1
3. All of these services are provided by the majority of dental hygienists in the clinical setting
except one. Which one is the exception?
a. Perform periodontal maintenance care.
b. Implement interventions to direct a person back to oral wellness.
c. Provide fluoride varnish treatment.
d. Place and remove restorations.
ANS: D
Perform periodontal maintenance care. This is a service provided in the clinical setting. The
clinical setting allows for application of preventive and therapeutic agents related to
periodontal disease. For example: subgingival sustained-release delivery systems containing
chlorhexidine.
Implement interventions to direct a person back to oral wellness. This is a service provided
in the clinical setting. The main goal of a dental hygienist is to prevent oral disease and
promote health. Therefore, if the state of an individual’s oral health changes, the dental
hygienist (within the scope of the clinical setting) can provide some degree of intervention to
direct the individual back to oral wellness.
Provide fluoride varnish treatment. This is a service provided in the clinical setting. The
clinical setting allows for application of preventive and therapeutic agents related to dental
caries. Fluoride varnish treatments prolong fluoride exposure on the tooth surface for safe
and effective caries control.
Place and remove restorations. This service is not provided by the majority of dental
hygienists in the clinical setting. Only a few dental hygienists have the certification to place
restorations, while many others do not. Also, the removal of restorations is not a given
action of a dental hygienist in the clinical setting.
REF: Clinician | 3
4. Which of the following is a key behavior within the dental hygiene process of care?
a. Observation
b. Diagnosis
c. Communication skills
d. Client care
ANS: B
Observation. This answer is wrong because dental hygienists must go further than simply
observing the client. The hygienist must assess the client by thoroughly collecting data.
Diagnosis. This answer is correct because identifying the diagnosis is the focal point for
establishing goals in the dental hygiene care plan. The client’s dental hygiene needs are
determined so that specific interventions can be implemented.
Communication skills. This answer is wrong because the communication skills are not a key
behavior and are not necessary to complete the dental hygiene process.
Client care. This answer is wrong because client care is not one of the steps in dental
hygiene care. However, proper client care is the goal being achieved through the key
behaviors.
4 | P a g eREF: What Is the Dental Hygiene Process of Care? | 1
5. Which of the following is not an environmental factor that the dental hygienist takes into
account in the Human Needs Model?
a. Age
b. Attitudes
c. Lifestyles
d. Weight
ANS: D
Age. This answer is an environmental factor that must be taken into account because age
plays a large role in the development of an individual’s oral health.
Attitudes. This answer is an environmental factor that must be taken into account because it
can have an effect on the dental hygiene process.
Lifestyles. This answer is an environmental factor that must be taken into account because an
individual’s oral health can be affected by lifestyle choices.
Weight. This answer is not an environmental factor that must be taken into account because
an individual’s weight does not affect their oral health. The diet choices that go along with a
person’s particular weight may affect oral health, but the overall weight of an individual does
not.
REF: What Is the Dental Hygiene Process of Care? | 1
6. Which of the following is not one of the seven roles of a dental hygienist?
a. Clinician
b. Public Health
c. Interpreter
d. Researcher
ANS: C
The seven roles of a dental hygienist are clinician, public health, researcher, educator,
administrator, and entrepreneur.
REF: Chapter One, Table 1-1 Seven Roles of the Dental Hygienist | 4
7. What is a paradigm?
a. A widely accepted worldview of a discipline that shapes the knowledge of its
practitioners, educators, administrators, and researchers
b. Decision-making skills that are used worldwide
c. A school of thought within a discipline
d. A widely accepted worldview of a discipline that shapes the direction and
methods of its practitioners, educators, administrators, and researchers
ANS: D
A widely accepted worldview of a discipline that shapes the knowledge of its practitioners,
educators, administrators, and researchers. This answer is incorrect because a paradigm
does not shape the knowledge but shapes the direction and methods of practitioners, etc.
Decision-making skills that are used worldwide. This answer is incorrect because a paradigm
does not focus on decision-making skills that are accepted worldwide.
A school of thought within a discipline. This answer is incorrect because it is the definition of a
conceptual model.
A widely accepted worldview of a discipline that shapes the direction and methods of its
practitioners, educators, administrators, and researchers. This answer is correct because
practitioners, educators, administrators, and researchers all accept this paradigm or
worldview of discipline in major concepts selected for study and statements about major
5 | P a g estatements that define them in a global matter.
REF: Dental Hygiene’s Paradigm | 5
8. Which of the following is not one of the four major concepts of paradigm for the dental
hygiene discipline?
a. Client
b. Health and oral health
c. Environment
d. Nutrition
ANS: D
Client. This answer is a major concept of paradigm because the client is the recipient of dental
hygiene care.
Health and oral health. This answer is a major concept of paradigm because the discipline of
dental hygiene exists to promote oral health, which influences overall health.
Environment. This answer is a major concept of paradigm because factors other than dental
hygiene actions affect the client’s attainment of optimal oral health.
Nutrition. This answer is not a major concept of paradigm because nutrition does not identify
the phenomena central to the discipline of dental hygiene in an abstract global manner.
REF: BOX 1-3: Four Major Concepts of the Dental Hygiene Paradigm | 6
9. The importance of a conceptual model is to provide philosophic and practical perspectives
about dental hygiene’s paradigm concepts. Dental hygiene’s paradigm is operationalized
via the Human Needs Conceptual Model.
a. Both statements are true.
b. The first statement is true, and the second statement is false.
c. The first statement is false, and the second statement is true.
d. Both statements are false.
ANS: A
Both statements are true. Conceptual models do provide philosophic and practical
perspectives about dental hygiene’s paradigm concepts; however, the models can explain
dental hygiene from different perspectives as well. Also, the Human Needs Conceptual
Model defines the paradigm concepts.
The first statement is true; the second statement is false. Both statements are
true. The first statement is false; the second statement is true. Both statements
are true. Both statements are false. Both statements are true.
REF: Conceptual Models | 6
10. What occurs when individuals with differing strengths and areas of expertise work together
as equal partners to achieve better outcomes than each would achieve working alone?
a. Implementation
b. Collaboration
c. Determination
d. Concentration
ANS: B
Implementation. This answer is incorrect because by definition implementation is the act of
putting something into effect. Implementing something can be done individually.
Collaboration. This answer is correct and is demonstrated in the Collaborative Practice
Model, which assumes that dentists and dental hygienists work together as colleagues.
Determination. This answer is incorrect because determination does not require partners of
differing strengths. Determination can be achieved individually by staying focused on the task
6 | P a g eat hand.
Concentration. This answer is incorrect because concentration is just maintaining a strong
focus on the task at hand. Collaboration can be done more efficiently if the partners are
concentrated but is not required.
REF: Collaborative Practice Model | 6
11. What is the collaborative practice conceptual model?
a. Dentist and dental hygienist work together as colleagues, each offering
professional expertise for the goal of providing optimum oral healthcare to the
public
b. Model describing the best methods of dentist and dental hygienist to work as
a team
c. Model showing how collaboration produces better work
d. Dental hygienists and other healthcare professionals work together as
colleagues, each offering professional expertise for the goal of providing
optimum oral healthcare to the public
ANS: A
Dentist and dental hygienists work together as colleagues, each offering professional expertise
for the goal of providing optimum oral healthcare to the public.
Model describing the best methods of dentist and dental hygienist to work as a team. This
answer is incorrect because the focus and main goal of the model is to provide optimum
oral healthcare to the public, not to learn to work as a team.
Model showing how collaboration produces better work. This answer is incorrect because the
model focuses on providing optimum oral healthcare to the public. Collaboration between a
dentist and dental hygienist is just an assisting factor to reach optimum oral healthcare.
Dental hygienists and other healthcare professionals work together as colleagues, each
offering professional expertise for the goal of providing optimum oral healthcare to the public.
This answer is incorrect because the collaboration must be between a dentist and a dental
hygienist. This plays a key role in establishing a co-therapist relationship within the
Collaborative Practice Conceptual Model.
REF: Collaborative Practice Model | 6-7
12. Which is not one of the five interrelated roles of a professional dental hygienist?
a. Educator
b. Manager
c. Researcher
d. Clients
ANS: D
Educator. This is one of the five interrelated roles of a professional dental hygienist. An
educator explains concepts regarding oral health and disease, and their relationship to
general health; demonstrates oral self-care procedures; determines client understanding;
motivates behavior change; reinforces learning or desired behavior; and evaluates the client’s
progress in learning.
Manager. This is one of the five interrelated roles of a professional dental hygienist. A
manager’s position is to guide and direct the work of others. They do this by planning, making
decisions, organizing, staffing, directing, and controlling.
Researcher. This is one of the five interrelated roles of a professional dental hygienist. A
researcher tests the assumptions of clinical practice.
Clients. This is not one of the five interrelated roles of a professional dental hygienist. The
client is the individual receiving oral healthcare from the dental hygienist.
REF: Roles | 2-5
7 | P a g e13. According to the Occupational Model, the dental hygienist:
a. uses a process of care to assess needs, diagnose dental hygiene problems,
and plan, implement, evaluate, and document dental hygiene care.
b. works together with the dentist, each offering professional expertise for the goal
of providing optimum oral healthcare to the public.
c. is a dental auxiliary who implements treatment plans and carries out
isolated duties as directed by the supervising dentist.
d. explains dental hygiene from different perspectives.
ANS: C
The Occupational Model5 presents the concept of dental hygiene actions as technically
based. According to this model the dental hygienist is a dental auxiliary who implements
treatment plans and carries out isolated duties as directed by the supervising dentist.
REF: Chapter One, Conceptual Models | 6
14. Which of the following is not a setting for a dental hygiene researcher?
a. Clinical practice
b. Research institutions
c. Hospitals
d. Oral healthcare industry
e. Public school programs
ANS: C
Clinical practice. This is a setting for a dental hygiene researcher because researchers
are testing assumptions from clinical practices. Researchers may go to the clinical
practice to assess the area of study.
Research institutions. This is a setting for a dental hygiene researcher because this is a
place where research is the prime goal and source of employment. Researchers gather
together here and are able to collaborate with one another if necessary.
Hospitals. This is not a setting for a dental hygiene researcher because a hospital is not
primarily focused on oral healthcare, rather it is focused on the overall health of an individual.
A researcher would not have the information or materials needed to do their studies.
Oral healthcare industry. This is a setting for a dental hygiene researcher because the
oral healthcare industry is the field that they are studying or researching. By working
within the oral healthcare industry, the researchers can make evidence-based decisions.
Public school programs. This is a setting for a dental hygiene researcher because this is
a place where the researcher can transmit current concepts of health promotion and
disease prevention to individuals and groups, and evaluate the educational outcomes.
REF: Researcher | 3
15. The three responsibilities of the dental hygiene clinician are:
a. preventive, therapeutic, educational.
b. manager, educator, researcher.
c. planner, organization of appointments, billing.
d. communicator, planner, researcher.
ANS: A
Preventive, therapeutic, educational. This answer is correct because a dental hygiene
clinician is expected to fulfill these areas. Preventive methods are created to promote health
and prevent oral disease. Therapeutic methods are created to arrest or control oral disease.
Educational methods are created to reinforce learning, evaluate understanding,
demonstrate self-care techniques, determine ability to perform desired behavior, and
8 | P a g eexplain oral disease and health concepts.
Manager, educator, researcher. This answer is incorrect because these are not
responsibilities; instead they are roles that can be played by dental hygienists based on the
degree of education. Planner, organization of appointments, billing. This answer is incorrect
because these are the responsibilities of an administrator or manager.
Communicator, planner, researcher. This answer is incorrect because these are the
responsibilities of a researcher.
REF: BOX 1-2: Responsibilities of the Dental Hygiene Clinician | 3
16. What is an administrator or manager not doing when referring to dental hygiene?
a. Planning
b. Staffing
c. Financial work
d. Directing
ANS: C
Planning. This is done by an administrator to acknowledge priorities and decide on
appropriate continuing care intervals and self-care measures.
Staffing. This is done by an administrator to create a knowledgeable and stable staff, and to
determine the line of authority and responsibilities of each co-worker.
Financial work. This is not done by an administrator because financial work does not relate
to the job of an administrator, which is to guide and direct the work of others.
Directing. This is done by an administrator while managing a professional educational
program and possibly serving as a dean for various schools.
REF: Administrator | 5
17. When considering the key roles of a dental hygienist, what does the client advocate most
refer to?
a. A dental hygienist who is working with the state legislature to change the dental
practice act
b. Dental hygienist’s role in protecting and supporting clients’ rights and well-being
c. A person whose official position is to guide and direct the work of others
d. A dental hygiene educator who is employed as a full-time faculty member
ANS: B
A dental hygienist who is working with the state legislature to change the dental practice act.
This answer is incorrect because it does not directly relate to the client.
Dental hygienist’s role in protecting and supporting clients’ rights and well-being. This is
correct because the definition directly links to the client’s best interests.
A person whose official position is to guide and direct the work of others. This is incorrect
because this is the key role of an administrator or manager.
A dental hygiene educator who is employed as a full-time faculty member. This is incorrect
because this is a role of an educator.
REF: What Is the Dental Hygiene Process of Care? | 1-2
18. A dental hygienist keeps up-to-date with the rapidly changing art and science of
dental hygiene by doing all of the following, except one. Which one is the exception?
a. Discussing updated techniques with other dental hygienists
b. Making evidence-based decisions
c. Using multiple research skills
d. Practicing at least part-time as a dental hygienist
ANS: A
9 | P a g eDiscussing updated techniques with other dental hygienists. This is not done to stay up-to-
date with the art and science of dental hygiene. Although discussing with other dental
hygienists will draw conversation to new changes, further research and analyzing must be
done to fully understand the rapid changes in the art and science of dental hygiene.
Making evidence-based decisions. This is done to stay up-to-date with the art and science of
dental hygiene. By looking in-depth at scientific evidence, client preferences or values,
clinical client circumstances, and experiences and judgment, dental hygienists can draw
conclusions and remain up-to-date in the discipline of dental hygiene.
Using multiple research skills. This is done to stay up-to-date with the art and science of
dental hygiene. Multiple research skills should be used to find relevant evidence and
critical appraisal skills to rapidly evaluate and sort out what is valid and useful.
Practicing at least part-time as a dental hygienist. This is done to stay up-to-date with the
art and science of dental hygiene. By staying involved in the discipline of dental hygiene,
more and more information can be learned. There are many different roles that a
professional can play as a dental hygienist; any of these roles will keep a dental hygienist
up-to-date with the rapid changes.
REF: Researcher | 3
19. What is accreditation?
a. The process of explaining the concepts of oral health and their relationship
to general health
b. The process of guiding and directing of the work of others so that they can
become certified
c. The process of researching a specific topic and analyzing it
d. A formal, voluntary nongovernmental process that establishes a minimum set
of national standards that promotes and ensures quality in education
ANS: D
The process of explaining the concepts of oral health and their relationship to general
health. This answer is incorrect because this statement is explaining the role of an educator.
The process of guiding and directing of the work of others so that they can become
certified. This answer is incorrect because guiding and directing the work of others is a role
played by an administrator.
The process of researching a specific topic and analyzing it. This answer is incorrect
because this process is performed by a dental hygienist researcher.
A formal, voluntary nongovernmental process that establishes a minimum set of national
standards that promotes and ensures quality in education. This answer is correct because
accreditation is given to institutions or programs to ensure that the education being taught is
proper and accurate.
REF: Accreditation | 8
20. What professional organization promotes the profession of dental hygiene globally?
a. ADHA
b. NDHA
c. CDHA
d. IFDH
ANS: D
ADHA. This answer is incorrect because the professional organization is limited to the United
States.
NDHA. This answer is incorrect because the professional organization specifically focuses on
minority professionals.
CDHA. This answer is incorrect because the professional organization is limited to Canada.
IFDH. This answer is correct because the professional organization includes several countries
10 | P a g eand focuses on worldwide issues of dental hygiene. REF: International Federation of Dental Hygienists | 9-10
21. What is the one most important reason why state dental practice laws were established? a. To regulate the practice of dental hygiene and dentistry b. To regulate the amount of education one must have to practice dentistry c. To ensure the best overall service to the general public d. To protect the health and welfare of the public
ANS: A To regulate the practice of dental hygiene and dentistry. This answer is correct because regulating the practice will ensure all criteria are met and education is fulfilled properly. The practice will be able to run smoothly in each state, ensuring beneficial service to the public. To regulate the amount of education one must have to practice dentistry. This answer is incorrect because the amount of education one must have to practice dentistry is similar for all states so that relocating can be more easily accomplished.
Content preview
Test Bank Darby & Walsh Dental Hygiene Theory and Practice, 4th Edition
Table of Contents
Chapter 01: The Dental Hygiene Profession ........................................................................................ 3
Chapter 02: Human Needs Theory and Dental Hygiene Care............................................................ 12
Chapter 03: Evidence-Based Decision Making .................................................................................. 21
Chapter 04: Health and Health Promotion .......................................................................................... 28
Chapter 05: Changing Behaviors ....................................................................................................... 37
Chapter 06: Cultural Competence ...................................................................................................... 44
Chapter 08: The Dental Hygiene Care Environment ........................................................................... 49
Chapter 10: Medical Emergencies ..................................................................................................... 55
Chapter 11: Ergonomics .................................................................................................................... 63
Chapter 12: The Health History .......................................................................................................... 66
Chapter 13: Vital Signs ...................................................................................................................... 73
Chapter 14: Pharmacologic History.................................................................................................... 79
Chapter 15: Extraoral and Intraoral Clinical Assessment .................................................................... 89
Chapter 16: Dentition Assessment ..................................................................................................... 95
Chapter 17: Oral Hygiene Assessment: Soft and Hard Deposits ..................................................... 103
Chapter 18: Dental Caries Management by Risk Assessment ......................................................... 108
Chapter 19: Periodontal and Risk Assessment................................................................................. 112
Chapter 20: Potential Impact of Periodontal Infections on Overall General Health ........................... 120
Chapter 21: Dental Hygiene Diagnosis ............................................................................................ 130
Chapter 22: Dental Hygiene Care Plan, Evaluation, and Documentation.......................................... 139
Chapter 23: Toothbrushing............................................................................................................... 149
Chapter 24: Mechanical Oral Biofilm Control: Interdental and Supplemental Self-CareDevices ........ 155
Chapter 25: Dentifrices .................................................................................................................... 167
Chapter 26: Hand-Activated Instrumentation.................................................................................... 173
Chapter 27: Ultrasonic Instrumentation ............................................................................................ 182
Chapter 28: Root Morphology and Instrumentation Implications ...................................................... 188
Chapter 29: Stain Management and Tooth Whitening ...................................................................... 195
Chapter 30: Decision Making Related to Nonsurgical Periodontal Therapy ...................................... 202
Chapter 31: Chemotherapy for the Control of Periodontal Disease .................................................. 214
Chapter 32: Acute Gingival and Periodontal Conditions, Lesions of Endodontic Origin,and Avulsed
Teeth ............................................................................................................................................... 220
Chapter 33: Fluorides, Chlorhexidine, Amorphous Calcium Phosphate, and Xylitol ......................... 222
Chapter 34: Pit and Fissure Sealants ............................................................................................... 229
Chapter 35: Nutritional Counseling .................................................................................................. 232
Chapter 36: Tobacco Cessation ....................................................................................................... 239
Chapter 37: Impressions, Study Casts, and Oral Appliances ........................................................... 247
Chapter 38: Restorative Therapy ..................................................................................................... 252
1|Page
,Chapter 39: Dentinal Hypersensitivity Management ......................................................................... 260
Chapter 40: Local Anesthesia .......................................................................................................... 267
Chapter 41: Nitrous Oxide–Oxygen Analgesia ................................................................................. 274
Chapter 42: Persons with Disabilities ............................................................................................... 280
Chapter 43: Cardiovascular Disease ................................................................................................ 288
Chapter 44: Diabetes Mellitus .......................................................................................................... 297
Chapter 45: Oral Care of Persons with Cancer ................................................................................ 305
Chapter 46: Human Immunodeficiency Virus Infection ..................................................................... 313
Chapter 47: Persons with Neurologic and Sensory Deficits .............................................................. 322
Chapter 48: Persons with Autoimmune Diseases ............................................................................. 329
Chapter 49: Renal Disease and Organ Transplantation.................................................................... 338
Chapter 50: Respiratory Diseases ................................................................................................... 346
Chapter 51: Cognitively and Developmentally Challenged Persons ................................................. 353
Chapter 52: Alcohol and Substance Abuse Problems ...................................................................... 360
Chapter 53: Eating Disorders ........................................................................................................... 365
Chapter 54: Women’s Health and the Health of Their Children ........................................................ 372
Chapter 55: The Older Adult............................................................................................................. 381
Chapter 56: Persons with Fixed and Removable Dental Prostheses ............................................... 389
Chapter 57: Orofacial Clefts and Fractured Jaw ............................................................................... 396
Chapter 58: Osseointegrated Dental Implants.................................................................................. 402
Chapter 59: Persons with Orthodontic Appliances............................................................................ 409
Chapter 60: Abuse and Neglect ....................................................................................................... 418
Chapter 61: Palliative Oral Care....................................................................................................... 426
Chapter 62: Practice Management................................................................................................... 433
Chapter 63: Career Planning and Job Searching ............................................................................. 441
2|Page
,Chapter 01: The Dental Hygiene Profession
MULTIPLE CHOICE
1. What is the discipline of dental hygiene?
a. The study of teeth and their supporting structures
b. Brushing and flossing one’s teeth and rinsing with an antimicrobial mouth rinse
twice a day, morning and night
c. The study of preventive oral healthcare, including the management of behavior
toprevent oral disease and promote health
d. The study of those procedures that dental hygienists provide to clients
ANS: C
The study of teeth and their supporting structures. This answer is wrong because the
disciplineof dental hygiene covers much more information than the study of teeth and
supporting structures. Dental hygiene focuses on the preventive measures that the teeth and
supporting structures must receive, in addition to other oral healthcare steps that must be
taken to promote one’s health.
Brushing and flossing one’s teeth and rinsing with an antimicrobial mouth rinse twice a day,
morning and night. This answer is wrong because this statement describes only one procedure
within the discipline of dental hygiene. Dental hygiene is a much larger and general field of
study than this simple preventive action.
The study of preventive oral healthcare including the management of behavior to prevent
oraldisease and promote health. This answer is correct because this is the direct definition
of dental hygiene. The definition can be broken down into smaller, specified divisions to
furtherdevelop the discipline of dental hygiene.
The study of those procedures that dental hygienists provide to clients. This answer is wrong
because dental hygienists play many interrelated roles, such as clinician, educator,
administrator or manager, advocate, and researcher. Although each of these roles is created
toassist in dental hygiene, the discipline is not centered on the actions and procedures of the
dental hygienist.
REF: What is Dental Hygiene? | 1
2. Who is the professional dental hygienist?
a. A licensed preventive oral health professional who has graduated from a
Commission on Dental Accreditation, accredited, entry level dental hygiene
program
b. A licensed person who has learned on the job via a preceptorship program, such
asthe Alabama Dental Hygienists Program
c. A dentist who has graduated from a Commission on Dental
Accreditation,accredited, dental school program
d. A person who has graduated from a Commission on Dental
Accreditation,accredited, dental assisting program
ANS: A
A licensed preventive oral health professional who has graduated from a Commission on
Dental Accreditation, accredited, entry level dental hygiene program. This answer is correct
because to be eligible as a professional dental hygienist, the person must have graduated
froman accredited dental hygiene program.
A licensed person who has learned on the job via a preceptorship program, such as the
Alabama Dental Hygienists Program. This answer is wrong because a dental hygienist
cannotlearn on the job to become a professional. Rather, they must pass written
examinations and graduate from an accredited dental hygiene program.
A dentist who has graduated from a Commission on Dental Accreditation, accredited,
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, dentalschool program. This answer is wrong because a dentist has a higher degree than a
dental hygienist and therefore, generally, works above a dental hygienist. It is not
necessary for a dental hygienist to receive an education from a dental school.
A person who has graduated from a Commission on Dental Accreditation, accredited,
dentalassisting program. This answer is wrong because a person graduating from an
accredited dental assisting program would only be licensed as a dental assistant.
REF: Who Is the Dental Hygienist? | 1
3. All of these services are provided by the majority of dental hygienists in the clinical setting
except one. Which one is the exception?
a. Perform periodontal maintenance care.
b. Implement interventions to direct a person back to oral wellness.
c. Provide fluoride varnish treatment.
d. Place and remove restorations.
ANS: D
Perform periodontal maintenance care. This is a service provided in the clinical setting. The
clinical setting allows for application of preventive and therapeutic agents related to
periodontal disease. For example: subgingival sustained-release delivery systems containing
chlorhexidine.
Implement interventions to direct a person back to oral wellness. This is a service provided
inthe clinical setting. The main goal of a dental hygienist is to prevent oral disease and
promotehealth. Therefore, if the state of an individual’s oral health changes, the dental
hygienist (within the scope of the clinical setting) can provide some degree of intervention to
direct theindividual back to oral wellness.
Provide fluoride varnish treatment. This is a service provided in the clinical setting. The
clinical setting allows for application of preventive and therapeutic agents related to dental
caries. Fluoride varnish treatments prolong fluoride exposure on the tooth surface for safe
andeffective caries control.
Place and remove restorations. This service is not provided by the majority of dental
hygienists in the clinical setting. Only a few dental hygienists have the certification to place
restorations, while many others do not. Also, the removal of restorations is not a given
actionof a dental hygienist in the clinical setting.
REF: Clinician | 3
4. Which of the following is a key behavior within the dental hygiene process of care?
a. Observation
b. Diagnosis
c. Communication skills
d. Client care
ANS: B
Observation. This answer is wrong because dental hygienists must go further than simply
observing the client. The hygienist must assess the client by thoroughly collecting data.
Diagnosis. This answer is correct because identifying the diagnosis is the focal point for
establishing goals in the dental hygiene care plan. The client’s dental hygiene needs are
determined so that specific interventions can be implemented.
Communication skills. This answer is wrong because the communication skills are not a key
behavior and are not necessary to complete the dental hygiene process.
Client care. This answer is wrong because client care is not one of the steps in dental
hygienecare. However, proper client care is the goal being achieved through the key
behaviors.
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