Using Preventive Agents
QUESTIONS
1. Which of the following statements describes the incorporation of chemotherapeutic agents in the control of bacterial components of plaque biofilm?
A Replaces brushing and flossing
B Supplements brushing and flossing
2. Which of the following fluoride compounds is NOT used in professionally administered fluoride products to prevent dental caries?
3. For each chemotherapeutic agent listed, select the MOST closely linked description on the agent’s use from the list provided.
| Chemotherapeutic Agent | Use |
| _____ 1. MI paste and NuvaMin | A. Added to dentifrices to control gingivitis as well as dental caries; does not usually cause staining at the low dose required for dentifrice |
| _____ 2. Hydrogen peroxide | B. Added to dentifrices to control formation of supramarginal calculus |
| _____ 3. Pyrophosphates | C. Complex of casein phosphopeptides and amorphous calcium phosphate; used to manage dental caries by enhancing remineralization, especially in patients with inadequate saliva |
| _____ 4. Quaternary ammonium compound | D. Broad-spectrum antimicrobial detergent formulation added to dentifrices as an antiplaque, antigingivitis, and antiinflammatory agent |
| _____ 5. Recaldent chewing gum | E. Only fluoride used for water fluoridation and in professionally applied fluoride treatments |
| _____ 6. Sodium fluoride | F. Releases oxygen for antimicrobial effect to reduce gingivitis and malodor; used in treatment of NUG |
| _____ 7. Sodium bicarbonate | G. Mouth rinse that binds to oral tissues; side effects include a burning sensation in the oral soft tissues and epithelial desquamation |
| _____ 8. Stannous fluoride | H. Amorphous calcium phosphate complex added to prophylaxis paste and professionally dispensed dentifrice to enhance remineralization |
| _____ 9. Triclosan | I. Used to neutralize acid after vomiting in patients with bulimia or those undergoing chemotherapy |
4. Which of the following additives has been shown to control dental caries by preventing the transmission of cariogenic bacteria from mother to infant?
5. Which of the following over-the-counter mouthrinses has been accepted by the ADA and approved by the FDA to control and treat plaque biofilm and gingivitis?
6. All the following are effective ways to control volatile sulfur compounds (VSC)–producing organisms that cause breath malodor EXCEPT one. Which one is the EXCEPTION?
7. Chlorhexidine has been shown to be effective as an antimicrobial to control dental caries in patients who are at high risk for caries. The recommended protocol is the same as that used to control gingivitis.
C The first statement is true, and the second statement is false.
D The first statement is false, and the second statement is true.
8. Which of the following is considered the major mechanism of action of fluoride in the inhibition of dental caries progression?
A Antimicrobial effect on acidogenic bacteria
B Enhancement of remineralization in the demineralization–remineralization cycle
C Formation of fluorapatite during the development of enamel prior to eruption
D Inhibition of demineralization through fluoride adsorption by enamel mineral crystals
9. Which of the following dentifrice ingredients should be avoided if a nonabrasive dentifrice is recommended?
10. Which of the following actions should be performed before the placement of dental sealants?
11. Pit and fissure sealants should be used in combination with fluorides for prevention of other types of caries because they are primarily effective in preventing pit and fissure caries.
A Both the statement and reason are correct and related.
B Both the statement and reason are correct but not related.
C The statement is correct, but the reason is not.
12. The emphasis in toothbrushing instruction to prevent and control gingivitis and mild to moderate periodontitis should be on developing and maintaining an effective technique. The emphasis on toothbrushing to prevent and control dental caries should be on increasing the frequency and duration of brushing with fluoride toothpaste.
C The first statement is true, and the second statement is false.
D The first statement is false, and the second statement is true.
13. Which of the following foods naturally contains the MOST fluoride?
14. Fluoride is stored in the body in which of the following two locations?
15. Ingested fluoride is excreted primarily through saliva. Excretion of fluoride through saliva is the reason that water fluoridation has posteruptive caries reduction benefits in both children and adults.
C The first statement is true, and the second statement is false.
D The first statement is false, and the second statement is true.
16. Fluoride supplements are recommended by the FDA because research has shown them to be safe to the developing fetus. Research has demonstrated that fetal plasma fluoride levels increase as a result of prenatal fluoride supplementation, but the benefit of prenatal fluoride to the child is minimal.
C The first statement is true, and the second statement is false.
D The first statement is false, and the second statement is true.
17. Which of the following first aid steps should be taken FIRST if a child swallows a toxic dose of fluoride?
18. When the fluoride ion replaces the hydroxyl ion in the enamel structure, which of the following is the MOST stable result?
19. Which of the following statements is MOST correct regarding the benefits of water fluoridation?
A The benefits of water fluoridation continue even after it is discontinued.
B Water fluoridation does not benefit adults because their teeth have already erupted.
C Partial exposure to water fluoridation provides benefits in proportion to the amount of fluoride in the water.
D Because of current multiple exposures to fluorides, water fluoridation is no longer considered cost effective and is not recommended by public health experts.
20. Which of the following is the MOST commonly used fluoride compound in water fluoridation?
21. Mild to moderate fluorosis occurs at which of the following parts per million (ppm) levels?
22. Which of the following are benefits of water fluoridation? (Select all that apply.)
B Reduction of childhood caries
C Savings in dental treatment costs
23. There are greater caries reduction benefits from combining several methods of self-administered topical fluoride products with water fluoridation rather than one method alone. Combining several methods of topical fluorides and water fluoridation will cause fluorosis in the adult patient.
C The first statement is true, and the second statement is false.
D The first statement is false, and the second statement is true.
24. School water fluoridation requires adjustment of the amount of fluoride to four to five times the optimal level that is required to fluoridate the community water supply. School water fluoridation is no longer recommended by the Centers for Disease Control and Prevention (CDC).
C The first statement is true, and the second statement is false.
D The first statement is false, and the second statement is true.
25. A 5-year-old child presents to the dental office in a community in which the water is not fluoridated and the natural level of fluoride in the water is 0.2 ppm. Which of the following daily dosages of sodium fluoride (NaF) supplement tablets should be prescribed for this child?
26. Which of the following is the LOWEST probable toxic dose (PTD) of fluoride for a child who weighs 20 kilograms?
27. All of the following statements are true EXCEPT one. Which one is the EXCEPTION?
A Fluorosis can be controlled in the population by controlling the risk factors.
B The trend in the United States is an increase in the prevalence of slight fluorosis in children.
C The new CDC recommendation to reduce fluoride levels in water supplies indicates that some public health care professionals consider the level of fluorosis to be a public health problem.
D The rate of fluorosis is continuing to increase because of the high level of fluoride in children’s toothpaste.
28. Detergent ingredients in dentifrices help loosen debris through their foaming action. An example of a detergent is sodium lauryl sulfate.
C The first statement is true, and the second statement is false.
D The first statement is false, and the second statement is true.
29. A patient presents with sloughing of the oral mucosa that has been present for 1 week and wonders why his gingival tissue is peeling. Which is the MOST likely cause for the patient’s condition?
30. Your patient has just concluded orthodontics therapy and is upset about the white areas in the former location of the brackets. Which of the following would be the BEST dentifrice recommendation for this patient?
A Anticaries dentifrice with fluoride
B Antiplaque dentifrice with triclosan
C Whitening dentifrice to even out enamel coloration
D Remineralization dentifrice with fluoride and calcium phosphate
31. All of the following are important considerations for a mouth rinse marketed for xerostomia EXCEPT one. Which one is the EXCEPTION?
32. One suitable option for an antiplaque mouth rinse recommendation is chlorhexidine. Chlorhexidine is readily available as an over-the-counter medication.
C The first statement is true, and the second statement is false.
D The first statement is false, and the second statement is true.
33. Which of the following characteristics represent ideal properties of an antimicrobial mouth rinse? (Select all that apply.)
34. Which of the following products are commonly associated with staining of teeth, tongue, and tooth-colored restorations? (Select all that apply.)
35. Sugar-free gums primarily use xylitol or sorbitol for their sweetening agents. Chewing gum may be a useful home care recommendation to stimulate saliva.
C The first statement is true, and the second statement is false.
D The first statement is false, and the second statement is true.
36. Which of the following situations are indications for placement of a dental sealant? (Select all that apply.)
37. Which of the following BEST describes the purpose of using an etchant or tooth conditioner during the sealant application process?
A Bonds the sealant material to the tooth
B Increases the surface area for the sealant material
38. If a sealant was lost within the first couple of months after application, which would be the MOST likely cause of failure?
39. Sealant material often contains filler particles. The purpose of the filler is to make the sealant more resistant to abrasion and wear.
C The first statement is true, and the second statement is false.
D The first statement is false, and the second statement is true.
40. Modern sealant products polymerize or “cure” through use of a blue light source. The disadvantage of using a light-cured system is that clinicians may experience wrist fatigue if necessary precautions are not utilized.
C The first statement is true, and the second statement is false.
D The first statement is false, and the second statement is true.
41. Which of the following BEST describes the purpose for the use of a sealant material with fluoride added?
A It increases the long-term retention of the sealant.
B It adds to the resistance against wear and abrasion.
C It acts as a long-term reservoir for fluoride in the oral cavity.
D It inhibits caries growth in the enamel surrounding the sealant.
42. When preparing a tooth for sealant placement, the amount of time required for the acid etchant to remain in place depends on the operator’s clinical judgment. If the tooth surface presents with a white chalky or frosty appearance on drying after rinsing the etchant, it is a good clinical indicator that the etching period was insufficient and should be repeated.
C The first statement is true, and the second statement is false.
D The first statement is false, and the second statement is true.
43. Which of the following represents the ADA’s recommendation for maintaining a dry field during sealant placement?
44. Which of the following strategies serve as effective patient management tools during sealant placement in children? (Select all that apply.)
A Use an assistant whenever possible.
B Have the parent stay in the treatment area.
C Keep the child distracted and calm through conversation.
D Have all supplies and materials ready before seating the child.
E Employ the “Tell, Show, Do” strategy to avoid any surprises.
45. Which of the following concentrations of neutral sodium fluoride is considered a professionally applied fluoride (in-office-administration) agent?
46. Which of the following formulations are considered professionally applied fluoride products and have been approved by the FDA for in-office use? (Select all that apply.)
47. When fluoride reacts with stomach acid, the reaction product is hydrogen fluoride. The initial symptoms of chronic fluoride toxicity are nausea, gastrointestinal pain, and vomiting.
C The first statement is true, and the second statement is false.
D The first statement is false, and the second statement is true.
48. The purpose of converting neutral sodium fluoride into acidulated phosphate fluoride is to lower the pH of the product. Evidence-based research indicates that a pH of 4 or lower enhances fluoride uptake.
C The first statement is true, and the second statement is false.
D The first statement is false, and the second statement is true.
49. Which of the following items are considered antibacterial agents for dental caries? (Select all that apply.)
50. Topically applied fluorides are most effective for prevention of dental caries formation in the pits and fissures of teeth. Dental sealants should be the primary preventive consideration by the dental hygienist for reduction in pit and fissure caries of teeth.
C The first statement is true, and the second statement is false.
D The first statement is false, and the second statement is true.
51. Which of the following are the methods of classification for sealants? (Select all that apply.)
52. The dental hygienist has finished placing a pit and fissure sealant and discovers a bubble in the cured sealant material. Which of the following actions is MOST appropriate?
A Using a high-speed hand piece and smooth the surface
B Adding more sealant material and polymerizing the area
C Leaving the bubble; mastication will remove the imperfection
D Reetching, washing and drying the tooth, and applying additional material
53. Dental sealants may be filled or unfilled resins or glass ionomers that contain fluoride. Glass ionomer sealants are the sealant of choice for occlusal surfaces.
C The first statement is true, and the second statement is false.
D The first statement is false, and the second statement is true.
54. During the placement of dental sealants, which of the following is used as an etching agent?
55. Continuous use of fluoridated water from birth may result in 40% to 65% fewer carious lesions. Anterior teeth, particularly maxillary anterior teeth, receive more protection from fluoride compared with posterior teeth because of the direct contact of drinking water as it passes into the mouth and earlier eruption dates.
C The first statement is true, and the second statement is false.
D The first statement is false, and the second statement is true.
56. Fluoride is added to the surface of enamel before tooth eruption. The uptake of fluoride depends on the level of fluoride in the oral environment and the length of time of exposure.
C The first statement is true, and the second statement is false.
D The first statement is false, and the second statement is true.
57. Which of the following conditions can be prevented by a fixed or removable prosthodontic appliance?
58. Which of the following preventive measures can be beneficial in the reduction of anterior disc displacement (RADD) and/or control the symptoms?
59. Which of the following is a best practice for the use of an oral irrigator?
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