Question 1

When performing a coronal polish, all of the following areas should be avoided EXCEPT one. Which one is the EXCEPTION?

Accepted Answer

Removal of unsightly dental stains on anterior teeth may contribute to improving the client ' s appearance and self-esteem.

Question 2

The straight calibrated periodontal probe can be used for all of the following assessment procedures EXCEPT one. Which one is the EXCEPTION?

Accepted Answer

The straight-calibrated probe can be used for all listed assessment procedures EXCEPT for the assessment of dental restorations.

Question 3

A periodontal instrument has the following design features: The face is perpendicular to the lower shank, the cutting edges are level with each other, and the working end has a rounded toe. Which of the following instruments also exhibits these design criteria?

Accepted Answer

A universal curet has level cutting edges that are perpendicular to the lower shank and a working end with a rounded toe.

Question 4

During periodontal instrumentation for calculus removal, the clinician's hand becomes fatigued. Self-assessment indicates he has been using finger motion with a hand instrument for calculus removal. Digital activation is acceptable for all of the following situations EXCEPT one. Which one is this EXCEPTION?

Accepted Answer

Wrist motion activation provides effective calculus removal without undue stress to the clinician ' s muscles.

Question 5

When the clinician puts a new mouth mirror in the client's mouth, she notices the image is distorted. What is the most reasonable explanation for this?

Accepted Answer

Mirrors with a concave reflective surface cause image distortion.

Question 6

An intraoral fulcrum is accomplished by establishing a finger rest near the tooth to be instrumented. Establishing a finger rest as close as possible to the working end of the instrument is preferable so the fingers in the grasp will remain touching.

Accepted Answer

The finger rest should be near to the tooth to be instrumented. The finger rest should not be so close to the working end that the clinician ' s finger is in the line of the stroke (so that when a stroke is made, the working end could puncture the glove and knick the clinician ' s finger).

Question 7

Tooth #8 is restored with a porcelain-fused-to-metal crown. Which of the following instruments is contraindicated for use around tooth #8?

Accepted Answer

An ultrasonic tip should not be used around porcelain crowns.

Question 8

The client started gagging on the ultrasonic's water spray, so the clinician decides to use a hand instrument to remove a tenacious, moderate calculus deposit on the facial surface of tooth #31. The calculus deposit is located supragingivally on the crown of the tooth. Which of the following instruments would you choose?

Accepted Answer

A posterior sickle scaler is an ideal choice to remove a tenacious supragingival deposit from the facial surface.

Question 9

A suspected carious lesion on the occlusal surface of tooth #19 is BEST detected by applying firm pressure with the sharp tip of an explorer to the occlusal grooves. Catching the tip of the explorer in the grooves of a tooth is a recommended method of caries detection.

Accepted Answer

Both statements are false. Firm application of a sharp explorer tip may cause additional damage to the tooth surface and can interfere with remineralization; in addition, research has shown this technique to be unreliable for carious lesion detection.

Question 10

To remove light subgingival calculus from the furcation area of a mandibular molar, which of the following instruments would be MOST efficient?

Accepted Answer

A Gracey curet with an extended shank and a miniature working end would facilitate access to the furcation area.

Question 11

The clinician determines that many of the client's multiple-rooted teeth have loss of clinical attachment. This information should prompt the clinician to use the following instrument to assess for possible furcation involvement.

Accepted Answer

A set of calibrated Nabers probes are the ideal instruments for assessing furcation areas; their working-end design facilitates access to furcation areas.

Question 12

The client's mandibular anterior teeth are in linguoversion and are crowded. The clinician is having difficulty accessing the lingual surfaces of these mandibular anterior teeth. Which of the following patient positioning suggestions is BEST to ensure an ergonomic instrumentation technique?

Accepted Answer

The chin-down client position provides the best view of the lingual aspect of the mandibular anterior te eth, provides the best access to this treatment area, and facilitates parallelism of the lower shank to the tooth surface.

Question 13

Which of the following ultrasonic tips would be MOST efficient for removing the heavy ledge of supragingival calculus on the client's mandibular anterior sextant, lingual aspect?

Accepted Answer

The beavertail ultrasonic tip would be effective in removing a ledge of supragingival calculus.

Question 14

To minimize client discomfort during root surface debridement in periodontal pockets, the clinician should use caution when inserting a universal curet beneath the gingival margin. The face-to-tooth surface angulation during insertion of the working end beneath the gingival margin is between:

Accepted Answer

Face-to-tooth surface angulation of 0 to 40 degrees facilitates insertion benea th the gingival margin and places the rounded back of the curet against the soft tissue wall of the sulcus or pocket.

Question 15

A posterior sickle is effective in removing moderate calculus deposits from the coronal surfaces of premolars and molars. A posterior sickle is a double-ended instrument that can be used on the facial, lingual, mesial, and distal surfaces of the crowns of posterior teeth.

Accepted Answer

Both statements are true.

Question 16

While removing calculus from the maxillary anterior tooth surfaces toward the clinician, good adaptation of the toe-third of the working end is facilitated by:

Accepted Answer

All listed techniques contribute to proper instrument adaptation on the maxill ary anterior surfaces toward the clinician.

Question 17

Before beginning calculus removal, the clinician uses an explorer to determine the type, amount, and location of calculus deposits. Which of the following explorers is NOT recommended for calculus detection?

Accepted Answer

A Shepherd ' s-hook explorer has a very curved working end; it is NOT recommended for calculus detection, as it causes extensive tissue distention and the sharp point would need to be directed toward the junctional epithelium.

Question 18

The posterior sextants exhibit moderate sub?gingival calculus deposits. The clinician plans to complete subgingival calculus removal on the mandibular left posterior sextant. Clinical attachment loss is present with periodontal pockets greater than 4 mm in depth. A class III furcation involvement is present on teeth #18 and #19. Which sequence of periodontal instruments would be MOST effective for subgingival calculus removal in this sextant?

Accepted Answer

A universal curet with an extended shank works well to remove moderate calculus deposits; Gracey curets with extended shanks will remove any remaining deposits that cannot be reached by the univer sal curet; Gracey curets with miniature working ends and extended shanks will remove any remaining light calculus or irregularities; a Nabers diamond-coated file can be used with a light stroke pressure to smoothen of the furcation area

Question 19

The posterior sextants exhibit moderate supragingival and subgingival calculus deposits. Clinical attachment loss is present with periodontal pockets greater than 4 mm in depth. The clinician plans to complete calculus removal on the maxillary right posterior sextant. He plans to use a series of ultrasonic tips followed by hand instruments. Which sequence of ultrasonic tips would be MOST effective for calculus removal in this sextant?

Accepted Answer

A standard-diameter universal tip would work well on all tooth surfaces for removing the supragingival deposits and some subgingival dep osits; the paired right and left slim diameter curved tips with extended shanks are ideal for adapting to the curved posterior root surfaces and concavities.

Question 20

A right-handed clinician is working on the buccal aspect of tooth #2. (For a left-handed clinician, this area would be equivalent to the buccal aspect of tooth #15.) The clinician is using a Gracey 13/14 curet and retracting the client's cheek with a mouth mirror. The clinician's neck is bent excessively as she works. What correction should the clinician make for more ergonomic positioning?

Accepted Answer

The clinician ' s poor neck position MOST likely indicates that the clinician is trying to use direct vision to see the treatment area. The mirror should be repositioned with the reflecting surface exposed so that the clinician can use indirect vision to see the distal surface of the tooth.

Quiz 17: Instrumentation for Client Assessment and Care