Question 1

When selecting an instrument to scale heavy calculus deposits, which of the following must be considered?

Accepted Answer

The thickness of the shank will be less flexible and allow greater strength to remove calculus when pressure is applied. Depending on the periodontal pocket depth, the length of shank matters. The angle of the shank matters more to the location of calculus in the mouth. Texture and shape assist in grasping the instrument.

Question 2

The advantage(s) of a standing position while scaling the mandibular arch are which of the following?

Accepted Answer

All of the above are advantages to scaling. The standing position allows the movement of the arms, hand, and body to consistently pull and apply pressure against the tooth to remove the calculus. The standing position allows the movement of the arms and hands to position the instrument to access deep pockets with extraoral fulcrums that could not otherwise be done in other same arch positions. The standing position allows the movement of the arms, hand, and body, keeping it from straining and being in a static position and lessening repetitive strain injuries.

Question 3

Depending on the area to be scaled, area of accessibility, and pocket depth, which of the following intraoral fulcrums may be used?

Accepted Answer

Finger on finger, same arch fulcrum, and cross arch fulcrum are all types of fulcrum placements that can be used. Finger on finger is used intraorally and assists in scaling and accessing deep pockets. Same arch fulcrum allows scaling close to the area. Cross arch is an intraoral fulcrum that allows you to reach an area across the area to be scaled.

Question 4

A client presents with periodontal pockets in maxillary left posteriors with light to moderate burnished calculus along the distal line angles with slightly loose tissue. Which instrument would be the best instrument for calculus removal?

Accepted Answer

The minibladed curet is small enough to adapt around the line angles without causing soft-tissue trauma, and the lower shank is longer to be able to access periodontally involved areas. The Gracey curet is too long to adapt around the line angle and does not have an extended shank. The extended shank curet is too long to adapt around the line angles. The universal curet is too long and may not adapt well at the line angle.

Question 5

The general purpose of furcation instruments are the following except:

Accepted Answer

The furcation instruments are designed to access the narrow areas that would otherwise be unable to be reached by treatment instruments. Furcation instruments do not enhance tactile sensitivity. These instruments are only used after heavy calculus removal and light calculus remains that needs to be removed.

Question 6

The smaller the angle and the fewer the number of shank bends, the more suitable for use on anterior teeth. The more acute the angle and the greater the number of shank bends, the more suitable for use on posterior teeth.

Accepted Answer

Both statements are True. The other choices are incorrect.

Question 7

The objective of instrument sharpening is to restore blade sharpness. Which clinical outcome is true as a result of a sharp instrument blade?

Accepted Answer

Control is increased because a sharp instrument blade does not slip readily over the tooth surface. Client safety and comfort is a factor. Blade sharpness requires less lateral pressure, more control, and efficient working strokes that result in the likelihood of increased safety and comfort. Lateral pressure is decreased with sharp blades. Sharp blades decrease the probability of burnished calculus.

Question 8

Which explorer(s) will adapt well to the line angles and detect calculus along these apical regions?

Accepted Answer

3-A and 11/12 explorers will adapt well to the line angles and detect calculus along apical regions. A Shepard's hook explorer is used for caries detection and has a short tip for exploring periodontal pockets. All of the above is incorrect because a Shepard's hook explorer does not adapt well to the line or reach apical regions.

Question 9

Reinforcement scaling techniques provide support and lateral pressure for all of the following extended fulcrums except:

Accepted Answer

Same arch fulcrum is not an extended fulcrum. Cross arch is an extended fulcrum. Opposite arch is an extended fulcrum. Extraoral fulcrum is an extended fulcrum.

Question 10

A proper body mechanics technique that must be considered while scaling is:

Accepted Answer

The rule in proper body mechanics is to maintain 20 degrees of freedom and not to overextend or underextend this amount. By maintaining a prolonged sitting position, your body will be inclined to stay in a static position that would fatigue or lead to RSI. Base of support should always be used when treating patients, not only while scaling. Clinician's knees must be below the hip, not on the same plane as the hip.

Question 11

The following instrument handle characteristics or specifications are considered to lessen repetitive strain injuries (RSI) except:

Accepted Answer

Larger handles are more comfortable and require less effort to grasp the instrument, decreasing fatigue. Slender handles lead to cramping over a prolonged period of time. Hollow handles are less strenuous and lighter to use and allow greater tactile sensitivity. Texture and shape: serrated or knurled handles allows the fingers to hold the instrument with less effort with the fingers and as a result lessen fatigue and increase comfort.

Question 12

The fundamental components that a clinician must consider to achieve protective and productive hand activated instrumentation are the following except:

Accepted Answer

Calculus formation is not a fundamental component in achieving protective and productive hand activated instruments. Instrumentation technique results are dependent on the types of calculus formation. Correct grasp is essential and standard in instrumentation. It would affect instrumentation if the grasp was positioned incorrectly, causing more strenuous pressure to the hands. Good adaptation is necessary and will control the amount of unnecessary pressure that would fatigue the hand and instrument effectively. Lateral pressure is beneficial in instrumentation to prevent unnecessary use of the hand or body that results in fatigue or RSI.

Question 13

In managing an instrument tip breakage, the dental hygienist must immediately stop instrumentation if a small metal fragment breaks off and inform the client. Low-speed or high-speed aspiration (suction) should be continued to prevent the client from swallowing the metal foreign object.

Accepted Answer

The first statement is True, and the second statement is False. It is False because you would not aspirate the patient. The other choices are incorrect.

Question 14

Which of the following assessment or treatment instruments use a pull and push stroke?

Accepted Answer

The explorer requires both directional strokes, and push and pull strokes for detection of calculus and exploration of tooth surfaces. Hirschfeld files use a pill stroke only. Chisel scalers use a push stroke only. Hoe scalers use a pull stroke only.

Question 15

Which set of treatment instruments are not used for supragingival and subgingival calculus removal where tissue is retractable?

Accepted Answer

Sickle scalers are primarily used for supragingival scaling. Hoes are used for subgingival and supragingival calculus removal. Files are used for subgingival and supragingival calculus removal. Universal curets are used for subgingival and supragingival calculus removal.

Question 16

Which treatment instrument will roughen and crush the calculus along these apical regions for easier access?

Accepted Answer

Hirschfeld files are used for subgingival and supragingival breaking away or crushing heavy calculus, and roughening tenacious and burnished calculus. Area-specific curets are for removing calculus with pull strokes and do not roughen or crush calculus. Diamond files are for light calculus for sanding down surfaces, such as furcations and concavities. Chisel scalers are for supragingival calculus and heavy calculus.

Question 17

Straighter shanked instruments are used mainly for anterior areas: however, what type of fulcrum will allow these instruments to be used in posterior areas?

Accepted Answer

An extended fulcrum allows the instrument to be extended; and to position the lower shank and handle parallel to the area being scaled; and to adapt to the surface. Same arch restricts or limits the instrument to being adapted as you progress posteriorly; the blade will not have the correct adaptation and angulation. The instrument at this position will not adapt the blade properly. It will not access the interproximal teeth and reach the base of the sulcus. This allows reach to deep pockets and provides stability, but as you approach or move posteriorly, the adaption and angulation will diminish.

Question 18

Important factor(s) to consider in a probe design that is too fine and sharp is (are) the following?

Accepted Answer

All the following are contributing factors. The fine tip may not easily break or bend during the sterilization procedure. The sharp or fine tip can penetrate through the tissue damaging the epithelium. The sharp or fine tip can inflict pain or discomfort if the instrument penetrates through the tissue.

Question 19

Clinicians who practice with finger reinforcement scaling techniques provide which of the following benefits?

Accepted Answer

Reinforcement provides additional lateral pressure with the dominant hand. Guiding the instrument with extended extraoral fulcrum is a benefit. Finger reinforcement supports thenar (radial palm or fleshy mass on lateral side of palm, thenar muscle) region during the strenuous and intensive instrumentation process.

Question 20

Fulcrums that move further away from the area being scaled may result in:

Accepted Answer

Fulcrums that move further away from the area being scaled may result in diminishing access to interproximal regions. This statement is True and it enhances access to periodontal pockets. Extended fulcrums or fulcrums that move farther away from the area to be scaled enhance access. Control is not lessened when fulcrums are farther away. Increases ability to scale the area.

Quiz 26: Hand-Activated Instrumentation