Question 1

Intrinsic erosion is a result of dietary factors that contribute to a highly acidic oral environment. The frequent consumption of acidic, carbonated, sports, or fruit drinks or frequent sugar consumption can cause intrinsic erosion.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true, and the second statement is false.
D) The first statement is false, and the second statement is true.

Both statements are false.

Accepted Answer

Both statements are False. Intrinsic erosion is caused by acid regurgitation associated with medical and psychologic disorders (e.g., morning sickness and bulimia). The statements given in the question refer to extrinsic erosion, not intrinsic erosion.

Question 2

The transient, well-localized, sharp pain associated with dentinal hypersensitivity is most likely the result of the stimulation of which of the following nerve fibers near the pulp-dentin interface?&#10;A) A-delta fibers&#10;B) A-beta fibers&#10;C) C-fibers&#10;D) A-delta fibers, A-beta fibers, and C-fibers

Accepted Answer

Activation of specific nerve fibers in the dentin results in different types of nerve pain. The transient, well-localized, sharp type of pain is a result of the stimulation of the A-delta fibers-small myelinated fibers that evoke a sensation of this type of pain. Activation of the A-delta fibers is responsible for dentinal hypersensitivity. The A-beta fibers are susceptible to the same type of stimuli but respond more sensitively to electrical stimulation. Stimulation of the unmyelinated C-fibers results in a dull, poorly localized, aching type of pain usually associated with pulpal pain.

Question 3

All of the following are characteristics of teeth observed to have dentinal hypersensitivity except:&#10;A) dentinal tubules open to the oral cavity.&#10;B) large and numerous dentinal tubules.&#10;C) ability of dentinal surface to communicate with vital pulp.&#10;D) intact cementum.

Accepted Answer

Cementum is not intact in areas of dentinal hypersensitivity. For dentinal hypersensitivity, dentin must be exposed, dentinal tubules must be open at the dentinal surface and open to vital pulp, and the layer of cementum is thin and labile and easily abraded or eroded away, therefore offering little protection against sensitivity.

Question 4

Which of the following occurs most of the time with regard to the relationship between cementum and enamel?&#10;A) Cementum overlaps enamel.&#10;B) Cementum and enamel meet (no overlap).&#10;C) Enamel overlaps cementum.&#10;D) Enamel and cementum do not meet.

Accepted Answer

Cementum and enamel meet with no overlap about 76% of the time; cementum overlaps enamel 14% of the time; enamel does not overlap cementum; and about 10% of the time, enamel and cementum do not meet.

Question 5

What term refers to the reduction of the dentinal tubule lumen as a result of the deposition of intratubular dentin?&#10;A) Abfraction&#10;B) Abrasion&#10;C) Dentinal sclerosis&#10;D) Attrition

Accepted Answer

Dental sclerosis is the reduction of the dentinal tubule lumen as a result of the deposition of intratubular dentin. Abfraction consists of the ongoing flexion, tension, and compression forces exerted in the cervical area of a tooth from mastication; occlusal trauma can result in cracking and eventual loss of cervical tooth structure. Abrasion is the loss of tooth structure associated with toothbrush stiffness and bristle configuration. The technique, frequency, duration, and force of brushing and toothbrush filaments have been implicated in recession. Attrition is the term used to refer to tooth structure wear on the incisal and occlusal surfaces that occurs from normal tooth use, including the mechanical tooth-to-tooth wear of the dentition from normal tooth contact.

Question 6

Client Profile&#10;&#8226; 45-year-old woman&#10;&#8226; Single mother of a 4-year-old girl&#10;&#8226; Occupation: Administrative Assistant&#10;Chief Complaint&#10;&#8226; &#34;My teeth are very sensitive when I eat or drink cold foods and beverages.&#34;&#10;Health History&#10;&#8226; No significant findings&#10;Pharmacologic History&#10;&#8226; Client taking Ortho Tri-Cyclen (norgestimate, ethinyl estradiol)&#10;Dental History&#10;&#8226; Regular 6-month continued-care appointments&#10;&#8226; Brushes twice daily (uses a hard toothbrush)&#10;Clinical Examination&#10;&#8226; Light to moderate dental calculus&#10;&#8226; Localized attrition along anterior incisal and canine tooth surfaces&#10;&#8226; Localized recession and cervical abfraction evident on teeth 6, 7, 8, 9, 22, 23, 24, 25, 26, 27, 28, and 29&#10;&#8226; Occlusal trauma on 6, 7, 8, 9, 22, 23, 24, 25, 26, 27, 28, and 29&#10;Radiographic Findings&#10;&#8226; Incipient enamel lesions (distal surface of 3, mesial surface of 15, distal surface of 19)&#10;All of the following would be good self-care recommendations for this client except which one?&#10;A) Use a daily, self-applied fluoride mouth rinse.&#10;B) Use a soft toothbrush.&#10;C) Use a low-abrasive fluoride toothpaste for sensitive teeth.&#10;D) Use an oral irrigation system.

Accepted Answer

This client with dentinal hypersensitivity would not benefit significantly from using an oral irrigation system. She would benefit from daily fluoride mouth rinse, a soft toothbrush, and low-abrasive fluoride toothpaste for sensitive teeth.

Question 7

For dentinal hypersensitivity to occur, all of the following conditions must exist except which one?&#10;A) Dentin must be exposed.&#10;B) A smear layer must cover the opening of the dentinal tubules.&#10;C) Dentinal tubules must be open.&#10;D) Vital pulp must be present.

Accepted Answer

In nonsensitive dentin, the smear layer covers the opening of the dentinal tubules or mineral compounds occlude the tubules, reducing the ability of stimuli to induce fluid flow. Loss or removal of the smear layer may result in a pain response. Therefore, for dentinal sensitivity to occur, dentin must be exposed, dentinal tubules must be open, and a vital pulp must be present for the client to respond to the stimulus.

Question 8

Client Profile&#10;&#8226; 45-year-old woman&#10;&#8226; Single mother of a 4-year-old girl&#10;&#8226; Occupation: Administrative Assistant&#10;Chief Complaint&#10;&#8226; &#34;My teeth are very sensitive when I eat or drink cold foods and beverages.&#34;&#10;Health History&#10;&#8226; No significant findings&#10;Pharmacologic History&#10;&#8226; Client taking Ortho Tri-Cyclen (norgestimate, ethinyl estradiol)&#10;Dental History&#10;&#8226; Regular 6-month continued-care appointments&#10;&#8226; Brushes twice daily (uses a hard toothbrush)&#10;Clinical Examination&#10;&#8226; Light to moderate dental calculus&#10;&#8226; Localized attrition along anterior incisal and canine tooth surfaces&#10;&#8226; Localized recession and cervical abfraction evident on teeth 6, 7, 8, 9, 22, 23, 24, 25, 26, 27, 28, and 29&#10;&#8226; Occlusal trauma on 6, 7, 8, 9, 22, 23, 24, 25, 26, 27, 28, and 29&#10;Radiographic Findings&#10;&#8226; Incipient enamel lesions (distal surface of 3, mesial surface of 15, distal surface of 19)&#10;All of the following interventions could be provided in the dental setting to treat this client's areas of dentinal hypersensitivity except which one?&#10;A) Use of a 5% sodium fluoride varnish&#10;B) Placement of Class V restorations&#10;C) Use of a desensitizing agent such as potassium nitrate&#10;D) In-office oral irrigation with 0.12% chlorhexidine

Accepted Answer

An in-office oral irrigation procedure with 0.12% chlorhexidine is not an evidence-based intervention for the treatment of dentinal hypersensitivity. She would benefit from fluoride varnish therapy, placement of a Class V restoration, or the use of a desensitizing agent.

Question 9

Mild dentinal hypersensitivity may be managed by using a sensitivity-protection toothpaste twice daily. Severe dentinal hypersensitivity with loss of tooth structure often requires restoration to control the hypersensitivity.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true, and the second statement is false.
D) The first statement is false, and the second statement is true.

Accepted Answer

Both statements are True. Mild hypersensitivity can usually be managed by the client, at home, using good oral hygiene with a sensitivity-protection dentifrice. Severe hypersensitivity associated with cervical tooth loss usually requires the placement of a Class V restoration.

Question 10

What age range is considered the peak for dentinal hypersensitivity?&#10;A) 10 to 20 years of age&#10;B) 20 to 40 years of age&#10;C) 40 to 60 years of age&#10;D) 60 to 80 years of age&#10;E) none of the above

Accepted Answer

Reports of dentinal hypersensitivity range among all ages of clients. However, as an individual ages, the prevalence of dentinal hypersensitivity decreases because of an increase in reparative dentin formation; reduction in pulpal chamber size, vascularity, and pulpal nerve fibers; and dentinal sclerosis (reduction of the dentinal tubule lumen as a result of the deposition of intratubular dentin).

Question 11

Which one of the following is the best self-applied home product to help decrease dentinal hypersensitivity?&#10;A) Fluoride mouth rinse or gel&#10;B) Nonfluoride antibacterial mouth rinse&#10;C) Oral irrigation system&#10;D) Medium- to hard-bristled toothbrush

Accepted Answer

The answer of Which one of the following is the...

Question 12

What term is used to refer to sites of tooth structure wear commonly found on the incisal or occlusal surfaces of teeth as a result of masticatory forces?&#10;A) Abrasion&#10;B) Erosion&#10;C) Attrition&#10;D) Abfraction

Accepted Answer

The answer of What term is used to refer to...

Question 13

Dentinal hypersensitivity is most common on what region of the tooth?&#10;A) Lingual&#10;B) Buccal cervical&#10;C) Facial&#10;D) Occlusal

Accepted Answer

The answer of Dentinal hypersensitivity is most common on what...

Question 14

Client Profile&#10;&#8226; 45-year-old woman&#10;&#8226; Single mother of a 4-year-old girl&#10;&#8226; Occupation: Administrative Assistant&#10;Chief Complaint&#10;&#8226; &#34;My teeth are very sensitive when I eat or drink cold foods and beverages.&#34;&#10;Health History&#10;&#8226; No significant findings&#10;Pharmacologic History&#10;&#8226; Client taking Ortho Tri-Cyclen (norgestimate, ethinyl estradiol)&#10;Dental History&#10;&#8226; Regular 6-month continued-care appointments&#10;&#8226; Brushes twice daily (uses a hard toothbrush)&#10;Clinical Examination&#10;&#8226; Light to moderate dental calculus&#10;&#8226; Localized attrition along anterior incisal and canine tooth surfaces&#10;&#8226; Localized recession and cervical abfraction evident on teeth 6, 7, 8, 9, 22, 23, 24, 25, 26, 27, 28, and 29&#10;&#8226; Occlusal trauma on 6, 7, 8, 9, 22, 23, 24, 25, 26, 27, 28, and 29&#10;Radiographic Findings&#10;&#8226; Incipient enamel lesions (distal surface of 3, mesial surface of 15, distal surface of 19)&#10;All of the following factors from the client's assessment data might be the cause of gingival recession except which one?&#10;A) Presence of carious lesions&#10;B) Use of a hard toothbrush&#10;C) Presence of abfraction&#10;D) Presence of occlusal trauma

Accepted Answer

The answer of Client Profile&#10;&#8226; 45-year-old woman&#10;&#8226; Single mother of...

Question 15

Behavior modification to decrease dentinal hypersensitivity would include all of the following except which one?&#10;A) Use of a daily, self-applied fluoride mouth rinse or gel&#10;B) Decreased intake of extreme hot and cold foods&#10;C) Use of low-abrasive dentifrice&#10;D) Periodontal surgery

Accepted Answer

The answer of Behavior modification to decrease dentinal hypersensitivity would...

Deck 39: Dental Hypersensitivity Management