Deck 17: Periodontal Maintenance and Prevention

Question 1

Most patients in periodontal maintenance are best maintained at which recall interval?

A) Between 2 and 3 months
B) Between 3 and 4 months
C) Between 6 and 8 months
D) Every 12 months

Answer 1

Between 3 and 4 months

Question 2

Studies have shown that patients receiving periodontal treatment lose fewer teeth than patients who do not receive treatment.Periodontal maintenance treatment is critical to the reduction of tooth mortality.

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.

Answer 2

Both statements are TRUE.

Question 3

Hyperensitivity occurs in many patients when root surfaces are exposed from periodontal therapy,malpositioned teeth,or improper toothbrushing techniques.Normal aging contributes to the exposure of root surfaces and may result in root sensitivity.

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.

Answer 3

Both statements are TRUE.

Question 4

Which agent has been demonstrated to be an effective desensitizer for sensitive teeth?

A) Tin oxide
B) Sodium nitrite
C) Potassium oxalate
D) Sodium lauryl sulfate

Question 5

Periodontal disease is always preceded by gingivitis.Gingivitis always leads to periodontal disease.

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.

Question 6

Managing dentinal hypersensitivity begins with recommending the use of fluoride toothpaste because hypersensitivity is more often related to root caries than to the exposure of root surfaces.

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 correct.
D) The statement is not correct, but the reason is correct.
E) Neither the statement nor the reason is correct.

Question 7

What is the best strategy to treat dentinal hypersensitivity after periodontal therapy?

A) Educate the patient on the benefit of gingival grafting.
B) Instruct the patient on plaque control and fluoride use.
C) Instruct the patient on the use of over-the-counter antiinflammatory agents.
D) Instruct the patient to avoid touching the sensitive area until the discomfort resolves.

Question 8

An environment for opportunistic reinfection by pathogenic microbes,possibly resulting in disease progression,can be fostered by the:

A) Use of desensitizing agents
B) Increased age of the patient
C) Lack of adequate oral hygiene
D) Presence of calcium in the diet

Question 9

Hypersensitivity in teeth is a common problem estimated to occur in:

A) One of three adult patients
B) One of seven adult patients
C) One of ten adult patients
D) One of twenty adult patients

Question 10

The highest rate of patient attrition occurs at what point in the periodontal maintenance treatment plan?

A) First 6 months
B) First year
C) Second year
D) Fifth year

Question 11

Patients with periodontal disease are at a greater risk of root caries because they have:

A) Recession
B) Deeper pockets
C) Poor oral hygiene
D) Heavy accumulation of calculus

Question 12

The usual reason reported for patient noncompliance in personal plaque biofilm control is that:

A) No value is perceived.
B) The program is too time consuming and difficult.
C) The patient is unaware of the options available to perform the procedures.
D) The patient is unaware of the need to perform personal oral hygiene procedures.

Question 13

Xerostomia is of concern in the management of the patient with periodontal disease because it is related to:

A) Decreased calculus
B) Increased root caries risk
C) Increased oral cancer risk
D) Decreased signs of gingival disease

Question 14

On examination,a soft,dark brown lesion is found on the cervical cementum of tooth #28,but the patient reports no discomfort in that area.What is the most likely cause of the lesion?

A) Active root caries
B) Arrested root caries
C) Cemental hyperplasia
D) A glass ionomer restoration

Question 15

Periodontal disease is a causative factor in the development of root caries.Almost one half of all patients in periodontal maintenance treatment exhibit root caries.

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.

Question 16

Daily application at home of 5000 parts per million (ppm)fluoride gel is an effective method to prevent root caries.The most effective fluoride gel preparation for root caries control has not been determined.

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.

Question 17

The objectives of periodontal maintenance include all of the following except one.Which objective is the exception?

A) Maintenance of oral health
B) Elimination of all oral bacteria
C) Maintenance of alveolar bone height
D) Preservation of clinical attachment levels
E) Evaluation and reinforcement of personal oral hygiene

Question 18

Treating dentinal hypersensitivity with 1.1% neutral sodium fluoride (NaF)is effective because it reduces the patient's susceptibility to root caries.

A) Both the statement and the 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 correct.
D) The statement is not correct, but the reason is correct.
E) Neither the statement nor the reason is correct.

Question 19

A standardized plaque biofilm control program for all patients is the best way to ensure that each patient is adequately educated in home care procedures.Printed material,rather than chairside instruction,is a superior means of informing patients of oral hygiene needs.

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.

Question 20

Fluoride therapy has proven to be an important protective factor in the caries balance.Most protective aspects of fluoride occur via systemic absorption during tooth development.

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.

Question 21

Phase _______ of periodontal therapy includes a second assessment of the periodontal condition to determine the results of the initial therapy and to determine whether additional periodontal intervention is required.

A) I (initial phase)
B) II (surgical phase)
C) IV (maintenance phase)

Question 22

Phase _______ of periodontal therapy includes a review of the medical history; dental and periodontal examinations; caries detection; plaque biofilm,calculus,and stain removal; fluoride therapy; and referral to specialists as indicated.

A) I (initial phase)
B) II (surgical phase)
C) IV (maintenance phase)

Question 23

The dental hygienist must collaborate with the dentist to ensure the success of the periodontal maintenance program.The dental hygienist must partner with the patient to develop a personalized and successful maintenance program.

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.

Question 24

During the maintenance appointment,a periodontal evaluation is mandatory to assess the current periodontal status of the patient.What components are included in the periodontal evaluation?

A) Probe depths, bleeding assessment, furcations, and mucogingival involvement
B) Probe depths, gingival recession, bleeding assessment, furcations, and mucogingival involvement
C) Probe depths, gingival recession, bleeding assessment, furcations, mobility, and mucogingival involvement
D) Probe depths, gingival recession, bleeding assessment, furcations, mobility, mucogingival involvement, and plaque biofilm and calculus assessment

Question 25

Use the following case description to complete the following exercises.
Mr.JTM, a 70-year-old man with a complex medical history and moderate-to-advanced periodontitis and extensive restorative dental treatment, reports to the dental hygienist for his annual dental checkup.During the clinical assessment, the dental hygienist notices moderate plaque biofilm accumulation.The patient reports that a few teeth are sensitive and that he has a "dry mouth." The patient is less than enthusiastic about discussing his daily home care protocol and wants to know how long the appointment will take.
The most likely cause of Mr.JTM's dry mouth is:

A) Malocclusion
B) Periodontal disease
C) Systemic medical condition
D) Extensive restorative treatment

Question 26

A key strategy for enhancing compliance with this patient should include a(an):

A) New toothbrush and floss
B) Complete dental caries assessment
C) Oral hygiene instruction pamphlet
D) Explanation of the relationship of plaque biofilm to his oral conditions

Question 27

The primary objective of periodontal maintenance is preserving the stable state achieved during the active phase of periodontal therapy.

Question 28

Use the following case description to complete the following exercises.
Mr.JTM, a 70-year-old man with a complex medical history and moderate-to-advanced periodontitis and extensive restorative dental treatment, reports to the dental hygienist for his annual dental checkup.During the clinical assessment, the dental hygienist notices moderate plaque biofilm accumulation.The patient reports that a few teeth are sensitive and that he has a "dry mouth." The patient is less than enthusiastic about discussing his daily home care protocol and wants to know how long the appointment will take.
The most likely contributing factor to the patient's complaint of "sensitive teeth" would be:

A) Lack of fluoride therapy
B) Possible faulty restorations
C) History of periodontal surgery
D) Inadequate plaque biofilm control
E) Lack of compliance with recall appointments

Question 29

What strategy should be tried in treating dentinal hypersensitivity?

A) Application of in-office therapy and diet counseling
B) Reassurance that sensitivity goes away without treatment
C) Recommendation of a home product such as desensitizing toothpaste, diet counseling, and referral to the dentist
D) Assessment, explanation, oral hygiene instruction, application of an in-office therapy, recommendation of a home treatment product, and possible referral to the dentist

Question 30

During Phase _______ of periodontal therapy,corrective surgical and restorative procedures are performed as indicated.

A) I (initial phase)
B) II (surgical phase)
C) IV (maintenance phase)

Question 31

Phase _______ of periodontal therapy consists of individualized oral hygiene instructions and supragingival and subgingival débridement of plaque biofilm and calculus.

A) I (initial phase)
B) II (surgical phase)
C) IV (maintenance phase)

Question 32

What maintenance interval would the dental hygienist recommend for Mr.JTM?

A) Annually
B) Every 6 months
C) Between 2 and 4 months
D) Maintenance appointments are not effective because Mr. JTM is not willing to follow instructions.

Question 33

Untreated periodontal disease results in:

A) Continual loss of periodontal support
B) Tooth mortality
C) All of above
D) None of above

Question 34

The dental hygienist notices that Mr.JTM has bubbly and ropy saliva,which increases the concern about xerostomia; consequently,the dental hygienist adds fluoride therapy to Mr.JTM's treatment plan.The most appropriate fluoride regimen would include:

A) Daily home rinses
B) Office fluoride treatments
C) Office treatments and daily home rinses
D) Office treatments, daily home rinses, and fluoride toothpaste

Question 35

Phase _______ of periodontal therapy is initiated immediately after re-evaluation to ensure the stability of results attained during the initial phase.

A) I (initial phase)
B) II (surgical phase)
C) IV (maintenance phase)

Question 36

Some patients will simply not comply with the recommended plaque biofilm control during maintenance.What effect can regular maintenance visits with the dental hygienist have on these noncompliant patients?

A) The dentist and the dental hygienist should not treat noncompliant patients.
B) The dental hygienist should refer noncompliant patients to the dentist for counseling and treatment.
C) The dental hygienist cannot help noncompliant patients and should not spend treatment time with them.
D) The dental hygienist can remove the plaque biofilm and calculus and contribute to improved, but not optimal, periodontal health.

Question 37

Supragingival plaque biofilm control is important to emphasize with patients in the maintenance program because it:

A) Improves patient compliance.
B) Prevents the development of a pathogenic subgingival flora.
C) Usually improves collaboration with the dentist and the patient.
D) Is too time consuming to teach plaque control during other appointment times.

Question 38

The goal of Phase _______ of periodontal therapy is to provide reconstructive or surgical therapy to improve further the periodontal condition and increase the ability of the patient to perform adequate daily oral hygiene.

A) I (initial phase)
B) II (surgical phase)
C) IV (maintenance phase)

Question 39

The effectiveness of periodontal therapy can be measured by:

A) Preventing disease
B) Slowing disease progression
C) Minimizing tooth loss
D) Maintaining teeth in a state of health and function
E) All of the above

Question 40

Phase _______ of periodontal therapy includes plaque biofilm control,dietary analysis and modification,and scaling and root planing.

A) I (initial phase)
B) II (surgical phase)
C) IV (maintenance phase)

Question 41

The secondary objective of periodontal maintenance is preserving the stable state achieved during the active phase of periodontal therapy.

Question 42

Phase _____ of periodontal therapy includes plaque biofilm control,dietary analysis and modification,and scaling and root planing.

Question 43

Phase _____ of periodontal therapy includes a review of the medical history; dental and periodontal examinations; caries detection; plaque biofilm,calculus,and stain removal; fluoride therapy; and a referral to specialists as indicated.

Question 44

Successful prevention of gingival and periodontal diseases begins with good personal oral hygiene to eliminate the etiologic factors that can lead to pathogenesis.

Question 45

Periodontal maintenance emphasizes the link between preventive oral health care and dental hygiene care with the goal of achieving optimal oral health.

Question 46

Periodontitis is always preceded by gingivitis.

Question 47

Gingivitis is always preceded by periodontitis.

Question 48

Dental hygienists are essential providers of preventive services during Phases I and IV of periodontal maintenance care.

Question 49

During Phase _____ of periodontal therapy,corrective surgical and restorative procedures are performed as indicated.

Question 50

To prevent disease,the role of the dental hygienist does not include the need to emphasize the significance of personal oral hygiene or to review the appropriate plaque biofilm removal techniques during each maintenance visit.

Question 51

Phase _____ of periodontal therapy consists of individualized oral hygiene instruction and supragingival and subgingival débridement of plaque biofilm and calculus.

Question 52

Phase _____ of periodontal therapy is initiated immediately after re-evaluation to ensure the stability of results attained during the initial phase.

Question 53

Periodontal therapy and care consists of a series of treatment phases.

Question 54

Phase _____ of periodontal therapy includes a second assessment of the periodontal condition for determining the results of the initial therapy and to determine whether additional periodontal intervention is required.

Question 55

The major objective of periodontal therapy is to ________________.

Question 56

The goal of Phase _____ of periodontal therapy is to provide reconstructive or surgical therapy to improve further the periodontal condition and increase the ability of the patient to perform adequate daily oral hygiene.