Question 1

All of the following are things to consider when selecting a dental floss except one. Which one is the exception?

Accepted Answer

The choice of which floss to recommend or even if dental floss is the best choice is influenced by the following:
• The tightness of the contact area
• The contour of the gingival tissue
• The roughness of the interproximal surface (e.g., margins of restorations)
• The client's manual dexterity and preference

Question 2

Which type of dental floss is best for Class II embrasure spaces?

Accepted Answer

Tufted floss is wider and fills the space of Class II embrasures better than other types of floss. Waxed, unwaxed, and dental tape are designed for type I embrasures.

Question 3

Massaging the gingival tissue with an interdental device can lead to improved circulation, increased keratinization, and epithelial thickening. It is important to recommend massaging the gingiva as part of self-care to all clients because the benefits help prevent gingivitis.

Accepted Answer

Massaging tissue has been shown to improve circulation, increase keratinization, and promote epithelial thickening. However, there are no data to show that this leads to improved gingival health. The assumption is anecdotal and not evidence-based.

Question 4

Which of the following devices is designed to clean slightly below the gingival margin?

Accepted Answer

The toothpick holder may be used to trace the gingival margin and disrupt plaque slightly below the gingival margin. All other devices are too large to fit subgingivally and are used to remove interproximal plaque biofilm.

Question 5

Which of the following aids should be discarded after one use?

Accepted Answer

A floss threader, rubber tip stimulator, and toothpick holder can be cleaned using soap and water between uses. The triangular toothpick, if wooden is porous and will absorb bacteria and blood and should be thrown out after one use.

Question 6

The benefits of daily flossing include the reduction of plaque biofilm, bleeding, and gingivitis. Reductions in these clinical findings have led to a reduction of interproximal dental caries.

Accepted Answer

Research shows that dental floss can reduce plaque biofilm, bleeding, and gingivitis. The reduction of interproximal dental caries by flossing has not been demonstrated in the research. The studies show the addition of fluoride as a key factor.

Question 7

The benefit of daily interdental cleaning such as flossing is the reduction or prevention of inflammation caused by the immune response to the toxins produced by interdental plaque biofilm. Evidence from a comprehensive systematic review indicated that flossing in addition to toothbrushing reduces gingivitis in comparison with toothbrushing alone.

Accepted Answer

The benefit of daily interdental cleaning such as flossing is the reduction or prevention of inflammation caused by the immune response to the toxins produced by interdental plaque biofilm. Evidence from a comprehensive systematic review indicated that flossing in addition to toothbrushing reduces gingivitis in comparison with toothbrushing alone.; however, reductions in plaque biofilm over toothbrushing alone are not significant.

Question 8

The dental water jet has been shown to effectively reduce signs of infection, such as bleeding and gingivitis, in clients with many conditions except which of the following?

Accepted Answer

Severe periodontitis should be treated before a dental water jet or any other self-care device is recommended because of the extensive infection. Once the condition has been treated as agreed by the client, self-care devices are recommended depending on the oral condition, specifically, embrasure spaces, recession, and pocket depth.

Question 9

The hydrokinetic activity produced by a dental water jet produces a compression and decompression action. The compression action has which impact on the subgingival bacteria?

Accepted Answer

The hydrokinetic activity of a pulsating dental water jet produces a compression phase that forces the solution and bacteria out of the pocket. The decompression phase allows the solution to flow into the pocket.

Question 10

Self-care devices can cause damage to the hard and soft tissues of the mouth if used improperly. It is the client's responsibility to find the products they like and to learn how to properly use them by reading the instructions on the packaging.

Accepted Answer

Clients depend on the dental hygienist to help them navigate the "oral healthcare aisle." There are many devices that will help clients, but they do not know which is the best for their oral condition, nor do they have easy access to the research or the skills to understand the studies. Client assessment and values will help the hygienist recommend the product or products that the client will use.

Question 11

Which of the following interproximal devices may be used from both the facial and lingual aspects of the teeth?

Accepted Answer

All other aids may induce trauma when insertion is attempted lingually.

Question 12

The interproximal device that is the least effective in removing plaque biofilm is the:

Accepted Answer

The rubber tip stimulator was designed for gingival stimulation, not for removal of plaque. All other aids are used for plaque removal as a primary function. There is no research to support the use of a rubber tip stimulator for plaque biofilm removal. Recommendation is anecdotal.

Question 13

Which step in dental flossing improves control and reduces the possibility of floss cuts?

Accepted Answer

Setting a fulcrum prevents "popping" through the contact area. Up-and-down strokes cover the entire interproximal area. Floss is wrapped around middle fingers, not index fingers. The C shape covers more surface area.

Question 14

Which of the following devices is contraindicated for type I embrasures?

Accepted Answer

Tufted dental floss is used in type II or III embrasures with larger spaces. Power flossers and floss holders are designed for type I embrasures. Floss threaders may be used to thread floss under the contact area in a type I embrasure with a tight contact.

Question 15

Tongue cleaners are most useful in improving which of the following oral conditions?

Accepted Answer

Tongue cleaners remove debris and bacteria from the dorsum of the tongue to reduce malodor. There is no research to support reduction of caries, gingivitis, or bleeding.

Question 16

An end-tufted toothbrush is most effective in which of the following areas?

Accepted Answer

End-tuft brushes are for type II or III embrasures, difficult-to-reach areas, or fixed appliances. The orthodontic bracket is a fixed appliance in a difficult-to-reach area. The two maxillary molars are too close (type I embrasure) to allow access for the end-tuft brush. The facial surface of a protruded incisor can be reached with a regular toothbrush. (Had the question specified a retruded lingual surface, then the end-tuft brush might have been helpful.) The partial denture can be removed and cleaned after denture protocol.

Question 17

Which of the following devices is not recommended for use with dental implants?

Accepted Answer

A clasp brush is used to clean removable partial dentures.

Question 18

A 45-year-old female patient has tight contacts and several crowns. She indicates that she has difficulty flossing and that the floss often breaks during use. Which of the following is an alternative to floss for this client?

Accepted Answer

The dental water jet has been shown to be an effective alternative to flossing for the reduction of bleeding and gingivitis. In addition, studies show it is effective in cleaning around crowns and bridges. The other products listed are not recommended for tight contacts with Class I embrasure.

Question 19

Which of the following is the appropriate interdental recommendation for type I embrasures?

Accepted Answer

Dental floss is the traditional device recommended for type I embrasures. The other products in this list are for type II or III embrasures.

Question 20

A dental water jet with 1200 pulsations per minute delivering an irrigant through a standard jet tip can deliver the solution to a depth of 71% in which type of pockets?

Accepted Answer

Research shows that a standard jet tip attached to a pulsating dental water jet with 1200 pulsations per minute and set on a medium to high setting will deliver the solution to 71% of the pocket depth. Delivery is 44% for medium pockets and 68% in deeper pockets. Depth of penetration will vary but is deeper than with flossing, brushing, rinsing, or using any other self-care device.

Quiz 24: Mechanical Oral Biofilm Control: Interdental and Supplemental Self-Care Devices