NBDHE Periodontal Assessment and Treatment Questions and Answers — Questions and Answers
Question 1: A patient presents with a probing depth of 6 mm on the mesial-buccal of tooth #30. The gingival margin is located 2 mm coronal to the cementoenamel junction (CEJ). What is the calculated clinical attachment loss (CAL) for this site?
- 2 mm
- 4 mm (Correct answer)
- 6 mm
- 8 mm
Correct answer: 4 mm
To calculate Clinical Attachment Loss (CAL) when the gingival margin is coronal to the CEJ (indicating gingival enlargement or a pseudopocket), you subtract the distance from the gingival margin to the CEJ from the probing depth. In this case: 6 mm (Probing Depth) - 2 mm (Gingival Margin to CEJ) = 4 mm CAL.
Question 2: Which of the following is considered the primary etiologic factor for periodontal disease?
- Genetic predisposition
- Tobacco use
- Poorly controlled diabetes
- Bacterial plaque biofilm (Correct answer)
Correct answer: Bacterial plaque biofilm
While genetics, smoking, and systemic diseases like diabetes are significant risk factors that modify the host response, bacterial plaque biofilm is universally recognized as the primary initiating factor for gingivitis and periodontitis.
Question 3: During a periodontal assessment of a multi-rooted tooth, the dental hygienist can detect the furcation with a Nabers probe, but it does not pass completely through. The bone between the roots is intact, allowing only partial penetration. According to Glickman's classification, this is classified as:
- Class I Furcation
- Class III Furcation
- Class IV Furcation
- Class II Furcation (Correct answer)
Correct answer: Class II Furcation
Glickman's classification describes a Class II furcation as a lesion where the probe can enter the furcation area but cannot pass through to the other side because a portion of the alveolar bone and periodontal ligament remains intact.
Question 4: A patient is scheduled for a 4-6 week re-evaluation following non-surgical periodontal therapy (NSPT). Which of the following clinical signs is the BEST indicator of successful initial therapy?
- Significant reduction in tooth mobility
- Absence of bleeding on probing (Correct answer)
- Formation of a long junctional epithelium
- Patient's reported improvement in oral hygiene
Correct answer: Absence of bleeding on probing
The absence of bleeding on probing is the most reliable clinical sign indicating a reduction in gingival inflammation and a positive response to NSPT. While other factors are important, the resolution of inflammation, evidenced by no bleeding, is the primary short-term goal.
Question 5: All of the following are considered non-modifiable risk factors for periodontal disease EXCEPT:
- Age
- Genetic predisposition
- Osteoporosis
- Stress (Correct answer)
Correct answer: Stress
Stress is considered a modifiable risk factor because individuals can potentially alter their coping mechanisms or reduce stressors, which can in turn affect their immune response and oral hygiene habits. Age, genetic factors, and osteoporosis are generally considered non-modifiable.
Question 6: When performing periodontal probing, which technique is recommended to ensure the entire sulcus is assessed?
- Applying firm pressure to feel the bony crest
- Angling the probe 45 degrees into the contact area
- Using a 'walking' stroke in 1 mm increments (Correct answer)
- Taking a single measurement at the center of each facial and lingual surface
Correct answer: Using a 'walking' stroke in 1 mm increments
The 'walking' stroke, which involves moving the probe up and down in 1 mm increments along the entire circumference of the sulcus, is the standard technique. This method ensures that the deepest point of the pocket is detected, as the junctional epithelium is not uniform around the tooth.
NBDHE Periodontal Assessment and Treatment Questions and Answers
A patient presents with a probing depth of 6 mm on the mesial-buccal of tooth #30.
The gingival margin is located 2 mm coronal to the cementoenamel junction (CEJ).
What is the calculated clinical attachment loss (CAL) for this site?