NBDHE NBDHE Dental Hygiene Care 3 — Questions and Answers
Question 1: A patient taking warfarin requires scaling and root planing. The INR is 3.8. What is the most appropriate action?
- Proceed with full-mouth debridement
- Consult the patient's physician before treatment (Correct answer)
- Administer local anesthetic without a vasoconstrictor
- Use only hand instruments to minimize bleeding
Correct answer: Consult the patient's physician before treatment
An INR above 3.5 indicates excessive anticoagulation; physician consultation is required before invasive periodontal procedures.
Question 2: Which oral hygiene aid is most recommended for a patient with fixed orthodontic appliances?
- Electric toothbrush only
- Interproximal brush (proxy brush) (Correct answer)
- Wooden wedge stimulator
- Rubber tip stimulator
Correct answer: Interproximal brush (proxy brush)
Interproximal brushes are effective at cleaning around brackets, wires, and under pontics of orthodontic appliances.
Question 3: A 45-year-old male patient presents with generalized bone loss affecting molars and incisors disproportionately, with deep pockets and no significant medical history. This pattern is consistent with:
- Chronic periodontitis
- Necrotizing ulcerative periodontitis
- Localized aggressive periodontitis
- Generalized aggressive periodontitis (Correct answer)
Correct answer: Generalized aggressive periodontitis
Generalized aggressive periodontitis affects multiple teeth including first molars and incisors and occurs in patients under 30 but can present in older adults.
Question 4: Which of the following best describes the mechanism of action of chlorhexidine gluconate as an antiplaque agent?
- It disrupts bacterial cell membranes through its cationic charge (Correct answer)
- It inhibits bacterial protein synthesis
- It chelates calcium ions in biofilm
- It raises plaque pH to inhibit bacterial growth
Correct answer: It disrupts bacterial cell membranes through its cationic charge
Chlorhexidine's cationic nature allows it to bind to negatively charged bacterial cell walls, disrupting membrane integrity.
Question 5: During periodontal re-evaluation 4–6 weeks after scaling and root planing, a site shows a pocket reduction from 6 mm to 4 mm with no bleeding on probing. What does this indicate?
- Surgical intervention is immediately required
- Active disease is still present
- Successful response to therapy; continue with supportive periodontal therapy (Correct answer)
- The area should be re-scaled immediately
Correct answer: Successful response to therapy; continue with supportive periodontal therapy
A pocket reduction to 4 mm with no bleeding on probing indicates successful healing and transition to supportive periodontal therapy is appropriate.
Question 6: A patient with xerostomia is at highest risk for which type of caries?
- Pit and fissure caries
- Smooth surface cervical caries (Correct answer)
- Secondary (recurrent) caries
- Interproximal caries at contact areas
Correct answer: Smooth surface cervical caries
Xerostomia dramatically increases risk of smooth surface and cervical root caries because saliva's buffering and cleansing actions are reduced.
Question 7: The modified Bass brushing technique is primarily indicated for which patient population?
- Children with primary dentition
- Patients with gingival recession only
- Patients with periodontal disease or those at high risk for gingivitis (Correct answer)
- Edentulous patients with implants
Correct answer: Patients with periodontal disease or those at high risk for gingivitis
The modified Bass technique places bristles at a 45-degree angle to the gingival margin to clean the sulcus, making it ideal for patients with periodontal concerns.
NBDHE NBDHE Dental Hygiene Care 3
A patient taking warfarin requires scaling and root planing.
The INR is 3.8.
What is the most appropriate action?