NBDHE NBDHE Dental Hygiene Care 4 — Questions and Answers
Question 1: A patient's blood pressure reading is 158/96 mmHg at the beginning of the appointment. According to ADA guidelines, what is the most appropriate course of action?
- Proceed normally with all planned treatment
- Proceed with routine non-surgical care and recheck at the end
- Defer elective treatment and refer to physician (Correct answer)
- Administer nitroglycerin and continue
Correct answer: Defer elective treatment and refer to physician
A reading of 158/96 mmHg is Stage 2 hypertension; elective dental treatment should be deferred and the patient referred for medical evaluation.
Question 2: Which local anesthetic has the longest duration of action and is most appropriate for lengthy periodontal procedures?
- Lidocaine 2% with 1:100,000 epinephrine
- Mepivacaine 3% plain
- Bupivacaine 0.5% with 1:200,000 epinephrine (Correct answer)
- Prilocaine 4% plain
Correct answer: Bupivacaine 0.5% with 1:200,000 epinephrine
Bupivacaine provides the longest duration of pulpal and soft-tissue anesthesia among common dental local anesthetics.
Question 3: A patient on bisphosphonate therapy (oral, 5 years) requires oral hygiene instruction. Which complication should the clinician be most concerned with when treating this patient?
- Excessive bleeding during probing
- Medication-related osteonecrosis of the jaw (MRONJ) (Correct answer)
- Increased risk of periodontal abscess
- Dry socket following extractions only
Correct answer: Medication-related osteonecrosis of the jaw (MRONJ)
MRONJ is a serious complication associated with bisphosphonate therapy, particularly with invasive procedures or poorly healing oral tissues.
Question 4: When applying fluoride varnish to an adult patient, what is the maximum recommended concentration of sodium fluoride?
- 1.1%
- 2.26% (Correct answer)
- 5%
- 0.5%
Correct answer: 2.26%
The standard professional fluoride varnish contains 5% NaF, which equals 2.26% fluoride ion by weight.
Question 5: A 7-year-old patient has an unerupted permanent maxillary central incisor 18 months after the contralateral incisor erupted. What is the most likely cause?
- Hyperdontia
- Ankylosed primary tooth
- Supernumerary tooth (mesiodens) (Correct answer)
- Normal variation in eruption
Correct answer: Supernumerary tooth (mesiodens)
A mesiodens (supernumerary tooth in the midline) is the most common cause of impacted or delayed eruption of a maxillary central incisor.
Question 6: Which of the following is the primary goal of root planing compared to scaling?
- Remove supragingival calculus deposits
- Smooth the root surface by removing cementum containing endotoxins (Correct answer)
- Remove the junctional epithelium
- Establish a new connective tissue attachment
Correct answer: Smooth the root surface by removing cementum containing endotoxins
Root planing removes the outermost layer of cementum embedded with calculus and bacterial endotoxins, creating a smooth, biologically compatible surface.
Question 7: A patient presents with linear erythema along the free gingival margin that does not respond to scaling and oral hygiene improvement. This finding is most suggestive of:
- Acute necrotizing ulcerative gingivitis
- HIV-associated linear gingival erythema (Correct answer)
- Plasma cell gingivitis
- Plaque-induced gingivitis
Correct answer: HIV-associated linear gingival erythema
Linear gingival erythema is a distinct red band at the gingival margin associated with HIV infection that does not resolve with conventional treatment.
NBDHE NBDHE Dental Hygiene Care 4
A patient's blood pressure reading is 158/96 mmHg at the beginning of the appointment.
According to ADA guidelines, what is the most appropriate course of action?