NBDHE NBDHE Dental Hygiene Care 5 — Questions and Answers
Question 1: During an oral cancer screening, which tissue change warrants an immediate biopsy referral?
- Fordyce spots on the buccal mucosa
- A white lesion that cannot be scraped off and has been present for 3 weeks (Correct answer)
- Geographic tongue with remission and recurrence
- Linea alba along the occlusal plane
Correct answer: A white lesion that cannot be scraped off and has been present for 3 weeks
A persistent white lesion (leukoplakia) that cannot be removed by wiping and has lasted more than 2 weeks must be referred for biopsy to rule out dysplasia or malignancy.
Question 2: A patient requires nitrous oxide/oxygen sedation. Which of the following is an absolute contraindication?
- Mild anxiety
- First trimester of pregnancy (Correct answer)
- Moderate hypertension
- Controlled asthma
Correct answer: First trimester of pregnancy
Nitrous oxide is absolutely contraindicated in the first trimester of pregnancy due to its inhibition of methionine synthase and potential teratogenic effects.
Question 3: Which instrument design feature makes a curette different from a sickle scaler?
- Curettes have two cutting edges; sickle scalers have one
- Curettes have a rounded back and toe; sickle scalers have a pointed back and toe (Correct answer)
- Curettes are used only supragingivally; sickles are used subgingivally
- Curettes have a 90-degree face angle; sickles have a 70-degree angle
Correct answer: Curettes have a rounded back and toe; sickle scalers have a pointed back and toe
Curettes have a rounded back and rounded toe, making them safe for subgingival use, whereas sickle scalers have a pointed toe and triangular cross-section.
Question 4: A patient has probe readings of 2–3 mm with no bone loss detected radiographically. There is bleeding on probing at 60% of sites. This presentation is consistent with:
- Chronic periodontitis — slight
- Plaque-induced gingivitis (Correct answer)
- Aggressive periodontitis
- Periodontal abscess
Correct answer: Plaque-induced gingivitis
Normal probing depths with no bone loss but widespread bleeding on probing indicates gingivitis, which is reversible with improved oral hygiene.
Question 5: Which of the following best explains the significance of the col in periodontal disease susceptibility?
- It is the thickest area of gingival tissue and most resistant to bacteria
- It is a non-keratinized valley between papillae that is difficult to clean and susceptible to disease (Correct answer)
- It is the attachment point of the junctional epithelium to enamel
- It is a keratinized region protected by high salivary flow
Correct answer: It is a non-keratinized valley between papillae that is difficult to clean and susceptible to disease
The col is a non-keratinized concave area between the facial and lingual papillae that is inaccessible to routine cleaning and highly susceptible to periodontal breakdown.
Question 6: Which ethical principle is violated when a dental hygienist continues treatment against a patient's clearly expressed wishes?
- Beneficence
- Justice
- Autonomy (Correct answer)
- Veracity
Correct answer: Autonomy
Autonomy is the patient's right to self-determination; continuing treatment against expressed wishes violates this fundamental ethical principle.
Question 7: A patient reports taking St. John's Wort as an herbal supplement. Which drug interaction is most clinically relevant in dental hygiene care?
- It potentiates the effects of local anesthetics
- It reduces the efficacy of oral contraceptives and many prescription medications via CYP450 induction (Correct answer)
- It causes gingival hyperplasia similar to cyclosporine
- It increases the anticoagulant effect of warfarin
Correct answer: It reduces the efficacy of oral contraceptives and many prescription medications via CYP450 induction
St. John's Wort is a potent CYP450 inducer that accelerates metabolism of many drugs including oral contraceptives, antiretrovirals, and warfarin, reducing their effectiveness.
NBDHE NBDHE Dental Hygiene Care 5
During an oral cancer screening, which tissue change warrants an immediate biopsy referral?