ADEX Dental Hygiene Periodontal Instrumentation and Care Questions and Answers

Question 1

A dental hygienist is performing periodontal debridement on the facial aspect of tooth #30. To effectively remove a tenacious, sheet-like piece of subgingival calculus, which type of instrumentation stroke is most appropriate to initiate the removal process?

Accepted Answer

A series of short, overlapping, horizontal strokes starting from the side edge of the deposit.

Answer

For tenacious or burnished calculus, using short, overlapping horizontal strokes starting from the edge of the deposit helps to break up the calculus into smaller, more manageable pieces for removal. A long vertical stroke may not engage the edge of the deposit effectively, and a light or push stroke would be ineffective and could even burnish the calculus further.

Question 2

When using a Gracey curette for subgingival calculus removal, what is the ideal angulation between the face of the blade and the tooth surface?

Accepted Answer

Greater than 45 but less than 90 degrees

Answer

The optimal angulation for calculus removal with a Gracey curette is between 70 and 80 degrees. This angle allows the cutting edge to effectively 'bite' into the calculus deposit for removal. An angle less than 45 degrees will lead to burnishing, while an angle of 90 degrees or more can gouge the root surface and damage soft tissue.

Question 3

A patient with a history of a cardiac pacemaker presents for their routine periodontal maintenance appointment. Which of the following instruments is generally contraindicated for this patient without a medical consultation?

Accepted Answer

Magnetostrictive ultrasonic scaler

Answer

Historically, magnetostrictive ultrasonic scalers have been considered a potential source of electromagnetic interference with older models of cardiac pacemakers. While many modern pacemakers are shielded, it is standard practice to avoid using magnetostrictive ultrasonic devices on patients with pacemakers unless clearance has been given by their cardiologist. Piezoelectric scalers are generally considered safer but consultation is still best practice.

Question 4

Which of the following BEST describes the primary goal of periodontal debridement, distinguishing it from traditional scaling and root planing?

Accepted Answer

Disruption and removal of biofilm and calculus while conserving cementum.

Answer

The contemporary understanding of periodontal therapy emphasizes that the goal is not the aggressive removal of cementum. Periodontal debridement focuses on the disruption and removal of bacterial biofilm and calculus deposits from the tooth surface and within the pocket, with the specific intent of preserving the underlying cementum.

Question 5

During instrumentation, a hygienist is using a modified pen grasp. The middle finger's primary role in this grasp is to:

Accepted Answer

Rest lightly on the shank to guide the working-end and feel vibrations.

Answer

In a correct modified pen grasp, the middle finger rests lightly on the instrument shank. This placement helps to guide the working-end and enhances tactile sensitivity, allowing the clinician to feel vibrations transmitted from the working-end to the shank. The thumb and index finger hold the instrument, and the ring finger serves as the fulcrum.

ADEX - Dental Hygiene Exam Practice Test

ADEX - Dental Hygiene Exam Practice Test

ADEX Dental Hygiene Periodontal Instrumentation and Care Questions and Answers