Mixed Deck — All ADEX Topics Flashcards

Which of the following best describes a pseudo-pocket (false pocket)?

Answer: Increased probing depth due to coronal enlargement of the gingival margin without loss of attachment

A pseudo-pocket forms when gingival enlargement increases the probing depth without actual apical migration of the junctional epithelium or loss of attachment.

Which drug interaction should a dental hygienist be aware of when a patient reports taking a monoamine oxidase inhibitor (MAOI)?

Answer: Avoid epinephrine in local anesthetic; use plain mepivacaine

MAOIs inhibit catecholamine breakdown, and epinephrine can cause dangerous hypertensive crisis; plain anesthetics without vasoconstrictors are recommended.

A patient with a history of periodontitis returns for a maintenance appointment. Which of the following findings would indicate disease progression and place them in Grade C (Rapid Progression) according to the AAP staging and grading system?

Answer: Radiographs show ≥2 mm of bone loss over a 5-year period.

The grading system estimates the future risk and rate of progression. Grade C indicates rapid progression. Direct evidence for this includes radiographic bone loss or clinical attachment loss of ≥2 mm over a 5-year period. Smoking >10 cigarettes/day is a Grade C modifier, but the radiographic evidence is a primary criterion.

Which hepatitis virus is most commonly transmitted via contaminated dental instruments?

Answer: Hepatitis B

Hepatitis B virus (HBV) is a primary bloodborne pathogen of concern in dentistry due to its high survival rate on surfaces and low infectious dose.

Which of the following describes the radiographic appearance of enamel pearls (enamelomas)?

Answer: Small, discrete radiopaque nodules located in the furcation area of molar roots

Enamel pearls are small deposits of ectopic enamel that appear as discrete radiopaque nodules, usually found in the furcation area of maxillary molars.

A child patient (8 years old, 25 kg) develops anaphylaxis. What is the correct epinephrine dose using an auto-injector?

Answer: EpiPen Jr. (0.15 mg) — pediatric dose for children 15–30 kg

Children weighing 15–30 kg should receive EpiPen Jr. (0.15 mg epinephrine), as the pediatric auto-injector delivers an appropriate weight-based dose for anaphylaxis management.

Which impression material is considered the most dimensionally accurate and is preferred for fixed prosthodontic impressions?

Answer: Polyvinyl siloxane (addition silicone)

Polyvinyl siloxane (addition silicone) is considered the gold standard for fixed prosthodontic impressions due to its exceptional dimensional accuracy and stability.

Which systemic condition related to nutrition is characterized by low salivary flow and dramatically increases caries risk?

Answer: Xerostomia associated with poor fluid intake and certain medications

Xerostomia reduces salivary buffering, antimicrobial proteins, and mineral ion availability, making teeth highly susceptible to caries.

Which of the following is the definitive, first-line medication for treating a patient experiencing a severe, life-threatening allergic reaction (anaphylaxis) characterized by respiratory distress and hypotension?

Answer: Intramuscular epinephrine

Intramuscular epinephrine is the primary, life-saving medication for anaphylaxis. It acts rapidly to counteract vasodilation and bronchoconstriction, which are the life-threatening components of the reaction. While antihistamines, corticosteroids, and albuterol are used as adjunctive therapies, they do not act fast enough and are not considered first-line treatment.

A dental hygienist develops a rash on her hands after extended glove use. The most appropriate next step is:

Answer: Consult a physician and consider allergy testing for latex or glove materials

A rash after glove use may indicate latex allergy or irritant/allergic contact dermatitis and requires medical evaluation and potential allergy testing.

According to OSHA's Bloodborne Pathogen Standard, who is responsible for providing hepatitis B vaccination to dental employees?

Answer: The employer at no cost to the employee

OSHA 29 CFR 1910.1030 requires employers to offer HBV vaccination to all employees with occupational exposure at no cost within 10 days of assignment.

A clinician is sharpening a Gracey 1/2 curette using a stationary flat stone and moving the instrument. To maintain the original design of the blade, the relationship between the face of the curette and the surface of the sharpening stone should be:

Answer: 100-110 degrees

When sharpening, the internal angle of the blade (between the face and the lateral surface) should be maintained at 70-80 degrees. To achieve this, the angle formed between the face of the curette blade and the stationary sharpening stone should be 100-110 degrees. This ensures the cutting edge is properly re-established without being weakened or excessively thinned.

Which of the following BEST describes the purpose of a dental hygiene diagnosis?

Answer: Label oral conditions the dental hygienist is licensed to treat

The dental hygiene diagnosis identifies oral health problems within the dental hygienist's scope that guide individualized care planning.

A radiopaque structure that appears to move in the same direction as the x-ray tube shift during SLOB technique is located:

Answer: Lingually

With the SLOB rule (Same = Lingual, Opposite = Buccal), an object moving with the tube shift is on the lingual side.

The pterygomandibular raphe serves as an attachment point for which two muscles?

Answer: Buccinator and superior pharyngeal constrictor

The pterygomandibular raphe is a fibrous band that serves as the attachment for the buccinator muscle anteriorly and the superior pharyngeal constrictor muscle posteriorly.

What three types of dental mirrors are there?

Answer: Front surface, concave, and plane

Dental mirrors come in three main types, each offering distinct advantages for intraoral examination. Front surface mirrors provide the clearest image by eliminating ghost images, as the reflective coating is on the front of the glass. Concave (magnifying) mirrors enlarge the image, which can be useful for detailed inspection, while plane (flat) mirrors offer a true-to-size image without magnification or distortion.

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?

Answer: Magnetostrictive ultrasonic scaler

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.

The recommended threshold for dental unit waterline water quality per CDC guidelines is:

Answer: <500 CFU/mL of heterotrophic bacteria

The CDC recommends that dental unit waterline output water contain <500 CFU/mL of heterotrophic bacteria, consistent with drinking water standards.

A patient's blood pressure reading is 185/110 mmHg before treatment. According to ADA guidelines, what should the dental hygienist do?

Answer: Reschedule treatment and refer for medical evaluation

A BP ≥180/110 mmHg (Stage 2 hypertensive crisis) requires postponing elective dental treatment and referring the patient for medical evaluation.

A 62-year-old patient with a history of stable angina complains of substernal chest pain. You stop the procedure and administer one dose of their sublingual nitroglycerin. After 5 minutes, the patient states the pain is unimproved. What is the most critical next step?

Answer: Assume the patient is experiencing a myocardial infarction and activate emergency medical services (EMS).

Chest pain that is not relieved by one dose of nitroglycerin should be treated as a potential myocardial infarction (heart attack). The absolute priority is to activate EMS (call 911) immediately. While administering oxygen or aspirin may be part of the subsequent management protocol, delaying the call for advanced medical care is detrimental.