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CASE STUDY #1: Your patient presents for a periodontal maintenance appointment after being gone for 10 months due to the pandemic.  She is usually on a 4 month recall, so this is an amount of time that would usually have included two appointments.   She reports hypertension and diabetes, both of which she controls with medications, and her vitals today are BP 130/86, pulse 88, respirations 14. In doing your periodontal assessments and radiographs, you determine that she has 4mm probe depths in the anterior teeth, several 5-6mm probe depths in the posterior teeth with isolated furcation involvement and generalized moderate to heavy calculus.  She has several amalgam restorations and crowns and you notice several areas of demineralization and recurrent decay, but she is not having any pain or sensitivity.  Use this information to answer the following questions. QUESTION: As you start with a standard insert on a magnetostrictive ultrasonic scaler, which statement does NOT describe the recommended adaptation?

CASE STUDY #5: You are doing your Capstone internship in your senior year with the Central Sterilization. As part of your job, you are working in dispensary distributing instruments and on the ground floor evaluating instruments for replacement and assisting with sterilization of instruments from the appointments throughout the College of Dentistry. Use this information to answer the following questions. QUESTION: How should ultrasonic inserts be sterilized?

You have completed all of the assessments and radiographs at an NPE (new patient exam) appointment on a 30 year old patient who has never has a dental hygiene procedure before. Today, you plan to check in the assessments with your instructor, create a treatment plan, complete a prophylaxis and get a dental examination.  He speaks English as a second language and has not requested an interpreter, but you are concerned that there may be a language barrier when discussing treatment and procedures, especially since this is the first dental office he has ever been to. You are preparing your instruments to treat this patient who has no signs of periodontal disease, but has a lot of supragingival and subgingival calculus.   QUESTION: Which would not be step in sharpening instruments to prepare this appointment?

You are preparing to complete scaling and root planing on the patient’s right side.  There are pockets on nearly every tooth, 4-5mm in the anterior and 4-7mm in the posteriors and nearly every tooth has 2-3mm of recession There is generalized moderate to heavy calculus both supra and subgingival, included radiographic, but the gingival tissue is generally tight and resilient. You need to determine what instruments you are using, what power setting and inserts will be necessary with your ultrasonic and how to determine if your hand instruments are well suited for treating a difficult periodontally involved patient. QUESTION: Which instrument would NOT be recommended for scaling the pockets on the posterior teeth?

CASE STUDY #4: Your patient reports being HIV positive with a CD4 count of 420, a case of COVID about a month ago with an emergency room visit for difficulty breathing and a two day hospitalization.  They report that they are no longer having breathing issues. They have high blood pressure and is current vitals are 140/90, pulse 82 and respirations of 16. They haven’t had their teeth cleaned in about a year and these photos represent some of your clinical findings–deep probe depths and moderate to heavy calculus supragingival and subgingival. Use this information to answer the following questions. QUESTION: If the white spots along the gingival margin of #29-31 are demineralization, what should be done with the ultrasonic?

CASE STUDY #4: Your patient reports being HIV positive with a CD4 count of 420, a case of COVID about a month ago with an emergency room visit for difficulty breathing and a two day hospitalization.  They report that they are no longer having breathing issues. They have high blood pressure and is current vitals are 140/90, pulse 82 and respirations of 16. They haven’t had their teeth cleaned in about a year and these photos represent some of your clinical findings–deep probe depths and moderate to heavy calculus supragingival and subgingival. Use this information to answer the following questions. QUESTION: Why would a standard straight not be recommended for the mesial pocket on #30?

When sharpening Universal curets, it is important to sharpen the toe as needed to maintain the shape.  Both curets and sickle scalers have toes.

CASE STUDY #3: Your patient is an international graduate student who is new to the United States and has never had an appointment with a dental hygienist before. They have never experienced the ultrasonic power scaler and are curious about how it works and what it is used for.  They are studying physics and are interested in the technology. Based on the amount of moderate to heavy calculus you choose to start with a standard tip, then follow up with the ultraslim thinsert. The patient asks questions about tip choice, why water is used, is this instrument more effective than hand instruments, among others. Use this information to answer questions for this patient. QUESTION: Which of the following is not a type of power scaler to discuss with the patient?

The Universal curets can be used on any tooth and surface.  One of the Universal curets in your cassette is only used for the anterior teeth and the other is only used for the posterior teeth.

At which angulation is the face to lower shank with the Universal Curets?