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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?

How many cutting/leading edges do the Universals have on each working end of the instrument?

You are scheduled to complete a periodontal maintenance on your patient.  They last had complete periodontal charting and head and neck exam at their last appointment 4 months ago.  When assessing your patient with a head and neck exam, you determine that they have a lesion on their lip from an accidental bite and that there are two large nevi on their face that were not noted before. While doing your periodontal assessments you determine that there are scattered 4-6mm probe depths, isolated areas of mobility and both generalized recession and furcation involvement.   QUESTION: Which of your instruments will be used to assess the furcation involvement?

You and your classmates are participating with a dental screening event at a local health fair for immigrant and refugee families that have recently relocated to central Ohio. As part of this screening, you are using your magnification loupes and headlight, and have access to shepherd hooks explorers, periodontal explorers, probes and mirrors. On any willing participate, you are completing a head and neck oral cancer screening, an abbreviated PSR screening using one tooth in each sextant, and identifying any clinical visible areas that you are suspicious of decay. You chart all of this information and present a summary form and referral to the OSU dental clinic for each of the participants.   QUESTION: Which of the patients would NOT require a pre-medication?

Case Study #3: Your first patient in clinic is a healthy 24 year old with probe depths 1-3mm and tight, resilient tissue. They report that they do not floss and have not had a dental visit in 6 years. They have generalized calculus interproximal and you are using the sickle scalers to access the calculus.  You notice that you don’t have a sharpening card in your cassette, so you begin scaling without sharpening. While you are scaling, you place the instrument at the proper location on each tooth and use light, sweeping, supragingival strokes using your fingers. When your clinic instructor checks your scaling progress, they indicate that you have missed several areas of calculus in the middle of the proximals and have burnished other areas of calculus. In summary, you have not made much progress with your scaling. Use this information to answer the following questions. QUESTION: Which would NOT be a contributing factor to the burnished calculus?

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 power setting will be used for treating this patient?