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Your 62 year old new patient presents with generalized calculus and periodontal issues including deep probe depths, mobility and furcation involvement. The patient had a massive stroke 2 years ago that left them with some cognitive impairment, speech impairment and reliance on a wheelchair for mobility. He has not been to the dentist since. He relies on his partner to drive him to appointments and to help him with completing medical paperwork. The patient also has some trouble speaking clearly and the partner helps you to understand what he is saying. QUESTION: Which would be an ineffective way to determine if the patient has full decision making capacity or if the partner needs to make the decisions?

What English monarch was “restored” to the throne in 1660?

Case #4: You are seeing a new patient and are finishing their assessments by taking intraoral camera photos. Through your assessments, you have determined that the patient does not have recession, gingival inflammation, or periodontal pockets and has a .2 level of calculus. You are primarily going to be using the sickles for scaling their teeth today. Use this information to answer the following questions.  QUESTION: For which photos will you use the cheek retractors?

On your new patient you are using the light, explorers and radiographic images to determine where there are restorations, check the restorations for areas of decay and to determine where there is calculus to remove.  On tooth #30 there is an area where there is a gap between the tooth and the amalgam that you can stick the explorer into.  On tooth #18, there is excessive amalgam material that extends into the proximal embrasure space.  You feel vibrations that indicate that there is calculus on many of proximal surfaces, you estimate about 25% of the surfaces total.  One of the patient’s chief complaints for today is that his bridge fell out and he brought it with him in hopes it could be re-cemented. QUESTION: What is the calculus classification for this patient?

Briefly describe Bacon’s Rebellion mentioning at least two points for full credit.

Your patient is a 90 year old man with several health conditions including a past stroke in 2017, past heart attack in 2000, hypertension since 1980 and dementia diagnosed in 2016.  His vital signs are BP: 132/84, pulse 84, respiration 14 and he takes his 5 prescribed medications daily to control his health issues.   His daughter brought him because he no longer drives and she helps him during the appointment with the paperwork and with answering your questions.  The daughter wishes he could have a dentist that comes to his nursing home, so you work with her to try to recruit the dentist you work for to see patients there 1 day per month. QUESTION: What would you chart for this wear on the gingival surfaces on his maxillary right posteriors?

CASE STUDY #1: You have completed your assessments on your patient and are getting ready to scale.  You don’t see a test stick in your cassette, so you are going to use the Visual Test using light to determine if your instruments are sharp on dull.  Once you have determined this, you sharpen several of your instruments using the technique that we practiced in class.  Once your instruments are sharpened, you decide to use the sickle scalers as your first hand instruments on your patient since they are periodontally healthy and do not have periodontal pockets to scale.  Use this information to answer the following questions.  QUESTION: As you start to use your H533, where will your insertion site be?

CASE STUDY #2: You are getting ready to see a difficult .3 periodontal maintenance patient. You want to verify that you are using sharp instruments throughout the appointment so you check and sharpen them carefully.  You work carefully during instrumentation to make sure that you are using accurate scaling strokes to avoid incomplete removal of the calculus. Use this information to answer the next 5 questions. QUESTION: When sharpening your instruments, which of the following statements describes the proper technique?

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: Why was the ultraslim thinsert not the first insert that you used?

This case study contains pictures that you would use to make notations on a head and neck examination form.  Choose the right description for each picture.