Periodontology for the Dental Hygienist, 4th Edition – Test Bank
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Chapter 5: Calculus and Other Disease-Associated Factors
MULTIPLE CHOICE
1. The mineral content of subgingival calculus is derived from:
a . Saliva.
b . Food particles.
ANS: D
c . Salivary ducts.
d . Crevicular fluid.
Minerals that make up subgingival calculus come from the crevicular fluid.
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2. How long does it take for plaque biofilm to begin to mineralize?
a . Less than 24 hours
b . 24 to 72 hours
c . 36 to 48 hours
d . 72 to 96 hours
e . More than 96 hours
ANS: A
Plaque biofilm begins to mineralize quickly, after just a few hours, and becomes about 90% mineralized in about 12 days.
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3. Each of the following characteristics is related to increased rates of calculus formation EXCEPT one. Which is the EXCEPTION?
a Elevated pH
b Higher individual inhibitory factors
c . Concentration of salivary bacterial protein and lipid
d . Concentration of calcium in saliva and crevicular fluid
ANS: C
Individual inhibitory factors help to slow calculus formation.
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4. Subgingival calculus is always covered with dental plaque biofilm. The presence of subgingival calculus and plaque biofilm causes
greater progression of periodontal disease than plaque biofilm alone.
a . Both statements are TRUE.
b . Both statements are FALSE.
c . The first statement is TRUE, and the second is FALSE.
d . The first statement is FALSE, and the second is TRUE.
ANS: A
Both statements are true. Calculus and its associated plaque bioflim has been shown to be associated with greater disease progression than plaque biofilm alone.
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5. The common name for calculus, “tartar,” was introduced by:
a . Paracelsus.
b . Alfred Fones.
ANS: A
c . Irene Newman.
d . Pierre Fouchard.
Paracelsus created the term “tartar” because the accumulations seen on teeth resembled deposits called “tartars” on the bottom of wine casks.
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6. Calculus becomes firmly attached to the tooth surfaces through which mechanism(s)?
a . Serum attachment
b . Pellicle attachment
c . Mechanical attachment
d Mechanical and pellicle attachment
e . Mechanical, pellicle, and serum attachment
ANS: D
Calculus becomes attached through plaque biofilm adherence to pellicle and by mechanical locking to the tooth structure.
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7. Subgingival calculus forms throughout the mouth. Regular calculus removal results in attachment loss.
a . Both statements are TRUE.
b . Both statements are FALSE.
c . The first statement is TRUE, and the second is FALSE.
d . The first statement is FALSE, and the second is TRUE.
ANS: C
The first statement is true. Subgingival calculus can form on any tooth in the mouth. The periodontium is preserved through calculus (and plaque biofilm) removal, not damaged by it.
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8. Adequate plaque biofilm control is more difficult to achieve with restored teeth. This is because poorly contoured restorations do not retain plaque.
a . Both statements are TRUE.
b . Both statements are FALSE.
c . The first statement is TRUE, and the second is FALSE.
d The first statement is FALSE, and the second is TRUE.
ANS: C
The first statement is true. Restorations often make plaque biofilm control more difficult to perform adequately, and rough or poorly contoured restorations can provide places for biofilm to remain protected from cleaning efforts.
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9. Significant tissue improvement occurs with calculus removal. Tissue health is unaffected by poorly contoured restorations.
a . Both statements are TRUE.
b . Both statements are FALSE.
c . The first statement is TRUE, and the second is FALSE.
d The first statement is FALSE, and the second is TRUE.
ANS: C
The first statement is true. Tissue health is improved with calculus removal. Poorly contoured restorations can limit the effectiveness of
treatment because they make treatment by the dental hygienist and home care by the patient more difficult to perform.
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10. The hygienic pontic, one that is easy for the patient to keep clean, should have what characteristics?
a . Saddle-shape
b . Spherical and 3 mm away from the gingiva
c . Spherical and tightly adapted to the gingiva
d Saddle-shaped and 3 mm away from the gingiva
e . Saddle-shaped and tightly adapted to the gingiva
ANS: B
The hygienic pontic should be spherical in shape and far enough away from the gingiva to allow good plaque biofilm control.
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11. The loss of the first molar is associated with periodontal disease. This condition can affect the extent and severity of disease.
a . Both statements are TRUE.
b . Both statements are FALSE.
c . The first statement is TRUE, and the second is FALSE.
d . The first statement is FALSE, and the second is TRUE.
ANS: A
Both statements are true. The loss of the first molar has not been proven to initiate periodontal disease but it is associated with gingival inflammation and pocket formation.
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12. Removable partial dentures are important to clean. They are associated with deeper pockets and caries susceptibility, especially on abutment teeth.
a . Both statements are TRUE.
b . Both statements are FALSE.
c . The first statement is TRUE, and the second is FALSE.
d The first statement is FALSE, and the second is TRUE.
ANS: A
Both statements are true. Removable appliances accumulate calculus like any tooth surface in the mouth. Natural teeth in function with removable partial denture appliances are more susceptible to caries and periodontal pocketing than nonabutment teeth.
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13. Orthodontic bands and brackets are associated with which of the following conditions?
a . Increased gingivitis and increased plaque biofilm
b . Decreased gingivitis and increased plaque biofilm
c . Increased gingivitis and decreased plaque biofilm
d Decreased gingivitis and decreased plaque biofilm
ANS: A
Orthodontic appliances are associated with increased amounts of plaque biofilm and gingivitis.
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14. The risk of severe periodontal disease is increased by approximately what amount for those who smoke tobacco products?
a . 1.5 times
b . 2 times
c . 2.8 times
d 3.5 times
e 4 times
ANS: C
The risk of severe periodontal disease is greatly increased for smokers, by as much as 2.8 times.
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15. The toxic effects of tobacco are caused by: a . Changes in gingival epithelium and mucosal cells.
b . Decreases in the vascular reaction to inflammation.
c Reduced ability of PMNs to phagocytize substances.
d All of the above.
ANS: D
Smoking has many effects on both the tissues and the immune response.
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16. The risk of periodontal disease is increased for moderate drinkers. The protective effects of alcohol consumption and presence of social habits must be considered when discussing these risk indicators with patients.
a . Both statements are TRUE.
b Both statements are FALSE.
c The first statement is TRUE, and the second is FALSE.
d . The first statement is FALSE, and the second is TRUE.
ANS: A
Both statements are true. Alcohol consumption is considered a risk indicator for periodontal disease, and those who drink alcohol are more likely to have the disease than those who do not drink. Social drinking is a common phenomenon and the dental hygienist must be aware of this association.
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17. Subgingival calculus is associated with which of the following?
a . Attachment loss
b . Attachment gain
c . First-molar loss syndrome
d Nonaggressive forms of periodontal disease
ANS: A
Subgingival calculus is associated with attachment loss and aggressive forms of periodontal disease.
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18. The results of calculus removal include:
a . Improved tissue tone.
b . Shorter recall intervals.
ANS: A
c . No changes in tissue color.
d . Little or no tissue shrinkage.
Calculus removal results in improved tissue tone, changes in tissue color, and gingival shrinkage.
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19. Hydroxyapatite is the predominant crystal type in mature supragingival calculus. About 80% of supragingival calculus is made up of minerals.
a . Both statements are TRUE.
b . Both statements are FALSE.
c . The first statement is TRUE, and the second is FALSE.
d . The first statement is FALSE, and the second is TRUE.
ANS: A
Both statements are true. Calculus is mostly hydroxyapatite crystals, and its mineral content is about 80%.
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20. Subgingival calculus is made up of crystals that can grow into cemental irregularities and bond to tooth structure. These qualities are important to understand because they explain why:
a . Supragingival calculus is harder to remove than subgingival calculus.
b . Supragingival calculus is often more tenacious than subgingival calculus.
c . Subgingival calculus is often more tenacious than supragingival calculus.
d . Subgingival calculus usually forms on the lower anterior and maxillary molar teeth.
ANS: C
Intercrystalline bonding and formation into tooth surface irregularities make subgingival calculus more tenacious than supragingival calculus.
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