Your 42 year old new patient presents in your new patient exam (NPE) rotation and has not been to a dentist for 20 years.  He has a large amount of supragingival calculus and stain with generalized inflammation.  You check in your head and neck exam with the faculty and determine that there are not any pathological findings, just a variation of normal consisting of bony deposits on the buccal of the mandibular alveolar process and on the palate.  The faculty advises you to get a full series of radiographs and to use the ultrasonic throughout the mouth first since there is so much calculus, charging out a 4355 code, before you will be able to accurately complete periodontal assessments and restorative charting. On the radiographs you see that there is a generally moderate bone loss and radiographic furcation involvement as well as generalized radiographic calculus deposits.  Use this information to answer following questions. QUESTION: What are the terms for the bony deposits that you discovered in the mouth?    

Your 72 year old, diabetic patient, with no known allergies, presents for her appointment and it has been a little over a year since you have seen her last. While going through her medical history you find out she had a joint replacement 9 months ago. You find out she didn’t take a pre-medication and and send her home after consulting with her surgeon. Before dismissing her, you complete the head exam and update the risk assessments. You notice a 5×5 mm red, raised lesion on her lower lip that she says she got from biting really hard a few days ago. She returns the next day, she took her pre-med and now you can begin the rest of your assessments. Vitals: BP-120/78, pulse 60, respirations 70.  During assessments she has generalized 5-6 mm probing depths in her posterior teeth and you determine she has a calculus level of .3. She will need full mouth SRP. You will begin the SRP on the maxillary right quadrant at the next appointment and ask her to check her glucose at the beginning of the next appointment.  QUESTION: Which would indicate the most desirable glucose level for this patient before giving anesthetic?

Your new patient is a 38-year-old woman whose health history shows that she is asthmatic, HIV positive, smokes hookah socially (between 1 and 3 days a week), has high blood pressure, and reports that all of her conditions are controlled with medications. She lists 5 medications that she takes that you look up to match with her conditions. Her last dental visit was approximately two years ago to have a tooth removed on an emergency basis, and she says she remembers them taking X-rays at that appointment. Her vitals today are BP 129/70, Pulse 54, Respiration 20. Use this information to answer the following questions. QUESTION:  Which of the following should be asked regarding her current HIV status to determine if you can safely treat her today?  

You are reviewing your clinic book to prepare for spring semester clinic.  Use the information that you have learned through these resources and your time in clinic to answer the following questions. QUESTION: How do you get a periodontist to come to do a periodontal consult?

Which of the following statements about mutations is true?

Your patient hasn’t been to the dentist in 5 years and has 3-6mm probe depths and a localized 8mm probe depth at an implant. On the full mouth series of radiographs, you see generalized radiographic calculus and 2 implants, one with significant bone loss. The dental hygiene diagnosis is moderate periodontal disease,  ADA III with a .3 level of calculus, and through a periodontal consult with the periodontist at the last appointment the patient is recommended to have 4 quadrants of scaling and root planing and a consultation in the graduate periodontal clinic regarding the implant.  You and a senior student are paired to begin their first appointment of SPR treatment today.  The senior student checks out a variety of ultrasonic inserts and instruments and you are helping to set up.  Use this information to answer the following questions. QUESTION: What consent form needs to be signed before beginning the periodontal treatment today?

Your 56 year old female patient presents for her 6 month recall appointment. Her medical history indicates a history of anxiety, depression and hypothyroidism. Her vitals today are blood pressure of 154/92, heart rate of 72, and 20 respirations and she expresses a lot of anxiety about the possibility of contracting illnesses when being in a patient care environment.  When conducting the head and neck exam, you note generalized lentigines, and severe acne. When inspecting her dentition, you note generalized restorations in the posterior, and notice facial notching on the anteriors from clenching and grinding. QUESTION:  How could you accurately answer the patient about how a cubicle is disinfected?

You have a 57-year-old female patient report for her Periodontal Maintenance appointment. She was running a few minutes behind schedule and missed her bus to get to your appointment, so she had to walk to the clinic. When you take her blood pressure, it reads 139/99. Her pulse is 95 BPM, and her respiratory rate is 22. After reviewing the patient’s medical history, she reports no new ER visits or hospital stays, but she is still having issues with her stent that was placed in 2019 from a previous heart attack, and is still taking the depressant drug, Valium for her generalized anxiety. During the dental history portion, you find out this patient has a 7/10 fear of the dentist due to past trauma. During assessments, you determine this patient is at high risk for caries. This patient has a lot of radiographic calculus subgingivally on the distals of her 2nd molars. Use this information to answer the following questions. QUESTION: Which instrument could be used to remove the subgingival calculus noted in the case?

Evaluate the limit.limx→-∞ 10x+33×2+1

Your new patient has a lot of restorations to chart and is also missing several teeth, so you use your visual clinical evaluation as well as the radiographs to determine all of the appropriate findings to chart. Use the following photographs and radiographs to help you answer the questions for this patient. QUESTION: What classification of composite is on the mesial of #9?