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 what you discovered on the palate and alveolar process?    

Your new patient is a 20 year old college student who is slightly overdue for his 6 month recall. He had radiographs transferred that included a set of bitewings and panoramic taken 8 months ago. He does not report any health issues and only takes a multivitamin, no medications.  He reports alcohol use 4-5 times per week, smoking marijuana 2 times weekly, occasional smokeless tobacco use and using e-cigarettes for vaping daily. His vitals today are 110/72, pulse 74, respirations 16.  The risk assessments indicate a moderate risk for perio, caries and nutrition.  You have some findings on the head and neck exam to discuss with the faculty and the periodontal findings indicate 4mm probe depths posterior proximals and recession where he uses the smokeless tobacco. QUESTION: What step are you completing when you are explaining the risks, benefits, and costs of your treatment recommendations to get patient acceptance?

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: When should you look up each of her medications to find the reason for taking them and any dental considerations?

CASE STUDY #1: Your patient presents for a periodontal maintenance appointment after 10 months.  She is usually on a 4 month recall, but has been dealing with health issues.  She reports hypertension and diabetes, both of which she controls with medications, and her vitals today are BP 130/86, pulse 88, respirations 14 and HbA1C is 9.7. 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: Which is not accurate to share with your patient who is feeling overwhelmed by the water with the ultrasonic?

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Who created the Nuclear model of the atom?

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Which scientist used the cathode ray tube?

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