Competency Exercises
Apply information from the chapter and use critical thinking skills to complete the competency exercises. Write responses on paper or create electronic documents to submit your answers.
1. As you evaluate Mrs. Eltheia Shore, you note that she presents with a significant amount of supragingival, subgingival, gingival, and fissure biofilm. Educate her about the factors that can contribute to biofilm accumulation and the surfaces most commonly affected. Describe the strategies used for the detection of biofilm.
2. You are providing patient education for Alison Alverez and her 10-year-old son, Juan. Juan has multiple carious lesions, and his mother is very interested in preventing more from occurring Juan drinks soda daily. He purchases a 32-oz bottle on his way to school and sips the soda every chance he gets. Juan’s mother remembers hearing something about acids in the mouth and wants to know more about this. Describe your approach to patient education.
3. Your patient, John Weston, is wandering about calculus formation. He is trying to understand the exact time frame of the process. Help him understand calculus formation by defining pellicle, biofilm, and calculus, and discussing the influencing factors. Make a list or draw a picture that describes calculus formation in terms of minutes hours and days
Wilkins’ Clinical Practice of the Dental Hygienist, Fourteenth Edition Linda D. Boyd, RDH, RD, EdD and Lisa F. Mallonee, RDH, RD, LD, MPH
4. While scaling in the mandibular right quadrant, you are having varying degrees of difficulty detecting and removing the calculus Describe the three modes of calculus attachment. Explain how each mode affects detection and removal
5. Your 1:30 pm. patient, Fawez Sadarage, 47 years old, presents with a stain on all the second and third molars caused by tetracycline. Describe the stain that you might see and list some follow-up questions you will ask Mr. Sadarage. Indicate why you would ask the questions
6. The patient in the scenario posed in Question 1 presented with generalized gray-brown stain on the second and third molars. Why weren’t all teeth affected?
7. At what age do you think the patient took the antibiotic?
8. Several strategies will help you recognize and identify stains that you observe during the assessment of the oral cavity. Explain the types of stains (color and cause) that can be identified using each of the strategies listed below.
Medical history
Questions about industrial occupation
Questions about dietary habits
Dental history
Dental charting (e.g., endodontic therapy, restorative materials)
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Everyday Ethics
Before completing the following learning exercises, it may also be useful to review the Dental Hygiene Ethics discussion in Chapter 1, the Ethical Applications in the introduction pages for each section in the textbook, as well as the Codes of Ethics in the textbook Appendices.
Robert returned to the dental office of Dr. Taylor after 3 years of working in Northern Quebec, Canada. At the age of 30, Robert was exhibiting signs of early periodontitis with gingival inflammation and moderate subgingival calculus. Susan, the dental hygienist, educated Robert about biofilm and suggested improvements for his personal daily brushing and flossing regimen. After debriding two quadrants with local anesthesia, Susan suggested that rinsing with chlorhexidine for the first week, after brushing before going to bed. would help the healing.
Dr. Taylor agreed with Susan’s recommendation and wrote the prescription. A few days later Robert called to complain about the “awful brown stain on his teeth and horrible taste of the mouth rinse.” He further indicated that he had stopped using the product and wanted to come in and have the stain removed immediately.
