ADEX Dental Hygiene cheat sheet

Periodontal ligament principal fiber groups are alveolar crest, horizontal, oblique, apical, and interradicular; oblique fibers are the largest group and resist axial occlusal forces.

Enamel rods extend from the dentinoenamel junction to the enamel surface, generally perpendicular to the surface, and are supported by interrod enamel.

Dentinal tubules follow an S-shaped course from pulp to the dentinoenamel junction; peritubular dentin is more mineralized than intertubular dentin.

Junctional epithelium attaches to enamel or cementum by hemidesmosomes; sulcular epithelium is nonkeratinized and lacks attachment.

Alveolar bone proper is the cribriform plate lining the socket; bundle bone receives periodontal ligament fibers and appears as the lamina dura radiographically.

Mandibular teeth receive sensory innervation from the mandibular division of the trigeminal nerve (V3); maxillary teeth from V2; the facial nerve (VII) supplies muscles of facial expression.

Streptococcus mutans is acidogenic and aciduric and produces glucosyltransferases that synthesize adhesive glucans from sucrose.

Porphyromonas gingivalis is a gram-negative anaerobic keystone periodontal pathogen; Aggregatibacter actinomycetemcomitans is associated with aggressive periodontitis.

Gingivitis is reversible inflammation confined to the gingiva; periodontitis involves clinical attachment loss and alveolar bone loss.

Probing depth is measured from the gingival margin to the base of the sulcus or pocket; clinical attachment level adjusts probing depth for the gingival margin position relative to the cementoenamel junction.

Clinical attachment loss equals probing depth plus recession when the gingival margin is apical to the cementoenamel junction; subtract when the margin is coronal to the cementoenamel junction.

Periodontitis stage I–IV uses clinical attachment loss, radiographic bone loss, tooth loss from periodontitis, and complexity factors; grade A–C estimates progression rate.

Bleeding on probing indicates gingival inflammation; its absence has high negative predictive value for periodontal stability.

Furcation involvement classes I–IV range from incipient bone loss to through-and-through exposure between roots.

Miller mobility grades 0–3 describe physiologic to severe horizontal and vertical tooth mobility.

Nonsurgical periodontal therapy includes plaque control instruction, scaling and root planing, risk-factor modification, and re-evaluation typically 4–6 weeks later.

A periodontal abscess usually shows localized swelling and a deep pocket in a vital tooth; a periapical abscess usually involves a nonvital tooth.

Enamel critical pH is approximately 5.5; dentin critical pH is higher, approximately 6.2–6.5, so root surfaces demineralize at less acidity.

Fluoride reduces demineralization, enhances remineralization, and inhibits bacterial metabolism; topical exposure is the main caries-preventive mechanism.

Five percent sodium fluoride varnish contains about 22,600 ppm fluoride; 1.23% acidulated phosphate fluoride gel contains about 12,300 ppm fluoride.

Pit-and-fissure sealants are indicated for deep, retentive pits and fissures, especially in patients with elevated caries risk.

Caries risk assessment weighs pathologic factors such as biofilm, frequent fermentable carbohydrate, low saliva flow, and past caries against protective factors such as fluoride and adequate saliva.

Frequent sucrose exposure increases cariogenicity more than total amount alone; retentive foods and between-meal snacks prolong acid challenge.

Xylitol reduces mutans streptococci and plaque cariogenicity; frequent divided doses, often 5–10 g/day, are used as an adjunct.

Recall interval is individualized by caries risk, periodontal status, age, and medical factors rather than fixed for all patients.

Saliva buffers acid mainly via bicarbonate; stimulated flow increases buffering and clearance.

Comprehensive periodontal examination records probing depths, clinical attachment levels, bleeding on probing, suppuration, mobility, furcation involvement, and mucogingival status.

Vitality testing uses cold or electric pulp tests; a brief sharp response that resolves suggests a normal pulp, while prolonged or absent response suggests pathology.

Percussion and palpation help localize apical pathosis; a nonvital tooth with apical tenderness suggests symptomatic apical periodontitis.

Medical history must identify bleeding disorders, anticoagulant use, bisphosphonate use, diabetes control, pregnancy, and allergy to local anesthetics or latex.

ASA physical status I–VI classifies medical risk; higher classes require consultation and possible treatment modification.

Treatment sequencing commonly proceeds from emergency care to disease control, re-evaluation, definitive care, and maintenance.

Informed consent requires diagnosis, proposed treatment, alternatives, risks, benefits, and consequences of no treatment.

Blood pressure categories: normal is less than 120/80 mm Hg; stage 2 hypertension is 140/90 mm Hg or higher; severe elevation warrants deferral or medical referral.

Radiographs are prescribed based on patient-specific need, not routine interval alone.

Maxillary infiltration is placed in the buccal vestibule adjacent to the tooth apex and anesthetizes maxillary teeth via V2 branches.

Inferior alveolar nerve block landmarks include the coronoid notch, pterygomandibular raphe, and occlusal plane; the target is the pterygomandibular space near the mandibular foramen.

Gow-Gates block targets the condylar neck and blocks V3, often producing broader mandibular anesthesia with fewer positive aspirations.

Two percent lidocaine with 1:100,000 epinephrine has a maximum recommended dose of about 7 mg/kg, not exceeding 500 mg in healthy adults.

Epinephrine vasoconstriction slows systemic absorption, prolongs anesthesia, reduces bleeding, and lowers systemic toxicity.

Aspiration before injection helps detect intravascular placement; positive aspiration requires repositioning and re-aspiration.

Benzocaine topical overuse can cause methemoglobinemia; use the smallest effective amount and avoid excessive application.

Common local anesthetic complications include hematoma, trismus, paresthesia, needle breakage, and syncope.

ALARA means keeping exposure as low as reasonably achievable using justification, the fastest receptor, collimation, and proper technique.

Bitewing radiographs show crowns and alveolar crests and are best for interproximal caries and crestal bone assessment.

Periapical radiographs show the entire tooth and surrounding bone and are used for apical pathology and endodontic assessment.

Panoramic radiographs provide a broad overview but have lower resolution and more distortion; they do not replace bitewings for caries detection.

Digital intraoral receptors and F-speed film reduce dose compared with D-speed film; rectangular collimation further reduces exposure.

Lead apron and thyroid collar reduce dose to radiosensitive tissues, especially in children and pregnant patients.

Paralleling technique places the receptor parallel to the tooth long axis and the central ray perpendicular, reducing distortion.

Radiographic landmarks include the maxillary sinus, mandibular canal, mental foramen, incisive foramen, and lamina dura.

Pregnancy is not an absolute contraindication to needed dental radiographs; use justified exposure and shielding.

Standard precautions apply to all patients regardless of diagnosis and include hand hygiene, gloves, masks, eye protection, gowns, and safe sharps handling.

Hand hygiene is performed before and after glove use and after contact with blood, saliva, or contaminated surfaces.

Critical items penetrate soft tissue or bone and must be sterilized; semicritical items contact mucous membranes and require at least high-level disinfection.

Steam autoclave commonly uses 121°C at 15 psi for 15–30 minutes or 132°C at 30 psi for about 4 minutes.

Spaulding classification groups items as critical, semicritical, or noncritical based on contact with sterile tissue, mucous membranes, or intact skin.

Ethical principles include autonomy, beneficence, nonmaleficence, justice, veracity, and confidentiality.

Needlestick or sharps exposure requires immediate washing, reporting, source evaluation, and post-exposure prophylaxis assessment.

HIPAA protects identifiable patient health information; disclosures require authorization or a permitted exception.

Scope of practice limits dental hygienists to duties permitted by state law and supervision level.