DANB CPFDA flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Sealant indication

Sealants are indicated for deep, retentive, non-carious pits and fissures on permanent molars and premolars, especially newly erupted teeth in patients at moderate or high caries risk.

Explorer test for sealant

A #23 explorer that cannot penetrate a fissure suggests a shallow fissure that may not need sealing; a fissure that catches or holds the tip is deep and benefits from sealant.

Sealant contraindications

Sealant is contraindicated over cavitated or dentinal caries, on teeth where moisture cannot be controlled, and on partially erupted teeth with tissue covering the field.

Etch times for sealants

Phosphoric acid 30-40% is applied for about 15-20 seconds on primary teeth and 20-30 seconds on permanent teeth, then rinsed and dried to a frosty white appearance.

Contaminated etched enamel

If etched enamel contacts saliva, water, or oil, the frosty appearance is lost and the surface must be re-etched for the full time before sealant placement.

Glass ionomer sealant

A moisture-tolerant, fluoride-releasing sealant useful when isolation is difficult or a tooth is partially erupted; retention is generally lower than resin-based sealants.

Coronal polishing definition

Coronal polishing removes plaque and extrinsic stain from the clinical crown using a rubber cup or brush and prophy paste; it does not remove calculus.

Selective polishing

Selective polishing means polishing only teeth with visible extrinsic stain or before fluoride varnish, adhesive procedures, or cementation, rather than polishing every tooth at every visit.

Polishing before bonding

Prophy paste residue and glycerin can interfere with etching and bonding, so surfaces must be thoroughly rinsed and, where indicated, re-etched before sealant or composite placement.

Prophy paste grit

Coarse paste is used for heavy stain, medium for routine polishing, and fine for maintenance or before restorative work; grit determines how much enamel and stain are removed.

Polishing contraindications

Do not polish exposed root surfaces, demineralized white-spot lesions, active carious lesions, or newly erupted teeth with immature enamel, to avoid removing tooth structure.

Topical anesthetic depth

Topical anesthetics act on mucosa and gingiva to a depth of about 2-3 mm; they do not anesthetize teeth or bone and never replace local anesthetic injection.

Benzocaine methemoglobinemia

Benzocaine can cause methemoglobinemia, presenting with cyanosis unresponsive to oxygen, chocolate-brown blood, and dyspnea; stop the agent and seek emergency care.

Benzocaine age warning

Benzocaine is contraindicated in children under 2 years and should be used cautiously in young children because of methemoglobinemia reports; many products carry this warning.

Topical anesthetic application

Apply to dried mucosa with a clean cotton swab, allow the full onset time of about 1-5 minutes, and use the smallest effective amount to limit systemic absorption.

Ester versus amide allergy

Ester anesthetics such as benzocaine are more likely to cause true allergy than amides; a documented ester allergy requires choosing an amide or another alternative.

Fluoride varnish concentration

5% sodium fluoride varnish contains 22,600 ppm fluoride and is the standard professional topical fluoride for caries prevention in children and adults.

APF restriction

1.23% acidulated phosphate fluoride contains 12,300 ppm fluoride but is contraindicated on porcelain, composite, glass ionomer, and sealants because its low pH can degrade them.

Varnish post-application instructions

After varnish, avoid brushing and hard food for at least 4-6 hours, do not suction the material away, and follow the manufacturer's specific instructions.

Fluoride application frequency

Application is risk-based: every 3-6 months for high caries risk, at least every 6 months for moderate risk, and less often for low-risk patients.

Probable toxic dose

The probable toxic dose of fluoride is 5 mg per kg of body weight; unit-dose varnish tubes reduce accidental ingestion compared with gel in trays.

Standard precautions

Standard precautions apply to all patients regardless of diagnosis and include gloves, mask, protective eyewear, gown as indicated, and hand hygiene before and after glove use.

Sterilization monitoring

Biological indicators (spore tests) are run at least weekly, chemical indicators are placed in each package, and physical parameters are checked on every load; a positive spore test requires load recall.

Dental unit waterline limit

Dental unit waterlines must meet drinking-water standards of no more than 500 CFU/mL of heterotrophic bacteria; flush lines and follow the manufacturer's treatment protocol.

Critical versus semicritical

Critical items that penetrate tissue require sterilization, usually steam autoclave; semicritical items such as mirrors and explorers require sterilization or high-level disinfection.

Sharps handling

Needles and other sharps go directly into a puncture-resistant container at the point of use; recapping by hand is avoided and a one-handed scoop or device is used if necessary.

Sealant failure causes

Sealant failure most often results from moisture contamination, incomplete etching, or occlusal trauma; marginal leakage can allow caries under an apparently intact sealant.

Sealant recall evaluation

At recall, inspect sealants visually and with an explorer; repair or replace partial loss, and take radiographs when caries is suspected beneath or adjacent to a sealant.

Polishing and fluoride sequence

Some protocols defer polishing after varnish or reapply varnish afterward; check the product instructions because polishing paste can remove freshly applied fluoride varnish.

Extrinsic versus intrinsic stain

Extrinsic stain from tobacco, coffee, tea, and chlorhexidine responds to polishing; intrinsic stain such as tetracycline or fluorosis does not and requires bleaching or restoration.

Topical anesthetic and aspiration

Topical anesthetic reduces needle pain but does not eliminate the need for aspiration and slow injection technique to reduce intravascular injection and nerve injury risk.

Fluoride varnish and restorations

Varnish is compatible with porcelain, composite, glass ionomer, and sealants, unlike acidulated phosphate fluoride gel, which can etch or degrade those materials.