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Hygienist Licensing Examination study materials
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Hygienist Licensing Examination practice questions

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Question 1Patient Assessment and Data Collection

During a periodontal assessment, which measurement represents the distance from the gingival margin to the base of the sulcus or pocket?

  1. Keratinized tissue width
  2. Gingival recession
  3. Clinical attachment level
  4. Probing depth Correct answer.

Explanation

Probing depth is measured from the gingival margin to the apical extent of the probe within the sulcus or pocket. Clinical attachment level instead references the cementoenamel junction, so it accounts for recession or hyperplasia.

Question 2Patient Assessment and Data Collection

A patient's radiograph shows a radiolucent area at the apex of a maxillary central incisor, and the tooth does not respond to cold testing. Which pulpal and periapical diagnosis is most consistent with these findings?

  1. Reversible pulpitis with normal apical tissues
  2. Necrotic pulp with asymptomatic apical periodontitis Correct answer.
  3. Necrotic pulp with symptomatic apical periodontitis
  4. Normal pulp with condensing osteitis

Explanation

A nonresponsive pulp indicates necrosis, and a periapical radiolucency without reported pain or tenderness fits asymptomatic apical periodontitis. Symptomatic apical periodontitis would require pain on percussion or biting.

Question 3Patient Assessment and Data Collection

Which index is used to record the presence and severity of gingival inflammation by scoring bleeding on gentle probing at the gingival margin?

  1. Gingival Bleeding Index Correct answer.
  2. Plaque Index
  3. Simplified Debris Index
  4. Community Periodontal Index

Explanation

The Gingival Bleeding Index records the presence or absence of bleeding after gentle probing of the gingival sulcus, providing a measure of inflammatory status. Debris and plaque indices quantify deposits rather than bleeding.

Question 4Patient Assessment and Data Collection

When assessing a patient's medical history, which finding most strongly requires deferral of elective periodontal instrumentation until medical clearance is obtained?

  1. Hypertension controlled with a diuretic
  2. Well-controlled type 2 diabetes with an A1c of 6.5%
  3. Recent myocardial infarction within the past month Correct answer.
  4. History of seasonal allergic rhinitis

Explanation

A myocardial infarction within the preceding weeks is a recognized reason to postpone elective dental care because of elevated perioperative cardiac risk. Controlled diabetes and hypertension do not generally require deferral of routine hygiene care.

Question 5Patient Assessment and Data Collection

A 45-year-old patient reports frequent gum bleeding and fatigue. Which laboratory finding would most directly support a hematologic cause for the bleeding?

  1. Elevated serum creatinine
  2. Low serum ferritin
  3. Elevated fasting glucose
  4. Low platelet count Correct answer.

Explanation

Thrombocytopenia reduces primary hemostasis and can present as gingival bleeding out of proportion to plaque levels. Glucose, creatinine, and ferritin do not directly explain mucosal bleeding tendency.

Question 6Patient Assessment and Data Collection

Which vital sign finding should prompt immediate medical referral before continuing a hygiene appointment?

  1. Blood pressure of 118/76 mmHg
  2. Blood pressure of 186/112 mmHg Correct answer.
  3. Pulse of 78 beats per minute
  4. Respiratory rate of 16 breaths per minute

Explanation

A blood pressure reading in the hypertensive crisis range (systolic at or above 180 or diastolic at or above 110) warrants prompt medical evaluation before elective dental treatment. The other values fall within normal adult ranges.

Question 7Patient Assessment and Data Collection

A patient's periodontal charting shows 3 mm of recession and a probing depth of 5 mm on the facial aspect of a mandibular canine. What is the clinical attachment level at that site?

  1. 2 mm
  2. 8 mm Correct answer.
  3. 5 mm
  4. 3 mm

Explanation

Clinical attachment level equals probing depth plus recession when the gingival margin is apical to the cementoenamel junction. Adding 5 mm and 3 mm yields 8 mm of attachment loss.

Question 8Patient Assessment and Data Collection

Which radiographic feature is most characteristic of early, localized aggressive periodontitis in an adolescent patient?

  1. Diffuse widening of the periodontal ligament at all teeth
  2. Vertical bone loss at first molars and incisors with minimal plaque Correct answer.
  3. Uniform bone height with isolated gingival enlargement
  4. Generalized horizontal bone loss with heavy calculus

Explanation

Localized aggressive periodontitis classically produces angular bone loss at first molars and incisors in young patients despite light plaque and calculus. Generalized horizontal loss with heavy deposits better fits chronic disease.

Question 9Patient Assessment and Data Collection

During an extraoral examination, a patient reports a clicking sound and pain in the preauricular area when opening wide. Which structure is most directly implicated?

  1. Temporomandibular joint Correct answer.
  2. Masseter muscle origin
  3. Parotid duct orifice
  4. Submandibular lymph node

Explanation

Preauricular clicking and pain with jaw opening point to the temporomandibular joint and its disc. The parotid duct, submandibular nodes, and masseter origin produce different findings and locations.

Question 10Patient Assessment and Data Collection

A patient presents with a 4 mm probing depth on the distal of a maxillary second molar and reports food impaction. Which assessment finding would best explain the impaction?

  1. Presence of a shallow 2 mm sulcus
  2. Absence of bleeding on probing
  3. Open contact due to drifted adjacent third molar Correct answer.
  4. Attached gingiva width of 6 mm

Explanation

Food impaction at a posterior site is commonly caused by an open contact or drifted tooth that traps debris. Shallow sulci, adequate attached gingiva, and absence of bleeding do not explain impaction.

Question 11Patient Assessment and Data Collection

Which finding on a soft tissue examination most warrants biopsy referral?

  1. Fordyce granules on the upper lip
  2. A firm, painless ulcer persisting for five weeks Correct answer.
  3. Transient aphthous ulcer resolving in ten days
  4. Bilateral linea alba along the buccal mucosa

Explanation

An ulcer that persists beyond two to three weeks and is firm and painless raises concern for malignancy and requires biopsy. Linea alba, Fordyce granules, and healing aphthae are benign and self-limiting.

Question 12Patient Assessment and Data Collection

A patient undergoing chemotherapy reports new-onset gingival bleeding and petechiae. Which assessment step is most appropriate before instrumentation?

  1. Recommend only a chlorhexidine rinse without contacting the physician
  2. Proceed with full-mouth scaling as scheduled
  3. Delay all care for six months regardless of counts
  4. Obtain current platelet and white blood cell counts from the oncologist Correct answer.

Explanation

Chemotherapy can cause thrombocytopenia and neutropenia, so current hematologic values guide whether instrumentation is safe. Proceeding blindly, substituting rinses, or imposing a blanket delay ignores the patient's actual status.

Question 13Patient Assessment and Data Collection

Which measurement is recorded when documenting the width of attached gingiva on a mandibular premolar?

  1. Distance from the gingival margin to the pocket base
  2. Distance from the mucogingival junction to the gingival margin Correct answer.
  3. Distance from the incisal edge to the gingival margin
  4. Distance from the cementoenamel junction to the alveolar crest

Explanation

Attached gingiva width is the keratinized band measured from the mucogingival junction to the gingival margin, minus any sulcus or pocket depth. The other distances describe pocket depth, bone level, or crown height.

Question 14Patient Assessment and Data Collection

A patient's plaque control record shows 85% of surfaces with visible plaque. Which interpretation is most accurate?

  1. Sufficient plaque to indicate aggressive periodontitis
  2. Poor plaque control requiring intensified oral hygiene instruction Correct answer.
  3. Excellent plaque control with low caries risk
  4. Normal plaque level for adults

Explanation

A plaque score of 85% indicates that most surfaces harbor visible biofilm and reflects inadequate hygiene. High plaque scores call for reinforced instruction and re-evaluation rather than reassurance.

Question 15Patient Assessment and Data Collection

Which factor in a patient's history most increases the risk of infective endocarditis from periodontal instrumentation?

  1. Mitral valve prolapse without regurgitation
  2. Prosthetic heart valve replacement Correct answer.
  3. Coronary artery bypass grafting
  4. History of rheumatic fever without valve damage

Explanation

Prosthetic heart valves carry the highest risk for infective endocarditis among the listed conditions and are a recognized indication for antibiotic prophylaxis before invasive dental procedures. The other conditions are not current prophylaxis indications.

Question 16Patient Assessment and Data Collection

During periodontal probing, which technique improves accuracy and reduces tissue trauma?

  1. Using a probe with a blunt, wide tip
  2. Probing only the midfacial surface of each tooth
  3. Applying heavy force to reach the base of the pocket
  4. Walking the probe with light force parallel to the long axis Correct answer.

Explanation

Light probing force with the probe walking along the sulcus and parallel to the long axis improves detection of attachment loss while minimizing trauma. Heavy force and limited site sampling reduce accuracy.

Question 17Patient Assessment and Data Collection

A patient reports a bitter taste and recurrent swelling under the tongue that worsens with meals. Which assessment finding would most support a diagnosis of sialolithiasis?

  1. A hard mass palpated in the floor of the mouth near the submandibular duct Correct answer.
  2. Diffuse gingival erythema with bleeding
  3. A fluctuant swelling on the buccal mucosa
  4. Bilateral parotid enlargement with dry eyes

Explanation

A hard, palpable mass along the submandibular duct with meal-related swelling and altered taste suggests a salivary stone obstructing flow. The other findings describe different conditions.

Question 18Patient Assessment and Data Collection

Which portion of a periodontal charting record is essential for tracking response to therapy over time?

  1. The patient's preferred toothpaste brand
  2. The number of teeth present at the first visit
  3. The date of the last radiograph only
  4. Serial probing depths and bleeding on probing at each site Correct answer.

Explanation

Repeated site-specific probing depths and bleeding scores allow clinicians to detect improvement or progression of disease. Brand preferences and single data points do not support longitudinal comparison.

Question 19Patient Assessment and Data Collection

A patient with a history of bisphosphonate therapy for osteoporosis reports a nonhealing extraction socket. Which assessment conclusion is most appropriate?

  1. The patient is at risk for medication-related osteonecrosis and should be referred for evaluation Correct answer.
  2. The socket will heal once antibiotics are started
  3. The finding is unrelated to medication history and needs no action
  4. The patient should undergo immediate bone grafting

Explanation

Nonhealing bone in a patient with bisphosphonate exposure raises concern for medication-related osteonecrosis of the jaw, which requires specialist evaluation. Antibiotics alone and immediate grafting are not appropriate first steps.

Question 20Patient Assessment and Data Collection

Which clinical sign most reliably distinguishes plaque-induced gingivitis from periodontitis?

  1. Redness of the marginal gingiva
  2. Presence of clinical attachment loss Correct answer.
  3. Presence of bleeding on probing
  4. Presence of calculus

Explanation

Periodontitis requires attachment loss beyond the gingival margin, whereas gingivitis is confined to reversible inflammation without attachment loss. Bleeding, calculus, and redness can occur in either condition.

Question 21Patient Assessment and Data Collection

A patient's medical history notes a latex allergy. Which precaution is most appropriate during a hygiene appointment?

  1. Use latex gloves because exposure is brief
  2. Proceed normally and monitor for symptoms
  3. Substitute nitrile gloves and latex-free dam and prophy cups Correct answer.
  4. Cancel all future hygiene appointments

Explanation

Latex allergy requires avoiding all latex-containing items, including gloves, rubber dam, and prophy cups, and substituting latex-free alternatives. Brief exposure and monitoring are unsafe because reactions can be severe.

Question 22Patient Assessment and Data Collection

Which site is the most appropriate location for assessing the pulse rate during a dental appointment?

  1. Dorsalis pedis artery at the foot
  2. Femoral artery at the groin
  3. Radial artery at the wrist Correct answer.
  4. Carotid artery at the neck

Explanation

The radial artery is the standard, accessible site for measuring pulse in a dental setting without compressing the airway or neck vessels. The carotid is used in emergencies but is less convenient for routine counting.

Question 23Patient Assessment and Data Collection

A patient's panoramic radiograph reveals a well-defined radiolucency with a sclerotic border at the mandibular angle. Which interpretation is most consistent with a benign cyst?

  1. Diffuse widening of the periodontal ligament
  2. Well-defined borders with a corticated rim Correct answer.
  3. Ill-defined borders with rapid expansion
  4. Multiple floating teeth

Explanation

Benign cysts typically show well-defined margins with a corticated rim, reflecting slow growth. Ill-defined borders, diffuse ligament widening, and floating teeth suggest malignancy or aggressive disease.

Question 24Patient Assessment and Data Collection

Which documentation element is required when obtaining informed consent for periodontal therapy?

  1. A description of alternatives, risks, and consequences of declining Correct answer.
  2. A guarantee of treatment success
  3. The clinician's personal opinion about the patient's prognosis
  4. The patient's insurance policy number only

Explanation

Informed consent requires disclosure of the proposed treatment, reasonable alternatives, material risks, and the consequences of refusing care. Guarantees and personal opinions are not elements of valid consent.

Question 25Patient Assessment and Data Collection

A patient reports pain on biting a maxillary premolar, and percussion produces a sharp response. Which periapical diagnosis is most consistent?

  1. Symptomatic apical periodontitis Correct answer.
  2. Asymptomatic apical periodontitis
  3. Normal apical tissues
  4. Chronic hyperplastic pulpitis

Explanation

Pain on biting and tenderness to percussion indicate inflammation of the periapical tissues, consistent with symptomatic apical periodontitis. Asymptomatic disease and normal tissues would not produce these responses.

Question 26Patient Assessment and Data Collection

During a patient assessment, which component of the medical history is most critical for identifying a condition that could alter the dental hygiene care plan?

  1. The patient's use of herbal supplements Correct answer.
  2. The patient's preferred appointment time
  3. The patient's family history of seasonal allergies
  4. The patient's childhood immunization record

Explanation

Herbal supplements can interact with medications, affect bleeding, and influence treatment decisions, so they are a critical part of the medical history. Preferred appointment time, childhood immunizations, and seasonal allergies are less likely to alter the hygiene care plan directly.

Question 27Patient Assessment and Data Collection

A patient's periodontal charting reveals generalized 2 mm probing depths with 1 mm recession and no bleeding on probing. Which interpretation of these findings is most accurate?

  1. The patient has a healthy periodontium. Correct answer.
  2. The patient has necrotizing periodontal disease.
  3. The patient has generalized periodontitis.
  4. The patient has gingival hyperplasia.

Explanation

Probing depths of 2 mm with 1 mm recession indicate a clinical attachment level of 3 mm, which is within the range of health when there is no bleeding on probing. The absence of bleeding and inflammation supports a healthy diagnosis rather than periodontitis, necrosis, or hyperplasia.

Question 28Patient Assessment and Data Collection

When assessing a patient's risk for dental caries, which factor is most predictive of future caries development?

  1. The patient's socioeconomic status
  2. The patient's preference for sweet foods
  3. The patient's previous caries experience Correct answer.
  4. The patient's frequency of flossing

Explanation

Previous caries experience is the strongest single predictor of future caries, as it reflects the patient's cumulative disease history and susceptibility. While socioeconomic status, flossing frequency, and dietary preferences influence risk, they are less directly predictive than past caries.

Question 29Patient Assessment and Data Collection

A patient presents with a 6 mm probing depth on the mesial of a maxillary first molar, accompanied by bleeding on probing and 3 mm of recession. Which descriptor most accurately documents this site?

  1. Clinical attachment level of 9 mm Correct answer.
  2. Clinical attachment level of 3 mm
  3. Probing depth of 3 mm
  4. Probing depth of 9 mm

Explanation

Clinical attachment level is calculated by adding the probing depth and recession, so 6 mm + 3 mm = 9 mm. This measurement reflects the true loss of attachment and is essential for accurate periodontal documentation.

Question 30Patient Assessment and Data Collection

During an extraoral examination, a patient reports a clicking sound and pain in the preauricular area when opening wide. Which assessment finding is most consistent with temporomandibular joint disorder?

  1. Bilateral swelling of the parotid glands
  2. Enlarged cervical lymph nodes
  3. Crepitus in the temporomandibular joint Correct answer.
  4. Limited mandibular opening with deviation to the affected side

Explanation

Crepitus, a grating or popping sensation, is a classic sign of temporomandibular joint disorder and indicates degenerative changes in the joint. Clicking and pain in the preauricular area further support this diagnosis, whereas the other options are not typical of temporomandibular joint disorder.

Question 31Dental Hygiene Diagnosis and Care Planning

During a comprehensive periodontal assessment, a dental hygienist records a probing depth of 5 mm with bleeding on probing and 2 mm of clinical attachment loss at the mesiofacial aspect of tooth 16. Which term best classifies this site?

  1. A gingival recession defect only
  2. A periodontal pocket with clinical attachment loss Correct answer.
  3. A healthy sulcus with physiologic depth
  4. A periodontal pseudopocket without attachment loss

Explanation

A true periodontal pocket is defined by apical migration of the junctional epithelium producing clinical attachment loss, so a 5 mm depth accompanied by 2 mm of attachment loss represents a periodontal pocket. Bleeding on probing further supports active inflammation at the site. Pseudopockets show deepened sulci without attachment loss.

Question 32Dental Hygiene Diagnosis and Care Planning

Which index is designed specifically to assess gingival inflammation by scoring bleeding on gentle probing at the gingival margin?

  1. Community Periodontal Index of Treatment Needs
  2. Silness-Löe Plaque Index
  3. Russell Periodontal Index
  4. Gingival Bleeding Index Correct answer.

Explanation

The Gingival Bleeding Index (Ainamo and Bay) records the presence or absence of bleeding after gentle probing of the sulcus, giving a direct measure of gingival inflammation. Plaque indices quantify deposits rather than bleeding. The CPITN and Russell index combine multiple periodontal parameters into broader scores.

Question 33Dental Hygiene Diagnosis and Care Planning

A patient reports taking phenytoin for seizure control. Which oral finding should the dental hygienist anticipate during the extraoral and intraoral examination?

  1. Desquamation of the gingival epithelium with pseudomembrane formation
  2. Gingival enlargement, particularly on the anterior facial surfaces Correct answer.
  3. Localized gingival necrosis with a fetid odor
  4. Diffuse brown pigmentation of the attached gingiva

Explanation

Phenytoin is a well-documented cause of drug-influenced gingival enlargement, typically beginning in the interdental papillae and anterior facial gingiva. The enlargement is aggravated by plaque, making oral hygiene instruction central to care planning. Pigmentation, desquamation, and necrosis are associated with other conditions.

Question 34Dental Hygiene Diagnosis and Care Planning

When formulating a dental hygiene diagnosis, which element distinguishes it from a dental diagnosis such as caries or periodontitis?

  1. It is recorded only after all restorative treatment is complete
  2. It identifies the causative microorganisms from a culture
  3. It replaces the need for a medical consultation
  4. It describes the human need or problem the hygienist is licensed to treat Correct answer.

Explanation

A dental hygiene diagnosis identifies actual or potential problems related to oral health that fall within the scope of dental hygiene practice, often framed by human needs. It complements rather than duplicates the dentist's disease diagnosis. It does not require microbial culture and is developed during assessment, not after restorative care.

Question 35Dental Hygiene Diagnosis and Care Planning

A 14-year-old patient has generalized marginal inflammation with no attachment loss and abundant supragingival plaque. Which dental hygiene diagnosis is most appropriate?

  1. Gingival recession
  2. Plaque-induced gingivitis Correct answer.
  3. Periodontitis, generalized
  4. Necrotizing periodontitis

Explanation

Marginal inflammation without clinical attachment loss in the presence of plaque is the hallmark of plaque-induced gingivitis, which is reversible with improved self-care. Periodontitis requires attachment loss, and necrotizing disease requires necrosis and pain. Recession is not described in the scenario.

Question 36Dental Hygiene Diagnosis and Care Planning

Which component of the care plan documents the specific, measurable oral health goal the patient agrees to achieve and the interval for re-evaluation?

  1. The expected outcome with a time frame Correct answer.
  2. The medical history summary
  3. The periodontal screening record
  4. The informed consent form

Explanation

Expected outcomes state measurable, patient-centered goals with target dates so that progress can be evaluated at reappointment. Consent forms, medical summaries, and screening records are assessment or legal documents, not goal statements. Clear outcomes guide intervention selection and re-evaluation intervals.

Question 37Dental Hygiene Diagnosis and Care Planning

A patient with type 2 diabetes has a hemoglobin A1c of 9.2% and generalized bleeding on probing. How should this finding most directly influence the dental hygiene care plan?

  1. It requires postponing all oral hygiene instruction
  2. It indicates that probing should be avoided permanently
  3. It has no bearing on periodontal therapy
  4. It supports coordination with the physician and intensified periodontal therapy Correct answer.

Explanation

Poorly controlled diabetes is a recognized risk factor for periodontal disease progression and impaired healing, so the hygienist should coordinate with the medical provider and intensify periodontal therapy and monitoring. Oral hygiene instruction remains essential. Probing is not permanently contraindicated, though timing may be adjusted to glycemic control.

Question 38Dental Hygiene Diagnosis and Care Planning

A patient's community periodontal index code is 3 in all sextants with no pockets exceeding 5 mm. What does this code indicate for care planning?

  1. Edentulous sextant
  2. Pocket depth of 4 to 5 mm requiring scaling and improved oral hygiene Correct answer.
  3. Healthy periodontium with no treatment needed
  4. Pocket depth of 6 mm or greater requiring complex therapy

Explanation

In the CPITN scoring system, code 3 denotes a probing depth of 4 to 5 mm in at least one site, indicating the need for scaling and oral hygiene instruction. Code 4 represents depths of 6 mm or more, and code 0 indicates health. This guides the minimum treatment need at the sextant level.

Question 39Dental Hygiene Diagnosis and Care Planning

During assessment, the hygienist notes that a patient's existing restorations have open margins and a fractured cusp on tooth 30. What is the most appropriate action within the dental hygiene process of care?

  1. Polish the restoration and document no concern
  2. Defer any documentation until the next recall
  3. Place a new restoration independently
  4. Refer the defective restoration to the dentist and note it in the care plan Correct answer.

Explanation

Defective restorations require diagnosis and treatment by the dentist, so the hygienist identifies and refers the finding while documenting it in the care plan. Polishing a defective margin does not resolve the problem, and restorative placement is outside hygiene scope. Timely documentation supports continuity of care.

Question 40Dental Hygiene Diagnosis and Care Planning

A patient presents with a 7 mm probing depth on the mesial of tooth 14, radiographic bone loss, and Class II furcation involvement. Which care plan element is most appropriate?

  1. Supragingival prophylaxis only
  2. Immediate extraction planning by the hygienist
  3. Nonsurgical periodontal therapy with re-evaluation and possible referral Correct answer.
  4. Fluoride varnish application only

Explanation

Deep pocketing with bone loss and furcation involvement calls for nonsurgical periodontal therapy such as scaling and root planing, followed by re-evaluation to determine whether referral for surgical therapy is needed. Prophylaxis alone is inadequate for established periodontitis. Extraction decisions belong to the dentist.

Question 41Dental Hygiene Diagnosis and Care Planning

A patient using a manual toothbrush reports difficulty cleaning the lingual surfaces of the mandibular molars. Which recommendation best addresses this specific limitation?

  1. Recommend increasing brushing force on the lingual surfaces
  2. Recommend a powered toothbrush with a small head and demonstrate lingual placement Correct answer.
  3. Recommend discontinuing interdental cleaning
  4. Recommend rinsing with water instead of brushing

Explanation

A powered brush with a compact head can improve access to hard-to-reach lingual surfaces, and demonstration ensures correct angulation. Increasing force risks abrasion and recession. Interdental cleaning and mechanical plaque removal should be reinforced, not replaced by rinsing.

Question 42Dental Hygiene Diagnosis and Care Planning

Which finding during an extraoral examination should prompt the hygienist to refer for further evaluation of possible temporomandibular joint dysfunction?

  1. Mild physiologic pigmentation of the gingiva
  2. Presence of a lingual frenum
  3. Symmetric mandibular opening of 45 mm
  4. Bilateral palpable masseter tenderness with limited opening Correct answer.

Explanation

Muscle tenderness on palpation combined with restricted mandibular opening suggests temporomandibular dysfunction and warrants referral for diagnosis. Normal opening is approximately 40 to 50 mm and symmetric. A lingual frenum and physiologic pigmentation are normal findings.

Question 43Dental Hygiene Diagnosis and Care Planning

A patient is scheduled for periodontal debridement and reports taking warfarin with an INR of 3.5. What is the most appropriate care-planning response?

  1. Double the next dose after treatment
  2. Proceed with debridement regardless of the INR
  3. Discontinue the warfarin for two weeks
  4. Consult the prescribing physician before invasive procedures Correct answer.

Explanation

An INR of 3.5 exceeds the usual therapeutic range for most indications and raises bleeding risk, so the hygienist should consult the prescriber before invasive care. The hygienist cannot alter anticoagulant therapy. Proceeding without consultation risks excessive bleeding.

Question 44Dental Hygiene Diagnosis and Care Planning

Which assessment finding most strongly indicates a need to modify the care plan toward caries risk reduction in an older adult?

  1. Monthly use of an alcohol-free mouthrinse
  2. A single amalgam restoration placed 20 years ago
  3. Well-controlled hypertension
  4. Root exposure with visible plaque and frequent sugar intake Correct answer.

Explanation

Root exposure, visible plaque, and frequent sugar exposure are established caries risk factors in older adults, especially with reduced salivary flow or medication burden. These findings justify fluoride therapy, dietary counseling, and closer recall intervals. The other findings do not independently indicate elevated caries risk.

Question 45Dental Hygiene Diagnosis and Care Planning

A patient's periodontal charting shows generalized 2 to 3 mm probing depths, no bleeding, and no attachment loss, but the patient reports occasional food impaction between posterior teeth. Which care plan focus is most appropriate?

  1. Systemic antibiotic therapy
  2. Maintenance with interdental cleaning instruction and re-evaluation Correct answer.
  3. Nonsurgical periodontal therapy with local anesthesia
  4. Immediate referral for periodontal surgery

Explanation

Healthy probing depths without bleeding or attachment loss indicate periodontal health, so care should focus on prevention, including interdental cleaning to address food impaction. Scaling and root planing, antibiotics, and surgery are not indicated without disease. Re-evaluation confirms whether the self-care change resolves the complaint.

Question 46Dental Hygiene Diagnosis and Care Planning

A patient reports xerostomia after starting a new antihypertensive medication. Which combination of interventions best fits the care plan?

  1. Recommend frequent water sips, fluoride supplementation, and a saliva substitute Correct answer.
  2. Increase caffeinated beverages and reduce fluoride use
  3. Increase sugar-containing lozenges to stimulate saliva
  4. Recommend discontinuing the medication without consultation

Explanation

Medication-induced xerostomia increases caries risk, so the plan should emphasize hydration, topical fluoride, and saliva substitutes while coordinating with the prescriber. Caffeine and sugar can worsen dryness and caries risk. The hygienist cannot advise stopping a prescribed medication.

Question 47Dental Hygiene Diagnosis and Care Planning

A patient's periodontal record shows a 6 mm probing depth with 1 mm of recession and 7 mm of clinical attachment loss. Which interpretation is correct?

  1. The recession reduces the attachment loss
  2. The attachment loss equals the probing depth
  3. The site is a pseudopocket
  4. The pocket depth underestimates the true attachment loss Correct answer.

Explanation

When recession is present, probing depth measures from the gingival margin to the base of the sulcus, so attachment loss equals probing depth plus recession. Here 6 mm plus 1 mm gives 7 mm of attachment loss, meaning the probing depth alone understates the destruction. Pseudopockets occur without attachment loss.

Question 48Dental Hygiene Diagnosis and Care Planning

A patient has generalized severe periodontitis, smokes one pack per day, and has poorly controlled diabetes. Which statement best reflects the interaction of these risk factors for care planning?

  1. Smoking and hyperglycemia independently worsen periodontal risk and healing, so both should be addressed Correct answer.
  2. Smoking protects against periodontitis by reducing bleeding
  3. Diabetes has no effect on periodontal progression
  4. Risk factors should be addressed only after periodontal therapy is complete

Explanation

Smoking and poor glycemic control are independent risk factors that accelerate periodontal destruction and impair healing, so both should be addressed alongside therapy. Smoking may mask bleeding but does not protect against disease. Risk factor counseling is integrated throughout care, not deferred until the end.

Question 49Dental Hygiene Diagnosis and Care Planning

During assessment of a patient with suspected bulimia nervosa, the hygienist observes erosion on the lingual surfaces of the maxillary anterior teeth. Which care-planning recommendation is most appropriate?

  1. Immediate vigorous brushing with an abrasive paste after vomiting
  2. Avoiding all fluoride products
  3. Increasing citrus intake to stimulate saliva
  4. Rinsing with water or a fluoride rinse after vomiting and delaying brushing Correct answer.

Explanation

Gastric acid exposure softens enamel, so rinsing with water or a fluoride rinse and delaying brushing reduces abrasion and demineralization. Vigorous brushing immediately after vomiting accelerates enamel loss. Fluoride and reduced acid exposure are protective, and referral for medical and psychological support is appropriate.

Question 50Dental Hygiene Diagnosis and Care Planning

A patient's care plan includes a re-evaluation appointment six weeks after scaling and root planing. Which set of findings best determines whether the plan should be maintained or modified?

  1. The dentist's vacation schedule
  2. The patient's preference for a different toothpaste flavor
  3. Comparison of probing depths, bleeding on probing, and plaque control with baseline Correct answer.
  4. The number of appointments attended in the past year

Explanation

Re-evaluation compares objective periodontal parameters such as probing depths, bleeding, and plaque scores against baseline to determine treatment response. This evidence-based comparison guides whether to continue maintenance or refer for further therapy. Scheduling and preferences do not determine clinical response.