Dental Hygiene Interventions and Treatment
Dental Hygiene Interventions and Treatment
This domain tests selection and delivery of nonsurgical therapy: instrumentation, polishing, fluoride, sealants, local anesthesia, and supportive care, with correct sequencing and evaluation.
Core rules
- Supragingival scaling removes coronal deposits; periodontal debridement or SRP removes biofilm and calculus from root surfaces in pockets, typically by quadrant or as tolerated, followed by reevaluation in 4–6 weeks.
- Hand instruments require correct angulation (blade toe 0–40 degrees for insertion, 45–90 for scaling), adaptation, and sharpening. Ultrasonic tips reduce hand fatigue and lavage pockets but require water coolant and aerosol control.
- Selective polishing preserves fluoride-rich enamel; do not polish demineralized or newly erupted teeth.
- Sealants are indicated for deep pits and fissures in caries-risk patients; isolate, etch, verify a frosty appearance, and check retention.
Worked example
A patient has heavy subgingival calculus, 5–6 mm pockets, and no pacemaker. Plan: ultrasonic debridement with high-volume evacuation, then hand scaling for tenacious deposits, one quadrant per visit; oral hygiene instruction; reevaluate in 6 weeks. Reasoning: ultrasonic improves efficiency and lavage, hand instruments verify smoothness; staging visits respects tissue tolerance and allows healing assessment.
Traps
- Calling periodontal debridement a “prophylaxis” for insurance or charting.
- Using an ultrasonic scaler without coolant or aerosol control.
- Over-angulating a curet and gouging cementum.
- Sealing a tooth without isolating or checking retention.
- Skipping reevaluation and repeating instrumentation blindly.