NBDHE Dental Hygienist Practice Test

All intrinsic muscles of the tongue are innervated by the Hypoglossal (CN XII) Nerve. “Glossal” is derived from the Latin word for tongue “glossa,” so this derivative can be used to remember that words associated with the tongue will have “glossal” in them. Glossopharyngeal also relates to the tongue, but is the nerve that regulates swallowing, as glossopharyngeal refers to both the mouth and the throat (pharyngeal/pharynx) along with the tongue. The Trochlear nerve is one of the cranial nerves that functions to control eye movement. The Trigeminal nerve is the nerve most commonly talked about in dentistry as it is the nerve that is responsible for transmitting sensory, motor, and other stimuli to the head and neck, but it does not supply the intrinsic muscles of the tongue.

Neurons are non-proliferating cells. Non-proliferating cells are more resistant to radiation than proliferating cells. Glands, reproductive organs, bone marrow, and skin all have proliferating cells, making these structures all radiosensitive.
 

Bleeding is the number one sign of gingivitis, as it occurs as an immune response due to localized irritants around the gums (plaque, food debris, etc.) Receding gums and deep pocketing may be a sign of gingivitis but in the context of this question, it are not the correct answer. A patient may have gums that do not reach the crown of the tooth but are healthy and stable. Once the gingiva starts to recede, it will not come back to its original position along the crown. Also, a deep pocket is usually a sign of gingivitis/periodontitis, but it can occur without either condition, such as when a tooth has a fracture in one of its roots. The gums may be completely healthy otherwise, but a clinician may record a localized 8-9mm pocket if a root fracture is present.

The face of the curette should be at a 100-110 degree angle to properly access the cutting edge of the curette. Insufficient angulation can alter the contour of the curette which can cause the instrument to weaken and dull quickly and potentially become unsafe for scaling.

Herpetic gingivostomatitis (also known as “cold sores”) is an infection caused by the herpes simplex virus (specifically type 1 or HSV-1). Neurons in the sacral ganglia are the site of all types of herpes simplex virus latency. 

A denture is a dental prosthesis used to replace missing teeth and restore a patient's dentition. A full denture is a removable dental prosthesis used when no natural teeth remain. An overdenture is a dental prosthesis that is attached to remaining natural teeth or dental implants, that is typically fixed or permanent. It could be used with an overbite or underbite and therefore could be a characteristic of an overdenture, however it is not ideal as this is not the preferred occlusion, and ideally corrected prior to needing any dental prosthesis. While these characteristics are not wrong, they are not the most significant. The main feature/characteristic of an overdenture is that in can be placed in conjunction with remaining natural teeth. 

A root canal is needed when the pulp within a tooth becomes infected with deep decay, or when the pulp cannot be fixed. Other plausible answers are when the tooth is cracked and when a cavity is present. It is true that a cavity is likely present, but the key concept here is that the cavity needs to be deep within the pulp in order for a root canal to be indicated. Also, a crack or fracture in the tooth may indicate the need for a root canal, but again, a root canal is the indicated treatment if the crack is deep enough into the crown of the tooth where it permeates into the pulp and cannot be treated with a simple restoration or crown.
 

The keyword here is “vital;” a vital tooth is a live tooth, or a tooth with a live nerve. It is important to note that a patient should not whiten a tooth with a cavity as the bleaching component in a whitening solution can cause more damage to the already demineralized carious lesion. 

An abscess indicates the presence of infection. A periapical abscess refers to the infection in the root of a tooth. A root canal is the indicated treatment once the root is infected, or dead/dying. Gum infections do not lead to a periapical abscess. An individual can present with gingivitis or even periodontitis and never experience a periapical abscess as a gum infection is typically superficial. Thinning of tooth enamel will not lead to a periapical abscess. Teeth are constantly experiencing wear and tear and may slowly break down or thin over time. This can lead to sensitivity issues, but likely will not lead to an abscess. Answer C is a plausible choice as a cavity could lead to an abscess if it becomes so deep it reaches the pulp/the roots, but this is not the best answer as a simple cavity can be restored and will not lead to a periapical abscess. Plaque build-up can lead to gum irritation or even a gum infection, but as stated before, it is unlikely to cause an abscess. If a periapical abscess is formed, it indicates that something significant is going on with the root of the tooth. For any periapical condition, think “root”.

The process of etching a tooth needs to be completed in order for the material of the bonded filling to adhere to the enamel. Etch is composed of an acid gel that demineralizes and roughens the enamel so that the filling material can bond to the tooth. All of the answers listed above are steps in the procedure of filling or restoring a tooth, but when referring to the process of bonding specifically, etching the tooth is the specific step necessary to ensure the filling bonds to the tooth.

Similarly to pedicle grafting, bone augmentation for implantation procedures comes from the chin or ramus as the cells in the bone are the same and are more likely to accept the implant following surgery. Another plausible answer would be the hip, as bone for other bone grafts of the body typically come from the iliac crest, or hip area. For dental bone grafts, the bone will be taken from the chin or jaw however. 

Veneers are similar to crowns (also known as caps) in that they are shells attached to teeth typically treatment planned for cosmetic purposes on anterior teeth, specifically maxillary anterior teeth. Veneers are a great solution to improve slightly crooked teeth, chipped teeth, to make teeth of different lengths uniform, and can even assist with closing gaps between teeth. If the tooth treatment planned for a veneer has an existing cavity, the cavity would be treated prior to the veneer being placed. 

The trigeminal nerve is the most significant nerve in dentistry, because it is the nerve that supplies all nerve innervation to the face and the mouth. This is the main nerve associated with injury, infection, and pain that a dentist or dental professional would need to take into consideration when planning dental procedures.

There are 8 regions of the face which include the orbital region, infraorbital region, nasal region, zygomatic region, buccal region, parotid region, oral region, and mental region. The word "labial" refers to the lips, but the oral region is the region used when referencing the mouth.

The muscles of mastication include all of the muscles listed above. It is commonly thought that the buccinator muscle is one of the muscles for mastication. However, the buccinator is considered to be one of the assistant muscles of mastication, not one of the four main muscles.

The Palmer Notation Method is most commonly used in orthodontics, where it is used to label and identify both primary teeth and adult teeth using a symbol to designate quadrants. All other dental specialties (periodontics, endodontics, and oral surgery) utilize the Universal Numbering System in the U.S. The FDI Numbering System is the numbering method used in other countries outside of the U.S.

Parafunctional habits are repetitive habits that affect the formation of the dentition and other structures within the oral cavity. Clenching affects facial muscles, causing them to be overactive and enlarged, and also wears down the enamel on the teeth, causing wear facets and attrition. Tongue thrusting can result in an overjet and misalignment of teeth. Lip incompetence involves the inability to close one's lips together at rest, which causes lower facial strain and can lead to mouth breathing and dryness of the oral cavity. Abfraction causes loss of tooth structure which can overall affect the dentition, by forcing some teeth to compensate in alignment and in function for others.

Syphilis may lead to a variety of symptoms and potential defects. Developmental disturbances occur while the fetus is developing. Congenital conditions and diseases are those that are present at birth. Another plausible answer may have been congenital heart disease or fetal alcohol syndrome as both of these affect the fetus and are present at birth. However, Hutchinson incisors and Mulberry molars occur due to defects in the formation of tooth cusps, which is caused by congenital syphilis.

Radiolucent is a term used to describe how a structure appears on a radiograph/x-ray. A radiolucent structure is almost completely transparent to radiation. The other descriptors describe lesions physically assessable on soft tissue such as the gingiva, for example.

All of the conditions listed may produce some type of lesion on the skin. Erythema Multiforme produces bulls-eye-shaped lesions, specifically. Another plausible answer may have been Systemic Lupus Erythematosus, as it also refers to erythema (redness/inflammation) within the name of the disorder. With this condition however, a common characteristic is a butterfly rash spread across the cheeks and nose of the face.

The pneumonic for the ABCDEs of melanoma was created to be used as a memorable reference when evaluating lesions found on the skin for melanoma. The "B" in the ABCDEs is for "Borders," as the lesion's borders should be evaluated. An irregular border can be a sign that a lesion should be further evaluated or biopsied.

Diabetes is the only disease listed above with scientific literature proving a direct systemic link to periodontal disease. Scientists are currently evaluating the link between periodontal disease and CHF and periodontal disease and Alzheimer's, however, there is not enough literature at this time. Smoking has also been proven to have a direct link to periodontal disease.

Scurvy results from a severe lack of Vitamin C. Oral manifestations of scurvy include swollen, bleeding gums that may become purple and spongy. Vitamin C is essential for tissue repair and healing wounds, such as bleeding gums.