Geriatric Patient Case 2
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The raised, hard nodule in the midline of the palate (arrow) is most likely
a. Denture stomatitis
b. A torus palatines
c. Herpangina
d. The median palatine suture
e. A traumatic ulcer
Which of the following can be observed on the lingual surfaces of the maxillary anterior teeth?
a. Green stain resulting from poor oral hygiene
b. Orange stain resulting from chromogenic bacteria
c. Black line stain that often manifests in clean mouths
d. Brown stain resulting from foodstuffs such as coffee or tea
e. Yellow stain associated with the presence of biofilm
Which of the following s the likely explanation for the darker yellow color of he facial aspect of
the anterior teeth at the gingival margin?
a. Accumulation of Biofilm
b. Intrinsic, endogeneous stain
c. Exposed root surfaces
d. Effects of medications
e. Enamel hypoplasia
The mandibular left second premolar is restored with a
a. Porcelain-fused-to-metal-crown
b. Full-coverage cast gold crown
c. MODBL amalgam
d. Porcelain veneer
e. Gold onlay
Which of the following mandibular teeth serve(s) as abutments?
a. Right second premolar
b. Each of the remaining mandibular teeth
c. Left central incisor and right central incisor
d. Left lateral incisor and right lateral incisor
e. Left second premolar and left third molar
The missing teeth on the mandibular left have been restored with a
a. Cantilever bridge
b. Maryland bridge
c. Fixed partial denture
d. Removable partial denture
e. Resin-bonded cast metal bridge
The metal appearance on the mesial occlusal of the mandibular right premolar indicates
a. A post-and-core buildup for support of the crown
b. A depression in the crown surface that has picked up stain
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c. An amalgam restoration present on the portion of the crown
d. That occlusal forces have worn through the porcelain exposing the metal
e. Where the rest of the partial denture connects with the crown
Which of the following is the most likely reason vertical bitewings were exposed on this patient?
a. To adapt the presence of tori
b. To image more of the alveolar bone
c. To assist with managing a gag reflex
d. To provide increased comfort during film packet placement
e. Usually recommended for the geriatric patient
The arrow drawn on the maxillary right molar radiograph is pointing to the
a. Coronoid process of the mandible
b. Maxillary tuberosity
c. Lateral pterygoid plate
d. Patient’s finger
e. Condyle
What film size was used to expose the maxillary central incisor periapical radiograph?
a. Size 0
b. Size 1
c. Size 2
d. Size 3
e. Size 4
Which of the following is the cause of the lack of image contrast of this patient’s full mouth
series of radiographs?
a. The PID was not aligned perpendicular to the film packet
b. The bisecting technique was used
c. The ope end of the PID was positioned an increased distance from the patient
d. The partial denture was not removed before exposure
e. The film packets were not properly stored away from stray radiation
Which of this patient’s medication puts her at risk for osteonecrosis of the jaws?
a. Donepezil (Aricept)
b. Risperidone (Risperdal)
c. Aledronate sodium (Fosomax)
d. Calcium carbonate (Caltrate)
This patient must regularly clean the partial denture to maintain health status of the mandibular
right second premolar. The longevity of the partial denture depends on the health of the
mandibular right second premolar.
a. The first statement is true, the second is false
b. The first statement is false, the second is true
c. Both statements are true
d. Both statements are false
Which of the following brushes should be recommended to help this patient care for her partial
denture?
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a. Clasp brush
b. Toothbrush used for natural teeth
c. Power toothbrush
d. Interproximal brush
e. End-tuft brush
Each of the following should be considered when giving instructions for oral self-care to this
patient EXCEPT one.
a. Ask permission to include her caregiver in the education process
b. Request the a she put on her glasses during instruction and at home during self-care
c. Eliminate distracting background noise and sit facing the patient when speaking
d. Encourage implementation of oral self-care at the same times each day
Each of the following is contraindicated for this patient EXCEPT one.
a. Air polishing
b. Antibiotic premedication
c. Implant surgery
d. Supine position in the treatment chair
e. Short-acting anti-anxiety medication before appointments
At the re-evaulation appointment, the measurement of recession on the facial surface of the
mandibular left central incisor is 6mm. What is the total loss of attachment in this region?
a. 5mm
b. 6mm
c. 7mm
d. 8mm
Which of the following is the reason the mandibular central incisors do not exhibit mobility?
a. Periodontal splint
b. Medication for osteoporosis
c. Effective oral self-care
d. Surgical intervention
e. Regular maintenance appointments
The hourglass shape exhibited by the mandibular anterior incisors is most likely caused by
a. Scrub-method brushing technique
b. Years of scaling and root planning
c. The use of course grit polishing agents
d. Congenital defect
e. Chemical erosion
Scaling is not likely to elicit hypersensitivity f this patient’s root surfaces because of the presence
of significant secondary dentin. Secondary dentin is helping this patient’s root surfaces from
decay.
a. The first statement is true, the second is false
b. The first statement is false, the second is true
c. Both statements are true
d. Both statements are false
21. Which of the following would be contraindicated for this patient?
a. 0.05% sodium fluoride rinse
b. 2% sodium fluoride gel
c. 5% sodium fluoride varnish
d. 1.23% acidulated phosphate fluoride foam
e. 0.76% sodium monofluorophosphate dentifrice
22. Which of the following agents should be recommended for at-home cleaning of this patient’s
partial denture?
a. Bleach
b. Vinegar
c. Hot water
d. Hydrogen peroxide
e. Household scouring abrasive
23. This patient and her family may benefit from counseling regarding each of the following EXCEPT
one.
a. The link between nutrition and root caries
b. The link between osteoporosis and periodontal disease
c. The link between joint replacement and prophylactic premedication
d. The link between bisphosphonate therapy and osteonecrosis of the jaws
e. The link between the caregiver’s active participation in the patient’s oral self-care and
oral health
24. Classify this patient as “aged” is a form of ageism. This patient is considered functionally
dependent.
a. The first statement is true, the second is false
b. The first statement is false, the second is true
c. Both statements are true
d. Both statements are false
25. Which of the following is the best course of action considering the defective restorative
treatment of the mandibular left second premolar?
a. Application of composite material to the facial surface
b. Metal bonding of composite veneer to the facial surface
c. Removing the defective crown and replacing with a new fixed bridge
d. Removing the defective crown and replacing with a partial denture similar t the one
recently applied to the mandibular right side
e. No restorative action required at this time
ANSWERS
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