A local risk factor for periodontitis can be acquired OR anatomical. Concavities and furcations are local risk factors acquired over time.
Select one:
A. Both statements are true
B. The first statement is true; the second false
C. The first statement is false; the second true
D. Both statements are false

B. The first statement is true; the second false

A patient has periodontal disease with moderate plaque biofilm. The hygienist informs the patient that she is going to develop periodontitis if she does not improve her oral self-care. Is this hygienist providing accurate educational advice to the patient?
Select one:
A. No, because in most patients with chronic gingivitis never progresses to periodontitis
B. Yes, because the terms "periodontal disease" and "periodontitis" are synonymous (words that mean the same thing)
C. No, because if this patent has periodontal disease, she obviously is not interested in improving her daily self-care and may feel that the hygienist is "nagging" her
D. Yes, without good self-care periodontal disease progresses from chronic gingivitis to periodontitis

A. No, because in most patients with chronic gingivitis never progresses to periodontitis

A patient refuses to comply with self-care recommendations but is more than willing to have the dental health team "do whatever is necessary to keep my mouth healthy." In addition, the patient is a smoker and so has a lot of extrinsic stain. How can the dental team help this patient?
Select one:
A. Frequent periodontal instrumentation to help disrupt plaque biofilms
B. Frequent polishing with an abrasive prophy paste to remove extrinsic stain
C. Inform the patient about the effects of smoking on the periodontium and recommend smoking cessation
D. Both A and C

D. Both A and C

An extended family of patients receiving care at your dental office has a long history of diabetes and periodontitis. The great grandmother, grandmother, grandfather, and mother of your 10-year-old patient all have well-controlled diabetes and periodontitis that does not respond well to periodontal therapy. The mother asks what can be done to help her 10-year-old avoid periodontitis. All of the following are good recommendations, EXCEPT:
Select one:
A. Explain to the mother that at the present time, we are unable to eliminate genetic risk factors for periodontal disease
B. Suggest genetic testing of the child for the possibility of a genetic risk factor for periodontitis, such as abnormal PMN function
C. Suggest that she make the family physician aware of the long history of diabetes in the family
D. Encourage the mother to help the child form good daily self-care habits

B. Suggest genetic testing of the child for the possibility of a genetic risk factor for periodontitis, such as abnormal PMN function

Biologic equilibrium in periodontal health means there is a balance between:
Select one:
A. Bacterial plaque biofilms and local risk factors
B. Local risk factors and acquired risk factors
C. Local contributing factors and systemic factors
D. Bacterial plaque biofilms and the host response

D. Bacterial plaque biofilms and the host response

Eventually, gingivitis always progresses to periodontitis. It is the body's host response that causes tissue destruction in periodontal disease.
Select one:
A. The first statement is false; the second true
B. The first statement is true; the second false
C. Both statements are false
D. Both statements are true

A. The first statement is false; the second true

Risk factors for periodontal disease other than plaque biofilms include all of the following EXCEPT:
Select one:
A. Systemic diseases
B. Socioeconomic factors
C. Pregnancy
D. Heredity

B. Socioeconomic factors

The FDI World Dental Federation considers oral health to be a fixed, unchangeable state of well-being. Oral health includes the ability to speak, smile, and swallow with confidence.
Select one:
A. Both statements are false
B. The first statement is true; the second false
C. The first statement is false; the second true
D. Both statements are true

C. The first statement is false; the second true

Which of the following factors is considered the MOST significant risk factor for developing periodontal disease?
Select one:
A. Long-term use of medicines that cause gingival overgrowth
B. Smoking cigarettes
C. Chronic poor home-care
D. Stress

B. Smoking cigarettes

A biofilm is a living film that grows on a surface. Biofilms are only found in the mouth.
Select one:
A. Both statements are false
B. The first statement is true; the second is false
C. The first statement is false; the second is true
D. Both statements are true

B. The first statement is true; the second is false

A biofilm is:
Select one:
A. A calcified community of bacteria difficult to remove
B. Free-floating bacteria loosely connected
C. An acellular translucent film thriving on moist surfaces
D. A well-organized community of bacteria

D. A well-organized community of bacteria

All of the following are classified as periodontal pathogens capable of colonizing the mouth, EXCEPT:
Select one:
A. Tannerella forsythia
B. A. odontolyticus
C. A. actinomycetemcomitans
D. Porphyromonas gingivalis

B. A. odontolyticus

All of the following are true regarding the benefits of daily disruption of plaque biofilms, EXCEPT:
Select one:
A. Periodontal pathogens cannot colonize the tooth surface until the nonpathogenic bacteria attach to the pellicle
B. A disrupted biofilm must start at step 1 and reform in a specific sequence
C. Each bacterial strain only has a limited set of bacteria to which it can adhere
D. Motile bacteria are important first colonizers of the pellicle

D. Motile bacteria are important first colonizers of the pellicle

All of the following statements about bacteria are true, EXCEPT:
Select one:
A. Most of the bacteria in a healthy site are very motile
B. There can be as many as 100 million bacteria in one disease site
C. Most of the bacteria in health are gram positive
D. Bacteria found in chronic gingivitis are evenly divided between gram-positive and gram-negative bacteria

A. Most of the bacteria in a healthy site are very motile

All of the following statements are true about biofilm, EXCEPT:
Select one:
A. Biofilm is a well-organized community of bacteria that adheres to surfaces
B. Biofilm forms rapidly on any dry surface
C. Bacteria in biofilm are embedded in an extracellular slime layer
D. An example of biofilm is tobacco stain on teeth

D. An example of biofilm is tobacco stain on teeth

Bacteria can penetrate through epithelium and invade the gingival connective tissue. Only gram-negative bacteria have the ability to invade gingival connective tissue.
Select one:
A. Both statements are false
B. The first statement is false; the second is true
C. Both statements are true
D. The first statement is true; the second false

D. The first statement is true; the second false

Early colonizers of the plaque biofilm are:
Select one:
A. Gram-positive bacteria
B. Anaerobic bacteria
C. Motile bacteria
D. Gram-negative bacteria

A. Gram-positive bacteria

Free-floating periodontal pathogens can cause periodontal disease. Biofilm development always begins supragingival.
Select one:
A. Both statements are true
B. Both statements are false
C. The first statement is true; the second is false
D. The first statement is false; the second is true

D. The first statement is false; the second is true

How do bacteria adhere during the process of coaggregation to a tooth surface?
Select one:
A. Each bacterial strain only has a limited set of bacteria to which it can adhere
B. The bacteria randomly attach to one another
C. Only one species of bacteria can attach within a biofilm community
D. The late bacterial colonizers determine the nature of the biofilm colony and are more significant than the earlier colonizers

A. Each bacterial strain only has a limited set of bacteria to which it can adhere

If a bacterium wants to join a biofilm, it should look for which of the following conditions:
Select one:
A. Clumps of bacteria floating in the saliva
B. An area of the mouth with a large number of free-floating bacteria
C. A group of bacteria attached to a tooth surface
D. A freshly formed area of pellicle on a tooth surface

C. A group of bacteria attached to a tooth surface

It is difficult to identify specific periodontal pathogens because
Select one:
A. Different bacteria in periodontal pockets require different culture media
B. Periodontal pockets contain pathogenic and nonpathogenic bacteria
C. Periodontal disease has episodes of active and dormant diseases
D. All of these

D. All of these

Legionnaire's disease, which killed 29 people in 1976, was caused by:
Select one:
A. Biofilm in the hotel's air conditioning unit
B. Biofilm in cold food that was allowed to sit in the sun
C. Biofilm that developed on a certain type of contact lens
D. Contaminated water lines in a dental office

A. Biofilm in the hotel's air conditioning unit

One human mouth is home to more microorganisms than there are people on the planet Earth. Periodontal disease is a bacterial infection.
Select one:
A. Both statements are true
B. The first statement is false; the second is true
C. Both statements are false
D. The first statement is true; the second is false

A. Both statements are true

Periodontal pathogens can be passed from the oral cavity of one person to another by direct contact. Periodontal pathogens also can be spread by contact with inanimate objects, such as cell phones.
Select one:
A. The first statement is true; the second is false
B. The first statement is false; the second is true
C. Both statements are false
D. Both statements are true

A. The first statement is true; the second is false

Periodontitis is associated with high proportions of:
Select one:
A. Innocuous bacteria
B. Aerobic bacteria
C. Nonmotile bacteria
D. Gram-negative bacteria

D. Gram-negative bacteria

Periodontitis is:
Select one:
A. A mixed infection
B. An infection caused by 5 to 10 species of bacteria
C. A single species infection
D. An infection caused by 700 species of bacteria

A. A mixed infection

Research suggests that this type of bacterial subgingival attachment is the most detrimental to the periodontal tissues:
Select one:
A. Bacteria that float in the periodontal pocket space
B. Pellicle-associated plaque biofilm
C. Tooth-associated plaque biofilm
D. Tissue-associated plaque biofilm

D. Tissue-associated plaque biofilm

Socransky grouped microorganisms into complexes and assigned each a color. Which color signifies bacterial species that are dominant in the late stages of biofilm development?
Select one:
A. Green
B. Red
C. Yellow
D. Purple

B. Red

The cell-to-cell adherence of one oral bacterium to another is termed:
Select one:
A. Coaggregation
B. A bacterial bloom
C. Acquired pellicle
D. A microcolony

A. Coaggregation

The first bacteria to colonize the tooth surface are:
Select one:
A. Pathogenic
B. Motile
C. Nonpathogenic
D. Anaerobic

C. Nonpathogenic

The most successful means of destroying plaque biofilm on teeth is:
Select one:
A. Antimicrobial rinse
B. Mechanical removal
C. Oxygen
D. Double dose of antibiotics

B. Mechanical removal

The organization of bacteria within biofilms is due to specific associations among bacterial species. The bacteria within a biofilm function together as a system of interdependent parts.
Select one:
A. The first statement is true; the second is false
B. The first statement is false; the second is true
C. Both statements are false
D. Both statements are true

D. Both statements are true

The protective factor that can prevent biofilm from being killed with antibiotics, antimicrobials, or the body's immune system is called:
Select one:
A. Fluid channels
B. Leukocytes
C. Extracellular slime layer
D. Microcolonies

C. Extracellular slime layer

The structure of biofilm resembles spiky columns. The bacteria comprising the biofilm are distributed evenly among the spikes.
Select one:
A. Both statements are true
B. The first statement is true; the second is false
C. The first statement is false; the second is true
D. Both statements are false

D. Both statements are false

The type of bacteria that can cause periodontal disease are referred to as:
Select one:
A. Innocuous
B. Pathogenic
C. Symbiotic
D. Flagellated

B. Pathogenic

What is the term for a bacterial virulence factor that is a class of proteins found in living bacterial cell membranes?
Select one:
A. Peptide proteins
B. Bacterial enzyme
C. Leukotoxin
D. Lipopolysaccharides

A. Peptide proteins

What percent of bacteria living on earth live as attached bacteria?
Select one:
A. 80%
B. 60%
C. 99%
D. 25%

C. 99%

When examining a bacterium under a microscope, you note the following features: a double cell membrane and a red stain. Which type of bacteria are you examining?
Select one:
A. Gram-negative bacterium
B. Innocuous bacterium
C. Gram-positive bacterium
D. Nonpathogenic bacterium

A. Gram-negative bacterium

Which of the following are believed to play an important role in periodontitis?
Select one:
A. Gram-negative bacteria
B. Nonpathogenic bacteria
C. Gram-positive bacteria
D. Innocuous bacteria

A. Gram-negative bacteria

Which of the following characteristics is typical of biofilm?
Select one:
A. Bacteria communicate with each other by sending out chemical signals
B. Bacteria exist in isolation from each other
C. The environment surrounding bacteria consists of the same or similar pH's
D. Bacteria are dispersed more or less evenly throughout the plaque biofilm

A. Bacteria communicate with each other by sending out chemical signals

Which of the following species is considered to be the most important bacterial risk factor that distinguishes individuals with periodontitis from those who are periodontally healthy?
Select one:
A. Tannerella forsythia
B. A. actinomycetemcomitans
C. Porphyromonas gingivalis
D. A. odontolyticus

A. Tannerella forsythia

Which of the following species is frequently detected in aggressive forms of periodontitis?
Select one:
A. A. odontolyticus
B. A. actinomycetemcomitans
C. Porphyromonas gingivalis
D. Both B and C

D. Both B and C

Which of the following statements about disease progression is FALSE?
Select one:
A. As disease progresses, the number of bacteria in a site increases
B. As disease progresses, the bacteria population becomes more gram-negative
C. As disease progresses, bacteria become more motile
D. As disease progresses, the bacteria associated with health completely disappear

D. As disease progresses, the bacteria associated with health completely disappear

Which of the following statements best describes bacterial blooms?
Select one:
A. Bacterial bloom is a period in which specific bacterial species grow at rapid rates
B. Bacterial bloom occurs when bacteria grow away from the tooth
C. Bacterial bloom is a rapid growth of biofilm by the addition of new bacteria
D. Bacterial bloom has central rod-shaped bacterium surrounded by round cocci

A. Bacterial bloom is a period in which specific bacterial species grow at rapid rates

Within minutes of a professional prophylaxis, the pellicle attaches to tooth surfaces. Within hours of the pellicle formation, bacteria begin to attach to the outer surface.
Select one:
A. The first statement is true; the second is false
B. Both statements are false
C. Both statements are true
D. The first statement is false; the second is true

C. Both statements are true

Your friend May wears contact lenses. In the last few months, May has had one eye infection after another. You notice that May does not clean her lens case daily. What might be causing May's eye infections?
Select one:
A. May is not washing her hands before inserting the lenses in her eyes
B. A bacterial biofilm might have developed in May's lens case
C. May be susceptible to innocuous bacteria
D. May is rubbing her eyes due to allergies

B. A bacterial biofilm might have developed in May's lens case

A leukocyte exits the blood vessel and enters the connective tissue to travel to the site of an infection. What is the process called whereby leukocytes are attracted to an infection site?
Select one:
A. Phagocytosis
B. Opsonization
C. Chemotaxis
D. Trans-endothelial migration

C. Chemotaxis

A leukocyte secretes a biologically active compound that attracts more immune cells to an infection site. Biologically active compounds secreted by cells that activate the body's immune system are termed:
Select one:
A. Biochemical mediators
B. Degranulation proteins
C. C-reactive proteins
D. Chemotaxic chemicals

A. Biochemical mediators

A leukocyte travels through the bloodstream to an infection site and pushes its way between the cells lining the blood vessel. This process of exiting the blood vessel is termed:
Select one:
A. Trans-endothelial migration
B. Opsonization
C. Chemotaxis
D. Phagocytosis

A. Trans-endothelial migration

A polymorphonuclear leukocyte travels to an infection site, attaches to a bacterium, ingests, and digests the unfortunate bacterium. The process of engulfing and digesting microorganisms is termed:
Select one:
A. Trans-endothelial migration
B. Opsonization
C. Chemotaxis
D. Phagocytosis

D. Phagocytosis

All of the following are symptoms of inflammation EXCEPT:
Select one:
A. Bruising
B. Pain
C. Swelling
D. Heat

A. Bruising

An individual has an acute inflammation. Which of the following would you expect to see elevated in his blood tests?
Select one:
A. Chemotaxis
B. Phagosome
C. C-reactive protein (CRP)
D. Opsonization

C. C-reactive protein (CRP)

B-lymphocytes affect microorganisms by:
Select one:
A. Killing microorganisms on contact
B. Engulfing and phagocytizing invading organisms
C. Intensifying the immune system
D. Secreting antibodies that neutralize microorganisms

D. Secreting antibodies that neutralize microorganisms

Chronic inflammation begins suddenly and is of short duration. Acute inflammation continues for more than a few weeks.
Select one:
A. Both statements are true
B. Both statements are false
C. The first statement is true; the second is false
D. The first statement is false; the second is true

B. Both statements are false

In a bacterial infection of the periodontium, the cells that arrive to the infection site first (the rapid responders) are the:
Select one:
A. Polymorphonuclear leukocytes (PMNs)
B. Macrophages
C. T-lymphocytes
D. Monocytes

A. Polymorphonuclear leukocytes (PMNs)

Inflammation is the body's reaction to:
Select one:
A. Injury
B. Invasion of pathogens
C. Edema
D. A and B

D. A and B

Pus at a site of inflammation consists of:
Select one:
A. Leukocytes that have engorged on bacteria and died
B. Edematous fluid that leaked out of capillaries
C. Plaque biofilm mixed with blood
D. T- and B-lymphocytes

A. Leukocytes that have engorged on bacteria and died

The complement system carries out all of the following functions, EXCEPT:
Select one:
A. Removal of immune complexes from circulation
B. Puncturing the cell membranes of certain bacteria
C. Engulfing (eating) bacteria
D. Recruiting additional phagocytic cells to the infection site

C. Engulfing (eating) bacteria

The complement system is part of:
Select one:
A. Breakdown in collagen matrix
B. Treatment of chronic disease
C. Activity that breaks down bone
D. The immune response

D. The immune response

The immune system protects the body against all of the following, EXCEPT:
Select one:
A. Basophils
B. Viruses
C. Bacteria
D. Toxins

A. Basophils

The liver produces this type of acute phase protein during episodes of acute inflammation:
Select one:
A. Degranulation proteins
B. Biochemical mediators
C. C-reactive proteins
D. Chemotaxic chemicals

C. C-reactive proteins

When an area of the mouth becomes inflamed, there is an increased blood flow in affected tissues to:
Select one:
A. Wash the offending invaders from the site
B. Create heat for healing
C. Deliver immune defenders to the site
D. None of these

C. Deliver immune defenders to the site

Your friend cut her finger while chopping vegetables yesterday. Today her finger is twice its normal size. What is the cause of the SWELLING?
Select one:
A. Destruction of epithelial tissue cells in the area of the cut
B. Increased blood flow rushing to the area of the cut in her finger
C. Entry of fluid and cells into the connective tissues of the finger
D. A bacterial infection in the open cut in her finger

C. Entry of fluid and cells into the connective tissues of the finger

Your friend is walking on the beach barefoot and cuts his foot on something sharp hidden in the sand. At home, he washes the foot and puts on an adhesive bandage over the cut. The next day the area around the cut is swollen, red, and hot. What is the cause of the REDNESS?
Select one:
A. Entry of fluid and cells into the connective tissues of the foot
B. Increased blood flow rushing to the area of the cut in his foot
C. A bacterial infection in the open cut in his foot
D. Destruction of epithelial tissue cells in the area of the cut

B. Increased blood flow rushing to the area of the cut in his foot

Your friend is walking on the beach barefoot and cuts his foot on something sharp hidden in the sand. At home, he washes the foot and puts on an adhesive bandage over the cut. The next day the area around the cut is swollen, red, and hot. What is the cause of the HEAT in the area?
Select one:
A. Increased blood flow rushing to the area of the cut in his foot
B. A bacterial infection in the open cut in his foot
C. Destruction of epithelial tissue cells in the area of the cut
D. Entry of fluid and cells into the connective tissues of the foot

A. Increased blood flow rushing to the area of the cut in his foot

Your neighbor has a chronic inflammation in her foot due to diabetes. What signs and symptoms would you expect your neighbor to experience with this chronic inflammation?
Select one:
A. Redness
B. Heat
C. Pain
D. None of these

D. None of these

Your young daughter goes to bed at night feeling fine and everything seems normal. In the morning, she complains that her ear hurts. You see that her ear lobe is very swollen, red, hot to the touch, and slightly painful to the touch. Should you take your daughter to her physician?
Select one:
A. Yes, because the ear shows four signs of inflammation
B. Yes, because you cannot stand to see your little daughter being uncomfortable
C. No, a swollen ear cannot be that important; wait and see how it is tomorrow
D. Yes, because this could result from an injury to her ear; like a bug bite

A. Yes, because the ear shows four signs of inflammation