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NBDHE Part B (NBDHE Part B) Practice Tests & Test Prep by Exam Edge - Review


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National Board Dental Hygiene Examination Part B - Reviews


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National Board Dental Hygiene Examination Part B - Test Reviews Sample Questions

The patient's chief complain is most likely attributed to which of the following?





Correct Answer:
periodontal status


when assessing a patient's chief complaint regarding oral health issues, several factors are considered. one key aspect is the periodontal status, which involves the health of the gums and structures supporting the teeth. periodontal problems, such as gingivitis or periodontitis, are significant contributors to oral health issues, primarily due to the accumulation of plaque and calculus (tartar) on the teeth and along the gumline.

plaque is a sticky, colorless film of bacteria that forms on teeth. if not adequately removed through brushing and flossing, it can harden into calculus. both plaque and calculus are harmful because they harbor bacteria that produce toxins, leading to inflammation of the gum tissues. this inflammation, if unchecked, can cause the gums to begin to pull away from the teeth, creating pockets that can become infected, leading to further breakdown of the periodontal ligament and the supporting bone structure.

one of the distinctive symptoms of periodontal disease is oral malodor, or bad breath. this is primarily caused by the bacteria in plaque and calculus, which release volatile sulfur compounds as they metabolize food particles and tissues in the oral cavity. the extent of malodor often correlates with the severity of periodontal disease. therefore, a patient complaining of persistent bad breath is likely experiencing issues related to their periodontal health.

while other factors like smoking, pharmacological side effects, and improper tongue brushing can also contribute to oral malodor, periodontal status is often a primary contributor. smoking, for instance, does affect oral health by increasing plaque and calculus build-up and inhibiting the normal function of gum tissue cells, but these effects ultimately tie back into periodontal health. similarly, while some medications can cause dry mouth, which can lead to malodor, the lack of saliva can further exacerbate the build-up of plaque, again pointing back to periodontal issues.

in conclusion, the patient's chief complaint of bad breath is most likely attributed to their periodontal status. the presence of significant plaque and calculus, indicative of poor periodontal health, contributes to the distinctive malodor observed. addressing this issue typically involves thorough dental cleaning, improved oral hygiene practices, and possibly more targeted periodontal treatments depending on the severity of the condition.

In order to create a healthy oral cavity and increase the patient's chance of saving her dentition, It will be important to implement a smoking cessation program for this patient. Smoking has facilitated an environment where there is an increase in the diagnostic parameters of periodontal disease.  This is because:  





Correct Answer:
smoking causes a decrease in the vascular reaction to inflammation and reduced ability of pmn's to phagocytize substances. 
to address the significance of implementing a smoking cessation program for a patient to foster a healthy oral environment and bolster the chances of preserving their dentition, it is crucial to understand the detrimental effects of smoking on periodontal health.

smoking is known to exacerbate periodontal disease through several biological mechanisms. first, smoking induces a decrease in the vascular reaction to inflammation. normally, inflammation is a protective response that helps the body to repair tissue and ward off pathogens. however, in smokers, the normal vascular response is impaired. this impairment leads to a reduced blood flow, which decreases the supply of immune cells and nutrients needed for tissue repair and defense. as a result, the inflammatory markers that are typically observed during periodontal assessment, such as bleeding on probing, are often misleadingly low in smokers. this diminished bleeding does not indicate healthier gums but rather reflects an inadequate inflammatory response.

additionally, smoking impairs the function of polymorphonuclear leukocytes (pmns). pmns play a critical role in the body's defense against bacterial infections, including those affecting the periodontal tissues. they do this primarily through the process of phagocytosis, where they engulf and destroy pathogens. in smokers, the ability of pmns to effectively phagocytize is reduced. this impairment hampers the body’s ability to fight off the bacteria that cause periodontal disease, thereby increasing the risk and severity of the condition.

together, these two mechanisms foster an environment conducive to the progression of periodontal disease. by reducing the vascular inflammatory response and weakening the antimicrobial actions of pmns, smoking creates conditions that allow periodontal disease-causing bacteria to thrive and damage the tissues supporting the teeth. this is why smoking cessation is a critical recommendation for patients with periodontal issues, as it can significantly mitigate these deleterious effects and improve overall oral health outcomes.