1.

Inthepositioningofthedentalassistantforfourhandeddentistry,whichofthe
followingisnotrecommended?
a.Eyelevelispositioned4to6inchesabovethedentist'seyelevel
b.Feetplacedonthefootringorbaseofthestoolandthestoolispositionedclosetothedental
chair
c.Legsaretogether,seatingpositionisclosetothebackofthestool,feetplantedfirmlyonthe
floor
d.Stoolpositionedclosetothedentalchairwithlegsparalleltothedentalchair
2.Whatisthenameoftheinstrumentthatincludesthefollowingtypes:straight,binangle,
Wedelstaedt,andangleformer?
a.Excavator
b.Hatchet
c.Gingivaltrimmer
d.Chisel
3.Apatientundergoingaprocedureofapproximately30minuteswillmostlikelyrequire
whichofthefollowingtypesofanesthetics?
a.Bupivacaine
b.PrilocaineHClblock
c.Novocain
d.LidocaineHCl
4.Whichofthefollowingstatementswouldbethemosteffectiveincommunicatingwithan
apprehensivepatient?
a.Thenextsoundyouhearwillbethedrill.
b.Wearepreparingthetoothforrestoration.
c.Youwilllikelyfeelalittlepaininitiallybutitwillsubsideoncetheanesthetickicksin.
d.Iamapplyingatopicalanestheticbeforethedentistcomesintogiveyoutheshot.
5.Whichofthefollowingmaybecontraindicatedinapatientwithseverehypertension?
a.Fluoride
b.Nitrousoxide
c.Levonordefrin
d.Lidocaine

Answers&Explanations

1.C:Properpositioningforthedentalassistantisextremelyimportant.Aspecializedstoolis
usedtohelpprovidecomfortandpromoteeasymobilitywhileprotectingagainstunnecessary
straintotheupperbody.Thedentalassistantshouldbeseatedtowardsthebackofthestool,
closetothedentalchair,andlegsshouldbeparallelwiththedentalchair.Thefeetshouldreston
thebottomofthestoolsuchasthefootring.Theeyelevelofthedentalassistantshouldbe46
inchesabovethatofthedentistorothertypeofoperatorsuchasdentalhygienist.
2.D:Handcuttinginstrumentsareusedtoallowthedentisttoeasilyremovethepartsofthe
tooththataredecayed.Theseinstrumentsarepositionednexttothebasicsetuponthetray.
Typesofhandcuttinginstrumentsincludetheexcavator,hoe,chisel,hatchet,andgingival
margintrimmer.Manytypesofchiselsareavailable,allwithaslightlydifferentfunction.
Straight,binangle,Wedelstaedt,andangleformerarealltypesofchisels.Chiselsareusedtoget
throughtheenamelpartofthetoothortomakestraightlines.Mostdentistswillhavetheir
personalpreferenceastowhattypeofchiselstheyusemostoften.
3.D:ThemostcommonlyusedanestheticindentistryislidocaineHCl.Itisatypeofshort
durationanestheticusedforproceduresexpectingtolastapproximately30minutes.For
proceduresthatwilllastaboutanhour,anintermediatedurationanestheticwillmostlikelybe
selectedbythedentist.Thiswouldincludelidocainewithepinephrine,mepivacainewith
epinephrine,prilocaineHCl(withandwithoutepinephrine),andarticainewithepinephrine.
Longdurationanestheticsuchasbupivacainewithepinephrineisusedforproceduresthatwill
last90minutesormore.Procaine(Novocain)isnotusedasfrequentlyasashortduration
anestheticsincetheintroductionoflidocaine.
4.B:Dentalfearorphobiaisveryrealandhowapatientisapproachedcanmakeabig
differenceinfuturetreatment.Verbalcommunicationisveryimportant.Itisimportantto
communicatewiththepatientinawaythatheorshewillunderstand.Itisalsoimportantto
makeappropriatewordchoicestominimizethepatient'sreaction.Certainwords,suchaspain,
shot,drill,orfilling,mayevokefearorintimidation.Wordsthatmaybesubstitutedinclude
discomfort,anesthetic,preparetooth,orrestoration.Thesemaybemoreeffective.Nonverbal
communicationisalsoimportant.Thepatientisabletoobservebodylanguage,soitisimportant
toshowapositive,stressfreeimagetothepatient.Thiscanbeaccomplishedbybreathing
slowlyanddeeply,usingcalmfacialexpressions,andhavinganoverallpositiveattitude.Good
listeningskillsarealsoessential.
5.C:Levonordefrin(NeoCobefrin)andepinephrinearevasoconstrictorsthatshouldbeavoided
incertainsituations.Avasoconstrictorisatypeofdrugthatcausesthesmoothmusclesto
constrictornarrow.Thismaycauseunduestrainontheheartorotherorgans.Patientswitha
historyofseverehypertension,unstableangina,recentheartattacksorbypasssurgery,or
uncontrolledcongestiveheartfailureshouldnotreceiveavasoconstrictor.Instead,ananesthetic
withoutavasoconstrictorshouldbeusedsuchaslidocaineorprilocaineHCl.Nitrousoxidecan
alsobeused.Anotherhelpfulconsiderationforpatientswithheartdiseaseistominimizethe
lengthoftheappointmentifpossibletoavoidadditionalstress.Vitalsignsshouldbemonitored
andsomepatientsmayrequiresupplementaloxygenduringaprocedure.

DANB GC Practice Questions

1. Which of the following is TRUE about the administration of nitrous oxide and oxygen
(N2O/O2)?
A. The patient should be encourage to mouth breathe in order to maximize the effectiveness of
N2O/O2
B. Once the dosage is determined for N2O/O2, the same dosage can be used at subsequent dental
visits
C. The N2O/O2 procedure should end with the administration of 100% pure oxygen for at least an
hour
D. Administration of N2O/O2 should begin 100% pure oxygen
2. When assisting with the delivery of a partial denture, which of the following is NOT
something a dental assistant would be responsible for?
A. Adjusting the tension on the retainer
B. Disinfecting the prosthesis before it is placed in the patients mouth
C. Placing articulating paper in the patients mouth in order to check the occlusion
D. Polishing the prosthesis before delivering to patient for instruction on use
3. When assisting with root canal therapy, what is the first instrument the dentist will need to
enter the coronal portion of the tooth?
A. Carbide round bur
B. Endodontic explorer
C. Reamer files
D. Dental broach
4. Which of the following statements is false concerning light-cured sealant application?
A. Poor sealant retention on the tooth surface may be due contamination of the sealant with saliva
during application.
B. Dental dams or cotton rolls will help to maintain a dry field when applying sealants.
C. Shining the curing light for 30 seconds will be the appropriate length of time to cure all surfaces

that have been sealed.

D. Use floss to make sure there is no sealant in contact with the interproximal area of the teeth.
5. A pregnant patient receiving dental treatment may experience which of the following after
sitting up quickly in the chair?
A. Postural hypertension
B. Hypoglycemia
C. Postural hypotension
D. Syncope

Answers & Explanations

1. D: Nitrous oxide/oxygen (N2O/O2) analgesia is also known as inhalation sedation. It has been in
use since 1844. This type of sedation is administered through a nosepiece and is fast acting.
N2O/O2 provides a very relaxing and good experience for the patient but can become habit forming
if abused. A tightly fitting face mask should be used for administration and the patient should be
instructed not to talk or breathe through the mouth to prevent nitrous oxide (N2O) from escaping.
The process starts with the administration of pure oxygen to establish the patients tidal volume. N2O
is then titrated to achieve appropriate results. The dosage of N2O can vary from one visit to the next;
therefore, the dose must be reestablished each time. The N2O/O2 analgesia process should
conclude with the administration of pure oxygen for approximately 3-5 minutes. The patient should
be evaluated for the presence of headache, lethargy, or dizziness. If any of these symptoms are
present, the patient should continue to receive 100% oxygen until the symptoms normalize.
2. A: The dental assistant will lead the patient into the dental chair. After the prosthesis is scrubbed
and disinfected, the dentist will place it in the patients mouth. The dentist examines the fit and use of
the dentures. The dental assistant places articulating paper into the patients mouth in order to check
the occlusion or the contact between the upper and lower teeth. Pressure indicator paste is also
used to check for pressure points on the tissue that touches the prosthesis. The dentist makes
appropriate adjustments for the comfort of the patient, including adjustment of the tension. Finally,
the partial denture is polished and then thoroughly cleaned and disinfected before being given to the
patient. The patient is educated regarding proper use and care of the partial dentures.
3. A: Root canal therapy involves removing the dental pulp and replacing it with dental material. The
dentist will need the carbide round bur to enter into the coronal part of the tooth to start the process

of removing the decay and inner structure of the tooth. The next instrument will be the endodontic
explorer and other intracanal instruments. These instruments may include endodontic spoon
excavator, spreaders, and pluggers, which are used in the obturation of the canal. A Glick no. 1
instrument is used to place the temporary restorations. There are a variety of files, both hand and
rotary operated, that will also be used within the pulpal cavity, such as the K-type file, Hedstrom file,
Reamer file, and broaches.
4. C: The sealant application process is very detailed. The surface of the tooth is first cleaned using
a rubber cup and pumice or by air polishing the surface. Next, the enamel is etched using 37%
phosphoric acid to allow the pores within the enamel to open up and accept the sealant material.
Next, drying of the surface is extremely important. The presence of any moisture will cause the
sealant to fail. A dental dam or cotton rolls can be used to maintain a dry field around the area. Lightcured sealants require the use of a curing light to cure or set the sealant. The light is shone on the
surface for 20 seconds. Each surface that has received sealant application must be cured
separately. Dental floss should be used to make sure sealant has not entered into the interproximal
spaces. After the sealant application, the patients bite should be checked using articulating paper.
5. C: Postural hypotension is also known as orthostatic hypotension. It is a form of low blood
pressure. This condition may occur when moving into an upright position too quickly. The person
may experience dizziness, lightheadedness, nausea, confusion, or blurred vision. Fainting may
occur. This condition is usually mild and may only last for a few minutes. Treatment is not required if
this happens only occasionally. If the patient becomes unconscious for more than a few minutes,
emergency medical treatment should be instituted. This may occur because of pregnancy,
dehydration, heart issues, or diabetes. Pregnant women may experience a similar reaction when
seated in the chair in a supine position because the uterus may be pressing on the abdominal veins.
The woman should be positioned on her left side to allow improved blood flow.