Periodontics Question Bank

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1. Which toothbrushing technique places bristles at a 45-degree angle to the long axis of the tooth, directed into the gingival sulcus, with a gentle vibratory motion?

The Bass technique positions bristles at a 45-degree angle into the gingival sulcus and uses a short vibratory motion. It is favored for disrupting subgingival and sulcular plaque near the gingival margin.

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2. The Charters toothbrushing technique directs bristles away from the gingiva at 45 degrees. What is this method especially useful for?

Charters points bristles coronally at 45 degrees so bristle sides contact interproximal areas. It is often recommended after periodontal surgery and around fixed prostheses and orthodontic appliances.

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3. The modified Stillman technique combines a vibratory motion with a coronal roll stroke primarily to accomplish what?

The modified Stillman technique stimulates gingiva and cleans the cervical portion of the tooth using a vibratory motion followed by a coronal roll stroke. It is useful in patients with recession to minimize abrasion.

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4. Which method, using large circular motions with teeth in occlusion, is most appropriate for a young child with limited dexterity?

The Fones technique uses large circular motions with teeth in occlusion and is simple enough for young children to master. It requires little dexterity and is easy to teach.

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5. A patient shows gingival abrasion and cervical wear from overzealous horizontal scrubbing. What is the most appropriate first recommendation?

Horizontal scrubbing with firm bristles causes cervical abrasion and gingival trauma. A soft brush with a gentle sulcular technique reduces damage while maintaining plaque control.

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6. Which interdental aid is most effective for open (Type III) embrasures with significant papillary loss?

Interdental brushes clean open embrasures better than floss when the papilla no longer fills the space. They remove plaque from concave root surfaces that floss cannot adapt to well.

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7. For a patient with intact papillae and tight contacts (Type I embrasure), which interdental aid is generally most appropriate?

With embrasures filled by intact papillae and tight contacts, floss is the aid of choice because an interdental brush would not fit and could traumatize the papilla. Floss removes plaque below the contact point.

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8. When flossing, how should the floss be adapted to clean the proximal surface effectively?

Proper flossing wraps the floss in a C-shape around the proximal surface and moves it up and down, adapting to the tooth. Snapping through contacts can traumatize the papilla and does not clean the surface.

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9. Chlorhexidine gluconate achieves its prolonged antiplaque effect primarily through which property?

Chlorhexidine binds oral surfaces and is released slowly over hours, a property called substantivity. This sustained release gives it superior antiplaque efficacy compared with rapidly cleared agents.

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10. Which is a well-recognized side effect of prolonged chlorhexidine mouthrinse use?

Extrinsic brown staining of teeth, restorations, and tongue plus transient taste alteration are common. Staining is usually removable by professional cleaning and reverses on discontinuation.