Clinical Dental Hygiene Study Guide Questions
Course Introduction
Clinical Dental Hygiene is a comprehensive course that provides students with the theoretical knowledge and hands-on skills necessary for effective dental hygiene practice. Emphasizing patient-centered care, the course covers assessment, planning, implementation, and evaluation of individualized dental hygiene treatment plans. Students gain proficiency in essential clinical procedures such as oral health assessments, periodontal therapy, scaling and root planing, dental radiography, and infection control. The curriculum also highlights patient education, communication skills, and ethical responsibilities required to promote optimal oral health and prevent disease in diverse populations within a clinical setting.
Recommended Textbook
Essentials of Dental Radiography for Dental Assistants and Hygienists 10th Edition by Evelyn Thomson
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Chapter 1: Dental Radiography: Historical Perspective and Future Trends
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Q1) What are the two techniques for exposing intraoral dental radiographs?
Answer: The bisecting technique, the first and earliest technique, and the par</KT> technique, the </KT>technique of choice that is taught in all dental assisting, dental hygiene, and dental schools.
Q2) What component of the dental x-ray machine best limits the size of the x-ray beam to the approximate size of the image receptor?
A) A pointed cone
B) An open round cylinder
C) A rectangular PID
D) A slit collimator
Answer: C
Q3) A radiograph is an image produced by exposure to x-rays.
A)True
B)False
Answer: True
Q4) Computed tomography eliminates the use of radiation to produce an image.
A)True
B)False
Answer: False
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Chapter 2: Characteristics and Measurement of Radiation
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Q1) What is defined as anything that occupies space and has mass?
Answer: Matter. The world consists of matter and energy. Matter makes up anything we can see, touch, and recognize
Q2) The speed of a wave is its
A) Wavelength
B) Velocity
C) Frequency
D) Photon
Answer: B
Q3) When radiation has great penetrating power it is called what?
Answer: Hard radiation. Useful wavelengths in diagnostic dental radiography range from 0.1 to 0.5 Angstrom and are called "hard radiation" because they have sufficient penetrating power to expose dental radiographs.
Q4) A weighting (qualifying) factor is used to determine which of the following?
A) coulombs per kilogram
B) sievert
C) roentgen
D) gray
Answer: B
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Chapter 3: The Dental X-Ray Machine: Components and Function
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Q1) Increasing which of the following would best increase the number of electrons flowing through the dental x-ray electrical circuit?
A) Impulses
B) Kilovoltage
C) Milliamperage
D) PID length
Answer: C
Q2) Dental x-ray machines may have controls for manual adjustment of kVp and mA, or these controls may be preset by the manufacturer.
A)True
B)False
Answer: True
Q3) The tungsten anode is embedded in a core of copper to conduct heat away to a radiator.
A)True
B)False
Answer: True
Q4) Inside the dental x-ray machine, what does the speed of the electrons determine?
Answer: The energy (penetrating power) of the x-rays produced
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Chapter 4: Factors Affecting Radiographic Quality
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Q1) The target-image receptor distance should be short to create radiographs with the best definition.
A)True
B)False
Q2) What is penumbra?
Q3) Radiographic density (film darkening) is decreased when the milliamperage or exposure time is increased.
A)True
B)False
Q4) Which of the following is recommended for increasing radiographic contrast while maintaining radiographic density?
A) Increase kVp and increase exposure time.
B) Decrease kVp and decrease exposure time.
C) Increase kVp and decrease exposure time.
D) Decrease kVp and increase exposure time.
Q5) Increasing the kVP results in a more penetrating x-ray beam.
A)True
B)False
Q6) What is radiographic density?
Q7) What is long-scale contrast?
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Chapter 5: Effects of Radiation Exposure
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Q1) Each of the following is a potential effect of a low dose of radiation EXCEPT one. Which one is the EXCEPTION?
A) No cell response.
B) Cell repairs itself and functions at pre-exposure levels.
C) Cell repairs itself abnormally.
D) Cell becomes radioactive.
Q2) Which of the following statements regarding the biological effect mechanisms of the indirect effect is FALSE?
A) Ionization dissociates water into hydrogen and hydroxyl radicals.
B) Ions have a strong tendency to seek out new combinations.
C) New chemicals, such as hydrogen peroxide, can form from hydrogen and hydroxyl radicals.
D) Radiation must be massive to destroy entire body tissues that result in death.
Q3) What do scientists believe about radiation damage to somatic cells from repetitive exposures?
Q4) Why are children more susceptible to radiation than adults?
Q5) In addition to x-radiation, list other causes of changes to the genetic material of cells.
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Chapter 6: Radiation Protection
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Q1) Regulations governing the use of radiation-producing equipment include federal, state, and some local laws.
A)True
B)False
Q2) The ALARA concept implies that:
A) any radiation dose that can be reduced without major difficulty, great expense, or inconvenience, should be reduced or eliminated.
B) if a radiation dose cannot be reduced without major difficulty, great expense, or inconvenience, then no radiographs should be exposed.
C) radiation dosages slightly above the acceptable level of risk are acceptable only in emergency treatment situations.
D) fewer radiographs should be taken only if a radiation dose cannot be reduced due to major difficulty, inconvenience, and great expense.
Q3) The best way to reduce patient risk from radiation exposure is to keep exposures ALARA.
A)True B)False
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Chapter 7: Dental X-Ray Film and Processing Methods
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Q1) Each of the following statements regarding duplication of radiographs is correct EXCEPT one. Which one is the EXCEPTION?
A) The emulsion side of duplicating film contains an antihalation coating.
B) The solarized emulsion records the copy of the image.
C) The emulsion side of duplicating film is placed against the original radiograph.
D) The antihalation coating prevents back-scattered light from re-exposing the film.
Q2) The purpose of the lead foil in the film packet is to absorb back-scattered x-rays to reduce film fog.
A)True
B)False
Q3) Graininess of a radiographic image results from:
A) large silver halide crystals.
B) the addition of radiosensitive dyes.
C) a decrease in film speed.
D) film packets that contain two films.
Q4) The sensitivity of a given type of dental x-ray film is known as its what?
Q5) What number is given to occlusal film to indicate its size?
Q6) Which side of the film packet faces the source of radiation?
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Chapter 8: Digital Radiography and Image Acquisition
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Q1) The purpose of the developing step is to:
A) remove unexposed silver halide crystals from the film emulsion.
B) neutralize the alkalinity prior to the film progressing to the fixer.
C) reduce exposed silver halide crystals to black metallic silver.
D) prevent the rapid buildup of image contrast.
Q2) The optimum developing temperature for manual time-temperature film processing is:
A) 58 degrees F.
B) 68 degrees F.
C) 78 degrees F.
D) 88 degrees F.
Q3) The dark portion of the radiograph is called "radiolucent."
A)True
B)False
Q4) The darkroom door should be locked when processing film.
A)True
B)False
Q5) Which processing solution prevents further film development?
Q6) What is the name of the component of developer that prevents development of unexposed silver halide crystals?
Page 10
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Chapter 9: Infection Control
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Q1) Which of the following is NOT a type of digital image receptor?
A) Photostimulable phosphor
B) Scanner
C) Complementary metal oxide semiconductor
D) Charge-coupled device
Q2) How many gray levels can a computer monitor display?
A) 8
B) 32
C) 256
D) 65,500
Q3) Film-based radiographs contain analog data.
A)True
B)False
Q4) How many shades of gray can the unaided human eye detect?
A) 32
B) 320
C) 3,200
D) 32,000
Q5) How can two images, taken over time, be compared using digital subtraction?
Q6) What are the advantages of digital radiography?
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Chapter 10: Legal and Ethical Responsibilities
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Q1) What is the definition of "disinfect"?
Q2) After aseptically removing the barriers, film packets that were packaged inside barrier envelopes may be processed with clean, dry hands because the film packets are not contaminated.
A) The first part of the statement is true. The second part of the statement is false.
B) The first part of the statement is false. The second part of the statement is true.
C) Both parts of the statement are true.
D) Both parts of the statement are false.
Q3) Which of the following will require adhering to infection control protocol for a semicritical object?
A) A lead apron and thyroid collar
B) A control panel and timer selector
C) A film mount and counter top
D) An image receptor holder
Q4) How can the chain of infection be broken?
Q5) How should films secured in barrier envelopes be handled?
Q6) How often should protective clothing be changed?
Q7) Are some patients likely to be reluctant to admit infectious conditions?
Page 12
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Chapter 11: Patient Relations and Education
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Q1) Each of the following statements regarding risk management is correct EXCEPT one. Which one is the EXCEPTION?
A) An attempt should be made to obtain duplicate copies of a new patient's radiographs.
B) The fastest film speed currently available should be used for all radiographs.
C) Unless required by law, personnel monitoring devices should be discouraged.
D) All intraoral radiograph exposures should use an image receptor holding device.
Q2) The statute of limitations for bringing a malpractice suit begins:
A) from the date that treatment was started.
B) from the date that treatment was completed.
C) from the date that the patient discovers an injury.
D) within 5 years from the date that the patient discovered an injury.
Q3) Who has a legal right to request copies of a patient's radiographs?
A) Another dentist
B) The patient
C) An insurance company
D) All of the above
Q4) Generally, how frequently must x-ray machines be inspected?
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Page 13
Chapter 12: Introduction to Radiographic Examinations
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Q1) Nonverbal communication includes gestures, facial expressions, body movement, and listening.
A)True
B)False
Q2) Which of the following statements regarding dental radiography during pregnancy is correct?
A) It causes premature delivery.
B) It overexposes the area of the developing fetus.
C) It has been linked to full-term, low birth-weight infants.
D) It creates birth defects.
Q3) Each of the following is a precaution that minimizes the amount of radiation a patient receives EXCEPT one. Which one is the EXCEPTION?
A) Take only necessary radiographs.
B) Use the slowest film speed currently available.
C) Use collimating equipment that restricts the beam size and shape.
D) Cover all patients with a lead/lead-equivalent apron and thyroid shield.
Q4) Is it acceptable for the radiographer to use such slang terms as "zap" or "shoot" to describe radiographic procedures?
Q5) How should the radiographer greet the patient?
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Chapter 13: The Periapical Examinationparalleling Technique
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Q1) Which of the two techniques for obtaining intraoral radiographs is considered the technique of choice?
A)True
B)False
Q2) Where should the open end of the PID be placed relative to the patient for radiographic exposures?
Q3) Each of the following statements regarding the fundamentals of periapical radiographs is correct EXCEPT one. Which one is the EXCEPTION?
A) Periapical radiographs may be taken using the paralleling or bisecting technique.
B) Placement of the image receptor-holding device must be evaluated to avoid angulation errors.
C) The patient's finger can be used to hold a large image receptor in position in the oral cavity.
D) The size of image receptor chosen depends on the shape and size of the dental arches.
Q4) Why is it important to not position the embossed dot on the film near the apices of the teeth?
Q5) Have film holders always been used in dental radiography?
Page 15
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Chapter 14: The Periapical Examinationbisecting Technique
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Q1) If an image receptor holder has an external aiming device, then the patient must be seated upright with the head straight.
A)True
B)False
Q2) The paralleling technique is preferred over the bisecting technique.
A)True
B)False
Q3) Which of these statements is FALSE?
A) The paralleling technique does not meet all five shadow-casting principles in all regions of the oral cavity on all patients.
B) With the paralleling technique, it is not possible to direct the central rays of the x-ray beam to both the tooth and the image receptor simultaneously.
C) The paralleling technique is the technique of choice for obtaining periapical radiographs.
D) With the paralleling technique, the object and image receptor are positioned parallel to each other.
Q4) How is correct vertical angulation achieved when using the paralleling technique?
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Chapter 15: The Bitewing Examination
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Q1) Even when the positioning and angulation steps are accurate and precise, the bisecting technique will produce some dimension distortion.
A)True
B)False
Q2) Why is it important for the radiographer to know how to apply both the paralleling and bisecting techniques?
Q3) To determine the vertical angulation when using the bisecting technique, the central rays of the x-ray beam should be directed:
A) perpendicular to the image receptor.
B) parallel to the image receptor.
C) perpendicular to the imaginary bisector.
D) parallel to the imaginary bisector.
Q4) Careful attention to the steps of the bisecting technique can produce acceptable radiographs.
A)True
B)False
Q5) Name an image receptor holder that may be used with both the paralleling and the bisecting techniques.
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Chapter 16: The Occlusal Examination
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Q1) Which of the following image receptor sizes would necessitate that only two bitewing radiographs be exposed?
A) Size #0
B) Size #1
C) Size #2
D) Size #3
Q2) For an adult horizontal or vertical molar bitewing, align the film packet so that the anterior edge lines up:
A) behind the distal half of the first premolar.
B) behind the distal half of the second premolar.
C) in front of the mesial half of the first premolar.
D) in front of the mesial half of the second premolar.
Q3) What is the name of the portion of the image receptor holder that helps the radiographer determine the point of entry?
Q4) Anterior bitewings should be exposed using a vertical angulation of +20 degrees.
A)True
B)False
Q5) What type of error results when the image receptor is not centered within the x-ray beam?
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Chapter 17: The Panoramic Examination
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Q1) Which of the following statements regarding managing occlusal radiograph exposures is FALSE?
A) Exposure factors are the same as those used for periapical and bitewing radiographs in the same region.
B) The open end of the PID should be positioned as close to the patient's skin as possible, without touching.
C) A modification of the paralleling technique is used to determine the vertical angulation.
D) A shorter PID minimizes distortion.
Q2) What are the recommended exposure settings for occlusal radiographs?
Q3) A 16-inch (41-cm) PID should be used for the occlusal radiographic exam.
A)True
B)False
Q4) When imaging the maxillary arch, the white, unprinted side of the occlusal film packet will face the maxilla.
A)True
B)False
Q5) Is it acceptable to recline the chair or tip the headrest back to facilitate obtaining an occlusal radiograph?
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Chapter 18: Identifying and Correcting Undiagnostic Radiographs
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Q1) Does radiographic film have an expiration date?
Q2) Failing to record the incisal or occlusal edges of the teeth on a periapical radiograph most likely results from an error made in which of the following steps?
A) Placement of the image receptor
B) Horizontal angulation
C) Vertical angulation
D) Centering the x-ray beam
Q3) Overlapping of adjacent teeth on the radiographic image most likely results from an error made in which of the following steps?
A) Placement of the image receptor
B) Horizontal angulation
C) Vertical angulation
D) Centering the x-ray beam
Q4) A dark radiograph can result from either overexposure or overdeveloping.
A)True
B)False
Q5) What causes discrete black lines to appear on the radiograph?
Q6) Film not protected from stray radiation is susceptible to what?
Q7) What is film fog?
Page 20
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Chapter 19: Quality Control and Environmental Safety in Dental Radiography
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Q1) Keeping a log of retakes can help identify the radiographer who needs continuing education.
A)True
B)False
Q2) Operator competency can reduce patient radiation exposure.
A)True
B)False
Q3) What is a reference film?
Q4) Each of the following statements regarding the coin test is correct EXCEPT one. Which one is the EXCEPTION?
A) A true test of the safelight uses a film pre-exposed to a small amount of radiation.
B) When the period of exposure to the safelight is up, the film is processed as usual.
C) A coin is placed on top of the unwrapped film for 10 minutes.
D) A coin test uses a coin and a lightly exposed film to determine safelight adequacy.
Q5) What is the key to peak performance of an automatic processor?
Q6) What is quality assurance in dental radiography?
Q7) In the coin test, how long is a coin placed on top of the unwrapped film?
Page 21
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Chapter 20: Image Orientation and Introduction to Interpretation
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Q1) The interaction of fixer with the silver ions in the emulsion of film produces:
A) sodium carbonate solution.
B) a hydroquinone-elon combination.
C) silver halide molecules.
D) silver thiosulphate complex.
Q2) Which of these statements is FALSE?
A) All containers holding developer and fixer must be labeled.
B) Developer and fixer manufacturers are required to provide labels for their product.
C) Chemical labels must be at least 3 inches by 5 inches in size.
D) Towels used to wipe a spill must be placed in a labeled container for disposal.
Q3) Contact lenses should be removed prior to using the emergency eyewash station.
A)True
B)False
Q4) List personal protective equipment (PPE) required for safe handling of processing chemicals.
Q5) Describe at least 10 general recommendations for safe handling of hazardous chemicals used in dental radiography.
Page 22
Q6) What happens if fixer chemicals are accidentally mixed with developer?
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Chapter 21: Recognizing Normal Radiographic Anatomy
Intraoral Radiographs
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Q1) All radiographs, whether intraoral or extraoral, should be mounted.
A)True
B)False
Q2) Who is responsible for interpreting a patient's radiographs?
Q3) Which of these statements is FALSE?
A) Dental radiographs may be viewed by the dentist, dental hygienist, or dental assistant.
B) Diagnosis is defined as identification and determination of the nature of an abnormal condition or disease.
C) Dental radiographs may be interpreted by all members of the oral health care team.
D) Diagnosis is the responsibility of the dental assistant and dental hygienist.
Q4) How long should dental radiographs be retained?
Q5) Black opaque or cardboard film mounts are preferred because they:
A) are less expensive and more readily available from the manufacturer.
B) are more common and therefore easily shared with other practices.
C) make placing films in the windows easier.
D) block extraneous light to aid in interpretion.
Page 23
Q6) Which is the preferred method of mounting films?
Q7) What type of film mount is preferable?
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Chapter 22: Recognizing Normal Radiographic Anatomy
Panoramic Radiographs
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Q1) Examples of anatomic landmarks that may appear on a maxillary anterior radiograph include the nasal septum, anterior nasal spine, and soft tissue shadow of the nose.
A)True
B)False
Q2) Structures that are dense and absorb or resist the passage of x-rays will appear dark or black on the radiograph.
A)True
B)False
Q3) Which of the following lists the structures in order of decreasing radiopacity?
A) Pulp, dentin, cementum, enamel
B) Enamel, dentin, cementum, pulp
C) Pulp, cementum, dentin, enamel
D) Enamel, cementum, dentin, pulp
Q4) What is the round radiolucency often observed near the apices of the mandibular premolars called?
Q5) How does the lateral fossa appear on a dental radiograph?
Q6) Radiographs taken on a 5-year-old child will most likely image 20 primary teeth.
A)True
B)False Page 24
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Chapter 3: Radiographic Appearance of Dental Materials and Foreign Objects
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Q1) Each of the following dental materials may be observed within the pulp chamber and/or root canals of the tooth EXCEPT one. Which one is the EXCEPTION?
A) Post and core
B) A silver point
C) Gutta-percha
D) An implant
Q2) A granuloma is a mass of granulation tissue.
A)True
B)False
Q3) A nonodontogenic cyst arises from epithelial cells associated with the development of a tooth.
A)True
B)False
Q4) Which of these will appear radiopaque?
A) An abscess
B) A cyst
C) A granuloma
D) Osteosclerosis
Q5) What is the term applied to tumors that do little or no harm?
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Chapter 24: The Use of Radiographs in the Detection of Dental Caries
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Q1) Which of the following statements regarding radiographic detection of caries is FALSE?
A) Radiographs aid significantly in the detection of proximal decay.
B) Bitewing radiographs are the radiographs of choice for the evaluation of caries.
C) Incorrect vertical angulation overlaps the contacts between teeth to render the radiograph useless for caries detection.
D) Radiographs have limited usefulness in detection of early occlusal caries.
Q2) Which of the following statements regarding radiographic detection of caries is correct?
A) Decalcification must reach 80-90 percent loss of hard structure to be imaged radiographically.
B) The depth of the caries appears more advanced radiographically than clinically.
C) The periapical radiograph is the radiograph of choice to image caries.
D) Some practitioners prefer to use a low kVp to best image caries.
Q3) What is the term applied to the pathologic process in which acids produced by microorganisms cause local destruction of dental hard tissues?
Q4) How do caries appear radiographically compared to radiopaque enamel?
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Chapter 25: The Use of Radiographs in the Evaluation of
Periodontal Diseases
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Q1) Periodontal diseases affect both soft tissues (gingiva) and bone around the teeth.
A)True
B)False
Q2) Each of the following is a use of radiographs in the assessment of periodontal disease prognosis EXCEPT one. Which one is the EXCEPTION?
A) Evaluating root-to-crown ratio
B) Detecting furcation involvement
C) Determining active versus inactive disease
D) Revealing root shape and length
Q3) Can radiographs reveal the effects of traumatic occlusion on the periodontium?
Q4) The effects of occlusal trauma may be evident on a radiograph as A) a widening of the PDL space.
B) an excessive buildup of calculus.
C) dilacerations of the teeth roots.
D) furcation involvement.
Q5) Localized bone loss is the same diagnosis as generalized bone loss.
A)True
B)False
Q6) Describe the earliest radiographic evidence of periodontal disease.
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Chapter 26: Describing Radiographic Anomalies, Lesions, and Opportunistic Screening
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Q1) A lateral jaw extraoral radiograph can be used to assist with providing radiographic information for the child patient who cannot tolerate placement of an intraoral image receptor.
A)True
B)False
Q2) Which of these statements is FALSE?
A) A size #0 or #1 intraoral image receptor is usually the choice for a child with primary teeth.
B) The preferred image receptor for use with a child with transitional dentition is size #1.
C) The radiographer should use the largest size image receptor the child can tolerate.
D) The amount of radiation required does not depend on the size of the intraoral image receptor.
Q3) The evidence-based guidelines for prescribing dental radiographs pertain to adults and not to children.
A)True
B)False
Q4) Should a thyroid collar be used when exposing radiographs on children?
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Chapter 27: Pediatric Radiographic Techniques
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Q1) How should pregnant patients who need dental radiographs be prepared for the procedure?
Q2) Is receipt of large amounts of therapeutic radiation to the head and neck area a contraindication to future dental radiographs?
Q3) Prior to beginning the radiographic procedure, the radiographer may need to remove the mask worn for PPE when treating a patient with a hearing impairment.
A)True B)False
Q4) The radiographer should do each of the following to aid in managing the apprehensive patient EXCEPT one. Which one is the EXCEPTION?
A) Demonstrate attentive listening.
B) Maintain control over the procedure.
C) Expose the more difficult posterior radiographs first.
D) Compliment the patient on his or her cooperation.
Q5) It is best to ask the caregiver of a person with disabilities questions about the patient.
A)True B)False
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Chapter 28: Radiographic Techniques for Patients With Special Needs
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Q1) Which localization technique requires the exposure of only one radiograph?
A) The definitive evaluation method
B) The right-angle method
C) The tube-shift method
Q2) Can dental radiographs be taken in edentulous areas?
Q3) A torus mandibularis</KT> is a benign outgrowth of bone along the midline of the hard palate.
A)True
B)False
Q4) Which of the following statements regarding localization methods is FALSE?
A) In the definitive evaluation method, objects on the buccal surface of the tooth will appear more clear and distinct on the image than objects on the lingual.
B) To apply the tube-shift method, two radiographs are needed.
C) The occlusal radiograph can identify whether an impacted tooth is located on the buccal or lingual.
D) The definitive method of localization is the least reliable.
Q5) What is a duplicate radiograph?
Q6) Can radiographs be exposed during endodontic therapy?
Q7) What is the principle behind the tubeshift method of localization?
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Chapter 29: Radiographic Techniques for Specific Oral Conditions
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Q1) Cone beam computed tomography (CBCT) is computed tomography technology dedicated to dental applications.
A)True
B)False
Q2) Of what is the back cover of a rigid extraoral film cassette constructed?
Q3) Extraoral radiographs are useful for each of the following EXCEPT one. Which one is the EXCEPTION?
A) Unexplained gingival bleeding
B) Growth and development
C) Suspected impactions
D) A patient with limited ability to open the mouth
Q4) Which of these extraoral radiographs is most often used to aid in diagnosing temporomandibular joint problems?
A) Lateral skull projection
B) Transcranial projection
C) Reverse Towne projection
D) Posteroanterior projection
Q5) A transcranial radiograph evaluates the maxillary, frontal, and ethmoid sinuses.
A)True
B)False
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Chapter 30: Radiographic Techniques
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Q1) The nasopharyngeal air space is located between the tongue and the palate.
A)True
B)False
Q2) The bite block is used to position the arches correctly in the forward-backward dimension of the focal trough.
A)True
B)False
Q3) What is the name of the anatomic landmark that appears on a panoramic image as a thick radiopaque horizontal band superior to the maxillary teeth?
Q4) Which of these statements regarding the focal trough is FALSE?
A) Its shape varies from one manufacturer to another.
B) It is where structures will be imaged the sharpest.
C) It is two-dimensional.
D) It is used to determine where to position the dental arches.
Q5) What is the name of the anatomic landmark that appears on a panoramic image as a radiolucent, round opening on the body of the mandible, near the roots of the mandibular premolars?
Q6) What happens to the radiographic image if intensifying screens and film are not in tight contact?
Page 33
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