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FOB &3STAL HYGIENISTS 
LEONARD ANSWERS 
TO STATE BOARD QUESTIONS 
FOR DENTAL HYGIENISTS 
DR. EDWARD J. LEONARD 
DIRECTOR, CLASS IN DENTAL HYGIENE OF HARTFORD; 
FORMERLY DENTAL SUPERVISOR, 
SOUTH DISTRICT PUBLIC SCHOOLS, 
HARTFORD, CONN. Copyright / 922 Edward J. Leonard 
Press of 
E. S. Pig. Co. 
Hartford, Conn. To M. L. R., lover and condenser of facts FOREWORD. 
The questions contained in this book have been 
gathered from the examinations of dental hygienists 
by schools and examining Boards. The answers, 
obtained from standard sources, in many instances 
have been condensed or revised to serve the need 
of brevity but without, it is believed, sacrifice of 
clearness. References would prove so cumbersome 
that they have been generally omitted. 
To those who have aided in various ways in 
the preparation of this work the author wishes to 
express his thanks. 
E. J- L. CONTENTS. 
Chapter I 
ANATOMY AND HISTOLOGY 5-27 
Chapter IT 
PHYSIOLOGY 28-39 
Chapter HI 
BACTERIOLOGY 40-41 
Chapter IV 
DENTAL CARIES AND MALOCCLUSION 45-50 
Chapter V 
DENTAL PATHOLOGY 51-53 
Pyorrhea Alveolaris 53 
Chapter VI 
ORAL PROPHYLAXIS 54-57 
Chapter VII 
MISCELLANEOUS 58-60 
Anesthesia Assisting 58 INDEX 
A 
Absorption, defined, 33 
Adenoids, defined; effect of, 59 
Alimentary Tract, Divisions of, 8 
" Secretions of, 30 
" Subdivisions of, 8 
Alveolar Process, Description of, 21 
Amboceptor, defined, 43 
Anesthesia, defined, preparations for, 58-59 
Anesthetic, local, 59 
Angle's Classification, 48 
Antigen, defined, 43 
Antiseptic, defined, 42 
Antitoxin, defined, 41 
Apnea, defined. 29 
Arch, Zygomatic, 10 
Artery, Difference between vein, 8, 14 
Articulation, Temporo-Mandibular, 9, 15 
Assimilation, defined, 34 
B 
Bacteria, Essentials to life of, 44 
" Aerobic, 41 
" Anaerobic, 41 
Classification of, 40 
How multiply, 43 
Development in mouth of, 42 
Bacterial Plaque (Gelatinous Film, etc.), 45 
How located, 55 
Bacteriology, defined, 40 
Bile, Description of, 32 
Bicuspids, Upper 1st and 2nd, 18 
Blastoderm, defined, 22 
Blood, functions of, constituents of, 28 
" Coagulation of, 28 
Blood Pressure, 29 
Specific Gravity of, 28 
Body, Systems of, Tissues of, 5 
Buccinator Muscle, Origin, Insertion of, 10 
C 
Calcification, defined, 11 
Calorie, defined, 34 
Caries, Dental, defined, 45 
" Miller's Theory of, 45 
" Relation of Diet to, 
" Causes and conditions of, 45-46 
Carotid, Location of Common, 11 
Cell, Description of, Division of, 24 
Cementum, Description of, 21 
Bone and, 27 
Function of, 37 
Chyle, Description of, 31 
Chyme, Description of, 31 
Circulation, Portal, 32 
Complement, defined, 43 INDEX 
Congestion, defined, 51 
Corpuscles, Red, 8, 28 
" White, 8, 28 
Cranial Nerves, Names of, 16 
Cranium, Bones of, 16 
Culture Media, Description of, 40 
Cuspids, Upper and Lower, 17 
In Occlusion, 49 
D 
Deciduous (See under Teeth) 
Deglutition, Description of, 32 
Muscles of, 33 
Dental Follicle, defined, 25 
Hygiene, Law Relating to, 57 
Hygienist, Dangers to hand of, 42 
Papilla, defined, 25 
Ridge, defined, 25 
Tissues, Blood and Nerve Supply, 15 
Dentin, Causes of sensation in, 59 
Description of, 23 
Secondary, 21 
Diaphram, Description of, 16 
Diet, Dental Caries and, 36 
Digestion, Gastric, 31 
Disinfectants, Three efficient, 41 
defined, 42 
E 
Embryo, defined, 27 
Enamel, Description of, 23 
Enzyme, Description of, 36 
Epithelium, Description of, 25 
Varieties of, 25 
Erosian, defined, 46 
Eustachian Tube, Description of, 6 
< F 
Faces, Bones of, 6 
Facial Expression, Muscles of, 16 
Fats, Where absorbed, 31 
Ferment, Amylolytic, 30 
Fibers of Tomes, 26 
Food, defined, classified, 35 
" Absorption of, 33 
Fifth Nerve, Description of, 13 
" Ganglia of, 15 
G 
Gasserion Ganglion, Description of, 12 
Gingivitis, defined, 51 
Green Stains, Cause and effect of, 55 
Groove, Primitive Dental, 22 INDEX 
Gums, Description of, 21 
" Massage of, 55 
" Color of, 54 
" Congestion of, 57 
Gum Margin, defined, 55 
Glycogen, Described, 32 
H 
Healing, First Intention, 52 
Head, Blood Supply, 14 
" Nerve Supply, 14 
Heart, Description of, 12 
" Valves of, 11 
Hemoglobin, Description of, 29 
Histology, defined, 11, 22 
I 
Internal Maxillary Artery, 15 
Inferior Dental Artery, 15 
" Nerve, 
Inferior Maxillary Nerve, 17 
Immunity, defined, 42 
Incisors, Labial Surface of, 18 
Incline Plane, defined, 48 
Infection, defined, etc., 41 
Inflammation, defined, classified, 52 
Infra-Occlusion, defined, 48 
Irregularities, Causes of, 48 
Interglobular Spaces, 26 
Instruments, Disinfection of, 40 
J 
Jaws, Development of, 25 
K 
Kidneys* Purpose of, 39 
Koch's Law, 40 
L 
Leukocyte, Described, 41 
Leukocytosis, defined, 29 
Lines of Schreger, 26 
Liver, Functions of, 32 
Lymph, Origin, Uses, 31 
Lymphatic Glands, 8 
System, 14 
M 
Malocclusion, defined, etc., 47-50, 59 
Mandible, Part limiting motion of, 9 
Description of, 7 
Muscles pulling downward, 14 
Mastication, Nutrition and, 35 
Muscles of, 27 
Maxilla, Description of Superior, 7 INDEX 
Membranes, Varieties of, 13 
Metabolism, defined, 33 
Nervous System and, 34 
Milk, Value of, 33 
" Ferment of, 29 
Molar, Lower First, 18 
" Upper First, 19 
Mouth, Bones forming framework of, 6 
Mucuous Membrane of, 22 
Muscles of floor of, 10 
Masseter Muscle, Functions of, 33 
N 
Nasal Fossae, Bones forming, 10 
Nasmyth's Membrane, Description of, 26 
Necrosis, defined, 53 
Neuralgia, defined, 51 
Neurone, defined, 38 
Neuman's Sheath, Description of, 26 
Nutrition, defined, 35 
O 
Occlusion, defined, 48 
Odontalgia, 51 
Odontoblast, defined, 24, 26 
Oral cavity, Boundaries of, 6 
" " Lining of, 22 
Orbital cavity, Bones of, 9 
Orthodontia, defined, 49; value of, 59 
Osteoblast, defined, 24 
Osteoclast, defined, 24 
Osmosis, defined, 29 
P 
Pacifier, Effect upon teeth by use of, 49 
Palate, Description of soft, 6 
Palate Bones, Description of, 6 
Pancreatic Juice, Enzvmes of, Actions of, 30 
Parasite, Definition of, 41 
Pathology, defined, 52 
Patient, Instructions to, 56 
Pericementitis, defined, 51 
Peridental Membrane, 23 
Perichondrium, Description of, 10 
Periostitis, defined, 53 
Peristalsis, defined, 38 
Pharynx, Openings into, 9 
Phagocytosis, defined, 44 
Pocket, defined, 55 
Porte Polisher, 57 
Prophylaxis, defined, 54 
Protoplasm, Description and Functions of, 22 
Pulp, Description of, 16, 38 
Pulpitis, defined, 57 
Pulse Rate, Normal, 29 
Pyogenic, defined, 41 
Pyorrhea Alveolari®. 53 INDEX 
R 
Reflex, defined, 38 
Refracting Media, Name of, 17 
Residual Air, Definition of, 29 
Respiration, 29-30 
Rubber Dam, Disinfection of, 40 
S 
Saliva, Action upon foods, 30 
Description of, 30 
Definition of stringy, 47 
Type of stimulation most effective in influence on, 34 
Varieties of, 31 
Salivary Glands, Description of, 5 
Saprophyte, defined, 41 
Secretion, defined, 
Septicemia, defined, 52 
Sensation, Phenomena of, 37 
Sequestrum, defined, 53 
Sinus, Description of, 21 
Sinuses, Description of maxillary, 20 
Skeleton, Bones of, Classification of, 5 
Spores, defined, 40 
Sterilization, Definition of, 41 
Method of, 43 
Stomatitis, Definition and varieties, 52 
Suppuration, defined, 52 
Surgical Shock, defined, 59 
Syncope, Definition and treatment of, 58 
Syphilis, Manifestations in mouth of, Cause of, 43 
T 
Tartar, 47, 54 
Taste Buds, Location of, 28 
Teeth, Nerve Supply of Upper and Lower, 5 
" Cleaning approximal surfaces of, 57 
" Result of early extraction of, 49, 56 
" Difference between Temporary and Permanent, 18 
" Shedding of Deciduous, 27 
" Time of Eruption of, 19 
Tongue, Blood and Nerve Supply, 9 
Description of, 12 
Muscles of, 16 
Tooth, Calcification of, 26 
" Germ, defined, 25 
Tonsils, Varieties of, 8 
Toxin, defined, 41 
Trachea, Description of, 14 
V 
Vitamins, defined, 35 
W 
Wounds, Plealing of, 52 
X-Ray, Principle of, 58 
Z 
Zygomatic Arch, Muscles passing under, 10 CHAPTER I. 
ANATOMY 
NAME THE PRINCIPAL TISSUES OF THE BODY. 
Epithelial, Muscular, Nervous and Connective. 
HOW MANY BONES IN THE SKELETON? HOW 
CLASSIFIED? 
206. They are classified as long, short, flat and irregular. 
NAME THE VARIOUS SYSTEMS FOUND IN THE 
HUMAN BODY. 
Skeletal, Respiratory, Alimentary, Muscular, Vascular, Ex- 
cretory, Nervous, Reproductive. 
DESCRIBE THE SALIVARY GLANDS. 
The Parotid gland lies upon the face, immediately below and 
in front of the ear, limited above by the zygoma. It empties 
its secretion into the mouth by way of Stenson's duct, which 
runs parallel with the zygoma and pierces the buccinator 
muscle and the mucous membrane of the cheek opposite the 
second molar tooth. The submaxillary gland is below the 
jaw in the submaxillary triangle; it is irregular in form and 
weighs about two drams. Wharton's duct is about two inches 
long. It passes forward and inward and opens by the side of 
the frenum of the tongue. The sublingual gland is situated 
beneath the mucous membrane of the floor of the mouth by 
the side of the frenum, in contract with the inner surface of 
the lower jaw. The ducts of Rivinus, eight to twenty in num- 
ber, open on the floor of the mouth on each side of the frenum; 
one larger duct opens into Wharton's duct and is called the 
duct of Bartholin. 
GIVE NERVE SUPPLY OF THE UPPER AND LOWER 
TEETH. 
The nerve supply of the upper teeth is derived from the second 
division of the fifth nerve through posterior, middle and an- 
terior superior dental branches. The lower teeth are supplied 
by the inferior dental branch of the third division of the fifth 
nerve. 
5 DESCRIBE THE EUSTACHIAN TUBE AND GIVE ITS 
FUNCTION. 
This canal begins at the anterior end of the middle ear cavity, 
passes downward, forward and somewhat inward to the naso- 
pharynx. It is about an inch and a half in length. The func- 
tion of the Eustachian tube is to keep the air in the middle ear 
of the same density as that of the exterior. 
WHAT BONES FORM THE FRAMEWORK OF THE 
MOUTH? 
The bony framework of the mouth is formed by (a) the su- 
perior maxillary bones, (b) the palate bones, and (c) the 
inferior maxillary bone or mandible. 
GIVE THE BOUNDARIES OF THE ORAL CAVITY. 
The oral cavity is bounded in front by the lips, laterally by the 
cheeks, above by the hard and soft palate, and below by the 
mylohyoid and genio-hyoid muscles which form the floor. 
DESCRIBE THE PALATE BONES. 
There are two palate bones. In form they are likened to the 
letter "L". Their upright portion, called the verticle plate, 
helps to form the outer wall of the nasal cavity. The bones 
corresponding to the base of the "L" is called the horizontal 
plate and articulates anteriorly with the palate process of the 
superior maxilla, thus aiding in the formation of the floor of 
the nose and the roof of the mouth. Posteriorly the horizontal 
plate ends in the free border to which is attached the soft 
palate. 
DESCRIBE THE SOFT PALATE. 
This structure is attached to the posterior border of the hard 
palate and is formed by five different muscles. These are in 
turn covered with mucous membrane. 
NAME THE BONES OF THE FACE. 
Two nasal, Two lacrimal, One vomar, Two malar, Two palate. 
Two inferior turbinated, Two maxilla and One Mandible. 
6 DESCRIBE THE GUSTATORY NERVE. 
It is a branch of the posterior division of the inferior maxillary 
portion of the fifth nerve. It is situated posterior to the ex- 
ternal pterygoid muscle, and just before it enters the side of 
the tongue, it is joined by the Chorda tympani nerve, a branch 
of the seventh (facial). It supplies the anterior two-thirds of 
the tongue with common sensation. 
DESCRIBE THE MANDIBLE. 
The inferior maxillary bone consists of a horse-shoe-shaped 
body and two rami. Each ramus is prolonged into two 
processes-one, the coronoid process, and the other the con- 
dyloid process. Between the, two is situated the sigmoid 
notch. The portion of the body into which the teeth are in- 
serted is called the alveolar margin. On the inner surface of 
the ramus is situated the inferior dental foramen. This canal 
continues through the center of the bone until it reaches the 
mental foramen, which is situated on the external surface of 
the jaw, opposite the canine tooth. The line of union of the 
two sides is called the symphysis. On the posterior surfaces 
of the symphysis are situated the genial tubercles. 
DESCRIBE THE SUPERIOR MAXILLA. 
The bone consists of a hollow body and four processes. The 
body is cuboidal in form and hollowed out in the center into 
a pyramidal cavity, called the antrum of Highmore. It has 
four surfaces, an external, which looks forward and outward; 
a posterior convex surface, which forms part of the zygomatic 
fossa; a superior surface (orbital plare), which forms part 
of the floor of the orbit; and an internal, which forms part of 
the outer wall of the nasal fossa and the mouth. The bone 
has four processes: Malar, nasal, alveolar and palatine. It 
articulates with the following bones: the opposite maxilla, 
tuberosity of the palate by the posterior outer border, the 
palate in the floor of the orbit, the ethmoid, lacrimal, malar, 
nasal, and inferior turbinated. 
7 DESCRIBE CONNECTIVE TISSUE. 
It is of mesodermic origin and is composed of cells and inter- 
cellular substance, the latter being in excess of the cellular 
elements. Connective tissue cells are round, spindle shaped, 
stellate and fusiform. It is the most widely distributed tissue 
in the body. 
DESCRIBE (A) RED CORPUSCLE (B) WHITE CORPUS- 
CLE. 
A red corpuscle is a bi-concave disk containing no nucleus. 
It measures about 1/3200 in. in diameter. 
The white blood cells or leu kocytes are 1/2500 in. in diameter, 
nucleated and contain glycogen, fat nuclein, etc. There are 
several varieties grouped as lympocytes and leukocytes. 
NAME THE SUBDIVISIONS OF THE ALIMENTARY 
CANAL. 
Mouth, pharynx, esophagus, stomach, duodenum, jejunum, 
ileum, ascending, transverse, descending and sigmoid colon, 
rectum and anus. 
WHAT IS THE STRUCTURAL DIFFERENCE BETWEEN 
AN ARTERY AND A VEIN? 
Veins have much thinner walls than the arteries. They con- 
tain valves and there is more endothelial lining than in the 
arteries. 
WHAT ARE LYMPHATIC GLANDS? 
They are globular, ovoid, flattened bodies, consisting of fi- 
brous framework, lymph sinuses and lymph follicles. They 
form part of the general lymphatic system. 
NAME THREE VARIETIES OF TONSILS? AND GIVE 
THE LOCATION OF EACH. 
Hie pharyngeal tonsil (adenoid), when present, is found on 
the posterior wall of the naso-pharynx. The lingual tonsil 
8 is situated on the posterious surface of the tongue. The 
faucial or true tonsils are situated between the anterior and 
posterior palatine arches. The blood supply of the true ton- 
sils come from the ascending pharyngeal, and ascending and 
descending palatine arteries. 
WHAT BONES FORM THE ORBITAL CAVITIES? 
Frontal, Ethmoid, sphenoid, two superior maxillary, two 
lacrimal, two palate, two inferior turbinated and vomer. 
NAME THE BONES FORMING THE HARD PALATE. 
Palate bones, palatal processes of the superior maxillae. 
WHAT BONY PART LIMITS THE FORWARD MOTION 
OF THE TEMPORO-MANDIBULAR ARTICULATION? 
The glenoid fossa, the articulating eminence of the temporal 
bone and the condyle of the mandible. 
WHAT BONY PART LIMITS THE FORWARD MOTION 
OF THE MANDIBLE? 
The eminentia Articularis. 
GIVE THE CLASSIFICATION OF THE TEMPORO- 
MANDIBULAR ARTICULATION. 
Diarthrosis or movable. 
GIVE THE BLOOD AND NERVE SUPPLY TO THE 
TONGUE. 
Lingual and ascending pharyngeal arteries. Motor nerve, 
twelfth, Special sense, ninth, and chorda tympani from the 
seventh. Common sensation, lingual branch of the third 
division of the fifth. 
NAME THE SEVEN OPENINGS INTO THE PHARYNX. 
Larynx, mouth, esophagus, two eustachion tubes, and two 
posterior nares. 
Diarthrosis or movable. 
9 DESCRIBE THE INFERIOR DENTAL NERVE. 
It is a branch of the inferior maxillary division of the fifth 
nerve. With the artery it enters the inferior dental canal, 
supplies the teeth and at the mental foramen divides into in- 
cisor and mental branches; the latter supplies the chin and 
lower lips. Its branches are the dentals to molars and bicus- 
pid teeth, and mylohyoid to mylohyoid and digastric muscles. 
WHAT MUSCLES FORM THE FLOOR OF THE MOUTH? 
Mylo-hyoid and hypoglossus. 
GIVE THE ORIGIN INSERTION AND ACTION OF THE 
BUCCINATOR MUSCLE. 
ORIGIN : Pterygo-maxillary ligament and alveolar portions 
of the superior and inferior maxillary bones. INSERTION : 
Upper fibers assist in forming the lower portion of the orbicu- 
laris oris; lower fibers form the upper portion of the orbicu- 
laris oris. ACTION: To draw the angle of the mouth 
backward, keep the food between the teeth in mastication, 
and assist in the formation of sounds. 
WHAT IS PERICHONDRIUM ? 
A fibrous investment surrounding cartilage. 
WHAT BONES ENTER INTO THE FORMATION OF 
THE NASAL FOSSAE? 
Frontal, sphenoid, ethmoid, two nasal, two superior maxillary, 
two lacrimal, two palate, two inferior turbinated, and vomer. 
DESCRIBE THE ZYGOMATIC ARCH? NAME THE 
MUSCLE THAT PASSES UNDER IT. 
The zygomatic arch is formed by the zygomatic process of the 
temporal bone uniting with a like process from the malar 
bone. The temporal muscle passes under it. 
10 WHAT IS HISTOLOGY? 
Histology is the study of the minute structure of normal 
tissue. 
WHAT IS CALCIFICATION? 
It is the process by which tissue becomes infiltrated with 
lime salts. 
GIVE THE LOCATION OF THE COMMON CAROTID, 
RADIAL AND FEMORAL ARTERIES. 
The left common carotid arises from the middle of the arch 
of the Aorta; the right common at the division of the in- 
nominate. They ascend obliquely on either side of the neck 
until, on a level with the upper border of the laryngeal prom- 
inence, they divide into the external carotid and the internal 
carotid. 
The radial artery extends from the brachial along the outer 
side of the front of the forearm as far as the lower end of 
the radius. It terminates in the deep palmer arch. 
The femoral artery lies in the upper three fourths of the 
thigh, its limits being marked above by the inguinal ligament 
and below by the opening in the great adducter muscle. 
NAME THE VALVES OF THE HEART, THEIR POSI- 
TION AND FUNCTION. 
The Eustachian valve: situated below the opening of the 
inferior Vena Cava. 
The Tricuspid valve: guards the orifice of the same name 
on the right side of the heart. 
The Mitral valve: guards the left auriculo-ventricular or 
mitral orifice. 
The semilunar valves: are situated at the opening of the 
right ventricle into the pulmonary artery. 
The valves of the heart prevent regurgitation of the blood 
in its passage. 
11 GIVE A BRIEF DESCRIPTION OF THE HEART. 
The heart is a muscular organ situated in the thorax between 
the lungs and above the central depression of the diaphragm. 
It is conical in shape and about the size of the closed fist. 
Enclosing it is a membranous sac called pericardium. The 
heart is divided into the right and left half by a fixed partition. 
Each half is subdivided into two cavities, the upper called 
auricle, the lower, ventricle. The muscular walls of the 
the auricles are much thinner than those of the ventricles, 
and the wall of the left ventricle is thicker than that of the 
right. 
The auricles and ventricles communicate with other by means 
of restricted openings protected by valves. 
The right auriculo-ventricular valve is called the tricuspid. 
The valves between the ventricles and the aorta and pul- 
monary artery are named semilunar. 
Continuous with the blood vessels, and lining all cavities of 
the heart is a smooth, delicate membrane called endocardium. 
The heart receives its blood supply from the right and left 
coronary arteries. Its nerve supply is derived (1) from the 
vagi nerves of the central nervous system and (2) from the 
pneumogastric. 
BRIEFLY DESCRIBE THE GASSERION GANGLION. 
The Gasserion Ganglion is situated on the floor of the middle 
fossa of the skull just behind the foramen Ovale. It receives 
the sensory root of the Trifacial nerve and divides into an 
opthalmic, or first division, the superior maxillary, or second 
division, and an inferior maxillary, or third division. 
DESCRIBE THE TONGUE. 
The tongue is a muscular organ composed of a root, a body 
and an anterior extremity or tip. It is made up of five mus- 
cles and is covered with mucous membrane. Underneath it 
is attached to the floor of the mouth by a fold of membrane 
called the frenum. The base of the tongue is attached to the 
hyoid bone and to the muscles of the pharynx. The papillae 
12 are found on the surface of the tongue, the most important 
being the circum vallate papillae; these are situated on the 
back part of the tongue, are arranged in the form of a "V", 
about eight to twelve in number. At the base of the papillae 
are located the taste buds transmitting the sense of taste. 
The lingual tonsil, composed of lymphoid tissue, is situated 
behind the circumvallate. Nerve supply: special sense, the 
glossopharyngeal and the chorda tympani; common sensation: 
the trifacial motor, hypoglossal, or twelfth cranial. 
BRIEFLY DESCRIBE THE FIFTFI NERVE 
The first two divisions of the trifacial nerve are sensory, the 
third retaining both sensory and motor fibers. It arises from 
the side of the Pons by two roots, the motor and sensory. 
Upon the sensory root is situated the Gasserion Ganglion, 
which rests upon the petrous portion of the temporal bone. 
The Gasserion Ganglion has three divisions: opthalmic, su- 
perior maxillary and inferior maxillary. 
The opthalmic division leaves the skull through the sphe- 
noidal fissure and divides into frontal, nasal and lacrimal 
branches. The superior maxillary division leaves the skull 
through the foramen rotundum, enters the spheno-maxillary 
fossa, there assists in the formation of Meckel's ganglion, and 
enters the orbit through the spheno-maxillary fissure, leaving 
the orbit through the infra-orbital canal, and appearing upon 
the surface of the face at the infraorbital foramen. The in- 
ferior maxillary division is joined by the motor root, leaves the 
skull through the foramen ovale, divides into the anterior 
and posterior divisions, and supplies the muscles of mastica- 
tion, the tongue, lower jaw and a portion of the face. 
NAME THE VARIOUS KINDS OF MEMBRANES AND 
DESCRIBE ONE. 
Serous, Synovial, Mucous and Cutaneous. 
The mucous membrane is the soft, red, vascular tissue which 
communicates with the skin at all the openings leading to or 
from the interior of the body. 
13 DESCRIBE THE TRACHEA. 
The trachea is a cylindrical tube, about 41/2 inches long, which 
extends from the larynx to the upper part of the thorax, divid- 
ing into the two bronchi. Structurally it is composed of 
muscular and fibrous tissue with from fifteen to twenty in- 
complete rings of cartilage embedded in the fibrous tissue and 
situated one above the other. 
MENTION SOME DIFFERENCES BETWEEN VEINS 
AND ARTERIES. 
The veins are provided with valves; the arteries, with the ex- 
ception of the aorta and pulmonary artery at their cardiac 
connection, are not; the walls of veins are thinner than those 
of arteries; the arteries generally carry aerated blood, veins 
blood containing less oxygen and more carbon dioxide. 
WHICH OF THE ARTERIES SUPPLIES THE HEAD 
WITH BLOOD ? 
The left common carotid, together with right common carotid, 
which opens from the innominate. 
NAME THE PARTS OF THE LYMPHATIC SYSTEM. 
The lymphatic spaces, vessels, glands and ducts. 
WHAT IS THE GREAT MOTOR NERVE OF THE HEAD? 
WHAT IS THE GREAT SENSORY NERVE OF THE 
HEAD? 
The Seventh Cranial Nerve. 
The Fifth Cranial Nerve. 
NAME THE MUSCLES THAT PULL THE MANDIBLE 
DOWNWARD. 
Genio-hyoid, genio-hyo-glossus, mylo-hyoid, Digastric, and 
Platysma myoides. 
14 GIVE THE BLOOD AND NERVE SUPPLY TO THE DEN- 
TAL TISSUES. 
NERVE SUPPLY: The trifacial or fifth cranial and the 
facial or seventh cranial. 
BLOOD SUPPLY: The internal maxillary artery, a 
branch of the external carotid artery. 
DESCRIBE THE TEMPORO MAXILLARY ARTICULA- 
TION. 
This is a sliding hinge joint and is formed by the glenoid 
fossa on the base of the skull and the condyle of the mani- 
ble. The glenoid fossa is somewhat cup-shaped and is limited 
anteriorly by a ridge, the eminentia articularis. This aids the 
ligaments of the joint in restricting the forward slide of the 
mandible. Lying between the condyle and the fossa is the 
inter-articular fibro-cartilage. The capsular ligament en- 
closes the entire joint in a fibrous sheath. Four strong fibrous 
ligaments help to maintain the proper position of the condyle. 
NAME THE BRANCHES OF THE INTERNAL MAXIL- 
LARY ARTERY. 
The middle meningeal artery, the mandibular or inferior den- 
tal artery, the sphenomaxillary, the infraorbital artery, the 
descending palatine artery, the sphenopalatine artery and the 
dentals. 
NAME THE GANGLIA CONNECTED WITH THE FIFTH 
PAIR OF CRANIAL NERVES. 
Gasserion, ophthalmic, sphenopalatine (Meckel's), otic and 
sub-maxillary. 
DESCRIBE THE INFERIOR DENTAL ARTERY. 
It is a branch from the first portion of the internal maxillary 
artery. It passes into the inferior dental canal and supplies 
15 all the lower teeth, finally leaving the canal at the mental 
foramen, where it becomes the mental artery. 
NAME THE TWELVE PAIRS OF CRANIAL NERVES. 
Olfactory, Optic, motor oculi, trochlear, trigminal, abducens, 
facials, auditory, glossopharyngeal, pneumograstic, spinal ac- 
cessory, and hypoglossal. 
NAME THE MUSCLES OF THE TONGUE. 
Lingualis, genio-hyo-glossus, hypo-glossus, stylo-glossus, 
palato-glossus. 
NAME THE CHIEF MUSCLES OF FACIAL EXPRES- 
SION. 
Olfactory, optic motor oculi, trochlear, trigminal, abducens, 
oris, levator labii superioris alaeque nasi, platysma myoides. 
NAME THE BONES OF THE CRANIUM. 
Occipital, two parietal, frontal, two temporal, sphenoid, and 
ethmoid. 
WHAT IS THE DIAPHRAGM ? 
The diaphragm is a thin, musculo-fibrous partition which 
divides the ventral cavity of the body into the thoracic cavity 
(above) and abdominal cavity (below). 
DESCRIBE THE DENTAL PULP AND GIVE ITS FUNC- 
TIONS. 
The dental pulp is made up of connective tissue and supplied 
by blood vessels, nerves and lymphatics. It completely fills 
the chamber or hollow of the tooth. The odontoblasts or 
dentin forming cells lie along its periphery in contact with the 
dentin walls. 
It has a two fold function: (a) The formation of dentin (b) 
It transmits thermal changes and gives the sensation of pain 
when irritated. 
16 NAME THE REFRACTING MEDIA. 
Aqueous humor, Crystalline lens and Vitreous humor. 
NAME THE COATS OF THE EYEBALE. 
Outer or fibour, Middle or vascular, Inner or nervous. 
TRACE THE INFERIOR MAXILLARY DIVISION OF 
THE FIFTH NERVE. 
It emerges from the cranium through the foramen ovale. 
This motor root and sensory nerve is now located in the 
zygomatic fossa. One of these divisions contains nearly all 
the motor fibers and is distributed to the muscles of mastica- 
tion, excluding the buccinator. The other containing but few 
motor fibers and made up mostly of sensory ones, divides 
into three branches: (a) the auriculotemporal, which sup- 
plies the tissues about the ear, the temporo-mandibular articu- 
lation and sends communicating branches to facial (seventh, 
cranial) nerve; (b) the lingual which, supplies common sen- 
sation to the tongue and which is joined by the chorda tym- 
pani branch of the facial nerve; (c) the inferior dental nerve. 
This branch enters the mandibular canal in the body of the 
inferior maxillary bone, traverses its entire length and 
emerges through the mental foramen as the mental nerve to 
supply sensation to the surrounding tissues. While in the 
mandibular canal minute branches are given off to the various 
lower teeth. 
Just as the inferior dental nerve is about to enter the man- 
dibular canal it gives off quite a large branch, the mylohyoid 
nerve. This contains motor fibers and passes downward to 
supply the mylohyoid and digastric muscles. The inferior 
dental nerve also sends branches to two ganglia, the otic and 
sub-maxillary, furnishing them with their sensory roots. 
STATE THE POINTS OF DISTINCTION BETWEEN 
THE UPPER AND LOWER CUSPIDS. 
The crown of the lower cuspid is more delicate in shape and 
slightly larger than the upper. Its root is more flattened 
mesially and distally. 
17 GIVE THE POINTS OF DISTINCTION BETWEEN AN 
UPPER FIRST AND SECOND BICUSPID. 
The first bicuspid is larger; the buccal cusp is larger than 
the lingual and the angles more acute. The second bicuspid 
is smaller, the cusps more nearly the same size buccally and 
lingually. 
DESCRIBE THE LABIAL SURFACE OF THE INCISORS. 
The surface is convex with two grooves running verticallv 
called the developmental grooves. The borders are convex 
with a distinct ridge at the gingivus. The mesio-incisal angle 
is sharp, the disto-incisal angle rounded. 
DESCRIBE THE OCCLUSAL SURFACE OF A LOWER 
FIRST MOLAR. 
The occlusal surface of the lower first molar is irregularly 
cuboidal in form and presents five cusps, three buccal and 
two lingual. 
Two grooves separate the buccal cusps, namely, mesio-buccal 
and distal; these extend over on to the buccal surface. The 
lingual cusps are separated by the lingual groove. On the 
forepart of the surface two sulci come from the central fossa 
and fork buccally and lingually. These are the mesio-lingual 
triangular groove and the mesio-buccal triangular groove. 
The surface occludes with the upper second bicuspid and the 
upper first molar. 
GIVE THE GENERAL DISTINGUISHING POINTS BE- 
TWEEN THE TEMPORARY AND PERMANENT TEETH. 
The temporary teeth are smaller and their cusps not so well 
defined. The molars and cuspids are larger at the neck than 
at the occlusal aspect. The permanent teeth have a deep 
color while the temporary teeth are invariably light in hue. 
18 HOW MANY ROOT CANALS HAVE THE FOLLOWING: 
(A) UPPER 1ST BICUSPID, (B) LOWER FIRST MOLAR, 
(C) LOWER SECOND BICUSPID, (D) UPPER SECOND 
MOLAR? 
(A) Two; (B) Three; (C) One; (D) Three. 
GIVE THE TIME OF ERUPTION OF THE TEMPORARY 
TEETH. 
Central incisors, 6th to 8th month. 
Lateral incisors, 8th to 10th month. 
First molars, 10th to 16th month. 
Cuspids, 16th to 20th month. 
Second molars, 20th to 30th month. 
GIVE THE TIME OF ERUPTION OF THE PERMANENT 
TEETH. 
First molars, 5th to 7th year. 
Central incisors, 6th to 8th year. 
Lateral incisors, 7th to 9th year. 
First bicuspids, 8th to 10th year. 
Lower cuspids, 9th to 11 th year. 
Second bicuspids, 10th to 12th year. 
Upper cuspids, 11 th to 13th year. 
Second molars, 12th to 14th year. 
Third molars, 17th to any time. 
DESCRIBE AN UPPER FIRST MOLAR. 
This tooth presents a crown and three roots. The crown has 
five surfaces. 
Buccal Surface: This surface is convex and a modified rec- 
tangle in form. The occlusal border is surmounted by two 
cusps, the mesio-buccal and the disto-buccal; dividing these 
is the buccal groove which often has a pit in the center. The 
19 surface has four point angles and four line angles. 
Lingual Surface: This surface resembles the buccal except 
that the mesial and distal borders converge towards the gin- 
gival border about equally where they join the wide diameter 
of the lingual root. 
Mesial Surface: This surface at the occlusal third is convex 
while the gingival two thirds is straight or concave. 
Distal Surface: Similar to the mesial tho perhaps in general 
a little more convex. 
Occlusal Surface: Is irregularly rhomboidal, the acute 
angles being the mesio-buccal and the disto-buccal. It presents 
four cusps, sometimes a fifth. The two buccal cusps are 
called the mesio-buccal, and the disto-buccal; the two lingual, 
the mesio-lingual and the disto-lingual, the mesio-lingual is 
the mesio-lingual and the disto-lingual, the mesio-lingual 
the largest cusp. The first groove across the surface starts at 
the mesial end passes distally and buccally to the interval be- 
the two cusps, where it is continued over on the buccal surface 
as the buccal groove. The triangular ridge from the mesio- 
lingual cusp to the disto-buccal cusp is well developed. The 
second groove begins between the two lingual cusps and runs 
distally and buccally to the center of the distal margin. 
The Roots: They are three in number, two buccal and one 
lingual. The lingual is the largest root and the disto-buccal 
the smallest. The apices of the two buccal roots tend to con- 
verge towards each other. 
The Pulp Cavity: Resembles the form of the crown. On 
the floor of this chamber are three openings leading into three 
root canals. 
GIVE A DESCRIPTION OF THE MAXILLARY SINUSES. 
The maxillary sinuses are situated within the bodies of the 
superior maxillary bones, external to the nose and below the 
orbits. In shape they are somewhat pyramidal, with their 
bases directed toward the nose and the apices at the prom- 
inence of the cheek. They open into the middle meati of the 
nose at points known as the infundibula. They are lined with 
a mucous membrane which is directly continuous with that 
of the nose and is covered with ciliated epithelium. Often 
the roots of the molar and bicuspid teeth form elevations on 
the floors of the sinuses. 
20 WHAT IS A SINUS? NAME THE SINUSES OF THE 
SKULL. 
A cavity in the bones of the skull, reducing the weight of 
the bone in the region of the mouth and nose and rendering 
bone more resonant for the purpose of speech. 
Maxillary, sphenoidal, frontal, anterior, middle and posterior 
ethmoidal, mastoid. 
BRIEFLY DESCRIBE THE ALVEOLAR PROCESS. 
The alveolar process of both mandible and maxillae are made 
up of a cancellated variety of bone. There is a dense layer 
of bone surrounding the teeth of the maxillae, being the thick 
est lingually; the incisors and cuspids present a thick layer 
labially; the buccal roots of the bicuspids and molars have a 
much thinner covering. The alveolar process is covered by a 
soft issue called the gums. 
DESCRIBE CEMENTUM. 
Cementum is a calcified connective tissue arranged in layers 
around the tooth root and slightly overlapping the enamel. 
The lamellae are the layers of the cementum, thin at the cervix 
and thickest at the apex. The lacunae are small spaces in the 
cementum; from these radiate small communicating canals 
called canaliculi. The cementoblasts are found in the lacunae. 
The cementum receives the imbedded fibers of the peridental 
membrane. 
WHAT IS SECONDARY DENTIN AND DESCRIBE ITS 
FORMATION. 
Secondary dentin is an imperfectly formed tissue laid down 
by the pulp after the normal amount of dentin has been 
formed. It is due to an irritation of the odontoblasts. 
DESCRIBE THE GUMS. 
The gum tissue is composed of mucous membrane under 
which is a submucous tissue which lies on and is firmly at- 
tached to the periosteum of the bony process. The gum 
21 tissue about the necks of the teeth is supported and held in 
position by fibers from the peridental membrane. The blood 
vessels and lymphatics of the gums anastomose freely with 
those of the peridental membrane. 
WHAT IS HISTOLOGY? 
Histology is the microscopic study of the structure of tissue. 
WHAT IS PROTOPLASM ? 
It is the substance that makes up the body of the cell and is 
divided into spongioplasm and hyaloplasm. 
WHAT FORM OF EPITHELIUM LINES THE ORAL 
CAVITY? FROM WHAT ELEMENTARY TISSUE IS IT 
DEVELOPED? 
Stratified squamous. It is developed from the ectoderm. 
DESCRIBE THE MUCOUS MEMBRANE LINING THE 
MOUTH. 
The mucous membrane of the oral cavity consists of a primarj' 
layer of epithelium (stratified squamous) and underneath a 
connective tissue stroma (Tunica Propria) which gives place 
and support to the blood vessels, nerves and lymphatics. Ly- 
ing between these two layers and separating them is found the 
submucosa. 
WHAT IS THE BLASTODERM? (A) PRIMITIVE DEN 
TAL GROOVE? 
The Blastoderm is a cavity surrounded by embryonal cells 
formed from the morula. It consists of three layers, namely, 
ectoderm, mesoderm, and entoderm. 
The Primitive Dental Groove is a longitudinal groove seen on 
the surface of the oral ectoderm which marks the point of 
attachment of the dental ridge. 
22 GIVE A DESCRIPTION OF ENAMEL AND NAME ITS 
FUNCTIONS. 
Enamel is a calcified tissue covering the exposed portion or 
crown of the tooth. It is derived from epithelium and is the 
hardest tissue in the body. Structurally it consists of prisms 
or rods held together by a cementing substance. The prisms 
run from the dentin to the surface in a straight or intertwined 
arrangement. The' cementing substance like the prisms con- 
tain no organic, substance but is more susceptible to injury. 
The enamel organ develops from within outward. 
• Functions: (I) Mechanically it is the hard contact organ in 
mastication. (2) It serves as a protection for the underlying 
dentin. 
GIVE A MINUTE DESCRIPTION OF DENTIN. 
Dentin is a calcified connective tissue containing both organic 
and inorganic matter. It is composed of the Dentin Matrix, 
the dentinal tubules and the dentinel fibrils. The tubules are 
surrounded by a very dense portion of the matrix called the 
Sheath of Neuman. The dentinal tubules are the minute tubes 
radiating from the pulp to end at the dento-enamel junction in 
delta-like formations which communicate with each other. In 
the root the tubes end in spaces between the cementum and 
dentin called the granular layer of Tomes. The dentinal fibrils 
are branching processes of the odontoblasts in the dentinal 
tubules. 
Functions: It gives bulk and strength to the entire tooth, (2) 
It supports the enamel. 
DESCRIBE BRIEFLY TFIE PERIDENTAL MEMBRANE 
STATING WHICH IS THE MOST VULNERABLE AREA 
AND WHY. 
The peridental membrane is a composition of white fibrous 
connective tissue investing the root of the tooth. These fibers 
have been divided into three groups: The gingival, alveolar 
and apical. The first or gingival group, from a point of at- 
tachment in the cementum, pass into and mingle with fibers of 
23 the connective tissue stroma of the gums. Approximally 
other fibers pass across and are attached to the cementum of 
the adjoining tooth. These fibers support the gum. Below 
these are a stronger bundle of fibers which pass from their 
cemental attachment and on the labial and lingual sides are 
joined to the periosteum covering the alveolar process. 
Approximally they may pass to the cementum of the adjoin- 
ing tooth or attach themselves to the sides of the bone between 
the teeth. The uppermost fibers are arranged constrictor-like 
around the gum margin, holding this tissue in close contact 
with the neck of the tooth. 
The Alveolar group extend from the apex to the top of the 
alveolus. 
The Apical group fill in the apical space at the root end. The 
Gingival Group is the most important area of the peridental 
membrane because of its location being most susceptible to 
injury by foreign bodies and infection. 
DESCRIBE A CELL. 
A Cell is a mass of protoplasm usually nucleated. The pro- 
toplasm is composed of a liquid portion (hyaloplasm) and a 
fibrous network (spongioplasm). 
DESCRIBE THE PROCESS OF CELL DIVISION. 
Cell division takes place in two ways: (a) Direct or amitosis 
and (b) indirect or mitosis. In the direct method the cell 
divides into two, finally forming two separate cells. In the 
indirect or universal method the cell nucleus passes through 
a series of remarkable changes rather complicated. 
DEFINE (a) Osteoblast; (b) Osteoclast; (c) Odontoblast. 
An osteoblast assists in the calicfication of bone. 
An osteoclast is a variety of leucocyte which absorbs the 
calcified substance of bone. 
An odontoblast is a dentin forming cell. 
24 TO WHAT CLASS OF TISSUES DO THE TEETH 
BELONG? 
With the exception of the enamel, the teeth belong to the con- 
nective tissue group. 
NAME THE VARIETIES OF EPITHELIUM. 
Simple, Transitional and Stratified. 
WHAT IS EPITHELIUM AND WHERE FOUND? 
Epithelium is an elementary tissue derived from ectoderm or 
entoderm. It is found lining all surfaces that communicate 
with the air. 
DESCRIBE THE DENTAL RIDGE. 
It is a thickening of the primitive oral epithelium over the 
alveolar margin from which the enamel germ is later de- 
veloped. 
WHAT IS (a) a tooth germ (b) Dental Papilla (c) Dental 
Follicle ? 
The tooth germ is the structure formed by the enamel organ 
and the dental papilla. 
The dental papilla is a name given form assumed by the un- 
derlying tissues as the enamel organ develops. It finally 
assumes the shape of the future crown of the tooth. 
The Fibrous wall enclosing the tooth germ, the papilla and the 
enamel organ constitute the dental follicle. 
AT WHAT PERIOD OF THE EMBRYO DO THE TEETH 
START TO DEVELOP? 
At about two and a half months. 
DESCRIBE THE DEVELOPMENT OF THE JAWS. 
Vertical growth, which is downward in the upper jaw and 
25 upward in the lower and is coincident with tooth eruption. 
Lateral growth, or expanding growth to allow for the differ- 
ence in size between the teeth of the deciduous and permanent 
dentures. 
Forward growth, to make room for the developing permanent 
molars. 
WHAT IS NASMYTH'S MEMBRANE? (B) NEUMAN'S 
SHEATH? 
It is an extremely delicate membrane enveloping the crown 
of the newly erupted tooth. 
Neuman's Sheath is that more densely calcified portion of 
the dentinal matrix immediately surrounding the dentinal 
tubuli. 
WHAT THREE ORGANS AFFECT THE CALCIFICA- 
TION OF THE TOOTH? 
Ameloblasts in the enamel, odontoblasts in the dentin, cemen- 
toblasts in the alveolar periosteum. 
WHAT ARE THE INTERGLOBULAR SPACES? LINES 
OF SCHREGER? 
At the dento-cementum junction are seen small, irregularly 
shaped spaces called the interglobular spaces. 
The lines of Schreger are the striations seen by reflected light 
due to the formation of the enamel prisms. 
WHAT ARE THE FIBERS OF TOMES? 
Branching processes of the odontoblasts in the dentinal canals. 
WHAT IS AN ODONTOBLAST? 
Tall columnar cells, situated vertically to the surface of the 
pulp. They send out long processes, the dentinal fibrils into 
the dentinal tubules. 
26 WHAT ARE SUCCEDANEOUS TEETH ? 
Succedaneous teeth are those which erupt after the loss of 
the permanent set. 
SUPERNUMARY TEETH? 
Supernumary teeth are those erupting in excess of the nat- 
ural number present. 
WHAT IS THE EMBRYO? 
The embryo is the union of the male and female germ cells. 
IS THE SHEDDING OF DECIDUOUS TEETH PHYSIO- 
LOGIC? DESCRIBE THE PROCESS. 
Yes. The pressure of the erupting permanent teeth stimu- 
late the osteoclasts into activity; a fluid is formed which 
absorbs the roots of the temporary teeth. 
WHAT IS THE DIFFERENCE BETWEEN CEMENTUM 
AND BONE? 
Cementum differs from bone in that it contains no canals and 
is formed by a special type of cell called cementoblast. 
NAME THE PRINCIPAL MUSCLES OF MASTICATION. 
Temporal, Internal and external Pterygoids, Masseter, and 
Buccinator. 
27 CHAPTER II 
PHYSIOLOGY 
WHERE ARE THE TASTE BUDS LOCATED? 
The taste buds are situated chiefly on the surface of the 
tongue, although some are scattered over the soft palate, 
blood in the lungs and exhaling carbon dioxide gas. 
NAME THE NORMAL CONSTITUENTS OF THE 
BLOOD. 
The plasma, red and white corpuscles, blood pletelets and 
some inorganic salts. 
WHAT IS THE FUNCTION OF THE BLOOD? 
To carry oxygen and nutriment to the tissues and to convey 
waste material to the excretory organs. It also aids in main- 
taining an even body temperature. 
DESCRIBE THE PROCESS OF COAGULATION OF 
BLOOD. 
Fibrin ferment or thrombrin acts upon the fibrinogen, the 
soluble albumin of the plasma, converting it into the solid 
fibrin. The fibrinogen and thrombrin are formed by the dis- 
integration of the white corpuscles. The solid substances of 
the blood become entangled in the fibrin forming the clot. 
WHAT IS THE SPECIFIC GRAVITY OF THE BLOOD? 
About 1055. 
WHERE ARE THE RED CORPUSCLES FORMED? (B) 
WHAT IS THEIR FUNCTION? 
They are formed in the spleen and in the bone marrow, (b) 
They carry oxygen from the lungs to the tissues and carbon 
dioxide from the tissues to the lungs. 
28 WHAT IS HEMOGLOBIN? WITH WHAT DOES IT 
COMBINE? 
Hemoglobin is the coloring matter of the blood. It combines 
with oxygen to form oxyhemoglobin. 
WHAT IS LEUKOCYTOSIS? 
It is an increase of the number of leukocytes above 10,000 in 
a cubic millimeter of blood. 
WHAT IS BLOOD PRESSURE? 
The pressure of the blood in the circulatory system. 
WHAT IS (A) NORMAL PULSE RATE (B) NORMAL 
RESPIRATION? 
(A) 72 to 85 per minute. 
(B) 18 to 24 per minute. 
WHAT IS THE PROCESS OF OSMOSIS? GIVE AN EX- 
AMPLE. 
Osmosis is the diffusion of liquids through a porous mem- 
brane. The passage of plasma through the capillary wall into 
the tissues. 
WHAT IS THE NUMBER OF WHITE CORPUSCLES TO 
1 C/C OF BLOOD? 
Between 5,000 and 10,000. 
WHAT IS RESPIRATION? 
Respiration is the act of inhaling air for oxygenation of the 
blood in the lungs and exhaling carbon dioxide. 
DEFINE ASPHYXIA; (B) TIDAL AIR; (C) APNEA; (D) 
DYSPNEA; (E) RESIDUAL AIR. 
Asphyxia is a condition resulting from lack of oxygenation of 
the tissues. 
Tidal Air: The normal flow of air in the lungs. 
29 Apnea: Cessation of breathing due to mechanical excita- 
tion of the pulmonary plexus of the pneumograstic nerve. 
Dyspnea: Difficult and rapid breathing. 
Residual air: Air remaining in the lungs after a forced ex- 
piration and cannot be forced out. 
WHERE IS THE CENTER OF RESPIRATION? 
In that part of the brain called the Medulla Oblongata. 
WHAT ORGANS ARE CONCERNED IN RESPIRATION? 
The nose, larynx, trachea, bronchi and lungs. 
NAME THE SECRETIONS OF THE ALIMENTARY 
CANAL. 
Salava, Gastric Juice, Pancreatic Juice, Bile and Succus En- 
tericus. 
DESCRIBE THE ACTION OF SALIVA UPON FOODS. 
Saliva forms the bolus and lubricates it for swallowing. Its 
enzyme ptyalin acts upon starch converting it into maltose. 
DESCRIBE SALIVA. 
Saliva is a tasteless, odorless, somewhat ropy fluid with a 
specific gravity of 1002. It is normally alkaline. It is se- 
creted by the parotid, submaxillary and sublingual glands. 
NAME THE ENZYMES OF THE PANCREATIC JUICE 
AND GIVE THEIR ACTION. 
Trypsin converts proteids into peptones. 
Amylopsin changes starch into maltose. 
Steapsin splits up fats into fatty acids. 
Rennin coagulates milk. 
WHAT IS AN AMYLOLYTIC FERMENT? 
It is a ferment such as amylopsin that acts upon starch covert- 
ing it into maltose. 
30 DESCRIBE THE VARIETIES OF SALIVA. 
The parotid saliva is a watery type containing a great deal 
of ptyalin. 
The sublingual contains much mucin. 
The submaxillary is a mixture. 
WHAT CIRCUMSTANCES FAVOR DIGESTION? 
Thorough mastication; sight and smell of well-prepared food; 
cheerfulness and a general healthy condition of the body. 
BRIEFLY DESCRIBE GASTRIC DIGESTION. 
Food reaching the stomach is mixed with the gastric juice 
and the mixture is called chyme. The ferment pepsin acts 
upon proteids coverting them into peptones. The Hydro- 
chloric acid is the necessary medium for the action of the 
pepsin. The digestion of starches continues for a while in 
the stomach. The chyme is gradually forced out of the 
stomach into the duodenum by peristalsis. 
WHAT FERMENT IS CONCERNED WITH THE DIGES- 
TION OF MILK? 
The ferment rennin coagulates milk and changes caseinogen 
into casein. This ferment is found in the gastric and pan- 
creative juices. 
WHERE ARE FATS ABSORBED? 
In the small intestine. 
WHAT IS CHYLE? 
Chyle is the fluid lymph contained in the lacteals of the diges- 
tive tract. 
DESCRIBE THE ORIGIN AND USES OF LYMPH. 
Lymph originates in the lymph spaces surrounding the blood 
vessels and the lymphatic glands. It conveys the products 
of digestion; carries off excess fluid; acts as a reserve after 
hemorrhage, and is a lubricant and solvent. 
31 WHAT IS GLYCOGEN? 
Glycogen is derived from the digestion of carbohydrates and 
is stored away as a reserve fuel in the cells of the liver. 
• NAME THE FUNCTIONS OF THE LIVER. 
The formation of bile; the formation of glycogen; the forma- 
tion of urea; the decomposition of red blood corpuscles. 
WHAT IS THE PORTAL CIRCULATION ? 
Blood collected from the capillaries of the spleen, stomach 
and intestines is carried by the portal vein to the liver. It is 
returned by the hepatic vein to the inferior vena cava. 
DESCRIBE BILE AND ITS USES. 
Bile is a greenish liquid secreted by the liver, alkaline in re- 
action. It aids in the digestion and absorption of fats and 
acts as an intestinal antiseptic. 
NAME THE DIVISIONS OF THE ALIMENTARY TRACT. 
Mouth, pharynx, oesophagus, stomach, small intestine, large 
intestine. 
BRIEFLY DESCRIBE THE ACT OF DEGLUTITION. 
The mandible is closed by the muscles of mastication. The 
tongue, pressed against the hard palate, forces the bolus back 
into the pharynx. The base of the tongue and a contraction 
of the palatine arches prevent a return of the bolus to the 
mouth. A contraction of the three constrictor muscles of 
the pharynx sends the food into the oesophagus. The peris- 
taltic action of the oesophageal muscles forces it into the 
stomach. The first part of the act is voluntary, the rest is 
reflex in character. 
32 NAME THE MUSCLES OF DEGLUTION. 
Orbicularis oris, muscles of mastication, mylohyoid, levator 
veli palati, constrictors of the pharynx, oesophageal muscles. 
WHAT IS THE FUNCTION OF (A) MASSETER MUS- 
CLE (B) TEMPORAL MUSCLE (C) THE PTERYGOID 
MUSCLES? 
The Masseter elevates the mandible, assisted by the temporal 
and internal pterygoid. The external pterygoid moves the 
mandible downward and forward. 
DEFINE ABSORPTION. 
Absorption is the process by which the digested food is taken 
from the intestines and carried into the blood. 
WHERE IS FOOD CHIEFLY ABSORBED? 
Food is chiefly absorbed by the villi of the small intestines. 
WHERE DOES THE ABSORPTION OF WATER TAKE 
PLACE ? 
In the small and large intestines. 
DIFFERENTIATE SECRETION AND EXCRETION. 
A secretion is the product of the activity of the glands and 
follicles. Example: Saliva. 
Execretion: The separation of the waste products of an 
organ or of the body as a whole, out of the blood. Example: 
Urine. 
DEFINE METABOLISM. 
Metabolism is the constructive and destructive changes in the 
tissues of the organism. 
33 DEFINE ASSIMILATION. 
Assimilation or anabolism is the process by which nutrient 
material is converted into protoplasm. 
HOW DOES THE NERVOUS SYSTEM INFLUENCE 
METABOLISM? 
The different centers of the brain through the motor and sen- 
sory nerves regulates and controls the action of all organs 
within the body. 
DISCUSS THE RELATION OF NUTRITIVE VALUE TO 
CALORIC VALUE. 
Caloric value is the heat producing or fuel value of a food; 
fats represent the highest caloric value. The nutritive value 
of a food is determined by the proportion of alimentary prin- 
ciples it contains to the whole, its ease of digestibility and 
assimilation. The nutritive value of proteids and carbohy- 
drates is about equal. 
DEFINE CALORIE. 
The calorie is the unit for measuring heat. It is the amount 
of heat that is necessary to raise 1000 grams of water through 
I degree Centigrade. 
WHAT TYPE OF STIMULATION IS MOST EFFECTIVE 
IN ITS INFLUENCE ON THE FLOW OF SALIVA? IL- 
LUSTRATE AND EXPLAIN. 
Reflex stimulation. The reflex is begun by the sight, thought 
or smell of food acting as a stimulant to the sensory or 
efferent nerves; these impulses are carried to a nerve center in 
the brain and from thence motor impulses are transmitted 
through efferent nerves to the salivary glands. 
34 WHAT DO YOU UNDERSTAND BY THE TERM NUTRI- 
TION? 
Nutrition means the taking in of food principles and their 
conversion into living protoplasm. It includes digestion, ab- 
sorption, metabolism and excretion. 
DISCUSS THE RELATION OF MASTICATION TO NU- 
TRITION. 
Mechanical: Food that is thoroughly triturated is acted upon 
more readily by the digestive secretions and better assimilated. 
Chemical: During mastication the ptyalin of the saliva acts 
upon starches converting them into maltose. 
WHAT ARE VITAMINS? 
Vitamins are unknown food elements contained in fresh, un- 
cooked foods. They have been classified as fat-soluble, water 
soluble and anti-scorbutic. Fresh vegetables and unpasteur- 
ized milk are believed to contain vitamins. 
DEFINE FOOD. 
Food is any substance taken into the body that provides 
material for the growth of the young, supplies the waste of 
metabolism and supplies heat and energy. 
DISCUSS THE PLACE OF WATER IN THE DIETARY. 
Water is essential to life constituting about two-thirds of the 
body weight. It supplies fluid for the tissues, acts as a sol- 
vent for food and helps to maintain an even body tempera- 
ture. 
HOW ARE FOODS CLASSIFIED? 
Foods are classified as (1) inorganic : water and mineral salts; 
organic: Carbohydrates, fats and proteins. 
35 WHAT IS THE RELATION OF DIET TO NUTRITION? 
For the proper nourishment of the body the diet must contain 
the various foods in proper proportion. Proteids are neces- 
sary for tissue repair; salts neutralize acids, assist in the for- 
mation of some of the secretions and complete calcification. 
Fats are a reserve food and carbohydrates supply heat and 
energy. 
WHY IS MILK SUCH AN IDEAL FOOD? 
Milk contains all the principles necessary to sustain life and 
because of its ease of digestibility is especially adapted to 
the young. 
WHAT IS AN ENZYME? 
An enzyme or ferment is a substance which acts upon other 
substances to change their character without changing its own. 
INDICATE THE MOST IMPORTANT CHANGES 
THROUGH WHICH THE LEADING FOODS PASS AS 
THEY PROCEED ALONG THE ALIMENTARY TRACT. 
In the mouth carbohydrates are acted upon by the ptyalin of 
the saliva and converted into maltose; their digestion is com- 
pleted in the small intestine by the amylopsin of the pancreatic 
juice which changes them into maltose and dextrose. 
Proteids are changed by the gastric juice in the stomach into 
peptones and albuminoses, and in the small intestines are fur- 
ther converted into peptones by the action of the pancreatic 
juice. 
Fats are digested in the small intestine by the action of steap- 
sin, which splits them up into fatty acids and glycerin. 
WHAT IS THE RELATIONSHIP OF DIET TO DENTAL 
CARIES? 
Proper diet is believed to be a great factor in the prevention 
of dental caries. 
36 --Course, fibrous foods by the friction produced upon the 
tooth surfaces during their mastication help to forestall caries. 
The resistance of solid foods promotes growth and develop- 
ment of the teeth and jaws of children and increases the cir- 
culation in these parts in adults. 
WHY DOES A DIET RICH IN STARCHES PRODUCE 
DENTAL DECAY? 
Sugars remaining in the mouth are fermented by a class of 
micro-organisms which produce lactic acid. The acid dis- 
solves out the mineral contents of the teeth with consequent 
disintegration. 
HOW IS THE SENSE OF TASTE PRODUCED? 
The sense of taste is produced by food coming in contact with 
the taste buds. The taste buds are end organs of nerve fila- 
ments derived from the facial, trifacial and glossopharyngeal 
nerves and found chiefly on the surface of the tongue, 
EXPLAIN THE PHENOMENA OF SENSATION. 
The end organ at first receives the stimulus which is conveyed 
to the brain. A sensation or feeling is felt and interpreted in 
the brain and projected back to the end organ for fulfillment. 
WHAT ARE THE FUNCTIONS OF THE PERIDENTAL 
MEMBRANE? 
(1) It serves as a cushion and imparts sense of touch to the 
tooth. 
(2) It supplies nourishment to the cementum. 
GIVE THE FUNCTIONS OF THE CEMENTUM. 
The cementum holds the tooth in position by its attachment to 
the surrounding tissues. It is also a source of vitality after 
the death of the pulp. 
37 WHAT ARE THE FUNCTIONS OF THE PULP? 
(1) The formation of dentin. (2) It receives various 
sensations from the dentinal fibrils transmitting them to the 
nervous system. 
WHAT ARE THE ACCESSORY FUNCTIONS OF THE 
TEETH? 
They assist in speech and deglutition. 
DEFINE THE TERM NEURONE. 
Neurone is a term ascribed to cells forming the nervous sys- 
tem. 
WHAT IS A REFLEX ? 
A reflex is an impulse in response to stimulation from the peri- 
phery without of necessity involving the brain. 
WHAT ARE THE DIFFERENT MOVEMENTS EXE- 
CUTED DURING THE PROCESS OF MASTICATION 
AND WHAT MUSCLES TAKE PART IN EACH MOVE- 
MENT? 
An up and down movement, a forward movement, and a lat- 
eral movement. The Masseter, Temporarl, Interior Ptery- 
goid, Exterior Pterygoid and Buccinator muscles. 
The masseter and temporal muscles bring the lower jaw 
against the upper. The external pterygoid brings the mandi- 
ble forward; they all assist in the lateral movement; the fol- 
lowing muscles depress the lower jaw: genio-hyoid, mylo- 
hoid, genio hyo-glossus and anterior belly of digestric. 
DEFINE THE TERM PERISTALSIS. 
The term peristalsis signifies a wave-like or vermicular move- 
ment. 
38 TN WHICH PART OF THE DIGESTIVE CHANNEL IS 
THIS MOVEMENT IN EVIDENCE? 
It occurs in the stomach, large intestines, small intestines in 
which they are the most marked. 
NAME THE DIFFERENT EXCRETORY CHANNELS. 
The skin, kidneys, intestinal and respiratory tracts. 
WHAT IS THE PURPOSE OF THE KIDNEYS? 
The purpose of the kidneys is to remove from the blood, wa- 
ter and waste substances. 
39 CHAPTER HI 
(BACTERIOLOGY & STERILIZATION) 
DEFINE BACTERIOLOGY. 
Bacteriology is the science of micro-organic life or of bacteria. 
GIVE AN EXAMPLE OF THE THREE DIFFERENT 
FORMS OF BACTERIA. 
Cocco: Staphylococcus Pyogenes Aures. 
Baccilli: Bacillus Tuberculosis. 
Spirilla: Spirochetes Pallidum. 
WHAT ARE SPORES? 
A spore is an oval, refractive body appearing in the proto- 
plasm of bacteria and capable of developing into a bacterium. 
DEFINE KOCH'S LAW. 
Koch's law is to prove whether an organism is pathogenic 
or not. 
(1) It must be cultivated for several generations in artificial 
culture media. 
(2) The pure culture upon inoculation into healthy animals 
must produce the disease in question. 
(3) The same micro-organism must again be found in the 
tissues, blood or secretions of the inoculated animal. 
WHAT IS A CULTURE MEDIA? GIVE THE MOST IM- 
PORTANT ONES. 
Any substance in which micro-organisms may be cultivated. 
Agar-agar, blood serum, milk, bouillon, potato. 
HOW WOULD YOU DISINFECT METAL INSTRU- 
MENTS? GLASS SYRINGES? RUBBER DAM? 
Metal instruments may be disinfected by exposing them to the 
40 action of formaldehyde for ten minutes, or immersing them 
in alcohol for twenty minutes. 
Glass syringe parts may be placed in a 1:1000 sol. of bichlor- 
ide of mercury for about twenty minutes. 
Rubber dam should first be washed with soap and warm 
water, followed by alcohol and cold water. 
DEFINE: (A) INFECTION; (B) TOXIN; (C) ANTI- 
TOXIN. 
Infection is the successful invasion of micro-organisms. 
Toxins are the products, more or less poisonous, given off by 
bacterial cells. 
Antitoxins are specific bodies obtained from the serum of 
immunized animals which combine with and neutralize toxins. 
NAME THREE EFFICIENT DISINFECTANTS. 
Formaldehyd, carbolic acid and bichlorid of mercury. 
WHAT IS MEANT BY STERILIZATION? 
Sterilization means the complete destruction of bacteria and 
their spores. 
DEFINE: (A) PARASITE; (B) SAPROPHYTE; (C) PYO- 
GENIC; (D) LEUKOCYTE. 
(a) Parasites are animal or vegetable organisms which sub- 
sist upon other living organisms. 
(b) Saprophytes are vegetable organisms living upon dead 
organic matter. 
(c) Pyogenic refers to pus-producing organisms. 
(d) Leukocytes are the white or colorless corpuscles of the 
blood. 
WHAT ARE (A) AEROBIC BACTERIA AND (B) ANA- 
EROBIC BACTERIA? 
Aerobic bacteria have the property of developing in oxygen. 
Anaerobic bacteria are incapable of growing in uncombined 
oxygen. 
41 WHY IS THE MOUTH A FAVORABLE PLACE FOR THE 
DEVELOPMENT OF BACTERIA? 
The mouth is a favorable place for the development of bac- 
teria because it contains all the conditions necessary for their 
growth, i.e., oxygen, moisture, darkness, body temperature 
and food particles. 
DEFINE: (A) DISINFECTANT, (B) ANTISEPTIC. 
A disinfectant is a chemical agent that destroys bacteria and 
their spores. 
An antiseptic is an agent that retards the growth and de- 
velopment of bacteria. 
HOW DO DISEASE GERMS LEAVE THE BODY? 
Disease germs leave the body by the skin, kidneys, intestinal 
and respiratory tract. 
STATE THE DANGERS TO A HYGIENIST OF WOUND- 
ING THE HAND WHILE OPERATING. 
Because of the presence of vast numbers of bacteria there 
is always the danger of infection. 
NAME FIVE DISEASES CAUSED BY MICROORGAN- 
ISMS. 
Diphtheria, Typhoid Fever, Tetanus, Septicemia, Pneumonia. 
DEFINE: (A) NATURAL IMMUNITY, (B) ACQUIRED 
IMMUNITY. 
Natural immunity is the ability of certain individuals and 
races to resist certain diseases at all times. 
Acquired immunity is set up in an individual (1) As the se- 
quence of an attack of some infectious disease such as 
scarlet fever, (2) by the injection of antitoxins, vaccination, 
inoculation, etc. 
42 WHAT IS THE MOST EFFECTIVE METHOD OF 
STERILIZATION? 
Heat-fire, dry heat or hot air, live steam, steam under pres- 
sure and boiling. 
HOW DO BACTERIA MULTIPLY? 
By direct division. (2) By the development of spores. 
IN WHAT WAY MAY BACTERIA BE USEFUL IN 
FOODS? 
Bacteria may be useful in food by producing ferments whose 
action changes the ingredients of the food into simpler and 
more staple substances. This illustrated by the action of the 
Bacterium Lactis on milk to form lactic acid. 
WHAT PRECAUTIONS SHOULD A HYGIENIST TAKE 
WHILE OPERATING UPON A PATIENT WITH 
SYPHILIS? 
She should wear rubber gloves. Before putting on the rub- 
ber gloves the hands should be covered with a 25% calomel 
ointment. Afterwards the hands should be scrubbed and 
washed in alcohol. Articles such as used cotton and towels 
should be destroyed. 
WHAT IS SYPHILIS CAUSED BY AND HOW MAY IT 
MANIFEST ITSELF IN THE MOUTH? 
Syphilis is caused by the entrance into the system of micro- 
organism called Spirochetes Pallidum. 
It may appear as a hard chance on the lip (primary stage) 
or so-called mucous patches may arise on the mucous mem- 
brane of the oral cavity. These are slightly convex, grayish 
white elevations which secrete a highly infectious discharge. 
DEFINE: (A) ANTIGEN; (B) AMBOCEPTOR; (C) THE 
COMPLEMENT. 
Antigen: The extract of the liver of a fetus. 
43 Amboceptor : Serum from rabbit immunized with sheep's red 
blood corpuscles. 
The Complement: Normal serum from a guinea pig. 
WHAT IS PHAGOCYTOSIS? 
Certain white cells in the blood, mainly leukocytes, have the 
power of taking up and destroying bacteria when they have 
entered the circulation. 
WHAT IS ESSENTIAL TO THE LIFE OF BACTERIA? 
A suitable temperature; the presence of oxygen (usually); 
sufficient moisture; darkness; certain organic and inorganic 
matter. 
HOW DO DISEASE GERMS ENTER THE BODY? 
Through abraded skin surfaces, the intestinal and respiratory 
tracts. 
ARE BACTERIA FOUND IN THE AVERAGE WELL- 
KEPT MOUTH? 
Yes. 
44 CHAPTER IV 
DENTAL CARIES AND MALOCCLUSION 
DEFINE DENTAL CARIES. 
Dental caries is the molecular disintegration of tooth struc- 
ture. 
DESCRIBE THE FORMATION OF THE BACTERIAL 
PLAQUE. 
Certain bacteria acting upon sugar split it up into lactic acid. 
At the point of acid production in the saliva there occurs a 
precipitation of insoluble mucin. The action is started by the 
lodgement of organisms upon a tooth surface, where they are 
allowed to multiply in protected locations and the process con- 
tinues until what we call a bacterial plaque is formed. 
GIVE MILLER'S THEORY OF DENTAL CARIES. 
Bacteria acting upon carbohydrate foods produce lactic acid. 
The acid attacks and destroys the enamel, exposing the dentin. 
Bacteria invade and subsist upon the organic matter of dentin. 
WHAT IN YOUR OPINION IS THE MOST IMPORTANT 
FACTOR IN THE PREVENTION OF CARIES? 
Aside from the influence of heredity the most important fac- 
tors are proper diet and extreme cleanliness. 
WHAT SURFACES OF THE TEETH ARE MOST SUS- 
CEPTIBLE TO DENTAL CARIES? 
The approximal and occlusal surfaces. 
WHAT CAUSES THE PAIN UPON CONTACT OF 
SWEETS WITH CERTAIN TEETH? 
The fermentation of the sugar by the bacteria irritates the 
dentinal fibrils which convey sensation to the pulp. 
WHAT IS THE MOST SUSCEPTIBLE PERIOD TO DEN- 
TAL CARIES ? 
During childhood and adolescence. 
45 NAME TWELVE CAUSES OF DENTAL CARIES INDI- 
CATING WHICH ARE DIRECT OR INDIRECT, LOCAL, 
OR CONSTITUTIONAL. 
DIRECT OR LOCAL: Oral acidity, food deposits upon the 
teeth, abrasion or injury to enamel, acid erosions, malocclu- 
sion, partial plates, bridgework, etc. 
INDIRECT OR CONSTITUTIONAL: Pregnancy, debili- 
tating diseases and low vital resistance. 
WHICH OF THE TEETH SURFACES ARE LEAST SUS- 
CEPTIBLE TO CARIES AND WHY? 
The labial, lingual and buccal surfaces. Because these are 
subjected to the cleansing action of friction by the tongue, the 
lining mucous membrane of the lips and cheek surfaces and 
are kept free of bacterial invasion by the friction of rough or 
fibrous food materials. 
ARE TEETH DENSE IN STRUCTURE LESS LIABLE TO 
DECAY THAN SO CALLED SOFT OR IMPERFECTLY 
CALCIFIED TEETH? EXPLAIN. 
NO. "Any tooth will decay in a mouth where the conditions 
causing decay are active and no tooth will decay whatever its 
structure may be in a mouth where the conditions causing 
decay are not active." 
DIFFERENTIATE BETWEEN EROSION AND CARIES 
OF TEETH. 
Erosion is a destruction of tooth structure brought about by 
the presence in the mouth of an acid formed in the mouth, 
exuded into the mouth, or taken into the mouth. Erosions 
are generally found at the necks of teeth where the enamel is 
the thinnest. Caries is a disease of the teeth causd by the 
local destruction of the hard tissues of the teeth by the solvent 
action of lactic acid followed by the invasion of bacteria. 
46 WHAT IS TARTAR? 
Tartar is a general term used to designate the various deposits 
found upon the teeth. They are composed of food debris and 
dead bacteria held together by mucin. 
WHAT IS MEANT BY SO-CALLED STRINGY SALIVA? 
Saliva rich in mucin which gives it a ropy, adhesive quality. 
DOES MALOCCLUSION PREDISPOSE TO DENTAL 
CARIES? EXPLAIN. 
Teeth without normal occlusal contact are more liable to 
decay because of the loss of friction and because they are 
more difficult to keep clean. 
WHAT IS YOUR METHOD OF PREVENTING DECAY 
OF THE 1ST MOLARS OF CHILDREN? 
By cleaning the sulci of food debris; sterilizing with silver 
reduction solutions or alcohol; then placing soft, rapidly set- 
ting cement in the sulci and trimming it by the finger tip 
dipped in water. 
HOW DOES THE DECAY OF CHILDREN'S TEETH DIF- 
FER FROM THAT OF ADULTS ? 
The factors causing the decay are the same; but the greater 
amount of cartilaginous matter in children's teeth causes it to 
assume under decay a leathery, brownish appearance. The 
decay of adult's teeth is more molecular and is much darker 
in appearance because of greater absorption. 
DEFINE MALOCCLUSION. 
Malocclusion is any deviation of the teeth or arches from nor- 
mal relation. 
47 WHAT IS MEANT BY (A) SUTRA-OCCLUSION, (B) 
INFRA-OCCLUSION, (C) MESIAL-OCCLUSION? 
Supra-occlusion means that a tooth has erupted to an abnor- 
mal height in its socket. 
Infra-oc elusion means that a tooth has not erupted to its nor- 
mal height in its socket. 
Me sial-occlusion means that the tooth crown is mesially of the 
position which it should normally occupy. 
WHY SHOULD A DENTAL HYGIENIST HAVE SOME 
KNOWLEDGE OF ORTHODONTIA? 
A dental hygienist should have some knowledge of orthodontia 
so that she may diagnose conditions of malocclusion and in- 
telligently point out those factors which bring about or aggra- 
vate malocclusions. 
GIVE SOME CAUSES OF IRREGULARITIES. 
The premature loss of deciduous teeth. Extraction of per- 
manent teeth, pernicious habits, lack of use. 
GIVE ANGLE'S CLASSIFICATION. 
Class I. Arches in normal mesio-distal relation. 
Class II. Lower arch distal to normal in relation to upper. 
Division 1. Protruding upper anterior teeth. 
Subdivision-Arch unilaterally distal. 
Division 2. Retruding upper anterior teeth. 
Subdivision-Arch unilaterally distal. 
Class HI. Lower arch mesial to normal in its relation to 
upper. 
Subdivision-Arch unilaterally mesial. 
DEFINE (A) OCCLUSION; (B) INCLINE PLANE. 
Occlusion means the relationship of the teeth when the jaws 
are closed. 
The incline plane is the sloping side of a tooth cusp. 
48 WHAT EFFECT DOES A PACIFIER HAVE UPON THE 
DEVELOPMENT OF THE TEETH? 
A pacifier brings about a condition of malocclusion charac- 
terized by a protrusion of the upper front teeth. 
WHAT IS THE RESULT OF THE PREMATURE LOSS 
OF THE TEMPORARY TEETH? 
The space made by the loss of the temporary tooth closes in so 
that the incoming permanent tooth erupts out of alignment in 
a position of malocclusion. 
DEFINE ORTHODONTIA. 
Orthodontia is the science of the treatment of malocclusion. 
WHAT CLASS OF MALOCCLUSION COMPRISES THE 
GREATEST NUMBER? 
Class 1 or neutroclusion. 
STATE THE EFFECT OF MASTICATING FOOD ON 
ONE SIDE OF THE MOUTH ONLY. 
In children one-sided mastication causes an uneven develop- 
ment of the facial and some of the cranial bones. In adults 
disuse of the teeth predisposes to caries, pyorrhea and maloc- 
clusion. 
WHAT IS THE RELATION OF THE FIRST PERMA- 
NENT MOLARS IN NORMAL OCCLUSION? 
In normal occlusion the mesio-buccal cusp of the upper first 
molar occludes in the buccal groove of the lower first molar. 
WHAT TEETH WOULD YOU USE AS GUIDES TO OC- 
CLUSION WHEN THE FIRST PERMANENT MOLARS 
ARE ABSENT? 
The permanent cuspids. 
49 STATE THE DIFFERENT POSITIONS OF MALOCCLU- 
SION THAT A TOOTH MAY OCCUPY. 
Labial or buccal occlusion, lingual occlusion, mesial occlusion, 
occlusion, distal occlusion, supra-occlusion, infra-occlusion, 
torso-occlusion. 
50 CHAPTER V 
(DENTAL PATHOLOGY) 
DEFINE (A) PERICEMENTITIS; (B) GINGIVITIS; (C) 
PULPITIS. 
Pericementitis is an inflammation of the Peridental Membrane. 
Gingivitis is an inflammation of the gum tissue. 
Pulpitis, an inflammation of the dental pulp. 
WHAT IS MEANT BY CONGESTION? 
Congestion means an increased amount of blood to a part 
above normal. It is classified as active and passive. 
WHAT ARE THE NECESSARY FACTORS IN SUCCESS- 
FULLY TEACHING MOUTH HYGIENE TO VERY 
YOUNG CHILDREN? 
A sympathetic attitude, clearness and brevity. 
WHAT IS ODONTALGIA? Name and Describe varieties. 
Odontalgia is a pain in or about a tooth or teeth. 
Varieties: Pulpitis, an inflammation of the pulp. 
Pericementitis or periodontitis, an inflammation of 
the peridental membrane. 
NAME A REMEDY FOR (A) Pulpitis (B) PERICEMTITIS 
Oil of Cloves. 
Tincture of Iodine. 
Define NEURALGIA. 
Neuralgia means pain along the distribution of a sensory 
nerve. 
WHAT WOULD BE YOUR INSTRUCTIONS TO A PA- 
TIENT WITH SEVERE PAIN IN OR NEAR THE TEETH? 
To consult a dentist for treatment. 
51 DEFINE PATHOLOGY. 
Pathology is that branch of science which deals with the study 
of the disturbance of function or structure in disease. 
GIVE THE CARDINAL SIGNS OF INFLAMMATION. 
Redness, pain, heat and swelling. 
DEFINE STOMATITIS AND GIVE THE VARIETIES. 
Stomatitis is an inflammation of the mucous membrane of 
the mouth. 
Varieties: Catarrhal, Apthous, Thrush, Gangrenous, Mer 
curial and Syphylitic. 
DEFINE AND CLASSIFY INFLAMMATION. 
Inflammation is the response of living tissue to injury. It is 
classified as acute and chronic. 
DEFINE (A) SUPPURATION; (B) SEPTICEMIA. 
Suppuration means a flow of pus. 
Septicemia means general blood poisoning. 
HOW DO WOUNDS HEAL? 
Wounds heal (I) By primary healing or healing by first inten 
tion. (2) By secondary healing, or healing by second inten 
tion, or healing by granulation tissue. 
DESCRIBE HEALING BY FIRST INTENTION. 
The blood clot is gradually replaced by connective tissue and 
the surface by epithelial tissue if the sides of the wound are 
in close contact. Otherwise more connective tissue is needed 
to span the breech and what is known as a cicatrix is formed 
The crust on the top of the wound is called the scab. The 
process is accompanied by the various stages of inflammation 
and charges in the circulation. 
52 DEFINE: (A) NECROSIS; (B) SEQUESTRUM. 
Necrosis is the death or molecular desruction of bone. 
A sequestrum is a porition of dead bone thrown off during 
necrosis. 
WHAT IS PERIOSITITIS ? 
Periostitis is an inflammation of the membrane surrounding 
bone. 
WHAT IS PYORRHEA ALVEOLARIS? 
It is a progressive disease of the alveolar process and peri- 
cementum, accompanied by a shrinkage of the gums and loos- 
ening of the teeth. 
GIVE SOME CAUSES OF PYORRHEA. 
Uncleanliness of the mouth, poorly constructed fillings, ill- 
fitting crowns, bridges, etc., malocclusion causing food im- 
pactions. 
WHAT ARE THE SYMPTOMS OF PYORRHEA? 
Tender, swollen and bleeding gums, a discharge of pus, re- 
cession of gums and the formation of pockets, loosening of 
the teeth. 
WHAT ARE CHIEF FACTORS IN THE PREVENTION 
OF PYORRHEA? 
Strict cleanliness of the mouth, especially the removal of all 
irritants from the gum margin. Proper occlusion and proper 
contact points are also important. 
IS PYORRHEA CONSIDERED A CURABLE DISEASE? 
Yes, if taken in time. 
53 CHAPTER VI 
ORAL PROPHYLAXIS 
DEFINE DENTAL PROPHYLAXIS. 
Dental prophylaxis is that scientific effort either operative 
or therapeutic which tends to prevent diseases of the teeth 
and their surrounding tissues. 
STATE THE RELATIONSHIP OF THE COLOR OF THE 
GUMS TO THEIR HEALTH. 
The gums in health are a light coral pink of characteristic hue. 
Local irritants will cause them to take on a deep red color- 
the sign of congestion. 
WHAT VARIETY OF TARTAR IS FREQUENTLY 
FOUND BENEATH THE GUM MARGIN? 
A dark brown deposit called serumal calculus. It is precipi- 
tated from the blood serum deriving its color from the hemo- 
globin. 
WHY SHOULD DEPOSITS BE REMOVED FROM THE 
NECKS OF TEETH? 
Because if they are allowed to remain they will set up irrita- 
tion and infection of the gingivae and pericementum will 
follow. 
IS BLEEDING OF GUMS BENEFICIAL DURING IN- 
STRUMENTATION? EXPLAIN. 
Yes. When the gums bleed readily during instrumentation 
it shows that the capillaries are congested; therefor the more 
blood allowed to escape from the gingivae the sooner the con- 
gestion will be relieved. 
54 WHAT IS THE VALUE OF MASSAGE OF THE GUMS? 
Massage of the gums stimulates the circulation in them and 
also in the pericementum. This results in a better oxidation 
and elimination of waste products. 
GIVE FOUR REASONS WHY THE FIRST PERMANENT 
MOLAR IS THE MOST IMPORTANT TOOTH. 
(1) It is the first permanent tooth to erupt and is the key to 
occlusion. (2) It has the greatest triturating surface. (3) 
It is essential to the normal development of the arches. (4) 
It serves as a prop to the jaws while the deciduous teeth are 
being shed. 
WHAT IS MEANT BY "GUM MARGIN"? 
The level of gingiva at the cervix of a tooth is referred to as 
the gum margin. 
WHAT IS A POCKET ? 
A pocket is a space around a tooth caused by the destruction 
of alveolar process and pericementum. 
WHAT IS YOUR METHOD OF LOCATING BACTERIAL 
PLAQUES ? 
By the use of disclosing solutions or solutions of iodine. These 
cause the plaques to assume a darker appearance. 
WHY SHOULD THE GREEN STAINS ON CHILDREN'S 
TEETH BE REMOVED? 
Because they allow the accumulation of food deposits, bac- 
terial plaques, etc., predisposing to caries. 
WHAT CAUSES THE GREEN STAINS ON CHILDREN'S 
TEETH ? 
The action of the Bacillus Leptothrix. 
55 WHAT IS THE RESULT OF THE EARLY EXTRACTION 
OF THE DECIDUOUS TEETH ? 
Malocclusion of the permanent teeth. 
WHY IS YOUR METHOD OF BRUSHING THE TEETH 
HELPFUL? 
Because it removes food debris from the tooth surfaces with- 
out forcing it into the approximal spaces. It also promotes 
health of the gum tissues by gently stimulating the circulation. 
WHAT INSTRUCTIONS WOULD YOU GIVE A PA- 
TIENT ON HIS FIRST VISIT TO YOUR OFFICE? 
After examining the patient's mouth and carefully cleaning 
the teeth the patient should be given full instructions in the 
home care of the mouth. 1-Use of toothbrush. 2-Use of 
floss silk between the teeth, and 3-Use of lime water for a 
mouth wash. 
Brushing: 1st. Outside surfaces of the teeth and gums of 
both the upper and lower jaws-in a rapid circular motion so 
as to stimulate the circulation and the teeth cleansed of food. 
Do not go crosswise. 2nd. Inside surfaces of the teeth and 
gums and roof of the mouth-with bristles of brush pointing 
upward, brush the roof of the mouth, inside gums and sur- 
faces of teeth, use rapid in and out stroke. Do same on lower 
inside surfaces with bristles turned down. 3rd. Top or 
grinding surfaces-Brush with in and out stroke, food must 
be removed from the grooves of the molars. 
Use of Floss Silk: Four fifths of decay takes place on the 
surfaces between teeth and surfaces on which you chew. 
Floss silk is the only way to remove food from these surfaces. 
Force the floss carefully between the teeth and rub back and 
forth against the surface of each tooth to loosen and remove 
food and clean the surfaces. 
Lime Water: With new patients and those with tender gums 
it can be diluted. When taken in the mouth it should be 
forced back and forth until it foams. Rinse with clear water. 
The natient should be told of the proper diet during infancy 
56 and childhood, the important substance for growth of bones 
and teeth is calcium phosphate. Milk contains all the neces- 
sities for infant growth, when the temporary teeth have 
erupted, foods containing a large amount of calcium are re- 
quired, such as milk, cheese, vegetables and whole grains 
(unrefined). 
Beware of sugar--Free sugar is the chief cause of dental 
decay and dental decay is the chief cause of serious illness. 
STATE WHAT A DENTAL HYGIENIST MAY DO 
UNDER THE DENTAL LAWS. 
She may "remove calcareous deposits, accretions and stains 
from the exposed surfaces of the teeth and directly beneath 
the free margin of the gum." 
WHAT WOULD YOU DO IN A CASE WHERE THE 
GUMS WERE BADLY CONGESTED? 
Determine the cause. If the congestion is due to the presence 
of the deposits at the gum margin (food debris) they should 
be removed. Applications of iodine and instrumentation will 
relieve congestion. This may be supplemented by gum mas- 
sage and the proper use of the tooth brush. 
STATE YOUR METHOD OF CLEANING THE APPROXI- 
MAL SURFACES OF THE TEETH. 
Plaques' should first be located with iodine applications. The 
surfaces may then to a large extent be cleaned with a small 
sharp orange wood point, charged with pumice. The contact 
point and area beyond may be cleaned by dental floss; the 
floss is wet, charged with pumice and carefully worked back 
and forth over the surface. 
STATE THE ADVANTAGES OF THE PORTE POLISHER 
OVER THE USE OF THE DENTAL ENGINE. 
The porte polisher is better adapted to the gingival margin as 
well as the approximal surfaces. It is believed that the pres- 
sure exercised in its use stimulates circulation in the parts. 
Because of better control it is less apt to injure the soft tissues 
and is less abrasive to the enamel. 
57 CHAPTER VII 
(MISCELLANEOUS) 
DEFINE ANESTHESIA. 
Anesthesia may be defined as insensibility to pain or sensation. 
WHAT SHOULD BE THE PREPARATION OF A PA- 
TIENT FOR NITROUS OXIDE ANESTHESIA? 
A towel or apron is used to protect the patient's clothing. All 
■ foreign bodies should be removed from the mouth such as 
plates, removable bridges, etc. The clothing should be loos- 
ened to permit the easy, natural respiration. A kindly, 
cheerful word helps to dispel the psychology of fear. 
DEFINE SYNCOPE AND GIVE TREATMENT. 
Syncope is a sudden anemia of the brain caused by fright, 
fear of pain. Place head low; administer smelling salts, aro- 
matic spirits of ammonia and apply heat to body. 
STATE THE PRINCIPAL OF THE X-RAY. 
The rays passing through a substance register the relative 
density and opacity of the contained objects upon the film by 
means of shadows. The shadows determine the shape, posi- 
tion, etc., of the various objects. 
WHAT IS YOUR PROCEDURE WITH A FILM AFTER 
IT IS EXPOSED. 
It is developed and allowed to dry. After it is mounted, the 
patient's name, date and position of tooth or area are noted. 
MENTION THE DANGER SIGNS DURING ANESTHE- 
SIA. 
Cyanosis, failure of respiration, failure of pulse and collapse. 
58 WHAT IS MEANT BY SURGICAL SHOCK? 
Surgical shock is a sudden depression of the vital powers, due 
to reaction upon the nerve centers. 
WHAT IS A LOCAL ANESTHETIC? NAME ONE, DE- 
SCRIBE ITS PREPARATION. 
A local anesthetic is one which will produce anesthesia or 
numbness of a part. NOVOCAINE. A solution of from 
1 to 2 per cent may be used. Suprarenin extract is added to 
it and it is boiled before using. 
WHAT PRECAUTION SHOULD BE TAKEN IN THE USE 
OF LOCAL ANESTHETICS? 
They should be rendered sterile by boiling. A sterile needle 
and syringe should be used. The part should be painted with 
iodine. 
WHAT ARE ADENOIDS ? OF WHAT INTEREST ARE 
THEY TO THE DENTAL HYGIENIST? 
Adenoids is the term used to describe hyper-trophied lymphoid 
tissue in the naso-pharynx. 
They are of interest to the dental hygienist inasmuch as they 
commonly cause mouth breathing which in children results in 
an extreme type of malocclusion characterized by narrowed 
arches, protruding front teeth, etc. The dental hygienist who 
learns of the presence of adenoids should advise parents of 
their effect upon the arrangement of the teeth. 
WHY SHOULD MALOCCLUSION BE TREATED? 
Malocclusion should be treated to restore the normal function- 
ing of the teeth. Malposed teeth are more susceptible to 
caries and diseases of the gums, peridental membrane, etc. 
Altered facial expression is often prevented or corrected by 
orthodontic treatment. 
TO WHAT IS SENSATION IN THE DENTIN DUE? 
Sensation in the dentin is due to an irritation of the protoplas- 
mic contents of the dentin tubules. 
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