ADEX Dental Hygiene Cheat Sheet

Cheat sheet ADEX Dental Hygiene Cheat Sheet Practice Questions Study Guide Print / Save PDF

Medical and Dental Assessment 12% of exam ASA Classification Vital Signs Antibiotic Prophylaxis Drug Interactions

Intra/Extra Oral Assessment and Charting 27% of exam AAP Staging AAP Grading CAL Math Furcation Mobility

Radiology and Imaging 15% of exam Radiographic Errors Anatomic Landmarks ALARA Bone Loss Patterns

Dental Hygiene Care Planning 13% of exam Treatment Selection Recall Intervals Re-Evaluation Timing SRP vs Maintenance

Patient Care 19% of exam Gracey Curettes Grasp and Fulcrum SPTCE Scoring Patient Selection

Specialties and Applied Pharmacology 14% of exam Infection Control Chairside Pharmacology Medical Emergencies Pediatric

Quick Facts Exam ADEX Dental Hygiene Administrator ABDE (CDCA-WREB-CITA/ADEX) CSCE items 100 points, up to 120 CSCE time 1h55m actual SPTCE format Typodont, not live patient Pass score 75, Pass/Fail Accepted ~85% of US jurisdictions SPTCE treatment time 2 hours

ASA Physical Status ME ASA I Healthy patient ASA II Mild systemic disease ASA III Severe, not incapacitating ASA IV Constant threat to life

AHA Antibiotic Prophylaxis ME Prosthetic heart valve Premedication required Prior infective endocarditis Premedication required MVP, no regurgitation No premedication needed Regimen Amoxicillin 2g, 1 hour before

CAL Quick Math IN Overgrowth subtracts, recession adds, at CEJ equals PD Margin coronal: PD minus overlap Margin apical: PD plus recession Margin at CEJ: CAL equals PD

AAP Stage vs Grade IN

Stage Severity and extent CAL plus bone loss Tooth loss count

Grade Rate of progression Smoking, HbA1c modifiers A slow, C rapid How bad vs how fast

2017 AAP Staging IN Stage I CAL 1-2mm, initial Stage II CAL 3-4mm, moderate Stage III 5mm+ CAL, up to 4 lost Stage IV 5+ teeth lost or dysfunction

AAP Grade Speed IN Grade A slow, B moderate, C rapid or high-risk A: no 5-year progression B: under 2mm in 5 years C: 2mm plus or risk modifier

2017 AAP Grading IN Grade A Slow progression Grade B Moderate progression Grade C Rapid, high-risk Grade C modifier Smoking 10+/day or HbA1c 7%+

CAL Calculation Rules IN Margin at CEJ CAL equals probing depth Recession present CAL equals PD plus recession Coronal overgrowth CAL equals PD minus overlap CAL definition CEJ to base of pocket

Furcation - Glickman Class IN Class I Incipient probe engagement Class II Partial penetration, no through Class III Through-through, gingiva covers Class IV Through-through, visibly open

Mobility - Miller Class IN Class 0 Physiologic movement only Class I Horizontal, less than 1mm Class II Horizontal, 1-2mm, no vertical Class III Over 2mm or vertical depression

Perio Diagnosis Thresholds IN Perio health 3mm or less PD, low BoP Gingivitis BoP 10%+, no CAL BoP meaning Inflammation, not diagnosis Mucogingival concern Keratinized tissue under 1-2mm

Horizontal vs Vertical Bone Loss RA

Horizontal Parallel to CEJ line Multiple teeth even

Vertical Angular, one-sided defect Deeper on one surface Even loss vs angular defect

Radiographic Errors RA Foreshortening Excess vertical angulation Elongation Insufficient vertical angulation Overlap Wrong horizontal angulation Cone-cut PID off receptor center Ghost image Dense object, opposite side

Foreshortening vs Elongation RA

Foreshortening Excess vertical angle Image too short

Elongation Too little vertical angle Image too long Too much angle vs too little

Radiographic Landmarks RA Inverted Y Nasal fossa meets sinus wall Zygomatic process Band over molar apices Mental foramen Radiolucency near premolar apex Genial tubercles Radiopaque ring at midline

ALARA Dose Reduction RA F-speed or digital About 60% dose cut Rectangular collimation Beam matches receptor size Thyroid collar Priority for children Vertical bitewing More apical bone coverage

Radiograph Appearance and Selection RA Subgingival calculus Radiopaque spike on root Interproximal caries Radiolucent notch below contact New perio patient FMX or panoramic plus bitewings High caries-risk recall Bitewings every 6-18 months

Prophylaxis vs SRP CA

Prophylaxis Gingivitis only No attachment loss Supragingival focus

SRP Periodontitis present CAL and bone loss Subgingival root planing No CAL vs confirmed CAL

Treatment Selection CA Gingivitis, intact periodontium → Prophylaxis Stage I-II periodontitis → Scaling and root planing Post-SRP check needed → Re-evaluate in 4-6 weeks Stable Stage III-IV → Perio maintenance, 3-4 months High caries-risk adult → Bitewings every 6-18 months Low caries-risk adult → Bitewings every 24-36 months Persistent BoP after therapy → Continue maintenance, reassess Thin biotype with recession → Refer for soft-tissue graft

Treatment and Recall Rules CA Gingivitis, no CAL Prophylaxis Periodontitis present Scaling and root planing Post-SRP re-eval 4-6 weeks later Stable perio maintenance Recall every 3-4 months

Gracey Working-End Map PA 1-2 anterior, 7-8 facial, 11-12 mesial, 13-14 distal 1-2: anteriors 7-8: facial or lingual post 11-12: mesial posterior 13-14: distal posterior

Universal vs Gracey Curette PA

Universal Two cutting edges 90 degree blade General use

Gracey One cutting edge 60-70 degree offset Area-specific General purpose vs site-specific

Instrument Selection PA Heavy subgingival calculus → Ultrasonic scaler Anterior surfaces → Gracey 1-2 Posterior mesial surfaces → Gracey 11-12 Posterior distal surfaces → Gracey 13-14 Posterior facial-lingual → Gracey 7-8 Supragingival calculus only → Sickle scaler Unshielded pacemaker present → Avoid magnetostrictive ultrasonic Furcation entrance access → Mini or after-five curette

Gracey Curette Working Ends PA Gracey 1-2 Anterior teeth Gracey 7-8 Posterior facial-lingual Gracey 11-12 Posterior mesial Gracey 13-14 Posterior distal

SPTCE 100-Point Split PA 16 detection, 66 removal, 6 complete, 12 probe Detection: 16 pts, 4 teeth Removal: 66 pts, 12 surfaces Completeness: 6 pts remaining Probing: 12 pts, 2 teeth

CSCE vs SPTCE PA

CSCE Computer-based 100 points, ~120 items ~2 hours seat time

SPTCE Typodont clinical Calculus and probing scoring 2-hour treatment Cognitive exam vs psychomotor exam

SPTCE Exam-Day Decisions PA Receiving typodont assignment → 4 detection, 12 removal surfaces Calculus on one other surface → -3 completeness deduction Calculus on two other surfaces → -6 completeness deduction Laceration over 3mm → Major critical error Treatment time expiring → No extensions given Instrument contamination mid-exam → Report to Chief Examiner Probing depths needed → 2 teeth, 6 readings each

Grasp, Fulcrum, Angulation PA Modified pen grasp Standard scaling grasp Intraoral fulcrum Nearest tooth or arch Curette angulation 60-80 degrees ideal Ultrasonic angulation 0-15 degrees, light strokes

SPTCE 100-Point Scoring PA Calculus detection 16 points, 4 maxillary teeth Calculus removal 66 points, 12 key surfaces Removal completeness 6 points, other surfaces Periodontal probing 12 points, 2 teeth Remaining calculus penalty -3 one, -6 two+

SPTCE Fixed Assignment PA Detection teeth 4 maxillary, pre-assigned Removal quadrant One assigned mandibular quadrant Removal surfaces 12 key subgingival surfaces Probing teeth 2 assigned teeth No case selection Assignment is fixed

SPTCE Exam Logistics PA Exam medium ABDE-provided typodonts Treatment time 2 hours, no extensions Instruments permitted Curettes, sickles, ultrasonic Sterilization rule Clean and disinfect, not sterile Major soft-tissue error Laceration over 3mm

Chairside Pharmacology SP Chlorhexidine 0.12% Rinse, staining side effect Arestin Locally delivered minocycline Fluoride varnish 5% NaF, high-risk children OTC dentifrice max About 1,100-1,500 ppm F

Infection Control Categories SP Critical instrument Heat sterilize always Semi-critical instrument Mirror, sterilize when possible Spore test frequency Weekly, per sterilizer Waterline standard 500 CFU/mL or less

Medical Emergencies SP Vasovagal syncope Supine, legs elevated first Adult CPR ratio 30 compressions to 2 breaths Acute asthma wheeze Albuterol inhaler first-line Percutaneous injury Wash first, then report

Common Traps

Prophylaxis is not SRP Prophy: no attachment loss ≠ SRP: periodontitis present

PD is not always CAL PD: margin to pocket base ≠ CAL: CEJ to pocket base

Horizontal loss is not vertical Horizontal: parallel to CEJ line ≠ Vertical: angular one-sided defect

CSCE is not SPTCE CSCE: computer cognitive exam ≠ SPTCE: typodont psychomotor exam

Universal curette is not Gracey Universal: two edges, general ≠ Gracey: one edge, area-specific

BoP alone is not periodontitis BoP: inflammation marker only ≠ Periodontitis needs CAL and bone loss

Foreshortening is not elongation Foreshortening: too much vertical angle ≠ Elongation: too little vertical angle

Disinfected is not sterile SPTCE: clean and disinfect only ≠ Critical items: heat sterilize always

Last Minute 1 . IEO charting is heaviest domain (27%) 2 . SPTCE now uses typodonts, not patients 3 . Detection 16 pts, removal 66 pts 4 . Missing 1 surface costs -3 points 5 . Passing score 75, pass or fail 6 . Gracey 11-12 mesial, 13-14 distal 7 . Stage means severity, grade means risk 8 . Ultrasonic angle 0-15 degrees, light strokes 9 . Working curette angulation 60-80 degrees 10 . SPTCE treatment window is 2 hours

ADEX Dental Hygiene Clinical Examination Practice Questions 177 questions Study Guide 21 topics Cheat Sheet 88 facts Flashcards 50 cards Shorts 3 short s Free CE Podcast

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