Dr.

PC 1

Fulcrum
Dr. PranC
Patient Management

Best of Luck to All

 Dr. PC 2

Professionalism

➢ Ethics: The science of Human duty, correlate motives and attitudes with moral actions
and values
➢ Professional Ethics: Rules or Standards governing conduct of members of profession

➢ Battery: Intentional infliction of offensive or harmful bodily contact, unwanted touching,

Treatment without patient consent.

➢ Tort Law:
• If you treat without patient consent, then technical assault battery as known as
Tort law.
• 2 types: Intentional and Unintentional Tort law
• Intentional: An act of willful, Example: Assault, Battery, Defamation
• Unintentional: Negligence & Malpractice

➢ Negligence: failure to use such care as a reasonable person would use under similar
circumstances.

➢ Malpractice:
• wrongful acts of professional persons, usually failure to meet the standard of care
or failure to foresee consequences that one with his or her particular skills and
education should foresee.

➢ Informed consent: From concept of battery and individual rights to make choices
regarding own body

➢ Confidentiality: Based on an individual’s right to privacy. For example, A client has the
right to expect all his or her medical records and communications to be kept confidential.

➢ The Principles of the Code of Ethics:

• Autonomy
• Non maleficence
• Beneficence
• Justice
• Veracity

Best of Luck to All

 Dr. PC 3

Principles Definition Examples

Patient involvement: Information patient of
proposed treatment and alternatives in manner that
allows patient to become involved in treatment.
Patient records: keep records confidential and safe
to protect patient welfare. Give new offices
information that be beneficial for future treatment
Autonomy Patient rights of the patient
To self Furnishing copied of records: Giving x-rays and
determination information to the patient new office.
Confidentiality of the patient records: Can’t give
HIV statue, sexuality, health history, chemical
dependence to new offices without patient consent.

✓ Keeping knowledge and skills current

✓ Referring patient or consulting for welfare
of the patient
✓ Can’t practice while abusing controlled
substances, alcohol, or chemical agents
which impair ability to practice
✓ Ability to practice: Doc contracts any
disease or becomes impaired that might
Non maleficence DO not HARM endanger patients or staff should no longer
practice
✓ Immediately inform the patient who may
have been exposed to blood or OPIM of the
need for postexposure evaluation and
immediately refer patient to health care
provider
✓ Patient abandonment: should not
discontinue treatment without giving patient
adequate notice and opportunity to obtain
the services of another dentist
✓ Abide interpersonal relationships that could
impair professional judgement

✓ Community service: use skills to improve

dental health in a community
Do GOOD ✓ Make yourself apart of a society to help
Beneficence Promoting GOOD regulation itself
or WELL Being ✓ Do research and help efforts to promote
health
✓ Become familiar with signs of neglect,
abuse, and to report suspicious cases

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 Dr. PC 4

✓ Dentist shall not refuse to accept patients

into practice or deny service because of
race, creed, color, sex, or national origin
✓ Can’t refuse to provide treatment because of
HIV, HBV, or other bloodborne pathogens
or diseases
✓ Must make reasonable arrangements for
Justice Equality for ALL emergency care for patients of records.
Treat patient not of record but return when
done
✓ Can’t tell patients their previous dental
work was horrible, but have to let them the
proper status of their dental health
✓ Can’t agree to a fee contingent upon the
favorable outcome of the litigation
✓ Can not accept rebates or splits fees

✓ Do not represents care being rendered to

patient in false or misleading manner
✓ Can’t tell patient they have to remove all
amalgam because its toxic to your body to
non-allergic patients
✓ Giving treatment or advice without
scientific knowledge or research
To Tell the TRUTH ✓ Shall not represents the fees being charged
Veracity for providing care in false or misleading
Truthfulness manner
✓ Overbilling the insurance company,
increased, or charged extra fee to patient
because they are covered under dental
benefits
✓ Submitting incorrect treatment dates to
obtain benefits
✓ Gives insurance false treatments and
procedures for greater payment
✓ Recommends unnecessary service

Best of Luck to All

 Dr. PC 5

➢ Dental Records of an Employee:

•The Joint Commission on National Dental Examinations recommends that all
dental records should be kept as long as possible. They are patient property, and
the police may require them for forensic identification.
• The American Dental Association (ADA) has different recommendations. The
ADA recommends that records may be destroyed for inactive adult patients who
have not been seen in seven years (longer in some localities) or at the expiration
of the statute of limitation on contract and tort actions. The oral health record of
inactive minors generally should not be destroyed until seven years after a child
reaches the age of majority.
➢ The Good Samaritan Act:
• The Good Samaritan Act legally protects health care professionals who provide
emergency treatment at the scene of accidents.
• Good Samaritan laws offer legal protection to those who provide “reasonable
assistance” to individuals who are in an accident, ill, in danger, or incapacitated.
Such laws are meant to reduce bystanders’ hesitation to help for the fear of being
sued or prosecuted for unintentional injury or wrongful or accidental death.
➢ Dental Specialty Recognition by ADA:
• Dental public health is a specialization that focuses on epidemiology, analysis of
social health policies, and the dental needs of the general population.
• To be considered a dental specialist, a dentist must attend an advanced training
program or residency training dedicated to the mastery of a field. After
completing the training, the dentist is provided with a certification. The United
States, Australia, and Canada acknowledge nine dental specialties.

➢ Report of elderly abuse suspicious:

• Report Immediately or As soon As possible
• Telephone or confidential internet reporting tool
• After phone or internet report, written or internet report within 2 working days
Place of Abuse Authorities to report To
✓ Local Ombudsperson
Long Term Care Facility ✓ Law Enforcement Agency

✓ State Department of Hospital

State Mental Hospital or State ✓ State Department or Development
Development Center services
✓ Local Law Enforcement Agency

Any Other Place ✓ Adult Protective Services

✓ Local Law Enforcement

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 Dr. PC 6

➢ Forms of Elder Abuse: Abandonment, Abduction, Isolation, Financial abuse, Neglect.

Physical abuse.

Important Definitions

➢ Incidence: The rate of NEW diseases/cases in a given period of time in a specific

population
➢ Prevalence: Total percent/cases of diseases or conditions within the population.
➢ Attributable Risks:
• The difference in rate of a condition between an exposed population and an
unexposed population.
• Attributable risk is most commonly used in COHORT STUDIES to measure
individuals are assembled on exposure status and followed over a period of time.
➢ Penetrance:
• Describes the extent to which a particular gene or set of gene is expressed in the
phenotypes of individuals carrying it.
• It is measured by the proportion of carriers showing the characteristic phenotype
➢ Specificity: Disease FREE.
• The ability of a test to accurately identify the absence of a disease or condition.
• % of persons having the disease TP/TP+FN X 100%
➢ Sensitivity: Disease Present
• The ability of a test to accurately identify the presence of a disease or condition
when disease is, in fact, present.
• % of persons not having the disease TN/TN+FP X 100%
➢ Value Prediction for a Population:
• Predictive value positive....> TP/TP+FP X 100%
• Predictive value negative....> TN/TN+FN X 100%
• TP: True Positive, TN: True Negative, FP: False Positive, FN: False Negative
➢ Repeatability: The variation in measurements taken by a single person or instrument on
the same item and under the same condition.
➢ Precision: A test which has a predictive value, is the chance that a subject testing positive
actually has the condition being tested for.
➢ Efficacy:
• Measured by capacity/capability of a drug or medical device to produce a desired
or required effect.
• The drug or medical device is considered to be optimal if it produces the intended
results within the calculated amounts.

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 Dr. PC 7

➢ Reliability:
• Consistency or reproducibility of a measurement overtime.
• Should be reproducible and repeatable with same value means produce similar
results
➢ Validity:
• The Accuracy of a measure produced by measuring what supposed to be
measured.
• Should be compared to gold standard and should be highly sensitive, specific and
unbiased

➢ Leading question: is designed to VERIFY particular information by leading a person to

suggested answer.

➢ Funnel Question: Provides questions that may ASK information from a SPECIFIC detail
to more general information or vice versa.

➢ Close Question: A SPECIFIC or PARTICULAR word or phrase. (YES or NO)

➢ Open Question: Can be answer unlimited ways and manner. Usually require elaborative
and long answer.
➢ Cultural Diversity:
• Should considered when creating a customized treatment plan for a patient.
Patients differ in race and ethnicity which may lead to different practices in
maintaining their health.
• Knowing the ethnic identity and heritage of your patients may provide insights to
their health practices that might have the dental problems that the patient is
experiencing at present.
• Other cultural backgrounds may object to treatment options that include different
animal products such as bovine bone grafts, should be accounted for.
➢ Biofeedback: A type of therapy in which patients are taught to achieve better health
through controlling certain regulatory and involuntary process that occur within their
body. It involves training patients to control physiological processes such as muscle
tension, blood pressure, or heart rate. Biofeedback is conducted in 3 ways:
• Electromyography functions by measuring the tension within a muscle
• Thermal biofeedback focuses on the skin’s temperature
• Neuro biofeedback promotes a deeper understanding of how the brain waves of
the patient function.
• Example: Calmness and relaxation, controlling Blood pressure

Best of Luck to All

 Dr. PC 8

➢ Dental Phobias:
• Arise due to NEGATIVE direct or indirect dental experiences.
• Can be managed through Pharmacological & Behavioral techniques such as:
▪ Nitrous Oxide
▪ Anti-Anxiety Oral Medications
▪ Positive Reinforcement
▪ Tell-Show-Do Technique
▪ Relaxation technique
➢ Tell-Show-Do Technique:
➢ Relaxation Technique:

➢ Voice Control: a method should be used in a moderately developmentally disabled child in

emergency treatment procedure. Voice control will be acceptable method in making the
child corporative.

➢ Occult Lesion:
• Are not easily detectable by clinical method alone
• Most are asymptomatic and do not show signs of the disease progression
• Best way to evaluate this lesion by HISTOLOGICALLY and MRI.

➢ Stress:
• Stress is known to contribute to the initiation and progress of illnesses
experienced by people.
• Stress weakens the immune system, making the body more prone to acquire
disease. Once the illness progresses, it causes further stress to the affected person.
• Stress also compromises the ability of a person to act accordingly and adapt to
certain situations which may also affect a person's emotional and social health.
• Having illness causes significant stress in people. Stress alters a person's lifestyle,
work, and personal interactions which may be detrimental to their morale and lead
to depression, loss of self-confidence, and lowering of self-worth.

➢ Fear: Anticipation of a threat elicited by an external object. It is distinguished from

anxiety on the basis of the person’s ability to locate the threatening agents and recognize
the presence of a behavior that will reduce perceived danger.

➢ Anxiety: A subjective experience involving cognition, emotion, behavior, and

physiological arousal.

Best of Luck to All

 Dr. PC 9

MOST COMMON FOUND IN POPULATION

Most Common Population

Highest prevalence of caries Hispanics

Highest DMFT White (Caucasian)

highest number of restored teeth.

Highest untreated primary teeth Hispanic

Highest untreated perm teeth Black (African American)

Moderate periodontitis Black males (African American)

Class II caries Whites (Caucasian)

Class III caries Blacks (African American)

Cleft lip/palate w/ Class III occlusion Native American

Cleft lip alone Asian

Cleft lip in USA 1:700 to 1:800

Class 2 malocclusion whites of northern European descent

Class 3 malocclusion Asian

Anterior open bite African American(blacks)

Deep Bite Caucasians(whites)

Cemento-osseous dysplasia Black middle-aged women

Caucasians have more lip cancer while African American have more
oropharyngeal carcinoma

Best of Luck to All

 Dr. PC 10

Dental office Materials & Equipment’s Safety and

Handling
➢ Air born particles:
• Spatter: Large visible particles 50um or larger and it’s the route of infection of
blood borne pathogens
• MIST: Settle from air after 10-15 mins and is produced by cough
• Aerosol: Invisible particles between 5-50um floating in air for hours

➢ Current OSHA standard for mercury is 0.1mg /m3 over 8 hours work shift

➢ Noise Inducing Hearing Loss: above 90db and protection recommended when noise
reaches 85db (Autism pts are very sensitive to loud sounds put muffler on your turbine
and work)

➢ During photopolymerization of composite or any resin material (Bridge to operative: 1-

1.5mm from restoration and use of VLC and alpha diketone with camphor quinone to
initiate the polymerization) always wear eye protector to avoid retinal damage
➢ Before starting any clinic flush all dental instruments including handpiece for several
mins to ensure that the waterline is < 500CFU/mL.

➢ MSDS is regulated by manufacturers for employees and use colors to notify the
employees as follows:
• BLUE: Health Hazard
• RED: Fire Hazard
• YELLOW: Reactivity and Stability of Chemicals
• WHITE: Use PPE

➢ Biological Indicators:
• Biological indicators used in biological monitoring tests are the most accepted
means of monitoring the sterilization process. They directly determine the
presence of the most resistant microorganisms or spores (spore testing).
• Biological monitoring tests also carry out the determination of the physical and
chemical conditions of the sterilization met.
• More Resistant Bacteria: Bacillus artrophaeus and Geobacillus
stearothermophilus (Used for Spore test)
• Spore test should be done WEEKLY, documented and maintained for 12 months.

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 Dr. PC 11

➢ OSHA:
• The Occupational Safety and Health Administration's (OSHA) Bloodborne
Pathogens Standard mandates that the clothes worn by office personnel should not
be laundered at the employee’s home.
• OSHA mandates employers to provide laundry services at the dental office or at a
standard laundry company, at no cost to the employees.
• At the place of use (office), soiled linens should be put into color-coded bags to
indicate the required universal precautions.
• The Occupational Safety and Health Administration (OSHA) ensures that workers
will be provided ergonomic working places.
• OSHA protects healthcare professionals from occupational hazards by creating
standards regarding recognition, control, and prevention of threats in the
workplace.
• OSHA has partnered with the American Dental Association (ADA) to provide
better training resources to dental professionals to ensure that dental health
hazards are recognized and minimized.
• The occupational Safety and Health Administration’s Blood Borne Pathogens
Standard does not include the regulation of nitrous oxide scavenging systems.
• This standard was created and designed to protect healthcare workers and
personnel from the risk of exposure to blood borne pathogens, like hepatitis B
virus (HBV) and human immunodeficiency virus (HIV).
• The Blood Borne Pathogens Standard involves the following:
▪ Management of sharps and disposal of regulated wastes
▪ Communication of hazards to employees
▪ Training and hepatitis B vaccination of employees
▪ Exposure incident plan
▪ Sterilization and storage of instruments
➢ EPA:
• The EPA established maximum exposure levels for Hg vapor. They are intended
to be highly protective at 0.1 µg/kg body weight per day.
• The EPA also regulates transportation of dental waste from dental offices.
➢ Exposure of Mercury:
• Exposure to mercury must be minimized because mercury is detrimental to a
person’s health.
• Exposure to mercury may cause the following:
▪ Weight loss
▪ Gastrointestinal disorders
▪ Exhaustion
• Preventive measures against mercury spills and exposure include the following:
▪ Wearing personal protective equipment
▪ Avoiding bulk dispensing of mercury
▪ Using tile or wood flooring

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 Dr. PC 12

• If a spill occurs, a special vacuum system may be used, followed by application of

sulfur powder on the area.

➢ MSDS (Material Safety Data Sheets):

• The MSDS is not regulated based on the Bloodborne Pathogen Standard.
• The MSDS indicates procedures for the proper management and safe handling of
products.
• The MSDS contains information about the product’s physical data, storage,
toxicity, health effects, disposal, and other relevant data.

LEGEND of Organization in Patient Management

➢ ACF: Administration of Children & Family, A department of Health & Human
Service
• Associated with economy and social well-being
• Example: low income children get free food meal in school
➢ CMS: Center for Medicare & Medicaid (Federal Insurance Program)
• Medicare: For Elderly and Disabled people. Dental insurance is limited to
services that have medical implication.
• Medicaid: For Low income people Elderly and Children
➢ EPSDT Program: Early & Periodic Screening, Diagnosis, & Treatment
• Dental services for children
➢ CHIP Program: Children Health Insurance Program (Joint Federal-State program)
• Offers basic preventive and diagnostic services
• Offer insurance to children up to 19 years from families with income above
Medicaid level, but too low to afford health insurance.
• Example: Vaccinations
➢ HRSA: Health Resource & Service Agency
• Offers health care services for uninsured live in rural areas and urban
neighborhoods plus dental services for HIV pts
➢ CDC: Center for Disease Control & Prevention
• Prevent outbreak of disease and dental infection control
• Example: Community water fluoridation
➢ FDA: Foods & Drug Administration
• Protecting health against impure and unsafe foods plus temperature of autoclave
➢ NIH: National Institute of Health
• Deals with supporting medical research

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 Dr. PC 13

➢ NIDCR: National Institute of Dental & Craniofacial Research

• Branch of NIH deals with dental research
➢ AHRQ: Agency for Health Resource & Quality
• Support health care system and quality
➢ HHSA: Health & Human Service Agency
• Provides a broad range of health and social services, promoting wellness, self-
sufficiency, and a better quality of life for all individuals and families
➢ DEA: Drugs Enforcement Administration
• Combating drug smuggling and deals and also has sole responsibility for
coordinating and pursuing U.S. drug investigations abroad.
➢ NHANES: National Health & Nutrition Examination Survey
• A program of studies designed to assess the health and nutritional status

Research Studies Categories: 3 major types:

1. Descriptive:
• Classification: Cross-sectional (establish Prevalence)
• Types: Survey
2. Analytical:
• Classification: Longitudinal, Prospective, Retrospective, Cross sectional
• Types: Case control, Cohort (Incidence), Cross sectional (Prevalence)
3. Experimental:
• Classification: Longitudinal
• Types: Randomized clinical trial, Quasi experimental

➢ Descriptive Research:
• Involves description, documentation, analysis, and interpretation of data to
evaluate a current event or situation
• DOES NOT test a HYPOTHESIS.
• Quantify the disease
• Example: Survey
➢ Analytic/ Observational/ Developmental Research:
• Encompasses observation of a disease or condition to IDENTIFY determinants of
the disease by showing relationships or associations between diseases and other
factors.
• Etiology of a disease

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 Dr. PC 14

• DOES NOT establish CAUSE and EFFECT relationship.

• Example: Cohort, case control, cross sectional.
➢ Experimental Research:
• Carefully designated study to test a HYPOTHESIS
• Involves manipulation of the supposed CAUSE or CONTROLLING agent and
OBSERVATION of the RESULT.
• Effectiveness of the therapy or intervention
• Example: Randomized clinical trial, Quasi-Experimental.
➢ Cohort Study:
• One group observe overtime, can be compared to comparison group.
• Establish INCIDENCE, Determine RISK
➢ Case Control Study:
• 2 groups, 1 with DISEASE (cases group) & 1 without diseases (control group)
• Compared to IDENTIFY factors in their history that can be associated with the
DISEASE or CONDITION.
➢ Cross Sectional Study:
• Representative cross section of the population (One group, but several subgroups)
is observed at one point in time.
• DISEASE attributes and potential RISK attributes are Associates
• IDENTIFY Risk INDICATORS & risk PREDICTORS, but cannot confirm RISK
factors
• Establish Prevalence
➢ Randomized Clinical Trial:
• A well-controlled experimental study with HUMANAS.
• Establish CAUSE & EFFECT Relationship (Causality)
• Longitudinal Study
➢ Quasi-Experiment:
• An experiment that is NOT well-controlled

➢ Risk Factor (strong indication of risk): Cohort study/Longitudinal, Case

Control/Retrospective
➢ Risk Indicator (weaker indication of risk): Cross Sectional
➢ Demographic Risk Factor (Risk predictor): Cross Sectional, Case control
➢ Double Blind Study: Both EXAMINER & SUBJECT DO NOT know which one is
experimental group and which one is the control group
➢ Longitudinal Survey: An observational correlational research study that involves repeated
observations of the same variables over long period of time
➢ Mean: The arithmetic average, the sum of the values divided by the number of items
➢ Median: Midpoint of a distribution

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 Dr. PC 15

➢ Mode: The most frequently occurring score in a distribution.

➢ Range: the spread between the highest and the lowest scores in a distribution
➢ Standard Deviation: The positive square root of the variance. Smaller SD indicates that
the distribution of scores is clustered closely around the mean, A large SD indicates that
scores are dispersed widely around the mean.
➢ Correlation Coefficient (r):
• Determines the strength of relationship between 2 variables
• Ranging from +1.0 to -1.0. The sign indicates the direction of the correlation, and
the number indicates the strength of the correlation. The closer number is to either
+1 or -1, the stronger the relationship
▪ Positive (Direct association): If X value increases, then Y value also
increases, if X value decreases, Y value also decreases
Example: The more hour you study for board, the higher your
Board score will be
▪ Negative (Opposite): If X value increases, then Y value decreases, if X
value decreases, Y value increases
Example: The more fluoride exposure, the less carious lesions a
child will have
➢ t-test: Used determine if a statistically significant difference exist between Two
MEANS.
• Hints: “T” stand for TWO
➢ Chi square test: Used to determine if a statistically significant difference exists between
FREQUENCIES of data

➢ ANOVA: (Analysis of Variance)

• Used to analyze differences among Three or more MEANS scores.
• Used to examine the effects of two or more independent variables simultaneously
within the same research design and to determine interactions among the variables
in multiple same groups.
➢ P Value: (Probability value)
• Used when testing hypothesis
• P value should be less than 0.05 to reject the null hypothesis
• P-value greater than 0.05 will negatively affect the study result, means accepting
null hypothesis.

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 Dr. PC 16

➢ Null Hypothesis:

➢ Most reliable evidence-based research:

➢ Water Fluoridation:

Best of Luck to All

 Dr. PC 17

Insurance & Billing

➢ Preferred Provider Organizations (PPOs):
• Health Service and Dental Service Corporation (Not for Profit), Commercial
insurance companies (For profit)
• Patient can visit a dentist outside of the PPO and pay the difference including co-
pay, deductible, etc.
• Arrange a discounted rate accepted by dental providers in exchange for a higher
volume of patients.
➢ Health Maintenance Organizations (HMO): Capitation
• Health Service and Dental Service Corporation: commercial insurance, prepaid,
large group practices
• In HMOs, individual practice organizations combine the risk of capitation with
fee-for-service reimbursement. HMOs and other managed-care plans can contract
with an insurance provider association, which then contracts with independent
physicians to treat members at discounted fees or on a capitation basis. HMOs
usually limit coverage to care from doctors who work for (or contract with) the
HMO. An HMO generally will not cover out-of-network care, except in an
emergency.
• Capitation is a payment method in which an entity pays the dentist a fixed
amount irrespective of the services provided by the dentist
➢ Direct Reimbursement:
• Employer. Beneficiaries are reimbursed by employer or benefit administrator
• Not a true insurance.
• Self-funded plan that reimburses patients according to dollars spent on dental
care, not type of treatment received.
• Employers pay employees a percentage of actual treatment received, saving cost
of middleman, the insurance plan administrator.
• Allow freedom of choice and autonomy of decision making about treatment
• ADA’s preferred method of financing dental treatment.
➢ IPA: Individual Practice Association
• More of a business arrangement than a dental benefits plan, organization contracts
with independent dentists to provide services to HMO patients for discounted fees
or though capitation arrangement.
➢ Fee for Service:
• Traditional two-party arrangement in which fee is set for a service and client is
charged for service performed
• Declining method of payment as third-party payment becomes more prevalent.

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 Dr. PC 18

➢ Closed Panel Practice:

• In a closed panel practice, dental patients receive care at specified facilities by a
limited group of clinicians on a prepayment basis. Dentists must accept any
beneficiary of a closed panel as a patient.
➢ Out-of-Pocket Costs:
• The health insurance definition of out-of-pocket costs is any amount of money
that will have to come from you, hence the term "out of [your]pocket". Two main
areas to understand out-of-pocket costs in insurance are the out-of-pocket costs
for services not covered and the out-of-pocket costs you are expected to pay
before your insurance will pay.
• Out-of-pocket costs include expenses that your insurance company does not feel
are covered services included in your plan. Some examples would be elective
procedures, such as cosmetic surgery or procedures specifically excluded by your
insurance company. If you don't want to have to pay for something out-of-pocket,
you can easily find out what services are not covered by your insurance company
by calling them and asking.
• Another main out-of-pocket cost in health insurance are the costs you are
expected to pay for covered procedures before your insurance will pay. The two
primary ones are your deductible and co-insurance. The deductible is the amount
you have to pay, out-of-pocket, before your insurance company will start paying.
The co-insurance amount is the percent you are required to pay towards a covered
procedure. For example, your insurance company may cover 80% of your surgery
and you have to pay the remaining 20% out-of-pocket. There is usually an out-of-
pocket maximum and once that is reached the insurance
• company will cover 100% of the costs and the deductible and co-insurance
payments count towards the out of pocket maximum.
➢ Coinsurance: Similar to Co-payment, but it is a percentage rather than a fixed amount,
used by most dental insurance plans
• Most health insurance policies have a coinsurance, or sometimes misspelled as
co-insurance, clause. This simply is the percentage amount you are required to
pay towards your health insurance bill when you file a health insurance claim.
The coinsurance percentage is usually in addition to the deductible, that would
need to be paid first before the insurance company would pay anything. Example
• Mary Jo had a 20% coinsurance clause on her new health insurance policy. She
just got a bill, for her recent surgery, from her health insurance company. The
total of the bill was $2000. Her health insurance deductible was $200 for the year
and none of her deductible was paid yet since this was her first claim. This means
that Mary Jo would need to pay, out of her own pocket, her full deductible ($200),
and then 20% of the remaining amount of the insurance bill ($360). So, her total
out of pocket expense for her surgery was $560 ($200+$360).

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 Dr. PC 19

➢ Copayment: Patient pays a fixed amount at each visit, and the remainder of the fee is
covered by third party, the purpose is to discourage overuse.
• The copayment is a fixed amount the insured is required to pay to the provider.
Some call it the copayment or copays since there can be different copayment
amounts for different services. Copays are usually what one pays when they visit
a doctor or purchase a prescription. The copayment is almost always required at
the time of service or at the time one would purchase their prescription
medication. Then the doctor or pharmacist will bill the insured's insurance
company for the remaining amount due.
• Sometimes copays are confused with the co-insurance payment. The co-insurance
payment is different as it is a percentage that the insured is required to pay and is
usually due for larger procedures such as a surgery. Examples: Dean needed to go
see his doctor for a lingering cough. When he went to his visit, he was required to
pay a $40 copayment to the doctor at the time of service. The doctor's office then
billed the remaining amount due to Dean's insurance company.
➢ Deductible: Patient must pay a required amount as an out-of-pocket expense before the
insurance plan will pay.
➢ Annual Limits (Maximum Coverage): Insurance plan will pay only up to a specific dollar
limit each year.
➢ Predetermination:
• Predetermination of benefits is an administrative procedure that may require the
dentist to submit a treatment plan to the third party before treatment begins. The
third party usually returns the treatment plan indicating one or more of the
following: patient’s eligibility, covered services, benefit amounts payable,
application of appropriate deductibles, co-payment and/or maximum limitation.
Under some
• Programs, predetermination by the third party is required when covered charges
are expected to exceed a certain amount.

➢ Claims Bundling:
• Claims bundling is the systematic combining of distinct dental procedures by
third-party payers that results in a reduced benefit for the patient/beneficiary. The
ADA considers bundling of procedures to be potentially fraudulent.
➢ Bundling: (Dentist submit claims sperate, insurance paid as one service)
• Bundling is when a dentist submits a claim for two or more procedures performed
on a single patient during office visit and the insurer bundles the services together
and only pays for one service.
• What is often described as bundling is the effort of payers to follow guidelines
established in the Code. For example, payers commonly see claims submitted
with the following combinations of services that are not consistent with the Code:

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 Dr. PC 20

• Pins reported as a separate service from a core buildup (the D2950 buildup code
includes pins)
• Adhesives, bases or liners as a separate service from the restorations (the Code
defines these to be included as part of the restoration);
• Occlusal adjustments and minor adjustments to prostheses as a separate service,
when the prosthetic service includes routine post-delivery care
• Suture removal, as a separate service from the extractions, which include suturing
and postoperative care.
• X-rays taken during the course of root canal therapy as a separate service from the
root canal, which by definition, includes intra-operative X-rays. For the examples
above, payers will often consider these component services as part of the main
procedure in accordance with the Code and pay benefits accordingly.

➢ Unbundling: (Dentist abused benefits by charging separate fee)

• The practice abused by dentist to get a program to pay more than the actual
benefits by charging a separate fee for each component.
• Example: if the service for a crown was unbundled the dentist would send
separate fees for temp. Crown, tissue prep, occlusal correction etc. instead of
charging one fee for the crown.

➢ Up Coding: If you treat tooth with one crown and you get the money for two crown this
is upcoding,
➢ Down Coding: is the reverse of upcoding, you treated two teeth, fixed two crowns but you
get the money for one only.
➢ Classical Conditioning:
• a neutral stimulus (one that is not associated with particular response) is paired
with an unconditioned stimulus, one that naturally elicits a particular response.
• Examples: Dentist gives a painful injection and patient experiences anxiety and
upset
➢ Classical Extinction:
• When unconditioned stimulus does not occur after the conditioned stimulus is
presented over time.
• Example:
➢ Operant Extinction:
• Reduction of some response by removal of reinforcers to decrease a behavior.
• Example:
➢ Operant Conditioning:
• A behavior is followed by particular consequences (reinforcement or punishment)
and as a result, the frequency of the behavior increases or decreases.
• 4 types: Positive reinforcement, Negative reinforcement, Positive punishment,
Negative punishment

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➢ Positive reinforcement:
• Occurs when an event or stimulus is presented as a consequence of a behavior and
the behavior increases.
• Example: A father gives candy to his daughter when she picks up her toys. If the
frequency of picking up the toys increases, the candy is a positive reinforcer (to
reinforce the behavior of cleaning up).

➢ Negative Reinforcement:
• Occurs when the rate of a behavior increases because an aversive event or
stimulus is removed or prevented from happening.
• Example: A person puts ointment on a bug bite to soothe an itch. If the ointment
works, the person will likely increase the usage of the ointment because it resulted
in removing the itch, which is the negative reinforcer.

➢ Positive Punishment:
• Occurs when a response produces a stimulus and that responses decreases in
probability in the future in similar circumstances.
• Example: A mother yells at a child when he or she runs into the street. If the child
stops running into the street, the yelling acts as positive punishment because the
mother presents (adds) an unpleasant stimulus in the form of yelling.

➢ Negative Punishment:
• Occurs when a response produces the removal of a stimulus and that response
decreases in probability in the future in similar circumstances.
• Example: A teenager comes home after curfew and the parents take away a
privilege, such as cell phone usage. If the frequency of the child coming home late
decreases, the removal of the phone is negative punishment because the parents
are taking away a pleasant stimulus (the phone) and motivating the child to return
home earlier.

Types of Stimulus Adding/Presenting Removing/Taking Away

Pleasant Stimulus Positive Reinforcement Negative Punishment

Aversive (unpleasant) Positive Punishment Negative Reinforcement

Stimulus

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➢ Systemic desensitization:
• Uses a hierarchy of slowly increasing the anxiety provoking stimuli like from
least anxiety provoking to most allowing the patient to use his coping skills.

➢ Flooding:
• An intense prolonged exposure to a feared stimulus at a time wherein the patient
uses coping skills to deal with the exposure.
• In simple language systemic desensitization is step by step increase stimulus And
In flooding, it is everything at a single step

➢ Social enforcement:

➢ Behavioral Shaping: An operant conditioning technique in which a new behavior is

produced by providing reinforcement for progressively closer to approximations of final
desired behavior, sometimes called Stimulus response theory.

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Questions

1. Through the bloodborne pathogen standard, the occupational safety and health
administration directs activity for each of the following except one. Which one is the
exception? a. Using barrier techniques
a) Using material safety data sheets
b) Obtaining hepatitis B vaccines
c) Communicating hazards to employees
d) Performing housekeeping
2. Stress and illness are often related. The best description of their relationship is which of the
following?
a) Stress is primary cause of illness
b) Illness is adaptation to stress
c) Stress is a psychological reaction
d) They often occur together but are casually unrelated
e) Stress is contributory to illness and illness is usually stressful
3. On the basis of diagnostic test results, a dentist classifies a group of patients as being free
from disease. These results possess high
a) Sensitivity
b) Specificity
c) Generalizability
d) Repeatability
4. In pursuit of what the dentist believes is best for the patient, the dentist attempts to control
patient behavior. This is known as
a) Autonomy
b) Competence
c) Maleficence
d) Paternalism
5. Most epidemiologic studies indicate that gingivitis in children is relatively common. A strong
positive association between specific nutritional deficiencies and the presence of periodontal
disease in children and adults has been demonstrated.
a) both r true
b) both r false
c) 1st true, 2nd false
d) 1st false, 2nd true
6. In assessing patient’s dental fears, the dentist should use each of the following factors
except one. Which one is the exception?
a) Verbal statements
b) Physiological responses
c) Behavior
d) Personality
7. HIPAA was designed to
a) ensure the security and privacy of health information
b) provide insurance coverage for providers
c) increase hospital testing ability

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d) encourage employees to stay in their jobs to retain insurance coverage

8. information about subjects in a study included their ethnicity. what level of measurement is
ethnicity?
a) ordinal
b) nominal
c) ratio
d) Interval
9. MOST APPROPRIATE TEST TO DETERMINE THE DIFFERENCES BETWEEN TWO MEANS?
a) CHI SQUARE TEST
b) T TEST
c) BOTH
10. A patient after extraction says, "Thank you”, that wasn’t as bad as I expected, but my sister
told me that the first night after having a tooth pulled is very painful. What if the medication u
gave me isn’t strong enough!?Choose the most appropriate answer.
a) Did she make you feel worried about that?
b) It sounds like you are worried that you might not have enough pain relief when you
are at home
c) I understand your concern
d) Do not worry I’ll give you plenty of pain medication
e) it sounds like your sister had an unusually bad experienced let other worry you,
you’ll be just fine.
11. The most important concept of C.E.A. Winslow’s definition of public health is:
a) To encourage mental and physical efficiency
b) Promotion through organized community effort
c) Individuals acting alone can solve any problem
d) The science and art of preventing disease

(C.E.A. Winslow, characterized public health practice as the science and art of DISEASE PREVENTION,
prolonging life, and promoting health and well-being THROUGH organized community effort.)

12. A moderately mentally challenged 5-year-old child becomes physically combative. The parents
are unable to calm the child. Which action should the dentist take?
a) Force the nitrous oxide nosepiece over the child’s mouth and nose.
b) Hand over mouth exercise (HOME).
c) Discuss the situation with the parents.
d) Firm voice control.
13. Which of the following is the principal nonverbal cue that two or more people can use to
regulate verbal communication?
a) eye contact
b) gentle touch
c) facial expressions
14. In an experiment comparing the effectiveness of new fluoride gel verses an older fluoride
gel, a null hypothesis is rejected when
a) a chi square is zero
b) a chi square is high

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c) a chi square is low

d) the experimental and control groups have similar results

(If you have higher chi-square, there is a high likely chance of your p-value being less than 0.05, so in
that case you reject your null hypothesis.)

15. On a prepayment basis, dental patients receive care at specified facilities from a limited
number of dentists. This practice plan is classified as which of the following?
a) Closed panel
b) Open panel
c) Group practice
d) Solo practice
16. Which of the following computer databases contain references to dental literature
electronically?
a) LEXIS
b) OVOID-MEDLINE
c) Dental Abstracts
d) Index to dental Literature
17. The measure of the quality of care provided in a particular setting is called:
a) Quality assurance (
b) Quality evaluation
c) Quality assessment
d) Quality inspection
18. Which of the following is a social enforcer for a child?
a) Dentist provides toothbrush kit
b) Allows child to watch his favorite tv show
c) Provide the child with stickers of his best cartoons
d) Patient on the back of the child's shoulder
19. Which is not a part of classical conditioning:
a) Acquisition
b) Equilibration
c) Discrimination
d) Generalization
e) Extinction
f) Spontaneous recovery
20. The following were the scores for six dental students in their restorative dentistry exam: 56,
64, 68,46, 82,86. Therefore the median is_____________
a) 68
b) 64
c) 67
d) 40
e) 66
21. Which of the following may be used to disinfect gutta percha points?
a) Glass bead
b) Autoclave
c) Chemical solutions (Sodium hypochlorite)

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d) Dry heat
22. Correlation analysis shows that as the income of population increases, the number of decayed
teeth decreases. Therefore, an expected value for this correlation coefficient (r) would be: T/F

23. Which federal agency protects the health of Americans and provides essential human
services?
a) NIH
b) HRSA
c) DHHS
d) AHRQ
e) None of the above
24. Which is the most important feature of systematic desensitization?
a) Muscle relaxation
b) Diaphragmatic breathing
c) Cognitive restructuring
d) Exposure
e) Education
25. Which statement is incorrect about behavior change?
a) Shaping is a behavior change strategy in which the patient learns though
demonstration.
b) The behavioral model consists of antecedents, behaviors, and consequences.
c) Goals are long-term targets, whereas objectives are reachable steps along the way.
d) Positive consequences will strengthen a behavior and negative consequences will
weaken it.
e) Consequences of today’s behavior will affect behavior tomorrow.
26. network model is often used in
a) D-IPA
b) D-HMO
c) D-PPO
27. If a dentist is stuck with a needle while treating an HIV-infected patient, which should he
perform?
a) Stop work and apply hypochlorite 1:10 to the finger for 5 minutes
b) Stop work, compress the affected area, and apply hypochlorite
c) Antiretroviral therapy
d) Stop work, compress the affected area, and wash with soap and water
28. The substitution of a relaxation response for an anxiety response using a relaxation strategy
such as diaphragmatic breathing when one is exposed to a feared stimulus is called?
a) Progressive muscle stimulation
b) Habituation
c) Flooding
d) Systematic desensitization
e) Biofeedback
29. When a patient expresses anger about a physician’s colleague, which of the following
statements would be the most appropriate response?
a) Why are you so aggravated over something so trivial?
b) Before I ask any questions, please calm down.

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c) What concerns do you have about how you were treated?

d) Why don’t we go talk to Dr. X about your anger?

30. A patient has difficulty inhibiting the gag reflex during x-ray procedures. The patient is asked
to take an x-ray packets home and practice holding the packet in his mouth for increasingly
longer periods. Which technique is being used?
a) Graded exposure
b) Modeling
c) Reinforcement
d) Behavioral control
e) Systematic desensitization
31. Which is not correct about stress?
a) Predictability-less predictability causes more stress.
b) Controllability - less controllability causes the more stress.
c) Familiarity-less familiarity causes more stress.
d) Positive situations are less stressful than negative situations.
e) Imminence-more imminent situations are more stressful.
32. The following component of a scientific article provides the reader with detailed information
regarding the study design: A. Introduction
a) Background
b) Literature review
c) Methods
d) Abstract
33. incidence of untreated coronal caries is higher in
a) Caucasians
b) African American
c) identical for both
34. A patient says that, “Even if there is some pain, it will be brief. I have effective methods of
coping.” The patient reminds himself of this during dental procedures. This patient’s
statement exemplifies which strategy?
a) Self-efficacy induction
b) Relaxation statement
c) Rational response
d) Imagery
e) Systematic desensitization
35. Ryan white care act provides dental care to HIV + / AIDS individual. They get their funds via
a) NIH
b) AHRO
c) HRSA
d) NIDCR
36. A student performs a complicated symphony, and he becomes less anxious each time he
performs. Which phenomenon is this?
a) Systematic desensitization
b) Habituation
c) Covert conditioning

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d) Cognitive restructuring
e) Psychoeducation

37. 5-year survival rate of oropharyngeal cancer is

a) 25%
b) 50%
c) 60%
d) 75%
38. OSHA standard for mercury is
a) 1mg per cubic meter for 8 hr work shifts
b) 0.1 mg cubic meter for 4 hr work shifts
c) 0.5 mg cubic meter for 8 hr work shifts
d) 0.05 mg cubic meter for 4 hr work shifts
39. Percentage of USA with Community water fluoridation
a) 40%
b) 60%
c) 75%
d) 80%
40. Prevalence of subgingival calculus in US ADULTS as suggested by surveys is
a) 0-0.25
b) 0.25-0.5
c) 0.5-0.75
d) 0.75-1.0
41. Percentage of DFS is more in
a) Caucasians
b) Hispanics
c) blacks
d) Asians
42. Outliers’ control
a) mean
b) median
c) mode
d) standard deviation
43. Contaminate sharps must be handled in such ways except for
a) The container must be labeled
b) The container has a metal case
c) The container has to be non-puncturable
d) The container must be closable.
44. Which is the acceptable CDC water quality in a dental office?
a) <250 CFU/mL
b) <500 CFU/mL
c) <125 CFU/mL
d) <700 CFU/mL

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45. Which is the best question to ask a slightly nervous child?

a) Are you worried about pain?
b) Are you nervous?
c) "Why can't you be quiet?"
d) "Can you tell me what is bothering you?" Are you worried about the needle?"
46. Test result which erroneously assigns an individual to a specific diagnostic or reference group,
due particularly to insufficiently exact methods of testing is known as:
a) A false negative test
b) A true negative test
c) A false positive test
d) A true positive test
47. Gi index –
a) ordinal
b) nominal
c) range
d) ratio
48. Which term listed below measures the proportion of those without disease who are correctly
identified by a negative test:
a) Specificity
b) Sensitivity
c) Reliability
49. A 38-year-old man is fearful of injections. First, you show him the syringe. You talk about the
characteristics of the needle. You then place the needle in his mouth with the cap on and
simulate the procedure with the cap on. You then simulate the procedure with the cap off.
Eventually, you proceed with the injection. What method is being used to reduce fever?
a) Cognitive control
b) Systematic desensitization
c) Habituation
d) Flooding
e) Behavior modification
50. if there is an article and if you want to understand the definition of Dependent and
independent, which part of the article you look:
a) Introduction
b) Method
c) Body
d) Result
e) Summary
(its introduction or background in which you describe your hypothesis definitions of dependent and
independent variables, innovations, specific aims... define variables in introduction, methods of variable
recording are in method section)

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51. Research showed to remove plaque from the resident’s teeth more effectively with
mechanical toothbrushes than with manual ones. What is the independent variable in this
study?
a) The gingival health of the residents
b) The amount of plaque present on the resident’s teeth
c) The type of toothbrush used
d) Time of day that brushing took place
e) How long teeth were brushed

52. 70 percent dentists become anxious with anxious dental patients. True /false

53. Obtaining informed consent hold true in each of the following cases except:
a) A conscious mentally competent patient.
b) A pregnant patient
c) In emergency cases
d) None of the above
54. Providing and explaining the informed consent to the patient in understandable terms is
considered a duty of:
a) The office receptionist
b) Dental assistant
c) Resident
d) Attending dentist
55. In the section of a scientific aritcle,the researcher interprets and explains the results obtained
in?
a) results
b) summary and conclusion
c) discussion
d) abstract
e) none of the above
56. HOME is an example of:
a) Positive reinforcement
b) Negative reinforcement
c) Positive punishment
d) Negative punishment
57. Restoring a carious tooth relieved the toothache in a patient which further motivated him to
perform better oral health care. This is a type of
a) Positive reinforcement
b) Negative reinforcement
c) Positive punishment
d) Negative punishment

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58. One of your patient is having a dental problem that is not under your capability and you are
referring that patient to a specialist, this type of behavior comes under which of the following
codes?
a) autonomy
b) beneficence
c) veracity
d) Non maleficence
59. what do we watch in a patient during dental dental treatment to find out if he's in pain??
a) saliva
b) hair
c) lips
d) eyes
e) eyebrows
60. Women have a lower survival rate of cancer of the lip. T/F

61. Dental waterline should be flushed at beginning of day for

a) 30 sec (Answer is quite not correct)
b) 45 sec
c) 60 sec
Beginning of the day: 2 minutes
During the day: 20-30 seconds

62. 1 L of 1 ppm of NaF contains how many G fluoride? Ans:0.5

63. what is the difference between flooding and systemic desensitization?

Ans. Systemic desensitization uses a hierarchy of slowly increasing the anxiety provoking stimuli
like from least anxiety provoking to most allowing the patient to use his coping skills.
In flooding there is an intense prolonged exposure to a feared stimulus at a time wherein the
patient uses coping skills to deal with the exposure.
In simple language systemic desensitization is step by step increase stimulus And In flooding,
it is everything at a single step

64. While extracting a maxillary molar, you lose a root down the maxillary sinus which cannot be
retracted at the moment. You do not inform the patient of the incident. Which code of ethical
principle did you break?
a) Beneficence
b) Non maleficence
c) Patient Autonomy
d) Veracity
e) Justice
65. Which will aid in the cognitive appraisal of a threat?
a) Adaptability, preventability, inevitability, and constancy
b) Controllability, familiarity, predictability, and imminence
c) Interference, adaptability, longevity, and reactance
d) Validity, reliability, adaptability, and predictability

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e) Accountability, reliability, validity, and familiarity

66. Which of the following are necessary for a test to be accurate?
a) specificity
b) reliability
c) validity
d) sensitivity
67. When patient have to pay from his out of pocket?
a) Deductible
b) Co pays
c) Third party payment
68. A dentist is doing research on 5 unrelated patients with different background. He records data
etc. dentist is doing what kind of research?
a) clinical trial
b) cohort
c) Cross sectional
69. how does parent of special needs child feel most of the time?
a) Hopeless
b) depressed
c) agitated
70. which of the following MOST accurately explains how biofeedback works?
a) it reduced cognitive dissonance
b) it stimulates the sympathetic nervous system
c) it relaxes and to some extent hypnotizes the patient
d) it distracts and engages the patient in an active coping task.
e) it enables the patient to gain control of certain physiological function

(Biofeedback therapy involves training patients to control physiological processes such as muscle
tension, blood pressure, or heart rate.
These processes usually occur involuntarily, however, patients who receive help from a biofeedback
therapist can learn how to completely manipulate them at will.
Biofeedback is typically used to treat chronic pain, urinary incontinence, high blood pressure, tension
headache, and migraine headache.)

71. According to ADA publication entitled principles of ethics and code of professional conduct, a
dentist can announce specialization in which of the following?
a) implantology
b) hospital dentistry
c) aesthetic dentistry
d) dental public health
e) geriatric dentistry
72. What does the Weight and height stand for in recordings?
a) Ratio
b) Ordinal
c) Nominal
d) Range

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73. where you can find dental literature online?

a) MEDLINE
b) lexis
c) Dental town
d) google
74. Which of the following exhibits the MOST personal behavior by the dentist?
a) leaning toward the patient
b) facing directly toward the patient
c) being seated 2 feet from the patient
d) touching the patient gently on the arm
75. which is the acronym for a patient management system?
a) recruit
b) success
c) optimum

76. persistent and repetitions questions asked by an 8-year-old patient during treatment are?
a) attempted to delay treatment
b) medication of hyperactivity
c) sign that child may be autistic
d) expression of the child curiosity about

77. incidence of coronal caries is higher in

a) Caucasian
b) African American
c) identical for both

➢ What is the prophylactic regimen for patients with prosthetic joints?

Ans. Antibiotic prophylaxis guidelines also have been developed for people who have
orthopedic implants such as artificial joints. In 2012, the ADA and American Association
of Orthopedic Surgeons updated the recommendations and no longer recommend
antibiotics for everyone with artificial joints. As a result, your healthcare provider may
rely more on your personal medical history to determine when antibiotics are appropriate
for people with orthopedic implants. For example, antibiotic prophylaxis might be useful
for patients who also have compromised immune systems (due to, for instance, diabetes,
rheumatoid arthritis, cancer, chemotherapy, and chronic steroid use), which increases the
risk of orthopedic implant infection.
➢ Do you any idea about minors, under 18, in this regard?
Ans. Under 18 can give implied consent but not actual consent… But under 18 can give
consent to their treatment if: they are living independently, are pregnant, married and an
emancipated minor can give consent for his/her child.
➢ Statute of limitations- can someone please explain?
Ans: Minimum 2 years of time from Malfunction incident by dentist to patient's sue
procedure…. time starts when dentists inform the patient about the incident.

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Mental Dental Questions

1. Which of the following ADA principles of Ethics states that a dentist has a duty to respect the
patient’s right to self-determination and confidentiality?
a) Patient Autonomy
b) Non-Maleficence
c) Privacy
d) Justice
e) Veracity
2. During an informal session of motivational interviewing, your patient says, “I don’t have time
to quit smoking.” What stage of behavior change is he or she in?
a) Precontemplation
b) Contemplation
c) Preparation
d) Action
e) Maintenance
3. Which section of a scientific article provides the reader with detailed information regarding
the study design?
a) Abstract
b) Background
c) Methods
d) Introduction
e) Discussion
4. Which of the following is an effective community prevention program?
a) Brushing twice a day
b) Flossing once a day
c) Regular dentals check up
d) School sealant program
e) Low sugar diet
5. Which method of sterilization is least likely to dull and corrode carbide instruments?
a) Glutaraldehyde
b) Steam heat
c) Dry heat
d) Ethylene oxide
6. What is an example of a conditioned stimulus for a dental patient that had a previous bad
experience?
a) Dental chair
b) High BP
c) Intrinsic fear
d) Anxiety of parent
7. Which of the following is not included in the ADA Code of Conduct?
a) Licensure by credentials
b) Advertising
c) Slander
d) Fees

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e) Patient care
8. Which technique is typically not useful in treating an anxious patient?
a) Using less structure in establishing rapport
b) Reassuring the patient by telling the patient not to worry
c) Providing reasons before asking for sensitive information
d) Using empathy
e) Making expectations clear
9. The variance for data set A is 21 and for data set B is 7. We can conclude that
a) There are more items in data set A than data set B
b) The mean of data set B is similar than the mean of data set B
c) The items in data set A are more widely spread about the mean value than the
items in data set B
d) The standard deviation for data set B is larger than the standard deviation for data
set A
e) None of above
10. Which of the following is an arrangement between a plan and a group of dentists whereby the
providers agree to accept certain payments (Usually less than their usual fees) in anticipation
of a higher volume of patients?
a) PPO
b) HMP
c) Capitation
d) Medicare
e) None of the above
11. Which of the following is a component of the OARS model?
a) Assertions
b) Appraisals
c) Affirmation
d) Absolutes
12. Fluoride supplementation for a 2-year-old child who lives in a nonfluorinated=ted community
can best be accomplished by initially prescribing
a) Fluoride tablets
b) Fluoride lozenges
c) Fluoride drops
d) Fluoride mouth rinse
e) Fluoride toothpaste
13. An amalgam restoration is considered
a) Primary prevention
b) Secondary prevention
c) Tertiary prevention
d) Unsafe

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14. Ryan is a young child who consistently presents as an anxious, hypervigilant, and upset during
dental visits. Ryan is often accompanied by his parents, who appears to very concerned about
the child and wants to be involved at all times in her evaluation and treatment. During this
visit, Ryan’s treatment requires an injection and rubber dam application, which strategy
would be least effective in completing the rubber dam application?
a) Tell-show-Do
b) Ask child to be helper
c) Structure time
d) Rehearsals
15. Ryan has a strong gag reflex during x-ray procedures. You suggest he take several x-ray
packets home and practice holding the packets in his mouth for increasingly longer periods of
time. Which of the following techniques does this best exemplify?
a) Social reinforcement
b) Systemic desensitization
c) Modeling
d) Guided imagery
e) Behavioral learning

Best of Luck to All