LEVEL 3

DIPLOMA IN DENTAL NURSING

Task Marking Guide and Record

Unit DN 13

Learner Name Alesea

TASK MARKING GUIDE AND RECORD - UNIT DN 13

PART 1

1. DN13 1.1
Below is the deciduous (primary) and permanent (secondary) dentitions. Explain and
label:
 The function of each tooth.
 The average age it erupts and how many roots and cusps it has.

Deciduous
1-Upper central incisor 8-12 month

2-Lateral incisor 9-13 month

3-Canine 16-22 month
4-Upper first molar 13-19 month
5-Upper second molar 25-33 month
10-Lower first incisor 6-10 month
9-Lower second incisor 10-16 month
8-Lower canine 17-23 month
7-Lower first molar 14-18 month
6-Lower second molar 23-31 month

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Permanent

Deciduous Upper Roots/Cusps Lower Roots/Cusps Function

Upper
central
incisor 1/- First incisor 1/- Biting

Upper lateral
Second
incisor 1/- 1/- Biting
Incisor
Grinding
Canine 1/- Canine 1/-
food
First molar 3/4 First molar 2/4 Chewing
Second Second
3/5 2/5 Chewing
molar molar
Permanent Upper Roots/Cusps Lower Roots/Cusps Function
Upper
Central Central Take bits
Incisor 1/- 1/-
incisor food

Lateral Lateral Take bits

1/- 1/-
incisor incisor food
Ripping and
Canine 1/- Canine 1/-
tearing
Chewing
First First
2/2 1/2 and
premolar premolar
Grinding
Chewing
Second Second
1/2 1/2 and
premolar premolar
Grinding
First molar 3 or more/4- First molar 2 or more/4- Chewing

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and
5 5
Grinding
Chewing
Second 3 or more/4- Second
2 or more/4 and
molar 5 molar
Grinding
Chewing
3 or more/4- 2 or more/4-
Third molar Third molar and
5 5
Grinding

2. DN13 1.2
Describe the function and structure of the mineralised tissues and supporting tissues of
the tooth.

Tooth is a composite of the three different biological mineralized tissues (dentin, enamel, and cementum)
that acquired supreme mechanical properties and function necessary for the mechanical digestion of the food
throughout life.

3. DN13 1.3
Describe the function of the salivary glands and ducts, research this and label each on
the diagram.

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Describe and name the muscles of mastication

A-Tongue
B-sublingual gland
C-parotid gland
D-parotid duct
E-submandibular duct
D-submandibular gland

The function of all the salivary glands is to produce the secretion saliva, which is
deposited from the glands into the oral cavity only - it occurs nowhere else in the body.
The saliva is transported to the oral cavity through tube-like structures called ducts, so
the salivary glands are classed as exocrine glands.

4. Label the following diagrams of the skull:

1.Frontal bone
2.Orbit
3.Zygomatic bone
4.Maxilla
5.Mental foramen
6.Nasal bone

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7. Zygomatic arch
8.Infraorbital foramen
9.Ramus of mandible
10.Angle of mandible

1.Frontal bone
2.Sphenoid
3.Nasal bone
4.Zygomatic arch
5.Coronoid process
6.Ramus of mandible
7.Angle of mandible
8.Body of mandible
9.Condyle
10.Parietal bone
11.Temporal bone
12.Occipital bone

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5. DN13 1.4
Label the diagram of the mandible, then describe the function of the mandible AND
maxilla.

1.Coronoid process
2.Mental foramen
3.Condyle
4.Sigmoid notch
5.Ramus
6.External oblique line
7.Angle
8.Body
9.Lingula
10.Mandibular foramen
11.Mylohyoid line

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The lower jaw (mandible) supports the bottom row of teeth and gives shape to the lower face and chin.
This is the bone that moves as the mouth opens and closes. The upper jaw (maxilla) holds the upper teeth,
shapes the middle of the face, and supports the nose.

6. DN13 1.5
Describe the movements of the temporo-mandibular joint.

The basic anatomical function of the mandible is to: 1) open and close;
2) protrusion and retru- sion; and
3) lateral deviation which are provided through two types of basic
movements. These movements are termed rotation and translation. Rotation
occurs in the lower portion of the joint.

7. DN13 1.6
Describe the nerves and their branches to the teeth and supporting structures.
o Ophthalmic division: sensory supply of the soft tissues around the eye and the upper
face.
o Maxillary division: sensory supply of the upper teeth, the maxilla and the middle area
of the face.
o Mandibular division: sensory supply of the lower teeth, the mandible and the lower
area of the face, and motor supply to the muscles of mastication and some of the
suprahyoids.

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PART 2

1. DN13 2.3, 2.4, 2.5 range 2ab

Describe the methods associated with the following and evaluate:
 Assessing and recording soft and hard tissue.
 Assessing and recording of periodontal conditions, include BPE and Perio charts
 Measuring pulp vitality.
1. A Hard Tissue Intraoral Exam is a complete cavity check, performed tooth by
tooth, and is recorded in a detailed tooth chart. The conditions of the teeth and
mouth are documented. The Dentist will check fracturelines, old fillings, broken
teeth, identify congentinally missing teeth, and keep on the lookout for deformed
teeth, or teeth with abnormal wear, which may or may not be caused by drifting
teeth. Another component of the Hard Tissue Intraoral Exam includes checking for
abnormal jaw bone growth.
The Hard Tissue Intraoral Exam is followed by a Soft Tissue Intraoral Exam to
maintain a more complete profile of your dental history.
The intraoral soft tissue examination includes checking the soft tissues of the
mouth, the throat, the tongue and the gums.
2. A periodontal examination should include a periodontal probing, a radiographic
analysis, a gingival index, mobility charting, and an evaluation of the amount of
attached gingiva. These clinical exercises require simple instrumentation and a
minimal amount of clinical calibration on the part of the examiner.
3. This involves applying cold stimuli to different areas of the mouth and
evaluating the immediacy, intensity and duration of the patient's response. The
patient will rate the intensity of the feeling on a 1 to 10 scale, while the dentist will
measure how quickly and for how long the feeling is present.

2. DN13 2.1, 2.2, 2.6 range 3ab

Oral assessment is a routine procedure performed in the dental surgery: Explain the
following:
a) The main purpose of an oral health assessment.
Regular oral health assessments give your dentist the opportunity to
halt any signs of gum disease, screen for mouth cancer and offer advice
on how to maintain and improve dental health. Routinely examining
your smile can identify problems early.

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b) The reasons for taking photographs and radiographs when diagnosing and
treatment planning.
 They help the clinician plan treatment (alongside other forms of record-taking, such as radiographs
and charting).They provide a baseline reference point for the patient’s mouth at the start of treatment.
Taking clinical photographs at different stages of treatment help us as dental professionals to
communicate with patients more effectively – visual aids are very useful when discussing findings and
progress. The photographs can be used as a medico-legal record. It is recommended that clinicians
keep photographic records of any procedures that could lead to litigation.

What materials are used during an oral health assessment and why. Include impressions
and articulating paper.
Articulating paper is commonly used by the dental community to identify contact points between the
maxillary and mandibular teeth during all forms of natural tooth occlusal adjustments and dental
prosthesis insertions.
Dental impressions are used to create models, or casts, of your mouth. These models show your dentist how
your dental arches fit together, as well as the size and relationship of your teeth and gums. Dental impressions
are used for a wide range of dental restorations and oral appliances, including: Dental crowns.
Probes- check your gum health by measuring gum recession.

Dental mirror- to
look at the hard to reach areas of your teeth and gums, which makes them
especially helpful during exams, fillings, and cleanings.

3. DN13 2.7
Explain the reasons why written informed consent must be obtained prior carrying out
treatment. Use the GDC 'Principles of Patient Consent' to help.

It is a general legal and ethical principle that you must get valid consent
before starting treatment or physical investigation, or providing personal
care, for a patient. This principle reflects the right of patients to decide what
happens to their own bodies, and is an essential part of good practice.

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PART 4

1. DN13 4.1 range 1a 5.1

Explain diseases of the oral mucosa, include both malignant and non malignant lesions.
How could we help prevent the occurrence of these and the methods we use to
diagnose them.

2. DN13 4.2
What effects can ageing have on the soft and hard tissues of the mouth?

As you age, your will teeth shift, your body loses bone mass, and your gums will recede. You may find
that your top teeth look shorter as they wear down, and your bottom teeth look taller as the gum tissue
recedes. Your bottom front teeth are more prone to shifting, so you may notice a lot of changes to your
smile.

Problems tasting, chewing, and swallowing. Mouth sores. Gum disease and
tooth decay. Yeast infection in the mouth (thrush).

3. DN13 4.3 range 2a-g LO5 range 1a-d

How can the following medical conditions affect the oral tissues?
1. Oral Cancer.
2. Herpes Simplex
3. HIV.
4. Hepatitis B.
5. Diabetes
6. Epilepsy.
7. Eating and digestive disorders.

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Oral cancer can present itself in many different ways, which could include: a lip or mouth sore that
doesn't heal, a white or reddish patch on the inside of your mouth, loose teeth, a growth or lump
1 inside your mouth, mouth pain, ear pain, and difficulty or pain while swallowing, opening your
mouth or chewing.

When the herpes are inside the mouth, it can cause damage to the soft
tissue of the gums. This can cause the teeth and gums to separate and
2 create gaps where bacteria can grow. This can lead to problems with
gum disease. Many people suffer from recurring bouts with the sores
related to oral herpes.
Some of the most common oral problems for people with HIV/AIDS are:
chronic dry mouth, gingivitis, bone loss around the teeth (periodontitis), canker
3 sores, oral warts, fever blisters, oral candidiasis (thrush), hairy
leukoplakia (which causes a rough, white patch on the tongue), and dental
caries.

Manifestations in the oral cavity include lichen planus, Sjögrens syndrome, and
sialadenitis, some forms of oral cancers may also be seen. Furthermore,
4
cirrhotic patients may have thrombocytopenia due to hypersplenism or
treatment with interferon.

With increased blood glucose levels, people living with diabetes may have more glucose in their
5 saliva and very dry mouths. These conditions allow dental plaque to build up on teeth, which
can lead to tooth decay and cavities.

Seizure medications can affect your oral health. Many drugs that help control seizures
6 also increase the risk of periodontal disease, tooth decay, and oral infections such as thrush.
Dilantin is a common drug used to treat certain forms of epilepsy.

Some of the most common diseases that impact our oral health include cavities (tooth decay),
7 gum (periodontal) disease, and oral cancer.

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PART 5

1. DN13 5.3, 5.4 range 2a-d

Complete the following table:

Drug Examples Use in dentistry

a group of drugs that
include aspirin, acetaminophen
(commercial name Tylenol), and
ibuprofen (commercial names
hydrocodone, codeine,
Analgesics Motrin, Advil, and Medipren) and
oxycodone, and tramadol
are used as painkillers. Aspirin
and ibuprofen are also known as
nonsteroidal anti-inflammatory
drugs (NSAID).
The main types of antibiotics
include: Penicillins - for
example, phenoxymethylpenicilli Antibiotics are generally used
n, flucloxacillin and amoxicillin. in dental procedures to
treat odontogenic infections,
Antibiotics Cephalosporins - for example,
nonodontogenic infections,
cefaclor, cefadroxil and cefalexin. local infection, focal infection,
Tetracyclines - for example, and prophylaxis.
tetracycline, doxycycline and
lymecycline.
There are two main types of
sedative-hypnotics –
benzodiazepines and Z-drugs.
Common benzodiazepines
include Xanax (alprazolam),
Tranquilizer
Librium (chlordiazepoxide), zaleplon and lorazepa
s-Hypnotics
Valium (diazepam), and Ativan
(lorazepam). Common Z-drugs
include Ambien (zolpidem),
Lunesta (eszopiclone), and Sonata
(zaleplon)

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Emergency Oxygen, epinephrine, nitroglycerin,

drugs Diphenhydramine, salbutamol,
aspirin,glucose.  adrenaline/
epinephrine injection,
adrenaline 1 in 1000,
(adrenaline 1 mg/mL
as acid tartrate), 1 mL
amps

 aspirin dispersible
tablets 300 mg

 glucagon injection,
glucagon (as
hydrochloride), 1 -
unit vial (with solvent)

 glucose (for
administration by
mouth)

 glyceryl trinitrate
spray

 midazolam
oromucosal solution

 medical oxygen

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 salbutamol aerosol
inhalation, salbutamol
100 micrograms/mete
red inhalation.

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2. DN13 5.2 range 1bcefg

Describe the diagnosis and management of the following disorders:- think about the
oral mucosa, soft tissues, facial pain and facial bones and joints.
a) Lichen planus
b) Oral Candidiasis
c) Glossitis
d) Osteoporosis
e) Salivary gland disorders

-Your doctor or dentist may diagnose lichen planus, based on the changes on your skin or in your
mouth. To make sure of the diagnosis, your doctor will perform a biopsy. He or she will remove
mouth mucosa, or a small piece of skin, and send it to be examined it under a microscope
a
-Corticosteroids may reduce inflammation related to oral lichen planus. One of these forms
may be recommended: Topical. Mouthwash, ointment or gel is applied directly to the mucous
membrane — the preferred method
-Healthcare providers can usually diagnose candidiasis in the mouth or throat simply by looking
inside. Sometimes a healthcare provider will take a small sample from the mouth or throat. The
sample is sent to a laboratory for testing, usually to be examined under a microscope
-Candidiasis in the mouth, throat, or esophagus is usually treated with antifungal
b medicine. The treatment for mild to moderate infections in the mouth or throat is
usually an antifungal medicine applied to the inside of the mouth for 7 to 14 days.
These medications include clotrimazole, miconazole, or nystatin

-Your dentist or health care provider will do an exam to look for: Finger-like bumps on the
surface of the tongue (called papillae) that may be missing. Swollen tongue (or patches of swelling
c -Most causes of glossitis are self-limiting and require no treatment. Symptomatic relief is
possible with good oral hygiene and mouth rinses (various formulations of "magic mouthwash"
contain corticosteroids and lidocaine that can soothe acute exacerbations of migratory glossitis)

-Your dentist may recognize the early stages of osteoporosis. Your dentist may be the first
health professional to suspect you have osteoporosis. This bone disease can weaken bones by
d reducing their density and is most common in women over age 50
-Bisphosphonates are usually the first choice for osteoporosis treatment. These include:
Alendronate (Fosamax), a weekly pill. Risedronate (Actonel), a weekly or monthly pill

e -Dry mouth, tooth decay, mouth sores, enlarged salivary glands, sialoliths and recurrent
salivary gland infections are possible symptoms. The syndrome also effects moisture in the eyes,
which might cause chronic eye infections, corneal ulcers and vision loss
 -For dry mouth, good dental hygiene and sometimes drugs.
 For stones, pain relievers, fluids, physical measures, or sometimes removal.
 For infection, antibiotics and physical measures.
 For swelling, various treatments, possibly including surgery.

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PART 6

1. DN13 6.1, 6.2 range 1a-g

What action would you take in the following medical emergencies?

Position the person on his or her back.

Fainting Loosen belts, collars or other constrictive clothing. To reduce the chance of fainting
again, don't get the person up too quickly. If the person doesn't regain consciousness
within one minute, call 911 or your local emergency number

Treatment options for diabetic coma include: ketoacidotic coma – intravenous fluids,
Diabetic
insulin and administration of potassium. hyperosmolar coma – intravenous fluids,
Coma insulin, potassium and sodium given as soon as possible

The Asthma Action Plan (AAP) lists all medications with instructions on when they
Asthma should be taken. It is a simple plan that describes how to achieve long-term control and
what to do when asthma symptoms arises

Angina
o -Make the patient rest
o Help the patient sit reclined, with the body leaned back at about 45
degrees, with feet on the floor, but knees raised - this puts the
patient in a 'W' position.
o If already diagnosed will have own medication so help them take it -
Angina/ Glyceryl Trinitrate spray under the tongue. Same spray should be in
Myocardial emergency kit.
infarction • Better to use an adrenaline free local anaesthetic.
Adrenalin will make the heart beat faster adding to the stress.
-Myocardial infection
Recurrent chest discomfort thought to be caused by myocardial ischemia should be
treated with intravenous nitroglycerin, analgesics, and antithrombotic medications
(aspirin, heparin). Coronary angiography with subsequent revascularization therapy
should be considered

The two emergency medications used to prevent status in the community (outside of the
Epileptic
hospital setting) are midazolam and diazepam: Buccal (oromucosal) midazolam – is
seizure given into the buccal cavity (the side of the mouth between the cheek and the gum).

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Open the patient's airway and provide positive pressure ventilation with a bag-
Respirator
valve-mask device. In most cases, unless the patient has a neck or spinal cord injury, you
y arrest can open the airway using the head-tilt chin-lift method

Cardiac Call 999 and start CPR/ Use Defibrillator.

arrest

Question 1 of range questions

DN13 LO2 range 1a-h

Explain the following methods of clinical assessment,
a) use of dental probes and mouth mirrors
b) Palmer notation/FDI charting
c) visual and manual inspection
d) dyes
e) transillumination
f) vitality testing
g) study models
h) radiographs
i) and photographs.

a) Mouth mirrors are in the dental armamentarium with a range of uses from reflecting light to
retraction of tissues. Areas of the mouth that are difficult to light need a mouth mirror to
reflect light onto the surfaces. Mirrors help prevent injury during tongue and cheek retraction.
Dental probing is done by using a tool called a dental “probe” to measure the depth of a
tooth's pocket. The probe acts like a ruler, and has markings along its side measured out in
millimeters.
b) Palmer notation is a system used by dentists to associate information to a specific tooth.
Although supposedly superseded by the FDI World Dental Federation notation, it
overwhelming continues to be the preferred method used by dental students and practitioners
in the United Kingdom.

c) Inspection (looking at the body). Visual inspection presents good accuracy

in the detection of carious lesions in primary and permanent teeth, with a
trend for higher specificity than sensitivity. Importantly, the use of detailed
and validated methods improves the accuracy of visual inspection for
caries.

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d) The term dye refers to compounds which can impart color to a substrate when applied in solution from either
aqueous or organic solvents. The substrates include textiles, plastics, polymers, etc. Both the applications to
materials and color constitutions of dyes involve essentially chemical principles.
e) Transillumination is the shining of a light through a body area or organ to check for abnormalities. The
doctor will dim the lights and use a bright light directed towards a specific body part to see what's underneath
the skin.
f) The most common type of vitality test is thermal testing. In this process, your dentist will place a cold
stimulus on the affected tooth as well as other areas of the mouth. They will monitor the reaction time and the
intensity of the sensation. A slower speed or less feeling from the stimulus may signify a dead tooth.
g) Study models provide information about your patient's teeth and occlusion. They are an essential diagnostic
aid when planning cosmetic dentistry, oral surgery, and orthodontics. Study models provide vital information
about your patient's teeth and occlusion.
h) A dental radiograph gives your dentist a picture. of your hard tissues (teeth and bones) and the. soft tissues
that surround your teeth and jaw- bones.
i) The clinical uses of photography for dental students include treatment planning, documentation of the
treatment, follow-up, self-evaluation, and referrals to specialists or tutors for a case discussion.

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References used: Please list all references/ resources used:

1. Goregen M, Miloglu O, Buyukkurt MC, Caglayan F, Aktas AE. Median

rhomboid glossitis: a clinical and microbiological study
Beal Jf. social factors and preventive dentistry. In: Murray JJ, editor. The
2.
prevention of oral
disease. Oxford: Oxford University Press; 1996. p.216-233

3. Hobson P. sugar-based medicines and dental disease. community Dent Health

1985
Koch G, Arneberg P, Thylstrup A. Oral hygiene and dental caries. In: Thylstrup A,
4.
fejerskov

5. Hausen H. caries prediction – state of the art. community Dent Oral epidemiol
1997
Zachrisson BU, Zachrisson s. caries incidence and oral hygiene during orthodontic
6.
treatment.
scand J Dent Res 1971

Name: Alesea

Date: 5/04

I confirm that this is my own work:

Signature Alesea

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Please ensure that you have checked your spelling and grammar prior to
submitting.
Please ensure all evidence is signed and dated by yourself to confirm authenticity
of your evidence.

Kindly Reminder: Ensure your evidence is not plagiarised.

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