Additional Information
Book Details
Abstract
Focusing on the core clinical skills and knowledge necessary to become a practicing dental assistant, Essentials of Dental Assisting, 6th Edition, is the perfect resource to help you succeed in this fast-paced program. Fully updated to include the latest procedures and trends, this practice resource has been specifically designed and written to help you easily grasp the most important information. Plus, with its vivid step-by-step procedures, practical application exercises, learning aids, and built-in study tools, you’ll have the everything you need to master the essential skills and start a successful and rewarding career as a dental assistant!
- Focus on Clinical Dental Assisting provides essential information on core skills and procedures.
- Cutting-edge content and approachable writing style ensure that you learn to perform the most up-to-date practices.
- Easy-to-follow organization offers 29 succinct chapters that move from profession basics and sciences to infection control, chair-side treatment foundations, and patient care in general and specific dentistry.
- Step-by-step procedures of skills dental assistants must master feature a consistent format that includes a goal, equipment, chronological steps, and rationales, supplemented liberally with photos to einforce explanations and icons to identify key issues.
- Exam practice includes review questions at the end of each chapter and a practice exam online to help you test your understanding of chapter content and prepare for classroom and board exams.
- Apply Your Knowledge boxes encourage you to assimilate the chapter content and apply it to common situations in the practice setting.
- Ethical Implications at the end of each chapter’s narrative encourage students to focus on the legal and ethical behaviors they will need to practice to protect themselves, their patients, and the practices for which they work.
- Key terminology begins each chapter and is highlighted within text discussions.
- Learning objectives help you set goals for accomplishment and also serve as checkpoints for comprehension.
- NEW! Updated chapter discussions provide additional information on dynamic areas such as the electronic health record, impact of the Affordable Care Act (ACA), preventive techniques, and the new hazard communication standard.
- NEW! Revised photos and illustrations feature more modern illustrations and newer products and equipment.
- NEW! 10 new and 20 revised video clips feature significant changes in the dental imaging and dental materials sections of the comprehensive video collection – now with 70 video clips in total.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Essentials of Dental Assisting | i | ||
| Copyright Page | ii | ||
| About the Authors | iii | ||
| Preface | iv | ||
| The Learning Package | iv | ||
| Textbook | iv | ||
| Evolve Resources | v | ||
| Student Resources | v | ||
| Videos | v | ||
| Instructor Resources | v | ||
| TEACH Instructor Resources | v | ||
| Student Workbook | v | ||
| Acknowledgments | v | ||
| How to Use Essentials of Dental Assisting | vi | ||
| Icon Key | vii | ||
| Table Of Contents | viii | ||
| One The Profession | 1 | ||
| Chapter1 Introduction to Dental Assisting | 1 | ||
| Learning Objectives | 1 | ||
| Key Terms | 1 | ||
| History of Dentistry | 1 | ||
| African Americans in Dental History | 2 | ||
| Native Americans in Dental History | 3 | ||
| Members of the Dental Health Care Team | 4 | ||
| Dentist | 4 | ||
| Dental Specialists | 4 | ||
| Registered Dental Hygienist | 6 | ||
| Dental Assistant | 6 | ||
| Chairside Dental Assistant | 7 | ||
| Sterilization Assistant | 7 | ||
| State-Specific Categories | 7 | ||
| Business Assistant | 7 | ||
| Dental Laboratory Technician | 8 | ||
| Overview of the Dental Office | 8 | ||
| Reception Area | 9 | ||
| Business Office | 9 | ||
| Nonclinical Areas | 9 | ||
| Instrument-Processing Area | 9 | ||
| Dental Laboratory | 9 | ||
| Treatment Rooms | 10 | ||
| Chapter Exercises | 10 | ||
| Multiple Choice | 10 | ||
| Apply Your Knowledge | 10 | ||
| Chapter2 Professional and Legal Aspects of Dental Assisting | 11 | ||
| Learning Objectives | 11 | ||
| Key Terms | 11 | ||
| Characteristics of a Professional Dental Assistant | 11 | ||
| Professional Appearance | 12 | ||
| Teamwork | 12 | ||
| Attitude | 12 | ||
| Dedication | 12 | ||
| Responsibility and Initiative | 12 | ||
| Confidentiality | 13 | ||
| Personal Qualities | 13 | ||
| Ethics and Law | 13 | ||
| Difference Between Ethics and Law | 13 | ||
| Types of Law | 13 | ||
| Legal Aspects of Dentistry | 13 | ||
| State Dental Practice Act | 14 | ||
| State Board of Dentistry | 14 | ||
| Licensure | 14 | ||
| Levels of Dental Auxiliary Supervision | 15 | ||
| Unlicensed Practice of Dentistry | 15 | ||
| Credentialing of Dental Assistants | 15 | ||
| Certified Dental Assistants | 15 | ||
| Registered Dental Assistant | 15 | ||
| Risk Management | 15 | ||
| Avoiding Malpractice Lawsuits | 16 | ||
| “Silence Is Golden” | 16 | ||
| Guidelines for Informed Consent | 16 | ||
| Informed Patient Consent | 16 | ||
| Informed Refusal | 16 | ||
| Informed Consent for Minors | 16 | ||
| Documenting Informed Consent | 16 | ||
| Patient Records | 17 | ||
| Ownership of Dental Records and Radiographs | 17 | ||
| Reporting Child Abuse and Neglect | 17 | ||
| Immunity | 17 | ||
| Regulatory and Professional Organizations | 17 | ||
| Chapter Exercises | 19 | ||
| Multiple Choice | 19 | ||
| Apply Your Knowledge | 19 | ||
| Two The Sciences | 20 | ||
| Chapter3 Anatomy and Physiology | 20 | ||
| Learning Objectives | 20 | ||
| Key Terms | 20 | ||
| Directions and Body Planes | 20 | ||
| Directions in the Body | 20 | ||
| Planes and Sections of the Body | 20 | ||
| Organizational Levels of the Body | 21 | ||
| Cells | 21 | ||
| Tissues | 21 | ||
| Organs | 22 | ||
| Body Systems | 22 | ||
| Systems of the Body | 22 | ||
| Digestive System | 22 | ||
| Nervous System | 22 | ||
| Cardiovascular System | 23 | ||
| Endocrine System | 23 | ||
| Respiratory System | 23 | ||
| Lymphatic System | 24 | ||
| Muscular System | 24 | ||
| Types of Muscle | 24 | ||
| Skeletal System | 24 | ||
| Urinary System | 24 | ||
| Integumentary or Skin System | 24 | ||
| Reproductive System | 24 | ||
| Structures of the Head and Neck | 24 | ||
| Types of Bone | 25 | ||
| Anatomy of the Skull | 25 | ||
| Paranasal Sinuses | 25 | ||
| Temporomandibular Joint | 25 | ||
| Capsular Ligament | 25 | ||
| Articular Space | 28 | ||
| Movements of the Temporomandibular Joint | 28 | ||
| Hinge Action | 28 | ||
| Gliding Action | 28 | ||
| Major Muscles of Mastication and Facial Expression | 30 | ||
| Blood Supply to the Face and Mouth | 30 | ||
| Lymph Nodes | 30 | ||
| Nerve Supply to the Mouth | 30 | ||
| Maxillary Innervation | 31 | ||
| Mandibular Innervation | 33 | ||
| Structures of the Face and Oral Cavity | 34 | ||
| Landmarks of the Face | 34 | ||
| Regions of the Face | 34 | ||
| Features of the Face | 34 | ||
| Oral Cavity | 34 | ||
| Tongue | 35 | ||
| Frenum | 36 | ||
| Salivary Glands | 36 | ||
| Hard and Soft Palates | 36 | ||
| Gag Reflex | 36 | ||
| Alveolar Process | 37 | ||
| Cortical Plate | 37 | ||
| The Alveolar Crest | 37 | ||
| Alveolar Socket | 37 | ||
| Oral Mucosa | 37 | ||
| Gingivae | 37 | ||
| Epithelial Attachment | 37 | ||
| Free Gingivae | 38 | ||
| Teeth | 38 | ||
| Chapter Exercises | 40 | ||
| Multiple Choice | 40 | ||
| Apply Your Knowledge | 40 | ||
| Chapter4 Dental Anatomy | 41 | ||
| Learning Objectives | 41 | ||
| Key Terms | 41 | ||
| Anatomic Parts of the Tooth | 41 | ||
| Crown | 41 | ||
| Anatomic Crown | 41 | ||
| Clinical Crown | 41 | ||
| Root | 42 | ||
| Cervix | 42 | ||
| Tissues of the Tooth | 42 | ||
| Enamel | 42 | ||
| Dentin | 43 | ||
| Structure of Dentin | 43 | ||
| Pulp | 43 | ||
| Structure of the Pulp | 43 | ||
| Cementum | 43 | ||
| Periodontium | 43 | ||
| Periodontal Ligament | 43 | ||
| Types of Teeth | 44 | ||
| Dental Arches | 44 | ||
| Quadrants and Sextants | 44 | ||
| Quadrants | 44 | ||
| Sextants | 44 | ||
| Anterior and Posterior Teeth | 45 | ||
| Tooth Surfaces | 45 | ||
| Anatomic Features of the Teeth | 45 | ||
| Contours | 45 | ||
| Facial and Lingual Contours | 46 | ||
| Contacts | 47 | ||
| Embrasures | 47 | ||
| Occlusion | 48 | ||
| Dentition | 48 | ||
| Primary Dentition | 48 | ||
| Mixed Dentition | 49 | ||
| Permanent Dentition | 49 | ||
| Tooth Numbering Systems | 49 | ||
| Universal National System | 49 | ||
| International Standards Organization System | 51 | ||
| Palmer Notation System | 51 | ||
| Tooth Diagrams | 52 | ||
| Chapter Exercises | 53 | ||
| Multiple Choice | 53 | ||
| Apply Your Knowledge | 53 | ||
| Three Infection Prevention and Hazardous Materials | 54 | ||
| Chapter5 Disease Transmission | 54 | ||
| Learning Objectives | 54 | ||
| Key Terms | 54 | ||
| Pathogens | 54 | ||
| Bacteria | 54 | ||
| Spores | 55 | ||
| Viruses | 55 | ||
| Latency | 55 | ||
| Treatment of Viral Diseases | 56 | ||
| Fungi | 56 | ||
| Chain of Infection | 56 | ||
| Types of Infections | 57 | ||
| Acute Infection | 57 | ||
| Chronic Infection | 57 | ||
| Latent Infection | 57 | ||
| Opportunistic Infection | 57 | ||
| Modes of Disease Transmission | 57 | ||
| Direct Transmission | 58 | ||
| Indirect Transmission | 58 | ||
| Splash or Spatter | 58 | ||
| Airborne Transmission | 58 | ||
| Parenteral Transmission | 59 | ||
| Bloodborne Transmission | 59 | ||
| Food and Water Transmission | 59 | ||
| Fecal-Oral Transmission | 59 | ||
| Transient Bacteremia | 59 | ||
| Viral Diseases of Major Concern to Dental Health Care Workers | 59 | ||
| Viral Hepatitis | 59 | ||
| Hepatitis A | 59 | ||
| Hepatitis B | 60 | ||
| Hepatitis B immunization | 60 | ||
| Hepatitis C | 60 | ||
| Hepatitis D | 60 | ||
| Hepatitis E | 60 | ||
| Human Immunodeficiency Virus | 60 | ||
| Routes of Human Immunodeficiency Virus Transmission | 60 | ||
| Herpesviruses | 60 | ||
| Herpes Simplex Virus Type 1 | 61 | ||
| Primary Herpes | 61 | ||
| Recurrent Herpes Labialis | 61 | ||
| Herpes Simplex Virus Type 2 | 61 | ||
| Herpes Zoster Virus | 61 | ||
| Cytomegalovirus | 62 | ||
| Epstein-Barr Virus | 62 | ||
| Herpes Transmission | 62 | ||
| Measles | 62 | ||
| Bacterial Diseases of Major Concern to Dental Health Care Workers | 62 | ||
| Tuberculosis | 62 | ||
| Transmission of Tuberculosis | 63 | ||
| Infection with active disease | 63 | ||
| Infection without active disease | 63 | ||
| Legionnaires’ Disease | 63 | ||
| Tetanus | 63 | ||
| Syphilis | 63 | ||
| Chapter Exercises | 64 | ||
| Multiple Choice | 64 | ||
| Apply Your Knowledge | 64 | ||
| Chapter6 Infection Control and Management of Hazardous Materials | 65 | ||
| Learning Objectives | 65 | ||
| Key Terms | 65 | ||
| Roles and Responsibilities of the CDC and OSHA | 66 | ||
| OSHA’s Bloodborne Pathogens Standard | 66 | ||
| Exposure Control Plan | 66 | ||
| Standard and Universal Precautions | 66 | ||
| Categories of Employees | 67 | ||
| Employee Training | 67 | ||
| Hepatitis B Immunization | 67 | ||
| Need for an HBV Booster Vaccine | 68 | ||
| Employee Medical Records | 68 | ||
| Managing Contaminated Sharps | 68 | ||
| Preventing Needlesticks | 68 | ||
| Postexposure Management | 68 | ||
| Handwashing and Hand Care | 69 | ||
| Handwashing | 69 | ||
| Alcohol-Based Hand Rubs | 69 | ||
| Hand-Hygiene Recommendations | 70 | ||
| Lotions | 70 | ||
| Personal Protective Equipment | 70 | ||
| Protective Clothing | 70 | ||
| Protective Clothing Requirements | 71 | ||
| Handling Contaminated Laundry | 71 | ||
| Protective Masks | 71 | ||
| Protective Eyewear | 71 | ||
| Face Shields | 71 | ||
| Patient Eyewear | 72 | ||
| Gloves | 73 | ||
| Examination Gloves | 73 | ||
| Gloves Damaged during Treatment | 73 | ||
| Overgloves | 74 | ||
| Sterile Surgical Gloves | 74 | ||
| Utility Gloves | 74 | ||
| Non–Latex-Containing Gloves | 74 | ||
| Medical Waste Management | 74 | ||
| Classifications of Waste | 74 | ||
| OSHA’s Hazard Communication Standard | 75 | ||
| Revision of the Hazard Communication Standard | 75 | ||
| Written Program | 76 | ||
| Chemical Inventory | 76 | ||
| Safety Data Sheet | 76 | ||
| Labeling | 76 | ||
| Hazard Classification | 76 | ||
| Employee Training | 76 | ||
| Exemptions to Labeling Requirements | 77 | ||
| Chapter Exercises | 86 | ||
| Multiple Choice | 86 | ||
| Apply Your Knowledge | 86 | ||
| Chapter7 Surface Disinfection and Treatment Room Preparation | 87 | ||
| Learning Objectives | 87 | ||
| Key Terms | 87 | ||
| Surface Barriers | 87 | ||
| Types of Surface Barriers | 87 | ||
| Precleaning and Disinfection | 88 | ||
| Precleaning | 89 | ||
| Disinfection | 89 | ||
| Levels of Disinfectants | 89 | ||
| Characteristics of Disinfectants | 89 | ||
| Types of Chemical Disinfectants | 90 | ||
| Iodophors | 90 | ||
| Synthetic phenol compounds | 90 | ||
| Sodium hypochlorite | 90 | ||
| Alcohol | 91 | ||
| Liquid chemical sterilants and high-level disinfectants | 91 | ||
| Glutaraldehyde | 92 | ||
| Chlorine dioxide | 92 | ||
| Ortho-phthalaldehyde | 92 | ||
| Classifications of Instruments, Equipment, and Surfaces | 92 | ||
| Critical Instruments | 92 | ||
| Semicritical Instruments | 92 | ||
| Noncritical Instruments | 92 | ||
| Additional Aseptic Techniques | 93 | ||
| Unnecessary Touching of Surfaces | 93 | ||
| High-Volume Evacuation | 93 | ||
| Rubber Dam | 93 | ||
| Preprocedure Mouth Rinse | 93 | ||
| Use of Disposables | 93 | ||
| Dental Unit Water Line Contamination | 93 | ||
| Cleaning and Disinfection of the Laboratory Area | 94 | ||
| Impressions | 94 | ||
| Disinfection of Casts | 95 | ||
| Disinfection of Other Materials | 95 | ||
| Cleaning and Disinfecting the Radiology Area | 95 | ||
| Chapter Exercises | 98 | ||
| Multiple Choice | 98 | ||
| Apply Your Knowledge | 98 | ||
| Chapter8 Instrument Processing | 99 | ||
| Learning Objectives | 99 | ||
| Key Terms | 99 | ||
| Sterilization Center | 99 | ||
| Workflow Pattern | 101 | ||
| Contaminated Area | 101 | ||
| Holding Solution | 101 | ||
| Clean Area | 101 | ||
| Precleaning and Packaging Instruments | 102 | ||
| Hand Scrubbing | 102 | ||
| Ultrasonic Cleaning | 102 | ||
| Care of the Ultrasonic Cleaner | 103 | ||
| Testing the Ultrasonic Cleaner | 103 | ||
| Automated Washers and Disinfectors | 103 | ||
| Drying, Lubrication, and Corrosion Control | 104 | ||
| Packaging Instruments | 104 | ||
| Packaging Materials | 104 | ||
| Reusing Wraps | 105 | ||
| Methods of Sterilization | 105 | ||
| Autoclaving | 105 | ||
| Operation Cycles | 106 | ||
| Flash Sterilization | 106 | ||
| Chemical Vapor Sterilization | 106 | ||
| Advantages | 107 | ||
| Disadvantages | 107 | ||
| Packaging | 107 | ||
| Pressure, Temperature, and Time | 107 | ||
| Dry Heat Sterilization | 107 | ||
| Static Air Sterilizers | 107 | ||
| Forced Air Sterilizers | 107 | ||
| Chemical Liquid Sterilization | 107 | ||
| Sterilization Monitoring | 107 | ||
| Physical Monitoring | 107 | ||
| Chemical Monitoring | 108 | ||
| Process Indicators | 108 | ||
| Process Integrators | 108 | ||
| Limitations | 108 | ||
| Biologic Monitoring | 108 | ||
| Sterilization Failures | 109 | ||
| Chapter Exercises | 115 | ||
| Multiple Choice | 115 | ||
| Apply Your Knowledge | 115 | ||
| Four Dental Treatment | 116 | ||
| Chapter9 Clinical Dentistry | 116 | ||
| Learning Objectives | 116 | ||
| Key Terms | 116 | ||
| Clinical Area | 116 | ||
| Dental Treatment Area Equipment | 116 | ||
| Care of Dental Equipment | 116 | ||
| Standard Procedure Routine | 116 | ||
| Admitting the Patient | 117 | ||
| Positioning the Patient | 117 | ||
| Positioning the Dental Team | 117 | ||
| Criteria for Proper Positioning of the Seated Operator (Figure 9-5) | 120 | ||
| Criteria for Proper Positioning of the Clinical Assistant (Figure 9-6) | 121 | ||
| Team Dentistry | 121 | ||
| Instrument Transfer | 121 | ||
| Basic Principles of Instrument Transfer | 121 | ||
| Clinical Assistant’s Transfer Technique | 121 | ||
| Operator’s Grasp in Receiving an Instrument | 121 | ||
| Variations of Instrument Exchange | 121 | ||
| Mirror and Explorer | 121 | ||
| Hinged Instruments | 122 | ||
| Cotton Pliers | 122 | ||
| Transfer of Dental Materials | 124 | ||
| Expanded Functions for the Dental Assistant | 124 | ||
| Types of Expanded Functions | 124 | ||
| Chapter Exercises | 127 | ||
| Multiple Choice | 127 | ||
| Apply Your Knowledge | 127 | ||
| Chapter10 Moisture Control | 128 | ||
| Learning Objectives | 128 | ||
| Key Terms | 128 | ||
| Mouth Rinsing | 128 | ||
| Oral Evacuation Methods | 128 | ||
| Saliva Ejector | 128 | ||
| High-Volume Oral Evacuation | 128 | ||
| HVE Tips | 129 | ||
| Holding the Oral Evacuator | 129 | ||
| Oral Evacuation Caution | 130 | ||
| Isolation Techniques | 130 | ||
| Cotton Rolls | 130 | ||
| Cotton Roll Placement | 130 | ||
| Related Aids | 131 | ||
| Dry Angles | 131 | ||
| Dental Dam | 131 | ||
| Dental Dam Equipment | 132 | ||
| Preparation of the Dental Dam Application | 132 | ||
| Maxillary Arch Applications | 132 | ||
| Mandibular Arch Applications | 132 | ||
| Curve of the Arch | 132 | ||
| Malaligned Teeth | 132 | ||
| Teeth to be Isolated | 132 | ||
| Key-Punch Hole | 132 | ||
| Hole Size and Spacing | 135 | ||
| Chapter Exercises | 141 | ||
| Multiple Choice | 141 | ||
| Apply Your Knowledge | 141 | ||
| Five Patient Care | 142 | ||
| Chapter11 The Dental Patient | 142 | ||
| Learning Objectives | 142 | ||
| Key Terms | 142 | ||
| Patient Record | 143 | ||
| Patient Registration | 143 | ||
| Clinical Information | 143 | ||
| Medical History | 143 | ||
| Medication History | 143 | ||
| Allergies | 143 | ||
| Medical Alert | 143 | ||
| Dental History | 147 | ||
| Privacy Policy of the Health Insurance Portability and Accountability Act | 147 | ||
| Clinical Examination | 148 | ||
| Treatment Plan | 148 | ||
| Progress Notes | 148 | ||
| Vital Signs | 148 | ||
| Temperature | 148 | ||
| Pulse | 148 | ||
| Respiration | 148 | ||
| Blood Pressure | 148 | ||
| Chapter Exercises | 158 | ||
| Multiple Choice | 158 | ||
| Apply Your Knowledge | 158 | ||
| Chapter12 The Dental Examination | 159 | ||
| Learning Objectives | 159 | ||
| Key Terms | 159 | ||
| Components of the Dental Examination | 159 | ||
| Examination Techniques | 159 | ||
| Recording the Dental Examination | 159 | ||
| Oral Examination | 162 | ||
| Soft Tissue Examination | 162 | ||
| Examination of the Periodontal Tissue | 162 | ||
| Examination of the Teeth | 162 | ||
| Tooth Diagrams, Numbering Systems, and Color Coding | 162 | ||
| Tooth Numbering | 162 | ||
| Tooth Arrangement | 162 | ||
| Color Coding | 163 | ||
| Cavity Classifications | 163 | ||
| Charting Symbols | 163 | ||
| Charting Abbreviations | 163 | ||
| Treatment Abbreviations | 163 | ||
| Single surface abbreviations | 163 | ||
| Combination of surfaces | 163 | ||
| Treatment Plan | 163 | ||
| Types of Treatment Plans | 164 | ||
| Recording Dental Treatment | 170 | ||
| About Fees | 170 | ||
| Chapter Exercises | 176 | ||
| Multiple Choice | 176 | ||
| Apply Your Knowledge | 176 | ||
| Chapter13 Medical Emergencies in the Dental Office | 177 | ||
| Learning Objectives | 177 | ||
| Key Terms | 177 | ||
| Preventing Emergencies | 177 | ||
| Legal Responsibilities | 178 | ||
| Emergency Preparedness | 178 | ||
| Assigned Roles | 178 | ||
| Routine Drills | 178 | ||
| Emergency Telephone Numbers | 178 | ||
| Emergency Supplies | 178 | ||
| Patient Assessment | 179 | ||
| Signs and Symptoms | 179 | ||
| Vital Signs | 179 | ||
| Emergency Responses | 179 | ||
| Syncope | 180 | ||
| Postural Hypotension | 180 | ||
| Hyperventilation | 180 | ||
| Asthmatic Attack | 180 | ||
| Epilepsy | 180 | ||
| Diabetes | 181 | ||
| Angina Pectoris | 181 | ||
| Acute Myocardial Infarction | 181 | ||
| Cerebrovascular Accident | 181 | ||
| Allergic Reactions | 181 | ||
| Documentation of an Emergency | 182 | ||
| Chapter Exercises | 188 | ||
| Multiple Choice | 188 | ||
| Apply Your Knowledge | 188 | ||
| Chapter14 Pain and Anxiety Control | 189 | ||
| Learning Objectives | 189 | ||
| Key Terms | 189 | ||
| Topical Anesthesia | 189 | ||
| Topical Anesthetic Ointment | 190 | ||
| Local Anesthesia | 190 | ||
| Local Anesthetic Agents | 190 | ||
| Induction and Duration of an Anesthetic | 190 | ||
| Vasoconstrictors | 190 | ||
| Health Status of the Patient | 190 | ||
| Local Anesthesia Techniques | 190 | ||
| Infiltration Anesthesia | 191 | ||
| Periodontal Ligament Injection | 191 | ||
| Block Anesthesia | 191 | ||
| Preparing the Anesthetic Syringe | 191 | ||
| Transferring the Anesthetic Syringe | 191 | ||
| Local Anesthetic Cautions | 193 | ||
| Pain and Anxiety Control Methods | 194 | ||
| Relaxation Techniques | 194 | ||
| Nitrous Oxide Analgesia | 194 | ||
| Safety Precautions with Nitrous Oxide | 195 | ||
| Patient Assessment and Monitoring | 195 | ||
| Antianxiety Agents | 195 | ||
| Analgesic Agents | 196 | ||
| Prescriptions | 196 | ||
| Documentation of Anesthesia and Pain Control | 196 | ||
| Chapter Exercises | 201 | ||
| Multiple Choice | 201 | ||
| Apply Your Knowledge | 201 | ||
| Six Dental Imaging | 202 | ||
| Chapter15 Radiation Safety and Production of X-Rays | 202 | ||
| Learning Objectives | 202 | ||
| Key Terms | 202 | ||
| Radiation Physics | 203 | ||
| Definition | 203 | ||
| Atomic Structure | 203 | ||
| Ionization | 203 | ||
| Properties of X-Ray Beams | 203 | ||
| Types of Radiation | 204 | ||
| Radiation Measurement | 205 | ||
| Radiation Exposure | 205 | ||
| Absorbed Dose | 205 | ||
| Dose Equivalence | 205 | ||
| Radiation Hazards and Protection | 205 | ||
| Maximum Permissible Dose | 205 | ||
| ALARA Principle | 206 | ||
| Biologic Effects of Radiation | 206 | ||
| Cumulative Effects | 206 | ||
| Acute and Chronic Radiation Exposure | 206 | ||
| Genetic and Somatic Effects | 206 | ||
| Patient Protection | 207 | ||
| Minimizing Genetic Effects | 207 | ||
| Prescribing Radiographs | 207 | ||
| Fast-Speed Film | 207 | ||
| Digital Imaging | 207 | ||
| Proper Equipment | 207 | ||
| Filtration | 207 | ||
| Collimation | 208 | ||
| Position Indicator Device | 208 | ||
| Proper Film Exposure Technique | 208 | ||
| Film-Holding Instruments | 208 | ||
| Lead Aprons and Thyroid Collars | 208 | ||
| If the Patient is Unable to Hold the Film | 209 | ||
| Protection of the Operator | 210 | ||
| Radiation Monitoring | 210 | ||
| Personnel Monitoring | 210 | ||
| Equipment Monitoring | 210 | ||
| Rules of Operator Protection | 210 | ||
| Dental X-Ray Machine | 210 | ||
| Components of the Dental X-Ray Machine | 210 | ||
| Tubehead | 210 | ||
| Components of the dental x-ray tube | 210 | ||
| Cathode. | 210 | ||
| Focusing cup. | 210 | ||
| Anode. | 211 | ||
| Collimator. | 211 | ||
| Filter. | 211 | ||
| Position indicator device. | 211 | ||
| Extension Arm | 211 | ||
| Control Panel | 212 | ||
| Master switch and indicator lights | 212 | ||
| Exposure timer | 212 | ||
| Milliamperage selector | 212 | ||
| Kilovoltage selector | 212 | ||
| Image Characteristics | 212 | ||
| Radiographic Quality | 212 | ||
| Contrast | 212 | ||
| Density | 212 | ||
| Image Distortion | 212 | ||
| Object-Film Distance | 213 | ||
| Source-Film Distance | 213 | ||
| Movement | 213 | ||
| Chapter Exercises | 214 | ||
| Multiple Choice | 214 | ||
| Apply Your Knowledge | 214 | ||
| Chapter16 Oral Radiography | 215 | ||
| Learning Objectives | 215 | ||
| Key Terms | 215 | ||
| Intraoral Views | 216 | ||
| Types of Intraoral Views | 216 | ||
| Film-Based Radiography | 216 | ||
| Seven Preventive Dentistry | 262 | ||
| Chapter17 Preventive Care | 262 | ||
| Learning Objectives | 262 | ||
| Key Terms | 262 | ||
| Process of Dental Disease | 263 | ||
| Bacterial Dental Biofilm | 263 | ||
| Dental Calculus | 263 | ||
| Dental Caries | 263 | ||
| Periodontal Disease | 263 | ||
| Tooth Brushing | 264 | ||
| How Often to Brush | 264 | ||
| Toothbrush Selection | 264 | ||
| Tooth Brushing Precaution | 265 | ||
| Disclosing Agents | 265 | ||
| Bass Method of Sulcular Tooth Brushing | 265 | ||
| Brushing the Tongue | 265 | ||
| Care of the Toothbrush | 265 | ||
| Flossing | 265 | ||
| Home Care Techniques | 266 | ||
| Fluoride | 267 | ||
| Demineralization and Remineralization | 267 | ||
| Safe Use of Fluoride | 268 | ||
| Sources of Systemic Fluoride | 268 | ||
| Fluoridated Water | 268 | ||
| Other Dietary Sources | 268 | ||
| Foods and Beverages | 268 | ||
| Toothpaste and Mouth Rinses | 268 | ||
| Prescribed Dietary Fluoride Supplements | 268 | ||
| Topical Fluoride | 269 | ||
| Types of Self-Applied Fluoride | 269 | ||
| Fluoride-Containing Toothpastes | 269 | ||
| Fluoride Mouth Rinses | 269 | ||
| Brush-On Fluoride Gel | 269 | ||
| Professional Topical Fluoride Applications | 270 | ||
| Nutrition | 270 | ||
| Key Nutrients | 270 | ||
| Cariogenic Foods | 270 | ||
| Dietary Guidelines | 270 | ||
| MyPlate | 270 | ||
| Preventive Dental Care | 274 | ||
| Patient Education | 274 | ||
| Motivation | 274 | ||
| Education | 275 | ||
| Acceptance | 275 | ||
| Active Learning | 275 | ||
| Chapter Exercises | 280 | ||
| Multiple Choice | 280 | ||
| Apply Your Knowledge | 280 | ||
| Chapter18 Coronal Polishing and Dental Sealants | 281 | ||
| Learning Objectives | 281 | ||
| Key Terms | 281 | ||
| Coronal Polishing | 281 | ||
| Stains of the Teeth | 281 | ||
| Methods of Removing Plaque and Stains | 284 | ||
| Air-Powder Polishing | 284 | ||
| Rubber-Cup Polishing | 284 | ||
| Equipment for Rubber-Cup Coronal Polishing | 284 | ||
| Polishing Cups | 284 | ||
| Prophylaxis Angle and Handpiece | 284 | ||
| Handpiece Grasp | 284 | ||
| Fulcrum and Finger Rest | 284 | ||
| Bristle Brushes | 285 | ||
| Abrasives | 285 | ||
| Rubber-Cup Coronal Polishing | 285 | ||
| Rubber-Cup Polishing Stroke | 285 | ||
| Positioning the Patient and Operator | 286 | ||
| Positioning the Patient | 286 | ||
| Positioning the Operator | 286 | ||
| Sequence of Polishing | 287 | ||
| Flossing after Coronal Polishing | 287 | ||
| Evaluation of Polishing | 287 | ||
| Pit and Fissure Sealants | 287 | ||
| Types of Sealant Materials | 288 | ||
| Method of Polymerization | 288 | ||
| Color | 289 | ||
| Storage and Use | 289 | ||
| Precautions for Dental Personnel and Patients | 289 | ||
| Etchant Precautions | 289 | ||
| Sealant Precautions | 289 | ||
| Chapter Exercises | 295 | ||
| Multiple Choice | 295 | ||
| Apply Your Knowledge | 296 | ||
| Eight Restorative Dentistry | 297 | ||
| Chapter19 Instruments, Handpieces, and Accessories | 297 | ||
| Learning Objectives | 297 | ||
| Key Terms | 297 | ||
| Hand Instruments | 297 | ||
| Hand Instrument Design | 297 | ||
| Types of Hand Instruments | 297 | ||
| Instrument Setup and Care | 298 | ||
| Rotary Instruments | 300 | ||
| Low-Speed Handpiece | 300 | ||
| High-Speed Handpiece | 305 | ||
| Changing Burs in the Handpiece | 306 | ||
| Laboratory Handpiece | 307 | ||
| Ultrasonic Handpiece | 307 | ||
| Air Abrasion Handpiece | 307 | ||
| Laser Handpiece | 307 | ||
| Handpiece Maintenance | 308 | ||
| Handpiece Sterilization | 308 | ||
| Dental Burs | 308 | ||
| Bur Shapes | 308 | ||
| Bur Care | 308 | ||
| Diamond Accessories | 308 | ||
| Trimming and Finishing Burs | 308 | ||
| Abrasive Rotary Instruments | 308 | ||
| Chapter Exercises | 315 | ||
| Multiple Choice | 315 | ||
| Apply Your Knowledge | 315 | ||
| Chapter20 Restorative and Esthetic Dental Materials | 316 | ||
| Learning Objectives | 316 | ||
| Key Terms | 316 | ||
| Characteristics of Dental Materials | 317 | ||
| Properties Affecting a Dental Material | 317 | ||
| Amalgam | 317 | ||
| Application of the Dental Amalgam | 318 | ||
| Amalgam Disposal | 318 | ||
| Composite Resins | 318 | ||
| Shade Selection | 319 | ||
| Application of Composite Resins | 319 | ||
| Finishing and Polishing | 320 | ||
| Dental Liners | 320 | ||
| Calcium Hydroxide | 320 | ||
| Cavity Varnish | 320 | ||
| Dental Bases | 321 | ||
| Etching Systems | 321 | ||
| Bonding Systems | 321 | ||
| Temporary Restorative Materials | 321 | ||
| Dental Cements | 321 | ||
| Mixing Dental Cements | 321 | ||
| Types of Cements | 322 | ||
| Zinc Oxide–Eugenol Cement | 322 | ||
| Glass Ionomer Cements | 322 | ||
| Zinc Phosphate Cement | 322 | ||
| Polycarboxylate Cement | 322 | ||
| Tooth-Whitening Materials | 322 | ||
| Methods of Tooth Whitening | 323 | ||
| Chapter Exercises | 333 | ||
| Multiple Choice | 333 | ||
| Apply Your Knowledge | 333 | ||
| Chapter21 Restorative Procedures | 334 | ||
| Learning Objectives | 334 | ||
| Key Terms | 334 | ||
| Cavity Preparation | 335 | ||
| Matrix Systems | 335 | ||
| Posterior Matrix System | 336 | ||
| Matrix Bands | 336 | ||
| Universal Retainer | 336 | ||
| Anterior Matrix System | 337 | ||
| Wedges | 337 | ||
| Permanent Restoration | 337 | ||
| Complex Restorations | 338 | ||
| Veneers | 338 | ||
| Vital Bleaching | 338 | ||
| Treatment Options | 339 | ||
| Chapter Exercises | 347 | ||
| Multiple Choice | 347 | ||
| Apply Your Knowledge | 347 | ||
| Chapter22 Impression Materials and Laboratory Procedures | 348 | ||
| Learning Objectives | 348 | ||
| Key Terms | 348 | ||
| Impression Trays | 348 | ||
| Impression Materials | 349 | ||
| Types of Impression Materials | 349 | ||
| Alginate | 349 | ||
| Taking alginate impressions | 352 | ||
| Elastomeric Impression Materials | 352 | ||
| Mixing Impression Materials | 353 | ||
| Bite Registration | 353 | ||
| Bite Registration Materials | 354 | ||
| Wax Bite Registration | 354 | ||
| Bite Registration Paste | 354 | ||
| Laboratory Procedures | 354 | ||
| Diagnostic Casts | 354 | ||
| Water-to-Powder Ratios | 354 | ||
| Influences on Setting Time | 355 | ||
| Pouring Diagnostic Casts | 355 | ||
| Trimming and Finishing Diagnostic Casts | 355 | ||
| Chapter Exercises | 366 | ||
| Multiple Choice | 366 | ||
| Apply Your Knowledge | 366 | ||
| Chapter23 Prosthodontics and Dental Implants | 367 | ||
| Learning Objectives | 367 | ||
| Key Terms | 367 | ||
| Fixed Prosthodontics | 367 | ||
| Crown and Bridge Procedural Steps | 369 | ||
| Shade Selection | 369 | ||
| Preparation | 370 | ||
| Tooth Preparation | 370 | ||
| Core buildups | 370 | ||
| Pin retention | 370 | ||
| Post and core | 370 | ||
| Gingival Retraction | 370 | ||
| Final Impression | 370 | ||
| Provisional | 370 | ||
| Types of provisional coverage | 372 | ||
| Laboratory Prescription | 372 | ||
| Laboratory working days | 372 | ||
| Removable Prosthodontics | 372 | ||
| Partial Dentures | 374 | ||
| Components of a Partial Denture | 374 | ||
| Abutment Teeth | 374 | ||
| Selection of Abutment Teeth | 374 | ||
| Preparation of Abutment Teeth | 375 | ||
| Final Impressions | 375 | ||
| Selecting the Artificial Teeth | 375 | ||
| Laboratory Prescription | 376 | ||
| Try-In Appointment | 376 | ||
| Delivery of the Partial Denture | 376 | ||
| Home Care Instructions to the Patient with a Partial Denture | 376 | ||
| Postdelivery Check | 376 | ||
| Full Dentures | 376 | ||
| Denture Retention | 376 | ||
| Retention of a Maxillary Denture | 376 | ||
| Retention of a Mandibular Denture | 377 | ||
| Impressions for Diagnostic Casts of Edentulous Arches | 377 | ||
| Final Impressions for Complete Dentures | 377 | ||
| Try-In of the Baseplate–Occlusal Rim Assembly | 377 | ||
| Selecting the Artificial Teeth | 378 | ||
| Occlusal Registration | 378 | ||
| Wax Setup Try-In Appointment | 378 | ||
| Home Care Instructions to the Patient with a Partial and Full Denture | 378 | ||
| Relining of a Partial or Complete Denture | 378 | ||
| Impression for Laboratory Relining | 379 | ||
| Delivery of a Laboratory Relined Denture | 379 | ||
| Immediate Dentures | 379 | ||
| Dental Implants | 379 | ||
| Types of Dental Implants | 379 | ||
| Endosteal Implant | 379 | ||
| Subperiosteal Implant | 381 | ||
| Transosteal Implant | 381 | ||
| Maintenance of Dental Implants | 381 | ||
| Recall Visits | 381 | ||
| Chapter Exercises | 391 | ||
| Multiple Choice | 391 | ||
| Apply Your Knowledge | 391 | ||
| Nine Specialized Dentistry | 392 | ||
| Chapter24 Periodontics | 392 | ||
| Learning Objectives | 392 | ||
| Key Terms | 392 | ||
| Periodontal Diseases | 392 | ||
| Description of Periodontal Disease | 393 | ||
| Signs and Symptoms | 393 | ||
| Gingivitis | 393 | ||
| Periodontitis | 395 | ||
| Periodontal Examination | 395 | ||
| Radiographs | 395 | ||
| Examination of the Teeth | 395 | ||
| Mobility | 395 | ||
| Examination of the Gingivae and Supporting Structures | 395 | ||
| Probing Periodontal Pockets | 396 | ||
| Instruments Used in the Periodontal Examination | 399 | ||
| Periodontal Probes | 399 | ||
| Explorers | 399 | ||
| Scalers | 399 | ||
| Curettes | 400 | ||
| Periodontal Surgical Instruments | 401 | ||
| Periodontal Knives | 401 | ||
| Pocket Markers | 401 | ||
| Periodontal Treatment Procedures | 401 | ||
| Dental Prophylaxis | 401 | ||
| Ultrasonic Scaler | 403 | ||
| Scaling, Root Planing, and Gingival Curettage | 403 | ||
| Scaling | 403 | ||
| Root Planing | 403 | ||
| Gingival Curettage | 404 | ||
| Postoperative Instruction after Scaling and Curettage | 404 | ||
| Discomfort | 404 | ||
| Diet | 404 | ||
| Home care | 404 | ||
| Antimicrobial and Antibiotic Agents | 404 | ||
| Periodontal Surgery | 405 | ||
| Gingivectomy | 405 | ||
| Gingivoplasty | 405 | ||
| Periodontal Flap Surgery | 405 | ||
| Gingival Grafting | 405 | ||
| Osseous Surgery | 406 | ||
| Osteoplasty | 406 | ||
| Ostectomy | 406 | ||
| Postperiodontal Surgery | 406 | ||
| Instructions | 406 | ||
| Discomfort | 406 | ||
| Periodontal Dressing | 406 | ||
| Rinsing | 407 | ||
| Diet | 407 | ||
| Activity | 407 | ||
| Home Care | 407 | ||
| Postoperative Visit | 407 | ||
| Periodontal Dressing | 407 | ||
| Types of Periodontal Dressings | 408 | ||
| Zinc oxide–eugenol dressing | 408 | ||
| Noneugenol dressing | 408 | ||
| Chapter Exercises | 413 | ||
| Multiple Choice | 413 | ||
| Apply Your Knowledge | 413 | ||
| Chapter25 Endodontics | 414 | ||
| Learning Objectives | 414 | ||
| Key Terms | 414 | ||
| Endodontic Diagnosis | 414 | ||
| Use of Radiographic Imaging in Endodontics | 415 | ||
| Diagnostic Conclusions | 415 | ||
| Instruments in Endodontics | 416 | ||
| Microscopic Endodontics | 416 | ||
| Medication and Filling Materials in Endodontics | 420 | ||
| Irrigation Solution | 420 | ||
| Root Canal–Filling Materials | 421 | ||
| Root Canal Sealers | 421 | ||
| Pulp Therapy | 421 | ||
| Pulp Capping | 421 | ||
| Pulpotomy | 421 | ||
| Pulpectomy | 421 | ||
| Overview of Root Canal Therapy | 421 | ||
| Anesthesia and Pain Control | 422 | ||
| Isolation and Disinfection of the Operating Field | 422 | ||
| Access Preparation | 422 | ||
| Estimated Working Length | 422 | ||
| Debridement and Shaping of the Canal | 422 | ||
| Obturation | 423 | ||
| Surgical Endodontics | 423 | ||
| Chapter Exercises | 427 | ||
| Multiple Choice | 427 | ||
| Apply Your Knowledge | 427 | ||
| Chapter26 Oral and Maxillofacial Surgery | 428 | ||
| Learning Objectives | 428 | ||
| Key Terms | 428 | ||
| Surgical Environment | 428 | ||
| Patient Record | 428 | ||
| Signed Consent | 428 | ||
| Oral Surgery Instruments | 428 | ||
| Extraction Forceps | 429 | ||
| Surgical Asepsis | 429 | ||
| Surgical Procedures | 429 | ||
| Types of Surgical Procedures | 432 | ||
| Forceps Extraction | 432 | ||
| Multiple Extractions | 432 | ||
| Removal of Impacted Teeth | 432 | ||
| Suture Placement | 433 | ||
| Immediate Postoperative Care | 433 | ||
| Control of Bleeding | 433 | ||
| Control of Swelling | 433 | ||
| Alveolitis (Dry Socket) | 433 | ||
| Chapter Exercises | 442 | ||
| Multiple Choice | 442 | ||
| Apply Your Knowledge | 442 | ||
| Chapter27 Pediatric Dentistry | 443 | ||
| Learning Objectives | 443 | ||
| Key Terms | 443 | ||
| Pediatric Dental Office | 443 | ||
| Behavioral Management Techniques | 443 | ||
| Guidelines for Child Behavior | 443 | ||
| Challenging Patient | 444 | ||
| Patients With Special Needs | 445 | ||
| Examination of the Pediatric Patient | 445 | ||
| Medical and Dental Histories | 445 | ||
| General Appraisal and Behavioral Assessment | 445 | ||
| Intraoral Examination | 445 | ||
| Radiographic Examination | 445 | ||
| Pediatric Procedures | 445 | ||
| Preventive Dentistry | 445 | ||
| Oral Hygiene | 445 | ||
| Nutrition | 446 | ||
| Topical Fluorides | 446 | ||
| Sealants | 446 | ||
| Preventive Orthodontics | 446 | ||
| Sports Safety | 446 | ||
| Restorative Procedures | 447 | ||
| Matrix Systems for Primary Teeth | 447 | ||
| Pulp Therapy | 447 | ||
| Pulpotomy | 447 | ||
| Stainless Steel Crowns | 447 | ||
| Types of Stainless Steel Crowns | 448 | ||
| Traumatic Injury | 448 | ||
| Fractured Anterior Teeth | 448 | ||
| Avulsed Teeth | 448 | ||
| Chapter Exercises | 453 | ||
| Multiple Choice | 453 | ||
| Apply Your Knowledge | 453 | ||
| Chapter28 Orthodontics | 454 | ||
| Learning Objectives | 454 | ||
| Key Terms | 454 | ||
| Angle Classifications of Malocclusion | 454 | ||
| Indications for Orthodontic Treatment | 454 | ||
| Records Visit and Treatment Planning | 456 | ||
| Interview Information | 456 | ||
| Medical and Dental History | 456 | ||
| Physical Growth Evaluation | 456 | ||
| Social and Behavioral Evaluation | 456 | ||
| Clinical Examination | 456 | ||
| Evaluation of Facial Form | 456 | ||
| Evaluation of Oral Health | 456 | ||
| Diagnostic Records | 456 | ||
| Photographs | 456 | ||
| Extraoral photographs | 456 | ||
| Intraoral photographs | 456 | ||
| Cephalometric Radiographs | 456 | ||
| Diagnostic Casts | 456 | ||
| Case Presentation | 457 | ||
| Orthodontic Treatment | 457 | ||
| Preventive Orthodontic Treatment | 457 | ||
| Limited Orthodontic Treatment | 459 | ||
| Interceptive Orthodontic Treatment | 459 | ||
| Comprehensive Orthodontic Treatment | 459 | ||
| Instruments for Orthodontics | 460 | ||
| Fixed Orthodontic Appliances | 460 | ||
| Orthodontic Bands | 463 | ||
| Use of Separators Before Banding | 463 | ||
| Selecting Bands | 463 | ||
| Fitting Maxillary Bands | 463 | ||
| Fitting Mandibular Bands | 463 | ||
| Cementing Bands | 463 | ||
| Bonded Brackets | 463 | ||
| Arch Wires | 464 | ||
| Ligating the Arch Wire | 464 | ||
| Elastics | 464 | ||
| Auxiliaries | 464 | ||
| Headgear | 465 | ||
| Face Bow | 465 | ||
| Traction Devices | 465 | ||
| Oral Hygiene and Dietary Instructions | 465 | ||
| Oral Hygiene | 465 | ||
| Dietary Instructions | 465 | ||
| Adjustment Visits | 465 | ||
| Checking the Appliance | 465 | ||
| Bands | 465 | ||
| Bonded Brackets | 466 | ||
| Arch Wires | 466 | ||
| Completed Treatment | 466 | ||
| Retention | 466 | ||
| Chapter Exercises | 472 | ||
| Multiple Choice | 472 | ||
| Apply Your Knowledge | 472 | ||
| Ten Preparation for Employment | 473 | ||
| Chapter29 The Job Search | 473 | ||
| Learning Objectives | 473 | ||
| Key Terms | 473 | ||
| Personal and Professional Goals | 473 | ||
| Career Opportunities | 473 | ||
| Private Practice | 473 | ||
| Insurance Company | 473 | ||
| Sales Representative | 474 | ||
| Public Health and Government Programs | 474 | ||
| Dental Schools | 474 | ||
| Hospital | 474 | ||
| Teaching | 474 | ||
| Marketing Your Skills | 474 | ||
| Social Media and Job Search | 474 | ||
| 474 | |||
| 474 | |||
| 475 | |||
| Seeking Employment | 475 | ||
| Telephone Contact | 475 | ||
| Cover Letter | 475 | ||
| Resume | 475 | ||
| Heading | 477 | ||
| Professional Objective | 477 | ||
| Education | 477 | ||
| Professional Experience | 477 | ||
| Certifications | 477 | ||
| References | 478 | ||
| Volunteer Experience | 478 | ||
| Awards and Scholarships | 478 | ||
| Job Application | 478 | ||
| Interview | 478 | ||
| Preparation | 478 | ||
| Appearance | 479 | ||
| Arrival | 479 | ||
| Interviewing Professionally | 479 | ||
| Concluding the Interview | 479 | ||
| Follow-up Letter | 480 | ||
| Salary Negotiations | 480 | ||
| Job Termination | 481 | ||
| Chapter Exercises | 482 | ||
| Multiple Choice | 482 | ||
| Apply Your Knowledge | 482 | ||
| Glossary | 483 | ||
| Index | 493 | ||
| A | 493 | ||
| B | 493 | ||
| C | 494 | ||
| D | 495 | ||
| E | 496 | ||
| F | 497 | ||
| G | 497 | ||
| H | 497 | ||
| I | 498 | ||
| J | 499 | ||
| K | 499 | ||
| L | 499 | ||
| M | 499 | ||
| N | 500 | ||
| O | 500 | ||
| P | 501 | ||
| Q | 502 | ||
| R | 502 | ||
| S | 503 | ||
| T | 504 | ||
| U | 504 | ||
| V | 505 | ||
| W | 505 | ||
| X | 505 | ||
| Y | 505 | ||
| Z | 505 |