Article 1: Exploring the Relationship Between Periodontal Disease and Pregnancy Complications 
Y.A. Bobetsis, S.P. Barros, S. Offenbacher

1. Approximately what percentage of pregnancies in the United States is complicated by preterm birth each year?
Select answer A. 6 percent B. 12 percent C. 16 percent D. 21 percent

2. In studies in which pregnant hamsters were injected with Porphyromonas gingivalis, what was the average reduction in fetal weight?
Select answer A. approximately 20 percent B. approximately 30 percent C. approximately 40 percent D. approximately 50 percent

3. Based on the authors’ review of case-control studies, what is the magnitude of the risk of experiencing pregnancy complications when the mother has active periodontal disease?
Select answer A. up to 2.5 times greater B. up to 4.5 times greater C. up to 7.5 times greater D. up to 20.5 times greater

4. Based on the authors’ review of cohort studies, what is the magnitude of the risk of experiencing pregnancy complications when the mother has active periodontal disease?
Select answer A. up to two times greater B. up to four times greater C. up to seven times greater D. up to 20 times greater

Article 2: Periodontal Infections and Cardiovascular Disease: The Heart of the Matter 
R.T. Demmer, M. Desvarieux

1. In a recent study of the association between tooth loss and stroke among those who have never smoked, what was the risk of experiencing stroke for people with 24 or fewer teeth?
Select answer A. 10 percent lower than that for people with 25 or more teeth B. 10 percent greater than that for people with 25 or more teeth C. 40 percent greater than that for people with 25 or more teeth D. 80 percent greater than that for people with 25 or more teeth

2. Which one of the following bacterial species has not been found to be associated with carotid atherosclerosis as measured by intima-media thickening?
Select answer A. Actinomyces naeslundii B. Actinobacillus actinomycetemcomitans C. Porphyromonas gingivalis D. Tannerella forsythensis

3. Strains of which bacterial species have been shown to be capable of infecting macrophages and enhancing foam cell formation in the vascular walls?
Select answer A. A. naeslundii B. A. actinomycetemcomitans C. P. gingivalis D. T. forsythensis

4. Which one of the following features of the association between periodontal disease and cardiovascular disease is supported least strongly by research conducted to date?
Select answer A. It is stronger for men than women. B. It is more pronounced in younger age groups. C. It is not observed among totally edentulous people. D. It is stronger for clinical stroke outcomes than for coronary artery disease.

Article 3: Pneumonia in Nonambulatory Patients: The Role of Oral Bacteria and Oral Hygiene 
F.A. Scannapieco

1. Pneumonia caused by which one of the following organisms is most likely to have been community acquired?
Select answer A. Escherichia coli B. Haemophilus influenzae C. Klebsiella pneumoniae D. Pseudomonas aeruginosa

2. In a study comparing dental plaque colonization in patients treated in medical intensive care units (ICUs) with that in control patients, what were the findings regarding pathogens known to cause pneumonia?
Select answer A. extremely rare in both groups B. occasionally found in patients treated in medical ICUs, but rarely in control patients C. commonly found in patients treated in medical ICUs, but rarely in control patients D. commonly found in both groups

3. What was the reduction in pneumonia cases observed among patients admitted to a surgical ICU who received chlorhexidine oral rinse twice a day?
Select answer A. 21 percent B. 39 percent C. 46 percent D. 60 percent

4. What was the reduction in pneumonia cases observed among nursing home residents who received daily povidine iodine rinses and had supervised toothbrushing three times per day?
Select answer A. 21 percent B. 39 percent C. 46 percent D. 60 percent

Article 4: Periodontal Disease and Diabetes: A Two-Way Street 
B.L. Mealey

1. Approximately what percentage of Americans with diabetes has not been diagnosed with the disease?
Select answer A. 5 to 10 percent B. 15 to 20 percent C. 25 to 30 percent D. 35 to 40 percent

2. According to the Third National Health and Nutrition Examination Survey, what is the estimated increase in the risk of having periodontitis among adults with poorly controlled diabetes?
Select answer A. about 50 percent greater B. almost twice as great C. almost three times as great D. almost six times as great

3. What is the estimated increase in the risk of having worsening glycemic control among people with type 2 diabetes who also have severe periodontitis?
Select answer A. about 50 percent greater B. twice as great C. three times as great D. six times as great

4. Which one of the following statements about the mechanisms of interaction between diabetes and periodontal disease is not correct?
Select answer A. Fibroblasts do not function properly in high-glucose environments. B. Elevated levels of matrix metalloproteinase enzymes rapidly degrade collagen. C. High levels of advanced glycation end products induce abnormal endothelial cell functioning. D. Elevated levels of proinflammatory cytokines have the potential to decrease insulin resistance.

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