DH 210W - Periodontics II

Credits: 2
Instructional Contact Hours: 4

1. Demonstrate understanding of periodontal assessment and diagnosis.

1. List the components of a comprehensive periodontal assessment.
2. Describe how to evaluate each component.
3. Calculate width of attached gingiva and clinical attachment loss
4. Compare and contrast PSR and comprehensive periodontal assessment.
5. List fundamental questions for assigning periodontal diagnoses for natural dentition and dental implants.
6. Explain the difference between signs and symptoms of disease.
7. List signs and symptoms of periodontal inflammation.
8. List steps performed during periodontal maintenance.
9. Define baseline data and explain its importance to periodontal assessments.
10. Describe how strategies for assessment and management of periodontal disease may evolve in the future.

2. Accurately analyze radiographic and clinical findings to distinguish between health and disease.

1. Interpret dental radiographic features of healthy and diseased periodontium.
2. Name techniques to improve high-quality dental radiographs for periodontal patients.
3. Explain the principles of horizontal bitewings vs. vertical bitewings.
4. Describe limitations of dental radiographs.
5. Describe the clinical appearance of the periodontium in health and disease for pediatric patients.
6. Describe normal radiographic appearance of the periodontium in primary vs. permanent dentition.
7. Explain the implications of untreated pediatric periodontal diseases.
8. List common types of pediatric periodontal conditions.

3. Apply dental hygiene treatment planning to periodontally involved patients

1. List phases of periodontal treatment.
2. Develop a treatment plan for patients with various stages of periodontal disease.
3. Describe clinical attachment loss and its role in treatment planning.
4. Explain why a patient's diagnosis and treatment plan may require modifications over time.
5. Describe guidelines for determining whether patients should be treated in general practice or referred to a periodontist.
6. Establish appropriate intervals between periodontal maintenance appointments.
7. List signs of periodontal disease recurrence.
8. Define recurrent and refractory periodontitis.
9. Explain the rationale and indications for referring a patient to a periodontist.
10. Describe implications of xerostomia on periodontal disease and its effect on treatment plans.

4.Demonstrate understanding of Nonsurgical Periodontal Therapy (NSPT) techniques.

a. Define NSPT and list its goals.
b. Describe healing after NSPT.
c. Explain strategies for managing hypersensitivity.
d. Explain why reevaluation after NSPT is needed.
e. List steps for the clinician to perform during the reevaluation appointment.
f.  Explain and demonstrate proper techniques for scaling and root debridement in a periodontally involved patient.
g. Explain ADA codes associated with periodontal treatment.

5. Define host modulation and adjunctive therapies in NSPT.

a. Define host modulation therapy.
b. List and explain mechanisms for drugs approved for host modulation therapy.
c. Define sub-antimicrobial dose.
d. Compare and contrast systemic and local delivery of antibiotic agents.
e. Explain the limitations of systemic antibiotics for treating periodontal disease.
f. List antibacterial agents in over-the-counter dental products that reduce inflammation.

6. Compare and contrast various types of surgical periodontal therapy.

a. List indications and contraindications for periodontal surgery.
b. List goals and objectives for periodontal surgery.
c. Define repair, reattachment, and regeneration in periodontal surgery.
d. Differentiate various materials used in periodontal surgery (e.g., grafting materials, membranes, sutures).
e. Describe various suture techniques used in periodontal surgery.
f. Explain the dental hygienist’s role in periodontal surgery and post-operative care.
g. Demonstrate steps in suture removal and post-surgical care.

7. Apply patient education techniques for periodontal patients.

1. Demonstrate how to select appropriate oral health aids for home biofilm removal.
2. Explain the importance of daily biofilm removal and interdental care.
3. Recommend and demonstrate interdental aids for various embrasure space classifications.
4. Explain how root concavities affect the selection of home care aids.
5. Educate patients on the use of irrigation devices and techniques.
6. Describe the patient’s role in decision-making.
7. Explain the importance of informed consent or informed refusal.
8. Define specific criteria for obtaining informed consent.
9. List key steps for shared decision-making with patients.
10. Define the term compliance and explain its role in periodontal maintenance.
11. List strategies to improve patient compliance.

8. Explain strategies for pain and anxiety control during periodontal treatment.

1. Explain the need for pain control during periodontal instrumentation.
2. Explain the relationship between anxiety and perception of pain.
3. List strategies for reducing patient anxiety and fear.
4. Explain factors to consider when selecting local anesthetic agents.
5. List reasons for local anesthetic use during nonsurgical periodontal therapy.

9. Demonstrate use of chemotherapeutic agents and irrigation.

1. Describe benefits of home and professional irrigation devices for patients with periodontal disease.
2. Distinguish subgingival depths that various aids can reach for biofilm removal.
3. List agents used for irrigation and their indications/contraindications.
4. Educate patients on irrigation techniques and benefits.
5. Compare and contrast systemic and local delivery of antibiotic agents.
6. Explain limitations of systemic antibiotics in treating periodontal disease.

10. Explain cessation counseling strategies in relation to various smoking products.

a. Discuss implications of smoking and nicotine on periodontal health.
b. Describe tobacco/nicotine delivery systems with examples.
c. Explain effects of tobacco, nicotine, and cannabis on host response to periodontal disease.
d. Explain effects of tobacco and nicotine on periodontal treatment outcomes.
e. Demonstrate cessation counseling techniques in a clinical settings
f. Explain the importance of cessation counseling during routine dental treatment.

11. Define acute periodontal conditions.

a. Define acute periodontal diseases and conditions that fall under this category.
b. Describe abscesses of the periodontium, their causes, and treatment.
c. Describe characteristics and treatment of necrotizing periodontal diseases.
d. Explain treatment precautions for primary herpetic gingivostomatitis.

12. Define pediatric periodontitis.

a. Assess clinical features of the pediatric periodontium.
b. Distinguish clinical signs of pediatric periodontitis.
c. Describe implications of untreated pediatric periodontal diseases.
d. Explain treatment of pediatric periodontitis.

13. Display knowledge of xerostomia and malodor in relation to periodontally involved patients.

1. List potential risks of xerostomia and their relation to periodontal disease.
2. Explain potential causes of malodor.
3. List aids for patients with xerostomia and/or malodor.
4. Explain how xerostomia may alter the dental hygiene treatment plan.

14.  Explain standards of professional documentation within the dental hygienist’s role.

1. Review core values as they apply to the dental hygienist’s role.
2. Define liability and explain areas of potential liability for dental hygienist.
3. Demonstrate thorough documentation of a patient’s dental record.
4. List common errors in documentation.
5. Describe documentation formats for informed consent.

15. Demonstrate advanced periodontal instrumentation and techniques.

a. Identify instruments appropriate for root surface instrumentation in deep periodontal pockets.
b. Discuss advantages and limitations of periodontal instrument designs.
c. Demonstrate the proper use of periodontal files.
d. Discuss anatomical features that complicate instrumentation with attachment loss.
e. Demonstrate the use of periodontal assessment and calculus removal instruments in root concavities and furcations.
f. Select appropriate instruments based on calculus deposits and site.
g. Demonstrate advanced instrumentation and fulcrum techniques.
h. Demonstrate correct technique and power for powered instrumentation tips.
i.  implement all phases of the dental hygiene process of care on a periodontal lab patient.