Abrasion of teeth involves an abnormal mechanical process that results in enamel, dentin and cementum being worn away over time. Susceptibility to abrasion is increased in the presence of erosion of the surface of the tooth, which results in softening of the tooth structure. Professional dental care is aimed at preventing disease and restoring oral health for patients with oral disease. The appropriate use of professional and home use oral care products is required to achieve these objectives. Careful selection of polishing techniques is required by the dental clinician to ensure optimized stain removal, polishing and preservation of surface integrity, and the oral care regimen recommended to patients for home care must also consider the risk of abrasion.

This course addresses the challenge of communicating periodontal disease protocols to patients in a manner that maximizes patient compliance and reduces patient overwhelm and resistance. Current scientific research continues to reinforce periodontal and systemic disease connections. Communicating this information to dental patients can be life changing and indeed life saving. It is therefore imperative that dental health care professionals convey this information to patients, and do it in a compelling manner that makes patients want the treatment they need.
Additionally, main stream media & social media report their versions of oral systemic health issues to our patients daily. Today’s patients are better educated and have higher expectations than ever before. It is crucial that oral health care professionals present themselves as reliable experts and patient advocates. Older models of patient education which involve a lot of “telling” are no longer effective. Health care professionals today must know how to create rapport quickly, ask appropriate questions, listen carefully, discover patients’ values, and relate them to customized treatment plans. This is accomplished through focused communication, as outlined in this course.
This course teaches a communication plan that will create success for oral health care professionals and their patients, implementing protocols that diminish overwhelm and encourage trusting relationships to help patients accept and embrace presented periodontal treatments.

Dentinal hypersensitivity has been referred to as one of the most painful and chronic dental conditions, with a reported prevalence of between 4% and 57% in the general population and a higher prevalence in periodontal patients. It may also occur as a result of, or during, dental treatment. Clinicians must screen for dentinal hypersensitivity and diagnose by exclusion, determine appropriate treatment, and provide treatment and preventive recommendations. Consideration should also be given to treating dentinal hypersensitivity associated with dental treatment. Traditional treatments have included adhesive resins, fluoride varnishes, HEMA, iontophoresis, gingival grafts and desensitizing dentifrices. Other technologies include the use of bioglass particles, ACP, as well as 8% arginine and calcium carbonate paste.

Poor extraction site management can lead to future esthetic and functional prosthetic complications. On the other hand, preservation of bone volume and soft tissue height at the time of tooth extraction can help make possible prosthetically-driven implant placement and attainment of functional and esthetic restorative goals. Proper management of extraction sites at the time of tooth extraction may also can reduce or eliminate the future need for advanced ridge augmentation procedures prior to implant placement.

The initiation and progression of periodontal disease requires the presence of bacterial accumulations. Once periodontal disease exists, its progression depends on the host response. In order to treat periodontal disease, the biofilm must be disrupted and all hard and soft deposits removed from the tooth surfaces. In order to thoroughly remove deposits and debris without removing excessive tooth structure, instruments must be selected that are suitable for the intended site and technique. The selected debridement method should offer predictable results independent of operator skill level; be efficient to perform clinically, well tolerated by patients and cost effective; and have a low potential for adverse side effects.

Lasers were first conceived of almost a century ago and were introduced into dentistry in 1989. Several types of dental lasers are now available, with the diode laser being of particular interest for the orthodontic clinician. It is now possible to treat many soft tissue conditions that present as challenges in orthodontics and can impact the overall aesthetic outcome, and to treat these more easily. Before using lasers, it is necessary to understand how they work, the steps involved in setup, precautions that must be taken (such as eye protection), and troubleshooting steps. Periodontal considerations must also be known and understood. Soft tissue procedures that can benefit from use of a diode laser include frenectomy, gingival recontouring, the removal of hypertrophic tissue, and exposure of a partially erupted tooth.

Methamphetamines were originally derived from amphetamine. Meth can be illegally and easily synthesized, and is known by many names, including speed, crystal meth and ice. In the United States, more than 10 million people report having tried meth. Its use results in immediate effects that can be pleasurable but medically dangerous. Longer-term use results in serious and devastating medical, psychological and oral conditions, and in extreme cases can result in death. Dental professionals are in a position to help with the early identification of meth abuse and to refer patients to medical professionals for counseling and treatment. Palliative and preventive oral care and treatment, as well as counseling, should be provided, along with monitoring of the patient, and definitive care should be provided when appropriate for the individual patient.

 Periodontitis is a disease that is more serious from a health perspective than previously known. Peri-implant diseases are prevalent: They not only present risk for implant failure but may also present systemic risk. The doctor’s ability to determine an accurate diagnosis for both of these diseases is critical. Ideally, the diagnostic capacity should be able to accomplish five important goals:

• To determine if the risk for disease is present in any given patient

• To determine if this risk is high or low in each patient

• To determine if actual disease is present at any level of disease (early, moderate, or late stages)

• To define which treatment is most advisable for the specific patient.

• To determine if co-management is appropriate for each patient.

Periodontal disease is progressive and episodic in nature, with tissue destruction resulting from the host response to bacterial antigens and irritants. Risk factors encompass systemic influences, external influences, intrinsic factors and local factors. An individual patient’s responsiveness to treatment also depends on the host response and the presence of risk factors. Adjunctive systemic and/or local therapy can positively impact periodontal therapy. Considerations in determining which to select include clinical preference and efficacy.

The prevalence of periodontal disease and estimates of provided treatment are indicative of treatment needs. Current technology offers standardized probing, automated charting, risk assessment, differential diagnosis and suggested treatment plans, as well as enabling clinicians to involve patients in the process. Patient awareness and treatment acceptance can be encouraged with full evaluation, a consistent protocol and message, and through the use of technology.

Dentists are routinely presented with patients that have Type 2 diabetes and cardiovascular disease (CVD). Among these patients, the potential health benefit of diagnosing and treating chronic inflammatory periodontal disease may be uncertain. This article reviews studies over the last decade to help understand the potential effect of periodontal therapy among these two patient groups. While there are many factors involved outside the realm of oral health and our understanding of cause and effect, these studies reveal that the dental professional’s role in systemic health care management is significant. Based on these studies, the management of chronic periodontal disease in specific chronically diseased patients appears to have a significant health benefit: plus an additional benefit in the reduction of over-all medical expenditures.