Periodontology Syllabus for 2013-2014
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Instructor Information
Instructor
Donna Cleere (Curriculum Vitae)Office Location
West Campus Jones Hall 123Office Hours
Student Office Hours: Wednesday 10:00 am to 12 noon or By Appointment as needed
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Course
DHYG-1311-001 Periodontology
Prerequisites
Course Description
Normal and diseased periodontium including the structural, functional and environmental factors. Emphasis on etiology, pathology, treatment modalities and therapeutic and preventive periodontics.
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Department Expectations
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Hours
(3 sem hrs; 3 lec)
Class Type
On Campus Course
Syllabus Information
Textbooks
\ Required Course Textbooks
\\ 1. Foundations of Periodontics for the Dental Hygienist , Jill S. Nield-Gehrig and Donald E. Willmann. Wolters Kluwer/Lippincott Williams & Wilkins, 2011
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Supplies
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Course Supply List
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1. Library Card for AC and/or city library
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2. Computer and Internet Access, printer, print cartridges
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3. Index cards, Scantrons, paper, pens, markers<
Student Performance
End-of-Course Outcomes
Contrast normal and abnormal periodontium; analyze the etiology and pathology of periodontal diseases; differentiate treatment modalities used for therapy and prevention; and interpret periodontal assessment data to develop a dental hygiene care plan.
Course Meeting Days and Times
Lecture: Tuesday 2:00 - 5:00
WCJH 111
Course Instructor
Name: Donna Cleere, RDH, M.Ed.
Professor/Program Director
Office Location: WCJH Room 123
Office Phone: 806-354-6064
Campus E-Mail Address: dkcleere@actx.edu
Office Hours: As Posted on Office Door
Instructor Objectives for the Course
Chapter objectives will coordinate with the materials presented in lecture, handouts, reading assignments, and exams. The student will know that these objectives have been successfully completed if he or she earns a final course grade of "C" or higher as evaluated by the instructor.
The standard for the objectives may be one or any combination of the following:
- as given in lecture
- as demonstrated, discussed in the clinic/lab experience
- as given in handouts
- as stated in course texts
1. Learn and recognize the clinical features of periodontal health.
2. Describe the function that each tissue serves in the periodontium, including the gingiva, periodontal ligament, cementum, and alveolar bone.
3. Identify the tissues of the periodontium on an unlabeled drawing depicting the periodontium in a cross section.
4. Identify the alveolar process (alveolar bone) on a human skull.
5. Describe the position and contours of the alveolar crest of the alveolar bone in health.
6. Describe the nerve and blood supply to the periodontium.
7. Explain the role of the lymphatic system in the health of the periodontium.
8. Define the key terms in this chapter.
9. Demonstrate knowledge of the tissues of the periodontium by applying concepts from this chapter to the cases found in the section "Focus on the Patient" of this chapter.
10. Define the term epithelial tissue and describe its function in the body.
11. List and define the layers that comprise the stratified squamous epithelium of the skin.
12. Define keratin and describe its function in the epithelium.
13. Define the term cell junction and describe its function in the epithelial tissues.
14. Compare and contrast the terms desmosome and hemidesmosome.
15. Describe the epithelium-connective tissue interface found in most tissues of the body, such as the interface between epithelium and connective tissues of the skin.
16. Describe the function of connective tissue in the body.
17. List and recognize the histologic features of periodontal health.
18. List and define the layers that comprise the stratified squamous epithelium of the gingiva.
19. Identify the three anatomical areas of the gingival epithelium on an unlabeled drawing of the anatomical areas of the gingival epithelium.
20. Define the term oral epithelium and describe its location and function in the gingival epithelium.
21. Define the term junctional epithelium and describe its location and function in the gingival epithelium.
22. State which of the anatomical areas of the gingival epithelium have an uneven, wavy epithelium-connective tissue interface in health and which have a smooth junction in health.
23. State the level of keratinization present in each of the three anatomical areas of the gingival epithelium (keratinized, nonkeratinized, or parakeratinized).
24. Identify the enamel, gingival connective tissue, junctional epithelium, internal basal lamina, external basal lamina, epithelial cells, desmosomes, and hemidesmosomes on an unlabeled drawing depicting the microscopic anatomy of the junctional epithelium and surrounding tissues.
25. Describe the function of the gingival connective tissue.
26. Define the term supragingival fiber bundles and decribe their function in the periodontium.
27. Define the term periodontal ligament and describe its function in the periodontium.
28. Identify the principle fiber groups of the periodontal ligament on an unlabeled drawing.
29. Define the term Sharpey fibers.
30. Define the term cementum and describe its function in the periodontium.
31. State the three relationships that the cementun may have in relation to the enamel at the cementoenamel junction.
32. Define the term alveolar bone and describe its function in the periodontium.
33. Define the term pathogenesis.
34. Define the term periodontal disease and contrast it with the term periodontitis.
35. Name and define the two types of periodontal disease.
36. Compare and contrast the clinical and histologic characteristics of the periodontium in health, gingivitis, and periodontitis.
37. Describe the sequential development of inflammatory periodontal disease.
38. Describe the position of the crest of the alveolar bone in gingivitis.
39. Describe the position of the junctional epithelium in health, gingivitis, and periodontitis.
40. Describe the epithelial-connective tissue junction in health, gingivitis, and periodontitis.
41. Explain why there is a band of intact transseptal fibers even in the presence of severe bone loss.
42. Describe the progressive destruction of alveolar bone loss that occurs in periodontitis.
43. Compare and contrast horizontal and vertical bone loss.
44. Describe the pathway of inflammation that occurs in horizontal bone loss.
45. Describe the pathway of inflammation that occurs in vertical bone loss.
46. Define the terms active disease site and inactive disease site.
47. Define the term attachment loss.
48. Define the term gingival pocket. Explain why a gingival pocket sometimes is referred to as a false pocket.
49. Define the term periodontal pocket.
50. Name the two types of periodontal pockets.
51. Given a drawing of a periodontal pocket, determine whether the pocket illustrated is a suprabony or infrabony pocket.
52. List, describe, and differentiate the various periodontal diseases according to the 1999 classification system established by the American Academy of Periodontology.
53. Define and contrast the terms gingival disease, periodontal disease, and periodontitis.
54. Define and contrast the terms plaque-induced gingival diseases and non-plaque-induced gingival lesions.
55. Define and contrast the terms chronic periodontitis and aggressive periodontitis.
56. Describe the variables associated with periodontal disease that an epidemiologist might include in a research study.
57. Define prevalence and incidence as measurements of disease within a population.
58. Discuss historical and current theories associated with the progression of periodontal disease.
59. Describe how clinical dental hygiene practice can be affected by epidemiological research.
60. Define the terms innocuous, pathogenic, virulent, Gram-positive, and Gram-negative.
61. Recognize that not all bacteria are equally capable of causing periodontal disease.
62. Define the term biofilm and explain the advantages to a bacterium of living in a biofilm.
63. Name three everyday examples of biofilms in the environment.
64. Name the three bacteria designated by The World Workshop in Periodontology as periodontal pathogens.
65. Identify bacteria associated with health, gingival diseases, and periodontitits.
66. Describe how the numbers of bacteria vary from health to disease in the periodontium.
67. Name and describe the components of the biofilm structure.
68. Given a drawing of a mature biofilm, label the following: bacterial microcolonies, fluid channels, extracellular slime layer, acquired pellicle, and tooth surface.
69. Explain the significance of the extracellular slime layer to a bacterial microcolony.
70. Explain the purpose of the fluid channels in a biofilm.
71. Define coaggregation and explain its significance in bacterial colonization of the tooth surface.
72. Explain why systemic antibiotics and antimicrobial agents are not effective in eliminating dental plaque biofilms.
73. State the most effective ways to control dental plaque biofilms.
74. Explain why frequent periodontal instrumentation is vital in the control of dental plaque biofilms located within periodontal pockets.
75. Given a drawing of the subgingival plaque biofilm, label the zones of bacterial attachment.
76. Define the terms pathogenecity and local contributing factors.
77. Identify local etiologic factors that contribute to the retention and accumulation of microbial plaque biofilm.
78. Explain the meaning of the phrase "pathogenicity of plaque biofilm".
79. Identify and differentiate the location, composition, modes of attachment, mechanisms of mineralization, and pathogenic potential of supragingival and subgingival calculus deposits.
80. Describe four local contributing factors that can lead to direct damage to the periodontium.
81. Describe the role of trauma from occlusion as a contributing factor in periodontal disease.
82. Define the term immune system and name its primary function.
83. Define the term inflammation and name two events that can trigger the inflammatory response.
84. Name the five classic symptoms of acute inflammation and explain what events in the tissues result in these classic symptoms.
85. Give an example of a type of injury or infection that would result in inflammation in an individual's arm. Describe the symptoms of inflammation that the individual would experience.
86. Compare and contrast acute inflammation and chronic inflammation.
87. Define the term phagocytosis and describe the steps in this process.
88. Describe the role of polymorphonuclear leukocytes in the immune system.
89. Describe the role of macrophages in the immune system.
90. Contrast the terms macrophage and monocyte.
91. Describe the role of B lymphocytes in the immune system.
92. Describe the role of T lymphocytes in the immune system.
93. Decribe the three ways that antibodies participate in the host defense.
94. Define the term inflammatory mediator.
95. Define the complement system and explain its principle functions in the immune response.
96. Define the term immune system and name its primary function.
97. Define the term biochemical mediator and name three types of mediators.
98. Describe the tissue destruction that can be initiated by the biochemical mediators secreted by immune cells.
99. Describe the sequential development of periodontal disease.
100. Describe the role of the host response in the severity and tissue destruction seen in periodontitis.
101. Explain immunologic interactions of the host in periodontal diseases.
102. Describe and differentiate the mechanisms of tissue destruction in periodontal disease.
103. Describe and discuss current knowledge of the immunopathology of periodontal disease.
104. Describe systemic factors that may modify or amplify the host response to periodontal pathogens.
105. Discuss the implications of diabetes on the periodontium.
106. Define the term osteoporosis and discuss the link between skeletal osteoporosis and alveolar bone loss in the jaw.
107. Discuss how hormone alterations may affect the periodontium.
108. Define the term pregnancy-associated pyogenic granuloma.
109. Explain how abnormalities of polymorphonuclear leukocytes may affect the body's response to periodontal pathogens.
110. Describe the genetic and physical characteristics of Down syndrome.
111. Discuss the implications of Down syndrome on the periodontium.
112. Define the term drug-influenced gingival enlargement.
113. Name three medications that can cause gingival enlargement.
114. Discuss the implications of smoking on periodontal health status.
115. Discuss the implications of smoking on the host response to periodontal disease.
116. Discuss the effects of smoking on periodontal treatment outcomes.
117. Discuss the current theories as to why smokers have more periodontal disease than nonsmokers.
118. Explain why tobacco cessation counseling is a valuable part of patient care in the dental setting.
119. Define the term biologic equilibrium and discuss factors that can disrupt the balance between health and disease in the periodontium.
120. Define and give examples of the term contributing risk factors.
121. Describe the characteristics of the gingiva in health.
122. List clinical signs of gingival inflammation.
123. Compare and contrast clinical features of healthy and inflamed gingival tissue.
124. Explain the difference in color between acute and chronic inflammation.
125. Differentiate between bulbous, blunted, and cratered papilla.
126. Name and define the two major subdivisions of gingival disease as established by the American Academy of Periodontology.
127. Compare and contrast dental plaque - induced gingival disease and non-plaque-induced gingival lesions.
128. Describe the clinical signs of inflammation you would expect to find in a patient with moderate plaque-induced gingivitis.
129. List systemic factors that modify gingival disease.
130. Name three types of medications that may cause gingival enlargement.
131. Explain how the use of certain medications and malnutrition can modify gingival disease.
132. Develop a list of suggestions for managing patients with primary herpetic gingivostomatitis.
133. Name and define the three major categories of periodontitis.
134. Recognize and describe clinical and radiographic features of chronic periodontitis.
135. Define the term clinical attachment loss.
136. List systemic factors that may be contributing factors to periodontitis.
137. Define recurrent chronic periodontitis.
138. Define refractory chronic periodontitis.
139. Compare and contrast the clinical and radiographic features of chronic periodontitis and aggressive periodontitis.
140. Discuss the differences between ideal and reasonable treatment goals for aggressive periodontitis.
141. Given the clinical and radiographic features for a patient with a history of aggressive periodontitis, determine if the disease is localized or generalized aggressive periodontitis.
142. Name and define the three major categories of periodontitis.
143. Name and explain systemic or genetic factors that may contribute to the initiation and progression of periodontitis.
144. Describe the impact of PMN (neutrophil) dysfunction on the periodontium.
145. Define necrotizing periodontal diseases.
146. Describe the tissue destruction that occurs in necrotizing periodontal diseases.
147. Compare and contrast the clinical findings of necrotizing ulcerative gingivitis and necrotizing ulcerative periodontitis.
148. Compare and contrast the tissue destruction in chronic periodontitis with that seen in necrotizing ulcerative periodontitis.
149. Name several local factors that may contribute to the initiation and progression of periodontitis.
150. Define secondary occlusal trauma and explain how it can lead to rapid bone loss.
151. Explain which members of the dental team are responsible for the clinical periodontal assessment.
152. Compare and contrast a periodontal screening examination and a comprehensive periodontal assessment.
153. Describe how to perform one type of periodontal screening examination.
154. Name the components of a comprehensive periodontal assessment.
155. Describe how to evaluate each component of a comprehensive periodontal assessment.
156. Explain how to calculate the width of the attached gingiva.
157. Explain how to calculate clinical attachment level given several different clinical scenarios.
158 Recognize the radiographic characteristics of normal and abnormal alveolar bone.
159. Recognize and describe early radiographic evidence of periodontal disease.
160. Distinguish between vertical and horizontal alveolar bone loss.
161. Recognize potential etiologic agents for periodontal disease radiographically.
162. Gain practical experience in radiographic assessment by applying information from this chapter in the clinical setting.
163. Explain the possible relationship between vitamin D and calcium deficiency and periodontal disease.
164. List some oral symptoms that can be seen in chronic or severe vitamin C deficiency.
165. Explain the term ascorbic acid-deficiency gingivitis.
166. List several nutrient deficiencies that may increase the risk for periodontal disease.
167. Name two dietary factors that may increase the risk for periodontal disease in addition to specific nutrient deficiencies.
168. Name three general functions of nutrients in maintaining periodontal health.
169. Define the term best practice.
170. Summarize how the explosion of knowledge is impacting practitioners and patients.
171. Identify the three components of evidence-based decision making.
172. Define a systemic review.
173. Describe the role of the patient in the evidence-based model.
174. List locations for accessing systematic reviews.
175. Explain the difference between a peer-reviewed journal and trade magazine.
176. Formulate a question using the PICO process.
177. List the three fundamental diagnostic questions used when assigning a periodontal diagnosis.
178. Explain how to arrive at appropriate answers to each of the fundamental diagnostic questions.
179. Explain the difference between the terms signs of a disease and symptoms of a disease.
180. Explain the term silent disease.
181. Describe what is meant by the term clinical attachment loss.
182. Describe the elements of a well written diagnosis for periodontitis.
183. List the phases of treatment.
184. Explain the term informed consent.
185. List guidelines for obtaining informed consent.
186. Explain the term nonsurgical periodontal therapy.
187. Name four goals for nonsurgical therapy.
188. Write a typical plan for nonsurgical therapy for a patient with plaque-induced gingivitis.
189. Explain the terms periodontal debridement and deplaquing.
190. Describe the type of healing to be expected following successful instrumentation of root surfaces.
191. Explain the origin of the condition called dental hypersensitivity.
192. Describe a strategy for managing dentinal hypersensitivity during nonsurgical therapy.
193. Explain why reevalation is a critical step during nonsurgical therapy.
194. List steps in an appointment for reevaluation of the results of nonsurgical therapy.
195. Describe three decisions made during the reevaluation appointment.
196. Explain current American Academy of Periodontology recommendations for deciding which patients should be managed by a periodontist.
197. Recognize the role of ambivalence in patient behavior change and explain the goal of motivational interviewing with respect to ambivalence.
198. Describe the primary difference between how hygienists often approach patient education and the motivational interviewing approach.
199. Be able to identify the three elements of the motivational interviewing philosophy and the four general principles.
200. Give examples of specific motivational interviewing methods and how they are used to enhance patient motivation.
201. Explain the term host modulation.
202. Explain the potential importance of host modulation.
203. Name some proinflammatory mediators.
204. List three types of drugs that have been studied for use as possible host modulating agents.
205. Explain why low dose doxycycline are useful as host modulating agents.
206. Explain the term sub-antibacterial dose.
207. Make a list of treatment strategies for a periodontitis patient that includes host modulation.
208. List objectives for periodontal surgery.
209. Explain the term relative contraindications for periodontal surgery.
210. Define the terms repair, reattachment, new attachment, and regeneration.
211. Explain the difference between healing by primary intention and healing by secondary intention.
212. Explain the term elevation of a flap.
213. Explain two methods for classification of periodontal flaps.
214. Describe two types of incisions used during periodontal flaps.
215. Describe healing following flap for access and open flap debridement.
216. Describe the typical outcomes for apically positioned flap with osseous surgery.
217. Define the terms ostectomy and osteoplasty.
218. Define the terms osteoinductive and osteoconductive.
219. Explain the terms autograft, allograft, xenograft, and alloplast.
220. Name two types of materials available for bone replacement grafts.
221. Explain why a barrier material is used during guided tissue regeneration.
222. Explain the term periodontal plastic surgery.
223. List two types of crown lengthening surgery.
224. List some disadvantages of gingivectomy.
225. Describe the technique for a gingival curettage.
226. Explain what is meant by biological enhancement of periodontal surgical outcomes.
227. Name two broad categories of materials used for suturing periodontal wounds.
228. Explain the term interrupted interdental suture.
229. List general guidelines for suture removal.
230. Describe the technique for periodontal dressing placement.
231. List general guidelines for periodontal dressing management.
232. Explain the important topics that should be covered in postsurgical instructions.
233. Explain the term periodontal maintenance.
234. List three objectives of periodontal maintenance.
235. Describe how periodontal maintenance relates to other phases of periodontal treatment.
236. Name useful procedures performed during a patient appointment for periodontal maintenance.
237. Define the term baseline data.
238. Describe guidelines for determining whether the general practice office or the periodontal office should provide periodontal maintenance for a particular patient.
239. Describe how to establish an appropriate maintenance interval.
240. Define the term recurrence of periodontitis.
241. List clinical signs of recurrence of periodontitis.
242. List reasons for recurrence of periodontitis.
243. Explain the term compliance.
244. Define the terms compliant patient and noncompliant patient.
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