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1 G ood by e R ou tin e R ecall Hello Health y Clien t an d Pr actice A System of Successful Treatment of Soft Tissues Beth Ryerse, RDH

2 Oral Disease and Oral Care Solutions Three major diseases we are concerned with as RDH s Periodontal Disease Oral Cancer Caries

3 Oral Dis-ease Management Ease being very comfortable and able to live as you want, without any worries or problems. Dis-ease being uncomfortable and not able to live as you want, with worries or problems. Oral Health context ability to chew, talk, smile, kiss and be comfortable with your presenting self. Oral Dis-ease a state where those simple tasks are troublesome, humiliating and possibly, painful.

4 September 4, 2012 One out of every two American adults aged 30 and over has periodontal disease, according to recent findings from the Centers for Disease Control and Prevention (CDC). A study titled Prevalence of Periodontitis in Adults in the United State estimates that 47.2 percent, or 64.7 million American adults, have mild, moderate or severe periodontitis, the more advanced form of periodontal disease. P.I. Eke, B.A. Dye, L. Wei, G.O. Thornton-Evans, and R.J. Genco. Prevalence of Periodontitis in Adults in the United States: 2009 and J DENT RES , first published on August 30, 2012 as doi: /

5 Periodontal Disease is a Bacterial Infection and the body s reaction to that infection Other factors that may increase risk: Family history Medications Age Gender Family transmission Smoking Prior gum disease Clenching/grinding Stress Osteoporosis Diabetes Hormones

6 Periodontal Disease may increase your risk for a variety of health concerns including: Diabetes Cardiovascular disease Stroke Lung Infections Preterm, low birth-weight infants Respiratory diseases

7 Examination & Charting History Oral Exam Data Gathering Co-Discovery Co-Diagnosis Case Presentation Fees and Insurance

8 Perio Exam Call the numbers out loud once client understands the significance of them Give the client a hand mirror hold in right hand see what I am seeing Ask client to raise left hand if any areas are tender Client is now very involved in the exam and learning!

9 Case Type I Gingivitis Case Type II Chronic Periodontitis Generalized, Slight Case Type III Chronic Periodontitis Generalized, Moderate

10 Root Caries and Overall Health root caries was an independent predictor of incident myocardial infarction.may be a marker for an overall decline in health. Mauriello SM et al Root caries prevalence and incident myocardial infarction. Abstract 1471, v. 85, Special Issue A, AADR Annual Meeting, Orlando, FL

11 Oral Cancer Two etiological factors: 1. Alcohol and tobacco 2. Human Papilloma virus Approximately 75% of Canadians will have a HPV infection in their lifetime. A 225% increase in HPV-positive oropharyngeal cancers is reported by major cancer registries. If this trend continues, this type of cancer will surpass cervical by year (8):2011; JADA

12 Case Presentation Pain / Time / $

13 Elements of a Complete Case Presentation Information data collected and assessment findings are shared Education explanation of the significance of assessment short and long range possibilities and consequences - ASK? s to determine level of understanding and client priorities and interest in pursuing care Options alternative methods of care - benefits, time involved, treatment risks, risks of non-treatment and cost for each option Choice informed decision based on understanding of info, priorities, desire for treatment and perceived needs Agreement client and professional concur on a course to follow dental hygienist as advocate, supports the informed decision made by the client

14 Scaling Instrumentation of the crown and root surfaces of the teeth to remove bacterial plaque biofilm, calculus, and extrinsic stains from surfaces without the intentional removal of tooth surface. Root Planing Definitive treatment procedure designed to remove cementum or surface dentin that is rough, impregnated with calculus, or contaminated with toxins or microorganisms; no longer recommended as a routine procedure for all root surfaces of periodontally involved teeth D & W 2003

15 Dr. Irene Woodall Ultrasonic instrumentation is now the first choice over hand instrumentation for most patients. This constitutes a major shift in dental hygiene approach to treatment This text has placed hand instrumentation secondary to ultrasonic instrumentation (Woodall I., et al Comprehensive Dental Hygiene Care, 4th ed.)

16 Disease What role does Management disease management at home play in a successful therapy How Important is Homecare? program? What are the tools our patients need to be successful? What role do we play in the success of a patient's disease management at home?

17 A Novel Strategy to Reduce Biofilm 17

18 The ADA Risk Management Series states: In viewing periodontal treatment, the role of the patient should not be overlooked. The patient must be an active participant in the treatment through compliance in fact, the role of the patient is paramount to the success of therapy.

19 Multi-Modal Options Mechanical Professional -- Scaling / Root Planing Patient -- cleaning Chemical Brushing & interproximal Professional -- Antimicrobial (local & systemic) Patient -- Dentifrice, Rinses 19

20 Qualities of an Ideal Chemotherapeutic Agent Effective against specific microbes Inhibit the overgrowth of other organisms Not cause bacterial resistance Nontoxic to oral tissues Acceptable to the patient (taste, ease of use, cost) Bioactive (available and active in the oral cavity) long after the application has ceased. 20

21 Behavior Modification An approach to correction of undesirable conduct that focuses on changing observable actions; modification of behaviour is accomplished through systematic manipulation of the environmental and behavioral variables related to the specific behaviour to be changed.

22 Dispensing Easy way to help clients get the self-care products that can provide them with the greatest benefit Part of an all encompassing treatment plan and ensures measurable clinical results To recommend is human; to dispense is divine Julie Csoki RDH, BS & Liz Lundry RDH

23 Supportive Periodontal Therapy Long-term, frequent maintenance therapy (scaling and antimicrobial therapy) used after active therapy has been successful in eliminating periodontitis - continues for the life of the dentition or its implant replacements - Clients must understand that they have a chronic disease that cannot be cured, only controlled by frequent periodontal care and daily self-care.

24 Keys To Your Success? Better client communication. Increased client compliance. Making a more powerful contribution to the practice. HealthyPracticeNow.ca Online continuing education: dentalcare.ca

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