Pierce College Dental Hygiene Syllabus
Campus – Lakewood, WA
Quarter
Winter, 2010
Course Title
DHYG 111
Periodontology I
Course Credits
2 credits
Pre-requisites
Enrollment in the dental hygiene program at Pierce College
Course Description
The first in a series of three courses, DHGY 111, 121, and 231
introducing the dental hygiene student to the basic science and
introductory components for assessing and evaluating the periodontal
health of individuals.
Room Location
Pierce Campus: Cascade 125
Day and Time
Thursdays, 10am-12pm
Instructor
Kathy S. Forbes, RDH, BS
Office Hours and Room
To be arranged – 8am-10am on Thursdays
Contact Information
Email: ks.forbes@comcast.net
Emergency phone: 253-848-5385 (home) or 253-905-7781 (cell)
Required Textbooks
Carranza’s Clinical Periodontology (10th Edition) by
Carranza FA, Newman MG, Takei HH, Klokkevold, PR;
WB Saunders Co: Philadelphia, PA, 2006 (ISBN 978-14160-2400-2 and ISBN-10: 1-4160-2400-X)
Required References
Illustrated Dental Embryology, Histology, and Anatomy (2nd Edition)by
Bath-Balogh, M, Fehrenbach, MJ: Elsevier Saunders, 2006 (ISBN 9871-4160-2499-6)
Additional articles will be posted on Angel on a week-by-week basis in
order to provide current information to supplement the text which was
published in 2006
Course Topics
(with approximate
distribution hours)
What is periodontal disease? – basics (1 hr)
Historical background of Periodontology (1/2 hr)
Review normal periodontium (1.5 hrs)
Classification of diseases and conditions affecting periodontium (1 hr)
Epidemiology of gingival and periodontal diseases (2 hrs)
Microbiology of periodontal diseases (2 hrs)
Immunity and inflammation – basic concepts (1.5 hrs)
Microbial interactions and defense mechanisms (2 hrs)
Periodontal pathology (2 hrs)
Host immune response to periodontal pathology (2 hrs)
1
Course Outcomes
1. Discuss the historical background of Periodontology from early
civilizations until post World War II (A,T)
2. Identify, discuss and explain the function of the normal/healthy
periodontal structures of the periodontium using correct terminology:
marginal gingival; gingival sulcus; attached gingival; interdental
gingival; alveolar gingival; mucogingival junction; gingival epithelium;
gingival connective tissue; periodontal ligament (fibers, ground
substance); cementum (types, permeability, cementoenamel junction,
resorption, repair; alveolar process (socket wall, bone marrow,
periosteum, endosteum, and etc. (A, T) (1.3,2.2,3.2,3.3,11.1)
3. Identify and explain the histological features and embryological
development of the periodontal structures in health and in a diseased
state. (A, T) (3.2,3.3)
4. Discuss and describe the effects of aging on the periodontium. (A,
B, T, Z)
5. Describe, define and list the current American Academy of
Periodontology (AAP) classifications of periodontal diseases and their
epidemiology. Compare, contrast and differentiate from previous
classifications. (A, D, T) (3.2,3.3)
6. Use and apply the AAP classifications to analyze and provide a
dental hygiene diagnosis for case studies in class and eventually, for
clinical patients. (A, B, T, Z)
7. Describe and discuss the inflammatory process and immune
system. This includes identifying and describing the vascular response
to injury, the chemical mediators in vascular response, the blood
leukocytes and their respective roles or functions. (A, F, T) (3.2,3.3)
8. Identify the AAP classification for patients from written case
descriptions which may include narratives, photos, x-rays, etc. (F, T)
(3.1,3.2,8.3)
Optional References
Lexicomp ONLINE for Dentistryv2009
Periodontology for the Dental Hygienist (3rd Edition) by Perry, DA &
Beemsterboer, PL; Saunders: Philadelphia, PA, 2007. (ISBN-13: 9781-4160-0175-1 and ISBN-10: 1-4160-0175-1)
Manual of Clinical Periodontics by Serio FG & Hawley, CE; Lexi-Comp,
Inc.: Hudson, OH, 2002. (ISBN 1-930598-82-3)
Fundamentals of Periodontics (2nd Edition) by Wilson, TB & Kornman,
KS; Quintessence Publishing: Chicago, 2003. (ISBN 0-86715-405-5)
Method of Instruction
Course instruction will utilize a variety of approaches:
Lecture
Classroom/group discussion
Group assignments, projects and presentations
Instructor observation
Written examinations
Student Conduct Policy
Please refer directly to the Pierce College Student Code of Conduct and
the Pierce College Dental Hygiene Program Student Handbook for the
general guidelines of conduct within and related to this class.
Professional behavior is expected. Please remember that you signed
and agreed to all of the rules, policies, criteria, etc. set forth in the
handbook. In addition, please review for the use of cell phones in the
classroom and clinic.
2
Course Evaluation
As with most courses within the Dental Hygiene Curriculum, this course
provides a foundation for other courses, therefore attendance is
required. Should an emergency arise, it is the student’s responsibility
to contact the course instructor immediately. Further, the student
must initiate and be responsible for obtaining any missed information
presented during the class(es) missed.
Group Assignments, Projects and Presentations:
For most assignments student will work collaboratively as groups of 5.
These grouping will be determined on the first day of class. In
addition, there may be subgroups assigned to portions of various
assignments.
Course Evaluation Weighting:
Unit Objectives and Evaluation (3):
15%
Group Assignments/Projects/Presentations (6): 30%
Exams (3):
55%
Students are expected to come to class prepared, to have completed
the assigned reading and/or homework in advance of scheduled
lectures, actively participate in activities of learning and apply concepts
to contiguous units rather than merely rely on memorization.
Deficiencies in any of these areas may be reflected in the student’s
final course grade.
Late work: Students are expected to complete all course assignments
by 8:00am on the posted due date. Grades for all assignments
received or completed after the end of the class period in which it is
due will be reduced by 50% for each 24 hours period it is late. Since
most of the assignments for this class are submitted as a group
assignment, all members of the group will receive the reduced grade.
It is imperative that all members of each group work together to help
each other if someone is unable to complete their portion on time.
Course Requirements
Unit Objectives (15%)
Unit #1 – Normal Periodontium
Unit #2 – Classifications of Periodontal Diseases and Conditions,
Microbiology of Periodontal Diseases and the Role of Dental Calculus
and Other Predisposing Factors
Unit #3 – Immunity and Inflammation: Basic Concepts, Microbial
Interactions with the Host in Periodontal Disease and Periodontal
Pathology
Group Assignments, Projects or Presentations (30%)
#1 – Presentation – Review of Normal Periodontium (Chapters 4-6)
#2 – Presentation – Epidemiology (Chapter 8)
#3 – Complete PPT (Chapters 9-10)
#4 – Homework and Group Discussion (Chapter 12)
#5 – Complete PPT (Chapters 20, 21, 22, 23, 24, 25)
#6 – (Small Group) Presentation – Role Playing (Chapters 12, 13)
3
Exams (55%)
#1 – History, Chapters 4, 5, 6, (1 hour)
#2 – Chapters 7, 8, 9, 10 (2 hours)
#3 – Chapters 12, 13, 20, 21, 22, 23, 24, 25 (2 hours)
Exams may include essay/short answer, true/false, multiple choice and
matching responses. Students are expected to complete any assigned
exams on the scheduled dates. There will be no make-up sessions for
an unexcused absence and a grade of zero will be given.
If an emergency should arise, it is the student’s responsibility to
contact the instructor before the scheduled time of the exam to make
alternative arrangements. The student must be prepared to make-up
the exam prior to the next class session. Alternative arrangements, if
any, will be at the discretion of the instructor.
Written exams will be graded on the basis of one of the following
methods:
1. Straight percentage of points available (students will be advised in
advance if this method is used).
2. Adjusted percentage after item audit (allowing for questions to be
eliminated).
3. Adjusted to a “class curve”, the highest score earned equaling
100% providing the highest score is not below 92% of the possible
points, in which case 92% becomes the base for 100%.
If a student earns less than a 2.0 on any of the exams, s/he must
make an appointment with the course instructor, within one week of
the grades being posted, to review the exam and determine additional
course work which needs to be completed in order to show minimum
understanding of the material.
Course Grading
All percent scores earned for the evaluation criteria categories will be
added together and converted to a final numeric course grade
according to the following scale:
100%
99%
98%
97%
96%
95%
94%
93%
92%
91%
90%
4.0
3.9
3.8
3.8
3.7
3.6
3.5
3.4
3.3
3.2
3.2
89%
88%
87%
86%
85%
84%
83%
82%
81%
80%
3.1
3.0
2.9
2.9
2.8
2.7
2.6
2.5
2.4
2.4
79%
78%
77%
76%
75%
74%
73%
72%
71%
70%
2.3
2.2
2.1
2.0
2.0
1.9
1.8
1.7
1.6
1.5
Decimal grades will be awarded according to the Pierce College Dental
Hygiene Department grading scale with the lowest acceptable score
being 75% or 2.0
Grade from 1.9-1.6 are considered “probationary” grades and 1.5 or
below grades are considered “failing” according to the Dental Hygiene
4
Department Academic Policy and are subject to probationary and/or
dismissal actions.
By the end of the quarter, each student will have had the opportunity
to attain minimum competency in the expected student outcomes. If it
is determined by the course instructor that a student has not
successfully achieved the student outcomes, the student may have
additional course work assigned, the course grade adjusted accordingly
(reduction of grade or incomplete grade with remediation assigned to
determine competency in all course objectives), and/or the student
may be placed on academic probation with possible dismissal from the
Dental Hygiene Program as outlined in Pierce College Department of
Dental Hygiene Program Policy.
Incomplete Grades
The student must complete all course requirements and attain a
minimum grade of 2.0 in the course to progress to the next sequential
courses. Incomplete grades are expected to be completed within the
first 3 weeks of the next quarter. The student is responsible to
schedule an appointment with the course instructor to examine the
reason the coursework has not been completed and define a plan for
completion of the course. Students are expected to submit, in writing,
their proposal for completion of requirements to the course instructor
at this meeting. If the work is not completed at this time and there are
no extenuating circumstances for the work to be outstanding, the final
course grade may be changed to a 1.5.
Additional Grading
Factors
Professionalism – Students are expected to project professional
conduct and communication towards faculty, staff, classmates, patients
and visitors at all times as outlined in the Department of Dental
Hygiene Program Policy. Deficiencies in professional conduct and
communication will be reflected as a reduction in the student’s final
course grade.
Honesty – Students are expected to demonstrate unquestionable
honesty at all times as outlined in the Department of Dental Hygiene
Program Policy. Deficiencies in honesty will be reflected as a reduction
in the student’s final course grade. Breeches in the Academic Honesty
Policy may be subject to the student’s immediate dismissal from the
Dental Hygiene Program.
Considerations which may be reflected in the student’s final course
grade include:
*promptness to class sessions
*preparation and participation during class sessions
*individual effort put toward group assignments/projects/presentations
5
Schedule
Topic
Week 1
January 7
Week 2
January 14
Week 3
January 21
Reading/Assignments
Review Syllabus
Review assignments,
projects, requirements
Create groups
Introduction to
Periodontal Disease
Syllabus
Historical background
Review normal
periodontium
Introduction:
History pp 1-9 (9)
Chapter 4:
The Gingiva (18)
Chapter 5:
The Tooth- Supporting
Structures (20)
Chapter 6:
Aging and the
Periodontium (5)
Exam #1 (1 hour)
History, Chapters 4-6
10am-11am in SNR 213
Assignments
(Due dates noted)
Bring textbook to class.
Group assign. #1 to be
presented by each
group during class
Unit #1 due to
Evaluators Monday,
January 11.
Unit #1 due today at
8am
Chapter 7:
Classification of Diseases
and Conditions Affecting
the Periodontium (9)
11:10am-12pm
Introduction to
Classification of
Periodontal Diseases
Students should “scan”
chapter prior to class.
Week 4
January 28
Continued discussion of
Classification of
Periodontal Diseases
Epidemiology
Chapter 8:
Epidemiology of Gingival
and Periodontal Diseases
(19)
Group Assign. #2 due
during class:
homework or
presentation
Week 5
February 4
Etiology of Periodontal
Diseases
Chapter 9:
Microbiology of
Periodontal Diseases (29)
Chapter 10:
The Role of Dental
Calculus and Other
Predisposing Factors (17)
Unit #2 due to
Evaluators Monday,
February 1
Group Assign. #3 –
Complete PPT due to
instructor February 2
at 8am
Unit #2 due today at
8am
Week 6
February 11
Exam #2 (2 hours)
Chapters 7, 8, 9, 10
10am-12pm in SNR 213
None
6
Week 7
February 18
Immunity and
Inflammation
Chapter 12:
Immunity and
Inflammation: Basic
Concepts (17)
Review notes and text
from A&P classes related
to inflammation and the
immune system
Week 8
February 25
Periodontal Pathology
Chapter 13:
Microbial Interactions with
the Host in Periodontal
Diseases (17)
Chapter 20:
Defense Mechanisms of
the Gingiva (6)
Chapter 21:
Gingival Inflammation (6)
Group Assign. #4 –
Homework/In-class
discussion today
Small Group Assign #6
Select role-playing
topics.
Unit #3 due to
Evaluators Monday,
February 22
Group Assign. #5 –
Develop PPT due to
instructor February 23
at 8am
Unit #3 due today at
8am
Week 9
March 4
Periodontal Pathology
(continued)
Week 10
March 11
Role-Playing
Presentations
Finals Week
March 18
Exam #3 (2 hours)
Chapters 12, 13, 20, 21,
22, 23, 24, 25
10am-12pm in SNR 213
Disclaimer
Chapter 22:
Clinical Features of
Gingivitis (8)
Chapter 23:
Gingival Enlargement (15)
Chapter 24:
Acute Gingival Infections
(10)
Chapter 25:
Gingival Disease in
Childhood (5)
Group Assign. #5 –
continued.
None
Small Group
Assignment #6 - RolePlaying Presentations
today
Rough draft outline of
Role Playing
Presentation due today
during class.
Course handouts are for the purpose of directing self-study and note
taking. PowerPoint presentations are provided on Angel for study and
review. It is not considered a requirement to print all presentations for
class. They will be heavily loaded with color graphics and photographs
that can be time and ink intensive to print. Students are encouraged
to use a variety of note taking strategies and should consider printing
only what they individually wish to have in class. Using “draft” and
“grayscale” print modes can conserve on ink. Faculty are not required
to post multiple versions for convenience as these are supplemental to
class and an “added benefit”.
7
The syllabus may be altered at any time during the course as deemed
necessary by the instructor. Changes requiring a schedule or time
frame alteration will be given with sufficient notice for students to
accommodate. Emergencies are the exception.
Security/Emergency
Procedures for
Classrooms
Call 911 and then Campus Safety in response to an imminent threat to
persons or property. In the event of an evacuation (intermittent horns
& strokes), gather all personal belongings and leave the building using
the nearest available safe exit. Be prepared to be outside for one hour
and stay a minimum of 200 feet from any building or structure. So
long as it is safe to do so, students are expected to stay on campus
and return to class after evacuations that last less than 15 minutes.
Do not attempt to re-enter the building until instructed by an
Evacuation Director (identified by orange vests) or by three horn blasts
or bell rings. Please notify the nearest Campus Safety Officer or
Evacuation Director of any one left in the building or in need of
assistance.
Fort Steilacoom Campus Safety (253) 964-6751
Puyallup Campus Safety (253) 840-8481
Chapter Objectives
Unit #1:
1. Demonstrate correct usage and spelling of dental terminology.
Historical
2. Discuss the historical background of Periodontology from early
Background
civilizations until post World War II, specifically as it relates to:
Chapter 4
a. Early civilizations: Egyptians, Chinese, Hebrews
Chapter 5
b. Hippocrates
Chapter 6
c. Romans
d. Albucasis
e. Pierre Fauchard
f. Leonard Koecker
g. John W. Riggs
h. Adolph Witzel
i. Current understanding of plaque and periodontal diseases.
3. Describe and discuss each aspect of the following:
a. Periodontium including gingiva, periodontal ligament, cementum,
alveolar bone.
b. Functions of the parts of the periodontium, both general and specific.
c. Oral mucous membranes
d. Effects of aging on the periodontium
4. Describe and discuss the names, functions, types, significant
components and major microscopic features of the following:
a. Gingiva: marginal, attached, interdental, free gingival groove,
mucogingival junction
b. Gingival sulcus: probing depths
c. Gingival epithelium: stratified squamous, four layers, Rete
ridges/pegs, Langerhans cells, and their degree of keratinization
d. Sulcular epithelium
e. Junctional epithelium: thickness, formation needs, location,
permeability and the dentogingival unit.
8
5. Describe and discuss the names, functions, types, significant
components, and major microscopic features of the following:
a. Blood sources
b. PDL: components, fibers, how arranged, ground substance, defense
mechanism and remodeling, facts.
c. Gingival crevicular fluid
d. Cementum: permeability, CEJ, relation to tooth eruption, resorption
(local and systemic)
e. Alveolar bone: structure, relation to periosteum, bundle bone,
interdental septum, crestal bone, dehiscences, fenestrations, remodeling,
mesial migration
Unit #2:
Chapter 7
Chapter 8
Chapter 9
Chapter 10
1. Demonstrate correct usage and spelling of dental terminology.
2. Describe each of the following 1989 Classification categories according
to their clinical characteristics:
a. O – healthy
b. I – Early/Chronic Gingivitis
c. II – Established Gingivitis / Early Periodontitis
d. III – Moderate Periodontitis / Chronic Periodontitis
e. IV – Advanced Periodontitis
f. V – Refractory Periodontitis
3.Explain the rationale used to create the 1999 Classification System
including:
a. Why Gingival Disease was added?
b. Why Adult Periodontitis was replaced with Chronic Periodontitis?
c. Why Early-Onset Periodontitis was replaced with Aggressive
Periodontitis?
d. Why Refractory Periodontitis was eliminated?
e. Why Periodontitis as a Manifestation of Systemic Diseases were
added?
f. Why place Necrotizing Ulcerative Periodontitis with Necrotizing
Periodontal Diseases?
g. Why Periodontal Abscess was added?
h. Why Periodontal-Endodontic Lesions was added
i. Why Developmental or Acquired Deformities and Conditions were
added?
4. Describe the following:
a. What is meant by “loss of attachment” or “clinical attachment loss”
b. Acute vs. Chronic in relation to periodontal conditions
c. Developmental or acquired
5. Utilizing the General Guidelines established by the AAP, define what is
meant by:
a. Localized
b. Generalized
c. Slight loss of attachment/Clinical attachment loss
d. Moderate loss of attachment/Clinical attachment loss
e. Severe loss of attachment/Clinical attachment loss
6. In general terms, describe each of the 1999 AAP Classification
categories I-VIII according to the following:
a. Clinical characteristics
b. Any know contributing factors/causes? List and describe.
c. Any modifiers of the condition? List and describe.
7. Describe the structure of dental plaque. Is plaque considered a
biofilm? Why or why not?
9
8. Describe the differences betwe3en supragingival plaque, toothassociated plaque, tissue-associated plaque, and junctional epithelium
plaque.
9. Describe the phases of plaque formation including adhesion, transport,
attachment, colonization and maturation.
10. Describe coaggregation
11. Describe the interactions between microbial communities, early
colonizers vs. secondary colonizers (complexes or independent?)
12. For gingivitis: List and describe the microbes involved – their
amount, types and characteristics.
13. For periodontitis: List and describe the microbes involved – their
amount, types and characteristics.
14. List known risk factors for periodontitis and any potential risk factors.
15. Describe aggressive etiology and list aggressive microbes, systemic
microbes, necrotizing microbes, abscess microbes. Notice any correlation
between abscess microbes and chronic microbes.
16. Why are the regions where plaque accumulates significant?
17. Describe the role of microorganisms in the mineralization of calculus.
18. Describe how the following predisposing factors can contribute to
gingival inflammation and periodontal destruction:
a. margins of restorations
b. contours and open contacts
c. materials
d. design of removable partial dentures
e. malocclusion
f. orthodontic therapy
g. extraction of impacted third molars
h. habits and self-inflicted injuries
i. tobacco use
j. radiation therapy
19. Using verbage a patient would understand, explain the difference
between plaque and calculus.
Unit #3:
Chapter 12
Chapter 13
Chapter 20
Chapter 21
Chapter 22
Chapter 23
Chapter 24
Chapter 25
1. Demonstrate correct usage and spelling of dental terminology.
2. Describe the immune system by defining its purpose, properties, and
how it completes its function.
3. Describe the mediators in vascular response and how they interact:
a. Histamine
b. Serotonin
c. Plasma proteins or enzyme systems: kinin, fibrinolytic, complement
(including the five ways it promotes inflammation)
d. Prostaglandins
e. Leukotrienes (eichosanoids)
f. Platelet activating factor
g. Nitric oxide
h. Neuropeptides
4. Define the role of neutrophils including what happens when an
accumulation destroys host tissues.
5. Define transendothelial migration and its role in the inflammatory
process.
6. Explain the steps in phagocytosis. Explain “rolling”, chemotaxis,
opsonization, and digestion.
7. Describe lysosomal leakage and why this is important to know.
8. List the three enzymes that are damaging to the extracellular matrix
and explain why.
10
9. Describe lymphocytes including the main types, where they are found,
how they respond to stimulus, and their life span.
10. Differential between repair, resolution and regeneration.
11. Describe the stages of repair.
12. Describe the role of the following in wound healing:
a. Neutrophils
b. Macrophages
c. Platelets
d. Fibroblasts
13. Explain why debridement of a wound is important.
14. Describe the difference between retraction of a wound and
contraction of a wound.
15. Describe how lipopolysaccharides or endotoxins
disrupt the host immune system and explain what has been documented
regarding the host response and lipopolysaccharides.
16. Describe the properties/components of the extracellular matrix and
explain its function/purpose.
17. Describe the pathway (alternative or classical) which the host
responds to in periodontal disease.
18. Describe the four stages of gingival inflammation.
19. Explain the significance of bleeding on probing and how to use this
information clinically.
20. Explain the significance of gingival crevicular fluid and saliva and their
interrelationship in health/disease with leukocytes, etc.
21. Define and discuss “actual” versus “apparent” position of:
a. Gingival recession
b. Stillman’s cleft
c. McCall’s festoon
22. Describe the different types and grades of gingival enlargement
including their causes and clinical features.
23. Describe the clinical features, diagnostic criteria, differentiation
criteria, microbial predominance if determined and any significant facts
associated with the following (including association with systemic
diseases):
a. Three types of acute gingival diseases: NUG, NUP, NUS
b. Primary herpetic gingivostomatitis
c. Periocoronitis
d. Pre-eruption bulge
e. Desquamative gingivitis
24. Compare the terms transmissible and communicable and provide one
example of each.
25. Describe the most prevalent childhood gingival disease.
26. Describe the causes of recession in children.
27. Identify the syndrome in the developmentally disabled population
which is usually associated with NUG and explain why.
28. Differentiate between stomatitis medicamentosa and stomatitis
venenata or contact stomatitis.
11