Quarter
Course Title
Campus – Lakewood, WA and Port Angeles, WA
Spring, 2011
DHYG 121
Periodontology II
Course Credits
Pre-requisites
Course Description
Room Location
Day and Time
Instructors
3 credits
Enrollment in the dental hygiene program at Pierce College
The second 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.
Pierce Campus: Cascade 125 and Peninsula Campus: L19A
Thursdays, 8:30am-12pm
Kathy S. Forbes, RDH, BS
Linda Walsh, RDH, BS
Office Hours and Room To be arranged – 7:30-8:30 on Thursdays
Contact Information Email: ks.forbes@comcast.net
Emergency phone: 253-848-5385 (home) or 253-905-7781 (cell)
Required Textbooks
Email: lwrdh@comcast.net
Emergency phone: 206-243-3310
Carranza’s Clinical Periodontology (10 th Edition) by
Carranza FA, Newman MG, Takei HH, Klokkevold, PR;
WB Saunders Co: Philadelphia, PA, 2006 (ISBN 978-1-
4160-2400-2 and ISBN-10: 1-4160-2400-X)
Required References
Course Topics
(with approximate distribution hours)
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
Lecture:
Review of Gingival Description/Radiographic Interpretation/Case
Histories/Classification of Periodontal Diseases – 1 hour
Desquamative and acute gingival diseases – 2 hours
Chronic periodontal diseases, bone loss patterns – 2 hours
Initial periodontal therapy (phase 1), scaling and root planing – 2 hours
Periodontal medicine, clinical diagnosis – 2 hours
Risk assessment, prognosis, treatment plan and rationale – 2 hours
Endoscopy use in periodontal treatment – 1 hr
Chemotherapeutics, antimicrobials, periodontal packs, irrigation – 2 hrs
(+6 hrs exams) TOTAL: 20 hours.
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Course Outcomes
Optional References
Lab:
Gingival descriptions and radiographic interpretation – 1.5 hours
Root morphology and furcation ID – 3 hours
Instrument selection for periodontal treatment –2.5 hours
Instrumentation adaptation to root surfaces – 3.0 hours
Review instrument sharpening and sharpening files – 1 hour
Root identification, instrument identification and selection – 2 hours
(+2 hrs lab exams) TOTAL: 15 hours
1. Describe and synthesize content for the etiology and pathogenesis of periodontal disease. Include applicable microbiology, host/microbe interaction, would healing, process, development and consequences
(A,E,F,T,)
2. Describe and identify various consequences of periodontal disease processes. Include bony defects, recession, etc. (A,T)
3. Identify, contrast, and compare select systemic diseases and their relationship in the progression, severity and treatment of periodontal diseases. Infer knowledge to case studies. (A,F)
4. Identify and discuss for adult dentition, root morphology, periodontal instruments, and periodontal instrumentation. Include designating indications for specific instrument selection. The specific instruments are from the current instrument issue and will include files, the Gracey series and Langer/Pattison. (A,I,J,K,L)
5. Demonstrate correct sharpening techniques for the periodontal instruments introduced in this course. (J,K,L)
6. Identify and discuss Non-Surgical Periodontal Therapy (NSPT) treatment planning. Focus on the determining prognostic and risk factors and the rationale for determining prognosis and treatment.
(A,I,J,K)
7. Identify and discuss treatment options for plaque associated gingivitis, chronic periodontitis and aggressive forms of periodontitis.
(A,F,T)
8. Discuss the criteria for, advantages and disadvantages, and describe or demonstrate the use of antimicrobials/chemotherapeutic agents and adjunctive therapies. (A,C,E,J, M,T)
9. Discuss the reasons and rationale for using chemotherapeutic agents and antimicrobials in periodontal patients. (A,F,T)
10. Discuss the reasons and use of periodontal packs following periodontal surgeries. (A, F, T)
11. Synthesize and utilize knowledge from DENT 111 to enhance learning in DENT 121. (A,F,T)
Lexicomp ONLINE for Dentistryv2009
Periodontology for the Dental Hygienist (3 rd Edition) by Perry, DA &
Beemsterboer, PL; Saunders: Philadelphia, PA, 2007. (ISBN-13: 978-
1-4160-0175-1 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 (2 nd Edition) by Wilson, TB & Kornman,
KS; Quintessence Publishing: Chicago, 2003. (ISBN 0-86715-405-5)
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Method of Instruction Course instruction will utilize a variety of approaches:
 Web-enhanced and ITV through the utilization of ANGEL®, a course management and collaborative web portal. Student

 outcomes, lecture outlines, publications, etc. will be posted and available for student download and printing.
 Lectures which may include MSPowerpoint® presentations
Classroom/group discussion
Group assignments, projects and presentations
 Self evaluation
 Instructor observation
 Written examinations
When appropriate, course content introduces, develops or measures the five Pierce College Core Abilities: Responsibility, Effective
Communication, Multiculturalism, Information Competency and Critical
Thinking and Problem Solving. Descriptions of the Core Abilities can be found on Pierce College’s website at www.pierce.ctc.edu/programs/coreabilities.php3
.
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
Course Evaluation 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.
As with most of the 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 obtaining any missed information presented during the class(es) missed. The instructors will not accept this responsibility.
Grouping Learning:
For some of the assignments students will work collaboratively within groups. These groupings will vary in number as well as members.
Course Evaluation Weighting:
Small group assignments: 25%
Lab Assignments (A-J) 10%
Lab Exams (2) 20%
Exams (3) 45%
Students may also be evaluated on their application of knowledge from past coursework, time management during class time, communication and cooperation with group members, self-evaluation of progress during the course and professionalism.
Students are expected to come to class prepared, to have completed the assigned reading and/or homework in advance of scheduled lectures, to actively participate in activities of learning and apply concepts to contiguous units rather than merely rely on memorization.
Deficiencies in preparation and participation may be reflected in the student’s final course grade.
Late work: Students are expected to complete all course assignments by the posted due date. Grades for all assignments received or
3

Course Requirements completed past the time which it is due will be reduced by 50% for each 24 hour period it is late. For group or team assignments, all members of the group or team will receive the same grade. It is imperative that all members of each group or team work together to help each other if someone is unable to complete their portion on time.
All assignments must be submitted or a grade of zero may be assigned.
Small Group Assignments:
**Acute Gingival Diseases-chart/assignment (5%)
 Objective: To develop a tool which will help with the recognition and understanding of the various acute gingival diseases including treatment options. This tool will be especially helpful during clinical practice
 Complete PPT and present topic (5 minutes)
 Written Due: Tuesday, April 5 by 6pm
 Presentation of topic: Thursday, April 7
**Risk Assessment (10%)
 Objective: To further develop understanding of the risk factors
 associated with periodontal infections and their relationship to systemic conditions.
Presentation of topic: Thursday, May 26
**Dental Hygiene Periodontal Treatment Planning Presentation (10%)
 Objective: To provide the opportunity for students to develop and present a complete dental hygiene treatment plan based on information from the patient interview, chart review, clinical observations (if possible) and appropriate rationale.
 Presentations will be given in a PPT format. Specifics may include:
 Patient interview
 Medical history
 Dental history
 Intraoral photos
 Radiographs
 Bleeding scores and oral hygiene recommendations
 Periodontal charting, AAP classification, Billing case/code
 Gingival assessment including plaque, calculus, and stain assessment
 Initial treatment plan
 Periodontal Prognosis
 Presentation of topic: Thursday, June 2
Lab Assignments A-J (10%)
All 9 assignments must be completed. Grading will be using the A, I, S system.
Lab Exams #1 and #2 (20%)
Timed exams focusing on tooth identification, root anatomy, root identification, periodontal instrument identification, etc.
4

Course Grading
Written Exams (45%)
Exam #1 interpretation
Chapters 26, 47, 48, 27, 28, 31, 32, 33, X-ray
Exam #2 Chapters 18, 35, 36, 40, 41, 42, Root morphology (38 &
51 on Exam #3)
Exam #3
Antimicrobials
Chapters 38, 51, 52, 53, 55, Treatment Planning, PPT for
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 and a grade of zero will be given to those exams missed due to an unexcused absence.
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. If the student does not contact the instructor, there will be no make-up exam. Alternative arrangements, if any, will be at the discretion of the instructors.
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 individual exams, s/he must make an appointment with the course instructor(s), within one week of the grades being posted, to review the exam and determine additional course work to be completed prior to the next exam in order to show minimum understanding.
In addition, since the exams in this course do not test for collective knowledge of the material, students must earn a minimum cumulative examination score of 75% (Exam #1, Exam #2, and Exam #3) to successfully pass this course. Students who fail to earn a minimum cumulative examination score of 75% will earn no higher than a final course grade of 1.9. Students who fail to earn a minimum cumulative examination score of 70% will earn no higher than a final course grade of 1.5.
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:
5

Additional Grading
Factors
100% 4.0
99% 3.9
89%
88%
3.1
3.0
79%
78%
2.3
2.2
98%
97%
96%
95%
3.8
3.8
3.7
3.6
87%
86%
85%
84%
2.9
2.9
2.8
2.7
77%
76%
75%
74%
2.1
2.0
2.0
1.9
94%
93%
92%
91%
3.5
3.4
3.3
3.2
83%
82%
81%
80%
2.6
2.5
2.4
2.4
73%
72%
71%
70%
1.8
1.7
1.6
1.5
90% 3.2
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
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 course outcomes, the student may have additional course work assigned, and/or the course grade adjusted accordingly (reduction of grade or incomplete grade with remediation assigned to determine competency in all course objectives).
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
6

Class Schedule
Topic
Lecture:
Pre-Test (non-graded)
Review Syllabus,
Schedule, etc.
Review:
Gingival Description
Case Histories
Classification of
Periodontal Diseases
Topic
Lecture:
STUDENT
PRESENTATIONS
Desquamative
Gingivitis
Treatment of Acute
Gingival Disease
Treatment of
Periodontal Abscess
Treatment of
Periodontal
Emergencies
Assign Risk
Assessment
Assignments
Reading
Review “Gingival
Description” PPT from
Fall Quarter
Fundamentals course
(DHYG 108)
Reading
Ch. 26:
Desquamative
Gingivitis (19)
Ch. 47:
Treatment of Acute
Gingival Disease (8)
Ch. 48:
Treatment of
Periodontal Abscess
(7)
Lab Prep
Lab Exercises
Lab Prep for March 31:
Each Student brings all of their Kilgore artificial teeth along with modeling clay/Play Dough/wax, something to support the teeth
Complete Lab Assignment
A
As a Group:
1. Gingival Description
2. RAD Interpretation
Each Student:
3. Place teeth in 2 arches with crowns visible and roots buried
(timed practice)
Lab Prep
Lab Exercises
Lab Prep for April 7:
Each Student brings all of their Kilgore artificial teeth and modeling clay/Play
Dough/wax, something to support the teeth
Bring all extracted teeth that you have collected
Lab review:
Root Morphology
Complete Lab Assignment
B
Each student:
1. Place teeth in 2 arches with roots visible and crowns buried.
Non-graded, timed exercise with Kilgore teeth and real teeth.
As a Group
2. Sort teeth for next week and complete grid
3. Pick out teeth for next week’s exercises
7

Topic
Lecture:
The Periodontal
Pocket
Bone Loss Patterns
STUDENTS REVIEW –
NO FORMAL
LECTURE:
Chronic Periodontitis
NUP
Aggressive Perio.
Reading
Ch. 27:
The Periodontal Pocket
(16)
Ch. 28:
Bone Loss and
Patterns of Bone
Destruction (12)
Ch. 31:
Chronic Periodontitis
(5)
Ch. 32:
Necrotizing Ulcerative
Periodontitis (4)
Ch. 33:
Aggressive
Periodontitis (5)
Lab Prep
Lab Exercises
Lab Prep for April 14:
As a Group bring:
* Examples of Class I, II and
III furcations embedded in plaster.
* Nabor’s probe
Each Student brings:
* 1 Anterior or canine with root LIGHTLY painted with red nail polish
* 1 Premolar or molar with root/roots LIGHTLY painted with red nail polish
* Instruments: 4R/4L,
Gracey 11/12 or 13/14
Mini-Gracey 11/12 or 13/14
* #2 pencil (not a mechanical pencil)
* Coin envelope
Lab review:
Root and furcation ID
Complete Lab Assignment
C
As a Group:
1. Furcation exercise
Each Student:
2. Anterior/canine tooth exercise
3. Premolar/molar tooth exercise
As a Group:
4. Evaluate root provided
Topic
Exam #1 (2 hours)
Ch. 26, 47, 48, 27 ,
28, 31, 32, 33
X-ray Interpretation
Reading Lab Prep
Lab Exercises
Lab Prep for April 21:
Bring Kilgore teeth, clay/play dough
Bring extracted teeth.
Complete Lab Assignment
D
Each Student:
Non-graded, timed exercise with real teeth.
Non-graded, timed exercise with plastic teeth and arches
8

Topic
Lecture:
Initial Periodontal
Therapy (Phase I)
/Scaling and Root
Planing
Reading
Ch. 51
Scaling and Root
Planing pp. 749-764 (12) and review pp.768-784
(11) p. 759-760 – pictures of Quetin furcation curette and diamond files
P. 956 – picture of
Sugarman file
Lab Prep
Lab Exercises
Lab Prep for April 28:
Each Student brings:
* 1 molar with Class III furcation and at least 5mm of root surface exposed and mounted in plaster which should be at the top of the cup holder.
From the CEJ, LIGHTLY apply red nail polish to cover from CEJ to base of plaster.
* Once nail polish dry, apply at least 3 coats LIGHTLY of whiteout-type liquid to exposed root surface.
* Once dry, use #2 pencil to divide into line angles as done previously on MB, DM,
ML, DL
* Instruments: Nabor’s probe, Orban files,
Hirschfield files, all Graceys and mini-Graceys
* #2 pencil
Lab review:
Instrument Selection,
Instrument Adaptation to
Root Surfaces
Calculus Formula
Complete Lab Assignment
E
Each Student:
1. Draw line angles and instructor signs off before you start
2. Use of files
3. Instrument B and L surfaces according to directions.
Complete Lab Assignment
F
Each student:
1. Instructor signs off before you start
2. Use of files
3. Instrument B and L surfaces according to directions.
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Topic
Lecture:
Periodontal Medicine
Radiographic Aids
Clinical Diagnosis
Reading
Ch. 18:
Periodontal Medicine:
Impact of Periodontal
Infection on Systemic
Health (16)
Ch. 36:
Radiographic Aids in the Diagnosis of
Periodontal Disease
(16)
Ch. 35:
Clinical Diagnosis (19)
Handout:
Sharpening files
Quetins
Lab Prep
Lab Exercises
Lab Prep for May 5:
Each Student brings:
* 1 premolar with at least
5mm of root surface exposed and mounted in plaster as for previous labs.
Apply the tenacious calculus formula to the lingual side from the CEJ to base of plaster.
* 1 molar with at least 5mm of root surface exposed and mounted in plaster as for previous labs. Apply the granular calculus formula to the buccal side from the CEJ to base of plaster.
* #2 pencil to divide into line angles as done previously on MB, DM, ML,
DL
* Instruments: Nabor’s probe, Orban files,
Hirschfield files, Quetin curette, diamond file
*Magnifying glass and/or loupes and tanged sharpening file
Lab review:
Instrument adaptation
Sharpening files
Complete Lab Assignment
G
Each student:
1. Instructor signs off both teeth before you start
2. Use of files/Quetin - premolar
3. Use of files/Quetin – molar
Complete Lab Assignment
H
As a Group:
Sharpening Files and
Quetins
10

Topic
Lecture:
Risk Assessment,
Prognosis,
Treatment Plan,
Rationale for
Periodontal
Treatment
Assign Risk
Assessment Topics
Reading
Ch. 38:
Risk Assessment (5)
Ch. 40:
Determination of
Prognosis (10)
Ch. 41:
The Treatment Plan
(4)
Ch. 42:
Rationale for
Periodontal Treatment
(5)
Lab Prep
Lab Exercises
Lab Prep for May 12:
* 1 molar with Class III furcation and at least 5mm of root surface exposed and mounted in plaster as for previous labs. From the CEJ,
LIGHTLY apply red nail polish to cover from CEJ to base of plaster. Be sure to apply into the furcation.
* Once dry, apply granular calculus formula to the furcation roof and sides of the furcation. DO not make this so thick that it closes the furcation entrance.
* Instruments: All instruments used this quarter including the 11/12 explorer
*Magnifying glass and/or loupes and tanged sharpening file
*Coin envelope
Lab review:
Sharpening files
Risk Assessment
Complete Lab Assignment
I
If not done last week
Complete Lab Assignment
J
Each student:
1. Instructor signs off teeth before you start
2. Use of periodontal instruments on specific surfaces
3. Completed instrumentation of root surfaces/turn in tooth
11

Topic
Exam #2 (2 hours)
Ch. 18 , 35 , 36 , 40,
41 , 42, Root
Morphology
(Ch. 38 and 51 on
NEXT exam)
Topic
Lecture:
Chemotherapeutic
Agents and
Antimicrobials
Host Modulation
Irrigation
Reading Lab Prep
Lab Exercises
Lab Prep for May 19:
Each Student brings set of artificial teeth and modeling clay/Play Dough/wax, something to support the teeth
Lab review:
Endoscopy
Lab Exam #1
Graded, timed exercise with
Kilgore teeth: maxillary and mandibular arches – crowns down
Graded, timed exercise with real teeth including instrument selection
Reading
Ch. 52:
Chemotherapeutic
Agents (13)
Ch. 53:
Host Modulation
Agents (14)
Ch. 55:
Supragingival and
Subgingival Irrigation
(8)
Lab Prep
Lab Exercises
Lab:
Risk Assessment
Presentations
Dental Hygiene Periodontal Treatment Planning Presentations.
(Lab practice if time)
Exam #3:
Written (2 hours)
Ch. 38, 51 , 52, 53,
55, Treatment
Planning, PPT:
Antimicrobial Agents
Bring calculator for
Risk Assessment questions
Lab Exam #2
Root ID, Instrument ID and
Selection (timed)
12

Disclaimer
Security/Emergency
Procedures for
Classrooms
Access and Disability
Service
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”.
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.
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
Pierce College: Students with disabilities who believe they may need academic adjustments, auxiliary aids or services to fully participate in course activities or meet course requirements are encouraged to register with the Access and Disability Services (ADS) Office, Room
300K in the Cascade Building. You may also call the ADS Office to make an appointment to meet with the ADS Coordinator at (253) 964-
6526 or 964-6527. Students requesting accommodations must obtain the “Approved Quarterly Academic Adjustments, Auxiliary Aids or
Services (green) form provided by ADS.
Note: Access and Disability Services has been relocated during the
“Cascade core renovations”. Check with the advising center in the performance lounge for directions, if needed.
Peninsula College: “The ADA is designed to ensure that students with disabilities have an equal opportunity to access academic programs and successfully complete their studies.” Peninsula College is committed to providing accessibility to all students.
For more information, please contact the Student Development Center.
Your information will remain strictly confidential. If you require accommodations based on a documented disability, emergency medical information to share, or special arrangement in case of an emergency evacuation, please make an appointment with Monica Hospenthal,
13

Other
Program Director, as soon as possible or feel free to contact the
Student Development Center at 360-417-6340.
Please refer to the Pierce College Catalog and/or the Peninsula College
Catalog and associated websites ( www.pierce.ctc.edu
and www.pc.ctc.edu
) for available learning resources, campus services and student life opportunities including, but not limited to, access & disability services, bookstore, campus safety, child care, computer labs, emergency campus closings, fitness facilities/recreation, food service, medical & dental insurance, human relations instruction, library, multicultural student services, student actives & government, student rights and responsibilities, student success workshops, tutoring, and women & family services.
Chapter Objectives
Unit #1:
Chapter 26
Chapter 47
Chapter 48
Chapter 27
Chapter 28
Chapter 31
Chapter 32
Chapter 33
1. Demonstrate correct usage and spelling of dental terminology.
2. Describe the clinical features, diagnostic criteria, differentiation criteria, microbial predominance if determined and any significant facts associated with the following (including associations with systemic diseases, etc.):
A. Lichen Planus
B. Pemphigoid
(1) Bullous pemphigoid
(2) Mucous membrane pemphigoid (cicatricial pemphigoid)
C. Pemphigus vulgaris
D. Chronic ulcerative stomatitis
E. Linear IgA disease (linear IgA dematosis)
F. Dermatitis herpetiformis
G. Lupus erythematosus
H. Erythema multiforme
3. Describe the therapeutic approaches to treating the following:
A. Erosive lichen planus
B. Mucous membrane pemphigoid (cicatricial pemphigoid)
C. Pemphigus
D. Chronic ulcerative stomatitis
4. Differentiate between stomatitis medicamentosa and stomatitis venenata or contact stomatitis.
5. When treating acute gingival diseases, treatment focuses on two major items. What are they?
6. When is treatment complete in NUG?
7. Describe the three phases of treatment.
8. Explain the significance of a thorough health history.
9. List and describe the four stages of healing in NUG.
10. Adjunctive therapies may help in treatment and prevention of NUG.
Describe them. If treatment is unresponsive to NUG, what next?
11. Describe the primary goal in treating Periocoronitis.
12. Describe the primary goal in treating Acute Herpetic
Gingivostomatitis.
13. Define Periodontal Abscess, describe two types and discuss the primary goal in their treatment
14. Describe the characteristics of each of the following in order to determine a differential diagnosis
A. Acute Abscess
B. Chronic Abscess
C. Periodontal Abscess
D. Pulpal Abscess
14

15. Define and discuss the following terms :
A. Periodontal pocket
B. Histological features of perio pocket versus gingival diseases
C. Classifications of pockets
D. Suprabony and infrabony pockets
E. Pocket formation
F. Topography of a pocket
16. Discuss the clinical significance of fibrous versus edematous pocket wall.
17. Describe the contents of a pocket?
18. Discuss the significance of pus as a common feature of periodontal abscess?
19. What changes does the root surface wall undergo during periodontal infection?
20. How do these changes manifest clinically and what is the resulting impact for the patient and clinician?
21. What are the five zones of the surface of the tooth in a periodontal pocket?
22. What is the significance of each zone?
23. Discuss the five ways periodontal abscesses form?
24. Discuss the classification of periodontal abscesses by location?
25. What is a periodontal cyst?
A. What are the possible etiologies?
B. What does it look like radiographically?
26. Describe how bone destruction is caused by an extension of gingival inflammation including the histopathologic changes, effect on periodontal fibers, etc.
27. Describe how occlusal trauma may contribute to periodontal bone destruction.
28. Describe how local and systemic factors have an influence on bone destruction patterns.
29. Variation in periodontal bone patterns can exist. Describe and recognize the features of:
A. Exostosis
B. Trauma from occlusion
C. Buttressing bone formation
D. Food impaction
30. Describe and recognize the following patterns of bone destruction in periodontal disease:
A. Horizontal bone loss
B. Osseous defects
C. Vertical defects
D. Osseous craters
E. Bulbous bone contours
F. Reverse architecture
G. Ledges
H. Furcation involvement
31. Describe the following as it relates to Chronic Periodontitis:
A. Characteristics and clinical features
B. Disease Distribution
C. Disease Severity
D. Symptoms
E. Disease Progression
F. Prevalence
15

Unit #2:
Chapter 51 &
Root Morphology
Chapter 18
Chapter 35
Chapter 36
Chapter 38
Chapter 40
Chapter 41
Chapter 42
32. Describe the risk factors for Chronic Periodontitis.
33. Describe the following as it related to Necrotizing Ulcerative
Periodontitis:
A. Characteristics and clinical features
B. Microscopic findings
C. Etiology and microbial flora
34. Why is an immunocompromised patient more prone to NUP?
35. Explain how psychological stress can affect patients with NUP?
36. Describe the following as it related to Localized and Generalized
Aggressive Periodontitis:
A. Characteristics and clinical features
B. Radiographic findings
C. Risk factors
D. Immunologic factors
E. Genetic factors
1. Demonstrate correct usage and spelling of dental terminology.
2. Explain the difference between the conventional Gracey curette and
A. the Gracey curvette
B. the Langer curette
C. the Quetin curette
D. the “after 5” curette
3. Discuss the general principles for effective periodontal instrumentation.
4. To prevent injury to the patient, what must one be constantly aware of while instrumenting?
5. Describe why proper grasp is ESSENTIAL?
6. List finger rests/fulcrums used in periodontal instrumentation.
7. Define adaptation. How is precise adaptation achieved? How much of the working end is adapted at any given time?
8. Define angulation. Why is correct angulation ESSENTIAL for the removal of calculus?
9. Exact angulation depends on what 4 items?
10. What angulation does one use for heavy calculus? After removal
of calculus? curettage?
11. Define lateral pressure. Why is lateral pressure CRITICAL to the success of scaling and root planing?
12. List the three types of strokes. Directions?
13. Discuss wrist/arm movement versus finger movement.
14. Discuss notable factors regarding root planing and scaling. Include proper angulation, shank positioning, etc
15. Why are detection skills so important?
16. What are the two items in which one must develop an expertise when scaling and root planing subgingivally?
17. Compare supragingival scaling and subgingival scaling and root planing in relation to stroke, pressure, angulation, adaptation, etc.
18. There are many ways to burnish calculus. List as many as you can from the material you read.
19. Review and know the positioning of operator and pt., and fulcrums for each area.
20. What is the distance between the apical edge of the calculus and the bottom of the pocket?
21. Review and know the following terminology (from Biostructures)
A. Apex of root
B. Root axis line
C. Anatomical crown/root
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D. Cervical Line (CEJ)
E. Cervix/root trunk
F. Furcation
G. Concave/convex
H. Longitudinal groove
I. Alveolus
J. Line angle
22. Define and recognize the following:
A. Trifurcation
B. Bifurcation
C. Depth of depression
D. Lingual convergence
E. Furcation roof
F. Root trunk
G. Terminal root
H. Intermediate bifurcation ridge
I. Longitudinal axis of the root
23. How do concavities and anomalies affect the survival of a tooth with periodontal disease?
24. Which arch/ general principles do you use to identify a particular root type?
25. Which specific characteristics do you use for individual root identification?
26. Which teeth have roots with the deepest depressions/concavities?
27. What is the general shape of the roof of a trifurcation? Bifurcation?
28. Describe the importance of host susceptibility to understanding the differences in the onset, natural history, and progression of periodontitis.
29. List the organ systems and conditions which may possibly influence periodontal conditions.
30. Explain why eradication of gram- bacteria in the periodontal pocket is so difficult and the reemergence is often rapid.
31. Describe how periodontal disease may affect mortality.
32. Describe the impact of periodontal infections for the following conditions:
A. Coronary heart disease/atherosclerosis
B. Stroke
C. Diabetes Mellitus
D. Pregnancy outcome
E. Chronic Obstructive Pulmonary Disease
F. Acute Respiratory Infections
33. What are the diagnostic tools used for clinical diagnosis of periodontal disease?
34. How does trauma from occlusion relate to radiographic changes?
What are the changes?
35. Where is the diagnosis of trauma from occlusion made?
36. What is pathologic migration of the teeth?
37. What does pathologic migration have to do with destruction of the periodontium?
38. Radiographs reveal what about periodontal disease. How do we use radiographs in periodontal diagnosis?
39. How do viewing distortions determine our interpretation of radiographs?
40. Give four items that can alter views of radiographs or create distortions?
41. What are three things we DO see regarding bone loss?
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Unit #3:
Chapter 52
Chapter 53
(also refer to
Learning Module 3 in Pharmacology)
Chapter 55
PPT: Antimicrobial
Agents
42. What radiographs DO NOT show?
43. What is the sequence of radiographic changes/causative tissue changes seen in radiographic appearance in periodontitis?
44. What radiographic changes are seen in aggressive periodontitis and traumatic occlusion?
45. Define risk assessment
46. Define and differentiate:
A. Risk factors
B. Risk determinant/background characteristics
C. Risk indicators
D. Risk markers
47. Name four known risk factors? How were they identified?
48. Name five risk determinants? How were they identified?
49. Name three risk indicators? How were they identified?
50. Name 2 risk markers? How were they identified? What is the relationship to disease?
51. What are the factors to consider when determining a prognosis?
Why?
52. What are the types of prognosis?
53. Define and discuss the overall versus individual tooth prognosis.
54. What is the relationship between diagnosis, classification, and prognosis?
55. What is the significance of periodontal re-evaluation?
56. What is the prognosis for patients with gingival diseases?
Periodontitis? Periodontitis as a manifestation of systemic disease? Give each separate disease by category and the prognosis for each per your text.
57. Define treatment plan.
58. What are the ten prognostic factors that must be included in the treatment plan decisions?
59. What is the cardinal rule with the treatment plan?
60. What is the primary goal of a treatment plan?
61. When should a tooth be extracted?
62. How do you explain the treatment plan to a patient?
63. What are the five phases of periodontal treatment? What is the significance of each?
64. What does periodontal therapy accomplish?
65. What are two ways to provide therapy?
66. Define:
A. New attachment
B. Epithelial adaptation
67. What do we typically achieve in healing as a result of periodontal therapy, non-surgical?
1. Demonstrate correct usage and spelling of dental terminology.
2. Describe each of the following:



Chemotherapeutic agent
 Antimicrobial agent
 Anti-infective agent
Antibiotic
Antiseptic
 Disinfectant
3. For each of the following –
a. list the bacteria that the antibiotic affects
b. use with what type(s) of periodontitis
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c. contraindications or precautions
 Tetrycycline
 Minocycline
 Doxycycline
 Metraonidazole
 Penicillin


Amoxicillin
Augmentin
 Cephalasporins
 Clindamycin
 Ciproflxicin
 Macrolides
 Spiramycin
 Azithromycin
4. Compare serial therapy versus combination therapy.
5. Compare local delivery antibiotics versus systemic antibiotics.
6. Define host modulatory therapy (HMT). Explain its role in periodontal treatment.
7. For the following host modulation agents, describe how they work, advantages and disadvantages of choosing a specific agent, when they would be indicated in the treatment of periodontal conditions and why or why not.
Systemically administered agents:
 Nonsteriodal anti-inflammatory drugs
 Bisphosphonates
 Subantimicrobial-dose doxycycline
Locally administered agents:
 Nonsteriodal anti-inflammatory drugs
 Enamel matrix proteins, growth factors, and bone morphogenetic proteins
8. What is meant by the term “periodontal management” and why is it important to understand this concept?
9. Describe the use of tetracyclines in the treatment/management of periodontal therapy. What is the goal of tetracycline therapy?
10. Describe the mechanisms of action when using subantimicrobial dose doxycycline. Why is it considered a safe drug of choice in treating periodontal conditions?
11. What considerations should be taken into account before recommending the use of SDD?
12. Describe chemically modified tetracyclines (CMT) and why they are considered “one of the most promising groups of potential HMTs”.
13. In patient with periodontal diseases, professionally delivered irrigation has been used in two distinct ways. Describe along with the rationale for using them and efficacy of use (how do they work).
14. Describe the mechanism of action for home (self-applied) irrigation.
15. Discuss the advantages and disadvantages of dental irrigators.
16. Discuss safety concerns with oral irrigation, both professional delivered as well as home irrigation.
23. Identify and discuss the therapeutic effectiveness of antimicrobial agents that are being used or researched for caries, calculus, periodontal disease and dentin hypersensitivity.
24. Explain how the Food and Drug Administration and the ADA can protect the consumer from misleading advertising of over-the-counter
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sales of antimicrobial rinses.
25. Name the general components of an antimicrobial rinse and explain the purpose of each type of agent.
26. Explain why alcohol content in an antimicrobial rinse can be hazardous.
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