Specialty Chairside



Faculty Teaching Guide for Specialty Chairside Assisting

Module –Periodontics

Faculty Teaching Guide for Specialty Chairside Assisting

Module: Periodontics

Review of Previous Module

Review topics from the previous module to confirm understanding prior to presenting new material.

Module Overview

This module will discuss the dental assistant’s responsibilities as a team member for the specialty of periodontics. Specialty procedures may be performed by a general dentist or the patient may be referred to an expert limited to a particular discipline. The general dentist works closely with the periodontist to ensure the best overall care for the patient. The periodontist specializes in the diagnosis and treatment of diseases of the tissues that support and surround the tooth. Patients who experience loss of bone around the tooth due to periodontal disease are referred to a periodontist specialist for treatment.

The Big Picture

Resources

This module utilizes the following learner resources:

Textbook: Dental Assisting, A Comprehensive Approach, 2nd edition, by Donna J. Phinney and Judy Halstead. Delmar Learning, 2004. ISBN 1-4018-3480-9.

Workbook: Workbook to Accompany Dental Assisting, A Comprehensive Approach, 2nd edition, by Donna J. Phinney and Judy Halstead, prepared by Karen L. Waide, Delmar Learning, 2004. ISBN 1-4018-3483-3.

Instructor’s Manual: Instructor’s Manual to Accompany Delmar’s Dental Assisting, A Comprehensive Approach, 2nd edition, by Donna J. Phinney and Judy Halstead. Delmar Learning, 2004. ISBN 1-4018-3482-5.

Electronic CD-ROM: Delmar’s Dental Assisting Interactive Skills and Procedures CD-ROM, ISBN 1-4018-3485-X

Faculty CD-ROM: The faculty CD-ROM includes this Faculty Guide and the PowerPoint presentation for Specialty Chairside Assisting.

Section 1: Periodontics

Section Overview

Periodontics is the branch of dentistry that deals with the cause, prevention, and treatment of diseases of the supporting structures of the teeth. These supporting structures include the gingiva, periodontal ligaments, and alveolar bone. The periodontal dental assistant will provide oral hygiene instruction, assist the dentist in periodontal surgeries, and coordinate patient care with the referring dental office.

Outline of Section

Part A: The Periodontal Team

Part B: Periodontal Disease and Procedures

Learning Objectives and Competencies

These learning activities directly address the Learning Objectives and

Competencies as stated.

Knowledge

1. Define the Key Terms.

2. Define periodontics.

Comprehension

3. Describe the stages of periodontal disease.

4. Identify periodontal instruments and explain their uses.

5. Explain non-surgical and surgical periodontal treatment and the dental assistant’s role for each.

Application

6. Demonstrate the knowledge and ability to assist during periodontal procedures.

Learning Activities

These learning activities directly address the Learning Objectives and Competencies as stated.

[Insert Homework Assignment icon] Key Term Glossary (Part A, Objective 1)

[Insert In-Class Activity icon] Periodontal Charting (Part A, Objective 4)

[Insert Homework Assignment icon] Textbook Assignment (Part A, All Objectives)

[Insert In-Class Activity icon] Occlusal Adjustment (Part B, Objective 6)

[Insert In-Class Activity icon] Scaling, Curettage, and Polishing (Part B, Objective 6)

[Insert In-Class Activity icon] Gingivectomy (Part B, Objective 6)

[Insert In-Class Activity icon] Osseous Surgery (Part B, Objective 6)

[Insert In-Class Activity icon] Preparation and Placement of the Non-Eugenol Periodontal Dressing (Part B, Objective 6)

[Insert In-Class Activity icon] Removal of the Periodontal Dressing (Part B, Objective 6)

[Insert Homework Assignment icon] Interactive Skills and Procedures CD-ROM (Part B, Objective 6)

[Insert Homework Assignment icon] End of Chapter Activities (Part B, All Objectives)

[Insert Homework Assignment icon] Posttest (Part B, All Objectives)

Part A: The Periodontal Team

Overview

The dental hygienist is the most valuable team member in a periodontal dental practice. He or she will provide scaling, curettage, and root planing which are non-surgical treatments for periodontal disease. The dental assistant has many duties in a periodontal office, including many expanded functions, depending on state regulations. Some responsibilities of the dental assistant will include exposing and processing radiographs, coronal polishing, assisting the dentist or dental hygienist throughout a periodontal examination, including documenting tooth mobility, and recording the depth of the gingival sulcus during periodontal probing. The dental assistant will assist the dentist during periodontal surgery, may place and remove periodontal dressings, and has an important role to educate the patient in how to maintain their oral health at home.

Initial Questions and Activities

1. What is your perception of periodontal disease? Why is periodontal disease important for the patient to not

ignore?

There will be various responses, many of which will relate periodontal disease to “old age.” The

beginning stages of gingivitis often occur in the teenage years, and will progress if not taken care of.

|Key Concepts |References and Acti vities |Slides |

|Introduction to Module | |Slides 1-2 |

|Introduction to Section | |Slides 3-4 |

|Key Terms |Chapter ____, pg. ____ |Slides 5-7 |

| |[Insert Homeword Ass icon] Key Term Glossary | |

|The Periodontal Team |Chapter ____, pg. ____ |Slide 8 |

| |[Insert In-Class Activity icon] Periodontal Charting | |

| |[Insert Home Ass icon] Textbook Assignment | |

[ ] Group Activities [ ] Homework [ ] Individual Activity [ ] Internet Activity [ ] In-Class Discussion [ ] In-Class Activity [ ] Evaluation

[Insert In-Class Act icon] In-Class Activities

❑ Periodontal Charting (Part A, Objective 18). Goal: For learners to chart during a periodontal probing procedure. Instructor should explain the six areas probed during patient periodontal charting and ensure each learner has a chart with areas for recording probings along with red and blue pencils. Discuss how the periodontal probing instruments can be metal or plastic, and is used to measure the depth of the gingival sulcus in millimeters as it surrounds each tooth. Explain how the pocket depth is measured at the mesiofacial, facial, and distofacial; then the dentist or dental hygienist will call out the depth of the distolingual, lingual, and mesiolingual. Tell learners that numbers 1-3mm are charted in blue, and any probe 4mm or higher are charted in red. Learners should record the number of each reading as dictated. Instructor may make up numbers as desired and have learners circle in red any periodontal probe reading that might be bleeding. Make sure to remind learners how to cross out missing teeth so as not to probe those areas.

[Insert In-Class Dis Ques icon] In-Class Discussion

1. What is the main cause of dental disease? Why is it so important for individuals to address any dental disease they may have?

Dental plaque is the principle cause of caries and periodontal disease. It is responsible for forming the first stage of calculus, and if left on the teeth and surrounding tissues will cause gingival bleeding and eventually a loss of bone supporting the teeth. This will cause the teeth to become loose.

2. What is calculus?

Calculus is an accumulation of inorganic salts of the saliva or blood. It is usually deposited on the lingual surfaces of the teeth near the salivary glands and duct, and may accumulate supragingivally and subgingivally.

[Insert Home Ass icon] Homework Assignments

Key Term Glossary. Learners will define key terms listed in the PowerPoint presentation. They are to enter this glossary on disk, in a dedicated notebook or in a designated part of a notebook. They are expected to augment information from text or lecture with other resources including any available in the school or public libraries or on the Internet and will be graded at the end of the module on completeness and presentation.

Textbook Assignment. Learners are to read Chapter ____.

Ideas for learners struggling with this material …

❑ Research Periodontal Disease. Have learners go to for consumer information and the most frequently asked questions about periodontal disease and treatments.

Ideas for learners who are ahead and want to learn more…

❑ Research Periodontal and Heart Disease. Have learners research more about periodontal disease and heart disease by visiting . Have learners write a short report to share with the class.

Presentation Tools

Note: If you change Objectives or Assignments, don’t forget to change the slides accordingly.

|Slide 1 |[Insert SCA 6-1] |PowerPoint Presentation for Specialty Chairside Assisting |

| |SCA – Stands for Specialty Chairside Assisting. The|Module: Periodontics |

| |1st number indicates the Module called |Prior to introducing this module. Ask learners if any questions remain from |

| |Periodontics. The 2nd number indicates the slide. |the previous module. If questions remain review the material as needed. |

| | |Introduce this module. |

|Slide 2 |[Insert SCA 6-2] |Module: Periodontics |

| | |Introduce the section and each part. |

|Slide 3 |[Insert SCA 6-3] |Section 1: Periodontics |

| | |Discuss each objective for this section in detail. Learners need to know what |

| | |they will be learning and why. Try to relate it back to their careers as |

| | |dental assistants. |

|Slide 4 |[Insert SCA 6-4] |Section 1: Periodontics (cont.) |

| | |Continue to discuss each objective in detail. |

|Slide 5 |[Insert SCA 6-5] |Key Terms |

| | |Review each key term and discuss the importance of knowing the definition of |

| | |each. |

|Slide 6 |[Insert SCA 6-6] |Key Terms (cont.) |

| | |Continue discussing each term. |

|Slide 7 |[Insert SCA 6-7] |Key Terms (cont.) |

| | |Continue discussing each term. |

| | |Homework Assignment: Stop here and go over the Key Term Glossary assignment. |

|Slide 8 |[Insert SCA 6-8] |Part A: The Periodontal Team |

| | |Discuss the different roles and responsibilities of the individuals on the |

| | |periodontal team. |

| | |Address how important communication with the referring dentist is to patient |

| | |care. |

| | |Define the difference between the responsibilities of the DA and the dental |

| | |hygienist. |

| | |In-Class Activity: Stop here for the Periodontal Charting activity. |

| | |Homework Assignment: Stop here to assign and discuss the homework. |

Part B: Periodontal Disease and Procedures

Overview

Periodontal disease and the resulting loss of teeth are a major threat to the dental health of the majority of adults. It is a condition that cannot be eliminated by a discipline of prevention, nutrition or oral hygiene due to the resorption of the alveolar bone and other supporting tissues. Periodontal treatment may be used as an adjunct to endodontics or orthodontics to make it possible for the patient to retain their teeth. The dental assistant will communicate with other health care teams in order to provide the best care for the patient. This may include coordinating the periodontal treatment plan along with procedures to be completed at other dental offices.

Initial Questions and Activities

1. What problems did you have with the periodontal probing procedure?

There will be a variety of responses. Discuss with learners their difficulties

during the procedure and how to improve their competency. Explain that the dentist or dental hygienist will call out the periodontal probing numbers quickly, so as to not cause the patient to be uncomfortable any longer than necessary. Tell them that the dental assistant must listen carefully, but should not be afraid to ask the dentist or hygienist to slow down, or to repeat a probe, so the numbers can be recorded accurately.

|Key Concepts |References and Activities |Slides |

|Periodontal Disease and Procedures |Chapter ____, pgs. ____ |Slides 9-26 |

| |[Insert Group Activity icon] Occlusal Adjustment | |

| |[Insert Group Activity icon] Scaling, Curettage, and Polishing | |

| |[Insert Group Activity icon] Gingivectomy | |

| |[Insert Group Activity icon] Osseous Surgery | |

| |[Insert Group Activity icon] Preparation and Placement of the | |

| |Non-Eugenol Periodontal Dressing | |

| |[Insert Group Activity icon] Removal of the Periodontal Dressing | |

| |[Insert Home Ass icon] Interactive Skills and Procedures CD-ROM | |

| |[Insert Home Ass icon] Workbook Assignment | |

| |[Insert Home Ass icon] End of Chapter Activities | |

|Assessment Questions | |Slide 27 |

|Summary of Module | |Slide 28 |

[ ] Group Activities [ ] Homework [ ] Individual Activity [ ] Internet Activity [ ] In-Class Discussion [ ] In-Class Activity [ ] Evaluation

[Insert In-Class Act icon] In-Class Activities

❑ Occlusal Adjustment (Part B, Objective 6). Goal: For learners to gain experience during an occlusal equilibration procedure. Instructor should ensure there are enough materials and supplies for the class, and separate learners into teams. Learners should be graded on the procedure steps as outlined on pg. ____, Chapter ____. Learner workbooks contain check off sheets that can be utilized.

❑ Scaling, Curettage, and Polishing (Part B, Objective 6). Goal: For learners to gain experience during a scaling, curettage, and polishing procedure. Instructor should ensure there are enough materials and supplies for the class, and separate learners into teams. Learners should be graded on the procedure steps as outlined on pg. ____, Chapter ____. Learner workbooks contain check off sheets that can be utilized.

❑ Gingivectomy (Part B, Objective 6). Goal: For learners to set up and assist during a gingivectomy procedure. Instructor will need to provide instruments and supplies necessary to practice this skill. Separated learners into teams. Learners should be graded on the procedure steps as outlined on pg. ____, Chapter ____. Learner workbooks contain check off sheets that can be utilized.

❑ Osseous Surgery (Part B, Objective 6). Goal: For learners to set up and assist during osseuos surgery. Instructor will need to provide instruments and supplies necessary to practice this skill. Separated learners into teams. Learners should be graded on the procedure steps as outlined on pg. ____, Chapter ____. Learner workbooks contain check off sheets that can be utilized.

❑ Preparation and Placement of the Non-Eugenol Periodontal Dressing (Part B, Objective 6). Goal: For learners to set up and place periodontal dressing. Instructor will need to provide typodonts, instruments and supplies necessary to practice this skill. The typodonts should be lubricated with Vaseline to facilitate removal of dressing, or learners may practice this skill on each other. Learners should be graded on the procedure steps as outlined on pg. ____, Chapter ____. Learner workbooks contain check off sheets that can be utilized.

❑ Removal of the Periodontal Dressing (Part B, Objective 6). Goal: For learners to remove periodontal dressing. Instructor will need to provide instruments and supplies necessary to practice this skill. Separated learners into teams. Learners should be graded on the procedure steps as outlined on pg. ____, Chapter ____. Learner workbooks contain check off sheets that can be utilized.

[Insert In-Class Dis Ques icon] In-Class Discussion

1. With whom must the periodontist consult before a surgical procedure, and why?

The periodontist will consult the patient’s physician to ensure which

medications the patient may be prescribed.

[Insert Home Ass icon] Homework Assignments

Interactive Skills and Procedures CD-ROM. Learners should use the case studies presented on the CD-ROM as practice setting up for the two periodontic cases given.

Workbook Assignment. Have learners complete the questions in Chapter ___ of the workbook.

End of Chapter Activities. Have learners complete the Review Questions and Critical Thinking Questions in Chapter ____.

Ideas for learners struggling with this material …

❑ Periodontal Probing Practice: Provide another probing exercise for learners to gain more experience. At first dictate slowly after explaining the procedure again, then call out the numbers more quickly as learners become more proficient. Learners should also be given as much lab time as possible in order to know the periodontal instruments and set-ups. They should work with the instructor as the operator, or learners who are ahead may play the role of the dentist, which could be less intimidating for a struggling learner.

Ideas for learners who are ahead and want to learn more…

❑ Web Research: Have learners visit , to find AAP guidelines, position papers, product/procedure statements, and parameters of care. Have them read this material and select one or two interesting areas to present to the class.

Presentation Tools

Note: If you change Objectives or Assignments, don’t forget to change the slides accordingly.

|Slide 9 |[Insert SCA 6-9] |Part B: Periodontal Disease and Procedures |

| | |Review Part A. Make sure that any remaining questions are answered. |

| | |Introduce Part B. |

| | |Explain the specialty of periodontics. |

| | |Define the term periodontium. |

|Slide 10 |[Insert SCA 6-10] |Symptoms of Periodontal Disease |

| | |Review the symptoms of periodontal disease. |

|Slide 11 |[Insert SCA 6-11] |Causes of Periodontal Disease |

| | |Discuss the causes of periodontal disease. |

| | |Point out that periodontal disease can begin at any age. |

|Slide 12 |[Insert SCA 6-12] |Classifications of Periodontal Disease |

| | |Explain that periodontal disease begins with gingivitis and may progress to |

| | |periodontitis. |

| | |Refer learners to the Table in Chapter ____ that reviews the common forms of |

| | |periodontal disease. (This Table can also be found at the end of this faculty |

| | |guide.) |

|Slide 13 |[Insert SCA 6-13] |The Periodontal Visit |

| | |Discuss periodontal pocket probing, tooth mobility, furcation involvement, |

| | |bleeding, gingival recession, and evaluation of occlusion. |

| | |Explain how the depth of the gingival sulcus surrounding each tooth is measured |

| | |using a periodontal probe. |

| | |Explain that a normal sulcus is 3 mm or less, and if the depth is greater it is |

| | |considered a periodontal pocket. |

| | |Point out that there are six readings of pocket depth for each tooth: |

| | |mesiofacial, facial, distofacial, mesiolingual, lingual, and distolingual. Inform|

| | |learners that bleeding upon probing is also noted on the patient’s chart. |

| | |Describe how the patient’s occlusion is evaluated and the individual teeth |

| | |checked for sensitivity to percussion and mobility, using the numbers 0-3. |

| | |Explain each number. |

| | |Inform learners that the patient’s occlusion is also examined for bruxism. |

| | |Discuss how vertical bitewing radiographs help the dentist evaluate the location,|

| | |amount, quality, and contour of the alveolar bone. |

| | |Explain that the patient must have a positive attitude toward treatment and be |

| | |cooperative in establishing and maintaining good oral hygiene and sound nutrition|

| | |in order for the treatment plan to be successful. |

|Slide 14 |[Insert SCA 6-14] |Periodontal Instruments |

| | |Inform learners that periodontal instruments must be kept sharp and that improper|

| | |sharpening techniques will ruin the blade. |

| | |Note to Instructor: During the lecture on periodontal instruments, when possible |

| | |have instruments available to show learners. |

|Slide 15 |[Insert SCA 6-15] |Periodontal Probes |

| | |Discuss the purpose of the periodontal probe and explain how the periodontal |

| | |probe is used during a periodontal examination. |

| | |Point out how a computerized probe system works. |

| | |Explain what explorers are used for. |

|Slide 16 |[Insert SCA 6-16] |Periodontal Curettes |

| | |Discuss the use curettes. |

| | |Explain curettage as the process of cleansing an area or pocket and removing |

| | |necrotic tissue. |

|Slide 17 |[Insert SCA 6-17] |Periodontal Scalers |

| | |Describe scaling as the process of removing calculus, plaque, and bacteria. |

| | |Discuss planing as the process of smoothing and slightly contouring the root |

| | |surface to remove nectrotic material found in the periodontal pocket. |

| | |Explain the use of periodontal files. |

|Slide 18 |[Insert SCA 6-18] |Ultrasonic Instruments |

| | |Explain the purpose of using ultrasonic instruments. |

|Slide 19 |[Insert SCA 6-19] |Periodontal Knives |

| | |Discuss what periodontal knives are used for. |

| | |Explain interdental knives. |

| | |Discuss the use of surgical scalpels for periodontal surgical procedures. |

| | |Point out the elements of the electrosurgery setup. |

|Slide 20 |[Insert SCA 6-20] |Pocket Marking Pliers |

| | |Explain the use of pocket marking pliers. |

|Slide 21 |[Insert SCA 6-21] |Periosteal Elevators |

| | |Discuss the use of periosteal elevators. |

|Slide 22 |[Insert SCA 6-22] |Rongeurs and Forceps |

| | |Explain the use of periodontal scissors, rongeurs, and forceps. |

|Slide 23 |[Insert SCA 6-23] |Laser Technology |

| | |Discuss the uses of the dental laser. |

| | |Point out the advantages of using lasers in dentistry. |

|Slide 24 |[Insert SCA 6-24] |Non-Surgical Periodontal Procedures |

| | |Review the principles of periodontal procedures. |

| | |Explain the various types of non-surgical periodontal procedures. |

| | |Discuss the postoperative treatment for non-surgical periodontal procedures. |

|Slide 25 |[Insert SCA 6-25] |Surgical Periodontal Procedures |

| | |Discuss the various types of surgical periodontal procedures. |

| | |Explain the postoperative treatment following periodontal surgery. |

|Slide 26 |[Insert SCA 6-26] |Periodontal Disease |

| | |Discuss how periodontal dressing will act as a bandage to protect a surgical |

| | |site. |

|Slide 27 |[Insert SCA 6-27] |Assessment Questions |

| | |Short Activity: Ask the group to answer these questions to assess their |

| | |comprehension of the material recently presented. Review any material that does |

| | |not seem clear. |

| | |Short Activity: Stop here to have the class discuss the case study at the end of |

| | |Chapter ____. |

| | |In-Class Activity: Stop here to complete the in-class activities for Part B. |

| | |Homework Assignment: Stop here to assign and discuss the homework. |

|Slide 28 |[Insert SCA 6-28] |Summary of Module |

| | |Go through each specialty topic discussed throughout this module. Review any |

| | |areas that need clarification. |

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Faculty Teaching Guide for

Specialty Chairside Assisting

Module:

Periodontics

▪

Teaching Tip

Encourage learners to take turns teaching concepts to each other. Successful learning requires a thorough understanding of the material at a deeper level. Consider conducting a short in-class activity where learners turn to the person next to them and explain the concept you have just covered. This also gets learners involved in the class.

Teaching Tip

Set specific expectations for homework. How do learners submit the homework? What guidelines do they need to follow? What expectations for professionalism do you have? Remember that your expectations can help in training learners for success in the workplace.

Part A: The Periodontal Team

Part B: Periodontal Disease and Procedures

Section 1:

Periodontics

Teaching Tip

Encourage learners to review their class notes on a regular basis. Suggest that they do this in logical learning chunks. This will help with retention and will make studying for exams that much easier because the materials will have been reviewed over an extended period of time.

Teaching Tip

Encourage learners to turn in clearly thought out homework assignments as though they were completing a work project. Professionalism is a characteristic that should become a habit.

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