39200 - Oral Hygiene Tecnique 2

Learning outcomes

At the end of the course the student has a preparation that allows him to plan and to carry out a dental hygiene treatment in causal and supportive therapy. In particular, the student is able to: 1) identify the needs for educational and therapeutic interventions for primary and secondary prevention based on the clinical, oral and anamnestic situation, and knowledge relating to the oral health of each individual; 2) formulate a dental hygiene treatment plan personalized including educational, motivational and therapeutic interventions with the aim of improving the patient's quality of life in relation to oral health; 3) identify the most suitable protocol, establishing the number of non-surgical periodontal instrumentation sessions and apply the different non-surgical periodontal instrumentation techniques in relation to both the oral and systemic clinical situation of the patient. Pre-requisites: Coordinate the knowledge acquired in Professional Hygiene Sciences and Techniques 1, Laboratory and First Year Internship and apply them correctly.

Course contents

Patient evaluation: medical history and clinical examination.

• Patient evaluation: medical history. Antibiotic prophylaxis of bacterial endocarditis according to AHA guidelines; ASA classification of the patient.
• Extraoral and intraoral clinical examination of the patient. Tools and techniques for examining the soft tissues and anatomical structures of the oral cavity.
• Dental formula and dental anatomy, dentition, Black classes, congenital and acquired dental anomalies.

Role of the dental hygienist: primary and secondary prevention.

• Evaluation of risk factors, examination of existing dental rehabilitations, planning of  primary and secondary prevention interventions in relation to the patient's needs.
• Update of ministerial guidelines for maintaining oral health. Detection of clinical parameters: plaque index according to O'Leary.
• Plaque detectors.
• Primary prevention of carious pathology: fluoroprophylaxis and sealing of the grooves.
• Secondary prevention: polishing of tooth restoration. Extrinsic and intrinsic stains: polishing, air-polishing and whitening techniques.
  

Detection of clinical indices and parameters.

• Anatomy of the periodontium.
• Periodontal and tooth probing: types of periodontal probe, probing method, recording of probing depth, clinical attachment level.
• Detection of clinical parameters. Indices that measure oral hygiene status: plaque index (PI); plaque index according to O'Leary; Plaque-free score; Patient oral hygiene performance (PHP); Simplified oral hygiene index (OHI-S). Scoring indices for gingival and periodontal health: PSR (Periodontal Screening and Recording); Community periodontal index (CPI); SBI (Sulcular Bleeding Index); GI (Gum Index); Gum Bleeding Index (GBI). Dental caries indices: DMFT, dmft; Root caries index (RCI); Dean fluorosis index; Fluorosis index of the tooth surface.
• Furcation examination: survey and factors influencing therapy. Evaluation of the mobility of the dental elements. Measurement of the amount of keratinized gum. Gingival recessions: definition, risk factors, clinical implications, dentinal hypersensitivity. Radiographic examination.
• Characteristics and risk factors of gingivitis and periodontitis. Ministerial Guidelines for the prevention of gingivitis and mucosal diseases in children.
• New classification of periodontal diseases.

Non-surgical periodontal treatment: instruments and principles of instrumentation.

• Scaling, root planing, root debridement.Purpose of non-surgical therapy: objectives and expected results.Manual instrumentation: instruments (universal and area-specific curettes, scalers), characteristics, sharpening, methods of use (scaling and smoothing technique: correct working angle, finger support point, adaptation of the blade to the tooth, implementation of the cutting movements instrumentation). Positions of patient and operator in relation to the area to be treated.Mechanical instrumentation: sonic and ultrasonic instruments (piezoelectric, magnetostrictive). Indications  for the use of mechanical instruments, design of the instrument tip, comparison between manual and ultrasonic instrumentation, advantages and disadvantages. Procedures.

Data evaluation, treatment plan, patient clinic.

• EFP Manifesto: correlation between general health and periodontal condition. Risk factors for periodontal infections or poor response to periodontal therapy. Periodontal disease as a risk factor for systemic conditions. Risk factors for dental caries and oral cancer.Tissue conditioning: aims and procedures. Scheduling of scaling sessions. Revaluation. Maintenance: goals and scheduling of appointment frequency. Periodontal supportive therapy. Pharmacological therapy (antibiotics and antiseptics). Critical reading of a scientific article. Evidence Based Medicine: pyramid of evidence (meta-analyses, systematic literature reviews, randomized controlled trials, cohort studies, case control studies, case reports and case series).Treatment, education and motivation of the patient in different clinical cases. Notes on gender medicine. The pregnant patient. Children patients up to 5 years old. The growing patient and the orthodontic patient. The adult patient. The elderly patient. The cancer patient. The patient with respiratory pathology. The patient with cardiovascular disease. The patient with circulatory problems. The patient with diabetes mellitus.

Readings/Bibliography

V. Cortesi Ardizzone e A. Abbinante. Igienista orale. Teoria e pratica professionale - Seconda edizione, Edra, 2023.

Teaching methods

Frontal lessons and practice on simulators and patients.

Assessment methods

Written exam with open-ended questions.

Office hours

See the website of Angelica Bertacci