Advanced Hygiene Therapy – Developing a Comprehensive Approach


Course Description – In treating today’s periodontal patient successfully, the clinician must customize a treatment plan that goes beyond the removal of plaque and calculus.  Achieving excellent clinical outcomes involves assessing for systemic issues, communicating and customizing home care according to the patient’s level of understanding and ability to perform home care procedures, and choosing appropriate adjuncts to care.  In this course, we will explore the multi-faceted treatment planning approach, including scheduling and coding.  We will also discuss the assisted model of hygiene care and effective instrument sharpening.  We will also explore strategies for dealing with refusal of definitive care. 

Course Objectives –
Upon completion of this course, the participant will be able to:

  • Understand the factors involved in periodontal breakdown
  • Explore the most prominent systemic disease interrelationships
  • Choose adjuncts to care based on severity and appropriateness
  • Develop better clinical protocol
  • Customize home care modalities
  • Understand which codes are most appropriate for particular case types
  • Consider how the assisted model of hygiene could be implemented and why it is beneficial
  • Understand how instrument sharpening can be accomplished easily and effectively
  • Develop the best approach when patients refuse definitive care for periodontal disease

A.  Etiology of periodontitis/host involvement

  • Etiology and microbes associated with disease progression
  • Bacterial complexes and role of viruses
  • Role of biofilm
  • Efficacy of various antimicrobials
  • High velocity lavage
  • Other risk factors

B.  Systemic interrelationships

  • Diabetes
  • Cardiovascular disease
  • Respiratory diseases
  • Other systemic diseases

C.  Adjuncts to care

  • Interdental cleaning aids
  • Power brushes
  • Lasers
  • Systemic antibiotics

D.  Probing technique

  • Protocol
  • Angulation

E.  Clinical process

  • Step-by-step debridement process
  • Treatment planning by case type

F.  Scheduling

  • Time consideration
  • Recall systems

G.  Teaching homecare/interdental cleaning

  • Customizing according to patient ability
  • Changing home care behavior

H.  Coding considerations

  • Using the most appropriate codes
  • How to code the gingivitis patient
  • Site-specific periodontal treatment

I.  Periodontal maintenance

  • Debridement protocol
  • Adjuncts to care

J.  Assisted hygiene

  • Duties of the hygiene assistant
  • Scheduling for assisted hygiene
  • How to sabotage the model
  • Pre-requisites

K.  Instrument sharpening

  • Friction-grip stones
  • Angulation and magnification

L.  Legal issues/refusal of treatment

  • Informed refusal/informed consent
  • How to deal with patients that refuse definitive care


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