ConcordSeminars Course Content
Clinical Update in Periodontics
	with Charles M. Cobb, D.D.S., M.S., Ph.D.   Lasers and Periodontics: Fact and Fiction   This course is primarily intended for the general dentist and dental hygienist with an interest in the application of laser technology in the treatment of the inflammatory periodontal diseases and other common soft tissue problems. The course will address both the good and questionable aspects of laser applications in periodontics. In addition, the course will provide sufficient information to allow the practitioner to make an informed decision regarding purchase of laser and what type of laser is best suited for his/her specific practice.   Educational Objectives Those attending this seminar will become familiar with: The different types of laser wavelengths and the importance of wavelength in clinical applications. How lasers interact with biological tissues and how variations in laser parameters impact on wavelength/tissue interactions. A variety of oral soft tissue applications and the indications and contraindications for laser usage. The concept of evidence based decision making and treatment based on peer-reviewed published evidence. The published clinical trials in the process of answering the following questions:  A. Is laser mediated periodontal therapy vs. traditional non-surgical therapy, equal to, worse than, or better at reducing probing depth and bleeding on probing and increasing gains in clinical attachment? B. Is laser mediated periodontal therapy vs. traditional non-surgical therapy, equal to, worse than, or better at reducing subgingival bacterial populations? C. Does laser periodontal therapy predictably achieve desired clinical end-points?  D. Does the evidence support use of the laser mediated crown lengthening as a routine procedure in practice? COURSE OUTLINE I. The importance of wavelength: A. The Electromagnetic Spectrum  B. Wavelength (nm) Absorption in Oral Tissues a. Argon (480-510 nm) b. Diode (810-980 nm) c. Nd:YAG (1,060 nm)  d. Er,Cr:YAG (2,780 nm)  e. Er:YAG (2,940 nm)  f. CO2 (10,600 nm)  C. Wavelength and extinction coefficient in water  D. Factors that dictate laser wavelength interaction with oral tissues:  a. Waveform (continuous, pulsed and hyperpulsed)  b. Energy beam profile  c. Energy level  d. Duration of irradiation  e. Tissue factors:  1. Water content  2. Mineral content  3. Organic components  4. Color  E. Possible interactions of laser with oral tissues:  a. Penetration  b. Scatter  c. Reflection  d. Absorption  F. Thermal interactions of laser with oral tissues:  a. Warming  b. Coagulation  c. Vaporization  d. Carbonization  e. Rapid incision  G. Bad Decisions on Parameters = Bad Results II. Laser Applications for Soft Tissue Problems  A. Gingivectomy  B. Gingivoplasty  C. Frenulectomy  D. Lesion Ablation  E. Crown Lengthening  F. Gingival Depigmentation  G. Excisional & Incisional Biopsy  H. Removal of Granulation Tissue I. Cauterization of Aphthous Ulcers  J. 2nd Stage Exposure of Dental Implants  K. Coagulation of Soft Tissue Graft Donor Sites III. Evidence-Based Decision Making and Analysis of Perio & Lasers in the Peer- Reviewed Literature A. Wound Healing B. Effects on Root Surfaces  C. Effects on Bone  D. Effects on Calculus and Dental Biofilm IV. Failure of surgical treatment and/or laser treatment of chronic periodontitis is due to access and inability to remove all calculus V. Laser Treatment of Periodontitis: Ability, Predictability, Success or Failure  A. The use of a dental laser as a periodontal treatment modality is based on the perceived benefits of:  a. Subgingival curettage  b. Laser Assisted New Attachment Procedure (LANAP ')  c. Significant decreases in subgingival bacterial loads  B. The LANAP TM Technique (Nd:YAG)  VI. Review of Published Clinical Trials  A. Problems associated with a critical analysis of the literature  B. Comparative results for Nd:YAG, Diode and Er:YAG lasers  a. Reduction in probing depth  b. Reduction in bleeding on probing  c. Reduction in subgingival bacterial load  d. Gains in clinical attachment level VII. Laser Mediated Flapless Crown Lengthening Technique  A. Problems to look for during initial diagnosis and treatment planning  a. Bone dehiscence  b. Location of CEJ  c. Potential for root damage  d. Ability to contour bone as required and desired  e. Thick facial bone and potential for creating an intrabony pocket VIII. Conclusions and Editorial  A. Is laser mediated periodontal therapy vs. traditional non-surgical therapy, equal to worse than or better at reducing probing depth and bleeding on probing and increasing gains in clinical attachment? B. Is laser mediated periodontal therapy vs. traditional non-surgical therapy, equal to worse than or better at reducing subgingival bacterial populations?  C. Does laser periodontal therapy predictably achieve desired clinical end-points?  D. Does the evidence support laser mediated crown lengthening as aroutine procedure in practice?  E. From the Wall Street Journal, Market Place Section, September 14, 2007: "Most science studies appear to be tainted by sloppy analysis"   Periodontal Disease and the Systemic Link This course is primarily intended for the general dentist and dental hygienist with an interest in the treatment of the inflammatory periodontal diseases. The course will provide sufficient information to allow the practitioner to make informed decisions regarding patient care based on risk assessment for development of periodontal disease and the risk of potential systemic complication if oral inflammation is not controlled.  Educational Objectives Those attending this seminar will become familiar with the: Current epidemiology of periodontal disease. Role of subgingival microbial biofilm, successional colonization, and the Red Complex microbes and their associations with inflammation and the systemic inflammatory response. Pathogenesis of chronic periodontitis Biologic plausibility for an oral-systemic link. Relationship between periodontal disease and atherosclerosis and cardiovascular disease and ischemic stroke.  Relationship between periodontal disease and adverse pregnancy outcomes, pre-term birth, low birth weight, fetal growth restriction, and pre-eclampsia. The bi-directional relationship between the inflammatory periodontal diseases and diabetes. COURSE OUTLINE I. Introduction A. Epidemiology of periodontitis  a. Cobb CM, Williams KB, Gerkovitch M. Is The Prevalence of Periodontitis in the United States in Decline? Periodontol 2000 2008; In Press. B. Is the profession of dentistry fulfilling its role in the timely diagnosis of periodontal disease?  a. Cobb CM, et al. Periodontal Referral Patterns, 1980 versus 2000: A Preliminary Study. J Periodontol 2003:74:1470-1474.  b. Dockter KM, et al. Relationship Between Pre-referral Periodontal Care and Periodontal Status at Time of Referral. J Periodontol 2006;77:1708-1716.  c. Couper DJ, et al. The periodontitis and vascular events (PAVE) pilot study: Recruitment, retention, and community care controls. J Periodontol 2008;79:80-89. C. Subgingival microbial biofilm, successional colonization, and the Red Complex microbes.  a. Root associated biofilm  b. Epithelial associated biofilm  c. Plankton microbes  d. Tissue Invasive microbes D. The pathogenesis of chronic periodontitis:  a. Bacteremia and Endotoxemia  b. Pathogenesis of and role of genetics in periodontitis:  1. Cytokines  2. Inflammatory mediators  3. Matrix metalloproteinase  4. Genetics and the hyper-inflammatory response II. Biologic Plausibility for an Oral-Systemic Link  A. The common periodontal diseases (gingivitis and periodontitis) are characterized by a host immune response to a mixed Gram-negative anaerobic bacterial infection. The host reaction results in a localized inflammation that, in turn, generates a variety inflammatory mediators, such as IL-1, IL-6, TNF-(, and PGE2 and matrix metalloproteinases.  B. There is a direct relationship between poor oral hygiene and the presence and severity of periodontal disease and the incidence of bacteremia.  C. There is evidence that bacteremia, endotoxemia, and elevated systemic levels of inflammatory mediators are associated with moderate and advanced chronic periodontitis.  D. There is evidence of the presence of viable bacteria in atheromas and/or the tunica intima/media of vessels that exhibit atherosclerotic lesions.  E. There is evidence suggesting that chronic periodontitis is associated with elevated levels of acute-phase proteins, particularly C-reactive protein.  F. There is evidence that treatment of periodontal disease can decrease levels of C-reactive protein. III. The Relationship between Periodontal Disease & Cardiovascular Diseases  A. Current research literature indicates: a. The odds of having a history of heart attacks increases with the severity of periodontal disease. b. The odds of experiencing a stroke are even greater with increased severity of periodontal disease. c. Specific periodontal pathogenic bacteria have been associated with atherosclerosis. d. Periodontal bacteria may remain viable and survive translocation from the oral cavity to cardiovascular and/or arterial endothelium.  B. Model for relationship between periodontal inflammation, atherosclerosis, cardiovascular, and cerebrovascular disease C. The evidence (selected articles): a. Haraszthy VI, et al. Identification of periodontal pathogens in atheromatous plaques. J Periodontol 2000;71:1554-1560 b. Desvarieux M, et al. Periodontal microbiota and carotid intima-media thickness. The oral infections and vascular disease epidemiology study (INVEST). Circulation 2005;111:576-582 c. Feihn N-E, et al. Identification of periodontal pathogens in atherosclerotic vessels. J Periodontol 2005;76:731-736 d. Kozarov EV, et al. Human atherosclerotic plaque contains viable invasive Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. Arterioscler Thromb Vasc Biol 2005;25:e17-e18  e. Spahr A, et al. Periodontal infections and coronary heart disease. Arch Intern Med 2006;166:554-559 f. Offenbacher S, Beck JD. A perspective on the potential cardioprotective benefits of periodontal therapy. Am Heart J 2005;149:950-954. g. Espinola-Klein C, et al. Impact of infectious burden on progression of carotid atherosclerosis. Stroke 2002;33:2581-2586 h. Amar S, Gokce N, Morgan S, et al. Periodontal disease is associated with brachial artery endothelial dysfunction and systemic inflammation. Arterioscler Thromb Vasc Biol 2003;23(8):1309-1311. i. Grau AJ, et al. Periodontal disease as a risk factor for ischemic stroke. Stroke 2004;35:496-501. j. D'Aiuto F, Parkar M, Nibali L, et al. Periodontal infections cause changes in traditional and novel cardiovascular risk factors: Results from a randomized controlled clinical trial. Am Heart J 2006;151:977-984. k. Cairo F, Castellani S, Gori AM, Nieri M, Baldelli G, Abbate R, Pini-Prato GP. Severe periodontitis in young adults is associated with sub-clinical atherosclerosis. J Clin Periodontol 2008;35: In Press. l. Colhoun HM, Slaney JM, Rubens MB, Fuller JH, Sheiham A, Curtis MA. Antibodies to periodontal pathogens and coronary artery calcification in type 1 diabetic and nondiabetic subjects. J Periodont Res 2008;43:103-110. m. Elka(m R, Dahan M, Kocgozlu L, Werner S, Kanter D, Kretz JG, Tenenbaum H. Prevalence of periodontal pathogens in subgingival lesions, atherosclerotic plaques and healthy blood vessels: A preliminary study. J Periodont Res 2008;43: 224-231.  n. Paraskevas S, Huizinga JD, Loos BG. A systematic review and meta-analyses on C-reactive protein in relation to periodontitis. J Clin Periodontol 2008;35:277-290. o. D'Aiuto F, Parkar M, Tonetti MS. Acute effects of periodontal therapy on bio-markers of vascular health. J Clin Periodontol 2007;34:124-129.  D. Conclusion:  a. The number of inflammatory disease events to which an individual has been exposed is a major risk factor for development of atherosclerosis. Chronic periodontitis represents an inflammatory infection that may exist for years, thereby exposing the patient to continuous microbial insult with all the inherent metabolic events associated with inflammation. Given such a scenario, moderate and advanced chronic periodontitis represent a controllable risk factor for development of atherosclerosis that, in turn, may lead to adverse cardiovascular and cerebrovascular events.  E. Implications: a. Dentists and physicians may need to focus more on primary prevention of infection by periodontal pathogens. b. End-points for prevention will involve eliminating periodontal pathogens and reducing inflammation.  c. Controlling inflammation and infection may create an increased need for anti-infective and anti-inflammatory pharmacological strategies for high risk patients. IV. The Relationship Between Periodontal Disease and Adverse Pregnancy Outcome  A. Pregnancy related periodontal disease:  a. Gingivitis  b. Periodontitis  c. Pyogenic Granuloma  1. Hormones, Prevotella intermedia and Inflammation  B. Preterm Low Birth Weight Delivery (PTLBW)  a. In the United States, 6% to 9% of all births are preterm.  b. Preterm births account for 70% of all perinatal deaths and 50% ofall long-term neurologic morbidity.  C. Evidence for a relationship between infection and PTLBW delivery:  a. Clinically evident infection is increased in mothers and newborns after preterm birth (PTB). b. The prevalence of histologic chorioamnionitis is increased in PTB. c. Positive bacterial cultures of the amniotic fluid or membranes are common in patients with preterm labor/PTB. d. Bacterial vaginosis as well as genital tract infections of Ureaplasma urealyticus, Chlamydia, or Trichamonas vaginalis have been associated with PTLBW. e. Some antibiotic clinical trials have shown a lower rate of PTB or have prolonged gestation. f. In a mouse model, maternal Campylobacter rectus infection induces placental inflammation, decidual * hyperplasia, and increase in fetal brain IFN-(. These changes, in turn, resulted in increased pup mortality and ultrastructural changes in the hippocampal region of the brain. 1. Decidual cells are surface cells of the endometrium surrounding the implanted embryo that are stimulated to proliferate and contribute to placenta formation.  g. Numerous biochemical markers of infection are seen in preterm labor. There are increased levels of PGE2, IL-1, IL-6 and TNF-( found in the amniotic fluid.  1. All of these may lead to myometrial contractions, membrane rupture, cervical ripening, and PTLBW delivery. h. The association of periodontal disease with PTLBW is not due to a concomitant vaginosis or chorioamnionitis.  i. Periodontal disease seems to represent an additional pathway of infectious and/or inflammatory exposure to the maternal-fetal unit.  j. Bacteria or their products induce PTB in animal models (Porphyromonas gingivalis & Campylobacter rectus).  k. Looking at fetal and maternal antibody activity against certain periodontal pathogens shows that in the absence of maternal IgG reactivity and the presence of fetal IgM reactivity, the prematurity rate was 66.7% (OR 10.3) - suggestive of a blood-borne infectious pathway (Madianos, et al., Ann Periodontol 2001;6:175-182) l. Yiping WH, et al. Transmission of an uncultivated Bergeyella strain from the oral cavity to amniotic fluid in a case of preterm birth. J Clin Microbiol 2006;44:1475-1483.  1. This article demonstrates the potential for placental barrier invasion and habitation of an oral pathogenic microbe within the amniotic cavity. D. Model for the relationship between periodontal disease and preterm low birth rate delivery  a. Pitiphat W, et al. Maternal periodontitis and adverse pregnancy outcomes. Community Dent Oral Epidemiol 2008;36:3-11.  b. Goldenberg RL, et al. Epidemiology and causes of preterm birth. Lancet 2008;371(9606):75-84.  E. Periodontal disease and pre-eclampsia  F. Periodontal disease and fetal growth restriction V. Periodontal Disease and Diabetes A. The six major complications of diabetes:  a. Angiopathy  b. Nephropathy  c. Neuropathy  d. Retinopathy  e. Altered Wound Healing  f. Periodontal Disease B. Pathobiology of diabetes and the relationship to:  a. Altered function and loss of vascular integrity  b. Thrombosis and atheroma formationc. Elevated serum levels of inflammatory mediators, e.g., IL-1, IL-6, and TNF-( C. Southerland JH, et al. Commonality in chronic inflammatory diseases: Periodontitis, diabetes, and coronary artery disease. Periodontol 2000 2006;40:130-143.  D. Model for the bi-directional relationship between periodontitis and diabetes a. Poorly controlled diabetic patients are at 2-3 times greater risk for developing periodontal disease b. Once periodontal disease has developed, poor metabolic control leads to more aggressive periodontal destruction  c. Periodontal disease, like any other infection, complicates glycemic control d. Poor glycemic control increases the risk for delayed and impaired wound healing and serious diabetic complications (e.g., angiopathy, retinopathy, neuropathy, nephropathy). E. Model for the relationship between inflammation, obesity, diabetes, and periodontal disease F. Clinical presentation of the oral manifestations of Type I and Type II diabetes. G. The Scottsdale Project: a. Hein C, Cobb CM, Iacopino A. Report of Independent Panel of Experts of The Scottsdale Project. The Independent Study Initiative for Collaboration in Diabetes, Cardiovascular Disease and Periodontal Disease Intervention. Grand Rounds in Oral-Systemic Medicine 2007;2(No. 3, Supplement):1-27
Care Considerations for the Periodontal Patient
	with Dianne D. Glasscoe, RDH, BS   Excellence in patient care should be the goal of the consummate dental hygienist/dentist when treating the periodontal patient non-surgically. This course examines the latest information related to patient care protocol, including (but not limited to) systemic factors related to periodontal disease, patient classification, blood pressure guidelines, pain control modalities, and treatment sequence and protocol. COURSE OBJECTIVES Upon completion of this course, the attendee should be able to: understand many of the links between the oral and systemic disease. classify the periodontal patient through expanded classification guidelines. implement effective sequencing protocol for the periodontal patient. understand the role of inflammation. use proper pain control techniques. understand the new pre-medication guidelines. discuss the usage of intrapocket therapies. implement enhanced verbal skills with patients. ascertain when referral to a specialist is needed. COURSE BENEFITS In order to provide the patient with optimum care, staying current regarding technology and treatment modalities is very important for the dental professional. This course will provide the clinician with up-to-date, evidence-based information related to comprehensive care for the hygiene patient. COURSE TOPICS Basic considerations of the periodontal patient Homecare Susceptibility Systemic disease Fear Lifestyle factors Local oral factors Classification systems Suggestions for the gingivitis patient Non-surgical and maintenance coding New pre-medication guidelines Implications for clinicians and patients Components of intraoral/extraoral exam Pain control measures Step-by-step debridement process Use of power scalers Use of fluoride varnish Scaling considerations The role of calculus The inflammatory response Use of low-dose doxycycline Use of amoxicillin/metronidazole Recommended armamentarium Power scalers Magnification Instruments Patient aids to treatment Communication considerations Barriers to communication Using effective analogies in treatment discussions Handling difficult situations
Successfully Treating Older Adults: Techniques for the Entire Dental Team
	with Randy F. Huffines, D.D.S   American Dental Association statistics confirm that older patients are a large and growing segment of the oral healthcare market. The 78 million boomers now entering their senior years are sophisticated healthcare consumers who are willing to invest in their oral health if the dental team is trained to meet their unique needs. However, these patients can be very challenging due to an array of complex dental and medical conditions that become more common as we age.  In this entertaining and informative presentation, Dr. Huffines will share valuable clinical pearls in the areas of: pharmacology, soft tissue lesions, prosthodontics, esthetics and aging, remineralization products such as CPP-ACP and fluoride varnish, implants, xerostomia, CAMBRA protocols, simplifying medically complex patients, endodontics, communicating with seniors, and periodontics. The latest in the restoration and prevention of root caries will be covered in detail. Procedures are clearly explained by extensive use of clinical images and video clips so they can immediately be put into practice. Everyone in your office needs to understand these concepts and techniques to make treating seniors enjoyable and profitable. COURSE OBJECTIVES At the conclusion of the course the clinician will be able to: Describe the clinical implications of aging on the oral cavity Modify treatment based on the patient's medical conditions  Select therapeutic interventions for common oral conditions Manage periodontal disease in the elderly Evaluate how to make their office more senior-friendly Appropriately manage root caries COURSE OUTLINE THE AGING MOUTH: FACT AND FICTION  Teeth  Oral mucosa  Alveolar bone  Gingiva  SIMPLIFYING THE MEDICALLY COMPLEX PATIENT Time-saving medical resources Avoiding pitfalls in medical consultation Heart disease and stroke Alzheimer's  Diabetes Cancer Respiratory disease Osteoporosis Renal Disease Liver disease PRACTICAL PHARMACOLOGY AND AGING Time-saving drug information resources Evidence-Based Pain Management Antibiotics, antifungals, antivirals Oral sedation, oral anxiolysis, and nitrous oxide Local anesthetics and vasoconstrictors Bisphosphonates and osteonecrosis: current recommendations Xerostomia: implications and treatment New endocarditis guidelines: legal and practical considerations Managing patients on "blood thinners": ADA recommendations ROOT CARIES: RESTORATION  Glass Ionomer and composite techniques  Isolating subgingival lesions Matrixing techniques Full coverage: when and how ROOT CARIES: PREVENTION Antimicrobial protocols ACP versus CCP-ACP Sodium fluoride and difluorosilane varnishes At home prescription fluorides Xylitol products Improving oral hygiene Implementing CAMBRA guidelines REMOVABLE PROSTHODONTICS  What every dental hygienist and assistant should know Clinical implications of alveolar resorption Prosthesis-related soft tissue disease Aging and esthetics Implants and aging Immediate and conventional denture techniques PERIODONTAL DISEASE IN THE ELDERLY Is the pathogenesis different? Implications for diagnosis and treatment Oral-systemic link: science or sensation THE SENIOR-FRIENDLY OFFICE Office design and modification  Marketing to seniors: "Gold in Gray" Improving communication with seniors
Successfully Treating Older Adults: Techniques for the Entire Dental Team - Alaska Day 1 + 2
	with Randy F. Huffines, D.D.S This is a two part seminar. It is not required that you attend both days but it is recommended. American Dental Association statistics confirm that older patients are a large and growing segment of the oral healthcare market. The 78 million boomers now entering their senior years are sophisticated healthcare consumers who are willing to invest in their oral health if the dental team is trained to meet their unique needs. However, these patients can be very challenging due to an array of complex dental and medical conditions that become more common as we age.  In this entertaining and informative presentation, Dr. Huffines will share valuable clinical pearls in the areas of: pharmacology, soft tissue lesions, prosthodontics, esthetics and aging, remineralization products such as CPP-ACP and fluoride varnish, implants, xerostomia, CAMBRA protocols, simplifying medically complex patients, endodontics, communicating with seniors, and periodontics. The latest in the restoration and prevention of root caries will be covered in detail. Procedures are clearly explained by extensive use of clinical images and video clips so they can immediately be put into practice. Everyone in your office needs to understand these concepts and techniques to make treating seniors enjoyable and profitable. COURSE OBJECTIVES At the conclusion of the course the clinician will be able to: Describe the clinical implications of aging on the oral cavity Modify treatment based on the patient's medical conditions  Select therapeutic interventions for common oral conditions Manage periodontal disease in the elderly Evaluate how to make their office more senior-friendly Appropriately manage root caries COURSE OUTLINE - Day 1 (Friday) THE AGING MOUTH: FACT AND FICTION Teeth Oral mucosa Alveolar bone Gingiva Salivary glands Taste Mastication Swallowing SIMPLIFYING THE MEDICALLY COMPLEX PATIENT Time-saving medical resources Avoiding pitfalls in medical consultation Heart disease Stroke Alzheimer’s Diabetes Cancer Respiratory disease Osteoporosis Renal Disease Liver disease PRACTICAL PHARMACOLOGY AND AGING Time-saving drug information resources Evidence-Based Pain Management Antibiotics, antifungals, antivirals Oral sedation, oral anxiolysis, and nitrous oxide Local anesthetics Myths about vasoconstrictors Bisphosphonates: current recommendations Xerostomia: implications, palliation, treatment Controversies about antibiotic premedication New endocarditis guidelines: legal and practical considerations Managing patients on “blood thinners”: ADA recommendations TEAM TREATMENT OF EDENTULOUS PATIENTS Common myths about tooth loss Prosthesis-related soft tissue disease Role of hygienist and assistants in treatment Clinical implications of alveolar resorption Aging and esthetics Implants and aging Socket grafting: science or marketing hype? Immediate and conventional denture techniques COURSE OUTLINE - Day 2 (Saturday) PERIODONTAL DISEASE IN THE ELDERLY How is it different? Pathogenesis: current concepts Implications for diagnosis and treatment Chemotherapeutics: marketing hype? Predicting prognosis Drug-induced gingival enlargement Periimplantitis Oral-systemic link: science or sensation? CHEMOTHERAPEUTICS FOR CARIES Antimicrobial protocols ACP versus CCP-ACP Sodium fluoride and difluorosilane varnishes Sodium calcium phosphosilicate Calcium carbonate, bicarbonate Chlorhexidine: rinse or varnish? At home prescription fluorides Bioactive restoratives Xylitol products Improving compliance in older patients Implementing CAMBRA guidelines ROOT CARIES: DIAGNOSIS & RESTORATION Diagnostic pitfalls Glass Ionomer, amalgam, and composite techniques Isolating subgingival lesions Matrixing and finishing techniques Full coverage: when and how Salvaging existing restorations THE SENIOR-FRIENDLY OFFICE Office design and modifications Marketing to seniors: “Gold in Gray” Improving communication with seniors This is a two part seminar. It is not required that you attend both days but it is recommended.
Oral Pathology for Dental Professionals
	with Olga A.C. Ibsen, RDH, MS   "Oral Pathology for Dental Professionals" 9:00 am - 12:30 pm This course will provide the participant with the seven diagnostic methods that are a part of the diagnostic process. They include: clinical, radiographic, historical, laboratory, surgical, therapeutic and differential. Lesions in each category will be discussed from etiology to prognosis of the disease. OBJECTIVES 1. List and describe the seven diagnostic methods. 2. Give two examples of lesions/conditions that are diagnosed using one or more of the diagnostic methods. 3. State characteristics of benign and malignant lesions. 4. State and describe three types of biopsy. 5. Identify information on the medical history that can contribute to the diagnosis of five conditions discussed under historical diagnosis. 6. Know when it is appropriate to refer a patient to a specialist. 7. List three variants of normal diagnosed through clinical diagnosis. 8. Describe the clinical and histological feature and prognosis for squamous cell carcinoma, verrucous carcinoma and basal cell carcinoma. "Differential Diagnosis of Oral Lesions" 1:30 - 5:00 pm After a brief introduction of the diagnostic process, there will be a discussion of normal structures, variations of normal, and pathologic conditions of the oral cavity. This will include the lips, tongue, floor of the mouth, buccal mucosa, palate and gingiva. Clinical features will be emphasized; however, oral lesions and conditions will be discussed from etiology to prognosis. OBJECTIVES 1. Describe two variations of normal for each area discussed. 2. Name the diagnostic method that contributes significantly to the differential diagnosis. 3. Describe the histologic features of Pemphigus and Lichen Planus. 4. Describe leukoplakia and erythroplakia. 5. List two screening procedures that may assist in the diagnostic process. 6. List and describe three conditions which are example of molecular chromosomal abnormalities. 7. Name three oral conditions that may be treated with therapeutic diagnosis. 8. List and describe four conditions with immunologic pathogenesis. Oral lesions to be discussed, but not limited, to include: Herpes Simplex White Sponge Nevus Minor + Major Aphthous Ulcers Syphilis Erythema Multiforme Candidiasis Squamous Cell Carcinoma Pyogenic Granuloma Lichen Planus Myoblastoma (Granular Cell Tumor) Carcinoma in Situ Pemphigus Vulgaris Agranulocytosis Condyloma Acuminatum Tobacco Pouch Keratosis Papillary Hyperplasia Pleomorphic Adenoma Nicotine Stomatitis About this Course: A comprehensive review of Oral Pathology which will enhance your clinical expertise.
Update on Infection Control in the Dental Practice
	with John A. Molinari, Ph.D.   Accumulated knowledge describing the risks of hepatitis B, hepatitis C, human immunodeficiency virus infection, tuberculosis, and other occupational infections have increased both the awareness and efficiency of health care infection control practices. These and other infectious disease challenges along with appropriate prevention strategies, will be considered in light of current scientific evidence. The most recent guidelines for infection control in dentistry will serve as the framework for the presentation. Applications of aseptic technique principles and standard precautions for the treatment of patients will be re-enforced throughout the session. A major area of discussion will consider the use of recommended vaccines for prevention of occupational diseases. A component of this section will also address certain perceptions and opinions against vaccines which threaten their documented global success against many infectious diseases. In addition, evolving issues including patient and provider allergic reactions to latex, strategies for control of dental waterline contamination, and respiratory protection against aerosolized pathogens will also be emphasized. Updated approaches and recommendations for instrument reprocessing protocols, heat sterilization modalities and monitoring, protective barriers, evaluation of available products and their application in disinfection procedures, will be presented in a manner to assist dental professionals in the practical application effective infection control principles. COURSE OBJECTIVES At the conclusion of this presentation, the participants should be able to:   consider the latest information on emerging diseases in dentistry and around the world.  understand the rationale for effective, practical, infection control precautions.   use aseptic procedures as fundamental components of an infection control program.   describe major infectious diseases that are occupational risks to dental professionals and their patients.   understand the application of standard precautions when providing patient care.   adhere to the most current vaccine recommendations for prevention of hepatitis B and other diseases.   discuss immunological mechanisms and manifestations of allergic reactions associated with latex products.   comprehend appropriate use of PPE for dental care.   describe recent advances and applications of heat sterilization technology.  describe the use of disposable barriers and disinfectants used in environmental surface asepsis.   describe factors which can lead to dental unit waterline (DUWL) contamination.   list microorganisms which may be found in DUWL, and discuss strategies which may minimize formation of biofilms and DUWL contamination.   describe and understand strategies which may minimize forms of bio and DUWL contamination.
Dental Pharmacology: An Overview and Update
	with Thomas Viola, B.S., R.Ph.   Throughout the course of their everyday practice, dental professionals must frequently draw upon their knowledge of Pharmacology. Recently introduced competency-based curriculums have demonstrated that tasks ranging from the routine, such as obtaining a complete patient medical history and appointment planning, to the extreme, such as handling a medical emergency in the office, all require a foundation knowledge in Pharmacology. However, the science of Pharmacology consistently represents only a small portion of most dental degree programs. Armed with a relatively brief exposure to such vast subject matter, many dental professionals have difficulty retaining this knowledge throughout their career as well as staying current with new pharmacotherapeutic trends, especially when faced with a marketplace awash in direct-to-consumer advertising of prescription drugs and an explosion of new drug entities over the last several years.   The purpose of this program is to provide dental professionals with an overview of the basic principles of Pharmacology and the classes of drugs used in the current therapy of most common disease states. Throughout the program, special emphasis will be given to drugs administered or prescribed in dental practice, as well as to drugs whose actions, side effects, or interactions with other drugs may impact dental healthcare.   LEARNING OBJECTIVES Upon successful completion of this program, participants will be able to: Review the history of drugs and their use Identify references and sources of drug information to be used in practice Explain basic pharmacokinetics and related factors that affect a drug’s handling and action Review the etiology of most common disease states and describe the classes of drugs used in their treatment Identify a drug listed on a patient’s medical history and explain the drug’s basic mechanism of action and pharmacologic effects potential adverse reactions and contraindications potential drug interactions and considerations important to patient management during dental treatment. Discuss and compare the classes of drugs used in dental practice for: local anesthesia and pain management prophylaxis and treatment of infection treatment of oral conditions Recognize the generic and trade names of some of the most commonly prescribed drugs and be able to classify them according to their principle therapeutic indications. COURSE OUTLINE PHARMACOLOGY BASICS Importance to the dental professions Drug Nomenclature Pharmacokinetics Natural Medicine Sources of Drug Information TREATMENT & MANAGEMENT OF PAIN Non-Narcotic Analgesics Opioid Analgesics Local Anesthetics Vasoconstrictors TREATMENT OF INFECTION Antibiotic Agents Antituberculosis Agents Antifungal Agents Antiviral Agents TREATMENT OF DISEASE OF MAJOR ORGAN SYSTEMS Autonomic Drugs Cardiovascular Drugs Respiratory Drugs Gastrointestinal Drugs TREATMENT OF DISEASE OF THE CNS Antianxiety Agents Antidepressants Psychotherapeutic Agents Agents Used to Treat Bipolar Disorder Anticonvulsants Agents Used to Treat Neuropathic Pain Agents Used in the Treatment of Migraine Headache Agents Used in the Treatment of Alzheimer’s Disease Antiparkinsonism Drugs TREATMENT OF ENDOCRINE & OTHER DISEASES Adrenalcorticosteroids Antidiabetic Agents Thyroid Agents Reproductive Hormones Anti-osteoporosis Agents Antineoplastic Agents Anti-rheumatic Agents