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Oral Hygiene: Office and Home Care During the COVID-19 Pandemic

Oral Hygiene: Office and Home Care During the COVID-19 Pandemic COVID-19 (SARS-CoV-2) emerged globally in the latter part of 2019 and has spread to every country, leading to a pandemic with increasing infections and deaths related to the virus. COVID-19 has an aerosol transmission that causes infection primarily through the mouth, nose, and eyes and is transmitted primarily by the mouth (breathing, coughing) and nose (sneezing). Use of masks when out in public has been recommended, and in some geographic areas, mandated to limit potential contact with aerosol containing the virus in an attempt to stem infection spread. Recent studies have indicated that a large percentage of those infected with COVID-19 are asymptomatic carriers able to transmit the virus to others through normal activities that produce aerosol, such as talking, exhaling, sneezing, and coughing. Viral load related to COVID-19 has been reported to be consistently high in the saliva and relatively higher than found in the oropharynx during the early stages of infection. Patients need to remove their masks during dental treatment, and if the virus is present in the mouth, they may spread it into the room air via aerosol when talking or breathing prior to treatment initiation. High volume evacuation aids in elimination of aerosol created during treatment but may not completely eliminate virus particle spread into the operatory air and hence throughout the office. Pretreatment rinsing with specific mouth rinses has been advocated to inactivate any SARS-CoV-2 virus present in the patient’s mouth and eliminate aerosolization of those active particles. This course will review the various mouth rinses available, and their effectiveness on SARS-CoV-2 for use as pretreatment rinses, and improved home care to limit potential spread of the virus with asymptomatic carriers.

Educational Objectives
Upon completion of this course, the dental professional should be able to:

1. Incorporate basic practices to limit or prevent COVID-19 spread in the dental practice
2. Minimize the potential of asymptomatic carriers to spread the virus in the dental practice
3. Describe available mouth rinses and their effectiveness against COVID-19
4. Limit potential spread of the virus to those one may encounter when unable to wear a mask, such as fellow home residents, and aid in improving periodontal health in general through incorporation of antiviral oral rinses in home care

Gregori M. Kurtzman, DDS, MAGD ADA CERP/AGD PACE Credits: 3 Fee: $59.00

Breathless: Oral Signs of a Silent Epidemic

Breathless: Oral Signs of a Silent EpidemicThis is an exciting time to be in dentistry. Dentistry and dental hygiene are growing as medical specialties. As our understanding of the multiple links between the mouth and the body has increased, our roles have expanded to include comprehensive care of the patient’s whole health. One aspect of whole health care that can have an enormous life-changing and life-saving effect is to screen for sleep-disordered breathing. Breathing is the most essential function of our bodies. Without oxygen, we cannot survive. Yet, until recently, breathing was not considered a part of dentistry’s scope of practice. With the advent of comprehensive health care and integrative dental medicine, focus on the central role of airway and breathing disorders represents a shift in dentistry’s approach to patient care.1

Educational Objectives
Upon completion of this educational activity, the participant will be able to:

1. Identify various types of sleep-disordered breathing
2. Describe the screening process for identifying sleep-disordered breathing
3. Appraise the risks of undiagnosed and untreated sleep-disordered breathing
4. Recognize the signs and symptoms for sleep-disordered breathing in adults
5. Distinguish the treatment options available for sleep-disordered breathing

Kathryn Gilliam, BA, RDH, FAAOSH ADA CERP/AGD PACE Credits: 3 Fee: $59.00

Dental Handpieces: Maintenance, Repair, and Infection Control (3rd Edition)

Dental Handpieces: Maintenance, Repair, and Infection Control (3rd Edition)Dental handpieces have evolved significantly through the years.1 While traditional air-driven handpieces are still preferred by many practitioners, electric handpieces are preferred by many due to the constant torque, reduced noise, and improvements in smoothness of final preparations.2 Regardless of which handpiece is used in practice, proper maintenance and care will elongate the lifespan of the equipment and promote improved functionality. Understanding how to clean and maintain these handpieces and their components properly will help the clinician achieve optimal results. Moreover, it is essential for quality and turnaround times to know when to replace or rebuild handpiece turbines and who to send the handpiece to for repairs. The purpose of this article is to describe protocols for handpiece maintenance, including disinfection, sterilization, and repair.

Educational Objectives
Upon completion of this educational activity, the participant will be able to:

1. Implement proper cleaning and sterilization techniques
2. Provide proper lubrication of each handpiece and its components
3. Avoid common mistakes
4. Provide proper care for a fiber-optic or LED lens
5. Demonstrate proper sterilization techniques for various handpieces
6. Discuss handpiece turbines and the factors to consider when repair or replacement is necessary

Tija Hunter, CDA, EFDA, CDIA, MADAA ADA CERP/AGD PACE Credits: 3 Fee: $59.00

Digit-Sucking: Etiology, Clinical Implications, and Treatment Options

Digit-Sucking: Etiology, Clinical Implications, and Treatment Options Nonnutritive sucking is a normal reflex in infants up to six months of age. While most children grow out of this habit, many do not. There are several different theories as to why a child may continue the habit. Clinical implications include the development or relapse of malocclusions and bony structural changes, speech and articulation issues, chewing and swallowing problems, airway and breathing difficulty, and more. The severity of this habit and the corresponding signs are dependent on many factors, including frequency, intensity, duration, and the number and position of digits involved. There are several treatment options available, which will be discussed in this course. It is important for the dental care provider to be able to identify clinical signs of sucking habits, determine if and when treatment is necessary, and provide the patient and/or guardian with treatment options, referrals, and other resources. This course will provide the dental care provider with the confidence and knowledge to adequately manage these patients.

Educational Objectives
Upon completion of this course, the dental professional should be able to:

1. Recognize the signs of digit-sucking habits and explain the potential ramifications
2. Identify possible causes
3. Determine when to seek treatment
4. Provide treatment options, referrals, and other resources

Alyssa Stiles, BS, RDH, LMT, COM ADA CERP/AGD PACE Credits: 3 Fee: $59.00

Asthma, Allergic Rhinitis, and Tooth Decay

Asthma, Allergic Rhinitis, and Tooth DecayAsthma and seasonal allergies are chronic, yet treatable conditions that have been shown to alter the oral microbiome. As oral health providers, we are called to help our patients cultivate the microbiome of their oral cavity to achieve and maintain health. Specifically, this course will define asthma and seasonal allergies, explain the current treatment recommendations, and discuss how these disease processes and treatments affect oral health. This course also identifies ways that oral health professionals can help patients with seasonal allergies and/or asthma achieve oral and overall wellness.

Educational Objectives
Upon completion of this course, the dental professional should be able to:

  1. Understand the impact of asthma and seasonal allergies locally (for the patient) and nationally
  2. Review the current treatment recommendations for asthma and seasonal allergies
  3. Compare and contrast how both disease processes and their subsequent treatments can impact oral health
  4. Discuss how changing patient behaviors and using innovative products can improve oral health in patients with asthma and allergic rhinitis (AR)
Erinne Kennedy, DMD, MPH, MMSc ADA CERP/AGD PACE Credits: 3 Fee: $59.00

The ABCs of HbA1c: A Review of In-Office Diabetes Testing for the Dental Professional

The ABCs of HbA1c:Diabetes mellitus is a metabolic disorder affecting an estimated 463 million people or one in 11 adults worldwide. As research unpacks the codependent relationship between diabetes mellitus and a variety of diseases of oral origin, dental providers become an integral aspect to the identification, counseling, and referral of at-risk patients. Moreover, dental professionals are now encouraged to take an active role in the early identification of diabetes through hemoglobin A1c (HbA1c) testing, which strengthens a partnership between primary care providers and dental specialists while enhancing multidisciplinary involvement in optimal patient care. This article investigates the risks as well as signs and symptoms associated with undiagnosed diabetes mellitus, the manifestations of diabetes mellitus, and the step-by-step process for integrating HbA1c testing into the dental practice.

Educational Objectives
Upon completion of this course, the dental professional should be able to:

  1. Understand the current scientific literature indicating implications for incidence and prevalence of diabetes mellitus and oral disease, as well as the signs and symptoms of uncontrolled diabetes mellitus in the dental patient.
  2. Review the oral manifestations as well as the systemic sequelae of diabetes mellitus, while identifying the risk factors and potential shared etiologic factors associated with diabetes mellitus and oral disease.
  3. Discuss the opportunities for cotherapeutic management of diabetes mellitus and associated complications, including counseling strategies and guidelines for the implementation of dental services for patients with diabetes.
  4. Identify the clinical provision, indications, and process for gathering HbA1c point-of-service tests in the dental office while utilizing the Code on Dental Procedures and Nomenclature (CDT)-approved code.
Katrina M. Sanders, RDH, BSDH, MEd, RF, Elizabeth Sanders, DPM, DABPM, AACFAS ADA CERP/AGD PACE Credits: 3 Fee: $59.00

Carotid Stenosis and the Dental Patient: An Overview for the Dental Hygienist

Carotid Stenosis and the Dental Patient: To provide the patient with the best possible outcomes, it is crucial that the dental hygienist be able to detect carotid stenosis on a panoramic radiograph. Understanding the pathology behind carotid stenosis, as well as identifying risk factors, assists the dental hygienist with this detection. To optimize care, the dental hygienist must also be able to instruct patients on the importance of follow-up care with their primary health-care provider in a timely manner. It is also important that the dental hygienist is able to provide referral information to the patient who does not have a primary health-care provider.

Educational Objectives
Upon completion of this course, the dental hygienist should be able to:

  1. Locate physical landmarks associated with carotid stenosis
  2. Identify pathology associated with carotid stenosis
  3. List risk factors associated with carotid stenosis
  4. Discuss the role of the hygienist in detecting blockage visible on a panoramic radiograph
  5. Instruct patients on the importance of timely follow-up care with their primary health-care provider
  6. Facilitate a referral if the patient does not have a primary health-care provider established
Stacey McKinney, MSEd, RDH, Kelli D. Whittington, PhD, RN, CNE ADA CERP/AGD PACE Credits: 3 Fee: $59.00

The Power of a Prehuddle Morning Yoga Flow: How to Implement a Prehuddle Yoga Flow to Reduce Stress and Increase Daily Productivity

The Power of a Prehuddle Morning Yoga Flow: The prehuddle yoga flow is a five-to-10-minute sequence of breathing and movements designed to help release physical and mental tension in order to optimize movement and focus throughout the workday. The goal of this practice is to strengthen overall health and prevent chronic stress. This course will break down each component of the five-to-10-minute prehuddle yoga flow and discuss the purpose and application of each individual exercise. One healthy decision will lead to the next. This sequence is designed to reduce stress and increase physical mobility while facilitating a constructive bond between coworkers.

Educational Objectives
At the conclusion of this educational activity, participants will be able to:

  1. Self-regulate energy and focus
  2. Prevent chronic pains
  3. Prevent chronic stress
Danielle Cascioli, DDS, RYT 200, Cristian Pavel, DDS, RYT 200 ADA CERP/AGD PACE Credits: 3 Fee: $59.00

COVID-19: Part 2—Is There Something in the Air? Aerosols and Infection Prevention/Control in the Dental Office

COVID-19: Part 2 Dental procedures that employ handpieces, lasers, electrosurgery units, ultrasonic scalers, air polishers, prophy angles, hand instruments, and air/water syringes can create bioaerosols and spatter. Ultrasonic scalers and high-speed handpieces produce more airborne contamination than any other instruments in dentistry, but much is still unknown about the nature and infectivity of such aerosols. As dental procedures and technologies have evolved, the incidence of aerosol-creating procedures has increased. Inhalation of airborne particles and aerosols produced during dental procedures may cause adverse respiratory health effects, including high-consequence infectious diseases (HCIDs) spread by airborne routes. While transmission-based precautions may minimize risk to dental health-care providers, the evidence to support the most effective interventions and the guidance for infection control and prevention in regard to airborne disease transmission is rapidly evolving. During the initial pandemic stages, limiting dental practice and minimizing aerosol-generating procedures was critical, but as the current pandemic evolves, it has highlighted our understanding of potential modes of airobone disease transmission in the dental office and effective methods to mitigate such risks. Going forward, dental health-care providers should be aware of invisible risks within their operatories and stay abreast of evolving infection prevention protocols before, during, and after patient care. This course seeks to review up-to-date infection control recommendations and emerging evidence for ongoing infection control when delivering dental care, particularly in relation to the COVID-19 pandemic. 

Educational Objectives
Upon completion of this course, the dental professional should be able to:

  1. Explain the risk factors and basic properties of aerosols generated during routine dental procedures
  2. Describe what types of dental procedures result in significant dental aerosol production
  3. Understand the types of pathogens and resultant illnesses associated with such aerosols
  4. Differentiate between standard and transmission-based precautions and their utility in the dental office for safe delivery of care
  5. List infection control and aerosol mitigation techniques that may reduce the risk of cross-contamination to patients and providers
Maria L. Geisinger, DDS, MS ADA CERP/AGD PACE Credits: 3 Fee: $59.00

COVID-19: Part 1—Separating Science Fact from Science Fiction

COVID-19: Part 1With the rapid pandemic incited by SARS-CoV-2, which causes the disease COVID-19, widespread governmental and societal changes have affected much of our society. Airborne transmission of respiratory diseases has been shown to contribute to community spread of COVID-19 and respiratory diseases overall are common, causing up to 6 million deaths annually.1 While the current pandemic is caused by a virus that is similar to previous viral causes of epidemics/pandemics, it appears to be unique in its characteristics regarding the clinical presentation of the infection. SARS-CoV-2 is a coronavirus, and understanding the virology associated with this particular virus is critical to evaluating the biologic rationale for future interventions. This continuing education course will review the current status of understanding regarding the SARS-CoV-2 virus, its activity with host cells, and potential biologic targets for future interventions.

Educational Objectives
Upon completion of this course, the dental professional should be able to:

  1. Discuss the current understanding of the structure and function of the SARS-CoV-2 virus.
  2. List related viruses and the diseases they caused.
  3. Understand the differences in infectivity and viral activity between SARSCoV-1 and SARS-CoV-2.
  4. Develop an understanding of the potential therapeutic targets for SARS-CoV-2.
Maria L. Geisinger, DDS, MS ADA CERP/AGD PACE Credits: 2 Fee: $49.00
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