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HIV in the Migrant and Seasonal Farm Worker Population: Oral Conditions as Early Indicators of Infection

Migrant and seasonal farmworkers are an underserved population with a myriad of health challenges. Mobility, isolation from family, lack of education, and cultural barriers are just some of the issues placing them at increased risk for HIV infection. Because they are often unaware of their HIV status and have limited access to care, diagnosis is often later in the disease process than that of the average infected individual. Some of the earliest signs of HIV infection manifest in the oral cavity, which makes dental professionals frontline practitioners for possible diagnosis, referral for treatment, and educational strategies. Dental hygienists must be knowledgeable of and able to recognize these oral manifestations as well as equipped with appropriate educational materials as they work collaboratively with other health-care providers. Implications for policy development are warranted to aid in serving this difficult-to-reach population.

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

1. Describe the migrant and seasonal farmworker (MSFW) population serving the US
2. Explain the population’s vulnerability to HIV infection
3. Describe HIV-related oral lesions that may suggest HIV infection 
4. Discuss appropriate HIV education and intervention strategies to utilize with the MSFW population

Sherri Lukes, RDH, MS, FAADH ADA CERP/AGD PACE Credits: 3 Fee: $59.00

The Dental Practitioner’s Ultimate Guide to Adult Patient Fear, Anxiety, and Phobia

The American Dental Association reports 22% of adult Americans avoid the dentist due to fear and anxiety, which equates to one in five.Fifty-nine percent of Americans cite cost as the top reason they do not visit the dentist more frequently. Patient anxiety etiologically can be psychological, financial, physical, or a combination of these. The anxious patient presents with significant challenges to rendering care in the dental environment. This course takes a practical approach in the dental management of fearful, anxious, and/or phobic patients that can be incorporated into even the busiest offices. Multimodal, evidence-based, nonpharmacological, and pharmacological approaches to anxiety management are summarized to assist dental practitioners in successfully treating these patients and improving their oral health and overall quality of life.

Educational Objectives
At the conclusion of this course, dental practitioners will be able to:

1. Incorporate an anxiety management plan that best fits their patient population.
2. Identify dentally fearful, anxious, or phobic patients and apply correct management techniques.
3. Provide more pleasant and relaxed appointments to improve both the patient and provider experience.

Lisa Dowst-Mayo, RDH, BSDH ADA CERP/AGD PACE Credits: 3 Fee: $59.00

Is Beauty Truly in the Eye of the Beholder? Evidence-Based Ideal Smile Esthetics

Is Beauty Truly in the Eye of the Beholder? Evidence-Based Ideal Smile EstheticsA smile is a universal greeting and translates into all languages. Smiling individuals are judged as more pleasant and trustworthy, and the act of smiling actually releases endorphins that improve the mood of the person who smiles. As dentists, we are trained to create, maintain, and protect the ideal smile, but what should our goals be in achieving that “gold standard” of beauty? The essential components of an ideal smile involve the relationship between three primary components: the teeth, the lip framework, and the gingival scaffold. While beauty may be in the eye of the beholder, factors that allow assessment of overall smile esthetics include tooth width/height ratio, shape, position, quality of restoration, and general arrangement of the dentition, especially of the anteriior teeth, upper lip position, buccal corridor, visibility of teeth, and amount of gingival display, These factors are considered in concert and usually judged esthetically as a group. It is considered that in the composition of a beautfiul smile, the form balance, symmetry, and relationship of these elements make it attractive or unattractive. This course seeks to present the current data regarding ideal smile components and the differences regarding ideal smile components based upon age, gender, and race/ethnicity to allow dentists to create personalized road maps and help their patients achieve vibrant smiles.

Educational Objectives
At the conclusion of this course, the reader should be able to:

  1. List the components of a smile and discuss their roles in optimal smile esthetics
  2. Describe the step-by-step approach to evaluating a patient’s smile, including assessing tooth shape/shade, gingival display, and lip length/mobility
  3. Understand the role of patient-based characteristics on acceptable esthetics and ideal smile components
  4. Discuss personalized treatment options to achieve ideal smile esthetics based upon underlying diagnoses in each patient
Hussein Basma, DDS, DESS, MS, Maria L. Geisinger, DDS, MS ADA CERP/AGD PACE Credits: 3 Fee: $59.00

Oral Lichen Planus: Identification and Management (2nd Edition)

Oral Lichen Planus: Identification and Management (2nd Edition)Oral lichen planus—a chronic, inflammatory, immune-mediated condition—may result in erosion of the oral mucosa. The disease presents in four forms—reticular, erosive, atrophic, or bullous—and typically develops in women in their fifth and sixth decades. Reticular oral lichen planus, when absent of erythema, is asymptomatic and does not typically require intervention. However, there is clinical potential of conversion to carcinoma with reticular oral lichen planus associated with erythema or erosion. This potential requires treatment and periodic reevaluation for tissue changes that may indicate conversion to carcinoma. The erosive and ulcerated forms of oral lichen planus are best managed with topical corticosteroids. Refractory cases are recommended to be treated with systemic steroids or other immunosuppressive medications. Nonmedication-based interventions are also available, but with greater potential for adverse reactions, greater degree of side effects, and at greater cost. This review article will discuss identification of oral lichen planus and its management.

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

  1. Identify the clinical presentation of oral lichen planus
  2. Identify the different forms of lichen planus and differentiate them from lichenoid reaction
  3. Understand how to treat lichen planus and manage patient comfort
  4. Identify interventions discussed in the literature that are supported by limited evidence
Gregori M. Kurtzman, DDS, MAGD ADA CERP/AGD PACE Credits: 3 Fee: $59.00

Anatomy of a Handpiece: Understanding Handpiece Maintenance and Repairs

Anatomy of a Handpiece: Understanding Handpiece Maintenance and RepairsToday’s clinician is extremely dependent on the handpiece to sustain a smooth-running practice. The handpiece is an incredibly sophisticated device that requires a diligent maintenance protocol to keep it running properly and safely. Routine, repeated heat sterilization has the most adverse effect on the dental handpiece. Perhaps due to this dependency on handpieces, combined with the damage resulting from repeated routine sterilization and the need for consistent maintenance, the handpiece has earned an undeserved reputation for excessive breakdowns. The dental team can keep handpieces functioning smoothly longer, and maximize the return on the significant investment the dentist has made in handpiece technology, through appropriate maintenance procedures. Careful selection from repair options is also required.

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

  1. List and describe the major components of air-driven high-speed handpieces and electric handpieces.
  2. List and describe the main differences between air-driven high-speed handpieces and electric handpieces.
  3. List and describe the signs of failure for air-driven and electric handpieces.
  4. List and describe the maintenance steps for air-driven handpieces.
  5. List and describe the options for repair/rebuild of air-driven handpieces and considerations in selecting one.
Glenn Williams, BS ADA CERP/AGD PACE Credits: 3 Fee: $59.00

The Human Trafficking Crisis: Identifying and Reporting in the Dental Setting

The Human Trafficking Crisis: Identifying and Reporting in the Dental SettingHuman trafficking is a growing public health and safety issue in the United States. It is the fastest growing commerce in the world with more than 200,000 minors at risk in the US. People of all ages are forced into labor or sexual exploitation through fraud and coercion. It is believed that up to 80% of victims are seen by health-care providers while under the influence of traffickers. These victims will not identify themselves as such due to the fear of being further abused by their traffickers. Currently, only 13 states require health-care professionals to take courses on recognizing the signs of a trafficked individual. As dental care providers, it is imperative to identify the signs and know how to report suspected human trafficking. Through education of professionals in all health-care settings, victims of trafficking may be more likely to be rescued and receive the proper resources for healing and recovery.

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

  1. Understand the definition of human trafficking
  2. Learn who is at risk to be trafficked
  3. Understand the difference between sex trafficking and sex work
  4. Learn how to identify a person who is being trafficked
  5. Evaluate the need to report a potentially trafficked person
  6. Understand the procedures for reporting a potentially trafficked person
  7. Use trauma-informed care and apply effective communication skills with a potentially trafficked patient
Kandice Swarthout, RDH, LPC ADA CERP/AGD PACE Credits: 3 Fee: $59.00

Oral Hygiene Recommendations in the Age of Dr. Google: An Evidence-Based Approach for Dental Professionals

Oral Hygiene Recommendations in the Age of Dr. Google: An Evidence-Based Approach for Dental Professionals From charcoal toothpaste to oil pulling to “Flossgate,” recent controversies regarding ideal oral hygiene in the lay media have left many of our patients with questions about the best way to take care of their teeth at home. While dental associations, the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and the United States Surgeon General agree on the importance of proper self-delivered oral hygiene, there continues to be confusion in the lay media and the public with regard to the role of patient-administered oral hygiene for the prevention of oral diseases. Current recommendations include brushing for two minutes twice daily and cleaning between teeth to maintain a healthy mouth and smile. Furthermore, customization of oral hygiene recommendations for patients based upon their risk profiles allows for optimal outcomes for disease prevention. It is well established that there are over 700 identified species of bacteria and up to 1,500 putative pathologic microorganisms found in dental plaque biofilms. Many of these organisms as well as other factors, including bacterial nutrients, food debris, molecules that facilitate bacterial adhesion and invasion and other extrinsic factors in the environment, and the body’s own immune response, contribute to diseases of the teeth and gingival tissues. This course will review current recommendations for oral home care, discuss strategies to deliver person-centered oral hygiene instructions for patients based upon risks for oral diseases, and review the current evidence regarding oral hygiene practices and/or products.

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

  1. Understand the risks and benefits of controversial oral hygiene practices and/or products
  2. List the optimal strategies and rationale for oral hygiene, including toothbrushing, interdental cleaning, and use of dentifrices and mouth rinses
  3. Develop home-care recommendations that focus on evidence-based strategies for oral health and emphasize individualized patient care recommendations based upon patient needs
  4. Discuss the importance of preventive strategies for oral diseases, including maintaining good oral hygiene in order to promote oral and overall well-being with a wide range of patients and interdisciplinary colleagues
Maria L. Geisinger, DDS, MS ADA CERP/AGD PACE Credits: 3 Fee: $59.00

Cognitive Bias Within the Dental Community

Cognitive Bias Within the Dental CommunityCognitive bias is a pattern of thinking in humans that, although flawed, is repeated mindlessly, sometimes resulting in irrational behavior and decisions. Dental personnel need to understand how cognitive biases impact both their patients and their team members. Left unchecked, these automatic associations can cause grave mistakes and injuries, and result in real harm. This course is designed to help dental team members recognize their own biases and see the need to introspect and self-regulate to change them.

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

  1. Identify cognitive biases
  2. Link some of the common biases to behavior in the dental environment
  3. Understand heuristics
  4. Describe questions to challenge assumptions
  5. Apply tactics to reduce unconscious biases
Dorothy Garlough, RDH, MPA ADA CERP/AGD PACE Credits: 3 Fee: $59.00

Direct Composite Veneers: A Simplified Approach (Second Edition)

Direct Composite Veneers: A Simplified Approach (Second Edition)Direct composite veneers serve as one method for restoring anterior teeth. However, many dentists shy away from this procedure due to a lack of innate artistic talent, lack of experience, past failures, and the length of time needed to complete the procedure. As a result, they opt for laboratory-fabricated alternatives, resulting in deep preparation designs. This course will demonstrate the steps required to fabricate direct composite veneers in a highly simplified manner using veneer templates and microhybrid composite resin.

Educational Objectives
The focus of this clinical study will provide the dental professional with the steps needed to fabricate direct composite veneers in a highly simplified manner. 

  1. Describe the properties of esthetic composite resin
  2. Describe technique differences between direct and indirect veneers
  3. Refer to the history of direct composite veneers
  4. Restore anterior teeth in a rapid manner using the materials outlined with the steps discussed
Ian Shuman, DDS ADA CERP/AGD PACE Credits: 3 Fee: $59.00

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
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