If you can't read please download the document
Upload
buihanh
View
221
Download
2
Embed Size (px)
Citation preview
G ood by e R ou tin e R ecal l Hel lo Health y Cl ien t an d Pr actice
A System of Successful Treatment of Soft Tissues Beth Ryerse, RDH
Oral Disease and Oral Care Solutions
Three major diseases we are concerned with as RDHs
Periodontal Disease Oral Cancer Caries
Oral Dis-ease ManagementEase being very comfortable and able to live as you want, without any worries or problems.
Dis-ease being uncomfortable and not able to live as you want, with worries or problems.
Oral Health context ability to chew, talk, smile, kiss and be comfortable with your presenting self.
Oral Dis-ease a state where those simple tasks are troublesome, humiliating and possibly, painful.
P.I. Eke, B.A. Dye, L. Wei, G.O. Thornton-Evans, and R.J. Genco. Prevalence of Periodontitis in Adults in the United States: 2009 and 2010. J DENT RES 0022034512457373, first published on August 30, 2012 as doi:10.1177/0022034512457373
September 4, 2012One out of every two American adults aged 30 and over has periodontal disease, according to recent findings from the Centers for Disease Control and Prevention (CDC). A study titled Prevalence of Periodontitis in Adults in the United States: 2009 and 2010 estimates that 47.2 percent, or 64.7 million American adults, have mild, moderate or severe periodontitis, the more advanced form of periodontal disease.
http://jdr.sagepub.com/content/early/2012/08/29/0022034512457373.abstract
Periodontal Disease is a Bacterial Infectionand the bodys reaction to that infection
Other factors that may increase risk:
Family history
Medications
Age
Gender
Family transmission
Smoking
Prior gum disease
Clenching/grinding
Stress
Osteoporosis
Diabetes
Hormones
Periodontal Disease may increase your risk for a variety of health concerns including:
Diabetes Cardiovascular disease Stroke Lung Infections Preterm, low birth-weight
infants Respiratory diseases
Examination & Charting
History Oral Exam Data Gathering Co-Discovery Co-Diagnosis Case Presentation Fees and Insurance
Perio Exam
Call the numbers out loud once client understands the significance of them
Give the client a hand mirror hold in right hand see what I am seeing
Ask client to raise left hand if any areas are tender
Client is now very involved in the exam
and learning!
Case Type I Gingivitis
Case Type II Chronic Periodontitis
Generalized, Slight
Case Type III Chronic Periodontitis
Generalized, Moderate
Root Caries and Overall Health
root caries was an independent predictor of incident myocardial infarction.may be a marker for an overall decline in health.
Mauriello SM et al. 2006. Root caries prevalence and incident myocardial infarction. Abstract 1471, v. 85,
Special Issue A, AADR Annual Meeting, Orlando, FL
Oral CancerTwo etiological factors:1. Alcohol and tobacco
2. Human Papilloma virus
Approximately 75% of Canadians will have a HPV infection in their lifetime.
A 225% increase in HPV-positive oropharyngeal cancers is reported by major cancer registries.
If this trend continues, this type of cancer will surpass cervical by year 2020.
- JADA 142(8):2011;915-924
Case Presentation
Pain / Time / $
Elements of a Complete Case Presentation
Information data collected and assessment findings are shared
Education explanation of the significance of assessment short and long range possibilities and consequences - ASK ?s to determine level of understanding and client priorities and interest in pursuing care
Options alternative methods of care - benefits, time involved, treatment risks, risks of non-treatment and cost for each option
Choice informed decision based on understanding of info, priorities, desire for treatment and perceived needs
Agreement client and professional concur on a course to follow dental hygienist as advocate, supports the informed decision made by the client
Scaling
Instrumentation of the crown and root surfaces of the teeth to remove bacterial plaque biofilm, calculus, and extrinsic stains from surfaces without the intentional removal of tooth surface.
D & W 2003
Root PlaningDefinitive treatment procedure designed to remove cementum or surface dentin that is rough, impregnated with calculus, or contaminated with toxins or microorganisms; no longer recommended as a routine procedure for all root surfaces of periodontally involved teeth
Dr. Irene Woodall
Ultrasonic instrumentation is now the first choice over hand instrumentation for most patients. This constitutes a major shift in dental hygiene approach to treatment This text has placed hand instrumentation secondary to ultrasonic instrumentation
(Woodall I., et al Comprehensive Dental Hygiene Care, 4th ed.)
Disease ManagementHow Important is Homecare?
What role does disease management at home play in a successful therapy program?
What are the tools our patients need to be successful?
What role do we play in the success of a patient's disease management at home?
17
A Novel Strategy to Reduce Biofilm
The ADA Risk Management Series states:
In viewing periodontal treatment, the role of the patient should not be overlooked. The patient must be an active participant in the treatment through compliancein fact, the role of the patient is paramount to the success of therapy.
19
Multi-Modal Options
MechanicalProfessional -- Scaling / Root Planing
Patient -- Brushing & interproximal cleaning
ChemicalProfessional -- Antimicrobial (local &
systemic)
Patient -- Dentifrice, Rinses
20
Qualities of an Ideal Chemotherapeutic Agent
Effective against specific microbes Inhibit the overgrowth of other organisms
Not cause bacterial resistance
Nontoxic to oral tissues Acceptable to the patient (taste, ease of
use, cost)
Bioactive (available and active in the oral cavity) long after the application has ceased.
Behavior Modification
An approach to correction of undesirable conduct that focuses on changing observable actions; modification of behaviour is accomplished through systematic manipulation of the environmental and behavioral variables related to the specific behaviour to be changed.
Dispensing Easy way to help clients get the self-care
products that can provide them with the greatest benefit
Part of an all encompassing treatment plan and ensures measurable clinical results
To recommend is human; to dispense is divine
Julie Csoki RDH, BS & Liz Lundry RDH
RDH Feb 2009
Supportive Periodontal Therapy
Long-term, frequent maintenance therapy (scaling and antimicrobial therapy) used after active therapy has been successful in eliminating periodontitis
- continues for the life of the dentition or its implant replacements
- Clients must understand that they have a chronic disease that cannot be cured , only controlled by frequent periodontal care and daily self-care.
Keys To Your Success?
Better client communication. Increased client compliance. Making a more powerful contribution to the practice.
HealthyPracticeNow.ca
Online continuing education:
dentalcare.ca