The student will be able to:

1. Integrate the technique of digital intraoral imaging into dental hygiene practice.
2. Assess patient oral conditions and determine appropriate instruments, advanced fulcrums, and patient-operator positioning for effective advanced dental hygiene instrumentation.
3. Analyze gingival health and integrate soft tissue curettage into dental hygiene treatment and post-operative instructions as needed.
4. Adhere to standard infection and hazard control protocols during all procedures.
5. Apply the principles of law and ethics to the practice of dental hygiene.

1. Digital intraoral imaging (Lec, Lab)
   1. ​​​​Armamentarium
      1. Digital camera
      2. Intraoral camera
      3. Computer and printer
      4. Mouth retractors, mirrors, contrastors
   2. Digital intraoral imaging technique
      1. Use of cameras
      2. Views of teeth and structures
         1. Anterior view - normal bite
         2. Anterior view - edge to edge
         3. Maxillary occlusal
         4. Mandibular occlusal
         5. Right lateral
         6. Left lateral
         7. Lower anterior lingual
   3. Rationale for taking intraoral photographs
      1. Case presentation
      2. Legal purposes
      3. Treatment planning
      4. Case documentation
      5. Patient education
      6. Diagnosis
   4. Advanced patient-operator positioning techniques (Lec, Lab)
      1. Alternative fulcrums
      2. Extraoral fulcrums
      3. Intraoral opposite arch fulcrums
      4. Intraoral cross arch fulcrums
      5. Finger on finger fulcrums
      6. Assisted fulcrums
      7. Alternative patient/operator positioning
      8. Around the clock positioning
      9. Standing while scaling techniques
      10. Ergonomics
2. Advanced instrumentation (Lec, Lab)
   1. Dental root morphology
   2. Clinical vs. therapeutic endpoints for treatment
   3. Root debridement techniques
      1. Vertical, horizontal, and oblique strokes
      2. Exploring, scaling, and root debridement strokes
   4. Instruments
      1. Type of instruments
         1. After Five Gracey curets
         2. After Five Mini Gracey curets
         3. Nevi anterior sickle scaler
         4. Nevi posterior sickle scaler
         5. Langer curet
         6. Younger Good curet
         7. After Five 11/12 explorer
         8. UNC periodontal probe
      2. Design and functions
      3. Advantages and disadvantages
      4. Rationale for use
         1. Deep, narrow pockets
         2. Line angles
         3. Root concavities
         4. Furcations
   5. Advanced dental hygiene techniques
      1. Horizontal strokes in root concavities
      2. Accessing furcations
      3. Horizontal strokes at line angles
      4. Advanced strokes for contact areas
   6. Soft tissue trauma
      1. Types
      2. Causes
      3. Techniques to prevent trauma
         1. Adaptation of working end
3. Soft tissue curettage (Lec, Lab)
   1. Histology
      1. Epithelial tissue
         1. Oral epithelium
         2. Sulcular epithelium
         3. Junctional epithelium
      2. Connective tissue
      3. Gingival curettage theory
   2. Rationale for use
      1. Removal of diseased tissue
      2. Promote formation of new epithelial tissue
   3. Indications and contraindications
      1. Periodontal pocket depth
      2. Architecture of the periodontium
      3. Health status of the patient
   4. Armamentarium
      1. Sharp universal curet
      2. Cotton tip applicator
      3. Gauze
      4. Mouth mirror
      5. Periodontal probe
   5. Technique
      1. Adaptation of the cutting edge
      2. Lateral pressure
      3. Removal of tissue tags
      4. Use of cotton applicator for control
      5. Control of post-operative bleeding
   6. Post-operative healing process
      1. Epithelial wound healing
      2. Connective tissue formation
      3. Post-operative instructions
      4. Local anesthesia
      5. Bleeding
      6. Tobacco use
      7. Rinsing
      8. Brushing
      9. Diet recommendations
      10. Use of straws
      11. Periodontal dressing
4. Infection and hazard control protocols (Lec, Lab)
   1. Follow program guidelines for infection control when handling instruments and setting up units
   2. Prevention of cross-contamination
5. Principles of law and ethics (Lec, Lab)
   1. Legal duties and supervision levels of California dental hygienists
      1. Locally delivered antimicrobials
      2. Soft tissue curettage
   2. Informed consent
   3. Accurate patient records
   4. Patient's right to privacy
   5. Professional interactions with faculty and peers
   6. Cultural competency

Practice techniques for clinical procedures: advanced dental hygiene instrumentation, digital intraoral photography, and soft tissue curettage.

Examinations:
1. Complete written examinations on subject areas to a level of 75%
2. Complete final written examination to a level of 75%
Clinical proficiencies:
1. As recorded on a process evaluation, complete clinical proficiencies on ultrasonic instrumentation to a level of 75%
2. As recorded on a process evaluation, complete instrumentation proficiencies on advanced dental hygiene instruments to a level of 75%
Project requirements:
1. As recorded on a digital photography evaluation, complete a digital series to a level of 75% and include a self-evaluation
Class participation:
1. Students must prepare for all classes as demonstrated by having all necessary supplies and equipment in lecture and lab and by participating in class discussions

Lecture
Laboratory

Bowen, D., and J. Pieren. Darby and Walsh Dental Hygiene Theory and Practice, 5th ed.. 2019.

Nield-Gehrig. Fundamentals of Periodontal Instrumentation, 8th ed.. 2019.

Nield-Gehrig, J., D. Shin, and D. Willman. Foundations of Periodontics for the Dental Hygienist, 5th ed.. 2018.

Hoang, L.. Clinical Dental Hygiene Theory Manual I. 2024.

1. Read 20 page chapter on advanced instruments in textbook
2. Practice advanced clinical techniques on typodont including the use of the After Five Gracey curets in root concavities
3. Complete digital intraoral photography assignment including a self-evaluation of photographs using the grading rubric