The student will be able to:
A. Integrate the technique of digital intraoral imaging into dental hygiene practice.
B. Assess patient oral conditions and determine appropriate instruments for effective advanced dental hygiene instrumentation.
C. Demonstrate appropriate advanced ultrasonic techniques for dental hygiene treatment based on individualized patient needs.
D. Evaluate patient periodontal status and administer locally delivered antimicrobials when appropriate.
E. Analyze gingival health and integrate soft tissue curettage into dental hygiene treatment as needed.
F. Discuss procedures and post-operative instructions with patients.
G. Adhere to standard infection and hazard control protocols during all procedures.
H. Apply the principles of law and ethics to the practice of dental hygiene.

A. Intraoral imaging (Lec and Lab)
1. Armamentarium
a. Digital camera
b. Intraoral camera
c. Computer and printer
d. Mouth retractors, mirrors, contrastors
2. Digital intraoral imaging technique
a. Use of cameras
b. 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
a. Case presentation
b. Legal purposes
c. Treatment planning
d. Case documentation
e. Patient education
f. Diagnosis
B. Advanced instrumentation (Lec and Lab)
1. Instruments
a. 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) 3CH pigtail explorer
8) UNC periodontal probe
b. Design and functions
c. Advantages and disadvantages
d. Rationale for use
1) Deep, narrow pockets
2) Line angles
3) Root concavities
4) Furcations
2. Advanced dental hygiene techniques
a. Basic dental root morphology
b. Types of instrumentation techniques
1) Horizontal strokes in root concavities
2) Accessing furcations
3) Horizontal strokes at line angles
4) Advanced strokes for contact areas
c. Rationale for use
3. Soft tissue trauma
a. Types
b. Causes
c. Techniques to prevent trauma
1) Adaptation of working end
C. Advanced ultrasonic techniques (Lec and Lab)
1. Types of ultrasonic inserts
a. Right and left curved
b. Powerline
c. Implant soft-tip
2. Indications and contraindications for use
3. Advanced ultrasonic techniques and procedures for variations in root anatomy
a. Furcations
b. Root concavities
c. Dental implants
D. Soft tissue curettage (Lec and Lab)
1. Rationale for use
a. Removal of diseased tissue
b. Promote formation of new epithelial tissue
2. Indications and contraindications
a. Periodontal pocket depth
b. Architecture of the periodontium
c. Medical status of the patient
3. Armamentarium
a. Sharp universal curet
b. Cotton tip
c. Gauze
4. Technique
a. Adaptation of the cutting edge
b. Use of cotton applicator for control
5. Post-operative healing process
a. Epithelial wound healing
b. Connective tissue formation
E. Locally delivered antimicrobials (Lec and Lab)
1. Types of antimicrobials
a. Chlorhexadine embedded chip
b. Minocycline
c. Doxycyline
2. Rationale for use
a. Apply antibiotic to area of high bacterial load
b. Reduce inflammation
c. Promote gingival healing
3. Indications and contraindications
a. Medical status of patient
1) Drug allergies
4. Armamentarium
a. Pre-loaded capsule of antibiotic
b. Syringe
5. Technique for placement
6. Post-operative healing process
a. Clinical parameters for healing
1) Tissue color and texture
2) Bleeding
3) Pocket reduction
F. Post-operative instructions (Lec)
1. Locally delivered antimicrobials
2. Soft tissue curettage
G. Infection and hazard control protocols (Lec and Lab)
1. Follow program guidelines for infection control when handling instruments and setting up units
2. Prevention of cross-contamination
H. Principles of law and ethics (Lec and Lab)
1. Legal duties and supervision levels of California dental hygienists
a. Locally delivered antimicrobials
b. Soft tissue curettage
2. Accurate patient records
3. Patient's right to privacy
4. Professional interactions with faculty and peers
5. Cultural competency

Practice techniques for clinical procedures: dental hygiene instruments, ultrasonic instrumentation, digital intraoral photography, placement of antimicrobials 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. 2020.

A. Read 20 page chapter on advanced instruments in textbook.
B. Practice advanced clinical techniques on typodont including the use of the ultrasonic in furcation areas.
C. Complete intraoral photographic assignment including a self-evaluation of photographs using the grading rubric.