Child abuse and neglect continue to be a significant problem in the United States.  Pediatric abusive head trauma (PAHT) is the most common cause of child abuse resulting in fatality and long-term disability. Although this is a problem of substantial magnitude, many cases often go undiagnosed or misdiagnosed. Pediatric abusive head trauma (PAHT) is preventable; therefore, the need to focus on possible solutions is paramount.  Healthcare professionals are in strategic frontline positions to impact prevention and identification efforts and ultimately to reduce the prevalence of this problem.  Dental professionals in particular could be pivotal in recognizing this type of abuse.

This basic-level course provides dentists, dental hygienists, and dental assistants with the knowledge necessary to effectively assess and implement interventions in families and children with suspected or diagnosed PAHT (previously recognized by the name Shaken Baby Syndrome). The prevalence of PAHT is reviewed in this course along with the anatomical features of infants and young children that make them susceptible to significant head injuries. Other topics discussed include perpetrator characteristics and the most common reasons that PAHT occurs.  The most frequent injuries associated with PAHT and their possible long-term consequences are also discussed. The overall goal of the course is to reduce this type of child abuse by providing a basic working knowledge of PAHT to all dental professionals including dentists, dental hygienists and dental assistants. By recognizing predisposing factors and identifying those at risk for perpetrating PAHT, dental professionals can be instrumental in increasing the identification, awareness, and prevention of PAHT.

In spring 2009, an outbreak of what was thought to be swine flu occurred in Mexico and was soon confirmed in many other countries. Although this illness was first called swine flu, upon further analysis it was determined that the virus’s genetic makeup was a mixture of swine and avian influenza viruses—a new contagious strain of influenza A virus, known as the H1N1 virus. To more accurately denote its type, the U.S. Centers for Disease Control and Prevention (CDC) named it novel influenza A (H1N1) virus. Throughout this course, the pathogen is referred to as the H1N1 virus, and the illness it causes is referred to as the H1N1 flu.

Infection was first reported in humans in Mexico, and federal health officials determined that the virus was contagious and was being transmitted from person to person. In late March and early April 2009, human cases of H1N1 virus infection were identified in California as well as in Texas. Through the spring, the number of reported cases grew each day. The CDC declared a public health emergency in order to mobilize health teams and treatment therapies to needed areas and to initiate containment. The World Health Organization (WHO), which is responsible for maintaining the H1N1 flu case count worldwide, declared this outbreak a global pandemic and advised governments to be prepared for this first 21st-century flu pandemic. By June 2009, all 50 states in the United States, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands had reported novel H1N1 virus cases. There were two distinct patient waves during the 2009–2010 H1N1 pandemic before it officially ended in August 2010. Laboratory testing for H1N1 virus was inaccurate, and the high number of cases coupled with frequent false negatives led U.S. health officials to stop reporting individual cases. Though the mortality rate for H1N1 virus infection was low (<1%), more than 18,000 individuals worldwide died from H1N1 flu during the pandemic, and it is believed that the actual number is significantly higher than that estimate because of a general lack of reporting and inaccurate laboratory testing.

Despite the fact that the H1N1 virus pandemic has ended, H1N1 influenza has become endemic within the United States and around the world. Healthcare professionals and others who may come in contact with infected persons must have basic knowledge and practice competencies that enable them to understand the transmission, symptoms, diagnosis, identification, treatment modalities, and prevention of H1N1 flu in order to help contain an outbreak. This course gives readers essential information regarding the evolution of H1N1 flu so that they can identify potential H1N1 flu cases. This course also describes the virus and its transmission; reviews symptoms that may be exhibited by infected persons; discusses how to screen and protect patients; reviews the methods of case confirmation and outlines how H1N1 flu can be differentiated from other influenzas; reviews treatment, prevention, and control; and describes how readers can protect themselves.

This course consists of classifications of Parkinson's Disease clinical features of the disease treatment of Parkinson's and oral health concerns of Parkinson's Disease inclucing xerostomia dysphagia and drooling muscle control and dentures and maintenance of oral hygiene. The course also includes management of dental patients with Parkinson's Disease common dental complaints of patients afflicted with the disease and dental and oral side effects and interactions of drugs most commonly used for treating Parkinson's Disease.

This course explains routine polishing in the dental office polishing before fluoride treatment polishing and sealants traditional rubber cup/brush polishing research findings on the air polisher patient criteria for air polishing air polishing technique and air polishing unit cleanup.

This course examines nonpharmacological therapies utilized to reduce patient anxiety and stress in the dental office. Various methods are listed including audio and visual programming hypnosis biofeedback acupuncture and brain wave synchronizers. The course also includes information on using "people skills" to reduce dental anxiety using a team approach.

This course lists the most common clinical signs and symptoms of pulpitis relevant to the anatomic position of the dental pulp. The "self-strangulation theory" of pulpal necrosis is described. Reversible and irreversible painful pulpitis is compared and contrasted. The course describes pathophysology and histopathology of pulpal inflammation the interstitial fluid pressure and the unlrastructure of pulpal inflammation. A description of the thermal electric and percussion methods of pulp testing are included.

This course discusses the purpose of provisional restorations diagnostic uses of provisional restorations and direct and indirect provisional coverage. It describes the various provisional restorative materials including aluminum shell crowns polycarbonate crowns nickel-chrome crowns and new resin materials. It includes information on simple resin temporary restorations for single-tooth coverage resin temporary restorations for multiple units and cementation of provisional restorations. A guide to the functions of provisional restorations is also included.

This course was written specifically to help dental clinicians deal with victims of disasters. The course discusses and reviews the causes of PTSD symptoms and management of dental manifestations. It briefly reviews PTSD in forensic dental personnel.

This course identifies the causes of crown and bridge failure and factors that affect manipulation of dental cements. Types of permanent cements are discussed with references to traditional and adhesive cements. 

This course describes periodontal ligament injection techniques for administering local anesthetics to provide pulpal anesthesia when conventional infiltration and regional block methods are unsatisfactory or inadequate. The indications and contraindications for periodontal ligament injections are discussed in addition to factors influencing efficacy of the injection site preparation for the injection and potential postoperative side effects.

Periodontal disease is the major cause of tooth loss in adults affecting three out of four people over the age of 35. This course discusses prevention strategies for periodontal disease including the importance of correct tooth brushing, mouth cleansing, flossing, and regular dental visits. Current and emerging interventional treatments including mechanical nonsurgical therapy, as well as surgical options for periodontal disease, are described. Medications used to treat periodontal disease are identified, including use of antibiotic medications, subantimicrobial dose doxycycline, and tetracycline-based drugs. The course includes the separate antimicrobial and anticollagenolytic properties of tetracyclines. Other pharmacologic treatments are listed, including non-steroidal anti-inflammatory drugs, bisphosphonates, vaccines, gene therapy, and growth factors.

This course reviews normal oral structures. It describes soft tissue problems of the oral cavity in adults i.e. inflammatory and infectious process degenerative processes and abnormal growths. This course does not include photographs of the various oral soft and hard tissue lesions due to the difficulty and expense of reproducing them.

This course includes a listing of chemotherapeutic agents used to treat cancer patients alterations in oral mucosa due to chemotherapy oral infections in immunocompromised patients including white red and pigmented lesions and oral infections in immunocompromised patients by origin including bacterial fungal and viral infections. This course also consists of dental management of chemotherapy patients including pre-chemotherapy through post-chemotherapy.

This course includes a brief history of the use of nitrous oxide and its current place in pain and anxiety management in dental practice. Special considerations for N2O use for pediatric patients are discussed with reference to guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures. Nitrous oxide titration technique for safe administration of the gas and recognizing the signs and symptoms of progressive stages of N2O sedation are explained. The course describes potential emergencies and their management resulting from the administration of nitrous oxide. Potential biohazards for clinical personnel chronically exposed to N2O are identified.

This course explains mercury toxicity effects and symptoms of mercury poisoning. The uses of mercury in dentistry are listed with recommendations for mercury levels and measures for controlling contamination.

This course lists herb-drug interactions including hepatoxicity, increased bleeding, induction of mania, serotonin syndrome, excessive sedation and coma, lowered seizure threshold, absorption of iron and additive, and opposing pharmacologic effects. Food-drug interactions, a survey of common herbal medicines, and the dentist's role in managing herb-drug interactions are also discussed.

This course covers mechanisms of fluoride professionally applied fluorides; including sodium fluoride, acidulated phosphate fluoride, stannous fluoride and varnishes; treatment of acute fluoride toxicity; including first-aid measures and medical management; cautions regarding home-care fluoride products; home care fluorides; and fluoride and the future.

Exostoses are localized bony protuberances that arise from the cortical plate. These developmental anomalies frequently affect the skeletal jaw. Intraoral exostoses are the focus of this course. The clinical and radiographic features of exostoses are described. The course identifies the pathophysiology as well as the treatment and prognosis of exostoses. Relevant diagnostic coding and coding for treatment are included.

This course describes the basic principles of Endodontics irrigating solutions instrumentation obturation (filling and sealing materials) and new endodontic fillers and sealers including calcium phosphate cement obturation and adhesive resins. It offers helpful information on controlling coronal microleakage using microscopes which look inside the root canal and the use of antibiotic therapy.

This course explores failures of post and cores, design principles of post and core systems, traditional custom cast post and core, prefabricated post and core systems, nonmetallic prefabricated posts, post cements, choices in build up materials, and fixed restoration of core build up.

This course focuses on systemic factors and their role in periodontal disease. It examines how smoking can affect treatment outcomes. Poor patient compliance with oral hygiene is reviewed along with patient age. It also discusses systemic disease including diabetes HIV infection and emotional and physical stress genetics and gene relation to periodontal disease and assessment of periodontal risk factors.

The American Dental Association (ADA) and the American Academy of Pediatric Dentistry (AAPD) recognize that when applied properly sealants can play an important role in the prevention of tooth decay. This course identifies the clinical indications and contraindications for sealant suitability effectiveness and retention. It reviews and compares three generations of dental sealants. The selection of teeth and tooth surfaces to be sealed and the retention of sealants in primary teeth are identified. The steps required for proper sealant application and the reasons for sealant failure are described as well as recommendations for preventing and correcting such failures. The implications and advantages of fluoride use in conjunction with dental sealants are also discussed.

This course includes traditional and digital dental radiography. Radiographic procedures in the diagnosis of proximal caries and periodontal disease are discussed. The basics of infection control in dental radiographic procedures in the darkroom/daylight loading area are described including recommendations for placement of protective barriers and handling of radiographic film. The course presents ADA recommendations for radiographic films and equipment. Radiation safety for the operator and the patient and waste management requirements for disposing of used radiographic film chemicals are discussed.

This course identifies the risks associated with dental radiographs. It describes practical measures that may be employed to protect clinical personnel and patients. It relates the benefits advantages and techniques of radiovisiography to reduce occupational exposure cost film chemistry usage and chairside time.

This course describes the associations between pregnancy and periodontal disease and the American Academy of Periodontology's summary statement regarding this association. The available clinical evidence relevant to periodontal disease and its adverse effects on pregnancy is reviewed and evaluated. The course reviews the research findings on the positive results of treatment on pregnant patients who have been diagnosed with periodontal disease and stresses a proactive approach to the periodontal care of women who are pregnant who may be pregnant or who may become pregnant. The most direct method for improving periodontal disease in pregnant women is identified.

Dental professionals use a number of medications in the treatment of patients. The most frequently used fall into the following classes: antibiotics local anesthetics analgesics and anxiolytics. All dental professionals should be familiar with the pharmacology of medications commonly used in dentistry. This course reviews the most frequently prescribed medications. The mechanism of action of individual drugs side effects and adverse reactions are identified. Drug interactions of concern to dentistry and precautions in drug usage are outlined. The course includes special dental considerations involving herb-drug interactions.

This course involves oral bacteria and related health risks periodontal disease and bacterial reduction diabetes HIV infection aging and systemic factors related to periodontal disease that include socio-psychological factors cardiovascular disease valvular heart disease pregnancy and stroke.

This course lists the risk factors for periodontal disease including abnormal oral environment age female hormones genetic factors smoking and nicotine and diseases associated with periodontal disease. Potential links between periodontal disease and system conditions are discussed including diabetes mellitus obesity pregnancy and low birth weight coronary heart disease rheumatoid arthritis and osteoporosis. The course describes the etiology and pathophysiology of periodontal disease focusing on microbiology viral causes autoimmune and inflammatory response resident and infiltrating cells of the periodontium and matrix metalloproteinases. The role of the host response in periodontal disease is also discussed.

Dental caries and oral diseases may interfere with a child's ability to eat sleep and learn and it can have a significant impact on their self-esteem. This course identifies those children and adolescents at highest risk and targets effective treatment therapies. It reviews the etiology of dental caries the role of carbohydrates in caries production and the role of fluoride as a decay-preventive measure. The course discusses periodontal disease in children and clinical manifestations of early childhood caries and offers appropriate treatment options. It identifies ways the dental team can educate and advise young patients and their parents about preventing tooth decay.

This course emphasizes the importance of infection control in dentistry. By understanding certain principles of disease transmission and using infection control practices dental personnel can prevent disease transmission. The CDC recommendations for barrier precautions in the dental healthcare setting are outlined and the application of OSHA regulations to infection control is identified. The course explains universal precautions as well as describes personal protective equipment. Environmental infection control procedures are identified including general cleaning recommendations cleaning clinical contact surfaces and cleaning housekeeping surfaces.

Oral or facial piercings are now commonplace and therefore dentists and oral and maxillofacial surgeons should be in a position to advise patients. It is important that the dental profession become aware of the recent interest in this type of body piercing of the impact this trend may have on dentition and speech and of the health risks that are associated with piercing. This course identifies the sites and types of perioral and intraoral piercing and complications associated with each type. Complications during piercing immediately following piercing and possible long-term complications are identified. The management of complications from perioral and intraoral piercing is explained.

This course addresses oral manifestations of anorexia and bulimia. It includes the incidence and scope personality traits and physical manifestations oral signs and symptoms preventive oral strategies for treating these patients and restorative treatment options. Additional resources are offered. 

This course addresses nutritional deficiencies oral signs and symptoms and preventive oral strategies for patients with anorexia nervosa bulimia iron-deficiency anemia pernicious anemia scurvy. Inflammatory bowel diseases including Crohn's disease ulcerative colitis and pyostomatitis vegetans as well as Polyposis syndromes including Gardner's syndrome and Peutz-Jeghers syndrome and their manifestations in the oral cavity are described.

This course presents information on the occupational hazards and preventative measures associated with working in the dental office. It covers mercury radiation caustic agents nitrous oxide oxygen and ethylene oxide airborne particles and contaminants latex allergies white visible light and dental lasers and bonding materials and acrylics. Also discussed are steps to help prevent carpal tunnel syndrome and hazardous noise levels and the health risks associated with these occupational hazards.

This course distinguishes between the definitions of fear anxiety and phobia. It identifies the most common reactions that accompany phobias and common reasons for avoidance of dental treatment. The course describes the behavioral treatment options for anxious dental patients and techniques for reducing general anxiety in dental patients and types of psychological and pharmacological treatment techniques useful to manage dental phobics. A proven effective technique for injection of local anesthetic when treating fearful or phobic dental patients is also discussed.

This course provides information on examination of the patient with halitosis, halitosis of dental and oral origin, oral malodor due to systemic disease, and other causes. Also included are diagnostic guidelines and management of malodor along with frequently asked questions.

This course describes the various adverse events toxicities and allergies that can be caused by the administration of local anesthetics. The various local anesthetics currently in clinical dental use are identified and their onset of action and duration of action are defined. The problem of syncope following local dental anesthetic administration and methods to provide appropriate supportive therapy are included. The course explains true allergic responses to local anesthetics and how to recognize life-threatening anaphylactic reactions. The various needle insertion difficulties relevant to the administration of local anesthetic agents in dental practice are discussed.

This course describes the pharmacology absorption and onset and duration of action of local anesthetics. Adverse reactions associated with local anesthetics are identified. Topical anesthetics are identified and described. The course explains the use of local anesthetics in special patient populations. New developments and advances in local anesthetics including alternative delivery methods are listed.

Latex hypersensitivity or allergy is the result of an immune system response to natural rubber latex. This sensitivity comes before a reaction (latex dermatitis) that causes pain, unsightliness, and even anaphylactic shock. This course focuses primarily on Type 1 allergy to latex, which has the greatest potential to be life threatening. The signs and symptoms of reactions to latex and methods of diagnosis for latex sensitivity are discussed. An explanation of the steps to take to prevent latex allergy sensitization is included. The course lists management options for persons with latex sensitivity and includes a latex-free list and guidelines for dentistry.

This course illustrates the role of saliva in demineralization and remineralization. Fluoride, calcium, inorganic phosphates, foods, and confections are discussed. Also discussed is the use of CPP-ACP in sugar-free gums and as a food additive. 

This course identifies inhalant abuse categories of inhalants, classes, and examples of inhalants, a description of nitrous oxide abuse and the dangers of it getting into the hands of abusers, why people abuse inhalants, techniques of abuse, oral manifestations of inhalant abuse, physical manifestations of inhalant abuse, psychological manifestations, sometimes fatal consequences, developmental harm to fetuses, legal regulations of nitrous oxide, and implications for dentists.

This course describes and compares types, characteristics, and properties of impression materials and the procedures for fashioning a custom tray. It provides necessary steps and protocols for making good impressions.

This course describes the nature of hypnosis and its application for pain. The history of hypnotism is outlined. Areas where hypnotism is particularly relevant to dental practice are identified in addition to the limitations of dental hypnotism. The course explains the training involved for dental hypnotism and explores the integration of hypnotism into one's dental practice.

Fluoridation of public drinking water and fluoride-bearing topical dental treatments have become familiar widely accepted practices aimed at preventing dental caries. This course addresses various types of topical fluoride fluoride dentifrices dental fluorosis fluoridation of water dental research risk to dental caries and age-related treatment with fluoride. The different modalities for delivering fluoride and mechanisms of action of fluoride are identified. The course summarizes the suspected and real toxicity of fluoride. The place of fluoride in the overall context of public health is also discussed.

This course cites the incidence and prevalence of elder abuse and neglect reported in this country. It describes definitions and specific types of elder abuse and neglect. Theories pertaining to the cause of elder abuse and associated risk factors are described. Types of injuries to the face and neck most commonly seen in elder abuse and neglect of patients are explained. The course lists intervention and prevention strategies and specific requirements to report suspected abuse and penalties for not reporting suspected cases. Specific questions and the nature of the examination the dentist should conduct if he or she suspects an elderly patient of having been abused ore included.

Diabetes mellitus a chronic disease of metabolism poses a significant public health challenge in the United States. This course discusses the pathophysiologic link between diabetes and periodontal disease. It describes and differentiates between the classic signs and symptoms associated with these two types lists the most common oral manifestations and discusses xerostomia and other oral infections. The course includes the principles of treatment and dental care of the diabetic patient special considerations for surgical procedures emergency management and the use of antibiotics and glucocorticosteroids.

This course cites the CDC guidelines for infection control in dental radiography. Potential sources of cross-contamination are explained. Infection control practices before during and after film exposure are identified in addition to the handling of film with and without barrier use. The course also describes infection control issues with digital imaging.

This course explains and defines the most common postoperative oral surgical complications including pain trismus infection ecchymosis hemorrhage nausea dislocation and fibrinolytic alveolitis.

This course describes the relationship between condensable composites and their earlier counterparts. The characteristics of the first-generation condensable composites and the additives that make second-generation condensable composites unique are listed. The course identifies the physical properties and clinical advantages of nanofilled resins. The comparative advantages and disadvantages of flowable composites and light-cured resin-modified glass ionomer as cavity liners are also discussed.

This course presents an overview of substance abuse and addiction in the United States from the 1940s to the present. The epidemiology of substance abuse, the progressive nature of addition, and their cost to society are discussed. The signs and symptoms commonly seen in those who are abusing or addicted to drugs and/or alcohol are also identified. Both past and present treatment modalities are described.

There have been many advances in dental cutting, notably the development of the air turbine in the 1950s and the ultra-high speed handpiece in the 1970s. The differences between diamond and carborundum trimming wheels and between conventional and disposable burs are outlined. Various grits in terms of cutting efficiency are discussed. The influence of load and the effects of irrigants and coolant supplies on cutting rates are also covered. The course discusses which type of bur is preferred for removing various types of crowns.

Following the September 11, 2001 attacks on New York City and Washington, D.C., The Centers for Disease Control and Prevention (CDC) issued surveillance guidelines for healthcare providers to heighten their awareness to potential attacks via biological agents. This course provides an overview of the primary (Category A) pathogens that the CDC listed as potential biological terrorism agents and explains how and why they were selected. The Public Health impact that these agents may have if utilized as terrorism agents is discussed as well as the illness patterns and diagnostic clues that may indicate an unusual infectious disease outbreak. This course identifies the signs, symptoms, and diagnostic criteria for the six primary (Category A) agents.

Latex allergies are not a new problem. However, the first documented case of anaphylaxis from natural rubber latex in a dental healthcare worker was not reported until 1987. This course identifies the risk factors for developing a latex allergy. It describes the three types of allergic reactions and their recommended treatment. Strategies for avoidance or reduction of natural rubber latex in the dental office are also discussed.

This course is designed as a review of radiography for dental professionals. Different types of intra-oral film are described. Darkroom and processing techniques are explained along with common radiographic and processing errors. The course differentiates various types of extra-oral projections and emphasizes the importance of intensifying screens. Course participants will become familiar with paralleling technique and focal lengths.

According to the National Sleep Foundation, more than 40 million people in the U.S. suffer from chronic sleep disorders. As the U.S. population continues to age, the prevalence of sleep disorders will increase. This course explains why the shift in population demographics has created more sleep breathing disorders in our country. The link between excess weight and airway obstruction is discussed as well as the impact that alcohol and drugs can have on the ability to sleep and breathe normally. The booming sleep aid market is described.

Treatment philosophy concerning the extraction of third molars varies in different developed countries. It ranges from observation, in many European countries, to a prophylactic removal approach, in U.S. This course discusses the rationale behind the prophylactic removal of third molars and the signs and symptoms associated with impacted third molars. The progression of infection from pericoronitis to head and neck space infections is explained. The classifications of impacted third molars and the relationship of each to the difficulty of extraction are outlined.

Advances in the endodontic arena have elevated the quality of endodontic treatment and improved the long term prognosis for those teeth that have been treated. With so many new products being introduced, it is difficult to stay up-to-date on the most current technology. This course reviews the basics of endodontics such as the importance of proper access and the benefits of using pre-endodontic treatment build-ups. The rationale for the use of irrigation is discussed along with the use of apex locators. The importance of coronal sealing and the principles of obturation are explained.

This course distinguishes between the two forms of radiation and their associated hazards. The concept of ALARA and its application in dentistry is explained. Governmental regulations governing radiation, accepted methods of measuring radiation dose, and the effects of exposure to ionizing radiation are presented. The risk assessment of radiation is also discussed.

The use of amalgam, as a restorative material, has been documented for over 150 years. However, its use has declined in recent years due to the rapid evolution of alternative, tooth-colored restorative materials. This course reviews the metal and chemical compounds contained in dental amalgam and describes the clinical situations when amalgam should and should not be the restorative material of choice. The course also explains the origin of mercury in wastewater and improved mercury hygiene techniques.

Methicillin-resistant Staphylococcus aureus (MRSA) was identified in scientific literature in the early 1960s as the major cause of healthcare associated infections. It is a form of staphylococcal infections that involves bacteria that have developed a resistance, over time, to most common antibiotics used for soft tissue and skin infections. This course describes the difference between its hospital and community strains. The epidemiology, risk groups, and modes of transmission of MRSA are outlined along with the currently available treatment modalities. This course will help clinicians incorporate the CDC Guidelines into their clinical practice to reduce cross-transmission of potential pathogens. 

At some point in their career, dental professionals will experience discomfort with their hands. Repetitive practices, such as those done in the course of performing dental procedures, can put a lot of wear on your hands, leading to pain and swelling, numbness, or decreased range of motion and grip strength. Conservative therapies such as the application of heat or cold are discussed along with activities that can be implemented at work to reduce stress on the hands and wrists. Different types of assistive equipment and devices that can be used to stabilize and support the wrist are also explained.

Over the past few decades, the prevalence of edentulism has declined rapidly in the United States and most developed nations. The origin of this decline can be attributed to several factors including increased acceptance of basic oral care recommendations and the expanded use of dental implants and partial dentures. Yet despite these advances, the number of new denture wearers is projected to significantly increase in the coming years. This course describes this rising prevalence of denture wearers and several denture care modalities such as the use of denture adhesive and the various denture cleansing options available. The methods for proper denture storage are outlined along with the importance of reviewing the basics of denture care with patients with new dentures.

With the increased usage of crowns and fixed partial dentures, dental clinicians are sometimes faced with the dilemma of repairing these esthetic restorations. This course describes the indications and techniques for crown and bridge repair. Course participants will become familiar with how to adhere restorative material successfully to exposed metal for a fractured porcelain-metal restoration in the esthetic zone. Adhering to fractured porcelain is also discussed. Techniques for crown and bridge repair with direct composite resin are presented.

A patient’s periodontal status needs continuous monitoring to avoid uncontrolled disease or possible tooth loss. Controlling the disease can occur with patient education and application of evidence-based nonsurgical and surgical therapy. This course focuses on the nonsurgical phase of periodontal treatment outlining clinical techniques regarding diagnosis, hand scaling, ultrasonification, biofilm removal, supportive periodontal therapy, selective polishing and air polishing procedures for nonsurgical periodontal control.

While dental practitioners want patients to be comfortable, it is evident that better anesthetic techniques must be used to ensure that dental treatment is indeed pain free. This course reviews the most common anesthetic techniques beginning with mandibular nerve locks and proceeding to maxillary blocks. It familiarizes the reader with medical conditions that affect anesthetic choices, methods and techniques to ensure patient comfort during injections, the importance and rational behind needle aspirations, proper injection technique, common barriers to local anesthetic success, and alternatives to traditional local anesthetic for controlling pain. 

One of the relatively new buzz phrases in dentistry is minimally invasive dentistry. It is not about doing the least amount of dentistry, but the appropriate amount of dentistry for the risk level of each individual. This course describes the conceptual approach to minimally invasive dentistry and explains the role of biofilms and quorum sensing in dental disease. It identifies current international thinking with regards to caries risk assessment and the interplay of destructive and reparative factors in the oral cavity. The various treatment modalities are discussed along with the armamentarium used for minimally invasive dentistry. The specific treatment strategies applied to each risk level are also outlined.

The key to contemporary restorative dentistry is the fabrication of healthy, maintainable, aesthetic, and functional prostheses. The true success of any restoration is reliant on the creation of an “illusion of reality” regardless of the restorative modality used. This course focuses on reviewing the clinical protocols associated with the placement of osseointegrated implants in the esthetic zone. It also describes the importance of utilizing a multi-disciplinary treatment approach when restoring complex cases that require smile design considerations.

With increasing numbers of patients selecting dental implants as a treatment option, the dental team faces the challenge of maintaining these sometimes complex restorations. This course identifies the similarities and differences in the periodontal structure of a natural tooth versus an implant. The course discusses how dental implants should be treated during routine maintenance appointments and describes the clinical procedures for evaluating the status of dental implants and overall implant health. Methods for improved home care of implants are also outlined. 

Ionizing radiation in the form of x-rays has both diagnostic and therapeutic uses. X-rays provide valuable information and can reveal early signs of disease or decay. Taking x-rays is generally a painless procedure. However, misinformation about radiation has made the public fearful of x-rays. It is vital for the dental professional to know more facts about radiation in order to better inform the public about its usefulness and safety. This includes knowledge of other common sources of radiation beside medical and dental x-rays. New technology as well as adhering to basic safety protocols have made dental x-rays safer. This course reviews the basic physics, biology, and safety issues involved in radiation, the beneficial and detrimental effects of radiation, and the most common sources of radiation. If safety protocols are followed, both the patient and the dental professional should have little concern with any problems associated with dental radiology.

The oral and general health of individuals is determined by, and dependent upon, an adequate salivary flow. Salivary clearance is essential to reducing the cariogenic potential of foodstuffs as well as providing a mechanism for remineralization of dental enamel after minor assaults such as ingestion of acidic foods and beverages. This article examines dry mouth, referred to as xerostomia, which is a common symptom associated with a decrease in the amount and/or quality of saliva. The function of saliva and the factors affecting salivary flow are discussed along with the potential causes of dry mouth. Treatment protocols for dry mouth and its link to other dental and general health issues are explained. 

Despite a growing body of research, the function and necessity of sleep remain basically unknown. Although sleep seems to be an innocuous daily function, the loss of sleep can affect productivity, motor function, memory, and the maintenance of mental health. The rising prevalence of insufficient or non-restorative sleep in the general U.S. population may therefore be a cause for concern. This course discusses memory and skill acquisition, insomnia, sleep apnea, restless legs syndrome, and the impact of normal aging on sleep. The course presents recommendations for preserving the integrity of the vital function of sleep.

This course addresses the impact of the shortened dental arch on patient oral functionality and hygiene. The effect of dental arch length on chewing ability is discussed. The course presents the advantages and disadvantages of short dental arch therapy as a treatment option. Oral functionality, prosthetic considerations, patient comfort, and financial factors are identified.

Forensic dentistry can be defined as the application of dental expertise to the justice system. The most common role of the forensic dentist or forensic odontologist is the identification of deceased individuals. In the last decade there has been a growing utilization of dental odontology in mass disasters, bitemark perpetrator identifications, crime investigations, and confirmatory identification of newsworthy decedents. This course provides an overview of the scope of forensic dentistry, the forensic dental examination, and forensic odontology guidelines. The significance of bitemarks and the role of DNA are discussed. 

Since the introduction of adhesive bonding, the types and uses of dental resins have increased. Composite resins can be classified by filler size and percent filler loading, as well as by the viscosity of the composite. The development of flowable composites is based upon its flowable viscosity. This course describes the characteristics of flowable composites, explores the use of flowable composites as preventive resin restorations, and lists other appropriate uses for them.

Cancers of the oral cavity and oropharynx contribute to many deaths in the United States every year. Early detection of potentially premalignant oral mucosal abnormalities is essential to the battle against cancer. Epithelial dysplasia can present as innocuous red, white, or mixed patches on the mucosa in early stages, often mimicking minor soft tissue injury or inflammation. When early diagnosis is made and appropriate intervention and treatment is rendered, the overall survival and patient morbidity is improved. This course distinguishes between adjunctive tools for visual screening and screening tests for tissue sampling. The physical oral cancer exam is outlined and its importance is emphasized. Current risk factors for oral cancer are identified along with a description of the basic principles of surgical biopsy.

The majority of the caries in children and adolescents occur on the occlusal and buccal/lingual surfaces of teeth. This could be prevented with the application of sealants in the pit and fissures of teeth. This course describes the effectiveness of pit and fissure sealants, as shown in clinical studies, and discusses which teeth and specific surfaces should be sealed. The types of available pit and fissure sealants are presented along with the techniques for placing them. 

A relatively new material in endodontics, mineral trioxide aggregate (MTA) was developed in the mid-1990s with the specific objective of improving the prognosis of perforation repairs. This course discusses the biologic basis, clinical indications and techniques for the use of MTA. Case examples are used to illustrate the use of MTA.

Restorations can be divided into two distinct categories -direct and indirect placement restorations. Indirect restorations fabricated by a laboratory or by a dentist away from the patient require the use of dental cements. Today, the options for laboratory fabricated restorations are much more complex and therefore so are the cementation options. This course provides an overview of the classes of cements, the mixing of the cements and recommendations for their use.

The single most common chronic disease in children worldwide, including the United States, is dental caries. These high rates in children and adults may be attributed to the fact that dental caries is a chronic, infectious and transmissible disease of multi-factorial origin. There are a multitude of preventive regimens designed to control or reduce demineralization of the tooth structure associated with this infectious disease process. Fluoride holds a special place in this paradigm because of its documented effectiveness in controlling and reducing dental caries. This course discusses the pre-eruptive and post-eruptive mechanisms of fluoride action and identifies the US standards for water fluoridation. The processes of demineralization and remineralization are explained along with the concept of dental fluorosis.

Recurrent aphthous ulceration also known as aphthous ulceration, recurrent aphthous stomatitis, or canker sores, is a common oral ulceration. Widely considered to be a chronic inflammatory condition, these lesions may repeatedly arise over the course of a year in otherwise healthy individuals. The three forms commonly seen in dental practice are discussed along with the differential diagnosis. Therapies, including the use of steroids and other immunosuppressants, are outlined.

This course distinguishes the difference between legal and ethical concerns. It explains the structure of the American Dental Association Principles of Ethics Codes of Professional Conduct and Advisory Opinions. The course describes ethical duties involved with specific areas including prescription abuse by patients access to dental care advertising child abuse reporting confidentiality dating patients emergency care obligations informed consent managed care and obligation to treat patients. The difference between risk management and ethical practices are discussed and an explanation of the elements and principles of ethical decision making is included.

Antibiotic prophylaxis for the prevention of infective endocarditis related to dental therapy is a widespread therapeutic intervention. The judicious use of antibiotic prophylaxis for prevention of infective endocarditis in conjunction with optimal oral health care should serve to minimize the adverse effects of antibiotic therapy and at the same time reduce the significant morbidity and mortality association with these infections. This course describes the causes of cardiac conditions associated with infective endocarditis and the special populations at risk for complications of infective endocarditis. The new American Heart Association guidelines for antibiotic infective endocarditis prophylaxis and recommended medications for dental patients are listed. The course includes arguments to reassure patients who are no longer recommended for antibiotic prophylaxis. Antibiotic prophylaxis in dental patients with total joint replacements is also described.

This course addresses the pros and cons of placing mercury-containing restorations and the most commonly used alternative (composite resin). It is a refresher course that reviews current materials used for tooth restorations; gives an historical perspective; discusses the positions of authoritative bodies on the safety efficacy compatibility and serviceability of mercury-amalgam restorations; summarizes recent research comparing amalgam versus composite restorations; describes a number of safety issues that have arisen regarding the use of composite resins; and discusses clinical and cost comparisons of resin composites and amalgam restorations. 

Tooth sensitivity is a common clinical presentation that can cause considerable concern for patients of dentists, hygienists, and dental assistants. Its management requires a skilled understanding of the complexity of the problem and a current knowledge of available treatments. This course describes the differential diagnosis, etiology, treatment, pathogenesis, and management of tooth sensitivity with major emphasis on dentin hypersensitivity. The course includes both at-home patient treatments and in-office patient treatment modalities. 

To aid in diagnosis and guide the approach to dental treatment, dental healthcare professionals should recognize oral manifestations of cardiovascular diseases as well as other systemic/multiorgan diseases with a vascular component. This course addresses current concepts regarding the relationship between oral health and vascular and cardiovascular diseases, including the impact on oral health of common cardiovascular pharmacotherapies.

This course describes several behavioral techniques effective in guiding fearful dental patients into accepting dental treatment. These nonpharmacological techniques may be used with unduly anxious patients, individuals with specific or general fears of a dental environment and dental phobics. The course addresses the needs of fearful pediatric patients, persons with disabilities including medical or mental disorders and the frail and elderly and discusses appropriate behavioral guidance for these individuals. 

Many drugs or chemicals can affect the soft and hard oral structures with adverse manifestations, particularly oral mucosal ulceration and gingival swelling. This course describes medication-related damage to soft and hard dental structures and explains the etiology and treatment of disorders, lesions, and discoloration of the oral mucosa related to drugs. It identifies drug-related changes to salivary glands and oral contact allergic reactions that may develop due to exposure to particular medications.

This course addresses obstructive sleep apnea as one aspect of sleep disordered breathing problems. It covers the risk factors for this disorder and the related co-morbidities. The course provides information to dentists on their role in the management of OSA. Discussion on the treatment for these disorders covers the multiple effective treatments available. A dentist completing this course will appreciate their potential role as a member of a multidisciplinary medical team. 

This course discusses the complex anatomy of the temporomandibular joint followed by an analysis of the epidemiology of temporomandibular disorders including etiologic factors, both intra-articular and extra-articular. A guide to evidence based treatment modalities is included to aid the reader in learning how to diagnose, evaluate, and manage tempromandibular disorders in children and adults by incorporating imaging such as cone beam CT technology and MRI. Finally, a synopsis of emerging approaches to therapy ranging from tissue-engineered TMJ implants to biomimetic scaffolding is included.

Abuse of prescription drugs has been labeled a national epidemic. It crosses boundaries of gender, age, race, and socioeconomic status. For dental patients, pain is often an unavoidable sequela of invasive dental procedures and untreated or long-standing oral disease. Balancing the desire to alleviate pain against the suspicion that the patient may be a drug seeker is just one issue that confronts dental providers. This basic-level course provides dental providers with an appreciation of the scope of prescription drug abuse, and a realization that this problem likely exist among the patient populations they serve. By becoming familiar with the pharmacology of the most commonly abused drugs, the risk factors for developing addictive behaviors, and the manner in which these medications are commonly acquired, dental providers will be positioned to curb prescribing practices that contribute to this growing problem and better serve their patients and their communities as informed prevention advocates.

The prevalence of smoking in the United States has hovered at approximately 20% of the population for each of the last five years, but there has been an increase in the use of smokeless tobacco products. Healthcare professionals must redouble their efforts to intervene with all patients who continue to smoke. This basic-level course provides dental professionals with background and guidelines for tobacco interventions in clinical practice. The course addresses the prevalence of smoking of combustible tobacco and the use of smokeless tobacco products, the health risks of tobacco use and tobacco exposure, the effects of nicotine on human physiology and their implications for nicotine dependency and withdrawal. Techniques for tobacco intervention and the pharmacotherapy used in tobacco cessation are described for both the smoking of combustible tobacco and the use of smokeless tobacco.

A growing body of work has focused on the benefits of probiotics therapy for the oral cavity and there is mounting evidence that certain probiotic strains may be very beneficial to oral health. The basis of the therapeutic mode is that ingested probiotic bacterial species provide effector bacterial strains that replace pathogens and control bacterial disease. Probiotics for the oral cavity is an exciting area of dental care research and eventually may offer a novel and effective approach to treating or even preventing periodontal disease and denture stomatitis. 

Once considered only for transitional implants, mini dental implants have a success rate that rivals those of traditional implants when accepted placement protocols are followed in patients with adequate bone. This course identifies the indications for mini dental implant denture treatment, describes successful case selection/planning strategies, and discusses the mini dental implant placement protocol for stabilization of a lower denture. The course also explains what is unique and different with maxillary mini dental implant denture cases.

In the course of providing dental care, patients and dental health care personnel can be exposed to pathogens through contact with blood, oral and respiratory secretions, and contaminated equipment. Transmission of infectious organisms can be prevented by following established guidelines. This course provides an overview of standard precautions and routine practice for infection control in a dental practice. The concept of the "chain of infection" is explained along with the use of personal protective equipment such as gloves, masks, and eyewear. Proper instrument sterilization techniques are outlined. 

This course is a refresher for dental professionals on infection control cross-contamination and instrument sterilization techniques. Areas addressed include infection control guidelines; understanding standard versus universal precautions; sterilization and disinfection of patient care items; goals for ensuring disease containment through proper instrument recirculation techniques; handling of contaminated instruments from the treatment room through precleaning cleaning and preparation for sterilization; the most commonly used (and accepted) methods of dental instrument sterilization; environmental infection control; dental unit waterlines biofilm and water quality; and other infection control considerations.

During the delivery of dental care, both patients and dental healthcare workers can be exposed to a wide array of infectious diseases, including HIV/AIDS, hepatitis B, hepatitis C, influenza, and numerous other viral and bacterial infections. It is the dental professional’s responsibility to adhere to scientifically accepted principles and practices of infection control. This basic-level course reviews published guidelines and principles of infection control and outlines the methods that can be used to effectively break the chain of infection, including the use of work practice controls, barriers and/or personal protective equipment, and practices of effective cleaning, disinfecting, and sterilization. Relevant to all dentists, dental hygienists, and dental assistants, this course focuses on the core elements of infection control that are essential to prevent the spread of infectious disease in the dental office.

Dental professionals are exposed to potentially infectious materials in daily practice. This course is an overview of infection control procedures in the dental setting. The concept of standard precautions is reviewed along with the recommendations for personal protective equipment, appropriate hand hygiene, and the management of contaminated sharps. The requirements for safety equipment in both the clinical and laboratory setting are outlined. The management of occupational exposures is also discussed.

This course describes the difference between ethics and jurisprudence and discusses the ethical principles outlined by the ADA and the Indiana State Board of Dentistry. OSHA regulations for dental offices and the CDC recommendations for infection control in dentistry are discussed, including the most frequent OSHA violations committed within the dental setting. The latest changes in the Indiana Dental Practice Act are included in this updated state-required course.

This course presents the basics of incorporating the use of magnification into dental practice. The course describes the evolution of the use of magnification in the field of dentistry along with the magnification alternatives currently available, including surgical telescopic loupes and the dental operating microscope. The concept of the magnification continuum is explained and the challenges of incorporating magnification into the daily practice of dentistry are identified.

Disparities in oral health status and access to dental care are major and increasing problems for people with special healthcare needs. This course addresses current thinking about the challenges dental professionals face with providing oral healthcare services for people with special needs. It identifies the factors that hinder access to dental care and presents strategies to improve the provision of care for the special needs population. The course includes recommendations for the management and treatment of special needs patients.

Understanding exactly what is meant by domestic violence is sometimes complex. This course educates dental healthcare workers in Florida about the epidemic of domestic violence in that state. It includes the Florida Statutes dealing with domestic violence, adult protective services, emergency shelters, and counseling and outreach programs. The process for evaluating patients for suspected abuse and neglect is outlined including questioning, assessment of the signs and symptoms, and evidence collection (e.g., impressions, radiographs, and photographs). The populations at risk are discussed, using local and national statistics on domestic violence to emphasize the scope of this pernicious problem.

The number of adults age 65 and older in the U.S. is expected to swell to 72 million by 2030. The aging population will bring both opportunities and challenges to the practice of dentistry. Dentists need to be trained in meeting the oral health needs of older adults to help reduce their burden of chronic disease.

This basic-level course provides dental professionals with basic knowledge and information in gerontology and geriatric dentistry that will enhance their ability to diagnose and manage older patients, distinguish between normal aging-related changes in the tissues of the oral cavity and those resulting from pathological changes, implement appropriate strategies for dealing with patients with cognitive impairments who exhibit care resistance, and make clinical modifications in their dental practices to accommodate the biological changes in their patients that occur as a part of normal aging.

Course Objectives 

• Describe the demographic characteristics of older adults in the United States.
• Identify the normal biological changes associated with aging.
• Explain the normal oral changes associated with aging.
• Describe the incidence of xerostomia and dental caries in older adults.
• Identify the oral-systemic links in the older adult population.
• Describe oral health considerations for the institutionalized older adult.
• Describe access to care and utilization patterns of older adults.

Recurrent aphthous stomatitis ( also known as recurrent aphthous ulcerations, aphthous ulcerations, or canker sores) develops when the body has decreased levels of folic acid. Numerous medical conditions and medications that are taken over long periods can cause these ulcerations. Dental healthcare providers must have the necessary knowledge to identify such conditions or medication usage when a patient is experiencing these painful ulcerations. After reviewing the history, conditions, and signs and symptoms of RAS, this course outlines prescription and over-the-counter (OTC) medications that can cause these oral ulcerations to develop. The possible treatments of recurrent aphthous ulcers are also discussed.

Tooth preparation (removal of caries, cavity preparation, and margination) and the finishing and polishing of restorations require the use of abrasives and rotary cutting instruments (burs). Differences in the bur rotational speed/torque relationships of different types of handpieces affect clinical technique and selection of the cutting instrument. This course reviews the basics of bur and handpiece designs. It emphasizes the importance of cooling during cutting procedures and discusses the relationship between coolant flow rates and cutting speeds. The fact that chemo-mechanical effects can accelerate cutting rates is discussed.

Individuals of all age groups can be affected by family violence. Family violence includes child abuse and neglect, intimate partner violence, as well as abuse and neglect of disabled persons, vulnerable adults, and the elderly. Approximately 75% of physical abuse involves injuries to the head, neck, and mouth. Orofacial injuries resulting from family violence are often easy to identify in the dental setting. This basic-level course will enable all members of the dental team to recognize the physical and behavioral signs and symptoms of family violence, differentiate indicators of trauma from normal conditions or accidental injuries, and easily adapt clinical protocols to include identification and intervention for victims of family violence. By applying their knowledge of symptomology and providing appropriate intervention, every member of the dental team can help stem the epidemic of family violence. This course contains legislative information, statistics, and resources specific to the State of Maryland.

Individuals of all age groups can be affected by family violence. Family violence includes child abuse and neglect, intimate partner violence, as well as abuse and neglect of disabled persons, vulnerable adults, and the elderly. Approximately 75% of physical abuse involves injuries to the head, neck, and mouth. Orofacial injuries resulting from family violence are often easy to identify in the dental setting. This basic-level course will enable all members of the dental team to recognize the physical and behavioral signs and symptoms of family violence, differentiate indicators of trauma from normal conditions or accidental injuries, and easily adapt clinical protocols to include identification and intervention for victims of family violence. By applying their knowledge of symptomology and providing appropriate intervention, every member of the dental team can help stem the epidemic of family violence. This course contains legislative information, statistics, and resources specific to the State of Florida.

Individuals of all age groups can be affected by family violence. Family violence includes child abuse and neglect, intimate partner violence, as well as abuse and neglect of disabled persons, vulnerable adults, and the elderly. Approximately 75% of physical abuse involves injuries to the head, neck, and mouth. Orofacial injuries resulting from family violence are often easy to identify in the dental setting. This basic-level course will enable all members of the dental team to recognize the physical and behavioral signs and symptoms of family violence, differentiate indicators of trauma from normal conditions or accidental injuries, and easily adapt clinical protocols to include identification and intervention for victims of family violence. By applying their knowledge of symptomology and providing appropriate intervention, every member of the dental team can help stem the epidemic of family violence. This course contains legislative information, statistics, and resources specific to the State of Connecticut.

This course discusses the mechanisms by which teeth wear and differentiates between attrition, erosion, and abrasion. These mechanisms seldom operate singly, and the overlap of two or more of them, often at different times, adds to the complexity of diagnosis and the phenomenon of tooth wear. This course explains the pathogenic processes of erosion-related tooth wear, (including extrinsic and intrinsic causes), the value of early recognition, and the prevalence and typical signs of erosion. It describes what to include in the diagnostic protocol, gives important management options to prevent disease progression, and examines restorative treatment choices.

Musculoskeletal pain in dental healthcare providers is a real phenomenon. Often attributed to repetitive movements, the truth is that musculoskeletal pain may be attributed not only to microtrauma caused by repetitive movements and precision work in strenuous and static positions, but ergonomics and psychosocial aspects of the job as well. This course defines the concept of the ergonomic postural triad of loupes, head mounted lights, and ergonomic chair, and describes which of these components can help to reduce the pain experienced by dental healthcare providers, when they should be incorporated into clinical practice, and how they can affect the inflammation cascade.

Dental amalgam is one of the oldest dental materials used in the oral cavity. This course examines the difference in corrosion resistance between high and low copper amalgam. Also discussed are the effects of bonding agents on the corrosion resistance of dental amalgam and the importance of the marginal interface on corrosion resistance.

One of the most difficult space management problems occurs when a preschool child loses a primary molar before the eruption of the first permanent molar. This course explains the strategic importance of a second primary molar during the eruption of the first permanent first molar and discusses the effective treatment of premature loss of second primary molars. This course also describes three methods for treating ectopically erupting first permanent molars.