Gingival Recession Management Study Guide

Pediatric Oral Health and Dietary Assessment

A case study of a 10-year-old male involving family history, oral hygiene regime, intra-oral examination, and diet history.

• Family & Social History
• Oral Hygiene Regime
• Intra-oral Examination
• Occlusion
• Plaque score
• ICDAS
• Diet History
• Dietitian’s dietary assessment

Nutrition Guidelines and Dietary Assessment

Guidelines for free sugars intake, healthy diet protective factors, and dietary assessment strategies for improving oral and general health.

• free sugars intake recommendations
• diet quality score and dental caries risk
• minimally processed foods
• wholegrain foods
• nutrient reference values
• dietary assessment
• cultural factors in eating habits
• patient communication and empathy
• personalized dietary recommendations

Obesity Statistics and Weight Management

• Weight management in children and young people
• BMI for children
• Dietitian referral
• Special dietary needs
• SSB consumption

Nutrition Scenarios and Elderly Oral Health

Case-based learning explores nutrition scenarios involving paediatrics, periodontics, and the elderly, focusing on oral diseases, malnutrition, and sarcopenia.

• NZ dietary recommendations
• Malnutrition in elderly
• Oral diseases
• Sarcopenia
• Unintentional weight loss
• Xerostomia
• Edentulism
• Dental caries
• Periodontal disease
• Oral cancer
• Nutritional deficiencies

Malnutrition Risk and Nutritional Care

Identifying malnutrition risk using MST scores and implementing nutritional care strategies for elderly patients.

• MST score
• Malnutrition risk
• High Energy, High Protein Diet (HEHP)
• Dehydration
• Nutrition care for dry mouth
• Dietitian referral
• Unintentional weight loss

Child Abuse, Neglect, and Family Violence

Information regarding family violence, child protection, and management strategies for dental neglect including support services and referral processes.

• Family violence
• Protection Orders
• Police Safety Orders
• Child protection
• Dental neglect management
• Preventive strategies
• Multi-agency approaches
• Referral processes

ORAH705 Cultural Safety Introduction

An introduction to cultural safety involving Karakia Timatanga, Maori Language Week, and historical figures related to Te Tiriti o Waitangi.

• Karakia Timatanga
• Whakataka te Hau
• Maori Language Week
• Te Tiriti o Waitangi
• Maramataka

Cultural Safety in Oral Health Practice

• Whakawhanaungatanga
• Cultural Safety
• Power Dynamics
• Critical Self-Reflection
• Systemic Inequities
• Oral Health Professional Positionality
• Whānau
• Clinical Competency

Data Equity and Oral Health Inequities

This content explores how data equity, addressing invisibilisation and silencing, can support system level change and address oral health inequities for Māori, Pacific peoples, and other underserved populations.

• invisibilisation and silencing
• social integration
• equity focused key messages
• data equity
• system level change
• oral health inequities
• underservice
• data collection and accessibility
• data analysis and reporting
• evidence-based decision making
• targeted interventions
• resource allocation
• indigenous knowledge
• community engagement

Principles of Cultural Safety

Cultural safety is defined by the recipient of care through continuous learning, reflection, and addressing historical and systemic inequities.

• Cultural Safety
• Power Dynamics
• Critical Self-Reflection
• Whanaungatanga
• Hauora
• Addressing Historical and Systemic Inequities
• Deconstructing Power Imbalances
• Partnership and Collaboration

Interconnected Mental Health and Oral Health

Addressing the connection between mental health and oral health for individuals with complex needs.

• Mental health definition
• Anxiety and depression
• Suicide risk
• Trauma and PTSD
• Substance use
• Access disparities
• Oral health neglect
• Stress and cortisol
• Inflammation
• Sleep disruption
• Neuroinflammation

Barriers to Care and Consumer Rights

Recognising barriers like shame, judgement, racism, cost, and transport to adapt care around the Code of Health and Disability Services Consumers’ Rights (1996).

• Barriers to care
• Shame judgement
• Cost
• Transport
• Code of Health and Disability Services Consumers’ Rights (1996)
• Respect
• Freedom from discrimination
• Appropriate standard of care
• Effective communication

Trauma-Informed Approaches and Self-Care

Principles for a trauma-informed approach include predictability, choice, control, and pace, alongside self-care strategies to recognise the vicarious impact of work.

• Trauma-Informed Approach
• Predictability
• Choice
• Control
• Pace
• Self-care
• Vicarious impact
• Realistic boundaries

Gingival Recession Classifications and Symptoms

Gingival recession is a common clinical finding that presents a significant diagnostic challenge: when is it merely a stable anatomical variation, and when does it require surgical intervention? The decision-making process is not solely based on the depth of the recession, but rather on a holistic assessment of the patient's biological phenotype, their symptomatic experience, and their personal expectations. Understanding the interplay between a patient's risk factors and their quality of life i

• Recession Type (RT1, RT2, RT3)
• Patient discomfort and sensitivity
• Bleeding and swollen gums
• Aesthetic expectations
• Oral hygiene regime
• Smoking
• Periodontal Phenotypes (Thin vs. Thick)
• Anatomical Factors (Frenal attachments)
• Dento-alveolar Housing (Bone dehiscence)
• Restorative Factors (Biological width violation)

Multifactorial Etiologies of TMD

Temporomandibular disorders involve multifactorial causes including trauma, stress, anxiety, occlusion, bruxism, and airway issues.

• Macrotrauma
• Microtrauma
• Bruxing and clenching
• Malocclusion
• Disc displacements
• Arthralgia and arthritis
• Myofascial pain
• Forward head posture
• Obstructive sleep apnoea
• Psychosocial factors
• Autonomic nervous system upregulation
• Sympathetic and parasympathetic systems
• TMD screening

Chronic TMD Management and Treatment Approaches

A team approach for chronic TMD management includes dentists, psychologists, and physical therapists using self-management techniques, non-invasive therapies, and surgical procedures.

• TMD diagnosis
• Self-management techniques
• Physical Self-Regulation techniques (PSR)
• Non-invasive therapies
• Oral appliance therapy
• Pharmacologic therapy
• Arthrocentesis
• Arthroscopy-lysis & lavage
• Surgical procedures
• TMD screening

Understanding Obstructive Sleep Apnoea

Obstructive Sleep Apnoea is a sleep-related breathing disorder characterized by repeated interruptions in breathing due to muscle relaxation and collapse at the back of the throat.

• Obstructive Sleep Apnoea
• Apnea
• Hypopnea
• O2 desaturations
• Sleep arousals
• Polysomnogram
• Apnea-Hypopnea Index
• OSA severity
• Excessive daytime sleepiness
• Nocturnal symptoms
• Diurnal symptoms
• Cardiovascular dysregulation
• Neuro-cognitive dysfunction

Pathophysiology of Obstructive Sleep Apnoea

This content discusses the pathophysiology of OSA including impaired upper airway anatomy, anatomical reasons, obesity, lifestyle factors, and dentofacial characteristics in children.

• Impaired upper airway anatomy
• Obesity and fat accumulation
• Neck circumference
• Anatomical reasons for airway collapse
• Lifestyle factors including smoking and alcohol
• Sleep position
• Adenoid face
• Adenotonsillar hypertrophy
• SDB-associated neurocognitive morbidity

Obstructive Sleep Apnoea Prevalence and Risk Factors

This content discusses the prevalence of obstructive sleep apnoea across global, USA, and New Zealand populations, including risk factors such as gender, age, and obesity.

• Obstructive sleep apnoea prevalence
• Gender differences in OSA risk
• Hormonal influences on airway morphology
• Age-related airway collapsibility
• Anatomical changes in the airway

Obstructive Sleep Apnoea Management and Dental Implications

This content discusses the management of obstructive sleep apnoea through positive airway pressure therapy, oral appliance therapy, and upper airway surgery, while examining associated dental stressors and side effects.

• Obstructive sleep apnoea
• Positive airway pressure therapy
• Mandibular advancement splint
• Oral appliance therapy
• Upper airway surgery
• Dental associated conditions
• Sleep bruxism
• Temporomandibular disorders
• Gastro-oesophageal reflux disease
• Tooth wear
• Adenotonsillectomy
• Compliance rates
• Occlusal changes
• Side effects of oral appliance therapy

Obstructive Sleep Apnoea Screening and Treatment

This content covers obstructive sleep apnea symptoms, screening questionnaires like Epworth Sleepiness Scale and STOP-BANG, health risks, and treatment options including PAP therapy and oral appliance therapy.

• Obstructive sleep apnea symptoms
• Epworth Sleepiness Scale
• STOP-BANG Questionnaire
• Health risks of untreated OSA
• Oral appliance therapy
• PAP therapy
• Adult versus paediatric OSA
• OSA screening risk factors

Managing Dental Patients on Polypharmacy

Managing the dental patient on polypharmacy involves understanding the importance of accurate medication history and the dental professionals' role in deprescribing.

• Hyper-polypharmacy
• Extreme hyper-polypharmacy
• Problematic polypharmacy
• Appropriate polypharmacy
• Medication misadventure
• Adverse drug reactions
• Drug interactions
• Medication errors
• Prescribing cascades
• High risk medicines
• Deprescribing
• Medication history

Polypharmacy and Dental Implications

This content discusses the dental implications of various medications including corticosteroids, cytotoxic antineoplastic agents, immunosuppressants, and bisphosphonates.

• Corticosteroid side effects
• Adrenocortical suppression
• Impaired wound healing
• Osteonecrosis of the jaw (ONJ)
• Bisphosphonates and denosumab management
• Anti-angiogenic drugs
• Immunosuppressant and biologic drug risks
• Adverse drug reactions in the oral cavity
• Perioperative management of medications
• Deprescribing in dental practice

• Polypharmacy and Dental Implications: A Guide for Clinical Practice

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Chemical Plaque Control and Mouthrinses

An analysis of chemical plaque control agents including chlorhexidine, essential oils, and cetylpyridinium chloride for managing periodontal disease and gingival inflammation.

• Desensitising toothpastes
• Arginine and calcium carbonate
• Potassium nitrate
• Chlorhexidine (CHX)
• Essential Oils (EO)
• Cetylpyridinium Chloride (CPC)
• Antimicrobial action
• Substantivity
• Plaque reduction
• Gingival inflammation
• Interproximal bleeding
• Adverse effects
• Mouthrinses and alcohol

Salivary Dysfunction and Sjogren’s Syndrome

Discuss function and roles of saliva, salivary gland dysfunction, hyposalivation, xerostomia, and Sjogren’s syndrome including clinical manifestations and oral complications.

• Saliva function and roles
• Hyposalivation
• Sialometry
• Xerostomia
• Primary Sjogren’s syndrome
• Keratoconjunctivitis sicca
• Connective tissue disease
• Oral Candidiasis
• Dental caries risk
• Periodontal disease
• Dysphagia
• Glossodynia
• Salivary flow rates

Managing Dental Patients on Polypharmacy

Managing the dental patient on polypharmacy involves understanding the importance of accurate medication history and the dental professionals' role in deprescribing.

• Hyper-polypharmacy
• Extreme hyper-polypharmacy
• Problematic polypharmacy
• Appropriate polypharmacy
• Medication misadventure
• Adverse drug reactions
• Drug interactions
• Medication errors
• Prescribing cascades
• High risk medicines
• Deprescribing
• Medication history

Polypharmacy and Dental Implications

This content discusses the dental implications of various medications including corticosteroids, cytotoxic antineoplastic agents, immunosuppressants, and bisphosphonates.

• Corticosteroid side effects
• Adrenocortical suppression
• Impaired wound healing
• Osteonecrosis of the jaw (ONJ)
• Bisphosphonates and denosumab management
• Anti-angiogenic drugs
• Immunosuppressant and biologic drug risks
• Adverse drug reactions in the oral cavity
• Perioperative management of medications
• Deprescribing in dental practice

Tooth Whitening Process and Ingredients

• Oxidation
• Hydrogen Peroxide
• Enamel and dentin discoloration
• Oxygen ions
• Double bond (C=C) destruction
• Hydrogen peroxide systems advantages and disadvantages
• Carbamide peroxide systems advantages and disadvantages

Tooth Whitening Overview and Procedures

An overview of tooth whitening methods including take home whitening and in-office whitening using hydrogen peroxide and carbamide peroxide gels.

• Take home whitening
• Hydrogen peroxide
• Sensitivity management
• Potassium nitrate
• Existing restorations
• Pre-operative shade recording
• Gingival barrier
• Pola Rapid application

Tooth Whitening and Bleaching Principles

An overview of extrinsic and intrinsic tooth discolouration, peroxide-mediated chemical bleaching, and various whitening delivery methods.

• Extrinsic discolouration
• Intrinsic discolouration
• Peroxide-mediated chemical bleaching
• Hydrogen peroxide
• Vital tooth whitening
• Non-vital tooth whitening
• Internal whitening
• Over the counter whitening
• Causative factors of staining
• Teeth sensitivity
• Dentine and enamel optical properties

Management and Classification of Dental Trauma

Understand the role in responding to dental trauma, differentiate between different types of dental trauma, and understand emergency procedures.

• Maxillofacial trauma
• Dental injury classification
• Emergency procedures
• Avulsion of permanent tooth
• Injuries in primary dentition
• Fracture and luxations
• Pulpal and periodontal origin
• Pulp necrosis
• Resorption
• Periodontal complications

Dental Trauma Features and Management

Clinical features, management protocols, possible treatment options, and unfavorable outcomes for various types of dental trauma.

• Enamel Infraction
• Enamel Fracture
• Enamel-Dentine Fracture
• Enamel-Dentine Fracture with Pulp Exposure
• Root Fracture Variation
• Alveolar Fracture
• Concussion
• Subluxation
• Extrusive Luxation
• Lateral Luxation
• Intrusive Luxation
• Avulsion
• Pulp Necrosis
• Apical Periodontitis
• Splinting
• Pulp Capping
• Partial Pulpotomy

Management of Dental Avulsion Trauma

Procedures for avulsion management of permanent and primary teeth including replantation techniques and potential unfavorable outcomes.

• Avulsion management
• Permanent tooth replantation
• Primary tooth management
• Transporting medium
• Pulp necrosis
• Apical periodontitis
• External inflammatory resorption
• Ankylosis

Periodontal Phenotypes and Gingival Recession Management

Assessment of periodontal phenotypes, prognostic factors for success, and treatment selection for gingival recession and root coverage procedures.

• Periodontal phenotypes
• Gingival recession
• Root coverage procedures
• Connective tissue graft
• Free gingival graft
• Coronally advanced flap
• Keratinised gingiva
• Gingival thickness
• Frenal attachments
• Vestibule depth
• Phenotype modification therapy
• Prognostic factors

• Periodontal Phenotypes and Gingival Recession Management

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Monitoring Gingival Recession and Patient Factors

Assess when to treat versus monitor based on patient discomfort, bleeding, swelling, aesthetic concerns, sensitivity, oral hygiene, smoking, and aesthetic expectation.

• Treat vs. monitor criteria
• Patient discomfort and sensitivity
• Bleeding and swollen gums
• Aesthetic expectations
• Oral hygiene standard and regime
• Smoking

• Gingival Recession: Monitoring vs. Treatment Decisions

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Peri-implantitis and Implant Tissue Comparison

A comparison of anatomical, functional, and histological differences between implants and teeth regarding epithelial attachment, connective tissue, vascular supply, and disease initiation.

• Epithelial attachment
• Connective tissue orientation
• Vascular supply
• Periodontal ligament absence
• Peri-implantitis histology
• Biofilm formation
• Microbiota diversity
• Peri-implant mucositis

Peri-implantitis Treatment and Maintenance Approaches

Commonalities in treatment approaches for peri-implantitis include non-surgical debridement, surgical access, and maintenance care.

• Non-surgical debridement
• Surgical access
• Implant surface decontamination
• Systemic antibiotics
• Mechanical debridement
• Maintenance care
• Resective surgery
• Reconstructive approaches
• Oral hygiene instruction
• Biofilm removal

Peri-implantitis Treatment and Implant Maintenance

Evaluating surgical approaches and predictability for peri-implantitis treatment including access/open flap debridement, pocket elimination surgery, implantoplasty, regenerative/reconstructive surgery, and explantation.

• Access/open flap debridement
• Pocket elimination surgery
• Implantoplasty
• Regenerative/reconstructive surgery
• Explantation
• Peri-implant bone loss
• Supportive implant therapy
• Implant survival
• Defect anatomy

Peri-implantitis and Implant Maintenance Protocols

Clinical guidelines for implant maintenance, monitoring biofilm control, soft tissues, prosthesis, and radiographic bone levels to manage peri-implantitis risk.

• Biofilm control
• Peri-implantitis
• Implant maintenance visits
• Prosthesis cleansability
• Soft-tissue anatomy
• Probing depth and BOP
• Radiographic crestal bone monitoring
• Professional debridement
• Titanium curettes
• Air polishing
• Risk assessment for recall intervals
• Peri-implant charting

Compact Self Dispensing Whitening Kits

Compact self dispensing whitening kits allow customers to apply whitening directly to teeth for a whitening touch up.

• self dispensing whitening kits
• whitening touch up

Chemical Plaque Control and Antimicrobial Therapy

Chemical plaque control and antimicrobial therapy serve as adjuncts to mechanical plaque removal for the primary prevention of periodontal disease.

• Chemical plaque control
• Antimicrobial therapy
• Periodontal disease
• Gingivitis
• Periodontitis
• Supragingival biofilm control
• Subgingival colonisation
• Mechanical plaque control
• Antiplaque agents
• Substantivity
• Bacterial resistance
• Mouthrinses
• Toothpastes
• Irrigators
• Sustained-release systems

Antibiotics in Periodontal Disease Management

Systemic and local antibiotic adjuncts aim to suppress pathogenic bacterial species and strengthen the immune response in periodontal disease.

• Systemic antibiotics
• Local antibiotic delivery
• Amoxicillin plus metronidazole
• Azithromycin
• Host modulatory properties
• Mechanical therapy
• Periodontal tissue healing
• Gingival crevicular fluid

Managing Persisting Periodontal Pockets

Management of persisting periodontal pockets through non-surgical debridement, periodontal surgery, and addressing local factors to prevent periodontal disease progression and tooth loss.

• Non-surgical debridement
• Residual pockets
• Bleeding on probing
• Local factors
• Residual calculus
• Intrabony defects
• Perio-endo lesions
• Occlusal trauma
• Furcations
• Suprabony defects
• Intrabony defects
• Periodontal surgical techniques
• Open flap debridement
• Regeneration
• Resective surgery
• Modified Widman flap
• Gingivectomy
• Osteoplasty
• Ostectomy

Periodontitis Aetiology, Classification, and Treatment Modalities

Evidence based modalities for the management of the periodontally susceptible individual including classification, diagnosis, and treatment of periodontitis.

• Periodontal disease aetiology
• Classification and diagnosis of periodontitis
• Clinical attachment loss
• Radiographic bone loss
• Plaque biofilm
• Host inflammatory response
• Genetic predisposition
• Staging and grading of periodontitis
• Supragingival and subgingival instrumentation
• Systemic antibiotic adjuncts
• Host modulation
• Supportive periodontal therapy
• Disease prognosis

Prognosis, Attachment, and Clinical Parameters

Evidence based modalities for the management of the periodontally susceptible individual involving assessment of mobility, attachment, recession, plaque, bleeding, pus, and pocket depth.

• Mobility
• Attachment
• Recession
• Plaque
• Bleeding
• Pus
• Pocket Depth
• Prognosis

Assessment of Recession, Plaque, and Furcation

Evidence based modalities for managing recession, plaque, bleeding, pus, pocket depth, attachment, furcation, and mobility.

• Recession
• Plaque
• Bleeding
• Pus
• Pocket Depth
• Attachment
• Mobility

Management of Periodontally Susceptible Individuals

Evidence based modalities for the management of the periodontally susceptible individual including assessment of attachment, pocket depth, and furcation.

• Attachment
• Bleeding, Pus & Pocket Depth
• Furcation
• Prognosis