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Case Study 2

- 79-year old African-American female
- Insulin injections
- Co-existing diseases
- Multiple medications
- Physical limitations
- Overdue for dental treatment

Updated: 09/08/2020

Dental And Oral Health - Case Study 2

Case Study 3

- 65-year old African-American female
- History of periodontal disease
- Missing teeth
- Furcation involvement
- Multiple medications
- GI concerns
- Arthritis in wrists, hands

Updated: 09/08/2020

Dental And Oral Health - Case Study 3

Case Study 8

- 29-year old African-American female
- Never had a prophylaxis
- Family history with medical risks
- Gingival/Periodontal conditions
- Smoker

Updated: 09/08/2020

Dental And Oral Health - Case Study 8

Case Study 12

- 71-year old White Caucasian female
- Cancer survivor
- Smoker
- History of stomach problems
- Overdue for dental exam
- Extensive restorative dentistry

Updated: 09/08/2020

Dental And Oral Health - Case Study 12

Case Study 13

- 41-year old White Caucasian female
- Former smoker
- History of hepatitis
- Family history of diabetes
- Sensitivity to cold
- Overdue for dental care

Updated: 09/08/2020

Dental And Oral Health - Case Study 13

Case Study 15

- 65-year old White Caucasian male
- History of stroke and slurred speech
- Uses a phenol rinse
- Overdue for dental care

Dental And Oral Health - Case Study 15

Case Study 16

- 75-year old White Caucasian male
- Palatal irritation
- History of cardiovascular disease
- Uses a CPC rinse
- Extensive restorative dentistry

Updated: 09/08/2020

Dental And Oral Health - Case Study 16

Case Study 17

- 60-year old White Caucasian male
- Multiple medications
- Frequent aphthous ulcers
- Former smoker
- Under the care of a physician

Updated: 09/08/2020

Dental And Oral Health - Case Study 17

Case Study 18

- 68-year old White Caucasian male
- History of cancer
- Multiple medications
- Smoker
- Interested in whitening his teeth

Updated: 09/28/2020

Dental And Oral Health - Case Study 18

Case Study 19

- 67-year old White Caucasian male
- History of periodontal disease
- Former smoker
- Allergic to penicillin
- Furcation involvement

Updated: 09/28/2020

Dental And Oral Health - Case Study 19

Case Study 20

- 50-year old White Caucasian male
- Smoker
- Xerostomia
- Overdue for dental care
- Concerned about stains

Updated: 09/28/2020

Dental And Oral Health - Case Study 20

Case Study 22

- 75-year old White Caucasian female
- Multiple surgeries
- Smoker
- Large nevus
- Burning sensation from phenol mouthrinse

Updated: 09/28/2020

Dental And Oral Health - Case Study 22

Case Study 23

- 35-year old White Caucasian male
- Gingivitis
- Varix on lower lip
- Overdue for dental care
- TMJ concerns

Updated: 09/28/2020

Dental And Oral Health - Case Study 23

Case Study 24

- 62-year old White Caucasian female
- Tender nodes during extraoral examination
- Crowded lower anteriors
- Furcation involvement
- Multiple restorations

Updated: 09/28/2020

Dental And Oral Health - Case Study 24

Case Study 29

- 23-year old White Caucasian male
- Overdue for dental care
- Family history of hypertension, alcoholism, substance abuse
- Frequent consumption of high energy drinks
- Significant dietary concerns/poor plaque control
- Multiple erosive/carious lesions

Updated: 09/28/2020

Dental And Oral Health - Case Study 29

Case Study 30

- 28-year old White Caucasian male
- Last dental visit 6 years ago
- History of sudden weight loss, substance abuse, frequent migraines
- Apprehensive about dental work
- Smoker

Updated: 09/08/2020

Dental And Oral Health - Case Study 30

Case Study 31

- 38-year old White Caucasian male
- Family history of systemic diseases
- Overdue for dental care
- Chronic periodontitis
- Heavy bleeding/numerous sensitive areas
- GERD related symptoms

Updated: 09/08/2020

Dental And Oral Health - Case Study 31

Case Study 35

- 65-year old White Caucasian female
- Type 2 diabetes
- Co-existing systemic diseases
- Dental anxiety
- Hepatitis B

Updated: 09/28/2020

Dental And Oral Health - Case Study 35

Case Study 36

- 70-year old White Caucasian male (retired)
- Type 2 diabetes
- GERD
- Hip replacement (2 years ago)
- Full mouth reconstruction

Updated: 09/28/2020

Dental And Oral Health - Case Study 36

Case Study 37

- 59-year old White Caucasian female
- Hypothyroidism
- Family history of CVD
- Hepatitis A
- Allergies

Updated: 09/28/2020

Dental And Oral Health - Case Study 37

Case Study 38

- 32-year old Latino Hispanic female
- Overdue for dental care
- Frequent oral lesions
- Elevated (GBI)
- Anxiety regarding dental work

Updated: 10/20/2020

Dental And Oral Health - Case Study 38

Case Study 40

- 67-year old White Caucasian male
- Type 2 diabetes
- Hypertension
- Parkinson’s disease
- Mouth breather

Updated: 10/20/2020

Dental And Oral Health - Case Study 40

Case Study 42

- 24-year old African-American male, 5’10” and weighs 190 lbs.
- Has gingival discomfort, bleeding when brushing and isolated recession.
- Caries free dentition and no restorations.
- Both parents have complete dentures and lost teeth from severe “gum disease.”
- Sister has been diagnosed with “some type of gum disease.”
- Brushes once or twice daily with a manual brush and fluoride toothpaste.

Posted: 10/20/2020

Dental And Oral Health - Case Study 42

Case Study 43

- 45-year old Caucasian male, 5’ 8” and weighs 210 lbs.
- Both parents are alive and have Type II diabetes with multiple systemic issues.
- Complains of swollen, painful and bleeding gingival tissues in maxillary posterior areas.
- Takes multiple medications.
- Last HbA1c was 9.3
- Patient brushes once daily with whatever toothbrush and toothpaste he can buy on sale.

Posted: 10/20/2020

Dental And Oral Health - Case Study 43

Case Study 44

- Patient is a 7½-year old African-American female, 5’ 3” and weighs 67 lbs.
- Complains of several back teeth hurting when she chews and are loose.
- Caries free with no restorations.
- Previous dentist told mother that patient had some bone loss, but it involved only “baby” teeth.
- Localized profuse bleed on probing.
- Mother has a previous diagnosis of severe periodontal disease.

Posted: 10/20/2020

Dental And Oral Health - Case Study 44

Case Study 45

- Patient is a Caucasian male, 5’ 10” and 155 lbs.
- Under orthodontic treatment from age 11.5 years through age 15 yrs.
- No caries and has only three Class I amalgam restorations in teeth #3 and #19.
- Patient has an aortic valve heart murmur.
- High gingival bleeding index of 66%.
- Patient brushes three times daily with a power toothbrush and a fluoride toothpaste.

Posted: 10/20/2020

Dental And Oral Health - Case Study 45

Case Study 46

- Patient is a 45-year old male, 5’ 9” and 150 lbs., originally from India.
- Complaint of gingival discomfort, burning sensation and worried about oral cancer.
- No caries and no restorations.
- Takes hydrochlorothiazide and naproxen sodium (OTC).
- Could not do periodontal probing because of gingival pain.
- Gingival biopsy was taken and submitted for histologic diagnosis.

Posted: 10/20/2020

Dental And Oral Health - Case Study 46

Case Study 47

Patient #1
- 80-year old Caucasian male.
- Chief complaint of foul breath.
- Has had implant supported lower denture for 15 years.
- 40 pack-year of cigarette smoking and snuff user for 20 years.
- Takes multiple prescribed medications.
- May have xerostomia.

Patient #2
- 62-year old Caucasian female.
- Recently retired from very stressful job.
- Complaint of difficulty cleaning around implants and “gums bleed.”
- Inflamed and edematous gingiva around implants with bone loss.
- Full mouth bleeding index is high.
- Full mouth plaque index is high.

Posted: 10/20/2020

Dental And Oral Health - Case Study 47

Case Study 48

Three patients, all Caucasian males, with similar profiles and ranging in age from 13-15 yrs.
- All have skeletal orthodontic malocclusion problems.
- Chief complaints for all patients were: “puffy gums;” 2) foul breath odor; and 3) “sore and bleeding gums when brushing.”
- All patients were caries free and had no restorations.
- All patients use a power toothbrush and sometimes it “hurts” to brush.
- Bleed index for the three patients ranges from 47% up to 80%.

Posted: 10/20/2020

Case Study 49

Patient #1
- 32-year old Caucasian female, 5’ 6” and weighs 128 lbs.
- Complains that “gums are sore and bleed.”
- Complains that “gums are receding.” 
- Fixed partial denture (fixed bridge) was placed about 2 years ago.
- Patient states that she has always had trouble cleaning around the bridge.
- Takes Zyrtec (OTC) for allergies and may have xerostomia.

Patient #2
- 70-year old Caucasian male, 5’ 11” and weighs 212 lbs.
- Family history of cardiovascular disease and hypertension.
- Complaint of “gums bleed and itch.”
- Last dental visit was approximately 4 years ago.
- Smokes cigars – 5 or 6 a week.
- Moderate calculus deposits associated with all crown margins.

Posted: 10/20/2020

Dental And Oral Health - Case Study 49

Case Study 50

- 5-year-old Asian male.    
- Parents worried about the dark discoloration of the teeth.
- Mother mentioned that “the teeth seem to be dissolving.”
- Prior dental visits were mostly emergency care for fractured enamel.
- Generalized and dental caries with severe involvement of the facial surfaces.
- When a baby, patient was frequently put to bed with a bottle of warm milk.

Posted: 10/20/2020

Dental And Oral Health - Case Study 50

Case Study 51

- 5 year-old Hispanic female, 43” (108 cm) tall and weighs 40 lbs. (18 kg).
- Mother worried about “enamel chipping” and yellow color of teeth.    
- Patient has never been to the dentist.
- Patient hospitalized for bilateral pneumonia and treated with IV antibiotic and respiratory therapy.
- High carbohydrate diet and access to unlimited soft drinks and orange juice.
- Patient brushes her own teeth, 1-2 times a day, for about 30 seconds each time.

Posted: 10/20/2020

Extensive Restorative

Extensive Bleeding on Probing

Full Mouth Breakdown

Implants

Multiple Medications

Oral Medicine

Orthodontics

Dark Discolored Teeth

Puffy Gums

Complex Medical History

Chipped Yellow Teeth

Smoker

Type 2 Diabetes

Multiple Restorations

Periodontitis

James Bahcall

The clinical advances and changes in thought within the field of endodontics during the last few years have been significant. Unfortunately, these changes have led to difficulties for the general dentist in keeping up in everyday practice. This course will encompass diagnosis, local anesthesia, instrumentation/obturation, and pain medications and antibiotics in clinical endodontic treatment.


A Clinician’s Guide to Clinical Endodontics

Michael W. Finkelstein

Emily Lanzel

John W. Hellstein

This course will provide an overview of common oral mucosal entities, including their presentation, management and diagnosis. The primary goal of this course is to help dental professionals learn the process of clinical differential diagnosis of diseases and lesions of the oral mucosa. This course also includes both an interactive and downloadable decision tree to assist in the diagnosis. 

Several atlases are recommended in the Additional Resources section of this course. The textual material in this course is designed to be used with “[The Oral Pathology Image Database (Atlas)](https://www.dentistry.uiowa.edu/oprm-atlas).”

Please note that lesions or diseases discussed in the textual material that have clinical images available on “*The Oral Pathology Image Database*” are designated with *.

The primary goal of this course is to help dental professionals learn the process of clinical differential diagnosis of diseases and lesions of the oral mucosa. This course also includes both an interactive and downloadable decision tree to assist in the diagnosis.

A Guide to Clinical Differential Diagnosis of Oral Mucosal Lesions

James L. Harrison

David G. Dunning

Motivation plays a crucial role in driving the performance and success of teams in various organizational settings.  While traditional approaches to motivation focus on extrinsic factors such as rewards and punishments, a humanistic approach emphasizes team members' intrinsic motivation and psychological well-being.  This course explores the fundamental principles of a humanistic approach to team member motivation and real-world examples highlighting its effectiveness. Its institution by the employer contributes to more harmonious and productive team members and plays a vital role in providing excellent customer service to patients.


Motivation plays a crucial role in driving the performance and success of teams in various organizational settings.  While traditional approaches to motivation focus on extrinsic factors such as rewards and punishments, a humanistic approach emphasizes team members' intrinsic motivation and psychological well-being.  This course explores the fundamental principles of a humanistic approach to team member motivation and real-world examples highlighting its effectiveness.

A History and Update of Fluoride Dentifrices

A Humanistic Approach to Team Member Motivation

Jeanette MacLean

This course will discuss the science and clinical use of silver diamine fluoride (SDF) for dentinal desensitization and caries arrest. A brief review of the literature and basic clinical application protocol will be reviewed.

Silver diamine fluoride (SDF) is a revolutionary approach to combating caries in a non-invasive manner. Following a widely publicized 2016 feature in the New York Times, there has been tremendous interest surrounding the use of SDF from patients and dentists. In October 2018, the ADA released its first ever evidence-based clinical practice guideline for nonrestorative treatments for carious lesions, including SDF. SDF represents an nonsurgical treatment option, which can be done without the use of local anesthetic or hand pieces. Learn the principles of case selection, informed consent, treatment planning, and a clinical protocol for SDF. Find out how offering minimally invasive options like SDF can attract new patients, improve patient satisfaction, and increase internal marketing and word of mouth referrals to your practice.


This course will discuss the science and clinical use of silver diamine fluoride (SDF) for dentinal desensitization and caries arrest. A brief review of the literature and basic clinical application protocol will be reviewed

A Nonsurgical Caries Treatment Option: Silver Diamine Fluoride (SDF)

Gentiane Valiquette

Maria L. Geisinger

Controversies about the utility of flossing were thrust into the spotlight in 2016 in a controversy known amongst dental professionals as “Flossgate. As a part of the update to the 2015-2020 Dietary Guidelines for Americans, the federal government omitted a recommendation for flossing previously included in the guidelines in 2000, 2005, and 2015.[1](/en-us/ce-courses/ce550/references#1) Citing the reasons for the omission, the Dietary Guideline Advisory Committee (DGAC) stated they focused on food and nutrient intake (e.g., added sugar) and cited the 2011 Cochrane systematic review,[2](/en-us/ce-courses/ce550/references#2) which concluded there is currently a lack of strong evidence to support the use of floss as a preventative measure for caries and periodontal diseases, although the systematic review does acknowledge evidence that flossing results in a reduction in gingival inflammation and interdental plaque. The Surgeon General, Centers for Disease Control (CDC), the Department of Health and Human Services, and other federal and state health agencies continue to publish materials that support the importance of flossing and interdental cleaning, and that advice is available to the public through the National Institute of Dental and Craniofacial Health (NIDCR),[3](/en-us/ce-courses/ce550/references#3) CDC’s Division of Oral Health,[4](/en-us/ce-courses/ce550/references#4) and Healthy People 2020.[5](/en-us/ce-courses/ce550/references#5)

The appropriateness of floss as an interdental cleaning aid for all individuals was further questioned with the release of the European Federation of Periodontology’s (EFP) statement regarding flossing efficacy in individuals with periodontal diseases. Iain Chapple, PhD, BDS, an EFP spokesperson, stated that the use of floss demonstrates utility in healthy patients without diastema may prevent the development of periodontal diseases and gingival inflammation, but that in patients with gingivitis or periodontitis, evidence suggests that floss is not useful in reversing disease and interdental brushes are advocated for use in those patients.[6,](/en-us/ce-courses/ce550/references#6)[7](/en-us/ce-courses/ce550/references#7) Dr. Chapple suggested that dental healthcare providers need to consider changing our behavior and recommendations based upon the current evidence.[6,](/en-us/ce-courses/ce550/references#6)[7](/en-us/ce-courses/ce550/references#7)

Despite the support of governmental agencies and numerous nonprofit groups, this messaging has created confusion in the lay media and the public with regards to the role of patient-administered oral hygiene for the prevention of oral diseases. Interdental cleaning continues to be an essential part of oral hygiene to maintain a healthy oral environment.[8](/en-us/ce-courses/ce550/references#8) There are 700+ identified species of bacteria and up to 1,500 putative pathologic microorganisms found in dental biofilm.[9-11](/en-us/ce-courses/ce550/references#9) Many of these organisms as well as other factors including bacterial nutrients, food debris, molecules that facilitate bacterial adhesion and invasion, and other extrinsic factors in the environment and the body’s own immune response contribute to diseases of the teeth and gingival tissues.[12,](/en-us/ce-courses/ce550/references#12)[13](/en-us/ce-courses/ce550/references#13) Current recommendations from the American Dental Association (ADA) include brushing for two minutes twice daily and cleaning between teeth to maintain a healthy mouth and smile, but these may be tailored to individuals based upon risk factors and their current oral health![14](/en-us/ce-courses/ce550/references#14)

This course will review current literature on the effectiveness of flossing and other interdental cleaning methods for patients with periodontal health, gingivitis, and periodontitis. In August 2016, the Associated Press (AP) printed an article that was widely disseminated in the lay media that there is scanty research supporting flossing as a method to improve oral health outcomes. This course will look at the 2011 Cochrane systematic review upon which the government based its decision to omit the recommendation to floss from the 2015-2020 Dietary Guidelines for Americans, the 2015 European Federation of Periodontology’s Workgroup 2015 statement, as well as the broader literature and scientific rationale behind flossing and interdental cleaning. Finally, this course will evaluate the utility of interdental cleaning methods in patients with high caries risk, periodontal health, gingivitis, and periodontitis.

A String around Your Finger: Do We Really Need to Floss

A String around Your Finger: Do We Really Need to Floss?

Beth Jordan

This course will focus on the most common dentifrice ingredients and the oral health benefits they provide. Upon completion of the course, participants will understand not only the fundamentals of dentifrice ingredients, but also key regulatory aspects of the dentifrice market and the role of the ADA Seal program in credentialing consumer dentifrices.

A-Z Fundamentals of Dentifrice: Oral Health Benefits in a Tube

Grishondra-L- Branch-Mays

Keith A. Mays

This course will present an overview of the role of the oral health care provider in interprofessional education and collaborative practice; discuss the importance of oral health on overall health and the necessity of working on an interprofessional team to provide patient-centered care and to improve population health; and will provide an overview of the core competencies for collaborative practice.


Achieving Patient-Centered Care through Interprofessional Collaborative Practice

Michaell A. Huber

David Ojeda Diaz

This continuing education course presents the etiology, epidemiology, clinical manifestations, diagnosis, and treatment of actinic cheilosis. 

Actinic cheilosis is a chronic degenerative disorder primarily of the lower lip caused by long-term exposure to sunlight. It is premalignant and usually occurs in fair-skinned men over 40 years of age. Reducing exposure to sunlight is the single most important measure in preventing actinic cheilosis. Diagnosis is predicated on histological examination of biopsy specimens. Topical chemotherapy may be used in early lesions. Prophylactic ablation or vermilionectomy may be performed in cases where malignant transformation has not yet occurred. The treatment of malignancy is primarily surgical.

This continuing education course presents the etiology, epidemiology, clinical manifestations, diagnosis, and treatment of actinic cheilosis.

Actinic Cheilosis: Etiology, Epidemiology, Clinical Manifestations, Diagnosis, and Treatment

The first step is to select a case from the Case Studies to assign to students or team members. A search feature is provided to browse through both the cases.

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