Author Archives: Rosie

PRINCIPLES OF DENTAL HYGIENE CARE IV: CLINICAL CASE STUDY – ARESTIN PATIENT #2

DEMOGRAPHICS

Name: L.A.

Age: 49 years old

Case/Type: Medium/Type II

ASSESSMENT

This patient had her last medical exam in March of 2019. She doesn’t have any allergies but she does have iron-deficiency anemia and manages it through diet and by taking a daily OTC iron supplement.

L.A.’s blood pressure reading was 106/72 and her pulse was 65 beats per minute.

L.A. does not drink alcohol or smoke.

L.A. did not require any premedication for dental treatment.

L.A. takes an OTC iron supplement (65 mg, two times per day).

ORAL PATHOLOGY (Extraoral and Intraoral findings)

L.A.’s extraoral exam produced bilateral submandibular swelling. She did not report any pain. A leukoedema was found on the patient’s lower right side along with a coated, slightly scalloped tongue. L.A. also exhibited signs of experiencing chemical burn on her lower lip due to Listerine Antiseptic use.

DENTITION

L.A.’s class of occlusion was Class I with 50% overbite and 3 mm overjet.

L.A. was missing teeth #s 1, 2, 16 and 17. Teeth #s 6-11 and 22-27 had mild attrition. Teeth #s 6-11 also exhibited incisal erosion.

L.A.’s dental charting record

L.A. had caries present on teeth #s 18B, 19B and 30B

PERIODONTAL

L.A. was classified as a Medium Case, Type II. This patient’s probing depths were between 3-5 mm. She had minimal bleeding upon probing. L.A. also had generalized recession 2-3 mm.

L.A.’s periodontal charting record

ORAL HYGIENE

L.A.’s initial plaque score was 1.3 (fair). At the time of her subsequent appointment, the plaque index score was 1.0 (fair).

L.A. had generalized light staining and generalized moderate interproximal subgingival calculus deposits.

L.A. reported brushing two times per day with an electric toothbrush. She also stated that he flosses once per day with traditional waxed dental floss and rinses once per day with Listerine Total Care mouthwash and coconut oil (“oil-pulling”). L.A. reported using non-fluoridated toothpaste such as “Desert Essence.” I reviewed the appropriate electric toothbrushing technique with this patient (she was using it like a manual toothbrush). I also recommended that the patient use fluoridated toothpaste.

At the patient’s next visit, I demonstrated flossing with waxed dental floss and the patient practiced the technique.

RADIOGRAPHS

L.A. had an FMS done at a private dental practice in July of 2017. She required two periapical radiographs of teeth #s 18, 19, 30 and 31 to assess the level of bone loss in the intended Arestin placement sites.

Right side (showing vertical bone loss between teeth #s 30 and 31).
Left side (showing vertical bone loss between teeth #s 18, 19 and 20).

ARESTIN PLACEMENT

I placed Arestin (minocycline HCl microspheres 1 mg) in the following sites: #18MB, #19DB, #30DL and #31DB on April 15th, 2019.

*L.A. refused before and after intraoral photos.

ARESTIN EVALUATION

L.A. returned for a post-Arestin placement evaluation on May 16th, 2019. The following graph shows the reduction in pocket depths in the sites that were treated with Arestin.

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PRINCIPLES OF DENTAL HYGIENE CARE IV: CLINICAL CASE STUDY – ARESTIN PATIENT #1

DEMOGRAPHICS

Name: C.B.

Age: 62 years old

Case/Type: Heavy/Type II

ASSESSMENT

This patient had his last medical exam in March of 2019. He is allergic to pork and pineapple. He was never hospitalized because of it, but he has experienced anaphylaxis in the past. C.B. had a hip operation in 2001. He was scheduled for back surgery on April 28th, 2019, but it was postponed until July of 2019 due to issues with hospital administrative procedures (paperwork not being filed). This patient suffers from life-long depression. He stated that he was abused as a child. He has recurring sinus trouble (stuffy nose and congestion). The patient also stated that he has severe-stage OSA. He clenches at night to prevent snoring. C.B. was recommended to use a CPAP machine after he had his last sleep test approximately two and a half years ago. He thought that his symptoms have since improved, so he stopped using it, but now his snoring has returned. C.B. exhibits signs of mouth breathing (chronic dry mouth, chapped lips, localized marginal gingivitis).

C.B.’s initial blood pressure reading was 172/122 and his pulse was 76 beats per minute. The second blood pressure reading was 169/104 and his pulse was 73 beats per minute.

C.B. does not drink alcohol but he smokes about 7-10 cigarettes per day for the past 40 years.

C.B. did not require any premedication for dental treatment.

C.B. takes Albuterol 90 mcg for chronic asthma which he has had since 2001.

Albuterol (Ventolin HFA) is a prescription drug used to treat asthma and bronchospasm.

ORAL PATHOLOGY (Extraoral and Intraoral findings)

C.B.’s extraoral exam produced “popping” on the right side of his TMJ but he stated that he does not experience any pain from it. He stated that he does clench his teeth at night. Enlarged tonsils (obstructed airway) and an enlarged, coated tongue were found during his intraoral exam. Additionally, the patient had slightly fibrotic tissue on his lower right, upper middle and upper left lip (from biting). The patient also had hyperkeratinized tissue on the right buccal mucosa from biting and sucking his cheeks due to the absence of teeth #s 1, 2, 4, 5 and 30. C.B. also had hyperkeratinization on the left and right side of his tongue.

DENTITION

C.B.’s class of occlusion was Class I with 5% overbite and 2 mm overjet.

C.B. had occlusal amalgam restorations on teeth #s 12, 13, 17, 21, 28 and 29, a disto-occlusal amalgam restoration on tooth #15, an occlusal-buccal-lingual amalgam restoration on tooth #3, and an occlusal-buccal amalgam on tooth #18. He was missing teeth #s 1, 2, 4, 5, 14, 16, 19, 20 and 30. 

C.B.’s dental charting record

C.B. had caries present on tooth #13O.

PERIODONTAL

C.B. was classified as a Heavy Case, Type II. This patient’s probing depths were between 3-4 mm. He had minimal bleeding upon probing.

C.B.’s periodontal charting record

ORAL HYGIENE

C.B.’s initial plaque score was 2.0 (poor). At the time of his subsequent appointment, the plaque index score was also 2.0 (poor).

C.B. had generalized staining, heavy interproximal, facial and lingual subgingival calculus deposits present on the posterior surfaces and the facial/lingual anterior teeth.

C.B. reported brushing one time per day in the morning with an electric toothbrush. He also stated that he uses floss picks periodically throughout the day and ACT mouthwash one time per day. I reviewed the appropriate electric toothbrushing technique with this patient and instructed him to focus on posterior areas. The patient answered positively to a sleep apnea symptom questionnaire. I advised the patient to practice nasal breathing and to be aware of open-mouth posture. I also provided the patient with a referral for a sleep test.

At the patient’s next visit, I demonstrated flossing with waxed dental floss and the patient practiced the technique.

RADIOGRAPHS

C.B. had an FMS done at a dental clinic in March of 2018. He required bitewing radiographs to assess the level of bone loss in the intended Arestin placement sites.

C.B.’s X-rays show horizontal bone loss between teeth #s 31 and 32 and between teeth #s 17 and 18.

ARESTIN PLACEMENT

I placed Arestin (minocycline HCl microspheres 1 mg) in the following sites: #17MB, #18DB, #31DB, #32ML and #32MB on March 28th, 2019.

C.B.’s right side (pre-Arestin placement)
C.B.’s left side (pre-Arestin placement)

ARESTIN EVALUATION

C.B. returned for a post-Arestin placement evaluation on May 17th, 2019.The following graph shows the reduction in pocket depths in the sites that were treated with Arestin.

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ORAL PATHOLOGY PAPER TOPIC: ANKYLOGLOSSIA

As part of our oral pathology coursework, we were to research a specific oral condition or disease. Because of my interest in orofacial myofunctional therapy, I chose to research ankyloglossia, commonly referred to as “tongue-tie.” This condition is often undetected and happens during pregnancy when a small portion of tissue that is supposed to disappear during the baby’s development remains at the bottom of the tongue. An orofacial myofunctional therapist is able to identify tongue-tie since they know about the lingual frenulum and the normal way that a baby feeds. When the tongue cannot move properly, functions such as sucking, swallowing, chewing or talking can be negatively impacted.

Read the complete research paper here:

Clinical patient with a Class IV tie
Clinical patient with a Class I tie

SERVICE LEARNING FIELD PROJECT ACTIVITY

East River Child Development Center
570 Grand Street
New York, NY 10002

The East River Child Development Center is a non-profit, family centered, community-based preschool program. They offer educational and therapeutic services to children with special needs between the ages of 2 and 5 pursuant to Section 4410 of the education law. Some of the special needs services that they provide are specialized instruction, speech therapy, occupational therapy, physical therapy, counseling, assistive technology and parent education.

As part of our coursework in public health, the students were divided into groups and instructed to choose a community-based center (nursing home, hospital, daycare, etc.) in which to develop and present a structured oral hygiene lesson. Our group chose a center for developmentally disabled children based on their need and lack of access to dental health care options. According to the U.S. Department of Health and Human Services, 1 in 5 households in the U.S. have at least one child with a special health care need. Many general dentists don’t treat children with special needs and this makes it very challenging for parents and caregivers to find a dentist to care for their child. This may be one of the reasons that dental care is the leading unmet health care need among children with special needs, according to the National Maternal and Child Oral Health Resource Center.

The lesson plan that our public health group created was based on interactive learning since our audience was comprised of preschool-aged children. We taught toothbrushing, flossing and nutrition. During our post-project evaluation phase, we decided that it would have been beneficial to also host an educational seminar for the parents and caregivers of these children, to learn the barriers and challenges that they may face when providing oral health care at home. I thoroughly enjoyed working on this project and researching the dental health care needs of developmentally disabled children. Additionally, the center that we chose to present at had never had our students visit before. Since there were over 90 preschoolers in attendance, I was able to arrange for three other public health groups to also complete their service learning field project activity there. The center was very pleased and requested that the students return again next year.

View the lesson plan here:

View the complete service learning field project activity here:

We created a poster featuring cartoon images of brushing, flossing, healthy and unhealthy foods and a dental hygienist
Toothbrushing instruction featuring the “rule of 3.” There are 3 sides of the teeth to brush – the outside, inside and the tops. This little rule helps children to remember to brush all sides of the teeth.
Children learned to “floss” using pieces of yarn “floss” and plastic ice cube tray “teeth” filled with Play-Doh “germs.”
“Only use a little bit of toothpaste when you brush.”
At the end of the lesson, we sang a song about brushing and flossing and danced with the children.

Emerging Scholars Program

Emerging Scholars Program Fall 2018

Alongside Professor Davide, RDH, MS, MSEd, myself and two other senior dental hygiene students began a research project over the summer of 2018 that was based on a community service activity that we participated in at the CUNY Graduate Center. In an effort to create awareness of our dental hygiene clinic and the services that we offer to the public, we invited the dental screening participants from the CUNY Graduate Center Wellness Festival to make an appointment for a dental cleaning. Based on their initial registration forms, we compiled data regarding their current oral health care habits, most recent dental visit, age, occupation, etc. After they completed their treatment in our clinic, we asked them to fill out a survey (anonymously) detailing their experience with our students, faculty and the value of the services provided. We then used this data to analyze where we can make improvements within our program and clinic facility. This has been a very interesting research project and its focus has grown immensely over the course of the past year. Additionally, this research was accepted into the Emerging Scholars Program for the duration of two semesters up to and including Spring 2019.

View the ESP research poster from Fall 2018 here:

View the ESP 2018 Book of Abstracts here:

Fall 2018 Emerging Scholars Research Poster Presentation
Fall 2018 Emerging Scholars Program

Emerging Scholars Program Spring 2019

As a continuum of our prior research that was completed in the Fall of 2018, myself and two other senior dental hygiene students treated more of the participants from the CUNY Graduate Center in our clinic and continued to gather data from them based on their experience. In assessing the methodology used to initially survey the participants, we decided to gather more comprehensive information at the next dental screening event held at the CUNY Graduate Center in the spring of 2019. We asked participants questions related to currently experiencing dry mouth, if they think they could benefit from toothbrushing instruction, snoring at night, etc. These questions were recorded so that when the new participants visit our clinic for dental hygiene treatment, we have prior knowledge regarding their concerns and have a better “picture” of their overall health compared to their oral health. This research is ongoing and it is our hope that the freshman students will continue to treat the dental screening participants during their Fall 2019 semester. Further goals regarding this research project include seeking publishing opportunities in a dental journal. Additionally, I will be presenting this particular research poster as part of the Undergraduate Student Research Poster Competition at the upcoming ADHA 2019 Annual Conference in Louisville, Kentucky.

View the ESP research poster from Spring 2019 here:

Spring 2019 Emerging Scholars Research Poster Presentation
Spring 2019 Emerging Scholars Program

Dental Hygiene – A.A.S.

DEN 1100Principles of Dental Hygiene Care I
DEN 1112Oral Anatomy
DEN 1114Histology and Embryology  
DEN 1200Principles of Dental Hygiene Care II
DEN 1217Periodontics
DEN 1218Dental Radiology
DEN 2300Principles of Dental Hygiene Care III
DEN 2311Oral Pathology
DEN 2315Pharmacology
DEN 2318Dental Materials   
DEN 2400Principles of Dental Hygiene Care IV
DEN 2413Introduction to Public Health
BIO 3302Microbiology 
BIO 3524Nutrition 

STUDENT AMERICAN DENTAL HYGIENISTS’ ASSOCIATION (SADHA)

The purpose of the Student American Dental Hygienists’ Association is to improve the public’s total health, advance the art and science of dental hygiene by ensuring access to quality oral health care, increase awareness of the cost effective benefits of prevention, promote the highest standards of dental hygiene education, practice and research and to encourage the interests and leadership skills of dental hygiene students.

From 2018-2019, I’ve had the privilege of serving as the President of City Tech’s SADHA chapter. My role in this position and its responsibilities were as follows: I presided at all meetings and activities, managed the progress of all committees, supervised the work of the organization, prepared and organized social and professional events efficiently, implemented the necessary steps to get all events approved by the Student Life Department, was responsible for follow-up on all events, prepared agendas for each meeting and kept communication open between students and faculty. I also utilized this role to serve as a mentor and motivator for my fellow students as well as the incoming freshman class.

During my term as President, I specifically focused on two main goals for the dental hygiene program to benefit the students. The first was the development and implementation of a structured “Mentor-Mentee” program. Although freshman students are assigned a senior student mentor when they enter the program, the intended benefits of such relationship do not always form. Our students are very diverse and have different levels of work and life experience. It is for this reason that I suggested the use of weekly club hours on Thursdays from 12:30 PM – 2:00 PM be reserved for student mentoring. Because students can openly express themselves without faculty members present, it creates an open, comfortable environment in which the freshmen are able to bond with senior students.

The second goal that I had for the dental hygiene program was directly related to increasing awareness of our patient care clinic. With access to over 17,000 faculty members, students and staff, our program is vastly underrepresented within the college community. Besides our biannual toothbrush sales, our SADHA club took advantage of nearly every college-wide event and established a presence, educated the City Tech community about oral health care, access to our dental hygiene clinic, provided oral hygiene educational resources and recruited patients to meet clinical requirements. Participating in these events also served another purpose – it built up the confidence and leadership skills of the students. They learned effective communication skills, professional representation of their clinical knowledge and honed their public speaking skills.

Celebrating the graduating dental hygiene class of 2018 at the annual SADHA Farewell Party.
No more PNPs!

SUMMER 2018 DENTAL HYGIENE INTERNSHIP: NATIONAL DENTAL – OAKLAND GARDENS, NY

During the summer after my second semester in the dental hygiene program, I was given the opportunity to intern at a private dental practice from May through July of 2018. Under the supervision and direction of one of the dental hygienists, Diana Lorenzo, RDH, I learned how to take radiographs such as panoramic X-rays, full mouth series X-rays, bitewings and periapicals, how to autoclave instruments and was able to complete oral prophylaxis for approximately five patients per day. Being an intern at National Dental was my first comprehensive experience working in a dental office. The office and all of its equipment was new, which gave me exposure to updated technology and integrated patient care. Completing this internship gave me even more confidence as a clinician and really prepared me for patient management and care for the upcoming third semester. The best experience that I had at National Dental was treating a twelve year-old girl who had dental anxiety and phobia. By using the “tell-show-do” behavioral method, I was successfully able to complete her treatment and provide her with a positive experience.

Cavitron practice

2018 GREATER NY DENTAL MEETING: 94th ANNUAL SCIENTIFIC POSTER SESSION

Presenting at the 2018 Greater NY Dental Meeting in the annual scientific poster session was an amazing experience. During the session, students are required to present their material before live audiences. Each demonstration consists of a research topic that is discussed within a 2-4 minute period and it is repeated as often as warranted during the three hours. My research topic was based on my interest in myofunctional therapy and the importance of extraoral and intraoral evaluations as a crucial part of the patient treatment process.

View poster here:

SPRING 2018 CITY TECH WELLNESS FESTIVAL TABLE CLINIC

This research project was based on my interest in myofunctional therapy. During my first semester of clinic, Professor Marsiliani, BA, RDH, FBPI was one of my clinical instructors. Besides being a dental hygienist, she is also an orofacial myofunctional therapist (OMT). When we learned about conducting extraoral and intraoral exams, she stressed the importance of assessing patients for signs and symptoms of conditions such as malocclusion, nail biting, tongue thrust, open mouth at rest, incorrect mastication, poor oral rest posture, headaches, GERD, heartburn, TMD, neck pain and Sleep Disordered Breathing (SDB). With myofunctional therapy, a patient can regain the joy of eating, speaking, breathing, and even sleeping more soundly. The focus for this particular research presentation was on mouth breathing and its adverse effects on overall systemic health.

View the complete presentation and brochure here:

Download (PDF, 550KB)

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