Mia L. Geisinger, DDS, MS Assistant Professor Predoctoral Periodontal Program Director

1. Periodontal Education in the Age of Google:Vertical Integration of Periodontal Predoctoral Curriculum at University of Alabama at Birmingham. Mia L. Geisinger, DDS, MS Assistant Professor Predoctoral Periodontal Program Director University of Alabama at Birmingham

2. Google Results for “Gum Disease”

3. Google Results for “Gum Disease” “…Gingivitis is a form of periodontal disease. Periodontal disease involves inflammation and infection that destroys the tissues that support the teeth, including the gums, the periodontal ligaments, and the tooth sockets (alveolar bone). Gingivitis is due to the long-term effects of plaque deposits. Plaque is a sticky material made of bacteria, mucus, and food debris that develops on the exposed parts of the teeth. It is a major cause of tooth decay. If you do not remove plaque, it turns into a hard deposit called tartar that becomes trapped at the base of the tooth. Plaque and tartar irritate and inflame the gums. Bacteria and the toxins they produce cause the gums to become infected, swollen and tender...” http://www.ncbi.nlm.nih.gov/pubmedhealth

4. Wikipedia Results for “Gum Disease” …Gingivitis (“infammation of the gum tissue”) is a term used to describe non-destructive periodontal disease. The most common form of gingivitis is in response to bacterial biofilms (also called plaque) adherent to tooth surfaces, termed plaque-induced gingivitis and the is the most common form of periodontal disease. In the absence of treatment, gingivitis may progress to periodontitis, which is a destructive form of periodontal disease. While in some sites or individuals, gingivitis never progresses to periodontitis, data indicate that periodontitis is always preceded by gingivitis.” http://en.wikipedia.org/wiki/Gingivitis

5. WHAT’S THAT?!?!

6. Advantages of Vertical Integration • Begins teaching relationship building and working with referrals • Models private practice setting • Allows post-doctoral residents opportunity for teaching and mentoring • Provides students opportunity exposure to complex cases without being solely responsible for the technical and diagnostic skills required to complete those cases • Builds student clinical confidence early on

7. Advantages of Vertical Integration • More timely and cost effective treatment of the patients with complex dental needs • Allows for collaboration of student and periodontal resident • Allows opportunities for bidirectional referrals within the UAB Dentistry system • Relieves postgraduate residents of burden of preliminary lab work and/or diagnostics--responsibility shared with student, residents and supervising faculty

8. Advantages of Vertical Integration • Reduces costs to patients • Increases case acceptance of ideal comprehensive treatment plans • Increases revenue to comprehensive care and specialty clinics because appointments are utilized more efficiently • Faculty resources are utilized most effectively

9. Disadvantages and Difficulties • Model requires proper scheduling of the patients by the care coordinators • Difficulty coordinating resident-student interaction and tx plan timing • Model requires student understanding of necessity for continuity of care • May require more out of clinic time for faculty/resident/student consultation

10. Get Them Young!

11. Periodontal Diadactic Curriculum • DY1 • Oral Hygiene Small Group Clinical Exercises • D1 Periodontology • Case Based Education • DY2 • D2 Periodontology • Case Based Education • DY3 • D3 Periodontology • Practice Management • Health Promotion • DY4 • Practice Management

12. DY1 Periodontal Philosophy: What do we want entry-level general dentists to know? • Diagnosis • Etiology • Prognosis • Referral • Diagnostic case based comprehensive examination • Hands-on laboratory/clinical exercises

13. DY2 Periodontal Philosophy • Diagnosis • Etiology • Prognosis • Referral • Management of Mild Periodontitis and Phase I Therapy • Hands-on clinical exercises • Oral hygiene clinical laboratories

14. DY 3 Periodontal Philosophy • Diagnosis • Etiology • Prognosis • Referral • Emerging Technologies and Novel Research • Student Driven Topics • Interactive (Clicker) Driven Clinical Diagnostic and Treatment Planning Course • Turning Point • Built-in Class Discussion Times to Address Clinical Concerns

15. DY4 Periodontal Philosophy • Diagnosis • Etiology • Prognosis • Referral • Practice Management and Transition • Practice Management • Medicolegal, Patient Management, and Ethical Implications of Practice Decisions and Referrals

16. Reinforcement of Diadactic Periodontal Excellence • AAP DSIG Membership as a Reward for the Top 5% of Performers in each Diadactic Year • Periodontal Curriculum Consistently Rated as Rigorous and Well-Instructed • Upperclass Guidebook states that the key to passing DY1 “Gross Anatomy and Periodontology D1” • D3 Periodontology: Course Designed to Incorporate Student Generated Topics to Reinforce Student Interest and Allow their Personal Involvement • Case Based Education Includes 2 Periodontally Generated and Centered Cases, and a Periodontist Facilitator for all Cases. • Periodontist as a Co-Course Director for Practice Management Curriculum (DY3 and DY4) to Stress the Importance of the Specialist in all Aspects of Practice

17. Clinical Vertical Integration • D1 Oral Hygiene Clinics • Periodontist instruction of Small Groups for Intenstive Oral Hygiene Instruction • Physical Examination • D2 Clinical Integration • Periodontal Clinical Rotations • Clinical Examination and Supragingival Prophylaxis Exercise

18. Clinical Vertical Integration • D3 Clinical Periodontology • Periodontal Portfolio • Resident Periodontist Assignment within Comprehensive Care Groups • Competency Examinations • Health Promotion • Diagnosis and Treatment Planning • Scaling and Root Planing • D4 Clinical Periodontology • Resident Periodontist Assignment within Comprehensive Care Groups • Case Management Competency Examination/Case Management Research Paper

19. Vertically Integrated Clinical Treatment Team Faculty Manager Resident Periodontist Managing Partners Faculty Mentors/Advisors Specialists Supportive Team Patient Service Coordinator Dental Assistant Patient Account Representative Sterilization Technicians D4 Student Doctor D3 Student Doctor D2 Entry Level Clinical Skills D1 Entry Level Clinical Skills Postdoctoral Residents

20. Millenials Learn Differently • “If You do What You Have Always Done, You Will Get What You Have Always Got…Or Less” • More Appealing Student Driven Lectures and Independent Study • One-on-One Interaction Valued Highly • Value Clinically Related Information/Presentations • “How Will This Relate to MY Practice” • Reinforcement of Previously Taught Concepts in New Ways is Important • Millenials are Influenced by Peers • Junior Faculty • Residents

21. “Education is not the filling of a pail, but the lighting of a Fire.” -W.B. Yeats