Susan K. Anderson, R.D.H., B.S., M.Ed.

 Esther M. Wilkins, D.M.D., was our featured presenter at the April 18, 1997, CE Course. Esther truly is a friend to dental hygiene, in that she is a hygienist who went to dental school and followed that by completing her graduate degree in periodontics. You all may remember your textbook by Dr. Wilkins, we call it the Hygienists Bible. The eighth edition is in the works now. Esther has remained active in our professional organization, having served as President of the Massachusetts constituent, as well as ADHA and Sigma Phi Alpha Supreme Chapter. All who meet her find her inspirational for her energy and enthusiasm.

Because of all these characteristics, UPDHS had the highest enrollment ever for a CE course and had to turn people away. Unfortunately, for many, this was a disappointment.

The course for the day was, Nonsurgical Periodontal Therapy - New Challenges. Some of the identified challenges were: new research in caries control and periodontal infections, new tests for patient assessment, new high tech products, better documentation, anticipatory guidance, root caries, patient risk factors related to dental hygiene care plans, and sharing responsibility with the patient for complete professional and daily personal care.

For newer graduates, this course provided an excellent review; while for those experiencing extended clinical dental hygiene lives, the course provided valuable and easy to implement new directions for patient care. In terms of patient motivation and education, we were told to be honest about discussing the patients INFECTION. Tell it like it is, call them what they are. Too often our patients do not grasp the magnitude of a little redness at the gum line; face it folks, there is an infection here! Patients also need to understand how life style factors such as diet, alcohol, and drugs influence the risks involved.

A new topic to most in the audience was Anticipatory Guidance where we need to provide practical, developmentally appropriate health information about children to their parents.

Dr. Wilkins term for root caries was cleverly labeled retirement caries. With more of our aging population retaining their dentition, risk factors were illustrated. We learned researchers have now renamed strept mutans to mutans strept, and there are ten varieties responsible for oral diseases. The role of fluorides throughout life was emphasized. We need to be aware of drugs related to gingival and oral changes. We=re not just talking about cocaine and other illegal drugs, but so many drugs used by our older patients. The extensive and informative handout material alone was worth the cost of enrolling for this course. Dr. Wilkins knows how to pull together the latest material and illustrate it in written form. As in her textbook, charts and outlines were clear and concise. References were listed on each page, so that anyone interested in further reading on a subject could do so. An example of interest to most women was the comparison of risk factors for osteoporosis and periodontitis, a chart pulled from the Journal of Periodontology 67:1076, October, 1996, supplement.

Assuming all practicing dental hygienists are fully aware of the use of the PSR and know the value and legality of this screening tool, Dr. Wilkins reviewed the clinical markers for the dental hygiene diagnosis:

• Color.........Probing...........Furcations
• Size...........Attachment......Mobility
• Shape........Mucogingival Levels
• Bleeding.....Bacterial Plaque Distribution

  Sometimes we as clinicians fall short on observations of all aspects listed here. Dr. Wilkins took some time to give a pep talk to hygienists about how under utilized and over educated we are for what we are allowed by time and money to do with our patients. She suggests we educate first, inform before you perform; for instance, probe out loud so patient hears the numbers.

Dr. Wilkins took time to encourage more frequent use of local anesthetics by listing the following criteria for their use:

• Pain control
• Efficiency and time factors
• This is the way to do it

She also listed criteria for the use of quadrant scaling and talking to the patient about recovering sick tissue.

Ultrasonic instrumentation was discussed with prevention of disease transmission for most in the use of this therapy. Essentials are an antimicrobial pre procedural rinse and the use of high velocity evacuation. Articles were referenced concerning transmission of lung disorders to the patient through the use of ultrasonics and contraindications for use with implants.

Selective polishing and air abrasive polishing were shared, and references listed.

Those participating experienced a very full day, enjoying the opportunity to spend time with a real icon of our profession. It was a privilege and an honor to be part of the audience that day.

As a footnote, the SADHA banquet was the following evening, and Dr. Wilkins attended, participated in the installation of new officers, and danced the night away.