• Axium includes medical, drug, and dental history, all of which are updated regularly.
• It also encompasses caries risk assessment, oral-facial evaluation, perio chart, and odontogram.
• TB1 should be completed only once, while TB2 is required every time, suitable for all tobacco users whether new or previous.
• Treatment notes are new with codes are not linked to the notes
• Codes must be entered for billing or attached to the charges, and there should be notes for each code.
• In Axium, alerts are indicated with a red box, forms needing approval are light blue, and general messages appear in dark blue.

Syllabus

• Regular practical exams are allotted 20 minutes, while final practical exams have 30 minutes.
• The course is split into 75% didactic and 90% laboratory work.
• A passing grade in the first practical exam is required to pass overall.
• Food and drink are restricted within 30 feet of the lab.

Other Key Information

• HIPAA, short for Health Insurance Portability and Accountability Act, is relevant to the course.

G.V. Black's Classification

• Class I involves caries on the occlusal surfaces of premolars and molars, the occlusal two-thirds of facial and lingual surfaces of molars, and the lingual surface of maxillary incisors.
• Class II refers to caries on the proximal surfaces of posterior teeth.
• Class III is defined as caries on the proximal surfaces of anterior teeth, but excludes the incisal angle.
• Class IV includes caries on the proximal surfaces of anterior teeth, and includes the incisal angle.
• Class V is caries on the gingival third of the facial or lingual surfaces of any tooth.
• Class VI involves caries on the incisal edges of anterior teeth or the occlusal cusp height of posterior teeth.

Instrumentation: Explorers

• Instruments like 3CH, 11/12, and #5 are used for assessments to locate irregularities on tooth surfaces, defective margins on restorations, carious lesions, and calculus deposits, which helps evaluate completeness of treatment.
• An exploratory stroke uses a feather-light grasp and requires precise movements.
• Tips are at a 90° angle.
• Tactile sensitivity allows sensing tooth irregularities by feeling vibrations when transferred from the instrument tip, to handle.

Specific Explorers

• The #5 Orban 17 end explorer is designed for narrow pockets in anterior teeth and assessing root surfaces, though it may cause slight tissue distention.
• The Shepherd's hook 23 end is for assessing caries.
• The 3CH explorer, sometimes called a "pigtail," detects calculus and assesses normal sulcus depth, possibly causing tissue distention.
• The 11/12 explorer is multi-functional and can be used anywhere in the mouth.

Graceys

• They are area-specific instruments, each with one usable cutting edge.
• The blade is offset to the terminal shank and has a semi-circular cross-section.
• Only one cutting edge is used, making two total.
• Use a pull stroke, utilizing the lower one-third of the blade.
• When using Graceys, one should explore, adapt, tighten during the stroke, and then relax.
• Angle of the blade face to the tooth should be greater than 45° but less than 90°, ideally angled at 110° to the cutting edge.
• The terminal shank should be parallel to the surface of the tooth or its long axis.
• The face and lateral edge form the blade's face.
• The 1/2 Gracey is used on anterior teeth on all surfaces.
• The 13/16 Gracey is for posterior teeth, with 13 for distal and 16 for mesial.
• The 14/15 Gracey is for posterior teeth, with 14 for distal and 15 for mesial.
• Additionally, the 13 and 14 ends can be employed on anterior teeth as well.
• Finishing Graceys are indicated for lighter calculus removal and smoothing surfaces.
• Rigid Graceys are heavier with a more rigid shank, suitable for removing tenacious or large pieces of calculus.

After-Five and Mini-Five

• An After-Five has a terminal shank 3mm longer than a standard Gracey, allowing access to pockets greater than 5mm.
• A Mini-Five's terminal shank is 3mm longer than the standard, but its blade is half the length.
• The Mini-Five grants access into deep pockets, onto narrow roots, or in areas with recessions or clefts.

Root Debridement

• Aims for a smooth, disease-free surface, that is not glass-like.
• This stroke uses more of the blade, beginning with short, pressured strokes and ending using longer, lighter strokes.

Universals

• These are double-ended instruments with mirror image blades, suitable for a pry stroke.
• Total of 4 cutting edges, as there are 2 cutting edges on each blade.
• Face of the blade must be perpendicular at 90° to the terminal shank.
• The terminal shank must be titled toward the tooth surface.
• Handle is held parallel or vertical to tooth surface when scaling the mesial surface.
• When scaling a distal surface, the handle must be positioned perpendicular or horizontal to the long axis of the tooth.

Sickles

• May be curved or straight with pry stroke.
• Have a triangular cross-section.
• Features 4 cutting edges or 2 per blade.
• The blade is positioned so that the face is perpendicular or 90° to the terminal shank.
• Primarily used on supragingival proximal calculus just under the contact point of adjacent teeth.
• Subgingival scaling is contraindicated.
• Only the lower third of the cutting edge nearest the point is utilized.
• The SH 6/7 is used solely on anterior teeth.
• The NEVI 3 is used on posterior and anterior teeth, especially on proximal surfaces of posterior teeth.
• Graceys, Universals, and Sickles are all scaling instruments.

Topical Anesthetics

• Benzocaine is an ester anesthetic available as a gel, spray, ointment, or patch with a duration of 5-15 minutes.
• Lidocaine is an amide anesthetic available as an ointment for 15 minutes, a patch for 45 minutes, or a gel lasting 5-15 minutes.
• Lidocaine transoral patch is the most efficient

Hypersensitivity

• The 3 active ingredients for hypersensitivity in products like Colgate, Sensodyne, and Pronamel are potassium nitrate, strontium chloride, and dibastic sodium.

Subgingival Irrigation

• Common antimicrobial agents include chlorhexidine gluconate, stannous fluoride, and providine iodine with substantivity and staining.
• In performing the procedure with a disposable syringe, subgingival debridement must be performed first.
• First, explain that the procedure is to the patient advise no eating or drinking for 30 minutes after.
• Fill syringe and loosen cannula cover and bend it at a slight angle with the cover still on.
• Slowly administer agents into pockets while he patient uses a saliva injector.
• Substantivity refers to the property of an agent that allows it to be absorbed rapidly by the tissue and released slowly.
• The quick turnover rate of cervicular fluids inhibits retention of most antimicrobial agents.
• Removing stains interproximally involves epidex and finishing strips.

This lesson covers subgingival irrigation, focusing on antimicrobial agents, timing, and techniques. It highlights the importance of patient education and proper agent selection for optimal results. It also touches on caries risk assessment and related dental history.