2 CE credits
This course was
written for dentists,
Supplement to Penn Well Publications
Go Green, Go Online to take your course
Shell Shocking Impacts
A Peer-Reviewed Publication
Written by Brittany Getz, RDH, Rey Gabriel Carandang, RDH,
Samantha Harpenau, RDH, Emily R. Holt, RDH, MHA, CDA, EFDA
Post-traumatic stress disorder (P TSD) is a mental health
condition that may develop after experiencing or witnessing a
shocking, scary, or dangerous event. Individuals with P TSD have
demonstrated increased levels of stress hormones that initiate
an inflammatory response. The inflammatory response releases
chemicals that assist in the breakdown of the periodontium.
Individuals with P TSD are more likely to create their own coping
mechanisms that may include tobacco use, alcohol abuse, and
poor diet. The oral effects of these unhealthy habits include
loss of tooth structure, gingival inflammation, xerostomia,
periodontal disease, and oral cancer. Bruxism may occur due
to the untreated stress. Replacing unhealthy P TSD coping
mechanisms with alternative methods aimed at reducing stress
may improve systemic and periodontal inflammation.
During this course the participant will:
1. Describe the inflammatory process
that evolves from P TSD.
2. Identify harmful coping mechanisms
used when P TSD is untreated.
3. Identify oral damage seen in patients
with P TSD and bruxism.
4. Implement methods to manage
P TSD and stress.
Brittany Getz is a 2017 dental hygiene graduate from the University of Southern Indiana.
She is looking forward to providing quality care in Colorado upon completion of licensure
Rey Gabriel Carandang is a 2014 graduate of the University of Evansville for Exercise and
Sports Sciences, and a 2017 graduate of the University of Southern Indiana, majoring in
Dental Hygiene. He is looking forward to providing quality care upon completion of licensure
Samantha Harpenau is a recent graduate from the University of Southern Indiana majoring
in dental hygiene. She plans to provide clinical care upon completion of licensure requirements.
Emily R. Holt, RDH, MHA, CDA, EFDA is a Clinical Associate Professor of Dental Hygiene at
the University of Southern Indiana. She also provides clinical care in Indiana and is a consultant
member of the Commission on Dental Competency Assessments.
The authors have no commercial ties with the sponsors or the providers of the
unrestricted educational grant for this course.
Publication date: July 2017
Expiration date: June 2020
This educational activity was developed by Penn Well’s Dental Group with no commercial support.
This course was written for dentists, dental hygienists and assistants, from novice to skilled.
Educational Methods: This course is a self-instructional journal and web activity.
Provider Disclosure: Penn Well does not have a leadership position or a commercial interest in any products or services
discussed or shared in this educational activity nor with the commercial supporter. No manufacturer or third party has had
any input into the development of course content.
Requirements for Successful Completion: To obtain 2 CE credits for this educational activity you must pay the required
fee, review the material, complete the course evaluation and obtain a score of at least 70%.
CE Planner Disclosure: Heather Hodges, CE Coordinator does not have a leadership or commercial interest with products
or services discussed in this educational activity. Heather can be reached at email@example.com
Educational Disclaimer: Completing a single continuing education course does not provide enough information to result
in the participant being an expert in the field related to the course topic. It is a combination of many educational courses
and clinical experience that allows the participant to develop skills and expertise.
Image Authenticity Statement: The images in this educational activity have not been altered.
Scientific Integrity Statement: Information shared in this CE course is developed from clinical research and represents
the most current information available from evidence based dentistry.
Known Benefits and Limitations of the Data: The information presented in this educational activity is derived from the
data and information contained in reference section. The research data is extensive and provides direct benefit to the patient
and improvements in oral health.
Registration: The cost of this CE course is $49.00 for 2 CE credits.
Cancellation/Refund Policy: Any participant who is not 100% satisfied with this course can request a full refund by
contacting PennWell in writing.
PennWell designates this activity for 2 continuing educational credits.
Dental Board of California: Provider 4527, course registration number CA# 02-4527-15171
“This course meets the Dental Board of California’s requirements for 2 units of continuing education.”
The PennWell Corporation is designated as an Approved PACE Program Provider by the
Academy of General Dentistry. The formal continuing dental education programs of this
program provider are accepted by the AGD for Fellowship, Mastership and membership
maintenance credit. Approval does not imply acceptance by a state or provincial board of
dentistry or AGD endorsement. The current term of approval extends from (11/1/2015) to
(10/31/2019) Provider ID# 320452.
INS TAN T EXAM CODE 15171