DH_manual_ver74.doc

THE UNIVERSITY OF OKLAHOMACOLLEGE OF DENTISTRY

DEPARTMENT OF DENTAL HYGIENE

DENTAL HYGIENE MANUAL2006-2007

TABLE of CONTENTS

SECTION I-ADMINISTRATION and otherimportant information 5Dental Hygiene Faculty & Staff 7Distant Sites Faculty 8College of Dentistry Phone List 1FERPA-Family Educational Rights & Privacy Act 7Blackboard 9

SECTION II- GOALS, PHILOSOPHY 10Goals 1Mission Statement 2Philosophy 5Patient Care 6Clinical Dental Hygiene Objectives 7Clinical Course Evaluation 9Attitude/Professionalism 11

SECTION II A-PROFESSIONALISM, ATTENDANCEDeficiency in Professional Conduct Form 1 Dress Code 4Attendance 5Reporting Absences 6

SECTION III-SCHEDULESAcademic Calendar 1Orientation Schedule 4Senior DH Classroom Schedule 5Junior DH Classroom Schedule 6Faculty Clinic Schedule 2COD Clinic Schedule 3DS IV Clinic Coverage 4Faculty Senior Clinic Assignments 5

SECTION IV-CURRICULUM & COMPETENCIES 4Dental Hygiene Curriculum 5Clinical Patient Care Competencies 6Process Competencies 7Simulation Competencies 8

2

Competencies for Entry Level Dental Hygienist 9Clinical Competencies by Student Level 14

3

SECTION V- HEALTH ISSUES 15Antibiotic Premed Guidelines 16PreMed Protocol at COD 18Blood Pressure Policy 19Emergency Procedures 20Emergency Numbers 21Safety Protocol for Clinics & LabsCoumarin Protocol 2122

SECTION VI-CLINIC FORMS 23Blue Recall Form 24Clinical Evaluation Form 26Calculus Chart 27CDI Screening Form 28CDI 29Patient Release COD 30Sign Up Sheet for Clinic 31Dental Hygiene Care Only 32Treatment Plan-Dental Hygiene 33Adjustment to Account Form 34Patient Survey 35Patient Absence Form 36Rotation Report Form 37OD exam sign up 38

Post-Op Scaling Root Planing InstructionsLocal Anesthesia Worksheet

SECTION VII-SENIOR COMPETENCIESENTENCIES & OTHER CLINICAL EVALUATION FORMS 38Air Polishing Evaluation 45Bleaching Protocol Bleaching 46Bleaching Consent FormBleaching Follow Up Instructions 46Calculus Charting Exercise 40CDI C Scaling Competency Information ???? Competency Evaluation Summary Self Assessment for Scaling Competency Self Assessment Competency 42SS

4

Local Anesthesia Competency 52Local Anesthesia Placement Table 56Nitrous Oxide Evaluation COD 57Nitrous Oxide Evaluation other sites 58Periodontal Charting Competency 61Periodontal Charting Scanned Form 62Scaling Polishing Competency Form 41Instrument Sharpening Competency 63Treatment Planning Competency 64Ultrasonic Competency 65

5

SECTION VII-A SENIOR REQUIREMENTS 66

SECTION VIII- JUNIOR COMPETENCIES 67

& CLINICAL EXERCISESAbbreviations 68Barnhart Competency 70EIE Competency 73Fluoride Tray Competency 75Gracey 1 / 2 Competency 76Gracey 11 / 12 Competency 77Gracey13 / 14 Competency 79H6 H7 Competency 81Mouth Mirror Competency 83ODU 11 / 12 Explorer Competency 84Periodontal Probe Competency 86Polishing Rubber Cup Competency 88Patient Operator Positioning Left Handed 90Patient Operator Positioning Right Handed 92TU 17 / 23 Competency 94Unit Disinfection Competency 96

SECTION VIII-A-PRE-CLINIC 98Lab Station Assignments-Assistants 99Lab Station Assignment 1 100Lab Station Assignment 2 101Lab Station Assignment 3 102

SECTION IX-CLINICAL EVALUATION, CLINIC PROTOCOL & PROCEDURES 103DH I Evaluation Criteria 104DH II Evaluation Criteria 106Patient Reception, positioning 109Patient history 110Permission to proceed PTP 111PTP monologue 114Subsequent PTP monologue 115Case complete monologue 118PTP laminate 117

6

Complete sequence 120

Vital signs 119

7

Blood Pressure procedure 120EIE Extra-oral, intra-oral exam 122Definitions of terms for EIE 124EIE palpation 126Lesion description chart 130EIE sequence 127Periodontal charting !!! 130Bleeding index 134Oral Diagnosis charting key for existing oral conditions 135Occlusion, malpositions 138Plaque index 140Stress reduction protocol 141Sterilization 143Sterilization table 143Infection control terminology 145TPN & recall card 147

SECTION X-ROTATIONS 149Clinical Assistant 150Assist Senior DH Rotation 152Good Shepherd Mission 153Map Good Shepherd Mission 154Graduate Periodontics 155Implantology 160Oral Diagnosis 161Pediatric Dentistry & Sealant Clinic 164Sealant Clinic 164Radiography 166Screener 167Teaching Assistant 168Tinker Air Force Base 170Tinker Map 172VA Dental Clinic 173

SECTION XI-COD CLINIC MISCELLANEOUS Appointment schedulingFax in Green Clinic 184Medical consult form for fax 185Fax cover sheet 186Recall exam 178Patient protocolPatient Contact Card protocol 201

8

DH Documentation check list 204DH Patient Information-Clinic OpsDH Student Instructions-Clinic Ops 208Fee SchedulePatient CancellationsCancellations Policy COD September 28, 2006Friday emails

9

City Rescue Mission Patients SECTION XII-BOARD EXAMS 187 WREB 188 NBDHE 188 State Jurisprudence Exam 188

SECTION XIII-COURSE SYLLABI Junior YearDH 3513 Preventive DentistryDH 3313 Clinical Dental Hygiene I

Senior YearDH 4331 Clinical RotationsDH 4332 DH Process of CareDH 4336 Clinical Dental Hygiene IIIDH 4552 Community Health Issues

SECTION XIV-STUDENT ORGANIZATIONSSADHA

Class Officers

10

SECTION I

Administration & other

important information

11

FACULTY and STAFF

DENTAL HYGIENE FACULTY-OUCOD SITE

Jane Bowers, R.D.H., Ph.D Department Co-Chair. Clinical FacultyDCSB 572 271-4435

Vicki Coury, R.D.H., M.Ed, M.P.H. Department Co-Chair, Clinical FacultyDCSB 574 271-4435

Jane Gray, R.D.H., CDA, M.Ed Senior Clinical Coordinator/Clinical FacultyDCSB 570 271-4445 (M) 405-830-4880

Tammie Vargo, R.D.H., M.Ed Junior Clinical Coordinator/Clinical Faculty DCSB 582 271-4562

Laurie Cunningham, R.D.H., CDA, M.Ed Clinical FacultyDCSB 565 271- 4423

Kathy Miller, R.D.H., B.S. Asst. Director of Clinics/ Clinical Faculty DCSB 521C Implantology, Pediatric Dentistry

271-8001 x46525

Carol Zerby, R.D.H.,B.S. Clinical Faculty / SADHA AdvisorDCSB 583 271-6532

Donna Brogan, R.D.H., B.S. Part Time Clinical FacultyDCSB 583 271-4435

Sheri French, R.D.H., B.S. Part Time Clinical FacultyDCSB 583 271-4435

Kim Graziano, R.D.H., A.A.S. Part Time Clinical FacultyDCSB 583 271-4435

Kathy Rogers, R.D.H., A.A.S. Part Time Clinical FacultyDCSB 583 271-4435

Stephanie Schmidt, R.D.H.. B.S. Part Time Clinical FacultyDCSB 583 271-4435

Kristy Jurko Administrative SecretaryDCSB 567 271-4435

12

DENTAL HYGIENE FACULTY DISTANT SITES

ARDMORE

Southern Oklahoma Technology Center Christy Brannock, Site CoordinatorDept Of Dental Hygiene Mobile: (580)-504-9421 2610 Sam Noble Parkway Office: (580) 223-2070 x 278Ardmore, Ok 73401 Keila Pierson- Admin Secretary(580) 223-2070 ext 268 Lindsey Hays- Clinical Instructor

Judy West- Clinical InstructorRoom Numbers: #C1 (Senior Room) (580) 224-9861#C2 (Junior Room) (580) 224-9863Fax: (580) 223-4261

BARTLESVILLETri County Technology Center Lydia Snyder, Site Coordinator:Dept Of Dental Hygiene Mobile: (918) 277-62226101 S.E. Nowata Rd Office: (918) 331-3282Bartlesville, Ok 74006 Nina Hill, Admin Secretary(918) 331-3218 Tammie Golden- Clinical Instructor

Abbie Gustafson- Clinical InstructorNina Hill, Admin Secretary

Room Phone Numbers:#326 (918) 331-3378#107 (918) 331-3201Fax: (918) 331-3499 WEATHERFORDWestern Technology Center Julie McClung, Site CoordinatorDept Of Dental Hygiene Mobile (405) 831-14062605 E. Main Office: (580) 772-0294 Ext 243Weatherford, Ok 73096 Evelyn Tilson, Admin Secretary(580) 774-0224 Ext 241 Tina Tuck- Clinical Instructor

Room Phone Number: #1: (580) 772-0294 Ext 248#2: (580) 772-0294 Ext 228 (Jr rm) Fax: (580) 772-2967

13

COLLEGE OF DENTISTRY PHONE LIST

ACCOUNTING Ellen Ware, Business Manager 5363

ADMINISTRATION Roxanne Vidal (34158) 5444

Stephen K. Young, Dean 15444

Frank J. Miranda, Senior Associate Dean 34159Diana Stone, Administrative Manager 34163Carla Lawson, Student Affairs Specialist 34162Sally J. Davenport, Administrative Secretary 34160Dean’s Office Fax #’s 271-3423 or 271-7775

ADMISSIONS Judy 34156 / Erica 34128 3530

Randy Jones, Assoc. Dean of Student Affairs (34155) 3531

AEGD Jan Fortelney Delores Simpson 5222 Stephen Reagan, Director 14121 Jan’s Office #323 6486

Barry Greenley 46451 or 52, 53

Clinic Room #318 46454 Fax # 3851

Clinic Operations

Jeanne Panza, Asst. Dean for Clinics 34134

Kathy Miller, Asst. Director of Clinics 46525

Tammy Vogt, Billing & Technology Administrator 34137

Linda Hale, Staff Assistant/Patient Advocate 34135Glenda Jenkins, Supervisor of Clinics 34136Kathan Kent, Infection Control Officer 13083Central Business Office 14711Patient Care Coordinators 15422Chart Room 34147

DENTAL SERVICES ADMINISTRATION(COMMUNITY DENTISTRY) Janet Powell 4919

Dunn Cumby *

DENTAL HYGIENE Kristy Jurko 4435 Jane Bowers * 14436 Jane Gray 14445Vicki Coury 13869 Carol Zerby 46532Laurie Cunningham 14423 TammieVargo 14562

DENTAL INFORMATICS______ ___ 3694

1

Scott Newhouse 34152

Hal Horton 34129

Jason Jones 34154

Computer Lab - (Across from Dean’s Office) x34151 13651

DENTAL MATERIALS 6545

Sharukh Khajotia *

DEVELOPMENT Amanda Bleakley4380

ENDODONTICS Irene Quintero 5550 David Clement* 48556Harry S. Heget 48553Andrew Goldbeck 48550

FIXED PROSTHODONTICS Julie Hall 5346 Luis Blanco * 48547 David Sather 48546Barry Greenley 48544 Booseh Jafari 48566Frank Lipsinic 48567

MAXILLOFACIAL Teri Forster 5744

OCCLUSION Julie Hall 5052

Edwin Wilson * 48549

OPERATIVE Suzan Stone 5735 Terry J. Fruits 46878Robert Miller 46883 Randy White 46877Lynn Montgomery 46879

ORAL DIAGNOSIS Andie Stringfellow 5988 Appt. Desk “New” Screenings 6056

Susan Settle * 46824 Dr. Jennings 46826Emile Farha 46829 Dr. Beavers 46825Farah Masood 46827 Dr. Panza 46828Clinic Dispensary 14946 Radiology Staff 15687

ORAL IMPLANTOLOGY Jana Williams 3956Don Mitchell 48640 Joy Hasebe 46521

ORAL PATHOLOGY Karen Lassiter 4333

Glen Houston * David Lewis

ORAL PATHOLOGY LAB Geri Stevens 5880

Glen Houston

2

ORAL SURGERY Luellen Chenoweth 46963 or 4441

Steven M. Sullivan *50055 Appointment Desk 4079Kevin Smith *50056 Debbie Wedemeyer 46981

Alan Miyake 46976 or 50057 Lisa Nichols 46964

Van Henson 46940 Oral Facial Surgery Center 4955

ORTHODONTICS Terrie Birdsong 6087 Frans Currier * 46836 Ram Nanda 16117 John Clayton 46837 Seminar Room 46838Yellow/Orange Clinic 14148 or 33263 T. Dandajena 33277

GRAD. ORTHODONTICS Angel Miller 4271 Grad. Clinic Heather 4148 or 33261 Donna Mead 33260

PEDIATRIC DENTISTRY Roberta Rains 5579Kevin Haney * 46523 Kathy Miller 46525

Theresa White * 46522

PERIODONTICS Robin Barnes 4544 Robert Carson * 46534 Doug Hall 46533Jane Amme 46538 Sharon Severson 46537David Weiner 46536

GRAD. PERIODONTICS Lisa J. Smith 6531 Joy BeckerleyRobert Carson - Director

REMOVABLE PROST. Helen Lowery 4160 Frank Wiebelt * 48561 Joseph Cain 48564Paul Mullasseril 48542 Nancy Jacobsen 48563 Removable Lab 48565 Dan Tylka 48548

RESEARCH DEVELOPMENT Karen Rucker 2929

John Dmytryk, Assoc. Dean Research *

RESTORATIVE Suzan Stone 6400

SUPPORT LAB David Dembinski 4565

STOREROOM 5620Allen Williams Darla Hall (Store Rm 46663) 5560Billy Harley Cyndi Hughes (Store Rm 46664)Jack Dever

3

UDFG RECEPT. Felita Sapp 5714

Jody Maddox 46583 or 46575 Appt. Desk 2209

*Departmental Chairs Deans New Screenings

ADMISSIONS & RECORDS OUHSC 2359

Registration 1539 Records 1537

BOARD OF GOVERNORS OK PRACTICES 524-9037

Linda Campbell, Executive Director Fax 524-2223

BURSAR Sherry Glover 2433

CAB SERVICES: YELLOW CAB 232-6161

CAMPUS POLICE Emergency 4911

Non-Emergency 4300Fire 4112Coronary Care – St. Anthony’s 236-0191OMH = Emergency 4363

CENTRAL STERILIZATION 5350

Labs: Dental Support 4565Pre-Clinic Lab 6462

CHILDRENS HOSPITAL

940 NE 13TH Room Info. X5437

CHO Dental Clinic Dr. King - #44138 or Rose X-4750

CLINICS Blue 3 rd fl Fixed 5056

Brown 2 nd fl Restorative 6333

Burgundy 3 rd fl Removable 4008

Gold 3 rd fl Operative 6532

Green 4 th fl Endo/Maxillofacial 6953/5744

Yellow/Orange 4 th fl Pedo/Ortho 2360

Maxillofacial 2 nd fl Oral Surgery 5744

New Screening and Emergency Clinic OD 2 nd fl 6056

COMPUTER LAB 3691

FACULTY HOUSE Reservations 235-8212

FINANCIAL SERVICES 2345 A/P 2410 Fax 2367Budget Office 2404 Ext. 46504Bursar 2441 Fax 2057Vice President Dr. Ferretti 2399

4

Controller 2376Grants & Contracts 2177Payroll 2055 Fax 2057SUR Accounting 2246Special Account 2410

GOOD SHEPHERD MISSION 232-8631

216 NW 12TH

HOUSEKEEPING Cheryl – Pager 530-1372 5726

LEGAL 2033

Jill Raines Fax 1076

OKLAHOMA DENTAL ASSOCIATION 848-8873 Dana Davis Fax 848-8875

PURCHASING 5313

Director 4903Assoc. Director 6587Secretary 5313 Fax 2148

LAB 3 rd Floor 4565

LOCK SHOP Charlie or Tom 2158

MARY MAHONEY CLINIC 769-3301

NORMAN CAMPUS INFORMATION 325-0311

PARKING OFFICE Larry _ 2020

PRE-CLINIC 433 LAB 6462

PRINT SHOP Tony 2322

PERSONNEL OFFICE Fax 3925 2180 Administration 2191Employee 2190 Benefits 2188Wage / Salary 2187

Worker’s Comp. Unemployment 2189Records 2186

PHOTOGRAPHY Lanny, Terri, Trish 2173

POISON CONTROL 5454

POST OFFICE 2225

PROVOST Ann Whittmann X2332 X 48400

Jason Dixon 12332

Cheryl Ottman 48416Dr. Marcia Bennett 48408

5

Peggy Brown 48409Legal –Jill Raines 12033 Fax 3151Karen Ambrose, Dr. Raskob’s Office 48401

RATCLIFFE’S BOOKSTORE Sammi 2448

SITE SUPPORT 2121

STAPLES KITCHEN - Located in The Commons 6323

STATE FUNDS APPROPRIATIONS 2355

ST. ANTHONY’S HOSPITAL 272-7373

1000 N. LEE

SWITCHBOARD Front Desk Jo Rumley 6326

TICKETS Football/Basketball (Norman) 325-2424

TRAVEL Marilyn SCB - 218 2038

UNIVERSITY OMH (OMS) 271-4131

V.A. HOSPITAL 270-1505 Dr. Nasser 270-5139

WEATHER LINE 6499

WREB 602 – 944-3315 Fax 602 – 371-8131

6

FERPAFamily Educational Rights and Privacy Act

http://www.ed.gov/policy/gen/guid/fpco/ferpa/index.html

The Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. § 1232g; 34 CFR Part 99) is a Federal law that protects the privacy of student education records. The law applies to all schools that receive funds under an applicable program of the U.S. Department of Education.

FERPA gives parents certain rights with respect to their children's education records. These rights transfer to the student when he or she reaches the age of 18 or attends a school beyond the high school level. Students to whom the rights have transferred are "eligible students."

D. Parents or eligible students have the right to inspect and review the student's education records maintained by the school. Schools are not required to provide copies of records unless, for reasons such as great distance, it is impossible for parents or eligible students to review the records. Schools may charge a fee for copies.

E. Parents or eligible students have the right to request that a school correct records which they believe to be inaccurate or misleading. If the school decides not to amend the record, the parent or eligible student then has the right to a formal hearing. After the hearing, if the school still decides not to amend the record, the parent or eligible student has the right to place a statement with the record setting forth his or her view about the contested information.

F. Generally, schools must have written permission from the parent or eligible student in order to release any information from a student's education record. However, FERPA allows schools to disclose those records, without consent, to the following parties or under the following conditions (34 CFR § 99.31):

1. School officials with legitimate educational interest;2. Other schools to which a student is transferring;3. Specified officials for audit or evaluation purposes;4. Appropriate parties in connection with financial aid to a student;5. Organizations conducting certain studies for or on behalf of the school;6. Accrediting organizations;7. To comply with a judicial order or lawfully issued subpoena; 8. Appropriate officials in cases of health and safety emergencies; and9. State and local authorities, within a juvenile justice system, pursuant to specific State law.

Schools may disclose, without consent, "directory" information such as a student's name, address, telephone number, date and place of birth, honors and awards, and dates of attendance. However, schools must tell parents and eligible students about directory information and allow parents and eligible students a reasonable amount of time to request that the school not disclose directory information about them. Schools must notify parents and eligible students annually of

7

their rights under FERPA. The actual means of notification (special letter, inclusion in a PTA bulletin, student handbook, or newspaper article) is left to the discretion of each school.

For additional information or technical assistance, you may call (202) 260-3887 (voice). Individuals who use TDD may call the Federal Information Relay Service at 1-800-877-8339.

Or you may contact us at the following address:

Family Policy Compliance OfficeU.S. Department of Education400 Maryland Avenue, SWWashington, D.C. 20202-5920

8

Blackboard Instructions for Students

How to Access Blackboard

1. Enter the Blackboard site at ouhsc.blackboard.com (Do not precede with www.)

2. Sign-on using campus username and password 3. Click on the course that you wish to enter

How to Access On-line Course Evaluation

1. Enter the Blackboard site at ouhsc.blackboard.com (Do not precede with www.)

2. Sign-on using campus username and password 3. Click on the course that you wish to complete the course evaluation

on the right side of the Welcome screen4. On the left side of the Announcement screen, click Course

Evaluation. 5. On the next screen, click Course Evaluation and follow instructions

given.

9

SECTION II

GoalsPhilosophy

10

DEPARTMENT OF DENTAL HYGIENEGOALS and PHILOSOPHY

The philosophy of the Dental Hygiene Program at the University of Oklahoma is one of

commitment to the education of oral health professionals who are capable of integrating

educational, clinical, and individual services that support and promote the total health of the

patient as well as optimal oral health.

In addition to the broader goals of the University and the College, the following goals have been

adopted. Graduates of the Department of Dental Hygiene are expected to:

1. Be competent in recognition, evaluation, and appropriate treatment of oral diseases.

2. In all settings in which responsibility has been delegated, apply scientific principles and an

analytic approach to the practice of dental hygiene, educational endeavors, public health and

research.

3. Act as an integral member of the dental health team by performing quality preventive and

therapeutic dental hygiene services, in a variety of settings, in order to improve the oral

health status of the consumer.

4. Function as a valuable member of interdisciplinary teams of health personnel recognizing

the unique contributions of each discipline.

5. Communicate effectively with patients and colleagues, develop intellectual curiosity and

demonstrate the skills necessary to enhance learning and continue professional development

throughout their career.

The curriculum is designed and implemented with the goals as a foundation. The facilities offer

a good environment for basic science and pre-clinical instruction, laboratory and clinical

experiences. Faculty are dedicated to excellence; sensitive to the depth of the curriculum

offered; offer a wide range of professional experiences; and attempt to establish an atmosphere

of respect and understanding with students.

The program goals require that students provide appropriate treatment of oral diseases, apply the

scientific principles and an analytic approach to all aspects of dental hygiene practice, act as an

integral member of the health team, communicate effectively with patients and colleagues and

demonstrate skills necessary to enhance continued professional development. In order to meet

the goals of the program, one of the educator's primary challenges is to provide opportunities to

foster and improve the students' critical thinking skills. This task falls not just to didactic course

directors, but even more importantly to clinical instructors who are most likely to have more

occasions to reinforce theoretical concepts and apply what has been learned in the classroom to

actuality.1

The attainment of the program's goals necessitate background knowledge and skills in a variety

of curriculum areas but just as importantly, the addition of knowledge of the latest scientific

advancements and innovations in dental hygiene practice and health care systems. This essential

information on the latest scientific advancements is provided by faculty in the classroom,

laboratory, clinic and community projects, but training for student involvement both while in the

educational process and later as a professional is provided by requiring active participation by

the students in the attainment of information (i.e., library assignments, reading updated texts,

individual research assignments, sharing of information by peer presentations, etc).

The goals are a living document sensitive to the changing needs of the profession. Each year

usually in late summer the goals are reviewed, evaluated and revised as necessary by the faculty

during a faculty retreat established for that purpose. The retreat is mandatory for faculty holding

50% or greater commitments to the school and other part-time faculty may attend.

MISSION STATEMENT

The mission of the Department of Dental Hygiene (DDH) incorporates the four-fold mission of the University of Oklahoma College of Dentistry (OUCOD) to:

1. improve the health of the people of Oklahoma and others through the academic and clinical training of highly qualified dental professionals

2. provide the highest quality oral health care services to the community3. advance the art and science of dentistry via research and other scholarly/creative activities4. provide, sponsor and/or participate in activities and services that validate the educational

programs of the College as integral and vital parts of the entire health care spectrum.

The following departmental goals are integral to accomplishment of the mission of the University of Oklahoma as they relate to the Department of Dental Hygiene:

DDH GOAL #1(EDUCATION)

Prepare students, through appropriate academic and clinical education, to be qualified dental professionals.

1. Recruit students of the highest quality who can reasonably be predicted to successfully complete the educational programs of the College within specified time frames.

2. Provide appropriate didactic and clinical instruction through an interactive, competency-based curriculum that is reviewed regularly and modified as necessary to address the

2

dynamics of a constantly changing profession.

3

3. Provide this didactic and clinical instruction in a positive learning environment that leads to social and ethical development.

4. Create and provide opportunities for learning beyond graduation through relevant continuing education.

5. Incorporate relevant innovations in information technology and management, consistent with available resources, as an integral facet of the department's goals in the areas of teaching, patient care, research, and student/faculty service.

DDH GOAL #2(PATIENT CARE)

Provide comprehensive dental treatment to those communities served by the College through a complete, sequential, and fully monitored system of oral health care delivery.

1. Provide comprehensive patient-centered care throughout the clinical education programs as an integral component of the College's teaching and service missions.

2. Develop and implement program standards of care based on measurable criteria that facilitate reliable and valid assessment.

DDH GOAL #3(CREATIVE & SCHOLARLY ACTIVITY)

Create a positive and rewarding academic environment that facilitates continued growth and enrichment of all students and faculty.

1. Provide opportunities for faculty development and recognition.

2. Participation in scholarly activities that lead to the discovery and dissemination of new knowledge in the art and science of dental hygiene through research programs involving faculty and students.

DDH GOAL #4(PROFESSIONAL SERVICE)

Foster opportunities, utilizing resources both locally and nationally, for faculty and student involvement in service activities that are consistent with personal development goals and that promote dentistry as an integral component in the overall health and welfare of the community.

1. Identify new and strengthen existing relationships between the College's academic programs, the public and organized dentistry and dental hygiene.

4

2. Promote programs and activities that emphasize an interdisciplinary approach between dental hygiene and dentistry and other health profession components.

3. Encourage student and faculty participation in and support of professional service organizations that promote the service mission of the College and the dental hygiene profession.

The goals are a living document sensitive to the changing needs of the profession. Goals are reviewed, evaluated, and revised annually by the faculty and by the Dental Hygiene Advisory Committee.

5

DEPARTMENT OF DENTAL HYGIENEPHILOSOPHY

The philosophy of the Dental Hygiene Department is one of commitment to the education of oral health professionals who are capable of integrating a full range of knowledge and skills that support and promote the total health of the patient as well as optimal oral health.

The curriculum is designed and implemented with competencies as the foundation. The program goals require that students provide appropriate prevention and treatment of oral diseases, apply scientific principles and an analytic approach to practice, act as an integral member of the health team, communicate effectively with patients and colleagues, and demonstrate continued professional development. In order to meet the goals of the program, one of the educator's primary challenges is to provide opportunities to foster and improve the students' critical thinking skills. This task falls not just to didactic course directors, but even more importantly to clinical instructors who are most likely to have more occasions to reinforce theoretical concepts and apply what has been learned in the classroom to actuality.

The attainment of the program's goals necessitate background knowledge and skills in a variety of curriculum areas but just as importantly, the addition of knowledge of the latest scientific advancements and innovations in dental hygiene practice and health care systems. Students are required to take active roles and responsibility for their education, including attainment of information and skills and self-assessments.

Areas of emphasis within the curriculum will include, but not be limited to the following:

I. PROFESSIONALISM The competent dental hygiene practitioner provides skilled care using the highest professional knowledge, judgment and ability (ADHA Code of Ethics). This skilled care should be based on contemporary knowledge, and the practitioner should be capable of discerning and managing ethical issues and problems in the practice of dental hygiene. However, the practice of dental hygiene occurs in a rapidly changing environment where therapy and ethical issues are influenced by regulatory action, economics, social policy, cultural diversity and health care reform. Additionally, dental hygiene is trying to create a unique identity for the profession and increase the knowledge base. Thus, the competent dental hygienist must have regular involvement with large and diverse amounts of information in order to be prepared to practice in this dynamic environment.

II. HEALTH PROMOTION AND PREVENTION The dental hygienist serves the community in both practice and public health settings. Public health is concerned with promoting health and preventing disease through organized community efforts, which is an important component of any interdisciplinary approach. In the practice setting, the dental hygienist plays an active role in the promotion of optimal oral health and its relationship to general health. The dental hygienist therefore should be competent in the performance and delivery of oral health promotion and disease prevention services in the public health, private practice and alternative settings.

6

III. PATIENT CARE The dental hygienist is a licensed preventive oral health professional that provides educational and clinical services in the support of optimal oral health. The dental hygiene process of care applies principles from biomedical, clinical and social sciences to diverse populations that may include the medically compromised, mentally or physically challenged, or socially or culturally disadvantaged.

7

CLINICAL DENTAL HYGIENE OBJECTIVES

As the student progresses through the clinical program, he/ she will be expected to assume greater responsibility for total patient care. The student will utilize problem solving and critical thinking skills to apply knowledge from didactic courses to the clinical setting.

OBJECTIVES: The student will: ACTIVITY USED TO ACHIEVE OR MEASURE OBJECTIVE:

l. Exhibit professional demeanor a. Faculty serves as a role model.(i.e. attitudes, conduct, andpersonal appearance). b. Students exhibit professional

demeanor.

2. Utilize correct dental terminology a. Student utilizes professional professional communications. terminology with professionals.

b. Student utilizes laymanterminology with patients

c. Student utilizes correctterminology in presentation

of oral exam findings.d. Student utilizes correct

terminology in written

communications (i.e. clinic records and treatment plans).

3. Demonstrate proper maintenance, a. Student satisfactorilysterilization, and storage of clinical completes clinical assistant armamentarium. duty assignments.

b. Faculty monitors student preparation and maintenance

of equipment and

armamentarium by commenting on

student/faculty comment sheets.

4. Demonstrate principles of asepsis a. Faculty monitors demon strationin treatment of all patients. of asepsisComments on student/faculty sheets. b. Student demonstrates

competency by performing all criteria stated in asepsis

performance

8

.

5. Demonstrate use of fundamental a. Student identifiesprinciples of, and perform patient necessary treatmentevaluation, data collection, treatment for each patient,planning, and delivery of documents these indicated indicated therapeutic and services on the treatment plan.preventive services with emphasis on b. Student prepares written individualized treatment and/or patient treatment plan according to need. criteria.

c. Student satisfactorilycompletes clinical requirementsspecified in clinical contract,meeting competency

level.

6. Apply basic principles of a. Student completes instrumentation for patient competencies for basic examination and removal of deposits. instrumentation for removal of

deposits as well as root planning

with Gracey curets.b. Tissue trauma and

calculus removal is within acceptable limits.

7. Assume responsibility for a. Student plans in orderhis/her educational experience. to complete clinical requirements.

b. Student matches patientprofile with requirements.

c. Student completes properpreparation and evaluation.

8. Demonstrate effective time a. Faculty monitors skillsmanagement skills in completing completed with specifiedclinical services. time expected.

b. Student performancedemonstrates efficient time

utilization.

9. Identify or describe anatomic a. Student interprets and utilizesstructures and conditions in a radiographs for patientgiven radiograph. education and treatment

planning.

9

CLINICAL COURSE EVALUATION

Evaluation Policy Goals:

The dental hygiene program faculty at the University of Oklahoma believes that learning should be based on a firm foundation of didactic education, and then built layer by layer with practical experience and additional learning. Evaluation is basically another methodology by which learning can be facilitated. The intent of evaluation is not to penalize, to discipline or to measure a person's potential worth, but rather it is an effective mechanism to provide constructive feedback to aid in student learning. In addition, evaluation provides a medium for ingraining those skills and attributes indicative of the professional health care provider. In addition, the faculty desires that evaluation be a two-way interaction between student and faculty. Evaluation allows improvement in both directions. The faculty hopes to foster a climate of teamwork with mentor and scholar having the same ultimate goal...the education of a learned ethical professional dental hygienist. The following further explain the clinical evaluation process:

1. Evaluations are based upon specific instructional objectives that are made known to the student as early as possible and appropriate for each phase of the clinical educational process.

2. Skills are defined in didactic, laboratory and clinical instruction. Competencies have been established for each critical skill and step-by-step evaluations are provided. Grading is based on the degree of skill demonstrated by the student in carrying out the established steps within each competency.

3. Competencies are based on progression and in the final semester will be at the appropriate level for the entry-level dental hygienist.

4. Product will be evaluated as well as process and all domains are appraised.

5. The student has ultimate responsibility for the degree of clinical aptitude that will be acquired in the professional program of dental hygiene. It is expected that the student will have a positive attitude and a driving thirst for knowledge making use of faculty expertise at -every opportunity. Students are encouraged and expected to seek maximum help from faculty members particularly in the early development of clinical knowledge and skills.

6. As the student progresses through the program, critical clinical thinking skills become more finely honed. The faculty will encourage the student to progressively assume more responsibility for clinical planning, therapies, and outcomes, but will remain available for consultation and assistance as necessary.

7. Performance objectives and evaluation criteria are established in the Dental Hygiene Manual. For a student to be successful in the dental hygiene clinical program, it is mandatory that the student be thoroughly familiar with these clinical expectations. It is further requisite that the student evaluate his or her personal performance according to the specified criteria for each clinical skill

10

8. Clinical course requirements and grading are established based on student need and are written in contract form at the beginning of each clinical semester. Amendments to the grade contract may be made upon agreement of both facultyand students.

9. Fellow students may not be used as patients to fulfill requirements except in special circumstances that have been approved by the course director. Please refer to course syllabus.

10. In addition to specified requirements, students must complete the following• For the clinical program to be considered complete:

treatment for all assigned patients has been concluded or arrangements have been made for continuation of long term therapy

• documentation is complete and has been reviewed with assigned case instructor

• any equipment loaned to the student by the Dental Hygiene Department has been returned or paid for in full

11. Final clinical course grades will be assigned in the following way-A - 90-100B - 80-89C - 70-79D - 60-69F - <60

11

ATTITUDE/PROFESSIONALISM

Members of the health professions need to exemplify the traits which they hold as objectives for others if response and cooperation is to be expected. As future members of a health profession, dental hygiene students must be willing to accept the responsibilities placed on them in order to prove themselves capable of assuming future responsibilities. The transition from layperson to professional which must be made during professional training is not easy, but can be facilitated by the individual's striving to learn and transferring this learning to clinical experiences.

Professional behavior is a combination of technical skills, mature observation and judgment, and ethics. Technical skills are achieved through the preclinical dental hygiene course and gradually refined through clinical experiences until the students achieve the level of proficiency required for graduation. Clinical observation of normal and abnormal must be mastered, based on the knowledge acquired in the didactic clinical courses and in clinical experiences. Judgment is based on obtaining and utilizing pertinent information gained through observation and patient need, patient-student interaction, technical skills and continuing clinical experiences.

Professional ethics is concerned with the conscientious use of technical skills, observation and judgment affecting the patient's health and well-being, interpersonal relationships, community involvement and a commitment to service.

The following are specific expectations of dental hygiene students at The University of Oklahoma. A willing attitude on the part of the student to accept these responsibilities in a positive manner is partial evidence of {our ability and sincere desire to become an effective member of the dental health team.

I. General Clinical Guidelines

A. The Clinic Manual must remain at the clinic station at all times, and students must refer to the manual to ensure that procedures are properly done.

B. Certain procedures (i.e.: asepsis, appearance, patient management, professionalism, patient education, etc.) apply to each patient and are

considered part of the total competency evaluation .

C. The student will utilize feedback given by instructors on all procedures.

G. Once a student has achieved competency in a certain procedure, that procedure may be subject to spot checks. An unsatisfactory spot check will require an additional demonstration of competency for that procedure.

E. Faculty must be in clinic for any procedure to be started on a patient.

F. PTP is to be obtained from a clinical instructor before procedures are begun.

12

II. General Clinic Conduct

A. During clinic sessions, students entering the clinic must be in uniform.

B. According to the departmental policy, food, drinks, or smoking are not allowed in the clinic area.

III. Professional Conduct

A. Class, Laboratory and Clinic AttendanceYou are expected to attend all classes, laboratories, and clinic sessions

and to have patients for all clinic appointments.

B. Absenteeism from pre-clinic to laboratory and clinic sessions must be reported to the dental hygiene secretary at 271-4435 and the course director in advance of the session to be missed.

C. Gum chewing is not permitted in any area where patient contact is likely.

IV. Professional Attitude

A. Shows initiative while seeking to utilize free time.

B. Uses time efficiently.

C. Demonstrates responsibility for the total preventive treatment of all patients assigned.

D. Demonstrates discretion when conversing in the clinic.

E. Protects patient's rights to privacy.

F. Upholds honest and ethical behavior in all situations

G. Demonstrates maturity in judgment, actions and reactions during clinical situations.

H. Willingness to accept suggestions for improvement and evaluation of procedures gracefully.

I. Continued eagerness to learn.

J. Placing the patient's welfare first when planning and implementing patient care.

K. Attitudes of respect, concern, and cooperation toward fellow classmates, support personnel, and faculty.

L. Honesty.

13

Section IIA

PROFESSIONALISM

1

DEFICIENCY IN PROFESSIONAL CONDUCT OR PERFORMANCE

Purpose: To document serious deviations from acceptable norms of professional conduct or performance. (1) *

Name of Student Date

Faculty/Staff Time

Chart # (if applicable) Location

Check applicable category(ies) of deficiency:

Conduct Performance

Attitude Interpersonal relations Judgment Skill/competence

Behavior Integrity Preparation Other

Dress Code Other Patient neglect

Description of occurrence and immediate action taken:(continue on reverse side if necessary)

Faculty/Staff recommendation(s) for further action:(continue on reverse if necessary)

_____________________________________________ _____________________Faculty/Staff Signature Date

_____________________________________________ _____________________Student Signature (2) * Date

Submit completed form to the Associate Dean for Student Affairs or the Associate Dean for Clinics (3) *

* SEE REVERSE

(1) This form is intended to document serious occurrences that should be consideredwhen evaluating a student’s fitness for promotion and advancement. Examplesof such occurrences include, but are not limited to:

a. Actions endangering a patient’s well-beingb. Cheating, plagiarism, or falsification of recordsc. Harassment or discriminationd. Thefte. Serious and/or repeated lapses of professional behavior, preparation, judgment, or

competence in clinical, pre-clinical or classroom areas

(2) The student signature acknowledges awareness of this documentation, but doesnot imply agreement or disagreement with its contents. The student mayprovide a written response to the Associate Dean for Student Affairs or the Associate Dean for Clinics.

(3) This form is to be submitted promptly to the Associate Dean for Student Affairs or the Associate Dean for Clinics who will coordinate distribution of copies to the student, Course Director, and the Chair of the appropriate Periodic Review Committee.

______________________________________________________________________________

Description of occurrence and immediate action taken (continued):

2

Faculty/Staff recommendation(s) for further action (continued):

3

COLLEGE OF DENTISTRY DRESS CODE (Revised July 24, 2006)

Because patient care is delivered in the College of Dentistry throughout the year, it is important that all students, whether in the clinic, pre-clinic or classroom maintain a professional appearance at all times. Therefore this policy is in effect from 7:30 a.m. to 5:30 p.m. Monday through Friday.

General Attire

Students are expected to dress and act professionally while enrolled in the College of Dentistry, when present anywhere on the Health Sciences Campus and when representing the College of Dentistry at any external site. Neatness, cleanliness and modesty are expected.

Guidelines

Hair must be kept clean, neat, and out of the patient's face and operator’s eyes. Moustaches and beards must be kept neatly trimmed. The remainder of the face must be clean-shaven. No jewelry worn in facial body piercing (other than ear lobes) is allowed.

Acceptable: Dresses, skirts of professionally appropriate length, dress slacks, casual or dress shirts with collars or blouses (long or short sleeve), polo type shirts with collars, and sweaters. Most varieties of footwear are acceptable as long as they are clean and presentable. Jeans are discouraged; however, if worn, they must be neat and clean, with no holes, tears or frayed fabric.

Unacceptable: Rubber flip-flops, T-shirts, baseball caps or other hats. Bare midriffs, exposed undergarments, and improperly fitting clothing are expressly prohibited.

Pre-clinic Attire

Scrubs must be worn in the preclinical laboratory, room 433.

Clinic Attire

Professional appearance should be maintained at all times by all students. Going to and from a clinic laboratory will require the appropriate clinic attire.

Hands must be clean and well manicured with fingernails short and free of nail polish to ensure efficient work and cleanliness. Artificial nails are not permitted. Certain jewelry, rings (with the exception of smooth surface wedding rings), watches, long necklaces or large earrings must be removed during patient treatment to avoid unnecessary collection of microorganisms and possible cross-contamination.

4

Clothing such as jeans, shorts, and open-toed sandals and bare ankles are not allowed in clinics. Although there is no restriction on hair length of students, long hair must be pinned up while in clinic and the pre-clinic laboratory.

Scrub tops and pants are required as general clinic attire. Scrubs are issued as part of your student kit. You are responsible for laundering them. A white short sleeve T-shirt or a tee shirt matching the color of the scrub top may be worn under the scrub top provided no writing or design is visible and the shirt tail of the T-shirt is worn inside the scrub pants.

Shoes must be white, clean and in the judgment of the attending clinical faculty, appropriate for clinic. High-tops, hard-soled clogs, sandals and heels are expressly prohibited. Socks covering the ankles are required. “Crocs” are acceptable as long as they are white and not perforated. (Amended August 17, 2005)

If replacement scrubs are required, they must be purchased from The Uniform Shoppe and be identical to the original issued scrubs in both company of manufacture and color. They must also be monogrammed with the students name above the pocket.

You must wear a long-sleeve gown (provided in each clinic) for procedures in which splatter with blood or saliva is likely. Contaminated gowns must be turned in at the end of the clinic session in the container designated in each clinic. Gowns may not be worn going to and from clinics and the support laboratory during patient care, and may not be worn to the Student Commons or outside the building. The College will provide and launder these gowns.

Violations of this policy will be handled in the following manner:

First offense: writing warning (copy to Associate Dean of Student Affairs)

Second offense: written reprimand (copy to Associate Dean of Student Affairs)

Third offense: appearance before the appropriate Periodic Review Committee, which could result in further disciplinary action.

5

ATTENDANCE

Classroom and Laboratories

Attendance at classroom, seminar, and laboratory sessions is of valueand is, therefore, MANDATORY.

Exceptions can be made for legitimate excuses acceptable to the course directors.

The methods of enforcing the attendance policy will be carried out at the departmental level. Students will be informed of departmental procedures for checking attendance at the beginning of each course.

Unexcused absences may result in grade reduction or failure, at the discretion of the department chairperson and/or course director.

Clinics

Attendance in clinic is required unless the student is excused by the course director. If not treating a patient, the student will be expected to be assisting in clinic.

PROPER PROCEDURE FOR REPORTING ABSENCES

Unanticipated absences, (i.e., personal illness, family emergency, transportation problems, etc.) are to be reported to individual course directors and the departmental Administrative secretary at 271-4435 on the date the absence occurs and before the class/clinic missed ends on that date. In the case of unanticipated absences necessitating cancellation of patient(s), it is your responsibility to notify the patient and the Clinical Coordinator.

Anticipated absences, (i.e., family events, advanced program interviews, personal business, doctor appointments, etc.) should be discussed with appropriate faculty prior to the time of the absence so arrangements can be made for make-up work.

All absences are to be reported to the Course Director/ Dept Administrative Secretary and the Clinical Coordinator

for documentation; however, this DOES NOT EXCUSE the absence.Arrangements must be made with individual course directors.

6

SECTION III

SCHEDULE

S

ACADEMIC CALENDARSUMMER 2006

June 12.....................................................................................................DS1 and DS2 Grades DueJune 14...............................................................................................................PRC1 at noon, DCRJune 16...........................................................................................................PRC2 at 8:15am, DCRJune 16...............................................................................................DS3 Mock Boards (No clinic)June 20................................................................................................................PAC at noon, DCRJune 26....................................................................................................................DS1 Orientation June 27....................................................................................................................Anatomy BeginsJuly 4.....................................................................................................Independence Day Holiday July 14..................................................................................................................Last Day of ClinicJuly 17....................................................................................................NBDE Part I Written ExamJuly 17-18..................................................................................................................Faculty RetreatJuly 18-20..........................................................................DS4 Professional Development SeminarJuly 19.....................................................................................................................DS3 Grades DueJuly 24..............................................................................................................PRC3 at 10am, DCRJuly 24-Aug 4.............................................................................................DS4 Group 1 ExternshipJuly 27.................................................................................................................PAC at noon, DCRAugust 7-18................................................................................................DS4 Group 2 ExternshipAugust 9...............................................................................................Anatomy Final Examination

ORIENTATION DATES August 15 (1:00-5:00) & 16 (10:15-5:00)..................................................................................DS2August 16 (8:00-5:00) & 17 (8:00-5:00)....................................................................................DS3August 16-17..............................................................................................................................DH2August 16-18..............................................................................................................................DH1August 18 (10:00-5:00)...............................................................................................................DS1August 21 (8:00-5:00).................................................................................................................DS4

FALL SEMESTER 2006 August 15.............................................DS2 Dental Microbiology/Immunology (BSEB at 8:00am)August 16..............................................................................DS1 Embryology (BSEB at 10:00am)August 17.......................................................................................................................ODA PicnicAugust 18...........................................................DS1 Physiology (College of Pharmacy at 8:00am)August 21 .............................................................................................................All Classes BeginSept 4..................................................................................................................Labor Day HolidaySept 14......................................................................................................................OUCOD PicnicOct 6............................................................................................. Fall Break (no classes or clinics)Nov 20-22...............................................................................................DS2 & DS4 Board ReviewNov 22-26......................................................................................................Thanksgiving HolidayDec 8 (week 16)................................................................................................Last Day of Classes Dec 11.......................................................................................NBDE Part I Written Exam (DS2) Dec 11-15 (week 17)................................................................................. Final Examination WeekDec 19 ............................................................................................................................Grades DueDec 16-Jan 1.........................................................................................................DS1 Winter Break

2

Dec 16-Jan 7.....................................................................................................DS2-4 Winter BreakDec 16-Jan 15..................................................................................................DH1-2 Winter Break

SPRING SEMESTER 2007

January 2.................................................................................DS1 Dental Materials Course BeginsJanuary 8..........................................................................................................DS2-4 Classes BeginJanuary 15.............................................................................................Martin Luther King HolidayJanuary 16.......................................................................................................DH1-2 Classes BeginMarch17-25...................................................................................................................Spring BreakMarch 27....................................................................National Board Dental Hygiene ExaminationApril 11.......................................................................................................................Scientific DayMay 4.......................................................................................................WREB Dental OrientationMay 5-7............................................................................................................WREB Dental ExamMay 7-11 (week 17)...................................................................................Final Examination Week

May 11...............................................................................OU Norman/Dental Hygiene Commencement

May 12............................................................................................................Dental Hygiene Convocation

May 15.................................................................................................................DS1-3 Grades DueMay 28..........................................................................................................Memorial Day HolidayJune 1 (week 20)........................................................................................DS4 Last Day of ClassesJune 5......................................................................................................................DS4 Grades DueJune 2............................................................................................................Dental CommencementJune 8....................................................................................... WREB Dental Hygiene OrientationJune 9-10............................................................................................WREB Dental Hygiene Exam

DS1 and DS2 POST SESSION: May 14-June 1 (weeks 18-20)**June 1.................................................................................................................Last Day of ClassesJune 5..............................................................................................................................Grades Due**The DS1 and DS2 Post Sessions have been shortened to 3 weeks. If this is problematic please notify Carla Lawson in the Dean’s Office.

DS3 - LATE SPRING CLINIC: May 7-July 13 (weeks 17-26)

July 4...................................................................................................................Independence Day Holiday

July 13.................................................................................................................Last Day of ClinicsJuly 17.............................................................................................................................Grades Due

DS4 – SUMMER II SESSION: July 16-August 17July 17-19…………………………………………….Professional Development WorkshopJuly 23-August 3…...………………………………………………………Group 1 ExternshipAugust 6-17………………………………………………………………...Group 2 Externship

2006-07AcadCalSent to Faculty & Staff 6/5/06

3

DH II ORIENTATION SCHEDULE – HSC STUDENTSCLASS OF 2007

WEDNESDAY, AUGUST 16, 2006

COD Students only

10:00 am Rm. 364 TB Shots Judy Davis

ALL DH II STUDENTS AT COD11:00 a.m. Rm. 133

Student StoreInstrument Kit Issue Darla Hall

12:30 p.m. Commons Lunch and Welcome to Class of 2008 Senior DH Students

2:45 pm Rm. 104 Enrollment/Details Kristy Jurko

3:00 p.m. Rm. 104 Oral Pathology Dr. Glen HoustonDr. David Lewis

4:00 p.m. Rm. 104 Welcome BackReview of Student HandbookMust sign and return to Kristy Jurko before August 21, 2006 that you agree to comply with handbook regulations

Dr. Stephen K. Young, DeanDr. Jane Bowers, Prof. Vicki Coury

THURSDAY, AUGUST 17, 20068:30 a.m. Rm. 364 Clinical Dental Hygiene Orientation

(Disconnect from distance sites)Rotation Information

Professor Jane Gray, Senior Clinical Coordinator

10:30 a.m. Break

10:45 a.m. Rm. 364 Clinical Operations UpdateImplantology and Pedo

Ms. Kathy MillerAssistant Director of Clinics

12:15 p.m. Lunch (on your own) On Your Own

1:45 p.m. Rm. 364 Oral Diagnosis & Radiology Orientation Dr. Susan Settle,Chair Oral Diagnosis

2:15 p.m. Rm. 364 Tinker Diana Mills

3:00 p.m. Break

3:15 p.m. Rm. 364 Good Shepherd Mission Dr. Lipsinic

3:45 p.m. Brown Clinic

Graduate Periodontics Orientation & Tour

Tiffany Johnson

FRIDAY, August 18, 2006

Enjoy your last day of vacation!!

4

MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY

8 AM Perio III*DH 4601Dr. John Dmytryk

Pain Control

DH 4472Dr. Van Henson

9 AM DH Process of Care

DH 4332Prof. Jane

Gray

Rotation IDH 4331Prof. Jane

Gray

Tammie GoldenChristy Brannock

Tina Tuck

DH Process of Care

DH 4332 Prof. Jane

GrayTammie Golden

Christy BrannockTina Tuck

CDH IIIDH 4336Prof. Jane

Gray

Tammie GoldenChristy

BrannockTina Tuck

10 AM Oral PathologyDH 4144

Dr. Glen Houston

CommunityHealth Issues

DH 4552

Profs. Laurie Cunningham/ Vicki Coury

11 AM

12 NOON1 PM CDH III

DH 4336Prof. Jane

Gray

Tammie GoldenChristy

BrannockTina Tuck

CDH IIIDH 4336Prof. Jane

Gray


Tina Tuck

CDH IIIDH 4336

Prof. Jane Gray


Tina Tuck

Oral PathologyDH 4144

Dr. Glen Houston

2 PM

3 PM

Fall 2006 DH III

5

4 PM

6

DHI Fall 2006MONDAY TUESDAY WEDNESDA

YTHURSDAY

FRIDAY

8AMDental

MorphologyLecture

Dr. Ed Wilson9AM

CDH I Theory Lecture/

Clinic

Prof Tammie Vargo

Lydia Snyder Christy

BrannockJulie

McClung

CDH I Theory

Lecture/ Clinic

Prof Tammie Vargo

Lydia Snyder Christy

BrannockJulie

McClung

CDH I Theory Lecture/ Clinic

Prof Tammie Vargo

Lydia SnyderChristy

BrannockJulie McClung

Computer Orientation

Jason

10AMOral Radiology

Dr. Farah MasoodLecture

Head & Neck Anatomy

Lecture(First half

semester)

Gen/Oral

Histology

(Second half semester)Prof. Julie Mc Clung

11AM

12 NOON

1PMOral Diagnosis

Lecture

Dr. Kay Beavers

CDH I Theory Lecture

Prof Tammie Vargo

Preventive DentistryLecture

(10 weeks) /Health

Education (5 weeks)

Prof. Laurie CunninghamDr. Jane Bowers

Perio I Lecture

Dr. Robert Carson

OUCOD*

Oral Radiology

Lab

Staff 2PM

Oral Radiology Lab

Staff

3PM Head & Neck Anatomy

(First 8 wks)

Gen/Oral Histology

(Second 8 wks)

Prof. Julie Mc Clung

4PM

2

Dental Hygiene Faculty Clinic Schedule

Monday a.m.

Yellow/Orange

(5 faculty)

DH I Lecture/Clinic/Lab

18 Juniors Spring ONLY

Tuesday a.m.Blue

(4 faculty)

DH I Lecture/Clinic/Lab ONLY

12 Juniors SpringONLY

Wednesday a.m.Yellow/Orange

(5 faculty)

DH I Lecture/Clinic/Lab

18 Juniors Spring ONLY

Thursday a.m.Green

(4 faculty)

12 Seniors

Tammie Vargo Tammie Vargo Tammie Vargo Jane Gray

Carol Zerby Carol Zerby Carol Zerby Vicki Coury

Kim Graziano Laurie Cunningham Kathy Rogers Laurie Cunningham

Donna Brogan Stephanie Schmidt Carol Zerby Sheri French Carol Zerby

Sheri French Jane Bowers prn Sheri

French

Jane Bowers prn

Vicki to VA

Monday p.m.

Green

(5 faculty)

21 Seniors

Tuesday p.m.

Green

(4 faculty)

16 Seniors

Wednesday p.m.

Green

(3 faculty)

12 Seniors

Jane Gray Jane Gray Carol Zerby

Donna BroganCarol Zerby Kathy Rogers

Kim Graziano Stephanie Schmidt Sheri French

Carol Zerby Sheri French

Sheri French Vicki Coury -prn

3

Jane Bowers

4

Eminent Scholar TBA No Clinic AM

Fall Break - October 6 COD CLINIC SCHEDULELabor Day - September 4 FALL 2006

Thanksgiving - Nov. 22-26 AUGUST 21 - DECEMBER 08

Final Exam Week – December 11-15 WEEKS 1 - 16

AM MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAYDS - 4OPER 24P SURG 2FPD 17RPD 6ENDO 11PERIO (Grn) 6

DS -2 PAIREDPerio/OD 3024 Perio/3 Grad Perio 3 ReserveDH -1 Yellow/OR 24

DS - 4 – PEDO

DS - 3OPER 24PERIO 16P. SURG 2FPD 6RPD 12OD - BURG 10

OCCL IN TP CLINICTP CLINIC 10OCCL 1

DH - 1BLUE CLINIC 12

DS - 4PERIO 20P. SURG 2FPD 21RPD 12OD - BURG 6ENDO 6

DH - 1YELLOW/OR 24

DS - 3OPER 24PERIO 20P. SURG 2FPD 6ENDO 6RPD 12OD – Brown 4

DH - 2GRN CLINIC 12

DS-4OPER 24RPD 12ENDO 11OD-BURG 6

PM MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAYDS - 3 PEDO/ORTHO

DS - 2 PAIREDPERIO/OD 24OCCL (DS 2)OPER (TX PLANS)RESERVE LIST 3GRAD PERIO 3

DH - 2 GRN CLINIC 24

DS - 3 & DS - 4OPER 24PERIO 16P. SURG 2FPD 14#RPD 12ENDO 6

TP CLINIC 10OCCL 1

DH - 2GRN CLINIC 16

DS - 4 PEDO/ORTHO

DS-3OPER 24RPD 12ENDO 11OD-BURG 8

DH-2GRN CLINIC 12

DS-4OPER 24FPD 14ENDO 11

DS-1 PAIREDOral ProphylaxisTechniqueBrn Clinic 24 OD 5

DS-3 PEDO/ORTHO

DS-4FPD 14ENDO 6OD - GRN 6

5

DS-IV Dental Hygiene RotationFall 2006

All Times P.M. - Names

All Times P.M. - Names

Week 1 Week 11Tues, Aug 22

No PATIENT Clinic Tues, Oct 31

Benbajja, Samad

Wed, Aug 23

No PATIENT Clinic Wed, Nov 1 Fields, Lonny

Week 2 Week 12Tues, Aug 29

Burkett, Travis Tues, Nov 7 Bird, Gabriel

Wed, Aug 30

Reid, Chad Wed, Nov 8 Huynh, Dan

Week 3 Week 13Tues, Sep 5 Chang, Euna Tues, Nov

14Arnold, Ryan

Wed, Sep 6 Nguyen, Monika Wed, Nov 15

Jensen, Brandon

Week 4 Week 14Tues, Sep 12

Chastain, Brian Tues, Nov 21

Happy Thanksgiving

Wed, Sep 13

Shankle, Keith Wed, Nov 22

Holiday


Curtis, Blaine Tues, Nov 28

Bowman, Benjamin

Wed, Sep 20

Nabors, Gabe Wed, Nov 29

Meacham, Stephen


Dang, Hanh Tues, Dec 5 Briggs, Misty

Wed, Sep 27

Lamb, Whitney Wed, Dec 6 Chambers, Cory

Week 7

Continued On Back

Tues, Oct 3 Ahrend, MindyWed, Oct 4 Daniel, Ryan

Week 8Tues, Oct 10

Alavizadeh, Ashley

Wed, Oct 11

Hall, Barrett

Week 9Tues, Oct 17

Blythe, Andrea

Wed, Oct 18

Hanson, Eric

Week 10Tues, Oct 24

Baird, Robert

Wed, Oct 25

Holloman, Ashley

6

Faculty Assignments – Senior Clinic Fall 2006

Weeks 1-4 (Aug 21-Sept 14)

Monday pm 21 chairsFaculty Bowers

Brogan French

Gray Graziano

Zerby

Unit # 24, 23, 22 21, 20, 19, 18

17, 16, 15, 14

13, 12, 11 10, 9, 8 7, 6, 5,

Tuesday pm 16 chairs

Faculty French Gray Schmidt Zerby Coury (prn)

Unit # 24, 23, 22, 21

20, 19, 18, 17

16, 15, 14, 13

12, 11, 10, 9

Wednesday pm 12 chairsFaculty Gray French Zerby Rogers Unit # 24, 23, 22 21, 20, 19 18, 17, 16 15, 14, 13

Thursday am 12 chairsFaculty Zerby Cunningha

mCoury

Unit # 24, 23, 22, 21

20, 19, 18, 17 16, 15, 14, 13

8


Weeks 5-8 (Sept 18-Oct 12)

Monday pm 21 chairsFaculty Zerby Bowers Brogan French Gray Grazian

o

Unit # 24, 23, 22 21, 20, 19, 18

17, 16, 15, 14

13, 12, 11 10, 9, 8 7, 6, 5,


Faculty Zerby French Gray Schmidt Coury (prn)

Unit # 24, 23, 22, 21

20, 19, 18, 17

16, 15, 14, 13

12, 11, 10, 9

Wednesday pm 12 chairsFaculty Rogers Gray French Zerby

Unit # 24, 23, 22 21, 20, 19 18, 17, 16 15, 14, 13

Thursday am 12 chairsFaculty Coury Zerby Cunningha

m Unit # 24, 23, 22,

2120, 19, 18,

1716, 15, 14, 13

9


Weeks 9-12 (Oct 16-Nov 9)

Monday pm 21 chairsFaculty

Graziano Zerby

Bowers

Brogan French Gray

Unit # 24, 23, 22 21, 20, 19, 18

17, 16, 15, 14

13, 12, 11 10, 9, 8 7, 6, 5,


Faculty Schmidt Zerby French Gray Coury (prn)

Unit # 24, 23, 22, 21

20, 19, 18, 17

16, 15, 14, 13

12, 11, 10, 9

Wednesday pm 12 chairsFaculty Zerby Rogers Gray FrenchUnit # 24, 23, 22 21, 20, 19 18, 17, 16 15, 14, 13

Thursday am 12 chairsFaculty Cunningha

mCoury Zerby

Unit # 24, 23, 22, 21 20, 19, 18, 17

16, 15, 14, 13

10


Weeks 13-16 (Nov 13-Dec 7)

Monday pm 21 chairsFaculty Gray

Graziano

Zerby Bowers

Brogan French

Unit # 24, 23, 22 21, 20, 19, 18

17, 16, 15, 14

13, 12, 11 10, 9, 8 7, 6, 5,


Faculty Gray Schmidt Zerby French Coury (prn)

Unit # 24, 23, 22, 21

20, 19, 18, 17

16, 15, 14, 13

12, 11, 10, 9

Wednesday pm 12 chairsFaculty Gray French Zerby Rogers Unit # 24, 23, 22 21, 20, 19 18, 17, 16 15, 14, 13

Thursday am 12 chairsFaculty Zerby Cunningha

mCoury

Unit # 24, 23, 22, 21

20, 19, 18, 17 16, 15, 14, 13

11

SECTION IVCurriculum & Competencies

13

University of OklahomaCollege of Dentistry

2006-2007DENTAL HYGIENE CURRICULM

3RD YEAR

Course TitleCrd Hrs

ClockHours/ Week

Fac/StudRatio

CourseDirector

Fall Lec Lab Cln Lec Lab ClnDH 3342 Head & Neck Anatomy 2 2 0 0 1:46 McClungDH 3242 Gen/Oral Histology 2 2 0 0 1:241:46 McClungDH 32723271 Dental Morphology 21 1 02 0 1:781:46 1:12 Wilson, EDH 3313 Clinical DH Theory I 3 3 0 0 1:241:46 VargoDH 3312 Clinical Dental Hygiene I 2 0 8 0 NA 1:4 VargoDH 3322 Oral Diagnosis 2 2 0 0 1:241:46 BeaversDH 3423 Oral Radiography I 3 2 2 0 1:241:46 1:5 MasoodDH 3513 Preventive Dentistry 3 3 0 0 1:241:46 Cunningham/

Bowers/NunnDH 4401 Periodontics I 1 1 0 0 1:781:106 Carson

TOTAL for Semester 2019 16 1210 0

Spring DH 3111

Pediatric Dentistry1 1 0 0 1:241:46 White

DH 3113 Pharmacology 3 3 0 0 1:241:46 SettleDH 31213122 Geriatric Dentistry 12 12 0 0 1:241:46 VargoDH 3422 Clinical DH Theory II 2 0 0 0 1:46 VargoDH 3323 Clinical Dental Hygiene II 3 0 0 9 1:24NA 1:4 VargoDH 3421 Oral Radiography II 1 1 0 0 1:241:46 MasoodDH 3441 Dental Mat. Science 1 1 0 0 1:241:46 1:12 Khajotia

DH 3411Applied Dental Materials 1 1 1 0 1:46 1:10 Gray

DH 3523 DH Research Methods 3 3 0 0 1:241:46 CouryDH 4421 Ethics and Jurisprudence 1 1 0 0 1:46 CunninghamDH 4501 Periodontics II 1 1 0 0 1:781:106 Weiner


4th YEARFallDH 4144 Oral Pathology 4 4 0 0 1:241

:46Houston

DH 4331 Clinical Rotation I 1 0 0 3 NA 1:5 GrayDH 4332 Dental Hygiene Process of

Care2 2 0 0 1:46 Gray

DH 4336 Clinical Dental Hygiene III 6 0 0 12 NA 1:5 GrayDH 4472 Pain Control 2 2 0 0 1:781

:1061:5 Henson

DH 4552 Comm. Health Issues 2 2 0 0 1:241:46

Cunningham/Coury

DH 4601 Periodontics III 1 1 0 0 1:781:106

Dmytryk


Spring DH 4341 Clin. Rotation II 1 0 0 3 NA 1:5 GrayDH 4442 Advanced Clinical DH

Practice2 0 0 0 1:46 Gray

DH 4446 Clinical Dent. Hyg. IV 6 0 0 12 1:241:46

1:5 Gray

DH 4411 Practice Management 1 1 0 0 1:46 CunninghamDH 4413 Senior Capstone Seminar 3 2 2 0 1:241

:46Coury, Bowers

DH 4541 Comm. Health Practicum 1 0 3P 0 NA 1:24 CunninghamP = Practicum

TOTAL for Semester 1314 43 5 15PROGRAM TOTAL 70 45 1

939

14

CLINICAL PATIENT CARE COMPETENCIES

I = Introduced C-B = Clinical Competency CDI B Patient D = Developed C-C = Clinical Competency CDI C PatientC = Clinical Competency C-D = Clinical Competency CDI D Patient

LC = Laboratory Competency Evaluation

CDHCDH

CDH CDH

SKILL III

III IV

INFECTION CONTROLUniversal precautions I-CInstrument preparation for sterilization I I-CDental unit set up I-CPATIENT ASSESSMENTExtraoral/Intraoral examination (EIE) I-CRadiograph utilization I CPeriodontal charting I D C-C C-D

TREATMENTScaling instrumentation: hand I C-B C-C C-DRoot planing instrumentation: hand I C-C C-DScaling and root planing instrumentation: ultrasonic, sonic

I CC CD

Coronal polishing I-LC C-BFluoride therapy I-CSelf-assessment of treatment procedures I-C-

BC-C C-D

Patient ergonomics I-LCOperator ergonomics I-LC

ADJUNCT PROCEDURESLocal anesthesia I/D CTopical anesthesia I/D CInstrument sharpening C D D D

/tt/file_convert/54544cf0af79592e458b68bc/document.doc

15

PROCESS COMPETENCIES

I = IntroducedD = DevelopedC = Competency

SKILL CDH I CDH II

CDH III

CDH IV

INFECTION CONTROLStandard precautions I-CInstrument preparation for sterilization

I-C

Dental unit set up I-CINSTRUMENTATIONMouth mirror I-CTU 17/23 I-CODU 11/12 I-CPeriodontal probe I-CH6/H7 scaler I-CBarnhart ½ I-CGracey 11/12 I-CGracey 13/14 I-CCoronal Polishing I-CFluoride tray/application I-C


16

SIMULATION COMPETENCIES

I = IntroducedD = DevelopedC = Competency

SKILL Oral Diagnos

is

CDH I CDH II

CDH III

CDH IV

MEDICAL HISTORYI C

DENTAL CHARTINGI C

ORAL HYGIENE INSTRUCTIONS

I C-B C-C C-D

RISK ASSESSMENT

I-CC-B C-C C-D

TREATMENT PLANNINGCDI B patient I C-BCDI C patient I C-CCDI D patient I C-DCARE OF REMOVABLE PROSTHESIS

I-CMEDICAL EMERGENCIES

I D C


17

Competencies for theEntry-Level Dental Hygienist

UNIVERSITY OF OKLAHOMA COLLEGE OF DENTISTRY

COMPETENCIES FOR THE ENTRY-LEVEL DENTAL HYGIENIST

Introduction/Definitions

Dreyfus, et al.* describe five stages from beginner to being an expert.

Stage One (Beginner) is characterized by learning facts and features relevant to a skill and acquiring the rules for determining actions. "They are rule driven, externally motivated, lack understanding of any but the surface features of what they are doing, fail unless a knowledgeable person structures nearly ideal situations and offers frequent guidance."**

Stage Two (Novice) is characterized by obtaining practical experience in concrete situations with meaningful elements. "They understand a great deal about the theory underlying what they are doing and are sometimes able to use it in combination with rules to guide behavior.

Stage Three (Competence) is characterized by a hierarchical procedure of decision making. "They are capable of independent performance. They are skilled enough to handle situations that arise under normal circumstances, understand what actions are necessary, recognize when the challenge is beyond their talents, manage tasks that are not going well, take pride in doing well, and find intrinsic reward in their own good performance."**

Stage Four (Proficiency) involves the development of intuition to use patterns without decomposing them. "Proficiency involves greater breadth and depth of understanding, and ability to handle a wider range of presenting problems."**

Stage Five (Expert) is characterized by knowing what to do based on mature and practiced understanding. This level "includes fluid and natural responses to a great range of problems. It also includes the highest level of professionalism in terms of internalized standards."*______________* Dreyfus, H.L. and Dreyfus, S. E.: Mind Over Machine. New York: The Free Press, 1986.** Chambers, D.W.: Competencies: A New View of Becoming A Dentist. Personal communication.

The entry-level dental hygienist is generally considered to be at stage three -- competency. With additional experience and perhaps additional training, he/she may progress to become a master or expert in dental hygiene. The development of competency statements is an attempt to define what knowledge, skills and attitudes the entry-level dental hygienist should possess that are a typical part of the practice of dental hygiene and able to be performed at or above an acceptable level of defined standards by entry-level dental hygienists. These then provide a standard for defining the core content of the curriculum and allowing the assessment of outcomes of our curriculum.

ORGANIZATION

DomainsThe general organization of this document (And ultimately the curriculum) is structured from the general to the more specific. Three "Domains" have been identified. These represent broad categories of professional activity and concerns which occur in the general practice of dental hygiene. By design, these categories have not been related to specific sections within the University of Oklahoma College of Dentistry Department of Dental Hygiene because that administrative structure does not reflect the delivery of oral health care. The concept of Domains is intended to encourage an eventual structure and process in the curriculum that is more interdisciplinary and less sectional. In this document, the Domains are indicated by Roman numerals (I-VI).

Major CompetenciesWithin each Domain, one or more "Major Competencies" are identified as relating to that Domain's activity or concern. A Major Competency is the ability to perform or provide a particular, but complex, service or task. For example, "The entry-level dental hygienist must be able to perform an examination that collects biological, psychological and social information needed to evaluate the medical and oral condition for patients of all ages." The complexity of this service suggests that multiple and more specific abilities are required to support the performance of any Major Competency. In this document, Major Competencies are indicated by Arabic numbers (1-20).

Supporting CompetenciesThe more specific abilities could be considered subdivisions of the "Major Competencies" and are termed "Supporting Competencies." Examples of Supporting Competencies would include "The ability to identify the chief complaint and reason for the patient's visit." or "The ability to perform a radiographic examination appropriate for the patient." Achievement of a major competency requires the acquisition and

18

demonstration of all Supporting Competencies related to that particular service or task. While less complex than a Major Competency, a Supporting Competency also requires more specific abilities which are termed "Foundational Competencies." The Supporting Competencies are listed by decimal numbering under their respective Major Competencies.

Foundational CompetenciesFoundational competency is the product of didactic and laboratory instruction which imparts the information and experiences that are prerequisite for satisfactory attainment of Supporting Competencies. Foundational ability encompass knowledge, skill and attitudes. Foundational knowledge is the ability to use information and correctly answer specific questions when asked, for example, on an examination. Foundational attitudes are positive intellectual and behavioral actions, i.e., scheduling appointments in the patient's best interest and not at the student's convenience.

The basic medical and dental sciences, behavioral sciences and clinical sciences all provide instruction at the foundational level. Didactic, small group, seminar and laboratory instruction provides information and psychomotor experiences that enable students to acquire and demonstrate competence in the clinical setting or context. The inclusion of any specific foundational competency in the curriculum should be based on the direct support of one or more of the "Supporting" and "Major" Competencies. Once a competency has been stated, it is not repeated even though it may relate to later "Major" or "Secondary" competencies as well. In time, a complete definition of the curriculum will identify all "Foundational Competencies." These "Foundational Competencies" are associated with particular "Supporting Competencies" and are listed without regard to ranking or priority. The "Foundational Competencies" are listed by decimal numbering under their respective Supporting Competencies.

SUMMARY

The worth and practicality of Competencies for the Entry-Level Dental Hygienist will depend on its acceptance and application by the faculty responsible for the dental hygiene educational mission of the University of Oklahoma College of Dentistry. In the process of defining the curriculum content, competencies also emphasize the educational philosophy that ensures new dental hygiene graduates are competent to provide whole patient care. Competencies should never be chiseled in stone, but responsive to and reflective of the educational needs of our students. Ultimately, the true measure of the value of competencies will be the quality of our graduates in the care they render to the patients they treat.

19


COMPETENCIES FOR THE ENTRY-LEVEL DENTAL HYGIENIST

I. PROFESSIONALISMThe competent dental hygiene practitioner provides skilled care using the highest professional knowledge, judgment and ability (ADHA Code of Ethics). This skilled care should be based on contemporary knowledge, and the practitioner should be capable of discerning and managing ethical issues and problems in the practice of dental hygiene. However, the practice of dental hygiene occurs in a rapidly changing environment where therapy and ethical issues are influenced by regulatory action, economics, social policy, cultural diversity and health care reform. Additionally, dental hygiene is trying to create a unique identity for the profession and increase the knowledge base. Thus, the competent dental hygienist must have regular involvement with large and diverse amounts of information in order to be prepared to practice in this dynamic environment.

1. Ethics: the entry-level dental hygienist must be able to discern and manage ethical issues of dental hygiene practice in a rapidly changing environment. Specifically, the dental hygienist must:

1.1. Apply the provisions of the Oklahoma State Dental Practice Act in dental hygiene practice.1.2 Apply the provisions of the American Dental Hygienists’ Association Code of Ethics in dental hygiene practice.1.3. Apply the principles of ethical behavior in decision-making, in interactions with patients and staff, and in personal conduct.

2. Information Management and Critical Thinking: the entry-level dental hygienist must be able to acquire and synthesize information in a critical, scientific and effective manner. Specifically, the dental hygienist must:

2.1 Recognize and use written and electronic sources of information.2.2 Evaluate the credibility and potential hazards of dental products and techniques.

2.3 Evaluate published clinical and basic science research and integrate this information to improve the oral health of the patient.2.4 Recognize the responsibility and demonstrate the ability to communicate professional knowledge verbally and in writing.2.5 Accept responsibility for solving problems and making decisions based on accepted scientific principles, as well as the

accepted standard of care.

3. Professional Identity: the entry-level dental hygienist must be concerned with improving the knowledge, skill, and values of the profession. Specifically, the dental hygienist must:3.1 Advance the profession through leadership, service activities and affiliation with professional organizations.3.2 Expand and contribute to the knowledge base of dental hygiene.3.3 Promote the values of the profession to the public and other organizations outside of

the dental profession.

II. HEALTH PROMOTION AND PREVENTIONThe dental hygienist serves the community in both practice and public health settings. Public health is concerned with promoting health and preventing disease through organized community efforts, which is an important component of any interdisciplinary approach. In the practice setting, the dental hygienist plays an active role in the promotion of optimal oral health and its relationship to general health. The dental hygienist therefore should be competent in the performance and delivery of oral health promotion and disease prevention services in the public health, private practice and alternative settings.

4. Self-Care Instruction: the dental hygienist must be able to provide planned educational services using appropriate interpersonal communication skills and educational strategies to promote optimal health. Specifically, the entry-level dental hygienist must:

4.1 Promote preventive health behaviors by maintaining optimal personal oral and general health.4.2 Identify the health needs of individuals and assist them in the development of appropriate and individualized self-care

regimens.4.3 Respect the goals, values, beliefs and preferences of the patient while promoting optimal oral and general health.4.4 Evaluate factors that can be used to promote patient adherence to disease prevention and encourage patients to assume

responsibility for health and wellness.

5. Community involvement: the entry-level dental hygienist must be able to initiate and assume responsibility for health promotion and disease prevention activities for diverse populations. Specifically, the entry-level dental hygienist must:

1. Promote the values of oral and general health and wellness to the public and organizations within and outside the profession.5.2 Identify services that promote oral health and prevent oral disease and related conditions.5.3 Assess, plan, implement and evaluate community-based oral health programs.5.4 Be able to influence consumer groups, businesses and government agencies to support health care issues.5.5 Use screening, referral and education to bring consumers into the health care delivery system.5.6 Provide dental hygiene services in a variety of settings including offices, hospitals, clinics, extended care facilities, community

programs, and schools.5.7 Discuss selected reimbursement mechanisms and their impact on the patient’s access to oral health care.

III. PATIENT CAREThe dental hygienist is a licensed preventive oral health professional who provides educational and clinical services in the support of optimal oral health. The dental hygiene process of care applies principles from biomedical, clinical and social sciences to diverse populations that may include the medically compromised, mentally or physically challenged, or socially or culturally disadvantaged.

20

6. Assessment: the dental hygienist must be able to systematically collect, analyze and accurately record baseline data on the general, oral and psychosocial health status using methods consistent with medicolegal principles. Specifically, the entry-level dental hygienist must be able to:

6.1 Obtain, review and update a complete medical, family, psychological, and dental history, including assessment of vital signs, and be able to record the findings.6.2 Recognize the patient record as a legal document and maintain its accuracy and consistency.6.3 Recognize medical conditions and medications that require special precautions or consideration prior to or during dental

hygiene treatment.

6.4 Identify the patient at risk for a medical emergency and be prepared to handle the emergency should it occur during an appointment.

6.5 Perform an extraoral & intraoral examination and record the findings.6.6 Perform an examination of the teeth and accurately record the results.6.7 Recognize need for & obtain radiographs of diagnostic quality.6.8 Radiographically distinguish normal from abnormal anatomical findings.6.9 Evaluate the periodontium and identify conditions that compromise periodontal health and function.6.10 Identify conditions and diseases that affect dietary intake and food selection, and recognize risks and benefits of alternative

food patterns.6.11 Analyze and interpret the data related to and congruent with the diagnosis of the dentist and other health professionals.6.12 Utilize, interpret and analyze appropriate indices for patient assessment.6.13 Assess and analyze patient risk factors that may impact dental hygiene care.

7. Planning: the dental hygienist must be able to discuss the condition of the oral cavity, actual and potential problems identified, etiological and contributing factors, as well as recommended and alternative treatments available. Specifically, the entry-level dental hygienist must be able to:

7.1 Use critical decision-making skills to reach conclusions about the patient’s dental hygiene needs based on all available assessment data including:

7.1.1 Use of assessment findings, etiologic factors, clinical and other diagnostic data in determining a dental hygiene diagnosis.

7.1.2 Identification of patient needs and significant findings that impact the delivery of dental hygiene care.7.2 Determine priorities and establish oral health goals with the patient/family and/or guardian as an active participant.7.3 Using a problem-based approach establish a planned sequence of educational and clinical services based on the diagnosis.7.4 Communicate the plan for dental hygiene services to the dentist or other interdisciplinary health team members to determine its

congruence with the overall plan for oral health care.7.5 Communicate the plan for dental hygiene services to the patient, including its congruence with the overall plan for oral health

care.

8. Implementation: the dental hygienist must be able to provide treatment in compliance with the overall treatment plan that includes preventive and therapeutic procedures to promote and maintain oral health and assist the patient in achieving oral health goals. Specifically, the entry-level dental hygienist must be able to:

8.1 Evaluate and utilize methods to ensure the health and safety of the patient and the dental hygienist in the delivery of dental hygiene care.

8.2 Apply basic and advanced principles of both hand and powered dental hygiene instrumentation to locate and remove deposits without undue trauma to hard and/or soft tissue:8.2.1 Compare/contrast use of hand & powered instruments;8.2.2 Identify indications and contraindications for sonic and ultrasonic use;8.2.3 Identify appropriate instrument and/or insert for task;8.2.4 Demonstrate finger rests & fulcrums for use of hand instruments;8.2.5 Demonstrate placement, adaptation, angulation and working strokes with hand instruments;8.2.6 Appropriately utilize explorers, curettes, scalers, and other suitable hand instruments;8.2.7 Demonstrate finger rest modifications for powered instruments;8.2.8 Utilize standard ultrasonic or sonic insert for removal of heavy calculus;8.2.9 Utilize modified ultrasonic inserts for subgingival debridement and root planing.

8.3 Control pain and anxiety during treatment through the use of accepted clinical techniques and appropriate behavioral management strategies, including, but not limited to:8.3.1 administration of local anesthesia8.3.2 application of topical anesthesia

8.4 Select and administer appropriate chemotherapeutic agent and provide pre- and post-treatment instructions.8.4.1 subgingival irrigation technique8.4.2 use of site specific delivery vehicle systems8.4.3 professional and home fluoride therapy

8.5 Provide adjunct dental hygiene services that can be legally performed including, but not limited to:8.5.1 application of pit and fissure sealants8.5.2 cleaning of removable prostheses and insertion8.5.3 placement of temporary restoration8.5.4 care and maintenance of restorations8.5.5 selective coronal polishing8.5.6 taking impressions8.5.7 providing health education and preventive counseling

21

8.5.8 providing nutritional counseling related to oral conditions and/or disease

22

8.6 Describe experiential adjunct procedures8.7 Implement and evaluate measures to minimize occupational hazards in the work place, including postural and engineering

factors, such as equipment and instrument design.

9. Evaluation: the dental hygienist must be able to evaluate the effectiveness of planned clinical and educational services and modify as necessary.Specifically, the entry-level dental hygienist must be able to:

9.1 Determine the outcomes of dental hygiene interventions (re-evaluation) using indices, instruments, examination techniques and patient self-report.

9.2 Evaluate the patient’s satisfaction with the oral health care received and the oral health status achieved.9.3 Provide subsequent treatment based on evaluation findings.9.4 Develop and maintain a continuing care program.

ACKNOWLEDGMENTSThis document is based on work previously completed at the University of Oklahoma College of Dentistry, as well as that carried out by several other schools of dentistry, including the University of California, Los Angeles; Baylor College of Dentistry; SUNY at Buffalo; University of Puerto Rico; The University of Texas Health Science Center at San Antonio; and the University of the Pacific, as well as the AADS document, Competencies for Entry into the Profession of Dental Hygiene.

The Commission on Dental Accreditation will review complaints that relate to a program’s compliance with the accreditation standards. The Commission is interested in the sustained quality and continued improvement of dental and dental-related education programs but does not intervene on behalf of individuals or act as a court of Appeal for individuals in matters of admission, appointment, promotion or dismissal of faculty, staff or students.

A copy of the appropriate accreditation standards and/or the Commission’s policy and procedure for submission of complaints may be obtained by contacting the Commission at 211 East Chicago Avenue, Chicago IL 60611 or by calling 1-800-621-8099 extension 2719.

23

Clinical Competencies by Student Level

Pre-Clinic I*Dental Charting*Medical HistoryInfection ControlMultiple Instrument CompetenciesRubber Cup PolishingFluoride TrayOral Inspection and Recording (EIE)Instrument Sharpening

Clinic IICalculus Removal on CDI BPlaque Removal Patient Education for basically healthy periodontal and dental patients (OHI)*Treatment Planning – CDI B patient*Care of Removable Prosthesis*Medical Emergencies

Clinic III*Treatment Planning - CDI C patientPeriodontal Charting on CDI C patient Calculus Removal and Root Planing on CDI C patientUltrasonic Scaling

Clinic IVPeriodontal Charting on CDI D patient Calculus Removal and Root Planing on CDI D patient*Treatment Planning - CDI D patientLocal Anesthesia

*Competency determined by written examAll other competencies examined by clinical exam

24

SECTION V

HEATLTH ISSUES

25

ANTIBIOTIC PREMEDICATION GUIDELINESCurrent AHA Recommendations for Antibiotic Premedication for Prevention of

Subacute Bacterial Endocarditis (SBE)

I. CARDIAC CONDITIONS ASSOCIATED WITH ENDOCARDITIS

Endocarditis Prophylaxis Recommended

High risk category

Prosthetic cardiac valves, including bioprosthectic and homograft valves Previous bacterial endocarditis Complex cyanotic congenital heart disease (eg. single ventricle states, transposition of the

great arteries, tetralogy of Fallot) Surgically constructed systemic pulmonary shunts or conduits

Moderate-risk category

Most other congenital cardiac malformations (other than above and below) Acquired valvular dysfunction (eg, rheumatic heart disease) Hypertrophic cardiomyopathy Mitral valve prolapse with valvular regurgitation and/or thickened leaflets*

Endocarditis Prophylaxis NOT Recommended

Negligible-risk category (no greater risk than the general population)

Isolated secundum atrial septal defect Surgical repair of atrial septal defect, ventricular septal defect, or patent ductus arteriosus (without residual beyond 6 mos) Previous coronary artery bypass graft surgery (CABG) Mitral valve prolapse without valvular regurgitation* Physiologic, functional, or innocent heart murmurs* Previous Kawasaki disease without valvular dysfunction Previous rheumatic fever without valvular dysfunction Cardiac pacemakers (intravascular and epicardial) and implanted defibrillators

II. DENTAL PROCEDURES and ENDOCARDITIS PROPHYLAXISIII.

Endocarditis Prophylaxis Recommended*

Dental extractions Periodontal procedures including surgery, scaling and root planing. probing. and recall maintenance Dental implant placement and reimplantation of avulsed teeth Endodontic (root canal) instrumentation or surgery only beyond the apex Subgingival placement of antibiotic fibers or strips Initial placement of orthodontic bands but not brackets Intraligamentary local anesthetic injections Prophylactic cleaning of teeth or implants where bleeding is anticipated

Endocarditis Prophylaxis NOT Recommended

Restorative dentistry (operative and prosthodontic) with of without retraction cord Local anesthetic injections (nonintraligamentary) Intracanal endodontic treatment; post placement and buildup Placement of rubber dams Postoperative suture removal Placement of removable prosthodontic or orthodontic appliances Taking of oral impressions Fluoride treatments Taking of oral radiographs Orthodontic appliance adjustment

26

Shedding of primary teeth

27

*Prophylaxis is recommended for patients with high- and moderate-risk cardiac conditions.This includes restoration of decayed teeth (filling cavities) and replacement of missing teeth.Clinical judgment may indicate antibiotic use in selected circumstances that may create significant bleeding

IV. PROPHYLACTIC REGIMENS for DENTAL PROCEDURES

Situation Agent Regimen

Standard general prophylaxis Amoxicillin Adults: 2.0 g; children: 50mg/kg orallyPO 1 hour prior to procedure

Unable to take oral meds Ampicillin Adults: 2.0 g; children: 50 mg/kg IM/IV1 hour prior to procedure

Allergic to penicillin Clindamycin Adults: 600 mg: children: 20 mg/kg Cephalexinm or Adults: 2.0 g; children 50 mg/kg

Cefadroxil Adults: 2.0 g; children 50 mg/kgPO 1 hour prior to procedure

Azithromycin or Adults: 500 mg; children 15 mg/kg Clarithromycin PO 1 hour prior to procedure

Allergic to penicillin Clindamycin or Adults: 600 mg; children: 20 mg/kg IVand unable to take Cefazolin Adults: 1.0 g; children 25 mg/kg IM or IVoral medication 30 min prior to procedure

*Total children's dose should not exceed adult dose.†Cephalosporins should not be used in individuals with immediate-type hypersensitivity reaction (urticaria, angioedema, or anaphylaxis) to penicillins

OTHER CONDITIONS REQUIRING ANTIBIOTIC PREMEDICATION PRIOR TO DENTAL HYGIENE TREATMENT:

Previous use of Fenfluramine o Ponderal, Pondimin

Previous use of Dexfluramineo Redux

Previous joint infection Shunts (stents are acceptable) Immunosuppressed Uncontrolled diabetes (Type 1) Malignancy Malnourished

References

Prophylactic regimens for dental, oral, respiratory tract or esophageal procedures.Reference: JADA, August 1997, Volume 128, page 1148

Cardiac conditions for which prophylaxis is or is not recommended.Reference: JADA, August 1997, Volume 128, page 1145

Dental procedures and endocarditis prophlaxis.Reference: JAMA, June 1997, Volume 277, #22, page 1794

Antiobiotic prophylaxis for dental patients with total joint replacements.Reference: JAMA, June 1997

Dietary weight loss supplementsReference: AHA, 1998. www.americanheart.org

ADA Statemetn on HHS warning to former Phen-Fen Users, July 1998www.org/prac/position/phen-fen.html

Advisory Statement Antibiotic Prophylaxis for Dental Patients with Total Joint Replacements, Reference: JADA, July 2003

28

http://www.org/prac/position/phen-fen.html

http://www.americanheart.org/

PROTOCOL FOR PRE-MED PATIENTS at OUCODRev 7/06

REMEMBER: **If a patient has taken antibiotic pre-medication, they may not be rescheduled for appointment #2 for 9-14 days.

ASK ALL PATIENTS IF THEY NEED PREMED, just to verify, when you are scheduling an appointment AND confirming.

IF A PATIENT NEEDS A PRESCRIPTION CALLED INRequest chart, give to Linda Hale with note attached requesting premed and Director of Clinic Operations will call it in. Then, call the patient & inform them that the prescription awaits them.

IF PATIENT ARRIVES WITHOUT TAKING PRE-MEDGo to OD with chart, ask for antibiotic, get chart signed by OD faculty. Dispense medication to your patient. Proceed with NON-INVASIVE treatment, waiting a minimum of 1 HOUR before probing.

IF THERE ARE NO FACULTY IN OD, go to GOLD CLINIC. Request antibiotic from dispensary personnel, have faculty in Gold Clinic sign the log book AND sign patient chart.

29

OUCOD Hypertension GuidelinesNovember 12, 2003

The Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure has issued new guidelines for classification of hypertension for purposes of prevention and management, as of May 2003.

BP Scheme for Adults

Normal systolic BP < 120 and diastolic BP < 80

Pre-hypertension SBP 120-139 or DBP 80-89

Stage 1 hypertension SBP 140-159 or DBP 90-99

Stage 2 hypertension SBP > 160 or DBP> 100

For patients with hypertension, the basic BP control target is <140/<90, but the target is <130/<80 for patients with diabetes or renal disease.

PRESSURE RANGE OUCOD DENTAL THERAPY CONSIDERATIONS

<120 Routine dental management. Recheck every recall.<80

120-139 Routine dental management. Recheck on subsequent visits.80-89 Stress reduction protocol if indicated. Refer to physician if

in this range for 3 consecutive appointments.

140-159 Recheck in 5 minutes. If still elevated, other factors (age, apparent 90-99 health, apprehension, history or hypertension, etc) will determine

if dental treatment is possible at this time or medical referral is necessary.

160-180 Recheck in 5 minutes. If still elevated, medical consult prior 100-110 to dental treatment is indicated. After medical clearance,

routine dental care with indicated stress reduction.

>180 Recheck in 5 minutes. Immediate medical consultation if still 110 elevated. No dental therapy until elevated blood pressure under

ccontrolontrol

30

EMERGENCY PROCEDURES

Medical Emergencies in the Dental Office:

The student is expected to:

1. Perform prophylactic procedures for preventing emergencies prior to treatment at each appointment (or ascertain that this has been accomplished) including:

A. Always review the medical/dental history. B. Always perform a general assessment of patient. C. Always check vital signs when indicated by COD blood pressure protocol.

2. Evaluate and identify symptoms of medical emergencies which may occur in the dental office including:

A. Circulatory emergencies

1. syncope2. shock3. toxic reaction4. cardiac arrest5. angina pectoris6. acute myocardial infarction7. postural hypotension

B. Neurologic disturbances

1. seizures2. cerebrovascular accident (stroke, CVA)

C. Allergic reactions

1. anaphylaxis2. allergic reaction to penicillin3. acute asthmatic attack

D. Metabolic disease

1. diabetic hypoglycemia2. diabetic hyperglycemia3. acute adrenal insufficiency4. thyroid storm5. myxedema coma

E. Respiratory disturbances

1. hyperventilation2. airway obstruction3. acute pulmonary edema

31

PROTOCOL for LIFE THREATENING EMERGENCIES at OUCOD

1. Summon aid immediately without alarming the patient or other patients. Notify clinic faculty. They will remain with your patient and institute basic life support if needed.

2. The clinic faculty will:

a. send someone to retrieve AED.b. send someone to the 1st floor main entrance to meet the EMS.c. direct someone to call Oral Surgery x 1-4079d. direct patient’s student to call 14911 (DO NOT call -16326) e. campus police will connect you to the EMS

1. identify yourself2. identify the college3. give floor number4. give name of clinic5. remain on telephone until EMS arrives

NOTE:Students are required to achieve certification in CPR in the fall of the junior and senior year.

EMERGENCY NUMBERS are posted in clinic next to telephone.

Campus police 1-4911Oral Surgery 1-4079 or 1-4441Ambulance 1-4911Fire 1-4911Poison Control 1-5454Exposure, needlestick/injury

Kathan Kent 1-3083; (M) 206-3978Infection Control Office 1-3083Patient aspiration foreign object 1-3083Kathan Kent pager 9-660-7656

Equipment

Emergency drugs and equipment shall be readily available in assigned location in the clinic area. This emergency kit shall be currently equipped and organized to provide treatment for unconsciousness, respiratory difficulty, seizures, drug-related emergencies, chest pain and cardiac arrest.

Personnel

All clinic faculty and students will be certified to perform basic life support and cardiopulmonary resuscitation. This certification will be renewed annually. Emergency drugs and equipment must be available in the dental clinic. Most emergency situations will not require drug administration; however, emergency drugs may prove to be life-saving on some occasions.

Eye Station

In the event a foreign body gets into the eyes, an eye station is available for emergency care. The station is centrally located and attached to a sink. The eye station is marked for easy detection. Students are taught the use of this station. All incidents of injury should be reported to the Clinic Coordinator.

Chemical Burns

32

The accidental contact of strong acids or alkalines to skin produces changes that are very similar to those resulting from heat. It is important, however, to ascertain in all cases of chemical burns the nature of the offending material so that intelligent treatment may be given. Acid burns may be neutralized with a mild alkaline (e.g., 5% sodium bicarbonate solution), while alkaline burns may be rinsed with weak acids (vinegar - 3% acetic acid). Washing the burned area with a generous amount of water is preferable followed by the placement of a sterile dressing.

SAFETY PROTOCOL FOR CLINICS & LABORATORIES

l. Students and faculty will observe all precautions noted in the section on Asepsis and according to the COD Hazard Communication document.

2. Gloves (clinic or utility), masks and protective eyewear (barrier technique) will be worn when handling potentially hazardous materials or equipment. Materials/equipment will be appropriately labeled as to type of hazard. (i.e. caustic, abrasive, corrosive).

3. Students and faculty, staff and patients will observe radiation safety guidelines. Adequate shielding (walls and lead aprons) and distance will be maintained when exposing radiographs in order to protect clinician, faculty, staff and patients as specified in section on Radiation Guidelines.

4. An eyewash station is located in a central clinic location. All students must demonstrate ability to operate eyewash during orientation to clinic (Spring, Junior Year).

5. Avoid injury with sharp instruments and needles.

A. Handle sharp items carefully. B. Do not bend or break disposable needles. C. All sharp items are to be placed in an appropriate puncture-resistant container. D. If needles are not recapped, place in a separate area. If recapping is necessary, use a method that protects hands from injury.

6. In the event of an injury with a sharp item, the incident must be reported to Kathy Kent, infection control office (ICO), at X13083

33

OUCODCOUMARIN THERAPY PROTOCOL

Fall 2006

Each patient should be considered on a case-by-case basis. Consult regarding INR:

If INR 3.5 or less, most surgical procedures can be performed (like perio surgery and extractions) with no modifications.

Local measures may be instituted to control blood loss, including gauze pressure, Gelfoam, CollaPlug, Surgicel, Bone wax, tranexamic acid and some others.

However, this should only be necessary when major invasive events have occurred.

Generally there is no need to stop or alter anticoagulant therapy for most dental procedures.

For those (again, major) in which it is necessary, low molecular weight heparins are available to bridge the gap between cessation of Coumadin and starting it again post-op. This is a physician's call, not the dentist's.

The AAP's official position is no treatment modification is indicated in patients with an INR of 3.5 or below, and implementation of local hemostatic agents is encouraged.

So, ideally, you should know the patient's most recent INR (like within the last month or so). However, that is sometimes difficult to find out easily.

Having said all this, if a patient is on 2.5 mg of Coumadin per day, they are more than likely going to be within the recommended INR range. If they are taking 5 mg, they are probably still okay, although bleeding may need to be controlled with local measures.

At a dose of 10 mg, you should definitely have a physician recommendation, as the INR will probably be above 3.5.

Recommendations for restorative procedures, simple exodontia and scaling/root planing would call for the patient to continue their anticoagulant medication.

34

SECTION VI

CLINIC FORMS

35

Patient Name: Chart No.

Date: Fee Form Number:

Procedure Numbers: Last FMX: Last BWX: Last Prophylaxis: Last Caries:

Med Hx: ALERT /

MEDS:

Chief Complaint:

Vitals: BP : 5 Min retake: Pulse: RPM: PTP:

EIE:

Risk Assessment:

Nutritional Assessment/counseling

Tobacco Cessation

Periodontal Assessment:

OHI:

CDI: Plaque Index: Bleeding Index: Occlusion: R L Overbite: Overjet: Radiographs Taken: None

2 BWX

4 BWX

PAX #

Other

TX:

Dental Tx Recommendations:

DH Faculty:

Examining Dental Student: Dental Faculty:

Reviewed by Associate Dean for Clinics Date: HSC-7520 rev 06/06

Expected CDI

A B C D

Recall Interval3mrc 4mrc 6mrc

DH RECALL EXAMINATION

Expected CDI Recall Interval

Patient Name: Chart #

Date Procedure Number

Fee Form Number

Tooth Number

Surface(s) or Area

Each entry must be complete and have signature of student/faculty

UNIVERSITY of OKLAHOMA COLLEGE OF DENTISTRYDepartment of Dental Hygiene

CLINICAL EVALUATION FORMSTUDENT PTP (1) PTP (2) PTP (3) PTP (4) PTP (5) PTP (6)

PATIENT Age MC CDI # Teeth Tx. Complete Date CI:

ASSESSMENT CLINICAL ADJUNCT SERVICES PTP/HHx A ND Instrumentation A ND Desensitization A NDEIE A ND Ultrasonic Use A ND Restoration Care A NDDental Evaluation A ND Plaque Removal A ND Care of Prosthesis A NDPeriodontal Evaluation A ND Re-eval/CCM A ND Chemotherapeutics A NDDH Dx/CDI A ND Instrument Care A ND Sealants A NDRisk Assess/Pt Education A ND Infection Control A ND Implant Care A NDTreatment Plan A ND Ergonomics A ND Pain Management A NDPatient Management A ND Time Mgmt A ND Experiential A NDDocumentation A ND Professionalism A ND Nutritional Assess/counsel A ND Radiographs A NDTobacco Cessation A ND

CI CI Date Date Errors Errors A/ND A/ND

CI CI Date Date Errors Errors A/ND A/ND

FACULTY COMMENTS:

REQUIREMENTSAir Polish Bleaching B Comp Scaling C Comp Scaling Cor Polish Comp Calc charting D Comp Scaling Desens/Chemo Impressions Local AnesthesiaPSA IO MSA IA ASA Mental GP Infil NP Other Nitrous

32 31 30 29 28 27 26 25

24 23 22 21 20 19 18 17

1 2 3 4 5 6 7 8

9 10 11 12 13 14 15 16

CLINIC SITE:

Quad 1

Quad 4

Quad 3

Quad 2

S=Supra D=Definite Sub R=Roughness sub T=Tissue Trauma

P=Plaque St= Stain

TOTAL CLINICAL RESULTS EVALUATION of all 4 quads (A, B or C pts)

: A or ND

HSC-7397 rev 06/06

Faculty UNIVERSITY of OKLAHOMACOLLEGE OF DENTISTRY

DEPARTMENT of DENTAL HYGIENE

CLINIC SIGN UP SHEET

Student Chair Number Time Service Needed

DENTAL HYGIENE CARE ONLY

In the event that I am not accepted for complete dental treatment by the College of Dentistry, I would still like to have my TEETH CLEANED (dental hygiene treatment) by dental hygiene students of the University of Oklahoma College of Dentistry.

I, __________________________________________________________, consent Print First MI Last Name

to have my teeth cleaned at the University of Oklahoma College of Dentistry and:

A. understand that after this care I must seek to have other dental work completed by a private dentist.

B. shall in no way hold the College of Dentistry or any of its faculty, staff, or students responsible for my failure to obtain dental treatment.

C. authorize the administration of local anesthetics or medications deemed necessary for completion of dental hygiene treatment.

D. authorize the taking of x-rays or photographs as deemed necessary for dental

hygiene treatment.

____________________________Signature of Patient

____________________________Date

HSC 7444 rev 6/06

DENTAL HYGIENE CASE DIFFICULTY INDEX (CDI)

PATIENT ___________________________________ DIRECTIONS: 1. Circle value for finding(s) in each categoryDATE ______________________________________ 2. Add point values to determine index ratingSTUDENT ___________________________________ 3. Use Classification Index below

Group 1: Periodontal Classification Group 2: Localized or Generalized Active

Group 3: Supra Calc

Group 4: Sub Calc

None 0 None 0Lower anteriors only-light 1 Isolated spicules 3Anteriors & molars 2 Generalized spicules 6Heavy or bridged 3 Generalized spicules

& isolated ledge(s) 9

Generalized ledges 12

Health 0 0Gingivitis 1 1Periodontitis - Slight 1 2Periodontitis - Moderate 2 3Periodontitis - Severe 3 4

NUG or NUP 1 2

011111

CASE DIFFICULTY INDEX KEY

0-4 Points =Class A 5-10 Points =Class B11-15 Points =Class C16-20 Points =Class D >20 Points =Class E

1234

CDICDI

DENTAL HYGIENE CASE DIFFICULTY INDEX (CDI)

PATIENT ___________________________________ DIRECTIONS:1. Circle value for finding(s) in each category

DATE ______________________________________ (only 1 in Groups 1-4, up to 3 in group 5)2. Add point values to determine index rating

STUDENT ___________________________________ 3. Use Classification Index below

NOTE: Localized: <30% of sites Generalized: >30% of sites

Group 1: Periodontal Health/ Disease Classification Group 2: Disease Status

Localized or Generalized Active Stable (Inactive)

Group 3: Supragingival

Calculus Group 4: Subgingival Calculus

Group 5: Other Difficulty FactorsExamples of “Other” Difficulties (√

max of 3)


Health 0 0

Gingivitis 1 1

Chronic Periodontitis - Slight 1 2

Chronic Periodontitis - Moderate 2 3

Chronic Periodontitis - Severe 3 4

NUG or NUP 1 2

0 01 01 01 01 01 0

None 0Isolated spicules – anterior OR posterior(definite click when explored) & RP prn

1 2 3

Generalized spicules & RP prn 6Generalized spicules with isolated random ledge(s) & RP prn 9Generalized ledges in each quadrant &

RP prn

12

None 0Veneer only, lower anteriors onlyVeneer is visible, but thin (< 1mm)

1

Veneer only, anterior & posterior 2

Anterior crustaceous – has thickness ( > 1mm)

2

Anterior & posterior crustaceous 3

Intrinsic, or in deposit, or light isolated stain

0

Generalized medium-heavy stain 1

Tooth hypersensitivity 1

Less than 5 teeth/quad=minus 1 point/quad

-1 -2 -3 -4

“Other” (requires faculty initials) maximum of 3

1 2 3

QuickTime™ and aTIFF (Uncompressed) decompressor

are needed to see this picture.

Overhanging margins Crown & Bridge Tongue issues Loquacious Gingival enlargement Anxiety Behavior Dilemma Patient positioning Excessive hemorrhage Caries Hyperactive gag reflex Other

TotalsOther (CI initial)

CDI Total


CDI

CASE DIFFICULTY INDEX KEY

0- 4 Points =Class A 5-10 Points =Class B 11-15 Points =Class C 16-20 Points =Class D >20 Points =Class E

12345

CI Verification

Date__________________

Patient Name____________________

Chart number______________

In order to fulfill our mission to provide optimum educational experiences for students, the College of Dentistry must release patients from the program that no longer meet the educational requirements we must provide. The College of Dentistry is a teaching institution and patients remain in the care of the College as long as their dental treatment needs have educational value.

According to the College of Dentistry Clinic Operations policy, patients will receive recall care for one year after their dental care has been completed and then they will be released from the program to pursue care in private practice. Our records indicate that you have received recall care for one year after it was determined that your dental care had been completed. Patients whose treatment is considered complete cannot be re-screened to return to the program.

At this time, you are being released from the College of Dentistry dental program and it is strongly recommended that you seek continuing oral health care in a private practice. We have appreciated your willingness to participate in the education of dental and dental hygiene students at the College of Dentistry. Your confidence in our abilities to provide for your oral health care needs and your commitment to the program have also been greatly appreciated.

Respectfully,

Jeanne Panza, D.M.D. Kathryn F. Miller, R.D.H., B.S.Assistant Dean for Clinics Clinical Associate ProfessorDirector of Clinics Assistant Director of Clinics

_________________________Patient Signature


DENTAL HYGIENE PATIENT SURVEYThe University of Oklahoma

College of Dentistry Department of Dental Hygiene

HOW ARE WE DOING?The Oklahoma University College of Dentistry (OUCOD) Dental Hygiene Department is dedicated to providing highest quality oral health care to our patients. What you think of our services is very important to us in meeting our goal of quality care. Individual answers are confidential. Please take a few minutes to complete this survey and return it to your dental hygiene student. Thank you for helping us make the OUCOD a better place to receive dental hygiene care.

Please check the box that best describes your opinion using the following key:4 = Strongly agree 3 = Agree 2 = No opinion 1 = Disagree 0 =

Strongly Disagree

4 3 2 1 01. I received professional and competent care by the dental hygiene student. Add name if you can ______________________________________________________

2. School policies were made clear to me.

3. The student seemed organized and efficient.

4. The student thoroughly informed me of the status of my oral health.

5. I was able to contact my dental hygiene student if needed

6. The student explained what was going to happen before each procedure.

7. The student made me feel protected from catching a disease or infection.

8. The student discussed treatment costs with me.

9. The student kept discomfort to a minimum.

10. At the completion of treatment, the student informed me of when I needed to return for continuing care.

11. The instructor treated me with courtesy and respect. Add the name if you can _______________________________________________________.

12. I will refer my friends and/or family to this clinic.

The following questions are optional and individual answers will be kept confidential.

Age:_________ Gender: Male Female

Race/Ethnic Background:a. White/Caucasian d. Hispanicb. Black e. Orientalc. Native American f. Other

Please circle the letter that includes your family income level:8 less than $16, 000 per year9 between $16, 001 and 49, 999 per year


Clinical Site:

10$50,000 or more per year

E. Please circle the letter that indicates the highest level of education you have completed?1. less than high school 4. Associate degree2. high school 5. Baccalaureate degree 3. some college or trade school coursework 6. Graduate degree

Thank you very much for your time and assistance!


UNIVERSITY of OKLAHOMACOLLEGE of DENTISTRY


NAME:

DATE:

TIME of APPOINTMENT:

This patient was treated in our clinic as noted. Please excuse this absence.

Sincerely,

Clinical FacultyDepartment of Dental HygieneHSC 7442 rev 6/06





NAME:

DATE:



Sincerely,




NAME:

DATE:



Sincerely,




NAME:

DATE:



Sincerely,




NAME:

DATE:



Sincerely,




NAME:

DATE:



Sincerely,




NAME:

DATE:



Sincerely,




NAME:

DATE:



Sincerely,




NAME:

DATE:



Sincerely,


UNIVERSITY OF OKLAHOMACOLLEGE OF DENTISTRY

DEPARTMENT OF DENTAL HYGIENEROTATION REPORT FORM

Student _________________________________ Date ______________

Patient __________________________________ Chart # ROTATION SITE

VAMC ImplantologyGraduate Periodontics Good Shepherd MissionTinker Air Force Base Junior Dental Hygiene ClinicPediatric Dentistry Geriatric RotationOral Diagnosis Senior Dental Hygiene ClinicOther: (List)___________

CLINICAL SERVICES PROVIDED

Alginate ImpressionsAmalgam Polishing, Removal of Overhang: Tooth #(s) _____________Assist Dental Hygiene Student: Procedure: ______________________Assist Dental Student or Dentist: Procedure: _____________________Desensitization: Tooth #(s) _____________Diet CounselingLocal Anesthesia: Type and site ______________________________Nitrous Oxide SedationRemovable Prosthesis Care: Type ___________________________Rubber Dam PlacementSealant Placement: Tooth #(s) _____________Temporary RestorationOther: List_____________

COMMENTS:

Faculty/Staff Signature

OU 5002 53

Date: _________ Examining Faculty: ______________________Contact Number____________

OU College of Dentistry Dental Hygiene ProgramDaily Periodic Exam Schedule

ExamComplete Student Name

Chair Number

Patient Name Chart NumberDate of Last

ExamPatient Requires1YR 2 YR

Signature Examining Faculty: ______________________________

Signature Hygiene Faculty:_______________________________

Date: _________ Examining Faculty: ______________________Contact Number____________

OU College of Dentistry Dental Hygiene ProgramDaily Periodic Exam Schedule

ExamComplete Student Name

Chair Number

Patient Name Chart NumberDate of Last

ExamPatient Requires1YR 2 YR

Signature Examining Faculty: ______________________________

Signature Hygiene Faculty:_______________________________

OU 5002 54

INSTRUCTIONS FOLLOWING ROOT PLANING

PROCEDURE: Root planing is a procedure whereby the roots of the teeth are cleaned and smoothed, even below the gumline, to remove deposits of plaque, calculus (tartar) and other irritants which contribute to your periodontal disease. Root planing combined with your daily effective plaque control should improve your periodontal condition.

MOUTHRINSES: Following the appointment, you may rinse with warm water, or warm salt water (1 tsp. to 8 oz of warm water). You may rinse as often as you feel is necessary. Rinsing will help keep your mouth clean and promote healing. Use any prescribed mouthrinse as directed.

ORAL HYGIENE: Brush very thoroughly, but gently, as you have been directed. Follow any additional plaque control measures that you have been shown. A clean mouth heals faster.

BLEEDING: You may notice some blood clots or minor oozing of blood immediately following the appointment. Do not attempt to wipe the clots away. Continue to clean your mouth as instructed. The gums may even bleed slightly for a few days but this is normal and should gradually decrease over time. If heavy bleeding occurs, please call.

DISCOMFORT: There may be some discomfort following root planing for a day or two. If necessary, you make take a mild pain medication that you normally take for a headache (such as Tylenol). If pain is persistent, please call. Occasionally, an abscess will occur. You may also notice sensitivity to cold, heat and certain foods (such as sweets) but this should gradually diminish. Good plaque control will help, but please advise us if the sensitivity persists.

ANESTHETIC: If a local anesthetic was used during your appointment, be careful that you do not bite your lips or tongue if they are numb. The numbness will last approximately 1-4 hours.

ADDITIONAL INSTRUCTIONS:

PHONE NUMBER:OU 5002 55

NEXT APPOINTMENT:

HSC 7430

OU 5002 56


LOCAL ANESTHESIA WORKSHEET

Student Name __________________ Date ___________Patient Name __________________ Chart #__________

Procedure Area _______________________________

Type of Injection _______________________________

Nerve(s) Anesthetized _______________________________

Type of Anesthetic _______________________________

Volume of Anesthetic _______________________________

Medical History Considerations _______________________________

Evaluation of Technique: A/ND

Comments:

________________________________________________________________________________________________________________________________________________

Number of Injections Tooth Number(s) or Quadrant(s)

_____ PSA _____________ MSA _____________ ASA _____________ Nasopalatine _____________ Greater Palatine _____________ Infraorbital _____________ Inferior Alveolar & LB _____________ Infiltration _____________ Incisive/Mental ________

Faculty Signature ___________________ Date ___________

OU 5002 57

SECTION VII

SENIOR COMPETENCIES

& CLINICAL

EVALUATION FORMS

OU 5002 58

OU 5002 59

UNIVERSITY of OKLAHOMA COLLEGE of DENTISTRYDepartment of Dental Hygiene

CALCULUS CHARTING EXERCISE

STUDENT: CI: KEY:SCORE: DATE:

Objective : Using the ODU 11/12 explorer and mirror, direct vision, transillumination, radiographs and compressed air, the student will chart one quadrant of a CDI “C” or “D” patient on the chart below using the criteria in the key with 80% accuracy.

Procedure: Student requests permission from CI to verify qualifying patient. CI may provide guidance & direction in

patient selection. CI assigns one quadrant with a minimum of 10 clicks of calculus. Student records amount of calculus present on each of 4 surfaces (M, D, F, L) using key. CI evaluates while student reads values and marks out incorrect values in RED. CI calculates score. Total correct/total possible

Evaluation: 80% accuracy

OU 5002

0=SMOOTH SURFACE

1=GRANULAR, LIGHT CALCULUS, OR SMOOTH BURNISHED

2=SPICULE(S), MODERATE CALCULUS

L

FACIAL

FACIAL

9 1 1

1

222 122 12 2 33

QuickTime™ and aTIFF (Uncompressed) decompressor

are needed to see this picture.

60

OU 5002 61

Student Date CI

CLASS ‘B’ ‘C’ ‘D’

SCALING or POLISHING

COMPETENCY EVALUATION SUMMARY

SCALING EVALUATION / + =

Formula: Number of removed deposits + Self-Assessment Points/Total # Deposits

POLISHING EVALUATION / + =

Formula: Number of removed deposits + Self-Assessment Points/Total # Deposits

HSC 7428 Rev 06.06

OU 5002 62

UNIVERSITY of OKLAHOMA COLLEGE of DENTISTRY

Department of Dental Hygiene

CRITERIA & PROCEDURE for SCALING COMPETENCY

complete 5 “C” pts generalized calculus 18 minimum clicks subgingival calculus 25 maximum clicks CI cursory exam to be followed up by CI with

complete calculus charting if acceptable for competency) check in by 1 CI check out by 1 part time CI and 1 full time CI student to do self-assessment

Criteria for Competency Patients:It is recommended that 5 “C” patients be completed prior to the Competency Exam. May be amended by Clinical Instructor.

CDI C Competency: 6 points must come from Group 4 (Subgingival Calculus) for patient acceptability as a competency patient

If a “D” patient is selected for the exam, only one or two quads will be evaluated. An additional 5 points will be added to the final grade. No “E” patients are to be used for the Competency Exam.

Students

1. inform the instructor that a competency exam is to be performed. This should be done as soon as the student determines that the patient is an

acceptable candidate for a competency.

2. proceed with appointment as usual but with no guidance from CI (student may have an assistant to document charting).

3. request check out at 11:15 or 3:15. Polishing and fluoride are to be completed following final check by 2 faculty. An ND will assessed for time management if failure to abide by check out time.

4. leave chairside when the product evaluation (final check out) is performed by the CI.

5. Complete a COMPETENCY SELF-ASSESSMENT WORKSHEET.

OU 5002 63

Faculty:

1. verify that the patient is an acceptable competency patient

2. 1 faculty verify deposits using Calculus Deposits Check in Sheet at determination of eligibility.

3. 1 Part-Time Faculty and 1 Full-Time Faculty will check end product (product evaluation). Document on Calculus Deposits Check in Sheet. “R” = Roughness“D”= Definite sub

Evaluation:

Product: End product is determined by two instructors and charted on the Results Evaluation form. Number of areas of calculus successfully removed divided by charted areasof calculus.

Example: 15 areas successfully removed

18 areas of charted calculus 15/18 = 83%

*It is critical that the Clinical Instructor who gives PTP and does the initial calculus charting for the Competency Exam remain the examiner throughout the course of the competency.

OU 5002 64

COMPETENCY SELF-ASSESSMENT WORKSHEETStudent Name________________

Date/ Faculty Signature________________

S/RP: B C D Polishing

Error

Self-assessment of Error (.25) Correction Method (.25) ErrorRemoved

(0.5)Tota

l

OU 5002 65

OU 5002 66

Error

Self-assessment of Error (.25) Correction Method (.25) ErrorRemove

d(0.5)

Value

OU 5002 67

OU 5002 68

DENTAL HYGIENE PLAN FOR CLINICAL SERVICES

HSC 7437 rev 6/06

PATIENT NAME DATE STUDENT NAME CIASSESSMENT

HHx/Meds

Chief Complaint

EIE

Perio Evaluation

Dental Chart

Oral Hygiene Technique

Risk Assessment

Nutritional Assessment/Counseling

Tobacco Cessation

Date of Last Prophy

APPT. PATIENT EDUCATION CLINICAL SERVICES

CDI:A B C D E

Patient Signature.____________ _________ Student Signature._______________________

HSC 7437 rev 6/06

APPT PATIENT EDUCATION CLINICAL SERVICES

DENTAL HYGIENE PLAN FOR CLINICAL SERVICES

ASSESSMENTHHx/Meds

Chief Complaint

EIE

Perio Evaluation

Dental Chart

Oral Hygiene Technique

Risk Assessment


Tobacco Cessation

Date of Last Prophy

HSC 7437 rev 6/06

PATIENT NAME DATE STUDENT NAME CI

CDI:A B C D E

Patient Signature.____________ _________ Student Signature._______________________

HSC 7437 rev 6/06

APPT. PATIENT EDUCATION CLINICAL SERVICES


AIR POLISHING EVALUATION

STUDENT: CI: DATE: SCORE: /10

Objective : Using an air polisher (Prophy Jet ®, Prophy Mate ® etc), and an appropriate patient, the student will air polish a minimum of one quadrant following the guidelines with 75% accuracy.

Procedure: Student requests permission from CI to verify qualifying patient. CI may provide guidance & direction in patient selection. CI observes procedure and marks “S” if step is satisfactory or “U” if unsatisfactory. (1 point each)

Evaluation: 75% accuracy (7.5/10 points )

GUIDELINES S U

1. Recognizes indications and contraindications.

2. Properly assembles equipment according to manufacturer’s instructions.

3. Properly adjusts controls; applies water based lubricant to patient’s lips

4. Demonstrates proper grasp and fulcrum.

5. Demonstrates proper patient/operator positioning.

6. Demonstrates proper angulation of tip.

7. Controls aerosols, uses correct evacuation.

8. Uses water to rinse periodically.

9. Manages patient to minimize anxiety, discomfort.

10. Properly disassembles unit, disinfects, bags tip,

COMMENTS

73

Contraindications-Restricted sodium diet (use sodium free powder)- Respiratory risk- Difficulty swallowing- Communicable diseases- Restorative materials- Exposed root surface- Soft spongy gingival

University of Oklahoma College of DentistryDepartment of Dental Hygiene

Protocol for Bleaching/Whitening Patients

PATIENT SELECTION Patient does not have to be a regular clinic patient.

(family members, friends are acceptable)

RECORDS Patient should have a chart with health history completed The Procedure and Consent form signed Dental Hygiene Only form signed (OKC only) Post-op instructions to patient

PROTOCOL Patient should have had a recent prophylaxis (within a year) Patient is scheduled during a regular clinic session Exam for patient acceptability determined by supervising dentist prior to procedure

(OKC students email Dr. Panza several days prior to appointment; call her to examine patient at first appointment)

PTP from Clinical Instructor

PROCEDURE APPOINTMENT #1

Obtain impressions

74

Wrap in a moist towel & place in a ziplock baggy Have CI sign encounter form & TPNs Pour up impressions After 24 hours, trim the casts down to make the trays (stone should be dry prior to placing block-

out resin; do not plan on making the trays immediately after you have trimmed them. The block-out resin won't adhere to a moist or wet stone surface)

Fabricate trays to be delivered at BOOST appointment Have CI evaluate trays for acceptability

APPOINTMENT #2 Perform the Boost whitening treatment Dispense trays with TAKE-HOME whitening syringes AND desensitizing agent Provide verbal and written post-op instructions

75

IN-OFFICE BLEACHING PROCEDURE (BOOST)

ArmamentariumMirror explorer surgical suctionSaliva ejector Vaseline cheek retractorsCotton swabs air/water 2x2’s Isoblock vita shade guide curing lightOpal Boost Opal Dam Polaroid camera for pre/post photos

1. Take maxillary and mandibular alginate impressions (pour during first 15 minute session)Trays will be given to patient at completion of visit for at-home-bleaching

2. Establish initial Vita shade with dental shade guide and record findings.a. Lateral and canine shades in both maxillary and mandibular arches

3. Place retractorsa. Petroleum jelly on inside of retractors and lipsb. Pinch handles, scoop one side of commissure, then the otherc. Gently release handles and free lips from retractor bordersd. Place bilateral bite block (Isoblock) in premolar area

Isoblock keeps patient in comfortable position and able to swallow

4. Place liquid dama. Dry gingiva with A/W syringeb. Scallop gingiva with gingival barrier (Opaldam) so NO gingiva shows

i. Go 1/2 mm onto tooth c. Place dam 1 tooth distal to bleaching area (General rule: first premolar to

first premolar, but may be larger due to patient’s smile area)i. Build dam slightly larger on most distal tooth to prevent backflow of

Hydrogen Peroxide whitening geld. Move to 12:00 and look toward the apex of the mandibular teeth or lean to

6:00 and look toward the apex of the maxillary teeth; observe for any areas of visible pink gingiva.

e. If any visible gingival is seen, recover with Opaldam f. Light cure Opaldam in continuous sweeping motion 3 mm from gingival

surface 20 seconds per quadrant (40-60 seconds per arch)

5. Attach activator and Boost end to enda. Mix back and forth 25 times

6. Apply tip to syringe (FX – black with fuzzy white end)7. Dry teeth,; place whitening agent approximately 1mm thick on facials8. Allow whitening agent to sit 15 minutes9. Remove with surgical suction located on INCISAL HALF of tooth – DO NOT

TOUCH DAM WITH SUCTION AS THIS MIGHT DISLODGE DAM ALLOWING LEAKAGE

a. Gingival burn could result10. Replace whitening gel for a second 15 minute application.

76

Repeat for 3rd and 4th application if desired

In determining how many applications use the vita shade guide (make certain shade tabs are in order of lightest to darkest)

B1, A1, B2, D2, A2, C1, C2, D3, A3, D4, B3, A3.5, B4, C3, A4, C4Under C1 2-15 minute applications

C1-B3 3-15 minute applicationsOver B3 4-15 minute applications

You can adapt depending on age and shade, choose more or less if desired. Young or yellow teeth whiten faster than old or grey teeth.

11. After final application, suction with surgical suction free of whitening solution, rinse well, and remove dam in one piece

12. Remove cheek retractors and rinse mouth well13. Check shade with shade guide and record (full shade change will not occur

for 24 -48 hours)14. Place desensitizing tray in patient mouth (if determined useful)

Follow up instructions for patientNo red wine, grape juice, blackberries, blueberries for 3 days.Drink colas through a straw.If you must drink coffee brush your teeth immediately.If happy with shade change whiten one time at home with traysIf patient needs to they can continue whitening with trays.

DURING THE PROCEDURE, INSTRUCT PATIENT TO RAISE HAND OF RELATED QUAD IF STINGING SENSATION OCCURS

a. Look for bubble in bleaching agent which would relate to probable leak in dam

b. Use surgical suction to remove bleach from that point to distal in that quadc. Clean surgical tip d. Go back with surgical suction and rinse areae. Dry area and patch and cure damf. Replace bleaching solution

Fabricate at-home bleaching trays

TIPS Look up the teeth for tissue coverage with the dam Do not apply the Boost over the incisal edges Use surgical suction to remove Boost, stay on INCISAL HALF OF TOOTH

to avoid dislodging dam Do not rinse between applications Place stack of 2x2’s on pt napkin to wipe Boost off saliva ejector If you run out of dam you can use LC block out but be careful of heat

77

Always have Opalustre handy

78

University of Oklahoma Dental Hygiene SchoolWhitening Options

White strips fund raiser non-patients of the COD teenagers patients with subtle staining patient who is not ready to commit to tray or in-office whitening

Advantages1. Inexpensive2. Does not require supervision.3. Does not require instruction.4. Does not require tray fabrication.5. Stepping block to other whitening options6. Builds patient awareness of dental health

Disadvantages1. Not as effective on crooked teeth because it will not reach into contact

area.2. Not as effective on patient with large smile because it is only canine to

canine.3. Not as effective on patient with tall anatomical crowns because it may

not cover entire facial surface.4. Recommended touch up period of 6 months.5. Not able to remove more difficult stain

TresWhite Same indications and advantages as strips Does not have disadvantages 1, 2, 3 or 4 May require second box for more difficult stain

At-home Tray Whitening 95% of teeth will whiten removes stains caused by aging removes stains caused by diet most effective choice for removing stain caused by medication 99% of offices offer tray whitening

Advantages1. Inexpensive2. Custom tray that fits patients teeth perfectly and comfortably3. Semi-permanent, touch ups only need to be done every 2-4 years and

are inexpensive because patient already has the custom tray4. Can be worn day or night

79

5. Fast, average patient is done in 6-8 nights or 14 days.6. Less sensitivity than light activated in-office whitening *****7. Very little clinician time required8. Builds cosmetic awareness in patient, usually improves home care9. Practice builder

Disadvantages1. Sensitivity 2. Patient compliance, they must wear tray consecutive days or nights3. Tray fabrication takes time to learn4. Some patients do not like to wear the trays5. Some patient can not wear the trays

In-office or Power Whitening 95% of teeth will whiten removes stains caused by aging removes stains caused by diet partially effective at removing stain caused by medication many more offices offer in-office whitening now than ever before hygienists can perform treatment

Advantages1. Immediate gratification2. Fast, appointment time from 1-2 hours3. Patient has trays to do inexpensive touch up in 2-4 years4. Very little compliance required from patient5. Increased production on hygiene schedule6. Depending on the type of in-office whitening done there may be less

sensitivity than with trays. This is not true if a light is used to activate gel***

7. Increases cosmetic awareness and sometimes improves home care8. Practice builder

Disadvantages1. Most expensive option for patient2. Most chair time required3. Requires at least one follow up session with trays4. Learning curve on placing gingival protection, patient can be burned5. Cheek retractors can be uncomfortable for patient

General statements about whitening1. Whitening is the least invasive procedure we can offer our patients.2. It is the least expensive ‘makeover’ they can give themselves. Compare

it to Botox injections, $200+ per area and repeated every 4-6 months, micro pigmentation (tattooed lipstick) $500 and repeated every 3-6

80

years, chemical peels, $100-800 repeated forever, fake nails $30-40 every 2 weeks. Compare it to dental procedures; one veneer is $800-900. You can whiten all of your teeth for a fraction of one veneer. Many times whitening will satisfy a patient so much that they cancel appointments for full veneers. This is the least invasive cosmetic procedure available.

3. Whitening is extremely safe. Carbamide peroxide is even used to treat babies with oral candidiasis (thrush).

81

4. Carbamide peroxide is anti-bacterial and anti-microbial. Many times patients with gingivitis will see a reduction in bleeding points and swelling. This is only temporary and will resume if home care does not improve. However, the whitening also tends to increase patient awareness of their home care and many improve it on their own.

5. Whitening occurs when hydrogen peroxide moves through the enamel and into the dentin. The peroxide then breaks up the stain inside the tooth.

6. Yellow or young teeth whiten fast and grey or more mature teeth whiten slower.

7. Tetracycline stained teeth can take up to 6 months to whiten. A patient with these stains should be aware of the time commitment and the extra expense of buying more gel.

8. Whitening will not change the color of crowns, veneers, or composites. Patients should be made aware of this and be prepared to replace those restorations if needed. The COD will not replace restorations due to shade only. Whitening will not harm any restorations.

9. To alleviate sensitivity have patient fill tray with toothpaste containing Potassium Nitrate and wear it for an hour or so.

10. If patient has pain we can supply them with a Potassium Nitrate desensitizing gel to wear in their tray for 1 to 8 hours.

11. Inform patient that acidic drinks such as colas and juices will make the sensitivity worse.

12. Inform patient that sensitivity should not worsen and will go away within a day of the last application.

13. Speed of whitening occurs in direct relation to % of product and time of contact.

14. At-home tray whitening and in-office power whitening followed by at home application will give you the same end result. Everyone has a shade that they can reach irregardless of the percentage used. The difference between the two is just how fast they will get to that shade.

82


WHITENING PROCEDURE INFORMATION AND CONSENT

Tooth whitening can, in many cases, restore the youthful color of your teeth.

As in all cosmetic enhancement procedures, there are variables and no results are guaranteed. This procedure does not add color to your smile, but rather returns your teeth to their natural youthful appearance. The type of discoloration affecting your teeth, your dietary habits and maintenance, and the overall condition of your teeth may affect the outcome of the treatment and the length of your results. Additional charges may be incurred for special cases.

Tooth sensitivity may occur during tooth whitening and persist for several days. You may experience “zingers” (shooting sensations that last for a few seconds). The sensitivity is temporary and will resolve with time. The sensitivity may be relieved by a mild analgesic such as Advil or Tylenol. A desensitizing agent may also be used in the bleaching tray overnight until sensitivity subsides.

Exposed root surfaces are grooves, notches or depressions where the teeth meet the gums. These will be isolated from the whitening gel, yet may be sensitive during and/or shortly following the treatment. Exposed root surfaces will not whiten.

Dental restorations such as bridges, crowns (caps), veneers and fillings WILL NOT lighten evenly with other teeth and may need partial or complete replacement. The College of Dentistry DOES NOT replace functional restorations based on color.

I understand the nature and purpose of the tooth whitening procedure and I understand the risks, benefits, possibility of complications as well as the expected results of the tooth whitening procedure. I have been given an opportunity to ask and have my questions answered. I further acknowledge that no guarantees have been given to me regarding the results of this procedure and that I may refuse this procedure without jeopardizing any current or future dental treatment with the College of Dentistry. _____________________________ _______________Patient Signature Date

83


INSTRUCTIONS FOR PATIENT

No red wine, grape juice, blackberries, blueberries for 3 days.

Drink colas through a straw.

If you must drink coffee, brush your teeth immediately.

If you are happy with the shade change, whiten once at home with custom bleaching trays.

If you desire a lighter shade, you may continue whitening with custom bleaching trays.

If at any time you experience sensitivity, apply desensitizing gel in trays and wear them for several hours or at night. This may need to be done a several days in a row prior to applying bleach again.

If discomfort persists for more than a few days, contact your dental hygiene student at _______________ and s/he will schedule a consultation appointment.

FOLLOW UP INSTRUCTIONS FOR PATIENT

No red wine, grape juice, blackberries, blueberries for 3 days.

84

Drink colas through a straw.

If you must drink coffee, brush your teeth immediately.

If you are happy with the shade change, whiten once at home with custom bleaching trays.

If you desire a lighter shade, you may continue whitening with custom bleaching trays.

If discomfort persists for more than a few days, call your hygiene student at _______________ and s/he will schedule a consultation appointment.

85

UNIVERSITY of OKLAHOMA COLLEGE OF DENTISTRYDEPARTMENT of DENTAL HYGIENE

LOCAL ANESTHESIA COMPETENCY

STUDENT: PTP: TOTAL POINTS POSSIBLE : 60 PATIENT: BP: TOTAL POINTS EARNED: DATE: FINAL GRADE: CI: Objective: Student will administer local anesthesia (PSA, IO, GP, NP IANB injections on classmate following the checklist with 75% accuracy. Procedure: Update HHx, BP, PTP. CI evaluates by placing a “check mark” in appropriate box & totals points for each. Total points for entire competency should be placed at top of form. CI to initial. Criteria: A= 1 point, ND= (-1) pointEvaluation: Minimum 75 % accuracy. (45/60)

ARMAMENTARIUM & SYRINGE PREPARATION2 aspirating syringes, 1 each: long & short needle, (27 gauge), 6 cotton tipped applicators, 6 gauze 2x2s, 2 carpules of 3% polocaine (mepivacaine), 20% benzocaine topical anesthetic.I. SYRINGE PREPARATION A ND

1. Secures thumb ring.2. Places needle on syringe, making certain it is straight.3. Retracts piston & inserts rubber stopper end of cartridge first. Looking down on needle, slides cartridge to perforate diaphragm. (allow it to click)4. Covers glass and engages harpoon.5. Holding syringe in palm, gently loosens sheath & allows it to fall off. 6. Expels a few drops of solution to determine proper flow.7. Determines if bevel is toward bone. If not, re-sheaths using scoop technique & firmly replaces it. Turns white part of needle hub 90 using white raised line as reference point. Loosens & allows sheath to fall off.8. Re-sheaths using scoop technique.9. Releases harpoon from rubber stopper by pulling back on thumb ring, removes carpule,

86

removes needles etc.

TOTAL POINTS POSSIBLE: 9 TOTAL POINTS EARNED:

87

INJECTION TECHNIQUE

TOTAL POINTS POSSIBLE: 10 TOTAL POINTS EARNED: III. INFRAORBITAL (use yellow 25/27 gauge long needle) A ND1. Identifies landmarks (infraorbital foramen, MB fold 1st premolar, needle parallel with long axis of tooth)2. Gently dries area with gauze3. Applies topical anesthetic for minimum 1 minute4. With palm up, window facing operator, grasps syringe and allows sheath to fall off; tests solution flow5. Orients bevel toward bone 6. Retract patient’s cheek, pull tissues taut7. Using syringe etiquette, establishes fulcrum & inserts needle to approx ½ depth, contacting bone8. Aspirates and deposits ½ carpule of solution; aspirates at least once more ; states ‘positive or negative’ aspirate9. Withdraws and re-sheaths using scoop technique10. Rinses patient and maintain firm pressure on foramen for 1 minute

II. POSTERIOR SUPERIOR ALVEOLAR (use yellow 25/27 gauge short needle) A ND1. Identifies landmarks (MB fold 2nd mx molar, maxillary tuberosity, zygomatic process 2. Gently dries area with gauze3. Applies topical anesthetic for minimum 1 minute4. With palm up, window facing operator, grasps syringe and allows sheath to fall off; tests solution flow5. Orients bevel toward bone 6. Retract patient’s cheek, pull tissues taut7. Using syringe etiquette, inserts needle to ¾ depth, in upward, inward, backward direction (in one motion) 8. Aspirates and deposits ½ carpule of solution; aspirates at least once more ; states ‘positive or negative’aspirate; 9. Withdraws and re-sheaths using scoop technique10. Rinses patient

88


89

IV. GREATER PALATINE (use yellow 27 gauge short needle) A ND1. Identifies landmarks (jct hard & soft palate, anterior to palatal foramen)2. Gently dries area with gauze3. With palm up, window facing operator, grasps syringe and allows sheath to fall off; tests solution flow 4. Orients bevel toward bone 5. With syringe in dominant hand (using syringe etiquette), and cotton tipped applicator in non-dominant hand, establishes fulcrum & uses gentle pressure, applying topical anesthetic for minimum 1 minute , increasing pressure incrementally

6. Moves cotton tipped applicator aside, establishes fulcrum & inserts needle 1-2 mm under mucosa 7. Aspirates and states ‘positive or negative’ aspirate; if positive, repositions, aspirates and continues deposition deposits ¼ to 1/3 carpule of solution; observes blanching tissue 8. Withdraws and re-sheaths using scoop technique9. Rinses patientTOTAL POINTS POSSIBLE: 9 TOTAL POINTS EARNED: V. NASOPALATINE (use yellow 27 gauge short needle) A ND1. Identifies landmarks (lateral to incisive papilla)2. Gently dries area with gauze3. With palm up, window facing operator, grasps syringe and allows sheath to fall off ; tests solution flow 4. Orients bevel toward bone 5. With syringe in dominant hand (using syringe etiquette), and cotton tipped applicator in non-dominant hand, establishes fulcrum & uses gentle pressure, applying topical anesthetic for minimum 1 minute, increasing pressure incrementally6. Moves cotton tipped applicator aside, inserts needle 1-2 mm under mucosa, depositing small volume of anesthetic. Continues applying pressure & slowly advances needle until osseous contact. 7. Aspirates and states ‘positive or negative’ aspirate; if positive, repositions, aspirates

90

and continues deposition. Deposits 1/4 or less carpule of solution; observes blanching tissue 8. Withdraws and re-sheaths using scoop technique9. Rinses patient

TOTAL POINTS

POSSIBLE: 9 TOTAL POINTS EARNED:

VI. INFERIOR ALVEOLAR NERVE BLOCK, LONG BUCCAL NERVE BLOCK(use yellow 25/27 gauge long needle)

A ND

1. Identifies landmarks, 6-10 mm above occlusal plane, distal to coronoid notch, ¾ distance from notch to pterygomandiublar raphe, using long needle; for LB, distal to 2nd molar2. Gently dries area with gauze3. Applies topical anesthetic for minimum 1 minute4. With palm up, window facing operator, grasps syringe and allows sheath to fall off; tests solution flow5. Orients bevel toward bone 6. Retracts patient’s cheek, pulls tissues taut, establishes fulcrum7. Using syringe etiquette, places barrel of syringe in commissure on contralateral side & inserts needle to ¾ depth, 8. Aspirates and deposits 3/4 carpule of solution; re aspirates throughout procedure; states ‘positive or negative’ aspirate; if positive, repositions, aspirates and continues deposition; for lingual, pulls needle out halfway, aspirates, states positive or negative and deposits 1/8 carpule. Removes needle and gives LB distal buccal & to 2nd molar.

9. Withdraws and re-sheaths using scoop technique10. Rinses patient

91


TOTAL POINTS POSSIBLE: 3 TOTAL POINTS EARNED: CI COMMENTS

LOCAL ANESTHESIA PLACEMENT TABLEMANDIBULAR

Type Needle % Carpule Insertion Nerve Anesthetized

VII. OVERALL TECHNIQUE A ND1. Maintains proper infection control and manages sharps throughout procedure 2. Communicates with patient throughout procedure; minimizes anxiety, reassures, avoids unnecessary relocation of needle, etc

3. Accurately records procedure in patient’s chart, including type of anesthetic, amount, and concentration, type of injection and any adverse reactions. Ex: Administered 1.8 cc lidocaine 2%, 1:100,000 epi. PSA, no complications.

92

Inferior Alveolar(Mandibular Block)

Long20-25mm2/3 to 3/4

3/4 6-10 mm above mand. occlusal plane, distal to coronoid notch, 3/4 distance from the coronoid notch to the pterygomandibular raphe.

Inferior AlveolarIncisive, Mental , Lingual (quite common)*Mandibular teeth to midline*Lingual tissue*Facial tissue

Gow-Gates Long25mm

3/4

1 Neck of the CondyleHeight of penetration: Needle tip just below the mesiolingual cusp of the maxillary 2nd molarPenetration: distal to the maxillary 2nd molar

Inferior Alveolar, Mental, Incisive, Lingual, Mylohyoid, Auriculotemporal, Buccal*Mandibular teeth to midline*Lingual tissue*Facial tissue

Long Buccal Long1mm-2mm

1/4 Mucous membrane distal buccal to last molar

Buccal nerve (branch of the anterior division of the mandibular)*Facial tissue of molars

Mental Short5-6mm

1/3 Mucobuccal fold at or anterior to mental foramen (usually between premolars)

Mental nerve (terminal branch of the inferior alveolar)*Facial tissue anterior to mental foramen to midline

93

MAXILLARY

Type Needle % Carpule Insertion Area Anesthetized

PSA Short16mm

3/4

1/2- 1 Mucobuccal fold 2nd molarPosterior Superoir Alveolar & branches*3rd, 2nd & 1st molar (no MB root)*facial tissue

Infra-orbital(ASA)

Long16mm

1/2

1/2 - 2/3 Mucobuccal fold over the 1st premolar Anterior Superior Alveolar NerveMiddle Superior Alveolar NerveInfraorbital Nerve*Mesial root of 1st molar to midline*facial tissues

MSA ShortAbove the apex of the 2nd premolar

1/2 - 2/3 Mucobuccal fold 2nd premolar Middle Superior Alveolar Nerve*Premolars & facial tissues

Greater Palatine ShortLess than 10mm

1/4 - 1/3 Palate anterior to greater palatine foramen

Greater Palatine Nerve*Palatal hard & soft tissue from3rd molar to 1st premolar

Nasopalatine Short6-10mm

1/4 or less Lateral to incisive papillaNasopalatine Nerves bilaterally*Canine to canine*hard & soft tissue (facial & lingual)

InfiltrationUsual sites*2nd molar*Between premolars*Canine*Between central & lateral

Short 1/3 Mucobuccal foldRoot apex depth Small terminal nerve endings in the area of

treatment*2-3 tooth area & facial tissue

Short needle = 20 mmLong needle = 32 mm

94


NITROUS OXIDE CONSCIOUS SEDATION ADMINISTRATION EVALUATION FORM

STUDENT: PTP: START TIME: STOP TIME: PATIENT: TOTAL TIME DATE: FINAL GRADE: A ND CI:

Objective: Student will administer N2O-O2 for appropriate patient with 75% accuracy. Procedure: Update HHx, BP, PTP. Set up unit. CI evaluates by placing a “check mark” in appropriate box. CI to initial top of form. Criteria: A-acceptable; 1 point, ND-needs development; -1 pointEvaluation: Minimum 75 % accuracy. (15/20)I. EQUIPMENT SET UP & PREPARATION A ND1. Tanks set up, ensure hoses prepared, bag prepared-place bag on bottom of “T”

2. Place sterilized nasal hood –(white part is scavenger; blue part is nasal hood. Insert “L” shaped tube into scavenger). Insert blocked tube into other hose on same side of scavenger. Flow hose is inserted on opposite side of scavenger.3. Trieger test available

4. Using wrench, loosen both nitrous and oxygen tank valves

5. Place scavenger hose into high volume evacuator (to be turned on low using butterfly valve) & lay on floorII. PROCEDURE

6. Review Heatlth History, recognize contraindications

7. Explain procedure to patient, gain consent, administer Trieger Test

8. PTP

9. Turn on system, 100% O2

10 Place nasal hood and adjust

11. Establish O2 flow at 7 LPM for 3 minutes (bag should have continuous minimal inflation/deflation)12. First nitrous increment maintained 1-3 minutes

13. 60-90 second maintenance for each increase thereafter

14. Observe patient throughout procedure

III. TERMINATION of PROCEDURE

15. 100% O2 administered minimum of 5 minutes

16. Patient fully recovered, administer Trieger Test

17. Proper documentation (concentration, flow rate, total time, recovery) (at COD, use stamp for chart)

95

18. Turn off tanks. Properly disassemble unit, disinfect & return nasal hood for autoclave.

IV. OVERALL TECHNIQUE

19. Maintains proper infection control and manages patient throughout procedure

20. Communicates with patient throughout procedure; minimizes anxiety, reassures, adjusts flow as necessaryTOTAL POINTS POSSIBLE: TOTAL POINTS EARNED:

96


NITROUS OXIDE CONSCIOUS SEDATION ADMINISTRATION EVALUATION FORM

STUDENT: PTP: START TIME: STOP TIME: PATIENT: TOTAL TIME DATE: FINAL GRADE: A ND CI:

Objective: Student will administer N2O-O2 for appropriate patient with 75% accuracy. Procedure: Update HHx, BP, PTP. Set up unit. CI evaluates by placing a “check mark” in appropriate box. CI to initial top of form. Criteria: A-acceptable, ND-needs developmentEvaluation: Minimum 75 % accuracy. (16/21)I. EQUIPMENT SET UP & PREPARATION A ND1. Tanks set up, ensure hoses prepared, bag prepared2. Place sterilized nasal hood 3. Trieger test available4. Using wrench, loosen both nitrous and oxygen tank valves 5. Place scavengere hose into high volume evacuator (to be turned on low) & lay on floor if applicableII. PROCEDURE6 Review Heatlth History, recognize contraindications7. Explain procedure to patient, gain consent, administer Trieger Test 8 PTP9. Turn on system, 100% O2

10 Place nasal hood and adjust11. Establish O2 flow at 7 LPM for 3 minutes (bag should have continuous minimal inflation/deflation)12. First nitrous increment maintained 1-3 minutes13. 60-90 second maintenance for each increase thereafter14. Observe patient throughout procedureIII. TERMINATION of PROCEDURE15. 100% O2 administered minimum of 10 minutes16. Patient fully recovered, administer Trieger Test 17. Proper documentation (concentration, flow rate, total time, recovery)18. Properly disassemble unit, disinfect & return nasal hood for autoclave. IV. OVERALL TECHNIQUE 19. Maintains proper infection control and manages patient throughout procedure20. Communicates with patient throughout procedure; minimizes anxiety, reassures, adjusts flow as necessaryTOTAL POINTS POSSIBLE: TOTAL POINTS EARNED

97

PERIODONTAL CHARTING COMPETENCYSTUDENT________________ PTP: TOTAL L POINTS POSSIBLE PATIENT_________________ TOTAL POINTS EARNED DATE____________ FINAL GRADE CI:

Objective: Using a periodontal probe, the student will assess the periodontium of ONE QUADRANT as assigned by charting the Recession, Probing Depths, and Calculate the Attachment Loss of all teeth in the quadrant with 80% accuracy. Remediation required.

Criteria: May be done pre-tx, immediately post-tx OR at the re-evaluation appointment. Patient must have at least one molar in each quadrant and a minimum of 6 teeth.

Procedure: Student requests acceptability/PTP from CI. Using Competency Form, student marks out missing teeth, draws & records Recession, records Probing Depths, and Calculates Clinical

Attachment Loss in the boxes provided. (6 for each tooth) Circles the Periodontal Disease Classification as Slight, Moderate or Severe for the assigned quadrant. CI verifies accuracy of recession, probing depths and CAL and Disease Classification.

Faculty Evaluation: Circle incorrect values. Deduct 2 points for deviation of more than 1 mm or number for each reading. Document the total number of readings at top of form and divide by the total number correct .

98

Periodontal DiseaseClassification-Slight-Moderate-Severe

INSTRUMENT SHARPENING Process Competency Examination

TASK COMPONENTS H6/H7

Gr 13/14

BH 5/6

PTS.

EVAL

PREPARATION1. Assembles complete armamentarium 62. Illuminates work area 63. Correctly identifies instrument to be sharpened 64. Verbalizes objective of sharpening 65. Identifies terminal shank 15PROCEDURE (Moving Stone Technique)6. Orients instrument correctly (palm grasp) 157. Stabilizes instrument 158. Positions face of instrument parallel with floor 159. Rolls stone up to establish 100 to 110-degree angle between stone and face in each third (heel, middle, toe/tip)

15

10. Begins stroke at heel and progresses toward toe/tip 1511. Makes 2-3 strokes in each third (heel, middle, toe/tip) 1512. Pressure is applied on down stroke 1513. Utilizes upward stroke to reposition with no pressure 1514. Completes with a downward stroke 1515. Utilizes light-to-moderate pressure 1516. Utilizes rhythmic up and down strokes 1517. Correctly evaluates instrument sharpness with test stick

15

SHARPENING FACE 1518. Turns toe/tip toward her/himself 1519. Places face of instrument parallel with stone20. Places back of terminal 1/3 of instrument against stone

15

21. Rolls stone away from her/himself while pulling stone toward toe/tip 15OTHER22. Preserves original design characteristics 1523. Identifies lower cutting edge to faculty 1524. Maintains asepsis 1525. Verbalizes advantages of utilizing sharp instruments 15

101

339

INSTRUCTOR:Comments:

102

TREATMENT PLANNING COMPETENCYPatient History

Patient ProfileDOB: 3/29/64East Indian femaleLiving in Shawnee

Medical HistoryRheumatic fever in 1975 – requires premedAllergic to penicillinFrequent morning headaches and jaw muscle tendernessTakes no medications

Dental HistoryNew patient at OKC dental officePatient has not had regular dental careLast visit was two years ago when she had bitewing radiographs, examination, scaling, polishing and fluoride treatmentLast full mouth was taken in 1991#30 was extracted in 1992 due to failed endodontic treatment and has not been replacedCurrently brushes once a day in a scrubbing motionPatient thinks she might grind her teeth at night

Social HistoryEmployed a s a quality controller for a large cement companyRates her job as stressfulMarried with two preschool aged childrenHas dental insurance and a cafeteria plan

Chief ComplaintMy gums bleed when I brush my teeth

EIENo significant findings at today’s appointment

103

No significant findings at today’s appointment

Dental ChartingNo significant findings at today’s appointment.

Periodontal ChartingNo probing depths greater than 3 mm, no recession. Generalized bleeding on probing

104


Student CI Date Total Points /27

ULTRASONIC INSTRUMENTATION COMPETENCYObjective: Student will demonstrate use of the ultrasonic scaler on a patient following the check sheet with 80% accuracy. Criteria: Using a clinic patient with demonstrative calculus, demonstrate use of ultrasonic in one quadrant. Evaluation: Total possible points: 27; 80% accuracy = 21/27. Remediation required.

105

CRITERIA COMMENTS A ND

Prepares Unit

1. Equipment is set up prior to appointment2. Unit and handpiece are disinfected3. Barriers are used4. Line is flushed5. Places insert into handpiece filled with water

Patient Selection is Appropriate

6. Informed consent is gained7. Rationale for use recognized

Patient Preparation

8. Procedure is explained including operation of unit, purpose, noise, evacuation,

and patient expectations9. An antibacterial mouthrinse is used for one minute10. Barrier techniques are usedInstrumentation11. Patient and clinician positioning are appropriate12. Evacuation is adequate13. Explores to locate deposit14. Appropriate insert is used15. Power setting is correct16. Approach is systematic17. A gentle pen grasp is used18. Uses appropriate fulcrum19. Handpiece is balanced20. Insert is adapted appropriately to tooth surface21. Tip is in motion at all times22. Strokes are multi-directional, brush like, tapping, or probe like23. Pressure is not used24. Stops periodically to allow complete evacuation25. Evaluates progress with explorer26. Identifies endpoint

Patient Management

27. Manages patient appropriately; Efficiency is demonstrated

106

CLINICAL DENTAL HYGENE III -CDH III

MINIMUM COURSE REQUIREMENTS

PROCEDURE MINIMUM NUMBER & CRITERIA

1. Air Polishing -1 patient- light to mod. stain

2. Bleaching (Boost) - 1 patient, includes bleaching tray

3. Calculus Charting - 1 CDI C or D pt - minimum of 10 clicks in one quad

- chart entire quad- 80% accuracy; remediation required

4. CDI Class A-B -PRN; must be signed off by faculty

5. CDI Class C -7 patients; must be signed off by faculty

6. CDI Class D -8 quads; must include re-evaluation

7. CDI Class E -experiential

8. Chemotherapeutics (Arestin or Perio Chip) -1 appropriate patient

9. Desensitization (Super Seal)-1 appropriate patient

10. Impressions/Study Models -1 patient for bleaching tray

11. Sealants -16 12 teeth; may be completed over fall & spring semesters 1st & 2nd yr

12. Temporary Restoration -PRN experiential only

13. Ultrasonic Scaler -PRN appropriate patient107

14. Local anesthesia -10 mandibular blocks and 10 infiltrations required by BOD for licensure (fall & spring)

15. Additional patients -Minimum 12Other additional procedures PRN:

-Temporary restoration-Vitality testing-Re-margination-Amalgam polishing-Additional patients: all patients appointed, regardless of rating shall be seen as assigned. If a patient is not seen as scheduled without CI approval, the student will be assessed a penalty of one letter grade.

108

SECTION VIII

Junior Clinical Competencies

109

ABBREVIATIONS

Anes - Anestheticapprox. - approximateappt - appointmentASA - aspirinASAP - as soon as possibleb.i.d. - twice a daybilat. - bilateralBP - blood pressureBWX - bitewing radiographsBX - biopsyCC - chief complaintC/C - complete denturesC/P - complete maxillary denture/mandibular partialCa - cancerCau. - CaucasianCBC - Complete blood countCHD - Congestive heart diseaseCHF - Congestive heart failureCNS - Central nervous systemcont. - continuedCOPD - Chronic obstructive pulmonary diseaseCP - Cerebral palsyCVA - Cerebral vascular attackDC - discontinueDH - dental hygieneDOB - date of birthDX - diagnosisEBV - Epstein Barr VirusEKG or ECG - ElectrocardiogramEEG - ElectroencephalogramEndo - EndodonticsENT - Ear, nose and throatEval - evaluationExt. - extract

110

FMX - Full Mouth surveyFPD - Fixed Prosthodontics

111

HBV - Hepatitis B VirusHHx - health historyIDDM - Insulin Dependent Diabetes MellitusIM - Intramuscularmand. - mandibularmax. - maxillarymeds. - medicationsMI - myocardial infarctionMVP - Mitral Valve ProlapseOP - OperativeOS - Oral Surgeryprn - as neededPCN - PenicillinPt. - patientq. - everyq.i.d. - four times a dayRCT - root canal treatmentRec. - recommendRHD - Rheumatic Heart DiseaseRPD - Removable Partial Denture or Removable Prosthodontics

DepartmentRXN - reactionSBE - Subacute Bacterial Endocarditist.i.d. - three times a dayTMJ - temporal mandibular jointw/ - withw/o or s - withoutWNL - within normal limits

112

BARNHART 5/6

Process Competency Examination TASK COMPONENTS AREA

1AREA

2PTS

.EVAL

OPERATOR POSITIONING Correct height of operator's stool 4 Back in neutral position 4Wrist in neutral position 4Correct seating area for instrumentation (Clock positions) 4PATIENT POSITIONINGBack of patient chair adjusted for appropriate arch 4Height of patient chair adjusted to level of operator's elbow 4Patient's head adjusted for treatment area 4Light positioned appropriately for treatment area 4MOUTH MIRRORAppropriate for area (retracts when appropriate, indirect when appropriate)

4

GRASP Uses pads of fingers to contact instrument 20Index finger and thumb near handle/shank junction with thumb flexed outward

20

Middle finger on shank 20Handle rests between second and third knuckle of index finger

20

All fingers contact as a unit 20FULCRUMTip of ring finger standing as tall as possible 20Fulcrum on incisal/occlusal edge or embrasure 10As close as possible to instrumentation area 10

113

Appropriate palm direction 10ADAPTATION/INSERTION Correct working end chosen 20 Adapts terminal 1-1.5 mm of working end 20 Point of insertion appropriate (distofacial, distolingual line angle)

20

Inserts as close to 0 degrees angulation as possible 20 Demonstrates insertion into col (half-way facial to lingual) 20 Establishes working angulation of 70-80 degrees 20ACTIVATION/STROKE (DEMONSTRATED SUPRAGINGIVALLY)Activates with appropriate wrist/forearm motion 20Pivots stroke from fulcrum 20Rolls instrument in fingers around line angles 20Appropriate stroke direction 20Covers circumference of tooth by channel scaling 20Tip directed obliquely toward junctional epithelium 20Short, controlled strokes 20Appropriate speed 20OTHERRecognizes tooth number 4Maintains asepsis 10INSTRUCTOR:

COMMENTS:

480

114

EXTRA/INTRA ORAL EXAMProcess Competency Examination

TASK COMPONENTS PTS EVALPREPARATION Assembles correct armamentarium 4 Patient seated upright in dental chair 4 Removes glasses of patient 4Operator standing 4SEQUENCE OF EXTRA ORAL EXAM Uses appropriate technique, pressure, stroke while palpating the following:Visual assessment of patient looking for anomalies of head and neck area 10Frontal and supraorbital region 10Infraorbital and zygomatic process region 10Maxillary sinus region 10Mandible and parotid gland region 10Temporal region (pre-auricular) 10TMJ and masseter 10Submental, submandibular and sublingual regions 10Trachea and thyroid 10Sternocleidomastoid muscle (Anterior cervical lymph chain) 10Supraclavicular region 10Trapezius muscle and occipital region (Posterior cervical node chain) 10Back and lateral portions of neck posterior to Sternocleidomastoid muscle 10SEQUENCE OF INTRA ORAL EXAMUses appropriate technique, pressure, stroke while palpating and/or evaluating the following:Visual assessment of lips and commissures 10Labial mucosa 10Buccal mucosa 10Vestibule and frenulas 10Floor of mouth 10Tongue 10

115

Hard and soft palate 10Uvula, tonsillar pillars, oropharynx 10Alveolar mucosa 10Edentulous gingiva if indicated 10Assess salivary flow by stimulating Stenson’s Duct 10GINGIVAL ASSESSMENT (VERBALIZE TO FACULTY)Color 10Form 10Density 10OTHERUtilizes mirror where appropriate 4Correct pt/op positioning for area 4Light placement appropriate for area 4Maintains asepsis 10INSTRUCTOR:

COMMENTS:

308

116

TOPICAL FLUORIDE (TRAY) Process Competency Examination

TASK COMPONENTS PTS. EVAL

PREPARATION1. Assembles complete armamentarium 42. Correct patient positioning (upright) 44. Selects correct tray size 45. Selects appropriate type of fluoride and states rationale 4PROCEDURE6. Thin band of fluoride dispensed in tray 47. Thoroughly dries maxillary, then mandibular teeth 48. Instructs patient not to swallow fluoride 49. Correctly places mandibular, then maxillary tray 410. Instructs patient to chew/tap into tray to disperse fluoride to gingival margin thoroughly

4

11. Places saliva ejector between trays for continuous suction 412. Times procedure correctly 413. Removes trays and excess fluoride 414. Gives appropriate post-treatment instruction 4OTHER15. Maintains asepsis 4 INSTRUCTOR:

COMMENTS:

56

118

GRACEY 1/2

Process Competency Examination TASK COMPONENTS AREA

1AREA

2PTS EVA

LOPERATOR POSITIONINGCorrect height of operator's stool 4Back in neutral position 4Wrist in neutral position 4 Correct seating area for instrumentation (Clock positions) 4PATIENT POSITIONINGBack of patient chair adjusted for appropriate arch 4Height of patient chair adjusted to level of operator's elbow 4Patient's head adjusted for treatment area 4Light positioned appropriately for treatment area 4MOUTH MIRRORAppropriate for area (retracts when appropriate, indirect when appropriate)

4


20

Middle finger on shank 20Handle rests between second and third knuckle of index finger 20All fingers contact as a unit 20FULCRUMTip of ring finger standing as tall as possible (Handle parallel to long axis)

20

Fulcrum on incisal/occlusal edge or embrasure 10As close as possible to instrumentation area 10Appropriate palm direction 10ADAPTATION/VERBALIZATION OF INSERTIONCorrect working end chosen 20Point of insertion appropriate (overlaps midline) 20

121

Adapts terminal 1-1.5 mm of working end 20Verbalizes insertion (slight closure of instrument face to tooth) 20Establishes working angulation of 60-70 degrees (demonstrate supra)

20

ACTIVATION/STROKEActivates with appropriate wrist/forearm motion 20Pivots stroke from fulcrum 20Rolls instrument in fingers around line angles 20Appropriate stroke direction 20Covers circumference of tooth by channel scaling 20Tip directed obliquely toward junctional epithelium 20Short, controlled stroke 20Appropriate speed 20OTHERRecognizes tooth number 4Maintains asepsis 10INSTRUCTOR:

COMMENTS:

460

122

GRACEY 11/12

Process Competency ExaminationTASK COMPONENTS AREA

1AREA

2PTS. EVA

LOPERATOR POSITIONING Correct height of operator's stool 4Back in neutral position 4Wrist in neutral position 4Correct seating area for instrumentation (Clock positions) 4PATIENT POSITIONINGBack of patient chair adjusted for appropriate arch 4Height of patient chair adjusted to level of operator's elbow 4Patient's head adjusted for treatment area 4Light positioned appropriately for treatment area 4MOUTH MIRRORAppropriate for area (retracts when appropriate, indirect when appropriate)

4


20

Middle finger on shank 20Handle rests between second and third knuckle of index finger 20All fingers contact as a unit 20FULCRUMTip of ring finger standing as tall as possible 20Fulcrum on incisal/occlusal edge or embrasure 10As close as possible to instrumentation area 10Appropriate palm direction 10ADAPTATION/VERBALIZATION OF INSERTIONCorrect working end chosen 20Point of insertion appropriate (distal line angle) 20

123

Adapts terminal 1-1.5 mm of working end 20Verbalizes insertion (slight closure of instrument face to tooth) 20Establishes working angulation of 60-70 degrees (demonstrate supra)

20

ACTIVATION/STROKE (DEMONSTRATED SUPRAGINGIVALLY)Activates with appropriate wrist/forearm motion 20Pivots stroke from fulcrum 20Rolls instrument in fingers around line angles 20Appropriate stroke direction 20Covers circumference of tooth by channel scaling 20Tip directed obliquely toward junctional epithelium 20Short, controlled stroke 20Appropriate speed 20OTHERRecognizes tooth number 4Maintains asepsis 10INSTRUCTOR:

COMMENTS:

460

124

GRACEY 13/14

Process Competency ExaminationTASK COMPONENTS AREA

1AREA

2PTS. EVA

LOPERATOR POSITIONINGCorrect height of operator's stool 4Back in neutral position 4Wrist in neutral position 4Correct seating area for instrumentation (Clock positions) 4PATIENT POSITIONINGBack of patient chair adjusted for appropriate arch 4Height of patient chair adjusted to level of operator's elbow 4Patient's head adjusted for treatment area 4Light positioned appropriately for treatment area 4MOUTH MIRRORAppropriate for area (retracts when appropriate, indirect when appropriate)

4


20

Middle finger on shank 20Handle rests between second and third knuckle of index finger 20All fingers contact as a unit 20FULCRUMTip of ring finger standing as tall as possible 20Fulcrum on incisal/occlusal edge or embrasure 10As close as possible to instrumentation area 10Appropriate palm direction 10ADAPTATION/DEMONSTRATION OF INSERTIONCorrect working end chosen 20Point of insertion appropriate (distal line angle) 20Adapts terminal 1-1.5 mm of working end 20

125

Demonstrates insertion (slight closure of instrument face to tooth)

20

Establishes working angulation of 60-70 degrees (demonstrate supra)

20

ACTIVATION/STROKE (DEMONSTRATED SUPRAGINGIVALLY)Activates with appropriate wrist/forearm motion 20Pivots stroke from fulcrum 20Rolls instrument in fingers around line angles 20Appropriate stroke direction 20Covers circumference of tooth by channel scaling 20Tip directed obliquely toward junctional epithelium 20Short, controlled stroke 20Appropriate speed 20OTHERRecognizes tooth number 4Maintains asepsis 10INSTRUCTOR:

COMMENTS:

460

126

H6/H7 SCALER Process Competency Examination

TASK COMPONENTS AREA 1 AREA 2

PTS EVAL

OPERATOR POSITIONINGCorrect height of operator's stool 4Back in neutral position 4Wrist in neutral position 4Correct seating area for instrumentation (Clock positions) 4PATIENT POSITIONINGBack of patient chair adjusted for appropriate arch 4Height of patient chair adjusted to level of operator's elbow 4Patient's head adjusted for treatment area 4Light positioned appropriately for treatment area 4MOUTH MIRRORAppropriate for area (retracts when appropriate, indirect when appropriate)

4


20

Middle finger on shank 20Handle rests between second and third knuckle of index finger 20All fingers contact as a unit 20

FULCRUMTip of ring finger standing as tall as possible 20Fulcrum on incisal/occlusal edge or embrasure 10As close as possible to instrumentation area 10Appropriate palm direction 10

ADAPTATIONCorrect working end chosen (lower cutting edge) 20Adapts terminal 1-1.5 mm of working end 20

127

Establishes working angulation of 70-80 degrees 20Tip directed obliquely toward junctional epithelium 20Overlaps midline at initial placement of instrument 20

ACTIVATION/STROKEActivates with left to right wrist/forearm motion 20Pivots stroke from fulcrum 20Rolls instrument in fingers around line angles 20Appropriate stroke direction 20Covers circumference of tooth by channel scaling 20Tip directed obliquely toward junctional epithelium 20Short, controlled stroke (2-3mm in length) 20Appropriate speed 20

OTHERRecognizes tooth number 4Maintains asepsis 10INSTRUCTOR:

COMMENTS:

460

128

MOUTH MIRROR Process Competency Examination

STUDENT MUST UTILIZE NON-DOMINANT HAND TO HOLD MIRROR

TASK COMPONENTS AREA EVALMIRROR TECHNIQUE

Demonstrates and explains uses of mouth mirror a. Illumination 4 b. Transillumination 4 c. Retraction 4 d. Indirect Vision 4Uses pads of fingers to contact instrument 16Index finger and thumb near handle/shank junction 16Middle finger on shank 16Fulcrum appropriate for area 16Light position appropriate for area 16Provides for patient comfort with insertion and placement of Mirror

16

Pt/Op position appropriate for area 16Recognizes tooth number 16Maintains asepsis 16INSTRUCTOR:

COMMENTS:

160

129

ODU 11/12Process Competency Examination

TASK COMPONENTS AREA 1

AREA 2

PTS. EVAL

OPERATOR POSITIONINGCorrect height of operator's stool 4Back in neutral position 4Wrist in neutral position 4Correct seating area for instrumentation (Clock positions) 4PATIENT POSITIONING Back of patient chair adjusted for appropriate arch 4 Height of patient chair adjusted to level of operator's elbow 4 Patient's head adjusted for treatment area (ex. toward/away, chin-up / down)

4

Light positioned appropriately for treatment area 4MOUTH MIRROR Appropriate for area (retracts when appropriate, indirect vision when appropriate)

4

GRASPUses pads of fingers to contact instrument 4Index finger and thumb near handle/shank junction with thumb flexed outward

4

Middle finger on shank 4Handle rests between second and third knuckle of index finger 4All fingers contact instrument as unit 4*Light but secure grasp pressure 20FULCRUM*Tip of ring finger standing as tall as possible 20Fulcrum on incisal/occlusal surface or embrasure 10As close as possible to instrumentation area (1-2 teeth away) 10Appropriate palm direction 10ADAPTATION, INSERTION

130

Correct working end chosen 20Point of insertion appropriate 20Adapts 1-1.5 mm of tip to tooth 20ACTIVATION/STROKEActivates with appropriate wrist-forearm motion 20Pivots stroke from fulcrum 20Rolls instrument in fingers around line angles 20Appropriate stroke direction (oblique on facial and lingual; vertical into proximal)

20

Light, exploratory stroke pressure 20Slow, feeling stroke speed 20Controlled stroke 20OTHERRecognizes tooth number 4Maintains asepsis 10INSTRUCTOR:

COMMENTS:

340

131

PERIODONTAL PROBE

Process Competency Examination


AREA 2

PTS. EVAL

OPERATOR POSITIONINGCorrect height of operator's stool 4Back in neutral position 4Wrist in neutral position 4PATIENT POSITIONINGBack of patient chair adjusted for appropriate arch 4Height of patient chair adjusted to level of operator's elbow

4

Patient's head adjusted for treatment area 4Light positioned appropriately for treatment area 4MOUTH MIRRORAppropriate for area (retracts when appropriate, indirect vision when appropriate)

4


4

Middle finger on shank 4Handle rests between second and third knuckle of index finger

4

All fingers contact as a unit 4Light but secure pressure 20FULCRUMTip of ring finger standing as tall as possible 20Fulcrum on incisal/occlusal edge or embrasure 10As close as possible to instrumentation area 10Appropriate palm direction 10

132

ADAPTATION/INSERTIONInitial insertion at line angle 20Tip remains in contact with tooth surface 20Maintains parallelism to long axis of tooth/root morphology

20

Insertion to junctional epithelium 20ACTIVATION/STROKEActivates with left to right wrist/forearm motion 20Pivots stroke from fulcrum to maintain parallelism 20Controlled stroke remaining in sulcus 20Vertical stroke direction 20Walking stroke covers circumference of tooth 20Walks to proximal contact, readjusts to enter col 20Light pressure against junctional epithelium 20OTHERMaintains asepsis 10Recognizes tooth number 4INSTRUCTOR:

COMMENTS:

356

133

RUBBER CUP POLISHING



AREA 2

PTS EVAL

OPERATOR POSITIONINGCorrect height of operator's stool 4Back in neutral position 4Wrist in neutral position 4Correct seating area for instrumentation 4PATIENT POSITIONINGBack of patient chair adjusted for appropriate arch 4Height of patient chair adjusted to level of operator's elbow

4

Patient's head adjusted for treatment area 4Light positioned appropriately for treatment area 4MOUTH MIRRORAppropriate for area (retracts when appropriate, indirect when appropriate)

4

GRASP Uses pads of fingers to contact handpiece as unit 20 Holds as near working end as possible 20FULCRUM Appropriate for working area(intra-oral when appropriate and extra-oral when appropriate)

20

ADAPTATION/INSERTIONAngles rubber cup to flare apical half 20Appropriate cup direction (Cup pointed toward incisal/occlusal)

20

Turns handpiece to adapt to proximal surface- wraps around line angles

40

134

Places cup near or slightly below gingival margin 20ACTIVATION/STROKEBegins stroke at distal/mesial cervical margin 20Activates with "paint-brush" stroke – DO NOT DAB 20Strokes across facial and lingual covering entire surface into proximal (Anterior sextants 3-6 strokes) (Posterior sextants 3-6 strokes)

20

Pivots stroke from fulcrum 20Uses light but secure/ controlled stroke 20Covers occlusal surface with brush 10Slow, even speed with handpiece 20OTHERRecognizes tooth number 4Maintains asepsis 10INSTRUCTOR:

COMMENTS:

340

135

PATIENT/ OPERATOR POSITIONING(LEFT -HANDED OPERATOR)

FRONT of chair denotes operator at 3:00-4:00BACK of chair denotes operator at 12:00- 1:00

MIDDLE of chair denotes operator at 2:00

MANDIBULAR ARCH POSITIONING

Area Chair Back Op Pt Mirror MF=Mirror Face Fulcrum

Mandibular Anterior Sextant (22-27)

Near Surfaces (Facial and Lingual)

Far Surfaces (Facial and Lingual)

15 ° up Front

Back

Chin Down/ Toward Op

Chin Down/ Away from Op

Facial: Palm Lingual: Left Commissure

Facial: Palm Lingual: Right Commissure

#28-24

#21-25

Mandibular Right Posterior Facial Mandibular Left Posterior Lingual

15 ° up Front Chin Down/ Toward OpRight Facial: Retract from Lt. Commissure

Left Lingual: Retract tongue, MF toward tooth, directed from left Commissure

Anterior to working

area

Mandibular Right Posterior Lingual

Mandibular Left Posterior Facial

15 ° Middle Chin Down/ Away from OpRight Lingual: Retract, MF toward tooth from left commissure

Pos. Facial: Retract , MF toward tooth from left commissure

Anterior to working

area

136

MAXILLARY ARCH POSITIONING (Left - handed)

Area Chair Back Op Pt Mirror MF = Mirror Face Fulcrum

Maxillary Anterior Sextant (6-11)



5° up Back Chin Up/ Straight Facial: Palm Lingual: Right Commissure #9-12

Maxillary Right Posterior Facial

Maxillary Left Posterior Lingual

5 ° up Middle to Front

Chin up/ Toward Op

Right Facial: Retract from Lt. Commissure

Left Lingual: Retract tongue, MF toward tooth, directed from Lt. commissure

Posterior or on lingual

cusp of working

area

Maxillary Right Posterior Lingual

Maxillary Left Posterior Facial

5 ° up Middle

Chin Up/ Away from Op

Right Lingual: Retract, MF toward tooth from left commissure


Anterior to working

area

137

PATIENT/ OPERATOR POSITIONING( RIGHT -HANDED OPERATOR)

FRONT of chair denotes operator at 8:00 - 9:00BACK of chair denotes operator at 11:00 - 12:00

MIDDLE of chair denotes operator at 10:00

MANDIBULAR ARCH POSITIONING


Mandibular Anterior Sextant (22-27)



15 ° up Front

Back

Chin Down/ Toward Op

Chin Down/ Away from Op

Facial: Palm Lingual: Rt. Commissure

Facial: Palm Lingual: Left Commissure

#21-25

#28-24

Mandibular Right Posterior Facial Mandibular Left Posterior Lingual

15 ° up Front Chin Down/ Away from OpRight Facial: Retract from Rt. Commissure

Left Lingual: Retract tongue, MF toward tooth, directed from rt. Commissure

Anterior to

working area

Mandibular Right Posterior Lingual Mandibular Left Posterior Facial

15 ° Middle Chin Down/ Toward OpRight Lingual: Retract, MF toward tooth from rt. commissure


Anterior to

working area

138

MAXILLARY ARCH POSITIONING (Right-handed)


Maxillary Anterior Sextant 6-11)



5° up Back Chin Up/ Straight Facial: Palm Lingual: Left Commissure #5-8

Maxillary Right Posterior Facial

Maxillary Left Posterior Lingual

5 ° up Middle to Front

Chin up/ Away from Op

Right Facial: Retract from Rt. Commissure

Left Lingual: Retract tongue, MF toward tooth, directed from rt. commissure

Posterior or on lingual

cusp of working area

Maxillary Right Posterior Lingual

Maxillary Left Posterior Facial

5 ° up Middle

Chin Up/ Toward

Right Lingual: Retract, MF toward tooth from left commissure


Anterior to working area

139

TU17/23



AREA 2

PTS.

EVAL

OPERATOR POSITIONING Correct height of operator's stool 4Back in neutral position 4Wrist in neutral position 4Correct seating area for instrumentation (Clock positions) 4PATIENT POSITIONINGBack of patient chair adjusted for appropriate arch 4Height of patient chair adjusted to level of operator's elbow 4Patient's head adjusted for treatment area (ex. toward/away, chin-up / down)

4

Light positioned appropriately for treatment area 4MOUTH MIRROR Appropriate for area (retracts when appropriate, indirect vision when appropriate)

4

GRASPUses pads of fingers to contact instrument 4 Index finger and thumb near handle/shank junction with thumb flexed outward

4

Middle finger on shank 4Handle rests between second and third knuckle of index finger 4All fingers contact instrument as unit 4Light but secure grasp pressure 20FULCRUMTip of ring finger standing as tall as possible (Visual cue: Handle parallel to long axis of tooth)

20

Fulcrum on incisal/occlusal surface or embrasure 10As close as possible to instrumentation area (1-2 teeth away) 10Appropriate palm direction 10ADAPTATION, INSERTIONPoint of insertion appropriate (overlaps midline on anteriors) 20

140

Adapts 1-1.5 mm of tip to tooth 20ACTIVATION/STROKEActivates with appropriate wrist-forearm motion 20Pivots stroke from fulcrum 20Rolls instrument in fingers around line angles 20Appropriate stroke direction (oblique on facial and lingual; vertical into proximal)

20

Light, exploratory stroke pressure 20Slow, feeling stroke speed 20SHEPHERD'S HOOK EXPLORERDemonstrates vertical stroke with appropriate pressure into occlusal surface

20

OTHERRecognizes tooth number 4Maintains asepsis 10INSTRUCTOR:

COMMENTS:

320

141

DISINFECTION AND SET-UP OF THE DENTAL UNIT AREA


TASK COMPONENTS/PROCEDURES EVALUATION Obtain supplies (goggles & alligator clip) from carry box. Place on paper towel. 3Perform short scrub (15 seconds)- gather PPE & cup to flush evacuation system 3Put on mask and glasses. Perform thorough scrub (3 latherings and rinses in 30 seconds) 3Put on gloves and overgloves ; position op and asst chairs, light, carts, & rheostat 3Flush evacuation system for 2 minutes (cup in sink with running water) -Does not include HVE

3

Flush water lines for 30 seconds 3Remove overgloves and discard into round opening next to sink 1PRECLEAN ("Modified spray-wipe-spray" technique using disinfectant unless otherwise noted) Dental chair, operator's and assistant's stools (soap & water) 3Discard paper towel 1Dental light switch and handles 3 Operators and assistant’s levers 3Discard paper towel 1Bracket table and accessories (A/W syringe , connectors, holders and hoses) 3Discard paper towel 1Assistant's cart, swivel arm and accessories ( A/W syringe, connectors, holders and hoses)

3

Discard paper towel 1Countertops, paper towel holder, soap dispenser, faucet handle, & sink rim & viewbox 3Discard paper towel ; Remove gloves, discard into round opening next to sink 1Wash hands - gather supplies 3Cover chair with plastic, plastic tape on switches, controls, and arm rests 3Cover bracket table and cart with patient napkins; Place instrument cassette on bracket table (Retain bag for instrument return to Central Sterilization)

3

Drop 1 ICX tab into water reservoir bottle; fill w/ distilled water 3Insert saliva ejector and A/W syringe tip; cover with plastic sleeves 3

143

Hang biohazard bag from unit; Tape overgloves to unit below bracket table 3BREAKDOWN PROCEDURE ( FOLLOWING PATIENT TX AND PATIENT DISMISSAL)Reglove, remask. Put on protective eyewear 1Close instrument cassette securely; place in retained autoclave bag for transport to CS 3Place contaminated disposables in red biohazard bag; remove and place bag into biohazard container. Remove contaminated gloves into container

3

Reglove 1Disinfect unit using modified spray-wipe-spray technique. 3Flush water and evacuation lines for 30 seconds 3Return equipment to its original position; rheostat on dental chair (on paper towel) 3Remove mask and discard; remove protective eye wear (operator and patient) and disinfect

3

Remove gloves into round opening next to sink 3Wash hands and dry thoroughly 3

OTHERMaintains asepsis 3Thoroughness of disinfection process 3Leaves surface area wet after disinfection process 3Performed in appropriate time frame 5Professional appearance 3 SCORE 10

3 INSTRUCTOR:

COMMENTS

144

SECTION VIII-A

PRE-CLINIC

145

DH 3312LABORATORY ACTIVITIES INSTRUCTIONS (Rm. 433)

NOTE: I will post a ‘Lab Activities Sheet’ on Blackboard prior to each lab session. You must print a copy of the document and bring it to the lab. Divide your time and perform each activity on the sheet.

1. Place a sheet of white paper (torn from the roll) on your lab countertop area. 2. Mount your typodont in the manikin. Adjust height accordingly to simulate patient treatment. (Keep in mind, height of occlusal plane in relation to your elbow, dental chair back position (i.e., 5-20 degrees from horizontal depending on the arch you are treating), your back and wrist positions in neutral, etc.3. Position your chair in relation to the mounted typodont in accordance with correct patient/operator positioning (you must visualize the patient in a dental chair to do this)4. Use the light at the unit to illuminate your work area.5. Turn the typodont toward or away from you as indicated in patient/operator positioning handout.

146

LAB BREAKDOWN SHOULD BEGIN AT 11:30!

147

Laboratory Assignment #1– OKC 2006(Wed., Aug. 30)

Simulator Student Instructor17 Acosta18 Avila Vargo19 Caruthers20 Clampitt21 Colbert

22 Deupree23 Dille Zerby24 Douglas25 Eaton26 Glasco

27 Gray28 Grocholski Rogers29 Idleman30 Kneggs31 Knop

32 Nollan33 Pickering French34 Shores35 Swarb36 Swift

37 Titsworth

Bowers38 Weaver39 Willis40 Wilson

148

Laboratory Assignment #2– OKC 2006

(Tues., Sept. 5)

Simulator Student Instructor17 Acosta18 Avila Schmidt19 Caruthers (TA #1)20 Clampitt21 Colbert22 Titsworth

23 Deupree24 Dille Cunningham25 Douglas (TA #2)26 Eaton27 Glasco28 Weaver

29 Gray30 Grocholski Zerby

(TA #3)31 Idleman

32 Kneggs33 Knop34 Willis

35 Nollan36 Pickering Vargo37 Shores (TA #4)38 Swarb39 Swift40 Wilson

150

Laboratory Assignment #3– OKC 2006(Tues., Sept. 26)

Simulator Student Instructor17 Acosta18 Avila Cunningham19 Caruthers (TA #4)20 Clampitt21 Colbert22 Titsworth

23 Deupree24 Dille Schmidt25 Douglas (TA #3)26 Eaton27 Glasco28 Weaver

29 Gray30 Grocholski Vargo31 Idleman32 Kneggs (TA #2)33 Knop34 Willis

35 Nollan36 Pickering Zerby37 Shores38 Swarb (TA #1)39 Swift40 Wilson

152

SECTION IX

Clinical Evaluation

154

Protocol &

Procedures

155

*

DH I CLINICAL EVALUATION CRITERIA

STEP CLINICALLY ACCEPTABLE NEEDS DEVELOPMENT

ASSESSMENT

PTP HHX / Vital Signs

Extra/Intra oral examDental Evaluation Periodontal Evaluation/occlusion

CDI

Radiographic interpretation

Risk AssessmentPatient Education

Treatment Plan

Patient management

Documentation


Comprehensively collects and synthesizes

all appropriate data

Recognizes need for consult and adaptations in care Seeks consultation prn

CDI accurate

Utilizes radiographs for assessment and in

developing treatment plan

Identifies all relevant assessment data Involves patient in planning process Follows logical sequence of prioritized

care Provides sound rationale Treatment proposed includes

comprehensive DH intervention Integrates and logically sequences

patient self-care Sets acceptable goals with patient input Assesses patient progress at each

appointment; modifies prn

Establishes and maintains rapport with patients, peers, and faculty

Demonstrates concern for patient's well-being

Documentation accurate and complete

Lack of documentation or differentiation between significant and insignificant findings

Use of incorrect terms

Failure to seek faculty assistance Failure to recognize necessary

adaptations in care

CDI inaccurate

Failure to utilize radiographs

Unable to identify or omits essential assessment data Does not involve patient in planning

process Plan content is inappropriate; lacks

essential elements Sequence choice compromises care Answers to questions indicate inadequate

knowledge Omits patient self-care Goals not established Does not reassess patient progress or

modify at each appointment

Lack of rapport with patient, peers, faculty

Lack of concern for patient's well-being

Records are illegible, unorganized,

156

Tobacco Cessation Assesses caries index, tissue healing

Assesses need for intervention

Sets acceptable goals with patient

inadequate

Omits or fails to identify correlation to overall health

Omits or fails to address need for behavior modification

DH I EVALUATION CRITERIA

STEP CLINICALLY ACCEPTABLE NEEDS DEVELOPMENT

157

CLINICALInstrumentation

Ultrasonic use

Calculus removal

Plaque removal

Tissue Trauma

Instrument care

Infection control

Posture

Time management

Professionalism

Demonstrates safe instrument control Activates with appropriate adaptation

and stroke pressure

Effectively utilizes US scaler and appropriate inserts

Self-evaluates with light, air, and explorer

Identifies remaining areas to faculty in advance

Able to remove remaining deposits identified by faculty

Removes areas of disclosable plaque/stain

Evaluates adequacy of patient's self-care Involves patient in evaluation of results Appropriate recall interval set Recognizes need for consultation

Recognizes tissue as inflamed, not traumatized

Selects correct instruments and maintains sharpness

Follows infection control protocols throughout

clinical period

Correct patient/operator positioning

Prepared prior to clinical session so treatment

moves smoothly Uses time efficiently and effectively On time for clinical session

Exhibits professional appearance Demonstrates concern for confidentiality Demonstrates ethical behavior

Hazardous instrument control Unacceptable adaptation and stroke

Ineffective use of US scaler

Self-evaluation is ineffective or omitted Excessive hard deposits remain

o Class A 2 or moreo Class B 4 or moreo Class C 6 or more

Excessive plaque/stain remainso Class A,B,C 4 or more

Fails to follow up on patient self care and/or

adapt to patient need Does not involve patient in evaluation

process

Tissue traumatized by hand or ultrasonics

Excessive trauma 2 or more

Faculty assists in instrument selection; sharpness not maintained

Does not follow infection control guidelines

or breaks aseptic chain

Improper patient/operator positioning

Demonstrates lack of clinic preparation resulting in major clinic interruptions

Does not complete procedures in a timely fashion

Late for clinic sessionUnprofessional appearance

Violates patient's confidentiality Demonstrates unethical behavior

158

DH II EVALUATION CRITERIASTEP CLINICALLY ACCEPTABLE NEEDS DEVELOPMENT

ASSESSMENT

Comprehensive health history/vital signsExtra/Intra oral examDental chartingPerio charting/occlusion

CDI

Radiographic interpretation

Comprehensive treatment plan developed/pt. education

Documentation

Patient management


Tobacco Cessation

Comprehensively collects and synthesizes all appropriate data Recognizes need for consult/adaptations

in care Seeks consultation prn

CDI accurate

Utilizes radiographs for assessment and in

developing treatment plan

Identifies all relevant assessment data Involves patient in planning process Follows logical sequence of care Provides sound rationale Treatment proposed includes

comprehensive DH intervention Integrates and logically sequences patient

self-care Sets acceptable goals with patient input Assesses patient progress at each

appointment; modifies prn

Documentation accurate and complete Establishes and maintains rapport with

patients, peers, and faculty

Demonstrates concern for patient's well-being

Assesses caries index, tissue healing Assesses need for intervention Sets acceptable goals with patient

Lack of documentation or differentiation between

significant and insignificant findings Use of incorrect terms Failure to seek faculty assistance Failure to recognize necessar adaptations in care

CDI inaccurate

Failure to utilize radiographs

Unable to identify or omits essential assessment data

Does not involve patient in planning process Plan content is inappropriate; lacks essential

elements Sequence choice compromises care Answers to questions indicate inadequate

knowledge Omits patient self-care Goals not established Does not reassess patient progress or modify at

each appointment

Records are illegible, unorganized, inadequate

Lack of rapport with patient, peers, faculty Lack of concern for patient's well-being

Omits or fails to identify correlation to overall health

Omits or fails to address need for behavior modification

159

DH II EVALUATION CRITERIA

STEP CLINICALLY ACCEPTABLE NEEDS DEVELOPMENTCLINICAL

Instrumentation

Ultrasonic use

Calculus removal

Plaque removal

Tissue Trauma

Re-evaluation

Instrument care

Infection control

Posture

Time management

Demonstrates safe instrument control Activates with appropriate

adaptation and stroke pressure Effectively utilizes US scaler and

appropriate inserts Self-evaluates with light, air, and explorer Identifies remaining areas to faculty in advance Able to remove remaining deposits identified by faculty

Removes areas of disclosable plaque/stain

Recognizes tissue as inflamed, not traumatized

Soft tissues evaluated after appropriate healing Evaluates adequacy of patient's self-care Involves patient in evaluation of results Appropriate recall interval set Recognizes need for consultation

Selects correct instruments and maintains sharpness Follows infection control protocols

throughout clinical period Correct patient/operator positioning Prepared prior to clinical session so

treatment moves smoothly Uses time efficiently and effectively On time for clinical session Exhibits professional appearance

Hazardous instrument control Unacceptable adaptation and stroke

Ineffective use of US scaler

Self-evaluation is ineffective or omitted Excessive supra deposits remain 2 or more Excessive sub deposits remain B more than 2 per mouth C more than 3 per mouth D more than 2 per quad E more than 2 per quad Unable to remove remaining deposits

Excessive plaque/stain remains more than 4 Tissue traumatized by hand or ultrasonics Excessive trauma 2 or more

Does not plan for soft tissue evaluation when appropriate Fails to follow up on patient self care and/or

adapt to patient need Does not involve patient in the evaluation process Inappropriate recall interval Faculty assists in instrument selection; sharpness not maintained Does not follow infection control guidelines or

breaks aseptic chain Improper patient/operator positioning Demonstrates lack of clinic preparation resulting in major clinic interruptions Does not complete procedures in a timely fashion Late for clinic session

Unprofessional appearance Violates patient's confidentiality Demonstrates unethical behavior

160

Professionalism Demonstrates concern for confidentiality Demonstrates ethical behavior

STEP CLINICALLY ACCEPTABLE NEEDS DEVELOPMENTSUPPORTIVE TREATMENT

Diet counselingTobacco cessationImpressions, bleaching traysAmalgam polishing Care of removable prosthesisDesensitization SealantsRemarginationPain control (IA, PSA, Infiltrations)Nitrous Oxide & oxygen sedation

Recognizes need for procedure Explains rationale to patient Follows prescribed technique Procedure completed according to guidelines Quality of product is acceptable Administers pain control when necessary Proper protocol/technique is followed

when administering pain control

Faculty identifies need Needs moderate faculty assistance to complete Finished product is not clinically acceptable

Omission of pain control compromises patient care

Protocol not followed when administering pain control

161

PATIENT RECEPTION AND OPERATOR/PATIENT POSITIONING

l. Prepares for appointment:

A. positions patient chair in comfortably upright position, with the chair seat at its lowest position

B. adjusts operator stool so that the operator's knees are parallel or slightly below, the thighs are parallel to the floor and the backrest is positioned to

provide support to the lumbar spine (a pillow, rolled up towel, back support, or cushion may be used for additional support)

C. Removes all obstacles from the patient's pathway to the chair, including cart, light, and operator stool, taking care not to obstruct the pathway of adjacent clinicians

2. Greets the patient:

A. secures patient records

B. greets patient by name, makes eye contact

C. introduces self to patient, maintaining friendly attitude and eye contact

3. Escorts patient to operatory using the center aisle and asks patient to place personal belongings in the closet, or place on floor beside light post

4. Assists the patient in being seated in the patient chair on the side opposite the light post.

5. Secures patient napkin and provides the patient with tissue(s) for removing lipstick, and/or for later use

6. Completes all forms, including medical history interview, completes vital signs and obtains PTP extraoral examination, with patient in comfortable seated position

7. Asks for patient's removable appliances and secures appropriately

8. For procedures beginning with the intraoral examination and if not contraindicated by medical history, lowers backrest of chair to place the patient in a comfortable supine position being careful that the neck rest is in a slightly upright position providing support to the neck.

162

9. Lowers or raises the total chair until the field of operation (mouth) is parallel to the operator's elbows

l0. Warns the patient of need for eye protection from airborne debris and provides patient with appropriate safety glasses or goggles

11. Asks small patient or child to place head at upper edge of chair for optimum visualization and operator position

12. Positions patient chair for mandibular instrumentation:

A. lowers the chair back to 20°

B. lowers or raises the chair base until patient's mandibular occlusal plane is parallel to operator's elbows, does not attempt to raise chair to allow

placement of legs under chair back if they do not fit with the patient at the appropriate height for operator

C. asks patient to lower chin and/or to turn to the appropriate side for optimum visualization

D. directs light directly down over area of instrumentation, adjusting light to optimally illuminate instrumentation area (may be to patient's left, right, or in the center)

13. Positions patient for maxillary instrumentation:

A. lowers the patient into the true supine position at 5

B. lowers or raises the chair base until the patient's maxillary occlusal plane is parallel to operator's elbows, does not attempt to raise chair to allow placement of legs under chair back if they do not fit with the patient at the appropriate height for operator

C. asks patient to raise chin and/or to turn to the appropriate side for optimum visualization

D. directs light down over patient's chest, then up toward area of

instrumentation, adjusting

g light to optimally illuminationinstrumentation area (may be to patients left, right, or in the center)

14. Maintains optimum operator positioning throughout procedure(s):

A. determines operator's individual neutral spine position and maintains throughout, and when necessary, moves forward by rotating from the hip.

Absolutely does NOT bend or arch spine, does NOT twist torso, does NOT 163

lean laterally. Asks patient to adjust his/her head position to allow visualization of instrumentation area

B. maintains eye level at 14-16 inches from the field of operation

C. correctly assumes the following clock positions for the area of instrumentation: 8 - 12 o'clock for right-handed operators; 12 - 4 o'clock for left-handed operators.

D. feet may be flat on floor to provide a stable tripod, legs should be separated as necessary to assume optimum position.

E. places cart and light for easy access from the operator's position with a minimum of turning or reaching

F. maintains shoulders in neutral, relaxed position

G. remains conscious of optimum operator/patient positioning throughout procedure

H. takes a break every thirty to sixty minutes by standing up and doing gentle back bends, stretching and walking around a little, does not work in the same position for longer than one hour

H. I. allows patient five minute break following each sixty minutes of active treatment

164

Permission to Proceed (PTP) Presentation

1. Age, race, sex of patiente.g.: 25 year old white female

2. Medicationsa. if taking medications either prescribed or over the counter, student will state:i. names of all drugsii. reason for taking

5 student should be prepared to answer questions from faculty about relevant drugs; student may use Dental Drug Reference or PDR

c. all PRESCRIBED drugs must be listed on Medical Alert form in patient's chartd. if taking no drugs, student will state "no medications"

3. Past Relevant Illnessa. previous illnesses/hospitalizations impacting dental hygiene care (faculty will check

medical history to determine correctness of student statement)b. student will state factors of illness that necessitate modifications to treatmentc. student will state necessary modificationsd. e.g.: History of rheumatic fever at age 12 years; will require prophylactic antibiotic therapy prior to treatment.e. if no relevant illness; will state "no previous illness of concern."

4. Present Relevant Illnessa. present illnesses impacting dental hygiene care (faculty will check medical history

to determine correctness of student statement)b. student will state factors of illness that necessitate modifications to treatmentc. student will state necessary modificationsd. e.g.: Hypertension currently under control with diet and exercise; will take

blood pressure pre and post treatment.e. if no relevant illness; will state "no present illness of concern."

5. Relevant Allergiesa. allergy impacting dental hygiene care (faculty will check medical history to determine

correctness of student statement)b. student will state previous patient reaction to allergenc. student will state necessary modifications to treatment protocold. allergy of concern must be listed on Medical Alert form in patient's charte. e.g.: allergy to latex; patient experienced hives and respiratory distress; will

utilize nitrile gloves for all treatment.e. if no relevant illness; will state "no allergy of concern."

6. Vital Signsa. student will state blood pressure, pulse and respiration valuesb. if not within normal limits, student will state protocol for deviationc e.g.: after two readings two minutes apart, current blood pressure

appears to be in the Stage 2, moderate hypertension category; however, patient has not been diagnosed and will be referred to her

165

physician for further evaluation within one month. Pre & post-treatment blood pressure will be taken.

7. Dental Historya. student will summarize dental visits history (i.e., periodic or emergency only)b. previous periodontal charting summary (recall only) and/or history of periodontal carec. approximate time since patient's most recent prophylaxisd. patient's last dental treatmente. if any negative dental experiences, the student will describef. e.g.: patient has previously been seen on an emergency basis only "whenever he recognizes that he has a problem"; patient had periodontal surgery and graft on facial of lower anteriors in 1995; previous charting depths of record dated May 13, 1994 indicated generalized pockets of 4-5

mm; last prophylaxis was May 13, 1994; last dental treatment was root canal done last month on #6.

8. Contributory Factorsa. student will state possibly detrimental oral habitsb. student will state lifestyle factors possibly impacting oral health6 e.g., "patient smokes two packs of cigarettes daily"7 if there are no apparent detrimental habits noted at this time, student will state,

"no apparent contributory factors"

9. Current Oral Health Concern(s)/Complaint(s)8 student will state concerns in the patient's words9 if there are no concerns or complaints; student will state "no current oral health

concerns or problems"

10. Family Health Historya. summarize contributory family health history factorsb. state relevance of history to patient carec. e.g.: both parents had history of hypertension; father died at age 47 years from CVA; mother currently has CHF at age 67. Patient may be genetically predisposed to hypertension.d. if family health history is not an apparent factor, student will state, "family health history is non-contributory"

11. Family Dental Historya. summarize contributory family dental history factorsb. state relevance of history to patient carec. e.g.: older sister had an extra third molar; will take panograph to check for supernumerary third molar.d. if family health history is not an apparent factor, student will state, "family health history is non-contributory"

12. Patient Suitability Opinion Statementa. end with a general statement of patient's apparent suitability as a patient in the dental hygiene clinicb. provide rational for any other than suitable patientc. e.g.: patient should not be seen in the dental hygiene clinic at this time because of an active herpes simplex lesion; patient will be instructed to reappoint after the lesion heals.d. if patient is suitable as a dental hygiene patient, student will state, "patient appears to be a good candidate for dental hygiene treatment.

166

MEDICAL ALERT SHEET:The medical alert sheet at the front of the patient's chart should be completed in any of the following circumstances:

1. Allergies to medications or materials likely to be encountered as a dental patient.2. Prescribed medications that are being taken.3. There is a history of either contributory present or past illness(es).4. There are conditions for which antibiotic prophylaxis or other premedication is indicated.5. Include current physician's name and phone number for EVERY patient.

NOTE:Information for PTP as stated above should be presented in the order given. The information should be presented only at the initial appointment. The only requirement for subsequent appointments is an oral review of the critical elements of the health history and a statement of any changes since the last appointment.

167

INITIAL VISIT PTP MONOLOGUE

Student States:

Patient presents as a (age, race, sex) in apparent (poor, fair, good health) with(no chief complaint/chief complaint) of "___________________".

This patient is (new, recall) at the COD.

Patient is currently taking: (meds) for (reason for meds). Student must state dental considerations related to medication.

Patient states (drug allergies/sensitivity) to the following: _________ with a reaction of ________.

Patient reports a history of : (pertinent personal health history information)

Patient reports a family history of: (pertinent immediate family health history information). (Ex. Mother is hypertensive)

Patient reports a dental history of: If a new patient to COD:

This information will be provided by the patient. i.e. Regular dental care, emergency care only, etc. If a recall patient at the COD: This information should include past probing depths (localized/generalized perio information

statement , date of last prophy/exam, date of last radiographs, last CDI classification)

Patients vitals are: BP: ______, Pulse _____bpm, Respirations_____rpm.

Patient appears to be a _________candidate for dental treatment at the COD.

168

SUBSEQUENT VISIT PTP MONOLOGUE

Student states :

1. Appt number with patient. (Ex. This is appt. #2 with this patient) 1. Changes in health history from the last appointment and/or significant health information (Ex. Asthma, diabetes, high BP, cardiac problems or any other medical issues that might effect Tx.

2. Current medication information. 3. CDI of patient and significant dental and perio findings of last appointment ( ex. severe bruxism, gross caries, ANUG, probe depths, BOP, etc).

4. Procedures that are to be accomplished at today's appointment.5. Any other information that the faculty may request to acquaint or reacquaint themselves with the patient.

CASE COMPLETE MONOLOGUE

1. Probing depths (pre-treatment and post-treatment)

2. BI (pre-treatment and post-treatment)

3. Amount/areas of residual calculus

4. Assessment of patient compliance

5. Reasons for non-resolution

6. Recommended recall

7. Further DH treatment/recommendations (including patient ed)

169

INITIAL VISIT PTP MONOLOGUE

(1st visit of series)

Student States:

Patient presents as a ________________________________(age, race, sex) in apparent

_____________________(poor, fair, good health) with a

(no chief complaint/chief complaint) of "________________________________".

This patient is _____________________(new, recall) at the COD.

Patient is currently taking: _______________________________________(meds) for

_____________________________________________________(reason for meds).

Dental considerations related to medication_____________________________________

Patient states _____________________________________(drug allergies/sensitivity) to

the following meds: _________________________________________with a reaction of

___________________________________________________.

Patient reports a history of : (pertinent personal health history

information)______________________________________________________________

______________________________________________________________________________________________________

__________________________________________

Patient reports a family history of: (pertinent immediate family health history information). ________________________________________________________________________Patient reports a personal dental history of: ________________________________________________________________________________________________________________________________________________________________________________________________________________________

Patients vitals are: BP: ____________, Pulse _________BPM, Resp__________RPM.

170

SUBSEQUENT VISIT PTP MONOLOGUE

(2nd….etc visit of series)

Student states :

This is appointment no. _________________ with patient (state name) There have been ____________________________________changes in health history from the last appointment and/or there have been no changes since the last appointment. The patient’s significant health information includes: ________________________________________________________________________________________________________________________________________________________________________________________________________________________The patient currently takes _________________________________________(state meds) for

_____________________________________________________________________ with dental considerations

of:_________________________________________________

At work-up I documented: (Chief Complaint, EIE, CDI , and any significant dental and perio

findings of last appointment)

______________________________________________________________________________________________________

______________________________________________________________________________________________________

____________________________________________________________________________________

Today I plan to accomplish:

______________________________________________________________________________________________________

__________________________________________

171

THE COMPLETE SEQUENCE

1. Arrive at 8:30 am: pick up cassette, handpiece, and sharpening stones at Central Sterilization (allow 10 minutes for set-up and 15-20 minutes for sharpening)2. Seat patient at 9:00am.

a. Faculty must be present before seating patient.3. Obtain (if new patient) or review (if recall patient) health history, vitals, medical alert sheet

a. Follow COD Blood Pressure Protocol Guidelines4. Obtain Permission to Proceed (PTP) from assigned instructor.

a. Written documentation in TPN and verbal presentation to faculty 5. Complete Work-up

Includes: EIE, D/P charting, BI, PASS PI, Case Difficulty Index (CDI), Occlusion, Overbite, Overjet

6. Sign up for instructor check of work-up STOP! NO FURTHER PATIENT TREATMENT MAY OCCUR

UNTIL INSTRUCTOR HAS CHECKED WORK UP!

a. You may begin working on DH Tx Plan while waiting for instructor check. If not complete by time instructor arrives, you may complete at home and bring to appt. 2 b. Oral diagnosis exam may be done after work-up check

7. Disclose and perform OHI8. Scale 2 quads – you may choose either 1 &4 or 2 & 39. Sign up for instructor check of scaling after 2 quads

a. Hold paperwork up on opposite side of dental chairb. You may being scaling other 2 quads while waiting for instructor check

10. Sign up for instructor check after scaling the remaining 2 quadsa. You may begin RC polishing while waiting for instructor check of

scaling11. Sign up for final instructor check after 4 quads of polishing complete

a. RC or TB Polish entire mouth. b. Check your work with disclosing solution.c. Have disclosing solution and cotton tip applicator ready for faculty

14, Administer fluoride after final instructor check of patient

The LATEST time to sign up for completed work TO BE CHECKED by faculty is 11:15 am. A time extension may be granted on a CASE BY CASE basis by assigned faculty, but must be requested prior to 11:15am. If no instructor check is needed, 11:45 am is patient dismissal time

172

VITAL SIGNS

1To be obtained at the primary appointment; 2on subsequent appointments for the patient with a history of heart disease or abnormal blood pressure, or any other

systemic condition that dictates blood pressure monitoring; 3if the patient takes a

medication that alters blood pressure; 4during pregnancy; 5prior to the administration of local anesthetic or nitrous oxide analgesia.

PULSE

1. Positions patients arm on a flat surface at level of the heart

2. Holds patient's forearm palm downward in palm of hand with index, second, and third fingertips securely over the radial artery

3. Places thumb on opposite side of wrist

4. Exerts firm pressure over radial artery and observes pulse for 30 seconds

5. Records pulse rate on patient's record by multiplying 30 seconds rate by 2

6. Records rhythm, volume, condition of arterial wall if abnormalities are observed

7. Pulse reading is accurate within 5 beats

RESPIRATION

1. Counts patient respiration while pulse is held as if being taken

2. Observes respirations before or after measuring the pulse

3. Counts for 30 seconds and multiplies by 2 if respirations observed are regular or counts respirations for one full minute if abnormalities of respiration are observed

4. Observes respiratory movements so patient is not aware of this observation

5. Records respiratory rate promptly

6. Records and reports observations if rhythm, depth or character of respirations are abnormal

7. Respirations are accurate within 2 breaths

174

BLOOD PRESSURE

1. Secures manometer, pressure cuff, and stethoscope

2. Determines whether patient has just engaged in physical activity, smoking , eating

3. Discusses activity to be carried out with the patient

4 . Removes all clothing from the extremity

5. Places manometer at proper viewing angle and distance

6. Wraps the cuff snugly and smoothly on the extremity

7. Places the center of the inflatable bag directly over the artery with the lower edge one inch above the antecubital space

8. Locates radial pulse and holds as if taking pulse

9. Inflates cuff until radial pulse is no longer palpated and notes reading obtained

10. Deflates cuff

11. Locates brachial pulse and apply bell to pulse area

12. Places earpieces in ears

13. Inflates cuff to 10 - 20 mm Hg higher than pressure necessary to stop radial pulse (step 10)

14. Allows pressure to fall evenly and notes systolic and diastolic readings

15. When diastolic is reached, releases cuff pressure

16. Inflates cuff and retakes after 30 seconds

17. Removes the cuff and stethoscope

18. Averages the two readings and records the measurement

19. Reading for systolic and diastolic are accurate to within + 5 mm Hg

20. Returns equipment to its storage place

176

EVALUATION

1. Identify abnormal levels/rates for each vital sign.

2. Recognize need to obtain an OD consult or terminate appointment.

3. Notify patient of need for medical consult if vital signs are above normal ranges. (See Blood Pressure Protocol).

178

EXTRAORAL/INTRAORAL EXAMINATION

EXTRAORAL1. Assembles armamentarium: mouth mirror, adequate light, two 2X2" gauze

sponges, tongue depressor, personal protective equipment2. Looks at the skin of the neck and face.3. Asks the patient to open and close the mouth while observing T.M.J. and

mandibular movements.4. Places the hands flat against the patient's face with the index fingers firmly

resting over the TMJ.5. Asks the patient to open and close the mouth while the operator's hands

remain in place to feel deviation in TMJ glide and to note possible vibrations from crepitation

6. Palpates the musclesA. temporalis - bilateral temple (fan) to coronoid processB. masseter - bilateral cheek to angle of mandibleC. buccinator - bilateral lips back toward ramusD. sternocleidomastoid - bilateral & bidigital

7. Palpates the lymph nodes:A. submandibular - by placing the fingers of each hand against the skin of

the neck approximately 1 or 2 inches below the interior border of the mandible. The fingers should be perpendicular to, and pressing firmly into the neck. The fingers are then drawn up slowly until the inferior border of the mandible is reached. Fingers arte "walked" from most posterior position until they meet in the anterior portion of the mandible

B. preauricular bilateral techniqueC. postauricular bilateral techniqueD. submental - bilateral digital techniqueE. anterior and posterior cervical chain (while palpating cervical tissues

surrounding the sterno-cleidomastoid)F. parotid (while examining TMJ)G. supraclavicular - bidigital techniqueH. thyroid - bimanual, digital - pressing alternately on opposite sides of

the larnyx, trachea, and above notch of sternum. Ask patient to swallow while plating thumb and fingers over the area

INTRAORAL1. Observes the lips and labial mucosae. The labial mucosae are examined with

the lips reflected up for the upper lip and down for the lower lip.2. With the lips reflected, examines the labial and buccal gingivae and

mucobuccal folds.3. Palpates the lips and labial mucosa bidigitally.4. Observes the buccal mucosae by holding cheek taut with the index and

middle fingers. Has the patient turn his head in the direction of the side being observed.

5. Palpates buccal. mucosae bidigitaly. Observe Stenson's Duct of parotid gland and note presence of Fordyce Granules.

179

6. Observes the dorsum of the tongue, asks the patient to touch the palate with

the tip of the tongue and examines the ventral surface of the tongue and the floor of the mouth. Note presence of papillae coatings

7. Palpates the floor of the mouth bimanually by placing a flat hand firmly inferior to the mandible as far as the neck and using one or two fingers of the opposite hand to presses firmly. May be done after step 9 is completed.

8. Examines the posterolateral border of the tongue by protruding the tongue and moving it to) one side, grasping the tongue with gauze sponge and gently pulling it forward and laterally. Note color of papillae.

9. Palpates the lateral borders of the tongue and the body of the tongue bidigitally.

10. The mandibular lingual gingivae and retromolar gingiva are observed using the mouth mirror. While the gingiva is seen on the reflecting (glass) side of the mirror the back of the mirror retracts the tongue.

11. Observes the palatal gingivae and mucosa of the hard palate either, by direct vision (changing head position appropriately), or indirectly with a mirror.

12. Observes the maxillary alveolar ridge and maxillary tuberosities using mouth mirror.

13. Depresses the patient's tongue with tongue blade or mirror, and observes the soft palate and uvula.

14. Observes the tonsillar pillars and oropharynx by depressing the tongue blade or mirror and having the patient say "aaah".

15. Note and record presence of mouth odor, such as fetor oris or sweet fruity smell.

16. Note and observe quantity and consistency of saliva.

CHARTING

1. Fills out all blanks on the extraoral and intraoral examination section on the patient chart.

2. Notes deviations from normal on the chart and records answers to the following questions:.A. locationB. description: sizeC. description: colorD. description: surface textureE. description: consistencyF. history: whether or not lesion is known to patientG. history: durationH. history: symptoms

180

DEFINITIONS OF TERMS

bidigital palpation - Use of one or more fingers and the thumb to examine tissues by grasping the tissue between thumb and fingers

bilateral palpation - examination of structures on both sides of the face or necksimultaneously to detect differences between the two sides

bimanual palpation - examination of structures on both sides of the face or necksimultaneously to detect differences between the two sides

bullae - large (5 mm to several centimeters) vesicles that are relatively deep seatedand less prone to rupture; often seen with pemphigus

circular compression - moving the fingertips in a circular pattern over a structurewhile simultaneously applying pressure to the tissue

confluent - blending or occurring together, originally separate, but subsequentlycombined

diffuse - spread out, blended together; used to describe borders of lesions

digital palpation - use of a finger to examine tissues

discrete - separate, well-defined, not blending; used to describe borders of lesions

erosion - shallow surface defect that does not extend through the epithelium into underlying tissues

erythema - red area of variable size or shape

induration - hardened area of tissue

keratosis - abnormal thickening of the outer layers of skin or mucosa that may appear as white, grayish white, or brown lesions; examples are linea alba, cheek-biting, nicotine stomatitis, lesions of lichen planus, and leukoplakia

macules flat areas that are differentiated from surrounding tissues by color; may vary in size, shape and color; examples are petechiae, ecchymoses, freckles, and maleness

manual palpation - use of all the fingers of one hand to examine tissues

nodules - enlarged papules that are seated in the submucosa or lower dermis; examples are traumatic fibromas, lesions associated rheumatoid arthritis, Kaposi's sarcoma

181

papules - small (pinhead to 5 mm) superficial elevated areas of tissue, which may

appear flattened, rounded, or pointed; color may vary; examples are found in lichen planus, and some condylomas

pedunculated - elevated papillary type of lesion attached to underlying tissue by a stem or narrow connector

petechia(e) - minute round red spot(s)

pustules - vesicles that contain pus

sessile - attachment of lesion by a broad base

tumor - solid growth of hard or soft tissue; swelling or overgrowth of cells independent of normal tissue; examples are papillomas, polyps, and tori

ulcer - defect in the skin or mucosa that extends beyond the surface epithelium and into the underlying issues; may be ragged or punched out; may be smooth, granular, glazed, pus-covered, or hemorrhagic, painless or extremely sensitive

verrucous, or verrucose - resembling a wart; denoting wartlike elevations

vesicles - small elevations containing fluid with a thin surface covering of epithelium or mucosa (e.g., blisters); they may occur singly or in clusters; examples are herpetic lesions

well-circumscribed - differentiated; having discrete borders and a definite shape

182

EXTRAORAL/INTRAORAL EXAMINATION SEQUENCE

General Instructions:

7 Operator uses the ends (fleshy parts) of finger pads for palpating tissues, and when possible, maintains contact between the fingers (index through fifth) in order to broaden palpation surface of hand and reduce chance of missing deviations.

8 Operator detects and questions patient regarding any tenderness as evidenced by verbal or nonverbal behavior.

9 Overgloves should be worn when documenting findings.

10 Findings should be documented when:a. baseline information is neededb. the area needs to be re-evaluated at subsequent appointmentsc. the finding may affect future treatment optionsNote: Scars, freckles, tori, linea alba, indentions from glasses, and other findings that have been present for an extended period of time and/or that will not change and are currently within normal limits should not be documented.

11 Findings should be described using the following categories and terminology:a. Size – measure in mm.

b. Color – pink, red, magenta, blue, white, yellow

c. Shape – linear, circular, irregular

d. Consistency – fluid-filled, firm, ulcerated

e. Mass – flat-macule, raised-papule

f. Location – specific – on left buccal mucosa adj. to #19 generalized – max. left alveolar ridge

g. Duration – how long has it been present

h. Symptoms – tender, asymptomatic

Example: 3 mm. pink round firm sessile papule on left buccal mucosa adjacent to #19, dur.-unknown, asymptomatic.

12 General assessment of patient should include:8 body build, gait, ease of movement9 intellectual ability, degree of alertness10 speech11 habits with physical manifestations12 general hygiene

184

7. Assemble armamentarium: mouth mirror, probe, 2X2 gauze squares, ppe.

Extraoral Examination

1. Don gloves.

2. While positioned standing in front of the patient (with the patient in a seated, upright position), look at the skin and structure of the face and neck observing symmetry as well as skin abnormalities.

3. Utilize bilateral palpation beginning with the forehead and progressing with the temple*, cheeks, nose, upper lip area, chin, and submandibular area. * After palpating the temple area, place two to three fingers over the TMJ position and ask the patient to open their mouth as wide as they can slowly and note any deviations and/or abnormalities (i.e. clicking, popping, crepitus, subluxation, or deviation). Be sure you are positioned in front of the patient to observe the TMJ.

I. Bidigitally palpate the tracheal area, including the thyroid. Observe the thyroid area and have the patient swallow.

5. Palpate the right sternocleidomastoid muscle simultaneously anteriorly and posteriorly beginning at the base and moving superiorly. Move around to the other side of the patient and repeat with the left sternocleidomastoid muscle.

6. While standing behind the patient, ask them to lean their head forward and down. Utilize bilateral palpation to examine the back of the neck, suboccipital area, and behind the ears. Utilize bidigital palpation to examine the trapezius muscle and supraclavicular area.

Intraoral Examination

Recline patient into supine position. Wash and reglove. Follow similar palpating and examination procedures as for extraoral exam. The operator should be seated.

1. Lips

10 Observe with the mouth closed and observe the location of the philtrum and the vermilion borders.

11 Observe with the mouth open and observe the labial commissures for a restricted opening.

12 Grasp the patient’s lower lip with the thumb and index fingers of each hand and gently palpate using both a bidigital and bilateral technique.

13 Repeat (c) on upper lip.

2. Labial and buccal mucosa

8. Gently grasp the patient’s lower lip with the thumb and index finger of each hand and deflect lower lip.

9. Visually examine the labial mucosa, the vestibule and the labial frenae.185

10. Gently palpate this area.11. Repeat a.,b.,c., on upper lip.12. Instruct patient to open wide and examine the buccal mucosa and buccal

vestibule.13. Observe and palpate the tissue from the inner commissure of the lip anteriorly

to the retromolar pad posteriorly.14. Check the appearance of the Parotid (Stensen’s duct).15. Test the duct by gently stroking it with a dry gauze and checking if the gentle

stimulation has caused secretion of saliva. Examine both right and left ducts.

3. Floor of mouth (operator should be seated at 8/9 o’clock)

8 Have patient open their mouth and tilt chin upward slightly.9 Utilize bimanual palpation technique, with one finger in the floor of the mouth

and two fingers directly opposite, underneath the chin.10 Cover the entire area, one side at a time (unilaterally).11 First, move from deep under the tongue and proceed towards the anterior

aspect of the sublingual area.12 Next, cross the mid-line area and palpate the opposite side in the same

manner.13 Have patient touch tip of tongue to the roof of his mouth so that the ventral

surface of the tongue and the floor of the mouth can be observed.14 Observe the attachment of the lingual frenulum.

4. Tongue

11 Examine the tongue as it normally rests in the mouth by instructing the patient to partially open.

12 Have the patient extend his tongue and visually observe any deviation or asymmetry.

13 After advising the patient of your intent, ask him to extend or “stick out” his tongue. Gently, but firmly, grasp the tip of the tongue in a 2X2 gauze square and pull it forward and laterally. Observe both left and right borders in this manner.

14 Use bidigital palpation along the lateral borders with your free hand.

5. Hard palate and soft palate

a. Instruct the patient to tilt his chin up and to open the mouth wide. Use direct and indirect vision to observe the hard and soft palates.

b. The hard palate should be palpated with the index finger to feel if there is any deviation or swelling not readily observed visually.

c. If easy observation of the soft palate is not possible with the patient in this position, the base of the tongue may be gently depressed with a mouth mirror or tongue blade while the patient is instructed to say “Ahh”.

6. Uvula, Tonsillar Pillars, Oropharynx

To observe the oropharynx area, it may be necessary to maintain gentle forward and slight downward pressure of a tongue blade or mouth mirror on the base of the tongue to depress

186

it out of the line of vision (may also need the patient to say “Ahh”). Be aware you may trigger the gag reflex if you depress too far posteriorly.Compare landmarks on both sides of the oropharynx.

7 Alveolar mucosa

Check visually at the apices of all teeth, both facially and lingually.

8 Edentulous gingiva

Visually examine for deviations.Palpate with thumb and forefinger.

9 Gingival Screening

Will follow periodontal charting and should include a brief description of the clinical observations of the periodontium.

The following should be included in the description:

Quality – mild, moderate, severeQuantity – localized, generalized

Location – scattered, area-specific (i.e. mand. ant., max. post., etc.)

Consistency/Texture – firm, spongy, fibrotic, etc.Contour/Form – uniform, recession, clefting,

bulbous, rolled margins, etc.Color – coral pink, pink, red, magenta, etc.Sulci – include a summary of depths and bleeding

observations (i.e. gen. 2-3 mm. with no BOP with loc. 4 mm. in max. post. with mild BOP)

Utilizing this descriptive terminology will enhance observation skills and therefore improve the ability to better define the needs of the patient.

10 Other

May note any unusual findings that do not fit in the above categories.

11 Saliva

1. Note consistency2. Note extreme dryness (xerostomia) or extreme salivation.

187

Elevated Lesions

(above the normal plane of mucosa)

Localized Generalized (limited to a small focal area) (involves most or all of an area)

Single MultipleMultiple lesions are either separate(widely spaced with distinct margins)or coalescing(close to each other withmargins that merge)

Blisterform Nonblisterform (containing fluid with translucent (solid lesion containing no appearance and a soft consistency) fluid and of a firm consistency)

Vesicle Bulla Papule Tumor(less than 1 cm (greater than (less than 1 cm in (1 cm or greater inin diameter, contains 1 cm in diameter diameter, consists of diameter, consists ofserum or mucin) contains serum tissue) tissue)

or mucin, maycontain extravasated

blood) Pustule blood) Nodule Plaque

(contains pus, yellowish color (smaller than 1 cm in (slightly raised

any size diameter, consists of with a broad flatPustule tissue) top and a “pasted

(contains pus, yellowish color, on” appearance)

any size

188

Depressed Lesions

(below the normal plane of mucosa,usually an ulcer where there is loss of

continuity of epithelium

Single MultipleMultiple lesions are eitherSeparate or coalescing

Regular Outline Irregular Outline(continuous linear outline that resembles a circle or oval) (numerous deviations from a circular or oval

pattern)

Smooth Margin Raised Margin(margin of lesion is on the same plane as normal mucosa) (margin of lesion is above the plane of

normal mucos)

Superficial Deep(distance from base of depression to plane of margin (distance from base of depression to plane of

is less than 3 mm.) margin is greater than 3 mm

189

Flat Lesions(surface is on the same plane as the normal mucosa)

Single Macule Multiple Macules

(flat lesion of abnormal color) multiple lesions are either separateor coalescing

Regular Outline Irregular

Outline

190

PERIODONTAL CHARTING

Full mouth periodontal charting to be completed on new patients.

1. Probes entire pocket topography of each tooth in the sextant(s)

2. Notes and records the deepest clinical probing depths found in six areas of the tooth: DB, B, MB, ML, L, DL

3. Notes and records gingival recession measuring from CEJ to junctional epithelium (clinical attachment level) marginal gingiva

4. Notes and records furcation involvement

A. Class I - tactile exposure of the groove or concavity on the root trunk only, detectable by the Naber's probe

B. Class II - bone loss that extends between the roots with a roof created by the root trunk; probe cannot be passed from the entrance of the furcation to another furcation area

C. Class III - bone loss allowing communication from one tooth surface to another, such as facial to lingual on mandibular teeth and facial to

proximal on maxillary teeth

D. Class IV- through & through (gingival recession, furcation visible, probe easily penetrates through furcation, visible from other side

5. Notes and records mobility using two instrument handle ends placed on the facial and lingual aspects of each tooth and pushing in the facial-lingual direction, tooth movement can be compared to adjacent teeth

A. Class I - tooth deflection measuring 0.5 mm to 1.0 mm facial-lingual (any perceptible movement)

B. Class II - deflection measuring greater than 1 mm, but less than 2 mm facial- lingual (movement that is more than perceptible)

C. Class III - deflection measuring 2 mm or more facial-lingual, or a tooth that is depressible in the socket

CLASS IV??? CDH I LECTURE

191

6. Given charting information above, can compute total attachment loss

7. Given charting information above, can compute probable bone loss

8. Notes and records bleeding index

9. Periodontal charting documentation is legible

10. Sign and date the form. Obtain faculty signature

192

BLEEDING INDEX

1. Utilize aseptic technique.

2. Communicate with patient re: procedure rationale and method.

3. Position patient appropriately.

4. Assemble armamentarium.

A. adequate illuminationB.mirror, periodontal probeC.appropriate chart

5. Accurately probe to depth of pocket.

6. Identify and record presence of bleeding in indicated area of chart.

7. Calculate and record the summary BI for the patient [total of teeth exhibiting bleeding point(s,) over total number of teeth, i.e. 15/28].

193

ORAL DIAGNOSISCHARTING /KEY FOR "RECORD OF EXISTING ORAL CONDITIONS"

1. Chart all conditions which are detectable by clinical examination and/or radiographic examination in red or blue pencil. Existing normal (healthy) conditions in blue; existing abnormal (unhealthy) conditions in red.

2. Mark all missing teeth not replaced by fixed prosthesis with a blue "X" through the entire tooth including occlusal and lingual views as well as the buccal and root view.

3. Outline every restoration in blue showing exactly what you see clinically from occlusal, buccal and lingual views.

4. Outline every crown in blue according to its outline or margins as you view it from occlusal, buccal, or lingual.

5. Fill in the interior outline of any amalgam restoration solidly in blue.

6. Fill in the interior of any gold restoration with slanting blue parallel lines.

7. Leave the interior of the outline of any "white" restoration clear.

8. Fill in the interior of any part of a crown which is gold with slanting blue parallel lines; leave any "white" part of the crown with only the blue outline already crown.

9. If a tooth is missing and replaced by a fixed bridge, "X" the root only in blue and mark the pontic in the same manner as a crown. Connect the abutments and the pontic with parallel lines at the occlusal view (Posterior) and lingual view (anterior). Mark the connecting parallel lines according to the material used in the bridge.

10. Mark any root canal fillings in blue as they appear radiographically. Also mark access restoration according to material used.

ii. Circle impacted or unerupted teeth in blue including all views in your. circle and Place a large blue arrow within the circle indicating the long axis of the tooth and where the crown is pointing.

194

12. Mark open contacts with parallel blue lines between the two teeth and extending through all three views of the crown. Note the extent of the opening to the closest millimeter.

13. Mark drifted or repositioned teeth with an arrow indicating the new position of the tooth. For extruded teeth or unusual drifting, make a statement about it in "Other findings".

14. Mark rotated teeth with an arrow around the occlusal view.

15. Mark an overhang as an extension in blue of your drawing of the restoration exactly as it appears, either clinically or radiographically, and circle the overhang area in red.

16. Mark carious lesions in red exactly as they appear clinically. If seen interproximally by radiograph only, mark them as a chevron (>) on the buccal view just as you view the radiographs from the buccal.

17. Mark open or carious margins of restorations in red exactly where you see them.

18. Mark any periapical radiolucency in red as it appears on the radiograph.

19. Outline any other pathology seen radiographically in red, identify it with a number within or near your outline and describe the lesion in "Other findings" prefixed by your identifying number.

20. Mark fractured, missing parts of teeth with a red line along the fracture site.

21. Missing parts due to carious activity would be colored in red; fractured, missing parts which have become carious on the fracture site would be marked solid red.

22. Do not mark any treatment suggestions on this chart, e.g. do not mark teeth to be extracted with two vertical parallel blue lines.

23. Indicate excessive wear, abrasion, or any condition localized to individual teeth in "Other findings" space.

24. For generalized conditions use space marked "Comments" at the bottom of the page.

195

25. Draw abnormal gingival architecture as accurately as possible with detail to clefts, recession and interproximal contour, using the red pencil. Do not mark normal gingival contour. Draw a line indicating the mucogingival junction in blue on the root surface the proper distance from the C-E junction and the free gingival margin in these areas of abnormal gingival architecture only. Remember, the lines on the root drawings indicated 2 mm increments.

26. Mark clinical furcation findings with an open triangle (^) in the furcal area and note the extent of involvement with the number 1, 2, 3 (1, 2, 3).

196

27. Mark high muscular or frenum attachment in the approximate

location with a "V" shaped line in red.

28. Write in areas of food impaction on the slanted lines indicating "Other Findings".

29. Mark mobility in Roman Numerals on the buccal view of the crown in red using an I through M scale.

30. Record all sulcular depths of 1-3 mm in the appropriate space in blue. Record sulcular readings 4 mm or greater in red. Circle the corresponding probing depths of any bleeding points.

30.31. Indicate any exudate in "other findings".

32. Classify occlusion according to Angle's system and record in "Comments" section.

197

OCCLUSION - MALPOSITIONS

1. Labioversion - a tooth that has assumed a position labial to normal.

2. Linguoversion - position lingual to normal.

3. Buccoversion - position buccal to normal.

4. Supraversion - elongated above the line of occlusion.

5. Torsoversion - turned or rotated.

6. Infraversion - depressed below the line of occlusion.

OCCLUSION - MALRELATIONSHIPS OF GROUPS OF TEETH

1. Crossbites - Anterior maxillary incisors ate lingual to mandibular

incisors.

2. Edge to edge - (Anterior teeth) incisal surfaces of maxillary teeth occlude with incisal surfaces of mandibular teeth instead of overlapping as an ideal occlusion.

3. End to end - (Posterior teeth) Molars and premolars occlude cusp to cusp viewed mesiodistally.

4. Openbite - Lack of occlusal or incisal contact between maxillary and mandibular teeth because have failed to reach the line of occlusion.

5. Overjet - The horizontal distance between the labibincisal surfaces of mandibular incisors and the linguoincisal surfaces of maxillary incisors.

6. Underjet - Maxillary teeth are lingual to mandibular teeth.

7. Overbite - Vertical distance by which the maxillary incisors overlap the mandibular incisors.

198

OCCLUSION - TYPES OF FACIAL PROFILES

1. Mesognathic - having slightly protruded jaws.

2. Retrognathic - (CONVEX) Having a prominent maxilla and a protruded mandible.

3. Prognathic - (CONCAVE) Having a prominent, protruded mandible and a normal maxilla.

199

PLAQUE INDEX

1. Utilize aseptic technique

2. Assemble armamentarium A. adequate illumination B. mirror C. disclosing solution in cup D. cotton applicator

3. Communicates with patient re: rationale and method for procedure

4. Positions patient properly (reclining)

5. Apply disclosing solution to all surfaces of all teeth

6. Rinse with water

7. Identify and record all designated surfaces that exhibit staining due to plaque

8. Tabulate the plaque score according to chart instructions; record in appropriate place on chart

9. Perform and record plaque index on patient at each subsequent visit

10. Subsequent plaque scores should be generated only if patient's initial score is above 20%. Generally, this will be done at the re-evaluation appointment. Plaque scores can be calculated at any appointment and will be left to the discretion of the clinician and case instructor.

200

STRESS REDUCTION PROTOCOL

1. Determines ASA statusA. ASA I

i. normal and healthyii. little or no anxietyiii. little or no risk

B. ASA IIi. mild systemic disease or healthy ASA I with extreme anxiety16. examples: well-controlled diabetes, epilepsy, asthma, and/or hypothyroid

or hyperthyroid conditions; ASA I with upper respiratory condition, pregnancy and/or allergies

17. minimal risk during treatmentC. ASA III

i. severe systemic disease that limits activity, but is not incapacitatingii. examples: angina pectoris or MI history, CVA history

insulin dependent diabetes, CHF(congestive heart failure) with orthopnea and ankle edema, COPD (chronic obstructive pulmonary disease (emphysema, chronic bronchitis, exercise asthma)

iii. dental treatment indicated, but stress reduction protocol and other treatment modifications are indicated

D. ASA IVi. incapacitating disease that is a constant threat to life, problem that is of

greater importance than the planned dental treatment. If possible, treatment should be postponed until medical condition has improved to at least ASA III

2. Utilizes Stress Reduction Protocol for normal, healthy anxious patient (ASA I)A. recognize anxietyB. clinic dentist may premedicate with an antianxiety or sedative-hypnotic agent on

the night before or immediately before appointment, prnC. morning appointmentD. minimize waiting timeE. non-drug psychosedation during therapy, such as telling the patient what to expect

and using TLC, Using a low, monotonous tone of voice or any technique which helps get the patient's thoughts centered oft something other than the procedure being accomplished

F. Uses adequate pain control during therapy, anesthesia may be administered by the clinic dentist

G. vary length of appointment depending on desire of patient (patient may prefer longer appointments to "get it over with", or may prefer shorter appointments)

H. telephones the patient later in the day of treatment to see how patient is doing and to reassure

201

3. Utilizes Stress Reduction Protocol for Medical Risk Patient (ASA II, III, IV)

A. recognize riskB. medical consult prnC. morning appointmentD. minimize waiting timeE. preoperative and postoperative vital signs monitoredF. psychosedation as described aboveG. adequate pain control determined by clinical dentistH. length of appointment variable, dependent on the tolerance of the patientI. postoperative pain/anxiety control as determined by clinical dentistJ. telephones the patient later in the day of treatment to see how patient is doing and to

reassureK. arrange for the appointment to be early in the week so that the patient will not be

left over the weekendL. other precautions may be taken dependent on the patient's condition, such as:

oxygen administration during the procedure, modifications of patient position, contraindication of rubber dam use

4. Positions patient properly (reclining)

5. Apply disclosing solution to all surfaces of all teeth

6. Rinse with water

7. Identify and record all designated surfaces that exhibit staining due to plaque

8. Tabulate the plaque score according to chart instructions; record in appropriate place on chart

9. Perform and record plaque index on patient at each subsequent visit

10. Subsequent plaque scores should be generated only if patient's initial score is above 20%. Generally, this will be done at the re-evaluation appointment. Plaque scores can be calculated at any appointment and will be left to the discretion of the clinician and case instructor.

202

STERILIZATION

Method TimeTemp

Requirement PressureAutoclave 20–30 minutes 250 degrees F

121 degrees C15 psi

Dry Heat 60-120 minutes1 hour to reach

temp & 1 hour at 320 degrees

320 degrees F160 degrees C

Chemical Vapor 20 minutes 270 degrees F132 degrees C

20-40 psi

Ethylene Oxide Gas 10-16 hours 75 degrees F25 degrees C

DISINFECTANTS

GLUTERALDEHYDES

High level disinfectant for instruments – Fumes toxic

2% neutral

2% alkaline2% with phenolic buffer2% acidic

CHLORINES

Intermediate level disinfectant – Not recommended for aluminum or metal

Chlorine DioxideSodium hypochlorite (Household Bleach)

IODOPHFORSHigh level disinfectant for chairs, unit, etc. Stains many surfaces1% available iodine

PHENOLICS

Intermediate level – irritating to skin. Used at OUCOD

*Water based Alcohol- based

PROPERTIES OF AN IDEAL DISINFECTANT1. Broad spectrum

203

2. Fact acting3. Unaffected by physical factors: Active in the presence of organic matter4. Non toxic5. Surface compatibility – non corrosive to metal, rubber and cloth surfaces6. Residual effect on treated surfaces7. Easy to use8. Odorless9. Economical

204

INFECTION CONTROL TERMINOLOGY

ANTISEPTICChemical agent that is used to inhibit or kill microorganisms on tissue surfaces. (Ex: handwash agent)

ASEPSISRemoval or destruction of disease or infected material. Includes sterile condition obtained by removing or killing organisms.

ASEPTIC TECHNIQUE (ASEPSIS)The use of procedures that break the cycle of infection and ideally eliminate cross contamination

AUTOGENOUS INFECTIONSelf-Produced infection Ex: Candidiasis (Yeast)

BACTEREMIAPresence of bacteria in the blood. Demonstrated by blood culture. Antibiotic treatment is specific to the organism found and appropriate to the location of infection

BACTERIOCIDALA chemical agent which is capable of directly killing target microorganisms

BACTERIOSTATICA chemical that is capable of inhibiting the growth and metabolism of a target microorganism but does NOT directly kill the microbe

CLEANINGPhysical removal of debris and reduction of microorganisms present. First step in decontamination

CROSS-CONTAMINATIONPassage of microorganisms from one person or inanimate object to another

CROSS INFECTIONPassage of microorganisms from one person to another

DISINFECTIONThe use of chemical agents to accomplish the destruction of disease-causing microorganisms, but not necessarily all pathogens or resistant spores on inanimate objects or surfaces

IATROGENIC INFECTIONInfection caused by treatment or diagnostic procedures

NOSOCOMIAL INFECTIONInfection acquired during hospitalization

OPPORTUNISITIC INFECTION

205

Infection caused by normally non-pathogenic microorganism in a host whose resistance has been decreased or compromised

PATHOGENAny microorganism capable of producing disease

SEPTICEMIASystemic infection in which pathogens are present in the circulating bloodstream having spread from an infection in any part of the body. Diagnosed by blood culture and vigorously treated with antibiotics. Also called "blood poisoning".

STERILIZATIONDestruction or removal of all forms of life, with particular reference to microbial organisms. The limiting requirement is destruction of heat resistant bacterial spores

SEPSISInfection, contamination

206

TREATMENT PROGRESS NOTES:New Patient Documentation

PTP DOCUMENTATION COMPONENT(Fill out this section PRIOR TO PTP and bring completed chart & Superbill with you to conference room at PTP with faculty)

Obtain HHX:Meds/ Med Allergies: Name current meds and what prescribed for CC: Write only if patient has specific concerns. Vitals: BP, Pulse, RPM Student Sig./ PTP Faculty Sig.

POST-TREATMENT DOCUMENTATION COMPONENT (Fill out this section AFTER TX HAS BEEN COMPLETED FOR THE DAY and

bring to conference room for faculty signature)

EIE: WNL or state specific findingPERIO: Statement of probe depths, BOP, calculus and plaque findings, recession, furcation involvement, mobility

(Ex: Gen. 2-3mm w/loc BOP, gen lt sub cal w/mod supra cal mand ant, gen. lt cervical plaque, Class II mobility #5, Class I furcation #3)

HTC: This may be omitted if no suspicious areas of caries are present. If isolated area is present: note specific tooth no. If multiple areas are present: note "see chart".

DHTP: Enclosed

PI____%, BI______%, CDI_____, OHI: State SPECIFIC recommendations given to patientTX: State TX that has been completed.

State TX that is in progress*On final appt write DH Tx Comp, CDIRECALL (Rec): On final appointment, state recommended recall interval

(Ex. 6 MRC) Student Sig./Faculty Signature

*Write Patient Name and Chart Number in upper right of TPN sheet*Write date, procedure number and fee form (Superbill) number in columns to left of notes on TPN sheet

207

RECALL PATIENT DOCUMENTATION(Blue Recall Form)

PTP DOCUMENTATION COMPONENT (Fill out this section PRIOR TO PTP and bring completed chart &

Superbill with you to conference room at PTP with faculty)

Patient Name ____________ Chart No. ________Date, Procedure Nos., Fee Form Number (Superbill)Last FMX______ BWX _____ Last Prophylaxis______ Last Caries________Med Hx: __________________Alert/ Meds_______Chief Complaint: _______Vitals________________(BP, Pulse, RPM) PTP for Recall Exam: Student Signature/Faculty Signature

POST-TREATMENT DOCUMENTATION COMPONENT(Fill out this section AFTER TX HAS BEEN COMPLETED FOR THAT DAY

and bring to conference room for faculty signature)

EIE: Note any significant findingsMultiple significant findings: Enclosed

Risk Assessment: State specific risks that present for this patient (Ex. Xerostomia from meds, high sugar intake on caries, recession/ dentinal hypersensitivityNutritional Assessment/Counseling: State specific behavior modifications that you wish to accomplish to address specific risk factors (Ex. Daily sugar exposures, adequacy of food intake, oral implications of vitamin and mineral deficiencies) Tobacco Cessation Assessment/Counseling: State specific recommendations for behavior modification that you wish to accomplish to address specific risk factors. (Ex. Advised patient of side effects--provided motivational materials, assisted with an intervention program, and/or follow-up plan)OHI: State specific behavior modifications that you wish to accomplish to address all presenting risk factors

CDI ____ Plaque Score ______ Bleeding Index_____ Occlusion: R & L

Overbite: _______ Overjet: ________

Radiographs Taken: Check appropriate or site-specific PA areaDental Chart: All chartable items until further notificationPerio Chart: Only 4 mm and above

Bleeding points circledRecession and MGJ

208

TX Received: Document exact TX performed that day (Ex. Work-up – do NOT re-document individual findings from first appointment day, SC Quads 1& 4. Began Quad 3) On final appointment with patient, write DH TX Compete. Please remove from my list Recommended Recall Date: ________ Student Signature/Faculty Signature**next CDI and recall: top, right of form

SECTION X

Rotations

209

CLINICAL ROTATION PROTOCOL

Each student assigned to any rotation or completing any unassigned rotations are required to complete a Rotation Report Form . These forms are available in Clinic. Any adjunct service or rotation requirement completed on a rotation site should be marked by the dental hygiene student including the patient's name and chart number and signed by attending dental faculty/dental hygiene faculty/staff.

Rotation Report Forms must be completely filled out, signed by faculty, resident or dental student as appropriate and turned in to the Department of Dental Hygiene by 5:00 p.m. on Friday of the week of the rotation. Credit will not be given for any forms that are not received in the department by the aforementioned time.

Compliance with the College of Dentistry Infection Control Policy is mandatory at all rotations.

Students are reminded that all guidelines for clinical appearance and behavior apply to all clinical rotations.

Students are expected to assume responsibility for learning: ask appropriate questions, be on time, be courteous, be helpful, Do NOT leave early unless specifically directed by the faculty responsible for the rotation experience. Please remember that we are guests at the rotation sites.

Few dental hygiene students are afforded similar opportunities for enhancement of their dental hygiene educational experience.

In case of an emergency that prevents attendance, the student must contact BOTH the rotation site coordinator and the Course Director. It is strongly recommended that every effort be made to attend the assigned rotation. Grade penalty may be imposed for repeated absences.

210

CLINICAL ASSISTANT ROTATION

GOALSTo allow each student the opportunity to experience dental assistant duties. The duties involve skills necessary for: l) efficient maintenance of the clinic and 2) chairside assistance in dental hygiene procedures. Students will serve as clinical assistants when they do not have a patient.

REQUIREMENTS:

1. Dispensing instruments and supplies to dental hygiene students prn.

2. Assist clinicians/instructors, as requested, with procedures such as periodontal charting and ultrasonic scaling.

Duties:

Students assigned to clinic assistant position will perform the following infection control procedures:

l. Observe asepsis protocol in clinic.

2. Procure and distribute equipment and supplies in accordance with asepsis protocol.

3. Abide by clinical asepsis protocol when assisting clinician chairside oral stations.

211

4. Wear appropriate barrier equipment when handling contaminated, caustic or otherwise dangerous materials. These materials will be labeled. See section on Safety Protocol.

5. Properly sterilize, disinfect, sanitize equipment, instruments, and counters.

Students assigned to be clinic assistant should report to the clinic 15 minutes before the clinic begins and should remain on duty until the close of the clinic period when all students and patients have left the clinic area.

Faculty to report to:

The clinic assistant should report to the Clinical Coordinator to receive specific duties. However, any faculty member may request the student's help.

212

ASSIST SENIOR DENTAL HYGIENE ROTATION

GOALS

To provide the student with the opportunity to:

Apply the didactic principles and clinical skills learned in Clinical Dental Hygiene I and II in assisting senior dental hygiene students.

REQUIREMENTS

Attend scheduled senior clinic rotations as listed on the Clinic Rotation Schedule.

Dress in appropriate clinic attire and bring safety glasses.

Assist a senior dental hygiene student during the assessment and treatment of a patient. (Principles of four-handed dentistry are to be followed during assisting.)

Assist in care, sterilization and disinfection of instruments and equipment.

PROTOCOL

Students are to report to the Clinical Coordinator and present a rotation report form to her. She will instruct the student as to his/her specific duties for that clinic session.

The dental hygiene student is expected to be present during the entire clinic session.

213

GOOD SHEPHERD MISSIONThe Mission Clinics-Good Shepherd Ministries, OKC, Inc.

222 N.W. 12th Street (12th & Robinson)Oklahoma City, Ok 73110

(405) 232-8631Dr. Teresa Davis- Children’s Dental Clinic Director

(405) 359-0362; (405) 473-4032 (M)Dr. Frank Lipsinic OUCOD Faculty Coordinator

(405) 271-5346, ext 48567(405) 821-7343 (M)

www.goodshepherdokc.org

GOALTo provide the dental hygiene student with the opportunity to:

Apply the didactic principles from Developmental Dentistry and Clinical Dental Hygiene to providing dental hygiene services to children from the community.

REQUIREMENTSDress in appropriate clinic attire and bring your safety glasses.

Students will wear overgown provided at the Mission.

PROTOCOLStudents should report to The Good Shepherd Mission no later than 5:30 for Tuesday evening clinic.

Students will be required to provide the following services (but not exclusively) for 2-3 pediatric dental patients during the scheduled clinic session:

1. Help take and/or update the medical history.2. Chart deciduous and mixed dentition teeth as needed. 3. Provide patient education.

214

4. Provide a prophylaxis, fluoride treatment, sealants as needed.5. Expose and process radiographs as indicated by dental faculty.6. Administer local anesthesia as needed, following successful completion of DH 4472 Pain Control)

A Rotation Report Form must be signed by supervising dentist and turned in by noon on Friday of the week of the rotation for credit.

215

GRADUATE PERIODONTICS ROTATION forDENTAL HYGIENE STUDENTS2nd floor, west side of Brown Clinic

Dr. Robert Carson, D.M.D., M.S., ChairDr. John Dmytryk, D.M.D. M.S.Dr. Joy Beckerley, D.D.S., M.S.

Ms. Josie Shaw- Patient Account Representative; ext 1-7020(405) 271-6531 Lisa Desjardins Smith ???-Office Manager 271-6531

Tiffany Johnson – Clinic Supervisor 271-7064Hayden Sjong-Dental Assistant

GOAL: To provide the dental hygiene student with the opportunity to observe and carry out periodontal evaluation, treatment planning, therapeutic debridement; to assist in surgical phases of periodontal therapy and to observe case presentations of graduate periodontal residents in order to better understand the rationale for various types of periodontal therapy.

PROTOCOL: Plan to arrive and set up operatory 30 minutes prior to the assigned clinic time. The dental hygiene student will be assigned to attend clinic sessions each semester. Dental hygiene students will report to the graduate periodontics clinic on the west side of Brown Clinic and will be assigned to work with the Graduate Periodontics Resident of the Day (ROD). Proper clinic attire is mandatory. Students will assist the residents in whatever phase of therapy to be performed that clinic session, or will provide maintenance therapy for assigned patients.

GENERAL PROTOCOL FOR NEW PATIENT ASSIGNMENT

I. Patient Assignment:The Patient Account Representative for Graduate Periodontics will assign the new patient to the dental hygiene student. Concurrently, the patient will also be assigned to a periodontal resident. If the assigned resident is not available, a graduate periodontics faculty member or

another resident will cover. Radiographs will be taken, as indicated, as early as possible in the appointment

sequence as possible.

II. Setting up the unit Spray paper towel with disinfectant, wipe down unit, repeat towel/spray/wipe

method. (Includes chrome areas as well as operators cart & chrome) Place new headrest cover after each patientlarge chair cover for entire back of

chair Sticky tape barriers on chair control panels, light handles & operator table handles Place clear, long sheaths over all suction tips & air/water tips. Only push tips

through sheaths when using them. Place headrest covers as barriers for ultrasonics Place plastic sleeve on air/water syringe and on the suction you will be using Tape Place red biohazard bag to assistants cartto handle of bracket tray

218

Provide plastic cup to place all contaminated 2x2s

III. Seating the patient Provide appropriate DH treatment

IV. Periodontal Evaluation and Data Collection:The dental hygiene student will:

Take a complete medical and dental history Take and record vital signs Record medication history Obtain PTP from the ROD. If a medical concern is present - consult with the assigned resident or

Graduate Periodontics faculty. Perform a head and neck examination. Comprehensive periodontal evaluation/charting with all appropriate entries

entered in the dental record. It is not necessary to record sulci depths 3mm and less.

Chart restorations/ caries. Assist resident in photographs, occlusal analysis, TMJ, muscle evaluation and/or

any other diagnostic evaluation. Take alginate impressions, prn, obtain approval of impressions prior to pouring-

up study casts. Document subjective and objective findings.

V. Treatment planning by Graduate Periodontics Resident:

Upon completion of all data collection by the dental hygiene student, the assigned resident will confirm, and obtain all necessary consultations.

The resident will formulate a comprehensive treatment plan (in writing) which must be discussed and approved by a Graduate Periodontics Faculty.

The dental hygiene student should plan to attend treatment planning discussions, if possible.

VI. Non-surgical phase: The dental hygiene student will consult with the resident and dental hygiene

faculty to coordinate parameters of involvement in therapy.

The dental hygiene student will complete the oral hygiene evaluation:o Ascertain patient's oral hygiene status (by Plaque Index and evaluation of

routine)o Correlate level of plaque control to Bleeding Index score.o Discuss etiology of patient's disease & appropriate preventive POH,

include discussion of limitations of POH in restoring health.

219

The dental hygiene student will perform Supportive Periodontal Therapy (SPT) which may include scaling, root planing, polishing and fluoride treatment. Generally 2 to 5 appointments will be necessary.

o The dental hygiene student will perform therapy under the joint supervision of Graduate Periodontics faculty & assigned resident.

o All procedures performed by the dental hygiene student will be evaluated by ROD for technique and results.

o The Resident will be available for appropriate support, such as anesthesia, occlusal adjustment, emergency care, questions, etc.

After Phase I therapy, the patient will be re-evaluated to determine: progress obtained as a result of Phase I therapy based on

comparisons of objective baseline and post-treatment assessments; resident will determine need for surgery.

VII. Surgical Phase The dental hygiene student will assist the resident in surgery & suture removal, as possible.

VII. RecallUpon completion of treatment, the recall interval for the next appointment will be determined and patient's name placed in the computer. This is done in Brown clinic.

VIII. Dismissing the patient Make certain the fee slip is filled out with the code/fee/comments and next

appointment information before the patient leaves the clinic and notify the Clinic Coordinator who then will schedule the patient and give them a token for dismissal. If patient is seen in Green Clinic, fill out the encounter form and escort the patient back down to Josie in Brown Clinic to collect fees & reschedule patients as needed.

IX. Procedure for instrument sterilization Disinfect dental unit after patient is dismissed Rinse & place all instruments in metal container and ultrasonic for 16 minutes Drain, day and place them in proper sterilization Label front of bag with “G Perio” using black felt pen Handpiece maintenance:

o Place prophy angle head in ultrasonic, making sure end cap is tighto Wipe off adapter and motor with alcohol spongeo When dry, oil slow speed handpiece adapter gears and head port holes

GENERAL PROTOCOL FOR RECALL MAINTENANCE PROCEDURE in Brown Clinic

220

Patients are placed on the periodontal recall following completion of their definitive periodontal therapy. These patients are recalled for maintenance (Supportive Periodontal Therapy SPT) according to need.

I. The Clinic Supervisor will assign the recall patient to the dental hygiene student. The student will greet and seat the patient promptly at 9:00 or 1:00. If the patient is not present 15 minutes after the hour, it is the student’s responsibility to notify the Clinic Supervisor, who will then call the patient and determine the patient’s status. The Patient Accounts Representative will confirm all appointments.

Review dental record and past dental history Review and update medical history

o If medical concern, consult ROD or Graduate Periondontics faculty Obtain and record vitals Update medication summary PTP Perform Head & Neck exam Periodontal charting and dental evaluation Use safety glasses on all patients render DH treatment as necessary After treatment is rendered, record the encounter slip number and procedure code in

chart with date and progress notes. A fee notation is NOT required

221

GRADUATE PERIODONTICS PATIENTS IN GREEN CLINIC

GOALS: To provide the dental hygiene student the opportunity to provide dental hygiene care for patients from the Graduate Periodontics. Routine maintenance, Phase I therapy (S/RP) and re-evaluation appointments will be scheduled in Green Clinic.

REQUIREMENTS:

o Attend scheduled rotation (denoted “GPG” on the rotation schedule) in Green Clinic.

PROTOCOL:

o Refer to Graduate Periodontics fee schedule and document on the encounter form if different from present information. Use lines below to add any additional procedures.

o Fill out encounter form with faculty signature & stamp. ROD should also sign in appropriate box above or below dental hygiene faculty signature.

o At bottom of encounter form, put the next appointment information (reappt for S/RP, 3mrc, 4mrc etc)

o In the event of a cancellation or no show, turn form into Josie with documentation on the encounter form.

ASSIST GRADUATE PERIODONTICS

GOALS

To provide the student with the opportunity to:

Apply the didactic principles and clinical skills learned in Clinical Dental Hygiene I and II in assisting senior dental hygiene students or Graduate Periodontics Residents

REQUIREMENTS

Attend scheduled Graduate Periodotnics clinic rotations as listed on the Clinic Rotation Schedule.

Dress in appropriate clinic attire and bring safety glasses.

Assist a senior dental hygiene student or grad perio resident during the assessment and treatment of a patient. (Principles of four-handed dentistry are to be followed during assisting.)

Assist in care, sterilization and disinfection of instruments and equipment.

222

PROTOCOL

Students are to report to the Resident of the Day (ROD) and present a rotation report form to him/her. He/she will instruct the student as to his/her specific duties for that clinic session.

The dental hygiene student is expected to be present during the entire clinic session.

RESPONSIBILITIES FOR DENTAL HYGIENE STUDENTSIN PERIODONTAL SURGERY

PLEASE REMEMBER TO USE STERILE TECHNIQUE AT ALL TIMES!

NEVER TOUCH ANYTHING STERILE UNLESS YOU ARE WEARING STERILE GLOVES.

You must wear proper PPE when assisting or observing in surgery. (gown, mask, goggles, and head cover).When assisting, please see the dental assistants for assistance with proper sterile technique.

Students will assist Residents in perio surgery, including:1) taking blood pressure on the patient before and after surgery2) mixing the periodontal dressing3) please keep tray free of dirty 2 x 2's. There will be a red biohazard bag on the side of the

assisting cart for this purpose.

Students will also be responsible for cleaning up after the surgery, including:1) cleaning the surgical instruments in ultrasonic cleaner and replacing them on the tray.2) replacing the suction bag3) replacing the headcover on the chair4) placing a new patient napkin on the tray behind the chair5) wiping the entire surgery room with the disinfecting solution

When assisting the perio surgery, the following will be worn:1) surgical cap2) hat3) mask4) sterile gloves

When observing in perio surgery, the following will be worn:1) surgical cap2) mask

223

IMPLANTOLOGY3rd floor, Burgundy Clinic

Mrs. Kathy Miller, R.D.H., B.S.Assistant Director of Clinics

Clinical Faculty Department of Implantology(405) 271-8801 x46525

GOALTo provide the dental hygiene student with the opportunity to:

Apply the didactic principles from Clinical Dental Hygiene to providing dental hygiene services to patients with dental implants.

REQUIREMENTS

Attend scheduled implantology rotations as listed on the Clinic and Rotation Schedule.

Dress in appropriate clinic attire and bring your safety glasses.

Specific implant instruments will be available in the clinic

PROTOCOL

Students should report to dental hygiene faculty no later than 8:30 a.m. and 12:30 p.m. for clinic.

Use chairs 32 and 35 in the east side of Burgundy Clinic Oral hygiene products are in the red/black cabinet against the wall at unit 32 and fluoride

and sonic scaler lubricant are in the cabinet at unit 35. Sonic scalers are available Bring instrument cassettes and RDH handpiece Get PTP from Mrs. Miller (follow laminated guide sheet) No clinical evaluation sheets or blue recall forms are used No HTC; chart recall perio prn on perio chart; EIE updates are noted in the TPNs Recall appointments are scheduled by Mrs. Miller at the end of the appointment

224

ORAL DIAGNOSIS2nd floor, OD clinic

Dr. Susan Settle, ChairDr. Jeanne Panza

Ms. Charlene Shaw, Clinic Coordinator271-4945

Judy Hinkle-Radiology Technician x271-5687Donna Harrison - Radiology Technician

Dr. Robert Jennings-Clinic FacultyDr. Susie Beavers-Clinic FacultyDr. Farah Masood- Clinic Faculty

GOALSTo provide the dental hygiene student with the opportunity to:

Perform oral examinations on patients applying for dental treatment at the College of Dentistry.

Assist dental students in providing emergency dental care to patients.

Purpose of screenings: Provide suitable patients for dental hygiene and dental students Provide students with a diagnostic experience Increase awareness of oral conditions beyond patients assigned to you

REQUIREMENTS

Attend oral diagnosis rotations as listed in the Clinic and Rotation Schedule. Dress in

scrubs and bring your safety glasses.

Comply with College of Dentistry Infection Control Policies.

PROTOCOL

Students are to report to staff in the dispensing area of the Oral Diagnosis clinic promptly at 9:00 a.m. for morning clinics and 1:00 p.m. for afternoon sessions. You will screen 2-3 patients each clinic session.

Dental hygiene students assigned to clinics designated for screening patients applying for dental treatment at the College will perform the following:

225

Seat patient & review health history If questions regarding pre med etc., contact OD faculty Take vital signs (blood pressure, pulse and respirations). Ask faculty if they would like to briefly examine patient at that time HHx reviewed by faculty Complete a head and neck examination: record under “Comments” Record carious lesions; restorations that are fractured, have defective margins,

recurrent decay, or are missing; and missing teeth. Record periodontal probe readings: only deepest in each sextant is recorded Record an abbreviated CDI. (Case Difficulty Index) Request appropriate radiographs. Faculty will sign for radiographs. Patient returns to reception area & is then called to Radiology

Place the Patient Folder in the chart holder in Radiology Expose and process radiographs as directed by dental faculty. Radiology tech will return the folder to the clinic when films are developed. Review films and findings with faculty Return patient to chair and review findings with faculty Accept or Reject the patient

o Provisionally accepted may NOT ever be assigned

If patient is accepted: Give patient the “Patient Bill of Rights” Tell patient they will be contacted by a student but there is no set time they will

be calledIf patient is rejected:

If they inquire, we can make copies of the screening films to either be sent to another dentist or taken with them

There is a $5.00 charge for duplicating

Types of patients to reject: Patients with unrealistic expectations Patients who do not have time to commit to OUCOD Patients with rampant caries Patients with severe periodontal disease Many other complex dental conditions

Give Original Superbill to Charlene and the Copy to the patient. Refund money ($10 or the $25 screening fee) if no radiographs are taken or at discretion of instructor.

MISCELLANEOUSDental students may be seeing emergency or screening patients during your rotation.

Dental hygiene students assigned to clinics designated for emergency dental care will: Assist dental students in the provision of dental care.

226

Provide clinical services such as: o Placing temporary restorations.o Exposing and processing radiographs.o Pulp vitality testing.o Administering local anesthesia (after successful completion of DH 4472

Pain Control)

ALWAYS GET FACULTY PERMISSION TO LEAVE CLINIC PRIOR TO 12:00 OR 4:00

ASSIST ORAL DIAGNOSIS

GOALS:

To provide the dental hygiene student with the opportunity to: Assist and observe in oral diagnosis, screening clinic and radiology.

REQUIREMENTS:

Attend scheduled rotations as listed on the Rotation Schedule.

Oral Diagnosis is conducted in Orange Clinic on the 2ndd floor of the COD. Clinic begins at (9:00 am or 1:00 pm.

Assist and observe a dental or dental hygiene student during the Oral Diagnosis screening clinic.

Appropriate clinic attire and safety glasses are mandatory.

PROTOCOL:

Students are to report to the dentist in charge to present a rotation report form. They will then direct the dental hygiene student to assist a dental student utilizing four-handed dental methods.

The dental hygiene student is expected to be present during the entire procedure/clinic session or until released by the faculty of the assigned clinic.

227

PEDIATRIC DENTISTRY and SEALANT CLINIC4th floor, Yellow/Orange ClinicMrs. Kathy Miller, R.D.H., B.S.

Assistant Director of ClinicsClinical Faculty Department of Pediatric Dentistry

(405) 271-8801 X 46526 GOALTo provide the dental hygiene student with the opportunity to:Apply the didactic principles from Developmental Dentistry and Clinical Dental Hygiene to providing dental hygiene services to children and young adults.

REQUIREMENTSAttend scheduled pediatric dentistry rotations as listed on the Clinic and Rotation Schedule.


Each student should bring their handpiece and prophy angle.

PROTOCOLStudents should report to dental hygiene faculty no later than 12:30 p.m. for Wednesday afternoon clinic.

I. RECALLS One patient will be seen every 90 minutes with no assistant Use chairs 1, A, B, C

Protocol review for BWX: One year or longer since last BWX Caries history Interproximal watch areas from last visit Diagnostic integrity for previous BWX Remember to look for actual BWX and not just rely on radiographic log No BWX if bands and brackets are in place

Students will be required to provide the following services for 2-3 pediatric dentistry patients during the scheduled clinic session:

1. Update the medical history.2. Chart deciduous and mixed dentition teeth. 3. Periodontal probe as directed by pediatric dentistry faculty.4. Do a plaque score.5. Provide patient education.6. Provide a prophylaxis.

228

7. Expose and process radiographs as indicated by dental faculty.2. SEALANTS

Use designated “quiet room” 2 students will work as partners seeing one patient every hour (1:00, 2:00 and

3:00) complete a Rotation Report Form, obtain Pediatric faculty signature and turn in

to Senior Clinical Coordinator for credit.

ASSIST PEDIATRIC DENTISTRY

GOAL:

To provide the dental hygiene student with the opportunity to:

Assist DH II students in unit set-up, four-handed dentistry, and unit break-down during treatment of children, adolescents and young adults.

REQUIREMENTS:

Attend scheduled pediatric dentistry rotations as listed on the Clinical Rotation Schedule.

Dress in appropriate clinic attire.

PROTOCOL:

Students should report to Ms. Kathy Miller. R.D.H. for student assignment.

Pedo Clinic is conducted in Yellow/ Orange Clinic in 4th floor of the COD.

229

RADIOGRAPHY2nd Floor, OD Clinic

Ms. Judy Hinkle, Dental Radiology Supervising StaffMs. Donna Harrison-CDA, Radiology Tech

(405) 271-5687

GOALSTo provide the dental hygiene student with experiences that will develop proficiency in intraoral radiographic technique, patient management, radiation protection, infection control, quality evaluation, and diagnostic analysis. Students will be familiarized with panoramic and extraoral technique, darkroom care, film processor maintenance, and radiographic duplication.

REQUIREMENTS

1. Attend scheduled Oral Radiology Clinic sessions as assigned on the Clinic and Rotation Schedule.

2. Complete a minimum of ten complete intraoral radiographic surveys with a 70% score or better.

3. Complete other radiographic procedures as directed during rotations.

PROTOCOL

1. Report to the Radiographic Technicians in the Oral Radiology Clinic for room and patient assignment.

2. Prepare the cubical and x-ray unit for the patient.

3. Comply with “Radiation Use Policy” upheld by the University of Oklahoma College of Dentistry.

4. Expose and process films in compliance with The University of Oklahoma College of Dentistry Infection Control Policy.

5. Evaluate radiographic quality, document this evaluation and determine the number and type of retake radiographs necessary with the agreement of the teaching faculty.

6. Complete the rotation report form, recording the names of patients and the number and type of radiographs. Turn this form in to the Senior Clinical Coordinator for credit.

230

SCREENER in GREEN CLINIC

GOALSTo provide the dental hygiene student with the skills to screen prospective patients for senior clinic.

REQUIREMENTS

1. Attend scheduled Screener sessions as assigned on the Rotation Schedule.

2. Properly fill out required forms for DENTAL HYGIENE ONLY patients.Patient will arrive in Green Clinic with the following forms:

White OD Screening form (Health History) Encounter form indicating payment made Copy of insurance card if applicable Notice of Privacy Practices Hand written receipt for payment made

Screener will have these forms:

DH ONLY form (white & yellow copy) CDI screening form Radiographs properly labeled

3. Fill our Rotation Report Form & have CI sign.

PROTOCOL

Patients will be scheduled by DH patient scheduler every 45 minutes beginning at 12:30. Screener will see patients at 45 minute intervals with the first patient at 1:00 pm, and the last patient at 3:15.

Fee for DH only screening is $10 and includes radiographs. This is paid for prior to the appointment. Patient will have the encounter form and will already have a token. There is no need to take patient down to the Cashier at the end of the appointment.

Patients will check in at the Cashier’s Desk on 2nd floor to complete paperwork & pay the $10 screening fee. (The “Old" Oral Diagnosis screening forms will be used and stamped with "Dental Hygiene Only" on the top of the form).

Set up assigned unit & request exam sets from the dispensary personnel Green Clinic. These are in the locked cabinets. (Includes 11/12 explorer, mirror, probe). You may set up an extra chair if one is available. For Tues, Wed & Thurs clinics, please check with

231

dispensary personnel to verify a chair is available.

The DH patient scheduler will send a list of screening patients to Green Clinic. It will be located in the tub with the charts.

Seat patient and go over the white screening form (Health History), fill out information on first page regarding surgeries, hospitalizations etc, take BP & get PTP from CI. Request radiographs to be exposed. (limited to 2 Bitewings only or a reasonable alternative when a significant number of posterior teeth are missing). Have CI sign and stamp for films on the back of the white OD screening form.

Expose & develop prescribed radiographs

Collect enough data to complete the CDI. Use the boxes on the dentition chart to record probing depths.

Spot probe and chart only 4mm & above. On those teeth, draw recession & circle bleeding points.

Detect supragingival & subgingival calculus.

Have CI confirm CDI. Additional points may be added at the discretion of the CI. The CI must initial the CDI Screening form.

CI will be responsible for ensuring that acceptance as "Hygiene Only" forms are completed, and a financial policy is signed and distributed for each patient accepted. Have CI sign & stamp white Screening form at the bottom of the form.

On the back of the screening form, check the box “DENTAL HYGIENE” and put the CDI on the form.

Paper-clip all forms together & turn in to Rick Steucken in the Chart Room at the end of the clinic session.

Place instruments in autoclave bag & write “Green Clinic” and “Screener Exam Kit”. Place these in the basket on the cart at the dispensary.

Screener will assist other students in clinic when patients are not scheduled.

232

SCREENER in GREEN CLINIC

GOALS

To provide the dental hygiene student with the skills to screen prospective patients for senior clinic through a

REQUIREMENTS

Attend scheduled Screener sessions as assigned on the Rotation Schedule.

Properly fill out required forms for DENTAL HYGIENE ONLY patients.

Fill our Rotation Report Form

PROTOCOLPatient will be scheduled by patient schedulers.

Patients will check in at the Cashier’s Desk on 2nd floor to complete paperwork & pay screening fee. ("Old" Oral Diagnosis screening forms will be used stamped with "Dental Hygiene Only")Go over screening form Health History, take BP & get PTP from CI Request radiographs to be exposed. (limited to 2 Bitewings only or a reasonable alternative when a significant number of

posterior teeth are missing). Have CI sign for films.Expose & develop prescribed radiographs & collect data to complete the CDI. (recession, spot

probing, supragingival & subgingival calculus). Have CI confirm CDI.

CI will be responsible for ensuring that acceptance as "Hygiene Only" forms are completed, patient copies are made (until NCR form is ready) and a financial policy is signed and distributed

for each patient accepted.

Screener will assist other students in clinic when patients are not scheduled.

233

TEACHING ASSISTANT in JUNIOR CLINICMrs. Jane Gray, R.D.H., CDA, M.Ed, Senior Clinical Coordinator

(405) 271-4445 (M) (405) 830-4880Mrs. Tammie Vargo, R.D.H., M.Ed, Junior Clinical Coordinator

(405) 271-4562 GOALS:

To provide the student with the opportunity to apply the didactic principles and clinical skills learned in Clinical Dental Hygiene I, II, III, and IV in assisting and mentoring junior dental hygiene students.

REQUIREMENTS:

Review all class/lab/clinic material(s) prior to attending the rotation.

Attend DH-I & DH-II lectures, as instructed to do so by Mrs. Vargo.

Attend scheduled junior clinic rotations (see ‘Clinic Rotation Schedule’).


DUTIES:

Fall

1. Assist and mentor junior students in lab and clinical exercises

2. Assist clinical faculty as requested

Spring

1. Check instrument sharpening at the beginning of each clinic session.

2. Assist and mentor radiographic technique

3. Assist and mentor junior student in organization and treatment sequencing (Senior student is not allowed to record probing depths or hard tissue until notification by Mrs. Vargo)

4. Assist clinical faculty upon request by:

234

a. evaluating work-ups and documenting results on evaluation form. b. evaluating polishing and documenting results on evaluation form.c. providing instrumentation technique feedback and documenting prnd. providing individualized mentoring at chairside for students providing

care for Class ‘C’ patients

5. Dental hygiene faculty must co-sign all record documentation entries

This rotation is for the duration of the academic year (fall and spring semesters)

Selection process for TA is by application only. Those expressing interest should contact the senior clinic coordinator in the spring of the junior year. A one page essay on “Why I would like to be a Teaching Assistant” should be submitted.

235

TINKER AIR FORCE BASE72 Dental Squadron5700 Arnold StreetTAFB, OK 73145

(405) 736-2000 (dental clinic)(405) 736 -3159

FAX (405) 736-2072Diana Mills, R.D.H. Staff Dental Hygienist

[email protected]

GOALSTo provide the dental hygiene student with experiences that will develop competency in the areas of patient assessment, treatment planning, patient care and adjunct services in an environment similar to a private practice setting.

REQUIREMENTS

Attend scheduled Tinker rotations as assigned in the Clinic Rotation Schedule.

Need to pProvide: TB test results OUCOD HIPAA security training Proof of liability (malpractice insurance)

Records may be requested by DH Department Administrative Secretary from:OU Family Medicine Student Health Clinic 900 N.E. 10th St Oklahoma City, Ok 73104; (405) 271-2577Fax#: (405) 271-4059

Dress in street clothes or wear your scrubs and change into provided clinic attire (provided by Tinker) at the rotation site. Wear your clinic shoes. Take your own instruments and ultrasonic tips. Be prepared to finish by 3:40…clinic closes at 4:00

Provide patient treatment according to the guidelines established in the TAFB manual.

PROTOCOL

Students should report at 12:30 for the PM. clinic. First patient will be seen at 1:00. Locker assignments and name tags provided.

Enter at Sooner Road Gate

237

Tell guard you are with OU Dental Hygiene Program Need:

Current DL Proof Ins Current tag

NO cell phone use while driving on baseWatch speed!!!Do not park in reserved spots (cars will be towed)Bldg 5801

238

TINKER RADIOGRAPHY

GOALS:

To provide the dental hygiene student with experiences that will develop competency in intraoral radiographic technique, patient management, radiation protection, infection control. quality evaluation, and diagnostic analysis. Students will be familiarized with panoramic and extraoral technique, darkroom care, film processor maintenance, and radiographic duplication.

REQUIREMENTS:

1. Attend scheduled Oral Radiography Rotation as assigned on the Rotation Schedule.

2. Complete radiographic procedures as directed during rotations.

PROTOCOL:

1. Report to the Radiographic Technicians in the Oral Radiology Clinic for room and patient assignment at Tinker AFB.

2. Prepare the cubical and x-ray unit for the patient.

3. Comply with the OUCOD Radiation Use Policy.

4. Expose and process films in compliance with the Infection Control Policy.

5. Evaluate radiographic quality, document this evaluation and determine the number and type of retake radiographs necessary with the agreement of the teaching faculty.

6. Complete the rotation report form, record the names of patients and the number and type of radiographs.

239

VETERANS ADMINISTRATION HOSPITAL ROTATIONDepartment of Veterans Affairs

VAMC921 N.E. 13th St.

Oklahoma City, OK 73104Ms. Colleen Whorton

Administrative Officer- Dental Service(405) 270-5139 (dental clinic)

Fax (4050 405) [email protected]

Mrs. Vicki Coury, Clinical Faculty(405) 271-3869(405) 826-3411

Connie Martin, Staff Dental Hygienist

GOALSTo provide the student with an opportunity to learn hospital procedures as they relate to: (l) dental care, and (2) the team concept of total comprehensive patient care.

REQUIREMENTS

1. Observing a hospital-based dental hygienist perform patient care.

2. Providing direct patient care in the hospital dental clinic.

3. Adapting dental hygiene procedures to accommodate the special needs of the hospitalized patient.

4. Establish patient rapport.

5. Adapting home care procedures to meet the needs of each individual patient.

6. Assisting the dental staff in the clinic as necessary.

241

mailto:[email protected]

VA DENTAL CLINIC INSTRUCTIONS

BEFORE COMING TO THE VA

***You must annually complete the VA privacy training, print a copy of the training and turn in to the Course Director. You can access the website at vhaprivacytraining.net ***Print out the certificate & turn in to Course Director.

You must also read and sign the Statement of Commitment form & turn it in.

Annual TB testing is required and verfication must be on file.

***AT LEAST THREE STUDENTS NEED TO CHECK OUT AN ULTRASONIC RESERVOIR TYPE SCALER FROM GREEN CLINIC PRIORTO COMING TO VA ***

***ALL ASSISTANTS SHOULD BRING THEIR INSTRUMENT KITS IN THE EVENT THAT A PATIENT IS AVAILABLE TO BE SEEN BY A STUDENT***

Read this handout care thoroughly and bring it with you for reference. Review procedures you might use such as care of partials and dentures, placement

and patient instructions for fluoride varnish. Bring your Mosby’s Drug Reference because the patients you will see are generally

on multiple medications. If you do not see a patient you will need to fill out a Rotation Report form;

otherwise your Clinic Evaluation form will suffice.TIMES

For your first VA session, we will meet in the Commons at 7:30 and go as a group. For subsequent sessions, be at the VA no later than 8:00. The clinic opens at 7:30 and

you may go over and begin setting up your unit any time after 7:30. The operatories you will be working in will be marked with a sticky note.

RESTROOM Located in the hall outside the clinic, across from the patient waiting area.

PROCEDURESReview patient’s chart

New HHx yearly (front desk should give to patient) Review active medicines on printout Determine need for radiographs (pano every 5 years, BWX yearly)

Set up operatory

242

Gowns are in operatory drawers or in Linen Closet (first closet) on right side of hallway (Door will be locked)

Motors, adapters and cavitron tips are in Instrument Prep room on right side of hallway (also locked)

You will bring your own instrument kit (and sterilization bag to transport it back to the dental school)

Wash hands after every time you touch anything Fill water bottles on unit and cavitron with deionized water from sterilization area if

necessary

Get patient from reception area Verify full name and social security number in private (remember HIPAA laws)

Expose and process necessary radiographs Some rooms have an x-ray unit in them. If yours does not have a unit, take them

prior to seating your patient in your operatory. Mark off number of x-rays taken on log in x-ray room

Seat patient in your operatory and Verify medication information with patient Review Health History on left side of chart with patient

-positive answers must have a comment written in Dentist Remarks section-all sections must have a notation, so write N/A if not applicable

On right side of chart fill out clinical findings and remarks; make sure personal information is correct

Fill out patient post card for next visit (you write patient’s name and address) Take vital signs. Write a listed summary in the boxes at the lower right of the HHx

form to include: PMH (past medical hx), diabetes, hypertension, heart attack (what year), stroke (what year), heart murmur, allergies, blood sugar number, medications, etc. In the note box under question #36, the appropriate med(s) should be circled and med alert sticker placed if needed.

Diabetic patients should be asked what their blood sugar range is and what the number was when the patient tested it that morning. Perform a finger stick and document blood sugar number as “FBS - #” (Finger Blood Stick). Always ask the patient if a good breakfast was eaten. Ensure is available if the patient’s blood sugar is too low. If blood sugar is over 200, the patient is not treated.

An INR time should be known for patients on Coumadin and results should be below 3 for treatment. Patients are scheduled for bloodwork in the lab at 7:30 so their results should be ready by 8:30. We will consult with a dentist if unsure whether treatment can be done.

Obtain PTP from OU CLINICAL FACULTY. Monologue should include significant HHx information; names, indications, and dental considerations of medications; and vital signs.

Begin treatment: EIE, dental and perio charting, CDI (check in with OU CLINICAL FACULTY for CDI C or greater). If possible we will enter dental and perio charting on the VA computer

243

program. If someone is not available to enter data on the computer, it can be done on hard copies and entered later. Fill out Oral Examination Findings and Treatment Recommendation on right side of chart.

Disclose, provide OHI. This must be done PRIOR to scaling procedures.

If patient has a partial or denture, place it in a baggie (available in each operatory) and go to sterilization area. Put Tartar and Stain Remover in the baggie (located underneath the sink) and place the baggie in the PRO Sonic ultrasonic cleaner. Scrub with a denture brush in operatory.

Scale and root plane prn, polish.

Request check out with OU CLINICAL FACULTY. Checkout should be no later than 11:15. At this time, it will be determined if an exam is needed and a DDS will be asked to perform the exam after check out of scaling and polishing.

Prior to the dental exam, the right side of the exam sheet should be completed by the student. During the exam, the student writes in the proposed treatment on the left side of the exam sheet.

DENTIST MUST SIGN BOTH HEALTH HISTORY AND CLINICAL FINDINGS AND REMARKS

PATIENT MUST SIGN UNDER CLINICAL FINDINGS AND REMARKS

Treatment progress notes should be entered on the back of the exam sheet and write in PTPW if the “patient tolerated treatment well”. If not, note why not. A copy of the format for TPN is available from OU CLINICAL FACULTY or in the main hygiene room.

Administer tray or varnish fluoride treatment.

Escort patient to the reception area to schedule any additional appointments.

Complete paperwork.

Break down operatory , Wear all PPE to disinfect. Disinfectant bottles are located under the sink. Open glove drawer before washing hands, wash hands, take out and put on gloves and

close drawer with hip Remove headrest cover, turn inside out and put all disposable contaminated items inside

and throw in trash. Bag instruments in sterilization bag brought with you from OUCOD Close operatory door when leaving a contaminated room when no one is in it. Carry handpiec and motor to Soiled Instrument closet. It is locked, so someone will have

to open it for you. Place contaminated handpiece and motor in DRY contamination bucket. PPE must be worn in the contamination room.

XCPs and air/water syringe tips go in blue ultrasonic in sterilization area Ultrasonic tips are disinfected, put in a sterilizing bag and placed in the sterilizer tray.

244

Return to operatory, disinfect all contaminated surfaces with Cavicide, including chairs and let set 10 minutes

Empty water bottle if operatory will not be used in the afternoon.

J. RESET UNIT with Headrest cover Sticky tape on light switch and light handles Place large bag over hoses and switches

VAMC TREATMENT PROGRESS NOTES

The following items are to be written in the TPNs:

BP Radiographs obtained (BWX, pano) Px Rev HHx: NSF or state what findings H&N exam: NSF or state what findings Assessment Perio charting Tx rendered:

o Examples:1. Scaled, hand and ultrasonic scaled polished, flossed, fluoride varnish,

OHI : TB, floss aid etc. Patient understands OHI PTPW RTC: any treatment remaining: restorative, S/RP etc) or TC

2. S/RP UR quad, hand and ultrasonic scaled, POI, OHI (state what kind) PTPW RTC: any treatment remaining (restorative, S/RP etc) or TC

3. S/RP UR & UL quad, hand and ultrasonic scaled; type of local administered etc. POI, OHI (state what kind)

PTPW RTC: any treatment remaining or TC

Student signature/OU Faculty signature

Abbreviations:

245

BP Blood PressurePX Peridex Pan Panorex4 BWX 4 bitewingsNSF No significant findingsOHI Oral hygiene instructionTB Tooth brushingPTPW Patient tolerated procedure wellRTC Return to clinicTC Treatment complete

246

OUCOD SITECLINICAL ROTATIONS

Pediatric Dentistry Tinker AFB Graduate Periodontics Radiology Oral Diagnosis Implantology VA Medical Center Good Shepherd Mission

CLINICAL REQUIREMENTS 1. Students will provide dental hygiene services to patients during the fall semester in Pediatric

Dentistry, Implantology, Graduate Periodontics, Oral Diagnosis and Radiology, VA Medical Center and Good Shepherd Mission. In each of these rotations, students will be under the direct supervision of dental, dental hygiene faculty and/or staff.

2. The Dental Hygiene Clinic Manual contains the goals, requirements and protocol for each rotation site. Students are advised to consult this manual prior to attending each rotation. Orientation to the rotations will be scheduled at the beginning of the semester prior to students' attendance in the rotation.

3. Student use of local anesthesia and nitrous oxide analgesia is prohibited until notification by Ms. Gray that the student has attained a passing grade in the didactic and clinical exams for the use of local anesthesia and nitrous oxide analgesia

•Note: Administration of local anesthesia must be documented on the Local Anesthesia Report Form to receive credit

4. All students must have a current TB skin test on file and must also complete HIPAA training prior to VA rotations. You may log on to www.vhaprivacytraining.net to complete the training. Failure to do so prior to the beginning of the rotation schedule will prevent the student from participating in the VA rotation and will result in a failing grade in the clinical rotation course.

247

http://www.vhaprivacytraining.net/

BARTLESVILLE SITECLINICAL ROTATIONS

CLINICAL REQUIREMENTS 1. Students will provide dental hygiene services to patients during the fall semester in clinical

rotation sites as assigned. In each of these rotations, students will be under the direct supervision of dental, dental hygiene faculty and/or staff.


3. Student use of local anesthesia and nitrous oxide analgesia is prohibited until notification by Ms. Gray that the student has attained a passing grade in the didactic and clinical exams for the use of local anesthesia and nitrous oxide analgesia.

•Note: Administration of local anesthesia must be documented on the Local Anesthesia Report Form to receive credit.

248

ARDMORE SITECLINICAL ROTATIONS





•Note: Administration of local anesthesia must be documented on the Local Anesthesia Report Form to receive credit.

249

WEATHERFORD SITECLINICAL ROTATIONS





•Note: Administration of local anesthesia must be documented on the Local Anesthesia Report Form to receive credit

250

VAMC

Statement of Commitment and Understanding

As an employee of the Department of Veterans Affairs (VA), I am committed to safeguarding the personal information that veterans and their families have entrusted to the Department. I am also committed to safeguarding the personal information which VA employees and applicants have provided.

To ensure that I understand my obligations and responsibilities in handling the personal information of veterans and their families, I have completed both the annual General Privacy Awareness Training (or VHA Privacy Training, as applicable) and the annual VA Cyber Security Training. I know that I should contact my local Privacy Officer, Freedom of Information Act Officer, Information Security Officer, or Regional or General Counsel representative when I am unsure whether or how I may gather or create, maintain, use, disclose or dispose of information about veterans and their families, and VA employees and applicants.

I further understand that if I fail to comply with applicable confidentiality statutes and regulations, I may be subject to civil and criminal penalties, including fines and imprisonment. I recognize that VA may also impose administrative sanctions, up to and including removal, for violation of applicable confidentiality and security statutes, regulations and policies.

I certify that I have completed the training outlined above and am committed to safeguarding personal information about veterans and their families, and VA employees and applicants.

_____________________________ ___________________________[Print or type employee name] Employee Signature

______________________________ ___________________________Position Title Date

251

SECTION XI

COD Clinic Information

253

OUCOD APPOINTMENT SCHEDULING for DENTAL HYGIENE

255

LATE TRAYS

Normally completed when you have a patient cancel the evening before the appt. and you are able to get another patient in for the cancelled appointment.

1. complete the late tray request

2. keep one copy for yourself3.

4. take original to personnel in chart room

5. your patient’s chart and encounter form will be delivered to clinic

Do not worry about canceling the original patient in QR because your chart and encounter form have already been sent to clinic. It is your responsibility to document in the chart and on the encounter form that the patient called & cancelled the night before.

INITIAL APP T OINTMENT

1. Complete the appt slip.

2. Keep one copy for yourself and give one copy to your patient if they are a reappoint.

3. Place the completed appt. slip in the box outside room 232 where you turn your charts in to the staff.

4. Appt slips are retrieved by staff and will schedule the dates you have requested.

5. Check your schedule to make sure appts have been completed.

CANCELLATIONS

1. Complete cancellation slip ONLY if a patient calls before 3:00 pm the day before the appt.

2. The cancellation slip is taken to the appt slip box outside room 232

3. If you complete the cancellation slip before 3:00 pm, your chart and encounter form will be cancelled out of clinic.

4. It is still your responsibility to document the cancellation in the chart

256

SECTION XI

COD Clinic Miscellaneous

258

FAX TRANSMITTAL INFORMATIONGreen Clinic

In the event that the patient needs a Medical Consult from a physician, please do the following:

1. Fill out medical consult form

2. Cross out the phone number (271-3158)

& change it to 271-4181.

3. Fill out the Fax Transmission form

4. Contact Terri Forster in the Maxillofacial Clinic to request permission to send fax

5. Lay forms face down on fax machine. Dial 9 + number & press green button to send.

6. If long distance, contact Terri for further information.

7. PLACE FAX TRANSMITTAL FORM IN PATIENT’S CHART

260

University of OklahomaCollege of DentistryDepartment of Dental Hygiene 1201 N. Stonewall, Suite #567Oklahoma City, OK 73117(405) 271-4435 Telephone(405) 271-4181 Fax

FACSIMILE

TO:

COMPANY/DEPARTMENT:

ADDRESS:

FROM:

REFERENCE:

TOTAL NUMBER OF FAX PAGES

MESSAGE:

CONFIDENTIAL – PATIENT INFORMATIONIf this fax is accidentally received by a party other than theabove intended, please call (405) 271-4435 to report the error and destroy the fax copy sent to you. Thank you.


262

DENTAL HYGIENE RECALL EXAMINATIONInterval/Examiner Protocol

Effective 1-25-06

6-Month Recall ExamDS 4

Code 1120-10 (oral eval-no supervision)There is no charge to the patient for this procedure

Bitewings & PAs to be charged for when taken at this appointment

1-Year Recall ExamDental Faculty

Code 120Examination includes 4 bitewings if needed (do not mark on form, they are included)

2-Year Recall ExamDental Faculty

Code 120Examination includes bitewings & periapicals if needed

Additional radiographs should be charged for when taken

Dr. Panza 46828


263

DENTAL HYGIENE PATIENT PROTOCOL2006-2007

Only RECALL patients receive an OD exam. Only RECALL or DH ONLY patients may receive a Graduate

Periodontics consultation

PATIENT TYPE DH TREATMENT PROTOCOL

SCREENING PATIENTS

(Friends, family members, VA, OUHSC, Project Challenge, Epworth Villa, St. Ann’s, anyone)

Scheduled by patient scheduler to check in at Cashier’s Desk on 2nd floor at 12:30. 1:15, 2:00 & 2:45 to register (seen 30 minutes later in clinic)

Fill out all forms for Dental Hygiene Only (use OLD OD screening forms stamped DH Only)

Go over HHx, take BP, get PTP from CI. Request radiographs to be exposed (limited to 2 BWX or reasonable alternative) CI to sign for films Expose & develop prescribed radiographs & collect data to complete CDI (recession,

spot probing, supra & subgingival calculus) CI to confirm CDI CI will be responsible for ensuring that acceptance as "Hygiene Only" forms are completed, and a

financial policy is signed and distributed for each patient accepted Stamp front of chart and TPNs with Dental Hygiene Only stamp.

DH ONLY PATIENTSPatients screened in DH Clinic

or OD & accepted for hygiene only – no other dental care provided.

DH student completes new patient work-up & provides DH treatment. Patient does not receive an OD exam. These patients are not placed in recall system unless deemed an ongoing

teaching case at the discretion of the Clinical Instructor. Patient is told to seek care in private practice. Stamp front of chart and TPNs with Dental Hygiene Only stamp.

“PROJECT CHALLENGE”TECHNOLOGY

CENTER PATIENTS

Must have $50 voucher (covers ALL tx) Make note on encounter form to prevent additional charges Stamp front of chart and TPNs with Dental Hygiene Only stamp; DH Only consent

form must be signed. Tx documentd on white TPNs (including 4-6 wk re-eval) If follow-up is in 3-4 months, use Blue Recall Form & stamp DH only in exam section Can continue DH care if deemed ongoing teaching case and enrolled in Project

Challenge Stamp front of chart and TPNs with Dental Hygiene Only stamp.

GRADUATE PERIODONTICS

PATIENTS

Patients are scheduled by Graduate Periodontics & charts are available day prior to appt to review; go over meds etc. Charts will be in the tub in Green Clinic with schedule

Patients are seen in DH Clinic, with DH faculty supervision. Use Graduate Periodontics fee schedule; add any additional procedures to encounter

form & inform GP sec’y. Use lines below to add any additional procedures


264

PATIENT TYPE DH TREATMENT PROTOCOL DH tx as deemed necessary (radiographs, OHI, perio charting, CDI, S/RP, CMT, polish,

fluoride etc) Exam by ROD at end of appt if needed. (at their discretion) Discuss case and your tx with ROD. Have ROD sign encounter form Check boxes for current appt info (Green Clinic, Grad Perio, DH, AM or PM) Take patient to Brown Clinic to check out DH student can reappoint on any subsequent open appt in GC. (complete all DH tx

asap to facilitate Phase II therapy) 4910 perio maintenace include fluoride treatment

PERSONAL PATIENTSPatient is friend/relative of DH

student Patient should be screened in DH clinic prior to scheduling

appt.

DH student completes new patient work-up & provides DH treatment. Patient does not receive an OD exam. These patients are not placed in recall system unless deemed an ongoing

teaching case. Otherwise, patient is told to seek care in private practice. Stamp front of chart and TPNs with Dental Hygiene Only stamp

COMPREHENSIVE OR LIMITED TREATMENT

PATIENTSPatient screened in OD & accepted for complete care, limited care or disease

control.

DH student completes new patient work-up & provides DH treatment. Patient does not receive an OD exam or referral to any other clinic – patient will be

assigned to dental student for treatment.

RECALL PATIENTSAll Restorative Treatment has

been completed by dental student

Stamp “Recall” on outside of chart Dental student’s Case Complete appt should be documented in TPNs & on white post-

op dental/perio charting form DH student completes recall work-up & provides DH treatment. Patient receives an OD exam every 6 months. Treatment needs are noted on the Blue Recall Form (take BWX/PAX of involved area). If

patient needs endo, removable, or fixed bridges, appropriate departmental faculty must be consulted. If departmental faculty are unavailable, OD student must note there was no consultation. Patient is told if not contacted by recall date to seek care in private practice.

If pt has completed 2 years of recalls, he/she may be given the option of being re-classified DH Only; must sign new DH Only Consent Form

If not interested in being re-classified as DH Only, must sign DH Release Letter. Original is secured in chart on top of white TPNs & a notation made in TPNs that patient is not interested in DH Only & is being released due to completion of recall

OHI ONLY PATIENTReferred from Treatment

Planning ClinicAssigned to a dental student. Note will be made in TPN that the patient has been referred for oral hygiene instruction

and/or fabrication of fluoride trays.

Pt may not have had complete charting. Review HHX & case history for insight into social habits. Perform an oral inspection. Have pt complete nutritional screening questionnaire. The following may be provided depending on pt need: oral hygiene instructions

(1330), nutritional counseling (1310), fluoride tx (1204), fabrication of fluoride tray (5986) and medicaments (9630) prn.


265

Spouse25%

discount

PATIENT TYPE DH TREATMENT PROTOCOL

BLEACHING PATIENTS

Patients do not have to be previous patients of record. There is no screening fee. Includes impressions, bleaching trays, Boost procedure (9972) Dispense patient bleach and desensitizer with trays 2 appts

INFANT PARENTING PROGRAM (IPP)CITY RESCUE MISSIONSMILES FOR SUCCESSHEALTH FOR FRIENDSCATHOLIC CHARITIESLIGHTHOUSE MISSION

Patient completes health history. Patient does not go through screening process; no CDI DH student provides EIE, periodontal exam and completes CDI. Minimum of 2 BWX should be exposed. DH student provides DH treatment. These patients are not placed in recall system. Patient is told to seek care in private practice. There is no charge for these patients. Stamp front of chart and TPNs with Dental Hygiene Only stamp

WREB SCREENING PATIENTS

Patient completes WREB health history. Student explores for calculus. If patient appears to be acceptable, student completes calculus charting form & assesses probing depths. f acceptable patient will need PAX & BWX. Patient is responsible for payment for radiographs. A WREB radiographic request is available in OD.

COMPLETE DH TX Noted on back of screening form All tx is documented on white TPNs Note that pt needs to be transferred to dental student for restorative tx


266


267

PATIENT CONTACT CARDS PROTOCOL

Please follow the following protocol for contact cards:

1. The student brings the DH Coordinator the chart with an entry in the treatment progress notes requesting a contact card be sent.

Example: All of patient's phone numbers are disconnected, please send contact card.Example: Patient's home number disconnected, no longer works at work number, please send contact card.Example: Have left messages for patient on home and work number but have not received a response, please send contact card.

2. The DH Coordinator will co-sign behind the student's signature/stamp.

3. Have the student complete the contact card. The due date for a response should be 10 business days (which is usually 2 calendar weeks). When the student addresses the front of the card, he/she must print in all caps and use no punctuation.

Example: Patient Name Street address City, state, zip

The student should be emailed by the DH Coordinator if a response is received. The student is responsible for checking with the DH Coordinator once the 10 business days have passed to confirm no response. If there is no response, the student can then bring the chart to Mrs. Miller for release authorization.


268

Dental Hygiene Documentation Check List

August 2006

PTP has student and faculty signatures and stamps

Dates and signatures/stamps are on:o EIE formo Dental/Perio Chartingo CDI formo Radiographic Log

Patient name and date are on radiographs

Recall exam notes are present, signed and stamped, and clearly understood

Recall interval and expected CDI are noted at the top of the recall form

Completed treatment notes have been verified for accuracy and signed/stamped by student and faculty member

All Dental Hygiene Only patients must have a new (8/06) Dental Hygiene Only Consent Form in the chart (the new form allows us to follow up on their dental hygiene care without providing a dental exam)

With the exception of white TPN’s, all Dental Hygiene documents are placed behind the purple Dental Hygiene divider which should be behind the Oral Diagnosis section

If a release letter has been completed, the original is secured in the chart on top of the white TPN page


269

Dental Hygiene Patient InformationAugust 2006

At PTP: Determine the type of patient

Recall Dental Hygiene Only Complete Treatment

1. Should be stamped “Recall” on the chart. 1. Patients from technology centers have a 1. This is noted on $50 voucher agreement with the COD. Be the back of the2. The dental student’s case complete appointment sure to make a note on the encounter form screening form. for the patient should be documented in the TPN’s to prevent additional charges. and on the white post-op dental/perio charting form. 2. All treatment is

2. Chart and TPN form should be stamped documented on

3. Follow recall exam protocol. “Dental Hygiene Only”. white TPN pages. 4. Treatment is documented on the blue recall form. 3. Treatment is documented on white TPN page (including the 4-6 week re-eval).

4. If it is a follow up appointment in 3-4 months, use the blue recall form and stamp “Dental Hygiene Only” in the exam section.

At the completion of treatment:

Recall Dental Hygiene Only Complete Treatment

1. If patient has completed two (2) years of recalls, 1. Patients can continue dental hygiene care 1. Note in TPN’s that he/she may be given the option of being re- if deemed a good teaching case; must have dental hygiene classified as Dental Hygiene Only; must sign the new (8/06) Dental Hygiene Only Consent care is complete the new (8/06) Dental Hygiene Only Consent Form. Form. and the patient needs to be trans-2. If not interested in being re-classified as DH Only, ferred to a dental

he/she must sign and be given a copy of the DH student forRelease Letter. The original is secured in the chart restorative treatment.on top of the white TPN’s and a notation is made in TPN’s that the patient is not interested in being DHOnly and is being released due to completion of recalls.


270

Clinic Operations

Dental Hygiene Student Instructions

August 2006

Patient Assignments

Patients for the fall semester are included in your orientation packet. Patient pools from spring semester have been deleted. The patients are assigned in the QR system and in the Filemaker database (IT will train students on Filemaker as soon as it is web accessible). Each student has been assigned eight A/B patients and four C patients. D patients will be assigned automatically on September 15. Be sure to read any notes in the message box.

A reserve patient pool of unassigned patients will be available to the dental hygiene students on the Filemaker database. Five patients that are most overdue will be made available at a time. If a student contacts, or attempts to contact a patient, an entry must be made in the contact field. If a student schedules the patient, he/she must let the DH Coordinator know ASAP so that she can assign the patient to the student.

If a student needs additional patients, a Dental Hygiene Patient Request Form must be completed and submitted to the DH Coordinator. Please complete one form for each patient requested. Please note in the comments section if a specific patient is requested. Patient request forms must be date/time stamped.

The student will be notified of filled patient requests by email from the DH Coordinator.

Scheduling Patients

Students are responsible for scheduling their own patients and confirming their patients’ appointments. Students will turn in appointment request slips to the DH Scheduler who will enter them into the QR program. Appointment request slips must have the chart number, procedure codes and date/time stamp. Leave no blanks on the slip. Refer to the Dental Hygiene Procedure Code list to insure that appropriate codes are used. Superbills will no longer be used. Encounter forms will be used in their place.

Students need to contact the DH Scheduler ASAP regarding last minute schedule changes.

City Rescue Mission patients can only be scheduled on Wednesday afternoons. Identify these patients with CRM on the appointment request slip so that the DH Scheduler can arrange for their transportation through the DH Coordinator and the CRM Coordinator.


271

Rotation schedule blocks are provided to reserve chairs for Grad Perio patients.

Releasing Patients

If the student is unable to contact the patient with the phone numbers available in the chart, and in Filemaker, he/she must complete a postcard via the DH Coordinator who will co-sign the student’s TPN entry and mail the card.

If there is no response within 10 business days or if the card is returned with no change of address label, the patient may then be released (see release protocol).

If the card is returned with a change of address label, the DH Coordinator will send a corrected one with a new response due date and email the student.

All dental hygiene patients that need to be released must have Mrs. Miller’s signature in the TPN’s authorizing release. The exception to this is those recall patients that are released by supervising dental hygiene faculty when they are deemed no longer a teaching case.

Chart Documentation

Be sure to read any Patient Advocate notes inserted in the chart.

The blue recall report cards will no longer be used. The recall appointment form has been revised to include “CDI at next recall” and “Recall interval” at the top.

Be sure to include a dental hygiene divider in the chart and insert all dental hygiene documents behind the divider.

The student should ask each patient if he/she has had any changes in their phone and/or address. If he/she has, an information update form should be completed and given to the DH Coordinator.

If restorative treatment has been prescribed, the limited treatment form should be placed inside the chart.

Chart documentation must be complete. You will be contacted for clarification if your documentation is incomplete or unclear.

The charts of each dental hygiene patient are turned in at the Central Billing Office upon dismissal with the exception of the last visit. If the appointment is the patient’s last visit until returning for recall, the chart is turned in to the chart drop slot next to the Patient Coordinators’ door. The DH Coordinator and Scheduler will enter the data from the chart and forward the limited treatment form to the Director of Clinics for approval and assignment.


272

OUCOD Fee Schedule

Pre-Doctoral & Dental Hygiene Programs

Fall 2006 Fee

D0150* - asterisk designates the fee has been changed

Started procedure status A charges patient accountProcedure in process status B $0 charges patient accountCompleted procedure status C $0 charges patient accountStarted & Completed same day D charges patient account

Internal Codes Insurance not filed

1 0 PATIENT NO-SHOW $0.002 0 PATIENT CANCELLATION $0.003 0 STUDENT NO SHOW $0.004 0 STUDENT CANCELLATION $0.007 0 APPOINTMENT TERMINATION $0.00

11 0 REINSTATEMENT FEE $15.0013 0 SCHEDULING ERROR $0.0014 0 FINANCIAL ACTIVATION FEE PAYMENT PLANS $75.0020 0 CPY RCDS $1 @ $.50/PG $0.0021 0 DUPLICATION OF XRAY $5.00

D0100-D0999 DIAGNOSTIC110 0 MISC CONSULT All disciplines $0.00111 0 FOLLOWUP or POST-OP VISIT All disciplines $0.00112 0 TRANSFER PATIENT $0.00115 0 Screening Pedo $8.00117 0 initial exam pt not accepted full refund $0.00121 0 Hygiene Screening $10.00

D0120 0 Periodic Oral Eval pt of record/case cmpl $25.00D0140 0 Limited Oral Evaluation problem focused $25.00D0210 0 intraoral complete series includes bitewings $31.00D0220 0 PA, FIRST FILM $5.00D0230 0 PA, EACH ADDTL $4.00D0240 0 OCCLUSAL FILM $9.00D0270 0 BW, 1 FILM $5.00D0272 0 BW, 2 FILMS $10.00D0274 0 BW, 4 FILMS $26.00D0277 0 VERTICAL BITEWINGS 7-8 FILMS $26.00D0330 0 PANORAMIC FILM $21.00


273

D1000-D1999 PREVENTIVED1110 0 Prophylaxis Adult Excluding Fl Application $34.00D1115 0 case compl in/xrays $0.00D1120 0 prophylaxis , child $19.00D1201 0 prophy + fl tx, child $5.00D1203 0 Fluoride Tx only, child $5.00D1204 0 Fluoride TX only- ADULT $5.001300 0 Reseal per tooth $0.00D1310 0 NUTRITIONAL COUNSELING PER APPT $9.00D1320 0 TOBACCO COUNSEL PREV OF ORAL DISEASE $0.00D1330 0 OHI INSTRUCTION PER APPT $9.00D1351 0 SEALANT, PER TOOTH PER TOOTH, specify th# $12.00

D4000-D4999 PERIODONTICSD4000 0 DH REEVALUATION DH ONLY $0.00

D4341 0 SCALE & RP4 OR MORE TREATED TH/QUAD $41.00

D4342* 0 SCALE & RP 1-3 TREATED TH/PER QUAD $18.00D4355 0 FULL MOUTH DEBRIDEMENT GROSS SCALING $33.00D4381 0 CONTROLLED RELEASE ANTIMICRO PLACED IN CREVICE $40.00D4910 0 PERIO MTN PHASE 1 RE-EVAL/CMT/MT $41.00D4999 0 UNSPC PERIO PROC BY REPORT

D9000-D9999 Adjunctive General Services

9000 0 NITROUS OXIDE ANALGESIA Pedo onlyD9110 0 GINGIVAL TREATMENT NUG, PERICORONITIS $21.00D9230 0 NITROUS OXIDE ANALGESIA $26.00D9630 0 DRUG-MEDICAMENTS $12.00D9630 3 PERIDEX RINSE $12.00D9630 5 PREVIDENT $12.00D9630 6 FLUORIDE RINSE $12.00D9910 0 DESENSITIZING MEDICAMENT PER APPT $10.00D9972 0 EXTERNAL BLEACH BASIC PER ARCH $103.00D9973 0 EXTERNAL BLEACHING, per tooth $26.009975 0 HOME BLEACH SOLUTION $26.009999 0 ADJUNCTIVE PROCEDURE $0.00


274

Friday EmailOctober 20, 2006

Contact Card Protocol - we are doing better but I just want to review a few items. 1. If you are unable to contact your patient by phone, go to Sherreka and Robin's office and ask for a contact card. 2. Address it with all caps and no punctuation (I think everybody has this down now), write in the response due date on the back and make an entry in the white treatment progress notes. Your entry should include your unsuccessful attempts and details associated with those attempts i.e. all phone numbers disconnected, have left messages and received no return call, etc. 3. Sherreka or Robin will sign to the right of your signature/stamp to indicate the staff member who is responsible for mailing the card. 4. Make a note in your planner of the due date of the response to the card and be sure to follow up with Sherreka and/or Robin if you have not received an email regarding a response. 5. If the patient does not respond or the contact card is returned, make the appropriate entry in the TPN's and bring it to me so I can authorize release of the patient. 6. If the patient responds to the contact card and is an A or B and you do not have time to see him/her, you need to call him/her and explain that since you had difficulty contacting him/her, you will not have time to see him/her this semester and he/she will be reassigned in spring 07. And, as always, document this information in the TPN's and bring the chart to me for authorization of return to the pt. pool. 7. If the patient responds and has a new phone number and/or address, be sure to fill out an information update form and give it to Sherreka or Robin.

Missing Documentation Please remember to put the patient's name and chart number on all documents. I have seen white TPN pages added to the chart when you need to return a patient to the patient pool with no patient name or number on them. There have also been some DH Only Consent forms come through without the patient's chart number (this is in the upper left hand corner of the encounter form).

Upside Down Form Mrs. Gray and I discovered this week that the new blue recall forms that came from the printer will not work in our charts because the back side of TPN lines are upside down. The solution to this problem will be: 1. X out the back side of the blue recall form. If you need additional note space to supplement the front side of the recall form, place a white TPN page behind the blue recall form and document on it. On the top line, write "DH Tx notes continued". When that series of appts. is complete, X out any remaining white TPN lines.(This is very hard to explain verbally so let me or Mrs. Gray know if you have questions)

Web Database Access Jason came to see me this afternoon and reported that we now have the latest version of Lasso and he and Stacy are going to get the database updated and finalized this weekend. He will be giving instructions soon on setting up your passwords. As soon as the server is ready, we


275

will be good to go. He expects to be up by the end of next week but I will expect it the following week.

PROTOCOL FOR HANDLING DENTAL HYGIENE CANCELLATIONS.

Revised August 29, 2006

1. When a patient cancels before the day of the appointment, the DH student completes an appointment cancellation slip and submits it to Sherreka.

2. When a patient cancels the day of the appointment or does not show up for the appointment, that is considered a no show so does not require a cancellation slip but should be documented in the treatment progress notes and countersigned by a DH faculty member or myself. The encounter form should also reflect a no show (code 01) and be signed by the student and faculty member and turned in to the cashier.

3. Dental hygiene students are not required to turn in a cancellation slip to Ruth and should be allowed to check out with the cashier with the chart and encounter form appropriately signed.

4. Dental hygiene students are to turn their patient's chart in at the cashier if the patient is returning for additional visits. When treatment is complete, the chart is turned in to Sherreka for data entry and then she will forward it to Linda if limited treatment is needed.

Tammy, please inform the cashiers of items 3 and 4. There was some confusion with this today and they would not let a student check out because she did not have a cancellation slip for a patient that did not show up for an appointment. Also, dental students are not required to complete a cancellation slip for same day cancellations or no shows.


276

Changes to Cancellation Policy September 28, 2006

It has become rather obvious that the current cancellation policy, while well meaning, has created some hassles for students and Clinic Directors alike. During a recent meeting with the Class Presidents a few suggestions were discussed that might improve the system. Effective on Monday October 2, 2006 the following changes will be implemented.

Signatures are no longer required on cancellation slips however they still need to be completed appropriately (including all requested information on the slip) and given to your respective Patient Care Coordinator to determine the legitimacy of the request as cancellations are still being tracked as acceptable and unacceptable. Incomplete cancellation slips will be returned.

No shows* will no longer require a cancellation slip being submitted. You will need however, proper chart documentation, a notation on the encounter form (counter-signed by supervising clinic faculty) and initials near the chart entry by the respective Patient Care Coordinator. The chart is then returned to the chart room. The yellow copy of the completed (and faculty counter-signed) encounter slip remains in the clinic with the white copy. The Central Business Office cashiers should not have any role in the processing of cancellations.

*No shows have traditionally been regarded as broken appointments within 24 hours however in regard to the “cancellation slip” policy, a broken appointment after 5:00 pm the day before the appointment will be considered a no show.For students canceling appointments made in advance where the cancelled appointment will have no adverse effect on the patient’s time, initials from Patient Care Coordinators are not required in the chart.

Students will be allowed four (4) cancellations per discipline per month (as stated in the July 31st e-mail).

Modifications of Late Tray Process

I have noted that the majority of cancellation slips I've signed were for legitimate reasons usually involving the canceling of one well-appointed patient and the rescheduling of another last minute fill-in patient. I now feel that our focus should be on the late tray requests and in particular those that are specific for a different patient in the same clinic. Therefore special attention will be given to late trays and the nature of them. Cancellations will still be tracked but should not present a problem unless they far exceed


277

the prescribed number and then any concerns regarding this will then be dealt with on a case-by-case basis. Effective on Monday October 2, 2006, the following policies will be observed.

Students will need to obtain a signature on their late tray slip from a full-time faculty member providing coverage in that clinic. This is the only way to ensure that the faculty are aware of the change and that a chair will be available for the student. Late tray requests without appropriate faculty signatures cannot be processed.Upon revisiting our previous policy (as stated in the e-mail dated July 31st 2006) of 5 late trays for all combined disciplines and 5 late trays for ortho/ pedo, it was decided to allow 5 late trays per discipline per semester which will not include those late trays submitted for treatment planning (same patient different clinic) for more scheduling flexibility. Five late tray requests are also allowed for ortho/ pedo combined per semester.

If there are any questions regarding the above information, please e-mail me or stop by 240A. I wanted to be certain that faculty were included on this process and will be happy to answer their questions also, we need to keep the communication lines open as much as possible in order to achieve the best results. ThanksDr. Panza


278

Friday EmailsMs. Miller

FRIDAY September 22, 2006

1. For DH Only patients, please designate at the end of your TPN's if the patient is to be released (no longer a teaching case) or continued for DH only care.

2. OUCOD employees can be utilized for no shows but the patient still needs to be assigned to you as soon as you know they will be seen by you.

3. Please remember to cross out any remaining lines on the back of the blue recall form once you have completed that series of DH appts. to avoid subsequent treatment notes (i.e. restorative care and release entries) being placed in that area of the chart.

4. I am working on a final plan for what will occur with the Grad Perio patients on Thursday mornings. Josie left early today so I will contact her on Monday. I have already visited with others involved.

5. As a lot of you already know, the correct contact cards are here. Please be sure to use all caps and no punctuation when addressing your contact cards. These are University postal rules - not mine.

6. If a patient is seen in the clinic, regardless of the procedure (i.e. impressions for bleaching trays), an encounter form must be completed. Use the 110 consult code for the appt. when you take impressions.

7. Do not schedule subsequent appts. for CRM patients on a Wednesday afternoon on which you are assigned to CRM/rotation. Schedule these appts. on one of your regular clinic Wednesdays (unless the pt. has their own transportation for another day). The assigned CRM times are for starting new CRM patients. If this protocol is not followed, it is likely we would end up with too many patients to see.


279

Patient Management Protocol for City Rescue Mission Patients

August 30, 2006

1. City Rescue Mission patients are scheduled on Wednesday afternoons only.

2. Sherreka emails Jason Danel on Mondays to inform him of the patients he needs to bring on that Wednesday.

3. When Jason arrives with the patients, he will take them to Sherreka’s office.

4. Sherreka will complete the name, DOB, and SSN on the blue adult health history form and will note CRM and one of the CRM students’ names at the top of the form.

5. Sherreka will copy the forms and give the copies to Rick.

6. Sherreka will escort the patients to Green Clinic and deliver the forms to Mrs. Zerby.

7. Mrs. Zerby will distribute the forms to the appropriate students (names will be at the top of the form).

8. Patients should have a bus ticket for their transportation when the appointment is over.


280


281

DENTAL HYGIENE BOARD EXAMS

NATIONAL BOARD DENTAL HYGIENE EXAM (NBDHE)211 East Chicago AveChicago, IL 60611-2678www.ADA.org800-232-1694

Date: Last Tuesday in March (March 27, 2007)Application deadline: February 5, 2007 Fee: $145.00 Application process online, after January 1.Requires 2 passport photosResults usually available 6 weeks

WESTERN REGIONAL BOARD EXAM (WREB)9201 N. 25th Ave. Suite 185Phoenix, AZ 85201(602) 944-3315Fax (602) 371-8131Email: [email protected]

Date: 2nd weekend in June (June 9-11, 2007)Fee: $800.00Application process online after January 1Must submit verification from CODRequires 2 passport photosResults available usually 2-3 weeks

OKLAHOMA BOARD OF DENTISTRYJURISPRUDENCE EXAM FOR STATE LICENSURE201 NE 38th Terr, #2Oklahoma City, Ok 73105(405) 524-9037Linda Campbell, executive director www.state.ok.us/dentist/

Date: 3rd – 4th week of April; each site scheduled at different times; Fee: $100


282

http://www.state.ok.us/dentist/

http://www.wreb.org/

http://www.ADA.org/

Application process: form available 1st of MarchRequires physical exam Requires passport photo Must be notarizedResults available immediately


283

SECTION XIII

COURSESYLLABI


284

University of OklahomaCollege of Dentistry

Department of Dental Hygiene

General Information

Course & Number: Dental Hygiene Theory I (DH 3313)

Year/Semester: 2006/1

Credit Hours: 3

Scheduled Class: Monday – Wednesday, 9:00 a.m. to 12:00 p.m., Tuesday 1:00 p.m. to 4:00 p.m. (please refer to the course schedule)

Course Description: Introduction to theory of the dental hygiene process of care and clinical practice of dental hygiene. Students will become acquainted with concepts necessary to provide competent dental hygiene care. Principles of

ergonomics, basic instrumentation, prevention of disease transmission, patient assessment procedures, treatment interventions, and introduction to clinical protocol are included.

Teaching Methods: Lecture, discussion, demonstrations, small group collaboration, and role-playing

Course Director: Tammie J. Vargo, RDH, MEd, Gerontologist Rm. #582 (405) 271-4562, voice-mail (405) 314-6096, in case of an emergency [email protected]

Office Hours: Wednesday p.m. & Friday a.m. and p.m. BY APPOINTMENT ONLY! Call: (405) 271-4435 (Kristy) [email protected]

OKC Instructors: Jane Bowers, RDH, PhD Kim Graziano, RDH Donna Brogan, RDH, BS Kathy Miller, RDH, BS Vicki Coury, RDH, MEd, MPH Kathy Rogers, RDH Laurie Cunningham, RDH, MEd Stephanie Schmidt, RDH, BS Sheri French, RDH, BS Carol Zerby, RDH, BS


285



TCTC Instructors: Lydia Snyder, RDH, MS (Coordinator) Tammie Golden, RDH, MHS

Abbie Gustafson, RDH, BS

SOTC Instructors: Christy Brannock, RDH, BS (Coordinator) Judy West, RDH, MS Lindsey Hays, RDH, BS

WTC Instructors: Julie McClung, RDH, MEd (Coordinator) Tina Tuck, RDH, BS

Required Course Materials

Web Access: http://ouhsc.blackboard.com (MUST have PowerPoint, Microsoft Office or PowerPoint Viewer)

Required Textbooks: Dental Hygiene Theory and Practice, Darby and Walsh, Saunders, 2nd Edition, 2003

Mosby’s Dental Drug Reference, C.V. Mosby Company, 7th Edition, 2004

Clinic Manual, OU College of Dentistry (on-line @ www.dentistry.ouhsc.edu)

Clinic Manual, Department of Dental Hygiene (on-line @ www.ouhsc.blackboard.com ~3313 ~ Course Documents)

Reference Websites

OUHSC Library: www.ouhsc.eduCDC: www.cdc.eduP & G: www.dentalcare.comADHA: ` www.adha.orgODHA: www.okdha.orgADA: www.ada.orgOSAP: www.osap.orgNIH: www.nih.orgDHNet: www.usc.edu/hsc/dental/dhnet (National Center for DH Research)Federal Stats: www.fedstats.gov/ Latex Allergy: www.elastyren.com/info/question.htmlHIV: www.HIVDent.org

Course Requirements


286

http://www.HIVDent.org/

http://www.elastyren.com/info/question.html

http://www.fedstats.gov/

http://www.usc.edu/hsc/dental/dhnet

http://www.nih.org/

http://www.osap.org/

http://www.ada.org/

http://www.okdha.org/

http://www.adha.org/

http://www.dentalcare.com/

http://www.cdc.edu/

http://www.ouhsc.edu/

http://www.ouhsc.blackboard.com/

http://www.dentistry.ouhsc.edu/

http://ouhsc.blackboard.com/

1. Students are expected to be present and prompt for all lectures, labs and clinical assignments. Attendance will be recorded by the course director and will follow the guidelines of the Dental Hygiene Department Attendance Policy. Students will be considered tardy from 9:01 to 9:10. Arrival after 9:10 will be considered as an absence.

2. Students are responsible for all topics covered in required texts, and course materials located on the Blackboard website. Students must read all assigned chapters in the required text.

3. Students are expected to participate in classroom discussions and role-playing situations. This will require the student to prepare in advance, so as to make useful time of the class period.

4. No assignments will be accepted after the due date unless prior arrangements have been made with the course director. With permission, late assignments will result in a 25% grade deduction.

5. Students are expected to set up units PRIOR to the beginning of lecture, when lecture is followed by lab or clinic practice.

6. Students are expected to complete examinations as scheduled. If you are absent when an examination is administered, follow the procedure for any absence by calling the secretary (405-271-4435) or the course director (405-314-6096). Make-up examinations will be offered ONLY for excused absences, and after consultation with the course director. Make-up examination questions will consist of a short answer and essay format.

7. Students are responsible for checking campus e-mail on a DAILY basis.8. Students are expected to inactivate all cell phones and pagers during class hours

to avoid disruption and interference with distance technology. A cell phone infraction will result in a pop quiz for the entire class. Students should instruct family members to call the department secretary @ (405) 271-4562 (Kristy) with emergency messages.

Professionalism

1. Academic misconduct and dishonesty will not be tolerated under any circumstances. See your student handbook.

2. Failure to exhibit professional intellectual, ethical, behavioral and attitudinal attributes necessary to perform as a health care provider and interact in a collegial professional manner with peers, faculty and the patients will result in a 10% reduction in the final course grade. Students are expected to follow directions, maintain a positive attitude, avoid loud and disruptive behavior, maintain exemplary personal hygiene, uphold the ethics and standards of the professional dental hygienist—the College of Dentistry—the University of Oklahoma, and demonstrate continuing professional growth and maturity. The final course grade and promotion to the next DH Theory course are contingent upon the evaluation of professional growth and maturity as determined by clinical faculty and the course director/clinical coordinator.

Determination of the Course Grade

Evaluation Methods: Final grades will be determined by exams, in-class assignments and class participation.

Examination #1 20%


287

Examination #2* 20%

Examination #3* 20%

Final Examination* 30%

Class Participation 10%

*Comprehensive Exams

Grading Scale:

90 – 100 = A80 – 89 = B70 – 79 = C

60 – 69 = D*59 & = F

*A numerical score of 69% or below is failure insofar as credit toward a degree is concerned. A “D” grade must be remediated to a “C”. The terms of a remediation will be determined by the course director. If the terms are not remediatied by the assigned due date, the “D” grade becomes an “F” and the course must be repeated.

Extra Credit: One point will be added to the FINAL COURSE GRADE provided you attend an organized event arranged by the ODHA or the College of Dentistry. Extra credit may be used to raise the course grade only if the grade is passing. The extra credit point cannot be used to raise a semester grade of 69 or below.

Additional Information

An unannounced quiz may be given by the course director at any time to assess learning.


288


289

UNIVERSITY OF OKLAHOMACOLLEGE OF DENTISTRY


DH 3513 PREVENTIVE DENTISTRY

FALL 2006

COURSE DESCRIPTIONAn introduction to the philosophy of preventive dentistry as it relates to every aspect of dentistry including dental plaque, its role in the development and progression of dental disease and the current methods of plaque control. Emphasis is placed on the concepts of prevention as a part of total patient care in the dental practice as well as a part of the community.

COURSE DIRECTORSLaurie Cunningham, RDH, MEd Office Hours: By appointment Phone: 271-4423 Email: [email protected]. Jane Bowers, RDH, PhD Office Hours: By appointment Phone: 271-4436 Email: [email protected]

TCTC (Bartlesville) SITE COORDINATOR: ,Lydia Snyder RDH, MSSOTC (Ardmore) SITE COORDINATOR: Christy Brannock, RDH, BSWTC (Weatherford) SITE COORDINATOR: Julie McClung, RDH, MEd

WRITING CENTER OUHSC Office of Student Services Student Center, Room 300 Hours: T & F, 10-2 Phone (405) 271- 2416 E-mail: [email protected]

CONTACT TIME 3 hours credit

42 hours lecture including examinations 12-16 hours learning activities Wednesday 1:00-3:50 pm

REQUIRED TEXTBOOKS


290




Harris, Norman O., and Garcia-Godoy, Franklin, Primary Preventive Dentistry, 6th ed., Appleton and Lange, 2004.

Darby and Walsh, Dental Hygiene Theory and Practice, 2nd ed., Saunders, 2003.

WEB ACCESS FOR COURSE MATERIALS AND INFORMATIONhttp://ouhsc.blackboard.com

Note: Must have PowerPoint, Microsoft Office or PowerPoint ViewerACADEMIC MISCONDUCT Academic misconduct will result in AUTOMATIC FAILURE of the course.

Academic Misconduct includes any act which improperly affects the evaluation of a student's academic performance or achievement, including but not limited to the following:a. Cheating: the use of unauthorized materials, methods, or information in any

academic exercise, including improper collaboration;

b. Plagiarism: the representation of the words or ideas of another as one's own, including:

1. direct quotation without both attribution and indication that the material is being directly quoted; e.g., quotation marks;

2. paraphrase without attribution;3. paraphrase with or without attribution where wording of the original

remains substantially intact and is represented as the author's own;4. expression in one's own words, but without attribution, of ideas,

arguments, lines of reasoning, facts, processes, or other products of the intellect where such material is learned from the work of another and is not part of the general fund of common academic knowledge;

c. Fabrication: the falsification or invention of any information or citation in an academic exercise;

d. Fraud: the falsification, forgery, or misrepresentation of academic work, including the resubmission of work performed for one class for credit in another class without the informed permission of the second instructor; or the falsification, forgery, or misrepresentation of other academic documents; or the communication of false or misleading statements to obtain academic advantage or to avoid academic penalty;

COURSE RATIONALEA basic knowledge of preventive dentistry is an essential element in the practice of clinical dental hygiene. The dental hygienist must be able to relate the many factors that play a part in preventive dentistry in patient education, clinical services and community activities.

This course has been customized to provide the dental hygiene student with an introduction to dental plaque, its role in the development and progression of dental diseases and the current methods of oral disease control.


291

http://ouhsc.blackboard.com/

Current preventive dentistry research will continually change the face of this discipline; this course will present information on the current state of the art techniques plus the latest research proceedings in this area. The student will become familiar with the use of the library, internet, and other resources for keeping informed with rapidly changing preventive dentistry techniques.

The provision of dental health education to patients and groups is the ethical responsibility and a large part of the total role of the dental hygienist. In order to be an effective educator, the dental hygienist must become knowledgeable in the psychology of human behavior as it relates to the priorities of all age groups. This course will provide the basic principles of motivation, teaching and learning as they relate to the many factors in dealing with patients in clinical and community settings.

Emphasis will be placed on developing appropriate preventive oral health educational plans to effectively encourage individuals to practice preventive dentistry.

COURSE GOALS1.0 Describe the philosophy and discipline of preventive dentistry and relate its role in the

practice of clinical dental hygiene and community health activities.

2.0 Describe the structure and function of dental plaque and its relationship to oral diseases.

3.0 Describe the process of plaque related periodontal diseases.

4.0 Describe and evaluate proper oral hygiene disease control measures.

5.0 Describe the efficiency and effectiveness of chemical oral disease control measures in the prevention of oral diseases.

6.0 Describe the relationship of tobacco to oral diseases and the methods for implementing tobacco cessation programs.

7.0 Describe the relationship of nutrition and dietary control in the prevention and treatment of oral diseases.

8.0 Conduct a nutritional counseling program.

9.0 Use the library to obtain a literature review and create a report on an assigned subject area of preventive dentistry.

10.0 Demonstrate background knowledge and skills necessary for further study into the role of dental plaque and the disease process and the state of the art control measures.

11.0 Apply the principles of behavior change to the instruction of preventive dentistry.


292

12.0 Apply the principles of teaching and learning in the provision of oral health education to individual clinic patients and groups.

INSTRUCTIONAL COURSE OBJECTIVES WILL BE POSTED ON BLACKBOARD AT THE TIME THE MATERIAL IS PRESENTED.

COURSE REQUIREMENTS, EVALUATION METHODS, AND GRADING CRITERIA.

1. Each student is responsible for reading the assigned materials prior to lecture and mastering the objectives provided in the syllabus and textbooks. Discussions and examinations will cover all assigned materials and lectures.

2. LATE ASSIGNMENTS will result in a 20% grade penalty reduction for each day late.

3. Assignments returned for substandard work will result in 15% grade penalty reduction. Assignment must be redone are returned to the instructor with 48 hours.

3. ATTENDANCE at all lectures and laboratory sessions are MANDATORY. Please refer to the College of Dentistry Attendance Policy. THERE ARE NO EXCUSED ABSENCES.

4. MAKE-UP EXAMINATIONS must be taken within one week of the missed exam. All make-up examinations will be objective format (essay and short answer).

5. CELL PHONES and PAGERS must be turned off or not brought to class. A class disruption by cell phone/pager will result in a tardy penalty assessed or a quiz administered to the entire class. The penalty assessed will be the decision of the course director.

6. The final grade for this course will be derived from scores achieved in performance during the following:

Examination 1 20% Examination 2 20% Research Paper 20% Assignments 10% Nutritional Counseling, Tobacco Cessation, Adult in Learning Quizzes 5% Final Examination (comprehensive) 25%

Final grades will be awarded as follows:

100-90 A 89-80 B 79-70 C 69-60 D 59-0 F


293

A - for outstanding work demonstrating exceptional mastery of course material (EXCELLENCE)B - for good work clearly beyond simple mastery of material (SUPERIOR)C - for acceptable work indicating a mastery of the basic concepts of the course (COMPETENCE)D- is failure insofar as credit toward a degree is concerned. A “D” grade must be remediated to a “C”. The terms of the remediation will be determined by the course director. If the terms are not remediated by the due date, the “D” grade becomes an “F” and the course must be repeated. (POOR)F - a failing grade for work failing to meet course requirements (FAILURE)I - to be given for an administratively excused absence for extenuating circumstances only (INCOMPLETE)


294


295

THE UNIVERSITY OF OKLAHOMA COLLEGE OF DENTISTRY


COURSE TITLE: Clinical Rotations I

COURSE NO: Dental Hygiene 4331

SEMESTER: Fall 2006 DESCRIPTION: Practical experiences in various clinical aspects of general

and specialty dentistry. Includes assisting and observing dental students, residents, and faculty providing dental care to patients. Students will provide dental hygiene services to patients in selected settings to observe the integration of clinical dental hygiene within the field of dentistry.

PREREQUISITES: DH 3314 and DH 3324Students will be responsible for all subject matter covered in prerequisite courses in all rotation sessions. Thorough and continuous review of material is strongly suggested. A current CPR card with a copy filed in the Department of Dental Hygiene office is mandatory for attendance in rotations.

COURSE DIRECTOR: Jane Gray, R.D.H., CDA, M.Ed.Office hours by appointment only: 271-4435 (Kristy)Office voice-mail: 271-4445E-mail: [email protected] phone: (405) 348-7582 Cell phone: (405) 830-4880

COURSE OBJECTIVES:At the conclusion of the course the student will be able to: 1. utilize knowledge and aspects of four-handed dentistry in assisting dental students, residents,

and faculty.2. perform specialized care for pediatric patients including exposure of radiographs and

appropriate home care.3. perform specialized care for medically compromised patients4. utilize knowledge gained in radiography as it relates to radiographic technique.5. provide dental hygiene care to periodontally involved patients.6. assist in screening and classification of College of Dentistry patients.


296


COURSE EVALUATIONThe grade for this course will be S (satisfactory) or U (unsatisfactory). Satisfactory completion of this course requires the following:

1. Attend all assigned rotations for the entire procedure/clinic. Assigned rotations are listed in the clinic rotation schedule. Students who do not have patients scheduled for dental hygiene clinic sessions may request assignment to additional rotation. Students are to contact Ms. Gray to determine if reassignment to a rotation is feasible for that day.

2. Observe and assist clinical procedures as listed in Dental Hygiene Manual.

3. Complete a Rotation Report Form for each rotation site following the protocol as stated in this course syllabus.

4. Scheduled rotations for the fall semester will be assigned at each site.

ROTATION REPORT FORM PROTOCOL• Each student attending a rotation is required to complete a Rotation Report Form or

Clinical Evaluation Form. These forms are available in most dispensing areas of the clinics. Any adjunct service or rotation requirement completed on a rotation site should be recorded on the Rotation Report Form and signed by supervising dental/dental hygiene faculty. The Rotation Report Forms and Local Anesthesia Report Forms must be completed and turned in no later than the last day of class to ensure credit.


297



COURSE TITLE: Dental Hygiene Process of Care

COURSE NO. DH 4332

SEMESTER: Fall 2006

DESCRIPTION: This course is designed to begin preparing the learner for the transition to practitioner. Includes theory and practice of advanced instrumentation techniques and care of patients with complex medical needs.

PREREQUISITE: DH 3422Students will be responsible for all subject matter covered in prerequisite courses and clinical lab sessions. Thorough and continuous review of material is strongly suggested.

COURSE DIRECTOR: Jane Gray, R.D.H., CDA, M.Ed.Office hours by appointment only: 271-4435 (Kristy)Office voice-mail: 271-4445E-mail: [email protected] phone: (405) 348-7582 Cell phone: (405) 830-4880

TCTC COORDINATOR Lydia Snyder, R.D.H., M.EdINSTRUCTORS Abbie Gustafsen, R.D.H.,, B.S.

Tammie Golden, R.D.H., M.S.

SOTC COORDINATOR Christy Brannock, R.D.H., B.S.INSTRUCTORS Judy West, R.D.H., M.S. Lindsey Hays, R.D.H., B.S.

WTC COORDINATOR Julie McClung, R.D.H., M.EdINSTRUCTOR Tina Tuck, R.D.H., B.S.

TEXTBOOKS/REFERENCES Dental Hygiene Theory and Practice.Darby and Walsh, W.B. Saunders Co.,2nd Edition, 2003.

OU College of Dentistry Clinic Manual OU College of Dentistry Health and Safety Manual www.dentistry.ouhsc.edu

Dental Hygiene Manual OU College of Dentistry Student Handbookwww.blackboard.ou.edu

OU College of Dentistry Bulletin


298


REFERENCE WEBSITES:OUHSC Library (Bird) www.ouhsc.eduCenter for Disease Control www.cdc.gov.Proctor and Gamble www.dentalcare.comADHA www.adha.orgADA www.ada.orgNational Institute of Health www.nih.govFederal Statistics www.fedstats.gov/National Guideline Clearinghouse www.guideline.govOUHSC Blackboard http://ouhsc.blackboard.com

Course ObjectivesAt the conclusion of the course the student will be able to:

1. Discuss hygiene processes necessary for the maintenance of implants.2. Discuss and demonstrate correct exploring technique on periodontal patients.3. List and describe the types of ultrasonic inserts.4. Compare and contrast sonic, ultrasonic, and piezoelectric scalers.6. Describe and demonstrate operation of the air polisher.7. Describe and demonstrate use and maintenance of the air polisher.8. Describe and demonstrate the fabrication of bleaching trays.9. Describe and demonstrate the application of an in-office bleaching system.10. State the objectives of a dental hygiene treatment plan.11. Outline and describe the parts of a total treatment plan and steps necessary for planning periodontal

therapy.12. Prepare a dental hygiene treatment plan for any level of patient care.13. Discuss advanced instrumentation as it relates to root morphology.14. Describe and discuss non-surgical periodontal therapy, including the expected results of scaling and

root planing and patient post treatment instruction.15. Describe the steps necessary for tissue maintenance during long term therapy.16. Describe design features and appropriate uses of alternate instruments.17. Discuss and demonstrate the procedure for subgingival irrigation.18. List and describe alternativee fulcrums.19. Discuss antimicrobial therapeutic agents and delivery systems.20. Discuss the need for and list the steps necessary for prevention of medical emergencies in the dental

office21. Describe the emergency treatment of the following conditions:

hyperventilation asthmatic attack obstructed airway myocardial infarction hypoglycemia chest pain overdose of local anesthetic seizure allergic reactionanaphylaxis syncope

22. Demonstrate local anesthesia techniques.23. Identify intraoral & extraoral lesions using differential diagnosis.24. Incorporate principles of DH 4336 into a case-based module relating to the following:


299

http://www.nih.gov/

http://www.ada.org/



http://WWW.cdc.gov/


pregnant patient/infant and toddler patient with cancer patient with physical impairment patient with disabilities/homebound patient with sensory disability patient with mental disorder patient with alcohol & substance abuse problems patient with cardiovascular disease patient with blood/bleeding disorder patient with diabetes mellitus patient with cystic fibrosis patient with seizure disorder patient with mental retardation women’s health patient living in poverty patient using tobacco products patients with autoimmune disorders

Clinical Dental Hygiene LectureDH 4332

Fall Schedule 2006

DATE TIME DAY TOPIC ASSIGNMENTAUG 21 9-10 am M Implant Maintenance

(Ms. Miller)

Darby Chapter 50Pg 1008-1038

Powerpoint slidesAUG 23 9-11 am W Syllabus Review -CCM

Exploring (Advanced Tech)

Advanced Instrumentation Horizontal Strokes

Alternative FulcrumsExtended Instruments

(Ms. Gray)

Bring Kit C &

typodont to class

Darby Chapter 20, 21AUG 28 9-10 am M Air Polishing

(Ms. Gray)

Darby: Chapter 22 pg 447-456

AUG 30 9-11 am W Tobacco Cessation(Ms. Tuck)

Handout

SEPT 4 M Labor Day – NO CLASS

SEPT 6 9-11 am W Non-surgical Periodontal Therapy Antimicrobial Delivery Methods

Periodontal ChemotherapySubgingival Irrigation

Post Scaling/Root Planing Inst

(Ms. Gray)

Darby Chapter 23

pg 457-473

Darby Chapter 24pg 493-511

SEPT 11 9-10 am M CDI – CTx Planning Competency

(15%)(D&E tx plan, perio comp practice

CCM)


300

SEPT 11 1-4 pm M Implant Lab Rm 433 OKC

Distant Sites TBA

(Dr. Mitchell)

Bring safety glasses

Get 6 curing lights from Green Clinic

SEPT 13

9-12 am W Bleaching Tray Fabrication Room 433 OKC

(Mms. Brogan)

Bring safety glasses and your study models from

Applied Dental Materials

SEPT 18 10-11 am

1-4 pm

M

M

Lecture – BOOST

(Mms. Brogan) Green Clinic (OKC) for BOOST on

student partners in pmDistant Sites TBA

Wear scrubsAssigned Partners

SEPT 20 9-11 am W Mental retardationMental disorders

(Ms. Gray)

Darby pp 224-225Darby Chapter 39

pg 816-833Darby: pp 489-49

SEPT 25

9-10 M Panoramic ID Exercise

(15%)

Review radiography textbook

SEPT 27 9-11 am W Eating Disorders

(Ms. Gray)


OCT 2 9-10 am M Radiographic Landmarks Exercise (15%)

Review radiography textbook

OCT 4 9-11 am W Local Anesthesia Techniques (Ms. Gray)

MalamedChapter 5-9,

11-14Darby Chapter 43

Pg 694-744OCT 9 8-10 am

1-4 pm

M Local Anesthesia Techniques(Ms. Gray)

Local Anesthesia Lab in Clinic

MalamedChapter 5-9,

11-14 Assigned partners

OCT 11 9-11 am W “A Framework for Understanding Poverty”

Guest SpeakerBecky Boyd

Handout

OCT 16 9-10 am M MID TERM EXAMCase Study

(15%)

OCT 18 9-11 am W Physical disabilities: ambulatoryPhysical disabilities: homebound or

bedridden

Neurologic & Sensory disabilities

(Ms. Gray)


Darby Chapter 38

pg 794-815

Lab Experience


301

OCT 23 9-10 am M Autoimmune diseases

(Ms. Gray)


OCT 25 9-11 am W Autoimmune con’tHIV Infection

(Ms. Gray)


OCT 30 9-10 am M Diabetes Mellitus & Other Endocrine Disorders.

(Ms. Gray)

Darby Chapter 41 Pg 855-869

NOV 1 9-11 am W Diabetes Mellitus con’t

(Ms. Gray)


NOV 6 9-10 am M Respiratory diseasesCystic Fibrosis

(Ms. Gray)

Darby: Chapter 42Pg 870-877

NOV 8 9-11 am W Persons with Cancer

(Ms. Gray)


NOV 13 9-11 am M Blood & bleeding disorders

(Ms. Gray)

Powerpoint slides

NOV 15 9-11 am W Case Studies

Review

(Ms. Gray)NOV 20 9-10 am M Alcohol & substance abuse

Seizure disorders

(Ms. Gray)


NOV 22 off W HAPPY THANKSGIVING!

NOV 27 9-10 am M Cardiovascular diseases

(Ms. Gray)


NOV 29 9-11 am W Cardiovascular diseases

(Ms. Gray)DEC 4 9-10 am M Women’s Health

Pregnant Patient(Ms. Gray)

Darby Chapter 46 pg 932-944

DEC 6 9-11 am W Caries ID exerciseCase Study Reviews

(Ms. Gray)

Bring to Radiography textbook

DEC 11 9-10 M REVIEW for Final Exam

DEC 13 10-11 am W FINAL EXAMCase Studies

(40%)


302

ATTENDANCEAbsence will affect the final course grade as stated in the Dental Hygiene Attendance Policy. Students will be counted as tardy if arriving between 9:01 and 9:10. An absence will be recorded after 9:10.

PROFESSIONALISM1. Following directions2. Maintaining positive attitude & behavior, i.e., courtesy toward pts, peers, faculty, staff & visitors3. Maintaining personal appearance at all times, following guidelines found in COD publications4. Continuing to uphold the ethics & standards of the professional dental hygienist and of the University of Oklahoma and

the College of Dentistry5. A student will be asked to leave the classroom if his/her conduct or appearance does not meet professional

standards and will be counted as being absent for the time missed6. Students must demonstrate continuing professional growth and maturity. Unsatisfactory performance may adversely

affect the final grade in the course or progression to the next clinical theory course.

PROFESSIONAL GROWTH AND MATURITYThe final grade in this course as well as promotion to the next dental hygiene theory course will also be contingent upon evaluation of professional growth and maturity as determined by clinical faculty and the clinical coordinator. Unsatisfactory performance may adversely affect the final grade in the course or progression to the next clinical theory course dependent upon the seriousness of the deficit.

ACADEMIC MISCONDUCT ACADEMIC MISCONDUCT will result in AUTOMATIC FAILURE of the course.

Academic Misconduct includes any act which improperly affects the evaluation of a student's academic performance or achievement, including but not limited to the following:1. Cheating: the use of unauthorized materials, methods, or information

in any academic exercise, including improper collaboration;2. Plagiarism: the representation of the words or ideas of another as

one's own, including:

a. direct quotation without both attribution and indication that the material is being directly quoted; e.g., quotation marks;

b. paraphrase without attribution; c. paraphrase with or without attribution where wording of

the original remains substantially intact and is represented as

the author's own; d. expression in one's own words, but without

attribution, of ideas, arguments, lines of reasoning, facts, processes, or other products of the intellect where such material is learned from the work of another and is not part of the general fund of common academic knowledge;

3. Fabrication: the falsification or invention of any information or citation in an academic exercise;

4. Fraud: the falsification, forgery, or misrepresentation of academic work, including the resubmission of work performed for one class for credit in another class without the informed permission of the second instructor; or the falsification, forgery, or misrepresentation of other


303

academic documents; or the communication of false or misleading statements to obtain academic advantage or to avoid academic penalty;

COURSE REQUIREMENTS:In order to receive a passing grade and be promoted to Clinical Dental Hygiene IV, the student must meet the following course requirements.

1. Complete all reading and other assignments prior to the lecture. Students are responsible for topics covered in required texts. Course material is available on Blackboard. Students requiring a handout for class may download and print PowerPoint presentations from the Blackboard site.

2. Mandatory attendance - class begins promptly at 9:00am3. Students are responsible for checking e-mail on a daily basis.4. Maintain familiarity with information located in College of Dentistry Health and Safety Manual, College of Dentistry

Student Handbook, College of Dentistry Bulletin and Dental Hygiene Manual

DETERMINATION OF COURSE GRADE:Note: Before a final grade is determined, all coursee requirements must be satisfactorily completed.requirements must be satisfactorily completed.

CDI C Tx Plannning Competency 15%Mid Term Exam - Case Study 15% Radiographic Landmark Exercise 15%Panoramic Radiographic ID exercise 15%Case Studies Final Examination 40%

The score received on the final examination will take the place of any missed examination scores. For example, if the mid-term examination is missed, the score received on the final will account for 75% of the course grade. If the final examination is missed, the student will be required to complete a comprehensive short answer and/or essay examination.

. Only questions regarding editing issues will be answered during an exam. Students will receive their examination scores as well as feedback immediately following submission of their exam. There will be no class review of examinations. Students may make an appointment with Ms. Gray to discuss individual questions.

Grading ScaleA = 90 - 100B = 80 - 89C = 70 - 79D = 60 - 69F = < 60


A score of 69 or below is considered failing. No “D” will be given. In the event of a score of 69 or below, student will be required to remediate to a minimum of “C” to receive credit. The terms of remediation and the due date will be determined by the course director. If the terms are not remediated by the due

304



COURSE TITLE: Clinical Dental Hygiene III

COURSE NO. DH 4336

SEMESTER: Fall 2006

DESCRIPTION: Continuation of supervised clinical practice with emphasis on meeting the needs of patients with special needs and/or complex medical problems. Self-assessment is an integral part of the learning experience.

PREREQUISITE: DH 3423Students will be responsible for all subject matter covered in prerequisite courses and clinical lab sessions. Thorough and continuous review of material is strongly suggested. A current CPR card, (Level C) with a copy filed in the Department of Dental Hygiene office is mandatory for attendance in clinic.

COURSE DIRECTOR: Jane Gray, R.D.H., CDA, M.EdOffice hours by appointment only: 271-4435 (Kristy)Office voice-mail: 271-4445E-mail: [email protected] phone: (405) 348-7582 Mobile (405) 830-4880

OKC CLINICAL INSTRUCTORS Jane Bowers, R.D.H., Ph.D Donna Brogan, R.D.H., B.S.Vicki Coury, R.D.H., M.Ed, MPH Laurie Cunningham, R.D.H., CDA, M.EdSheri French, R.D.H., B.S. Kim Graziano, R.D.H., A.A.S. Kathy Miller, R.D.H., B.S. Kathy Rogers, R.D.H., A.A.S. Stephanie Schmidt, R.D.H., B.S. Carol Zerby, R.D.H., B.S. TCTC COORDINATOR Lydia Synder, R.D.H., M.S INSTRUCTORS Tammie Golden, R.D.H., M.H.S. Abbie Gustafson, R.D.H., B.S.

SOTC COORDINATOR Christy Brannock, R.D.H., B.S.INSTRUCTORS Judy West, R.D.H., M.S. Lindsey Hays, R.D.H., B.S.

WTC COORDINATOR Julie McClung, R.D.H., M.EdINSTRUCTOR Tina Tuck, R.D.H., B.S.

TEXTBOOKS/REFERENCES: Dental Hygiene Theory and Practice. Darby and Walsh, W.B. Saunders Co., 2nd Edition, 2003. OU College of Dentistry Clinic Manual OU College of Dentistry Health and Safety Manual www.dentistry.ouhsc.edu

Dental Hygiene Manual OU College of Dentistry Student Handbook www.blackboard.ou.eduOU College of Dentistry Bulletin


305


REFERENCE WEBSITES:OUHSC Library (Bird) www.ouhsc.eduCenter for Disease Control www.cdc.govProctor and Gamble www.dentalcare.comADHA www.adha.orgADA www.ada.orgNational Institute of Health www.nih.govFederal Statistics www.fedstats.gov/National Guideline Clearinghouse www.guideline.govOUHSC Blackboard http://ouhsc.blackboard.com SUPPLIES: Red/Blue Pencil (3) X-er tube #2 Pencils RDH Handpiece Blue/Black Ink Pen Prophylaxis Instrument Kits

Course ObjectivesAt the conclusion of the course the student will be able to:

1. demonstrate hygiene processes necessary for the maintenance of implants2. demonstrate the appropriate use of mechanical scalers 3. demonstrate advanced instrumentation as it relates to root morphology 4. demonstrate alternative instrumentation techniques5. incorporate didactic principles of DH 4332 into clinical care of patients

MINIMUM COURSE REQUIREMENTS

PROCEDURE MINIMUM NUMBER & CRITERIA DATE

1. Air Polishing - 1 patient- light to mod. Stain (fall & spring)

2. Bleaching (Boost) - 1 patient, includes bleaching tray (fall or spring)

3. Calculus Charting - 1 CDI C or D pt (fall & spring) - minimum of 10 clicks in one quad

- chart entire quad- 80% accuracy; remediation required

4. CDI Class A-B -12; must be signed off by faculty

5. CDI Class C - 7 patients; must be signed off by faculty

6. CDI Class D - 8 quads; must include re-evaluation, signed

7. CDI Class E - as assigned (1 quad = 2 quads of ‘D’)

8. Chemotherapeutics (Arestin) - 1 appropriate patient (fall & spring) (Perio Chip etc)

9. Desensitization (Super Seal) - 1 appropriate patient (fall & spring)

10. Impressions/Study Models - 1 patient for bleaching tray(fall or spring)

11. Sealants - 12 teeth; may be completed over fall & spring semesters 1st & 2nd yr


306

http://www.guideline.gov/

http://www.fedstats.gov/

http://www.nih.gov/

http://www.ada.org/



http://WWW.cdc.gov/


12. Temporary Restoration -PRN experiential only

13. Ultrasonic Scaler -PRN appropriate patient

14. Local anesthesia -10 mandibular blocks and 10 infiltrations required by BOD for licensure (fall & spring)

15. Additional patients -Minimum 12

Other additional procedures PRN:Temporary restorationVitality testingRe-marginationAmalgam polishingAdditional patients-all patients appointed, regardless of rating shall be seen as assigned. If a patient is not seen as scheduled without CI approval, the student will be assessed a penalty of one letter grade.

*total number of patients may be amended by Clinical Coordinator according to patient pool*

ALL ROTATIONS MUST BE COMPLETED AS ASSIGNED

CLINICAL COMPETENCIES

PROCEDURES CRITERIA

1. INSTRUMENT SHARPENING -3 instruments: H6H7, Gracey 13/14, Universal curette 75% accuracy

2. CDI C -8 quads of CDI C prior to comp - minimum of 9 points from Group 4 - minimum 18 clicks in 1 or 2 quads - maximum 25 clicks in 1 or 2 quads- 75% accuracy

3. PERIODONTAL CHARTING -to be accomplished on CDI C or D patient-approved by CI (1 quadrant) -minimum 80% accuracy

4. ULTRASONIC SCALER -appropriate clinic patient - 1 quadrant -80% accuracy

OTHER CLINICAL EXERCISE S


307

1. CALCULUS CHARTING - 1 CDI C or D pt - minimum of 10 clicks in one quad

- chart entire quad - 80% accuracy; remediation required

ATTENDANCEAbsences will affect the final course grade as stated in the Dental Hygiene Attendance Policy. Students will be counted absent if more than 10 minutes late for class.

PROFESSIONALISM

1. Following directions.2. Maintaining positive attitude & behavior, i.e., courtesy toward pts, peers, faculty, staff & visitors.3. Maintaining personal appearance at all times, following guidelines found in COD publications.4. Avoiding loud and/or inappropriate interaction at any time that pts are in the clinic.5. Continuing to uphold the ethics & standards of the professional dental hygienist and of the University of

Oklahoma University and the College of Dentistry.6. A student will be asked to leave the clinic if his/her conduct or appearance does not meet professional

standards and will be counted as being absent for the time missed.7. Students must demonstrate continuing clinical growth and maturity. Unsatisfactory performance may adversely

affect the final grade in the course or progression to the next clinical course.

Clinical and Professional Growth and MaturityThe final grade in this course as well as promotion to the next clinical course will also be contingent upon evaluation of clinical and professional growth and maturity as determined by clinical faculty and the clinical coordinator. Unsatisfactory performance may adversely affect the final grade in the course or progression to the next clinical course dependent upon the seriousness of the deficit.

COURSE REQUIREMENTS

1. Clinic is to begin promptly at 9:00 and 1:00. Arrival is strongly suggested at 8:30 & 12:30 in order for sufficient time for unit set-up and instrument sharpening. ATTENDANCE IN ALL CLINIC AND ROTATION SESSIONS IS MANDATORY. Failure to attend a clinic or rotation session without notifying Ms. Gray or the contact person for the rotation, will result in a decrease of one letter grade. Additionally, Clinic Operations will suspend the student from clinic for 3 weeks. Off-site students must notify their site coordinators, appropriate contacts and patients. If a student fails to attend clinic without proper notification more than once, the student will receive a failing grade in the course. When not treating a patient, students are expected to assist other dental hygiene students unless permission to leave is granted by the CDH Clinical Coordinator. If a student leaves without permission s/he will be counted as absent.

2. Students are responsible for checking e-mail on a daily basis.3. Maintain familiarity with information located in College of Dentistry Health and Safety Manual, College of

Dentistry Student Handbook, College of Dentistry Bulletin and Dental Hygiene Clinic Manual

4. clinical performance will be given to the student but no daily grades will be given. The previous evaluation sheet on the same patient is to be brought to the clinical instructor at the beginning of each clinic session.

5. Evaluation forms for completed patients are to be given to the CI at the completion of the appointment. Three NDs in a specific category will necessitate consultation and/or remediation with the clinical coordinator. 4 NDs in the same category will result in a grade reduction of 2 (TWO) points on the final course grade. Students are required to keep copies of their evaluation forms in order to maintain an ND record

6. Achieve a minimum score of 75% on all clinical competency exams. A score lower than 75% will require remediation with faculty and a retake exam with a resulting score of 75% or greater. Remediation will be


308

determined by the clinical coordinator and prescriptive feedback given to the student. Failure to achieve a 75% after remediation and 2 attempts at retake exam will prohibit promotion and graduation.

DETERMINATION OF COURSE GRADENote: Before a final grade is determined, all graded and non-graded clinical course requirements and rotations must

be satisfactorily completed.

COMPETENCIES Instrument Sharpening 15% CDI C Competency 40 % Periodontal Probing Competency 15% Ultrasonic Competency 15%

CLINICAL EXERCISE Calculus Charting 15% Competency grades will be awarded as follows:

• If the earned grade is a score of 75% or higher, that grade will be awarded.

• If the earned grade is a score lower than 75%, the student must be re-mediated and is allowed 2 more attempts to obtain competency. The student will have a grade of 0% until competency is attained, at that time the student will be awarded the grade attained on the initial exam. Remediation will be determined by the course director and is dependent upon the type of competency and area of need.

1. More than 3 NDs in the same category (on the 4th one) will result in a deduction of 2 (TWO) points from the final

course grade and mandatory remediation to be determined by the course director

2. More than 6 clinics without a patient will be reviewed by faculty and may result in a deduction of 2 (TWO) points from the final grade. Each subsequent clinic without a patient may result in a 1 point per clinic deduction from the final grade.

3. Faculty evaluations post competency exams are to help you monitor your progress

Grading ScaleA = 90 - 100B = 80 - 89C = 70 – 79D= 60-69F = < 60


A score of 69 or below is considered failing. No “D” will be given. In the event of a score of 69 or below, student will be required to remediate to a minimum of “C” to receive credit. The terms of remediation and the due date will be determined by the course director. If the terms are not remediated by the due date, the “D” grade becomes

309

UNIVERSITY OF OKLAHOMA COLLEGE OF DENTISTRYDEPARTMENT OF DENTAL HYGIENE

DH 4552 COMMUNITY HEALTH ISSUES

FALL 2006

COURSE DESCRIPTION

The principles of community dental health including the social, cultural, political, psychological and economic factors that influence the demand for and utilization of health services within the health care system. Includes the epidemiological patterns of oral diseases and community dental health program planning.

COURSE DIRECTORS

Vicki Coury, RDH, MEd, MPH Laurie Cunningham, RDH, MEd

OFFICE HOURS

Scheduled by appointment . Voice mail: Vicki Coury: (405) 271-3869 Laurie Cunningham: (405) 271-4423

E-mail: E-mails will be answered Monday-Friday by the end of the school day in which they were sent. [email protected] [email protected]

CONTACT TIME Two hours credit Friday 10:00 – 11:50 a.m.

32 hours lecture and participation, including examinations Community health activities/assignments are conducted at times other than lecture hours.

WRITING CENTER

OUHSC Office of Student Services Student Center, Room 300 Hours: T & F, 10-2 Phone (405) 271-2416 Email: [email protected]

REQUIRED TEXTBOOKSGagliardi, Lori, Dental Health Education Lesson Planning and Implementation, Appleton and Lange, 1999.Mason, Jill, Concepts in Dental Public Health, Lippincott, Williams & Wilkins, 2005.

Harris, Norman O., and Garcia-Godoy, Franklin, Primary Preventive Dentistry, 6th ed. Appleton and Lange, 2004.

ON-LINE READING MATERIALS:

Healthy People 2010


310




http://www.healthypeople.gov/

A National Call to Action to Promote Oral Health http://www.nidr.nih.gov/sgr/nationalcalltoaction.htm

Surgeon General’s Report on Oral Health http://www.nidr.nih.gov/sgr/sgrohweb/welcome.htm

Oral Health America National Grading Project http://www.oralhealthamerica.org/ Download Report Card

ADHA Handbook for Dental Public Health Activities http://www.adha.org/publichealth

WEB ACCESS FOR COURSE MATERIALS AND INFORMATION:

http://ouhsc.blackboard.com

Note: Must have PowerPoint, Microsoft Office or PowerPoint Viewer

COURSE RATIONALE

Community Health Issues provides the knowledge and skills necessary for evidence-based oral health promotion and disease prevention in diverse populations and organizations within the community setting. The development of appropriate preventive oral health educational programs, including assessment, program planning, implementation and evaluation is emphasized.

This course presents a broad overview of the dental health care system including delivery systems, financing, demand, supply, utilization patterns, and the assessment and epidemiology of oral diseases. The effectiveness and efficiency of preventive measures used in community-based preventive programs is stressed along with current health care problems and trends that may influence future delivery systems.

COURSE GOALS 1. Discuss the history and scope of community health dentistry.

2. Describe concepts of community dental health education and oral health promotion.

3. Assess, plan, implement, and evaluate community dental health education and health promotion programs for classroom and community settings.

4. Describe epidemiological trends of oral diseases.

5. Describe characteristics and factors influencing current dental care delivery systems.

6. Discuss major public health issues related to the financing of dental care.

7. Discuss utilization and trends related to dental care.

8. Compare the effectiveness and efficiency of community-based oral health measures or programs./tt/file_convert/54544cf0af79592e458b68bc/document.doc

311

http://www.adha.org/publichealth

http://www.oralhealthamerica.org/

http://www.nidr.nih.gov/sgr/sgrohweb/welcome.htm

http://www.nidr.nih.gov/sgr/nationalcalltoaction.htm

http://www.healthypeople.gov/

9. Describe public dental health programs at the community, state, federal and international level and the role of government and politics at the various levels.

10. Influence groups, businesses and government agencies to support health care issues.

COURSE OBJECTIVES

Instructional course objectives will be presented at the time the lecture material is presented.


312

COURSE REQUIREMENTS, EVALUATION METHODS AND GRADING CRITERIA

1. STUDENT RESPONSIBILITY. Each student is responsible for reading the assigned materials prior to lecture and mastering the objectives provided in the syllabus and handouts. Discussions and examinations will cover all assigned reading materials and lectures.

2. LATE ASSIGNMENTS will result in a 10% grade penalty reduction for each day late. 3. ATTENDANCE at all lectures and laboratory sessions is MANDATORY

4. EXAMINATION POLICY.

There will be no electronic devices allowed during examinations. All books and materials will be placed in the front of the classroom during the exam.

MAKE-UP EXAMINATIONS must be taken within one week of the missed examination, and will be subjective format (essay and short answer). Examinations will be reviewed during class time, but individual questions over any exam items must be addressed in a meeting or email with the

course director. 5. CELL PHONES and PAGERS must be inactivated during class hours.

6. The final grade for this course will be derived from scores achieved in performance during: (1) midterm examination (2) final examination, and the (3) community health project.

7. Unannounced quizzes may be given by the course director at any time to assess learning.8. ACADEMIC MISCONDUCT will result in AUTOMATIC FAILURE of the course.

Academic Misconduct includes any act which improperly affects the evaluation of a student's academic performance or achievement, including but not limited to the following:a. Cheating: the use of unauthorized materials, methods, or information in any

academic exercise, including improper collaboration;b. Plagiarism: the representation of the words or ideas of another as one's own,

including: 1. direct quotation without both attribution and indication that the material is

being directly quoted; e.g., quotation marks; 2. paraphrase without attribution;

3. paraphrase with or without attribution where wording of the original remains substantially intact and is represented as the author's own;

4. expression in one's own words, but without attribution, of ideas, arguments, lines of reasoning, facts, processes, or other products of the intellect where such material is learned from the work of another and is not part of the general fund of common academic knowledge;

c. Fabrication: the falsification or invention of any information or citation in an academic exercise;

d. Fraud: the falsification, forgery, or misrepresentation of academic work, including the resubmission of work performed for one class for credit in another class without the informed permission of the second instructor; or the falsification, forgery, or misrepresentation of other academic documents; or the communication of false or misleading statements to obtain academic advantage or to avoid academic penalty.

Each of the evaluations will be worth 100 points and computed as follows: Midterm Examination 30% Final Examination 35% Community Project 35%

Final grades will be awarded as follows:/tt/file_convert/54544cf0af79592e458b68bc/document.doc

313

100-90 A 89-80 B 79-70 C 69-60 D 59-0 F

A - for outstanding work which demonstrates exceptional mastery of course material. (EXCELLENCE)

B - for good work which is clearly beyond simple mastery of course material (SUPERIOR).C - for acceptable work indicating a mastery of the basic concept of a course (COMPETENCE).

D - is failure insofar as credit toward a degree is concerned. A “D” grade must be remediated to a “C”. The terms of the remediation will be determined by the course director. If the terms are not remediated by the due date, the “D” grade becomes an “F” and the course must be repeated. (POOR)

F - a failing grade for work that fails to meet course requirements. It is a permanent grade which remains on the transcript and must be made up. (FAILURE).

I - May be given only for an administratively excused absence for extenuating circumstances: personal illness, family tragedy, etc. (INCOMPLETE).

EXTRA CREDIT:

You may receive a maximum of 10 extra credit points of your final course grade.

Extra credit points are awarded on a per person basis only. Exceptions for extenuating circumstances must be approved in advance by Mrs. Coury or your site designated community health coordinator.

Extra credit points:1) 5 points: Promotion of dental hygiene and/or oral health in the public media during the semester; i.e. television, newspaper article, radio, or magazine article read by the general public. Promotions must be approved by the course director prior to implementation.2) 2 points: Picture with heading in media such as newspaper or weekly magazine. 3) 2 points: Each additional approved community health project over the required 3 projects. You receive the extra credit in the semester in which the projects are presented. 4) Extra credit will not be given in this course for school sponsored events or events that earn extra credit in other courses.

COMMUNITY HEALTH PROJECT REQUIREMENTS: YEAR 2006-2007Fall Semester 2006:

8 Design a major community health project for an approved group. You may work in pairs or individually.

Spring Semester 2006:

1. Present and evaluate the designed community health project 2. Required community health projects in addition to the major community health project.

Special needs population Underserved school population Elderly population “Other” population of your choice

Additional Information:/tt/file_convert/54544cf0af79592e458b68bc/document.doc

314

9 You must have prior approval from Mrs. Coury or Mrs. Cunningham in OKC or your designated site community health coordinator for your projects and presentations.

10 Although you may carry out your projects any time during your senior year, you will be assigned time to carry out projects only during Spring Semester.

11 Projects may be conducted singly or in pairs. Special permission may be granted for more students to participate in projects involving larger groups.


315

TENTATIVE COURSE OUTLINE

DATE TOPIC ASSIGNMENT

August 25 Introduction and Orientation (1)(Coury) History , Scope, Issues of Public Health Dentistry (1) Mason: Chapt 1 & 2 September 1 Effective State and Community-based Dental Programs (1) Mason: Chapt 5, 6, 7 (Coury) Planning/Evaluating Community Dental Health Programs (1) H/G: Chapt 17

September 8 Oral Health Promotion (2) Mason: Chapt 8(Coury) September 15 Oral Health Education in the Community (2) Mason: Chapt 9 (Cunningham) Mason: Chapt 8

September 22 Planning School Oral Health Education Programs (2) Gagliardi(Cunningham) September 29 Developing Educational Materials (2) Gagliardi(Cunningham) H/G: Chapt 19 Mason: Chapt 6-7

October 6 Fall Break

October 13 Midterm Exam

October 20 Dr. Mike Morgan, Dental Director, State Health Department

October 27 Federal and International Dental Programs Mason: Chapt 3, (Cunningham) pp 11-13, 345-346

November 3 Amy Holder, Indian Health Service and Public Health Service November 10 Epidemiology of Oral Diseases (2) Mason: Chapt 11-12(Cunningham) November 17 Delivery, Utilization and Trends (2) (Coury)

November 24 Thanksgiving Break

December 1 Financing Dental Care (2) Mason: pp. 24-26(Cunningham) December 8 Dr. Leon Bragg, Medicaid Projects Due Final Exam TBA Exam Week Dec (12-16)


316

SECTION XIVStudent

Organizations


317

CONSTITUTION OF THE UNIVERSITY OF OKLAHOMA STUDENT MEMBER ORGANIZATION

OF THE AMERICAN DENTAL HYGIENISTS’ ASSOCIATION

ARTICLE I – NAMEThe name of this organization shall be the University of Oklahoma Student Member Organization of the American Dental Hygienists’ Association, hereafter referred to as “the Organization” or this Organization.

ARTICLE II – OBJECTIVESThe objectives of this Organization shall be to cultivate, promote, and sustain the art and science of dental hygiene, to represent and safeguard the common interest of the members of the dental hygiene profession, and to contribute toward the improvement of the oral health of the public.

ARTICLE III – ORGANIZATIONThe membership of this Organization shall consist of an unlimited number of dental hygiene students who are attending the accredited program of dental hygiene at the University of Oklahoma College of Dentistry.

ARTICLE IV – OFFICERSThe elective officers of this Organization shall be six (6) in number per site. The 3 senior class officers shall be the President, Vice President, and the Secretary/Treasurer. The 3 junior class representatives shall be the President-Elect, Vice President-Elect, and the Secretary/Treasurer-Elect.

ARTICLE V – MEETINGSMeetings shall be held as deemed necessary by the SADHA Advisors and the Officers who shall determine the date, time, and place.

ARTICLE VI – PRINCIPLES OF ETHICSThe Principles of Ethics of the American Dental Hygienists’ Association shall govern the professional conduct of all members.

ARTICLE VII – AMENDMENTS This Constitution may be amended by a two-thirds (2/3) affirmative vote of the membership provided that the proposed amendments or revisions shall have been presented in writing to the Executive Council and advisor 30 days prior to the voting.


318

BYLAWS OF THEUNIVERSITY OF OKLAHOMA

STUDENT AMERICAN DENTAL HYGIENISTS’ ASSOCIATION

Adopted, 2001

CHAPTER I – MEMBERSHIPSection I – Classification . The membership of the University of Oklahoma Student American Dental Hygienists’ Association shall be classified as Active Membership.

Section II – Qualifications . The active members shall be dental hygiene students enrolled in University of Oklahoma, College of Dentistry, who are of good moral character, who possess a satisfactory scholastic standing, and who are Student Members of the American Dental Hygienists’ Association.

Section III – Privileges . Members shall be entitled to an annual membership card, a subscription to Journal of Dental Hygiene, the Access news magazine, admission to any scientific session of the Association at the current student rate, and such other services provided by the American Dental Hygienists’ Association or the Oklahoma Dental Hygienists’ Association for the benefit of student members.

CHAPTER II – OFFICERSSection I – Number and Title . The officers of the University of Oklahoma Student Member Organization shall be six (6) in number per site. (President, Vice President, Secretary-Treasurer, President-Elect ,Vice President-Elect, and Secretary/Treasurer-Elect.)

Section II – Qualifications . Any active junior Class student member of SADHA may be elected to serve as President-Elect, Vice President-Elect, or Secretary/Treasurer-Elect. Section III – Nominations and Elections . President-Elect, Vice President-Elect, and Secretary/Treasurer-Elect officers are elected at the beginning of their junior year by floor nominations and class vote. The candidate receiving the majority of votes cast for each office shall be declared elected.

Section IV – Tenure of Office . The President-Elect, Vice President-Elect, and Secretary/Treasurer-Elect will serve until the completion of their junior year, at which time they will automatically advance without election to the offices of President, Vice President, and Secretary/Treasure, respectfully.

Section V – Vacancies . In the event of a vacancy in one of the offices, the Executive Council and Student Advisor(s) shall consider all factors which govern the situation, and shall determine the course of action.

Section VI – Duties

A. President. The duties of the President shall be:

1. To set the date, time, and place of all meetings.2. To preside at all meetings.


319

3. To call special meetings.4. To appoint members of all committees.5. To perform such other duties as may be expected of the President or as may be provided in

these bylaws.6. To maintain communications with the Oklahoma Dental Hygienists’ Association and the

American Dental Hygienists’ Association.

B. Vice President. The duties of the Vice-President shall be:

1. To preside at all meetings in the absence of the President.2. In the event that the President’s term of office is terminated, the Vice President will preside

as President for the duration of the President’s term of office.

C. Secretary/Treasurer. The duties of the Secretary/Treasurer shall be:

1. To announce all meeting information in advance to the membership.2. To serve as secretary for all meetings, and submit minutes of each meeting to the Advisor.3. To prepare correspondence.4. To collect and preserve data relative to the history of the Organization.5. To maintain an official register of all members with current home addresses, telephone

numbers, Social Security numbers, class level (1st yr., 2nd yr., graduate, etc.).6. To submit news of the Organization to the school publications, and to the publications of

the American Dental Hygienists’ Association and Oklahoma Dental Hygienists’ Association.

7. To maintain accurate financial records of the Organization.8. To endorse each expenditure of the Organization and obtain a second signature of either

the SADHA Advisor or the Senior Staff Accountant at the University of Oklahoma College of Dentistry.

9. To submit a financial report and at the commencement and completion of their office, at each local meeting, or as requested by the Advisor or President.

D. President-Elect.

1. This officer shall advance to the office of President, without election, at the completion of the current President’s term.

18. Vice President-Elect.

1. This officer shall advance to the office of Vice President, without election, at the completion of the current Vice President’s term.

19. Secretary/Treasurer-Elect.

1. This officer shall advance to the office of Secretary/Treasurer, without election, at the completion of the current Secretary/Treasurer’s term.

CHAPTER III – MEETINGS

Section I – Regular Meetings . Meetings shall be held as deemed necessary by the SADHA Advisors and Officers.


320

Section II – Special Meetings . Special meetings may be held with one-week notice to the members.

Section III – Quorum . 1/2 of the active members of the Organization shall constitute a quorum for the transaction of business.

Section IV – Order of Business . Unless changed by a quorum affirmative vote, the order of business at each meeting shall be:

a. Call to Orderb. Advisor’s Reportc. Unfinished Businessd. New Businesse. Programsf. Adjournment

CHAPTER IV – ACTIVITIESThe Student Advisors and Officers shall determine the focus of activities. Proper protocol would then consist of presentation of ideas to the general membership for their discussion and approval through a majority vote.

CHAPTER V – COMMITTEES1. The presidents shall appoint members.2. Committees shall prepare goals.3. Meetings on a semi-regular basis are recommended.4. Committee activities should be presented to the general membership for their input,

support, and approval.

CHAPTER VI – FINANCESSection I – Membership Dues. Each member shall submit $75 dues. Forty-five dollars ($45.00) shall be forwarded to ADHA/ODHA, and $30.00 will be deposited for the expenditures of the University of Oklahoma component. Two (2) signatures will be required for payments by check from the SADHA account. The Secretary/Treasurer will provide one signature, and the other will be either the SADHA Advisor or the Senior Staff Accountant of the University of Oklahoma College of Dentistry or financial officers at each distant site. .

CHAPTER VII – PARLIAMENTARY AUTHORITY

Robert’s Rule of Order Newly Revised shall govern all meetings of this Organization in all cases to which they are applicable and in which they are not inconsistent with these bylaws.

CHAPTER VIII – AMENDMENTSThese bylaws may be amended upon two-thirds (2/3) affirmative vote of the members present and voting provided that written notice has been given to the members seven days prior to voting.


321


322

Dental Hygiene Class Officers Election and Duties

ELECTION PROCESS1. The faculty advisor will be call and preside over a class meeting for the purpose of electing

officers 2. Nominations will be accepted from the floor and voted by office. 3. Candidates each office will be provided two minutes to speak to their colleagues if desired.4. Votes will be counted by the site faculty advisor and an appointed official.

JUNIOR CLASS OFFICER JOB DESCRIPTIONS/DUTIES

PRESIDENT will: 1 AT EACH SITE• call and preside over meetings of the Site Class• assume responsibility for representing the Site Class and act as spokesperson for the Site Class when

indicated• act as liaison between Dental Hygiene Department Co-Chairs, Site Coordinators, and the Class• be responsible for informing DH Department Co-Chairs of Class activities, event, and functions• coordinate functions, schedule locations of events for the Class with the Dental Hygiene Department,

Dean's office and various COD departments as necessary• call a meeting in April of the first year to elect Senior Class Officers • serve as member of the Class Executive Council

VICE-PRESIDENT will: 1 AT EACH SITE• assume duties of the President in case of absence• assist the president in organization of class functions• carry out other duties assigned by the president• serve as member of the Class Executive Council

SECRETARY/ TREASURER will: 1 AT EACH SITE• collect and deposit individual site class funds• maintain an accounting system for individual class funds• work with COD accounting Department to monitor class funds derived from the Student Activity Fee record minutes from class meetings • disburse funds on behalf of the class• serve as member of the Class Executive Council

Class Executive Council will consist of: Site Presidents

Site Vice Presidents Site Secretary/Treasurer

Duties: 1. Plan and coordinate class activities, events, and social functions (in collaboration with DH

I and DH II Executive Councils from individual sites or jointly with all sites if indicated2. Delegate class members to arrange facility, time, invitations, food, beverages and clean up


323

DH I STUDENT COUNCIL REPRESENTATIVES (2) will: *MUST BE OKC SITE STUDENTS AS MEETINGS OCCUR ON WEDNESDAY AFTERNOONS AT 5:00PM AT COD

OKC Site President, VP will represent all sites as a voting members of Student Council

• represent the DH I Class from all sites on the Student Council (STUCO). • attend monthly STUCO meetings• volunteer as appropriate in activities organized by STUCO• keep classmates informed about the activities of STUCO and promote participation in its activities

STAPLES SOCIETY REPRESENTATIVE will: MUST BE OKC SITE STUDENT• attend and participate in Staples Society meetings• participate as appropriate in the various activities and fund raisers of the Society• keep classmates informed about activities of the Society and promote participation in Society

activities

YEAR BOOK COMMITTEE will: 2 AT EACH SITE• responsible for collecting pictures and other information about the class for publication in the

yearbook• coordinate items, photos, etc from class to be included in the COD yearbook

SADHA OFFICERS will: 3 AT EACH SITESADHA officers will be elected as DHI and will continue these elected positions through the second year the second yearPresident - elect will: will: • plan assigned SADHA meeting date and speaker in collaboration with the Site SADHA Faculty

Advisor • inform class of ADHA and ODHA meeting dates, activities, and national and state issues

Vice President-elect will: will: represent the president in her/his absence Assist the president with planning meetings and functions

Sec-Treasurer-elect will: will: record proceedings from SADHA Meetings collect and deposit SADHA funds

DH I CLASS SITE FACULTY ADVISOR will:

provide guidance and counsel to class officers approve individual site fund-raising activities

Junior Year Responsibilities

o Fundraisingo Senior Sendoff Assist Seniors with WREB backup patient pool


324

Senior Year Responsibilities New Class Welcome during orientation Fundraising Christmas Party (Optional) WREB Backup patient pool


325

DH_manual_ver74.doc

Documents

Transcript of DH_manual_ver74.doc