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LOG BOOK NEW DENTAL OFFICER PROGRAMME (NDOP) MINISTRY OF...
58
BOOK 1A LOG BOOK NEW DENTAL OFFICER PROGRAMME (NDOP) MINISTRY OF HEALTH MALAYSIA BOOK 1A LOG BOOK NEW DENTAL OFFICER PROGRAMME (NDOP) MINISTRY OF HEALTH MALAYSIA ORAL HEALTH DIVISION MINISTRY OF HEALTH MALAYSIA JULY 2017 ORAL HEALTH DIVISION MINISTRY OF HEALTH MALAYSIA JULY 2017 PRIMARY ORAL HEALTHCARE PRIMARY ORAL HEALTHCARE
Transcript of LOG BOOK NEW DENTAL OFFICER PROGRAMME (NDOP) MINISTRY OF...
BOOK 1A
LOG BOOK
NEW DENTAL OFFICER PROGRAMME (NDOP)
MINISTRY OF HEALTH MALAYSIA
BOOK 1A
LOG BOOK
NEW DENTAL OFFICER PROGRAMME (NDOP)
MINISTRY OF HEALTH MALAYSIA
ORAL HEALTH DIVISION MINISTRY OF HEALTH MALAYSIA
JULY 2017
ORAL HEALTH DIVISION MINISTRY OF HEALTH MALAYSIA
JULY 2017
PRIMARY ORAL HEALTHCARE
PRIMARY ORAL HEALTHCARE
PERSONAL PARTICULARS OF NEW DENTAL OFFICER
1. Name:…………………………………………………………………………………………………………………………………
2. I.C. No. :………………………………………………………………………………………………………………………………
3. Date of Birth: ………………………………………………………………………………………………………………………
4. Date of Appointment Into Service:………………………………………………………………………………………
5. Name of Clinic: …………………………………………….……….… 6. State :……………………….….…………..
7. MDC No.: …………………………………………………………………………………………………………………………..
8. Basic Degree & Year Obtained: ………………………………… 9. University:……………………………….
PERSONAL PARTICULARS OF NEW DENTAL OFFICER
1. Name:…………………………………………………………………………………………………………………………………
2. I.C. No. :………………………………………………………………………………………………………………………………
3. Date of Birth: ………………………………………………………………………………………………………………………
4. Date of Appointment Into Service:………………………………………………………………………………………
5. Name of Clinic: …………………………………………….……….… 6. State :……………………….….…………..
7. MDC No.: …………………………………………………………………………………………………………………………..
8. Basic Degree & Year Obtained: ………………………………… 9. University:……………………………….
Passport
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Passport
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Table of Content
Content Page
I Objectives and Expected Learning Outcomes of New Dental Officer
Programme (NDOP)
1
1 Patient Management
1.1 Treatment Planning 2
1.2 Manage post-treatment complication 15
1.3 Identify suitable cases for specialist care 19
2 Clinical Procedures
2.1 Restoration of Anterior Teeth 23
2.2 Restoration of Posterior Teeth 25
2.3 Extraction of Anterior Teeth 27
2.4 Extraction of Posterior Teeth 29
2.5 Scaling and Polishing 31
2.6 Partial Denture 33
2.7 Full Denture 34
2.8 Endodontic Treatment 35
Table of Content
Content Page
I Objectives and Expected Learning Outcomes of New Dental Officer
Programme (NDOP)
1
1 Patient Management
1.1 Treatment Planning 2
1.2 Management of post-treatment complication 15
1.3 Identification of suitable cases for specialist care 19
2 Clinical Procedures
2.1 Restoration of Anterior Teeth 23
2.2 Restoration of Posterior Teeth 25
2.3 Extraction of Anterior Teeth 27
2.4 Extraction of Posterior Teeth 29
2.5 Scaling and Polishing 31
2.6 Partial Denture 33
2.7 Full Denture 34
2.8 Endodontic Treatment 35
Content Page
3 Clinical Prevention
3.1 Fissure Sealant 36
3.2 Preventive Resin Restoration 38
3.3 Fluoride Varnish 39
4 Minor Oral Surgery 40
5 Management of Oral and Maxillofacial Trauma
5.1 Simple Toilet and Suturing of Soft Tissue Injury 41
5.2 Management of Hard Tissue/Dento-alveolar Injury 42
6 Medical and/or Dental Emergencies 43
7 Management of Oro-facial Infection 45
8 Prescription of Medication 46
Content Page
3 Clinical Prevention
3.1 Fissure Sealant 36
3.2 Preventive Resin Restoration 38
3.3 Fluoride Varnish 39
4 Minor Oral Surgery 40
5 Management of Oral and Maxillofacial Trauma
5.1 Simple Toilet and Suturing of Soft Tissue Injury 41
5.2 Management of Hard Tissue/Dento-alveolar Injury 42
6 Medical and/or Dental Emergencies 43
7 Management of Oro-facial Infection 45
8 Prescription of Medication 46
Content Page
9 Oral Health Promotion/Community Programme 48
10 Health and Safety
10.1 Guidelines and policies 50
10.2 Practice of infection control/ radiation safety/ mercury hygiene/
management of sharp injuries
51
11 Law and Ethics 52
Content Page
9 Oral Health Promotion/Community Programme 48
10 Health and Safety
10.1 Guidelines and policies 50
10.2 Practice of infection control/ radiation safety/ mercury hygiene/
management of sharp injuries
51
11 Law and Ethics 52
OBJECTIVES AND EXPECTED LEARNING OUTCOMES OF NEW DENTAL OFFICER PROGRAMME (NDOP)
1. OBJECTIVES OF NDOP
1.1 To familiarise new dental officers to the working environment; and
1.2 To be able to provide safe and quality care to the population.
2. EXPECTED LEARNING OUTCOME OF NDOP
At the end of the programme, the new dental officer:
2.1 shall be confident to practice independently;
2.2 shall be equipped with sufficient managerial, administrative and leadership skills
for better patient management and be able to discharge professional and ethical
responsibilities;
2.3 shall be able to make sound clinical decisions in patient care;
2.4 shall be able to perform clinical procedures competently.
OBJECTIVES AND EXPECTED LEARNING OUTCOMES OF NEW DENTAL OFFICER PROGRAMME (NDOP)
1. OBJECTIVES OF NDOP
1.1 To familiarise new dental officers to the working environment; and
1.2 To be able to provide safe and quality care to the population.
2. EXPECTED LEARNING OUTCOME OF NDOP
At the end of the programme, the new dental officer:
2.1 shall be confident to practice independently;
2.2 shall be equipped with sufficient managerial, administrative and leadership skills
for better patient management and be able to discharge professional and ethical
responsibilities;
2.3 shall be able to make sound clinical decisions in patient care;
2.4 shall be able to perform clinical procedures competently.
1
1
* Please bring patient's card together with this form for evaluation 2
* Please bring patient's card together with this form for evaluation 2
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
* Please bring patient's card together with this form for evaluation 3
* Please bring patient's card together with this form for evaluation 3
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
* Please bring patient's card together with this form for evaluation 4
* Please bring patient's card together with this form for evaluation 4
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
* Please bring patient's card together with this form for evaluation 5
* Please bring patient's card together with this form for evaluation 5
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
* Please bring patient's card together with this form for evaluation 6
* Please bring patient's card together with this form for evaluation 6
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
* Please bring patient's card together with this form for evaluation 7
* Please bring patient's card together with this form for evaluation 7
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
* Please bring patient's card together with this form for evaluation 8
* Please bring patient's card together with this form for evaluation 8
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
* Please bring patient's card together with this form for evaluation 9
* Please bring patient's card together with this form for evaluation 9
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
* Please bring patient's card together with this form for evaluation 10
* Please bring patient's card together with this form for evaluation 10
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
* Please bring patient's card together with this form for evaluation 11
* Please bring patient's card together with this form for evaluation 11
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
* Please bring patient's card together with this form for evaluation 12
* Please bring patient's card together with this form for evaluation 12
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
* Please bring patient's card together with this form for evaluation 13
* Please bring patient's card together with this form for evaluation 13
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
* Please bring patient's card together with this form for evaluation 14
* Please bring patient's card together with this form for evaluation 14
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
1. PATIENT MANAGEMENT [AT LEAST ONE (1) CASE OF MEDICALLY-COMPROMISED PATIENT]
1.1 Treatment Planning - minimum of 10 cases
a. Patient’s Name : .............................................................................................................................................
b. Patient’s ID/NRIC: .............................................................................................................................................
c. Placement : Primary Oral Healthcare
Date Procedure Score
Name & Signature of Supervisor
Remarks Weak (1)
Average (3)
Good (5)
Overall remarks (by supervisor): ...............................................................................................................................
...................................................................................................................................................................................
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
Only
1
score
Perform comprehensive
patient examination
Perform relevant
investigation/s (e.g.
X-ray, pulp test, risk
assessment etc.)
Develop differential/
provisional/ definitive
diagnosis caries
Outline the appropriate
treatment plan
1. PATIENT MANAGEMENT
1.2 Manage post-treatment complication (as and when indicated) - minimum of 3 cases
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Type of Case
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 15
1. PATIENT MANAGEMENT
1.2 Manage post-treatment complication (as and when indicated) - minimum of 3 cases
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Type of Case
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 15
1. PATIENT MANAGEMENT
1.2 Manage post-treatment complication (as and when indicated) - minimum of 3 cases
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Type of Case
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 16
1. PATIENT MANAGEMENT
1.2 Manage post-treatment complication (as and when indicated) - minimum of 3 cases
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Type of Case
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 16
1. PATIENT MANAGEMENT
1.2 Manage post-treatment complication (as and when indicated) - minimum of 3 cases
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Type of Case
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 17
1. PATIENT MANAGEMENT
1.2 Manage post-treatment complication (as and when indicated) - minimum of 3 cases
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Type of Case
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 17
1. PATIENT MANAGEMENT
1.2 Manage post-treatment complication (as and when indicated) - minimum of 3 cases
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Type of Case
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 18
1. PATIENT MANAGEMENT
1.2 Manage post-treatment complication (as and when indicated) - minimum of 3 cases
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Type of Case
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 18
1. PATIENT MANAGEMENT
1.3 Identify suitable cases for specialist care (as and when indicated) - minimum of 5 cases
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Specialty Department/
Unit
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 19
1. PATIENT MANAGEMENT
1.3 Identify suitable cases for specialist care (as and when indicated) - minimum of 5 cases
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Specialty Department/
Unit
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 19
1. PATIENT MANAGEMENT
1.3 Identify suitable cases for specialist care (as and when indicated) - minimum of 5 cases
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Specialty Department/
Unit
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ..............................................................................................................................
..................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 20
1. PATIENT MANAGEMENT
1.3 Identify suitable cases for specialist care (as and when indicated) - minimum of 5 cases
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Specialty Department/
Unit
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 20
1. PATIENT MANAGEMENT
1.3 Identify suitable cases for specialist care (as and when indicated) - minimum of 5 cases
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Specialty Department/
Unit
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 21
1. PATIENT MANAGEMENT
1.3 Identify suitable cases for specialist care (as and when indicated) - minimum of 5 cases
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Specialty Department/
Unit
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 21
1. PATIENT MANAGEMENT
1.3 Identify suitable cases for specialist care (as and when indicated) - minimum of 5 cases
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Specialty Department/
Unit
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 22
1. PATIENT MANAGEMENT
1.3 Identify suitable cases for specialist care (as and when indicated) - minimum of 5 cases
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Specialty Department/
Unit
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 22
2. CLINICAL PROCEDURES 2.1 Restoration of anterior teeth - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Teeth and
tooth surfaces
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 23
2. CLINICAL PROCEDURES 2.1 Restoration of anterior teeth - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Teeth and tooth
surfaces
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 23
2. CLINICAL PROCEDURES 2.1 Restoration of anterior teeth - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Teeth and
tooth surfaces
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 24
2. CLINICAL PROCEDURES 2.1 Restoration of anterior teeth - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Teeth and tooth
surfaces
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 24
2. CLINICAL PROCEDURES 2.2 Restoration of posterior teeth - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Teeth and
tooth surfaces
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 25
2. CLINICAL PROCEDURES 2.2 Restoration of posterior teeth - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Teeth and
tooth surfaces
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 25
2. CLINICAL PROCEDURES 2.2 Restoration of posterior teeth - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Teeth and
tooth surfaces
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 26
2. CLINICAL PROCEDURES 2.2 Restoration of posterior teeth - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Teeth and tooth
surfaces
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 26
2. CLINICAL PROCEDURES 2.3 Extraction of anterior tooth/teeth - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Tooth/Teeth
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 27
2. CLINICAL PROCEDURES 2.3 Extraction of anterior tooth/teeth - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Tooth/Teeth
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 27
2. CLINICAL PROCEDURES 2.3 Extraction of anterior tooth/teeth - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Tooth/Teeth
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ...............................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 28
2. CLINICAL PROCEDURES 2.3 Extraction of anterior tooth/teeth - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Tooth/Teeth
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 28
2. CLINICAL PROCEDURES 2.4 Extraction of posterior tooth/teeth - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Tooth/Teeth
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 29
2. CLINICAL PROCEDURES 2.4 Extraction of posterior tooth/teeth - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Tooth/Teeth
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 29
2. CLINICAL PROCEDURES 2.4 Extraction of posterior tooth/teeth - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Tooth/Teeth
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 30
2. CLINICAL PROCEDURES 2.4 Extraction of posterior tooth/teeth - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Tooth/Teeth
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 30
2. CLINICAL PROCEDURES 2.5 Scaling and Polishing - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Score Name & Signature
of Supervisor Remarks
Weak (1) Average (3) Good (5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 31
2. CLINICAL PROCEDURES 2.5 Scaling and Polishing - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Score Name & Signature
of Supervisor Remarks
Weak (1) Average (3) Good (5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 31
2. CLINICAL PROCEDURES 2.5 Scaling and Polishing - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Score Name & Signature
of Supervisor Remarks
Weak (1) Average (3) Good (5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 32
2. CLINICAL PROCEDURES 2.5 Scaling and Polishing - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Score Name & Signature
of Supervisor Remarks
Weak (1) Average (3) Good (5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 32
2. CLINICAL PROCEDURES 2.6 Partial denture - perform clinical procedures competently (minimum of 2 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Type of
Denture
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 33
2. CLINICAL PROCEDURES 2.6 Partial denture - perform clinical procedures competently (minimum of 2 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Type of
Denture
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 33
2. CLINICAL PROCEDURES 2.7 Full denture - perform clinical procedures competently (minimum of 2 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Type of
Denture
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 34
2. CLINICAL PROCEDURES 2.7 Full denture - perform clinical procedures competently (minimum of 2 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Type of
Denture
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 34
2. CLINICAL PROCEDURES 2.8 Endodontic treatment - perform clinical procedures competently (minimum of 1 case)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Tooth/Teeth
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 35
2. CLINICAL PROCEDURES 2.8 Endodontic treatment - perform clinical procedures competently (minimum of 1 case)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Tooth/Teeth
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 35
3. CLINICAL PREVENTION 3.1 Fissure Sealant - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Tooth/Teeth
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 36
3. CLINICAL PREVENTION 3.1 Fissure Sealant - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Tooth/Teeth
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 36
3. CLINICAL PREVENTION 3.1 Fissure Sealant - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Tooth/Teeth
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 37
3. CLINICAL PREVENTION 3.1 Fissure Sealant - perform clinical procedures competently (minimum of 5 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Tooth/Teeth
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 37
3. CLINICAL PREVENTION 3.2 Preventive Resin Restoration - perform clinical procedures competently (minimum of 3 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Tooth/Teeth
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ..............................................................................................................................
..................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 38
3. CLINICAL PREVENTION 3.2 Preventive Resin Restoration - perform clinical procedures competently (minimum of 3 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Tooth/Teeth
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 38
3. CLINICAL PREVENTION 3.3 Fluoride Varnish - perform clinical procedures competently (minimum of 3 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Tooth/Teeth
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ..............................................................................................................................
..................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 39
3. CLINICAL PREVENTION 3.3 Fluoride Varnish - perform clinical procedures competently (minimum of 3 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Tooth/Teeth
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 39
4. MINOR ORAL SURGERY Perform/Assist simple Minor Oral Surgery (minimum of 1 case)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Procedure
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .............................................................................................................................
..................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 40
4. MINOR ORAL SURGERY Perform/Assist simple Minor Oral Surgery (minimum of 1 case)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Procedure
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ...............................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 40
5. MANAGEMENT OF ORAL AND MAXILLOFACIAL TRAUMA 5.1 Perform/Assist simple toilet and suturing of soft tissue injury (minimum of 1 case)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Procedure
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ............................................................................................................................
..................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 41
5. MANAGEMENT OF ORAL AND MAXILLOFACIAL TRAUMA 5.1 Perform/Assist simple toilet and suturing of soft tissue injury (minimum of 1 case)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Procedure
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 41
5. MANAGEMENT OF ORAL AND MAXILLOFACIAL TRAUMA 5.2 Perform/Assist under supervision management of hard tissue/dento-alveolar injury (minimum of 1 case)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Procedure
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ............................................................................................................................
..................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 42
5. MANAGEMENT OF ORAL AND MAXILLOFACIAL TRAUMA 5.2 Perform/Assist under supervision management of hard tissue/dento-alveolar injury (minimum of 1 case)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC Procedure
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 42
6. MEDICAL AND/OR DENTAL EMERGENCIES Manage medically compromised and/or acute dental problems / medical emergencies appropriately
- minimum of 5 cases
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Type of Case,
Diagnosis &
Procedure
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 43
6. MEDICAL AND/OR DENTAL EMERGENCIES Manage medically compromised and/or acute dental problems / medical emergencies appropriately
- minimum of 5 cases
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Type of Case,
Diagnosis &
Procedure
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 43
6. MEDICAL AND/OR DENTAL EMERGENCIES Manage medically compromised and/or acute dental problems / medical emergencies appropriately
- minimum of 5 cases
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Type of Case,
Diagnosis &
Procedure
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .............................................................................................................................
..................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 44
6. MEDICAL AND/OR DENTAL EMERGENCIES Manage medically compromised and/or acute dental problems / medical emergencies appropriately
- minimum of 5 cases
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Type of Case,
Diagnosis &
Procedure
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 44
7. MANAGEMENT OF ORO-FACIAL INFECTIONS Identify and appropriately manage oro-facial infections (minimum of 3 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Diagnosis &
Procedure
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .............................................................................................................................
..................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 45
7. MANAGEMENT OF ORO-FACIAL INFECTIONS Identify and appropriately manage oro-facial infections (minimum of 3 cases)
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Diagnosis &
Procedure
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ...............................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 45
8. PRESCIPTION OF MEDICATION Demonstrate ability to prescribe medication appropriately (analgesic and antibiotic) - minimum of 5 cases
involving children and adult
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Diagnosis &
Procedure
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .............................................................................................................................
..................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 46
8. PRESCIPTION OF MEDICATION Demonstrate ability to prescribe medication appropriately (analgesic and antibiotic) - minimum of 5 cases
involving children and adult
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Diagnosis &
Procedure
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ...............................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 46
8. PRESCIPTION OF MEDICATION Demonstrate ability to prescribe medication appropriately (analgesic and antibiotic) - minimum of 5 cases
involving children and adult
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Diagnosis &
Procedure
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ............................................................................................................................
..................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 47
8. PRESCIPTION OF MEDICATION Demonstrate ability to prescribe medication appropriately (analgesic and antibiotic) - minimum of 5 cases
involving children and adult
a. Placement : Primary Oral Healthcare
Date Patient’s
ID/NRIC
Diagnosis &
Procedure
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ...........................................................................................................................
..................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 47
9. ORAL HEALTH PROMOTION (OHP)/ COMMUNITY PROGRAMME
Participate in Oral Health Promotion/ Community Activities - minimum of 5 activities
a. Placement : Primary Oral Healthcare
Date Programme Activity Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 48
9. ORAL HEALTH PROMOTION (OHP)/ COMMUNITY PROGRAMME
Participate in Oral Health Promotion/ Community Activities - minimum of 5 activities
a. Placement : Primary Oral Healthcare
Date Programme Activity Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 48
9. ORAL HEALTH PROMOTION (OHP)/ COMMUNITY PROGRAMME
Participate in Oral Health Promotion/ Community Activities - minimum of 5 activities
a. Placement : Primary Oral Healthcare
Date Programme Activity Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ..............................................................................................................................
.....................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 49
9. ORAL HEALTH PROMOTION (OHP)/ COMMUNITY PROGRAMME
Participate in Oral Health Promotion/ Community Activities - minimum of 5 activities
a. Placement : Primary Oral Healthcare
Date Programme Activity Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 49
10. HEALTH AND SAFETY
10.1 Explain related guidelines and policies e.g. Occupational Safety and Health (infection control, radiation safety,
mercury hygiene, management of sharp injuries) - minimum of 1 activity (Presentation, CDE etc.)
a. Placement : Primary Oral Healthcare
Date Guidelines/
SOP Activity
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 50
10. HEALTH AND SAFETY
10.1 Explain related guidelines and policies e.g. Occupational Safety and Health (infection control, radiation
safety, mercury hygiene, management of sharp injuries) - minimum of 1 activity (Presentation, CDE etc.)
a. Placement : Primary Oral Healthcare
Date Guidelines/
SOP Activity
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 50
10. HEALTH AND SAFETY
10.2 Demonstrate the practice of infection control/ radiation safety/ mercury hygiene management of
sharp injuries - minimum of 1 activity
a. Placement : Primary Oral Healthcare
Date Guidelines/
SOP Activity
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 51
10. HEALTH AND SAFETY
10.2 Demonstrate the practice of infection control/ radiation safety/ mercury hygiene management of
sharp injuries - minimum of 1 activity
a. Placement : Primary Oral Healthcare
Date Guidelines/
SOP Activity
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): .................................................................................................................................
......................................................................................................................................................................................
* Please bring patient's card together with this form for evaluation 51
11. LAW AND ETHICS
Describe relevant act and regulation related to dentistry [e.g. Dental Act 1971, Private Health Care
Services and Facilities Act (586 Act), Code of Professional Conduct] - minimum of 1 activity
a. Placement : Primary Oral Healthcare
Date Act/
Regulation Activity
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring evidence of performing activities with this form for evaluation 52
11. LAW AND ETHICS
Describe relevant act and regulation related to dentistry [e.g. Dental Act 1971, Private Health Care
Services and Facilities Act (586 Act), Code of Professional Conduct] - minimum of 1 activity
a. Placement : Primary Oral Healthcare
Date Act/
Regulation Activity
Score Name & Signature
of Supervisor Remarks Weak
(1) Average
(3) Good
(5)
Overall remarks (by supervisor): ................................................................................................................................
.....................................................................................................................................................................................
* Please bring evidence of performing activities with this form for evaluation 52
