On November 8, 2018, Nick Smith led training, uncovering some great resources for understanding the language, procedures design and standards required in a dental office.

One resource is this Dental Office Design Guide that was prepared by the VA in 2014.

The other resource (below) is the Dental Assistant curriculum prepared by the State of Utah.

Additionally, the Henry Schein Clinic Planning 2010 document is available.

Fundamentals of Dental Assisting Curriculum 2013

Adapted and revised to meet the requirements for entry-level and expanded functions Dental   Assistant   preparing   for   employment   in   dental   healthcare   settings   through secondary and postsecondary educational and training programs.

Table of Contents (all in blue text)

1.0   Introduction to the Dental Profession

1.01        The Dental Team

1.02        The Dental Specialties

1.03        Dental Assisting Credentials

1.04        Professional Organizations

2.0   Dental Ethics and the Law

2.01        Legal Considerations

2.02        Ethical Considerations

3.0   Dental Terminology

3.01        Dental Prefixes

3.02        Dental Root Words

3.03        Dental Suffixes

4.0   Preventive Oral Health

4.01        Comprehensive Preventive Dentistry

4.02        Bacterial Plaque

4.03        Dental Calculus

4.04        Dental Caries

4.05        Periodontal Disease

4.06        Patient Education

4.07        Fluoride

4.08        Nutrition

5.0   Infection Control

5.01        Disease Transmission

5.02        Infectious Diseases

5.03        Prevention of Disease Transmission

5.04        OSHA Bloodborne Pathogens Standard

5.05        Universal Precautions

5.06        Management of Hazardous Materials

5.07        Cleaning /Pre-cleaning

5.08        Disinfection

5.09        Sterilization

5.10        Instrument Processing

5.11        Treatment Room

5.12        Dental Unit Water Lines

6.0   Patient Management

6.01        Utilizing Effective Communication Skills

6.02        Non-Verbal Communication

6.03        Greet the Patient

6.04        Obtaining Information

6.05        Managing Patient Behavior

7.0   Anatomy

7.01        Head and Neck Anatomy

7.02        Oral Anatomy

7.03        Dental Anatomy

8.0   Dental Equipment

8.01        Equipment Identification

8.02        Equipment Uses

9.0   Dental Instruments and Procedures

9.01        Hand Instruments

9.02        Rotary Instruments

9.03        Dental Procedures

9.04        Lab Procedures

10.0 Clinical Records

10.01     Medical History

10.02     Dental History

10.03     Dental Charting and the Dental Exam

10.04     Recording Dental Treatment

11.0 Oral Pathology

11.01     Dental Caries

11.02     Periodontal Disease

11.03     Attrition, Abrasion, and Erosion

11.04     Soft Tissue Pathology

12.0 Emergency Care

12.01     Medical Emergency Care

12.02     Medical Emergencies

12.03     Dental Emergency Care

13.0 Dental Anesthesia

13.01     Dental Anesthesia Terminology

13.02     Dental Anesthesia

14.0 Chairside Assisting

14.01     Dental Ergonomics

14.02     Principles of Four-Handed Dentistry

14.03     Maintaining a Clear Operating Field

15.0 Dental Materials

15.01     Properties and Classification of Dental Materials

15.02     Metals in Dentistry

15.03     Resins and Bonding in Dentistry

15.04     Impression Materials in Dentistry

15.05     Gypsums Materials in Dentistry

15.06     Cements and Liners in Dentistry

15.07     Porcelain and Ceramics in Dentistry

15.08     Other Dental Materials

16.0 Obtaining Alginate Impressions

16.01     Hydrocolloid Impression Materials

16.02     Armamentarium Required to Mix

16.03     Patient Preparation

16.04     Tray Selection

16.05     Preparing Impression Trays

16.06     Spatulation Technique

16.07     Loading the Mandibular Alginate Tray

16.08     Loading the Maxillary Impression Tray

16.09     Seating the Trays

16.10     Evaluating the Alginate Impression

17.0 Introduction to Dental Radiography

17.01     Biological Effects of Ionizing Radiation

17.02     Protection Techniques

17.03     The X-Ray Machine

17.04     Dental Film/Sensors

17.05     Radiographic Techniques

17.06     Radiographic Landmarks

17.07     Mounting Radiographs

17.08     Processing Radiographs

17.09     Evaluating Radiographs for Diagnostic Value

 

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FUNDAMENTALS OF DENTAL ASSISTING

Educational parameters of the didactic component of the Fundamentals of Dental Assisting

 

1.0   Introduction to the Dental Profession
1.01   The Dental Team

A. Identify 5 members of the dental prof

1. Dentist

2. Dental Assistant

3. Dental Hygienist

4. Business Assistant

5. Dental Laboratory Technician

B. Define the 5 members of the dental team.

1. Dentist: Leader of the dental team, responsible for all of the treatment and care of the patien

2. Dental Assistant: Aids the dentist in diagnosis, treatment, and dental care.

3. Dental Hygienist: Concerned with the prevention of dental disease; specializing in the cleaning, polishing, and radiographing teeth; periodontal treatment; and patient education.

4. Business Assistant: Responsible for the smooth and efficient operation of the business office.

5. Dental Laboratory Technician: Performs dental lab procedures according to a written prescription of a licensed den

 

1.02   The Dental Specialties

 

1. A. Describe the 9 specialty fields of dentistry.
2. 1. Dental public health: Involves public/community education to control and prevent disease
3. 2. Endodontics: Concerned with the cause, diagnosis, prevention, and treatment of diseases and injuries to the pulp and associated structure
4. 3. Oral and maxillofacial radiology: Enhance imaging techniques to locate tumors and infectious diseases of the jaw, assist in trauma cases, and help pinpoint temporomandibular disorders (newest of the specialties).
5. 4. Oral and maxillofacial surgery: Involves the diagnosis and surgical treatment of diseases,

injuries, and defects of the oral and maxillofacial regions.

5. 5. Oral pathology: Concerned with the nature of the diseases affecting the oral cavity and adjacent structure Perform biopsies and work closely with oral surgeons to provide a diagnosis.
6. 6. Orthodontics: Involves the diagnosis, prevention, interception, and treatment of all forms of malocclusion of the teeth and associated structures.

7. 7. Pediatric dentistry: Concerned with the oral healthcare of children from birth to adolescence, often dealing with emotional or behavioral problem
8. 8. Periodontics: Concerned with the diagnosis and treatment of the oral tissues supporting and surrounding the teeth.
9. 9. Prosthodontics: Concerned with the restoration and replacement of natural teeth with

artificial replacements.

 

1.03   Dental Assisting Credentials

 

For the most current information check www.danb.org.

 

1. A. Identify 7 acronyms used in the identification of Dental Assistants.
2. 1. CDA: Certified Dental Assistant
3. 2. CDPMA: Certified Dental Practice Management Administrator
4. 3. COA: Certified Orthodontic Assistant
5. 4. COSMA: Certified Oral and Maxillofacial Surgery Assistant
6. 5. RDA: Registered Dental Assistant
7. 6. EFDA: Expanded Function Dental Assistant
8. 7. CPDA: Certified Preventative Dental Assistant

 

1. Explain how each of the 7 Dental Assisting credentials may be obtained.
2. 1. CDA: Granted by the Dental Assisting National Board after successful completion of the national certification examination.
3. 2. CDPMA: This credential is no longer granted but is still recognized. Granted by the Dental

Assisting National Board to recognize successful completion of the specialty examination in

Dental Practice Management.

3. 3. COA: Granted by the Dental Assisting National Board to recognize successful completion of the specialty examination on Orthodon
4. 4. COMSA: This credential is no longer granted but is still recognized. Granted by the Dental Assisting National Board to recognize successful completion of a specialty examination in oral and maxillofacial surgery.
5. 5. RDA: Given by some states to indicate that specific requirements have been met to practice

expanded and advanced functions for that state.

6. 6. EFDA: Given by some states to indicate specific requirements have been met to practice expanded and advanced functions of that state.
7. 7. CPDA: The newest credential granted by the Dental Assisting National Board to recognize successful completion of the specialty exam in the areas of coronal polishing, pit and fissure sealants, topical fluoride, and topical anesthe

 

1.04   Professional Organizations

 

1. A. List 5 dental organizations and the profession they repr
2. 1. ADA: American Dental Association
3. 2. ADHA: American Dental Hygiene Association
4. 3. ADAA: American Dental Assistants Association
5. 4. DANB: Dental Assisting National Board
6. 5. ADLTA: American Dental Laboratory Technician Association

 

 

 

Intended Outcome
2.0   Dental Ethics and the Law
2.01   Legal Considerations

 

1. A. Identify 5 agencies that regulate dentistry.
2. 1. State Board of Dentistry
3. 2. Drug Enforcement Agency
4. 3. State Board of Pharmacy
5. 4. Occupational Safety and Health Administration
6. 5. Environmental Protection Agency

 

1. Identify current prohibitions specified by Rule 35 of the Idaho Dental Practice Act which can be found at http://isbd.idaho.gov.

 

1. C. Define 2 types of statutory law that affects dentistry.
2. 1. Civil law: Crimes against an individual
3. Contract law refers to a binding agreement between two or more people.
4. b. Tort law involves acts, intentional or unintentional, that causes harm to a person or damage to property.
5. Administrative law involves regulations established by government agencies.
6. 2. Criminal law: Crimes against society.
7. Felony is a major crime; in dentistry this includes insurance fraud and drug abuse.
8. b. Misdemeanor is a lesser crime; in dentistry this usually involves an infraction of the dental practice
9. Infraction is a minor offense such as a traffic violation.

 

1. List who may be the subject of a law suit.
2. Initiating Dentist b.  Dental Assistant c.    Hygienist

 

1. E. State the purpose of professional liability insur F.   Explain who owns the dental record.

 

1. Define what a Dental Practice Act is.
2. 1. The Dental Practice Act specifies the legal requirements for the practice of dentistry within each sta

 

1. H. Define reciprocity.
2. 1. Reciprocity is a system that allows individuals in one state to obtain a license in another state without retesting.

 

1. I. Define 3 types of supervision according the Idaho State Dental Practice A
2. 1. Direct Supervision: Requires that a dentist diagnose the condition to be treated, a dentist authorize the procedure to be performed, a dentist remain in the dental office while the procedure is performed, and before dismissal of the patient a dentist approves the work performed by the dental au
3. 2. Indirect Supervision: Requires that a dentist authorize the procedure and that a dentist be in

the dental office while the procedure is performed.

3. 3. General Supervision: Requires that a dentist authorize the procedure which is carried out, but does not require that a dentist be in the office when the authorized procedure is performed.

 

1. J. Define malpr
2. 1. Malpractice: Professional negligence or failure to provide due care or the lack of due care.

 

1. Define standard of care.
2. 1. Standard of care: The level of knowledge, skill and care comparable with that of other dentists who are treating similar patients under similar condition

 

2.02   Ethical Considerations

 

1. A. Define risk manag
2. 1. Risk management: Procedures and practices that are used to avoid lawsu

 

1. List 7 elements of an informed consent.
2. 1. Description of treatment
3. 2. Alternatives of treatment
4. 3. Risk of complications
5. 4. Prognosis
6. 5. Cost
7. 6. Time needed to complete
8. 7. Age and mental capacity of patient

 

1. C. List 2 ways to obtain informed
2. 1. Verbal consent
3. 2. Written consent

 

1. List 13 ways to manage risk.
2. 1. Informed consent
3. 2. Review medical history
4. 3. Emergency preparedness
5. 4. Clear/realistic patient expectations
6. 5. Maintain high level of skill
7. 6. Adequate patient safety equipment
8. 7. Disclosure of unexpected events
9. 8. Comprehensive/accurate treatment record
10. 9. Never criticize previous treatment
11. 10. Protect privacy of patient (HIPPA)
12. 11. Document privacy of patient (HIPPA)
13. 12. Identify responsibility and obligations in the dentist/patient relationship
14. 13. How to respond to a threat of malpractice suit

 

1. E. List 6 guidelines for managing chart entries as a legal record.
2. 1. Keep a separate chart for each patient
3. 2. Correct errors properly
4. 3. Make chart entry during patient visit, do not rely on memory
5. 4. Write legibly in ink and date and initial each entry
6. 5. The entry should be complete
7. 6. Never change or alter the chart after a problem arises

 

 

 

 

3.0   Dental Terminology

 

 

 

Given information about the value of dental terminology, prefixes, word roots and suffixes the   student   will   perform   the   following   tasks   with   80%   accuracy   on   the   didactic

examination.

 

3.01   Dental Prefixes

 

1. A. List and define the following 83 dental prefix

 

1.   a-; an-	without, away from, not	26. edem/a-	swelling
2.   ab-	from, away negative,	27. endo-	within
	absent	28. epi-	over, upper, upon
3.   ad-	increase, toward	29. erythr/o	red
4.   an-	without, not	30. eth/m-	sieve
5.   ana-	up, throughout	31. eti/o	cause
6.   ano-	up	32. ex-; ex/o	out away from, completely
7.   anti-	opposed to, against,	33. extra-	beyond, outside
	counteracting	34. faci/a	face, appearance
8.   auto-	self	35. fore-	in front of
9.   bi-	two, twice, double	36. gene-	origin, beget
10. bio-	life	37. hem/a/i	blood
11. brady-	slow	38. hepa-	liver
12. canth-	corner of the eye	39. homo-	same
13. circum-	around	40. hydra-	water
14. contra-	against, opposed	41. hyo-	U-shaped, horseshoe-shaped
15. de-	from, lack of	42. hyper-	above, excessive, beyond
16. demi-	half	43. hypo-	less than, below, under
17. dens-	tooth	44. idio-	peculiar, one’s own
18. dent-	tooth, teeth,	45. inter-	in the midst, between
19. derma-	skin	46. intra-	within
20. di-	twice double	47. infra-	beneath, under, inferior
21. dia-	complete, through	48. leuk/o	white
22. dors-	back	49. macro-	large
23. dys-	bad, difficult, painful	50. mal-	evil, sickness, disorder, bad,
24. e-/ec-	out of, from		poor
25. ecto-	external, outside	51. mesi/o	middle

 

 

52. mucos/a	mucus membrane	69. pyo-	pus
53. myel/o	spinal cord, bone marrow	70. re-	back, again
54. myo-	muscle	71. retro-	backwards
55. neo-	new	72. sub-	under, beneath, less normal
56. necr/a	death, dead	73. super-	above, superior, beyond
57. nephr/o	kidney	74. supra-	above, excessive
58. neuro-	nerve	75. syn-	together, union
59. nutri-	feed, nourish	76. tachy-	fast
60. pan-	all	77. tic-	relation, belonging to
61. para-	besides, beyond	78. trans-	across, over, beyond,
62. peri-	around, about		through
63. poly-	many, much	79. tri-	three, trice, third
64. post-	behind, after	80. ventro-	body front
65. pre-	before, in front of	81. ultra-	beyond, excess
66. pseudo-	false	82. un-	not
67. ptery-	a wing	83. uni-	one
68. ptya/l	spit, saliva

 

3.02   Dental Root Words

 

1. A. List and define the following 56 dental root word

 

1. alve/o          alveolus (tooth socket bone)
2. amalg          soft mass
3. amel/o        tooth, enamel tissue
4. angio           vessel
5. ankyl            anchored, crooked
6. anter/o       before, in front of
7. apic/o          apex of the root, tip
8. brux/i/o      chew, grind
9. bucc             cheek
10. calcul small stone,  limestone
11. cardi/o heart
12. carcin/o cancer
13. cari/es/o rottenness, decay
14. cephal/o head
15. cheil/o lip
16. clavi/o a club
17. cocci round, spherical, bacteria
18. colli neck
19. coron/a crown
20. cyan/o blue
21. cyst fluid filled sac
22. cyt cell
23. decidu shedding
24. dens/t tooth
25. di across, separate, apart
26. diastem/a space, interval
27. dist/o farthest from center
28. edem/a swelling
29. edentul/o without teeth
30. erythr/o red
31. fluor/o fluoride
32. foss/o shallow depression
33. frene frenum, connecting tissue
34. gingiv gingival, gum tissue
35. gloss/o tongue
36. halit/o breath
37. hem/a/o blood
38. incis/o incisor tooth
39. infer/o under, below
40. labi/o lip area
41. lacrim/o tears
42. lingu/o tongue
43. lip/i/o fat
44. lith/o stone
45. mandibul/a lower jaw
46. mastic/o chew
47. maxill/a/o upper jaw
48. melan/o black
49. mesi/o middle, mid-line
50. muc/o tissue lining an orifice
51. my/o muscle
52. occlus/o occlusion, jaw closing
53. orth/o straight, proper order
54. stoma mouth
55. tempor/o temporal bone/joint

 

 

3.03   Dental Suffixes

 

1. A. List and define the following 52 dental suffix

 

 

1. 1. -ac, -ic, -ar  describes or shows relation to
2. -al  used to indicate connection with
3. 3. -algia/-esia pain, suffering
4. 4. -ia                 state of being
5. 5. -ase              enzyme
6. 6. -cide            kill
7. 7. -cise             cut into
8. 8. -cyte            cell
9. 9. -dema          swelling
10. 10. -ectomy surgical removal
11. 11. -emia blood
12. 12. -eme/-tic/-sis producing vomiting

26. 26. -lith stone
27. 27. -logist specialist
28. 28. -logy study of
29. 29. -lysis destruction
30. 30. -nomy science of
31. 31. -oid like, resembling
32. 32. -ology study of
33. 33. -oma tumor, swelling
34. 34. -orrhea flow, excessive flow
35. 35. -otomy cutting into, incision into
36. 36. -osis abnormal, condition of
37. 37. -ous pertaining to, full of

13. -esthesia sensation 39. -phob fear, dread 14. -eum a place where 40. -plasty surgical correction 15. -graph/y picture, recording of a 41. -pnea breathing picture 42. -rrhage excessive flow 16. -gram graph, picture (used in 43. -rrhea excessive radiology) 44. -scoli/o twisted 17. -iama medicine, remedy 45. -scopy scan, visual exam 18. -iasis abnormal condition 46. -sis the act of 19. -im not, in, into 47. -stalsis constriction, contraction 20. -ism state of, condition 48. -tic pertaining to 21. -ist specialist in, superlative 49. -tome cutting instrument 22. -itis inflammation of 50. -trophy development, growth, 23. -ium small nourishment 24. -ize take away, remove 51. -um pertaining to 25. -lar describing, about 52. -y act, result of an act

38. 38. -path/o/y disease

 

 

 

4.0   Preventive Oral Health
Given information about preventive dentistry, plaque removal, fluoride, and nutrition, the student will be able to perform the following tasks with 80% accuracy on the didactic

examination.

 

4.01   Comprehensive Preventive Dentistry

 

1. A. Explain the goal of preventive dentistry to help all people attain optimal oral health for their entire liv

 

1. Describe the 5 parts of a comprehensive preventive dentistry program.

 

1. 1. Nutrition
2. 2. Patient education
3. 3. Plaque control

4. 4. Fluoride therapy
5. 5. Sealants

 

 

4.02   4.02 Bacterial Plaque

 

1. A. Explain the composition of plaqu
2. 1. Plaque consists of colonies of bacteria, food debris and saliva that attach to the teeth above and below the gum line. Plaque reforms within 24 hours of remov

 

1. List the 3 steps of plaque formation.
2. 1. Pellicle formation
3. 2. Bacteria attach to the pellicle

 

3. 3. Bacteria multiply and mature

 

 

4.03   Dental Calculus

 

1. A. Define dental calculu
2. 1. Dental calculus: Mineralized bacterial plaque. It is a tenacious deposit that forms on the clinical crowns and roots of teeth.

 

1. List the two types of dental calculus.
2. 1. Supragingival calculus
3. 2. Subgingival calculus

 

4.04   Dental Caries

 

1. A. List 5 steps that result in the development of car
2. 1. Cariogenic food, in the form of carbohydrates, is mixed in with the plaque.
3. 2. Plaque and bacteria mix together and the pH of the plaque becomes more acid
4. 3. Acid formation begin
5. 4. Frequent exposure of tooth to acid begins demineralization of the tooth structure.
6. 5. Caries formation.

 

1. Define cariogenic.
2. 1. Cariogenic: Producing or promoting tooth decay.

 

1. C. List 3 factors that contribute to dental car
2. 1. Undisturbed plaque on teeth
3. 2. A diet high in cariogenic foods

 

3. 3. Frequent exposure to sucrose

 

 

4.05   Periodontal Disease

 

1. A. List the main contributing factor in periodontal d
2. 1. Bacterial plaque

 

1. List 4 contributing factors in periodontal disease.

 

1. 1. Inadequate plaque control
2. 2. Lack of patient compliance

3. 3. Tobacco use
4. 4. Systemic diseases

 

4.06   Patient Education

 

1. A. Evaluation of patien
2. 1. Oral health status and habits
3. 2. Use appropriate disclosing aides

 

 

 

 

3. 3. Provide individualized education plan
4. 4. Evaluate patients’ progress

 

1. List 4 factors in toothbrush selection.
2. 1. Soft bristles
3. 2. Easily cleaned

 

3. 3. Replaceable every 3 to 4 months
4. 4. Adapted to individual patient

 

 

1. C. Describe 2 tooth brushing techniqu
2. 1. Bass or intrasulcular brushing technique
3. 2. Rolling or circular brushing technique

 

1. List 3 flossing considerations.
2. 1. Floss every 24 hours
3. 2. Most effectively removes plaque between teeth
4. 3. Choice of type depends on individual patient needs

 

1. E. Identify 5 special interdental aid
2. 1. Floss holder
3. 2. Floss threader
4. 3. Stimulators
5. 4. Interproximal brush
6. 5. Oral irrigation device

 

 

4.07   Fluoride

 

1. A. Define 2 types of fluoride.
2. 1. Systemic: Obtained by eating or drinking.
3. 2. Topical: Applied as a gel, rinse, or varnish.

 

1. Identify 2 considerations concerning systemic fluoride.
2. 1. 1 PPM optimum amoun
3. 2. Obtained through fluoridated drinking water (added or natural), foods with fluoride, or through drops or table

 

1. C. Define 4 types of topical fluoride.
2. 1. 8-10% stannous fluoride: Applied every 6 to 8 months, is unstable, and may stain teeth.
3. 2. 1.23% acidulated phosphate fluoride: Applied every 6 months by trays for 1 to 4 minute

No food or drink for 30 minutes. Stored in plastic.

3. 3. Neutral 2% sodium fluoride: Applied to newly erupted teeth at ages 3, 7, 10, 13. Application is for 3 minutes once a week for 4 wee
4. 4. 5% sodium fluoride varnish: Applied to clean dry teeth. No food or brushing for two hou

 

1. Explain the possible dangers of fluoride.
2. 1. Dental fluorosis: Mottled or discolored enamel from too much systemic fluoride.
3. 2. Overdo

 

 

4.08   Nutrition

 

1. A. Define cariogenic food
2. 1. Cariogenic foods: Sticky, sugary foods, refined carbohydrate

 

1. Describe 3 effects cariogenic foods have on dental health
2. 1. Promotes plaque formation
3. 2. Promotes tooth decay
4. 3. Promotes periodontal disease

 

1. C. List the components of a dietary analy
2. 1. Patients prepare 3-day food diary
3. 2. Review with patient using a dietary form
4. 3. Suggest positive changes to patient

 

 

 

 

5.0   Infection Control

 

Given information about disease transmission, infectious diseases, universal precautions, the treatment room, cleaning, sterilization, disinfecting, disinfectants, hazards, and instrument sterilization, the student will be able to perform the following tasks with 80%

accuracy on the didactic examination.

 

As infection control policies and procedures can change more quickly than the texts, it is important to stay informed of the most current techniques. For the most current technologies visit the following websites often:  http://www.osap.org/ •  http://osha.gov/ •

http://www.cdc.gov/

 

 

5.01   Disease Transmission

 

1. A. Define pathog
2. 1. Pathogenic: Disease causing microorganisms

 

1. Define spore.
2. 1. Spore: Highly resistant form of bacteria that are able to remain inactive under unfavorable conditions and can become active when conditions are favorab

 

1. C. List 6 modes of disease transmission in a dental off
2. 1. Direct transmission
3. 2. Indirect transmission
4. 3. Airborne transmission a.    Aerosol
5. b. Spray
6. Spatter
7. 4. Parenteral transmission
8. 5. Bloodborne transmission
9. 6. Water transmission

 

1. Define 3 methods for airborne transmission.
2. 1. Splatter: Large particles, such as tooth fragments and debris, are released into the air during cavity preparation
3. 2. Mists: Droplets transported via coughing causing respiratory infection
4. 3. Aerosols: Microorganisms are found in the aerosols created by ultrasonic scalers, high-speed handpieces, and the use of air-water syringe

 

1. E. Define cross-contam
2. 1. Cross-contamination: The spread of microorganisms from one source to another source.

 

1. F. List 5 methods in which cross-contamination can occur.

 

1. 1. Patient to dental team
2. 2. Patient to patient
3. 3. Dental team to patient

4. 4. Dental office to community
5. 5. Community to dental office to patient

 

 

1. List 3 ways to prevent cross-contamination.
2. 1. Reduction of pathogenic microorganisms
3. 2. Breaking the chain of disease transmission
4. 3. Application of universal precautions

 

 

5.02   Infectious Diseases

 

1. A. List and explain the 5 types of hepatitis and the route of transmission for each typ
2. 1. Hepatitis A: Fecal and oral
3. 2. Hepatitis B (HBV): Blood, saliva and body fluids
4. 3. Hepatitis C: Percutaneous, blood, and contaminated needles
5. 4. Hepatitis D (Delta): Co-infection with hepatitis B, blood, sexual contact, and perinatal
6. 5. Hepatitis E: Fecal, oral, and contaminated water

 

1. List 5 types of individuals at risk for contracting hepatitis B.
2. 1. Patients with active or chronic liver disease
3. 2. Military populations stationed in countries with a high incidence of hepatitis B
4. 3. Infants born to HIV-infected mothers
5. 4. IV drug users
6. 5. Heterosexually active persons with multiple sexual partners

 

1. C. Explain the time interval for administering the hepatitis B vaccine.
2. 1. This is administered in 3 doses—the initial dose and then at 1 and 6 month

 

1. List 2 types of herpes viruses.
2. 1. Herpes simplex virus-1
3. 2. Herpes simplex virus-2

 

1. E. List 3 reasons to postpone treatment for a patient with an active herpetic lesion.

 

1. 1. Contiguousness of the lesion
2. 2. Transfer of the virus to other areas of the face
3. 3. Irritation to the lesion from dental procedures can prolong healing

 

1. F. Define the term HIV.
2. 1. HIV: Human immunodeficiency virus

 

1. List and explain 3 modes of transmission for HIV.
2. 1. Perinatal: Transmission across the placenta, during delivery or breastfeeding
3. 2. Sexual contact: Heterosexual or homosexual relations
4. 3. IV drug users: Shared or contaminated needles

 

1. H. List 4 other diseases of concern to dental healthcare worker

 

1. 1. Tuberculosis
2. 2. Tetanus

3. 3. Legionnaires
4. 4. Measles

 

 

5.03   Prevention of Disease Transmission

 

1. A. Define the 4 factors of disease transmission.
2. 1. Virulence
3. 2. Pathogenic organisms must be present in quantities and concentration sufficient to overtake the body defenses
4. 3. A susceptible host must be present, one who cannot resist infection
5. 4. Pathogens must have means of entering the body or a portal of entry

 

1. Explain 8 methods used to prevent disease transmission.
2. 1. Eliminating or controlling the organisms found in the oral cavity by brushing teeth or rinsing with an antiseptic mouthwash.
3. 2. Interruption of transmission of organisms by the use of rubber dam and high speed

evacuation system.

3. 3. Wearing protective eyewear, gloves and mask (universal precautions).
4. 4. Sterilization of dental instruments by autoclaving.
5. 5. Use of disposables when possible.
6. 6. Immunization of dental personne
7. 7. Avoid procedures on patients with lesions of communicable disease
8. 8. Properly store all instruments and mate

 

5.04   OSHA Bloodborne Pathogens Standard

 

1. A. List the components required the OSHA bloodborne pathogen standard
2. 1. Exposure control plan
3. 2. Standard and universal precaution
4. 3. Categorization of employees
5. 4. Post exposure management
6. 5. Employee training
7. 6. Hepatitis B immunization

 

1. List OSHA bloodborne pathogens standard training requirements.
2. 1. Epidemiology, modes of transmission, and prevention of HBV and HIV
3. 2. Risks to the fetus from HBV and HIV
4. 3. Location and proper use of all protective equipment
5. 4. Proper work practices using universal precaution
6. 5. Meaning of color codes, biohazard symbol, and precautions to following handling infectious waste.
7. 6. Procedures to follow if needlestick or other injury occu

 

1. C. Describe management of an exposure incid
2. 1. Document routes of exposure
3. 2. Document source
4. 3. Request blood screening of source
5. 4. Advise employee to be tested
6. 5. Provide prophylaxis treatment
7. 6. Provide appropriate counseling
8. 7. Evaluate post incident illness

 

5.05   Universal Precautions

 

1. A. Define universal precau
2. 1. Universal precautions: Guidelines based on treating all human blood and body fluids including saliva as potentially infectiou

 

1. Define standard precautions.
2. 1. Standard precautions: Standard of care designed to protect healthcare providers from pathogens that can spread by blood or other body fluid via excretion or secretion; expands upon the concept of universal precaution

 

1. C. List the 4 items of personal protective equipment (PPE).
2. 1. Protective clothing
3. 2. Face masks
4. 3. Eyewear
5. 4. Gloves

 

1. List and explain 7 appropriate personal protective guidelines.
2. 1. Uniform tops should be closed at the neck, disposable or easily laundered, and have long- sleeves with fitted cu Pants and socks should cover the legs and ankles.
3. 2. Clinic attire must not be worn in the staff lounge or outside the dental office. Clothing must

be changed daily.

3. 3. Hair should be worn off the shoulders and away from the face.  Facial hair should be covered with a face mask or shield.
4. 4. Face masks must have a high bacterial filtration efficiency rate. Masks should be changed

after each patient or after becoming splattered and/or saturated.

5. 5. Protective eyewear should have wide side shields to protect the area around the eyes and shatterproof lenses that are made of sturdy p
6. 6. Gloves should be impermeable to saliva, blood, and bacteria and fit snug over the cuffs of the uniform.
7. 7. Other barrier items such as dental dams

 

1. E. Describe the 6 guidelines for use of glov
2. 1. Gloves must be worn by all dental staff during the patient’s treatmen
3. 2. Torn or damaged gloves must be replaced immediately.
4. 3. Do not wear jewelry under glove
5. 4. Change gloves frequently, with each new patient or approximately every hou
6. 5. Contaminated gloves should be removed before leaving the operatory during patient treatmen
7. 6. Hands must be washed after glove removal and before re-gloving.

 

1. F. List 3 types of gloves worn.
2. 1. Overgloves
3. 2. Utility gloves
4. 3. Examination gloves

 

1. List 3 principles of effective hand washing.
2. 1. Reduction of the bacterial flora on the skin
3. 2. Removal of surface dirt and loosened debris
4. 3. Provide disinfection with a long-acting antiseptic

 

1. H. List the 7 steps for washing and drying of hand
2. 1. Remove all jewelry
3. 2. Wet hands with warm water
4. 3. Apply an ample amount of antibacterial liquid soap
5. 4. Vigorously rub hands together under a stream of water
6. 5. Rub together for a minimum of 15 seconds
7. 6. Rinse hands with cool water
8. 7. Thoroughly dry your hands using a paper towel

 

1. I. State 3 guidelines for handling contaminated laundry.
2. 1. Protective clothing should be laundered in the office and universal precautions are followed when handling the clothing.
3. 2. Disposable gowns are discarded daily, more often if visibly soiled.
4. 3. Contaminated clothing that is removed from the office must be in a leak proof bag that is labeled “Biohazar”

 

5.06   Management of Hazardous Materials

 

1. A. List 3 organizations that regulate the profession of dentistry.
2. 1. Occupational Safety and Health Administration (OSHA)
3. 2. Centers for Disease Control (CDC)
4. 3. Environmental Protection Agency (EPA)

 

1. List 4 classifications of waste.
2. 1. General waste
3. 2. Hazardous waste
4. 3. Contaminated waste
5. 4. Infectious or regulated waste

 

1. C. List 4 methods for disposal of w
2. 1. Gloves, mask, and barriers contaminated with body fluids or blood should be discarded in impermeable plastic bags as general waste.
3. 2. Sharps should be placed in a puncture resistant, leak proof container and labeled as

biohazard.

3. 3. Blood, blood soaked materials, tissue, and teeth should be placed in leak proof containers, labeled biohazard, and disposed of according to state guidelines for infectious waste.
4. 4. Proper disposal of liquid chemicals or solid chemicals may vary with local and state waste

management agencies. Check with the local agencies in your area.

 

1. List the 5 parts of the OSHA hazard communication standard.
2. 1. Written
3. 2. Chemical inventory
4. 3. MSDS sheets
5. 4. Container labeling
6. 5. Employee training

 

1. E. List the general protection used against chemical hazard
2. 1. Hand and eye protection
3. 2. Ventilation
4. 3. Handling and Storage
5. 4. Disposal

 

5.07   Cleaning /Pre-cleaning

 

1. A. Define cleaning/pre-cleaning.
2. 1. Cleaning/pre-cleaning: Initial removal of debris and reduction of bio-burden.

 

1. List 3 appropriate methods for cleaning instruments prior to sterilization.
2. 1. Ultrasonic cleaning
3. 2. Soaking instruments in a disinfectant solution
4. 3. Automatic washers

 

1. C. Explain 3 advantages of an ultrasonic cleaner.
2. 1. Reduced risk to operator from contact with contaminated instruments
3. 2. Penetration into difficult areas of instruments where brushes cannot reach
4. 3. Improved effectiveness in removing debris and blood from instruments

 

1. List the 4 steps for cleaning instruments manually.
2. 1. Wear heavy duty gloves, mask, and protective eyewea Dismantle instruments if parts are detachable.
3. 2. Use detergent and scrub instruments with a brush under running wate
4. 3. Brush away from the body and avoid splashing the surrounding are
5. 4. Rinse instruments thoroughly and dry on paper towel

 

5.08   Disinfection

 

1. A. Define disinf
2. 1. Disinfection: Killing or inhibiting pathogens by chemical mean Spores are not killed by disinfection.

 

1. Define the term disinfectant.
2. 1. Disinfectant: Chemicals that are applied to inanimate objects (i.e., countertops) that cannot be sterilized.

 

1. C. State the 3 types of disinfectants and their biocidal activity.
2. 1. High level inactivates all forms of bacteria, fungi, spores, and viruse
3. 2. Intermediate level inactivates all forms of microorganisms except spore
4. 3. Low level inactivates vegetative bacteria and certain viruses, but does not destroy spores, tubercle bacilli, or non-lipid viruse

 

1. List 5 properties of an ideal disinfectant.
2. 1. Broad spectrum
3. 2. Nontoxic
4. 3. Easy to use

 

4. 4. Fast acting
5. 5. Economical

 

 

1. E. Define the 4 recommended chemical disinfecta
2. 1. Chlorines
3. Sodium hypochlorite is unstable, use distilled water to improve stability b.  Economical
4. Harmful to the eyes and skin
5. 2. Glutaraldehydes
6. Solution is activated when the 2 containers are mixed b.  Not used as a surface disinfectant
7. Toxic fumes
8. d. Caustic to skin and eye
9. 3. Iodophores:
10. Broad spectrum antimicrobial
11. b. Hard water inactivates iodophores
12. Widely used for surgical scrubs and liquid soaps
13. 4. Combination phenolics
14. Used as surface disinfectants
15. b. Broad spectrum with residual biocidal activity

 

5.09   Sterilization

 

1. A. Define steriliz
2. 1. Sterilization: A process, usually by heat, by which all forms of life, including spores, are completely destroyed.

 

1. Explain the 4 approved methods for sterilization.
2. 1. Moist heat or steam under pressure: Sterilization is achieved by the action of heat and moistu Pressure is used to reach high temperatures
3. 2. Dry heat: Sterilization is achieved by heat conducted from the exterior surface to the

interior of the object.

3. 3. Chemical vapor steam: A combination of chemicals is heated under pressure which produces a gas-sterilizing agen
4. 4. Ethylene oxide: Commonly used in hosp Gaseous sterilization using ethylene oxide.

 

1. C. List 2 items that can be sterilized using dry hea
2. 1. Metal instruments in containers
3. 2. Instruments that may corrode or rust if exposed to moisture

 

1. Explain 2 advantages for using steam under pressure.
2. 1. All spores, microorganisms, and viruses are destroyed quickly.
3. 2. Economical method for sterilizing instrumen

 

1. E. List the temperatures for dry heat, steam under pressure and chemical vapor:
2. 1. Dry heat
3. 320°F for 2 hours b.  340°F for 1 hour
4. 2. Steam under pressure
5. 250°F at 15 pounds of pressure for 15 minutes and 30 minutes for heavy or large loads
6. 3. Chemical vapor
7. 260°F to 270°F at 20 to 40 pounds of pressure
8. b. Minimum of 20 minutes after the desired temperature and pressure is reached

 

1. F. Define spore testing.
2. 1. Spore testing: The only way to determine whether sterilization has occurred and to confirm that all bacteria and endospores have been killed.

 

1. Explain the frequency of spore testing. H.  Explain heat process monitoring.

 

5.10   Instrument Processing

 

1. A. List the 7 steps for instrument processing.

 

1.	Transport	5.   Storage
2.	Cleaning	6.   Delivery
3.	Packaging	7.   Quality assurance
4.	Sterilization

 

5.11   Treatment Room

 

1. A. List 6 features of an optimal treatment r
2. 1. Floor covering is easy to clean.  No carpeting in treatment room.
3. 2. Stools and dental chairs have a smooth surface that is easily disinfected.
4. 3. Water faucets should be electronic or foot-operated.
5. 4. Dental chairs are foot operated.
6. 5. Hoses are straight and removable.
7. 6. Syringes and handpieces are autoclavable.

 

1. List 4 objects that require barrier protection.
2. 1. Dental light handles
3. 2. Head rest and dental chair
4. 3. Air/water syringe
5. 4. Saliva ejector and HVE handles

 

1. C. Define the classification of surface categories for inanimate obj
2. 1. Critical: Penetrates soft tissue or bone, i.e., needles, dental instrumen Sterilize or dispose.
3. 2. Semi-critical: Touch intact mucous membranes and oral fluids, but does not penetrate, i., ultrasonic handpiece and probe. Sterilize or high level disinfectant.
4. 3. Non-critical: Does not touch mucous membrane Intermediate level of disinfection.
5. 4. Environmental surfaces: No contact with patien Intermediate to low level disinfection.

 

1. List 6 steps in cleaning and preparing the treatment room.
2. 1. Wear heavy-duty gloves and mask
3. 2. Flush handpieces
4. 3. Select appropriate disinfectant and prepare according to manufacturer
5. 4. Clean the surfaces with gauze soaked in a pre-cleaning disinfectant
6. 5. Scrub the disinfectant over the surface
7. 6. Wipe with disinfectant and leave the surfaces wet for the manufacturers’ recommended time

 

5.12   Dental Unit Water Lines

 

1. A. List 5 features of an optimal treatment r
2. 1. Use water that meets EPA standards for drinking water.
3. 2. Consult dental manufacturer for methods to maintain quality of wate
4. 3. Follow manufacturer recommendations for monitoring quality of wate
5. 4. After each patient discharge air/water 20 to 30 seconds.
6. 5. Follow manufacturer recommendations for maintenance schedule.

 

1. Methods to reduce bacterial contamination of dental unit waterlines.
2. 1. Flush waterlines for several minutes each mornin
3. 2. Use self-contained water system.
4. 3. Use periodic or continuous chemical germicide
5. 4. Use sterile water for surgery.
6. 5. Purge water from surgery lines at end of day.
7. 6. Use microfilm cartridges.
8. 7. Use current techniques and technology.
9. 8. Follow manufacturer recommendation

 

 

 

 

 

 

 

6.0   Patient Management

 

 

 

Given     information     about     utilizing     effective     communication     skills,     non-verbal communication, obtaining information and managing patient behavior.

 

 

 

 

6.01   Utilizing Effective Communication Skills

 

1. A. List 12 alternative terms to use in effective communication:
2. 1. Pull a tooth/remove a tooth
3. 2. Shot/needle/anesthetic
4. 3. Pain/hurt/ discomfort
5. 4. Plates/false teeth/dentures
6. 5. Spit/rinse your mouth
7. 6. Drugs/medication
8. 7. Filling/restoration
9. 8. Drill/prepare/handpiece
10. 9. Yeah/yes
11. 10. Cap/crown
12. 11. Operatory/treatment area
13. 12. Waiting room/reception area

 

1. List 3 rules of etiquette.
2. 1. Do not use nicknames or terms of endearment in an office settin
3. 2. Compliment and praise.
4. 3. Avoid the subjects of politics, religion, gender, ethnic, and off color jokes.

 

6.02   Non-Verbal Communication

 

1. A. Identify 4 key steps for improving telephone commu
2. 1. Smile.
3. 2. Identify the office, yourself, and ask, “How may I help you?”
4. 3. Listen and be attentive.
5. 4. Take not

 

1. Identify 7 items important to non-verbal communication.

 

1.	Good grooming versus bad grooming	5.   The effect of oral hygiene
2.	Professional hair styles	6.   Professional attire
3.	The use of fragrances and deodorants	7.   Makeup and body ornamentation
4.	The appearance of hands and nails

 

1. C. Identify 2 effects of body language and postur
2. 1. Slouching
3. 2. Crossed arms

 

1. List 2 examples of patient non-verbal cues.
2. 1. Facial expressions
3. 2. Body language

 

 

6.03   Greet the Patient

 

1. A. List 8 items included in welcoming the patient as a gu

 

1.	Greet within 30 seconds	5.   Initiate the patient orientation
2.	Survey the reception area	6.   Establish a relationship
3.	Sign in log	7.   Use the patient’s name
4.	Review the schedule	8.   Take notes

 

1. List 2 areas of common courtesy and office etiquette that should be used when talking on the phone.
2. 1. Common courtesy
3. 2. Say please and thank you

 

1. C. Identify 2 steps in introdu
2. 1. Introduce self
3. 2. Identify others by name and title

 

6.04   Obtaining Information

 

1. A. List 2 steps in obtaining information from a telephone call.
2. 1. Record all information on chart
3. 2. Record information in ink and initial

 

1. List 3 patient forms to be completed by the patient before treatment.

 

1. 1. Patient registration
2. 2. Medical/dental history

3. 3. HIPPA

 

6.05   Managing Patient Behavior

 

1. A. Identify 6 patient rig
2. 1. To be treated without discrimination
3. 2. To be informed about treatment
4. 3. To be informed about fees
5. 4. Confidentiality

 

 

 

 

5. 5. To be taught how to maintain dental health
6. 6. To refuse treatment

 

 

1. Identify 4 ways to comfort the anxious patient.

 

1. 1. Validate feelings
2. 2. Accommodate patient’s concerns
3. 3. Be positive

4. 4. Be honest (i.e., “this will pinch for just a moment,” instead of, “this won’t hurt

at all”)

 

 

1. C. Define the difference between the anxious and the phobic pati
2. 1. Anxious: Normal with enhanced feelings of concern.
3. 2. Phobic: Irrational fe

 

1. List 2 methods of treating the phobic patient.
2. 1. Behavior modification                                               2.   Hospital dentistry general anesthesia

 

1. E. List 5 steps to diffuse patient anger.
2. 1. Let the patient release ang
3. 2. Do not second-gue
4. 3. Do not respond until the patient has fully vented.
5. 4. Use the three F’s:
6. Feel b.  Felt
7. Found
8. 5. Avoid the urge to argue.

 

1. F. Identify 4 special patient management situation

 

1. 1. Elderly
2. 2. Mentally/physically challenged

3. 3. Children
4. 4. Pregnant

 

 

 

 

 

 

 

7.0   Anatomy

 

 

 

Information about head and neck anatomy, oral anatomy, and dental anatomy.

7.01   Head and Neck Anatomy

 

1. A. Locate  and  mark  5  bones  or  bony  areas  of the  face  and  skull  on the  model  or diagram provided.

 

1. 1. Calvarium (frontal, parietal, occipital bones)
2. 2. Zygoma

3. 3. Maxilla
4. 4. Mandible
5. 5. Nasal bones

 

 

1. Locate 7 landmarks of the skull on the diagram or model provided.

1.	External auditory meatus	5.   Mental foramen
2.	Nasal fossae	6.   Mandibular foramen
3.	Orbits of the eye	7.   Temporal mandibular joint (TMJ)
4.	Styloid process

 

1. C. Locate 4 sinuses on the model or diagram provided.

 

1. 1. Maxillary
2. 2. Ethmoid air cells

3. 3. Frontal
4. 4. Sphenoid

 

 

1. Locate and mark 8 muscles of mastication and facial expression.

1.	Buccinator	5.   Mentalis
2.	External pterygoid	6.   Orbicularis oris
3.	Internal pterygoid	7.   Temporal
4.	Masseter	8.   Zygomatic major

 

1. Maxillary 7.   Buccal 2. Nasopalatine 8.   Mandibular 3. Anterior palatine 9.   Lingual 4. Anterior superior alveolar 10. Mental 5. Middle superior alveolar 11. Incisive 6. Posterior superior alveolar

1. E. Identify the nerves that supply the oral cavity.

 

7.02   Oral Anatomy

 

1. A. Locate and label the landmarks of the f
2. 1. Ala of the nose
3. 2. Commissure
4. 3. Canthus of the eye

 

 

 

 

4. 4. Vermillion border
5. 5. Tragus of the ear

 

 

6. 6. Philtrum

 

 

1. Locate and label 18 structures of the oral cavity.

 

1.	Maxillary arch	10. Tongue
2.	Mandibular arch	11. Tonsillar pillars
3.	Lips	12. Tonsils
4.	Mucosa (buccal, or labial)	13. Pharyngeal walls
5.	The dental alveolus	14. Retromolar pad
6.	Gingiva, attached and free	15. Maxillary tuberosity
7.	Floor of the mouth	16. Vestibules (buccal or labial)
8.	Hard palate	17. Frenum
9.	Soft palate (rugae and incisive papilla)	18. Teeth

 

1. C. Locate 3 of the main salivary gland
2. 1. Parotid gland
3. 2. Sublingual gland
4. 3. Submandibular gland

 

1. Locate and label 3 structures of the gingiva.
2. 1. Gingival sulcus
3. 2. Gingival papilla
4. 3. Gingival margin

 

 

7.03   Dental Anatomy

 

1. A. Define the following 8 dental anatomy ter
2. 1. Primary dentition: First 20 teeth erupting as children.
3. 2. Permanent dentition 32 teeth erupting for adu
4. 3. Mixed dentition: Time when both primary and permanent teeth are presen
5. 4. Anterior: Towards the front of the mouth (cupids and incisors).
6. 5. Posterior: Towards the back (bicuspids and molars).
7. 6. Contact: Place where teeth come together and touch.
8. 7. Contour: Natural rounded shape of teeth.
9. 8. Occlusion: How teeth fit together when biting down.

 

1. Identify the 4 kinds of teeth.
2. 1. Incisors
3. 2. Cuspid/canine
4. 3. Bicuspids/premolars
5. 4. Molars

 

1. C. Locate and label the 4 parts of a tooth.
2. 1. Crown
3. 2. Root
4. 3. Neck
5. 4. Apex

 

1. Locate and label 5 tissues of a tooth.
2. 1. Enamel
3. 2. Dentin
4. 3. Pulp

 

4. 4. Cementum
5. 5. Periodontal ligament

 

 

1. E. Locate and label the 6 maxillary anterior teeth.
2. 1. Maxillary central incisors (2)
3. 2. Maxillary lateral incisors (2)
4. 3. Maxillary canines (2)

 

1. F. Locate and identify the 10 maxillary posterior t

 

1. 1. Maxillary first premolar (2)
2. 2. Maxillary second premolar (2)
3. 3. Maxillary first molar (2)

4. 4. Maxillary second molar (2)
5. 5. Maxillary third molar (2)

 

 

1. Locate and identify the 6 mandibular anterior teeth.
2. 1. Mandibular central incisors (2)
3. 2. Mandibular lateral incisors (2)
4. 3. Mandibular canine (2)

 

1. H. Locate and identify the 10 mandibular anterior teeth.

 

1. 1. Mandibular first premolar (2)
2. 2. Mandibular second premolar (2)
3. 3. Mandibular first molar (2)

4. 4. Mandibular second molar (2)
5. 5. Mandibular third molar (2)

 

1. I. Locate the 6 surfaces of a tooth.
2. 1. Mesial
3. 2. Occlusal
4. 3. Distal

 

4. 4. Buccal
5. 5. Lingual
6. 6. Facial

 

 

 

 

Intended Outcome

 

 

8.0   Dental Equipment

 

 

 

Given information about equipment identification and equipment uses, the student will be able to perform 80% of the following tasks the necessary information, instruction, and equipment the student will be able to perform 80% of the following tasks with accuracy on

the didactic examination.

 

Tasks

 

 

Number of tasks to master = 50

 

 

8.01   Equipment Identification

 

1. A. Describe 5 pieces of lab equipment.
2. 1. Lathe
3. 2. Handpiece/lab engine
4. 3. Model trimmer

 

 

 

 

4. 4. Vacuum adapter “The Machine”
5. 5. Vibrator

 

 

1. Describe 13 pieces of equipment found in the treatment room.

 

1.	Patient chair	7.   Saliva ejector
2.	Doctor and assistant stools (show	8.   Curing light
	footrest, indicate differences)	9.   Air/water syringe
3.	Treatment light	10. Rheostat/foot control
4.	Cart/console	11. Computer
5.	Handpieces (high speed/low speed)	12. Amalgamator/triturator
6.	High velocity evacuation (HVE)	13. Bleach machine

 

1. C. Identify 3 items found in the sterile ar
2. 1. Ultrasonic instrument cleaner
3. 2. Cold disinfectant/sterilant container
4. 3. Autoclaves/sterilization equipment

 

1. Identify 5 items in the radiographic area.
2. 1. Control panel
3. 2. Conventional or intraoral x-ray head
4. 3. Lead apron-thyroid x-ray head

 

4. 4. Automatic processor-daylight
5. 5. Extraoral equipment

 

8.02   Equipment Uses

 

1. A. Give the uses of 5 lab equipment items.
2. 1. Lathe: Polishes and grinds appliance
3. 2. Handpiece/lab engine: Trims and smooth smaller items outside the mouth.
4. 3. Model trimmer: Trims plaster and stone mode
5. 4. Vacuum adapter: Heats and adapts a variety of plastics to models, i.e., bleaching trays, mouth guard
6. 5. Vibrator: Used in pouring models to remove bubbles from mix and aid in pouring.

 

1. Give the uses of 12 treatment room items of equipment.
2. 1. Patient chair: Provides support and supine-seating for the patien
3. 2. Stools
4. Doctor stool: Provides adjustable seating for the operator while performing dental treatment.
5. b. Assistant stool: Provides adjustable seating for the assistant while assisting in dental treatmen
6. 3. Treatment light: Provides illumination during dental treatmen
7. 4. Cart/console: Provides support supplies and easy access to equipmen
8. 5. Handpieces: Rotary instruments that are used intra-orally to cut and polish (see dental instruments).
9. 6. High velocity evacuation: Assistant controlled device that removes fluids and reduces aerosols (show tips).
10. 7. Saliva ejector: Low volume device for removing oral fluids (show tips).
11. 8. Curing light: Sets selected acrylic mate
12. 9. Air/water syringe: Provides air/water spray.
13. 10. Rheostat-foot control: Controls the rotary handpieces.
14. 11. Computer: Used chairside to record and transmit d
15. 12. Amalgamator/triturator: Mixes amalgam filling materi

 

1. C. Give the uses for 3 sterile area items.
2. 1. Ultrasonic instrument cleaner: Removes debris from contaminated instruments
3. 2. Cold disinfectant/sterilant container: Liquid for non-autoclavable item
4. 3. Autoclaves/sterilization equipment: Sterilizes equipment and instrumen

 

1. Give the uses of 5 pieces of radiographic equipment.
2. 1. Control panel: Controls x-ray production.
3. 2. Conventional or intraoral x-ray head: Produces and directs x-ray
4. 3. Lead apron: Provides patient protection during radiograph
5. 4. Automatic processor: Processes x-ray film.
6. 5. Extraoral x-ray equipment: Takes x-rays outside the mouth.

 

 

 

9.0   Dental Instruments and Procedures

 

Intended Outcome

 

Given information about hand/rotary instruments and dental procedures, the student will be able to perform 80% of the following tasks with accuracy on the didactic examination.

 

Tasks

 

 

Number of tasks to master = 121

 

9.01   A.	Hand Instruments   Define the term “hand instrument”.
B.	Identify 4 components of hand instruments.
	1.   Handle/shaft	3.	Blade
	2.   Shank	4.	Double-ended instruments
C.	Identify 6 basic tray setup instruments.
	1.   Mouth mirror	4.	Saliva ejector/high-volume evacuator
	2.   Explorer	5.	3-way syringe tip
	3.   Cotton pliers	6.	2×2
D.	Identify 17 restorative instruments.
	1.   Excavator/spoon excavator	10.	Matrix band
	2.   Discoid-cleoid carver	11.	Tofflemire/matrix retainer
	3.   Hollenback carver	12.	Wedge
	4.   Amalgam well	13.	Articulating paper
	5.   Amalgam carrier	14.	Articulating paper forceps
	6.   Amalgam condenser/plugger	15.	Cord packer
	7.   Plastic composite instrument	16.	Hand cutting instruments
	8.   Burnisher 9.   Mixing spatula	17.	Decay locator

 

1. E. Identify 6 instruments of a rubber dam procedure.

 

1. 1. Dental dam material
2. 2. Dental dam frame
3. 3. Dental dam hole punch

4. 4. Dental dam clamp forceps
5. 5. Dental dam clamps
6. 6. Floss

 

1. F. Discuss 5 periodontal instru
2. 1. Periodontal probe
3. 2. Curette
4. 3. Ultrasonic scaler

 

4. 4. Scalers
5. 5. Periodontal knives

 

 

1. Identify 15 endodontic instruments.

 

1.	Gates glidden	9.   Endodontic explorer
2.	Barbed broach	10. Endodontic condenser
3.	Endodontic files	11. Endodontic excavator
4.	Endodontic syringe	12. Millimeter measure
5.	Paper points	13. Rubber stoppers
6.	Gutta-percha	14. Pulp tester
7.	Lentulo spirals	15. Apex locator
8.	Endodontic spreader

 

1. H. Identify 16 oral surgery instru

 

1.	Elevator	9.   Needle holder
2.	Forceps	10. Surgical scissors
3.	Surgical curette	11. Tissue retractors
4.	Rongeur	12. Surgical aspirator
5.	Bone file	13. Sutures
6.	Bard-Parker handle	14. Bite blocks/mouth prop
7.	Blade	15. Surgical chisel and mallet
8.	Hemostat	16. Surgical hand piece/burs

 

9.02   Rotary Instruments

 

1. A. Identify 5 uses of rotary instru

 

	1.   Cavity preparations 2.   Removing defective restorations 3.   Crown preparations	4.   Polishing teeth 5.   Polishing and finishing restorations
B.	Identify 3 parts of a dental bur.
	1.   Shank 2.   Neck	3.   Head
C.	Identify 3 types of dental burs.
	1.   Carbide 2.   Diamond stones	3.   Steel burs
D.	Identify the different rotary instruments
	1.   Round 2.   Inverted cone 3.   Fissures 4.   Points 5.   Stones	6.   Mandrel 7.   Rubber wheel 8.   Rubber cup 9.   Discs

 

 

1. E. Identify 2 styles of dental handp
2. 1. High speed
3. 2. Low speed attachments a.    Contra-angle
4. b. Prophy-angle c.    Straight

 

1. F. Discuss handpiece placement and remov

 

1. Describe  dental  handpiece  maintenance  and  sterilization  as  per  manufacturers’

recommendations.

 

 

9.03   Dental Procedures

 

1. A. List 10 common dental procedur
2. 1. Exam
3. 2. Prophylaxis, non-surgical periodontal therapy
4. 3. Amalgam
5. 4. Composite
6. 5. Simple extraction
7. 6. Endodontic
8. 7. Crown and bridge preparation
9. 8. Crown and bridge cementation
10. 9. Implants
11. 10. Bleach

 

 

9.04   Lab Procedures

 

1. A. Define the following laboratory procedures:
2. 1. Fabricate diagnostic casts
3. 2. Trimming diagnostic casts
4. 3. Debride and polish fixed and removable appliances and prosthesis;
5. 4. Splints
6. 5. Fabricate custom impression trays, mouth/athletic guards, bleaching trays, acrylic temps, etc.

 

 

 

 

Intended Outcome

 

 

10.0 Clinical Records

 

 

 

Given   information   about   medical/dental   histories,   recording   dental   treatment   and dental/radiographic chartings, the student will be able to perform 80% of the following

tasks on the didactic examination.

 

Tasks

 

 

Number of tasks to master = 84

 

 

10.01 Medical History

 

1. A. List 6 purposes for obtaining a medical history from every p
2. 1. Provides information relevant to the etiology and diagnosis of oral condition
3. 2. Used in treatment planni
4. 3. Reveals conditions, diseases, and drug therapy or reactions that may change treatmen
5. 4. Provides insight into the emotional and/or psychological factors and attitudes that may affect patient care.
6. 5. Provides baseline documentation for comparison at future appointmen
7. 6. Provides a basis for legal evidence should treatment ever be called into question.

 

1. Describe  6  conditions  that  may  limit  the  ability  of  dental  personnel  to  gather required information from patients.
2. 1. Some patients either cannot or choose not to provide correct information when answering

questions.

2. 2. Language barriers or comprehension may limit the information obtained.
3. 3. If there is a lack of privacy where the information is requested, the patient may be less than hone
4. 4. If the patient does not see the relevance between certain diseases or conditions and dental treatment, information may be withheld.
5. 5. Medical conditions may be embarrassing to report.
6. 6. The patient may be fearful of having dental treatment refused.

 

1. C. List 5 factors that must be explained to the pati
2. 1. The need for obtaining and keeping an up-to-date medical history.
3. 2. Assurance that the information obtained will be kept in strict confidence.
4. 3. The relationship between general health and oral health.
5. 4. The relationship between medical health and dental care.
6. 5. The importance of following instructions on pre-medications, preventive dental care, and regular medical and dental care.

 

1. List the 5 components of the medical history that must be verified.
2. 1. Recordings must be made in ink
3. 2. Accuracy of all dates
4. 3. Confirm all information
5. 4. Medical alert codes
6. 5. Patient signature verifying accuracy of all information

 

 

10.02 Dental History

 

1. A. List 8 components of the dental history required.
2. 1. Any immediate problem, discomfort, or pain reported by the patien
3. 2. Information about previous restorative, preventive and specialty dental care.
4. 3. Attitudes regarding oral health.
5. 4. Information about personal daily oral care.
6. 5. Anesthetic history.
7. 6. Medical and dental radiation history and current medication
8. 7. History of oral or facial injuries, past medical and dental procedure
9. 8. Oral hab

 

10.03 Dental Charting and the Dental Exam

 

1. A. List the 9 parts of the dental exam.

 

1.	Radiographs	6.   TMJ evaluation
2.	Diagnostic models	7.   Photography
3.	Oral examination	8.   Intra-oral imaging
4.	Periodontal examination	9.   Patients chief complaint
5.	Examination of the teeth

 

1. Identify 6 purposes of dental charting.
2. 1. Provides a graphic representation of existing conditions
3. 2. An assessment tool used to develop a patient treatment plan
4. 3. Used during treatment to guide procedures performed
5. 4. Evaluate treatment by comparing initial data with follow-up findings
6. 5. Provides realistic evidence for legal documentation
7. 6. Used in forensic investigations and/or identification

 

1. C. Identify Black’s Classification of Cavities

 

1.	Class I	4.	Class IV
2.	Class II	5.	Class V
3.	Class III	6.	Class VI

 

1. Identify 2 types of tooth diagrams.
2. 1. Anatomical
3. 2. Geometric

 

1. E. Identify the universal tooth numbering system for teeth.
2. 1. Universal
3. 2. Palmer
4. 3. FDI/ISO

 

1. F. Identify 7 dental conditions that are evaluated clinically by the dentist or dental hygienist and recorded on the dental char
2. 1. Missing teeth
3. 2. Teeth indicated for extraction
4. 3. Occlusal caries
5. 4. Mal-positioned teeth
6. 5. Existing restorations (i.e., amalgam, composite, gold)
7. 6. Sealants
8. 7. Appliances

 

1. Identify 11 dental conditions to be charted from radiographs.

 

1.	Missing teeth	7.   Retained root tips
2.	Unerupted teeth	8.   Proximal carious lesions
3.	Impacted teeth	9.   Recurrent carious lesions
4.	Endodontic restorations	10. Bone loss
5.	Periapical abscesses	11. Other deviations from normal
6.	Retained primary teeth

 

1. H. Identify 6 tooth surfaces where periodontal pocket readings are recorded on the

periodontal chart.

 

1.	Distofacial	4.	Distolingual
2.	Facial	5.	Lingual
3.	Mesiofacial	6.	Mesiolingual

 

10.04 Recording Dental Treatment

 

1. A. Record all pertinent infor

 

 

 

 

 

1. Record in ink 5. Types of materials used 2. One entry per line 6. Clear and concise 3. Anesthetic used 7. Sign/initial and date 4. Tooth treated 8. Proper correction meth

ods

 

 

 

 

Intended Outcome

 

 

11.0 Oral Pathology

 

 

 

Given information about dental caries; attrition, abrasion, and soft tissue pathology the student will be able to perform 80% of the following tasks with accuracy on the didactic

examination.

 

Tasks

 

 

Number of tasks to master = 95

 

 

11.01 Dental Caries

 

1. A. Define Car
2. 1. Caries: Tooth decay.

 

1. Identify 3 primary factors present to cause caries.
2. 1. Susceptible tooth
3. 2. Fermentable carbohydrate diet
4. 3. Specific bacteria (i.e., Streptococcus Mutans and Lactobacilli)

 

1. C. List 4 contributing factors of car
2. 1. Diet
3. 2. Oral hygiene

 

3. 3. Immune system
4. 4. Personal habits

 

 

1. List stages of caries development.
2. 1. Incipient
3. 2. Cavitation
4. Rampant b.  Recurrent c.    Root caries

 

1. E. List 4 subcomponents of personal habits that contribute to caries for

 

1. 1. Tobacco
2. 2. Alcohol

 

1. List 6 cavity Classifications for caries.

Class I          Pit and fissures

Class II         Interproximal posterior

Class III        Interproximal anterior

3. 3. Frequency of sugary drinks
4. 4. Frequency of gum/candy

Class IV        Interproximal including

incisal edge anterior

Class V         Smooth surface

Class VI        Occlusal wear (abbrasions)

 

11.02 Periodontal Disease

 

A.	Define the 2 types of periodontal disease. 1.   Gingivitis	2.	Periodontitis
B.	List the 6 structures of the periodontum.
	1.   Gingiva	4.	Periodontal ligaments
	2.   Epithelial attachment	5.	Cementum
	3.   Sulcus	6.	Alveolar bone

 

1. C. List systemic risk that may increase susceptibility to periodontal d

 

1. 1. Cardiovascular disease
2. 2. Respiratory disease

3. 3. Diabetes

 

 

1. Define Necrotizing Ulcerative Gingivitis/Periodontitis.

 

1. E. Define a periodontal pock
2. 1. Periodontal pocket: The disease causing the normal gingival sulcus to become deeper than normal forming a pocke Periodontal depths greater or equal to 4mm.

 

1. F. List 2 causes of periodontal d
2. 1. Dental plaque                                                             2.   Calculus

 

 

11.03 Attrition, Abrasion, and Erosion

 

1. A. Define attrition.
2. 1. Attrition: Normal wearing-away of tooth structure

 

1. Identify the two primary cause of attrition.
2. 1. Parafunctional habits                                                2.   Occurs with age

 

1. C. Define abr
2. 1. Abrasion: The abnormal wearing-away of tooth structure.

 

1. List 3 causes of abrasion.
2. 1. Abrasive dentifrice
3. 2. Improper tooth brushing technique

 

3. 3. Use of a hard toothbrush

 

 

1. E. List the primary cause of er
2. 1. Prolonged contact of acid with the tooth structure

 

1. F. List 2 situations where prolonged acid contact may occur.
2. 1. Bulimia                                                                         2.   Citrus habits

 

11.04 Soft Tissue Pathology

 

1. A. Identify 5 conditions of the tongu
2. 1. Black hairy tongue
3. 2. Geographic tongue
4. 3. Fissured tongue

 

 

 

 

4. 4. Glossitis
5. 5. Pernicious anemia

 

 

1. Identify 6 white lesions of the mouth.
2. 1. Candidiasis (can appear white or as red patches)
3. 2. Benign hyperkeratosis (leukoplakia)
4. 3. Stomatitis nicotina (irritation from smoking)
5. 4. Chemical burn (aspirin burn)
6. 5. Trauma
7. 6. Lichen planus

 

1. C. Identify 3 oral lesions of the mouth.
2. 1. Secondary herpetic lesion
3. 2. Apthous ulcer
4. 3. Mucocele

 

1. Identify 8 conditions of the mouth.

 

1.	Xerostomia	5.	Papilloma
2.	Torus (exostosis)	6.	Abscess (periapical or periodontal)
3.	Irritation fibroma	7.	Angular chelitis
4.	Cyst	8.	Cellulitis

 

1. E. Identify 9 development abnormalities in the mouth.

 

1.	Cleft palate/lip	6.   Macro/micro dontia
2.	Super numerary	7.   Ameliogenesis imperfecta
3.	Enamel dysplasia	8.   Dens in dente
4.	Ankylosis	9.   Fusion
5.	Ankylglossia

 

1. F. Identify other cond
2. 1. Piercings
3. 2. Drug use, i., meth mouth

 

1. Identify possible oral manifestations associated with HIV/AIDS

 

1.	HIV gingivitis	6.   Hairy leukoplakia
2.	HIV periodontitis	7.   Kaposi’s sarcoma
3.	Cervical lymphadenopathy	8.   HPV lesions
4.	Candidiasis	9.   Herpes lesions
5.	Lymphoma

 

 

1. H. Identify 3 things that increase risk of oral cancer.
2. 1. Tobacco use
3. 2. Alcohol use
4. 3. HPV

 

1. I. Identify 3 types of oral cancer.
2. 1. Carcinoma
3. 2. Sarcoma
4. 3. Leukemia

 

1. J. Identify 3 implications following cancer treatm
2. 1. Xerostomia
3. 2. Osteonecrosis
4. 3. Radiation caries due to xerostomia

 

 

 

 

Intended Outcome

 

 

12.0 Emergency Care

 

 

 

Given  information  about  medical  emergencies  the  student  will  perform  80%  of  the

following tasks with accuracy on the didactic exam.

 

Tasks

 

 

Number of tasks to master = 62

 

 

12.01 Medical Emergency Care

 

1. A. List 4 vital sig
2. 1. Temperature
3. 2. Blood pressure
4. 3. Pulse
5. 4. Respiration

 

1. List 4 aspects of blood pressure.
2. 1. Normal range 90-140/60-90
3. 2. Recommended technique to obtain blood pressure
4. 3. Define systolic versus diastolic
5. 4. Health risks associated with high or low blood pressure in dentistry

 

1. C. List normal range of heart rate (pulse) in adults as 60-100

 

1. List 3 aspects of respiration rate
2. 1. Normal range for adults is 12-20
3. 2. Methods for obtaining a reading
4. 3. Hyperventilation

 

1. E. List 2 methods to obtain a temperatur
2. 1. Oral
3. 2. Tympanic

 

1. F. Describe 5 ways to prevent emerg
2. 1. Obtain current and complete medical history.
3. 2. All dental personnel are competent in DANBY accepted CPR/AED course, abdominal thrusts, and first aid.
4. 3. Assess patient during treatmen
5. 4. Have an office emergency plan.
6. 5. Have emergency equipment ready.

 

1. Identify 4 parts of the emergency preparedness plan.
2. 1. Assigned roles
3. 2. Routine drills
4. 3. Emergency telephone numbers
5. 4. Emergency supplies

 

1. H. Identify 5 signs of an impending emergency.
2. 1. Change in patient breathing
3. 2. Change in patient level of consciousness
4. 3. Change in patient skin color
5. 4. Change in patient skin temperature
6. 5. Change in patient behavior

 

1. I. Identify the sequence of action for performing CA
2. 1. Compression
3. 2. Airway
4. 3. Breathing
5. 4. Defibrillation as soon as available

 

1. J. Identify 3 signs that indicate it may be necessary to perform abdominal thru
2. 1. The victim indicates they are choking
3. 2. The victim cannot cough
4. 3. The victim cannot breathe

 

 

12.02 Medical Emergencies

 

1. A. Identify 7 possible emergency situ
2. 1. Allergic reaction
3. 2. Blood loss
4. 3. Cardiovascular or cerebrovascular irregularities
5. 4. Emergencies by metabolic or neurological disease
6. 5. Respiratory irregularities and obstructions
7. 6. Shock
8. 7. Transient unconsciousness
9. Recognize signs and symptoms for medical emergencies. C.   List emergency equipment and supplies.
10. 1. Oxygen tank and mask
11. 2. Medical emergency drug kit
12. 3. AED

 

1. Explain emergency responses.

 

1. E. Describe documentation of emergency.
2. 1. Date
3. 2. Location
4. 3. Signs and symptoms
5. 4. Treatment

 

1. F. Identify 2 most common emergencies in the dental off
2. 1. Syncope
3. 2. Postural hypotension

 

 

12.03 Dental Emergency Care

 

1. A. List 4 steps in responding to an avulsed tooth that will assist in replant
2. 1. Recover tooth
3. 2. Gently rinse, do not scrub
4. 3. Wrap in moist gauze
5. 4. Go immediately to a dental office

 

1. List 3 situations when a patient has fractured a tooth and must be treated in a dental office as soon as possible.
2. 1. There is blood present that appears to be coming from the tooth
3. 2. When the tooth is displaced
4. 3. When you are unable to calm the patient

 

1. C. List 4 recommendations for patients experiencing minor dental p
2. 1. Take an over the counter analgesic
3. 2. Place oil of clove for an open cavity
4. 3. Alternate ice and heat packs 15 minutes on and 15 minutes off
5. 4. Rinse with warm salt water for soft tissue pain

 

 

 

 

Intended Outcome

 

 

13.0 Dental Anesthesia

 

 

 

Given information about dental anesthesia, principles of anesthesia and drug interactions

the student will perform 80% of the following tasks with accuracy on the didactic exam.

 

Tasks

 

 

Number of tasks to master = 78

 

 

13.01 Dental Anesthesia Terminology

 

1. A. Identify the following terms as they apply to dental anesthet

 

1.	Anesthetic	9.   Local anesthetic
2.	Analgesic	10. Nitrous oxide
3.	Medical history	11. Dental syringe
4.	Contraindication	12. Needle gauge
5.	Epinephrine	13. Lumen
6.	Infiltration anesthetic	14. Diffusion
7.	Block anesthetic	15. Vasoconstrictor
8.	Topical anesthetic	16. Anaphylaxis

 

13.02 Dental Anesthesia

 

1. A. Identify the most commonly used application methods for pain and anxiety in the dental off

 

1.	Topical	5.   Sedation
2.	Local	6.   General
3.	Nitrous oxide	7.   IV- conscious
4.	Anti-anxiety medications	8.   General anesthesia

 

1. Identify 5 important reasons for checking a patients’ medical history as it relates to dental anesthesia.
2. 1. Informs staff of patients physical conditions
3. 2. Chronic conditions
4. 3. Allergies
5. 4. Medications the patient is taking
6. 5. Contraindications for dental anesthetics and nitrous oxide

 

1. C. Identify 6 health conditions that can effect anesthetic choice.

 

1. 1. Hypertension
2. 2. Cardiovascular disease
3. 3. Hyperthyroidism

4. 4. Liver disease
5. 5. Kidney disease
6. 6. Pregnancy

 

1. Identify the parts of a dental syringe.
2. 1. Thumb ring
3. 2. Barrel
4. 3. Piston rod/harpoon

 

4. 4. Threaded tip
5. 5. Finger grip

 

 

1. E. Identify 4 parts of the dental anesthetic need

 

1. 1. Plastic housing for needle
2. 2. Needle hub

3. 3. Injection end with beveled tip
4. 4. Cartridge end of needle

 

 

1. F. Identify the 2 most common needle lengths and gaug
2. 1. 1 inch: 30 gauge short needle for infiltrations
3. 2. 1 and 5/8 inch: 27 gauge long needle for blocks

 

1. Identify the 4 parts of anesthetic carpule.
2. 1. Rubber stopper
3. 2. Glass cartridge
4. 3. Aluminum cap with rubber diaphragm
5. 4. Mylar band with color-coded strip for identification of type of anesthetic manufacturer and expiration date

 

1. H. List the 6 items needed for giving a local anesthetic injec

 

1.	Topical anesthetic	4.	Needle shield
2.	Sterile cotton tip applicator	5.	Sterile anesthetic syringe
3.	Sterile 2×2 gauze sponges	6.	Anesthetic carpule

 

1. I. List in order the 4 steps for topical anesthetic site preparation and delivery.
2. 1. Place a small amount of topical on a cotton tip applicator
3. 2. Dry the proposed site with sterile 2×2 gauze
4. 3. Place the topical on site for approximately 2 to 5 minutes
5. 4. Remove the cotton tip and discard in designated receptacle

 

1. J. List the 7 steps in loading an anesthetic syringe without the need
2. 1. Select anesthetic indicated by the dentist and patient’s health history.
3. 2. Hold the syringe in one hand and use thumb ring to pull back the plunger for insertion of the carpu
4. 3. With the other hand load the carpule in the syringe barrel opening, the stopper end goes in first toward the harpoon.
5. 4. Release the thumb ring and allow the harpoon to engage in the rubber stoppe

 

5. 5. Use the other hand to apply firm pressure or a gentle tapping on the thumb ring to engage the harpoon into the rubber stoppe
6. 6. Check to make sure the harpoon is securely engaged in the stoppe
7. 7. Gently pull back on the plunger to make sure the dentist can aspirate the anesthetic during injection

 

1. List the 5 steps for attaching the needle to the anesthetic syringe.
2. 1. Break the seal on the needle and remove the protective cap.
3. 2. Carefully align the insertion end of the needle and screw the hub onto the dental syringe.
4. 3. Expel a small amount of anesthetic to confirm engagemen
5. 4. Gently pull back on the thumb ring to confirm aspiration.
6. 5. Place the re-capped syringe on the tray, ready for use, and out of patient sigh

 

1. L. List 5 steps for safely passing the anesthetic syringe to the d
2. 1. Loosen the needle guard.
3. 2. Check the needle guard for stability.
4. 3. Place the thumb ring over the dentist’s thumb. At the same time rotate the syringe barrel so the glass carpule is in full view for the dentis
5. 4. Gently, carefully, and smoothly remove the loosened needle guard as the dentist takes the

syringe.

5. 5. Put the needle guard in the holde After injection the dentist will put the used syringe into the holder to safely re-cap the needle.

 

1. M. List the 2 necessary steps needed for re-capping and discarding used anesthetic need
2. 1. The dental assistant, hygienist, or dentist may recap the needle only by use of a needle

guard or a one handed scoop. This is usually completed by the dentist for employee protection as required by OSHA regulations.

2. 2. The used anesthetic needle must be discarded in the sharps containe

 

 

 

 

Intended Outcome

 

 

14.0 Chairside Assisting

 

 

 

Given  information  about  dental  ergonomics,  principles  of  four  handed  dentistry  and maintaining a clear operating field the student will perform 80% of the following tasks

with accuracy on the didactic exam.

 

Tasks

 

 

Number of tasks to master = 66

 

 

14.01 Dental Ergonomics

 

1. A. Define the 5 classifications of
2. 1. Class I: Movement of the fingers only, as when picking up a cotton ro
3. 2. Class II: Fingers and wrist motion, as used when transferring an instrument to the operato
4. 3. Class III: Fingers, wrist, and elbow motion, as when reaching for a handpiece.
5. 4. Class IV: Movement of the entire arm and shoulder, as when reaching into a supply tub or containe
6. 5. Class V: Movement of the entire torso, as when turning around to reach for equipment from a side or split delivery un

 

1. List the 4 zones of activity.
2. 1. Operator’s zone
3. 2. Assistant’s zone
4. 3. Transfer zone
5. 4. Static zone

 

1. C. Describe the activities of the above 4 z
2. 1. Operator’s zone: Where the operator is positioned to access the oral cavity and have the best visibility.
3. 2. Assistant’s zone: Where the assistant is positioned to easily assist the dentist and have

access to instruments, the evacuator, etc., on the dental unit or cart without interference.

3. 3. Transfer zone: Where instruments and materials are passed and received.
4. 4. Static zone: Where rear delivery systems, dental instruments, mobile cart, and equipment can be found.

 

1. Using the face of a clock, define each zone of activity for the right-handed dentist.
2. 1. Operator: 7 o’clock to 12 o’clock
3. 2. Static: 12 o’clock to 2 o’clock
4. 3. Assistant: 2 o’clock to 4 o’clock
5. 4. Transfer: 4 o’clock to 7 o’clock

 

1. E. Using the face of a clock, define each zone of activity for the left-handed d
2. 1. Operator: 12 o’clock to 5 o’clock
3. 2. Transfer: 5 o’clock to 8 o’clock
4. 3. Assistant: 8 o’clock to 10 o’clock
5. 4. Static: 10 o’clock to 12 o’clock

 

1. F. Define the 3 commonly used patient positions in general dentistry.
2. 1. Upright position: The back of the chair is upright at a 90° ang This position is used for patient entry and dismissal and while taking radiographs or impressions.
3. 2. Supine position: The back of the chair is lowered back until the patient’s head and knees are at the same plan Most dental treatment takes place in the supine position.
4. 3. Subsupine position: The back of the chair is lowered until the patient’s head is lower than the fe This position is only recommended in emergency situations.

 

1. Describe 4 criteria for positioning the operator.
2. 1. Back straight, feet on the floor, and thighs angled so that the knees are slightly lower than hip leve
3. 2. Elbows close to the sides with shoulders relaxed.
4. 3. Patient’s oral cavity should be at elbow heigh
5. 4. The operator should be facing forward with eyes focused downward.

 

1. H. Describe 4 criteria for positioning the dental as
2. 1. Back straight with eye level approximately 4 to 6 inches higher than the operato
3. 2. Torso centered on the stool with the stool as close to the patient as possib
4. 3. Feet positioned on the ring or platform near the base of the stoo
5. 4. The assistant’s body is facing toward the patient’s head with hips and thighs level to the floor and parallel to the patient’s shoulde

 

14.02 Principles of Four-Handed Dentistry

 

1. A. Define four-handed or sit-down dentistry.
2. 1. The dentist and dental assistant are working together at the dental chair in an effort to provide a smooth and efficient transfer of instruments and materials during patient procedure

 

1. List 3 benefits of fourhanded dentistry.
2. 1. Increased patient comfort and safety
3. 2. Decreased stress and fatigue for the operator and assistant
4. 3. Increased production with decreased chair time

 

1. C. List 6 general rules of transferring instru
2. 1. Pass with the left hand for right handed operato
3. 2. Never pass instruments over the patient’s face.
4. 3. Avoid moving the operator’s hand and eyes from the working site.
5. 4. Always wait for a signal from the operator before exchanging instruments.
6. 5. Keep the passing zone close to the face, a few inches below the ch
7. 6. Pass the instrument in the position of use.

 

1. Define the 3 types of instrument grasps.
2. 1. Pen grasp: The instrument is held in the same manner as a pen.
3. 2. Palm grasp: The instrument is held in the palm of the hand.
4. 3. Palm-thumb grasp: The instrument is held in the palm of the hand and the thumb is used to stabilize the instrumen

 

1. E. Define the 2 most commonly used types of instrument transfer
2. 1. One-handed transfer: The assistant passes and receives the instrument with one hand allowing for the use of the evacuator or the air/water syringe at the same tim
3. 2. Two-handed transfer: The assistant uses both hands for the transfer, one to pass and the

other to receive.

 

14.03 Maintaining a Clear Operating Field

 

1. A. List 6 responsibilities the dental assistant has in maintaining a clear operating field.
2. 1. Adjust the dental light so the light shines directly on the area where the operator is working.
3. 2. Use retraction techniques to keep tissues out of the operator’s way.
4. 3. Use evacuator to remove water, saliva, and debris from the patient’s mouth.
5. 4. Keep the operator’s mirror clear during treatmen
6. 5. Rinse and dry the area where the operator is workin
7. 6. Help keep the patient’s mouth open during the treatmen

 

1. Identify 2 evacuation methods.
2. 1. Saliva ejector
3. 2. High volume evacuator (HVE)

 

1. C. List 3 isolation techniqu
2. 1. Cotton rolls
3. 2. Dry-angles and other related aids
4. 3. Dental (rubber) dam

 

1. List 2 grasps that an oral evacuator may be held in.
2. 1. Palm-thumb grasp
3. 2. Pen grasp

 

1. E. Describe 10 guidelines for oral evacuation tip p
2. 1. Hold evacuator tip in right hand for right handed operato
3. 2. Carefully place the evacuator tip in the patient’s mouth. Avoid bumping the teeth, lips, or gingiv
4. 3. Place the evacuator tip approximately one tooth distal to the tooth being worked on.
5. 4. Hold the bevel of the evacuator tip parallel to the buccal or lingual surface of the tooth.
6. 5. The middle of the evacuator tip opening should be even with the occlusal surface and held still so that it does not draw the water coolant away from the bu
7. 6. Keep the evacuator tip far enough away from the mucosal tissue to prevent it from being

sucked into the tip.

7. 7. Place the evacuator tip approximately one tooth distal to the tooth being worked on.
8. 8. Hold the bevel of the evacuator tip parallel to the buccal or lingual surface of the tooth.
9. 9. The middle of the evacuator tip opening should be even with the occlusal surface and held still so that it does not draw the water coolant away from the bu
10. 10. Keep the evacuator tip far enough away from the mucosal tissue to prevent it from being sucked into the tip.

 

 

 

 

Intended Outcome

 

 

15.0 Dental Materials

 

 

 

Given information about the properties and different classifications of dental materials, the student will be able to perform 80% of the following tasks with accuracy on the didactic

examination.

 

Tasks

 

 

Number of tasks to master = 77

 

 

15.01 Properties and Classification of Dental Materials

 

1. A. List  the  4  properties  a  dental  material  must  display  to  be  used  successfully  to restore oral structur
2. 1. Durability
3. 2. Corrosion resistance
4. 3. Non-toxicity
5. 4. Bio-compatibility

 

1. List and define the 3 properties of dental materials listed below which are evaluated to determine the materials suitability for use in the mouth.
2. 1. Stress: The force, per unit body, within a body that resists an external for
3. 2. Strain: The distortion within a body that results from an applied force.
4. 3. Strength: The maximum stress required to fracture a structu

 

1. C. List 6 classifications of dental mater
2. 1. Metals
3. 2. Resins
4. 3. Impression materials
5. 4. Gypsums
6. 5. Cements and liners
7. 6. Porcelain and ceramics

 

15.02 Metals in Dentistry

 

1. A. List 4 uses of metals in dentistry.
2. 1. Crowns and bridge restorations
3. 2. Partial dentures
4. 3. Implants
5. 4. Amalgam restorations

 

1. Explain 6 important information points about amalgam.
2. 1. Amalgam is the most common and widely used dental restorative worldwide.
3. 2. The American Dental Association and various independent agencies have studied the mercury in amalgam and reported no adverse effe
4. 3. Mercury is needed to make the material into a paste form, which allows it to be placed into the tooth preparation.
5. 4. The mercury is lost during condensation into the tooth and over the life of the restoration as mercury vapo Use no touch technique.
6. 5. Amalgam breaks down by corrosion over time requiring replacemen
7. 6. Amalgam is an unusual alloy composed of silver, tin, copper, and mercury.

 

 

15.03 Resins and Bonding in Dentistry

 

1. A. List and define 4 types of dental r
2. 1. Acrylic resins: Primarily used for denture bases and provisional (temporary) crown and bridge restoration.
3. 2. Composite resins: Primarily used for restorations and cemen
4. 3. Glass ionomers: Used as cements, liners, bases, and restoration
5. 4. Compomers: A combination of glass ionomer and composite that is used primarily as a restorative, particularly for pediatric dentistry because it inherently releases fluoride to the tooth structure once it is placed.

 

1. List the 2 types of bonds that occur in the resin-to-tooth bond.
2. 1. Mechanical
3. 2. Chemical

 

1. C. Explain why phosphoric acid is used to etch the surface of the enamel and d
2. 1. This creates micro-crevasses that the liquid of the bonding agent enters into. When the bonding agent is set, it becomes a tiny finger that grabs onto microporosities and fissures in the tooth surface, increasing the mechanical bond.

 

1. Explain when the chemical bond occurs.
2. 1. When the etchant breaks down the enamel and dentin exposing the organic component of the structure. These are primarily collagen fibe The bonding agent has a chemical affinity to collagen, so it attaches to it.

 

15.04 Impression Materials in Dentistry

 

1. A. Explain how to prepare, mix and deliver 3 major types of impression mater
2. 1. Wax
3. 2. Hydrocolloid
4. 3. Elastomer

 

1. Explain the purpose of wax as an impression material.
2. 1. To take bite registrations

 

1. C. List 2 forms of hydrocolloid impression material and state their u
2. 1. Reversible: Crown and bridge impressions
3. 2. Irreversible (alginate): Study model impressions

 

1. List the 4 forms of elastomeric impression materials.
2. 1. Polysulfide
3. 2. Polyether
4. 3. Addition reaction silicone, polyvinyl siloxane or vinyl polysiloxane (most commonly used)
5. 4. Condensation reaction silicone

 

15.05 Gypsums Materials in Dentistry

 

1. A. Regarding gypsum materials, explain what will happen if the water-to-powder ratio varies from optimu
2. 1. The plaster will weaken
3. 2. The mixing and set time will change

 

1. Describe  gypsum  products  according  to  ADA  Spec  #,  traditional  name,  liquid powder ratio and uses.

 

 

ADA Spec #	Traditional Name	Liquid/Powder Ratio	Uses
Type I	Impression plaster	60 ml water/ 100 grams powder	Impressions Not used anymore
Type II	Lab or model plaster	50 ml water/ 100 grams powder	Study models
Type III	Dental stone	30 ml water/ 100 grams powder	Working models to build appliances
Type IV	Die stone or improved dental stone	24 ml water/ 100 grams powder	Die models
Type V	High strength, high expansion dental stone	18-22 ml water/ 100 grams powder	Models for partial framework

 

 

 

15.06 Cements and Liners in Dentistry

 

1. A. Identify 2 liners/var
2. 1. Calcium hydroxide
3. 2. Cavity varnish

 

1. List 4 uses of cements.
2. 1. Permanent luting /cementation
3. 2. Temporary luting / cementation
4. 3. Temporary fillings
5. 4. Base fillings

 

1. C. Identify 5 types of dental cements.
2. 1. Glass ionomer
3. 2. Zinc phosphate
4. 3. Polycarboxylate
5. 4. Zinc oxide eugenol
6. 5. Composite resin

 

1. List 5 considerations when mixing cements.
2. 1. Read and follow manufacturer’s directions
3. 2. Measure carefully
4. 3. Avoid moisture contamination
5. 4. Mix powder into liquid
6. 5. Allow to set completely or according to directions

 

 

15.07 Porcelain and Ceramics in Dentistry

 

1. A. List the 5 major uses of porcelain in the dental off
2. 1. Porcelain is used as a coating of porcelain fused to metal crown
3. 2. Porcelain is used as a crown material that can be bonded directly to the tooth.
4. 3. Porcelain is used as an inlay/onlay material that can be bonded directly into the tooth.
5. 4. Porcelain is used as teeth in denture
6. 5. Porcelain is often used as a veneering material that can be bonded to structure directly.

 

 

15.08 Other Dental Materials

 

1. A. List and give the use of the following dental mater
2. 1. Sedative dressings: Soothing dressing placed to reduce inflammation.
3. 2. Periodontal surgical dressings: Used to protect surgical site after periodontal surgery.
4. 3. Bleaching agents: Used to whiten teeth.
5. 4. Bonding agents: Used to increase the mechanical retention of materials to teeth.
6. 5. Endodontic materials: Used to fill the root canals of teeth.
7. 6. Etchants-acidic materials: Used to create surface irregularities for more surface to bond to.
8. 7. Pit and fissure sealants: Resin introduced into the pits and fissures of occlusal surfaces to prevent decay.

 

 

 

16.0 Obtaining Alginate Impressions

 

 

 

DIDACTIC EDUCATION

 

 

 

Intended Outcome

 

 

Given information about hydrocolloid impression materials, the armamentarium required to mix alginate, patient preparation, tray selection, preparing impression trays, spatulation technique, loading the mandibular alginate and maxillary impression tray, and seating the

trays. The student must demonstrate at least an 80 % accuracy on the didactic examination.

 

Tasks

 

 

Number of tasks to master = 147

 

 

16.01 Hydrocolloid Impression Materials

 

1. A. Define 2 types of hydrocolloid.
2. 1. Irreversible hydrocolloid: A material that has the ability to change from a liquid state (sol, solution) to a semisolid state (gel) but does not have the ability to change back to a liquid (sol) state.
3. 2. Reversible hydrocolloid: A material that has the ability to change from a solid state to a

liquid state and back to a solid state by changing the temperature.

 

1. List 4 characteristics of alginate impression material.

 

1. 1. Irreversible hydrocolloid
2. 2. Lacks dimensional stability

3. 3. Sensitive to heat and moisture
4. 4. Easy to use

 

 

1. C. Define impr
2. 1. Impression: A negative replication of a dental structur

 

1. Explain 4 reasons for taking alginate impressions.
2. 1. Study models
3. 2. Opposing models
4. 3. Construction of temporary crowns
5. 4. Working models to build custom trays, bleach trays e

 

1. E. Name 2 factors that will affect gel strength.
2. 1. Water powder ratio
3. 2. Spatulation time

 

1. F. Name 2 factors that will affect setting tim
2. 1. Manufacturer’s properties a.    Fast set, 1 to 2 minutes
3. b. Slow set, 2 to 4.5 minutes
4. 2. Water temperature (heat increases set time, cold decreases set time)

 

1. Identify 2 factors that affect dimensional stability.
2. 1. Syneresis: Loss of water
3. 2. Imbibition: Uptake of water

 

 

16.02 Armamentarium Required to Mix

 

1. A. Identify 7 items required to mix alg

 

1.	Alginate material	5.   Room temperature water
2.	Water measure	6.   Flexible bowl
3.	Powder scoop	7.   Alginate spatula, flexible, and broad
4.	Paper cup or paper towel

 

16.03 Patient Preparation

 

1. A. List 5 steps in preparing the patient in order.
2. 1. Review the health history
3. 2. Explain the procedure
4. 3. Instruct the patient
5. 4. Inspect the mouth
6. 5. Rinse the mouth

 

 

16.04 Tray Selection

 

1. A. Identify 3 purposes of an alginate tray.
2. 1. Carry material
3. 2. Control material
4. 3. Confine material

 

1. List 5 techniques to reduce gagging the patient.
2. 1. Take mandibular impressions
3. 2. Have patient breathe through in and out through their nose.
4. 3. Have the patient concentrate on an object in the operatory rather than the procedure (i.e., a spot on the wall), or have the patient lift his/her leg and hold it until the material se
5. 4. An ice cube placed in the patient’s mouth prior to taking the impression will have a numbing effect and may help prevent the gagging sensation.
6. 5. Since nitrous oxide/oxygen inhalation sedation depresses the gag reflex, it can be used to

relax the patient to reduce gagging during the taking of impression.

 

1. C. Identify 4 types of trays availab
2. 1. Disposable Styrofoam
3. 2. Perforated metal

 

 

3. 3. Solid rim-lock metal
4. 4. Plastic/perforated or solid

 

 

1. Identify 3 variations in alginate tray coverage.
2. 1. Full arch, maxillary or mandibular
3. 2. Anterior only
4. 3. Right or left quadrant

 

1. E. List the steps in tray selection in order.

 

1.	Put on PPE	4.	Use mirror to inspect fit
2.	Inspect the mouth	5.	Ask patient about comfort
3.	Try in tray	6.	Evaluate fit

 

1. F. List 6 requirements in tray
2. 1. Clears tissue by 3mm
3. 2. Long enough to clear the retromolar pad or the tuberosity (1-2mm) while not touching the incisors
4. 3. The tray falls at least 1mm short of the peripheral turn
5. 4. Incisors should sit in the deepest anterior portion of the tray
6. 5. The tray sides do not grossly depress any frenum
7. 6. The patient does not feel excessive pain or pressure

 

 

16.05 Preparing Impression Trays

 

1. A. Identify 3 reasons for applying beading wax.
2. 1. Patient comfort
3. 2. Molds periphery of the tray to the vestibule
4. 3. Prevents the teeth from touching the tray

 

1. List 3 criteria for correctly placed beading wax.
2. 1. Wax extended around the entire periphery of the tray
3. 2. Wax does not interfere with tray fit
4. 3. Three small wax squares placed in the occlusal anterior and posterior left and right

 

 

16.06 Spatulation Technique

 

1. A. List in order the 12 steps in mixing alg
2. 1. Read the manufacturer’s direction
3. 2. Measure required amount of room temperature wate
4. 3. Pour water in bowl (or powder first as indicated by the manufacturer).
5. 4. Fluff alginate powde

 

5. 5. Fill powder with scoop according to manufacturer’s directions and place in a cup or on a paper towe Repeat if required.
6. 6. Replace alginate lid.
7. 7. Combine water and powder as indicated by the manufacture
8. 8. Stir the mix to wet all powder part
9. 9. Begin spatulation in a stropping motion. Rotate the bo Spread the mix against the sides of the bowl.
10. 10. Gather the mix after 20 seconds and repeat step 9.
11. 11. Mix until the mix is creamy.
12. 12. Gather the mass and load the tray. Total mixing time should not exceed 1 minute.

 

 

16.07 Loading the Mandibular Alginate Tray

 

1. A. List the 7 steps in loading the mandibular tray.
2. 1. Have a small cup of water available to smooth the alginate surface.
3. 2. Spatulate alginate according to instruction
4. 3. Gather alginate on spatu
5. 4. Wipe half into one side of the tray from the peripheral border and press into tray.
6. 5. Repeat by wiping the other half into the other side of the tray.
7. 6. Wet finger and smooth the surface of the alginate mate
8. Optional: Wipe small amount of alginate onto the occlusal surfaces of the mandibular teeth just prior to seating the tray to minimize trapping bubbles.
9. 7. Loading time should be less than 30 second

 

 

16.08 Loading the Maxillary Impression Tray

 

1. A. List the 7 steps in loading the tray.
2. 1. Have a small cup of water ready for smoothing tray alginate.
3. 2. Spatulate alginate according to instruction
4. 3. Remove alginate from the bowl in one mas
5. 4. Load the tray from the posterio
6. 5. Press the mass down with the spatula into the anterior. Make sure no voids are created.
7. 6. Wet fingers and smooth the surface of the algin
8. Optional: Wipe alginate onto the occlusal of the teeth to minimize bubbles.
9. b. Optional: Remove any unwanted material from the palate area to minimize gagging.
10. 7. Loading time should be less than 30 second

 

 

16.09 Seating the Trays

 

1. A. List the 15 steps in taking the mandibular impr
2. 1. Position yourself between 8 and 9 o’clo
3. 2. The patient’s shoulder should be at the same height as the operator’s elbo
4. 3. Instruct the patient to rinse just prior to taking the impression.

 

4. 4. Mix and load the tray.
5. 5. Insert the tray.
6. 6. Hold the tray in one hand and, with the other hand retract the chee
7. 7. Slide the tray in sideways until one-half of the tray is in the mouth then rotate the tray and cente The handle of the tray should be centered with the nose and perpendicular to the anterior teeth. The anterior portion of the tray must be positioned over the centrals to provide adequate material in the vestibule.
8. 8. Ask the patient to close slightly.
9. 9. Depress the tray, posterior to anterio
10. 10. Have the patient elevate the tongue then depress the tray mo
11. 11. Ask the patient to relax the cheeks and lip.
12. 12. Position the tray by pressing firmly on the occlusal with the index fingers; place the thumbs under the mandible.
13. 13. Instruct the patient to breathe deeply through the nos
14. 14. When the material is set, run your fingers around the peripheral border to break the seal, protect the upper teeth with your index finger of your left hand and remove with one firm movement or snap.
15. 15. Rinse the impression under water, inspect, spray with disinfectant, wrap in a moist paper towel, and place in a baggie.

 

1. List 11 steps in taking the maxillary impression.
2. 1. The patient’s shoulder should be positioned at the height of the operator’s elbo
3. 2. The operator should be between 9 o’clock and 12 o’clock (for right-handed operators.)
4. 3. Insert the loaded tray, holding the tray with one hand and retracting the cheek with the oth
5. 4. Slide the tray in sideways until one-half of the tray is in the mouth, then rotate the tray and

center. The handle of the tray should be centered with the nose and perpendicular to the anterior teeth. The anterior portion of the tray must be positioned over the centrals to provide adequate material in the vestibule.

5. 5. Seat the posterior of the tray firmly first, this will expel the material forward, instead of

down the throat.

6. 6. Continue seating the anterior portion of the tray.
7. 7. Lift the upper lip to free it from the tray. Have the patient relax cheek and lip Lift the lip over tray to obtain an impression of vestibules and the frenum.
8. 8. The patient’s head should be tipped forward to prevent flow down the thro
9. 9. Instruct the patient to breathe deeply and slowly through the nose.
10. 10. When the material is set, lift the cheeks to break the seal, protect the opposing teeth, separate with one firm, continuous motion.
11. 11. Rinse the impression under water, inspect, spray with disinfectant, wrap in a moist paper towel, and place in a baggie.

 

1. C. List the 7 steps in creating a tongue space on the mandibular.
2. 1. Unwrap the mandibular alginate.
3. 2. Mix one scoop of alginate.
4. 3. Wipe it on the middle two fingers of your non-dominate hand.
5. 4. Place the mandibular alginate tray handle towards the heel of the hand, over the algin

Use the heel of the hand to support the tray handle.

5. 5. Using moistened fingers of your dominant hand, join the alginate to the lingual borders of the impression, creating a smooth, flat floo
6. 6. Hold the tray in place until
7. 7. Gently free the fingers, wrap and ba

 

 

16.10 Evaluating the Alginate Impression

 

1. A. List the 10 criteria for a completed satisfactory mandibular alginate impr
2. 1. The tray was seated so all detail is reproduced, including the teeth, the complete peripheral turn (vestibule and frenum) and a portion of the retromolar pad
3. 2. The detail is sharp, not blurred or indistin
4. 3. The impression is free of voids in critical are
5. 4. The impression is free of large folds of alginate extending into the patient’s throa
6. 5. There are no areas where the alginate has pulled away from the tray.
7. 6. The impression is free of rips and tears, except in interproximal are
8. 7. The alginate covers the tray (no unwaxed tray is visible through the alginate).
9. 8. The alginate is free of bulges or depressions that indicate a sub-surface bubble.
10. 9. The alginate is smooth, not sponge-like or grainy.
11. 10. The tongue space is smooth, flat and does not overlap the impression.

 

1. List the 10 criteria for a satisfactory maxillary impression.
2. 1. The tray was seated so all detail is reproduced, including the teeth, the complete peripheral turn (vestibule and frenum) and all of the tuberosity.
3. 2. The detail is sharp, not blurred or indistin
4. 3. The impression is free of voids in critical are
5. 4. The impression is free of large folds of alginate extending down the thro
6. 5. There are no areas where the alginate has pulled away from the tray.
7. 6. The impression is free of rips and tears, except in interproximal are
8. 7. The alginate covers the tray (no unwaxed tray is visible through the alginate).
9. 8. The alginate is free of bulges or depressions that indicate a sub-surface bubble.
10. 9. The alginate is smooth, not sponge-like or grainy.
11. 10. The palatal arch is complete.

 

 

Given the  necessary didactic instruction, supplies and equipment to obtain an alginate impression, the student will perform the following tasks on 4 patients with 100% accuracy in a clinical setting.  The student will perform the following tasks on 4 adult patients with at

least 85% accuracy on the final clinical examination.

 

Time allotment: 60 minutes

 

Tasks Pass Fail Pass Fail 1 Use universal precautions. 2 Assemble the alginate impression tray setup. a.    Alginate material b.    Water measure c.    Powder scoop d.    Paper cup e.    Water f.     Flexible bowl g.    Alginate spatula 3 Seat the patient and place patient bib. 4 Review patient’s medical history. If patient is a minor, review medical history with the parent or guardian of the patient. 5 Explain the procedure to the patient. 6 Instruct the patient. 7 Inspect the mouth. 8 Rinse the mouth. Select maxillary and mandibular trays. 10 Install the wax on the maxillary and mandibular trays. 11 Measure required amount of room temperature water for mandibular impression. 12 Fluff alginate powder. 13 Measure powder as indicated by the manufacturer. 14 Fill powder with scoop, tap to eliminate air pockets, level and place in a bowl. 15 Replace alginate lid. 16 Combine water and powder as indicated by the manufacturer. 17 Mix until creamy. Total mixing time should not exceed 1 minute. 18 Gather the alginate on the spatula.

Practice 1    Practice 2

 

Practice 1    Practice 2

	Tasks	Pass	Fail	Pass	Fail
19	Load tray from the sides in two increments. Wet finger and smooth the surface of the alginate material. Loading time should be approximately 30 seconds. Optional: Wipe small amount of alginate onto the occlusal surfaces of the mandibular teeth just prior to seating the tray to minimize trapping bubbles.
20	Instruct the patient to rinse just prior to taking the impression.
21	Position yourself between 8 and 9 o’clock.
22	The patient’s shoulder should be at the same height as the operator’s elbow.
23	Hold the tray in one hand and, with the other hand retract the cheek.
24	Insert the loaded tray.
25	Ask the patient to raise their tongue.
26	Depress the tray, posterior to anterior.
27	Ask the patient to relax the cheeks and lip with the index fingers; place the thumbs under the mandible.
28	Instruct the patient to breathe deeply through their nose.
29	When the material is set, run your fingers around the peripheral border to break the seal, protect their upper teeth with your index finger of your left hand and remove with one firm movement or snap.
30	Rinse, disinfect, and bag impression.
31	Measure required amount of room temperature water for maxillary impressions.
32	Measure powder as indicated by manufacturer.
33	Fill powder with scoop, tap to eliminate air pockets, level and place in bowl.
34	Replace alginate lid.
35	Combine water and powder as indicated by the manufacturer.
36	Mix until creamy. Total mixing time should not exceed 1 minute.
37	Gather the alginate on the spatula.
38	Load the tray from the back in one or two increments. Wet finger and smooth the surface of the alginate material. Loading time should be approximately 30 seconds. Optional: Wipe small amount of alginate onto the occlusal surfaces of the maxillary teeth just prior to seating the tray to minimize trapping bubbles.
39	The operator’s elbow should be at the same height as the patient’s shoulder.
40	Position yourself between 9 and 12 o’clock (right handed operators).
41	Hold the tray in one hand, and with the other hand retract the cheek as you seat the tray.
42	Seat the posterior of the tray firmly toward the maxillary teeth. This will expel the material forward instead of down the throat.
43	Continue seating the anterior portion of the tray, lifting the upper lip to free it from the tray (the patient should relax cheek and lips).
44	Instruct the patient to tip head forward to prevent flow down the throat.
45	When the material is set, lift the cheeks to break the seal, protect the opposing teeth, separate with one firm continuous motion.
46	Rinse, disinfect, and bag impression.
47	Create a tongue space on the mandibular.
48	Mix one scoop of alginate.
49	Wipe it on the middle two fingers of your non-dominate hand.
50	Place the mandibular alginate tray; handle towards the heel of the hand, over the alginate. Use the heel of the hand to support the tray handle.
51	Using moistened fingers of your dominant hand, join the alginate to the lingual borders of the impression, creating a smooth, flat floor.
52	Hold the tray in place until set.
53	Gently free the fingers, wrap, and bag.
54	Check for a satisfactory maxillary and mandibular alginate impression.

 

75

 

Practice 1    Practice 2

	Tasks	Pass	Fail	Pass	Fail
55	The dated chart entry is recorded in ink.
56	Student signs record of services.
57	Instructor initials the record of services.
Comments:

 

 

Practice 3    Practice 4

	Tasks	Pass	Fail	Pass	Fail
1	Use universal precautions.
2	Assemble the alginate impression tray setup. a.    Alginate material b.    Water measure c.     Powder scoop d.    Paper cup e.    Water f.     Flexible bowl g.    Alginate spatula
3	Seat the patient and place patient bib.
4	Review patient’s medical history. If patient is a minor, review medical history with the parent or guardian of the patient.
5	Explain the procedure to the patient.
6	Instruct the patient.
7	Inspect the mouth.
8	Rinse the mouth.
9	Select maxillary and mandibular trays.
10	Install the wax on the maxillary and mandibular trays.
11	Measure required amount of room temperature water for mandibular impression.
12	Fluff alginate powder.
13	Measure powder as indicated by the manufacturer.
14	Fill powder with scoop, tap to eliminate air pockets, level and place in a bowl.
15	Replace alginate lid.
16	Combine water and powder as indicated by the manufacturer.
17	Mix until creamy. Total mixing time should not exceed 1 minute.
18	Gather the alginate on the spatula.
19	Load tray from the sides in two increments. Wet finger and smooth the surface of the alginate material. Loading time should be approximately 30 seconds. Optional: Wipe small amount of alginate onto the occlusal surfaces of the mandibular teeth just prior to seating the tray to minimize trapping bubbles.
20	Instruct the patient to rinse just prior to taking the impression.
21	Position yourself between 8 and 9 o’clock.
22	The patient’s shoulder should be at the same height as the operator’s elbow.
23	Hold the tray in one hand and, with the other hand retract the cheek.
24	Insert the loaded tray.
25	Ask the patient to raise their tongue.
26	Depress the tray, posterior to anterior.
27	Ask the patient to relax the cheeks and lip with the index fingers; place the thumbs under the mandible.
28	Instruct the patient to breathe deeply through their nose.

 

 

 

 

 

76

 

Practice 3    Practice 4

	Tasks	Pass	Fail	Pass	Fail
29	When the material is set, run your fingers around the peripheral border to break the seal, protect their upper teeth with your index finger of your left hand and remove with one firm movement or snap.
30	Rinse, disinfect, and bag impression.
31	Measure required amount of room temperature water for maxillary impressions.
32	Measure powder as indicated by manufacturer.
33	Fill powder with scoop, tap to eliminate air pockets, level and place in bowl.
34	Replace alginate lid.
35	Combine water and powder as indicated by the manufacturer.
36	Mix until creamy. Total mixing time should not exceed 1 minute.
37	Gather the alginate on the spatula.
38	Load the tray from the back in one or two increments. Wet finger and smooth the surface of the alginate material. Loading time should be approximately 30 seconds. Optional: Wipe small amount of alginate onto the occlusal surfaces of the maxillary teeth just prior to seating the tray to minimize trapping bubbles.
39	The operator’s elbow should be at the same height as the patient’s shoulder.
40	Position yourself between 9 and 12 o’clock (right handed operators).
41	Hold the tray in one hand, and with the other hand retract the cheek as you seat the tray.
42	Seat the posterior of the tray firmly toward the maxillary teeth. This will expel the material forward instead of down the throat.
43	Continue seating the anterior portion of the tray, lifting the upper lip to free it from the tray (the patient should relax cheek and lips).
44	Instruct the patient to tip head forward to prevent flow down the throat.
45	When the material is set, lift the cheeks to break the seal, protect the opposing teeth, separate with one firm continuous motion.
46	Rinse, disinfect, and bag impression.
47	Create a tongue space on the mandibular.
48	Mix one scoop of alginate.
49	Wipe it on the middle two fingers of your non-dominate hand.
50	Place the mandibular alginate tray; handle towards the heel of the hand, over the alginate. Use the heel of the hand to support the tray handle.
51	Using moistened fingers of your dominant hand, join the alginate to the lingual borders of the impression, creating a smooth, flat floor.
52	Hold the tray in place until set.
53	Gently free the fingers, wrap, and bag.
54	Check for a satisfactory maxillary and mandibular alginate impression.
55	The dated chart entry is recorded in ink.
56	Student signs record of services.
57	Instructor initials the record of services.
Comments:

 

 

 

 

 

 

 

 

 

77

 

CLINICAL REQUIREMENTS COMPLETED

 

 

 

 

 

 

 

17.0 Introduction to Dental Radiography

 

Intended Outcome

 

 

Given information about biological effects of ionizing radiation, health protection techniques, x-ray machines, dental film/sensors, radiographic landmarks, mounting radiographs and processing procedures, the student will be able to perform 80% of the

following tasks with accuracy on the didactic examination.

 

Tasks

 

 

Number of tasks to master = 159

 

 

17.01 Biological Effects of Ionizing Radiation

 

1. A. Define types of radiating eff
2. 1. Somatic effects: Changes in non-reproductive cells resulting in illness such as cancer or cataract
3. 2. Genetic effects: Changes in reproductive cells resulting in genetic defects passed on to future generation
4. 3. Cumulative effects: Increasing in effect with each successive additional dose.

 

1. List 4 critical organs exposed to radiation during a dental x-ray.
2. 1. Bone marrow
3. 2. Lens of the eye
4. 3. Thyroid gland
5. 4. Skin

 

1. C. List 10 tissues/cells in order from most to least sensitive to radiation.
2. 1. White blood cells
3. 2. Red blood cells
4. 3. Immature reproductive cells
5. 4. Epithelial cells
6. 5. Endothelial cells
7. 6. Connective tissue cells
8. 7. Bone cells
9. 8. Nerve cells
10. 9. Brain cells
11. 10. Muscles cells

 

17.02 Protection Techniques

 

1. A. Define 4 types of rad
2. 1. Primary radiation: Initial radiation produced at the tungsten target that exits the tube head.
3. 2. Secondary radiation: Formed when the primary bead comes in contact with matte
4. 3. Scatter radiation: Secondary radiation that occurs when the primary beam is defected off of matte
5. 4. Leakage radiation: Radiation that escapes out of the tube head.

 

1. Define ALARA.
2. 1. ALARA: As Low As Reasonably Achievable

 

1. C. Define maximum permissible dose (MPD).
2. 1. Maximum permissible does: The dose equivalent of ionizing radiation that, in light of present knowledge, is not expected to cause detectable body damage to average person at any time during their lifetime
3. 50mSv per year for radiation workers
4. b. 5mSv per year for general public

 

1. List the 6 methods of radiation protection for the patient.
2. 1. Use the fastest film speed available or digital, if availab
3. 2. Use open-ended, shielded, Position Indicating Devices no larger than 2.75 inches in diamete Rectangular devices are superior.
4. 3. Use good technique including film holders to diminish the need for retaking film
5. 4. Carefully follow manufacturer’s directions for processing.
6. 5. Use lead aprons and thyroid collars to cover the patien
7. 6. ALARA (as low as reasonably achievable).

 

1. E. List 5 methods of operator protection from x-ray rad
2. 1. Stand behind the patient at a point between 90° and 135° from the source of the beam.
3. 2. Stand behind a wall or radiation-resistant barrier or at least 6 feet away from the radiation source.
4. 3. Have machine tested every 2 y
5. 4. Never hold the film or PID for the patients during and exposure.
6. 5. Use of radiation monitoring devices, film badges, or dosimeters to measure exposure.

 

17.03 The X-Ray Machine

 

1. A. List the 5 major components of the x-ray mach
2. 1. Tube
3. 2. Glass housing
4. 3. Tubehead
5. 4. Position Indicating Device (cone)
6. Collimation b.  Filtration
7. 5. Control panel adjustments

 

1. Describe the 5 major components of the x-ray machine.
2. 1. Tube: Contains negative (cathode) and the positive (anode) terminals that first create and then attract electrons to produce x-ray
3. 2. Glass housing: Leaded glass that surrounds the tube.
4. 3. Tubehead: Heavy metal enclosure that surrounds the x-ray tube.
5. 4. Position Indicating Device (cone): Used to direct and contain the beam of radiation.
6. 5. Control panel adjustments:
7. The kilovolt peak (kVp) control adjusts the voltage or force of electricity in the tube between 70 and 90 (quality).
8. b. The milliampere (mA) control adjusts the intensity of the current flow or number of

electrons flowing through a circuit between 5 and 15 (quantity).

1. The time control or exposure button activates the x-ray machine and adjusts the amount of time that the stream of electrons is allowed to travel between the cathode and the anode can be either traditional or impulse driven.

 

17.04 Dental Film/Sensors

 

1. A. List 4 types of dental f
2. 1. Intraoral
3. Film sizes: 0, 1, 2, 3, 4
4. 2. Extraoral
5. Film sizes: 5×7, 8×10, 5 or 6×12
6. 3. Duplicating
7. 4. Digital
8. Charge-coupled device (CCD)
9. b. Complementary metal oxide semiconductor/active pixel sensor (CMOS/APS)
10. Charge injection device (CID)

 

1. Describe 5 types of dental radiographs.
2. 1. Periapical: Intraoral film showing the entire tooth and surrounding tissue.
3. 2. Bitewing: Intraoral film showing the interproximal and bone height of the crowns of maxillary and mandibular teeth.
4. 3. Occlusal: Intraoral film showing the entire maxillary or mandibular arch.
5. 4. Panoramic: Extraoral film showing the entire maxillary and mandibular arche
6. 5. Other: Extraoral, i.e. Cephlome

 

1. C. Explain the 3 important film storage factor
2. 1. Optimum temperature for storage should be between 50° and 70° F.
3. 2. The relative humidity for film storage should be between 30% and 50%.
4. 3. Film should not be stored in areas where radiation exposures are made.

 

1. List the parts of the film package.
2. 1. Outer covering
3. 2. Black paper
4. 3. Lead foil
5. 4. Film

 

1. E. List the layers of a dental f
2. 1. Plastic film base
3. 2. Adhesive layer
4. 3. Emulsion (gelatin and silver halide crystals)

 

17.05 Radiographic Techniques

 

1. A. Define the paralleling techniqu
2. 1. Paralleling technique: Uses a film holder to position the film parallel to the tooth and the

PID perpendicular to the tooth and film.

 

1. Define the bisecting angle technique.
2. 1. Bisecting angle technique: Positions the film close to the tooth forming an ang That angle is bisected and the PID is angle perpendicular to the bisecting line.

 

1. C. Define extra oral techniqu
2. 1. Extra oral technique: The patient is positioned in the extra oral radiographic unit and the film is loaded into a cassette and placed on the un The x-ray head and the cassette rotate around each other when taking the film.

 

17.06 Radiographic Landmarks

 

1. A. Identify 5 image characteristics used to identify landmarks visible in radiographic fi

 

1. 1. Radiopaque
2. 2. Radiolucent
3. 3. Density

4. 4. Contrast
5. 5. Sharpness

 

 

1. Identify 6 landmarks visible in the maxillary molar film.

 

1.	Maxillary sinus	4.	Hamulus
2.	Zygomatic process	5.	Maxillary tuberosity
3.	Zygomatic bone	6.	Coronoid process of the mandible

 

1. C. Identify 1 landmark visible in the maxillary premolar f
2. 1. Maxillary sinus

 

1. Identify 2 landmarks visible in the maxillary canine film.
2. 1. Maxillary sinus
3. 2. Junction of the maxillary sinus and nasal fossa

 

1. E. Identify 5 landmarks visible in the maxillary incisor f

 

1. 1. Incisive foramen
2. 2. Nasal septum
3. 3. Nasal fossa

4. 4. Anterior nasal spine
5. 5. Median palatine suture

 

 

1. F. Identify 4 landmarks visible in the mandibular molar f

 

1. 1. Mandibular canal
2. 2. Internal oblique line

3. 3. External oblique ridge
4. 4. Mylohyoid ridge

 

 

1. Identify 1 landmark visible in the mandibular premolar film.
2. 1. Mental foramen

 

1. H. Identify 3 landmarks visible in the mandibular incisor f
2. 1. Lingual foramen
3. 2. Mental ridge
4. 3. Genial tubercles

 

 

17.07 Mounting Radiographs

 

1. A. Describe the 9 step procedure for mounting a full mouth set of radiograp
2. 1. Mark the mount with the patient name, age, and date.
3. 2. Place a clean, dry paper towel on the countertop in front of a lighted viewbo
4. 3. With clean, dry hands, handle radiographs by edges only.
5. 4. Place all radiographs on the paper towel with the embossed (raised) dot facing up.
6. 5. Sort the radiographs into three groups: bitewings, posterior periapicals, and anterior periap
7. 6. Further arrange the radiographs by maxillary arch, posterior and anterio
8. 7. Futher arrange the radiographs by mandibular arch, posterior and anterio
9. 8. Separate all films left from right and orient periapical films with maxillary roots pointing up and mandibular roots pointing down.
10. 9. Begin mounting by inserting the bitewing radiographs into the mount, followed by the posterior periapicals, and finally the anterior periapica

 

17.08 Processing Radiographs

 

1. A. Describe  the  6 steps required during film processing to assure proper infection contr
2. 1. Wipe saliva from film
3. 2. Placed films in a labeled disposable containe
4. 3. Wash hand
5. 4. With non-powdered gloved hands in safelight conditions, open the film packets by pulling on their tab
6. 5. Allow films to drop onto a clean paper towel or into a paper cup.
7. 6. Remove contaminated gloves, rewash hands, and re-glove prior to processing.  An alternative is to wear over gloves when opening film packe

 

1. State the 10 steps required to hand process films.
2. 1. Check solution levels
3. 2. Maintain appropriate chemical temperatures: between 68° and 70°
4. 3. Turn white lights off and safelight on
5. 4. Remove films from packets using appropriate methods of infection control

 

5. 5. Securely place films onto hanger
6. 6. Immerse film in developer and activate timer for 5 minutes
7. 7. Remove from developer and rinse by agitation for 30 seconds
8. 8. Immerse films in fixer and activate timer for 10 minutes
9. 9. Remove films and place in circulating water bath for 10 minutes
10. 10. Dry films in electric dryer or air-dry until films are no longer tacky

 

1. C. State 4 principles of operation for automatic processing.
2. 1. Manufacturer’s recommendations must be followed precisely
3. 2. Rollers or tracks are used to transport the films through the processing chemicals
4. 3. Much higher temperatures are required for automatic processing
5. 4. Chemical concentrations are higher for automatic processing

 

1. Describe 3 elements of caring for the automatic processor.
2. 1. Special cleaning films must be run through the system daily.
3. 2. Depending on usage, the processor must be scoured with a nylon pad weekly or biweekly.

Harsh cleansers should not be used.

3. 3. At the same time interval, the rollers should be removed from roller-type systems and soaked in warm water for 20 minutes then special cleaning solutions used.

 

1. E. Describe the 3 principles for care of processing solu
2. 1. Levels of the solutions must be checked regularly and replenished as required by manufacturer recommendation.
3. 2. If large films such as panoramic films are processed frequently, the solutions will need to be replenished more often.
4. 3. Solutions should be change at least every 4 wee

 

1. F. Identify quality assurance procedures for processing.
2. 1. Recording solution temperatures
3. 2. Dates of solution changes
4. 3. Test films
5. 4. Equipment maintenance
6. 5. Inspections

 

17.09 Evaluating Radiographs for Diagnostic Value

 

1. A. Identify intraoral exposure error
2. 1. Elongation
3. 2. Foreshortening
4. 3. Horizontal overlap
5. 4. Cone cutting
6. 5. Light image
7. 6. Dark image
8. 7. Film bending
9. 8. Reverse film (herringbone effect)
10. 9. Blurred image
11. 10. Superimposed image
12. 11. Double exposure
13. 12. Film placement errors

 

1. Identify processing errors and causes.
2. 1. Spots on film
3. 2. Fogging
4. 3. Light and dark images
5. 4. Clear (blank film)
6. 5. Black film
7. 6. Partial images
8. 7. Stains
9. 8. Discoloration
10. 9. Overlapped films
11. 10. White or black lines
12. 11. Static electricity artifacts
13. 12. Fingerprints