DENTAL ASSISTING PROGRAM STUDENT___________________
DENTAL MATERIALS DATE ______________
COURSE DENT 1200 INSTRUCTOR___________
LAB EVALUATION FORM: Demonstrate Polycarboxylate Cement Mixing Techniques
Scoring: 3 points - Task performed satisfactorily without prompting.
2 points - Task performed satisfactorily with self-initiated correction.
1 point - Task performed with prompting required.
0 point - Unable to perform
Performance Objective: The student will demonstrate the ability to mix polycarboxylate cement
1. Select matching powder and liquid, spatula and pad. _____
2. Fluff powder and swirl liquid. _____
3. Dispense powder onto mixing pad. _____
4. Dispense liquid onto mixing pad. _____
5. Incorporate powder into liquid using flat side of blade. _____
6. Gather entire mass into one unit to check consistency. _____
7. Clean up of spatula and mixing pad. _____
Possible 21 pts Actual score________ % grade_________