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THE UNIVERSITY OF OKLAHOMA COLLEGE OF DENTISTRY DEPARTMENT OF

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THE UNIVERSITY OF OKLAHOMA COLLEGE OF DENTISTRY DEPARTMENT OF Powered By Docstoc
					 THE UNIVERSITY OF OKLAHOMA
    COLLEGE OF DENTISTRY
DEPARTMENT OF DENTAL HYGIENE




   DENTAL HYGIENE MANUAL
          2007-2008
                   TABLE of CONTENTS

SECTION A - ADMINISTRATION                        Page
              and other important information
Dental Hygiene Faculty and Staff                  1
Distance Sites Faculty                            2
College of Dentistry Phone List
FERPA-Family Educational Rights and Privacy Act   6
Background Checks
Blackboard                                        8

SECTION B - GOALS, PHILOSOPHY
Goals                                              9
Mission Statement/Goals                           11
Philosophy                                        14
Patient Care
Clinical Dental Hygiene Objectives                15
Clinical Course Evaluation                        17

SECTION C – PROFESSIONALISM, ATTENDANCE
Attitude/Professionalism                          19
Deficiency in Professional Conduct Form           22
Dress Code                                        25
Attendance                                        26
Reporting Absences                                27

 SECTION D – SCHEDULES
Academic Calendar                                 29
Orientation Schedule                              31
Junior DH Classroom Schedule-fall                 33
Senior DH Classroom Schedule-fall                 34
Faculty Clinic Schedule                           35
OKC Clinic Schedule                               36
DS IV Rotation Schedule                           37
Senior DH Classroom Schedule-spring             TBA
Junior DH Classroom Schedule-spring             TBA

SECTION E – CURRICULUM and COMPETENCIES
Dental Hygiene Curriculum                       39
Competencies for Entry Level Dental Hygienist   40
Clinical Competencies by Student Level          46

SECTION F – HEALTH ISSUES
Antibiotic Premed Guidelines                    48
Antibiotic Regimens                             49
PreMed Protocol at OUCOD                        50
Blood Pressure Policy                           51
Coumadin Protocol                               52
Emergency Procedures                            53
Emergency Numbers                               54
Protocol for Life Threatening Emergencies       54
Safety Protocol for Clinics and Labs            56

SECTION G – SENIOR COMPETENCIES and other Clinical
                Evaluations/Forms
Air Polishing Evaluation                     58
Bleaching Protocol                           59
Bleaching/whitening                          60
Bleaching Consent Form                       65
Bleaching Follow-up Instructions             66
Calculus Charting Exercise                   67
Competency Evaluation Summary                68
CDI C Scaling Competency Information         69
CDI D Scaling Competency Information         TBA
Self-Assessment for Scaling Competency       70
Local Anesthesia Competency                  72
Local Anesthesia Placement Table             75
Nitrous Oxide Competency                     77
Periodontal Charting Competency              79
Transitional Dentition Charting Exercise    80
Treatment Planning Competency Form          81
Ultrasonic Scaling Competency               82
Senior Clinical Course Requirements         84
Senior Clinical Competencies                85
Senior Clinical Exercises                   86



SECTION H – JUNIOR COMPETENCIES
                 and CLINICAL EXERCISES
Abbreviations                               88
Barnhart Competency                         90
EIE Competency                              91
Fluoride Tray Competency                    92
Gracey 1/ 2 Competency                      93
Gracey 11/12 Competency                     94
Gracey 13/14 Competency                     95
H6 H7 Competency                            96
Mouth Mirror Competency                     97
ODU 11/12 Explorer Competency               98
Periodontal Probe Competency                99
Polishing-Rubber Cup Competency             100
Patient/Operator Positioning Left Handed    101
Patient/Operator Positioning Right Handed   103
Unit Disinfection Competency                105

SECTION I – SENIOR CLINICAL REQUIREMENTS
Fall Requirements                           106

SECTION J– CLINICAL EVALUATION, CLINICAL
              PROTOCOL AND PROCEDURES
DH I Evaluation Criteria                    108
DH II Evaluation Criteria                   110
Patient/Operator Positioning                112
Patient Reception/Positioning                         113
Permission to Proceed (PTP)                           116
PTP Monologue                                         119
Subsequent PTP Monologue                              122
Case Complete Monologue                               120
PTP Laminate                                          121
Case Complete Sequence                                123
Vital Signs                                           124
Blood Pressure Procedure                              125
EIE (Extra-Oral, Intra-Oral Exam)                     127
Definitions of Terms for EIE                          129
EIE Palpation                                         131
EIE Sequence                                          132
Lesion Description Flow Chart                         137
Periodontal Charting                                  139
Bleeding Index                                        140
Oral Diagnosis Charting Key for Existing Conditions   141
Occlusion/Malpositions                                144
Plaque Index                                          145
Stress Reduction Protocol                             146
Sterilization Table                                   148
Infection Control Terminology                         149
TPNs & Recall Card                                    151
Radiography Guidelines                                153


SECTION K – CLINIC FORMS
One Year Release Form                                 158
Patient Satisfaction Survey                           159
CDI Screening Form                                    160
CDI Form                                              159
Clinical Evaluation Form                              160
Competency Self- Assessment Worsheet                  161
Scaling/Polishing Competency Evaluation Summary       163
Rotation Report Form                                  164
Dental Hygiene Care Only                                 165
Blue DH Recall Examination Form                          166
Sign-Up Sheet for Clinic                                 167
Treatment Plan-Dental Hygiene                            168
Adjustment to Account Form                               170
Patient Absence Form                                     171
OD Exam Sign Up Form                                     172
Local Anesthesia Worksheet                               173
Post-Op Scaling/Root Planing Instructions                174
Post-Op Instructions for Arestin                         175
Post-Op Instructions for Fluoride Varnish                176
Non-working Ultrasonic Form



SECTION L – BOARD EXAMS INFORMATION
NBDHE                                                    178
State Jurisprudence Exam
WREB

SECTION M – STUDENT ORGANIZATIONS                        180
Class Officers                                           180
SADHA                                                    181

SECTION N – OKC SITE CLINIC MISCELLANEOUS
See E-Version of COD Clinic Policies Manual, Section B
      -Appointment Scheduling
      - Patient Contact Card Protocol
      - Cancellation Policy
      - Fee Schedule
Fax in Green Clinic                                      183
Medical Consult Form for Fax                             184
Fax Cover Sheet                                          185
Recall Exam Interval info                                186
Patient Treatment Protocol                               187
DH Documentation Check List              190
DH Patient Information-Clinic Ops        193



SECTION O – COMMUNITY DENTAL CLINICS     194


SECTION P – ROTATIONS- OKC SITE          198
Clinical Rotation Protocol               199
Clinical Assistant                       200
Assist Senior DH Rotation                201
Crossings Community Center               202
Good Shepherd Mission                    203
Map Good Shepherd Mission                204
Graduate Periodontics                    205
Health for Friends Clinic                211
Implantology                             212
Oral Diagnosis                           213
Pediatric Dentistry and Sealant Clinic   214
Sealant Clinic                           215
Radiography                              216
Screener                                 219
Teaching Assistant                       221
Tinker Air Force Base                    222
Tinker Map                               224
VA Dental Clinic                         226
SECTION A2

Administration
   & other
  important
 information
                               FACULTY and STAFF

               DENTAL HYGIENE FACULTY-OUCOD SITE
Vicki Coury, R.D.H., M.Ed, M.P.H.        Department Co-Chair, Clinical Faculty
DCSB 572                                 271-4435

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

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

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

Carolyn Ray, R.D.H., M.Ed                Full Time Faculty
DCSB 574                                 271-4435

Kathy Miller, R.D.H., B.S.               Asst. Director of Clinics/ Clinical Faculty
DCSB 521C                                Implantology
                                         271-8001 x34143

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

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

Sheri French, R.D.H., B.S.               Part Time Faculty
DCSB 583                                 271-6532

Kim Graziano, R.D.H., B.S.               Part Time Clinical Faculty
DCSB 583                                 271-4435

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

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

Kristy Jurko                             Administrative Secretary
DCSB 567                                 271-4435
           DENTAL HYGIENE FACULTY DISTANT SITES

ARDMORE
Southern Oklahoma Technology Center    Christy Brannock, Site Coordinator
Dept Of Dental Hygiene                 Mobile: (580)-504-9421
2610 Sam Noble Parkway                 Office: (580) 223-2070 x 268
Ardmore, Ok 73401                      Keila Pierson- Admin Secretary
(580) 223-2070 ext 268 (clinic x285)   Lindsey Hays- Clinical Instructor
                                       Judy West- Clinical Instructor x278
Room Numbers:
#C1 (Senior Room) (580) 224-9861
#C2 (Junior Room) (580) 224-9863
Fax: (580) 223-4261


BARTLESVILLE
Tri County Technology Center           Lydia Snyder, Site Coordinator:
Dept Of Dental Hygiene                 Mobile: (918) 277-6222
6101 S.E. Nowata Rd                    Office: (918) 331-3282
Bartlesville, Ok 74006                 Nina Hill Admin Secretary
(918) 331-3218                         Tammie Golden- Clinical Instructor
                                       Abbie Gustafson- Clinical Instructor

Room Phone Numbers:
#326 (918) 331-3378
#107 (918) 331-3201
Fax: (918) 331-3499

WEATHERFORD
Western Technology Center              Julie McClung, Site Coordinator
Dept Of Dental Hygiene                 Mobile (405) 831-1406
2605 E. Main                           Office: (580) 772-0294 Ext 243
Weatherford, Ok 73096                  Evelyn Tilson, Admin Secretary
(580) 774-0224 Ext 241                 Tina Tuck- Clinical Instructor x244

Room Phone Number:
#1: (580) 772-0294 Ext 248
#2: (580) 772-0294 Ext 228 (Jr rm)
Fax: (580) 772-2967
University of Oklahoma                             Patient Care Coordinators       15422
                                                   Chart Room     34147
College of Dentistry

ACCOUNTING Ellen Ware, Business
                                                   DENTAL SERVICES ADMINISTRATION
Manager    5363
                                                   (COMMUNITY DENTISTRY) Janet
                                                   Powell 4919
ADMINISTRATION             Roxanne Vidal
(34158)   5444
                                                   Dunn Cumby * 46229
                                                   Rosita Long            46236
Stephen K. Young, Dean 15444
                                                   Hugh McDougall 14919
Kenneth Coy, Associate Dean Academic Affairs
                        34159                      DENTAL HYGIENE
                                                   Kristy Jurko                   4435
Diana Stone, Administrative Manager                Jane Bowers * 14436
34163                                              Jane Gray     14445
Carla Lawson, Student Affairs Specialist           Vicki Coury   13869
34162                                              Carol Zerby   46532
Sally J. Davenport, Administrative                 Laurie Cunningham 14423
Secretary                                          Tammie Vargo 14562
34160
Dean’s Office Fax #’ 271-3423 or 271-7775
                                                   DENTAL INFORMATICS______ 3694
ADMISSIONS                                         Scott Newhouse               34152
Judy 34156 / Erica 34128           3530            Hal Horton                   3412
                                                   Jason Jones                  34154
Randy Jones, Director, Admissions / Stu. Affairs   Computer Lab - (Across from Dean’s
34155                                              Office) x34151 13651
Student Affairs OUHSC
                                                   DENTAL MATERIALS               6545
Kate Stanton             12416

AEGD Jan Fortelney         Delores                 Sharukh Khajotia *
Simpson        5222
Stephen Reagan, Director 14121 Jan’s               DEVELOPMENT                    4380
Office #323 6486                                   Jodana Johnson, Director       34153
                                                   Amanda Bleakley, Assistant     14050
Barry Greenley 46451 or 52, 53
                                                   ENDODONTICS           Irene Quintero
Clinic Room #318 46454 Fax # 3851                  5550
                                                   David Clement * 48556
                                                   Harry S. Heget 48553
Clinic Operations                  5422
                                                   Andrew Goldbeck 48550
Jeanne Panza, Asst. Dean for Clinics               FIXED PROSTHODONTICS           Julie Hall
34134                                              5346
Kathy Miller, Asst. Director of Clinics            Luis Blanco * 48547
34143                                              Frank Lipsinic 48567
                                                   Barry Greenley 48544
Tammy Vogt, Billing & Technology                   David Sather 48546
Administrator 34137                                Siler, J.      46884
Linda Hale, Staff Assistant/Patient                Booseh Jafari 48566
Advocate        34135
Glenda Jenkins, Supervisor of Clinics              MAXILLOFACIAL Teri Forster5744
        34136
                                                   OCCLUSION Julie Hall 5052
Kathan Kent, Infection Control Officer
                                                   Edwin Wilson *                 48549
        13083
Central Business Office         14711
Deans * Departmental Chairs/Directors      Alan Miyake 46976 or 50057
New Patient Screening                      Lisa Nichols   46964
                                           Van Henson 46940
OPERATIVE               Suzan Stone 5735
Terry J. Fruits * 46878                    Oral Facial Surgery Center 4955
Randy White 46877
Robert Miller 46883
                                           ORTHODONTIC Terrie Birdsong 6087
Frank Miranda 46880
                                           Frans Currier * 46836
Lynn Montgomery 46879
                                           T. Dandajena 33277
Colin Foster      46884
                                           John Clayton 46837
                                           Seminar Room 46838
ORAL DIAGNOSIS         Andie               Yellow/Orange Clinic 14148 or 33263
Stringfellow 5988
Appt. Desk “New” Patients                  GRAD. ORTHODONTICS
Screenings     6056                        Angel Miller   4271
                                           Grad. Clinic
                                           Heather 4148 or 33261
Susan Settle *         46824               Donna Mead 33260

Dr. Jennings   46826
Emile Farha    46829                       PEDIATRIC DENTISTRY
Dr. Beavers    46825                       Roberta Rains 5579
Farah Masood 46827                         Kevin Haney * 46523
Dr. Lyda Radfor        46828               Nancy Romano 46525
Radiology Staff 15687                      Theresa White * 46522
Clinic Dispensary 14946
Charlene Shaw 14945                        PERIODONTICS                    Robin
                                           Barnes 4544
                                           Robert Carson *         46534
ORAL IMPLANTOLOGY              Jana        Doug Hall               46533
Williams      3956                         Jane Amme               46538
Nancy Jacobsen *48640                      Sharon Severson                  46537
Joy Hasebe     46521                       David Weiner            46536

ORAL PATHOLOGY                             GRAD. PERIODONTICS              Ann
Karen Lassiter 4333                        Sullivan        6531
                                           Robert Carson - Director
Glen Houston *                             Joy Beckerley 17020

David Lewis                                REMOVABLE PROST. Ruth Alferos
                                           4160
ORAL PATHOLOGY LAB                         Frank Wiebelt * 48561
Geri Stevens 5880                          Joseph Cain    48564
                                           Paul Mullasseril      48542
ORAL SURGERY (Sheri Foster-4955)           Nancy Jacobsen        48563
46963 4441                                 Removable Lab 48565
                                           Dan Tylka      48548
Steven M. Sullivan *50055
Appointment Desk 4079                      RESEARCH Development Luellen
Kevin Smith *50056                         Chenoweth 2929
Debbie Wedemeyer 46981
                                           John Dmytryk, Assoc. Dean Research *

                                           RESTORATIVE                     Suzan
                                           Stone 6400

                                           James Kessler * 18751
                                         CHILDRENS HOSPITAL
SUPPORT LAB David Dembinski 4565
                                         940 NE 13TH                       Room Info.
STOREROOM              5620                       X5437
Allen Williams
Darla Hall (Store Rm 46663) 5560         CHO Dental Clinic Dr. King - #44138 or
Billy Harley                             Rose X-4750 44137
Cyndi Hughes (Store Rm 46664)
Jack Dever                               CLINICS     Blue 3rd fl Fixed
Fax #1x5192                                    X5222 or 5056
Rocky Polk      15053
                                                            Brown 2nd fl Restorative
UDFG RECEPT.                                                 6333
Felita Sapp                      5714
                                                          Burgundy 3rd fl Removable
Tim Rudd, Executive Director * 48562               4008
Appt. Desk      2209
                                                          Gold 3rd fl Operative
Jody Maddox 46583                                  6532
Jade 46575                                             Green 4 th fl
                                         Endo/Maxillofacial 6953/5744
ADMISSIONS & RECORDS OUHSC
            2359                                          Yellow/Orange 4th fl
Registration   1539                      Pedo/Ortho        2360
        Records     1537
                                                          Maxillofacial 2nd fl Oral
                                         Surgery            5744
BOARD OF GOVERNORS OK
PRACTICES          524-9037              New Screening and Emergency Clinic OD
                                         2nd fl   6056
Linda Campbell, Executive Director
Fax 524-2223                             COMMONS AREA             1ST FLOOR
                                               4690
BURSAR
Sherry Glover             2433
                                         COMPUTER LAB
CAB SERVICES:          YELLOW CAB
232-6161                                 3691

CAMPUS POLICE        Emergency           FACULTY HOUSE            Reservations
                       4911              235-8212
Non-Emergency                 4300       FINANCIAL SERVICES
Fire                          4112       2345
Coronary Care – St. Anthony’s 236-0191   Financial Aid
OMH = Emergency               4363       Pam Jordon 12118
                                         A/P                2410
                                         Fax 2367
CENTRAL STERILIZATION                    Budget Office      2404
          5350                           Ext. 46504
Labs: Dental Support          4565       Bursar             2441
      Pre-Clinic Lab          6462       Fax 2057
                                         Controller         2376
                                         Grants & Contracts 2177
                                         Payroll            2055
                                         Fax 2057
                                         SUR Accounting     2246
Special Account               2410       Terry, Lanny, Terri, Trish          2173

                                         POISON CONTROL                   15454
GOOD SHEPHERD MISSION
232-8631                                 POST OFFICE                      2225
216 NW 12TH
                                         PROVOST
HOUSEKEEPING         Cheryl – 521-7931   Ann Whittmann           X2332 X 48400
5726
                                         Becky Wood                       12332
LEGAL                         2033       Vice President - Provost
Jill Raines                              Dr. Ferretti                     12399
Fax 1076                                 Cheryl Ottman                    48416
                                         Dr. Marcia Bennett               48408
OKLAHOMA DENTAL ASSOCIATIO               Peggy Brown                      48409
848-8873                                 Legal –Jill Raines               12033
Dana Davis
Fax 848-8875                             Fax 3151
                                         Karen Ambrose,
                                         Dr. Raskob’s Office              48401
PURCHASING                    5313
Director                      4903
                                         RATCLIFFE’S BOOKSTORE
Assoc. Director               6587
                                         Sammi         2448
Secretary                     5313
Fax 2148
                                         SITE SUPPORT                        1121
      rd
LAB 3 Floor                   4565
LECTURE HALL                             STAPLES KITCHEN -
In Room 108                   2567       Located in The Commons              6323

                                         STATE FUNDS APPROPRIATIONS 2355
LOCK SHOP
Charlie or Tom                2158
                                         ST. ANTHONY’S HOSPITAL
                                         272-7373 1000 N. LEE
MARY MAHONEY CLINIC
769-3301                                 STUDENT AFFAIRS              Kate Stanton
                                         271-2416
NORMAN CAMPUS INFORMATION
         325-0311                        SWITCHBOARD            Front Desk
                                         Jo Rumley 6326
PARKING OFFICE          Larry 2020
                                         TICKETS       Football/Basketball
PRE-CLINIC 433 LAB            6462       (Norman)         325-2424

Senior Lab 301                2635
                                         TRAVEL          Reimbursements
PRINT SHOP Tony               2322       SCB - 218          2038
PERSONNEL OFFICE Fax 3925 2180
                                         UNIVERSITY OMH (OMS)             271-4131
Administration 2191
Employee       2190
Benefits       2188                      V.A. HOSPITAL                    270-1505
                                         Dr. Nasser2                      270-5139
Wage / Salary 2187
                                         WEATHER LIN                          6499
1) Worker’s Comp. Unemployment2189       WREB
Records             2186                 602 – 944-3315
                                         A Fax 602 – 371-8131
PHOTOGRAPHY
                                       FERPA
                  Family Educational Rights and Privacy Act



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

The Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. § 1232g; 34 CFR
Part 99) is a Federal law that protects the privacy of student education records. The law
applies to all schools that receive funds under an applicable program of the U.S.
Department of Education.
FERPA gives parents certain rights with respect to their children's education records.
These rights transfer to the student when he or she reaches the age of 18 or attends a
school beyond the high school level. Students to whom the rights have transferred are
"eligible students."


D.     Parents or eligible students have the right to inspect and review the student's
       education records maintained by the school. Schools are not required to provide
       copies of records unless, for reasons such as great distance, it is impossible for
       parents or eligible students to review the records. Schools may charge a fee for
       copies.
E.     Parents or eligible students have the right to request that a school correct records
       which they believe to be inaccurate or misleading. If the school decides not to
       amend the record, the parent or eligible student then has the right to a formal
       hearing. After the hearing, if the school still decides not to amend the record, the
       parent or eligible student has the right to place a statement with the record setting
       forth his or her view about the contested information.
F.     Generally, schools must have written permission from the parent or eligible
       student in order to release any information from a student's education record.
       However, FERPA allows schools to disclose those records, without consent, to
       the following parties or under the following conditions (34 CFR § 99.31):
G.       School officials with legitimate educational interest;
H.       Other schools to which a student is transferring;
I.       Specified officials for audit or evaluation purposes;
J.       Appropriate parties in connection with financial aid to a student;
K.       Organizations conducting certain studies for or on behalf of the school;
L.       Accrediting organizations;
M.       To comply with a judicial order or lawfully issued subpoena;
N.       Appropriate officials in cases of health and safety emergencies; and
O.       State and local authorities, within a juvenile justice system, pursuant to specific
              State law.
Schools may disclose, without consent, "directory" information such as a student's name,
address, telephone number, date and place of birth, honors and awards, and dates of
attendance. However, schools must tell parents and eligible students about directory
information and allow parents and eligible students a reasonable amount of time to
request that the school not disclose directory information about them. Schools must
notify parents and eligible students annually of their rights under FERPA. The actual
means of notification (special letter, inclusion in a PTA bulletin, student handbook, or
newspaper article) is left to the discretion of each school.
For additional information or technical assistance, you may call (202) 260-3887 (voice).
Individuals who use TDD may call the Federal Information Relay Service at 1-800-877-
8339.
Or you may contact us at the following address:
Family Policy Compliance Office U.S. Department of Education 400 Maryland Avenue,
SW Washington, D.C. 20202-5920
                           University of Oklahoma
                  Health Sciences Center (OKC/OU-Tulsa)
             On-Site Provision of Services at K – 12 Schools Policy
                             Background Checks

Application of Policy
This policy applies to all employees, residents and students of the University of
Oklahoma Health Sciences Center and OU-Tulsa who provide University
sponsored
services on K – 12 school premises. Faculty, staff, or students who volunteer to
perform
services unrelated to the business of the University to support humanitarian,
charitable, or
public service activities are not subject to this policy; but are subject to any
policies and
procedures regarding background checks established by the organization where
they
volunteer to provide services.
A. Purpose
1. Oklahoma state law prohibits entities that contract with or provide services to
school
districts from allowing any person to provide services on school premises if the
person has been convicted of any sex offense, subject to the Oklahoma Sex
Offenders
Registration Act (or similar state or federal law), or any felony offense, within the
past ten years. The entity providing services is legally responsible for
compliance
with this law.
2. This policy is intended to ensure the state law requirements for persons
providing
services on K-12 school premises are met, and the University provided on-site
services meet their commitments.
B. Statement of General Policy
1. It is the policy of the University of Oklahoma Health Sciences Center and OU-
Tulsa
that all employees, residents and students who provide on-site services on K – 12
school premises complete the University of Oklahoma Declaration Regarding
Prohibition of Sex Offenders and Convicted Felons on School Premises form and
have this background information verified prior to and as a condition of
providing on-
site services to schools. Faculty, staff, or students who volunteer to perform
services
unrelated to the business of the University to support humanitarian, charitable,
or
public service activities are not subject to this policy, but are subject to any
policies
and procedures regarding background checks established by the organization
where
they volunteer to provide services.
2. This policy applies to all employees, residents and students who provide any
University sponsored on-site services to K – 12 schools. Individuals subject to
this
policy must notify Human Resources and their department if there is any change
in
their status regarding criminal or violent offender registry.
3. Declining to submit the declaration is grounds for not selecting or allowing an
individual to participate in the services. Discovery of violations of University
policies shall be handled in accordance with paragraph C, Sanctions for
Violation.
Appropriate action will be taken by the department in consultation with the
applicable
campus Human Resources office.
University of Oklahoma Health Sciences Center
Human Resources September 1, 2006
University of Oklahoma
Health Sciences Center (OKC/OU-Tulsa)
On-Site Provision of Services at K – 12 Schools Policy

4. Providing on-site services may not begin until the University has received the
Declaration and verified the information.
C. Sanctions for Violation
Violations of University policies, discovered after approval to provide services to
include
providing false or misleading information, will be handled in accordance with
applicable
University policies and procedures; providing for disciplinary actions up to and
including
termination of employment from the University. Violations by students or
residents will
be handled in accordance with University policies regarding standards of
conduct.
D. Appeals
Individuals who are notified they are listed on the registries and will not be
permitted to
provide services on K – 12 premises may contact the appropriate Human
Resources
office to initiate an appeal.
Office Responsible for this Policy
Office of Human Resources
Effective Date
September 1, 2006



University of Oklahoma Health Sciences Center
Human Resources September 1, 2006
             Blackboard Instructions for Students

                         How to Access Blackboard

1. Enter the Blackboard site at ouhsc.blackboard.com (Do not precede with
   www.)
2. Sign-on using campus username and password
3. Click on the course that you wish to enter



             How to Access On-line Course Evaluation

1.    Enter the Blackboard site at ouhsc.blackboard.com (Do not precede with
     www.)
2.   Sign-on using campus username and password
3.   Click on the course that you wish to complete the course evaluation on
     the right side of the Welcome screen
4.   On the left side of the Announcement screen, click Course Evaluation.
5.   On the next screen, click Course Evaluation and follow instructions given.
SECTION B

  Goals
    &
Philosophy
                       DEPARTMENT OF DENTAL HYGIENE
                           GOALS and PHILOSOPHY

The philosophy of the Dental Hygiene Program at the University of Oklahoma is one of
commitment to the education of oral health professionals who are capable of integrating
educational, clinical, and individual services that support and promote the total health of the
patient as well as optimal oral health.


In addition to the broader goals of the University and the College, the following goals have been
adopted. Graduates of the Department of Dental Hygiene are expected to:
1. Be competent in recognition, evaluation, and appropriate treatment of oral diseases.
2. In all settings in which responsibility has been delegated, apply scientific principles and an
    analytic approach to the practice of dental hygiene, educational endeavors, public health and
    research.
3. Act as an integral member of the dental health team by performing quality preventive and
    therapeutic dental hygiene services, in a variety of settings, in order to improve the oral
    health status of the consumer.
4. Function as a valuable member of interdisciplinary teams of health personnel recognizing
    the unique contributions of each discipline.
5. Communicate effectively with patients and colleagues, develop intellectual          curiosity and
    demonstrate the skills necessary to enhance learning and continue professional development
    throughout their career.


The curriculum is designed and implemented with the goals as a foundation. The facilities offer
a good environment for basic science and pre-clinical instruction, laboratory and clinical
experiences. Faculty are dedicated to excellence; sensitive to the depth of the curriculum
offered; offer a wide range of professional experiences; and attempt to establish an atmosphere
of respect and understanding with students.


The program goals require that students provide appropriate treatment of oral diseases, apply the
scientific principles and an analytic approach to all aspects of dental hygiene practice, act as an
integral member of the health team, communicate effectively with patients and colleagues and
demonstrate skills necessary to enhance continued professional development. In order to meet
the goals of the program, one of the educator's primary challenges is to provide opportunities to
foster and improve the students' critical thinking skills. This task falls not just to didactic course
directors, but even more importantly to clinical instructors who are most likely to have more
occasions to reinforce theoretical concepts and apply what has been learned in the classroom to
actuality.
                                                                                                       9
The attainment of the program's goals necessitate background knowledge and skills in a variety
of curriculum areas but just as importantly, the addition of knowledge of the latest scientific
advancements and innovations in dental hygiene practice and health care systems. This essential
information on the latest scientific advancements is provided by faculty in the classroom,
laboratory, clinic and community projects, but training for student involvement both while in the
educational process and later as a professional is provided by requiring active participation by
the students in the attainment of information (i.e., library assignments, reading updated texts,
individual research assignments, sharing of information by peer presentations, etc).


The goals are a living document sensitive to the changing needs of the profession. Each year
usually in late summer the goals are reviewed, evaluated and revised as necessary by the faculty
during a faculty retreat established for that purpose. The retreat is mandatory for faculty holding
50% or greater commitments to the school and other part-time faculty may attend.




                                                                                                   10
                          DEPARTMENT OF DENTAL HYGIENE
                               MISSION STATEMENT

The mission of the Department of Dental Hygiene (DDH) is to improve the health of
Oklahomans and shape the future of dentistry by developing highly qualified dental
hygienists through excellence in education, patient care, research, community service,
faculty, and facilities.

                                 GOAL #1: EDUCATION

Prepare students, through appropriate academic and clinical education, to be
qualified dental hygienists.
1.1    Recruit students of the highest quality who can reasonably be predicted to successfully complete the
               educational programs of the College within specified time frames.
  1.2 Provide appropriate didactic and clinical instruction through an inter- active,
      competency-based curriculum that is reviewed regularly and modified as
      necessary to address the dynamics of a constantly changing profession.
  1.3 Provide didactic and clinical instruction in a positive learning environment
      that leads to social and ethical development along with technical competency
      and practice management skills.
  1.4 Create opportunities for life-long learning.
  1.5 Develop a curriculum that incorporates critical thinking skills and is
      evidence-based where possible.
  1.6 Integrate biomedical and clinical sciences throughout the curriculum.


                               GOAL #2: PATIENT CARE

Provide appropriately supervised dental hygiene treatment of the highest quality.
2.1    Provide comprehensive patient-centered care throughout the clinical education programs as an integral
               component of the College's teaching and service missions.
  2.2 Develop and implement a quality of care program based on measurable
      criteria that facilitate reliable and valid assessment.
  2.3 Teach the necessity of professional ethics and responsibility in the delivery of
      patient care.


             GOAL #3: RESEARCH and SCHOLARLY ACTIVITY
Create a positive and rewarding academic environment that facilitates research and
scholarly activity by both students and faculty.

3.1 Provide opportunities for the discovery and dissemination of new knowledge in
    oral health science and dental hygiene education through research programs
    involving faculty and students.
3.2 Provide faculty with sufficient time and resources to engage in productive research
    and other scholarly activities.

                                                                                                     11
3.3 Create a culture in which achievements in research and scholarly activity by both
    faculty and students are recognized and rewarded.


                         GOAL #4: COMMUNITY SERVICE

Foster opportunities for involvement in service activities that are consistent with the
dental hygienist’s responsibility to promote oral health care as an integral component
of the overall health and welfare of the community.
4.1    Identify new and strengthen existing relationships between the College's academic programs and the
               public.
  4.2 Encourage student and faculty participation in and support of professional
      service organizations that promote the service mission of the College and the
      dental profession.


                                   GOAL #5: FACULTY

Provide students with highly qualified faculty and provide faculty with an
environment that facilitates personal and professional growth.

  5.1 Recruit and retain highly qualified faculty with the requisite education,
      knowledge, clinical skills, and motivation to facilitate student advancement of
      the College's didactic and clinical goals.
  5.2 Provide a total compensation package and an environment that are competitive
      with peer institutions.
  5.3 Provide opportunities for faculty development.

                                  GOAL #6: FACILITIES

Provide a state-of-the-art educational environment.

  6.1 Incorporate relevant innovations in information technology and management
      as an integral facet of the College's goals in the areas of teaching, patient care,
      research, and service.
  6.2 Expose students to advanced dental technology and equipment to best prepare
      them for practice.
  6.3 Initiate an ongoing program for facility maintenance and improvement.


                                                      Adopted by Faculty June 14, 2007




                                                                                                   12
                           DEPARTMENT OF DENTAL HYGIENE
                                   PHILOSOPHY


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

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


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

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

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

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



                                                                                                  13
III. PATIENT CARE
The dental hygienist is a licensed preventive oral health professional that provides
educational and clinical services in the support of optimal oral health. The dental hygiene
process of care applies principles from biomedical, clinical and social sciences to diverse
populations that may include the medically compromised, mentally or physically challenged,
or socially or culturally disadvantaged.




                                                                                              14
                   CLINICAL DENTAL HYGIENE OBJECTIVES

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

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

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

2. Utilize correct dental terminology                  a.      Student utilizes professional
   professional communications.                                terminology with professionals.
                                                       b.      Student utilizes layman
                                                               terminology with patients
                                                       c.      Student utilizes correct
                                                               terminology in presentation
                                                               of oral exam findings.
                                                       d.      Student utilizes correct
                                                               terminology in written
                                                               communications (i.e. clinic
                                                               records and treatment plans).

3. Demonstrate proper maintenance,                     a.      Student satisfactorily
   sterilization, and storage of clinical                      completes clinical assistant
   armamentarium.                                              duty assignments.
                                                       b.      Faculty monitors student
                                                               preparation and maintenance
                                                               of equipment and
                                                               armamentarium by
                                                               commenting on
                                                               student/faculty comment
                                                               sheets.


4. Demonstrate principles of asepsis                   a.      Faculty monitors demon stration
   in treatment of all patients.                               of asepsis
   Comments on student/faculty sheets.                 b.      Student demonstrates
                                                               competency by performing all
                                                               criteria stated in asepsis
                                                               performance




                                                                                                   15
5. Demonstrate use of fundamental            a.   Student identifies
   principles of, and perform patient             necessary treatment
   evaluation, data collection, treatment         for each patient,
   planning, and delivery of                      documents these indicated indicated
   therapeutic and                                services on the treatment plan.
   preventive services with emphasis on      b.   Student prepares written
   individualized treatment and/or patient        treatment plan according to
   need.                                          criteria.
                                             c.   Student satisfactorily
                                                  completes clinical requirements
                                                  specified in clinical contract,
                                                  meeting competency
                                                  level.

6. Apply basic principles of                 a.   Student completes instrumentation
   for patient                                    competencies for basic examination
   and removal of deposits.                       instrumentation for removal of
                                                  deposits as well as root planning
                                                  with Gracey curets.
                                             b.   Tissue trauma and
                                                  calculus removal is within
                                                  acceptable limits.

7. Assume responsibility for                 a.   Student plans in order
   his/her educational experience.                to complete clinical requirements.
                                             b.   Student matches patient
                                                  profile with requirements.
                                             c.   Student completes proper
                                                  preparation and evaluation.

8. Demonstrate effective time                a.   Faculty monitors skills
   management skills in completing                completed with specified
   clinical services.                             time expected.
                                             b.   Student performance
                                                  demonstrates efficient time
                                                  utilization.

9. Identify or describe anatomic             a.   Student interprets and utilizes
   structures and conditions in a                 radiographs for patient
   given radiograph.                              education and treatment
                                                  planning.




                                                                                       16
                             CLINICAL COURSE EVALUATION

Evaluation Policy Goals:

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

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

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

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

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

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

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

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




                                                                                                  17
8.    Clinical course requirements and grading are established based on student need and are
      written in contract form at the beginning of each clinical semester. Amendments to the
      grade contract may be made upon agreement of both faculty
      and students.

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

10. In addition to specified requirements, students must complete the following
     • For the clinical program to be considered complete:
         treatment for all assigned patients has been concluded or arrangements have been
         made for continuation of long term therapy

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

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

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




                                                                                               18
 SECTION C
PROFESSIONALISM
  ATTENDANCE
ATTITUDE/PROFESSIONALISM

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

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

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

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

I.     General Clinical Guidelines

       A.      The Clinic Manual must remain at the clinic station at all times, and
               students must refer to the manual to ensure that procedures are properly
               done.
       B.      Certain procedures (i.e.: asepsis, appearance, patient management,
               professionalism, patient education, etc.) apply to each patient and are
               considered part of the total competency evaluation .

       C.      The student will utilize feedback given by instructors on all procedures.
       D.      Once a student has achieved competency in a certain procedure,
               that procedure may be subject to spot checks. An unsatisfactory spot check
               will require an additional demonstration of competency for that procedure.
       E.      Faculty must be in clinic for any procedure to be started on a patient.

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


                                                                                        19
II.    General Clinic Conduct

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

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

III.   Professional Conduct

       A.     Class, Laboratory and Clinic Attendance
              You are expected to attend all classes, laboratories, and clinic sessions
                      and to have patients for all clinic appointments.

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

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

IV.    Professional Attitude

       A.     Shows initiative while seeking to utilize free time.

       B.     Uses time efficiently.

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

       D.     Demonstrates discretion when conversing in the clinic.

       E.     Protects patient's rights to privacy.

       F.     Upholds honest and ethical behavior in all situations

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

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

       I.     Continued eagerness to learn.

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




                                                                                          20
K.   Attitudes of respect, concern, and cooperation toward fellow classmates,
     support personnel, and faculty.
L.   Honesty.




                                                                            21
                   DEFICIENCY IN PROFESSIONAL
                     CONDUCT OR PERFORMANCE

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


Name of Student                                              Date


Faculty/Staff                                                Time


Chart # (if applicable)                                      Location


Check applicable category(ies) of deficiency:

                    Conduct                                             Performance

Attitude            Interpersonal relations           Judgment               Skill/competence



Behavior            Integrity                         Preparation            Other



Dress Code          Other                             Patient neglect


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




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

_____________________________________________                       _____________________
Faculty/Staff Signature                                             Date


_____________________________________________                       _____________________


                                                                                      22
Student Signature (2) *                                            Date


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




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

       a.     Actions endangering a patient’s well-being
       b.     Cheating, plagiarism, or falsification of records
       c.     Harassment or discrimination
       d.     Theft
       e.     Serious and/or repeated lapses of professional behavior, preparation,
              judgment, or competence in clinical, pre-clinical or classroom areas

(2)    The student signature acknowledges awareness of this documentation, but does
       not imply agreement or disagreement with its contents. The student may
       provide a written response to the Associate Dean for Student Affairs or the
       Associate Dean for Clinics.

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


_____________________________________________________________________________
_

Description of occurrence and immediate action taken (continued):




                                                                                       23
Faculty/Staff recommendation(s) for further action (continued):




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

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


General Attire

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

Guidelines

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

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

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

Pre-clinic Attire

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

Clinic Attire

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

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



                                                                                        25
Clothing such as jeans, shorts, and open-toed sandals and bare ankles are not allowed in
clinics. Although there is no restriction on hair length of students, long hair must be
pinned up while in clinic and the pre-clinic laboratory.

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

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

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

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

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

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

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

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




                                                                                          26
                                     ATTENDANCE

Classroom and Laboratories

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

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

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

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

Clinics

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

               PROPER PROCEDURE FOR REPORTING ABSENCES

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

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

        All absences are to be reported to the Course Director/ Dept Administrative
                      Secretary and the Clinical Coordinator
            for documentation; however, this DOES NOT EXCUSE the absence.
Arrangements must be made with individual course directors




                                                                                            27
SECTION D

SCHEDULES
SUMMER II SEMESTER 2007

June 22 ...............................................................................................................DH1 Orientation
June 25 ............................................................................DS1 Orientation/White Coat Ceremony
June 26 ....................................................................................................... DS1 Anatomy Begins
July 4 ..................................................................................................Independence Day Holiday
July 13 ..................................................................................................... DS3 Last Day of Clinic
July 16 .................................................................................................................. Faculty Retreat
July 17-19 ................................................................... DS4 Professional Development Workshop
July 17 ................................................................................................................DH Board Exam
July 18 ................................................................................................................DS3 Grades Due
July 23-Aug 3 .........................................................................................DS4 Group 1 Externship
August 6-17 ............................................................................................DS4 Group 2 Externship
August 9 .................................................................................. DS 1 Anatomy Final Examination

                                                        ORIENTATION

August 14 & 15................................................................................................... DS2 Orientation
August 15 & 16................................................................................................... DS3 Orientation
August 15-16 ......................................................................................................DH2 Orientation
August 15-17 ......................................................................................................DH1 Orientation
August 17 ........................................................................................................... DS1 Orientation
August 20 ........................................................................................................... DS4 Orientation

                                                  FALL SEMESTER 2007

August 14 .....................................................................DS2 EPD (BSEB-ELH) begins at 8:00am
August 15 ..................................................... DS1 Embryology (BSEB-WLH) begins at 10:00am
August 17 ...............................................................DS1 Physiology (CPB-103) begins at 8:00am
August 20 ........................................................................................................ All Classes Begin
August 21 ........................................................................................................ ODA Fall Festival
September 3....................................................................................................Labor Day Holiday
TBD......................................................................................................................OUCOD Picnic
October 5 ................................................................................... Fall Break (no classes or clinics)
November 2-4.........................................................................Hinman Student Research Meeting
November 16 .......................................................................Statehood Day (no classes or clinics)
November 19-21....................... ..................................DS2 & DS4 Board Review (NO CLASSES)
November 21-25 ........................................................................................ Thanksgiving Holiday
December 7 (week 16) ................................................................................... Last Day of Classes
December 10-14 (week 17) ................................................................... Final Examination Week
December 17-18.................................................................................................... Faculty Retreat
December 19 ..............................................................................................................Grades Due
December 15.................................................................................Student’s Winter Break Begins




                                                                                                                                      29
                                                    SPRING SEMESTER 2008

January 2-4 .......................................................................................DS1 Dental Material Course
January 7 ........................................................................................ Dental Student Classes Begin
January 14...................................................................................... Dental Hygiene Classes Begin
January 21......................................................................................... Martin Luther King Holiday
February 23.................................................................................................... OUCOD Kids’ Day
March15-23 ............................................................................................................. Spring Break
March 25 ................................................................ National Board Dental Hygiene Examination
April 2-5 .............................................................................................................. AADR Meeting
TBD........................................................................................................................Scientific Day
TBD..................................................................................................... WREB Dental Orientation
TBD............................................................................................................. WREB Dental Exam
May 5-9 (week 17)................................................................................. Final Examination Week

May 10................................................................................... OU Norman/Dental Hygiene Commencement

May 11.................................................................................................................Dental Hygiene Convocation
May 13 ........................................................................................................... DS1-3 Grades Due
May 26 .....................................................................................................Memorial Day Holiday
June 6 (week 20).................................................................................... DS4 Last Day of Classes
June 7 .......................................................................................................Dental Commencement
June 10 ...............................................................................................................DS4 Grades Due
TBD...................................................................................... WREB Dental Hygiene Orientation
TBD............................................................................................... WREB Dental Hygiene Exam
                                       DS1 POST SESSION: May 12-May 30 (weeks 18-20)
May 30 .......................................................................................................... Last Day of Classes
June 3 .........................................................................................................................Grades Due

                                       DS2 POST SESSION: May 12-June (weeks 18-21)*
June 6 ............................................................................................................ Last Day of Classes
June 10 Grades Due

                                  DS3 LATE SPRING CLINIC: May 5-July 11 (weeks 17-26)

July 4 .......................................................................................................................Independence Day Holiday
July 11 ............................................................................................................Last Day of Clinics
July 15 ........................................................................................................................Grades Due

                                          DS4 SUMMER II SESSION: July 15-August 15
July 15-17…...…………………...……………………………………Prof Develop Workshop
July 21-August 1…...………………………………………………………Group 1 Externship
August 4-15………………………………………………………………...Group 2 Externship
2007-08AcadCal
                                                (SKY & KC approved; 6/13/07




                                                                                                                                                  30
           DH II ORIENTATION SCHEDULE – HSC STUDENTS
                           CLASS OF 2008
WEDNESDAY, AUGUST 15, 2007

                             HSC Students only
10:00 am     Room 108        TB Shots                                       Judy Davis



                                ALL DH II STUDENTS AT COD
10:30 a.m.   Room 108       Welcome Back                                    Dr. Bowers/ Ms. Coury
                            Background Checks
                            Complaint Log
                            Student tutoring/policy
11:00 a.m.   Room 133       Instrument Kit Issue                            Darla Hall
             StudentStore
12:00 p.m.   Commons        Lunch and Welcome to Class of 2009              Senior DH Students
1:00 p.m.    Room 108       Welcome                                         Dr. Bowers/ Ms. Coury
             (with DH I     Review of Student Handbook
             Students)      Must read, sign that you have read the
                            document, and return to Kristy Jurko or your
                            site coordinator before Friday of the first
                            week of classes that you agree to comply with
                            handbook regulations
                            Explanation of Program Competencies
                            Enrollment/Details
2:00 p.m.    BSEB 320       Oral Pathology                                  Dr. Glen Houston
                                                                            Dr. David Lewis
3:00 pm –    BSEB 320       Clinical Dental Hygiene Orientation             Professor Jane Gray,
5:00 pm                     TA orientation                                  Senior Clinical Coordinator

THURSDAY, AUGUST 16, 2007
8:30 a.m.    Room 364       Rotation Information                            Professor Jane Gray,
                                                                            Senior Clinical Coordinator
10:00 a.m.   Room 364       Clinical Operations Update                      Ms. Kathy Miller
                                                                            Asst. Director of Clinics
11:30 a.m.   Room 364       Implantology and Pedo                           Ms. Nancy Romano
                                                                            Pedo Coordinator
12:00 p.m.                  Lunch (on your own)
1:30 p.m.    Room 364       Oral Diagnosis & Radiology Orientation          Dr. Susan Settle,
                                                                            Chair Oral Diagnosis
2:00 p.m.    Room 364       Tinker                                          Dr. McLeod
                                                                            Diana Mills
2:45 p.m.                   Break
3:00 p.m.    Room 364       Good Shepherd Mission                           Dr. Lipsinic
3:30 p.m.    Brown          Graduate Periodontics Orientation & Tour        Jean Lapham
             Clinic




                                                                                                     31
                                                             The University of Oklahoma
                                                            Department of Dental Hygiene
                                                                  Fall 2007 DHI

          MONDAY               TUESDAY                WEDNESDAY                   THURSDAY                   FRIDAY
8AM
                                                                                     Dental Morphology
                                                                                          Lecture
9AM
             CDH I Theory         CDH I Theory        CDH I Theory Lecture/                Dr. Ed Wilson     Computer Orientation
             Lecture/ Clinic      Lecture/ Clinic            Clinic
                                                                                                                    Jason
          Prof Tammie Vargo    Prof Tammie Vargo       Prof Tammie Vargo
10AM
                                                                                      Oral Radiology            Head & Neck
                                                                                     Dr. Farah Masood          Anatomy Lecture
             Lydia Snyder          Lydia Snyder            Lydia Snyder                   Lecture               Prof. Julie Mc
           Christy Brannock      Christy Brannock        Christy Brannock                                           Clung
            Julie McClung         Julie McClung           Julie McClung

11AM
12 NOON

1PM
             Oral Diagnosis    CDH I Theory Lecture   Preventive Dentistry                 Perio I Lecture
                Lecture                                       Lecture
                                                            (10 weeks) /          Dr. Robert Carson          Oral Radiology Lab
                               Prof Tammie Vargo         Health Education                    OUCOD*
                                                             (5 weeks)
2PM
          Dr. Kay S.                                                                 Oral Radiology Lab             Staff
          Beavers
                                                          Prof. Laurie                         Staff
                                                          Cunningham
                                                        Prof. Sheri French


3PM       Gen/Oral Histology
          Prof. Julie Mc
          Clung
4PM
                                                      The University of Oklahoma
                                                     Department of Dental Hygiene
                                                           Fall 2007 DHII
              MONDAY              TUESDAY           WEDNESDAY                        THURSDAY           FRIDAY
 8 AM                                                                                 Perio III*      Pain Control
                                                                                      DH 4601           DH 4472

                                                                                Dr. John Dmytryk     Dr. Van Henson
 9 AM     DH Process of Care      Rotation I      DH Process of Care                   CDH III
              DH 4332             DH 4331             DH 4332                          DH 4336

           Prof. Jane Gray     Prof. Jane Gray     Prof. Jane Gray              Prof. Jane Gray
                                                                                Tammie Golden
                               Tammie Golden                                    Christy Brannock
                               Christy Brannock
 10 AM      Oral Pathology                                                                           Community
              DH 4144                                                                                Health Issues
                                                                                                      DH 4552
                                                                                                     Prof. Laurie
          Dr. Glen Houston                                                                           Cunningham

 11 AM

12 NOON
 1 PM          CDH III            CDH III              CDH III                      Oral Pathology
               DH 4336            DH 4336              DH 4336                        DH 4144

           Prof. Jane Gray     Prof. Jane Gray     Prof. Jane Gray             Dr. Glen Houston

           Tammie Golden       Tammie Golden       Tammie Golden
           Christy Brannock    Christy Brannock    Christy Brannock
 2 PM


 3 PM

 4 PM
                        Dental Hygiene Faculty Clinic Schedule
Travel days
Coury                 Thursday
Cunningham            Wednesday
Gray                  Wednesday
Vargo                 Wednesday
Zerby                 Wednesday


     Monday a.m.                    Tuesday a.m.           Wednesday a.m.          Thursday a.m.
                                        Blue               Yellow/Orange              Green
    Yellow/Orange
                                      (4 faculty)             (5 faculty)             (4 faculty)
        (5 faculty)
                             DH I Lecture/Clinic/Lab   DH I Lecture/Clinic/Lab
DH I Lecture/Clinic/Lab              ONLY


   12 Junior Partners             12 Junior Partners      12 Junior Partners         12 Seniors

Tammie Vargo                 Tammie Vargo              Tammie Vargo              Carol Zerby
Carol Zerby                  Carol Zerby               Carol Zerby
                                                                                 Sheri French
Kim Graziano                 Laurie Cunningham         Kathy Rogers              Laurie Cunningham
Donna Brogan                 Stephanie Schmidt         Sheri French
Sheri French


                             Vicki to VA               Carolyn Ray prn           Vargo prn
     Monday p.m.                    Tuesday p.m.           Wednesday p.m.
          Green                         Green                   Green
       (5 faculty)                   (4 faculty)              (3 faculty)
       18 Seniors                     16 Seniors              12 Seniors


Jane Gray                    Jane Gray                 Jane Gray
                             Carol Zerby               Kathy Rogers
Donna Brogan
Sheri French                 Stephanie Schmidt         Carol Zerby
Carol Zerby                  Carolyn Ray
Kim Graziano                                           Sheri French prn
                             Laurie Cunningham prn     Carolyn Ray prn
                                               2008 SPRING
                             Dental Hygiene Faculty Clinic Schedule
Travel days
Ray                         Tuesday
Coury                       Thursday
Cunningham                  Wednesday
Gray                        Wednesday
Vargo                       Wednesday
Zerby                       Wednesday
        Monday a.m.                   Tuesday a.m.              Wednesday a.m.            Thursday a.m.
       Yellow/Orange                      Blue                  Yellow/Orange                Green

         (5 faculty)                    (4 faculty)                (5 faculty)              (4 faculty)

  DH I Lecture/Clinic/Lab       DH I Lecture/Clinic/Lab     DH I Lecture/Clinic/Lab
                                        ONLY
         18 Juniors
        Spring ONLY                    12 Juniors                  18 Juniors
                                      Spring ONLY                 Spring ONLY               12 Seniors

Tammie Vargo                  Tammie Vargo                Tammie Vargo                Carol Zerby
Carol Zerby                   Laurie Cunningham           Carol Zerby
                                                                                      Sheri French
Kim Graziano                  Stephanie Schmidt           Kathy Rogers                Laurie Cunningham
Donna Brogan                                              Sheri French
Sheri French                                              Jane Bowers
                              Carol Zerby to IHS
                              Vicki to VA
        Monday p.m.                   Tuesday p.m.              Wednesday p.m.
              Green                         Green                        Green


         (5 faculty)                    (4 faculty)                (3 faculty)

         18 Seniors
                                        16 Seniors                 12 Seniors
  3 to TAFB
Jane Gray                     Jane Gray                   Jane Gray
                              Carol Zerby                 Kathy Rogers
Donna Brogan
Carol Zerby                   Stephanie Schmidt           Carol Zerby
Sheri French                  Laurie Cunningham

Kim Graziano
                                                          Tammie Vargo prn
     Labor Day - September 3                                          CLINIC SCHEDULE
     Fall Break - October 5                                               FALL 2007                                        Eminent Scholar TBD
     Statehood Day - November 16                                                                                                         No Classes
     Thanksgiving - November 21 - 25                               AUGUST 20 DECEMBER 07
     Final Exam Week - December 10 - 14                                WEEKS 1 - 16

AM                Monday                            Tuesday                Wednesday                Thursday                    Friday

     DS-4                                   DS-4 - PEDO            DS-4                         DS-3                DS-4
     Perio (GRN)                        6                          PERIO                   20   PERIO          20   OPER                              24
     P. SURG                            2   DS-3                   P. SURG                  2   P. SURG         2   FPD                                7
     OPER                              24   PERIO             16   FPD                     23   OPER           24   *RPD                              12
     FPD                               22   P. SURG            2   RPD                     12   FPD             6   ENDO                              11
     ENDO                              11   OPER              24   ENDO                     6   RPD            12   OD - BURG                          6
     RPD                               12   FPD                6   OD - BURG                6   ENDO            6
                                            RPD               12                                OD - BROWN      4
     DS-2 PAIRED                            ENDO               6
     PERIO/OD                          24   OD - BURG          6
     Grad Perio                         3
     **Reserve                          3   TPC               10
                                            OCCL               1
     DH-1                                   DH-1                   DH-1                         DH-2
     Yellow/OR                         24   BLUE CLINIC       12   YELLOW/OR               24   GRN CLINIC     12



PM                Monday                            Tuesday                Wednesday                Thursday                    Friday

     DS-3 PEDO/ORTHO                        DS-3 & DS-4            DS-4 PEDO/ORTHO              DS-4                DS-3 PEDO/ORTHO
                                            PERIO             16                                OPER           24
     DS-2 PAIRED                            P. SURG            2   DS-3                         FPD            22   DS-4
     PERIO/OD                          24   OPER              24   OPER                    24   ENDO           11   FPD                               21
     OCCL (DS-2)                            FPD               21   RPD                     12                       ENDO                               6
     OPER (TX PLANS)                        RPD               12   ENDO                    11   DS-1 PAIRED         OD - GRN                           6
                                                                                                ORAL
                                       3                                                   6
     Grad Perio                                                    OD - BURG                    PROPHYLAXIS
     **Reserve                         3                                                        TECHNIQUE
                                            TPC               10                                BRN CLINIC     24
                                            OCCL               1                                OD              5

     DH-2                                   DH-2                   DH-2
     GRN CLINIC                        24   GRN CLINIC        16   GRN CLINIC              12




                                                                                                                                                           2
                             DS-IV Dental Hygiene Rotation Fall 2007

                         P.M.                                        P.M.
Week 1                                      Week 9
Tues, Aug                                   Tues, Oct 16   McConnell, Mindy
21
Wed, Aug 22                                 Wed, Oct 17    McNair, Daniel

Week 2                                      Week 10
Tues, Aug      Fortenberry, Alan            Tues, Oct 23   Dunnington, Cody
28
Wed, Aug 29    Hobbs, Randi                 Wed, Oct 24    Mohanna, Parnam

Week 3                                      Week 11
Tues, Sep 4    Bockus, Marie                Tues, Oct 30   Pfeifer, Somer
Wed, Sep 5     Coever, Ashley               Wed, Oct 31    Schafer, Nicki

Week 4                                      Week 12
Tues, Sep 11   Deming, Steven               Tues, Nov 6    Vinson, Christopher
Wed, Sep 12    Saumur, Michael              Wed, Nov 7     Vu, John

Week 5                                      Week 13
Tues, Sep 18   Spencer, Lauren              Tues, Nov      Lawson, Mark
                                            13
Wed, Sep 19    Sulaver, Blake               Wed, Nov       Ludwig, Brian
                                            14

Week 6                                      Week 14
Tues, Sep 25   Adams, John
                                            Nov 19 -23 Happy Thanksgiving
Wed, Sep 26    Allen, Ross

Week 7                                      Week 15
Tues, Oct 2    Abou-Nasser, Elie            Tues, Nov      Holder, Wendy
                                            27
Wed, Oct 3     Adams, Blake                 Wed, Nov       Torabi, Ali
                                            28

Week 8                                      Week 16
Tues, Oct 9    Hammond, Kendra              Tues, Dec 4    Christensen, André
Wed, Oct 10    Kierl, Philip                Wed, Dec 5     Jenkins, Jennifer

                        Week 17 Dec 10 – 14 Finals Week




                                                                                 3
 Spring Rotation, if you have not been assigned a Hygiene Recall date for the fall

Bullard, Blake        Pettigrew, Janna        Tetik, Whitney
Cole, Matthew         Dauphin, Jeromy         Weaver, Zane
Hager, Mary           Wright, Asher           Sigmon, Clay
Hammond, Lindsay      Spurlock, Sara          Winters, Tyler
Jensen, Jamon         Albiston, Robert        Shutts, Terrance
Swisher, Brendon      Chang, Jason            Tims, Kara
Lanman, Ryan          Sixkiller, Cheryl       Whitman, Ryan
Noah, Ryan            Odejimi, Shina          Streight, Ryan
Peterson, Lindsay     Roberts, Ryan           Youngblood, Chase
                                              Whenry, Lauren




                                                                                     4
SECTION E


Curriculum &
Competencies
                                               University of Oklahoma
                                                College of Dentistry
                                                     2007-2008
                                        DENTAL HYGIENE CURRICULM


3RD        Course Title                          Clock               Faculty/Student            Course
YEAR                                     Crd     Hours/                  Ratio                  Director
                                         Hrs     Week

Fall                                           Lec   Lab   Cln           Lec      Lab    Cln
DH 3342    Head & Neck Anatomy            2     2     0     0            1:46                   McClung
DH 3242    Gen/Oral Histology             2     2     0     0            1:46                   McClung
DH 3271    Dental Morphology              1     1     0     0            1:46                    Wilson
DH 3313    Clinical DH Theory I           3     3     0     0            1:46                     Vargo
DH 3312    Clinical Dental Hygiene I      2     0     8     0            NA       1:4             Vargo
DH 3322    Oral Diagnosis                 2     2     0     0            1:46                    Beavers
DH 3423    Oral Radiography I             3     2     2     0            1:46     1:5            Masood
DH 3513    Preventive Dentistry           3     3     0     0            1:46                  Cunningham/
                                                                                                 French
DH 4401    Periodontics I                  1    1    0      0           1:106                    Carson
                TOTAL for Semester       19     16   10     0




Spring
DH 3111                                   1     1     0     0            1:46                     White
           Pediatric Dentistry
DH 3113    Pharmacology                   3     3     0     0            1:46                     Settle
DH 3121    Geriatric Dentistry            1     1     0     0            1:46                   Beavers/
                                                                                                 Vargo
DH 3422    Clinical DH Theory II          2     2     0     0            1:46                    Vargo
DH 3323    Clinical Dental Hygiene II     3     0     0     9            NA              1:4     Vargo
DH 3421    Oral Radiography II            1     1     0     0            1:46                    Masood
DH 3441    Dental Mat. Science            1     1     0     0            1:46     1:12          Khajotia
DH 3523    DH Research Methods            3     3     0     0            1:46                    Coury
DH 4421    Ethics and Jurisprudence       1     1     0     0            1:46                  Cunningham
DH 4501    Periodontics II                1     1     0     0           1:106                    Weiner
           TOTAL for Semester             17   14     0     9

4th YEAR
Fall
           Applied Dental Materials       1     0     1         0          1:46   1:10         Coury/Bowers
DH 3411
DH 4144    Oral Pathology                 4     4     0         0          1:46                  Houston
DH 4331    Clinical Rotation I            1     0     0         3          NA            1:5      Gray
DH 4332    Dental Hygiene Process of      2     2     0         0          1:46                   Gray
           Care
DH 4336    Clinical Dental Hygiene III    6     0     0         12         NA            1:5      Gray
DH 4472    Pain Control                   2     2     0          0        1:106   1:5            Henson
DH 4552    Comm. Health Issues            2     2     0          0         1:46                Cunningham
DH 4601    Periodontics III               1     1     0          0        1:106                 Dmytryk
                TOTAL for Semester        19   11     1         15


                                                                                                           40
Spring
DH 4341   Clin. Rotation II         1    0     0          3    NA     1:5      Gray
DH 4442   Advanced Clinical DH      2    0     0          0    1:46            Gray
          Practice
DH 4446   Clinical Dent. Hyg. IV    6    0      0         12   1:46   1:5      Gray
DH 4411   Practice Management       1    1      0          0   1:46           French
DH 4413   Senior Capstone Seminar   3    2      2          0   1:46           Bowers
DH 4541   Comm. Health Practicum    1    0     3P          0   NA           Cunningham
                                              P = Practicum
             TOTAL for Semester     14   3      5         15
          PROGRAM TOTAL             69   44    16        39




                                                                                      41
   Competencies for the
Entry-Level Dental Hygienist
            UNIVERSITY OF OKLAHOMA COLLEGE OF DENTISTRY
       COMPETENCIES FOR THE ENTRY-LEVEL DENTAL HYGIENIST


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

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

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

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

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

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



The entry-level dental hygienist is generally considered to be at stage three -- competency. With
additional experience and perhaps additional training, he/she may progress to become a master or
expert in dental hygiene. The development of competency statements is an attempt to define


                                                                                                42
what knowledge, skills and attitudes the entry-level dental hygienist should possess that are a
typical part of the practice of dental hygiene and able to be performed at or above an acceptable
level of defined standards by entry-level dental hygienists. These then provide a standard for
defining the core content of the curriculum and allowing the assessment of outcomes of our
curriculum.

ORGANIZATION

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

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

Supporting Competencies
The more specific abilities could be considered subdivisions of the "Major Competencies" and
are termed "Supporting Competencies." Examples of Supporting Competencies would include
"The ability to identify the chief complaint and reason for the patient's visit." or "The ability to
perform a radiographic examination appropriate for the patient." Achievement of a major
competency requires the acquisition and demonstration of all Supporting Competencies related to
that particular service or task. While less complex than a Major Competency, a Supporting
Competency also requires more specific abilities which are termed "Foundational
Competencies." The Supporting Competencies are listed by decimal numbering under their
respective Major Competencies.

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

The basic medical and dental sciences, behavioral sciences and clinical sciences all provide
instruction at the foundational level. Didactic, small group, seminar and laboratory instruction


                                                                                                   43
provides information and psychomotor experiences that enable students to acquire and
demonstrate competence in the clinical setting or context. The inclusion of any specific
foundational competency in the curriculum should be based on the direct support of one or more
of the "Supporting" and "Major" Competencies. Once a competency has been stated, it is not
repeated even though it may relate to later "Major" or "Secondary" competencies as well. In
time, a complete definition of the curriculum will identify all "Foundational Competencies."
These "Foundational Competencies" are associated with particular "Supporting Competencies"
and are listed without regard to ranking or priority. The "Foundational Competencies" are listed
by decimal numbering under their respective Supporting Competencies.

SUMMARY

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




                                                                                               44
                      THE UNIVERSITY OF OKLAHOMA
                         COLLEGE OF DENTISTRY
COMPETENCIES FOR THE ENTRY-LEVEL DENTAL HYGIENIST

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

1. Ethics: the entry-level dental hygienist must be able to discern and manage ethical issues
   of dental hygiene practice in a rapidly changing environment. Specifically, the dental
   hygienist must:
       1.1.   Apply the provisions of the Oklahoma State Dental Practice Act in dental
              hygiene practice.
       1.2    Apply the provisions of the American Dental Hygienists’ Association Code of
              Ethics in dental hygiene practice.
       1.3.   Apply the principles of ethical behavior in decision-making, in interactions with
              patients and staff, and in personal conduct.

2. Information Management and Critical Thinking: the entry-level dental hygienist must be
   able to acquire and synthesize information in a critical, scientific and effective manner.
   Specifically, the dental hygienist must:
       2.1      Recognize and use written and electronic sources of information.
       2.2      Evaluate the credibility and potential hazards of dental products and techniques.
2.3       Evaluate published clinical and basic science research and integrate this
          information to improve the oral health of the patient.
          2.4     Recognize the responsibility and demonstrate the ability to communicate
                  professional knowledge verbally and in writing.
          2.5     Accept responsibility for solving problems and making decisions based on
                  accepted scientific principles, as well as the accepted standard of care.

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

II. HEALTH PROMOTION AND PREVENTION


                                                                                                   45
    The dental hygienist serves the community in both practice and public health settings. Public
    health is concerned with promoting health and preventing disease through organized
    community efforts, which is an important component of any interdisciplinary approach. In
    the practice setting, the dental hygienist plays an active role in the promotion of optimal oral
    health and its relationship to general health. The dental hygienist therefore should be
    competent in the performance and delivery of oral health promotion and disease prevention
    services in the public health, private practice and alternative settings.

4. Self-Care Instruction: the dental hygienist must be able to provide planned educational
   services using appropriate interpersonal communication skills and educational
   strategies to promote optimal health. Specifically, the entry-level dental hygienist must:
       4.1      Promote preventive health behaviors by maintaining optimal personal oral and
                general health.
       4.2      Identify the health needs of individuals and assist them in the development of
                appropriate and individualized self-care regimens.
       4.3      Respect the goals, values, beliefs and preferences of the patient while promoting
                optimal oral and general health.
       4.4      Evaluate factors that can be used to promote patient adherence to disease
                prevention and encourage patients to assume responsibility for health and
                wellness.

5. Community involvement: the entry-level dental hygienist must be able to initiate and
   assume responsibility for health promotion and disease prevention activities for diverse
   populations. Specifically, the entry-level dental hygienist must:
       D.     Promote the values of oral and general health and wellness to the public and
              organizations within and outside the profession.
       5.2    Identify services that promote oral health and prevent oral disease and related
              conditions.
       5.3    Assess, plan, implement and evaluate community-based oral health programs.
       5.4    Be able to influence consumer groups, businesses and government agencies to
              support health care issues.
       5.5    Use screening, referral and education to bring consumers into the health care
              delivery system.
       5.6    Provide dental hygiene services in a variety of settings including offices,
              hospitals, clinics, extended care facilities, community programs, and schools.
       5.7    Discuss selected reimbursement mechanisms and their impact on the patient’s
              access to oral health care.

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




                                                                                                 46
6.      Assessment: the dental hygienist must be able to systematically collect, analyze and
accurately record baseline data on the general, oral and psychosocial health status using
methods consistent with medicolegal principles. Specifically, the entry-level dental hygienist
must be able to:

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

        6.4     Identify the patient at risk for a medical emergency and be prepared to handle the
                emergency should it occur during an appointment.
        6.5     Perform an extraoral & intraoral examination and record the findings.
        6.6     Perform an examination of the teeth and accurately record the results.
        6.7     Recognize need for & obtain radiographs of diagnostic quality.
        6.8     Radiographically distinguish normal from abnormal anatomical findings.
        6.9     Evaluate the periodontium and identify conditions that compromise periodontal
                health and function.
        6.10    Identify conditions and diseases that affect dietary intake and food selection, and
                recognize risks and benefits of alternative food patterns.
        6.11    Analyze and interpret the data related to and congruent with the diagnosis of the
                dentist and other health professionals.
        6.12    Utilize, interpret and analyze appropriate indices for patient assessment.
        6.13    Assess and analyze patient risk factors that may impact dental hygiene care.

7. Planning: the dental hygienist must be able to discuss the condition of the oral cavity,
   actual and potential problems identified, etiological and contributing factors, as well as
   recommended and alternative treatments available. Specifically, the entry-level dental
   hygienist must be able to:
       7.1    Use critical decision-making skills to reach conclusions about the patient’s dental
   hygiene needs based on all available assessment data including:
        7.1.1   Use of assessment findings, etiologic factors, clinical and other diagnostic data in
                determining a dental hygiene diagnosis.
        7.1.2   Identification of patient needs and significant findings that impact the delivery of
                dental hygiene care.
        7.2     Determine priorities and establish oral health goals with the patient/family and/or
                guardian as an active participant.
        7.3     Using a problem-based approach establish a planned sequence of educational and
                clinical services based on the diagnosis.
        7.4     Communicate the plan for dental hygiene services to the dentist or other
                interdisciplinary health team members to determine its congruence with the
                overall plan for oral health care.
        7.5     Communicate the plan for dental hygiene services to the patient, including its
                congruence with the overall plan for oral health care.

8. Implementation: the dental hygienist must be able to provide treatment in compliance
   with the overall treatment plan that includes preventive and therapeutic procedures to


                                                                                                 47
      promote and maintain oral health and assist the patient in achieving oral health goals.
      Specifically, the entry-level dental hygienist must be able to:
         8.1       Evaluate and utilize methods to ensure the health and safety of the patient and the
                   dental hygienist in the delivery of dental hygiene care.
         8.2       Apply basic and advanced principles of both hand and powered dental hygiene
                   instrumentation to locate and remove deposits without undue trauma to hard
                   and/or soft tissue:
                   8.2.1 Compare/contrast use of hand & powered instruments;
                   8.2.2 Identify indications and contraindications for sonic and ultrasonic use;
                   8.2.3 Identify appropriate instrument and/or insert for task;
                   8.2.4 Demonstrate finger rests & fulcrums for use of hand instruments;
                   8.2.5 Demonstrate placement, adaptation, angulation and working strokes with
                            hand instruments;
                   8.2.6 Appropriately utilize explorers, curettes, scalers, and other suitable hand
                            instruments;
                   8.2.7 Demonstrate finger rest modifications for powered instruments;
                   8.2.8 Utilize standard ultrasonic or sonic insert for removal of heavy calculus;
                   8.2.9 Utilize modified ultrasonic inserts for subgingival debridement and
                            root planing.
         8.3       Control pain and anxiety during treatment through the use of accepted clinical
                   techniques and appropriate behavioral management strategies, including, but not
                   limited to:
                   8.3.1 administration of local anesthesia
                   8.3.2 application of topical anesthesia
         8.4       Select and administer appropriate chemotherapeutic agent and provide pre- and
                   post-treatment instructions.
                   8.4.1 subgingival irrigation technique
                   8.4.2 use of site specific delivery vehicle systems
                   8.4.3 professional and home fluoride therapy
8.5       Provide adjunct dental hygiene services that can be legally performed
                including, but not limited to:
                  8.5.1 application of pit and fissure sealants
                  8.5.2 cleaning of removable prostheses and insertion
                  8.5.3 placement of temporary restoration
                  8.5.4 care and maintenance of restorations
                  8.5.5 selective coronal polishing
                  8.5.6 taking impressions
                  8.5.7 providing health education and preventive counseling
                  8.5.8 providing nutritional counseling related to oral conditions and/or disease
                  8.6     Describe experiential adjunct procedures
          8.7     Implement and evaluate measures to minimize occupational hazards in the work
                  place, including postural and engineering factors, such as equipment and
                  instrument design.

9. Evaluation: the dental hygienist must be able to evaluate the effectiveness of planned
   clinical and educational services and modify as necessary.
   Specifically, the entry-level dental hygienist must be able to:
       9.1      Determine the outcomes of dental hygiene interventions (re-evaluation) using
                indices, instruments, examination techniques and patient self-report.
       9.2      Evaluate the patient’s satisfaction with the oral health care received and the oral
                health status achieved.


                                                                                                   48
         9.3       Provide subsequent treatment based on evaluation findings.
         9.4       Develop and maintain a continuing care program.

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




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

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




                                                                                                                 49
             Clinical Competencies by Student Level

Pre-Clinic I
      *Dental Charting
      *Medical History
      Infection Control
      Multiple Instrument Competencies
      Rubber Cup Polishing
      Fluoride Tray
      Oral Inspection and Recording (EIE)
      Instrument Sharpening

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

Clinic III
       *Treatment Planning - CDI C patient
       Periodontal Charting on CDI C patient
       Calculus Removal and Root Planing on CDI C patient
       Ultrasonic Scaling
       Nitrous Oxide/Oxygen Analgesia Administration


Clinic IV
       Periodontal Charting on CDI D patient
       Calculus Removal and Root Planing on CDI D patient
       Local Anesthesia



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




                                                                                       50
SECTION F

HEALTH
ISSUES
    ANTIBIOTIC PREMEDICATION GUIDELINES
                           (2007)
 Current AHA Recommendations for Antibiotic Premedication for
                       Prevention of
            Subacute Bacterial Endocarditis (SBE)

Table 2: Primary Reasons for Revision of the IE Prophylaxis Guidelines

• IE is much more likely to result from frequent exposure to random bacteremias
associated with daily activities than from bacteremia caused by a dental, GI tract
or GU tract procedure.

• Prophylaxis may prevent an exceedingly small number of cases of IE, if any, in
individuals who undergo a dental, GI tract, or GU tract procedure.

• The risk of antibiotic-associated adverse events exceeds the benefit, if any, from
prophylactic antibiotic therapy.

• Maintenance of optimal oral health and hygiene may reduce the incidence of
bacteremia from daily activities and is more important than prophylactic
antibiotics for a dental procedure to reduce the risk of IE.

Table 3: Cardiac Conditions Associated with the Highest Risk of Adverse
Outcome from Endocarditis for Which Prophylaxis with Dental Procedures Is
Recommended

• Prosthetic cardiac valve

• Previous infective endocarditis

• Congenital heart disease (CHD)*

   o Unrepaired cyanotic CHD, including palliative shunts and conduits

   o Completely repaired congenital heart defect with prosthetic material or
       device, whether
       placed by surgery or by catheter intervention, during the first six months
   after the
       procedure**

   o Repaired CHD with residual defects at the site or adjacent to the site of a
     prosthetic
     patch or prosthetic device (which inhibit endothelialization)




                                                                                 48
• Cardiac transplantation recipients who develop cardiac valvulopathy


* Except for the conditions listed above, antibiotic prophylaxis is no longer
recommended for any
other form of CHD

**Prophylaxis is recommended because endothelialization of prosthetic material
occurs within 6
months after the procedure

Table 4: Dental Procedures for which Endocarditis Prophylaxis is
Recommended for
Patients in Table 3

All dental procedures that involve manipulation of gingival tissue or the
periapical region of teeth
or perforation of the oral mucosa *

*The following procedures and events do not need prophylaxis:
routine anesthetic injections through noninfected tissue, taking dental
radiographs, placement of removable
prosthodontic or orthodontic appliances, adjustment of orthodontic appliances,
placement of
orthodontic brackets, shedding of deciduous teeth and bleeding from trauma to
the lips or
oral mucosa.




                                                                                49
                                         Table 5: Regimens for a Dental Procedure

                                                                Regimen- Single Dose
    Situation                         Agent                     30-60 minutes before
                                                                     procedure
                                                                       Adults                             Children
       Oral                      Amoxicillin                            2gm                               50mg/kg
 Unable to take                   Ampicillin                        2g IM or IV*                      50 mg/kg IM or IV
 oral medication                      Or
                            Cefazolin or ceftriaxone
                                                                      1 g IM or IV                    50 mg/kg IM or IV
   Allerigic to                Cephalexin**†                               2g                             50 m/kg
  penicillins or                    OR
   ampicillin                   Clindamycin                              600mg                             20 mg/kg
      Oral                          OR
                       Azithromycin or Clarithromycin                    500mg                             15 mg/kg
   Allergic to             Cefazolin or ceftriaxone†                  1 g IM or IV                    50 mg/kg IM or IV
  penicillins or                     OR
 ampicillin and                 Clindamycin                        600 mg IM or IV                    20 mg/kg IM or IV
  unable to take
 oral medication
*IM – intramuscular; IV – intravenous.
**or other first or second generation oral cephalosporin in equivalent adult or pediatric dosage.
†Cephalosporins should not be used in an individual with a history of anaphylaxis, angioedema, or urticaria with penicillins or
ampicillin




                                                                                                                                  50
           PROTOCOL FOR PRE-MED PATIENTS at OUCOD
Rev 7/06




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


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



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



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


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




                                                                                     51
    OUCOD Hypertension Guidelines
    November 12, 2003

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


BP Scheme for Adults

•   Normal systolic BP < 120 and diastolic BP < 80

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

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

•   Stage 2 hypertension SBP > 160 or DBP> 100


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


PRESSURE RANGE                    OUCOD DENTAL THERAPY CONSIDERATIONS

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


    120-139                       Routine dental management. Recheck on subsequent visits.
     80-89                        Stress reduction protocol if indicated. Refer to physician if
                                  in this range for 3 consecutive appointments.

    140-159                       Recheck in 5 minutes. If still elevated, other factors (age, apparent
     90-99                        health, apprehension, history or hypertension, etc) will determine
                                  if dental treatment is possible at this time or medical referral is necessary.

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

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

Spring 2007

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

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

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

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

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

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

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

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

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

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

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




                                                                                                     53
                              EMERGENCY PROCEDURES
Medical Emergencies in the Dental Office:

The student is expected to:

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

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

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

       1.      syncope
       2.      shock
       3.      toxic reaction
       4.      cardiac arrest
       5.      angina pectoris
       6.      acute myocardial infarction
       7.      postural hypotension

   B. Neurologic disturbances

       1.      seizures
       2.      cerebrovascular accident (stroke, CVA)

   C. Allergic reactions

       1.      anaphylaxis
       2.      allergic reaction to penicillin
       3.      acute asthmatic attack

   D. Metabolic disease

       1.      diabetic hypoglycemia
       2.      diabetic hyperglycemia
       3.      acute adrenal insufficiency
       4.      thyroid storm
       5.      myxedema coma

   E. Respiratory disturbances

       1.      hyperventilation
       2.      airway obstruction
       3.      acute pulmonary edema
                                                                                                54
               PROTOCOL for LIFE THREATENING EMERGENCIES at OUCOD

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

2.   The clinic faculty will:

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

          1.   identify yourself
          2.   identify the college
          3.   give floor number
          4.   give name of clinic
          5.   remain on telephone until EMS arrives


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

EMERGENCY NUMBERS are posted in clinic next to telephone.

Campus police                           1-4911
Oral Surgery                            1-4079 or 1-4441
Ambulance                               1-4911
Fire                                    1-4911
Poison Control                          1-5454
Exposure,
needlestick/injury
        Kathan Kent                     1-3083; (M) 206-3978
Infection Control Office                1-3083
Patient aspiration foreign object       1-3083
Kathan Kent pager                       9-660-7656




                                                                                                    55
                                        Equipment

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

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

                                        Eye Station

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



                                     Chemical Burns

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




                                                                                         56
            SAFETY PROTOCOL FOR CLINICS & LABORATORIES


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

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

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

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

5. Avoid injury with sharp instruments and needles.

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

6. In the event of an injury with a sharp item, the incident must be reported to Kathy
   Kent, infection control office (ICO), at x13083




                                                                                            57
 SECTION G
     SENIOR
  COMPETENCIES
       &
    CLINICAL
EVALUATION FORM
                                                                                                                          Contraindications
                                                                                                                   -Restricted sodium diet
                                                                                                                     (use sodium free powder)
                                                                                                                   - Respiratory risk
                                                                                                                   - Difficulty swallowing
                                            UNIVERSITY of OKLAHOMA COLLEGE of DENTISTRY
                                                                                                                   - Communicable diseases
                                                       Department of Dental Hygiene                                - Restorative materials
                                                                                                                   - Exposed root surface
                                                   AIR POLISHING EVALUATION                                        - Soft spongy gingival
                                                                                                                   - Immunosuppressed

STUDENT:                                         CI:                        DATE:                        SCORE:            /10

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

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

Evaluation: 75% accuracy (7.5/10 points)

    GUIDELINES                                                                                                                   S        U
   1.   Recognizes indications and contraindications.
   2.   Properly assembles equipment according to manufacturer’s instructions.
   3.   Properly adjusts controls; applies water based lubricant to patient’s lips; applies disclosant
   4.   Demonstrates proper grasp and fulcrum.
   5.   Demonstrates proper patient/operator positioning.
   6.   Demonstrates proper angulation of tip.
   7.   Controls aerosols, uses correct evacuation.
   8.   Uses water to rinse periodically.
   9.    Manages patient to minimize anxiety, discomfort.
   10. Properly disassembles unit, disinfects, bags tip,

        COMMENTS
                                                 University of Oklahoma College of Dentistry
                                                                                                                                                     58
                                                 Department of Dental Hygiene

                                     Protocol for Bleaching/Whitening Patients

PATIENT SELECTION
           Patient does not have to be a regular clinic patient.
                (family members, friends are acceptable)

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

PROTOCOL
               Patient should have had a recent prophylaxis (within a year)
               Patient is scheduled during a regular clinic session
               Exam for patient acceptability determined by supervising dentist prior to procedure
                (OKC students email Dr. Panza several days prior to appointment; call her to examine patient at first appointment)
               PTP from Clinical Instructor

PROCEDURE
        APPOINTMENT #1
         Obtain impressions
         Wrap in a moist towel & place in a ziplock baggy
         Have CI sign encounter form & TPNs
         Pour up impressions
         After 24 hours, trim the casts down to make the trays (stone should be dry prior to placing block-out resin; do not plan on
          making the trays immediately after you have trimmed them. The block-out resin won't adhere to a moist or wet stone surface)
         Fabricate trays to be delivered at BOOST appointment
         Have CI evaluate trays for acceptability
              APPOINTMENT #2
               Perform the Boost whitening treatment
               Dispense trays with TAKE-HOME whitening syringes AND desensitizing agent
               Provide verbal and written post-op instructions


                                                                                                                                     59
IN-OFFICE BLEACHING PROCEDURE (BOOST)

Armamentarium
       Mirror                explorer              surgical suction
       Saliva ejector        Vaseline              cheek retractors
       Cotton swabs          air/water             2x2’s
       Isoblock              vita shade guide      curing light
       Opal Boost            Opal Dam              Polaroid camera for pre/post photos

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

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

   3. Place retractors
         a. Petroleum jelly on inside of retractors and lips
         b. Pinch handles, scoop one side of commissure, then the other
         c. Gently release handles and free lips from retractor borders
         d. Place bilateral bite block (Isoblock) in premolar area
              Isoblock keeps patient in comfortable position and able to swallow

   4. Place liquid dam
         a. Dry gingiva with A/W syringe
         b. Scallop gingiva with gingival barrier (Opaldam) so NO gingiva shows
                   i. Go 1/2 mm onto tooth
         c. Place dam 1 tooth distal to bleaching area (General rule: first premolar to first premolar, but may
              be larger due to patient’s smile area)
                   i. Build dam slightly larger on most distal tooth to prevent backflow of Hydrogen Peroxide
                      whitening gel
         d. Move to 12:00 and look toward the apex of the mandibular teeth or lean to 6:00 and look toward
              the apex of the maxillary teeth; observe for any areas of visible pink gingiva.
         e. If any visible gingival is seen, recover with Opaldam
         f. Light cure Opaldam in continuous sweeping motion 3 mm from gingival surface 20 seconds per
              quadrant (40-60 seconds per arch)

   5. Attach activator and Boost end to end
         a. Mix back and forth 25 times
   6. Apply tip to syringe (FX – black with fuzzy white end)
   7. Dry teeth,; place whitening agent approximately 1mm thick on facials
   8. Allow whitening agent to sit 15 minutes
   9. Remove with surgical suction located on INCISAL HALF of tooth – DO NOT TOUCH DAM WITH
      SUCTION AS THIS MIGHT DISLODGE DAM ALLOWING LEAKAGE
         a. Gingival burn could result
   10. Replace whitening gel for a second 15 minute application.
    Repeat for 3rd and 4th application if desired

   In determining how many applications use the vita shade guide (make certain           shade tabs are
   in order of lightest to darkest)
                                                                                                      60
                 B1, A1, B2, D2, A2, C1, C2, D3, A3, D4, B3, A3.5, B4, C3, A4, C4
                        Under C1 2-15 minute application
                        C1-B3      3-15 minute applications
                        Over B3    4-15 minute applications
          You can adapt depending on age and shade, choose more or less if desired.
            Young or yellow teeth whiten faster than old or grey teeth.

       11. After final application, suction with surgical suction free of whitening solution, rinse well, and remove
           dam in one piece
       12. Remove cheek retractors and rinse mouth well
       13. Check shade with shade guide and record (full shade change will not occur for 24 -48 hours)
       14. Place desensitizing tray in patient mouth (if determined useful)
       Follow up instructions for patient
                       No red wine, grape juice, blackberries, blueberries for 3 days.
                       Drink colas through a straw.
                       If you must drink coffee brush your teeth immediately.
                       If happy with shade change whiten one time at home with trays
                       If patient needs to they can continue whitening with trays.


DURING THE PROCEDURE, INSTRUCT PATIENT TO RAISE HAND OF RELATED QUAD IF
STINGING SENSATION OCCURS
       a. Look for bubble in bleaching agent which would relate to probable leak in dam
       b. Use surgical suction to remove bleach from that point to distal in that quad
       c. Clean surgical tip
       d. Go back with surgical suction and rinse area
       e. Dry area and patch and cure dam
       f. Replace bleaching solution

Fabricate at-home bleaching trays
TIPS
            •    Look up the teeth for tissue coverage with the dam
            •    Do not apply the Boost over the incisal edges
            •    Use surgical suction to remove Boost, stay on INCISAL HALF OF TOOTH to avoid
                 dislodging dam
            •    Do not rinse between applications
            •    Place stack of 2x2’s on pt napkin to wipe Boost off saliva ejector
            •    If you run out of dam you can use LC block out but be careful of heat
            •    Always have Opalustre handy




                                                                                                             61
University of Oklahoma College of Dentistry
Department of Dental Hygiene
Whitening Options



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

   Advantages
        1. Inexpensive
        2. Does not require supervision.
        3. Does not require instruction.
        4. Does not require tray fabrication.
        5. Stepping block to other whitening options
        6. Builds patient awareness of dental health

   Disadvantages
         1. Not as effective on crooked teeth because it will not reach into contact area.
         2. Not as effective on patient with large smile because it is only canine to canine.
         3. Not as effective on patient with tall anatomical crowns because it may not cover entire
            facial surface.
         4. Recommended touch up period of 6 months.
         5. Not able to remove more difficult stain

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

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

   Advantages
        1. Inexpensive
        2. Custom tray that fits patients teeth perfectly and comfortably
        3. Semi-permanent, touch ups only need to be done every 2-4 years and are inexpensive
            because patient already has the custom tray
        4. Can be worn day or night
        5. Fast, average patient is done in 6-8 nights or 14 days.
        6. Less sensitivity than light activated in-office whitening *****
        7. Very little clinician time required
                                                                                                      62
          8. Builds cosmetic awareness in patient, usually improves home care
          9. Practice builder

Disadvantages
         1. Sensitivity
         2. Patient compliance, they must wear tray consecutive days or nights
         3. Tray fabrication takes time to learn
         4. Some patients do not like to wear the trays
         5. Some patient can not wear the trays


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

Advantages
         1.  Immediate gratification
         2.  Fast, appointment time from 1-2 hours
         3.  Patient has trays to do inexpensive touch up in 2-4 years
         4.  Very little compliance required from patient
         5.  Increased production on hygiene schedule
         6.  Depending on the type of in-office whitening done there may be less sensitivity than with
             trays. This is not true if a light is used to activate gel***
          7. Increases cosmetic awareness and sometimes improves home care
          8. Practice builder

Disadvantages
         1. Most expensive option for patient
         2. Most chair time required
         3. Requires at least one follow up session with trays
         4. Learning curve on placing gingival protection, patient can be burned
         5. Cheek retractors can be uncomfortable for patient


General statements about whitening
          1. Whitening is the least invasive procedure we can offer our patients.
          2. It is the least expensive ‘makeover’ they can give themselves. Compare it to Botox
             injections, $200+ per area and repeated every 4-6 months, micro pigmentation (tattooed
             lipstick) $500 and repeated every 3-6 years, chemical peels, $100-800 repeated forever,
             fake nails $30-40 every 2 weeks. Compare it to dental procedures; one veneer is $800-
             900. You can whiten all of your teeth for a fraction of one veneer. Many times whitening
             will satisfy a patient so much that they cancel appointments for full veneers. This is the
             least invasive cosmetic procedure available.
          3. Whitening is extremely safe. Carbamide peroxide is even used to treat babies with oral
             candidiasis (thrush).


                                                                                                     63
4. Carbamide peroxide is anti-bacterial and anti-microbial. Many times patients with
    gingivitis will see a reduction in bleeding points and swelling. This is only temporary and
    will resume if home care does not improve. However, the whitening also tends to increase
    patient awareness of their home care and many improve it on their own.
5. Whitening occurs when hydrogen peroxide moves through the enamel and into the dentin.
    The peroxide then breaks up the stain inside the tooth.
6. Yellow or young teeth whiten fast and grey or more mature teeth whiten slower.
7. Tetracycline stained teeth can take up to 6 months to whiten. A patient with these stains
    should be aware of the time commitment and the extra expense of buying more gel.
8. Whitening will not change the color of crowns, veneers, or composites. Patients should be
    made aware of this and be prepared to replace those restorations if needed. The COD will
    not replace restorations due to shade only. Whitening will not harm any restorations.
9. To alleviate sensitivity have patient fill tray with toothpaste containing Potassium Nitrate
    and wear it for an hour or so.
10. If patient has pain we can supply them with a Potassium Nitrate desensitizing gel to wear
    in their tray for 1 to 8 hours.
11. Inform patient that acidic drinks such as colas and juices will make the sensitivity worse.
12. Inform patient that sensitivity should not worsen and will go away within a day of the last
    application.
13. Speed of whitening occurs in direct relation to % of product and time of contact.
14. At-home tray whitening and in-office power whitening followed by at home application
    will give you the same end result. Everyone has a shade that they can reach irregardless of
    the percentage used. The difference between the two is just how fast they will get to that
    shade.




                                                                                             64
                             University of Oklahoma College of Dentistry
                                   Department of Dental Hygiene


                  WHITENING PROCEDURE INFORMATION AND CONSENT

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

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

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

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

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

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

_____________________________                               _______________
Patient Signature                                                 Date




                                                                                                        65
                   University of Oklahoma College of Dentistry
                         Department of Dental Hygiene



INSTRUCTIONS FOR PATIENT

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

 Drink colas through a straw.

 If you must drink coffee, brush your teeth immediately.

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

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

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



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




                                                                                    66
                                            UNIVERSITY of OKLAHOMA COLLEGE of DENTISTRY
                                                       Department of Dental Hygiene

                                                 CALCULUS CHARTING EXERCISE
    STUDENT:                                                                             0=SMOOTH SURFACE
    CI:                                                                   KEY:           1=GRANULAR, LIGHT CALCULUS , OR SMOOTH BURNISHED
    SCORE:                                                                               2=SPICULE(S), MODERATE CALCULUS
    DATE:                                                                                3=LEDGE, RING, HEAVY CALCULUS


    Objective: Using the ODU 11/12 explorer and mirror, direct vision, transillumination, radiographs and compressed air, the student
    will chart one quadrant of a CDI “C” or “D” patient on the chart below using the criteria in the key with 75% accuracy.

    Procedure:
             •     Student requests permission from CI to verify qualifying patient. CI may provide guidance & direction in patient
                   selection.
               •   CI assigns one quadrant with a minimum of 10 clicks of calculus.
               •   Student records amount of calculus present on each of 4 surfaces (M, D, F, L) using key.
               •   CI evaluates while student reads values and marks out incorrect values in RED.
               •   CI calculates score. Divide total correct by total possible.

    Evaluation: 75% accuracy

                                                                     FACIAL
       1      2       3      4       5      6       7      8                         9        10    11     12     13      14     15      16
                                                                                                    2



R                                                                   LINGUAL                                                                   L
                                                                   LINGUALL
                                                                   INGUAL



      32     31      30      29     28     27      26     25         FACIAL         24        23    22     21     20     19      18     17
                                                                                                                                        67
SECTION H
 Junior Clinical
 Competencies
                                 ABBREVIATIONS
anes         -   anesthetic
approx.      -   approximate
appt         -   appointment
ASA          -   aspirin
ASAP -           as soon as possible
b.i.d.       -   twice a day
bilat.       -   bilateral
BP           -   blood pressure
BWX          -   bitewing radiographs
BX           -   biopsy
CC           -   chief complaint
C/C          -   complete dentures
C/P          -   complete maxillary denture/mandibular partial
Ca           -   cancer
Cau.         -   Caucasian
CBC          -   Complete blood count
CHD          -   Congestive heart disease
CHF          -   Congestive heart failure
CNS          -   Central nervous system
cont.        -   continued
COPD -           Chronic obstructive pulmonary disease
CP           -   Cerebral palsy
CVA          -   Cerebral vascular attack
DC           -   discontinue
DH           -   dental hygiene
DOB          -   date of birth
DX           -   diagnosis
EBV          -   Epstein Barr Virus
EKG or ECG   -   Electrocardiogram
EEG          -   Electroencephalogram
Endo         -   Endodontics
ENT          -   Ear, nose and throat
Eval         -   evaluation
Ext.         -   extract
FMX          -   Full Mouth survey
FPD          -   Fixed Prosthodontics
HBV          -   Hepatitis B Virus
HHx          -   health history
IDDM -           Insulin Dependent Diabetes Mellitus
IM           -   Intramuscular
mand. -          mandibular
max.         -   maxillary
meds.        -   medications
MI           -   myocardial infarction
MVP          -   Mitral Valve Prolapse
OP           -   Operative
OS           -   Oral Surgery
prn          -   as needed
PCN          -   Penicillin

1-A                                                              88
Pt.        -   patient
q.         -   every
q.i.d.     -   four times a day
RCT        -   root canal treatment
Rec.       -   recommend
RHD        -   Rheumatic Heart Disease
RPD        -   Removable Partial Denture or Removable Prosthodontics
               Department
RXN        -   reaction
SBE        -   Subacute Bacterial Endocarditis
t.i.d.     -   three times a day
TMJ        -   temporal mandibular joint
w/     -       with
w/o or s   -   without
WNL -          within normal limits




1-A                                                                    89
                                                BARNHART 5/6
                                        Process Competency Examination
                         TASK COMPONENTS                               AREA 1 AREA 2 PTS.   EVAL
OPERATOR POSITIONING
Correct height of operator's stool                                                     3
Back in neutral position                                                               3
Wrist in neutral position                                                              3
Correct seating area for instrumentation (Clock positions)                             3
PATIENT POSITIONING
Back of patient chair adjusted for appropriate arch                                    3
Height of patient chair adjusted to level of operator's elbow                          3
Patient's head adjusted for treatment area                                             3
Light positioned appropriately for treatment area                                      3
MOUTH MIRROR
Appropriate for area (retracts when appropriate, indirect when                         3
appropriate)
GRASP
Thumb and index finger pads positioned opposite one another on                         3
handle; fingers not touching or overlapping
Index finger and thumb near handle/shank junction with thumb                           3
flexed outward
Upper inside corner of middle finger rests lightly on shank                            3
Handle rests between second and third knuckle of index finger                          3
All fingers contact as a unit (NO SPLITTING) using a stacked                           3
fulcrum
FULCRUM
Tip of ring finger standing as tall as possible                                        3
Fulcrum on incisal/occlusal edge or embrasure                                          3
As close as possible to instrumentation area                                           3
Appropriate palm direction                                                             3
ADAPTATION/INSERTION
Correct working end chosen                                                             3
Adapts terminal 1-2 mm of working end                                                  3
Point of insertion appropriate                                                         3
Inserts as close to 0-degrees angulation as possible (terminal shank                   3
tipped toward the midline of tooth)
Demonstrates insertion into col (half-way facial to lingual)                           3
Establishes working angulation of 70-80 degrees                                        3
ACTIVATION/STROKE (DEMONSTRATED
SUPRAGINGIVALLY)
Activates with appropriate wrist/forearm motion                                        3
Pivots stroke from fulcrum                                                             3
Rolls instrument in fingers around line angles                                         3
Appropriate stroke direction                                                           3
Covers circumference of tooth by channel scaling                                       3
Toe directed obliquely toward junctional epithelium                                    3
Short, controlled strokes                                                              3
Appropriate speed                                                                      3
OTHER
Recognizes tooth number                                                                2
Maintains asepsis                                                                      2
INSTRUCTOR:                                                                           100
Comments:




1-A                                                                                                90
_________________Student



                               EXTRA/INTRA ORAL EXAM
                                  Process Competency Examination

TASK COMPONENTS                                                                            EVAL
PREPARATION
Assembles correct armamentarium                                                       2
Patient seated upright in dental chair                                                2
Removes glasses of patient                                                            2
Operator standing                                                                     2
SEQUENCE OF EXTRA ORAL EXAM
Uses appropriate technique, pressure, stroke while palpating the following:
Visual assessment of patient looking for anomalies of head and neck area              3
Frontal and supraorbital region                                                       3
Infraorbital and zygomatic process region                                             3
Maxillary sinus region                                                                3
Mandible and parotid gland region                                                     3
Temporal region (pre-auricular)                                                       3
TMJ and masseter                                                                      3
Submental, submandibular and sublingual regions                                       3
Trachea and thyroid                                                                   3
Sternocleidomastoid muscle (Anterior cervical lymph chain)                            3
Supraclavicular region                                                                3
Trapezius muscle and occipital region (Posterior cervical node chain)                 3
Back and lateral portions of neck posterior to Sternocleidomastoid muscle             3
SEQUENCE OF INTRA ORAL EXAM
Uses appropriate technique, pressure, stroke while palpating and/or evaluating the
following:
Visual assessment of lips and commissures                                             3
Labial mucosa                                                                         3
Buccal mucosa                                                                         3
Vestibule and frenulas                                                                3
Floor of mouth                                                                        3
Tongue                                                                                3
Hard and soft palate                                                                  3
Uvula, tonsillar pillars, oropharynx                                                  3
Alveolar mucosa                                                                       3
Edentulous gingiva if indicated                                                       2
Assess salivary flow by stimulating Stenson’s Duct                                    3
GINGIVAL ASSESSMENT (VERBALIZE TO FACULTY)
Color                                                                                 3
Form                                                                                  3
Density                                                                               3
OTHER
Utilizes ‘SCSCMLDS’ to describe intra/extra oral findings                             2
Utilizes mirror where appropriate                                                     2
Correct pt/op positioning for area                                                    2
Light placement appropriate for area                                                  2
Describes self-exam techniques to patient                                             2
Maintains asepsis                                                                     2
INSTRUCTOR:                                                                          100
COMMENTS:

1-A                                                                                               91
________________Student




                                      TOPICAL FLUORIDE (TRAY)
                                       Process Competency Examination

TASK COMPONENTS                                                                              PTS.   EVAL
PREPARATION
Assembles complete armamentarium                                                              5
Correct patient positioning (upright)                                                         5
Selects correct tray size                                                                     5
Selects appropriate type of fluoride and states rationale                                     5
PROCEDURE
Thin band of fluoride dispensed in tray                                                       8
Thoroughly dries maxillary, then mandibular teeth                                             8
Instructs patient not to swallow fluoride                                                     8
Correctly places mandibular, then maxillary tray                                              8
Instructs patient to chew/tap into tray to disperse fluoride to gingival margin thoroughly    8
Places saliva ejector between trays for continuous suction                                    8
Times procedure correctly                                                                     8
Removes trays and excess fluoride                                                             8
Gives appropriate post-treatment instruction                                                  8
OTHER
Maintains asepsis                                                                             8

INSTRUCTOR:                                                                                  100

COMMENTS:




                                                                                                           92
__________________Student




                                                    GRACEY 1/2
                                          Process Competency Examination
                                TASK COMPONENTS                                  AREA 1 AREA 2   PTS   EVAL
OPERATOR POSITIONING
Correct height of operator's stool                                                                3
Back in neutral position                                                                          3
Wrist in neutral position                                                                         3
 Correct seating area for instrumentation (Clock positions)                                       3
PATIENT POSITIONING
Back of patient chair adjusted for appropriate arch                                               3
Height of patient chair adjusted to level of operator's elbow                                     3
Patient's head adjusted for treatment area                                                        3
Light positioned appropriately for treatment area                                                 3
MOUTH MIRROR
Appropriate for area (retracts when appropriate, indirect when                                    3
appropriate)
  GRASP
Thumb and index finger pads positioned opposite one another on handle;                            3
fingers not touching or overlapping
Index finger and thumb near handle/shank junction with thumb                                      3
flexed outward
Upper inside corner of middle finger rests lightly on shank                                       3
Handle rests between second and third knuckle of index finger                                     3
All fingers contact as a unit (NO “SPLITTING”) using a stacked fulcrum                            3
FULCRUM
Tip of ring finger standing as tall as possible (Handle parallel to long axis)                    3
Fulcrum on incisal/occlusal edge or embrasure                                                     3
As close as possible to instrumentation area                                                      3
Appropriate palm direction                                                                        3
ADAPTATION/VERBALIZATION OF INSERTION
Correct working end chosen                                                                        3
Point of insertion appropriate (overlaps midline)                                                 3
Adapts terminal 1-2 mm of working end                                                             3
Verbalizes insertion (slight closure of instrument face to tooth)                                 3
Establishes working angulation of 60-70 degrees (demonstrate supra)                               3
ACTIVATION/STROKE
Activates with appropriate wrist/forearm motion                                                   3
Pivots stroke from fulcrum                                                                        3
Rolls instrument in fingers around line angles                                                    3
Appropriate stroke direction                                                                      3
Covers circumference of tooth by channel scaling                                                  3
Tip directed obliquely toward junctional epithelium                                               3
Short, controlled stroke                                                                          3
Appropriate speed                                                                                 3
OTHER
Recognizes tooth number                                                                           3
Maintains asepsis                                                                                 4
INSTRUCTOR:                                                                                      100

COMMENTS:




                                                                                                              OOOO
__________________Student



                                               GRACEY 11/12
                                      Process Competency Examination
                           TASK COMPONENTS                               AREA 1 AREA 2         EVAL
OPERATOR POSITIONING
 Correct height of operator's stool                                                       3
Back in neutral position                                                                  3
Wrist in neutral position                                                                 3
Correct seating area for instrumentation (Clock positions)                                3
PATIENT POSITIONING
Back of patient chair adjusted for appropriate arch                                       3
Height of patient chair adjusted to level of operator's elbow                             3
Patient's head adjusted for treatment area                                                3
Light positioned appropriately for treatment area                                         3
MOUTH MIRROR
Appropriate for area (retracts when appropriate, indirect when                            3
appropriate)
GRASP
Thumb and index finger pads positioned opposite one another on handle;                    3
fingers not touching or overlapped
Index finger and thumb near handle/shank junction with thumb                              3
flexed outward
Upper inside corner of middle finger rests lightly on shank                               3
Handle rests between second and third knuckle of index finger                             3
All fingers contact as a unit (NO “SPLITTING) using a stacked fulcrum                     3
FULCRUM
Tip of ring finger standing as tall as possible                                           3
Fulcrum on incisal/occlusal edge or embrasure                                             3
As close as possible to instrumentation area                                              3
Appropriate palm direction                                                                3
ADAPTATION/VERBALIZATION OF INSERTION
Correct working end chosen                                                                3
Point of insertion appropriate (distal line angle)                                        3
Adapts terminal 2 mm of working end                                                       3
Verbalizes insertion (slight closure of instrument face to tooth)                         3
Establishes working angulation of 60-70 degrees (demonstrate supra)                       3
ACTIVATION/STROKE (DEMONSTRATED SUPRAGINGIVALLY)
Activates with appropriate wrist/forearm motion                                           3
Pivots stroke from fulcrum                                                                3
Rolls instrument in fingers around line angles                                            3
Appropriate stroke direction                                                              3
Covers facial to mesial tooth surface by channel scaling                                  3
Toe directed obliquely toward junctional epithelium                                       3
Short, controlled stroke                                                                  3
Appropriate speed                                                                         3
OTHER
Recognizes tooth number                                                                   3
Maintains asepsis                                                                         4
INSTRUCTOR:                                                                              100

COMMENTS:




                                                                                                      94
__________________Student



                                               GRACEY 13/14
                                      Process Competency Examination
                           TASK COMPONENTS                               AREA 1   AREA 2         EVAL
OPERATOR POSITIONING
Correct height of operator's stool                                                          3
Back in neutral position                                                                    3
Wrist in neutral position                                                                   3
Correct seating area for instrumentation (Clock positions)                                  3
PATIENT POSITIONING
Back of patient chair adjusted for appropriate arch                                         3
Height of patient chair adjusted to level of operator's elbow                               3
Patient's head adjusted for treatment area                                                  3
Light positioned appropriately for treatment area                                           3
MOUTH MIRROR
Appropriate for area (retracts when appropriate, indirect when                              3
appropriate)
GRASP
Thumb and index finger pads positioned opposite one another on handle;                      3
fingers not touching or overlapped
Index finger and thumb near handle/shank junction with thumb                                3
flexed outward
Upper inside corner of middle finger rests lightly on shank                                 3
Handle rests between second and third knuckle of index finger                               3
All fingers contact as a unit (NO “SPLITTING”) using a stacked fulcrum                      3
FULCRUM
Tip of ring finger standing as tall as possible                                             3
Fulcrum on incisal/occlusal edge or embrasure                                               3
As close as possible to instrumentation area                                                3
Appropriate palm direction                                                                  3
ADAPTATION/DEMONSTRATION OF INSERTION
Correct working end chosen                                                                  3
Point of insertion appropriate (distal line angle)                                          3
Adapts terminal 1-2 mm of working end                                                       3
Demonstrates insertion (slight closure of instrument face to tooth)                         3
Establishes working angulation of 60-70 degrees (demonstrate supra)                         3
ACTIVATION/STROKE (DEMONSTRATED SUPRAGINGIVALLY)
Activates with appropriate wrist/forearm motion                                             3
Pivots stroke from fulcrum                                                                  3
Rolls instrument in fingers around line angles                                              3
Appropriate stroke direction                                                                3
Covers distal tooth surface by channel scaling                                              3
Toe directed obliquely toward junctional epithelium                                         3
Short, controlled stroke                                                                    3
Appropriate speed                                                                           3
OTHER
Recognizes tooth number                                                                     3
Maintains asepsis                                                                           4
INSTRUCTOR:                                                                                100

COMMENTS:




                                                                                                        95
__________________Student




                                                  H6/H7 SCALER
                                       Process Competency Examination
                          TASK COMPONENTS                        AREA 1   AREA 2         EVAL
OPERATOR POSITIONING
Correct height of operator's stool                                                  3
Back in neutral position                                                            3
Wrist in neutral position                                                           3
Correct seating area for instrumentation (Clock positions)                          3
PATIENT POSITIONING
Back of patient chair adjusted for appropriate arch                                 3
Height of patient chair adjusted to level of operator's elbow                       3
Patient's head adjusted for treatment area                                          3
Light positioned appropriately for treatment area                                   3
MOUTH MIRROR
Appropriate for area (retracts when appropriate, indirect when                      3
appropriate)
 GRASP
Thumb and index finger pads positioned opposite one another on                      3
handle; fingers not touching or overlapped
Index finger and thumb near handle/shank junction with thumb                        3
flexed outward
Upper inside corner of middle finger rests lightly on shank                         3
Handle rests between second and third knuckle of index finger                       3
All fingers contact as a unit (NO “SPLITTING”)                                      3
                            FULCRUM
Tip of ring finger standing as tall as possible                                     3
Fulcrum on incisal/occlusal edge or embrasure                                       3
As close as possible to instrumentation area                                        3
Appropriate palm direction                                                          3
                         ADAPTATION
Correct working end chosen (lower cutting edge)                                     3
Adapts terminal 2 mm of working end                                                 3
Establishes working angulation of 70-80 degrees                                     3
Tip directed obliquely toward junctional epithelium                                 3
Overlaps midline at initial placement of instrument                                 3
                  ACTIVATION/STROKE
Activates with left to right wrist/forearm motion                                   3
Pivots stroke from fulcrum                                                          3
Rolls instrument in fingers around line angles                                      3
Appropriate stroke direction                                                        3
Covers circumference of tooth by channel scaling                                    3
Tip directed obliquely toward junctional epithelium                                 3
Short, controlled stroke (2-3mm in length)                                          3
Appropriate speed                                                                   3
                              OTHER
Recognizes tooth number                                                             3
Maintains asepsis                                                                   4
INSTRUCTOR:                                                                        100

COMMENTS:




                                                                                                96
__________________Student




                                      MOUTH MIRROR
                               Process Competency Examination
            STUDENT MUST UTILIZE NON-DOMINANT HAND TO HOLD MIRROR

                    TASK COMPONENTS                            AREA        EVAL
                    MIRROR TECHNIQUE
Demonstrates (using NON-DOMINANT hand) and explains
uses of mouth mirror:
    a. Illumination                                                    8
    b. Transillumination                                               8
    c. Retraction                                                      8
    d. Indirect Vision                                                 8
Thumb and index finger pads positioned opposite one another            7
on handle; fingers not touching or overlapping
Index finger and thumb near handle/shank junction                      7
Upper inside corner of middle finger rests lightly on shank;           7
touches the ring finger
Fulcrum appropriate for area                                           7
Light position appropriate for area                                    7
Provides for patient comfort with insertion and placement of           7
mirror
Pt/Op position appropriate for area                                    8
Recognizes tooth number                                                8
Maintains asepsis                                                     10
INSTRUCTOR:                                                           100

COMMENTS:




                                                                                  97
__________________Student

                                                                                       _________________
                                                                                           Student Name
                          ODU 11/12 & SHEPHERD HOOK EXPLORERS
                                       Process Competency Examination


TASK COMPONENTS                                                                                EVAL
OPERATOR POSITIONING
Correct height of operator's stool                                                        3
Back in neutral position                                                                  3
Wrist in neutral position                                                                 3
Correct seating area for instrumentation (Clock positions)                                3
PATIENT POSITIONING
Back of patient chair adjusted for appropriate arch                                       3
Height of patient chair adjusted to level of operator's elbow                             3
Patient's head adjusted for treatment area (ex. toward/away, chin-up / down)              3
Light positioned appropriately for treatment area                                         3
MOUTH MIRROR
Appropriate for area (retracts when appropriate, indirect vision when appropriate)        3
GRASP
Thumb and index finger pads positioned opposite one another on handle; fingers not        3
touching or overlapped
Index finger and thumb near handle/shank junction with thumb flexed outward               3
Upper inside corner of middle finger rests lightly on shank                               3
Handle rests between second and third knuckle of index finger                             3
All fingers contact instrument as unit (NO “SPLITTING”) using a stacked fulcrum           3
Grasp is relaxed but secure (no blanching of fingers)                                     3
FULCRUM
Tip of ring finger standing as tall as possible                                           3
Fulcrum on incisal/occlusal surface or embrasure                                          3
As close as possible to instrumentation area (1-2 teeth away)                             3
Appropriate palm direction                                                                3
ADAPTATION, INSERTION
Correct working end chosen                                                                3
Point of insertion appropriate                                                            3
Adapts 1-2 mm of tip to tooth                                                             3
ACTIVATION/STROKE
Activates with appropriate wrist-forearm motion                                           3
Pivots stroke from fulcrum                                                                3
Rolls instrument in fingers around line angles                                            3
Appropriate stroke direction (oblique on facial and lingual; vertical into proximal)      3
Light, exploratory stroke pressure                                                        3
Slow, feeling stroke speed                                                                3
OTHER
Recognizes tooth number                                                                   3
Maintains asepsis                                                                         3
SHEPHERD HOOK EXPLORER
Demonstrates vertical stroke with appropriate pressure into occlusal surface              10
COMMENTS/INSTRUCTOR INITIALS                                                             100




                                                                                                      98
__________________Student




                                     PERIODONTAL PROBE
                                 Process Competency Examination
                        TASK COMPONENTS                            AREA 1   AREA 2         EVAL
OPERATOR POSITIONING
Correct height of operator's stool                                                    4
Back in neutral position                                                              4
Wrist in neutral position                                                             4
PATIENT POSITIONING
Back of patient chair adjusted for appropriate arch                                   3
Height of patient chair adjusted to level of operator's elbow                         3
Patient's head adjusted for treatment area                                            3
Light positioned appropriately for treatment area                                     3
MOUTH MIRROR
Appropriate for area (retracts when appropriate, indirect vision                      3
when appropriate)
GRASP
Thumb and index finger pads positioned opposite one another on                        3
handle; fingers not touching or overlapping
Index finger and thumb near handle/shank junction with thumb                          3
flexed outward
Upper inside corner of middle finger rests lightly on shank                           3
Handle rests between second and third knuckle of index finger                         3
All fingers contact as a unit (NO “SPLITTING) using a stacked                         3
fulcrum
Grasp is secure and relaxed (no blanching of fingers)                                 3
FULCRUM
Tip of ring finger standing as tall as possible                                       3
Fulcrum on incisal/occlusal edge or embrasure                                         3
As close as possible to instrumentation area                                          3
Appropriate palm direction                                                            3
ADAPTATION/INSERTION
Initial insertion at line angle                                                       3
Tip remains in contact with tooth surface                                             3
Maintains parallelism to long axis of tooth/root morphology                           3
Insertion to junctional epithelium                                                    3
ACTIVATION/STROKE
Activates with left to right wrist/forearm motion                                     3
Pivots stroke from fulcrum to maintain parallelism                                    3
Controlled stroke remaining in sulcus                                                 3
Vertical stroke direction                                                             3
Walking, short stroke covers circumference of tooth                                   3
Walks to proximal contact                                                             3
Maintains contact with tooth while readjusting angulation to                          3
enter col
Light pressure against junctional epithelium                                          3
OTHER
Maintains asepsis                                                                     4
Recognizes tooth number                                                               3
INSTRUCTOR:                                                                          100

COMMENTS:



                                                                                                  99
________________Student




                                   RUBBER CUP POLISHING
                                Process Competency Examination
                            TASK COMPONENTS                            AREA 1 AREA 2   PTS   EVAL
     OPERATOR POSITIONING
     Correct height of operator's stool                                                 4
     Back in neutral position                                                           4
     Wrist in neutral position                                                          4
     Correct seating area for instrumentation                                           4
     PATIENT POSITIONING
     Back of patient chair adjusted for appropriate arch                                4
     Height of patient chair adjusted to level of operator's elbow                      4
     Patient's head adjusted for treatment area                                         4
     Light positioned appropriately for treatment area                                  4
     MOUTH MIRROR
     Appropriate for area (retracts when appropriate, indirect when                     4
     appropriate)
     GRASP
     Uses modified pen grasp                                                            4
     Holds as near working end as possible                                              4
     FULCRUM
     Appropriate for working area (intraoral when appropriate and                       4
     extraoral when appropriate)
     ADAPTATION/INSERTION
     Angles rubber cup to flare apical half                                             4
     Appropriate cup direction (Cup pointed toward incisal/occlusal)                    4
     Turns handpiece to adapt to proximal surface- wraps around line                    4
     angles
     Places cup near or slightly below gingival margin                                  4
     ACTIVATION/STROKE
     Begins stroke at distal/mesial cervical margin                                     4
     Uses intermittent, overlapping strokes                                             4
     Strokes across facial and lingual covering entire surface into                     4
     proximal
     Pivots stroke from fulcrum                                                         4
     Uses light but secure/controlled stroke                                            4
     Covers occlusal surface with brush                                                 3
     Slow, even speed with handpiece                                                    4
     OTHER
     Flosses, rinses and evacuates patient’s mouth                                      3
     Recognizes tooth number                                                            3
     Maintains asepsis                                                                  3
     INSTRUCTOR:

     COMMENTS:




                                                                                                    100
________________Student



                                             PATIENT/ OPERATOR POSITIONING
                                                  (LEFT-HANDED OPERATOR)

                                          FRONT of chair denotes operator at 3:00-4:00
                                          BACK of chair denotes operator at 12:00- 1:00
                                           MIDDLE of chair denotes operator at 2:00
                                             MANDIBULAR ARCH POSITIONING


  Area           Chair Back             Op                  Pt           Mirror         MF=Mirror Face                          Fulcrum
    Mandibular Anterior Sextant
             (22-27)
                                        15 ° up    Front         Chin Down/ Toward Op      Facial: Palm Lingual: Left Commissure                #28-24
  Near Surfaces (Facial and Lingual)
                                                   Back      Chin Down/ Away from Op       Facial: Palm Lingual: Right Commissure               #21-25
  Far Surfaces   (Facial and Lingual)



  Mandibular Right Posterior Facial                                                        Right Facial: Retract from Lt. Commissure            Anterior to
                                        15 ° up    Front         Chin Down/ Toward Op                                                            working
  Mandibular Left Posterior Lingual                                                        Left Lingual: Retract tongue, MF toward                 area
                                                                                                              tooth, directed from left
                                                                                                              Commissure


  Mandibular Right Posterior Lingual                                                       Right Lingual: Retract, MF toward tooth              Anterior to
                                         15 °     Middle     Chin Down/ Away from Op                            from left commissure             working
                                                                                                                                                   area
  Mandibular Left Posterior Facial                                                         Pos. Facial: Retract , MF toward tooth from
                                                                                                             left commissure




                                                                                                                                          101
________________Student



                                        MAXILLARY ARCH POSITIONING (Left - handed)


  Area                     Chair Back               Op              Pt        Mirror          MF = Mirror Face                         Fulcrum
  Maxillary Anterior Sextant (6-11)

  Near Surfaces (Facial and Lingual)       5° up         Back             Chin Up/ Straight      Facial: Palm Lingual: Right Commissure                #9-12

  Far Surfaces   (Facial and Lingual)


  Maxillary Right Posterior Facial                                                               Right Facial: Retract from Lt. Commissure

                                                                                                                                                     Posterior or
                                           5 ° up    Middle to           Chin up/ Toward Op                                                           on lingual
                                                      Front                                                                                            cusp of
  Maxillary Left Posterior Lingual                                                               Left Lingual: Retract tongue, MF toward               working
                                                                                                                    tooth, directed from Lt.             area
                                                                                                                   commissure




  Maxillary Right Posterior Lingual                                                              Right Lingual: Retract, MF toward tooth             Anterior to
                                           5 ° up                                                                     from left commissure            working
                                                         Middle                                                                                         area
  Maxillary Left Posterior Facial                                 Chin Up/ Away from Op          Pos. Facial: Retract , MF toward tooth from
                                                                                                                        left commissure




                                                                                                                                               102
________________Student

                                                    PATIENT/ OPERATOR POSITIONING
                                                          (RIGHT-HANDED OPERATOR)

                                                  FRONT of chair denotes operator at 8:00 - 9:00
                                                  BACK of chair denotes operator at 11:00 - 12:00
                                                   MIDDLE of chair denotes operator at 10:00
                                                    MANDIBULAR ARCH POSITIONING

      Area                          Chair Back           Op           Pt                 Mirror      MF=Mirror Face                  Fulcrum
    Mandibular          Anterior
  Sextant (22-27)
                                     15 ° up     Front         Chin Down/ Toward Op     Facial: Palm Lingual: Rt. Commissure        #21-25
  Near Surfaces     (Facial and
  Lingual)                                       Back          Chin Down/ Away from     Facial: Palm Lingual: Left Commissure       #28-24
                                                                        Op
  Far Surfaces      (Facial   and
  Lingual)


  Mandibular   Right    Posterior                                                       Right Facial: Retract from Rt. Commissure   Anterior
  Facial                             15 ° up     Front        Chin Down/ Away from Op                                                 to
                                                                                        Left Lingual: Retract tongue, MF toward     working
  Mandibular    Left    Posterior                                                       tooth, directed from rt. Commissure          area
  Lingual


  Mandibular   Right    Posterior                                                       Right Lingual: Retract, MF toward tooth     Anterior
  Lingual                             15 °       Middle        Chin Down/ Toward Op     from rt. commissure                           to
                                                                                                                                    working
  Mandibular    Left    Posterior                                                       Pos. Facial: Retract , MF toward tooth       area
  Facial                                                                                from left commissure




                                                                                                                                               103
________________Student
                                         MAXILLARY ARCH POSITIONING (Right-handed)

Area                       Chair Back           Op                Pt                  Mirror         MF=Mirror Face            Fulcrum
  Maxillary Anterior Sextant
  6-11)
                                   5° up          Back          Chin Up/ Straight    Facial: Palm Lingual: Left Commissure          #5-8
  Near Surfaces (Facial and
  Lingual)

  Far Surfaces           (Facial and
  Lingual)


  Maxillary      Right     Posterior                                                 Right Facial: Retract from Rt.
  Facial                                                                             Commissure
                                                                                                                               Posterior or
                                       5 ° up   Middle to    Chin up/ Away from Op                                              on lingual
                                                 Front                                                                           cusp of
                                                                                                                               working area
  Maxillary      Left      Posterior                                                 Left Lingual: Retract tongue, MF toward
  Lingual                                                                            tooth, directed from rt. commissure




  Maxillary      Right     Posterior                                                 Right Lingual: Retract, MF toward tooth    Anterior to
  Lingual                              5 ° up                                        from left commissure                      working area
                                                 Middle
                                                            Chin Up/ Toward          Pos. Facial: Retract , MF toward tooth
  Maxillary Left Posterior Facial                                                    from left commissure




                                                                                                                                              104
_________________Student



                          DISINFECTION AND SET-UP OF THE DENTAL UNIT AREA
                                    Process Competency Examination
                                            TASK COMPONENTS/PROCEDURES
                                                EVALUATION
     Obtain supplies (goggles & alligator clip) from carry box. Place on paper towel.                              2
     Perform short scrub (15 seconds)- gather PPE & cup to flush evacuation system                                 2
     Put on mask and glasses. Perform thorough scrub (3 latherings and rinses in 30 seconds)                       2
     Put on gloves and overgloves; position op and asst. chairs, light (position light pole to opposite side of    2
     operator), carts, & rheostat
     Flush evacuation system for 2 minutes (cup in sink with running water) -Does not include HVE*                 2
     (*unless you plan to utilize the HVE)
     Flush water lines for 30 seconds                                                                              2
     Remove overgloves and discard into round opening next to sink                                                 2
     PRECLEAN ("Modified spray-wipe-spray" technique using disinfectant unless otherwise noted)
     Dental light switch and handles                                                                               3
     Operators and assistant’s levers                                                                              3
     Discard paper towel                                                                                           2
     Dental chair, operator's and assistant's stools (soap & water)                                                3
     Discard paper towel                                                                                           2
     Bracket table and accessories (A/W syringe, connectors, holders and hoses)                                    3
     Discard paper towel                                                                                           2
     Assistant's cart, swivel arm and accessories ( A/W syringe, connectors, holders and hoses)                    3
     Discard paper towel                                                                                           2
     Viewbox, paper towel holder, soap dispenser, faucet handle, countertops & sink rim                            3
     Discard paper towel; Remove gloves, discard into round opening next to sink                                   2
     Wash hands - gather supplies                                                                                  3
     Cover chair w/plastic, plastic tape on switches, controls, and arm rests—includes the hydraulic lever         3
     Cover bracket table and cart with patient napkins; Place instrument cassette on bracket table                 3
     (Retain bag for instrument return to central sterilization area)
     Fill water bottle with properly treated water                                                                 3
     Insert saliva ejector and A/W syringe tip; cover with plastic sleeves                                         3
     Hang biohazard bag from unit; Tape overgloves to unit below bracket table/tray                                3
     BREAKDOWN PROCEDURE (FOLLOWING PATIENT TX AND PATIENT DISMISSAL)
     Reglove, remask, and put on protective eyewear                                                                3
     Close instrument cassette securely; place in retained autoclave bag or inverted headrest cover for            3
     transport to central sterilization area
     Place contaminated disposables in red biohazard bag; remove and place bag into                                3
     biohazard container. Remove contaminated gloves into container, wash hands and dry thoroughly.
     Reglove                                                                                                       3
     Disinfect unit using modified spray-wipe-spray technique.                                                     3
     Flush water and evacuation lines for 30 seconds                                                               3
     Return equipment to its original position; rheostat on dental chair (on paper towel)                          2
     Remove protective eye wear and disinfect (operator and patient); remove mask                                  3
     Remove gloves into round opening next to sink                                                                 3
     Wash hands and dry thoroughly                                                                                 3
                                                    OTHER
     Maintains asepsis                                                                                             3
     Thoroughness of disinfection process                                                                          2
     Leaves surface area wet after disinfection process                                                            2
     Performed in appropriate time frame                                                                           2
     Professional appearance                                                                                       2
     Instructor:                                                                                                  100


                                                                                                                        105
SECTION I
   SENIOR
  CLINICAL
REQUIREMENTS




               106
             MINIMUM COURSE REQUIREMENTS
              CLINICAL DENTAL HYGIENE III
         PROCEDURE                        MINIMUM NUMBER & CRITERIA                               DATE

   1. Air Polishing                      - 1 patient- light to mod. Stain (fall and spring)

   2.   Bleaching (Boost)                - 1 patient, includes bleaching tray (fall or spring)

   3. Calculus Charting                   - 1 CDI C or D pt (fall and spring)
                                          - minimum of 10 clicks in one quad
                                           - chart entire quad
                                           - 75% accuracy; remediation required

   4.   CDI Class A-B                    -12 patients; must be signed off by faculty
                                           (12 in fall & 12 in spring)
   5.   CDI Class C                      - 7 patients; must be signed off by faculty
                                            (7 in fall and 7 in spring)
   6.   CDI Class D                      - 4 patients or 8 quads; must include tx plan
                                                       & re-evaluation
   7. CDI Class E                        - as assigned (1 quad = 2 quads of ‘D’)

   8. Chemotherapeutics                  - 1 appropriate patient (fall & spring)
       (Arestin or Perio Chip)
   9. Desensitization (Super Seal etc)   - 1 appropriate patient (fall & spring)

   10. Impressions/Study Models          - 1 patient for bleaching tray (fall or spring)

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

   12. Temporary Restoration             -PRN     (experiential only)


   13. Transitional/Mixed Dentition      - 1 each (fall and spring) during open clinic time
        charting

   14. Local anesthesia                  -10 mandibular blocks (total for fall and spring)
                                          - 14 Infiltrations (total for fall and spring)
                                                    -5 PSA
                                                    -5 Infraorbital
                                                    -2 Nasopalatine
                                                    -2 Greater Palatine

   15. Pediatric patients                - 6 minimum (fall and spring) (does not include sealant
    patients)


    TOTAL MINIMUM NUMBER OF ADULT PATIENTS FOR THE ENTIRE SENIOR YEAR: 60
    (credit will be given for patients treated at all rotation sites)

Other additional procedures PRN:
        Temporary restoration



                                                                                                    107
     Vitality testing
     Re-margination
     Amalgam polishing
     Additional patients-all patients appointed, regardless of rating shall be seen as assigned. If a
     patient is not seen as scheduled without CI approval, the student will be assessed a penalty of one
     letter grade.


                ALL ROTATIONS MUST BE COMPLETED AS ASSIGNED

                       CLINICAL COMPETENCIES

PROCEDURES                                        CRITERIA


1. CDI C                                          - 8 quads of CDI C prior to comp
                                                  - minimum of 9 points from Group 4
                                                  - minimum 18 clicks in 1 or 2 quads
                                                  - maximum 25 clicks in 1 or 2 quads
                                                  - 75% accuracy

2. PERIODONTAL CHARTING                           - to be accomplished on CDI C or D patient
                                                  - approved by CI (1 quadrant)
                                                  - 75% accuracy


3. ULTRASONIC SCALER                              - appropriate clinic patient
                                                  - 1 quadrant
                                                  - 75% accuracy

4. NITROUS OXIDE/OXYGEN                           - clinic partner
   ANALGESIA ADMINISTRATION                       - 75% accuracy

                        OTHER CLINICAL EXERCISES


1. CALCULUS CHARTING                     - 1 CDI C or D pt
                                         - minimum of 10 clicks in one quad
                                         - chart entire quad
                                         - 75% accuracy; remediation required

2. TRANSITIONAL/MIXED                    - 1 using cast
   DENTITION CHARTING                    - use pediatric dentition chart
                                         - 75% accuracy; remediation required




                                                                                                     108
SECTION J
Clinical Evaluation

    Protocol
       &
   Procedures
                                    DH I CLINICAL EVALUATION CRITERIA
                        STEP                  CLINICALLY ACCEPTABLE                                    NEEDS DEVELOPMENT

                     ASSESSMENT

PTP HHX / Vital Signs                    •   Comprehensively collects and synthesizes           •   Lack of documentation or differentiation
                                             all appropriate data                                   between significant and insignificant findings
                                                                                                •   Use of incorrect terms
Extra/Intra oral exam
Dental Evaluation
Periodontal Evaluation/occlusion         •   Recognizes need for consult                        •   Failure to seek faculty assistance
                                             and adaptations in care                            •   Failure to recognize necessary adaptations in
                                         •   Seeks consultation prn                                 care

CDI                                      •   CDI accurate                                       •   CDI inaccurate


Radiographic interpretation              •   Utilizes radiographs for assessment and in         •   Failure to utilize radiographs
                                             developing treatment plan

Risk Assessment
Patient Education                        •   Identifies all relevant assessment data            •   Unable to identify or omits essential
                                         •   Involves patient in planning process               •   assessment data
Treatment Plan                           •   Follows logical sequence of prioritized care       •   Does not involve patient in planning process
                                         •   Provides sound rationale                           •   Plan content is inappropriate; lacks essential
                                         •   Treatment proposed includes comprehensive              elements
                                             DH intervention                                    •   Sequence choice compromises care
                                         •   Integrates and logically sequences patient self-   •   Answers to questions indicate inadequate
                                             care                                                   knowledge
                                         •   Sets acceptable goals with patient input           •   Omits patient self-care
                                         •   Assesses patient progress at each                  •   Goals not established
                                             appointment; modifies prn                          •   Does not reassess patient progress or modify
                                                                                                •   at each appointment
                                         •   Establishes and maintains rapport with
                                             patients, peers, and faculty
                                         •   Demonstrates concern for patient's well-being      •   Lack of rapport with patient, peers, faculty
Patient management                                                                              •   Lack of concern for patient's well-being

                                         •   Documentation accurate and complete                •   Records are illegible, unorganized, inadequate
Documentation
                                         •   Assesses caries index, tissue healing
                                                                                                •   Omits or fails to identify correlation to overall
Nutritional Assessment/Counseling        •   Assesses need for intervention                         health
                                                                                                •   Omits or fails to address need for behavior
                                         •   Sets acceptable goals with patient                     modification
Tobacco Cessation
                                   DH I EVALUATION
                                       CRITERIA
                     STEP            CLINICALLY ACCEPTABLE                                     NEEDS DEVELOPMENT
                    CLINICAL
Instrumentation                •   Demonstrates safe instrument control               •   Hazardous instrument control
                               •   Activates with appropriate adaptation and          •   Unacceptable adaptation and stroke
                                   stroke pressure

Ultrasonic use                 •   Effectively utilizes US scaler and appropriate     •   Ineffective use of US scaler
                                   inserts


Calculus removal               •   Self-evaluates with light, air, and explorer       •   Self-evaluation is ineffective or omitted
                               •   Identifies remaining areas to faculty in advance   •   Excessive hard deposits remain
                               •   Able to remove remaining deposits identified                o Class A           2 or more
                                   by faculty                                                  o Class B           4 or more
                                                                                               o Class C           6 or more

                               •   Removes areas of disclosable plaque/stain
Plaque removal                 •   Evaluates adequacy of patient's self-care          •   Excessive plaque/stain remains
                               •   Involves patient in evaluation of results                   o Class A,B,C        4 or more
                               •   Appropriate recall interval set                    •   Fails to follow up on patient self care and/or
                               •   Recognizes need for consultation                       adapt to patient need
                                                                                      •   Does not involve patient in evaluation process

                               •   Recognizes tissue as inflamed, not traumatized     •   Tissue traumatized by hand or ultrasonics
Tissue Trauma                                                                         •   Excessive trauma       2 or more


                               •   Selects correct instruments and maintains          •   Faculty assists in instrument selection;
                                   sharpness                                              sharpness not maintained
Instrument care
                               •   Follows infection control protocols throughout     •   Does not follow infection control guidelines
                                   clinical period                                        or breaks aseptic chain

Infection control              •   Correct patient/operator positioning               •   Improper patient/operator positioning

                               •   Prepared prior to clinical session so treatment    •   Demonstrates lack of clinic preparation
Posture                            moves smoothly                                         resulting in major clinic interruptions
                               •   Uses time efficiently and effectively              •   Does not complete procedures in a timely
Time management                •   On time for clinical session                           fashion
                                                                                      •   Late for clinic session
Professionalism                •   Exhibits professional appearance                   •   Unprofessional appearance
                               •   Demonstrates concern for confidentiality           •   Violates patient's confidentiality
                               •   Demonstrates ethical behavior                      •   Demonstrates unethical behavior




                                                                                                                                           109
                                                 DH II          EVALUATION CRITERIA
                     STEP                            CLINICALLY ACCEPTABLE                                        NEEDS DEVELOPMENT
                ASSESSMENT
                                             •    Comprehensively collects and synthesizes          •   Lack of documentation or differentiation between
Comprehensive health history/vital signs         all appropriate data                                   significant and insignificant findings
Extra/Intra oral exam                        •    Recognizes need for consult/adaptations in care   •   Use of incorrect terms
Dental charting                              •    Seeks consultation prn                            •   Failure to seek faculty assistance
Perio charting/occlusion                                                                            •   Failure to recognize necessary adaptations in care

                                             •   CDI accurate                                       •   CDI inaccurate
CDI
                                             •   Utilizes radiographs for assessment and in         •   Failure to utilize radiographs
Radiographic interpretation                      developing treatment plan
                                                                                                    •   Unable to identify or omits essential assessment data
Comprehensive treatment plan developed/pt.   •   Identifies all relevant assessment data            •   Does not involve patient in planning process
education                                    •   Involves patient in planning process               •   Plan content is inappropriate; lacks essential elements
                                             •   Follows logical sequence of care                   •   Sequence choice compromises care
                                             •   Provides sound rationale                           •   Answers to questions indicate inadequate knowledge
                                             •   Treatment proposed includes comprehensive          •   Omits patient self-care
                                                 DH intervention                                    •   Goals not established
                                             •   Integrates and logically sequences patient self-   •   Does not reassess patient progress or modify at each
                                                 care                                                   appointment
                                             •   Sets acceptable goals with patient input
                                             •   Assesses patient progress at each
                                                  appointment; modifies prn

Documentation                                                                                       •   Records are illegible, unorganized, inadequate
                                             •   Documentation accurate and complete
                                             •   Establishes and maintains rapport with patients,
                                                 peers, and faculty                                 •   Lack of rapport with patient, peers, faculty
Patient management                                                                                  •   Lack of concern for patient's well-being
                                             •   Demonstrates concern for patient's well-being



Nutritional Assessment/Counseling            •   Assesses caries index, tissue healing              •   Omits or fails to identify correlation to overall health
                                             •   Assesses need for intervention                     •   Omits or fails to address need for behavior modification
                                             •   Sets acceptable goals with patient
Tobacco Cessation




                                                                                                                                                                   110
                    CLINICAL
Instrumentation                •   Demonstrates safe instrument control              •   Hazardous instrument control
                               •   Activates with appropriate                        •   Unacceptable adaptation and stroke
                                   adaptation and stroke pressure
Ultrasonic use                 •   Effectively utilizes US scaler and appropriate    •   Ineffective use of US scaler
                                   inserts
Calculus removal               •   Self-evaluates with light, air, and               •   Self-evaluation is ineffective or omitted
                                    explorer                                         •   Excessive supra deposits remain 2 or more
                               •   Identifies remaining areas to faculty             •   Excessive sub deposits remain
                                   in advance                                        •   B more than 2 per patient
                               •   Able to remove remaining deposits                 •   C more than 3 per patient
                                   identified by faculty                             •   D more than 2 per quad
                                                                                     •   E more than 2 per quad
Plaque removal                 •   Removes areas of disclosable plaque/stain         •   Unable to remove remaining deposits

                                                                                     •   Excessive plaque/stain remains more than 4
                                                                                     •   Tissue traumatized by hand or ultrasonics
Tissue Trauma                  •   Recognizes tissue as inflamed, not traumatized    •   Excessive trauma     2 or more


                                                                                     •   Does not plan for soft tissue evaluation
                                                                                         when appropriate
Re-evaluation                  •   Soft tissues evaluated after appropriate          •   Fails to follow up on patient self care and/or adapt to
                                   healing                                               patient need
                               •   Evaluates adequacy of patient's self-care         •   Does not involve patient in the evaluation
                               •   Involves patient in evaluation of results             process
                               •   Appropriate recall interval set                   •   Inappropriate recall interval
                               •   Recognizes need for consultation                  •   Faculty assists in instrument
                                                                                         selection; sharpness not maintained
Instrument care                •   Selects correct instruments and                   •   Does not follow infection control guidelines or breaks
                               •   maintains sharpness                                   aseptic chain
Infection control              •   Follows infection control protocols throughout    •   Improper patient/operator positioning
                                   clinical period                                   •   Demonstrates lack of clinic preparation resulting
Posture                        •   Correct patient/operator positioning                  in major clinic interruptions
                               •   Prepared prior to clinical session so treatment   •   Does not complete procedures in a timely fashion
                                   moves smoothly                                    •   Late for clinic session
                               •   Uses time efficiently and effectively
Time management                •   On time for clinical session                      •   Unprofessional appearance
                               •   Exhibits professional appearance                  •   Violates patient's confidentiality
                               •   Demonstrates concern for confidentiality          •   Demonstrates unethical behavior
Professionalism                •   Demonstrates ethical behavior




                                                                                                                                                   111
                    STEP                       CLINICALLY ACCEPTABLE                                  NEEDS DEVELOPMENT
          SUPPORTIVE TREATMENT          •   Recognizes need for procedure                •   Faculty identifies need
Diet counseling                         •   Explains rationale to patient                •   Needs moderate faculty assistance
Tobacco cessation                       •   Follows prescribed technique                     to complete
Impressions, bleaching trays            •   Procedure completed according to             •   Finished product is not clinically
Amalgam polishing                           guidelines                                       acceptable
Care of removable prosthesis            •   Quality of product is acceptable
Desensitization                         •   Administers pain control when necessary      •   Omission of pain control compromises patient care
Sealants                                •   Proper protocol/technique is followed when   •   Protocol not followed when administering pain control
Remargination                               administering pain control
Pain control (IA, PSA, Infiltrations)
Nitrous Oxide & oxygen sedation




                                                                                                                                                     112
    PATIENT RECEPTION AND OPERATOR/PATIENT POSITIONING

l. Prepares for appointment:

   A. positions patient chair in comfortably upright position, with the chair seat
   at its lowest position

   B. adjusts operator stool so that the operator's knees are parallel or slightly
      below, the thighs are parallel to the floor and the backrest is positioned to
      provide support to the lumbar spine (a pillow, rolled up towel, back
      support, or cushion may be used for additional support)

   C. Removes all obstacles from the patient's pathway to the chair, including
   cart, light, and operator stool, taking care not to obstruct the pathway of
   adjacent clinicians

2. Greets the patient:

   A. secures patient records

   B. greets patient by name, makes eye contact

   C. introduces self to patient, maintaining friendly attitude and eye contact

3. Escorts patient to operatory using the center aisle and asks patient to place
   personal belongings in the closet, or place on floor beside light post

4. Assists the patient in being seated in the patient chair on the side opposite the
   light post.

5. Secures patient napkin and provides the patient with tissue(s) for removing
   lipstick, and/or for later use

6. Completes all forms, including medical history interview, completes vital
   signs and obtains PTP extraoral examination, with patient in comfortable
   seated position

7. Asks for patient's removable appliances and secures appropriately

8.     For procedures beginning with the intraoral examination and if not
contraindicated by medical history, lowers backrest of chair to place the patient
in a comfortable supine position being careful that the neck rest is in a slightly
upright position providing support to the neck.




                                                                                   113
9. Lowers or raises the total chair until the field of operation (mouth) is parallel
   to the operator's elbows

l0. Warns the patient of need for eye protection from airborne debris and
    provides patient with appropriate safety glasses or goggles

11. Asks small patient or child to place head at upper edge of chair for optimum
    visualization and operator position

12. Positions patient chair for mandibular instrumentation:

   A. lowers the chair back to 20°

   B. lowers or raises the chair base until patient's mandibular occlusal plane is
      parallel to operator's elbows, does not attempt to raise chair to allow
   placement of legs under chair back if they do not fit with the patient at the
      appropriate height for operator

   C. asks patient to lower chin and/or to turn to the appropriate side for
   optimum visualization

   D. directs light directly down over area of instrumentation, adjusting light to
      optimally illuminate instrumentation area (may be to patient's left, right,
   or in the center)

13. Positions patient for maxillary instrumentation:

   A. lowers the patient into the true supine position at 5°

   B. lowers or raises the chair base until the patient's maxillary occlusal plane
   is parallel to operator's elbows, does not attempt to raise chair to allow
   placement of legs under chair back if they do not fit with the patient at the
   appropriate height for operator

   C. asks patient to raise chin and/or to turn to the appropriate side for
   optimum visualization

   D. directs light down over patient's chest, then up toward area of
   instrumentation adjusting light to optimally illumination instrumentation
   area (may be to patients left, right, or in the center)

14. Maintains optimum operator positioning throughout procedure(s):

   A. determines operator's individual neutral spine position and maintains
   throughout, and when necessary, moves forward by rotating from the hip.
   Absolutely does NOT bend or arch spine, does NOT twist torso, does NOT



                                                                                 114
lean laterally. Asks patient to adjust his/her head position to allow
visualization of instrumentation area

B. maintains eye level at 14-16 inches from the field of operation

C. correctly assumes the following clock positions for the area of
instrumentation: 8 - 12 o'clock for right-handed operators; 12 - 4 o'clock for
left-handed operators.

D. feet may be flat on floor to provide a stable tripod, legs should be
separated as necessary to assume optimum position.

E. places cart and light for easy access from the operator's position with a
   minimum of turning or reaching

F. maintains shoulders in neutral, relaxed position

G. remains conscious of optimum operator/patient positioning throughout
   procedure

H. takes a break every thirty to sixty minutes by standing up and doing
gentle back bends, stretching and walking around a little, does not work in
the same position for longer than one hour

I. allows patient five minute break following each sixty minutes of active
treatment




                                                                               115
       Permission to Proceed (PTP) Presentation

1. Age, race, sex of patient
   e.g.:      25 year old white female

2. Medications
   a. if taking medications either prescribed or over the counter, student will state:
    i. names of all drugs
    ii. reason for taking
   5 student should be prepared to answer questions from faculty about relevant drugs;
        student
        may use Dental Drug Reference or PDR
   c. all PRESCRIBED drugs must be listed on Medical Alert form in patient's chart
   d. if taking no drugs, student will state "no medications"

3. Past Relevant Illness
   a. previous illnesses/hospitalizations impacting dental hygiene care (faculty will
   check
       medical history to determine correctness of student statement)
   b. student will state factors of illness that necessitate modifications to treatment
   c. student will state necessary modifications
   d. e.g.: History of rheumatic fever at age 12 years; will require prophylactic
   antibiotic therapy prior to treatment.
   e. if no relevant illness; will state "no previous illness of concern."

4. Present Relevant Illness
   a. present illnesses impacting dental hygiene care (faculty will check medical history
      to determine correctness of student statement)
   b. student will state factors of illness that necessitate modifications to treatment
   c. student will state necessary modifications
   d. e.g.: Hypertension currently under control with diet and exercise; will take
      blood pressure pre and post treatment.
   e. if no relevant illness; will state "no present illness of concern."

5. Relevant Allergies
   a. allergy impacting dental hygiene care (faculty will check medical history to
   determine
       correctness of student statement)
   b. student will state previous patient reaction to allergen
   c. student will state necessary modifications to treatment protocol
   d. allergy of concern must be listed on Medical Alert form in patient's chart
   e. e.g.: allergy to latex; patient experienced hives and respiratory distress; will

      utilize nitrile gloves for all treatment.
   e. if no relevant illness; will state "no allergy of concern."




                                                                                          116
6. Vital Signs
   a. student will state blood pressure, pulse and respiration values
   b. if not within normal limits, student will state protocol for deviation
   c e.g.: after two readings two minutes apart, current blood pressure
      appears to be in the Stage 2, moderate hypertension category;
      however, patient has not been diagnosed and will be referred to her
      physician for further evaluation within one month. Pre & post-
      treatment blood pressure will be taken.

7. Dental History
   a. student will summarize dental visits history (i.e., periodic or emergency only)
   b. previous periodontal charting summary (recall only) and/or history of periodontal
   care
   c. approximate time since patient's most recent prophylaxis
   d. patient's last dental treatment
   e. if any negative dental experiences, the student will describe
   f. e.g.: patient has previously been seen on an emergency basis only "whenever
   he recognizes that he has a problem"; patient had periodontal surgery and graft on
   facial of lower anteriors in 1995; previous charting depths of record dated May 13,
   1994 indicated      generalized pockets of 4-5 mm; last prophylaxis was May 13,
   1994; last dental treatment was root canal done last month on #6.

8. Contributory Factors
   a. student will state possibly detrimental oral habits
   b. student will state lifestyle factors possibly impacting oral health
   6 e.g., "patient smokes two packs of cigarettes daily"
   7 if there are no apparent detrimental habits noted at this time, student will state,
      "no apparent contributory factors"

9. Current Oral Health Concern(s)/Complaint(s)
   8 student will state concerns in the patient's words
   9 if there are no concerns or complaints; student will state "no current oral     health
      concerns or problems"

10. Family Health History
    a. summarize contributory family health history factors
    b. state relevance of history to patient care
    c. e.g.: both parents had history of hypertension; father died at age 47 years from
    CVA; mother currently has CHF at age 67. Patient may be genetically predisposed to
    hypertension.
    d. if family health history is not an apparent factor, student will state, "family health
    history is non-contributory"

11.      Family Dental History
      a. summarize contributory family dental history factors


                                                                                           117
   b. state relevance of history to patient care
   c. e.g.: older sister had an extra third molar; will take panograph to check for
   supernumerary third molar.
   d. if family health history is not an apparent factor, student will state, "family health
   history is non-contributory"

12. Patient Suitability Opinion Statement
   a. end with a general statement of patient's apparent suitability as a patient in the
   dental hygiene clinic
   b. provide rational for any other than suitable patient
   c. e.g.: patient should not be seen in the dental hygiene clinic at this time because
   of an active herpes simplex lesion; patient will be instructed to reappoint after the
   lesion heals.
   d. if patient is suitable as a dental hygiene patient, student will state, "patient
    appears to be a good candidate for dental hygiene treatment.

MEDICAL ALERT SHEET:
The medical alert sheet at the front of the patient's chart should be completed in any of
the following circumstances:
    1. Allergies to medications or materials likely to be encountered as a dental patient.
    2. Prescribed medications that are being taken.
    3. There is a history of either contributory present or past illness(es).
    4. There are conditions for which antibiotic prophylaxis or other premedication is
    indicated.
    5. Include current physician's name and phone number for EVERY patient.

NOTE:
Information for PTP as stated above should be presented in the order given. The
information should be presented only at the initial appointment. The only requirement
for subsequent appointments is an oral review of the critical elements of the health
history and a statement of any changes since the last appointment.




                                                                                         118
                  INITIAL VISIT PTP MONOLOGUE
Student States:

Patient presents as a (age, race, sex) in apparent (poor, fair, good health) with
(no chief complaint/chief complaint) of "___________________".

This patient is (new, recall) at the COD.

Patient is currently taking: (meds) for (reason for meds). Student must state dental considerations
related to medication.

Patient states (drug allergies/sensitivity) to the following: _________ with a reaction of ________.

Patient reports a history of : (pertinent personal health history information)

Patient reports a family history of: (pertinent immediate family health history information). (Ex. Mother is
hypertensive)

Patient reports a dental history of:
If a new patient to COD:
                   This information will be provided by the patient.
                        i.e. Regular dental care, emergency care only, etc.
If a recall patient at the COD:
                   This information should include past
                   probing depths (localized/generalized perio information
                   statement , date of last prophy/exam, date of last radiographs, last CDI classification)

Patients vitals are: BP: ______, Pulse _____bpm, Respirations_____rpm.

Patient appears to be a _________candidate for dental treatment at the COD.




                                                                                                              119
                   SUBSEQUENT VISIT PTP MONOLOGUE

Student states :

        1. Appt number with patient. (Ex. This is appt. #2 with this patient)
        1. Changes in health history from the last appointment and/or
               significant health information (Ex. Asthma, diabetes, high BP,
               cardiac problems or any other medical issues that might effect Tx.
        2. Current medication information.
        3. CDI of patient and significant dental and perio findings of last
               appointment ( ex. severe bruxism, gross caries, ANUG, probe depths, BOP, etc).
        4. Procedures that are to be accomplished at today's appointment.
        5. Any other information that the faculty may request to acquaint or
            reacquaint themselves with the patient.




                   CASE COMPLETE MONOLOGUE

1.      Probing depths (pre-treatment and post-treatment)

2.      BI (pre-treatment and post-treatment)

3.      Amount/areas of residual calculus

4.      Assessment of patient compliance

5.      Reasons for non-resolution

6.      Recommended recall

7.      Further DH treatment/recommendations (including patient ed)




                                                                                            120
               INITIAL VISIT PTP MONOLOGUE
                                 (1st visit of series)
Student States:
Patient presents as a ________________________________(age, race, sex) in apparent

_____________________(poor, fair, good health)     with a

(no chief complaint/chief complaint) of "________________________________".

This patient is _____________________(new, recall) at the COD.

Patient is currently taking: _______________________________________(meds) for

_____________________________________________________(reason for meds).

Dental considerations related to medication_____________________________________

Patient states _____________________________________(drug allergies/sensitivity) to

the following meds: _________________________________________with a reaction of

___________________________________________________.

Patient reports a history of : (pertinent personal health history

information)______________________________________________________________

______________________________________________________________________________________

__________________________________________________________

Patient reports a family history of: (pertinent immediate family health history
information).
______________________________________________________________________
__
Patient     reports      a      personal     dental      history      of:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

Patients vitals are:           BP: ____________,                    Pulse _________BPM,
Resp__________RPM.




                                                                                      121
        SUBSEQUENT VISIT PTP MONOLOGUE
                              (2nd….etc visit of series)
Student states :

This is appointment no. _________________ with patient (state name)
 There have been ____________________________________changes in health
history from the last appointment and/or there have been no changes since the last
appointment.
The      patient’s    significant    health     information     includes:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
The patient currently takes _________________________________________(state meds) for

_____________________________________________________________________ with dental

considerations of:_________________________________________________

At work-up I documented: (Chief Complaint, EIE, CDI , and any significant dental and perio

findings of last appointment)

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________



Today I plan to accomplish:

______________________________________________________________________________________

__________________________________________________________




                                                                                             122
                       THE COMPLETE SEQUENCE
1. Arrive at 8:30 am: pick up cassette, handpiece, and sharpening stones at
Central Sterilization (allow 10 minutes for set-up and 15-20 minutes for
sharpening)
2. Seat patient at 9:00am.
       a. Faculty must be present before seating patient.
3. Obtain (if new patient) or review (if recall patient) health history, vitals,
   medical alert sheet
       a. Follow COD Blood Pressure Protocol Guidelines
4. Obtain Permission to Proceed (PTP) from assigned instructor.
       a. Written documentation in TPN and verbal presentation to faculty
5. Complete Work-up
       Includes: EIE, D/P charting, BI, PASS PI, Case Difficulty Index (CDI),
                   Occlusion, Overbite, Overjet
6. Sign up for instructor check of work-up
   STOP! NO FURTHER PATIENT TREATMENT MAY OCCUR
           UNTIL INSTRUCTOR HAS CHECKED
                      WORK UP!
       a. You may begin working on DH Tx Plan while waiting for instructor
       check. If not complete by time instructor arrives, you may complete at
        home and bring to appt. 2
       b. Oral diagnosis exam may be done after work-up check
7. Disclose and perform OHI
8. Scale 2 quads – you may choose either 1 &4 or 2 & 3
9. Sign up for instructor check of scaling after 2 quads
       a. Hold paperwork up on opposite side of dental chair
       b. You may being scaling other 2 quads while waiting for instructor check
10. Sign up for instructor check after scaling the remaining 2 quads
a. You may begin RC polishing while waiting for instructor check of scaling
11. Sign up for final instructor check after 4 quads of polishing complete
       a. RC or TB Polish entire mouth.
       b. Check your work with disclosing solution.
       c. Have disclosing solution and cotton tip applicator ready for faculty
14, Administer fluoride after final instructor check of patient

The LATEST time to sign up for completed work TO BE CHECKED by faculty
is 11:15 am. A time extension may be granted on a CASE BY CASE basis by
assigned faculty, but must be requested prior to 11:15am. If no instructor
check is needed, 11:45 am is patient dismissal time




                                                                                   123
                                 VITAL SIGNS

1To be obtained at the primary appointment; 2on subsequent appointments for
the patient with a history of heart disease or abnormal blood pressure, or any
other systemic condition that dictates blood pressure monitoring; 3if the patient
takes a medication that alters blood pressure; 4during pregnancy; 5prior to the
administration of local anesthetic or nitrous oxide analgesia.

PULSE

1. Positions patients arm on a flat surface at level of the heart

2. Holds patient's forearm palm downward in palm of hand with index, second,
   and third fingertips securely over the radial artery

3. Places thumb on opposite side of wrist

4. Exerts firm pressure over radial artery and observes pulse for 30 seconds

5. Records pulse rate on patient's record by multiplying 30 seconds rate by 2

6. Records rhythm, volume, condition of arterial wall if abnormalities are
   observed

7. Pulse reading is accurate within 5 beats

RESPIRATION

1. Counts patient respiration while pulse is held as if being taken

2. Observes respirations before or after measuring the pulse

3. Counts for 30 seconds and multiplies by 2 if respirations observed are regular
   or counts respirations for one full minute if abnormalities of respiration are
   observed

4. Observes respiratory movements so patient is not aware of this observation

5. Records respiratory rate promptly

6. Records and reports observations if rhythm, depth or character of respirations
   are abnormal

7. Respirations are accurate within 2 breaths




                                                                                124
BLOOD PRESSURE

1. Secures manometer, pressure cuff, and stethoscope

2. Determines whether patient has just engaged in physical activity, smoking ,
   eating

3. Discusses activity to be carried out with the patient

4 . Removes all clothing from the extremity

5. Places manometer at proper viewing angle and distance

6. Wraps the cuff snugly and smoothly on the extremity

7. Places the center of the inflatable bag directly over the artery with the lower
   edge one inch above the antecubital space

8. Locates radial pulse and holds as if taking pulse

9. Inflates cuff until radial pulse is no longer palpated and notes reading
   obtained

10. Deflates cuff

11. Locates brachial pulse and apply bell to pulse area

12. Places earpieces in ears

13. Inflates cuff to 10 - 20 mm Hg higher than pressure necessary to stop radial
    pulse (step 10)

14. Allows pressure to fall evenly and notes systolic and diastolic readings

15. When diastolic is reached, releases cuff pressure

16. Inflates cuff and retakes after 30 seconds

17. Removes the cuff and stethoscope

18. Averages the two readings and records the measurement

19. Reading for systolic and diastolic are accurate to within + 5 mm Hg

20. Returns equipment to its storage place




                                                                                125
EVALUATION

1. Identify abnormal levels/rates for each vital sign.

2. Recognize need to obtain an OD consult or terminate appointment.

3. Notify patient of need for medical consult if vital signs are above normal
   ranges. (See Blood Pressure Protocol).




                                                                                126
            EXTRAORAL/INTRAORAL EXAMINATION
EXTRAORAL
1.  Assembles armamentarium: mouth mirror, adequate light, two 2X2"
    gauze sponges, tongue depressor, personal protective equipment
2.  Looks at the skin of the neck and face.
3.  Asks the patient to open and close the mouth while observing T.M.J. and
    mandibular movements.
4.  Places the hands flat against the patient's face with the index fingers
    firmly resting over the TMJ.
5.  Asks the patient to open and close the mouth while the operator's hands
    remain in place to feel deviation in TMJ glide and to note possible
    vibrations from crepitation
6.  Palpates the muscles
    A.     temporalis - bilateral temple (fan) to coronoid process
    B.     masseter - bilateral cheek to angle of mandible
    C.     buccinator - bilateral lips back toward ramus
    D.     sternocleidomastoid - bilateral & bidigital
7.  Palpates the lymph nodes:
    A.     submandibular - by placing the fingers of each hand against the
           skin of the neck approximately 1 or 2 inches below the interior
           border of the mandible. The fingers should be perpendicular to,
           and pressing firmly into the neck. The fingers are then drawn up
           slowly until the inferior border of the mandible is reached. Fingers
           are "walked" from most posterior position until they meet in the
           anterior portion of the mandible
    B.     preauricular bilateral technique
    C.     postauricular bilateral technique
    D.     submental - bilateral digital technique
    E.     anterior and posterior cervical chain (while palpating cervical
           tissues surrounding the sterno-cleidomastoid)
    F.     parotid (while examining TMJ)
    G.     supraclavicular - bidigital technique
    H.     thyroid - bimanual, digital - pressing alternately on opposite sides
           of the larnyx, trachea, and above notch of sternum. Ask patient to
           swallow while plating thumb and fingers over the area
INTRAORAL
1.   Observes the lips and labial mucosae. The labial mucosae are examined
     with the lips reflected up for the upper lip and down for the lower lip.
2.   With the lips reflected, examines the labial and buccal gingivae and
     mucobuccal folds.
3.   Palpates the lips and labial mucosa bidigitally.
4.   Observes the buccal mucosae by holding cheek taut with the index and
     middle fingers. Has the patient turn his head in the direction of the side
     being observed.
5.   Palpates buccal. mucosae bidigitaly. Observe Stenson's Duct of parotid
     gland and note presence of Fordyce Granules.



                                                                              127
6.    Observes the dorsum of the tongue, asks the patient to touch the palate
      with the tip of the tongue and examines the ventral surface of the tongue
      and the floor of the mouth. Note presence of papillae coatings
7.    Palpates the floor of the mouth bimanually by placing a flat hand firmly
      inferior to the mandible as far as the neck and using one or two fingers of
      the opposite hand to presses firmly. May be done after step 9 is
      completed.
8.    Examines the posterolateral border of the tongue by protruding the
      tongue and moving it to) one side, grasping the tongue with gauze sponge
      and gently pulling it forward and laterally. Note color of papillae.
9.    Palpates the lateral borders of the tongue and the body of the tongue
      bidigitally.
10.   The mandibular lingual gingivae and retromolar gingiva are observed
      using the mouth mirror. While the gingiva is seen on the reflecting (glass)
      side of the mirror the back of the mirror retracts the tongue.
11.   Observes the palatal gingivae and mucosa of the hard palate either, by
      direct vision (changing head position appropriately), or indirectly with a
      mirror.
12.   Observes the maxillary alveolar ridge and maxillary tuberosities using
      mouth mirror.
13.   Depresses the patient's tongue with tongue blade or mirror, and observes
      the soft palate and uvula.
14.   Observes the tonsillar pillars and oropharynx by depressing the tongue
      blade or mirror and having the patient say "aaah".
15.   Note and record presence of mouth odor, such as fetor oris or sweet fruity
      smell.
16.   Note and observe quantity and consistency of saliva.

CHARTING

1.    Fills out all blanks on the extraoral and intraoral examination section on
      the patient chart.
2.    Notes deviations from normal on the chart and records answers to the
      following questions:.
      A.      location
      B.      description: size
      C.      description: color
      D.      description: surface texture
      E.      description: consistency
      F.      history: whether or not lesion is known to patient
      G.      history: duration
       H.     history: symptoms




                                                                               128
                           DEFINITIONS OF TERMS

bidigital palpation - Use of one or more fingers and the thumb to examine tissues
by grasping the tissue between thumb and fingers

bilateral palpation - examination of structures on both sides of the face or neck
       simultaneously to detect differences between the two sides

bimanual palpation - examination of structures on both sides of the face or neck
     simultaneously to detect differences between the two sides

bullae - large (5 mm to several centimeters) vesicles that are relatively deep
seated
       and less prone to rupture; often seen with pemphigus

circular compression - moving the fingertips in a circular pattern over a structure
       while simultaneously applying pressure to the tissue

confluent - blending or occurring together, originally separate, but subsequently
      combined

diffuse - spread out, blended together; used to describe borders of lesions

digital palpation - use of a finger to examine tissues

discrete - separate, well-defined, not blending; used to describe borders of lesions

erosion - shallow surface defect that does not extend through the epithelium into
        underlying tissues

erythema - red area of variable size or shape

induration - hardened area of tissue

keratosis - abnormal thickening of the outer layers of skin or mucosa that may
        appear as white, grayish white, or brown lesions; examples are linea
        alba, cheek-biting, nicotine stomatitis, lesions of lichen planus, and
        leukoplakia

macules flat areas that are differentiated from surrounding tissues by color; may
       vary in size, shape and color; examples are petechiae, ecchymoses,
       freckles, and maleness

manual palpation - use of all the fingers of one hand to examine tissues

nodules - enlarged papules that are seated in the submucosa or lower dermis;
       examples are traumatic fibromas, lesions associated rheumatoid arthritis,
       Kaposi's sarcoma




                                                                                 129
papules - small (pinhead to 5 mm) superficial elevated areas of tissue, which may
       appear flattened, rounded, or pointed; color may vary; examples are
       found in lichen planus, and some condylomas

pedunculated - elevated papillary type of lesion attached to underlying tissue by
      a stem or narrow connector

petechia(e) - minute round red spot(s)

pustules - vesicles that contain pus

sessile - attachment of lesion by a broad base

tumor - solid growth of hard or soft tissue; swelling or overgrowth of cells
        independent of normal tissue; examples are papillomas, polyps, and tori

ulcer - defect in the skin or mucosa that extends beyond the surface epithelium
         and into the underlying issues; may be ragged or punched out; may be
         smooth, granular, glazed, pus-covered, or hemorrhagic, painless or
         extremely sensitive

verrucous, or verrucose - resembling a wart; denoting wartlike elevations

vesicles - small elevations containing fluid with a thin surface covering of
         epithelium or mucosa (e.g., blisters); they may occur singly or in clusters;
         examples are herpetic lesions

well-circumscribed - differentiated; having discrete borders and a definite shape




                                                                                 130
131
            EXTRAORAL/INTRAORAL EXAMINATION SEQUENCE

General Instructions:

1. Operator uses the ends (fleshy parts) of finger pads for palpating tissues, and when
possible, maintains contact between the fingers (index through fifth) in order to broaden
palpation surface of hand and reduce chance of missing deviations

2. Operator detects and questions patient regarding any tenderness as evidenced by
verbal or nonverbal behavior.

3. Overgloves should be worn when documenting findings.

4. Findings should be documented when:
       a.      baseline information is needed
       b.      the area needs to be re-evaluated at subsequent appointments
       c.      the finding may affect future treatment options
       Note: Scars, freckles, tori, linea alba, indentions from glasses, and other findings
       that have been present for an extended period of time and/or that will not change
       and are currently within normal limits should not be documented.

5. Findings should be described using the following categories and terminology:
       a.     Size – measure in mm.

       b.      Color – pink, red, magenta, blue, white, yellow

       c.      Shape – linear, circular, irregular

       d.      Consistency – fluid-filled, firm, ulcerated

       e.      Mass – flat-macule, raised-papule

       f.      Location – specific – on left buccal mucosa adj. to #19
                          generalized – max. left alveolar ridge

       g.      Duration – how long has it been present

       h.      Symptoms – tender, asymptomatic

       Example: 3 mm. pink round firm sessile papule on left buccal mucosa adjacent to
       #19, dur.-unknown, asymptomatic.

6      General assessment of patient should include:
       7     body build, gait, ease of movement
       8     intellectual ability, degree of alertness


                                                                                        132
       9      speech
       10     habits with physical manifestations
       11     general hygiene

7.     Assemble armamentarium: mouth mirror, probe, 2X2 gauze squares, ppe.

                              Extraoral Examination


1.     Don gloves.

2.     While positioned standing in front of the patient (with the patient in a seated,
       upright position), look at the skin and structure of the face and neck observing
       symmetry as well as skin abnormalities.

3.     Utilize bilateral palpation beginning with the forehead and progressing with the
       temple*, cheeks, nose, upper lip area, chin, and submandibular area. * After
       palpating the temple area, place two to three fingers over the TMJ position and
       ask the patient to open their mouth as wide as they can slowly and note any
       deviations and/or abnormalities (i.e. clicking, popping, crepitus, subluxation, or
       deviation). Be sure you are positioned in front of the patient to observe the TMJ.

D.     Bidigitally palpate the tracheal area, including the thyroid. Observe the thyroid
       area and have the patient swallow.

5.     Palpate the right sternocleidomastoid muscle simultaneously anteriorly and
       posteriorly beginning at the base and moving superiorly. Move around to the
       other side of the patient and repeat with the left sternocleidomastoid muscle.

6.     While standing behind the patient, ask them to lean their head forward and down.
       Utilize bilateral palpation to examine the back of the neck, suboccipital area, and
       behind the ears. Utilize bidigital palpation to examine the trapezius muscle and
       supraclavicular area.


Intraoral Examination

Recline patient into supine position. Wash and reglove. Follow similar palpating and
examination procedures as for extraoral exam. The operator should be seated.

1.     Lips

              10      Observe with the mouth closed and observe the location of the
                      philtrum and the vermilion borders.
              11      Observe with the mouth open and observe the labial commissures
                      for a restricted opening.


                                                                                          133
            12     Grasp the patient’s lower lip with the thumb and index fingers of
                   each hand and gently palpate using both a bidigital and bilateral
                   technique.
            13     Repeat (c) on upper lip.


2.   Labial and buccal mucosa

            8.     Gently grasp the patient’s lower lip with the thumb and index
                   finger of each hand and deflect lower lip.
            9.     Visually examine the labial mucosa, the vestibule and the labial
                   frenae.
            10.    Gently palpate this area.
            11.    Repeat a.,b.,c., on upper lip.
            12.    Instruct patient to open wide and examine the buccal mucosa and
                   buccal vestibule.
            13.    Observe and palpate the tissue from the inner commissure of the
                   lip anteriorly to the retromolar pad posteriorly.
            14.    Check the appearance of the Parotid (Stensen’s duct).
            15.    Test the duct by gently stroking it with a dry gauze and checking if
                   the gentle stimulation has caused secretion of saliva. Examine
                   both right and left ducts.

3.   Floor of mouth (operator should be seated at 8/9 o’clock)

            8      Have patient open their mouth and tilt chin upward slightly.
            9      Utilize bimanual palpation technique, with one finger in the floor
                   of the mouth and two fingers directly opposite, underneath the
                   chin.
            10     Cover the entire area, one side at a time (unilaterally).
            11     First, move from deep under the tongue and proceed towards the
                   anterior aspect of the sublingual area.
            12     Next, cross the mid-line area and palpate the opposite side in the
                   same manner.
            13     Have patient touch tip of tongue to the roof of his mouth so that the
                   ventral surface of the tongue and the floor of the mouth can be
                   observed.
            14     Observe the attachment of the lingual frenulum.

4.   Tongue

            8      Examine the tongue as it normally rests in the mouth by instructing
                   the patient to partially open.
            9      Have the patient extend his tongue and visually observe any
                   deviation or asymmetry.




                                                                                    134
            10      After advising the patient of your intent, ask him to extend or
                    “stick out” his tongue. Gently, but firmly, grasp the tip of the
                    tongue in a 2X2 gauze square and pull it forward and laterally.
                    Observe both left and right borders in this manner.
            11      Use bidigital palpation along the lateral borders with your free
                    hand.

5.   Hard palate and soft palate

            a.      Instruct the patient to tilt his chin up and to open the mouth wide.
                    Use direct and indirect vision to observe the hard and soft palates.
            b.      The hard palate should be palpated with the index finger to feel if
                    there is any deviation or swelling not readily observed visually.
            c.      If easy observation of the soft palate is not possible with the patient in this
                    position, the base of the tongue may be gently depressed with a mouth
                    mirror or tongue blade while the patient is instructed to say “Ahh”.

6.   Uvula, Tonsillar Pillars, Oropharynx

            To observe the oropharynx area, it may be necessary to maintain gentle forward
            and slight downward pressure of a tongue blade or mouth mirror on the base of
            the tongue to depress it out of the line of vision (may also need the patient to say
            “Ahh”). Be aware you may trigger the gag reflex if you depress too far
            posteriorly.
            Compare landmarks on both sides of the oropharynx.

6    Alveolar mucosa

     Check visually at the apices of all teeth, both facially and lingually.

7    Edentulous gingiva

            Visually examine for deviations.
            Palpate with thumb and forefinger.

8    Gingival Screening

     Will follow periodontal charting and should include a brief description of the clinical
            observations of the periodontium.
     The following should be included in the description:

            Quality – mild, moderate, severe
            Quantity – localized, generalized
                   Location – scattered, area-specific (i.e. mand. ant., max.
                           post., etc.)
                   Consistency/Texture – firm, spongy, fibrotic, etc.


                                                                                       135
                      Contour/Form – uniform, recession, clefting,
                              bulbous, rolled margins, etc.
                      Color – coral pink, pink, red, magenta, etc.
                      Sulci – include a summary of depths and bleeding
                              observations (i.e. gen. 2-3 mm. with no BOP
                              with loc. 4 mm. in max. post. with mild BOP)

              Utilizing this descriptive terminology will enhance observation skills and
              therefore improve the ability to better define the needs of the patient.

9   Other

       May note any unusual findings that do not fit in the above categories.

10 Saliva

              1.      Note consistency
              2.      Note extreme dryness (xerostomia) or extreme salivation.




                                                                                     136
Elevated Lesions
                              (above the normal plane of mucosa)
                         Localized                           Generalized
                  (limited to a small focal area)                (involves most or all of
an area)


                             Single                                Multiple
                                                            Multiple lesions are either separate
                                                            (widely spaced with distinct
margins)
                                                            or coalescing(close to each other
with
                                                            margins that merge)


               Blisterform                                                    Nonblisterform
   (containing fluid with translucent                                (solid lesion containing no
   appearance and a soft consistency)                                       fluid and of a firm
consistency)




Vesicle                      Bulla                  Papule                       Tumor
(less than 1 cm              (greater than          (less than 1 cm in (1 cm or greater in
in diameter, contains        1 cm in diameter       diameter, consists of       diameter, consists of
serum or mucin)              contains serum         tissue)                     tissue)
                             or mucin, may
                             contain extravasated
                             blood)
                  Pustule                                                  Nodule
Plaque
                  (contains pus, yellowish color                     (smaller than 1 cm in      (slightly
raised
                  any size                                           diameter, consists of      with a
broad flat
                                                                     tissue)                    top and
a “pasted
                                                                                                on”
appearance)




                                                                                                      137
Depressed Lesions
                                 (below the normal plane of mucosa,
                                usually an ulcer where there is loss of
                                       continuity of epithelium

                           Single                             Multiple
                                                              Multiple lesions are either
                                                              Separate or coalescing



         Regular Outline                                               Irregular Outline
(continuous linear outline that resembles a circle or oval)   (numerous deviations from a circular or oval
                                                                               pattern)


         Smooth Margin                                                 Raised Margin
(margin of lesion is on the same plane as normal mucosa)      (margin of lesion is above the plane of
                                                                     normal mucos)


         Superficial                                                   Deep
(distance from base of depression to plane of margin          (distance from base of depression to plane of


         is less than 3 mm.)                                           margin is greater than 3

Flat Lesions
                       (surface is on the same plane as the normal mucosa)




                  Single Macule                               Multiple Macules
       (flat lesion of abnormal color)                                 multiple lesions are either
separate
                                                                       or coalescing



         Regular Outline                                                        Irregular




Full mouth periodontal charting to be completed on new patients.



                                                                                                        138
                         PERIODON TAL CHARTING

1.Probes entire pocket topography of each tooth in the sextant(s)

2. Notes and records the deepest clinical probing depths found in six areas of
   the tooth: DB, B, MB, ML, L, DL

3. Notes and records gingival recession measuring from CEJ to junctional
   epithelium (clinical attachment level) marginal gingiva

4. Notes and records furcation involvement

   A. Class I - tactile exposure of the groove or concavity on the root trunk only,
      detectable by the Naber's probe

   B. Class II - bone loss that extends between the roots with a roof created by
   the        root trunk; probe cannot be passed from the entrance of the
   furcation to      another furcation area

   C. Class III - bone loss allowing communication from one tooth surface to
      another, such as facial to lingual on mandibular teeth and facial to
   proximal on maxillary teeth

   D. Class IV- through & through (gingival recession, furcation visible, probe
      easily penetrates through furcation, visible from other side


5. Notes and records mobility using two instrument handle ends placed on the
   facial and lingual aspects of each tooth and pushing in the facial-lingual
   direction, tooth movement can be compared to adjacent teeth

   A. Class I - tooth deflection measuring 0.5 mm to 1.0 mm facial-lingual (any
      perceptible movement)

   B. Class II - deflection measuring greater than 1 mm, but less than 2 mm
   facial-   lingual (movement that is more than perceptible)

   C. Class III - deflection measuring 2 mm or more facial-lingual, or a tooth
   that is   depressible in the socket

6. Given charting information above, can compute total attachment loss

7. Given charting information above, can compute probable bone loss

8. Notes and records bleeding index

9. Periodontal charting documentation is legible

10. Sign and date the form. Obtain faculty signature


                                                                                 139
                             BLEEDING INDEX


1.   Utilize aseptic technique.

2.   Communicate with patient re: procedure rationale and method.

3.   Position patient appropriately.

4.   Assemble armamentarium.

     A. adequate illumination
     B. mirror, periodontal probe
     C. appropriate chart

5.   Accurately probe to depth of pocket.

6.   Identify and record presence of bleeding in indicated area of chart.

7.   Calculate and record the summary BI for the patient [total of teeth
     exhibiting bleeding point(s,) over total number of teeth, i.e. 15/28].




                                                                              140
                      ORAL DIAGNOSIS
CHARTING /KEY FOR "RECORD OF EXISTING ORAL CONDITIONS"


1.     Chart all conditions which are detectable by clinical examination and/or
       radiographic examination in red or blue pencil. Existing normal (healthy)
       conditions in blue; existing abnormal (unhealthy) conditions in red.

2.     Mark all missing teeth not replaced by fixed prosthesis with a blue "X"
       through the entire tooth including occlusal and lingual views as well as
       the buccal and root view.

3.     Outline every restoration in blue showing exactly what you see clinically
       from occlusal, buccal and lingual views.

4.     Outline every crown in blue according to its outline or margins as you
       view it from occlusal, buccal, or lingual.

5.     Fill in the interior outline of any amalgam restoration solidly in blue.

6.     Fill in the interior of any gold restoration with slanting blue parallel lines.

7.     Leave the interior of the outline of any "white" restoration clear.

8.     Fill in the interior of any part of a crown which is gold with slanting blue
       parallel lines; leave any "white" part of the crown with only the blue
       outline already crown.

9.     If a tooth is missing and replaced by a fixed bridge, "X" the root only in
       blue and mark the pontic in the same manner as a crown. Connect the
       abutments and the pontic with parallel lines at the occlusal view
       (Posterior) and lingual view (anterior). Mark the connecting parallel lines
       according to the material used in the bridge.

10.   Mark any root canal fillings in blue as they appear radiographically. Also
      mark access restoration according to material used.

11.   Circle impacted or unerupted teeth in blue including all views in your.
      circle and Place a large blue arrow within the circle indicating the long axis
      of the tooth and where the crown is pointing.

12.   Mark open contacts with parallel blue lines between the two teeth and
      extending through all three views of the crown. Note the extent of the
      opening to the closest millimeter.




                                                                                   141
13.   Mark drifted or repositioned teeth with an arrow indicating the new
      position of the tooth. For extruded teeth or unusual drifting, make a
      statement about it in "Other findings".

14.   Mark rotated teeth with an arrow around the occlusal view.

15.   Mark an overhang as an extension in blue of your drawing of the
      restoration exactly as it appears, either clinically or radiographically, and
      circle the overhang area in red.

16.   Mark carious lesions in red exactly as they appear clinically. If seen
      interproximally by radiograph only, mark them as a chevron (>) on the
      buccal view just as you view the radiographs from the buccal.

17.   Mark open or carious margins of restorations in red exactly where you see
      them.

18.   Mark any periapical radiolucency in red as it appears on the radiograph.

19.   Outline any other pathology seen radiographically in red, identify it with
      a number within or near your outline and describe the lesion in "Other
      findings" prefixed by your identifying number.

20.   Mark fractured, missing parts of teeth with a red line along the fracture
      site.

21.   Missing parts due to carious activity would be colored in red; fractured,
      missing parts which have become carious on the fracture site would be
      marked solid red.

22.   Do not mark any treatment suggestions on this chart, e.g. do not mark
      teeth to be extracted with two vertical parallel blue lines.

23.   Indicate excessive wear, abrasion, or any condition localized to individual
             teeth in "Other findings" space.

24.   For generalized conditions use space marked "Comments" at the bottom
      of the page.

25.   Draw abnormal gingival architecture as accurately as possible with detail
      to clefts, recession and interproximal contour, using the red pencil. Do
      not mark normal gingival contour. Draw a line indicating the
      mucogingival junction in blue on the root surface the proper distance from
      the C-E junction and the free gingival margin in these areas of abnormal
      gingival architecture only. Remember, the lines on the root drawings
      indicated 2 mm increments.

26.   Mark clinical furcation findings with an open triangle (^) in the furcal area
      and note the extent of involvement with the number 1, 2, 3 (1, 2, 3).


                                                                                  142
27.   Mark high muscular or frenum attachment in the approximate location
      with a "V" shaped line in red.

28.   Write in areas of food impaction on the slanted lines indicating "Other
      Findings".

29.   Mark mobility in Roman Numerals on the buccal view of the crown in red
      using an I through M scale.
30.   Record all sulcular depths of 1-3 mm in the appropriate space in blue.
      Record sulcular readings 4 mm or greater in red. Circle the corresponding
      probing depths of any bleeding points.
31.    Indicate any exudate in "other findings".
32.   Classify occlusion according to Angle's system and record in "Comments"
      section.




                                                                                143
                      OCCLUSION - MALPOSITIONS


1.   Labioversion - a tooth that has assumed a position labial to normal.

2.   Linguoversion - position lingual to normal.

3.   Buccoversion - position buccal to normal.

4.   Supraversion - elongated above the line of occlusion.

5.   Torsoversion - turned or rotated.

6.   Infraversion - depressed below the line of occlusion.

     OCCLUSION - MALRELATIONSHIPS OF GROUPS OF TEETH
1.   Crossbites - Anterior maxillary incisors ate lingual to mandibular incisors.

2.   Edge to edge - (Anterior teeth) incisal surfaces of maxillary teeth occlude
     with incisal surfaces of mandibular teeth instead of overlapping as an
     ideal occlusion.

3.   End to end - (Posterior teeth) Molars and premolars occlude cusp to cusp
     viewed mesiodistally.

4.   Openbite - Lack of occlusal or incisal contact between maxillary and
     mandibular teeth because have failed to reach the line of occlusion.

5.   Overjet - The horizontal distance between the labibincisal surfaces of
     mandibular incisors and the linguoincisal surfaces of maxillary incisors.

6.   Underjet - Maxillary teeth are lingual to mandibular teeth.

7.   Overbite - Vertical distance by which the maxillary incisors overlap the
     mandibular incisors.



               OCCLUSION - TYPES OF FACIAL PROFILES

1.   Mesognathic - having slightly protruded jaws.

2.   Retrognathic - (CONVEX) Having a prominent maxilla and a protruded
     mandible.

3.   Prognathic - (CONCAVE) Having a prominent, protruded mandible and a
     normal maxilla.




                                                                                144
                                 PLAQUE INDEX


1. Utilize aseptic technique

2. Assemble armamentarium
      A.    adequate illumination
      B.    mirror
      C.    disclosing solution in cup
      D.    cotton applicator

3. Communicates with patient re: rationale and method for procedure

4. Positions patient properly (reclining)

5. Apply disclosing solution to all surfaces of all teeth

6. Rinse with water

7. Identify and record all designated surfaces that exhibit staining due to plaque

8. Tabulate the plaque score according to chart instructions; record in
   appropriate place on chart

9. Perform and record plaque index on patient at each subsequent visit

10. Subsequent plaque scores should be generated only if patient's initial score is
    above 20%. Generally, this will be done at the re-evaluation appointment.
    Plaque scores can be calculated at any appointment and will be left to the
    discretion of the clinician and case instructor.




                                                                                145
                        STRESS REDUCTION PROTOCOL

1.   Determines ASA status
      A. ASA I
            i.    normal and healthy
            ii.   little or no anxiety
            iii. little or no risk
      B. ASA II
             i.   mild systemic disease or healthy ASA I with extreme anxiety
             16.     examples: well-controlled diabetes, epilepsy, asthma, and/or
                     hypothyroid or hyperthyroid conditions; ASA I with upper
                     respiratory condition, pregnancy and/or allergies
             17.     minimal risk during treatment
      C. ASA III
             i.   severe systemic disease that limits activity, but is not incapacitating
             ii. examples: angina pectoris or MI history, CVA history
                  insulin dependent diabetes, CHF(congestive heart failure) with
                  orthopnea and ankle edema, COPD (chronic obstructive pulmonary
                  disease (emphysema, chronic bronchitis, exercise asthma)
             iii. dental treatment indicated, but stress reduction protocol and other
                  treatment modifications are indicated
      D. ASA IV
             i.   incapacitating disease that is a constant threat to life, problem that is
                  of greater importance than the planned dental treatment. If possible,
                  treatment should be postponed until medical condition has improved
                  to at least ASA III

2.   Utilizes Stress Reduction Protocol for normal, healthy anxious patient (ASA I)
      A.      recognize anxiety
      B.      clinic dentist may premedicate with an antianxiety or sedative-hypnotic
              agent on the night before or immediately before appointment, prn
      C.      morning appointment
      D.      minimize waiting time
      E.      non-drug psychosedation during therapy, such as telling the patient what
              to expect and using TLC, Using a low, monotonous tone of voice or any
              technique which helps get the patient's thoughts centered oft something
              other than the procedure being accomplished
      F.      Uses adequate pain control during therapy, anesthesia may be
              administered by the clinic dentist
      G.      vary length of appointment depending on desire of patient (patient may
              prefer longer appointments to "get it over with", or may prefer shorter
              appointments)
      H.      telephones the patient later in the day of treatment to see how patient is
              doing and to reassure




                                                                                       146
3.     Utilizes Stress Reduction Protocol for Medical Risk Patient (ASA II, III, IV)

       A.   recognize risk
       B.    medical consult prn
       C.    morning appointment
       D.    minimize waiting time
       E.    preoperative and postoperative vital signs monitored
       F.    psychosedation as described above
       G.   adequate pain control determined by clinical dentist
       H.   length of appointment variable, dependent on the tolerance of the patient
       I.   postoperative pain/anxiety control as determined by clinical dentist
       J.   telephones the patient later in the day of treatment to see how patient is
            doing and to reassure
       K.   arrange for the appointment to be early in the week so that the patient will
            not be left over the weekend
       L.   other precautions may be taken dependent on the patient's condition, such
            as: oxygen administration during the procedure, modifications of patient
            position, contraindication of rubber dam use

4. Positions patient properly (reclining)

5. Apply disclosing solution to all surfaces of all teeth

6. Rinse with water

7. Identify and record all designated surfaces that exhibit staining due to plaque

8. Tabulate the plaque score according to chart instructions; record in
   appropriate place on chart

9. Perform and record plaque index on patient at each subsequent visit

10. Subsequent plaque scores should be generated only if patient's initial score is
    above 20%. Generally, this will be done at the re-evaluation appointment.
    Plaque scores can be calculated at any appointment and will be left to the
    discretion of the clinician and case instructor.




                                                                                       147
                                        STERILIZATION
                                                               Temp
Method                              Time                    Requirement          Pressure
    Autoclave                  20–30 minutes             250 degrees F            15 psi
                                                         121 degrees C
        Dry Heat               60-120 minutes            320 degrees F
                            1 hour to reach temp         160 degrees C
                               & 1 hour at 320
                                   degrees
     Chemical Vapor              20 minutes              270 degrees F           20-40 psi
                                                         132 degrees C
 Ethylene Oxide Gas             10-16 hours               75 degrees F
                                                         25 degrees C
DISINFECTANTS

GLUTERALDEHYDES
High level disinfectant for instruments – Fumes toxic
2% neutral
                                              2% alkaline
2% with phenolic buffer
2% acidic

CHLORINES

Intermediate level disinfectant – Not recommended for aluminum or metal
Chlorine Dioxide
Sodium hypochlorite (Household Bleach)

IODOPHORS
High level disinfectant for chairs, unit, etc. Stains many surfaces
1% available iodine

PHENOLICS

Intermediate level – irritating to skin. Used at OUCOD
*Water based
Alcohol- based


            PROPERTIES OF AN IDEAL DISINFECTANT
1.   Broad spectrum
2.   Fact acting
3.   Unaffected by physical factors: Active in the presence of organic matter
4.   Non toxic
5.   Surface compatibility – non corrosive to metal, rubber and cloth surfaces
6.   Residual effect on treated surfaces
7.   Easy to use
8.   Odorless
9.   Economical




                                                                                             148
                 INFECTION CONTROL TERMINOLOGY

ANTISEPTIC
Chemical agent that is used to inhibit or kill microorganisms on tissue surfaces. (Ex: handwash
agent)

ASEPSIS
Removal or destruction of disease or infected material. Includes sterile condition obtained by
removing or killing organisms.

ASEPTIC TECHNIQUE (ASEPSIS)
The use of procedures that break the cycle of infection and ideally eliminate cross
contamination

AUTOGENOUS INFECTION
Self-Produced infection Ex: Candidiasis (Yeast)

BACTEREMIA
Presence of bacteria in the blood. Demonstrated by blood culture. Antibiotic treatment is
specific to the organism found and appropriate to the location of infection

BACTERIOCIDAL
A chemical agent which is capable of directly killing target microorganisms

BACTERIOSTATIC
A chemical that is capable of inhibiting the growth and metabolism of a target microorganism but
does NOT directly kill the microbe

CLEANING
Physical removal of debris and reduction of microorganisms present. First step in
decontamination

CROSS-CONTAMINATION
Passage of microorganisms from one person or inanimate object to another

CROSS INFECTION
Passage of microorganisms from one person to another

DISINFECTION
The use of chemical agents to accomplish the destruction of disease-causing microorganisms, but
not necessarily all pathogens or resistant spores on inanimate objects or surfaces

IATROGENIC INFECTION
Infection caused by treatment or diagnostic procedures

NOSOCOMIAL INFECTION
Infection acquired during hospitalization

OPPORTUNISITIC INFECTION
Infection caused by normally non-pathogenic microorganism in a host whose resistance has been
decreased or compromised




                                                                                            149
PATHOGEN
Any microorganism capable of producing disease

SEPTICEMIA
Systemic infection in which pathogens are present in the circulating bloodstream having spread
from an infection in any part of the body. Diagnosed by blood culture and vigorously treated
with antibiotics. Also called "blood poisoning".
STERILIZATION
Destruction or removal of all forms of life, with particular reference to microbial organisms. The
limiting requirement is destruction of heat resistant bacterial spores

SEPSIS
Infection, contamination




                                                                                             150
                  TREATMENT PROGRESS NOTES:
                     New Patient Documentation

                     PTP DOCUMENTATION COMPONENT
(Fill out this section PRIOR TO PTP and bring completed chart & Superbill with
you to conference room at PTP with faculty)
        Obtain HHX:
        Meds/ Med Allergies: Name current meds and what prescribed for
        CC: Write only if patient has specific concerns.
        Vitals: BP, Pulse, RPM
        Student Sig./ PTP Faculty Sig.


           POST-TREATMENT DOCUMENTATION COMPONENT
 (Fill out this section AFTER TX HAS BEEN COMPLETED FOR THE DAY and
                   bring to conference room for faculty signature)

EIE: WNL or state specific finding
PERIO: Statement of probe depths, BOP, calculus and plaque findings,
      recession, furcation involvement, mobility
     (Ex: Gen. 2-3mm w/loc BOP, gen lt sub cal w/mod supra cal mand ant,
     gen. lt cervical plaque, Class II mobility #5, Class I furcation #3)
HTC: This may be omitted if no suspicious areas of caries are present. If
     isolated area is present: note specific tooth no. If multiple areas are
     present: note "see chart".
DHTP: Enclosed

PI____%, BI______%, CDI_____,
OHI: State SPECIFIC recommendations given to patient
TX: State TX that has been completed.
      State TX that is in progress
*On final appt write DH Tx Comp, CDI
RECALL (Rec): On final appointment, state recommended recall interval
         (Ex. 6 MRC) Student Sig./Faculty Signature

*Write Patient Name and Chart Number in upper right of TPN sheet
*Write date, procedure number and fee form (Superbill) number in columns to
left of notes on TPN sheet




                                                                          151
RECALL PATIENT DOCUMENTATION
(Blue Recall Form)
                     PTP DOCUMENTATION COMPONENT
(Fill out this section PRIOR TO PTP and bring completed chart & Superbill with
                     you to conference room at PTP with faculty)

Patient Name ____________ Chart No. ________
Date, Procedure Nos., Fee Form Number (Superbill)
Last FMX______ BWX _____ Last Prophylaxis______ Last Caries________
Med Hx: __________________
Alert/ Meds_______
Chief Complaint: _______
Vitals________________(BP, Pulse, RPM) PTP for Recall Exam:
Student Signature/Faculty Signature
POST-TREATMENT DOCUMENTATION COMPONENT
(Fill out this section AFTER TX HAS BEEN COMPLETED FOR THAT DAY and
                   bring to conference room for faculty signature)

EIE:   Note any significant findings
       Multiple significant findings: Enclosed
Risk Assessment: State specific risks that present for this patient (Ex.
Xerostomia from meds, high sugar intake on caries, recession/ dentinal
hypersensitivity
Nutritional Assessment/Counseling: State specific behavior modifications that
you wish to accomplish to address specific risk factors (Ex. Daily sugar
exposures, adequacy of food intake, oral implications of vitamin and mineral
deficiencies)
Tobacco Cessation Assessment/Counseling: State specific recommendations for
behavior modification that you wish to accomplish to address specific risk
factors. (Ex. Advised patient of side effects--provided motivational materials,
assisted with an intervention program, and/or follow-up plan)
OHI: State specific behavior modifications that you wish to accomplish to
address all presenting risk factors

CDI ____      Plaque Score ______ Bleeding Index_____ Occlusion: R & L

Overbite: _______    Overjet: ________
Radiographs Taken: Check appropriate or site-specific PA area
Dental Chart:      All chartable items until further notification
Perio Chart: Only 4 mm and above
                   Bleeding points circled
                   Recession and MGJ
TX Received: Document exact TX performed that day (Ex. Work-up – do NOT
re-document individual findings from first appointment day, SC Quads 1& 4.
Began Quad 3) On final appointment with patient, write DH TX Compete.
Please remove from my list Recommended Recall Date: ________ Student
Signature/Faculty Signature
**next CDI and recall: top, right of form


                                                                           152
                 Guidelines For Prescribing Dental Radiographs


The recommendations in this chart are subject to clinical judgment and may not
apply to every patient. They are to be used by dentists only after reviewing the
patient’s health history and completing a clinical examination. The
recommendations do not need to be altered because of pregnancy.

The recommendations contained in this material were developed by an expert
dental panel comprised of representatives from the Academy of General
Dentistry, American Academy of Dental Radiology, American Academy of Oral
Medicine, American Academy of Pediatric Dentistry, American Academy of
Periodontology, and the American Dental Association under the sponsorship of
the Food and Drug Administration (FDA). The chart is being reproduced and
distributed to the dental community by Eastman Kodak Company in cooperation
with the FDA.

*Clinical situations for which radiographs may be indicated include:
A.    Positive Historical Findings
      1.      Previous periodontal or endodontic therapy
      2.      History of pain or trauma
      3.      Familial history of dental anomalies
      4.      Postoperative evaluation of healing
      5.      Presence of implants

B.    Positive Clinical Signs/Symptoms
      1.     Clinical evidence of periodontal disease
      2.     Large or deep restorations
      3.     Deep carious lesions
      4.     Malposed or clinically impacted teeth
      5.     Swelling
      6.     Evidence of facial trauma
      7.     Mobility of teeth
      8.     Fistula or sinus tract infection
      9.     Clinically suspected sinus pathology
      10.    Growth abnormalities
      11.    Oral involvement in known or suspects systemic disease
      12.    Positive neurologic findings in the head and neck
      13.    Evidence of foreign objects
      14.    Pain and/or dysfunction of the temporomandibular joint
      15.    Facial asymmetry
      16.    Abutment teeth for fixed or removable partial prosthesis
      17.    Unexplained bleeding
      18.    Unexplained sensitivity of teeth
      19.    Unusual eruption, spacing or migration of teeth
      20.    Unusual tooth morphology, calcification or color
      21.    Missing teeth with unknown reason



                                                                              153
**Patients at high risk for caries may demonstrate any of the following:

      1.     High level of caries experience
      2.     History of recurrent caries
      3.     Existing restoration of poor quality
      4.     Poor oral hygiene
      5.     Inadequate fluoride exposure
      6.     Prolonged nursing (bottle or breast)
      7.     Diet with high sucrose frequency
      8.     Poor family dental health
      9.     Developmental enamel defects
      10.    Developmental disability
      11.    Xerostomia
      12.    Genetic abnormalities of teeth
      13.    Many multisurface restorations
      14.    Chemo/radiation therapy




                                                                           154
                                                Guidelines For Prescribing Dental Radiographs

Patient Category        Child                                                  Adolescent                  Adult

                        Primary Dentition           Transitional               Permanent Dentition         Dentulous                 Edentulous
                        (prior to eruption of       Dentition (following       (prior to eruption of
                        first permanent             eruption of first          third molars)
                        tooth)                      permanent tooth)


New Patient*            Posterior bitewing          Individualized             Individualized radiographic examination consisting    Full mouth intraoral
All new patients to     examination if proximal     radiographic               of posterior bitewings and selected periapicals. A    radiographic
                        surfaces of primary         examination consisting     full mouth intraoral radiographic examination is      examination or
assess dental
                        teeth cannot be             of periapical/             appropriate when the patient presents with clinical   panoramic examination
diseases and growth     visualized or probed        occlusal views and         evidence of generalized dental disease or a history
and development                                     posterior bitewings or     of extensive dental treatment
                                                    panoramic examination
                                                    and posterior bitewings

Recall Patient*         Posterior bitewing examinations at 6-month             Posterior bitewing          Posterior bitewing        Not applicable
Clinical caries or      intervals or until no carious lesions are evident      examination at 6- to 12-    examination at 12- to
                                                                               month intervals or until    18-month intervals
high-risk factors for
                                                                               no carious lesions are
caries**                                                                       evident

No clinical caries      Posterior bitewing          Posterior bitewing         Posterior bitewing          Posterior bitewing        Not applicable
and no high-risk        examination at 12- to       examination at 12- to      examination at 18- to 36-   examination at 24- to
factors for caries**    24-month intervals if       24-month intervals         month intervals             36-month intervals
                        proximal surfaces of
                        primary teeth cannot be
                        visualized or probed

Periodontal disease     Individualized radiographic examination                Individualized radiographic examination consisting    Not applicable
or a history of         consisting of selected periapical and/or bitewing      of selected periapical and/or bitewing radiographs
periodontal             radiographs for areas where periodontal disease        for areas where periodontal disease (other than
                        (other than nonspecific gingivitis) can be             nonspecific gingivitis) can be demonstrated
treatment
                        demonstrated clinically                                clinically

Growth and              Usually not indicated       Individualized             Periapical or panoramic     Usually not indicated     Usually not indicated
development                                         radiographic               examination to assess
assessment                                          examination consisting     developing third molars
                                                    of a periapical/occlusal
                                                    or panoramic
                                                    examination

                                                                                                                                                        155
SECTION K

 CLINIC
 FORMS
Date__________________

Patient Name__________________

Chart number______________


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

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

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

Respectfully,


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




                                                                                        159
                               DENTAL HYGIENE PATIENT SURVEY
                                         The University of Oklahoma
                              College of Dentistry Department of Dental Hygiene

     Clinical Site:

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

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


                                                                                                      4     3    2     1    0
1.        I received professional and competent care by the dental hygiene student.
          Student name ______________________________________________________
2.        School policies were made clear to me.
3.        The student seemed organized and efficient.
4.        The student thoroughly informed me of the status of my oral health.
5.        I was able to contact my dental hygiene student if needed
6.        The student explained what was going to happen before each procedure.
7.     The student made me feel protected from catching a disease or infection.
8.        The student discussed treatment costs with me.
9.        The student kept discomfort to a minimum.
10.       At the completion of treatment, the student informed me of when I needed to
          return for continuing care.
11. The instructor treated me with courtesy and respect.
    Instructor name_______________________________________________________
12.       I will refer my friends and/or family to this clinic.

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

Age:_________               Gender:      Male          Female

Race/Ethnic Background:
        a.      White/Caucasian                        d.          Hispanic
        b.      Black                                  e.          Oriental
        c.      Native American                        f.          Other

Please circle the letter that includes your family income level:
     a. less than $16, 000 per year
     b. between $16, 001 and $49, 999 per year
     c. $50,000 or more per year

E.        Please circle the letter that indicates the highest level of education you have completed?
          1.       less than high school                                                     4.      Associate degree
          2.       high school                                                               5.      Baccalaureate degree
          3.       some college or trade school coursework                                   6.      Graduate degree
                                Thank you very much for your time and assistance!
                             DENTAL HYGIENE CASE DIFFICULTY INDEX (CDI)
PATIENT ___________________________________                DIRECTIONS: 1. Circle value for finding(s) in each category
DATE ______________________________________                            2. Add point values to determine index rating
STUDENT ___________________________________                            3. Use Classification Index below

Group 1: Periodontal Classification                  Group 2:
                       Localized or Generalized      Active
                                                                               CASE DIFFICULTY INDEX
Health                             0      0                0                            KEY
Gingivitis                         1      1                1
Periodontitis - Slight             1      2                1                    0-4     Points   =Class A
Periodontitis - Moderate           2      3                                    5-10     Points   =Class B
                                                           1
Periodontitis - Severe             3      4                                   11-15     Points   =Class C
                                                           1                  16-20     Points   =Class D
NUG or NUP                         1      2                1                    >20     Points   =Class E
Group 3: Supra Calc                 Group 4: Sub Calc

None                          0     None                   0                        1
Lower anteriors only-light    1     Isolated spicules      3                        2                        CDI
Anteriors & molars            2     Generalized spicules   6                        3
Heavy or bridged              3     Generalized spicules   9                        4
                                    & isolated ledge(s)
                                    Generalized ledges     12


HSC 7384 rev 6/06




                             DENTAL HYGIENE CASE DIFFICULTY INDEX (CDI)
PATIENT ___________________________________                DIRECTIONS: 1. Circle value for finding(s) in each category
DATE ______________________________________                            2. Add point values to determine index rating
STUDENT ___________________________________                            3. Use Classification Index below

Group 1: Periodontal Classification                   Group 2:
                         Localized or Generalized      Active
                                                                                  CASE DIFFICULTY INDEX
Health                             0      0                0                               KEY
Gingivitis                         1      1                1
Periodontitis - Slight             1      2                1                    0-4     Points   =Class A
Periodontitis - Moderate           2      3                                    5-10     Points   =Class B
                                                           1
Periodontitis - Severe             3      4                                   11-15     Points   =Class C
                                                           1                  16-20     Points   =Class D
NUG or NUP                         1      2                1                    >20     Points   =Class E
Group 3: Supra Calc                 Group 4: Sub Calc
                                                                              1
None                          0     None                   0
                                                                              2                              CDI
Lower anteriors only-light    1     Isolated spicules      3
                                                                              3
Anteriors & molars            2     Generalized spicules   6
Heavy or bridged              3     Generalized spicules   9                  4
                                    & isolated ledge(s)
                                    Generalized ledges     12

                                                                                                                  158
               DENTAL HYGIENE CASE DIFFICULTY INDEX (CDI)
PATIENT ___________________________________                                           DIRECTIONS:
                                                                                      1. Circle value for finding(s) in each category
DATE ______________________________________                                              (only 1 in Groups 1-4, up to 3 in group 5)
                                                                                      2. Add point values to determine index rating
STUDENT ___________________________________                                           3. Use Classification Index below

NOTE: Localized:             <30% of sites
    Generalized: >30% of sites
Group 1: Periodontal Health/ Disease Classification                                   Group 2:              Disease Status
                                         Localized or Generalized                     Active            Stable (Inactive)
Health                                              0            0
Gingivitis                                          1            1                            0               0
Chronic Periodontitis - Slight                      1            2
                                                                                              1               0
Chronic Periodontitis - Moderate                    2            3
                                                                                              1               0
Chronic Periodontitis - Severe                      3            4
                                                                                              1               0
NUG or NUP                                          1            2
                                                                                              1               0
                                                                                              1               0
Group 3:     Supragingival Calculus                                                                                              Group 4:
Subgingival Calculus
None                                                                 0               None                                                     0
Veneer only, lower anteriors only                                    1               Isolated spicules – anterior OR posterior              1 2 3
Veneer is visible, but thin (< 1mm)                                                  (definite click when explored) & RP prn
Veneer only, anterior & posterior                                    2               Generalized spicules & RP prn                               6
                                                                                     Generalized spicules with isolated random
Anterior crustaceous – has thickness ( > 1mm)                        2
                                                                                     ledge(s) & RP prn                                         9
Anterior & posterior crustaceous                                     3               Generalized ledges in each quadrant &                     12
                                                                                     RP prn



Group 5:           Other Difficulty Factors                                       Examples of “Other” Difficulties (√ max of 3)
Intrinsic, or in deposit, or light isolated stain                        0                        Overhanging margins            Crown & Bridge
Generalized medium-heavy stain                                           1                        Tongue issues                  Loquacious
                                                                                                  Gingival enlargement           Anxiety
Tooth hypersensitivity                                                   1                        Behavior Dilemma               Patient positioning
Less than 5 teeth/quad=minus 1 point/quad                       -1 -2 -3 -4                       Excessive hemorrhage           Caries
                                                                                                  Hyperactive gag reflex         Other
“Other” (requires faculty initials) maximum of 3                1 2          3



1                 Group
2                 Totals                                  CASE DIFFICULTY                                             CI              CDI
                                                             INDEX KEY                                            Verification
3
4
5                                                        0- 4    Points          =Class   A
                  Other (CI initial)                     5-10    Points          =Class   B
                                                        11-15    Points          =Class   C
                                                        16-20    Points          =Class   D
                  CDI Total                              >20     Points          =Class   E


                                                                                                                                           159
CLINIC SITE:
Survey completed

                                                         UNIVERSITY of OKLAHOMA COLLEGE OF DENTISTRY
                                                                    Department of Dental Hygiene
                                                                  CLINICAL EVALUATION FORM
STUDENT                                                       PTP (1)                   PTP (2)         PTP (3)         PTP (4)          PTP (5)                             PTP (6)
PATIENT                                                        Age         MC                         CDI       # Teeth       Tx. Complete Date                        CI:

           ASSESSMENT                                                    CLINICAL                                   ADJUNCT SERVICES                                               REQUIREMENTS
PTP/HHx                          A        A-        ND        Instrumentation       A           A-    ND      Desensitization                 A          A-      ND          Air Polish
EIE                              A        A-        ND        Ultrasonic Use        A           A-    ND      Restoration Care                A          A-      ND          Bleaching
Dental Evaluation                A        A-        ND        Plaq/Stn Removal      A           A-    ND      Care of Prosthesis              A          A-      ND          B Scaling Comp
                                                                                                                                                                             C Scaling Comp
Periodontal Evaluation           A        A-        ND        Re-eval/CCM           A           A-    ND      Chemotherapeutics               A          A-      ND
                                                                                                                                                                             Cor Polish Comp
DH Dx/CDI                        A        A-        ND        Instrument Care       A           A-    ND      Sealants                        A          A-      ND          Calc charting
Risk Assess/Pt Education         A        A-        ND        Infection Control     A           A-    ND      Implant Care                    A          A-      ND          D Scaling Comp
Treatment Plan                   A        A-        ND        Ergonomics            A           A-    ND      Pain Management                 A          A-      ND          Desens/Chemo
Patient Management               A        A-        ND        Time Mgmt             A           A-    ND      Experiential                    A          A-      ND          Impressions
Documentation                    A        A-        ND        Professionalism       A           A-    ND                                                                     Local Anesthesia
Nutritional Assess/counsel       A        A-        ND        Radiographs           A           A-    ND                                                                     Nitrous
Tobacco Cessation                A        A-        ND                                                                                                                       Perio Charting Comp
                                                                                                                                                                             Sealants
                                                                                                                                                                             Transitional Dentition
                                               S=Supra        D=Definite Sub        R=Roughness sub    T=Tissue Trauma        P=Plaque       St= Stain                       Ultrasonic
                                                                                                                                                                             2 Pts in 1 clinic


                                                    Quad 1- UR                                                                           Quad 2- UL

                        1    2       3         4         5          6          7           8           9       10        11         12         13        14       15          16
CI                                                                                                                                                                                      CI
Date                                                                                                                                                                                    Date
Errors                                                                                                                                                                                  Errors
A/ND                                                                                                                                                                                    A/ND

                       32   31       30        29        28         27         26          25          24      23        22        21          20        19       18          17
CI                                                                                                                                                                                      CI
Date                                                                                                                                                                                    Date
Errors                                                                                                                                                                                  Errors
A/ND                                                                                                                                                                                    A/ND

                                                    Quad 4- LR                                                                           Quad 3- LL
                                                                                                                                                              Supra Calculus            Sub Calculus
                                                                                                                                                              2 or more per pt          A > 2 per pt
 FACULTY COMMENTS:
 TOTAL HARD DEPOSITS REMOVAL RESULTS EVALUATION of all 4 quads (A, B or C pts) :                                         A or ND                                                        B > 4, 2 per pt
HSC-7397   rev 06/07                                                                                                                                          Plaque/St                 C > 6, 3 per pt
                                                                                                                                                              >4 per pt                 D > 2 per quad
                                                                                                                                                              Trauma 2 or more          E > 2 per quad

                                                                                                                                                                                                      160
            COMPETENCY SELF-ASSESSMENT WORKSHEET
                                                                        Student Name________________

                                                                Date/ Faculty Signature________________

                                         S/RP:   B     C    D        Polishing

                                                                                              Error       Total
Error   Self-assessment of Error (.25)           Correction Method (.25)
                                                                                             Removed
                                                                                               (0.5)




                                                                                                   161
                                                                    Error    Value
Error   Self-assessment of Error (.25)   Correction Method (.25)
                                                                   Removed
                                                                     (0.5)




                                                                       162
                                               Student
                                               Date
                                               CI


               CLASS            ‘B’           ‘C’            ‘D’

                     SCALING or POLISHING


 COMPETENCY EVALUATION SUMMARY



SCALING EVALUATION                             /     +           =

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




POLISHING EVALUATION                           /     +           =
Formula: Number of removed deposits + Self-Assessment Points/Total # Deposits
HSC 7428 Rev 06.06



                                                                          163
                     UNIVERSITY OF OKLAHOMA
                      COLLEGE OF DENTISTRY
                  DEPARTMENT OF DENTAL HYGIENE
                     ROTATION REPORT FORM

Student _________________________________ Date ______________

Patient __________________________________ Chart #
                         ROTATION SITE

  VAMC                             Implantology
  Graduate Periodontics            Good Shepherd Mission
  Tinker Air Force Base            Junior Dental Hygiene Clinic
  Pediatric Dentistry              Geriatric Rotation
  Oral Diagnosis                   Senior Dental Hygiene Clinic
  Other: (List)___________


                    CLINICAL SERVICES PROVIDED
     Alginate Impressions
     Amalgam Polishing, Removal of Overhang: Tooth #(s) _____________
     Assist Dental Hygiene Student: Procedure: ______________________
     Assist Dental Student or Dentist: Procedure: _____________________
     Desensitization: Tooth #(s) _____________
     Diet Counseling
     Local Anesthesia: Type and site ______________________________
     Nitrous Oxide Sedation
     Removable Prosthesis Care: Type ___________________________
     Rubber Dam Placement
     Sealant Placement: Tooth #(s) _____________
     Temporary Restoration
     Other: List_____________

COMMENTS:

Faculty/Staff Signature


                                                                    164
               DENTAL HYGIENE CARE ONLY


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


I, __________________________________________________________, consent
     Print First              MI             Last Name

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


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

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

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

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




                                                       ____________________________
                                                       Signature of Patient

                                                       ____________________________
                                                       Date

HSC 7444 rev 6/06




                                                                                             165
                                                        DH RECALL
                                                       EXAMINATION
Patient Name:                                                                               Expected CDI         Recall Interval
Date:                          Chart No.               Fee Form Number:                                          3mrc      4mrc
                                                                                            A B C D E            6mrc     12mrc
Procedure Numbers:
Last FMX:                      Last BWX:               Last Prophylaxis:              Last Caries:
Med Hx:
ALERT / MEDS:
Chief Complaint:
Vitals: BP                     5 Min retake             Pulse           RPM           PTP
EIE:
Risk Assessment:
Nutritional Assessment/Counseling:
Tobacco Cessation:
Periodontal Assessment:
OHI:
CDI:                 Plaque Index:         Bleeding Index:         Occlusion: R        L             Overbite:     Overjet:
Radiographs Taken:            None            2 BWX             4 BWX         PAX #         Other




Tx:


Dental Tx Recommendations:                                                    DH Faculty:
Examining Dental Student:                                                     Dental Faculty:
Reviewed by Associate Dean for Clinics                                        Date:
HSC-7520 rev 06/07


                                                                                                                                   166
                                                    Faculty


                         UNIVERSITY of OKLAHOMA
                          COLLEGE OF DENTISTRY
                      DEPARTMENT of DENTAL HYGIENE

                           CLINIC SIGN UP SHEET

            Student   Chair Number          Time              Service Needed




                                          Faculty


                         UNIVERSITY of OKLAHOMA
                          COLLEGE OF DENTISTRY
                      DEPARTMENT of DENTAL HYGIENE

                           CLINIC SIGN UP SHEET

            Student   Chair Number          Time              Service Needed




Rev 06/06
                                                                     CDI:
                                                                    ABCDE

            DENTAL HYGIENE PLAN FOR CLINICAL SERVICES
       PATIENT NAME                  DATE     STUDENT NAME             CI



ASSESSMENT
         HHx/Meds


          Chief Complaint

                EIE
          Perio Evaluation


           Dental Chart

     Oral Hygiene Technique


          Risk Assessment


 Nutritional Assessment/Counseling

        Tobacco Cessation


       Date of Last Prophy




  APPT.                   PATIENT EDUCATION            CLINICAL SERVICES
APPT            PATIENT EDUCATION                            CLINICAL SERVICES




       Patient Signature.____________ _________ Student Signature._______________________
                      OU COLLEGE OF DENTISTRY
                      ADJUSTMENT TO ACCOUNT


Patient Number:____________________________________________


Name:_____________________________________________________


Doctor Number:_____________________________________________


Location:___________________________________________________


Account Code:______________________________________________


Date:______________________________________________________


Debit Amount:______________________________________________


Credit Amount:_____________________________________________


Reference:__________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________
                              UNIVERSITY of OKLAHOMA
                               COLLEGE of DENTISTRY
                           DEPARTMENT of DENTAL HYGIENE

NAME:

DATE:

TIME of APPOINTMENT:

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

Sincerely,


Clinical Faculty
Department of Dental Hygiene
HSC 7442   rev 6/06
                                            OU College of Dentistry
                                           Dental Hygiene Program
                                         Daily Periodic Exam Schedule

 Exam                            Chair                                         Date of Last   Patient Requires
Complete
               Student Name                  Patient Name       Chart Number
                                Number                                            Exam         1YR      2 YR




           Signature Examining Faculty: ______________________________

              Signature Hygiene Faculty:_______________________________
                       DEPARTMENT OF DENTAL HYGIENE
                        LOCAL ANESTHESIA WORKSHEET


Student Name __________________            Date ___________
Patient Name __________________            Chart #__________


Procedure Area                       _______________________________

Type of Injection                    _______________________________

Nerve(s) Anesthetized                _______________________________

Type of Anesthetic                   _______________________________

Volume of Anesthetic                 _______________________________

Medical History Considerations       _______________________________


Evaluation of Technique:      A/ND

Comments:

________________________________________________________________________
________________________________________________________________________

Number of Injections                    Tooth Number(s)
                                       or Quadrant(s)
_____   PSA                                ________
_____   MSA                                ________
_____   ASA                                ________
_____   Nasopalatine                       ________
_____   Greater Palatine                   ________
_____   Infraorbital                       ________
_____   Inferior Alveolar & LB             ________
_____   Infiltration                       ________
_____   Incisive/Mental                    ________


Faculty Signature       ___________________      Date     ___________
             INSTRUCTIONS FOLLOWING ROOT PLANING

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

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

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

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


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

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

ADDITIONAL INSTRUCTIONS:

PHONE NUMBER:

NEXT APPOINTMENT:

HSC 7430
                Directions For Care After Treatment
                       With Fluoride Varnish
After the application you will feel a coating and may notice a difference in
color while the varnish remains on your teeth. To obtain the maximum
benefit during the 4-6 hour treatment period, we ask that you take the
following care after you leave our clinic:

    Do not remove the varnish by brushing or flossing for at least 4-6
     hours.
    If possible, wait until tomorrow morning to resume normal oral
     hygiene.
    Eat a soft food diet during the treatment period.
    Avoid hot drinks and products containing alcohol (i.e.: beverages, oral
     rinses, etc.) during the treatment period.

A thorough brushing and flossing will easily remove any remaining varnish.
Your teeth will return to the same shine and brightness as before the
treatment.
             ARESTIN POST OP INSTRUCTIONS:
   Avoid eating hard, crunchy, or sticky foods for 1 week

   Postpone brushing for a 12-hour period

   Avoid touching treated areas

   Postpone the use of interproximal cleaning devices (ex. Floss) for 10 days after
    administration of Arestin

   Some mild to moderate sensitivity is expected during the first week after
    administration of Arestin

   Notify the dentist promptly if pain, swelling, or other problems occur
SECTION L

Board Exams




          178
                  DENTAL HYGIENE BOARD EXAMS
NATIONAL BOARD DENTAL HYGIENE EXAM (NBDHE)
211 East Chicago Ave
Chicago, IL 60611-2678
www.ADA.org
800-232-1694

Date: Last Tuesday in March
Application deadline: February 4, 2008
Fee: $165.00
Application process online, after January 1.
Requires 2 passport photos
Results usually available 6 weeks


WESTERN REGIONAL BOARD EXAM (WREB)
9201 N. 25th Ave. Suite 185
Phoenix, AZ 85201
(602) 944-3315
Fax (602) 371-8131
Email: hygieneinfo@wreb.org
www.wreb.org

Date: end of May 2008
Fee: $825.00
Application process online after January 1
Must submit verification from COD
Requires 2 passport photos
Results available usually 2-3 weeks


OKLAHOMA BOARD OF DENTISTRY
JURISPRUDENCE EXAM FOR STATE LICENSURE
201 NE 38th Terr, #2
Oklahoma City, Ok 73105
(405) 524-9037
Linda Campbell, executive director
 www.state.ok.us/dentist/

Date: 3rd – 4th week of April; each site scheduled at different times;
Fee: $100
Application process: form available 1st of March
Requires physical exam
Requires passport photo
Must be notarized
Results available immediately




                                                                         179
SECTION M


  Student
Organizations




                180
                                DH II Officers 2007-2008
                        Ardmore            B-Ville             OKC             Weatherford

 Class Advisor      Ms. Brannock        Ms. Snyder          Dr. Bowers         Ms. McClung
                    Julie Charnock      Amanda Beal        Sheena Chance       Falisha Bowers
    President
                        Te Idleman       Linda Tran        Lindsey Shores     LaNae Meacham
      VP
                    Bonny Farmer        Melissa Smith      Teresa De Luna      Rachel Harper
  Sec/Treasurer

                                                          Kristen Caruthers
 STUCO Rep (2)                                                   ???

     Staples                                                   ??????
                                                                ?????
  Yearbook (2)     Tiffany Newberry    Andrea Mouser         Julie Swift       Melanie Carr
                    Cassie Puckett                           Kara Knop         Brooke Zorger
SADHA Advisor                          Ms. Gustafson         Ms. Zerby           Ms. Tuck
                  ???
  SADHA Pres          Sherri Jolly       Alisha Soule     Amanda Pickering    Heather Coleman
  SADHA VP         Tiffany Newberry   Linzi Sabeh Ayoun    Sheena Chance      LaNae Meacham
SADHA Sec/Treas     Cassie Puckett      Melissa Smith      Lindsey Shores     Falisha Bowers




                                                                                                180
                 Dental Hygiene Class Officers Election and Duties

                                      ELECTION PROCESS
    1. The faculty advisor will be call and preside over a class meeting for the purpose of electing
       officers
    2. Nominations will be accepted from the floor and voted by office.
    3. Candidates each office will be provided two minutes to speak to
    4. their colleagues if desired.
    5. Votes will be counted by the site faculty advisor and an appointed official.


JUNIOR CLASS OFFICER JOB DESCRIPTIONS/DUTIES

PRESIDENT will: 1 AT EACH SITE
• call and preside over meetings of the Site Class
• assume responsibility for representing the Site Class and act as spokesperson for the Site Class when
  indicated
• act as liaison between Dental Hygiene Department Co-Chairs, Site Coordinators, and the Class
• be responsible for informing DH Department Co-Chairs of Class activities, event, and functions
• coordinate functions, schedule locations of events for the Class with the Dental Hygiene
  Department, Dean's office and various COD departments as necessary
• call a meeting in April of the first year to elect Senior Class Officers
• serve as member of the Class Executive Council

VICE-PRESIDENT will: 1 AT EACH SITE
• assume duties of the President in case of absence
• assist the president in organization of class functions
• carry out other duties assigned by the president
• serve as member of the Class Executive Council

SECRETARY/ TREASURER will: 1 AT EACH SITE
• collect and deposit individual site class funds
• maintain an accounting system for individual class funds
• work with COD accounting Department to monitor class funds derived from the Student Activity
  Fee
 record minutes from class meetings
• disburse funds on behalf of the class
• serve as member of the Class Executive Council


Class Executive Council will consist of:
   Site Presidents
   Site Vice Presidents
   Site Secretary/Treasurer



                                                                                                       180
    Duties:
           1. Plan and coordinate class activities, events, and social functions (in collaboration with
              DH I and DH II Executive Councils from individual sites or jointly with all sites if
              indicated
           2. Delegate class members to arrange facility, time, invitations, food, beverages and clean
              up

DH I STUDENT COUNCIL REPRESENTATIVES (2) will: *MUST BE OKC SITE STUDENTS
  AS MEETINGS OCCUR ON WEDNESDAY AFTERNOONS AT 5:00PM AT COD
OKC Site President, VP will represent all sites as a voting members of Student Council

•   represent the DH I Class from all sites on the Student Council (STUCO).
•   attend monthly STUCO meetings
•   volunteer as appropriate in activities organized by STUCO
•    keep classmates informed about the activities of STUCO and promote participation in its activities

STAPLES SOCIETY REPRESENTATIVE will: MUST BE OKC SITE STUDENT
• attend and participate in Staples Society meetings
• participate as appropriate in the various activities and fund raisers of the Society
• keep classmates informed about activities of the Society and promote participation in Society
  activities

YEAR BOOK COMMITTEE will: 2 AT EACH SITE
• responsible for collecting pictures and other information about the class for publication in the
  yearbook
• coordinate items, photos, etc from class to be included in the COD yearbook


SADHA OFFICERS will: 3 AT EACH SITE
SADHA officers will be elected as DHI and will continue these elected positions through the second
   year
President - elect will:
• plan assigned SADHA meeting date and speaker in collaboration with the Site SADHA Faculty
   Advisor
• inform class of ADHA and ODHA meeting dates, activities, and national and state issues

Vice President-elect will:
   • represent the president in her/his absence
   • Assist the president with planning meetings and functions
Sec-Treasurer-elect will:
   • record proceedings from SADHA Meetings
   • collect and deposit SADHA funds



DH I CLASS SITE FACULTY ADVISOR will:
  • provide guidance and counsel to class officers
  • approve individual site fund-raising activities
                                                                                                     181
•

               Junior Year Responsibilities

    o Fundraising
    o Senior Sendoff
    • Assist Seniors with WREB backup patient pool

              Senior Year Responsibilities
    •   New Class Welcome during orientation
    •   Fundraising
    •   Christmas Party (Optional)
    •   WREB Backup patient pool




                                                     182
SECTION N

    OKC
 COD Clinic
Miscellaneous

                1
       FAX TRANSMITTAL INFORMATION
                          Green Clinic

In the event that the patient needs a Medical Consult from a
physician, please do the following:

  1.   Fill out medical consult form

  2.   Cross out the phone number      (271-3158) & change
       it to 271-4181.

  3.   Fill out the Fax Transmission form

  4.   Contact Terri Forster in the Maxillofacial Clinic to
       request permission to send fax

  5.   Lay forms face down on fax machine. Dial 9 + number
       & press green button to send.

  6.   If long distance, contact Terri for further information.

  7. PLACE FAX TRANSMITTAL
     FORM IN PATIENT’S CHART




                                                                  183
184
                                                                              University of Oklahoma
                                                                              College of Dentistry
                                                                              Department of Dental Hygiene
                                                                              1201 N. Stonewall, Suite #567
                                                                              Oklahoma City, OK 73117
                                                                              (405) 271-4435 Telephone
                                                                              (405) 271-4181 Fax

                                          TO:

  F                                       COMPANY/DEPARTMENT:


  A                                       ADDRESS:



  C                                       FROM:




  S                                       REFERENCE:

                                          TOTAL NUMBER OF FAX PAGES


  I
                                          MESSAGE:




  M
  I
                                                       CONFIDENTIAL – PATIENT INFORMATION
                                          If this fax is accidentally received by a party other than the
                                          above intended, please call (405) 271-4435 to report the error


  L
                                          and destroy the fax copy sent to you. Thank you.




  E
                                                                                                              185
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                                DENTAL HYGIENE RECALL EXAMINATION
                                                                              Interval/Examiner Protocol
                                                                                     Effective 1-25-07


                         6-Month Recall Exam
                                   DS 4
                 Code 1120-10 (oral eval-no supervision)
           There is no charge to the patient for this procedure
    Bitewings & PAs to be charged for when taken at this appointment



                                                                            1-Year Recall Exam
                                                                              Dental Faculty
                                                                                 Code 120
                                                                 Examination includes 4 bitewings if needed
                                                                  (do not mark on form, they are included)


                                                 2-Year Recall Exam
                                                    Dental Faculty
                                                       Code 120
                                 Examination includes bitewings & periapicals if needed

                           Additional radiographs should be charged for when taken

Dr. Panza 46828




                                                                                                              186
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                                       DENTAL HYGIENE PATIENT PROTOCOL
                                                                  Fall 2007
                                           Only RECALL patients receive an OD exam.
                                         Only RECALL patients may receive a Graduate Periodontics consultation
                           DH ONLY can be taken to Grad Perio to set up an appointment upon advice of CI.

      PATIENT TYPE                                                 DH TREATMENT PROTOCOL
                                       •   Scheduled by patient scheduler to check in at Cashier’s Desk on 2nd floor at 12:30. 1:15, 2:00 & 2:45 to
                                           register (seen 30 minutes later in clinic) 271-7327
 SCREENING PATIENTS                    •   Fill out all forms for Dental Hygiene Only (use OLD OD screening forms stamped DH Only)
(Friends, family members, VA,          •   On Screening form-write down where patient heard about program and note the CDI
OUHSC, Project Challenge, or           •   Go over HHx, take BP, get PTP from CI.
anyone)                                •   Request radiographs to be exposed (limited to 2 BWX or reasonable alternative)
                                       •   CI to sign for films on radiographic log
                                       •   Expose & develop prescribed radiographs & collect data to complete CDI (recession, spot probing,
                                           supra & subgingival calculus)
                                       •   CI to confirm CDI
                                       •   CI will be responsible for ensuring that acceptance as "Hygiene Only" forms are completed, and a
                                           payment policy is signed and distributed for each patient accepted
                                       •   Stamp front of chart and TPNs with Dental Hygiene Only stamp.
                                       •   Student must fill out rotation form.
                                       •   DH student completes new patient work-up & provides DH treatment.
                                       •   Patient does not receive an OD exam.
   DH ONLY PATIENTS                    •   Take 2 BWX
Patients screened in DH Clinic or OD   •   These patients may be placed in recall system if deemed an ongoing teaching case at the discretion
  & accepted for hygiene only – no         of the Clinical Instructor.
     other dental care provided.       •   Patient is told to seek care in private practice for other dental care, including exams.
                                       •   Stamp front of chart and TPNs with Dental Hygiene Only stamp.
 “PROJECT CHALLENGE”                   •   Must have $50 voucher (covers ALL DH tx)
                                       •   Make note on encounter form to prevent additional charges (Project Challenge)
   ALL TECHNOLOGY                      •   Stamp front of chart and TPNs with Dental Hygiene Only stamp
   CENTER PATIENTS                     •   DH Only consent form must be signed.
                                       •   Tx documented on white TPNs (including 4-6 wk re-eval)
                                       •   If follow-up is in 3-4 months, use Blue Recall Form & stamp DH only in exam section
                                       •   Can continue DH care if deemed ongoing teaching case and enrolled in Project Challenge
                                       •   Workup and treatment is the same as all new DH patients
   PATIENT TYPE                                                    DH TREATMENT PROTOCOL
                                   •       Patients are scheduled by Graduate Periodontics & charts are available day prior to appt to review;
                                           go over meds etc. Charts will be in the tub in Green Clinic with schedule
                                   •       Patients are seen in DH Clinic, with DH faculty supervision.
                                   •       Use Graduate Periodontics fee schedule; add any additional procedures to encounter form & inform
                                           GP sec’y. Use lines below to add any additional procedures
      GRADUATE                     •       Rev HHx. (Recent meds already reviewed by ROD. List any new meds, & dental considerations
                                           only; at PTP: mention only changes in meds b/c ROD has already reviewed. Quick but thorough
    PERIODONTICS                           EIE; Probe but note marked recession, major changes in PD or BOP; get CDI check from CI.
       PATIENTS                    •       DH tx as deemed necessary (radiographs, OHI, S/RP, CMT, polish, fluoride etc)
        Updated 3-07               •       Have CI check scaling at end of appt. either before or after ROD.
                                   •       Exam by ROD at end of appt to check for remaining deposits, and PD. (at their discretion)
                                   •       Discuss case and your tx with ROD. Have ROD sign encounter form
                                   •       Check boxes for current appt info (Green Clinic, Grad Perio, DH, AM or PM) on enounter form
                                   •       Take patient to Brown Clinic to check out & make mext appt.
                                   •       DH student can reappoint on any subsequent open appt in GC. (complete all DH tx asap to facilitate
                                           Phase II therapy)
                                   •       4910 perio maintenance includes fluoride treatment

                                   •       DH student completes new patient work-up including 2 BWX, unless done recently elsewhere, &
PERSONAL PATIENTS                          provides DH treatment.
Patient is friend/relative of DH   •       Patient does not receive an OD exam.
              student              •       Acquire forms from Pt Care Coordinator ( Payment policy, HIPPA form, HHX form, Case history
                                           form and DH Only letter. Return to Health Record (chart) to Pt. Care Coordinator.
                                   •       These patients are not placed in recall system unless deemed an ongoing teaching case. Otherwise,
                                           patient is told to seek care in private practice. Patient will be released upon graduation of student.
                                   •       Stamp front of chart and TPNs with Dental Hygiene Only stamp.
                                   •       Immediate family receives 25% discount.

  WREB SCREENING
                                       •    Using WREB screening packet, patient completes WREB HHx/Consent & OU Consent Form.
     PATIENTS                          •    Student explores for calculus
                                       •    If patient appears to be acceptable, student completes calculus charting form (on a scale of 1-3) &
                                            documents probing depths
                                       •    If acceptable, patient will need PAX & BWX of area to be submitted
                                       •    Patient is responsible for payment of radiographs
                                       •    A radiographic log should be placed on outside of WREB packet & signed by faculty
     PATIENT TYPE                                                DH TREATMENT PROTOCOL
                                     •   DH student completes new patient work-up & provides DH treatment.
                                     •   Patient does not receive an OD exam or referral to any other clinic – patient will be assigned to
                                         dental student for treatment.
   RECALL PATIENTS                   •   Dental student’s Case Complete appt should be documented in TPNs & on white post-op
All Restorative Treatment has been       dental/perio charting form
                                     •   DH student completes recall work-up & provides DH treatment.
   completed by dental student
                                     •   Patient receives an OD exam every 6 months.
                                     •   Treatment needs are noted on the Blue Recall Form (take BWX/PAX of involved area). If patient
                                         needs endo, removable, or fixed appropriate departmental faculty must be consulted. If
                                         departmental faculty are unavailable, OD student must note there was no consultation. Patient is
                                         told if not contacted by recall date to call 271-7327 for follow up.
                                     •   If pt has completed 2 years of recalls, he/she may be given the option of being re-classified DH Only;
                                         must sign new DH Only Consent Form
                                     •   If not interested in being re-classified as DH Only, must sign DH Release Letter. Original is secured
                                         in chart on top of white TPNs & a notation made in TPNs that patient is not interested in DH Only &
                                         is being released due to completion of recall
                                     •   Consent form and DH only form to be signed
                                     •   Patients do not have to be previous patients of record.
BLEACHING PATIENTS                   •   There is no screening fee, however Dr. Panza or Dr. Radfur must approve the pt. for bleaching.
                                     •   Includes impressions, bleaching trays, Boost procedure (9972)
                                     •   Dispense patient bleach and desensitizer with trays
                                     •   2 appts
CITY RESCUE MISSION                  •   Scheduled on Wednesday afternoons only by Pt. Care Coordinator
                                     •   Pt completes blue adult health history form (as they are able) with Pt. Care Coordinator. It will be
                                         noted ‘CRM’ and the assigned students’ names at the top of the form.
                                     •   Forms are copied and charts are made
                                     •   Pt. Care Coordinator will escort the patients to Green Clinic and deliver the forms to assigned
                                         students.
                                     •   Rev HHx. (List meds, & dental considerations only; at PTP. Quick but thorough EIE; Probe enough
                                         to classify disease and determine CDI. Check in by CI.
                                     •   DH tx as deemed necessary (radiographs, OHI, S/RP, CMT, polish, fluoride etc)
                                     •   Patients should have a bus ticket for their transportation when the appointment is over.
                                     •   If patient needs to be reappointed, they may be seen on other Green Clinic days other than
                                         Wednesday if they have transportation.
                                                                              Dental Hygiene Documentation Check List


              PTP has student and faculty signatures and stamps

              Dates and signatures/stamps are on:
                  o EIE form
                  o Dental/Perio Charting
                  o CDI form
                  o Radiographic Log

              Patient name and date are on radiographs

              Recall exam notes are present, signed and stamped, and clearly
               understood

              Recall interval and expected CDI are noted at the top of the recall form

              Completed treatment notes have been verified for accuracy and
               signed/stamped by student and faculty member

              All Dental Hygiene Only patients must have a new (8/06) Dental Hygiene
               Only Consent Form in the chart (the new form allows us to follow up on
               their dental hygiene care without providing a dental exam)

              With the exception of white TPN’s, all Dental Hygiene documents are
               placed behind the purple Dental Hygiene divider which should be behind
               the Oral Diagnosis section

              If a release letter has been completed, the original is secured in the chart
               on top of the white TPN page




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                                                                              Dental Hygiene Patient Information
                                                                                        August 2006

At PTP: Determine the type of patient
Recall                                                                                        Dental Hygiene Only
                           Complete Treatment

1. Should be stamped “Recall” on the chart.                                                   1. Patients from technology centers have a            1.
This is noted on the back of the
                                                                                              $50 voucher agreement with the COD.
                           screening form
                                                                                              Be sure to make a note on the encounter form
                                                                                              to prevent additional charges.
2. The dental student’s case complete appointment
   for the patient should be documented in the TPN’s
   and on the white post-op dental/perio charting form.                                                                                             2.
All treatment is documented on
                                                                                              2. Chart and TPN form should be stamped
         white TPN pages.
3. Follow recall exam protocol.                                                                “Dental Hygiene Only”.

4. Treatment is documented on the blue recall form.                                           3. Treatment is documented on white TPN page
                                                                                                         (including the 4-6 week re-eval).

                                                                                              4. If it is a follow up appointment in 3-4 months,
                                                                                              use the blue recall form and stamp “Dental Hygiene
                                                                                              Only” in the exam section.

At the completion of treatment:

Recall                                                                                                  Dental Hygiene Only
                           Complete Treatment

1. If patient has completed two (2) years of recalls,                                         1. Patients can continue dental hygiene care          1.
Note in TPN’s that
   he/she may be given the option of being re-                                                  if deemed a good teaching case; must have
dental hygiene
   classified as Dental Hygiene Only; must sign                                                 the new (8/06) Dental Hygiene Only Consent
care is complete
   the new (8/06) Dental Hygiene Only Consent Form.                                             Form.
and the patient

needs to be trans ferred
2. If not interested in being re-classified as DH Only,
           to a dental
     he/she must sign and be given a copy of the DH
           student for
     Release Letter. The original is secured in the chart
     restorative treatment.
     on top of the white TPN’s and a notation is made in
     TPN’s that the patient is not interested in being DH
     Only and is being released due to completion of recal




                                                                                                                                                   191
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SECTION 0


COMMUNITY
  DENTAL
  CLINICS
RESOURCES


            194
         Oklahoma City Area Reduced-Rate Dental Care Resource Listing
                       (last updated February 16, 2007; Dr. Frank Lipsinic, O.U. College of Dentistry, Ph: 271-5346)


     denotes “free” clinic
** - denotes there are special qualifications for free care

EXTRACTIONS or ORAL SURGERY:

         Baptist Community Clinic (at Mt. Olivet Baptist Church)
        1201 NW 10th St..
        Ph: 951-2645
                 - call 951-2645 for service availability
                 - 3:00 P.M. on 2nd, 3rd, ad 4th Mondays
                 - first come, first served
                 - tooth extractions only
                 - Oklahoma County residents only

         Baptist Mission Center
        2125 Exchange Ave.
        Ph: 235-6162
                 - call for service availability
                 - tooth extractions only

                Cross and Crown Mission
        1008 N. McKinley,
        Ph: 232-7696
                 - NO DENTIST AT THIS TIME

         Good Shepherd Mission
        1201 North Robinson Ave., Oklahoma City
        Ph: 232-8631 for general information and client qualification
                 Oklahoma City residents only
                 Extractions and pain (adults)
                           -free simple extractions, or adults in pain
                           - care by undergraduate dental students, with faculty supervisors
                           - Monday evenings, September through May
                           - call Mondays after 9:00 A.M. for limited appointments
                 Children’s Dental Clinic
                           - extractions and restorative services
                           - licensed local area dentist volunteers, some dental & dental hygiene students
                           - every other Tuesday evening, September through June
                           - referrals from local school nurses; call 232-8631 for information and qualification

        ** Lighthouse Medical Ministries, Inc.
        at Capital Hill Church of Christ, 2801South Robinson, Oklahoma City
        Ph: 622-6371
                   - Serving the Hispanic community of the south side of OKCity
                   - tooth extractions; cleanings

        Oklahoma University College of Dentistry, Undergraduate Student Oral Surgery Clinic
        1201 N. Stonewall, Oklahoma City
        Ph: 271-4079
                 - $25 exam fee for first visit of year
                 - care by undergraduate dental students with faculty supervision, Mon-Friday
                 - $36 per tooth extraction (up to 6 teeth)
                 - simple extractions only; not impacted wisdom teeth

        Oklahoma University College of Dentistry, Oral and Maxillofacial Surgery Resident Clinic
        1201 N. Stonewall, OKCity
        Ph: 271-4079
                 - Care by Oral Surgery residents; may be scheduled or asked to come through University Hospital E.R.
                 - $35 consultation fee applies; includes x-ray
                 - Medicaid accepted
                 - cost ranges from $54 per extraction to $225 for impacted tooth

                                                                                                                        195
            - sedation and general anesthesia available
            - don’t do full mouth extractions at one setting (unless denture is “ready”)
     **Oklahoma City Indian Clinic (free care to CDIB card holders) (see information below)
     **El Reno Indian Health Center (free care to CDIB card holders) (see Oklahoma City Indian Clinic information
     below)

     **Saint Anthony’s Hospital (Medicaid & fee for service) (see information below)

GENERAL DENTISTRY:

            D-DENT Program (Oklahoma City and Tulsa areas)
     (A cooperative program utilizing local dentists, the Oklahoma Dental Association, and other community partners)
                                                         (424-8092, Shirley Harris, Executive Director)
     Call 1-800-522-9510 for information and applications
               - Free dental care to non-insured patients over age 60, and adults with developmental disabilities
               - covers the full range of general dentistry; except, does not cover implants
               -“D-Dent” pays lab fees; Oklahoma dentists volunteer their services for limited number of patients a year
               - care provided by private dentists
               - call above 1-800 number for applications and info

      Good Shepherd Mission
     1201 North Robinson, Oklahoma City
     Ph: 232-8631 for general information and qualification
              Children’s Dental Clinic
              Oklahoma City residents (children) only
                       - extractions, restorative services, and prevention
                       - licensed local area dentists and volunteers
                       - every other Tuesday evening, September through June
                       - referrals from local schools; call 232-8631 for information

     ** Oklahoma City Indian Clinic (I.H.S)
     4913 W. Reno, Oklahoma City
     Ph: 948-4900
              - FREE CARE TO CDIB Card Holders only; limited dental staff
              - cleanings, fillings, extractions, and anterior root canals
              - emergencies, “triage” at 7:45 A.M., Mon., Tue., Thur., & Fri. mornings
              - taking first 5 patients
              - care by contract dentists
              - call 1st working day of each month for scheduling and appointment availability

     **Indian Health Service - El Reno (I.H.S.)
     Ph: 262-7631, call for information
              - No dental care available at this time

     **Mary Mahoney Memorial Health Center
     12716 NE 36th Street, Spencer, OK
     Ph: 769-3301; call for registration and qualification
              - adults & children; all types of restorative dentistry, cleanings
              - Medicaid & sliding scale fees
              - call after 8 A.M. on 1st business day of the month
              - call for specifics about eligibility and fees
              - refers their dentures to local area and Tecumseh, OK private dentists

     Neighborhood Services Organization (NSO) Health Center
     431 S.W. 11th Street, Oklahoma City (at South 11th St. & Walker)
     Call 236-0413, ext 111 for appointment availability and qualification
              - sliding scale fees
              - Mon-Friday, 8:30-5:00 P.M.
              - extractions, cleanings, fillings
              - exams $10-35; dentures $230-460

     **The City Rescue Mission
     800 W. California, Oklahoma City
     Ph: 232-2709 at 10:00 A.M. for information
              - free care for residents of Rescue Mission Shelter only, and dependant children
              - simple extractions, fillings, and dentures
                                                                                                                           196
                   - Mon, Wed, and and Friday evenings; 6-8:30 P.M.


         **Saint Anthony’s Hospital
         1000 N. Lee Street, OKCity
         Ph: 272-7373
                  - Medicaid children and adults under age 21 are the only free care
                  - dentures $1,200-1,400

         Oklahoma Community Health Services, Inc. (formerly Southeast Area Health Ctr)
         1025 Estrake Terrace, Oklahoma City 73139
         (near I-240 & Western)
         Call 632-6688 for availability of services and qualification
                   - sliding scale fees
                   - women and children age 8 and up
                   - extractions, fillings, root canals, crowns, and cleanings
                   - Mon-Fri; care by contract/staff dentist
                   - $30 minimum fee plus x-rays; call for appointment

         University of Oklahoma College of Dentistry (comprehensive student care)
         1201 N. Stonewall, Oklahoma City
         Ph: 271-6056, Oral Diagnosis
                  - Preventive and Restorative care available at reduced rates (60% of downtown fees)
                  - once screened, typically a waiting list for student assignment
                  - call for emergencies; clinic schedules vary during school year

PREVENTIVE CARE or CLEANINGS:
     Oklahoma University College of Dentistry, Dental Hygiene Department
         1201 N. Stonewall, Oklahoma City 73117
         Ph: 271-7327
                  -$10 screening required to establish suitability for hygiene student care
                  -Following a screening appointment and determination of acceptability for Dental Hygiene care, an assignment is made
                  and appointment scheduled
                  -$34-165 fee for cleaning only, depending on difficulty level

         Rose State College
         I-40 and Hudiburg Drive, Midwest City
         Ph: 733-7336
                   -Adult and Child Cleanings
                   -adults only Mondays, 8:30-11:30, and 1:30-4:30
                   -children, call for schedule
                   -Screening and cleaning $5
                   -Call for screenings starting 1 August (until “full”)
                   -Sealants and x-rays upon doctor’s prescription
                   -Full-mouth X-Rays, $10 postage fee to send to private dentist

**NORMAN
      Health for Friends
         317 East Hines, 73070
         Ph: 329-4161
                  -serving Norman area
                  -general dentistry
                  -sliding scale fees; dentures $440 upper & lower

**TULSA
      Eastern Oklahoma Donated Dental Services, Inc.
         (formerly D-Dent East)
         Ph: (918) 595-4151/4152
                   -free care or dentures, for elderly or disabled low-income patients
                   -call for information
                   -Web Page info at (EODDS.org)

FINDING OKLAHOMA STATE RESOURCES
          - Oklahoma D-Dent community clinic listing
          - go to <www.d-dentok.org>, and navigate to “Dental Referral List” on left side of page, and then “Dental Referral
Listing” as an Adobe Acrobat file.

                                                                                                                                   197
SECTION P

  OKC
Rotations


            198
                  GRADUATE PERIODONTICS ROTATION for
                         DENTAL HYGIENE STUDENTS
                        2nd floor, west side of Brown Clinic
                       Dr. Robert Carson, D.M.D., M.S., Chair
                           Dr. John Dmytryk, D.M.D. M.S.
                           Dr. Joy Beckerley, D.D.S., M.S.
           Ms. Diane Yamamoto- Patient Account Representative; ext 1-7020
                       Anne Sullivan-Office Manager 271-6531
                      Jean Lapham-Clinic Supervisor 271-7064
                              Heather- Dental Assistant


GOAL:          To provide the dental hygiene student with the opportunity to observe and
carry out periodontal evaluation, treatment planning, therapeutic debridement; to assist in
surgical phases of periodontal therapy and to observe case presentations of graduate
periodontal residents in order to better understand the rationale for various types of
periodontal therapy.

PROTOCOL:              Plan to arrive and set up operatory 30 minutes prior to the assigned
clinic time. The dental hygiene student will be assigned to attend clinic sessions each
semester. Dental hygiene students will report to the graduate periodontics clinic on the
west side of Brown Clinic and will be assigned to work with the Graduate Periodontics
Resident of the Day (ROD). Proper clinic attire is mandatory. Students will assist the
residents in whatever phase of therapy to be performed that clinic session, or will provide
maintenance therapy for assigned patients.


              GENERAL PROTOCOL FOR NEW PATIENT ASSIGNMENT

I.     Patient Assignment:
       The Patient Account Representative for Graduate Periodontics will assign the new
       patient to the dental hygiene student. Concurrently, the patient will also be
       assigned to a periodontal resident.
       • If the assigned resident is not available, a graduate periodontics faculty
           member or another resident will cover.
       • Radiographs will be taken, as indicated, as early as possible in the
           appointment sequence as possible.

II.    Setting up the unit
          • Spray paper towel with disinfectant, wipe down unit, repeat
              towel/spray/wipe method. (Includes chrome areas as well as operators
              cart & chrome)
          • Place large chair cover for entire back of chair
          • Sticky tape barriers on chair control panels, light handles & operator table
              handles
          • Place clear, long sheaths over all suction tips & air/water tips. Only push
              tips through sheaths when using them.


                                                                                       206
          •   Place headrest covers as barriers for ultrasonics
          •   Place red biohazard bag to handle of bracket tray


III.   Seating the patient
          • Provide appropriate DH treatment

IV.    Periodontal Evaluation and Data Collection:
       The dental hygiene student will:
          • Take a complete medical and dental history
          • Take and record vital signs
          • Record medication history
          • Obtain PTP from the ROD.
          • If a medical concern is present - consult with the assigned resident or
             Graduate Periodontics faculty.
          • Perform a head and neck examination.
          • Comprehensive periodontal evaluation/charting with all appropriate
             entries entered in the dental record. It is not necessary to record sulci
             depths 3mm and less.
          • Chart restorations/ caries.
          • Assist resident in photographs, occlusal analysis, TMJ, muscle evaluation
             and/or any other diagnostic evaluation.
          • Take alginate impressions, prn, obtain approval of impressions prior to
             pouring-up study casts.
          • Document subjective and objective findings.

V. Treatment planning by Graduate Periodontics Resident:

          •   Upon completion of all data collection by the dental hygiene student, the
              assigned resident will confirm, and obtain all necessary consultations.
          •   The resident will formulate a comprehensive treatment plan (in writing)
              which must be discussed and approved by a Graduate Periodontics
              Faculty.
          •   The dental hygiene student should plan to attend treatment planning
              discussions, if possible.

VI. Non-surgical phase:
         • The dental hygiene student will consult with the resident and dental
            hygiene faculty to coordinate parameters of involvement in therapy.

          •   The dental hygiene student will complete the oral hygiene evaluation:
                 o Ascertain patient's oral hygiene status (by Plaque Index and
                    evaluation of routine)
                 o Correlate level of plaque control to Bleeding Index score.
                 o Discuss etiology of patient's disease & appropriate preventive POH,
                    include discussion of limitations of POH in restoring health.



                                                                                     207
          •   The dental hygiene student will perform Supportive Periodontal Therapy
              (SPT) which may include scaling, root planing, polishing and fluoride
              treatment. Generally 2 to 5 appointments will be necessary.
                  o The dental hygiene student will perform therapy under the joint
                     supervision of Graduate Periodontics faculty & assigned resident.
                  o All procedures performed by the dental hygiene student will be
                     evaluated by ROD for technique and results.
                  o The Resident will be available for appropriate support, such as
                     anesthesia, occlusal adjustment, emergency care, questions, etc.

                  •   After Phase I therapy, the patient will be re-evaluated to determine:
                         • progress obtained as a result of Phase I therapy based on
                             comparisons of objective baseline and post-treatment
                             assessments;
                         • resident will determine need for surgery.

VII. Surgical Phase
    • The dental hygiene student will assist the resident in surgery & suture removal, as
       possible.

VII. Recall
       Upon completion of treatment, the recall interval for the next appointment will be
       determined and patient's name placed in the computer. This is done in Brown
       clinic.

VIII. Dismissing the patient
         • Make certain the fee slip is filled out with the code/fee/comments and next
            appointment information before the patient leaves the clinic and notify the
            Clinic Coordinator who then will schedule the patient and give them a
            token for dismissal. If patient is seen in Green Clinic, fill out the
            encounter form and escort the patient back down to Brown Clinic to
            collect fees & reschedule patients as needed.

IX.    Procedure for instrument sterilization
          • Disinfect dental unit after patient is dismissed
          • Rinse & place all instruments in metal container and ultrasonic for 16
             minutes
          • Drain, day and place them in proper sterilization
          • Label front of bag with “G Perio” using black felt pen
          • Handpiece maintenance:
                o Place prophy angle head in ultrasonic, making sure end cap is tight
                o Wipe off adapter and motor with alcohol sponge
                o When dry, oil slow speed handpiece adapter gears and head port
                    holes




                                                                                       208
           GENERAL PROTOCOL FOR RECALL MAINTENANCE PROCEDURE
                              in Brown Clinic

Patients are placed on the periodontal recall following completion of their definitive
periodontal therapy. These patients are recalled for maintenance (Supportive
Periodontal Therapy SPT) according to need.

I.     The Clinic Supervisor will assign the recall patient to the dental hygiene student.
       The student will greet and seat the patient promptly at 9:00 or 1:00. If the patient
is
       not present 15 minutes after the hour, it is the student’s responsibility to notify the
       Clinic Supervisor, who will then call the patient and determine the patient’s
       status. The Patient Accounts Representative will confirm all appointments.

       •    Review dental record and past dental history
       •    Review and update medical history
                o If medical concern, consult ROD or Graduate Periondontics faculty
       •    Obtain and record vitals
       •    Update medication summary
       •    PTP
       •    Perform Head & Neck exam
       •    Periodontal charting and dental evaluation
       •    Use safety glasses on all patients
       •    render DH treatment as necessary
       •    After treatment is rendered, record the encounter slip number and procedure
            code in chart with date and progress notes. A fee notation is NOT required




                                                                                          209
       GRADUATE PERIODONTICS PATIENTS IN GREEN CLINIC

       GOALS:         To provide the dental hygiene student the opportunity to provide
       dental hygiene care for patients from the Graduate Periodontics. Routine
       maintenance, Phase I therapy (S/RP) and re-evaluation appointments will be
       scheduled in Green Clinic.

       REQUIREMENTS:

   o Attend scheduled rotation (denoted “GPG” on the rotation schedule) in Green
     Clinic.

       PROTOCOL:

   o Refer to Graduate Periodontics fee schedule and document on the encounter form
     if different from present information. Use lines below to add any additional
     procedures.

   o Fill out encounter form with faculty signature & stamp. ROD should also sign in
     appropriate box above or below dental hygiene faculty signature.

   o At bottom of encounter form, put the next appointment information (reappt for
     S/RP, 3mrc, 4mrc etc)

   o In the event of a cancellation or no show, turn form into Josie with documentation
     on the encounter form.


ASSIST GRADUATE PERIODONTICS

GOALS

To provide the student with the opportunity to:

Apply the didactic principles and clinical skills learned in Clinical Dental Hygiene I and
II in assisting senior dental hygiene students or Graduate Periodontics Residents

REQUIREMENTS

Attend scheduled Graduate Periodotnics clinic rotations as listed on the Clinic Rotation
Schedule.

Dress in appropriate clinic attire and bring safety glasses.




                                                                                       210
Assist a senior dental hygiene student or grad perio resident during the assessment and
treatment of a patient. (Principles of four-handed dentistry are to be followed during
assisting.)

Assist in care, sterilization and disinfection of instruments and equipment.

PROTOCOL

Students are to report to the Resident of the Day (ROD) and present a rotation report
form to him/her. He/she will instruct the student as to his/her specific duties for that
clinic session.

The dental hygiene student is expected to be present during the entire clinic session.

            RESPONSIBILITIES FOR DENTAL HYGIENE STUDENTS
                       IN PERIODONTAL SURGERY

    PLEASE REMEMBER TO USE STERILE TECHNIQUE AT ALL TIMES!
  NEVER TOUCH ANYTHING STERILE UNLESS YOU ARE WEARING STERILE GLOVES.

You must wear proper PPE when assisting or observing in surgery. (gown, mask, goggles, and head
 cover).When assisting, please see the dental assistants for assistance with proper sterile technique.

Students will assist Residents in perio surgery, including:
1)     taking blood pressure on the patient before and after surgery
2)     mixing the periodontal dressing
3)     please keep tray free of dirty 2 x 2's. There will be a red biohazard bag on the
       side of the assisting cart for this purpose.

Students will also be responsible for cleaning up after the surgery, including:
1)     cleaning the surgical instruments in ultrasonic cleaner and replacing them on the
       tray.
2)     replacing the suction bag
3)     replacing the headcover on the chair
4)     placing a new patient napkin on the tray behind the chair
5)     wiping the entire surgery room with the disinfecting solution

When assisting the perio surgery, the following will be worn:
1)    surgical cap
2)    hat
3)    mask
4)    sterile gloves

When observing in perio surgery, the following will be worn:
1)    surgical cap
2)    mask


                                                                                                  211
                            HEALTH FOR FRIENDS
                                   317 E. Himes
                               Norman, OK 73069
                                  (405) 329-4161
                        Jaime Hajjari- Dental Coordinator
                Mrs. Ashley Langford, R.D.H., B.S., Adjunct Faculty
                 Mrs. Kala Phillips, R.D.H., B.S., Adjunct Faculty


GOAL
To provide the dental hygiene student with the opportunity to:

Apply the didactic principles from Clinical Dental Hygiene to providing dental
hygiene services to persons from economically disadvantaged circumstances.

REQUIREMENTS


PROTOCOL

Students should report to dental hygiene adjunct faculty no later than 12:30 p.m. for
clinic on dates assigned. Patients will be scheduled at 1:00 p.m.


Take the following items:
           • Check out ultrasonic scaler from Green Clinic
           • instrument cassette and RDH handpiece
           • lab coat (or take blue gown & return it in a red biohazard bag to OUCOD)
           • BP cuff, stethescope
           • Clinic evaluation form, CDI, local anesthesia worksheet and any other
               forms possibly needed
           • Biohazard bag

           •   Get PTP from faculty
           •   Provide necessary services
           •   Clinical evaluation, CDI and other forms to be turned in for credit


DIRECTIONS: I-35, exit on US 77. Turn LEFT on Robinson going east. Turn
LEFT on Porter. Go 3 blocks south & turn RIGHT on Himes.




                                                                                        212
                                  IMPLANTOLOGY
                                3rd floor, Burgundy Clinic
                             Mrs. Kathy Miller, R.D.H., B.S.
                                Assistant Director of Clinics
                       Clinical Faculty Department of Implantology
                                 (405) 271-8001 x 34143
GOAL
To provide the dental hygiene student with the opportunity to:

Apply the didactic principles from Clinical Dental Hygiene to providing dental hygiene
services to patients with dental implants.


REQUIREMENTS

Attend scheduled implantology rotations as listed on the Clinic and Rotation Schedule.

Dress in appropriate clinic attire and bring your safety glasses.

Specific implant instruments will be available in the clinic



PROTOCOL

Students should report to dental hygiene faculty no later than 8:30 a.m. and 12:30 p.m.
for clinic.

           •   Use chairs 32 and 35 in the east side of Burgundy Clinic
           •   Oral hygiene products are in the red/black cabinet against the wall at unit
               32 and fluoride and sonic scaler lubricant are in the cabinet at unit 35.
           •   Sonic scalers are available
           •   Bring instrument cassettes and RDH handpiece
           •   Get PTP from Mrs. Miller (follow laminated guide sheet)
           •   No clinical evaluation sheets or blue recall forms are used
           •   No HTC; chart recall perio prn on perio chart; EIE updates are noted in
               the TPNs
           •   Recall appointments are scheduled by Mrs. Miller at the end of the
               appointment




                                                                                       213
                               ORAL DIAGNOSIS
                                2nd floor, OD clinic
                              Dr. Susan Settle, Chair
                                 Dr. Jeanne Panza
                       Ms. Charlene Shaw, Clinic Coordinator
                                      271-4945
                    Judy Hinkle-Radiology Technician 271-5687
                    Donna Harrison, CDA - Radiology Technician
                         Pam Lujan– Radiology Technician
                         Dr. Robert Jennings-Clinic Faculty
                          Dr. Susie Beavers-Clinic Faculty
                         Dr. Farah Masood- Clinic Faculty
                          Dr. Emil Farha-Clinical Faculty
                          Dr. Lida Radfar-Clinical Faculty


GOALS
To provide the dental hygiene student with the opportunity to:

Perform oral examinations on patients applying for dental treatment at the College of
Dentistry.

Assist dental students in providing emergency dental care to patients.

Purpose of screenings:
         • Provide suitable patients for dental hygiene and dental students
         • Provide students with a diagnostic experience
         • Increase awareness of oral conditions beyond patients assigned to you



REQUIREMENTS

Attend oral diagnosis rotations as listed in the Clinic and Rotation Schedule. Dress in

scrubs and bring your safety glasses.

Comply with College of Dentistry Infection Control Policies.


PROTOCOL

Students are to report to staff in the dispensing area of the Oral Diagnosis clinic
promptly at 9:00 a.m. for morning clinics and 1:00 p.m. for afternoon sessions. You
will screen 2-3 patients each clinic session.

Dental hygiene students assigned to clinics designated for screening patients applying
for dental treatment at the College will perform the following:

                                                                                      214
           •   Seat patient & review health history
           •   If questions regarding pre med etc., contact OD faculty
           •   Take vital signs (blood pressure, pulse and respirations).
           •   Ask faculty if they would like to briefly examine patient at that time
           •   HHx reviewed by faculty
           •   Complete a head and neck examination: record under “Comments”
           •   Record carious lesions; restorations that are fractured, have defective
               margins, recurrent decay, or are missing; and missing teeth.
           •   Record periodontal probe readings: only deepest in each sextant is
               recorded
           •   Record an abbreviated CDI. (Case Difficulty Index)
           •   Request appropriate radiographs. Faculty will sign for radiographs.
           •   Patient returns to reception area & is then called to Radiology
           •   Place the Patient Folder in the chart holder in Radiology
           •   Expose and process radiographs as directed by dental faculty.
           •   Radiology tech will return the folder to the clinic when films are
               developed.
           •   Review films and findings with faculty
           •   Return patient to chair and review findings with faculty
           •   Accept or Reject the patient
                   o Provisionally accepted may NOT ever be assigned

If patient is accepted:
            • Give patient the “Patient Bill of Rights”
            • Tell patient they will be contacted by a student but there is no set time
                they will be called
If patient is rejected:
            • If they inquire, we can make copies of the screening films to either be sent
                to another dentist or taken with them
            • There is a $5.00 charge for duplicating

                      Types of patients to reject:
                         • Patients with unrealistic expectations
                         • Patients who do not have time to commit to OUCOD
                         • Patients with rampant caries
                         • Patients with severe periodontal disease
                         • Many other complex dental conditions

Give Original Superbill to Charlene and the copy to the patient.

MISCELLANEOUS
 Dental students may be seeing emergency or screening patients during your rotation.

 Dental hygiene students assigned to clinics designated for emergency dental care will:
          • Assist dental students in the provision of dental care.


                                                                                         215
           •   Provide clinical services such as:
                  o Placing temporary restorations.
                  o Exposing and processing radiographs.
                  o Pulp vitality testing.
                  o Administering local anesthesia (after successful completion of DH
                      4472 Pain Control)

ALWAYS GET FACULTY PERMISSION TO LEAVE CLINIC PRIOR TO
12:00 OR 4:00
                  ASSIST ORAL DIAGNOSIS


GOALS:

To provide the dental hygiene student with the opportunity to:

Assist and observe in oral diagnosis, screening clinic and radiology.

REQUIREMENTS:

Attend scheduled rotations as listed on the Rotation Schedule.

Oral Diagnosis is conducted in Orange Clinic on the 2ndd floor of the COD. Clinic
begins at (9:00 am or 1:00 pm.

Assist and observe a dental or dental hygiene student during the Oral Diagnosis screening
clinic.

Appropriate clinic attire and safety glasses are mandatory.



PROTOCOL:

Students are to report to the dentist in charge to present a rotation report form. They will
then direct the dental hygiene student to assist a dental student utilizing four-handed
dental methods.

The dental hygiene student is expected to be present during the entire procedure/clinic
session or until released by the faculty of the assigned clinic.




                                                                                        216
                  PEDIATRIC DENTISTRY and SEALANT CLINIC
                             4th floor, Yellow/Orange Clinic
                            Mrs. Nancy Romano, R.D.H., B.S.
                    Clinical Faculty Department of Pediatric Dentistry
                                 (405) 271-8801 X 46526
GOAL
To provide the dental hygiene student with the opportunity to:
Apply the didactic principles from Developmental Dentistry and Clinical Dental Hygiene
to providing dental hygiene services to children and young adults.

REQUIREMENTS
Attend scheduled pediatric dentistry rotations as listed on the Clinic and Rotation
Schedule.

Dress in appropriate clinic attire and bring your safety glasses.

Each student should bring their handpiece and prophy angle.

PROTOCOL
Students should report to dental hygiene faculty no later than 12:30 p.m. for Wednesday
afternoon clinic.

I.       RECALLS
     •    One patient will be seen every 90 minutes with no assistant
     •    Use chairs 1, A, B, C

 Protocol review for BWX:
    • One year or longer since last BWX
    • Caries history
    • Interproximal watch areas from last visit
    • Diagnostic integrity for previous BWX
    • Remember to look for actual BWX and not just rely on radiographic log
    • No BWX if bands and brackets are in place

 Students will be required to provide the following services for 2-3 pediatric dentistry
 patients during the scheduled clinic session:
       1.      Update the medical history.
       2.      Chart deciduous and mixed dentition teeth.
       3.      Periodontal probe as directed by pediatric dentistry faculty.
       4.      Do a plaque score.
       5.      Provide patient education.
       6.      Provide a prophylaxis.
       7.      Expose and process radiographs as indicated by dental faculty.
2.     SEALANTS
           • Use designated “quiet room”



                                                                                       198
           •   2 students will work as partners seeing one patient every hour (1:00, 2:00
               and 3:00)
           •   complete a Rotation Report Form, obtain Pediatric faculty signature and
               turn in to Senior Clinical Coordinator for credit.



                           ASSIST PEDIATRIC DENTISTRY

GOAL:

To provide the dental hygiene student with the opportunity to:

Assist DH II students in unit set-up, four-handed dentistry, and unit break-down during
treatment of children, adolescents and young adults.

REQUIREMENTS:

Attend scheduled pediatric dentistry rotations as listed on the Clinical Rotation Schedule.

Dress in appropriate clinic attire.


PROTOCOL:

Students should report to Ms. Nancy Romano. R.D.H. for student assignment.




                                                                                       199
                                  RADIOGRAPHY
                                 2nd Floor, OD Clinic
                  Ms. Judy Hinkle, Dental Radiology Supervising Staff
                      Ms. Donna Harrison-CDA, Radiology Tech
                           Ms. Pam Lujan- Radiology Tech
                                    (405) 271-5687



GOALS
To provide the dental hygiene student with experiences that will develop proficiency
in intraoral radiographic technique, patient management, radiation protection,
infection control, quality evaluation, and diagnostic analysis. Students will be
familiarized with panoramic and extraoral technique, darkroom care, film
processor maintenance, and radiographic duplication.

REQUIREMENTS

1.     Attend scheduled Oral Radiology Clinic sessions as assigned on the Clinic and
       Rotation Schedule.

2.     Complete a minimum of ten complete intraoral radiographic surveys with a 70%
       score or better.

3.     Complete other radiographic procedures as directed during rotations.

PROTOCOL

1.     Report to the Radiographic Technicians in the Oral Radiology Clinic for room
       and patient assignment.

2.     Prepare the cubical and x-ray unit for the patient.

3.     Comply with “Radiation Use Policy” upheld by the University of Oklahoma
       College of Dentistry.

4.     Expose and process films in compliance with The University of Oklahoma
       College of Dentistry Infection Control Policy.

5.     Evaluate radiographic quality, document this evaluation and determine the
       number and type of retake radiographs necessary with the agreement of the
       teaching faculty.

6.     Complete the rotation report form, recording the names of patients and the
       number and type of radiographs. Turn this form in to the Senior Clinical
       Coordinator for credit.


                                                                                      200
                            SCREENER in GREEN CLINIC

GOALS
To provide the dental hygiene student with the skills to screen prospective patients
for senior clinic.

REQUIREMENTS

1.       Attend scheduled Screener sessions as assigned on the Rotation Schedule.

2.       Properly fill out required forms for DENTAL HYGIENE ONLY patients.
         Patient will arrive in Green Clinic with the following forms:

                    •   White OD Screening form (Health History)
                    •   Encounter form indicating payment made
                    •   Copy of insurance card if applicable
                    •   Notice of Privacy Practices
                    •   Hand written receipt for payment made

         Screener will have these forms:

                    •   DH ONLY form (white & yellow copy)
                    •   CDI screening form
                    •   Radiograph log (ask CI to dispense)
                    •   Radiographs properly labeled

3.       Fill our Rotation Report Form & have CI sign.


PROTOCOL

     •   Patients will be scheduled by DH patient scheduler every 45 minutes beginning at
         12:30. Screener will see patients at 45 minute intervals with the first patient at
         1:00 pm, and the last patient at 3:15.

     •   Fee for DH only screening is $10 and includes radiographs. This is paid for prior
         to the appointment. Patient will have the encounter form and will already have a
         token. There is no need to take patient down to the Cashier at the end of the
         appointment.

     •   Patients will check in at the Cashier’s Desk on 2nd floor to complete paperwork &
         pay the $10 screening fee. (The “Old" Oral Diagnosis screening forms will be
         used and stamped with "Dental Hygiene Only" on the top of the form).

     •   Set up assigned unit & request exam sets from the dispensary personnel Green
         Clinic. These are in the locked cabinets. (Includes 11/12 explorer, mirror,
         probe). You may set up an extra chair if one is available. For Tues, Wed &


                                                                                        201
    Thurs clinics, please check with dispensary personnel to verify a chair is
    available.

•   The DH patient scheduler will send a list of screening patients to Green Clinic. It
    will be located in the tub with the charts.

•   Seat patient and go over the white screening form (Health History), fill out
    information on first page regarding surgeries, hospitalizations etc, take BP & get
    PTP from CI. Request radiographs to be exposed. (limited to 2 Bitewings only or
    a reasonable alternative when a significant number of posterior teeth are
    missing). Have CI sign and stamp for films on the back of the white OD
    screening form.

•   Expose & develop prescribed radiographs

•   Collect enough data to complete the CDI. Use the boxes on the dentition chart to
    record probing depths.

•   Spot probe and chart only 4mm & above. On those teeth, draw recession & circle
    bleeding points.

•   Detect supragingival & subgingival calculus.

•   Have CI confirm CDI. Additional points may be added at the discretion of the
    CI. The CI must initial the CDI Screening form.

•   CI will be responsible for ensuring that acceptance as "Hygiene Only" forms are
    completed, and a financial policy is signed and distributed for each patient
    accepted. Have CI sign & stamp white Screening form at the bottom of the form.

•   On the back of the screening form, check the box “DENTAL HYGIENE”
    and put the CDI on the form.

•   Paper-clip all forms together & turn in to Rick Steucken in the Chart Room at the
    end of the clinic session.

•   Place instruments in autoclave bag & write your “Name”, “Green Clinic” and
    “Screener Exam Kit”. Place these in the basket on the cart at the dispensary.

•   Screener will assist other students in clinic when patients are not scheduled.




                                                                                     202
              TEACHING ASSISTANT in JUNIOR CLINIC
            Mrs. Jane Gray, R.D.H., CDA, M.Ed, Senior Clinical Coordinator
                         (405) 271-4445 (M) (405) 830-4880
            Mrs. Tammie Vargo, R.D.H., M.Ed, Junior Clinical Coordinator
                                    (405) 271-4562
GOALS:

To provide the student with the opportunity to apply the didactic principles and clinical
skills learned in Clinical Dental Hygiene I, II, III, and IV in assisting and mentoring
junior dental hygiene students.

REQUIREMENTS:

Review all class/lab/clinic material(s) prior to attending the rotation.

Attend DH-I & DH-II lectures, as instructed to do so by Mrs. Vargo.

Attend scheduled junior clinic rotations (see ‘Clinic Rotation Schedule’).

Dress in appropriate clinic attire and bring your safety glasses.

Write a summary of the clinic experience and upload to Blackboard at the end of the day.

DUTIES:

Fall

   1. Assist and mentor junior students in lab and clinical exercises

   2. Assist clinical faculty as requested

Spring

       1. Check instrument sharpening at the beginning of each clinic session.

       2. Assist and mentor radiographic technique

       3. Assist and mentor junior student in organization and treatment sequencing
       (Senior student is not allowed to record probing depths or hard tissue until
       notification by Mrs. Vargo)

       4. Assist clinical faculty upon request by:
              a. evaluating work-ups and documenting results on evaluation form.
              b. evaluating polishing and documenting results on evaluation form.

                                                                                       203
               c. providing instrumentation technique feedback and documenting prn
               d. providing individualized mentoring at chairside for students providing
                      care for Class ‘C’ patients

       6. Dental hygiene faculty must co-sign all record documentation entries

              •   This rotation is for the duration of the academic year (fall and spring
                                                 semesters)




Selection process for TA is by application only. Those expressing interest should contact
the senior clinic coordinator in the spring of the junior year. A one page essay on “Why I
would like to be a Teaching Assistant” should be submitted.




                                                                                        204
                             TINKER AIR FORCE BASE
                                  72 Dental Squadron
                                  5700 Arnold Street
                                   TAFB, OK 73145
                             (405) 736-2000 (dental clinic)
                                    (405) 736 -3159
                                  FAX (405) 736-2072
                       Diana Mills, R.D.H. Staff Dental Hygienist
                               diana.mills@tinker.af.mil

GOALS
To provide the dental hygiene student with experiences that will develop
competency in the areas of patient assessment, treatment planning, patient care and
adjunct services in an environment similar to a private practice setting.

REQUIREMENTS

Attend scheduled Tinker rotations as assigned in the Clinic Rotation Schedule.
Need to provide:
    • TB test results
    • OUCOD HIPAA security training
    • Proof of liability (malpractice insurance)

Records may be requested by DH Department Administrative Secretary from:
OU Family Medicine Student Health Clinic
900 N.E. 10th St Oklahoma City, Ok 73104
(405) 271-2577
Fax#: (405) 271-4059

Dress in street clothes or wear your scrubs and change into provided clinic attire
(provided by Tinker) at the rotation site. Wear your clinic shoes. Take your own
instruments and ultrasonic tips. Be prepared to finish by 3:40…clinic closes at 4:00

Provide patient treatment according to the guidelines established in the TAFB manual.

PROTOCOL
Students should report at 12:30 for the PM. clinic. First patient will be seen at 1:00.
Locker assignments and name tags provided.

Enter at Sooner Road Gate
Tell guard you are with OU Dental Hygiene Program
Need:
    • Current DL
    • Proof Ins
    • Current tag
NO cell phone use while driving on base
Watch speed!!!
Do not park in reserved spots (cars will be towed)
Bldg 5801




                                                     170
                            TINKER RADIOGRAPHY

GOALS:

To provide the dental hygiene student with experiences that will develop competency in
intraoral radiographic technique, patient management, radiation protection, infection
control. quality evaluation, and diagnostic analysis. Students will be familiarized with
panoramic and extraoral technique, darkroom care, film processor maintenance, and
radiographic duplication.

REQUIREMENTS:

1. Attend scheduled Oral Radiography Rotation as assigned on the
   Rotation Schedule.

2. Complete radiographic procedures as directed during rotations.


PROTOCOL:

1. Report to the Radiographic Technicians in the Oral Radiology Clinic for room and
      patient assignment at Tinker AFB.

2. Prepare the cubical and x-ray unit for the patient.

3. Comply with the OUCOD Radiation Use Policy.

4. Expose and process films in compliance with the Infection Control Policy.

5. Evaluate radiographic quality, document this evaluation and determine the number
and type of retake radiographs necessary with the agreement of the teaching faculty.

6. Complete the rotation report form, record the names of patients and the number and
type of radiographs.




                                                                                    171
172
            VETERANS ADMINISTRATION HOSPITAL ROTATION
                      Department of Veterans Affairs
                                  VAMC
                              921 N.E. 13th St.
                         Oklahoma City, OK 73104
                           Ms. Colleen Whorton
                   Administrative Officer- Dental Service
                       (405) 270-5139 (dental clinic)
                            Fax (405) 290-1650
                      Colleen.Whorton@med.va.gov
                    Mrs. Vicki Coury, Clinical Faculty
                               (405) 271-3869
                               (405) 826-3411
                   Connie Martin, Staff Dental Hygienist
                  Michelle Williams, Staff Dental Hygienist


GOALS
To provide the student with an opportunity to learn hospital procedures as they
relate to: (l) dental care, and (2) the team concept of total comprehensive patient
care.

REQUIREMENTS

   1. Observing a hospital-based dental hygienist perform patient care.

   2. Providing direct patient care in the hospital dental clinic.

   3. Adapting dental hygiene procedures to accommodate the special needs of the
      hospitalized patient.

   4. Establish patient rapport.

   5. Adapting home care procedures to meet the needs of each individual patient.

   6. Assisting the dental staff in the clinic as necessary.




                                                                                      173
                                            VAMC
                        Statement of Commitment and Understanding

As an employee of the Department of Veterans Affairs (VA), I am committed to safeguarding
the personal information that veterans and their families have entrusted to the Department. I am
also committed to safeguarding the personal information which VA employees and applicants
have provided.

To ensure that I understand my obligations and responsibilities in handling the personal
information of veterans and their families, I have completed both the annual General Privacy
Awareness Training (or VHA Privacy Training, as applicable) and the annual VA Cyber Security
Training. I know that I should contact my local Privacy Officer, Freedom of Information Act
Officer, Information Security Officer, or Regional or General Counsel representative when I am
unsure whether or how I may gather or create, maintain, use, disclose or dispose of information
about veterans and their families, and VA employees and applicants.

I further understand that if I fail to comply with applicable confidentiality statutes and
regulations, I may be subject to civil and criminal penalties, including fines and imprisonment. I
recognize that VA may also impose administrative sanctions, up to and including removal, for
violation of applicable confidentiality and security statutes, regulations and policies.

I certify that I have completed the training outlined above and am committed to safeguarding
personal information about veterans and their families, and VA employees and applicants.



_____________________________                        ___________________________
[Print or type employee name]                        Employee Signature


______________________________                       ___________________________
Position Title                                       Date




                                                                                       174
                      VA DENTAL CLINIC INSTRUCTIONS

BEFORE COMING TO THE VA

***You must annually complete the VA privacy training, print a copy of the
training and turn in to the Course Director. You can access the website at
vhaprivacytraining.net ***
Print out the certificate & turn in to Course Director.

You must also read and sign the Statement of Commitment form & turn it in.

Annual TB testing is required and verfication must be on file.
Fingerprinting is also required.


*** STUDENTS NEED TO CHECK OUT AN ULTRASONIC RESERVOIR TYPE
SCALER FROM GREEN CLINIC PRIOR TO COMING TO VA ***

***ALL ASSISTANTS SHOULD BRING THEIR INSTRUMENT KITS IN THE
EVENT THAT A PATIENT IS AVAILABLE TO BE SEEN BY A STUDENT***

       •   Read this handout care thoroughly and bring it with you for reference.
       •   Review procedures you might use such as care of partials and dentures,
           placement and patient instructions for fluoride varnish.
       •   Bring your Mosby’s Drug Reference because the patients you will see are
           generally on multiple medications.
       •   If you do not see a patient you will need to fill out a Rotation Report form;
           otherwise your Clinic Evaluation form will suffice.
TIMES
  • For your first VA session, we will meet in the Commons at 7:30 and go as a
     group.
  • For subsequent sessions, be at the VA no later than 8:00. The clinic opens at 7:30
     and you may go over and begin setting up your unit any time after 7:30.
  • The operatories you will be working in will be marked with a sticky note.

RESTROOM
  • Located in the hall outside the clinic, across from the patient waiting area.


PROCEDURES
Review patient’s chart
      • New HHx yearly (front desk should give to patient)
      • Review active medicines on printout



                                                                                      175
       •   Determine need for radiographs (pano every 5 years, BWX yearly)

Set up operatory
       • Gowns are in operatory drawers or in Linen Closet (first closet) on right side
           of hallway (Door will be locked)
       • Motors, adapters and cavitron tips are in Instrument Prep room on right side of
           hallway (also locked)
       • You will bring your own instrument kit (and sterilization bag to transport it
           back to the dental school)
       • Wash hands after every time you touch anything
       • Fill water bottles on unit and cavitron with deionized water from sterilization
           area if necessary

Get patient from reception area
       • Verify full name and social security number in private (remember HIPAA
           laws)

Expose and process necessary radiographs
      • Some rooms have an x-ray unit in them. If yours does not have a unit, take
          them prior to seating your patient in your operatory.
      • Mark off number of x-rays taken on log in x-ray room

Seat patient in your operatory and
       • Verify medication information with patient
       • Review Health History on left side of chart with patient
           -positive answers must have a comment written in Dentist Remarks section
           -all sections must have a notation, so write N/A if not applicable
       • On right side of chart fill out clinical findings and remarks; make sure
           personal information is correct
       • Fill out patient post card for next visit (you write patient’s name and address)
       • Take vital signs. Write a listed summary in the boxes at the lower right of the
           HHx form to include: PMH (past medical hx), diabetes, hypertension, heart
           attack (what year), stroke (what year), heart murmur, allergies, blood sugar
           number, medications, etc. In the note box under question #36, the appropriate
           med(s) should be circled and med alert sticker placed if needed.
       • Diabetic patients should be asked what their blood sugar range is and what the
           number was when the patient tested it that morning. Perform a finger stick and
           document blood sugar number as “FBS - #” (Finger Blood Stick). Always ask
           the patient if a good breakfast was eaten. Ensure is available if the patient’s
           blood sugar is too low. If blood sugar is over 200, the patient is not treated.
       • An INR time should be known for patients on Coumadin and results should be
           below 3 for treatment. Patients are scheduled for bloodwork in the lab at 7:30
           so their results should be ready by 8:30. We will consult with a dentist if
           unsure whether treatment can be done.




                                                                                      176
Obtain PTP from OU CLINICAL FACULTY. Monologue should include significant
HHx information; names, indications, and dental considerations of medications; and vital
signs.

Begin treatment: EIE, dental and perio charting, CDI (check in with OU CLINICAL
FACULTY for CDI C or greater). If possible we will enter dental and perio charting on
the VA computer program. If someone is not available to enter data on the computer, it
can be done on hard copies and entered later. Fill out Oral Examination Findings and
Treatment Recommendation on right side of chart.

Disclose, provide OHI. This must be done PRIOR to scaling procedures.

If patient has a partial or denture, place it in a baggie (available in each operatory) and go
to sterilization area. Put Tartar and Stain Remover in the baggie (located underneath the
sink) and place the baggie in the PRO Sonic ultrasonic cleaner. Scrub with a denture
brush in operatory.

Scale and root plane prn, polish.

Request check out with OU CLINICAL FACULTY. Checkout should be no later than
11:15. At this time, it will be determined if an exam is needed and a DDS will be asked to
perform the exam after check out of scaling and polishing.

Prior to the dental exam, the right side of the exam sheet should be completed by the
student. During the exam, the student writes in the proposed treatment on the left side of
the exam sheet.

       •   DENTIST MUST SIGN BOTH HEALTH HISTORY AND CLINICAL
           FINDINGS AND REMARKS
       •   PATIENT MUST SIGN UNDER CLINICAL FINDINGS AND REMARKS

Treatment progress notes should be entered on the back of the exam sheet and write in
PTPW if the “patient tolerated treatment well”. If not, note why not. A copy of the format
for TPN is available from OU CLINICAL FACULTY or in the main hygiene room.

Administer tray or varnish fluoride treatment.

Escort patient to the reception area to schedule any additional appointments.

Complete paperwork.

Break down operatory ,
   • Wear all PPE to disinfect. Disinfectant bottles are located under the sink.
   • Open glove drawer before washing hands, wash hands, take out and put on gloves
       and close drawer with hip



                                                                                          177
     •   Remove headrest cover, turn inside out and put all disposable contaminated items
         inside and throw in trash.
     •   Bag instruments in sterilization bag brought with you from OUCOD
     •   Close operatory door when leaving a contaminated room when no one is in it.
     •   Carry handpiec and motor to Soiled Instrument closet. It is locked, so someone
         will have to open it for you. Place contaminated handpiece and motor in DRY
         contamination bucket. PPE must be worn in the contamination room.
     •   XCPs and air/water syringe tips go in blue ultrasonic in sterilization area
     •   Ultrasonic tips are disinfected, put in a sterilizing bag and placed in the sterilizer
         tray.
     •   Return to operatory, disinfect all contaminated surfaces with Cavicide, including
         chairs and let set 10 minutes
     •   Empty water bottle if operatory will not be used in the afternoon.

D.       RESET UNIT with
     •   Headrest cover
     •   Sticky tape on light switch and light handles
     •   Place large bag over hoses and switches



                       VAMC TREATMENT PROGRESS NOTES

The following items are to be written in the TPNs:

     •   BP
     •   Radiographs obtained (BWX, pano)
     •   Px
     •   Rev HHx: NSF or state what findings
     •   H&N exam: NSF or state what findings
     •   Assessment
     •   Perio charting
     •   Tx rendered:
             o Examples:
                      E. Scaled, hand and ultrasonic scaled polished, flossed, fluoride
                         varnish, OHI : TB, floss aid etc.
                           • Patient understands OHI
                           • PTPW
                           • RTC: any treatment remaining: restorative, S/RP etc) or
                              TC


                      F. S/RP UR quad, hand and ultrasonic scaled, POI, OHI (state what
                         kind)
                               • PTPW



                                                                                           178
                                •   RTC: any treatment remaining (restorative, S/RP etc) or
                                    TC

                      G. S/RP UR & UL quad, hand and ultrasonic scaled; type of local
                         administered etc. POI, OHI (state what kind)
                              • PTPW
                              • RTC: any treatment remaining or TC

Student signature/OU Faculty signature


Abbreviations:

BP               Blood Pressure
PX               Peridex
Pan              Panorex
4 BWX            4 bitewings
NSF              No significant findings
OHI              Oral hygiene instruction
TB               Tooth brushing
PTPW             Patient tolerated procedure well
RTC              Return to clinic
TC               Treatment complete




                                                                                       179
                                    OUCOD SITE
                                CLINICAL ROTATIONS



       Pediatric Dentistry                   Tinker AFB
       Graduate Periodontics                 Radiology
       Oral Diagnosis                        Implantology
       VA Medical Center                     Good Shepherd Mission
       Health For Friends                    Indian Health Clinic
       Crossings Community Center


CLINICAL REQUIREMENTS
1. Students will provide dental hygiene services to patients during the fall semester in
   Pediatric Dentistry, Implantology, Graduate Periodontics, Oral Diagnosis and
   Radiology, VA Medical Center, Crossings Community Center, Indian Health Clinic
   and Good Shepherd Mission. In each of these rotations, students will be under the
   direct supervision of dental, dental hygiene faculty and/or staff.

2. The Dental Hygiene Clinic Manual contains the goals, requirements and protocol for
   each rotation site. Students are advised to consult this manual prior to attending each
   rotation. Orientation to the rotations will be scheduled at the beginning of the
   semester prior to students' attendance in the rotation.

3. Student use of local anesthesia and nitrous oxide analgesia is prohibited until
   notification by Ms. Gray that the student has attained a passing grade in the didactic
   and clinical exams for the use of local anesthesia and nitrous oxide analgesia

•Note: Administration of local anesthesia must be documented on the Local
             Anesthesia Report Form to receive credit

4. All students must have a current TB skin test on file and must also complete
   HIPAA training prior to VA rotations. You may log on to
   www.vhaprivacytraining.net to complete the training. Failure to do so prior to
   the beginning of the rotation schedule will prevent the student from
   participating in the VA rotation and will result in a failing grade in the clinical
   rotation course.




                                                                                       180
             Oklahoma City Indian Clinic (I.H.S)
                       4913 W. Reno, Oklahoma City
  Ph: 948-4900 x 263 -front desk in dental clinic; John Fish - dental assistant
                     948-4918 x 271- Dr. Anna Farrell
                                948-4927 Fax
                   948-4918 x 277 (Personnel) –Yolanda

Items needed by students:

      All clinic forms
      Ultrasonics with reservoirs
      Local anesthetic syringes (Petite syringes if desired)

      Sign in and out in the black log book that is located in the office on the left
      as you enter the building on the east side. (morning, after lunch & when
      you leave at the end of the day)
      Wear scrubs
      Report any incidents to supervisor
      Black ink ONLY (not gel- use ball point pen)
      Fire drill once a month so be prepared.
      Call pts back to tx area by their chart number, not their name
      Radiographs are in brown envelope in back of chart
      Need criminal background check
      Need shot record (MMR, Varicella, HBV, TB)

      Items on hand:
      Arestin & syringe
      Oraqix & cartridges
      Desensitizer – Seal and Protect
      Local anesthetic & 27 gauge long & short needles
      Fine prophy paste
      Crest Pro Health Rinse

      Faculty:
      Orientation
      Sign in & out in log book
      Use last 3 operatories
      All pts have had exams, bwx & pano
      Only perio chart pts who have commercial dental insurance
      Current pts are diabetic pts.
      Check BP, blood sugar; Check for premed
      Dental info on Left Side of chart…purple tab
      Meds on Left side of chart…
      All charts are combination Medical & Dental
      Green sheet on outside of chart: put check by 4341 & put # of quads
      completed; then under NV: put what is needed at the next visit.


                                                                                 181
                                 BARTLESVILLE SITE
                                CLINICAL ROTATIONS



CLINICAL REQUIREMENTS
1. Students will provide dental hygiene services to patients during the fall semester in
   clinical rotation sites as assigned. In each of these rotations, students will be under
   the direct supervision of dental, dental hygiene faculty and/or staff.

2. The Dental Hygiene Clinic Manual contains the goals, requirements and protocol for
   each rotation site. Students are advised to consult this manual prior to attending each
   rotation. Orientation to the rotations will be scheduled at the beginning of the
   semester prior to students' attendance in the rotation.

3. Student use of local anesthesia and nitrous oxide analgesia is prohibited until
   notification by Ms. Gray that the student has attained a passing grade in the didactic
   and clinical exams for the use of local anesthesia and nitrous oxide analgesia.

   •Note:      Administration of local anesthesia must be documented on the Local
               Anesthesia Report Form to receive credit.




                                                                                         182
                                     ARDMORE SITE
                                  CLINICAL ROTATIONS


CLINICAL REQUIREMENTS
1. Students will provide dental hygiene services to patients during the fall semester in
   clinical rotation sites as assigned. In each of these rotations, students will be under
   the direct supervision of dental, dental hygiene faculty and/or staff.

2. The Dental Hygiene Clinic Manual contains the goals, requirements and protocol for
   each rotation site. Students are advised to consult this manual prior to attending each
   rotation. Orientation to the rotations will be scheduled at the beginning of the
   semester prior to students' attendance in the rotation.

3. Student use of local anesthesia and nitrous oxide analgesia is prohibited until
   notification by Ms. Gray that the student has attained a passing grade in the didactic
   and clinical exams for the use of local anesthesia and nitrous oxide analgesia

   •Note:      Administration of local anesthesia must be documented on the Local
                     Anesthesia Report Form to receive credit.




                                                                                         183
                                   WEATHERFORD SITE
                                  CLINICAL ROTATIONS

CLINICAL REQUIREMENTS
1. Students will provide dental hygiene services to patients during the fall semester in
   clinical rotation sites as assigned. In each of these rotations, students will be under
   the direct supervision of dental, dental hygiene faculty and/or staff.

2. The Dental Hygiene Clinic Manual contains the goals, requirements and protocol for
   each rotation site. Students are advised to consult this manual prior to attending each
   rotation. Orientation to the rotations will be scheduled at the beginning of the
   semester prior to students' attendance in the rotation.


3. Student use of local anesthesia and nitrous oxide analgesia is prohibited until
   notification by Ms. Gray that the student has attained a passing grade on the didactic
   and clinical exams for the use of local anesthesia and nitrous oxide analgesia

•Note: Administration of local anesthesia must be documented on the Local
             Anesthesia Report Form to receive credit




                                                                                         184
185
                             Crossings Community Center
                                      Dental Clinic
                             2208 W. Hefner Road, Suite B
                               Oklahoma City, OK 73120
              Mrs. Jane Gray, R.D.H., CDA, M.Ed, Senior Clinical Coordinator
                           (405) 271-4445 (M) (405) 830-4880
                         Dr. Teresa Davis, Supervising Dentist
                                       473-4032 (M)

 GOAL
 To provide the dental hygiene student with the opportunity to:

 Apply the didactic principles from Clinical Dental Hygiene to providing dental
 hygiene services to adults from the community.


 REQUIREMENTS
 Dress in appropriate clinic attire and bring your safety glasses.




 PROTOCOL
 Students should report to The Crossings Community Center no later than 5:30 for
 Tuesday evening clinic. The rotation will be from 6:00 to 8:30 p.m.

 Students will be required to provide the following services (but not exclusively) for 2-3
 pediatric dental patients during the scheduled clinic session:

      1.   Help take and/or update the medical history.
      2.   Charting as needed.
      3.   Provide patient education.
      4.   Provide a prophylaxis, scaling & root planing, fluoride treatment, sealants
           as needed.
      5.   Expose and process radiographs as indicated by dental faculty.
      6.   Administer local anesthesia as needed, following successful completion
      of DH 4472 Pain Control.


A Rotation Report Form must be signed by supervising dentist and turned in by
noon on Friday of the week of the rotation for credit.




                                                                               202
204
205
                             CLINICAL ROTATION PROTOCOL


Each student assigned to any rotation or completing any unassigned rotations are required to
complete a Rotation Report Form. These forms are available in Clinic. Any adjunct service or
rotation requirement completed on a rotation site should be marked by the dental hygiene student
including the patient's name and chart number and signed by attending dental faculty/dental
hygiene faculty/staff.

Rotation Report Forms must be completely filled out, signed by faculty, resident or dental
student as appropriate and turned in to the Department of Dental Hygiene by 5:00 p.m. on Friday
of the week of the rotation. Credit will not be given for any forms that are not received in the
department by the aforementioned time.

Compliance with the College of Dentistry Infection Control Policy is mandatory at all rotations.

Students are reminded that all guidelines for clinical appearance and behavior apply to all
clinical rotations.

Students are expected to assume responsibility for learning: ask appropriate questions, be on
time, be courteous, be helpful, Do NOT leave early unless specifically directed by the faculty
responsible for the rotation experience. Please remember that we are guests at the rotation
sites.

Few dental hygiene students are afforded similar opportunities for enhancement of their dental
hygiene educational experience.

In case of an emergency that prevents attendance, the student must contact BOTH the rotation site
coordinator and the Course Director. It is strongly recommended that every effort be made to attend the
assigned rotation. Grade penalty may be imposed for repeated absences.




                                                                                           198
                            CLINICAL ASSISTANT ROTATION


GOALS
To allow each student the opportunity to experience dental assistant duties. The duties
involve skills necessary for: l) efficient maintenance of the clinic and 2) chairside assistance
in dental hygiene procedures. Students will serve as clinical assistants in the event that
there is no patient available during clinic.


REQUIREMENTS:

1. Dispensing instruments and supplies to dental hygiene students prn.

2. Assist clinicians/instructors, as requested, with procedures such as periodontal charting and
   ultrasonic scaling.

Duties:

Students assigned to clinic assistant position will perform the following infection control
procedures:

l. Observe asepsis protocol in clinic.

2. Procure and distribute equipment and supplies in accordance with asepsis protocol.

3. Abide by clinical asepsis protocol when assisting clinician chairside oral stations.

4. Wear appropriate barrier equipment when handling contaminated, caustic or otherwise
   dangerous materials. These materials will be labeled. See section on Safety Protocol.

5. Properly sterilize, disinfect, sanitize equipment, instruments, and counters.

Students assigned to be clinic assistant should report to the clinic 15 minutes before the clinic
begins and should remain on duty until the close of the clinic period when all students and
patients have left the clinic area.


Reporting:
The clinic assistant should report to the Clinical Coordinator to receive specific duties.
However, any faculty member may request the student's help.




                                                                                          199
                ASSIST SENIOR DENTAL HYGIENE ROTATION


GOALS

To provide the student with the opportunity to:

Apply the didactic principles and clinical skills learned in Clinical Dental Hygiene I and II in
assisting senior dental hygiene students.



REQUIREMENTS

Attend scheduled senior clinic rotations as listed on the Clinic Rotation Schedule.

Dress in appropriate clinic attire and bring safety glasses.

Assist a senior dental hygiene student during the assessment and treatment of a patient.
(Principles of four-handed dentistry are to be followed during assisting.)

Assist in care, sterilization and disinfection of instruments and equipment.



PROTOCOL

Students are to report to the Clinical Coordinator and present a rotation report form to her. She
will instruct the student as to his/her specific duties for that clinic session.

The dental hygiene student is expected to be present during the entire clinic session.




                                                                                        200
                              GOOD SHEPHERD MISSION
                 The Mission Clinics-Good Shepherd Ministries, OKC, Inc.
                          222 N.W. 12th Street (12th & Robinson)
                                Oklahoma City, Ok 73110
                                      (405) 232-8631

                        Dr. Frank Lipsinic OUCOD Faculty Coordinator
                                  (405) 271-5346, ext 48567
                                      (405) 821-7343 (M)
                                 www.goodshepherdokc.org


 GOAL
 To provide the dental hygiene student with the opportunity to:

 Apply the didactic principles from Developmental Dentistry and Clinical Dental Hygiene to
 providing dental hygiene services to children from the community.


 REQUIREMENTS
 Dress in appropriate clinic attire and bring your safety glasses.

 Students will wear overgown provided at the Mission.


 PROTOCOL
 Students should report to The Good Shepherd Mission no later than 5:30 for Tuesday evening
 clinic.

 Students will be required to provide the following services (but not exclusively) for 2-3
 pediatric dental patients during the scheduled clinic session:

       1.      Help take and/or update the medical history.
       2.      Chart deciduous and mixed dentition teeth as needed.
       3.      Provide patient education.
       4.      Provide a prophylaxis, fluoride treatment, sealants as needed.
       5.      Expose and process radiographs as indicated by dental faculty.
       6.      Administer local anesthesia as needed, following successful completion of
               DH 4472 Pain Control)


A Rotation Report Form must be signed by supervising dentist and turned in by noon on
Friday of the week of the rotation for credit.




                                                                                       201

				
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