Dental Hygiene 10/16/2012 8/20/2012 8/29/2013 COURSE OUTLINE DHT 105 Dental Hygiene Clinic I - Preclinic 5 credit hours

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1 COURSE OUTLINE Dental Hygiene Clinic I - Preclinic 5 credit hours Course Description This course will introduce theories, rationales, and foundational knowledge for performing basic dental hygiene skills by preparing the student for overall patient care in the clinical setting. This will include the use of basic dental equipment and instruments, patient assessment, treatment planning, documentation, patient education, preventive treatment, oral hygiene instruction, and supportive procedures. Emphasis is on the principles, procedures, and professionalism utilized when performing comprehensive oral preventive and therapeutic care. Under the direction of the course instructor, students will apply these newly-learned principles in a clinical setting, offering the opportunity to integrate hands-on skills with entry-level critical thinking and problem-solving skills. Prerequisite(s) Acceptance into the dental hygiene program. Purpose of Course To introduce the student to the dental hygiene profession and prepare them to provide safe and comprehensive preventive and therapeutic dental hygiene treatment by introducing concepts related to patient assessment, basic instrumentation techniques, periodontal treatment planning, documentation, patient education for health promotion, oral hygiene instruction, and supportive procedures. Required Materials Textbook(s): Nield-Gehrig, J. (2013). Fundamentals of Periodontal Instrumentation and Advanced Root Instrumentation, (7 th edition). Baltimore, MD: Lippincott, Williams, and Wilkins Nield-Gehrig, J. (2013). Patient Assessment Tutorials: A Step-by-Step Guide for the Dental Hygienist, (3rd edition). Philadelphia, PA: Lippincott, Williams, and Wilkins Wilkins, E. (2012). Clinical Practice of the Dental Hygienist, (11 th edition). Philadelphia, PA: Lippincott, Williams, and Wilkins Pickett FA, Terezhalmy GT (2009). Dental drug reference with clinical implications, 2 nd ed. Philadelphia, PA: Lippincott Williams & Wilkins. Little and Falace (2013). Dental Management of the Medically Compromised Patient, (8 th edition). Philadelphia, PA: Mosby Elsevier Other: MATC Dental Hygiene Clinic Handbook (current edition) Instrument kits Learning Outcomes The intention is for the student to be able to 1. Demonstrate knowledge of basic dental hygiene skills.

2 2. Demonstrate the ability to provide comprehensive patient treatment. 3. Critically analyze appropriate patient treatment options. Course Competencies Actions that are essential to achieve the learning outcomes: 1. Discuss the concepts relative to the prevention of disease transmission. (C1, C2, C4, C8, HP5, PC9) 2. Identify the purpose for and methods utilized in obtaining diagnostic information relative to the patients past and present health status including vital signs and their oral health-related quality of life. (C3, C4, PC1, PC3, PC4) 3. Recognize systemic conditions that may have implications in rendering dental treatment, thereby requiring further consultation and review. (C3, C4, PC1, PC3, PC4) 4. Identify alternatives to explore in patient/operator positioning with consideration of the principles of body mechanics. (C6, HP5) 5. Identify normal oral structure by location and description. (C3, PC3, PC4) 6. Utilize appropriate terminology in describing the extraoral and intraoral findings that deviate from normal. (C3, C5, PC3, PC4) 7. Correlate and apply information obtained in oral anatomy, histology, and radiology to identify and document basic dental and periodontal assessments. (C3, C5, PC3, PC4, PC5) 8. Discuss the composition and implications of plaque, calculus and stain. (PC3, PC6, PC8, PC9) 9. Discuss the principles of instrument design and function and provide rationale for instrument selection. (PC8, PC10) 10. Describe and apply the principles of instrument insertion, adaptation, angulation, and activation. (PC8, PC10) 11. Discuss the principles of scaling techniques including grasp, fulcrum, and stroke. (PC8, PC10) 12. Identify the purpose and techniques available for supragingival and subgingival scaling, root planning, and polishing. (PC5, HP5, PC6, PC7, PC8, PC9, PC10, PC12, PC13) 13. Discuss the indications and contraindications in selecting cleansing and polishing agents with respect to the characteristics of the abrasive particles and method of application. (HP5, PC5, PC6, PC7, PC8, PC9, PC10, PC12, PC13) 14. Identify and discuss the methods by which fluorides may be applied or ingested. (HP5, PC5, PC6, PC7, PC8, PC9, PC10, PC12, PC13) 15. Recognize the types of professionally-appplied fluoride agents available and discuss their indications and contraindications. (HP5, PC5, PC6, PC7, PC8, PC9, PC10, PC12, PC13) 16. Differentiate between healthy periodontium and clinical signs of periodontal disease. (PC1, PC3, PC4) 17. Identify and discuss the basic considerations inherent in appointment planning when deciding the course of treatment to be rendered in a diverse population. (HP5, PC5, PC6, PC7, PC8, PC9, PC10, PC12, PC13) 18. Recognize signs and symptoms of a medical emergency and demonstrate use of the procedures and equipment necessary to sustain life. (PC2, PC11) 19. Discuss common dental emergencies and the proper procedures to follow for immediate treatment and pain relief. (PC2, PC11) Weekly Units I. Week 1 a. Recognize the importance of adequate infection control standards in patient care.

3 b. Review the infection control protocols utilized in the MATC dental hygiene clinic to promote patient and operator safety. c. Define the term standard precaution. d. Discuss the chain of disease transmission and how different elements of infection control interrupt that chain. e. Recognize the various types of sterilization and disinfection and identify advantages and disadvantages of each. f. Demonstrate the proper disinfection technique in preparing the dental unit and operatory for patient treatment. g. Demonstrate the proper hand washing technique. II. Week 2 a. Define terms relevant to medical/dental history interviews and vital signs. b. Discuss informed consent, HIPAA, and patient confidentiality as they relate to dental hygiene treatment. c. Explain the significance of each item on the medical/dental history and recognize its effect on comprehensive patient and oral health care. d. Demonstrate knowledge of appropriate follow-up questions for each section of the medical/dental history form. e. Describe normal parameters and the significance of deviations for the vital signs of blood pressure, pulse, respiration and temperature. f. Utilize textbooks and reference materials to further explore medical conditions, medications and supplements. g. Describe the medication, dosage, and indications/contraindications for prophylactic antibiotics during dental procedures for prevention of infective endocarditis. h. Demonstrate correct technique when taking blood pressure, pulse, and respiration on a patient. i. Demonstrate the ability to complete a thorough and accurate medical/dental history interview asking appropriate, probing questions that encourage the patient to elaborate on given responses. j. Present health history findings to faculty using professional terminology and identifying all potential effects on oral health conditions or treatment as a result of the medical condition(s). III. Week 3 a. Define terms relevant to patient and operator positioning. b. Identify correct patient positioning based on the area of the mouth being treated. c. Discuss principles of effective unit, tray, and light placement. d. Discuss operator zones for right-and left-handed clinicians. e. Demonstrate operation of the operator stool, dental unit and chair. f. Demonstrate operator, patient, and light positioning for each sextant of the mouth (buccal and lingual). g. Demonstrate the correct modified pen grasp and fulcrum technique. h. Demonstrate correct use of the mouth mirror. i. Demonstrate proper finger rests and fulcrums for the different areas of the mouth. IV. Week 4 a. Discuss design features of instrument handles, shanks and working ends. b. Name and describe the basic parts of an explorer. c. Discuss the basic uses of the explorer and demonstrate adaptability. d. Describe and demonstrate the explorer grasp. e. Define tactile sensitivity.

4 f. Recognize and demonstrate the correct technique used in exploring. g. Compare and contrast supragingival and subgingival exploratory technique. h. Discuss the rationale for maintaining a sharp explorer tip. i. Recognize the uses of different explorers in clinical assessments. j. Demonstrate the concept of tooth surfaces away and toward the operator as a sequencing technique. V. Week 5 a. Discuss the use of the calibrated probe and Nabors furcation probe. b. Identify millimeter markings on various calibrated probes. c. Describe the difference between a periodontal pocket and a gingival/pseudo pocket. d. Discuss the accuracy of periodontal pockets and level of attachment in determining true periodontal status. e. State the three conditions involved when measuring level of attachment. f. Describe an enamel projection and state implications in response to treatment. g. Demonstrate proper probing technique. h. List classifications of furcation involvement. i. List classifications of tooth mobility. j. Describe the assessment of bleeding points upon probing. k. Describe the evaluation of oral lesions using a calibrated probe. l. Describe the use of and calculations of clinical indices. m. Accurately chart clinical findings related to periodontal assessment. n. Identify and describe the eight categories of periodontal disease classification as outlined by the AAP. o. Identify and describe the four categories of periodontal case types. p. Discuss the significance of probing depths, gingival recession, clinical attachment loss, bleeding on probing, and exudate as they relate to a periodontal diagnosis. q. Discuss the significance of horizontal and vertical bone loss as it relates to a periodontal diagnosis. r. Utilize findings from the medical, dental, clinical and radiographic findings to determine a patient s current disease classification. s. Utilize findings from the medical, dental, clinical and radiographic findings to determine a patient s current disease case type. VI. Week 6 a. Obtain and record a patient s dental history. b. Identify and accurately document the presence of various restorations on a dental chart. c. Utilize radiographs and clinical examination to differentiate between common restorative materials. d. Correctly classify patient occlusion using Angle s occlusion classification. e. Determine the presence and severity of an overbite, overjet, or crossbite and describe its potential implications on overall health of the dentition and gingiva. VII. Week 7 a. Define terms relevant to the extraoral and intraoral examinations. b. Describe characteristics about the patient s appearance and discuss how that may be significant to treatment. c. Demonstrate the appropriate sequence for the extraoral and intraoral examinations. d. Demonstrate the different types of palpation techniques using adequate pressure.

5 e. Demonstrate between significant and insignificant findings during the extraoral and intraoral examinations. f. Differentiate between atypical and abnormal findings during the extraoral and intraoral examinations. g. Correctly document all extraoral/intraoral findings and the appropriate follow-up treatment. VIII. Week 8 a. List the three design features of the sickle scaler. b. Discuss the uses of the anterior and posterior scalers. c. Discuss the advantages and disadvantages of the design features of the sickle scalers. d. Demonstrate the adaptations, angulations, and strokes used with the anterior and posterior sickle scalers. IX. Week 9 a. Describe the uses for universal curets. b. Describe the design features of universal curets. c. Identify the correct working end of universal curets for all aspects of the mouth. d. Demonstrate the correct adaptation, angulation, and activation of universal curets. e. Describe the design features of the area-specific curets. f. Explain the design different between the anterior and posterior curets. g. Compare and contrast the area-specific curets with universal curets. h. Identify the area-specific curets found in the instrument cassette and determine their areas of use. i. Correctly identify the terminal shank, the lower cutting edge, and adapt the correct working end to the appropriate tooth surface for the universal and area-specific curets. X. Week 10 a. Correctly identify intrinsic and extrinsic stains. b. Discuss the current policy regarding selective polishing in clinical practice. c. Examine the indications and contraindications for polishing teeth. d. Recognize the effects of polishing on both hard and soft tooth tissues. e. Explain the proper technique for polishing. f. Discuss the recommended method of application of abrasives and the results of improper application. g. Identify the characteristics of abrasive particles. h. Recognize the best polishing procedures for the removal of stain without causing trauma and discomfort. XI. Week 11 a. Describe the uses for electronically powered instrumentation in periodontal debridement. b. Describe the features of ultrasonic devices. c. Compare and contrast standard and slim insert designs. d. Identify pre-treatment considerations before initiation of ultrasonic instrumentation, including medical and dental contraindications. e. Explain proper infection control of the ultrasonic unit and inserts. f. Prepare the ultrasonic unit for use. g. Identify the correct inserts for adaptation to all aspects of the mouth. h. Demonstrate the correct technique for using the ultrasonic in patient treatment. i. Discuss the purpose and benefits of instrument sharpening. j. Demonstrate proper instrument sharpening technique for sickle scalers and universal and areaspecific curets.

6 XII. Week 12 a. Discuss the incidence of medical emergencies in the dental settings. b. Describe when medical emergencies are most likely to occur in the dental setting. c. Understand why dental hygienists should be able to identify and promptly react to the early signs and symptoms of medical emergencies. d. Identify and understand the appropriate use of advanced emergency drug protocols. e. Use a complete medical history and pre-operative vital signs to help prevent, predict and identify medical emergencies. f. Appropriately manage specific medical emergencies in response to given signs and symptoms. g. Be prepared for an emergency situation in the dental hygiene clinic and in private practice. XIII. Week 13 a. Follow a systematic appointment sequence when treating patients. b. Understand the appointment system that is followed at the MATC dental hygiene clinic. c. Utilize the MATC dental hygiene clinic handbook as a guide and reference in all patient appointments. d. Assemble and interpret assessment date from patient cases and develop a dental hygiene diagnosis. e. Design a care plan best suited to the specific needs of each patient. f. Design a logical sequence of planned appointments to fulfill the care plan for each patient case. g. Identify priorities for treatment including emergency needs, prevention of disease, therapy and maintenance needs. h. Understand the importance of individualized patient care plans. i. Discuss evaluation of treatment outcomes and strategize appropriate follow-up care. j. Define referral and consultation in the context of medical/dental settings. k. Discuss various forms of professional communication when initiating a referral or consultation. l. Understand and recognize when a referral is required prior to administering dental hygiene treatment. m. Compare the obligations of referring professionals with obligations to the consult. n. Locate and review forms required when a referral or consultation of medical/dental professionals required. o. Accurately complete the appropriate documents in the patient s clinical chart. XIV. Week 14 a. Apply all concepts/procedures/skills discussed thus far in this course to prepare a Case Study report that highlights assessment findings, treatment planning recommendations, and instrumentation recommendations for a fictitious patient. b. Prepare a case study presentation that will be provided to peers and the instructor. Method of Delivery/Instruction Face-to-face Blended Online Learning activities will be assigned within and outside the classroom to assist the student to achieve the intended learning outcomes through lecture, Instructor-led class discussion, guest speakers, group activities, lab, drills/skill practice, and others at the discretion of the instructor. Method of Grading and Evaluation The student will be graded on learning activities and assessment tasks. Grade determinants may include the following: daily work, quizzes, chapter or unit tests, comprehensive examinations, student projects,

7 student presentations, class participation, and other methods of evaluation employed at the discretion of the instructor.