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Effective: Summer 2013
D A 51CADVANCED DENTAL ASSISTING SKILLS3.5 Unit(s)

Grade Type: Letter Grade Only
Not Repeatable.
FHGE: Non-GE Transferable: CSU
2.5 hours lecture, 4 hours laboratory. (78 hours total per quarter)

Student Learning Outcomes -
  • The student will successfully remove stain and soft deposits from the majority of the tooth surfaces utilizing a selective coronal polishing technique.
  • The student must participate in a mock state board practical examination and perform a blind peer evaluation of the final product.
Description -
Continuation of techniques introduced in D A 51A and 51B to include pulp vitality testing, fluoride administration, intraoral/extraoral exam, polishing removable partial and full dentures, dental implants, and pedodontic procedures. Theory and practice of coronal polishing. Intended for students in the dental assisting program.

Course Objectives -
The student will be able to:
Dental Assisting Theory & Practice Competency
  1. perform, document and report pulp vitality testing on a patient/partner.
  2. provide and document an in-office fluoride treatment on a patient/partner.
  3. perform and document a intraoral/extraoral exam on clinical patients
  4. polish a removable partial or full denture using standard performance criteria.
  5. describe the types, indications and contraindications for dental implants
  6. state the sequence of implant placement
  7. cite appropriate implant oral hygiene aids and uses.
  8. state the objectives for coronal polishing of the teeth.
  9. identify the various types and etiology of common stains by color and describe them clinically
  10. describe tooth morphology and anatomy of the oral cavity and relationship to plaque stains and polishing techniques
  11. discuss the principles of disclosing materials as to composition, clinical application and contraindications.
  12. define "abrasive" and list the four factors which affect the rate of abrasion and the consequences of misuse of an abrasive agent.
  13. name four of the commonly used abrasive agents and describe their composition and use.
  14. demonstrate the appropriate technique for use of mouth mirror for indirect vision, illumination, and retraction when coronal polishing.
  15. list the steps necessary in the care of the prophy angle and slow-speed handpiece.
  16. list the armamentarium necessary for the completion of the coronal polishing procedure.
  17. disclose a clinic patient in preparation for oral hygiene instructions or coronal polishing.
  18. deliver appropriate oral hygiene instruction on a clinic patient based on the patient's age, amount & location of plaque, along with other
  19. acquire at least 5 patient experiences for coronal polishing using standard performance criteria.
  20. fabricate, deliver and give instructions for a bleaching splint.
  21. fabricate a custom tray on a edentulous or partially edentulous model.
Infection Control and Hazardous Waste Management
  1. decide which PPE, decontamination, disinfect ion and sterilization techniques are appropriate for the prevention of disease transmission for coronal polishing, extraoral/intraoral exam, pulp vitality testing, fluoride treatments, and polishing of a removable partial or a full denture.
  2. describe the infection control procedures that should be performed for coronal polishing, extraoral/intraoral exam, pulp vitality testing, fluoride treatments, and polishing of a removable partial or a full denture.
  3. perform appropriate hazardous waste and sharps management for coronal polishing, extraoral/intraoral exam, pulp vitality testing, fluoride treatments, and polishing of a removable partial or a full denture.
  4. describe how to avoid cross contamination when performing dental assisting duties
Ethical and Legal Principles
  1. identify and describe the common dental procedures in which the registered dental assistant is directly supporting or directly involved in the procedure.
  2. state the legal duties of a RDA and DA for coronal polishing, extraoral/intraoral exam, pulp vitality testing, fluoride treatments, and polishing of a removable partial or a full denture.
  3. cite the legal and ethical implications of performing duties that are not designated to the licensed RDA in the California State Practice Act.
  4. prepare and/or evaluate complete and accurate patient procedure records.
  5. demonstrate professional behavior and appearance in clinical and laboratory situations.
  6. demonstrate teamwork with assigned student-partner in classroom, laboratory and clinical situations.
Foothill College Dental Assisting Program Competencies
  1. Dental Assisting Theory & Practice: dental assisting students must be competent in applying the theory and practice of dental assisting for persons of all ages and abilities.
  2. Infection Control and Hazardous Waste Management: dental assistants must possess the knowledge and abilities to prevent the transmission of infectious diseases.
  3. Ethical and Legal Principles: dental assisting students must be competent in understanding ethical/legal principles as applied to the dental office.
Special Facilities and/or Equipment -
  1. Dental operatory demonstration and practice units, laboratory facilities with individual student work areas
  2. Clinical supplies to support demonstration and student practices activities

Course Content (Body of knowledge) -
Dental Assisting Theory & Practice Competency
  1. Pulp testing (L-L)
    1. Pulp vitality testing (L-L and Lab)
      1. Indications for pulp vitality testing (L-L)
      2. Types of pulp vitality testing (L-L)
        1. Cold test (L-L)
          1. Ice (L-L)
          2. Ethyl chloride (L-L)
        2. Hot test (L-L)
        3. Percussion (L-L)
        4. Palpation (L-L)
        5. Electric or electronic pulp testing (Lab)
          1. Armamentarium (L-L and Lab)
          2. State Practice Act (L-L)
          3. Patient instructions (L-L and Lab)
          4. Procedure (L-L)
          5. Documentation of findings in treatment record (L-L and Lab)
          6. Infection control including PPE, instrument decontamination, disinfection and instrument sterilization. (L-L and Lab)
        6. Radiographs (L-L)
      3. Diagnostic findings from pulp testing (L-L)
        1. Normal (L-L)
        2. Pulpitis (L-L)
          1. reversible (L-L)
          2. irreversible (L-L)
        3. Periradicular abscess (L-L)
        4. Nectrotic tooth (L-L)
  2. Fluoride treatment (L-L and Lab)
    1. Indications and contraindications (L-L)
    2. State Practice Act (L-L)
    3. Armamentarium (L-L and Lab)
      1. Fluoride gel/foam versus varnish (L-L and Lab)
    4. Patient instructions (L-L and Lab)
    5. Procedure (L-L and Lab)
    6. Documentation in treatment record (L-L and Lab)
    7. Infection control including PPE, instrument decontamination, disinfection and instrument sterilization (L-L and Lab)
  3. Extraoral/Intraoral exam (Lec., L-L, and Lab)
    1. Purpose (Lec)
    2. State Practice Act (Lec)
    3. Armamentarium (L-L and Lab)
    4. Patient instructions (L-L and Lab)
    5. Procedure (L-L and Lab) (L-L and Lab)
    6. Documentation of findings in treatment record (L-L and Lab)
      1. Size (Lec)
      2. Shape (Lec)
      3. Location (Lec)
      4. Duration (Lec)
      5. Color (Lec)
      6. Infection control including PPE, instrument decontamination, disinfection and instrument sterilization (L-L and Lab)
  4. Polishing of removable partials or full upper dentures (L-L and Lab)
    1. Indications and contraindications (Lec)
    2. State Practice Act (Lec)
    3. Armamentarium (L-L and Lab)
    4. Patient instructions (L-L and Lab)
    5. Procedure (L-L and Lab)
    6. Infection control in the dental laboratory (L-L and Lab)
    7. Documentation in treatment record (L-L and Lab)
  5. Dental implants (Lec)
    1. Types (Lec)
    2. Indications and contraindications (Lec)
  6. Sequence of placement and timeline (Lec)
    1. Cost (Lec)
  7. Oral hygiene instructions (Lec)
    1. Brushing and flossing (Lec)
    2. Alternative or supplemental plaque removal aids (Lec)
  8. Coronal polishing (Lec., L-L and Lab)
    1. Definition (Lec)
    2. State Practice Act (Lec)
    3. Purpose (Lec)
    4. Medical history significance (Lec)
      1. Prophylactic antibiotic premedication (Lec)
    5. Stains (Lec)
      1. Identifying types and etiology of stains (Lec)
    6. Tooth morphology in relation to stains and plaque accumulation (Lec)
      1. Tooth concavities (Lec)
      2. Common areas of stain and plaque accumulation (Lec)
    7. Disclosing materials (Lec)
      1. Types and compositions (Lec)
      2. Disclosing methods (Lec)
      3. Indications and contraindications (Lec)
      4. Armanentarium (L-L and Lab)
      5. Patient instructions (L-L and Lab)
      6. Procedure (L-L and Lab)
    8. Abrasive agents (L-L and Lab)
      1. Factors which affect the rate of abrasion (Lec)
      2. Consequences of misuse (Lec)
    9. Types (Lec)
      1. Consequences of misusage (Lec)
      2. Factors involved in misusage (Lec)
    10. Mouth mirror usage (Lec., L-L and Lab)
      1. Illumination (L-L and Lab)
      2. Retraction (L-L and Lab)
      3. Indirect vision (L-L and Lab)
    11. Care of prophy angle and handpiece (L-L and Lab)
      1. Cleaning and lubrication (L-L and Lab)
      2. Assembly (L-L and Lab)
      3. Use (L-L and Lab)
      4. Coronal polishing technique (L-L and Lab)
    12. Armamentarium (Lec)
      1. Instruments (Lec)
      2. Equipment (Lec)
      3. Materials (Lec)
    13. Patient disclosing (L-L and Lab)
      1. Evaluation criteria (L-L and Lab)
    14. Oral hygiene instruction
      1. Toothbrushing and flossing (Lec)
      2. Supplemental aids (Lec)
    15. Patient experience (Lec)
      1. Fulcrum options(L-L and Lab)
      2. Patient/operator positioning (L-L and Lab)
      3. Disclosing (L-L and Lab)
      4. Use of abrasive agent (L-L and Lab)
      5. Selective polishing (L-L and Lab)
      6. Interproximal polishing (L-L and Lab)
      7. Polishing of facial, lingual and occlusal surfaces (L-L and Lab)
      8. Documentation in the treatment plan (L-L and Lab)
    16. Bleaching splint (Lec., L-L and Lab)
      1. Fabrication (L-L and Lab)
      2. Delivery and patient instructions (L-L and Lab)
    17. Custom Tray (L-L and Lab)
      1. Fabrication (L-L and Lab)
    Infection Control and Hazardous Waste Management
    1. Prevention of disease transmission (L-L and Lab)
      1. Guidelines by regulatory and advisory agencies (Lec)
    2. Infection control including PPE, instrument decontamination, disinfection, instrument sterilization (L-L and Lab)
      1. Instrument processing (L-L and Lab)
      2. Set-up of unit (L-L and Lab)
    3. Hazardous waste and sharps management. (Lec)
      1. regulatory versus non-regulatory waste (Lec)
    4. Prevention of cross contamination (Lec)
      1. Overgloves, cotton pliers (Lec)
      2. Barriers (Lec)
    Ethical and Legal Principles
    1. Duties (Lec)
      1. Dental practice act (Lec)
      2. Coronal polish versus dental prophylaxis (Lec)
      3. Ethical obligations (Lec)
      4. Informed consent (Lec)
Methods of Evaluation -
  1. Exams (multiple choice, short answer, spelling and instrument identification)
  2. Laboratory assignments
  3. Clinical assignments
  4. Written assignments
Representative Text(s) -
Bird, DL, Robinson, DS. Modern Dental Assisting, 10th edition. St, Louis, MO: WB Saunders, 2012. ISBN: 978-1-4377-1729-7
Bird, DL, Robinson, DS. Student Workbook to Accompany Modern Dental Assisting, 10th edition. St, Louis, MO: WB Saunders 2012. ISBN: 978-1-4377-2728-9
Leicht, J, Coronal Polishing Lecture Manual, Los Altos Hills, CA: Foothill College Bookstore, 2012.


Disciplines -
Dental Technology
 
Method of Instruction -
Lecture, Laboratory, Demonstration.
 
Lab Content -
  1. Pulp Testing
  2. polishing partials and dentures
  3. fluoride treatment
  4. intraoral and extraoral exam
  5. coronal polishing
 
Types and/or Examples of Required Reading, Writing and Outside of Class Assignments -
  1. Reading Coronal Polishing chapter from textbook.
  2. Reading and reviewing course lecture/Lab manual
  3. Documentation in the treatment record of vital signs, pulp vitality testing, medical history review, findings for intraoral and extraoral exams.
  4. Writing reflection and competency papers.