DH 115 - Clinical TechniquesCredits: 5
Presents theory and application of various periodontal instruments, plaque and stain removal and instrument sharpening skills that are necessary for proper use in the dental hygiene diagnostic and therapeutic services. Emphasizes proper documentation of findings.
Prerequisite(s): DH 100 , DH 101 each with a C (2.0) minimum grade and admission to the Dental Hygiene Program.
Corequisite(s): DH 110 , DH 111 , DH 112 , DH 114 , DH 116 , DH 118
Lecture Hours: 45 Lab Hours: 90
Meets MTA Requirement: None
Pass/NoCredit: No
Outcomes and Objectives 1: Correctly position various types of patients. In addition, the student will understand and incorporate proper operator's and equipment positioning in relationship to the patient during treatment.
A. State the proper way to greet an adult or child patient.
B. Explain and list the items that are needed to be done to the dental unit and operatory as preparation for patient reception.
C. List and explain the eight objectives for proper positioning of the operator.
D. Describe and demonstrate the proper seating and dismissing of a dental adult or child patient.
E. Demonstrate the proper seating methods for the operator for the different areas of the mouth relating it to a clock.
F. Describe and demonstrate the chair positioning for an adult or small child patient.
G. Describe and demonstrate the proper method for adjusting the dental light to illuminate the following areas of the oral cavity:
1. maxillary arch
2. mandibular arch
3. palate
4. lingual of mandibular anteriors
H. State the best height and location of the bracket tray and/or unit cart.
I. State the best working and light distance between the operator and the patient’s face.
J. List the conditions which contraindicate patient positioning in a supine position.
K. Explain the “Basic Zone for Operation.” fig. 5-5 p.74 (Wilkins) and handout.
L. Explain seating positions with four-handed.
M. Define the following terms:
1. body language
2. body mechanics
3. cumulative trauma
4. ergonomics
5. postural (orthostatic) hypotension
6. supine
7. Trendelenburg
8. work simplification
2. Identify the need and benefit of dental hygiene treatment and the basic components of instruments. They will have an understanding of
the fundamental skills need to accomplish various treatments and the hazards inherent with these skills.
A. Define the terms oral prophylaxis and periodontal debridement.
B. Discuss the general objectives of treatment.
C. Explain the effects and benefits of complete scaling and root planing.
D. Discuss the preliminary steps for instrumentation.
E. List and define the major parts of a dental instrument. Identify what different labels mean on the handle of an instrument. Discuss ideal
characteristics of certain instrument parts.
F. Identify the 2 major categories of dental hygiene instruments. Give an example in each category.
G. Define and/or describe the following terms:
1. Modified pen grasp
2. Palm grasp
3. Fulcrum, finger rest
4. Wrist rock
5. Pivot (s)
6. Adaptation
7. Angulation
8. Activation
9. Stroke
10. Dexterity
11. Tactile sensitivity
12. Lateral Pressure
13. Exploratory stroke
14. Working stroke
15. Long axis
16. Insertion
17. neutral positions
18. carpal tunnel syndrome
19. cumulative trauma
H. List and explain a few variations of the so-called standard fulcrum.
I. What are the effects of excess pressure applied to the finger rest?
J. Demonstrate the palm grasp using the following:
1. air/water syringe
2. oral evacuator
K. Describe the parts of an “order of instrumentation.” Why is it important?
L. Practice dexterity development exercises.
M. Discuss risk factors and prevention activities for cumulative trauma.
3. Identify and locate different types of dental calculus. They student will understand the significance and composition of dental calculus.
They will be able to educate the patient on the formation, and prevention of dental calculus.
A. Differentiate between supragingival and subgingival calculus on the basis of location, distribution, color, shape, texture, and organisms.
B. List the inorganic and organic elements found in calculus.
C. Discuss the formation of calculus.
D. Describe the three (3) methods in which calculus can attach itself to the tooth.
E. Explain the four (4) basic methods of detecting calculus.
F. Explain the significance of dental calculus and how it may be prevented.
4. Properly utilize with beginning competencies examination instruments during assessment, treatment and evaluation of the dental
hygiene patient.
A. Identify the parts of a mouth mirror, explorer, and periodontal probe.
B. Demonstrate and explain the use of a mouth mirror doing the following: (Repeat: switching hands)
1. retraction
2. indirect illumination
3. indirect vision
4. transillumination
C. State three purposes of using compressed air.
D. List precautions one must take with the use of compressed air.
E. Explain the technique of use of compressed air and alternatives to its use.
F. List five uses for explorers.
G. List three advantages of a sharp explorer.
H. Discuss the various designs and the 5 main uses of different explorers.
I. Describe the periodontal probe and list examples of the different markings and types.
J. Explain the six purposes and uses of the periodontal probe.
K. List the calibrated markings on the periodontal probe that we use in our clinic.
L. Describe and differentiate between an absolute perio pocket and a relative perio pocket.
M. Describe and demonstrate the proper technique for the use of the probe and explorers; both on the typodont and intraoral.
N. Describe how to examine for furcation and mucogingival involvement.
5. Properly utilize with beginning competencies curettes during treatment of the dental hygiene patient.
A. Define the following terms:
1. scaling
2. root planing/debridement
3. curettage
4. universal curet
5. area specific curet
6. burnish
7. endotoxin
8. furcation
B. Identify the parts of a curet:
C. Identify and differentiate between the basic curettes:
D. Describe the strokes used with curettes.
E. State the indications and contraindications of use for curettes.
F. Describe how a deposit of calculus is fractured from a tooth surface and differentiate from a “shaving” process.
G. Identify the factors that make subgingival scaling a more complicated procedure than supragingival scaling.
H. Describe characteristics of implant scalers.
I. Demonstrate the application and use of curettes on a typodont and the oral cavity.
6. Properly utilize with beginning competencies sickles during treatment of the dental hygiene patient.
A. Identify curved sickle from a straight sickle and identify its:
1. blades (cutting edges)
2. facial or bevel surfaces
3. lateral surfaces
4. shank (terminal portion, also)
B. Compare and contract sickle scalers (both straight & curved) and curettes. Be sure to discuss cross sections, face, and indications.
C. Identify the sickle scalers that you have in your kit.
D. Describe the stroke(s) used for sickles.
E. List any contraindications for using sickle scalers.
F. Demonstrate the sickle scalers use in the different areas of the typodont and mouth, maintaining all the principles of instrumentation.
7. Properly utilize with beginning competencies the ultrasonic inserts during treatment of the dental hygiene patient.
A. State the purpose of the ultrasonic scaling device.
B. List actions of ultrasonic scaling/root debridement.
C. Explain the various types of ultrasonic dental units and their mode of action.
D. List and explain the function of the various types of ultrasonic inserts/tips.
E. List contraindications of ultrasonics.
F. Describe the limitations with the use of the ultrasonic scaling device.
G. Explain Sonic Scaling. State the difference of the ultrasonic unit and inserts.
H. Explain proper disinfection/sterilization of the ultrasonic unit and inserts.
I. Compare and contrast hand versus ultrasonic instruments.
J. Describe the magnetostrictive transducer (stacks) and piezoelectric transducer (crystals).
K. Discuss the advantages and disadvantages of ultrasonic instrumentation.
8. Understand the need to maintain their instruments and be able to properly utilize a number of sharpening techniques with beginning
competencies.
A. Explain the purpose of instrument sharpening and the effect of a dull instrument on scaling and root planing procedures.
B. Identify when instruments should be sharpened.
C. Demonstrate and explain at least three methods of testing instrument sharpness.
D. Identify the angle necessary for sharpening procedures between the instrument and the stone.
E. Explain the purpose of using various stone shapes, sizes, and types.
F. Discuss the need to lubricate certain stones and what may be used.
G. Explain when to sharpen in relation to sterilizing the instruments.
H. Demonstrate various sharpening techniques and explain the advantages and disadvantages of each.
I. Define the following terms:
1. hone
2. wire edge
3. sludge
9. Understand the causes of various stains in order to be able to identify and determine if the stain may be removed with different
techniques.
A. Describe how the following factors can cause discoloration of a patient’s teeth: hereditary, congenital, and environmental
B. Stains and discoloration can occur in three basic ways; describe and give examples of each way.
C. Define the following terms: EXOGENOUS, ENDOGENOUS, EXTRINSIC, AND INTRINSIC.
D. Describe the appearance, location, cause, and technique used to remove the following stains: Yellow Stain, Green Stain, Black Line
Stain,Tobacco Stain, Brown Stain, Food Stain, Orange and Red Stain, Metallic Stain
E. Describe the cause, appearance, methods of treatment and location of the following conditions with intrinsic stain: Amelogenesis
Imperfecta, Dentinogenesis Imperfecta, Enamel Hypoplasia, Dental Fluorosis, Pulpless Teeth
F. List the four items that would cause Exogenous Intrinsic Stains and describe the discoloration associated with each cause.
10. Assess the need for selective polishing and be able to properly utilize with beginning competencies different polishing agents and
techniques.
A. Identify and explain the reasons for polishing teeth as part of the treatment plan, include which technique is indicated for a specific
condition.
B. Identify and explain the reasons not to include polishing teeth in the treatment plan, include specific contraindications for each technique.
C. Define the following terms:
1. soft deposits
2. intrinsic stains
3. extrinsic stains
4. abrasive and abrasion
5. grit
6. cleaning
7. polishing
8. selective polishing
9. air abrasive
10. binder
11. glycerin
12. p.s.i.
13. r.p.m.
14. slurry
D. Identify, demonstrate correct technique of use (both on a typodont and intraoral), and explain the maintenance of the following pieces of
equipment/instruments:
1. slow speed handpiece
2. prophy angle
3. contra-angle
4. rubber polishing cups
5. polishing brushes
6. porte polisher
7. wood points
8. polishing paste
9. air abrasive machine
E. State the critical factors involved in selecting a polishing agent, include characteristics, application principles and available agents.
F. List the reasons that floss should always follow scaling and/or polishing.
G. Describe the indications for the following:
1. dental tape
2. waxed dental floss
3. unwaxed dental floss
4. polishing strips
11. Understand the need and requirements of legally accurate records.
A. Explain the necessity for accurate, honest and complete record keeping, with the following in mind:
1. dates and initials or signature
2. recording in ink
3. obtain patient signature on authorization forms, M.H., etc.
4. confidentiality
5. legality
B. State the significance of and correctly record appropriate data on all the following forms:
1. authorization form
2. medical history*
3. dental history
4. patient information form (personal history)
5. all sections of the oral exam form
6. clinical evaluation form
7. injury report form
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