2014 Preventive Dental Sciences Department Pediatric Dentistry Division Table of Contents



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Preventive Dental Sciences Department

Pediatric Dentistry Division

(PDS 615, 511)
Clinical Evaluation Manual-Part 2


Student name: …………………………………

Computer #: ………………………………..


Academic Year 2013/2014
Preventive Dental Sciences Department

Pediatric Dentistry Division

Table of Contents

  1. Competency Evaluation Rubrics

    1. Rubric for Examination & Treatment Planning

    2. Rubric for Oral hygiene Instruction

    3. Rubric for Prophylaxis & Topical Fluoride Application

    4. Rubric for Rubber Dam Isolation

    5. Rubric for Local Anesthesia

    6. Rubric for Fissure Sealant

    7. Rubric for Preventive Resin Restorations

    8. Rubric for Cavity Preparation and Restoration

    9. Rubric for Stainless Steel Crown/Strip Crown/Class IV Permanent

    10. Rubric for Formocresol Pulpotomy

    11. Rubric for Extraction of Primary Teeth

    12. Rubric for Diet Evaluation

    13. Rubric for Space Analysis

    14. Rubric for Space Maintainer I (Band’s Selection and Impression)

    15. Rubric for Space Maintainer II (Appliance Fitting and Cementation)

  2. Oral Hygiene instruction and Diet evaluation

    1. Oral Hygiene Instruction (Students Copy)

    2. Dietary Evaluation Form (R4)

  3. Arabic Forms

    1. First Visit Introduction

    2. Oral Hygiene Introduction Parents

    3. Post Extraction Instruction

  4. Dietary Advice Forms

  5. AAPD Guideline on Caries-risk Assessment and Management for Infants, Children, and Adolescents



  1. Competency Evaluation Rubrics


Pediatric Dentistry Division


Form 1.1
Rubric for Examination & Treatment Planning


Steps and procedures

Instructor Evaluation

0

Not Competent

1

Competent

2

Proficient

1. History and Personal Data

- Patient's complete personal data recorded

- All questions on the medical history answered.*

- All questions on the dental history answered.

- Caries risk assessment *


Mistake in one or more of the critical steps(*)

Complete only Critical steps*

Complete all the steps including critical steps*,

2. Examination:

a. Extra oral/Intra Oral

  • Head and neck

  • Soft Tissue Evaluation: Gingiva, mucosa, etc.

  • Oral hygiene

b. Occlusion and Orthodontic Evaluation / Referral

c. Dental Charting:

  • Teeth present or absent*

  • Existing restorations

  • Presence of dental decay *

  • Fractures and developmental anomalies

Mistake in one or more of the critical steps(*) misdiagnosed cavitated caries

Complete Critical steps* but misdiagnosed non cavitated carious lesions.

Complete all the steps including critical steps*,

3. Radiographic Diagnosis:

1. Indicated radiographs were taken*

2. Examine quality of bone, tooth structure and development

3. Identify proximal caries in bite wing *



Missed more than 2 proximal caries in dentin in bite wing radiograph

Missed 1 or 2 proximal carious lesion in dentin in bite wing

Did not missed any proximal caries in dentin in bite wing

4. Treatment Planning

  1. Prevention of caries is emphasized in initial appointments.*

  2. QUADRANT dentistry is one of the main emphasis points.

  3. Accurate plan for restoration*

  4. Appliances will be left until after all operative has been completed in that arch.

  5. The recall period of 3 to 6 months.*

Mistake in one or more of the critical steps(*) or wrongly planned restoration for 4 teeth or more

Complete all critical steps (*) but wrongly planned restoration for not more than 3 teeth

Complete all critical steps (*) and non critical and currently planned all restorations

5.Behavior guidance:

TSD, distraction, positive reinforcement, voice control



Uses none

Uses 1 or 2

Uses 3 or more

6. Presenting the case to Parents (*)

- Disclosing sufficient informative using radiographs, photographs, study casts.*

- Suggest treatment for the problems with benefits and risks.*

- Alternative treatment with benefits and risks*

- Cost

- How many visits and lengths



- Preventive meaning and anticipating guidelines

- Signed consent form*



Mistake in one or more of the critical steps(*)

Complete only critical steps (*)

Complete all the steps including critical steps*,

7. Time *

> 180 min

60– 180 min

< 60 min



Form 1.2
Pediatric Dentistry Division

Rubric for Oral Hygiene Instructions


Steps and procedures

Instructor Evaluation

0

Not Competent

1

Competent

2

Proficient

1. Use a model to demonstrate the brushing

technique. *

Did not use Models

Used a study cast

Used the proper model

2. Technique description to child and parents

a. The student describes the technique of tooth brushing to the patient and parent adequately *.

b. Following a systematic order (starting from buccal surface of the last right maxillary tooth across the arches and ending by the lingual surface of this tooth)*

c. Supply a toothbrush and allow the child to do tooth brushing.

d. Ask the child to brush each segment (15 times)


Mistake in one or more of the critical steps (*).

Complete only critical steps (*) but not all other steps.

Complete all critical (*) and other steps.

3. Parent’s Instruction:

a. Recommends the appropriate frequency of brushing *

b. Recommends appropriate toothbrush type

c. Recommends appropriate toothpaste type and amount *

d. The parent is responsible for tooth brushing for children (up to 8 years) the parent should supervise tooth brushing for (older children).*


Mistake in one or more of the critical steps (*).

Complete only critical steps (*) but not all other steps.

Complete all critical (*) and other steps. Plus supplying pictures or toothbrush

4. Behavior guidance:

TSD, positive reinforcement



Use none

Use 1

Uses 2


Form 1.3
Pediatric Dentistry Division

Rubric for Prophylaxis and Topical Fluoride Application


Steps and procedures

Instructor Evaluation

0

Not Competent

1

Competent

2

Proficient

1. Prophy

  • Clean the stained surfaces by using a paste on a rotating rubber cup.

  • Caution the patient not to swallow the prophy paste and provide continual use of high suction.

Used slurry of pumice or did not instruct the patient on swallowing.

Complete the steps but used rotating brush

Applied the steps

2. Fluoride*

  • Seat the patient upright*

  • Teeth should be dried and free of saliva

  • Select the suitable trays. Place approximately 2.5 ml of APF gel in each tray and place the trays over the arches and squeeze the buccal and lingual surfaces. *

  • Provide the patient with a saliva ejector, instruct patient to avoid swallowing excess fluoride and allow the trays to remain in the mouth for 4 minutes.*

  • Remove the trays and use high suction to thoroughly remove the remaining APF. Have the patient expectorate immediately and repeatedly for 1 minute.

  • Instruct the patient not to eat, drink or rinse for 30 minutes after treatment.*

One or more mistakes of the critical steps (*) e.g did not upright in seat.

Complete all the critical steps (*) but used saliva ejector to remove remaining APF.

Completed all the critical steps (*) plus using high suction in removing the remaining APF

3. Behavior Guidance

TSD, distraction, positive reinforcement, voice control



Uses none

Uses 1 or 2

Uses 3 or more

4. Time for fluoride *

> 30 min

15- 30 min

< 15 min


Form 1.4
Pediatric Dentistry Division

Rubric for Rubber Dam Isolation


Steps and procedures

Instructor Evaluation

0

Not Competent

1

Competent

2

Proficient

1. Rubber Dam Preparation:

a. Punches appropriate areas

b. Use appropriate clamp

c. Has floss tied to the clamp*

d. Punches multiples holes*


Mistake in one or more of the critical steps(*)

Critical steps are completed (*)

Critical steps (*) and all other steps are completed

2. Procedure:

a. Places clamp on appropriate tooth

b. Avoid tissue trauma

c. One quadrant is exposed*

d. Moisture control*

e. Checks patient's face for clearance (breathing) *

f. Rubber Dam is reverted

g. frame is not deviated



Mistake in one or more of the critical steps(*)

Critical steps are completed (*)

Critical steps (*) and all other steps are completed

3. Behavior guidance

TSD, distraction, positive reinforcement, voice control



Uses none

Uses 1 or 2

Uses 3 or more

4.Time *

> 20 min

20 min

< 20 min


Form 1.5
Pediatric Dentistry Division

Rubric for Local Anesthesia


Steps and procedures

Instructor Evaluation

0

Not Competent

1

Competent

2

Proficient

1. Behavior

TSD, positive reinforcement, voice control, distraction



  • Explain the procedure *

  • Did not instruct the patient to close his eyes

  • Describe the feeling *

One or more Critical mistakes (*)

All critical steps are completed (*)

All critical steps (*) and other steps are completed

2. Pre-operative procedure

  • Proper positioning of the patient (supine)*

  • The child head is stabilized between the body and arm of the dentist.

  • Dry the site of injection and apply topical anesthesia *

  • Select the proper gauge and length (short in maxilla and 3 mm long in mandible) for the needle*

One or more Critical mistakes (*)

All critical steps are completed (*)

All critical steps (*) and other steps are completed

3. Procedure & Effectiveness

  • Establish a firm hand rest during the injection

  • Keep syringe out of the patient vision block the patient vision by hands *

  • Slowly advance needle through the mucosa, deposit the LA (1ml/min) and withdraw the syringe *

  • Correct landmarks*

  • Patient experiences, no pain or discomfort during different procedures*

One or more Critical mistakes (*)

All critical steps are completed (*)

All critical steps (*) and other steps are completed


Form 1.6
Pediatric Dentistry Division

Rubric for Fissure Sealant


Steps and procedures

Instructor Evaluation

0

Not Competent

1

Competent

2

Proficient

1. Rubber Dam/Cotton rolls

Isolation rubber dam is applied*

  • Rubber dam (fully erupted tooth)

  • Cotton roll (partly erupted tooth)

Only 3 teeth are exposed, seepage of fluids, clamp unstable

Follow all criteria

All criteria plus: Rubber dam is reverted and frame is not deviated

2. Prophylaxis

  • Tooth surface is cleaned using a fluoride-free pumice slurry and a rubber cup or brush.

  • Rinsed and dried.*

  • All remaining pumice is removed*

One or more mistake in the critical steps (*)

Complete Critical

steps (*)



Complete Critical steps (*) and all other steps.

3. Sealant Application

  • Sealant material is applied and cured with no voids*

  • The sealant material carried into the buccal and lingual grooves and pits.*

  • Check occlusion

One or more mistakes in the critical steps(*)

Complete all critical steps (*)

Complete all critical steps (*) and all other steps

4. Behavior Guidance

TSD, distraction, positive reinforcement, voice control



Uses none

Uses 1 or 2

Uses 3 or more

5. Time*

> 30 minutes

30 minutes

15 minutes


Form 1.7
Pediatric Dentistry Division

Rubric for Preventive Resin Restorations


Steps and procedures

Instructor Evaluation

0

Not Competent

1

Competent

2

Proficient

1. Rubber Dam

  • One quadrant is exposed

  • Floss tight to clamp

  • Allow patient breathing

Only 3 teeth are exposed, seepage of fluids, clamp unstable

Follow all criteria

All criteria plus: Rubber dam is reverted and frame is not deviated

2. Prophylaxis and caries removal

1. Tooth surface is cleaned using fluoride-free pumice slurry and a rubber cup, rinsed and dried.*

2. Removal of caries from isolated pits and fissures only using round bur # ¼ or ½ bur in an exploratory manner.*

3. All caries are removed *



One or more mistake in the critical steps(*)

Complete Critical steps*

Complete critical steps (*) and all other steps.

3. Restoration and sealant application

a. Prepared areas are restored with composite resin.*

b. Sealant material is applied over the restored area and to adjacent etched fissures and buccal and lingual grooves and light cured. *

c. The sealed surface explored and with no voids*.

d. Rubber dam removed and occlusion evaluated


One or more mistake in the critical steps(*)

Complete Critical steps*

Complete critical steps (*) and all other steps.

4.Behavior guidance

TSD, distraction, positive reinforcement, voice control



Uses none

Uses 1 or 2

Uses 3 or more

5. Time*

60 min

40 min

30 min

Directory: Files -> 0016815 -> Subjects
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Subjects -> Preventive Dental Sciences Department Pediatric Dentistry Division


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