CLINICAL PROCEDURES & TIPS Flashcards by sophie rosen

First CASE:

Must be a non-
complicated anterior or
premolar tooth

How well did you know this?

Not at all

Perfectly

Third CASE:

Must be a
non-complicated
anterior or premolar
tooth

How well did you know this?

Not at all

Perfectly

Second CASE:

Must be a
non-complicated anterior
or premolar tooth

How well did you know this?

Not at all

Perfectly

Last CASE:

Must be a
COMPETENCY (Mock
board examination plastic
teeth)

How well did you know this?

Not at all

Perfectly

ALL COMPLICATED TEETH will be REFERRED to

ADVANCED ENDO.

How well did you know this?

Not at all

Perfectly

– teeth are optional and will
be assigned depending on the student’s
Expertise

Molar

How well did you know this?

Not at all

Perfectly

Two Endo Recalls
Any RCT done at UMKC yours or
other including advanced endo.
Should be about – mos. Since
completion or last check
Do Clinical Testing and Record
results and patient’s concerns
— Radiographs = No Charge
Must be checked by Endo faculty.
Complete the recall on Axium and
print out sheet for credit

6
1-2

How well did you know this?

Not at all

Perfectly

Two Assisting in Grad.

Go to Advanced Endo Clinic and
volunteer to assist and observe for 2 half
days
Best to do this early in your 3rd year
You will receive a time unit credit/ 1.0
day be sure to get Signed Card & take to
the clinical dean’s office

How well did you know this?

Not at all

Perfectly

It is mandatory to assist in the predoc
clinic – weeks before renderingclinic two weeks before rendering
ttreatment to your first patientreatment to your first patient

two

How well did you know this?

Not at all

Perfectly

skipped
TRIAL (MOCK) BOARD as Y-4
in Jan.
Trial Boards requested by students as preparation for the CDCA-WREB-CITA Exam.
TRIAL BOARD is FORMAL & is designed to be as much like the actual Exam as we
can make it. You may not bring “cheat sheets”, images, or anything other than
the test materials, your Zip-Lock Bag, and the Candidate Manual.
GET YOUR CANDIDATE MANUAL ASAP and START READING IT ALL - CAREFULLY.
REMEMBER THIS IS YOUR COMPETENCY. TREAT IT AS SUCH
You will be expected to know the protocol and follow it religiously for TRIAL and Dental board. You will do
mounted sextants and manikins with heads. You will be graded as on CDCA-WREB-CITA and those NOT prepared
will likely FAIL. Don’t let it happen – be prepared.

skipped

How well did you know this?

Not at all

Perfectly

The General Protocol for CLINICIANS
(4)

PROTECT:
COLLECT:
SELECT
INSPECT:

How well did you know this?

Not at all

Perfectly

PROTECT

-Patient, Yourself, Staff:

-Med. And Dental HX
-Vital Signs & Meds.
-Other Med testing or
consultations p.r.n.
-CC (Chief Complaint)
-Expectations/Desires &
Attitude of patient

How well did you know this?

Not at all

Perfectly

INSPECT:

-Problem Focused Exam:

-Inspection
-Clinical Testing
-Radiographs
-Other
-Document all findings
A Separate DX Form for
each tooth in Area O.S.

How well did you know this?

Not at all

Perfectly

COLLECT

-Exam, Testing and
Radiographic Studies
Perio and Restorability

-ENGAGE BRAIN
-Try to Prove or
Disprove etiology of C.C

How well did you know this?

Not at all

Perfectly

SELECT

-The MOST APPROPRIATE
DX & TX PLAN which
explains the CC and
symptoms IN CONCERT
with the Exams and
Testing results.
_ CAN YOU deliver the
appropriate TX?

How well did you know this?

Not at all

Perfectly

ISSUES commonly seen in Clinic to be
mastered as a CLINICIAN in practice
(9)

consultation
clinical testing and diagnostic rx
dx and case selection
isolation via RD
temp restoration
patient handling, protocol, and records
documentation
time management
procedures and incidents

How well did you know this?

Not at all

Perfectly

CONSULTATION: important &
free @ UMKC
PREPARATION: (3)

Complete entry interview: CC, Med/Dental HX etc.

How well did you know this?

Not at all

Perfectly

Complete —
Complete & Documented —
Complete Diagnostic — (New if new restoration)
Complete Diagnostic — in AxiUm (one for EACH tooth)
Complete — Forms
Complete — Consult (if needed)
Be ready with your — and prepare to defend
Be prepared to perform — or repeat:
Trans-illumination ?
Tracing DST ?
EPT

MEDICAL & DENTAL HX
Clinical Exam and Testing
Radiographs
Forms
Restorability and Consult
Periodontal
Tentative DX
additional testing

How well did you know this?

Not at all

Perfectly

You MUST fill out — DX Form including
other teeth in the quadrant and ,
Consult Form and restorability form for
— requiring an Endo
Consult

one
EACH TOOTH

How well did you know this?

Not at all

Perfectly

IF current x-rays are:
(3)
TAKE — NEW RADIOGRAPHS

-Incomplete or inadequate
-More than 2 mos. old
-Any TX, restoration etc. done

2-3

Now & ONLY NOW, you are
prepared to ask your Team
Clerk to CALL for an ENDO
CONSUL

How well did you know this?

Not at all

Perfectly

when not to ask for an endo consult

ANY TIME YOU HAVE
NOT COMPLETED THE
REQUIREMENTS which
are listed on the previous
slide

How well did you know this?

Not at all

Perfectly

Restorability

Study These Flashcards

To have reasonable
longevity following
heroic restoration

Previous O&R

Study These Flashcards

Periodontal or
Endodontic
outcome

Asymptomatic Pulp Exposures

Study These Flashcards

Strategic value of
tooth to retain

LOOK at the TOOTH and THINK about it. Not EVERY tooth needs to be saved Do Clinical Testing and Evaluation --- you waste time on O&R on a hopeless or non-strategic tooth.

BEFORE

WHEN DO you call for a CONSULTATION? REMEMBER: you may ONLY do --- in E-CHAIR. For RCT to be COMPLETED, you MUST

DEBRIDEMENT have the patient become a patient of record and the TEAM must approve the RCT & restoration and ENTER this on the TREATMENT PLAN

ENDO RECALL of RCT done at UMKC Pt in pain A TRUE Necrotic pulp: w/wo symptoms which is deemed desirable to retain

Previous RCT therapy w/wo symptoms and PARL that needs retreatment Symptomatic teeth, radiographic pathologic findings, need for RCT due to prosthetic reasons Create post-space before a perforation occurs

How to Obtain an Endo. CONSULTATION: ONE & ONLY WAY –

THE PAGER HAVE YOUR TEAM CLERK CALL ENDODONTIST will appear at your UNIT ASAP for the CONSULT. The Person on the BEEPER will perform NO TREATMENT

NO ENDO CONSULTS are done after

11:30 and 3:30 Please Plan Accordingly

What to do if pulp exposure may occur? Don’t PANIC! If you TESTED tooth BEFORE starting procedure & found it ASYMPTOMATIC & VITAL. (5)

1. Insure Dental Dam is in place and tooth is well isolated. 2. Remove ALL remaining Caries. 3. Irrigate with 8.3% NaOCl to gain hemostasis & to reduce microbial contamination. 4. Place dycal over exposure and place a good temporary restoration. 5. Take 2-3 radiographs of post-restoration tooth. IMMEDIATE PROCEDURE:

SUBSEQUENT PROCEDURE: at a later time

Contact Dr. Weisleder via Email: Only write the patient’s name and chart number in the body of the email. No need for explanations. We will review the chart, radiographs, diagnosis forms and consult. If any of these elements are are missing, we will e mail you back!!! - Get the patient referred and - Scheduled to the appropriate clinic

Remember to TEST teeth before anesthesia and --- O&R is done and take radiographs --- restoration is in place.

before after

Complete CLINICAL TESTING before calling for Endo Consult * Students develop skills by doing their own clinical testing – * Often Not Done correctly – * Only 1 tooth tested ? – (What does this tell us?) – – * Results not documented –

(Do NOT expect faculty to do it for you) (cotton tipped applicator vs. cotton on cotton forceps) No baseline has been established* Need a minimum of 2-3 control teeth*** Must PROVE reasons 4 your TX

The Axium DX & Consult Forms should state a

DX & justify and document the compelling reason(s) for doing RCT on this tooth.

Take OWNERSHIP of your case *** * It is the responsibility of the Student Doctor to arrive at a tentative --- (from clinical tests/radiographs) before presenting a case to his or her instructor – including residents & dental faculty at consultation and treatment planning. * This all must be recorded in --- (medico-legal) * --- should be ruled out.

PULPAL, P/A and PERIODONTAL DX AXIUM Differential Diagnoses

PROCEDURAL INCIDENTS * AVOID: (4)

– SEPARATED INSTRUMENTS – PERFORATION OF ROOTS – NaOCl ACCIDENT – UNPROFESSIONAL TREATMENT OF PATIENT

An OFFICIAL INCIDENT REPORT is REQUIRED from you and the faculty overseeing No LATER THAN -- Hours after the Incident to be on Chair’s Desk and recorded in students grades. One incident loses credit for that tooth; Incidents may affect Grade, NO ENDO. Clinic Privileges until Remediation is Completed.

Endo Recalls procedure: (4)

- Fill out the form on Axium - Do sensibility testing: Percussion, palpation mainly - Take two radiographs: Straight on and a shift shot (unless anterior). - Call the pager to get an Endo faculty

CASE SELECTION: Extremely Important * If you CANNOT predict a perfect outcome in YOUR hands:

* Don’t attempt the RCT!

UMKC Endo has 4 basic JOBS: 1. To offer basic guidance in .. 2. To present .. 3. To equip you to recognize and treat non-... 4. To give you the basic criteria to determine when ..

EXAMINATION & TESTING leading to an ACCURATE DIAGNOSIS ONE BASIC TECHNIQUE of NS Endodontic Treatment for NON-COMPLICATED RCT CASES complicated endodontic cases in a CLINICAL SITUATION REFERRAL is in the BEST INTEREST of the PATIENT

COME PREPARED to Clinic. If you don’t have a viable PLAN for what you are to do today, you are not prepared and the

patient may be taken away from you in favor of someone who is prepared. If you can’t describe in detail exactly what you plan to do (in proper sequence), you have no business treating the patient. (Your cheat sheet allowed

BE RESPONSIBLE to collect & confirm appropriate and accurate --- to keep the patient and yourself safe. Also to accumulate all indicated --- and studies to determine an accurate diagnosis and be able to prescribe appropriate treatment in an efficient and caring manner.

health history testing

Every file that we use will be placed in the red sharps container at completion of the appointment We believe that --- USE FILES help to prevent ---

SINGLE SEPARATION

TART RCT EARLY: Look for endo. all the time. Frequent E-chair. Don’t shy away. Traditionally, students accomplish --% of their endo in the 1st 20 mos. in the Clinic and --% in the last 4 mos. Worst Possible Time to learn! Faculty is overwhelmed with more difficult cases and less experienced & more desperate students. The least help on cases is available the last 4 mos

30 70

TEAM APPROACH! Buddy up!

Volunteer to assist your friend: You will learn the ropes and maybe your friend will help you. Save time and Learn! Appreciate the help of a good assistant!

Keep your operating area sterile and clean. Also keep it neat and organized. This will save you valuable treatment time (instead of looking for misplaced instruments). This habit will create time for you to have at least --- additional appoint each day and to look professional doing i

You may find that PERSONAL MANAGEMENT SKILLS may become very important to you as you advance to the Clinic:

among your SKILLS must be Communication, Motivation, Accommodation, Attitudes, Time Management, Patience, Analgesia, Antisepsis, and Self Control, etc

Don’t worry: Avoid all foreseeable failures by alert --- but some may still occur. But don’t worry. We learn little from success while Failure observed and corrected is the path to improvement

PLANNING AHEAD

Clinical Endodontics is DIFFICULT and requires ---. Look to your Clinical Faculty for help. We are happy to answer questions, look at the situation and generally help (UNLESS it is your competency Exam)

CONSTANT FOCUS

Learn to use your TIME responsibly. One eventually learns that --- is the secret to success and prosperity. Remember: The task will always expand to meet the time available (whether or not you choose to recognize it). Plan to start and finish at the given time or sooner

TIME MANAGEMENT

GET into the HABIT of --- BEFORE you begin treatment to learn to anticipate possible problems which may occur during treatment and may be revealed at the planning stage. Faculty will be helpful if asked.

searching tooth anatomy and radiographic studies

When you complete a case, be sure to have the --- Grade Sheet filled out and Graded by the faculty with whom you worked. Take a photo on your phone of the graded case and immediately take the --- Grade Sheet to the Endo Office to have the Grade recorded so we may be aware of your advancement toward graduation in Endo

Green Green

* If you think about it: You have been somewhat successful throughout your academic years by an ADVERSARIAL APPROACH with faculty (arguing the finest details to get another point in hope for a better grade) * Now, your OBJECT is to LEARN to

Perfect your SKILLS: Think of faculty more as a Mentor to help you learn. (no need to argue; we both want a good result)

CLINICAL PROCEDURES & TIPS Flashcards

(53 cards)