• Like
  • Save
Specialty Chairside Assisting 1.doc.doc
Upcoming SlideShare
Loading in...5
×
 

Specialty Chairside Assisting 1.doc.doc

on

  • 1,366 views

 

Statistics

Views

Total Views
1,366
Views on SlideShare
1,366
Embed Views
0

Actions

Likes
0
Downloads
11
Comments
0

0 Embeds 0

No embeds

Accessibility

Categories

Upload Details

Uploaded via as Microsoft Word

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    Specialty Chairside Assisting 1.doc.doc Specialty Chairside Assisting 1.doc.doc Document Transcript

    • Module: EndodonticsFaculty Teaching Guide for Specialty ChairsideAssistingModule – Endodontics -1- 1
    • Faculty Teaching Guide for Specialty Chairside AssistingFaculty Teaching Guide for Specialty Chairside AssistingModule: EndodonticsModule OverviewThis module will discuss the dental assistant’s responsibilities as a team member for the specialty of endodontics.The specialty of endodontics is concerned with diseases of the dental pulp and surrounding tissues. Specialtyprocedures may be performed by a general dentist or the patient may be referred to an expert limited to aparticular discipline. Patient’s are refered to an endodontist for procedures such as root canal treatment andperiapical surgery. The DA who understands the various dental specialties is better able to assist the dentist andbe a valued member of the health care team. The Big Picture Faculty Teaching Guide for Specialty Chairside Assisting Module: Endodontics Section 1: Endodontics Part A: The Endodontic Patient Part B: Materials and ProceduresResourcesThis module utilizes the following learner resources:Textbook: Dental Assisting, A Comprehensive Approach, 2nd edition, by Donna J. Phinney and Judy Halstead.Delmar Learning, 2004. ISBN 1-4018-3480-9.Workbook: Workbook to Accompany Dental Assisting, A Comprehensive Approach, 2nd edition, by Donna J.Phinney and Judy Halstead, prepared by Karen L. Waide, Delmar Learning, 2004. ISBN 1-4018-3483-3. 2
    • Module: EndodonticsInstructor’s Manual: Instructor’s Manual to Accompany Delmar’s Dental Assisting, A Comprehensive Approach,2nd edition, by Donna J. Phinney and Judy Halstead. Delmar Learning, 2004. ISBN 1-4018-3482-5.Electronic CD-ROM: Delmar’s Dental Assisting Interactive Skills and Procedures CD-ROM, ISBN 1-4018-3485-X.Faculty CD-ROM: The faculty CD-ROM includes this Faculty Guide and the PowerPoint Presentation forSpecialty Chairside Assisting.Section 1: EndodonticsSection OverviewEndodontics is the branch of dentistry concerning the diagnosis and treatment of the tooth pulp and periapicaltissues. Success of endodontic treatment depends on sterile technique, medications, profound anesthesia, andproper seal of the pulp canal. The dental assistant has a vital role to ensure universal precautions are followedand to know the specialized armamentarium used during these procedures. Periapical radiographs taken by thedental assistant during endodontics must be precise in order to show exact details of the tooth anatomy andsurrounding tissues. Teaching TipOutline of Section Be sure that learners thoroughly understandPart A: The Endodontic Patient each learning objectivePart B: Materials and Procedures and how the learning activity relates to them.Learning Objectives and Competencies Adults do not appreciate busy work andThese learning activities directly address the Learning Objectives and sometimes by merely pointing out theCompetencies as stated. relationship between the activities and learning,Knowledge they are more interested1. Define the Key Terms. in completing the activities successfully.2. Define endodontics, pulpal and periapical disease.3. List endodontic diagnostic procedures.4. List instruments and materials used in endodontic treatment and their functions.Application5. Demonstrate the ability and the knowledge to assist during an endodontic procedure.6. Demonstrate the ability and the knowledge to assist during an apicoectomy procedure.Learning ActivitiesThese learning activities directly address the Learning Objectives and Competencies as stated.[Insert Homework Assignment icon] Key Term Glossary (Part A, All Objectives) -3- 3
    • Faculty Teaching Guide for Specialty Chairside Assisting[Insert In-Class Activity icon] Electronic Pulp Testing (Part A, Objective 3)[Insert Homework Assignment icon] Textbook Assignment (Part A, All Objectives)[Insert In-Class Activity icon] Endodontic Set Up and Assist (Part B, Objective 5)[Insert In-Class Activity icon] Apicoectomy Set Up and Assist (Part B, Objective 6)[Insert Homework Assignment icon] Workbook Assignment (Part B, All Objectives)[Insert Homework Assignment icon] End of Chapter Activities (Part B, All Objectives)[Insert Homework Assignment icon] Interactive Skills and Procedures CD-ROM (Part B, Objective 4)Part A: The Endodontic PatientOverviewEndodontic therapy will enable the patient to retain their tooth and therefore the alveolar bone. The dentalassistant will not only help the dentist throughout the procedure, but will also coordinate information with thereferring dental office, make the patient comfortable, and explain much of the process to the patient.Initial Questions and Activities Teaching Tip1. What will happen if decay extends into the tooth pulp? When starting any topic, Learners should be able to easily answer this question from the encourage learners to think in general about previous studies. If this question does pose problems or confusion what you are going to say. The more you can engage their interest, the make sure to review prior to moving on to this modules material. more they will focus on the material. The tooth pulp will become irritated and infected all the way to the apex, and cause discomfort for the individual. Over time the pulp tissues will die and develop a periapical abscess.Key Concepts References and Activities SlidesIntroduction to Module Slides 1-2Introduction to Section Slides 3-4Key Terms [Insert Home Ass icon] Key Term Glossary Slides 5-6Periapical Diseases Chapter ___, pgs. ____ Slides 7-19 [Insert Group Activity icon] Electronic Pulp Testing [Insert Home Ass icon] Textbook Assignment,[ ] Group Activities [ ] Homework [ ] Individual Activity [ ] Internet Activity [ ] In-Class Discussion [ ] In-Class Act [ ] Evaluation 4
    • Module: Endodontics[Insert In-Class Act icon] In-Class Activities Electronic Pulp Testing (Part A, Objective 3). Goal: For learners to understand how an electronic pulp tester is used. Instructor should provide a pulp tester and ensure supplies are available. Learners should be placed into groups. Learners should be graded on the procedure steps as outlined on pg. ____, Chapter ____. Learner workbooks contain check off sheets that can be utilized.[Insert In-Class Dis Ques icon] In-Class Discussion 1. Why is it important to always review a patient’s medical history? Ensure learners realize how important a complete and accurate medical history is before any type of anesthesia is administered. Present medications being taken by the patient could cause an adverse, or an exacerbated reaction, if the dentist is going to prescribe other drug therapy for the patient. A thorough medical history will also ensure the patient hasn’t developed new drug allergies since the last appointment. Teaching Tip[Insert Home Ass icon] Homework AssignmentsKey Term Glossary. Learners will define key terms listed in the PowerPoint Encourage learners to talk amongst themselvespresentation. They are to enter this glossary on disk, in a dedicated notebook or about the course topics during breaks, or beforein a designated part of a notebook. They are expected to augment information or after class. Self- discovery is enlightening, and thefrom text or lecture with other resources including any available in the school or sharing of information helpful in a way that canpublic libraries or on the Internet and will be graded at the end of the module on be very powerful and safe.completeness and presentation. Textbook Assignment. Learners are to read Chapter ____ . Presentation Tools Note: If you change Objectives or Assignments, don’t forget to change the slides accordingly.Slide 1 [Insert SCA 1-1] Power Point Presentation for Specialty Chairside SCA – Stands for Specialty Assisting Chairside Assisting. The 1st “1” Module: Endodontics Prior to introducing this module. Ask learners if any indicates the Module called questions remain from the previous module. If questions Endodontics. The 2nd number remain review the material as needed. -5- 5
    • Faculty Teaching Guide for Specialty Chairside Assisting indicates the slide number. Introduce this Module.Slide 2 [Insert SCA 1-2] Module: Endodontics Introduce the sections and each part.Slide 3 [Insert SCA 1-3] Section 1: Endodontics Discuss each objective in detail. Learners need to know what they will be learning and why. Try to relate it back to their careers as dental assistants.Slide 4 [Insert SCA 1-4] Section 1: Endodontics (cont.) Continue to discuss each objective in detail.Slide 5 [Insert SCA 1-5] Key Terms Review each key term and discuss.Slide 6 [Insert SCA 1-6] Key Terms (cont.) Continue discussing each term. Homework Assignment: Stop here and go over the Key Term Glossary assignment.Slide 7 [Insert SCA 1-7] Part A: The Endodontic Patient Introduce the specialty field of endodontics. Explain that the only alternative to endodontic treatment is an extraction. Review who the members are on the endodontic team. Discuss the responsibility that the DA has when it comes to communicating with a referring dental office.Slide 8 [Insert SCA 1-8] Pulpal and Periapical Diseases Discuss the difference between vital and non-vital pulp. Point out that non-vital pulp is either dead or dying. Explain that with reversible pulpitis, the pulp may recover if the irritation is removed, but that with irreversible pulpitis, the inflammation is so severe that either the tooth 6
    • Module: Endodontics is extracted, or can be saved with endodontic therapy. Explain that a necrotic pulp is dead pulp. Point out that if the pulpal inflammation continues, a fistula will develop, in order to drain the infection. The fistula will create a path through the bone and create a “gumboil," in which case, the exudate will need to be drained by the dentist. Note to Instructor: Correct error in the textbook in the Endodontics chapter. (Phinney & Halstead). Under pulpal necrosis, the term “gumball” should be “gum boil.” Discuss that both apical periodontitis and a periapical abscess destroy bone, and that the longer an infection is present in the periapical tissues, the more alveolar bone loss there will be.Slide 9 [Insert SCA 1-9] The Endodontic Patient Ensure learners understand how important it is to take a thorough medical and dental history from the patient before beginning treatment. Discuss the difference between objective and subjective symptoms. Address that a treatment plan should be discussed with the patient prior to beginning any procedure.Slide 10 [Insert SCA 1-10] The Clinical Examination Explain that quality radiographs are essential diagnostic aids for the clinical examination of a patient. Ensure learners understand that an intraoral exam includes procedures performed inside the patient’s mouth and extraoral procedures are completed outside of the -7- 7
    • Faculty Teaching Guide for Specialty Chairside Assisting oral cavity.Slide 11 [Insert SCA 1-11] Clinical Tests Describe each test procedure. Explain that palpation is applying pressure to oral tissues, or checking the oral cavity, face, and neck by gently touching. Discuss how percussion is performed by tapping a few teeth gently with an instrument handle, which assists the dentist in distinguishing between a tooth with periapical inflammation from those without problems. Inform learners that if there is bone loss from longstanding infection, the tooth may be mobile. Discuss how temperature testing and an electronic or digital pulp test, helps determine the extent of pulpal damage. Explain that if there is little reaction from the patient, the pulp may already be necrotic. Describe how a fractured tooth may not be detected on a radiograph, and that a fiberoptic light, shown through the tooth, may indicate a fracture. Inform learners that sometimes the patient cannot determine which tooth is bothering them and the dentist may anesthetize the area to ensure the correct tooth is identified. In-Class Activity: Stop here for the Electronic Pulp Test activity. Homework Assignment: Stop here to assign and discuss the homework. 8
    • Module: EndodonticsPart B: Materials and ProceduresOverview Teaching TipThere are variety of materials that are used in performing endodontic procedures. Suggest to learners thatSome of the endodontic instruments used are very small and pointed and will be they take small breaks every thirty minutes or sopassed by the dental assistant to the endodontist very carefully using cotton when they are studying. The quick change ofpliers or specialized instrument holders. The dental assistant will also obtain a scene will refresh them, thus allowing them tocomplete medical and dental history, take and process radiographs, prepare concentrate better on the content when theyspecialized tray set-ups, materials, and supplies, and assist throughout the return.procedure. In addition to assisting the endodontist, the DA must be responsive tocomplaints of pain and swelling of the patient’s tooth and be capable of calmingthe anxious patient’s concerns regarding the endodontic procedure.Initial Questions and Activities 1. What are some of the fears a patient may experience if they are having a root canal? Pain is generally the biggest fear. Some may also think that they might lose their tooth. The dental team should never assume a patient understands what will happen in the procedure. Asking the patient questions to confirm their understanding, to help relieve unfounded fears is important.Key Concepts References and Activities SlidesMaterial and Procedures Chapter ____, pgs. ____ Slides 12-19 [Insert Group Activity icon] Endodontic Set Up and Assist [Insert Group Activity icon] Apicoectomy Set Up and Assist [Insert Home Ass icon] Workbook Assignment [Insert Home Ass icon] End of Chapter Activities -9- 9
    • Faculty Teaching Guide for Specialty Chairside AssistingKey Concepts References and Activities Slides [Insert Home Ass icon] Interactive Skills and Procedures CD-ROMAssessment Questions Slide 20Summary of Module Slide 21[ ] Group Activities [ ] Homework [ ] Individual Activity [ ] Internet Activity [ ] In-Class Discussion [ ] In-Class Activity [ ] Evaluation[Insert In-Class Act icon] In-Class Activities Endodontic Set Up and Assist (Part B, Objective 5). Goal: For learners to prepare a set-up and assist during an endodontic procedure. Instructor should ensure enough materials and supplies are available, and should be the operator for this procedure. Learners should be separated into groups. Learners should be graded on the procedure steps as outlined on pg. ____, Chapter ____. Learner workbooks contain check off sheets that can be utilized. Apicoectomy Set Up and Assist (Part B, Objective 6). Goal: For learners to prepare a set-up and assist during an apicoectomy procedure. Instructor should ensure enough materials and supplies are available, and should be the operator for this procedure. Learners should be separated into groups. Learners should be graded on the procedure steps as outlined on pg. ____, Chapter ____. Learner workbooks contain check off sheets that can be utilized.[Insert In-Class Dis Ques icon] In-Class Discussion 1. What happens to the bone during a periapical abscess or periodontitis? There is localized destruction of bone from the infection around the tooth.2. What is the purpose of a post and core? This should be a review question based on previous studies. A post is placed inside of the root canal following endodontic therapy in order to provide stability for the tooth, and the core is the filling material used to restore the tooth to it’s natural contour. Every endodontically treated tooth will need a crown for support and strength. [Insert Home Ass icon] Homework Assignments Workbook Assignment. Learners are to complete the workbook Chapter ____ questions. Learners should be prepared to review these in class. 10
    • Module: Endodontics End of Chapter Activities. Have learners complete the Review Questions and Critical Thinking Questions in Chapter ___ .Interactive Skills and Procedures CD-ROM: Learners should practice setting up for endodontic proceduresusing the two case studies on the CD-ROM.Ideas for learners struggling with this material … Web Research. Have learners go on the Internet and find a Web site for patients with questions about endodontic treatment. One recommended site is: http://www.aae.org, sponsored by the American Association of Endodontists. Learning how patient’s questions are answered should help the learner to further understand the endodontic process and to be able to answer these questions when asked by patients. Ideas for learners who are ahead and want to learn more … Web Research. To learn more about dental pain (pulpitis) have learners go to http://www.ncemi.org and enter “pulpitis” in the search. Have learners write a short paragraph on their findings and be prepared to present it to the class. Presentation Tools Note: If you change Objectives or Assignments, don’t forget to change the slides accordingly.Slide 12 [Insert SCA 1-12] Part B: Materials and Procedures Review Part A. Review the homework from Part A and make sure any remaining questions are answered. Introduce Part B. Explain that barbed broaches remove pulpal tissue, files are used to enlarge and smooth the canal walls, and reamers are designed to widen the opening of pulp canals. Ensure learners understand that the various intracanal instruments used are color coded by their width size and number. Discuss how each intracanal instrument is used consecutively to widen the canal, thereby removing any - 11 - 11
    • Faculty Teaching Guide for Specialty Chairside Assisting further diseased tissue (also known as mechanical debridement) and to create a space for the filling material. Address the importance for sterilizing endodontic instruments before, during, and after use. This may be done with a glass bead or salt sterilizing unit. Explain that the rubber stops are placed on the file to determine the millimeter length of the tooth root. Point out that Gates-Glidden drills and Peeso Reamers are used on slow speed handpieces. Explain that the Gates- Glidden will remove dentin, and the Peeso Reamer is used to remove some of the endodontic filling material in preparation for a post. Remind learners that ideally endodontically treated teeth will eventually need a post and core, and a crown, in order to strengthen the tooth following root canal treatment.Slide 13 [Insert SCA 1-13] Intracanal Instruments (cont.) Explain that the Lentulo spiral is placed on a slow speed handpiece and used to place root canal sealer. Point out that the endodontic spoon is longer than other spoon excavators, and endodontic explorers are tapered in order to reach into the pulp chamber, so the dentist can locate the canal opening. Discuss how the spreader is a hand instrument used to laterally condense the gutta percha filling material, and to create a space for the next gutta percha point, and the endo plugger used to condense the filling material. Explain that the Glick #1 is an endodontic instrument with a condenser / plugger on one end, and a flat end used to place the temporary filling material. 12
    • Module: EndodonticsSlide 14 [Insert SCA 1-14] Endodontic Materials Inform learners that paper points are placed into the canal, near the end of treatment, to dry out the canal in preparation for the filling material, and that gutta percha is used to fill, or obturate, the root canals. Ensure learners understand that paper points and gutta percha points are transferred to the dentist using locking cotton pliers.Slide 15 [Insert SCA 1-15] Endodontic Materials (cont.) Describe how irrigation solutions are placed into the canal with a Luer-Lock syringe, in order to remove debris, disinfect, and dissolve necrotic tissue. Point out the use of formocresol in dissolving residual nerve tissue. Ensure learners understand that the DA must have the tip of the oral evacuator very close to the tooth opening, so the irrigation solution doesn’t spray out of the area. Discuss the terms mechanical debridement and chemical debridement. Explain that the dentist may place a disinfectant into the canal to help sterilize the inside of the tooth, or a material used to help dissolve dentin in order to expose a root canal. Inform learners that there are a variety of cements and methods used to seal the root canal.Slide 16 [Insert SCA 1-16] Advanced Technologies Explain that advances in technology are changing endondontic procedures. The apex finder will tell the dentist the exact length of the tooth, the heating unit has many dental applications, and the endodontic low-speed - 13 - 13
    • Faculty Teaching Guide for Specialty Chairside Assisting handpiece may be used in conjunction with hand instruments.Slide 17 [Insert SCA 1-17] Root Canal Therapy Review the basic steps of a root canal treatment. Ensure learners understand that the gutta percha filling material should be placed within 1-2 millimeters of the tooth apex. Discuss the use of radiographs during and after the filing procedure.Slide 18 [Insert SCA 1-18] Other Endodontic Procedures Discuss that pulpectomy and pulpotomy procedures are usually performed on children. Explain that a pulpectomy is the complete removal of the pulp fibers in the pulp chamber and the root canals, and a pulpotomy is the removal of the pulp in the coronal portion of the pulp only, leaving the root portion intact. Point out that the intention of a pulpotomy is to maintain the vitality of the roots, especially for children, where the apex of the tooth isn’t fully developed. Inform learners that materials used for pulpotomy will be discussed in the module covering pediatric dentristry.Slide 19 [Insert SCA 1-19] Surgical Endodontics Explain that an apicoectomy is the surgical removal of the apex of a tooth in order to control an area of infection. Point out that this procedure is done when a persistent infection follows the endodontic seal. Make clear that this is a surgical procedure where the infectious debris and infected apex tip are removed, a small preparation cut into the tooth structure is performed, and a retrograde filling is 14
    • Module: Endodontics placed to facilitate sealing the tooth. Explain that root amputations and hemisections are done only on multi-rooted teeth, as a last resort, to save a tooth and alveolar bone. Discuss that these procedures are completed most often to retain teeth being used as abutments for a permanent bridge.Slide 20 [Insert SCA 1-20] Assessment Questions Short Activity: Stop here and have learners answer the questions on the slide. Review material as needed to enhance understanding. Short Activity: Stop here for the class to discuss the Case Study in Chapter ____. In-Class Activity: Stop here for the Endodontic Set Up and Assist activity and the Apicoectomy Set Up and Assist activity. Homework Assignment: Stop here to assign and discuss the homework.Slide 21 [Insert SCA 1-21] Summary of Module Review the topics from this module. Ask for questions and clarify the material as needed. - 15 - 15