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Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
Scott AEGD Residency
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Scott AEGD Residency

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  • 1. ADVANCED EDUCATION INGENERAL DENTISTRY (AEGD)RESIDENCY PROGRAM 375th MEDICAL GROUP/SGDDT Scott AFB, IL 2011-2012
  • 2. COMMANDER, 375th MEDICAL GROUP Col Jill L. Sterling, USAF, MC, FS COMMANDER, 375th DENTAL SQUADRON Col Steven L. Bartel, USAF, DCDIRECTOR, DENTAL RESIDENT EDUCATION Col Brent S. McClenny, USAF, DCDEPUTY DIRECTOR RESIDENT EDUCATION Lt Col Bryce G. Whisler III, USAF, DC AEGD CONTACT INFORMATION Director: (618) 256-3322 Main Clinic: (618) 256-6667 2
  • 3. Advanced Education in General Dentistry Program MISSION OF THE UNITED STATES AIR FORCE DENTAL SERVICEThe Air Force Dental Service mission is to maintain the oral health of Air Force personnel andother uniformed service members to ensure their maximum wartime readiness and combatcapability. The Dental Service trains to ensure competency in tasks required to support theoverall medical mission in time of war or other contingency situations. During peacetime andwartime, the Dental service provides a broad spectrum of oral health services for active dutymembers and some other eligible beneficiaries. SCOTT AIR FORCE BASE AND SURROUNDINGSScott Air Force Base is located in southwestern Illinois and is approximately 25 miles east of St.Louis, Missouri. The 375th Air Mobility Wing is comprised of several staff agencies and fourgroups: the 375th Medical Group, 375th Operations Group, 375th Mission Support Group and375th Communications Group. As the host unit, the 375th AMW supports four majorheadquarters and a numbered air force with worldwide responsibilities: U.S. TransportationCommand (USTRANSCOM), Air Mobility Command, the Surface Deployment DistributionCommand, Defense Information Technology Systems Agency and the 18th Air Force, as well asthe 932nd Airlift Wing (Reserve), the Illinois Air National Guards 126th Air Refueling Wing,and over 65 mission partners, including the 618th Tanker Airlift Control Center, which plans anddirects all US global airlift and air transport operations. USTRANSCOM is responsible for thecommand and control of the United States military transportation effort--in the air, on theground and over the sea, in peace and in war.The St Louis area has a wide-ranging variety of activities and facilities for every interest andtaste. Professional sport teams include the St Louis Cardinals (baseball), the St Louis Blues(hockey), and the St Louis Rams (football). In the event of no sellout, military members andtheir families may use their military ID to attend the Cardinals games free of charge. Nightlifeincludes numerous restaurants, bars, casinos, the theatre and a symphony. The St Louis Zoo is aworld class facility with an amazing array of wildlife for viewing. Many free museums areavailable throughout the area, as well. The Missouri Botanical Gardens include Japanese andChinese gardens, a tropical rain forest, walking trails and educational programs from homegardening to children’s activities. For the outdoorsman, fishing and hunting possibilities aboundin the lakes and forests of the region. In short, something for everyone is right here. 3
  • 4. 375th MEDICAL GROUPThe 375th Medical Group is a subordinate unit of the 375th Air Mobility Wing. Medicaloperations at Scott include a fully accredited outpatient ambulatory care facility with dental,medical and minor surgical services. The medical group supports a robust air evacuation missionthat transports patients from war zones and locations across the globe. Additionally, medicalreadiness responsibilities include training, equipping, and deploying medical response forces forwartime contingencies, peacetime disasters and other operational taskings.The medical staff includes specialists/clinics in internal medicine, pediatrics, obstetrics andgynecology, psychiatry, aerospace medicine, allergy, family practice, dermatology, andalternative medicine including acupuncture and chiropractic services. Supporting servicesinclude medical laboratory, radiology, pharmacy, physical therapy, occupational therapy,optometry, and bioenvironmental engineering. Additionally, the medical group may refer care tolocal civilian hospitals and practitioners to include the nationally ranked St Louis Children’sHospital and the prestigious Washington University and St Louis University Medical Systems. 375th DENTAL SQUADRONThe 375th Dental Squadron is located on Scott Air Force Base in the Scott Dental Clinic,dedicated in 1983 and remodeled in 2009. It is a fully modern, well-equipped facility with 35dental treatment rooms. The facility contains a conference room/library, dental instrumentprocessing center, prosthodontic laboratory, residency suite, supply area, and administrativeareas/offices. The residency includes six dedicated treatment rooms, resident prosthodonticmini-lab, and resident office/administrative area.In addition to the Scott Dental Clinic, the 375th Dental Squadron maintains an Oral andMaxillofacial Surgery Clinic in the main medical building. Our staff oral surgeon maintains abusy practice in which the residents rotate to learn moderate conscious sedation and exodontiatechniques. This is a unique aspect of Air Force AEGD residencies: upon successful completionof training, residents (general dentists) are credentialed to provide moderate conscious sedationin their practice of dentistry.Our AEGD teaching staff consists of general dentists and specialists who are all either boardcertified or board eligible (details in the Teaching Staff section of this brochure). 4
  • 5. RESIDENCY CURRICULUM PROGRAM GOALS AND OBJECTIVES AEGD RESIDENCY OVERVIEWThe 375th Dental Squadron sponsors a 12-month AEGD residency program accredited by theCommission on Dental Accreditation of the American Dental Association. The purpose of theresidency program is to provide a clinically oriented experience well beyond that of a dentalschool curriculum in the recognized dental specialties and related medical fields. Residentsspend the majority of their time providing comprehensive dental care to a broad spectrum ofpatients. The teaching staff consists of board certified or board eligible dentists representing arange of expertise as Air Force officers, clinicians, and educators. This highly qualified facultyis augmented by local and national consultants and guest lecturers from both the military andcivilian communities to provide a broad-based and diversified educational experience.Additionally, the Scott AEGD program has a Training Affiliation Agreement (TAA) with theSouthern Illinois University-Edwardsville (SIUE) School of Dental Medicine. This TAAenables our residents to have rotations in Pediatric/Special Care Dentistry and to providecommunity service for underserved children in the East St Louis area. OVERALL PROGRAM GOALS/OBJECTIVESThe goals and objectives for the Advanced Education in General Dentistry Residency are:Goal # 1. To support the mission of the United States Air Force Medical and DentalServices and to achieve and maintain accreditation by the American Dental Association.Objective #1a: To provide general dental officers capable of maintaining dental healthreadiness in diverse environments for the majority of active duty personnel in order to ensuretheir worldwide deployability.Achieved by: Resident clinical and didactic experience in the various phases of generaldentistry necessary to achieve and maintain sound oral health. Residents will experience anoperating room setting during Oral Surgery rotations to enhance war readiness training andprovide exposure to delivery of care in multiple settings. Residents also receive certification inhuman remains identification via a Forensic Dentistry course, to further augment capabilitiesassociated with a military practice. 5
  • 6. Objective #1b: To develop and maintain an advanced comprehensive education program ingeneral dentistry that complies with standards established by the American Dental Associationand required for program accreditation.Achieved by: Adherence to standards set forth by the American Dental Association forAdvanced Education in General Dentistry programs. Review of the program is accomplished asrequired, or at least annually, to ensure compliance.Goal #2. To enhance the resident’s competence and confidence in delivery of advancedcomprehensive dental care, to include employment of disease prevention and healthpromotion modalities that impact both individual patient and community health.Objective #2: To provide clinical and didactic experience in all aspects of general dentistry toeducate residents in modern dental practice, facilitate their provision of comprehensive dentalcare and encourage their participation in endeavors aimed at community oral healthenhancement.Achieved by: An emphasis is placed on clinical experience, with hands-on instruction anddirect feedback by trained staff, and the provision of a wide variety of patient treatmentrequirements to each resident. Clinical experience is reinforced with staff lectures, presentations,literature reviews and other didactic opportunities. Involvement with community healthenhancement programs is used to instill participatory awareness and demonstrate individualimpact on overall community health.Goal #3. To enhance the resident’s ability to make judgments in arriving at a diagnosisand treatment plan, changing a course of treatment and assessing post-treatment outcomes.Objective #3: To provide clinical experience and didactic information necessary to enable theresident to develop sound diagnostic rationales and implement logical sequential treatment withconfidence and ability to assess treatment outcomes.Achieved by: Formal and informal diagnosis and treatment planning seminars and treatmentplan reviews are provided. Oral pathology lectures, clinical pathology conferences, treatmentplanning exercises and physical assessment training are also utilized. Clinical assessment ofdiagnosis, treatment planning and treatment outcome is provided on a daily basis with facultyevaluations at appropriate times before and during patient care.Goal #4. To enhance the resident’s ability to accept responsibility for coordination of totalpatient dental care by successful interaction with other health care providers involved inthe treatment of the patient.Objective #4: To provide interaction with dental and medical specialists to enable the residentto develop confidence in coordinating total patient dental care, including care for patients havingsignificant medical problems, disabilities or other conditions that complicate treatment delivery.Achieved by: Independent assessment of patients with appropriate staff oversight isencouraged. Staff members review treatment plans with residents and may require consultationwith other dental/medical specialists. Residents coordinate all care for comprehensive carepatients, including dental/medical consultation. Oral Surgery rotations enable the resident tointerface directly with other medical specialty areas. 6
  • 7. Goal #5. To enhance the resident’s ability to supervise auxiliary personnel and manage adental practice in either a military or civilian setting.Objective #5: To provide experience in military practice management and instruction in civilianpractice management within the residency framework.Achieved by: Providing each resident the supervisory responsibility for management ofauxiliary personnel, patient appointments, supplies for dedicated treatment rooms, and otherrelated practice management areas is emphasized. Review of all patient records by staffmembers is required to evaluate and ensure proper record documentation. Faculty members withrecent experience in civilian practice or visiting private practitioners conduct practicemanagement seminars. Residents receive instruction in dental administration and directlyparticipate in activities pertaining to military practice management which augment overallpractice management training.Goal #6. To prepare residents to assume leadership roles through participation incontinuing dental education activities.Objective #6: To afford the resident experiences in presentations/public speaking and infocused reviews of the scientific literature to improve the resident’s ability to confidently speakbefore groups, support his/her position with scientifically-based findings, and develop skills foremploying technology-based tools in literature research.Achieved by: The program requires preparation and delivery of a table clinic at a regional ornational dental meeting and a formal lecture presentation on a dental or related topic to theprofessional staff. Preparation for both of these activities involves utilization of library writtenand computer-based resources as well as mastery of computer presentation graphics resources.Staff assistance is available and encouraged for these projects.Goal #7. To identify and instill the need to be a continuous student of dentistry in order tofacilitate clinical decision-making and base treatment approaches on ethical andscientific/evidence based foundations.Objective #7: To provide insight into the expanse of dental/medical literature and enable theresident to critically review scientific articles, recognize the necessity for continual advancementof dental education, and make clinical decisions based on scientific findings and demonstratedoutcomes.Achieved by: Expansion of the resident’s knowledge level beyond the standard dental educationexperience is achieved through routinely scheduled seminars and literature reviews. Residentsare responsible for review of literature topics in seminars and often present their reviews to otherresidents and departmental personnel. Additionally, training in ethical reasoning/decisionmaking and professional responsibility in academics, research, patient care, and practicemanagement will be provided. 7
  • 8. SCOTT AEGD-1 RESIDENT EVALUATION Competency and Proficiency StatementsDefinitions of Intended Training Outcomes:P (Proficient) - resident able to do this activity with repeated quality/efficient use of time.C (Competent) - resident able to perform with adequate knowledge, skill and judgment.E (Exposed) - resident participated in, assisted with, or watched this activity. COMPREHENSIVE CARE /TREATMENT PLANNING; OROFACIAL PAIN; AND FORENSIC DENTISTRYSCOPEResidents will receive instruction in the planning and delivery of treatment to patients withcomplex dental needs spanning various disciplines. An organized approach to problemidentification and appropriate sequencing of treatment will be emphasized which will allow thedentist to tailor treatment to each patient. Residents will receive instruction in the legalramifications of informed consent and will be required to document its accomplishment prior toprovision of treatment on frequent occasions. Residents will provide multidisciplinary treatmentto assigned patients and will review and share case progression at monthly seminars.INTENDED TRAINING OUTCOMESCOMPREHENSIVE CARE/ TREATMENT PLANNING1. Function as a patients primary oral health care provider. (P)2. Work with patients in a manner that is professional, builds rapport and confidence, respects patients’ rights and dignity, puts patients’ interests first, and maximizes patients’ satisfaction with dental care. (P)3. Integrate multiple disciplines into individualized, comprehensive, and sequenced treatment plans for patients with complex needs. Identify patients requiring referral to dental specialists for further evaluation and treatment. (P )4. Obtain informed consent for dental treatment by discussing with patients, or parents or guardians of patients, the following: findings; diagnoses; the risks, benefits, and process of various treatment options; patient responsibilities during and after treatment; and estimated fees and payment responsibilities. (P) 8
  • 9. OROFACIAL PAIN1. Based on the subjective history and clinical assessment, provide the diagnosis, contributing factors, management plan and treatment of uncomplicated orofacial pain. (ex. masticatory and cervical musculoskeletal disorders and TMJ dysfunction) (C)2. Manage complex orofacial pain cases.(C)DENTAL FORENSICS1. Perform postmortem examination of dental remains. (P)2. Provide postmortem forensic identification from dental remains. (C) ORAL MEDICINE AND SPECIAL CARE DENTISTRY alSCOPE (also see Pediatric/Special Care Dentistry Section)Throughout the residency year, a resident is trained to evaluate his/her patients systemic health.The patients health history is evaluated to determine relationships to oral health, and develop atreatment plan and protocol for patients with both simple and complex treatment needs andmedical conditions. This is accomplished by clinical experience with credentialed staff andlectures/courses presented by the Scott teaching staff and Air Force special consultants in OralPathology, Orofacial Pain, and Hospital Dentistry. See the Oral and Maxillofacial Section formore intended outcomes. A training affiliation agreement with SIUE School of Dental Medicineis also a means for special care patient treatment.INTENDED TRAINING OUTCOMES1. Perform dental evaluations, prepare appropriate responses to physicians’ consultation requests, develop treatment plans, and provide effective, appropriate management or treatment to dental outpatients with special needs and/or moderate medical problems. (C)2. Discuss a wide variety of systemic medical conditions and the implications for dental management of these patients. (C)3. To understand the classes and types of drugs that medically compromised patients are taking, and how these drugs are indicative of the disease processes affecting the patient. (C) OPERATIVE AND PREVENTIVE DENTISTRYSCOPETraining is provided through topic-oriented literature reviews, chairside instruction, and lecturesby the teaching staff. The clinical and didactic knowledge acquired in dental school by theresident is augmented with the latest concepts and trends in operative dentistry, preventivedentistry, and dental materials. Clinical experience is provided throughout the training year.INTENDED TRAINING OUTCOMES1. Restore single teeth with a wide range of direct placement materials and methods, with an emphasis on Minimally Invasive Dentistry techniques. (P)2. Restore single teeth with indirect placement materials and methods. (C) 9
  • 10. 3. Place restorations and perform techniques to enhance a patient’s facial esthetics. (P)4. Demonstrate an understanding of the etiology, progression, and prevention of dental caries to include the utilization of the Medical Model of Caries and applicable treatment protocols. (P) ENDODONTICSSCOPEThe endodontic component of the residency program consists of clinical and didactic phases,which emphasize diagnosis and treatment of pathoses of the dental pulp and periradicular tissues.The clinical phase of training includes experience in hand and rotary instrumentation. Thedidactic phase of the training consists of formal lectures from the clinical staff and literaturereviews.INTENDED TRAINING OUTCOMES1. Able to assess the pulpal and periodontal health of dental tissues using appropriate diagnostic procedures to include emergency management of endodontic pain and traumatic injuries. (P)2. Use adjunctive radiographic and alternative anesthetic techniques for clinical diagnosis and treatment. (P)3. Perform non-surgical anterior and posterior endodontic therapy to include re-treatment of failing endodontic cases. (C) PERIODONTICSSCOPETraining in this department emphasizes the prevention, diagnosis, and treatment of acute andchronic pathological conditions of the periodontal tissues. The didactic portion consists oflectures, pre-surgical lab, discussions and seminars. The staff assigns selected material from thedental literature and textbooks. Clinical experience is provided throughout the year in anintegrated format. Patients are assigned to provide the resident experience with a wide range oftreatment modalities. Pre-Surgical Pig Jaw Lab: Residents Learn Surgical Techniques, Suturing, Diode Laser Use, and Advanced Restorative Isolation Techniques 10
  • 11. INTENDED TRAINING OUTCOMES1. Demonstrate an understanding of the prevention, etiology, pathogenesis, diagnosis, prognosis, prognosis, treatment planning, and management of periodontal disease. (P)2. Provide non-surgical management of all forms of periodontal disease. (P)3. Provide surgical treatment of mild to moderate periodontitis. (P)4. Manage advanced periodontal disease. (C)5. Perform soft tissue surgery necessary to correct mucogingival defects. (C) Competency not required to graduate from program6. Perform minor pre-restorative/pre-prosthetic surgery. (C) PROSTHODONTICS: FIXED, REMOVABLE & IMPLANTSSCOPEThis portion of the residency program is aimed at increasing the skill and knowledge level in thefield of prosthodontics. The base of previously acquired clinical and didactic training is enlargedto give the resident a practical, effective approach to the treatment of routine as well as complexpatient problems. Didactics in prosthodontics include lectures, demonstrations, discussions, andreading assignments. A hands-on CEREC® CAD/CAM course, removable partial denturecourse and implant dentistry course are provided. Training in implantology is limited due to thescope of training in all specialties. Residents can expect to gain experience through assignedimplant patients, and our goal is to provide credentialing for single implant restorations.However, competency is not required for graduation. In summary, patients are treated throughoutthe year in an integrated format and are selected by the staff to provide a wide variety of clinicalexperiences for the resident. Implant Seminar and LabINTENDED TRAINING OUTCOMES1. Diagnose and treat patients with missing teeth requiring removable appliances. (C)2. Diagnose and treat patients with missing teeth requiring uncomplicated fixed restorations. (P)3. Manage patients requiring complex prosthodontic needs (P)4. Demonstrate an understanding of the principles of implant placement and restoration, including indications and limitations. (C) 11
  • 12. 5. Perform uncomplicated endosseous implant placement (E) and restoration (C) “Exposure only” required to graduate from program6. Provide follow-up care and preventive maintenance therapy for patients with implant- supported prostheses. (C)7. Diagnose and provide care to a patient’s occlusion. (C)8. Communicate case design with laboratory staff and evaluate resultant prosthesis. (P) ORTHODONTICSSCOPEOrthodontic training is presented through lectures, clinical demonstrations and treatment ofselected cases that fall within a general dentistry scope of care. Clinical and didactic knowledgeacquired in dental school is augmented with increased levels of training in diagnosis andtreatment of common problems. Didactic training is provided in lectures and seminars by thestaff orthodontist. Orthodontic clinical experiences will include minor tooth movement foradults.INTENDED TRAINING OUTCOMES1. Utilize diagnostic techniques for recognition of orthodontic cases treatable by the general dentist, including cephalometric analysi, arch length analysis, and formulation of treatment plans (C) Competency not required to graduate from program2. Treat and retain minor tooth movement cases (i.e., uprighting, extrusion, mild crowding diastema closure, minor cross-bite correction, and space problems). (C) Competency in minor tooth movement not required to graduate from program3. Design and deliver retention appliances following orthodontic care. (C) Clinical Photography Lab for Restorative, Surgical and Orthodontic Treatment PEDIATRIC DENTISTRY / SPECIAL CARE DENTISTRYSCOPETraining in pediatric dentistry is presented through lectures, demonstrations, and treatment ofselected cases. Knowledge acquired in dental school is augmented with training and diagnosis ofcommon conditions such as caries and the need for space maintenance. A visiting Air Forcepediatric dentist provides a pediatric dentistry course annually. Our residency also has a training 12
  • 13. affiliation with Southern Illinois University (Edwardsville) School of Dental Medicine, andresidents get training in pediatric/special care dentistry through a 6-9 day rotation either at theEast St Louis Community Center facility or the main SIUE campus in Alton, IL.INTENDED TRAINING OUTCOMES1. Develop treatment plans and provide effective/appropriate management or treatment (emergency and routine) for pediatric and special care patients, to include discussing a wide variety of systemic medical conditions (C) “Exposure” only required for graduation2. Treat/restore teeth of the primary dentition using a variety of materials (C) “Exposure” only required for graduation3. Perform uncomplicated surgical and pulpal therapy procedures on pediatric patients. (C) “Exposure” only required for graduation4. Use behavior management skills with the pediatric/special care patients, to include nitrous oxide anxiolysis/minimal sedation (at or >50% O2) (E) ORAL & MAXILLOFACIAL SURGERY, PATIENT ASSESSMENT, PHYSICAL DIAGNOSIS, PAIN & ANXIETY CONTROL Residents are Trained in Moderate Conscious Sedation and ExodontiaSCOPE (ORAL & MAXILLOFACIAL SURGERY)The intent of this training is to provide the resident with the knowledge and experience necessaryto evaluate, diagnose, and treat various diseases, injuries, and other pathological conditions ofthe oral cavity. Formal lectures, literature reviews, and seminars comprise the didactic portion ofthe OMFS rotation. Clinical experience is provided on an integrated basis throughout theacademic year in block rotations. Residents will perform a variety of surgical services, and willassist on more complex procedures. The interdependence of all of the health specialties isstressed through the use of appropriate consultations. 13
  • 14. SCOPE (PHYSICAL DIAGNOSIS AND PATIENT ASSESSMENT)Throughout the residency year, a resident is trained to evaluate his/her patients systemic health.The patients health history is reviewed to determine relationships to oral health, and to developappropriate treatment protocols for patients with complex medical conditions. This isaccomplished by lectures and courses presented by Air Force consultants in Oral Pathology,Orofacial Pain, and Hospital Dentistry.The residents are exposed to a variety of medically complex patients. Residents receive in depthtraining in patient evaluation during Oral Surgery didactic and clinical sessions in relation toModerate Conscious Sedation training as noted in the Pain and Anxiety Control Scope of Care.SCOPE (PAIN AND ANXIETY CONTROL)Didactic and clinical instruction will prepare residents to employ moderate conscious sedationduring patient treatment to achieve anxiety and pain control. Training will enable residents toselect appropriate sedation techniques and agents based upon patient factors and procedures to beaccomplished. While emphasis is placed on certification in intravenous techniques, certificationin inhalational (nitrous oxide) minimal sedation technique is also available to those residents.Additionally, residents will have an approximately one-week rotation in airway management atthe local VA facility via a TAA with the VA Hospital Anesthesia Department.INTENDED TRAINING OUTCOMESEXODONTICS/MINOR ORAL SURGERY1. Routine extraction of all indicated erupted teeth and retained root fragments. (P)2. Removal of uncomplicated soft tissue and bony impactions. (C) Competency in bony impactions is not required for graduation3. Perform routine intraoral biopsies and minor intraoral surgical procedures (C)4. Be familiar with arch bar placement and removal (E)5. Exposure to surgical procedures in the Operating Room setting. (E)PATIENT ASSESSMENT/PHYSICAL DIAGNOSIS1. Perform adequate patient assessment, to include chief complaint, history of present illness, past medical history, past surgical history, allergies, medications, social history, medical lab tests, diagnostic imaging and a focused physical examination.(P)2. Recognize major infections, trauma, and pathology of the oral and maxillofacial structures, and make the appropriate specialty referral. (C)3. Recognize and treat uncomplicated surgical postoperative complications (P)PAIN/ANXIETY CONTROL1. Achieve and maintain certification in BLS and ACLS. (P)2. Possess a thorough working knowledge of medical emergencies in the dental clinic, and their treatment. (C)3. Possess a thorough knowledge of anatomy, physiology, pharmacology and psychology associated with various pain and anxiety control methods. (C)4. Select and use the proper regimen for the control of pain and anxiety after adequate physical and psychological assessment of the patient. Methods include intravenous moderate conscious sedation and inhalation (nitrous oxide) or oral anxiolysis. (C) Competency in moderate conscious sedation technique is not required for graduation5. Prevent, recognize and manage complications related to the use and interaction of local anesthetics, systemic medications and agents used in the control of pain and anxiety. (C) 14
  • 15. PRACTICE MANAGEMENT AND ETHICS/JURISPRUDENCESCOPEThe practice management portion of residency training is aimed at enhancing the understandingof and providing experience in the management of an Air Force and civilian dental practice.Experience is acquired through the maintenance of appointment schedules, daily supervision ofdental technicians, hygienists, and other support personnel as well as various lectures performedby both military and private practitioners.INTENDED TRAINING OUTCOMES1. Use selected business systems in dental practice including scheduling, patient flow, record keeping, and comprehensive care systems. (C)2. Provide care with allied dental personnel and an inter-professional health care team, using accepted methods and standards.(C)3. Apply principles of jurisprudence and professional ethics in the practice of dentistry to include: Ethical reasoning/decision making and professional responsibility in academics, research, patient care, and practice management. Draw on a range of resources such as professional codes, regulatory law, and ethical theories to guide judgment and action for issues. (C)4. Evaluate information systems, information technology and alternative patient care and reimbursement systems in dental practice. (C) 15
  • 16. Scott AEGD Residency Program GENERAL INFORMATIONApplication ProceduresIndividuals are selected by Headquarters USAF in October of the preceding year. Students mayobtain information and application forms by contacting the nearest Air Force Medical RecruitingOfficer, accessing the USAF Dental Corps Utilization and Education websitehttp://airforcemedicine.afms.mil/usafdentalor by writing to: Health Professions Recruiting Medical Recruiting Division Headquarters Recruiting Service 550 D Street West, Suite 1 Randolph AFB TX 78148-4527Non-Discriminatory PolicyIt is the official policy of the United States Air Force that applicants for entry, including thosepursing admission into this advanced education program, will not be subject to discrimination onthe basis of gender, race, religion or other factors. However, applicants must meet minimumstandards required for performing duties as commissioned military officers, and must begraduates of accredited American Dental Schools.Career CommitmentsDental residents enter active duty and incur a service commitment commensurate with the lengthof the Health Professions Scholarship (HPSP) they received. The AEGD residency training yearis considered a "neutral" year in terms of service obligation. Upon completion of residencytraining, dental officers are typically reassigned to a new duty station for the completion of theirinitial commitment. Dental resident assignments are released about four months prior to thecompletion of the training program.Commissioned Officer Training School (COTS)All new dental officers attend this training course conducted at Maxwell AFB, Alabama.Approximately four weeks in duration, COTS is usually held in July, immediately prior to theresidency program start in August. Its purpose is to familiarize and orient incoming dentalofficers with their new duties and responsibilities and introduce them to military customs,courtesies, regulations and core values. Additionally, a two to three-day medical readinesscourse is also conducted in conjunction with this training. Residents report to their AEGDlocations following completion of COTS. See the Air Force Health Professions Recruiter fordetails. 16
  • 17. State Dental LicenseMilitary dentists on active duty are required to have a valid state license. The license does nothave to be in the state in which the officer is assigned. It is strongly recommended that residentschallenge a dental licensure examination prior to their residency. Dental officers arriving for theresidency program without a license will be required to take a licensure examination within oneyear of graduation from dental school. Failure to obtain a license in the first year of active dutyis grounds for administrative discharge from the Air Force or transfer to duties not involvingdentistry. Residents with state dental licenses are typically eligible for bonus pay near the startof residency training. As of 2010, this bonus is $10,000.Personal Appearance and ConductAs commissioned officers of the United States Air Force, residents must comply fully withstandards of appearance and conduct. Initial USAF orientation briefings inform newcomers ofthese requirements. Nothing less than exemplary bearing and behavior is acceptable.Withdrawal or Removal From TrainingWith the approval of the USAF Surgeon General, a resident may be withdrawn from training forany of the following reasons: individual request; prolonged absence from the program; less thansatisfactory performance or academic progress; disciplinary problems; other acts orcircumstances which warrant release from the program; or national emergencies. Air ForceInstruction (AFI) 41-117, Medical Service Officer Education, and AFI 36-3207, SeparatingCommissioned Officers, are guidances/instructions that apply to such withdrawal.Due Process PolicyIf needed to improve student performance, discretionary actions can be used by the programdirector and methods include limitations on educational activities, academic notice, and formalprobation. If these steps do not rectify the situation, an investigation of the situation iscompleted, and a recommendation may be made to terminate the students participation in theprogram. The student may request a faculty board review of the situation. Specific details offaculty board composition and due process procedures, including appeal procedures andreinstatement, can be found in detail in Air Force Instruction (AFI) 41-117, Medical ServiceOfficer Education. Scott AFB AEGD also has a local policy based upon this AFI.Certificate of Training and Board Certification StatusA Certificate of Residency Training will be presented to those residents who have satisfactorilycompleted all the requirements of the training program. This program alone does not qualify theresident for any dental specialty board examination leading to certification.However, after successful completion of this program and documented attendance at a minimumof 600 hours of continuing dental education course (of which 200 hours are participation),applications may be made to challenge the American Board of General Dentistry. Current AirForce policy stipulates that dental officers must complete a 2-Year Advanced Education inGeneral Dentistry program to be eligible for board certification pay. 17
  • 18. Other Training CertificationCertificates of Training in Intravenous Moderate Conscious Sedation, Nitrous Oxide MinimalSedation/Anxiolysis, and Forensic Dentistry Identification may be awarded provided specificcriteria are fulfilled and competency/proficiency is demonstrated.Specialty Training Opportunities (After AEGD 1 Year Program)Formal postgraduate residencies are available in endodontics, general dentistry, oral andmaxillofacial surgery, oral and maxillofacial pathology, orthodontics, pediatric dentistry,periodontics, and prosthodontics. An AEGD provides a great exposure to the various specialties,and may help the resident be more certain regarding their application to a particular specialty. Ingeneral, an active duty service commitment equal to the length of the residency program isincurred following formal training; but some specialties may vary. Graduates are obliged tochallenge their respective specialty certifying boards. Air Force specialty programs arenationally recognized for their scholastic excellence and graduates consistently perform well onboard certification examinations. Dental officers who achieve diplomate status in generaldentistry or a traditional specialty are presently compensated with board certification pay.Resident Education FunctionThe Resident Education Function (REF) is chaired by the Director, Dental Resident Educationand includes members of the teaching staff and the Chief Resident as a rotating member. Itprovides overall program guidance and ensures that program objectives are being met andresidents performance meets minimum standards. It also reviews program goals and objectivesin order to ensure compliance with accreditation standards set forth by the Commission onDental Accreditation of the American Dental Association. The function meets monthly.Primary responsibilities of the function include development and review of curriculum plans andoutcomes assessment tools, evaluation of resident performance, education facility/equipmentassessment and improvement, support staff assessment and improvement and evaluation ofresident input through the Chief Resident.Library FacilitiesThe 375th Dental Squadron maintains a library for use by the residents and staff. An on-linemedical literature index is being made available through the Air Force’s Virtual Library online.Through inter-library agreements with the Wilford Hall Medical Center Library, the Scott AFBMain Library, and other Air Force medical libraries, virtually any literature source can beaccessed. SIUE School of Dentistry, is also available as a possible resource. The ADA providesexcellent library support and has a toll-free number to order copies of journal articles at anominal fee.Orientation / In-ProcessingPrior to the beginning of formal training activities, an orientation program is provided toacquaint the residents with their new associates and environment. Residents will also be orientedto the military hospital environment and given an overview of the residency program. Time willbe allowed for the residents to process into the 375th Medical Group and base, arrange fordelivery of household goods, and satisfy other military requirements. Since minimal time will be 18
  • 19. allotted for making initial housing arrangements, residents are encouraged to visit the Scott Air Force Base area prior to reporting to Commissioned Officer Training School. Typical Resident Weekly Schedule The weekly schedule represented below depicts a typical residency training week at the Scott AEGD Residency. At various times, special events and opportunities may necessitate changes to the schedule. Although adherence to this schedule is encouraged for patient treatment, flexibility does allow occasional deviation when special circumstances warrant. Our clinic uses a “Flex Schedule”, which means we average a 9-10 hour work day, but residents get ½ day off or more every other Friday. Mission demands, residency requirements, or the discretion of the Dental Squadron Commander can alter time off occasionally. Squadron physical fitness times are included twice per week. MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY Endo Ortho Roll Call @ 7:10 Clinic Clinic (Monthly)0700 Oper Periodontics Prostho Lectures Monthly (2nd wk) ~ Clinic Clinic Clinic - Implant Board &1100 - Literature Review Seminars - Oral Medicine - Tx Plan Seminar - Patient Care Conf Oper Endo Prostho Clinic Clinic Operative Perio Oper1200 Clinic Clinic Clinic Clinic ~ or1700 ½ Day off (alternating wks) Fitness Time Clinic Meetings Fitness Time Clinic Meetings 4:00 4:00 4:00 4:00 Two 2-wk block rotations in Oral Surgery initially, then up to 4 wks more (based on staff recommendation and resident input) Pediatric/Special Care rotations at SIUE School of Dental Medicine facilities for 6 days Orthodontic rotation will be once per month Resident Presentations During the training year, each resident prepares a lecture presentation of 30-40 minutes in length that is suitable as a continuing education presentation at their next duty station. Residents will also present a table clinic at a local and national dental meeting in the spring. Staff mentors are assigned to provide guidance on these and other projects required during the academic year. Residents document a major portion of their clinical cases through the use of intraoral photography. While 19
  • 20. purchase of intraoral camera equipment is encouraged, the residency program does provide camerason a loan basis for training.Dental Officer of the Day (DOD) – On Call DutiesDental residents will perform Dental Officer of the Day (DOD) duties on a rotating basis with othermembers of the dental staff. This duty involves being available by for dental emergencies afternormal duty hours and on weekends. Teaching staff back-up assistance is readily available to therotating officers. The DOD is called by the Medical Answering Service if needed (DOD cell phoneprovided). After initial telephone triage, the resident in concert with the staffer will make a decisionas to the level of urgency and will report to the clinic for patient treatment, if indicated. The residentcan expect to be on call one week every two months. Typically, the average call involves 1-2patients for the week.Leave/IllnessDental residents will be permitted to take two weeks of leave during the training program during adesignated December-January holiday period. Emergency leave, as defined by AFI 36-303, may betaken at any time. Special requests for other approved absences will be considered on a limited case-by-case basis. In the event of illness, the resident will seek medical care through the medical clinicand ensure that the program director is notified so that arrangements can be made for previouslyappointed patients.Seminars, Lectures, and Literature ReviewsFormal lectures, seminars, and literature reviews will be conducted by the various dental specialtydepartments. These presentations will be scheduled on a weekly basis. All residents are required toattend and participate.Dental Staff MeetingsResidents will be required to attend dental staff meetings, as directed by the 375th Dental Squadroncommander or the AEGD program director.Professional MembershipMembership in the American Dental Association (ADA) is highly recommended, but not required.Residents qualify for the ADA student/resident membership dues. In addition, residents are highlyencouraged to become members of the Academy of General Dentistry (AGD). Members can receive150 hours of participation continuing education credit toward the AGD Fellowship Award followingcompletion of the AEGD residency.Resident EvaluationResident performance evaluations will be completed at the end of each training period (threeevaluations) by each specialty area for each resident. These reports will be submitted to the programdirector, who compiles the information and formally presents it to each resident on an individualbasis. These documents will be filed in the residents local training record. Following completion ofthe residency program, a formal training report will be written, which becomes a part of the 20
  • 21. residents permanent military record. This report is equivalent to the annual Officer PerformanceReport (OPR) and can impact on a residents future military career and advanced education pursuits.Resident CritiquesTo aid in evaluating the effectiveness of the various components of the educational program, eachresident will submit a written critique on the training program periodically. This qualityimprovement tool provides valuable and constructive criticism. It is designed to ensure that residentneeds are being met in addition to facilitating communication between the residents and the teachingstaff. 2011-2012 AEGD Residency Teaching StaffProgram DirectorCol Brent S. McClenny, USAF, DCDegree: DMD, University of Alabama School of DentistryTraining: Certificate, AEGD 2-Year Program, Keesler Medical Center, Keesler AFB, MSBoard Status: Diplomate, Federal Services Board of General Dentistry and American Board of General DentistryDeputy Program DirectorLt Col Bryce G. Whisler III, USAF, DCDegree: DDS, Baylor College of DentistryTraining: Certificate, AEGD 2-Yr Program, Wilford Hall Medical Center, Lackland AFB, TXBoard Status: Diplomate, American Board of General DentistryChief of EndodonticsCol Kenneth J. Boone, USAF, DCDegree: DDS, Louisiana State University School of DentistryTraining: Certificate in Endodontics, Wilford Hall Medical Center, Lackland AFB, TXBoard Status: Board EligibleChief of OrthodonticsCol Brent E. Nikolaus, USAF, DCDegree: DDS, University of Tennessee Health Sciences CenterTraining: Certificate in Orthodontics, St. Louis UniversityBoard Status: Board Eligible 21
  • 22. Chief of PeriodonticsCol Lynn F. Haines, USAF, DCDegree: DDS, The Ohio State University College of DentistryTraining: Certificate in Periodontics, University of Maryland at BaltimoreBoard Status: Diplomate, American Board of PeriodontologyPeriodontics Training OfficerMaj Matthew T. Raper, Maj, USAF, DCDegree: DDS, The Ohio State University College of DentistryTraining: Certificate in Periodontics, Wilford Hall Medical Center, Lackland AFB, TXBoard Status: Diplomate, American Board of PeriodontologyChief of ProsthodonticsCol Randall C. Duncan, USAF, DCDegree: DDS, University of Texas at San Antonio Dental School MS, University of Texas Graduate School of Biomedical SciencesTraining: Prosthodontics Certificate, University of Texas Dental School at San AntonioBoard Status: Diplomate, American Board of ProsthodonticsProsthodontics Training OfficerLt Col David F. Pierson, USAF, DCDegree: DDS, University of Southern Illinois Edwardsville School of Dental MedicineTraining: Prosthodontics Certificate - Wilford Hall Medical Center, Lackland AFB, TexasBoard Status: Board EligibleChief of Oral and Maxillofacial SurgeryMaj Curtis J. Hayes, USAF, DCDegree: DDS, University of Colorado School of DentistryTraining: Certificate in Oral & Maxillofacial Surgery, Wilford Hall Medical Center, Lackland AFB, TXBoard Status: Diplomate, American Board of Oral and Maxillofacial Surgery 22
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