DHY 170 - Principles of Dental Hygiene

1. Demonstrate the ability to log on to a DMACC computer, access and utilize information on the DMACC network, access the Internet and search the Internet for information
2. Describe the tools and demonstrate techniques for self care biofilm remov­al
   1. List tools needed for a personal oral care program
   2. State the purpose and demonstrate the use of a disclosing agent
   3. Describe the preferred design of a toothbrush
   4. Relate toothbrushing instructions with regard to: grasp of brush; sequence of brushing; count system vs. clock system for amount of brushing
   5. State the purpose for the Bass method of toothbrushing
   6. Describe the type of toothbrush to be used with the Bass technique
   7. Describe and demonstrate the Bass technique with regard to; bristle placement; amount of pressure; motion
   8. Describe and demonstrate the rolling stroke technique with regard to bristle placement and motion.
   9. State the purpose for the rolling stroke technique
   10. State the benefit derived from using a fluoride dentifrice
   11. State the purpose for tongue brushing
   12. Outline and demonstrate the procedure for tongue brushing
   13. Name the types of floss
   14. Relate and demonstrate the techniques for utilizing dental floss
   15. State the purpose of re-examining the mouth after toothbrushing and flossing
   16. State when the toothbrush should be replaced
3. Discuss professional responsibilities of the dental hygienist and dental hygiene services for patient care
   1. Adhere to DMACC and Dental Hygiene Program policies
   2. Define “the dental hygienist.”
   3. Name the three basic categories of service performed by the dental hygienist
   4. Differentiate between primary and secondary prevention
   5. Define the term “dental hygiene care.”
   6. Identify the relationship between educational and clinical dental hygiene services
   7. Recall the name of the founder of dental hygiene and the year of the first course study
   8. Recognize the original concept of dental hygiene services and how this concept expanded
   9. Discuss some modern definitions and philosophies of dental hy­giene
   10. Define a paradigm and distinguish it from a conceptual model
   11. Compare Maslow’s hierarchy of needs theory with nursing’s human needs theory
   12. Identify and define the four central paradigm concepts for the dental hygiene human needs conceptual model
   13. Define the human needs related to dental hygiene care and describe their implications for dental hygienists
   14. For each of the identified human needs, plan dental hygiene intervention to help meet the deficiency.
   15. Discuss the relationship of the human need theory to the dental hygiene process of care.
   16. Discuss: planning dental hygience care, the role of the dental hygienist in patient care and modifications in dental hygiene care.
   17. Identify the special practice areas of dentistry and settings for the dental hygienist
   18. Review factors to teach the patient
4. Recall the components of a client’s personal, dental, and medical history that might influence dental treatment needs.
   1. Systematically collect, analyze, investigate, and record information from a client’s personal, dental and health histories.
   2. Assess health status and determine risks, disease control level and likihood of a medical emergency.
   3. Manage client and practitioner risks.
   4. Identify need for medical consultation.
   5. Collaborate with other healthcare practitioners to develop and individualized dental hygiene care plan.
   6. Recognize implications of client health status for dental hygiene care.
   7. State the specific objective of patient examination as part of diagnostic work-up.
   8. Define: sign and symptom.
   9. Distinguish between: subjective and objective symptoms, and general and pathognomic sysmptoms.
   10. Differentiate among the five types of examinations
   11. Identify the following general methods of examinations: visual; palpation; instrumentation; percussion; and auscultation.
   12. Name three general methods used to obtain a patient history
   13. Outline three alternative appointment procedures for obtaining the history
   14. Recount characteristics of an adequate patient history form
   15. Relate factors included in introducing the history to the patient
   16. Discuss introduction of the form to the patient and limitations of a history
   17. Describe a questionnaire and three categories of questions to be included
   18. Describe the interview with regard to: participants; setting; communication; attitude, and use of a structured form.
   19. Identify advantages and disadvantages for both the questionnaire and interview methods of patient history preparation
   20. Name the three sections to be included in a patient history and give at least three examples of items within each section
   21. State when and for what purpose the patient history should be reviewed
   22. Name the four categories of conditions for immediate evaluation of the patient history and items to be considered for each
   23. Identify conditions which are indications for prophylactic pre­medication
   24. Recall the standard and special regimens for prophylactic antibiotic therapy
   25. Adhere to Federal and State Health Insurance Portability & Accountability Act      (HIPAA) privacy policies and procedures
   26. Review factor to teach the patient
5. Recognize the objectives of effective health communication.
   1. Identify the types of communication relevant to the dental encoun­ter
   2. Recall the skills and attributes necessary for effective communication.
   3. Recognize categories of words that should be avoided in dental communication
   4. Demonstrate the ability to use “I” statements to provide effective feedback
   5. Discuss techniques used to influence behavior and perception
   6. Demonstrate the ability to formulate a variety of questions that maximize freedom of response
   7. Demonstrate the ability to use the components of reflective listening effectively
   8. Identify the major function of nonverbal communication
   9. Recall ways in which one may attend to the nonverbal behavior of themselves and the patient
6. Recall the application of attending physically in establishing patient relations
   1. List the five steps of attending physically
   2. Explain the importance of attending physically in establishing good patient relationships
   3. Consider factors when making alterations in physical attending behaviors
7. Apply the correct positioning of the patient and operator to facilitate proper instrumentation, comfort, and efficiency
   1. List steps to be taken in preparation for your patient
   2. Present considerations for reception of your patient
   3. State eight advantages of the preferred working position
   4. Outline the considerations in basic positioning for the seated clini­cian
   5. Identify the application of principles of good body mechanics for the standing clinician
   6. Name four commonly used body positions for the patient
   7. Outline the characteristics and sequence of procedures for effective dental chair adjustment
   8. Identify adjustments in chair positions for a small child
   9. Describe correct adjustment of the dental light
   10. List three objectives of working positions
   11. Review technical hints
   12. Review factors to teach the patient
8. Discuss and demonstrate application of principles and methods of preven­tion of disease transmission
   1. State the objective in dental hygiene concerning prevention of disease transmission
   2. Identify the two responsibilities of the dental team in this area
   3. Discuss the implications when pathogenic or potentially pathogenic organisms are present in the oral cavity of each patient
   4. Define terms related to transfer of infectious material
   5. Recall transmission of airborne infection with regard to: dust-borne organisms; aerosols and splatter; and means for prevention of transmission.
   6. Define “autogenous infection” and recognize: sources; factors that alter normal defenses, and prevention.
   7. Review pathogens transmissible by way of the oral cavity
   8. Review key questions, limitations, and use of the medical history as related to prevention of disease transmission
   9. Recognize an immunization program for the hygienist in private practice
   10. Discuss design and care of the most desirable clinical attire for the clinician.
   11. Identify use of the face mask and efficiency; indications and clinical application.
   12. Discuss use of protective eyeglasses and occurrence of eye infections and injuries; indications; features of acceptable glasses, and clinical applications.
   13. State how cross-infection from hands can be prevented.
   14. Identify the two times thorough handwashing is emphasized
   15. Define; resident bacteria; transient bacteria.
   16. State the rationale for and purposes of an effective handwashing procedure
   17. Describe proper hand care
   18. Outline appropriate times and steps for application of the short-scrub stroke - count procedure; and hand sanitation procedure.
   19. List indications for types and use of gloves
   20. Review hints and factors to teach the patient.
   21. State when procedures for prevention of disease transmission should take place
   22. Discuss treatment features considered in infection control
   23. Define the following terms: sterilization, disinfection, sanitization, surface disinfection, contamination, aseptic technique, sterile - clean technique
   24. Outline the steps and considerations in preparation of instruments for sterilization and their: handling, manual cleaning, ultrasonic cleaning, care of the unit, packaging
   25. Identify the acceptable methods of sterilization and their: uses, principles of action, preparation of materials, operation, advantages and disadvantages
   26. Identify methods of disinfection and their uses, principles of action, preparation of materials, operation, advantages and disadvantages
   27. Discuss proper care of dental unit water lines
   28. Outline procedures to prepare for an appointment and care of sterile instruments
   29. Recognize patient preparation with regard to: reduction of baceria in the oral cavity, appropriate situations for application of a surface disinfectant
   30. Review: summary of procedures for prevention of disease transmission, maximum precautions (as for hepatitis B carrier), technical hints, factors to teach the patient
9. Recount the regulations established by the Occupational Safety and Health Administration (OSHA), and guidelines from the Center for Disease Control and apply to infection control in dentistry
10. Identify infectious diseases of oral transmission
11. Explain that vital signs contribute to the proper evaluation of a patient in conjunction with the complete medical history
    1. Name the four vital signs of the body
    2. Relate the significance of recording normal and/or abnormal vital signs
    3. State the two general times the temperature of the patient should be taken
    4. Identify the correct Fahrenheit values for: normal body temperature, fever, hyperthermia, hypothermia
    5. Recall four factors which influence body temperature
    6. Recognize three methods for determining body temperature
    7. Name four indications for use of the oral thermometer
    8. Identify two types of thermometers
    9. Compare the three readings
    10. Outline the procedure for determining body temperature with regard to: necessary equipment, patient preparation, thermometer preparation, temperature taking, reading and recording, and care of the thermometer
    11. Relate proper care of the patient with a temperature elevation
    12. Define the pulse and pulse rate.
    13. List three factors, in addition to rate, to be evaluated during taking of the pulse
    14. State the normal pulse rate for: children, adults
    15. Define: tachycardia and bradycardia, and give five causes for each condition.
    16. Outline the procedure for pulse determination with regard to: site, patient preparation, time, and recording
    17. Define “a respiration.”
    18. State the normal respiratory rate for: children and adults.
    19. Recognize abnormal respiration rates for the adult
    20. Identify three influencing factors for: increased respiration rate, and decreased respiration rate.
    21. Outline the procedure for observing respiration with regard to: when performed, four factors to be evaluated, patient position and recording
    22. Define: blood pressure, systolic pressure, diastolic pressure, pulse pressure, and blood pressure classifications.
    23. Identify the three factors upon which blood pressure depends
    24. Identify four influencing factors of: increased blood pressure, and decreased blood pressure.
    25. Define: hypertension and its readings, and hypotension and its readings.
    26. Name and describe the necessary equipment for blood pressure determination
    27. Outline the procedure for blood pressure determination with regard to: patient preparation, application of cuff, placing stethoscope, inflation of cuff, deflation of cuff, recording of systolic and diastolic readings, and appropriate notification of unusual findings.
    28. Review technical hints and factors to teach the patient
12. Identify aspects of the Iowa Right to Understand Law that apply to the dental practice setting
    1. State the purpose of the Iowa Right to Understand Law
    2. Recognize the responsibilities of the: manufacturers, distributors, and/or importers, and employers.
    3. Identify the rights of the: employees and Bureau of Labor
13. Summarize the “Protocol for the Prevention of Transmission and the Management of HIV/AIDS at DMACC and its Clinical Sites.”
14. Identify and/or demonstrate the fundamental instrumentation techniques necessary for adaptation and activation of the working end to the tooth
    1. Classify instruments by purpose and use.
    2. Identify information provided on the instrument handle
    3. Name the three major parts of a dental instrument
    4. Define instrument balance
    5. Relate the functions of a proper instrument grasp
    6. State the two types of basic instrument grasps you will be using
    7. Define fulcrum
    8. List three characteristics of the preferred finger rest
    9. Identify variations of finger rest with regard to: problems and general categories
    10. State and demonstrate the proper pressure that should be applied with the fulcrum and adverse effects of excess pressure
    11. Define adaptation
    12. Identify characteristics of a well-adapted instrument
    13. Define: angulation, lateral pressure, and a stroke
    14. Describe and apply the motion, directions, and length in which a stroke may be ap­plied
    15. Relate factors which influence stroke selection
    16. State effects and components of adequate vision and accessibility
    17. Identify the necessity for a thorough procedure and adverse effects of roughness during instrumentation
15. Discuss the extraoral and intraoral examination
    1. List the objectives for conducting a thorough patient examination
    2. Discuss the current concept of patient care within our profession
    3. Relate steps to be taken in preparation for the examination
    4. Name and describe the 2 primary methods of examination for the extra- and intraoral inspection
    5. Recall advantages of a systematic sequence of examination
    6. Outline the sequence of steps for the oral cancer examination procedures
    7. Recall all information to include when describing a lesion
    8. State physical characteristics to be recorded
    9. Recall the three morphologic categories of lesions plus characteris­tics and terminology for each
    10. Define other descriptive terms
    11. State the principal method for control of oral cancer
    12. Identify the most common sites for oral cancer
    13. Recognize the basic forms of early cancer
    14. Name the two procedures for follow up of a suspicious lesion
    15. Define and list the indications for a biopsy
    16. Define and list indications and limitations of the cytological smear
    17. Recognize child abuse with regard to: general signs, oral signs, and parental attitude.
    18. Discuss the responsibility of professional personnel in reporting child abuse
    19. Recall definitions associated with substance abuse
    20. Identify general categories of substances of abuse
    21. Relate factors in recognition of drug abusers: general signs, and oral characteristics
    22. Discuss appointment factors for this type of patient
    23. Review technical hints and factors to teach the patient
16. Specify methods, instruments, and procedures for supra- and subgingival examination and evaluation
    1. Identify the two methods of examination and the instruments to be used
    2. State when, in the appointment sequence, the explorer and probe are applied
    3. Describe the various styles of periodontal probes and their uses.
    4. Describe the mouth mirror, its purposes and uses, techniques for use, and proper care
    5. Recall purposes for application of air
    6. Describe the compressed air syringe and the technique and precau­tions for use
    7. List the general purposes and uses of explorers
    8. Describe the basic parts of the explorer
    9. Differentiate the types of explorers and their specific functions
    10. Distinguish the three basic tactile sensations when exploring
    11. Identify types of stimuli used to detect irregularities
    12. Describe procedures for supragingival examination: use of vision, facial and lingual surfaces, and proximal surfaces.
    13. Relate the steps in proper technique for subgingival evaluation with the explorer
    14. Name the terms for recording findings
17. Describe and recognize characteristics of normal healthy gingiva and changes which occur in disease
    1. Review anatomy of the gingiva, periodontium, and related struc­tures
    2. Distinguish between gingival and periodontal disease
    3. Recall descriptive terminology with regard to severity and distribu­tion of disease
    4. Discuss importance of early recognition of tissue change
    5. Compare clinical signs of health in gingiva and changes which occur in disease with regard to: color, size, position, contour or shape (gingival margin or papillae; consistency, surface texture, bleeding and exudate.
    6. Recognize normal gingival characteristics for children with: primary dentition, mixed dentition
    7. Identify gingival changes in disease which may occur in children or young adults
    8. Recognize the characteristics of normal healthy gingiva following periodontal treatment
    9. Review factors to teach the patient
18. Name, describe, and state the function of instruments utilized for removal of dental deposits
    1. State the first objective of dental hygiene treatments
    2. Discuss the term “oral prophylaxis” as a preventive periodontal treatment procedure
    3. List nine general objectives of dental hygiene instrumentation
    4. State the purpose of instrumentation
    5. Identify the cutting edges, purposes and uses, and application of: curets (area specific and universal), sickle scalers
    6. Recognize six basic qualities of all instruments which influence their usefulness
    7. Give eight reasons for maintaining sharp instruments
    8. Define scaling and root planing
    9. List the effects of complete removal of calculus and root planning
    10. Outline the procedure to prepare for instrumentation
    11. Define “bacteremia” and relate its occurrence
    12. Identify two precautions for preventing bacteremia
    13. Describe the procedures or techniques used in examina­tion for supragingival calculus
    14. Describe the procedures or additional techniques used in examina­tion for subgingival calculus
    15. Recall advantages of using a systematic procedure of instrumen­ta­tion
    16. Outline the overall use and system of individual instruments in the clinical procedure for scaling
    17. Sequence and describe the fundamental steps in instrument applica­tion for calculus removal
    18. Recognize factors which make subgingival calculus removal more complicated than supragingival calculus removal
    19. Give several reasons why the curet should be used for subgingival scal­ing and root planing
    20. Describe variations in the steps for removing subgingival calcu­lus
    21. Name three differences between root planing and subgingival scaling
    22. Describe the strokes used in root planing
    23. Discuss the importance of irrigating sulci or pockets
    24. Trace the healing time and process following complete calculus removal
    25. Relate the effect of: partial scaling, scaling tooth surface, and instrumentation within the pocket
    26. State the principal objective in the location of a broken instrument tip
    27. Outline the seven steps in the correct procedure to follow when an instrument blade tip breaks in the patient’s mouth
    28. Recall methods of enhancing patient comfort related to
    29. List four techniques which may be used to maintain a clear field
    30. Review factors to teach the patient
19. Discuss disease development and contributing factors in gingival and periodontal tissues
    1. Define gingivitis and periodontal disease.
    2. Define a pocket
    3. Recall the parts of a pocket
    4. Name the two types of pockets and the basis of their classifica­tions
    5. Define and identify the characteristics of: a gingival pocket, and periodontal pockets
    6. Outline the sequence of steps in the development of a: gingival pocket and periodontal disease
    7. Identify the tooth surface pocket wall with regard to: tooth structure involved, substances found within the pocket, tooth surface changes which may occur as a result of pocket formation, methods and instruments for detection of surface irregularities, causes of surface roughness for enamel, CEJ, cemental surface, cementum.
    8. Define furcation involvement and relate clinical significance of observations
    9. Define mucogingival involvement and recall the significance of attached gingiva and clinical observations
    10. Describe the self-cleansing mechanism
    11. Distinguish between: complicating factors to disease development, and local or systemic factors.
    12. Identify complicating factors in the following areas: dental, gingival, and other
    13. State functions of saliva
    14. Define xerostomia and its: causes,effects, and treatment
    15. Review factors to teach the patient
20. Identify the derivation, composition, distribution, occurrence, clinical appearance and significance to oral health of soft deposits
    1. Name the four “soft deposits.”
    2. Define: acquired pellicle, dental plaque, and materia alba
    3. Outline the development of acquired pellicle with regard to: formation, and source of materials
    4. Distinguish between the three types of pellicle
    5. Relate the significance of acquired pellicle
    6. Outline the sequence and composition in formation on plaque
    7. Discuss distribution of plaque
    8. Identify factors influencing plaque accumulation
    9. State two factors responsible for the size and diversity of the oral microflora
    10. Define opportunistic pathogens
    11. Identify sites available for colonization by oral bacteria
    12. Discuss the dynamic nature of the oral cavity with regard to
    13. Relate aspects of gingival sulcus environment to microbial colonization
    14. Name the beneficial and detrimental effects of normal microflora
    15. Identify criteria for colonization of the mouth and related factors for each
    16. Discuss “bacterial succession.”
    17. List mechanisms that limit colonization of the mouth and factors related to each.
    18. Trace the development of the oral microbiota during stages of the life cycle: infancy, childhood and adolescence, and adulthood
    19. Discuss colonization of oral surfaces: soft tissues, smooth tooth surfaces, and retentive areas (occlusal pits and fissures, interproximal areas and gingival sulci).
    20. Relate the composition of plaque
    21. Describe and contrast the characteristics of dental plaque and materia alba with regard to clinical appearance, distribution, occurrence, removal, recurrence, composition and structure, source, attachment, and significance to oral health.
    22. Identify methods for detecting dental plaque
    23. Compare supra- and submarginal dental plaque
    24. Discuss the significance of bacterial plaque and its pathogenic effects
    25. Explain the equation for dental caries initiation including essential and contributing factors
    26. Discuss the relationship between bacterial plaque and periodontal disease
    27. Relate the effect of diet on dental plaque with regard to: food intake and texture.
    28. Discuss food debris with regard to: location and impaction, and effects
    29. Review technical hints
    30. Review factors to teach the patient
21. Compare the characteristics and techniques of examination for supra- and submarginal calculus
    1. Define “dental calculus.”
    2. State the purpose for removal of calculus
    3. Name the two classes of dental calculus
    4. Differentiate clinical characteristics of supra-and subgingival calcu­lus with regard to: location, color, shape, consistency and texture, quality, and distribution of teeth.
    5. Describe the occurrence of calculus
    6. List two techniques of examination for supragingival calculus
    7. List three techniques of examination and samples of conditions which indicate presence of subgingival calculus
22. Relate the formation, structure, and significance of dental calculus
    1. Outline the sequence of calculus formation
    2. Discuss formation time of dental calculus
    3. Describe the structure of calculus
    4. Identify three general modes of attachment of calculus
    5. Recognize the composition of calculus
    6. Discuss the significance of dental calculus with regard to: plaque, pocket, plaque control techniques and scaling, permeability, and drainage from diseased pocket.
    7. State the two effective measures for prevention and control of calcu­lus
    8. Review factors to teach the patient
23. Recognize the importance of instrument design as it applies to maintaining a sharp cutting edge and the original shape of the instrument
    1. List two objectives for techniques of instrument sharpening
    2. Identify sharpening stones with regard to: materials, categories and sterilization.
    3. Recognize four characteristics of facilities for sharpening
    4. Define a “cutting edge”.
    5. Explain the role of the sharpening stone in the dynamics of sharp­ening
    6. Describe three types of tests to conduct for examination of instru­ment sharpness
    7. Discuss care of instruments when sharpening before sterilization
    8. State when instruments should be sharpened
    9. Recall techniques to be applied after sharpening
    10. When sharpening curets and sickle scalers, identify: surfaces to be sharpened, and most desirable sharpening procedure.
    11. Outline the steps, pressure, and strokes in sharpening lateral and facial surfaces of your sickle and curet scalers
    12. Describe the techniques for sharpening the hoe
    13. Outline procedures for care and storage of the: ceramic stone and mounted stones.
    14. Declare when to discard an instrument
    15. Review technical hints
24. Recount the etiology, composition, distribution, and clinical appearance of extrinsic and intrinsic stains
    1. State the two discolorations of the teeth which are the concern of the dental hygienist
    2. Recall the significance of stains
    3. Define: extrinsic & intrinsic, exogenous and endogenous.
    4. Relate techniques for the identification and removal of stains: occurring directly on the tooth surface, and incorporated within tooth deposits.
    5. Identify clinical appearance, distribution on tooth surfaces, composition, occurrence, and etiology of the following extrinsic stains: yellow, green, black line, tobacco, brown pellicle and other brown stains, orange and red, and metallic stains.
    6. Recognize intrinsic stains associated with: pulpless teeth, tetracycline, restorative metals, endodontic therapy, hereditary amelogenesis and dentinogenesis imperfecta, enamel hypoplasia and dental fluorosis
    7. Recognize five examples of exogenous intrinsic stains
    8. Recall technical hints for stain removal
    9. Review factors to teach the patient regarding tooth staining