Pediatric Dentistry Rotation

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Dr. Wood and the Pediatric department have organized the rotation to be very efficient and orderly.  You,  as  a  student  doctor,  should  come  to  the  pediatric  clinic  equally  as  prepared  and  organized.  Organization  and  a  little  studying  (reviewing)  before  each  day  will  benefit  your  experience tremendously. Be sure to review the Orientation handout you receive the first day of this rotation.  Every  day,  each  student  doctor  works  under  the  supervision  of  a  Dental  Auxiliary  Utilization  (DAU) assistant and a Pediatric Specialist. The faculty and staff are awesome and will teach you a lot. Don’t be scared, have fun, smile, and learn something new each day.

Overview of Rotation
The first two rotations are two weeks long, alternating morning and afternoon clinic sessions. The third rotation is one week long and includes both the morning and afternoon session each day. (No seeing “main clinic” patients during the days, so consider night clinics for your regular patients if possible). The first couple of days, during your first rotation, have been designed to gradually introduce you to the ways of the pediatric clinic and make you comfortable to see your young patients.

The pediatric clinic stresses student preparedness prior to the patient appointment. What can you do to be prepared?

  • Review any PD240 topics that are relating to the treatment you are expected to do for your patient.
  • Review the patient record completely (read their full history at the clinic), do not just look at previous visit
  • ​Research any medical conditions or medications that your patient is taking and have an understanding as to how that might relate to your treatment.
  • Review the proposed treatment for the day and decide if you agree with it. Be prepared to discuss your treatment rational with the faculty.

Rotation 1 (7th quarter)

  • Day 1    Orientation with Dr. Wood
    • DAU (Dental Auxiliary Utilization) assistant Chairside Orientation
    • Review proper ergonomics and chair position
    • Anesthesia Demonstration
    • Introduction to Patient Charts and Patient Presentation Worksheet (PPW)
    • Homework assignment to draw prep designs, review restoration of preps and sequencing
  • Day 2  Turn  in  prep  designs,  discuss  restoration  &  sequencing  with  your  instructor  (graded competency)
  •  Practice ergonomics and tooth preparations on YOUR pediatric typodont.*
  • Class II Prep
  • Stainless Steel Crown
  • Infection Control
  • Review Dental Chart/ PPW of FIRST patient!
  • Days 3-9  See patients and be a pediatric student doctor!
  • Day 10    Group Seminar
    • Reflection write-ups due to Dr. Wood at least 24 hours before your seminar. Please check Canvas for form and examples.
    • DAU Evaluations
    • Each student gives a brief presentation on their most interesting case for the week.

Rotation 2 (8th quarter)

  • Day 1-9   See patients and be a pediatric student doctor!

DAU quiz on “Dental Team Concepts” handout and dental auxiliary instruction.

  • Day 10    Same as Rotation 1

What to bring (on the first day) Loupes, pediatric typodont, gown from Main Clinic

Patient Presentation Worksheet (PPW)
A worksheet that must be filled out for each patient. You should fill out as much information as possible PRIOR  to  the  appointment.  All  information  to  complete  the  form  is  within  patient  axiUm  chart  or obtained by interviewing the guardian/patient the day of the appointment. The purpose of the PPW is to  orient  and  prepare  you  for  each  patient.  (i.e.  Health  history,  dental  management,  dental  history, patient behavior, treatment plan). If you have trouble finding information or need help ASK a faculty member or DAU assistant for help.

New Patient Exam
For each new patient brought to our pediatric clinic, TWO separate appointments are necessary.

  1. ODTP appointment
  2. Prevention/Prophy/Fluoride appointment (plus possible treatment)

The ODTP, Recall and Prevention Appointments
For the ODTP,/Recall/Prevention Appointment you will be provided with an “Appointment Procedures” handout  which  guides  you  through  the  appointment  step-by-step.  As  reminders,  these  handouts  are laminated and posted in each cubicle for you.

ODTP Appointment Overview
1.  Before clinic, review patient chart & complete PPW. Review the diagnosis and treatment planning section of the PD240 manual.
2.  In reception area, confirm that the adult is a parent/court-appointed legal guardian, update the medical history with the parent, record medical history, update the axiUm record, and have the parent sign the update In the axiUm record at the conclusion of the appointment. If you plan on taking x-rays, you must ask the parent for permission to take the x-rays.
3.  In the clinic, do a quick intraoral exam.  Use the quick intraoral exam to figure out which teeth are permanent vs. primary, which teeth are erupting, and which teeth are mobile. Be prepared and know your eruption sequence and which teeth you expect to see in the mouth based on your patient’s age before you come to clinic.
4.  Start check with the Pediatric faculty. Review the PPW and be prepared to tell your faculty what radiographs you think are necessary. If the faculty is not available, start the soft & hard tissue charting until the faculty is available.
5.  Take radiographs (if needed). While your assistant develops them, begin or complete the soft tissue exam (white form), and the hard tissue charting treatment plan worksheet (yellow form).

Clinic Tip:  When taking x-rays, remember the Tell-Show-Do technique to make sure that your patient is comfortable with the x-ray sensor in his/her mouth before you place it there. Patients also get a sticker after taking x-rays.  

6.  Review radiographs and determine the appropriate treatment plan.

 Clinic Tip: Remember, always treatment plan a stainless steel crown if the marginal ridge is broken down, or the decay extends beyond the proximal line angles.

7.  Call over the faculty for a final check to review hard tissue exam, radiographs and treatment recommendations  and  sequencing.  Your  DAU  assistant    will  enter  the  final  treatment  In  the axiUm record. Now is your patient’s chance to get something from the toy chest!

8.  Present the treatment plan to your patient’s parents in the operatory or the prevention room. Make sure to explain the treatment and the sequence. Explain that the treatment and fees may change based on the child’s intraoral condition, but that the parent will be consulted before any other treatment is rendered.

9.  Have the parent sign the treatment plan In the axiUm record.

10. Take the parent to the front desk to handle payments and scheduling the next appointment.

11. Return to the operatory to disinfect and prepare for your next patient!

Clinic  Tip:    Remember,  the  appointments  are  only  1  hour  long,  so  you  must  be prepared mentally and be efficient with your time.  

Prevention Appointment Overview
This is the second appointment for a new patient of the pediatric clinic. The goal of this appointment is to teach patient and parent about nutrition, diet, decay process, effective home preventive care. This appointment  lasts  about  20  minutes  and  takes  place  in  the  special  Prevention  area.  (Following  the prevention  session,  you  may  be  treating  the  patient  in  that  same  clinic  period,  depending  on  the patient’s treatment plan.)
Topics you will discuss are:

  • Nutrition
  • Perio disease/ Caries Process
  • Disclosing/ Plaque Index Record
  • Brushing / Flossing Instruction
  • Fluoride
  • Specific prevention treatment plan developed for your patient

There is an initial prevention plan the axiUm records that you can use as an outline.

Recall Appointment Overview
The recall appointments are similar to the ODTP appointment except that the patient is a patient of record, and you must also clean his/her teeth and give a fluoride treatment. You will do this after you have decided on a tentative treatment plan and sequence. Here are the steps to keep you on track (see
the ODTP appointment protocol for more details):
Complete a PPW.

  1. Interview the parent in reception area.
  2. Quick intraoral exam.
  3. Start check with faculty. Review PPW and tell faculty what radiographs are needed. Take the radiographs.
  4. Complete Hard Tissue Charting.
  5. Review radiographs, propose a treatment plan and sequence.
  6. Disclose the patient’s teeth and record a plaque index.
  7. Give oral hygiene instruction (OHI).  Use the toothbrush to demonstrate the proper brushing technique and also floss the patient’s teeth.
  8. Remove any calculus and prophy your patient’s teeth.
  9. Confirm all plaque and calculus has been removed, then perform a topical fluoride treatment.
  10. The fluoride tray should stay in place for 1 minute, with the patient holding the suction “Mr. Thirsty” in between the trays.
  11. Now you are ready to call over the faculty for the final check.
  12. Present treatment plan to the parent.
  13. Have the parent sign the treatment plan in the axiUm record.
  14. Take the patient to the front desk for payment and appointment scheduling.
  15.  Return to disinfect the operatory.
  1. Clinic Tip:  Make sure your patient is upright when you give them the fluoride tray, and  be  sure  to  insert  the  saliva  ejector  between  the  trays  After  treatment, remember  to  tell  the  patient  not  to  eat,  drink  or  rinse  for  30  minutes,  and  then reiterate this to the parents.

Restorative Procedures
Each  restorative  procedure  is  explained  in  the  Pediatric  Course  Manual  (PD240),  so  review  each pertinent  procedure  the  night  before  your  appointment.  You  should  be  prepared  to  discuss  the procedure with your faculty and demonstrate that you understand the course material.

Dr. Seth Reder’s (Class of 2005) Helpful Hints!
When a patient is misbehaving I like to say to the patient in a polite tone, “Johnny/ Jane this is not how boys/girls your age usually act. You’re a big boy/girl, right? Can you show me how boys/girls your age should act?” —This phrase may seem funny; but I really find it effective.  Be confident and honest with your patient. Preparation prior to procedures precipitates confidence.

A DAU assistant will be with you for every procedure. They have a lot of knowledge, experience, and are tremendously helpful. Be very respectful to them and don’t forget to say “thank you!”  The  faculty  and  DAU  assistants  will  be  grading  you  on  ergonomics,  so  be  mindful  of  your  seating position, your movements and the four-handed dentistry principles.  Make sure to review the handouts you are given the first day of the rotation. They explain everything in detail and there is even a cheat sheet for drawing your homework assignment on the first day!   Note: Your pediatric course manual (PD240) and handouts are an essential resource for diagrams, flow charts, pictures, and other information to refresh your mind about the various procedures performed in our clinic!  Review them the night before.

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