Pre-Clinical Treatment Planning DSPR-824!04!4132_Syllabus

8/12/2019 Pre-Clinical Treatment Planning DSPR-824!04!4132_Syllabus

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The University of LouisvilleSchool of Dentistry

Competencies (Student Learning Objectives) for the Pre-Doctoral Curriculum

Addressed in DSPR 824, DSPR 833-56, DSPR 844-78Approved by the DMD Curriculum Committee: August 28, 2008

1. Professionalism, Ethics, and the Law1.1. Provide compassionate and ethical care to a diverse population of patients

1.2. Communicate effectively with peers, other professionals, staff, patients or guardians and the

public at large.

1.3. Recognize the role of lifelong learning and self-assessment in maintaining competency.

1.4. Obtain informed consent for oral health therapies that meets ethical and legal responsibilities.

1.5. Apply the principles of ethical reasoning, evidence-based information, and professional

responsibility as they pertain to patient care, practice management and addressing the oral healthstatus of the community at large.

2. Information Management and Critical Thinking2.1. Apply critical thinking and problem solving skills in the comprehensive care of patients.

2.2. Evaluate and integrate the best research outcomes with clinical expertise and patient values for

evidence based practice.2.3 Apply information technology resources in contemporary dental practice.

3. Practice Management3.1. Comply with federal, state, and local regulations related to infection control, radiation and

environmental safety measures in all clinical procedures.3.2. Evaluate relevant models of oral health care management and delivery.

3.3. Understand the basic principles and philosophies of practice management and have the skills tofunction successfully as the leader of the oral health care team.

3.4. Establish and maintain patient records and assure confidentiality of information.

4. Patient Assessment4.1. Identify a patients chief complaint, general needs, past dental history, and treatment expectations.

4.2. Obtain patient data adequate to provide dental treatment.

4.3. Perform a clinical examination of the head and neck and intraoral structures.

4.4. Assess the need for, apply radiographic selection criteria, perform selected intra and extraoralradiographic procedures, and interpret appropriate oral and maxillofacial radiographs required for

diagnosis.

4.5. Obtain other relevant diagnostic information such as laboratory tests and medical consultationswhen appropriate.

4.6. Recognize the normal range of clinical and radiographic findings and conditions that requiremonitoring or management.

4.7. Recognize predisposing and etiologic factors that require intervention to prevent disease.

4.8. Interpret findings from the history, clinical and radiographic examinations, and other diagnosticprocedures.

4.9 Recognize the manifestations of systemic disease and how the disease and its management mayaffect the delivery of dental care.4.10. Integrate subjective and objective clinical findings in the formulation of the diagnosis.

4.11. Evaluate the prognosis of various treatment options.

5. Treatment Planning5.1. Formulate and discuss with the patient an individual, comprehensive, sequenced treatment plan

and alternate plans based on relevant diagnostic findings and patient considerations.


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5.2. Discuss etiologies, prognoses, and preventive strategies with the patient; educate the patient so

he/she can participate in the management of his/her own oral health care.

5.3. Identify the need for and manage timely referrals and consultations with other health care

providers when appropriate.

6. Patient Care: Managing the oral health care of the infant, child, adolescent, and adult, as well as,

the unique needs of women, geriatric, and special needs patients.6.1. Manage (refer or treat) dental pain and emergencies, including the diagnosis and management of

traumatic injuries to the tooth, pulp, and maxillofacial structures.

6.2. Perform and evaluate therapies that emphasize prevention of oral disease.

6.3. Restore missing or defective tooth structure to proper form, function, and esthetics.

6.4. Diagnose and manage (refer or treat) patients with uncomplicated partial or complete edentulousareas, including the use of implants.

6.5. Diagnose and manage (refer or treat) patients with periodontal disease.

6.6. Diagnose and manage (refer or treat) patients with pulpal disease and related periradicular

pathology.

6.7. Diagnose and manage (refer or treat) patients with temporomandibular disorders.6.8. Diagnose and manage (refer or treat) patients with malocclusion in the primary, mixed, and

permanent dentition.

6.9. Diagnose and manage (refer or treat) patients requiring orthodontic treatment or spacemaintenance.

6.10. Diagnose and manage (refer or treat) patients with oral mucosal and osseous disorders.

6.11. Diagnose and manage (refer or treat) patients requiring oral surgical procedures.

6.12. Identify and manage (refer or treat) patients with pain and anxiety associated with dental

procedures.6.13. Select and administer/prescribe appropriate pharmacological agents in the treatment of patients

with dental disease.

6.14. Apply principles of behavioral patient management and interpersonal skills sciences as theypertain to patient-centered approaches for promoting, improving, and maintaining oral health.

6.15. Diagnose and manage (refer or treat) patients whose medical, physical, psychological, or socialsituations make it necessary to modify normal dental routines in order to provide dental treatment

including, but not limited to, people with developmental and/or mental disabilities, complex

medical problems, and significant physical limitations.6.16. Recognize and manage (refer or treat) substance abuse in dental patients.

6.17. Anticipate, prevent, and manage (refer or treat) complications of dental treatment.

6.18. Periodically assess and monitor the outcomes of comprehensive dental care.


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The University of LouisvilleSchool of Dentistry

Commission On Dental Accreditation (CODA) Standards Met

In DSPR 824, DSPR 833-56, DSPR 844-78

This course contributes to foundation knowledge in the attainment of CODA standards:

2-1 In advance of each course or other unit of instruction, students must be provided written

information about the goals and requirements of each course, the nature of the course content,

the method(s) of evaluation to be used, and how grades and competency are determined.

2-9 Graduates must be competent in the use of critical thinking and problem-solving, includingtheir use in the comprehensive care of patients, scientific inquiry and research methodology.

2-10 Graduates must demonstrate the ability to self-assess, including the development of professional

competencies and the demonstration of professional values and capacities associated with

self-directed, lifelong learning (GDOM 833-56 and GDOM 844-78 only).

2-17 Graduates must be competent in applying legal and regulatory concepts related to the provision

and/or support of oral health care services.

2-20 Graduates must be competent in the application of the principles of ethical decision making and

professional responsibility.

2-23 At a minimum, graduates must be competent in providing oral health care within the scope ofgeneral dentistry, as defined by the school, including:

a. patient assessment, diagnosis, comprehensive treatment planning, prognosis, and informed

consentc. recognizing the complexity of patient treatment and identifying when referral is indicated

d. health promotion and disease prevention

h. replacement of teeth including fixed, removable, and dental implant prosthodontic therapieso. evaluation of the outcomes of treatment, recall strategies, and prognosis

5-2 Patient care must be evidenced-based, integrating the best research evidence and patient values.


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CURRICULUM OBJECTIVES FOR PRE-CLINICALAND CLINICAL TREATMENT PLANNING

The following objectives serve for the entire three year curriculum in treatment planning. Itis not practical to separate these objectives in class levels. Evaluation and synthesis is a highlevel learning skill and will reflect many layers of prerequisite learning.

A candidate for graduation should demonstrate the ability to:--Recognize those rights and responsibilities of the dentist.--Recognize those rights and responsibilities of the student dentist as a developingprofessional.--Recognize those rights and responsibilities of the patient.--Develop basic data entry skills using the clinical computer.--Interpret and evaluate the following as each relates to the treatment plan of a patient:A. Medical History.B. Family History.C. Social History.D. Dental History.E. Chief Complaint/Concern.--Distinguish between normal and abnormal findings contained in a medical history and

be able to relate these findings to systemic and dental disease processes.--Correlate the medical history with clinical signs and symptoms.--Determine whether conditions found in a medical history or clinical observations andvital signs necessitate further evaluation by a physician and/or medicalconsultations and follow-up.


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--Correlate the dental history with clinical signs and symptoms.--Consult with a patients previous dentist if the history warrants further investigation.--Explain why knowledge of general state of physical and mental health social and

cultural background patient attitude about health and health care teeth andsupporting structures of patient is important to the synthesis of a treatment plan.--Identify a patients knowledge and appreciation of dentistry.--Determine the effect of a patients past dental experience on a treatment plan.--Determine when psychological or psychiatric consultation is necessary to insuresuccessful dental treatment.--Discuss the significance of the medications a patient is taking as they relate to the

patients illness, the choice of anesthesia, the overall treatment plan, and iftreatment modifications may be necessary.--Predict the possible significance of any finding in dental or medical history to the totalcare of a patient.--State precautions/modifications necessary when treating patients with any of thefollowing medical conditions:A. Allergies.B. Anticoagulant Therapy.C. Asthma/COPD.

D. Bisphosphonates Use.E. Cardiovascular Disease.F. Cerebrovascular Disease.G. Cirrhosis.H. Diabetes.I. Hepatitis.J. HIV/AIDS.K. Hypertension.L. Infective Endocarditis.M. Pregnancy.N. Prosthetic Joints.O. Psychiatric/Cognitive Disorders.P. Renal Disease.Q. Seizure Disorder/Epilepsy.R. Tuberculosis.

--Identify undiagnosed systemic diseases based on observed signs and patient symptoms.--Describe current AHA recommendations for prevention of subacute bacterial


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endocarditis.

--Recommend to treatment planning faculty the appropriate medications required forthe treatment of a patient.--Indicate appropriate drugs which might substitute for penicillin when prophylacticantibiotic coverage is indicated.--State what medical and dental complications may develop in an uncontrolled diabetic.--Evaluate the results of heat cold percussion and electric pulp tests in relation to asequential comprehensive treatment plan.--Identify the need for endodontic treatment/retreatment and endodontic surgery.--Evaluate a patients ability to perform oral hygiene procedures in relation to theproposed comprehensive treatment plan.--Evaluate patients diet in relation to proposed comprehensive treatment plan.--Evaluate the effect of oral habits on the proposed comprehensive treatment plan.--Evaluate the effects of xerostomia.--Evaluate the indication for fluoride and sealants as related to the proposedcomprehensive treatment plan.--Correlate dental radiographic findings with clinical dental findings.--Be able to detect clinical dental caries.--Identify radiographically incipient carious lesions and recommend appropriatetherapeutic measures.--Identify the classification and surfaces of a required restoration.--Recognize the diagnostic value of therapeutic services.--Recognize and interpret roentgenologic signs of traumatic occlusion.--Recognize and interpret roentgenologic signs tooth pathology.--Consistently produce quality diagnostic casts.--Identify when the use of mounted casts is indicated for diagnostic purposes.


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--Demonstrate ability to obtain accurate facebow transfer.--Determine when diagnostic casts must be mounted in MICP vs. RJP.--Understand the importance of properly mounted diagnostic casts.--Identify the significant findings from the collected data which may contribute to thediagnosis and plan of treatment.--Identify the nglesorthodontic classification of a patient.--Diagnosis need and determine proper sequencing of orthodontic treatment in acomprehensive treatment plan.--Identify indications for orthognathic surgery.--Recognize a patients need for specialty consultations within and outside of thecomprehensive care clinic and demonstrate the ability to clearly communicate theissues with the appropriate specialist.--Demonstrate the ability to properly diagnose periodontal disease.--Correlate the relationship of all local etiologic factors contributing to periodontaldisease with the dental findings and proposed treatment.--Explain the clinical significance of radiographic vertical and horizontal bone loss.--Be able to recommend proper treatment modalities to address periodontal disease andsequence them properly in a comprehensive treatment plan.--Identify the indications for periodontal surgery.--Determine the proper sequencing of periodontal surgery in a comprehensive treatmentplan.--Be able to explain the risks vs. benefits of periodontal surgery to a patient.--Describe the effect of missing teeth on the periodontium of a patient.--Discuss indications and contraindications for removal of erupted third molars.--Discuss indications and contraindications for removal of impacted teeth.--Discuss criteria which would result in a hopeless prognosis for a tooth.--Evaluate crown to root ratio relative to utilization of a tooth as a potential abutment


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for a prosthesis.--Evaluate the risks vs. benefits of using a questionable tooth as an abutment for aprosthesis.--Summarize treatment alternatives for a tooth in an abnormal intra-arch or inter-arch

position.--Evaluate all pertinent diagnostic factors substantially affecting the decision forplacement of a fixed or removable prosthesis in a patient with appropriateindications.--Select the most appropriate treatment modality for tooth in an abnormal intra-arch orinter-arch position.--Identify dental implant indications.--Identify dental implant medical and dental contraindications.--Identify the need for orthodontic consultation in relation to a patients fixedprosthodontic needs.--Interpret radiographs in relation to crown to root ratio alveolar bone height crownand root angulation and edentulous areas.--Justify the need for orthodontic correction of an abnormal maxillary/mandibularintra-arch and/or inter-arch relationship.--Justify the need for surgical correction of an abnormal maxillary-mandibular ridge/inter-arch relationship.--Summarize treatment alternatives when inter-ridge distance is inadequate for properprosthetic restoration.--Make informed defensible decision relative to the recommendation of a removableprosthesis.--Evaluate the risks vs. benefits of not replacing a missing tooth.--Discuss maintenance of arch integrity with a patient.--Plan the appropriate restoration for carious teeth.--Identify teeth to be extracted.--List pertinent factors relating to the decision to extract a mobile tooth.


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--Evaluate the effect of extraction of hopeless teeth on the overall proposed treatment.--Determine proper sequence of extractions in a comprehensive treatment plan.--Describe the sequellae of not replacing a missing tooth.--Collate and analyze all pertinent findings necessary to determine a protocol ofpreventive therapeutic and educational services for a patient.-- ssess a patients ability to follow treatment recommendations.--Avoid prejudicial analysis.--Synthesize a treatment plan sequence which by carefully selected treatment prioritieswill preclude patient emergencies.--Synthesize a treatment plan which by carefully selected treatment priorities willaddress a patients need for preventive services.--Synthesize a treatment plan in a logical sequence based on complete diagnostic findingson a patient.--Alter treatment plans based on the aging process and other environmental factors whennecessary.--Present a properly sequenced comprehensive treatment plan to faculty.--Write a treatment plan containing the following four phases:A. Emergency care.B. Disease control and preprosthetic surgery.C. Reconstruction of form function and esthetics.D. Maintenance protocol.--Utilize appropriate identifying ADA codes and fees for a patients comprehensivetreatment plan.--List the reasons for proper sequencing in a comprehensive treatment plan.--Synthesize a treatment plan in a logical sequence based on complete diagnostic findingsfor a patient.--Justify the sequence of a treatment plan for a patient.

--Discuss the total patient care concept as it relates to the students responsibility to


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patients while in school and the dentists responsibility to patients andcommunity while in private practice.--Develop an appropriate alternate treatment plan if necessary.-- lter treatment plans based on a patients handicap if indicated.--Provide complete current information to a patient in understandable terms concerningthe diagnosis treatment and prognosis.--Explain to a patient reasons why recommended procedures are considered necessary.--Give a patient the right to refuse treatment after providing information about theconsequences of such action.--Make a reasonable response to the request of a patient for services.--Avoid withholding information from a patient.--Evaluate whether a tooth is of sufficient strategic value to warrant retention viaendodontic/periodontal therapy for advanced restorative procedures.--Recognize the purpose of the periodontal reevaluation by proper entry into thesequence of treatment.-- ppraise a patients needs for consultation or referral for endodontic, oral surgery,periodontal, or orthodontic problems which are beyond the students capacity to

treat.--Identify the potential need for special appointment planning or special precautions toprevent diseases transmission allergic reaction or emergency care.

Criteria For Determination of Final Grade

Pre-Clinical Treatment Planning

(DSPR 824)


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I. Pre-requisiteEligibility as determined by acceptable academic status for advancement to secondsemester sophomore year.

II. Class attendance for all scheduled sessions and class participation for the purpose of materialpresentation and discussion relative to diagnosis and treatment planning is required. Your decision toattend class is a personal matter. Planned class activities will continue with or without your presence,

and no time is provided for makeup sessions. Please be on time. This class will start promptly at 9:00a.m. Once you have arrived in class, please stay. Due to the lecture hall configuration, leaving andentering is disruptive to the class during lecture time. Breaks will be taken every 60 minutes or less.Return from breaks at the stated time. As a courtesy to the lecturer and your classmates, please turn offall electronics, with the exception of recording or note taking devices. If you need to use a prohibitedelectronic device, please leave the lecture room. Your ability to become an astute listener will positively

contribute to your success in this class and your future practice of dentistry.

III. The schools Code of Professional Responsibility and Professional Decorum Policy will be strictlyenforced in this class. Make yourself completely aware with these policies. Cheating, dishonesty, or

other unprofessional conduct will not be tolerated and will be reported as required.

IV. Seventy (70) percent is the minimum passing grade. The final grade percentages will be rounded to thenearest percentage.

V. Grade ranges:

A = 93-100%

B = 86-92%C = 78-85%

D = 70-77%F = 69% or less

VI. Final grade will determined as follows:

5% Quizzes (10 quizzes, 5 points/quiz, grade based on 40 total points)5 % Patient Bill axiUm treatment plan (graded)*

20 % Exam 1

30 % Exam 240 % Final

100 %

*Assignment must be completed and turned in by the end of lecture April 23, 2013 for credit.

VII. This course is a prerequisite for Clinical Treatment Planning I (DSPR 833-56).

VIII. Course Requirement Not Met.

An X grade will be recorded, at the course directors discretion, for those students whose attendanceand participation are limited to such an extent as to prevent the completion of the course objectives andrequirements. The method of replacement of the X grade with a permanent grade will be determined

by the course directors, but this must occur before clinic privileges are granted and within the timeallotment set by the administration.


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IX. Course Failure: An F grade may be removed only by (to be determined by the course directors):

A. Repeating the entire course when it is next offered, orB. Self-study/review of course and passing score on a challenge examination to include oral section.

Final grade can be no higher than a D.

X. Performance Review

You are encouraged to review your standing in this class with a course director at any time. If you areexperiencing problems, personal or academic, please see a course director as soon as possible for

personal attention. Do not wait until the end of the course to address these issues.


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COURSE SCHEDULE 2013

SOPHOMORE TREATMENT PLANNING

(DSPR 824)

I. Jan. 8, 2013 AGENDA:Class Rules

Introduction

EthicsDr./Pt. Rights, Responsibilities

Treatment Planning Overview

Best Prognosis Profile

(Reading Assignment: 3.1-3.3)

II. Jan. 15, 2013 AGENDA:Dental Caries


Periodontal Disease

(Reading Assignment: 3.17-3.21)Preventive Items In Treatment Planning

III. Jan. 22, 2013 AGENDA:Endodontics

(Reading Assignment: 3.22-3.25)Dental Materials

IV. Jan. 29, 2013 AGENDA:Treatment Planning At ULSD

(Reading Assignment: 2-7-2.15, 3.26-3.31)

V. Feb. 5, 2013 AGENDA:

Test #1 (9-10:50)ULSD Fee Schedule

VI. Feb. 12, 2013 AGENDA:Test #1 ReviewInformed Consent

Common ULSD Exam Types

Prosthodontically Important Teeth

Hopeless/Questionable Teeth


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VII. Feb. 19, 2013 AGENDA:Periodontal Crown Lengthening/Orthodontic Extrusion


Ferrule Effect/Biologic WidthCores(Reading Assignment: 3.44)

VIII. Feb. 26, 2013 AGENDA:Periodontal Considerations In Treatment Planning

Occlusion/TMD Issues In Treatment Planning

Endodontic Codes In Treatment Planning

(Reading Assignment: 3.45-3.48)Cracked Tooth Syndrome


Orthodontic Issues In Treatment Planning(Reading Assignment: 3.52-3.53)

Oral Surgery/Extraction Codes


IX. Mar. 5, 2013 AGENDA:Indirect Single Restorations

Fixed Partial Dentures(Reading Assignment: 3.58-3.59)

Implants


X. Mar. 12, 2013 AGENDA:

Test #2 (9-10:50)

Removable Partial Dentures(Reading Assignment: 3.68-3.69)

Complete Dentures


Mar. 19, 2013: SPRING BREAK (NO CLASS)

XI. Mar. 26, 2013 AGENDA:Review Test #2

Interim/Immediate CDs, RPDsEsthetics In Dentistry



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XII. Apr. 2, 2013 AGENDA:Prosthodontic Esthetic Considerations (Dr. Harris)Treatment Planning Recall Patients


Treatment Planning Emergency Patients(Reading Assignment: 3.95-9.97)

Treatment Planning Transfer Patients

XIII. Apr. 9, 2013 AGENDA:Prosthodontic Treatment Planning (Dr. Nation)

Treatment Planning Referral Patients

Diagnostic Casts(Reading Assignment: 3.98)

XIV. Apr. 16, 2013 AGENDA:Diagnostic Wax-Ups In Treatment PlanningULSD Consults

ULSD Reviews

Treatment Planning With axiUmStandard Of Care


XV. Apr. 23, 2013 AGENDA:Communication In Dentistry (Dr. Flesch)

Case Presentation

(Reading Assignment: 2.13-2.21; 3.109-3.110)Treatment Notes

Sequencing At ULSD

Sequencing Sample Questions

Apr. 30, 2013: TENTATI VE FINAL EXAM

NOTE: All powerpoint presentations will be posted on Blackboard in PDF format

following the scheduled lecture time. Due to time and lecture hall constraints, material notpresented in class must be viewed independently by students on Blackboard. If any questions

arise as a result of this or for any questions relative to this course, students are encouraged to

contact a course director.

Documents

Pre-Clinical Treatment Planning DSPR-824!04!4132_Syllabus