The chairside dental assistant plays a vital role in the smooth operation of a dental practice. A knowledgeable and educated assistant is an even greater asset to the dental health team. She/he will be more effective because of an understanding of chairside, laboratory, and office procedures, thereby helping to increase production. In addition, the more knowledge the assistant has, the less stress she/he will have from day to day. This will also decrease the stress of the dentist as well as other team members, and increase the positive atmosphere of the dental office. Most importantly, an educated dental assistant will be able to provide quality patient care. This course is designed to help the dental assistant prepare for a national exam, such as the Dental Assisting National Board's (DANB) General Chairside Assisting exam. It provides an overview of basic concepts and procedures of general chairside assisting, and can act as one portion of the preparation necessary to take the DANB exam. By taking and passing the DANB General Chairside exam, the dental assistant will demonstrate that she/he has made the commitment to become a better dental assistant and to increase the quality of the dental assisting profession.
Antoinette P. Metivier, CDA, BS
Antoinette Metivier is a Certified Dental Assistant with a Bachelor of Science in Education from the University of Maine. She has seven years experience as a chairside assistant and four years experience as an assistant professor of dental assisting at the New Hampshire Technical Institute in Concord, NH. She has developed and presented a radiology review course for the New Hampshire Dental Assistants Association, and has also authored or co-authored several other workbook courses for the American Dental Assistants Association. She is a member of the American Dental Assistants Association and has served on the Council on Education. She is also a member of the Organization for Safety and Asepsis Procedures.
Kimberly Bland, CDA, EDDA, BS
Kimberly Bland has served as ADAA’s Fifth District Trustee and as both national Secretary and national Vice President. She is currently serving as President-Elect of the ADAA. She has held several offices in both the local and state ADAA organizations, having been President of the Florida Dental Assistants Association for three terms and is past president of the Sara-Mana Dental Assistants Society of Florida. Ms. Bland is a member of the Florida Board of Dentistry Dental Assisting Council and has held offices in the Florida Allied Dental Educators Association and as Florida region V Post Secondary Advisor of the Florida Health Occupation Students of America (HOSA). Kimberly is a graduate of the University of South Florida, she majored in Industrial Technical Education. Earlier, she earned her Dental Assisting Certificate at Manatee Technical Institute where she is now the dental assisting program director.
Part I – Anatomy
1. Identify and describe the appearance of the normal anatomic structures of the face and oral cavity.
2. Identify and describe the following: types of teeth and their functions, the divisions of a tooth, the tissues of a tooth, the surfaces of a tooth, and the anatomical landmarks of teeth.
3. Discuss the importance of occlusion and describe the classifications of occlusion.
4. Describe the two dentitions and the types of teeth in each dentition.
5. Discuss the importance of the primary teeth.
6. Identify and describe the components of the periodontium, and discuss the importance of the periodontium.
Part II – Oral Pathology
1. Describe and recognize the various types of dental caries.
2. Demonstrate an understanding of the causes of dentin hypersensitivity, and the various procedures used for treatment.
3. Describe the types of pulpitis and discuss the treatment of each type.
4. Define, give the causes of, and describe the appearance of the following: attrition, abrasion, erosion and resorption.
5. Describe the types and causes of periodontal diseases.
6. Recognize abnormal conditions of the soft tissues of the oral cavity.
7. Recognize the warning signs of oral cancer.
8. Discuss with a patient the steps for prevention of oral cancer.
9. Recognize the oral manifestations of various systemic diseases and nutritional disorders.
10. List the oral and facial tissues to be examined during a yearly oral cancer screening.
11. Describe the three oral biopsy techniques utilized on questionable oral lesions.
Part III – Collection and Recording of Clinical Data
1. Describe the components of a dental record and give the legal significance of medical and dental histories.
2. Obtain and record patient vital signs (temperature, pulse, respiration, and blood pressure).
3. State the ranges for normal vital signs.
4. Assess and record a patient’s general physical appearance (ex: skin, gait, etc.), and note any abnormal characteristics (ex: nervousness, evidence of physical or substance abuse, eating disorders, age-related changes).
5. Describe the techniques and instruments used for an oral examination.
6. Describe the components of an extraoral and intraoral exam.
7. Chart conditions in the patient’s oral cavity including caries, restorative materials and existing conditions, and periodontal conditions.
8. Identify the primary and permanent teeth according to the Universal Numbering System.
9. Identify and describe the various cavity classifications.
10. Recite the words for the acronym HIPAA.
11. Discuss the three privacy requirement types of HIPAA.
12. Describe the penalties involved with failing to comply with HIPAA standards.
Part IV – Medical and Dental Emergencies
1. Describe various techniques for the prevention of and preparation for medical emergencies in the dental office, including the necessary supplies, drugs, and equipment, and maintenance of a list of emergency support personnel.
2. Implement techniques for the prevention of medical emergencies in patients with a history of various known medical conditions.
3. Recognize the signs and symptoms of various medical conditions/emergencies that may occur in the dental office, and respond to and assist with the management of the emergency.
4. Assemble and maintain the appropriate emergency supplies and equipment in the dental office.
5. Recognize the uses for various drugs used in the management of an emergency.
6. Recognize the signs and symptoms of various dental emergencies, and implement or assist with the management of the emergency.
7. Recite the words for the acronym AED.
8. Explain when to utilize an AED during a medical emergency.
9. List the ways the dental team must be prepared for emergencies in the dental office.
Part V – Pharmacology
1. Recognize drugs that are controlled substances, and describe the importance of this knowledge in relation to a patient’s dental treatment.
2. Describe the routes of administration of a drug, the effects of a drug on the body, and the factors that alter the effects of a drug, and the significance of these in relation to dental treatment.
3. Describe the storage and handling of office medications, including maintaining security and records of controlled substances.
4. Describe the protocol to be followed when medications are administered to a patient in a dental office.
5. Recognize medications listed on a patient’s medical history and understand their relation to dental treatment.
6. Demonstrate the ability to refer to drug information resources in order to obtain information on an unknown medication on a patient’s medical history.
7. Recognize the signs and symptoms of substance abuse.
Part VI – Anesthesia
1. Prepare the setup for and apply, or assist with the application of, topical anesthetic, including appropriate placement for various injections.
2. Describe the various local anesthetic agents and their uses.
3. Identify the appropriate uses for a vasoconstrictor, and describe safety precautions when using a vasoconstrictor.
4. Identify the various types of injections used for local anesthesia in dentistry.
5. Describe the safety precautions and storage for local anesthetic cartridges.
6. Correctly assemble an aspirating syringe with the appropriate needle (depending on the type and location of injection to be given) and anesthetic cartridge (depending on the procedure, and patient requirements).
7. Describe the stages of general anesthesia.
8. Describe the setup, procedure, precautions, and contraindications for nitrous oxideoxygen conscious sedation.
9. Identify the possible complications with the various anesthetic techniques.
10. Discuss the differences between topical, local, general, jet-injection, computer-controlled, and inhalation anesthetic techniques.
Part VII – Chairside Assisting
1. Describe the categories of chairside movements, and explain the significance of each movement in four-handed dentistry.
2. Discuss the basic concepts of four-handed dentistry.
3. Describe the preparation of a treatment room for patient treatment.
4. Prepare preset trays with the appropriate armamentarium in the correct sequence of use and delivery position.
5. Seat and prepare the patient in the appropriate position for treatment, and position and adjust all necessary equipment.
6. Assume the appropriate chairside position and implement the concepts of four-handed dentistry when performing the various treatment procedures.
7. Recognize the appropriate position for the operator during various treatment procedures.
8. Describe the various types of instruments grasps, and their uses.
9. Describe the different types of instrument transfer methods.
10. Describe the appropriate use of lighting, isolation techniques, high volume evacuation and saliva ejector, air/water syringe, and retraction in the maintenance of access and visibility during treatment procedures.
11. Prepare the appropriate set up and apply, or assist with the application of, the dental dam.
12. Place the high-volume evacuation tip in the appropriate position for effective suction, depending on the situation.
Part VIII – Dental Instruments
1. Describe the various types of hand instruments and their uses, and place them in the appropriate sequence on a preset treatment tray.
2. Identify the uses for high- and slow-speed handpieces, and describe the preparation of the appropriate handpiece, depending on the situation.
3. Identify and describe the uses for various rotary instruments and exchange them in dental handpieces, as needed.
4. Maintain dental handpieces according to the manufacturer’s instructions.
Part IX – Chairside Restorative Materials
1. Describe the factors that affect the manipulation of dental materials, and discuss how these factors affect the dental assistant’s role in the manipulation of dental materials.
2. Identify the principal uses of dental cements.
3. Identify the various cements used in dentistry, and describe the uses, setup, and procedure for mixing each type of cement.
4. Compare and contrast the various cements used in dentistry.
5. Describe the various bases and cavity lining agents used in dentistry, including the setup and procedure for mixing each type.
6. Discuss the purpose of bonding systems (acid etchants, dentin primer, and bonding agents) used in dentistry, and describe the setup and procedure for enamel and dentin bonding.
7. List the components of dental amalgam.
8. Discuss the importance of mercury hygiene, and describe various safety precautions that should be taken when working with mercury.
9. Describe the properties of amalgam and discuss how these affect its manipulation.
10. Describe the appropriate procedure for the manipulation of amalgam, including trituration, condensation, and finishing procedures.
11. Discuss the setup and procedure for amalgam bonding.
12. Describe the properties of direct esthetic restorative materials (including composites and glass ionomers) and describe the appropriate setup and procedure for their manipulation.
Part X – Laboratory Materials and Procedures
1. List the three types of rigid impression materials used in dentistry, and describe their uses.
2. List the two types of elastic impression materials, and describe their uses.
3. Describe the setup and procedure for a reversible hydrocolloid impression.
4. Describe the setup and procedure for an alginate impression.
5. List the four types of elastomeric impression materials, and describe their uses.
6. Describe the setup and procedure for each type of elastomeric impression material.
7. Describe the materials used for making an occlusal registration.
8. List the types of gypsum products used in dentistry, and describe their uses.
9. Discuss the importance of the water-to powder ratio for various gypsum products, and give the water-to-powder ratio for each product.
10. Describe the setup and procedure for mixing gypsum products and for the pouring of an alginate impression.
11. Describe the three methods of pouring gypsum products.
12. Discuss the factors that affect the setting time of gypsum products.
13. Describe and evaluate the trimming and finishing of a diagnostic study cast.
14. List the various types of waxes used in dentistry, and describe their uses.
15. Discuss the various uses of acrylics in dentistry.
16. Describe the setup and procedure for the fabrication of a bleaching tray or mouthguard.
17. Describe the setup and procedure for the fabrication of a custom acrylic impression tray.
18. Select the appropriate type of impression tray depending on the situation, and explain how to modify the tray as needed.
Part XI – Preventative Dentistry
1. Discuss the components of preventive dentistry.
2. Describe the importance and components of patient education in home care therapy.
3. Provide the patient with basic nutritional information.
4. Provide basic nutritional information to the patient with special dental needs.
5. Discuss the formation of plaque and calculus.
6. Discuss the role of plaque in the formation of caries and periodontal disease.
7. Describe the factors that affect the cariogenicity of foods.
8. Discuss the importance of saliva.
9. Demonstrate the appropriate method of toothbrushing to a patient, depending on that patient’s needs.
10. Demonstrate the appropriate method of flossing.
11. Provide the patient with information on interdental and oral hygiene aids, depending on the patient’s needs.
12. Describe the setup and procedure for a dental prophylaxis and coronal polishing.
13. Discuss fluoride safety with a patient.
14. Describe the various methods of administration of fluoride, including the advantages and disadvantages of each.
15. Recognize the various types of systemic and topical fluoride used in dentistry.
16. Discuss the role of fluoride in the prevention of dental caries.
17. Describe the setup and procedure for the application of professional topical fluoride.
18. Discuss the indications, probable indications, and contraindications for pit and fissure sealants.
19. Describe the factors necessary for sealant retention.
20. Describe the setup and procedure for the application of pit and fissure sealants.
21. Compare and contrast the different types of sealant materials.
Part XII – Restorative and Cosmetic Dentistry Procedures
1. Describe the steps involved in cavity preparation and discuss the assistant’s role during cavity preparation.
2. Discuss the purpose of matrices and wedges in cavity preparation and describe the setup of the Tofflemire retainer.
3. Describe the setup and procedure for an amalgam restoration.
4. Describe the setup and procedure for a composite restoration.
5. Describe the materials and procedures used for the various finishing and polishing techniques.
6. Identify the materials used for bleaching and describe the various techniques used for bleaching.
7. Discuss the various materials and methods used for desensitization of teeth.
Part XIII – Dental Specialties
1. Identify the various types of fixed prostheses used in dentistry, and discuss the materials used.
2. Describe the setup and procedure for the fabrication of a fixed prosthesis.
3. Describe the setup and procedure for the fabrication and cementation of an acrylic temporary crown, including the removal of excess cement from coronal surfaces.
4. Describe the various materials and methods used for retention of a fixed prosthesis.
5. Describe the setup and procedure for the fabrication of partial and complete dentures, and immediate dentures.
6. Discuss the purpose of tissue conditioners, relines and rebases.
7. Provide the patient with instructions on caring for fixed and removable prostheses.
8. Describe the various types of periodontal diseases.
9. Discuss the various methods used in the diagnosis of periodontal diseases, and chart periodontal conditions.
10. Identify various periodontal instruments.
11. Describe the various surgical and nonsurgical (including occlusal equilibration) treatments used in periodontics.
12. Describe the setup and procedure for suture placement and removal.
13. Describe the setup and procedure for the placement and removal of a surgical dressing.
14. Provide the patient with appropriate postoperative instructions following periodontal surgery.
15. Describe the various materials and methods used in endodontic diagnoses.
16. Describe the setup and procedure for the various vitality tests, including electrical pulp testing.
17. Identify various endodontic instruments.
18. Describe the setup and procedure for a pulpectomy (root canal therapy).
19. Describe the various endodontic procedures.
20. Discuss the use of orthodontic treatments for malocclusion, TMJ dysfunction, and esthetics.
21. Recall possible factors causing malocclusion.
22. Differentiate between crowding, overbite, overjet, open bite, and cross bite.
23. Discuss preventive or interceptive orthodontic treatments.
24. Explain the use of a space maintainer.
25. Describe the setup and procedure for the placement of a stainless steel crown.
26. Describe the procedure for the preparation of a patient prior to oral surgery, including the preparation of a medication syringe.
27. Identify various oral surgery instruments.
28. Describe the setup and procedure for various oral surgery procedures, including routine extractions, complex extractions and impactions.
29. Provide the patient with appropriate postoperative instructions following oral surgery.
30. Discuss the possible complications following oral surgery, including the treatment for each.
31. Discuss the procedure for the various stages of an implant.
Part XIV – Office Operations
1. Discuss the importance of communication among the entire dental health care team.
2. Identify methods of calming and reassuring apprehensive patients and managing all types of patients during clinical procedures.
3. Discuss the importance of accurate and thorough documentation in the dental office, including documentation of recommended treatments, patient acceptance or refusal of recommended treatment, completed treatments and outcomes, patient compliance, prescriptions, and patient response to drugs or medications.
4. Demonstrate an understanding of how to schedule appointments and make entries in the appointment book, or on the computer.
5. Describe the purpose of and the various types of preventive recare/recall programs.
6. Explain the dentist’s fee schedule. Describe the three basic and the various alternative third party payment plans.
7. List the three types of dental office supplies and give examples of each.
8. Maintain an office inventory control system.
9. Demonstrate the ability to order supplies, instruments, and equipment to maintain necessary levels.
10. Describe the appropriate method of rotating and storing offices supplies.
11. Define and describe the proper method of handling a backorder.
12. Discuss the importance of following the manufacturer’s instructions for preventive maintenance of equipment and supplies in the dental office.
13. Describe the reason for and methods of sharpening hand instruments.
14. Explain the importance of maintaining HIPAA standards.
CONTINUING EDUCATION CREDIT
The ADAA has an obligation to disseminate knowledge in the field of dentistry. Sponsorship of a continuing education program by the ADAA does not necessarily imply endorsement of a particular philosophy, product or technique.
Credits earned upon completion of the course may be used to meet DANB’s Recertification Requirements.
This course has been produced in part by a grant from the American Dental Assistants Association Foundation.
CONCERNS OR HELP
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