CLINICAL GOALS OF PATIENT CARE AND CLINIC MANAGEMENT. Philosophical Basis of the Patient Care System. Patient Care Goals

University of Washington School of Dentistry

CLINICAL GOALS OF PATIENT CARE AND

CLINIC MANAGEMENT

Philosophical Basis of the Patient Care System

The overall mission of the patient care system in the School of Dentistry is to create positive professional relationships between our patients and the health care providers of the School and provide patient-centered dental care.

The outcomes are threefold: to educate competent clinicians well prepared to enter the dental profession, to provide comprehensive dental care assessed by a quality assurance program, and to maintain an effective and fiscally sound clinical operation.

Patient Care Goals

The overall goal of the patient care system is to model ethical and responsible

professional behavior while providing dental treatment which meets the standard of care.

Specific goals are to:

• inform patients of the patient care process within the School of Dentistry.

• establish and maintain a professional and mutually satisfying relationship with patients.

• inform patients of their oral health care needs and treatment options.

• deliver care in a timely manner within the constraints of an academic setting.

• complete all planned treatment services authorized by the patient.

• deliver appropriate and quality care.

• make appropriate emergency services available to patients.

• provide patients with a safe environment for the delivery of oral health care services.

• provide a recall program to monitor the oral health of the patients.

Clinic Management Goals

• maintain an effective and efficient patient care delivery system.

• maintain and communicate current patient care policies and procedures throughout School of Dentistry clinics.

• maintain a system of operation that can accommodate changes in the educational programs.

• maintain a patient care system that complies with the state regulated practice of dentistry.

• maintain a patient care system with fiscal integrity.

• operate a records management system that facilitates ready access to patient records for patient care providers.

• operate a quality assurance program for records management.

Departmental Clinical Goals

Endodontics

The objectives of the predoctoral endodontic program are five-fold.

• The student should be able to differentiate between signs and symptoms caused by pulpal or periapical pathosis and those caused by other forms of orofacial pathosis.

• When pulpal or periapical pathosis has been identified, the student should be able to determine its cause, select and carry out appropriate treatment, and estimate the prognosis.

• The student should be able to complete, at a clinically acceptable level, those clinical procedures which are consistent with his/her experience level.

• The student should be able to identify those factors which affect the complexity of treatment in each endodontic case and distinguish between those cases which are within his/her ability to manage effectively and those which should be referred to practitioners who can more appropriately provide for the care of the patient.

• The student should be able to accurately critique completed clinical procedures.

Oral Medicine

At the completion of the clinical programs in the Oral Medicine undergraduate curriculum the student will be:

• competent in obtaining a clinical history consisting of an interview,

administration of history forms, and analysis of the data collected as related to the chief complaint, medical, dental and social history of the patient;

• proficient in completing a physical examination of the structures of the head, neck, and oral cavity appropriate to the modern practice of dentistry;

• competent in the use of other diagnostic methods including pulp testing, radiographic assessment, neurologic testing of the cranial nerves and use of auxiliary diagnostic tests as needed in the assessment of Orofacial problems;

• skilled in the recognition and clinical management of oral soft tissue disease and stomatitis, including development of an acceptable differential diagnostic list and identification of appropriate primary care treatments for each condition;

• competent in, the primary care, pharmacological management of oral soft tissue diseases including infections, immune based disorders and other forms of stomatitis;

• skilled in the recognition and primary care management of oral osseous and hard tissue diseases of the jaws and able to develop an acceptable differential

diagnostic list and appropriate primary treatments for each condition;

• proficient in the recognition, diagnosis and primary care treatment of major types of acute and chronic Orofacial pain including pulpal and dental pathology, Temporomandibular disorders, and other major causes of facial pain;

• competent in, the primary care, pharmacological, physical and dental management of acute and chronic Orofacial pain states including Temporomandibular disorders and other major causes of facial pain;

• competent in the use of behavioral approaches in the assessment, diagnosis and treatment of chronic Orofacial pain and other oral soft tissue diseases;

• competent in the recognition, diagnosis and primary care treatment of most common salivary disorders and the management of their impact on oral health;

• proficient in the recognition and diagnosis of common neurosensory disorders of the mouth and jaws and their primary care management and referral;

• proficient in the recognition of risk factors for diseases of the oral, hard and soft tissues;

• competent in the diagnosis and treatment of dental emergencies;

• skilled in the taking and interpretation of intraoral dental radiographs;

• proficient in the assessment of radiographic quality and identification of causes of technical errors leading to loss of diagnostic quality of dental radiographs;

• competent in the interpretation of panoramic dental radiographs;

• competent in the use of a problem oriented approach in treatment planning of dental patients including medical management of compromising conditions and dental planning for the treatment of oral diseases and conditions; and

• competent in the primary dental care and medical management, in ambulatory dental settings, of patients with disabling conditions including developmentally, medically, mentally and physically disabling disorders.

Oral and Maxillofacial Surgery

At the completion of the clinical component of the undergraduate curriculum in Oral and Maxillofacial Surgery the student will be:

• proficient in uncomplicated minor oral surgery and in the management or referral of resultant complications;

• familiar with the indications and contraindications associated with oral and parenteral sedation as they relate to surgical procedures in the dentoalveolus and associated structures;

• proficient in the use of nitrous oxide inhalation sedation;

• competent in the use of local anesthetics in the control of acute pain associated with minor oral surgery;

• competent in obtaining and interpreting a medical history in patients needing minor oral surgery and familiar with commonly used medications and their significance in the oral surgery patient;

• competent to perform a limited physical examination on patients in need of uncomplicated minor oral surgery;

• familiar with the management of the psychological manifestations of acute pain and the anxiety associated with the surgical correction of disorders of the dentoalveolus and adjacent structures;

• competent in the pharmacological management of acute post-operative pain resulting from minor oral surgery;

• competent in the surgical and pharmacological management of minor dentoalveolar infections;

• competent to write prescriptions for the medications commonly used peri- operatively;

• competent in the assessment of common pathologic conditions as they occur in the mouth and peri-oral structures and familiar with the basic principles of biopsy as they relate to oral lesions;

• competent in the recognition of disorders requiring referral of patients to oral and maxillofacial surgeons and in the making of such referrals;

• familiar with the scope of the specialty of Oral and Maxillofacial Surgery as it relates to Dentistry as practiced in this country; and

• competent in the management of medical emergencies as they occur in the dental office and certified in basic cardiac life support procedures.

Orthodontics

At the completion of clinical studies, the students will be able to:

• differentiate between simple and complex orthodontic problems;

• provide interceptive, preventive, and limited corrective procedures for the mixed dentition patient;

• provide limited orthodontic treatment for the adult patient; and

• provide consultation and referral to specialists in an efficient and knowledgeable manner.

Pediatric Dentistry

At the completion of clinical studies, the students will be able to:

• recognize and explain the difference between primary and permanent teeth, particularly as they affect appropriate clinical protocol used, and provide treatment accordingly;

• recognize and explain the relative merits and uses of specific instruments and dental and biomaterials as they apply to dental restorations involving pediatric patients, and provide treatment accordingly;

• recognize and explain the specific steps involved in restoring primary and young permanent teeth with amalgam, stainless steel crowns, composite and glass ionomer materials, and provide therapy accordingly;

• recognize and explain the specific steps involved in providing pulp therapy for primary and immature permanent teeth, and provide treatment accordingly;

• recognize and explain preventive strategies for children, including diet assessment and counseling, fluoride therapy, oral hygiene techniques and other approaches, and provide appropriate clinical care and counseling;

• explain the procedures for providing care for traumatically involved primary and young permanent teeth;

• recognize and explain the principles involved in assessment and treatment of space management problems;

• recognize, explain, and demonstrate sound principles of patient management for pediatric patients; and

• create a treatment environment that fosters a positive attitude regarding personal oral health and regular dental care in the pediatric patient.

Periodontics

At the completion of the predoctoral clinical program in Periodontics the student will be:

• competent in the use of diagnostic periodontal methods and the making of a periodontal diagnosis;

• proficient in the making of a prognosis for the dentition from a periodontal perspective;

• competent in the sequencing and treatment planning of periodontal therapy in patients with periodontal diseases (severity type I-III cases - as defined by the American Academy of Periodontology);

• competent in the delivery of prophylactic periodontal care;

• competent in the delivery of non-surgical periodontal therapy in patients with periodontal diseases;

• proficient in uncomplicated minor periodontal surgery (flap debridement);

• competent in the pharmacological management of post-operative pain resulting from minor periodontal surgery;

• competent in the pharmacological management of anti-inflammatory and anti- bacterial agents in the treatment of periodontal diseases;

• competent in the provision of maintenance periodontal care;

• competent in the management of periodontal emergencies; and

• competent in the assessment and recognition of periodontal conditions requiring referrals and competent in making referrals to and working with specialists in Periodontics.

Prosthodontics

At the completion of clinical studies, the students will be able to:

• diagnose and treat the completely or partially edentulous patient which includes the delivery of complete dentures, immediate complete dentures or overdentures, removable partial dentures, and temporary removable complete or partial

dentures;

• coordinate fixed and removable prosthodontic treatment through modified (surveyed) restorations;

• assess the general adequacy of a prosthodontic patient's diet and counsel the patient about diet and oral health;

• reline and repair removable complete and partial dentures;

• delegate and supervise certain prosthodontic procedures involving a dental technician; and

• recognize clinical problems requiring referral to a specialist for preparatory or comprehensive therapy.

At the completion of clinical studies, the students will be:

• exposed to the fields of maxillofacial and implant prosthodontics.

Restorative Dentistry

Students in the Restorative Dentistry clinical programs shall be able to:

• develop and apply suitable preventive regimens to forestall destructive processes involving the dentition, such as caries, attrition, abrasion, and erosion;

• provide appropriate diagnosis and treatment planning for the restoration of the dentition;

• critically assess and select appropriate biomaterials to aid in the restoration of the dentition;

• furnish patients with dental restorations to satisfy patient needs in both function and esthetics without damage to adjacent teeth and tissues;

• perform the requisite technical procedures necessary to provide patients with high quality dental restorations which will remain in service for a reasonable length of time; and

• re-evaluate patients periodically and assess the stability of existing dental restorations and provide replacements where appropriate.

Pre-doctoral dental students shall:

• understand the structure and organization of hospitals and procedures necessary for staff membership;

• become familiar with the dental management of medically compromised patients; and

• experience the provision of dental care in hospital-based clinics including the treatment of patients through a hospital emergency department.

4/19/94