Category: EPA-4

EPA 4B: Deliver Preventive Care – Procedures

SCOPE OF WORK: This activity includes emphasizing prevention to reduce the development of disease and to minimize the progression of disease. In addition, this activity conducts appropriate follow- up to build a long-term relationship with patients and their caregivers.

Domains of Competence
  • Professionalism and Ethics
  • Person-Centered Care
  • Health Promotion
  • Critical Thinking and Decision Making
  • Biomedical Science Application
  • Self-Assessment
Knowledge
  • Indications and contraindications for preventive procedures including biopsychosocial parameters of care and application of evidence
  • Technical standards for preventive procedures (see rubrics)
  • Properties, selection, and use of biomaterials relevant to applicable procedures and the patient
  • Infection control, patient safety, and comfort
  • Awareness of complications or contingencies that may arise during or following treatment
  • Strategies, techniques, and instrumentation to perform the procedure
  • Ergonomics and four-handed dentistry
  • Required documentation of non-surgical and surgical procedures in electronic patient record (EPIC Wisdom)
Skills
  • Apply evidence and critical thinking to material and treatment selection
  • Apply principles of health promotion and person-centered care in the planning and execution of all preventive procedures
  • Provides patient care in a safe and comfortable manner using proper infection control
  • Utilizes appropriate instrumentation and ergonomically sound technique
  • Performs preventive procedures according to acceptable criteria outlined in the rubrics
  • Performs treatment systematically and efficiently
  • Identifies new relevant information that arises during the procedure and discerns when to modify the technique or treatment
  • Informs the patient regarding contingencies that arise during treatment, post operative instructions, and problems that may arise following treatment
  • Accurately self-assess technical and non-technical aspects of treatment performed on a patient
  • Properly documents information in electronic patient record (EPIC Wisdom)
Deliver Preventive Care – Prophylaxis
Meets Expectations of the Graduate
Progressing
Below Expectations
Critical Error
ISOLATION AND TISSUE MANAGEMENT Excellent tissue management Slight tissue damage Moderate tissue damage Severe tissue damage requiring a suture and/or loss of papilla
CALCULUS IDENTIFICATION All calculus correctly identified > 90% of sites identified > 75% of sites identified < 75% of sites identified
CALCULUS AND PLAQUE REMOVAL All calculus removed > 90% of plaque/calculus removed > 75% of detectable calculus removed < 75% of detectable calculus removed
STAIN REMOVAL All stain removed > 90% of sites with stain removed > 75% of sites with stain removed < 75% of sites with stain removed
Deliver Preventive Care – Fluoride
Meets Expectations of the Graduate
Progressing
Below Expectations
Critical Error
ISOLATION AND TISSUE MANAGEMENT Excellent tissue management/retraction with moisture control
Tooth/teeth properly dried in all quadrants 		Good tissue management/retraction
Tooth/teeth not properly dried in one quadrant 		Saliva contamination/inadequate moisture control
Teeth were not dried on 2+ quadrants 		Tissues were not isolated/teeth not dried, or poor moisture control resulting in fluoride ingestion and contamination
APPLICATION Proper technique (amount and placement) and fluoride remaining on teeth Proper technique (amount and placement) and majority of fluoride remaining on tissue Inappropriate technique (amount and placement) fluoride on soft tissue not teeth Fluoride was not applied during the appointment or placement not targeted to teeth in 3-4 quadrants fluoride on soft tissue not teeth
Communication (Post-Op Instructions) Provides evidence-based information to the patient appropriate for the fluoride type Lacks minor element in discussing instructions Lacks major elements in discussing instructions, not individualized Fails to provide post-op instructions to patient/caregiver, or inaccurate information that may result in harm
Deliver Preventive Care – Periodontal Maintenance
Meets Expectations of the Graduate
Progressing
Below Expectations
Critical Error
ISOLATION AND TISSUE MANAGEMENT No damage and/or optimal isolation Slight tissue damage Poor isolation and/or tissue damage Poor isolation and/or tissue damage requiring a suture and/or loss of papilla
Removal of Plaque and Calculus All plaque and calculus removed > 90% of plaque/calculus removed > 75% of plaque/calculus removed < 75% of plaque/calculus removed
STAIN REMOVAL All stain removed > 90% of sites with stain removed > 75% of sites with stain removed < 75% of sites with stain removed
Local Medication Delivery Appropriate delivery of local medication Inappropriate delivery of local medication Inappropriate delivery of local medication
Deliver Preventive Care – Sealant
Meets Expectations of the Graduate
Progressing
Below Expectations
Critical Error
ISOLATION AND TISSUE MANAGEMENT Excellent tissue management/retraction with moisture control Tooth/teeth properly dried Good tissue management/retraction with moisture control tooth/teeth not properly dried Saliva contamination/inadequate moisture control Poor isolation/teeth not dried, or poor moisture control resulting in ingestion and contamination
Preparation
Prophylaxis Free of plaque and calculus Plaque and calculus present
Etchant Chalky white Chalky white Contamination Contamination
Dentin Adhesive Even layer of DA applied, and light cured Pooling of DA or uneven layer
Restoration
Surface Quality Light cured/smooth Light cured/rough Undercured/rough/requires finishing/retained Undercured/rough/requires replacement/not retained
Marginal Integrity Non-detectable; all pits and fissures covered Detectable; all pits and fissures covered Flawed-minor; not all pits/fissures covered Flawed-major; not all pits/fissures covered
Occlusal Function Ideal occlusion restored/ maintained Restoration in occlusion Hyperocclusion
Counseling Introduction