The Diagnostics of Clinical Remediation: Teaching Dental Hygiene

We have omitted the pictures and video clips in order
to submit to ADEA. We will have handouts for
participants on the day of the workshop.
Carolyn Ray
The Diagnostics of Clinical
Remediation: Teaching Dental Hygiene
Clinical Instructors How to Teach
88th ADEA Annual Session
San Diego, California
March 16, 2011
Carolyn Ray, RDH, M.Ed.
Professor
Department of Dental Hygiene
University of Oklahoma
Oklahoma City, Oklahoma
Jane Gray, CDA, RDH, M.Ed.
Associate Professor
Senior Clinic Coordinator
Department of Dental Hygiene
University of Oklahoma
Oklahoma City, Oklahoma
Lizabeth Spoonts, RDH, M.S.
Associate Clinical Professor
1st Year Clinic Coordinator
Dental Hygiene Program
Texas Woman’s University
Denton, Texas
Course Objectives
• At the end of this course, you will be able to:
• Identify instrumentation techniques that
prevent students from achieving positive
outcomes.
• Formulate individualized clinical instruction
unique to each students’ needs.
• Communicate clinical instruction customized to
achieve student competence.
Agenda
8:30 – 8:40
Faculty and course introductions
8:40 – 10:00 Didactic Content
Historical Perspectives
Novice Students
Advanced Students
10:00 – 10:10 Break
10:10 – 11:30
Interactive Activities
Ray
Spoonts
Gray
Historical Perspectives
Where did the rules come from?
Instrumentation Textbooks
• 1916, 1921, 1927, 1934
• Mouth Hygiene
•
Alfred Fones
• 1959, 1963, 1968, 1972
• Clinical Dental Hygiene
•
Shailer Peterson
• 1973, 1979, 1992, soon to come?
• Periodontal Instrumentation
•
•
Anna Matsuishi Pattison
Gordon L. Pattison
• 2004, 2005
• Essentials of Dental Hygiene: Preclinical Skills; and Clinical Skills
•
•
Mary Danusis Cooper
Lauri Wiechmann
• 1983, 1988, 1996 , 2000, 2004, 2008
• Fundamentals of Periodontal
Instrumentation
•
•
Jill Nield, Ginger O’Conner
Jill S. Nield-Gehrig
• 2002, 2010
• Experience is the Best Teacher:
Manual of Dental Hygiene
•
Antonella Tani Botticelli
Dr. Alfred Fones
December 17, 1869 – March 13, 1938
Dentist and Social Reformer
Founder of the Fones School of Dental Hygiene
University of Bridgeport
(1st Dental Hygiene Program in the World)
st
1
Dental Hygiene Textbook
• Published in 1916
• Chapter XII – Dental Prophylaxis
• Pages 288 – 367
• Topics include, but not limited to:
•
•
•
•
The Principles of Dental Prophylaxis
Practical Work
Instrumentation (pgs. 313 – 326)
Polishing (porte polisher) (pgs. 326 – 339)
•
•
•
•
“Those who would advocate the dental engine are
those who have failed to make themselves
proficient with the hand polishers.” (pg. 327)
Brushing
Floss Silk
Some office facts and statistics (practice
management)
1983 - present
Evidence-based Decision Making
“….it is important for practitioners to make
decisions that are firmly grounded in
knowledge that is obtained from research…”
National Dental Hygiene Research Agenda
3/9/2011
3/9/2011
Evidence-based education
”The integration of professional wisdom with
the best available empirical evidence in making
decisions about how to deliver instruction”
www2.ed.gov/nclb/methods/whatworks/eb/edlite-slide003.
(empirical: ”originating in or based on
observation or experience”
http://www.merriam-webster.com/dictionary/
Principles of Instrumentation
• Focus on upper right
posterior sextant
• Where to sit?
• 8-9 o’clock
• 11 o’clock
• Where to fulcrum?
•
•
•
•
Intra-oral
Extra-oral
Same arch
Opposite arch
• What to see?
• Indirect vision
• Direct vision
Formative
Assessment
The Language of Learning
Formative Assessment
• Formative and Summative Assessment
• Phrases first coined by Michael Scriven – 1967
• Benjamin Bloom – 1968
• made formative assessments a keystone of Learning
for Mastery
• Bloom, Hastings and Maddox – 1971
• produced the handbook of Formative and
Summative Evaluation. 1971
• Formative assessments were linked to instructional
units in a variety of content areas.
Who Benefits from
Formative Assessment
• Formative assessments were designed to
provide crucial feedback for both the educator
and the student.
• The role of formative assessment in a clinical
setting
Back to the Basics
• Foundational Principles in Dental Hygiene
Does Anyone Remember
Penmanship??
• The Modified Pen Grasp
Role of Each Finger
• Thumb
• Fore-finger
• Middle Finger
• Ring Finger
• Little Finger
Relaxed or Stressed!
• Relationship of the fingers
• When to apply tension and where
Up to Bat!
• Choking up on the instrument:
• Handles are hollow for better tactile sensitivity
• Finger on some portion of the shank no longer
necessary
• The relationship of the fingers must be the
focus
“It’s a Beautiful Day in
the Neighborhood”
• Establishing a fulcrum
“Taking it on the Chin”
• Extra-oral fulcrums
• For Beginners???
Adaptation
• Focus on more than the tip 1/3rd
• Terminal Shank position
Geometry – Thought
You’d Never Use It!
• Angulation
• Visual Cues:
• Position of the blade
• Use of the blade
• Handle placement
Insertion
• Visual Cues
• Getting a perspective of the sulcus
Motion or Emotion
• Activation of Motion
• Focus on “feeling” the motion
Dental Anatomy & the
Pivot
• Visual Cues
• Handle placement
Diagnosing Errors - Grasp
• Too far on the pad of the middle finger.
• Results in downward pressure while trying to
move the instrument in an upward motion.
Diagnosing Errors –
Establishing a Fulcrum
• Leading with the wrist
• Lazy fulcrum
Diagnosing Errors Motion
• Understanding the push/pull motion
Diagnosing Errors - Pivot
• Starting Point
• Over-rolling
• Anatomy of a stroke
• Handle crossing over
• End-point
• Visual cues
1975
Technique Preferences
Exploring and Rolling
Turning the corner
Begin turning prior to
approaching the corner
Liability Statement
Flexed Thumb
Collapsed Thumb
Flexed Thumb
Collapsed Thumb
LLL Cross Over Occlusal
LLL Handle Up
LLL Crossover Intraoral
LLL Mirror & Light
Intraoral
LLL Fulcrum
LRL Crossover
LRL Handle Up
URL Intraoral Posterior
URL Extraoral Posterior