*general supervision
The dentist has prior knowledge and has given consent for the procedures being performed during which the dentist is not required to be present in the dental office or on the premises.
*indirect
The dentist is in the office, authorizes the procedures, and remains in the office while the procedures are being performed by the allied dental personnel.
direct
The dentist is in the dental office, personally diagnoses the condition to be treated, personally authorizes the procedure, and before dismissal of the patient, evaluates the performance of the allied dental personnel.
personal
The dentist is personally operating on a patient and authorizes the allied dental personnel to aid in treatment by concurrently performing supportive procedures.
DH, DT or DA must do these before administering nitrous
take a course with a minimum of 12 hours total comprised of didactic instruction, personally administering and managing at least 3 individual supervised cases
who can place sealants after completing a course by a school accredited by the commission on dental accreditation?
DH, DT, DA
*WHO can give local anesthesia after completing a course on local anesthesia from a school accredited by the Commission on Dental Accreditation
DH and DT (not DA)
*Dental hygienists and licensed dental assistants shall not take impressions and bite registrations for _ of fixed and removable prostheses.
Final construction
*Before removal of bond material, a dental hygienist or licensed dental assistant must successfully complete a course in the use of __ for the express purpose of the removal of bond material from teeth.
rotary instruments
Scope of Practice
DH and DA with restorative functions can place, contour, and adjust amalgam, glass ionomers, and stainless steel crowns on class _
(supragingival)
Class I, II, V
- a dental hygienist or dental assistant must successfully complete a board approved course on these specific restorative procedures.
application of pit and fissure sealants
DH – general
LDA – indirect
*Administer LA
DH – general
*monitor a patient on nitrous
DH – General
LDA – Indirect
T/F — DH or LDA shall NOT take impressions and bite registrations for the FINAL construction of fixed and removable prostheses.
True
*Utilizing rotary instruments for the removal of bond material from teeth
DH – indirect
LDA – indirect
Performing any or all restorative procedures limited to placing, contouring, & adjusting amalgam, glass ionomers, and Class I and V supra composite restorations
DH – indirect
LDA – indirect
*managing and removing IV lines
DH – indirect
LDA – indirect
*placing an IV line
DH – direct
LDA – direct
administering any medications or agents
Personal DH and RDA
*Perform preliminary charting including assessments and existing restoration, determine the perio status, and formulate the DH tx plan in coordination with DDS
DH – general
*make referrals in consultation with DDS
DH – general
*complete prophy with scaling, root planing, and polishing restorations
DH – general
dietary and nutritional counseling
DH – general
*replacement, cementation and adjustment of INTACT temporary restorations
DH – general
LDA – general
*remove overhangs
DH – general
Complete preliminary charting of oral cavity and surrounding structures w/ exception of perio probing and assessment of the perio structure
LDA – general
of course DH can do this too, with probing
take photographs intra or extra orally
DH – general
LDA – general
take vital signs
DH – general
LDA – general
place temporary fillings
DH – general
LDA – general
*cut arch wires, remove loose bands or brackets
DH – general
LDA – general
*take X-rays
DH – general
LDA – general
*take impressions for casts and bite registrations
DH – general
LDA – general
*place and remove ortho separators
DH – general
LDA – general
*deliver vacuum-formed ortho retainers
DH – general
DA – general
*etch enamel surfaces; apply and adjust sealants
DH – general
LDA – indirect
*monitor a patient on nitrous oxide
DH – general
LDA – indirect
*mechanical polishing clinical crowns (calculus must be removed by DDS or DH before polishing)
DH – general
LDA – indirect
*remove excess cement from inlays, crowns, bridges, ortho appliances with HAND INSTRUMENTS
DH – general
LDA – indirect
apply topical fluoride and bleaching agents prescribed by DDS
DH – general
LDA – indirect
*can a LDA or DH place a cavity liner or endo filler
no
place topical gel before injection
DH – general
LDA – indirect
*place and remove rubber dam
DH – general
LDA – indirect
*Preselect ortho bands
DH – general
LDA – indirect
can a LDA give local anesthesia?
No
*remove and replace ligature ties and arch wires
DH – general
LDA – indirect
*remove sutures
DH – general
LDA – indirect
Perform restorative procedures limited to: placing, contouring, and adjusting amalgam
restorations and glass ionomers; adapting and cementing stainless steel crowns; and placing,
contouring, and adjusting class I, II, & V supragingival composite restorations on primary and permanent teeth.
DH – Indirect
LDA – indirect
*place and remove periodontal packs
DH – General
LDA – indirect
*dry root canals with paper points
DH – general
LDA – indirect
*remove bond material with rotary instruments after removal of ortho
DH – direct
LDA – direct
*place and remove matrix bands
DH – direct
LDA – direct
fabricate, cement, and adjust temporary crowns
DH – direct
LDA – direct
*remove temporary RESTORATIONS with hand instruments only
DH – direct
LDA – direct
*etch enamel surfaces before bonding of ortho by DDS
DH – direct
LDA – direct
*attach prefit and preadjusted ortho appliances
DH – direct
LDA – direct
*remove fixed ortho brackets
DH – direct
LDA – direct
remove excess bond material from appliances
DH – general
LDA – direct
*administer N2O2
DH – general
LDA – direct
T/F – ONLY a dentist can cement ortho bands and adjust ortho wires
true
Concurrently perform supportive services if the dentist holds a valid general anesthesia or moderate sedation certificate, is personally treating a patient, and authorizes the allied dental personnel to aid in treatment including the administration of medications into an existing intravenous line, an enteral agent, or emergency medications in an emergent situation.
DH – personal
LDA – personal
(apply meds)
*Place nonsurgical retraction material for gingival displacement.
DH – direct
LDA – direct
-Perform preliminary charting of the oral cavity, oral health instruction and disease prevention, including nutritional counseling, dietary analysis.
-Apply topical medications such as, but not limited to, topical fluoride and cavity varnishes in appropriate dosages.
*-Perform mechanical polishing
GENERAL (DT and ADT)
-Etch appropriate enamel surfaces, apply and adjust pit and fissure sealants.
-Placement of temporary restorations.
-Fabrication of soft occlusal guards and athletic mouthguards.
-Pulp vitality testing.
GENERAL (DT and ADT)
-Administer local anesthesia.
-Administer nitrous oxide inhalation analgesia
*Application of desensitizing medication or resin
-Tissue conditioning and soft reline.
DT – general
ADT – general
-Atraumatic restorative therapy.
*Tooth reimplantation.
-Dressing changes.
-Dispense and administer analgesics, anti-inflammatories, and antibiotics as (permitted by the collaborative management agreement)
general ADT and DT
-Cavity preparation; and restoration of primary and permanent teeth
-Pulpotomies on primary teeth
-pulp capping on primary and permanent teeth.
-Stabilization of reimplanted teeth.
-Remove sutures.
-Brush biopsies.
DT – indirect
ADT – general
-Extraction of periodontaly diseased permanent teeth with mobility of +3 to +4 as permitted by the collaborative management agreement. (Not including unerupted, impacted, fractured)
-Oral evaluation and assessment of dental disease and the formation of an individualized treatment plan authorized by a collaborating dentist
-Make appropriate referrals to dentists, physicians, and other practitioners in consultation with the collaborating dentist.
ADT – GENERAL
—DT cannot do these
-Repair of defective prosthetic devices
-Placement of temporary crowns: and preparation and placement of preformed crowns
*Provide emergency palliative treatment of dental pain
-Extractions of baby teeth
DT – indirect
ADT – general
LDA General Supervision (all)
-cut arch wires on ortho appliance
-remove loose bands on ortho appliance
-remove loose brackets on ortho appliances
-re-cement intact temp restorations
-place temp fillings, not including temporization of Inlays, onlays, crowns, and bridges
-take radiographs
-impressions for casts and appropriate bite registration, not to include impressions and bite registrations for final construction of fixed and removable prostheses
-deliver vacuum-formed ortho retainers
-place and remove elastic ortho separators
-complete prelim charting
-take photographs extra and intraorally
-vital signs – pulse, bp as directed by dds
-obtain informed consent for treatments authorized by the supervising dentist pursuant to the licensed da scope
DH Direct supervision (all)
Etch for ortho, remove CRs, fabricate temp restorations, place/remove matrix bands, remove ortho cement with rotary instruments, attach ortho appliances, remove fixed ortho bands/brackets, initiate and place IV lines, place nonsurgical retraction material for gingival displacement.
DH personal supervision
Help DDS with sedation if completed extra education.
Rules, regulations, and CE requirements
*can a dentist accept money for making a referral (renumeration = $) to another dentist?
nope
*the patient can be terminated for:
- pt failure to comply with treatment or professional advice (ex: advanced perio)
- consistent tardiness or failed appts
- failure to pay for services rendered
- behavior mngmt issues
*Can a LDA scale and clean mandibular anteriors on a pediatric patient?
NO
The LDA and DDS would both be held accountable
*Who could be in trouble by the Board of Dentistry if a DH/LDA practices beyond their scope of practice, even when the DDS did NOT request them to and the DH/LDA acted on their own
both the DDS and DH/LDA
Ad: “Our practice specialized in cosmetic dentistry, promising superior results in the quest to achieve your perfect smile”
What is wrong w/ the above ad?
DDS cannot say they are SUPERIOR and cannot PROMISE the results of a tx.
They are creating a false/unjustified expectation.
Also, cosmetic dentistry is not recognized as a ‘specialty’ by the ADA
In advertising a dental office, the DDS cannot use terms such as “top” or “best”. They cannot make a claim that a survey, ballot, or poll constitutes a ranking for who they are or what they do; ex) “the top 15%” or “voted best..” T/F
true
5 components of CPR training
-AED
-Barrier mask or bag for ventilation
-Foreign body airway obstruction
-Two person rescuer
-Adult, child, and infant CPR
Good Samaritan Law
a person at the scene of an emergency who knows that another person is exposed to or has suffer harm shall give reasonable assistance to the exposed person
Criminal law
law that deals with crime and the legal punishment of criminal offenses (crime against society)
Civil law
deal with disputes between individuals, organizations, or between the two, in which compensation is awarded to the victim
What actions would cause an immediate suspension of a Dental Professional License?
- Dependence on alcohol, drugs, or other substances
- Writing unauthorized prescriptions
*How many CE credits does a LDA, DDS, DT and DH need to have in a 2 year period?
25 for LDA and DH
50 for DDS and DT’s
fundamental credits
directly related to clinical practice of dentistry
*minimum of 15 credits for LDA and DH;
30 for DDS and dental therapists
Core Subjects (fundamental credits)
areas of knowledge that relate to public safety and professionalism
*minimum of 2 different core subjects needed in 2 yrs
*what are core subjects??
-Record Keeping
-Ethics
-Infection Control
-Patient Communication
-Management of med. emergencies
-Diagnosis and tx. planning (optional for DH/LDA)
CPR is a _ credit
Fundamental; must be updated every 2 yrs
*self assessment is a _ credit
Fundamental; printed from ADA website; usually updated every 2yrs. completed and put in professional portfolio; 1 credit
Can all of your credits be earned in the fundamental category?
yes, but they cannot all be in the elective category
*elective credits
activities directly related to, or supportive of the practice of dentistry;
Max. of 10 credits for DH/LDA; 20 for DDS and dental therapists
ex) Self-study-scholarly articles
Scholarly activities- presentations
Volunteering/Community Service
General Attendance- 3 credits for a state or national dental convention
BOD will randomly select individuals for an audit; you will be notified by letter and have __ days to submit COPIES of your CE record
60 days (never send an original)
*Each dental professional is required to keep documentation of their CE for the current 2 year cycle AND the previous __ year cycle
past 2 year cycle
*all dental professionals must notify the board of dentistry within _ of a name or address change
30 days
**T/F : must display annual renewal certificate w/ license in plain sight for pts to see. When renewing license, copies can be requested if one is employed at multiple practices.
(One must carry a wallet copy if they float to variety of offices)
True (you cannot make copies yourself)
*All DHCP must renew their license every _ on the date when they originally got their license
2 years
When is reading a professional article considered a fundamental credit and when is it an elective credit?
A professional article w/ a post test is considered fundamental
Reading a professional article for the information is considered elective
the board can grant a GUEST LICENSE for a DA, DDS, DH if the following conditions are met
- must be currently licensed
- is currently engaged in practice
- is approved by the board
- was established by a non profit organization that is tax exempt
- provides dental care to patients who have difficulty accessing to care
- must agree to treat “indigent” patients
- has to pay a non refundable free no more than $75
- guest license must be renewed anually and expires on Dec. 31
- the care must be provided without compensation
- board requires proof of application
11.must be subject to all state rules and regulations
continuing education waiver for a dental professional who is RETIRED from active practice and has limited the provision of dental care services
-board may require written documentation that they are retired — proof they are not working as a full time dental professional (maybe working a few times a month)
-must complete and document at least 5 hours of approved courses on infection control, medical emergencies, etc.
-provide documentation of current CPR certificate
what is the boards mission?
to ensure that all MN citizens receive quality dental health care from competent dental health care professionals
MN Board of Dentistry has _ members
9 total :
- 5 DDS
- 1 LDA
- 1 DH
- 2 public members
who appoints the 9 members of the board?
governor
what qualifications must the DH, DA, & DDS have to become part of the board?
lawfully in active practice in the state for 5 years immediately preceding appointment into the board
how long can members serve?
2 consecutive 4-year-terms (8 years total)
practicing dental hygienists may provide what services?
1-provides care that is educational, preventative, and therapeutic through observation, assessment, eval, counseling, and therapeutic services to establish and maintain oral health
2-evaluates pt heath status through review of med and dental histories, assesses and plans dh care needs, performs a prophy including complete removal of calc, accretions and stains by scaling, polishing, and performs root planing and debridement
3- administers local and nitrous
4- provides other related services as permitted by rules of the board
DH
A person of GOOD MORAL CHARACTER, who has graduated from a DH PROGRAM accredited by the commission on Dental Accreditation and established in an institution accredited by an agency recognized by the US department of education to offer college-level programs, may apply for licensure
DH program
min of 2 academic years of dental hygiene education
The services provided by a dental hygienist shall not include what?
final diagnosis
all dental hygiene services must be provided under supervision of a licensed dentist. T or F
True
a DH may be employed by a nonprofit organization to preform DH services without the pt first being examined by a licensed DDS if the Dental hygienist….
- has been engaged in active practice of clinical dh for no less than 2400 hours in past 18 mo or a career total of 3,000 hours
-has entered into a collaborative agreement with a licensed DDS that designates authorization for the services provided by dental hygienist
-has documented participation in courses in infection control and med emergencies within each continuing education cycle
- maintains CPR certificate from AHA or American red cross
dental hygiene services authorized to be performed are:
1- oral health promotion
2- removal of deposit and stain from surface of teeth
3- application of topical preventive or prophy agents, including fluoride varnish and pit and fissure sealants
4- polishing and smoothing restorations
5- removal of marginal overhangs
6- performance of preliminary charting
7- taking radiographs
8- performance of SRP
(all under general supervision)
does the dentist need to examine the pt or be present during injection of local anesthesia or nitrous once delegated in collaborative agreement with licensed dds and dh?
no
DH collaborative agreement must include..
1- consideration for med comp pt and med conditions for which dental eval and treatment plan must occur prior to provision of dh services
2- age and procedure specific standard collaborative practice protocols, including recommended intervals for the performance of dh services and a period of time in which an exam by dds should occur
3- copies of consent to treatment form provide to patient by dental hygienist
4- specific protocols for the placement of pit and fissure sealants and requirements for follow up care to assure efficacy of sealants after applications
5- procedure for creating and maintaining dental records for the patients that are treated
collaborative management agreement between a DDS and a DT must include:
- settings where the DT can serve
- any practice limitations (DT vrs. ADT) with the level of supervision
- procedure specific protocalls
- procedure to maintain dental records
- a plan to manage medical emergencies
- quality assurance plan (referral, chart review, follow up care)
- protocalls for administering and dispensing meds
- supervision criteria for DAs
dental hygiene consent to treatment must include statement stating that
dh services provided are not a substitute for dental exam by licensed dds
A DT is limited to practicing in settings that serve __
low income, uninsured, and underserved patients
referal form
for all referrals to pt for further procedures, dh must fill out and provide a copy for collaborating dds
health care facility or nonprofit organizations are limited to: (for collaborative agreement)
hospital, nursing home, home health agency, group home serving elderly, disabled, or juveniles; state-operated facility licensed by commissioner of human services or commissioner of corrections; and federal, state, or local public health facility, community clinic, tribal clinic, schools
what must be on every complete upper and lower denture and removable dental prosthesis?
patients name and social security number
if ssn and pt name on prosthesis is not practicable id should be presented as follows:
- ssn of pt may be omitted if name of pt is shown
-initials of pt must be shown alone if use of pt name is impracticable - identification marks may be omitted in entirety if none of the forms of id are practicable or clinically safe
do you ID mark older prosthesis without this info?
yes
applicant must submit new background check if more than __ has Relapsed since the applicants last submitted background check to the board
1 year
no license issued to any applicant who refuses to consent to a criminal background check or fails to submit fingerprints within __ after submission of application for licensure
90 days
how long does a person have to challenge accuracy of a report of background check
30 days after they get their report back
how long does the board give the applicant to challenge the accuracy or completeness of the report
180 days
when temp license is suspended, the regulated person shall be provided with at least ___ notice of any hearing held pursuant to this section
10 days
if the board has not completed its investigation and final order within _____ days the temp suspension shall be lifted unless the regulated person requests a delay in disciplinary preceedings for any reason
30 days
self-reporting: when should a regulated person who is diagnosed as infected with HIV, HBV, or HCVreport the info to the commissioner
no more than 30 days after learning of the diagnosis or 30 days after becoming licensed or registered by the state
*infection control reporting- a regulated person shall, within _, report to the appropriate board personal knowledge of a serious failure or a pattern of failure by another regulated person to comply with accepted and prevailing infection control procedures related to prevention of hiv hbv and hcv transmission
10 days
how long after an infection control report does the designated office have to meet with the board
30 days of receiving report
without hearing, the board may temporarily suspend the right to practice of a regulated person if they find they have refused to submit or comply with monitoring….
infection control
it is unlawful for any person to..
-enable a unlicensed person to practice dentistry
-practice without a license
-not go by his or her own name (and degree)
regulated person shall be provided with at least ________notice of a hearing under temp suspension infection control
20 days
supervising dds requirements
-board-approved MN licensed dds for at least 5 consecutive years
-license shall not be subject to, or pending, corrective or disciplinary action within the previous five years according to NN statutes
- acceptable written agreement between limited licensed dds and supervising dds- may only supervise 1 for duration of agreement- written agreement shall include info acknowledgment that limited dds agrees to practice clinical dentistry at least 1,100 hours annual for a period of 3 consecutive years
-no more than 2 limited licensed dds are allowed to practice gen dentistry under supervision in one facility
-modifications to written agreement must be submitted in writing to board within 7 business days
-supervising dds must inform the board in writing about the termination of a written agreement with a limited dds within 7 business day of termination
-must inform board in writing about any known disciplinary or malpractice proceedings involving the limited dds w/I 7 business days of proceeding
-submit performance eval no earlier than 90 days before completion of limited dds practice period
-disciplinary actions
limited license dds agrees to practice clinical dentistry for at least hours annually, for a period of _ consecutive years
1,100
3 years
applicant for dental assisting and DH requires. .. -application -copy of diploma or certificate -submit evidence of satisfactory passing boards state and national boards -picture -backround check
*DA without license can…
-perform all duties not directly related with performing dental treatment or services on patients
-retract
-assist with the placement or removal of rubber dam and accessories used for its placement and retention as directed by operating dds
-remove debris with suction devices, air, mouthwash, water
-aid dh and licensed da in their duties
-apply fluoride varnish in community setting under licensed dds
*what is biennial term
properly renewed license or permit issued by board valid from first day of month following expiration for 24 months until renewed or terminated according to procedures in this part
*a DT can supervise no more than __ licensed or non-licensed DAs in any one practice setting
4
*A DT must enter into a __ with a DDS
collaborative management agreement
(all agreements but be reviewed, signed. updated and submitted to the board EVERY YEAR)
Amount of credit hours each biennial a dentist, specialty, guest full faculty or DT needs.
50
minimum of _ credit hours for dentists and DT’s of fundamental CE’s
30
maximum of ___credit hours of elective CEs for DT and DDS
20
_ credit hours each biennial cycle for a hygienist and dental assistant; minimum of _ of fundamental and maximum of _ elective
25, 15, 10
A minimum of _ courses must be completed in _ of the core subject areas per biennial cycle
2, 2
Core subjects
Infection control, record keeping, ethics, management of med emergencies, pt communications, diagnosis and treatment planning.
Fundamental
Activities directly related to the provision of clinical dental services
elective
Activities directly related to, or supportive of the practice of dentistry, dental hygiene, or dental assisting
clinical subject
Subjects directly related to the provision of dental care and treatment to pts
core subject
ares of knowledge that relate to public safety and professionalism
acceptable documentation for CE hours
Every form should include: name and location of organization/presenter, contact information and credentials or training that qualifies presenter to teach course, course title, date, hours and subject matter.
*specialty dental practices:
- dental public health
- endodontics
- oral and maxillofacial radiology & pathology
- oral surgery
- ortho
- pediatric dentistry
- periodontics
- prosthodontics
A dental tech and DDS may practice in the same facility but may each have their own practice.
True;
- the DDS is not responsible for the dental tech unless the tech is EMPLOYED by the DDS
*what if a patient stops by and asks the tech for a denture adjustment??
what about for it to be cleaned?
lab tech cannot do either
*how many dental therapists can a dentist have?
5
*a dentist can have a collaborative agreement with no more than __ DH’s unless authorized by the Board
4
what do you need in order to advertise for sales, construction, reproduction, or repair??
(dental prosthetic appliances)
a written work order from a DDS (good for 2 years)
*non licensed dental assistants:
can be trained ON THE JOB, on site with dentist
duties: retract the cheek, suction, transfer instruments, mix cements, help in sterilization, turn rooms around, set up/tear down, set pts, and walk pts out. (general???)
a DDS is responsible for ensuring that any DA complies with …
- completing a CPR course and maintaining certificate
-compliance with most current infection control guidelines
*limited licensed dental assistants
non licensed but have taken a course in taking RADIOGRAPHS
Sedation
Minimal Sedation (Conscious sedation)
-to reduce anxiety — Anxiolysis
-lightest form of sedation
-ex: N2O2, oral meds, or IV sedation (need 12 hours of a course with 3 different “practice cases”)
characterized by moderate impairment to the patient’s cognitive function and coordination, but leaves unaffected the patient’s ventilator and cardiovascular
minimal sedation
Moderate Sedation (still conscious)
relaxed, awake and can still respond
ex: N2O2, oral meds, IV sedation (need 60 hours during an extra course with practice)
Deep sedation (unconscious)
can only be performed by an anesthesiologist or an oral surgeon (need extra schooling)
*means a depressed level of consciousness produced by a pharmacological agent during which the patient cannot be easily aroused but responds purposefully following repeated or painful stimulation
deep sedation
*general anesthesia (unconscious)
for extreme cases of dental care
*oral and maxillofacial surgeons
Infection Control
high level disinfection
Elimination of all microorganisms except bacterial spores
decontamination
Removal, inactivation, or destruction of HBV and HIV on a surface or item to the point where HBV and/or HIV are no longer capable of causing infection and the surface or item is rendered safe for barehanded touching, use or disposal.
Disinfection
destroys most pathogenic and other microorganisms by physical or chemical means
-does not ensure the degree of safety associated with sterilization processes
(ex: sanitary wipes used to wipe down the cubicle)
sterilization
destroys all microorganisms, including substantial numbers of resistant bacterial spores, by heat (steam autoclave, dry heat, and unsaturated chemical vapor) or liquid chemical sterilants
*Use surface barriers on __ to protect, particularly for surfaces that are hard to clean
light switches, radiographic equipment, drawer handles, computers (change barriers between patients) —-still need to use EPA approved wipes to clean after barriers are removed
The ___ regulates low- and intermediate-level disinfectants that are used on surfaces
Environmental Protection Agency
The __ regulates liquid chemical sterilants/high-level disinfectants
Food and Drug Administration
Any disinfectant used in a dental setting should be registered by the __ and be approved for use in health care settings
Environmental Protection Agency (EPA)
can you use disinfectant wipes from the grocery store?
no, the are not EPA registered
*what does PPE include?
gloves, masks, gowns, and eye protection
disposal of liquid and human waste (blood)
all liquid and human waste, including floor wash water, must be disposed of through trap drains into a public sanitary sewer system
*what type of gloves should you use?
chemical and puncture resistant gloves
-even for “household cleaning” of the dentist office
use barrier protective coverings as appropriate for noncritical equipment surfaces that are
1) touched frequently with gloved hands during patient care
2) likely to become contaminated with blood or body substances
3) hard to clean (e.g., computer keyboards).
Digital radiography sensors are considered
semicritical (they go inside of patients’ mouths but don’t puncture mucous membranes)
-use a barrier then cleaned with high level disinfectant wipes between patients
what types of FLOORS are NOT recommended
carpeting
*hand pieces and intraoral instruments that can be removed from the air and waterlines of dental units are considered _
semi-critical
-should be heat sterilized between patients
-do not just wipe them down!!
examples: high-speed, low-speed, electric, endodontic, and surgical handpieces
Dental health care personnel should use water that meets environmental protection agency regulatory standards for drinking water
≤500 colony forming units (CFU)/mL
Can contaminated dental unit waterlines transmit disease?
yes
*DHCP should receive infection prevention training:
- When they are hired
- When new procedures affect their occupational exposure
- Annually
- According to state or federal requirements
*dental techs must have a work order from the DDS and will keep their work order on infection control for __ years
2
*training should include:
-A description of their exposure risks
-Review of prevention strategies and infection prevention policies and procedures
-Discussion of how to manage work-related illness and injuries
-Review of work restrictions for the exposure or infection
*The infection prevention coordinator
will be responsible for developing and maintaining a written infection prevention program; monitoring/evaluating the program; and implementing quality improvement measures as needed.
*extracted teeth are infectious and should be disposed in
medical waste containers
(but not if it has amalgam in it) — find out local regulations regarding disposal of amalgam
*can we give patients their teeth after extractions?
yes, it is no longer our responsibility once it is handed over
extracted teeth for educational purposes must be…
-Cleaned so there is no visible blood or debris.
-Kept moist in a simple solution such as water or saline
placed in a container with a secure lid to prevent leaking during transport or storage, and labeled with the biohazard symbol until sterilization
-Heat-sterilized to allow for safe handling.
if you get poked by a needle, instrument or were exposed by blood.. you should
- Wash the site of the needlestick or cut with soap and water.
- Flush splashes to the nose, mouth, or skin with water.
- Irrigate eyes with clean water, saline, or sterile irrigants.
- Report the incident to your supervisor or the person in your practice responsible for managing exposures.
- Immediately seek medical evaluation from a qualified health care professional1 because, in some cases, postexposure treatment may be recommended and should be started as soon as possible.
- fill out incident form and submit to board
*OSHA (Occupational Safety and Health Act) requires
employers make hep B vaccine available to all employees who have potential contact w/ blood or OPIM (other potentially infectious materials)
*What employees need Hep B vaccination?
any employee that has potential for contact with blood
Every dental office needs to have a written exposure plan; written policies and procedures for prompt reporting, evaluation, counsel, tx. and follow-up to occupational exposures. T/F
True
*Exposure training should include:
1) Description of their exposure risks
2) Review of prevention strategies & infection control policies/procedures
3) Discussion regarding how to manage work related illnesses and injuries
4) Review of work restrictions for the exposure/infection
*When to wash hands:
-before treating a patient
-before gloves are put on
-right after gloves are taken off
-after treating a patient
Fingernails should be kept SHORT; Artificial nails carry greater __ and are implicated in fungal and bacterial infections
gram negative organisms
when should your eyewear be cleaned?
between every patient and after your last patient at the end of the day
*A surgical mask that covers both the nose and mouth and protective eye wear w/ solid side shields (or a face shield) should be worn by DHCP
T/F
true
when should you change your mask?
-when it becomes wet or visibly soiled
-between patients
-every 3 hours
*destruction of most bacteria, some viruses, and fungi( but not mycrobaterium tuberculosis or bacterial spores) -through the exposure to a chemical registered with EPA as hospital disinfectant but with —-no label claim for tuberculdcidal
low level disinfection
*destruction of mycobacterium tuberculosis, vegetative bacteria, most viruses and fungi (not bacterial spores) through exposure to a chemical registered with EPA hospital disinfectant WITH label claim for tubercluocidal activity
intermediate level disinfection
means the destruction of all forms of microbial life except high numbers of bacterial spores through exposure to a chemical registered with enviormental protection agency “sterilant”
high level disinfection
T/F: Change protective clothing when it becomes visibly soiled as soon as feasible if penetrated by blood or saliva
true
*When should you change gloves?
between patients, and when they become torn or punctured
critical items
penetrate soft tissue or bone; GREATEST risk of transmitting infection and needs to be sterilized by HEAT
(hand instruments, ultrasonic)
Semi critical items
contact mucous membranes but don’t penetrate
**high level disinfectant required
**sterilization by heat still recommended
(dental mirror, impression trays)
non-critical items
pose least risk for transmission of infection
-contacts skin only
**disinfection with EPA registered wipes
(blood pressure cuff, dental chair, etc.)
*chemical indicators
indicator tape: does NOT prove sterile
(ex: brown colored tag after heat sterilization on outside of instrument case)
*biological indicators
spore testing assess by killing highly resistant microbes
-best way to tell if sterilizing equipment is working properly
-MUST be performed WEEKLY
dirty uniforms and lab coats should be _ at the location where they were used
bagged
–must be handled as little as possible
–must not be sorted or rinsed
if spore test comes back positive….
indicated that the sterilizer is not working properly and items are NOT sterile
-needs to be corrected and temporarily be out of service
T/F
a tooth with an amalgam filling in it is considered hazardous waste only
false: hazardous and infectious
autoclaving =
sterilizing
-destroy all microbes
what testing should be available to all DHCW for those concerned that they may be infected by HIV
serologic testing
how should the amalgam scrap be stored and handled
stored in a closed unbreakable container labled ” hazardous “contains mercury” and should be recycled
website for more info on infection control
https://www.cdc.gov/oralhealth/infectioncontrol/questions/
Record Keeping
*Dental records must include
- pt’s name, address, DOB
- if minor, need parent’s name
- name and telephone number of contact person
- name of insurance and ID number if applicable
- patient’s reason for visit
- dental and medical history
- clinical exam
- diagnosis and treatment plan
- informed consent
- progress note
*informed consent consists of…
giving options
benefits
risks
cost
patient’s approval (signature)
*correction of records
notations must be legible, written in ink, no erasures or white outs
-if incorrect info is on paper, must cross out with one line and initialed
*transfer of records
digital Xrays must be transfered by compact or optical disc, electric communication, or printed on high quality photographic paper
-need diagnostic quality using proper exposure settings
- T/F: as a request of patient, records must be transferred, even if their bill hasn’t been paid
True
*when electronic records are kept, a dentist must keep either a _ or use an _
duplicate hard copy
unalterable electronic record
*adults records must be kept for _ years beyond last time they were seen
7
A minor (child) records must be kept for __ years beyond the age of 18
7
*can the dentist charge a patient a fee for transferring records?
yes.
should original X-rays or forms be sent if requested??
No, NEVER. diagnostic duplicate X-rays and records must be copied and sent
who decides the max. fee a DDS can charge?
Minnesota Department of Health
the provider can charge for copies of records
no more than 75 cents per page AND $10 charge for time spent
When a pt requests a copy of the pt’s record for purposes of reviewing current medical care
the provider must not charge a fee
means an accumulation of written documentation of professional development activites
portfolio
each licensee must establish a portfolio for the purpose of:
-record professional development activities
-monitor CE
-retain acceptable documentaion of professional activities
-CPR certificate
Ethics
if a dental therapist, dental hygienist,or a dental assistant performs a services not authorized by the dentist, that behavior is called
conduct of unbecoming a licensee
failure to cooperate with the minnesota board dentistry is considered which of the following
conduct unbecoming a licensee
fraud upon a patient’s or third party payers is called
conduct unbecoming
violation of any statues of the dental practice act shall be guilty of _ _
gross misdamenor
what is the common tort liability in dentistry
negligence
what concept is demonstrated in the philosophy that all patients should recieve the same quality of dental care?
justice
what is the term for voluntary standards for behavior established by a professor
code of ethics
what does DHCP stand for
dental health care personal
which of the following is elected position on the minnesota board of dentistry?
-public board member
-executive director
-secretary
-dentist
secretary
if a licnesed dental professional fails to report the habitual use of drugs and alcohol by their employing dentist, the licnesed dental professions shall be subject to which of the following?
a. civil penalties
b. censure
c. tort liability
d. discrimination
a. civil penalties
for a dental therapist to become an advanced dental therpist, the dental therapist must complete how many hours of dental therapy clinical practice?
2000 hours
*a professional firm must submit a _ to the board of dentistry?
annual report
*__ would be considered an elective professional development activity?
dental management practice course
- a course in treatment planning and diagnosis
all applicants for licensure in mn must do which of the following if they fail the clinical examination or the licensure exam twice as specified by board rule
get more education and training
*which of the following would be considered a fundamental professional development activity
a course in treatment planning and diagnosis
_ means a corporation, partnership, sole proprietor, or business enity engaged in the manufacturer or repair of dental prosthetic appliances
dental laboratory
*To administer general anesthesia, a dentist must complete what?
1 year residency
*T/F OSHA aims to protect the providers/clinicians and CDC aims to protect all patients
true