Unit information: Advanced Care Dentistry Year 4 in 2019/20

Unit name	Advanced Care Dentistry Year 4
Unit code	ORDS30005
Credit points	20
Level of study	H/6
Teaching block(s)	Academic Year (weeks 1 - 52)
Unit director	Professor. Spiteri Staines
Open unit status	Not open
Pre-requisites	None
Co-requisites	None
School/department	Bristol Dental School
Faculty	Faculty of Health Sciences

Description including Unit Aims

The Unit of Advanced Care Dentistry Year 4 (ACD4) falls within the Theme of Advanced Care Dentistry which spans year 4 and 5.

The Unit comprises of these elements:

1. Oral Disease (lecture course) Terms 1 & 2

• Lecture based course covering
• Oral Medicine
• Oral Pathology
• Dental & Maxillofacial Radiology
• Special Care Dentistry
• Oral & Maxillofacial Surgery (OMFS)

2. Oral Disease Term 3 Year 4 (Ground Floor rotation)

• Rotations to Oral Diagnosis (Primary Care Unit)
• Rotations to Consultant Clinics
• Problem based learning sessions

3. Orthodontics

• Clinical teaching
• Tutorials

Oral Disease Year 4:

• Impart a theoretical understanding of the range of disorders which affect the teeth, their supporting structures oral mucosa and the surrounding oro-facial tissues and how they are diagnosed and managed.
• To have awareness of how systemic disease may manifest within the oral cavity and surrounding structures.
• To have an understanding of how systemic disease may affect the dental management of patients.
• To have knowledge to manage medical emergencies within the dental surgery.

Orthodontics Year 4:

• Orthodontics is concerned with the extent of normal variation of form and function of both the hard and soft tissues of the face and the way in which such variations produce differences in the occlusion.
• The role of orthodontics in the overall development of a healthy and attractive dentition is emphasized and the part that orthodontics plays in dental care as a whole.
• An important aspect of the course is to ensure that the graduate understands when and to whom referral for orthodontic treatment is indicated.
• The graduate will have a good orthodontic knowledge relating to patient information, instruction and informed consent.
• The graduate will understand the importance of the GDP’s role in the care necessary to support patients during orthodontic treatment.

The course is designed to provide graduates with excellent ‘orthodontic literacy’ rather than full orthodontic competence. This will enable the graduate when in dental practice to:

• Monitor and manage the developing occlusion
• Categorise and describe presenting malocclusions
• Compile problem lists and know when to refer or treat the problem.

The graduate will be able to:

• Discuss with confidence the basic treatment options with patients and parents.
• The course also aims to provide a well-informed view of any treatment proposed for or being carried out on a patient by an orthodontist.

Intended Learning Outcomes

Students should obtain a knowledge and understanding of the following:

Oral Disease

1. Identify relevant and appropriate dental and oro- facial anatomy and variants.
2. The aetiology and pathogenesis and clinical manifestations of oro-facial diseases and their relevance to prevention, diagnosis and treatment including malignancy.
3. The diagnosis and management of oro facial infections.
4. The role and selection of clinical, radiological, pathology, laboratory investigations and special tests.
5. The standards of record keeping and information governance.
6. Identification and management of medical emergencies.
7. The differential diagnosis of radiolucent, radioapaque and mixed lesions affecting the jaws.
8. The dental management of medically compromised patients.

Orthodontics

1. To develop skills in the collection of the orthodontic clinical data and the formulation of a problem list.
2. To gain knowledge of the correct management of orthodontic appliances and of emergencies that may arise during their use.
3. To improve their ability to inform patients about the scope, nature and requirements of orthodontic treatment.
4. To begin to develop ability to refer patients for an orthodontic opinion at the optimal time and in an optimal fashion.

This unit contributes to delivery and assessment of the following General Dental Council learning outcomes as specified in Preparing for Practice:

Q1 / Q2 / Q3 / Q5 / Q6 / Q7

1.1: 1.1.1 / 1.1.2 / 1.1.3 / 1.1.4 / 1.1.5 / 1.1.6 / 1.1.7 / 1.1.8 / 1.1.9

1.2: 1.2.1 / 1.2.2 / 1.2.3 / 1.2.4 / 1.2.5 / 1.2.6 / 1.2.7

1.4: 1.4.1 / 1.4.2

1.5: 1.5.1 / 1.5.3 / 1.5.4 / 1.5.5 / 1.5.6

1.7: 1.7.1 / 1.7.2 / 1.7.3 / 1.7.4 / 1.7.5 / 1.7.7 / 1.7.8 / 1.7.9 / 1.7.10 / 1.7.11

1.8: 1.8.1 / 1.8.4 / 1.8.5 / 1.8.6 / 1.8.7

1.9: 1.9.1 / 1.9.2 / 1.9.3 / 1.9.4

1.10: 1.10.1 / 1.10.2 / 1.10.3 / 1.10.4 / 1.10.5 / 1.10.6 / 1.10.7

1.11: 1.11.1 / 1.11.2 / 1.11.3 / 1.11.4

1.12: 1.12.1 / 1.12.2 / 1.12.3 / 1.12.4 / 1.12.5 / 1.12.6 / 1.12.7 / 1.12.8

1.13: 1.13.1 / 1.13.2 / 1.13.3 / 1.13.4 / 1.13.5 / 1.13.7

1.14: 1.14.1 / 1.14.2 / 1.14.3 / 1.14.4 / 1.14.5 / 1.14.6 / 1.14.8 / 1.14.9 / 1.14.10 / 1.14.11

2: 2.2 / 2.3 / 2.4 / 2.5

3: 3.1 / 3.2 / 3.3 / 3.4

4: 4.1 / 4.2 / 4.3 / 4.4

5: 5.1 / 5.2 / 5.3 / 5.4 / 5.5

6: 6.1 / 6.2 / 6.3 / 6.4 / 6.5

7: 7.1 / 7.2 / 7.3 / 7.4 / 7.5

8: 8.1 / 8.2 / 8.3

9: 9.1 / 9.2 / 9.3 / 9.4 / 9.5 / 9.6 / 9.7

10: 10.1 / 10.2 / 10.3 / 10.4 / 10.5 / 10.6 / 10.7 / 10.8

11: 11.1 /11.2 / 11.3 / 11.4 / 11.5 / 11.7 / 11.8

12: 12.1 / 12.2 / 12.3 / 12.4 / 12.5

Teaching Information

Oral Disease

The Oral Disease course element will consist of:

• 39 Oral Medicine/Maxillofacial Surgery/Pathology/Radiology/Special Care Dentistry lectures
• Problem based learning tutorials (Number TBC)
• 2 x 3 hours of student presentations
• Clinical chairside teaching

Oral disease lecture course would expect 1-2 hours pre-reading and 1-2 hours follow up per lecture/ topic teaching.

Contact hours per week (average) – 3 hours per week

Student Input (average) – 5 hours per week

Orthodontics

Teaching in this element is carried out by an integrated combination of:

• Tutorials.
• Clinical demonstrations.
• Supervised patient care of both continuing care patients and emergency visits to deal with orthodontic braces which are broken or in need of urgent adjustment.
• The main body of the teaching takes place on the clinic and is led by one or two supervisors who teach the same group through years 4 and 5, following introductory teaching in year 3.
• Tutorials are scheduled fortnightly for an hour before the clinical sessions which are weekly. The tutorials frequently contain a PowerPoint presentation and have associated reading from the recommended textbook.
• Use is also made of case scenarios to increase the ability to apply knowledge to specific situations though problem-based learning. Case scenarios are also available on-line in the clinic for use when patients fail to arrive or happen not be scheduled for a pair of students.

Assessment Information

The final Unit mark is an aggregate of the following assessments:

• eAssessment in Oral Disease (80% of the final unit mark)
• eAssessment in Orthodontics (20%)

Both assessments must be passed. The standard set pass mark will be scaled to 50%.

eAssessment in Oral Disease - The Oral Disease eAssessment takes place in term 4.2. It comprises a range of question types amounting to 80 marks (approximately) and lasts 60 minutes.

eAssessment in Orthodontics - The Orthodontic eAssessment takes place in term 4.3. It comprises a range of question types amounting to 75 marks (approximately) and lasts 45 minutes.

Reading and References

Element of Oral Disease (16 items)

Essential reading (5 items)

• Oral and maxillofacial medicine: the basis of diagnosis and treatment - Crispian Scully, 2013. Selected chapters as relevant to lecture content including Chapters: 4, 5, 11, 16, 22, 23, 24, 26, 29, 31, 32, 34, 35, 38, 41, 42, 43.
• Scully's medical problems in dentistry - Crispian Scully, Crispian Scully, 2014. Chapter 47. Selected chapters as relevant to lecture content
• Cawson's essentials of oral pathology and oral medicine - E. W. Odell, R. A. Cawson, 2017
• Oral medicine: update for the dental team - Jane Luker, Crispian Scully, David H. Felix, 2015
• Essentials of oral and maxillofacial surgery / edited by M. Anthony (Tony) Pogrel, Karl-Erik Kahnberg, Lars Andersson. M. Anthony Pogrel editor. Karl-Erik Kahnberg editor. L Andersson (Lars), 1950- editor. Chichester: Wiley Blackwell, 2014. Relevant material linked to lectures.

Recommended reading (7 items)

• Essentials of dental radiography and radiology - Eric Whaites, Nicholas Drage, 2013. Selected chapters as relevant to lecture content.

• Marsh and Martin's oral microbiology - Philip Marsh, Michael A. O. Lewis, Helen Rogers, David Williams, Melanie Wilson, 2016
• Oral and maxillofacial surgery: an objective-based textbook - Jonathan Pedlar, John W. Frame, 2007
• Principles of oral and maxillofacial surgery - U. J. Moore, 2011. Selected chapters as relevant to lecture content.

• Oral pathology. 5th edition - J. V. Soames, J. C. Southam, 1998.

1: Disorders of development of teeth and craniofacial anomalies

2: Dental caries

3: Other disorders of teeth

4: Disorders of the dental pulp

5: Periapical periodontitis

6: Cysts of the jaws and oral soft tissues

7: Diseases of the periodontium

8: Hyperplastic, neoplastic and related disorders of oral mucosa

9: Keratoses and related disorders of oral mucosa

10: Oral epithelial tumours, melanocytic naevi, and malignant melanoma

11: Infections of the oral mucosa

12: Oral ulceration and vesiculobullous diseases

13: Miscellaneous disorders of oral mucosa

14: Diseases of salivary glands

15: Odontomes and odontogenic tumours

16: Disorders of bone

17: Diseases of the temporomandibular joint

• A clinical guide to oral surgery. Book 1 / Tara Renton, C. Michael Hill. London: British Dental Association, 2013

• A clinical guide to oral surgery. Book 2 / Tara Renton, C. Michael Hill. London: British Dental Association, 2017

Further reading (4 items)

• BNF Publications – Website - Use as reference.
• Dental Radiography: Diagnostic Ultrasound in the Head and Neck Region - October 2008 (Article)
• Management of severe acute dental infections - D. P. Robertson, W. Keys, R. Rautemaa-Richardson, R. Burns, A. J. Smith, 2015-03-24 (Article)
• Special care in dentistry: handbook of oral healthcare - Crispian Scully, Pedro Diz Dios, Navdeep Kumar, 2007. Selected chapters as relevant to lecture content including sections:

INTRODUCTION - Definitions, Causes of disability, Access and legal background (Disability Discrimination Act), Implications of disability legislation

APPROPRIATE ORAL HEALTH CARE - Barriers to oral healthcare, Goals, The people involved in providing care, Treatment planning, Consent, Oral health in people with disabilities, Treatment modification

SPECIFIC PROBLEM AREAS; ALPHABETICALLY ARRANGED A – W

MAIN OROFACIAL PROBLEMS

Element of Orthodontics (1 items)

Essential reading (1 items)

• An introduction to orthodontics - Laura Mitchell, 2013. This text is essential, and students are strongly recommended to purchase this book.