Unit information: Advanced Care Dentistry Year 5 in 2015/16

Unit name	Advanced Care Dentistry Year 5
Unit code	ORDSM0011
Credit points	40
Level of study	M/7
Teaching block(s)	Academic Year (weeks 1 - 52)
Unit director	Mr. Brooke
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

This Unit of Teaching will take place in year 4 term 3 and year 5 terms 1 & 2 and will comprise of the following 3 Elements:

• Oral Diagnosis – including Specialist Clinics (Oral Medicine, Maxillofacial Surgery (OMFS), Restorative, Special Needs, Paediatric and Orthodontics) and acute dental care and management of medically compromised patients
• Conscious Sedation Year 5
• Orthodontics Year 5

The general aims of these elements are:

Oral Diagnosis:

• To have clarity as to when patients require specialist referral and how to refer
• To be able to identify patients who may have a malignant or pre malignant condition and undertake urgent referral
• To have knowledge and understanding of the dental specialties.
• To provide a knowledge of the use of conscious sedation in dentistry.
• Develop competency in the diagnosis and management of acute conditions of the teeth, jaws and surrounding structures.
• To develop competency in managing acute dental problems in medically compromised patients.
• To have clarity as to when patients require specialist referral and how to refer.
• To be able to identify patients who may have a malignant or pre malignant condition and undertake urgent referral.
• To be competent in managing medical emergencies within a dental practice setting.

Conscious Sedation Year 5:

• To provide a knowledge of conscious sedation in dentistry.

Orthodontics Year 5:

• To increase skills in the collection of the orthodontic clinical data and the formulation of a problem list.
• To increase knowledge of the correct management of orthodontic appliances and of emergencies that may arise during their use.
• To improve their ability to inform patients about the scope, nature and requirements of orthodontic treatment.
• To improve their ability to refer patients for an orthodontic opinion at the optimal time and in an optimal fashion.
• To improve their knowledge of the interaction between orthodontics and other parts of dental care.

Intended Learning Outcomes

The student should acquire the skills and attributes necessary to:

1. Obtain, record and interpret a comprehensive and contemporaneous patient history and be able to discuss the importance of each component
2. Undertake a systematic approach to intra and extra oral examination
3. Undertake relevant special investigations and diagnostic procedures and manage appropriate clinical and laboratory investigations
4. Synthesise the full results of a patient assessment and make an appropriate diagnosis and treatment plan which may include referral to a specialist service
5. Treat all patients and staff with equality, respect and dignity
6. Recognise, diagnose and manage acute and chronic oral facial pain and dental pain appropriately , effectively and safely including Temporomandibular Joint pain
7. Recognise, diagnose and manage acute dento alveolar and mucosal trauma
8. Recognise and diagnose and manage diseases of the oral mucosa and surrounding structures and refer as appropriate
9. Identify malignant and premalignant conditions and risk factors and undertake urgent referral
10. Safely and appropriately prescribe and administer drugs and therapeutic agents
11. Comply with current best practice guidelines
12. Identify, assess and manage medical emergencies
13. Have clinical experience of administering intravenous conscious sedation.
14. Have experience of treating patients under intravenous conscious sedation
15. Have experience of the monitoring of consciously sedated patients
16. Have experience of the recovery and discharge of consciously sedated patients
17. Recognise and explain to patients the range of contemporary orthodontic treatment options, their impact, outcomes, limitations and risks
18. Identify and explain the principles of interceptive occlusal treatment, including interceptive orthodontics, and refer when and where appropriate

Teaching Information

Oral Diagnosis:

• Attendance at Clinical Consultant Clinics:
• Rotation A am PCU 3.5-4.5 hours a day X 5 days = 17.5-22.5 per week
• Rotation B Consult ant Clinics/Oral Medicine 26 hours per week Minumim of 1 rotation majority 2
• Rotation C Consultant Clinics/Oral Medicine 32 hours per week
• Charlotte Keel 28 hours per week
• Oral Surgery 7 hours a day for one week
• Tutorial based teaching Tutorials on specific topics, problem-based learning, lectures, treatment of patients under supervision
• Problem based learning
• Supervised clinical care of patients attending the walk in dental emergency department

Conscious Sedation Year 5:

• 5 clinical sessions per student for Conscious Sedation

Orthodontics Year 5:

• 1 session per week consisting of supervised treatment
• 30 minutes tutorial /problem-based learning
• 6 lectures in term 5.1
• A three-hour topic teaching session combined with paediatric dentistry in term 5.1.

Assessment Information

Oral Diagnosis

Formative:

• Takes place during clinical rotations (Maxillofacial, Ortho, Conscious Sedation, Oral Medicine, Restorative) and tutorials on a sessional basis, assessing skills, knowledge and professionalism (Graded A –E)

Summative oral assessment:

• Structured assessment of Case Scenarios

(viva voce) Term 2 Year 5 (gateway to finals) - 30% of the Unit mark.

• Competency case presentation and management of a walk in, unseen patient to include history taking and examination Term 2 Year 5 (gateway to finals) - 50% of the Unit mark (must pass to progress)

Conscious Sedation

Formative:

• The assessment will take place during the gateway to Finals examination.

Orthodontics

Summative:

• The Gateway-to-finals exam is the summative test for this element. It consists of the presentation of a case which they have treated – 20% of the Unit mark.

Reading and References

Oral Medicine:

1. Scully C. Oral & maxillofacial medicine. 3rd ed. Churchill Livingstone; 2013. ISBN:9780702049484.

Special Needs:

1. Scully C. Medical problems in dentistry. 6th ed. Churchill Livingstone; 2010. ISBN:9780702030574.
2. Scully C, Dios PD, Kumar N. Special care in Dentistry: Handbook of oral health care. Churchill Livingstone Elsevier; 2007. ISBN:9780443071515.
3. Cawson RA, Odell EW. Cawson’s essentials of oral pathology and oral medicine, 8th ed. Churchill Livingstone. 2008. ISBN:9780443101250.
4. Soames JV, Southam JC. Oral pathology 4th ed. Oxford University Press; 2005. ISBN:9780198537947.
5. Pedlar J, Frame JW. Oral and maxillofacial surgery :an objective-based textbook. Edinburgh : Churchill Livingstone; 2001. ISBN:9780443060175.
6. Moore UJ. Principles of oral and maxillofacial Surgery. 6th ed. Wiley Blackwell; 2011. ISBN:9781405199988.
7. Dimitroulis G. A synopsis of minor oral surgery, 4th ed Butterworth Heinemann; 1996. ISBN:9780723610946.
8. Meechan JG, Robb ND, Seymour RA. Pain and anxiety control for the conscious dental patient. Oxford: Oxford University Press; 1998. ISBN:0192628488.
9. Craig D, Skelly A. Practical conscious sedation. Quintessentials of dental practice. London: Quintessence; 2004. ISBN:97818509070705.
10. Mitchell L. An Introduction to Orthodontics. 4th ed. Oxford University Press; 2013. ISBN:9780199594719.