General Practice Dentistry

Competency Statements

• Identify, define and assess the skills necessary to master in order to graduate from our GPR.
• The GPR Program will provide the structure and opportunity to master the competencies.
• Each resident will be responsible to maintain documentation demonstrating that these skills have been mastered.
• Provide the basis for on-going resident assessment and evaluations.

Resident skill levels achieved in each of the competency areas will be assessed by the faculty as follows:

1. Novice:  When the resident is completely or recently new to a particular knowledge, skill, or value; unable to perform without direct supervision, makes errors, is slow or hesitant, rule driven, and relies upon one method to complete the task.
2. Beginner:  A resident who can demonstrate knowledge, skill and value sufficiently to complete a task, but still is unable to do so completely independently. Errors are fewer that the novice, but may still be present.
3. Competent:  The level of knowledge, skills, and values required by residents to perform independently an aspect of dental practice after completing the program.
4. Proficient:  The level of knowledge, skill, and values attained when a particular activity is accomplished in more complex situations, with repeated quality, and with a more efficient utilization of time.
5. Expert:  The level of knowledge, skills, and values attained when execution is flawless, fast, fluid, easily modified, conformed to context, done with multiple methods, integrated.

• Your performance will be continually monitored throughout the program.
   You will receive formal progress reviews at 4 times (Oct., Jan., April, and June) as evaluated by the core faculty and conducted by the Program Director.
  Your procedural experiences/log will be reviewed 3 times (Oct., Jan., and April) with your Associate Program Director to identify any deficiencies in performance and procedural exposures allowing adequate time for corrections.
• In order to receive a Certificate of Completion from the program, each resident must achieve a level of “Competent” or better.
• If, at completion of the Program, a resident is unable to achieve a level of “Competent” or better, you will receive a Certificate of Participation.
   

Global Competencies
 

1. Ethics - Practice and promote ethical principles in all aspects of the program. Show professional manner in relationships with colleagues, patients, and families.
2. Values and Motivation – Self-assess abilities and limitations. Demonstrate motivation and interest to be an inquisitive, continuous student who strives for quality education and self-improvement. Demonstrate organization, responsibility and reliability. Attend all scheduled clinical and didactic sessions in a punctual way.
3. Organization – Complete all paperwork/patient records/requested bureaucratic information in a timely and appropriate manner.
4. Interaction/Diversity – Interact sensitively and effectively with persons from diverse cultural, socio-economic, educational, and professional backgrounds, and with persons of all ages and lifestyle preferences.
5. Colleagues – Interact effectively with attending, consulting, auxiliary, medical, and other colleagues.
6. Overall Patient Care – Apply “Best Care” principles to all patient care interaction.
7. Medical Workup – Obtain sufficient medical history, physical examination, supplemental studies (radiographs, labs, diagnostic exams, etc.) and any other appropriate information to render appropriate and safe care to each patient.
8. Efficiency – Manage time and treat patients efficiently.
9. OSHA – Use and implement accepted sterilization, disinfection, universal precautions and occupational hazard prevention procedures.
10. Patient Records – Maintain complete and accurate patient records that facilitate the retrieval and analysis of the patient treatment process and outcomes assessment.

Pediatric Dentistry

• Incorporate caries risk assessment protocols and provide appropriate recommended treatment regimens.
• Perform pediatric pulpal therapy.
• Restore intra and extra-coronal defects in the primary dentition.
• Perform uncomplicated surgical procedures on pediatric patients.
• Use pharmacologic and non-pharmacologic behavior management skills with the pediatric patient.

Pulpal Therapy

• Diagnose and treat pain of pulpal origin. Perform uncomplicated, non-surgical anterior and posterior endodontic therapy employing rotary techniques.
• Recognize and manage uncomplicated endodontic situations and emergencies.
• Manage complex endodontic therapy complications and identify indications for endodontic referral.

Restorative Dentistry

• Restore single teeth using a functionally acceptable range of materials and methods.
• Place restorations and perform techniques to satisfy both functional/esthetic demands of the patient.
• Restore intra and extra-coronal defects.
• Restore endodontically treated teeth.
• Employ CAD/CAM technology to restore teeth.

Temporomandibular Dysfunction and Occlusion

• Understand basic masticatory system anatomy, function, and dysfunction.
• Diagnose and non-surgically treat uncomplicated temporomandibular disorders.
• Identify and order appropriate imaging modalities.
• Identify indications for referral.
• Evaluate patients for occlusal disorders including malocclusion, attrition, erosion, rumination, occlusal interferences, etc. Provide appropriate intervention (direct vs. referral) as appropriate.
• Treat minor occlusal abnormalities and arch space problems using space maintenance and other orthodontic appliances.

Prosthetic Dentistry

• Treat patients with missing teeth requiring uncomplicated removable and/or fixed prostheses.
• Communicate prosthesis design with laboratory technicians and evaluate resultant prostheses.
• Recognize and manage cases requiring complicated prostheses.
• Treat patients with missing teeth using uncomplicated dental implant restorations.
• Manage the surgical component of dental implant systems.
• Manage the fixed and removable prosthetics of dental implant systems.
• Assess and manage complications of dental implants.

Treatment of Medical and Dental Emergencies

• Anticipate, diagnose and provide initial treatment and follow-up management for medical emergencies that may occur during dental treatment.
• Diagnose and manage dental emergencies, performing uncomplicated or reversible techniques where indicated.
• Provide initial treatment and then manage patients with intra-oral, extra-oral, and complex oral-facial emergencies and infections.
• Perform initial treatment and management of intra-oral and extra-oral facial trauma. 
• Treat intra-oral hard and soft tissue lesions of traumatic origin.
• Manage intra-oral soft tissue lesions of non-traumatic origin.

Periodontal Therapy

• Diagnose periodontal disease demonstrating periodontal examination and utilizing radiographic review and interpretation.
• Treat and manage mild and moderate periodontal disease, including non-surgical and surgical techniques.
• Recognize and manage periodontal emergencies and complications of periodontal treatment.
• Evaluate the results of periodontal treatment, establish and monitor a periodontal maintenance program.

Obtain Informed Consent

• Explain and discuss with patients, parents or guardians of patients who lack decisional capacity, findings, diagnoses, treatment options, realistic treatment expectations, patient responsibilities, time requirements, sequence of treatment, estimated fees and payment responsibilities, in order to establish therapeutic alliance between the patient and/or parent or guardian, and care provider.

Oral Pathology and Oral Surgery

• Identify indications, manage, and perform surgical and non-surgical extraction of erupted teeth.
• Identify indications, manage, and perform uncomplicated pre-prosthetic surgery
• Identify indications, manage, and perform biopsies of oral tissues
• Recognize and manage surgical emergencies and complications of intraoral surgical treatment
• Extract uncomplicated impacted wisdom teeth.
• Diagnose and manage oral manifestations of systemic disease.
• Diagnose and manage common oral pathological abnormalities.
• Recognize and manage oral mucosal diseases (i.e. autoimmune conditions, cancer, mucositis, drug reactions). Use palliative care, biopsy, pharmacologic intervention, and/or referral as appropriate

Hospital Protocols

• Provide dental treatment in the operating room.
• Provide comprehensive management and care for individual inpatients or same day surgery patients from the beginning to the end of a patient’s hospital experience.
• Request and respond to requests for consultations.
• Identify needs and make referrals to appropriate health care providers for the treatment of physiologic, psychologic and social problems presented by dental patients.
• Perform dental consultations and request medical consultations for hospitalized patients and patients in other health care settings.

Planning and Providing Multidisciplinary Comprehensive Care

• Integrate multiple disciplines into an individualized, comprehensive, sequenced treatment plan using diagnostic, risk assessment and prognostic information for patients with complex needs.
• Develop and implement dental treatment plans for special needs patients in a manner that considers and integrates those patients’ medical, psychological and social needs.
• Provide dental care as part of an inter-professional health care team.

Patient Assessment and Diagnosis

• Obtain and interpret a patient’s chief complaint, history of present illness, medical, dental, family and cultural background, social histories, and review of systems.
• Obtain and interpret appropriate laboratory and radiographic data and obtain additional diagnostic information through consultation with other health care providers.
• Perform a history and physical examination and collect other data to establish a risk assessment for use in the development of a dental treatment plan.
• Establish diagnosis and risk assessment incorporating historical, laboratory, radiographic and clinical findings.

Pain and Anxiety Control

• Patient Selection- Select an appropriate sedation modality for patients who require or would otherwise benefit from the use of conscious sedation.
   
• Oral/N2O-Provide control of pain and/or anxiety through the proper use of    oral, or oral and nitrous oxide conscious sedation techniques.
   
• IV Sedation-Provide control of pain and/or anxiety through the proper use of intravenous conscious sedation techniques.
   
• Sedation Emergency-Understand how to prevent, recognize and manage complications related to the use of conscious sedation.
   
• Sedation Records-Demonstrate appropriate record keeping during conscious sedation.
   
• General Anesthesia-Understand the indications for GA and the 22 point threshold of medical necessity.

Practice Management 

• Function as a patient’s primary oral health care provider.
• Treat patients efficiently in a dental practice setting.
• Use and implement accepted sterilization, disinfection, universal precautions and occupational hazard prevention procedures in the practice of dentistry.
• Practice and promote the principles of jurisprudence and ethics in the practice of dentistry and in relationships with patients, personnel and colleagues.
• Provide patient care by working effectively with allied dental personnel including performing sit down, four-handed dentistry.

Medical Risk Assessment

• Select and use assessment techniques to arrive at differential, provisional and definitive diagnoses for patients with complex needs.
• Treat patients with a broad variety of acute and chronic systemic disorders and social difficulties, including patients with special needs

Promoting Oral and Systemic Health and Disease Prevention

• Use accepted prevention strategies such as oral hygiene instruction, nutritional education, and pharmacologic intervention to help patients maintain and improve their oral and systemic health.