1 Truman Medical Center Lakewood General Practice Residency in Dentistry

2 Information about what happens at the Truman Medical Center Lakewood GPR

33 Please take a few minutes to review this information about our program. Hopefully this will stir some interest in our program. All of the photos in this presentation are of procedures performed by former residents of the program.

4 The vision and goals of the General Practice Residency program

5 To provide residents advanced training in the full use the resources of the hospital as a site for the practice of dentistry. In doing so provide experiences in management of patients with medical, mental, and physical problems that would challenge the routine delivery of dental treatment.

6 In order to accomplish this the resident will receive instruction and experience providing dental treatment experience to advance their skills beyond their dental school training to enable the residents to :

7 Diagnose oral and maxillo-facial diseases and provide dental care in the context of each patient’s total health care needs. Diagnose oral and maxillo-facial diseases and provide dental care in the context of each patient’s total health care needs. Communicate and function effectively with other health care professionals in a variety of health care settings and understand the role of these professionals and the organization and function of the settings.

8 Plan and provide both routine and complex dental care for a wide variety of patients by applying advance knowledge and clinical skills. Plan and provide both routine and complex dental care for a wide variety of patients by applying advance knowledge and clinical skills. Pursue individual areas of interest and achieve career goals.

9 Structure of the Educational Program

10 The following is an estimate the percent of time devoted by the residents to each of the following: Hours % of Year Ambulatory Patient Care Services Seminars (during business hours)964.6 Seminars (over lunch hour or after hours)36* Departmental off Service Rotations56027 Other Total 100%2080 (vacations etc)

11 Competency Patient assessment and diagnosis

12 Obtain a patient’s chief complaint (CC), history of present illness (HPI), past medical history (PMH), social history (SH) and Review of Systems (ROS) Order and interpret appropriate laboratory and radiographic tests Perform problem based physical evaluation, and determine medical risk of dental procedures

13 Competency Planning and providing multidisciplinary comprehensive dental care

14 Plans treatment that includes multiple disciplines into comprehensive treatment plan Plans treatment that includes multiple disciplines into comprehensive treatment plan Develop and carry out dental treatment for compromised patients accounting for the patient’s medical, mental and social needs. Develop and carry out dental treatment for compromised patients accounting for the patient’s medical, mental and social needs.

15 Obtaining Informed consent

16 Presents and discusses proposed treatment with patients. Presents and discusses proposed treatment with patients. Determines who has guardianship status if patient lacks ability to make treatment decisions. Determines who has guardianship status if patient lacks ability to make treatment decisions. Presents reasonable expectations, details Presents reasonable expectations, details risks of procedures and of not completing procedures. Involves the patient (parent/guardian) in the treatment description/consent procedures. Involves the patient (parent/guardian) in the treatment description/consent procedures.

17 Competency sedation, pain and anxiety control

18 Correctly evaluates and determines the patient’s need for the use of behavioral and/or pharmacologic modalities in the management of pain and anxiety based on patient’s reaction to clinical procedures. Correctly evaluates and determines the patient’s need for the use of behavioral and/or pharmacologic modalities in the management of pain and anxiety based on patient’s reaction to clinical procedures. Coordinate with patient’s physician, care takers and family to determine appropriate medications or behavioral management techniques that would be effective for this patient. Coordinate with patient’s physician, care takers and family to determine appropriate medications or behavioral management techniques that would be effective for this patient.

19 Demonstrates an understanding of medications used to achieve sedation or anxiolytic state. Demonstrates an understanding of medications used to achieve sedation or anxiolytic state. Demonstrate an understanding of prevention, recognition and management of complications related to the use and interactions of drugs used to sedate patients and control pain and anxiety. Demonstrate an understanding of prevention, recognition and management of complications related to the use and interactions of drugs used to sedate patients and control pain and anxiety.

20 Competency restoration of teeth

21 Restores single teeth using a functionally acceptable range of materials and methods. Restores single teeth using a functionally acceptable range of materials and methods. Place restorations and perform techniques to enhance dental esthetics Place restorations and perform techniques to enhance dental esthetics Restore intra and extra coronal defects Restore intra and extra coronal defects Restore endodontically treated teeth Restore endodontically treated teeth

22 Competency replacement of teeth

23 Treat patients with missing teeth requiring uncomplicated removable and/or fixed prostheses Treat patients with missing teeth requiring uncomplicated removable and/or fixed prostheses Communicate care design with laboratory technicians and evaluate the resultant prostheses Communicate care design with laboratory technicians and evaluate the resultant prostheses Recognize and manage cases requiring complicated prostheses Recognize and manage cases requiring complicated prostheses

24 Competency periodontal therapy

25 Demonstrate ability to diagnose periodontal conditions Demonstrate ability to diagnose periodontal conditions Evaluate patients with periodontal conditions and propose effective treatment plans Evaluate patients with periodontal conditions and propose effective treatment plans Provide both non-surgical and surgical periodontal treatment for patients with periodontal disease Provide both non-surgical and surgical periodontal treatment for patients with periodontal disease

26 Competency pulpal therapy

27 Diagnose and treat pain of pulpal origin Diagnose and treat pain of pulpal origin Perform uncomplicated non-surgical endodontic therapy Perform uncomplicated non-surgical endodontic therapy Diagnose need for surgical endodontic therapy Diagnose need for surgical endodontic therapy Recognize and manage endodontic complications and emergencies Recognize and manage endodontic complications and emergencies

28 Competency hard and soft tissue surgery

29 Perform surgical and non- surgical extraction of teeth Perform surgical and non- surgical extraction of teeth Perform soft tissue biopsy Perform soft tissue biopsy Perform uncomplicated pre-prosthetic surgery Perform uncomplicated pre-prosthetic surgery Recognize and manage surgical emergencies and complications Recognize and manage surgical emergencies and complications

30 Competency treatment of medical and dental emergencies

31 Anticipate, diagnose and provide initial treatment and follow up for medical emergencies that may occur during dental treatment Anticipate, diagnose and provide initial treatment and follow up for medical emergencies that may occur during dental treatment Diagnose and manage dental emergencies Diagnose and manage dental emergencies

32 Competency management of compromised patients

33 Select and use assessment techniques to form a differential, provisional and /or definitive diagnosis for patients with complex needs Select and use assessment techniques to form a differential, provisional and /or definitive diagnosis for patients with complex needs Treat patients with a acute and systemic conditions and/or social disorders modifying treatment plans and modalities to meet their special needs Treat patients with a acute and systemic conditions and/or social disorders modifying treatment plans and modalities to meet their special needs

34 Competency request and respond to requests for consultations

35 Identify needs and make referrals to appropriate health care providers for the treatment of physiologic, psychological and social problems presented by dental patients. Identify needs and make referrals to appropriate health care providers for the treatment of physiologic, psychological and social problems presented by dental patients. Perform dental consultations and request medical consultations for hospitalized patients and patients in other health care settings. Perform dental consultations and request medical consultations for hospitalized patients and patients in other health care settings.

36 Competency provide dental services utilizing the hospital setting for patient care.

37 Perform dental treatment utilizing the operating room, completing the necessary pre and post - operative assessments and reports. Perform dental treatment utilizing the operating room, completing the necessary pre and post - operative assessments and reports. Admit and discharge a patient from the acute hospital. Completing the necessary daily notes as well as admission and discharge notes or reports. Admit and discharge a patient from the acute hospital. Completing the necessary daily notes as well as admission and discharge notes or reports.

38 Resident Experiences

39 Each resident has at least one teaching case a year. Each resident has at least one teaching case a year. They select a challenging patient with multidisciplinary needs. They select a challenging patient with multidisciplinary needs.

40 Residents Place Implants!

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42 Manage Other Prosthetic Challenges

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44 For more information or to schedule an interview Contact Dr. John Dane