ORALM 640

Advanced Clinical Diagnosis and Oral Medicine

Karen Manookin

1 Credit Per Quarter, 3 Credits Total / Quarters 13-15 (Autumn-Spring, Fourth Year)

Course Description

This is a clinical course series for the fourth year dental student that is a continuation of skills development initiated in ORALM 630. Clinical activities include history-taking and physical examination, radiology, diagnosis and emergency dental care. Additionally, the course includes rotations to the Oral Medicine Clinic, the DECOD Clinic (for dental care for the developmentally disabled patient) and the off-site Provail Clinic (for treatment of patients with cerebral palsy). Rotations to two geriatric facilities are also possible. The focus of clinical activity is on the assessment and delivery of patients seeking urgent dental care at the School of Dentistry, treatment of developmentally disabled patients, and management of patients with oral medicine problems. The level of complexity of patients evaluated and treated by students of ORALM 640 is generally greater than those seen by the students in ORALM 630. Additionally, the fourth year student will frequently act as mentors for the 1st and 2nd year students who participate in clinical observation rotations, as well as taking the lead in team delivery of care when working with third year students in the clinic.

Educational Objectives

The objectives for this course are identical to those for ORALM 630 and are listed below. The goals are for the student to develop the following skills:

  1. Communication with patients that establishes rapport and facilitates gathering of subjective data.
  2. Complete and accurate medical history taking and understanding of the role between medical and psychosocial problems to oral health and delivery of care.
  3. Identification, through general survey, vital signs and complete physical examination of the head and neck, of signs of diseases or conditions that affect the oral health of the patient or delivery of care.
  4. Development of differential diagnoses for signs and symptoms identified during the examination.
  5. Formation of problem lists for the patients that include pertinent health issues, patient’s desires for treatment, urgent care needs and diseases of the soft and hard tissues of the oral cavity and associated structures.
  6. Determination of radiographic needs of the patient, development of radiograph-taking skills and interpretation of radiographic findings.
  7. Communication with other health care providers in the form of referrals to physicians, dental specialists or other clinics within the school when indicated.
  8. Assessment and treatment of urgent dental problems that includes determination, sequencing, delivery and follow-up of the correct treatment for urgent dental problems.
  9. Dental care of patients with developmental disabilities.
  10. Diagnosis and management of patients with chronic orofacial pain, mucosal abnormalities, diseases of the salivary glands, chemosensory disorders and halitosis.
  11. Appropriate use of pharmacological agents for pain, infection and anxiety management.

Course Outline

The student attends one clinic session (2.5-3 hours each) every week during her/his fourth year. In total, each student attends approximately thirty clinical sessions during the three quarters of this course. For each session, the student is assigned to one of the following activities:

  1. Medical and problem history interview of one or more patients with emergency dental problems. Physical examination, radiographic evaluation and appropriate diagnostic testing are conducted to determine the diagnosis. The diagnosis and treatment options are confirmed with the attending faculty, followed by delivery of the appropriate treatment of the patient’s emergency.
  2. Rotations to either of two clinics specializing in dental care for the developmentally disabled patient. The student will conduct exams and deliver care under the supervision of faculty with expertise in the treatment of these patients.
  3. Rotation to the Oral Medicine Clinical Services Faculty Practice, where students will observe the evaluation and management of patients with chronic orofacial pain, mucosal disorders, chemosensory disorders and salivary gland diseases.

Course Expectations

To successfully meet the requirements of this course, the student must attend assigned clinic sessions, exhibit professional conduct, and demonstrate her/his clinical skills by participation in the activities (1-3) listed above.

Daily assessment of clinical skills is obtained through review by the attending faculty of standardized forms completed by the student for collection of historical and physical examination data. The student presents this information, the diagnosis(es) and treatment plan to the attending faculty. The attending faculty confirms the examination findings, problem identification, determination of radiographic needs and treatment plan by the student. Completed treatment is also assessed. The attending faculty completes a form with clinical performance criteria for each student at the end of each session. At the end of each quarter, the assessments are summarized by the attending faculty on a form designed for this purpose.

Effective Winter Quarter 2007, completion of on-line course evaluation is a requirement of this course. Failure to comply will result in an “Incomplete” grade being assigned.

Competencies Addressed

  • UWSOD Competency 1: Examine a patient using contemporary diagnostic methods to evaluate the head and neck region and to reach a diagnosis of the patient’s oral and craniofacial health status.
  • UWSOD Competency 3: Formulate a comprehensive treatment plan based on diagnostic findings, then implement treatment in a safe, properly sequenced and timely manner.
  • UWSOD Competency 4: Provide patient education in the prevention of oral diseases to promote oral and general health.
  • UWSOD Competency 6: Manage acute and chronic orofacial and dental pain.
  • UWSOD Competency 7: Manage pulpal and periradicular disease.
  • UWSOD Competency 8: Manage dental emergencies.
  • UWSOD Competency 10: Prescribe and administer pharmacological agents for patient care.
  • UWSOD Competency 11: Diagnose and manage hard and soft tissue lesions and diseases of the orofacial complex.
  • UWSOD Competency 14: Manage periodontal diseases.
  • UWSOD Competency 15: Assess the teeth and supporting structures and provide preventive services.
  • UWSOD Competency 16: Manage diseases and conditions of the teeth.
  • UWSOD Competency 22: Utilize critical thinking in assessing technical and scientific information for use in identifying patient needs and treatments.
  • UWSOD Competency 25: Manage a diverse patient population and have the interpersonal and communication skills to function successfully in a multicultural work environment.

Media

  • Student’s choice of drug reference manuals

*last updated: 11/28/2011

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