Psychology - law, ethics and professionalism Flashcards

1
Q

Who makes up the dental team?

A

Dentist

Dental hygienist

Dental therapist

Orthodontic therapist

Dental nurse

Clinical/dental technicians

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2
Q

Why are dental care professionals (DCP) important to dentists?

A
  • Understand legal implications for dentist & DCP if fitness to practice is called into question
  • Should understand who you work with & what they are able to undertake as part of their scope of practice

e.g. employing a DCP who is not registered or asking a DCP to underake something they are not trained/competant to do e.g. dental hygienists cannot remove hard tooth tissue!

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3
Q

Where can you find out about the role of the dental hygienist and dental therapist?

A

GDC scope of practice document

http://www.gdc-uk.org/Dentalprofessionals/Standards/Documents/Scope%20of%20Practice%20September%202013%20(3).pdf

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4
Q

What is indemnity?

A
  • All DCP’s whether clinical or not should have theor own professional indemnity (insurance to protect the individual on their advice & work)
  • As dentists employing DCPs you need to know if they are indemnified
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5
Q

What is the GDC fitness to practice?

A
  • From april 2010
  • Moniter progress throughout clinical training e.g. plagarism & behaviour outside
  • Any unprofessional behaiour or serious health problems during training can affect your aboloty to register with the GDC once qualified
  • Students can be suied in their own right & would almost certainly be individually named in any legal proceeding that might be brought about in respect of any treatment they provided (do not mislead patients, should bond with them = empathy & trust)
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6
Q

What can a Dental hygeinists & therapists do?

A

Allowed to undertake duties for which they are trained and competant

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7
Q

Which duties can a dental hygienist do?

A
  • Provide dental hygiene care to a wide range of patients
  • Plan the delivery of care for patients to improve and maintain their periodontal health
  • Obtain a detailed dental history from patients and evaluate their medical history
  • Complete periodontal examination and charting (indicies to screen & moniter periodontal disease)
  • Provide preventative oral care to patients & liase with dentists over the treatment of caries, periodontal disease and tooth wear
  • Undertake supragingival & subgingival scaling & root surface debridement using manual and powered instruments (management but can’t do invasive care)
  • Use appropriate anti-microbial therapy to manage plaque and related diseases
  • Adjust restored surfaces in relation to periodontal treatment
  • Apply topical treatments and fissure sealants e.g. overhanging amalgam
  • Giving patients advice on how to stop smoking
  • Take, process & interpret various film views used in general dental practice
  • Give infiltration and inferior dental block analgesia
  • Place temporary dressings and re-cement corwns with temporary cement
  • Take impressions
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8
Q

What can dental hygienists NOT do?

A
  • Diagnose disease (but can interpret disease)
  • Do not restore teeth
  • Do not carry out pulp treatments
  • Do not adjust unrestored surfaces
  • Do not extract teeth
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9
Q

What additional skills may a dental hygienist have?

A
  • Tooth whitening to the prescription of dentist (dentist must be on the premises)
  • Prescribing radiographs (details currently being debated)
  • Administering inhalation sedation
  • Removing sutures after the wound has been checked by a dentist
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10
Q

What do dental therapists do?

A

Provide holistic patient care and are trained as a hygienist but also trained in additional therapist skills

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11
Q

What can dental therapists do?

A
  • All intracoronal (class I-V) restorations in primary & permanent teeth
  • Use all materials and adhesive techniques including bonded amalgams (not pre-cast and pinned placements)
  • Administer local infiltration anaesthetics (LIA) & inferior alveolar nerve blocks (IDB)
  • Provision of treatment under rubber dam
  • Take dental radiographs
  • Take alginate impressions (cannot prescribe them)
  • Perform pulp therapy treatment in primary teeth
  • Fit preformed metal crowns in primary teeth
  • Extract primary teeth under local anaesthetic
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12
Q

What can dental therapists NOT do?

A
  • Carry out initial diagnosis
  • Do not take overall responsibility for planning a patient’s treatment (cannot change the direction of treatment)
  • Do not undetake any of the skills described within the roles of dental technicians, clinical dental technicians or dentists
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13
Q

What additional duties may a dental therapist have?

A
  • Tooth whitening to the prescription of a dentist
  • Prescribing radiographs
  • Administering inhalation sedation
  • Removing sutures after the wound has been checked by a dentist
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14
Q

By which system was dental care in the UK largely delivered by?

A

Dental care in UK largely delivered via a system whereby patients must first be seen by a dentist in order to access dental care

Dentist = examine, diagnose & treatment plan

SEEN AS BARRIER -> introduce direct access

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15
Q

What is the direct access system?

A

Giving patients access to a dental care professional (DCP) e.g. dental hygienist without having to see a dentist first (point of access before referral to a dentist)

Practice must be compliant with legislation & codes of practice relating to direct access (GDC & FGDP)

Must advertise on website or in practice

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16
Q

Which DCP’s must be registered (in the expanded regestration of 2006)?

A

Dentists

Dental nurses

Dental technicians

Orthodontic therapists

Clinical denal technicians

Dentists act: practice of dentistry is limited to GDC registrants who may carry out treatments or duties for which they are trained and competant

17
Q

Who may perform tooth whitening?

A

Registered dental professional (not hairdressers & beauticians etc.!)

18
Q

GDC standards:

booklet of guidance 2006

A

Patients should first be seen by a dentist before seeing another member of the dental team

The only exception: patients who have no teeth can see a clinical dental technician (CDT) directly to have full dentures made

19
Q

What must be taken by a dentist for a referral to a dental therapist/hygienist?

A
  • Medical history & consent
  • Full mouth assessment & charting including BPE
  • Radiographs (reported & diagnosis)
  • Treatment prescription
  • Local analgesia (drug, dose & route)
  • Prescriptions of Medicine (PoMs) e.g. sodium fluoride varnish, antibiotics
  • Time period for review, or discharge on completeion of course of treatment
20
Q

What is the bog standard max of local anaesthetic dose?

A

3 x 2.2 ml cartridges

21
Q

Following initial assessment by a dentists for how long can a patient be seen by a dental hygienist and therapist independantly of the dentist?

A

Up to 3 years (only refer back to dentist if the oral health status changes significantly which warrants further assessment and planning)

22
Q

Which document is especially useful for paeds?

A

Delivering better oral health: an ecidence based toolkit for prevention

23
Q

What additional skills may a dental nurse have?

A
  • Oral health education
  • Intra-oral photography
  • Shade taking
  • Placing rubber dam
  • Measuring and recording plaque indicies
  • Pouring, casting and trimming study models
  • Removing sutures after wound has been checked by a dentist
  • Applying fluoride varnish as part of a programme overseen by a consultant in dental public health
  • Constructing occlusal rims and special trays
  • Repairing the acrylic components of removable appliances
  • Tracing cephalographs
24
Q

What additional skills can a nurse undertake on prescription of a dentist?

A
  • Taking radiographs
  • Taking impressions
  • Constructing mouth guards and bleaching trays
  • Constructing vacuum formed retainers
25
Q

What additional skills may a dental technician have (with additional training)?

A
  • Taking impressions
  • Recording face bows
  • Carrying out intraoral & extraoral tracing
  • Recording occlusal registrations
  • Carrying out intra oral scanning for CAD/CAM (computer aided design & computer aided manufacturing)
  • Helping dentists fir attachments at the chair side
26
Q

What can clinical dental technicians do?

A
  • Provide complete dentures direct to patients and other dental devices on the prescription of a dentist
  • Take detailed dental and relevant medical history
  • Perform technical and clinical prcedures related to providing removable dental appliances
  • Carry out clinical examinations
  • Fit removable appliances

CANNOT PROVIDE DENTURES WHEN THERE ARE STILL TEETH IN THE MOUTH… is this just when not prescribed by dentist? ****

27
Q

What additional skill smay a clinical dental dechnician have?

A
  • Oral health education
  • Providing soft mouth guards
  • Re-cementing crowns with temporary cement
  • Providing anti-snoring devices on prescription of a dentist
  • Removing sutures after the wound has been checked by a dentist
28
Q

What can orthodontic therapists do?

(n.b. relatively new only around 350 in the country)

A
  • Clinical records
  • Placement of fixed and removable appliances
  • Removal of fixed and removable appliances
  • Emergency care
29
Q

What can orthodontic therapists NOT do?

A

Provide a diagnosis and treatment plan

Activate appliances (screws etc. that put pressure on teeth)

30
Q

What is included in the GDC standards?

A

Duty of Care

Confidentiality

Professional misconduct

31
Q

Learning outcomes document designed to:

A
  • have a greater patient focus & put their interests and needs first
  • meet current and future oral health needs
  • cover the full range of skills, knowledge and behaviours needed to work in dental practice (i.e. clinical, professionalism, communication and management and leadership)
  • cover all registrant categories in one publication with a consistent approach
32
Q

What are the 4 main domains of focus for learning outcomes?

A
  1. Clinical
  2. Communication
  3. Professionalism
  4. Management and leadership