B
OH8 Provide chairside support during the extraction of teeth and minor oral surgery
Overview
This standard is intended for those who provide close support during the extraction of erupted teeth, the extraction of unerupted teeth or roots, and bone removal. You will need to ensure that the patient is properly prepared for the procedure and monitor them at all stages of the treatment, reporting any problems or concerns to the operator. You will also need to anticipate the operator’s requirements to ensure that there is no unnecessary delay during the procedure. Managing the control of cross-infection is also a key requirement.
You will need to know about the different types of extraction and minor surgical procedures including the reasons for carrying them out, and the instruments, materials, equipment and medicaments involved.
Users of this standard will need to ensure that practice reflects up to date information and policies.
Version No 1
Knowledge and Understanding
You will need to know and understand:
- the structures of the skull and oral cavity
- nerve and blood supply to teeth and gingiva
- morphology of teeth and roots of teeth
- primary and secondary dentition and the dates of eruption
- the equipment, instruments, materials and medicaments which are used in the following procedures:
- extraction of erupted teeth
- extraction unerupted teeth and roots including local and regional anaesthesia
- the purpose and correct methods of preparing and handling the range of equipment, instruments, materials and medicaments
- the relationship of the equipment, instruments, materials and medicaments to the different procedures and the order in which they are likely to be used in each procedure
- the different forms of pain and anxiety control that are available in dentistry (including conscious sedation)
- the reasons why the extraction of teeth may be necessary
- the purpose of removing roots and unerupted teeth, the different forms which this may take and its relationship to other forms of dental treatment
- the purpose and reasons for raising mucoperiosteal flaps and the dental nurse’s role in providing chairside support for this procedure
- the purpose and reason for tooth sectioning or bone removal and the dental nurse’s role in providing chairside support for this procedure
- the potential risks and complications that may arise during and after extractions (including nerve damage, haemorrhage, oral antral fistulas, equipment failure
- standard precautions and quality standards of infection control, and the worker’s role in maintaining them
- what is and is not a sterile field and how the correct level of cleanliness may be maintained for the patient’s condition, the treatment and the setting
- legislation and practice guidelines related to health and safety and control of infection and how these affect the worker’s actions (including COSHH and Health and Safety at Work Act)
- the ergonomics of dental practice (eg seating, positioning of the patient and team, instrument passing, suction tip placement)
- methods of working which will complement the work of the operator and the reasons for this
- the function, use and maintenance of suction equipment and aspirators
- methods of protecting and retracting the soft tissues
- methods of aspirating during treatment
- methods of facilitating a clear view of the treatment area for the operator and the consequences of doing this incorrectly (such as tissue damage)
- your role in assisting haemostasis, including assisting the placement and cutting of sutures, preparing packs
- methods of monitoring the patient
- how to recognise and respond to actual or potential emergencies
- why the patient should be confirmed as fit prior to leaving the surgery
- methods of communicating information clearly and effectively
- methods of modifying information and communication methods for different individuals including patients from different social and ethnic backgrounds, children (including those with special needs), and the elderly
- the different types of records used in the organisation (including medical history, personal details, dental charts, radiographs/photographs and study models for assessment and treatment planning) and their purpose
- confidentiality in relation to patient records
Performance Criteria
You must be able to do the following:
- retrieve and make available the correct patient’s charts, records and images and identify correctly the planned treatment
- check with the patient that they have followed the prescribed pre-treatment instructions and report any non-compliance promptly to the appropriate member of the team
- apply standard precautions for infection control and take other appropriate health and safety measures
- provide appropriate support during the administration of local or regional analgesia
- anticipate, select and arrange the equipment, instruments, materials and medicaments in their most likely order of use and easy reach of the chairside in a manner that minimises the possibility of damage and cross-infection
- suitably protect the patient's soft tissues using instruments and materials appropriate to the procedure, irrigate and aspirate the treatment area and maintain a clear field of operation
- continuously monitor the patient, identify any complications and take the necessary actions without delay
- assist the operator in the placement and cutting of sutures (if used), record the sutures correctly and prepare an appropriate post-operative dressing
- provide post-operative instructions or information to the patient on care of the mouth, post-extraction haemorrhage, suture removal (if required), and access to emergency care and advice
- support the patient appropriately throughout and confirm with the operator that the patient is fit to leave the surgery prior to them doing so
- ensure that all charts and records are complete, accurate, and legible following the procedure
Additional Information
This National Occupational Standard was developed by Skills for Health.
This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004):
Dimension: HWB7 Interventions and treatments