OH5.2012 Provide chairside support during the prevention and control of periodontal disease and caries and the restoration of cavities

Overview

This standard describes the role of the oral health worker in providing chairside support during the prevention and control of periodontal diseases and caries, and the restoration of cavities. You will need to prepare and mix a wide range of materials/medicaments which, if not carried out correctly, can seriously affect the success of the treatment. You will need to know the reason for using particular materials and medicaments, the alternatives that may be used and the mixing and handling instructions recommended by the manufacturers. This standard is applicable to workers in all settings where patients require treatment related to the prevention and control of periodontal diseases and the preparation and restoration of cavities. Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 2

Knowledge and Understanding

You need to know and understand:

1. the structure and function of teeth and periodontium including the number of roots
2. regional anatomy of the head and neck and dental anatomy
3. the development of dental plaque and methods for controlling it
4. the main causes and treatment of periodontal disease and caries
5. methods of and the use of techniques, agents or materials to prevent caries
6. the nature and progression of dental and oral disease
7. recognised forms of valid consent and their application before any treatment is undertaken
8. methods of protecting and retracting the soft tissues
9. methods of aspirating during treatment
10. the ways in which periodontal disease can be prevented and/or minimised including effective oral hygiene techniques
11. the different forms of fluoride and its optimum levels
12. the function of the different kinds of equipment, instruments and materials/medicaments used in:
    1. periodontal therapy
    2. the preparation and restorations of cavities
    3. the prevention of primary and secondary caries
13. the ergonomics of dental practice including seating, positioning of the patient and team, instrument passing, suction tip placement
14. methods of working which will complement the work of the operator and the reasons for this
15. methods of facilitating a clear view of the treatment area for the operator and the consequences of doing this incorrectly
16. the equipment used in the administration of local and regional anaesthesia
17. the different stages in cavity preparation for both deciduous and permanent teeth
18. the circumstances where linings may be required, and which materials are available
19. the advantages and disadvantages of the different types of:
    1. amalgam
    2. temporary restorations
    3. composite restorations
    4. glass ionomer restoration
    5. sealants
20. the purpose and different types of etchants, when and where they are used
21. the purpose and different types of bonding agents, when and where they are used
22. the importance of finishing restorations and the equipment, instruments and materials that may be used
23. the importance of matrix systems and the equipment and instruments that may be used
24. the safe use of curing lights and their potential hazards
25. standard precautions and quality standards of infection prevention and control, including personal protective equipment and your role in maintaining them
26. the hazards associated with amalgam including:
    1. the reasons for, and importance of, preparing amalgam in ventilated areas
    2. the appropriate precautions that should be taken to prevent mercury spillage
    3. the correct action to take in the event of mercury spillage
27. health and safety regulations and national policies and procedures
28. the legal and organisational policies relating to the disposal of waste and spillage from clinical treatments and investigations
29. how to monitor, support and reassure the patient throughout treatment including identifying anxiety
30. the reasons for continually observing the operator during the procedure
31. how to recognise and respond to actual or potential emergencies
32. methods of communicating information clearly and effectively
33. how to modify information and communication methods for individuals, including patients with special needs, patients from diverse social and ethnic backgrounds, children and the elderly and where necessary, provide representation for them
34. 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
35. the importance of keeping full contemporaneous records and the legislation and guidelines relating to patients' records and confidentiality
36. methods of effective team working in oral health care

Performance Criteria

You must be able to:

1. retrieve and make available the correct patient's charts, records and images and identify correctly the planned treatment
2. apply standard precautions for infection prevention and control and take other appropriate health and safety measures
3. provide appropriate support during the administration of local or regional analgesia
4. anticipate, select and arrange the equipment, instruments, materials and medicaments in their most likely order of use and easy reach of the chairside for:
   1. prevention and control of periodontal diseases
   2. the prevention and control of dental caries
   3. the provision of amalgam restorations
   4. the provision of composite restorations
   5. the provision of glass ionomer restorations
5. aspirate the treatment area, maintain a clear field of operation and suitably protect the patient's soft tissues using instruments and materials appropriate to the procedure
6. correctly anticipate, select and offer to the operator:
   1. a suitable matrix system to aid the placement of a restoration
   2. the correct quantity of the appropriately mixed restorative materials
   3. any materials or equipment required for the finishing of the restoration
7. handle equipment, instruments, materials and medicaments in a manner that minimises the possibility of injury, damage and cross-infection
8. continuously monitor and reassure the patient, identify any complications and take the necessary actions without delay
9. dispose of waste, spillage promptly and in a safe manner and place
10. ensure that all records and other appropriate documents are complete, accurate and legible following the procedure

Additional Information

This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004): Dimension: HWB7 Interventions and treatments