THE DAYTON VA MEDICAL CENTER

The Department of Veterans Affairs Medical Center at Dayton, Ohio
consists of a general medical, surgical, and psychiatric hospital with
120 beds located in a new hospital building dedicated in 1992, a nursing
home care unit with 265 beds, and a domiciliary with 115 beds, all
combined under one management. It is located on a beautifully landscaped
382‑acre tract at the western edge of Dayton.

The Medical Center employs approximately 1500 full‑time equivalent
personnel. Our staff includes 71 physicians, 8 dentists, and 4 dental
residents, as well as physician and dentist consultants. Volunteer
workers from many civic, service, and fraternal organizations in the
local community augment the medical staff.

The Dental Service provides comprehensive dental treatment to eligible
veterans in two clinics: the main clinic located in the new Patient
Tower and in the satellite clinic at the Extended Care and Nursing Home.

The modern expanded dental clinic in the patient tower is comprised of
twelve general treatment chairs, two examination chairs, two hygiene
chairs, and two oral surgical suites. A completely digital radiology
section includes intraoral, panoramic, and cephalometric capability. A
centralized sterilization system and complete dental laboratory
facilities provide outstanding clinical support.

**Our Mission:**

-   To provide veterans a continuum of care that is accessible,
    value-added, cost-effective, and of the highest quality, within an
    environment of outstanding education and research.

-   To promote a culture that supports and develops a caring,
    compassionate, competent, and quality-oriented workforce.

**Our Vision:**

-   Our vision as a vital component of the VA Healthcare System in Ohio
    is to be recognized as the healthcare provider of choice for
    veterans and as an innovative leader in education and research.

**Our Values:**

-   Trust

-   Respect

-   Commitment

-   Compassion

-   Excellence

TABLE OF CONTENTS

Introduction............................................................................3

Goals and
Objectives...............................................................4

Competency and Proficiency
Measures.......................................5

General
Information............................................................\....13

Educational Experience and
Requirements.................................16

Weekly Rotation
Schedule.......................................................21

Orientation --
2006..................................................................24

Yearly
Schedule.....................................................................25

Inservice
Training...................................................................26

Case
Presentation..................................................................27

Table
Clinic...........................................................................28

Publication
Topic....................................................................29

Restorative
Dentistry......................................................\.........30

Oral and Maxillofacial
Surgery.......................................\............32

Periodontics.....................................................................\......33

Practice
Administration.............................................................35

History and Physical
Examination...............................................36

Pharmacology/Conscious
Sedation..........................................\...37

Endodontics........................................................................\...39

Pediatric
Dentistry...................................................................40

Oral and Maxillofacial
Pathology.................................\................42

Implant Restorative Dentistry and
Occlusion.................................43

Orthodontics...........................................................................44

Oral
Radiology........................................................................46

Dental Service Procedures and
Programs....................................47

Dental Care
Policy...................................................................48

Daily Evaluation
Forms.............................................................50

Quarterly Evaluation
Forms.......................................................55

Dental Training Program
Staff....................................................58

Medical/Consultant
Staff...........................................................59

Resident Graduates -- Dayton VA Medical
Center..........................61

VA Campus
Map..................................................................\...64

INTRODUCTION

The Dental General Practice Residency offered by the Department of
Veterans Affairs Medical Center, Dayton, Ohio was first approved as a
Rotating Dental Internship in December 1967, and then again in May 1969.
Following Council policy, the program was converted to a General
Practice Residency in December 1973. At its May 1975 meeting, the
Commission on Accreditation of Dental and Dental Auxiliary Educational
Programs adopted a resolution granting the General Practice Residency
Program the accreditation classification of \"approval\", after an
evaluation conducted on February 4, 1975. An on site evaluation of the
program by the ADA Commission on Accreditation was conducted on January
29, 1982. Following this evaluation the program was granted \"approval\"
status, with the recommendation to \"expand from 2 to 4 residents based
on the dedication of the attending staff and the clinical experiences
available at the hospital.\" In January 1991, \"preliminary provisional
approval\" was granted for a 24 month advanced education program,
however, this was not implemented due to a lack of funding. An on site
evaluation of the one year program was completed on May 27, 1992, and
subsequently, the Commission adopted a resolution again granting the
program the accreditation classification of \"approval\" at its December
1992 meeting. Periodic on site evaluation of our program was completed
on October 20, 1999. At its January 28, 2000 meeting, the Commission on
Dental Accreditation once more granted accreditation to the Dayton VA
Dental General Practice Residency program. The Commission is the dental
speciality accrediting body recognized by the United States Department
of Education.

The program presently has two one-year residents. Residents spend a
minimum of 60% of their time in the program treating the oral health
needs of ambulatory patients. While in the dental clinic, the residents
rotate through Oral Surgery and Periodontics as well as General
Dentistry. Residents maintain an On Call schedule, attend conferences,
seminars, grand rounds, autopsies, etc. as is the custom of the Service
the resident rotates through. The scheduled practice hours are 8:00 AM
to 4:30 PM, but may be extended as necessary by the Service to which the
resident is assigned. He/she rotates through Anesthesia for four weeks,
General Medicine for two weeks, and Pathology and Laboratory (PALMS) for
one week. Additionally, residents spend a two week rotation in the
Emergency Room. The Dayton Children's Medical Center Pediatric Dentistry
Section provides training in clinical hands-on treatment, as well as
pediatric operating room cases.

It is our hope our residents find the training year to be a truly
rewarding experience. Our goal has been to make this program one of the
finest in the nation. **We can only provide an environment for learning,
the value received is only as great as the effort invested!**

***Andrew J. Mesaros, Jr., D.D.S.***

Director, Dental General Practice Residency

***Paul M. Lambert, D.D.S.***

Chief, Dental Service

**GOALS AND OBJECTIVES**

**Objective #1:**

To train the residents to coordinate the treatment of a diverse patient
population and work effectively with other healthcare professionals.
This includes providing emergency and multidisciplinary comprehensive
oral health care, patient focused care and directing health promotion
and disease prevention activities.

**Objective #2:**

To offer experiences that enable the resident to refine and advance his
or her knowledge and clinical skills in the practice of general
dentistry.

**Objective #3:**

To provide a better understanding of medical and dental sciences as they
relate to the delivery of comprehensive dental care including the
critical review of literature and evidence based practice in order to
provide comprehensive preventive and definitive health care.

**Objective #4:**

To provide the resident with the necessary skills to become lifelong,
self-motivated learning professionals who utilize evidence based
information for clinical decision making and technology based
information retrieval systems.

**Objective #5:**

To provide educational opportunities that will prepare the resident to
effectively establish and maintain an efficient private practice outside
the hospital environment or to evaluate the best opportunity that
matches the resident's long term professional goals.

**Objective #6:**

To provide educational experiences that will prepare the resident to
provide quality dental care to a wide variety of patients taking into
consideration their special needs, cultural diversity and ability to
access care.

> **COMPETENCY AND PROFICIENCY MEASURES**

Patient Assessment and Diagnosis

  ---------------------------------------------------------- ------------
  1\. Perform comprehensive patient assessment, obtain and   **P C E N**
  interpret chief complaint, history of present illness,     
  past medical history, past surgical history, review of     
  systems, and a focused physical exam. **(P)**              

  2\. Make referrals to, obtain consultations from, and      **P C E N**
  interpret clinical and other diagnostic data from          
  professional colleagues for the treatment of dental,       
  medical, psychological, and social problems presented by   
  dental patients. **(C)**                                   

  3\. Perform examination, diagnostic, and treatment         **P C E N**
  planning procedures. **(P)**                               

  4\. Order and interpret appropriate radiographs. **(P)**   **P C E N**

  5\. Develop a findings or problem list to arrive at a      **P C E N**
  differential, provisional , and definitive diagnosis, and  
  risk assessment for patients with complex needs. **(C)**   

  6\. Order and interpret appropriate medical laboratory     **P C E N**
  tests for patients, as required to guide treatment         
  decisions. **(C)**                                         

  7\. Demonstrate an understanding of the etiology and       **P C E N**
  progression of dental caries. **(P)**                      

  8\. Demonstrate the ability to assess the pulpal and       **P C E N**
  periodontal health of dental tissues using appropriate     
  diagnostic procedures. **(P)**                             

  9\. Demonstrate an understanding of the prevention,        **P C E N**
  etiology, pathogenesis, prognosis, and management of       
  periodontal disease. **(P)**                               

  10\. Evaluate a patient's occlusion, and properly treat    **P C E N**
  any dysfunction when indicated. **(C)**                    

  11\. Perform a comprehensive orofacial pain examination.   **P C E N**
  **(C)**                                                    

  12\. Based on the subjective history and clinical          **P C E N**
  assessment, provide the diagnosis, contributing factors,   
  and management plan for orofacial pain. **(C)**            

  13\. Take and analyze orthodontic records as an aid for    **P C E N**
  diagnosis, to include facial and intraoral photos,         
  accurate casts, and cephalometric radiographs. **(E)**     

  14\. Differentiate minor orthodontic cases treatable by    **P C E N**
  the general dentist from those that should be referred for 
  treatment by the orthodontic specialist. **(C)**           

  15\. Recognize major infections of the oral and            **P C E N**
  maxillofacial structure and make the appropriate specialty 
  referral. **(P)**                                          

  16\. Recognize major maxillofacial trauma and refer for    **P C E N**
  specialty care. **(P)**                                    

  17\. Clinically diagnose and manage common oral            **P C E N**
  pathological abnormalities. **(C)**                        
  ---------------------------------------------------------- ------------

> **COMPETENCY AND PROFICIENCY MEASURES**

**Planning and Providing Comprehensive Multidisciplinary Oral Health
Care**

  ---------------------------------------------------------- ------------
  1\. Function as a patient's primary/comprehensive oral     **P C E N**
  health care provider. **(C)**                              

  2\. Work with patients in a manner that is professional,   **P C E N**
  builds rapport and confidence, respects patient's rights   
  and dignity, puts patient's interests first, and maximizes 
  patient's satisfaction with dental care. **(P)**           

  3\. Obtain and interpret the patient's chief complaint,    **P C E N**
  medical dental, and social history, and review of systems. 
  **(P)**                                                    

  4\. Develop a findings or problem list to arrive at a      **P C E N**
  differential, provisional, and definitive diagnosis, and   
  risk assessment for patients with complex needs. **(C)**   

  5\. Make referrals to, obtain consultations from, and      **P C E N**
  interpret clinical and other diagnostic data from          
  professional colleagues for the treatment of dental,       
  medical, psychological, and social problems presented by   
  dental patients. **(C)**                                   

  6\. Integrate multiple disciplines into individualized,    **P C E N**
  comprehensive, and sequenced treatment plans for patients  
  with complex needs. **(C)**                                

  7\. Modify the treatment plan, if indicated, based on      **P C E N**
  therapeutic outcomes, unexpected circumstances, or the     
  patient's individualized needs. **(C)**                    

  8\. Maintain a patient record system that facilitates the  **P C E N**
  retrieval and analysis of the process and outcomes of      
  patient treatment. **(P)**                                 

  9\. Obtain informed consent for dental treatment by        **P C E N**
  discussing with patients,or parents or guardians of        
  patients: findings; diagnoses; the risks, benefits, and    
  process of various treatment options; patient              
  responsibilities during and after treatment; and estimated 
  fees and payment responsibilities. **(P)**                 

  10\. Properly use pharmacological agents in the treatment  **P C E N**
  of dental patients. **(C)**                                

  11\. Assist in the diagnosis, treatment planning,          **P C E N**
  placement, and restoration of implant supported prostheses 
  with the aid of appropriate radiographs and/or tomographs, 
  diagnostic mountings, comprehensive medical and dental     
  histories, and to present these findings to the attending  
  staff provider. **(E)**                                    
  ---------------------------------------------------------- ------------

> **COMPETENCY AND PROFICIENCY MEASURES**

**Obtaining Informed Consent**

  ---------------------------------------------------------- ------------
  1\. Obtain informed consent for dental treatment by        **P C E N**
  discussing with patients,or parents or guardians of        
  patients: findings; diagnoses; the risks, benefits, and    
  process of various treatment options; patient              
  responsibilities during and after treatment; and estimated 
  fees and payment responsibilities. **(P)**                 

  2\. Document wrong site/wrong surgery prevention by        **P C E N**
  identifying patient with name and last four of SSN, and    
  confirming procedure to be accomplished -- documented in   
  the record per JCAHO instruction. **(P)**                  

  3\. Appropriately document informed consent in the         **P C E N**
  electronic patient record (iMed). **(P)**                  
  ---------------------------------------------------------- ------------

**Promoting Oral Health and Systemic Health and Disease Prevention**

  ---------------------------------------------------------- ------------
  1\. Demonstrate an understanding of the etiology and       **P C E N**
  progression of dental caries. **(P)**                      

  2\. Demonstrate an understanding of the modes of           **P C E N**
  preventing dental caries, to include the "Medical Model".  
  **(P)**                                                    

  3\. Demonstrate an understanding of the prevention,        **P C E N**
  etiology, pathogenesis, prognosis, and management of       
  periodontal disease. **(P)**                               

  4\. Educate the patient on TMD self-management, stretching **P C E N**
  exercises, and describe the mechanical detrimentas related 
  to the diagnosis. **(C)**                                  

  5\. Evaluate and educate the patient on                    **P C E N**
  bisphosphonate-associated oral pathology. **(C)**          

  6\. Demonstrate an understanding of, and educate           **P C E N**
  patient/parents on pediatric preventative and oral disease 
  process. **(C)**                                           
  ---------------------------------------------------------- ------------

> **COMPETENCY AND PROFICIENCY MEASURES**

**Treatment of Dental and Medical Emergencies**

  ---------------------------------------------------------- ------------
  1\. Achieve and maintain certification in BLS and ACLS.    **P C E N**
  **(P)**                                                    

  2\. Properly use pharmacological agents in the treatment   **P C E N**
  of dental patients. **(C)**                                

  3\. Prevent, recognize, and manage complications related   **P C E N**
  to the use and interaction of local anesthetics, systemic  
  medications, and agents used in the control of pain and    
  anxiety. **(C)**                                           

  4\. Treat and manage patients with localized dentoalveolar **P C E N**
  infections and appropriately refer those which have        
  extended into adjacent head and neck fascial spaces.       
  **(P)**                                                    

  5\. Manage routine post-extraction complications. **(P)**  **P C E N**

  6\. Manage acute periodontal conditions and routine        **P C E N**
  post-surgical complications. **(P)**                       

  7\. Provide diagnostic and emergency endodontic services   **P C E N**
  in the acute care environment, including the management of 
  traumatic injuries. **(C)**                                

  8\. Possess a working knowledge of medical emergencies in  **P C E N**
  the dental clinic and their treatment. **(P)**             
  ---------------------------------------------------------- ------------

**Medical Risk Assessment**

  ---------------------------------------------------------- ------------
  1\. Perform adequate patient assessment, to include chief  **P C E N**
  complaint, history of present illness, past medical        
  history, past surgical history, allergies, medications,    
  social history, and a focused physical examination.        
  **(P)**                                                    

  2\. Order and interpret appropriate medical laboratory     **P C E N**
  tests for patients as required to guide treatment          
  decisions. **(C)**                                         
  ---------------------------------------------------------- ------------

> **COMPETENCY AND PROFICIENCY MEASURES**

**Sedation, Pain, and Anxiety Control**

  ---------------------------------------------------------- ------------
  1\. Properly use pharmacological agents in the treatment   **P C E N**
  of dental patients. **(C)**                                

  2\. Possess a thorough knowledge of anatomy, physiology,   **P C E N**
  pharmacology, and psychology associated with various pain  
  and anxiety control methods. **(C)**                       

  3\. Select the proper regimen for control of pain and      **P C E N**
  anxiety after adequate physical and psychological          
  assessment of the patient, and evaluation of the procedure 
  required. **(C)**                                          

  4\. Determine the appropriate modality for the control of  **P C E N**
  pain and anxiety (intravenous, inhalation, or oral         
  anxiolysis) appropriate for the individual patient and     
  procedure. **(C)**                                         

  5\. Prevent, recognize, and manage complications related   **P C E N**
  to the use and interaction of local anesthetics, systemic  
  medications, and agents used in the control of pain and    
  anxiety. **(C)**                                           

  6\. Pre and post anesthetic evaluation and management of   **P C E N**
  the anesthetized and/or consciously sedated patient.       
  **(C)**                                                    

  7\. Provide additional therapies of medications, referrals **P C E N**
  to physical therapy and psychology. **(C)**                

  8\. Use non-pharmacalogical behavior management skills     **P C E N**
  with the pediatric patient. **(C)**                        
  ---------------------------------------------------------- ------------

**Hard and Soft Tissue Surgery**

  ---------------------------------------------------------- ------------
  1\. Routine extraction of all indicated erupted teeth and  **P C E N**
  retained root fragments. **(P)**                           

  2\. Removal of uncomplicated soft tissue impactions.       **P C E N**
  **(C)**                                                    

  3\. Removal of uncomplicated bony impactions. **(C)**      **P C E N**

  4\. Perform routine alveoloplasty and exostosis removal.   **P C E N**
  **(C)**                                                    

  5\. Perform minor pre-restorative/prosthetic surgery.      **P C E N**
  **(C)**                                                    

  6\. Perform suturing of uncomplicated intraoral            **P C E N**
  lacerations. **(C)**                                       

  7\. Perform routine intraoral biopsies. **(C)**            **P C E N**

  8\. Manage routine post-op surgical complications. **(P)** **P C E N**

  9\. Perform soft tissue surgery necessary to correct       **P C E N**
  mucogingival defects. **(E)**                              

  10\. Perform surgical endodontic therapy for anterior and  **P C E N**
  premolar teeth. **(E)**                                    

  11\. Perform uncomplicated surgical procedures on          **P C E N**
  pediatric patients. **(E)**                                
  ---------------------------------------------------------- ------------

> **COMPETENCY AND PROFICIENCY MEASURES**

**Restoration of Teeth**

  ---------------------------------------------------------- ------------
  1\. Demonstrate the ability to properly isolate teeth to   **P C E N**
  be restored with rubber dan and/or other adjunctive        
  techniques. **(P)**                                        

  2\. Restore teeth with a wide range of direct placement    **P C E N**
  materials and methods. **(P)**                             

  3\. Restore teeth with a wide range of indirect placement  **P C E N**
  materials and methods. **(C)**                             

  4\. Place restorations and perform techniques to enhance a **P C E N**
  patient's facial esthetics. **(C)**                        

  5\. Restore endodontically treated teeth. **(C)**          **P C E N**

  6\. Demonstrate an understanding of the modes of           **P C E N**
  preventing dental caries, to include the "Medical Model".  
  **(P)**                                                    
  ---------------------------------------------------------- ------------

**Replacement of Teeth Using Fixed and Removable Appliances**

  ---------------------------------------------------------- ------------
  1\. Treat patients with missing teeth requiring            **P C E N**
  uncomplicated removable prostheses. **(C)**                

  2\. Manage patients with missing teeth requiring complex   **P C E N**
  removable prostheses. **(E)**                              

  3\. Treat patients with missing teeth requiring            **P C E N**
  uncomplicated fixed restorations. **(C)**                  

  4\. Manage patients with missing teeth requiring complex   **P C E N**
  fixed restorations. **(E)**                                

  5\. Communicate case design with laboratory staff. **(P)** **P C E N**

  6\. Diagnose and manage a patient's occlusion. **(C)**     **P C E N**

  7\. Recognize, diagnose, and manage complex occlusal       **P C E N**
  abnormalities. **(E)**                                     

  8\. Demonstrate an understanding of the principles of      **P C E N**
  implant placement, its indications and limitations.        
  **(C)**                                                    

  9\. Assist in the diagnosis, treatment planning,           **P C E N**
  placement, and restoration of implant supported prostheses 
  with the aid of appropriate radiographs and/or tomographs, 
  diagnostic mountings, comprehensive medical and dental     
  histories, and to present these findings to the attending  
  staff provider. **(C)**                                    

  10\. Provide follow-up care and preventive maintenance     **P C E N**
  therapy for patients with implant supported prostheses.    
  **(C)**                                                    
  ---------------------------------------------------------- ------------

> **COMPETENCY AND PROFICIENCY MEASURES**

**Periodontal Therapy**

  ---------------------------------------------------------- ------------
  1\. Demonstrate an understanding of the prevention,        **P C E N**
  etiology, pathogenesis, prognosis, and management of       
  periodontal disease. **(P)**                               

  2\. Perform examination, diagnostic, and treatment         **P C E N**
  planning procedures. **(P)**                               

  3\. Provide non-surgical management of mild-moderate       **P C E N**
  irritant-related periodontal disease. **(P)**              

  4\. Provide surgical treatment of uncomplicated mild to    **P C E N**
  moderate periodontitis. **(P)**                            

  5\. Provide surgical treatment of moderate periodontitis   **P C E N**
  with or without osseous regeneration. **(C)**              

  6\. Understand guidelines for specialist referral in       **P C E N**
  advanced periodontal disease. **(P)**                      

  7\. Become acquainted with soft tissue surgery necessary   **P C E N**
  to correct mucogingival defects. **(E)**                   

  8\. Perform minor pre-restorative/prosthetic surgery.      **P C E N**
  **(C)**                                                    

  9\. Manage acute periodontal conditions and routine        **P C E N**
  post-surgical complications. **(P)**                       

  10\. Evaluate treatment results, establish and monitor     **P C E N**
  supportive periodontal treatment. **(P)**                  

  11\. Provide follow-up care and preventive maintenance     **P C E N**
  therapy for patients with implant supported prostheses.    
  **(C)**                                                    

  12\. Identify dental implant complications. **(C)**        **P C E N**

  13\. Become familiar with complex soft tissue augmentation **P C E N**
  and periodontal regenerative procedures. **(E)**           
  ---------------------------------------------------------- ------------

> **COMPETENCY AND PROFICIENCY MEASURES**

**Pulpal Therapy**

  ---------------------------------------------------------- ------------
  1\. Assess the pulpal health of dental tissues using       **P C E N**
  appropriate diagnostic procedures. **(P)**                 

  2\. Provide diagnostic and emergency endodontic services   **P C E N**
  in the acute care environment, including the management of 
  traumatic injuries. **(P)**                                

  3\. Use adjunctive, radiographic, and alternative          **P C E N**
  anesthetic techniques for diagnosis and treatment. **(C)** 

  4\. Perform independent nonsurgical endodontic treatment   **P C E N**
  for routine single and multirooted teeth. **(C)**          

  5\. Diagnose, treat, and assess the prognosis of           **P C E N**
  endo-perio lesions. **(C)**                                

  6\. Become familiar with nonsurgical retreatment of        **P C E N**
  failing endodontic cases. **(E)**                          

  7\. Accomplish accurate diagnosis and case selection of    **P C E N**
  teeth indicated for endodontic periapical surgery. **(E)** 

  8\. Become familiar with indications for, and techniques   **P C E N**
  of endodontic surgical therapy. **(E)**                    

  9\. Gain knowledge regarding etiology, clinical            **P C E N**
  management, and prognosis of resorption defects. **(E)**   
  ---------------------------------------------------------- ------------

## GENERAL INFORMATION

### CERTIFICATION OF TRAINING:

A certificate of training will be awarded to the resident upon
completion of all clinical and educational requirements of their Dental
General Practice Residency.

**SALARY:**

The Dental General Practice Resident's salary is established by The
Department of Veterans Affairs Central Office. As of June 2006, it is
set at approximately \$47,000 annually, plus health insurance benefit.

**OBLIGATION:**

There is no obligation for the General Practice Resident to remain in
Government Service after his/her residency year.

**LICENSURE REQUIREMENTS:**

The resident must apply to the Ohio State Dental Board for a 1‑year
resident certificate. The resident must possess the certificate and be
credentialed before he/she can practice in the hospital. It is therefore
critical that the resident start the application process as soon as
he/she receives notification of acceptance into the program. Dental
practice outside the GPR Program is not permitted under the provisions
of this license.

### PROFESSIONAL LIABILITY COVERAGE:

Department of Veterans Affairs employees are covered while on station by
the Federal Government, which is self-insured. Residents are also
covered by the government while on rotation at Wright-Patterson AFB,
Grandview, Southview, and The Children's Medical Center of Dayton.
Additional information may be found in the Medical Staff By-Laws Article
XI.

### LEAVE:

Residents will accrue 14 calendar days of annual leave and 15 days of
sick leave per year. The leave year begins July 1 and ends June 30.
Annual leave earned but not used by the end of the leave year is lost.
There is no entitlement to a lump sum payment for unused leave.

Annual leave should not be used during the first 90 days of employment.
Residents are encouraged to save leave for such things as taking boards,
looking at prospective practices and housing, extra time at holidays,
etc. ***All leave must be requested, reviewed, and approved by the
Program Director at least two weeks in advance, to accommodate patient
scheduling**.* Legitimate emergency leave requests will be considered at
any time. In case of emergency leave or unscheduled sick leave,
residents must contact the Director via telephone to advise of the
situation, and enter their leave in the computer (VISTA) on the first
day they return.

**ON‑CALL DUTY (DOD):**

Dental residents will be scheduled for on‑call duty for seven days, once
every other four week. While on call, the resident does not have to be
physically present at the hospital but is required to be available
within 30 minutes of the hospital, carry their beeper, and have
telephone access. If the resident has to be off during his/her on‑call
duty, the resident is responsible for notifying the Program Director and
the Emergency Room of the name and phone number of the resident covering
for them.

**BLS/ACLS:**

Residents are required to have an up to date BLS (Basic Life Support)
Card when they arrive for the GPR Program. Residents will take and pass
ACLS (Advanced Cardiac Life Support) at the VA, as part of their
Conscious Sedation requirements.

**THE ACADEMY OF GENERAL DENTISTRY:**

Residents are encouraged to join the Academy of General Dentistry. A
maximum of 250 hours may be granted toward Fellowship for post-graduate
dental education. In order to be eligible for these credits, the
resident must join the Academy during the residency year, and submit
application for credit within 12 months after completion of the
residency.

**DENTAL RESIDENT\'S EVALUATION:**

The Program Director and Dental Service Chief will formally evaluate
residents quarterly. This evaluation will be based upon the input
received from the Dental Staff as well as the evaluation of the
resident\'s performance by those Services through which the resident has
rotated. Resident input will also be solicited quarterly, in the form of
Resident Critiques of their rotations. In addition, a final evaluation
is completed at the end of the year. Each Monday morning from 8-8:30, an
informal feedback session is conducted between residents, the Program
Director and other relevant dental staff, as needed.

### OUTCOME ASSESSMENT EXAM:

A written examination prepared by the American Board of General
Dentistry will be given to all residents at the beginning and end of the
academic year. This serves as an educational and outcome assessment
tool, and permits the teaching staff to gauge the success of the
training, and areas in which it may be improved.

**CLINICAL REQUIREMENTS:**

In general, there are no set requirements as to the number of procedures
to be performed - thus the attention is to detail, precision, and
perfection of the various techniques. Quality, not quantity, is
stressed. Strive to achieve proficiency, and speed will come by itself
with repetition. However, residents are expected to be constructively
engaged in clinical activities throughout the duty day. If you are in
need of more clinical experiences, please see the Program Director.
Individual residents have unique interests - interactive discussion
regarding the types of cases assigned is encouraged.

**DUE PROCESS POLICY:**

Due process policy for residents is governed by Department of Veterans
Affairs policy, contained in VA Handbook 5021/2, for Title 38 employees,
covering Disciplinary Actions, Grievances, and Hearings.

NOTICE OF OPPORTUNITY TO FILE COMPLAINTS WITH THE COMMISSION ON DENTAL
ACCREDITATION:

The Commission on Dental Accreditation will review complaints that
relate to a program\'s compliance with the accreditation standards. The
Commission is interested in the sustained quality and continued
improvement of dental and dental-related education programs but does not
intervene on behalf of individuals or act as a court of appeal for
individuals in matters of admission, appointment, promotion or dismissal
of faculty, staff or students.

A copy of the appropriate accreditation standards and/or the
Commission\'s policy and procedure for submission of complaints may be
obtained by contacting the Commission at 211 East Chicago Avenue,
Chicago IL 60611, or by calling 1-800-621-8099, extension 2719.

**EDUCATIONAL EXPERIENCE AND REQUIREMENTS**

Before being eligible for the VA Certificate of Training, the Dental
General Practice Resident must complete the following educational
requirements within the Dental Department as well as their rotation
through the different services of the hospital.

### TABLE CLINIC:

Residents are required research, develop, and present a Table Clinic on
a topic of general dental interest. The presentation will be made twice
-- once during the annual Ohio Dental Association meeting in late
August, and at the early February evening dinner meeting of the Dayton
Dental Society. Additional information is contained in a later section
of this manual.

#### **PUBLICATION TOPIC:**

#### 

#### Residents are required to research and write a manuscript -- suitable for submission to a peer-reviewed journal -- as part of their fulfillment of residency requirements. Additional information is contained in a later section of this manual.

#### 

#### **INSERVICE TRAINING:**

During the course of the residency year, the resident is expected to
attend all monthly Inservice Training Programs. Professional public
speaking is an acquired skill, honed by practice. Residents will present
a one‑hour Inservice lecture as part their training experience. The date
of presentation is contained in the Yearly Schedule. Topic of the
lecture will be selected by the resident, with concurrence of the
Program Director.

# **CASE PRESENTATION:**

Residents are required to present four interesting cases for review and
evaluation by the dental staff during his/her residency year. This will
provide the resident an opportunity to formulate a comprehensive
treatment plan for a variety of patients, as well as experience in
presenting and defending the treatment plan. Presentation Dates and
Guidelines are included in a later section of this manual.

CASE REVIEW:

Two Mondays a month, from 3:30 to 4:30 PM, residents will bring current
cases to a gathering with attending staff for treatment planning and
discussion. Each case should stand as a "mini-seminar" -- emphasizing
some point of interest, which will be of benefit for all in attendance.
Each resident is responsible for bringing a case. Dates for Case Review
may be found on the Monthly Calendar, and usually alternate with that of
Journal Club.

### JOURNAL CLUB:

The resident is required to attend all meetings of the Dental Journal
Club. These are scheduled every other Monday from 3:30 to 4:30 PM unless
otherwise directed (usually alternating with Case Review). Once a month,
each resident will be required to present and discuss classic or current
articles in the dental literature. Articles must be from peer-reviewed
periodicals. The Library subscribes to the several dental journals, and
a wealth of dental literature may be found on-line. Guidance on the
selection of articles may be obtained from the Program Director.

# 

# **CONSULTANTS:**

The Dayton Veteran\'s Administration Residency Program is enhanced by
the quality of its consultants. ***Attendance at these lectures is
mandatory and is a first priority - it is the personal responsibility of
each resident to be in attendance and on time***. If there is a conflict
with a scheduled rotation, consult the Program Director for guidance, as
to which takes precedence . A schedule of lectures is listed in
subsequent sections of this manual. Additionally, be aware of schedule
changes, which will show-up on the monthly calendar.

RESTORATIVE/GERIATRIC DENTISTRY:

Dental residents will be given the opportunity to perform comprehensive
restorative dentistry. A significant portion of patients treated at the
VA are elderly and medically compromised. Residents will treat these
patients routinely. The residents will be under the supervision of
full‑time staff dentists at all times.

Spot checks will be accomplished upon the completion of some significant
aspect of the dental treatment plan -- complex amalgam, quadrant
restorations, veneers, fixed or removal prosthetics, endodontics. ***A
minimum of 10 Spot Checks per quarter is expected.*** This allows the
Program Director and Staff to ensure that the resident is benefiting
from an adequate variety of clinical experiences, as well as helping to
identify any areas in which additional instruction may be required.

When an extended course of treatment is completed by a resident, it
should be documented as a ***Completed Case.*** This mechanism allows
the Staff to ensure that the residents and our patients are benefiting
from the comprehensive care experience, from treatment planning to
definitive restoration.

### PERIODONTICS:

Clinical training in this area is conducted under the direct supervision
of our staff periodontist, every Monday and Wednesday, for approximately
twelve weeks per resident. The schedule of lectures and seminars on a
variety of periodontal topics is included later in this manual.
Residents are encouraged to be aggressively pursue periodontal training
experiences, starting with conservative treatment and progressing to
surgery. Our patient population presents with a great need for
periodontal treatment. Residents are reminded that one of their required
Case Presentations must be a periodontal case that includes surgery.
Start your periodontal Case Presentation preparation early (remember to
contact Medical Media for pre-op, surgical, and post-op photos), so you
are fully prepared when the time comes to present. ***Three cases of
crown lengthening by the resident are required.***

### PEDIATRIC DENTISTRY:

Pediatric dentistry lectures will be conducted at Wright-Patterson Air
Force Base. Clinical cases and pedodontic OR will be coordinated with
The Children's Medical Center of Dayton, under the direct supervision of
a pediatric dentist. A wide variety of pediatric patients will be
selected to provide clinical experience in all areas of diagnosis,
treatment planning, patient management and restorative treatment.
Residents will have the opportunity to accompany the pediatric dentist
to the operating room as the schedule permits. Likewise, residents may
have the opportunity to observe dental treatment of patients with
special physical and behavioral problems (handicapped, mentally
retarded, craniofacial board, hematology/oncology/cardiac patients). The
lecture schedule is listed later in this manual.

**ORAL AND MAXILLOFACIAL SURGERY/IV CONSCIOUS SEDATION:**

Each dental resident is assigned to our OMFS Section for approximately
12 weeks. They will be exposed to all facets of oral surgery, and
emphasis will be placed on the development of skills in those phases of
oral surgery which are commonly performed in general dental practices.
The resident will be afforded the opportunity to perform more
complicated procedures if he/she has the particular interest and
aptitude, as well as demonstrable clinical judgment and skills. Under
the direct supervision of an oral and maxillofacial surgeon, the
resident will perform a broad range of clinical and surgical procedures
including, but not necessarily limited to, exodontia, alveoplasty,
preprosthetic surgery and biopsy. When appropriate, clinical procedures
may be performed with consent of and under the direction of the Oral and
Maxillofacial Surgeon, with the use of intravenous and/or inhalation
sedation techniques. Emphasis will be placed on the evaluation of the
patient\'s physical status and the appropriate treatment of the
compromised patient.

Residents on Oral Surgery rotation will be directly involved with dental
inpatients from admission through discharge. All residents will be
encouraged to participate in major maxillofacial cases treated in the
operating room. Residents will go on daily morning rounds of
hospitalized dental patients. Residents will receive advanced
instruction and clinical experience in the control of pain and anxiety
in the conscious patient through the use of behavioral management, local
anesthesia, and conscious sedation techniques. Residents are required to
complete a minimum of five dental Inpatient cases (or, Outpatient
surgeries performed in the Operating Room). Each case that is completed
will be reviewed by the Program Director. Record Review Forms to
document these cases may be found at the back of this manual.

*Specific requirements of the Oral and Maxillofacial Surgery section,
and to meet the requirements for endorsement for an IV Conscious
Sedation License:*

-   25 Total IV Sedation Cases

    -   May include 10 performed in OR, on Anesthesia Rotation

    -   15 Cases in OMFS (preferred)

    -   If unable to do 15 in OMFS, contact GI Clinic for additional
        cases

-   5 Dental Inpatients (or, Outpatient OR cases -- with notes)

-   2 General Anesthesias (while on Rotation)

-   5 History and Physical (Dental Inpatient or Medicine Rotation)

*It is the resident's responsibility to stay on top of these
requirements, so as to not "come up short" at the end of the year!*

### DENTAL EMERGENCY:

Dental residents are expected to see dental emergencies (often called
"10-10" from the number of the VA Form). The resident will accomplish a
problem-oriented exam, and advise the patient of their treatment
options. Available options are based on a complex set of guidelines
established by Congress and Public Law -- an abbreviated list is
included as a separate section in this manual*. **If in doubt as to the
treatment the veteran may be eligible for -- please see a staff member
prior to presenting treatment options to the patient.*** The resident
will then accomplish the indicated treatment.

### 

ANESTHESIA:

The resident will be scheduled for a four-week rotation (all day) to
observe, assist and perform endotracheal intubation, general anesthesia
and intravenous sedation. Residents are required to be present when
cases start (usually 7:30-7:45 AM), and follow the cases to the end.
Residents should not schedule patients during this rotation. Afternoons
are spent in pre-op evaluation. Residents should think of total patient
management, of which the specific procedures are a part. Objectives
include training in preoperative evaluation, assessment of the effects
of pharmacologic agents, venipuncture technique and administration of
intravenous agents, patient monitoring, airway management, anesthetic
induction and intubation, maintenance of anesthesia, prevention and
treatment of anesthetic emergencies, and assessment of patient recovery
from anesthesia. They will be under the general supervision of the Chief
of Anesthesiology Section, and under the direct supervision of the
specific Anesthesiologist or CRNA responsible for that particular case.

EMERGENCY ROOM:

Dental residents will have the opportunity to participate in the
treatment of traumatic injuries as well as in the evaluation and
management of acutely ill patients in an emergency room setting. They
will be assigned for a two‑week rotation (10 days, 80 hours) and be
under direct supervision of emergency room personnel.

The goals/objectives of this rotation are:

-   Reinforce interview, physical examination, and risk assessment
    skills.

-   Further development of airway management skills previously learned
    through anesthesia and surgery rotations.

-   Practice and refine the skills learned in ACLS.

-   Strengthen skills in the recognition and management of emergency
    medical problems which may be seen in the dental office:

MEDICAL SERVICE:

Each dental resident will be scheduled for a two-week rotation (10 days,
80 hours) with Internal Medicine. This will clinically reinforce the
principals learned during the History and Physical lecture series --
patient evaluation, medical history, system review, and physical
examination. Additional emphasis will be placed on understanding the
pathophysiology and management of patients with common medical
conditions which are seen in the clinical dental practice environment.
Pharmacological approaches to treating these conditions will be
addressed. Dental residents will gain experience working with their
physician counterparts in admitting/discharging patients, lab
tests/consultations and referrals, and prescribing appropriate medical
treatments.

PATHOLOGY AND LABORATORY MEDICINE SERVICE (PALMS):

The residents will learn surgical and medical pathology by correlating
the histopathological diagnosis of the biopsy specimen with the clinical
and laboratory data. Reference values (normal values) of clinical
laboratory tests will be reviewed and the clinical significance of
abnormal values explored. They will be under direct supervision of the
Chief of the Laboratory Service or designee, and will rotate through the
different sections of the Laboratory such as blood bank, phlebotomy,
clinical chemistry, clinical microbiology, immunology, and
histopathology.

### 

### PRACTICE ADMINISTRATION:

The Dental Staff of the Dayton VA strongly believes that it is our
obligation to provide experiences which will prepare our residents for
the challenges of dental practice, once they leave the educational
setting. Therefore the residents are provided a wide variety of practice
administration experiences, including first‑hand observation of private
dental practices. Differing practice settings and philosophies of health
care delivery are analyzed, and residents are given insight into the
principles of hospital organization and function (medical staff
membership and responsibilities, by‑laws, quality assurance, etc). They
will also be instructed in transition to private practice, and
techniques to facilitate scheduling.

**WEEKLY ROTATION SCHEDULE**

> Dr Michelle Dr Chonda
>
> Bernard Higgins

WEEK DATE AM PM AM PM

**2006**

1 7/3 See Orientation Schedule

2 7/10 See Orientation Schedule

3 7/17 D D OS OS

4 7/24 D D OS OS

5 7/31 D D OS OS

6 8/7 OS OS M/W Perio T/H/F D-D

7 8/14 OS OS M/W Perio T/H/F D-D

8 8/21 OS OS M/W Perio T/H/F D-D

9 8/28 M/W Perio T/H/F D-D M/T D-D W/H/F Lab

10 9/4 M/W Perio T/H/F D-D D D

11 9/11 M/W Perio T/H/F D-D D D

12 9/18 D D OS OS

13 9/25 M/T D-D W/H/F Lab OS OS

14 10/2 D D OS OS

15 10/9 OS OS M/W Perio T/H/F D-D

16 10/16 OS OS Anes Anes

17 10/23 OS OS Anes Anes

18 10/30 M/W Perio T/H/F D-D Anes Anes

19 11/6 M/W Perio T/H/F D-D Anes Anes

20 11/13 Anes Anes D D

21 11/20 Anes Anes OS OS

> Dr Michelle Dr Chonda
>
> Bernard Higgins

WEEK DATE AM PM AM PM

**2006**

22 11/27 Anes Anes OS OS

23 12/4 Anes Anes OS OS

24 12/11 OS OS M/W Perio T/H/F D-D

25 12/18 OS OS M/W Perio T/H/F D-D

26 12/25 OS OS M/W Perio T/H/F D-D

**2007**

27 1/1 M/W Perio T/H/F D-D D D

28 1/8 M/W Perio T/H/F D-D D D

29 1/15 M/W Perio T/H/F D-D D D

30 1/22 D D OS OS

31 1/29 D D OS OS

32 2/5 Med Med OS OS

33 2/12 Med Med M/W Perio T/H/F D-D

34 2/19 OS OS M/W Perio T/H/F D-D

35 2/26 OS OS M/W Perio T/H/F D-D

36 3/5 M/W Perio T/H/F D-D Med Med

37 3/12 M/W Perio T/H/F D-D Med Med

38 3/19 ER ER D D

39 3/26 ER ER OS OS

40 4/2 D D OS OS

41 4/9 D D OS OS

42 4/16 OS OS ER ER

43 4/23 OS OS ER ER

44 4/30 OS OS M/W Perio T/H/F D-D

> Dr Michelle Dr Chonda
>
> Bernard Higgins

WEEK DATE AM PM AM PM

**2007**

45 5/7 M/W Perio T/H/F D-D D D

46 5/14 M/W Perio T/H/F D-D D D

47 5/21 M/W Perio T/H/F D-D D D

48 5/28 D D OS OS

49 6/4 D D OS OS

50 6/11 D D OS OS

51 6/18 OS OS M/W Perio T/H/F D-D

52 6/25 OS OS M/W Perio T/H/F D-D

6/29 Residents Clear Station

**Rotations:**

Anes Anesthesia

D General Dentistry

ER Emergency Room

PALMS Pathology and Laboratory Medical Services

Med Medicine

OS Oral & Maxillofacial Surgery

Perio Periodontics

**Holidays:**

4 July Independence Day

4 September Labor Day

9 October Columbus Day

10 November Veteran's Day

23 November Thanksgiving Day

25 December Christmas Day

1 January New Year's Day

15 January Martin Luther King, Jr

19 February President's Day

28 May Memorial Day

ORIENTATION - 2006

Dr Michelle Bernard

Dr Chonda Higgins

Monday 3 July 8-12 HRMS -- Inprocess, Badges, Laundry, Insurance, Etc

> 1-3 Dr Mesaros -- Administration
>
> 3-4 Josunde Collins -- Computer Training, VISTA, Etc

Tuesday 4 July HOLIDAY

Wednesday 5 July 8-9 Debbie Lawrence -- Charts, Administration

9-10 Dr Slattery -- Administration

10-11 Nutritional Medicine (Resident Room)

1-2:30 Drs Mesaros/Richardson (Table Clinic/Research Paper)

2:30-4:30 ABGD Pre-Test

Thursday 6 July 8-9 Ray & Sherrie Perdue -- Dental Lab

9-10 Physical Medicine & Rehabilitation (2C-100)

10-11 Police/Security

11-12 Radiation Oncology

1-2 Nuclear Medicine (1C-135)

2-3 Audiology Speech Pathology (2D-160)

Friday 7 July 8-9 Program Director -- Resident Meeting

9-10 Morristine Neal -- Safety

12. Dr Pemberton -- Practice Administration (9C-100)

> 1-5 Dr Becker (Miami Valley)

Monday 10 July 8-4:30 VA New Employee Orientation (2A-103)

Tuesday 11 July 8-4:30 VA New Employee Orientation (2A-103)

Wednesday 12 July 8-9:30 Dr Mesaros -- Operative Orientation

9:30-11:30 Intergenerational Training

1-2 Dr Mesaros -- Operative Orientation (Continued)

2-3:30 DRM Training (9D-138)

Thursday 13 July Operatory Set-up

Clinical DRM Training

Friday 14 July First Patients Scheduled

# **YEARLY SCHEDULE**

**2006**

14 July Table Clinic - Title

21 July Table Clinic - Outline

28 July Table Clinic -- First Draft Due

4 August Table Clinic -- Final Draft

26 August Table Clinic -- Present at Ohio Dental Association

1 September Publication -- Topic and Journal Selection Due

13-14 September ACLS

2 October Case Presentation #1

16 October Quarterly Review #1

4 December Case Presentation #2

8 December Publication -- Outline Due

> **2007**

8 January Quarterly Review #2

5 February Dayton Dental Society Table Clinics

20 February Inservice Training - Dr Michelle Bernard

23 February Publication -- Lit Search and Rough Draft Due

20 March Inservice Training - Dr Chonda Higgins

26 March Case Presentation #3

9 April Quarterly Review #3

4 May Publication -- Final Manuscript Due

14 May Case Presentation #4

18 June Quarterly Review #4

INSERVICE TRAINING

THIRD TUESDAY ‑ 8-9

Room 2A - 103

**2006**

18 July Health History Review Dr A. J. Mesaros

\*15 August DVA Mission and Chief of Staff (11)

Dental Service Dr Steven Cohen

\* (Time change -- 11-12)

19 September Quality Assurance Lisa Shear, RN (00Q)

17 October Radiation Safety Eileen King

21 November OMFS -- Trauma Dr Douglas Richardson

19 December TBA Dr Erin Slattery

**2007**

16 January RPD Considerations Dr Mahle

20 February TBA Dr Michelle Bernard

20 March TBA Dr Chonda Higgins

\*18 April Periodontics Dr Glenn Jividen

\* (Date change - Wednesday)

15 May TBA Dr Lee

19 June OMFS Dr Lambert

# **CASE PRESENTATION**

General Practice Dental Residents are required to present four
significant treatment cases during their training year. Cases will be
presented to the assembled dental staff on the following dates:

Case 1 2 October 2006

Case 2 4 December 2006

Case 3 26 March 2007

Case 4 14 May 2007

**Guidelines:**

-   All case presentations will be **formatted on the computer** (i.e .
    -- Word and/or PowerPoint document) and copies must be distributed
    to the dental staff **at least two days** prior to the presentation.
    A copy will be kept in the resident\'s permanent record.

-   **One case presentation must be a periodontal surgical case.**

-   It is suggested that the other three cases might include one
    significant surgical case, and two complex restorative case
    (significant fixed prosthetics, implants, RPDs).

-   The presenting resident should be prepared to answer any questions
    regarding the case and defend his/her treatment plans.

-   PowerPoint presentation format is required.

**Specific Requirements:**

-   Diagnostic casts

-   Intraoral photos

-   Radiographs -- Pano/BWXR or full mouth series

-   Past medical history

-   Past dental history

-   Laboratory tests and findings if indicated

-   Dental examination findings (perio chart if indicated)

-   Problem list

-   Ideal treatment plan

-   Alternate treatment plans

# **TABLE CLINIC**

In the course of the academic year, residents are required to research
and develop a table clinic on a topic of interest to a general dental
audience. Presentation will be at the Ohio State Dental Meeting, held in
late August, and at the February meeting of the Dayton Dental Society.
At the Dayton Dental Society event, Department of Veterans Affairs
residents usually present in conjunction with the residents from the
Advanced Education in General Dentistry program from Wright-Patterson
AFB.

Residents will select their topics with input from the VA Dental Staff,
subject to the approval of the Program Director. Only one topic is
required -- the same table clinic will be presented at both events.
Background research and development of a suitable format is the
responsibility of the resident. Once the final draft has been approved,
Medical Media will complete the display board presentation. **It is
critical to maintain the timeline, to ensure the presentations are ready
for the day of the ODA meeting.**

**Guidelines:**

-   Select a topic that is interesting to **you!**

-   Avoid selecting a topic that is too broad -- pick a topic that is
    narrow enough to be presented well in a 3-panel format, speaking for
    5-10 minutes.

-   Display must be esthetically pleasing - avoid filling the panels
    with text -- select interesting photos, then use the text to
    elaborate.

-   Use the text on the display as the outline - practice the delivery
    until you can carry on a discussion with your audience.

-   Attention to details: watch for typographic errors, cite credits
    appropriately, have references available for your audience.

**Table Clinic Timeline:**

14 July 2006 Title of presentation due

21 July 2006 Outline due

28 July 2006 First draft due - approval by Program Director

4 August 2006 Review final draft

11 August 2006 Text/photos/format to Medical Media

26 August 2006 (Sat) Present at Ohio Dental Association Meeting

5 February 2007 Present at Dayton Dental Society

# **PUBLICATION TOPIC - GUIDELINES**

Residents are required to research and write a manuscript -- suitable
for submission to a peer-reviewed journal -- as part of their
fulfillment of residency requirements. Dr Richardson will serve as a
mentor for this project, and topics selected will be subject to the
approval of the Program Director. The objective of this exercise is to
expose the Resident to the scientific method of researching the
literature, discerning pertinent material, and assimilating it into a
cohesive, publishable format. Although it is not a requirement that the
manuscript actually be submitted to a peer-reviewed journal, it is
certainly encouraged, if the topic is of sufficient interest to the
broader dental community. A copy of the paper will be kept in the
resident\'s permanent record. The document should follow the format of
the individual journal to which submission is to be made, and would
typically include:

-   Title

-   Abstract

-   Purpose

-   Literature Review

-   Results

-   Discussion

-   Conclusion

-   Summary

-   Bibliography

**Publication Topic Timetable:**

1 September 2006 Topic of paper and select journal for submission

8 December 2006 Outline due -- consultation/approval of Program Director
required

23 February 2007 Literature search and rough draft due

4 May 2007 Final manuscript due

# **RESTORATIVE DENTISTRY**

Dr. A. J. Mesaros, Jr

Dr. Richard Lee

Ray Perdue, CDT/Sherry Perdue, CDT

## 

## 6 July 2006, Thursday 8:00-9:00

## Local and Central Dental Lab (CDL) Procedures

**Objectives:**

-   To acquaint residents with fixed and removable procedures done in
    our laboratory, and requirements in order to work smoothly and
    effectively.

-   Resident requirements for CDL cases.

-   Preparation and submission guidelines for fixed prosthesis, veneers,
    post and cores, all-ceramic restorations, implants, complete
    dentures, removable partial dentures, nightguards and orthotics.

## 12 July 2006, Wednesday 8:00-9:30 and 1:00-2:00

## Operative Dentistry Overview -- Complex Amalgam Restorations

**Objectives:**

-   Familiarize residents with restorative philosophy of care, establish
    the basic fundamentals -- isolation, retention and resistance,
    pulpal protection, material selection, adjunctive features (pins,
    posts, slots, boxes, grooves).

-   Learn advanced techniques -- direct full cuspal coverage
    restorations.

-   Introduction to restorative challenges -- Auto Matrix, and copper
    band

## 

**4 August 2006, Friday 1:00-4:30**

**Guest Lecturer -- Dr Rob Bettineschi**

**Esthetic Dentistry**

\- Esthetics Overview

\- Composite Technique -- Layering

\- Porcelain Veneers and Onlays

**21 September 2006, Thursday 8:00-9:00**

**Occlusal Concepts**

**Objectives:**

-   To acquaint the resident with the various occlusal concepts, and
    their indications -- centric relation, anterior guidance, group
    function.

-   Indications/technique of occlusal adjustment.

-   Dealing with grossly mutilated dentitions.

## 19 October 2006, Thursday 8:00-10:00

**Comprehensive Treatment Planning**

**Objectives:**

-   To understand the rationale behind the comprehensive treatment
    planning concept.

-   To identify the patient who needs a comprehensive treatment plan.

-   To acquire the skills necessary to develop a comprehensive problem
    list.

-   To acquire the skills necessary to develop an ideal comprehensive
    treatment plan, and alternative plans -- taking into consideration
    the patient's overall goals and desires.

```{=html}
<!-- -->
```
-   To be able to identify the best plan for the patient in any given
    situation.

## 16 November 2006, Thursday 8:00-10:00

## Removable Partial Dentures - Survey and Design

**Objectives:**

-   To understand the importance of accurate diagnosis and treatment
    planning in caring for the partially edentulous patient.

-   Review basic components of removable partial dentures.

-   Master the techniques involved in the survey and design of RPDs.

-   Special situations -- acrylic based and transitional prostheses.

# **ORAL AND MAXILLOFACIAL SURGERY**

Dr. Paul Lambert, WEDNESDAYS 2:30 - 4:30

Dr. Douglas Richardson, WEDNESDAYS 8:00 - 10:00

**2006**

\*18 July Dr Richardson Intro, Admission Notes, H & P Review,

Admission Orders, Daily Progress Notes,

Operative Notes, Discharge Notes/Orders

16 August Dr Lambert Osteoradionecrosis

27 September Dr Lambert Hyperbaric Oxygen Therapy

11 October Dr Richardson Implants - Surgical Phase

15 November Dr Richardson Dento‑Alveolar Surgery

13 December Dr Richardson Facial Trauma and Concomitant Problems

**2007**

10 January Dr Richardson Management of Oral and Maxillofacial

Infections

14 February Dr Richardson Pre‑prosthetic Surgery

14 March Dr Richardson Orthognathic Surgery

11 April Dr Lambert Maxillofacial Rehabilitation

9 May Dr Richardson Head and Neck Malignancies

6 June Dr Lambert Special Topics

(submit requests by 1 Jan 2007)

**OBJECTIVES:**

-   To increase the resident's depth and knowledge of fundamental
    treatments utilized in oral surgery. Emphasis will be placed on the
    treatment of medically compromised patients.

-   To expose the residents to the more specialized aspects of oral and
    maxillofacial surgery, to better enable them to refer those patients
    requiring this specialized care.

-   To provide a vehicle for discussion of oral surgical topics of
    concern and interest to the residents.

## PERIODONTICS

Dr. Glenn Jividen, Sr

FRIDAY 7:30--9:00 at MVH

**2006**

\*17 July **PERIODONTAL CLINIC PROTOCOL**

4 August **INTRODUCTION**

-   Review basic periodontal surgical principles

-   In depth discussion of rationale and techniques of surgical crown
    lengthening

-   Case review of a tentative crown lengthening

\*8 September **OSSEOUS SURGERY**

-   Distal Wedge Procedure

```{=html}
<!-- -->
```
-   Basic surgical principles

-   Flap design/Armamentarium/Suturing

6 October **PRINCIPLES OF PERIODONTAL PLASTIC SURGERY**

-   Classification of Recession (Miller)

-   Treatment Options

-   Review of Common Surgical Modalities

\*3 November **ROOT ANATOMY/PATHOLOGY, ROOT RESECTION,**

**AND HEMISECTION**

\- Furcations, perforations, and cracked roots

> \- Management of maxillary and mandibular furcations

1 December **NON-SURGICAL PERIODONTAL TREATMENT**

\- Scaling and Root Planing

\- Pharmacotherapeutics

\- Plaque Control

**2007**

5 January **PERIODONTAL** **MAINTENANCE THERAPY**

2 February **OSSEOUS REGENERATION AND GROWTH FACTORS**

2 March **CREATING "THE OPTIMAL SMILE"**

6 April **TREATMENT OF INFRABONY POCKETS**

4 May **PERIODONTAL MEDICINE**

\- Systemic diseases and periodontal disease -- diabetes,

cardiovascular, osteoporosis, hormonal replacement

## 

## 

## PERIODONTICS

Dr. Glenn Jividen, Jr

SECOND TUESDAY 8:00--9:00 at MVH

**2006**

11 July **OVERVIEW OF PERIODONTAL SPECIALTY**

8 August **PERIODONTAL TREATMENT PLANNING**

12 September **IMPLANT THERAPY I**

\- Implant Therapy vs "Conventional" Dentistry

\- Implant biomechanics, hard and soft tissue healing

10 October **OSSEOUS SURGERY**

14 November **IMPLANT THERAPY II**

\- Divisions of available bone/bone density

\- Rationale for implant design and selection

12 December **NON-SURGICAL PERIODONTAL TREATMENT**

\- Rationale for scaling and root planning

\- Systemic and local pharmacotherapeutics

\- Occlusal therapy

**2007**

9 January **IMPLANT THERAPY III**

\- Single tooth implant -- indication and contraindication

\- Immediate implant placement

13 February **MUCOGINGIVAL DIAGNOSIS AND TREATMENT**

\- Free gingival grafting

\- Connective tissue grafting -- autogeneous/allograft

13 March **DIGITAL RADIOGRAPHIC TECHNIQUE**

10 April **BONE AUGMENTATION FOR IMPLANT THERAPY**

\- Ramus and symphysis augmentation

\- Sinus grafting

8 May **PERIODONTAL REGENERATION**

\- Defect classification and bone grafting materials

\- Guided tissue regeneration

12 June **TOPIC TBA**

## PRACTICE ADMINISTRATION

Dr. Dwight M. Pemberton

Dr. Richard Lee

**2006**

7 July (10:00-12:00 Dr Pemberton)

-   VA Regulations

-   Hospital Organization, Governance and Function

-   Medical Staff By Laws and Rules

-   Hospital Management and Committees

-   Dental Law

-   Procedures for Obtaining Staff Appointment and Clinical Privileges

24 August (8:00-10:00 Dr Pemberton)

-   Practice Management

-   Quality Assurance, Risk Management

-   OSHA compliance, Insurance problems

-   Utilization Review

5 October (8:00-12:00 Dr Pemberton)

-   Field trip - large group practice setting

> (Practice of Dr Charles Smith)

-   Professional adaptation and computerized business management

7 December (8:00-10:00 Dr Pemberton)

-   Review of dental practice options

-   Professional association contracts

> **2007**

2 April (8:00-10:00 Dr Lee)

-   Transition to private practice

-   Scheduling -- emergencies, prosthetic cases

-   Office management

**OBJECTIVES:**

-   Learn and understand hospital organization and function

-   Understand how a private dental practitioner functions in a hospital
    practice setting

-   Observe a modern, efficient group practice with computerized
    business technology

-   Understand and be able to utilize and design programs in risk
    management and quality assurance

-   Preparations for the transition to private dental practice

# **HISTORY AND PHYSICAL EXAMINATION**

MEDICAL SERVICE - DVAMC DAYTON

MONDAY 2-4

**2006**

17 July History Dr Luna

24 July Vital signs and skin exam Chief Resident, Medicine

31 July General physical exam Dr C. Bashir

7 August Cardiovascular exam Dr Osman, Cardiology Fellow

14 August HEENT, Practical Dr M. Patel

\*18 August Pulmonary exam Dr S. Srivastava

(\* date change)

28 August Abdominal exam GI Fellow

11 September Neurological and Trudy Adams, PA

Musculoskeletal exam Kathy Zoerb, PA

18 September General physical exam Jan Prettyman, ENT PA-C

25 September Medical Risk Assessment Dr Kathleen Wolner

Lab Values

Text: [Physical Diagnosis]{.underline} - Prior, Silberstein, and Stang

**Objective:** Dental residents will become proficient in conducting an
accurate medical risk assessment. This includes obtaining a patient\'s
medical history, performing a physical examination, and ordering and
interpreting the laboratory, radiographic and other data as needed to
knowledgeably plan and carry out dental therapy and management of
hospitalized and ambulatory patients.

## PHARMACOLOGY/CONSCIOUS SEDATION COURSE

Dr. Daniel E. Becker

FRIDAY MORNINGS

A series of lectures and practicums presenting essential principles of
pharmacology applicable to drug use in dental practice. The series
emphasizes drug classes having therapeutic use during the delivery of
dental care, and medically prescribed drugs that impact dental treatment
by altering patient management or presenting risk for drug interactions.
Topics related to oral, nitrous oxide, and conscious sedation are also
addressed, including pharmacology, monitoring, assessment and management
of untoward events. Prerequisite reading, lecture outlines, and module
objectives are contained in workbooks provided to each resident.

**2006**

> 7 July (1-5) Pharmacology -- Analgesics, Steroids, and Antibiotics
>
> 20 July (8-12) Pharmacology -- Local Anesthetics
>
> 28 July (1-5) Sedation -- N2O Objectives and IV Technique

11 August (8-12) Sedation -- IV Technique

> 31 August (8-12) Sedation -- Physiology and Patient Monitoring
>
> 13 September (All Day) ACLS Provider Course at VA
>
> 14 September (8-12) ACLS Provider Course at VA
>
> 15 September (8-12) Sedation -- Physiology and Patient Monitoring
>
> Written Exam
>
> 22 Sept (7:30-9:30) Sedation -- Exam and ECG ID
>
> 13 October (8-12) Sedation -- Medical Emergencies/Exam
>
> 27 October (8-12) Sedation -- IV Pharmacology and Technique
>
> 17 Nov (7:30-9:30) Pharmacology -- Cardiovascular Drugs
>
> 15 Dec (7:30-9:30) Pharmacology -- Psychotropic/Endocrine Drugs
>
> **2007**
>
> 19 January (8-4) Sedation -- "Becker/Phero Day"
>
> 16 Feb (7:30-9:30) Sedation -- Written Exam
>
> Date TBA Sedation - Practical Exam: Human Simulator

The following table summarizes the curriculum in Pharmacology,
Anesthesia, and IV Sedation. It reflects the didactic components of the
training, off-Service rotation, and individual case requirements. By the
completion of the residency, all residents are expected to accomplish a
minimum of 25 cases in which they provided IV sedation.

+--------------------+-----------------------+-------------------------+
| **Required For All |                       |                         |
| Residents**        |                       |                         |
+--------------------+-----------------------+-------------------------+
| **Pharmacology**   | **Oral/N~2~O          | **I.V. Sedation**       |
|                    | Sedation**            |                         |
+--------------------+-----------------------+-------------------------+
| Analgesics (2 hr)  | Sedative/Anxiolytics  | Technical               |
|                    | (2 hr)                | Considerations          |
|                    |                       |                         |
|                    |                       | (1 hr lecture/6 hr lab) |
+--------------------+-----------------------+-------------------------+
| Antibiotics (2 hr) | Nitrous Oxide (2 hr)  | Pharmacology of IV      |
|                    |                       | Agents                  |
|                    |                       |                         |
|                    |                       | (2 hr)                  |
+--------------------+-----------------------+-------------------------+
| Gl                 | Physiology &          | Local/Systemic          |
| ucocorticosteroids | Monitoring            | Complications           |
|                    |                       |                         |
| (1 hr)             | (8 hr)                | (4 hr lecture/12 hr     |
|                    |                       | lab)                    |
+--------------------+-----------------------+-------------------------+
| Psychotropics (1   | Local Anesthetics (2  | Preoperative Assessment |
| hr)                | hr)                   |                         |
|                    |                       | (4 hr)                  |
+--------------------+-----------------------+-------------------------+
| Cardiovasculars (2 | Medical Emergencies   |                         |
| hr)                | (4 hr lecture/4 hr    |                         |
|                    | lab)                  |                         |
+--------------------+-----------------------+-------------------------+
| Hormones (1 hr)    | ACLS (16 hr)          |                         |
+--------------------+-----------------------+-------------------------+
| Anesthesia         |                       |                         |
| Rotation (4 Weeks) |                       |                         |
+--------------------+-----------------------+-------------------------+
| Medicine Rotation  |                       |                         |
| (2 Weeks)          |                       |                         |
+--------------------+-----------------------+-------------------------+
| IV Sedation Cases  |                       |                         |
| (25 minimum)       |                       |                         |
+--------------------+-----------------------+-------------------------+

All residents are expected to meet these requirements for successful
completion of the Residency. The award of certification in IV Sedation
is dependent on the successful completion of all examinations, and the
recommendation of Dr Becker, the Chief of Oral and Maxillofacial
Surgery, and the Residency Program Director.

# **ENDODONTICS**

Dr. Maria Santos, LtCol, USAF, DC

Wright-Patterson AFB, Ohio

**2006**

21 August (7:30-11) Introduction - Diagnosis, Emergencies, Trauma

11 September (7:30-11) Anatomy, Access, Hand Instrumentation (Lab)

14 September (7:30-11) Hand Instrumentation (SS/NiTi), Obturation (Lab)

18 September (7:30-11) Irrigation, Medicaments, Procedural Accidents

1 December (7:30-11) Rotary Instrumentation (Lab)

**OBJECTIVES:** Upon completion of the lectures and laboratory exercises
the resident will be able to:

-   Review the root canal system and be able to recognize its
    application to endodontics.

-   Recognize the reasons for cleaning and shaping the root canal system
    and list the properties of the materials used.

-   List the various techniques required to make the crown access
    opening, clean and shape the canal system, and obturate the root
    canal system.

-   Provide information necessary to diagnose endodontic emergencies and
    how to treat these conditions clinically.

-   Address complex situations such as perforations, crown and root
    fractures, luxations, and avulsions.

## PEDIATRIC DENTISTRY

Dr. Kim Gill, LtCol, USAF, DC

Wright-Patterson AFB, Ohio

### 21 August 2006, Monday 2:00-4:00

**Introduction, Pediatric Dental Emergencies**

**Objectives:**

-   To familiarize the residents with the rotation schedule, the
    clinical and didactic objectives of the rotation, and the necessary
    record documentation.

```{=html}
<!-- -->
```
-   To become proficient in evaluating and treating acute pediatric
    dental emergencies - specifically dental infections, trauma, and
    pulpalgia.

> **References:** Pinkham; Pediatric Dentistry - Infancy through
> Adolescence.
>
> 2nd edition, 1994, Chapter 15:209-22; 492-504

**23 August 2006, Wednesday 1:00-3:30**

**Diagnosis/Treatment Planning**

**Objective:**

-   To become proficient in diagnosing oral diseases in children, to
    plan appropriate treatment, and to present clearly and concisely the
    proposed dental care plan to parent and child.

**References:** Pinkham; Pediatric Dentistry -- Infancy through
Adolescence.

2nd edition, 1994, Chapter 13:181-5; 18:257-77; 30:416-420; 37:568-70

**Behavior Management**

**Objectives:**

-   To acquire understanding of the philosophy and to develop skill in
    managing the behavior of children and parents.

-   To master methods of organization indispensable for clinical
    efficiency.

**References:** Pinkham; Pediatric Dentistry - Infancy through
Adolescence.

2nd edition, 1994, Chapter 7; 8; 9; 23:339-352

**Preventive Dentistry**

**Objectives:**

-   To become knowledgeable of preventive dental strategies for
    children.

-   To become proficient in establishing appropriate preventive dental
    treatment plans for children in the clinic.

-   To become familiar with community preventive dental programs
    including prenatal dental education classes and children\'s dental
    health month activities.

### 25 October 2006, Wednesday 12:00-1:00

# 

**Space Management & Interceptive Orthodontics**

**Objectives:**

-   To become proficient in normal and abnormal growth and development.

-   To become aware of habit therapy, eruption guidance and interceptive
    orthodontics in the primary and mixed dentition.

-   To become knowledgeable in controlling and maintaining space.

**References:** Pinkham; Pediatric Dentistry - Infancy through
Adolescence.

2nd edition, 1994, Chapter 14:205-8; 25:358-65; 26:366-73; 27:374- 80;
35:505-37; 37:420-44

**Pediatric Treatment Planning**

**Objective:**

-   To become proficient in diagnosing and treatment planning complex
    restorative and minor tooth movement.

### 

### 

### 

### 29 November 2006, Wednesday 12:00-1:00

**Restorative Dentistry**

**Objective:**

-   To become proficient in pediatric dental restorative techniques in
    the primary and mixed dentition.

References: Pinkham; Pediatric Dentistry - Infancy through Adolescence,

2nd edition, 1994, Chapter 21:298-317; 32:451-82

**Pulpal Therapy**

**Objectives:**

-   To become proficient at assessing the health of pulpal and
    periapical tissues of primary teeth.

-   To become proficient at performing emergency procedures on primary
    teeth with vital and necrotic pulps.

**References:** Pinkham; Pediatric Dentistry - Infancy through
Adolescence,

2nd Edition, 1994, Chapter 22:326-338; 33:483-91

# **ORAL AND MAXILLOFACIAL PATHOLOGY SEMINAR**

# Dr. Brian S. Shumway

College of Dentistry

The Ohio State University

Columbus, Ohio

FIRST TUESDAY 10-12

**2006**

1 August Red & White Lesions

5 September Pigmented and Blue and Black Lesions

3 October Vesiculobullous and other Skin Lesions

7 November Odontogenic Cysts and Tumors

5 December Common Lesions

**2007**

9 January Bone Pathology

6 February Salivary Gland Disease

6 March Bacterial and Viral Infections

3 April Candidiasis and other fungal/protozoan Infectionsl

1 May Oral Lesions of HIV Infection

5 June Oral manifestations of Systemic Disease

**Objective:** This series of lectures will provide current and detailed
information about diseases involving the oral and para-oral regions. The
student will learn the salient clinical features and be able to
recommend appropriate treatment for the entities discussed.

# **PROSTHETICS AND IMPLANT RESTORATIVE DENTISTRY**

Dr. Cory B. Sellers

Indiana University School of Dentistry

Indianapolis, Indiana

FIRST TUESDAY 8-10

**2006**

1 August Implant Considerations (Wood, 2004)

\- Systemic and local host factors

\- Restoration considerations

3 October The Definitive Restoration

\- Fixed vs removable

\- Tissue considerations

5 December Implants and Components (Binon, 2000)

\- Implant classification

\- Abutments

\- Fixture geometry

**2007**

6 February Interim Prostheses

3 April Communication to the Surgeon

\- Radiographic survey

\- Surgical guides

\- Placement limitations (augmentation, etc)

5 June Complex Restoration Considerations (Zitzmann, 1999)

# **ORTHODONTICS SEMINAR**

Dr. Walter Buchsieb

College of Dentistry

The Ohio State University

Columbus, Ohio

FIRST WEDNESDAY 8-10

**2006**

2 August Orthodontic Diagnostic Records

\- Reading: handout, Profitt -- Chap 6

\- Slide and case presentation

6 September Cephalometrics

\- Reading: handout, Profitt -- Chap 6

\- Slide presentation

\- Technique: trace two cephalograms

4 October Etiology/Incidence of Malocclusion

\- Reading: handout, Profitt -- Chap 5

\- Slide presentation

\- Technique: crossbite correction - Typodont

1 November Interceptive Orthodontic Care

\- Reading: handout, Profitt -- Chap 13

\- Slide presentation

\- Technique: crossbite correction - Typodont

6 December Limited Tooth Movement, Adults

\- Reading: handout, Profitt -- Chap 19

\- Slide presentation

\- Technique: molar uprighting - Typodont

**2007**

3 January Fixed Orthodontic Appliances

\- Reading: handout, Profitt -- Chap 12

\- Slide presentation

\- Technique: molar uprighting - Typodont

7 February Biology of Tooth Movement

7 March Orthopedic Appliances

\- Reading: handout, Profitt -- Chap 14

\- Slide presentation

\- Technique: molar uprighting - Typodont

4 April Retention

\- Reading: handout, Profitt -- Chap 18

\- Slide and case presentation

**OBJECTIVES:** Those orthodontic seminars herein described are directed
toward the following goals:

## Diagnosis:

1\. To teach each resident basic craniofacial anatomy, physiology, and
growth and development such that functional interrelationships may be
associated with a comprehensive dental diagnostic regime.

2\. To introduce each resident to fundamental orthodontic diagnostic
criteria which may be employed in the general practice of dentistry.

3\. To develop an aptitude whereby simple orthodontic problems that are
amenable to general dental care may be differentiated from complex
orthodontic concerns that dictate the supervision of a specialist.

**Treatment:**

1\. To introduce fundamental biomechanical concerns which are relevant
to the clinical application of orthodontic forces.

2\. To teach each resident basic principles which apply toward the
design, construction, insertion, and adjustment of limited orthodontic
tooth movement appliances.

3\. To introduce each resident to fundamental concepts of comprehensive
orthodontic care as they relate toward:

a\. fixed orthodontic appliances

b\. orthopedic applications

c\. orthodontic‑surgical considerations

The intent of such goals is focused upon the attainment of basic
diagnostic skills and the concomitant application of same toward the
effective clinical management of orthodontic concerns.

# **ORAL RADIOLOGY**

Dr. Robert M. Jaynes

College of Dentistry

The Ohio State University

Columbus, Ohio

The intent is to highlight the different aspects of radiology and
identify practical

considerations for a general dentist. This web-based resource may be
accessed at:

<http://www.dent.ohio-state.edu/radiology/resources.htm>

**Topics:**

-   Radiation Physics

-   Film Characteristics

-   Radiobiology

-   Radiation Protection

-   Intraoral Radiographic Technique

-   Film Processing and Duplicating

-   Panoramic Technique

-   Extraoral Radiography

-   Tomograms

-   Special Imaging Techniques (Arthrography, Magnetic Resonance,
    Digital Radiography

-   Radiographic Interpretation

**Objectives:**

-   To reinforce and expand on current knowledge of radiographic
    technique, including intraoral and panoramic films.

-   To review radiation biology, dosimetry and protection in order to
    reduce patient exposure and insure operator protection.

-   To familiarize residents with the standard extraoral radiographic
    techniques used in surgery and orthodontics and the specialized
    imaging techniques used in hospital settings.

-   To review radiographic interpretation, including anatomy,
    abnormalities and pathology.

# **DENTAL SERVICE PROCEDURES AND PROGRAMS**

The Procedure Manual, in the Dental Service Chiefs Office, should be
read by the residents, and contains guidance on the following topics
which are pertinent and beneficial to the resident:

-   By‑Laws of the Department of Veterans Affairs Medical Center in
    Dayton

-   Dental Laboratory Procedures and Forms

-   Dental X‑ray and Radiation Safety Policy

-   Dress Code

-   Exam Policy

-   Examples of VA Forms Used by Dentistry ‑ Inpatient and Outpatient

-   Fire Safety

-   Clinic Forms

-   Infection Control

-   Interdisciplinary Management of Patients Having Medically

Compelling Needs for Dental Treatment ‑ Program Guide

-   Oral Lesion Policy

-   Oral Surgery Procedures, Including Hyperbaric Patients

-   Patient Eligibility ‑ Inpatient and Outpatient

-   Patient Informed Consent

-   Preventive Dentistry

-   Risk Assessment

-   Sterilization Procedures

-   Standard Precautions

The following notebooks and manuals are located in the back hallway,
above the computer desk:

-   MSDS (Material Data Safety Sheets)

-   Exposure Control Plan

-   Chemical Safety

-   Infection Control

-   Equipment Program

-   Emergency Preparedness Plan

-   Safety

-   Occupational Health and Safety

-   Disciplinary Appeal Board Workshop

# **DENTAL CARE POLICY**

This is a condensation of the VISN 10 Dental Care Policy. Dental
eligibility criteria are mandated by Congress and Public Law. If there
is any question regarding the veteran's eligibility for a given
procedure, discuss the case with a member of the dental staff
***prior*** to initiating any course of treatment.

#### 

#### **Level 4 -- Comprehensive Dental Care**

These patients may receive any dental treatment that is reasonably
necessary and clinically determined to meet their dental needs. [The
goal of care is to attain and sustain optimum oral health and function
including prosthetic rehabilitation if indicated.]{.underline}

General guidelines are as follows:

-   **Class I-** Patients with service-connected compensable dental
    conditions.

-   **Class II** -- Patients recently discharged from military service
    are limited to a one-time episode of care. Replacement of missing
    teeth, when indicated, is limited to teeth extracted while in the
    service.

-   **Class IIC**- Former prisoners of war.

-   **Class IV-** 100% service connected veterans.

```{=html}
<!-- -->
```
-   **Veterans continuously hospitalized for more than 100 days**

##### [Level 3 -- Focused Dental Care]{.underline}

These patients may receive care limited to the treatment of those dental
conditions which are professionally determined by the examining or
treating dentist to be compromising a medical condition. [The goal of
care is to provide a reasonable level of oral health and specific
improvement of the oral conditions that directly impact the medical
condition]{.underline}. Dental treatment is generally limited to
supportive periodontal therapy, endodontic therapy, restorative
dentistry, and oral surgical procedures. Removable prosthetics only if
deemed necessary, and approved by authorized staff.

-   **Class III** - Those having a dental condition professionally
    determined by VA to be currently aggravating a service-connected
    medical condition.

```{=html}
<!-- -->
```
-   **Class V** - Service-connected veterans in approved vocational
    rehabilitation training.

```{=html}
<!-- -->
```
-   **Class VI** - Veterans who are scheduled for admission or who are
    receiving outpatient care, if the dental condition is clinically
    determined to be complicating a non-service connected medical
    condition currently under VA treatment.

Examples of medical conditions where management of dental disease may be
required to prevent complication of medical care:

-   Cardiac valve replacement surgery

-   Synthetic vascular graft surgery

-   Orthopedic joint replacement surgery

-   Severe chronic pulmonary disease

-   Advanced liver disease, with hepatic-based coagulopathies

-   Uncontrolled diabetes

-   End stage renal disease, undergoing hemodialysis

-   HIV positive, or immunocompromised, receiving immunosuppresants

```{=html}
<!-- -->
```
-   Iatrogenic changes to oral tissues that are a direct result of a
    medical condition/therapeutic regimen such as:

```{=html}
<!-- -->
```
-   Dilantin, Nifedipine hyperplasia

-   Radiation/Chemotherapy

-   Candidiasis secondary to immunosuppression.

###### [Level 2 -- Limited Dental Care]{.underline}

These patients may receive care limited to the treatment of those dental
conditions which are professionally determined by the examining or
treating dentist to be compromising a medical condition. [The goal of
the treatment is specific improvement of the oral condition that
directly affects the medical condition and the elimination and/or
prevention of foci of infection.]{.underline} Dental care is generally
limited to essential periodontal therapy, essential restorative
dentistry, and oral surgical procedures:

-   Patients placed on organ transplant list

-   Patients scheduled for chemotherapy.

###### [Level 1 -- Minimal Care (Emergency Care)]{.underline}

These patients may receive essential care limited to oral conditions in
which symptoms of acute pain, uncontrolled bleeding, or significant
infection are present. [The goal of treatment is to eliminate symptoms
or remove foci of infection.]{.underline} Dental care is generally
limited to appropriate medication therapy, one time palliative
restorative procedures or extractions. These are generally dental
outpatients with no other established dental eligibility, that require
emergency treatment.

SPOT CHECKS -- RESIDENT \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Patients Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**Last 4 SSN: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

# **Treatment plan appropriate: Yes No -- Changes: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_** 

**Assessment: EXCELLENT 10 9 8 7 6 5 4 3 2 1 POOR**

# **Patient satisfied with treatment: Yes No**

**Treatment: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Evaluator: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\***

**Patients Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**Last 4 SSN: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

# **Treatment plan appropriate: Yes No -- Changes: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_** 

**Assessment: EXCELLENT 10 9 8 7 6 5 4 3 2 1 POOR**

# **Patient satisfied with treatment: Yes No**

**Treatment: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Evaluator: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\***

**Patients Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**Last 4 SSN: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

# **Treatment plan appropriate: Yes No -- Changes: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_** 

**Assessment: EXCELLENT 10 9 8 7 6 5 4 3 2 1 POOR**

# **Patient satisfied with treatment: Yes No**

**Treatment: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Evaluator: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

# **IV CONSCIOUS SEDATION**

**Resident Name:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**In conjunction with Staff:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

## Circle Location Performed: OR Dental Other Clinic 

**Clinic (Indicate):** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Medications administered:**

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Patients Name:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Last 4 SSN:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Date:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

# **IV CONSCIOUS SEDATION**

**Resident Name:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**In conjunction with Staff:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

## Circle Location Performed: OR Dental Other Clinic 

**Clinic (Indicate):** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Medications administered:**

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Patients Name:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Last 4 SSN:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Date:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

# **DENTAL INPATIENT -- SAME DAY SURGERY -- INPATIENT EMERGENCY\***

**Resident Name:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**In conjunction with Staff:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**CHECKLIST:**

**Date Admitted:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**History and Physical Exam (with entry in chart):**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Medication:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Daily Rounds:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Date of Dental Treatment in the OR:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Description of Surgical Procedure:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

## Date of Entries in the Hospital Chart:

**Pre‑op Orders:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Post‑op Orders:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Progress Notes:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Discharge Summary:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Disposition:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Patients Name:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Last 4 SSN:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Admission Date:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Discharge Date:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

## Continue as Outpatient: Yes No

**\*please circle category**

# **HISTORY AND PHYSICAL**

**Resident Name:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**In conjunction with Staff:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

## Chief complaint: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Admission Diagnosis:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Medications:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Scheduled Treatment:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Patients Name:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Last 4 SSN:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Date:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

# **GENERAL ANESTHESIA**

**Resident Name:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**In conjunction with Staff:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Medications administered:**

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Patients Name:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Last 4 SSN:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Date:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

VETERANS ADMINISTRATION DENTAL SERVICE

**CASE PRESENTATION EVALUATION**

**Resident:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Date of Presentation:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Case Presentation No:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**NEEDS**

**EXCELLENT GOOD FAIR IMPROVEMENT**

**Medical History** \_\_\_\_ \_\_\_\_ \_\_\_ \_\_\_\_\_

**Past Dental History­** \_\_\_\_ \_\_\_\_ \_\_\_ \_\_\_\_\_

# **Diagnostic Casts and**

**Roentgenographs** \_\_\_\_ \_\_\_\_ \_\_\_ \_\_\_\_\_

**Use of visual aids** \_\_\_\_ \_\_\_\_ \_\_\_ \_\_\_\_\_

# **Treatment plans**

**presented** \_\_\_\_ \_\_\_\_ \_\_\_ \_\_\_\_\_

**Form of presentation** \_\_\_\_ \_\_\_\_ \_\_\_ \_\_\_\_\_

**Terminology used** \_\_\_\_ \_\_\_\_ \_\_\_ \_\_\_\_\_

**General impression** \_\_\_\_ \_\_\_\_ \_\_\_ \_\_\_\_\_

**Answering questions** \_\_\_\_ \_\_\_\_ \_\_\_ \_\_\_\_\_

**Comments:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Staff Evaluator**

VETERANS ADMINISTRATION DENTAL SERVICE

**QUARTERLY**

# **GENERAL PRACTICE RESIDENT EVALUATION**

**Discipline:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Resident:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

  --------------------- ----------------- --------------- ------------------ -------------- -------------------- ---------
                        **Outstanding**   **Excellent**   **Satisfactory**   **Marginal**   **Unsatisfactory**   **N/A**

  **Attendance**                                                                                                 

  **Dependability**                                                                                              

  **Handling emergency                                                                                           
  situations**                                                                                                   

  **Thoroughness in                                                                                              
  exam/diagnosis**                                                                                               

  **Quality of work**                                                                                            

  **Effectiveness in                                                                                             
  expressing ideas**                                                                                             

  **Personal                                                                                                     
  relationships with                                                                                             
  patients and                                                                                                   
  co-workers**                                                                                                   

  **Attitude towards                                                                                             
  profession**                                                                                                   

  **Motivation**                                                                                                 

  **Knowledge**                                                                                                  

  **Patient management                                                                                           
  skills**                                                                                                       
  --------------------- ----------------- --------------- ------------------ -------------- -------------------- ---------

**COMMENTS:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Date:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Evaluator's name & title**

**VETERANS ADMINISTRATION DENTAL SERVICE**

**QUARTERLY SUMMARY**

**GENERAL PRACTICE RESIDENT'S EVALUATION**

**RESIDENT:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ **DATE:**
\_\_\_\_\_\_\_\_\_\_\_\_

  --------------------- ----------------- --------------- ------------------ -------------- -------------------- ---------
                        **Outstanding**   **Excellent**   **Satisfactory**   **Marginal**   **Unsatisfactory**   **N/A**

  **Operative**                                                                                                  

  **Fixed                                                                                                        
  Prosthodontics**                                                                                               

  **Removable                                                                                                    
  Prosthodontics**                                                                                               

  **Oral and                                                                                                     
  Maxillofacial                                                                                                  
  Surgery**                                                                                                      

  **Endodontics**                                                                                                

  **Periodontics**                                                                                               

  **Preventive                                                                                                   
  Dentistry**                                                                                                    

  **Occlusion**                                                                                                  

  **Pedodontics**                                                                                                
  --------------------- ----------------- --------------- ------------------ -------------- -------------------- ---------

**COMMENTS:**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Andrew J. Mesaros, Jr., DDS Residency Director**

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Paul M. Lambert, DDS Dental Service Chief**

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Resident**

VETERANS ADMINISTRATION DENTAL SERVICE

QUARTERLY FEEDBACK

EVALUATION OF ROTATION BY GENERAL PRACTICE RESIDENT

**Resident: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**Discipline: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

# **Length of Rotation: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

# 

#  **Was this the proper length?**

#  **If not, what would you recommend?**

# **Strong point of rotation, or what did you learn?**

# **Weak point of rotation, or what did you not learn that you would have liked to?**

# **What would you like changed?**

# **Were the Staff and Ancillary Personnel receptive and helpful?**

# **Comments:** 

DENTAL TRAINING PROGRAM STAFF

-   **Paul M. Lambert, DDS**

    -   Chief, Dental Service

    -   Oral and Maxillofacial Surgeon

    -   Assistant Clinical Professor, Department of Surgery, Wright
        State University School of Medicine

-   **Andrew J. Mesaros, Jr., DDS, MAGD, ABGD**

    -   Director, General Practice Residency

    -   Staff Dentist

    -   Adjunct Faculty -- Assistant Professor, Ohio State University

```{=html}
<!-- -->
```
-   **Glenn Jividen, Sr., DDS, MS**

    -   Staff Periodontist

    -   Diplomat American Board of Periodontics

```{=html}
<!-- -->
```
-   **Richard A. Lee, DDS, FAGD**

    -   Staff Dentist

-   **Robert M. Mahle, DDS**

    -   Staff Dentist, Extended Care Section

-   **Dwight M. Pemberton, DDS, MPH, FAGD, FICD, FACD**

    -   Staff Dentist

        -   Adjunct Associate Professor, Department of Medicine in
            Society and Community Medicine, Wright State University
            School of Medicine

        -   Adjunct Professor of Arts and Science, Central State
            University

-   **Douglas D. Richardson, DDS, MS**

    -   Staff Oral and Maxillofacial Surgeon

    -   Diplomat American Board of Oral Surgery

-   **Erin M. Slattery, DDS**

    -   Staff Dentist

    -   Adjunct Faculty -- Assistant Professor, Ohio State University

MEDICAL STAFF

-   **Guy B. Richardson, MHSA, CHE**

    -   Director, Dayton VA Medical Center

```{=html}
<!-- -->
```
-   **Steven M. Cohen, MD**

    -   Chief of Staff

    -   Associate Professor, Wright State University School of Medicine

-   **Samuel Adebonojo, MD**

    -   Chief, Surgical Service

    -   Associate Clinical Professor, Department of Surgery, Wright
        State University School of Medicine

```{=html}
<!-- -->
```
-   **Ann Marie Barrett**

    -   Chief, Nutrition and Food Service

```{=html}
<!-- -->
```
-   **Chowdry M. Bashir, MD**

    -   Chief, Medical Service

-   **Dorothy J. Burton**

    -   Chief, Physical Therapy

# **Nosrat M. Hillman, MD**

-   Chief Pathology and Laboratory Medicine Service

-   Clinical Professor of Pathology, Wright State University School of
    Medicine

```{=html}
<!-- -->
```
-   **Neil Katz, MD**

    -   Chief, Nuclear Medicine

    -   Assistant Clinical Professor, Wright State University School of
        Medicine

-   **Jyung Kim**

    -   Chief, Radiation Therapy

-   **Mahendrakumar Patel, MD**

    -   Otolaryngology Service

    -   Associate Clinical Professor, Wright State University School of
        Medicine

-   **Joan Padgett, PhD**

    -   Chief, Learning Resources Center

-   **Sujatha Reddy, MD**

    -   Chief, Anesthesia Section

-   **Stanley C. Erk, RPh**

    -   Chief, Pharmacy Service

**DAYTON CHILDREN'S MEDICAL CENTER**

-   **Thomas Murphy, MD**

    -   Vice President of Medical Affairs

    -   Director Medical Education

```{=html}
<!-- -->
```
-   **Gordon Womack, DDS**

    -   Division Head for Dentistry

## DENTAL CONSULTANTS

-   **Daniel E. Becker, DDS**

    -   Consultant in Pharmacology and Anesthesiology

    -   Professor of Allied Health Sciences, Sinclair Community College

    -   Associate Director of Education, Miami Valley Hospital

```{=html}
<!-- -->
```
-   **Walter Buchsieb, DDS**

    -   Consultant in Orthodontics

    -   Associate Professor, Department of Orthodontics, Ohio State
        University

```{=html}
<!-- -->
```
-   **Gregory Buerschen, DDS**

    -   Consultant in Restorative Dentistry

```{=html}
<!-- -->
```
-   **(LtCol) Kimberly Gill, DDS**

    -   Consultant in Pediatric Dentistry, Wright-Patterson Air Force
        Base

-   **Robert M. Jaynes, DDS, MS**

    -   Consultant in Oral Radiology

    -   Associate Professor, Section of Diagnostic Services, Ohio State
        University

-   **(LtCol) Maria Santos, DDS**

    -   Consultant in Endodontics, Wright-Patterson Air Force Base

-   **Cory Sellers, DDS**

    -   Consultant in Restorative Dentistry and Implant Prosthodontics

    -   Assistant Professor, Indiana University College of Dentistry

-   **Brian S. Shumway, DDS**

    -   Consultant in Oral Pathology, Ohio State University College of
        Dentistry

```{=html}
<!-- -->
```
-   **Charles Smith, DDS**

    -   Consultant in Practice Management

RESIDENTS -- DAYTON VA MEDICAL CENTER

1967‑68 Dr. William Weaver University of Louisville

1968‑69 Dr. Ricardo DeLeon University of Louisville

1969‑70 Dr. Barry S. Blank The Ohio State University

Dr. Daniel J. Whitner Howard University

1970‑71 Dr. James Ullmer The Ohio State University

Dr. William Ronan Temple University

1971‑72 Dr. Robert A. Hageman Georgetown University

1972‑73 Dr. Michael T. Ducar Case Western Reserve University

1973‑74 Dr. Steven Meltzner Washington University St. Louis

1974‑75 Dr. Robert Mahle Case Western Reserve University

1975‑76 Dr. John Fuller The Ohio State University

Dr. Steven B. Roholt Marquette University

1976‑77 Dr. Charles R. Doan The Ohio State University

Dr. Ho‑Ching Ma Georgetown University

1977‑78 Dr. Martin Levine Case Western Reserve University

Dr. Frank Lopez West Virginia University

1978‑79 Dr. Mark T. Shue The Ohio State University

Dr. Dennis Pasko Loyola University

1979‑80 Dr. Thomas R. Mee S.U.N.Y. ‑ Buffalo

Dr. Vidya Z. Ortiz University of Puerto Rico

1980‑81 Dr. William E. Cowling Loma Linda University

Dr. Michael Ashe Case Western Reserve University

1981‑82 Dr. Wendy J. LaBarr The Ohio State University

Dr. Richard M. Lofthouse Marquette University

1982‑83 Dr. Steven N. Berkowitz Georgetown University

Dr. Alfredo Fernandez University of Puerto Rico

Dr. Richard M. Wagner Marquette University

1983‑84 Dr. Suzan Miller Baltimore College Dental Surgery

Dr. Rick Burger The Ohio State University

Dr. Sean O\'Brien University of Detroit

Dr. George Yung Case Western Reserve University

1984‑85 Dr. Diane Danner Indiana University

Dr. Karen Hayes Indiana University

Dr. Terrence Poole University of San Francisco

Dr. John Utz Howard University

1985‑86 Dr. Bruce Mutchler West Virginia University

Dr. William Ricks University of Texas San Antonio

Dr. John Sartorio University of Pittsburgh

Dr. Stuart Field Medical University South Carolina

1986‑87 Dr. Natalie Gedge Indiana University

Dr. John Nista University of Pittsburgh

Dr. John Prather The Ohio State University

Dr. Todd Williams The Ohio State University

1987‑88 Dr. Rene Brignoni University of Puerto Rico

Dr. Luis Diaz University of Puerto Rico

Dr. Steven England The Ohio State University

Dr. Darren McKeever New Jersey Dental School

1988‑89 Dr. William Gioiello The Ohio State University

Dr. Jose Gonzalez Marquette University

Dr. Ivette Martinez University of Puerto Rico

Dr. Frank Raab University of Texas Houston

1989‑90 Dr. Roger Kaneshiro Marquette University

Dr. Kim Shaw The Ohio State University

Dr. Suzanne Sison Marquette University

Dr. Kimberley Zaremba University of Pittsburgh

1990‑91 Dr. Carol B.Smith University of Pittsburgh

Dr. Michael Johnson Howard University

Dr. Catherine Lawler The Ohio State University

Dr. Geneva W.Walker Case Western Reserve University

1991-92 Dr. Hamid Karimnamazi The Ohio State University

Dr. Christina Rapadas Marquette University

Dr. Oula Kowatli Damascus University, Syria

Dr. Carlos Stone The Ohio State University

1992-93 Dr. John Puet University of Pittsburgh

Dr. Maria Carmen Ramos University of the Philippines

Dr. Erickson Callejo The Ohio State University

Dr. Mehdi Motakef The Ohio State University

1993-94 Dr. Joel Palmer The Ohio State University

Dr. Dayo Obebe University of Pennsylvania

Dr. Kulwant Verraich Case Western Reserve University

Dr. Masoud Hekmatyar Temple University

Dr. Linda Kim (2nd year) Case Western Reserve University

1994-95 Dr. Vijay Badhwar Boston University

Dr. Eric Gallatin The Ohio State University

Dr. Melody Igleheart University of Louisville

Dr. Mark Nista Southern Illinois University

1995-96 Dr. Timothy Edwards The Ohio State University

Dr. David Hayes The Ohio State University

Dr. Dina Khoury University of Michigan

Dr. Phuoc Tran University of Detroit Mercy

1996-97 Dr. M. Annette Callejo The Ohio State University

Dr. Bradley Fawcett Indiana University

Dr. Bryan Pope Boston University

Dr. Rachelle Ziemba Case Western Reserve University

1997-98 Dr. Timothy Kreimer The Ohio State University

Dr. Nanette Mick The Ohio State University

Dr. Julie Obenchain Case Western Reserve University

Dr. Brenda Roman-Amador The Ohio State University

1998-99 Dr. Seema Amin University of Florida

Dr. Annette Barbay The Ohio State University

Dr. Dennis Garpetti The Ohio State University

Dr. Glenn Waters The University of North Carolina

1999-00 Dr. Pradeep Bekal New York University

Dr. Herbert McNeal, Jr. Meharry Medical College

Dr. Lucas Nazario-Correa University of Puerto Rico

2000-01 Dr. Regan Bradford Meharry Medical College

Dr. Cynthia Eaddy Meharry Medical College

Dr. April Hearns Meharry Medical College

Dr. Shanetta Sutton Meharry Medical College

2001-02 Dr. Basem Al-Taani University of Jordan

Dr. Tam Nguyen University of Pittsburgh

Dr. Suprina B. Nindra University of Pittsburgh

Dr. Jacqueline Ojimba University of Pittsburgh

2002-03 Dr. Dennis S. Christensen The Ohio State University

Dr. Nader S. Jahshan University of Western Ontario

Dr. Joel J. Napenas University of Western Ontario

Dr. Erin M. Slattery Creighton University

2003-04 Dr. Madiha Basit University of Maryland

Dr. Faizullah Khan University of Pakistan

Dr. Jimmy Kim University of Western Ontario

Dr. Paul Robinson Nova Southeastern University

2004-05 Dr. Alyson K. Burns The Ohio State University

Dr. Errol E. Isaac Meharry Medical College

Dr. Christopher R. Smith The Ohio State University

Dr. Cindy B. Wolt The Ohio State University

2005-06 Dr. Anniece C. Cox Howard University

Dr. Neel Patel McGill University

Dr. Paige M. Prather The Ohio State University