The didactic component of the AEGD program provides the resident with a broad academic background from which sound clinical judgments can be made regarding diagnosis, treatment planning and the selection of the appropriate method of treatment for each individual patient. The didactic phase is scheduled on a regular basis and includes lectures, seminars, literature reviews, treatment planning conferences, clinical pathological conferences and special projects.
Examples of special projects may include table clinics and preparation of a professional lecture.
The following areas of interest are included in didactic sessions:
- Oral pathology & Oral medicine
- Physical evaluation
- Oral diagnosis and treatment planning
- Preventive dentistry
- Comprehensive control of pain and anxiety in the conscious patient,
- Geriatric dentistry
- Special care and medically compromised patients
- Asepsis, infection and hazard control.
In addition, residents will gain didactic knowledge and clinical experience in practice management techniques, which will enable them to be prepared to deal with acquiring, managing and coordinating different types of potential practice situations they may explore upon graduation.
ORAL PATHOLOGY & ORAL MEDICINE
This phase of training will supplement the resident's ability to evaluate and manage patients comprehensively through heightened awareness and increased knowledge in oral pathology/oral medicine. Specific emphasis will be placed on clinical differential diagnosis, medically compromised patients, use of laboratory tests and the taking and interpretation of a medical/dental history.
As a formal course entitled "Physical Diagnosis", this course serves as an introduction to the process of physical diagnosis in Internal Medicine. This includes not only the basic skills of physical examination, but is fundamentally dependent upon the ability to obtain a complete and accurate medical history. Therefore, the course will begin by examining parts of the medical history and will then complete a survey of the physical examination of the major organ systems. Throughout the latter part of the course, the concepts of history taking will be referred to frequently in order to integrate them with the basics of physical diagnosis, the fundamental element in most medical specialties.
ORAL MEDICINE - DIAGNOSIS & TREATMENT PLANNING
The formal course entitled "Internal Medicine" will expand on knowledge obtained in the course on Physical Diagnosis. A broad range of topics will be covered emphasizing the understanding of the pathophysiology of diseases and effects on the oral health of the patient, the ability to perform adequate oral hygiene and the need for modification of the dental treatment plan. The course is based on resident participation, and each resident will gain experience in the preparation and delivery of a formal presentation using audiovisual aids.
Modern dentistry requires a working knowledge of preventive care that ranges from individual oral hygiene instruction to advising community groups on fluoridation. Residents should be conversant in the theories and research concerning dental caries to include its etiology, microbiology, progression and prevention. The AEGD goals in this area are to have residents attain a working didactic and clinical knowledge of all aspects of preventive dentistry, to include diagnosis, prevention and treatment for varying oral conditions of hard and soft tissue that are manageable. Oral hygiene must be taught and reinforced in all patients, especially those with altered quantity/quality of saliva. Because BCD has a Stomatology Center and the co-location of a cancer hospital, residents will gain extensive clinical experience in the care of these patients. In addition, it is the resident’s responsibility to educate patients as to their personal responsibility in prevention and control of disease as well as maintenance of restorative care. In addition, general practitioners must be knowledgeable in the application of fluoride, oral hygiene, behavior modification, patient counseling and nutrition to the area of preventive dentistry. The role of saliva as to its sources, composition, reasons for changes in flow/chemistry and its significance in the maintenance of oral health must be appreciated.
COMPREHENSIVE CONTROL OF PAIN AND ANXIETY
A major reason for avoidance of routine dental care is fear of discomfort. The comprehensive control of pain and anxiety in the conscious patient is not only the standard of care in modern practice, but it is a major practice builder. Instruction, consultations, demonstrations and participation in a formal course entitled "Enteral Conscious Sedation" will lead to a working knowledge of which techniques and agents to employ for the comfort of each individual patient.
Implants have become an important component of the restorative armamentarium. Residents will gain clinical experience in the treatment of patients who require dental implants as part of their comprehensive care. Residents will gain experience in the diagnosis, treatment planning and restoration of implant cases.
The purpose of the geriatric dentistry component of the program is to increase the resident's awareness of the changing and potentially more challenging needs of the aging patient. Didactic instruction and clinical experience will be provided concerning the dental, emotional, psychological and medical complications as they relate to dentistry for the geriatric patient.
SPECIAL CARE & MEDICALLY COMPROMISED PATIENTS
As described in the sections of this website on oral and maxillofacial surgery, oral pathology, oral medicine, physical evaluation, comprehensive control of pain and anxiety, pediatric dentistry and geriatric dentistry, there will be extensive classroom and clinical experience in treating medically compromised patients.
In addition to many comprehensive care patients being cared for in the AEGD clinic, experience will be gained in more extensive cases through the AEGD Special Care Clinic. Treatment of patients with special needs will be scheduled Wednesday mornings in the AEGD clinic. The goals and objectives in this area are to build a level of confidence and competence that enable the resident to accurately assess the medical status of all patients related to dental treatment, to understand the process of obtaining effective medical consultation pertaining to proposed care and to provide dental treatment that may or not be modified due to the existing medical status of the patient. Residents must realize when consultation is warranted and when referral to another specialist or facility is advantageous for the patient.
To achieve these goals, significant clinical experience will be gained in the evaluation, diagnosis, treatment planning and dental care of patients possessing one or more modifying characteristics compromising treatment which must be factored into the evaluation, treatment plan and resultant care.
Residents will gain experience in treating Special Needs Patients, which are defined as persons with medical, physical, psychological, access factors or social situations that make it necessary to modify normal dental routines in order to provide dental treatment. These individuals include, but are not limited to, people with developmental disabilities, complex medical problems, and significant physical limitations. The AEGD treats patients in concert with the hospital on a referral basis, particularly bone marrow and organ transplant patients. Significant experience will be gained with dental care of this group.
ASEPSIS, INFECTION AND HAZARD CONTROL
The practice of "standard-of-care" dentistry requires a working knowledge and constant practice of proper asepsis and hazard control in the clinic, x-ray room and laboratory. All residents, staff and employees are required by OSHA to attend training annually.
The Infection Control Manual published by Baylor College of Dentistry Texas A & M Health Science Center is current and is given to each resident and staff member. This document must be read and its protocol followed. All regulations are in accordance with the most current guidelines on a federal, state and local level, and must be adhered to in all clinical and laboratory activities. Correct use of personal protective equipment and barrier technique will be adhered to in the clinic and laboratory to ensure asepsis. The AEGD clinic is a large multiple chair clinic, and diligent effort must be made to avoid potentially hazardous contamination and/or cross-contamination of any kind. All residents and health care workers are required to be immunized against hepatitis B, receive annual TB testing and are strongly encouraged to be immunized against measles, mumps and rubella.
Hazard control includes knowledge of the risks and proper handling of all potentially harmful materials and devices used in the clinic and laboratory. Knowledge of proper labeling and MSDS information is required. All staff must know where to gain rapid access to MSDS information when necessary. Residents and staff must be responsible for the proper handling of sharps to avoid needle and instrument sticks. In addition, in the event of an accident with a sharp, an Incident Report must be filled out immediately and the required protocol followed. Annual training in OSHA/Hazard Control is a Baylor College of Dentistry Texas A & M Health Science Center requirement.
Clinically applicable basic sciences will be integrated into the didactic program. This will assist the resident in understanding the biologic, physiologic, psychologic and physical ramifications of all proposed treatment. This knowledge is extremely important ethically and medicolegally when a professional is entrusted with treating patients.
In order to achieve a fulfilling career in dentistry, a well-rounded knowledge of the many facets of practice management is essential. This section of the AEGD will provide residents with the basics of locating, purchasing and managing a practice. In addition to lectures on financial matters, the behavioral and practical side of personnel management will be discussed in depth.