Competencies and Rotations for the General Practice Residency

Competencies

The General Practice Residency Program provides one-and two-year didactic and clinical experience in general dentistry in a hospital setting. While the program provides the structure and opportunity to achieve these competencies, it is the resident's responsibility to obtain documentation showing that these skills have been obtained. Most of this documentation will be completed on standard forms by full- or part-time faculty members.

At the conclusion of the one-year residency program, each resident should have fulfilled a set of competencies as outlined below:

Documentation, information management and quality improvement

Evaluate scientific literature and use information in the literature to make professional decisions.
Maintain a patient record system that facilitates the retrieval and analysis of the
process and outcomes of patient treatment.
Modify the treatment plan, if indicated, based on therapeutic outcomes, unexpected circumstances or the patient's individual needs.

Pediatric Dentistry

Perform pediatric pulpal therapy.
Restore intra and extra-coronal defects in the primary dentition.
Perform uncomplicated surgical procedures on pediatric patients.
Use pharmacologic and non-pharmacologic behavior management skills with the pediatric patient.

Pulpal therapy

Diagnose and treat pain of pulpal origin. Perform uncomplicated, non-surgical endodontic therapy.
Recognize and manage uncomplicated endodontic situations and emergencies.
Manage complex endodontic therapy and complications.

Restoration of Teeth

Restore single teeth using a functionally acceptable range of materials and methods.
Place restorations and perform techniques to enhance facial esthetics.
Restore intra and extra-oral coronal defects
Restore endodontically treated teeth.

Temporomandibular Dysfunction and Occlusion

Diagnose and manage a patient's occlusion.
Treat minor occlusal abnormalities and arch space problems using space maintenance and other orthodontic appliances.
Diagnose and non-surgically treat uncomplicated temporomandibular disorders.

Replacement of teeth

Treat patients with missing teeth requiring uncomplicated removable and/or fixed
prostheses.
Communicate care design with laboratory technicians and evaluate resultant
prostheses.
Recognize and manage cases requiring complicated prostheses.
Treat patients with missing teeth using uncomplicated dental implant restorations.
Manage the surgical component of dental implant systems.
Assess and manage complications of dental implants.

Treatment of medical and dental emergencies

Anticipate, diagnose and provide initial treatment and follow-up management for medical emergencies that may occur during dental treatment.
Diagnose and manage dental emergencies, performing uncomplicated or reversible techniques where indicated
Provide initial treatment and then manage patients with extra-oral and complex oral- facial emergencies and infections.
Perform initial treatment and management of extra-oral facial trauma.
Treat intraoral hard and soft tissue lesions of traumatic origin.
Manage intraoral soft tissue lesions of nontraumatic origin.

Periodontal Therapy

Diagnose periodontal disease demonstrating periodontal examination and utilizing radiographs.
Treat and manage mild and moderate periodontal disease, including non-surgical and surgical techniques.
Recognize and manage periodontal emergencies and complications of periodontal treatment.
Evaluate the results of periodontal treatment and establish and monitor a periodontal maintenance program.

Obtain Informed Consent

Explain and discuss with patients, parents or guardians of patients who lack decisional capacity, findings, diagnoses, treatment options, realistic treatment expectations, patient responsibilities, time requirements, sequence of treatment, estimated fees and payment responsibilities, in order to establish therapeutic alliance between the patient and/or parent or guardian, and care provider.

Oral Pathology, Oral Surgery and Hospital Protocol

Perform surgical and nonsurgical extraction of erupted teeth.
Perform uncomplicated pre-prosthetic surgery
Perform biopsies of oral tissues.
Recognize and manage surgical emergencies and complications of intraoral surgical treatment.
Extract uncomplicated impacted wisdom teeth.
Diagnose and manage common oral pathological abnormalities.
Provide dental treatment in an operating room.
Provide comprehensive management and care for individual inpatients or same day surgery patients from the beginning to the end of a patient's hospital experience.
Request and respond to requests for consultations.
Identify needs and make referrals to appropriate health care providers for the
treatment of physiologic, psychologic and social problems presented by dental
patients.
Perform dental consultations and request medical consultations for hospitalized
patients and patients in other health care settings.

Planning and providing multidisciplinary comprehensive care

Integrate multiple disciplines into an individualized, comprehensive, sequenced
treatment plan using diagnostic, risk assessment and prognostic information for
patients with complex needs.
Develop and carry out dental treatment plans for special needs patients in a manner that considers and integrates those patients’ medical, psychological and social needs.
Provide dental care as part of an interprofessional health care team.
Diagnose and manage oral manifestations of systemic disease.

Patient assessment and diagnosis

Obtain and interpret a patient’s chief complaint, history of present illness, medical, dental, family and cultural background, social histories, and review of systems.
Obtain and interpret appropriate laboratory and radiographic data and obtain additional diagnostic information through consultation with other health care
providers.
Perform a history and physical examination and collect other data to establish a risk assessment for use in the development of a dental treatment plan.
Establish diagnosis and risk assessment incorporating historical, laboratory, radiographic and clinical findings.

Practice management

Function as a patient’s primary oral health care provider.
Treat patients efficiently in a dental practice setting
Use and implement accepted sterilization, disinfection, universal precautions and
occupational hazard prevention procedures in the practice of dentistry.
Practice and promote the principles of jurisprudence and ethics in the practice of
dentistry and in relationships with patients, personnel and colleagues.
Provide patient care by working effectively with allied dental personnel including
performing sit down, fourhanded dentistry.

Medical risk assessment

Select and use assessment techniques to arrive at a differential, provisional and
definitive diagnoses for patients with complex needs.
Treat patients with a broad variety of acute and chronic systemic disorders and social difficulties, including patients with special needs.

Promoting oral and systemic health and disease prevention

Use accepted prevention strategies such as oral hygiene instruction, nutritional education, and pharmacologic intervention to help patients maintain and improve their oral and systemic health.

Rotations

Required Rotations

Anesthesiology
Each resident will be assigned to the Anesthesiology Department at SMH full-time for a period of two weeks.

Family Medicine Department
All general dental residents will spend a two-week period on rotation in the Family Medicine Center. The resident will be present from 8:00 AM until 6:00 PM. The resident will spend time with the Family Medicine residents and attendings, helping and observing the delivery of non-urgent medical care.

Consultations (Throughout the year)
Consultation requests from all departments of the hospital are increasing in number. Currently up to 15-20 consultations at SMH are received by the dental services per week. The resident is exposed to patients with a broad range of medical and emotional problems on the consultation service and works closely with other health professionals.

Oral Surgery (5 - 7 weeks)
The University of Rochester School of Medicine and Dentistry offers a fully accredited Advanced Training Program in Oral Surgery. The close cooperative working arrangement between the oral surgery and general practice programs affords the GP resident extensive oral surgical experience.

Elective Rotations

Salivary Dysfunction Center (Fridays for 1.5 months)
The broad goal of this rotation is to expose students to the diagnosis and treatment of patients with salivary dysfunction. Students will develop greater understanding and expertise in the management of these patients, and also be exposed to the research programs that are ongoing in this population.

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