2.7 Placement and Removal of Dental Dam
Protocol: The learner must successfully demonstrate placement and removal of dental dam.
Criteria:
| Student completed procedure protocol accurately | Successful (S) |
| Student did not complete procedure protocol accurately | Unsuccessful (U) |
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Procedure Protocol |
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Complete armamentarium assembled |
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Positioned the dental equipment to facilitate the treatment procedure and ergonomics |
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Procedure explained to the patient |
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Use mouth mirror to inspect the oral cavity |
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Topical anesthetic applied when necessary |
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Flossed the teeth where the dam is to be placed |
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Correct number of holes punched |
| Use ligatures to secure dental dam |
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Frame positioned properly |
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Flossed to seat the interproximal areas |
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Dental dam inverted in operative area |
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Correct spacing of holes (no bunching or stretching of dam) |
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Dam punched accurately (proper curve, missing or malaligned teeth notated) |
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Placed LVE suction in oral cavity |
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No tears or gaps that would allow leakage around the operative tooth |
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Removed ligatures |
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Removed LVE suction from oral cavity |
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Septum cut prior to removal |
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Removed frame and dental dam |
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Dental dam checked for integrity |
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Flossed to check contacts for dental dam |
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Checked for tissue trauma |
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Rinsed oral cavity |
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Completed procedure in allotted time |
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Procedure accurately documented |
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Safety measured followed |
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Infection control protocol was adhered to |
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Demonstrates professionalism and appropriate communication skills |
