Curriculum Fourth Year

Adjunctive orthodontic intervention involves the management of orthodontic problems prior to restorative treatment. Each student is required to complete the treatment of a clinical case which may involve the following:

1) repositioning teeth that have drifted after extraction or bone loss caused by periodontal disease.

2) forced eruption of broken teeth to expose sound root structure on which to place permanent restorations.

3) correction of crossbites which do not involve a skeletal discrepancy.

4) alignment of anterior teeth for more esthetic restorations.

Clinical experiences provide students with the opportunity to apply knowledge and develop competencies related to oral health promotion and disease prevention activities with individual patients in the clinics at Penn Dental Medicine.

Experiences in alternate oral health care delivery settings provide students with the opportunity to develop and expand their skills in providing comprehensive oral health care in community based settings under the direct supervision of faculty members. Students are scheduled in the mobile dental vehicle, PennSmiles, and are also scheduled at Community Volunteers in Medicine, a community based medical and dental treatment facility in West Chester, PA. Students attend small group seminars to discuss their experiences and theoretical underpinnings of community oral health activities.

Fourth-year students, within their PCU groups, continue to perform examination and diagnostic procedures, comprehensive treatment planning, all restorative dental procedures, fixed and removable prosthodontic procedures, including implant supported restorations, non-surgical periodontal procedures, and maintenance therapy. The PCU program goal is to produce a practitioner who can integrate basic science knowledge with clinical proficiency in all phases of general dentistry, based on the concept of recognition and treatment of oral disease.

This clinical course attempts to expose the student to many components of pediatric dentistry, including but not limited to diagnosis, prevention, restorative dentistry, pulp therapy, management of the developing occlusion, behavior guidance, and care of special children. Penn Dental Medicine competency statements, as they apply to children, adolescents, and special needs patients are the focus.

Competency examinations for this course relate to restorative dental care for the child patient.

The Endodontic Clinic trains predoctoral students to become competent in basic endodontic procedures on vital and non-vital teeth. This includes instruction in diagnosis, treatment planning, treatment/obturation, post-endodontic restoration and related entities (bleaching of non-vital teeth, treatment of traumatic injuries, etc.). This instruction is expanded and reinforced in the fourth-year clinic.

The Admissions and Emergency Care Clinic rotation consists of combined rotations in the Emergency Care Clinic and the Oral Diagnosis Clinic. The Emergency Care Clinic provides emergency care to ‘walk- in’ non-registered patients. Emphasis is placed on efficient and thorough dental care to ensure that the patient receives the highest quality of emergency dental care in a timely manner. The Admissions or Oral Diagnosis Clinic provides an initial evaluation for Penn Dental Medicine patients who register for comprehensive care on an appointment basis. Students that rotate through the Oral Diagnosis Clinic assess the medical and oral health status of the patients. Additionally, the medical status of all patients (except ASA I patients) are reassessed annually in the Oral Diagnosis Clinic.

Students perform uncomplicated exodontia and minor pre-prosthetic surgical procedures that are approved by the clinical instructors, assist the instructors in complicated surgical procedures, and observe the administration of intravenous sedation and general anesthesia. The bulk of the students’ clinical experience will be delivered in a continuous 2-week block. This type of experience will enable students to get a better understanding in delivering surgical care by having more hands-on experience as they will be able to follow up on the recovery of individual patients.

Students are assigned 12-15 rotations in the Radiology Clinic during their third and fourth years. During their rotations, they take full-mouth x-ray series on newly admitted patients who are sent to Radiology from the Admissions Clinic.

The Periodontics Clinic provides fourth-year students the opportunity to treat patients with differences of severity in existing periodontal disease. In most cases, the patients afford the students adequate experiences and impart to them comprehensive knowledge of the tissues of the periodontium and the fundamental principles underlying the prevention and treatment of diseases that afflict the periodontal tissues.

Lectures and online learning provide students with foundation knowledge regarding career planning and policies and procedures related to employment and business management in dental practice.

Students spend four weeks of their senior year in an extramural program at an affiliated hospital or a non- affiliated hospital program approved by Penn Dental Medicine. During the hospital rotation, students evaluate hospitalized patients to reinforce principles of physical and laboratory diagnosis, participate in dental treatment for patients with severe medical problems, and learn to request and answer consultations from other clinical departments such as radiology and otolaryngology (see below).

The seminar is an open forum discussion in which students make case presentations, after which the diagnosis, treatment plan, and therapy are analyzed and evaluated. Initially, the PCU leader may present cases in order to establish the proper method of case presentation; thereafter, it is the student’s responsibility to present thoroughly documented cases which include photographic slides of pretreatment, a complete dental and medical evaluation, study models, radiographs, and other pertinent data.