CDAMP PATIENT EDUCATION (click here to download)

 

CDAMP (Complete this skill with 4 patients, use a separate sheet for each skill)

EVALUATION: Patient Education – Oral Hygiene                                            

STUDENT NAME                                                                             ID #                       

DATE                                                                     PATIENT’S INITIALS                        

Materials: 0 – 10 points

The following armamentarium is present:

___ Gloves, basic set up, soft bristled, ADA approved toothbrush, floss, typodont, face mirror 

Steps:  0 – 10 points each

Brushing:

___ 1.  Places brush at a 95-degree angle to teeth so that bristles are directed

             into the gingival sulcus

___ 2.  Vibrates bristle tips back and forth with short strokes for a count of

             10, so that the tips enter the gingival sulcus and cover the gingival

             margin

___ 3.  Moves brush to next area, overlapping first position to repeat

             actions above until all maxillary & mandibular facial and lingual

             tooth surfaces are covered

___ 4.  Uses a scrubbing or circular brush stroke on maxillary &

              mandibular occlusal surfaces

___ 5.  Turns head of brush lengthwise to brush lingual surfaces of anterior

              teeth

___ 6.   Brushes plaque from dorsal surface of tongue

___ 7.   Instructs to brush at least 2 times a day

 

____ TOTAL POINT AVERAGE

 

Preceptor declares skill was successfully completed. (75% of total possible points)

 

PRECEPTOR’S SIGNATURE:

_____________________________________________

STUDENT’S SIGNATURE:

________________________________________________

 

CDAMP (Complete this skill with 4 patients)

EVALUATION: Patient Education –Oral Hygiene- 2

STUDENT NAME ___________________________ ID # _____________

DATE ________________________ PATIENT’S INITIALS __________ 

 

Flossing: 

___ 8.   Dispenses length of floss 18 – 24 inches long

___ 9.   Wraps ends of floss around first joint of third fingers, more on one

              finger than the other

___ 10.  Grasps floss between thumb & index finger of both hands, allowing

               ½ – 1 inch to remain between hands

___ 11.  Instructs to begin in same place every time so that no area of mouth

              is passed over

___ 12.  With floss passed over the thumbs to clean maxillary teeth, & over

              index fingers for the mandibular teeth, directs between teeth using a

              sawing motion, gently maneuvering through the contact points

___ 13.  Curves floss around tooth into a C-shape and shaves up & down

              tooth surface & gingival sulcus to remove plaque

___ 14.  Switches floss to adjacent tooth and shaves plaque from tooth

              surface and gingival sulcus

___ 15.  Successfully removes floss from between teeth

___ 16.  Rotates floss on fingers to access a fresh section of floss each time

              before cleaning a new area

___ 17.  Curving floss into a c-shape around distal area of each most

              posterior tooth, flosses area with firm pressure

___ 18.  Instructs patient to floss once a day

 

____ TOTAL POINT AVERAGE

 

Preceptor declares skill was successfully completed. (75% of total possible points)

 

PRECEPTOR’S SIGNATURE _________________________________­­­_________

STUDENT’S SIGNATURE _____________________________________________