This unit applies to work in dental prosthetics at advanced diploma level

Pre-requisite units

This unit must be assessed after successful achievement of pre-requisites:

HLTIN301C Comply with infection control policies and procedures

HLTIN302C Process reusable instruments and equipment in health work

HLTWHS401A Maintain workplace WHS processes

ELEMENT

PERFORMANCE CRITERIA

1. Plan treatment

1.1 Make accessible in the clean zone of the surgery the client's required laboratory work and necessary charts andrecords

1.2 Obtain accurate, complete and legal records of the client's personal, medical and dental history

1.3 Interpret prescription where required

1.4 Provide full details of the procedure to the client and/or carer

1.5 Obtain and document consent following ethical and legal requirements

1.6 Implement standard precaution during all procedures

1.7 Ensure emergency procedures are in place and ready for use according to relevant guidelines

2. Take a primary impression

2.1 Select correctly the equipment, instruments and materials for the primary impression

2.2 Take primary impressions of the maxilla and/or mandible using an alginate material in stock edentulous trays

2.3 Relieve the denture in the area of the abutments

2.4 Reline the denture with a tissue conditioning material

2.5 Pour alginate impression in dental stone and trim for custom tray fabrication

3. Prepare to take a final impression

3.1 Fabricate an open window custom tray to provide an accurate impression of tissue details and the relationship of the abutments to one another and to surrounding oral tissues

3.2 Ensure abutment screw tightness

3.3 Attach impression copings to the abutments with the proper length guide pins

3.4 Try-in the custom tray in the mouth and check for comfort and path of insertion

3.5 Mould the borders of the custom tray

3.6 Seal the window with baseplate wax and soften in a heated water bath

3.7 Insert custom tray over the guide pins and impression copings

4. Take the final impression

4.1 Paint the custom tray with an appropriate adhesive for the impression material to be used

4.2 Mix the selected impression material according to the manufacturer's specifications

4.3 Load the impression material into the tray and syringe and inject around the impression copings

4.4 Seat the impression tray using the guide pins and holes in the wax window as a guide for placement

4.5 Complete moulding of the borders

4.6 Clear excess impression material from guide pins before complete setting

4.7 Loosen the guide pins and remove the impression

5. Pour master cast and fabricate occlusal rims

5.1 Screw replicas onto the impression copings with guide pins

5.2 Bead and box the final impression and cast in diestone

5.3 Unscrew each guide pin completely before separating the impression from the cast

5.4 Fabricate attachment and bar extensions according to the prescription

5.5 Evaluate casting for accuracy of fit on the abutments

5.6 Fabricate a customized record base incorporating attachments

5.7 Add occlusal rims to the trimmed and polished base

6. Establish maxillomandibular relations

6.1 Position the attachment bar in the mouth

6.2 Place pressure indicator paste on the fitting surface of the base and ensure the base is fully seated in the mouth

6.3 Check the base for attachment retention and potential pressure areas

6.4 Record maxillomandibular relationships

6.5 Establish lip support and phonetics at the correct vertical dimension

6.6 Select tooth shade and denture tooth mould

7. Try-in of waxed denture in client's mouth and process

7.1 Evaluate trial denture for tooth arrangement, aesthetics, phonetics and vertical dimension of the occlusion

7.2 Adjust the trial denture for denture soreness

7.3 Record another centric relation and process as normal

7.4 Ensure complete seating of the overdenture into the attachment bar

8. Insert the completed overdenture

8.1 Snap denture onto the attachment bar

8.2 Use pressure indicator paste to adjust any potential sore areas

8.3 Check centric relation and remount denture for final adjusment

8.4 Provide hygiene and home care instructions

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge:

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes knowledge of:

Advantages of an implant retained overdenture to the client including:

better aesthetics especially when resorption has decreased the size of the alveolar process in the maxilla

fewer implants, abutments and prosthetic components

les component stress and breakage

lower treatment costs compared to fixed prosthetics

simplified construction technique

Applied oral anatomy including:

dentition - arrangement of the teeth, naming and coding of teeth

structures of the oral cavity - hard and soft palate, lateral and posterior borders of the oral cavity, tongue and floor of the mouth

teeth - form and function

Dental and medical records and charts including:

confidentiality of client records

FDI notation and Palmer notation systems and charting symbols for tooth surfaces, cavities and other dental problems

items that constitute a dental record

knowledge of correct dental terminology and how it is used in dental charting

the purpose and requirements for maintaining accurate records of examination, treatments, materials used and drugs/medicaments prescribed

the purpose of study casts and the materials used in their construction

the reasons for taking radiographs and photographs

Dental materials

Dental practice/organisation policy and procedures

Disadvantages of implant retained overdentures including the wear of attachments with repeated removal and seating of the overdenture

Implant attachment options for overdentures including:

bar attachment systems

unconnected fixture options

Retracting soft tissues and moisture control

methods of retracting and protecting soft tissue

methods for providing a clear field of vision

methods for controlling moisture

The importance for clients to follow pre and post operative instructions

Why medical and dental emergencies occur and the appropriate response

Essential skills:

It is critical that the candidate demonstrate the ability to

Consistently prepare clients, environments, instruments and materials for insertion of an implant retained overdenture

Consistently carry out all clinical and related laboratory stages necessary to construct a functional and aesthetic implant retained overdenture

Consistently comply with work health and safety (WHS) procedures

Consistently implement standard precautions

Consistently follow procedures to ensure client safety during prosthetic procedures

In addition, the candidate must be able to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes the ability to:

Consistently apply standard and additional precautions during all prosthetic procedures

Consistently follow sequenced written instructions and manufacturer specifications for the preparation of materials and medicaments

Consistently demonstrate interpersonal skills when relating to people from a range of social, cultural and religious backgrounds and physical and mental abilities

Consistently demonstrate communication skills as required in fulfilling the job role as specified by the dental practice/organisation including:

acknowledging and responding to a range of views

active listening

asking for clarification from client and/or carer

asking questions

negotiation

Consistently deal with conflict

Consistently use problem solving skills required including:

using available resources

selecting and preparing instruments, equipment and materials as required for specific removable dental prosthetic procedures

Consistently work with others and display empathy with client and relatives

Recognise, respond to and assist with dental and medical emergencies

Select and apply procedures to perform a range of tasks specific to the dental prosthetist's job role

Take into account opportunities to address waste minimisation, environmental responsibility and sustainable practice issues

continued ...

Essential skills (contd):

Use safe work practices to minimise the risk of transmission of infection including.

consistently follow the procedure for washing and drying hands

consistently limit contamination

consistently maintain clean surfaces and manage blood and body fluid spills

consistently protect materials, equipment and instruments from contamination until required for use

consistently put into practice clean and sterile techniques

consistently use personal protective equipment

Use literacy skills to read and follow directions, policies and procedures including:

infection control policies and procedures

work health and safety (WHS) policies and procedures

practice policies and procedures

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this competency unit:

The individual being assessed must provide evidence of specified essential knowledge as well as skills

Observation of workplace performance is essential for assessment of this unit

Consistent compliance with infection control guidelines, Australian and New Zealand Standards and legislative requirements as they relate to the dental prosthetist's specific job role

Consistency of performance should be demonstrated over the required range of workplace situations

Method of assessment

Evidence of essential knowledge and understanding may be provided by:

traditional or online (computer-based) assessment

questions during workplace assessment

written assignments/projects

Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice

Staff and/or client feedback

Supporting statement of supervisor

Authenticated evidence of relevant work experience and/or formal/informal learning

Role play/simulation

Access and equity considerations:

All workers in the health industry should be aware of access and equity issues in relation to their own area of work

All workers should develop their ability to work in a culturally diverse environment

In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people

Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance.

Charts, records and required laboratory work may include:

Completed medical questionnaires

Consent documents obtained for treatment

Copies of correspondence relating to the client

Dental charts and dental treatment records

Diagnostic models

Notes made by staff following telephone conversations

Photographs

Radiographs, tracings and measurements

Records of financial transactions

Reports to and from referring dentists and specialists

Personal protective equipmentmay include:

Examination gloves that comply with AS/NZS 4011 and surgical gloves that comply with AS/NZS 4179

Footwear to protect from dropped sharps and other contaminated items

Glasses, goggles or face-shields

Gowns and waterproof aprons that comply with AS 3789.2 and AS 3789.3

Guidelines for latex allergic clients and staff

Surgical face masks that comply with AS 4381

Standard precautions must include:

Appropriate reprocessing and storage of reusable instruments

Aseptic technique

Personal hygiene practices especially washing and drying hands before and after client contact

Safe disposal of sharps and other clinical waste

Safe handling of sharps

Surface cleaning and management of blood and body fluid spills

Techniques to limit contamination

Use of personal protective equipment

Attachment and bar extension options may include:

Bar attachment systems:

mechanical - clips, stud, O-rings

magnetic

Unconnected fixture options

mechanical - magnetic

Maxillomandibular relationships must include:

Centric relation records

Protrusive records

Facebow registration

Hygiene, home care and maintenance instructions may include but are limited to:

Instructing the client:

on the removal of the overdenture

on the use of a standard soft toothbrush to brush abutments

on the use of dental floss to clean under the bar and around each abutment cylinder

on the use of an interdental brush to clean the under surface of the denture and the overdenture framework

to attending for review one month after overdenture insertion

Establishing a recall interval of 3 to 6 months as determined by the client history

This unit contains Employability Skills