Curriculum - 8 th semester

Periodontology - Prosthetics (removeable) - Prosthetic (implant based) - Cariology - Biomaterials - Oral tumours - Oral medicine and oral surgery - Maxillofacial radiology - Gerodontology - Orthodontics - Pharmacology - Nitrous oxide sedation

Introduction

In the course of the 8 th semester the student must understand the relationship between external influence and the individual's reactions. They must recognise different tissue reactions and the various methods to treat these. They must also recognise the natural ageing process in the organism and they must know common medical conditions which can influence oral health. In this semester the students must develop independent attitudes towards treatment alternatives for various diseases and they must enhance their skills in the practical aspects of dentistry. It is expected that the student can make independent decisions and give their reasons for their choice. It is important to develop positive attitudes towards patients' treatment both with regard to communication with the patient and the qualitative aspects of diagnosis and treatment. It is also important that the students develop their practical /clinical knowledge and skills. The most important areas will be:

• diagnosis
• individual treatment planning
• individual treatment
• cooperation between different disciplines
• knowledge about more advanced treatment alternatives
• integration between pre- and paraclinical subjects
• introduction to more advanced diagnostic tools and treatment alternatives
• project

Curriculum in periodontology

Knowledge and understanding

The students should be able to

• discuss and evaluate treatment modalities for periodontal diseases which have poor response to mechanical treatment
• discuss problems in differential diagnosis in relation to periodontal diseases
• describe chemical, biological and genetic methods for periodontal diagnosis, their limitations and possible use
• give indications for muco-gingival surgery and some methods for such treatment
• describe the relations between periodontal diseases and tooth mobility and tooth movement and occlusion.
• describe different forms of periodontal disease, their aetiology and epidemiology and their importance in the oral health and the various treatment alternatives available.

Skills

The student shall be able to

• diagnose periodontitis
• register furcation involvement
• register progression in attachment loss
• perform a systematic depuration
• perform periodontal surgery

Curriculum in prosthetics - "removable prosthetics"

Knowledge and understanding

The student shall have

• knowledge about the epidemiology of tooth loss and anodontia
• knowledge about the consequences of tooth loss and edentuolousness
• knowledge about anatomical characteristics and physiological development after loss of tooth/teeth
• knowledge about the remaining structures potentials for carrying replacement devices and the anatomical and physiological condition which affect these including specific competency in oral function
• knowledge about different forms of tooth replacement
• knowledge about dental material for such replacements with regard to technicallity and biocompatibility
• knowledge about microbiological conditions in relation to prostheses
• knowledge about the functional forces influencing protheses
• knowledge about the most important factors guiding the choice of denture structure
• knowledge about the most important factors influencing the adaptation to wearing dentures
• knowledge about importance of existing dentures for individual assessment and choice of treatment
• know general principles for construction of dentures with regard to aesthetics, vertical and lateral stability, retention, the risk of damage to the denture and the underlying structures
• know the criteria for the quality of the results for different forms of treatment of partial or total edentulousness

Skills

The students shall

• be able to interpret OPG radiographs of edentulous patients with regard to impacted teeth and root fragments and other asymptomatic pathology
• instruct the patient in oral hygiene suitable for the situation
• be competent in the working stages for standardised treatment with conventional full upper and lower denture and clasp retained removable partial denture

Attitude

The students shall

• accept the patients basic treatment needs independent of the possibilities for an ideal technical and functional solution
• avoid moralizing attitudes in front of the patient who has failed to keep his/her dentition
• give priority treatment to the patients complaints instead of focusing on his/her own skill
• have a critical attitude towards documented advanced treatment alternatives
• recognise his/her own skill limits when choosing treatment alternatives and seek necessary collegial support and establish cooperation with specially qualified colleges

Curriculum in prosthetics - Implant based

Knowledge and understanding

The students shall

• have knowledge about possibilities and limitations with implant based prosthetics in relation to other clinical solutions
• be familiar with the existence of different implant systems
• have knowledge about surgical and prosthetic indications/contraindications for implant based prosthetics
• have knowledge about the implant material biocompatibility
• have knowledge about tissue reactions in osseo-integration of implant biomaterial
• have knowledge of which forces are expected to be imposed on single implants and groups of implants using different types of replacement prosthesis
• have knowledge of procedures to perform implant based prosthetics
• have knowledge of radiological examination techniques which may be used to plan and perform implant based prosthetics
• to understand the importance of hygiene regimes for maintenance of the implants supporting the prosthetic replacement.

Skills

• be able to recognise pathogenic conditions around an implant including conditions which predisposes to this
• be able to recognise mechanical defects in and around implant based prosthesis
• be able to assess the degree of bone loss around the dental implants on radiographs
• be able to carry out periodically identical radiographic examination
• be able to instruct patients in adequate hygiene requirements following implant based prosthetics

Attitudes

• attain a critical attitude to scientific documentation about implant systems
• as newly qualified dentist recognise their limited skills with regard to carrying out implant based prosthetics
• recognise that treatment with implants requires experience and knowledge beyond the level given in the undergraduate education

Curriculum in cariology

Knowledge and understanding

The student shall

• be able to describe how age changes can influence caries susceptibility, localisation and risk for complications
• describe the typical localisation including the clinical and radiographic picture of primary and secondary root caries
• be able to explain how difference in structures and construction between enamel , dentine and cement can influence the clinical picture and the prognosis for caries lesions
• be able to judge the caries risk and know the guideline for caries diagnosis in elderly patients.
• be able to describe the function of saliva in the oral environment with pellicle formation, pellicle protective function and what can influence its function
• be able to describe the basis for clinical decision making based on scientific or empirical evidence
• be able to describe the cause of toothwear and how this can be treated both prophylactically and operatively

Skills

Be able to diagnose caries

• make a treatment plan and initiate simple caries prophylactic measures
• perform simple operative caries therapy
• in cooperation with clinical instructor perform more complicated caries diagnosis and treatment
• in cooperation with clinical instructor perform simple inlay therapy
• recognise and register different types of tooth wear and be able to make a simple treatment plan for this.

Curriculum in Biomaterial

Knowledge and understanding

The student shall

• understand the mechanism for a simple adhesionpolymerisation
• know the polymer types and polymerisation methods used in dentistry
• know the pigments used in acrylic dentures
• know the different methods to process acrylic for dentures and the results of these methods.
• understand the relationship between the mechanical and physical properties in the material used in the dentures and the finished product
• know the divisions, classification and composition of dental composites
• understand the curing principles of composites
• know the significance of the curing time, material depth and -colour for light-cured composites with regard to durability understand the significance of the forces in composite material and be able to apply this knowledge in practice
• know the mechanical and surface properties of composites as a function of all types of filling materials
• know the compositions and setting mechanisms for polyalkenoate cement and hybrids
• know the factors giving bonding to dentine/enamel and other materials using polyalkenoate cement and hybrids
• understand the factors which influence solutions and mechanical properties for polyalkenoate cement
• understand why polyalkenoate cements may be used in combination with other materials such as linings and as a source of fluoride

Curriculum in oral tumours

Knowledge and understanding

The students shall:

• have knowledge about the most common oral tumours
• have knowledge about which tumours are malignant and which are benign
• have knowledge about primary tissue histological characteristics
• have knowledge about the clinical manifestations such as predisposition sites, and relationship to sex and age
• have knowledge about treatment of simple tumours
• have knowledge about prognosis for the different tumour types treated and untreated
• have knowledge about performing biopsy ; why, how and the meaning of the pathologist's report
• have knowledge about radiological differential diagnosis of tumours localized to the jaws
• have knowledge about radiological characteristics in benign and malignant tumours
• have knowledge about diagnostic limitations of radiological examination relevant to general practice
• have some knowledge about special radiology examination/diagnosis (advanced examinations with CT, MR etc)

Skills

• judge if there is a tumour and if it is malignant or benign
• compare clinical and radiological findings with regard to possible malignancy and assess the developmental stage
• suggest differential diagnosis, possibly with necessary support from findings with radiological examinations

The student shall also be able to:

• fill in a request form for pathological or laboratory examinations
• refer patient for special radiological examination /diagnosis
• be able to give a final diagnosis after considering all results and information

Attitudes

The student shall

• recognise that oral tumours are the responsibility of the dentist
• accept the importance of accurate examination and diagnosis
• show interest for acquiring knowledge about oral tumours

Curriculum in other parts of oral surgery and oral medicine

Knowledge and understanding

The student shall have knowledge about

• impacted teeth
• surgical removal of wisdom teeth
• disorders and diseases of the temporomandibular joint
• surgical treatment of oral implants
• anaesthesia of the temporomandibular joint and muscles
• fractures of the jaws

Skills

• make referrals for special diagnosis

Curriculum in other parts of maxillofacial radiology

Knowledge and understanding

• knowledge about the importance of radiological examination /diagnosis of malignant tumours originating in the oral mucosa
• knowledge about radiological techniques and the theoretical bases for localisation e.g. in connection with tumours and impacted teeth.
• knowledge about the general quality demands on different radiographic examinations/pictures
• knowledge how a systematic examination should be performed and how a radiological description should be presented
• some knowledge about advanced radiological examination/diagnosis in connection with implant based prosthetics
• some knowledge about advanced radiological examination /diagnosis of TMJ conditions /diseases

References should also be made to the knowledge and understanding registered under periodontology, removable dentures, implant based prosthetics, cariology, oral tumours and oral surgery/medicine

Skills

• localisation with the aid of radiological examination
• judge the need for and perform preprosthetic radiological examination (if necessary together with clinical tutor)
• perform certain occlusal film examinations and perform an OPG-examination with the emphasis on technical performance and quality assessment
• perform quality assessment, and systematic examination of dental, occlusal and OPG pictures
• present a self-selected radiological examination of a patient
• evaluate the need for referral to specialist radiological examination and diagnosis

References should also be made to the Knowledge and understanding registered under periodontology, removable dentures, implant based prosthetics, cariology, oral tumours and oral surgery/medicine

Curriculum in gerodontology

Knowledge and understanding

The students should have knowledge about

• the ageing process at cellular and tissue level
• systemic somatic diseases in elderly
• mental diseases in the elderly
• clinical profile of dental/oral diseases among elderly
• the cause of xerostomia and treatment possibilities
• variation in behaviour among elderly
• communication with elderly
• treatment of elderly in institutions

Skills

• to take history from an elderly patient including information from staff and relatives
• to diagnose and treat late stages of periodontal diseases
• to give preventive dentistry in the elderly
• to make endodontic diagnosis and perform endodontic treatment for the elderly
• to diagnose xerostomia and related dysfunctions/complaints
• to communicate with the elderly at their individual level

Attitudes

• show empathy for the patients problem
• have an overall view on the patients health
• show respect for the elderly patient's view on the need for treatment and methods

Curriculum in orthodontic

Knowledge and understanding

The student shall

• be able to judge the indications and need for orthodontic treatment
• be able to judge the developmental stage where malocclusions ought to be treated
• be able give information on the treatment and what appliances will be used and what is required by the patient and the relatives for successful treatment
• be able to explain the treatment principles for the different malocclusions and the possibilities for interdisciplinary orthodontic treatment
• know how orthodontic treatment is organised in society

Curridulum in pharmacology

Knowledge and understanding

The students shall

• know the laws and regulations which at any time applies to dentists' rights to prescribe and order medicines including reimbursement rules
• know how to write prescriptions in the different prescription categories permitted to dentists
• know the laws and regulations which apply for storing medicines, acquire medicine on exemption from registration, import medicines and natural products
• know the mechanisms and properties of anaesthetics including side effects
• know the working mechanism for the analgetic/seditative effects of nitrous oxide including side effects, contraindications and precautions applied to the use of nitrous oxide
• be able to choose the right medicines for the elderly based on the changes from the ageing process to the body's organs and functions
• know the principles for pharmakinetics and pharmacodynamic interactions of clinical importance in polypharmacology
• have knowledge about the general principles for cytostatic drugs, hormone and bone- marrow stimulating drugs
• know the functional mechanisms for medicines for asthma and chronic obstructive airway diseases. Side effects. Contraindications
• know the functional mechanisms for drugs against tumours, it's use and side effects
• know the working principles for medicines for airway diseases, their use and side effects
• know the principles for treatment of cardiac diseases and side effects including interactions with dental treatment
• know the relations between drug induced sedation and anxiety control
• have knowledge of the importance from placebo/nocebo effects
• have knowledge about relevant anxiolytica, seditiva/hypnotica and the pharmacodynamic /cinetic clinical effect and administration
• have knowledge about the relevant drugs' side effects, interactions, risk and toxicity, preconditions and precautions with medicinal anxiety control

Skills

• how to choose drugs for use in dental practice based on Usefulnessand the patient's possible existing medication regime
• write different types of prescriptions
• give adequate drug information to patient at their level of comprehension or to the accompanying person or staff from institution
• drug dosage assessed according to patient's age
• identify the patient's need for drug induced sedation and anxiety control
• be able to give an comparative evaluations between advantages and disadvantages in nitrous oxide sedation and per oral sedation

Curriculum in nitrous oxide sedation

Knowledge and understanding

The student shall

• know the indications for preoperative sedation
• have knowledge about the environmental considerations in the use of nitrous oxide sedation
• have knowledge about nitrous oxide sedation and general anaesthesia
• be able to evaluate the relevance of general medical conditions for carrying out dental treatment

Skill

• initiate correct odontological pharmacotherapy based on the patients clinical condition and taking into consideration possible previous pharmacotherapy
• administer nitrous oxide sedation