PERS4.4b.

1 bite stage acrylic

1. Removable Prosthesis Procedure Carried Out:

Guidance Notes:
Students should state the procedure to be carried out.
Students should explain how the clinincal area was made ready for this particular procedure, how
they assisted both the clinician and the patient during the procedure.
Students should describe the patient on which the treatment was carried out.

PROCEDURE TO BE CARRIED OUT: Bite registration stage for partial acrylic denture for
upper right 5,6,7 and for upper left 4,5,6and 7
TYPE OF PRACTICE: Mixed NHS and Private dental practice.
AGE AND GENDER: Patient is 49 years male
MEDICAL HISTORY: fit and well, no allergies, no prescribed medications
SOCIAL HISTORY: Smoker – 15 cigarettes a day; 10 units of alcohol a week
CONSENT: Written signature
MEDICAL RECORDS: Patient medical history was checked and made sure that it was up to
date and available for the dentist on the computer.
EQUIPMENT SWITCHED ON: Turned lights on, dental chair, compressor unit, computer, X-
ray machine, suction pump, light cure, amalgamator, water distillation unit, ventilation,
autoclave- which was filled with distillate water. A TST strip was placed in the autoclave for the
first morning cycle to check sterilisation process and recorded in the dated log book. The
ultrasonic bath was filled with enzymatic cleaning solution and water and de-gas process
started.
Patient was provided with safety glasses and protective bib.
PPE for the Dentist included- uniform, visor, disposable gloves, apron and mask.
PPE for the nurse (myself) – full uniform, including closed toe shoes, visor, apron, disposable
gloves and mask.
INSTRUMENTS: disposable tray liner, mouth mirror, right-angle probe, BPE probe, tweezers,
Willis bite gauge, shade guide, dividers, straight handpiece and acrylic trimer, LeCrone carver,
wooden spatula, wax knife and burner.
MATERIALS: Wax bite rims on model, air tight plastic bag, lab work ticket, pink sheet wax,
green stick compound, disposable aspiration tip, disposable 3 in1 tip and disposable saliva
ejector.
PREPARATION OF THE SURGERY: Prior to starting I confirmed the procedure with the dentist and made
ensured the lab work was available for the treatment. Afterwards I applied hand detergent to wet
hands, washed and dried them with paper towel. Also, I put on new PPE- mask, visor and gloves. After
that I disinfected all working surfaces: chair, control buttons, bracket table, light handles, light, spittoon,
computer, cupboards, x-ray machine, amalgamator with viricidal disinfectant and paper towels. Then I flushed
the lines through with distilled water for 30 seconds to make sure the suctions were working, and the tubes were
clean. Afterwards I removed PPE-gloves, mask, visor and disposed in the orange clinical waste and applied
alcohol-based hand gel.

I discussed with the dentist prior to treatment if he needs any materials and then I put on new PPE- mask,
visor, gloves and set up for the clinical procedure.

For the appointment I added disposable aspirating tip, disposable saliva ejector and fitted
disposable 3 in 1 tip. I also applied disposable plastic covers for the armrest, light handle, head
cover, all couplets and over the aspirator tubes. Placed disposable cup with mildly antiseptic
mouthwash tablet and water provided on the side of the chair with a box of tissues for the patient.
Then placed the lined tray with instruments on the bracket table and c onnected the straight
handpiece. I disposed of PPE- mask, gloves and visor in the clinical waste and washed hands.
In the clinical area I placed earlier a container with a lid, filled with enzymatic solution, available to
collect the contaminated instruments. On the clean side I had wooden spatula, wax knife and burner
ready on the dentist request.

I greeted the patient in a friendly manner and sat him comfortably, and applied a protective bib and safety
glasses. I reassured the patient that there is nothing to be worried about the procedure.
For myself I put on PPE- mask, visor and gloves before the treatment started.
I was supporting the dentist with clear and dry operative field throughout treatment, using
retraction and aspiration techniques.
All along the treatment I was monitoring the patient for any signs of distress or discomfort so
to inform the dentist if necessary.
After the dentist finished with the bite registration, I took the rims models to the clinical area
and disinfected with viricidal disinfectant and dry them. I filled in and enclosed work ticket with
in the bag ready for the laboratory.
During the procedure the dentist required a shade guide, which I placed earlier on the side.
When the procedure was completed, I removed the protective bib and safety glasses off the
patient and ensured she was cleaned before leaving the surgery.
On the dentist request the patient made appointment to come back in one-week time for next
stage.
I followed try the practice guidelines, safety procedures and HTM-01-05 compliances.

2. Aim of the Procedure:

Guidance Notes:
Students should state the overall aim of the process.

Removable prostheses are all types of dentures. They are made in the laboratory in different stages to replace
missing teeth. They can be removed from the mouth by the patient and put back easily. In general, removable
prostheses are made to replace several missing teeth rather than just one or two, or even to replace all the teeth
in some point.

When there are no teeth left in a jaw, it is said to be edentulous and the artificial replacement is called a full or
complete denture. If some teeth are still present, the replacement is called a partial denture.

3. Reflective Account:

Guidance Notes:
Students should identify their strengths and weaknesses during the procedure and describe any action they
would take to address weaknesses in the future, if required.

My strength’s in this appointment was that the laboratory work ticket was filled out correctly.

My weakness was that I forgot to place an antiseptic mouthwash tablet in the water.
I will prepare them in advance to make this avoided in the future.

Preparation:

Student turned on all equipment required for the procedure:

Student donned appropriate PPE (gloves, mask, eye protection, appropriate clinical dress):

Student cleaned work surface using viricidal disinfectant or detergent solution:

Student flushed through all water lines:

Student applied disposable covers to required areas of the dental surgery e.g. light handles, control panel etc:
Student made all required patient records and radiographs available:

Student prepared all relevant equipment and materials:

Student established zoning of clean and dirty areas within the working field:

During Procedure:

Student greeted patient appropriately:

Student provided the patient with a bib and safety glasses:

Student aspirated and retracted soft tissues when appropriate:

Student followed safe practise procedures throughout:

Student monitored the patient throughout:

Student reassured the patient during the treatment:

Student ensured lab work was made available:

Student assisted with shade taking:

Student disinfected bite records appropriately and prepared them for dispatch to the laboratory:

Student arranged follow up appointment:

Professionalism:

Student demonstrated professionalism in his/her duties and effective team working towards the delivery of safe, effe

Student demonstrated effective clinical decision making throughout the task:

Student managed themselves and the clinical environment in line with current standards and guidelines:

Student demonstrated knowledge and clinical skills appropriate to the patient's condition:

Student communicated appropriately, effectively and sensitively with the patient, their relatives or carers and colleag