Dental Hygiene Educators


Examination and Policy Updates for Dental Hygiene, Restorative and Local Anesthesia

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2017 EXAMINATION UPDATES

Dental Hygiene, Restorative and Local Anesthesia Information and Examination Updates for 2017

Dental Hygiene Examination

Patient Criteria

A patient with a known allergy or sensitivity to latex may be accepted.

Radiographic Criteria

Bitewing radiographs for all posterior teeth are required. In addition to the bitewings, Candidates may submit  any combination of the following diagnostic quality images, which show all the required structures for each tooth in the treatment submission:

  • Periapicals within 36 (thirty-six) months of the examination date
  • Panoramic within 36 (thirty-six) months of the examination date

A single four (4) point penalty will be assessed if radiographs do not meet diagnostic criteria.

Instruments

The following instruments are required:

  • #4 or #5 front surface mouth mirror (double-sided is acceptable)
  • 11/12 Old Dominion University (ODU) (double-end explorer or ODU extended (EXD) is also acceptable)
  • University of North Carolina (UNC) periodontal probe with 1-12mm increments

(PCP UNC12)  (Right-angle probes are unacceptable)

Two (2) single ended instruments are required for testing mobility. If required mirror or probe is not single-ended, an additional single-ended instrument must be submitted.  

Extraoral and Intraoral Examination (EIE)

For the purposes of the WREB exam, you are only required to describe and indicate proper recommendation for atypical or abnormal conditions, which either:

  • Pose a serious health threat warranting immediate referral for medical or dental evaluation. This should be a rare occurrence
  • Require follow up or monitoring.
    • Follow up could be short term, in-office or referral to a medical or dental evaluation (non-immediate)
    • Monitoring would be indicated for ongoing evaluation at future re-care.

Record on the front of the Candidate Assignment Form and submit form at Check-In. Candidates recorded findings will not be graded at Check-In, and the form will be returned to them with their patient.  Candidates may make additions or changes to the EIE section before submitting the Candidate Assignment Form for final grading.  Candidates must complete the EIE section.

Full credit is given when the condition is correctly recognized and the recommendation is correct. Partial credit will be given if either description or recommendation is correct. No credit will be given if both “NSF” and a description are noted, or if the section is left blank.

 Periodontal Assessment

The Periodontal Assessment includes assessment and recording of:

  • Periodontal pocket depth
  • Gingival recession
  • Classification of furcation involvement
  • Classification of mobility
  • Radiographic bone loss
  • Classification of Severity of Periodontal Disease

Probing And Recession

A total of 18 (eighteen) probing and recession areas are pre-determined for grading.

Periodontal Assessment Questions

Utilizing a Candidates assessment records, including submitted radiographs and instruments, answer the four (4) questions on an assigned molar in the treatment quadrant.

  1. What is the degree of mobility? Use two (2) single-ended instruments to test mobility and submit those instruments at Check-Out.
  • Choose “None”, Class I-II, “Class-III”
  1. What type of radiographic bone loss is present? Mark all that apply if more than one (1) type is present for full credit.  Partial credit may be given if multiple types of bone loss are present, but only one (1) type is selected.) (e.g.  “None” on distal and “Horizontal” on mesial, but only “Horizontal” is selected.)
  • Choose “None”, “Horizontal” and/or “Vertical”
  1. What is the classification of furcation for the facial aspect only?
  • Choose “None”, “Class I-II” or “Class III-IV”
  1. What is the Classification for the Severity of Periodontal Disease on the facial aspect only? Periodontal pocket depths, distance from the gingival margin (GM) to the Cementoenamel Junction (CEJ), and radiographic evidence are all used to determine Clinical Attachment Loss (CAL).

A Clinical Attachment Loss (CAL) computation table is provided to demonstrate their understanding of the classification process and to aid both Candidates and Examiners’ determination of proper classification.

  • Enter the appropriate measurements for pocket depth, gingival margin and CAL in the computation table. Examiners will consider recorded measurements allowing a one millimeter (1mm) leeway. The information in the table is not graded.
  • Choose “Gingivitis”, “Slight”, “Moderate” or “Severe”

 Treatment Submission Accepted

Candidates are assigned up to two hours and fifteen minutes to complete their treatment. If Candidates incur late penalties, or have up to three (3) submissions, they may not have the entire two hours and fifteen minutes for the clinical procedures. Patients are not allowed to remain in the clinic area beyond the time specified on your Candidate schedule.

Scoring Information

Assigned points are deducted from a Candidates score if an error is validated. A validated error is an error independently agreed upon by two (2) or more Examiners.

Radiographic Evaluation

A single four (4) point penalty will be assessed if radiographs do not meet diagnostic criteria.

            Extraoral And Intraoral Examination

A maximum of two (2) points will be deducted.  Partial credit of one (1) point may be given.

            Periodontal   Assessment

Probing and Recession

A maximum of three (3) points are deducted for one (1) or more gingival recession errors. One (1) point is deducted for each probing error up to a maximum of 12 (twelve).  A maximum of 15 (fifteen) points is possible.

            Periodontal Assessment questions

Two (2) points will be deducted for each wrong answer for questions #1-4.  Partial credit of one (1) point may be given for question #2 (radiographic bone loss). A maximum of eight (8) points is possible.

 

Restorative Examination

Onsite Retakes

WREB is pleased to introduce onsite retakes for Restorative Candidates beginning in 2017. Candidates are eligible for the retake onsite if they failed only one prep and/or do not require remediation or board approval to retake the examination. The retake examination is a separate attempt and is included in their total number of examination attempts.

For the retake examination, Candidates will be required to restore the same preparation that they failed. If Candidates choose to retake the examination at another site, they will be required to complete both preparation assignments.

In order to retake the Clinical Examination onsite, you must:

  • Within the time frame announced during the Candidate Orientation, notify the WREB Site Coordinator that you are retaking the examination.
  • Pay the retake fee. Provide a valid card that displays either the MasterCard, Visa, American Express or Discover logo, or cashier’s check or money order made payable to WREB. Cash or personal checks cannot be accepted.
  • You will be scheduled a retake time and session.

Performance Evaluation For Retake Examination

The retake examination is a separate attempt and a final value of 3.00 or higher is required to pass the Restorative retake examination.

Online Candidate Tutorial

The online tutorial is intended to familiarize Restorative Candidates with the exam process prior to taking the Restorative Examination. A mandatory onsite Candidate Orientation is held the day prior to the Clinical Examination. The 2017 tutorial can be found on the WREB website on January 9. We encourage all faculty and students to view this tutorial, particularly prior to attending the onsite Candidate Orientation.

Examination Materials Used by Candidates

Polishing agents are allowed. The use of petroleum jelly products (i.e. Vaseline®, etc.) is not allowed.

Grading Criteria

Please review the 2017 Restorative grading criteria below.

exam-updates

Local Anesthesia Examination

 

Registering for a Local Anesthesia Examination, if applicable

WREB offers the Local Anesthesia Examination to those member states that have statutes or rules that require the applicant pass an examination. Applicants whose state does not require a local anesthesia examination for licensure are not required to take WREB’s Local Anesthesia Examination.

The Local Anesthesia Examination is a two-part examination; written and clinical. Overall successful completion of the WREB Local Anesthesia Examination requires passing scores in both the Written Examination and the Clinical Examination within a period of 12 (twelve) months. Candidates may register for the Local Anesthesia Clinical Examination with the understanding that they are not eligible to challenge the Clinical Examination until successfully passing the Written Examination. Failure to pass the Written Examination may result in forfeiture of the Clinical Examination fees.

When registering for a 2017 Local Anesthesia Clinical Examination, the WREB website will automatically include the Written Examination fee (if the applicant has not previously registered and paid for the written portion) to their clinical fee. After selecting the clinical site it will add the written fees ($105.00) to the clinical fee. Both fees (written and clinical) will be charged upon completion of the registration process.

Candidates have two registration options for the Local Anesthesia Examination:

  1. Written-Only Registration: Attempt the Written Examination within the specified timeframe (an immediate 45 [forty-five] day window). Successful Candidates must then register separately for an available Clinical Examination by the stated application deadline on the WREB website.
  1. Simultaneous Local Anesthesia Written & Clinical Registration: Attempt the Written Examination within the specified timeframe attached to the Clinical Examination (60-15 days prior to the Clinical Examination). Successful Candidates then proceed to their scheduled Clinical E

Local Anesthesia Clinical

Patient Criteria

A patient with a known allergy or sensitivity to latex may be accepted.

Critical Aspects of the Injection

One category has been renamed and one category has been separated into two separate critical aspects.

Critical aspect category (*7) “Excessive Trauma” was renamed “Tissue Management”. The criteria remains the same.

Critical aspect category (*8) “Handling of Sharps” has been split into two separate critical aspects.

  • *8 Recapping

                        Proper Recapping Technique

                        A single handed recapping method is required when   recapping the needle.                     Once the needle is protected within the cap, the needle must be secured.                          Needles and cartridges must be disposed of properly.

Errors:

  • Two (2) handed recapping
  • Hand anywhere on safety shield during recapping
  • Holding needle cap during recapping
  • *9 Sharps Disposal

                       Errors:

  • After the completion of both injection, sharps and cartridge are not properly disposed of in the appropriate container(s) and/or according to school policy

Improper handling of Sharps will results in failure of both injections.

All eight (8) critical aspects of the injection have an (*) asterisk and must be performed to examination specifications.

WREB Reminder – No Faculty Allowed Onsite at Examination Sites

WREB does not permit faculty or educators to be present on the premises during the examinations. Enforcing this policy, will assure that the exam process is consistent from site-to-site and fair for all Candidates. Please note, this policy does not prohibit onsite faculty from working in their office, away from the reception area and examination clinics, while the exam is being administered.

Administration of Local Anesthesia by Faculty

Local Anesthesia Examination

Local Anesthesia Written
WREB is pleased to announce that we will be utilizing Prometric to administer the 2016 Local Anesthesia Written Examination.

https://www.prometric.com/en-us/clients/wreb/pages/landing.aspx

Based on Candidate feedback WREB will now collect all Written Examination fees (both WREB’s and Prometrics) from the Candidate thru the WREB registration process. This new policy will eliminate Candidate confusion when asked to pay the testing center when scheduling their Written Examination appointment. The written fees combined equal $105.00. This change upholds no fee increase to Candidates in 2016.

Registering for a Local Anesthesia Examination, if Applicable
WREB offers the Local Anesthesia Examination to those member states that have statutes or rules that require the applicant pass an examination. Applicants whose state does not require a local anesthesia examination for licensure are not required to take WREB’s Local Anesthesia Examination.

The Local Anesthesia Examination is a two-part examination; written and clinical. Overall successful completion of the WREB Local Anesthesia Examination requires passing scores in both the Written Examination and the Clinical Examination within a period of 12 (twelve) months. Candidates may register for the Local Anesthesia Clinical Examination with the understanding that they are not eligible to challenge the Clinical Examination until successfully passing the Written Examination. Failure to pass the Written Examination may result in forfeiture of the Clinical Examination fees.

When registering for a 2016 Local Anesthesia Clinical Examination, the WREB website will automatically include the Written Examination fee (if the applicant has not previously registered and paid for the written portion) to their clinical fee. After selecting the clinical site it will add the written fees ($105.00) to the clinical fee. Both fees (written and clinical) will be charged upon completion of the registration process.

Candidates have two registration options for the Local Anesthesia Examination:

1. Written-Only Registration: Attempt the Written Examination within the specified timeframe (an immediate 45 [forty-five] day window). Successful Candidates must then register separately for an available Clinical Examination by the stated application deadline on the WREB website.

2. Simultaneous Local Anesthesia Written & Clinical Registration: Attempt the Written Examination within the specified timeframe attached to the Clinical Examination (60-15 days prior to the Clinical Examination). Successful Candidates then proceed to their scheduled Clinical Examination.

Local Anesthesia Clinical

Clinical Preparation
Effective 2016, Candidates must not loosen the needle cap until instructed by the Examiners.

Clinical Examination
In, 2016, there will be four (4) times that a Candidate is required to stop and inform the Examiners when reaching each critical aspect of the injection.

After each critical phase, one (1) Examiner will say, “I see,” and the other Examiner will say, “Proceed.” Both Examiners must be able to fully observe all four (4) aspects of the injection.

1. Initial Penetration. After the needle has penetrated the tissue, stop and hold the    position. Inform the Examiners upon reaching the penetration site. The Candidate must wait until instructed to proceed.

2. Angle and Depth. Advance to the deposition site, stop and hold the position. Inform the examiners when at the optimum depth and angle. The Candidate must wait until instructed to proceed.

3. Aspiration. Aspirate and announce if the aspiration is positive or negative. If the aspiration is negative, the Candidate will be instructed to proceed and deposit the anesthetic solution. WREB requires that a Candidate aspirate on one (1) plane. There is no penalty if aspiration is on two (2) planes.

4. NEW-Deposition Rate. Once instructed to proceed, inform the Examiners when beginning to deposit the anesthetic. It is not necessary to deposit the entire cartridge since the Patient is not being anesthetized for clinical procedures. The Candidate will be instructed when to stop and withdraw.


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