1. Practice ManagementPractice Management
In DentistryIn Dentistry

2.  Recognize the basic concepts of quality assurance andRecognize the basic concepts of quality assurance and
practice management.practice management.
 Prioritize workload and manage personal stress in thePrioritize workload and manage personal stress in the
frame work of proper performance and management.frame work of proper performance and management.
 Work in collaboration as a member of anWork in collaboration as a member of an
interdisciplinary teaminterdisciplinary team
 share information and professional knowledge withshare information and professional knowledge with
both the patient and other professionals, verbally and inboth the patient and other professionals, verbally and in
writing, including being able to negotiate and give andwriting, including being able to negotiate and give and
receive constructive criticism.receive constructive criticism.

3.  Recognize and effectively utilize all sources forRecognize and effectively utilize all sources for
continuing professional development and life-longcontinuing professional development and life-long
learning.learning.
 Adopt a creative attitude in an ethical and scientificAdopt a creative attitude in an ethical and scientific
approach.approach.
 Self evaluate professional abilities, performance, andSelf evaluate professional abilities, performance, and
progress.progress.
 use contemporary information technology foruse contemporary information technology for
communication, management of information andcommunication, management of information and
applications related to health care.applications related to health care.

4. Successful DentistSuccessful Dentist
1.1. Establish a practice in a desirable conditionsEstablish a practice in a desirable conditions
2.2. Good relationship with the patientsGood relationship with the patients
3.3. A happy practice teamA happy practice team
4.4. Reasonable income to maintain reasonable livingReasonable income to maintain reasonable living
standardstandard
5.5. Abilities & facilities to keep abreast of modernAbilities & facilities to keep abreast of modern
dentistry, both educationally & in equipmentdentistry, both educationally & in equipment
6.6. Technically Skilful in dental proceduresTechnically Skilful in dental procedures
7.7. Respect timeRespect time
8.8. Three As are important in making a successful dentistThree As are important in making a successful dentist
Availability, Affability and Ability.Availability, Affability and Ability.
** Devote his time to caring of patient as a human being without the pressure ofDevote his time to caring of patient as a human being without the pressure of
thinking every minute without the drill in his hand is lost income.thinking every minute without the drill in his hand is lost income.

5. Making The ChoiceMaking The Choice
&&
Planning The CareerPlanning The Career

6.  It is important to love & enjoy the pattern ofIt is important to love & enjoy the pattern of
workwork
 Typical dentist works at the dental chairside,Typical dentist works at the dental chairside,
operate on patients restoring teeth, fillings etc..operate on patients restoring teeth, fillings etc..
 Students must be asked if they good with theirStudents must be asked if they good with their
handshands
 All dentist must be able to do adequateAll dentist must be able to do adequate
treatment at final examination leveltreatment at final examination level
 There are different areas of dentistry we can gainThere are different areas of dentistry we can gain
experiences in, and we decide which would beexperiences in, and we decide which would be
suitable to our temperamentsuitable to our temperament

7. Dentist may be employed in:Dentist may be employed in:
 Academic ( full time or part-time)Academic ( full time or part-time)
1.1. TeachingTeaching
2.2. ResearchResearch
 Hospital (full time or part-time)Hospital (full time or part-time)
 General dental practiceGeneral dental practice
 Specialist dental practiceSpecialist dental practice
 Participant in commercial promotionParticipant in commercial promotion
 Writing (journalism)Writing (journalism)
 Organizations & management ( WHO)Organizations & management ( WHO)
 Public relationPublic relation
 Armed servicesArmed services

8.  Technique of part-time option to aid in decisionTechnique of part-time option to aid in decision
making.making.
 The option of military services is almost a one-The option of military services is almost a one-
way option.way option.
 Possible ladder of promotion depending onPossible ladder of promotion depending on
further trainingfurther training

9. Planning The PracticePlanning The Practice
CareerCareer

10.  There are two kinds of doctors; those who areThere are two kinds of doctors; those who are
primarily interested in disease and those who areprimarily interested in disease and those who are
primarily interested in peopleprimarily interested in people
 There are two kinds of dentists; those who areThere are two kinds of dentists; those who are
primarily interested in the mechanics ofprimarily interested in the mechanics of
treatment and those who are interested in peopletreatment and those who are interested in people

11. For Private PracticeFor Private Practice
CHOOSING A PLACE DEPENDS ON:CHOOSING A PLACE DEPENDS ON:
 AgeAge
 RaceRace
 Social classSocial class
 CustomCustom
 Town OR countryTown OR country
* Remember, you can practice at home !* Remember, you can practice at home !

12.  The question of how far away the place of workThe question of how far away the place of work
will be from home is important in term ofwill be from home is important in term of
travelling time and emergencies that necessitatetravelling time and emergencies that necessitate
attendance even at weekends.attendance even at weekends.
 Malpractice cover is sought, especially as aMalpractice cover is sought, especially as a
beginner.beginner.
 Payment issues ( fixed salary, percentage basis)Payment issues ( fixed salary, percentage basis)

13. Special Consideration OfSpecial Consideration Of
The Woman DentistThe Woman Dentist

14.  Prejudice against women dentists both on thePrejudice against women dentists both on the
public & dentists themselves DOES exist.public & dentists themselves DOES exist.
 In Sudan intake of new dental studentIn Sudan intake of new dental student
approaches equality in examination resultsapproaches equality in examination results
indicating no superiority in skills of one genderindicating no superiority in skills of one gender
over another.over another.

15.  Women dentists can do all dental procedureWomen dentists can do all dental procedure
which were once considered to be exclusivelywhich were once considered to be exclusively
carried out by male dentistcarried out by male dentist
 Many patients, however, question the ability ofMany patients, however, question the ability of
women to extract a tooth, this coincide with thewomen to extract a tooth, this coincide with the
view that dentistry is a manual skills in whichview that dentistry is a manual skills in which
dentist is always operating, while generaldentist is always operating, while general
medicine (for women) is merely examination andmedicine (for women) is merely examination and
advice.advice.

16.  Another point is the instability or interruptionAnother point is the instability or interruption
in women's career:in women's career:
1.1. She may have to take more days for sicknessShe may have to take more days for sickness
2.2. She may leave to have childrenShe may leave to have children
3.3. If married, might find it necessary toIf married, might find it necessary to
accompany her husband should he beaccompany her husband should he be
transferred in his job to another area.transferred in his job to another area.

17.  Another prejudice from female ancillary staff,Another prejudice from female ancillary staff,
secretaries, chairside assistant etc who prefer asecretaries, chairside assistant etc who prefer a
male ‘boss’.male ‘boss’.
 Some women solve this problem by taking upSome women solve this problem by taking up
dental practice seriously after child bearing anddental practice seriously after child bearing and
rearing is over, although it may be a sacrifice torearing is over, although it may be a sacrifice to
wait too long before contributing to the home,wait too long before contributing to the home,
learning late become difficult.learning late become difficult.

18.  To overcome this prejudice, educating the publicTo overcome this prejudice, educating the public
is important .is important .
 Another means of decreasing this trend is whenAnother means of decreasing this trend is when
the male gender is becoming a minoritythe male gender is becoming a minority

19. Building up aBuilding up a
sufficient list ofsufficient list of
patientspatients

20. Entering an existingEntering an existing
practicepractice

21. For a new graduate dentist in private clinic, thereFor a new graduate dentist in private clinic, there
are two main situations:are two main situations:
 Working at another's clinicWorking at another's clinic
 Beginning on his own clinicBeginning on his own clinic

22. Working at another's clinicWorking at another's clinic
 It affords a reasonable numbers of patients.It affords a reasonable numbers of patients.
 It necessitates a support from the owner’s andIt necessitates a support from the owner’s and
put them in the embarrassment of getting rid ofput them in the embarrassment of getting rid of
their patients to an unknown dentisttheir patients to an unknown dentist
 You must be patient and understanding to thisYou must be patient and understanding to this
situationsituation

23.  It may need the existing practice team to get theIt may need the existing practice team to get the
patient's initial approval for the changepatient's initial approval for the change
 Once the referral has taken place the contest isOnce the referral has taken place the contest is
within the hand of the new dentist, to provewithin the hand of the new dentist, to prove
himself.himself.

24.  For a new comer younger dentist to start anFor a new comer younger dentist to start an
established practice busy enough to reliveestablished practice busy enough to relive
him/her of the worry of acquiring a new patienthim/her of the worry of acquiring a new patient
 The condition at which it may occur, is having aThe condition at which it may occur, is having a
new patient.new patient.
 Old patients may protest and claim being rid ofOld patients may protest and claim being rid of
by the owner of the clinic to unknown dentistby the owner of the clinic to unknown dentist

25.  His personality & relationship with patientsHis personality & relationship with patients
must be pleasing, he must show compassion, bemust be pleasing, he must show compassion, be
gentlegentle
 He must not compete or degrade his bossHe must not compete or degrade his boss
 He must show the advantage of his youthfulHe must show the advantage of his youthful
appearance of the new& latest methods &appearance of the new& latest methods &
techniques in dentistrytechniques in dentistry

26.  The next problem is being short of patientsThe next problem is being short of patients
 Being pleasant, skilful, friendly, compassionate,Being pleasant, skilful, friendly, compassionate,
definitely will attract more patients.definitely will attract more patients.
 A common failing is the use of language theA common failing is the use of language the
patient does not understandpatient does not understand
 One has to explain each procedure to the patientOne has to explain each procedure to the patient
language & general comprehensionlanguage & general comprehension

27.  The dentist who spend a little time discussingThe dentist who spend a little time discussing
the procedures to be advised and does this inthe procedures to be advised and does this in
simple everyday language will often find ansimple everyday language will often find an
appreciative and co-operative patient.appreciative and co-operative patient.

28. The influence of chargesThe influence of charges
 A free system of payment in Sudan and otherA free system of payment in Sudan and other
countries, although in others the fees of eachcountries, although in others the fees of each
procedure performed by GP or specialist isprocedure performed by GP or specialist is
governed and established.governed and established.
 The first system allow any dentist whatever hisThe first system allow any dentist whatever his
standards to make a living.standards to make a living.
 Often the lower standards the better incomeOften the lower standards the better income

29.  Because of the accelerated inflation, the dentistBecause of the accelerated inflation, the dentist
is finding it necessary to compete with care andis finding it necessary to compete with care and
service and has to give value he is giving to theservice and has to give value he is giving to the
patient for the fees he is demanding.patient for the fees he is demanding.
 The patient himself is comparing between theThe patient himself is comparing between the
service he is getting to the fees he is paying.service he is getting to the fees he is paying.
 An advice from a senior colleague, accountantAn advice from a senior colleague, accountant
receptionist is recommended, with due respectreceptionist is recommended, with due respect
for socioeconomic status for the patients of thefor socioeconomic status for the patients of the
areaarea

30.  Generally, older patient tend to refuse payingGenerally, older patient tend to refuse paying
much for procedure in comparison to youngermuch for procedure in comparison to younger
ones.ones.
 A patient who is regular visitor an older dentistA patient who is regular visitor an older dentist
also will find the fees unexplainably high.also will find the fees unexplainably high.
 A differential charges between dentists for theA differential charges between dentists for the
same practice gives the impression to patientssame practice gives the impression to patients
there is a lower charge because the dentist isthere is a lower charge because the dentist is
somewhat inferior in his standardssomewhat inferior in his standards

31.  Other aspect that is the quality of patients whoOther aspect that is the quality of patients who
present to the new dentist with lower chargespresent to the new dentist with lower charges
are those of problematic in nature, although it isare those of problematic in nature, although it is
an opportunity to test your kindness, coldan opportunity to test your kindness, cold
nerves, controlling pattern.nerves, controlling pattern.
 There are two schools, one is discussing the feesThere are two schools, one is discussing the fees
with the patients the other does notwith the patients the other does not

32. How the patient will pay ?How the patient will pay ?
 Pay in advancePay in advance
 Having an accountHaving an account
 Young dentist should suspect who looks smartYoung dentist should suspect who looks smart
and honest because of thier financial inabilityand honest because of thier financial inability

33.  Dentist must be clear, and definite about feesDentist must be clear, and definite about fees
otherwise he will loose honest who will pay evenotherwise he will loose honest who will pay even
if under protestif under protest

34. Starting your ownStarting your own
practicepractice

35. Making oneself knownMaking oneself known
 The dentist has find his own patientsThe dentist has find his own patients
 Where do they come fromWhere do they come from

36.  Being pleasant, skilful, friendly, compassionate,Being pleasant, skilful, friendly, compassionate,
definitely will attract more patients.definitely will attract more patients.
 A common failing is the use of language theA common failing is the use of language the
patient does not understandpatient does not understand
 One has to explain each procedure to the patientOne has to explain each procedure to the patient
language & general comprehensionlanguage & general comprehension

37. Patient sourcesPatient sources
 FamilyFamily
 FriendsFriends
 Referral of emergenciesReferral of emergencies
 Referral by doctors & dentistsReferral by doctors & dentists
 Recommendations by those patients already seenRecommendations by those patients already seen

38. Appointment bookAppointment book
 Filling the appointment bookFilling the appointment book
 Never saying there is nothing to do if I cameNever saying there is nothing to do if I came
waiting for patients to comewaiting for patients to come

39. Basic Furnishing &Basic Furnishing &
EquipmentEquipment

40.  Buy only what is needed in the immediateBuy only what is needed in the immediate
foreseeable futureforeseeable future
 If offered some new gadget a carful appraisalIf offered some new gadget a carful appraisal
should be made of its properties, and reportsshould be made of its properties, and reports
and evaluation by other dentists in practiceand evaluation by other dentists in practice
conditionsconditions

41. ErgonomicsErgonomics
 The study that concerns the relation betweenThe study that concerns the relation between
workers and their energy and environmentworkers and their energy and environment
 In dentistry, it is concerned with the study ofIn dentistry, it is concerned with the study of
unnecessary movement and wasted energy,unnecessary movement and wasted energy,
saving time, lessening fatigue.saving time, lessening fatigue.
 Dentistry is physically demanding profession,Dentistry is physically demanding profession,
long hours is spent in one positionlong hours is spent in one position

42.  Standing for a long period of time will cause varicose,Standing for a long period of time will cause varicose,
strain in musculoskeletal systemstrain in musculoskeletal system
 Consideration should start with the positioning of theConsideration should start with the positioning of the
dental chair in relation to the door & patient path.dental chair in relation to the door & patient path.
 Another parameter is the entrance of light positionAnother parameter is the entrance of light position
 Once the chair position is established, plumbing for theOnce the chair position is established, plumbing for the
wash basin is arranged, near to the dentist.wash basin is arranged, near to the dentist.
 Base cabinet should have tops at comfortable height forBase cabinet should have tops at comfortable height for
dentist to workdentist to work

43. DesignersDesigners
 A satisfactory practical workable apparentlyA satisfactory practical workable apparently
clean design is preferableclean design is preferable
 A conference between designer, plumber,A conference between designer, plumber,
electrician and those wishing to supplyelectrician and those wishing to supply
equipmentequipment
 Those people should work under supervision ofThose people should work under supervision of
the dentist who guide toward his objectivesthe dentist who guide toward his objectives
 Never hesitate of asking any stupid question!Never hesitate of asking any stupid question!

44. EquipmentEquipment
 Specialist dentist will know what items required,Specialist dentist will know what items required,
the followings are concerned with the generalthe followings are concerned with the general
practitioners.practitioners.
 Planning for the future can take place whenPlanning for the future can take place when
economic factor improves.economic factor improves.
 Some of the equipment is bought as a secondSome of the equipment is bought as a second
hand so you need to take care ( the poor can nothand so you need to take care ( the poor can not
afford the cheap.afford the cheap.

45. Dental chairsDental chairs
Most patients do not likeMost patients do not like
 one arm chairone arm chair
 Flat head restFlat head rest
 Chairs with noisy mechanisms or with type ofChairs with noisy mechanisms or with type of
stimulated leather that make noises as patientsstimulated leather that make noises as patients
movemove
 The more complicated, the more difficult to fixThe more complicated, the more difficult to fix
if it goes wrongif it goes wrong

46.  Recent chairs are computerized, but they guaranteedRecent chairs are computerized, but they guaranteed
from companies unless there is misuse of dentist.from companies unless there is misuse of dentist.
 They supplied with new accessories that you need (nonThey supplied with new accessories that you need (non
touchable light, suction, high hand piece, air dispensertouchable light, suction, high hand piece, air dispenser
light cure applicator, ultrasonic scaler, intraoral camera,light cure applicator, ultrasonic scaler, intraoral camera,
X-ray viewer etc…).X-ray viewer etc…).
 A programmed position is set even an emergencyA programmed position is set even an emergency
positionposition

47. Dental stoolDental stool
Requirement are:Requirement are:
 Comfort at all positionsComfort at all positions
 Support for the backSupport for the back
 Easily adjustable for heightEasily adjustable for height
 Should be stableShould be stable
 Should be movable when requiredShould be movable when required

48. The suction/ spittoonThe suction/ spittoon
 Some clinics are supplied central suction, toSome clinics are supplied central suction, to
place the motor in distance from the clinic.place the motor in distance from the clinic.
 Most today's clinics the suction & spittoon areMost today's clinics the suction & spittoon are
built within the dental unit, the difference is thebuilt within the dental unit, the difference is the
quality in companies.quality in companies.

49. CompressorCompressor
The compressor needs to be:The compressor needs to be:
 Powerful in performing the desired pressurePowerful in performing the desired pressure
with either low speed or high speed hand pieces.with either low speed or high speed hand pieces.
 Quite & friendly with much noisesQuite & friendly with much noises
 Time of regular check ups is important for theTime of regular check ups is important for the
air and oilair and oil

50. AutoclaveAutoclave
 An essential item in the dental clinic, may assureAn essential item in the dental clinic, may assure
the quality of standards the dentist aiming at.the quality of standards the dentist aiming at.
 If expensive its cost is wastedIf expensive its cost is wasted
 It should be big enough to accommodate clinic'sIt should be big enough to accommodate clinic's
items.items.
 In the contract at least 2 years maintenance isIn the contract at least 2 years maintenance is
advised.advised.

51. Other itemsOther items
 Sphygmomanometer, stethoscopeSphygmomanometer, stethoscope
 Amalgam mixerAmalgam mixer
 Digital timerDigital timer
 Pulp testerPulp tester
 Root canal depth indicatorRoot canal depth indicator
 Panoramic X-rayPanoramic X-ray
 Oxygen unitOxygen unit
 General anaesthesia equipmentGeneral anaesthesia equipment

52. Laboratory equipmentLaboratory equipment
 Although the dentist is sending dentures andAlthough the dentist is sending dentures and
bridges to a commercial lab, sometimes somebridges to a commercial lab, sometimes some
preliminary technician job & corrections neededpreliminary technician job & corrections needed
to be made at the clinicto be made at the clinic

53. Water distillationWater distillation
 Dirty water may damage the water circuit in theDirty water may damage the water circuit in the
dental unit, filter or water distiller is important atdental unit, filter or water distiller is important at
the contextthe context

54. Installation & servicesInstallation & services
 Air, water, electricity and drainage will beAir, water, electricity and drainage will be
requiredrequired
 The installation of waste pipes is the mostThe installation of waste pipes is the most
difficult task of all.difficult task of all.
 Plumbing is vital in cross infection issuesPlumbing is vital in cross infection issues

55. Clinical photographyClinical photography

56. Why the camera ?Why the camera ?
 Before and after photographs to demonstrateBefore and after photographs to demonstrate
improvement in oral conditionimprovement in oral condition
 To demonstrate the merit of different materialsTo demonstrate the merit of different materials
 Recording of unusual & interesting oralRecording of unusual & interesting oral
conditionsconditions
 The provision of teaching materialThe provision of teaching material

57. The waiting roomThe waiting room

58.  It is better to call it the reception roomIt is better to call it the reception room
 You need to implement your own personality in itYou need to implement your own personality in it
 You do not need to give education because they areYou do not need to give education because they are
quite anxious .quite anxious .
 The waiting time should be briefThe waiting time should be brief
 Receptionist should welcome the patient and make itReceptionist should welcome the patient and make it
clear that we know his arrivalclear that we know his arrival
 The question of music or other entertaining material isThe question of music or other entertaining material is
becoming mandatorybecoming mandatory
 Furniture of the waiting room to be cleansableFurniture of the waiting room to be cleansable
 The bathroom must be kept clean all the time.The bathroom must be kept clean all the time.

59. The business officeThe business office

60. ComputerComputer
 It is advisable to acquire computer in the clinicIt is advisable to acquire computer in the clinic
to save, organize datato save, organize data
 New software for dental practice management isNew software for dental practice management is
designed for clinics according to their needs.designed for clinics according to their needs.
 This software is easily trained for theThis software is easily trained for the
receptionistreceptionist

61. Copying machineCopying machine
It is used in our practice for:It is used in our practice for:
 Daily appointment schedule, one copy to eachDaily appointment schedule, one copy to each
dentistdentist
 Information to be given to patients eg.Information to be given to patients eg.
instructionsinstructions

62. TelephoneTelephone
&&
answering machineanswering machine
 It is useful aid in good patient relationshipIt is useful aid in good patient relationship
 It is used to make patient able to cancel or toIt is used to make patient able to cancel or to
change his appointmentchange his appointment
 Their message should be shortTheir message should be short

63. Dictating machineDictating machine
 Micro cassette to help the dentist leaving aMicro cassette to help the dentist leaving a
message, written material for copying, medicalmessage, written material for copying, medical
report etc…report etc…

64. The appointment bookThe appointment book

65.  Appointment book is a planning system forAppointment book is a planning system for
dentist and for the other operating staffdentist and for the other operating staff
members and should be a method of planningmembers and should be a method of planning
free time as well as chairside time.free time as well as chairside time.
 It should be stressed that the only earning powerIt should be stressed that the only earning power
is in the time given to patientsis in the time given to patients

66. A general plan of appointmentA general plan of appointment
makingmaking
 Extractions are better done earlier in the day soExtractions are better done earlier in the day so
that by the end of the day freedom fromthat by the end of the day freedom from
excessive discomfort or haemorrhage can beexcessive discomfort or haemorrhage can be
assured.assured.
 It is often recommended that children be seenIt is often recommended that children be seen
early in the day, obviously not school time!early in the day, obviously not school time!
 It is good idea to leave new patients requiringIt is good idea to leave new patients requiring
examination, consultation, X-rays, etc.. , to theexamination, consultation, X-rays, etc.. , to the
end of the dayend of the day

67.  Emergencies should ideally be seen in twoEmergencies should ideally be seen in two
selected periods during the day, the 1st half hourselected periods during the day, the 1st half hour
is left openis left open
 Ensure open communication with patient duringEnsure open communication with patient during
the daytime hours of openingthe daytime hours of opening

68. A short notice list of patientsA short notice list of patients
 Is a list of patients that can be used to fill in lateIs a list of patients that can be used to fill in late
cancellations or blanks in the day .cancellations or blanks in the day .
 This is a list of patients a secretary should keepThis is a list of patients a secretary should keep
at reach & consist of patients who live or workat reach & consist of patients who live or work
nearby and come at short notice for treatmentnearby and come at short notice for treatment
 Could be classified into 1 hour, 3 hours, 24Could be classified into 1 hour, 3 hours, 24
hours according to the time required to attend.hours according to the time required to attend.

69. General considerations in caring forGeneral considerations in caring for
the new patientsthe new patients
 First impressionFirst impression
 The approachThe approach
 Introduce yourself to the patientIntroduce yourself to the patient
 Shake handsShake hands
 Careful general & dental history is takenCareful general & dental history is taken
 Attentive listening with interest is important.Attentive listening with interest is important.
 Match question & instruction with the pace of &Match question & instruction with the pace of &
comprehension of the patientcomprehension of the patient

70. StaffStaff
 The dental team may be consist of: the seniorThe dental team may be consist of: the senior
dentist, a partner (if any), dentist assistant, dentaldentist, a partner (if any), dentist assistant, dental
hygienist, secretary/receptionist, dental chairsidehygienist, secretary/receptionist, dental chairside
assistant, dental technician, (and often) theassistant, dental technician, (and often) the
patient.patient.
 A four to six weeks period of testing a staff isA four to six weeks period of testing a staff is
satisfactorysatisfactory

71. Redundancy & firingRedundancy & firing
 A staff who have been employed continuouslyA staff who have been employed continuously
for more than 2 years can not be fired without afor more than 2 years can not be fired without a
very good reasonvery good reason
 Tell employee formally that their conduct isTell employee formally that their conduct is
unsatisfactory, giving a timetable forunsatisfactory, giving a timetable for
improvement, advice, and help.improvement, advice, and help.
 Give written warning that if there is noGive written warning that if there is no
improvement, dismissal will follow.improvement, dismissal will follow.
 Give written notice as per contract.Give written notice as per contract.

72. Redundancy paymentRedundancy payment
 These are made for members who have beenThese are made for members who have been
employed for the minimum legal periodemployed for the minimum legal period
 Payment do not have to be made to employee:Payment do not have to be made to employee:
1.1. Who work less than 2 years (104 weeks)Who work less than 2 years (104 weeks)
2.2. Who workless than 21 hour per weekWho workless than 21 hour per week
3.3. Who are or will be over 65 yrs at the theWho are or will be over 65 yrs at the the
termination of the service.termination of the service.
Of continuous serviceOf continuous service

73. Health care in theHealth care in the
practicepractice

74. Hazards to the dental teamHazards to the dental team
 MercuryMercury
 Posture problemPosture problem
 ElectricalElectrical
 Injuries from instrumentsInjuries from instruments
 X-raysX-rays
 Infection- hepatitis BInfection- hepatitis B
 Anaesthetic gasesAnaesthetic gases
 Allergies- skin reactionAllergies- skin reaction
 Inhalation of aerosolsInhalation of aerosols

75. Continuing educationContinuing education

76. Keeping with contemporary dentistryKeeping with contemporary dentistry
 Regular reading of dental journalsRegular reading of dental journals
 Joining a learned societyJoining a learned society
 Enrolling in coursesEnrolling in courses
 Attending dental meetingsAttending dental meetings
 Part-time teaching at dental schoolPart-time teaching at dental school
 The pankey continuumThe pankey continuum
 Internet or www.Internet or www.

77. Evidence-based DentistryEvidence-based Dentistry
 The concept of using current evidence to guideThe concept of using current evidence to guide
decision-making was first introduced by Gordondecision-making was first introduced by Gordon
Guyatt and the Evidence-Based Medicine WorkingGuyatt and the Evidence-Based Medicine Working
Group at McMaster University in Ontario, Canada inGroup at McMaster University in Ontario, Canada in
the 1990s. A new concept for medical educationthe 1990s. A new concept for medical education
designed to incorporate current research into educationdesigned to incorporate current research into education
and practice was developed to help practitionersand practice was developed to help practitioners
provide the best care for their patients.provide the best care for their patients.
 The term evidence-based medicine (EBM)is defined asThe term evidence-based medicine (EBM)is defined as
"the integration of best research evidence with clinical"the integration of best research evidence with clinical
expertise and patient values."expertise and patient values."

78.  The new concept of EBM utilizes a systematicThe new concept of EBM utilizes a systematic
process to incorporate current research intoprocess to incorporate current research into
practice.practice.

79. The evidence-based process requiresThe evidence-based process requires
the development of five key skills:the development of five key skills:
1.1. Formulate information needs/questions into four partFormulate information needs/questions into four part
questions. These questions identify thequestions. These questions identify the
patient/problem (P), intervention (I), comparison (C),patient/problem (P), intervention (I), comparison (C),
and outcomes (O) also known as PICO questions.and outcomes (O) also known as PICO questions.
2.2. Conduct an efficient computerized search of theConduct an efficient computerized search of the
literature for the appropriate type and level ofliterature for the appropriate type and level of
evidence.evidence.
3.3. Critically appraise the evidence for validity with anCritically appraise the evidence for validity with an
understanding of research methods.understanding of research methods.
4.4. Apply the results of the evidence to patient care orApply the results of the evidence to patient care or
practice in consideration for the patient's preferences,practice in consideration for the patient's preferences,
values and circumstances.values and circumstances.
5.5. Evaluate the process and your performance throughEvaluate the process and your performance through
self-evaluation.self-evaluation.

80. Levels of evidenceLevels of evidence
 When deciding whether to implement evidenceWhen deciding whether to implement evidence
from a study, it is important to look at the typefrom a study, it is important to look at the type
of study design employed, which determines theof study design employed, which determines the
“strength” of evidence on which to base the“strength” of evidence on which to base the
clinical decision.clinical decision.

81. The 5 levels of evidenceThe 5 levels of evidence
1a. Systematic review of multiple randomized controlled1a. Systematic review of multiple randomized controlled
trials (RCTs)trials (RCTs)
1b. Individual well-designed RCT1b. Individual well-designed RCT
2a. Systematic review of cohort studies2a. Systematic review of cohort studies
2b. Individual cohort study, or low quality RCT2b. Individual cohort study, or low quality RCT
3a. Systematic review of case control studies3a. Systematic review of case control studies
3b. Individual case control study3b. Individual case control study
4. Non-analytical studies (case series)4. Non-analytical studies (case series)
5. Opinions of expert committees or respected authorities5. Opinions of expert committees or respected authorities

82. AA randomized controlled trial (RCT)randomized controlled trial (RCT)
 is a type of scientificis a type of scientific experimentexperiment most commonly usedmost commonly used
in testing thein testing the efficacyefficacy oror effectivenesseffectiveness ofof healthcarehealthcare
services or clinical research . The key distinguishingservices or clinical research . The key distinguishing
feature of the usual RCT is that study subjects, afterfeature of the usual RCT is that study subjects, after
assessment of eligibility and recruitment, but before theassessment of eligibility and recruitment, but before the
intervention to be studied begins, are randomlyintervention to be studied begins, are randomly
allocated to receive one or other of the alternativeallocated to receive one or other of the alternative
treatments under study. Random allocation in real trialstreatments under study. Random allocation in real trials
is complex, but conceptually, the process is like tossingis complex, but conceptually, the process is like tossing
a coin. After randomization, the two (or more) groupsa coin. After randomization, the two (or more) groups
of subjects are followed up in exactly the same way, andof subjects are followed up in exactly the same way, and
the only differences between the care they receivethe only differences between the care they receive

83. AA systematic reviewsystematic review
 Is a literature review focused on a singleIs a literature review focused on a single
question that tries to identify, appraise, selectquestion that tries to identify, appraise, select
and synthesize all high quality research evidenceand synthesize all high quality research evidence
relevant to that question. Systematic reviews ofrelevant to that question. Systematic reviews of
high-quality randomized controlled trials arehigh-quality randomized controlled trials are
crucial to evidence-based medicine.crucial to evidence-based medicine.

84.  AA cohort studycohort study is a form of longitudinal study (a typeis a form of longitudinal study (a type
of observational study) used in medicine, dentistry. It isof observational study) used in medicine, dentistry. It is
an analysis of risk factors and follows a group of peoplean analysis of risk factors and follows a group of people
who do not have the disease, and uses correlations towho do not have the disease, and uses correlations to
determine the absolute risk of subject contraction. It isdetermine the absolute risk of subject contraction. It is
one type of clinical study design and should beone type of clinical study design and should be
compared with a cross-sectional study.compared with a cross-sectional study.
 A cohort is a group of people who share a commonA cohort is a group of people who share a common
characteristic or experience within a defined periodcharacteristic or experience within a defined period
(e.g., are born, are exposed to a drug or a vaccine, etc.).(e.g., are born, are exposed to a drug or a vaccine, etc.).

85. Case-control studyCase-control study
 is a type of retrospective, epidemiological, clinical studyis a type of retrospective, epidemiological, clinical study
design. In a case-control study, people with a diseasedesign. In a case-control study, people with a disease
(often, a specific diagnosis, perhaps lung cancer) are(often, a specific diagnosis, perhaps lung cancer) are
matched with people who do not have the disease (thematched with people who do not have the disease (the
'controls').'controls').
 Further data are then collected on those individuals andFurther data are then collected on those individuals and
the groups are compared to find out if otherthe groups are compared to find out if other
characteristics (perhaps a history of smoking) are alsocharacteristics (perhaps a history of smoking) are also
different between the two groups.different between the two groups.

86. AA case seriescase series
 (also known as a(also known as a clinical seriesclinical series) is a medical) is a medical
research observational study that tracks patientsresearch observational study that tracks patients
with a known exposure given similar treatmentwith a known exposure given similar treatment
or examines their medical records for exposureor examines their medical records for exposure
and outcome.and outcome.
 It can be retrospective or prospective .It can be retrospective or prospective .