Specialty Chairside



Faculty Teaching Guide for Specialty Chairside Assisting

Module – Oral Pathology

Faculty Teaching Guide for Specialty Chairside Assisting

Module: Oral Pathology

Module Overview

This module will discuss the dental assistant’s responsibilities as a team member for the treatment of oral diseases. Oral lesions are classified according to their placement in the surface of the mucosa. A variety of different agents and distrubances can contribute to oral cavity conditions. It is the responsibility of the DA to recognize abnormal conditions of the mouth and to alert the dentist of these existing conditions. The DA must know how to prevent disease transmission, how the condition may interfere with the patient’s treatment, and how the condition may affect the patient’s overall health.

The Big Picture

Resources

This module utilizes the following learner resources:

Textbook: Dental Assisting, A Comprehensive Approach, 2nd edition, by Donna J. Phinney and Judy Halstead. Delmar Learning, 2004. ISBN 1-4018-3480-9.

Workbook: Workbook to Accompany Dental Assisting, A Comprehensive Approach, 2nd edition, by Donna J. Phinney and Judy Halstead, prepared by Karen L. Waide, Delmar Learning, 2004. ISBN 1-4018-3483-3.

Instructor’s Manual: Instructor’s Manual to Accompany Delmar’s Dental Assisting, A Comprehensive Approach, 2nd edition, by Donna J. Phinney and Judy Halstead. Delmar Learning, 2004. ISBN 1-4018-3482-5.

Electronic CD-ROM: Delmar’s Dental Assisting Interactive Skills and Procedures CD-ROM, ISBN 1-4018-3485-X.

Faculty CD-ROM: The faculty CD-ROM includes this Faculty Guide and the PowerPoint Presentation for Specialty Chairside Assisting.

Section 1: Oral Pathology

Section Overview

Oral pathology is the study of diseases that manifest abnormal conditions or symptoms in the mouth. The dentist may take a sample of tissue from the patient and send it to an oral pathologist for microscopic examination for the purpose of diagnosis. The dental assistant should remain observant of the patient’s oral condition in order to be aware of abnormal signs in the patient’s mouth and should inform the dentist if something is noticed.

Outline of Section

Part A: Key Terms

Part B: Cause and Effect of Oral Diseases

Learning Objectives and Competencies

These learning activities directly address the Learning Objectives and

Competencies as stated.

Knowledge

1. Define key terms.

2. Define oral pathology.

3. List the signs of inflammation.

Comprehension

4. Describe oral lesions caused by biological, physical, and chemical agents.

5. Distinguish oral conditions related to hormonal, developmental, and nutritional disturbances.

Application

6. Demonstrate the knowledge and ability to assist during a surgical biopsy procedure.

Learning Activities

These learning activities directly address the Learning Objectives and Competencies as stated.

[Insert Homework Assignment icon] Key Term Glossary (Part A, Objective 1)

[Insert In-Class Activity icon] Guest Speaker (Part A, Objectives 4-5)

[Insert Homework Assignment icon] Textbook Assignment (Part A, All Objectives)

[Insert In-Class Activity icon] Surgical Biopsy (Part B, Objective 6)

[Insert Homework Assignment icon] Workbook Assignment (Part B, All Objectives)

[Insert Homework Assignment icon] End of Chapter Activities (Part B, All Objectives)

Part A: Key Terms

Overview

Medical and dental terminology is easily broken down into word parts helping to make their meaning clearer. The many disorders that can occur in the oral cavity will be learned in this part. As a dental assistant learning the correct usage and pronouciation of each term is important for accurate and professional communication.

Initial Questions and Activities

1. What dental terms have been the most difficult for you to understand and learn?

Remind learners that the more they are exposed to a word and its meaning, the better they will

understand and recognize it, and eventually be able to use it as part of their everyday vocabulary.

Encourage learners to pronounce these words and definitions out loud rather than to just read them.

Mention their Key Term Glossary they have been creating throughout their dental course and the

importance of using this tool to continue to review terms previously discussed.

|Key Concepts |References and Activities |Slides |

|Introduction to Module | |Slides 1-2 |

|Introduction to Section | |Slide 3-4 |

|Key Terms |Chapter ____, pgs. ____ |Slides 5-6 |

| |[Insert Home Ass icon] Key Term Glossary | |

| |[Insert In-Class Activity icon] Guest Speaker | |

| |[Insert Home Ass icon] Textbook Assignment | |

[ ] Group Activities [ ] Homework [ ] Individual Activity [ ] Internet Activity [ ] In-Class Discussion [ ] In-Class Activity [ ] Evaluation

[Insert In-Class Act icon] In-Class Activities

❑ Guest Speaker (Part A, Objectives 4-5). Goal: To have learners hear from an expert in the field of oral pathology. Instructor should contact a local college or university and ask a specialist in oral pathology or oral cancer to speak to the class about how to prevent oral diseases.

[Insert In-Class Dis Ques icon] In-Class Discussion

1. How will knowing and understanding oral pathology terms help the dental assistant?

Comprehension and pronunciation of oral pathology terms are necessary so the dental assistant will be informed of the patient’s condition identified by the dentist, or even noticed by the DA, and brought to the dentist’s attention. The patient may ask the assistant about the word when the dentist is not in the room. The DA should answer patient questions carefully so that the patient isn’t alarmed by their possible condition. The DA could also wait to ask the patient’s question to the dentist when he or she returns, so both the patient and the dental assistant hear the answer.

[Insert Home Ass icon] Homework Assignments

Key Term Glossary. Learners will define key terms listed in the PowerPoint presentation. They are to enter this glossary on disk, in a dedicated notebook or in a designated part of a notebook. They are expected to augment information from text or lecture with other resources including any available in the school or public libraries or on the Internet and will be graded at the end of the module on completeness and presentation.

Textbook Assignment. Learners are to read Chapter ____ .

Ideas for learners struggling with this material …

❑ Web Research. Have learners go to and find the number of individuals who will develop oral cancer this year and what it looks like in the mouth? Learners should prepare a short report on their findings so they will better understand these conditions and be more observant of patient’s oral conditions, as well as their own health.

Ideas for learners who are ahead and want to learn more…

❑ Web Research. Have learners go to and identify the number of people currently living with AIDS, and the number of deaths in the most recent year that data was collected. Learners should prepare a short report on the signs and symptoms of AIDS manifestations in the mouth.

Presentation Tools

Note: If you change Objectives or Assignments, don’t forget to change the slides accordingly.

|Slide 1 |[Insert SCA 3-1] |PowerPoint Presentation for Specialty Chairside Assisting |

| |SCA – Stands for Specialty Chairside Assisting. The|Module: Oral Pathology |

| |1st number indicates the Module called Oral |Prior to introducing this module. Ask learners if any questions remain from |

| |Pathology. The 2nd number indicates the slide. |the previous module. If questions remain review the material as needed. |

| | |Introduce this module. |

|Slide 2 |[Insert SCA 3-2] |Module: Oral Pathology |

| | |Introduce the section and each part. |

|Slide 3 |[Insert SCA 3-3] |Section 1: Oral Pathology |

| | |Discuss each objective for this section in detail. Learners need to know what |

| | |they will be learning and why. Try to relate it back to their careers as |

| | |dental assistants. |

|Slide 4 |[Insert SCA 3-4] |Section 1: Oral Pathology (cont.) |

| | |Continue to discuss each objective in detail. |

|Slide 5 |[Insert SCA 3-5] |Part A: Key Terms |

| | |Review each key term and discuss the importance of knowing the definition of |

| | |each. |

| | |Homework Assignment: Stop here to discuss the Key Term Glossary assignment. |

| | |Make sure learners understand the importance of continue to add to their |

| | |glossary the various terms they are learning. |

|Slide 6 |[Insert SCA 3-6] |Key Terms (cont.) |

| | |Continue discussing each term. |

| | |In-Class Activity: Stop here for the Guest Speaker activity. |

| | |Homework Assignment: Stop here to assign and discuss the homework. |

Part B: Cause and Effect of Oral Diseases

Overview

A clean mouth is a healthy mouth. The warm moist oral environment is perfect for the multiplication of bacteria, viruses and other pathogens, and any variation from the normal could be an indication of systemic problems in other areas of the body. It is important for dental personnel to be able to recognize pathological conditions in the mouth and realize how it may impact the patient’s general health and planned dental treatment. Prevention of disease transmission by the dental assistant is mandatory for all dental procedures in order to prevent the spread of infectious microorganisms.

Initial Questions and Activities

1. Who here has ever had a canker sore? How does it feel when you eat or drink?

Most learners will have had this experience and will express how uncomfortable it is to eat and drink something with these sores present. Tell them that the technical term for canker sore is aphthous ulcer, that they tend to erupt during times of stress, and that they last about one to two weeks. Discuss how a patient with an aphthous ulcer may want to reschedule their dental appointment to avoid irritation during the procedure.

|Key Concepts |References and Activities |Slides |

|Oral Pathology |Chapter ____, pgs. ____ |Slides 7-17 |

|Assessment Questions |[Insert Group Activity icon] Surgical Biopsy |Slide 18 |

|Summary of Module |[Insert Home Ass icon] Workbook Assignment |Slide 19 |

| |[Insert Home Ass icon] End of Chapter Activities | |

[ ] Group Activities [ ] Homework [ ] Individual Activity [ ] Internet Activity [ ] In-Class Discussion [ ] In-Class Activity [ ] Evaluation

[Insert In-Class Act icon] In-Class Activities

❑ Surgical Biopsy (Part B, Objective 6). Goal: For learners to set up and assist during a surgical biopsy procedure. Instructor will need to provide instruments and supplies necessary to practice this skill. Separate learners into teams. Learners should be graded on the procedure steps as outlined on pg. ____, Chapter ____. Learner workbooks contain check off sheets that can be utilized.

[Insert In-Class Dis Ques icon] In-Class Discussion

1. What is a biopsy? How is a biopsy treated in dentistry?

A biopsy is the surgical removal of a small amount of tissue for microscopic examination.

[Insert Home Ass icon] Homework Assignments

Workbook Assignment. Have learners complete the questions in Chapter ___ of the workbook.

End of Chapter Activities. Have learners complete the Review Questions and Critical Thinking Questions at the end of Chapter ____.

Ideas for learners struggling with this material …

❑ Study: Suggest that learners spread their study time out over more days and shorter periods of study. Inform them that cramming for quizzes and exams and completing homework too quickly is not as effective as studying small chunks at a time and more thoroughly.

Ideas for learners who are ahead and want to learn more

❑ Web Research: Have learners go to and identify the physical repercussions of anorexia nervosa and bulimia nervosa. Which of these physical repercussions are related specifically to dentistry? Have them write a brief report and be prepared to present to the class.

Presentation Tools

Note: If you change Objectives or Assignments, don’t forget to change the slides accordingly.

|Slide 7 |[Insert SCA 3-7] |Part B: Cause and Effect of Oral Diseases |

| | |Review Part A. Make sure that any remaining questions are answered. |

| | |Introduce Part B. |

| | |Discuss how lesions are classified. |

|Slide 8 |[Insert SCA 3-8] |Diseases Caused by Biological Agents |

| | |Address how oral diseases are often caused by microorganisms. |

| | |Discuss the four signs of inflammation and the etiology of the inflammatory |

| | |process. |

| | |Inform learners that actinomycosis and syphilis are caused by bacteria, herpes |

| | |simplex and herpes zoster are caused by viruses, thrush is caused by fungus, and |

| | |the cause of aphthous ulcers is unknown. |

|Slide 9 |[Insert SCA 3-9] |Diseases Caused by Physical Agents |

| | |Discuss how physical agents may cause oral disease. Examples include pulling a |

| | |dry cotton roll too quickly from a patient’s mouth and tearing the mucosa. This |

| | |dental sore may cause a gingival ulcer. |

| | |Ensure learners understand that an amalgam tattoo is amalgam filling material |

| | |that became embedded under ginvigal tissues. Point out that this can be prevented|

| | |by the DA by ensuring that excess filling material is rinsed from the patient’s |

| | |mouth during restorative procedures. |

| | |Explain that patients undergoing radiation treatment for cancer may develop oral |

| | |abnormalities. |

|Slide 10 |[Insert SCA 3-10] |Diseases Caused by Chemical Agents |

| | |Inform learners that oral diseases caused by chemical agents can usually be |

| | |prevented. |

| | |Discuss aspirin burn, nicotine somatitis, smokeless tobacco lesions, and hairy |

| | |tongue. |

| | |Explain that gingival hyperplasia is a common side effect of the medication |

| | |Dilantin. |

|Slide 11 |[Insert SCA 3-11] |Oral Conditions Caused by Hormonal Disturbances |

| | |Discuss how hormonal changes may manifest in oral tissues and that these all |

| | |improve with good oral hygiene. |

|Slide 12 |[Insert SCA 3-12] |Oral Cavity Conditions Caused by Developmental Disturbances |

| | |Explain that congenital defects may cause cleft palate or cleft lip, defective |

| | |enamel, missing teeth, extra teeth, abnormally large or abnormally small teeth, |

| | |or other conditions. |

| | |Describe tori as a common boney growth, usually seen on the lingual, near the |

| | |mandibular bicuspids, or on the palate. Ensure learners understand that before |

| | |taking impressions or x-rays of a patient, the DA should check the oral cavity |

| | |for tori, which are covered only by thin mucosa, which can make these procedures |

| | |uncomfortable for the patient. Tell them that many individuals have tori, which |

| | |are not a problem, unless the person is a candidate for removable prosthetics, |

| | |where the bone may need to be removed. |

| | |Discuss the other cavity conditions caused by developmental disturbances. |

|Slide 13 |[Insert SCA 3-13] |Oral Conditions Due to Nutritional Deficiencies |

| | |Discuss how important nutrition is to oral as well as overall health and that |

| | |nutritional problems will show up in the mouth. |

|Slide 14 |[Insert SCA 3-14] |Neoplasms |

| | |Ensure learners understand that any growth that exceeds normal form has the |

| | |potential to become cancerous. Explain each type of neoplasm. |

|Slide 15 |[Insert SCA 3-15] |Oral Cancer Warning Signs |

| | |Review the warning signs. |

| | |Point out that potential warning signs of oral cancer are unusual bleeding and |

| | |discharge, a lump or swelling on the lip, gums, cheek, palate, tonsils, or neck. |

| | | |

| | |Explain that a sore or ulceration that doesn’t heal in two weeks and is white or |

| | |scaley should be shown to the dentist. |

| | |Inform learners of the recent method of detecting precancerous lesions through |

| | |the brush biopsy method, therefore identifying them at early curable stages. |

|Slide 16 |[Insert SCA 3-16] |Lesions Caused by AIDS and HIV |

| | |Explain that individuals with HIV and AIDS are susceptible to many oral diseases |

| | |due to their compromised immune system, as well as side effects from their |

| | |numerous medications. |

| | |Point out that these three types of lesions are the most common oral conditions |

| | |for these patients. |

|Slide 17 |[Insert SCA 3-17] |Other Oral Disorders |

| | |Explain that acute necrotizing ulcerative gingivitis is treated with antibiotics |

| | |and good oral hygiene. |

| | |Point out that a mucocele is trauma to a saliva gland, which creates a buildup of|

| | |salivary fluids into a blister. |

| | |Explain that varix is weakened blood vessels which do not cause any problems. |

| | |Point out that geographic tongue is common and doesn’t require treatment and that|

| | |anorexia and bulimia may cause severe damage to oral tissues. |

| | |Discuss how Bell’s palsy temporarily causes paralysis of facial muscles on one |

| | |side of the face and that the cause is unknown. |

|Slide 18 |[Insert SCA 3-18] |Assessment Questions |

| | |Short Activity: Ask the group to answer these questions to assess their |

| | |comprehension of the material recently presented. Review any material that does |

| | |not seem clear. |

| | |Short Activity: Stop and discuss the case study at the end of Chapter ____. |

| | |In-Class Activity: Stop here for the Surgical Biopsy activity. |

|Slide 19 |[Insert SCA 3-19] |Summary of Module |

| | |Go through the each specialty topic discussed throughout this module and learners|

| | |for questions. Clarify areas that are still unclear. |

| | |Homework Assignment: Stop here to assign and discuss the homework. |

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Faculty Teaching Guide for

Specialty Chairside Assisting

Module:

Oral Pathology

▪

Teaching Tip

Encourage learners to form study group to assist them in learning the material and holding each other accountable. Study groups work best with no more than five learners. An effective approach is for each member to be responsible for presenting a portion of the information to be studied and to provide strategies to help the group to retain the information. Each learner should write at least 5 questions on each topic to be provided as a study aid.

Teaching Tip

Adult learners dislike one-way communication and long lectures. Ask questions, recognize the expertise of learners, and involve the class.

Part A: Key Terms

Part B: Cause and Effect of Oral Diseases

Section 1:

Oral Pathology

The Adult Learner…

a

more easily puts information into long-term memory when several learning strategies are utilized, such as: drawing, association, color, discussion, seeing, hearing, reading, writing, etc. Try to use all strategies in each class session.

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