COURSE NAME : 60.61 Steps of the Orthodontic Debanding Appointment
COURSE DESCRIPTION : 60.61 The Orthodontic Debanding Course Presentation: 55 minutes Run Time, Knowledge Quiz: 28 Questions, 4 CE Credits Contents of The Orthodontic Debanding Course This course trains the student in the important concepts for safe removal of bands and brackets from a patient’s teeth. It also teaches that, as evaluated by scanning electron microscopy (SEM) research, the best method of removal of bond adhesive from tooth surfaces is with a 30-fluted carbide finishing bur in a high-speed handpiece followed by polishing the enamel surface with a rubber point designed for this purpose. This method of removal of adhesive results in a smooth enamel surface with a high shine. Whereas, use of an adhesive removing plier often results in scarring and gouging of the enamel surface that is then prone to decalcification and decay. If taught how to perform this procedure, orthodontic assistants can be as safe an orthodontist or dentist in performing adhesive removal with a high-speed handpiece. In fact, safe removal of composite aligner attachments or bonding adhesive is not even taught or mentioned in dental school or in orthodontic residency programs. It is assumed that dental students will figure out how to do this. However, in this course, orthodontic assisting students are cautioned to know the Dental Practice Act for the state in which they are practicing to determine if it is legal for licensed orthodontic assistants to perform any procedures with a high-speed handpiece. Some states may require orthodontic assistants to carry liability insurance as registered dental hygienists are required to do. Goal: The goal of this course is to train the student in all of the details that are important to know to remove cemented bands, bonded brackets, and other orthodontic attachments from the teeth of a patient and then restoring the teeth to a high shine. Objectives: At the conclusion of this course, the student will be able to: Gather the materials used in debanding Perform the necessary procedures before the patient arrives Seat the patient and determine any patient concerns Have the doctor check and evaluate concerns Remove bonded brackets Remove cemented bands Remove bond adhesive and band cement completely Ask the doctor to complete finishing procedures Complete all final procedures after the debanding Sections of The Orthodontic Debanding Course 1. Materials for Debanding 2. Other materials used when debonding brackets 3. Pre-appointment Procedures 4. Seat the Patient 5. Request that the orthodontist check 6. Bonding Lingual Retainers Before Debonding 7. Plan debanding sequence and a Progressive Debanding 8. Removal of bonded brackets on the archwire 9. Removal of bonded brackets from the maxillary arch 10. Removal of Archwire with brackets attached 11. Debonding self-ligating brackets 12. 0607-Debonding clear brackets 13. Removal of Orthodontic Bands 14. Chip off Bond Adhesive 15. Bonding Adhesive is Dull, Enamel is Shiny 16. Video: Adhesive removal with a flame finishing bur in the mandibular left posteriors 17. Video Removing adhesive from the mandibular anteriors 18. Video Removing adhesive from the mandibular right posteriors 19. Video Removing adhesive from the maxillary left posteriors with barrel and flame burs 20. Video Removing adhesive from the maxillary anteriors 21. Video Removing adhesive in the maxillary right using different fulcrums 22. Scaling and Curetting if needed 23. Polish with rubber points 24. Polishing with Greenie rubber points 25. Polish with fluoride prophy paste 26. Polishing Porcelain Procedures 27. Final Procedures Course Resources: This course includes the following resources: The Orthodontic Debanding Script which is a script of the narration of this presentation. The DB01-Debanding Steps Checklist which lists each step you should do when you are doing a debanding. The DB02-Debanding Result Quality 7-7 Checklist which you may use to check the quality of your debanding, and The Post-treatment Consult Checklist. In practice I did a Post-treatment consult with every patient and sent a letter with pre- and post-treatment photos to the dentist and to the patient with a summary of what happened. This was effective marketing for my practice. These resource documents are provided to help the student learn and retain the important concepts of the course. The checklists are designed for the student to learn a standard for completing the Orthodontic Debonding. Also, the student needs to know when the steps have resulted in the highest standard of performance, and if not, what are the problems the student should correct to achieve a high standard. Learning Activities of the Course The learner views this course presentation as many times as it takes to understand the important concepts, which may be measured by answering the 28 embedded quiz questions correctly. These quiz questions help the learner focus on the important points. Then the learner rests his/her brain so the learning can be transferred to long term memory. Then the learner takes the Knowledge Quiz for the course to measure his/her learning of the objectives of the course. There is one Steps Checklist and one Quality Results Checklist to help the student learn the steps of this procedure and evaluate the quality of the results of the procedure. SCORM Tracking of Each Student’s Learning Activities and Recording on the Student Dashboard Report Each student’s learning activities such as correctly answering presentation embedded quiz questions, presentation viewing time, Knowledge Quiz completion time, Knowledge Quiz Score, and other learning data, are tracked so that a “learning analysis” can be done for each student and for the quality of each course. This data documents student performance and reports it on the Student Dashboard as well as in the Gradebook. This holds the student accountable for learning. In the future, student performance of this procedure in the clinic may be used to identify students who have not learned to actually perform the procedure, so that intervention can be made to help the student become proficient. No data is share with any entity. If data is ever used for learning research, all data will be de-identified following research protocol. Who should take this course? All orthodontists, orthodontic residents, and orthodontic assistants should learn and be able to perform this procedure when they are in training.