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Clinical Practice IV

Course Details

Course Number
DNHY 4038
Spring 2016
Bridwell Hall
Classroom Number
Days & Times


Mon 8:00-12:00

Tues 8:00-12:00 OR 1:00-5:00

Wed. 8:00 - 12:00   AND 1:00 - 5:00 PM


Barbara J DeBois RDH, MS (view Profile)

Course Attachments


Course Objectives


 Given the integration of didactic and clinical experiences, the prerequisite courses, Clinical Practice I (DNHY 3114), Clinical Practice II (DNHY 3005), and Clinical Practice III (DNHY 4018) upon completion of this course the student should be able to: 

1.     Utilize information obtained from the Med History in providing comprehensive patient care; determining need for special precautions, modifications and/or contradictions for treatment; manage emergency situations, and make appropriate referrals to other health care providers. 

2.     Conduct a respectful cultural assessment of patients recognizing various dynamics that might have an effect on the dental hygiene care plan and treatment.

 3.     Assess and document patient vital signs, counsel patients on any irregularities, and make appropriate recommendations or referrals.

 4.     Perform an extraoral inspection and accurately document the findings with appropriate detail.

 5.     Thoroughly examine all oral tissues for signs of pathological changes, correctly document findings, and make appropriate recommendations and/or referrals.

 6.     Perform a periodontal assessment and accurately document the findings including: AAP Classification, pocket depths, loss of attachment, mobility, furcation involvement, and bleeding sites within a reasonable time frame.

7.     Graphically represent a patient's teeth with regard to caries, missing teeth or tooth structure, types and locations  of restorations, fixed and removable appliances and developmental abnormalities within a reasonable time frame

8.     Determine need for radiographic evaluation of specific areas and/or entire dentitions and make appropriate recommendations for such surveys based on patient assessment/need.                   

9.     Position and expose intraoral x-ray films; process, mount, label, and critique radiographic surveys according to radiological standards.

10.   Analyze data collected to assess patient's needs, abilities, resources and attitudes as a basis for developing and prioritizing the Dental Hygiene Care Plan. 

11.   Revise treatment plans in accordance with the progress of clinical treatment. 

12.   Obtain the patient’s informed consent based on effective case presentations of  dental hygiene care plans.

13.   Determine the outcomes of dental hygiene interventions using indices, instruments, examination techniques and patient self-report.

14.   Utilize effective infection control techniques in accordance with the M.S.U. Dental Hygiene Program's Standard Protocol; identifying any breach of protocol and remedying accordingly.

15.   Apply principles of instrumentation and knowledge of tooth morphology in selecting hand and/or powered instruments to remove deposits, root plane, and reduce/ eliminate amalgam overhangs, in a  timely manner. 

16. Maintain tissue integrity while performing all intraoral instrumentation.

 17. Select appropriate candidates for air powdered polishing and demonstrate adequate patient preparation as well as proper set-up, utilization, and break-down of air powered polishing unit.

 18.  Control pain and anxiety during treatment through the use of accepted clinical and behavioral management  techniques which are within the scope of dental hygiene practice in Texas. 

19. Demonstrate adequate patient preparation, as well as proper set-up, utilization, and break-down of various powered scalers.

20.  Select and administer topical fluoride treatments, based on the needs of the individual patient; with appropriate patient preparation and education.  

21.  Accurately complete all patient records and charting forms with appropriate detail and in a timely manner. 

22.  Demonstrate correct techniques in administering CPR Basic Life Support, as may be necessary.        

23.  Select appropriate candidates for pit and fissure sealant placement and demonstrate proper un-assisted application of sealants on clinical patients; with adequate patient education and preparation.

24.  Properly take alginate impressions; pour and trim acceptable diagnostic casts.

25.  Correctly and efficiently perform all clinic receptionist duties in a professional manner, with a positive attitude. 

26.  Correctly and efficiently perform all clinic assistant duties with a positive attitude and in a professional manner, utilizing correct technique and infection control protocol.

27.  Schedule patient appointments (procedures and time frame) in a manner that is both time efficient and meets the needs of the patient.

28.  Demonstrate proper equipment maintenance in the lab, clinical, radiology and sterilization areas.

29.  Select applicable candidates for placement of chemotherapeutic agents and demonstrate placement with appropriate patient education to clinical competency.

30.  Electronically document patient assessment findings utilizing Dentrix computer software.




Course Expectations




The purpose of this course is to further develop and refine the assessment, instrumentation and patient management skills acquired in prerequisite clinical courses.  Advanced clinical experiences with emphasis on refinement of abilities to assess, plan, implement and evaluate patient treatment will enable students to develop competency in providing comprehensive individualized patient care. Assistant and receptionist rotations in the Gaines Dental Hygiene Clinic will further develop students’ abilities to multitask and develop an understanding of the concept of the dental office staff working as one team.  Clinical Practice IV consists of sixteen actual clock hours per week; students receive eight credit hours for successful completion of this course. 

Grading Standards



The grade for this course is based on QUALITY (instrumentation, assessment/documentation, patient management, radiographs, professionalism and clinic assistant/receptionist grades) AND QUANTITY  (patient experiences)  requirements. Both play a significant role in the development of student competencies  in patient care.                

Competency evaluations (Process Evals) ensure that students can perform procedures at the minimum level of expertise determined necessary for this point in time in their education.  Upon successful completion of the competency evaluations students can then work on improving their abilities with instructor assistance on patients in the Gaines Dental Hygiene Clinic (Clinic Grade Sheets).  Due to the substantial instructor-student collaboration during treatment QUALITY grades via Clinic Grade Sheets are NOT true indicators of student competency.

 QUANTITY (patient experiences) requirements are set to ensure that each student has appropriate experiences  to develop entry level competencies in patient care.  QUANTITY also reflects the student’s competency level as time management abilities are ultimately reflected in the number and type of patients upon which treatment is completed. Therefore, the number/type of patients treated and the number/type of procedures performed have a significant bearing on the student’s final course grade for Clinical Practice 3 and 4.


Student #1 has final Quality Grade (96) for 60 Class 2/2+, 12 Class 3 and 2 Class 4 level quads.  = Final course grade B

Student #2 has final Quality Grade (96) for 60 Class 2/2+, 16 Class 3 and 8 Class 4 level quads.  = Final course grade A

 The final Quality Grade (daily clinic grades earned with instructor input & assistance) are the same for each student.  


Student #2 met all quantity requirements which demonstrated a higher level of self-sufficient performance / competency level and resulted in a Final grade of A.



 QUALITY GRADE POINTS                      

 50%        Instrumentation

20%        Assessment/Documentation

20%        Patient Management/Professionalism

  5%         Radiographs

  5%         Clinic Assistant/Receptionist


Clinic Assistant/Receptionist Grade: Students will start with 100 points in this area.  Infractions will result in deduction of points from the applicable “100” starting points. Each infraction will incur a five (5) point deduction from the initial 100 points. (See Assistant/Receptionist Forms, objectives & criteria – Student Handbook/Clinic Manual, Section 6.7).                   

 Breach of Professionalism Protocol –During a clinical session a breach of the professionalism protocol not directly related to  the  treatment of a patient: will result in:             1st  Infraction -Formal warning

                                                   2nd Infraction- 5 point deduction from the FINAL clinic Quality grade  

(See Student Handbook/Clinic  Manual, Sections 2.8 & 2.9)



 Quantity Requirements have been set for each of the clinical procedures (Breakdown on the following pages)

Points will be deducted from the FINAL QUALITY GRADE POINTS for deficiencies in each of the areas.

          XX       Quality Grade Points                                                                                                                                                         

     -   XX      Deductions for failure to meet Quantity Requirements                    

                      = XX      FINAL COURSE GRADE


                Dental Hygiene Department Grading Scale

                     A =   92 - 100

                     B =   83 -   91

                     C =   75 -   82   Minimum competency level required to pass Clinic 4

                     D =   65 -   74   Failure in Dental Hygiene



 Competency evaluations in Clinical Practice 4: 

  • Air Powdered Polishing -On fellow students - To be scheduled by instructor
  • Management of Class 3+/ 4 Level Patient Treatment – April 2, 2013
  • Placement of Chemotherapeutic Agents- To be scheduled by instructor & student

 All Evaluation forms/criteria are in Student Handbook/Clinic Manual- Section 7             



If student is unsuccessful in demonstrating the specified competency the following will apply:

Air Powered Polishing -Cannot be performed on patients (to satisfy quantity requirements) until Competency Re-Eval successfully completed.

Management of Class 3+/ 4 Level Patient Treatment - Regularly scheduled clinic patients will not be treated until a Competency Re-Eval is successfully completed. This can have an effect on meeting quantity requirements for Clinic 4 which in turn can affect the final course grade.

Failure of Class 3+/ 4 Level Patient Treatment Competency Evaluation:                                                                                                                       

 1.  1st Remediation Session-         Prior to treating another patient in the Gaines Dental Hygiene student must remediate one-on-one with       instructor outside of regular clinic sessions (on typodont).

 2.   2nd Remediation Session-        Remediate on the Eval patient or equivalent classification patient with instructor assistance during a regularly scheduled clinic session. No quantity points and/or grades are earned for treatment provided during this session.

 3.  Competency Re-Eval-                 Re-Eval on equivalent classification patient during a regularly scheduled clinic session.  No quantity points and/or grades are earned for treatment provided during this session.            

                 Each unsuccessful demonstration of competency could have an effect on the final course grade as clinic sessions available to accumulate quantity points would be reduced, thus resulting in reductions of the quality grade


Failure of Competency Re-Eval

 A student who is unsuccessful on the 1st Competency Re-Eval can repeat steps 1-3 above two (2) more times. If competency is not demonstrated at the 3rd Competency Re-Eval student will be given a course grade of D (failure in

Dental Hygiene) and not be permitted to graduate from the program in May 2013.  In this situation the following will apply.     

  • A student who successfully completes ( C or better) ALL 4th semester didactic courses may return in Fall 2013 to complete a full semester of clinical practice sessions (running concurrently with Clinical Practice 3 sessions) for graduation in December 2013. 
  • A student who DOES NOT successfully complete ALL 4th semester didactic courses, will be required to return in Fall 2013 to formally audit  ALL  3rd semester courses (clinical and didactic) and then retake the  4th semester courses (clinical and didactic) in Spring 2014 for graduation in May 2014. 

The dental hygiene department has the right to make arrangements on an individual basis for students failing to maintain a passing grade in any course.  Whatever arrangements made will be based upon an examination of the individual student’s overall dental hygiene scholastic record. This will be decided by the Department Chair and at least two other Dental Hygiene faculty members.  Readmission is not automatic.


Submission Format Policy Note: You may not submit a paper for a grade in this class that already has been (or will be) submitted for a grade in another course, unless you obtain the explicit written permission of me and the other instructor involved in advance.
Plagiarism Policy

Plagiarism is the use of someone else's thoughts, words, ideas, or lines of argument in your own work without appropriate documentation (a parenthetical citation at the end and a listing in "Works Cited")-whether you use that material in a quote, paraphrase, or summary. It is a theft of intellectual property and will not be tolerated, whether intentional or not.

Student Honor Creed

As an MSU Student, I pledge not to lie, cheat, steal, or help anyone else do so."

As students at MSU, we recognize that any great society must be composed of empowered, responsible citizens. We also recognize universities play an important role in helping mold these responsible citizens. We believe students themselves play an important part in developing responsible citizenship by maintaining a community where integrity and honorable character are the norm, not the exception.

Thus, We, the Students of Midwestern State University, resolve to uphold the honor of the University by affirming our commitment to complete academic honesty. We resolve not only to be honest but also to hold our peers accountable for complete honesty in all university matters.

We consider it dishonest to ask for, give, or receive help in examinations or quizzes, to use any unauthorized material in examinations, or to present, as one's own, work or ideas which are not entirely one's own. We recognize that any instructor has the right to expect that all student work is honest, original work. We accept and acknowledge that responsibility for lying, cheating, stealing, plagiarism, and other forms of academic dishonesty fundamentally rests within each individual student.

We expect of ourselves academic integrity, personal professionalism, and ethical character. We appreciate steps taken by University officials to protect the honor of the University against any who would disgrace the MSU student body by violating the spirit of this creed.

Written and adopted by the 2002-2003 MSU Student Senate.

Students with Disabilities

The Americans with Disabilities Act (ADA) is a federal anti-discrimination statute that provides comprehensive civil rights protection for persons with disabilities. Among other things, this legislation requires that all students with disabilities be guaranteed a learning environment that provides for reasonable accommodation of their disabilities. If you believe you have a disability requiring an accommodation, please contact the Disability Support Services in Room 168 of the Clark Student Center, (940) 397-4140.

Safe Zones Statement

The professor considers this classroom to be a place where you will be treated with respect as a human being - regardless of gender, race, ethnicity, national origin, religious affiliation, sexual orientation, political beliefs, age, or ability. Additionally, diversity of thought is appreciated and encouraged, provided you can agree to disagree. It is the professor's expectation that ALL students consider the classroom a safe environment.

Contacting your Instructor

All instructors in the Department have voicemail in their offices and MWSU e-mail addresses. Make sure you add your instructor's phone number and e-mail address to both email and cell phone lists of contacts.

Attendance Requirements

The Dental Hygiene Faculty feel very strongly that maximum participation in all clinical and laboratory exercises is  critical to the development of clinical competencies. Therefore, more than two absences for any reason will result in a loss of 5 points from the final course grade for each absence over 2.           


A student on Probationary Status will not be permitted absences for any reason until he/she is taken off of probationary status by the Dental Hygiene Admissions Committee. 

When the student has an open appointment time due to a No-show, cancellation, or no scheduled patient the student will be expected to work on impression requirements, help the clinic assistant or receptionist as needed, or assigned a specific skill to practice.  YOU MUST REMAIN IN THE CLINIC AREA.  THE dressing/locker room is not considered a clinical area (See Professionalism Criteria - Student Handbook)

 DO NOT SIT IN THE RECEPTION ROOM OR AT THE RECEPTION DESK unless you are the scheduled receptionist. If an instructor and/or the department secretary must ask you to leave the reception desk FIVE (5) points for Breach of Professionalism WILL BE DEDUCTED FROM your FINAL clinic grade. You may study in your operatory with clinical instructor permission. 


(See Professionalism Criteria - Student Handbook)


Other Policies



 Dental Hygiene Honor System:                       

All Dental Hygiene courses adhere to the MSU Code of Conduct. In particular, academic dishonesty, however small, creates a breach  in academic integrity.  A student’s participation in this course comes with the expectation that his or her work will be completed in full observance of the MSU Code of Student Conduct.  A student should consult the current Student Handbook for answers to any questions about the code.   Many components of dental hygiene courses are designed to be highly interactive with students helping each other learn.  Students are encouraged to take full advantage of many resources available including course resources, Internet sites, other textbooks and journals, faculty, and peers when answering objectives. This interactive collegial learning environment is conducive for life-long learning.

Cheating includes, but is not limited to, (1) use of any unauthorized assistance in taking quizzes, tests, or examinations; (2) dependence upon the aid of sources beyond those authorized by the instructor in writing papers, preparing reports, solving problems, or completing other assignments; or (3) the acquisition of tests or other academic materials belonging to the university faculty or staff without permission.

Plagiarism includes, but is not limited to, the use of, by paraphrase or direct quotation without correct citation in the text and on the reference list, the published or unpublished works of another person. Students may NOT submit papers and assignments that they have previously submitted for this or other courses. The use of materials generated by agencies engaged in "selling" term papers is also plagiarism. Students are encouraged to review the tutorials and suggested websites for more information about plagiarism. 

Academic dishonesty (cheating, plagiarism, etc.) will not be tolerated in this class. Whenever a student is unsure of whether a particular situation will be interpreted as academic dishonesty, he/she should ask the instructor for clarification.  If students are guilty of academic dishonesty, a grade of zero (0) will be given for the quiz, assignment, etc.  Cases may also be referred to the Dean of Students for possible dismissal from the university               


By enrolling in this course, the student expressly grants MSU a “limited right” in all intellectual property created by the student for the purpose of this course.  The “limited right” shall include but shall not be limited to the right to reproduce the student’s work product in order to verify originality and authenticity, and for educational purposes. Specifically, faculty may submit student papers and assignments to an external agency to verify originality and authenticity, and to detect for plagiarism


MSU COHSHS Student Conduct Appeals Committee

 All Midwestern State University (MSU) students may legitimately appeal a course grade if 1) the student has not be evaluated  according to the same criteria as his or her classmates, or 2) an error has been made in grading and/or posting (MSU Student Handbook, p. 37.) In addition, the Office of the Dean of Students has the responsibility to enforce standards of conduct for students  as outlined in the MSU Student Handbook (p. 70-80).

 When enrolled in the College of Health Sciences and Human Services (COHSHS), students are often assigned to community agencies, such as health care facilities, social service agencies, or athletic environments, as part of their academic process. During these experiences, the student is expected to behave in a manner required of professionals working in this environment. COHSHS students may also be required to successfully complete a licensing/certification process following graduation. As a result, students in these programs are often held to a different academic and/or behavioral standard than students in other MSU programs. For example, students may not be allowed to progress in a program if they have been unsuccessful (D or F) in a certain number of courses in the major. In these circumstances, COHSHS faculty and administration, all of whom have had similar professional experience, may make decisions which negatively impact students’ programmatic progress.

 COHSHS students have a right to a review of decisions made by the program faculty, which prevent individuals from progressing in  their program in a timely manner. However, those who participate in the review must understand the context of the professions involved. Therefore, issues concerning the professional conduct of students in the COHSHS will NOT be brought to the University Grade Committee, but to the COHSHS Student Conduct Appeals Committee. Specifically, the COHSHS Student Conduct Appeals Committee will review faculty decisions related to:

  • Student conduct in a clinical experience, internship, or other work-related environment that negatively impacts the student’s academic progress. This conduct may include behavior which is prohibited by licensing and/or professional standards or departmental policy. 
  • Student removal from a program because of a) professional conduct issues or b) failure to maintain academic standardsrequired specifically by the program*



The American with Disabilities Act:

 Midwestern State University does not discriminate on the basis of an individual’s disability and complies with Section 504 and the Americans with Disabilities Act in its admission, accessibility, and employment of individuals in programs and activities. MSU provides academic accommodations and auxiliary aids to individuals with disabilities, as defined by law, who are otherwise qualified to meet academic employment requirements. For assistance call (940) 397-4618 or (940) 397-4515. 

It is the student=s responsibility to declare any disabilities.  After declaration, preferably at the beginning of each semester, the student needs to contact individual instructors to determine any reasonable accommodations that may be required.



Writing Proficiency Requirement

All students seeking a Bachelor's degree from Midwestern State University must satisfy a writing proficiency requirement once they've 1) passed the 6 hours of Communication Core and and 2) earned 60 hours. You may meet this requirement by passing either the Writing Proficiency Exam or English 2113. Please keep in mind that, once you've earned over 90 hours, you lose the opportunity to take the $25 exam and have no option but to enroll in the three-credit hour course. If you have any questions about the exam, visit the Writing Proficiency Office website at, or call 397-4131.

Campus Carry

Senate Bill 11 passed by the 84th Texas Legislature allows licensed handgun holders to carry concealed handguns on campus, effective August 1, 2016. Areas excluded from concealed carry are appropriately marked, in accordance with state law. For more information regarding campus carry, please refer to the University’s webpage at

If you have questions or concerns, please contact MSU Chief of Police Patrick Coggins at