AFAMS Master Lesson Plan (MLP)
Dental Therapist Program
008.03 Sealers, Bases, and Indirect Pulp Cap
Instructor
Serial/Semester
Location
Start/Finish Time
Date
LESSON OBJECTIVE
Performance: Place any Pre-Restorative Treatments..
Conditions:
Given: supervision.
Denied:
nil.
Environment: classroom / clinic.
Standard:
The Dental Therapist Trainee will place any pre-restorative treatments as required to include: Cavity sealer, Liner,
Base, Indirect Pulp cap
1.
2.
3.
4.
5.
6.
7.
Provide pulpal protection
Know the indication of pre-restorative treatments
Instrument selection
Know the classification and functions of pre-restorative treatments
Prepare pre-restorative treatments in accordance with manufacturer’s instructions
Demonstrate application techniques in accordance with manufacturer’s instructions
Managing deep preparations and the proper selection of pre-restorative treatments
8. Performing an indirect pulp cap
TEACHING POINTS
1.
Provide pulpal protection by:
a) Understanding the causes of pulp irritation
b) Conservation of tooth structure
2.
Knowing the indication of pre-restorative treatment
a) After the preparation of a restoration
b) Reduction of the post-operative sensitivity
3.
Knowing instrument selection to include but not limited to:
a) cotton pliers
b) cotton ball
c) plastic cotton tip
1
AFAMS Master Lesson Plan (MLP)
Dental Therapist Program
008.03 Sealers, Bases, and Indirect Pulp Cap
d) condensers / pluggers
e) blunt instrument
f) Dycal applicator
4.
Knowing the pre-restorative treatment classification, function, preparation in accordance with manufacturer’s
instructions and application techniques to include :
cavity sealer
i) Resin bonding system
b) Liner
i) Calcium hydroxide liner
ii) Glass Ionomer liner
c) Base
i) zinc-oxide eugenol (ZOE) temporary restorations
ii) Glass Ionomer
iii) zinc phosphate cement
5. Managing the deep preparations and the proper selection of pre-restorative treatments
a)
6.
Performing an indirect pulp cap by:
a)
Knowing the indications of indirect pulp cap:
i) Deep caries with no pulp exposure during the preparation of the restoration
ii) the tooth is vital
b) Knowing the contraindications of indirect pulp cap:
i) Teeth with a history of spontaneous prolonged pain or painful response to thermal stimuli or
percussion
ii) Teeth showing radiographic periapical radiolucencies
iii) Non-vital teeth
c) Knowing the concept of infected or affected dentin
d) Knowing the instruments selection this procedure to include:
i) cotton pliers
ii) cotton ball
iii) plastic cotton tip
iv) condensers / pluggers
v) blunt instrument
vi) Dycal applicator
e) Knowing the preparation and application in accordance with the manufacturer’s instructions of
i) Calcium hydroxide
ii) Glass ionomer
f) Knowing the clinical steps of an indirect pulp cap include:
i) Proper tentative diagnostic
ii) Caries removal following the infected/affected caries concept
iii) Placing properly the calcium hydroxide or glass ionomer on affected dentin
iv) Continue with restorative plan
g) Monitor tooth for symptoms and refer to a stomatology as required
2
AFAMS Master Lesson Plan (MLP)
Dental Therapist Program
008.03 Sealers, Bases, and Indirect Pulp Cap
INSTRUCTIONAL STRATEGY
Method:
Lecture, demonstrate, practice
Media:
Training aids
Environment: Dental Operatory.
OTHER LESSON SPECIFICATIONS
Type of Lesson:
Skills Lab
End of Lesson Test: Informal EC
Instructional Time: 120 minutes
Reference(s):
The Fundamentals of Operative Dentistry by
Summit, et al. ISBN 0-86715-452-7
Resources: dentaform (dental model), cavity
varnish, glass ionomer, CaOH, operative set-up (to
include a dycal applicator), cotton pellet, and
microbruch.
LESSON PLAN APPROVAL
__________________________________________________________
Signature of AHPI Director
_______________________
Date
3
AFAMS Master Lesson Plan (MLP)
Dental Therapist Program
008.03 Sealers, Bases, and Indirect Pulp Cap
INTRODUCTION
Allocated Time:
1 Minutes
Objective:
To know when and how to use liners, bases, and perform an indirect pulp cap.
Importance:
This is important to help protect the tooth and increase the longevity of the
restoration.
BODY
1. Teaching Point: Apply Cavity Varnish
Allocated Time:
30 Minutes
PERFORMANCE STEPS:
The Instructor will take a dentoform with a class 1 cavity preparation and demonstrate the application of a
cavity varnish such as Copalite by:
1. Apply two thin coats. A cotton pledget, cut in half, can be used with cotton pliers to wipe
or paint all the cavity walls. Air-dry in between the layers to evaporate the chloroform.
The second coat ensures that all the dentinal tubules are sealed. The preparation will look
shiny or wet.
PRACTICAL – students will use one of the class 1 preparation on the dentaform and duplicate the
instructor. The instructor will verify this has been done correctly – this will be the informal EC,
4
AFAMS Master Lesson Plan (MLP)
Dental Therapist Program
008.03 Sealers, Bases, and Indirect Pulp Cap
2. Teaching Point: Placing Cavity Liners as Indirect Pulp Cap
Allocated Time:
90 Minutes
PERFORMANCE STEPS:
The Instructor will use a dentaform with class 2 cavity preparation and matrix band /wedge in place. The
instructor will show the student how to mix and apply Calcium Hydroxide (Dycal), and Glass Ionomer on
both the pulpal floor and then on the axial wall. The Instructor will reinforce that this should only be
attempted for INDIRECT PULP CAPPING. The technique is as follows:
1. The first liner will be the Calcium Hydroxide.
a. Equal small amounts of base and catalyst are placed on a paper mixing pad
and mixed with a spatula within 10 seconds until the paste is smooth and
homogeneous.
b. The mixed material will set in 21/2 to31/2 minutes on the mixing pad (or less if
the room temperature is hot).
c. Work quickly - take a Dycal applicator and scoop up a small amount of the
Dycal on the ball of the applicator and apply to the dentine. If you quickly the
Dycal will have better flow characteristics.
d. Avoid touching the margins of the cavity
e. Avoid placing a large bulk of material
2. The second liner will be glass ionomer
a. Mixing instructions:
i.One level scoop of loosely packed powder to one drop of liquid
(must confirm with the specific product you are using)
ii.The powder/liquid ratio of the mix may be varied to change
the viscosity needed. Ratios ranging from 1 scoop powder/2
drops liquid to 2 scoops powder/1drop liquid are acceptable.
iii.Rapidly mix (10-15 seconds) all powder and liquid
b. Placement instructions:
i. Place in ½ mm increments up to .75 mm thick. Place on
dentin only. Do not cover the walls of the preparation.
ii.Light cure for 30 seconds
PRACTICAL – students will use one of the class 2 preparation on the dentaform and duplicate the
instructor. The instructor will verify this has been done correctly – this will be the informal EC.
5
AFAMS Master Lesson Plan (MLP)
Dental Therapist Program
008.03 Sealers, Bases, and Indirect Pulp Cap
END OF LESSON TEST
Allocated Time:
Instructions:
Test Questions or
Performance
Expected:
Test Key:
5 Minutes
The Instructor will simply as the group a following questions
1. Is it OK to have a bulk of Calcium Hydroxide?
2. Is it OK to put a liner on the margin of a cavity?
3. True or false – glass ionomer should only be placed on the enamel?
4. If the room is very hot you have 5 minutes working time for the
Calcium Hydroxide
5. True or False - Indirect Pulp Cap is more predictable than Direct
Pulp Cap
1 – NO
2 – NO
3 – False
4- NO
5 – True
CONCLUSION
This is a small part of the restorative procedure but an important part. Take the time to understand the
concepts and don’t rush the application of liners.
6