1. law, govt and politics
2. law enforcement
3. fire department

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What All Volunteers Need to Know
These patients are our guests. Treat them politely and with interest. Engage them in conversation. If
possible, address them by name. If you don’t know their names, it’s OK to ask. The people we serve
are here by our invitation, so please give them you attention.
Be patient with our guests. They have probably been in pain for a long time to be so desperate as to
stand outside all night long waiting for treatment. They may also have a fear of dentistry. That’s why we
want to keep it lite and keep it fun!
First of all, NO EATING, DRINKING, or GUM CHEWING ON THE CLINIC FLOOR.
DO NOT LEAVE TO GO ON BREAK WITHOUT INFORMING YOUR LEAD.
Patient Escorts – you probably have the most important job of any. Why? Because if the patient chairs
are empty the volunteer dentists can not do their jobs. If there are delays, fewer patients get treated,
fewer services are provided, and less pain is alleviated. It is our goal to treat as many as we can.
When you engage with patients and are talking to them, ask them anything: how long have they waited,
how far have they traveled where do they live, anything. Getting patients talking relieves some
anxieties. It also helps you determine if you should ask the dentist if he or she would like a translator.
Introduce the patients to the dentist and the assistants and/or hygienists. Hand the patient off to the
caregiver.
When you pick up a patient at the chair, ask how he or she feels. If he feels faint, immediately sit him
down and get the dentist who was treating him, or get the nearest EMT. Nothing is worse than having a
patient drop at your feet because you didn’t pay attention to him.
Stay on your toes and fill the patient chairs as quickly as you can.
Be certain you know the meaning of all color-coded cards.
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Clinic Philosophy and Treatment Approach
At the IndianaMOM event, thousands of patients will be seeking dental treatment in a limited time
period. During this two-day event, dentists in the dental triage unit will be asked to establish
individual treatment plans with the goal of relieving pain and infection. Those plans are then
reviewed with patients to ensure they understand their immediate needs and agree to what can be
accomplished during that day.
In private practice, dentists can develop comprehensive and long-term treatment plans because they know
that future appointments are likely. This approach is unrealistic for patients who attend events such as
IndianaMOM; access to dental care may continue to be a problem so the limited treatment available needs
to be carefully prescribed and prioritized to yield the greatest impact on the patients’ oral and overall
health. Each practitioner must consider the needs of the entire patient population as well as each
individual they treat.
Prior to dental triage, patients will complete a limited medical assessment. It is important for the
physicians and nurses working in medical triage to identify patients with:
! Serious medical conditions, medications, or other issues that may interfere with or prevent dental
treatment
! Infections
! The need for antibiotics prior to dental treatment
! The need for immediate medical treatment that cannot be provided on site
Patients in consultation with the triage dental and/or the dentist reviewing x-rays will rank their top
treatment priorities. Clinical dentists should focus treatment efforts on the first priority but can use their
professional judgment to determine if time allows for additional procedures, for instance, within the same
quadrant.
The priority guidelines for treatment are:
! Providing dental treatment to relieve pain and infection
! Providing dental treatment specific to a medical condition (e.g., prophylaxis for patients with
diabetes or advance periodontitis)
! Extracting teeth that cannot be restored in a limited amount of time (e.g., 45 minutes).
! Patients will receive a list of community dental care resources upon exiting the clinic.
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Restoring teeth when appropriate and time permits (e.g., pulp caps may not be appropriate treatment at this
event as we do not know whether the patient will seek the recommended follow-up care.)
Endodontic procedures on anterior teeth can be done.
!
!
!
!
Recommending x-rays only as needed or appropriate based on the professional judgment of the
triage dentist rather than for routine screening purposes.
o For extractions, restorations and endodontics, x-rays should be taken, as deemed
appropriate, in the general x-ray area.
o Children should be sent to the Pediatric Department for x-ray determination.
Providing anterior flippers to restore a patient’s smile within the capacity of the clinic’s lab.
Dental hygiene should focus on debridement of gross calculus.
Routine prophylaxis for patients without immediate dental treatment needs if the hygiene
department coordinator indicates availability of space and time.
Following treatment, patients will also receive:
! Community resources for follow-up or additional treatment.
! An opportunity to provide feedback about the care they received at the event.
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Dental Assisting Protocol
Our goal is to relieve pain and address the most urgent need(s). Refer to the priority section of the
patient form to find out what treatment and which teeth will be treated today.
Please practice universal precautions and follow all standard infection control practices.
1. Patients are only offered one dental service (i.e., treatment in one quadrant; cleaning, fillings or
extractions) unless the capacity of the clinic allows for more. Please do not promise
patients more.
2. Composite guns and curing lights must be shared. Please wipe them down when you are done
and place them back on the table where they can be reached by other teams.
3. When picking up instruments and supplies, pick up ONLY what you need for the patient
you are working on at that time. Return unused instruments and supplies as soon as possible so
the next person can have instruments and supplies they need.
4. The patient will be anesthetized before arriving to the dental chair (the exception is the first
patients of each day).
5. Printed radiographs will arrive with the patient.
6. EMTs are onsite to deal with patient and volunteer emergencies. If you have a patient
emergency, stay with the patient, send your assistant or someone near you to alert the
Department lead who will immediately radio for an EMT. Hold up the EMT station card so the
EMT can quickly identify where to go once they have been radioed.
7. Please PRINT on the patient charts – DO NOT USE ABBREVIATIONS.
8. Only BLUE pens should be used on patient charts – NO BLACK ink.
9. Patients are not allowed to walk unattended on the clinic floor. Use your station cards for
moving patients or for problems.
Green – bring me a patient
Red – take the patient to Exit Interview
Yellow – translator needed
Orange – equipment concern
White w/Red Cross – EMT needed
Purple – request Nomad x-ray
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10. Amalgam restorations are recommended – especially in posterior teeth. Not only is it quicker to
put in an amalgam than a composite, but in the majority of cases it will serve the
patient longer. You can, however, place composites; limited colors of composite material will
be available. There are approximately 20 curing lights available for the entire clinic.
11. Please place extracted teeth that contain amalgam fillings in the nearest container labeled
DENTAL AMALGAM. The container is located on the head table in the Restorative area. This
waste will be recycled and/or disposed of according to state and local regulations.
12. Place extra amalgam and amalgam capsules in the nearest container labeled DENTAL
AMALGAM. The container is located on the head table in the Restorative area.
13. Dispose of carpules with left over anesthetic in the designated biohazard container at the head of
your department (plastic container with biohazard label). Do not throw them in the
regular trash.
14. Remove all sharps from the instruments and all burs from handpieces and dispose of them in the
nearest sharps container. Do not walk on the clinic floor with sharps.
15. When treatment is complete, fill out the chart indicating the treatment provided.
16. Over the counter medications are available by checking the appropriate box on the lower left
corner of the registration form. Prescribe these medications only when necessary instead of
routinely.
17. Discuss post op medications with each patient and hand them a post-op instructions sheet.
Let the patient know about the 800 number they can call should they have any problems with
the care they received at the clinic. The phone line is open for 2 weeks following the
clinic.
18. Hold up a red card to indicate the patient’s treatment is complete. A patient escort will take the
clipboard and patient record from the practitioner and take the patient to the exhibit
interview area when treatment is complete.
19. Translators are available. Hold up a yellow card and a translator will come to your chair.
20. If you receive a sharps injury (instrument or needle stick) or incur any other personal injury, notify
the Department Lead immediately. He/she will follow the sharps or accident
protocol.
21. Please stagger your breaks. Be sure to let the department lead know how long you will be gone,
depending on the time someone else may use the chair while you are gone so patient flow isn’t
disrupted.
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STERLIZATION and INSTRUMENTS
Remove all sharps from the instruments and all burs from handpieces and dispose of them in the
nearest sharps container. Do not walk on the clinic floor with sharps.
Put all instruments that come out of a cassette back into the cassette.
You are responsible for make sure that your personal instruments are identified as yours when they go
through sterilization. To ensure this, drop your instruments off at the sterilization table marked
“Used Personal Instruments” that have your name written on the sterilization pouch(es), then leave the
pouch(es) on the tray with the instruments. You will pick up sterilized instruments at the “Clean
Personal Instruments” station.
If you are using ADCF instruments, place all instruments that came out of a cassette back in the
cassette and close it. Place the cassettes and any loose instruments and don’t belong in a cassette
and close it. Place the cassettes and any loose instruments that don’t belong in a cassette in the plastic
container on the head of your department. They will be transported to the sterilization area.
Broken ADCF instruments should be returned to sterilization, do NOT throw them away. Notify
someone in sterilization that the instrument is broken.
In addition, the following must be adhered to throughout the event:
1. Do NOT allow patient to form a lip seal on the saliva ejector or large suction.
2. Before turning off the suction, remove it from the patient’s mouth, point it at the ceiling,
then turn it off.
3. After each patient, obtain two (2) one-once cups of pre-mixed peroxide/water solution and
pull one cup through the salvia ejector and one cup through the large suction.
4. After the patient is escorted away, don new gloves and use utility gloves over those to clean
the operator after each patient.
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Dental Triage Protocol
Our goal is to relieve pain and address the most urgent need(s). Please remember, this setting is very
different from your office where more options are available to you and the patient has regular access
to care.
Please practice universal precautions and follow all standard infection control practices.
1.
Only BLUE pens should be used on patient charts – NO BLACK INK. Please PRINT all
information and do not use abbreviations, they may not be universal to the wide variety of
volunteers.
2.
All patients go through Medical Triage. If blood pressure and glucose readings were not
acceptable upon first readings, the patient is re-tested. If they test at acceptable levels, they move
onto Dental Triage. If a patient test above the upper limits listed below, the Medical Triage Lead
consults with the Dental Triage Lead to make a final determination about the patient receiving
dental treatment. The patient either moves onto Dental Triage or is advised to seek medical
attention and is escorted to the Exit Interview (unless immediate medical attention is needed and
then EMT’s are called.)
Blood pressure cutoff: 160/100
Acceptable Blood Sugar: 80-200
3.
Patients are only offered one dental service (i.e., treatment in one quadrant; cleaning or fillings or
extractions) unless the capacity of the clinic allows for more. Let patients know it is unlikely that all
of their dental needs will be met but their immediate needs will be addressed.
4.
Dentists doing the initial screening should identify the areas of concern, not specific restorative
options. Only note the top two – three priorities in the “Dental Screening” box. Do not list all
teeth that need treatment.
5.
If the patient needs pre-medication antibiotics, indicate it on the form. When screening is complete,
have an escort take the form and patient to the Routing table. The Routing table will send a runner
to the medication area to retrieve the pre-meds. Patients will then go to x- ray or to a specific area
of the clinic for treatment.
6.
Print the screening doctor’s name in the screening notes box.
7.
Route patients needing x-rays to Radiology unless exempted according to radiology protocol.
Send patients who don’t need x-rays to Routing. Children should be sent to the Pediatrics area
for medical and dental triage and x-rays.
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8. Dentists working in x-ray triage should chart the exam by indicating the work that is
recommended to be done in the priority treatment sections on the patient form. Discuss the
recommended treatment with the patient and answer any questions. If a patient does not wish to
have a certain recommended treatment done, indicate “patient does not want” by the
recommended treatment.
9. Circle the tooth numbers within the priority that need attention first. Depending on the
number of patients, treatment will initially be limited to one quadrant so identify teeth
accordingly.
10. Check with the Routing Lead before recommending endo or lab services to ensure capacity has
not been reached for the day. Endo is only done on anterior teeth. Flippers are only to replace
up to 4 anterior teeth.
11. 3rd molars will only be extracted if symptomatic and visible on clinical examination.
12. Lab services are limited to anterior stay plates, denture and partial repair.
13. If a treatment partial is recommended, you do not need to list x-ray, lab and oral surgery
individual priorities; they should all be listed as one priority
14. Print the x-ray triage doctor’s name on the form.
15. If you receive a sharps injury (instrument or needle stick) or incur any other personal injury,
notify the department Lead immediately. He/she will follow the sharps or accident protocol.
16. EMTs are onsite to deal with patient and volunteer emergencies. If you have a patient
emergency, stay with the patient, send your assistant or someone near you to alert the
Department Lead who will immediately radio for EMT. Hold up the EMT station card so the
EMT can quickly identify where to go once they have been radioed.
17. Please stagger your breaks. Be sure to let the department head know how long you will be gone,
depending on the time someone else may use the chair while you are gone so patient flow isn’t
disrupted.
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Hygiene Department Protocol
Our goal is to relieve pain and address the most urgent need(s). Please remember, this setting is very
different from your office where more options are available to you and the patient has regular access to
care. Please do not promise patients additional services (i.e., fillings or extractions).
Please practice universal precautions and follow all standard infection control practices.
1. EMTs are onsite to deal with patient and volunteer emergencies. If you have a patient
emergency, stay with the patient, and your assistant or someone near you to alert the
department head who will immediately radio for an EMT. Hold up the EMT station card so
the EMT can quickly identify where to go once they have been radioed.
2. Recommended time per patient:
a. 30 minutes (child prophy, fluoride varnish, (Class I Adult prophy)
b. 40 minutes for full mouth debridement with cavitron (Class II, III, IV)
3. Topical is available. If your patient needs local anesthetic, contact your hygiene lead.
4. Use only BLUE ink to complete patient treatment form. Check the treatment services
rendered in designation hygiene box (child prophy, fluoride, adult prophy or full mouth
debridement, sealants)
5. A limited number of ultrasonic scalers are available – you may wish to bring you own. If you
do, please be sure to clearly label it with your name.
6. Print your full name on patient treatment form (no initials). Make sure patient form is complete
(you have indicated the treatment you provided) before patient leaves your chair and that the
patient escort takes their form with them to the exit interview.
7. Patients are not allowed to walk unattended on the clinic floor. Use your station cards for
moving patients or for problems.
a. Green – bring me a patient
b. Red – Escort
c. Yellow – translator needed
d. Orange – equipment concern
e. White w/Red Cross – EMT needed
8. You may utilize your own instruments or the cassettes provided.
a. Return all of the instruments that came out of a cassette back to that cassette. Close it.
b. Take all dirty instruments to the Hygiene Supply Table and place them in the plastic
container marked “used instruments.”
c. If using your own instruments, you are responsible for labeling your instruments, and
putting your name on a sterilization pouch.
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d. It takes approximately 45 minutes to turn instruments around in sterilization.
9. Remove all sharps from the instruments and dispose of them in the nearest sharps container.
Do not walk on the clinic floor with sharps.
10. Carpules with left over anesthetic should be disposed of in the designated biohazard
container at the head of your department.
11. Translators are available. Hold up your translator card and someone in a yellow shirt will be
directed to your chair.
12. If you receive a sharps injury (instrument or needle stick) or have any other personal injury, notify
the department lead immediately. He/she will follow the sharps or accident protocol.
13. Return any broken instruments to sterilization and inform the sterilization staff of the
broken instrument.
14. Patient escorts should take patients to the Exit Interview area when treatment is complete.
The escort should obtain the clipboard and patient record from the practitioner and take it, along
with the patient to the exit interview area.
15. Please stagger your lunch breaks. Be sure to let the department head know how long you will be
gone, depending on the time someone else may use the chair while you are gone so patient flow isn’t
disrupted.
In addition, the following must be adhered to throughout the event:
Do NOT allow patient to form a lip seal on the saliva ejector or large suction.
Before turning off the suction, remove it from the patient’s mouth, point it at the ceiling, then turn it off.
After each patient, obtain two (2) one-ounce cups of pre-mixed peroxide/water solution and pull one
cup through the ejector and one cup through the large suction.
After the patient is escorted away, don new gloves and use utility gloves over those to clean the
operatory after each patient.
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Incident Lead Protocol 1) Obtain clipboard with incident forms from Volunteer Registration area 2) Be available with radio communication at all times 3) If incident occurs-­‐go to area with EMT 4) Contact clinical lead, event director and/or event coordinator and inform of incident and location 5) Fill out form as indicated 6) Review all form filled out with clinical lead and event coordinator and/or director at end of day 7) All forms to go to Data Entry in incident file 11 Page 12 of 44
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Infection Control Protocol
Please practice universal precautions and follow all standard infection control practices including,
but not limited to:
1. Medical exam gloves shall be worn whenever there is a potential for contact with mucous
membranes, blood or other potentially infections materials. Gloves must be discarded upon
completion of treatment and before leaving laboratories or areas of patient care activities.
Clinical volunteers shall perform hand hygiene procedures after removing and discarding
gloves. Gloves shall not be washed before or after use.
2. Clinical volunteers shall wash contaminated or visibly soiled hands with soap and water and put
on new gloves before treating each patient. If hands are not visibly soiled or contaminated an
alcohol based hand rub may be used as an alternative to soap and water.
3. All clinical volunteers shall wear surgical facemasks in combination with either chin length
plastic face shields or protective eyewear whenever there is potential for aerosol spray, splashing
or spattering of the following: droplet nuclei, blood, chemical or germicidal agents. Chemicalresistant utility gloves and appropriate, task specific personal protective equipment (PPE) shall
be worn when handling hazardous chemicals. After each patient treatment, masks shall be
changed and disposed. After each patient treatment, face shields and protective eyewear shall be
cleaned, disinfected, or disposed.
4. Clinical volunteers shall wear reusable or disposable protective attire when their clothing or skin is
likely to be soiled with blood. Gowns must be changed daily or between patients or when they
come moist or visibly soiled. Protective attire must be removed when leaving laboratories or
areas of patient care activities.
5. Sterilize all instruments (including handpieces) between patients and thoroughly wipe down
equipment and surfaces between patients.
6. If non-critical items or surfaces likely to be contaminated are manufactured in a manner
preventing clean and disinfection, they shall be protected with disposable impervious barriers.
Disposable barriers shall be changed when visibly soiled or damaged and between patients.
7. Place only bio hazardous waste (fully blood soaked gauze, teeth, etc.) in the red bag. No
general trash in these please!
8. Please place extracted teeth that contain amalgam fillings in the nearest container labeled DENTAL
AMALGAM. This waste will be recycled and/or disposed of according to state and local
regulations.
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9. Place extra amalgam and amalgam capsules in the nearest container labeled DENTAL
AMALGAM.
10. Dispose of carpules with left over anesthetic in the designated biohazard container at the head of
your department (plastic container with biohazard label). Do not throw them in the regular trash.
11. Dispose of sharps in the nearest sharps container to your station. Do not walk the clinic floor
with sharps on a tray.
12. If you receive a sharps injury (instrument or needle stick) or incur any other personal injury, notify
the Department Lead immediately. He/she will follow the sharps or accident protocol.
In addition, the following must be adhered to throughout the event:
1. Do NOT allow patient to form a lip seal on the saliva ejector or large suction.
2. Before turning off the suction, remove it from the patient’s mouth, point it at the ceiling, then turn
it off.
3. After each patient, obtain two (2) one-ounce cups of pre-mixed peroxide/water solution and pull
one cup through the saliva ejector and one cup through the large suction.
4. After the patient is escorted away, don new gloves and use utility gloves over those to clean the
operatory after each patient.
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Interpreter Protocol
Our goal of this clinic is to relieve pain and address the most urgent dental need(s).
1. Any information you see on the patient registration form or information the patient tells you about
their care needs to be kept private. Please do not discuss it with anyone.
2. Interpreters are needed throughout the clinic. Your Lead will go over the clinic layout with you
and explain the patient flow. You will be given direction about where to stand or sit etc.
3. If/when you are needed to help a patient, a yellow card will be held up. Please go to the person
holding the card and assist the patient.
4. In most cases, you will not stay with one patient throughout the clinic. You will help that person
and then be dismissed to help another patient.
5. Interpreters will serve in various areas of the clinic – sometimes remaining at a particular post
and sometimes moving around to see where you are needed.
6. Please do not promise patients any particular treatment. Ask someone in an orange shirt if you
are unsure what to tell a patient.
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Lab Protocol
Please practice universal precautions and follow all standard infection control practices.
1. Treatment partials are limited to anterior teeth a.
Limited to 6 anterior or less
b. Need sufficient inter-occlusal space to accommodate the treatment partial\
c. Lab Lead will inform the triage lead when they can’t accept any more lab cases
d When needed, the triage lead can request a consult with the Lab Lead on complex cases
e. ALL PATIENTS NEEDED TREATMENT PARTIALS WILL BE ROUTED TO THE
LAB AREA FOR IMPRESSIONS AFTER THEY HAVE HAD THEIR
PANOREX TAKEN AND PRIOR TO GONG TO THE ORAL SURGERY
NUMBING AREA
2. Other lab services (denture repairs, addition of teeth, etc.)
a. Other lab services will be evaluated on a case by case basis – those that we can treat will be
routed to the lab area.
b. When needed, the triage lead or routing lead can requires a consult with the lab led on
individual cases.
3. New patients will be accepted in the lab up until noon on Saturday or until 75 lab orders have
been placed – whichever comes FIRST.
4. At the time of impression, the patient’s record should have the type of partial indicated on it in the
treatment area.
5. The patient should be escorted to the appropriate department waiting area (restorative or oral
surgery) if they have work to be done or to the exit interview area if the dental work has been
completed.
6. Patients will be given a lab slip with a set time to return to the clinic to pick up their
prosthesis.
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MEDICAL TRIAGE PROTOCOL
Please practice universal precautions and follow all standard
infection control practices.
1. EMTs are onsite to deal with patient and volunteer emergencies. If you have a patient emergency, stay
with the patient, send your assistant or someone near you to alert the department head who will
immediately radio for an EMT. Hold up the EMT station card so the EMT can quickly identify where
to go once they have been radioed.
2. If you receive a sharps injury (instrument or needle stick) or incur any other personal injury, notify the
department lead immediately. He/she will follow the sharps or accident protocol.
3. Only BLUE pens should be used on patient charts – NO BLACK ink.
4. Please PRINT on the patient charts – do not use abbreviations. Be sure to PRINT (not sign) your
name to the patient record after providing care.
5. Review health history and medications.
6. Take blood pressure and pulse and record findings.
7. Take glucose levels, if appropriate.
8. If blood pressure and glucose readings are not in our acceptable range, the patient may be re-tested.
If they test at acceptable levels, they can be treated if the maximum number of patients of the day has
not been reached. If a patient tests slightly above these upper limits, consult the Medical Triage Lead.
Blood pressure cutoff: 160/100
Acceptable Blood sugar: 80-200
9. If the patient fails medical and we can’t get them into an acceptable range on Day 1 of the event, we
will give them a color coded wrist band to come back the next day at a designated time. Same is true
if they are allowed to go home and take their meds and come back the same day in time to receive
care, we will give them a wristband that gets them back in the side door. Any other person who fails
and we can’t get back in (those patients on the afternoon of Day 2 for example) IndianaMOM will
work with the local dental society to find a dentist willing to treat the person’s #1 priority. Please
make sure their chart reflects the fact they failed medical and the “needs follow-up” box is marked, we
can set aside these records for follow-up by the Foundation. The Lead dentist should take a quick
look in the persons mouth and talk to them about their # dental need (and note it on their chart) so
the Foundation has an idea of what we would be asking a local dentist to treat.
10. Accepted patients should be taken by a patient escort to the dental triage waiting area.
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11. Patients not passing the medical minimums should be escorted to the exit area (they will receive a
take home bag, completed an exit survey, etc.). The patient record should be marked non-treated
with the reason why listed. Turn in the patient form at the exit interview area.
12. Please stagger your lunch breaks. While you are on break, another provider may move into your chair
so patient flow isn’t disrupted.
MEDICAL CONDIDTIONS TO CONSIDER BEFORE TREATMENT
1. Patients on ASA or Plavix can receive extractions.
2. Patients that have been off Coumadin/anticoagulants for 3 days prior to treatment may receive
extractions or other surgical procedures.
3. Patients not off of Coumadin/anticoagulants must show their current INR card during the medical
screening process. If the card is more than 3 days old complete an INR test.
4. Bisphosphonates (Aredia & Zometa):
5. Routine dental care may be provided.
6. Local anesthesia can be used as necessary
7. Scaling and prophylaxis as atraumatically as possible with gentle soft tissue management.
8. Avoid dental extractions if possible unless Class 3 mobility.
9. Blood pressure cutoff: 160/100
10. Acceptable Blood sugar: 80-200
11. Pregnancy: provide treatment as needed. Do not use nonsteroidal anti-inflammatory drugs
(NSAIDs), erythromycin estolate or tetracycline.
12. Heart stents – no treatment until 3 months post-op – no pre-med.
13. Heart surgery – no treatment until 6 months post op – pre-med case by case.
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Needle Stick/Sharps Injury Protocol
If you are cut, stuck or scratched by a contaminated sharp instrument or a needle, please
follow these guidelines:
1. Clean the wound immediately with soap and water.
2. Advise the Department Lead of the incident, they in turn will notify the Clinic Director.
3. If you know which patient the instrument was used on, ask the patient to please remain with you
until it can be determined if there is need to have the patient tested.
4. The Clinic Director or Assistant Clinic Director will go over criteria with you to determine if there
is a need for you and the patient to be tested.
5. All incidents must be reported to the Department Lead at the time they occur.
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Numbing Protocol
Please practice universal precautions and follow all standard infection control practices.
The purpose of numbing areas is to ready patients for restorative care or oral surgery in an effort to
maximize the number of patients the clinic is able to treat.
1. EMTs are onsite to deal with patient and volunteer emergencies. If you have a patient
emergency, stay with the patient, send your assistant or someone near you to alert the
department head who will immediately radio for an EMT. Hold up the EMT station card so
the EMT can quickly identify where to go once they have been radioed.
2. If you receive a sharps injury (instrument or needle stick) or incur any other personal injury, notify
the department lead immediately. He/she will follow the sharps or accident protocol.
3. Only BLUE pens should be used on patient charts – NO BLACK ink.
4. Please PRINT on the patient charts – DO NOT USE ABBREVIATIONS. Be sure to
PRINT (not sign) your name to the patient record after providing care.
5. Review health history and medications.
6. The treatment to be done will be circled in RED pen. Anesthetize accordingly.
The following anesthetic agents are available (unless supplies run out). Choose your anesthetic
agents based on your best clinical judgment for the procedures to be done.
a)
b)
c)
d)
Lidocaine 2% epi 1:100,000
Articaine 4% epi 1:100,000
Mepivicaine 3% no epi
Bupivicaine 0.5% epi 1:200,000
7. We do NOT recommend use of Articaine for mandibular blocks although supplemental
infiltrations buccal and lingual are fine.
8. Multiple extractions are best served by Bupivicaine because of the duration issue.
9. We suggest the use of block (PSA, MSA, IO) anesthesia administration rather than multiple
infiltrations for multiple maxillary teeth to help minimize the amount of anesthetic used. This will
also help make the addition of more anesthetic less of an issue if anesthesia wears off due to
delays before treatment begins.
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10. There is a chart in the numbing station with the manufacturer’s maximum recommended
dosages by anesthetic and weight for your reference.
11. Please print the amount, type and location(s) of anesthesia administered and PRINT the provider
name on the patient’s record. All patients should have their record verified before being taken to
the clinic waiting area for their respective department.
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Oral Surgery Protocol
Please practice universal precautions and follow all standard infection control practices.
Our goal is relieve pain and address the most urgent need(s). Please remember this setting is very different
from your office where more options are available to you and the patient has regular access to care. This
fact was kept in mind as patients went through triage and routing and when it was determined what care
they would receive today. Refer to the priority section of the patient form to find out what treatment and
which teeth will be treated today. Please do not offer patients
additional treatments in another area of the clinic (i.e., fillings or cleanings.).
1. The patient will be anesthetized before arriving in your chair (with the exception of the first
round of patients each day). Ensure that they are (still) numb before proceeding. Apply
additional anesthetic if needed.
2. Printed radiographs will arrive with the patient. Review recommended treatment plan and x- rays.
3. Teeth to be extracted include:
a. Visible non-restorable teeth
b. Painful or infected teeth that do not fit IndianaMOM protocol for endodontic treatment
c. Teeth, in addition to a and b above, that would complicate prosthetics fabrication if left in
place
d. Minor pre-prosthetic surgical procedures (alveoloplasty, exostosis) in patients treated for a,
b, or c above in order to simplify later prosthetic rehab.
e. 3rd molars only if symptomatic and visible on clinical examinations
4. EMTs are onsite to deal with patient and volunteer emergencies. Oxygen and an AED are
available. If you have a patient emergency, stay with the patient, send your assistant or someone
near you to alert the department lead who will immediately radio for an EMT. Hold up the EMT
station card so the EMT can quickly identify where to go once they have been radioed.
5. Please PRINT on the patient charts – DO NOT USE ABBREVIATIONS.
6. Only BLUE pens should be used on patient charts – NO BLACK ink.
7. Patients are not allowed to walk unattended on the clinic floor. Use your station cards for
moving patients or for problems.
a. Green – bring me a patient
b. Red – Escort
c. Yellow – translator needed
d. Orange – equipment concern
e. White w/Red Cross – EMT needed
f. BLUE – request Nomad x-ray
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8. When you are done treating the patient, record the treatment provided. Raise a red card to indicate
the patient is finished. A Patient Escort will obtain the clipboard and patient record from the
practitioner and take the patient to the exit interview when treatment is complete.
9. Translators are available. Raise a yellow card if a translator is needed.
10. Please place extracted teeth that contain amalgam fillings in the nearest container labeled DENTAL
AMALGAM. The container is located on the head table in the Oral Surgery area. This waste will be
recycled and/or disposed of according to state and local regulations.
11. Dispose of carpules with left over anesthetic in the designated biohazard container or the head of your
department (plastic container with biohazard label). Do not throw them in the regular trash.
12. Remove all sharps from the instruments and all burs from handpieces and dispose of them in the
nearest sharps container. Do not walk on the clinic floor with sharps.
13. If you receive a sharps injury (instrument or needle stick) or incur any other personal injury, notify the
Department Lead immediately. He/she will follow the sharps or accident protocol.
14. Prescription forms will not be needed for Acetaminophen, Amoxicillin, Clindamycin, Ibuprofen.
Those will be indicated on the patient registration form and the patient will receive those free of
charge onsite. Any other prescription will be at the patient’s expense.
15. Please stagger your lunch breaks. Be sure to let the Department Lead know how long you will be
gone, depending on the time someone else may use the chair while you are gone to patient flow isn’t
disrupted.
Sterilization and Instruments
1. Remove all sharps from the instruments and all burs from handpieces and dispose of them in the
nearest sharps container. Do not walk on the clinic floor with sharps.
2. You are responsible for making sure that your personal instruments are identified as yours when they
go through sterilization. To ensure this, drop your instruments off at the sterilization table marked
“Used Personal Instruments” and have your name written on the sterilization pouch(es), then leave
the pouch(es) on the tray with the instruments. You will pick up sterilized instruments from the
“Clean Personal Instruments” station.
3. If you are using ADCF instruments, place all instruments that come out of a cassette tray back in the
cassette and place them in the plastic container at the head of your department for pick-up.
4. Broken ADCF instruments should be returned to sterilization, do NOT throw them away. Notify
someone in sterilization that the instrument is broken.
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In addition, the following must be adhered to throughout the event:
1. Do NOT allow patient to form a lip seal on the saliva ejector or large suction.
2. Before turning off the suction, remove it from the patient’s mouth, point it at the ceiling, then turn it
off.
3. After each patient, obtain two (2) one-ounce cups of pre-mixed peroxide/water solution and pull one
cup through the saliva ejector and one cup through the large suction.
4. After the patient is escorted away, don new gloves and use utility gloves over those to clean
the operatory after each patient.
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EARLY REGISTRATION PATIENT GUIDELINES
Thursday at approximately 4:00 p.m., colored/numbered wristbands will be given out to the first
100 patients in line.
•
Patients will be sent to agricultural building to registration area and bands will be verified at the door.
•
Paperwork completed in registration area, name tag attached to paperwork and given to patient
to take through triage.
•
Patients escorted to dental triage.
•
Patients escorted to x-ray.
•
Patients escorted to routing.
•
Patients escorted to exit and all paperwork collected at registration desk located in this area and filed
numerically.
•
Patient informed to return to the rear entrance on Friday morning at
5:30
Stress that if not in line at assigned time they will have to return to the end of other line!
•
Friday morning at 5:30 a.m. door security will have patients form a line outside the back
entrance and check wristbands to verify correct time, 1-75 only and correct color.
•
Patients will line up in the order they arrive.
•
At appointed time security will send in first 50 patients.
•
Patients will stop at the registration table and get their paperwork and put on name tag and be
seated.
•
Patients will be escorted in number order – 10 per escort.
•
Repeat procedure for next 50 patients.
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Saturday Returning Patients
On Friday returning patients will be instructed to return to the back entrance on Saturday morning
at 5:30 a.m. Stress that if not at the door at this time they will lose their appointment and
will go to the end of the other line.
•
Patient will be escorted to exit interview.
• Patient will be given return slip with appointed return time and be instructed to return to the back
entrance.
•
Saturday the door security at entrance will check patients in with return slips and they will be
seated in back registration area.
• Paperwork will be pulled and given to patient with new name tag.
• Patients will be escorted to correct treatment area as indicated on return slip.
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Patient Education Protocol
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Please remember that all patient information is confidential!
Once a group has completed their paper work in Patient Registration, they will be escorted to
Patient Education in groups of approximately 16-20.
The patients will be welcomed and asked if there is a need for an interpreter.
The speaker will introduce themselves and any other volunteers.
The patients will be told what to expect as they begin their dental trek into the coliseum. (Triage,
treatment, exit etc.) A hand-out, if available, would give visual reminders to patients.
Patients can be shown either a very short DVD on good dental hygiene practices (brushing and
flossing) or a demonstration using a visual aide or typodontic for patients to experience first-hand
proper dental care procedures.
Once the volunteers have fielded any questions or concerns, the patients will be escorted to Medical
Triage.
Once the chairs are empty in Patient Education, a new group will be escorted into the area from
Patient Registration.
As the volunteer shift is ending, volunteers may be asked to fill out a short survey of their
experience, adding suggestions on ways to improve Patient Education practices.
For any additional questions, please seek the help of a Lead Volunteer.
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PATIENT ESCORT PROTOCOL
Our goal of this clinic is to relieve pain and address the
most urgent dental need(s).
1. Any information you see on the patient registration form or information the patient tells you about
their care needs to be kept private. Please do not discuss it with anyone.
2. Patient escorts are needed throughout the clinic. Your Lead will go over the clinic layout and explain
the patient flow. You will be given direction about where to stand and what to do.
3. Patients are escorted at all times unless they are sitting in a chair waiting for or receiving treatment.
4. When a patient is ready to go from one areas of the clinic to the next, you will be asked to take the
patient. Carry the clipboard with their registration form and take them to their destination. When you
arrive at the destination, stay with the patient until another volunteer directs the patient to sit down
and/or takes the chart from you.
5. After you deliver the patient to his/her destination, go back to the area to which you are assigned
and wait for the next patient.
6. Patients will be escorted to the restroom, but you do not need to go into the restroom with them;
wait outside and then take the patient to their destination.
7. If you see a patient walking around without an escort, please ask if you can help them and find out
where they are going. Accompany the patient to their destination.
8. Please do not promise patients any particular treatment. Ask someone in an orange shirt if you are
unsure what to tell a patient when asked.
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Exit Interview Protocol
1. The goal of the clinic is to relieve pain and eliminate infection. Patients are only offered one dental
service (i.e. treatment in one quadrant; cleaning or fillings or extractions) unless the capacity of the
clinic allows for more. In most cases, patients are unlikely to get all of their dental needs met. Please
do not comment or give your opinion on the care the patient received, or the care a different patient
received (i.e., I can’t believe you didn’t get all of your fillings done).
2. Prior to patient survey, verify the patient record is complete (treatment done indicated on chart) and
the treating dentist(s) have signed the form.
3. Remove the patient’s wristband.
4. Check for prescriptions.
a. If the dentist has indicated a need for medication, ensure the patient has received it prior to
the exit interview.
5. Check if the patient plans to come back the following day.
a. If we have not cut off accepting new patients and the patient needs additional work, ask the
patient if they would like to get in line again (if it is Day 1, they could come back on Day 2).
b. Patient will fill out a re-entry form. The top half goes to the patient, the bottom gets stapled to
patient registration, filed in a re-entry file and filed with registration, Instruct patient to get
back in line.
6. Collect the patient record and put into collection box for data entry pick up.
a. X-rays and the patient privacy notice should be stapled to the original patient record. b.
Original patient records are property of IndianaMOM. A patient should never walk out
with the original, only copies.
8. Hand patient a “Goody Bag”.
9. Ensure patients received post-op instructions and know about the number they can call if they have
any problems with the care they received for 2 weeks following the clinic.
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10. Let the patient know there is a list of community dental providers they can call to schedule additional
dental care (for a cost) if needed.
11. Conduct patient survey.
a. Some patients may not be able to read or write. Be patient and guide them through with
respect and understanding.
b. Be mindful some patients cannot speak because of the work they had done. Ask them to
give you thumbs up when you read the answer they wish to give.
c. If the patient is a repeat patient (they will have a color paper copy of the patient form)
they do not need to complete another survey.
12. If patient has completed all requirements, have an escort take the patient to either:
a. The clinic exit or
b. The family waiting area
13. If you come into contact with any blood or saliva from a patient, wash your hands immediately. If a
patient leaves blood or saliva on the table, chair, etc., please, wash your hands, put on gloves and
dispose of the contaminated item. Use a disinfecting wipe to clean the area. Remove gloves and wash
your hands.
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Pediatric Protocol
Our goal is to relive pain and address the most urgent need(s). Please remember this setting is very
different from your office where more options are available to you and the patient has regular access
to care. This fact was kept in mind as patients went through triage and routing and when it was determined
what care they would receive today. Refer to the priority section of the patient form to find out what
treatment and which teeth will be treated today.
Please practice universal precautions and follow all standard infection control practice.
1. EMTs are onsite to deal with patient and volunteer emergencies. If you have a patient
emergency, stay with the patient, send your assistant to someone near you to alert the
department head who will immediately radio for an EMT. Hold up the EMT station card so
the EMT can quickly identify where to go once they have been radioed.
2. Only BLUE pens should be used on patient charts – NO BLACK ink.
3. Please PRINT on the patient charts – DO NOT USE ABBREVIATIONS.
4. A pediatric patient is defined as a child 12 years of age or younger.
a. If there is a back up of adolescent patients waiting in the Restorative area and the pediatric
department is in need of additional patients, patients up to 18 years of age may be sent to the
pediatric department.
5. The Pediatric Department will review medical and dental history and develop a treatment plan.
6. Nomad x-rays are available. Please request x-rays on an as-needed-basis.
7. Please triage treatment into work that can be completed with a 45-minute time space – e.g.,
Quadrant Dentistry.
8. Patients are not allowed to walk unattended on the clinic floor. Use your station cards for
moving patients or for problems.
a. Green – bring me a patient
b. Red – Escort needed
c. Yellow – translator needed
d. Orange – equipment concern
e. White w/Red Cross – EMT needed f.
Blue – request Nomad x-ray
9. Amalgam restorations are recommended – especially in posterior teeth. Not only is it quicker to
put in an amalgam than a composite, but in the majority of cases, it will serve the patient longer.
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You can, however, place composites; limited colors of composite material will be available. There
are approximately 20 curing lights available for the entire clinic.
10. Please place extracted teeth that contain amalgam fillings in the nearest container labeled DENTAL
AMALGAM. This waste will be recycled and/or disposed of according to state and local
regulations.
11. Place extra amalgam and amalgam capsules in the nearest container labeled DENTAL
AMALGAM.
12. STAINLESS STEEL CROWNS will not be provided. If you wish to place these types of
crowns you are encouraged to bring your own materials.
13. Dispose of carpules with left over anesthetic in the designated biohazard container at the head of
your department (plastic container with biohazard label). Do not throw them in the
regular trash.
14. Remove all sharps from the instruments and dispose of them in the nearest sharps container.
Do not walk on the clinic floor with sharps.
15. Translators are available. Raise a yellow card if a translator is needed.
16. If you receive a sharps injury (instrument or needle stick) or incur any other personal injury, notify
the department lead immediately. He/she will follow the sharps or accident protocol.
17. Prescription forms will not be needed for Acetaminophen, Amoxicillin, Clindamycin, or Ibuprofen.
Those will be indicated on the patient registration form and the patient will receive those free of
charge onsite.
18. Please stagger your lunch breaks. While you are on break, another dentist may move to your chair
so patient flow isn’t disrupted.
Sterilization and Instruments
1. Remove all sharps from the instruments and dispose of them in the nearest sharps container.
Do not walk on the clinic floor with sharps.
2. You are responsible for making sure that your personal instruments are identified on yours when
they go through sterilization. To ensure this, drop your instruments off at the sterilization table
marked “Dirty Personal Instruments” and have your name written on the sterilization pouch(es),
then leave the pouch(es) on the tray with the instruments. You will pick up sterilized instruments
at the “Clean Personal Instruments” station.
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3. If you are using ADCF instruments, please return all instruments to the cassette from which they
came and close the lid. Place the cassette and any loose instruments in the plastic bin at the head
of your department.
4. Broken ADCF instruments should be returned to sterilization, do NOT throw them away. Notify
someone in sterilization the instrument is broken.
In addition, the following must be adhered to throughout the event:
1. Do NOT allow patient to form a lip seal on the saliva ejector or large suction.
2. Before turning off the suction, remove it from the patient’s mouth, point I at the ceiling, then turn
it off.
3. After each patient, obtain two (2) one-once cups of pre-mixed peroxide/water solution and pull one
cup through the saliva ejector and one cup through the large suction.
4. After the patient is escorted away, don new gloves and use utility gloves over those to clean the
operator after each patient.
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Pharmacy Protocol
Please practice universal precautions and follow all standard infection control practices.
Our goal is to relieve pain and address the most urgent need(s).
EMTs are onsite to deal with patient and volunteer emergencies. If you have a patient emergency, stay
with the patient, send your assistant or someone near you to alert the department head who will
immediately radio for an EMT.
Translators are available. They are in yellow shirts and are readily available. Please
PRINT on the patient charts – DO NOT USE ABBREVIATIONS.
Review the patient health history. If antibiotics or OTC meds are needed, it will be noted in the lower
right corner of the patient registration form.
Write the patients name on the prescription and stick the label to the appropriate coin envelope of
medication.
Review the instructions with the patient.
Record the patients name and the medication they received on the Medication log.
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WAITING AREA DEPARTURE PROTOCOL
1. Any departures from the waiting area (restrooms, phone call, beverage, check on a family member)
should have the exit time noted on the tracking sheet next to their routing number and the patient
should be told they must be back within 15 minutes.
2. Patient may NOT go onto the clinic floor without an escort. Preferably, they wouldn’t go anywhere
without a patient escort. If you feel it is appropriate or if you are concerned about why the patient is
leaving, send an escort with them.
SMOKING IS NOT ALLOWED ON THE STATE FAIR GROUND PREMISES
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Restorative Protocol
Our goal is to relieve pain and address the most urgent need(s). Please remember, this setting is very
different from your office where more options are available to you and the patient has regular access to
care. This fact was kept in mind as patients went through triage and routing and when it was determined
what care they would receive today. Refer to the priority section of the patient form to find out what
treatment and which teeth will be treated today.
Please practice universal precautions and follow all standard infection control practices.
1. Patients are only offered one dental service (i.e., treatment in one quadrant; cleaning, fillings or
extractions) unless the capacity of the clinic allows for more. Please do not promise patients more.
2. Composite guns and curing lights must be shared. Please wipe them down when you are done
and place them back on the table where they can be reached by other teams.
3. When picking up instruments and supplies, pick up ONLY what you need for the patient you
are working on at that time. Return unused instruments and supplies as soon as possible so the
next person can have instruments and supplies they need.
4. The patient will be anesthetized before arriving in your chair (the exception is the first patients of
each day). Ensure that they are (still) numb before proceeding. Apply additional anesthetic if
needed.
5. Printed radiographs will arrive with the patient. Review recommended treatment plan and x- rays.
6. EMTs are onsite to deal with patient and volunteer emergencies. If you have a patient
emergency, stay with the patient, send your assistant or someone near you to alert the
Department Lead who will immediately radio for an EMT. Hold up the EMT station card so
the EMT can quickly identify where to go once they have been radioed.
7. Please PRINT on the patient charts – DO NOT USE ABBREVIATIONS.
8. Only BLUE pens should be used on patient charts – NO BLACK ink.
9. Patients are not allowed to walk unattended on the clinic floor. Use your station cards for
moving patients or for problems.
a. Green – bring me a patient
b. Red – Escort needed
c. Yellow – translator needed
d. Orange – equipment concern
e. White w/Red Cross – EMT needed f.
BLUE – request Nomad x-ray
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10. We are working to improve the dental situation of these patients. If you get an exposure on a
posterior tooth, the tooth should be extracted. We do not want to place a pulp cap and risk
having the tooth flare up in the future. These patients will not be able to afford the treatment to
fix that situation. Therefore, no posterior root canals are done. If triage has noted a posterior
tooth is a possible endo, that tooth should be extracted or left alone. Endodontic procedures on
anterior teeth can be done, as well as critical posterior abutments (if the condition of the teeth is
favorable). Endodontic procedures are limited based on the number of dentists providing
endodontic treatment.
11. If your patient needs an extraction and you are not comfortable doing it, the Restorative
Department Lead can get the patient into the Oral Surgery Department or utilize a revolving
surgeon to have the tooth extracted.
12. PULPCAPS and 4+ surfaces are not a practical service to provide at this IndianaMOM event. If
triage has noted a posterior tooth is a possible endo, that tooth should be extracted or left alone.
13. Amalgam restorations are recommended – especially in posterior teeth. Not only is it quicker
to put in amalgam than a composite, but in the majority of cases it will serve the patient
longer. You can, however, place composites; limited colors of composite material will be
available. There are approximately 20 curing lights available for the entire clinic.
14. Please place extracted teeth that contain amalgam fillings in the nearest container labeled DENTAL
AMALGAM. The container is located on the head table in the Restorative area. This waste will be
recycled and/or disposed of according to state and local regulations.
15. Place extra amalgam and amalgam capsules in the nearest container labeled DENTAL
AMALGAM. The container is located on the head table in the Restorative area.
16. Dispose of carpules with left over anesthetic in the designated biohazard container at the head of
your department (plastic container with biohazard label). Do not throw them in the regular trash.
17. Remove all sharps from the instruments and all burs from handpieces and dispose of them in the
nearest sharps container. Do not walk on the clinic floor with sharps.
18. When treatment is complete, fill out the chart indicating the treatment you provided in blue ink.
19. Over the counter medications are available by checking the appropriate box on the lower left
corner of the registration form. Prescribe these medications only when necessary instead of
routinely.
20. Discuss post op instructions with each patient and hand them a post-op instruction sheet.
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Let the patient know about the 800 number they can call should they have any problems with
the care they received at the clinic. The phone line is open for 2 weeks following the clinic.
21. Hold up a red card to indicate the patient’s treatment is complete. A patient escort will take the
clipboard and patient record from the practitioner and take the patient to the exit interview area
when treatment is complete.
22. Translators are available. Hold up a yellow card and a translator will come to your chair.
23. If you receive a sharps injury (instrument or needle stick) or incur any other personal injury, notify
the Department Lead immediately. He/she will follow the sharps or accident protocol.
24. Prescription forms will not be needed for Acetaminophen, Amoxicillin, Clindamycin,
Ibuprofen. Those will be indicated on the patient registration form and the patient will
receive those free of charge onsite. Any other prescription will be at the patient’s expense.
25. Please stagger your lunch breaks. Be sure to let the department head know how long you will be
gone, depending on the time someone else may use the chair while you are gone so patient flow
isn’t disrupted.
Sterilization and Instruments
1. Remove all sharps from the instruments and all burs from handpieces and dispose of them in the
nearest sharps container. Do not walk on the clinic floor with sharps.
2. You are responsible for making sure that your personal instruments are identified as yours when
they go through sterilization. To ensure this, drop your instruments off at the sterilization table
marked “Used Personal Instruments” and have your name written on the sterilization pouch(es),
then leave the pouch(es) on the tray with the instruments. You will pick up sterilized instruments
from the “Clean Personal Instruments” station.
3. If you are using ADCF instruments, place all instruments that came out of a cassette back in the
cassette and close it. Place the cassettes and any loose instruments that don’t belong in a cassette in
the plastic container at the head of your department. They will be transported to the sterilization
area.
4. Syringes should be set aside for sterilization in the Numbing area in the Statim.
5. Broken ADCF instruments should be returned to sterilization, do NOT throw them away. Notify
someone in sterilization that the instrument is broken.
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In addition, the following must be adhered to throughout the event:
1. Do NOT allow patient to form a lip seal on the saliva ejector or large suction.
2. Before turning off the suction, remove it from the patient’s mouth, point it at the ceiling, then turn
it off.
3. After each patient, obtain two (2) one-ounce cups of pre-mixed peroxide/water solution and pull
one cup through the saliva ejector and one cup through the large suction.
4. After the patient is escorted away, don new gloves and use utility gloves over those to clean the
operatory after each patient.
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Routing Protocol
Please practice universal precautions and follow all standard infection control practices.
Our goal is to relieve pain and address the most urgent need(s). Please remember, this setting is very
different from your office where more options are available to you and the patient has regular access to
care. This fact was kept in mind as patients went through triage. Refer to the priority section of the
patient form to find out what treatment and which teeth will be treated.
1. EMTs are onsite to deal with patient and volunteer emergencies. If you have a patient
emergency, stay with the patient, send your assistant or someone near you to alert the
department head who will immediately radio for an EMT. Hold up the EMT station card so
the EMT can quickly identify where to go once they have been radioed.
2. Translators are available.
3. Please PRINT on the patient charts – DO NOT USE ABBREVIATIONS.
4. Only RED pens should be used on patient charts in Routing – NO BLACK ink. In the priority
section of the form, circle the work to be done using the RED pen and indicate the Routing
number on the patient record.
5. Treatment will be provided in priority order, one service per patient.
6. Anyone wanting a second dental service must go to the end of the line after receiving their first
service. When they reach medical and dental triage they can skip those stations.
7. Anyone needing partials must be triaged and routed, first to x-ray (if that is deemed
necessary) and then to the lab for impressions BEFORE going to oral surgery.
8. Check their medical history. If patient requires antibiotic premedication for indicated treatment,
send a runner to the medication area to retrieve the pre-meds and administer the pre-med at
routing.
9. Read x-rays, if available, and consult with patient regarding dental priority and patient priority.
Make sure the patient understands the treatment they are being provided before sending
them to the appropriate waiting area. Remind the patient they are only receiving one service.
After an hour or two goes by, try and find out how many patients are seen per hour by each department. To
find the number seen by each department per hour check how many patients were sent by clipboard
volunteers to each department (not how many are waiting), and then go to each department to find out how
many have been seen by each department. Then divide by the number of hours to find out how many
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people are being seen each hour in each department. Then find out from a clipboard volunteer how many
people are waiting for each department and determine the cut-off for the day for each department. Reevaluate the numbers throughout the day to ensure accuracy
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STERILIZATION PROTOCOL FOR INSTRUMENT PROCESSING
Please practice universal precautions and follow all standard infection control practices.
Begin instrument processing by cleaning your hands and donning personal protective equipment – Fluid
resistant body protection, protective eyewear, mask, and heavy duty nitrile gloves.
WHILE AT THE TREATMENT CHAIR
1. Place all contaminated sharps into the sharps container closest to the point of use. Never carry
contaminated sharps by hand and Do not walk the clinic floor with sharps.
2. Place biohazard waste into biohazard container or bag. Red Bag waste bags should be sealed and will
be disposed of in designated 5-gallon Red Bag Waste Containers.
3. Throw empty carpules without anesthetic in the regular garbage. Carpules with visible blood should
be disposed of in biohazard sharps containers.
4. Place carpules with left over anesthetic into the designated plastic container labeled “For Incineration
Only” located near the biohazard sharps container.
5. Place amalgam capsules, scrap amalgam, and extracted teeth containing amalgam into the designated
plastic containers for amalgam waste.
6. Place any crowns that were removed into the designated container for Crowns for Kids.
7. Wipe any debris from used instruments using gauze, and place instruments back into cassette and
close cassette. Place any hinged instrument into cassette in the “open position.”
8. Carefully transport the tray to the bio hazard contaminated instrument collection area
designated in each of treatment areas.
9. Transfer the cassette and all remaining used items into the plastic container designated for
contaminated instruments located in each of the treatment areas.
10. Remove your gloves. Use hand sanitizer.
TRANSPORTING CONTAMINATED INSTRUMENTS TO STERILIZATION AREA
1.
2.
3.
4.
5.
Use a hand sanitizer and then don heavy duty gloves.
Place the lid to the plastic transporting container on securely.
Walk the container with the used instruments to the “Used ADCF Instruments” area.
Remove the lid.
Sterilizing volunteers will remove the instruments from the container. These volunteers will be
wearing utility gloves.
6. Place the lid back on the contaminated instrument container return the container to the area of the
clinic from which it came (restorative, hygiene, numbing, oral surgery or pediatrics). Open the
container so that instruments can be easily placed inside until container is ready to be transported
again.
PERSONAL INSTRUMENTS
1. Use the same protocol as above to transport personal instruments to the sterilization area.
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2. Take personal instruments to the area in sterilization designated for personal used
instruments.
3. Write your name on the outside of a sterilization pouch.
4. If special handling of your instruments is required, instruct the sterilization volunteer on the process
each time you bring the instruments to sterilization.
5. Allow 45 minutes for your instruments to be processed.
6. Pick up clean personal instrument from the designated area in sterilization.
CLEANING USED INSTRUMENTS
1. Clean hands with alcohol hand rub and don gloves. Then don heavy duty utility gloves
2. Place cassettes and any loose instruments in ultrasonic cleaner and replace the cover. Process
instruments for 5-10 minutes.
3. Lift the basket inside ultrasonic cleaner and rinse. Dump instruments onto clean dry towel. If
additional items are still in ultrasonic cleaner, use tongs to pick-up. Do not reach into the ultrasonic
cleaner to remove instruments.
4. Place a second clean, dry towel on top of instruments and thoroughly dry prior to packaging.
5. If additional manual scrubbing is necessary, use a long-handled brush.
6. Visually inspect instruments for residual debris and damage; re-clean/replace as necessary.
LUBRICATING HANDPIECES
1. Place each hand piece on the lubricator and push start.
2. Wipe off any visible debris.
3. Place the hand piece into a sterilization bag.
PACKAGING INSTRUMENTS
1.
2.
3.
4.
After cleaning and drying the instruments, place them in a sterilizing pouch.
Package loose instruments so they lay in a single layer.
Hinged instruments should be processed opened and unlocked.
Transport the cassettes and pouches to the sterilizer area.
STERILIZATION
1. Place instruments in the sterilizer.
2. Load the sterilizer according to manufacturer’s instructions. Do not overload. Use the
manufacturer’s recommended cycle times for wrapped instruments.
3. With clean, gloved hands, lock the door and press start.
4. Allow packages to cool before handling. Use the oven mitts provided to remove sterilized
instruments.
5. When removing packages from sterilizer verify sterilization has occurred by inspecting
process indicators.
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INSTRUMENT DISPENSION
1. Several volunteers will be designated to dispense instruments to volunteers. These are the only
volunteers that should handle sterilized instruments after they have cooled. Clinical volunteers
(assistants, hygienists, dentists) are not allowed to reach into bins or grab sterilized instruments
themselves.
2. Volunteers designated to dispense instruments should wash hands with alcohol hand sanitizer and
don gloves. Place the requested instruments set-ups on barrier covered trays for transport by clinical
volunteers to treatment areas.
3. Clinical staff will request what instruments they need and should wash hands with hand rub before
receiving trays or instrument pouches for transport back to treatment areas.
4. Packages containing sterile supplies should be inspected before use to verify barrier integrity and
dryness.
5. If packaging is compromised, instruments shall be re-cleaned, repackaged, and sterilized again.
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Volunteer Registration Protocol
EMTs are onsite to deal with patient and volunteer emergencies. If there is an emergency, stay with the
person in need of medical assistance. Send someone near you to alert the department head who
will immediately radio for an EMT.
Thursday Set Up
! Volunteer registration is one of the first areas we set up. The volunteers who are helping set up the
clinic want to register ASAP.
! The majority of volunteers will register Thursday night before the orientation dinner.
! Have T-shirts laid out on tables behind the registration counter.
Red is for dentists (ONLY DENISTS)
o
Purple is for hygienists
o
Kelly Green is for assistants
o
o
Grey is for all other volunteers
! Orange is for clinic Leads only – the Leads will be designated on a list.
! All volunteers must wear the assigned T-shirt when volunteering – this helps us
distinguished patients from volunteers
Greeting and Name Tags
! Volunteers should be greeted and thanked for volunteering
! Once you know the volunteer is a dentist, please refer to that person as Dr. Last name
! For dentists, hygienists and assistants, check the volunteer list to see if the volunteer needs to
indicate they are Hep B vaccinated. Most of the volunteers indicated their status when they
registered online, but some did not and we need to have their initials by their name if they are in
fact Hep B vaccinated
! Give each volunteer their name tag, their designated T-shirt (assignment and T-shirt size will be
found on the back of their name tag)
! Put a check by the volunteers name indicating they have checked in
Where do Volunteers Go?
! Registration Desk will direct volunteer to area in which they are assigned. Lead for that area will be
in an orange T-shirt.
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