Download DAY FOUR


The best possible tool for training a new clinical assistant is a typodont.
If
you do not have a typodont and would like to purchase one contact
KILGORE at 800-892-9999.
1
TRAINER Important
Notes
1) You are in charge of this training
manual. It is your step-by-step
guide to preparing a new assistant
to be a valuable asset to your staff
in the shortest time possible. Do
not bypass any of the processes in
this manual. Follow it page by
page, day by day and you will be
amazed at how easy your job will
be and what a tremendous
employee you will train!
2) V i d e o s : The first one is for you to give to the doctor. The second one is for
you and the trainee to listen to on the first day of orientation. The other
tapes are specifically for the trainee to listen to throughout the training.
However, we suggest that you take the time to review those before the
training process starts so that you will understand the information the
trainee is getting from Charlene and how valuable it is in addition to the
materials you will be covering in this manual.
3) Please do not forget to give this trainee as much positive feedback as you
possibly can. Positive feedback is critical!
4) The pages in this manual intended for you to give to the “trainee” are
marked with a “”at the top right corner of the first page of each segment.
Do not pull all of these out at once. Pass them on to the trainee as you are
instructed throughout the training manual. This will keep the trainee from
feeling so overwhelmed with all the information.
5) There is a “Wrap Up Box” at the end of each day. Be sure that you and the
trainee complete this at the end of each training session.
6) Always review the following day’s session in the evening so that you are
prepared when you arrive at the office the next day.
7) Always let the trainee know when you will be giving them a test the
following day. Reassure them that the tests are not only evaluating how well
they are learning, but also how well you are training them.
8) We have provided many detailed procedures throughout this manual for you
to give to the trainee daily as procedures are being taught. You should
always review those procedures first and make any necessary changes to
our information to make it align with the particular way those procedures
are performed in your office.
2
TRAINING PROFILE:
Trainee:
Date of Hire:
Position:
Previous Experience in Ortho:
Dental Experience:
Dental Assisting School:
Brief Definition of Previous Experience:
Yes
Yes
Yes
No
No
No
Trainer:
Number of Years Experience:
Orthodontist:
Dr.
Date Training Began:
Record quiz scores below (i.e. excellent, good/average, below average):
Quiz #1
Quiz #2
Quiz #3
Quiz #4
Quiz #5
Quiz #6
Quiz #7
Quiz #8
Quiz #9
Quiz #10
Quiz #11
Quiz #12
Quiz #13
Quiz #14
Quiz #15
Any special notations the trainer would like to put on file concerning the
trainee:
Date Training Ended:
3
DAY ONE:
(date)
TRAINER – This agenda is intended for you to follow. Please give the trainee
the agenda on pages 7-8 for their manual.
Trainee is greeted by doctor and trainer.
Attend morning huddle (introduce trainee to other staff).
Trainer (or office manager) meets with the trainee to cover misc. items to get
employee on payroll and to get familiarized with the office (i.e.
parking, restrooms, office policies, etc.). Be sure to schedule
any vaccinations required by your practice.
Trainee - meet with the new patient coordinator to get an overview of the new
patient process.
Trainee – sit in on a new patient appointment – see the new patient process
from a patient’s perspective.
Trainee - sit in with the records coordinator (if no patient is scheduled for records at
that time, actually take records on the new employee).
Lunch together as a team (get take out or go out).
where they can brush their teeth.
After lunch, show trainee
Doctor explains the treatment planning process to trainee.
Trainee - meet with the appointment coordinator for a brief overview of their
position.
Trainee - meet with the lab technician for a brief overview of their position.
Trainee - meet with the financial coordinator for a brief overview of their position.
Meet with the marketing coordinator for a brief overview of their position.
The trainee and trainee should meet to discuss the first day.
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GETTING ACQUAINTED 
WITH THE TRAINER
Check the box(s) beneath each statement that pertain to you.
Trainer’s Name:
Years with the Practice:
Years experience in Orthodontics:
My teaching style is:

Slow and methodical

Fast and direct

Laid back

Relationship oriented

Authoritative

Participatory
What I like to see in the “Trainee” is:

Enthusiasm

Note taking

Asking questions

Jumps in and does it

Waits and observes (and does it when instructed)

Studies at home
List four things about yourself that you would like the “Trainee” to
know (i.e. play piano, have 2 children, etc.):
1.
2.
3.
4.
5
GETTING ACQUAINTED
WITH THE TRAINEE
Check the box(s) beneath each statement that pertain to you.
Trainee’s Name:
I learn best when:

I see it done

I hear it

I do it myself

I hear it several times

Someone is patient with me

When someone is direct and to the point

When I get all the details
What I would like to have from my trainer is:

Honesty

Tell me what I’m doing wrong in private

Regular encouragement and positive feedback

Understanding

Open communication

Be direct with feedback

Tell me gently
List four things about yourself that you would like the “Trainer” to
know (i.e. play piano, have 2 children, etc.):
1.
2.
3.
4.
6
DAY ONE:
(date)

TRAINEE’S AGENDA
Greeting by doctor and trainer.
Attend morning huddle.
Meet with the trainer (or office manager) to cover misc. items to
get employee on payroll and to get familiarized with the office
(i.e. parking, restrooms, office policies, etc.).
Meet with the trainer to review tape #2 together in a private and
quiet area. Next, review tape #3 on your own.
Meet with the new patient coordinator to get an overview of the
new patient process. Make notes here:
Sit in on a new patient appointment – see the tour of the office
from a patient’s perspective. Make notes here:
Sit in with the records coordinator (if no patient is scheduled for records at that
time, they may actually do records you, the trainee). Make
notes here:
Lunch together as a team (get take out or go out).
Doctor explains the treatment planning process. Make notes
here:
7
Meet with the appointment coordinator for a brief overview of
their position. Make notes here:
Meet with the lab technician for a brief overview of their position.
Make notes here:
Meet with the financial coordinator for a brief overview of their
position. Make notes here:
Meet with the marketing coordinator for a brief overview of their
position. Make notes here:
Meet with the trainer to discuss the first day. Make notes here:
Congratulations, you completed Day One!
Trainer:
Trainee:
Comments:
8
DAY TWO:
(date)
TRAINER – This agenda is intended for you to follow. Please give the trainee
the agenda on pages 10-11 for their manual.
Have the trainee meet with the doctor to discuss the first day’s
observation.
Attend morning huddle.
Trainee - clinical observation (divide time by procedure or by
assistant).
Trainee and trainer - lunch with clinical team (discuss any
questions the new employee has from the morning observation).
Trainee and trainer – official training begins. Check each box as
it is completed:

Learn to greet & seat a patient

Learn how to operate the computer sign-in

Learn the patient flow system

Learn how to sterilize instruments (give the sample
sterilization checklist on page 160 to the trainee)
The purpose of having the trainee learn these procedures is so
that they can be productive in the practice during the early part
of their training when you, the trainer, are working on patients.
Trainer should visit with the trainee to see how comfortable they
are feeling with the process so far.
9
DAY TWO:
(date)

TRAINEE’S AGENDA:
Meet with the doctor to discuss the first day’s observation.
Attend morning huddle.
Observation in the clinic. This is simply an observation, do not
feel that you need to absorb too much. Make notes here:
Lunch with clinical team. List any questions you would like to
have answered during lunch:
Official training begins. The trainer will guide you through the
following procedures. Be sure to ask questions and make notes.
Check each box as it is completed:

Learn to greet & seat a patient. Make notes here:
10

Learn how to operate the computer sign-in. Make notes here:

Learn the patient flow system. Make notes here:

Learn to sterilize instruments. Make notes here:
Congratulations, you completed Day Two!
Trainer:
Trainee:
Comments:
11
DAY THREE:
(date)
TRAINER: You will need approximately 2 hours of uninterrupted time in the
morning. You have 3 main goals for this morning:

Review the four procedures the trainee learned in the afternoon on day two.
Be
sure that you feel very confident that they are capable of handling any of those
four duties before you move on.

Review
the ideal image for an orthodontic assistant on page 14. This is very
important information that you may even want to share with trained assistants in
your practice.

Demonstrate the following orthodontic terminology to the trainee. Ask the trainee
to review these at home in the evening in order to prepare for a quiz on day four.
For the person new in the field of dentistry or orthodontics, you should give the
trainee the definitions on pages 15-18, which coincide with the following list. We
recommend that you have the trainee look at their own mouth in a hand-held
mirror as you point out the different teeth, surfaces, etc. Participation increases
the level of retention. As an enhancement to this process, you can use any visual
aids that you routinely use for your educating your patients (i.e. CD ROM
programs, hand-held models, typodonts).
For the person with previous experience in the field of dentistry or orthodontics,
have them define the following items for you without giving them pages 15-18 to
confirm their proficiency on the terminology.
For the certified dental assistant who has been formally trained in college or
technical school, move directly to day four.

Central Incisor

Lateral Incisor

Cuspid

First Bicuspid

Second Bicuspid

First Molar

Second Molar

Third Molar

Palmer’s Notation

Anterior Teeth

Posterior Teeth

Premolar Biscupid

Buccal Surfaces

Lingual Surfaces

Cusp

Incisal Edge

Deciduous Teeth

Permanent Teeth

Distal

Mesial

Facial Surfaces

Occlusal Surfaces

Proximal Surfaces

Impacted Tooth

Interproximal

Malocclusion

Mandibular

Maxillary

Midline

Supernumerary Teeth

Congenitally Missing
Teeth

TMJ
(Temporomandibular
Joint)
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
Have the trainee spend the remainder of the day doing one or all of the
following:
 Studying materials covered in the morning.
 Watching any training videos you may have in your library.
 Reviewing all of your practice’s printed materials for patient
education.
 Observing in the clinic.
 If the trainee is needed in the clinic, have them help with patient
flow and sterilization.
13
15

DAY THREE:
(date)
TRAINEE STUDY GUIDE: The trainer will demonstrate the following
dental terminology. You will need to review these for a short quiz
tomorrow. Don’t panic, you won’t get a report card.
Great study tip – record yourself reading these definitions out loud, and
then play it back while looking in the mirror at the different teeth, etc.
Central Incisor
Lateral Incisor
Cuspid
1st Molar
2nd Molar
Maxillary
Arch
1st ndBicuspid
2
3rd Molar
Mandibular
Arch
Central Incisor - The two upper and two lower teeth in the very center of
your mouth.
Lateral Incisor - The teeth just adjacent to the centrals.
Cuspid - The pointy teeth just behind the laterals. These teeth have one cusp
(or point). Cuspids are also called canines.
First Bicuspid - The teeth just behind the cuspids. These teeth have two
cuspals (or points)
Second Bicuspid - The teeth just behind the first bicuspids. These teeth also
have two cuspals (or points)
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First Molar - The teeth just behind the second bicuspids. These teeth have a
level surface with four cuspals.
Second Molar - The teeth just behind the first. These teeth also have a level
surface with four cuspals.
Third Molar - The teeth just behind the second molars. These teeth also have
a level surface with four cuspals.
Palmer's Notation - Palmer's notation is a widely used method to designate
individual teeth. In Palmer's notation, your mouth is divided into four parts
called quadrants, that is the upper left quadrant, the upper right quadrant, the
lower left quadrant, and the lower right quadrant as illustrated in the figure
below. Then each individual tooth in the quadrant is given a name. For
example the two upper and two lower teeth at the center of your mouth are
called centrals. One then combines the names of the quadrant and the tooth to
come up with a Palmer's notation. For example, the central on the upper right
side of your mouth is called an upper right central.
Tooth Identification - Most orthodontic offices use a numbering scheme on
permanent teeth from 1-8. This numbering scheme combined with the
quadrants noted in Palmer’s Notation are demonstrated below.
Upper Right Quadrant
8
7
6
5 4 3
8
7
6
5 4 3
Lower Right Quadrant
Upper Left Quadrant
Midline
1 2
1 2
3 4
3 4
5 6
5 6
7
7
Lower Left Quadrant
Anterior Teeth - Your centrals, laterals, and cuspids. These are the teeth in
the front of your mouth
Posterior Teeth - Your bicuspids and molars. These are the teeth in the back
17
of your mouth.
Premolar Bicuspid – A baby tooth that is lost when the bicuspid erupts into
the space.
Buccal Surface - The tooth surface, which is next to your cheeks. Usually only
posterior teeth touch your cheeks, so people usually use the term "buccal"
only when talking about your back teeth.
Lingual Surface - The tooth surface next to your tongue or things mounted on
the tooth surfaces next to your tongue.
Cuspal - The chewing or tearing points of the cuspids, bicuspids, and molars.
Incisal - The biting edge of your centrals and laterals.
Deciduous Teeth - Your primary, or "baby teeth"
Permanent Teeth - Your secondary teeth (i.e. the second group of teeth to
come in).
Distal – Behind, towards the back of the mouth. For example you might say
that the first bicuspid is distal to the cuspid.
Mesial - Forward or front (i.e. your cuspid is mesial to you bicuspid). The
mesial surface of your bicuspid is the part of the bicuspid closest to your
cuspid.
Facial – The tooth surface next to the inside of the lips.
Occlusal - The chewing or grinding surface of the bicuspid and molar teeth.
Proximal - Refers to the surfaces of teeth that touch the next tooth; the space
between adjacent teeth is the interproximal space.
Impacted Tooth -An unerupted tooth that somehow has gotten stuck and
cannot come in.
Interproximal - The space between adjacent teeth.
Malocclusion - When your upper teeth and lower teeth do not fit together
properly.
Mandibular - Pertaining to your lower jaw.
Maxillary - Pertaining to your upper jaw.
Midline - A plane through the very center of your mouth perpendicular to
your nose.
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Supernumerary Teeth - Some people have extra teeth. These are called
"supernumerary teeth".
Congenitally Missing Teeth – Permanent teeth that never develop and are
therefore missing from the arch.
TMJ (Temporomandibular Joint) – The joint or hinge that connects the lower
jaw to the skull.
P.M.
The trainer will give you an assignment or assignments for the afternoon
based on what she/he feels is most needed at this time. Record the trainer’s
assignment(s) here:
Make notes here of anything you learn:
Congratulations, you completed Day Three!
Trainer:
Trainee:
Comments:
19
DAY FOUR:
(date)
TRAINER: You will need approximately 2 hours of uninterrupted time in
the morning. Here are your goals for this morning:

Give
the trainee quiz #1 on page 21. Be sure to tell the trainee that the
purpose of the quiz is to make sure that you have communicated the
information clearly from the previous day. Your goal is to support the
trainee in the learning process.
Grade the test (see the scoring sheet for quiz #1 on page 23). If they have
an excellent score, congratulate the trainee and compliment them on a job
well-done. If they receive a good to average score, compliment the
trainee and reinforce the areas they missed. Question the trainee on their
best learning style to make sure your approach works well for them. Some
people need to see it, some need to hear it, and some need to do it! If they
score below average on the test, reassure them that this is normal and that
you will work with them through the process. Understand that some
people simply don’t test well. Question the trainee verbally to see if they
possibly have retained the material even though they scored poorly on the
test. If someone scores poorly, repeat day three training before moving
forward to day four.

At this
time, proceed to the next step, which is explaining all aspects of
clinical record taking. Give the trainee pages 24-26 to put in their binder
for note taking. Your goal is not to teach the trainee how to take records at
this time, it is simply to introduce them to the process and to teach them
the terminology. Pull out one or two sets of records (adult & child) and
cover the following:

Diagnostic Records

Panorex x-ray

Cephalometric x-ray

Additional x-rays you
may take in your practice
(i.e. periapicals, occlusal
films, wrist films, etc.)

Models

Facial Photos

Intraoral Photos

Alginate

Impression Trays

Wax Bite

Initial Records

Final Records

Progress Records
Have the trainee observe one or two sets of records during day four.
20

Next, cover these types of treatment:

Full-treatment on adults & children

Partial or early treatment

Limited treatment

Second phase treatment

TMJ therapy

Orthognathic surgery

Observation recall

Active treatment

Retention phase

Give
the trainee Appendix C in your manual beginning on page 189
entitled, “General Questions about Braces”. Ask that they read it at home
this evening. It will give them an excellent idea of the basic questions that
most patients have about orthodontics. It will also help them better
understand the continuation of this training.

Have the trainee spend the remainder of the day doing one or all of the
following:
 Studying materials covered in the morning.
 Reviewing the definitions from day three.
 Watching any training videos you may have in your library.
 Reviewing all of your practice’s printed materials for patient education.
 Observing in the clinic.
 Observing one or two sets of records.
 If the trainee is needed in the clinic, have them help with patient flow
and sterilization.
Inform the trainee that there will be another brief quiz on day five.
21
QUIZ #1
Trainee:
Date:
This is a multiple choice quiz. Circle the term under each item that is
being defined in that statement.
1. A plane through the very center of your mouth perpendicular to your nose.
a. Incisal
b. Midline
c. Maxillary
2. Where your upper teeth and lower teeth do not fit together properly.
a. Occlusal
b. Malocclusion
c. Neither
3. Your secondary teeth, i.e. the second group of teeth to come in.
a. Permanent
b. Second Molar
c. Deciduous
4. The biting edge of your centrals and laterals.
a. Incisal
b. Cuspal
c. Lingual Surface
5. The tooth surface, which is next to your cheeks. Usually only posterior
teeth touch your cheeks, so people usually use this term only when talking
about your back teeth.
a. Lingual Surface
b. Mesial
c. Buccal Surface
6. Refers to the surfaces of teeth that touch the next tooth.
a. Occlusal
b. Proximal
c. Neither
7. An unerupted tooth that somehow has gotten stuck and cannot come in.
a. Impacted Tooth
b. Lateral
c. Palmer’s Notation
8. Your bicuspids and molars. These are the teeth in the back of your mouth.
a. Anterior
b. Deciduous
c. Posterior
9. Forward or front.
a. Mesial
b. Proximal
c. Distal
10. The chewing or grinding surface of the bicuspid and molar teeth.
a. Proximal
b. Mesial
c. Occlusal
11. Pertaining to your lower jaw.
a. Mandibular
b. Maxillary
c. Midline
22
12. Behind, towards the back of the mouth.
a. Mesial
b. Incisal
c. Distal
13. The chewing or tearing points of the cuspids, bicuspids, and molars.
a. Incisal
b. Cuspal
c. Distal
14. The tooth surface next to your tongue or things mounted on the tooth
surfaces next to your tongue.
a. Lingual
b. Buccal
c. Mesial
15. Your primary, or "baby teeth" .
a. Permanent
b. Supernumerary
c. Deciduous Teeth
16. The space between adjacent teeth.
a. Interproximal
b. Malocclusion
c. Buccal Surface
17. Pertaining to your upper jaw.
a. Midline
b. Maxillary
c. Mandibular
18. Extra teeth.
a. First Molar
c. Supernumerary Teeth
b. First Bicuspid
19. Your centrals, laterals, and cuspids. These are the teeth in the front of your
mouth.
a. Anterior
b. Posterior
c. Deciduous
20. A widely used method to designate individual teeth. In this method, your
mouth is divided into four parts called quadrants.
a. Parker’s Notation
b. Palmer’s Notation
c. Dental Notation
21. Using the lettering on the picture below, put the appropriate letter next to
each of the following types of teeth:
Central
Lateral
Cuspid
First Bicuspid
Second Bicuspid
First Molar
Second Molar
Third Molar
G
C
H
E
A
D
B
F
23
TRAINER’S SCORING SHEET
QUIZ #1
1-B
12-C
2-B
13-B
3-A
14-A
4-A
15-C
5-C
16-A
6-B
17-B
7-A
18-C
8-C
19-A
9-A
20-B
10-C
21-C,B,F,D,G,H,A,E
11-A
There are 28 possible correct answers or points on this quiz (question #21 has 8
different answers). On the trainee’s quiz total the number of correct answers and
place that number here:
. Following is a scale on which you can judge the
trainee’s progress:
Excellent
Good
Average
Below Average
23-28 correct answers
19-22 correct answers
15-18 correct answers
less than 15 correct answers
Be sure to record the trainee’s score (i.e. excellent, good, average, needs focus) on
the Training Profile on page 3 and on the Doctor’s Report Card on page 38.
24
DAY FOUR:
(date)

TRAINEE STUDY GUIDE: By the end of this morning, you should have a good
understanding of the following procedures, etc.. Take good notes as your trainer
explain and/or demonstrates these to you:

Diagnostic
Records: X-rays, photos and impressions taken prior to starting
orthodontic treatment for diagnostic purposes.

Panorex x-ray:
A long, rectangular x-ray that shows a panoramic (or full) view of
all the teeth and jaw joints.

Cephalometric x-ray:
A large x-ray that shows a side view of the entire head.

Additional
x-rays that this practice uses (i.e. periapicals, occlusal films,
wrist films, etc.):

Models:
Plaster duplications of the upper and lower teeth.

Facial Photos:
Photos of the face from the front and sides.

Intraoral Photos:

Alginate:
Photos of the teeth from the front, sides and occlusal surfaces.
A powder material that is mixed with water to take impressions.
24

Impression Trays:
Metal or plastic trays that hold the alginate for impression
taking.

Wax
Bite: A softened piece of wax that is placed between the teeth for the
patient to bite down on. This measures how well the teeth come together.

Initial
Records:
treatment.
The diagnostic records that are taken prior to orthodontic

Final
Records: The models, photos and x-rays taken after the braces are
removed to document the finished results.

Progress
Records: Models, photos and x-rays taken during orthodontic
treatment for the doctor to study and evaluate the progress of the patient.

Full-treatment
on adults & children: Braces on the upper and lower
permanent teeth. Normally for a period of 18-24 months.

Partial or early treatment:
Also called first phase. Typically done around the
ages of 8-10 years of age to change the jaw relationships for 12-18 months.

Limited
treatment:
Very minor appliance treatment that is done for
approximately 6 months to correct a specific problem.

Second
phase treatment: Patients who complete a first phase of treatment
typically go into a second phase of treatment when all of the permanent teeth are
erupted. It requires braces on the upper and lower teeth.

TMJ therapy:
Therapy to correct or ease pain and discomfort in the jaw joint.
25

Orthognathic
surgery: Surgery done by an oral surgeon to correct the jaw
relationships of the maxilla and mandible.

Observation
recall: Patients who will need orthodontic treatment in the future
when more permanent teeth erupt. The orthodontist observes them every 6-12
months until they are ready for treatment.

Active
treatment: When the patient is in braces and they are coming in for
regular 6-10 week adjustments.

Retention phase:
Once the braces are removed, the patient receives retainers
to hold the teeth in place. They are typically seen every 3-6 months for one to
two years. This is the retention phase.
P.M.
The trainer will give you an assignment or assignments for the afternoon based on
what she/he feels is most needed at this time. Record the trainer’s assignment(s)
here:
Make notes here of anything you learn:
Congratulations, you completed Day Four!
Trainer:
Trainee:
Comments:
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DOCTOR’S REPORT CARD
To be completed by the trainer and reported to the doctor
at the end of day 5 of training.
Trainer:
Date:
Trainee:
Test Scores To-Date:
Quiz # 1
Quiz # 2
Score
Score
Trainer, answer these questions on a scale of 1-10 with 10 being excellent. Base
your response on the interaction you have had with the trainee during this training
process:
The trainee’s learning speed.
The trainee’s ability to comprehend the materials presented so far.
The trainee’s communication skills exhibited.
The trainee’s enthusiasm exhibited to this point.
The trainee’s conformity to practice policies and procedures.
The trainee’s hand/eye coordination exhibited so far.
The trainee’s cooperation level.
The trainee’s interaction with patients and parents.
The trainee’s overall hygiene (nails, perfume, uniform, etc.).
Trainer, please give an explanation for any of the above statements that you rated
less than 7.
Trainer – optional comments:
Use the back of this sheet for further comment. Put a copy of this report in the trainee’s personnel file.
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