1 - Clinic Operations

Clinic hours are 8:00 a.m. to 12:00 p.m. and 1:00 p.m. to 5:00 p.m. Clinic sessions are 9:00 a.m. to 11:45 a.m. and 1:00 p.m. to 3:45 p.m. Every effort should be made to have all electronic/evaluation forms completed, procedure codes entered, session notes completed, and authorized/approved by the attending faculty. Students should turn in instruments for sterilization within the allotted clinic time. Organized and efficient time management builds patient confidence. 

Students are not permitted to provide any clinical treatment outside regular clinic periods without specific permission from a faculty member and that faculty member must be present in the clinic. Students may bring their patients back into the clinical area 5 minutes before the clinic session begins with the expressed verbal permission of a faculty member on the floor. Treating patients without direct faculty supervision is a serious infraction of COD clinic policy resulting in the filing of a Professionalism Concerns Report (PCR). The PCR will be given to the Assistant Dean for Clinical Affairs, the Director for Quality Assurance, the Director of Compliance, and the Dean of Student Affairs. There will be a loss of clinic privileges for no less than 1 week, resulting in a loss of RVUs for that week.

See section 3.4 Attendance in the COD Student Handbook. 

See section 3.4 Attendance in the COD Student Handbook.

A schedule is published each semester that indicates the disciplines providing clinic coverage on each half-day of the week and when specific clinics are closed for cleaning and re-stocking supplies.  The schedule will also indicate the student academic class (DS2, DS3, and DS4) and the maximum number of students scheduled for each clinic session. The clinic schedule will be e-mailed to all students at the beginning of each semester.

The clinics are restricted solely to the academic classes designated on the schedule. Students may not use the clinic if their class is scheduled to be in a lecture or laboratory. For example: if a patient requires emergency care during a time when the student is not appointed to be in the clinic, the student must get written permission from [1] the course instructor to be excused from class and [2] the attending clinical faculty (Department Faculty or GPD, as applicable and the Clinic Manager) to be allowed into the clinic to treat the emergency.

A clinic schedule is published each semester indicating where and when the hygiene students will provide clinic coverage on half-days each week. The clinic schedule will be e-mailed to all students at the beginning of each semester and available on Canvas under the appropriate clinic course. Clinics are restricted solely to the academic classes designated on the clinic schedule. Students may not use the clinic when their class is scheduled to be in a lecture.

During the third and fourth years, each dental student is required to participate in several clinical rotations. Scheduled rotations always take precedence over regular clinic time; when students are on rotation, they must attend every assigned session. Students may not treat patients in other clinics when on rotation without the permission of the department conducting the rotation and the department covering the clinic they wish to work.

Once published, rotation schedules are final. Any requested changes in the schedule will be considered only if approved by the involved department and the Division Head of Comprehensive Care and if such changes will not compromise the student coverage necessary to staff the rotation.

Dental Students:

The minimum clinical experiences in Periodontics, Operative Dentistry, Endodontics, Removable Prosthodontics, and Fixed Prosthodontics are summarized in the next few pages.  Other clinical disciplines (Oral Diagnosis, Orthodontics, Pediatric Dentistry, Occlusion, and Oral Surgery) also have specific expectations; however, their minimum clinical experiences are generally managed in conjunction with other departments or through clinic rotations. For specific information regarding these disciplines and their current requirements, consult the individual departments and/or appropriate clinic manuals.

The following are the current clinical divisions:

Comprehensive Care 
Endodontics
Occlusion
Operative
Oral Diagnosis
Oral Surgery
Orthodontics
Pediatric Dentistry
Periodontics
Prosthodontics

During clinic appointments, students should remove all items non-related to treatment (books, backpacks, notes, etc.) and place them in their assigned locker. Students must reserve countertops for instruments and supplies needed for treatment. Never seat the patient until after the armamentarium is set up and the operatory is prepared. 

For prosthodontic procedures completed at the operatory, place white lab paper on the countertops. Use the adjacent clinic laboratory for routine laboratory procedures; do not perform laboratory work in clinic operatories. 

Refer to section 10 Health and Safety/Infection Control for the appropriate infection control procedures to use for each clinic appointment. After the patient has been dismissed and the dental unit has been disinfected, reposition your operatory equipment as follows: 

1. Return the dental chair to an upright position, place the rheostat on a paper towel and place it on the chair seat, then raise the chair to at least the length of the rheostat cord. 

2. Reposition the dental lamp and handpiece unit over the center of the chair seat. 

3. Return the assistant cabinet to its position under the operatory counter. 

4. Position operator and assistant stools next to counters. 

5. Report any problems with your assigned operator unit to the Inventory Associate. 

As healthcare facilities, the clinics must be kept as clean as possible and must present a desirable, safe, and professional image to the public. Students are responsible for the cleanliness of the operatory assigned to them and for any clinic laboratory space they use. 

Food and drink may not be taken into operatories, reception areas, dispensaries, consultation rooms, or x-ray facilities.

The College and University are tobacco-free environments; tobacco use, in any form, including E-cigarettes, is strictly prohibited. 

No animals are allowed in the dental building except for service animals. See section 2.9 Service Animal Policy. 

Clinical Appearance: All workforce members and students must comply with the following guidelines for clinical participation.  

Clinical Appearance: 

1. Hair should be clean, well-groomed, neutral or natural color, kept secured away from the face and front of the over-gown, and out of the field of operation so that it does not require handling during a procedure. 

2. Men must be clean-shaven, or beards and mustaches must be clean, neatly trimmed, and well-groomed 

3. Personal body hygiene is required so that offensive body odor is avoided 

4. Avoid strong perfumes, colognes, or aftershaves 

5. Fingernails must be kept clean, short, and well-manicured 

6. Fingernail polish/gel nails must be free of any chips or wear 

7. Artificial nails are strictly prohibited 

8. Jewelry should be kept out of the field of operation.

   • Watches must be covered by the over-gown.

   • Earrings cannot hang past the bottom of the ear lobe.

   • Rings can be worn if smooth and do not compromise the glove’s integrity.

9. Visible tattoos must be covered 

Clinical Attire: 

1. COD ID badges must always be worn and visible. 

2. Scrub top and pants must be clean, wrinkle-free, and matching. Scrub sets must be in the same color as the student's class.

3. Scrubs must be properly fitted; they cannot be excessively tight or baggy. Scrubs must permit bending, leaning, and squatting while preserving modesty. 

4. Student scrub tops must be embroidered using the following criteria:
   a. 1 centimeter tall
   b. Full block font
   c. White thread
   d. First and last name

5. Scrub pants can be a jogger or traditional style and must reach the ankles when standing. 

6. White- or solid-colored T-shirts or long-sleeved shirts can be worn under the scrubs as long as they are tucked inside the scrub pant 

7. Socks are required 

8. Shoes must be protective, clean, closed-toed, solid upper (no visible perforations), with a rubber or leather sole 

9. Outer garments may be worn if the jackets have been purchased through The Uniform Shoppe. They must be embroidered with the first and last name of the student. They may be worn in the clinic, but not at the chairside during patient treatment. They may be worn outside the clinical environment as they are not treatment jackets. 

10. Workforce members are responsible for laundering their scrubs.

If a student wants to purchase additional scrubs, the scrubs must comply with the above criteria. The student may be sent home to change if purchases of scrubs do not meet the dress code criteria.

A long-sleeve protective gown (provided in each clinic) is required for procedures when aerosols are anticipated. Gowns may NOT be worn in public areas including bathrooms, PSC offices, and reception areas. They may be worn from clinic to clinic on the 3rd floor but may not be worn outside of the clinic on the 2nd and 4th floors. 

Violations of this policy will be handled in the following manner: 

For students: 

First offense: Written warning (copy to Assistant Dean for Clinical Affairs and Director of Compliance). 

Second offense: Professional Concerns Report (PCR) filed (copy to Assistant Dean for Clinical Affairs and Director of Compliance). 

Third offense: Appearance before the appropriate Periodic Assessment Committee, which could result in further disciplinary action. 

For workforce members: 

First infraction: e-mail warning from Director of Compliance to workforce member cc’d to workforce member’s supervisor. 

Second infraction: a review with Supervisor and Director of Compliance; potential training: review on D2L and quiz within 10 days of notification of infraction. 

Third infraction: reviewed by the Dean of the College of Dentistry.  

Fourth infraction: disciplinary measure up to and including dismissal. 

Any incident involving patient endangerment may result in immediate disciplinary action. 

All freshman and sophomore dental students must work in pairs in the clinic. Junior and senior dental students work solo during all clinic sessions except when in the pediatric or orthodontic clinic, where pairing is required. Additionally, DS3 students may be paired for certain courses involving patient treatment-specific disciplines (check with individual departments for further clarification).

The Department of Periodontics determines an initial pairing of students in the freshman class; however, the clinic partners assigned for the 2nd, 3rd, and 4th year will be assigned by the Director of Comprehensive Care. Students are required to always work with their designated partner when pairing is mandatory. Exceptions must be authorized by the Course Director, Group Practice Director, or the Director of Clinics. Failure to observe the clinic pairings while scheduling patients will result in clinic suspension, the length of which will be at the discretion of the clinical course director. Students are also expected to share available clinic sessions so they and their partners have access to an equal amount of time to treat their respective patients.

Because student pairings are used in the development of rotation schedules, students may not switch partners without the approval of the Director of Comprehensive Care. For pairs wishing to change partners, all four students involved must personally inform the Director of Comprehensive Care that they agree to the switch. Even if all parties agree, the request will be postponed if there is any potential adverse impact on rotation schedules. 

If your partner is absent during a clinic session when pairing is required, notify the attending faculty member in that clinic who will determine the appropriate course of action. In most instances, students must find another classmate to assist them. 

For dental hygiene students, pairing is required only during the fall semester of the first year. The Department of Dental Hygiene pairs hygiene students for courses.

Patients may park in the Stonewall Parking Garage (P4), northeast of and across the street from the College. To park in the garage without being charged, the patient must have their parking ticket validated at the clinic where they are seen for their appointment. All patients must be escorted to the PSC or 3rd-floor receptionist for payment upon dismissal (If no payment is due or no fee is assessed, the patient must still be escorted to the PSC or 3rd-floor receptionist for checkout).

Patients may not park in the driveway in front of the building. This area is reserved for the loading/unloading of patients only. Parking in this area without proper permission may result in your patient's car being towed at their expense. If your patient is handicapped and has the appropriate placard, they may park in the designated handicapped parking spaces.

The College of Dentistry has a patient shuttle service to and from the P4 parking garage and the college's front door. The shuttle service hours are Monday through Friday 7:45 am to 4:45 pm. 

The Predoctoral Clinics are on the second, third, and fourth floors; some are discipline-specific. All Predoctoral Clinics are shared with Dental Hygiene students. Any Predoctoral Clinic can also serve as a preclinical space for use on manikin heads.  

SECOND FLOOR CLINIC  

Hygiene Clinic, Room 280

THIRD FLOOR COMPREHENSIVE CARE CLINICS 

Miranda Clinic, Room 370

Robertson Clinic, Room 330

Shillingburg Clinic, Room 306

At the beginning of their DS2 year, predoctoral students will be assigned to one of the three clinics and a Group Practice Director (GPD). The Comprehensive Care Clinics accommodate Periodontics, Oral Diagnosis, Fixed Prosthodontics, Operatives, some Removable Prosthodontics, and emergencies.    

FOURTH FLOOR CLINICS

Miller Clinic, Room 432 

Green Clinic, Room 406
Bay 1:  Implantology Clinic
Bay 2:  Removable Prosthodontics
Bay 3:  Endodontics 

The College of Dentistry includes two graduate programs, three residency programs, and a clinic for faculty practice.

Oral Surgery Residency Clinic (also hospital locations), Room 230

Graduate Periodontics*, Room 261 

Advanced Education for General Dentists* (AEGD), Room 261

Graduate Orthodontics, Room 442

OU Dentistry Faculty Practice, Room 494

OU Pediatric Dentistry, OU Children's Hospital

*Graduate Periodontics and Advanced Education in General Dentistry (AEGD) share the same common reception area.

CLINIC HOURS: 9:00 a.m. - 12:00 p.m. and 1:00 p.m. - 4:00 p.m.

Clinic staff must clean the clinic and inventory and stock supplies before and after clinic sessions. Students should not request clinic materials, supplies, and supplemental equipment before 8:30 a.m. and 12:30 p.m. to allow clinic personnel to make these preparations uninterrupted. 

Inventory Associates manage equipment/supplies inventory, storeroom restocking, cleaning of clinics, and student needs when clinics are in session. Supplies, such as masks and gloves, are now located in each clinic operatory chair unit.  Students are not allowed in the clinic dispensaries at any time.

Each dispensary is stocked with the equipment and materials necessary for all dental procedures governed by the respective clinic discipline.  Certain supplies (e.g., additional anesthetic carpules) require faculty approval before they will be dispensed.  The third floor contains clinic equipment where dental supplies to support the dental procedures are maintained in the assistants’ carts. For all other clinics, the supplies are available in the dispensary.

Additional dental equipment, such as nitrous oxide equipment, apex locators, etc, may be checked out from the clinic dispensary. Failure to return the equipment at the end of the clinic session will result in the student being charged the replacement cost of the item(s). 

Students requesting nitrous oxide must obtain faculty permission via axiUm; the Inventory Associate will assign them a mobile unit assembly. Students must obtain patient consent before the administration of nitrous oxide. Students will enter the D9230 code - Inhalation of Nitrous Oxide, and complete the required consent and the Nitrous Oxide Analgesia template note.

The axiUm section must be filled out and authorized by the student and the attending faculty. If using nitrous oxide, remember to post it as a completed treatment code under ADA procedure code #9230 (9000 in Pediatric Dentistry is no charge). 

NITROUS OXIDE ANALGESIA RECORD EXAMPLE: 

The patient has been made aware of the reasons for and benefits of nitrous oxide/oxygen sedation, the potential complications related to its use, and the consequences of not using nitrous oxide/oxygen sedation. The patient’s questions regarding nitrous oxide/oxygen sedation have been answered and consent was obtained (patient signature on file for Nitrous Oxide Consent). The following is a record of the nitrous/oxide oxygen administration for the visit. 

Start Time: {*}, End Time {*} Flow Rate: {*}, {*}%, N20 

Post-op: 110%02 administered for {*} Patient condition upon dismissal: {*} Adverse reactions/comments: {*} Student Name: {*} 

The main student laboratory (Room 433) is used for most pre-clinic-related laboratory work. However, as students transition into the third-floor clinics, each clinic has a clinic lab area associated with their assigned chair and clinic. Each location has sit-down chair spaces, air and gas outlets, and quick handpiece connections (tubing required).  Also available are model trimmers, vibrators, vacuum mixers, high and low-speed polishing lathes, and work sinks.

Clinic laboratories are available Monday through Friday, 6:00 am to 12:00 am, and must be accessed via your student ID card after 4:30 p.m. Each clinic is monitored, and access will be restricted if clinical areas are not maintained acceptably. To maintain the clinical laboratories in a presentable condition, the following rules will apply: 

1. Use white lab paper (available in each clinic laboratory) on countertops. 

2. Always use water with model trimmers. Flush with copious amounts of water to prevent clogging. Turn off model trimmers when not in use. 

3. Keep sinks free of excess stone, plaster, and impression material. 

4. Keep personal possessions to the minimum necessary to do your work. 

5. Mixing bowls, spatulas, and hoses for vacuum mixers are provided by the COD. They must be cleaned immediately after use. Failure to maintain equipment may result in loss of lab privileges. 

6. When working after hours, students are responsible for checking out any necessary equipment from Central Sterilization. 

7. Do not use these areas for social gatherings. Those activities should be confined to the student commons area, student lounge, or atrium. 

8. Students must clean up after themselves. 

The College has an in-house dental laboratory to process crowns, fixed and removable partial dentures, and complete dentures for student patients; they also use outside laboratory services for additional support. These services are obtained via laboratory prescription through the axiUm system only.

Support laboratory services are critical to the timeliness of patient care and the student's attainment of minimum clinical experiences. To better ensure that cases are expedited, students' submitted work authorizations must be completed properly and fully, including a description of the required work, patient name, type of restoration and material required, case design, faculty, and all approved authorizations in the axiUm system.

If students need a case completed sooner than the published number of days normally required (refer to laboratory service schedule), they must obtain approval from the laboratory supervisor. Do not enter the laboratory area without permission; always check in at the receiving desk first.

To submit any case to the laboratory, the Central Business Office must certify via axiUm request that the patient has paid appropriately and must have been approved in the axiUm system.

Any gold crown that is found unacceptable for delivery must be returned to the support lab.

The protocols for the requisition of artificial teeth for Removable Prosthodontics may be found in their department manual. 

The Dental Support Lab schedule indicates the average time (in school days) necessary to complete the services listed.

The day the case is turned in and the day the case is picked up does not count toward production lead time. Weekends and holidays do not count.

Central Sterilization (CS) is on the first floor and is responsible for sterilizing all items related to patient care in the college. The primary sterilization method is steam under vacuum pressure.

Routine sterilization of instruments, burs, and handpieces is mandatory for safe patient care in all clinic areas. Before using dental instruments or equipment for patient care, all students must confirm their equipment has been sterilized by evaluating the sterilization packaging. All patient-used instruments must be stored in Central Sterilization when not in use. Items used on patients can NEVER be stored in the student's assigned clinic locker.

• No outside equipment can be used in the clinic unless it has been reviewed and approved by the Clinic Materials Committee.
• Students may not check out any equipment, instruments, or handpieces for a classmate. If a student picks up instruments for a classmate, the instruments will be checked out to the student at CS, and the student will be responsible for returning the instruments.
• Students are responsible for all instruments or equipment checked out in their name. The student will be responsible for the replacement costs for any unreturned or broken items.
• Students may not keep patient care items in their locker; they must be checked in and stored in Central Sterilization or the Clinic Dispensary.  

The instrument delivery/pickup system in Central Sterilization is designed to minimize cross-contamination. This process is as follows: 

1. Pick up sterilized burs, handpieces, cassettes, and other equipment from the Sterile Instrument Pickup window (Room 131A). 

2. Follow the process below for returning contaminated instruments to the dirty carts, found in each clinic.

3. DO NOT Bag:

   1. Operative instrument cassette

   2. Perio instrument cassette

   3. Handpiece cassette - Disinfect with a disinfectant wipe; then run the handpiece through the cleaner and lubricant machine located in the dry labs.

   4. Exam instrument cassette

4. Bag:

   1. Ultrasonic inserts

   2. All bur blocks into one bag

   3. Rubber dam kit including punch, forceps, frame, Paladent force, Paladent pin tweezers, Paladent Ring (1), and 3 rubber dam clamps.

   4. Bite fork

Central Sterilization has automated washers to clean, high-level disinfect, and dry instruments in cassettes. Cassettes are bagged and sterilized. The sterilization cycles are approximately 40-50 minutes. Sterilized instruments are stored in storage bins.

Students will acquire instrument kits issued by Central Sterilization on the day of their patient's appointment. Students may only check out sterilized instruments for patient care on the day of the appointment and not before.

EACH STUDENT IS RESPONSIBLE FOR:

• Placing contaminated instruments into dirty bins within each clinic for the Central Sterilization staff to transport for sterilization.
• Students will be required to replace any lost instruments as soon as possible.
• Informing a staff member in Central Sterilization of a broken or defective instrument so it can be replaced.
• Verify that any visible debris is removed from their instruments before packaging in the clinic.
• Ensuring all contaminated instruments are secure inside the cassettes to prevent bloodborne pathogen exposures or injuries to the Central Sterilization staff.  

The College of Dentistry provides student kits/instruments for the dental students.

1. Exam Kit
2. Operative Kits
3. Perio Cassettes
4. Electric Handpieces
5. Endodontic Kits
6. Rubber Dam Kits
7. Digital Studio Kits
8. Bur Blocks
9. Ultrasonic Tips
10. Impression Trays

Dental Hygiene students own their instruments.

The Assistant Dean for Clinical Affairs has the ultimate responsibility for clinic administration; however, advice and input are received from many clinic-related committees. Student representation, on committees that help govern clinical affairs and set clinic policy, is necessary to ensure student interests and concerns are being addressed.

The function of the Clinic Operations Committee (COC) is to set procedures and policies for the operation of the student clinics. The areas of responsibility include Quality Assurance and Clinical Material and Instruments. Recommendations that have significant budgetary or personnel implications shall be forwarded to the Faculty Board and Dean’s Advisory Council for review.

The Assistant Dean for Clinical Affairs shall serve as chair. The committee shall consist of the following division heads and program directors (or their respective designees): Comprehensive Care, Dental Hygiene, Endodontics, Operative Dentistry, Orthodontics, Pediatric Dentistry, Periodontics, and Prosthodontics. The committee shall also include one junior and one senior dental student, and one senior dental hygiene student selected by the committee chair and approved by the committee membership, each of whom will serve one-year terms and may be re-selected. The Director of Compliance, the Director of Quality Assurance, the Clinic Manager, and the Senior Billing Manager are ex officio members. The COC shall meet three times per year – that is, once per academic term. The Office of the Assistant Dean of Clinical Affairs shall provide administrative support to the committee.

To facilitate the mission of the Clinic Operations Committee, two subcommittees will be established: Clinical Equipment and Materials and Continuous Quality Improvement.

The purpose of the Clinical Equipment and Materials Subcommittee is to address and track specialty equipment and materials used in the clinical and pre-clinical setting to achieve uniformity, contain costs, and maintain quality. The subcommittee shall forward its recommendations to the Clinic Operations Committee. The subcommittee must meet at least three times per year (i.e., once during each academic term) as set forth by the Clinic Operations Committee.

The Assistant Dean for Clinical Affairs will serve as chair. Membership of the subcommittee shall consist of two at-large members appointed by the Assistant Dean for Clinical Affairs who will serve one-year terms and may be reappointed, plus the heads of the divisions of Comprehensive Care, Dental Biomaterials, Operative Dentistry, Pediatric Dentistry, and Prosthodontics. The heads of these divisions may, with approval from the Assistant Dean for Clinical Affairs, select an alternate to serve as a member of this subcommittee. The Clinic Manager and Director of Compliance will serve as ex officio members. The Office of the Assistant Dean for Clinical Affairs shall provide administrative support to the subcommittee.

The Continuous Quality Improvement Subcommittee shall be responsible for establishing policies and procedures that assess the quality of patient care.  The subcommittee shall monitor and ensure compliance with the patient care standards of the College of Dentistry. The subcommittee will conduct a tri-annual review of the data collected and prepare reports with any necessary recommendations for presentation to the Assistant Dean of Clinical Affairs and the Dean.

The Director of Quality Assurance and Director of Patient Relations will serve as chair. Membership of the subcommittee will be composed of one faculty representative from each of the following: Comprehensive Care, Dental Hygiene, and Pediatric Dentistry. These positions are nominated by the subcommittee chair and approved by the respective department chairs. The subcommittee also includes one student nominated by the subcommittee chair and approved by the Clinic Operations Committee. Faculty members will serve three-year, staggered terms and may be reappointed. The student will serve a one-year term and may be reappointed. The subcommittee shall meet three times per year – that is, once at the end of each academic term. The Office of the Director of Quality Assurance shall provide administrative support to the subcommittee.

The Health and Safety Committee shall establish policies and procedures regarding infection control, hazardous waste management, and employee, student, and patient safety.  The committee shall ensure compliance with the various local, state, university, and federal policies that regulate these areas.  

The Health and Safety Committee will meet at least annually to review and revise sections of the Clinic Operations Manual that pertain to health and safety and make recommendations to the Dean to effect change and maintain compliance. 

The Director of Compliance (or his or her designee) will serve as chair. The Director of Compliance will nominate the committee members to be approved by their respective division heads/program directors. The committee shall be composed of the Director of Compliance, plus one representative each from the predoctoral program, dental hygiene program, post-graduate programs, and OU Dentistry Faculty Practice who will serve one-year terms and who may be reappointed.  In addition, student members on the committee will be nominated by the Director of Compliance and approved by the Assistant Dean for Clinical Affairs. The student membership will include one senior dental hygiene student to serve a one-year term and one junior dental student to serve a two-year term. The Office of the Director of Compliance shall supply administrative support to the committee.