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Date Mailed: [Date Mailing]

National Denturist Association, USA Examination Eligibility Notice and Information

This is your notice of eligibility to take the Denturist examinations. The practical examination is given at a date and time established by the National Denturist Association, USA and held at (a site to be determined). A map of this location is enclosed for your convenience. PRACTICAL EXAMINATION DATE AND TIME Examination Site to be Determined [Examination Date] Registration: 8:00 a.m. Exam Begins: 8:30 a.m. Exam Ends: 6:30 p.m. A total of ten hours is allotted for the timed practical examination. This time takes into account potential waiting periods for evaluations by proctors. Candidates should have no problems with time, but should calculate wait periods into their planning. Practical examination candidates will be allowed to gain entry into the building at 7:30 a.m. on the examination date to set up equipment and supplies. The examination will begin promptly at 8:30 a.m. with no time allowance for late arrivals, so we strongly recommend that you organize your supplies as quickly as possible. The exam will end promptly at 6:30 pm.

The  National  Denturist  Association,  USA  Executive  Office  P.O.  Box  2344  Poulsbo,  WA      98370  360.232.4353  

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National Denturist Association, USA Practical Examination

Information Packet The ability of a candidate to read and Interpret instructions and examination Material is a part of the examination.

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FORMS Forms included in this packet must be submitted to National Denturist Association, USA (NDA, USA) staff on the day of the examination. The only form to be completed before the exam is the Oral Health Certificate! The Oral Health Certificate is prescribed by the NDA, USA and must be signed by a licensed DENTURIST (Denturists must be licensed after January 1, 2004 or if licensed prior to January 1, 2004, have been issued an oral pathology endorsement), DENTIST or PHYSICIAN verifying an oral examination took place within 30 days of the date of the practical examination. All other forms, which include the patient information and treatment record, must be completed at the time of the examination. SUPPLIES Candidates MUST furnish the following: Cold sterilization solution Teeth (No block plane teeth and no flat plane 0o

CVSD posteriors) Knife Any semi adjustable articulator Hammer Plaster and yellow stone Rigid instrument tray Candidates Must furnish the following supplies if used to fabricate dentures: Impression trays and materials Small propane tank/canister and burner Waxes Vibrator Wax pot Lathe with chuck or straight hand piece Burrs Base plate material Disinfecting tray Clinic gown and patient bib with chain Bunsen burner Examination gloves Tray material Mouth mirror Alcohol torch Articulation Paper (tape) Denture cup Any favorite instruments or supplies Hand instruments Cheek Retractors

Gloves Compressed air can

NDA, USA will furnish: Paper goods (paper towels) Natural Gas (if available) Model Trimmer and Bunsen burners

CONFIDENTIALITY All proctors and candidates names will remain confidential to ensure an objective unbiased examination and to safeguard the integrity of the examination. Examination candidates must not have any contact with the proctors and will be known throughout the examination only by a number assigned to identify the candidates work. Examiners are stationed in a separate area and do not observe candidates during the examination. However, due to limitations imposed by the facility, absolute anonymity is not guaranteed.

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ASSUMPTION OF RISK The NDA, USA, its representatives, and facility where the examination is held; its offices, agents and employees; assume no responsibility for injuries that may occur during the administration of the examination, for instruments or personal effects which may be lost, stolen or damaged or for the work done on patients by a candidates. PURPOSE AND OVERVIEW The purpose of the practical examination is to determine and verify that a denturist candidate possesses the minimum level of practical and cognitive skills essential for the competent and safe practice of denturism. The practical examination includes patient treatment, alginate impressions, final impression, bite registration, and development and try-in of trial (wax) denture. The examination will be conducted as if the patient has no existing dentures. EXAMINATION ADMINISTRATION TEAM Proctors - licensed denturists with a minimum of three years general practice selected and trained to grade the practical examination. Mediators - licensed denturists with a minimum of three years of general practice have been trained to grade the practical examination and are there to assist candidates with technical issues. Staff – staff are responsible for the overall administration of the examination. CANDIDATE RESPONSIBILITIES

1. Candidates are responsible for providing their own fully edentulous patients.

2. Candidates are encouraged to bring a patient that has: a. A class one bite; b. Been wearing an existing set of dentures for at least one year; c. Have sufficient vertical dimension to easily set teeth.

3. Candidates may have one alternate patient in case their first patient is rejected; alternates must

meet patient qualifications.

4. Candidates must clean their assigned spaces at the completion of the examination, which includes the lab and clinic area by the use of disinfectant/cleaner and scrub brush/paper towels to clean counters, cabinets, walls and floor surfaces.

5. Candidates are required to turn off all machinery used and place in original positions.

6. Read, understand and sign a Disclosure Statement and Assumption of Risk Form

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CANDIDATE DISQUALIFICATION Candidates who violate any rules or instructions may be declared by the NDA, USA to have failed the examination.

1. Failing to occupy the space assigned throughout the entire examination. 2. Failing to provide his/her own edentulous patient. 3. Failing to provide required materials to be utilized for each phase of the examination. 4. Leaving the examination area without permission from NDA, USA staff. 5. Dismissing the patient without approval from NDA, USA staff. 6. Failing to follow directions relative to the administration of the examination, including termination of

treatment procedures at the scheduled or announced time. 7. Contacting the proctors regarding the examination prior to the scheduled examination or after the

examination has been administered. 8. Using an existing denture in the clinic area. 9. Giving or receiving aid, either directly or indirectly, during the examination process. 10. Failing to clean assigned space upon completion of the examination.

PATIENT QUALIFICATION

7. Patients must be: a. 18 years or older; b. Completely edentulous; c. Examined by a qualified denturist, dentist or physician which is documented on forms

approved by the NDA, USA within 30 days preceding the date of the practical examination verifying the patient is free of oral lesions/diseases;

d. In general good overall health; e. Present, on time, and able to remain in the clinic until all work is completed; f. Read, understand and sign a Disclosure Statement and Assumption of Risk Form; g. Able to carry the tray with your work into the examination area for evaluation.

8. Patients shall not:

a. Be a denturist, denturist student, dentist or dental student; b. Enter the laboratory area at any time; c. Leave the examination site for more than 10 minutes at a time without approval from NDA,

USA staff. PATIENT DISQUALIFICATION If any instructions, requirements or qualifications are not met or have been violated, the candidate will be dismissed from the examination and be declared by the Agency to have failed the examination. CONCERNS OR QUESTIONS Any concerns or questions must be addressed to NDA, USA staff. All staff will be clearly identified through introductions and name badges.

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SCORING AND RETAINED DENTURES The practical examination is a pass/fail evaluation based on established criteria; candidates are required to receive a minimum of 70% to receive a passing score. All examination candidates’ dentures will be retained at the completion of the examination. GENERAL INFORMATION There will be long waiting periods for patients while candidates are in the laboratory. Patients are encouraged to bring adequate reading materials, food, etc. to ensure their comfort while waiting. Candidates are encouraged to bring a “box” lunch as candidates may not have time to break for lunch.

FRIENDS AND FAMILY Friends and family members may assist candidates in carrying supplies and equipment into the examination site from 7:30am – 8:00am. Registration begins at 8:00 am at which time the area is limited to candidates, patients and staff.

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National Denturist Association, USA

Practical Examination Process

1.0 Patient Treatment Record Patient presents with treatment record, oral health certificate and mouth mirror, on a tray.

1.1 1.2 1.3

1.4

1.5

Oral Health Certificate Provided. Documents appropriate medical and dental history: Conducts proper extra-oral exam and documents abnormalities of the glands, tissue, and TMJ. Conducts proper intra-oral exam and MUST document a classification of existing oral condition, supporting structure and previous dentures. Provides appropriate treatment plan in organized manner and chart notes for each visit.

2.0 Final Impression and Model

Take preliminary impressions prior to examination. Bring diagnostic casts (preliminary models) and custom trays to the examination. Patient presents with diagnostic casts, final models, final impression, mouth mirror, and treatment record, on a tray.

2.1 2.2 2.3 2.4 2.5 2.6 2.7

Extension – Lingual/sub-lingual – lower only Accuracy – overall Peripheral Roll – Buccal Labial Hamular Notch – Tuberosities Frenum (upper and lower) Retromolar Pad (lower) Free of Bubbles and Voids – Palate and Alveolar Ridge.

3.0 Trial Denture Patient presents with Articulated Model. Wax model denture, mouth mirror, and treatment record on a tray. Post-dam model at this phase.

3.1 3.2 3.3 3.4 3.5

Centric relation/ ridge crest relation Vertical dimension Excursive movement Occlusal plane Arrangements/aesthetics

4.0 Asepsis Observation of candidates conduct and procedures during examination

National Denturist Association, USA staff will retain dentures at the completion of the examination.

Please Note: Do Not • At this time, correct any defects on

models after pour up. • Post-dam final models during this phase.

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Candidate / Patient Disclosure Statement and Assumption of Risk

By my signature below I attest that: I have read and understand the National Denturist Association, USA Practical Examination Information Packet. I hold harmless the National Denturist Association, USA, facility where the examination is held; its officers, agents and employees; from any claims, actions, liability or cost, including attorney’s fees or cost of defense arising out of or in any way relating to instruments or personal effects which may be lost, stolen or damaged, any injury occurred, or for work performed by the candidate during the course of the examination. I will protect the anonymity of the examination candidates and proctors during the practical examination. I will take any concerns or questions that may arise to staff. I will only enter designated areas as instructed during the examination with approval from staff. Failing to follow instructions or perform requirements may result in failure of the examination. Distractions that delay prompt completion of the examination process may result in failure of the examination. Breach of examination security may result in failure of the examination. ____________________________________________________________________________ Patients Name (Please Print) ____________________________________________________________________________ Patients Signature Date ____________________________________________________________________________ Candidates Name (Please Print) ____________________________________________________________________________ Candidates Signature Date

The  National  Denturist  Association,  USA                                    Executive  Office    P.O.  Box  2344  Poulsbo  WA  98370  360.232.4353  

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Board of Denture Technology

Certificate of Oral Inspection for Denture Construction

I have examined____________________________________________________ Print Patients Full Name ___________________________________________________________________________________________

Print Patients Residential Address On ___/___/____ to establish the level of oral health in relation to the construction Date of a full denture(s). I do ( ) do not ( ) believe the oral cavity of this patient to be substantially free of significant disease. Remarks:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _________________________________________________________________ Denturist, Dentist, or Physician Name (Please Print) License Number ____________________________________________________________________________ Denturist, Dentist, or Physician Signature Date (Denturists must be licensed after January 1, 2004 or if licensed prior to January 1, 2004, have been issued an oral pathology endorsement) I understand the results of my oral inspection as they relate to the construction of a denture(s). __________________________________________________________________ Patients Name (Please Print) ____________________________________________________________________________ Patients Signature Date

The  National  Denturist  Association,  USA                            Executive  Office  P.O.  Box  2344  Poulsbo  WA  98370  360.232.4353  

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Candidate Number____________

Patient Information Patient Name: ______________________________________ Birthdate: __________ Gender: M / F Address:_____________________________________________City:____________Zip:___________

Health History Although dental personnel primarily treat the area in and around your mouth, your mouth is a part of your entire body. Health problems that you may have, or medication that you may be taking, could have an interrelationship with the dentistry you will be receiving. Your denturist is legally obligated to ask the following questions; thank you for answering them. Do you have or have you had any of the following conditions? Yes No Yes No Rheumatic fever High/low blood pressure Heat disease Drug sensitivities Asthma Liver disease Diabetes Kidney disease Epilepsy Prolonged /abnormal bleeding Tuberculosis Fainting Hepatitis / Jaundice Venereal disease Heart attack / stroke Cancer Mental / Nervous disorders Arthritis Do you smoke or use chewing tobacco H.I.V. positive A.I.D.S Thyroid disorder Clenching/grinding/headaches Chronic dry mouth T.M.J. injuries/lower jaw problems Allergies to dental materials Drug allergies Neuromuscular disorder Yes No Do you have any disease, condition, or handicap not listed above that you should mention? If so, please explain:________________________________________________________ Are you now under the care or treatment of a doctor? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Have you had any serious difficulty during previous dental treatment? . . . . . . . . . . . . . . . . . Do you have any difficulty chewing food? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Do you have any difficulty opening your mouth wide? Closing? . . . . . . . . . . . . . . . . . . . . . . . Do you have pain while wearing your dentures? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Are you satisfied with the appearance of your present dentures? . . . . . . . . . . . . . . . . . . . . . . How old are your dentures? __________________________________________________ Date of last dental visit:_______________________ Dental X-rays___________________ Please list all prescription medication you are currently taking: Name of Medication Condition Being Treated

________________________________________ Patient Signature Date

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ORAL EXAMINATION OF: _____________________________________________DATE__________________________ Digital and Visual Examination Comments / Notes Patient’s general appearance Dental radiographs taken Palpate glands of neck and jaw Outer surface of lips and face Gingiva; Describe;______________________________ _____________________________________________

Buccal Mucosa Palate/palatal form; Describe:_____________________ _____________________________________________

Tongue upward/outward Sublingual glands Frenal attachments Vestibules Vibrating line Denture bearing mucosa Saliva; Describe;_______________________________ TMJ _________________________________________

Floor of mouth high/low to crest of ridge Ridge form Ridge relationship; Describe:_____________________ _____________________________________________

Age of present dentures a. Fit b. Function c. Esthetics Tooth selection a. Shade b. Mould c. Material

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TREATMENT RECORD PATIENT____________________________________________________________________________________ Date Activity / Service Charges Payments Balance

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ATTENTION

Attached are the forms the proctors use to evaluate and grade the dentures that you

construct during the examination.

These forms are provided to you in advance as a courtesy for your

understanding of the criteria used to grade the practical examination.

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Practical Examination Record 1.0 PATIENT TREATMENT RECORD Patient presents with Treatment Record, oral health certificate and mouth mirror, on a tray. Examiner must ensure patient meets minimum qualifications.

POSSIBLE POINTS POINTS

GIVEN

1.1 Oral health certificate provided - patient must be an acceptable denture candidate. If another patient is not immediately available; do not move to 1.2

Pass / Fail

1.2 Documents appropriate medical and dental history.

25 (full credit

for completed

form)

1.3 Conducts proper extra-oral exam and documents abnormalities of the glands, tissue, and TMJ.

25

1.4 Conducts proper intra-oral exam and MUST document a classification of existing oral condition, supporting structures and previous dentures.

25

1.5 Prescribes appropriate treatment plan in organized manner and chart notes for each visit.

25

TOTAL: 100 2.0 FINAL IMPRESSION AND MODEL Patient presents with final model, final impression and mouth mirror and treatment record, on a tray. Examiner ensures impression and model meets minimum standards:

POSSIBLE POINTS

POINTS GIVEN

2.1 Extension – Lingual/Sub-Lingual – Lower Only.

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2.2 Accuracy - Overall.

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2.3 Peripheral Roll – Buccal Labial.

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2.4 Hamular Notch – Tuberosities – Hard Palate.

15

2.5 Frenum (upper and lower).

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2.6 Retromolar Pad (Lower).

15

2.7 Free of Bubbles and Voids – Palate and Alveolar Ridge.

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TOTAL: 100

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Practical Examination Record 3.0 TRIAL DENTURE Patient presents with Articulated Model, Wax Model Denture and mouth mirror and treatment record, on a tray. Examiner ensures products meet minimum standards.

POSSIBLE POINTS

POINTS GIVEN

3.1 Centric Relation/ Ridge Crest Relation Protrusive Lateral Note: If centric relation and ridge crest relation is not correct on the candidates 3rd attempt the candidate will fail and the proctor will not proceed to score 3.2.

1st - 325/ 2nd - 225 3rd -

130 or Fail

3.2 Vertical Dimension Open Closed Note: If vertical dimension is not between these measurements, do not move to 3.3 - send back to candidate until pass or time expires

325

Or

Fail

3.3 Excursive Movement

50

3.4 Occlusal Plane Too High Too Low Not Level

50

3.5 Arrangement/Aesthetics Level appearance Speech

50

TOTAL: 800

Practical Examination Record 4.0 GENERAL OBSERVATIONS (MEDIATOR)

• Mediator will mark model with initials after final model is poured and ground

Mediator provides general observations on candidate conduct and procedures during examination. In addition to observing candidates, mediator may recommend disqualification of any candidate for flagrant violation of aseptic procedures

YES NO

4.1 Patient Relations:

4.1.1 Patient treated courteously, and with caring and kindness

4.2 Uses Aseptic techniques:

Laboratory 4.2.1 Wears Gloves When Handling Contaminants.

4.2.2 Disinfects Contaminants Properly.

4.2.3 Uses Proper Transportation Methods Between Lab and Clinic

Personal/Patient Clinical 4.2.4 Wears Gloves.

4.2.5 Washes Hands Appropriately.

4.2.6 Disinfects Contaminants Properly

4.2.7 Paperwork Not Contaminated

If mediator observes any violation of examination rules or flagrant violation of aseptic procedures, they may recommend disqualification of the candidate from the examination.