Dental HO SHO & CDS Training Portfolio - 46 -

Paediatric Dentistry In a Previous Appointment

Name: _______________________________

Please indicate below the number you may have assisted (#A) or performed (#P)None # A # P

Deciduous Teeth:a. indirect pulp cap

……………………………………………………….b. direct pulp cap

…………………………………………………………c. vital one stage pulpotomy

……………………………………………..d. vital multi visit pulpotomy

……………………………………………e. non-vital

pulpotomy……………………………………………………

……………………………………………………

……………………………………………………

……………………………………………………

Permanent Teeth:a. indirect pulp cap

………………………………………………………b. direct pulp cap ………………………………………………………..c. minimal pulpotomy …………………………………………………..d. cervical pulpotomy …………………………………………………..e. pulpectomy …………………………………………………………..f. vital anterior tooth with open apex …………………………………..g. vital posterior tooth with open apex …………………………………h. non-vital anterior tooth with open apex ……………………………..i. multi-rooted canal treatment …………………………………………j. inflammatory root resorption ………………………………………..k. internal root resorption ……………………………………………..

……………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………

Traumatic injuries to the teeth:Crown fractures

a. enamel only ……………………………………………………………

b. enamel-dentine ………………………………………………………..

c. with pulpal involvement ………………………………………………Crown-root fractures ……………………………………………………………….Avulsion ……………………………………………………………………………

……………………………………………………

……………………………………………………

……………………………………………………

Discoloured teeth:vital bleaching ……………………………………………………………………...non-vital bleaching …………………………………………………………………

……………………

…………………….

……………………

Patients with soft tissue and/or body lesions ………………………………………Cases of non carious tooth surface loss ……………………………………………Cases requiring minor oral surgery ………………………………………………..

………………………………

………………………………

………………………………

What clinics have you attended

a. Paedodontic Consultant Clinics ………………………………………b. Joint Orthodontic/Paedodontic Clinic ……………………………….c. IV/GA Clinic ……………………………………………………….

…d. Cleft Palate Clinic

…………………………………………………….e. Haematology ………………………………………………………….f. Cardiology …………………………………………………………….

………………………………………………………………

………………………………………………………………

………………………………………………………………

Dental HO SHO & CDS Training Portfolio - 47 -

Comments:

Signed…………………………………………. ………………………………………….Trainee Educational Supervisor

Date……………………………………………

Dental HO SHO & CDS Training Portfolio - 48 -

Paediatric Dentistry After 2 Months

Name: _______________________________

Please indicate below the number you may have assisted (#A) or performed (#P)None # A # P

Deciduous Teeth:a. indirect pulp cap

……………………………………………………….b. direct pulp cap

…………………………………………………………c. vital one stage pulpotomy …………………………………………….d. vital multi visit pulpotomy

……………………………………………e. non-vital pulpotomy ………………………………………………….

……………………………………………………

……………………………………………………

……………………………………………………

Permanent Teeth:a. indirect pulp cap

……………………………………………………..b. direct pulp cap

……………………………………………………….c. minimal pulpotomy

………………………………………………….d. cervical pulpotomy ………………………………………………….e. pulpectomy ………………………………………………………….f. vital anterior tooth with open apex ………………………………….g. vital posterior tooth with open apex ………………………………..h. non-vital anterior tooth with open apex ……………………………i. multi-rooted canal treatment ………………………………………..j. inflammatory root resorption ……………………………………….k. internal root resorption …………………………………………….

……………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………

Traumatic injuries to the teeth ………………………………………………………Crown fractures ……………………………………………………………………..

a. enamel only ……………………………………………………………

b. enamel-dentine ……………………………………………………….c. with pulpal involvement

………………………………………………Crown-root fractures ……………………………………………………………….Avulsion ……………………………………………………………………………

…………………………………………………………………………

…………………………………………………………………………

…………………………………………………………………………

Discoloured teeth ……………………………………………………………………Vital bleaching ……………………………………………………………………...Non-vital bleaching …………………………………………………………………

………………………………

………………………………

………………………………

Patients with soft tissue and/or body lesions ……………………………………….Cases of non carious tooth surface loss …………………………………………….Cases requiring minor oral surgery …………………………………………………

………………………………

………………………………

………………………………

What clinics have you attended

Dental HO SHO & CDS Training Portfolio - 49 -

a. Paedodontic Consultant Clinics ……………………………………….

b. Joint Orthodontic/Paedodontic Clinic …………………………………c. IV/GA Clinic

…………………………………………………………..d. Cleft Palate Clinic

……………………………………………………..e. Haematology

…………………………………………………………..f. Cardiology

……………………………………………………………..

………………………………………………………………

………………………………………………………………

………………………………………………………………

Comments:

Signed…………………………………………. ………………………………………….Trainee Educational Supervisor

Date……………………………………………

Dental HO SHO & CDS Training Portfolio - 50 -

Paediatric Dentistry After 10 Months

Name: _______________________________

Please indicate below the number you may have assisted (#A) or performed (#P)None # A # P

Deciduous Teeth:a.indirect pulp cap

……………………………………………………b.direct pulp cap ……………………………………………………..c.vital one stage pulpotomy …………………………………………d.vital multi visit pulpotomy ……………………………………….e.non-vital pulpotomy ………………………………………………

…………………………………………………………………

…………………………………………………….

……………………………………………………

Permanent Teeth:a. indirect pulp cap ………………………………………………….b. direct pulp cap ……………………………………………………c. minimal pulpotomy ……………………………………………….d. cervical pulpotomy ……………………………………………….e. pulpectomy ……………………………………………………….f. vital anterior tooth with open apex ……………………………….g. vital posterior tooth with open apex ……………………………..h. non-vital anterior tooth with open apex ………………………….i. multi-rooted canal treatment

………………………………………j. inflammatory root resorption …………………………………….. k.internal root resorption ……………………………………………

………………………………………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………

Traumatic injuries to the teeth ………………………………………………..Crown fractures ………………………………………………………………

a. enamel only ……………………………………………………..

b. enamel-dentine ………………………………………………….

c. with pulpal involvement ………………………………………..Crown-root fractures ………………………………………………………….Avulsion ………………………………………………………………………

………………………………………………………………………………………………………………

………….………….……………………………………………………

………….………….……………………………………………………

Niscoloured teeth ……………………………………………………………..Nital bleaching ……………………………………………………………….Non-vital bleaching ………………………………………………………….

………………………………………………

………………………………

………………………………

Patients with soft tissue and/or body lesions …………………………………Cases of non carious tooth surface loss ………………………………………Cases requiring minor oral surgery …………………………………………..

………………………………………………

………………………………

………………………………

What clinics have you attended

Dental HO SHO & CDS Training Portfolio - 51 -

a. Paedodontic Consultant Clinics …………………………………

b. Joint Orthodontic/Paedodontic Clinic …………………………..c. IV/GA Clinic

…………………………………………………….d. Cleft Palate Clinic

……………………………………………….e. Haematology

…………………………………………………….f. Cardiology

……………………………………………………….

………………………………………………………………………………………………

………………………………………………………………

………………………………………………………………

Comments:

Signed…………………………………………. ………………………………………….Trainee Educational Supervisor

Date……………………………………………