MASTER OF SCIENCE
IN CLINICAL DENTISTRY
ORTHODONTICS
Speciality Programme Handbook
2020 – 2021
Faculty of Biology, Medicine and Health
The University of Manchester
Division of Dentistry
Coupland Building 3
Oxford Road
Manchester
M13 9PL
tel +44 (0) 161 275 6620
www.dentistry.manchester.ac.uk
Dear Postgraduate Student,
As Programme Lead for the MSc in Clinical Dentistry: Orthodontics, I would like to welcome you to Manchester and to the Orthodontic department within the Division of Dentistry in the School of Medical Sciences.
Orthodontics presents you with a challenge, our speciality requires rigorous academic discipline combined with precise clinical skills. You will face a series of new clinical challenges and, unlike your fellow students will be learning new and complex clinical skills throughout your 3 year period of study.
Early in the programme you will meet with a number of people to help and support you. This include’s Ms Kim Britt the programme administrator, our team of orthodontic nurses and your clinical/academic teachers, all of whom have a wealth of clinical and academic experience to share. You will be introduced to the clinical routines and should listen carefully to our staff who will try their best to support your clinical learning. You will have your first experience of orthodontic research and I hope you will find all of this interesting and rewarding.
I hope you will feel confident in your new environment and ready for the challenges ahead, however, do bear in mind that all the teaching staff are always available to support and help you in any way possible.
Orthodontics is a fascinating and rewarding area of study and to become a successful specialist orthodontist you will need the right attitude, skills and knowledge. On behalf of all the Orthodontic staff I wish you great success with your studies.
Yours sincerely
STEPHEN WARD
Consultant in Orthodontics/Programme Lead
1. STAFF CONTACTS
Mr Stephen Ward, Programme Lead
Tel. : 0161 275 6620
e-Mail: Stephen.Ward-2@manchester.ac..uk
Office Location : Coupland Building III (Wednesdays only)
Ms Mariyah Nazir
Clinical Programme Director
e-Mail: Mariyah.Nazir@manchester.ac.uk
Office Location: University of Manchester Dental Hospital, Floor 2.
Miss Kim Britt, Programme Administrator
Tel : 0161 275 6620
e-Mail : kimberley.britt@manchester.ac.uk
Office location : Coupland Building III
Ms Pauline Stringer, Clinical Reception
Tel : 0161 275 6668
Office Location : Orthodontic Reception, Dental Hospital (Floor 2)
For a full list of contact details, please see Appendix 2.
Staying Safe – Covid-19
Feeling prepared and equipped at the present time inevitably brings thoughts of health and safety. We have followed the advice from Universities UK, Public Health England and the Foreign and Commonwealth Office to make sure our campus is a safe and happy environment for you to start your studies. When arriving on campus, you’ll notice the changes we’ve made to keep everyone safe. For example, our buildings will have clearly marked entry and exit points; we’ll be asking everyone to sanitise or clean their hands immediately on entry; and markings on floors, stairwells and doors will help maintain social distancing. Read our detailed safety guidance here. As part of our University’s commitment to keep all staff and students safe we are strongly recommending everyone on campus to download the NHS COVID-19 app It’s important for everyone to follow the guidelines on campus to keep themselves and others safe. We have faith that all members of our University community will do the right thing. You can politely remind people of the guidelines if they aren’t following them. If you still have concerns, you can report these to our COVID-19 team via Covid-info@manchester.ac.uk Breaches of COVID-19 guidelines may be subject to University disciplinary action. Our ‘Staying Safe’ microsite outlines the safety measures that are in place as well as useful information regarding:-
- Face Coverings
- What to do if you, or someone you live with, has COVID-19 symptoms
- How to register with a GP (doctor)
- Keeping yourself and your neighbours safe off campus (incl. local restrictions and consequences for breaking the rules)
- Health and wellbeing support
- Financial Support
Student Frequently Asked Questions is regularly updated online but if you can’t find what you are looking for, please contact your school as soon as possible.
Faculty of Biology, Medicine and Health PGT Online Skills Training
The Faculty has developed a skills training resource to support you through your postgraduate taught programme. This online material should supplement the assessed learning material and activities undertaken in your taught programme.
Introductory Course
All students are automatically enrolled onto a number of introductory course units that provides information on health and safety, academic malpractice and academic literacy. Completion instructions for each of these units are clearly defined within the course. Completion of these units is mandatory for all students. All assessments must be completed as soon as possible after the programme begins, with the academic malpractice assessment completed before the first piece of coursework is submitted. Completion of these units is monitored by the School.
Accessing the online skills resource
You can access Blackboard through the My Manchester portal (http://my.manchester.ac.uk). The skills training resource is available in an academic community space available to all registered PGT students in the Faculty through Blackboard.
If you cannot see these units in your Blackboard please contact your Programme Administrator.
2. ORTHODONTIC PROGRAMME OVERVIEW
2.1 Introduction
Teaching will mainly take place the University of Manchester Dental Hospital University Campus and the peripheral District General Hospitals.
This handbook includes information on the aims and objectives, structure, teaching and learning methods and management of the orthodontic clinical units and should be read in conjunction with the PGT Handbook.
2.2. Aims and objectives of the Programme.
The aim of the clinical unit is to give the student clinical skills and knowledge relevant to the diagnosis, treatment planning and clinical management of patients.
To educate graduate students to provide high quality care for patients with malocclusion.
To equip students with skills for critically evaluating evidence;
and to encourage a spirit of enquiry.
The clinical training part of the programme involves attendance at clinics in the University of Manchester Dental Hospital and associated NHS Hospital Trusts. During this time students provide treatment for a carefully selected group of patients under direct supervision of Consultant Orthodontists.
2.3. Basic Outline
The programme is offered on a full-time basis over 36 months. See timetable for further information. Applicants admitted to the programme will attend for a minimum of 44 weeks in each year of enrolment.
Students will be given a personal cohort of patients ready to start treatment and some transfer cases already under orthodontic care.
Each student will start approx. 100 untreated cases and be expected to complete treatment of at least 50 cases.
Cases will be treated with contemporary fixed appliances, temporary anchorage devices, extra oral anchorage and rapid maxillary expansion. Some cases will require surgical and restorative involvement.
Disability Advisory and Support Service (DASS) The University of Manchester welcomes students with a disability or specific learning difficulties. The University has a Disability Advisory and Support Service, who can supply further information and DASS advisors will be pleased to meet you to discuss you needs. DASS will liaise with your School through the Disability Coordinator to make the necessary arrangements for your support during your time in Manchester. The DASS office can also provide a copy of the University’s Disability Statement, ‘Opportunities for Students with Additional Support Needs at the University of Manchester’ which sets out the policy and provision for students with a disability. DASS Contact Details:- Location: 2nd Floor, University Place Tel (Disability Service) +44 (0)161 275 7512 Tel (Assessment Centre) +44 (0)161 275 0990 Mobile Number (Text only for d/Deaf students) 07899 658 790 Email (Disability Service) dass@manchester.ac.uk Email (Assessment Centre) assessments@manchester.ac.uk School Disability Coordinator Contact Details:- Email: dc.medicalsciences.pgt@manchester.ac.uk
2.4. Overview of the Programme
The programme is designed for dental practitioners with a minimum of two years recent experience in general professional training or equivalent and who wish to further their knowledge in Orthodontics. Academic teaching will take place predominantly in seminar rooms in the University of Manchester Dental Hospital and Campus with Clinical sessions in the University of Manchester Dental Hospital and selected District General Hospitals in the North West of England.
3. SUMMARY OF PROGRAMME STRUCTURE
3.1. Structure of the Programme
Programme Specifications can be found on Blackboard. The structure of the Masters course is as follows:
Each unit has a credit rating.
The number of credits required for the award of the degree of MSc in
Dental Specialties (Orthodontics) is 180 credits.
Year 1
DENT61010 Research Methods 15 credits
DENT70001 Biostatistics 15 credits
DENT60050 Basic Orthodontic Diagnosis 15 credits
Year 2
DENT60051 Orthodontic Principles 15 credits
Year 3
DENT60052 Reflective Orthodontic Practice 30 credits
DENT60053 Applied Principles of Orthodontics 30 credits
DENT60020 Dissertation 60 credits
Award of MSc 180 credits
3.2. Research Methods and Biostatistics Units (DENT 61010 and
DENT70001) – (30 credits)
See Personal Academic Development Programme and PGT Handbook 2020.
3.3. Specialty Clinical Unit (90 credits)
Aims
The aim of the clinical unit is to give you an understanding of the scientific basis of orthodontics, with particular emphasis on current thinking relevant to the diagnosis, treatment planning and clinical management of patients.
Teaching in orthodontics will be provided throughout the programme, details of which are given in this handbook. This element will include tutorials, seminars and clinical demonstrations. You are encouraged to attend other relevant seminars in other clinical disciplines to gain a broad-based perspective to orthodontics.
Instruction will be given in clinical and laboratory aspects of Orthodontics. These will take the form of demonstrations, seminars and practical laboratory exercises.
Objectives:
-
- To equip you with the knowledge base needed to provide high quality care for patients with malocclusion
- To equip you with the skills for critically evaluating evidence
- To encourage a spirit of enquiry.
More details of specific aims and learning objectives are to be found under the appropriate headings in Section 8.
3.4. Research Unit
Dissertation (60 credits)
Aims
The aims of this part of the programme are:
- To train the student in the identification, formulation and implementation of a specific research project
- To give the student experience of working (researching) independently
- To test the extent to which the student has achieved synthesis of his/her skills and knowledge via a report (dissertation) of the research topic.
Objectives
On successful completion of the programme, each student will have acquired:
- Training to carry out a supervised research topic
- Experience in preparing the research topic
- Experience in producing a bound dissertation of 10,000 – 15,000 words based on research and by the required submission date
- Skills to be able to discuss and defend the research and results in an oral examination.
4. TEACHING & LEARNING METHODS (Course Unit
Outlines)
The Specialty Clinical Unit is designed to encourage you to take responsibility for your own learning. The taught elements are based around small group learning, didactic seminars, practical skills training, online learning and student-led enhancement sessions.
Clinical teaching involves close supervision of a personal cohort of patients with severe malocclusions led by orthodontic specialists and hospital consultants.
The type of teaching and learning opportunities vary, and include tutorials, small group seminars, self-directed learning and laboratory tuition.
In addition, activities on the taught clinical unit are supplemented by:
- Participation in appropriate extra-curricular clinical courses
- Attendance at seminars given by guest lecturers.
The mandatory clinical training module that complements the MSc programme provides you with the opportunity to put the knowledge gained through the taught unit into practice on closely supervised clinics within the Dental Hospital and associated local Hospital Trusts.
During this time students provide treatment for a carefully selected group of patients under direct supervision of Consultant Orthodontists.
4.1 DENT 61010 and DENT70001 – Research Methods and Biostatistics Units – (30 credits)
See Section Two of the PGT Handbook for further information.
4.2. Content of Specialty Clinical Unit (90 credits)
Teaching in the specialty clinical unit of orthodontics is provided throughout the programme. Instruction will be given in clinical and laboratory aspects of orthodontics in the form of seminars and practical laboratory sessions as well as clinical exercises.
Seminars will be planned and reading from the scientific literature on related subjects will be assigned, the aim being to expose the student to a range of topics in a short period. Students will be challenged to assess the available evidence and to determine the biological basis for acceptable and non-acceptable methods and techniques.
4.2.1. DENT 60050 Basic Orthodontic Diagnosis (15 credits)
The aim of this first part of the programme is to ensure students have an ability to describe malocclusion and the skills to produce high quality patient records. Students will begin to build their orthodontic knowledge base and develop clinical skills compatible with the clinical progress of their patients. The beginning of the programme is busy with many conflicting demands on students to begin their research and scientific understanding but at the same time build the clinical case load and develop clinical skills.
4.2.2. DENT 60051 Orthodontic Principles (15 credits)
The aim of this second part of the programme is to complete the content part of the academic programme. Through seminars, teaching, external courses and personal study students should have built up a knowledge base. Whilst continuing with the research and clinical learning
4.2.3. DENT 60052 Reflective Orthodontic practice (30 credits)
4.2.4. DENT 60053 Applied Principles of Orthodontics (30 credits)
Units DENT60052 and DENT60053 include preparation for the summative assessment and a revision programme to ensure curriculum coverage prior to programme completion. The content of some of these seminars will be driven by the students and the final year includes preparation for the external Royal College assessment M.Orth, essential for inclusion on the specialist list.
The nature of orthodontic care means even at this late stage new clinical skills are being introduced however; confidence and proficiency will be developed in other areas. A high degree of professionalism is expected throughout the programme but at this stage these attributes are evidenced by the portfolio of cases produced by the students, the quality of diagnosis, skills in treatment planning and delivery, records of the cases, their analysis and understanding of the outcomes and the ability to recognise alternative options and areas for improvement.
4.3. DENT60020 Dissertation (60 credits)
Each student must undertake a research project and a review of relevant literature, methodology and results presented in the form of a dissertation.
Guidelines for the preparation of a dissertation and the Notice of Intention to Submit form can be found on Blackboard.
Supervisors will discuss with the student suggested topics but students are also encouraged to suggest potential topics. As the dissertation must be completed within the time span of the programme, it is essential that the project is commenced early in the programme. As most of the second half of the last semester in year 3 will be taken up with examinations and writing-up of the dissertation, it is recommended that the presentation cases be completed prior to the middle of the second semester.
Regular meetings between each student and the member of staff nominated as his/her supervisor will be arranged albeit it is your responsibility to request a meeting with your supervisor. These meetings are inevitably frequent in the early stages of the project when design and preparation work demands a high intensity of work. Each meeting must be recorded with outcomes summarised and objectives set for research to be performed prior to the next visit by way of completion of progress forms.
4.4. Blackboard
The Orthodontic programme also has an online presence via the Virtual Learning Environment (VLE) known as Blackboard. The Blackboard unit is DENT77001.
Blackboard is a repository of the learning resources and will be used for providing programme-related information and announcements and thus students are expected to check their Blackboard space frequently.
Access to Blackboard is possible by using your central university username and password to log into the Student Portal at https://login.manchester.ac.uk/cas/login?service=https%3A%2F%2Fmy.manchester.ac.uk%2F
4.5. Laboratory Module
You will be required to familiarise yourself with the laboratory techniques for fabrication of orthodontic appliances. Prescribed exercises are assessed.
Requirements
You are expected to be familiar with the technological aspects of removable appliance construction. You will be expected to be able to construct the following components to a clinical standard:
- Adams clasp
- T spring
- Z spring
- Hawley labial bow
5. ASSESSMENT, PROGRESSION & EXAMINATIONS
See Section Five of the PGT Handbook 2020.
It is important that all students familiarise themselves with the University’s Taught Masters regulations at the link below, a copy of which is on the Orthodontic Blackboard.
5.1. Assessments
5.1.1 Year One Assessments
DENT 61010 and DENT70001 –
Research Methods and Biostatistics Units.
See Section Five of the PGT Handbook.
DENT60050 – Basic Orthodontic Diagnosis (15 credits)
An assessment at the end of year 1 consisting of:
- The presentation of an ongoing treated case using the format of the Royal College of Surgeons M.Orth examination. The presentation will include the diagnosis, clinical records, special investigations as needed and a problem list. (30%)
- The Oral presentation of an ongoing treated case. The presentation will include the diagnosis, clinical records, special investigations as needed and a problem list. (30%)
- The description and diagnosis of an unseen case. The case material will include clinical records, special investigations as needed and the candidate is expected to describe their findings from an examination of the records, come to a diagnosis and include a problem list structured in a logical and defensible order. (40%)
5.1.2. Year Two Assessment
DENT60051 – Orthodontic Principles (15 credits)
Assessment at the end of Year 2 will be in MCQ format with questions to test knowledge of orthodontics and application of knowledge to solve clinical problems.
5.1.3. Year Three Assessments
DENT60052 – Reflective Orthodontic Practice (30 credits)
Assessment at the end of Year 3 will be by a written paper using a short answer format.
DENT60053 – Applied Principles of Orthodontics (30 credits)
Assessment at the end of Year 3 will be
- By the presentation of the records of two completed cases using the template developed by the Royal College of Surgeons for the M.Orth examination. The portfolio will be the candidate’s opportunity to demonstrate the clinical skills and knowledge they have gained on the programme. (30%)
- Candidates will examine the records of an unseen case and will be expected to describe the malocclusion, provide a diagnosis and options for treatment, describe the sequence of mechanotherapy used for any of the available options and be able to respond when clinical treatment fails to make the normally expected progress. (40%)
- Candidates will also be expected to describe their knowledge, skills and behaviours tested in an oral assessment with two examiners, one of whom will be the external examiner. (30%)
5.1.4. DENT60020 – Dissertation (60 credits)
In order to progress to dissertation, candidates have to achieve a minimum of 120 credits in the taught component of the programme.
The dissertation must be submitted in accordance with University of Manchester prescribed guidelines.
See Section 3 of the PGT Handbook 2020 for further information.
Marking
Year 2 and Year 3 written paper examinations will be marked anonymously by two internal examiners (members of the Orthodontic team).
Any discrepancies will be discussed. The students’ names will be revealed only when the marking of all the manuscripts has been completed.
Year 1 oral examination will be in the presence of one internal examiner (member of the Orthodontic team).
The Year 3 oral examinations are led by the external examiner (see 5.3. Examiner below) and the Programme Director.
Before they can be published to the students, all exam marks have to be ratified by the Postgraduate Taught Tutor at the Exam Board Meeting.
The Exam Board Meeting will be held immediately following the completion of all examinations for Year 1, Year 2 and Year 3.
The dissertations will be marked independently by two internal examiners, one of which will be the supervisor. Any discrepancies will be discussed. Once the internal examiners have marked the dissertations, these, together with the internal examiners’ reports, will be forwarded to the external examiner for moderation.
N.B. The taught part of the programme must be successfully passed before the student may proceed to dissertation.
External Examiner
External examiners are individuals from another institution or organisation who monitor the assessment processes of the University to ensure fairness and academic standards. They ensure that assessment and examination procedures have been fairly and properly implemented and that decisions have been made after appropriate deliberation.
They also ensure that standards of awards and levels of student performance are at least comparable with those in equivalent higher education institutions.
The external examiner for this programme is Simon Littlewood.
External Examiners’ reports relating to this programme will be shared with student representatives at the Staff Student Liaison Committee (SSLC) where details of any actions carried out by the programme team/Division of Dentistry in response to the External Examiner’s comments will be discussed. Students should contact their representatives if they require any further information about External Examiners’ reports on the process for considering them.
Please note:
It is inappropriate for students to make direct contact with External Examiners under any circumstances, in particular with regards to a student’s individual performance in assessments. Other appropriate mechanisms are available for students, including the University’s appeals or complaints procedures (http://www.studentsupport.manchester.ac.uk/who-can-i-talk-to/complaints-and-appeals/)
And the UMSU Advice Centre
In cases where a student does contact an External Examiner directly, External Examiners have been requested not to respond to direct queries. Instead, External Examiners should report the matter to their programme contact who will then contact the student to remind them of the other methods available for students.
If students have any queries concerning this, they should contact their Programme Office (or equivalent).
Regulations and Arrangements For Mitigating Circumstances, Resits, Compensation – See the PGT Handbook 2020.
Referrals
The pass mark for the combined taught units (Research Methods, Biostatistics and the four specialty units) is 50%.
Candidates who fail one of the four clinical units detailed above may be required to resit that unit.
In the case of failure in the Basic Orthodontic Diagnosis unit, candidates who are required to resit this unit will have to submit a new clinical case.
5.6. Student Appraisals
Feedback sessions with the programme lead will be held on completion of each module of the taught programme. The dates for these reviews can be found in the timetables.
5.7. Attendance
Students are expected to attend all scheduled teaching sessions punctually.
A record of non-attendance and reason for non-attendance will be maintained and students giving cause for concern will be required to see the Programme Director. (See PGT Handbook 2020). Unjustified non-attendance is considered to be unprofessional and will be reflected in the periodic progress forms.
Holiday leave will, in general, have to be taken during the breaks in teaching.
As you have a professional responsibility to provide ongoing care for your patients a maximum of 3 weeks continual holiday absence will be allowed.
In all instances, the leave form (available on Blackboard) will have to be completed and approval granted BEFORE making travel arrangements.
This is applicable for any leave even if it is only half a day. In the event of illness or unavoidable absence from a teaching session, students are required to inform Kim Britt by email before the start of the session.
It is important you organise your clinics effectively and inform clinical support staff if you will be absent at any time.
A minimum notice period of 6 weeks will be required for cancellation of clinics due to leave or attendance at third party courses.
In case your absence due to sickness is 7 days or less, you will also have to complete the sickness form (Self certification) and email a copy to the programme administrator. If you sickness is for more than 7 days you will need a certificate from your GP or, in case of hospitalisation, from the hospital consultant.
The Self Certification form can be found on Blackboard.
As you are provided with a cohort of NHS patients for your clinical training, it is important you act professionally and manage your clinical diary correctly. Complaints from patients will be taken very seriously and will form part of your appraisal as will feedback from nursing and clinical staff.
Absences from the clinic due to illness should be reported by phone directly to the Ortho Clinic Reception Desk (0161 393 7732)
5.8. Consequence of Unsatisfactory Progress
Students who are considered to be making unsatisfactory progress will be discussed by the Dental Graduate Education Committee (GEC). GEC will appoint a GEC Progress Committee (normally the Chairman, the Postgraduate Manager and the relevant Specialty Clinical Unit Director) and the student will be required to attend the duly convened Progress Committee meeting of the GEC.
The student may be advised that his/her registration be suspended or terminated. (See PGT Handbook 2017).
6. FEEDBACK
The principles of feedback are as follows:
- Feedback should be provided in a timely manner that helps students understand
(i) the marks or grades they have received for work submitted and
(ii) how they might improve their performance in the future. - Feedback should be as personal as possible to the individual student to enable reflection on individual skills and performance.
- Students have a responsibility to consider feedback given on their work, to seek to understand it, and to act on it.
Examination feedback
Feedback forms will be completed by examiners for all elements of accredited assessment and students are encouraged to make an appointment with the Programme Director via the Programme Administrator to discuss such feedback.
Feedback to Students Policy: http://documents.manchester.ac.uk/display.aspx?DocID=6518
7. STUDENT REPRESENTATION
a) Formal:
There is an elected postgraduate student representative for postgraduate taught programmes in the Division of Dentistry on the Graduate Programme Committee.
b) Informal:
The small student: staff ratio on clinics means that problems may be discussed and resolved expeditiously.
See PGT Handbook 2020.
8. Academic malpractice
See PGT Handbook 2020
9. ACADEMIC APPEALS/COMPLAINTS
See PGT Handbook 2020.
10. PROGRAMME MANAGEMENT
See Appendix 1.
11. SUBMISSION OF DISSERTATION
See PGT Handbook 2020.
12. GENERAL DENTAL COUNCIL UK SPECIALIST LIST
Whilst the programme is recognised by the UK Royal Colleges for Membership in Orthodontics examinations, the Orthodontic Specialty Training programme (with national Training Number) is designed for those who wish to undertake full orthodontic training by competitive entry via National Recruitment, organised by the London Deanery.
Please note that the MSc training programme does not have UK National Training Numbers (NTNs).
13. LIST OF SUBJECTS IN THE CURRICULUM
The broad contents of the programme are described below. The detailed content may vary from time to time in response to student needs and recent developments in the fields. The content reflects the Erasmus recommendations on European orthodontic courses.
13.1. Biological Sciences relevant to Orthodontics
Aim
The aim is to provide information on biological sciences relevant to orthodontics.
Objectives
At the end of the module the students should have an understanding of:
- Fundamental concepts in cell and molecular biology
- Current concepts in genetics and the relation of genetics to normal and abnormal craniofacial form
- Current opinions in craniofacial embryology and malformations
- Somatic and craniofacial growth with particular reference to age changes
- The physiology of breathing, swallowing, mastication and speech which are of relevance to understanding the aetiology and treatment of malocclusion.
- The psychological concepts in the child, adolescent and adult, together with modifications in facial impairment.
13.2. Basic Orthodontic Subjects
This includes:
- Development of dentition
- Tooth movement and biomechanics
- Orthodontic materials
- Radiology and analysis of radiographs
13.3. Development of the dentition
Aim
To provide information on the development of the dentition.
Objectives
At the end of this section the student will have detailed knowledge of
- Eruption times of deciduous and permanent teeth in addition to the dental anatomy and embryology relevant to tooth eruption
- Calcification times, root formation and crown and root completion times
- Methods of assessing dental age and comparing with chronological age of an individual using a radiograph
Teaching activity : Problem-based learning, seminars, computer assisted learning.
13.4. Tooth movement and biomechanics
Aim
To provide information on the physiology of tooth movement.
Objectives
At the end of this module the student should have detailed knowledge of
- The factors involved in the tooth movement
- The scientific research work on the tooth movement
- Bio-chemical mediators and their role in tooth movement
- Mechanics of tooth eruption and specific timing of tooth development and eruption
- Bio-mechanics in relation to orthodontic tooth movement and dentofacial orthopaedics
13.5. Orthodontic Materials
Aim
To provide information on contemporary orthodontic materials
Objectives
At the end of this module the students should:
- Be familiar with the development of orthodontic materials over the past few decades with emphasis on archwire and adhesive technology
- Have an understanding of the historical relevance of archwire materials such as gold and stainless steel archwires as well as the less commonly used archwires such as TMA and Elgiloy.
- Have an understanding of the development of adhesives
- Have a knowledge of the current attempts to incorporate a useful form of fluoride within the cement material and an understanding of the relative strenghts of bonding adhesives.
- Knowledge of the development that is being made in the field of adhesive technology.
Teaching activity : Problem-based learning, seminars.
13.6. Radiology and its relevance to Orthodontics
Aim
To provide information on radiology relevant to orthodontic clinical practice.
Objectives
At the end of the module the student should:
- Be familiar with the various radiographic techniques currently used in orthodontics
- Understand how to take the radiographs
- Interpret and analyse the radiographs
- Understand their relevant advantages and disadvantages of available radiographic techniques
- Should be familiar with the recommendations of the British Orthodontic Society (BOS) Working Party into the use of radiographs in orthodontics.
Teaching activity : Problem-based learning, seminars.
13.7. General Orthodontic Subjects
This includes a general background to the aetiology, diagnosis and treatment of malocclusions taking into account growth and the long-term effects of orthodontic treatment. Its content will be divided into:
- Examination and diagnosis
- Treatment planning
- Growth prediction
- Orthodontic relapse
- Hazards of orthodontics
13.8. Examination and diagnosis
Aim
To provide information on orthodontic examination and diagnosis.
Objectives
At the end of this module the student should be able to:
- Take full history and instigate any special tests that are required to enable a complete diagnosis to be made
- Have an understanding of all records needed to allow a full diagnosis
- Demonstrate their ability to carry out diagnosis.
Teaching activity : Problem-based learning, seminars and practical demonstrations of patient examination and diagnosis.
13.9. Treatment Planning
Aim
To provide information on orthodontic treatment planning.
Objectives
At the end of this module the student should be able to:
- Formulate a number of treatment plans considering all the available options
- To understand when and why an interdisciplinary referral is necessary
- Have full understanding of the limitation of orthodontic treatment and be able to transmit this information effectively to the patients.
Teaching activity : seminars on treatment planning form a core part of the programme prior to clinical sessions.
13.10. Growth Prediction
Aim
To provide information on the historical and contemporary role of growth prediction in orthodontics.
Objectives
At the end of this module the student will have an understanding of
- Literature on growth prediction
- The relative merits of hand-wrist radiographs, single lateral skull radiographs, serial lateral skull radiographs, growth charts, height measurements and cervical vertebrae maturation indices
- Cephalometric superimposition to indicate the growth that has occurred and they should also be able to make an assessment of what further growth may or may not occur.
- Of the relevance of growth to the success or failure of orthodontic treatment.
Teaching activity : problem-based learning and seminars.
13.11. Orthodontic relapse
Aim
The student will be able to understand and appreciate the role of relapse in orthodontic treatment.
Objectives
At the end of the module the student should have an understanding of
- The factors that may contribute towards change in tooth position following a course of orthodontic treatment
- Differences between maturation of the dentition and relapse as a direct result of inappropriate tooth movement
- Movement which may occur following orthognathic surgery and be able to discuss whether the movements are a result of orthodontics or surgery
- Methods of minimising post treatment relapse
- A throrough understanding of the research on the position of the lower labial segment
Teaching activity : Problem-based learning and seminars.
13.12. Hazards of Orthodontics
Aim
To provide information on orthodontic iatrogenic hazards.
Objectives
- Latrogenic hazards of orthodontic treatment
- Risk/benefit balance in orthodontic treatment
- Informed consent. Should be able to obtain comprehensive consent from all their patients.
Teaching activity : Problem-based learning and seminars.
13.13. Orthodontic Treatment Techniques
The objective of this area is to develop the proficiency to perform operative orthodontic procedures independently. It will be divided as follows:
13.14. Removable appliances
Aim
To provide information and experience in the use of removable appliances in orthodontic treatment.
Objectives
You should have an understanding of:
- The place of removable appliances in contemporary orthodontic therapy
- The indications for removable appliances
- The limitations of removable appliances
- Fabrication and repair of removable appliances
- All removable appliances
Teaching activity : Problem-based learning, seminars and preceptorship in the laboratory fabricating appliances.unctional Appliances
13.15. Functional Appliances
Provide information and experience of the use of functional orthodontic appliances.
Objectives
You should have knowledge of
- The history of functional appliances
- The advantages and disadvantages of all the commonly used functional appliances and should be familiar with several of these and reasonably competent with one or two.
Teaching activity : Problem-based learning, seminars and fitting of funtional appliances.
13.16. Headgear
Aim
To provide information and experience of the use of orthodontic headgear.
Objectives
You should
- Be familiar with all the headgear types available
- Understand the advantages and disadvantages of each type of headgear
- Be able to fit all headgear to their patients to provide suitable therapeutic forces.
- Have knowledge of the dangers of headgear.
Teaching activity : Problem-based learning and Seminars. Fitting of headgear to each other in practical sessions. Fitting patients with headgear.
13.17. Fixed Appliance Therapy
Aim
To provide information on the use of fixed appliances.
Objectives
- Knowledge of the development of fixed appliances
- Confidence in the use of pre-adjusted edgewise system
- A theoretical grounding in the use of other techniques such as Begg technique or the Tip Edge technique. The scope and limitations of these different techniques should be discussed in some detail.
Teaching activity : Problem-based learning and seminars. Clinical teaching.
13.18. Multidisciplinary Procedures
This provides a foundation for the student to understand the treatment needs of patients with craniofacial anomalies who require multidisciplinary management.
Aim
To provide information on the multidisciplinary nature of orthodontic treatment.
Objectives
You will have an understanding of
- The role of the orthodontist in multidisciplinary care of patients with craniofacial anomalies including cleft lip and palate.
- The history of the clinical techniques that have been used in the treatment of individual’s with clefts of the lip and palate
- Pre-surgical orthopaedics and its aims and limitations
- The role of the inter-disciplinary team.
13.19. Orthodontic/oral Surgery Interface
Aim
To provide information and experience in orthognathic surgery.
Objectives
You should have
- Knowledge of the development of orthognathic surgery
- Knowledge of diagnosis and planning methods
- Clinical techniques
- Post-surgical care
- Relapse
Teaching activity : Problem-based learning, seminars and clinical.
13.20. Orthodontic Practice Management
The objective of this module is to provide information on
- The management of current orthodontic practice
- Health and safety legislation
- Management within the National Health Service
- Personnel management, recruitment and employment legislation.
Teaching activity : Problem-based learning, seminars and external teaching
14. REGIONAL TRAINERS/CONSULTANTS MEETING
All trainers involved with the Manchester Orthodontic programme meet twice a year. The aims of the meetings are:
- To monitor student progress in all areas.
- To discuss the programme content and direction
- To update trainers.
Journal Club forms part of the formal teaching programme. The Journal Club is held from 8.30am (PROMPT) to 9.30am on Wednesday mornings during term time. Consultants, Post CCSTs, postgraduate students and NHS StRs participate and attendance is compulsory.
The format of the Journal Club consists of article presentations from contemporaneous peer reviewed journals which are then discussed and critiqued.
This gives the presenter experience in the scientific analysis and critique of methodology essential to an evidence-based approach to clinical care.
Additionally, some sessions are allocated to guest speakers from other disciplines such as restorative and paediatric dentistry. Occasionally potential M.Orth cases are presented.
These are extremely rewarding sessions as it gives students the opportunity to interact with other colleagues as well as developing critical appraisal and presentation skills.
16. RECOMMENDED READING
Orthodontics and Occlusal Management
(Clinical Dentistry in Health & Disease) Professor Bill Shaw
Contemporary Orthodontics William R Profitt
Introduction to Orthodontics Laura Mitchell
Twin Block functional therapy
applications William J Clark
Systemized orthodontic treatment
mechanics R McLaughlin et al
Fixed orthodontic appliances:
principles and practice J K Williams et al
Any material on BOS VLE Various authors
Handbook of Orthodontics M.T. Cobourne
Orthodontics: Principles and Practice D. Gill
The Orthodontic patient:
Treatment and Biomechanics A.J. Ireland
17. CLINICAL STAFFING
The Unit is presently staffed by six Consultant Orthodontists (3 with lecturer status), 2 visiting Consultant Orthodontists and 3 Post CCSTs.
Additionally there is one Senior Dental Nurse, fulltime, and 9 qualified dental nurses.
18. CLINICAL FACILITIES
The Orthodontic Clinic
The re-equipped clinical facilities are situated in the west quadrant of the University of Manchester Dental Hospital. The Orthodontic Unit has sole use of 8 fully equipped dental units plus access to a large multidisciplinary clinic with its own waiting area, and three dental surgeries.
There is a junior staff area which is equipped with computers, scanners, printers and digitiser. The computers have access to the AJO and Angle CD-Rom via the network and have also direct link versions of the Journal of Orthodontics, European Journal of Orthodontics and the American Journal of Orthodontics.
Radiographs are no longer available on film. Postgraduate Students will need to carry out online PACS training in order to be able to view radiographs on the CentriCity web pages.
The Regional Cleft Lip and Palate Centre is situated at Central Manchester and Manchester Children’s University Hospitals NHS Foundation Trust (Manchester Royal Infirmary).
APPENDIX 1: CLINICAL UNIT AND TEACHING STAFF
| Mr Stephen Ward | Consultant Orthodontist/Programme Director |
| Dr David Waring | Consultant Orthodontist |
| Mrs Noreen Akram | Consultant Orthodontist |
| Mrs Susi Caldwell | Consultant Orthodontist |
| Mr Stephen Chadwick | Consultant Orthodontist |
| Professor Bill Shaw | Professor of Orthodontics and Dentofacial Development |
| Mr John Brady | Consultant Orthodontist |
| Mrs Maria McNally | Consultant Orthodontist |
| Mr Ovais Malik | Consultant Orthodontist |
| Miss Ailbhe McMullin | Consultant Orthodontist (Manchester Children’s Hospital) |
| Mr John Scholey | Consultant Orthodontist (University Hospital of North Staffordshire, Stoke-on-Trent) |
| Mr Jinesh Shah | Consultant Orthodontist (University Hospital of North Staffordshire, Stoke-on-Trent |
| Mrs Mariyah Nazir | Consultant Orthodontist/ Clinical Training Director |
| Miss Victoria Elton | Consultant Orthodontist |
| Mr Jonathan Smith | Consultant Orthodontist |
| Mr Inderjit Shargill | Consultant Orthodontist |
| Mr Richard Needham | Consultant Orthodontist |
Post CCST’s
Ms Madeleine Storey
Mrs Charlotte Dugdale
Ms Cara Miller
Mr Hesham Ali
Joanna Virgin Senior Dental Nurse
Lisa J. Drzymala Qualified Dental Nurse
Dominique Shorkey Qualified Dental Nurse
Pamela Gill Qualified Dental Nurse
Victoria Lambert Qualified Dental Nurse
Bernice Graham Qualified Dental Nurse
Joanne Laing Qualified Dental Nurse
Sophie Tompson Qualified Dental Nurse
Louise Cowell Qualified Dental Nurse
Lena O’Neill Qualified Dental Nurse
Clinical Reception
Ms Pauline Stringer
Orthodontic Programme Administrator
| Kim Britt | Programme Administrator |
APPENDIX 2: ATTENDANCE AT UNIVERSITY OF MANCHESTER DENTAL HOSPITAL CLINICS
On the days when students are on clinic at the University of Manchester Dental Hospital (UMDH), they are expected to be on clinic at the beginning of each session (9.30am) to assist with broken braces or to look at other cases and generally get involved with other orthodontic cases and not turn up when the first patient is due.
Students will have to stay on the clinic until the end of each session i.e. 9.30am to 12.30pm and 1.30pm to 4.30pm (if applicable).
BOOKING PATIENTS
Only patients referred from a consultant should be taken from the waiting list.
You are NOT permitted to treat friends or relatives.
APPOINTMENTS FOR PATIENTS
It is imperative that all patients are booked through the desk and that the reception staff know who is attending and at what time. This is to ensure that notes can be drawn in good time as well as for other reasons.
It is Trust Policy that you do not treat patients without a set of notes. It is not possible to get the notes unless the patients are booked on the system. It is unprofessional and unacceptable that reception staff should have to find patient notes at the time of arrival of the patient.
If a patient changes or cancel an appointment, a message will be left for the postgraduate student. It is the postgraduate student’s responsibility to re-arrange the appointment with the patient.
Patients should not be contacted in the evenings nor should mobile phone numbers be exchanges.
If a patient does not keep his/her appointment, the postgraduate student will have to re-arrange the appointment. This information must be recorded in the patient’s notes. A further appointment can be sent, however the letter should state clearly that if the patient cannot attend, they must give as much notice as possible with a minimum of one week. If a patient fails a further appointment a defaulter’s letter will have to be sent clearly and politely stating that if they wish to continue to have treatment they must reply within one week to the department otherwise it will be assumed that they no longer wish to have care at the Manchester Dental Hospital. In order to have further treatment they would then have to be re-referred.
NEEDLE STICK INJURIES
There are to be no such injuries!
At all times great care must be taken to ensure that all sharps are handled appropriately. Needles are not re-sheathed but disposed of after local anaesthetic has been given. This is hospital policy and must be adhered to.
Any sharp instrument to be discarded must be placed in the sharps container, not in the bin, this includes damaged files.
Should needle stick injury occur, the Trust guidelines must be adhered to.
SETTING UP THE DENTAL UNIT
The Senior Dental Nurse on the clinic will cover this important subject.
DRESS CODE
As professionals it is expected that we appear smart when attending a clinic. Jeans are not acceptable. Because we wear gowns with short sleeves, it is important that long sleeves can be rolled up. It is not acceptable for sleeved clothes to be worn beyond the gown sleeve.
Watches and jewellery are to be removed before treating patients. Gentlemen are expected to attend wearing a shirt and tie. Ladies should attend with appropriate smart clothes, and with hair tied back if necessary.
Chewing gum on the clinic is not permitted. All personal belongings must be left in your locker except for the immediate requirements for the clinic.
PUNCTUALITY AND TIMING
Clinical sessions may start with some form of seminar or group discussion, often involving topics that are relevant to ‘the day’s business’ For you to gain the most from the clinic it is important that you attend punctually.
Clinical work should be finished at least 15 minutes before the end of the clinical session. This gives you time to write up notes, plan your next visit, appointments etc and time to tidy the units.
You will be warned about finishing your work at an appropriate time. Therefore you must manage your time carefully.
NOTE TAKING
Please ensure that all relevant procedures to a treatment session are recorded chronologically in legible handwriting.
These must be signed by your tutor at the end of the session along with your log book. You must record all relevant information. Your tutors will give you guidance and help with this.
REMEMBER: You have a medico-legal responsibility to ensure your written entries are accurate, legible and signed by a t
SUMMARY
This is by no means an exhaustive list; there will be other information yet to be included. There are many do’s and don’ts however most of this information is common sense.
It is a privilege to do the work that we do, patients gives us their trust, it is our duty to respect this by delivering the highest standards of care at all times in a safe and professional manner respecting all members of the dental team equally.
If we stick to these simple rules, though having to work hard, we will enhance the benefit we have to offer every patient we treat and create a working environment that will make the work enjoyable for all involved.
REMEMBER : When in doubt, ask your supervisor, your clinical supervisor
or the programme administrator. We are all here to help you.
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