Lesson 1Red flags and referral criteria for specialist input (endodontics, periodontics, oral surgery)This section defines clinical and radiographic red flags that require specialist referral, and outlines criteria for timely consultation with endodontists, periodontists, oral surgeons, and other providers to optimize patient safety and outcomes in Zambia.
Endodontic referral indicators and complexityPeriodontal referral based on staging and gradingOral surgery referral for impacted or complex teethSuspicious lesions and urgent oncology referralTrauma cases needing multidisciplinary inputCommunicating findings in referral lettersLesson 2Use of auxiliary tests: blood glucose considerations, bleeding risk assessment, and when to liaise with medical providersThis section reviews auxiliary tests relevant to dental care, including blood glucose checks, bleeding risk assessment, and indications for liaising with physicians to coordinate management of medically complex dental patients in Zambian settings.
Chairside blood glucose thresholds for treatmentINR, platelet count, and bleeding risk factorsAnticoagulant and antiplatelet management basicsWhen to defer care and seek medical clearanceCoordinating care with primary physiciansDocumenting medical advice and shared decisionsLesson 3Extraoral and intraoral examination steps: soft tissue, TMJ, lymph nodes, occlusion, periodontal screening (PSR/CPPITN)This section outlines systematic extraoral and intraoral examination, including facial symmetry, TMJ, lymph nodes, soft tissues, occlusion, and periodontal screening using PSR or CPITN, with adaptations for pediatric and geriatric patients in Zambia.
Facial inspection and assessment of symmetryTMJ palpation, range of motion, and joint soundsLymph node palpation and infection red flagsSoft tissue inspection and oral cancer screeningOcclusal analysis and functional assessmentPSR and CPITN periodontal screening protocolsLesson 4Comprehensive history-taking: medical, dental, social, behavioral, medications, allergies, and diabetes-specific questionsThis section explains structured history-taking for mixed-age patients, integrating medical, dental, social, and behavioral data, with emphasis on medications, allergies, diabetes, and how these factors guide safe, individualized dental care in Zambia.
Core elements of a comprehensive dental historyScreening for systemic disease and hospitalizationsMedication review, interactions, and xerostomia riskAllergy verification and documentation standardsDiabetes-focused questions and glycemic controlSocial, behavioral, and substance use historyLesson 5Special considerations for pediatric exam techniques and behavioral observation during assessmentThis section focuses on pediatric examination techniques, including age-appropriate communication, behavior guidance, observation of nonverbal cues, and modifications of clinical and radiographic procedures to reduce anxiety and improve cooperation in Zambian children.
Tell–show–do and positive reinforcement methodsNonverbal behavior and anxiety recognitionKnee-to-knee exam and lap-to-lap positioningModified radiographic techniques for childrenParental presence and communication strategiesAssessing growth, eruption, and caries riskLesson 6Pulp and periapical assessment: percussion, palpation, sensibility testing (cold, EPT), and interpretationThis section details pulp and periapical assessment using percussion, palpation, and sensibility tests such as cold and EPT, and explains interpretation of results in conjunction with radiographic and clinical findings for accurate diagnosis in Zambia.
Percussion and palpation techniques and findingsCold testing protocols and response patternsElectric pulp testing indications and pitfallsDifferentiating reversible and irreversible pulpitisDiagnosing necrotic pulp and acute apical abscessCorrelating clinical tests with radiographic signsLesson 7Documentation and clinical photography: standardized intraoral photos, image labeling, and record keeping for diagnosis and consentThis section explains standardized clinical documentation and photography, including intraoral views, camera settings, retraction, image labeling, and secure record keeping to support diagnosis, treatment planning, monitoring, and informed consent in Zambian practice.
Essential elements of a complete dental recordStandard intraoral photographic series viewsCamera selection, settings, and lighting basicsUse of mirrors, retractors, and contrastorsImage labeling, storage, and backup systemsUsing photos for patient education and consentLesson 8Radiographic features of caries, endodontic pathology, periodontal bone loss, and prosthetic planningThis section details radiographic signs of caries, pulpal and periapical disease, periodontal bone loss, and features relevant to prosthetic planning, including crown–root ratios, bone quality, and anatomical limitations for implants and fixed work in Zambia.
Radiographic appearance of enamel and dentin cariesDetecting recurrent and root surface cariesPulpal calcifications and periapical radiolucenciesPatterns of horizontal and vertical bone lossAssessing bone height, width, and densityEvaluating abutment teeth and crown–root ratioLesson 9Radiographic selection and interpretation: bitewings, periapicals, panoramic, CBCT indications and radiation safety principles (ALARA)This section covers choosing appropriate radiographs, including bitewings, periapicals, panoramic, and CBCT, based on age and risk, and explains radiation physics basics, selection criteria, ALARA principles, and protective measures for patients in Zambia.
Indications for bitewings in caries risk groupsPeriapical views for endodontic and trauma casesPanoramic radiographs in mixed and adult dentitionsCBCT indications, limitations, and dose concernsRadiation biology basics and ALARA applicationLead shielding, collimation, and exposure protocols
