64B5-2.013: Examination Grading System and Examination Requirements for Dental Examination
PURPOSE AND EFFECT: The Board proposes the rule amendment to reorganize the rule in order to clarify the examination content, grading and requirements.
SUMMARY: The proposed rule reorganizes the rule and addresses the dental examination requirements, the exam content and the exam grading.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: No Statement of Estimated Regulatory Cost was prepared.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
SPECIFIC AUTHORITY: 456.017(1)(b), 466.004(4), 466.006(4) FS.
LAW IMPLEMENTED: 456.017(1)(b), 466.004(4), 466.006(4) FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN FAW.
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Sue Foster, Executive Director, Board of Dentistry/MQA, 4052 Bald Cypress Way, Bin #8, Tallahassee, Florida 32399-3258
THE FULL TEXT OF THE PROPOSED RULE IS:
(Substantial rewording of Rule 64B5-2.013 follows. See Florida Administrative Code for present text.)
64B5-2.013 Dental Examination Requirements and Grading System and Examination Requirements for Dental Examination.
(1)(a) Applicants for examination or re-examination must have taken and successfully completed the National Board of Dental Examiner’s dental examination and received a National Board Certificate within the past ten (10) years.
(b) Each applicant is required to complete the examinations as provided for in Section 466.006, F.S. The examinations for dentistry shall consist of a Written Examination, a Practical or Clinical Examination and a Diagnostic Skills Examination.
(c) A candidate must successfully complete all three examinations as provided for in Section 466.006, F.S. within a thirteen month period in order to qualify for licensure. If the candidate fails to successfully complete all three examinations within that time period, then the candidate must retake all three of the examinations.
(d) All examinations will be conducted in English.
(2) WRITTEN EXAMINATION.
(a) The Written Examination for dental licensure shall consist of the laws and rules of the State of
(b) A final grade of 75 or better is required to pass the Written Examination.
(3) PRACTICAL OR CLINICAL EXAMINATION:
(a) To take the Practical or Clinical Examination, it is the applicant’s responsibility to provide a patient who is at least 18 years of age and whose medical history is consistent with that prescribed by the board in order for patients to qualify as a patient for the examination. An applicant will be allowed no more than three attempts to qualify a patient during the specified check-in period for each procedure requiring a patient. Candidates for the state dental practical or clinical examination may assess patients for suitability as board patients at any dental office under the direct supervision of a
(b) Every candidate who is scheduled to take the entire practical or clinical examination or who is scheduled to retake any part of the practical or clinical examination which involves the use of a live patient must secure liability insurance coverage in amounts determined by the board. This protection is for injuries which may be sustained or may be claimed to have been sustained by a dental patient in the course of the examination. Each candidate must present proof of such coverage to the credentials committee before he or she will be allowed to perform any procedures on a live patient.
(c) The Practical or Clinical Examination for dental licensure shall consist of seven (7) parts and be graded as to each part as follows:
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1. Class II Amalgam on a Patient a. Preparation 2/3 b. Restoration 1/3 |
30% |
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2. Demonstration of Periodontal Skills on a Patient: Definitive debridement (root planing, deep scaling/removal of subgingival calculus, and removal of plaque, stain and supra-gingival calculus) |
20% |
|
3. Restoration of Class II Composite Resin with Cusp Replacement on Specified Tooth |
10% |
|
4. Demonstration of Endodontic Skills on Specified Teeth |
10% |
|
5. Demonstration of Prosthetics Skills: Preparation for a 3-unit fixed partial denture on a specified model |
20% |
|
6. Class IV Composite Restoration on a Specified Tooth |
5% |
|
7. Class II Amalgam Restoration with a Cusp Replacement on a Specified Tooth |
5% |
(d) The Practical or Clinical Examination shall include the following parts and procedures and be graded on criteria as described below each examination part or procedure. Listed criteria are to be accorded equal importance in grading. Equal importance does not mean that each criteria has a numerical or point value but means that any one of the criteria, if missed to a severe enough degree so as to render the completed part or procedure potentially useless or harmful to the patient in the judgment of the examiner, could result in a failing grade on the part or procedure. The criteria do not have assigned numerical or point value but are utilized in making a holistic evaluation of the part or procedure.
1. Class II Amalgam on Patient. This part of the Practical or Clinical Examination shall consist of a preparation procedure and a restoration procedure. The following areas will be assessed in determining a grade for each procedure:
a. Preparation:
(I) Outline form – all prepared surfaces smooth and acceptable extensions without weakening tooth surfaces.
(II) Depth – adequate shape and form designed to resist functional displacement forces.
(III) Retention.
(IV) Mutilation of opposing or adjacent teeth.
(V) Debris removal from cavity preparation.
(VI) Management of soft tissue is considered adequate in the absence of trauma or mutilation. Additionally, a grade of zero (0) is mandatory if caries remain; if gross overcutting occurs; if mechanical exposure occurs; if the preparation is prepared or attempted on the wrong tooth or wrong surface; or if the candidate fails to attempt or complete the procedure.
b. Restoration: The following areas will be assessed in determining a grade.
(I) Functional anatomy – appropriate occlusal and interproximal anatomy.
(II) Proximal contour and contact – contact is considered present if there is definite, but not excessive resistance to the passage of dental floss through the contact area.
(III) Margins – suitable continuity with the cavosurface margin should be smooth with the absence of flash or overcarving.
(IV) Gingival overhang – overhang is considered to be excess amalgam in either a proximal or gingival direction at the gingival cavosurface margin.
(V) Proper handing of materials including but not limited to condensation and finishing.
(VI) Management of soft tissue – is considered adequate in the absence of trauma or mutilation. Additionally, a grade of zero (0) is mandatory if there is a total lack of contact; gross overhang; tissues grossly mutilated (may require suturing or surgical intervention); if the preparation for the restoration is prepared or attempted to be prepared on the wrong tooth or wrong surface; or there is a failure to attempt or complete the procedure.
2. Demonstration of Periodontal Skills on a Patient. Must be performed on a minimum of 5 teeth, none of which shall have a full crown restoration, each of which shall have pockets at least 4 mm. in depth with obvious sub-gingival calculus detectable by visual or tactile means and radiographic evidence of osseous destruction; at least one tooth shall be a multi-rooted molar which shall be in proximal contact with at least one other tooth; none of the 5 teeth shall be primary teeth. All calculus appearing on radiographs must be detectable by visual or tactile means. The periodontal exercise shall be a definitive debridement (root planing, deep scale of subgingival calculus, and plaque, stain and supragingival calculus removal). The following areas will be assessed in determining a grade.
a. Diagnosis – clinical and radiographic.
b. Presence of stain on assigned teeth.
c. Presence of supra-gingival calculus on assigned teeth.
d. Presence of sub-gingival calculus on assigned teeth.
e. Root roughness on assigned teeth.
f. Management of soft tissue is considered adequate in the absence of trauma or mutilation. Additionally, a grade of zero (0) is mandatory if there is gross mutilation of gingival tissue or if the candidate fails to attempt or complete the part.
3. Restoration of a Class II Composite Resin with Cusp Replacement on a Specified Tooth. The following areas will be assessed in determining a grade for this part.
a. Functional anatomy – appropriate occlusal, and interproximal anatomy.
b. Proximal contour and contact – contact is considered present if there is definite, but not excessive, resistance to the passage of dental floss through the contact area.
c. Margins – suitable continuity with the cavosurface margin should be smooth with the absence of trauma or mutilation.
d. Gingival overhang – overhang is considered to be excess composite resin in either a proximal or gingival direction at the gingival cavosurface margin.
e. Proper handling of material including but not limited to condensing, curing, and finishing.
f. Re-establishment of correct tooth morphology.
g. Management of soft tissue is considered appropriate in the absence of trauma or mutilation.
h. Mutilation of adjacent tooth structure or restoration during finishing procedures.
Additionally, a grade of zero (0) is mandatory if the restoration is completed or is attempted to be completed on the wrong tooth or wrong surface; if there is a lack of contact; gross overhang; or if the candidate fails to attempt to complete the part.
4. Demonstration of Endodontic Skills on Specified Teeth. The following areas will be assessed in determining a grade for this part:
a. Access preparation:
(I) Outline form and access preparation – all prepared surfaces smooth, absence of undercuts and ledges.
(II) Straight line access to all canals.
(III) Presence of remaining adequate dentin.
b. Canal identification.
c. Instrumentation and shaping of canals.
d. Proper filling of the canal spaces with gutta percha.
Additionally, a grade of zero (0) is mandatory if: a perforation occurs, the candidate fails to retrieve, or fails to successfully instrument around a broken instrument, the preparation is prepared or attempted to be prepared on the wrong tooth, or the candidate fails to attempt or complete the part.
5. Demonstration of Prosthetics Skills – Preparation for a 3-unit fixed partial denture on a specified model. The following areas will be assessed in determining a grade for this part:
a. Outline form – all prepared surfaces smooth with adequate parallelism and absence of undercuts.
b. Depth – occlusal reduction and axial reduction.
c. Retention – all axial walls draw from gingival margin with resistance to displacement.
d. Adequate margins for the assigned preparation.
e. Mutilation of opposing or adjacent teeth.
f. Management of soft tissue is considered adequate in the absence of trauma of mutilation. Additionally, a grade of zero (0) is mandatory if the preparation is prepared or is attempted to be prepared on the wrong tooth or wrong surface; if the wrong type of preparation is performed or attempted to be performed, or if the candidate fails to attempt or complete the procedure.
6. Class IV Composite Restoration on a Specified Tooth- The following areas will be assessed in determining a grade for this part:
a. Functional anatomy – appropriate occlusal, incisal and interproximal anatomy.
b. Proximal contour and contact – contact is considered present if there is definite, but not excessive, resistance with dental floss through the contact area.
c. Margins – suitable continuity with the cavosurface margin should be smooth with the absence of trauma or mutilation.
d. Gingival overhang – overhang is considered to be excess amalgam in either a proximal or gingival direction at the gingival cavosurface margin.
e. Proper handling of material including but not limited to condensing, curing, and finishing.
f. Re-establishment of correct tooth morphology.
g. Management of soft tissue is considered adequate in the absence of trauma or mutilation.
h. Mutilation of adjacent tooth structure or restoration during finishing procedures.
Additionally, a grade of zero (0) is mandatory if the preparation for the Class IV lesion is prepared or attempted to be prepared or the restoration is completed or attempted to be completed on the wrong tooth or wrong surface; if the interproximal contact has not been re-established, or if the candidate fails to attempt or complete the part.
7. Class II Amalgam Restoration with a Cusp Replacement on a Specified Tooth. The following areas will be assessed in determining a grade for this part:
a. Functional anatomy – acceptable occlusal and interproximal anatomy.
b. Proximal contour and contact – contact is considered present if there is definite, but not excessive resistance to the passage of dental floss through the contact area.
c. Margins – suitable continuity with the cavosurface margin should be smooth with the absence of trauma or mutilation.
d. Gingival overhang – overhang is considered to be excess amalgam in either a proximal or gingival direction at the gingival cavosurface margin.
e. Proper handling of material including but not limited to condensing and finishing.
f. Management of soft tissue is considered adequate in the absence of trauma or mutilation. Additionally, a grade of zero (0) is mandatory if there is lack of contact; gross overhang; if the restoration is completed or attempted to be completed on the wrong tooth or wrong surface; or if the candidate fails to attempt or complete the part.
(e) The grading system used during the Practical or Clinical Examination is as follows:
0 – Complete failure
1 – Unacceptable dental treatment
2 – Below minimal acceptable dental treatment
3 – Minimal acceptable dental treatment
4 – Better than minimally acceptable dental treatment
5 – Outstanding dental treatment
(f) A final grade of 3 or better, as a general average is required to pass the Practical or Clinical Examination.
(g) If an applicant fails to achieve a final grade of 3 or better, as a general average, on the Practical or Clinical Examination because of a failing grade on just one part, the applicant shall be required to retake only that part. On any such retake, the applicant shall be required to obtain a passing grade on the part that is retaken. A failing grade on the retaken part shall not be averaged to obtain a passing score on the Practical or Clinical Examination.
(h) If an applicant fails to achieve a final grade of 3 or better, as a general average, on the Practical or Clinical Examination because of a failing grade on more than one part, the applicant shall be required to retake the entire Practical or Clinical Examination.
(i) Whenever an applicant is repeating only one part of the Practical or Clinical Examination and that part requires the use of a patient, that candidate shall be allowed the same amount of time to complete the part that is allowed candidates currently taking the part for the first time. Whenever a candidate is repeating only one part of the Practical or Clinical Examination and that part is performed on a mannequin, that candidate shall be allowed 3 hours to complete the part.
(j) As provided in Section 466.006(4)(b)3., F.S., if an applicant fails to pass the Practical or Clinical Examination in three (3) attempts, the applicant shall not be eligible for reexamination unless she or he completes additional educational requirements as specified by the Board.
(3) DIAGNOSTIC SKILLS EXAMINATION.
(a) The Diagnostic Skills Examination shall be an objective type of examination, demonstrating ability to diagnose conditions within the human oral cavity and its adjacent tissues and structures from photographs, slides, radiographs, or models. The Diagnostic Skills Examination may include, but not be limited to the following: medical considerations, periodontist, and prosthetics including the viewing and evaluation of digitalized photographs of exhibits of complete, fixed, partial and removable partial prosthetics. Exhibits may include, but not be limited to, impressions, denture set-ups, study models, master casts, wax rims, partial denture frameworks, bite registrations, crowns, bridges, crown and bridge dies and preparations, and radiographs. The Diagnostic Skills Examination should assess the examinee’s abilities to recognize critical clinical conditions or situations encountered regularly in the general practice of dentistry and to formulate appropriate treatment options.
(b) A final grade of 75% or better is required to pass the Diagnostic Skills Examination.
(c) As provided by Section 466.006(4)(c), F.S., if an applicant fails to pass the Diagnostic Skills Examination in three attempts, the applicant shall not be eligible for re-examination unless she or he completes additional educational requirements established by the Board. For purposes of this subsection, on examinations administered prior to June 2007, that portion of the examination identified as “an objective type of examination with respect to dental prosthetics” and the “dental prosthetics written practical” shall be considered to be the Diagnostic Skills Examination.
Specific Authority 456.017(1)(b), 466.004(4), 466.006(4) FS. Law Implemented 456.017(1)(b), (2), 466.006(4), 466.009 FS. History– New 10-8-79, Amended 6-22-80, 12-3-81, 12-6-82, 5-24-83, 12-12-83, 5-2-84, 5-27-84, Formerly 21G-2.13, Amended 12-8-85, 12-31-86, 5-10-87, 10-19-87, 12-10-89, 12-24-91, 2-1-93, Formerly 21G-2.013, 61F5-2.013, Amended 1-9-95, 2-7-96, 7-16-97, Formerly 59Q-2.013, Amended 8-25-98, 3-25-99, 11-15-99, 8-3-05, __________.