Skill Checklists
Dental Hygienist
Name
Email
LAST 4 OF SSN
This checklist was electronically signed on (Today’s date)
Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.
Proficiency Scale:
1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently
Newborn (0 to 1)
Toddler (1 to 3)
Preschool (3 to 5)
School age (6 to 12)
Adolescent (13 to 18)
Adult (19 to 65)
Elderly (over 65)
Community Care
Corrections
Dental Supply Company
Federal or State Institution/MHMR
General Dentistry
Acute Care/Hospital
Mobile Dental Unit
Orthodontic Office
Periodontal Office
School
Intra-Oral//Extra- Oral Photography
Digital Radiology (Intra-Oral/Extra- Oral/Panoramic)
Hard Tissue Charting
Periodontal Charting
Clinical Narrative Charting
Scheduling of Appointments
Use of CDA Coding of Dental Procedures for Third Party Coverage
Generation of Correspondence to Patients, Third Parties and Other Professionals
Modes of Disease Transmission in a Dental Office
Practice Infection Control/Prevention
Administer Local Anesthetic
Adverse Effects of Local Anesthetics
Adverse Reactions to Nitrous Oxide Conscious Sedation
Assist with Administration of Local Anesthetic
Common Oral Manifestations of Drug Categories
Medications Commonly Used to Treat Asthma
Medications Commonly Used to Treat Cardiovascular Disease
Medications Commonly Used to Treat Diabetes
Medications Commonly Used to Treat Immunocompromised Patients
Medications Commonly Used to Treat Psychosis
Medications Commonly Used to Treat Pulmonary Disease
Medications Commonly Used to Treat Seizures
Medications Commonly Used to Treat Thyroid Conditions
Medications on Commonly Used to Treat Organ Transplants
Fluoride Regimen Dosage/Duration Indicated
Interpret and Explain Directions for a Written Prescription
Medications that can Cause Gingival Hyperplasia
Medications that can Cause Xerostomia
Monitor Dates of Emergency Medications/Order/Replace
Need for Antibiotics to Treat Dental Related Infection
Need for Prescription Strength Fluoride/Remineralization Agent
Need for Prophylactic Premedication Prior to Dental Treatment
Observe for Side Effects and Adverse Reactions
Protocol for Placement of Local Chemotherapeutic Agents in Periodontal Pockets
Use of Drug Reference Manual/Computer Program
Diseases of Concern to Dental Healthcare Workers
Head and Neck Anatomy
Identify/Report Neglect or Abuse
Identify and Assess Oral Head Neck Pathology
Identify Medical Risk Patients
Identify Need for Medical Consultation Prior to Dental Treatment
Medical Emergency in Dental Office/CPR/AED
Obtain/Assess Comprehensive Medical and Dental History
Obtain/Assess Vital Signs (BP, Pulse, Resp and Temp)
OSHA
Practice Correct Operator Ergonomics
Prevention of Medical Emergencies in the Dental Office
Anaphylaxis
Angina Pectoris
Apnea
Arrythmias
Asthma
Bedridden Patient
Congenital Heart Defect/Heart Murmur
Congestive Heart Failure
Conscious Oral Sedation Patient
COVID-19
Diabetes
Epilepsy
Fearful Client (Anxiety/Phobia)
General Sedation Patient
Heart Valve
Hospital/Nursing Home Patient
Hyperglycemia
Hypertension
Hyperthyroidism
Hyperventilation
Hypoglycemia
Hypothyroidism
Immunocompromised Patient
Implant Patient
IV Sedation Client
Joint Replacement
Methamphetamine Patient (Meth Mouth)
Myocardial Infarction
Oral Manifestations of Systemic Diseases
Organ Transplant Patient
Patient Undergoing Chemotherapy/Radiation Therapy
Pregnant Patient
Pulmonary Distress
Respiratory Arrest
Seizure
Special Needs Patient (MHMR/Physical Disability)
Stroke
Syncope
Tachycardia
Transient Ischemic Attack (TIA)
Vertigo
Effects of Aging on the Dentition
Ages of Tooth Formation for Permanent and Deciduous Dentition
Air Abrasive Polishing
Assist with Air Abrasive Polishing
Automatic/Manual Radiographic Processing Technique
Basic Dental Anatomy and Root Morphology
Caries Risk Assessment
CDC Classification of Instruments and Procedures
Classification of Dental Carious Lesions
Classify Stages of Periodontal Disease
Classify Types Occlusion
Cleaning of Fixed Prostheses
Cleaning of Removable Appliances/Prostheses
Conventional Dental Radiography(Intra- Oral/Panoramic)
Conventional Radiology
Developmental Anomalies of Oral Tissues
Diagnodent Laser
Digital Dental Radiography (Intra- Oral/Panoramic)
Digital Photography/Computer Imaging Program
Disinfect Patient Care Area
Distinguish Deciduous Teeth from Permanent Teeth
Emergency Oxygen Operation
Eruption Pattern/Ages of Eruption for Permanent/Deciduous Dentition
Fabricate Whitening Trays
Finishing and Polishing of Amalgam Restorations
Formulate Treatment Plan and Appointment Sequencing
Identify Contraindications to Treatment Modalities
Identify Presence of Third Molars in Teens and Adults
Implant Care
In-Office Whitening
Intra-Oral Camera Digital Radiology
Inventory Control: Ensuring Rotation of Supplies and Expiration Dates
Monitoring Placement/Removal of Rubber Dam Components
Nitrous Oxide Conscious Sedation Monitoring
Operate Diagnodent Laser
Operate Whitening Equipment (Light)
Operation of AED (Automated External Defibrillator)
Oral Hygiene Instructions
Patients Demonstrating Dental Anxiety
Perform Extraoral/Intraoral Cancer Screening
Periodontal Assessment and Recording
Pit and Fissure Sealant Application/Curing Light
Pouring/Trimming of Dental Study Casts
Practice Precautions Necessary Treating a Patient with Active TB
Preparation and Delivery of Dental Bonding Agent Glass Ionomers
Proper Disposal of Sharps
Radiographic Evidence of Disease Process (Caries, Periodontal Disease, and Pathology)
Removal of Sutures
Restorative Dental Materials
Sharpening of Hand Instruments
Signs and Symptoms of Periodontal Disease
Single-Handed Technique Transfer of Instruments
Slow Speed Polishing
Subgingival Antimicrobial Irrigation
TMJ Assessment
Topical Application of Fluoride
Ultrasonic/Sonic Instrumentation
Age Related Decay
Dental and Dental Hygiene Procedures
Fixed Versus Removable Prosthodontics
Home Plaque Removal Devices and Equipment
Oral Disease Process
Restorative Crowns
I hereby certify that ALL information I have provided on this skills checklist and all other documentation is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.