NEBDN NATIONAL DIPLOMA IN DENTAL NURSING

PRACTICAL EXPERIENCE RECORD SHEET

Unit 4.1: Cavity Restoration Procedure

Student Dental Nurse Name:

Date of Activity: 18/04/2024
Range: Composite
Patient Type: Adult
1. Procedure Carried Out
Guidance Notes:
 Student should state the procedure to be carried out.
 Students should state how the area was prepared, the equipment switched on, the safety and PPE
requirements considered, and how they assisted the clinician and the patient during the procedure.
 Students should describe the patient on which the treatment was carried out
PROCEDURE TO BE CARRIED OUT: Composite cavity restoration procedure on the upper right
lateral incisor permanent tooth.
PATIENT DETAILS: Male, 37 years old
MEDICAL HISTORY: Patient is not currently receiving any medical treatment or medication, has no
allergies or reactions to local or general anaesthetics, no history of any heart or circulatory
disorders or any respiratory disorders. The patient is a smoker 10-15 cigarettes per day and
consumes 3 unit of alcohol per week.
CLINICAL AREA: NHS Dental Practice

At the beginning of the day, I have changed into uniform, washed my hands (procedure
according to HTM 01-05 using antibacterial soap, following the steps shown on the hand washing
poster placed above the designated hand washing sink), put on the gloves, facemask and safety
glasses. I have switched on all the equipment: dental chair, curing lights, aspiration equipment, x-
ray viewer, computer, compressor, ultrasonic bath, autoclave and I have checked if the suction is
working. Made sure that everything is in good working order performing a visual inspecting,
testing the lights and sounds. I have prepared the scrubbing and rising sink to have them ready for
the decontamination procedure. Last to do was the autoclave (type 'N') test with a TST strip (I
have filled up the autoclave with distilled water and run the A cycle: Sterilisation at 134°C, Range
(°C): 134°C - 137°C, Approx pressure bar: 2.25, Minimum hold (min): 3.), and refill the ultrasonic
bath with fresh water and tablets. I have disposed all PPE in the hazardous clinical waste.
After washing hands (procedure according to HTM 01-05 using antibacterial soap, following
the steps shown on the hand washing poster placed above the designated hand washing sink) and
having new PPE (gloves, facemask and safety glasses) on, I have placed a box in the dirty zone for
all used instruments. I have flushed all dental water lines through handpieces and 3 in 1 air water
syringe tips for two minutes, taking care to avoid splashing and the generation of aerosols. I have
disinfected all working surfaces from the clean area to dirty area with surface disinfectant wipes,
after which I have discharged all PPE in the hazardous clinical waste and put on new PPE after
washing my hands (procedure according to HTM 01-05 using antibacterial soap, following the
steps shown on the hand washing poster placed above the designated hand washing sink).
We do not use disposable covers in our practice, however, I am aware this is the best
practice requirement.
Instruments:
- mouth mirror and handle (allowing indirect vision by the dentist, reflecting light
onto desired surfaces, and retraction of soft tissues);
- Sickle/contra-angled probe (is an instrument in dentistry commonly used in the
dental armamentarium);
 - college tweezers (are small tools used for picking up objects too small to be easily
handled with the human fingers);
- 3-in-1 syringe (a unique 2-chamber system to separate air from water);
- self-aspirating local anaesthetic syringe(the syringe has an ergonomic design that
provides optimal balance and a tactile control of the injection. Automatic aspiration occurs by a
light pressure on the plunger);
- air turbine hand piece (is a hand-held, mechanical instrument used to perform a
variety of common dental procedures, including removing decay, polishing fillings, and altering
prostheses);
- slow hand piece (used for removal of caries, refining a cavity preparation,
performing prophylaxis, and other endodontic and implant procedures);
- various burs (are used for cutting hard tissues - tooth or bone);
- shade guide (shade guides are available for colour interpretation of restorative
materials);
- applicator brush (used for the placement of small controlled amounts of material in
limited access areas);
- light cured unit (they are used daily in restorative dentistry, orthodontics and
hygiene to cure resin-based restoratives, luting materials and sealants);
- composite gun (specially designed to provide smooth, efficient delivery of
composite materials from unit dose capsules);
- Teflon tipped flat plastic instrument (designed for placing and contouring pliable
restorative materials into cavity preparations and other dental procedures);
- mandrel (dental polishing disk, cutting device, or sharpening stone, that is inserted
into a handpiece or lathe and supports the object while it rotates);
- Miller's forceps (used for holding articulating paper when checking occlusion of
dental restorations and teeth).
Materials:
- acid etch;
- bonding agent;
- composite capsules.
Disposables:
- disposable needle;
- disposable glass anaesthetic cartridge;
- clear transparent matrix strip;
- composite polishing/finishing strip;
- pop-on sandpaper disc;
- high and low volume/disposable saliva ejector suction tips;
- dental floss;
- articulating paper.
I have prepared the patient’s records: dental notes, x-rays, charts, medical history for any
allergy (latex) and highlight the fact the patient is a smoker to the dentist. I have discharged all
PPE in the hazardous clinical waste.
After washing hands (procedure according to HTM 01-05 using antibacterial soap, following
the steps shown on the hand washing poster placed above the designated hand washing sink) and
placing new PPE (gloves, facemask and safety glasses) on I have prepared the PPE for the dentist
(facemask, visor, gloves) and for the patient (bib and safety glasses).
Before bringing the patient into the room, I have set up a cup of mouthwash for the patient
and some tissues. After that, I invited the patient in. I made sure that her coat is on the coat rack
and her belongings are placed in a secure area. I had her seated comfortably, adjusting the
headrest and applied a protective bib and the safety glasses.
Assisting the Dentist: I collected out the patient medical history (checked for any allergies
or medical conditions), dental card, radiographs and made them available for the dentist.
I prepared all the instruments and materials for the procedure, I aspirated to ensure a clear
view of vision for the clinician when preparing the tooth for restoration. I moved the dental light
into position for the dentist. I assisted the dentist with the administration of the local anaesthetic.
I handed the mirror and explorer to the dentist so he can check the area being treated. I placed on
the tray the acid etch. I had to hold the suction as the dentist washed off the acid etch after 20
seconds. I provided careful but efficient moisture control and soft tissue retraction throughout the
procedure, ensuring that no soft tissue trauma is caused. I passed the bonding agent using the
applicator brush and passed the light cure unit. I placed the Teflon tipped flat plastic instrument
on the tray, the composite material on the paper pad for the dentist to place the filling material
into the cavity. I passed the light cure unit. I load the tray with composite polishing/finishing strip,
Miller's forceps and articulating paper, dental floss. In my practice we don’t use rubber dam,
however, I am aware this would be the best practice requirement.
The dentist wrote down the notes of the procedure on the dental card. I monitored the
patient for any signs of impending medical emergency. The patient was fine.
Assisting the patient: I provided the patient with safety glasses, bib, mouthwash, tissues. I
reassured the patient and monitored her during the procedure and after the procedure. I ensured
that he is comfortable, clean and tidy of any materials or saliva on his clothes before leaving the
surgery. I gave the patient verbal and written post-operative instructions. I also gave him the
cabinet's emergency number.
My role throughout the procedure:
Regarding the dentist: To prepare the surgery, to maintain a clear and dry operating field, to
hand out materials and instruments, to watch the patient for signs of being unwell, to record and
make notes of the procedure.
Regarding the patient: To observe for signs of being unwell, to reassure and put him at
ease, to ensure that he is clean and tidy at the end of the procedure.
End of procedure: I have decontaminated and sterilized the instruments and prepare the
surgery for the next patient.
2. Aim of the procedure
Guidance Notes:
 Students should state the overall aim of the procedure
The patient requires a composite restoration to the upper right lateral incisor permanent
tooth as the tooth has a class III cavity and has being done in order to restore the function and
shape of the tooth to provide adequate mastication.

3. Reflective Account
Guidance Notes:
Students should identify their strengths and weaknesses during the procedure and describe any action they
would take to address weaknesses in the future, if required.
Patient consent was gained for the trainee dental nurse to assist the dentist prior
treatment.
STRENGTHS:
- I have followed my practice guidelines at all times during the procedure;
 - I prepared all the materials required as requested by the dentist;
- I demonstrated knowledge and clinical skills appropriate to the patient’s condition;
- I demonstrated professionalism throughout the procedure.
WEAKNESSES:
-Forgot to prepare the anaesthetic for the patient.
ACTION TO BE TAKEN:
-I was reminded by the dentist, and prepared the anaesthetic for the patient.

Advantages: appearance and conservation of tooth structure, they blend in with the surrounding
tooth structure for a natural appearance.

Disadvantages: They don't last as long as the other options (five to ten years, usually), and can't
withstand as much chewing force as the other options.
4. Witness assessment
This Section should be completed by the GDC (or other) registrant who witnessed the activity of the student
and is assessing their competence. Constructive feedback will help the student to develop their performance
in the workplace
Not Yet
Criteria Competent
Competent
Preparation
Student turned on all equipment required for the procedure x☐ ☐
Student donned appropriate PPE (gloves, mask, eye protection,
x☐ ☐
clinical dress)
Student cleaned work surface using viricidal disinfectant or
x☐ ☐
detergent solution
Student flushed through all water lines x☐ ☐
Student applied disposable covers to required areas of the dental
☐ ☐
surgery e.g. light handles, control panel etc.
Student made all required patient records and radiographs
x☐ ☐
available
Student prepared all instruments, materials and equipment
x☐ ☐
required for the procedure in their order of use
Student established clean and dirty zones within the working field x☐ ☐
During Procedure
Student greeted patient appropriately x☐ ☐
Student provided the patient with bib and safety glasses x☐ ☐
Student aspirated and retracted soft tissues when appropriate x☐ ☐
Student provided eye shields when required during use of curing
x☐ ☐
light (if applicable)
Student followed safe practice procedures throughout x☐ ☐
Student monitored the patient throughout the treatment x☐ ☐
Student reassured the patient throughout the treatment x☐ ☐
Student prepared anaesthetic appropriate to the patient’s
x☐ ☐
medical history
Student assisted with the placement of the rubber dam (if used) x☐ ☐
Student prepared any materials required as requested by the
x☐ ☐
clinician
Student maintained contemporaneous notes as directed by the
x☐ ☐
clinician
Student ensured the patient was cleaned prior to leaving x☐ ☐
Professionalism
Student demonstrated knowledge and clinical skills appropriate to x☐ ☐
the patient’s condition
Student demonstrated professionalism throughout the procedure x☐ ☐
Student demonstrated effective team working throughout the
x☐ ☐
procedure
Student demonstrated effective clinical decision making
x☐ ☐
throughout the procedure
Student communicated appropriately, effectively and sensitively
x☐ ☐
with patients, their relatives or carers and colleagues
Student managed themselves and the clinical environment in line
x☐ ☐
with current standards and guidelines:
5. Witness feedback
Good work but still needs to concentrate on routine procedures.

I confirm that the performance of the student demonstrated competence as indicated in the table
above.
Witness Name:
Date: 19/07/2019
GDC Number:
6. Tutor feedback
This section should be completed by the GDC registrant who is assessing all sections of the completed PER
and is normally based at the Training Centre. Constructive feedback will help the student to develop their
performance in the workplace.

Satisfactory ☐ Not Yet Satisfactory 

Tutor Name:
Date: Click here to enter a date.
GDC Number:

Internal Moderation
Internal Moderator Name:
Date Sampled: Click here to enter a date.
GDC Number:
Meets NEBDN Requirements: Yes ☐ No ☐