General Dentistry Practice Residency

The general practice dentistry resident will spend two full weeks under the direct supervision of a hospital internal medicine attending physician who will oversee and assess the resident's education in medical history record-taking; physical examination; ordering of appropriate radiographs and laboratory body fluid analyses; diagnosis; patient admissions; daily in-patient treatment and progress notes; and patient discharges from the hospital. The purpose of this rotation is to give the resident first-hand experience in the medical management of patients; to learn to integrate medical and dental correlations where applicable; to gain more experience in evidence-based learning; and, to improve the resident's ability to communicate effectively with their medical colleagues.

The two-week anesthesia rotation will provide residents with an overview of the scope of medical anesthesia and its application in dentistry. The goal of the anesthesia rotation is to train residents in operating room procedures and protocol, including oral and nasal intubation. Emphasis will also be placed on pre-operative preparation and post-operative management of patients. Additional anesthesia emergencies, pharmacological and physiologic action of general anesthesia agents will be covered. The Anesthesia Rotation also affords the resident the opportunity of working with the staff anesthesiologist in the operating room performing inhalation and spinal anesthesia, intravenous sedation techniques, and to learn pain management beyond the use of local anesthesia.

The general practice dentistry resident will spend one full week in the Emergency Department under the supervision of an emergency room physician who will oversee and assess the resident's education in triage; medical history recording; physical examination; pain assessment; treatment of mostly non-acute emergency cases that present to the emergency room, including cases that may require hospital admission; and discharge and follow-up with appropriate medical service(s). The purpose of this rotation is to train the resident to recognize obvious and subtle signs of medical and mental instability of patients; improve diagnostic, physical examination, and referral skills; and to improve the resident's ability to communicate effectively with their emergency medicine colleagues.

The general practice dentistry resident will spend two weeks in the Pediatric Dentistry Center, one of which will be in the Pediatric Primary Care Center under the direct supervision of pediatric dentists who will oversee and assess the resident's education in the dental treatment of children and their parents. All dental services offered for the dental management of children will be taught including pain management using chemical agents beyond local anesthesia. The purpose of this rotation is to give the resident familiarity, and expertise in comprehensive dental care of children and their parents; to learn to correlate and coordinate appropriate dental treatment with the age of the child, taking into consideration and monitoring the growth and development of the child; to make appropriate referrals when indicated; and to improve the resident's communication with their pediatric dentistry colleagues.

The two-week oral and maxillofacial surgery rotation will provide the resident with direct insight and overview of new advances in the treatment of maxillofacial surgery. The resident will discuss treatment options for the pathologic conditions of the maxillofacial region, develop a comprehensive evaluation of a trauma patient, identify approaches for treatment and options of managing post-operative pain. The resident will learn to evaluate and assess dentoalveolar surgeries, different types of dental implants, and will learn to recognize the impact of systemic diseases on patient management.

Residents undergo supervised teaching and performance of goals and objectives while on the Anesthesia rotation. These include:

• Preoperative evaluation
• Assessment of the effects of behavioral and pharmacological techniques
• Venipuncture technique
• Patient monitoring
• Airway management
• Administration of pharmacological agents
• Prevention and treatment of anesthetic emergencies
• Assessment of patient recovery from anesthesia

The program provides formal instruction and supervised clinical experience in physical evaluation and medical risk assessment, including:

• Taking, recording and interpreting a complete medical history
• Understanding the indications of and interpretations of laboratory studies and other techniques used in the diagnosis of oral and systematic diseases
• Understanding the relationship between oral health care and system diseases
• Interpreting the physical evaluation performed by a physician with an understanding of the process, terms and techniques employed
• Using the techniques of physical examination (i.e., inspection, palpation, percussion, and auscultation)

The goals and objectives of the Emergency Medicine rotation are designed to evaluate the resident’s ability to:

• Attain a comprehensive medical assessment
• Perform physical examination
• Review data and laboratory studies
• Arrive at therapeutic decisions based on available evidence, sound judgment and patient preferences
• Demonstrate respect, compassion, integrity and honesty, always considering the needs of patients, families and colleagues

• Perform restorative techniques and understand different dental treatment modalities while using different and new materials. 
• Use clinical judgements to produce the best restorative option.
• Utilize various dental materials and techniques to achieve desirable esthetics. 
• Provide emergency treatment to the natural dentition affected by caries or trauma.
• Manage occlusal disorders. 

• Define the interrelationships between periodontics, oral surgery, endodontics and prosthodontics. 
• Develop ideal treatment plans, including fixed/removable prosthetics and implant restorations. 
• Understand the interrelationships between the periodontium and prosthetics. 
• Identify options and associated risks. 
• Successfully examine, diagnose, treatment plan, and implement steps which will result in effective and satisfying prosthetic appliances and restorations. 

O.R. Screening-Medical risk assessment: Obtain useful medical history, assess vital signs, perform routine examination, order test and lab work, and interpret those portions of the medical record necessary to satisfactory comprehend the patient’s medical status and provide safe and appropriate dental management. |

• Obtain informed consent.
• Obtain/Interpret history and physical. 
• Perform orders and dictation. 
• Perform proper scheduling, admission planning, coordination/interacting with outside agencies. 
• Perform O.R. general dentistry with an attending. 
• Follow up and post-op care of O.R. patients. 

• Obtain useful medical history, access vital signs, perform routine examination, order tests and lab work, and interpret those portions of the medical record necessary to satisfactorily comprehend the patient’s medical status and provide safe, appropriate dental management
• Provide appropriate treatment for dental care, taking into consideration medical, dental and psychosocial components of a diverse patient population
• The resident will be competent in: medical history taking, history and physicals, orders and dictation, admission planning, scheduling procedures and interacting with outside agencies
• Become proficient in prescribing medications at appropriate therapeutic levels for a broad-based patient population
• Resident will be able to visually see and demonstrate implant prosthetics on models; choose fixture types and find restorations
• Discern the rationale for implant placement
• Medical history review for implant placement
• Types of fixtures
• Fixed and removable implant uses
• Order and understand and assess lab values
• Perform routine exodontias
• Demonstrate proficiency in third molar extraction
• Identification of oral pathology
• Recognize need for referral

• Understand and recognize healthy and diseased periodontium
• Formulate a treatment plan to treat simple to advanced cases
• Accurately describe the histological, anatomical, and physiological characteristics of periodontal disease
• Diagnose the extent of the disease process, develop a treatment plan, implement treatment and evaluate outcomes at a satisfactory level
• Demonstrate satisfactory proficiency in the following procedures: 
  • Debridement: scaling and curettage, management of infections
  • Periodontal surgery: 
    • Full and partial thickness mucogingival flaps
    • Free gingival grafts
    • Gingivectomy
    • Osseous graft
    • Tissue contouring (soft, osseous)
    • Root amputations/hemisections
    • Stabilization of teeth
    • Suturing and packs
  • Occlusal adjustments
• Preventive services personally and via the use of auxiliary personnel

• Identify indications and contraindications for endodontic therapy
• Identify risk and benefits of treatment options
• Perform endodontic therapy for a wide-ranging population having multiple dental needs
• Become proficient in rotary endodontics
• Understand the needs for and rationale for pediatric pulpal therapy
• Referral to specialist when appropriate for assistance or treatment

• Identify emergency treatment, dental anatomy
• Use of pediatric antibiotics and analgesic therapy
• Identify and treat nursing bottle syndrome
• Proficiency in pedodontic medical risk assessment
• Interpret the need and use of sedative agents
• Pediatric restorative care
• Utilize behavior management techniques

The resident will be expected to be able to define the method necessary for implant placement and discuss the nature and type of fixtures necessary for meaningful implant prosthesis. The resident will be familiar with removable and fixed implant prosthesis. 

• Discuss the rational for implant placement.
• Medical history review for implant placement.
• Ideal placement of implant with direction of surgeon.
• Restore implant with direction of attending. 

Yale New Haven Hospital dentistry externship programs offer both 1-week and 2-week sessions in one of our three sections, Oral Surgery, Pediatric Dentistry or General Practice Dentistry. The application process is as follows:

1. Applicant submits a formal request letter with the following attached:

1. Three letters of recommendation
2. Proof of vaccinations
3. Proof of malpractice/liability insurance
4. Attached application completed

2. Upon acceptance and verification of documentation, the applicant will be contacted to schedule a time/date to take the HIPPA Examination. This can be same day as starting externship.

3. Following successful completion of the HIPPA Exam an initial meeting will take place/be scheduled. The purpose of the meeting is as follows:

1. Meet and Greet
2. Q & A Session
3. Delivery of initial documentation (if applicable)
4. Discussion of schedule

All submissions/requests should be sent to the following address:

YNHH Department of Dentistry
ATTN: Clara Quiles
1 Long Wharf Drive 
 4th floor, Suite 175
New Haven, CT 06510

We generally ask that all requests be made at least 30-60 days is advance to allow time for documentation verification. Please note that we do not accept externs for the months of June or July. 

Clara M. Quiles
Residency Coordinator
YNHH Department of Dentistry
1 Long Wharf Drive, 4th Fl. Suite 175
New Haven, CT 06510
Phone: 203 688-2397
Fax: 203 688-4461
clara.quiles@ynhh.org

  General Practice externship

  Pediatric Dentistry externship

  Oral and Maxillofacial Surgery externship