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Board :
California Clinical Exam : Information The California Clinical Examination Course This course is designed as preparation for the California Clinical Board Examination. It is open to any dentist with US training or having passed the RT examination. Many of the subjects covered will apply toward other examinations as well. For the year 2000 and beyond for California ( as much as is foreseeable ) this includes amalgam Class II on patient, composite Class Ill on patient, periodontal measurement, diagnosis, written and therapy on patient, mannequin bridge and PFM preparations, written examinations for endodontics, removable prosthodontics and lab endo on extracted teeth. The current course is a combination of the best parts of our original Clinical course created and held at Loma Linda University for seven years and the "off-campus" clinical course held the last few years at DSI. For the clinical procedures we simulate patients using mannequins, typodonts, and extracted teeth mounted in realistic positions and in clinical chairs. For the amalgam and composite procedures this is very effective, closely mimicking the procedures on actual patients since rubber dams are used. We practice with water spray and solve many realistic problems on actual teeth, including caries removal, dealing with unsupported enamel, decalcified surfaces and grooves, abnormal anatomy, cracked surfaces, etc. The major emphasis of the Clinical course is judgment. To work with the problems of real teeth, there are many decisions that have to be made and we practice how to make these and how to handle these decisions during an examination environment. The ideal preparations and procedures are reviewed in detail, but it is the elaboration of these preparations, modification beyond ideal that solves real problems. Former students of the Bench course are extremely well prepared for the Clinical course because they have such a profound understanding of the ideal preparations from that examination experience. But it is the furthering of the learning process that is emphasized here. Also, for those not routinely working with patients, this course involves an adaptation from the bench to the clinical angles and a development of comfortable mirror usage. While each aspect of the Clinical Exam is covered thoroughly in this course, it is the emphasis on patient selection and evaluation that often makes the difference between success and failure. If a patient is chosen that presents too difficult a challenge for the time period allowed during the examination, the chances of success on the first attempt are remote. We try to make certain that each student's patients present challenges that are within his or her range of capability. Throughout the course there are many opportunities to discuss X-rays and casts so that an initial screening of the prospective patients can be accomplished. The discussion of X-rays and models is recorded on videotape and edited copies from previous classes are provided to registered students so they can more quickly learn these analytical skills by study at home. Later in the course patients, that by this analysis, are deemed possible patients are brought in for more detailed evaluation. We make the best predictions possible as to what may happen once the tooth is opened so we can be prepared for any eventuality. We check the student's periodontal measurements and classifications to make sure that they are properly calibrated on particular patients before the examination. Important preparation for the course mainly involves location of a dental office in the area of their home or work where they can screen patients. Many practicing dentists are willing to help with assignment of suitable time for dental assistants and hygienists. It is certainly an advantage to work in a dental office where the owner is willing to help with this. It is necessary to have some location where X-rays and impressions can be taken, and more detailed periodontal screening, measurement and prescaling is an important capability. The other challenge prior to the start of the course is to procure as many extracted natural teeth as possible. These are important for a variety of practice procedures. We practice mainly on natural teeth due to the similarity of problem solving situations with the conditions found in patient's mouths. Ivorine teeth are used only to get an initial understanding of the principles of preparation design. Many hundreds of our students have successfully negotiated the California Clinical Exam after taking this course, but we also prepare for life beyond the Board Exam. Many of the decisions that need to be made while choosing patients for the exam and while taking the examination are similar to those decisions that are made throughout life as a dental practioner. We evaluate each patient's needs in terms of the most conservative restoration that will adequately restore the tooth for the longest period of time. Since the emphasis is to best serve the patient and understanding the principles and choices that permit this, we feel that our graduates bring a strong ethical standard to their practice environments.
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