NZ Dental Therapy REX common mistakes
NZ Dental Therapy REX · Understand the traps and how to avoid them.
Writing 'examined and discussed' or 'OHI given' in the clinical record instead of describing what was actually seen, said, and demonstrated, so the record cannot support the treatment decision or show informed consent.
Candidates practise documenting in shorthand during clinical placements and assume the reader shares their context; under exam conditions the pressure to finish the station quickly pushes them toward summary phrases that hide missing clinical reasoning.
What to do instead
Practise a fixed documentation template: presenting complaint in the patient's words, relevant history, objective findings with tooth/site specificity, diagnosis, options offered with risks and benefits, patient's decision, and the next appointment. Write one full record for every practice patient and self-audit against the Dental Council standards for clinical records before the exam.
Treating consent as a single signature at the start of care rather than an ongoing conversation, and failing to check capacity or the child/whānau dynamic when a parent and adolescent disagree about treatment.
Candidates conflate 'consent form signed' with 'valid informed consent' and are unsure how consent works when a competent older child's views differ from the parent's, so they avoid the conversation entirely.
What to do instead
Rehearse the consent conversation aloud: explain the condition, all reasonable options including doing nothing, material risks, and costs, then confirm understanding with teach-back. Study the Council's consent and children/young persons guidance so you can state the age-and-competence position and how to proceed when views conflict.
Describing hand hygiene, reprocessing, or waste segregation in vague generalities ('clean the instruments properly') when asked to sequence a procedure step by step.
Candidates learn infection control as principles rather than as a timed workflow, so they can recite the five moments of hand hygiene but cannot order the steps for a handpiece, a used bur, or a contaminated impression.
What to do instead
Write out and memorise step-by-step algorithms for the items the exam is likely to probe: routine hand hygiene, surgical hand antisepsis, reprocessing of reusable instruments from chairside pre-cleaning through washer-disinfector or autoclave with validation records, and sharps and waste streams. Practise stating each step with the reason it exists.
Missing a risk-based detail in the medical history - for example not linking a bleeding disorder, bisphosphonate use, or a cardiac condition to a modification of treatment or to antibiotic prophylaxis decisions.
Candidates record the medical history as a tick-box list and never practise translating a positive finding into a concrete change in plan, so the link between history and action is absent in their answers.
What to do instead
Build a personal 'condition to action' table covering the conditions you will meet: bleeding risk, immunosuppression, infective endocarditis risk, medication-related osteonecrosis, uncontrolled diabetes, and pregnancy. For each, write the specific modification, the referral trigger, and the current local guidance you would follow.
Producing a treatment plan that lists a sequence of procedures without stated diagnoses, without prioritisation (urgent versus elective), and without review intervals or success criteria.
Candidates think of a plan as a list of tasks to be done rather than as a reasoned argument from findings to goals, and they under-use the patient's own goals as the anchor for prioritisation.
What to do instead
Structure every plan as: problem list with diagnoses, patient goals, options with pros and cons, chosen option with rationale, sequenced phases with review points, and measurable outcomes. Practise converting a set of findings into this format under time pressure until it is automatic.
Giving generic prevention advice ('brush twice a day, cut down sugar') instead of a tailored, behaviour-specific plan with a method for follow-up.
Candidates memorise population-level messages and have not practised negotiating a single achievable change with an individual patient, so they default to a checklist that the patient has already heard and ignored.
What to do instead
Use a structured behaviour-change conversation: elicit the patient's own view of the problem, agree one specific goal, identify barriers, plan the cue and the environment change, and set the review. Practise applying it to a high-caries-risk child, a patient with dry mouth, and a smoker, and state how you will measure whether it worked.
Answering clinical scenarios with textbook ideal technique while ignoring the actual constraints in the scenario - a child who cannot cooperate, a missing instrument, a time limit, or a patient in pain.
Candidates rehearse procedures in ideal conditions and treat deviations as failures rather than as the clinical judgement being tested; they also fear that describing a modified approach looks like admitting incompetence.
What to do instead
For each core procedure, prepare a 'if X is not possible' branch: what you would do, what you would defer, when you would stop and refer, and how you would record the decision. Practise verbalising the reasoning so the examiner hears the judgement, not just the technique.
Not stating how a clinical error or near miss would be managed - who is told, what is recorded, what is reported, and what changes as a result.
Candidates see error management as an administrative topic unrelated to clinical practice and have not rehearsed open disclosure, so under pressure they minimise or omit it.
What to do instead
Learn and rehearse the open disclosure sequence and the local incident reporting pathway, then apply it to concrete scenarios: a swallowed restoration, a needlestick, a wrong tooth treated, a child who faints. Include what you would say to the patient or whānau and what you would record.
Ignoring the patient's expressed concerns and the emotional content of a scenario, answering only the clinical question that was asked.
Candidates focus on demonstrating knowledge and run out of time, so they skip the rapport-building and agenda-setting phases; some also avoid emotional content because they feel unskilled at responding to distress.
What to do instead
Practise a fixed opening: greet, confirm identity and reason for visit, ask what matters most today, and summarise back before examining. Rehearse responses to fear, pain, cost worry, and a complaint, using reflection and open questions rather than reassurance alone. Record yourself and check that the patient's words appear in your summary.
Failing to adapt communication for a child, a whānau group, a patient with limited English, or a patient with a communication disability, and not using an interpreter when one is indicated.
Candidates default to the communication style they use with articulate adults and are unsure how to check understanding without appearing patronising, so they simplify content but not method.
What to do instead
Prepare an approach for each group: for children, tell-show-do and age-appropriate language with the parent included appropriately; for interpreter-mediated consultations, brief the interpreter, speak to the patient, and check understanding with teach-back; for disability, ask the patient what works for them. Rehearse each aloud once.