General Information
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Relevance date:These instructions will apply to the National Dental Specialty Examination (NDSE) conducted beginning in 2010. See the RCDC website for instructions for examinations conducted on earlier or later dates.
Periodontics in Canada
Periodontics is the specialty of dentistry concerned with the diagnosis, prevention, and treatment of diseases and conditions of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and aesthetics of these structures and tissues.
Examination Information
Examination Structure
| Component | Element | Time | Cohort B |
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Component I (written exam)
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Paper I
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3 hrs
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29 April, 2010
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Paper II
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3 hrs
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Component II
(case reports and oral exam) |
Case Report Submission and Grading
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N/A
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Due: 14 July, 2010
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Oral Examination A
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1.5 hrs
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22-24 October, 2010
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Oral Examination B
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1.5 hrs
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Oral Examination
(Oral Medicine and Oral Pathology) |
1 hour
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Passing Scores
- Candidates must achieve a passing score on both Component I (the written examination) and on Component II (the case report and oral examinations) to qualify for the NDSE in Periodontics.
- A candidate must pass Component I (the written examination) to qualify for Component II (Oral examination)).
- To pass Component II candidates must receive a passing score in the Periodontics parts of the oral examinations.
Written Examination (Component I)
The written component of the NDSE in Periodontics is divided into two papers, both to be completed over one day.
The oral component of the NDSE in Periodontics is divided into four parts:
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A Case Report*
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Oral Examination A: case scenarios as presented by the examining team
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Oral Examination B: case scenarios as presented by the examining team
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Examination of the candidate’s abilities in oral pathology and oral medicine.
* Submission of the candidate’s Case Report is due three months in advance of the oral examinations.
NOTE: Submitted cases will be graded for the quality and completeness of the submitted case. The candidate can expect a reduction in their overall score on the Oral Examination as a consequence of any shortfall from the guidelines or absence of required documentation. Consistency between documents (photographs, radiographs, charts, written reports) will be carefully scrutinized and graded. (For example, the location of the gingival margin at a given site as charted, photographed, and reported must be verifiable and consistent with each document.)
Any queries about the Case Report requirements should be directed to the College prior to case submission.
Components
COMPONENT I: The Written Examination
The written component will be comprised of two (2) papers, each of three (3) hours duration. The papers will consist of short answer questions. Topics for the written examination can include the following:
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COMPONENT II: The Case Report and Oral Examination
The examination dates for Component II will be determined following completion of the written examinations and the publishing of the written component results, and will be based on the number of candidates challenging Component II. These dates may fall anywhere within the indicated window and are fixed once set. The RCDC cannot accommodate requests for exceptions, other than in the case of religious or special needs that have been indicated before the date has been set.
The Oral Exam
Two (2) Examiners conduct the Oral Examination and grade the candidate’s performance independently.
- Both Oral A and Oral B have Case scenarios in Periodontics presented to candidates. Each examination takes 1 hour and 30 minutes.
- Case scenarios used in the oral exam are realistic situations covering a sampling of these topics: mucogingival surgery, pre-prosthetic surgery, implantology, periodontic-endodontic considerations, minor tooth movement, treatment of the medically compromised patient, anxiety management and the various forms of conscious sedation. Emphasis will be given to intravenous sedation techniques.
- The Oral Pathology and Oral Medicine part of the Oral Examination is for one hour.,. Candidates are presented with colour slides or digital images and questioned on their interpretation of findings in Oral Pathology, Oral Medicine, and case management.
Scoring of Component II
A passing score is based upon a combined passing score for the four parts of Component II.
Cases
Identifying Information : Case Report
All case material submitted as part of the Case Report must not have any form of identifying logo, text or information regarding your office, university or any other institution from which you may have obtained the case material. Patients must not be identified by name or initials. Use ID numbers when referencing the patient in any documentation. Full-face photographs that could identify the patient must have the eyes blacked-out.
The Case Report
The Report must be submitted for grading and received at least three months prior to the date of the planned oral examination. The submission will consist of the following:
The submitted copy of the Case Report will remain with the Royal College of Dentists of Canada.
General Case Information
The comprehensive case report will be prepared from patients treated by the candidate during graduate studies or subsequent to the completion of graduate studies.
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The case must be of sufficient complexity so as to test the diagnostic and therapeutic competence of the candidate. A rationale for the treatment modalities employed is required, as well as an objective critique of the goals achieved.
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The case should exhibit generalized severe disease in both arches and should consist of at least two molars, which must be present after treatment.
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Documentation will consist of a written case report, periodontal charts*, digital (or digitized) radiographs, and digital photographic images.
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Documentation for the case must be completed up to a minimum of six months following surgical treatment. Longer-term documentation is encouraged, if available.
* Periodontal Charts can be downloaded from this website as a .PDF file.
Click here for a checklist of criteria used by NDSE Examiners to grade the submitted Case Reports.
The Written Report
The periodontal case report will include a Written Report detailing the:
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Medical history
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Extraoral history and findings
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Intraoral history and findings
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Clinical findings to include oral hygiene proficiency and compliance, bleeding on probing, purulence, mobility, furcation involvement, probing depths, gingival recession, laboratory test results, and attachment levels pre-treatment, post-initial therapy and post-treatment (where applicable)
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Diagnosis
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Etiology
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Prognosis (Short-term, long-term, with/without treatment, individual, overall)
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Treatment plan and therapy, to include objectives and goals
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Evaluation of the results
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Scheduled maintenance programs, if applicable
The Written Report will be graded on the basis of accuracy, readability (grammar, spelling, sentence structure, etc.), and succinctness. Consistency with the radiographs, photographs, and charts will also form an important part of the grade. It may be submitted as an electronic file (e.g. Word document).
Photography
Teeth and tissues are to be dried before photographing so that saliva, blood and other material do not obscure the views. Candidates are expected to record the photographs in electronic format. Traditional 35 mm slide formats are to be transferred by the candidate into digital images for submission. All photographs must be of high resolution and submitted in CD or DVD format. The quality of the intraoral photographs will be graded. It is expected that intraoral photographs will be taken using intraoral mirrors to ensure quality, clarity and proper angulation. Mirror view photographs will be displayed as if looking directly at the tissues (non-mirror image).
Pre-treatment, post-initial therapy and post-treatment digital photographs (or 35 mm colour transparencies copied as high-resolution digital images) are required as follows:
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At least three (3) facial views, one (1) showing the anterior teeth and tissues and one (1) each for the left and right posterior regions
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Palatal/lingual maxillary/mandibular views demonstrating all teeth (anterior and posteriors)
The comprehensive case report must include at least one sextent of surgery. Documentation shall include digital photographic images of the surgical procedure(s) (Surgery 1; Surgery 2; Surgery 3), which record high-quality buccal and lingual views of the following:
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Immediate pre-surgical presentation
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Incision design prior to flap reflection
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Flap reflection, surgical debridement and osseous architecture before resection or regeneration
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Presentation of the surgical site after resective or regenerative procedure, if performed
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Presentation of the flaps sutured in place
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Post-operative healing, to include a one- or two-week post-operative view and a four-week post-operative view.
Radiographs
Thorough radiographic documentation of the patient is required prior to treatment. All radiographs must be of high diagnostic quality, appropriately mounted, clearly labelled, and dated. Radiograph quality will be graded. Radiographic interpretation by the candidate will be graded from the Written Report. Radiographic images are to be submitted in CD or DVD format. If traditional film radiology is employed, the candidate must prepare digital images (photographs) made from the radiographs. Radiographic images will be submitted with the Case Report as follows:
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Complete dentition periapical views
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Posterior bitewing views, preferably with vertical orientation
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Panoramic views are required before treatment.
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Post-treatment periapical radiographs of surgical sites taken at least six months post-operatively are required.
Image Index
An index of the submitted photographs and radiographs (i.e. a numbered and descriptive list of images) is required. The index may be created as an electronic file (e.g. Word document or thumbnails) in CD or DVD format.
Periodontal Charting
General
Detailed Periodontal Charting is required for the pre-treatment, post-initial therapy (pre-surgical) and final (at least six months post-surgical) stages of the submitted case.
One (1) original and two (2) colour hard copies of the Periodontal Chart will be submitted for grading. Colour digital scanned copies may also be submitted in addition to the hard copies. Grading will be based on completeness, neatness, accuracy, and overall consistency with the written report, photographs, and radiographs. (For example, the level of the gingival margin as charted for a given site is consistent with the photography.)
Instructions for Completion of Periodontal Charts
Red, green, black and blue markers or pens will be needed to complete the charts.
Click here for an example of how to complete the Periodontal Charts. Consider the horizontal lines in the area of the tooth roots to be 2 mm apart.
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Measurements in millimetres of probing depth (PD), recession (REC), and clinical attachment level (CAL) should be entered in black ink in the boxes associated with each tooth as per:
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PD
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• Probing depth is recorded in millimetres measuring from the GM to the base of pocket/sulcus
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REC
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• The distance from the cementoenamel junction (CEJ) to the gingival margin (GM) is recorded. When the GM is apical to the CEJ, enter a positive number (e.g. 1). When the GM is coronal to the CEJ, enter a negative number (e.g. –2).
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CAL
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• The clinical attachment level from CEJ to the base of pocket/sulcus is recorded. This may be measured directly or calculated from GM-CEJ and PD.
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Three measurements on the facial and three measurements on the lingual are required for each tooth. When dental implants are present, the restoration margin shall be considered the CEJ.
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Plaque and/or calculus are recorded by placing a blue dot above the number for the probing depth for that site.
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Purulence (PUR) is recorded by placing a black dot above the number for the recession (REC) for that site.
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Presence of bleeding on probing (BOP) is recorded by placing a red dot above the number for clinical attachment loss (CAL) for that site.
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Missing teeth, or portions of teeth, should be coloured in solidly in black.
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Impacted and/or unerupted teeth should be outlined in black.
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Dental implants that replace missing teeth should be indicated by a heavy black outline surrounding diagonal black lines reflecting the relative implant size and shape. Write “DI” in black in the space above or below the appropriate tooth number boxes.
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The gingival margin (GM), relative to the cementoenamel junction (CEJ), is drawn in blue.
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Only those probing depths (PD) greater than 4 mm are to be drawn vertically in red along the appropriate tooth surface.
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Areas where the zone of keratinized gingiva is less than 2 mm are recorded by placing a green asterisk between the box for the REC measurement and the drawing of the tooth or implant.
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Root canal fillings are recorded with a heavy blue line in the root(s) of the appropriate teeth.
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An open blue circle at the tooth apex should be used to record a periapical radioluscency.
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Caries and/or overhanging restorative margins are recorded with a jagged red line on the appropriate tooth surfaces.
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Open or loose tooth contacts are recorded with a jagged blue line through the appropriate contact area.
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Specify the mobility classification or measurement system used in the space provided. Mobility scores greater than zero (0) should be recorded in blue in the occlusal surface drawing of the appropriate teeth.
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Specify the furcation involvement grading system used in the space provided. Furcation involvement should be marked in red adjacent to the appropriate tooth surface according to the following scheme:
Grade I 
Grade II 
Grade III 
Case Submissions for Re-Sit (Oral) Candidates
The weighting of the submitted Case Reports in the overall scoring of the oral examination suggests that unsuccessful candidates should consider submission of a different case to re-sit the examination. For this reason, the candidate is strongly encouraged to document several cases in preparation for this exam. Nevertheless, candidates who are unsuccessful in the oral examination (Component II) may choose to:
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Submit the same case, unchanged;
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Submit the same case, with changes;
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Submit a new case for review (recommended).
Blank Case Report Forms (PDF)
