Old Dominion University Gene W. Hirschfeld School of Dental Hygiene Health Sciences Building, Room 2011 4608 Hampton Blvd Norfolk, VA 23529



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Application Packet for Bachelor of Science in Dental Hygiene Entry-Level Degree Program Old Dominion University Gene W. Hirschfeld School of Dental Hygiene Health Sciences Building, Room 2011 4608 Hampton Blvd Norfolk, VA 23529 www.odu.edu/dental

Dear Prospective Undergraduate Dental Hygiene Student: Thank you for your interest in the Bachelor of Science in Dental Hygiene-Entry Level Degree Program at Old Dominion University. Applicants for admission to the baccalaureate program in dental hygiene should apply initially to the Office of Admissions of Old Dominion University. Students cannot be accepted into the dental hygiene program without first being admitted to the University. To obtain an application to the University, use the website: http://admissions.odu.edu/home.php or call the Admissions Office at (757) 683-3685. Indicate on the University application your intention to enter the dental hygiene program. Acceptance to the University and/or as a second degree student does not constitute admission to the Bachelor of Science in Dental Hygiene-Entry Level Degree Program. Applicants are admitted to the dental hygiene program after completion of the required dental hygiene prerequisite courses and the lower-level University general education courses. Transfer students may complete prerequisite and lower-level general education courses at another college or university, but are responsible for having the Old Dominion University Admissions Office determine if the courses are equivalent to Old Dominion University courses. Students transferring to Old Dominion University from another college or university must send official transcripts to the University Office of Admissions for a transfer credit evaluation which will be used as documentation that transfer courses are acceptable. Attach the following to the dental hygiene application: 1. All OFFICIAL transcripts must be attached to the dental hygiene application, including high school transcripts. Do not have transcripts mailed separately to the School of Dental Hygiene. Official Old Dominion University transcripts MUST also be attached. 2. Applicants must document completion of at least 12 hours of observation in a dental care facility on the Employment/Observation Verification Form within this packet. 3. Attach two completed Recommendation Forms. At least one of these forms must be from a dental or academic professional. Only these forms should be submitted; a separate letter of recommendation is not needed. Incomplete application packets will not be considered for admission. Return complete application packet by February 1 to: Chair, Admissions Committee Gene W. Hirschfeld School of Dental Hygiene, Health Science Bldg, Room 2011 Old Dominion University Norfolk, VA 23529 Applicants accepted into the program will be notified by April 1 and are required to pay a nonrefundable deposit of $300 to reserve their place in the program. This fee is applied toward spring semester tuition. Applicants who are wait-listed or not accepted will receive notice and recommendations for academic advising. For additional information, please contact the School of Dental Hygiene at (757) 683-3338. Applications received after February 1 may be considered on a space available basis. Enclosures: Dental Hygiene Program Application Dental Hygiene Program Applicant Selection Criteria Employment/Observation Verification Form Recommendation Forms (2) Entry-Level BSDH Curriculum Sheet Curriculum Guide

Dental Hygiene Program Applicant Selection Criteria A point system is used by the Admissions Committee to help rank qualified candidates for admission. Criteria Possible Points 1. Science Grade Point Average 16 Grade points for all science s based courses is highly weighted. The higher the science grade point average (GPA), the more points earned. 2. Cumulative Grade Point Average 8 Points are awarded for cumulative grade point average for all schools attended. The higher the GPA the more points earned. 3. Educational Background 1-3 Awarded an Associate Degree = 1 Awarded an Bachelor Degree = 2 Awarded a Master s Degree = 3 NOTE: An ODU student candidate also earns points according to the # of semesters enrolled at ODU. 4. Lower Level General Education & Prerequisite Courses 0-48 A = 4 points A- = 3.7 points B+ = 3.3 points B = 3 points B- = 2.7 points C+ = 2.3 points C = 2 points C-, D and F = 0 points. Currently enrolled in a required class receives = 1 point Exempt/Waiver = 4 points AP credit = 4 points 5. Dental Background 1-4 Graduate from an Accredited Dental Assisting Program = 1 point Certified as a Dental Assistant (current ADAA certification) = 1 point Radiation Safety Certificate = 1 point Current CPR Certificate = 1 point NOTE: Each item requires copy of official certificate to document certification. 6. Quality of Application The manner in which the application packet is completed, as well as, recommendation forms, quality of essay, honors and activities are considered as qualitative indications of potential for success. Completion and accuracy of grades and GPA information is critical. All official high school, college and/or university transcripts must be submitted. Candidates can lose points if the packet is incomplete and poorly presented.

Application for Admission Old Dominion University Bachelor of Science in Dental Hygiene Entry-Level Degree Program Desired Date of Admissions: Fall (Year) NAME: TODAY S DATE: Other names in which records may appear: ODU UNIVERSITY IDENTIFICATION NUMBER: E-MAIL ADDRESS: LOCAL ADDRESS: LOCAL PHONE: PERMANENT ADDRESS: PERSONAL BACKGROUND Please complete the items which pertain to you. PERMANENT PHONE: Honors awarded Community service activities Leadership roles Educational goals Professional goals DENTAL BACKGROUND Please type a brief (approximately 300-500 words) description of how you would contribute to the health of society by becoming a licensed dental hygienist. (Attach a separate sheet) OFFICE USE ONLY: DATE ACCEPTED DENIED WAITING LIST

EDUCATIONAL BACKGROUND: 1. Please list all colleges you have attended and dates attended: College Dates Attended GPA Degree or Certificate Date Awarded Date To Be Awarded 2. Provide dates of completion for related certifications. (Attach copy of Certificate) DA Program CDA CPR Radiation Safety Certification 3. Prerequisite Courses Date course completed & where Grade(s) received Where currently enrolled? (Spring) When plan to enroll? (Summer) English Composition I College Chemistry I Introduction of Sociology Introduction to Psychology Bacteriology or Microbiology Human Anatomy & Physiology I Human Anatomy & Physiology II Nutrition

4. Lower Level General Education Requirements* English Composition II Date course completed and where Grade(s) received Where currently enrolled? (Spring) Where you plan to enroll? (Summer) Elementary Statistics Human Creativity History Literature Impact of Technology 5. FOREIGN LANGUAGE: (Check response after reviewing Dental Hygiene Curriculum Guide) Exempt (Met in H.S. or AA, AS, AA +S). Associate of Applied Science does not satisfy Foreign Language requirement. College grade received: Language Course I Language Course II Date planned to enroll 6. Admission to Old Dominion University as a degree-seeking student: Already admitted and taking classes at ODU since. Already admitted but not presently enrolled in classes at ODU. Have submitted application and official transcripts to the University s Office of Admissions, but have not heard decision yet. Have not applied and have not been admitted, but I will apply by deadline. 7. Please check if you included the following information with this Dental Hygiene Program Application. All official high school and college transcripts (including ODU). Two Recommendation Forms sealed in a envelope with signature of author across seal. Completed Employment/Observation Form. Signature of Applicant Date OFFICE USE ONLY Quality of Application Dental Background Multiple Course Attempts

*Students who have received an Associate in Arts (A.A.), Associate in Science (A.S.), or Associate in Arts and Sciences (A.A.S.) degree from the Virginia Community College System have met all lower division General Education requirements. College-parallel programs at other community colleges or systems are reviewed at admissions for determination of acceptable transfer courses. Return application packet by February 1 to: Chair, Admissions Committee Gene W. Hirschfeld School of Dental Hygiene Health Sciences Bldg., Room 2011 Old Dominion University Norfolk, VA 23529 As a health care professional/student, you are at an increased risk for contracting blood borne infectious diseases. The Gene W. Hirschfeld School of Dental Hygiene is not responsible for any medical cost associated with you contracting any communicable disease during your education and/or participation in Old Dominion University sponsored functions. If you contract a blood borne infectious disease during your enrollment, appropriate health care experts will be consulted about your ability to continue to treat patients.

EMPLOYMENT/OBSERVATION VERIFICATION FORM APPLICANT S NAME: ADDRESS: PHONE NUMBER: Please document at least 12 hours of one or more of the following: employment, observation, or volunteer experience in a dental health care facility of your choice. Note examples given below. Please circle: DENTAL EMPLOYMENT DATES EMPLOYED RESPONSIBILITIES PROVIDER S NAME, ADDRESS, PHONE PROVIDER S SIGNATURE 2005-07 dental hygiene assistant, took x rays, instructed patients in home care Mary Smith, DDS, 123 Main St. Any Town, VA (757)555-5555 Mary Smith, DDS Please circle: DENTAL OBSERVATION DATES & TIME IN HOURS PROCEDURES OBSERVED PROVIDER S NAME, ADDRESS, PHONE PROVIDER S SIGNATURE 10/6/08 8 hrs. Crown prep, composite restoration, x-rays Mary Smith, DDS, 123 Main St. Any Town, VA (757)555-5555 Mary Smith, DDS Please circle: DENTAL VOLUNTEER EXPERIENCE DATES & TIME IN HOURS SERVICE PROVIDED PROVIDER S NAME, ADDRESS, PHONE PROVIDER S SIGNATURE 10/6/08 8 hrs. Assisted dental hygienist by using air and suction, seated patients, took blood pressure Joseph Jones, RDH, MS 123 Main St. Any Town, VA (757)555-5555 Joseph Jones, RDH, MS

RECOMMENDATION FORM To the Candidate: Please write your name in the space provided. Candidate s Name (Print) Check one of the following statements and sign your name below: I waive my rights to see my evaluation and recognize that it will remain confidential. I do not waive my rights of confidentiality and will be able to see my evaluation. Applicant s signature To the Referrer: The candidate is applying to the Old Dominion University, Gene W. Hirschfeld School of Dental Hygiene. Please complete this form (print or type) and return it to the Candidate in a sealed envelope with your signature across the closure. Thank you for your assistance. 1. Knowledge of the Candidate (Please check (Τ) all that apply) I have known the candidate for (add #) Month(s) Year(s) I know the candidate Very well Moderately well Slightly Nature of my contact with the candidate Academic Employment Other (specify) Truly Below No Basis for 2. Evaluation of the Candidate Exceptional Excellent Good Average Average Comment Knowledge /preparation Judgment/analytical ability Interpersonal relations/ cooperation Ability to accept criticism Personal conduct & appearance Emotional maturity & stability Organization skills Empathy/compassion Manual dexterity Reliability/responsibility Additional Comments (Please type. If necessary, please use an additional sheet of paper.) 3. Overall Endorsement of the Candidate for admission to the Dental Hygiene Program Highly recommend Recommend Recommend with reservations Referrer s Name/Degrees Position/Title Address Signature Date

RECOMMENDATION FORM To the Candidate: Please write your name in the spaces provided. Candidate s Name (Print) Check one of the following statements and sign your name below: I waive my rights to see my evaluation and recognize that it will remain confidential. I do not waive my rights of confidentiality and will be able to see my evaluation. Applicant s signature To the Referrer: The candidate is applying to the Old Dominion University, School of Dental Hygiene. Please complete this form (print or type) and return it to the Candidate in a sealed envelope with your signature across the closure. Thank you for your assistance. 1. Knowledge of the Candidate (Please check (Τ) all that apply) I have known the candidate for (add #) Month(s) Year(s) I know the candidate Very well Moderately well Slightly Nature of my contact with the candidate Academic Employment Other (specify) Truly Below No Basis for 2. Evaluation of the Candidate Exceptional Excellent Good Average Average Comment Knowledge /preparation Judgment/analytical Ability Interpersonal relations/ cooperation Ability to accept criticism Personal conduct & appearance Emotional maturity & stability Organization skills Empathy/compassion Manual dexterity Reliability/responsibility Additional Comments (Please type. If necessary, please use an additional sheet of paper.) 3. Overall Endorsement of the Candidate for admission to the Dental Hygiene Program Highly recommend Recommend Recommend with reservations Referrer s Name/Degrees Position/Title Address Signature Date

Dental Hygiene Curriculum Guide Coursework Credit Hours Credit Hours Fall Year 1 Freshman Level Spring Year I Freshman Level *ENGL 110C English Composition I 3 *ENGL 211C English Composition II 3 *CHEM 105N/106N Intro to Chemistry 4 *BIOL 103 Basic Bacteriology 4 *PSYC 201C Introduction to Psychology 3 *SOC 201S Introduction to Sociology 3 HIST (100H, 101H, 102H, 103H, 104H) 3 Human Creativity 3 13 13 Fall Year 2 Sophomore Level Spring Year 2 Sophomore Level STAT 130M Elementary Statistics 3 *BIOL 251 Human Anatomy & Phys II 4 *BIOL 250 Human Anatomy & Phys I 4 *CHP 318 Principles of Nutrition 3 ENGL 112L Enjoying Literature 3 Foreign Language II 0-3 Foreign Language I 0-3 +Option D or Minor 3-12 11-14 13-16 Fall Year 3 Junior Level Spring Year 3 Junior Level DNTH 300 Dental Hygiene Theory I 4 DNTH 305 Dental Hygiene Theory II 3 DNTH 301 Dental Hygiene Services I 3 DNTH 306 Dental Hygiene Services II 3 DNTH 302 Oral Anatomy & Histology 4 DNTH 307 Pharmacology 2 DNTH 303 Applied Dental Materials 3 DNTH 308 Oral Pathology 3 DNTH 304 Oral Radiology I 2 DNTH 309 Oral Radiology II 2 DNTH 310 Dental Hygiene Therapies 3 16 16 Summer Year 3 Junior Level DNTH 316 Dental Hygiene Theory III 3 DNTH 317 Anxiety & Pain Control 2 +Option D or Minor 3-12 8-15 Fall Year 4 Senior Level Spring Year 4 Senior Level DNTH 410 Dental Hygiene Theory IV 3 DNTH 416 Adm Leadership & Prof Dev 3 DNTH 411 Dental Hygiene Services 6 DNTH 417W Dental Hygiene Theory V 3 DNTH 413 Community OH Planning 3 DNTH 418 Dental Hygiene Services V 6 DNTH 414 Educational Concepts 3 DNTH 419 Community OH Practice 3 DNTH 415 Research Methods 3 18 14 *Courses must be completed with a grade of C or better for consideration into the entry-level BSDH program; C- is not acceptable. +Approved Minor or Option D is a University requirement see academic advisor for selection Foreign language is needed if requirement is not met by 3 years of same language or 4 years of 2 different languages in high school does not apply to students who graduated from high school before 12/31/1985. Foreign Language needs to be in a sequence. SELECTED MINORS: Community Health Professions, Environmental Health, Marketing, Management, Psychology

BACHELOR OF SCIENCE IN DENTAL HYGIENE 2014-2015 Name UIN Phone E-mail Address Virginia Community College Degree*: AAS AS in I. General Education Requirements: Lower Division* WSPT COMPLETE: YES NO 40-46 Credits Skills Area Cr Hrs Courses Transfer ODU Semester Grade Still Need Composition I 3 ENGL 110C Composition I Composition II (Select one course) 3 ENGL 211C Composition ENGL 221C Composition ENGL 231C Composition Mathematics 3 STAT 130M Elem. Statistics Oral Communications 0 Will be met in major Information Literacy 0 Will be met in major Language & Culture** Satisfied in High School 0-3** 101F** 0-3** 102F** YES NO Ways of Knowing Human Creativity 3 ARTH 121A, ARTH 122A DANC 185A COMM 270A THEA241A, MUSC264A Literature 3 ENGL 112L Enjoying Literature The Nature of Science Need (2) NS = 8 credits 3 CHEM 105N Introductory Chemistry 1 CHEM 106N Introductory Chemistry Lab COMBO (12) BIOL 250 Human Anatomy & Physiology I BIOL 251 Human Anatomy & Physiology II BIOL 103 Basic Bacteriology Human Behavior 3 PSYC 201S Introduction to Psychology 3 SOC 201S Introduction to Sociology Interpreting the Past 3 HIST 100H, 101H, 102H, 103H, 104H Philosophy/Ethics 0 Will be met in major The Impact of Technology 3 HIST 304T,CS 300T, PHIL 383T STEM T O T A L S 40-46 370T, WMST 390T *Students who have received an AA or AS degree from the Virginia Community College System (except the AS in General Studies prior to April 1993) receive waiver of lower division requirements. ** Students may complete the 101F/1-02F foreign language requirement by earning 3 high school credits in one foreign language or 4 high school credits in two foreign languages. BRING THIS CURRICULUM PLANNING SHEET WITH YOU TO EVERY ADVISING SESSION.

II. PREREQUITES: 3 Credit Hours Course Cr. Hrs Transfer ODU Semester Grade Still Need CHP 318U Nutrition 3 I11. UPPER DIVISION GENERAL EDUCATION COURSES at 300 or 400 level/approved Minor 6-12 Credit Hours 1. Students Need a (W) Writing Intensive Course within Major 3 hours 2. Upper-Division Fulfillment Options minimum 6 hours Option A: Disciplinary Minor or Second Major or Second Degree Option B: Interdisciplinary Minor 12 hours, 3 of which may be in the major Option C: International Business License or Teaching Licensure Option D: Six hours of elective upper-division courses from outside discipline and not required by the major/college Course Cr. Hrs ODU Semester Grade Still Need Impact of Technology a (T) 300 level course 3 3 3 3 IV. PROGRAM COURSES: DNTH 305,410, 413, 414, 417W, 416 meet University requirement for Oral Communications DNT H 415 meet University requirement for Information Literacy DNTH 300, 305, 306, 316, 411, 414, 415, 416, 417W and 418 meet University requirement for Philosophy/Ethics 70 credit hours Course Cr. Hrs. Semester Grade Course Cr. Hrs. Semester Grade DNTH 300 Dental Hygiene Theory I 4 Fall DNTH 316 Dental Hygiene Theory III 3 Summer DNTH 301 Dental Hygiene Services I 3 Fall DNTH 317 Anxiety & Pain Control 2 Summer DNTH 302 Oral Anatomy & Histology 4 Fall GPA DNTH 303 Applied Dental Materials 3 Fall DNTH 410 Dental Hygiene Theory IV 3 Fall DNTH 304 Oral Radiology I 2 Fall DNTH 411 Dental Hygiene Services IV 6 Fall GPA DNTH 413 Community OH Planning 3 Fall DNTH 305 Dental Hygiene Theory II 3 Spring DNTH 414 Educational Concepts 3 Fall DNTH 306 Dental Hygiene Services II 3 Spring DNTH 415 Research Methods 3 Fall DNTH 307 Pharmacology 2 Spring GPA DNTH 308 Oral Pathology 3 Spring DNTH 416 Adm Leadership & Prof Dev 3 Spring DNTH 309 Oral Radiology II 2 Spring DNTH 417W Dental Hygiene Theory V 3 Spring DNTH 310 Dental Hygiene Therapies 3 Spring DNTH 418 Dental Hygiene Services V 6 Spring GPA DNTH 419 Community OH Practice 3 Spring Exit Exam of Writing Proficiency GPA Overall Major Minor Senior Assessment Advisor: Denise Claiborne BSDH, MS Program Director BS Entry-level Dental Hygiene Program Phone: 757-683-5949 E-mail: dclaibor@odu.edu Total 119 credit hours