2017 – 2018
Florida Department of Education
Curriculum Framework 

Program Title:	Dental Assisting Technology and Management
Career Cluster:	Health Science

AS	
CIP Number	1351060104	
Program Type	College Credit	
Standard Length	70 credit hours	
CTSO	HOSA: Future Health Professionals	
SOC Codes (all applicable) 	31-9091 Dental Assistants	
CTE Program Resources 	http://www.fldoe.org/academics/career-adult-edu/career-tech-edu/program-resources.stml 	

Purpose

This program offers a sequence of courses that provides coherent and rigorous content aligned with challenging academic standards and relevant technical knowledge and skills needed to prepare for further education and careers in the Health Science career cluster; provides technical skill proficiency, and includes competency-based applied learning that contributes to the academic knowledge, higher-order reasoning and problem-solving skills, work attitudes, general employability skills, technical skills, and occupation-specific skills, and knowledge of all aspects of Health Science career cluster. 

The program is designed to prepare students for employment as dental assistants 66002 (SOC code 31-9091), dental auxiliaries as practice managers, educational managers for dental companies, and dental assisting educators.  The program will prepare students for the Dental Assisting National Board Examination as well as state requirements.  The program should meet the requirements of the Commission on Dental Accreditation of the American Dental Association and standards recommended by the Florida Board of Dentistry.

The content includes but is not limited to dental and general anatomy, dental terminology, nutrition, microbiology, dental pharmacology and anesthesia, chairside assisting, expanded functions, dental office emergencies/CPR, dental radiography, maintenance and asepsis of dental operatory and instruments, dental instrument and equipment utilization, dental specialty procedures, basic dental laboratory procedures, dental materials, preventive dentistry, employability skills, leadership and human relations skills, ethics and jurisprudence, dental office and patient management, general studies, physical sciences, business principles, educational leadership, and communication skills.

Additional Information relevant to this Career and Technical Education (CTE) program is provided at the end of this document.

Program Structure

This program is a planned sequence of instruction consisting of 70 credit hours.

Standards

After successfully completing this program, the student will be able to perform the following:

01.0	Demonstrate knowledge of the dental health care delivery system and dental health occupations 
02.0	Use oral and written communication skills in creating, expressing and interpreting information and ideas 
03.0	Describe the legal and ethical responsibilities of the dental health care worker 
04.0	Demonstrate an understanding of general anatomy and physiology and apply wellness and disease concepts 
05.0	Demonstrate the importance of health, safety, and environmental management systems in dental organizations and their importance to organizational performance and regulatory compliance 
06.0	Recognize and respond to emergency situations
07.0	Use information technology tools 
08.0	Explain the importance of employability skills 
09.0	Demonstrate knowledge of blood borne diseases, including HIV/AIDS 
10.0	Demonstrate leadership and teamwork skills needed to accomplish team goals and objectives 
11.0	Use dental terminology.
12.0	Identify structures and explain functions and pathologies of dental and general head and neck anatomy.
13.0	Identify principles of microbiology and disease prevention and perform infection control procedures.
14.0	Identify, describe, maintain and utilize dental instruments and equipment.
15.0	Record patient assessment and treatment data.
16.0	Identify the functions of pharmacology and anesthesia as they relate to dentistry
17.0	Identify and perform dental and carpal radiographic procedures.
18.0	Identify properties and uses, and manipulate dental materials.
19.0	Perform chairside assisting for general dentistry and specialty procedures.
20.0	Describe principles and perform techniques of preventive dentistry.
21.0	Perform general dental business office procedures.
22.0	Demonstrate professionalism as a dental team member in the clinical setting.

The following Standards are Specialty Options:

23.0	Demonstrate skills for educational methodologies and strategies.
24.0	Demonstrate skills necessary for marketing, sales, and educational programs for dental products.
25.0	Demonstrate knowledge of dental practice set up and management procedures.

2017 – 2018
Florida Department of Education
Student Performance Standards

Program Title:	Dental Assisting Technology and Management 
CIP Number:	 	1351060104
Program Length:	70 credit hours 
SOC Code(s):		31-9091

The AS degree requires the inclusion of a minimum of 15 credits of general education coursework according to SACS, and it must be transferable according to Rule 6A-14.030 (2), F.A.C.  At the completion of this program, the student will be able to:	
01.0	Demonstrate knowledge of the dental health care delivery system and dental health occupations – The student will be able to:	
01.01	Identify the basic components of the dental health care delivery system including public, private, government and non-profit. 	
01.02	Describe the various types of dental health care providers and the range of services available.	
01.03	Describe the composition and functions of a dental health care team	
01.04	Identify the general roles and responsibilities of the individual members of the dental health care team.	
01.05	Identify the roles and responsibilities of the consumer within the dental healthcare system. 	
01.06	Explain the cause and effects of factors that influence the current delivery system of dental healthcare. 	
01.07	Explain the impact of emerging issues including technology, epidemiology, bioethics and socioeconomics on the dental healthcare delivery system. 	
01.08	Discuss the history of dentistry.	
02.0	Use oral and written communication skills in creating, expressing and interpreting information and ideas – The student will be able to:	
02.01	Apply basic speaking and active listening skills including reflection, restatement, and clarification techniques. 	
02.02	Develop basic observational skills and related documentation strategies in written and oral form. 	
02.03	Identify characteristics of successful and unsuccessful communication including communication styles and barriers. 	
02.04	Compose written communication using correct spelling, grammar, a formatting and confidentiality and specific formats of letter writing.	
02.05	Recognize components of medical and dental terminology and abbreviations. 	
02.06	Recognize the importance of courtesy and respect for patients and other health care workers and maintain good interpersonal relationships. 	
02.07	Recognize the importance of patient education regarding dental and health care. 	
02.08	Adapt communication skills to varied levels of understanding and cultural orientation including diverse age, cultural, economic, ethnic and religious groups. 	
02.09	Identify psychological considerations influencing communication and behaviors.	
03.0	Describe the legal and ethical responsibilities of the dental health care worker – The student will be able to:	
03.01	Identify areas of Florida Statute 466 and Rule 64B5-16 FAC and Rule 64B5-25 FAC applicable to practice by the dental health workers.	
03.02	Explain practices that could result in malpractice, liability, negligence, abandonment, false imprisonment and fraud. 	
03.03	Demonstrate procedures for accurate documentation and record keeping. 	
03.04	Interpret healthcare facility policy and procedures. 	
03.05	Explain the patients' "Bill of Rights." 	
03.06	Identify and implement standards of the Health Insurance Portability and Accountability Act (HIPAA).	
03.07	Distinguish between express, implied and informed consent. 	
03.08	Explain the laws governing harassment, labor and employment. 	
03.09	Differentiate between legal and ethical issues in dentistry.	
03.10	Describe a Code of Ethics consistent with the dental assisting profession.	
03.11	Identify and compare personal, professional and organizational ethics. 	
03.12	Recognize the limits of authority and responsibility of dental health care workers including legislated scope of practice. 	
03.13	Recognize and report illegal and/or unethical practices of dental health care workers. 	
03.14	Recognize and report abuse including domestic violence and neglect.	
03.15	Identify resources to victims of domestic violence.	
03.16	Explain risk management.	
04.0	Demonstrate an understanding of general anatomy and physiology and apply wellness and disease concepts – The student will be able to:	
04.01	Develop a basic understanding of the structure and function of the body systems	
04.02	Identify common disorders related to each of the body systems.	
04.03	Explain basic concepts of positive self-image, wellness and stress. 	
04.04	Develop a wellness and stress control plan that can be used in personal and professional life. 	
05.0	Demonstrate the importance of health, safety, and environmental management systems in dental organizations and their importance to organizational performance and regulatory compliance – The student will be able to:	
05.01	Describe personal and jobsite safety rules and regulations that maintain safe and healthy work environments.	
05.02	Identify and describe methods in medical error reduction and prevention in the dental healthcare setting.	
05.03	Demonstrate an understanding of personal safety procedures based on Occupations Safety and Health Administration (OSHA) and Centers for Disease Control (CDC) regulations (including standard precautions).	
05.04	Recognize Safety Data Sheets (SDS) and comply with safety signs, symbols and labels. 	
05.05	Demonstrate procedures for the safe transport and transfer of patients.	
05.06	Describe fire safety, disaster and evacuation procedures. 	
05.07	Explain emergency procedures to follow in response to workplace accidents. 	
05.08	Demonstrate handwashing and the use of personal protective equipment used in dentistry.	
06.0	Recognize and respond to emergency situations – The student will be able to:	
06.01	Take and record vital signs. 	
06.02	Describe legal parameters relating to the administration of emergency care. 	
06.03	Obtain and maintain training or certification in cardiopulmonary resuscitation (CPR), automated external defibrillator (AED), foreign body airway obstruction (FBAO) and first aid. 	
07.0	Use information technology tools – The student will be able to:	
07.01	Define terms and demonstrate basic computer skills. 	
07.01.01	Interpret information from electronic medical documents. 	
08.0	Explain the importance of employability skills – The student will be able to:	
08.01	Identify personal traits or attitudes desirable in a member of the healthcare team. 	
08.02	Exemplify basic professional standards of dental healthcare workers as they apply to hygiene, dress, language, confidentiality and behavior (i.e. telephone etiquette, courtesy and self-introductions). 	
08.03	Maintain a career portfolio to document knowledge, skills, and experience. 	
08.04	Write an appropriate resume. 	
08.05	Conduct a job search and complete a job application form correctly.  	
08.06	Demonstrate competence in job interview techniques. 	
08.07	Examine levels of education, credentialing requirements including licensure and   certification, employment opportunities, workplace environments and career growth potential. 	
08.08	Examine licensing, certification, and industry credentialing requirements.	
09.0	Demonstrate knowledge of blood borne diseases, including HIV/AIDS – The student will be able to:	
09.01	Recognize emerging diseases and disorders.	
09.02	Distinguish between fact and fallacy about the transmission and treatment of diseases caused by blood borne pathogens including Hepatitis B. 	
09.03	Identify "at risk" behaviors that promote the spread of diseases caused by blood borne pathogens and the public education necessary to combat the spread of these diseases. 	
09.04	Identify community resources and services available to the individuals with diseases caused by blood borne pathogens. 	
09.05	Apply infection control techniques designed to prevent the spread of diseases caused by blood borne pathogens to the care of all patients following Centers for Disease Control (CDC) guidelines. 	
09.06	Demonstrate knowledge of the legal aspects of AIDS, including testing. 	
10.0	Demonstrate leadership and teamwork skills needed to accomplish team goals and objectives – The students will be able to:	
10.01	Analyze attributes and attitudes of an effective leader. 	
10.02	Recognize factors and situations that may lead to conflict.  	
10.03	Demonstrate effective techniques for managing team conflict.	
Students completing the following intended outcomes (11-22) meet the requirements of the Dental Assisting Technology and Management-ATD program 66002 (SOC Code 31-9091)	
11.0	Use dental terminology -- The student will be able to:	
11.01	Identify and define common dental terms.  	
11.02	Demonstrate the use of proper dental terminology in the dental environment.	
12.0	Identify structures and explain functions and pathologies of dental and general head and neck anatomy -- The student will be able to:	
12.01	Identify structures and functions of head and neck anatomy including bones, muscles, sinuses, salivary glands, lymph nodes, nerves, and blood vessels.	
12.02	Identify embryonic development of head, oral cavity, and teeth.	
12.03	Identify teeth and their landmarks, and the morphological characteristics of each individual tooth.	
12.04	Describe the histological components of the head, oral cavity, and elements of the teeth and supporting structures.	
12.05	Recognize and describe oral pathological conditions, related to the teeth and their supporting structures.	
12.06	Recognize and describe developmental anomalies related to the teeth, face, and oral structures.	
12.07	Describe and differentiate between normal and malocclusion.	
12.08	Discuss the adverse effects of the use of alcohol, tobacco, and both legal and illegal drugs on the oral cavity.	
13.0	Identify principles of microbiology and disease prevention and perform infection control procedures -- The student will be able to:	
13.01	Differentiate between pathogenic and non-pathogenic microorganisms.	
13.02	Describe pathogens and modes of disease transmission.	
13.03	Differentiate between aseptic and non-aseptic environments.	
13.04	Describe and apply methods of cleaning, disinfection, and sterilization.	
13.05	Identify chemicals and their uses for controlling the spread of disease in the dental environment 	
13.06	Identify and practice the current CDC guidelines for infection control in dental healthcare settings.	
13.07	Describe the duties of the dental office safety coordinator 	
13.08	Demonstrate compliance with the OSHA Bloodborne Pathogens Standard (29CFR-1910.1030) applicable to the dental office environment.	
13.09	Identify and manage hazardous chemicals and biomedical wastes in accordance with the OSHA Hazard Communications Standard (29CFR-1910.1200), 64E-16 F.A.C., and Environmental Protection Agency regulations.	
13.10	Define principles of infection control including standard and transmission based precautions.	
13.11	Demonstrate knowledge of dental asepsis 	
13.12	Implement appropriate handwashing procedures and use of protective barriers 	
13.13	Demonstrate knowledge of surgical asepsis and isolation. 	
14.0	Identify, describe, maintain and utilize dental instruments and equipment.--The student will be able to:	
14.01	Identify various types, functions and operations of dental operatory and laboratory equipment.	
14.02	Identify types and functions of operative, restorative, surgical, prosthodontic, orthodontic and endodontic dental instruments.	
14.03	Maintain dental operatory equipment and instruments.	
14.04	Identify types and functions of specific dental hygiene instruments with emphasis on category rather than individual instruments.	
14.05	Seat and dismiss patients.	
14.06	Operate oral evacuation devices and air/water syringe.	
14.07	Maintain a clear field of vision including isolation techniques.	
14.08	Perform a variety of instrument transfers to include four-handed dentistry.	
14.09	Utilize appropriate chairside assistant ergonomics. 	
15.0	Record patient assessment and treatment data -- The student will be able to:	
15.01	Take and record medical-dental histories.	
15.02	Record assessment of existing oral conditions.	
15.03	Record conditions diagnosed by the dentist.	
15.04	Record treatment-related data on the patient’s clinical record	
15.05	Record treatment plan and treatment in patient’s chart	
15.06	Perform a visual assessment of existing oral conditions.	
15.07	Distinguish between and report subjective and objective information. 	
15.08	Report relevant information in order of occurrence. 	
16.0	Identify the functions of pharmacology and anesthesia as they relate to dentistry -- The student will be able to:	
16.01	Identify drug requirements, agencies, and regulations.	
16.02	Distinguish among the five schedules of controlled substances.	
16.03	Record a drug prescription in a patient’s chart. 	
16.04	Utilize ratios and proportional problems to calculate prescribed drug dosages.	
16.05	Identify drug actions, side effects, indications and contraindications; verify with Physician’s Desk Reference or its equivalent.	
16.06	Identify common drugs used in dentistry.	
16.07	Prepare and apply topical anesthetic agent.	
16.08	Identify properties of anesthetics.	
16.09	Prepare syringes for the administration of local anesthetics.	
16.10	Monitor and identify precautions in the use of nitrous oxide-oxygen conscious sedation.	
16.11	Calculate the percentage of nitrous oxide-oxygen delivered during a conscious sedation procedure.	
16.12	Identify drugs and agents used for treating dental-related infection	
16.13	Identify and respond to dental office emergencies 	
17.0	Identify and perform dental and carpal radiographic procedures -- The student will be able to:  	
17.01	Describe history, physics and biological effects of ionizing radiation.	
17.02	Identify parts of the X-ray machine including accessories.	
17.03	Demonstrate radiologic health protection techniques.	
17.04	Describe dark room/processing procedures, mix solutions.	
17.05	Describe the proper disposal of hazardous radiographic waste.	
17.06	Place and expose dental radiographic films or phosphors and digital sensors. 	
17.07	Perform extraoral and carpal radiography as required for dental diagnostic procedures.	
17.08	Identify radiographic anatomical landmarks and pathologies.	
17.09	Mount radiographic surveys.	
17.10	Describe how to maintain unexposed film inventory and storage.	
17.11	Maintain digitally acquired radiographic images. 	
18.0	Identify properties and uses, and manipulate dental materials -- The student will be able to:	
18.01	Identify properties and uses and manipulate gypsum.	
18.02	Identify properties and uses and manipulate restorative materials.	
18.03	Identify properties and uses and manipulate dental cements.	
18.04	Place and remove matrices as permitted by Florida Statute and Florida Board of Dentistry Rule.	
18.05	Place and remove temporary restorations as permitted by Florida Statute and Florida Board of Dentistry Rule.	
18.06	Identify properties and uses and manipulate impression materials.	
18.07	Make intraoral impressions as permitted by Florida Statute and Florida Board of Dentistry Rule.	
18.08	Identify properties and uses and manipulate acrylics and thermoplastics.	
18.09	Identify properties and uses and manipulate waxes.	
18.10	Perform dental laboratory procedures to include the fabrication of casts, custom trays, and temporary crowns and bridges.	
18.11	Identify and manage hazardous dental materials and wastes in accordance with the OSHA Hazard Communications Standard (29CFR-1910.1200) and Environmental Protection Agency regulations.	
18.12	Employ measurements of time, temperature, distance, capacity, and mass/weight during the manipulation of dental materials. 	
19.0	Perform chairside assisting for general dentistry and specialty procedures.  The student will be able to:  	
19.01	Describe procedures, equipment, materials, and instrumentation used in the dental specialties to include but not limited to periodontics, endodontics, pedodontics, oral surgery, orthodontics, and prosthodontics.	
19.02	Assemble tray set-ups for general and specialty dental procedures.	
19.03	Assist in general and specialty dental procedures.	
19.04	Perform patient education to include pre- and post-operative instructions as prescribed by a dentist.	
19.05	Describe procedures, equipment, and materials utilized in digital dentistry to include CAD/CAM Technology.	
20.0	Describe principles and perform techniques of preventive dentistry -- The student will be able to:	
20.01	Provide patient preventive education and oral hygiene instruction.	
20.02	Prepare and set up for various preventive procedures. 	
20.03	Identify properties and uses of abrasive agents used to polish coronal surfaces and appliances. 	
20.04	Perform coronal polish and apply anticariogenic and desensitizing treatments as permitted by Florida Statute and Florida Board of Dentistry Rule.	
20.05	Clean and polish removable dental appliances. 	
20.06	Assist with and place dental dams as permitted by Florida Statute and Florida Board of Dentistry Rule.	
20.07	Apply dental sealants as permitted by Florida Statute and Florida Board of Dentistry Rule.	
20.08	Identify the elements of nutrition, basic food groups, and acceptable diets as recommended by the U.S. Department of Agriculture.	
20.09	Identify dietary deficiencies and dietary practices that contribute to the manifestation of symptoms in the oral cavity.	
20.10	Identify community dental resources and services available.	
21.0	Perform general dental business office procedures -- The student will be able to:	
21.01	Maintain appointment control.	
21.02	Maintain an active recall system.	
21.03	Prepare and maintain accurate patient records.	
21.04	Prepare and maintain patient financial records, collect fees.	
21.05	Prepare and maintain office financial records.	
21.06	Prepare and maintain dental office inventory control and purchasing.	
21.07	Demonstrate public relations responsibilities of the secretary/receptionist.	
21.08	Demonstrate skills on office equipment.	
21.09	Maintain the dental business office environment.	
21.10	Receive and dismiss patients and visitors.	
21.11	Demonstrate appropriate patient management/customer service skills. 	
21.12	Describe the effect of money management on practice goals. 	
22.0	Demonstrate professionalism as a dental team member in the clinical setting – The student will be able to:	
22.01.01	Perform dental assisting duties, dental assisting expanded functions, and dental radiographic procedures in a clinical setting under the direct supervision of a licensed dentist.	
22.01.02	Interact with a professional dental team in the delivery of patient services.	
22.01.03	Utilize employability skills.	
Specialty Option 1: Education	
23.0	Demonstrate skills for educational methodologies and strategies--The student will be able to:	
23.01	Develop and implement policies and operational procedures that meet the American Dental Association accreditation standards for Allied Dental Programs.	
23.02	Identify and describe educational theory and methodology as they relate to Allied Dental Education.	
23.03	Establish liaison with appropriate accrediting organizations, community partners, and educational institutions.	
Specialty Option 2: Product Marketing, Sales, and Educational Programs	
24.0	Demonstrate skills necessary for marketing, sales, and educational programs for dental products--The student will be able to:	
24.01	Establish educational programs relating the value and effectiveness of various dental products.	
24.02	Apply economic principles for product marketing, distribution and sales.	
24.03	Demonstrate effective product evaluation and comparison.	
24.04	Identify appropriate consumer populations.	
Specialty Option 3: Dental Practice Management	
25.0	Demonstrate knowledge of dental practice set up and management procedures--The student will be able to:	
25.01	Establish policies and procedures for dental practice operations.	
25.02	Identify roles and responsibilities of all employees.	
25.03	Implement policies and procedures for establishing effective management of a dental practice.	

Additional Information

Laboratory Activities

Laboratory investigations that include scientific inquiry, research, measurement, problem solving, emerging technologies, tools and equipment, as well as, experimental, quality, and safety procedures are an integral part of this career and technical program/course. Laboratory investigations benefit all students by developing an understanding of the complexity and ambiguity of empirical work, as well as the skills required to manage, operate, calibrate and troubleshoot equipment/tools used to make observations. Students understand measurement error; and have the skills to aggregate, interpret, and present the resulting data. Equipment and supplies should be provided to enhance hands-on experiences for students.

Field Internship Activities:  Clinical experiences are integrated with the didactic portion of this program.  Clinical experience assisting a dentist must be an integral part of the educational program designed to perfect students’ competence in performing dental assisting functions, rather than to provide basic instruction.  The major portion of the students’ time in clinical assignments must be spent assisting with or participating in patient care.  Prior to clinical assignments, students demonstrate minimum competence in performing the procedures which they will be expected to perform in their clinical experience. 

Special Notes

The following industry certifications have been approved by the Florida State Board of Education for statewide articulation credit into this degree program.  

Certified Dental Assistant (DANBD001) – 5 credits 

Dental assisting programs accredited by the American Dental Association Commission on Dental Accreditation are required to implement enrollment and admissions criteria that include the selection of adult students with a high school diploma, its equivalent, or an advanced degree.

This program focuses on broad, transferable skills and stresses understanding and demonstration of the following elements of the health care industry; planning, management, finance, technical and production skills, underlying principles of technology, labor issues, community issues and health, safety, and environmental issues.

This program meets the goals of TECH PREP and is based on the model developed by the Allied Health Articulation Task Force.

This program should meet the most current edition of the American Dental Association Accreditation Standards for Dental Assisting Education Programs.  For further information, contact:  Commission on Dental Accreditation, 211 East Chicago Avenue, Chicago, Illinois 60611.  

For Florida information contact the Florida Agency for Health Care Administration (AHCA), Division of Health Quality Assurance, Board of Dentistry, 4052 Bald Cypress Way, Tallahassee, FL 32399, 850/245-4161.

This program meets the Department of Health HIV/AIDS Domestic Violence and Prevention of Medical Errors education requirements.  Upon completion of this program, the instructor will provide a certificate to the student verifying that these requirements have been met.

If students in this program are seeking a licensure, certificate or registration through the Department of Health, please refer to 456.0635 F.S. for more information on disqualification for a license, certificate, or registration through the Department of Health. 

Pursuant to 466.024 F.S., 64B5-16.002 F.A.C. and 64B5-9.011 F.A.C., completers of the dental assisting program may be awarded a certificate verifying formal training which is required for the performance of certain remediable tasks (also known as expanded functions.)  

Students should be encouraged to become members and participate in the activities of the professional organization:  The American Dental Assistants Association.  

Completers of the dental assisting program should be encouraged to take the Dental Assisting National Board (DANB) Certified Dental Assistant (CDA) exam.   DANB is recognized by the American Dental Association as the national certification board for dental assistants.

Career and Technical Student Organization (CTSO)

HOSA: Future Health Professionals is the intercurricular career and technical student organization providing leadership training and reinforcing specific career and technical skills. Career and Technical Student Organizations provide activities for students as an integral part of the instruction offered. 

Accommodations

Federal and state legislation requires the provision of accommodations for students with disabilities to meet individual needs and ensure equal access. Postsecondary students with disabilities must self-identify, present documentation, request accommodations if needed, and develop a plan with their counselor and/or instructors. Accommodations received in postsecondary education may differ from those received in secondary education. Accommodations change the way the student is instructed. Students with disabilities may need accommodations in such areas as instructional methods and materials, assignments and assessments, time demands and schedules, learning environment, assistive technology and special communication systems. Documentation of the accommodations requested and provided should be maintained in a confidential file.

Additional Resources

For additional information regarding articulation agreements, Bright Futures Scholarships, Fine Arts/Practical Arts Credit and Equivalent Mathematics and Equally Rigorous Science Courses please refer to:
http://www.fldoe.org/academics/career-adult-edu/career-tech-edu/program-resources.stml