Dental Hygiene Diagnosis and Care Plan

Question 1

What are the 4 basic steps when planning patient care?

Answer 1

1. Assessment
2. Diagnosis
3. Tratment plan
4. Develop formal plan for care

Question 2

What is teh dental hygiene diagnosis?

Answer 2

• Involves the use of evidence-based analysis of the assessment findings to determine the patients or community’s dental hygiene needs
• Provides a basis for the dental hygiene care plan

Question 3

What is the chief complaint?

Answer 3

Reason for seeking care or significant concern expressed

Question 4

Individual risk factors for periodontal disease

Answer 4

• Stress
• Lifestyle choices
• Gender (more prevalent in men)
• Ethnicity
• Sstemic conditions
• Genetic factors
• Nutritional status

Question 5

Systemic conditions associated with periodontal disease

Answer 5

• Cardiovascular disease
• Diabetes
• Metabolic syndrome
• Obesity
• Respiratory disease
• Osteoporosis
• Adverse pregnancy outcome

Question 6

Risk factors for dental caries

Answer 6

Behavioral
Dietary factors
Low fluoride
Tooth morphology/position
Xerostomia
Personal and family history
Developmental factors

Question 7

Risk factors for oral cancer

Answer 7

• Tobacco
• HEavy alcohol use
• Excessive sun exposure
• HPV
• Genetics

Question 8

Examples of systemic approaches to assess physical status

Answer 8

ASA classification system
The Oral, Systemic, Capability, Autonamy, Reality, Planning Guide (OSCAR)

Question 9

What do we need to assess before planning individualized homecare?

Answer 9

• Assess knowledge/oral healthcare literacy of the patient
• Build on current knowledge

Question 10

What does OSCAR stand for?

Answer 10

Oral, Systemi, Capability, Autonomy and Reality Planning Guide

Question 11

If the issue is oral, what are factors of concern?

Answer 11

Teeth, restorations, prestheses, periodontium, pulpal status, oral mucosa, occlusion, saliva, tongue, alveolar bone

Question 12

If teh issue is systemic, what are factors of concern?

Answer 12

Normative age changes, medical diagnoses, pharmacologic agents, interdisciplinary communication

Question 13

If the patients issue is with capability, what are factors of concern?

Answer 13

Functional ability, self-care, caregivers, oral hygiene, transportation to appointments, mobility within the dental office

Question 14

If the issue is autonomy, what are factors of concern?

Answer 14

Decision-making ability, dependence on alternative or supplemental decision makers

Question 15

If the issue is reality, what are factors of concern?

Answer 15

Prioritization of oral health, financial ability or limitations, significance or anticipated life span

Question 16

What is the dental hygiene prognosis?

Answer 16

Looking ahead at the anticipated outcome or end point expected from the dental hygiene intervention selected for the individual patient

One factor is based on treatement and self-behavior goals set by the clinician w/ teh patient during the planning phase of care

Question 17

Describe the dental hygiene care plan

Answer 17

Prioritized sequence of evidence-based DH interventions that are:
* Based on the DH diagnosis
* Composed of integrate dplans for the care and control of PD, caries control, and managing other modifiable risk factors
* Encompasses the pt’s preventive, restorative and surgical needs
* Identifies treatment referrals to toher HC providers
* Contained within the scope of practice as defined by each state or province practice act

Question 18

What are the components of a written care plan?

Answer 18

• Demographic data: Name, DOB, gender, date of plan, chief complaint, initial or M therapy, clinician name
• Assessment findings and risk factors: ASA, meds, mod risk factors
• Perio diagnosis and status
• Caries risk status- oral health ed and treatment interventions

Question 19

What is the purpose of presenting the plan to the collaborating dentist?

Answer 19

To integrate the DH care plan into the pt’s comp treatment plan
To provide a coordinated dental and DH statement to the pt regarding oral health needs

Question 20

How do we present the DH care plan to the dentist?

Answer 20

• Follow sequence on the pt’s written care plan
• Summarize demographic data
• Summarize major systemic and dental health assessment findings
• Summarize risk factors
• Indicate suggested intervention strategies, goals, expected outcomes adn referrals
• Outline suggested appointment sequence and services
• Be prepared to give detail and answer questions

Question 21

How do we explain the tx plan to the pt?

Answer 21

• Good communication skills builds trust
• Use of radiographs and IO camera provides visual documentation of need
• Use motivational interviewing approach can help determine and respond to the pt’s readiness to change health behaviors that increase risk for oral disease

Question 22

What is the purpose of explaining the tx plan to the pt?

Answer 22

• To provide the pt w/ information needed to give informed consent for tx
• To reinforce the pt’s role in setting and reaching oral health goals outlined in the plan

Question 23

How to we attain good communication with our pt’s?

Answer 23

• Sit face-to-face with pt
• Use terminology that they can understand
• Educate the pt regarding link btw systemic and oral health
• Educate pt regarding DH services, appointment sequence, expected outcomes and referrals
• Present info using visual aids such as radiographs, dental models, drawings, videos, brochures or IO camera
• Engage the pt in planning and setting goals
• Answer questions
• Obtain signed informed consent

Question 24

What is informed consent?

Answer 24

• Legal concept that can exist even without a written document
• Can be lacking even when a document has been signed if the ot hs not had the opportunity to comprehend and evaluate teh risks and benefits of the suggested tx

Question 25

What is informed refusal?

Answer 25

• The pt’s right to refuse treatment that requires a practitioners respect
• Refusal of care or any recommended tx options should always be documented in the pt’s record
• Depending on the state, this may or may not protect clinicians who provide tx that does not meet the standard of care from legal action