TEST 5 Flashcards

Question

USE OF DISCLOSING SOLUTION describe the tones and color

Answer 1

2 tone: (what we use in clinic) - red/pink: new plaque - blue: old plaque 1 color: (trace) - dyes all plaque pink

Answer 2

- SOFT, WHITISH tooth deposit - CLINICALLY VISIBLE without APPLICATION OF DISCLOSING AGENT - unorganized accumulation of LIVING AND DEAD BACTERIA, DESQUAMATED EPITHELIAL CELLS, DISINEGRATING LEUKOCYTES, SALIVARY PROTEINS, AND FOOD DEBRIS - removed with WATER SPRAY, ORAL IRRIGATOR, OR TONGUE ACTION

Answer 3

- food remnants may collect around the CERVICAL 1/3 and PROXIMAL EMBRASURES of teeth - FOOD FORCED INTO OPEN CONTACT AREAS DURING MASTICATION - left unattended: the accumulation of food debris adds to the GENERAL UNSANITARY condition of the mouth and can contribute to INITIATION OF DENTAL CARIES and oral MALODOR

Answer 4

Dental calculus (TARTAR) is oral biofilm that has been mineralized by CALCIUM and PHOSPHATE SALTS FROM SALIVA can be SUPRAGINGIVAL or SUBGINGIVAL

Answer 5

supra - calculus coronal to the free gingival margin sub - calculus apical to the FGM, often on the root surface

Answer 6

pellicle formation, biofilm formation, mineralization

Answer 7

- approximately 10-20 DAYS are typically required for oral biofilm to become FULLY MINERALIZED CALCULUS DEPOSITS, though mineralization starts in 24-48 HOURS - HEAVY CALCULUS formers have higher SALIVA CONCENTRATIONS of CALCIUM and PHOSPHATE than light calculus formers

Answer 8

supragingival: saliva subgingival: gingival crevicular fluid and inflammatory exudate

Answer 9

SOFT and HARD dental deposits are assessed: 1. LOCATION: supragivial/subgingival 2. AMOUNT: slight, moderate, heavy 3. EXTENT AND DISTRIBUTION - Generalized (more than 30% of dentition) - Localized (less than 30%) - If localized, must include where it is localized to

Answer 10

CALCULUS PREVENTION - RISK FACTORS related to calculus formation are similar to those for DENTAL BIOFILM FORMATION and relate to the PATIENTS DAILY BIOFILM REMOVAL REGIMEN - effective daily biofilm removal and regular professional continuing care - anti-calculus toothpaste and mouthrinse may contain PYROPHOSPHATES, ZINC, AND SODIUM HEXAMETAPHOSPHATE - select the appropriate method for REMOVAL. Identify/do HANDS-ON DEMO with the patient. FOLLOW UP during recare. Identify DIETARY behaviors

Answer 11

Tooth stains are DISCOLORED AREAS ON THE TEETH that contrast with the COLOR OF THE REST OF THE TOOTH Adhere DIRECTLY on tooth surface, contained WITHIN CALCULUS and SOFT DEPOSITS, or incorporated within the TOOTH STRUCTURE or RESTORATIVE MATERIAL

Answer 12

- occur on the EXTERNAL TOOTH SURFACE - can usually BE REMOVED with TOOTHBRUSHING, CORONAL POLISHING, OR SCALING

Answer 13

- occur WITHIN THE TOOTH - cannot BE REMOVED BY SCALING OR POLISHING - improved by USING WHITENING AGENTS

Answer 14

ENDOGENOUS - originate form WITHIN the tooth - ALWAYS intrinsic - dentin discoloration through the enamel EXOGENOUS - originate from sources OUTSIDE the tooth - may be extrinsic or intrinsic

Answer 15

the clients ABILITY TO MANAGE ORAL SELF CARE must be assessed through the following means questioning the client about THIER ORAL SELF CARE RECORD the clients ORAL HYGIENE STATUS

Answer 16

oral hygiene indices measure the CLIENTS LEVEL OF ORAL HYGIENE to accomplish - establish a baseline for an individual - survey the oral hygiene status within a population - establish a baseline for a target population - evaluate an intervention, drug, or device

Answer 17

maintaining a RECORD OF A CLIENTS ORAL HYIGENE STATUS is an important part of the assessment document the ORAL HYGIENE PRODUCTS USED and the PREVIOUS INSTRUCTION GIVEN compare THE CLIENTS CURRENT AND PREVIOUS PLAQUE SCORES

Answer 18

In axiU, document: - located (generalized/localized) and degree (slight, moderate, or heavy) EX: Gen/slight

Answer 19

assessment: data collection *diagnose: identify problems based on assessment data planning: select, prioritize, and sequence dental hygiene interventions implementation: activating the plan evaluation: feedback on effectiveness documentation: comprehensive record-keeping

Answer 20

identification of a CONDITION, PROBLEM, or SITUATION based on THE ANALYSIS OF ITS CAUSE and its DEFINING CHARACTERISTICS

Answer 21

1. focuses on CLIENT conditions, behaviors, or risk factors related to oral health and disease 2. is derived from client data (collected during assessment) 3. requires interventions within the scope of dental hygiene practice 4. is necessary for planning and implementing effective care and evaluation outcomes

Answer 22

1. UNMET HUMAN NEEDS that can be met through dental hygiene care 2. factors CONTRIBUTING TO OR CAUSING the unmet human needs (causes and risk factors) 3. EVIDENCE to support the dental hygiene diagnosis (signs and symptoms)

Answer 23

dental: - identifies a specific oral disease - identifies conditions or problems for which the dentist directs the primary treatment - often deals with the actual pathophysiologic changes - remains the same for as long as the disease is present

Answer 24

- identifies unmet human need - identifies conditions or problems within the scope of dental hygiene - often deals with the clients perceptions, beliefs, attitudes, and motivations regarding his or her own oral status - may change as the clients responses and behaviors change

Answer 25

A DENTAL CONSULTATION and REFERRAL are indicated if a client displays signs and symptoms of an ORAL DISEASE that requires DIAGNOSIS and TREATMENT by the DENTIST A MEDICAL CONSULTATOIN and REFERRAL are indicated if a client displays signs and symptoms of SYSTEMIC CONDITIONS that require DIAGNOSIS and TREATMENT by a PHYSCIAN

Answer 26

a classification of EIGHT POSSIBLE DIAGNOSES (EIGHT HUMAN NEEDS) creates a standardized language for identifying client oral health conditions classification uses DESCRIPTORS that focus on THE CLIENTS HUMANS NEEDS

Answer 27

1. protection from health risks 2. freedom from fear and stress 3. freedom from head and neck pain 4. wholesome facial image 5. skin and mucous membrane integrity of the head and neck 6. biologically sound and functional dentition 7. conceptualization and problem solving 8. responsibility for oral health

Answer 28

- patient needs to be in a state of good general health Patient has uncontrolled disease - High blood pressure - Diabetes HbA1c of 8 or greater Lifestyle practices that place patient at risk - Smoker - Inconsistent use of athletic mouth guard

Answer 29

- Patient needs to feel safe and free from emotional discomfort in the oral healthcare environment - patient states they are afraid of needles - previous negative experiences - signs of stress

Answer 30

- patient needs to be exempt from physical discomfort in the head and neck area Patient self reports pain - sensitivity - tooth ache Signs of discomfort - wincing or squinting of the eyes

Answer 31

- patient needs to feel satisfied with ones own oral-facial features and breath - ask the patient: "Are you satisfied with your teeth and mouth?" - patient expresses dissatisfaction with tooth stain, calculus, receding gums, discolored restoration, tooth loss, misaligned teeth, disfigurement from facial trauma

Answer 32

*MOST COMMON* patient need for an intact and functioning covering of the persons head and neck area including the periodontium extraoral and intraoral lesions tenderness and swelling periodontal bleeding bleeding nutritional deficiency manifestation

Answer 33

patient need for intact teeth and/or protheses and restorations suspected caries defective restorations fractured tooth missing teeth

Answer 34

patient need to understand ideas in order to make sound judgments of ones oral health patient has misconceptions or a lack of knowledge about oral healthcare interventions, cause of an oral problem, or relationship to overall health - patient does not understand caries process - patient refuses flouride - patient does not understand how periodontal disease works

Answer 35

patient needs for accountability for ones oral health - inadequate oral self care - lengthy periods of time in between oral exams - statements like: "my mother had bad teeth so I always had bad teeth."

Answer 36

To arrive at a valid DENTAL HYGIENE DIAGNOSIS, compare data (ASSESSMENT OR PATIENT RECORD) with an ACCEPTED STANDARD Changes in a client’s usual oral or systemic health patterns that are unexplained by EXPECTED NORMS FOR GROWTH, DEVELOPMENT, AND MATURATION Oral and systemic health status that DEVIATES FROM NORMAL LIMITES BEHAVIOR or CONDITION that indicates a risk to HEALTH or PERSONAL SAFETY

Answer 37

Dental hygiene diagnoses should always be based on A CLUSTER OF SIGNIFICANT INFORMATION rather than A SINGLE SIGN OR SYMPTOM Gathering COMPLETE DATA to support a RECOGNIZABLE PATTERN prevents the FORMULATION OF AN INCORRECT DIAGNOSIS

Answer 38

CRITICAL THINKING determines whether the identified condition requires a DENTAL DIAGNOSIS, DENTAL HYGIENE DIAGNOSIS, or a MEDICAL DIAGNOSIS Clients may also indicate that they are AT RISK for DEVELOPING an unmet human need Dental hygiene diagnoses have IMPLICATIONS FOR PLANNING INTERVENTIONS

Answer 39

1. unmet human need (deficit) 2. cause (due to) 3. evidence (signs and symptoms)

Answer 40

1. factors that led to the condition or potential problem 2. objective signs observed by the hygienist 3. subjective symptoms reported by the client

Answer 41

1. using EMOTIONAL terms 2. including a DENTAL or MEDICAL diagnosis (not within our scope of practice) 3. presenting the CAUSE as the DIAGNOSIS 4. presenting signs and symptoms as the diagnosis rather than in terms of the clients UNMET NEEDS

Answer 42

1. is the database complete, accurate, and based on scope of dental hygiene 2. does the data reflect the existence of a pattern 3. does it include both subjective and objective data that supports the existence of the unmet human need identified in the dental hygiene diagnosis 4. is the diagnosis based on scientific knowledge and evidence 5. can the dental hygiene diagnosis be prevented, controlled, or resolved by DENTAL HYGIENE interventions 6. given the same data, would other qualified practitioners formulate the same dental hygiene diagnosis

Answer 43

POOR Unmet need for skin and mucous membrane integrity due to periodontitis, as evidenced by generalized bleeding and clinical attachment loss of 5-8 mm.

Answer 44

POOR Unmet need for responsibility for oral health due to lack of adherence to oral self-care regimen, as evidenced by heavy biofilm accumulation and patient reports.

Answer 45

Unmet need in protection from health risks due to cigarette smoking, as evidenced by patient reports.

Answer 46

Facilitates PROFESSIONAL AUTONOMY by focusing on DH SCOPE OF PRACTICE Patient needs are more ACCURATELY COMMUNICATED which supports TREATMENT and APPROPRIATE REFERRALS Since dental hygiene diagnoses are based on DIAGNOSTIC CLASSIFICATION SYSTEM, communication among ORAL HEALTH PROFESSIONALS is enhanced Provide a measurement of CLINICAL OUTCOMES, which has several implications: PATIENT EDUCATION, RESEARCH, PROFESSIONAL ACCOUNTABILITY, etc.

Answer 47

The purpose of the planning phase is to DEVELOP A PLAN OF CARE that will result in THE RESOLUTION OF AN ORAL HEALTH PROBLEM, the PREVENTION OF A PROBLEM, or the PROMOTION OF ORAL AND GENERAL HEALTH Phase of the process of care in which DIAGNOSED CLIENT NEEDS are prioritized, CLIENT GOALS AND EVALUATIVE MEAURES are established, and INTERVENTION STRATEGIES are determined

Answer 48

The term CARE PLAN rather than TREATMENT PLAN is intentional Denotes the BROAD range of PREVENETIVE, EDUCATIONAL, THERAPEUTIC, and SUPPORT SERVICES that are within the scope of dental hygiene practice

Answer 49

the DENTAL HYGINEST and CLIENT both discuss CLIENT GOALS, PRIORITIES, and INTERVENTIONS for goal attainment. 1. set goals and evaluate measures 2. identify interventions 3. establish priorities 4. write a care plan

Answer 50

1. dental diagnosis 2. all essential phases of therapy to be carried out by the dentist, the dental hygienist, and the client to eliminate or control disease and to promote health 3. prognosis 4. the dental hygiene care plan supports the overall dental treatment plan

Answer 51

1. link the DH care plan to the dental hygiene diagnosis 2. establish priorities 3. set goals 4. select evidence based interventions 5. establish an appointment schedule

Answer 52

Priorities are based on the degree the DH diagnosis: - Threatens the CLIENTS WELL BEING - Poses the greatest threat to THE PATIENTS SAFETY, HEALTH, and COMFORT - Can be addressed SIMULTANEOUSLY with other diagnoses - Is a client priority (CHIEF COMPLAINT) - Protection from HEALTH RISKS - may require PRELIMINARY EMERGENCY CARE - Responsibility for ORAL HEALTH is a PRIMARY priority - ORAL DISEASE is a priority

Answer 53

1. The VALUES, BELIEFS, and ATTITUDES of the client 2. The philosophy of the HEALTHCARE PROVIDER 3. The goals of the COLLABORATING DENTIST 4. The HEALTH STATUS of the client 5. Whether the client is experiencing INFECTION, DISCOMFORT, ANXIETY, or PAIN

Answer 54

CLIENT CENTERED GOAL: the desired outcome the client aims to achieve through specific dental hygiene intervention strategies to satisfy an unmet human need related to DH care COGNITIVE GOALS: target an increase the client’s knowledge and understanding PSYCHOMOTOR GOALS: target the client’s skill development and mastery AFFECTIVE GOALS: involve changing the client’s values, beliefs, and attitudes ORAL HEALTH STATUS GOALS: addresses the signs and symptoms of oral disease

Answer 55

you will make REALISTIC and PERSONAL goals WITH your patient FOR your patient Specific Measurable Attainable Realistic Timely

Answer 56

1. subject: client or the clients caregiver 2. verb: action to be performed by the client to achieve the desired outcome 3. a criterion for measurement: observable behavior or tangible outcome 4. a time dimension for evaluation: when the client is to have achieved the goal at least ONE goal should be established for each DENTAL HYGIENE DIAGNOSIS

Answer 57

COGNITIVE (increase in knowledge and understanding) 1. Client will report using disclosing tablets daily before brushing by appt #3. 2. Client will verbalize the periodontal disease process by appt #2 PSYCHOMOTOR (skill development and mastery) 1. Client will demonstrate the correct use of a floss holder by appt #4. 2. Client will demonstrate correct c-shape flossing by appt #4 AFFECTIVE (desired changes in values/beliefs) 1. Client will verbalize the importance of dental hygiene appointments every 6 months by appt #2. 2. Client will verbalize the benefits of improved oral hygiene by appt #3 ORAL HEALTH STATUS (signs and symptoms or oral disease) 1. Client will eliminate 100% of bleeding on probing by recare. 2. Client will decrease 50% of pocket depths >3mm by 1mm by appt #4. 3. Client will seek DDS evaluation for suspected caries by 1 month

Answer 58

Client goals are best established by THE DENTAL HYGIENIST in collaboration with the CLIENT. individuals are more likely to EXPRESS COMMITMENT TO A CARE PLAN and a WILLINGNESS TO CHANGE if they share in the DEVELOPMENT OF GOALS, PRIORITIES, INTERVENTIONS, AND APPOINTMENT PLANNING

Answer 59

factors that contribute to the clients human need deficit

Answer 60

- lack of knowledge - Lack of protective factors - Skill deficit in oral self-care - Low value placed on oral health - Low self-esteem - Inadequate financial resources - Culture as a barrier to professional care - Presence of other risk factors

Answer 61

- number of visits - time needed for each visit - interventions to be implemented at each visit

Answer 62

BE PUT INTO ACTION AT THE PLANNED APPOINTMENTS

Answer 63

- time needed for each intervention - logic of grouping interrelated procedures - status and severity of the clients unmet human needs - clients tolerance for long sessions

Answer 64

Before presenting the care plan to the client, the dental hygienist ASSESSES THE COMPREHENSIVE NATURE OF THE PLAN When satisfied with the completeness of the dental hygiene care plan, the hygienist DISCUSSES IT WITH THE CLIENT and MAKES MODIFICATIONS TO INCLUDE THE PATIENT

Answer 65

- nature of the condition - proposed care plan - risks involved - potential for failure - prognosis if the problem goes untreated - expected outcomes - alternative treatment options

Answer 66

involves the CLIENTS ACCEPTANCE of care AFTER discussion with the HEALTHCARE PROVIDER regarding THE PROPOSED CARE PLAN and THE RISKS OF NOT RECIEVING CARE client must be KNOWLEDGABLE about what is the healthcare provider plans to do, have ENOUGH INFORMATIN TO MAKE A RATIONAL CHOICE, and give PERMISSION FOR THE PLAN TO BE CARRIED OUT informed consent should NOT be viewed AS A ONE TIME ACTIVITY but rather as AN ONGOING PROCESS during which the client is CONTINUOUSLY REMINDED AND INFORMED of the terms of care

Answer 67

- give consent for a specific treatment - Give consent for a procedure that is legal - Give consent under truthful conditions - Be legally competent to give consent for care

Answer 68

a client may decline all or part of the proposed care plan

Answer 69

evaluation is performed to DOCUMENT the ACHIEVEMENT OF DESIRED THERAPEUTIC OUTCOMES although it is indicated as the SECOND TO LAST phase of the dental hygiene process, EVALUATION is linked to EVERY PHASE OF CARE GOAL: to MEASURE the extent to which the PATIENT HAS ACHIEVED the goals defined in the DH CARE PLAN

Answer 70

- defined by client centered goals during the planning phase - applied during the care implementation phase, at the completion of care, and at continued care visits

Answer 71

evaluation is ONGOING so that the clinician can 1. Modify the plan because the client is having difficulty with achieving the goal 2. Modify the plan because the client is not ready to achieve the goal 3. Continue the plan with more time added to achieve the goal 4. Terminate the plan of care because the client has achieved the goal

Answer 72

1. asking open ended questions (cognitive goals) 2. having the client demonstrate the technique (psychomotor) 3. having the client report a change in bebavior (affective goals) 4. showing the client clinical improvements (oral health status goals)

Answer 73

determines whether DENTAL HYGIENE CARE has achieved the clients CLIENTS UNMET HUMAN NEEDS evaluation methods should REFLECT THE INTENT OF THE GOAL STATEMENT, which may reflect COGNITIVE, PSYCHOMOTOR, AFFECTIVE or ORAL HEALTH STATUS concerns

Answer 74

- goal met - goal partially met - goal not met

Answer 75

Client reassessment identifies BARRIERS that continue to CONTRIBUTE to the client’s UNMET HUMAN NEEDS If the goal is PARTIALLY MET or UNMET, the hygienist reassesses: - Client’s READINESS TO CHANGE as well as the client’s ATTITUDES, BELIEFS, AND PRACTICES - New findings are then discussed with the DENTIST: may lead to NEW DIAGNOSIS, REVISED GOALS, or ALTERNATIVE INTERVENTIONS After it is clear why the client has FAILED TO ACHIEVE THEIR GOALS, the evaluative statement can be used to REDIRECT THE CARE PLAN When evaluation determines SUCCESSFULL ATTAINMENT of client goals and no NEW PROBLEMS are identified, the care plan is TERMINATED

Answer 76

1. document evidence that previous care plan has addressed patients needs 2. identify any reoccurrence of an unmet need 3. identify any new condition that may be present 4. formulate a care plan that supports the clients continued needs

Answer 77

Documentation is necessary to MONITOR THE CLIENTS HEALTH STATUS during ACTIVE THERAPY and OVER A LIFETIME for REGULAR maintenance care DOCUMENTATION in the client record is the BEST DEFENSE against a client’s ACCUSATION OF NEGLIGENCE

Answer 78

- link the DENTAL HYGIENE CARE PLAN to the DENTAL HYGIENE DIAGNOSIS - each goal should have 4 PARTS - each goal must have ITS OWN NUMBER