ANÁHUAC CARRIZALEZ HERNÁNDEZ. DOMICILIO IGNORADO

1. Research the potential risks to oral wellness of chemotherapy and radiation therapy. Prepare an educational program on effective oral self-care for the patient undergo- ing chemotherapy and radiation therapy. Contact a cancer center or cancer support group to present your in-service program.

● Determine and defend your choices of action.

❍ Empathically respond to the patient by acknowledging the nurse’s concern that excess radiation be avoided. Tactfully explain, and present the patient with evidence-based recommendations that a dental radiographic examina- tion will not expose her to an excessive radiation dose. Inform the patient that the oral health care team will consult with the nurse to discuss how best to meet the patient’s oral wellness needs while cancer treatment continues. Contact the nurse to explain the oral health care team’s need to coordinate treatment for the patient that is safe and will meet her needs. In addition to explaining the need for a radiographic assessment, input would be sought from the nurse regarding specific risks to oral wellness and potential side effects of cancer treament so that oral self-care strategies taught to the patient can achieve maximum effectivness. Solicite the nurse’s assistance in reinforc- ing these strategies with the patient.

❍ This course of action opens communication between all parties and corrects misinformation.

It is important to remember that when facing an ethical issue, there may be more than one correct action.

LEARNING TIPS

These application exercises provide you with various and innovative ways to develop your knowledge base, application skills, and opportunity to solve problems. Many suggested activities prompt you to think outside the box. Do not consider this addi- tional work, but have fun! Be creative and use the suggested activities to demonstrate your potential as a skilled, caring, and dedicated dental hygiene professional.

DID YOU NOTICE?

Can you come up with other ideas for suggested activities for this sample case?

Consider modifying your in-service educational program to present to the medical pro- fessionals who provide cancer treatments to patients.

Chapter 2 Tutorial: Getting Started with a Sample Case 33

BIBLIOGRAPHY

LEARNING TIPS

Each case provides a bibliography of resources for further reference. As you work through the case questions, if you do not understand a term or fail to see why an answer is correct, the references listed in the bibliography can assist you in learning more about that topic.

DID YOU NOTICE?

If a beginning student struggles with understanding how this patient’s root expo- sure contributes to sensitive teeth, the resources for learning more about this can be found by consulting the list of reference materials.

Darby ML: Mosby’s Comprehensive Review of Dental Hygiene, 7th ed. St. Louis: Saunders (Elsevier), 2012, pp. 528–531.

Darby ML, Walsh MM: Dental Hygiene Theory and Practice, 3rd ed. St. Louis: Saunders (Elsevier), 2010, pp. 401–413, 868–885. Dockter KM: Oral implications of cancer treatment. Dimensions of

Dental Hygiene, 9(6), 74–79, 2011.

Hanioka T, Tanaka M, Tamagawa H, Shizukuishi S: Epidemio- logic study of melanin pigmentation in the attached gingiva in relation to cigarette smoking. Journal of Dental Health, 43, 40–47, 1993.

Ibsen OAC, Phelan J: Oral Pathology for the Dental Hygienist, 5th ed. St. Louis: Saunders (Elsevier), 2009, pp. 305–306.

Nield-Gehrig JS, Willmann DE: Foundations of Periodontics for the Dental Hygienist, 3rd ed. Philadelphia: Lippincott Williams & Wilkins, 2011, pp. 67–84, 361–364.

Tilliss T: Addressing the pain of dentinal hypersensitivity. Dimen- sions of Dental Hygiene, 8(4), 46, 48, 50, 2010.

Wilkins EM: Clinical Practice of the Dental Hygienist, 10th ed. Philadelphia: Lippincott Williams & Wilkins, 2008, pp. 560, 711–723, 838–845, 865–879.

Wynn RL, Meiller TF, Crossley HL (eds.): Drug Information Handbook for Dentistry. Including Oral Medicine for Medically- Compromised Patients & Specific Oral Conditions, 16th ed. Hudson, OH: Lexi-Comp, 2010, pp. 33–36, 1263–1264, 1981–1984.

If you want to spot-test your knowledge on a topic, for example, fluorides, turn to the study question index and its listing of question numbers by case to assist you with locating each of the questions pertaining to fluorides.

ANCILLARIES

● A study question index by topic completes the book. This index can help you quickly locate information or a study question on each of the topics covered in the cases. Use the index to further your practice and enhance your review study.

● http://www.myhealthprofessionskit.com/ a companion Web site enhances your learning experiences. All the images from the cases are available to you on-line where you can review them in greater detail. Using image manipulation features on your computer such as a zoom tool and brightness and contrast scales you can enlarge and enhance the images. In addition to assisting you with reading the images, the ability to enlarge and zoom in on details, and to lighten and darken the images provides you with a simulated experience of reading digital radiographs.

Answering the electronic version of the book’s study questions posted to myhealth-

professionskit allows your instructor to provide feedback as you progress through

the cases, and you will find blank patient history synopsis forms, clinical examina- ton charts, and risk assessment forms that can be printed for use with the exercises in the book or as assigned by your instructor. Up-to-date links to data bases and search engines provide ready access to scientific literature.

The companion Web site myhealthprofessionskit also offers you the opportunity to gain real-life experience by producing your own patient case study. Once you begin to treat patients at your clinical academic setting your instructor may provide you with this opportunity to document your assessment, diagnoses, treatment plan, implementation strategies, and evaluation of a real-life case patient, start to finish. The objective of this project is to help you integrate basic sciences with patient care and to link dental hygiene theories with effective clinical application; in essence, to gain experience in professional decision making. The capstone to developing the case is to present it to the class, your professional peers, for discussion. In addition to the guidelines that your instructor provides, you will find instructions for select- ing a patient, guidelines for documentation, a comprehensive tutorial on obtaining intraoral photographs, and tips for developing your classroom presentation. Completing this tutorial on how to use this book while working through the sample case has prepared you for the challenges that await in the next 15 cases. Refer back to this chapter for instruction and clarification of the exercises and activities as your knowledge base grows and you progress from a basic level of study toward competency.

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Part II