Dental hygiene actions/interventions:
record vital signs; document medical alert on
patient chart; plan for medical emergency; establish rapport that encourages trust; use lis-
tening and communication skills to assist patient with identifying the cause (physical or
psychological) and address to help patient gain control
Deficit identified in freedom from fear and stress
Due to: apprehension regarding pain and embarrassment regarding fainting episodes Evidenced by: rapid speech, nervous laughter, and overt enthusiasm
Goals: ______________________________________________________________ Dental hygiene actions/interventions: ____________________________________ Deficit identified in freedom from pain
Due to: teeth sensitivity
Evidenced by: self-report; exposed root surfaces
Goals: ______________________________________________________________ Dental hygiene actions/interventions: ____________________________________ Deficit identified in skin and mucous membrane integrity of the head and neck Due to: bacterial plaque and trauma from occlusion
Evidenced by: mucogingival involvement
Goals: ______________________________________________________________ Dental hygiene actions/interventions: ____________________________________ Deficit identified in biologically sound and functional dentition
Due to: decreased salivary production and root exposure Evidenced by: dental caries and dentinal hypersensitivity
Goals: ______________________________________________________________ Dental hygiene actions/interventions: ____________________________________
ASSESSING RISK
What is this patient’s risk for:
● Caries
● Periodontal disease
● Oral cancer
Use the appropriate form (see appendices) to determine the patient’s level of risk and to plan strategies for reducing this risk.
PICO question
P = Problem/Patient I = Intervention C = Comparison O = Outcomes For this patient’s exposed root surfaces (P), will casein phosphate-amorphous calcium phosphate complex (such as MI Paste™) (I) as compared with a sodium fluoride varnish (such as Colgate Duraphat® Varnish) (C) decrease sensitivity (O)?
APPLYING EVIDENCE-BASED PRACTICE
Using a database or search engine (consult your campus library), find and evaluate articles on a product or treatment that you will recommend for this patient. Use the PICO process (see Chapter 1) to determine your recommendation. Provide the list of references used to support your decision. Here is one example of a possible recommendation for this patient. Repeat this process for additional recommendations.
MAKING ETHICAL DECISIONS
At the beginning of the appointment, the patient points out certain teeth that are sensitive to scaling and polishing and tells you that she does not want you to “touch” these teeth.
● What ethical issue(s) do you face?
● Is there a law, regulation, or standard of care objective that can assist you with resolving the issue(s)?
● What choices of action do you have?
● What are the worst- and best-case scenarios of your choices of action?
Chapter 6 Case D 81
LEARNING ACTIVITIES
1. Describe methods of anxiety control that could be implemented for this patient. 2. Outline a plan of appointments addressing time needed, services planned, specific
instruments, equipment necessary, and reevaluation intervals for each appointment. 3. Identify self-care instructions to address the challenges associated with remov- able partial dentures, dentinal hypersensitivity, mucogingival involvement, and xerostomia.
BIBLIOGRAPHY
Bennett JD, Rosenberg MB: Medical Emergencies in Dentistry. St. Louis: Saunders (Elsevier), 2002, pp. 183–188, 254–256, 313–324. Blackwell RE: G. V. Black’s Operative Dentistry, vol. 2, 9th ed.
Milwaukee: Medico-Dental, 1955, p. 1–4.
Collins F, Veis R: Periodontal treatment: The delivery and role of locally applied therapeutics. Dental CE Digest, 3(4), 14–20, 2006. Darby ML: Mosby’s Comprehensive Review of Dental Hygiene, 7th
ed. St. Louis: Mosby (Elsevier), 2012, pp. 537–550, 868–869. Darby ML, Walsh MM: Dental Hygiene Theory and Practice, 3rd ed. St.
Louis: Saunders (Elsevier), 2010, pp. 305–337, 712–735, 833–851. Denstply Pharmaceutical: Oraqix: The needle-free pain relief
system for scaling and root planing. http://www.oraqix.com/. Accessed August 12, 2011.
Hatrick CD, Eakle WS, Bird WF: Dental Materials: Clinical Appli- cations for Dental Assistants and Dental Hygienists, 2nd ed. Philadelphia: Saunders (Elsevier), 2011, pp. 78–79, 99–100. Haveles EB: Applied Pharmacology for the Dental Hygienist, 6th ed.
St. Louis: Mosby (Elsevier), 2011, pp. 186–212, 249–268. Kimbrough VJ, Henderson K: Oral Health Education. Upper Saddle
River, NJ: Pearson, 2006, pp. 63–65.
Kimbrough VJ, Lauter CJ: Ethics, Jurisprudence, & Practice Management, 3rd ed. Upper Saddle River, NJ: Pearson, 2012, pp. 16–29.
Little JW, Falace DA, Miller CS, Rhodus NL: Dental Management of the Medically Compromised Patient, 7th ed. St. Louis: Mosby (Elsevier), 2008, pp. 56–59.
Magnusson I, Geurs N, Harris P, Hefti A, Mariotti A, Mauriello S, Soler L, Offenbacher S: Intrapocket anesthesia for scaling and root planing in pain-sensitive patients. Journal of Periodontology, 74(5), 597–602, 2003.
Malamed SF: Sedation. A Guide to Patient Management, 5th ed. St. Louis: Mosby (Elsevier), 2010, pp. 8–93, 551–552.
Nield-Gehrig JS, Willmann DE: Foundations of Periodontics for the Dental Hygienist, 3rd ed. Philadelphia: Lippincott Williams & Wilkins, 2012, pp. 239–250, 101–136, 179–196, 244–245, 339–355.
Page RC: The microbiological case for adjunctive therapy for peri- odontitis. Journal of the International Academy of Periodontol- ogy, 6(4), 143–149, 2004.
Reinhardt RA, Stoner JA, Golub LM, et al.: Efficacy of sub- antimicrobial dose doxycycline in post menopausal women: Clinical outcomes. Journal of Clinical Periodontology, 34(9), 768–775, 2007.
Rule JT: Ethical Questions in Dentistry, 2nd ed. Chicago: Quintes- sence, 2004, pp. 57–72.
Serio FG, Hawley CE: Manual of Clinical Periodontics. Hudson, OH: Lexi-Comp, 2002, pp. 59–60.
Sleeper LJ, Stefanou LB: Tips for chairside hypersensitivity treat- ment. Dimensions of Dental Hygiene, 9(4), 56, 58–59, 2011. Stamm JW, Banting DW, Imrey PB: Adult root caries survey of two
similar communities with contrasting natural water levels. Journal of the American Dental Association, 120(2), 143–149, 1990. Tilliss T: Addressing the pain of dentinal hypersensitivity. Dimen-
sions of Dental Hygiene, 8(4), 46, 48, 50, 2010.
Weinberg MA, Westphal C, Froum SJ, Palat M, Schoor R: Com- prehensive Periodontics for the Dental Hygienist, 3rd ed. Upper Saddle River, NJ: Pearson, 2011, pp. 56–58, 157–158, 253, 265–266, 420–432.
Wilder R, Ryan M: Chemotherapeutics in the treatment of periodon- tal diseases. Dimensions of Dental Hygiene, 8(6), 44–48, 2010. Willis, S: Help your patients treat their dentinal hypersensitivity at
home with these strategies. Dimensions of Dental Hygiene, 9(7), 32–34, 36, 2011.
Wilkins EM: Clinical Practice of the Dental Hygienist, 10th ed. Phila- delphia: Lippincott Williams & Wilkins, 2009, pp. 5–8, 353–355, 477–479, 554, 563–565, 718–719, 724–738, 814–815, 837–841. 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, 515–519, 536–539, 635–636, 1861–1863, 1893, 1901–1902.
PEARSON
Use this address to access the Companion Website cre- ated for this textbook. Simply select “Dental Hygiene” from the choice of disciplines. Find this book and
click the Enter button to access interactive assessment, sample forms, and much more.
83