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dental hygiene exists to help educate and care for peoples oral hygiene -…
dental hygiene exists to help educate and care for peoples oral hygiene
quality
-having a scale check done to see if there's any spots we need to work on
-having skill evals/practicals to evaluate where the student is at with using the instrument as well as give feedback that they can use
building that knowledge for the student so that they can develop proper values and have a high standard for care
Evaluation: skill evals/practicals/tests help us to see where we are at skill wise/knowledge. We can compare the skill evals we have every semester and see where it is that we have improved/need to work on
collaboration
when working with our patients we need to collaborate to find what works best for them.
This includes:
-going through health history to make any treatment modifications
-discussing homecare and products
-adjunctive therapies that may be appropriate
when working with our coworkers there needs to be collaboration in order to work as a team
-meet before each day to discuss what we are doing
-talking about the teams goals and any concerns
-meet at the end of the day to debrief
Evaluation:
have anonymous forms for coworkers to communicate any concerns, changes, comments
have a review page where patients can give feedback, so that appropriate changes can be made to cater
periodontal philosophy
why: why do you choose to treat I choose to treat based off of what I am seeing intraorally and what I am determining through their assessments
when: I intervene when I see that my patient does not understand their condition and wants help to figure out what can be done to help improve their oral health. I determine recare by reassessing at their PSE and determining what my patient's homecare looks like. From this evaluation, I can determine what interval of recare would be most appropriate for them
what: what will you evaluate in order to determine disease, inflammation, CAL, BOP, plaque, calc, med history
My threshold is determined by the education I have received as well as the AAP classification/CDT coding. I follow the appropriate guidelines for classification by looking at my assessments and determine where my patient is at
signs and symptoms: what does a site look like when I need to treat it the sight may have bleeding, inflammation, high plaque, calculus. I look for attachment loss, probe depths, RBL, what kind of bone loss, furcations, mobility, tooth loss
Instruments: I must have the appropriate scalers /curets to reach specific areas, ultrasonic, files, probe, explore, and mirror. Also have adjunct service instruments available so that I can provide these for my patients
when do you refer?
Periodontist: I refer to a periodontist when the patient has MJD, significant attachment loss, lots of recession, mobility, ridge defects, severe periodontitis where treatment is not arresting disease, class 2 and above furcations
I am going to refer to a physician if the patient doesn't have one, or if I see anything suspicious intraoraly that I think needs to get checked out. I may also refer if I notice a medical condition that needs to be checked on.
what does the sequence look like?
Adult Prophy: Asseess/evaluate ( med history, radiographs, homecare, educate, dental checkin, dental exam, periocheck in, PASS, Calculus, recare) debride using appropriate instruments, polish, fluoride
Periodontal Maintanence: Asseess/evaluate ( med history, radiographs, homecare, educate, dental checkin, dental exam, reevaluate periocheck in, PASS, Calculus, possible adjunct therapies, recare)Debride using appropriate instruments, polish, fluoride
NSPT: Asseess/evaluate ( med history, radiographs, homecare, educate, dental checkin, dental exam, reevaluate periocheck in, PASS, Calculus, possible adjunct therapies,recare) determine use for anesthetic, debride by quads using appropriate instruments
PSE: Asseess/evaluate ( med history, radiographs, homecare, educate, dental checkin, dental exam, reevaluate periocheck in, PASS, Calculus, recare, possible adjunct therapies), ultrasonic, touch up on any missed spots, polish, fluoride
what is my protocol
GBT: I would use the GBT if it is available. It has shown through research to be affective in both removing supra gingival plaque and sub gingival compared to the traditional trophy cup
Paste/Polish: I like to use the polisher to take off plaque usually before the debridement. I find that this helps me to save time. If there isn't a lot of plaque ai like to use the polisher at the end of the debridement to leave the patients mouth feeling smooth.
Handscale: depending on the situation. For majority I handscale at localized sites. I determine by going back over with my explorer after I have used the ultrasonic to find any residual spots. If the patient cannot use the ultrasonic than I would handscale all sites.
Ultrasonic scaler: For any debridement I ultra sonic first. Not only does it help get rid of plaque and calculus, but it also helps to irrigate the pockets and disrupt the biofilm. For heavier build up I go through multiple times, but if it is mostly just plaque and no calculus than I go through once.
Self assessment: I explore before and after every debridement. Frequency is whenever I feel unsure or feel the need to double check an area after I have debrided