RCC 2 Final Exam

Sexual Harassment

Unwanted behavior of a sexual nature that creates a hostile working environment.

First Degree Sexual Harassment

Hostile working environment based on the employee's sex, including crude jokes, body references, and repeated requests for dates.

Second Degree Sexual Harassment

Quid pro quo harassment where employment decisions are based on succumbing to or refusing sexual advances.

Sources of Sexual Harassment

Employee to employee, dental staff to patients, patients to staff, and vendors to staff.

Professionalism Threat

Sexual harassment undermines mutual respect and trust in the dentist-patient relationship.

Vulnerability of Patients

Patients are vulnerable, and exploitation is an abuse of power.

Psychological Damage

Sexual misconduct by a dentist can cause psychological harm to the patient.

Impairment of Clinical Care

Sexual involvement with a patient may impair their clinical care.

Unethical Sexual Contact

Sexual contact between doctors and patients is unethical and can lead to professional discipline.

Power Imbalance

The dynamic between doctors and patients creates a substantial power imbalance that must not be exploited.

Minimizing Harassment Risk

Strategies include not disclosing personal details, documenting intrusions, and using the buddy system.

Preventing Patient Harassment

Harassment includes unwanted comments or behavior that is sexually demeaning to the patient.

ADA Code of Ethics - Beneficence

Dentists must provide a respectful and collaborative workplace environment.

ADA Code of Ethics - Nonmaleficence

Dentists should avoid relationships that impair professional judgment or exploit patient confidence.

Patient Autonomy

The right of patients to self-govern and have their confidentiality respected.

Non-maleficence

The principle of doing no harm to patients.

Beneficence

The obligation to promote the welfare of patients.

Justice

The principle of fairness in treating all people.

Veracity

The principle of truthfulness in patient interactions.

Signs of Abuse

Common signs include injuries to teeth, soft tissues, and psychological indicators like depression and anxiety.

AVDR Model

A model for addressing signs of abuse: Ask, Validate, Document, Refer/Report.

ASK (AVDR Model)

Precautions before asking about domestic violence, ensuring privacy and proper training.

VALIDATE (AVDR Model)

Using validating statements to facilitate conversations without judgment.

DOCUMENT (AVDR Model)

Recording the interaction and signs observed for health and legal purposes.

REFER/REPORT (AVDR Model)

Having a plan of action for reporting suspected abuse and addressing safety concerns.

Dentist's Obligation

Ethically obligated to identify and report suspected abuse and neglect.

Legal Obligation

Dentists must report suspected abuse or neglect as required by law.

Legal obligation

Requirement to report suspected abuse or neglect.

Child abuse

Legal duty to report suspected child abuse under 18.

Adult abuse

Dentist's ethical duty to report suspected adult abuse.

Elder abuse

Mandatory reporting of abuse for endangered adults.

Endangered adult

Adult incapable of self-care due to various conditions.

Autonomy

Respecting patient's rights to self-determination.

Nonmaleficence

Obligation to avoid causing harm to patients.

Intimate Partner Violence (IPV)

Abuse occurring between current or former partners.

Physical IPV

Includes hitting, slapping, and strangulation.

Emotional IPV

Involves name-calling and gaslighting behaviors.

Financial IPV

Control over finances without partner's consent.

Reproductive coercion

Manipulation regarding birth control and reproductive choices.

CDC statistics 2022

1 in 3 women report severe IPV lifetime.

Homicide victims

1 in 5 homicide victims killed by intimate partners.

Indiana IPV rates

42% of women and 27.9% of men experience IPV.

Child abuse reporting

Report when suspecting abuse for individuals under 18.

Domestic violence reporting

Respect adult patient's confidentiality unless mandated.

Adult Protective Services (APS)

Agency to report suspected elder abuse cases.

Communication with visually impaired

Use clear communication and allow patient interaction.

Oral Hygiene Instructions

Demonstrate techniques and ask for patient input.

Patient confidentiality

Legal protection of patient information from disclosure.

Reporting requirements

Legal obligations vary by jurisdiction and situation.

Ethical obligations

Dentists must align ethical duties with legal requirements.

Comprehensive assessment

Required for all residents in long-term care facilities.

Transportation for dental care

Assistance in arranging transport for residents.

Routine dental care

Essential services provided to long-term care residents.

Phobia

Persistent, unrealistic, and intense fear of a specific stimulus, leading to complete avoidance of the stimulus/perceived danger.

Symptoms of Depression (DSM)

Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

Impact of Depression on Oral Health Care

Tricyclic antidepressants, SSRIs, both linked to xerostomia which can lead to increased incidence of caries.

Mental Illness

Something that affects a person's thinking, feeling, mood, relation to others or function throughout the day.

Bipolar Hypomania (DSM)

Presence of a manic episode of at least 1 week duration that leads to hospitalization or other occupational or social impairment.

Fear

A feeling of disquiet that begins rapidly in the presence of danger and dissipates quickly once the threat is removed.

Anxiety

Uneasiness over the anticipation of less specific or predictable threats that lasts longer and can also be adaptive.

Hypnotherapy

Hypnotist attempts to influence the subjects' perceptions, feelings, thinking, and behavior by asking them to concentrate on ideas and images that may evoke the intended effects.

Biofeedback

Use of instruments to measure, amplify, and feedback physiological information to the patient being monitored.

Visualization

Part of guided imagery - Relaxation →visualization →positive suggestion.

Progressive Muscle Relaxation

Tensing specific muscle groups for 5-7 seconds followed by 20 seconds of relaxation.

Cognitive Behavioral Therapy

Learning to change negatively distorted thoughts (cognitions) and actions (behaviors).

Exposure Therapy

Encourage the patients to discuss their status of fear and anxiety to construct a hierarchy of feared dental situations from least to most anxiety-provoking.

Mental Health Chatbots

Newer Alternative Methods of Managing Anxiety.

Impact of VR on Dental Anxiety

VR acts as a form of cognitive behavioral therapy.

GAD Anxiety Scale

Asks patients how anxious they have been feeling in general and sums the point total to determine how anxious they are.

Modified Dental Scale

Asks patients how anxious they have been feeling regarding the dentist. A score of 19 or above is a highly dentally anxious patient.

Referral to Mental Health Providers

When a patient presents with suicidal, homicidal, or psychotic features such as auditory or visual hallucinations, mood or psychotic disorders.

ADA Laws for Service Dogs

Under the federal Americans with Disabilities Act ("AwDA"), a service animal is a dog or miniature horse that is trained to do work or perform tasks for a person with a disability.