Chapter One: Intro to Dental Hygiene Theory

Key Terms/Concepts Related to the Professional Dental Hygienist

• graduated from accredited university

• licensed to provide education, assessments, research, administration, diagnostic, preventatives, and therapeutic services

• collaborations with dental team, health care team, and communities

• supports overall health through promotion of optimal oral health and disease prevention

Father of Dental Hygiene

Dr. Alfred C. Fones

• emphasized prevention and education in oral health care

Who was the First Dental Hygienist?

Irene Newman

• trained by Dr. Fones

• was as assistant but Dr Fones wanted to focus on prevention and education instead of just treating already diseased patients

What are the Professional Roles of a Dental Hygienist?

1. Education

2. Assessment

3. Diagnosis

4. Prevention

5. Non-surgical Therapy

6. Research

7. Administration

8. Entreprenuer

Education Role of a DH

use educational theory and methodology to educate competent oral health professionals

provide continuing education for licensed providers

Assessment Role of a DH

assess medical and dental history of all individuals

Diagnosis Role of a DH

self awareness for what you as the hygienist can and cannot diagnose

Prevention Role as a DH

educate patients on oral hygiene (brush/floss)

offer preventatives such as sealants or flouride treatments

Non-Surgical Therapy Role as a DH

provide treatment for periodontal disease through non-invasive methods like scaling and root planing

Research Role as a DH

conduct studies to test new procedures, products, or theories for advancements or effectiveness

staying up to date with new techniques and procedures

Administration Role for a DH

organizing, communicating, identifying, and managing resources

evaluating/modifying health or educational programs

Entrepreneur Role of a DH

initiate or finance new oral health-related inter-prices

some states allow RDHs to own their own practice without a dentist’s supervision

Direct Supervision

dentist must be present

Personal Supervision

dentist has to authorize procedures, be present, and check work of RDH before patient dismissal

General Supervision

dentist authorized treatment by an RDH for a patient of record can be performed in the dentist’s absence (must follow DDS’s plan for tx")

What kind of supervision does the state of AR have?

General Supervision

Direct Access Supervision

RDH can provide service without specific authorization from a DDS (as determined appropriate)

usually limited to preventative services in public health settings

Collaborative Supervision

RDH can practice without supervision with a collaborative agreement between the RDH and the dentist

What kind of supervision do the states of CO and AK have?

Collaborative Supervision

Indirect Supervision

DDS is in the office, present, and must authorize procedures

Remote Supervision

teledentistry-assisted, affiliated DH practice (DDS IS NOT ON SITE)

Independent Practice

RDH can provide services within the scope of DH practice in any setting without authorization/supervision of a DDS

What are the 3 Categories of Preventative Services?

1. Primary Prevention

2. Secondary Prevention

3. Tertiary Prevention

Primary Prevention

carried out before disease occurs to prevent disease or injury

ex. sealants, fluoride, education

Secondary Prevention

tx of early disease to prevent further progression of potentially irreversible conditions

can lead to extensive rehabilitation or tooth loss

ex. removal of calculus while debriding root surface in a shallow periodontal pocket to prevent further attachment loss

Tertiary Prevention

methods to replace lost tissues and to rehabilitate the oral cavity to a level where funtion is as near as normal as possible

ex. partial denture, bridge, implants, crown restorations, bone/tissue graphs

What are the components of the DH Process of Care?

1. Assess (A)

2. Diagnose (D)

3. Plan (P)

4. Implement (I)

5. Evaluate (E)

6. Document (D)

What is the purpose of the DH Process of Care?

provides a framework to individualize the process for each patient

identifies risk factors to aid in prevention and/or management of oral disease through dental hygiene interventions

Assess - DH Process of Care

provides a foundation for pt care by collecting subjected and objective data

ex. medical hx, dental hx, vitals

Diagnosis - DH Process of Care

use critical thinking to interpret assessment date

identify health behaviors (potential oral health risks)

provide basis on which DH care plan is designed

justify proposed tx to the patient

Plan - DH Process of Care

present to dentist for integration w/ comprehensive plan

present plan to patient to develop undertstanding of tx needed and appointment requirements

obtain pt informed consent for treatment

Implementation - DH Process of Care

process of care is “activated”

Evaluation - DH Process of Care

determine if pt will need retreatment, a referral, or placed on a continuing care schedule

was the previous tx successful or no?

Documentation - DH Process of Care

details of the patients appointment by documenting:

• data

• diagnosis

• care plan

• treatments

• patient education

• evaluation

represents chronological history of patient appointments

What is the Purpose of the DH Code of Ethics?

increase awareness of, and sensitivity to, ethical situations

define standard of conduct to give each individual a strong sense of ethical consciousness in practice and everyday life

What are the components for the DH Code of Ethics?

1. Individual Autonomy and Respect for Human Beings

2. Confidentiality

3. Societal Trust

4. Non-maleficience

5. Beneficence

6. Justice and Fairness

7. Veracity

Individual Autonomy and Respect for Human Beings - code of ethics

people have the right to be treated with respect, informed consent prior to tx, and full disclosure of all relavent information

ex. respect and selflessness

Confidentiality - code of ethics

respect confidentiality of all patients and their relations

ex. hippa

Societal Trust - code of ethics

establishing a patients trust in us and valuing that trust

understand that public trust in our profession is based on our own actions and behavior

ex. not lying to patients about tx

Non-maleficence - code of ethics

provide services in a manner that protects all patients and minimizes harm to them

ex. always having good intent

Beneficence - code of ethics

promote well-being of individuals and the public by engaging in health promotion/disease prevention activities

ex. public outreach

Justice and Fairness - code of ethics

value justice and support fair/equitable distribution of healthcare resources

all people should have access to high quality/affordable healthcare

ex. volunteer clinics for low-income communities

Veracity - code of ethics

obligation to tell the truth and expect other to do the same

ex. always being truthful with patients

What is an Ethical Issue?

clearly defined

common problem wherein a solution is grounded in governing practice act, recognizes laws or accepted standards of care based on standard rules of practice

What is an ethical deliemma?

problem that may involve two morally correct choices or courses of action

may not have just ONE answer

outcomes can differ

Steps to Resolve Ethical Issues or Dilemmas

1. gather information

2. identify the issue present

3. clarification

4. assessment

5. recommendation

6. documentation and follow up

Legal Factors in DH Practice

Laws between different states/counties/providences will differ and must be studied and respected by the DH

terminology might vary across different regions

active engagement with state DH association will aid in keeping the DH up to date

Personal Factors that affect DH Practice

1. Personal Values

2. Putting the Patient First

3. Lifelong Learning

How do Personal Values Affect DH Practice

influence by family, social, or economic factory

life experiences (success and failure)

values, attitude, and responsibility

How does putting the patient first affect DH practice?

ethical, moral, and legal responsibility to the patients discrimination

always making ethical decisions

having professional behavior

treating all patients the same regardless of background

How does Lifelong Learning Affect DH Practice?

maintaining competency
learning new scientific advances

providing evidence-based patient care and consistent ethical reasoning during procedures

ensure the fulfillment of each patient’s individual rights

What are the Components of Professionalism in DH?

1. Competence

2. Fairness

3. Integrity

4. Responsibility

5. Respect

6. Service-mindedness

Competence in DH Professionalism

maintain a high level of knowledge through lifelong learning, clinical expertise, and professional behavior for provision of patient care

Fairness in DH Professionalism

demonstrate consistency and equity when dealing with others

promote equal access to care for the public

Integrity in DH Professionalism

be honest

do the right thing by your patients

demonstrate strong moral principles

Responsibility in DH Professionalism

accountable for one’s actions in accordance with the ADHA Code of Ethics

Respect in DH Professionalism

value and honor the patients feelings and rights

Service-mindedness in DH Professionalism

act out of benefit for the patients and the public

approach those served with compassion

Basic Components of Self-Care to improve Professionalism in DH Practice

1. General/Physical Needs

2. Physical Activity

3. Mental Health

General/Physical Needs for Maintaining Professionalism in DH

personal hygiene (healthy oral practice)

sleep

nutrition

routine exams/immunizations

Physical Activity Needs for Maintaining Professionalism in DH

helps with:

• weight control

• maintaining good mental health

• prevention of chronic disease

• strengthening bone and muscle

• managing stress

• improving daily activity performance

Mental Health Needs for Maintaining Professionalism in DH

reflected in interpersonal relationships

ability to inspire confidence through a display of professional and emotional maturity

stress management will improve mental health

avoid risky behaviors (tobacco, excessive drinking, illicit drugs) to prevent adverse effects