1. Dental Hygiene Process of Care Model
B.Leggett
12/8/2018
Dental Hygiene Program...Algonquin College

2. What is this model? It provides a logical, systematic approach to care
It is characterized by its client-centered collaborative concept of care
It is based on the Human Needs Conceptual model (Darby, 1990)
Dental Hygiene
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3. OUTCOMES EVALUATION IMPLEMENTATION PLANNING ASSESSMENT ASSESSMENT
Dental Hygiene
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4. Human Needs Theory Explains that :
human activity is motivated by a perceived need
AND
Human behaviour is GOAL directed
Dental Hygiene
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5. A Human Needs Approach
There are 11 human needs relevant to dental hygiene care
If these needs are unfulfilled, specific behaviours will be activated in order to eliminate any perceived deficit
Dental Hygiene
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6. #1.. Safety Freedom from potential harm
Unmet need may be indicated by:
Abnormal vital signs
Potential for antibiotic premedication
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7. #2 Pain and Stress Freedom from physical/emotional discomfort
Unmet need may:
Be displayed by verbal OR non-verbal behaviour
Involve fear or anxiety or
Discomfort prior to or during care
Dental Hygiene
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8. #3 ..Wholesome facial image
Client may express dissatifaction with appearance of teeth,or concerns re breathe odour
Dental Hygiene
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9. #4 ..Head and Neck – Integrity of tissues
Deficits may be discovered during extra/intraoral examination… such as :
Presence of lesions
Gingival inflammation
Bleeding on probing
Dental Hygiene
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10. #5.. Functional dentition
A biologically sound and functionally intact dentition
Signs of need deficit could include:
Difficulty in chewing
Teeth with signs of abrasion, caries, trauma
Presence of plaque, calculus or stains
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11. Unmet Oral Health Needs
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12. #6 Adequate Nutrition
The need to ingest adequate nutrients for body growth, repair and maintenance
Deficits may include signs of:
Eating disorders
Rampant caries
Malnutrition
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13. #7 ..Appreciation and Respect
Involves the following aspects of the dental hygienist - client relationship
Using empathic communication skills
Acting as client advocate
Understanding and accepting client’s attitudes and emotions
Dental Hygiene
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14. #8 .. Conceptualization and Problem solving
The need to grasp ideas and concepts
Make sound judgements about own oral health
D.H. should:
Measure client’s oral health knowledge
Explain disease process
Explain rationale for care
In order to;
Promote client’s self-evaluation
Enable client to understand rationale for treament
Dental Hygiene
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15. # 9 .. Self-determination and Responsibility
Involves the need for accountability for one’s own health behaviours
Client must be a committed and active participant in oral wellness
Involvement in setting goals
Facilitate decision making about role in oral health
Dental Hygiene
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16. #10 .. Territoriality Respect for the client’s personal space
Awareness of diverse cultures
Recognize issues with personal information
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17. #11 .. Value System
Involves the need to develop one’s own priorities through experience and culture
Care providers can advocate the importance of optimum wellness
Exert influence in order to increase the value placed on oral health maintenance
Dental Hygiene
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18. Phases of the dental hygiene process of care
Assessment
Information gathering on current health status
Sources:
Observation
Clinical exams
X-ray
Reports from family
Lab tests etc.
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19. Diagnostic Statement
“ formal statement regarding the actual or potential problems of a client that are amenable to treatment through the DH Process of Care” ( Mueller-Joseph, and Petersen)
Provides the foundation for preparing the care plan
Must respect the DH “scope of practice “
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20. DH Diagnosis Is a two part statement which describes:
An oral condition &
Possible etiology
Is based on both subjective & objective data
Is validated with the client
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21. DH Diagnosis FORMAT of STATEMENT
Describes client’s current condition “related to” contributing factors
eg .. “potential for clinical attachment loss related to high levels of periodontal pathogens”
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22. Diagnostic Statements
Generalized dental abrasion related to traumatic toothbrushing techniques
Generalized brown stain related to cigarette smoking
Inflamed palatal mucosa related to improper denture care
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23. Planning Care
Focus of care is meeting client’s needs as identified in diagnostic statements
Goal is to resolve oral health problems (deficits)
Involves analysis and synthesis of data to develop strategies and interventions
Dental Hygiene
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24. Stages of Planning Setting priorities in collaboration with client
Develop goals and establish desired outcomes
“expected outcomes” language >>> each should begin with
Client will…demonstrate, perform, eliminate,stop, choose, remove etc.
Dental Hygiene
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25. Planning Care D.H. Diagnostic statement: Goal: Intervention
Increased potential for root exposure related to incorrect brushing technique
Goal:
Decrease potential for root exposure
Intervention
educate client and demonstrate correct toothbrushing method
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26. Planning Care Expected outcome(s) Documentation
Client will demonstrate correct method at next appoinment
Attachment levels will remain unchanged over next 12 months
Documentation
Outcomes should be specific and measurable ( action language) and prioritized with time guidelines
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27. Implementation of D.H. Care Plan
Preparation of treatment area
Performance of “skills” plus
All educational interventions
Information and OHI
Counselling ( dietary, Smoking cessation)
Post treatment care
Record keeping
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28. Evaluation Phase
Failure to evaluate the client’s oral health status after care may be considered professional negligence (Darby & Walsh, 1995)
Each goal should be reviewed—was it:
Fully met?
Partially met?
Not met at all?
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29. Evaluation Phase Partially or completely unmet Goals
Goals unrealistic?
Time frames too short?
Client non-compliance?
Inaccurate diagnosis?
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30. Evaluation Phase Goals Fully Met Client goes on Supportive care plan
Recare intervals will vary
Process is on-going at every appointment
Always refer back to baseline data
Accurate documentation for continuing maintenance of oral health
Dental Hygiene
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31. D.H. Process of Care Assessment Evaluation D.H. Diagnosis Planning
Implementation
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