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/Institutions/University-of-Maryland-School-of-Dentistry/json/Clinic-Manual/Dental-Hygiene-Program-local.json

/Institutions/University-of-Maryland-School-of-Dentistry/json/Clinic-Manual/Dental-Hygiene-Program.json

Dental Hygiene Assessment

The student will collect data as indicated by patient/client conditions, correlate with health status and disease processes and utilize data during all components of patient/client care.

Assessment includes extra- and intra-oral, hard tissue (including occlusal evaluation), periodontal (includes health behaviors evaluation) and accretion exams; exposing and interpreting appropriate radiographs; obtaining diagnostic models; and other diagnostic procedures (e.g. vitality test, perio and caries tests).

Extra- and Intra-Oral Examination

Observable behaviors The student will:

1. Review patient record prior to appointment for any previously documented abnormal conditions, pathology reports and need for follow up.
   • Appropriately follow up on previously reported and documented pathology
2. Perform extra- and intra-oral examination for every patient at every appointment.
   • Explain procedure to patient prior to beginning exam 
   • Competently perform and utilize correct examination technique
   • Accurately describes and document ALL conditions correctly (WNL, deviations from normal, and abnormalities)
     • Detects minor abnormalities or variations of normal
     • Identify findings per location, size, shape, texture, and other appropriate descriptors
     • Use appropriate and professional terminology when reporting and documenting findings o Compare current findings to previously determined findings
     • Record and maintain accurate, legible and concise patient records
     • Provide, determine need for, and interpret radiographs that are diagnostically acceptable and current 
     • Provide, determine need for, and interpret additional diagnostic data, e.g. impressions and study models, vitality testing, etc. to further assess all EIOE findings
   • Suggest possible etiologies for variations and pathologies
3. Identifies need for further evaluation of pathology or variations from normal.
   • Identifies need for consults related to data
   • Facilitates and follows up on consultations

*Critical errors: automatic failure for errors this category. Items listed as quantitative errors are counted individually.

Hard Tissue Examination

Observable behaviors The student will:

1. Utilize appropriate radiographs for hard tissue exam.
2. Identify present, missing, impacted and partially erupted teeth.
3. Detect obvious caries or faulty restorations clinically or on radiographs.
4. Identify existing restorations.
5. Identify occlusion.
6. Use proper techniques for caries assessment (e.g., air, transillumination, instrument selection).
7. Detect condition of teeth such as attrition, fluorosis, etc.
8. Identify diastemas.
9. Document findings using appropriate marking / colors in the EPR.

*Critical errors: automatic failure for errors this category. Items listed as quantitative errors are counted individually.

Periodontal Examination

Observable behaviors The student will:

1. Examine the gingiva and give an accurate gingival description.
2. Probe entire dentition.
   • Correctly measure and record probing depth within 1 mm
3. Compare current periodontal findings to previous charting.
4. Note attachment level changes over time.
5. Determine periodontal classification.
6. Assess patient’s current health behaviors
   • Plaque control
   • Tobacco use
   • Alcohol consumption
   • Diet
   • Caries risk
   • Periodontal risk
7. Suggest need for consult.
8. Perform and calculate
   • Plaque index at every dental hygiene visit
   • Bleeding index
9. Perform exploring / probing without tissue trauma.
10. Detect type and amount of supragingival and/or subgingival deposits to determine patient difficulty level.

    Document findings in the EPR

    • Probing depths
    • Bleeding on probing
    • Recession
    • Mobility
    • Furcation
11. Utilize correct instrumentation and technique.

*Critical errors: automatic failure for errors this category. Items listed as quantitative errors are counted individually.

Case Presentation

The student will develop comprehensive patient/client centered care plans designed to meet the individual's needs for achieving and/or maintaining optimal oral health. Treatment planning includes all preventive and therapeutic strategies.

Dental Hygiene Care Plan

The student will:

1. Identify an appropriate care plan based on patient/client needs, clinical findings, risk assessments and mutually agreeable goals.
2. Identify an appropriate sequence of services and the number of appointments needed to complete services.
3. Coordinate dental hygiene care plan with comprehensive dental treatment plan.
4. Discuss fully with patient the treatment options, obtains informed consent from patient and has patient sign consent prior to initiating treatment.
5. Respond to questions relating to patients'/clients' treatment needs.
6. Provide appropriate rationale for planned services and sequencing.
7. Assess patient prognosis and devise appropriate evaluation strategies for attainment of treatment goals.
8. Determines appropriate recare intervals based on patient outcomes.
9. Implement consented treatment plan as written and/or modifies treatment plan as needed after consulting with appropriate faculty.

*Critical errors: automatic failure for errors this category. Items listed as quantitative errors are counted individually.

Prophy

The student will implement appropriate, effective and efficient non-traumatic instrumentation techniques and/or other additional services (ie: desensitization, sealants, anesthesia) to achieve and/or maintain patients'/clients' optimal oral health.

Home Care Strategies:

Observable behaviors

The student will:

1. Reevaluate patient self/home care prior to implementation.
   • Determine plaque-free score at each visit
2. Modify patient/client self/home care techniques where appropriate.
3. Engage patient/client in appropriate self/home care strategies.
   • Patient removes soft deposit prior to instrumentation

*Critical errors: automatic failure for errors this category. Items listed as quantitative errors are counted individually.

Instrumentation:

Observable behaviors

The student will:

1. Have sharp instruments available.
2. Use detection skills (e.g., air, explorer, disclosing, indirect vision) appropriately.
3. Employ instrumentation techniques consistent with competence criteria.
   • Appropriate ergonomic principles
   • Select appropriate instrument(s) for removal process
   • Appropriate implementation principles
4. Use radiographs to guide clinical implementation.
5. Remove all hard/soft deposits and stain with no observable trauma.
6. Reevaluate previously instrumented areas.

*Critical errors: automatic failure for errors this category. Items listed as quantitative errors are counted individually.

Other treatment services:

The student will:

1. Obtain patient/client consent prior to implementing procedure.
2. Employ techniques consistent with competence criteria. (i.e. Sealants, Arestin, polishing, anesthesia, etc.).
3. Provide service with no observable trauma.
4. Document completely all treatment services in the EPR (e.g., for sealant placement specify material type, tooth #, surface, etc.).

*Critical errors: automatic failure for errors this category. Items listed as quantitative errors are counted individually.

Instrumentation Grading Criteria

Instrumentation skills (product only) will be evaluated and documented on the Student Clinic Record Form (SCRF) based on the accretion difficulty level. "Light” accretions are evaluated by arch. "Moderate" or "heavy" accretions will be evaluated by quadrant. Grades of Superior (S), Acceptable (A), Needs Improvement (N), and Unacceptable (U) will be submitted into the Axium computer grading system.

Errors to be documented on SCRF

X Detectable calculus

P Plaque

S Stain

T Trauma

Varnish method:

The student will:

1. Discuss treatment service to patient prior to implementation.
2. Obtain consent prior to implementation of procedure.
3. Give post -op instructions to patient/client prior to dismissal.
4. Employ instrumentation techniques consistent with competence criteria.
   • Appropriate ergonomic principles
   • Select appropriate armamentarium
   • Appropriate implementation principles
5. Check-in with supervising faculty prior to patient dismissal.
   • Faculty must observe patient prior to dismissal
6. Fully document procedure and evaluate patient behavior in patient records.

*Critical errors: automatic failure for errors this category. Items listed as quantitative errors are counted individually.

Tray method:

The student will:

1. Discuss treatment services with patient prior to implementation.
2. Obtain consent prior to implementation of procedure.
3. Give post -op instructions to patient/client prior to dismissal.
4. Employ techniques consistent with competence criteria
   • Seats patient in an upright positions
   • Select appropriate armamentarium.
     • Select appropriate tray size
     • Select appropriate amount of fluoride
   • Appropriate implementation principles
     • Provide patient/client with paper towel or spit cup
     • Dries the teeth
     • Places saliva ejector
   • Follow manufacturer’s recommendations
5. Check-in with supervising faculty prior to patient dismissal.
   • Faculty must observe patient prior to dismissal
6. Fully document procedure and evaluate patient behavior in patient records.

*Critical errors: automatic failure for errors this category. Items listed as quantitative errors are counted individually.