CRITERIA:
Purpose: The dental hygienist is involved in a continuous process of interacting with patients, making clinical decisions, performing clinical procedures, and developing strategies to improve the overall oral and systemic health of their patients. This assignment will allow the student to collaborate with members of the dental team to identify and diagnose a patient who presents with a periodontal condition and develop strategies that will promote overall health of the patient. Goals of periodontal treatment strategies may include the following:
Minimize bacterial challenge to the patient
Eliminate or control local contributing factors for periodontal disease
Minimize the impact of systemic factors for periodontal disease
Stabilize the attachment level
Assignment: Using the 1999 American Academy of Periodontology classification of periodontal diseases and conditions, identify a patient who would be classified as having a periodontal disease and obtain approval from a clinical instructor. It is recommended that the patient be selected early in the semester in order to allow time for patient completion.
Treatment: In order for students to obtain full credit, the student must complete the following requirements:
Complete all assessments
Complete radiographs
Obtain all signatures
Adhere to infection control, professionalism, HIPAA and standards of care during treatment
Obtain dental hygiene diagnosis and patient classification
Complete treatment plan form(s) and obtain referrals (if indicated)
Complete any local anesthesia and/or Arestin* consent form(s)
Complete treatment start to finish (including any re-evaluation appointments)
Present findings to the class.
*Arestin placement is only on the Periodontal Case Study Patient during the DHYG 250 Clinic IV semester.
WRITTEN PROJECT
Students will be required to provide a written summary of the periodontal case study. The summary should include a generalized synopsis of patient characteristics, patient assessments, patient history, diagnosis and prognosis, treatment recommendations, and any adjunct therapies that were included in treatment. Below an outline is provided and should be followed to ensure that all topics are covered in the summary of findings. Students should consult their periodontal textbook used in DHYG 209 as well as 2 additional peer-reviewed journals and/or resources. A bibliography of resources should be included.
Project Outline
Section I: Patient Profile. In this section you need to include generalized patient information and the chief complaint. (Age, gender, relevant physical characteristics)
Section II: Relevant Patient History. Describe significant medical history factors and social history. Be sure include vital signs as they pertain to the patients overall health status, assessment of patient characteristics.
Research patient systemic conditions, medications.
What systemic factors (diseases/medications/lifestyle habits) did the patient present that were critical for the dental team to consider during diagnosis and treatment?
Section III: Clinical Assessments. Using clinical assessment date, what factors did you use to determine the dental hygiene diagnosis, oral hygiene instruction and treatment regimen? Included in this section are: Intraoral photographs, radiographs, interpretation of radiographs, hard tissue charting and periodontal charting.
Rational for case selection:
Why did you consider this patient? What was unique about this patient’s periodontal condition? Had this patient been diagnosed with periodontal disease prior to you seeing them? Had they had prior periodontal treatment?
What are some of the biological factors that contributed to the development and progression of the periodontal disease?
Treatment goals and desired outcomes:
What was the prognosis of the patient’s periodontal disease? Did you make any referrals? If so, to whom?
Were there any contraindications to treatment?
Did you need to contact the patient’s physician for co-diagnosis or consultations?
Are there any restorative and/or cosmetic needs for this patient?
Preventive education strategy:
What oral hygiene instructions did you consider? Was the patient compliant? Did the patient show resistance to change? What motivational factors did you use to convince the patient to comply? Was there follow-up?
Describe in detail the treatment plan and recommendations for this patient.
What was the appointment sequence?
What outside resources did you use to come to diagnosis and treatment plan considerations? What evidence-based knowledge did you incorporate into treatment?
What is the recommended periodontal maintenance schedule for this patient?
Consideration of adjunct therapies:
Was ARESTIN and/or Chlorhexidine irrigation used to treat this patient?
Did you provide your patient with the knowledge concerning periodontal treatment and adjunct therapies to treatment? Was the patient open to the use of ARESTIN and/or Chlorhexidine irrigation? If not, what motivating factors did you use to convince the patient the need for adjunct therapies?
Did you discuss pre and post-operative treatment? Did you give and discuss the patient an ARESTIN pamphlet? What types of questions did the patient have?
Intra-Extraoral examination assessment:
Did the patient present with any intra-extraoral pathologies? Did the patient require a referral to an oral surgeon? Was the patient a smoker? If so, describe the clinical periodontal condition of the oral cavity. What were some of the differences that you noticed in the smoking patient?
What were some of the local factors that contributed to the development or progression of the periodontal disease?
Periodontal assessment:
What etiological factors contributed the development and progression of periodontal disease?
Were there any specific bony defects? Furcation involvement? Mobility?
Utilizing the clinical notes, dental radiographs, and gingival assessments, describe in detail the following clinical features: gingival description, bleeding, presence of plaque, calculus bone level, recession, and exudate.
When describing clinical features, remember to mention if generalized and/or localized.
Clinical Treatment:
Document all completed services or treatment performed.
Explain treatment revisions and the rationale.
How many appointments did it take? Was patient compliant in keeping appointments?
Bibliography/NLM (National Library of Medicine) citation guidelines format
Dental Charting and Periodontal Charting forms
Medical history information
Patient assessment questionnaire forms
CAMBRA, Diabetes, and Tobacco Risk Assessment Forms
Dental hygiene care plan questionnaire form
Patient written consent form (patient needs to be informed and permission given)
ARESTIN Consent form
Scaling/patient completed form/instructor signature
Chart documentation
Final Analysis:
Did the patient respond to treatment? If so, what were the outcomes? Was there periodontal pocket and/or bleeding reduction?
Describe the patient’s role in their treatment? What is the role of the dental hygienists?
Do you predict the patient to continue with follow-up treatment?
Has the patient demonstrated any lifestyle changes for the future?
How has this project prepare you for the future profession of dental hygiene care?
PRESENTATION: Power point
Students will be required to share their case study with classmates during the week of the semester. Students may be creative in how they present their findings. This portion of the assignment will be included in the overall final grade of the assignment. If a student is not available to present, there will be a point deduction.
Students will be required to share their case study with classmates during the last two weeks of the semester. Students may be creative in how they present their findings. This portion of the assignment will be included in the overall final grade of the assignment. If a student is not available to present, there will be a point deduction. Since we are in remote learning for the lecture portion of this course, students will submit the presentation on a discussion board by the due date. Each student will make a comment and/or ask a question in response to at least one classmate’s presentation. Students must maintain professional discussion board etiquette when submitting responses. Responses will be due one week after the presentation upload due date. Remember to follow rules according to HIPAA. NO patient information such as name is to be given. The patient MUST agree to allow the student to use their information in this case study. STUDENT WILL RECEIVE A ZERO (0) IF HIPAA IS VIOLATED IN ANY WAY.If a student fails the clinical portion of the treatment, the student may still opt to use the patient as thisperiodontal case study assignment.
If a student fails the clinical portion of the treatment, the student may still opt to use the patient as this periodontal case study assignment.
Textbook:
Boyd, Linda, Mallonee, Lisa, Wyche, Charlotte. Wilkins’ Clinical Practice of the Dental Hygienist
Foundations of Periodontics for the Dental Hygienist, Enhanced 5th Edition
by Jill S. Gehrig (Author), Daniel E. Shin (Author), Donald E. Willmann (Author)(13th ed.). Burlington, MA: Jones & Bartlett Learning, 2021
Attachment: I have clinical notes of the patient. Multiple appointment sessions. I used arestin placement. Nonsurgical periodontal therapy performed.