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106 terms

Preventive Dentistry Exam 1

STUDY
PLAY
A licensed primary healthcare professional, oral health educator, and clinician who provides preventive, educational, and therapeutic services supporting total health for the control of oral diseases and the promotion of oral health
dental hygienist
Professional roles of the dental hygienist
Educator
Researcher
Administrator/Manager
Advocate
Clinician
All professional roles of the dental hygienist are interconnected through their common application to ___________.
public health
The science and practice of the prevention of oral diseases and the integrated preventive and treatment services administered for a patient by a dental hygienist
dental hygiene care
Services of dental hygiene care
preventive

educational

therapeutic
Types of preventive services
primary

secondary

tertiary
Measures carried out so that disease does not occur
primary prevention
Treatment of early disease to prevent further progression of potentially irreversible conditions that, if not arrested, can lead eventually to extensive rehabilitative treatment or even loss of teeth
secondary prevention
What type of preventive service includes fluoridation of water supplies?
primary prevention
What type of preventive service includes removal of all calculus and dental biofilm while debriding a root surface in a relatively shallow periodontal pocket
secondary prevention
Uses methods to replace lost tissues and to rehabilitate the oral cavity to a level where function is as near normal as possible
tertiary prevention
What type of preventive service involves the replacement of a missing tooth using a fixed partial denture or implant and therefore restoring function?
tertiary prevention
strategies developed for an individual or a group to elicit behaviors directed toward health and permeates the entire patient care system
educational services
clinical treatments designed to arrest or control disease and maintain oral tissues in health
therapeutic services
What type of service involves all scaling and root debridement along with the steps in posttreatment care?
therapeutic service
What type of service involves the placement of a pit and fissure sealant?
preventive and therapeutic service
A framework within which individualized needs of the patient can be met; also, to identify the causative agents and risk factors of a condition that can be reduced, eliminated, or prevented by the services of a dental hygienist
purposes of the dental hygiene process of care
What are the elements of the dental hygiene process of care?
ADPIED

Assessment
Diagnosis
Planning
Implementation
Evaluation
Documentation
Which of the following is secondary prevention?
A) When disease does not occur
B) The treatment of early disease
C) The progression of disease
D) True prevention
B) The treatment of early disease
Which of the following may be influenced by a person's culture and language?
A) Their beliefs and behaviors about health and wellness
B) Their perceptions about the causes of illnesses
C) Attitudes of a patient about accessing healthcare
D) A person's beliefs, behaviors, perceptions, and attitudes may all be influenced by a person's culture or language
D) A person's beliefs, behaviors, perceptions, and attitudes may all be influenced by a person's culture or language

All are correct, but D is the BEST answer
ADA-recognized dental specialities
D-E-4O-3P

Dental Public Health
Endodontics
Oral (and Maxillofacial) Pathology
Oral (and Maxillofacial) Surgery
Orthodontics (and Dentofacial Orthopedics)
Oral (and Maxillofacial) Radiology
Pediatric Dentistry
Periodontics
Prosthodontics
Dental hygiene specialty practices
orthodontics
pediatric dentistry
periodontics
Objectives for professional practice
Overall goals

Personal goals
The professional dental hygienist carefully documents all aspects of patient care in the patient's permanent record to provide that is:
comprehensive
accurate
ongoing
ethical and legal
objective and facutal
The co-therapist role of the DH is:
-moral/ethical
-within scope of DH care
-combined educational and clinical services
-patient's oral wellness status/maintenance
Steps in a Preventive Program
Assess the patient's needs
Plan for intervention
Implementation
Perform clinical preventive services
Evaluate progressive changes
Plan short- and long-term maintenance
True or False: The clinician sets the patient's goals
False

Patient sets goals; RDH guides them to set goals
What may be factors to assess the patient's needs?
data:
x-rays; looking at past and comparing
PASS, PSR, and PI scores
infection present
What step in a preventive program involves a patient's learning factors, oral status, oral homecare, dexterity, and comprehension as well as outlines procedures and goals and explains outcomes?
plan for intervention
What step in a preventative program involves providing a demonstration, methods for self-evaluation?
implementation
What step in a preventive program involves scaling for complete calculus and biofilm removal as well as application of caries-preventive agents (fluoride & sealants)?
perform clinical preventive services
What step in a preventive program involves assessing the patient's compliance, recording their dental biofilm score, noting improvement in probing findings, and providing preventive counseling for corrective action when goals are not met?
evaluate progressive changes
What step in a preventive program involves determining appropriate intervals, reevaluating to monitor preventive practices, and providing supplemental care
plan for maintenance
What step in a preventive program involves personalized instructions, risk factors that can be controlled, prevention of oral accidents, and encouragement of action toward prevention?
patient counseling
The stimulus to act or think

Stimulation of behavior directed towards fulfilling a recognized goal
motivation
What are two theories of motivation
Maslow's hierarchy of human needs

behavior modification
What are Maslow's hierarchy of human needs?
Biological, physiological, or physical needs

Safety and security needs

Social needs-belongingness and love needs

Esteem-ego

Self-actualization
What are the two levels of Maslow's hierarchy that have potential as long-term motivators?
Social and Esteem levels
This theory involves breaking the change that is necessary into small steps and positively achieving one step at a time.
behavior modification
When people modify their ________, they take charge through ________ of the problem
behavior

"ownership"
What are the factors of motivation?
action toward behavioral change

value of oral health

factors of psychosocial change

peer group factors
What are the three types of learning?
Cognitive

Affective

Psychomotor
This type of learning pertains to the recall or recognition of facts and the development of intellectual skill and abilities; ex: Orofacial Anatomy
cognitive
This type of learning pertains to interests, attitudes, and values, as well as the development of appreciations and adequate adjustments; ex: Preventive Dentistry
affective
This kind of learning pertains to the manipulative or motor skill areas; ex: Preclinic Lab
psychomotor
What are the 4 steps to keep in mind for actual patient instruction?
small step size (small increments of info)

active participation

immediate feedback

self-pacing
What are the principles of learning?
Readiness to learn

Motivation to learn

Transfer of learning

Evaluation after instruction
Learning occurs when individuals:
A) understand the concepts presented to them
B) change their beliefs and attitudes about oral health
C) are motivated to practice good oral health habits
D) have received thorough oral hygiene instructions
E) change behavior and incorporate the changes into everyday living
E) change behavior and incorporate the changes into EVERYDAY living
What are the steps of the Learning Ladder?
1. Unawareness

2. Awareness

3. Self-interest

4. Involvement

5. Action

6. Habit
Involves when to teach, the setting of teaching, and the presentation with demonstration and practice
Individual patient planning
What patient education lesson number involves orientation to dental biofilm removal (do they know what it is?), description of biofilm, evaluation of patient's tissues with a mirror, demonstration, application of a disclosing agent, instruction, and summary?
first lesson
What is involved in the summary of the first lesson with a patient?
need for specific toothbrushing method

use of disclosing agent

need for regular cleaning

counsel regarding toothbrush selection and use
What patient education lesson number involves evaluating the patient's success to date, review and extension of knowledge, continuous instruction (relationship to gingival health, maintenance)
second lesson
What is involved in instruction adaptability?
methods adapted to any age level

awareness of motivation factors ("what are the benefits to you")

instruction for caregivers
What adaptions do you need to make to the instruction of preschool-aged children?
establish oral health habits

parental preventive education

risk factors and prevention
What are the components of The Teaching System?
Approach
-Content and goals

Outcomes of learning
-treatment outcomes
-prevention of recurrence
What are the criteria for teaching aides?
Simplicity

Content (relevant, practical, evidence-based)

Cultural and linguistic appropriateness

Level of orientation (appropriate)

Durability (reusable?)

Cost

Objectives (clear, educate not entertain)
Reading material for the patient must be
appropriately selected

"taught" by the dental hygienist
What kinds of models can be used as teaching aides?
patient's study cast

commercially available models

demonstration in patient's mouth
A person-centered, goal-directed method of communication for eliciting and strengthening intrinsic motivation for positive change
motivational interviewing
What are the levels in the MI pyramid?
Strategies (top)

Principles

Spirit (bottom)
What are the principles of motivational interviewing?
Express Empathy

Develop Discrepancies

Roll with Resistance

Support Self-efficacy
How would you express empathy to a patient?
through acceptance ("I hear you")

affirmation

open-ended questions

reflective listening
How would you develop discrepancies with the patient?
between current behavior vs. important goals/values

what their teeth are vs. what they think is healthy
How can you support self-efficacy with in a patient?
optimism (Spirit)

thank your patient for coming ("I'm so glad you're here")
What are the key components of brief MI which can be applied for the delivery of oral health information and advice?
Ask Permission

Elicit, Provide, Elicit

Explore Options and Affirm Commitment
What sets the collaborative spirit of MI right from the start and provides the patient with the autonomy?
Asking permission
What communication skills are used for Elicit-Provide-Elicit?
OARS

Open-ended questions (asking)

Affirmation (informing)

Reflection (listening)

Summaries
What term refers to a conflicted feeling or uncertainty about something?
ambivalence
There is empirical evidence that the skillful use of MI:
A) can be learned by dentists and dental hygienists.
B) reduces plaque and improves gingival health.
C) enhances internal motivation for regular brushing.
D) Only B and C.
E) All of the above.
E) All of the above.
The acquired or innate tendency for health professionals to "fix" a patient's problems by offering prescriptive advice is referred to as ________.
righting reflex
The clinician reflects back what he/she perceives the patient has communicated
reflective listening
The statement, "You're very determined, even in the face of discouragement. This change must really be important to you." is an example of ___________.
affirmation
What can be used to elicit the extent to which a person feels compelled to change?
motivational ruler
"Rolling with resistance" means the clinician ____________ resistance expressed by the patient.
acknowledges
True/False: The clinician will increase the likelihood of engaging patients if he/she clearly demonstrates respect for patients and recognizes they are autonomous individuals.
true
The foundation of MI is built on:
A) specific strategies the clinician teaches to the patient.
B) a sincere "spirit" of mutual respect and collaboration between the clinician and patient.
C) clinicians solving problems for patients.
D) patients' fear of losing their teeth.
B) a sincere "spirit" of mutual respect and collaboration between the clinician and patient.
Research has shown the average health care provider _________ a patient disclosure.
quickly interrupts
MI has been shown to positively affect health behavior change related to:
A) Smoking
B) Diabetes management
C) Oral health
D) All of the above
D) All of the above
A patient's verbal expression of their desire, reason, ability, or need to make a change in oral health behaviors
change talk
Andragogy refers to "the art and science of helping _____ learn."
adults
What are principles of good practice in andragogy
prior experience

readiness for learning

relevance

internal locus of control
Components of establishing an adult teacher-learner relationship include:
trust

mutual respect

authenticity (and non-possessive warmth)

accurate empathy
What are the stages of change?
Precontemplation

Contemplation

Preparation

Action

Maintenance/Relapse
What stage of change is this: the individual is not willing to change oral health habits in the next 6 months and may not even recognize there is a problem
precontemplation
What stage of change is this: the individual is considering change, undergoing a process of evaluating the pros/cons, and is ready to change current behavior within 6 months
contemplation
What stage of change is this: the individual is ready to make a commitment to change oral health habits in the next 30 days and to set a target date.
preparation
What stage of change is this: change or modification of behaviors actually takes place
action
What stage of change is this: this individual has had 3-6 months of successful behavior change and is focusing on lifestyle modifications in order to avoid relapse and stabilize behavior change
maintenance
What stage of change is this: individual and clinician asses the reason & discuss how the patient might handle the situation differently the next time.
relapse
a patient believes some force from the environment is in control of their behavior
external locus of control
the belief a person is in control of his/her own behavior
internal locus of control
Demonstrating denial and/or active resistance to change is consistant with the ___________ stage of change.
precontemplative
Patients in the preparation stage of change are ready to set a target date within ______ month(s).
1
What part of an appointment would this fall under?

examine tissues for signs of inflammation
assessment
What part of an appointment would this fall under?

examine teeth for carious lesions
assessment
What part of an appointment would this fall under?

utilize radiographs for signs of periodontal disease or carious areas
assessment
What part of an appointment would this fall under?

perform PASS
assessment
What part of an appointment would this fall under?

perform PSR and periodontal probing if necessary
assessment
What part of an appointment would this fall under?

disclose the patient and perform a plaque index if necessary
assessment
What part of an appointment would this fall under?

allow the patient to perform his/her usual cleaning routine
assessment
What part of an appointment would this fall under?

Engage the patient in conversation regarding the frequency of brushing and use of other aids, floss, etc. Seek additional information on the patient's general awareness and concert for oral conditions
assessment
What part of an appointment would this fall under?

Idendify some short- and long-term goals
planning
What part of an appointment would this fall under?

Share the plan with the patient - are the goals acceptable? What goals does the patient have? Is the patient committed to the plan?
implementation
Accepted steps to keep in mind for patient instruction
small step size

active participation

immediate feedback

self-pacing
What part of an appointment would this fall under?

Measures progress toward attaining the goals that have been set
evaluation