Client Care Reflection part 2

Communication was a major detriment to my care. Although the client and I went over the care plan, I feel I assumed and did not clarify what ultrasonic instrumentation would involve. Not only was I disappointed in myself for the lack of communication, I also felt I had failed to adhere to the CDHO Dental Hygiene standards of practice in the domain of responsibility. Responsibility according to the CDHO Dental Hygiene Standards of Practice states “Honoring the client’s rights and dignity by obtaining

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Term four Client # 5, had a very extensive medical history due to having past cardiovascular surgery, hypertension, diabetes and a mental disorder. Due to these conditions this client had a long pharmaceutical history. My client was a DD3-2 and his oral status comprised of BI’s of 2’s, GI’s of 2 with fibrotic tissues, CI’s of 1, GM’s of -2mm, PPD’s of >5, CAL’s <3mm, high CRA, polypharmacy, and missing teeth due to previous periodontal disease. The goals that the client and I had set out were one to understand the link between diabetes and periodontitis, and two to demonstrate an understanding of the importance of biofilm removal. Our appointment plan consisted of OHC, this included using two tone disclosing agent, reviewing and discussing the findings. My client then demonstrated his new flossing and tooth brushing techniques prior to my debridement.

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Mr. F, his wife and their teen daughter were all attending their hygiene appointments together at the Niagara College Dental clinic. They were each assigned to three different clinicians within the same POD. From the first moment of shaking his hand in the waiting room area, to walking him into my operatory, I knew I was going to enjoy getting know this client, as well as helping him with his oral health. Knowing that this would lead to an improvement of his over all health and wellness. Mr. F really enjoyed telling jokes and stories during our appointment’s. This was my first challenge as I was unsure at first on how to gain control of my appointment. I didn’t want to seem rude or unprofessional to my friendly client! I was able to solve this challenge by properly communicating what I needed to achieve that day and making him apart of every step, and learned how to redirect the conversation.

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My second challenge during his round of care came during our first debridement appointment. During this appointment I had planned on using my ultrasonic instruments to aid in removing debris within his deeper periodontal pockets. I put on my gown, mask/shield, and gloves, sat in my chair adjusted my position, and my light and began debridement. As soon as my tool went against his tooth’s surface, Mr. F jumped and shouted AHHHH! My heart skipped a beat as I was afraid that I had possibly caused tissue trauma. I instantly apologized to my client and asked him if he was ok. I checked the surrounding tissues of the oral cavity and found no trauma. The client had then mentioned he didn’t like the ultrasonic and didn’t want it to be used.

How could I have missed such an important piece of information?

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Communication was a major detriment to my care. Although the client and I went over the care plan, I feel I assumed and did not clarify what ultrasonic instrumentation would involve. Not only was I disappointed in myself for the lack of communication, I also felt I had failed to adhere to the CDHO Dental Hygiene standards of practice in the domain of responsibility. Responsibility according to the CDHO Dental Hygiene Standards of Practice states “Honouring the client’s rights and dignity by obtaining informed consent, respecting privacy and maintaining confidentiality.” Furthermore, I didn’t want to lose the great professional relationship my client and I had. I felt my mistake would cause Mr. F to not return due to a newfound dental anxiety caused by my performance.

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After his client care was over, I felt I had gained a wealth of knowledge when it comes to informed consent as well as client report. I could have improved my clients care by effectively communicating the appointment plan and not assume that the client had fully understood the procedure. Mr. F will be returning for a new round of continuing care and I plan to treat this client differently by ensuring he demonstrates an understanding of all information we share in order to truly provide client centered care and avoid any new dental anxieties.