Client Care reflections

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As part of my journey to achieving a successful career in the future, I know I must first take a step back and reflect. The Principles and Professionalism IV course at Niagara college as part of the Dental Hygiene program, has given out this assignment in order to

help me do just that!!! This assignment involves selecting and analyzing two of my client’s that I have struggled with, during their round of client care. Each client I have treated at the Niagara College Dental clinic has presented me with new experiences that will benefit me once I am in private practice. Although each client’s round of care was a good learning experience, there are two clients’ that I will be discussing for my assignment

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PART 1

Term 3 Client #8 , had a clear medical history that indicated no past or current health conditions. Her pharmaceutical record indicated that she was not taking any prescribed or over the counter medications, however she was using multivitamins. She was a DD2-1 and her oral status comprised of BI’s of 1, GI’s of 2 with fibrotic tissues, CI’s of 2 localized interproximal, GM’s of -1mm, 2mm, PPD’s of >4, CAL’s <3mm, low CRA, and drifting posterior teeth due to her sixes being removed at a young age. The goals that the client and I had decided upon included demonstrating knowledge of what is biofilm, the etiology of gingivitis and periodontitis and to demonstrate knowledge on the importance of removing biofilm from inter proximal surfaces. Our appointment plan consisted of OHC, this included using two tone disclosing agent, reviewing and discussing the findings. My client then demonstrated her new flossing and tooth brushing techniques and we had a discussion on the importance of regular dental/dental hygiene visits prior to debridement.

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Mrs.H was very vibrant and had a wonderful sense of humor. She and her husband were planning a trip to go and visit their grandchildren who lived some distance away. As our appointment went on Mrs. H had many questions in relation to her oral condition, such as “Do teeth move as we age? and what could be causing her gums to recede?”

I absolutely loved discussing OHI with this client. She was very open to all the new information and would voluntarily demonstrate her understanding during our conversation. It made me feel like I could really motivate Mrs. H to maintain a good oral health status by applying her newfound, knowledge along with her new oral hygiene aids. Our appointments at the Niagara College Dental Hygiene clinic have a specific order of how we proceed with our appointments. Firstly, we always do our medical history, pharmaceutical records and a sign in that consists of taking and recording the client’s vitals, a pre procedural rinse followed by an oral scan. Secondly, we always start with the first step of ADPIE, the assessments. One of our assessment tools used are radio graphs, that are prescribed by our DDS.

Once the DDS was finished assessing Mrs.H he wrote up her prescription for the radiographs that needed to be taken. I brought Mrs. H to the radiography room where I exposed a PA and BW’s, and we returned to my opratory. Once there I waited for the DDS to commence his DDS exam with my client. As we waited, I continued with my periodontal assessment. During this time my POD teacher had come to evaluate the quality of my radiographs. As we were looking over the quality together, the teacher had noticed that I was supposed to take a Panoramic image not a PA. Not only was the PA

not useful as it didn’t have the structures needed, it also not prescribed by the DDS. I was mortified, and then very concerned and upset with myself as I had breached ALARA (As Low as Reasonably Achievable).

As part of the CDHO Standards of practice the division of accountability needed to be applied. This would mean taking responsibility for and the appropriate steps towards informing and correcting errors in practice.

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On our second appointment I informed Mrs.H that I would have to take another radio graph, I was very embarrassed to have to explain that she would need to be exposed to another radio graph as the one taken previously didn’t have the structures the DDS needed in order to properly complete his exam. Luckily for me Mrs. H was not upset as I thought she would be and agreed to having another radio graph exposed. During the retake of the radio graph sweet Mrs. H reassured me I was doing a great job and that this one would turn out. Indeed, the retake was a success! I was so relieved. I continued with our appointment and finished her care.

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As I reflect and analyze this round of care, I came to the realization that yes, I had made a big mistake that warranted a critical error in clinic. However, despite my mistake I was proud of how efficient I was during all other aspects of the appointment. This was the first client I had finished in three appointments!

In order to ensure that this error doesn’t happen again and to ensure better clinical treatment, I have been utilizing the rad skills labs provided by Niagara College Dental Hygiene program. The DDS also help me by recommending that I work on my understanding of the rationale’s used in prescribing the images in the first place. Mrs. H was missing one of her eights and so a Panoramic would be appropriate for this, to detect caries especially inter proximal, Bite Wings would be used. I have gained an inundation of information from this one client experience. I am confident that this knowledge gained and applied will ensure a safe and effective second round of client care with Mrs.H