The Changing Face of Dental Hygiene Practice: Expert clinician, skilled motivator and preventive specialist Speaker: Lil Caperila, RDH, BSDH, M.Ed. Lcaperila@premusa.com Course Outline: MODULE 1: Changing Trends in Clinical Practice I. Historic trends and changing roles in Dental Hygiene a. What impacts our future? b. Skills self-assessment survey (see attached survey - Handout A) c. Mid-level Providers defined (see attached chart Handout B) d. Creating your E-Portfolio i. Qualifications: resume, licensure, professional references ii. Practice contributions: 1. increased production, use of new products/procedures 2. Thank you notes from patients 3. Employer annual review/positive comments 4. List of technologies you have mastered iii. Professional Development 1. Continuing education programs you attended 2. Professional membership 3. Association offices held/volunteer opportunities iv. Community Services v. Presentations/Publications: to dental programs, K-12 schools, professional journals II. III. IV. Role of Technology: Screening and Electronic recording a. Periodontal assessment, probing and treatment planning b. Efficiency in exam, post-treatment evaluation and electronic documentation c. CRA: Caries Risk Assessments (CAMBRA, CDA Foundation and ADA CRA) i. Source for risk assessment downloads: Dental Caries: www.ada.org or www.cda.org Periodontal Disease: www.aap.org or www.collagenex.com CAMBRA (Caries Management By Risk Assessment) a. Comparing 2 case studies utilizing CAMBRA to guide treatment decisions b. Developing Treatment Protocol: (CAMBRA/Guidelines, source: CDA Journal Oct 2010, Vol.38) New issues Oct, Nov 2011 CDA Journal Implementing CAMBRA in Practice Minimally-invasive - Caries examination a. International Caries Detection and Assessment System (ICDAS) i. Assessment of disease activity using visual examination procedures ii. Reference: Evolution of Caries Diagnosis by Andrea Ferreira Zandona, DDS, MSD, PhD Dimensions in Dental Hygiene Journal, September 2011 Issue " *Addendum Charts C & D!"
b. Caries Detection Technology systems: i. Diagnodent ii. Caries ID iii. Spectra iv. SoproLIFE v. CarieScan vi. Canary System V. Fluoride & Calcium/Phosphate innovations * See Addendum Chart E a. Understanding the differences in various product chemistry/efficacy b. Chart reviews the mechanism of action, bioavailability/solubility and product technologies i. ACP ii. CPP-ACP iii. Novamin iv. TCP VI. Expanding Instrumentation Skills a. Ergonomic considerations for operator positioning and instrument choices b. Patient Care Set-ups: i. Diagnostic assessment of patient ii. Clinical symptoms, pain management and active vs. recare protocol iii. Selecting power or hand instruments? iv. New designs in scalers, curettes and files v. Maintaining Implants View products: www.premusa.com (links to - Dental, Instruments) MODULE 2: Effective Whitening Strategies for the Next Decade Dental Hygienist role in guiding esthetic improvements in the practice a. Demographics and professional guidance for success in safe bleaching i. Patient choices for success ii. Predicting best options based on type of stains and shade origin b. Challenges in OTC versus in-office or take-home choices i. Patient compliance c. Preventing and/or treating sensitivity d. Enamel microabrasion techniques (when necessary) e. Practice building and marketing for new patients " #"
MODULE 3: MOTIVATIONAL INTERVIEWING: A Positive Approach in Guiding Patients to Change! Reference: Motivational Interviewing in Health Care Helping patients change behavior. Rollnick, William R. Miller, and Christopher C. Butler: 2008 Guilford Press, NY Authors: Stephen www.guilford.com I. Goal: Convey just enough of the essential method of MI to make it accessible, learnable, useful and effective in healthcare practice II. Define Motivational Interviewing III. IV. Rationale %& Shift of treating acute illness to managing chronic illness '& How MI guides practitioner in helping patients change behavior/poor lifestyles Origin? %& Principles of Carl Rogers but introduced in 1983 '& Chronic illness trials tested MI in 1990 s for patient behavior changes (& Activate the patient s internal motivation to adhere to change/treatment!" Spirit of MI: i. Collaborative ii. Evocative iii. Honor patient autonomy #" Built on 4 Guiding Principles: RULE i. Resist Righting Reflex ii. Understand iii. Listen iv. Empower V. How it fits into dental/healthcare practice? $" Communication styles i. Following ii. Directing iii. Guiding %" Why MI Guiding works? " &" 3 CORE - Communication skills $"
i. Asking ii. Listening iii. Informing VI. Practicing skillful guiding %& Ask '& Inform (& Listen Understanding AMBIVALENCE: What do you listen for during patient dialog? VII. Listening for Change Talk to BEHAVIOR CHANGE Cues that imply the following degree of change stages: listen for wish, want, like to! $" Acronym for change talk is DARN i. Desire ii. Ability iii. Reasons iv. Need %" Final 2 stages: i. Commitment ii. Take Steps 1. Take gentle small steps and don t force the change! VIII. Role Play on Change Behavior in Dental Care Typical approach to how you discuss these scenarios? What can you do differently to apply MI principles/skills? IX. Asking Questions? %& Open vs. Closed-ended questions '& Don t apply TAG questions to good open-ended questions " )"
Seminar Worksheet The Changing Face of Dental Hygiene Describe how you envision a dental hygienist in 2024? List the skills you believe we will need to fulfill this model? Can you currently list 3 5 of your greatest skills as an oral healthcare professional? Do these skills fit the model you envision for the future? What do you see as our greatest impediment in achieving the future hygienist? Addendum Handout A
ICDAS Addendum Chart C
ICDAS Technologies Addendum Chart D
Addendum: Chart E Chemistry ACP Amorphous Calcium Phosphate ADA licensing CPP ACP Casein Phosphopeptide Amorphous Calcium Phosphate (Recaldent ) CSPS Calcium Sodium Phosphosilicate (Novamin ) TCP Beta Tri calcium Phosphate (Functionalized TCP) Mechanism of Action Specialized salt compounds No defined structure or crystalline structure Highly reactive Casein binds to tooth surface until ph is lowered/ acidic challenge frees ions Silica binds Ca/P until sodium elevates ph to free CA/P ions Blended beta tricalcium phosphate is insoluble crystalline form Solubility and Bioavailability Rapid delivery Highly soluble & Bioavailable Greater Fluor uptake Becomes soluble only during lowered ph/acidity Becomes soluble when sodium elevates and buffers ph Low to moderate rate of solubility Professional Products Enamel Pro: Prophy paste/acp NaF Varnish & Gel/ACP Day White/Nite White & Relief gel /ACP Arm & Hammer Complete Care /ACP MI Paste MI Paste Plus MI NaF Varnish (all w/recaldent) Tooth Mousse (Intl) Cadbury Trident NUPRO NuSolutions Prophy paste NUPRO Sensodyne 5,000ppm Fluoride Topex ReNew Vanish Fvarnish with TCP Clinpro 950 Clinpro 5000