Additional Information
Book Details
Abstract
Emphasizing evidence-based research and clinical competencies, Dental Hygiene: Theory and Practice, 4th Edition, provides easy-to-understand coverage of the dental hygienist’s roles and responsibilities in today’s practice. It offers a clear approach to science and theory, a step-by-step guide to core dental hygiene procedures, and realistic scenarios to help you develop skills in decision-making. New chapters and content focus on evidence-based practice, palliative care, professional issues, and the electronic health record. Written by Michele Leonardi Darby, Margaret M. Walsh, and a veritable Who’s Who of expert contributors, Dental Hygiene follows the Human Needs Conceptual Model with a focus on client-centered care that takes the entire person into consideration.
- UNIQUE! Human Needs Conceptual Model framework follows Maslow’s human needs theory, helping hygienists treat the whole patient — not just specific diseases.
- Comprehensive coverage addresses the need-to-know issues in dental hygiene — from the rationale behind the need for dental hygiene care through assessment, diagnosis, care planning, implementation, pain and anxiety control, the care of individuals with special needs, and practice management.
- Step-by-step procedure boxes list the equipment required and the steps involved in performing key procedures. Rationales for the steps are provided in printable PDFs online.
- Critical Thinking exercises and Scenario boxes encourage application and problem solving, and help prepare students for the case-based portion of the NBDHE.
- Client Education boxes list teaching points that the dental hygienist may use to educate clients on at-home daily oral health care.
- High-quality and robust art program includes full-color illustrations and clinical photographs as well as radiographs to show anatomy, complex clinical procedures, and modern equipment.
- Legal, Ethical, and Safety Issues boxes address issues related to risk prevention and management.
- Expert authors Michele Darby and Margaret Walsh lead a team of international contributors consisting of leading dental hygiene instructors, researchers, and practitioners.
- NEW chapters on evidence-based practice, the development of a professional portfolio, and palliative care provide research-based findings and practical application of topics of interest in modern dental hygiene care.
- NEW content addresses the latest research and best practices in attaining clinical competency, including nutrition and community health guidelines, nonsurgical periodontal therapy, digital imaging, local anesthesia administration, pharmacology, infection control, and the use of the electronic health record (EHR) within dental hygiene practice.
- NEW photographs and illustrations show new guidelines and equipment, as well as emerging issues and trends.
- NEW! Companion product includes more than 50 dental hygiene procedures videos in areas such as periodontal instrumentation, local anesthesia administration, dental materials manipulation, common preventive care, and more. Sold separately.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | cover | ||
| Dental Hygiene Procedures | IFC2 | ||
| CHAPTER 10: Medical Emergencies | IFC2 | ||
| CHAPTER 13: Vital Signs | IFC2 | ||
| CHAPTER 15: Extraoral and Intraoral Clinical Assessment | IFC2 | ||
| CHAPTER 16: Dentition Assessment | IFC2 | ||
| CHAPTER 17: Oral Hygiene Assessment: Soft and Hard Deposits | IFC2 | ||
| CHAPTER 18: Dental Caries Management by Risk Assessment | IFC2 | ||
| CHAPTER 19: Periodontal Risk Assessment | IFC2 | ||
| CHAPTER 22: Dental Hygiene Care Plan, Evaluation, and Documentation | IFC2 | ||
| CHAPTER 24: Mechanical Oral Biofilm Control: Interdental and Supplemental Self-Care Devices | IFC2 | ||
| CHAPTER 26: Hand-Activated Instrumentation | IFC2 | ||
| CHAPTER 27: Ultrasonic Instrumentation | IFC2 | ||
| CHAPTER 28: Root Morphology and Instrumentation Implications | IFC2 | ||
| CHAPTER 29: Management of Extrinsic and Intrinsic Stains | IFC2 | ||
| CHAPTER 31: Chemotherapy for Control of Periodontitis | IFC2 | ||
| CHAPTER 32: Acute Gingival and Periodontal Conditions, Lesions of Endodontic Origin, and Avulsed Teeth | IFC3 | ||
| CHAPTER 33: Caries Management: Fluoride and Nonfluoride Caries-Preventive Agents | IFC3 | ||
| CHAPTER 34: Pit and Fissure Sealants | IFC3 | ||
| CHAPTER 35: Nutritional Counseling | IFC3 | ||
| CHAPTER 37: Impressions, Study Casts, and Oral Appliances | IFC3 | ||
| CHAPTER 38: Restorative Therapy | IFC3 | ||
| CHAPTER 39: Dentinal Hypersensitivity Management | IFC3 | ||
| CHAPTER 40: Local Anesthesia | IFC3 | ||
| CHAPTER 41: Nitrous Oxide–Oxygen Analgesia | IFC3 | ||
| CHAPTER 42: Persons with Disabilities | IFC3 | ||
| CHAPTER 46: Human Immunodeficiency Virus Infection | IFC3 | ||
| CHAPTER 48: Persons with Autoimmune Diseases | IFC3 | ||
| CHAPTER 50: Respiratory Diseases | IFC3 | ||
| CHAPTER 56: Persons with Fixed and Removable Dental Prostheses | IFC3 | ||
| Endsheet 4 | IFC4 | ||
| Dental Hygiene, 4/e | i | ||
| Copyright page | ii | ||
| Dedication | iii | ||
| Contributors | iv | ||
| Preface | ix | ||
| Evidence-Based Knowledge—The Foundation of Dental Hygiene | ix | ||
| Human Needs Theory | ix | ||
| Terminology | ix | ||
| Textbook Format | ix | ||
| Glossary | x | ||
| New to This Edition | x | ||
| Evolve Companion Website | x | ||
| For Instructors | x | ||
| TEACH Instructor’s Resources Manual | x | ||
| Test Question Bank | x | ||
| Image Collection | x | ||
| For Students | x | ||
| Practice Quizzes | x | ||
| Competency-Based Evaluation Forms | x | ||
| Procedure Ordering Exercises | x | ||
| Full Glossary | xi | ||
| Web Resources | xi | ||
| Suggested Readings | xi | ||
| Supplemental Material | xi | ||
| Procedure Videos | xi | ||
| Acknowledgments | xii | ||
| Table of Contents | xiii | ||
| Interactive Review – Dental Hygiene | e1 | ||
| I Conceptual Foundations | 1 | ||
| online_IR_Part 1 text | e2 | ||
| 1 The Dental Hygiene Profession | 1 | ||
| Competencies | 1 | ||
| What Is Dental Hygiene? | 1 | ||
| Who Is the Dental Hygienist? | 1 | ||
| What Is the Dental Hygiene Process of Care? | 1 | ||
| Roles | 2 | ||
| Clinician | 2 | ||
| Corporate Dental Hygienist | 3 | ||
| Public Health | 3 | ||
| Researcher | 3 | ||
| Educator | 3 | ||
| Administrator | 5 | ||
| Entrepreneur | 5 | ||
| Dental Hygiene’s Paradigm | 5 | ||
| Conceptual Models | 6 | ||
| Occupational Model versus the Professional Model | 6 | ||
| Human Needs Conceptual Model | 6 | ||
| Collaborative Practice Model | 6 | ||
| The Dental Hygienist in Interprofessional Practice | 7 | ||
| Professional Regulation | 8 | ||
| Accreditation | 8 | ||
| Standards of Dental Hygiene Practice | 8 | ||
| Standards in the United States | 8 | ||
| Standards in Canada | 8 | ||
| Practice Acts and Licensure | 8 | ||
| The Dental Hygiene National Board | 8 | ||
| Professional Dental Hygiene Organizations | 9 | ||
| American Dental Hygienists’ Association | 9 | ||
| National Dental Hygienists’ Association | 9 | ||
| Canadian Dental Hygienists’ Association | 9 | ||
| International Federation of Dental Hygienists | 9 | ||
| Workforce Model for Dental Hygienists | 10 | ||
| Levels of Supervision | 10 | ||
| Independent Practitioner or Independent Contractor | 10 | ||
| The Advanced Dental Hygiene Practitioner | 10 | ||
| Client Education Tips | 11 | ||
| Legal, Ethical, and Safety Issues | 11 | ||
| Key Concepts | 11 | ||
| Critical Thinking Exercises | 12 | ||
| References | 12 | ||
| Evolve Resources | 12 | ||
| 2 Human Needs Theory and Dental Hygiene Care | 13 | ||
| Competencies | 13 | ||
| Background | 13 | ||
| Maslow’s Hierarchy of Needs | 13 | ||
| Human Needs Conceptual Model of Dental Hygiene | 14 | ||
| Concept 1: Client | 14 | ||
| Concept 2: Environment | 14 | ||
| Concept 3: Health and Oral Health | 14 | ||
| Concept 4: Dental Hygiene Actions | 14 | ||
| Dental Hygiene’s Eight Human Needs | 17 | ||
| Protection from Health Risks | 17 | ||
| Assessment | 17 | ||
| Implications for Dental Hygiene Care | 18 | ||
| Freedom from Fear and Stress | 18 | ||
| Assessment | 18 | ||
| Implications for Dental Hygiene Care | 19 | ||
| Freedom from Pain | 20 | ||
| II Preparation for the Appointment | 91 | ||
| online_IR_Part 2 text | e3 | ||
| 8 The Dental Hygiene Care Environment | 91 | ||
| Competencies | 91 | ||
| Settings | 91 | ||
| Private Practice | 91 | ||
| Office Design | 91 | ||
| Business Area | 91 | ||
| Dental Hygiene Treatment Area | 91 | ||
| Floor Plan | 91 | ||
| Stools and Chairs | 91 | ||
| The Dental Unit | 91 | ||
| Structural Fixtures | 94 | ||
| Instrument Recirculation Area (see Chapter 9 on Infection Control) | 95 | ||
| Equipment Maintenance | 95 | ||
| Radiographic Equipment | 95 | ||
| Darkroom or Radiograph Processing Area | 96 | ||
| Dental Laboratory | 96 | ||
| Dental Hygiene Care Facility (College Setting) | 97 | ||
| Hospital Setting | 98 | ||
| Mobile Dental Facility | 98 | ||
| Client Education Tips | 98 | ||
| Legal, Ethical, and Safety Issues | 99 | ||
| Key Concepts | 100 | ||
| Critical Thinking Exercises | 100 | ||
| Bibliography | 100 | ||
| Evolve Resources | 100 | ||
| 9 Infection Control | 101 | ||
| Competencies | 101 | ||
| Standard Precautions and Basic Infection-Control Concepts | 101 | ||
| Infection-Control Model | 102 | ||
| Government Agencies and Infection Control | 102 | ||
| Standard of Care | 102 | ||
| Four Principles of Infection Control | 103 | ||
| Principle 1: Take Action to Stay Healthy | 103 | ||
| Principle 2: Avoid Contact with Blood and Other Infectious Body Substances | 103 | ||
| Principle 3: Make Client Care Items (Dental Instruments, Devices, and Equipment) Safe for Use | 103 | ||
| Principle 4: Limit the Spread of Blood and Other Infectious Body Substances | 103 | ||
| Strategies to Prevent Disease Transmission: Take Action to Stay Healthy | 103 | ||
| Immunizations for Vaccine-Preventable Diseases | 103 | ||
| Work Restrictions | 105 | ||
| Standard Precautions | 107 | ||
| Transmission-Based Precautions | 107 | ||
| Health History | 108 | ||
| Engineering Controls | 108 | ||
| Work Practice Controls | 109 | ||
| Personal Protective Equipment | 109 | ||
| Eye and Face Protection | 109 | ||
| Masks | 109 | ||
| Protective Clothing | 110 | ||
| Gloves | 110 | ||
| Hand Protection and Hand Hygiene | 110 | ||
| Limit the Spread of Blood and Other Infectious Bodies | 111 | ||
| Environmental Surface Disinfection | 111 | ||
| Cross-Contamination | 111 | ||
| Sterilization and Sterility Assurance—Make Client Care Items Safe for Use | 113 | ||
| Instrument Classification | 113 | ||
| Heat Methods of Sterilization | 113 | ||
| Chemical Disinfectants and Sterilants | 114 | ||
| Sterility Assurance | 114 | ||
| Exposure Prevention and Management | 115 | ||
| Steps for Risk Reduction | 115 | ||
| Risk Reduction Protocols | 115 | ||
| Postexposure Management | 115 | ||
| Step 1 | 116 | ||
| Step 2 | 116 | ||
| Step 3 | 116 | ||
| Step 4 | 116 | ||
| Step 5 | 116 | ||
| Exposure Follow-Up Guidelines | 117 | ||
| Risk of Exposure | 118 | ||
| Risk of Infection | 118 | ||
| Client Education Tips | 118 | ||
| Legal, Ethical, and Safety Issues | 118 | ||
| Key Concepts | 119 | ||
| Critical Thinking Exercises | 119 | ||
| Bibliography | 119 | ||
| Evolve Resources | 119 | ||
| 10 Medical Emergencies | 120 | ||
| Competencies | 120 | ||
| Preventing Medical Emergencies | 120 | ||
| Office Personnel and Environment Preparation | 120 | ||
| Client Assessment | 120 | ||
| Anxiety Recognition and Management | 120 | ||
| Direct Observation | 121 | ||
| Stress Reduction Protocols | 121 | ||
| Recognition of Unresponsiveness | 121 | ||
| Basic Life Support | 122 | ||
| Recognition of Unresponsiveness | 124 | ||
| Terminate Dental Hygiene Care, Summon Assistance, and Position the Client | 124 | ||
| Rescue Breathing and Bag Mask Ventilation | 127 | ||
| Resuscitation Masks | 127 | ||
| Mouth-to-Mask Ventilation | 127 | ||
| Oxygen-Enriched Ventilation | 128 | ||
| Cardiac Arrest | 128 | ||
| The Heart’s Electrical System | 129 | ||
| Effective Emergency Response | 131 | ||
| Early Recognition and Cardiopulmonary Resuscitation | 131 | ||
| Use of an Automated External Defibrillator | 132 | ||
| Use of an AED for Infants | 132 | ||
| Obstructed Airway | 132 | ||
| Oxygen Administration | 134 | ||
| Basic Dental Emergency Kit | 137 | ||
| Management of Specific Medical Emergencies | 138 | ||
| Client Education Tips | 138 | ||
| Legal, Ethical, and Safety Issues | 142 | ||
| Key Concepts | 142 | ||
| Critical Thinking Exercises | 143 | ||
| References | 143 | ||
| Acknowledgment | 143 | ||
| Evolve Resources | 143 | ||
| 11 Ergonomics | 144 | ||
| Competencies | 144 | ||
| Principles of Ergonomics | 144 | ||
| Environmental Factors | 144 | ||
| Equipment Factors | 144 | ||
| Dental Unit | 144 | ||
| Clinician’s Chair | 144 | ||
| Cords on Powered Instruments | 144 | ||
| Performance Factors | 144 | ||
| Five Categories of Motion | 144 | ||
| Grasp and Fulcrum | 145 | ||
| Fulcrum and Hand Stabilization | 147 | ||
| Wrist Motion During Instrument Activation | 147 | ||
| Appointment Management | 147 | ||
| Client-Clinician Positioning Factors | 148 | ||
| Position of the Clinician | 148 | ||
| Wrist, Arm, Elbow, and Shoulder Position | 148 | ||
| Back and Neck Support | 148 | ||
| Instrument Factors | 148 | ||
| Hand Instrument Cutting Edge Sharpness | 148 | ||
| Ergonomic Instrument Handles | 150 | ||
| Balanced Instruments | 150 | ||
| Mechanized and Vibrating Instruments | 151 | ||
| Dental Mirrors | 151 | ||
| Physical Exercise | 151 | ||
| Strengthening Exercises | 151 | ||
| Chairside Stretching Exercises | 151 | ||
| Repetitive Strain Injuries | 151 | ||
| Hand, Wrist, and Finger Injuries | 151 | ||
| Carpal Tunnel Syndrome | 151 | ||
| Signs and Symptoms | 153 | ||
| Risk Factors | 153 | ||
| Chairside Preventive Measures | 153 | ||
| Assessing Symptoms | 154 | ||
| Treatment | 154 | ||
| Thoracic Outlet Compression | 154 | ||
| III Assessments | 162 | ||
| online_IR_Part 3 text | e4 | ||
| 12 The Health History | 162 | ||
| Competencies | 162 | ||
| Purpose of the Health History | 162 | ||
| Health History Assessment | 162 | ||
| Documentation of Written Health History | 162 | ||
| Health History Oral Interview | 162 | ||
| Patient-Centered Interviewing | 163 | ||
| Interview Setting | 164 | ||
| Verbal and Nonverbal Communication | 164 | ||
| Completing a Comprehensive Health History | 166 | ||
| Legal and Ethical Issues Related to the Health History | 166 | ||
| Decision Making After the Health History Is Obtained | 179 | ||
| Tools to Interpret Client Data and Degree of Medical Risk | 179 | ||
| American Society of Anesthesiologists’ Physical Status Classification System | 179 | ||
| Assessment of Functional Capacity | 179 | ||
| Use of Drug References | 180 | ||
| Prophylactic Antibiotic Premedication for Prevention of Infective Endocarditis | 181 | ||
| Prophylactic Antibiotic Premedication for Prevention of Prosthetic Joint Infections | 182 | ||
| Antibiotic Premedication Dosage Regimen Guidelines | 182 | ||
| Physician Consultation and Referral | 183 | ||
| Referral | 184 | ||
| Client Education Tips | 184 | ||
| Legal, Ethical, and Safety Issues | 184 | ||
| Key Concepts | 188 | ||
| Critical Thinking Exercises | 188 | ||
| References | 189 | ||
| Acknowledgment | 189 | ||
| Evolve Resources | 189 | ||
| 13 Vital Signs | 190 | ||
| Competencies | 190 | ||
| Vital Signs | 190 | ||
| Body Temperature | 190 | ||
| Body Temperature Measurement Sites | 191 | ||
| Thermometers | 191 | ||
| Decision Making Based on Observed Temperature | 193 | ||
| Pulse | 194 | ||
| Pulse Measurement Sites | 194 | ||
| Decision Making Based on Observed Pulse Rate | 194 | ||
| Respiration | 195 | ||
| Respiration Measurement Site | 195 | ||
| Decision Making Based on Observed Respiration | 195 | ||
| Blood Pressure | 196 | ||
| Decision Making Based on Observed Blood Pressure | 196 | ||
| Blood Pressure Equipment and Measurement | 196 | ||
| Sphygmomanometer (Blood Pressure Cuff) | 196 | ||
| Stethoscope | 199 | ||
| Client Education Tips | 200 | ||
| Legal, Ethical, and Safety Issues | 201 | ||
| Key Concepts | 202 | ||
| Critical Thinking Exercises | 203 | ||
| References | 203 | ||
| Evolve Resources | 203 | ||
| 14 Pharmacologic History | 204 | ||
| Competencies | 204 | ||
| Comprehensive Pharmacologic History | 204 | ||
| Medication List | 204 | ||
| Eight Fundamental Assessment Questions | 204 | ||
| Question 1: Why Is the Client Taking Medication? | 204 | ||
| Question 2: What Are the Adverse Effects of This Drug? | 205 | ||
| Question 3: Are There Potential Drug Interactions? | 207 | ||
| Question 4: Do These Findings Suggest a Problem with Drug Dosage? | 207 | ||
| Question 5: How Is This Client Managing Medications? | 208 | ||
| Question 6: Will Any Oral Side Effects of This Medication Require Intervention? | 208 | ||
| Question 7: Are Symptoms Reported During the Client’s Health History Interview Caused by a Medical Condition, or Are They Drug Side Effects? | 210 | ||
| Question 8: Given the Pharmacologic History and Other Assessment Data, What Are the Risks of Treating This Client? | 210 | ||
| Client Education Tips | 211 | ||
| Legal, Ethical, and Safety Issues | 211 | ||
| Key Concepts | 211 | ||
| Critical Thinking Exercises | 211 | ||
| References | 213 | ||
| Evolve Resources | 213 | ||
| 15 Extraoral and Intraoral Clinical Assessment | 214 | ||
| Competencies | 214 | ||
| Clinical Assessment | 214 | ||
| Extraoral Clinical Assessment | 214 | ||
| Overall Client Evaluation | 214 | ||
| Head, Face, and Neck Evaluation | 215 | ||
| Lymph Nodes | 215 | ||
| Head and Neck Regions | 215 | ||
| Parietal and Occipital Regions | 216 | ||
| Temporal and Auricular Regions | 216 | ||
| Frontal, Orbital, and Nasal Regions | 217 | ||
| Infraorbital, Zygomatic, and Buccal Regions | 217 | ||
| Mental Region | 218 | ||
| Submandibular and Submental Triangles | 219 | ||
| Anterior and Posterior Cervical Triangles | 220 | ||
| Anterior Midline Cervical Region | 220 | ||
| Intraoral Clinical Assessment | 220 | ||
| Oral Region | 220 | ||
| Palate and Pharynx | 226 | ||
| Tongue | 227 | ||
| Floor of the Mouth | 227 | ||
| Describing and Documenting Significant Findings | 231 | ||
| Location and Distribution | 231 | ||
| Size and Shape | 233 | ||
| Color | 235 | ||
| Texture | 235 | ||
| Attachment and Depth | 235 | ||
| Consistency | 235 | ||
| Mobility | 236 | ||
| Symptomatology | 236 | ||
| Skin Cancer | 236 | ||
| Oral and Oropharyngeal Cancer | 236 | ||
| Client Self-Examination | 238 | ||
| Early Detection Discussion | 238 | ||
| Oral and Transepithelial Cytology | 238 | ||
| Tissue Reflectance and Autofluorescence for Identification of Abnormal Oral Tissue | 240 | ||
| Toluidine Blue Dye | 240 | ||
| Biopsy | 240 | ||
| Client Education Tips | 240 | ||
| Legal, Ethical, and Safety Issues | 240 | ||
| Key Concepts | 241 | ||
| Critical Thinking Exercises | 241 | ||
| References | 242 | ||
| Evolve Resources | 243 | ||
| 16 Dentition Assessment | 244 | ||
| Competencies | 244 | ||
| Documentation | 244 | ||
| Electronic Health Record | 244 | ||
| Electronic-Based Charting | 244 | ||
| Quadrant and Sextant Classification | 245 | ||
| Quadrants | 245 | ||
| Sextants | 245 | ||
| Tooth Surfaces and Zones | 245 | ||
| Tooth Divisions into Thirds | 245 | ||
| Types of Teeth | 245 | ||
| Tooth Numbering Systems | 245 | ||
| Universal Numbering System | 249 | ||
| International Numbering System (Federation Dentaire International) | 250 | ||
| Developmental Anomalies | 250 | ||
| Anomalies of the Dental Tissues | 260 | ||
| Anomalies of Enamel Formation: Enamel Dysplasia | 260 | ||
| Acquired Tooth Damage | 260 | ||
| Dental Caries | 260 | ||
| Types of Dental Caries | 261 | ||
| Rampant Caries | 261 | ||
| Early Childhood Caries | 261 | ||
| Chronic Caries | 262 | ||
| Arrested Caries | 263 | ||
| Recurrent Caries | 263 | ||
| Types of Carious Lesions by Location | 263 | ||
| Pit and Fissure Caries | 263 | ||
| Proximal Caries | 263 | ||
| Smooth Surface Caries | 263 | ||
| Root Caries | 263 | ||
| Pulpal Damage | 263 | ||
| Classification of Dental Caries and Restorations | 264 | ||
| Black’s Classification System | 264 | ||
| The Complexity Classification | 264 | ||
| Nomenclature | 264 | ||
| Tooth Assessment and Detection of Signs of Dental Caries | 264 | ||
| Clinical Assessment | 264 | ||
| Radiographic Assessment | 266 | ||
| Client Symptom Assessment | 268 | ||
| Dentition and Periodontal Charting | 269 | ||
| Occlusion | 269 | ||
| Centric Occlusion | 274 | ||
| Overjet | 274 | ||
| Overbite | 276 | ||
| Centric Relation | 277 | ||
| Contact Areas | 277 | ||
| Normal Occlusion | 277 | ||
| Malocclusion | 277 | ||
| Class I Malocclusion | 277 | ||
| Class II Malocclusion | 277 | ||
| Class III Malocclusion | 279 | ||
| Primary Occlusion | 280 | ||
| Parafunctional Habits | 280 | ||
| Trauma from Occlusion | 280 | ||
| Client Education Tips | 280 | ||
| Legal, Ethical, and Safety Issues | 280 | ||
| Key Concepts | 280 | ||
| Critical Thinking Exercises | 281 | ||
| References | 281 | ||
| Acknowledgment | 281 | ||
| Evolve Resources | 281 | ||
| 17 Oral Hygiene Assessment: | 282 | ||
| Competencies | 282 | ||
| Oral Hygiene Assessment | 282 | ||
| Assessment Tools | 282 | ||
| Concepts for Oral Hygiene Assessment | 282 | ||
| Oral Deposits | 283 | ||
| Oral Biofilm | 283 | ||
| Microorganisms Within Oral Biofilm | 284 | ||
| Supragingival Microorganisms | 284 | ||
| Subgingival Microorganisms | 284 | ||
| Stages of Oral Biofilm Formation | 284 | ||
| Initial Adherence | 285 | ||
| Lag Phase | 285 | ||
| Rapid Growth Bacterial Colonization | 285 | ||
| Steady State and Detachment | 286 | ||
| Clinical Assessment of Oral Biofilm | 286 | ||
| Disclosing Agents | 286 | ||
| Assessment | 287 | ||
| Tooth Stains | 287 | ||
| Dental Calculus | 288 | ||
| Supragingival Calculus | 288 | ||
| Subgingival Calculus | 289 | ||
| Calculus Formation | 290 | ||
| Calculus Composition | 290 | ||
| Materia Alba and Food Debris | 290 | ||
| Skill, Motivation, and Compliance | 291 | ||
| Oral Hygiene Indices | 291 | ||
| Indices Used for Assessing Oral Deposits | 291 | ||
| Record Keeping and Documentation | 292 | ||
| Client Education Tips | 292 | ||
| Legal, Ethical, and Safety Issues | 292 | ||
| Key Concepts | 293 | ||
| Critical Thinking Exercises | 293 | ||
| Bibliography | 293 | ||
| Acknowledgment | 293 | ||
| Evolve Resources | 293 | ||
| 18 Dental Caries Management by Risk Assessment | 294 | ||
| Competencies | 294 | ||
| Dental Caries: a Continuing Health Issue | 294 | ||
| Review of Dental Caries Process | 294 | ||
| Demineralization | 294 | ||
| Remineralization | 295 | ||
| The White Spot Lesion | 295 | ||
| The Caries Balance | 295 | ||
| Dental Caries Risk Assessment for CLIENTS Age 6 through Adult | 296 | ||
| Caries Disease Indicators | 296 | ||
| Caries Risk Factors | 296 | ||
| Caries Protective Factors | 296 | ||
| Use of the Caries Risk Assessment Form | 297 | ||
| Salivary Flow Rate Test | 299 | ||
| Caries Bacteria Testing | 299 | ||
| Dental Caries Risk Assessment for Children from 0 to 5 Years of Age1 | 299 | ||
| Parent Interview | 301 | ||
| Examination of the Child | 301 | ||
| Assignment of Caries Risk Level | 302 | ||
| Individualized Treatment Based on Skill Level | 302 | ||
| Bacterial Culture | 302 | ||
| Individualized Homecare Recommendations | 302 | ||
| Caries Management | 302 | ||
| Fluoride Therapies | 303 | ||
| Primary Mechanisms of Fluoride Action | 303 | ||
| Inhibition of Demineralization | 303 | ||
| Enhancement of Remineralization | 303 | ||
| Inhibition of Plaque Bacteria | 303 | ||
| Topical Fluoride | 303 | ||
| Self-Applied Dentifrices | 303 | ||
| Self-Applied Daily Fluoride Mouth Rinses | 306 | ||
| Professionally Applied Fluoride (In-Office Administration) | 307 | ||
| Gels | 307 | ||
| Varnishes | 307 | ||
| Client Selection | 307 | ||
| Product Selection | 307 | ||
| Chlorhexidine as an Antibacterial for Dental Caries | 307 | ||
| Remineralization Products | 308 | ||
| Other Antibacterial Therapeutics | 308 | ||
| Xylitol | 308 | ||
| Sodium Bicarbonate | 308 | ||
| Client Education Tips | 309 | ||
| Legal, Ethical, and Safety Issues | 310 | ||
| Key Concepts | 310 | ||
| Critical Thinking Exercises | 311 | ||
| References | 311 | ||
| Evolve Resources | 312 | ||
| Acknowledgement | 312 | ||
| 19 Periodontal and Risk Assessment | 313 | ||
| Competencies | 313 | ||
| Risk Assessment Defined | 313 | ||
| Risk Factors | 313 | ||
| Modifiable (Mutable) Risk Factors | 313 | ||
| Smoking | 313 | ||
| Diabetes Mellitus | 314 | ||
| Specific Bacterial Pathogens | 314 | ||
| Poor Oral Self-Care | 314 | ||
| Osteoporosis | 314 | ||
| Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome | 314 | ||
| Stress | 315 | ||
| Bleeding on Probing | 315 | ||
| Medications | 315 | ||
| Local Contributing Factors | 315 | ||
| Nonmodifiable (Nonmutable) Risk Factors | 316 | ||
| History of Periodontitis | 316 | ||
| Age | 316 | ||
| Gender and Race | 316 | ||
| Genetic Disorders | 316 | ||
| Genetic Marker | 316 | ||
| Clinical Application of Risk Assessment | 316 | ||
| Periodontal Assessment Instruments | 318 | ||
| Periodontal Screening and Recording | 319 | ||
| Healthy Periodontium | 319 | ||
| Gingiva | 319 | ||
| Gingival Sulcus | 319 | ||
| Attached Gingiva | 319 | ||
| Gingival Papilla | 319 | ||
| Alveolar Mucosa | 321 | ||
| Junctional Epithelium | 321 | ||
| Gingival Crevicular Fluid | 321 | ||
| Clinical Appearance of Gingiva | 321 | ||
| Healthy Gingiva | 321 | ||
| Cementum | 321 | ||
| Periodontal Ligament | 321 | ||
| Alveolar Bone | 321 | ||
| Diseased Periodontium | 321 | ||
| Gingivitis | 324 | ||
| Periodontitis | 324 | ||
| Immunopathology | 329 | ||
| Signs of Gingival Disease | 330 | ||
| Clinical Signs of Inflammation (Gingivitis) | 330 | ||
| Color Change. | 330 | ||
| Bleeding on Probing. | 330 | ||
| Swelling or Edema. | 332 | ||
| Changes in Texture and Contour. | 332 | ||
| Interdental Papillae Changes. | 332 | ||
| Exudate. | 333 | ||
| Documentation of the Clinical Gingival Assessment | 333 | ||
| Signs of Disease Progression (Periodontitis) | 333 | ||
| Periodontal Pocket | 333 | ||
| Gingival Recession | 334 | ||
| Clinical Attachment Level | 335 | ||
| Relative Attachment Level | 335 | ||
| Furcation Involvement | 335 | ||
| Tooth Mobility | 335 | ||
| Fremitus | 336 | ||
| Occlusal Traumatism | 336 | ||
| Mucogingiva Conditions | 338 | ||
| Inadequate Attached Gingiva | 338 | ||
| Radiographic Assessment | 338 | ||
| Clinical Use of Radiographs | 338 | ||
| Selecting Types and Techniques | 338 | ||
| Radiographic Interpretation | 339 | ||
| Furcation Involvement | 340 | ||
| Limitations of Radiographs | 341 | ||
| Digital Radiography | 343 | ||
| Assessment of Periodontal Disease Activity | 345 | ||
| Measurement of Attachment Loss | 345 | ||
| Clinical Signs of Inflammation | 345 | ||
| Supplemental Diagnostic Tests | 345 | ||
| Salivary Diagnostics | 345 | ||
| Microbiologic Cultural Analysis | 345 | ||
| Immunologic Methods | 345 | ||
| Periodontal Indices | 345 | ||
| Indices Used in Client Care | 345 | ||
| Indices Used in Research | 347 | ||
| Documentation and Record Keeping | 348 | ||
| Documentation | 348 | ||
| Record-Keeping Formats | 348 | ||
| Decision-Making Matrix | 348 | ||
| Client Education Tips | 350 | ||
| Legal, Ethical, and Safety Issues | 350 | ||
| Key Concepts | 352 | ||
| Critical Thinking Exercises | 352 | ||
| References | 353 | ||
| Evolve Resources | 353 | ||
| 20 Potential Impact of Periodontal Infections on Overall General Health | 354 | ||
| Competencies | 354 | ||
| Background | 354 | ||
| Periodontal Diseases and Common Medical Conditions | 354 | ||
| Coronary Heart Disease (Atherosclerosis) | 354 | ||
| Nonhemorrhagic (Ischemic) Stroke | 355 | ||
| Pregnancy Complications and Outcomes | 355 | ||
| Diabetes Mellitus | 357 | ||
| Pulmonary Diseases | 358 | ||
| Neurologic Diseases | 358 | ||
| Gastrointestinal Diseases and Cancer | 358 | ||
| Client Education Tips | 359 | ||
| Legal, Ethical, and Safety Issues | 359 | ||
| Key Concepts | 359 | ||
| References | 359 | ||
| Evolve Resources | 360 | ||
| IV Critical Thinking in Dental Hygiene Practice | 361 | ||
| online_IR_Part 4 text | e5 | ||
| 21 Dental Hygiene Diagnosis | 361 | ||
| Competencies | 361 | ||
| Diagnosis Defined | 361 | ||
| Dental Hygiene Diagnosis | 361 | ||
| Dental Hygiene Diagnosis versus Dental Diagnosis | 362 | ||
| Dental Hygiene Diagnostic Classifications | 362 | ||
| Dental Hygiene Diagnostic Process | 362 | ||
| Synthesis, Analysis, and Interpretation of Assessment Data | 362 | ||
| Using Standards to Validate Diagnoses | 366 | ||
| Recognizing Patterns | 366 | ||
| Identifying Unmet Human Needs | 366 | ||
| Identifying Strengths (Protective Factors) | 368 | ||
| Formulating and Validating Dental Hygiene Diagnoses | 368 | ||
| Writing Dental Hygiene Diagnostic Statements | 368 | ||
| Errors in Writing a Dental Hygiene Diagnostic Statement | 370 | ||
| Validation of the Dental Hygiene Diagnosis | 370 | ||
| Outcomes of Dental Hygiene Diagnoses | 371 | ||
| Client Education Tips | 372 | ||
| Legal, Ethical, and Safety Issues | 372 | ||
| Key Concepts | 372 | ||
| Critical Thinking Exercises | 372 | ||
| References | 376 | ||
| Evolve Resources | 376 | ||
| 22 Dental Hygiene Care Plan, Evaluation, and Documentation | 377 | ||
| Competencies | 377 | ||
| Planning | 377 | ||
| Dental Treatment Plan | 377 | ||
| Dental Hygiene Care Plan | 377 | ||
| Sequence of Dental Hygiene Care Plan Development | 380 | ||
| Linking the Diagnosis and the Care Plan | 380 | ||
| Establishing Priorities | 380 | ||
| Setting Goals | 381 | ||
| Writing Client-Centered Goals | 381 | ||
| Involving the Client | 382 | ||
| Selecting Dental Hygiene Interventions | 382 | ||
| Appointment Schedule | 383 | ||
| Care Plan Presentation | 383 | ||
| Informed Consent | 384 | ||
| Informed Refusal | 385 | ||
| Evaluation | 386 | ||
| Goal of Evaluation | 386 | ||
| Ongoing Monitoring | 386 | ||
| Evaluation of Client-Centered Goals | 387 | ||
| Factors Influencing Client Goal Attainment | 387 | ||
| Modifying or Terminating the Care Plan | 388 | ||
| Dental Hygiene Prognosis and Continued Care | 388 | ||
| Outcome at Continued-Care Visit | 389 | ||
| Documentation | 390 | ||
| Client Education Tips | 392 | ||
| Legal, Ethical, and Safety Issues | 392 | ||
| Key Concepts | 395 | ||
| Critical Thinking Exercises | 396 | ||
| Client Profile 1 | 396 | ||
| Client Profile 2 | 396 | ||
| References | 396 | ||
| Evolve Resources | 396 | ||
| V Implementation | 397 | ||
| online_IR_Part 5 text | e6 | ||
| 23 Toothbrushing | 397 | ||
| Competencies | 397 | ||
| Manual Toothbrushes | 397 | ||
| Parts of the Toothbrush | 397 | ||
| Toothbrush Filament Design | 397 | ||
| Toothbrush Bristle Wear | 398 | ||
| Power Toothbrushes | 398 | ||
| Toothbrushing Instruction | 399 | ||
| Toothbrushing Duration and Frequency | 399 | ||
| Toothbrushing Force (Pressure) | 400 | ||
| Toothbrushing Methods | 400 | ||
| Soft- and Hard-Tissue Lesions | 402 | ||
| Soft-Tissue Lesions | 402 | ||
| Hard-Tissue Lesions | 403 | ||
| Tongue Cleansing | 403 | ||
| Toothbrush Contamination | 403 | ||
| The Dental Hygiene Process of Care and Toothbrushing | 403 | ||
| Client Education Tips | 404 | ||
| Legal, Ethical, and Safety Issues | 404 | ||
| Key Concepts | 404 | ||
| Critical Thinking Exercises | 405 | ||
| References | 405 | ||
| Acknowledgment | 405 | ||
| Evolve Resources | 405 | ||
| 24 Mechanical Oral Biofilm Control: Interdental and Supplemental Self-Care Devices | 406 | ||
| Competencies | 406 | ||
| Selecting Self-Care Devices | 406 | ||
| Types of Interdental and Supplemental Self-Care Devices: Nonpowered | 406 | ||
| Dental Floss and Tape | 407 | ||
| Unwaxed and Waxed Floss and Dental Tape | 407 | ||
| Braided and Tufted Floss | 409 | ||
| String Flossing Methods | 410 | ||
| Floss Holders and Threaders | 411 | ||
| Benefits of Flossing | 411 | ||
| Toothpicks, Toothpick Holders, and Triangular Toothpicks | 412 | ||
| Rubber Tip Stimulators | 414 | ||
| Interdental Brushes and Tips | 414 | ||
| End-Tufted or Single-Tufted Brushes | 415 | ||
| Tongue Cleaners | 416 | ||
| Additional Devices | 416 | ||
| Tooth Towelettes or Finger-Mounted Wipes | 416 | ||
| Clasp and Denture Brush | 416 | ||
| Types of Interdental and Supplemental Self-Care Devices: Powered | 416 | ||
| Flossing Devices | 416 | ||
| Interproximal Brushes and Tips | 417 | ||
| Dental Water Jets | 417 | ||
| Mechanism of Action | 417 | ||
| Depth of Delivery of a Solution | 417 | ||
| Tongue Cleaner Attachments | 418 | ||
| Client Education Tips | 418 | ||
| Legal, Ethical, and Safety Issues | 418 | ||
| Key Concepts | 419 | ||
| Critical Thinking Exercises | 419 | ||
| References | 419 | ||
| Acknowledgment | 419 | ||
| Evolve Resources | 419 | ||
| 25 Dentifrices | 420 | ||
| Competencies | 420 | ||
| Purpose of a Dentifrice | 420 | ||
| Choosing a Dentifrice | 420 | ||
| Toothpaste Tube Contamination | 421 | ||
| Forms of Dentifrices | 421 | ||
| Components of Dentifrices | 421 | ||
| Abrasives | 424 | ||
| Humectants | 425 | ||
| Water | 426 | ||
| Preservatives | 426 | ||
| Binders | 426 | ||
| Detergents | 426 | ||
| Flavoring and Sweetening Agents | 426 | ||
| Coloring Agents | 426 | ||
| Therapeutic Agents or Medicinal Ingredients | 426 | ||
| Anticaries Agents | 427 | ||
| Fluoride | 427 | ||
| Nonfluoride Anticaries Components | 427 | ||
| Antimicrobial Components Targeting Caries Pathogens | 427 | ||
| Desensitizing Agents | 427 | ||
| Antigingivitis Agents | 427 | ||
| Triclosan | 427 | ||
| Chlorhexidine Gluconate | 427 | ||
| Anticalculus Agents | 427 | ||
| Sodium Hexametaphosphate, Tetrapotassium Pyrophosphate, Gantrez, Zinc Compounds | 427 | ||
| Antistain Agents | 428 | ||
| Hydrogen Peroxide | 428 | ||
| Sodium Bicarbonate | 428 | ||
| Antihalitosis Agents | 428 | ||
| Concept of Bioavailability | 428 | ||
| Dentifrice: Adverse Health Effects? | 428 | ||
| Insoluble and Soluble Materials | 429 | ||
| Advantages of Higher Abrasive Levels (More Than 2%) | 429 | ||
| Disadvantages of High Abrasive Levels | 429 | ||
| Abrasive Scales Used to Evaluate Dentifrices | 429 | ||
| Abrasiveness Scale | 429 | ||
| Relative Dentin Abrasivity Scale | 430 | ||
| Dentifrice pH | 430 | ||
| Low or Acidic pH | 430 | ||
| Advantages for Tooth Enamel | 430 | ||
| Disadvantages in the Case of Root Exposure or Titanium Implants | 430 | ||
| Neutral and Basic pH | 430 | ||
| Advantages for Teeth and Mucous Membrane | 430 | ||
| Disadvantages for Teeth and Gums | 430 | ||
| Recommending Dentifrices to Clients | 430 | ||
| Loss of Tooth Structures | 431 | ||
| Comparison of Methods to Evaluate Dentifrice Abrasiveness | 431 | ||
| Client Education Tips | 431 | ||
| Legal, Ethical, and Safety Issues | 432 | ||
| Key Concepts | 432 | ||
| Critical Thinking Exercises | 432 | ||
| References | 433 | ||
| Evolve Resources | 433 | ||
| 26 Hand-Activated Instrumentation | 434 | ||
| Competencies | 434 | ||
| Basic Dental Hygiene Instrument Design: Parts and Characteristics | 434 | ||
| Handle | 434 | ||
| Handle Material | 434 | ||
| Handle Diameter Size | 434 | ||
| Handle Texture and Shape | 435 | ||
| Handle Weight | 435 | ||
| Shank | 435 | ||
| Shank Length | 435 | ||
| Shank Angle | 435 | ||
| Shank Flexibility (Strength) | 436 | ||
| Working End | 436 | ||
| Working End Design | 438 | ||
| Working End Material | 438 | ||
| Working End Style | 438 | ||
| Balanced Instruments | 438 | ||
| Instrument Classification | 440 | ||
| Assessment Instruments | 440 | ||
| Mouth Mirror Design and Use | 440 | ||
| Explorer | 442 | ||
| Design and Use | 442 | ||
| Grasp and Fulcrum | 443 | ||
| Periodontal Probe | 445 | ||
| Design and Use | 445 | ||
| Furcation Probe | 450 | ||
| Tactile Sensitivity and Explorer Use | 450 | ||
| Treatment Instruments | 451 | ||
| Curets | 451 | ||
| Universal Curet | 451 | ||
| Design and Use. | 451 | ||
| Blade Selection for Anterior Teeth. | 451 | ||
| Blade Selection for Posterior Teeth. | 451 | ||
| Area-Specific Curets | 453 | ||
| Design and Use | 453 | ||
| Shank Design | 453 | ||
| Gracey Curet | 454 | ||
| Design and Use | 454 | ||
| Extended-Shank Curets | 457 | ||
| VI Pain and Anxiety Control | 696 | ||
| online_IR_Part 6 text | e7 | ||
| 39 Dentinal Hypersensitivity Management | 696 | ||
| Competencies | 696 | ||
| Dentinal Hypersensitivity | 696 | ||
| Etiology and Nature of Dentinal Hypersensitivity | 696 | ||
| Hydrodynamic Theory | 696 | ||
| Causes of Gingival Recession | 697 | ||
| Causes of Enamel Loss | 697 | ||
| Additional Causes | 697 | ||
| Prevalence and Distribution of Dentinal Hypersensitivity | 697 | ||
| Diagnosis | 698 | ||
| Clinical Criteria | 698 | ||
| Radiographic Criteria | 698 | ||
| Additional Testing | 698 | ||
| Management of Dentinal Hypersensitivity | 698 | ||
| Self-Applied Desensitizing Agents | 699 | ||
| Professionally Applied Desensitizing Agents | 700 | ||
| Varnishes | 700 | ||
| Precipitants | 700 | ||
| Primers Containing Hydroxyethyl Methacrylate (HEMA) | 703 | ||
| Polymerizing Agents | 703 | ||
| Iontophoresis | 703 | ||
| Lasers | 703 | ||
| Restorations | 704 | ||
| Periodontal Plastic Surgery | 704 | ||
| Client Education Tips | 704 | ||
| Legal, Ethical, and Safety Issues | 704 | ||
| Key Concepts | 704 | ||
| Critical Thinking Exercises | 705 | ||
| References | 705 | ||
| Acknowledgment | 706 | ||
| Evolve Resources | 706 | ||
| 40 Local Anesthesia | 707 | ||
| Competencies | 707 | ||
| Physiology of Nerve Conduction | 707 | ||
| Mechanism of Action of Local Anesthetic Agents | 708 | ||
| Local Anesthetic Agents | 708 | ||
| Metabolism (Biotransformation) and Excretion | 709 | ||
| Vasoconstrictors | 709 | ||
| Mechanism of Action | 709 | ||
| Concentrations | 710 | ||
| Epinephrine | 710 | ||
| Side Effects and Overdose | 710 | ||
| Norepinephrine (Levarterenol) | 710 | ||
| Levonordefrin | 710 | ||
| Selection of a Local Anesthetic Agent | 711 | ||
| Duration of Action and Length of Time That Pain Control Is Needed | 711 | ||
| Variation in Response to the Agent Administered | 711 | ||
| Accuracy of the Administration of the Agent | 711 | ||
| Condition of the Soft Tissues at the Site of Drug Deposition | 711 | ||
| Anatomic Variation | 711 | ||
| Type of Injection Administered | 712 | ||
| Need for Pain Control after Treatment | 712 | ||
| Maximal Safe Doses of Local Anesthetics | 712 | ||
| Preanesthetic Client Assessment | 714 | ||
| Client Health Status | 714 | ||
| Current Client Medications | 714 | ||
| Tricyclic Antidepressants | 715 | ||
| Beta-Receptor Blockers | 715 | ||
| Adrenergic Neuron Blockers | 715 | ||
| Allergies | 716 | ||
| Armamentarium | 716 | ||
| Syringe | 716 | ||
| Reusable Breech-Loading Metallic Cartridge-Type Aspirating Syringe | 716 | ||
| Reusable Breech-Loading Metallic Cartridge-Type Nonaspirating Syringe | 717 | ||
| Reusable Breech-Loading Metallic Cartridge-Type Self-Aspirating Syringe | 717 | ||
| Computer-Controlled Local Anesthetic Delivery | 718 | ||
| Pressure-Type Syringe | 718 | ||
| Jet Injector Syringe | 719 | ||
| Disposable Syringe | 719 | ||
| Care and Handling of the Syringe | 720 | ||
| Problems with the Syringe | 720 | ||
| Needle | 720 | ||
| Parts of the Needle | 720 | ||
| Gauge | 720 | ||
| Length | 721 | ||
| Care and Handling of the Needle | 721 | ||
| Problems with the Needle | 721 | ||
| Cartridge | 721 | ||
| Parts of the Cartridge | 721 | ||
| Ingredients | 722 | ||
| Cartridge Care and Handling | 722 | ||
| Problems | 723 | ||
| Supplementary Armamentarium | 723 | ||
| Topical Antiseptics | 723 | ||
| Topical Anesthetic Agents | 723 | ||
| Cotton-Tipped Applicator Sticks | 724 | ||
| Gauze | 724 | ||
| Hemostats, Forceps, and Cotton Pliers | 724 | ||
| Preparation of Armamentarium | 724 | ||
| Loading and Unloading the Metallic or Plastic Cartridge-Type Syringe | 724 | ||
| Unsheathing and Resheathing the Needle | 725 | ||
| Dismantling the Armamentarium | 728 | ||
| Trigeminal Nerve | 729 | ||
| Ophthalmic Division (V1) | 729 | ||
| Maxillary Division (V2) | 729 | ||
| Pterygopalatine Nerves | 730 | ||
| Posterior Superior Alveolar Nerve | 730 | ||
| Branches of the Infraorbital Nerve | 731 | ||
| Mandibular Division (V3) | 731 | ||
| Branches of the Anterior Division | 731 | ||
| Branches of the Posterior Division | 731 | ||
| Local Anesthesia Techniques | 733 | ||
| Local Infiltration | 733 | ||
| Field Block | 733 | ||
| Nerve Block | 733 | ||
| Procedures for a Successful Injection | 733 | ||
| Technical Aspects | 734 | ||
| Communication Aspects | 734 | ||
| Injection Techniques for the Maxillary Teeth and Facial Hard and Soft Tissues | 734 | ||
| Supraperiosteal Injection (Local Infiltration) | 734 | ||
| Anterior Superior Alveolar Field Block | 738 | ||
| Middle Superior Alveolar Field Block | 738 | ||
| Infraorbital Nerve Block | 738 | ||
| Posterior Superior Alveolar Nerve Block | 738 | ||
| Injection Techniques for the Palatal Hard and Soft Tissues | 742 | ||
| Greater Palatine Nerve Block | 742 | ||
| Nasopalatine Nerve Block | 745 | ||
| Injection Techniques for the Mandibular Teeth and the Hard and Soft Tissues | 746 | ||
| Inferior Alveolar Nerve Block and Lingual Nerve Block | 746 | ||
| Buccal Nerve Block | 746 | ||
| Mental Nerve Block | 746 | ||
| Incisive Nerve Block | 746 | ||
| Local Complications | 753 | ||
| Needle Breakage | 756 | ||
| Pain During the Injection | 757 | ||
| Burning During the Injection | 757 | ||
| Hematoma | 757 | ||
| Facial Nerve Paralysis | 758 | ||
| Paresthesia | 758 | ||
| Trismus | 758 | ||
| Infection | 759 | ||
| Edema | 759 | ||
| Tissue Sloughing | 759 | ||
| Soft-Tissue Trauma | 760 | ||
| Postanesthetic Intraoral Lesions | 760 | ||
| Systemic Complications | 760 | ||
| Local Anesthetic Overdose | 760 | ||
| Causes and Prevention | 760 | ||
| Biotransformation and Elimination of the Anesthetic | 761 | ||
| Excessive Total Dose of Anesthetic | 761 | ||
| Rapid Absorption of Anesthetic into the Circulation | 761 | ||
| Intravascular Injection | 762 | ||
| Clinical Manifestations and Management | 762 | ||
| Epinephrine Overdose | 762 | ||
| Causes and Prevention | 762 | ||
| Clinical Manifestations and Management | 763 | ||
| Allergy | 763 | ||
| Causes | 763 | ||
| Prevention | 765 | ||
| Clinical Manifestations and Management | 765 | ||
| Other Trends That Promote Client’s Freedom from Pain | 765 | ||
| Client Education Tips | 766 | ||
| Legal, Ethical, and Safety Issues | 766 | ||
| Key Concepts | 766 | ||
| Critical Thinking Exercises | 767 | ||
| References | 767 | ||
| Acknowledgment | 767 | ||
| Evolve Resources | 767 | ||
| 41 Nitrous Oxide–Oxygen Analgesia | 768 | ||
| Competencies | 768 | ||
| Chemistry | 768 | ||
| Nitrous Oxide | 768 | ||
| Oxygen | 769 | ||
| Pharmacology | 769 | ||
| Physiology | 770 | ||
| Stages of Anesthesia | 770 | ||
| Indications for Use | 770 | ||
| Mild Apprehension | 770 | ||
| Allergy to or Refusal of Other Anesthetics | 770 | ||
| Hypersensitive Gag Reflex | 770 | ||
| Inability to Tolerate Sitting for Long Periods | 770 | ||
| Cardiovascular Disease and Hypertension | 770 | ||
| Asthma | 771 | ||
| Cerebral Palsy and Intellectually and Developmentally Challenged Persons | 771 | ||
| Relative Contraindications to Use | 771 | ||
| Pregnancy | 771 | ||
| Communication Barrier | 771 | ||
| Nasal Obstructions | 771 | ||
| Chronic Obstructive Pulmonary Disease | 771 | ||
| Emotional Instability | 771 | ||
| Epilepsy | 771 | ||
| Fear of Nitrous Oxide–Oxygen Sedation | 771 | ||
| Advantages of Use | 771 | ||
| Disadvantages of Use | 772 | ||
| Signs and Symptoms of Nitrous Oxide–Oxygen Sedation | 772 | ||
| Signs | 772 | ||
| Symptoms | 773 | ||
| Equipment | 773 | ||
| Cylinders | 774 | ||
| Continuous-Flow Gas Machines | 774 | ||
| Yokes | 775 | ||
| Flowmeters | 775 | ||
| Pressure Gauge | 775 | ||
| Reservoir Bag | 775 | ||
| Nasal Mask | 777 | ||
| Safety Measures | 778 | ||
| Color-Coding | 778 | ||
| Pin Indexing System | 778 | ||
| Diameter Indexing System | 778 | ||
| Indicators That Oxygen Is Depleted | 779 | ||
| Automatic Maintenance of Minimal O2 Levels | 779 | ||
| Oxygen Flush Button | 779 | ||
| Administration | 779 | ||
| Preparation | 779 | ||
| Estimate Tidal Volume, Start Flow of Oxygen, Secure Nasal Mask Over Client’s Nose | 779 | ||
| Titration of Nitrous Oxide–Oxygen | 780 | ||
| Oxygenation, Client Discharge, and Documentation | 780 | ||
| Potential Complications | 783 | ||
| Diffusion Hypoxia | 783 | ||
| Head Injury During Expectoration | 783 | ||
| Nausea and Vomiting | 783 | ||
| Corneal Irritation | 784 | ||
| Behavioral Problems | 784 | ||
| Equipment Malfunction | 784 | ||
| Hazards to Personnel | 784 | ||
| Client Education Tips | 784 | ||
| Legal, Ethical, and Safety Issues | 784 | ||
| Key Concepts | 785 | ||
| Critical Thinking Exercises | 785 | ||
| References | 785 | ||
| Evolve Resources | 785 | ||
| VII Individuals with Special Needs | 786 | ||
| online_IR_Part 7 text | e8 | ||
| 42 Persons with Disabilities | 786 | ||
| Competencies | 786 | ||
| Legislation for Disabled Persons | 786 | ||
| Barriers to Healthcare | 787 | ||
| Financial Barriers | 787 | ||
| Architectural Barriers | 787 | ||
| Transportation Barriers | 787 | ||
| Attitude of Healthcare Professionals | 787 | ||
| Attitudes of Disabled Clients | 788 | ||
| Personal Self-Worth | 788 | ||
| Defining Disabilities | 788 | ||
| Classification of Disabilities | 788 | ||
| Interaction with People with Disabilities | 791 | ||
| Assistive Devices | 792 | ||
| Walking Devices | 792 | ||
| Prosthetic Devices | 792 | ||
| Assistive Listening Devices | 792 | ||
| Aids for the Visually Impaired | 793 | ||
| Assistive Speaking Devices | 793 | ||
| Assistive Devices for Paralyzed Persons | 793 | ||
| Elimination Devices | 793 | ||
| Communication Devices | 794 | ||
| Assistive Devices for Protection and Oral Function | 795 | ||
| Oral Self-Care Devices | 795 | ||
| Client Assessment | 795 | ||
| Customizing Oral Self-Care Devices | 796 | ||
| Client Positioning and Stabilization | 797 | ||
| Wheelchair Transfer Techniques | 799 | ||
| Transferring from Wheelchair to Dental Chair | 799 | ||
| Preparation for a Wheelchair Transfer | 799 | ||
| Complications in Wheelchair Transfer | 801 | ||
| Muscle Spasms | 801 | ||
| Decubitus Ulcers (Pressure Sores) | 802 | ||
| Bowel and Bladder Elimination Schedules | 802 | ||
| Autonomic Dysreflexia | 802 | ||
| Transferring from Dental Chair to Wheelchair | 802 | ||
| Health Promotion and Advocacy | 802 | ||
| Client Education Tips | 802 | ||
| Legal, Ethical, and Safety Issues | 802 | ||
| Key Concepts | 802 | ||
| Critical Thinking Exercises | 803 | ||
| References | 803 | ||
| Acknowledgment | 804 | ||
| Evolve Resources | 804 | ||
| 43 Cardiovascular Disease | 805 | ||
| Competencies | 805 | ||
| Cardiovascular Disease | 805 | ||
| Rheumatic Heart Disease | 805 | ||
| Etiology | 805 | ||
| Risk Factors | 805 | ||
| Disease Process | 805 | ||
| Prevention | 805 | ||
| Dental Hygiene Care | 806 | ||
| Appointment Guidelines | 806 | ||
| Infective Endocarditis | 806 | ||
| Etiology | 806 | ||
| Risk Factors | 806 | ||
| Disease Process | 806 | ||
| Prevention | 807 | ||
| Dental Hygiene Care | 808 | ||
| Appointment Guidelines | 808 | ||
| Valvular Heart Defects | 808 | ||
| Etiology | 808 | ||
| Disease Process | 808 | ||
| VIII Management | 1094 | ||
| online_IR_Part 8 text | e9 | ||
| 62 Practice Management | 1094 | ||
| Competencies | 1094 | ||
| Practice Management | 1094 | ||
| Standards for Clinical Dental Hygiene Practice | 1095 | ||
| Effective Office Collaboration Through Frequent Communication | 1095 | ||
| Conflict Resolution in the Dental and Dental Hygiene Practice | 1096 | ||
| Personnel Management | 1097 | ||
| Office Policies | 1097 | ||
| Client Management and Records | 1097 | ||
| Case Presentation | 1098 | ||
| Client Records | 1099 | ||
| Electronic Software and Dental Records | 1099 | ||
| Advantages of Electronic Health and Dental Records and Dental Software | 1100 | ||
| Disadvantages of Electronic Health and Dental Records | 1101 | ||
| Time Management and Scheduling | 1101 | ||
| Dental Hygiene Scheduling | 1102 | ||
| Continued-Care Systems | 1102 | ||
| Economic Overhead | 1102 | ||
| Practice Overhead | 1102 | ||
| Facility Management | 1103 | ||
| Dental Hygiene Revenues | 1103 | ||
| Integral Contributions of the Dental Hygienist | 1104 | ||
| Marketing Dentistry and Dental Hygiene | 1104 | ||
| Client Satisfaction | 1106 | ||
| Quality Assurance and Auditing of Client Records | 1106 | ||
| Client Education Tips | 1107 | ||
| Legal, Ethical, and Safety Issues | 1107 | ||
| Key Concepts | 1108 | ||
| Critical Thinking Exercises | 1109 | ||
| References | 1109 | ||
| Acknowledgement | 1109 | ||
| Evolve Resources | 1109 | ||
| 63 Career Planning and Job Searching | 1110 | ||
| Competencies | 1110 | ||
| Career Development in Dental Hygiene | 1110 | ||
| Steps to Career Development | 1110 | ||
| Self-Assessment | 1110 | ||
| Building a Relationship with a Mentor | 1110 | ||
| Networks for Professional Enhancement | 1111 | ||
| Career Goals | 1111 | ||
| Dental Hygiene as a Career | 1111 | ||
| The Job Search | 1111 | ||
| Researching Employment Opportunities | 1111 | ||
| Writing a Résumé | 1111 | ||
| Curriculum Vitae | 1111 | ||
| Electronic Portfolio | 1112 | ||
| Maintaining Professionalism on Social Media Websites | 1112 | ||
| References and Recommendations | 1112 | ||
| Cover Letter | 1112 | ||
| Response and Follow-up Before the Interview | 1112 | ||
| Preparing for the Job Interview | 1112 | ||
| The Interview | 1113 | ||
| Interview Communication | 1114 | ||
| Working Interview | 1117 | ||
| Office Observation | 1117 | ||
| Follow-up Communications | 1117 | ||
| Job Selection Considerations | 1117 | ||
| Compensation | 1118 | ||
| Salary Ranges | 1118 | ||
| Employment and Evaluation | 1119 | ||
| Employment Rights | 1119 | ||
| Employment Contracts | 1119 | ||
| Performance Evaluation | 1119 | ||
| Job Exiting | 1119 | ||
| Job Termination | 1119 | ||
| Stress and Burnout Among Dental Hygienists | 1119 | ||
| Dental Hygiene’s Expanding Scope | 1119 | ||
| Changes in the Profession | 1119 | ||
| Expanding Educational Opportunities | 1121 | ||
| Career Satisfaction | 1121 | ||
| Client Education Tips | 1121 | ||
| Legal, Ethical, and Safety Issues | 1121 | ||
| Key Concepts | 1122 | ||
| Critical Thinking Exercises | 1122 | ||
| References | 1122 | ||
| Acknowledgment | 1122 | ||
| Evolve Resources | 1122 | ||
| 64 Legal and Ethical Decision Making | 1123 | ||
| Competencies | 1123 | ||
| Foundations of Ethical Decision Making | 1123 | ||
| Ethics Defined | 1123 | ||
| Accountability and Responsibility | 1124 | ||
| Major Ethical Perspectives (Box 64-3) | 1124.e1 | ||
| Utilitarian Ethics | 1124.e1 | ||
| Deontologic Ethics | 1124.e1 | ||
| Virtue Ethics | 1124.e1 | ||
| Fundamental Ethical Principles | 1124 | ||
| Codes of Ethics | 1125 | ||
| Ethical Problems in Dental Hygiene | 1125 | ||
| Clinical Practice | 1125 | ||
| Public Health | 1125 | ||
| Administration | 1126 | ||
| Research | 1127 | ||
| Dental Hygienist–Dentist-Client Relationships | 1127 | ||
| Dental Hygienist–Dental Hygienist Relationships | 1127 | ||
| Employer-Employee Relationships | 1127 | ||
| Ethical Decision-Making Framework | 1128 | ||
| Define the Problem or Conflict | 1128 | ||
| Identify the Ethical Issues | 1128 | ||
| Gather Relevant Information | 1128 | ||
| Identify the Ethical Alternatives | 1128 | ||
| Establish an Ethical Position | 1128 | ||
| Select, Justify, and Defend the Alternatives | 1129 | ||
| Dental Ethics Committee | 1129 | ||
| Jurisprudence | 1129 | ||
| Oral Health Professionals at Risk | 1129 | ||
| Basic Legal Concepts | 1129 | ||
| Contract Principles and Relationships | 1131 | ||
| Terminating the Practitioner-Client Relationship | 1132 | ||
| Related Responsibilities | 1133 | ||
| Tort Principles | 1134 | ||
| Intentional Torts | 1134 | ||
| Unintentional Torts and Negligence | 1134 | ||
| Standard of Care | 1134 | ||
| Informed Consent | 1135 | ||
| Informed Refusal (Figure 64-4; see Chapter 22, Figure 22-5 and Box 22-6) | 1135 | ||
| Statute of Limitations | 1136 | ||
| Legal Concepts and the Dental Hygienist–Client Relationship | 1136 | ||
| Confidentiality | 1136 | ||
| Defamation | 1136 | ||
| Legal Concepts and the Dental Hygienist–Dentist Relationship | 1136 | ||
| Discrimination in Employment | 1136 | ||
| Americans with Disabilities Act | 1137 | ||
| Equal Pay Act | 1137 | ||
| Pregnancy and Employment Status | 1137 | ||
| Employer-Employee Relationships | 1137 | ||
| Sexual Harassment | 1138 | ||
| Termination of Employment | 1139 | ||
| Risk Management | 1139 | ||
| Communication as a Risk Management Tool | 1139 | ||
| Dental Hygienist–Client | 1139 | ||
| Dental Hygienist–Employer | 1140 | ||
| Dental Hygienist–Colleagues | 1140 | ||
| Client Record | 1140 | ||
| Client Identification Data | 1141 | ||
| Health and Dental History (see Chapter 12) | 1141 | ||
| Clinical Assessment and Diagnosis | 1141 | ||
| Treatment Information | 1141 | ||
| Legal Issues and Roles of the Dental Hygienist | 1141 | ||
| Dependent Practitioner | 1141 | ||
| Independent Practitioner | 1142 | ||
| Independent Contractor | 1143 | ||
| Educator | 1143 | ||
| Administrator or Manager | 1143 | ||
| Consumer Advocate | 1144 | ||
| Researcher | 1144 | ||
| Client Education Tips | 1144 | ||
| Legal, Ethical, and Safety Issues | 1144 | ||
| Key Concepts | 1144 | ||
| Critical Thinking Exercises | 1145 | ||
| References | 1146 | ||
| Evolve Resources | 1146 | ||
| Glossary | 1147 | ||
| A | 1147 | ||
| B | 1147 | ||
| C | 1147 | ||
| D | 1148 | ||
| E | 1148 | ||
| F | 1148 | ||
| G | 1149 | ||
| H | 1149 | ||
| I | 1149 | ||
| J | 1150 | ||
| K | 1150 | ||
| L | 1150 | ||
| M | 1150 | ||
| N | 1150 | ||
| O | 1150 | ||
| P | 1151 | ||
| Q | 1151 | ||
| R | 1151 | ||
| S | 1151 | ||
| T | 1152 | ||
| U | 1152 | ||
| W | 1152 | ||
| X | 1152 | ||
| Y | 1152 | ||
| Z | 1152 | ||
| Glossary | e10 | ||
| A | e10 | ||
| B | e13 | ||
| C | e14 | ||
| D | e18 | ||
| E | e21 | ||
| F | e23 | ||
| G | e24 | ||
| H | e25 | ||
| I | e27 | ||
| J | e28 | ||
| K | e28 | ||
| L | e28 | ||
| M | e29 | ||
| N | e31 | ||
| O | e32 | ||
| P | e34 | ||
| Q | e37 | ||
| R | e37 | ||
| S | e39 | ||
| T | e42 | ||
| U | e44 | ||
| V | e44 | ||
| W | e44 | ||
| X | e45 | ||
| Y | e45 | ||
| Z | e45 | ||
| Index | 1153 | ||
| A | 1153 | ||
| B | 1154 | ||
| C | 1155 | ||
| D | 1157 | ||
| E | 1159 | ||
| F | 1161 | ||
| G | 1161 | ||
| H | 1162 | ||
| I | 1163 | ||
| J | 1164 | ||
| K | 1164 | ||
| L | 1164 | ||
| M | 1165 | ||
| N | 1166 | ||
| O | 1167 | ||
| P | 1168 | ||
| Q | 1171 | ||
| R | 1171 | ||
| S | 1172 | ||
| T | 1174 | ||
| U | 1175 | ||
| V | 1175 | ||
| W | 1175 | ||
| X | 1176 | ||
| Y | 1176 | ||
| Z | 1176 | ||
| Endsheet 7 | IBC3 |