Dental Hygiene Diagnosis, Treatment Planning, and Collaboration
This section covers hygiene diagnosis and collaboration; the exam tests the boundary between hygiene diagnosis and dental diagnosis and the need for dentist authorization.
Hygiene diagnosis vs dental diagnosis
A dental hygienist may collect data, identify oral hygiene problems, and formulate a dental hygiene diagnosis and care plan. The dentist is responsible for the comprehensive dental diagnosis and the overall treatment plan. The hygienist's plan must be coordinated with, and authorized by, the supervising dentist.
Collaboration and referral
Collaboration means sharing findings, discussing risks, and confirming the sequence of care. The hygienist should present periodontal charting, radiographs, and medical history to the dentist, propose interventions such as nonsurgical periodontal therapy, and refer when findings exceed hygiene scope or when the dentist must evaluate. Document the dentist's approval and any changes.
Documentation
Record the assessment, hygiene diagnosis, planned interventions, patient education, informed consent, and the dentist's authorization. If the dentist modifies the plan, note the modification and the reason. The record should let another clinician see who decided what.
Worked example
A hygienist charts 6-7 mm pockets with bleeding and mobility. She may diagnose gingivitis or periodontal disease as a dental hygiene diagnosis and propose scaling and root planing, but she may not tell the patient she needs extractions or prescribe antibiotics. She presents the chart to the dentist, who confirms the periodontal diagnosis and orders therapy; she documents that authorization.
Traps
Signing a treatment plan as if you were the dentist. Making a definitive dental diagnosis outside hygiene scope. Acting on a plan the dentist never authorized. Failing to refer a suspicious lesion or uncontrolled medical condition.