Strive-the Student View
August, 2007 edition

Patient Education as Part of the Dental Hygiene Process of Care

By Kristine Smith, RDH

A friend of mine came to the Lansing Community College Dental Hygiene clinic for her scheduled appointment with me. She was under a common misconception: that she was scheduled for a "simple cleaning." Instead, not only did she receive a complete dental hygiene prophylaxis, she also received a thorough education on the care and maintenance of her teeth and the surrounding tissues. After her appointment, she told me that she had never been instructed on how to properly brush or floss her teeth. I realized then, that it was not until I began the dental hygiene program, that I myself had been educated on properly performing these essential daily tasks. The two most simple and important aspects of an individual’s oral home care had never been presented to me, either. Why?

Having worked for an oral surgeon for 10 years, I thought I had accumulated an abundance of knowledge regarding oral health. I learned how to educate and care for a patient before, during and after a surgical procedure. I never focused on why an individual was referred to the surgeon in the first place, or how the need for the procedure we were performing on them might have possibly been eliminated. I lacked the true understanding of preventive care. I realized, at the oral surgeon’s, we were preventing an unfavorable condition from becoming worse, but primary and secondary prevention strategies did not exist for many of the patients. Why?

The Importance of Patient Care

Patient education is a fundamental part of being a dental hygienist. Unfortunately, many practicing hygienists indicate that it is a difficult task to undertake with the time allotted for scheduled appointments. Some have also stated that they will not give education to patients whom they know will not listen or who do not care. This defeats the purpose and devalues the importance of patient education in successful treatment interventions. Isn't it, at the very least, our ethical responsibility to make the patient aware of what we observe during their appointment?

How can we allow our patients to leave our chair without any form of patient education? There are so many patients who cannot afford treatment, do not have the ability to seek care, or cannot gather up enough courage to see us. If a patient hasn't had preventive care in one year or 10 years, it is our ethical responsibility to share information with them to enhance their knowledge about oral health. We have the unique opportunity to provide patients with a much-needed service of prevention education and treatment.

As dental hygienists, we care for our patients and should want to prevent them from having to be in the oral surgeon's chair for reasons that could have otherwise been avoided. I will try my best to make this clear to every one of my patients. By individualizing patient treatment according to their needs and educating them on proper oral health care, we can achieve successful hygiene interventions with them.

Of course, it is important for health care providers to get to know their patients. Verbal as well as non-verbal communication must be recognized. Some individuals just want to get in and out of the dental office and do not care what you have to say. It is still important that you attempt to present information. Self-interest cannot occur without first having awareness. You may have to make an abbreviated point, but at least you tried to give your patient enough knowledge and ability to make informed decisions. Respect that the patient wanted a limited amount of information. On the flip side, there are those patients who want to know every detail, give them as much information as they need and want. Sometimes this can be time consuming, but try talking while you are working. Call or email them later with more information if necessary. This will let them know that you are focusing on their needs and that their health is important to you. Obviously, personality differences require the creation of customized treatment plans and being cognizant of this will only make you a stronger clinician and educator.

Not properly teaching a patient how to care for themselves is detrimental not only to them, but for the integrity of the dental profession. Being an oral health educator is part of the dental hygiene process of care. ADPIE is the foundation of the profession and the initial concept taught in school: we Assess a patient's history and current situation, co-Diagnose what needs we see, Plan with the dentist and patient regarding solutions, Implement solutions, and Evaluate the results of the treatment.

If we avoid or simply decide we do not have sufficient time to work through the dental hygiene process of care, we are violating the ADHA Code of Ethics. We know as professionals that within minutes of a patient leaving our chair, biofilm begins to form on the tooth surface. If we have not properly instructed our patient to remove it, we have failed at our most basic health provider responsibilities. It is unacceptable to compromise a patient's care for a quicker office visit or a better patient turnaround. You must decide what is important to you, but never forget that someone else's health rests in your hands. Excellent patient education will allow for appropriate treatment and intervention. It will strengthen our credibility as educators and clinicians. Knowledge is indeed power!

Surely, we do not have control over what the patient does outside of the office to care for themselves. What we can do is make sure that we always give our patients adequate information regarding their oral health so that we, as health providers, can feel confident we did our best. No matter how much time we spend, we will know that each patient has been educated. Our patients have the potential and we have the ability to impact their lives to insure successful dental hygiene interventions.

Kristine Smith just recently graduated from the dental hygiene program at Lansing Community College in Lansing, Michigan. In addition to her hygiene degree she has a BA in health communications from Michigan State University. Her interest in oral health care began in high school when she became an oral and maxillofacial surgery assistant. Ten years in oral surgery lead to a special interest in patient education and care. She is looking forward to beginning her career and is confident that public health care is her calling.