ASSESSMENT: select signs and symptoms | |||
1. Protection from Health Risks:
ÿ BP outside normal limits ÿ Need for prophylactic antibiotics ÿ Potential for injury ÿ Risk factors (diabetes, smoking, caries risk) ÿ Other______________
|
5. Skin and Mucous Membrane Integrity of the Head and Neck
ÿ Extra/intraoral lesion ÿ Swelling ÿ Gingival Inflammation ÿ Bleeding on probing ÿ Pockets > 4mm ÿ Attachment loss > 1mm ÿ Xerostomia ÿ Other__________________
|
||
2. Freedom from Fear/Stress:
Reports or displays ÿ Anxiety about proximity of clinician, confidentiality, or previous dental experience ÿ Oral habits ÿ Substance abuse Concerns about: ÿ infection control, fluoride therapy, fluoridation, mercury toxicity, ÿ other _________________
|
6. Biologically Sound and Functional Dentition
ÿ Reports difficulty in chewing
Presents with: ÿ Defective restoration ÿ Teeth with signs of disease ÿ Missing teeth ÿ Ill-fitting dentures, appliances ÿ Abrasion, erosion, abfraction ÿ Rampant caries ÿ Other_________________ |
||
3. Freedom from Pain:
ÿ Extra/intraoral pain and sensitivity ÿ Other__________________ |
7. Conceptualization and Problem Solving
ÿ Has questions about DH care and/or oral disease ÿ Other___________________
|
||
4. Wholesome Facial Image:
Expressed dissatisfaction with appearance: ÿ Teeth ÿ Gingiva ÿ Facial profile ÿ Breath ÿ Other________________
|
8. Responsibility for Oral Health:
ÿ Biofilm and calculus present ÿ Stain ÿ Inadequate parental supervision of oral healthcare ÿ No dental exam within the last 2 years ÿ Other_____________________ |
||
DENTAL HYGIENE DIAGNOSIS: (List the unmet human need, then be specific about the etiology and signs and symptoms) | |||
DH Diagnosis
(unmet human need) |
Etiology (due to) | Signs & Symptoms (evidenced by) | Client Goal (expected outcome) |
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