Human Needs Assessment and Dental Hygiene Diagnosis

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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