Preface
Evidence-Based Knowledge—The Foundation of Dental Hygiene
Dental Hygiene: Theory and Practice, Fourth Edition, is for students and professionals who are interested in the use of evidence-based knowledge to guide decision making in practice. Societal values and healthcare reforms forecast the need for dental hygienists who can assess situations, access information, make evidence-based decisions, and collaborate with dentists and other health professionals in providing quality, culturally appropriate healthcare. Research evidence provides a framework for making decisions, solving problems, explaining phenomena, and predicting outcomes that enables the practitioner to continually re-evaluate and advance service to society.
This book prepares dental hygienists to view their profession with pride, understand its scope, and influence its advancement. The book uses the process of care guided by a client's human needs to operationalize the roles of the dental hygienist as practitioner, client advocate, manager, researcher, and health promoter.
Dental Hygiene: Theory and Practice, Fourth Edition, is predicated on four key assumptions:
• Oral health and systemic health are inextricably linked; therefore collaboration with other healthcare professions is essential for quality client care.
• Theory, research, and client needs and values serve as the basis for decision making.
• Dental hygienists are responsible and accountable for the services they provide and for the professional judgments and decisions they render.
• Accountability requires a systematic approach to practice, and this approach is the dental hygiene process.
Given these assumptions, society has a right to access care from individuals who are competent in making dental hygiene assessments, diagnoses, and care plans; providing interventions; and evaluating clinical outcomes.
Human Needs Theory
Human needs theory serves as a unifying theme in this book. We have selected this theory for the following reasons: Dental hygiene promotes oral and systemic health through the fulfillment of human needs related to dental hygiene care. Human needs are universal, transcend all cultures, and are applicable to both individuals and groups. Human need fulfillment contributes to the quality of life of the individual, community, nation, and world. These facts were recognized by the World Health Organization when, in 1984, it redefined health as “the extent to which an individual or group is able, on the one hand, to realize aspirations and satisfy needs and, on the other hand, to change and cope with the environment.”
Because dental hygiene care assists individuals in their attainment of human needs, it is an essential component of the healthcare system, it enhances quality of life, and it is valued in today's wellness-oriented society.
Terminology
An effort was made to use the most current terms (e.g., terms from the American Academy of Periodontology Classification of Periodontal Diseases and Conditions, American Dental Association insurance codes and definitions, diabetes mellitus type 1 and type 2, oral biofilm). Progressing through the book, the reader may quickly notice that the term client is used more frequently than patient. We are sensitive to the responses that the term client may evoke. In general, however, we deliberately use the term client because it is broader in scope than the term patient, and it can refer to a group as well as an individual. In addition, given that the focus of dental hygiene is to prevent oral disease and promote wellness, the term client recognizes that not all of those for whom we provide care are in need of “treatment” for a disease. Also, the term client acknowledges the autonomy of the recipient of care, because individuals who seek dental hygiene care generally choose to do so in partnership with the dental hygienist.
Textbook Format
Dental Hygiene: Theory and Practice, Fourth Edition, is organized into eight sections:
• Section I: Conceptual Foundations (7 chapters)
• Section II: Preparation for the Appointment (4 chapters)
• Section III: Assessments (9 chapters)
• Section IV: Critical Thinking in Dental Hygiene Practice (2 chapters)
• Section V: Implementation (16 chapters)
• Section VI: Pain and Anxiety Control (3 chapters)
In terms of format, chapters include:
• Competencies to guide the teacher and the learner.
• Evidence-based explanations of the subject.
• Procedures with detailed steps and color illustrations to ensure that the learner attains clinical competence.
• Client Education Tips to remind the learner that there is more than just flossing and toothbrushing in educating a person about his or her oral and systemic health.
• Legal, Ethical, and Safety Issues that highlight areas in need of management to protect the health and welfare of both client and practitioner.
• Key Concepts that summarize the main points of the chapter at a glance.
• Critical Thinking Exercises and Scenarios that provide opportunities for independent thought, problem solving, reflection, and discussion.
Recognizing that this book may be used throughout North America, we have included, where appropriate, information that reflects the practice of dental hygiene in Canada.
Section I: Conceptual Foundations describes the evolving profession of dental hygiene, introduces human needs theory and the process of dental hygiene care, and provides the behavioral science and communication theory used by successful dental hygienists in human interactions. The dental hygiene process provides the framework for delivering quality care to all types of clients in a variety of settings and serves as the core of professional practice. Given dental hygiene's focus on oral disease prevention and health promotion, an entire chapter is devoted to evidence-based decision making. In addition, professional portfolios are introduced as a means of documenting the learner's progress in providing care and becoming a competent practitioner. Moreover, because we live in a global society and culture influences health, disease, behavior, beliefs, and lifestyle, a chapter on cultural competence is included in this section.
Section II: Preparation for the Appointment describes the dental hygiene care environment, guidelines for infection control, and strategies for adapting to guidelines as they change. One chapter is devoted to the management of medical emergencies, and another to the application of ergonomic principles to prevent occupational disabilities in practitioners.
Section III: Assessments includes chapters that delineate the competencies of the dental hygienist in assessment of a client's general, dental, and periodontal health and risk status. In addition, one chapter is devoted to the oral-systemic health connection.
Section IV: Critical Thinking in Dental Hygiene Practice explains the dental hygiene diagnosis and how a dental hygiene diagnosis is made. This section also details the value of including client goals in the care plan and demonstrates how evaluation is used to document outcomes of care. With evaluation and documentation, the dental hygienist is accountable for care provided and can be confident that interventions made a positive difference in the individual's systemic and oral health status.
Section V: Implementation presents numerous evidence-based interventions that comprise dental hygiene care. Specific clinical procedures, in table format, facilitate competency development in a variety of protocols within the context of total body health, including personal oral care, instrumentation and root morphology, stain management, nonsurgical periodontal therapy, periodontal chemotherapy, oral disease risk assessment and management, tobacco cessation, nutritional counseling, supportive diagnostic aids, and restorative therapy.
Section VI: Pain and Anxiety Control covers both the behavioral and pharmacologic management of the client via anxiety-reducing protocols and administration of desensitizing agents, intraoral local anesthetic agents, and nitrous oxide–oxygen analgesia. Pain and anxiety control is essential for quality dental hygiene care.
Section VII: Individuals with Special Needs recognizes that dental hygienists care for a growing number of individuals with diseases or disabilities that affect their daily living, self-care, and ability to access healthcare. Special needs clients that dental hygienists are likely to treat have been included to facilitate quality and access to care for all individuals.
Section VIII: Management provides the capstone for the dental hygienist who is interested in developing competencies in leadership, practice management, and legal and ethical decision making.
New to This Edition
The Fourth Edition of Dental Hygiene: Theory and Practice includes the following three new chapters essential to helping the learner meet the challenge of contemporary dental hygiene practice:
Chapter 3: Evidence-Based Decision Making
Chapter 7: Professional Portfolios
Chapter 61: Palliative Oral Care
Evolve Companion Website
http://evolve.elsevier.com/Darby/Hygiene
A website found at http://evolve.elsevier.com/Darby/Hygiene has been revised to support the content of the book and to enhance the faculty's instructional repertoire and student learning. The website includes:
For Instructors
TEACH Instructor's Resources Manual
Detailed and customizable chapter support materials based on textbook learning objectives. The manual includes:
Test Question Bank
With the current emphasis on student and curricular learning outcomes, competence, and assessment, a bank of more than 1,650 test questions can easily become part of an educator's overall assessment plan. These questions available on the website can be used independently by students or integrated into benchmark examinations that verify student knowledge at various points throughout the curriculum. With so many questions available, along with supporting rationales for the correct answers, questions can be selected and integrated into an annual comprehensive exam to prepare students for the National Board Dental Hygiene Examination.
For Students
Practice Quizzes
Approximately 1,500 multiple-choice questions, separated by chapter, with instant-feedback answers, rationales, and page number references for remediation.
Competency-Based Evaluation Forms
Procedures from the textbook have been modified into Competency-Based Evaluation Forms and posted on the text website. These can be downloaded for use in laboratory, preclinical, or clinical settings. Once downloaded, these forms can be used for self-evaluation, peer evaluation, instructor evaluation, and/or re-evaluation.
Web Resources
Website information and resources are posted on the website by chapter to connect users to Internet information on relevant and related topics. These are website resources that the dental hygienist will use to enhance knowledge and practice. These websites enrich the learning experience.
Suggested Readings
Suggested readings for some chapters can be accessed readily from the website. These relevant citations can be used to support evidence-based decisions or as a start to a search of the literature for a written paper, research project, oral presentation, or research poster/table clinic assignment or simply for those who need to know more.
Procedure Videos
Several of the procedures in Dental Hygiene: Theory and Practice, Fourth Edition, contain the following logo:
This logo indicates that a video is available for that skill in Elsevier's new online video collection, Dental Hygiene Procedures Videos. These videos are sold separately and can be purchased through the online Evolve bookstore at http://evolve.elsevier.com.