Chapter 3 Preventive Dentistry

CHAPTER 3 PREVENTIVE DENTISTRY INTRODUCTION The goal of preventive dentistry is to assist the patient in either establishing control of his or her dental disease or in continuing to maintain good oral health. Preventive dentistry includes all clinical tests, treatments, and patient education for the purpose of preventing oral disease and supporting the effectiveness of treatment aimed at caries and periodontitis. All patients will receive a careful assessment of their oral health needs and be provided with an individualized preventive dentistry treatment plan. PREVENTIVE DENTISTRY TECHNICIAN Each dental treatment facility has an appointed preventive dentistry officer responsible for the formulation, supervision, and execution of all aspects of the preventive dentistry program as per SECNAVINST 6600.5. For you to perform preventive dentistry procedures, you should elect to qualify as an expanded function preventive dentistry technician at your command. Details for this program can be found in BUMEDINST 6600.13. Some of the duties of a preventive dentistry technician are as follows: use of home care devices Demonstrates proper patient instruction in the Sharpens and demonstrates proper care of periodontal instruments Delivers pre-operative oral antimicrobial rinses Places pit and fissure sealants Applies topical anticariogenic agents Performs oral prophylaxis Provides nutrition/diet counseling Performs supragingival scalings with hand and sonic instruments Completes a thorough dental health questionnaire review ORAL PROPHYLAXIS The term prophylaxis means prevention of disease. When you apply its broadest interpretation to the oral cavity, it includes all measures to prevent oral disease. For our purposes, we define oral prophylaxis as the clinical procedures that you perform for your patients. Our discussion will include evaluation of records, the seating of the patient, instruments, examinations, and contraindications to prophylaxis. We will begin with the evaluation of the patient's dental health record. PREPARATION FOR ORAL PROPHYLAXIS Before the patient enters the dental treatment room (DTR), evaluate his or her dental record for completeness. The folder should contain the patient's dental records, current radiographs, a current dental health questionnaire and any other applicable forms discussed in Dental Technician, Volume 1, NAVEDTRA 12572, chapter 2, and chapter 2 of this manual. Check the past medical and dental history of the patient. Check the recommendations that were made during previous oral prophylaxis appointments and the recent dental examinations. If the patient has had radiographs taken since the previous oral prophylaxis, evaluate them for subgingival calculus and restoration margin overhangs. Subgingival calculus can appear on a radiograph as a "spur" or deposit between the teeth, below the gingival margin. NOTE: Subgingival calculus and overhangs can only be removed by a dental officer or dental hygienist. If you find any subgingival calculus during the patient examination or treatment, contact a dental officer or hygienist who will remove it either during your appointment with the patient or at a later time. A preventive dentistry technician should only treat patients with supragingival calculus who are scheduled for routine oral prophylaxis. Patients with subgingival calculus will be appointed with a dental officer or dental hygienist. The dental treatment plan will indicate who will treat the patient to ensure proper scheduling. 3-1