Protocol for Hygiene

PROTOCOL FOR POOR HYGIENE

orthodontic-problems
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First Warning 

 

Code OH1 

 

1. Show patient in the mirror where they are missing with brushing and flossing.

Give suggestions and demonstrate techniques.

2. Take 3 intra oral photos, name the time point as Poor oral hygiene 1.

3. Send patient to brush at the brushing sinks.

4. Check once patient returns to the chair. If areas of plaque still remain, disclose the teeth, take frontal photo.

5. Send patient to brush again.

6. Discuss findings with parent. If a parent is not with them at the appointment, call home to review concerns with the parent. Have parent monitor the patient’s brushing at home with disclosing tablets. Dispense tablets to patient.

7. Write OH1 in appointment column in treatment card.

8. Write number value for the standard of brushing (from 1-5, 1 being poor, 5 being excellent) in oral hygiene column in treatment card.

Book next appointment as a 71.

9. One week Later: Email or call parent to see how patient is doing with brushing

Second Warning

Code OH2

1. Take intra oral photos if oral hygiene is poor at beginning of appointment. Name time point as Poor oral hygiene 2.

2. Show patient in the mirror where they are missing with brushing and flossing. Send to the brushing sinks.

3. Check once patient returns to the chair. If areas of plaque still remain, disclose the teeth, take frontal photo.

4. Recommend parent to purchase a fluoride product to decrease the permanent damage to the enamel. Give sample of rinse or fluoride gel.

5. The procedure code will automatically send a letter to patient and to DDS Re: poor oral hygiene.

6. Discuss findings with parent. Let them know if oral hygiene does not improve we may have no choice but to demand early. If a parent is not present, call and discuss the findings with the parent.

7. Write OH2 in appointment column in treatment card.

8. Write number value for the standard of brushing (from 1-5, 1 being poor, 5 being excellent) in oral hygiene column in treatment card.

Book next appointment as a 71

Third warning

Code OH3

1. Take intra oral photos if oral hygiene is poor again at beginning of appointment, name time point as Poor oral hygiene 3.

2. Review with patient where they are missing with brushing and send to brush.

3. Check once patient returns to the chair. If areas of plaque still remain, disclose the teeth, take frontal photo.

4. Let the doctor know when he comes in that this is the 3rd time with poor oral 5. Leave the arch wires out for a period two weeks to assist in cleaning. Let patient and parent know that treatment is slowing down due to poor oral hygiene.

6. Discuss findings with parent. Let them know if oral hygiene has not improved by next appointment, a demand appointment will subsequently be booked.

7. If a parent is not present, call and discuss the findings with the parent.

8. The procedure code will generate a letter to the DDS and to the responsible party again reviewing the oral hygiene concerns.

9. Write OH3 in appointment column in treatment card

10. Write number value for the standard of brushing (from 1-5, 1 being poor, 5 being excellent) in oral hygiene column in treatment card

Book next appointment as a 71

Fourth Warning

Code OH4

1. If oral hygiene is still poor, take intra oral photos and name time point as Poor oral hygiene 4.

2. Book next appointment for a demand. Leave arch wires out.

3. The code will generate a letter to the DDS and to the responsible party informing him or her that we are unfortunately discontinuing treatment due to poor oral hygiene. The doctor will decide if any type of retention appliances will be made at the demand appointment.

4. Have patient and parent sign the discontinuation of treatment form.

5. Write OH4 in appointment column in treatment card.

6. Write number value for the standard of brushing (from 1-5, 1 being poor, 5 being excellent) in oral hygiene column in treatment card.

Book next appointment as a 97, possible 58 depending on type of appliance being made (if any).