Have you ever wondered how to filter through all of the information you have gathered in order to make the best choice for you or your patient? What if you are faced with an ethical problem at home or in the office and you need to come to a resolution? Due to our inherent nature of simply being human, we are faced with many dilemmas both personally and professionally throughout life. So, how do we begin to solve problems or identify the best solutions? One method is to learn to think critically by using a checklist of processes and steps to identify the problem, understand its definition, and conclude with a sound, justified resolution.1 In effect, one applies a set of critical thinking “tools” to work through problems to find the best solution.2 As hygienists, we must be able to apply critical thinking skills to daily situations as well as the process of lifelong learning.
Critical thinking is simply putting structure to your thoughts.1 That means to expand your thinking in a thorough and systematic way so that it is possible to consider all aspects of a problem. For example, take the common condition of a patient with a large filling that’s fractured. Do you replace it with an even larger filling or a full-coverage crown? Using the critical thinking process, you would look deeper into the problem from the perspectives of depth and breadth. You could also delve into precision, accuracy, and even logic. In addition, you would consider relevance and fairness. All of these lead to the most important aspect of all, clarity. This may sound familiar to you since this is part of the dental hygiene assessment process leading up to the dental hygiene diagnosis. Through critical thinking, your segmented assessment process can be examined from all aspects to determine the best treatment.
As hygienists, we have a specific armamentarium that we use on every patient. Hygienists have been educated to always have an explorer, a probe, and a mirror on every tray setup. The mirror allows the hygienist to look in the mouth for a closer view, the probe measures pockets and lesions, and the explorer feels for irregularities of restorations as well as identifies calculus. As part of the data processing for the dental hygiene diagnosis, the hygienist uses critical thinking skills to collect and interpret information.3 Let’s take these basic concepts further into the critical thinking process. These dental instruments give us the concepts of depth, breadth, precision, accuracy, and logic, which are all part of the Universal Intellectual Standards that form the basis of critical thinking.1
For example, as a clinician, begin to view your mirror as an instrument to look at both sides of a situation or issue with depth and breadth. You use the mirror intraorally to refract light for a better view, transilluminate on dentition to reveal suspicious lesions, and enlarge what you are seeing. Therefore, the mirror acts as a frame of reference, determines relevance and fairness, allows for reflection (mirror, mirror, on the wall), and reveals clarity.
Next, the explorer used by every dental hygienist depends upon tactile sensitivity for correct identification of calculus and defective restorations. You must use the explorer to determine the level of calculus and status of restorations to give the patient the proper dental hygiene diagnosis.3 Thus, the use of the explorer can be perceived as determining accuracy, precision, depth, and significance. Again, these are the standards used in the basis of critical thinking.1 Now, apply this concept to “explore” everyday problems when searching for the best solutions.
Lastly, the dental hygienist must have a probe on every tray setup. A clinician uses the probe to measure periodontal pockets, size of lesions, and horizontal overjet.3 It is imperative for the clinician to have an accurate measurement for assessment and diagnosis as well as future reference, especially in chart documentation. The probe also signifies data collection, accuracy, depth, breadth, logic, and interpretation.
Through the use of critical thinking, we are able to arrive at the best outcome for each patient. Due to the demands of the rapidly changing health-care industry and increasing employer demands on health-care workers, it is essential that the clinician embrace critical thinking concepts. In doing so, the hygienist is actuallymodeling lifelong learning. Note the title of a book by critical thinking experts Richard Paul and Linda Elder: Critical Thinking: Tools for Taking Charge of Your Learning and Your Life.4 Critical thinking tools are vital for the dental hygienist’s success in both the dental profession as well as in all aspects of life. RDH
1 Paul R, Elder L. The miniature guide to critical thinking concepts and tools. Third Edition, 2003.
2 Paul R, Elder L. Critical thinking: learn the tools the best thinkers use. Prentice Hall, 2006.
3 Wilkins EM. Clinical practice of the dental hygienist. 9th Edition, 2005, Lippincott, Williams and Wilkins, pg. 7, chap.13.
4 Paul R, Elder L. Critical thinking: tools for taking charge of your learning and your life. Prentice Hall, 2001.