Joy Horn, RDH
In these tumultuous times experienced by the dental-hygiene profession, public appreciation for our services is paramount. Dentistry, generally speaking, has been remiss in the early diagnosis and treatment of periodontal disease, resulting in an ever-increasing need for the expertise of a dental hygienist.
Considering this fact, together with the ADA`s mounting attack to deprecate our educational and professional status, we should dedicate ourselves to delivering care that exceeds our patients` expectations. That care should be at a level that no other dental health-care provider assumes, regardless of the office environment in which we work.
Communication is a vital ingredient in providing this high-quality care. It must be done efficiently and effectively to ensure that maintaining high standards is not compromised because of the demands placed upon us in practices that lack vision.
Many good educational tools are available today that will assist us in attaining our goal of promoting the art and science of dental hygiene. The Periodontal Screening and Recording System (PSR) is one such tool.
Many benefits of PSR
This system was designed as a fail-safe method for the early detection and documentation of periodontal disease. The American Dental Association introduced it in 1992 in a cooperative effort with the American Academy of Periodontology and Procter & Gamble Co.
The idea behind this effort was to facilitate increased case referral to the periodontist. Yet, with the many benefits that this screening system offers, difficulties continue to exist with regard to proper interpretation and utilization. We miss the mark when we fail to familiarize ourselves enough to attain proficient use of this "user-friendly" tool.
The PSR satisfies the dental-legal responsibility pertaining to recordkeeping, while simultaneously opening the lines of communication. This creates enhanced services for our pa-tients and the profession of dental hygiene.
Although the practice of dental hygiene is based upon a preventive philosophy, we need to increase our participation in active periodontal therapy. We need to do this to raise the standard of dental health care that is delivered and to ensure a stronger position in the dental community. As hygienists, we have a unique relationship with, and duty to, our patients to advocate optimum care by increasing their dental awareness. Let`s not take the path of least resistance, but rather use the tools at our disposal to gain the recognition we so rightly deserve - a prelude to our autonomy.
The PSR screening can be accomplished in less than two minutes, providing the hygienist with concrete information needed to utilize the appointment time in the most advantageous way. The PSR flows very nicely when performed directly after the head and neck inspection, conveying the message of comprehensive, quality care to the patient.
The six PSR numbers will assist the hygienist in making a determination on which of a variety of options to follow
? such as taking a full-mouth series versus a panorex or performing a therapeutic scaling vs. a prophylaxis ?depending on the results of the screening. PSR findings also will give the hygienist a clue about the necessity of further investigation into the patient?s medical history and the possibility of the need to initiate nutritional counseling.
Most importantly, it will be a major factor in recommendations for initial periodontal therapy or immediate referral to a periodontist. The information gleaned from the PSR will be valuable in advising patients of localized problems, requiring adjustments in home care to be taught. It also will serve as a guide for the staff in follow-up care issues by establishing clear directions regarding treatment modalities, recare intervals, and financial arrangements.
Don?t allow supervised neglect!
Too many cases of periodontal disease have slipped through the cracks because of supervised neglect. Many dentists in the practice of general dentistry are sacrificing their patients? dental health in their quest for increased production.
Dentists in this category are imposing unreasonable demands upon the hygienists through overscheduling, which has placed serious limitations on appointment time.
Lack of adequate time has led to inferior hygiene work and delayed diagnosis of periodontal disease. Because the early stage of periodontal disease is asymptomatic, it has much too often gone unrecognized, until the damage is significant.
PSR screening is a major factor in reducing the risk of tooth loss through early diagnosis, and it should be employed by every hygienist.
Apparently, the ADA has ignored the importance and need for PSR and has focused on downgrading the hygienist?s status. In the best interests of the public, the ADHA must meet this challenge head on and do whatever is necessary to preserve the public?s dental health. Support of the movement for autonomy is a must if the ADA does not reverse its position.
Joy Horn, RDH, serves as a mentor in the dental-assisting program at the Ocean County Vocational Assisting Program. She also maintains a membership in the ADHA, participating on the advisory board for the Career and Technical Institute.