Madelyne Smith

Peer Mentoring
1/27/2020

I had the pleasure of mentoring my little, Erin, through her first day of seeing patients
for clinic. Erin had a new patient that she had not seen before in her radiology course and her
last visit to the TNCC dental hygiene clinic was in 2017. The last time the patient was seen, she
had a full mouth series of radiographs taken with vertical bitewings. Erin made sure she had her
encounter form filled out as well as her radiograph form filled out and ready to go to take more
vertical bitewing radiographs. Prior to taking the x-rays, Erin made sure to update the patient’s
medical history, take vitals for the day which were within normal limits, and most importantly,
sign the HIPPA consent form. From there, Erin began to take digital vertical bitewing x-rays for
her patient. The patient had some teeth either broken down to the gum due to fracture or
decay. Due to these spaces, she had a hard time biting down on the ren, so we chose to also
take a panoramic x-ray since she also had some impacted 3 rd molars still present.
I went ahead to the pano room to set everything up for her patient, unfortunately there
were some computer issues with the system. Usually there should be one person or the
auxiliary person to check both the pano and digital x-rays before clinic starts so that if there is
any issues, the server can be re-booted before patients are seen. Luckily, after restarting the
computer three times, I was able to pull up the ready light for the pano to be taken. Erin took
this as a learning lesson to always make sure the panoramic machine is set up and ready to go
prior to the clinic starting. While I was getting the panoramic machine fixed, Erin went ahead
and started on her extra-oral and intra-oral exam. By the time I was back, she was starting on
the intra-oral exam. Other than the teeth that were broken down to the gumline, there were no
significant findings. From there we started working on the dental charting, which I was able to
help chart. Since the patient was seen in the clinic before, we made sure to check everything
previously charted to make sure there were no changes. One helpful tip I gave Erin, air is going
to be her best friend, especially when it comes to dental charting and plaque and calculus
detection.
Next we started on the periodontal assessment, first we checked for her deposit; there
were many subgingival deposits felt with the ODU 11/12 explorer and seen on the radiographs,
as well as heavy supragingival calculus on the lingual’s of the lower anterior so we classified the
patient as a deposit 4. Next we began probing to check the health of her gums and check for
bone loss. Her highest probe depth was a 6mm pocket on the distal lingual of #31, which might
be deeper because Erin said she was getting caught on a piece of calculus. In that same area, on
her previous chart, they had a 10mm probe depth. Most of her probe depths were 3’s and 4’s
with a few 5’s on the posterior teeth. There was mild recession in localized areas and some
interproximal inflammation throughout the whole mouth. She has slight mobility on the
maxillary and mandibular teeth and maybe a couple of teeth with class 1 furcation involvement.
Once Erin was done with the perio chart, she had her sign her medical history,
scheduled her for her next appointment, and dismissed for the day. I helped Erin classify her
patients periodontal classification for her SOAP note, and we thought of some DHD goals for
her patient. Since she hasn’t had her teeth cleaned in 3+ years, we made a DHD for her lack of
responsibility for oral health and to explain the importance of visiting the dental office for
cleanings and exams every 6 months. We also made a DHD for the teeth that need to be
extracted since they were broken/rotted down to the gumline, which she will receive a referral
form for. We also made a DHD for her bleeding sites to decrease by 25% by recommending a
waterpik with a subgingival insert to get deeper underneath the gums.
Overall, I feel as though Erin did a wonderful job for her first day especially with how
hard her patient was. She was very organized and prepared her everything she needed done.
Given that it was her first day and her patient was not the easiest, her time management was
great! I am so glad I was able to be there for her and mentor her through someone as difficult
as her patient, so she feels more prepared and ready for the next time. I wish I was there for
when she was getting to the cleaning so that I could help and advise her through that process
for a deposit 4 patient. I see Erin becoming a very successful dental hygienist and I cant wait to
see her grow and conquer through the hygiene program!