Case Study: Hygienist in the Middle Evaluated

Authors Note: This paper is being submitted on the 18th of March 2013 for the winter semester of Medical Law and Ethics section 05.

This research paper is being submitted on December 8, 2011, for Mara Pehkonen’s M230 Medical Law and Ethics Course.

As healthcare cost, rapidly increase, healthcare professionals are finding innovative ways to contain cost. Occasionally, the healthcare organization may find themselves entombed in an ethical decision and find it difficult to take the appropriate action. In this paper, I will analyze the case study of Dr. S. and Dr. V.; and deliberate how the actions of Dr. S. and Dr. V. violated the Stark Law.

I observed a second year student in the dental clinic who was incredibly enthusiastic, genuine, cheerful, and helpful, and her personality would fit perfectly into what I consider the typical dental hygienist. She seemed very well prepared and confident in her ability to treat her patient. A dynamic conversation was held throughout the appointment with her easygoing and cooperative patient. Besides the appropriate clock and chair positions, I was not aware of many proper techniques when I observed at the beginning of the semester. I noticed the student kept the patient chair in the same position for treating the maxillary and mandibular teeth. I observed her for the full four hours including the preparation before her patient arrived until

Reading over the outcomes and objectives, how will the skills developed in this class apply to your chosen career or field of study? If you are “undecided,” how will these skills help you in your future in college and in general?

The resident physician violated beneficence, because he did not do good by respecting the patient’s autonomy and he was being uncivil.

I reviewed the case of Mr. Sam Superstar and Dr. Peters, in regards to possible proceedings and to which party would be at fault. I have found that in this case both parties could be found at fault in many different violations, both civil and criminal. Therefore there could be possible proceedings brought against both parties. It shows many aspects, of many, violations of laws. These violations range from simple breach of contract to theft of property. We will need to look into the violations more in depth. Following you will find a summary of my findings.

All healthcare providers including dental hygienists should be knowledgeable when it comes to educating patients and use evidence based decision-making constructed on the research. The focus is to make an effort to find the right article and transform evidence into practice to improve quality and effectiveness of patient’s health care outcome.

The patient was keen to get her oral hygiene up to a good standard and prevent any

Prompted by another practitioner, the government intervened in the case of Dr. John Roger Lund, a Saratoga, Calif. dentist who was arrested June 6, 2016 for performing unnecessary procedures on his patients and bilking insurance companies out of hundreds of thousands of dollars (Dentist). The 28 counts of felony insurance fraud included factitious charges and superfluous procedures done on patients with healthy gums and teeth. One individual had 18 root canal procedures completed by Lund during a five-year period, which is considered to be overly aggressive treatment. Due to patients’ lack of awareness, Lund and many other practitioners are able to manipulate the modern, insurance-driven, healthcare system and operate with a sense

Treatment of periodontal disease can be broadly divided into two, non-surgical and surgical. Longitudinal comparison between non-surgical and surgical therapy had been studied extensively by groups of researchers, namely the Gothenburg, the Michigan, the Minnesota, the Nebraska, and the Arizona group. There are some heterogeneities between studies from different groups. Some studies focused on single rooted teeth, while others included molars. Majority of the studies are done in a university setting, while the Arizona study was done in private practices.

Some studies have been conducted but the World Workshop on Periodontics stated that controlled clinical trials that evaluated the role that occlusion had on the progression of periodontal disease in humans, was unethical. To avoid unethical situations, patient records from a private practice facility were collected and studied to see if there was a connection between occlusal discrepancies and the progression of periodontal disease. The records that were studied were from patients that had periodontal evaluations as well as occlusal assessments. All of the patients studied had periodontal disease but only some of them had occlusal decencies. After a twelve month period some patients returned and had another periodontal evaluation and occlusal assessment and the data was compared to the data that was collected twelve months prior. The data collected was compared. Patients without occlusal discrepancies and patients with occlusal discrepancies both had worsening periodontal disease after twelve months of no treatment but, the progression of periodontal disease and increased pocket probing depths

Periodontal disease is characterised by inflammation of tissues surrounding the teeth, damage to the supporting structures of teeth and the creation of pockets prone to bacterial infection (AIHW, 2015; Gehrig & Willmann, 2016). Periodontal disease is comprised of two main diagnostic categories: gingivitis and periodontitis. Gingivitis is characterised by inflammation, redness, oedema, and bleeding upon probing (Australian Research Centre for Population Oral Health, 2009; Gehrig & Willmann, 2016). Chronic untreated gingivitis can often lead to periodontitis (Gehrig & Willmann, 2016; Van der Weijden & Slot, 2015), which presents as a loss of attachment between the supporting structures of the teeth such as bones, gums and ligaments. The greatest contributing factor to periodontal disease is the chronic build up of plaque - a sticky film that adheres to the teeth, which is composed of microorganisms, microbial waste products and food debris (Australian Research Centre for Population Oral Health, 2009). Regular and effective oral hygiene practices such as frequent tooth brushing (Zimmermann et al., 2015), using a manual or power toothbrush (Van der Weijden & Slot, 2015) and interdental cleaning (Crocombe, Brennan, Slade, &

RESULTS: Out of the 10 cases, only 2 cases could be supported with a microbial evaluation. The remaining 8 cases were clinically and radiologically suggestive of Aggressive Periodontitis.

Once the D4 made his observations and explanations, the supervising dentist was called. Upon further evaluation, another opinion was needed, so the two decided to refer to Dr. Gopalakrishnan from Oral Pathology. He confirmed the potential seriousness, this lesion had; he agreed that this item needed to be dealt with as soon as possible. The moral I obtained from this situation was to have proper communication with your patient and your dental colleagues to make sure the patient receives the best care possible. In doing so, being calm and collective throughout the explanations to keep the patient at ease. I envisioned that this situation could have ended up much worse. A highly educated patient that was disgruntled about his previous treatments, accompanied with a potentially serious diagnosis could have escalated into a more volatile situation if the communication was less than