Be an “Eagle-Eye” – The Importance of Hygienist, Doctor, and Patient Co-diagnosing

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My employer often calls me “Eagle Eye” because he knows and appreciates my skills as a hygienist. Having a heightened sense of the oral condition of each patient sets up for a great handoff during the doctor’s examination. It is essential to go above and beyond routine care to assist in co-diagnosing with the doctor and patient for a practice to continue to grow.

Co-diagnosing can be a three-way channel in the dental profession. The chain links the hygienist, dentist, and patient in diagnosing, treatment planning, and treatment outcome. Each person in this chain creates a strong link in building a permanent relationship based on trust, confidence, and respect of each other’s opinions. The end result is a happy patient, happy hygienist, and happy dentist.

Where Co-diagnosis Starts

Dental hygienists sit in a prime position to build the first link in the chain. This link is between the hygienist and the patient.

It begins when we seat our patient and have that one-on-one motivational interview. The patient will either inform us of a problem or concern or state that everything is fine. Our job is to be a sleuth and determine what is bothering the patient and/or examine for any asymptomatic issues with the intraoral camera, radiographs, and visual examination.

By showing our findings to the patient, we are co-diagnosing. When patients visualize their oral health status with digital imaging, it allows them to see and inquire about conditions that they may not have been aware of.

A hygienist who uses the intraoral camera is imperative for the first link of co-diagnosing. Keep the image in question up on the screen throughout the appointment. This gives the patient adequate time to connect with the fact that, yes, something seems to be amiss, and will want to know what can be done to fix the situation.

The Doctor Joins the Link

The next link comes when the doctor performs the examination. By keeping the questionable image on the screen until the doctor arrives, the doctor is offered a first glance at a possible concern that either the patient or hygienist presents. This is the doctor-hygienist link. The doctor may inquire about the image, and the hygienist can then guide the discussion on clinical findings.

The patient-doctor link comes next. After a thorough examination of clinical and digital images, the doctor should discuss treatment options with the patient. By giving options, the patient becomes part of the co-diagnosis. After all, it is their mouth and, believe it or not, dental care is optional in most cases.

There is a lot of competition for dental patients. Gaining a patient’s trust is key in building a practice and growing patient referrals. With the onslaught of dental chain practices and insurance regulating care, trust becomes even more critical in keeping and growing your existing patient base.

The Eagle Eye of Co-diagnosis

The hygienist and patient then discuss the doctor’s treatment options in greater depth to aid in understanding and benefits of each potential option. This reaffirms that first link in the chain, the patient-hygienist link. Having a strong chain will result in trust and affirmation of the proposed treatment.

Being an “eagle eye” means going above and beyond just “cleaning teeth” and sitting aside while the doctor does the examination. Remember, we are perched on that saddle chair for the better part of an hour, while the doctor may be in there for only a few moments.

Use your loupes to help hone your eagle-eye vision on potential dental concerns such as cracks, fractures, attrition, abrasions, leaky restorations, secondary decay, tissue abnormalities, or a crown that has worn through. While scaling and exploring, we are better able to check crown margins than the doctor due to the simple fact that we are navigating every surface of every tooth. Listen to your gut when it tells you to take an intraoral image of a suspicious area. Your gut is guided by your “eagle eye” and is usually a major tool in the co-diagnostic process.

Get patients involved in the co-diagnostic process. People want to know they have a say in their health and finances and appreciate the guidance of an expert. Make sure you and the dentist are on the same page, trusting and respecting each other’s opinion. Your patients will pick up on this positive vibe.

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Rebecca Marie Friend, BS, RDH
Rebecca Marie Friend, RDH, BS, attained her Associate of Applied Science degree in Dental Hygiene from Ferris State University, Big Rapids, Michigan in 1987, where she also met and married her husband. She has been a practicing dental hygienist for over 30 years and has raised three sons while working as a full-time clinical dental hygienist. Rebecca currently practices in Battle Creek, Michigan, for Dr. Earl E. Gaball, DDS, a general and sedation dentist. She resides in neighboring historic Marshall, Michigan. Rebecca is board certified in Nitrous Oxide and Local Anesthesia Administration and is certified in low-level laser therapy. Continuously striving to improve upon her skills and methods of forward-thinking in the dental world, she recently attained her Bachelor of Science degree in Oral Health Promotion through Action Research at O’Hehir University. She is actively involved in a mentorship with students at O’Hehir University. “I take pride in my abilities as a skilled periodontal therapist. I enjoy the patient-practitioner relationship that develops when trust and health are gained, taking mindful care of every individual that I connect with. The benefits of helping others achieve a healthy mouth and regain their confidence with a great smile and healthier self are very rewarding. Whole body health begins with the mouth.” In her free time, Rebecca enjoys visiting the beautiful shores of Lake Michigan where the sunsets are magical, the dunes are stunning, and the rocks are a collector’s delight. She loves to immerse herself in nature whenever she gets a chance and enjoys canoeing, kayaking, nature-walks, flexibility training, yoga, and little “get-a-ways” with her husband. Family life has always been important to her, and now that her three grown sons have spread their wings, she has a little more time to spread hers.