Last week, we discussed the importance of transforming the hygiene department into a patient education center for oral health beginning with the process of care beginning with screening. Today, we continue with the SAPIE model of care beginning with Assessment

The Assessment phase of the model consists of a Comprehensive Oral Evaluation that includes the collection of data from a procedural perspective combined with behavioural discovery. The procedural component includes medical/dental history, intraoral cancer screening, restorative conditions, occlusion, gingival assessment, pocket depth measurements, recessions, furcations, bleeding, mobility, radiographs and intra-oral pictures. The behavioural component is often overlooked but it is vital in nurturing relationships with patients.

The behavioural information includes documentation of the patient’s perceived problem, dental knowledge, their motivators/expectations, personality style and the degree of behaviour modification necessary with respect to self-care.

The Planning phase of the model focuses on the extent of periodontal disease and the necessary periodontal and restorative treatment. This is the time to determine the number of visits, what treatment will be delivered at each visit, the patients’ role in treatment and what the financial investment will be.

The course of action taken for the periodontal treatment plan is based on the level of infection in the patient’s mouth (Case Type). The restorative treatment plan includes a comprehensive lifetime strategy for needs, and elective dentistry.

The implementation part of the model is the actual treatment phase of repetitive periodontal therapy. It includes making sure that the patient takes ownership for their role in the treatment, delivering current concepts of ultrasonic debridement, delivery of chemotherapeutics and “self-care instruction” with self-assessments.

The Evaluation phase occurs 4-6 weeks following the completion of active therapy and is crucial in determining the healing results and success of treatment. Was the treatment successful; or does it need modification? Does the patient require referral to a specialist; or have this patient’s needs been met within the scope of our practice? What is the appropriate maintenance interval to support the patient in maintaining this status? The evaluation appointments include full documentation of the periodontal status and self-care progress.

Dental Hygiene is the heartbeat of the dental practice. The entire practice depends upon the effectiveness of the hygiene process of care. Your commitment to the integration of new concepts into your practice will change your patient’s perception of value, therefore increasing production, reducing downtime and increasing case acceptance. Change is a normal part of life; as much as we resist it, it doesn’t go away.