Gertrude Schmidt is a dental hygienist in a family outpatient dentistry practice. One of her adult patients has been coming in regularly to have her teeth cleaned since she was a teenager. Ms. Schmidt has noticed a marked deterioration in her patient’s oral hygiene.
She is shocked at the number of new dental caries and the worsening of others. The patient also displays symptoms of gum disease, which was not noted on previous visits. Ms. Schmidt also notes that the patient appears to have lost a great deal of weight since her last visit a year ago.
The patient is fidgety, speaks rapidly, and has dilated pupils despite the overhead light. Ms. Smith suspects that the patient may be using amphetamines because she displays many symptoms, including the beginnings of “meth mouth,” which is distinguished by severe tooth decay and gum disease (American Dental Association, 2017). Ms. Schmidt completes her assessment of the patient’s dental health and begins to clean the patient’s teeth.
As she works, she wonders whether she should ask the patient directly about her suspected amphetamine use. Ms. Schmidt plans to tell the patient to make an appointment with the dentist as soon as possible, to treat the decay and potential gum disease.
She decides to take a break from the cleaning to contact Dr. Melville, the dentist, to discuss her suspicions about the patient’s drug use, her concern about the patient’s severely deteriorated dental health and to create a plan of care to present to the patient before the patient leaves.
Together, they decide to meet with the patient after her cleaning is complete, discuss their concern about her dental health, make an appointment with the dentist, and possibly provide education about amphetamine use and its consequences on dental health.
Discussion Questions
Did Gertrude Schmidt, the dental hygienist, respect the patient’s dignity, privacy, and confidentiality in this case? Explain, giving examples.
How did the dentist and dental hygienist work to maintain a trusting relationship with the patient?
How did team-based care contribute to acting with high ethical standards in this case?
What is your opinion of the dental team’s decision to provide education and dental treatment rather than confront the patient with their suspicions that she was using amphetamines?
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