By DOCS Education Staff
When hygiene services are provided to sedation patients, the typical oral hygiene instructions (OHI) and home care instruction (HCI) process differs from traditional procedures. Because the patient is sedated during their treatment, DOCS Education recommends that patients complete their OHI during 3-4 separate visits, each about 15-20 minutes long.
Basic Oral Hygiene Instruction Prior to Treatment
Initial HCI should always be provided prior to the planned sedation procedure so that patients can take appropriate measures to prepare. In most cases, instructions can be incorporated into the exam or consultation appointment after a patient accepts a recommended treatment plan. These 10-15 minutes of OHI serve both for educational purposes as well as establishing a personal rapport with the patient. It also creates the opportunity for personal investment from the patient in regard to the success of their treatment.
During the initial home care session, keep instructions basic. Brushing and flossing are all that you need to cover at this pre-treatment meeting. It’s not yet necessary to overwhelm the patient with more specialized types of oral hygiene devices.
On the Date of the Procedure
On the date of the procedure, the focus should be specifically on the treatment being rendered. Since the patient will be sedated, it’s unlikely that they will accurately remember any HCI provided at that time. However, you may as a courtesy review basic HCI with their escort and provide a written copy of the OHI instructions provided at the previous appointment as a refresher. This step allows the escort to ensure the patient is being looked after properly and serves as a reminder to the patient as their sedatives wear off.
One Week Follow-Up
Have the patient return for a one-week post-op visit to assess their response to treatment. After a periodontal debridement or scaling and root planing have been completed, you’ll have a better idea of the patient’s specific oral hygiene needs. Including any specific tools, products, or techniques that should be utilized around localized areas of their mouth.
During this appointment, re-evaluate their oral hygiene methods and introduce new techniques or products that may have previously been more challenging to use. Such as floss threaders, proxy brushes, or subgingival irrigation devices. Use the opportunity to reassure the patient of the progress that’s already been made. Reaffirm how their investment in their prescribed HCI has amplified their response to their periodontal procedure. Now is the time to adjust things further, specifically in the hopes of avoiding disease relapse in at-risk areas of their mouth.
Because you are introducing new oral hygiene techniques and devices, be sure to also provide a written copy of OHI at this appointment.
One Month Follow-Up
From here, a third hygiene instruction visit should be scheduled either at the four-week mark or following the completion of prescribed restorative treatment. At this time, review the overall progress of the patient’s soft tissue healing and their oral hygiene efficacy. Reassure them of the progress they’ve made thus far. Go back and review any brushing, flossing, or adjunctive device use as it relates to specific areas of concern.
These recurring home care sessions need not last more than 15-20 minutes each.
Placing the patient on a recare or periodontal maintenance schedule at appropriate intervals will allow for gentle reminders of past OHI, providing the assurance the patient needs to play an active role in the improvement of their oral health. Encourage your patient to continue incorporating each aspect of their oral hygiene routine. Not just for the purpose of tooth preservation and systemic health, but also to reduce the extent of treatment needs in the future, including additional sedation procedures.
Altogether, these oral hygiene educational reviews educate, remind, and prompt patients in a manner that isn’t easily overlooked, even given the use of sedation.
Sedation Training for Hygienists
Implementing sedation in the dental practice allows hygienists to collaborate with dentists for comprehensive patient care and fewer appointments. Dental hygienists who have completed DOCS sedation training courses can safely provide the same level of care to their patients without eliminating the personal OHI or HCI process that frequently accompanies the typical recall appointment.
Providing sedation services during necessary hygiene procedures expands the accessibility of care for patients experiencing severe anxiety, dental phobia, or who otherwise delay treatments because of the complexity of their oral health needs. In turn, hygienists can provide their sedation patients with the reassurance that their periodontal treatment will play a long-term, positive role in the future of their smile.