Deficits in Hearing
“Hearing loss occurs when there is damage to the inner ear (cochlea) or to nerve pathways in the auditory nerve (cranial nerve VIII) between the cochlea and the brainstem.” (Darby & Walsh, 2010)
Mock Case Study: Tammy
Demographics
Race: White
Gender: Female
Age: 47
Height: 5 ft 5 in
Home: Jackson
Physical Assessment
Patient presents with signs of deafness. Patient’s speech is broken and hesitant.
Mental Assessment
Patient appears to be very aware of surroundings
Social Assessment
Patient lives with friend
Is not employed
Patient does not like to speak for fear of ridicule, but says she is excellent at lipreading
Patient engages in very little social activity
Medical Assessment
Patient states in chart that she was born deaf, hearing aids are not beneficial to her
Patient’s blood pressure is 132/84-prehypertention
Dental Assessment
Patient has not been to the dentist in over 10 years
#2 MOD
#8 chipped incisal edge
#9 DO
#10 MO
#19-21 PFM bridge with root canals
Suspicious areas on #14, 16, 31,32
Patient presents with moderate amounts of calculus on buccal surfaces of maxillary first molars.
Extra Oral Exam
Patient has 3mm x 3mm nodule on left cheek. Patient confirms that it has been there for many years with no changes
Intra Oral Exam
General marginal redness
Heavy interproximal plaque
Consistency of attached gingival is soft and spongy
General texture is smooth and shiny
Tammy’s Appointment
Communication
Me: (speaking slowly and facing Tammy) “Do you have any concerns today?”
Tammy writes: “I would like to have my teeth cleaned and possibly whitened.”
Me: “Great, that is a good goal. I see that you have a lot of tarter in between your teeth. Do you floss?” (gesture of flossing)
Tammy writes: “Sometimes. Maybe once a week.”
Me: “Okay, I would like to work on flossing so we can keep your teeth clean, then on your next visit we can look at whitening. Is that okay?”
Tammy writes “Sure.”
I show Tammy how to floss the correct way, using my typodont. This way I do not have to have my mask on and I am able to communicate with Tammy throughout my demonstration.
Me: “Now I am going to floss your teeth. Then I will hand you the floss and have you demonstrate.”
Tammy nods in agreement
I hand Tammy the hand mirror. She watches as I floss a few of her teeth. I hand her the floss.
Tammy flosses her teeth. She accepts minor adjustments to “hug” the tooth. Tammy does very well.
I give Tammy a handout to take home about flossing and also one about whitening.
Appointment Planning
Tammy schedules an appointment after looking at the times and dates I have available on my calendar.
I schedule a post card reminder to be delivered 2 weeks before her appointment.
Client Positioning
Tammy is placed in a supine position
Dental Hygiene Procedures
Tammy’s teeth are disclosed to use as a visual aid to improve her flossing technique.
Safety Precautions
If Tammy were to wear a hearing aid, it should be turned off before instruments with high pitch sounds were used (i.e. slow speed, ultrasonic)
Individuals who are hard of hearing or deaf should not be approached from behind
If Tammy was not able to lipread, communication could be through writing or an interpreter.
Patient Recommendations
I recommend Act mouthwash with Fluoride
Tammy is encouraged to floss twice a day
Xylitol products are recommended (gum and mints)
Personal Reflection
I chose to make a mock case study about deficits in hearing because I have 2 family members who are deaf. One is able to use a hearing aid but the other is not. My family member that has the hearing aid speaks very naturally but sometimes her responses are delayed. My family member that is not able to benefit from a hearing aid is an excellent lipreader. Although she was born deaf, she is able speak, however, it does not sound as natural as my other family member. She is very hesitant to speak because a friend once told her that she “sounded funny”. When needed, I am able to sign the alphabet using American Sign Language and thankfully my family members have patients when I am trying to spell out sentences.
Additional Information
Learn more about American Sign Language
Watch this video to brush up on your signing
Find an American Sign Language Translator
References
Darby, Michele Leonardi, & Walsh, Margaret M. (2010). Dental Hygiene: Theory and Practice. St. Louis, MO: Saunders, an affiliation of Elsevier Inc.
*Pictures from Google Images
“Hearing loss occurs when there is damage to the inner ear (cochlea) or to nerve pathways in the auditory nerve (cranial nerve VIII) between the cochlea and the brainstem.” (Darby & Walsh, 2010)
Mock Case Study: Tammy
Demographics
Race: White
Gender: Female
Age: 47
Height: 5 ft 5 in
Home: Jackson
Physical Assessment
Patient presents with signs of deafness. Patient’s speech is broken and hesitant.
Mental Assessment
Patient appears to be very aware of surroundings
Social Assessment
Patient lives with friend
Is not employed
Patient does not like to speak for fear of ridicule, but says she is excellent at lipreading
Patient engages in very little social activity
Medical Assessment
Patient states in chart that she was born deaf, hearing aids are not beneficial to her
Patient’s blood pressure is 132/84-prehypertention
Dental Assessment
Patient has not been to the dentist in over 10 years
#2 MOD
#8 chipped incisal edge
#9 DO
#10 MO
#19-21 PFM bridge with root canals
Suspicious areas on #14, 16, 31,32
Patient presents with moderate amounts of calculus on buccal surfaces of maxillary first molars.
Extra Oral Exam
Patient has 3mm x 3mm nodule on left cheek. Patient confirms that it has been there for many years with no changes
Intra Oral Exam
General marginal redness
Heavy interproximal plaque
Consistency of attached gingival is soft and spongy
General texture is smooth and shiny
Tammy’s Appointment
Communication
Me: (speaking slowly and facing Tammy) “Do you have any concerns today?”
Tammy writes: “I would like to have my teeth cleaned and possibly whitened.”
Me: “Great, that is a good goal. I see that you have a lot of tarter in between your teeth. Do you floss?” (gesture of flossing)
Tammy writes: “Sometimes. Maybe once a week.”
Me: “Okay, I would like to work on flossing so we can keep your teeth clean, then on your next visit we can look at whitening. Is that okay?”
Tammy writes “Sure.”
I show Tammy how to floss the correct way, using my typodont. This way I do not have to have my mask on and I am able to communicate with Tammy throughout my demonstration.
Me: “Now I am going to floss your teeth. Then I will hand you the floss and have you demonstrate.”
Tammy nods in agreement
I hand Tammy the hand mirror. She watches as I floss a few of her teeth. I hand her the floss.
Tammy flosses her teeth. She accepts minor adjustments to “hug” the tooth. Tammy does very well.
I give Tammy a handout to take home about flossing and also one about whitening.
Appointment Planning
Tammy schedules an appointment after looking at the times and dates I have available on my calendar.
I schedule a post card reminder to be delivered 2 weeks before her appointment.
Client Positioning
Tammy is placed in a supine position
Dental Hygiene Procedures
Tammy’s teeth are disclosed to use as a visual aid to improve her flossing technique.
Safety Precautions
If Tammy were to wear a hearing aid, it should be turned off before instruments with high pitch sounds were used (i.e. slow speed, ultrasonic)
Individuals who are hard of hearing or deaf should not be approached from behind
If Tammy was not able to lipread, communication could be through writing or an interpreter.
Patient Recommendations
I recommend Act mouthwash with Fluoride
Tammy is encouraged to floss twice a day
Xylitol products are recommended (gum and mints)
Personal Reflection
I chose to make a mock case study about deficits in hearing because I have 2 family members who are deaf. One is able to use a hearing aid but the other is not. My family member that has the hearing aid speaks very naturally but sometimes her responses are delayed. My family member that is not able to benefit from a hearing aid is an excellent lipreader. Although she was born deaf, she is able speak, however, it does not sound as natural as my other family member. She is very hesitant to speak because a friend once told her that she “sounded funny”. When needed, I am able to sign the alphabet using American Sign Language and thankfully my family members have patients when I am trying to spell out sentences.
Additional Information
Learn more about American Sign Language
Watch this video to brush up on your signing
Find an American Sign Language Translator
References
Darby, Michele Leonardi, & Walsh, Margaret M. (2010). Dental Hygiene: Theory and Practice. St. Louis, MO: Saunders, an affiliation of Elsevier Inc.
*Pictures from Google Images