Caries Risk Assessment Clinical Case #3

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Question 1 of 3

1. Question
Cynthia, a 2-year-old girl, is brought to the community clinic by her mother for a well-child visit to establish primary care. She has had inconsistent well care and her mother would like to ensure that she is caught up on her immunizations. Her mother reports that the patient has never seen a dentist and does not use a toothbrush.

Which behavior best exemplifies effective teamwork among participating members of the healthcare team?
- Engage dental health professionals if the family identifies an oral health related concern. To appropriately deliver patient-centered care, it is important to engage other health professionals – appropriate to the specific care situation – in shared patient-centered problem-solving. Members of the team should be involved in developing a plan for the patient.
- Ignore disagreements about values, roles, goals, and actions that arise among healthcare professionals if it does not affect your patient’s care directly. To appropriately deliver patient-centered care, it is important to engage self and others to constructively manage disagreements about values, roles, goals, and actions that arise among healthcare professionals and with patients and families.
- Defer to dental health professionals regarding decisions about the oral health of the patient. To appropriately deliver patient-centered care, it is important to integrate the knowledge and experience of other professions – appropriate to the specific care situation – to inform care decisions, while respecting patient and community values and priorities/preferences for care. The family has identified key issues – the need to brush and floss – anticipatory guidance the medical team can initiate.
- Share accountability with dental providers for outcomes related to patient care.
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Question 2 of 3

2. Question
During the initial visit with Cynthia and her mother, you perform a risk assessment and an oral health history. In addition to a lack of regular health care, Chantelle also frequently eats sugary snacks and her mother has visibly obvious tooth decay and missing teeth.

Which behavior best exemplifies the acknowledgement of roles and responsibilities of participating members of the healthcare team?
- Explain that the patient medical home allows the primary care clinician to work independently and engage other team members, if needed. To appropriately assess and address the healthcare needs of patients, it is important to forge interdependent relationships with other professions to improve care and advance learning. It is important to recognize the limits of individual professional expertise and the value of collaboration across professions.
- Explain the specific aspects of Chantelle’s care that you will oversee. To appropriately assess and address the healthcare needs of patients, it is important to explain the roles and responsibilities of other care providers and how the team works together to provide care. Any explanation of the care plan for Chantelle should be in the context of collaborative team-based care.
- Communicate your roles and responsibilities in the context of the healthcare team.
- Seek solutions to the patients’ oral health needs that primarily involve medical professionals. To appropriately assess and address the healthcare needs of patients, it is important to engage diverse healthcare professionals who complement one’s own professional expertise, as well as associated resources, to develop strategies to meet specific patient care needs.
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Question 3 of 3

3. Question
You perform an oral examination and encounter white spots, consistent with early childhood caries. You determine that Cynthia is an appropriate candidate for fluoride varnish application. You will apply varnish in the office today and establish a referral to a dentist.

Which behavior best exemplifies effective communication among participating members of the healthcare team?
- Use modes of communication most comfortable for you. To appropriately deliver patient-centered care, it is important to choose effective communication tools and techniques, including information systems and communication technologies, to facilitate discussions and interactions that enhance team function. This may require using modes of communication that are not your preferred approach.
- Respect dental providers’ expertise and resist the urge to critique their interactions with your team. To appropriately deliver patient-centered care, it is important to give timely, sensitive, instructive feedback to others about their performance on the team, responding respectfully as a team member to feedback from others. Learning to give and receive this kind of feedback contributes to a more effective and responsive team.
- Only communicate your medical findings and opinions to dental providers involved in the patients’ care upon patient request. To appropriately deliver patient-centered care, it is important to express one’s knowledge and opinions to team members involved in patient care with confidence, clarity, and respect, working to ensure common understanding of information and treatment and care decisions.
- Organize and communicate information avoiding discipline-specific terminology when possible.
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Caries Risk Assessment, Fluoride Varnish, and Counseling

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