14 February 2012
With a team of fifty dento-legal advisers available to support the profession, Dental Health has selected some recent enquires they have received to see what the experts at Dental Protection have to say. The situations have been fictionalised to ensure confidentiality.
I am a dental hygienist working for the community dental service providing special care dentistry. I work in two clinics. In one clinic the dentist said that the BPE must be carried out by the dentist at the examination stage. In the other clinic, which is a single surgery clinic, the dentist undertakes an examination of the patient and requests me to do the BPE at the following visit. I am confused. Who should record the BPE - the dental hygienist or dentist?
The BPE is a simple and rapid screening tool which is intended to provide a snapshot of the state of the patient’s periodontal health. It is not necessarily designed to monitor the effect of treatment nor the progression of disease associated with individual teeth. The screening process involves a sequence of six numerical scores recorded in a standardise grid. As such this is most commonly carried out when a patient attends for a ‘check-up’.
There is nothing to say, however, that this has to be the case and as the skill set required to carry out a BPE is well within the competence of a dental hygienist, it is just as appropriate for a hygienist to undertake this screening as it is the dentist.
It has to be remembered that the most important element of any screening process is consistency. As such then it is often better if the same clinician undertakes the BPE scoring on each occasion simply to ensure a degree of uniformity.
The referral from the dentist then may well include a request to carry out a BPE on the understanding that any untoward findings are relayed back to the dentist so that the most appropriate care can be planned for the patient. The concept of team working implies that any relevant information about a patient (clinical and non-clinical) will be shared between members of the team for the overall benefit of the patient. In this way the team can work together to provide the most appropriate treatment for the patient. The changes however should be noted in the patient’s record. In addition a conversation between clinicians will ensure that everyone involved in the patient’s treatment has the same understanding.