Dental Hygiene III

Treatment planning Assignment #3

Special Needs Treatment Plan

Criteria Sheet & Rubric

Points Possible

Treatment Planning Assignme rrt #3

To be completed on a special needs patient treated in the clinic. This
patient can be taken from Clinic II or Clinic III.

*When completing this assignment, be aware of patient confidentiality; IE

change the patient's name.

Treatment Plans should be presented in written form, in a labeled folder.

Typed, double-spaced, maximum of 5 pages.

Site a minimum of two references. (Loss of all formatting points if

references are incorrect!)

Student should utilize the rubric as a guide to completing the treatment

planning assignment.

* Site reference according to attached sample, site references on separate

page appropriately titled. It is not necessary to site sources in the body of
the plan.
References
Morrow, M.J. (1988). Teaching about cancer to children. Journal of

School Health, 12, (8), 223-228

Grading Criteria 0 I 2 3
Not Beginning Developing Accomplished
Present
Understood, Understood, Understood,
Included, Included, Included,
Covered Covered Covered All
Few Some
I. Assessesment
patient interview 0 1 2 3-)
medical/dental 0 2
1
\
history s)
*identiff
implications
treatment of special
to
0 1 2
( o
needs patient
social history 0 1 1 ( o
vital signs 0 1 2 3
intra-oraUextra-oral 0 1 ) ( a_)
examination
periodontal 0 1 2
examination (
*relate oral 0 1 )
(
q)
changes based on
special needs
patient
)
radiographs if 0 1
( .&)
available
II. DH Diagnosis (Problem
Identification)
Level of Health 0 I 2 G JJ
*Relate Special Needs to Diagnosis 0 1 2

Gingivitis
Periodontal Disease
Caries
III. Plan
Consultations Necessary 0 1 ) ( 3\
Treatment Goals 0 I 2 7 rr*:
Addresses Phases of Treatment
fV. Implementation
0 1 2 I
(narrative section) 0 1 2
-q-)
Consultations (
Instruments used
Methods
Homecare Aids
Anesthetic
Prescriptions
+Identifu alterations to 0 1 2 (
implementation based on special
needs
V. Evaluation A
How will you or how did you
evaluate care
0 I 2 S'i
\#
F\
Follow up charting 0 I ) u:,
Radiographs 0 1 2 taJ

Patient OH behavior changes 0 1 ) 3

Other Items
References 0 1 2 3
Spelling/Grammar 0 I 2 3

Total

Final Score (0m