all right let's talk about human needs assessment now with there are eight human needs assessments um we look at when we're making a dental hygiene diagnosis and you can see them listed right here this is from the darby and walsh textbook and i can show you um make it smaller it's from figure 22.2 on the um fifth edition of the darby and welsh textbook and so what i want to show you i'm going to make this bigger is that there are eight human needs assessment and let's go over them so the way this works is when you finish treatment with your client sorry when you finish the assessment period with your client so you have gathered all their health history information their medical history their dental history their social history you have gathered the extra oral intraoral assessment you have done the perio assessment you have done radiographs you have general heart tissue partition charting so you have all the assessment now we need to circle all the things you found from your assessment so before we go over the different things that you have you could have possibly found with your client let's go over the human needs assessment the eight different human needs assessment let's go over what they actually mean so number one is protection from health risk protection from health risk is when you're free from any harm or danger so when the client is free from any harm or danger so if their blood pressure was too high i would circle this and that falls under protection from health risk because now they're at risk for high bp which can lead to stroke heart attacks and so on if they need pre-med i would serve i would put them under a protection from health risk category that human needs assessment because they need pre-med in order for them to be safe they're at risk without taking pre-med when they don't take pre-med potential for injury and risk factors so let's look at risk factors first if they are a smoker um if they are diabetic and it's uncontrolled so if they're immunocompromised and it can affect their um health i would put that all under protection from health risk you know if they're smoking and they are at risk for cancer potential for cancer potential for injury anything that can harm themselves you want to put you want to make sure you circle or you identify the needs under this human needs which is protection from health risk okay so your goal is to keep your client as healthy as possible if there is anything that's preventing you from keeping your client as healthy as possible we need to circle those we need to identify this and we're going to make a dhd we're going to make a dental hygiene diagnosis using protection for using the unmet need under protection from health risks what if your client is very fearful and how can you notice well when you the client comes in you can see that they're grabbing onto the dentural chair really tightly um every time you go close to them with an instrument they're like winking they're blinking they're closing their eyes they're um you know you can see that they're very nervous and they might even tell you that they're anxious and nervous then this is the unmet human need freedom from fear and stress so they're anxious um and it doesn't even have to be anxiety it could be other things such as oral habits so that means like um they're when they're nervous they're um they're biting on their nails or they're biting on the end of a pencil so something what habits do they have that they use when they are fearful when they are stressed substance abuse perhaps they're taking drugs perhaps they're you know drinking a lot of alcohol um you know anything that they're doing to compensate for their fear or stress and it could even be concerns that they have about infection control so they come into the office and they're really concerned about whether everything is sterile whether everything is clean disinfected and they're asking you lots of questions about that that's because they're scared that's because they have this fear or stress they could be asking you a lot of questions about fluoride because they're really scared about fluoride toxicity amalgam fillings they may be adamant against it because they have this issue or they have a sphere of mercury uh toxicity and so there's many different things that a client could tell you that they're really scared about they're really concerned about and if they are this is their unmet human need and any time to tell you something we need to resolve that so first we gotta identify what their needs are what their deficits are and then we're gonna later on find a way to help work around this deficit okay so protection from healthwise we want them as healthy as possible freedom from fear and stress we want them free from any fear or stress freedom from pain we want them having no pain so they could tell you that their um tmg maybe like their tmj is in pain so when they're um at night they've got lots of pain in their face maybe um they're extremely sensitive to deprivement and they're anxious about that um maybe they have a node uh a really swollen lymph node on you know uh in on their head and neck region and so that is something we need to address so if they are in pain we need to circle this or we need to identify that this is the unmet human need and then identify what pain they have number four wholesome facial image so if they're not happy about their image their facial image maybe they have crooked teeth maybe they have stain in their teeth and they tell you that maybe their gums are really inflamed and and they don't like that maybe they don't like their facial profile um and so maybe they need ortho to fix that facial profile because maybe they have a class three or you know occlusion maybe they tell you they have bad breath and they're worried about that so all these things you need to circle because that falls under the unmet human need of wholesome facial image they are not happy with the way they look you mean any teeth whitening they have yellow teeth and so that's um something we need to look at so we have to the reason why we're doing this it's um we're putting everything that they see and everything that we've seen over here so that when we make a care plan when you make a treatment plan we can address each and every problem that they have expressway that we see okay number five is the big one skin and mucus membrane integrity of the head and neck so um what this refers to is uh anything on the skin and anything on the mucous membrane to make this membrane think of inside your mouth your buccal mucosa your labial mucosa your albiolo mucosa your gums your tongue all that falls under here so coating on tongue will fall under here if you see an intro or a lesion that looks funny you would put that under skin and mucus if the gums are really swollen um if there is bleeding if there is deep pockets if there is cows if there is xerostomia so they have a dry mouth all that falls under skin and mucous membrane so anything gingivitis periodontitis like all that falls under here biologically sound and functional dentition so this is to do with teeth and only teeth so if they say that they have difficulty chewing that's a problem with the teeth if they say that they have you know if you see that they have overhangs that's a problem here if you see that they have uh cavities so carries teeth with signs of disease so typically carries that goes under here if they have missing teeth misunders is an issue because it can drift teeth can you know supra erupt there's lots of things that can happen when someone has missing teeth and it can really impact um their way they eat the way they talk sometimes the way there's lots of different things that can happen negative things that can happen so we need to address any missing teeth besides wisdom teeth um if wisdom teeth can be extracted but everything else if either is missing we need to address that we need to get that replaced if they say that they have dentures that don't fit right again it's impacting the way they um they won't be able to eat properly if they have ill-fitting dentures it's impacting their dentition appliances maybe they have an appliance in their mouth like a retainer for example that's not fitting properly if they have abrasion erosion abstraction we need to address that perhaps they are um you know perhaps they have a very maybe they're vomiting a lot and it's causing erosion maybe they're aggressively toothbrushing and it's causing um you know some of these things maybe they're grinding like crazy and it's causing the fraction rampant carries would have cavities everywhere again all this anything teeth related anything that you see that's happening on det is biologically sound and functional dentition their teeth are not sound and so we need to address that number seven conceptualization and problem solving so conceptualization and problem solving this is when they have a question about um anything dental hygiene related and this is a question that you know the general public would not know so it could be a question about you know is is there a link between diabetes and periodontal disease and they and you know they have they heard about it but they're not sure and they're asking you that question that's a you know conceptualization and problem solving type of deficit they have a knowledge deficit they have this lack of knowledge in the link between diabetes and periodontal disease and so that's something we're going to address or they say you know i've heard of periodontitis but i don't really know what that means well that falls under here conceptualization and problem solving they've heard of periodontitis they've heard of gingivitis but they don't know what it means so we're gonna address that and then number eight responsibility for oral health this is where you can tell that they're lacking in oral hygiene because you see lots of plaque you see that they haven't gone for a dental um visit in the past two years so if they haven't seen a dentist regularly they don't see a dentist regularly they've got lots of plaque and calculus then you know they're not taking responsibility for their oral health okay if you see the client their parent is not um brushing their kids teeth properly or taking them to a dentist often then that's you know they're not being responsible for their kids oral health so you need the client has to be responsible for their oral health and if you see that they're not then we need to circle these one of these items and we're gonna address them so let's recap human needs assessment there are eight of them protection from health risks we want our client to be healthy completely healthy if they are not we need to identify why they're not freedom from fear and stress we want our clients to not be anxious uh not be stressed not be fearful when they're in the dental office if they are we're gonna address it freedom from pain we want our client free from pain there should be no pain in their mouth if they are we're gonna address it wholesome facial image we want our client to be happy with the way they look um with the with their breath with the way their face a facial profile is with their gums with their teeth if they're not we'll make suggestions on how they can improve skin and mucus membrane we want everything inside their mouth to be healthy we don't want any lesions we don't want any swelling we don't want any bleeding we don't want any deep pockets any cows any dry mouth if there is we're going to address it biologically sound and functional dentition we want their dentition we want their teeth to be perfect and if it's not if we see some things that we can you know help make suggestions to improve we're going to address that conceptualization and problem solving our clients may have questions and if they do we're going to address them and then lastly responsibility for oral health if we see that our client has lots of black and calculus they're not taking good care of their oral hygiene they're not visiting visiting the dentist regularly we're going to address that once you do this so once you identify what their signs and symptoms are and you could do this by circling so i'll show you this this is an example again from darby and welsh where um they have circled the problems that the client has okay so this client that they saw didn't have any health and um risk factors they were not fearful um they had no pain but they said that they don't like the way their teeth looks maybe they said they don't like the way their gums look because perhaps it's inflamed or perhaps there's recession and they're not happy about it um we saw that they have cow we saw that they have dry mouth we saw that they have cavities we saw that they have questions about dental hygiene care or about oral disease maybe they have questions about periodontal disease and we noticed that they haven't gone to see a dentist within the last two years so that is why these have been circled so once you identify the signs and symptoms so all of these that are listed here are your signs and symptoms head signs and symptoms once you identify this then you gotta write down write out the dental hygiene diagnosis so the way to do it is you list the unmet human need so there's eight unmet human needs that we saw right we saw before these are the eight unmet human needs protection from health risk freedom from fear and stress freedom from pain wholesome facial image you would write this so this is the unmet human need then you will figure out the cause the ideology did you due to so why is this an unmet human need and what signs and symptoms do you see that makes this an unmet human needs so we're going to go over some of them and then we also come up with a goal how can we address this unmet human need so for example wholesome facial image you can see here that teeth is circled so the signs and symptoms need to be brought over here because signs and symptoms go over here okay and we usually say um evidence by evidenced by the signs and symptoms so here we're noticing that she's we circled teeth so this means that the client has said that they are subconscious and bothered by the front uh teeth that are loose so her front teeth are loose why is her front teeth loose well because she has class 2 mobility and she also has a knowledge deficit she doesn't know about periodontal disease and she's wearing a barbell tongue ring which can impact maybe it's hitting on the front teeth that's causing it to become even more loose even more mobile so host the unmet human need is wholesome facial image due to so why is wholesome facial image an unmet human needed well because she has mobility on her friend to teach and because she's got a barbell tongue ring that's probably knocking on that front two teeth and how do you know where's the evidence what's evidenced by the client telling us that her fronties are loose so what can we do about this now when you write a goal there are it's really important to note four things four things should always be listed in a goal the first one is the client so client name the subject the client's name should always be there the second thing is the verb in action so an action needs to be taken place so client well verbalize client will demonstrate client will participate something the client will do so in this case the verb is verbalized the client will verbalize back and then what what do we want so this is like what is the criterion of measurement what are we hoping for something tangible um client will verbalize an understanding of the ideology and progression of periodontal disease so they'll talk about don't understand periodontal disease they'll know why they shouldn't wear the tongue ring and they'll stop wearing the tongue this is what we're hoping for the client may not necessarily do it but this is what we're hoping for um the client will discontinue wearing that tongue ring and then so we set the subject the verb the criteria and lastly the time dimension the time when by end of treatment so we're hoping by the end of treatment client will agree to um client will do all these things so four things need to be put into a goal into a client goal let's look at the next one skin and mucous membrane so if we look over here skin enrique's membrane we have circled that this client has attachment loss so cal and xerostormia and we can make two different you know um goals under the skin and mucous membrane let's see what darby and walsh has done so the unmet human need is skin and mucous membrane what were the signs that we saw well if we look over here the signs and symptoms were attachment loss in xerostomia so i think here all they've talked about is attachment law xerostermia will be addressed elsewhere so they've said here that they have attachment loss of three to seven millimeters i'm simplifying this we saw a lot more but they haven't circled it but there is a lot more there this person has bi bleeding index um deep you know pockets of force uh you know five to seven millimeter pockets so there's lots of signs and evidence to show that skin and mucous membrane is unmet now why why do you think all this is happening well probably because they have lots of plaque and lots of calculus and they're not brushing and flossing so that is why all this is happening so ideology as well why is it happening what is causing us the heavy plaque is the calculus it's the lack of brushing and flossing that is causing all of these that is causing recession that is causing the bleeding index to be high that is causing deep pockets that is causing cows so how can we address it what can we do remember there's four things that need to be put into a goal first one is the client the subject so the client will what will the client do the next thing is the verb decrease bi so we wanted them to decrease their bleeding index we want them to decrease the pocket depth we want them to stabilize the cowl we don't want the cows to get worse we want them to see a periodontist so these are things we want them to do and then there's also time dimension so time dimension is by when so if you look at the first goal there's multiple goals here the first goal says the client will the subject decrease verb the bleeding index to less than 10 so this is the criteria for measurement by when time is by the periodontal re-eval appointment so by the four to six degree eval appointment their bleeding index should have been decreased by ten percent so that's one goal and all four criterias were put in the subject the verb the criteria of measurement which is ten percent less than ten percent and the time dimension by when by re-evaluating and you can see for all the other goals all four components are listed let's do one more biologically sound and functional dentition so if we look at biologically sound and functional dentition we see that the teeth with signs of disease have been circled so likely this person has cavities so we put down that they have cavities because that is the sign and symptom we know that we saw in their mouth evidence that they have cavities and if you did a camera if you did like a keri's risk assessment you will also notice that they're high risk because if they have active carries they're automatically high risk for carries so what caused the cavities ideologies what caused it well what caused this was a knowledge deficit so the client did not know about the caries process and how it happens and and all the adverse effects of the caries uh process and also more importantly remember how we said this client has xerostomia well dry mouth causes cavities so serostomia is also a possible um reason for the active cavities so what caused the active what caused the cavities what caused the carries well ideology is what caused it why did it happen she didn't know there was a knowledge deficit on kerry's process and also she has xerostomia and xerostarman can cause um carries can there's a link right when you have a dry mouth you're more at risk for cavities so what can we do when someone has active carriers what can we do well we have to make a goal so the client which is the subject will will decrease high risk for dental care so we want their high risk to go to low risk okay so if we have a criteria we want the high risk to go to low risk by when the time remember by periodontal maintenance appointment so in three months we're in four months we want the high risk to go to low risk and the way to do this is the client has to see a dentist and get it fixed we also so another goal is the client that's the subject will schedule so that's the verb we want them to schedule an appointment with the dentist for restorative needs to get all their cavities fixed by when by appointment four so by the fourth time we see them appointment four we hope that the client would have got got their carries restored i know they've left conceptualization and problem solving blank but let's just you know go over this for practice so we saw that this person has questions for us as hygienists and perhaps their question was on periodontal disease is they really didn't know about periodontal disease so what would we put over here unmet human need is conceptualization and problem solving they're signs and symptoms could be um you know patients reclined as a misconception about periodontal disease so maybe they said something that didn't make sense maybe they said oh i'm trying to think here maybe they said that they had recession because i'm trying to think of a reason that doesn't make sense so maybe they heard admit that if you eat i don't know so-and-so food it causes recession and they think that's why they got recession and not because they weren't brushing or flossing let's just hypothetically say well then what you would put over here is you would say unmet human need of conceptualization and problem due to lack of knowledge or due to knowledge deficit as evidenced by clients misconception about periodontal disease ideology or client's misconception about recession ideology or about the cause of recession and then you would say the client will understand or will verbalize an understanding of the periodontal disease process so that you can understand why so you can explain to her why recession is happening or maybe she thinks um the recession maybe the recession is happening because she's aggressively brushing her teeth so a client will demonstrate um you can say the client will demonstrate correct modified stillman technique of brushing with using a soft toothbrush by end of appointment three for example or by end of treatment make sure you have a time dimension so what i want you guys to get at is that when we're doing this and that human need is found from these over here so everything that you have circled anywhere you've circled that's an unmet humidity so you need to pull down put all those unmet human needs here then you got to write down your signs and symptoms so everything that you have circled over here needs to be put in this column and then you got to figure out well why why is this there like what is causing these signs and symptoms knowledge deficit could be causing carries heavy plaque could be causing recession sorry pockets and cal mobility and knowledge deficit about periodontal disease and and her wearing her tongue ring is causing her front teeth to be to be mobile so and then once you've done all that then you need to come up with a goal and once you've done the goal then you need to come up with interventions what are you gonna do about it so if we look at let's see let's look at this one over here the client's got um you know recession deep pockets cows octopus disease right gingival inflammation what are we going to do i would hope we would do a full mouth debridement to decrease that so we're going to give them phase one non-surgical periodontal therapy we're also more important but yes we're going to deprive that is extremely important but what's also very important is the education component so we're also going to teach them about periodontal disease we're going to teach them about caries so when you look at the dental hygiene interventions they talk about everything they're going to do to help with this issue because every problem needs to be addressed i'm going to teach them um about plaque and how this happens and we're going to teach them how to properly brush and how to properly floss we're going to teach them about what medication they're taking that's causing xerostomia and what they can do about it we're gonna give them fluoride because fluoride will help them with their cavities we're going to you know give them a full mouth periodontal debridement so non-surgical periodontal therapy therapy we're going to deprive their full mouth we're going to apply fluoride varnish because they're high risk for carries we're going to collaborate with the dentist and the periodontist to address the cavities and their periodontal disease the periodontitis and we're going to see them at four to six weeks and hope that the bleeding index decreases right we're gonna explain to them it's really important that you come every three months or every four months for periodontal maintain maintenance and to see a dentist regularly so all these interventions need to be met some things i notice actually when students are doing this is when they write down the dental hygiene interventions um be sure not to put the time the time dimension is only put in the client goal time dimension is not applied into in the interventions interventions you're just saying what you are doing for each and every goal so every goal should have an intervention every school does it differently so follow your school method um format on how to do it um but yeah i hope this is somewhat helpful in understanding what that eight different unmet human needs are and how to figure out what ideology means and what signs and symptoms mean and how to now write a goal remember this four things to look for subject verb criteria time okay let me know if you have any questions in the comments good luck guys