Annette was performing her usual head, neck, and oral exam on a patient and she found an enlarged thyroid. She recommended to the patient that she go see her primary care physician to get a better diagnosis. The patient went to her primary care physician and was told it was probably nothing. Later the patient returned to the dental office and saw Annette and told her what the physician said. Annette could not take that as a final answer and told her that she would not just leave it and should get a second opinion and have other test run. The patient went back and requested more thorough test be completed, she got the results back and everything was clear and her primary care physician assured her she was fine. During Annette’s follow up with the patient, the patient still questioned why everything came back normal is her thyroid was enlarged and asked if there was anything else she could do to make sure. Finally the patient convinced her primary care physician to take another look and after a sonogram was completed they found a tumor on her thyroid. Next time seeing Annette, the patient thanked her for pushing her to have the abnormality checked out.
o How did this occurrence affect your beliefs and attitudes regarding the importance of the head, neck and oral exam?
Initially she would perform the exams as learned in school, but now after finding something abnormal, she now does a more thorough check, especially on patients with previous history of cancer. This incident solidified her belief in early detection and proper documentation. By having the...
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...e are learning, oral cancer no longer has an optimum age, race, or gender. Everyone is susceptible, but other people may have habits that increase their risk and should be informed. If a thorough head, neck, and oral exam is not completed then you are putting that patient at greater risk for finding the abnormality when it is too late or has done extensive damage. As hygienist it is our job to do the exam even if the dentist has done it because multiple checks does not hurt the patient, the patient is at harm if anything is missed or not even examined. I would rather know that there is something looks suspicious, than not know until it is too late. The module also said everything should be considered cancerous until proven not, and I think that is what Annette was trying to determine when she continued to push the patient to get a definitive answer about her health.
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