How to Teach Your Patients To Clean Their Lower Anteriors More Effectively

I do a lot of oral hygiene education. I do it for my patients to live a healthier life, aaannnd because I'm kind of lazy, I don't want to clean as much when I see my patient in six months ;).

If a patient uses a manual tooth brush they should be dry brushing starting on the lower right linguals.  Research shows patients brush more effectively and longer. In addition to dry brushing I have my patients use many different directions on the LA- vertical, horizontal and oblique. I read an article in a hygiene magazine years ago (I can't remember the magazine) and I have been astonished how much more effective patients are at keeping the lower anterior teeth clean.

I always tell my patients that I want to "adjust" his or her technique to make him or her more effective.  I actually take the toothbrush out of the packaging and demonstrate in the patients mouth- showing the bass technique and where I want the patient to start.  After I've demonstrated, I put the tooth brush back in the packaging and in the patients bag.  

Patients have been VERY receptive and grateful, and I usually have a lot less to clean in 6 months ;) 

What to know more about how I teach this skill? Check out me educating a patient on dry brushing HERE.

Hygiene Edge Weekly Challenge:   Educate a Patient on Dry Brushing 

10 Tips to Get Radiographs on Patients Who Gag

10 Tips For a Pain Free Cleaning

One of the most common reasons a patient will leave a practice is because their "cleaning" hurt. No hygienist wants to hear the words, "She really hurt me today. Will you schedule me with the other hygienist?" We want all hygienists to feel valued and like they can provide the BEST comfortable care for patients. Thus the purpose of our latest video "10 Tips For a Pain Free Cleaning". Do you have any other suggestions to provide care pain free? 

Oral Hygiene Education Week- When Does OHE Start?

One of the questions that often gets brought up is when oral hygiene education should be started. Should it begin after the probe depths are recorded, after the diagnosis has been made, or after the prophy appointment is almost complete?

Our answer to this question is:

OHE starts in the waiting room!

What does this mean? From the very first second that you meet your patient, OHE has technically started. The patient determines from the first few minutes of meeting you if you are trustworthy and educated, or if you are just there to "polish" their teeth. This first few introduction minutes are critical to gain credibility with the patient. So make those minutes count! Make sure you are wearing clean scrubs, clean shoes, and your hair is off your face. Make sure jewelry minimal. And make sure you are wearing a white lab jacket! We'll talk more about lab jackets this week, but they can make a huge impression on patients. Second, no cattle calling in the waiting room. Treat the patient like a person. If you have never met a patient before, look up their photo or their birthday so you know generally who you will be looking for in the waiting room. Approach them, smile, and shake their hand. Direct them back to your operatory instead of running away from them and hoping they follow you along.

These little steps will help your oral hygiene education and will show your patient that what you are educating them on will help their health.

Do YOU have a favorite method of bringing patients from the waiting room to the op? Let us know below!

Stay tuned for more OHE tips throughout the week!

Oral Hygiene Education Week

We loved being able to talk to Hygienists at our Continuing Education course last week. We loved it so much, we wanted to share it every dental hygienist. For the next week, we'll be posting little tips and tricks to help your oral hygiene education practice in your offices. And to kick off the week, why not start with a giveaway? We'll be giving away 3 of the sample packs that were given away at the meeting!

Packet includes: 1 Orabrush, 1 package of Xyloburst mints, Xyloburst lollipops, Xyloburst gum samples, Closys sample package, and 1 Xyloburst oral rinse.

To enter, tell us in the comments below your favorite Oral Hygiene Education analogy you tell your patients, or your favorite product to recommend. 

Don't forget to check each day for new tips to improve your OHE!

Stop Measuring Success with Production

With an industry that measures success in the terms of "production" what I'm going to tell you might be a bit of a paradigm shift.

How many of you have had carrots dangled in front of your face or chased "the shiny pennies" that the dentist promises if a certain production goals is reach... only to have a bunch of "no shows" and other factors occur that are out of your control.

The truth is we can't control production at all. We like to think we can. We can't. Yes, we can influence it. But we can't force anyone to do anything. Ultimately, even with our best efforts, there will be patients that don't want to filling they absolutely need or the electronic toothbrush that would make ALL the difference to their oral health.

Instead, let's measure success with out efforts. Efforts can be controlled. Outcomes unfortunately cannot.

I'm not saying a "just try your best" attitude is enough. Although, I wholeheartedly hope every person does in fact try his/her best. I'm talking about very calculated efforts following certain tried and true principles.

There are studies that when patients are appreciated, they are more likely to return. You can't physically make a patient come back (unless you kidnapped them, which we don't recommend!) But you can follow the principle of writing thank you notes and expect to get the desired outcome. For example:

OUTCOME BASED GOAL: "Have 10 patients schedule re-care."

EFFORT BASED GOAL: "Today I'm going to write each new patient a hand written thank you note." or "I'm going to ask and encourage each patient to schedule their next 6 month appointment. If they don't, I'll write a postcard to be sent out 1 month before they are due to be sent as a reminder."

A non-hygiene example:

Outcome Based Goals: "Lose 30 pounds."

EFFORT/SYSTEM BASED GOALS: "Exercise Monday, Wednesday, and Friday this week."

Here are a few more dental examples.

"Today I'm going to point out treatment to each patient that needs it before the doctor walks in."

"Today each patient will leave with either a new product or an idea how to improve his/her oral hygiene."

"Today I'm going to offer fluoride to three patients (Notice: It's not give three patients fluoride.)"

I shouldn't put such a bad taste on productions. I honestly beleive it can be an instruments to review and see if your efforts are giving you the outcomes you except. The beauty in the above examples are that if you aren't ever getting the desired outcomes, it's completely acceptable to keep adjusting your efforts and approach.

Put laser focus on implementing systems and fee successful. Every. Single. Day.

How to Feel Renewed as a Dental Hygienist

 Are you hitting your 7 year, 7 month, or 7 hour slump of your career? Being a dental hygienist is hard. It’s hard on our bodies, minds, and self esteem. It can also be one of the most rewarding professions by helping so many people smile, so don’t throw in you scalers just yet! Follow these quick tips to help recharge your hygiene spark. 

1.     Get a Mentor. Do you know any Dental Hygienists that you admire and are interested in their life? Having these connections and learning from your colleagues can help inspire your career, learn from their mistakes and grow from their experiences. It also can be great to bounce dental hygiene ideas off of, ask hygiene related questions, or even vent about  a hard work day with. No one can relate as better as friend that knows your dental hygiene world.

2.     Go to a dental convention. Going to a dental convention or class does cost money, but in the long run, it could help make you money. It will help renew your love of dental hygiene, become inspired by other hygienists to improve your workspace, and show your employer you are committed to your career. In turn, being educated and expanding your knowledge of dental hygiene skills could be a good bargaining tool when the time to ask for a raise arises. Also, being inspired can make your practice of dental hygiene more enjoyable and keep you motivated to work those long hours. Don’t go for the CE’s- just go for yourself and learn for the fun of learning! Some options of sessions this summer: RDH Under One Roof is in Las Vegas this summer July 15-17, and ADHA Annual Session is in Nashville Jun 17-23.

3.     Read Dental Hygiene Magazines and Blogs. If going to a convention is out of the question, get inspired with all the free dental hygiene publications. In them, you can learn about other dental hygienists experiences from all over the country. You can read about the latest products, request samples, and learn about the newest techniques. Dimensions of Dental Hygiene is a free monthly magazine that is full of great information on clinical skills, business how-to's, workplace relationship improvement ideas, and everything else dental hygiene related. Subscribe to the free publication HERE.

4.     Get a new pair of scrubs, new shoes, a new headband, anything. Sometimes having something new, even if its small, will help motivate getting to work in the morning. That morning boost can help keep your spirits up all day.

We love dental hygiene and want you to feel the love for this amazing profession. The little steps listed seem minor, but they could help in a major way. Anytime you are feeling a little down with dental hygiene, try to switch it up with a tip and see if it helps! 

Becoming an INVESTED Dental Hygienist

Simon Sinek, author of “Start With Why “, tells a story about a lady named Christina Harbridge who was a debt collector. She realized one day that she was behaving like all of the other debt collectors- badgering people to pay their debts. 

 She did not like the way she was treating people and the way she was feeling so she decided to open her own debt collecting firm- based on treating the debtors with kindness and respect. The firm was named Bridge Point Financial. As you can imagine no one thought she would make any money this way.  

 She measured the employees success NOT on how much money they collected but on the amount of THANK YOU NOTES that were written. In order for a thank you note to be written the employees had to really build rapport and get to know the debtors in a short amount of time. Bridge Point Financial ended up collecting 300 percent more than the industry standard.  

I worked in an office where we were required to write at least one thank you note a day and I will say there was a tangible difference in the atmosphere of the office and patient loyalty to the office.    

I've noticed a shift in myself since I've made an effort to write thank you cards. I'm more actively engaged and finding more about the patient.  I noticed I intentionally point out more positive things they are doing in the appointment. Some days each patient will get one.  Other days I might only have time to write one.  But one thing is for sure there is something magical taking place.   

Here are some sample letters loosely following the layout picture. 
 

ADULT:
Dear Mrs. Jones,

Thank you for letting me take care of you on Wednesday.  I always feel happy when I see your name on the schedule.  I am so excited about the progress you have made with your oral health!  The dedication you have had coming to your three month appointments and the adjustments you’ve made with your home care have NOT gone unnoticed. Great job!!  Smile Works Dental Office is lucky to have you as a patient.  Please let me know if you have any further questions about the information that was discussed at your appointment. 

 Sincerely,

Candi Kidd, RDH

P.S.  I hope that you have fun on your trip to Disneyland with your grandkids!

CHILD:

Dear Julie,

            Thank you for doing such a GREAT job at the dentist!!  You held so still when I took the pictures in your mouth!   I couldn’t believe how big you opened your mouth during the cleaning.  Your teeth sure looked sparkly!  I hope that you have fun at the princess party that you told me about.  Don’t forget to keep up the great work!!
 

Sincerely,
Candi Kidd, RDH


TIP 1:  In the family chart under the "notes" put the date and that you wrote a card.   This will help you remember the next time you see the patient if you need to write a thank you note or not!

TIP 2:  For thank you cards for children always make sure the sibling that was a patient the same day (even by another hygienist or the dentist) gets one too!  I like to put stickers in each of the child’s thank you cards!!

Tip 3:  Buy bulk thank you cards.  Even if you have to bring them initially I think eventually the office will jump on board. If they don't, it's okay because investing in your relationships with your patients will only make work that much better to go to!

Always remember that in hygiene it’s all about doing the things that are super easy to do…but also super easy NOT to do that give you the Hygiene Edge. 

P. L. E. A. S. E Method

PICTURE THIS:


You are hunched over your patient frantically scaling half hazard strokes...the clock is ticking and you move to the next quadrant, you don't completely adjust your light but you can still kinda see (kinda/sorta).  You clean the distal lingual of 15 and keep moving on...only to realize that the distal of 15 still has a huge piece of calculus still on it.  You go back to 15, remove the calculus and then try to remember which teeth have been cleaned.... Meanwhile your body looks like a human pretzel..your patient is too high, you're too low- your elbows are high, shoulders hunched, your neck is twisted (because you haven't had the patient adjust his head) and some teeth are cleaned while others are not.   The faster you go the less adaptation you have and your patient keeps "jumping".  By the end of the day you've been behind all day, your body is killing you and you're very frustrated with your career choice!!

I remember sitting in hygiene school and one of my professors off handily saying that she wished there was a mnemonic/checklist to make sure that nothing was forgotten in the hygiene appointment.  For years after that comment I would randomly think about it.  One morning I was laying in bed and it came to my mind as clear as glass.



P= Position  for both yourself and patient.  If I was going to clean the lingual of quad 2 (as a right handed hygienist)  I would sit at 9:00. I would have my patient's head up and tilted towards the left.  If you notice yourself leaning…it's because your patient is most likely not in the correct position. 


L = Lighting.  It's important to use your overhead light and mirror for maximum illumination.  Often times (myself included) when hygienists move from one quadrant to the next the light isn’t adjusted in a way to provide maximum illumination and essentially when we do this we are cleaing in the dark.


E = Ergonomics. Make sure you are not leaning to one side in your chair but that you are sitting up straight, that your wrist is neutural and that you are not making chicken wings with your elbows.

A= Adaptation.  If your pt complains of you hurting them it is most likely that the toe third of your instrument is not adapted to the tooth. 

S=Strokes.  The quickest way to fatigue is doing a working stroke too often.  Its important to do exploratory strokes with your instrument and then working strokes.

E= Edge.  The saying "sharp tools make light work" is very true in DH. Continually check to make sure your instrument is sharp.  It's helpful, especially in SRP to have a sharpening stone on your tray. 


Now let's look at the above scenario with the Please Method.  

The clock is ticking.  I sit down to do the lingual of quad 2.  I take a deep breath.  I make sure my chair and the patient's seat is in the correct posistion.  I have my patient put his/her chin up and turn slightly to the left. I adjust my light for maximum illumination.   I check my ergonomics and notice I'm leaning so I adjust my patient more.  I then place my instrument in the distal of 15 and then adapt the toe third of my instrument to the tooth.  I start with exploratory strokes and make sure my instrument feels like it is sharp.  I clean the distal...when it feels great I move onto the straight... and then the mesial.  Then I move onto 14..I clean the distal, when it feels great I move onto the straight and then mesial. I keep going until I need to move onto the next quadrant. I then put the PLEASE method into practice again!!  

 With the PLEASE Method I have noticed that my cleanings are CONSISTENTLY more focused, gentle and thorough while still protecting myself as the dental hygienist.   Want to see it for yourself. Check it out in the video below.

Need a PLEASE reminder? Download the file and hang it where you keep your daily goals and reminders HERE.