Ways To Stay Positive In Dental Hygiene School

Hygiene Edge is excited to announce the winner of our 1st Student Essay Contest- Taylor Robell! Taylor is currently a second year dental hygiene student at Fortis College in Phoenix, Arizona. We've included her essay "Ways to Say Positive in Dental Hygiene School" below for both students and current hygienists to learn from.

---

I look back on my first week of dental hygiene school with a sort of fond envy. I was so full of excitement and energy, two things which are hard to come across as a second year dental hygiene student. I will admit that the stress and demand of school has taken a toll on my sanity and my social life, but I’ve found little ways to cope and keep my chin up:

1.       Do something simple and fun. Doing small things that interest you has been proven to help boost positivity and productivity. It’s science! I like to do small crafts and DIY projects that I can use around the house. Online shops like Darby Smart have tons of simple and easy project ideas. If you’re on a budget, Do it on a Dime is a great YouTube channel for projects using items found at the dollar store.

2.       Start a motivational Pinterest board. It might sound cheesy, but never underestimate the power of Pinterest. There are tons of motivational quotes and stories on Pinterest that you can reference. There are also plenty of dental hygiene memes which are good for a laugh when you need it most!

3.       Set short-term goals. We all know that graduating and passing boards is the end goal, but long-term goals don’t do much for present day positivity. It doesn’t have to be anything major to have a big impact. My current goal is to walk 10,000 steps a day. Setting measurable and attainable goals can be huge for your happiness.

4.       Start a thought journal. One of the things I struggled with the most initially was bringing my stress home and letting it rub off on my family. Instead of venting about how miserable I was at school that day, I write it down and let it exist only on the pages of my journal. It’s made me a happier person and helped my relationships as well.

5.       Try a new recipe. Think back to anatomy and physiology and release those endorphins by eating something delicious! The All Recipes app is a great tool for discovering new recipes. The “Dinner Spinner” feature allows you to select recipes that take a certain amount of time. It’s perfect for busy college students who don’t have hours to spend making food!

6.       Build a support system. The one redeeming factor about dental hygiene school is that you’re not alone. Simply surrounding yourself with like-minded people can be a gratifying tool for coping with stress. If you haven’t already, get together with classmates outside of school. Try new things and enjoy the moment you’re in.

7.       Do something nice for someone else. One thing that never fails to recharge my passion for life is helping others. But you don’t have to donate hours of your time at the local food bank to accomplish this. Simply buy a stranger’s coffee or help an elderly woman with her groceries and I promise you’ll feel the difference almost instantly.

8.       Remember that it’s okay to ask for help. It is so important to constantly evaluate your well-being and mental health. Dental hygiene school can be a major life-changing event, so know the symptoms of anxiety and depression. If you feel that way, you’re not alone. Roughly 30% of college students report feeling so depressed that it’s difficult to function. Know the signs and know when to get help.

It’s no secret that dental hygiene school is a constant battle. But with the right tools and an army of support, you won’t have to fight alone!

---

Thank you to all the students who entered! We loved each essay and how personal and pertinent the topic is to current dental hygiene students. 

SOAP-TOPE Notes

The SOAP Note is a format of writing medical records that started in physician’s offices, but was quickly adopted into the dental field. Do you work in a practice that requires using the SOAP Note technique? If not, give it a try. Let's break it down.

SOAP is an acronym- Subjective, Objective, Assessment, and Plan.  This system was created to help prevent charting mistakes or information from being left out. Just like each patient is unique, each chart in unique with information and length of notes.

Here is an example what each letter of SOAP includes:

S- Subjective

This section starts with the chief concern of the patient and any reported symptoms, such as when the pain started, how long it’s been happening, when and where the pain happens, etc. This section also includes health history notes of a new patient and health history updates on current patients.

O- Objective

This next section tells about the patients current health- blood pressure reading, extra and intra oral exam findings, which radiographs were exposed and findings based on them, any mobility or furcations, any symptoms to in office testing like percussion or cold tests, gingival descriptions, and a brief description of periodontal probing findings.

A- Assessment

This is where the dental hygiene diagnosis is recorded based on all previous findings.

P- Plan

Now we finish off with the treatment plan that needs to be carried out. In dental hygiene this could be completed at that day or over several appointments.

If you decide to use SOAP Note technique or if your office requires it, I’d recommend adding a few more letters to the acronym. Since hygiene appointments include so much information, use SOAP-TOPE. It’s definitely not as catchy, but it includes a little more information that we need.

T-Treatment

In hygiene, many appointments have us diagnosing, treatment planning, starting and finishing treatment all in the same day. Here you would include what treatments were completed at that appointment- full mouth prophy, fluoride, radiographs, and periodontal debridement quads with what anesthetic and how much was used.

O- Oral Hygiene Education

Here we would chart current habits, goals made, products recommended, and techniques taught at that appointment. Explanation of periodontal health and the importance of regular recall appointments would be written here too.

P- Personal Notes

Jot down just a few notes of what you talked about with your patient that appointment. It could be an upcoming trip, work or school information, family happenings, or important events coming up. This will make the next appointment in 6 months more personal for both the patient and you. Building meaningful relationships with patients is one of the best parts of dental hygiene!

E- Exam

Chart everything the dentist talks about with the patient. And I mean EVERYTHING! Of course, we always chart restorations that need to be completed, but be sure to chart conversations on whitening, night guards, headaches, areas to be watched, or any other possible treatment options that could be brought up in the future.

---

Real Life Example of SOAP-TOPE:

S: Patient is interested in whitening options. No toothaches or sensitivity today.

0: No changes to medical history per patient. Blood Pressure: 124/74. Healthy bone levels visible on radiographs, with generalized 1-3mm pocketing (see perio chart). Localized BOP on buccal of 2, 3, and 4. No mobility or furcations present.

A: Generalized healthy with localized marginal gingivitis due to pt missing brushing area.

P: Adult prophy, FL2 Tray

T: Adult prophy hand scale only- patient did not tolerate ultrasonic well. Polish with fine paste. Floss. APF FL2 tray placed for 1 minute with post op instructions of no eating or drinking for 30 mins. Pt agreed to post op ins.

O: Brush 1x day. Floss 1x day. Explained to patient area on buccal of 2, 3 and 4 that presented with heavy biofilm. Recommended pt close partially to brush that area, or switch to a smaller head toothbrush. Goal: Start brushing on the buccal of Quad 1 each time he brushes. Explained whitening procedures and post op sensitivity that may occur. Recommended at home FL2 treatment of Clinpro 5000 to prevent sensitivity. Disp: Soft TB, Glide Floss, Sensodyne Samples

P: Pt is getting married next month which is why he is interested in whitening. Wedding will be held at his grandparent’s farm. Met his fiancé in college.

E: Per Dr. Harris: Decay present #3-O, #14-DO. Explained Zoom Whitening to patient, procedure, cost, and post op pain and instructions.

---

Great charting habits will make your life, your dentist’s life, and your office manager’s life flow much smoother. Try out the SOAP-TOPE charting method and see how it works for you!

H.E.L.P! Hygiene Ergonomics, Loving Practice

Hygiene Edge is excited to announce a guest contributor- Willi Nixon Fuller, RDH. She has an amazing experience of how ergonomics changed her way of practicing and we're excited to have her share her secrets.

---

Let me first tell you about my personal story, and passion of ergonomics. I have been practicing as a hygienist for a short 4 years, and I've unfortunately learned the hard way how important ergonomics are to prolonging my career.

In my first year of practice, I experienced:

- Dislocation of the 3rd rib from the sternum

- Curving in my shoulders

- Midback pain

- A pulled psoas muscles lining my spine

All of these injuries manifested themselves while I was doing something else: skiing, lifting something while turning, running, ect. Each injury was very slow to heal because it coincidentally was the exact muscles I use to turn towards my instrument tray while working on a patient, or the rib that was affected most by my right hand instrumentation. I soon realized that my repetitive motions in the office are what caused my injuries, not the other way around.

Over the next 3 years, I worked hard to heal my body and keep it healthy through a combination of exercise and muscle therapy. I recognized that in order to have a long and enjoyable career, I needed to invest time and attention to my body.

How does it feel?

60% of hygienists complain of neck pain, which shoulder pain close behind. Over a third suffer from lower back pain, while 27% have mid to upper back pain, and pain in their hands. Work related pain can extend to the hip flexor muscle (psoas major) lining the inner lower spine, elbow, or wrist pain from tendonitis, and rounding of the shoulders. Whether it is continuous back pain or musculoskeletal pain, surveys show around 78% of hygienists experience work related pain on a fairly regular basis.

I Feel Fine

What are the results of chronic occupational pain?

- Dissatisfaction with daily tasks

- Discomfort at work and at home

- Shortened career

- Shortened work days

- Slower at completing hygiene duties

- Unable to continue physical hobbies

All I've Got To Do

So, is it hopeless? Should we all just recognize that we chose the wrong career for having a strong, comfortable body? Absolutely not. Let's start with a checklist of things we can do to improve ergonomics.

1. Invest in loupes and a light- they will help you sit up straight.

2. Use your loupes and light with every patient.

3. Begin a daily exercise routine, focusing on core and back strength.

4. Stretch 10 minutes before and after every work day.

5. Stretch for 1 minute between patients.

6. Lower your shoulders.

7. Use indirect vision when necessary rather than leaning/twisting.

8. Ask your patient to turn their head for visibility. They don't mind!

9. Visit the chiropractor once a month- don't wait for something to hurt first.

10. Find a massage therapist and go once a month.

I Want to Hold Your Hand

I can't stress enough how these simple changes in my daily practice changed my life. If there was a way I could check up on every hygienist and hold them responsible for taking care of their body, I'd do it. If there is ANY take away form this, let it be:

1. Find a massage therapist with a focus in deep tissue muscular therapy, and get a massage once a month. Ask a chiropractor or physical therapist for references of a good massage therapist. I cannot emphasize enough how important massage is. It will cost about $50 a month, but it will allow you to work more hours in comfort, for a much longer career. IT'S WORTH IT. 

2. Stretch and Exercise regularly.

Carry That Weight

Back exercises to be done 3x per week:

- Dead lift 15 sets of 5 reps

- Dead row 15 sets of 5 reps

- Clean and press 5 sets of 3

- Seated row 15 sets of 5 reps

Yoga poses to strengthen and stretch- 10 minutes before and after every work day

- Downward dog

- Cobra or up dog

- Child's pose

- Triangle pose

- Cat/cow sequence

- Forward Fold

1 minute stretch between patients- Any type of stretch that opens the chest, the hips, or elongates the forearm muscles. 30 seconds on each side. Alternate focus area between patients.

---

Willi Nixon Fuller, RDH- I’ve been practicing as a Dental Hygienist since 2011 with Mountain View Dental Care - general dentistry.  In addition to my role as a dental hygienist, I am the marketing director for my office. Along with maximizing SEO, I created our interactive website and connect with patients on Facebook, Twitter, Google Plus, and our Blog to provide them with new information about dentistry.  

I'm happiest when I'm exploring Salt Lake’s beautiful canyons through running, hiking, and skiing. 

4 Key Strategies for a Successful Dental Hygiene Salary Negotiation

Author Doug Perry                                   gethiredrdh.com

Salary negotiation, whether you are dental hygienist or a school teacher, makes everyone a little squeamish, and yet we use many of the basic principles in the normal course of a day without even realizing it.

So whether you are negotiating a better salary with your current boss or looking to improve an offer from a new employer, it may not be as tough or foreign as you think.

Here are four steps to a successful dental hygiene salary negotiation:

1. Decide It

Studies show women are more reluctant than men to negotiate a salary. So a dental hygienist (more than 95% of all hygienists are women) on the fence should just do it. Obviously, there are instances when you wouldn’t do it that’s why I said “on the fence.” But if you are undecided then go for it.

An annual review of performance and salary may not be something your employer prefers or agrees to. But certainly, if you have not received a raise in more than two or three years you really owe it to yourself to approach the subject with your boss if for no other reason than to remind them of the value you bring to the practice.

2. Plan It

Salary negotiation isn’t something you do without some research and planning. You will increase your odds of success if you take your time to develop a clear and focused plan. There are lots of factors to consider such as, the average wage in your area, what kinds of successes (or failings) you have had recently, how much experience you have, patient load, economic conditions for the employer, and other benefits that might interest you along with or in place of a simple wage increase.

Do some research and have a clear, intentional plan and goals (both short and long-term) that are part of it. At GetHiredRDH.com, I have posted historical dental hygiene salary data for every state in the US – this along with other resources, are valuable in planning your negotiation strategy.

3. Time It

The old mantra “timing is everything” is very true for salary negotiation. Let’s face it, as nice as your boss or new boss may seem, everyone has a bad day and even if you have carefully planned out your moment for negotiating, you may need to be prepared to retreat for a bit to improve your odds.

There are other considerations associated with timing, such as if the office recently gave you a bonus – that’s probably a bad time. Or, if the employer just invested in a bunch in new equipment (hoping to improve or maintain patient retention) – probably not ideal either.

If you are only one of several candidates for the job, don’t even get into salary discussions unless asked. And if asked, you can give them a range, but keep it vague or wide.

Most employers want to know if they are in the ballpark with you on it, so one way is to just simply respond pleasantly with, “I’m aware of what most hygienists make in this area and am comfortable that we can agree on an appropriate figure. But, I’m interested in sharing with you what I can do to become an asset to the practice first.”

4. Negotiate It

You’ve decided to do it, you have a plan, and the timing is right. Now what?

Salary negotiation is all about win-win. If either you or the employer feels like they tipped too far in one direction, one of you won’t be happy and that’s not a good long-term position to be in (and it usually results in parting ways sooner rather than later).

So, yes, you can and should expect to get something more than your offer or what you currently make, but they have to feel good about it, too.

Win-win can mean lots of different things, some of which can be psychological. Maybe an employer is glad they only have to give up a $1/hour more to you to keep you around because you have bonded with the patients.

Or maybe, you have won by drawing attention to the fact that you feel underpaid and there’s now a solid plan in place for regular salary adjustments going forward (even if not right now). Those are victories and even if they seem small will lead to more victories in the future for both of you.

So, let’s get down to a few simple tactics that will help you achieve a win for yourself.

• Before you make your proposed amount, and from your research, be ready to share with them the “why” – three or four specific things you have done to bring value to practice. Share actual examples of the time a certain patient raved about their experience with you, or how you were able to save the practice money.

Always share these before you give them your request. This is true for a job offer, too. Reiterate the things that make you value and specific examples.

• Ask for a little more than what you would be happy with. That gives you room to move on it. Employers want to know an employee is flexible – it’s a good omen for them coming to an agreement with you that is acceptable for both.

• Have several concessions ready to go. These are other things such as some paid holidays or sick days, a bonus program, or maybe it’s paid training or association membership fees. Just know ahead of time some things that may not be quite as good as a salary bump, but that will make life better for you and that might be easier for the employer to accept.

• Don’t be afraid to counter their offer. You don’t want to go back and forth more than a few times, but it’s generally acceptable to start with the big ask, then work your way down to smaller things (the concessions).

• Give their final offer space to breath. What I mean by that is once they give you their final offer, pause – make it look like you are thinking. Sometimes that little pause (of even a few awkward seconds) can actually compel them to offer a little more on the spot.

Then, after you have paused, tell them you would like to consider it and come back to them in say 24 hours. Most employers will agree to that. But that space gives you time to properly consider it and it actually causes them to re-think their position as well and sometimes they will come back prepared to offer a little more still.

And if all you do is come back and agree to their final offer – they will feel as though they got a big win (and that will help you in the future).

Final Advice

Always maintain a high level of professionalism and even give them a “thank you” note when it’s settled – even if you didn’t get as much as you wanted. It also doesn’t hurt to request it in writing, particularly for promises that are made in the future (future reviews or increases based on some measurement).

Salary negotiation can seem a little scary and worrisome, but if you have done your homework, have a plan, get the timing right, and engage in a thoughtful conversation over it you should feel confident.

_______________________________________________________________________________

Doug and Tracie Perry run the popular website gethiredrdh.com where the have helped thousands of dental hygienists land a great dental hygiene job.  

Oral Hygiene Education Week- WINNERS!

Thank you everyone for being part of Hygiene Edge's first Oral Hygiene Education Week! We've loved sharing tricks to help how you educate patients a little different and better. The winner's of our OHE Packets are:

Please email hygieneedge@gmail.com with your contact info!

Oral Hygiene Education Week- White Lab Jackets

What you wear to work matters and effects both you and your patient. Wearing a white lab coat has a positive effect on both.

1. Wearing a white lab coat portrays trust, respect and confidence in you from the patient. Do you think you'd be asked if you have a degree or went to school to be a hygienists if you were wearing a white lab coat? Though there is not officially a study at this time, we've heard from office's experiences that case acceptance goes up when a dentist and a dental hygienist goes up when they wear white lab coats. 

2. Studies show that when healthcare professionals wear white, they act different. They are more confident, and take pride in their profession. Who wouldn't want more confidence in treating patients and changing their oral and overall heath?

If you decide to only make one difference in your OHE routine, we recommend adding a white lab jacket. How you feel and how you act will trickle down to many different aspects of your hygiene practice.

Oral Hygiene Education- Educating about Perio

Educating a patient that presents with periodontal disease is rewarding, but can also be challenging. This patient usually hasn't been to see a hygienist regularly and can be apprehensive about being in the dental chair. Here are some tips to help:

1. Take your time with educating these patients. Use charts, pictures, and explain the procedure. If your office protocol doesn't allow you to reschedule perio patients when they are assessed, come up with some good talking points like how beneficial this extra education is to the patient, and have an educated discussion with your employer. These patients need the extra education time to know how important treatment is, and will increase case acceptance once they do. Show the patient radiographs and talk about the disease process. Treat this patient as if it was yourself- if you went to the doctor and were diagnosed with a disease that you knew nothing about, wouldn't you want to know the process of treatment, the outcomes, and the post op instructions?

2.  Ditch the word "Deep Cleaning". We've had patients ask- "Don't you always do a deep cleaning?" We do! Instead of "deep cleaning", maybe introduce the phrase "Gum infection therapy".

3. In this age of implants and bridges, patient's aren't nervous to loose their teeth as they once were since there as so many reliable ways to replace them. Instead of telling patients that this disease could cause them to loose their teeth, tell them they are loosing important bone in their jaw that is needed to place implants.

4. When explaining pocket depths and bleeding, avoid "I found..." Instead, say "You presented with" or "You have." It takes the responsibly of the disease off you and back on the patient.

Periodontal disease can have great results and high case acceptance with great patient education. How do YOU help explain periodontal disease to patients? 

Check back tomorrow for more OHE tips and tricks!

Oral Hygiene Education Week- Products We Love

There are hundreds of dental products on the market with new ones being launched every week. These are some of the products we like recommending right now. 

1. CloSYS- CloSYS makes mouthrinse, toothpaste, and oral spray, but we tend to recommend the mouthrinse mainly. It is an mild alcohol-free rinse perfect for patients with dry mouth, but due to it's stable chlorine dioxide, it is perfect for bad breathe in these patients. New studies are showing that it is almost as effective(a) than Chlorahexadine but with little side effects. The original has very little flavor so patient acceptance is high with CloSYS.

2. Interdental Aids- Hygienists love to talk about floss. It's all about the floss! However, there are so many great interdental aids on the market and honestly, lots of patients would benefit from these more than traditional floss. Right now, we love recommending Gumchucks to our patients have have a hard time wrapping floss around a tooth like teens and ortho patients. They even have an autoclavable handled set for dental professionals to use in the office.

3.  Xylitol- Xylitol can be recommended for many types of patients- dry mouth, teens, kids, orthodontic patients, even new moms. A recent study (b) showed that if a new mom chewed 3 pieces of xylitol gum a day, the bacteria transfer between her and her baby was lowered and less decay was present at age 5. Since most people chew gum, this is an easy way to have mothers help their babies with minimal effort.

Though these are the products we love right now, they many change in a few months as new products are developed. Keep an eye on the market, walk down the dental aisle at the grocery store every so often, and have reps come to your office and give lunch and learns to stay up on the latest and greatest to help your patients.

What do YOU like to recommend to your patients?

(a) Drake, D.: An In Vitro Comparative Study Determining Bactericidal Activity of Stabilized Chlorine Dioxide and Other Oral Rinses. J Clin Dent 22: 1-5, 2011. - See more at: http://www.dentaltown.com/dentaltown/article.aspx?aid=3213#sthash.8USXLQFF.dpuf

(b) Nakai, Y., et al., Xylitol gum and maternal transmission of mutans streptococci. J Dent Res, 2010. 89(1): p. 56-60. - Moms chewed xylitol gum 3x day and it decreased caries in children.

Oral Hygiene Education- Tiny Habits

Asking a patient to go from never brushing to brushing two times a day for two minutes seems impossible to both you and them! When we have patients that need a huge habit change, we actually start with tiny habits. BJ Fogg tells how to start tiny habits, and soon they will become big habits. It's worth a try it for some patients!

Oral Hygiene Education Week- Questions

After a great introduction and the patient is seated in your operatory, there are a few rules to follow to make a great connection and have education run smoothly throughout the appointment.

1. Start with the 1 minute rule. Build rapport in the first one minute of the appointment. Talk about anything positive that isn't related to dental hygiene or health, like if they have summer plans or what they like to do for fun. Try to ask open ended questions to keep the conversation moving and natural. If you're seeing a new patient, ask any question that doesn't talk about religion, politics, or controversial current events. If it's an established patient, look back at notes from last appointment and follow up with what was previously talked about.

2. Next, move onto home care questions. Again, ask questions that don't have a "yes" or " no answer. For example, try to avoid asking "How's your brushing?". Instead, ask "How many time's a day have you been brushing?" or "What do you use to clean in between your teeth and how often to do you use?" We find that while taking radiographs is a perfect time to ask this questions so you have a sense of what your patient may present  intraorally. It also will give you insight on how much the patient knows or even cares of what going on in their mouth and overall health.

3. While probing is a perfect time to talk about inflammation and the disease process that may be occurring subgingivally. One way of doing this is explaining what probing is before you start, and what the numbers mean. Also mention that greater than 5mm pockets and bleeding means there's a disease present. Disease is a huge motivating word for patients. That's exactly what it is, so we might as well be honest! Then as you probe, call out the numbers, even if you chart them yourself. This will let the patient know exactly where their level of disease is. The majority of the time if a patient has pocketing, they'll ask what needs to be done next as soon as the charting is complete, or even after the first deep pocket is called out. 

Now that the ground work is in place for your OHE, we can get into the actual education part!

Don't forget to come back each day this week! We'll be talking about products, habits, and much more!