The Diary of a Pregnant Hygienist- The First "Trial"mester

I wouldn’t call myself a pro at pregnancy, but with this being my third you could say that I have learned a thing or two about the balancing act of being pregnant and practicing hygiene. Being pregnant and working hygiene is no walk in the park. The body is going through many transformations which can be VERY challenging to work through.  Let's start at the beginning.

You have just read that little stick saying that you are pregnant. The first big work decision is how and when to tell your office that you are pregnant. One thing to note is that pregnant women shouldn’t use nitrous (see THIS RDH Magazine article) If you or your dentist needs to use nitrous on the patient then you shouldn’t be the one to administer any treatment to that patient while on nitrous. Better safe than sorry. You may decide not to tell the whole office for now but at least consider the dentist so they understand why you are refusing to treat some patients.

The nice thing about scrubs is that your growing belly will be kept hidden for several months if you want to keep it a secret a little longer. However, if you are sick pretty soon your coworkers are going to notice. Go ahead, let them in on the good news so you can get a little sympathy because those first few months can be really tough without some help.

Honestly, I have worried about telling my boss that I was pregnant for fear that I would get replaced or not advanced. According the United States Department of Labor Under the Civil Rights Act of 1964 an employer with 15 or more employees can not fire you because you are pregnant, and must permit you to continue working as long as you are able. Some states have laws that cover employers with less than 15 employees. If you work for an employer with less than 15 employees, check with your regional Women's Bureau Office to see if your state has an agency that can help you.

If it is your full intent to stay once the baby comes, make sure your employer knows. I planned to return after my babies and my conversation went as such:

“I wanted to let you know that I am 8 weeks pregnant. I have been feeling pretty ill but have been managing it with food and medication. I intend on returning once the baby is born. I will find, and help train an awesome temp while I am on a brief maternity leave. You can count on me to be here and ready to work as usual.”

I like to give them confidence that I can still properly treat patients and minimize the fact that I will be taking time off. I always figure that I could get into an accident and break my working arm at anytime and they would have to manage for a few weeks until I recover so they can handle a planned time off.

I get asked often how I managed to work through my “morning sickness.” If you are one of the lucky ones who doesn't get sick while pregnant then I invite you to produce away, and count your blessings. For the larger percentage of us who experience pregnancy sickness, this is where it gets difficult. There have been a many a time when I have had to puke between patients or excuse myself in the middle of an appointment to loose my lunch. If I need to leave mid-appointment I find some excuse, for example, “I am going to get a specific instrument, or let the dentist know they can come in when they are ready.” Then I rush to the ladies room, do my business, splash my face with water, and return. I apologize for any extra time delay, and if needed explain that I am newly pregnant but all is well, and I will deliver them the best care. If available, you could always ask the assistant to help out for a minute while you recover.

There are things you can to do combat pregnancy sickness. Check with your physician for a potential nausea reducing medications or keep some type of food close by that you can snack on between patients. Mine was Cheez-its and gatorade. (The crap your teeth go through while pregnant, I will save for another day.)

Thankfully I am finally to the end of my morning sickness with baby #3 and the baby bump is coming along nicely. Stay tuned for next time when I discuss the challenges of working with extra weight and an ever growing belly. I will also discuss the ins and outs of working as a nursing mom.

Hygiene Hack: Lip Product Application

Looking for a new idea to treat your patients even a little better than you already do?

2017

2017 is here! 

I love the fresh feeling of a new year- excitement and new possibilities. Plus, the stresses of the holidays are over and we can again focus on goals. Are you feeling a little blah about your current practice or career? We have made up a simple list of things to work on over the year to help restart your love of dental hygiene. We know that if you try them, you'll have a different outlook on our profession.

Download a printable version of the checklist to keep in your op.

Have you set career goals for yourself? Let's talk about them! Let us know below!

Merry Christmas from Hygiene Edge

Since 1964 Dentistry has been linked to Christmas thanks to a brave little elf named Hermey. In the animated movie Rudolph the Red-Nosed Reindeer Hermey declares that he wants to be a dentist. I grew up watching this movie and loving the story of Hermey, loving that he and I shared a love of Dentistry . Here at Hygiene Edge we have a love for the Holidays, a love for dental professionals and a love of cartoons. We wish you Happy Holidays and hope you enjoy these dental themed cartoons that celebrate the Holidays. I think Hermey would be proud.

Hygiene Spotlight-Jasmin Haley, RDH, BSDH, CDA, From Beyond The Prophy

Jasmin Haley, RDH, BSDH, CDA

School:

1. Allegany College of Maryland, AAS, 2007

2. University of Maryland, School of Dentistry, BSDH, 2008

3. Fones School of Dental Hygiene, MSDH(c), Expected graduation 2018

Hygiene Edge Interview

1. Where do you currently practice/what type of dental hygiene practice?

I am a PRN hygienist at a Federally Qualified Healthcare Center (FQHC) in Baltimore.  I have always loved educating and previously I spent 4 years teaching full-time at a community college. In Spring 2017, I will be joining a dental hygiene program as an adjunct instructor.

I am the founder of Beyond the Prophy LLC, through BTP I empower and inspire hygienists to provide the best patient-centered care and to explore career options that promote excellence. I am also the Co-founder of MOMgienists LLC, through Momgienists my friend Christie and I talk about everything except the kitchen sink and support other mothers through our podcast and Facebook support group.

2. What interested you in dental hygiene as a career?

My fascination with teeth started at age 13 because I had severe crowding and I was teased about my smile.  I was accepted to a specialized high school in NYC that had a dental assisting program. After the dental assistant program, I knew my journey in dentistry was not over. I wanted to pursue dental school and decided I would attend dental hygiene school to financially support myself through dental school. Low and behold! I have stuck with dental hygiene for 9 years and it has provided amazing opportunities in my professional career.  Many of my opportunities came through my involvement with the American Dental Hygienists' Association and my state constituent. As one my friends, Shavonne Healy, states "ADHA is your professional lifeline." My membership has meant more to me than I could have ever imagined as a student and I am so grateful. It has helped me unleash my potential and now the opportunities that await me are boundless!

3. What is your favorite thing about dental hygiene?

I enjoy connecting with my patients, students, or course attendees. Dental hygienists have a special role in building relationships with their patients and the opportunity to impact their lives every day.

4. What is one piece of advice that you'd give yourself as a dental hygiene student?

Have more fun! I was blessed to make lifelong friendships in dental hygiene school. Although, I went to the BEST program in Maryland, I could have had more fun! As SADHA Class president, I filled my time up with my responsibilities and school work. I didn’t make enough time for myself. I am thankful to my study partner and two women in my class from Ocean City, Maryland, who persistently asked me to hang out with them. I felt that I never had time for fun. However, when they took me out for karaoke it was the best decision I made! It was my Friday outlet that helped me to let out some steam and rejuvenate myself for the upcoming weeks before graduation. I still karaoke till this day!

5. Any funny or favorite stories from your career?

My first temp job out of dental hygiene school was very interesting. I was an awkward mess because of my nerves. My first patient of the day needed to take a full mouth set of radiographs and provide a prophylaxis in 45 minutes!  The pressure was overwhelming and I thought I was going to pass out on the spot. The gentleman that I was providing treatment for was very kind as I fumbled along gathering my equipment. Unfortunately, while assembling the XCP holders I didn’t realize I grabbed a defective set. I successfully took the anterior periapical and bitewing radiographs. I was almost finished until I was unable to remove the ring from the posterior periapical XCP to prepare for my final quadrant. I kept tugging and tugging until it finally released --and my hand hit the patient right upside his head! My hand was balled in a fist while I was tugging and I basically punched him in the face! He slumped down in the chair, head down into his chest and didn’t move. He then opened one eye and smiled at me. I was mortified! We both laughed it off and I survived that day. I often thought of him while teaching radiology lab. I remember where I once stood as a budding future dental hygienist.

Final takeaway for the future dental hygienist: It's okay to be a ball of nerves, anxious for your first day as a licensed hygienist -- EMBRACE it and REMEMBER don't stand too close to the patient's face when putting the XCP together! Ha!

Dental Service

It’s that wonderful time of year to spread joy, love and to help those in need. This time of year always get me thinking about those that so desperately need the services that we provide, but can’t afford it. I have decided to make this post about a few suggestions that you can do to give back to those in need, whether it is during the holidays or a New Year's resolution of yours.

Serve in your own office

Ask your employer if donating services to someone in need. Within HIPPA guidelines, write about it on your office social media page or website.

Another option is doing a free dental service day for those in need.

Check locally to see if there is a community health clinic that you can serve at

An example of this is a community in Utah has set up Community Health Connect which acts as a liaison between professionals and patients in need. They go around and ask for dental/medical offices to provide services to 1-2 patients per year.

Look into a state level service to see if there is a clinic that helps those in need

Check with your local state dental and dental hygiene associations to see

Nationwide service is also an option. Even though we have the best healthcare available right here in America, there are so many that don’t have access to care.

One national organization is called Dental Lifeline. They run a national nonprofit organization that provides access to dental care and education for people who cannot afford it. You can click on your state and see how you can get involved.

Consider International Service

In school, I knew of a group going to Honduras called Smiles for Central America. I would have loved to go, but being a poor college student, it wasn’t the right time. So instead, I helped hold a drive to gather stuffed animals. At the time, their mission was to send every child home with dental care and a stuffed animal.

If something like this is not affordable, you can always look around for sponsors for your trip.

There are so many ways to get involved.  Whether big or small, our services are needed. Below are several other service resources I found that may also be an option for you.

ADA International Volunteers

Have you served with your dental hygiene expertise? Let us all know what you have done, how it went, and if you would recommend it to another dental hygienist.

Arestin Placement

Top 10 Advancements in Dental Technology You Should Tell Your Patients You Are Using!

Patients want to know that the office that they choose is on the cutting edge of dentistry, and that they are getting the best care out there. If you are using any of the advancements listed below in your office consider telling your patients more about it in an office news letter or on your office social media sites. We want to thank Dr. Amruta Patel for putting together the information below! 

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Dental technology has been growing by leaps and bounds, with systems designed to improve dentist and patient comfort, reduce treatment times and enhance oral health.

Here are 10 examples of systems that are changing the way we work:

1. High-Tech X-Rays – Digital X-rays reduce radiation exposure for both doctors and patients, are faster as well as more sensitive, efficient and convenient than conventional film. Today, digital radiography is used for locating cavities, inspecting bone structure, root canals, implants, etc.

2. Caries Detection Solution – Quite similar to plaque disclosing tablets (which draw attention to any areas of teeth not cleaned thoroughly while brushing), dental care professionals apply this liquid red dye over your teeth to check if decay has been completely removed during treatment.

3. Composite Resin Materials – These materials are commonly used in restorative procedures like veneers, crowns and bondings. They replicate the look and feel of your natural teeth, and can be applied directly to the tooth surface. They cure quickly, hold their shape better and are far more durable than traditional materials.

4. CAD/CAM Technology – CAD (computer-assisted design) and CAM (computer-assisted manufacture) technology speeds up restorative dental treatment. With a computer-generated image used in place of a mold and temporary restoration, bridges, crowns, veneers and inlays can be created and fitted in one visit.

5. Digital Photography – Digital photographs can be adapted to offer you a “preview” of your post-treatment appearance. These are especially helpful for cosmetic dentistry and complex reconstructions, since treatment can be customized based on the patient’s expectations and requirements.

6. Dental Lasers – Today, diode lasers are used to locate cavities in your teeth, in addition to their use in dental care procedures. Lasers can help locate cavities earlier, and are often used alongside high-tech x-rays to detect decay between and inside teeth or for teeth that have previously been filled.

7. Intra-Oral Cameras – These small and lightweight cameras produce highly accurate images of your teeth and their supporting structure. They allow dentists, technicians and even patients to see defects, helping to detect and prevent oral health issues.

8. VELscope – This new FDA-approved oral cancer screening system allows dentists and oral surgeons to locate defects that may not be visible to the naked eye. The system uses incandescent light to help identify abnormalities, or define appropriate margins for surgical procedures (e.g. excision of diseased tissue around a lesion).

9. The Wand – This computerized tool is used to deliver anesthetic liquid in a gradual and methodic manner, reducing the pain caused by pressure from traditional injections. The small delivery holder makes it easy to use, and patients are more comfortable with the painless delivery of anesthesia.

10. Desensitizers – For patients with sensitive teeth, desensitizers are a godsend which improve your comfort during any dental procedure. Dentists or dental hygienists can use them alone or combine them with other relief methods for pain and anxiety (e.g. local anesthetic/sedation dentistry).

With newer advancements in dental technology, treatment is becoming faster, safer and more effective than ever before. We at All About Smiles always stay abreast of any advances in dental technology, call and let us help you clear your doubts.

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Author: Dr Amruta Patel is a warm and compassionate dentist caring for the community of San Antonio, TX. She practices at All About Smiles, where she provides cosmetic braces, endodontic treatments, implants, and veneers, as well as basic general dental services. Outside of practicing dentistry, Dr. Patel enjoys spending time with her husband and two dogs. 

The Formula to Happier Patients

"My hygienist wasn't that great. She only used the water." - My Aunt

"My hygienist was super lazy. She didn't even use the water." - My Sister

"My hygienist said I need shots in my mouth and all this stuff... I don't know why. I think she was just confused with all the bleeding." - My Friend

"My dentist wants me to come back after the root canal to get a crown, instead of having the endodontist do the crown. He is definitely trying to get my money." - Another Sister

Yes, there will be some patients that are NEVER happy. But, I think you'll see an increase in satisfaction and compliance among your patients by following the formula below.

State Observation + What you're going to do and why + "Let me know"

Here is an example for a patient that has generalized gingivitis.

Observation: You have 10 areas in your mouth with an active bacterial infection. We used to not be as aggressive treating gingivitis. However, studies are finding a strong link between your body and your overall health. I'm going to do everything I can here and then "adjust" your brushing slightly so you'll be more effective at home.

Procedure/Why: Research shows a mix between this water instrument and hand instruments are the most effective way for removing the harmful bacteria.

"Let me know": If you experience any discomfort, please let me know.

Hygiene Edge Challenge: Follow the above formula for 2 procedures per patient.

Selective Polishing or Polish Selection?

Remember learning about selective polishing when you were in hygiene school? Has selective polishing come to be just asking your patients to select what flavor of polish they would like you to use?

If it has, you are not alone. I took an impromptu poll of my hygienist friends asking them if they find themselves coronal polishing  every tooth on every patient. The most frequent answer was “yes” with few stipulations like “not gold crowns” or “only along the margins of crowns”.  So, while there were stipulations I don’t think they would qualify as the “selective” your  instructor and text books taught you.

While working as a Dental Assistant the words “prophy” and “polish” was synonymous. You can imagine my surprise when I learned the truth!  Maybe our patients will feel the same when they learn that same truth. Polishing is only and aesthetic treatment meant only to remove the extrinsic staining on the teeth. Polishing does not qualify as a therapeutic service, meaning that it doesn’t help treat disease or sustain health.

Selective polishing indicates that we as dental professionals are evaluating the present stain and choosing appropriate polish grit to remove the stain efficiently without injuring the tooth structure. This requires us to be educated on what abrasive particles and other additives are found in the polish is available to us.

Next time we reaching for the coarse paste, knowing that it will take anything off (including tooth structure,) we can use the time that saved us to read the manufacturer's instructions that come with our prophy paste.

Not all patients are in need of this aesthetic service but all seem to expect it. I choose not to polish the same day that I debride (SRP) as to not irritate the tissue (polish past gingivitis is a thing!) and I cannot count how many times my patients express distress at the thought of not getting polished. I have found that when I preface the scaling and root debridement with EDUCATION the distress is greatly reduced.  It also gives them an incentive to come back for their re-eval when their tissue have healed to be polished. What kinds of things can you do in your practice to educate your patients?

Trish Jones RDH, BSDH shared some valuable information in her article, Selective Polishing: An Approach to Comprehensive Polishing. “As the dental health-care provider, it is important to let the patient know the thought process behind selective polishing prior to performing the procedure. This in turn enhances the patient’s experience, adding value to the procedure. This is called pre-framing, a term used in the psychology of behavioral science. In this case, pre-framing involves explaining the procedure to the patient before and after it is completed to ensure they have a complete understanding. For example, when the patient is in the chair, the hygienist can let the patient know the purpose of abrasive type pastes and cleansing pastes. These include why the paste is splatter-free, why it rinses very quickly and minimizes the gritty feel (flash rinsing), and how the product can remove stain so a beautiful smile can be maintained. Patient concerns can also be addressed at this time.”

She went on to give great examples of how to approach that conversation:

“In order to preserve the investment in your smile, we are going to use a specialized paste that not only removes stain, but also polishes the teeth to a lustrous shine.”

“Research has now shown us . . .”

“Because I know white teeth are important to you . . .”

“I know you love the feeling of smooth teeth and fresh breath . . .”

“So we can reduce the gritty feeling when I am done . . .”

“Because you told me your teeth are sensitive, I have a special technique . . .”

“Because I noticed this about your smile, I am implementing a procedure and have chosen a product just for you that will ...”

As we educate our patients they feel that we care about them. So next time, think twice before offering that delicious grape flavored coarse paste to the lady with light stain and recession. Instead, explain the benefits of that mild mint desensitizing polish that will help with her hypersensitivity. She and her teeth will be grateful.