5 Helpful Tips to Make the Ultrasonic Use Comfortable for You and the Patient
This last 18 months has been a whirlwind, right? From closing offices to preventative treatments, to patients delaying treatments for over a year, to people’s home care routines completely changing due to their life routines changing. With all these changes, have you noticed your patients are presenting with much more inflammation, calculus, and stain? You may or may not be using the ultrasonic now, but I’m sure you have plenty of patients that could benefit from using it. If you have decided to use it on occasion for these overdue patients, here are a few helpful tips to make it a bit more comfortable for both the patient and for you.
1. Instrument Selection
There are several different design characteristics of an ultrasonic insert that can affect the use of the instrument. First off, the diameter, when you’re working on cementum and there aren't large deposits, the thinnest tip will be the best and most comfortable for your patient. A thick tip on biofilm removal will cause tooth sensitivity due to how much power the instrument is putting out and putting into the tooth surface. It will also help preserve the tooth surface but not using a higher power that minimal calculus doesn’t need. Once you’ve removed the moderate to heavy calculus with the thicker ultrasonic insert, switch tips to something thinner to get the fine calculus, biofilm and diseased epithelium removed.
Second, the cross section. Use a circle cross section instead of a diamond if there isn’t heavy calculus. When there’s a diamond shape, all the power goes into the corners of the shape, and transfers the power to the tooth and calculus. Use the diamond cross section tips on heavy deposits and not straight on the tooth.
2. Check out the tip for wear.
If your tip is 50% worn down, they need to be replaced. At that point, they’re no longer effective to remove anything. You’ll find soon that you’ll have to instrument the teeth longer or find yourself putting more pressure with the ultrasonic, which can in turn make the teeth sensitive.
3. Manage their expectations.
Before the procedure even begins, let the patient know what they’ll expect, especially if it is the first time they’ve experienced the ultrasonic. Let them know about the water, suction, pressure they could feel, etc. Let them know that if there is any pain, have them give feedback right away.
4. Don’t shy away from topical anesthesia.
There are lots of great options on the market today, and they’re easy and quick to apply. It’s a great option for localized inflammation and sensitivity in the gingiva. If the teeth or roots are sensitive, you’ll want to explore other options for local anesthesia. Get feedback from your patient to see how to proceed.
5. Visit Curved Tips.
Left and right ultrasonic tips are great for deeper pockets. They curve and hug the tooth anatomy, which can be more comfortable for the patient. We’ll have some videos coming up about these tips, how to use them, where to use them, and how they can be more comfortable for your patient and more ergonomic for you.
Next time you have a patient that you need to use the ultrasonic on, make sure you manage the appointment and their pain by reviewing these simple steps. You got this!
Dental Fads That Need to Go
We all know that fads come and go in our lives. Doc Martins? Scrunchies? Certain clothing items? We’ve all them and loved them, the dropped them so fast. Dentistry is no difference. We are constantly having new “findings” and “research” presented from social media, and patients will be asking about them in your operatory. We’ll break down a few current dental trends that your patients may have tried or will be asking you about.
DIY Braces
There are several ways that patients can perform an at home orthodontic treatment. One way is wrapping an elastic, string, or piece of floss around their two anterior teeth, 8 and 9, if they have a diastema. There are so many YouTube videos on this method. And it can work for a bit! The teeth will move, but will probably move back because there’s a space there for a reason. There’s also a high chance of bacteria being caught around the at home aid, causing inflection in the gingiva and bone. Another way is to make your own Invisalign trays with plastic from the craft store. You warm up the plastic beads, make a U shaped that’s a similar size to your teeth, and bite into the plastic when it’s not super hot. Then, before it fully sets, you’ll remove the tray and adjust the teeth that you want to move. And this works too! Not recommended however, because the plastic isn’t medical grade and probably it’s smart to be putting into your mouth during the day or night and constantly sucking on it.
Tooth Filing
You may have seen this on Tik Tok, but you can use a nile file to shape your teeth. Have 8 and 9 that are slightly different lengths? You can use a nail file from the drug store to make them shorter. Nail files and the files we use in the dental office are very similar (we usually use a smaller/less course grit however), and you can totally removal enamel with them. But, definitely not recommended since removal of the hard outer shell of the tooth makes it susceptible to sensitivity, decay, pain and more. Make sure you’re keeping an eye on the insial edges of your patients that are on social media (aka everyone). You never know who will be removing tooth structure for a quick cosmetic fix.
Tooth Gems
These have come and go over time, especially as celebraties like to try out new jewelry for the red carpet. These metal, diamond, or jeweled gems can be purchased anywhere (we actually bought ourselves a few different ones to try from Ali Express), and come with etch and bond to adhere it to the tooth. This definitely can be damaging to the tooth, since a patient with no real dental knowledge can be placing these. We’ve even seen some hair and nail salons adversing this service of them adhering a small decal to an anterior tooth.
What dental trends have you been seeing and what ones have your patients been asking out?
If Dental Hygiene Was Easy...
I have been thinking a lot about dental hygiene, our careers, our patience, our bodies and our families all at once this last little bit. These last 18 months have been so hard on everyone, especially people in healthcare or in a customer facing career. We are working every day on patients that are the entire a range of emotions every single hour- from excited to fearful. Anything else, this year also started to divide not only us is clinicians from patients, but now we’re on a divided front when it comes to ourselves. We have found that each clinician thinks differently, reacts differently, and has difference of opinions when it comes to important decisions that the last year and last few months have come to the surface.
I totally understand the importance of having our own thoughts and opinions and working out what’s best for ourselves and our families. What I am not understanding is the tearing each other down because of these differences of thoughts. We have worked so hard for our degrees, we have worked so hard to help our patients with their health. We have worked so hard to keep our profession growing in the healthcare space and to be seen as a whole healthcare providers. And really, the only way to do that is to keep combined, keep working together and keep supporting each other.
Let’s be kind and open, and help each other feel supported and cared for in our profession. We’re in this together.
Ideas to Get Dental Hygiene Patients in School
September means back to school, which means back to patients for many dental hygiene students. Finding patients and managing your schedule is one of the trickiest parts of hygiene school, since patient care is so important for your degree, but has so many wild cards involved.
Recently, a dental hygiene student asked us online how to find patients, and we put a call out to our community for some advice. And you delivered. Here are some of the ideas:
“Call homeless shelters. Recruit in low income communities as a group.”
“I used a lot of family. In my program, we had patients on State insurance sent over.”
“Make a posting at the unemployment office!”
“Ads at churches, homeless shelters, coffee shops, anything with a bulletin board.”
“Have trusted friends/family/acquaintances ready to come in as back up patients.”
“Ask people their schedules, and if they’d be open to coming in last minute. Some people have schedules where they always have, say, Tuesday morning off, and would be free to come in then.”
“Find retired people! We reached out to a couple retirement homes etc”
“See if your program will offer free/reduced fees to veterans in November. Post fliers about it.”
“I would make small talk everywhere I went- grocery stores, banks, restaurant.”
“I asked family and friends. And ask them to ask their friends too.”
“Local Facebook Groups! Life saver”
“Ask patients that you do have if they have any family or friends who would like to come in too."
“Make business cards and hand them out to places who don’t offer dental insurance.”
“Next Door app, Facebook posts, and their community help pages”
“Post on a local Facebook yard sale page or something similar”
“Facebook Marketplace! Many don’t know how cheap it is for those without insurance”
“FB groups, small business groups. Owners and staff are often uninsured and have flexible schedules.”
“Ads on Facebook and Craigslist”
“Family and friends, then after 6 months they came in again”
“Join an intramural sport, club or group of some time and make some friends!”
“Beg at the library. I’ve heard girls having Tinder/Bumble strictly for patients too!”
“I would make posts on Facebook. That worked really well.”
“Made business cards and handed them out to people I met just about anywhere.”
“Call previous patients from past years. Spend a lot of time in the front office doing recall.”
“Make sure to call and confirm a few days before, then you know it’s on them and not on you.”
“I had a classmate use a dating add. It worked well for her!”
“Hehe! Going clubbing and getting patients there! Before Covid of course.”
“Facebook Yard Sale Pages SAVED ME!”
“Go to the library/entertainment part at school and ask!”
“The Next Door App!”
“I walked around campus and asked other students! But it wasn’t easy”
“Family and friends you can trust! And pay them to show up”
“I did a Kijiji ad. It actually worked- no weirdos”
“Explain that your grade and degree relies on them showing up and being there.”
“Walk around the school and look for people hanging out.”
“I also got close with upperclassmen and took on their patients when they graduated.”
“Made a Google number and posted online. Craigslist, etc…”
“KSL, Facebook pages. It gets deleted but it gets out there they notice.”
“Look at surrounding towns. Other than people I know, that is where I found most of my patients”
“I paid them”
“Walked about my neighborhood with cards. Made posts online. It was way out of my comfort zone.”
“Being persistent and constantly reminding everyone that they made a commitment.”
“I literally negged my heavy SRP patient to come in every time I had a cancellation. He was the real MVP”
“Posted it on Offer Up to get local people and keep track of all my patients in details”
How did you end up finding your patients in dental hygiene school? Let us know to help others!
FAQs from Dental Hygienists
Recently, we asked on our Hygiene Edge Instagram page about any questions that dental hygienists or dental hygiene students have right now for us. And we had some of the best questions! Since they only last a day, we wanted to talk about them here, just in case other RDHs have a similar question pop up in their practice.
Q: About to start my last year of dental hygiene school! Any advice? Studying? Boards?
A: Start looking for a clinical boards patient right now! Is it ethical to make them wait until the spring to have treatment? Probably not. But now is the perfect time to get looking for one if you’re doing live patient this year. Don’t shy away from a boards prep course. They definitely help narrow down what you need to study and prepare for.
Q: New Grad! What are some helpful tips to manage a full schedule?
A: Look through the day at the beginning of the day to see what radiographs each patients need. Don’t spend time taking them if they aren’t due! If you’re feeling super overwhelmed and they have a full healthy perio chart within the last 6 months, spot probe today and record a full chart at the next appointment. Let the dentist know you’re ready for an exam right after taking radiographs. Then, you’re not waiting for 10-30 minutes after finishing for them to come, putting you more behind then we like to be.
Q: Tips for test anxiety? I failed boards and am retaking it soon!
A: While you’re taking the test, take a break, take a breathe, and then go back and focus on the question. It’s ok to spend a second a regroup before moving onto the next question. Make sure you surround yourself with people who love and support you no matter what. And just remeber- you can totally do this!
Q: What inspired you three to form your company? We really wanted great content for our students! There wasn’t anything available to teach and connect our students with easy to understand ways to instrument or to do injections. And it just grew from there! We definitely know there was/still is a need for great, helpful tips and tricks in dentistry to make our lives easier.
Dental Hygiene Irish Blessing
Dental hygienists amaze me. They are some of the most dedicated groups of people on the planet. I felt this month like writing a little “Dental Hygiene Irish Blessing” to my fellow dental hygienist to get you through the day, week, month and years. We here at Hygiene Edge want you to know that you are doing amazing! Keep up the great work!
May your cavi wipes be full and your glove box never empty.
May your fulcrum feel strong and your magnification not weak.
May your alginate not be too runny and your stone not too thick.
May your PPE be cool and your ultrasonic tips not be too hot.
May your patients be kind and your office manager not mean.
May your work week feel short and your weekend long.
May you feel like a valued team member and be the one that patients remember.
May you be rich in your hygiene blessings from this day forward.
-Shelley Brown, RDH
Silly Things Patients Do
I love a good “silly patient” story. You know the ones that have you shaking your head with a little giggle under your mask. Having had my own husband pull off his braces with pliers from the cabin tool box on a trip to Yellowstone has made me no stranger to the silly things that patients do. I hope you too have a good time reading the following “silly patient” list from other clinicians.
Trimming an operculum or frenum with toenail clippers
Using crazy or super glue to glue on crowns or broken teeth
Pull his own teeth while intoxicated
Using a dremel or nail file to smooth teeth
Had a nail tech make her own veneers with acrylic
Items used for home care
Oxiclean laundry detergent
Comet cleaner
Rinsing with bleach
Rinsing with half pool chlorine cleaner half water
I would love to hear of some of the “silly” things you have experienced your patients doing.
Step Up Your Customer Service
Looking for ways to step up your customer service? It is the small things that will set your practice apart. Here is a list of ideas to keep patients coming back, and referring friends.
1. If you're not already, do an oral cancer screening and inform your patient you are doing one. It is the standard of care, but not all clinicians make the time. If you do the patients WILL see the value and keep coming back to you.
2. Neck pillow: get a really nice neck shaped pillow that still allows you to keep your ergonomics perfect.
3. Virtual reality glasses. This new concept lets patients wear VR Goggles so they can watch a movie up close. Working around them can be a challenge just like working around a nitrous oxide nose piece. Check some out HERE
4. Let them choose the music station: You could have a Beats Pill speaker and a music subscription so the patient can listen to whatever they prefer in your operatory. You can also get headphones so that only the patient hears the music.
5. Switch up the smell: Always be cautious of using scents as they can be irritating to some. With that said there are all sorts of dental products that make the office smell...well like the dentist. You can try essential oils on the patient cover, diffusers, candles or sprays, just be sure it is MILD. Check some out HERE
6. Use a blanket: I know you NEED to work in a cool environment which makes it so that patients freeze. Giving the patient a blanket can make all the difference. You could get slightly weighted ones as well. You can let the patient keep the blanket or wash them daily.
7. Flowers: Roses, succulents, tulips; get some fresh flowers for the front desk and them give them to a patient that day.
8. Handwritten note of thanks. You can pre-write them and put them in the goodie bag or send them out in the mail.
9. Warm towels to wipe the face after treatment.
10. Water bottle with your office info.
11. Use Sunglasses: Give Sunglasses for safety glasses as they block out those bright dental lights.
Check out our Amazon store front to see many of these items in action HERE.
Considering a Commission Based Pay Model?
Thinking about taking a job with a commission based pay model ? Or would you like to moved to a commission based pay model? Whatever the reason, below are questions to ask and things to consider before accepting the job.
Questions To Ask If Commission Pay is Offered
1. Is this straight commission or comission plus a base pay?
2. Will I be paid on production or collections?
If production will this be net or gross?
3. Do I get commission on the dentists exam as it is done in hygiene?
4. Do I get commission on products I sell?
5. Are there any services or products that I don’t earn commission on?
6. What is your now show policy and do I receive commission on the no-show fee?
7. Consider asking what their previous hygienist produced the year prior.
8. Consider asking to see if the schedule is full and booked out 6 months.
9. Consider asking for commissions on the sale of cosmetic procedures such as orthodontic clear aligners, veneers etc.
10. If you have negotiated a deal to work on some type of commission pay, get the offer in writing.
Things To Keep in Mind If Accepting a Job with Commission Pay
1. Consider that you are getting a piece of the pie. The more you produce the more you make.
2. Consider that you get a raise when you increase your fee’s.
3. If working on commissions it is important to run your practice with ethics. Remember the mantra, “I recommend for products and services that patients NEED.” If the patient won’t benefit from this then don’t do it.
4. How do I make more money if I work off of commission? Add in more products and services such as in-office whitening, oral cancer screening tools, lasers, silver diamine fluoride treatments, Laser, Arestin, sensitivity treatments, sleep apnea screenings/appliances, night guards, toothbrushes, toothpastes and rinses.
SLOB Rule
In your radiology classes, remember learning the SLOB rule? This is a handy little technique to use to figure out where an abscess is, trauma is, etc on a 2D image from a 3D human. Now with cone beam technology, this little rule isn’t used as often. But, if your office doesn’t have a cone beam, or your patient isn’t willing to pay the extra money for the more advanced radiograph, you can try out this method. Check out the video below that explains the rule.