Tips for Finding a Great Dental Hygiene Clinical Board Patient
My sister in law has been a dental hygienist for over 12 years. She’s had kids, moved to a different state and different country in the time, and they’ve now settled in California. She’s ready to get back into the hygiene world and work clinically in her town. But because it has been a bit since she’s taken WREB, she’s back at it again. With taking the test comes finding a patient. I’ve been teaching students and assessing patients for the exam for years, but being back in the spot of actually finding a patient has been tricky and is taking me back for when I took the exam, both a few years ago and when I graduated! Here are a few tips and tricks for finding a great patient over the years that we’ve been using to find the perfect patient.
Post about the exam and your need for a patient on local Facebook Groups. However, once you post it, many times they’ll be deleted in a short amount of time, depending on the group. Once you post it, watch your post to see who responds or messages, and get the conversation going right away. If not, the post may be deleted, and you’ll miss who responded. Also, keep an eye on your “other” message folder to see if anything messages you but it gets hidden.
Get your prescreening questions ready. When talking to a potential patient, make sure you ask a few screening questions beforehand to make sure they’ll qualify for the exam. Here are a few I like to ask: Are you allergic to anything? Any medical conditions such as heart disease or diabetes? Are you available on (insert test date)? Do your gums bleed when you brush (don’t include flossing. It’s pretty common for people’s gingiva to bleed if they rarely floss. If they’re a regular brusher with no bleeding, however, they may not qualify for the exam).
Ask other students, past students, or your senior who graduated the year before you for a recommendation. They may have a great lead or two you could follow up with. Sometimes the patient they used didn’t get the rest of their mouth treated and it may qualify, or the patient has a family member or friend to refer to you.
Reach out to surrounding offices. Sometimes, these offices have patients come in that qualify and cannot afford periodontal therapy. If they have someone like you to refer them to, it would definitely help both you and the patient.
Don’t get overwhelmed. I know, this is the least helpful advice. But for some reason, when someone puts in the work, it all works out! I’ve had student’s patients end up in jail the week before their exam, patients that go into early labor before, patients that have gone completely MIA. And for some reason, it all works out how it is meant to be.
How did you find your board patient? What are some of your tips to finding a great patient for your clinical exam?
xoxo Melia Lewis, RDH
Does the Pace You Move the Power Scaler Matter?
Slow down to speed up. Pace matters when it comes to being efficient with power scalers.
I recently recorded myself using the power scaler. If I had been grading myself I’d have taken points for going too fast. I think we all get excited to knock off all the big pieces before we have completed the area prior. Pace is important when it comes to power scaling. The pace at which the power scaler is applied plays a critical role in ensuring effective plaque removal while minimizing damage to tooth surfaces. The general recommendation is to maintain a slow, deliberate pace to allow the ultrasonic vibrations to break down plaque and calculus efficiently. Moving the scaler too quickly can result in missed areas and ineffective cleaning, as the vibrations need time to dislodge the deposits. A slow and steady pace ensures thorough coverage and better patient outcomes.
Two key techniques for optimizing the use of an ultrasonic scaler are channeling and the use of short overlapping strokes. Channeling involves methodically guiding the scaler along the tooth surfaces in a systematic manner, ensuring that each area is treated thoroughly. This technique helps to prevent over-application in certain areas while missing others, leading to a more uniform cleaning process. Short overlapping strokes are another essential aspect of effective ultrasonic scaling. By using small, controlled movements that overlap slightly, the clinician can ensure that every part of the tooth surface is adequately treated. This technique reduces the likelihood of leaving behind plaque or calculus, enhancing the overall effectiveness of the procedure.
Research has shown that these techniques, combined with a slow pace, significantly improve clinical outcomes. A study by Eberhard et al. (2015) found that using short, overlapping strokes with an ultrasonic scaler leads to more effective plaque disruption and a more thorough cleaning process. Another study by Dragoo (1992) highlighted the importance of a systematic approach, such as channeling, in ensuring comprehensive debridement, particularly in hard-to-reach areas like interproximal spaces. These studies underscore the importance of technique and pacing in maximizing the effectiveness of ultrasonic scaling. Check out channeling and overlapping strokes in our latest video:
Happy Preventing Shelley Brown, MEd, BSDH, RDH, FADHA
References
Dragoo, M. R. (1992). A clinical evaluation of hand and ultrasonic instruments on subgingival debridement. International Journal of Periodontics & Restorative Dentistry, 12(4), 310-323.
Eberhard, J., Ehlers, H., Falk, W., Acil, Y., & Albers, H. K. (2015). Ultrasonic debridement with different irrigation fluids influences clinical outcomes in chronic periodontitis patients: A randomized controlled trial. Journal of Clinical Periodontology, 42(10), 958-967. https://doi.org/10.1111/jcpe.12456
References
Dragoo, M. R. (1992). A clinical evaluation of hand and ultrasonic instruments on subgingival debridement. International Journal of Periodontics & Restorative Dentistry, 12(4), 310-323.
Eberhard, J., Ehlers, H., Falk, W., Acil, Y., & Albers, H. K. (2015). Ultrasonic debridement with different irrigation fluids influences clinical outcomes in chronic periodontitis patients: A randomized controlled trial. Journal of Clinical Periodontology, 42(10), 958-967. https://doi.org/10.1111/jcpe.12456
Dental Hygiene Lunch and Learn List
I know that it’s tricky at times to attend a conference to learn about a new product, or read the hundreds of emails that come through about the products. Plus, once you learn about something new, it’s always nice to have a person or contact to ask questions to, get answers, and actually be able to try it out. This is why I love a lunch and learn. It’s a great way to learn about something new in a set amount of time when I have a break during a clinical day. Plus, having the entire team learn about the products are so helpful to keep the conversation going in your practice.
So, what companies actually offer this service? We’ve compiled a list of the companies that do, and the best place to reach out to about it. Sometimes these educators are location based, so you might have to meet with a certain rep, but then you’ll get to know your local rep which is so helpful. Some companies hold them virtually, which is very helpful to connect with placed that no not have any local.
A note about lunch and learns. Usually, these are most of sales and product information, so CE credits usually are not provided. They are usually full of the science behind the product, but since they are sponsored and 1 comapny/product heavy, they cannot give CE Credit. However, still a valuable lunch to attend!
Here is the list!
Arm and Hammer/Therabreathe
This is a great lunch to attend with lots of free samples. Usually taught by a dental hygienist.
https://ahpro.oralcarepro.com/en-US/officeregistration
BioGaia
Held virtually at times that work for you. Probiotics for adults and kids
https://calendly.com/biogaia-lunch-and-learn/biogaia-lunch-learn?month=2024-09
Centrix
Learn more about SDF or other prevention products and solutions.
https://www.centrixvirtuallearning.com/lunch-and-learn/
Crest Oral-B
I’ve been to some where the reps bring lunch, or it can be just informational.
https://www.dentalcare.com/en-us/product/request-teach-and-learn
DMG
More dental tailored, but some great topics to learn about.
https://dmg-connect.com/learn-over-lunch-with-dmg/
Dr. Jens
I’ve been to a few of the Dr Jens presentations, and have loved them all.
https://calendly.com/drjen-cepresentation/dr-jen-ce-presentation?month=2024-08
Elevate Oral Care
Learn more about some of my favorite prevention products. So much great research and support behind them as well.
https://www.elevateoralcare.com/staff-meetings
GC America
These can be tailored to your office, speciality or interest. From direct restorations to prevention, there are several topics you’ll love to learn about. I really loved the MI Paste one.
https://www.gc.dental/america/lunch-and-learn
Ivoclar
Reach out to your local rep about meeting to learn about a few products, or a specific one you’re curious about.
Oxyfresh
I’ve never used these products before, but signing up for a webinar lunch and learn to learn more.
https://oxyfresh.com/pages/dental-pro-resources-and-educational-material
Phillips Sonicare
Reach out to you local rep for more information. In Person and can cover whitening products or power toothbrushes
https://www.philipsohclearning.com/
Risewell
Learn more about hydroxiapetite and andd how to incorporate the porudcts in your office. Reach out to Melia (melia@hygieneedge.com) and she can help you find your local rep.
https://risewell.com/?srsltid=AfmBOopLzqjqMW_QxmFnWpcRjRIkY892qjmZQKnlwiGCM_MIcCH9nG3P
Stella Life
Mouthrinse, probiotics, and more
Spry
This is a local company to me in Utah, and I use their products regularly. If you’re not talking about xylitol in your practice, it’s time to learn a bit more from some amazing educators.
https://xlear.com/our-educators/
Waterpik
Offered both in the USA and Canada
https://www.waterpik.com/pro/lunch-learn/
I’m excited for you to learn a bit more about these amazing products, gain some insight on how you can help your patients, and keep up your clinical skills!
Which ones have you attended?
xoxo Melia Lewis, MED, RDH
How do you know you are at the base of the pocket?
A review the getting to the base of the pocket.
Identifying when you are at the base of the junctional epithelium during periodontal therapy is critical to ensure that you are effectively removing calculus without damaging the periodontal tissues. Here are 4 key indicators based on my clinical experience and studies:
1. Tactile Sensation
Texture Change: As you reach the base of the pocket, you will notice a change from a rough to a smoother root surface, indicating the absence of calculus and the proximity to the junctional epithelium (Armitage, 1996).
Increased Resistance: The tactile sensation of the instrument changes, often with a slight increase in resistance, as you approach the base of the pocket (Cobb, 2002).
2. Probing Depth and Anatomy
Use the Probe as a Guide: Knowledge of the patient’s probing depths and anatomy can help you estimate when you are near the base of the pocket. The junctional epithelium typically lies at the apical extent of the probing depth (Lindhe et al., 2015).
Limit of Attachment: The junctional epithelium is attached to the root surface via hemidesmosomes and is sensitive to mechanical trauma. Over-instrumentation can lead to bleeding, which might indicate you have gone beyond the base of the junctional epithelium (Haffajee & Socransky, 1994).
3. Clinical Signs
Bleeding on Instrumentation: Light bleeding may occur as you approach the base, but excessive bleeding could indicate that you have disrupted the junctional epithelium (Newman et al., 2018).
Patient Discomfort: Increased sensitivity or discomfort may occur if you are applying too much pressure or reaching the attachment level.
4. Instrumentation Technique
Correct Angulation of Hand Instruments: Proper angulation of the curette or scaler is important. Keeping a hand instruments instrument’s blade against the root surface at a correct angle can help prevent inadvertent damage to the junctional epithelium (Pihlstrom et al., 1983).
See it in action in our video here: VIDEO
-Shelley Brown, MEd, BSDH, RDH, FADHA
References:
Armitage, G. C. (1996). Periodontal diseases: diagnosis. Annals of Periodontology, 1(1), 37-215.
Cobb, C. M. (2002). Clinical significance of non-surgical periodontal therapy: an evidence-based perspective of scaling and root planing. Journal of Clinical Periodontology, 29(S2), 6-16.
Haffajee, A. D., & Socransky, S. S. (1994). Microbial etiological agents of destructive periodontal diseases. Periodontology 2000, 5(1), 78-111.
Lindhe, J., Lang, N. P., & Karring, T. (2015). Clinical periodontology and implant dentistry. John Wiley & Sons.
Newman, M. G., Takei, H., Klokkevold, P. R., & Carranza, F. A. (2018). Carranza's clinical periodontology. Elsevier Health Sciences.
Pihlstrom, B. L., Michalowicz, B. S., & Johnson, N. W. (1983). Periodontal diseases. The Lancet, 366(9499), 1809-1820.
Using a Sharpening Test Stick
For the past year, I have taken on 1 day a week temping. This has been such a great experience for me, seeing so many different offices and how they run, schedule, and what software they use. One thing I have noticed when I step into different offices for the day? How instruments are so different, and how many need to be sharpened! It’s hard to find the time to sharpen (more videos on that coming soon) but once you determine your instrument is dull and either take the time to sharpen or send them out to a company, you’ll see a word of difference on how they actually work so much better, you’ll spend less time hand scaling, and less force needed with our hands. A helpful tool to check your instrument is a sharpening test stick. We have definitely used and loved using plastic air water syringes before as a substitute test stick, but really love using a regular test stick even more. I find it gives me a better indicator of when an instrument is sharp and ready to be used, other than sharpening too much or too little on an edge.
If you haven’t used a test stick before, or haven’t since dental hygiene school, this video is for you!
xoxo Melia Lewis, RDH
Silver Diamine Fluoride Doesn’t Stain Sound Tooth Structure
SDF doesn’t stain sound tooth structure
Silver diamine fluoride (SDF) is an increasingly popular treatment in dentistry, primarily due to its efficacy in arresting dental caries. Yet we may forget that it is amazing for sensitivity which is its on-label use. SDF is a topical medicament that combines the antibacterial properties of silver with the remineralizing effects of fluoride. The application of SDF is minimally invasive and painless, making it an attractive option for pediatric and geriatric patients, as well as those with dental anxiety. Studies have shown that SDF can effectively halt the progression of caries, reducing the need for more invasive treatments like drilling and fillings .
One of the main indications for SDF use is in primary teeth, especially in children who may not tolerate conventional restorative procedures well. SDF is also indicated for root caries in older adults, which are challenging to treat due to the difficulty of maintaining moisture control and the high likelihood of recurrent decay. Additionally, SDF can be used as an interim measure to stabilize carious lesions until definitive treatment can be provided, which I do often in homebound settings.
A notable advantage of SDF is that it does not cause staining on sound tooth structure. While one of the common concerns with SDF is its potential to stain decayed areas black, but this does not affect healthy enamel and dentin. This selective staining property allows clinicians to distinguish between arrested carious lesions and healthy tooth structure easily. The non-staining characteristic on sound tooth surfaces makes SDF an excellent choice for patients concerned about the esthetic outcomes of their treatment. We recently posted a case study where we placed it on sensitivity on sound tooth structure and 1 month after, there was no staining. You can check it out HERE
As dental professionals continue to seek minimally invasive and patient-friendly treatment options, SDF stands out as a valuable tool in the prevention and management of dental caries .
-Shelley Brown, MEd, BSDH, FADHA
Crystal, Y. O., & Niederman, R. (2019). Silver diamine fluoride treatment considerations in children’s caries management. Pediatric Dentistry, 41(5), 292-298.
Horst, J. A., Ellenikiotis, H., & Milgrom, P. L. (2016). UCSF Protocol for Caries Arrest Using Silver Diamine Fluoride: Rationale, Indications, and Consent. Journal of the California Dental Association, 44(1), 16-28.
Clemens, J., Gold, J., & Chaffin, J. (2018). Effect and acceptance of silver diamine fluoride treatment on dental caries in primary teeth. Journal of Public Health Dentistry, 78(1), 63-68.
Gao, S. S., Zhao, I. S., Hiraishi, N., Duangthip, D., Mei, M. L., Lo, E. C., & Chu, C. H. (2016). Clinical trials of silver diamine fluoride in arresting caries among children: A systematic review. Journal of Dentistry, 44, 102-110.
Seifo, N., Cassie, H., Radford, J. R., & Innes, N. P. (2020). Silver diamine fluoride for managing carious lesions: An umbrella review. BMC Oral Health, 20(1), 145.
3 ways to answer “what’s your biggest weakness,” in your next dental hygiene interview.
3 ways to answer “what is your biggest weakness.”
One question that is often asked in an interview is "What is your biggest weakness?" Here are three effective strategies to use in your next dental hygiene interview:
Show self-awareness and growth: Acknowledge a genuine weakness you have identified in yourself, but emphasize how you are actively working to improve it. For example, you could say, "I used to struggle with time in hygiene school as it took me 3 hours to complete an appointment but now in my last semester I am able to be thorough and and efficient at the same time.”
Highlight a skill that is not essential for the job: Choose a weakness that is not directly related to the core skills of dental hygiene. This shows self-awareness without raising doubts about your ability to perform in the role. For instance, "I have a hard time remembering names so I like to write patients' names on a sticky note on each tray.”
Frame it as a learning opportunity: Discuss a weakness that you have successfully overcome in the past, demonstrating your ability to adapt and grow. For example, "In the past, I struggled with motivational interviewing, but I enrolled in a course and Now, I am effectively able to motivate my patients versus just lecture them.”
Remember, the key is to be honest yet strategic in your response, showcasing how you approach challenges and your commitment to continuous improvement. This demonstrates to the interviewer that you are self-aware, proactive, and capable of addressing weaknesses effectively. Best of luck on those interviews!
-Shelley Brown, MEd, BSDH, RDH, FADHA
Ultrasonic Tips with Nordent
I still remember the day we learned about the magneto ultrasonic device in dental hygiene school. Do you? I was so excited to be handed a machine to do it all and I wouldn’t have to use hand instruments ever again (I was obviously very naive in my thinking!) The day came in the clinic after learning about the technology in our lecture the previous day. I remember thinking “I just go for it?” and getting it set up, the correct amount of water mist, and figuring out the best way to hold the handle and the cord. And that’s what I did. Just went for it with no rhyme or reason and hoped it all worked out. Fast forward to a few years later when I was an instructor and teaching others how to use the ultrasonic. There is nothing quite like having to teach something that you have learned hands on before.
Early in my teaching career, I had the same mentality when it came to ultrasonic use-just go for it. But, after time and research, just “going for it” is probably not the best method for both you as a clinician and for your patients. There is so much science and research behind this machine that we use every hour and there are certain techniques that work better than others. One technique that gets lost as we hurry is channeling. This technique is critical to ensure the ultrasonic is working it’s best and both calculus and biofilm is removed without causing burnished areas or trauma to the tooth or tissue.
Here’s how it works:
1. Tip Orientation: The ultrasonic tip is placed at approximately a 0-15 degree angle to the tooth surface. This angle helps to direct the energy and vibrations produced by the ultrasonic scaler towards the calculus deposits.
2. Activation: The ultrasonic scaler is then activated.
3. Movement: The tip is moved in a controlled manner, following the natural contours of the tooth and focusing on areas with calculus buildup. The movement can be linear or curved, depending on the location of the deposits in small 2-3mm areas.
4. Adaptation: As the deposits are removed, the clinician adjusts the angle of the tip to ensure efficient and comfortable removal without damaging the tooth or surrounding tissues.
xoxo, Melia Lewis, MED, RDH
To learn more about this technique- channeling- and how to incorporate it into your practice, don’t miss our latest video which is highlighting Nordent LuxPoint magnetostrictive inserts.
The Perfect Dental PA with DentiMax
When I was a brand new dental hygienist, I was interviewing at offices all over my area trying to find the perfect first dental hygiene job. During one of the working interviews, the dentist would spend extra time during dental exams and take the time to thoroughly look through the radiographs. After the first few patients, one of the assistants pulled me aside and confided that the dentist is really particular on radiographs, and that mine were looking great! After that, I was sweating all day whenever I pushed that radiology button, hoping the image would turn out as well as I hoped.
This was many years ago and I definitely have learned so much about radiology and the techniques needed to have a successful image. One thing that is key to having a great radiograph? Great sensors known for its quality, just like the DentiMax Sensor. We have loved using it with our patients, and recently we were lucky enough to film our latest video with it. You can definitely see the quality of the images, even on video (which we all know throws it off at times). Plus, if you do decide to get a DentiMax sensor, they offer 1 on 1 training of your hygiene department or staff to help get the best images. With the combination of quality materials, videos from us at Hygiene Edge, and training straight from DentiMax, you’ll be feeling tip top with your radiology technique.
To learn more about the proper sensor placement to get the best image, definitely check out our latest video:
Also get up to $3000 of with this link: https://products.dentimax.com/hygiene-edge-exclusive-dentimax-discount.html
Thank you to DentiMax for supporing us at Hygiene Edge! To learn more, check out their website.
How Can I Get into Dental Hygiene Education?
We regularly get questions about being an educator. Usually the questions are “how did you get into education?” or “How do I break into education and get an educator role?” This is definitely a multifaceted question, but something I absolutely love talking about.
Education is so fun. We love being able to talk to coworkers about health, geek out with other educators about changes in learning, and stay up to date to help the next generation of dental hygienists. However, education can also be very tricky. If you are burnt out of dental hygiene, dental hygiene education may not be the answer. We still regularly work with patients, treat periodontal disease, and work one-on-one with patients all the time. But now in an education setting, we have an extra added layer of teaching at the same time. It is not the only way out of clinical Dental hygiene, but it is a fun way to keep dental hygiene interesting and may even renew your love for dentistry if you're feeling the sting.
So, what do we recommend to help you get into an education role? Here are a few things we have done that helped us get our foot in the door and introduce us to the amazing world of education.
Be a member of your professional organization. I know it is definitely a cost involved with joining an organization but being a member of a group of individuals who understand and love the profession is great for networking. I have found that Educators understand the value of a Professional Organization so there are many Educators part of the American Dental Hygienists’ Association, as well as working on a volunteer level of the organization. If you have the time and capacity, it might be great to volunteer for a role in your local component to get to know both educators and dental hygienists in your area. This has been such a great experience for me both personally and professionally and has helped with connecting with educators all over both my state and the country.
Take methodology courses now. Even before you start teaching, it's helpful to have teaching methodology courses before you jump into teaching. You'll have a broader range and knowledge of what education is instead of learning what is when you get into the role. Being a new educator can be overwhelming. Trying to add in methodology in addition can feel like a lot. There are many ways to get teaching education mythology online or through a local college or university, but we love hosting a monthly mastermind for educators called Hygiene Edgeucators. Each month, educators from all over the country come together virtually to talk about different teaching issues, problems, and work together in a mastermind to learn something new. Along with getting some methodology CE, you’ll also be networking with educators from all over the country since it is full of people from so many different schools. Having methodology classes will look great on a CV or your LinkedIn profile and help you stand out from other clinical dental hygienists applying for education roles.
Keep in contact with your instructors from your education. This is how I was first introduced to education. I reached out to a few of my past instructors and let them know I was interested in education if they had any opening or knew anyone looking. With that connection, they referred me to come interview for a clinical instructor position that I ended up loving and learning so much from. These educators are a great networking tool to keep the relationship you formed over a long two years after graduation.
Attend a conference. Educators love education (you might relate!). Attending even local component study clubs or your state dental hygiene association meetings is a helpful way to connect with educators face to face, for them to get to know you, and become friends with others in education.
I love having a role in an education, being part of the growth and changes in our education and future of dental hygiene, and have the opportunity to constantly learn through education. If you’re interested in a position in education, we are excited for you! Please connect with us so we can follow along and cheer you on with your journey.
xoxo Melia Lewis, MED, RDH
@meliardh