Over the last year, I can’t tell you how many times I have said or thought, “I have to do what now?” when it comes to the hygiene workflow. So much has changed and then changed again, and then yet again. As I’ve dug in to learn about these changes’ whys and hows, my team and I discovered many things we should have been doing all along.
It all feels overwhelming and a little defeating. How on earth are we supposed to do all the things? And on top of that, do them well and fit them into our already busy day. I joke about needing a catheter, but am I kidding?
My head is spinning between COVID-19 screening, preprocedural rinsing, aerosol mitigation, PPE, and infection control. I haven’t even touched on advances in science that make the oral-systemic connections undeniable and all that goes along with that. Something has got to give, right? But what?
Short of adding more hours to a day or significantly increasing appointment times, we need to figure out how to work smarter and let technology and advances help us succeed. Unless someone can help us increase insurance reimbursement significantly—I’ll keep dreaming about that one!
While your operatory is no doubt a comfortable space, you have got to break out of those four walls. Getting to know other hygienists has been what has kept me excited about hygiene. I remember graduating from hygiene school, and about three months into my career, I hated it. I even enrolled in graduate school classes convinced I had picked the wrong profession. Dental hygiene was not what I had pictured at all. There was so much about patient care that I didn’t learn in school, and I felt overwhelmed. Then I joined a study club and started talking to experienced RDHs and realized they all felt that way initially. They assured me that as I developed relationships with my patients and doctor, things would smooth out. Thankfully they were so right!
Now with social media, it’s easier than ever to network with other professionals. Recently, a post in a dental hygiene group from a new RDH asked how she can get it all done in the 60-minute appointment. Within an hour, there were tips from hygienists worldwide talking about what they do to save time or multitask. And even more comments to let her know she wasn’t alone in her struggle. There were excellent suggestions offered, from charting while the doctor was doing the exam to ensuring you have wipes with a short kill time. Many recommended polishing first as a way to remove plaque and biofilm to save time when scaling.
My favorite suggestion was to use disclosing agent first to reveal biofilm and educate patients on their home care.1 If you haven’t tried this yet, it’s a game-changer. You might be saying, “Wait, you want me to add a step? I thought we were streamlining the hygiene flow.” But as many hygienists can attest, when patients see the plaque in their own mouths, especially when you use a product like 2-Tone Solution by Young Dental that colors more recent plaque red and older plaque blue, they begin to take ownership of their home care. When they return for their next visits, they are eager to see fewer stains on their teeth, and your job gets easier!
Couple disclosing with polishing first, and you are already adding precious minutes to your appointment. I love my cordless Infinity handpiece (Young Dental) because it’s super lightweight and holds a long charge, and the best part is I can use any prophy angle I want. With all the concerns over aerosols, using the Splatter Guard prophy angle and high-volume suction to reduce aerosols2 keeps patients and clinicians safe, and gets the appointment moving right along. Starting your appointment with a clear field of view and a well-educated patient is a huge time-saver.
The tricky part about social media is not all the advice is good or scientifically sound. Professional judgment is critical. Over time you learn who to trust. You can even reach out to those professionals and establish a relationship. I have been lucky enough to form strong relationships with other professionals through direct messages on social media platforms. I have big dreams of meeting up with them this summer at RDH Under One Roof!
Speaking of RDH Under One Roof, continuing education is essential to staying on top of our ever-changing profession. Courses and especially conventions are great ways to learn about the latest technology and figure out what is worth implementing. Dental hygiene has changed so much in the 25 years since I graduated from hygiene school. If I were still using the same instruments or techniques that I learned in school, I’d be doing my patients and myself a huge disservice. Not to mention, I’d feel like I was in the movie Groundhog Day.
When it comes to continuing education, we all know you can phone it in. Take easy classes or jump straight to the test for an online course. I hang my head low to say I have done this. There were years when my kids were little, and my motivation was low, that I just didn’t care. I looked at CE as another chore to do and a box to check. Now that I’m on the other side of that, I realize that I missed out on opportunities to get excited about something and bring it back to the office.
After RDH Under One Roof in 2020, I had a list of to dos I wanted to implement in the office. My ever-patient doctor had me narrow down the list to five things.
- A new charting template—ensuring more complete chart notes and saving time
- Taking blood pressure on every patient—because we are health-care providers
- American Eagle sharpen-free instruments—because I can’t stand sharpening but understand why it matters. Who has the time?
- Silver diamine fluoride (SDF)—for sensitivity and as a stopgap for carious lesions
- 3D scanner—while this hasn’t been purchased yet, we did get a demo and one will hopefully be in use this summer
All of this was from information I learned in lectures, from talking with experts at the virtual booths or other attendees in focus groups. I headed back into the op, understanding the why behind many of the to dos and with excellent tips on how to implement them.
When you genuinely invest in continuing education, you are not only checking the licensure box. You are also investing in yourself, your career satisfaction, and your joy.
Having a team that is truly a team is necessary to make this all work. There is no way each person can get it all done by themselves. This is health care. That means we are taking care of human beings with different needs, and we can’t always schedule for that.
Offices that have a silo mentality3 or follow the “that’s not my job” philosophy will never get it all done. Maybe some days you’ll manage, but resentments and frustrations will build up over time. Eventually, there will be an explosion or staff turnover.
Adopting a cross-training culture, open communication, and honest feedback will go a long way to fostering a group of people who want to look out for each other. Unfortunately, we hygienists often have a reputation of being divas or above pitching in.
A few decades ago, I remember being accused of not helping enough in central sterile. My first reaction was defensiveness and to make excuses. Thankfully at the time, we had a consultant who helped mediate the discussion. After talking it through, we figured out the assistants were upset I wasn’t bagging their instruments. All the while, I was afraid to touch their setups because I didn’t know what went where. It was a simple conversation that we cleared up, and I was able to pitch in. In response, they started helping me more with perio charting and room turnover.
We all want to feel supported. Yet none of us are mind readers. Taking the time to openly communicate your needs with team members and actively listening to their needs is the final step to getting the hygiene workflow to flow.
While there is no magic formula to getting it all done, there are avenues to figure out what will work in your workflow. No matter how awesome you are, you cannot do this alone. Reach out, dig in, and cooperate to find your way. But above all be flexible because once you figure it all out, something else will have you saying, “I have to do what now?”
Editor’s note: This article is sponsored by Young Dental. The content has been reviewed for editorial integrity per RDH guidelines. Read more about our editorial standards here.
- de Alencar CR, de Oliveira GC, Tripodi CD, et al. Dental plaque disclosing as an auxiliary method for professional dental prophylaxis in early childhood. Int J Clin Pediatr Dent. 2019;12(3):189-193. doi:10.5005/jp-journals-10005-1617
- Harrel SK, Molinari J. Aerosols and splatter in dentistry: a brief review of the literature and infection control implications. J Am Dent Assoc. 2004;135(4):429-37. doi:10.14219/jada.archive.2004.0207
- McCauley A. Silo mentality: The silent toxin in dentistry. RDH. April 1, 2020. https://www.rdhmag.com/career-profession/article/14173517/silo-mentality-the-silent-toxin-in-dentistry
Amanda Hill, BSDH, RDH, a practicing dental hygienist, industry educator, and key opinion leader, is passionate about the dental industry. She is a speaker, award-winning author, and host of the Your Dental Top 5 podcast. A member of the advisory board for RDH magazine and OSAP’s Infection Control In Practice Editorial Review Board, Amanda strives to make topics in dentistry accurate, accessible, and fun! She can be reached at amandahillrdh.com and [email protected].