Honing our craft

Aug. 1, 2004
I've noticed that dental hygienists are very cautious when changing our mode of clinical practice. We read journals and talk with other dental professionals about how we practice and treat patients.

by Renee Marchant-Turner

I've noticed that dental hygienists are very cautious when changing our mode of clinical practice. We read journals and talk with other dental professionals about how we practice and treat patients. We attend classes and hear about all the latest and greatest in research and products, then go back to work and do the same old thing we've always done. Maybe we are too busy with our personal lives to muster the energy for change. Maybe our bosses haven't shown enough interest in anything new in the hygiene department to inspire us to discuss change with them. Maybe we're afraid to ask for new equipment, or haven't considered buying it ourselves. Maybe we are just complacent.

Could it be that all that science training we had in school is keeping us from believing new information? We need to look at the research, how a study was performed, and who sponsored the research. Some of us love the facts, preferably presented in a way that makes it easy to copy without much thought about what we're doing.

Practicing the same way year after year can lead to burnout. The challenge is gone. We may get stuck in a rut and do what we've always done. Did I mention that I graduated 23-plus years ago? Scary to think I could still be treating patients the same way I did back then. Sometimes I recall how I scaled teeth with vigor - patients were going to leave my chair with super smooth roots. Those roots were my signature, and that's how I learned to scale in school. That was state-of-the-art back then. I wonder how many sensitive roots I created?

I'll never forget one patient who told me he couldn't drink anything cold. It was a hot summer and he was not happy with my "exceptional" root planing.

I questioned what I was doing and whether I needed to do so much of it. Wasn't it enough to get the calculus off without removing cementum, the culprit of this cold sensitivity? Where was the end point of scaling? It wasn't long before research showed that we did not need to remove cementum any more.

Still, it was hard to abandon what I had been taught. I questioned each tooth — was it clean enough, or had I scaled too much? This shift in treatment was a big topic of discussion in peer groups back then. As the years progress, we all have to change our thinking and practice to reflect scientific changes in our profession.

Remember how exciting it was to learn all that new information in school? What happened to that enthusiastic open mind we all had back then? We tried new techniques.

I'm guilty of wanting all the best science behind any "new" treatment or product I try. I want proof and lots of unbiased research behind anything I use in my hygiene practice. School was great for teaching me how to read the research and not be swayed by a good sales pitch. Aren't we bombarded with sales reps, ads and mailers from companies on a daily basis?

It's really difficult to keep up with all the new science and products and change your clinical practice to accommodate all that information. Being active in your local dental hygiene meetings, talking to other hygienists, reading journals, and attending continuing education courses are imperative to keeping current. If we look at the research/science that we learn in continuing education, we can expand our work routines without taking more precious time away from our schedules.

My first reaction in a continuing education class may be to worry about how I'm going to add another procedure to my appointment. This is a common concern about the classes.

However, we can reappoint patients in order to acquire the information needed to properly treat them. This helps both the patient and our practices. Instead of trying to fit all the possible treatments into one appointment, have the patient return so you can do a better job.

When we worry about our patients' time and money, we sacrifice ourselves emotionally and physically. Remember, we're here to help them get healthy, not to work so fast that we become disabled.

We can be more effective getting our patients into better health without hand strain. Here's an example. Have you read the new biofilm research? It's changing from just a few years ago. Does a hand scaler remove biofilm as well as an ultrasonic scaler? Does it matter?

If you don't know or weren't taught enough about it, then I suggest reading the literature and taking a comprehensive class to learn hands-on to remove biofilm, plaque, and calculus. There are starter classes that use lecture and typodonts. You can get together with another hygienist to practice on each other. For a more profound learning experience, try a hands-on class using each other and/or real patients like we did in school. While it may seem intimidating to go to a class filled with strangers, don't let this stop you. Everyone is in the same boat. Hands-on classes are full of "light bulb" moments, especially when you are the patient!

Regarding the neck, shoulders, and back, go to an ergonomic class or a convention with numerous vendors and try magnification, illumination, and chairs with arm rests. There are many brands and one will work well for you. With these equipment advances, we can avoid most work injuries and save appointment time. With any of these changes there is a learning curve, and patience is required.

Dental hygiene school teaches us the current science of that time and the basics to be competent. When we get out of school we need to continue to hone our craft and change our ways of practicing by attending good continuing education classes, reading, and sharing with other hygienists and dentists. I've been very fortunate to be in a study group for the past 21 years, and I've taken classes from nationally known speakers, many of whom write for RDH magazine. These continuing education courses have been invaluable to my practice of dental hygiene.

I challenge you to be inspired by the techniques and products about which they speak and write. You will probably find a better mousetrap. New is often better. Try it, do it, and you'll like it!

Renee Marchant-Turner, RDH, has been in private practice since 1980. She teaches hands-on micro-ultrasonic continuing edcuation courses to hygienists and dentists. She can be contacted at [email protected].