Readers' Forum

Fighting supervision restrictions

Dear RDH:
I want to commend RDH for publishing the article in the June issue titled, "House Calls in Oregon." Kelli Swanson Jaecks, RDH, BSDH, gives the rest of us hope for the future, especially those of us who practice in very restrictive states such as North Carolina. Her article detailed the "Limited Access Permit" and providing dental hygiene services to underserved populations that desperately need preventive care. Obviously, her state dental hygiene association worked hard to get legislation that allows hygienists to work in this fashion.

Dental hygienists like Kelli clearly show that we can be part of the answer to the access to care problem that exists. In many states, restrictive supervision laws prohibit dental hygienists from using their skills to help people. It is a sad state of affairs when I, as a veteran dental hygienist, cannot go into a nursing home and clean my own grandmother's teeth, because it's illegal in North Carolina for me to work in any capacity except under direct supervision of a dentist.

We desperately need hygienists in nursing homes! You know what I think? I think legislators get old too and just may need to go to a nursing home at some point. Do you think they might appreciate having help from a qualified individual with their preventive care? Think about it.

Kelli's bio states that she is a member of ADHA and is active in her state and local component. If more hygienists would support their profession by joining ADHA, change would not be so difficult. In North Carolina, there are 4,700 registered hygienists, but only about 600 are members of ADHA. The dental society throws that in our faces when we ask for expanding the scope of practice. They say that we don't speak for the majority of hygienists in North Carolina. Low membership in the professional association is a problem in almost every state.

Kelli, we're proud of you! We need a lot more like you to advance this profession!

To the rest of you I say, quit being a part of the negative stats (those who are not members) and do something positive for you and your profession by joining ADHA. You will make a difference!
Dianne Glasscoe, RDH, BS
President, NCDHA 2003-2004
Lexington, North Carolina

An educator's view of magnification

Dear RDH:
I am writing in response to an article published in the May 2004 issue of RDH, titled "Zooming: Closing the Information Gap on Magnification," and written by Anne Nugent Guignon, RDH. While the focus of the article was on the benefits of magnification in the clinical practice of dental hygiene, I was disturbed by a few of the remarks made, as well as the tone of the article in reference to dental hygiene educators' perceived opinion of magnification use. In particular, I was concerned with the account of an adjunct faculty member's attempt to incorporate the use of magnification in the evaluation of student performance upon returning to her position following summer break during which time she had been introduced to the technology.

According to the article, the adjunct faculty member was given an ultimatum by the program's director to either discontinue the use of magnification or vacate her position. The reason cited was that magnification gave her an advantage over other faculty members in the student evaluation process. As a dental hygiene adjunct faculty member with 10 years experience, I feel it is imperative that this issue be addressed from a different perspective.

From the information given, I assume that the use of magnification in the grading process had not been integrated into the program's policy and procedures. With that in mind, it appears to be an issue of creating a situation of unfair grading practices as it relates to the students, as well as a disruption in faculty calibration. Fairness in student performance evaluation and calibration of faculty are essential responsibilities of dental hygiene program directors/department chairs. Therefore, it is inappropriate for a faculty member to arbitrarily change the process by incorporating technologies that place students at a disadvantage. Further, it needs to be understood that while the use of magnification may not have been a feasible option during the grading process, its introduction and demonstration to students may have been acceptable. It was the responsibility of the adjunct faculty to know the policies and procedures and act accordingly.

Another issue that often dictates the introduction of new technologies in educational settings is cost. As state budgets have been trimmed over the last few years, a greater burden of the clinical operating expenses has been placed on students. An additional large expenditure, such as magnification, may not be feasible for the students or for the strapped budget of the institution.

It has been my experience that while a number of technologies, inclusive of magnification, available for enhancing the practice of dental hygiene cannot feasibly be integrated into our educational programs for use, faculty are encouraged to introduce them to students. This occurs routinely in clinical and didactic courses, as well as through extracurricular learning opportunities. The value of instructing students regarding available technologies is important to the extent that students are then able to assess the technology and add it to their practical armamentarium in the future.

Adjunct faculty with multiple years experience in the private sector and limited experience in the academic environment must appreciate that while the incorporation of various technologies may be more immediate in private practice, for valid reasons, it may come more slowly in educational settings. In closing, I would recommend that dental hygiene professionals moving from private practice into education objectively evaluate their commitment, patience, and savvy in becoming effective advocates for change over time.
Barbara Wilkerson, RDH, BS
Jamestown, North Carolina

Voice-activated systems

Dear RDH:
I have ben utilizing a computer in my operatory for the past five years. It has proven to be efficient and provide a more professional atmosphere in my workplace.

In addition to the benefits as described in the June 2004 issue (Hy-Tech column), I am also able to type a letter from my own

operatory to a referring dentist or even send correspondence electronically without having to hover over the printer, lick an envelope, and locate postage. The savvy hygienist can also bill an insurance company from her operatory to reduce the amount of manpower needed at the front desk.

My biggest disappointment with my current dental softwear concerns the voice-activated periodontal charting system that is

provided by the software company. The voice activation program is a glorified Microsoft Word that takes longer than having an assistant provide note taking for me. The previous system that I used was created by Innova Dental, but unfortunately our office upgraded the dental software in the office and I lost my ability to avoid the need for an auxiliary for periodontal charting. Our current dental softwear company offered to refund our money to us because I was able to clearly and professionally point out its untruthful claims and flaws.

Please have your readers be aware that many of the voice activated programs are indeed not as time saving as the dental software company claims. It is frustrating to be told by a software designer at a dental software company that revisions to their software are made once a year at most and the software designer has never had to take actual periodontal measurements.

On a more positive note, software systems reduce the need for excessive manpower in the office and allow the hygienist to function as a more valuable employee.
Beth A. Kageyama, RDH
Sylmar, California

It's not that we expect dental hygienists to collectively follow the standings in the 2004 ESPN Redfish Cup. But if they did, they would have kept tabs on one of their own — Kim Krieger, RDH. During the spring and summer months, Krieger was all over the Gulf Coast, participating in four Cup tournaments (and, hopefully, a fifth — the championship) as a "redfish sleuth."

After one tournament near Kemah, Texas, she was the top female angler, she told RDH, "He (fishing partner and boat captain, Captain Don Mull) put me in a beanbag chair wearing a baseball helmet in four-foot seas, running 74 miles one-way to catch our two winning fish." Her anecdote reminded us that we're not talking about goldfish in a wading pool. The other tournaments were in Port Aransas, Texas, Punta Gorda, Fla., and Chalmette, La. Punta Gorda is also the home base for Krieger and Mull.

A 1972 graduate from Ferris State University in Big Rapids, Mich., Krieger has resided in Punta Gorda for 18 years. But it wasn't until 2003 that she caught her first redfish, a mere two weeks before her first tournament.

"I love the sun, water, and beaches of southwest Florida." she said. "I work with the Charlotte Dental Associates. I am still passionate about my profession, active at state and local levels."

While volunteering at a rural clinic in Florida, she met Mull. "He basically said, 'Get in the boat; life has a lot more to offer.' I'm learning to enjoy the benefits of more than 30 years of dedication to my profession through the art of fishing."

"It really is because of Captain Don Mull that I have discovered that there is life beyond Gracey and patients. He showed me how to relax, and enjoy the beautiful local waters, a nice change of pace from the hustle of a dental office."