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Readers' Forum

Nov. 1, 2003
I am writing in reference to the article, "Rolling with the Punches" ("New Heights" column, September 2003). I spoke with you previously concerning my personal disgust with that article...

Serve those in need with compassion

Dear RDH:
I am writing in reference to the article, "Rolling with the Punches" ("New Heights" column, September 2003). I spoke with you previously concerning my personal disgust with that article and hope there are other dental hygienists who are not as idealistic and superior as to refer to this large growing percentage of the population as this author did.

I am a dental hygienist of 30 years, a graduate of Loyola University in New Orleans and now a naturopathic physician/doctor of natural medicine. My training at Loyola provided a sound commitment to working with people without regard to their financial circumstances. The training included walking the streets of New Orleans, searching for people who would be gracious enough for us to "practice" our skills on them. These people were more than thankful we cared enough to ask them. We provided a positive community service. As a student in a Jesuit college, I learned how to stress compassion for all people, their souls, and their location on the path in life.

To the writer of the article — who made references about the "Medicaid" practices and "baby factory" as issues for her — I would like to thank her for not working in these practices. Throughout my career of three decades in medical and dental settings, my hands, my heart, and my compassion help these people with their current health issues, provide insight for support, and listen to a soul as they share. Never, ever did I regard people to follow an ideal of perfection that "I" set up or something I deemed "should" be the way of life.

There are several aspects to be considered:

• Respect for all people wherever they are in life. You are not here to judge them or their circumstances. Many hygienists or dental assistants may also be a paycheck away from assistance, or currently on "system" benefits. Do you know their circumstances? How do you treat them? Are they taking advantage of the system?

• Provide compassion, listen to them, support them, and lend information that may assist them in finding or shifting life's choices. Look at your self-portrayal image: Where are you in the ladder of life, and does that really work for you?

• Stop putting a label on the Medicaid population or the offices that service them. You need to review just what constitutes a person on Medicaid, low-income families, Healthy Kids programs, homeless families, and requirements to get any medical or dental help of any kind.

• Praise the offices that are helping these patients. They are not making millions by offering these services, but they are fulfilling a community need.

Maybe if hygienists took five hours per month and volunteered to work for these offices, the overhead of the office, the supply and demand ratio, the performance and morale of the office staff and the quality of care would raise to unheard of heights. By the way, are you sure the offices you recommend for quality dental or medical care do not help this population? How would that serve your ideals of what the practices should provide? Or the quality of care you hold as ideal?

I have been in all types of practices, ranging from the million dollar profits to community based care. I also used my corporate dental skills to work for Dental Network of America, a national provider relations company, and Three River Health Plans in Pennsylvania, as provider relations for the Medicaid population. I went to hundreds of dental offices in the eastern part of the state, both rural and urban, to credential dentists and their offices to provide care for the lower income and Medicaid participants.

I did OSHA inspections, quality of care, performance reviews and licensing requirement inspections. Many offices initially would refuse to accept the overwhelming population in their community; however, through community support and my encouragement, I did sign on several dentists who agreed to accept a limited number of new patients per month, therefore sharing the load amongst several practitioners. Limits were arranged for the offices in number of patients — also for helping people within a designated number of miles in the office radius. When approached correctly and compassionately, some dental practices are very open to the opportunity, and they see the benefits of helping others.

If you feel you cannot offer these attributes, please do not service these people.

• Remove yourself from offices that do.
• Do not blame burnout as a reason to leave.
• Look at what your place is in society. How you can give help to those in need?
• Look around you and in the offices you go to for health care — do you really know how they pay?
• Praise the offices that do provide these services, and report others to the Medicaid offices if they provide substandard quality of care. No one deserves to be hurt by human hands, no matter how much the patient can afford.

How can I say all these things and yet be reputable in saying them? I have been there in all aspects. I have been a mother of four children, a previous Medicaid recipient after a divorce. I have been a Healthy Children recipient while being a single parent and working full time at a dental practice in Pennsylvania, and as a medical student for six years with four minor children.

My ideal is to work with people and enrich their lives with compassion and insight. Can we all attest to doing that to our fullest?

Dr. Jeanette Gallagher, NMD
Scottsdale, Arizona

A testimonial for acupuncture

Dear RDH:
I read with interest the August article on acupuncture by Pamela Newhouse, RDH. In February 2002, I ate a piece of fish in the Caribbean which was affected with the neurotoxin, Ciguatera. This toxin causes misfiring of nerves, which then violently contract muscles (involuntarily), as well as temporary numbness and nervous dysfunction.

Luckily, it did not invade my heart or breathing muscles. The damage to peripheral nerves is long-lasting and left me with, among other things, weakened and painful leg muscles. Even 18 months later, my walking and standing abilities were quite restricted. There is very little treatment.

A patient suggested I see his Chinese acupuncturist/ herbalist and my doctor agreed.

The difference has been miraculous! I feel whole again, and can walk and stand normally. I have been seeing Dr. Cathay Fung weekly, and more recently, bi-weekly, for six months. The pain in my calves is completely gone, no matter how long I stand. She is still working to rid me of my burning, tingling toes. But they used to burn constantly and now it is only two to three times a day. Progress is being made!

This age-old treatment is like anything else. It takes the hands of a caring, competent, and skilled person to produce the best benefits. But I highly recommend it ... the results can be tremendous.

Amy Brown, RDH
Leawood, Kansas

Alabama visitors to UOR

Dear RDH:
I would like to thank you for the wonderful experience of attending the RDH Under One Roof conference in Chicago. My co-worker and I were a little apprehensive, since we are from the great state of Alabama. We were surprised that no one asked about our level of education or treated us like second class citizens.

Instead, what we found were informative classes, an action-packed conference, and many friendly faces. I was also excited to see one of my former hygiene professors as a speaker. I received a bachelor's degree from the University of Alabama at Birmingham School of Dentistry.

My fellow hygienist completed the preceptorship program. We work in a periodontal practice where we are both continually learning from experiences, patients, the doctor, and each other.

I could launch into all of my complaints about being a hygienist with a degree in Alabama, but you've heard it all before. You also cannot possibly understand the conflicting feelings of someone in that situation until you have been there. I have my negative opinions about the preceptorship program. But I also have many close friends and associates who have been through that program and are excellent and dedicated hygienists.

All of this to say we thoroughly enjoyed the conference, the city of Chicago, and especially all of "ya'll" wonderful people we had the opportunity to meet. Looking forward to the next one.

Beverly Sherer, RDH
Birmingham, Alabama

Kudos to South Carolina hosts

Dear RDH:
Recently, I traveled from another state from where I have practiced for 31 years to attend the South Carolina Dental Hygiene Association's symposium. This year, it was held at Hilton Head Island. After attending the two-day meeting,

I just felt so compelled to tell your readers what a wonderful group of dedicated professionals are in the SCDHA. The warm hospitality and kindness shown from this group could have not go unnoticed. This was not only an educational experience for me, but it was uplifting as well.

Thank you, SCDHA. It just reaffirms in my mind why I chose dental hygiene as a career.

Margie Bence, RDH
Lakeland, Florida

Understands math phobia

Dear RDH:
I recently read the Guest Commentary in June 2003 RDH, "Why I became a hygEEnist" by Kirsten Brancheau, RDH.

It really made my day!

Actually, I had a similar reason for becoming a hygienist. I didn't want to sit in an office in front of a typewriter all day (this was before PCs were around) and hated math as well! If I could take a program that didn't involve math, I was very happy.

And I have informally polled a few other hygienists; we all seem to be math phobics!

Anyone else found this as well? And, like Kirsten, I have practiced for 25 years and, despite the "math phobia," have been blessed with what dental hygiene has given me — the friends, patients, and opportunities that I would never have gained had I not become a hygienist.

Ann-Marie DePalma, RDH, BS
Stoneham, Massachusetts

To submit letters to the editor for publication in Readers' Forum, send by:

• Mail — P.O. Box 3408, Tulsa, OK 74101
• E-mail — [email protected]
• Fax — (918) 831-9804
Besides a "signature," letters also must indicate the city and state where the writer resides or practices.

About the cover
Click here to enlarge image

The presses work just fine, and there's a plentiful supply of color ink at the printer. It's just that Tenille Watts and her photographer, Karen Goforth, expressed a desire to experiment with black-and-white photography for the cover. So we said OK, but we advised them to shoot a roll of color film — just in case.

Guess what? We liked the black-and-white photos too. So RDH this month features a rare black-and-white cover.

And the photographs on this page are also intentionally black-and-white — but with the model's own camera.

"I love to take pictures of my family.My mom and I take black-and-white pictures of my babiesevery year at the beach.My grandmother, who I am very close to, makes white, simple outfits for them, and I have a white dress that I wear to make anice contrast in the pictures.

"One of the pictures is in the second stages of a photography contest right now!"

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Watts hails from China Grove, N.C. She works three days a week, spending the balance of her time with her children, Vada and Pacey.

She graduated with her dental hygiene degree in 2001. "Although not my first career choice, I could not be more pleased with anything other than dental hygiene.I was influenced to go into dental hygiene by my husband's family whoare also in dentistry. His father owns a dental lab, where my husband is a lab tech, and his mother is the office manager at a dental office."

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She adds, "Fresh out of school, I've quickly learned that although the patient's 'report' is important, 'rapport' with the patient is an even more important part of the visit.

"As opposed to focusing completely on the purpose of the dental visit, rapport establishes a sense of trust and agreement between my patients and myself. As a people person, the most thrilling part of my career is meeting and learning new things about each patient. Not only do I learn things from their stories and advice, but also a sharing process occurs that creates a sense of mutual esteem. I value making each person feel comfortable and respected."

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Besides her hobby of photography, she enjoys singing, reading, and vacationing in her spare time. Watts said, "I love music of all sorts, but I'm the biggest fan of Christian contemporary with artists such as Rachel Lampa, Avalon, etc. I sing with our youth praise team at church and at many, many weddings."

Update on Infection Control column

To the editor:

I am contacting you concerning the article I wrote, "The Flu Season," that appeared in the October 2003 issue of RDH. It mentioned that on June 17, 2003, the FDA had approved an intranasal, trivalent, cold-adapted, live, attenuated influenza vaccine called FluMist.

However, on September 25, 2003 the CDC released an important document (Using, Live, Attenuated Influenza Vaccine for Prevention and Control of Influenza. MMWR 52 (RR-13):1-8, 2003 -

Specifically, they stated: "Close contacts of persons at high risk for complications from influenza should receive influenza vaccine to reduce transmission of wild-type influenza viruses to persons at high risk. No data are available assessing the risk for transmission of LAIV (live attenuated influenza vaccine) from vaccine recipients to immunosuppressed contacts. In the absence of such data, use of inactivated influenza vaccine is preferred for vaccinating household members, health-care workers, and others who have close contact with immunosuppressed persons because of the theoretical risk that a live, attenuated vaccine virus could be transmitted to the immunosuppressed person and cause disease. Otherwise, no preference is given to either inactivated influenza vaccine or LAIV for vaccination of healthy persons aged 5–49 years in close contact with all other groups at high risk."

Until data exist that better describe the true level of risk associated with immunization by nasal spraying, health-care workers should be immunized only through the traditional injection of an inactivated influenza vaccine.

The timing of the CDC release, unfortunately, precluded a change in the article. I regret if this has caused any confusion among your readership.

— Charles John Palenik,
author of Infection Control column