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Evolving the dental hygienist

Feb. 1, 2011
One day while reading posts from, I came across two that made my mind whirl. One is a response about a resume.

What skills set you apart from other hygienists?

by Shirley Gutkowski, RDH, BSDH, FACE

One day while reading posts from, I came across two that made my mind whirl. One is a response about a resume. The advice seems good: write what sets you apart from the rest of the hygienists. The other post is about Sylc, the new prophy powder I started using a while ago. The hygienist is excited about the clinical results she is seeing from the use of NovaMin powder in her air polish unit. I am getting the same kind of exciting results, and I've been taking pictures. Could this be something that sets me apart from other hygienists, so I can find another job?

Revived, I click open the file that holds all 24 versions of my resume.

What sets me apart?
What else sets me apart from other hygienists?
I start to list my attributes:

  • Tired
  • Dehydrated
  • Work hard
  • Take X-rays
  • Review health history
  • Provide oral cancer screening
  • On time
  • Perio treatment
  • Patients request me
  • Good comments from patients
  • Expert stain and calculus removal
  • Periodontal treatment

I notice a pattern. The attributes resemble nearly every hygienist and procedure every hygienist knows. Many hygienists call themselves gentle, but they can't recommend dentistry ... which I know is a high priority for dentists. Lots of hygienists have patients following them from practice to practice, or who request them by name. That's all good. I've had conversations with other hygienists where I was the only one in a group who even knew about white spot treatments, Sylc, or the percent of periodontal treatment I provide. Patients ask for me too, and I get comments about being the best hygienist they've ever had all the time. That's no great talent. On the other hand, I've been evolving my entire career. Does using Sylc or knowing my production numbers really set me apart? I think it does!

I decide to go for it! I have a lot of case studies to show my enamel therapy expertise. I begin building a presentation portfolio, gathering case data I've saved over the years in my master portfolio, aka file drawer and external hard drive. The pictures are a little disappointing because they don't do justice to the quality of enamel change that is so evident after polishing with the right material.

Years ago, I opted for an air slurry polish for stain removal and sealant preps. Early on, the only product available for air polishing was sodium bicarbonate. When calcium carbonate powder came around, I switched. The calcium carbonate was better for the enamel and the pearls were more effective at removing stain. Calcium carbonate doesn't contain any sodium to worry about, plus the patients like the taste better.

Now I'm using a 100% NovaMin prophy powder called Sylc. I had to turn down the air pressure of my polishing unit, which helps decrease the amount of aerosol, which, of course, means less to clean up. The decrease in pressure makes the product a little less costly too, because it aerosolizes less and that translates to less product used.

After using Sylc in the office the first few times, I noticed the teeth look different; they have a different shine, and they feel slicker with the explorer. I instituted Sylc as a quick start for my white spot cases. The polish really seems to remineralize enamel. When the explorer slips over the enamel after the treatment, it makes me feel like I'm really helping my patient. The really amazing thing is that the teeth are slicker even before dismissing them.

I find a significant amount of supporting evidence for NovaMin at for home and professional use. A bibliography in the back of my portfolio makes it a little more scientific and comprehensive. A sheet that shows my evolution from one product to another and my reasoning for the change is also part of the portfolio (Tables 1 and 2).

Creating the portfolio

According to the book "The Purple Guide: Paper Persona (Exploring Transitions, LLC)," a dental hygiene portfolio is a document that collects and displays a clinician's accomplishments and growth as a person and in a profession. The portfolio includes the clinician's biodata – my resume – which acts as the first page. Information from self and others, such as photographs, letters, e-mails, or even audio recordings can be part of the portfolio. Short narratives give the reader an idea of my philosophy and proof of ability. I organize a few pictures to print out and write a short commentary. Then it all goes into a small, three-ring binder.

The Sylc cases in my master portfolio are awesome – better than I remember. My pictures show how Sylc can benefit enamel. One of the great features of NovaMin is its ability to raise the oral pH for hours after use. The higher pH creates an environment that is hostile to the perio and cariogenic pathogens, and NovaMin contains a sodium component that breaks apart bacterial cell walls without tasting salty or posing a sodium problem. A twofer!

My short commentary in the section on white spot reversals reads like this:

My quest to do more about people with poor enamel health motivated me to evaluate my patients' saliva. I began by purchasing litmus paper from the health food store and then conducted more comprehensive saliva testing. I noticed that people with a low pH had more cavities, as recognized by the studies, and I started to provide my patients with NovaMin products to take home.

Because I liked using the air polish in the office, I didn't use NovaMin polish until Sylc came around. Desensitizing teeth with Sylc works extremely well and saves me a step. Sylc works so well that I use it before instrumentation on my sensitive patients and the patients who arrive with a lot of biofilm on their teeth. In the past, I avoided polishing teeth with heavy accumulations before instrumentation because I didn't want to breakdown the enamel damaged by the low pH under the biofilm. NovaMin builds enamel – it doesn't break it down.

The issue of breathing in the aerosolized air polishing powder has been worrying me. I use a good mask to help protect me. The pressure of the polishing unit is decreased from 100 to 40 psi, which helps decrease the amount of overspray. The NovaMin powder particles are a little heavier than the other powders so it doesn't aerosolize as much. I'm using less product and have less aerosol.

Using Sylc and sending patients home with either a NovaMin or Recaldent paste for aftercare has made a difference in the way I practice dental hygiene. This has also become a practice builder. Patients often refer family members or colleagues so their teeth can be saved. I also have a 30% lower sealant redo rate than the other hygienists in the office since using the NovaMin in the air polisher.

NovaMin: likely clinical success. Adv Dent Res. 2009; 21(1):40-3.

Clinical evaluation of a dentifrice containing calcium sodium phosphosilicate (NovaMin) for the treatment of dentin hypersensitivity. Am J Dent. Aug. 2008; 21(4):210-4.

Calcium phosphate-based remineralization systems: scientific evidence Aust Dent J. Sept. 2008; 53(3):268-73.

Sending out resumes

I edited my resume down to one page, which really encourages me. Next I sent out five resumes, three in response to ads and two to offices where I really want to work. The resume I send out is also the first page of my portfolio. The "Paper Persona" book says it's OK to put a picture on the resume you bring to the office, but I'm not big on that. They can see me when I get there.

The trimmed down resume gets me three interviews. One of them was for an office that doesn't have an ad. The dentists are totally blown away with my organized approach to the interviewing process. I have to introduce the concept of the portfolio to the interviewing dentist because this is the first time someone has had a portfolio to show.

The pictures and statistics that I gathered and displayed had the dentists sitting on the edge of their seats (that's a good thing). One dentist thought he'd forgo the working interview because my talents were so evident in the portfolio. The dentists were also impressed with the way NovaMin and Sylc change the quality of enamel. My only disappointment is that I didn't get a job offer right away.

With the support from the hygienists, I did something really wild while waiting for an offer from my interviews. I repurposed the portfolio. Then I created a proposal, which is also recommended by "Paper Persona," to use for a discussion with the current practice manager. He's easily distracted or interrupted at the office so we made a lunch appointment for my day off and I paid. I showed him, in dollars and cents and pictures, how productive I am and how the office could be more productive with little upheaval. He hates change so I had to find a way to hit his "no change hot button." With my heart in my throat, I asked for a 15% raise in the middle of the year!

Looking at the naked numbers and pictures, the manager had no idea of the changes I was making in the lives of patients or how much more money could be made if the other hygienists practiced like me. The manager was so impressed that he offered me a part-time training position. Now I train the other hygienists in the multilocation practice, and my monthly goals are appropriately smaller. I get to track production to make sure we're not going backwards. Doing so gives me a break in my scheduled patient time and makes going to work fun again – a comfortable evolution.

Best of all, remaining with my employer has benefits. There are no new surroundings or people to get used to, and no three-month wait to get my health insurance reinstated.

Using my portfolio to show off the results I was getting with Sylc helped me make changes in my current position. I am very happy with myself for evolving and keeping records to prove it.

Author's note: The example presented in this article of career building through skill development stems from multiple success stories encountered by the author.

Shirley Gutkowski, RDH, BSDH, FACE, is technology director of CareerFusion and a practicing dental hygienist. She is author of "The Purple Guide: Confronting Caries," available at The author can be reached at [email protected].

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