Letting go is hard to do

June 1, 2006
Those of us who have been parents have witnessed the agony of a child giving up some type of security item.

Those of us who have been parents have witnessed the agony of a child giving up some type of security item. Whether it is a bottle, blanket, toy, or favorite article of clothing, the child resists all attempts to look at the process reasonably. But eventually the child must face this challenge. After all, giving up a little security is part of the growing up routine.

This resistance to maturing is not limited to children. Recently, I had to give up a favorite pair of shoes. Granted, they were old, ugly, and worn out, but they were still comfortable. Perfect, except for that little issue of water coming in through the holes in the bottom. These shoes had been with me through parenthood trials of raising teenagers, the stress of selling a home, and the additional stress of purchasing one at the same time. The shoes had been there through divorce and moving on. They were my blanket. I am the first to admit these shoes were not fit for public display, yet they were always in my closet for that time when I just needed the familiar.

In a rare moment of insanity, I made a deal that would separate me and my shoes. I agreed that if a certain number of “listers” attended the 2nd Annual Napa Dental Experience, I would part with the shoes. My friends won, or I lost, depending on how you look at it. (In the eyes of my fashion-minded friends, we all won.) There is photographic proof of the beloved shoes being put in the trash can - proof I was not shown until the trash had been emptied for the day. I considered dumpster diving, but decided to take the mature route. I finally let go.

Old and comfortable ideas

It is time we hygienists let go of some old and comfortable ideas in our profession. We must let go of the idea that the dentist is responsible for our health and safety while working. As a profession, we need to fight to abolish the idea that we must be controlled by dentists at all. The time has come to move on from outdated language that holds us back. Dental hygienists do not “clean teeth,” and no patient should ever be scheduled for a “cleaning appointment.” Most importantly, we need to get over the notion that the bad legislation and restrictive practice acts are never coming to our state. We cannot get comfortable with the status quo.

Everyone is aware of OSHA and its rules that protect us as workers. Those rules and regulations need to be followed to protect employee and employer. Believe it or not, I have worked in offices where my OSHA training consisted of signing a few forms stating I had been “trained.” If presented with the same situation today, my response will not be merely to sign the papers. Education brings power to handle inappropriate requests with appropriate reaction.

It’s alarming how many offices do not have needlestick protocol in place. Even some offices that do have protocols have employers with no idea how to properly apply the protocol. I recently conducted a small poll and was surprised at the number of hygienists who have no clue regarding the protocol in their office. Your health is at stake! It is your responsibility to know the proper action to take if you experience an injury at work. Simply knowing you should “tell the boss” is not enough.

We also risk our health and career by going into work while ill. I have done it more times than I care to admit. The dentist becomes the scapegoat as we whine to our friends and colleagues that our boss will be upset if we call in sick. Another great excuse is that the person who fills our schedule will be annoyed at having to move patients. Yet these same individuals do not want us sharing our creeping crud with them. All too often, the “solution” is to wear a mask. Will that really make you feel better? Will wearing a mask, which you do all the time, ensure that you perform up to standards even while fighting an illness? One of the biggest questions should be whether or not showing up for work ill will endanger any of your patients. The only person to blame when that happens will be you.

While I was still in college, one fact about dental hygiene had me shaking my head in disbelief. I have never understood why the American Dental Association gives the accreditation to our school programs. In order to sit for an exam to practice dental hygiene, our education needs to be OK’d by the dental community. Does this not seem strange to anyone but me? In the ideal world, dental hygienists would decide what education is necessary to practice in our profession. I am waiting for that day to come, but I won’t hold my breath.

The words used to describe the treatment we provide can be an asset or a burden to our profession as a whole. It does not matter that the patient is familiar with the term “cleaning”; it is still wrong. During the course of providing treatment, teeth will indeed be cleaner, but that is not the sole purpose of a dental hygiene visit. If all of your tireless efforts have not succeeded in changing the words “cleaning appointment” when confirming appointments, you have a couple of choices. You can offer to confirm your own appointments, although this is not often possible in a busy practice. Some hygienists are willing to confirm on their own time, but unless you are paid on production this is not something I would suggest. The other choice is to make sure you stress appropriate wording to the patient while he/she is in your chair. Ensure for yourself that your patients know the meaning of periodontal treatment, periodontal maintenance, and preventive recall appointment. Of course, your choice of words may differ from mine, but I sincerely hope the script does not include cleaning.

I obtained my dental hygiene education at Idaho State University. During our senior year, we attended Restorative Clinic one day a week. It was not my favorite day of clinical practice, but I would not trade the experience. My fellow classmates and I became proficient at placing amalgam and composite restorations. We were even given the opportunity to expand our assisting skills every other week while the dentists did the preps. Having never been a dental assistant, those opportunities were not easy for me.

At the end of my senior year, a proposal was introduced to the dental board that would have allowed dental hygienists with the proper education to place anterior composites. Several influential dentists in our clinic witnessed firsthand our extraordinary skills. Every student was confident the proposal would pass. This was my first lesson in getting involved. We didn’t attend any board meetings; we were too busy working toward graduation. Letters from students were not written in support of the proposal because we were just too busy. The proposal did not pass, in part because we were not involved. Being the ones who were placing restorations at the time, we should have been more vocal.

When my move to California became a reality, I was excited that I would be practicing in a progressive, cutting-edge state. It seemed logical that California would be less restrictive to dental hygienists. Shortly after passing the clinical board and settling in a California office, Idaho came up with the idea that hygienists could practice completely under general supervision. And the residents passed it into law. The place I left because of its “backward ways” is now steps ahead of my new home in freedom to practice the science and art of dental hygiene.

The concept of a scaling assistant had never entered my mind as a real threat, especially at this time when allowable hygiene duties go unchanged, even for alternative practice dental hygienists in California. It appears that some dentists believe an assistant with chairside training can provide recall perio treatment, but a fully educated and trained RDHAP cannot provide that same service without permission from that same trusting dentist. If this threat has not yet reached your state, you’d better act now to make sure it never does. To quote a colleague of mine, “It’s not just Florida anymore.”

Letting go is not easy. But it is essential to the growth of our profession. It is time to realize that words do matter and that we are the ones responsible for our well-being. Let go of the idea that it can’t happen to you or your office. Step to the edge of your circle of comfort and make a difference, if not for our generation of practitioners, then for the next.

For this column I let go of my notion that coherent ideas only come when I write at my desk with a Starbucks hot chocolate (extra hot) and a glass of ice within reach. Today I am at my laptop in the beautiful Sierra Mountains attempting to choke down a lukewarm, watery cocoa with no ice in sight. Boreal just may be my new muse - at least as long as the snowboard season lasts.