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PDAs, laptops, cell phones, PCs, local networks, broad bands, digital this, and digital that — what is going on? Now all of this digitalizing is starting to creep into the dental hygiene operatory. What's worse is that we are expected to fall in love with this digital revolution — throw away our green pens and paper charts and convert to "soft" copy? We now type, click, drag, and delete.

Jan 1st, 2019

by Victoria DaCosta, RDH, BS

I have a confession. I actually do love using a computer. When computers became a part of dentistry, I couldn't wait to experiment and try new things. What I discovered was that my love for organizing my hygiene note-taking and creating systems became a natural transition into computerized dental hygiene. What exactly is computerized dentistry?

What are the pros and cons of having a computer in a hygiene operatory? Basically, what is the truth about our changing world of dental hygiene, and what is to be our technological future? Will this make our job easier, or will it cause us more stress? I would like to take a look at some of the features, advantages, and benefits of a computerized dental hygiene program.

I decided to consult with an industry expert who has his finger on the pulse on "what is really out there." His name is David Jacklin, and he is one of the best technical and support-training managers for dental personnel. He has worked with dental hygienists all over the country. I approached him to find out the real truth about what dental hygienists think nationwide and what will computers do for us.

DaCosta: David, what is your background in dental software implementation?

Jacklin: I have spent the last eight years developing a high-end training and implementation programs for Dentrix Dental Systems. I have trained and facilitated literally tens of thousands of training sessions for customers around the country, as well as lectured nationwide on the features, advantages, and benefits of computer technology in the dental office.

DaCosta: What are some of the features of a computerized program that a dental hygienist, in particular, would utilize?

Jacklin: Perio chart, voice activation, dictation, automatic calculations of bleeding scores and production, posting off of the schedule, look at a patient's chart at the same time from other rooms, updating the schedule from all over, intraoral camera, digital X-rays, reports, imaging, online ordering — you name it and the computer can do it.

DaCosta: I have had opportunity to attend your lectures, and I know the value of some of these features within my own practice. Of those features, which ones have been the most popular? And why?

Jacklin: Scheduling your own patients! Why? It gives the hygienist control over his or her schedule. I want to tell you a little story. I was asked to come into an office to consult and train the office. I got to the location the day before I was scheduled to start, so I decided to get a head start by visiting the office. As I walked in the front door, I heard two ladies yelling at each other. Later, I found out it was the office manager and the hygienist. The gist of this discussion was that the office manager had overscheduled the hygienist by 15 minutes, and she was not pleased.

The next day, I spoke with the doctor about what I had observed. We agreed that the hygienist should schedule her own appointments. You can imagine what the hygienist's first comments were — "I don't have time for that." I let her know what I observed. I showed her how easy it was to schedule on the computer.

By the time I left the office, she was scheduling her own appointments. Three months later, her comment was, "I wouldn't have it any other way." Once the learning curve was breached, she was able to easily schedule the appointments and take control of her schedule.

DaCosta: That is what I like — more control over my time! I have used voice-activated perio charting. Patients really like the "high tech" microphone usage. They feel like our office is on the cutting edge.

Jacklin: Yes, this is the best addition to practice management software for hygienists. With voice activation, you no longer need to search for a person to manually record the perio exam. Just speak to the computer and it will record in the computer system.

DaCosta: And I love the fact it calculates the patients' bleeding scores in an instant too! I use this score to keep track of patients' gum health. In fact, some of these scores become family competition between husband and wife, daughter and father. It's a lot of fun to watch.

Some dental supply companies are enabling local dental offices to order their products online. Is this something new to your company? And are most practices Internet connected?

Jacklin: I would say that only about 50 percent of the offices are connected to the Internet at this time, but that number is growing rapidly. As for ordering online, Henry Schein and, I imagine, other supply houses allow you to order your products online. It is very quick and simple.

DaCosta: I also like being online because it allows me to "google it," if a patient has a health care question. I can, in less than two minutes, search and print out an article for the patient sitting in the chair. My patients really are impressed!

Dental practice consultants are hired by the doctor to help build the dental hygiene department. What specific tools will a computer program do for a hygienist in building the dental hygiene department?

Jacklin: I have often heard of the hygiene department referred to as the "lifeblood of the dental practice," and I have to agree. Without the appointments generated by the hygiene department, the doctor's patients would eventually become few and far between.

The ability of the hygienist to see problems in the patient's mouth and quickly treatment-plan them on the computer screen prior to the doctor seeing the patient will improve communication between hygienist and doctor. It will also help the doctor focus their attention on the proper area during their examination.

DaCosta: So treatment planning on the computer is key in building production for the practice within the hygiene department?

Jacklin: Yes, the hygienist can be key to planting the seed of work that may need to be completed in the future. They can also help by mentioning that patient financing options, such as CareCredit, are available. That way, the patient can get started on the work immediately. This helps the doctor and financial coordinator while presenting the case to the patient, thus contributing to the overall success of the practice.

DaCosta: I also have noticed that when I post my dental hygiene procedures, I am able to capture procedure charges that may get overlooked if I hand write procedures on a chart. And that helps my bottom line of hygiene production. I like looking up in the corner of my scheduling screen to see what I have been producing for the day. Having this knowledge helps me feel valued as a producer in a dental office.

Jacklin: To feel even more valued, you can run specific dental hygiene reports for the month. This will help you really see what procedures you are completing during the time period.

DaCosta: What kind of reports would be of interest for the hygiene department?

Jacklin: Just as the doctor can run his or her practice reports to track missed appointments, a hygienist can quickly run reports of procedure codes of what has been produced or procedures completed.

And, just as a side note from my experience in working with outside consultants, a third of the dental office production should come from the dental hygiene department. With a computer — literally with a click — dental hygienists can find out if they are meeting their goals.

DaCosta: By the way, what if my operatory is very small without enough space for a computer. What have you seen other practices do to solve this problem?

Jacklin: You can mount monitors on swing arms that will attach to the wall, ceiling, or a pole on the dental chair. The swing arms are convenient to use. The swing motion will allow you to move the monitor in and out of the patient's view.

DaCosta: For a dental hygienist, time is of the essence. I know that when I started using a computer there was a learning curve involved, which did seem to slow me down a bit at first. But now I can honestly say I have decreased my stress and increased my time with my patients. What will lower this learning curve?

Jacklin: Training. As the training manager for Dentrix Dental Systems, I have seen so many offices try to learn the computer system on their own, and it becomes a very frustrating endeavor that usually ends with the system being discarded or used only for the basics. I would recommend that you get training in the office by someone certified to train on that particular software.

I would also recommend that you consider some follow-up training or coaching over the phone and supplement these training options with a computer-based training program, such as our Dentrix Professor. The learning process never ends. Also, make sure that your company is constantly giving you opportunities to continue your software education through beneficial training seminars.

DaCosta: What exactly is a local network?

Jacklin: Many of the software programs on the market today have a Patient Chart module that allows you to put all information that is typically placed in the paper chart on the computer. This includes the graphical tooth chart. As for simplifying note-taking, there is nothing more monotonous than writing the same thing over and over for the same procedures. Dentrix allows you to automatically assign a note to a completed procedure, which means you do not have to retype the note every time it is completed. You only need to make changes or additions.

This saves a tremendous amount of time, allowing you to focus on the care of your patient. Because it is located in one area, everyone in the office has access to your patient's chart information on local network. Thus, no more misplacing charts.

DaCosta: This will help with standardizing data input as well, and make communication so much easier!

Jacklin: Yes, and, as for communication, the networking capabilities of a computer system enhance the ease of communication. A message can easily be sent from one computer to the next, eliminating the need to take time to track someone down.

DaCosta: How will having features such as digital X-rays, intraoral cameras, and imaging software save me time and help aid in patient care?

Jacklin: Digital X-rays give you instantaneous X-rays with about a tenth of the radiation. No more developing X-rays. The digital X-rays can be attached to insurance claims electronically, eliminating the need to send them through the mail. Intraoral imaging and cosmetic imaging helps to treatment plan and increase patient acceptance of the prescribed treatment. This also improves patient education. It is also perceived as cutting edge. It can give the patient the idea that you are up-to-date on all materials and techniques.

Now, Victoria, if I remember correctly you are working on a piece of software that is specifically designed for the hygienist. This software goes beyond what current practice management software offers, right?

DaCosta: That's correct. My company, which is called GumAerobics, Inc., is currently in development of a specialty software for the dental hygienist. This software program is comprised in sections of Self, Office, and Patient. It will integrate with any dental program out there or be utilized as a stand-alone program.

The objective of the GumAerobics software is to integrate the medical and dental side of whole body care. With the discussion of the heart and gum disease connection, consumers are addressing more questions for treatment of gum disease in the early stage with nutritional guidance. Because of a dental hygienist's college education and training in nutritional health care, GumAerobics software gives the dental hygienist the tools and systems to utilizing his or her training. The software will prompt screening questions for medical and dental concerns.

It will also provide the much-needed business tools for a dental hygienist to organize his or her dental hygiene department. And my favorite section, Self, helps aid the wellness of the caregiver.

There has never been a better time in the dental industry for a practicing dental hygienist. The homogenizing of our dental hygiene profession nationwide with technology is already providing dental hygienists with the tools to create a less stressful environment. Aside from all the points we have discussed, one of the main reasons I have enjoyed my computer is the ability to be online and send and receive e-mails from my peers. I no longer have to practice alone. If I have a question or concern, I can turn to my computer as a source of information and network contacts.

Victoria DaCosta, RDH, BS, is founder and president of GumAerobics, Inc. A practicing dental hygienist for 17 years, DaCosta is a speaker, author, consultant, and an expert in the design of medical/dental software. She is also acting state public relations chair for the California Dental Hygienists' Association. DaCosta can be contacted at victoria@gumaero

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