The Impossible Dream

Nov. 1, 2001
Perfection: an impossible goal. Excellence: an attainable goal. Striving for excellence is a joy, compatible with all that we believe about dental hygiene.

Perfection: an impossible goal. Excellence: an attainable goal. Striving for excellence is a joy, compatible with all that we believe about dental hygiene.

What makes a perfect hygienist? A perfect appointment? A perfect employer? A perfect patient? A perfect co-worker? Everyone has his or her own answer to these questions. Fortunately, we are allowed the luxury of creating a perfect world in our dreams, but our lives are grounded in the real world. We must learn to function in the real world of idiosyncrasies, unexpected events, and inconsistencies.

Years ago, my dental hygiene instructors drummed certain things into my head that they knew would make me a "perfect hygienist." When we graduated, we thought that's what we had to be. While I am sure that was a laudable goal, did we really know what that meant? All I really knew was that no one wanted a hygienist who would not strive for perfection. No one wanted a hygienist — or any other health care provider for that matter — who was willing to operate at less than their best. But suddenly, there we were — new, imperfect, dental hygienists — thrust into the real world. Whammo! The perfectionists encounter reality! I doubt new graduates feel any differently today than my classmates and I felt 30 years ago.

In 1971, the "perfect hygienist" scaled and polished by hand to remove all supragingival deposits and stain. We made attempts to scale subgingivally. We scaled as well as the instruments and time would permit. No one had yet invented dental hygiene periodontal therapy. Many patients bled at every six-month visit. Most had only bite wing X-rays year after year. We recommended floss, irrigators, electric brushes, and a myriad of other devices — anything that we thought would slow down the disease process. We were the prevention specialists, and most of us stood by helplessly as patients' gums kept bleeding and their teeth gradually became more mobile.

During the 1980s, research began to indicate that periodontal disease was really a group of closely related diseases classified by specific bacteria. More recent research has shown that an individual's specific host resistance also modifies periodontal disease development.

Now imagine this situation: You are a hygienist practicing today, but you went to school in 1971. What if your ideas of practicing hygiene are based on what you learned three decades ago? You would no longer be the perfect hygienist. You would be practicing well below the standard of care. Over time, research and knowledge have changed these standards.

How about some other snags in your quest for perfection? Try these:

  • Are you in total control of every aspect of your dental hygiene appointment?
  • Are you free to suggest the ideal dental hygiene treatment plan?
  • Do you have the exact equipment you need to perform optimal dental hygiene?
  • Are you given an unlimited amount of time for all of your procedures?
  • Can you recommend the treatment regimen or products you feel are best for the patient in your chair?

Surely some of you are really annoyed with this line of questioning, but don't shoot the messenger. I am one of you!

The definition of the perfect hygienist has not really changed through the years, but our understanding of the disease process is certainly more profound than it was 30 years ago. In those days, everything was a "prophy." We all knew the truth. All prophys were not equal, but we still struggled to be the perfect hygienist.

Now we know the real truth. It is not possible to be perfect, but with all of our fabulous diagnostic and clinical tools we can help our patients more than ever. Whether you use the newest of today's hand instruments or the latest in advanced power-driven scalers, it is possible to provide a higher quality appointment.

Perfection is impossible. It has many meanings. It changes over time. Striving for perfection takes up an exhausting amount of time, with very few positive outcomes. So what should we strive for? Can you live with excellence rather than perfection? Excellence means that we provide the best possible patient care given our circumstances. Some hygienists should ask for better equipment, others will have to purchase their own, and others need to seek a new employment setting in an effort to improve their circumstances.

Striving for excellence is a joy, compatible with all that we believe about dental hygiene. The secret to excellence is continuing your dental hygiene education as well as your personal education. Continuing education courses are the obvious way to keep up, but how about some less traditional approaches to continuing your education? Have you considered taking time to read a journal or getting a few hygiene friends together to discuss patient cases? How about joining your local hygiene association and getting to know others in your area? It is amazing that most hygienists struggle with this "perfection thing" and feel that they're deficient when they fall short of their unattainable goals.

Each one of you will have to assess your situation and make your own set of decisions, but I assure you that trying to be perfect is an impossible burden. You will waste loads of time and never achieve it. You will exhaust yourself and wonder why you can never feel the professional satisfaction that you're longing to achieve.

Dental hygiene excellence: an attainable goal. I invite all of you to join me in practicing dental hygiene excellence in the comfort zone.

Anne Nugent Guignon, RDH, MPH, practices clinical dental hygiene in Houston, Texas. She writes, speaks, and presents continuing- education courses on ergonomics and advanced ultrasonic instrumentation through her company, ErgoSonics ( She can be reached by phone at (713) 974-4540 or by e-mail at [email protected]