Dear RDH:
I just had to respond to Dr. Neiburger`s letter regarding dental hygiene and economics. I have not read anything recently that sounded so absurd and bashed hygienists so much!
Just as anyone can be taught to scrape teeth, anyone can be taught to drill a hole in a tooth. But dental hygiene and dentistry are so much more than that, and I am afraid Dr. Neiburger is missing the picture!
Economics is a big issue in any business. In the dental field, a hygienist is well aware of what the office production is, what he or she produces, etc. They also know that the most production comes out of the dentist`s chair. The majority of patients do not just come in off the street requesting bleaching, crowns, full-mouth reconstruction, etc. They come in for an immediate concern, such as a toothache, and want it fixed as cheaply as possible. This is not good business economics to rely on patients like this to generate income. This is where "quality" dental hygiene comes into the picture.
There is no way a hygienist can perform quality hygiene (including X-rays, period charting, education, etc.) in a "prophy-mill" office. Where is the time found talking with patients, not only about their dental health, but also about themselves? A golden opportunity is being missed here - in learning about patients` lives, we can better help them with their dental decisions.
The hygiene department is the place to plant "seeds" with the patient, such as cosmetic dentistry, full-mouth reconstruction, orthodontics, etc. The seeds are cultivated at recall appointments and the majority eventually make it to the dentist`s chair. It is much more rewarding to have the doctor complete a $15,000 case than to burn out because of just doing "patch" amalgams all day. And why would just amalgams be done all day? Because no time was spent educating the patient about a crown, bridge, etc. The hygiene chair is the perfect place to do this. We have 45 minutes to an hour just one-on-one with the patient. We can make it a rewarding experience for the patient, the office, and ourselves.
In the office where I`m employed, there are two other hygienists besides myself. We have control over the hygiene department and our employer is very generous in getting us the things we need to make it run smoothly, such as an intraoral camera, mouth models, current brochures and pamphlets, and continuing education. With this, though, comes the expectation that we work hard and instruct the patients, not just "scrape" teeth. Dr. Neiburger, I think you make a big assumption saying that most patients and dentists won`t recognize the difference. We have had quite a few patients that leave the office and come back within six months to one year because they have been to the "prophy mills" and "generic" dentistry. Quality is a big concern to our patients, and they won`t get that with a $10 an hour para-hygienist.
If Dr. Neiburger can train someone to work for $10 an hour - not only to clean teeth, but to provide periodontal therapy as well as full knowledge of the dental field in regards to restorative work - then more power to him! But remember, you get what you pay for!
Heather Phillips, RDH
Wausau, Wisconsin
