Dare to be a prophy pioneer

Take prophylaxis. Please. Here`s a bread-and-butter procedure in most offices that has to be done day in and day out by either the dentist or hygienist. Operators who have performed a prophylaxis five or ten thousand times have equated the task with doing the dishes. It has the same level of excitement and challenge, the only difference being that the results last for six months instead of overnight.

Robert E. Horseman, DDS

Take prophylaxis. Please. Here`s a bread-and-butter procedure in most offices that has to be done day in and day out by either the dentist or hygienist. Operators who have performed a prophylaxis five or ten thousand times have equated the task with doing the dishes. It has the same level of excitement and challenge, the only difference being that the results last for six months instead of overnight.

The dentist who does his or her own prophys is relatively lucky. There are other procedures coming along each day to provide variety. The hygienist, bless her heart, faces a day, a week, a lifetime of prophys.

The director of dental hygiene, addressing the freshman class, exults, "In two years, students, you will be scaling and polishing teeth for a living. In addition to educating patients about oral hygiene, you will be releasing the dentist, who thinks he`s God, and therefore above such work, to perform those tasks that only he, with his inflated self-esteem, can do. A noble pursuit, indeed!"

Thus fired up to an almost religious fervor, the newly minted hygienist goes forth to rack up her first million prophys, only to fall victim to mind-numbing boredom before she`s finished the first 300,000.

In my office, I do all my own prophys. It`s not that I`m too cheap to hire a hygienist (at least not entirely). It`s because I have discovered a new way to convert prophylaxis into a challenging and rewarding experience. I`d like to pass it along to other dental workers who may be asking themselves, "Is that, like - you know - all there is?"

I had no sooner finished my 30th year in practice when I began to notice a certain ennui falling over me when I was in the midst of polishing a mouthful of teeth. Initially, I dismissed the feeling as transient anoxia resulting from my customary lunch of cheeseburger, fries, and iced tea. Or perhaps it was the too-tight underwear, the sequela to that cuisine. On the occasion, however, when I actually drifted off over a patient, prophy angle slipping from my inert fingers, prophy cup dangling from my thumb, I knew I had to seek an answer before I fatally impaled myself on a scaler.

What I came up with is so revolutionary, so innovative, I`m surprised someone hasn`t thought of it before. I`ve already begun to practice my acceptance speech for the NuPro Dentist of the Year Award. Here, then, in all modesty, is my breakthrough idea:

Instead of starting with the lingual of the lower anteriors, then doing the lower left quadrant as had been my custom, followed by the lower right and the identical pattern for the upper arch, then segueing into the polishing and flossing in a similar sequence, I recklessly dared to pioneer. Throwing caution to the wind, I started with the upper right quadrant, skipped to the lower left, did a couple of teeth in front, one upper and one lower, flossed a bit, and finally finished up with some random pocket probing and a couple of bitewings.

It wasn`t easy - pioneering seldom is. It took me an hour and a half because I kept losing my place. The effort caused me to break into a cold sweat, saturating a box of 4x4 wipes that my concerned assistant kept applying to my forelock. Midway through, I was ready to call it quits. Only the determination to break the strangle hold that prophy burnout had on me kept me going.

Oh, the euphoria when I finished! My patient, sensing that history-in-the making was occurring, embraced me warmly. The entire staff gathered around, shouting huzzahs and waving multicolored bibs. They hoisted me on their tiny shoulders and off we staggered to the reception room for Dr Pepper and Twinkies. It was a moment I shall long treasure. With a hint of tears misting my eyes, I vowed to try all 38,637 permutations and combinations open to me doing prophys during the rest of my career.

Let this be your credo, then, if you suspect you?ve arrived at a plateau: Strike out boldly where no man or woman has gone before. Dare to alter your established routine. Or, if this sounds like too much of a bother, hire somebody to do it for you.

Robert E. Horseman, DDS, is a general practitioner in Whittier, Calif. He is a frequent contributor to the Journal of the California Dental Association.

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