Readers' Forum

Jan. 1, 2002
Treatment with heart

Dear RDH:
I could not have been more excited than when I received my license in the mail, saying congratulations, you are licensed to practice as a dental hygienist. All of my hard work had paid off. I was ready to find a position in an office that shared my same values, ethics, and quality of care. I am lucky to work for a dentist that truly respects my opinions along with my desire to provide the most complete care for my patients.

However, I've been very concerned with the quality of care I see provided by other hygienists. I'm not sure what happens when a hygienist goes into private practice, but they lose much of what they were taught in college. I know it is difficult to deal with the lack of patient compliance, but you still need to give the best care possible to all of your patients. Periodontal probing, oral cancer screenings, and home-care instruction all need to be done.

Instead, I hear lecturing and talking down to patients. It has been my experience that you get a lot more out of a person by treating them with respect. I still practice dental hygiene exactly the way I did in college — never taking short cuts. I have earned a great deal of respect from patients, peers, and co-workers. One of the greatest satisfactions I get from being a hygienist is when my patients hug me and thank me for taking great care of them.

The first few times I found a lump or cancerous lesion in patients I felt so bad for them. I sent them to their physician to have it checked. Some came out just fine; some did not. I have found several second-stage cancerous lesions and/or lumps on patients; one more stage reduces their life by 50 percent.

Recently, I found a lump in the neck of one of my male patients; I knew it was not good. It was thyroid cancer. They removed it, did radiation, and he is fine. He came into the office to tell me I was his angel for possibly saving his life.

These are the reasons why shortcuts should not happen when you practice dental hygiene. The hugs, the thank-yous, and the respect are all the satisfactions I need. Knowing I do the best job I can on each and every person I see in our practice makes me realize I was meant to be in this profession.

Dental hygienists, please find the way to practice the way you were taught, but add a lot of heart!

Dawn Nelson, RDH
Reno, Nevada

The old school

Dear RDH:
Wow! Another great issue. I've been reading your magazine for at least 13 years, and it just keeps getting better. The article, "To polish or not?" was especially informative and timely.

I currently work in a large office and practice assisted hygiene. The assistant polishes first (I love this!). The newest doctor on staff feels the assistant should polish after I scale so "we are sure to have smoothed up those roots." Apparently, after the hygienist has scaled, plaque that was trapped under the calculus still remains. What a hoot! Hygienists are working with many doctors who are trapped in the "old school mentality."

Thank you RDH for arming me with information to fight the outdated philosophies.

Anne Weierbach, RDH, BS
Pueblo, Colorado

A challenge from Dr. Neiburger

Dear RDH:
It is a normal reaction to take offense at someone who tells you that you can do an operation (which you have been doing for years) more efficiently — faster and better. This is the reaction I noticed in the November 2001 Readers' Forum regarding my letter (September 2001 RDH) on hygiene ergonomics and the 10-to-15 minute quality prophy. Most responses were emotional (for example "disrespect, shill, greed, ludicrous," etc.) as one would expect from a layperson and the ignorant.

No one asked, "How do I do this and still maintain quality?" No one requested, "Show me your research and references," as a scientifically trained professional would. No one mentioned his or her own research or references defending the lauded 45-minute prophy. This lack of professionalism and scientific methodology may explain why hygienists are so concerned about being respected as "real" professionals.

Ergonomics is the study of time and motion. It is accepted by the modern world as an important part of manufacturing, safety, and providing a service. A basic tenant of ergonomics is that you can always do things more efficiently, faster, and with a higher degree of quality. In the health-care professions, ergonomics also include better patient and worker comfort.

Workers (in this case, some hygienists) often reject ergonomics, dismissing it as a way that management gets more work out of the employee in a monkey-see-monkey-do-get-paid-peanuts type of mentality. They eventually realize it can make their lives easier, more profitable, and interesting.

The silliness and counterproductive comments expressed in many of the letters have no place in a professional team whose goal is to successfully serve the patient. I present to you a challenge:

  • If hygiene is truly an equal profession (as compared to dentistry, nursing, and medicine), present the controlled, unbiased scientific studies in peer-reviewed journals supporting the claim that a quality prophy cannot be done in 10 to 15 minutes. Please don't quote self-appointed gurus or your old, mentally constipated hygiene instructor's lecture in 1980. Look up the actual articles and read them. You will be surprised.
  • If you are bored with your work (scrape, scrape), poorly respected, and underpaid, consider the benefits and infinite challenges that ergonomics can offer you. You can get better and better with more speed, efficiency, and quality every day of your life. You will be able to see it and feel it. It's exciting.
  • If you think 45-minute prophys are better and kinder to your long-suffering, fearful patients ... ask them. They are the consumers. We just serve them. Ask if they would prefer a 10-minute prophy of equal quality as compared to what they are getting now. If they do, then learn how to do it.
  • If you are happy with the techniques you are now using, what you are doing now, and getting in return (include a sore back, carpal tunnel wrists, and a tiny retirement fund), don't change a thing. But quit complaining about being burned out, bored and unappreciated. The world is changing and, if you don't, it will pass you by. Remember that old fossils get buried.
  • If you want to learn more about doing prophys better and faster, check out the ergonomic literature. If you like, you can start with two books I wrote on the subject (The Dentists' Handbook, Speed Dentistry, Andent Publishing; www.andent. net). Keep an open mind; don't be lazy or negative; and experiment and expand the wonderful profession of dental hygiene. You, and your patients, may be pleasantly surprised.

E. J. Neiburger, DDS
Waukegan, Illinois

Editor's Note: In the event you missed it, Dr. Neiburger's original letter in the September 2001 issue generated many responses that were published in the November and December issues, or were posted online at Almost all of the letters that Dr. Neiburger refers to can be reviewed online at the RDH Web site.

To submit letters to the editor for publication in Readers' Forum, send by:

Mail —P.O. Box 3408, Tulsa, OK 74101
E-mail — [email protected]
Fax — (918) 831-9804
Signed letters must include the city and state where the reader resides or practices.