by Lory Laughter
Success in career, just as in life, is about answers. Failure is not always the result of making bad decisions. Success follows naturally when we ask questions and seek appropriate answers. Failure, on the other hand, can simply be due to the lack of query.
When looking for my own answers, I often turn to mentors. I receive answers from them in one of three ways: 1) my mentor simply tells me what action to take, 2) my mentor shows me options and gives advice on what action to take, or 3) my mentor pushes me to find my own answer, usually by asking me questions about my desired outcome. The first two styles of mentoring are easy and often exactly what I seek. However, the third method forces me to think and in the end results in greater satisfaction.
During my hyperactive preteen years, my mother often used a code phrase to suggest inappropriate behavior. Instead of raising her voice or embarrassing me in public, she would simply ask, “Is that really necessary?” If I was being extra obnoxious, the wording would change slightly to “Is that ENTIRELY necessary?” Being a child and extremely shy, it never crossed my mind to actually evaluate the situation and come up with an answer. I merely moved on to something else. As an adult, this phrase has become my measuring stick when considering actions to take or situations to leave alone.
In our busy lives, it is not always possible to spend time weighing the pros and cons. Not every decision requires the deep consideration of possible positive outcomes vs. probable negative results. We live in a fast-paced society where quick responses are often the only response that will be heard or valued. We think on our feet - and occasionally on the run. Consider how much easier tasks might become if the deciding factor were in “Is it necessary?”
I dare suggest that there is not a situation, crisis, or ethical dilemma in our profession that cannot be settled by deciding what is necessary. If you and a co-worker cannot agree on a particular sequence for delivering nonsurgical treatment, ask yourself if agreement is even necessary. Do you have to agree on the best brand of powered toothbrush or which oral care products to recommend for malodor to be effective co-workers? It is possible to deliver quality care in a variety of ways. The deciding factor in appropriate and adequate treatment lies in the outcome, not the method. Healing will probably not be based on whether polishing was performed at the beginning or the end of an appointment. In fact, healing may occur just as well without polishing.
Applying the test of necessary can challenge many of our long-held beliefs and traditions in dental hygiene. Is a prophy necessary for every patient? If you visit a medical doctor for a routine physical, tests and an exam are done before any treatment or preventive medicine is recommended. A prophy is an easy way to get patients in the dental chair for the exam and necessary screenings. A regularly scheduled head and neck exam along with an oral cancer screening is essential. Exams for decay and periodontal health are necessary for overall health. Education and instruction may even rank high on the list of must-be-done, but preventive services might be just as effective in response to findings instead of scheduled at some predetermined interval. Which parts of your routine hygiene appointments are truly necessary? Nobody can answer that question for you.
In keeping with the prevention theme, some of us question the necessity of sealing every permanent molar, while others still advocate that we cover the occlusal of each posterior tooth, whether deciduous or permanent. We know that not every tooth will experience decay. There are a number of factors that must be present for the caries process to take place, and the mere availability of a susceptible tooth is not enough to cause a cavity. On the other hand, sealants have been shown to be effective in preventing caries in the pits and fissures of posterior teeth. Fluoride has also been proven effective in slowing or preventing decay. Fluoride is now found in almost every toothpaste on the market as well as in many oral rinses and some bottled waters. Professionally, we also offer in-office as well as prescription take-home fluoride treatments. Many now question the necessity of fluoridated community water supplies, pointing to the quantity of fluoride available from other sources. Even within the dental world some are asking just how much fluoride is really necessary to help prevent decay.
It astonishes me to hear that some state dental boards do not consider continuing education necessary. It horrifies me to read that many dental hygienists agree with these boards. Education is key to health-care delivery, and it does not end when the diploma hits the palm. Research continually brings about new information to be incorporated into our practices. Theories are challenged and traditions are changed. Porte polishers are out. Ultrasonic disruption of the biofilm is in. Calculus is still our target, but not for the same reasons as 20 years ago. Rather than being viewed as a gingival irritant, calculus is known for providing a home to periodontal pathogens. We no longer strive to create a glassy smooth subgingival surface; we do all we can to create an environment that promotes healing and discourages infection. These facts are not learned without continual education.
I challenge us to take a few moments every day and assess what is really necessary. Focus on those tasks and treatments necessary to deliver quality oral health care. Let the petty stuff go, and spend more time developing positive working relationships. Ignore the small annoyances, and instead determine one thing you can do to make the anxious patient more comfortable. Decide what part of your oral hygiene instruction will produce the most positive results and do away with the memorized script. Ask yourself many times a day, “Is that really necessary?”
I’ll never forget the first time one of my own children responded to the query of necessity from my mother. We were riding in my mother’s car and my oldest son was sitting in the back seat rolling the window up and down without pause. This went on for several minutes until my mother finally asked, “Is that necessary?” My 8-year-old son quickly responded, “Yes!” I was about to reprimand him for his attitude when he explained, “I farted and if the smell gets to the front seat, you will kick me out and make me walk home.” In his eyes, the air flow was entirely necessary to avoid the quarter-mile walk to the house. Each situation is unique. No two people view necessity exactly the same. Think for yourself and encourage others to find their own answers.
Lory Laughter, RDH, BS, practices in Napa and Sonoma, Calif., in both general and periodontal offices. She is a partner of Dental IQ, a team committed to arranging quality continuing education opportunities for Northern California. Through her involvement with Dental Hygienists against Heart Disease and other organizations, she hopes to bring a total health concept to the dental practice. You may contact Lory at [email protected].
