by Cathy Hester Seckman, RDH
It took having a baby to make hygienist Carolyn Brown realize that kids can be fun. “Before I had my son, Najee,” says Brown, “whenever I saw a child on the schedule, I’d break out in a sweat. But now, I know how funny kids can be. It’s just second nature for me to see a child in the office.”
Brown’s office isn’t a typical place for a hygienist to work. For the past eight years, she’s been on staff at a large metropolitan facility, the Cincinnati Children’s Hospital Medical Center.
The center has a full dental clinic with 14 operatories and a three-chair section for orthodontics. Besides Brown there are four full-time hygienists, TammiRaussen, RDH, Janet Thompson, RDH, HilaryGlick, RDH, and Iris H. SageserRDH, MS.
Sageser oversees the craniofacial abnormality treatment division. She coordinates surgery and reconstruction treatment for all cleft palate patients, who come from several states and can begin treatment as infants.
The office also has 10 assistants, including a sterilization assistant. Five pediatric dentists work as attendings. There is one orthodontist, and three associate dentists who specialize in endodontics, oral surgery, and periodontics.
The management staff includes a director, assistant director, and clinic manager. There is also a rotating staff of residents. The center exists, basically, to provide a hospital-based clinic in which dental students can complete pediatric residencies.
“We definitely help teach the residents. Every week we get two different ones, and they rotate. They’re really young, usually between 25 and 33, and they have lots of energy. Besides working in the clinic, they run the ER and do community work, placing sealants and doing screenings. They get a very good education.”
The dental clinic is on the fifth floor of Building C (of A through E). The complex also includes a Ronald McDonald House and three research buildings.
Dental clinic patients come mostly by word of mouth, Brown says. “Most of our clients are well patients. Many are on Medicaid, but we do see patients with dental insurance, and patients who pay cash.” The staff also sees a lot of mentally and physically handicapped children. A resident is on call 24 hours a day for trauma cases.
There are an estimated 38,000 visits per year at the clinic, and 1,300 operating room cases each year. Brown has gone into the operating room to do prophylaxes on special needs patients who are under general anesthetic for other medical treatment.
The clinic uses a lot of sedation for pediatric patients, but Brown doesn’t get involved in that. In her hygiene operatory, she uses pediatric behavior management. “Little ones can come in really scared,” she reports, “especially around age 4. You have to work with them. One of the things I do is give out stickers first, ‘because I know you’re going to do a good job.’ I introduce the prophy angle as a ‘spin brush,’ because they’re familiar with that from television, and I use regular toothpaste. I polish a finger first, before I start in their mouth. I use simple names for things, like calling fluoride ‘vitamins for your teeth.’”
Brown sees children beginning at age 1. “But we don’t try to put them in the chair,” she says. “We do a lap-to-lap exam, with my knees facing a parent’s knees, and the child’s head in my lap. There are times we’re able to do a quick little polish that way, too. And we’ve been getting big on using fluoride varnish for decalcified teeth.”
For parents who can’t afford treatment for their children, a dental research foundation provides some funding.
There are times, Brown says, when communicating with parents and patients is a problem because of language barriers. “The hospital has a department called Children’s Caring Network and Interpreter Services. I use them for Spanish and French interpreters when necessary.”
Before she started at the clinic, Brown, who earned an associate’s degree in 1983 from Sinclair Community College in Dayton, Ohio, worked in general practice and for the Cincinnati Health Department Clinic. She was a dental assistant before that, going all the way back to after-school jobs in high school. But this job, at the hospital clinic, is by far her favorite.
“Oh, my goodness, I love my job. It’s the best I’ve ever had. My favorite thing is training parents and kids how to take care of their teeth, from the foundation up. We teach flossing, brushing, diet - all things that will follow through to their adulthood. Our primary focus is to educate, not to produce.”
Brown estimates that she sees 13 patients a day, working 8 a.m. to 5 p.m. five days a week. Her salary is “great - very fair,” and benefits include medical and dental insurance, a retirement program, bonus program, and four weeks’ paid vacation. Brown’s career as a hygienist is slightly unconventional, between the hospital setting and the 40-hour week, so she feels lucky to have it. Whenever you can say, “I love my job,” that’s a successful career.
Cathy Hester Seckman, RDH, is a frequent contributor based in Calcutta, Ohio. Besides working in a pediatric dental practice, Seckman is a prolific freelance writer and book indexer. She can be reached at [email protected].