Technology for Treating People

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High-tech tools to help you become the ultimate patient educator.

by Charles Samaras, DMD

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In a successful dental practice, a mutual respect and appreciation must exist for everyone on the team. Every team member is involved in the care of every patient. Education, technology, and communication enables all hygienists to reach their full potential in achieving professional and financial satisfaction.

Every team member should have a great deal of knowledge in all aspects of dentistry. Without that knowledge, patients cannot receive optimum care and service. We don't "fix teeth;" we treat people. Dentistry is not just about cleanings, fillings, and appointments; it's also about relationships. Only through knowledge can these relationships be developed. Therefore, the hygienist must possess far more dental knowledge than just cleaning teeth and providing home-care instruction.

Why do I feel this way? Because I realize that, more than any other team member, the hygienist spends the most time with patients. In my office, the one-hour hygiene appointment is the best opportunity for patient education. It is imperative that we continuously educate our patients so they can take responsibility for their oral and overall health.

Technology such as the intraoral camera, digital radiography, practice-management software, laser caries detection, and pulp testers enables hygienists to educate and communicate to patients about their oral health and treatment options. Remember, we are not in the profession of fixing, but, rather, treating.

Intraoral cameras
The intraoral camera (IOC) is the most essential technological tool for patient education. It enables patients to visualize (on a monitor) fractured restorations or tooth structure, mucogingival lesions, caries, calculus, and periodontal conditions. The education is enhanced by the ability to enlarge or "zoom in" on the image, allowing patients to clearly see the area in question.

The IOC also allows a portfolio of images to become part of the patient's record. This is important for before-and-after images, prior conditions, and documentation of treatment. For example, patients often are unaware of existing disease processes or fractured restorations because they are asymptomatic. However, the ability to show these conditions to patients and communicate the need for treatment is paramount for optimum patient care. Even the most unsophisticated patient can visualize disease processes when viewed on a large monitor. Otherwise, a patient might proceed only on blind faith, or, worse, opt not to proceed at all. With before-and-after images, patients can understand and appreciate the education and treatment process.

Digital radiography
Digital radiography provides a great diagnostic opportunity for hygienists and doctors. Imagine the ability to enlarge a radiograph to the full size of a monitor screen, or to contrast the image. We all remember the days of trying to show caries or a periodontal condition to a patient on a "size 2" film. Of course, patients could not visualize or understand their conditions even though they were nodding their heads. Wasn't that frustrating?

With digital radiography, the image is large, clear, and impressionable. As with IOC images, the radiography becomes part of the patient record or "portfolio" that can be viewed instantaneously. In addition, with digital radiography, there is less radiation for the patient, and no film, chemicals, processor, or hazardous waste — just an instantaneous image!

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Laser caries detectors
Another great instrument is the laser caries detector. How many times has the hygienist or dentist found "explorer sticks" on occlusal or smooth surfaces of virgin teeth and not know if they indicated actual decay? We've all said, "We'll watch this." What exactly are we going to watch it do? With laser caries detection, confirmation of the presence or absence of caries is absolute! No more guessing. No more "watching."

The use of this instrument is simple and should initially be conducted by the hygienist at the first new-patient visit or introduced at maintenance visits for established patients. Upon application of the probe to the tooth surface, a digital monitor will display a numerical reading. In some instances, the presence of decay will initiate an audible sound as well. The numerical display, along with the audible sound, is easily interpreted and understood by patients as to whether decay is or is not present.

Pulp testers
The most underutilized technological instrument by doctors and hygienists is the pulp tester. This is strange, because pulp testers have been around for many years. When a patient communicates symptoms of a potential endodontic case, the pulp tester should be used to determine tooth vitality.

This is yet another opportunity for hygienists to engage in diagnosis and patient education. Certainly, the complete hygienist does not have to wait for the doctor to authorize pulp-testing. It should be part of the hygiene routine.

Practice-management software
Finally, practice-management software not only harnesses and facilitates the use of these technologies, but it also provides the mechanism for the complete digital dental record. Make no mistake, the future of dentistry is the trend toward a paperless office: the virtual digital dental practice record.

This means that through dental software and hardware, every patient's complete dental record will be accessible at all times by every authorized team member. Nothing is absent; everything is complete. This provides the opportunity for optimum patient treatment and ultimate service. Not only is the patient record complete, it is reproducible. Nothing gets lost!

Any kind of information to be added to the records can be inserted by multiple team members at multiple network stations. This allows hygienists to enter information such as:

  • Restorative recommendations
  • Periodontal charting
  • IOC images and digital radiography
  • Case notes, cancer screening, or health history changes
  • Treatment recommended and/or performed
  • Appointment scheduling

It also allows hygienists to be creative with respect to cosmetic imaging. Two examples are 1) enabling patients to visualize their teeth two to three shades lighter from bleaching; 2) patients could see how they would look if a diastema were closed or how cosmetics could be improved through ceramic crowns or veneers.

Prognosis: satisfaction
It is evident that there is indeed more to the hygienist's role than just cleaning teeth. Practice-management software and high-tech tools enable hygienists to provide optimum treatment and service through effective patient education. In this way, hygienists are most valuable to patients, the practice, and themselves. This translates into higher professional, personal, and financial satisfaction. Believe me, there are plenty of dentists like me who understand and appreciate what the complete hygienist means to us and to our practices!

Dr. Charles D. Samaras is a 1982 graduate of Tufts University School of Dental Medicine. He maintains a practice specializing in esthetic and restorative dentistry in Lowell, Mass. He also is an associate clinical professor and the director of practice management at Tufts. Dr. Samaras is a member of numerous dental societies and civic organizations. Dr. Samaras may be reached by email at charles.samaras@tufts.edu or drsamaras@aol.com

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