Concerning the article titled, “Assisted Hygiene” in your October 2011 issue, I disagree with the statement, “The traditional solo dental hygiene model is inefficient.” You used the example of a hygienist seeing eight patients a day with one hour per patient, compared to that of an assisted hygienist seeing a patient every 40 minutes and seeing 12 to 13 patients a day. I see eight patients a day (one hour each, including adults and teens). The dental assistants in our office see the children until one of two things happen. Either they go into orthodontics or they start accumulating calculus. At that point, they see the hygienist.
I have plenty of time to take blood pressure, visit with the patient, review medical history, chart, take X-rays, schedule the next hygiene appointment, and discuss the treatment plan with the dentist when he examines the patient. The doctor I work for respects my opinion, and I want to be in the room and to be part of the diagnosis and treatment planning, not off in another room on to another patient. I put the treatment plan into the computer, print it and have the patient sign it, and answer any questions the patient has. Our patients consider their hygiene appointment as a “social event.” That is why our patients are so loyal.
I would not want anyone else to take my X-rays. In order to properly diagnose, the X-rays need to be as close to perfect as possible and that is my goal. Others are not as conscientious as I am. The hardest part of the hygiene appointment is the ultrasonic and hand scaling. Why would I want to do that 13 times a day, with the dental assistant doing the easiest part? What kind of challenge would it be for a dental assistant to assist a hygienist? In my opinion, none at all.
You said, “Assisted hygiene is like dental hygiene heaven.” Increasing hygiene production is heaven to the dentist, not the hygienist. If the dentist has to pay an assistant for the hygienist, that would be his or her reason to not pass on any increase in production to the hygienist.
As far as your statement that assisted hygiene is “an especially attractive option for areas when shortages of qualified hygienists exist,” there are no shortages of hygienists anywhere that I know of. There is, however, a shortage of jobs. Even the hygienist on the cover of the October issue mentions the lack of jobs for dental hygienists.
I discussed your article about assisted hygiene with four other hygienists today, and all of them said they would not like to practice that way.
Giovanna Becker, RDH
Charleston, South Carolina
I read Noel Kelsh’s article, “Using a Self-Adhesive Sterilization Pouch,” with some bewilderment (September 2011 issue).
The gist of the article is simple. Users of adhesive-sealing sterilization pouches must be sure to close them properly and completely, to avoid any and all contamination from other non-sterile surfaces after they emerge from the autoclave.
Here are my thoughts as I read the article. I debride used instruments well. I enclose them fully in a pouch and seal it completely. The instruments are totally sterile when I take them from the pouch.
When opening the pouch, I place the instruments neatly on a nonsterile paper tray cover plucked from an open box in an office cabinet. I pick one up with my nonsterile gloves made in a sweat shop in Malaysia. I expertly scale a tooth or two and wipe plaque and/or calculus off the tip of the scaler with a non-sterile 2x2 gauze made in a crowded Chinese factory.
Now how sterile is the instrument tip that I run along the root surface, under the patient’s gingival tissue?
Amy Brown, RDH, BS, EDH
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