The yellow brick road

Feb. 1, 2006
Shortly after she returns home wearing her ruby red slippers, Dorothy tries to get her life back to normal.

Shortly after she returns home wearing her ruby red slippers, Dorothy tries to get her life back to normal. She feeds the chickens, cares for Toto, continues singing, and eventually goes to college. As part of her routine, Dorothy visits the family dental office every six months. While she enjoys visiting the dentist, whom she has known all her life, the hygiene department is another story.

It seems that every six months a new hygienist treats Dorothy. Each has talents and shortcomings, but not one is Dorothy’s ideal provider. Sally Slicktalker is chatty and friendly. She comes to the waiting room and loudly says, “I’m the hygienist who will clean your teeth today.” Sally babbles endlessly about family members, school memories, and the horrible conditions at her last office. When Dorothy asks how her teeth look, Sally assures her that everything is fine and the appointment is finished. She hands Dorothy a bag containing a toothbrush and floss, points her toward the front desk, and instructs her to come in again in six months. It occurs to Dorothy that Sally has no brain.

Six months later, Dorothy is greeted by Wendy Whiner. Wendy is a sad woman in a sad state of being. Her body aches, her kids are trouble, and her job is less than satisfying. She talks about the great office down the street where the staff is treated to doughnuts every Friday. The cheap dentist at Dorothy’s office never purchases doughnuts for his staff. Wendy’s husband is a drunk and her mother is always in her business. Wendy is sure the office manager doesn’t like her and will talk the dentist into finding a new hygienist. When Dorothy suggests that Wendy talk to the dentist directly, Wendy says she’s intimidated by the doctor.

Dorothy mentions that her diet at college is not as healthy as the meals made by Auntie Em and asks if she should be concerned about her teeth. Wendy assures Dorothy that nobody eats more junk food than her bratty teenagers and they don’t have cavities, so Dorothy should be fine. When Dorothy asks if she needs X-rays, Wendy tells her that X-rays mean the dentist does an exam that very day, and insurance doesn’t cover such a fee until next Tuesday. Also, Wendy is not comfortable with the dentist “checking her work” and suggests Dorothy have her exam another time. It occurs to Dorothy that Wendy has no courage.

Dorothy’s next recall visit to the dental office introduces her to Harry Hammerer. Harry is all business. He scales and picks until Dorothy is “clean as a whistle.” He assures her that the discomfort is a sign of good service. He tells her if she would floss more, her visit would be less traumatic. Harry tells Dorothy she has four cavities, probably due to her terrible college diet, and that she needs to return during her next school break for injections, drilling, and fillings.

Dorothy asks Harry to show her how to care for her teeth. His blunt reply is, “Just floss once in a while and things will be much better.” She tells Harry that she does floss nearly every day, but he doesn’t believe her. Dorothy asks about mouthrinses, fluoride, and xylitol gum, since she has heard that all these items could be beneficial to her oral health. Harry tells her all these things are “hogwash,” and flossing is the only route to true gingival health. It occurs to Dorothy that Harry has no heart.

Dorothy knows it’s time to take action. She is not willing to settle for less than optimum care. After all, it’s her health that’s in jeopardy. She knows it’s time for a trip to the Wizard. Dorothy is sure the Wizard can help with the missing components of each hygienist. The only problem is finding a tornado and getting all of the hygienists into a twirling house. As luck has it, Dorothy finds that opportunity the following week.

When the house lands, Dorothy and her crew find themselves in the middle of the yellow, stained road. When they reach the castle, they are warmly welcomed. All of the subjects are happy to see Dorothy and more than willing to help in her quest for the ideal hygienist. Someone finds treats for Wendy, and another brave soul listens to Sally chat endlessly. They even pay attention to Harry and his suggestions for improving the castle interior. Dorothy is glad she made the voyage.

When they finally arrive at the door of the Wizard, Dorothy knocks timidly. She hopes his mood is good and that he will be willing to help. The door opens slowly and loudly. Everyone waits for the Wizard’s command to enter. Suddenly Dorothy finds herself in a warm embrace. The Wizard heard she was coming and is indeed happy to see her. They sit together to work on a solution for Sally, Wendy, and Harry.

They start with Sally. Dorothy explains the apparent lack of brains and Sally’s compulsion to engage in idle chatter during dental treatment. While Sally is willing to share intimate details about her family and friends, she is unable to teach vital home-care skills. The Wizard agrees that this is a serious problem. He tells Dorothy that Sally does have a brain; she just needs to remember how to use it. The Wizard is not going to be able to change Sally; instead he tells Dorothy change is something that only Sally can do for herself. Dorothy is sad that the Wizard cannot fix Sally, but she has two more chances in her quest.

Next is Wendy. Dorothy is concerned with Wendy’s lack of courage. She explains that Wendy is unable to discuss issues openly with her co-workers or employer. While Wendy is an excellent clinician, appointments are uncomfortable for patients because of the constant complaining. Again, the Wizard is unable to help. He assures Dorothy that a lack of courage is not the problem; rather, Wendy has forgotten the important elements of her profession. She has lost sight of the goals established during her early years of practicing dental hygiene. Once again, it will be up to Wendy to change. The Wizard can provide guidance, but the real effort has to come from Wendy herself, and she seems unwilling to transform.

Down to her final option, Dorothy presents Harry to the Wizard. She explains that Harry is harsh and judgmental. Instead of providing education, he barks orders at his patients. Harry’s sole purpose is to have every person leave with a sparkling, calculus-free mouth. He doesn’t care if patients can maintain the results, because in six months Harry can do it again himself. The Wizard sighs and again expresses his inability to solve Harry’s situation. Harry was once a pleasant practitioner who wanted to help all of his patients achieve optimal health. Somewhere along his journey, Harry became hardened and is now stuck in his routine. The desire to change needs to come from within; it cannot be provided by an outside source.

Dorothy is saddened by the Wizard’s inability to fix the hygienists and is about to give up hope. But just as she is about to leave the castle and return home, the Wizard presents a solution. He creates a new hygienist, one who possesses all of the traits the other three are missing - a health-care provider who can teach patients to be partners in their care, a dental professional who will listen to patients and address their concerns directly, and most importantly, a hygienist who is eager to attend continuing-education courses and stay up-to-date on procedures and facts.

The Wizard works for a long time on his creation. Finally, after periods of flickering lights and loud booms, he presents Dorothy with Quality. During their trial appointment, Quality asks Dorothy questions about her health history and any concerns she might have. Quality then does something new to Dorothy - a head and neck exam followed by an oral cancer screening. All through the appointment, Quality explains the procedures and why they are important. This appointment includes patient education about home-care techniques and how oral health affects systemic health. Dorothy leaves the chair with a sparkling, calculus-free mouth and the confidence to do the things necessary to keep it that way. Even the Wizard is amazed.

Dorothy returns home with Quality in tow. She introduces the new dental professional to her family dentist, and he is equally impressed. Quality practices there to this day, and Dorothy is a satisfied patient. Quality continues to learn and pass that knowledge on to co-workers and patients. Dorothy graduates from college and becomes a famous Broadway actress.

But not everyone lives happily ever after. Dorothy represents the public, and she deserves excellent dental care. While most members of the public are not willing to go to such extremes to find a solution, many will move from office to office until they find an acceptable level of care. Sally, Wendy, and Harry are examples of what can happen when we lose sight of our purpose and goals. These are the hygienists who go to “work” every day and bear with the situation to collect a paycheck. They are out there cleaning teeth. Scary, huh?

The Wizard represents mentors - the professors, instructors, and colleagues who inspire us to accomplish our goals. The Wizard is someone different for each of us, and is a combination of many people. My Wizard includes a college advisor who would not let me quit and a writer who challenged me to do more.

If you push yourself to be the best health-care provider possible, your Wizard will meet you at the edge to make sure you don’t fall. Your mentors may not be visible to you all the time, but their influence and teachings will stay with you forever. Each of us can be Quality.