Wednesday, December 30, 2015

I won!

Guys I'm so excited! I just won a sharpen-free XP Technology N137 “Curaler” by American Eagle Instruments through “Dental Hygiene with Kara RDH”! (I follow her on Facebook and love all of the articles and questions she posts).  This is a brand new instrument with a sickle on one end and a curette on the other.  It claims to be "sharpen free" and I am VERY excited to put it to the test!  I'll keep you posted on how it goes. 

I hope you all have had a wonderful 2015 and are ready to start a brand new year!  I know I am.  I love the hope and possibilities that a new year brings with it.  I've set a few goals for myself and am just excited for January to role in. 

Happy New Years Eve (eve)!

Wednesday, November 25, 2015

Instrumentation




When I was just starting out in dental hygiene school, instrumentation was brutal.  They give you a HUGE variety to choose from and want you to test each one out and gain an understanding for how to use it! (YIKES!)  I felt so overwhelmed. I remember thinking I would NEVER GET IT!  I wasn't even positive on how to use our curved explorer to check for calculus.  I felt discouraged.

At first I used the least intimidating scalers...like a straight sickle.  I was hesitant to apply lateral pressure and didn't want to go subgingivally in fear of hurting my patient.  After a few months I began to realize that what I was choosing wasn't enough and I needed to be brave.  I began truly trying all of them...but I was still paranoid about "using the wrong end"!  I then was given the best advice!  The curved end of the instrument always adapts to the mesial of the tooth.  THERE IT WAS!  THE GOLDEN RULE FOR INSTRUMENTS!  "Adapt mesially".  Once this clicked I began to venture out and use all of my instruments.  Some I liked and others I didn't care for...but I was trying!  In school I very much stuck to the proper way to use an instrument and the proper place to use it...but as I have gained experienced in private practice I realize the right instrument to use is the one that gets the job done!  If I have to use the backside or the wrong end - so be it!  The key is ADAPTATION!  If you can adapt the instrument comfortably to the tooth/root surface and not cause damage to the gingiva, you're good to go.  The main objective of instrumenting is to REMOVE CALCULUS AND BIOFILM.

Of course I have settled on my favorite instruments...my personal all time favorite is the Nevi **I want to be clear that I am in no way sponsored or endorsed by Hu-Friedy and I am not being paid to mention their product...I just love it!**



I have found the Nevi to be very versatile and able to adapt to pretty much any place in the mouth that I need it for.  It removes moderate to heavy calculus and is able to fit into tight contacts or areas with tight tissues.  Although it's recognized for being a posterior scaler it is easily adaptable to anteriors!  I use this instrument on adults and children. When I use other instruments to access calculus...I always go back to the nevi to fine scale and finish up.  It's my love.  (a bit dramatic I know...but seriously...I used to bring these to offices I temped in for fear they wouldn't have any!)  Another instrument I'm growing fonder of is the Gracey 3 / 4.  But its a gracey you say!  Perio only you say!  Wrong.  Remember what I said above?  The right instrument is the one that gets the job done.  This particular gracey has a way of sweeping the gingival margin of molars fabulously and although its an anterior site specific scaler, it gets the job done!

Now aside from hand scalers I utilize ultrasonic scalers on 90% of my patients.  I use a blended approach and almost always start with my ultrasonic to remove as much calculus and biofilm as possible.  I then fine scale with my hand instruments.  Some hygienist do not believe in using ultrasonics and I think that is absolutely silly!  Your worth as a hygienist is not determined by how much calculus you remove by hand!  Especially when the research is there to prove that ultrasonic instrumentation CAN remove all calculus (when used correctly) and does a great job! I recently went to a seminar that said a hygienist could and or should be using a ultrasonic for 90% of the cleaning!  This really resonated with me!  I've always felt like ultrasonics do a fantastic job and are actually quite comfortable for my patients.  Very few feel sensitivity during the procedure.  I have found that mostly the older generation do not like them (at first) due to them not understanding the research and advances of using this technology.  They are hesitant to accept that there are newer and better ways to do things then hand scaling alone.  And don't get me started on how important ultrasonics are for the clinician...repetitive hand movements is what have messed up many-a-hygienist!  When we are seeing 10-15 patients a day WE NEED to be using this technology!!  Stop feeling like you have something to prove by hand scaling the entire mouth for every patient.  :-)

Hopefully this gives you a little insight into instrumentation.  Feel free to comment and tell me your favorite instrument, WHY you love it and WHERE you use it!

Hygiene students BE PATIENT WITH YOURSELF!  One day instrumenting will "click" for you and your anxiety will be gone as you move forward with confidence.  

Wednesday, November 11, 2015

Your husband does what?

For all of you out there, I just wanted to put a smile on your face today!  My husband is a OB/GYN doc and many of my patients are learning this.

I had this convo with a patient yesterday:  **name has been changed of course**

Me: Hows your day going "Jane"??
Patient: Horrible...I have to be here and I'm going to the gynecologist next
Me: Oh yeah?? My husbands a gynecologist!
Patient: *Look of horror* Wow...what are the odds...you work at one end and he works at the other...
Me: It makes for great conversation every night!
Patient: Heaven help me



Have a great day everyone!


Monday, November 9, 2015

A day in the life of...

What does a hygienist do at work?  What does our normal day look like?  I'm here to break it down for you!  We are VERY busy.  Unless there is a patient who does not show up...we have no down time in our schedule.  Hygienist are in charge of prepping charts which includes: going over health history, previous work the patient had done, going over previous hygiene notes, looking to see if they need to update paper works and if they are eligible for x-rays and are they due to have a full mouth probe?  Typically prepping charts takes place a day or two prior to the scheduled day.  I am SO fortunate and have had an assistant at my current job who does this for me.  Hygiene assistants are AMAZING and so valuable to a hygienist!  If they are hard workers and willing to help out with all hygiene needs - THEY ARE GOLD!  Once the charts are prepped this is what my day looks like.

7:45 - Arrive at work and open up my rooms (Me & the other hygienist each have 2 rooms)
8:00 - First patient
  • Go over health history, take BP, ask about concerns, take pictures if interested in ortho
  • Take xrays if eligible - read xrays for decay & record findings for DDS to look at
  • Do a FMP (Full mouth probe 1 x a year) or PSR and go over periodontal readings with patient
  • Scale teeth "Aka: Clean teeth" (I am given approximately 20-25 minutes to do this)
  • Polish & floss & go over every tooth for decay/cracks/irregularities - record findings
  • Perform a TC/OCS (Tissue Check/Oral Cancer Screening) - I do this on EVERYONE
  • Provide oral hygiene instruction for my patient
  • Write in chart IN DETAIL everything done/discussed
  • Exam
  • Finish writing in chart whatever the doctor noted
8:45 - Patient (repeat ALL of above EVERY time)
9:30 - Patient
10:15 - Patient
11:00 - Patient
11:45 - Patient
12:30 - Patient
Stock rooms/sharpen instruments/Sterilize/Set up for after lunch

LUNCH 1:00-2:00 -


2:00 - Patient
2:45 - Patient
3:15 - Patient (last of the day for my short days)
3:45 - Patient
4:15 - Patient
5:00 - Patient (last of the day for my long days)
Close down rooms/take out trash/sterilize/suction/finish up any charts/prep for the following day! and if needed because I couldn't get to it earlier stock rooms & sharpen instruments.

 On average I am seeing anywhere between 10-15 patients (depends on if children have been seen...a child appointment only lasts 30 minutes which allows for MORE people in my schedule!) yay...

In my office I am given 45 minutes per patient...30 minutes for children.  Sometimes I am given an hour if it's a new patient who hasnt been to a dentist in awhile.  If I am getting them back for SC/RP that is up to me how long I schedule.  Typically 2-3 hours...depends on what I'm doing and what needs to be done!

This being said...I like the fast pace and I like what I do.  Sometimes I wish for more time but in reality...I get done what needs to get done and I stay on schedule.  Because I have an assistant this is possible!  If I didn't have an assistant there is no way I could stay on time, because she takes quite a few responsibilities off of me.  She typically sits my patient, does the initial "hi, how are you, what are your concerns?" and takes the xrays for me.  She helps me chart (charting a FMP by myself takes me twice as long) and she also stays in the room for my exams so I can move on to the next patient.
  
Yeah...try to tell me I just "clean teeth"...!



Saturday, November 7, 2015

What do YOU want to know??

Wow!  I don't know about you, but as a hygienist, my time seems to fly by in 6 month intervals!  I seem to always be thinking 6 months in advance...and before I know it it's here and gone.  I'm sure this is due, in part, to scheduling patients 6 months out for their next cleaning.  I can't tell you how many times I say to my patient "DIDN'T I JUST SEE YOU!?" or "6 MONTHS HAS PAST ALREADY?".  They all seem to agree ;-)  I'm already telling my patients "See ya next spring!"  and we're not even into the holidays yet!

This isn't meant to be a long, informative post just a "Hey I'm still here!" and I'm thinking of new topics to post on!  What do YOU want me to post about?  Just leave a comment below! 

Thanks as always for reading.  It always makes me happy to hear from any of you fellow hygienist or hygienist hopefuls! :-) 

Thursday, May 21, 2015

Do you have what it takes to be a RDH?

Hi friends!  I'm always amazed that even one person reads this blog.  I never intended on keeping up with it after hygiene school but here I am four years later!  I am honored that so many of you take the time to read and leave comments and contact me directly to ask questions.  One question I get often is "Can you give me some tips & advice on how to become a dental hygienist?".  So I thought, why not make it into a post for all to read!  What I'm getting from a lot of you is that there isn't a lot of information out there about HOW to become a hygienist or WHAT we do exactly (the "what" we do will be a post for a different day!).  So here we go, my best advice tied into a neat bow! ;-)

First and foremost: I would highly recommended those interested in becoming a hygienist to work as a dental or hygiene assistant first.  This is critical - it allows you to experience the field without committing to a program or degree that you may or may not be interested in.  Being an assistant will allow you to know if you can even handle working in someones mouth! (It's not for everyone)

Heavy calculus ("tartar") 

Bleeding gums (upon probing or in general)


Heavy plaque
Oral cancer caused by HPV


See what I'm saying?  If any of the above makes you sick to your stomach (not to mention the bad breath that accompanies most oral conditions that I couldn't post in a picture...)...you might not be cut out to work in the dental field! 

If you can't get a job assisting quite yet (depending on what state you live in, you do not have to have certification to become a dental assistant - I was trained on the job right out of high school.  In fact many high school programs have a dental assisting program you can be a part of junior or senior year! Look into it!), at very least shadow someone in the field.  You need to know what you're getting into, and most programs want their students to have that experience. 

I want to add in here to that working in the dental office hurts...physically!  If you are one who already has neck and shoulder problems, this might not be a great field for you.  You are in a hunched over position for most of the day and you do repetitive hand movements all day long.  You WILL have a sore neck/back at some point in your career.  YES!  There are loups & ergonomics that can really help you out (I live by ergonomics 90% of the time because I have developed very bad neck/shoulder problems already) but there are some patients where you absolutely cannot practice ergonomics and have to put your neck & back in positions that are very uncomfortable for extended periods of time.  You and a masseuse or chiropractor will become great friends! 
(PS: "Ergonomics" is posture for those who were wondering)

Second: It's very important to enroll in a school (a university or community college that has a DH program) and speak to a health counselor about the specific requirements for that school.  You will be a science major so a lot of science classes are involved.  Don't be intimidated!  I found all I needed was self-discipline to study and I was completely fine.  You do need good grades - most hygiene programs require a high GPA.  Even if they say a GPA of 3.0 to get in...you can bet that most of the gals (and guys!) have a 3.3-3.5 to be accepted. 

A lot of programs have a wait to get in.  Again, don't be discouraged by this.  Just apply every year until you're in!  It took me 3 tries before I was accepted.  I would say on average most people wait 2-4 years before being accepted into a program (unless you go to a stand alone hygiene school which I would NOT recommend what so ever - very expensive and not known to produce good hygienists).  I applied as soon as I was able and then continued to work on other classes I would need before the program started.  I also took upper division classes to allow me to complete my bachelor degree in dental hygiene.  (This is where the job is going these days...I would highly recommend a B.S degree and not just an A.S degree).  With a B.S. degree you are no longer limited to just clinical hygiene.  Your degree can take you so many places!  You can become a sales rep for well known dental companies, teach in dental hygiene programs, work on the dental hygiene board at local or national levels, the list goes on and on! 

I hope this has answered questions for some of you for HOW to go about becoming a hygienist.  If you have further questions please just comment below and I'll get back to you. 

Good luck future hygienist!


Sunday, February 15, 2015

Xray issues

So...I reluctantly admit to you readers that one of my biggest struggles as a hygienist (and past assistant) has been taking xrays...specifically molar bitewings...and then reading them!  I have always had the hardest time opening up the molar contacts and getting a good, readable xray.  I was so embarrassed by this and to be honest, it would give me a lot of anxiety at work.  I felt so horrible that as a hygienist I was taking horrible xrays!  And not just a hygienist...but someone who has been in the dental field for 10 years!  What was my problem?  Why wasn't I understanding how to do this?  And to top it off, I was even worse at reading the xrays I took!  (looking back, this is understandable when overlap is present - you cannot trust an overlapped xray)  So it was my goal at the end of this past year to fix this problem.  I started YouTubing it and reading articles, looking back through my old radiology book, to figure out where I was going wrong.  I was using the RINN kits (the plastic bite with the circle - its supposed to tell you EXACTLY where to put the xray head right?! WRONG!)  After many hours of researching I knew I just had to start really experimenting and using trial & error as my guide.  Well, I think I have FINALLY figured out the trick to taking a perfect molar bitewing!!  You don't even know how big of a relief this is for me!  I no longer start panicking in my mind when I know my assistant wont be taking my xrays for me (yes, I'm very lucky to have one and they are invaluable to a hygienist!)  So..wanna know my trick?


I have discovered that when you place the RINN bite tab in the mouth for the molar shot, make sure the line on the bite is between the molars

Now have the patient close down, and push the outside circle close to the patients cheek. Now the next step is where the "trick" takes place.  Do NOT line the xray tube flush with the circle.  I ALWAYS overlap when I have the xray tube in this position.  Instead, position your xray tube facing toward the distal of the tooth.  So, line it up with the circle THEN turn the tube to face the distal portion of the tooth.  (I hope this makes sense!!  Wish I had an actual picture of this)  The diagram of the arrow below is the direction I face my tube once I'm ready to take the xray.  Notice how it is not lined up with the circle, but on a diagonal.   


This makes the xray beam go straight through the contacts of the teeth.  You'll notice when you slightly turn the tube that its now parallel with the molars.  And WA-LA!  Seriously...test this theory out.  Other assistants in the office were having trouble too and are now using this "technique" and we are all getting open contacts, every time!  I really hope this helps someone else struggling out there.  I'm not alone in this problem am I!?! I was beginning to feel as if I was...and now I am so much more confident with my xray skills!  Good luck to all of you who struggle.  It just takes some trial & error and lots of practice.  You can obtain a perfect xray consistently! ;-)  It only took me 10 years...