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! :-)