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oralhygiene
NOVEMBER 2020
Inside this issue ORAL HYGIENE
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Scents, Sounds, and Sights: Managing Dental Fear in 2020 Alina Fintineanu, RDH, C.A Ed, CTP
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The Not So Grand Opening Irene Iancu, BSc, RDH, CDTP
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The Hygienist’s Pivotal Role in the Patient Experience Dru Halverson, RDH, BS, Chief of Advisor Development & Advisor, The Jameson Group.
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Breaking Down Barriers to an Exceptional Hygiene Department Gabriele Maycher, CEO, GEM Dental Experts Inc. BSc, PID, dip DH, RDH
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Streamlining Instrumentation Kathleen Bokrossy, RDH
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DEPARTMENTS 4
UNITED WE SCALE Irene Iancu, BSc, RDH, CDTP
5 NEWS Dentists Say Cracked Teeth Are More Common Post-Lockdown
Warning Over ‘Dangerous’ DIY Beauty Trends on TikTok Including Teeth Whitening
Kids That Believe in the Tooth Fairy Take Better Care of Their Teeth, Study Says
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EDITORIAL
United We Scale Irene Iancu, BSc, RDH, CDTP Irene Iancu has worked in various specialties including Paedo, Perio, General Practice and Orthodontics. Her goal in her current holistic practice is preventing and maintaining an optimal mind, mouth and body. Irene connects the systemic effects of oral conditions to her clients, while making a change for overall health and wellness. As a Peer and Quality Assurance Mentor contacted by the CDHO, a Clinical and Theoretical Dental Hygiene instructor at Oxford College, and a practicing dental hygienist in Toronto, Irene shares her passion for education with us today in the hopes we can change the lives of our clients and their loved ones. Irene can be contacted at Irene@toothlifestudios.ca, toothlifestudio.ca, IG: @ToothLife.Irene..
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I had virtual coffee with my former classmate last week. We’ve been having coffee nearly every month since we graduated from dental hygiene school together in 2007. We chat about dental hygiene, what’s new in our offices, cool things we’ve read, the weather, politics, the most recent Zara sales, and let’s face it, Facebook group topics come up, too. Since she doesn’t participate in Facebook groups and rarely uses Instagram, I get to be the storyteller of what’s happening in the hygienist social media world. Her reactions are both funny and innocent. We’ve never worked in the same practice and live two very different personal and professional lives. But this week, we realized we had a little more in common than we thought. The world’s devastating battle with the pandemic has revealed common ground we share, despite appearing so far apart on the social platforms. We spoke about dental hygiene in the past tense. Like we were mourning a person we once had the privilege of knowing intimately. Phrases like “remember when we could...” and “I wish we still had…” flooded our sentences like distilled water when you accidentally overfill the tank— the breakup we both experienced back in March that abruptly ended the way we once knew dental hygiene and provided little to no closure. Now we are trying to put the puzzle pieces back together without knowing what the new picture will look like. We spoke about how the pressure of hand scaling is slowly taking a toll on her body, heart and mind, and I found myself talking her out of retirement. You see, we are not only perio slayers; beneath the surface, we have souls and a conscience and we miss being the most efficient versions of ourselves. Two long years of planning and construc-
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tion are behind me and my new practice had just wrapped up five weeks of being open. But, I feel insensitive to celebrate. Two hundred brand new patients and 26 five-star Google reviews suddenly don’t feel impressive. Having fitted N95s, gowns and wipes is now more #goals. Things just aren’t the same. Dentistry is our home and many of you are celebrating milestone anniversaries. We share so much in common; we are a community. Other hygienists across the country are reading these words at the same moment as you; now, if that isn’t a small world, I don’t know what is. United we stand. United we scale. And united we miss the way things were. We miss smiling and talking without a mask on (not to mention the N95 and face shield). 2020 has been a rough year for huggers; often that warm embrace from a long-time patient would make everything feel worth it. We’ve lost even the simple handshake with a new patient to start off on the right foot. We miss sharing our lunches with our office fam, celebrating birthdays as a team, and let’s not forget the delicious baked goods from our patients. The memories of pre-COVID dental hygiene practice live in our minds and hearts. We may not all share the same views on what is happening today, but we all share common feelings about the past. Perhaps we will never get back to that past; however, if we stick together and remind ourselves of the reasons we became Dental Hygienists, maybe we won’t feel so alone in our noise-polluted bubbles pumping hot air through our HEPA filtration systems. One day the unobstructed sound of our voices and the clear sound of music will return. Until then, hang tight, you are not alone, we will get through this together.
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NEWS
Dentists Say Cracked Teeth Are More Common Post-Lockdown
Dentists have seen a surge in patients with cracked or damaged teeth over the course of the pandemic, a phenomenon some believe may be related to an increase in jaw clenching and grinding due to stress. Toronto-area dentist Dr. Kal Khaled closed his practice to all but emergency patients at the beginning of the lockdown and soon noticed an uptick in emergency patients coming in with cracked molars and damaged fillings leading to abscesses. To his surprise, his colleagues reported a similar trend, one he believes is a compounding issue of stress, poor diet, and a lack of oral care. “[Tooth] decay is accelerated by stress, and poor life conditions, such as not sleeping or eating well. Needless to say, teeth have taken a beating over the last few months,” Khaled, president of the Ontario Alliance of Dentists, told CTVNews.ca. For the full article, visit: https://www.ctvnews.ca/health/coronavirus/teeth-are-takinga-beating-dentists-say-cracked-teeth-are-more-common-post-lockdown-1.5096518
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OFFICE: Located at 5353 Dundas Street West, Suite 400 Toronto ON M9B 6H8 Telephone 416-614-5831, Fax 416-614-8861. Oral Hygiene serves dental hygienists across Canada. The editorial environment speaks to hygienists as professionals, helping them build and develop clinical skills, master new products and technologies and increase their productivity and effectiveness as key members of the dental team. Articles focus on topics of interest to the hygienist, including education, communication, prevention and treatment modalities. Please address all submissions to: The Editor, Oral Hygiene, 5353 Dundas Street West, Suite 400 Toronto ON M9B 6H8
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Warning Over ‘Dangerous’ DIY Beauty Trends on TikTok Including Teeth Whitening
DIY beauty trends popular on TikTok could be dangerous and harmful, healthcare groups have warned. Examples include applying bleach to whiten teeth, removing moles at home, and using eyelash glue to make lips appear larger, BBC News has discovered. When these videos went viral, they encouraged others to copy the so-called “beauty hacks”, which could cause permanent harm, the groups warned. TikTok told BBC News the videos did not violate its community guidelines. However, the British Association of Dermatologists, the British Dental Association and the British Skin Foundation - who viewed the videos - have today issued warnings about copying these treatments on social media. TikTok videos with the hashtag “teethwhitening” have amassed about 284 million views. Some recommend applying bleach to teeth, to avoid “expensive” over-the-counter treatments. For more information, please visit: https://www.bbc.com/news/technology-53921081
Kids That Believe in the Tooth Fairy Take Better Care of Their Teeth, Study Says
What role does the tooth fairy play in teaching children oral hygiene habits? Well, a new study says quite a lot. Delta Dental surveyed parents who ‘allow’ the tooth fairy into their homes, and they discovered more than just money under the pillow. They say the looming visit of the tooth fairy inspires kids to create and maintain good oral hygiene habits.
For the full article, visit: https://cw33.com/morning-after/kids-that-believe-in-thetooth-fairy-take-better-care-of-their-teeth-study-says/ For the latest coverage on COVID-19 as it pertains to the dental industry and profession, please visit www.oralhealthgroup.com/covid-19/
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ORAL HYGIENE
SCENTS, SOUNDS, AND SIGHTS:
Managing dental fear in 2020 Alina Fintineanu, RDH, C.A Ed, CTP Alina Fintineanu is a Registered Dental Hygienist with 10 years of experience in dentistry. She currently works in private orthodontic practice in Toronto. Alina has obtained a Certificate in Adult Education and is a Certified Training Practitioner. She is an educator on Invisalign and profoundly passionate about all things Orthodontics. When she is not reminding patients to wear their elastics, you can find her traveling, baking and petting dogs. Contact her at: alina_fin@yahoo.ca
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AN UPDATED LOOK AT OPTIONS FOR SETTING OUR PATIENTS AT EASE
Two of the main culprits that prevent our patients from seeking care are fear and anxiety. Dentophobia (or odontophobia) is defined as “the extreme fear of going to the dentist”.1 True phobias, stronger versions of the common fear, require different and sometimes more intensive measures. Phobias are considered a type of anxiety disorder, and are known to cause extreme distress and avoidance — so much so, that these interfere with your daily life.1 Managing these patients may
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require psychotherapeutic interventions, pharmacological interventions, or a combination of both, depending on the level of dental anxiety, patient characteristics, and clinical situations. 2 However, we may be able to improve dental fear by changes we can implement in-office to decrease triggering stimuli and promote relaxation.
THE START OF MY ANXIETY…
My earliest introduction to dentistry was a blur of tears and the sound of drills. Growing up in Romania,
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“Fear is only as deep as the mind allows.” — Japanese proverb dental care was limited at best. The modus operandi in those years was to instantly pull teeth that were hurting, dental cleanings weren’t a “thing” (they’re still considered a luxury there!) and seeing people in their early 20s with multiple missing teeth was the norm. The lack of comprehensive dental treatment and education led to rampant childhood caries. (At least that’s what I’ll try to blame it on, instead of my love of chocolate and dislike of brushing my teeth!) All my posterior deciduous teeth were riddled with decay. As a result, I have vivid memories of multiple visits to the dentist to have my teeth filled. The clearest memory, however, is not of pain or blood, but of the smell and sound. Zinc oxide eugenol was predominantly used, particularly for pedodontic restorations. The smell was so powerful and lingering, that for the rest of the day everyone within a 4-metre radius would know, without a doubt, that you’ve been to the dentist. The sound of various handpieces used by the dentist, given loving names such as “the bumble bee”, did little to assuage my fears.
PLANNING FOR THE FEARFUL PATIENT
Virtual consultations – For new and anxious patients, virtual tours of the office on your website can help the patient feel as though they’ve been there before. Treatment coordinators can field initial questions and assess insurance matters prior to the appointment, and time permitting, a brief meet and greet with the doctor can set the patient at ease for their upcoming examination. Companies such as Dental Monitoring® have streamlined remote assessment for
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convenience which can be particularly effective for the anxious patient. Weighted blankets – According to the ADA, “weighted blankets apply deep touch pressure. This is a proven technique to help alleviate anxiety and fear associated with dental treatments”. 3 Look into DentaCalm™, they provide heated weighted blankets that conform to disinfection protocols. Your lunchtime naps are about to reach a whole other level of comfort! Scheduling – Book nervous patients earlier in the day, such as first thing in the morning. There will be fewer other patients in the office and therefore fewer dental sounds to cope with. In addition, it prevents their apprehension from rising in level throughout the day. Seating – Bring the patient in as soon as possible upon arrival. Dental anxiety is shown to be “significantly higher in patients who had longer waiting time prior to treatment.” 4 Come on down! – Allow nervous patients to be accompanied by a friend or family member into the room if it makes them more comfortable.
ATMOSPHERE
Pet therapy – Human-animal interaction has been proven to benefit “stress-related parameters such as cortisol, heart rate, and blood pressure; self-reported fear and anxiety.”5 While you may want to keep the pooch outside of the operatory for surgical treatment such as implants, the CDC reports that “there is no evidence to suggest that animals pose a more significant
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risk of transmitting infection than people; therefore, dogs do not have to be excluded from such areas.” 6 Spa-like services – When you really want to spoil your patients. Commonly seen in dental spas, the treatments offered can include paraffin wax hand treatments, massage and relaxation therapy, aromatherapy, heated hand mitts and more. Music – Play relaxing ambient music in the waiting room. Include calming décor such carefully chosen art or an aquarium; exposure to natural environments can have calming and stress-reducing effects. 7 Lighting – When possible, use natural or ambient lighting rather than harsh fluorescent light. Glass doors – Sliding glass doors will minimize sounds and smells permeating through the office without making it feel too enclosed. Colour – Choose a colour scheme that is pleasing to look at and portrays the atmosphere you want to exude. Allow your personal preference to guide you, and remember that colours “limited in contrast will reinforce the ‘restful’ response, while colours selected from a range of high contract (dark to light) will elicit a ‘wow’ response”. 8
TECHNOLOGY
Computer-assisted local anesthesia – The Wand® offers a system to guide dental professionals in administering single-tooth anesthesia. Patients have found it “offers less pain and more contained numbness for the area that is being treated”.9
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“We are more often frightened than hurt; and we suffer more from imagination than from reality.” — Seneca challenge to the dental staff. The suggestions presented in this article are meant to encourage you to step into your own office as though you are a fearful patient, see which sights, sounds and smells may trigger anxiety, and assess what can be done about them. Implementing Virtual reality glasses – “Virtual reality (VR) has the ability to remove the association of fear, pain, and anxiety during patients’ dental visits.” 10 You have the ability to preselect a soothing theme that will help your patients feel relaxed and calm. Check out MeditainmentVR® if you’re looking to make your patients feel like they’re on a beach in Bali instead of getting a root canal! Air purifiers – A medical-grade air purifier can “remove chemicals, toxins, germs, odours, and most importantly they kill airborne viruses to help reduce the spread of illness”.11 Canadian company Surgically Clean Air™ has an excellent brochure online to have your office smelling fresh and clean, and remove the scents your acclimated nose no longer picks up.
START HERE
Netflix and noise-cancelling headphones – These can help patients who are sensitive to the dulcet sounds of your cavitron or “bumble bee” handpiece. Dental anxiety can be problematic for the dental office for multiple reasons. Anxious patients are more likely to cancel appointments and have a greater pain response. They can be irritable and difficult to work on, which translates to a significant
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some of these technologies or suggestions may set your patients at ease, establish your office as cutting-edge in technology, and amount to less cancelations and less stress for both your patients and your staff. Isn’t that something to smile about?
References 1 Cherney, Kristeen. “How to Cope with a Fear of the Dentist.” Healthline, February 7, 2020. https://www.healthline.com/health/mental-health/fear-of-dentist. 2 Appukuttan, Deva Priya. “Strategies to Manage Patients with Dental Anxiety and Dental Phobia: Literature Review.” Clin Cosmet Investig Dent 8 (March 10, 2016): 35–50. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4790493/#b1ccide-8-035. 3 “DentaCalm™ Adult - Product Profile.” American Dental Association. Accessed April 19, 2020. https://www.ada.org/en/publications/ada-dental-product-guide/ product-category/product-profile?productid=1775&catid=32. 4 Fux-Noy, A., Zohar, M., Herzog, K. et al. The effect of the waiting room’s environment on level of anxiety experienced by children prior to dental treatment: a case control study.BMC Oral Health 19, 294 (2019). https://doi.org/10.1186/ s12903-019-0995-y 5 Beetz, Andrea, Kerstin Uvnas-Moberg, Henri Julius, and Kurt Kotrschal. “Psychosocial and Psychophysiological Effects of Human-Animal Interactions: The Possible Role of Oxytocin.” Frontiers in Psychology 3, no. 234 (July 9, 2012). https://doi.org/10.3389/fpsyg.2012.00234. 6 “Background H. Animals in Health-Care Facilities.” Centers for Disease Control and Prevention, last reviewed November 5, 2015. https://www.cdc.gov/infectioncontrol/guidelines/environmental/background/animals.html. 7 Cracknell, Deborah, Mathew P. White, Sabine Pahl, Wallace J. Nichols, and Michael H. Depledge. “Marine Biota and Psychological Well-Being: A Preliminary Examination of Dose–Response Effects in an Aquarium Setting.” Environment and Behavior 48, no. 10 (July 28, 2015): 1242–69. https://doi. org/10.1177/0013916515597512. 8 Carter, Jeff, and Pat Carter. “Using Color in the Dental Office.” Dental Economics, April 1, 2013. https://www.dentaleconomics.com/science-tech/cad-camand-3d-printing/article/16393498/using-color-in-the-dental-office. 9 “The Wand.” Milestone Scientific Inc. Accessed April 19, 2020. https://www. milestonescientific.com/dental-solution/the-wand. 10 Schermerhorn, Lisa. “Can Virtual Reality Change Your Dental Practice? It’s Worked for Others.” DentistryIQ, January 10, 2020. https://www.dentistryiq. com/practice-management/patient-relationships/article/14074604/can-virtualreality-change-your-dental-practice-its-worked-for-others. 11 “It’s a Matter of Life and Breath.” Accessed April 19, 2020. https://surgicallycleanair.com/medical-dental/.
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ORAL HYGIENE
Irene Iancu, BSc, RDH, CDTP Irene Iancu has worked in various specialties including Paedo, Perio, General Practice and Orthodontics. Her goal in her current holistic practice is preventing and maintaining an optimal mind, mouth and body. Irene connects the systemic effects of oral conditions to her clients, while making a change for overall health and wellness. As a Peer and Quality Assurance Mentor contacted by the CDHO, a Clinical and Theoretical Dental Hygiene instructor at Oxford College, and a practicing dental hygienist in Toronto, Irene shares her passion for education with us today in the hopes we can change the lives of our clients and their loved ones. Irene can be contacted at Irene@toothlifestudios.ca, www.toothlifestudio.ca, IG: @ToothLife.Irene, @Toothlife, @Toothordare.podcast.
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THE NOT SO GRAND OPENING elcome back to part three of my article series, where did we leave off? In 2019, I shared the first steps that should be considered when opening a practice, a little sneak peek into the world of @Toothlife.Irene and the vision of my dream dental practice and studio. As a dental hygienist in the beaches of Toronto, the challenges were becoming my reality, but I was ready! I wrote about creating a business plan and finding financing, and I shared insights from my colleagues whom have had similar feelings when opening their own independent practices across the country. My vision was very clear. I set achievable expectations, targets and goals. My “to-do” lists were getting shorter and shorter and at
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times I even impressed myself with how laser focused I was, devoted to the process and completely committed to opening day. In my mind the champagne flutes were already filled, the electric violinist I found on Instagram was hired, and the grand opening invitations on crisp white vellum paper with a subtle hint of peppermint were already in the mail. Aside from the important stuff I mentioned about having a good accounting and legal team, figuring out the perfect location, working with awesome suppliers and contractors, there were quite a few things that I didn’t plan for. Shortly after my last article hit the blogosphere, we were all welcomed by an unexpected visitor, a teeny tiny little dream destroyer that froze time and all of my #goals.
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I’m not going to sit here like a keyboard warrior and complain about all of the things that held me back and crushed my opening dreams, what good would that do now? I choose instead to share with you the things I have learned, things I wish I knew, and perhaps some of the things I might change moving forward. I’m elated to share that Toothlife Studio celebrated eight weeks of being open on October 1, 2020. In the end, my mom was right again; you have to persevere, no matter what obstacles appear in your way out of nowhere. There was no champagne, no violins, and no crisp vellum paper. “Insert grand opening date here” remains an empty blank line on the Canva invitations I drafted what feels like a lifetime ago. As a team, we navigated 270+ new patients during what everyone said would be the hardest time to open a start-up. They were right. Navigating a start-up is likely one of the hardest things to do, and if you add a global pandemic to that COBB salad you can bet your CERB pay cheque that it’s a whole different experience. Here are some of the things I did.
GET YOUR WALLET HONEY, THIS LOOKS EXPENSIVE
My financial skills became necessarily savage during the office build. I decided to opt-out of a designer to save some money. My contractors likely thought I was insane but $100,000+ was a lot of cash to spend. So, I quit my high paying dental hygiene job as soon as I signed the lease, I cut back on teaching and I learned how to be a dental office designer. Seemed like a decent annual salary for an entry level designer such as myself. These days knowledge is at your fingertips, I didn’t need to index through my pristine gold-dusted 1990 limited edition Encyclopedia Britannica, to learn how an electrical circuit on a master switch operated, the different types of drywall needed in a commercial space to meet building
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code, or how to X-ray a floor to figure out if you can bring electricity and plumbing up to your dental chair through three feet of concrete. The internet is a powerful place and so are you when challenged. Sharing this entire learning experience brought me closer to the people in the community. I shared office updates during the build, the neighbourhood peeps would pop by and say hello or share a compliment about something that happened that week, like; “we follow your journey on Instagram, good job on the tiles!”. I used all experiences good, bad and at times disheartening, to share my journey with them as we worked hard to become a permanent part of their community. The journey remains documented in @ Toothlifestudio Instagram Story Highlights, as a reminder of how far we’ve come. I made friends with local business owners like a lovely couple across the street who own the local coffee spot. Morning Parade makes a mean breakfast brioche and Elektra’s Cappuccino is artistry in a cup. Budapest Restaurant has been around for a decade (try the chicken schnitzel) and the convenience store across the street is where we all go for our lotto tickets in hopes of hitting a jackpot. Local business owners keep the community alive, and I have helped out those who don’t have dental coverage. It’s turned out to be a good move, one
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“My mom was right again; you have to persevere, no matter what obstacles appear in your way out of nowhere.”
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every digital form from Yapi (one of the best software decisions I made, btw) needed to be reviewed word for word to ensure no element was missing. Some might say I had too much time on my hands, but if you asked me back in March, I was in a panic that any moment now the ban on elective care would be lifted and I wouldn’t be ready. I never felt ready. My friends who have children laugh; they say Irene back in March 2020 resembled a pregnant woman four weeks before giving birth. I was racing to get everything done before the finish line approached, little did I know the finish line was still four months away. I didn’t know I was making at the time. I just wanted to make some friends and, in the end, I also made some patients. Win-win.
LOCKED DOWN IN OP1
In January and February, we had a couple of floods. Minor, but at the time felt catastrophic. We were ready for our opening; March 2020 was the month, and I was mopping puddles in the kitchen and cutting holes in the drywall! Later in February, our dental chairs were “delayed due to bad weather,” which was a bummer and ultimately led to yet another delay in opening. Little did I know, that wouldn’t be the last reason to push my opening date. In March, elective dentistry in Toronto was shut down, and opening for emergencies wasn’t an option for me. So, I locked down in my office. I used to think I wasted the lockdown, but in hindsight, it was a mini blessing in disguise. I came to work every day, organized, cleaned, learned my software systems, created social media content, read books on business management like The first 90 Days and Radical Candor. I obsessed over making sure everything was perfect; every code needed to be manually checked,
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YOU ARE THE SUM OF YOUR EXPERIENCES
I graduated in 2007, and I wanted to use my 13 years of experience to create something magical. This includes four years in Perio, three in Pedo, a bougie Yorkville cosmetic practice, and overlapping seven years doing Ortho. This time was salted and peppered with both amazing and horrible bosses who inadvertently provided me the sum of my dental experience. I made a list of things I loved about every person or office I worked for/ in and naturally I made a list of things I hated. These experiences would determine what type of boss I want to be. These experiences, some that have held a place in my heart or brain for over a decade needed to be celebrated, and what better way to celebrate good practices than by repeating them and sharing them with a team of my own. Practices like the monthly meetings with Dr. Marvin Budd. We would sit in the same Elvis booth at Jack Astor’s and talk about anything but Perio surgery, and just get to know our fellow team members. The beautiful bouquet of flowers Dr. Cristina Udrea would give us all for our birthdays. Dr. Barry Lever’s generosity during the holidays. Dr.
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Dana Colson’s honourable mentions in the annual email to the entire patient base to recognize outstanding team members, and Dr. Carol Waldman’s team building weekends filled with laughter and delicious food. I needed to figure out a way to incorporate as many of these amazing gestures into my office finding my own leadership style. I’m still working on the “being a first-time boss” part; I’ll update you further on this journey once I have a few more months of experience under my belt.
THE MOM TRIBE IS STRONG
I have a toy poodle and I’d ride or die for Lou, but I’m told that love is 1000% intensified when you have a baby. I can see it in the faces and in the actions of parents bringing their little ones in for their first cleaning. In my Pedo practice life I learned this, and now in my practice ownership life, 10 years later, it is reaffirmed. Make an impression with the moms, take care of their babies, help them laugh, dance, smile and sing in your chair, and the moms will take care of you. This has been my experience in the last eight weeks. The Toronto Beaches has a healthy private Facebook parent group, which I was lucky enough to be mentioned in twice! A mom posted a lengthy Google review on our public business page and shared it in her network. Over the next few weeks, nearly three dozen tiny new patients were booked thanks to that one review and Facebook group recommendations. Setting up a new business isn’t finite or linear. Your plans and tasks are constantly changing, the to-do list gets smaller, then longer then smaller again. I believe it is my fear of failure that has given me fuel to work smarter, faster, and more efficiently. Temporary setbacks are always overshadowed by determination. You can do this too. All you have to do is start.
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ORAL HYGIENE
THE HYGIENIST’S PIVOTAL ROLE IN THE PATIENT EXPERIENCE
Dru Halverson, RDH, BS Chief of Advisor Development & Advisor, The Jameson Group Dru has worked as a business and hygiene advisor with Jameson since before its incorporation, and has proven herself as an effective advisor in both the management and clinical aspects of the consultation experience. As an advisor, Dru has worked with quite possibly the most diverse roster of clients – from specialty to general, single-doctor to multi-location, dental school residents to dental school practices – Dru goes above and beyond the standard of excellence in the field. For more information on Dru and Jameson’s management, marketing & hygiene coaching services, visit www.jmsn.com or call 877.369.5558.
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he hygienist plays such an integral role in the overall success of our relationship with our patients. From the work we provide directly with the patient, to the role we as hygienists play in passing the baton of goodwill to our doctors or business team members, how we execute each step of our hygiene appointments can build up or break down the relationship with that patient. Let’s review two major moments in a patient’s hygiene appointment where the team approach makes all the difference in the successful execution of a patient’s experience: The doctor-hygiene evaluation and the patient checkout.
THE DOCTOR-HYGIENE EVALUATION
Does your practice take the doctor – hygiene evaluation to the highest, most effective level to ensure that the patient says YES to restorative and periodontal treatment needs? Take your evaluation to a new level for your practice by following these steps below.
Get Prepared!
It is our responsibility as hygienists to investigate where the patient stands prior to the doctor arriving for the patient evaluation. There are many items to investigate. However, let’s focus on the items that will be ultimately important to have for the evaluation.
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• The patient’s goals for their mouth, teeth, smile. • The photos of the patient’s concerns and yours. • The necessary, diagnostic radiographs. • The periodontal comprehensive charting.
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Understand that the typical adult hygiene appointment should be approximately 60 minutes. This appointment can be divided up into three 20-minute increments. The doctorhygiene evaluation should happen in the middle 20 minutes of time. If the doctor comes in too early, all of the screening information cannot be gathered and reviewed. It is important for the hygienist to have some time to take and review the photos and radiographs with the patient so that they can begin to warm the patient up to possible active periodontal and restorative treatment. Many will term this as “pre-heating” the patient. If this has been completed before the doctor comes into the treatment room – the doctor can explain to the patient that there is no need for the option or the doctor may choose to move forward with diagnosing treatment. With the hygienist adding value and a higher level of trust with the patient talking through potential options –and a confirmation from the doctor, this approach builds a higher level of treatment acceptance.
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If the doctor comes in too late in the appointment, the patient is ready to get back to their day. They are not focused on or tuned into the evaluation and there will be a lower acceptance of treatment than you would experience if the doctor - hygiene evaluation happened in the second 20 minutes of the appointment. The TREATMENT ACCEPTANCE percentage should be at 85% at the FOUR MONTH mark.
Each developed treatment plan should be completed or started and moving through all phases at the four-month time frame. The Treatment Coordinator should keep the team abreast of the treatment acceptance; reviewing the statistics at the Team Meetings at least on a monthly basis. Be certain to celebrate the successes as you see your treatment acceptance improve.
How do you Pre-Plan to get in for the Middle 20 Minutes?
You must have an excellent Daily Huddle with your team and review with everyone. This is your organizational meeting to get prepared for the upcoming day. There are many items that need to be covered in this meeting and one of those items is to determine what hygiene appointments will require an evaluation and how you will come into those appointments between 20-40 minutes after the start of the appointment.
Performing the Doctor Hygiene Evaluation to Benefit the Patient
The doctor – hygiene exchange must happen at the appropriate hygiene appointment for the Adult or Child Prophylaxis and the Periodontal Maintenance appointments. When the doctor enters the treatment
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room, the hygienist must bring the doctor into the conversation. All of this allows the patient to build a strong relationship with both of you so that the patient will accept treatment all at once and more quickly in turn, getting the patient healthy.
Flow of the Hygiene Handoff to the Doctor
1. Start this as the Doctor enters the room and sits to get into the communication triangle with the patient. The communication triangle has the patient sitting up at the apex of the triangle with the doctor and hygienist sitting at eye level with the patient and an appropriate distance away from the patient. 2. Introduction of doctor if needed and transfer personal information. 3. Dentist: Either allow the hygienist to start the review or the dentist could ask, Jennifer, is there anything you would like to bring to my attention before we begin [Patient Name’s] evaluation? 4. Review the Health History update - meds or issues and status or conditions. 5. Mention the patient’s chief concern (or if no concern a review of the patient’s goals) and that you will get back to it during the evaluation. 6. Mention last treatment completed and comment/compliment. 7. Any appliance used or not. 8. Follow up on any referrals from last time. 9. Photos taken and comments. Pull up photos.
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10. Radiographs taken or not and comments. Pull up radiographs. 11. Doctor to really review the photos and radiographs. Move to look closely at these diagnostic images. 12. O ral Cancer Screening: first, tongue and throat. 13. Hard tissue: in order of quadrants, mention issues in the area as they come up, occlusion issues to be mentioned now. 14. Perio findings: good and bad. 15. Sit patient up and get back into the communication triangle and explain the diagnosis and treatment. The doctor will ask for the commitment to the next appointment. 16. Once the doctor leaves the treatment room the hygienist will review and wrap up any other questions or concerns that the patient has concerning today’s appointment or their next appointment. We know that you want all of your patients to be as healthy as possible. We must find ways to build stronger relationships with our patients. The more tightly they are tied to the dentist and the team emotionally, the more business they will do with you and your practice.
THE PATIENT CHECKOUT
It is important for each patient to be released in an effective manner. It is important for the hygienist to pass on the information. Great first impressions and parting impressions make certain that your commitment to their dental care stays on their mind. We know that a patient must hear
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the message a minimum of three to five times to understand and to own it. Our goal is to gather and record information to create “linkage communication”. At Jameson, we define linkage communication as communication that gets appropriate information from one provider or team member to another. We pass this on with our communication from the beginning of the appointment all the way through the check out process.
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Before you leave the clinical area make certain that you give a thorough review of the findings from the doctor hygiene evaluation. There are three very effective statements to remember to use through every step of the process. Use these to elevate your doctor - hygiene evaluation and the checkout process:
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Linkage communication of the clinical information to the business team member should flow in this fashion: 1. Work with the patient and your business team member to effectively communicate and support the patient’s ongoing decisions for healthy oral care through effective verbal skills, body language and partnership with the patient. 2. Review with the business team member and the patient what was accomplished in today’s appointment, what needs to be accomplished at the next appointment, and any questions that need to be addressed by that business team member. 3. Check in with the patient to make certain you covered everything, thank them for coming in and tell them that you look forward to seeing them at their next appointments. You can strengthen your ties to your patients through follow-up and thorough treatment in the hygiene appointments. Be the key to elevating the doctor - hygiene evaluation, supporting and clarifying the patient’s ongoing care and clearly and effortlessly linking them with the business team member for an effective patient checkout. Your role is pivotal in the ongoing engagement of your patients with your practice. Make sure you are taking the time and using the verbal skills and visual aids necessary to build the trust, value and relationship with your patients at every single appointment.
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ORAL HYGIENE
BREAKING DOWN BARRIERS TO AN EXCEPTIONAL HYGIENE DEPARTMENT What’s holding your team back?
Gabriele Maycher, CEO, GEM Dental Experts Inc. BSc, PID, dip DH, RDH A passionate educator with 30+ years of clinical and business experience, Gabriele has revolutionized the way practices optimize client outcomes, growth, and revenue through her consultancy company, GEM Dental Experts Inc. A former practice owner, dental hygiene program director, quality assurance program assessor, entrepreneur of the year, and thought leader for Crest and Oral B, Gabriele shares her innovative views on dental hygiene though her work as a public speaker, consultant, and business coach for forward-thinking dental practices. Gabriele can be reached at gem@gemdentalexperts.com or visit www.gemdentalexperts.com.
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s a clinical dental hygienist for 30+ years, it pains me to say this, but exceptional hygiene departments are not the norm in the dental industry. What do I mean by exceptional? I mean utilizing “best practices” in the treatment of periodontal disease resulting in optimized client outcomes (less than or equal to 3mm PD and zero bleeding). The American Academy of Periodontogy (AAP) reports that 86% of practices do not provide the standard of care to treat periodontal disease. Healthcare professionals report not having enough time to even probe on a regular basis, and the results are, frankly, devastating to our clients: 73% of practices are not diagnosing periodontal disease, leading to what the AAP calls an “epidemic” and what is known as “supervised neglect” in the dental profession. As a full-time consultant for the past 10 years, this has been my finding as well, unfortunately. The good news is that when given the opportunity, most hygienists want to practice according to the practice standards and codes of ethics set out by their college, but there are a lot of personal and practice barriers that get in the way of this goal. For starters, there is a lack of mentorship and practicum training
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for hygienists after graduation, a step that is seen as vital in other professions like medicine, architecture, law, and accounting. In some cases, a new grad may be the only hygienist in the office, armed only with his or her limited clinical experience. As a former program coordinator, I’ve questioned many times if the hygiene curriculum truly prepares our grads for entry-topractice, and what I hear from those on the front line is that practising dental hygiene in private practice is, in fact, different and that some of the fundamental concepts are lost in the transition. So, how do we bridge the gap in our treatment protocols and procedures and get back to providing optimal client care as it’s taught in school? It starts by removing some of the common practice barriers, limiting beliefs, and mental mindsets that can hold us back from becoming truly exceptional.
BARRIERS TO AN EXCEPTIONAL HYGIENE DEPARTMENT
None of the following “roadblocks” to success will surprise you. The question is: What are you going to do about them? In my years of clinical practise and consulting, these challenges are most often what’s holding hygiene departments back.
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Lagging support from the top. When discussing the benefits of building a forward-thinking, perio-focused practice, it’s not the dental hygienists that have to be convinced. They are almost always excited about the opportunity to up their game, hone their skills, and become even more proficient care providers. Instead, I’m often in the position of convincing the dentist that building a highly efficient, proficient hygiene department is worth the time and effort— and is essential in being able to provide optimal client care. Plus, a nice by-product is substantial practice growth and revenue. But let’s face it: Unless the dentist takes the lead, it won’t happen. In my experience, dentists tend to focus mainly on restorative care. And unless they have an affinity to periodontics, preventative care is often a neglected part of the practice. This becomes evident in my findings during chart audits. Most of the assessments collected are conducive to making a dental diagnosis but not a dental hygiene diagnosis. In most cases I am unable to
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determine a dental hygiene diagnosis because of insufficient radiographs to screen for all the possible periodontal conditions, the inability to see bone levels due to the type of radiographs taken, incomplete periodontal assessments, and inadequate notes. Developing systems and processes to support the practice’s vision of an exceptional hygiene department is essential. Consider getting an assistant for your hygiene team so more time can be dedicated to client care and ensure that all team members— not just your hygiene team—have been a part of the learning process in developing and implementing your vision. A great first step is taking professional development courses together so everyone is aligned to the same message and language. As for the hygiene team, you need to get back to the basics of what you learned in school. Implement ADPIE, the process of care, the way it was taught, comprehensively, every step of the way. Without proper Assessments you will not be able to determine an accurate Diagnosis,
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a logical Treatment Plan, effective Implementation, and your Evaluation will be pointless. Undervaluing your role as a health care provider. Most dental hygienist don’t value what they do. I hear it in the language they use, “you have a little bit of inflammation,” which only minimizes their role and the message we are trying to get across which is, “periodontal disease is a serious condition.” We know that 70-80% of clients have some level of periodontal disease and more than 90% of all systemic diseases have oral manifestations, which can lead to organ damage. By now we should understand that the impact of a skilled hygienist goes far beyond providing a “cleaning” and that by optimizing oral health we also optimize overall health. The team needs to make a commitment to stop using any verbiage that minimizes the impact of periodontal disease. As a profession, we have an ethical responsibly to inform the client of his or her condition and its consequences orally and systemically.
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Settling for uninformed consent. In most practices, treatment is based on insurance support rather than client needs because of our limiting beliefs about our clients and what they will and will not pay for. Worse yet hygienists allow clients to dictate treatment: “I only want what my insurance covers.” The truth is, our clients do have the right to choose their treatment and be active participants in their treatment, but unless a hygienist has explained the client’s periodontal condition, treatment options needed to achieve health, and the prognosis of not receiving treatment, the clinician has not received “informed consent” or “informed refusal” to treatment. This not only puts the hygienist in a position of liability but contravenes our code of ethics by taking away the patient’s right to choose. The practice of allowing insurance support and clients to dictate treatment is so engrained in clinicians that it takes most of my program to de-program this limiting belief and mindset. Believe me when I say, clients will pay for treatment over and above their insurance support if value is created. Unfortunately, selling “services” rather than “client outcomes” will never create value in our clients’ minds, and the price will always seem too high. You can start to change this dynamic by discussing what your treatment is trying to achieve, explain what needs to be done to get the desired outcome and give rationale based on the literature. From
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an administrative standpoint, your office mission statement and policies should adopt this mantra of focusing on client outcomes, and your team should be empowered to work toward achieving this goal. Doing so will invariably lead to evidence-informed treatment decisions and a hygiene team that’s aligned based on current evidence-based literature. Avoiding “the talk.” Hygienists are not comfortable talking about money, instead leaving it to the front end. But to get informed consent to treatment, the discussion about “how much is it going to cost” needs to happen. In the end, there still may be a difference between your recommended treatment and their accepted treatment based on insurance support and how much the client can afford to pay out of pocket. Remember, insurance support was not designed to treat disease, so support for dental or periodontal disease will likely be insufficient. And when you consider that most clients have some level of periodontal disease, this conversation will need to be had daily. So, it’s time to get comfortable talking about money. Instead of using verbiage that emphasizes the client’s insufficient insurance support, get excited about what their insurance does cover, emphasizing the fact that it will pay a portion of their necessary treatment. Financial discussions should not solely be left to administrators or treatment coordinators. Why?
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Financial discussions should not solely be left to administrators or treatment coordinators. Why? Because it is not in their scope of practice to offer alternative treatment options if a client is unable to afford the hygienist’s recommended treatment.
Because it is not in their scope of practice to offer alternative treatment options if a client is unable to afford the hygienist’s recommended treatment. Only a hygienist can do this. So with no other options and no further discussions with the hygienist, the client may simply leave without booking an appointment. This is the worst-case scenario, and it happens all the time. Not understanding the term “best practices.” This term is used in every profession but do we really understand what it means? The definition of “best practices” is: Treatments and interventions that result in consistent superior client outcomes which are measurable, reproducible, and based on the latest most current evidence–based literature research data, experience, and expert opinion. Knowing and integrating the new global 2018 AAP Periodontal Classification into the practice, at this time, would be an example of “best practices.” So, if you have not yet integrated the new system you are not providing best practices.
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PRESENTS
FROM PACKAGE TO PRACTICE
BECAUSE THE BOX MATTERS TOO… Join dental expert, educator and international speaker Irene Iancu as she reviews products from unboxing to patient care testing. The item is put to the patient test and highlighted in videos and images to show you, the reader, exactly how it ought to be used. To find out more or to submit your product for review, visit:
toothlifetests.com
Follow Irene on Instagram @toothlife.irene ORAL HEALTH GROUP
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@ORALHEALTHGROUP
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2020-10-26 2020-05-07 12:22 12:05 PM PM
2:05 PM
In an article by Dr. Mark Lin, “Bridging the Gap,” he reports that “it takes 10 to 20 years for new research to be reflected in everyday clinical practice.” I know this to be true through my own consulting experience. Rarely, if ever, have I read in clinical notes any reference to the last 1999 AAP Periodontal Classification, which was around for 20 years before being replace by the new classification. My favourite saying, as an educator is by Stephen Hawking, “The greatest enemy of knowledge is not ignorance. It is the illusion of knowledge.” Remember that when we graduate, we promise to our profession that we will be lifelong learners. Knowing, understanding, and implementing best practices is essential to providing exceptional client care. So, what does that look like in practise? Based on the literature, these are the metrics that an exceptional hygiene department should strive for: • Since most client have some level of periodontal disease, 70-80% of new clients should be in active nonsurgical periodontal therapy and not just getting a “cleaning.” • Depending on your practice demographics, approximately 65% of clients have periodontitis over 65 years of age. Of those clients, 48% have moderate to severe periodontitis and should receive quadrant or sextant scaling to achieve endpoint. • Once a periodontitis client always a periodontitis client; only managed never cured. We know more frequent maintenance appointments will sustain longer periods of stability so 50% plus of the practice’s clients should be on a 3M maintenance program. • Assessments for healthy and stable periodontitis clients is less than or equal to 4mm PD, less than 10% BOP and no 4mm pockets bleeding, otherwise the
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client should be put back into active nonsurgical periodontal therapy because of recurrence of their periodontitis. • Periodontitis clients should have a full mouth series to establish a baseline, to determine severity, complexity, and as direct evidence for the progression of the disease. Are these metrics possible? Not only does the literature support these numbers, but the practices that I have worked with have achieved them. So the answer is, absolutely! I strongly recommend your team learn and integrate the new 2018 AAP Periodontal Classification into the practice. With the new global classification, the future of periodontal therapy is moving away from an antiquated, biofilm-based model (which we now know only accounts for 20% of the direct risk of developing periodontitis) to a new holistic medical model that includes biofilms as well as predisposing and modifying factors. The new classification finally encompasses both oral and systemic factors in the treatment and prognosis of periodontal disease. It is a brilliant classification!
Remember that when we graduate, we promise to our profession that we will be lifelong learners. Knowing, understanding, and implementing best practices is essential to providing exceptional client care.
THE BOTTOM LINE
When dental hygienists are encouraged and supported to work according to their practice standards and codes of ethics with a focus on optimal client outcomes, practice growth will explode! Not only will you have that elusive exceptional dental hygiene department, you’ll find tremendous satisfaction in your role as an outstanding healthcare professional.
References 1 Foundations of Periodontics for the Dental Hygienist, 5th Edition, Jill S. NieldGehrig, Donald E. Willmann, 2019 2 Oral Health Magazine, Nov 2019, “Bridging the Gap”, by Dr. Mark H.E. Lin, Editorial 3 2017 World Workshop Articles • J Clin Periodontal. 2018;89(Supple 1):s9-S16. Periodontal Health, Niklaus P. Lang, P. Mark Bartold • J Clin Periodontol. 2018;45(Suppl 20):S68-S77. Periodontal Health and gingival disease and conditions on an intact and a reduced periodontium: Consensus report workgroup 1 of 2017 World Workshop on the Classification of Periodontal and Peri-Implant Health. Chapple_et_al-2018.JP • J Clin Periodontol. 2018;89(Suppl 1):S159-S172. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. Tonetti_et_al-2018-JP. • J Clin Periodontol. 2018;45(Suppl 20):S162-S170. Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Disease and Conditions. Papapanou_et_al-2018-JP.
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ORAL HYGIENE
STREAMLINING INSTRUMENTATION
Kathleen Bokrossy, RDH Kathleen is the president of ‘rdhu’, a Professional Development company, which provides team events, handson programs and online learning. Kathleen founded and sold a dental instrument company, had her own line of dental hygiene instruments and has participated in writing a chapter on instrumentation in a US textbook. Kathleen’s passion and vision is to help ‘Transform the Dental Hygiene Experience’ for dental hygienists, practices and their clients/patients. www.rdhu.ca
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s we try and get used to our new normal, we need to look for ways to make our days run more smoothly and more efficiently. We need to implement processes to make our days run a little easier in the midst of so much emotion, frustration and fatigue. Figuring out a way to try and accomplish all we need to do in an appointment and then prep our op and prepare for our next client/patient has become such a challenge. The way we used to practice is in the past. We cannot expect to move forward doing things the way we always did. As the popular quote from Gracey Murray Hopper demonstrates ~ “The most damaging phrase in the human language is ‘We’ve always done it this way’.” This was intended to reflect the need to constantly think forward, rather than look backwards, which is essential in times of disruption and change. Doing things the same old way is a recipe for disaster. One of the processes you can reexamine and rethink (and easily change), is to take a look at the flow of your instrumentation. Two major changes have occurred, which makes it no longer acceptable to manage your instrumentation the “same old way”.
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1. COVID has left many dental hygienists providing non-aerosol procedures only. 2. Due to IPAC concerns, most regulatory bodies have eliminated the ability to maintain/ sharpen instruments chairside. You have to re-think your instrumentation flow, because streamlining your instrumentation process will help you, your clients and your practice. As you think about your new process, ask yourself these questions: 1. Do you have enough instrument kits to get you through the day? 2. Are you compromising client care and your health by using dull instruments? 3. Have you scheduled a time in your day to sterilize instruments, sharpen and then re-sterilize? 4. Could you use a hybrid instrument so that you are using one instrument instead of two? This not only saves money but also is an efficient application during instrumentation. 5. Are you using all the instruments in your kit? Rethinking your instrumentation flow is one area of treatment care
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that should not be overlooked, especially during these uncertain times where many dental hygienists are providing non-aerosol procedures only and are hand scaling exclusively. Working with sharp instruments every time is essential. We should not compromise client treatment. We should not compromise our own health. Working with dull instruments will have a great impact on the treatment your clients receive. They will not receive optimal care; they will endure unnecessary pain and discomfort and they will spend longer time in your chair. It would be similar to the dentist trying to do a prep with a dull bur. It can’t and shouldn’t be done. It is ineffective and inefficient, and we are not meeting the Standard of Care. Working with sharp well-maintained instruments will also help prevent fatigue for the clinician. We have all worked with dull instruments at one time in our careers and we know the effect it has on us. If you would like to prevent major fatigue at the end of the day and prevent repetitive strain injuries, you must never compromise. Not once. Streamlining your instrumentation will help your office save money in the long run and at the same time will help prevent fatigue and burn-out of the clinician all the while providing optimal care to your clients and patients. Having enough sharp instruments on hand is essential. Do you have time set aside to open sterile instrument pouches and sharpen and then re-sterilize? At what time of the day are you doing this? Are you doing this at the end of a long day or are you sharpening during your lunch hour? Or worse yet, maybe hardly ever? Sharpening instruments has now become a major task, as most provinces can no longer sharpen
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PERIODONTAL HEALTH, GINGIVAL DISEASES AND CONDITIONS Diagnostic Kit • Mirror, Flexplorer, Probe *The flexplorer is a favourite and a must-try. Along with the light silicone ergonomically designed handle, one of the features is a very fine wire tip that increases tactile sensitivity. Treatment Kits - There are 2 options to choose from. Option 1: For dental hygienists who prefer Universal Curettes over Area Specific Curettes Universal Kit • SharpJack - Universal Sickle: both anterior & posterior • COL 4R/4L - Universal Curette: great ‘go to’ for posterior region • BH 5/6 - Universal Curette: can be used both posterior & anterior Option 2: For dental hygienists who prefer Area-Specific Curettes Area-Specific Kit • SharpJack - Universal Sickle: both anterior & posterior • Anterior-Syntette: Combination of GR 1/2 & GR 7/8 Curettes • *Syntette: Combination 11/12 & GR 13/14 Curettes *Available in a mini or standard blade *Flexplorer
www.oralhealthgroup.com
*Syntette
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chairside due to IPAC concerns. We now need to sterilize our instruments, sharpen and re-sterilize prior to use. This has created another task that needs to be done outside of client care hours. It has also created a waste of sterilization pouches, cycles and Chemical Indicators; which is a waste of money and has an environmental impact. Sharpening chairside is a thing in the past, we must move forward and look for an alternative solution. Using Sharp Diamond, SharpenFree instruments by LM Dental, will help eliminate the task of sharpening and will provide you with all the benefits of using sharp instruments. The LM Sharp Diamond instruments are treated with a new micro membrane coating using modern Physical Vapor Deposition (PVD) technology. This technology offers features such as being completely sharpen-free, tough but refined. The Rockwell Hardness scale is 62 which contributes to the durability of the instrument. Studies have proven that there is an 82% decrease in wear compared to typical dental hygiene instrument material. Should our kits be a one-size-fits all? Not at all. Why did we start off in our careers with the same instruments in every kit? Are you using every instrument, in every kit, every time? Most likely not. When we do this, we are putting the unused instrument(s) through unnecessary sterilization; thereby, shortening the lifespan of the instrument.
Periodontitis Kits Stage I - Diagnostic Kit • Mirror, Flexplorer, Probe Perio Kit • SharpJack • COL 4R/4L • *Anterior-Syntette • *Syntette *Available in a mini or standard blade Stage II, III & IV Kits - Diagnostic Kit • Mirror, Flexplorer, Probe, Furcation Probe Perio Kit: (same as Stage I) • SharpJack • COL 4R/4L • *Anterior-Syntette • *Syntette *Available in a mini or standard blade Additional Kit • M23: Similar shape to the 204S but larger and allows better posterior interproximal access • Furcator • GR 1/2 mini • GR 15/16 mini • GR 17/18 mini *The Furcator is ideal for CL I & II Furcations and has a spoon-like working end. *The mini blades are ideal for CL III & IV Furcations.
PERI-IMPLANT DISEASES AND CONDITIONS Implant Kit #1 • Mini Universal Curette • Mini Gracey ½ • Mini Gracey 11/12 • Mini Gracey 13/14 Implant Kit #2 • Mini Universal
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www.oralhealthgroup.com
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HARDNESS
The LM-ErgoMix is a great instrument series for implant maintenance. Their structure ensures excellent tactile sensitivity and optimal rigidity. Tips are made of sensitive but still effective titanium, which will not harm the abutments. Whenever there is a need for a tip replacement the lock grip is opened, a new tip is inserted and the lock grip is closed again. No extra tools are required. This ensures that your implant instruments are in optimal condition, minimizes waste and allows you the opportunity to personalize your tip combinations. Depending on the type of practice you are working in, will depend on the number and type of kits you will need to have available.
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Excellent Wear Resistance
Hardness contributes to the durability of the instruments. Sharp Diamond reach hardness of over 63 on Rockwell scale.
Basic Wear Resistance
Many dental hygienists typically use what the office provides them and what has always been ordered. When we look at what is in a typical hygiene kit, we often see an anterior sickle scaler, a posterior sickle scaler, a Universal Curette and 3 or 4 of the most popular Gracey’s. From a mindset and/or engagement aspect, when we create unique tray set-ups it helps the dental hygienist get re-engaged with her/his day as well. By looking and preparing for the day the night before or morning of and looking at what clients are coming in and preparing what type of kit will be needed, will help break-up some of the mundane tasks many dental hygienists feel when providing hand scaling every day. Based on the Classification of Periodontal and Peri-Implant Diseases and Conditions’ we created a Decision Tree for Instrument Selection using mostly instruments that are in the Sharp Diamond line by LM Dental. This will help streamline your instrumentation protocols. See chart starting on Page 21.
LM Sharp Diamond
Competitor Typical Dental Instrument (coated) Steel (uncoated)
Streamlining your instrumentation has so many benefits. We need to look for ways to implement efficiencies into our new workplace and at the same time continue to deliver quality care and an exceptional client experience. This is the time to implement change. We work so hard at getting new clients and patients into our practice and at the same time want to keep a loyal and happy dental hygiene team, as hygiene is the backbone to a successful practice. We often create a negative experience by cutting corners and costs on what I think, is one of the most important part of the dental hygiene experience. Transform the Dental Hygiene Experience, for your client/patients, your practice and yourself as the clinician, and implement an instrumentation protocol to ensure that your clients are receiving the best care and that your dental hygiene team are using optimal instruments. To receive a download of The Decision Tree for Instrument Selection visit www.rdhu.ca/instruments. I recommend to print and laminate for easy reference.
www.oralhealthgroup.com
By looking and preparing for the day the night before or morning of and looking at what clients are coming in and preparing what type of kit will be needed, will help break-up some of the mundane tasks many dental hygienists feel when providing hand scaling every day.
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Product Review By @Toothlife.Irene
Phillips ZOOM WhiteSpeed Lamp This month’s product for review is Phillips Zoom In-Office whitening system which is clinically proven to whiten teeth up to 8 shades!
UNBOXING 3 packages arrived neatly and carefully packaged. Including a large box with patient kits, take home and in-office whitening materials and a neatly rolled up box with marketing posters and material. In the largest box the treatment lamp for in-office treatment treatments was carefully and safely packaged. Detailed instructions on how to assemble were included, but with such an intuitive design we were able to assemble the pieces effortlessly without the use of any tools other than a provided hex key.
SOMETHING I LOVED! I’m absolutely obsessed with the 3 LED light intensities to better control operative sensitivity, or the potential of it. We conducted 2 sessions at “High” one at “Medium” and the final at “Low”. The Price point is competitive but offers a great product the WhiteSpeed Lamp will run you about $1,649 and the Patient kit ranges between $185$205 (for 2 patients) which puts the cost of treatment per patient at a super reasonable amount for a great predictable outcome.
SCIENCE Phillips has been perfecting their system for over 10 years and is available in both Canada and the US markets. Their Advanced blue LED technology provides about 50K hours of use, reducing operating costs, downtime and decreasing energy consumption by 40% over previous models.
PATIENT SELECTION When selecting a patient for treatment here are some disqualifying characteristic to consider: • Periodontal involvement; • Failing restorations; • Overall unhealthy oral health and overall health, Consulting with a physician is a good idea if you’re concerned about medical contraindications; • Women who are pregnant of breast feeding; • Not recommended for those under the age of 13. My amazing patient was fantastic, with limited experience whitening his teeth and a tobacco user he was very excited to brighten his smile and we both were really happy when we we achieved 6 full shades within 4 sessions of 15 minutes. Predictable outcomes with whitening is something we dental peeps love, working smarter not harder is the #Goal. To see more reviews, please visit www.oralhealthgroup.com/toothlife-tests/ SPONSORED CONTENT
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Dental Marketplace Contact: Karen Shaw | 416-510-6770 | 437-991-7187 | karen@newcom.ca fax: 416-510-5140 | toll free CDA & USA: 1-888-639-2669
OPPORTUN ITIES IN TH E D EN TISTRY PROF ESSION
H YGI E N I STS GREATER EDMONTON AREA FULL-TIME & PART-TIME HYGIENISTS Hourly/Commission based salaries 1st location Calmar, AB (20 mins from South Edmonton) 2nd location Wetaskiwin, AB (30 mins South of Edmonton) 3rd location (1hr East of Edmonton) Contact Admin@AlbertaDentalCare.ca or Phone/Text 780-233-9300
MOUNT PEARL, NL FULL-TIME MATERNITY LEAVE POSITION (PERMANENT) Bannister Street Dental is seeking a Registered Dental Hygienist for a full time maternity leave position beginning November 30, 2020. This position will become a permanent position in the future. Please forward your resume to reception@bannisterstreetdental.ca
WHITEHORSE DENTAL CLINIC WHITEHORSE, YUKON – LAND OF THE MIDNIGHT SUN 2 FULL TIME DENTAL HYGIENISTS REQUIRED Very busy practice located in the beautiful city of Whitehorse, Yukon. Large patient load with a continued flow of new clients. One of the oldest and most established practices in the Yukon. Whitehorse has a population of 30,000 and growing. Skiing, hiking, fishing and fantastic mountain bike trails…. all out your back door. Don’t let this opportunity pass you by. Apply by email to pinedental@northwestel.net
ASSOC I AT ES H I P S CALGARY AND SURROUNDING AREAS Oak Dental Group is currently looking to hire an associate dentist for our busy well established practices. The successful candidate will have a strong passion for building patient relationships and is proficient in performing regular checkups and complex dental procedures and is committed to the highest quality of patient care. Those who are qualified and in search of a long-term career opportunity are encouraged to submit an application today. E-mail: clinicalmanager@oakdentalgroup.ca
NORTH YORK – TORONTO, ON ORAL SURGEON Established North York clinic seeking an oral surgeon to practice once a month on a Friday, must have a nurse to work with. E-mail: islingtondental@gmail.com NOVEMBER 2020
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GRAND VALLEY, ON BUSY OFFICE LOOKING FOR A PT ASSOCIATE FOR TUESDAYS AND THURSDAYS PT associate opportunity available in a very busy high tech, digital office. Candidate should be motivated and patient-care focused to join our excellent, skilled and friendly team. Email: manager@grandvalleydental.ca
HIGH PRAIRIE, AB Wanted! Full time associate to start immediately in a busy established Northern Alberta Practice. Please email resumes to manager@hpdentalcentre.ca or call Nola @ 780-523-4448.
THOMPSON, MB ASSOCIATE DENTIST WANTED Our team at Westwood Dental clinic is looking for a motivated team player, experienced dentist in endodontics and oral surgery. To apply email: alln1963@yahoo.com
www.oralhealthgroup.com
YELLOWKNIFE, NT REGISTERED DENTAL HYGIENIST The Adam Dental Clinic has an immediate opening for a permanent, full-time RDH. The ideal candidate should be motivated, energetic, career minded and must be able to communicate effectively with patients and colleagues. All experience levels welcome. We offer: $100,000+ per year Well established practice 36 guaranteed hours per week Extra hours available Benefit package E-mail: info@admandentalclinic.ca
CA R E E R S CHATHAM, ON Immediate position available for a Level I or II Certified Dental Assistant as well as a Registered Dental Hygienist. Please apply to downtowndentalchatham@bellnet.ca
LOCUM DENTIST Locum dentist available for NUNAVUT, YUKON, NWT and Northern BC. Great experience, Great passion for caring and superb dentistry. Loving the Outdoors. Looking forward to work with a passionate team.
E-mail: dr.rahn@hotmail.com
ASSO C I AT ES HIPS OSHAWA, ON East Oshawa Dental Office seeking Part-Time leading to Full Time associate for busy established family clinic. Oral surgeon, periodontist, orthodontist and endodontist on site. State of the art facility including Cerec scanner, milling machine and CT scanner. Great location and community 40 mins East of Toronto. Please send resume to: kathy.eastvillagedental@gmail.com
WINNIPEG, MB Well established dental office in Winnipeg with great new patient flow is looking for a full time Associate. Should have min. 2 years of experience and should be willing to work evenings and Saturdays. Ability to do endo is an asset. Please send your resume to r.c.sandhu19@gmail.com
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ASSO C I AT ES H I P S OSHAWA, ON LOOKING FOR PART TIME CERTIFIED ORTHODONTIST (Licensed in Canada) We are a progressive general practice open 6 days a week. We offer all dental services in one location (Oshawa). Our current orthodontist is moving forward with a teaching position and we are looking to continue our Orthodontic program. Preferably Mondays 9-5 and we are able to run two ops with trained clinic staff . Email CV to ocdental@rogers.com
NORTH YORK – TORONTO, ON ENDODONTIST Busy North York clinic seeking an Endodontist to practice on a monthly basis to start. E-mail: islingtondental@gmail.com
FAMILY DENTISTRY & IMPLANTS
515 5th Street South, Lethbridge, Alberta Toll-Free: 1-800-552-8053 Office: 403-327-7227 Fax: 403-327-8816 Website: www.abledentalgroup.com
SEEKING FULL-TIME ASSOCIATE TO JOIN OUR FAMILY, IN A BUSY AND MODERN DENTAL PRACTICE IN MEDICINE HAT, AB – #10, 2020 Strachan Road S.E., Medicine Hat, Alberta, Canada OUR CLINIC IS EQUALLY WELL SUITED TO EXPERIENCED DENTISTS AS WELL AS RECENT GRADUATES WHO ARE PASSIONATE ABOUT PATIENT CARE. THE SUCCESSFUL CANDIDATE MUST HAVE Alberta practice permit and one to four years of pre-dentistry university studies, and a university degree from a recognized dental program. BE SKILLED IN THE FOLLOWING: • ALL ASPECTS OF GENERAL DENTISTRY INCLUDING CLINICAL DIAGNOSIS TREATMENT PLANNING • MUST BE A TEAM PLAYER AS WE PRIDE OUR COMPANY’S SUCCESS ON TEAMWORK AND PROVIDING A TEAM ENVIRONMENT • COMFORTABLE WITH MOLAR ROOT CANALS, SURGICAL EXTRACTIONS, COMPLETE AND PARTIAL DENTURES, CROWNS. • PROFICIENT IN ENGLISH AND THE ABILITY TO COMMUNICATE WITH A MULTI-GENERATIONAL CLIENT BASE • DESIRE FOR CONTINUED GROWTH PERSONALLY AND PROFESSIONALLY
ST. CATHARINES, ON Looking for a part time dental associate for an established practice in St. Catharines. Email CV to: niagaradental168@gmail.com
JOB DUTIES: • Examine patients' teeth, gums and surrounding tissue to diagnose disease, injury and decay and plan appropriate treatment • Restore, extract and replace diseased and decayed teeth • Perform oral surgery, periodontal surgery and other treatments • Clean teeth and instruct patients on oral hygiene • Design bridgework, fit dentures and provide appliances to correct abnormal positioning of the teeth and jaws, or write fabrication instructions or prescriptions for use by denturists and dental technicians • Supervise dental hygienists, dental assistants and other staff.
LLOYDMINSTER, AB Modern and nicely equipped clinic with a well established and growing patient base seeking a full-time or part-time Associate Dentist. Experienced or new grads welcome. Paid on PRODUCTION! Contact: admin@oriondentalgroup.ca
FERGUS, ON We are looking for a periodontist and an orthodontist to come to Fergus, Ontario 2 days per month. We are also interested in having an endodontist come once a month or once every two months. Please send resume to reception@drmauramckeown.ca Attention: Sandra
PLEASE CONTACT OUR OFFICE TO ARRANGE AN ON-SITE MEETING AND VIEWING
BURLINGTON, ON Our well established, high tech, multi chaired, family dental practice is seeking a PT energetic associate to join our expanding team. This is a great opportunity for a self-motivated individual to invest themselves long term. This position offers excellent earning potential and very high new patient flow in the rapidly growing area. E-mail resume to mgc@ldhadmin.ca
We are seeking an associate dentist to join our team. We are a busy clinic with state of the art technology. We are looking for a caring, respectful dentist with a minimum of 2-3 years experience or GPR/AEGD. Must have excellent communication skills to build a rapport with an established clientele. The successful candidate must meet challenges with any type of oral health situations. We offer competitive percentage remuneration with full time hours. Please forward resume to E-mail: jobs@peakdentalgroup.ca and liliana@peakdentalgroup.ca
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LONDON, ON Full-time associate needed for a busy practice in London. Minimum 3 years experience is required. The start date is Jan 1, 2021. E-mail: nathanchodds@gmail.com
KINGSTON, ON AT THE HEART OF THOUSAND ISLANDS Full time associate position for a very busy modern clinic. M-Th 8-5. Send CV to jlpmanthorne@me.com
BRAMPTON, ON
CALGARY, AB ASSOCIATE DENTIST
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ANGELA MURRAY – OPERATIONS MANAGER angela@abledentgroup.com – tel: 403-327-7529 ext 261
www.oralhealthgroup.com
Well-established, busy Brampton office seeking experienced associate dentist. Must be familiar with all aspects of dentistry, self-motivated, enthusiastic and excellent communication skills. Send resume to dentalspots@gmail.com
SARNIA, ON Busy office seeking associate M-T. The candidate should place primary focus on providing quality care and forming relationships with the patients. E-mail: chad19@hotmail.com
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