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trends, innovations, and quirks of dentistry

The gum whisperer

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First things first: yes, this “whispering” phenomenon has invaded every niche of our well-being. It all started in a novel with just this one guy, he whispered to horses, then Cesar Millan got famous shushing dogs on TV. There are book whisperers, baby whisperers, ghost whisperers. OMG, there’s even a Bra Whisperer if you need someone to speak quietly with you or your wife’s upper anatomy.

So I just realized the other day that, I am, in fact, the gum whisperer.

Is it because I’m the world’s utmost authority on periodontal disease? Do I have such a kingdom of knowledge that it only makes sense to become an intellectual philanthropist to my patients and can cure them of every infirmity that sits just inside their lip line? Do my mad hand skills mean that I can strip only the glue off of a postage stamp with a Gracey 13/14 while it’s still stuck to an envelope behind my back as PROOF of my superior subgingival scaling abilities?

No.

I am the gum whisperer because… I actually whisper to people’s gums.

“Hang in there, interproximal gingiva! Give that #5 an extra squeeze for me today because that class II mobility is making my probe shake.”

When you’ve given up trying to convince the lifelong smoker that nicotine is his enemy, sometimes it’s just time to try a new approach. Maybe the person attached to those gums will think you’ve gone a little cray-cray, or maybe, just maybe, they might realize that you’ve started digging into your bag of desperation because they just don’t want to hear what you have to say. They’d like to give you their problem instead of dealing with it themselves.

Years ago, I took care of a patient that was into visualization, in a new-agey kind of way. She asked me to paint pictures and describe what healing needed to take place in her gums, so that she could create a pathway for sending her healing energy into the periodontium. I dunno, it was kind of soothing for me, too.

So occasionally I’ll speak softly to a patient as I’m nudging their gums, kind of like scratching a dog’s belly, “You like that, yes you do, yes you do!” Well, not that silly — definitely more clinical-minded because really, I don’t want people to start asking me to read their auras or anything like that.

Please let me know if you’ve found yourself talking to teeth, tongues, whatever body parts have engaged your healing linguistics, so that I don’t feel so all alone in this situation. And if I really am crazy, then it’s probably best not to let me in on the truth.

 

 

How do you say “titillating” in Japanese?

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If you think that this sort of thing doesn’t happen here in the US, you’re wrong. Only we don’t use boobs, because that’s too obvious (not to mention, quite unacceptable in our culture). When times are tough, desperation can drive dentists to other ethical edges, like hiring only hygienists that are willing to sell unnecessary treatment to patients… instead of their own bodies.

 

Japan’s zoftig hygienists keep dental patients coming back for tender, rubbing care

A clinic hires only cute women in order to attract patients

by Kazutaka Shimanaka, The Tokyo Reporter

I was so shocked, my jaw was hanging in astonishment. After all, I am a dental hygienist.”

So says Hiromi, a 24-year-old native of Shizuoka Prefecture, who, after graduating from an occupational training school, sought work in a Tokyo dental clinic as a hygienist.

“The head doctor’s a real slimeball, he only hires cute women in order to attract patients,” she reveals to Shukan Taishu.

Hiromi and three cute colleagues at the clinic filled out their tight, white uniforms, which in addition to exposing cleavage are also designed to show lots of leg.

“The clinic attracts salarymen working in the area,” she says. “We were told the uniform went with the job.”
About three months after she was hired, Hiromi was told by the doctor to emulate an older assistant named Megumi. While the sensei was filling a patient’s cavity, Megumi would lean up against their shoulder, giving them a generous feel of her substantial mammaries.

So good was her service that the patients were in the practice of requesting Megumi by name when they phoned for an appointment.

“Well then, I’ll give the patients an oppai (tittie) rub, the way Megumi does,” Hiromi informed her employer, who nodded in approval.

“Please do understand that in this business, times are hard, and that’s what we’ve got to do if we want to eat,” he explained. “If you emulate Megumi, patients will be able to disregard their pain, and want to come back again, you see? It’s a good form of communication beween the hygienist and the patients. And they’ll come back for more expensive treatments that aren’t covered by their health insurance.”

Actually Megumi was extremely talented in persuading patients for such elective services, cooing softly into their ear as she motherly nudged them, saying things like, “Rather than a silver crown, which will make you look older, a ceramic one will be much more attractive.”

But then something happened that discouraged Hiromi from working at that particular clinic.

It seems that while removing tar stains from the teeth of a middle-aged patient, he began returning the skinship, using his shoulder.

“He also began licking my finger while it was in his mouth,” she complained.

No longer able to restrain himself, the patient shifted to a full manual assault on her breasts, to which she loudly voiced her objections.

The head of the clinic, seeing that the patient was a good customer, told Hiromi to grin and bear it, and she resigned in a huff.

“The market for dental clinics in Tokyo is saturated, with more clinics than convenience stores. The situation has become severe,” says 26-year-old physician Mariko Yamashita. “What’s more, other businesses have been draining off dental patients, such as cosmetic surgeons who perform implants and estheticians who can do tooth whitening.”

In the past, dentists were once one of Japan’s “big three” most profitable operations, along with pachinko shops and obstetricians. But those days are gone for good.

“Patients who used to go running to their dentist whenever they felt a twinge of pain now refrain, or else only request work that is covered by their health insurance,” journalist Junji Maki tells Shukan Taishu. “That’s why I suppose clinics have become increasingly aggressive in efforts to attract more patients.”

A recent white paper on dental care reported that dentists need to treat 20 patients per day to break even, and that one dentist in five earns less than three million yen per year — less than the average cab driver.

Under such circumstances, the article concludes the emergence of doctors who expect hygienists to perform “breast massages” on patients may be a harbinger of a coming collapse in the dental profession. (K.S.)

Source: “Bijin shika eiseishi ga kokuhatsu! Shika iin no oppai eigyo gyoten jittai,” Shukan Taishu (August 6, 2012 issue, page 190)

 

 

Christmas in July

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Forget the holly-hauling, fruitcake-slicing, and carols at the spinet. We have a whole new way to usher in a little Christmas where we need it, right this very minute!

You just got a puzzled look on your face. This is stupid, you say. What do these small, wet disposable towels that you use to rub all the potential spittage off of your x-ray sensors and keyboards have to do with Christmas?

Maybe a little of my rusty singing will be enough of a hint:

Here comes Sani-Cloth, here comes Sani-Cloth. Right down Sani-Cloth Lane. ♫

Take your face out of your palm now. Bad punnage will do that. sorry.

So. This all started about a month ago at an ophthalmologist’s office after waiting a painful amount of time in a quiet, poorly-lit room. The only entertainment was a red container of these towels, and prone as I am to fits of absurdity, I started cackling and generally cracking up because the ones we use in our dental practice are green, and of course I noticed the name of these things for the first. time. evah. Red. Green. Sani-Cloth.

*chortle*

*snort*

Sani-cloth. I’m a blind elf with a lisp. Does Sani-Cloth work with Hermey the elf? He wanted to be a dentist, not an optometrist. Ho Ho Ho!

*hiccup*

And here’s the WORST. worst worst worst example of what happens when humor strikes at the wrong time.

I had thoughts about Sani-Cloth on July 4th.

Only problem was, that day, I was with my extended family in an ICU unit, and my dearest, most precious, 92 year old grandfather was in his last moments of life. Right there, I picked up the red canister that they used in the hospital room, just like in the ophthalmology office, just like in our dental practice, and gave an appropriate preface to the punchline. Then I delivered it.

Ummm. Awkward bomb.

But my grandfather, this joke was right up his alley.  He loved puns. In my mind I could hear his own special delight sound made to reward my well-paced dork moment.

Iz Zat You, Sani-Cloth?

I sang gently off-key, in Grandfather’s ear, with his hospital caregivers using the wipes to protect all of the armamentarium in the room from the ick of the world that we, his family, had probably brought with us when we were welcomed into this final sanctum.

He died just after midnight, a few hours later after I’d told him the last joke he would ever hear.

Thank you, Sani-Cloth, for your wet-wipe wellness, and for being at an absurd yet expected place at a sacred time. And thank you, Grandfather, for sharing your sense of humor.

*sniffle*

 

 

Also, a ton of gratitude goes to my cousin Greg for posting this video tribute to our grandfather on YouTube. And that first song? That was the one I just happened to be singing off-key in his ear at the hospital… 🙂

Dental office acronyms

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One of my favorite dental blogs is the AGD’s The Daily Grind, with today’s post by Scott Jackson, DMD, MAGD sticking up like a wonderful, poignant nail that wants its head to be hit by this hammer of humor awareness. BAM! BAM! BAM!

In the midst of savoring life, Scott has also realized that textual shortcuts just might be the future of communicating in his dental practice, and so has offered up a few acronymic suggestions to ease the conversations in your office as well:

IGS……..I’m going to scream
WWIT…….What was I thinking?
DAPDA……Dog ate patient’s denture again
LCNHLTP….Lab case not here, lie to patient
IHDD…….I hate doing dentures
INAV…….I need a vacation
CTOSN……Call the oral surgeon, NOW!
IPTDS……I perforated the darn sinus
YAIOTP…..Your attorney is on the phone
INAGOW…..I need a glass of wine
SMAY…….Staff mad at you

There’s more!!!! but you’ll have to go here to read them, because that’s just how it works, this blogger thing. Borrow a few and it’s teasing and plugging. Take ’em all and it’s stealing. And if you have a hammer, well, aren’t you just supposed to hit nails on their heads when they make you smile with dental humorosity?

I now feel the urge to add a witty acronym of my own, but it would probably be something suckie uppie like:

SWTB……Scott writes them better.

 

 

Postcard from a square operatory

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Originally published in the May 2012 British print magazine Dental Hygiene and Therapy, this article was written as a snapshot of life as a hygienist in these United States, delivered as a postcard to the UK, and corrected to their spelling preferences. So if your spell-check throws up all over this piece, just remember, the intended audience is civilised hygienists and dental therapists.

_______________________

 
by Trish Walraven

I live in Texas, and work in a box.

Well, not really. But at the same time, really! This box, like most boxes, has four walls. There’s a ceiling and a floor, too, but those aren’t what drive this story. It’s all about the walls. When I look at the walls, instead of trying to climb one (or get driven up one!) my inner designer starts its analysis. What decorations help to make this box more enjoyable?

Most importantly, there’s a patient in the centre of my box.

So there’s a sky blue wall behind me as I’m facing the patient. This is the dental hygienist scope of practice in the state of Texas. You’ll notice the sleek steel shelf hung firmly on that wall that lets me provide all hygiene services – even when the doctor is away. On that shelf are my preventive allowances: pit and fissure sealants, fluoride treatments, periodontal therapy, temporary fillings, restoration polishing, and even a flashing snowglobe of laser-assisted bacterial decontamination. This wall is also marked by an ugly patched-up area. If you pulled off the patch, you’d find a pretty big hole, left by a restriction that the Texas laws place on the administration of local anaesthesia by hygienists. Texas is in that 10% of the US where a handful of Board dentists hold the rest of their profession hostage with this issue. It seems to deflect attention from those other efforts that will give hygienists better governance over their work lives but, for now, it is difficult to get the laws changed in favour of hygienists. The patch is cool, though. It’s made up of an intense pharmacy-compounded topical gel that I use on my patient when she needs scaling and root planing. It’s not perfect, but it does keep the dentist from having to stop what he’s doing to anaesthetise her, and she loves that there is no post-injection pain and lingering numbness afterwards.

Which brings me to the second wall: a green-means-go fluorescent mural featuring a hot pink clock. It flashes the amount of time I have with my patient: 30 minutes! And that’s if she’s on periodontal maintenance or has staining. If she’s healthy or a child the clock starts ticking at 20. Everything mounted to this wall is geared towards squeezing the most out of every moment. Ultrasonic tips? The thinnest, curviest ones available, and enjoyed even by my youngest patient because they knock off every bit of calculus and plaque at a range of comfortable settings. Baking soda jet polisher? Much faster than the rotary polishing cup and paste. Oral hygiene advice? Suggested as I’m performing the initial examination and demonstrated later with a hand-held mirror and floss. Assistants instantly appear to chart and record probing depths with the click of a mouse, loupes and a headlamp keep me from having to reach up and change the overhead light position. I am a master of efficiency.

The third wall is a more subtle shade of green. It’s the one with all the niches and windows, with family photos and favourite mementos left by patients. I love this wall the most because it lets me see the world outside. One of the windows faces the reception room. The room is empty – not because we don’t have patients, but because none of my patients ever have to wait there, thanks to a well-coordinated  team using custom-designed communication with audible BlueNotes that chime as soon as a treatment room is open, or when a patient arrives, or when the dentist needs supplies because of an unanticipated event. This kind of empty reception room can be found in all corners of the world. Many practices are now implementing this idea – a spark that came out of my brain and then became a computer programme. I am proud of helping to shape the world outside my box.

The final wall is painted metallic gold, with the words ‘Preferred Provider’ stencilled in black all along the baseboards. From this wall emerges a door into a second operatory where a dedicated hygiene assistant is waiting with my next patient. I’ll see him and then move back in here once my services are complete. I’ll also use my diagnostic skills to let the patient know the doctor will be recommending a crown on one tooth, a bridge in the opposite quadrant. Focusing on treatment plan acceptance and dollars on the doctor’s bottom line is how I make up for the 30% or more discount patients receive in this middle tier of managed care here in the US. And it’s how I earn all those glittery stars on the wall: my home, a car, vacation time, designer handbags.

I like my box just fine. But if I had my own way, the walls would be different. Maybe they would all be windows.

 

 

You can also view this article in its original PDF from the paper magazine.  Also, many, many thanks to Eva Watson and DH&T’s editor Julie Bissett for the opportunity and for getting this published!

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