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Postcard from a square operatory

May 29, 2012 By Trish Walraven 1 Comment

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!

Filed Under: Anecdotes, Operative Dentistry Tagged With: dental efficiency, dental hygiene, dental hygiene scope of practice, dental therapists, linkedin, postcard from America, topical anesthetics

Ethics videobites

March 28, 2012 By Trish Walraven 2 Comments

Today’s video from “The DEZiree Show,” produced by DentalEZ, like most dental humor, is almost there:

So you watch this clip, then you wonder, how many hygienists in job-saturated markets don’t even have the luxury of being able to wrestle with these sorts of ethical dilemmas? They’re just happy to have an income. And if you don’t want to work faster than you should, there’s the door, honey. We’ve got five more hygienists waiting for your position when you leave.

If you must ever make a decision to follow your halo out of a practice like that, remember, there are also dentists who would rather have ethical hygienists than ones who will do whatever they’re told to do regardless of whether or not it’s best for patients.

Just please, promise yourself, you will never, NEVER, consider taking a personal day to go watch a movie, especially NOT the upcoming Twilight one, like DEZiree is pretending to skip out for. Eyes will roll as your credibility sinks beyond all hope.

And a shirtless Robert Pattinson is just one of those things you can’t unsee.

Filed Under: Money, Practice Management Tagged With: dental hygiene, dental office production, DEZIree Show, hygienists, practice management

Dream patient of the week

January 24, 2012 By Eva Watson 4 Comments

Remember that oath we took at graduation? I remember that oath. I swore, along with my classmates, that I would carry out the very best dental care to any and all patients who sat in my operatory chair; regardless of gender, race, or socioeconomic status, I promised to give everyone the best treatment I could.

I also remember wanting to hurl myself into the bathroom. The speech I had to give moments before gave me nervous diarrhea really bad.

We have our clinical side. Then we have our human side. The clinical side is a given: do what we were trained to do. My human side? A bit more personal. I tend to muse about extra-special people that I would give anything to have in my chair. Anything. Just once. And it’s because of their gender, race, SES, political ideology, etc., that I must perform my titillating hygiene duties on them.

We all have our idiosyncrasies. My OCD compels me to share mine. Hee-heeee!

Dream Patient of the Week: Steven Colbert

Mr. Colbert, if there’s any chance you accidentally enter this site while surfing the internets for plaque-disrupting inspiration, I would like you to know that I love you. Every American-y, flag-waving inch of you. I adore you. Are you tall? I like tall. You appear taller than John Stewart. I also like suits. You wear a lot of suits. I like that. And I’m not crazy. My husband tolerates me just fine. He’s just playing Skyrim again.

I love your smile. I love the way you single me out and point that finger at me when you’re in my television. I love your ties, your glasses, and your opening-credit eagle that swoops into my face and shrieks hello. That eagle looks like it’s gonna fly right into me. Here it comes–  wheeeee!  I like that eagle.

I will also state the obvious: I love your teeth.

Let me see those patriotic beauties- oh! There they are. I don’t care how much calculus is on them. I love every one of your teeth equally. If you had the blackest, most tenacious chunks of bad boy tartar stuck to every inch of enamel in your mouth, I would still love you. That’s not strange, Mr. Colbert. That’s dedication. All I ask is for the chance to have you lay waaaay back on my USA-made operatory dental chair while I give you such a stone-cold, subgingival scaling it will flip your cyclopean Super PAC, baby.

And, after I gently marinate your inflamed gums with a superfreaky course of chlorhexidine gluconate, I would like to hold your hands and teach you how to floss… properly. That’s right.

In closing, I would appreciate an opportunity to express my respect and admiration of your brain… because it’s silly. You have a silly brain.

Filed Under: Fun, Humor Tagged With: dental humor, dental hygiene, Fun, humor

Italian hygienist career opportunity?

February 6, 2011 By Eva Watson 3 Comments

by Eva Watson

Bored with Dental Hygiene?

Enter an exciting, new career as an International Companion!

Hello and welcome!  My name is Sophia Arrapato and I am the founder and CEO of ‘Italiano Scortares’, a Trans global company dedicated to servicing the needs of our exclusive clientele.

As a previous dental hygienist, I have treated many patients for over twenty years.  After my 18th year of removing plaque and calculus, I eagerly wanted to pursue a new career as an entrepreneur, specializing in carnal pleasure. It only took less than twenty-four hours to say to myself, “Ho, scoperto!  Sesso!”

It took intense market research and interviewing countless women, but I officially opened my doors in 2010 and business has been booming!

You will be known as an International Companion for Italiano Scortares, and as such will have the best plastic surgeons at your disposal, an endless array of erotic dancing apparel, and, after completing six weeks of intense training, you will be awarded with your very own Little Black Book. As the CEO of Italiano Scortares, I will screen all prospective clients prior to assignment; I insist on the enduring scruples and respectability I have incorporated into my empire.


As a new employee, you will have the honor of training under Nicole Minetti, an Italian dental hygienist, esteemed lap-dancer, and long-time political advisor to Italian Prime Minister Silvio Berlusconi. Her experience is vast and hilariously adulterated, so I ask you pay close attention to Ms. Minetti’s teachings and advice. She will guide you through your career and enhance your presence and clientele list here with Italiano Scortares.

I thank you for visiting our website and hope to meet with you soon. Make sure to floss daily!

Questo è amore!

 

 

Click on the images and links above to see why dentistry was dragged into this whole sordid saga.

Filed Under: Fun, Humor Tagged With: dental hygiene, Fun, humor, scandal

Hygiene For Realz or corporate hijacking?

November 4, 2010 By Trish Walraven 3 Comments

Yes, she’s got a dental supply company backing her, and yes, she’s a little green and looks like she’s trying hard to be obnoxious (which she obviously isn’t), but there’s something about DESIree that is utterly fascinating.

Yesterday brought the unveiling of The DEZIree Show, a “just between us” video blog for dental hygienists. Will she be engaging, relevant, and positively bloom in her fun weekly rants so that her viewers want to share her messages and spirit? Or will this be a failed publicity experiment that a corporation is trying in order to find their place in the social media order?

Currently it could go either way. But you should totally root for DEZIree because she seems worth five minutes of your time per week.

Filed Under: Fun, Marketing, Technology Tagged With: dental hygiene, DentalEZ, DEZIree Show, Star Dental, video blog, video blogger

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DentalBuzz explores rising trends in dentistry with its own slant. The speed at which new products and ideas enter the dental field can often outpace our ability to understand just exactly the direction in which we are heading. But somehow, by being a little less serious about dentistry and dental care, we might get closer to making sense of it all.

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