Making lemonade with your half-ripe lemons: A bucket list for improving dental hygiene care

By Eileen Morrissey, RDH, MS

If I had an office pipe dream, it would be to open my drawer of instruments to find a full inventory of brand-spanking-new ones smiling back at me.

The reality is that this will not happen. Having exquisitely sharp, brand-new instruments that I am able to replace every six months is not within my office budget. So then, how do I make do? It’s simple. I have a certain number of setups containing my older instruments that enable me to get the task accomplished much of the time. Between my trusted ultrasonic and these setups, I scale patients with healthy mouths and minimal calculus effectively. It may not be ideal, but it can work.

But for those moments when I need the big guns, I open my secret drawer and retrieve those that are new and sharp, because they are used only on an as-needed basis. I’m then able to accomplish the task at hand (sorry, could not resist this) very effectively.

This serves as a reminder to all of us that trying to scale calculus with subpar, dull, and worn instruments is a disservice to our patients and ourselves. We will likely burnish calculus, and we will definitely be fatigued since we will work harder. If our curettes have become scalers from oversharpening, we risk breaking the tips. New, sharp instruments enable challenging cases to be completed more effectively, in less time, with less effort. Our patients will be more comfortable and better served. Lemonade!

Another wish would be saliva ejectors with cushioning so that patients who bruise easily could be made more comfortable. I do not have these available to me, so my compromise is to lower my ejector to half power. This allows for adequate suction while minimizing bruising risk. I question why I spent many years practicing at full power without seeing this as an alternative. Duh! It is a concession, quite simply, that works.

I queried some of my colleagues about their bucket lists and contingencies. One RDH wishes that the assistants in her office would be more attuned to her needs during times when she is running behind schedule. Why can’t they lend her a helping hand? she asks. Her solution is perhaps unconventional. She uses her downtime to help these same assistants whenever possible by turning over treatment rooms and keeping their instruments moving. The hope is that if karma manifests, sooner or later they will come around to be there for her in times of need.

Another RDH works part-time with a dentist whose infection control practices leave something to be desired. Since this RDH does not know what goes on in her treatment room when she is not there, she makes sure to arrive very early on the one weekday she is scheduled. She wipes every possible part of the room so that any cross-contamination that may have taken place gets addressed before patients are treated. She knows she has full control of the room when she is present, and this is her way of compensating for what happens when she is not.

The last hygienist I questioned told me she dreaded when her doctor would come in for an exam and tell a patient with poor oral hygiene and inflamed tissues that he looked healthy, and to please keep up the great work. This would take place after she’d spent time emphasizing the need to change oral hygiene habits to address the inflammation. It was an ongoing source of frustration. Her solution was to make certain she brings the areas of concern to her doctor’s attention the moment he picks up the mouth mirror and asks her how Mr. Patient is doing. She informs him immediately that she has observed a problem, proposed strategies, and that the patient has owned the challenge. It’s a win.

A final pipe dream that is almost universal among RDHs is the following: “I wish I had more time to do all that I know I need to do to provide the best possible care and service for my patients.” Having longer appointments may not be available to us. I offer the following: “We simply do the best that we can in the time that we have.” And this, my RDH colleagues, is wisdom to live and practice by! Onward we go; it is in our hearts’ core. RDH

EILEEN MORRISSEY, RDH, MS, is a practicing clinician, speaker, and writer. She is an adjunct dental hygiene faculty member at Rowan College at Burlington County. Eileen offers CE forums to doctors, hygienists, and their teams. Reach her at [email protected] or 609-259-8008. Visit her website at www.eileenmorrissey.com.