What Does a Hygienist Do?
What does a hygienist do? If you ask someone on the street they may say something like “helps the dentist” or “cleans teeth.” Due to an increase in consumer product advertising (as in “recommended by dentists and hygienists”) some people have become aware that a hygienist is a separate category of dental professional - one that might have knowledge of prevention and preventive dental products on par with a dentist.
Even so, when patients see the hygienist they usually believe that his or her focus is on “cleaning.” While providing professional cleaning is an important function for the hygienist, in a successful practice s/he does much more. So what else does a hygienist do? Identify and promote necessary dental treatment.
During the course of their patient care, hygienists have the opportunity to visually inspect every single tooth in a patient’s mouth. Issues with existing restorations, cracks and fractures, demineralized areas and decay are readily apparent. With the advent of easy to use intra-oral cameras, the hygienist can point out and photograph possible problems. Discussing these problems and giving potential solutions “sets the stage” for the dentist’s exam and diagnosis. The patient has time to digest the information and see what the problems look like before the dentist even enters the room.
The conversation between the patient and hygienist may go something like this:
Hygienist: “Mr. Patient, I am noticing a fracture next to a large silver filling you have in your lower right first molar. Has that tooth been bothering you at all?”
Patient: “I haven’t had any pain, but I can feel a sharp spot on that side.”
Hygienist: “That tooth has been in your mouth since you were six years old, and the filling you have in it may have been placed shortly after it erupted. So, it has been there a long time. Often a filling will become worn and break, or the filling may stay in place but the tooth structure next to it may crack or fracture. That’s what I think has happened here. Let me take a photo for us to look at.”
Hygienist (while showing the photo on the monitor): “Here is where I see the fracture. I think that Dr. M. will probably recommend a crown for that tooth. He can take away the fractured part of the tooth and place a crown to cover the entire top surface. That way the tooth will remain strong.”
Patient: “Can’t I just have another filling?”
Hygienist: “It might be possible, but I really doubt that it would be the best solution. When Dr. M. comes in for your exam, he can let us know what he recommends.”
When Dr. M. enters the hygiene treatment room he can start the conversation, “Hi Mr. Patient. Good to see you again. How have you been getting along?”
Patient: “Well, Ann tells me that I have a fractured tooth. I didn’t know that I had it.”
Ann replies, “I took a photo and have it there on the screen. I told Mr. Patient that you could let him know what the best solution might be.”
Dr. M. examines the patient’s mouth, identifies the tooth in question, sets the patient’s chair so that the monitor can be clearly seen, points out the problems, and affirms the need for a crown. “I think that Ann is right. A crown would be the best and probably only solution for this fracture.”
Patient: “How much will a crown cost?”
Dr. M. replies: “When we finish here I will let the treatment coordinator know what we have found and she can give you an estimate for your insurance and your portion. We now use computer milled crowns and can have yours ready for you the same day you come in for the preparation.”
Patient: “That’s great. It is hard for me to take time off from work.”
Dr. M. leaves the treatment room, Ann takes Mr. Patient to the front desk, an estimate is given and the appointment for the crown prep is made. The patient has been educated about his condition, he has seen a visual presentation (in the form of his own tooth on the monitor), has had (in his mind) two dental professionals agree on a course of action, has had an estimate presented, and has made an appointment that will enable him to leave the same day with his new crown. Success for everyone!
What happens if the dentist does not think a crown is the best solution? In that case he might say: “Good eye, Ann. That tooth definitely has a problem. The fracture is apparent. However, in this case I think I can restore the tooth with a white filling. I don’t think that a crown will be necessary.” Verbiage such as this affirms the hygienist’s credibility with the patient, and confirms Ann’s assertion that Dr. M. would be the “final word” on what should be done.
Working together in this manner is a professional way to handle a patient, whatever the dentist’s diagnosis and treatment recommendation. Hygienists are trained to apply a meticulous eye to their daily tasks, and if given adequate time during routine appointments, they can also forge lasting and trusting relationships with patients. When both the hygienist and the dentist agree that a course of action should be taken, patients also tend to agree. The hygienist is not “diagnosing” - s/he is identifying, educating and promoting necessary dental treatment. These are important aspects of “what hygienists do” and serve a vital function in a successful dental practice.
Next time: Educating patients and providing necessary periodontal care.
Carol Tekavec RDH is the Director of Hygiene for McKenzie Management. Carol can improve your hygiene department in just one day of training “in your office.” Interested in knowing more about how to improve your hygiene department? Email firstname.lastname@example.org.
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