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7.14.06 Issue #227


What is a Dental Hygienist?

Jean Gallienne RDH BS
Hygiene Consultant McKenzie Management

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What is a dental hygienist? Depending on who you ask you will get different answers. Many staff members and doctors consider the hygienist to be a prima donna. While many patients and the general public either consider the hygienist to be a cleaning lady or confuse the occupation with a dental assistant. Meanwhile the hygienist looks in the mirror and sees a college educated (in most states) professional. Some doctors view the hygiene department as a loss to the practice, a black hole, and rightfully so because their hygiene department is not a profit center.

Depending on the hygienist, any or all of these may be true. However, while going through hygiene school most of us were taught dental materials, computers, front office positions, how to take impressions, probe and evaluate periodontal health, root plane, take and read x-rays, take out the trash, work as an assistant, teach patient education, pharmacology, anatomy and physiology, head and neck, psychology, communication, oh…. and clean teeth. These are just a few of the skills taught and developed during hygiene school. Unfortunately, for whatever reason, many hygienists and doctors have decided to only utilize a portion of these skills. Let me rephrase that, we learned the skills but may not know how to implement them into private practice in order to be the health care provider that a hygienist is trained to be.
This is the time to decide on being a team player or the prima donna. When time permits between patients, there is always something that can be done to help another team member. Learn to utilize the operating software your office uses, take the trash out, do anesthesia for the doctor in order to help their schedule go smoother, (in states where it is legal), file charts, answer the phone, relieve an assistant, seat the doctors patient. Do whatever the office and state law permits that will help with the care of the patient and help reduce the stress of the office.
Being a hygienist is much more than cleaning teeth. Developing into a hygienist is like being a detective. Every skill we were taught must be utilized in order to provide complete oral care to our patients. Now is also the time to decide if you want to be a prophylaxis-based hygienist, a cleaning lady, or a diagnosis based hygienist.  A prophylaxis-based hygienist will do a lot of routine prophylaxis, x-rays, and exams. Where a diagnosis based hygienist will evaluate the patient’s medical and dental history then ask the patient what changes or problems there have been since their last visit. They will also ask the patient, “What changes would you like to make to your smile?”  The next step is to perform the necessary diagnostic tests which may include all of the following: blood pressure measurements, radiographs, intra-oral photographs, periodontal probings, gingival bleeding index, plaque index, caries detection, restoration evaluation, cosmetic evaluation, joint sounds, and cancer screening. Once the patient evaluation is performed, if the doctor is to examine the patient, now is the time. The doctor should be notified at this time if he/she was not already informed at the morning meeting.

If the periodontal condition is stable and it is determined the patient does not need any periodontal treatment, then the hygienist may proceed with the professional cleaning. Depending on office policy, the cleaning may be done at the first appointment with the root planing at future appointments, or the root planing may be started immediately if the patient has been informed of all financials and treatment recommended.
One more decision must be made to be all that you can be when it comes to being the professionals, we as hygienist, perceive ourselves to be. That is to take pride in ownership of the practice that you work for. No, that does not mean as a hygienist that you are the owner of the practice. However, that you work as if you are the owner of that practice and want not only to provide quality of care but to be profitable at the same time. You want to receive a paycheck, get raises, buy new state of the art technology, and go home knowing that you have done everything for your patients that you are legally and professionally trained to do, and being paid well for your services. Help stop dentists from viewing the hygiene department as a black hole, a non-profitable department. Look at the hygiene department as a business within a business. For example, the shoe department at Nordstrom’s is a department within a business and the hygiene department is not any different. Not even Nordstrom’s would consider keeping the shoe department if it didn’t prompt sales to the dress department or was profitable overall. What do you need to make your hygiene department profitable? Do you have an effective interceptive periodontal therapy program in place? Do you help promote the doctor’s treatment plans? Are you referring patients to your practice? Is the practice growing? These are all concerns of the doctors and should be your concerns too as a professional. Do you have an x-ray protocol in place? Is your hygiene department meeting or exceeding this protocol? Do you have goals? Has the number of hygiene days increased in the last year? I think you get the picture now that there is much more to a hygienist and a hygiene department than cleaning teeth.

These thoughts of what a hygienist and a hygiene department are or are not are not necessarily the fault of the hygienist. Often times they are seemingly booked into eternity and single handedly trying to manage patient recall. A number of factors can undermine your hygiene department. Improving hygiene is a multi-step process and the first place to start is tracking what is happening right now. Take the time to evaluate yourself as a hygienist and track your hygiene department, and decide for yourself what you really want for our profession.

Interested in knowing more about how to improve your hygiene department?  Email

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McKenzie Management's Seminar Schedule
  July 20 Del Mar, CA - Ortho Symposium * Sally McKenzie  
  July 26 San Diego, CA - San Diego Womens Dental Society Nancy Haller  
  Aug. 2-6 Denver, CO - Academy of General Dentistry * Sally McKenzie  
  Sept. 15-17 San Francisco, CA - California Dental Association * Sally McKenzie  
  Sept. 29-30 Oviedo, Spain - Clinica Sicilia Sally McKenzie  
  Oct. 7-8 Krakow, Poland - UNO Dental Sally McKenzie  
  Nov. 2-3 Santa Barbara - The Art of Endodontics Sally McKenzie  
  Nov. 8 San Diego, CA - San Diego Womens Dental Society Sally McKenzie  
  Nov. 17 Concord, NH - New Hampshire Dental Society Sally McKenzie  
  Dec. 7-8 Santa Barbara, CA - The Art of Endodontics Sally McKenzie  
* McKenzie Management will be exhibiting at this location
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