Hygiene Tribune U.S. No. 6, 2011
Fourth ‘Pros in the Profession’ winner / Dental hygiene practice: Is there a new model? / Whose choice is it anyway?
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[1] =>
HYGIENE TRIBUNE
The World’s Dental Hygiene Newspaper · U.S. Edition
June 2011
www.dental-tribune.com
Vol. 4, No. 6
Dental hygiene practice:
Is there a new model?
By Shirley Gutkowski, RDH, BSDH, FACE
You’ve been learning about all
the new products and risk assessment tools in lectures, articles in
magazines and on the Internet.
Saliva tests have evolved from simple litmus paper evaluating the oral
pH to tests that measure the periodontal pathogens and whether the
patient has an HPV infection.
Encouragement from thought
leaders has dental hygienists taking blood pressure, perio charting,
saliva testing and even taking blood
samples for periodontal therapy
management.
Testing occlusion, checking for
signs of sleep apnea, joint vibration
analysis, oxygenation of the blood,
caries manifestation and engaging
in small talk are all good dental hygiene practice, but when do
you get to scale and polish? The
bread and butter of dental hygiene
appointments can’t go away, can it?
The framework of dental hygiene
is changing. Dr. Fons thought having someone around who could
clean the teeth, often, would be
a great adjunct to a dental prac-
tice. That idea evolved to someone
who could educate and clean the
teeth then to someone who could
do some diagnostics, educate and
clean the teeth.
The cleaning alone in Dr. Fons’
time took the better part of an hour.
Adding these other processes into
the dental hygiene appointment is
just getting crazy, right? How is a
dedicated dental hygienist going to
get everything done without resorting to heroic efforts?
It is time to rethink the status quo. The number of diagnostic
tools and instruments we have in
dentistry today, the level of technology and the incredible information they provide is proving to be
very time consuming.
A simple salivary test to show the
health of someone’s saliva takes
about 10 minutes, add to that a
good oral cancer screening of at
least 5 minutes, then a perio chart
and blood pressure check and most
of the appointment time is gone. A
new position in the office called a
Risk Factor Manager (RFM) may
How is a dedicated dental hygienist going to get everything done without
resorting to heroic efforts? A new position in the dental office, called a Risk
Factor Manager (RFM), may be the answer to alleviate the time crunch during dental hygiene appointments. (Image/Provided by Shirley Gutkowski)
g HT page 2E
Fourth ‘Pros in the Profession’ winner
Crest® Oral-B® announced its recognition of RDH Linda Maciel of
Hudson, N.H., as the recipient of the
fourth Pros in the Profession award
for registered dental hygienists who
go above and beyond the call of
duty.
Throughout her 11 years of practice, Maciel has established a screening protocol to detect early signs of
oral cancer and has developed a
passion for educating members of
her community about the many factors that affect oral hygiene.
“I’m honored that Crest Oral-B
chose me,” said Maciel. “I feel very
fortunate to love what I do on a
daily basis. Making a difference in
patients’ lives is rewarding, and providing the most comprehensive care
is a high priority of mine.”
Maciel has a strong relationship
with each of her patients and considers this to be a key part of her
role as an RDH. Her focus during
patients’ checkups is screening for
oral cancer. Through this process,
Maciel has caught basal-cell carcinoma and detected early signs of
thyroid cancer.
Additionally, she has inspired
people to quit harmful habits such
as chewing tobacco and smoking
cigarettes. Patients and her colleagues appreciate Maciel’s sharp
eye and attention to detail.
“Linda’s oral cancer exam is a
signature service to her patients
and she regards this service as the
most important aspect of her job,”
said Dr. Cara Coleman, a dentist at
Merrimack Smiles, who nominated
Maciel for this award. “Her patients
and their families appreciate how
they benefit from her pursuit of
knowledge.”
Maciel realizes that oral health
goes beyond the dentist’s office so
she extends her passion for dental
care to the public through education. She frequently works with new
mothers, educating them about the
importance of good oral hygiene for
their children. Maciel also volunteers with her office at community
events and works to promote having a healthy mouth by discussing
the links between periodontal health
and systemic concerns.
With this honor, Maciel will join
previous Pros in the Profession winners Ann Benson, Trudy Meinberg
and Mary Lynne Murray-Ryder on a
VIP all-expense-paid trip to ADHA’s
88th Annual Session in Nashville.
In addition, she will receive a
$1,500 monetary prize, a pampering
spa experience, an award and recognition at major conferences and in
dental trade publications throughout
the year, plus an exclusive trip to
P&G headquarters.
Linda Maciel, RDH (Photo/Provided by
P&G)
To learn more about the Pros in
the Profession program and winners, please visit www.prosinthe
profession.com. HT
[2] =>
2E
Editor’s Letter
Hygiene Tribune | June 2011
Whose choice is it anyway?
Let’s imagine you went to your
doctor for an annual checkup. Nothing was wrong, you just needed to
have a once over. While the doctor
was checking you out, he noticed
a mole on your back that looked
a little strange … you know, the
infamous, “suspicious mole.” For
me, that saying always conjures up
a vision of a mole in a trench coat
with only its eyes sticking out above
the collar.
The doctor recommended you
have the mole removed and biopsied, but you were getting ready
to go on vacation and didn’t really
want to deal with a bandage over
the excision site. Also, you were not
sure if your insurance was going
to cover the procedure, and quite
frankly, you were not all that concerned about the mole. You mentioned these things to your doctor
and he said, “OK, well we really
should do this, but the decision is
up to you.”
Do you think your physician agonized over the fact you opted not
to have the procedure done? Do
you think he was saying to himself,
“Well, if she can go on vacation,
I don’t understand why she was
worried about the cost of this procedure.” Do you think that for one
minute the doctor thought about
not telling you about the mole he
felt needed to be removed? Seems
absurd doesn’t it? But yet, this scenario takes place every day in dental
offices.
I hear my colleagues complain
that patients will only “do what their
insurance will pay for.” I hear them
talking about other things they know
the patient spends money on. Even
worse, I have heard about hygienists
not discussing patients oral conditions because, “the patient will not
do anything about it anyway.”
When I was in dental hygiene
school, never once was I taught to
consider a patient’s insurance coverage when reporting my findings.
I was never taught to judge patients
if they opted not to accept recommended therapies. I am not sure at
what point all of this became OK in
our profession.
We need to remember it is our
responsibility to inform patients
about their oral situation, and just
because we tell them does not
mean they need to do anything
about it. Remember something
called informed consent? Patients
need to be advised of their situation, informed of the recommended
treatment and what the expected
outcome is, what the risks of treatment are and what the risk of no
HYGIENE TRIBUNE
The World’s Dental Hygiene Newspaper · U. S. Edition
Publisher & Chairman
Torsten Oemus
t.oemus@dental-tribune.com
Chief Operating Officer
Eric Seid
e.seid@dental-tribune.com
Group Editor & Designer
Robin Goodman
r.goodman@dental-tribune.com
Editor in Chief Hygiene Tribune
Angie Stone, RDH, BS
a.stone@dental-tribune.com
Managing Editor/Designer
Implant, Endo & Lab Tribunes
Sierra Rendon
s.rendon@dental-tribune.com
treatment is. Nowhere in informed
consent does it say the patient must
chose to do something.
Dental professionals need to
operate more like medical professionals: the patient decides what is
right for them and we honor their
wishes because it is not our decision to make. HT
Best Regards,
Angie Stone, RDH, BS
Managing Editor/Designer
Ortho Tribune & Show Dailies
Kristine Colker
k.colker@dental-tribune.com
Online Editor
Fred Michmershuizen
f.michmershuizen@dental-tribune.
com
Account Manager
Mark Eisen
m.eisen@dental-tribune.com
Marketing Manager
Anna Wlodarczyk
a.wlodarczyk@dental-tribune.com
Sales & Marketing Assistant
Lorrie Young
l.young@dental-tribune.com
C.E. Manager
Julia E. Wehkamp
j.wehkamp@dental-tribune.com
C.E. International Sales Manager
Christiane Ferret
c.ferret@dtstudyclub.com
Dental Tribune America, LLC
116 West 23rd Street, Suite 500
New York, NY 10011
Tel.: (212) 244-7181
Fax: (212) 244-7185
Published by Dental Tribune America
© 2011 Dental Tribune America, LLC
All rights reserved.
Hygiene Tribune strives to maintain
utmost accuracy in its news and clinical
reports. If you find a factual error or
content that requires clarification, please
contact Group Editor Robin Goodman at
r.goodman@dental-tribune.com.
Taking blood pressure, saliva and occlusion testing,
checking for signs of sleep apnea, joint vibration analysis
and engaging in small talk ... how is a dedicated dental
hygienist going to get everything done in the standard
appointment time? (Photo/Provided by Shirley Gutkowski)
f HT page 1E
alleviate the time crunch.
Imagine if your dental hygienist
position in the dental office was
shifted to one of gathering data only.
The RFM is the person in the office
who would perform blood pressure
and saliva tests, and when needed,
also caries and oral cancer screenings, test blood for inflammatory
markers and glucose management
and perform occlusal screenings
and joint vibration analysis.
Perio charting and all other data
would be gathered by the RFM
Perio charting and scaling and polishing are the bread
and butter of dental hygiene appointments, but how does
one fit in all of the other diagnostics expected during a
hygiene appointment? (Photo/Provided by Angie Stone)
for all new patients before any
treatments, and the collected data
reported to the dentist who would
evaluate that data for a diagnosis. In the ideal practice, the RFM
would alternate with the dental
hygienist at some interval, perhaps
weekly.
It’s so important to gather this
data, yet the gathering of it interferes with dental hygiene treatment, thus the time has come for a
new practice model. A RFM could
be in charge of many other things,
too. Tasks that are shuffled to the
bottom of the priority pile and
Hygiene Tribune cannot assume
responsibility for the validity of product
claims or for typographical errors.
The publisher also does not assume
responsibility for product names or
statements made by advertisers. Opinions
expressed by authors are their own and
may not reflect those of Dental Tribune
America.
Tell us what you think!
never see the light of day, such as
gathering practice data.
Can you find out, in short order,
how many patients with pockets
over 6 millimeters are in your practice, and of those, how many have
diabetes? Is that an important piece
of information? It sure is! The data
in dental hygiene to support the
science of our practice is lacking. Having case data — a practice
being a case — can streamline dentistry immensely once it’s reported.
In the light of the 2014 mandate
for interoperable electronic health
records (EHR), our data has to
Do you have general comments or criticism you would like to share? Is there
a particular topic you would like to see
articles about in Hygiene Tribune? Let
us know by e-mailing feedback@dentaltribune.com. We look forward to hearing
from you!
If you would like to make any change
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to opt out) please send us an e-mail
at database@dental-tribune.com and be
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to process.
[3] =>
Clinical
Hygiene Tribune | June 2011
hold up to the scrutiny of medical
records. Actual diagnosis, not just
treatment plans, will be part of
the insurance model of payment
as well.
We won’t be able to be paid
for periodontal therapy without a
diagnosis of periodontal therapy
and lab proof of an inflammatory
response and pathogens. The current model of dental hygiene as a
part of dentistry doesn’t allow time
for this level of data gathering.
We also know that there are
many interrelationships between
oral and systemic health. Patients
don’t know all there is to know
about the links, and we don’t
expect them to. However, we do
know that it sure would be nice to
have that data.
For instance, if we have patients
present with periodontal disease
and they do not know they have
diabetes, or if they do know, it’s
important to us. An interoperable
electronic health record would
allow us to go into their health
records and find out before treating diabetes as if it were periodontal disease. A RFM would have
time to locate that information and
share it with the dentist before the
patient sees the dental hygienist.
Here’s an example: There’s a
new correlation between obstructive sleep apnea (OSA) and periodontal disease. Having access to a
patient’s health record could allow
a dental practitioner to encourage
that patient to have treatment for
his/her OSA, which will allow the
periodontal condition to improve.
About the author
Shirley Gutkowski, RDH,
BSDH, FACE is an international speaker and award-winning
writer. She travels to speak on
Minimal Intervention Dental
Hygiene. Her work is also in
nursing journals. She is co-creator of Adopt A Nursing Home,
a board member and Fellow of
ACE and a member of the World
Congress of Minimally Invasive
Dentistry. Gutkowski is also
co-director of CareerFusion,
a retreat for clinicians interested in evolving their clinical
career. You may contact her at
crosslinkpresent@aol.com.
The benefit to this RFM model at
this time in health care is a boon.
Synchronizing new research is
nearly impossible in the current
dental practice model. Having a
RFM on the team will make it a little easier as this person could also
be tasked with monthly reporting
of new findings during the team
meetings.
Keeping up with the advances in
health care is everyone’s job in a
small practice, which often turns
out to have been “nobody’s job.”
Having one person researching,
considering and reporting on all of
the changes, as well as having a
total focus on managing patient
risks while collecting diagnostic
data, is a win for everyone in the
office. HT
3E
www.dental-tribune.com
What’s your specialty? Whichever area of dentistry you practice in,
you will find articles of interest at www.dental-tribune.com:
Dental Hygiene
The evolution of the toothbrush by Emily Sutter
www.dental-tribune.com/articles/content/scope/specialities/section/
dental_hygiene/id/4578
Cosmetic Dentistry
‘Everyone can have a celebrity smile’ (dentist interview) by Fred
Michmershuizen
www.dental-tribune.com/articles/content/scope/specialities/section/
cosmetic_dentistry/id/4537
Practice Management
Dental advertising on the Internet by Stuart J. Oberman
www.dental-tribune.com/articles/content/scope/specialities/section/
practice_management/id/4695
AD
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