Life Happens Outside of the Dental Chair

One of my most significant clinical experience occurred in the dental hygiene clinic earlier in the semester. This semester, my scaling technique, patient communication, and knowledge based skills increased. However, one of the most valuable lessons I learned is that “life happens.” My patient arrived for her dental visit after not visiting for two years. She was very cheerful and friendly and enjoyed talking about her three daughters. According to her record, she had a history of generally good oral health and home care. When I began the intra-oral extra-oral exam I noticed a moderate to heavy calculus buildup, especially around the linguals of sextant five. Furthermore gingival and periodontal assessments confirmed that there had been some recent neglect in homecare. Later on in her appointment, she opened up to me and informed me that she was recovering from dealing with the death of both of her parents in the past year. I quickly put two and two together and recognized that this tragedy was affecting her overall health. She was focused on other things and could not put the time and effort into her overall health. My patient informed me that things in her life were picking up and that she was committed to getting her oral health back on track. I was very sympathetic about the situation and praised her for her commitment. I ensured her that she was in good hands and that would review some ways to make her oral habits easier and mold to her life. Sometimes, we need a little reminder that patients have lives too that do not revolve around our dental chair. Daily brushing and flossing may be low on a patients priority list if they are experiencing difficult times in their lives including, but not limited to deaths, sick children, divorces, financial issues, and unemployment. It is important to praise them for their efforts and educate them with ways that work in their schedules and lifestyles for the best results.

Hygiene & Ethics

I enjoyed the ethics project in seminar. It was definitely a learning experience and opened up my eyes to many ethical issues that arise in dentistry. One of my favorite quotes from the project was, “Don’t hire someone that you cannot fire”. Personal relationships can make ethical decisions very difficult. I enjoyed how every group touched a different subject so that the class was educated on different ethical issues. Some of the videos and presentations were very creative! Our interview with our practitioner turned out to be very interesting. I have known this doctor for about two years, but I did not know much about his practice. I was shocked when he informed me of some of the ethical issues he has witnessed since practicing. My partner and I were very interested in getting a dentist’s opinion on dental assistants and subgingival scaling and ultrasonic use. This was based around my personal experience as an assistant before entering the program. After all of the hours we have spent in clinic perfecting a skill, it is hard to believe that some dentists just allow anybody to perform these skills. I was very happy that our interviewee remained honest with us during the interview. However, I’ll admit that I was a little shocked by his answers. On one hand, I was a little sympathetic since he believed that he was still following patient standard of care by assessing the quality of work first. On the other hand, this program has taught us the skills and knowledge it takes to provide a thorough quality exam. Honestly, I wish there was some way to highlight the multiple skills, techniques, and services required of a hygienist. This needs to be included in some type of CE course (haha I wish). In order to provide patients with the highest standard of care CE needs to be required. A variety of subjects need to be addressed in these CE courses including employee roles, insurance fraud, and HIPPA education.

All pedo patients are not the same!

I like working with kids so I was very excited about my pedo rotation. However, I was somewhat disappointed. Not all pedo patients are the same. There comes a time when a simple rubber cup polishing session will not remove all debris and further time and methods are needed!!! Kids do get calculus too and it is important to give them the same treatment that we would an adult. My patient was a thirteen year old male who was also suffering from developmental disorders. He brushed his teeth once at night and never flossed. When he opened his mouth I saw heavy accumulations of generalized plaque and I'm sure there was calculus below, BUT I wasn't allowed to get that far. The patient was very comfortable and friendly and I started working with the scalers to remove some debris. I was suddenly stopped by the dental assistant whom told me to just polish and that the dentist would remove anything else.I expressed my feelings that this patient had severe build up and would need more than that. Sometimes I feel like everything is a race for time in the pedo clinic. I believe this is one of the most important times to instill habits and oral health education that can follow into adulthood. There was no way that all of that debris could be removed with a rubber cup!!! I started going over oral hygiene instructions and introducing new techniques for my patient, but again I was interrupted. One of the assistants came in and gave her quick spiel on brushing twice and day and that was it. Next thing I knew the patient had a quick dental exam and was well on his way. I was shocked! Patients value their appointment and they come in and pay for a quality cleaning. They deserve adequate oral education and treatment no matter what age they are! ........That's enough venting =)

Oral Surgery and Hypertension Don't Mix!

My oral surgery rotation truly opened up my eyes to the problems associated with hypertension. It is our responsibility to provide medical consults to patients suffering from this issue. Hypertension is an epidemic in this country. It is really heartbreaking to witness young people dealing with this condition. My patient presented with an infection in an impacted third molar. She was my age and I was absolutely shocked when that blood pressure machine read 196/130. She was so young and in this life-threatening situation. I was surprised she did not go into shock right there in front of me! She explained to me that she suffered from preeclampsia while pregnant with her one month old son. I felt like the residents were very insensitive to the patient. She was extremely upset and in so much pain. They briefly told her they were not going to do treatment, told her to see, her doctor and sent her on her way. I think an official medical consult should've been emphasized and they should have sat down and went into more depth about her condition. My classmate and I sat and consoled her and she calmed down. I understand that you should not let appointments get to a personal level but some level of empathy has to be shown to build patient rapport, trust, and comfort.

Rally Day

I really enjoyed myself at Rally day. It is interesting that members of congress make critical decisions on dental care, with usually no background or education in these areas. These choices impact both clinicians and the community. Certain laws may restrict our roles in providing access to care. The community may be affected by legislative decisions pertaining to dental insurance, oral health program grants, and access to underserved areas. It is the responsibility of students and clinicians to educate these legislators and push for issues that affect the public. We are the voice for not only the community as a whole, but specifically the child with rampant decay, the adult with no dental insurance, the rural county with lack of dental care. I gained a lot of knowledge on the specific bills at this event. I have had the opportunity to witness the lack of available dental care in certain areas of the state, so I was very pleased to see the bill dealing with the ongoing project in underserved areas. There are too many people with a lack dental care and too big of an increase of carious lesions in children. We can make a change clinically in offices, but it takes legislative action to impact a bigger population. I look forward to participating in this event again.