A hygienist says: Stop cutting into my hygiene time!

Have you ever been in an office where the dentist wanted you to take intraoral pictures, discuss Invisalign or persuade patients into expensive dental procedures? And on top of that, discussing these dental procedures were far more important than performing your main job as a hygienist?

More offices are diagnosing their larger dental cases in your chair, rather than on a separate consult for a more thorough diagnosis. In any office, you are only given so much time to assess a patient’s oral and medical history, take multiple X-rays and still stay on schedule. If you have a hygiene assistant, then your patient load is doubled because the dentist wants the most out the both of you! Perish the thought if you, not the front desk, must also schedule your patient’s next appointment. Finally, let’s not forget that you also have to allow enough time to clean your operatory afterward. There are times where you may ask yourselves, how do you best utilize the time that you have to give your patients the platinum treatment they deserve when you are always behind schedule?

Related reading: When is it time to exit a dental practice?

One office I was working in had recently invested in an intraoral camera, and the dentist wanted at least 10 pictures on all patients and full mouth X-rays. She said it would better help her to diagnose patients and assist the insurance company with faster decisions in payments. The camera was heavy and at the end of the day, I would simply be exhausted from lugging it around. Even if the patient was a six-month recall and had X-rays in the past, she still wanted pictures of any new potential problems. I told her that with all the pictures and X-rays, after it was all said and done, I was only left with about 15 minutes to do any real cleaning during a 60-minute appointment. Unfortunately, this didn’t matter to her, and she told me to just make the pictures and X-rays my No. 1 priority.

Not to mention, it takes more out of your hygiene time if your dentist is discussing and reviewing X-rays in your chair, mounted on a TV screen in front of the patient. When faced with this, patients have a lot of questions, separate from their oral health, especially if it’s a new procedure to them, such as Invisalign or dental implants, which are becoming more common in dental offices. In the past, these dental procedures were referred to more specialized dentists; however, now general dentists are discussing these procedures during your scheduled hygiene time. Patients will often ask you of your opinion, and you will you be left with whether to possibly suggest a more affordable alternative or simply to keep your mouth shut. Be careful though because the dentist could be standing right outside your door, awaiting your response.

Don’t get me wrong, I’m all for promoting new technology in dentistry, but not when it cuts into my hygiene time. That time is not just about a cleaning, but could also adversely affect the health of your patient if not used wisely. For some patients who you haven’t seen for three to six months--or maybe even longer--if you don’t have the time to take their blood pressure and review their medical history, you could be on the verge of possibly having a medical emergency. We can’t take this for granted, and it is a key part of any hygiene exam. New medications and health changes can affect a patient’s oral hygiene, and it is imperative to have the time to review this vital information. Patients will appreciate that you not only took the time to clean their teeth, but also that you cared to review their overall heath history.

In the end, at this office we were instructed to simply do a fast scale and polish, and then to get our patients back in three months after they had agreed to the other work on the treatment plan, such as Invisalign, crowns or bridge work. In the middle of the day, we would discuss the cases we closed that morning and confirm those who agreed to treatment. These patients would then go on a list, and if they completed their treatment plan by the end of the month, we would be given a $50 bonus. I like bonuses just as much as the next person, yet unfortunately I knew it was time for me to turn in my notice. My job at this office wasn’t important anymore. The higher producing dental cases took higher priority over clean teeth and healthy gums.

It’s hard enough to clean all 32 teeth, polish, floss and stay on schedule. Value the dental care you are providing for every patient and allow time for patient education. When you are done, give them a mirror to see your work, and they will be pleased. It’s not just a cleaning, but a look into their overall dental health. As a hygienist, you should not only take pride in your profession but also be in an environment where you are allowed to perform it properly. Because remember, “In the end, your main goal is to make sure their teeth outlast them.”