To see Dianne Glasscoe's original article, please search for "Speed Demon" in the search box located on the left side of your computer screen. Following is a letter that appeared in the September edition of RDH in response to that article.
Speed it up, "girls"
In the July issue, Dianne Glasscoe responded to a letter (Speed Demon) from a hygienist who complained about another hygienist in the office doing a prophy in 10-15 minutes. The remarks concerning this service were negative and Dianne gave a list of 13 items a hygienist should do which would be impossible to do in 10 minutes.
The public, and indirectly, the dentist, are the ultimate sources of what treatment hygienists should do and the level of service and quality that is needed. Today, people want fast food, fast banking, fast gas station fill-ups, and fast dental service. No one likes to wait. No normal person wants to be in the dental chair having his or her teeth cleaned for 45 minutes when the job can be done in 10 or 15 minutes. Patients do not tolerate long procedures and if a quality service is offered at another office in less time, they will take their business to that office. A dental prophylaxis consists of removing calculus and polishing the teeth. The extras mentioned by Dianne (e.g. blood pressure, exam, inquire about dental problems, etc.) does not need to be done by the hygienist and may not be desired by the patient or the dentist. The dentist may want to do this him/herself as is office policy.
A well-trained dental hygienist with sharp instruments and an ergonomically efficient technique can easily do a good scaling and polishing in 10 minutes on most "normal" patients. I'm not talking about someone who has 30 inches of calculus on his lower anterior teeth, but just an average patient who keeps his or her six-month recall appointments. To say it takes more time to do the cleaning and that anyone doing the treatment in less time is providing lower quality treatment is ridiculous. If, after treatment, the mouth is clean and the dentist and patient are happy, then that is success. Do not equate retardation with quality. In today's competitive world, where the consumer dictates the terms, you better provide fast, efficient, quality service. Anything else will result in the loss of the patient, his or her family, and your job. In my and many of my colleague's practices, fast hygienists earn more money and get more respect from the dentists and patients. The slow ones get less. The real slow ones get fired. It's a tough world out there, girls. Are you up to the challenge?
E.J. Neiburger, DDS
Following are some of the letters we have received in response to Dr. Neiburger. We will publish additional letters soon. To see additional letters we have also put on our Web site, use the search box on the left side of your computer screen and type in "Neiburger."
Thank you for the amusing caricature of the ignorant Old Boys' Network personified in the letter entitled "Speed it up, 'girls'" by EJ Neiburger. The attitude of the letter provides insight into the minds of the dentists who have fallen for the rhetoric of their professional association.
Indeed, there are many dentists who believe they own hygienists' work and have total responsibility and authority over it despite the fact that only a patient or guardian may decide to choose or refuse therapy; that 10 minutes is normal for a hygiene procedure despite the fact that 80 to 90 percent of people walking into their offices have periodontal disease; that there is no need to check vitals and conditions requiring attention despite their liability; and that fast hygienists earn more money despite the fact that those who take the time to pay attention to these details will find more treatment needs to which they can attend. This includes treatments like sealants, bleaching trays, and root planing, which bring much more money into the office per hour and which greatly reduce the risk of malpractice lawsuits that can lose money for the office. Unfortunately, dentists with this attitude write "prophy" on each treatment plan without ever touching a periodontal probe and are not aware of the significance, or worse, do not care about the fact that the definition their professional association has made for prophylaxis does not even meet the minimum standards of the dictionary definition (prevention of disease), let alone the definition of those who are expected to perform the procedure.
Fortunately, dental hygienists have a higher standard of care, and the fact that there are so many EJs out there is the strongest testimony for the importance dental hygienists must place on taking control of our profession so that we may exercise the higher standard we have set.
Howard M. Notgarnie, RDH, BA
Cape Coral, Fla.
As I read your reader's forum this month and choke down the response by E.J. Neiburger, DDS, regarding the speedy hygienist, I not only became furious but also very sad in his approach to his profession. So speed has become the mode in which one sells out to?
As a licensed dental hygienist for 17 years I must agree, that I cannot fathom doing a prophy in 10 minutes on an adult patient. As a professional, the so-called "extras" do need to be done, for we are providing overall health for our patients, not just the "clean and polish and send you out the door", service that seems to be happening in Dr. Neiburger's practice. I shudder to think of all of the periodontal disease, oral cancer, dental decay, and heaven knows what else is going undiagnosed in Dr. Neiburger's practice. I would hope that instead of allowing patients to dictate how we practice that we can educate them in the importance of thorough care and that takes more than 10 minutes. Goodness it takes longer than that to have your hair cut.
Oh, and by the way, Dr. Neiburger, we are not "girls." We are licensed professionals, so please address us as such.
Cheryl L. Symonik, RDH