Exclusive! Our readers respond

Dec. 3, 2001
The roar of the crowd: RDH readers on cold-sore treatment, periodontal pain, and yes, Dr. Neiburger.

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.

Do we really want to be faster?

Dear RDH:

Dr. Neiburger, it�s so sad about the perception you have of quality dental hygiene care. Do people really want everything today so fast? Is it necessary? I don�t think so. Doctor, the next time you have surgery, do you want the registered nurse to work more quickly, as well as the surgeon and the pharmacist filling your pain medication prescription? After all, it�s just counting pills � 10 minutes or less � no extras, right?

Why in dentistry do you feel we need to speed it up? Quality and efficient patient treatment requires time. Patient relationships build a practice where doctor and staff profit and benefit. It is a tough world out there, boy; so just keep on reading RDH and, hopefully, one day you�ll understand. Are you up to the challenge?

Mary K. Jensen, RDH, MS

Winfield, Illinois

Outlook questionable

Dear RDH:

Comments by Neanderthal dentists such as Dr. E.J. Neiburger are what gives dentistry a bad name. To refer to his hygienists as �girls� was the first indication in his letter that he must put little value on their professional skills.

Dr. Neiburger�s outlook on dentistry caters to the �fast food� type of patient, who wants to be in and out of the chair and then given a clean bill of health. He feels a good prophylaxis can be done in 10 minutes. The extras that take up time aren�t necessary, according to him, and aren�t desired by the �normal, healthy� patient. Dr. Neiburger feels that these �extras,� including a thorough restorative and periodontal examination, cancer screening, medical history update, and an explanation of the patient�s immediate dental needs are unnecessary.

As a practicing dental hygienist for 26 years, I can say that not only do patients appreciate being informed about their dental needs, it is malpractice not to provide the �extras.� Without a thorough examination, problems will be overlooked and the overall health of the patient is compromised.

The odd concept of cramming the hygienist�s schedule with 10- to 20-minute prophys is not only neglectful care, it is less financially productive in the long run. A thorough examination, including a full-mouth series, full-mouth periodontal probing, and use of the intraoral camera can diagnose treatment that would otherwise be missed.

I have been blessed to have worked for top-notch dentists during my whole career. These providers have taught me a lot over the years and encouraged me to excel in my field. I regularly see patients for initial visits whose mouths are a disaster, and they are shocked that the dentist that they had been seeing every six months gave them a clean bill of health.

For Dr. Neiburger to reward his hygienist because she rushes through patient treatment � and to fire others because they are thorough and take more time � seems backwards to me. How unfortunate for his hygienist to be rewarded for mediocrity!

Anne Valenti-Storck, RDH

Abingdon, Maryland

Bananas on sale!

Dear RDH:

I wish to join the myriad of fellow hygienists in response to Dr. Neiburger�s preposterous letter in the September issue of RDH. After reading his letter, when my initial peals of laughter subsided, I, as many other hygienists, became quite annoyed with his insulting view of our profession. I was compelled to send in a lengthy response immediately. But as the events of September 11 unfolded, I put my response far on the backburner. I have spent some time today reading the numerous other responses that were sent in, and I must applaud them all! It comforts me to know that there are so many other hygienists out there who refuse to compromise their standard of care. I can only hope that the hygienists he employs will realize that his concepts of �fast prophys� and �quality vs. retardation� are counterproductive to everything we as health-care professionals have worked so hard to achieve.

An Illinois resident also, and frighteningly near the area in which Dr. Neiburger practices, I must agree with the RDH from Long Grove, Ill. who wrote that she is �embarrassed to be in the same state� as he is. Thankfully, in over eight years of practice in Illinois, I must say that I have never encountered any doctor that shares his views. If I ever do, I plan to �ergonomically,� and with sharp scalers in hand, run like hell!

Fortunately, I have recently acquired licensure status in California and plan to relocate soon. I can only imagine Dr. Neiburger�s views on hygienists administering local anesthesia, which is legal in California and some other states (and will soon be in Illinois as well). But please, doctor, no more letters, as we have heard enough from you. In your case, I believe silence is golden.

I could continue my response but I would only be repeating what has already been written by my colleagues. I could also finish this up with my original final thoughts on the matter, which were poised, professional, and in a more serious tone. But in light of all the events that have recently occurred, and continue to occur, I believe some humor is in order. As one of the �girls,� I have some ideas that may work for you, Dr. Neiburger: Why don�t you just open up a drive-thru practice? Perhaps acquire some chimps from the circus and have them perform the prophylaxis procedures? That would cut some of your overhead, since bananas are on sale at the market!

Michele Murdy, RDH

Barrington, Illinois

Another cold sore remedy

Dear RDH:

In the August 2001 issue, �Cold Sores� was well written and mentioned some new remedies. One technique for treating cold sores that was not mentioned, but which is very effective and easy to do, is the use of a red laser pointer. These �pointers� cost around $10 at most stationery, hardware, and novelty stores. They produce a bright red light at wavelengths of 630 to 680 nm.

Exposing injured epithelium to this light for 30 seconds (1-5 cm distance) will cause increased metabolic activity in the cells and allow healing to progress at two to three times the normal rates without any danger to the patient. �Lasing� cold sores and wounds (denture sores, cuts, extraction sites, etc.) significantly speeds healing, especially with cold sores and other apthae 80 percent of the time.

It is inexpensive, effective, harmless, and impressive to the patient. Try it.

E. J. Neiburger, DDS

Waukegan, Illinois

Find a system that eliminates pain

Dear RDH:

As is so often the case, Mark Hartley�s August �Editor�s Note� made me think. The topic of Mark�s most recent lucubration was, �Is pain acceptable during the course of hygiene care?� This is a critical question for dentists and hygienists to address. In my office, the answer is absolutely not ... but the devil lies in the details.

Modern dentistry shouldn�t hurt. Painful treatment from any oral-health provider reduces the likelihood of patients returning for needed care, cripples office potential, and diminishes professional reputations. But it�s imperative that all periodontal therapy be thorough, so it�s incumbent upon the dentist/hygienist/office team to develop systems and methods that make consistently comfortable, yet ideal periodontal treatment possible. The key lies with proper treatment planning.

My practice offered five levels of peridontal care based upon the tissue health of each patient. Time and fee must be adjusted to reflect the time and level of skill demanded for ideal treatment (as is routinely done for restorative dentistry). For example, times and fees for a second molar endodontic procedure vary greatly from that of a central incisor.

Dentistry owes it to patients to diagnose periodontal infection and treat it appropriately ... not with a 40-minute, one-size-fits-all prophy. Only the creation of a system that allows sufficient time for treatment and offers a fair remuneration allows comfortable, ideal care to be delivered to all patients.

John A. Wilde, DDS

Keokuk, Iowa