Postively Practicing

April 28, 2006
Keep the fire burning for your career with these eight rules.

By Amy M. Nieves, RDH

I had the opportunity one day a few weeks ago to have Nicole Laws, who will be graduating from Valencia Community College in Orlando, Fla., come in to observe our office. While she was observing, she was so positive and excited about everything. I remember being like that seven years ago when everything was new. Nicole asked the most intelligent questions. Our patients were impressed with her great personality. I was impressed with her positive outlook of dental hygiene. She just shined! What a brilliant star who is going to be welcome in our dental hygiene community. You will definitely see her in the future!

Seeing Nicole made me start thinking about ways to keep that fire burning within to continue to love dental hygiene. At times we can be alone in the office or stuck in the monotonous trap of just scraping teeth. But we can make our day and the patient's day more exciting! Here are a few rules to live by daily that can make hygiene more interesting — not just for you, but for the rest of your team and your patients.

1st Rule: Do not be just a cleaning lady! You do not just "clean teeth." You are providing a specialized area of care to help your patients achieve total body health. Show on your name tag that you are an RDH. Keep your license posted. You can even get framed artwork or RDH calendars to hang up from Ms. Flossy's site at: It can spark discussions on what exactly a hygienist is as opposed to an assistant.

2nd Rule: Keep up on all your medications. Continue to buy the latest PDR. For those who have Palm Pilots or BlackBerrys, I believe you can load a PDR into them for fast referencing. By doing this, you can check all of your patients' medications (even over-the-counter and herbal supplements) for any oral side effects. You will be very surprised about how many patients self-diagnose or take over-the-counter medications that interact with their prescribed medications. By taking the time to check your PDR, you will be letting patients know that you are not just treating their mouths; you are a health-care provider who cares that they achieve optimal health. Always ask patients if they taking any OTC or herbal supplements in addition to their prescription medications. There are great herbal supplement charts that you can print out from the Internet which show contraindications as well as oral side effects. You can keep this in a plastic sheet in your operatory to show patients.

Biotene also has a nice sheet that shows the medications that can cause xerostomia. It's important to keep these kinds of guides in your operatory to consult at a moment's notice. Many patients will remember more of the information you tell them if they have something visual to take home. Every tidbit you provide about how to take care of their teeth with certain conditions will give patients a boost in trusting you.

3rd Rule: Always provide dental education at any time. Look for those golden opportunities when a patient asks you a question. If your office has a Web site, ask if you can post some articles on patient education. You can provide copies or links to different research articles on tobacco and periodontal disease, diabetes and periodontal disease, and how to take care of your "new" teeth at home. Today, when people are spending a lot of money on "smile makeovers," we need to educate them about how to keep these materials clean. Ask your patients for their e-mail addresses and whether it is OK to send them a monthly newsletter. Not only will this remind patients to be involved with their oral care, but it will also get the "team" together to share favorite articles or tidbits. You can also add information to the newsletter about someone in the office who is having a baby to keep patients involved in your practice. This is a good way to develop patient relationships.

4th Rule: Make a binder of dental articles that you find in journals, as well as in mainstream media. If you have a great article on diabetics and periodontal disease, copy it and give it to your patient. Patients will see you as a professional when you provide them with take-home educational materials.

5th Rule: BLOOD PRESSURE, BLOOD PRESSURE, BLOOD PRESSURE. I cannot say enough times how important this is. Even if you get one of those good digital readers, always have your stethoscope and arm cuff ready to go if you have a high reading. If the patient's reading is high in one arm, take it again in five minutes in the other arm.

To keep a copy of the current blood pressure readings, please go to: Pam Mecagni, RDH, contributed this to the resource file so that everyone can use it at work. You will be amazed at how many people you will find a high reading on. By referring these patients to their doctors, you not only show the patient that you care about his/her health, but also that your office is interested in his/her well-being — not just drilling and filling. I can't begin to tell you how many patients have come back to me three to four months later saying that they were diagnosed with hypertension and are now on medication. One woman even told me that her doctor said she was on a path to a stroke. WE CAN POTENTIALLY SAVE LIVES!

If you have a patient with a high reading, note the reading number, the arm you took the reading on, and the date and time on your business card. Then tell the patient to take this to his/her MD. This will look good to the MD and you might even get some referrals out of doing this regularly. Call the patient in a few days and ask how he/she is feeling. If the patient hasn't gone to the doctor to get his/her blood pressure checked, gently remind the patient to make the appointment and remind the patient that you are calling because he/she is a valued patient. I have had patients thank me continuously because if I hadn't taken their blood pressure, they would never have known it was high and could have potentially gotten sick.

6th Rule: Bring in research articles on products you want to introduce in your office for use on patients. By doing so, you will justify to the dentist who in the office needs this. Tell your patients what you are using on them. Let them know about the exciting new products and why you are using them. If you use items like ProClude before scaling, tell your patients why. Let them know that your office cares about their comfort and that you have chosen that product to help relieve their sensitivity. As you are polishing the product on, talk about SensiStat and how it helps remineralize teeth. Do likewise if you use any of the other types of product like MI paste, ClinPro, or NuCare. Let patients in on these hot new products.

7th Rule: Always review medical history by asking inquisitive questions to which patients cannot just say "yes" or "no." "What medications have you been taking, Mr. Jones — even anything that is OTC or herbal supplements?" If you notice there is a contraindication, let the patient know about it, just like a pharmacist would. Recommend that patients see their pharmacist to ask about interactions that their prescriptions and over-the-counter medications might have on one another. Ask about hospitalizations or doctors' visits they have had since their last dental visit. If patients have had surgery, ask specifically what kind so you can note it in their charts. Ask if they have had any sudden weight loss or gain. Ask how they have been feeling in general. If possible, insert a sheet of paper or area in your computer template of notes where you can add personal tidbits. Nothing makes patients feel better when they come back in and you ask how their daughter's wedding went, or how their cruise was. Patients love this personal interaction. We can't spend the whole appointment chatting, but asking a few questions in the beginning serves as an ice-breaker.

8th Rule: Go to as many CE courses as you can . . . even if you have enough CEs to fulfill your state renewal requirement. Take "out-of-the-box" courses on occlusion, new dental materials, and exciting new technology. Stay ahead of the game and always learn something new. I saw a quote once that stated, "The truly educated never graduate." LEARN, LEARN, LEARN. Attend big conferences like RDH's UOR every year to meet new RDH friends. This meeting is so addicting that you will find yourself making plans to go every year. PennWell and the sponsors of UOR put on a great seminar. The networking is amazing. You truly will have a good time, learn so much, get excited about new technology, and even be able to write it off your taxes!

Add any ideas or passions that you might have, like tobacco cessation, to your appointment routine. It breaks up the day to make it not just about "cleaning teeth." Every bit of education and information you can give to your patients will amaze them. They will start to value you as a true health-care professional.

Good luck and best wishes on a rewarding and successful career in dental hygiene!
Amy M. Nieves, RDH

Amy and Joe celebrate their 20th wedding anniversary this year in October. They have three teenage daughters. Amy welcomes all dental hygienists to join her online hygiene community by going to Hygiene resources can be found at, including comprehensive resources for students to study for national boards. Amy has co-written a book with Shirley Gutkowski, RDH, BSDH, called The Purple Guide: Developing Your Clinical Dental Hygiene Career, which can be purchased at Amy practices four days a week in a periodontal practice in Longwood, Fla. She welcomes correspondence by e-mail at [email protected].