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Just Duet! Tune up your hygiene department by adding an assistant

May 1, 2004
Combining forces by using a dental hygienist and a trained coordinating assistant enables you to boost both preventive and restorative case acceptance during the recare appointment.

Combining forces by using a dental hygienist and a trained coordinating assistant enables you to boost both preventive and restorative case acceptance during the recare appointment. Through the use of an assistant, patients can receive a wider range of service options instead of strictly standard prophylaxis.

Find the idea appealing?

When a hygienist couples with a chairside assistant, more work gets done. Granted, certain workspace provisions must be in place, and misconceptions regarding expanding hygiene must be dispelled. First, allot fully equipped ergo-operatories solely to the duo, including ultrasonic instrumentation. This operatory should not be the office "overflow room," and the hygiene assistant should not "float" from the hygiene area to the restorative side.

A confident assistant — combined with a hygienist's touch — adds to the patient experience, increases case acceptance, and gives more direct patient care. The focus of each patient now becomes a well-orchestrated theme. As the baton is passed, patients benefit from a consistent message of care, education, and treatment recommended by both hygiene caregivers. Hygiene coordinators expand the procedures available at recare visits, allowing complete delivery of adjunctive hygiene services. Skilled hygiene coordinators recognize possible treatment sequences and prepare modalities in advance. Preparing carpules of site-specific antibiotic, readying fluoride varnish for desensitization application, or cleaving the diode laser can be set-up tasks for the trained assistant. This type of forward-thinking on the part of the dental assistant is integral to success on the restorative side, so why not apply it to hygiene?

More patients will be treated when the hygienist and coordinator form a team. For smooth flow, set a target limit of 12 to 14 patients per day using a staggered schedule on a 10-minute time frame. When exceeding this patient limit, the hygiene duo moves from assisted hygiene to accelerated hygiene, which is much less pleasurable. The coordinator also monitors the work schedule and adjusts time allotments as necessary for efficient flow. Your hygienist will no longer dread unforeseen schedule changes, touching up worn sealants, taking whitening impressions, or using a variety of high-tech tools for today's dentistry, because hygiene will run the schedule instead of the schedule running hygiene.

Selecting an assistant/coordinator

Permit your hygienist to locate and interview candidates. Hiring their "very own" assistant can make integration more comfortable. If the hygienist is offered a "hand-me-down" assistant who is not working out for the doctor, chances are the assistant will not blend in the hygiene area either. The solution for a poor employee is not to move him or her into a hygiene assisting position. Quality hygiene care should not be compromised. Why not grant the specialized assistant a distinctive title like "hygiene coordinator"? In fact, the coordinating distinction is exactly what the position warrants — orchestrating hygiene. The salary for the hygiene assistant must be comparable (even a bit higher) to the restorative assistant's wage. The assistant will be doing expanded (productive) procedures, offering professional advice on products, and serving as an ambassador for the hygiene department.

Assisted hygiene works! However, the assistant must be skilled and the hygienist must purge that "they can't do it as well as I can" attitude. Setting up home-care scripts, role-playing, and establishing specific duties for the assistant allows procedures to be delegated. Various duties for the assistant are to keep the schedule moving smoothly by preparing the treatment operatory, sterilizing instruments, sufficiently stocking operatories, and reordering hygiene goods. Empower your hygiene coordinator to order supplies and request new samples.

An assistant is helpful for the hygienist during new-patient work-ups, periodontal charting, suctioning during periodontal therapies, and soft-tissue laser treatments. With facetted high-technologies surfacing in the hygiene operatory, patients will experience a high level of combined care when hygiene and assisting merge. When your hygienist goes to continuing-education courses, send your coordinator too. Both will benefit.

Building patient relationships

The patient is seldom left alone in the operatory because either the hygienist or assistant are available chairside. This gives patients time to ask questions about their treatment and get answers right away. Dental assistants offer a different perspective on restorative procedures, so they can become a bridge between preventive and restorative care when explaining treatment to patients. Through combined conversations from assistant and hygienist, patient case acceptance soars.

With the concern over a perceived shortage of hygienists in underserved areas, optimal hygienist-only services can be highlighted with the use of an assistant. The hygienist's attentions are aimed toward precise care delivery from a licensed professional.

Subsequently, hygiene operatory tasks can be allocated to the trained assistant. Assistants share the workload, which gives the hygienist variety throughout the workday and helps avoid burnout. The duo provides a seamless transition from patient to patient.

When mutual respect exists among dental team members toward the assisted hygiene concept, harmonized hygiene happens.

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Karen Kaiser, RDH
Ms. Kaiser has more than 16 years of dental experience, from expanded chairside assisting to currently practicing clinical (assisted) hygiene in Illinois at the Center for Contemporary Dentistry. She was the recipient of the 2002 John O. Butler Co./RDH Magazine "Award of Distinction." Contact her at [email protected].