|   Hiring a Hygienist Who Will Fit Your Practice Philosophy
 
 by Trisha E. O’Hehir, RDH, MS,
            Editorial Director, Hygienetown Magazine
 
 Dentists often provide their own dental hygiene services when
            their practices are just getting off the ground. Don’t keep this up
            long or you’ll be using your valuable time and talents doing procedures
            that can be provided by a dental hygienist less expensively.
            Hiring a dental hygienist will create a stream of patients
            that need your specialized care. Your dental hygiene department
            will be the primary source of patients needing restorative work.
            Emergency patients come directly into the doctor’s schedule, but
            these patients will not keep a practice going. Far and away the
            majority of patients needing restorative work will come directly
            from the dental hygienist’s schedule. While the dentist is providing
            needed and more expensive restorative care, the dental
            hygienist will keep his or her restorations healthy, detect needed
            work in others and contribute significantly to office overhead.
 
 When interviewing for a dental hygienist there are three
            main topics of discussion: employment aspects of the job, specifics
            of the clinical position and practice philosophy. Obvious employment
            issues deal with the work schedule, hours, salary and benefits.
            Questions about the clinical position relate to the specifics of
            patient care: available instruments, supplies and oral hygiene products,
            appointment length, etc. And lastly, an important and enjoyable
            part of the interview is discussing your practice philosophy and
            that of the prospective hygienist.
 
 Your practice philosophy will be the foundation of the dental
            hygiene department within your practice. This is also the
            department that will be responsible for maintaining the health of
            tissues around your restorations and preventing any secondary
            decay. Well-organized, optimized dental hygiene departments will establish and maintain a high level of oral health for patients and
            also contribute significantly to the financial success of the practice.
            It’s never too soon to give some serious thought to your practice
            philosophy. Answering the following questions will provide a foundation
            for your practice philosophy as it relates to dental hygiene.
 
 1. Do you believe dental disease is preventable?
 Your dental education focused on repairing the destruction of
            dental disease, with little time for prevention. The vast array of new
            restorative products and materials used today naturally took up your
            time in school. It’s now, with your own practice and perhaps your
            own family, that you can consider the potential for prevention.
 
 2. Do you believe early demineralized lesions can be
            remineralized?
 You’re an expert on restoring lost tooth structure, but backing
            up just a few steps to identify lesions before they cavitate provides
            an option to reverse the caries process before restorations are
            needed. This is still a treatment that is being provided, with a
            code and fee.
 
 3. Do you want to know the pH, flow rate and buffering
            capacity of your patient’s saliva?
 Caries is now considered a pH disease, not just a sugar and
            poor oral hygiene disease. Frank carious lesions begin as demineralized
            areas. Normally the buffering and adequate flow of saliva will
            reverse early microscopic demineralization. Reduced salivary flow
            and compromised buffering will significantly increase the risk of
            dental caries. Placing a restoration will not cure caries when low pH
            of the mouth continues to demineralize the enamel. Identify and
            monitor risk factors like pH.
 
 4. Do you consider interproximal surfaces at greater
            risk for dental disease than facial and lingual surfaces?
 Toothbrushing is taught first, yet the greatest risk for caries
            and periodontal disease is found on the interproximal surfaces.
            Toothbrushing should come second to interproximal plaque
            biofilm removal.
 
 5. Is your primary tool for daily interdental oral
            hygiene dental floss or are you open to sticks, picks
            and water irrigation?
            Brushing and flossing are the traditional mantra of dentistry,
            but research shows us that more than 80 percent of people don’t
            floss and those who do are not effective. It’s time for alternatives
            that have been show by scientific research to be effective alternatives
            to flossing – or rather, to not flossing at all!
 
 6. What are your definitions for periodontal health and
            periodontal disease?
 As simple as this question appears to be, it will define your
            periodontal treatment. According to definitions, health is the
            absence of probing depths over 3mm and no bleeding upon probing.
            Allowing your practice and your dental hygienist to perform
            “bloody prophies” does not respect this definition of health.
            What is the definition of health you want for your patients?
 
 7. What are your criteria for referral to a periodontist?
 It’s not just probing depths, but also crown lengthening, grafting
            and implants. What do you plan to do and what do you want
            a specialist to handle for you?
 
 8. Do you have patients start brushing on the
            mandibular lingual surfaces?
 Since the greatest amount of plaque biofilm and calculus
            accumulate on the mandibular lingual surfaces, teach patients to
            begin here and not on the facial of the maxillary anterior teeth as
            shown in toothbrushing brochures.
 
 9. Do you counsel mouth-breathing patients to
            breathe through their nose and not their mouth?
 Dental school highlights the drying and irritation of anterior
            gingival tissues caused by mouth breathing, but the list of problems
            associated with mouth breathing is long and serious. Give this issue
            some thought as your advice will impact many lives.
 
 10. Do you check for and treat ankyloglossia or refer
            to a specialist?
 Untreated, tongue-tie can lead to significant problems with
            palatal – skeletal development and tooth alignment. Tongue-tie
            also leads to mouth breathing, among many other problems.
 
 11. Do you want a dental hygiene department in your
            practice or a dental hygienist employee?
 Working collaboratively with a dental hygiene colleague who
            manages your dental hygiene department can lead to healthy
            patients who appreciate and utilize the services you provide while
            contributing significantly to the financial success of your practice.
            These questions are a start to creating a clear picture of your
            practice philosophy. Discussing your goals, beliefs and desires for
            your practice with potential employees during the interview process
            will lead to hiring a dental hygiene colleague to lead your dental
            hygiene department to patient health and financial success.
 |