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Leaving calculus behind

I had a patient in January that came in and in one hour they wanted me to perform 1-3 teeth SRPs for all molars. The patient came in about 25 minutes late and then after a 3-month recommendation, she pushed she pushed the appointment back until last Friday. I was out of town and another hygienist saw her. She took X-rays and there seemed to be a significant amount of calculus left in those pockets. I knew that I did not scale to perfection and would get those the next appointment. In her notes, she noted “heavy residual calculus” and scaled it and proceeded to take pre and post X-rays. She has not said anything to me, the doctor, or anyone else that I know of… yet. How do I handle the situation? And does this make me a poor hygienist? I am horrified and wonder if I am a bad scaler. Also, should I mention it to her before she mentions it to anyone? else

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1 Answer

My first question is how do you or the other hygienist know the calculus present was all residual calculus? The fact this patient needed SRP in the first place, shows a history of lack in home care. Also, some people build calculus quite quickly and it is completely possible this is new calculus; calculus can build for some within days.
Patients’ lack of home care or not keeping regular appointments does not make you a poor hygienist! It’s like the old saying, you can lead a horse to water but you cannot make them drink.
It might be a good idea to speak directly to the other hygienist and ask why she is so certain the calculus present was residual calculus. I must mention, I think it’s in poor form to immediately throw another dental hygienist under the bus, especially in chart notes.
Also, if a patient is 25 minutes late to an appointment, this does not leave you enough time to be thorough in your treatment. This opens you, and the doctor, up to liability issues if pathology is missed, etc. due to a lack of time. Seeing a patient in an abbreviated amount of time doesn’t do any good for the patient, you, or the patients seen after this patient because you will most likely be running behind. Does your office not have a late policy? If not, this might be a good time to speak to the doctor about implementing one.
I’m really sorry this is happening! Speaking directly to the other hygienist and implementing a late policy might nip any future problems like this in the bud!

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