About Me: Hi, I'm Kara and I'm the founder of Dental Hygiene Answers! I started this site to expand the dental hygiene community beyond my Facebook page, Dental Hygiene with Kara RDH. I get many questions on a daily basis through my FB page, so I thought I would create a space where I can share my answers, as well as give other hygienists the opportunity to answer questions from their peers. I am always looking for ways to improve this site, so if you have any suggestions feel free to contact me on my FB page!
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Location: Portland, Oregon
While using an eCig or vape pen doesn’t contain tobacco, it does contain nicotine. Nicotine is a vasoconstrictor which leads to lowered immune ability and ability to fight infection. Vaping can also cause xerostomia, irritation of the oral tissues, and can lead to “Popcorn Lung.” I’ve also seen eCigs exploding in people’s pockets, and even during use causing serious damage to the face and mouth. There is a lack of long-term studies on oral and physical health because eCigs simply haven’t been in use long enough to study this.
As hygienists, we should explain the risks to the patients and continue to provide cessation advice and resources, just like traditional cigarettes. I’m glad you are going to take a CE course about this topic! Here is an article that explains a bit more: https://www.dentalacademyofce.com/courses/3229/PDF/1612cei_Sherry-Vaping_web.pdf
Also, if you do a Google search for something like “eCigs oral health,” other good articles come up.
Question: Vaping and the oral cavity | January 21, 2017
If you do a Google search for “dental education brochures” you will find many available. Here are a few links:
Your dental supply company should carry them too. For instance, here’s a link to Patterson:
Question: Educational brochures for patients | January 20, 2017
Yes! As long as you are able to practice good ergonomics its not a bad idea. In hygiene school, one of my fellow students decided right then and there that she was going to practice standing hygiene. Every time I would walk by her operatory her patient was up in the air and she was standing. Here’s an article that explains the benefits of standing hygiene: http://www.rdhmag.com/articles/print/volume-31/issue-1/features/go-ahead-take-a-stand.html
Question: Sitting is the new smoking?? | January 19, 2017
Here is a link to a similar question with many good answers on time given: http://www.dentalhygieneanswers.com/time/
My last office, I got one hour per quad. However, in the past I worked at an office where I only got one hour for 2 quads. It was not enough time for most patients. Plus it wore me down physically and mentally. To “keep working on things” at future appointments doesn’t sound ethical to me. Patients pay for a service and the service should be completed, not left half done. I wonder if the consultant is a hygienist! This is concerning because leaving residual calculus, and the tissue healing around it, can lead to a perio abscess. This could lead to the patient needing RCT/crown or even losing the tooth.
Question: How much time is everyone getting for 1/2 mouth SRP? | January 19, 2017
The presence of calculus alone isn’t an indicator for the need of SRPs. SRPs are warranted when there is active disease with loss of clinical attachment level. So you have to determine if this patient has active disease. If there’s no bleeding, I wonder if this patient has pseudopockets and clinical attachment loss due to bruxism instead of active disease. Or I wonder if this patient is a smoker, so vasoconstriction is occurring keeping the tissue from bleeding. Without seeing the patient its hard to know! I would suggest talking with your co-worker and put your thoughts out there and listen to their’s on why a prophy was treatment planned. It never hurts to get on the same page and collaborate as far as perio protocols!
Question: SRP on 4-5mm pocket w no BOP | January 19, 2017
I’m so sorry you feel that you aren’t getting the care you need! How long the actual cleaning takes really depends on how healthy your mouth is. If you have fantastic home care and clean in between your teeth and brush well, your cleaning may be quicker than if your home care is poor. Some hygienists are quicker than others as well. I wonder how long the hygienist actually has for appointments because if they aren’t allowed enough time, set by the boss, they can be rushed.
Like you, I certainly wouldn’t be satisfied with, “we’ll get that next time.” It may be in your best interest to try a different office and see how your care compares. When finding a new office, I would ask how long is allotted for hygiene appointments. I personally wouldn’t go to an office if they are under 50-60 minutes.
I know finding a new office is a pain, but it may be worth it to give you piece of mind about the quality of your dental treatment. Again, I’m sorry you feel your care is less than adequate, you shouldn’t leave a dental office feeling that way!
Question: How long for actual physical cleaning of teeth? | January 12, 2017
It’s such a struggle being a new hygienist (or seasoned, for that matter), needing a job, so accepting less than you should. Just because you are a “newer hygienist” doesn’t mean you shouldn’t get paid what you are worth! You are a trained professional and deserve to be paid as such.
After 90 days of working and being paid $10 below average, I think asking for a raise is appropriate. I would run a report on your production numbers and have it ready when speaking to your boss. The industry standard is that your wage should be about 35% of your production. To be very clear, 35% of production, not collection. I would also list out what you have done for the office; how you are a team player and basically your accomplishments thus far, showing other reasons you deserve a raise beyond just numbers. Unfortunately, I wouldn’t expect getting a $10 raise at once. If a dentist is going to pay so low in the first place, I don’t see them all of a sudden becoming generous, being a savvy business owner trying to keep good employees on staff, or caring about employee morale being high. However, I really hope your situation will be different! And whether a dentist is a big negotiator really depends on their personality; some are, some aren’t. Be prepared either way.
I would also suggest bringing up to your boss that you would like reviews every 6 months or every year going forward where you can discuss pay raises based on continued performance. It’s playing the long-game, but this may give you a chance at getting your wage where it should be.
Overall, some dentists hire new hygienists because its easier to take advantage and pay well below average. It’s sad, but its true. If your boss doesn’t budge on pay rate, personally, I would move on. No one should be taken advantage of especially when you are making them money. $10 below average is being taken advantage of in my opinion! I’ve been there, so I can say that out of personal experience!
I really wish you the best of luck! Stick to your guns; you should be paid an average wage or very near, even being new. It may take time getting your wage to average, but if it really is a good office to work at, it may be worth the wait. If not, consider other options.
Question: Asking for a raise? | January 11, 2017
The information given directly from the Dental Hygiene Committee of California is the info I would go with. They make the rules and regulations, so they are the most accurate. Yes, on top of hygiene school training they require extra training for local and N2O. Here is a link to approved courses for local anesthesia and nitrous oxide: http://www.dhcc.ca.gov/licensees/certifications.shtml
Here is a link to how to apply for licensure by credential: http://www.dhcc.ca.gov/applicants/becomelicensed_rdh_lbc.shtml
And a helpful checklist: http://www.dhcc.ca.gov/formspubs/app_rdh_lbc_checklist.pdf
I’m sorry who you spoke to was less than helpful! Hopefully these links will help!
Question: California Dental Hygiene License | January 7, 2017
Your wage should equal about 35% of your production. Take a day that assisted hygiene was done and run a report for hygiene production to give you an idea of what that 35% is. Depending on this number, you can gauge where your compensation should be. It’s hard to say what the standard is because it depends on your current wage and what you produce.
Question: Assisted hygiene | January 6, 2017
I really like the Young Hygiene Handpiece. Often times Young Dental runs specials if you buy so much of a product (prophy paste, prophy angles, etc.) you can get a handpiece for free or buy one handpiece get a second for free, offers like that. You can check out their website or ask your dental supply rep for offers.
Also, you may be able to send in the one that stopped working for repair so you can have it as a back up.
Question: Best Hygiene/Prophy Handpiece? | January 6, 2017
Wow, unbelievable! First, who is the person who is in charge of patient’s insurance and doing the insurance breakdown? If it’s not you, then YOU should not be “punished” for THEIR (big) mistake. Coverage should be checked before the patient even sits in the chair! So in my opinion, doing any work (especially SRPs!) you should be compensated and no it’s not fair that you aren’t. The Fair Labor Standards Act, which is Federal law, states that any work done on behalf of your employer must be compensated at or above minimum wage. Of course I believe you deserve more than minimum wage, but that’s just what the law says! So this almost makes me wonder if a Federal law is being broken here…
Regarding the no shows: I wonder why there are so many no shows. Do you have an office policy that patients sign stating that after so many no shows they will be released from the practice? Also, are these recall patients not showing up or new patients? If its recall patients, then something is going on there. Whether it be a patient care issue, front desk issues, whatever, finding out why this is happening, so it can be fixed, should be number one. I have heard of some offices making the hygienist clock out if there is a no show, however I think if you remain busy stocking, sharpening, even filing, I believe you should be paid for the same reasons I stated above.
If these things continue to be a problem, honestly, I would look for another office to work for. I know that’s hard, especially since you are only working part time right now and are probably looking for a full time job anyway. On the bright side, if and when the patient base grows in the practice getting paid on production can be extremely lucrative.
I hope I was able to help at least a little, and best of luck going forward!
Question: Should I still be getting paid if there is an insurance screwup and the office doesn't get paid? | March 16, 2014
Oil pulling is popping up all over the internet lately and I too am starting to have patients ask me about it. In fact, one patient of mine who has been oil pulling is now in need of SRPs as he presented with radiographic calculus, generalized 6mm pockets, mild bone loss, furcation involvement, and recession. I could barely get through perio charting as he was so tender due to infection. I don’t like not having a science-based answer when it comes to patient questions (even though clinically I had my answer) so I began my research into oil pulling.
Oil pulling is an ancient Ayurvedic remedy for oral health and detoxification. It involves the use of pure vegetable oils as agents for supposedly pulling harmful bacteria, fungus, and other organisms out of the mouth, teeth, gums, and even throat. As a hygienist, I’d like to focus on the oral health benefit claims as many people are oil pulling instead of brushing and flossing.
First, we need to look at dental plaque. For review: dental plaque is a bacterial biofilm that forms a physical barrier, a polysaccharide matrix, which protects bacteria from the effects of antibiotics, antiseptics (rinses), and your immune system. This is why taking an antibiotic for gum disease is not effective, as the antibiotic cannot break through the biofilm’s protective layer. The claim that oil can break this through this barrier has not been proven. The most effective and proven method to disrupt biofilm is through mechanical/physical means, in other words by brushing and flossing.
Next I’d like to comment on the claims of oil pulling “healing” gum disease. Simply rinsing with mouthwash, oil, or any other liquid only reaches 2 mm into a gingival sulcus. Most people have deeper pockets than this, especially when they have gingivitis or periodontitis. This is why rinsing, alone, is not the delivery of choice. Like mechanical removal of biofilm, this has been proven in scientific studies. So why would oil be able to miraculously get deeper into the pocket? Until I see a valid, reproducible, scientific study, again I must hold true to what has been proven thus far.
When you read these articles online I hope you notice who they are written by. Were they written by a dental hygienist or dentist? When studies are referenced validating the claims of oil pulling are you able to easily find these studies and fact check? I’ve noticed that the study results referenced in many articles were written in a way to make oil pulling look effective, but the actual results of the research were actually left out! For instance, saying oil pulling was effective after 4 weeks regarding plaque reduction, but leaving out the control group using chlorhexidine was effective at 2 weeks. Further, wouldn’t just swishing with water or any liquid for 20 minutes be just as “effective?” The studies do not delve into if it was the actual oil or the act of swishing that made it effective. Also, what about probing depths, bleeding indices, using a control group of just water or salt water, etc. So many questions unanswered!
Finally, brushing for two minutes twice per day along with flossing for a few minutes once per day, simply takes less time. I have a hard time motivating patients to brush for two minutes let alone swish with oil for 20 minutes! So if a patient chooses to oil pull, doing it in conjunction with brushing and flossing and not as a substitute, would be my recommendation as an oral healthcare professional whose job is prevention. A healthy mouth is a healthy body; so until I see scientific research that shows that oil can reach the bottom of a gingival pocket, can break through the barrier of biofilm, among other points of interest, I’m sticking with what is proven!
As hygienists, it is our duty to use science-based evidence so I urge you to do your own research and use your critical thinking in combination with what you know to be fact from your hygiene education to base your opinion on this fad.
Question: What are your thoughts on oil pulling? | March 22, 2014
In most cases, any pain or discomfort will get better without treatment. But if you have severe, ongoing pain, medication can help. These are examples of what your doctor or dentist may prescribe:
Over-the-counter pain relievers
Mouth rinses with anesthetic
Corticosteroids applied directly on the tongue
If you’re wondering about steps you can take to hasten the relief of symptoms, try limiting these substances or avoid them altogether:
Hot, spicy, or acidic foods or dried, salty nuts
Toothpaste with additives, whitening agents, or heavy flavoring (toothpaste for sensitive teeth is a better choice)
Question: Does anyone know how to soothe the burning of Geographic Tongue? | May 2, 2014
With time comes confidence. It sounds like you may be getting stressed out because of the limited time you have for SRPs. It also sounds like you are perceiving it as a need to question your technique, instead of the circumstances you are faced with. This may be presumptious, but is it time to move on from your current office? Top-notch patient care seems important to you and if you don’t feel like you have the proper time to accomplish this, it’s just not worth the stress. As far as taking BWX after SRPs, it’s not a must, unless as Sue Halverson stated, there’s a tenacious, questionable area. Just make sure you have an 11/12 explorer handy! That may not be the most popular answer, but I feel like you might be held back by working with an office that doesn’t share your same patient care standard. I want to applaud you for trying to be the best you can be! You are a professional, you got this!
Question: SRP | September 27, 2014
If an OSHA inspector saw this, your dentist would be fined. OSHA states to change masks between patients or during patient treatment if the mask becomes wet. A gown can be worn all day unless it becomes “visibly soiled.” It may help to print out OSHA guidelines to show the people who are in question.
Question: Using same mask all day | August 2, 2014
In my experience, I’ve not been given a lower pay rate for attending mandatory training or meetings – and I’ve worked for some very frugal doctors. I do agree with you that your time should be valued! My question would be, is every one in the office getting a lower rate of pay? If not, than that inflates the issue. It is my understanding that under the Fair Labor Standards Act, pay can be lowered but I believe you need to be informed and consent. I’m not an attorney, so that may be worth investigating. It’s hard to be a team player, if you are not valued as part of the team. This is a tough issue to address with the doctor, but it may be worth a chat him if only to express your feelings of being undervalued. I wish you the best of luck with this!
Question: Regular pay rate vs. education pay rate | February 5, 2016