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Minute by minute breakdown of a prophy

Hi! I just graduated, and will be working hopefully soon. We have been taught everything we need to know at school, but everything takes a woefully long time. I fear that when I walk into my first job I will have no idea how to do a prophy in the real world. It takes us 15 minutes to do an intra/extra! If some people wouldn’t mind, could you give me a minute by minute anatomy of a prophy? What you do at each stage. That would be so helpful! thanks



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I understand your fear but trust me, you’ll be fine. As I’ve said in a similar post, once you don’t have instructors hovering over you and miles of paperwork to fill out, everything suddenly takes less time! Here’s what I do when I bring in a patient. First, look at their health history and ask if there’s been any changes. Ask if they have any problems or concerns. Take any necessary films. Then I take a look in their mouth to see what the deal is and at that time, I’m making sure all tissues look healthy and don’t see anything suspect. Then I check pockets. If pockets are fine and there’s no BOP, I first cavitron them, then handscale, then a quick trip around with the cavitron again. Then polish. Then go get doc for exam! You’ll see, it will work out. Sorry I didn’t give an exact minute by minute breakdown but it kinda varies with each patient. Again, you’ll be fine once you establish your own routine. Keep your eye on that clock! 😉

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I would ask your first employer if you can sit with /shadow a hygienist for a few patients or afternoon before you start your own schedule…it helps in time management and as well learning the equipment and workings of the office…then you will feel more confident. ..also some offices have no problem lightening your schedule day 1 to help you adapt…especially knowing your brand new…dont worry tho…you will dofine managing time once you get going 🙂

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I too struggled with this at first and now I could do my one hour appointments without a clock! Here is a basic break down of my hour. Med HX update and concerns 5 min, probing 5 min, cavitron 5-10 min, hand scale 15-25 min, polish/floss 5 min. If there is an exam in there I keep my communication with the patient short, courteous, and professional (lots of great people at my place so it’s easy for me to chat it up lol). X-rays and exam usually take 20 min of my one hour. Over time it gets so much easier. For most prophylactic patients two or three strokes on each surface is enough. It really is pretty quick. Hope that helps and good luck!!

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My typical appointment: Rev med hx and ask about concerns/complaints-5 min. Films 5-10 mins (bwx vs fmx). Oral assessment-5 minutes. Probing 5-7 minutes. Ultrasonic/hand scaling 10-20 minutes. Polish and floss 5-7 minutes. We use an IM system so doc is usually there when I am done with flossing. OHI is done during the visit. This is typical, some patients are less time, some more. We are fortunate that we make our own recare appts, so we determine how much time we need for the next appt. I remember my first days in hygiene (a very long time ago) and I too never thought I would be able to get everything done in the time I was given. You will, not to worry 🙂

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Lisa Dowst-Mayo, RDH, BSDH, wrote an article with a few minute-by-minute models: http://www.rdhmag.com/articles/print/volume-33/issue-11/features/breakin-time-down.html

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