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Missing calculus

I work in an office 1 day a week. I am a new grad and this was my first job. We recently hired a new hygienist with years of experience. She saw one of my march SRP pts at their first recall recently. This pt has bad oral hygiene and up to 9+ mm pockets. She said that whoever did the SRP did a bad job and that the pt would need another deep cleaning. She said that there was a lot of tenacious heavy deposits left over. She also put in her notes that the pt made a comment that she spent more time doing one part of the teeth than I did the entire deep cleaning. I honestly just do not know what to think. I feel horrible that I did a bad job and that she had to “fix it”. I am always welcome for criticism, but I feel almost attacked at the way she wrote her notes. I took post op xrays of the cleaning and didn’t see any of this heavy tenacious calculus on the xrays which I would think would make a little appearance. My office knows about the situation but have kept completely quiet about it to me, I have heard from someone else that they think its the pts poor hygiene that caused it rather than my bad job. Can a pt build up that much after a deep cleaning in 5 months? I just don’t know what to think. I have never met her in real life but I may soon and I am so nervous.



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Author Note:
Also is this problem common of new grads? My teachers always praised me on how well I did and now I just feel like I am failing.

1 Answer

I’m so sorry you are being treated poorly in a passive aggressive way by the other hygienist! Whether you are a new grad or not, we all miss calculus on accident, even the hygienist who is blaming you. It is not normal to be treated this way (new grad or not). Some patients are “calculus builders” depending on many factors including composition of saliva. So absolutely, a patient can build calculus this fast, especially if their homecare isn’t up to par, which in reality, is why they needed SRPs in the first place. This patient should not have appointments so widely spread (5 months), their recall should be 3 months, at the most, apart. Further, with pockets that are 9+ deep, this patient should be referred to a periodontist. Our instruments become inadequate to remove deposits at around 6 mm.
 
While its very important for any hygienist to document thoroughly, to automatically assume it was that you did a poor job and to write that in the patient’s notes is hugely unprofessional. If there was a real concern, she should have come to you directly, not vented in patient notes. I have been in a similar situation where a very seasoned hygienist who worked on my day off would find anything to throw me under the bus. While she never criticized my scaling ability, she criticized everything else under the sun. A patient even told me that she was complaining that the “regular hygienist” didn’t sharpen her instruments (I sharpen at least once/week and she never sharpened) so that’s why she couldn’t do a good cleaning on them. Mind you, this is a hygienist who sprays the instruments with Cavicide after treatment which causes massive corrosion. The point is, she was showing her seniority (of age) over me in a passive aggressive way, instead of being a supportive co-worker and team member (even though we never saw each other).
 
That fact that the office knows about this and hasn’t said anything to you, speaks volumes. If their was a real concern about you doing poor work, your boss would have brought it to your attention (as they should). Maybe it would ease your mind if you chatted with the doctor about the situation. The doctor should be concerned, at the very least, of the unprofessionalism of their employee. It doesn’t make an office look good when co-workers are throwing each other under the bus and talking poorly about each other to patients.
 
It’s easier said than done, but please don’t feel nervous about this. Talk to the doctor, then try your best to let it go!

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