Moving forward as a team with assisted hygiene

DATE: July 2020
AUTHOR: Mandy Dennis, RDH

Many clinicians are scared and excited to get back to taking care of patients. We want to go back to the way things were, but we understand we must approach the newest way of practice with caution. This caution may not mean we are timid in taking care of patients, but it does have a different look in the “how” we take care of patients. Assisted hygiene, while not a new way of practice, may be a way of incorporating efficiency and help us with focused infection control and screening.

Time to go back

Dental Hygiene, without question, is going to look different for a while. There are frequent changes regarding guidelines and recommendations on how to take care of patients. An important component of going back to work is how we work together. Working collectively will allow us to take care of every patient who comes through the doors of the office. Communication and teamwork will be essential. Respecting the role each of us provides in care will be vital. Establishing a plan on how to return may be difficult, however it also may prove to establish success not only for the new changes but in the future.

What is Assisted Hygiene?

When considering whether or not assisted hygiene is right for your practice, it’s first important to understand what it is. Conventional four handed dentistry allows the dentist to perform dental procedures efficiently and effectively. Assisted hygiene is not defined as four handed dentistry. In referencing the role of a hygiene assistant, it’s important to look at the entire hygiene appointment. What are all of the parts of a hygiene visit? Review of medical history, radiographs, a doctor exam, preventative care or periodontal maintenance and the education portion are all important, but do not necessarily all need to be performed by the hygienist. Utilizing a hygiene assistant will allow the dental hygienist to move from room to room, thoroughly care for each of their patients and allow the assistant to do the parts they are licensed to do. This way of care isn’t designed or meant to make us faster, it is meant to help us be more efficient and effective with the time we have with our patients.

Give credit where it’s earned

Every member of the dental team is important. We couldn’t meet the needs of our patients, with the greatest care, without each other. Think of going to the dental office like flying an airplane. The dentist and dental hygienist could be seen as the pilot and co-pilot of the practice. Each provider gives specific types of care; however, the dentist is the ultimate one responsible in guiding the process. The assistant could be seen as the flight attendant. He/she ensures the process of the appointment works seamlessly. Have you ever been on a flight without a flight attendant? Would you want to? The same could be said of the dental/hygiene assistant. The care they provide is essential and without question, helps to ensure the provider can do their part. Hygiene assistants have been shown to perform important roles in the hygiene visit. They are educated, trained, and licensed to meet the needs within their scope of practice. Much like a dental hygienist, they want to do everything within that scope. Giving them an opportunity to do their jobs allows them validation and job satisfaction. Should any part of the team feel as if another person isn't performing the tasks set before them, they should sit down with a neutral party to discuss the situation and remedy the controversy. This part of problem resolution is one thing we should never change.

How can it help the practice?

Providing care now and post-pandemic has created many challenges. Our patients expect we have gone above and beyond to create a safe environment for them. While dental professionals have performed cleaning, sterilization and disinfection based on standard precautions, dental offices are in the spotlight due to the ongoing conversations about aerosols and the spread of the virus. Based on the recommendations laid out by the CDC, instrument layout and room preparation may have a new and different approach for the practice, than prior to the pandemic. Utilizing hygiene assistants in preparing rooms gives the dental hygienist an opportunity to continue conversations with a previous patient or take a moment to finish notes, or prepare him/herself for their next patient. In addition to room preparation, appointment flow can be met with reduced touch, by partnering with a hygiene assistant. Procedures such as perio probing can be performed by the dental hygienist and called out to an assistant to do the perio charting. This reduces the need for the dental hygienist to touch the keyboard and allows the patient to hear what is seen by the dental hygienist. Education and treatment can work hand in hand. Planning on how to structure the appointment can also prove to be most helpful. Communication between the doctor, dental hygienist and assistant on when to do all parts of the appointment, can help the flow and keep each care provider on time, allowing for proper infection control and preparation for the next patient.

Making it work

Change is inevitable. Choosing to change by developing training plans of all types will prove to be valuable. Dentists work so closely with their assistants, that the assistant anticipates the next step in treatment. This same type of care can work for dental hygienists and their assistants. While the four handed concept doesn’t apply in the same way, the hygiene assistant can anticipate the needs of the dental hygienist by understanding the appointment. Good communication between each party ensures all needs of the patient are met. It’s important to know no new position “just happens.” Discussions of expectations and roles are vital for the process to work. Setting these expectations on paper and in writing will help the hygiene assistant to know what is expected of them and what the dental hygienist is expected to perform.

Together we move forward

Just as in every part of society, we must be willing to adapt to daily change. The foundation of care is currently being questioned on a daily basis. As dental professionals, we must be willing to work together to move forward in providing the very best care. We must be willing to change our thoughts and possibly the way we do dentistry in order to meet the needs of our ever changing profession. By learning from each other and allowing each member of the dental team to do their part, we will ensure we provide the best possible care now and in the future.