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E R!
FEBRUARY 2020
Inside this issue ORAL HYGIENE
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Let Love Rule - Flight 1246, Seat 18A Irene Iancu, BSc, RDH, CTDP
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20/20 Vision on Dental Hygiene Katrina M. Sanders, RDH, BSDH, M.Ed, RF
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Collect What You Produce: Overcoming Objections Cathy Jameson, PhD
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Amazing, Innovative, Dental Hygienists! Linda M. Douglas, BSc, RDH
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WEB-EXCLUSIVE CONTENT
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Communicating Oral Inflammation: A Chair-side Conversation that Can Change a Life Lisa Hardill, RDH, BHADM
DEPARTMENTS 5
SELF-CARE ISN’T SELFISH Jillian Cecchini
6 NEWS Saskatchewan’s Dental Hygienist Shortage Exacerbated by Extra Year of Required Training
Dental Hygienist Offering Alternative to Traditional Dentist Visit
Health Minister’s Mandate Letter Advances National Dental Care in Canada
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EDITORIAL
Self-Care Isn’t Selfish
Jillian Cecchini Managing Editor
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FEBRUARY 2020
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As I’m writing this editorial, it happens to be the 10th #BellLetsTalk day. The Mental Health Commission of Canada (MHCC) is honouring Bell Canada for its visionary leadership on mental health and is urging everyone across Canada to join this game-changing and important annual conversation. Over the past decade, Bell Let’s Talk has made major strides in reducing the stigma around mental illness. Building on this momentum, Bell is using its sizeable influence to help us move beyond the talking phase. Expanding the campaign’s focus — from opening conversations to opening doors to improved services — is a natural progression. It speaks to the overwhelming desire of nearly nine in ten people in Canada to have increased funding for mental health services. According to MHCC’s press release, polling data was released that shows what matters most to people when it comes to mental health. Whether it’s suicide prevention or addressing the needs of youth, 85 per cent said mental health care is as important as physical health care. It’s a new decade, which means now is the ideal time for change. Now is the time to sit back and reevaluate what is making you happy – and simply put, what isn’t. I don’t necessarily believe in new year resolutions even though this editorial may sound like a “new year, new me” piece. I don’t enjoy the pressure of fulfilling goals that might be unrealistic for my lifestyle. I also don’t enjoy the guilt of not living up to said goals. But one goal that I did make for myself last year was fairly simple: selfcare and my mental well-being.
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I’ll be transparent – 2019 was a year of many challenges. I recognized that changes needed to be made and reevaluated multiple aspects of my life to get back on the right track. One of the most important lessons I learned was that the way to become the person I want to be is by taking small steps consistently over time. I believe that making time for self-care is vital to our overall health and happiness, no matter how busy we are. If you need a bit of inspiration, here are the steps I’ve used to make self-care a priority: 1. Understand what self-care means to you. Find the activities that feel right to you personally. 2. Write out what your ideal day looks like and compare it with the reality to plan out what you might need to change. 3. Treat self-care as you would any other goal. Be intentional and specific with a routine that fits best with your schedule. 4. Let go of guilt and realize that selfcare is essential to overall productivity and happiness. Stop seeing it as selfish or a waste of time. 5. Find a way to track your progress. Create a list to make sure you’re being consistent and sticking with your intentions. 6. Remember that self-care doesn’t have to be complicated. It can be as simple as getting some fresh air, exercising, reading a book or talking to a friend. Remember, the relationship you have with yourself sets the tone for every other relationship you have. Self-care isn’t selfish – it’s necessary. Let’s end the stigma.
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NEWS
Saskatchewan’s Dental Hygienist Shortage Exacerbated by Extra Year of Required Training A chronic shortage of dental hygienists in the province became worse this year after changes were made to the diploma program for students. Instead of two years to get a diploma, the Saskatchewan Dental Hygienists Association now requires students to have three years of training. That meant there was no graduating class of 26 students in the province this past spring. One reason for the change is the
expanding role of dental hygienists, said Shelby Hamm, the association's deputy registrar. Not only do hygienists take care of a patients' oral issues, they look out for their overall health, Hamm said. That means dental hygienists need a solid foundation in classes like physiology, chemistry, psychology, sociology and statistics.
For the full article, visit: https://www.oralhealthgroup.com/news/saskatchewansdental-hygienist-shortage-exacerbated-by-extra-year-of-required-training-1003947519/
Dental Hygienist Offering Alternative to Traditional Dentist Visit A Grande Prairie woman is hoping to change the way people look at a traditional visit to the dentist. Dental Hygienist Meg Kreutziger recently opened the only dental hygiene practice in Grande Prairie, Alberta. Kreutziger says she often hears the misconception that hygienists must work in a dentist’s office under the supervision of a dentist but says that’s not true. In 2006, the College of Registered Dental Hygienists of Alberta made it so they were able to practice
on their own. Kreutziger can perform x-rays and cleanings. She notes that while her practice doesn’t replace a visit to the dentist, she adds it does have a few benefits to the patient including lower prices despite the Alberta Dental Association and College releasing its 2020 fee guide which included a 4.4 per cent increase from 2019.
For the full article, visit: https://www.mygrandeprairienow.com/65893/dentalhygienist-offering-alternative-to-traditional-dentist-visit/
Health Minister’s Mandate Letter Advances National Dental Care in Canada The Canadian Dental Hygienists Association (CDHA) supports Prime Minister Trudeau’s instructions to the Hon. Patty Hajdu, minister of health, to work with Parliament to study the possibility of national dental care. “More access to preventive oral care could significantly reduce pres-
sure on Canada’s acute healthcare system,” explains Leanne Huvenaars, president of CDHA. “Dental care in Canada is currently based on ability to pay rather than need. A national dental care program would improve accessibility and enhance preventive oral care for millions of Canadians.”
For more information, visit: https://www.oralhealthgroup.com/news/saskatchewansdental-hygienist-shortage-exacerbated-by-extra-year-of-required-training-1003947519/
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A NEWCOM Media Inc. Publication
Managing Editor: Jillian Cecchini 416-510-5125 jillian@newcom.ca
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OFFICE: Located at 5353 Dundas Street West, Suite 400 Toronto ON M9B 6H8 Telephone 416-614-5831, Fax 416-614-8861. Oral Hygiene serves dental hygienists across Canada. The editorial environment speaks to hygienists as professionals, helping them build and develop clinical skills, master new products and technologies and increase their productivity and effectiveness as key members of the dental team. Articles focus on topics of interest to the hygienist, including education, communication, prevention and treatment modalities. Please address all submissions to: The Editor, Oral Hygiene, 5353 Dundas Street West, Suite 400 Toronto ON M9B 6H8
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ORAL HYGIENE
LET LOVE RULE
FLIGHT 1246, SEAT 18A
Irene Iancu, BSc, RDH, CDTP Irene Iancu has worked in various specialties including Paedo, Perio, General Practice and Orthodontics. Her goal in her current holistic practice is preventing and maintaining an optimal mind, mouth and body. Irene connects the systemic effects of oral conditions to her clients, while making a change for overall health and wellness. As a Peer and Quality Assurance Mentor contacted by the CDHO, a Clinical and Theoretical Dental Hygiene instructor at Oxford College, and a practicing dental hygienist in Toronto, Irene shares her passion for education with us today in the hopes we can change the lives of our clients and their loved ones. Irene can be contacted at Irene@toothlifestudios.ca, www. toothlifestudio.ca, IG: @ToothLife.Irene, @Toothlife, @Toothordare.podcast.
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rosscheck complete. Ready for departure from one of the most remarkable adventures I’ve had the privilege of embarking on. I’m faced with the incredibly challenging task of describing what seems to be an indescribable dream; a blur of circumstances sous vide in emotions that I had forgotten I was capable of feeling. Hold your hands out, palms up, and take a moment to appreciate those beautiful, meticulous, perfectly trained and wildly experienced hands. Thirty-four muscles and 27 bones combined in each hand to make the most delicate movements. Slow and soft index and thumb rotations with an endodontic dental file, gently maneuvering fine suture around delicate gingival tissues, then in a split second, firm luxation with a strong and dominating grasp in a full mouth
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extraction case. Our hands are gifted and with those gifts come the social responsibility to use them for every opportunity we have to do some good in the world. As dental professionals, we have three gifts. Our gifts stem from our formal education, however, they far exceed the simple intricacies between our thumb and fulcrum finger. These gifts include our ability to change someone’s future, save someone’s today, and give someone their smile back. We may forget this while living in the reality that dentistry is a business; a profitable endeavour we are constantly trying to hone, develop, grow and propagate into bigger and more productive practices. Raise your hand if you’re guilty of a sliver of that. I raise my hand here as well, and can reassure you that simply put, you’re only human. SEPTEMBER 2019
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As dental professionals, we have three gifts. Our gifts stem from our formal education, however, they far exceed the simple intricacies between our thumb and fulcrum finger. These gifts include our ability to change someone’s future, save someone’s today, and give someone their smile back.
WHERE IT ALL BEGAN
Dr. Jonathan Levine, a New York Prosthodontist who wears many entrepreneurial hats began his philanthropic endeavours after returning from a mission trip in Rwanda in 2012, which was hosted by Foundation Rwanda. They helped women get back on their feet after the devastating 1994 genocide; a muchneeded undertaking considering the population of 14 million people only had access to seven dental offices while living in poverty. The Levine family returned home to their New York life feeling empowered and did what we all do when we come home from any adventure: we share the stories with our patients. Dr. Levine did just that. The only difference in this story was who Dr. Levine shared his story with. As a respected clinician, his clientele is unique and FEBRUARY 2020
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who he shared his story with was Lenny Kravitz. Lenny posed a request to the “Doc” as we all call him. He wanted to know if a similar mission could be brought to his home in the Bahamas, specifically Eleuthera, an area with very limited access to dental care. The Levine family immediately flew to Eleuthera to explore this potential initiative and they felt an instant connection. They were convinced these were the people that they needed to help.
LOCATION: 25°23'35.6"N 76°33'23.4"W
On December 10th, 2019, I departed for the fifth mission to Eleuthera. This was my third (Honduras 2008, East Africa 2013) dental mission in my 10 plus years of practice, and it couldn’t have come at a more perfectly imperfect time.
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Considering my new practice build is in full swing, I’m constantly making tough decisions daily that could change how I operate my dental practice for the rest of my career. It’s also post-Black Friday shopping season and holiday online sale chaos with my Toothlife brand, and benchmark days at the dental hygiene school with chart audits stacking up. I was well aware of the sacrifices I would have to make in my busy life but then again, I’m no different than the nearly 100 other volunteers, some whom have busier lives than I do. Dental professionals with roots in every continent flew into Eleuthera over a two-week period to the Let Love Rule + GloGood Foundation + Twice mission. Some of us were first timers and others have been attending this mission since its infancy. These amazing individuals showed up and have proven that humanity and skilled dentistry adjoined bring a special kind of energy to an event like the one I’m about to describe. Dr. Levine and his two sons, Cody and Julian, sat down with me in a huddle to record a podcast episode in front of triage to the clinic, as an afternoon tropical storm quickly blew through the small town. The golden dust kicked up by
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Among the organized chaos of the clinic with patients streaming in and out, we felt it was the perfect place to capture the moment and share their enlightening history with the world. To listen to the full story of how they made this happen, visit the link at the bottom of this article to tune in to episode 29 of my podcast that dropped on December 19th.
INSPIRED INDIVIDUALS
To call these people remarkable humans is a significant understatement, but then again, I’m faced with this task of describing the indescribable. Their stories will give you goosebumps.
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the wind and rain looked like sparkles as the sun peeked through the storm clouds, sending sunlight beams scattered among the patients nearby waiting to be seen. The setting was surreal; the vibrations of the bass from our music resonated through the wooden boards beneath our feet and even with my fancy noise cancelling recording headphones, you could hear the laughter of children playing in the rain with Mrs. Stacey Levine, or Mamma Bear as they called her on the podcast. Our very own honorary tooth fairy.
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To call these people remarkable humans is a significant understatement but then again, I’m faced with this task of describing the indescribable. Their stories will give you goosebumps. There are so many inspiring stories for me to share with you, not one being more profound than the other. • A brave woman who escaped domestic abuse on a neighbouring island. • A single mother with three children – her youngest son had rampant decay and multiple broken teeth, who by far was the best patient of the week at only five years old. FEBRUARY 2020
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• Ancilla, a mother of two who traveled to the clinic in the hopes her children could be seen, putting aside her desperate need for treatment. We managed to see her as well but sadly, we were only able to complete part of her treatment. She covered her mouth to hide her deeply cavitated anterior tooth decay when speaking and she mentioned that she hadn’t smiled in years. She departed with only part of her treatment completed and left us all feeling hopeless when she said she wouldn’t be able to return. • A 23-year-old diabetic patient with generalized profound edematous tissue and severe bone loss, so painful that she could barely eat. My eyes filled with tears beneath my loupes that dripped down my cheeks and under my mask as I tried to comprehend how and why life is so different for some of us. Repeating under my breath, “This is so unfair”.
Throughout the week, our clinic had progressively closed later and later in the evenings simply to accommodate and treat more patients.
• An elderly man that hitched a ride in a truck for two hours, who gave me a surprise high-five and leaned in for a hug and kiss as I took off his bib. His parting words to me were, “Thank you for giving me my smile back”. Lastly, the patient that had the greatest impact on me. A 27-year-old female with only 10 remaining teeth, no posterior occlusion, no dentures, M3 mobility on all lower anteriors, and a bridge of calculus unlike anything I’ve seen in my life. I had a very amazing assistant by my side; a fellow high school classmate whom I haven’t seen in over a decade, with no dental experience. Nina was invested in this case just as much as I was and stood by my side suctioning and packing gauze while Julian carefully picked up 8 mm pieces of calculus chunks with cotton pliers to the very end. FEBRUARY 2020
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I scaled those 10 teeth for over an hour and a half. The moment I tore my gloves off of my sweating and trembling hands, I instantly burst into tears and it felt like I just called “time of death” to a patient for the first time. I knew that I did the best that I could under the circumstances but in my heart, I knew it likely wouldn’t be enough to save her remaining teeth to see her 30th birthday or daughter’s graduation. Seeing these beautiful people living in so much pain yet bringing so much happiness with them into the clinic was mind and heart opening to me, being someone who (before my last mission) would get upset when Starbucks ran out of blonde ameri-
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cano. My own worries felt so trivial. The best books you can read and movies you can see elicit your core human emotions. The last day of clinic did just that. Tears of happiness and sadness poured out at the same time; gut-wrenching feelings of panic that there just wasn’t enough time, the pressure in your chest in moments of overwhelming heartbreak, followed by newfound motivation and passion for treating patients. Throughout the week, our clinic had progressively closed later and later in the evenings, simply to accommodate and treat more patients. Many team members chose not to take a break or lunch. On the
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Seeing these beautiful people living in so much pain yet bringing so much happiness with them into the clinic was mind and heart opening to me, being someone who (before my last mission) would get upset when Starbucks ran out of blonde americano. My own worries felt so trivial. her that she did the best she could do but deep down, Emi was heartbroken and couldn’t stop thinking about her. Now the look on her face when Ancilla returned was priceless. Ancilla was seated with Dr. Sandra Garcia Martin and truly I have never seen someone as happy as I saw Emi that afternoon.
THE FINAL STRETCH: 7:30PM 1.5 HOURS AFTER CLOSE
final day, our clinic stayed open three hours later than scheduled. Ancilla, the patient who had been seen three days prior but hadn’t been able to complete her treatment, unexpectedly returned when we all feared we wouldn’t see her again. She had been treated for broken teeth that were filled and extractions, however, she returned to see if we could give her the ability to smile again. Despite her arrival during the
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hectic time where the clinic was no longer able to triage any new patients, the triage team was able to make her dream come true. Emi, the dental hygienist who saw her a few days prior, built a strong bond and truly advocated for her to come back and get the rest of her smile restored. When Ancilla told her that she couldn’t return, our very own RDH superhero was heartbroken and visibly devastated. We had encouraged
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While our last two patients were being treated, the unexpected happened. The clinic and town suffered a massive power outage and our last remaining generator was powering our speaker system. We didn’t need hand pieces or suctions; all we needed was the finesse of our clinicians, and the expert DJ services provided by Julian Levine to play us to the finish line. Queen, Michael Jackson, Aretha Franklin and Gloria Gaynor shook the converted community centre and gave our team the much-needed energy to power through the final treatments and to pack up the equipment. We lit the clinic with loupe lights, cellphones and flashlights to give us the light needed to navigate to the end of the day. Both remaining patients had FEBRUARY 2020
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extremely complex cases and were anxiously awaiting the sight of their smiles for the first time. In one chair, Dr. Levine, Dr. Mehy Lo Presti (London) and three assistants, Jamie, Rafaela (a dentist from Brazil working for Dr. Levine as his assistant in NYC) and myself finished up the anterior endos, restos and final denture insert among the other restorations and extractions that preceded the finishing touches. Meanwhile, in the back corner of the clinic, Dr. Sandra and Nasim finished the last anterior restorations for Ancilla. Utilizing advanced restoration techniques, they reconstructed the teeth prior to removing decay to recreate her tooth anatomy in its ideal shape. Taking a silicon index from the lingual surface of the teeth, followed by utilization of matrix bands and wedges to contour interproximal surfaces, and then using a layering technique to minimize the finishing line between composite and natural tooth structure. Like an artist, Dr. Sandra hand-painted the restorations with her own restorative kit she brought with her from London, finishing the case with polishing to give these restorations a perfect aesthetic. Everyone else danced and cheered for us and for our patients. Of the two last standing teams, Dr. Mehy, with complete relief and exhilaration, jumped out of his chair, raised his hands in the air and exclaimed, “I’m done!” – immediately followed by Dr. Levine rushing in to insert the final denture he had been modifying in the background to culminate this makeover. Within the next 15 minutes, the power came back on almost at the same time that Dr. Sandra completed Ancilla’s transformation. She too arose from her chair with a very stiff back and said, “I’m done, too!” Appropriately enough, Dr. Sandra and Dr. Mehy both reside in London, and they are best friends. What a perfect way to complete their adventure here in Eleuthera together.
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Cheering, dancing and singing became louder and finally after years of insecurity, our much-loved patient held a mirror in her unsteady hands and smiled for the first time. Not a dry eye was left in the room as the embraces began. Emi and Nasim comforted Ancilla and shared in her ecstasy of having her smile back.
REFLECTIONS FROM SEAT 18A
I went into this mission blindly, not knowing what to expect and how much of an impact I would make being an RDH. Now, I realize that a title and credentials, however important, are not the driver of the impact one can make. We all have talents; some clinical, some emotional and some organizational. I think of
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Angela, Jessica and Alejandra running around with their clipboards organizing treatment. Our sterilization and equipment team who held it all together. Because of this team, we all came together to make this trip as impactful as it was. Now, look down at your hands again, holding the magazine or phone you’re reading this article on. You’ve worked hard to be able to provide the treatment you do for your patients. Maybe one day, if you haven’t already, you may share your gifts with someone in need, in a place you haven’t yet visited. And maybe one day, you’ll write an article like this one and share your stories of how you have changed someone’s life with those two hands, each consisting of the same 34 muscles and 27 bones. FEBRUARY 2020
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ORAL HYGIENE
20/20 VISION ON DENTAL HYGIENE Katrina M. Sanders, RDH, BSDH, M.Ed, RF clinical dental hygienist, author and international speaker, Katrina is an award-winning educator with a unique approach to delivering continuing dental education. A distinguished speaker with many dental hygiene study clubs, Katrina’s lectures incorporate a caring, comedic and supportive style. She is the founder, CEO and keynote speaker for Sanders Board Preparatory, a comprehensive program designed to supplement student learning and enhance understanding of concepts, technology and procedures commonly discussed in preparation for the National Board Dental Hygiene Examination. She is also the co-founder, co-owner and Executive of Dental Hygiene Programs with The Core Group, a consulting firm dedicated to a customized approach to elevating standards within the dental practice. She the co-host of Tooth or Dare Podcast and is a published author with DentalTown, Today’sRDH, a columnist and advisory board member for Modern Hygienist and brand ambassador for Dimensions of Dental Hygiene. @thedentalWINEgenist.
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ith the ball drop at midnight and the off-key vocals of “Auld Lang Syne” bidding farewell to 2019, we enter a time of both reflection on what the previous year brought, as well as turning our sights to the future bringing new growth, new challenges and new opportunities. As we enter the year 2020 and, subsequently a new decade, it is imperative that the dental hygiene community come together to reflect on where we were, where we are, and where we are going. New Year’s resolutions aside, now is the time to evaluate what it is that we collectively see for the future of our industry and how we can move there, together. With loupes on, key experts recognize that our scope of practice will become magnified, our clinical savvy will become illuminated and the clarity of the vision of our future, so to speak, is 20/20.
THE PAST
As far back as the 1950’s, history tells us that dental hygienists were managing the sequelae of periodontal disease through the gold standard of scaling and root plan-
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ing, irrigation with a medicament and performing recall therapy at three, four or six-month intervals. Despite the advances in technology, equipment and research, many dental hygienists today continue to manage periodontal disease through the same measures, and empirical data indicate that most dental patients are placed on sixmonth recall intervals. It is safe to say that while other medical industries continue to advance their paradigms to align with the utmost in research, dentistry, in many ways, has remained stagnant with an unclear understanding on how to move forward.
THE PRESENT
Li, et. al (2010) estimates 55.7% of subjects age 18-90 without attachment loss have a gingival index at 1.0 or higher. Eke, et. al (2016) noted that approximately 45.2% of adults age 30-79 have some form of periodontitis. By all definitions, one could extrapolate that an average dental practice should find 45.2% of their adult population in either an active or stabilized state of periodontitis, 30.5% of their adult patients have FEBRUARY 2020
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It is safe to say that while other medical industries continue to advance their paradigms to align with the utmost in research, dentistry, in many ways, has remained stagnant with an unclear understanding on how to move forward.
gingivitis at a gingival index over 1.0, and that the remaining 24.3% of patients are healthy or incipient gingivitis patients. Yarbrough, et. al (2016) noted, however, that nearly 85% of adults aged 19-64 receive a prophylaxis as their hygiene service despite the clear incidence and prevalence of diseases of the periodontium as noted above. Additionally, increasing prevalence of diseases such as HPV have escalated the risk for oral cancer, and mounting research indicates, on average, one person per hour dies in North America due to complications of oral cancer. Dental caries remains the #1 most prevalent chronic childhood disease, far surpassing Asthma. Sleep apnea has been identified as a novel risk predictor for cardiovascular morbidity, airway evaluation in the dental chair may provide key indicators for long term chronic disease, and the new understandings of tethered oral tissues and tongue patterns have demonstrated a parafunctional cascade of symptoms, bringing dentistry further into the medical space. Research is continuing to unpack FEBRUARY 2020
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diseases that may originate or can be diagnosed by way of the oral cavity, and as such, this research has essentially kicked out a seat for dentistry at the table amongst medical modalities. Nevertheless, dentistry continues to struggle with the divergency of understanding the breadth, extent and importance of its existence while delicately balancing the general public’s lack of knowledge and perceived value in managing and controlling oral and, of course, systemic disease. Perhaps it is a culture shift that is needed. If so, this shift must begin with the dental community.
THE FUTURE
It seems that nearly every day, a new research article is published highlighting overwhelming conclusive evidence linking the bacteria associated with oral disease or the inflammatory burden as a result of oral infections to systemic disease. The unending dichotomy between newly evolving evidence and seasoned, unchanging procedures creates the greatest challenge in elevating dentistry to meet the needs
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of the community. Therefore, let 2020 be the year that you, as a dental professional, identify unique ways to integrate the change our industry and the community so desperately need. This begins with prevention. Prevention [pre-ven´shun] is defined as the keeping of something (such as illness or injury) from happening. Further definitions in medical dictionaries go on to discuss the inclusion of assessment, disease risk, health teaching, early diagnosis and treatment and screenings as integral parts of the preventive process. As dental hygienists and preventive experts, this is our opportunity to rise and serve our patients. Our responsibility begins with the gathering of vital signs such as blood pressure, pulse, respirations and pulse oximeter readings, is threaded through comprehensive evaluation of medical, dental, genetic and historical surveys, is tethered to screening for extra and intraoral lesions, airway evaluation, thyroid integrity and risk for oral cancer, is driven by complete and thorough periodontal and caries evaluations, is enhanced by comprehensive oral hygiene, nutrition and tobacco cessation counseling and ultimately driven by evaluation and subsequent implementation of risk assessment. It is time for the dental hygienist to re-think the hygiene preventive appointment and step into the
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Gone should be the days of experiencing incredible head/neck/ shoulder/back pain leading to physical and emotional burnout while struggling to effectively remove all debris due to underdiagnosing a patient with a prophylaxis. future as hygienists who understand and practice the value of screening and counseling for life-threatening systemic disease over concerns regarding ensuring we scale the residual stain on the lingual of #27. Gone should be the days of experiencing incredible head/neck/ shoulder/back pain leading to physical and emotional burnout while struggling to effectively remove all debris due to underdiagnosing a patient with a prophylaxis. I implore you to consider that the excessive utilization of the prophylaxis code throughout North America is not only not serving our patients, it is also allowing for the slow, gradual and oftentimes silent propagation of diseases of the periodontium. Additionally, the incredible time required to manage the gross amount of debris and inflammation through a prophylaxis rather than therapy of advanced disease poses a distraction to addressing other, more concerning diseases. Every time we misdiagnose, underdiagnose or skip procedures, not only do we de-value the work we do as professionals, we also put our patients at immense risk for advanced, and oftentimes undiagnosed disease. Active Therapy requires not only keen assessments and diagnostics but also the right tools, advanced train-
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ing, and a comprehensive approach. Periodontal disease is a multifactorial disease, requiring management of various modalities beyond biofilm control to include evaluation of genetic make-up, systemic health, degree of inflammation, immunity, anatomy, salivary flow and content, the duration of biofilm insult, biofilm location, biofilm composition, tobacco habits, utilization of systemic and recreational drugs, the burden of stress, occlusion, nutrition and home care habits, to name a few. (AlJehani, YA, 2014) Dental caries embody their own set of risk factors inclusive of salivary content and flow, dietary considerations, introduction or lack of remineralization therapy, tobacco usage and early detection and treatment, as significant examples. Changes to the oral tissues, advancement of suspicious lesions, greater threat from tethered oral tissues, development of airway obstruction and the inclusion of significant risk factors to chronic diseases require advanced training, certifications and screening modalities within the dental office for proper execution. Unfortunately, the inclusion of these advanced and, some might say futuristic techniques will separate the upper echelon of dental providers from those who choose
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not to update their protocols, thus remaining in the primitive world with our ghosts of dentistry past. This separation, while creating a disunioned chasm within the dental community, will push boundaries, instill question, challenge the status quo and, ultimately, create a culture shift around the integration of oral health services within the community. That, my friends, is how we make change, grow and rise.
CONCLUSION
As data continues to compile around oral and systemic diseases and their threat to our patient population, we recognize that dentistry has several opportunities‌ no, responsibilities to put on clearer lenses and see the industry for the highlevel, articulate, and comprehensive role it must play in integrative and supportive patient care. This role, however, must be fulfilled by taking off the dark and blinding shades and refocusing our sights, acknowledging we must become pupils in re-learning how to apply our foundational knowledge while rising up to meet the demands of dental providers in the new decade. Happy New Year and a Happy 2020 to you, your family, your practice and your patients. Cheers! FEBRUARY 2020
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ORAL HYGIENE
COLLECT WHAT YOU PRODUCE: OVERCOMING OBJECTIONS
‘‘ Cathy Jameson, PhD Cathy Jameson is the founder of Jameson Management, an international dental management, marketing and hygiene coaching firm. The Jameson Method of Management, developed by Cathy, offers proven management and marketing systems for helping organizations improve their workflow and efficiency in a positive, forward thinking culture. Cathy earned a bachelor’s degree in Education from the University of Nebraska at Omaha and then a Master’s Degree in psychology from Goddard College. She received her doctorate from Walden University. Cathy has been named one of the Top 25 Women in Dentistry as well as being the recipient of the second Lifetime Achievement Award from the American Association of Dental Office Managers in 2014. Cathy has been named a Leader in CE by Dentistry Today multiple times, including in 2019. She considers herself a life- long learner and encourages those around her to be in a constant state of study, growth and action. She is the author of several books, including her latest title, the third edition of Collect What You Produce.
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The # 1 secret to overcoming cost objections is to actively listen to your clients/patients and simply create value that exceeds their expectations.”
t the end of a great treatment presentation, you might think a patient is ready to say yes and instead, you hear a statement like this, “I know I need this treatment and I want to do it but it’s just too expensive! I can’t afford it right now. I’ll have to think about it.” Do you find this to be discouraging? Do you ever wonder how to deal with OBJECTIONS, including the one of cost? Cost, according to surveys, is the major reason that people either do not come to the dentist at all or do not say yes to treatment once it has been presented. Not suprising, right? However, an objection can be a gift. Yes, a gift. Let’s look at objections from that vantage point.
HANDLING OBJECTIONS
Tom Hopkins of Scottsdale, Arizona, says that an objection is actually a step forward in completing an agreement. Mr. Hopkins believes that if your patients do not pose any objections or raise any questions, they’re probably not interested in what you are proposing. In other words, an objection means that the person is interested. And that’s good! That’s why he says that “an objection is a gift”. Four Insights About Objections: 1. You identify an objection by asking questions and listening 2. An objection is a request for further information
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— John DiLemme 3. If a person presents an objection it means that he/she is interested 4. Objections are the necessary steps to the close—or to an agreement to go ahead with your recommendations An objection is actually an opportunity. It defines a specific area of concern. You will need to ask questions to isolate or identify what objections, if any, might get in the way of a person going forward with treatment. When an objection is posed by a patient, it’s important take the following steps: Hear Out The Objection – Don’t interrupt. Encourage the person to express him/herself. Objections often diminish when a person is allowed to speak. In addition, this gives you a chance to listen, to show concern, to empathize (not sympathize), and to let the person sense your understanding. Thus, you validate your patient. Actively Listen – Rephrase and repeat back to the person what you think you have heard them say. This gives you a chance to 1) clarify, 2) reinforce the patient, 3) clarify what the patient’s concern might be, and 4) move forward. Reinforce the Importance of the Objection – There’s no benefit to disagreeing with or arguing with a FEBRUARY 2020
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patient. When you listen to the concerns, reinforce those concerns and share in the development of possible solutions. You will be less likely to see that patient leave without scheduling an appointment.
Dentist/Team Member: “I totally agree with you. We will do our very best to make sure we accomplish great results and that your treatment lasts with excellent home and professional care.”
Example
Answer the Objection – Provide further education. Stress the end results and benefits of the treatment you are recommending. Turn the objection into a benefit. Establish value. Use the “feel, felt, found” response:
Patient: “I don’t want to lose my teeth but I sure don’t want to spend this much money if this isn’t going to last.” Dentist/Team Member: “Keeping your teeth for a lifetime is important to you, and you want to make sure that the investment you make is going to be one that lasts for as long as possible.” Patient: “Yes.” FEBRUARY 2020
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An objection is actually an opportunity. It defines a specific area of concern. You will need to ask questions to isolate or identify what objections, if any, might get in the way of a person going ahead with treatment.
Dentist/Team Member: “I understand how you feel. Many patients have felt the same concern about making an investment in comprehensive dental care until they found out that an investment in quality, comprehensive
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Remember that you control a conversation with questions. When a person poses an objection—don’t freeze up and feel that you’ve hit a dead end.
care now will (1) provide better health, (2) last longer, (3) look better, and (4) save money in the long run.” Confirm the Answer – Get the patient involved by asking questions. Then stop and wait for the response. This involvement helps a patient to feel like an active part of the decision-making process. And that’s exactly what you want! Dentist: Receiving this type of comprehensive care now would answer your concern about making a stable, long-term investment, wouldn’t it?” Change the Direction of the Conversation and Move Forward – Using a phrase, such as ‘by the way’ can change the flow of focus of the conversation. Move to another area of interest that will move the conversation in a positive direction. For example: Dentist: “By the way, Mr. or Mrs. Patient, do you have any particular scheduling concerns that we need to be aware of?”
CLOSE
Once you have dealt with the objections, ask for a commitment—close. Closing an agreement means asking! If you don’t ask for a commitment, you are giving your patient permission to procrastinate! Dentist: “Mr. or Mrs. Patient, do you have any further questions about the treatment that I am recommending for you—any questions
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about the clinical aspects of the treatment?” Patient: “No. I can see what is wrong and what you need to do.” Dentist: “Once you develop a financial agreement that works for you, shall we go ahead and schedule your first appointment to begin?” Patient: “I guess so. I might as well go for it.” There is the dentist’s close—he/she is asking for a commitment or finding out if there are any other objections or barriers that might get in the way of proceeding. Get all barriers out on the table to have a chance to resolve them. Now the financial coordinator will need to do the same thing. He/she will reconfirm the dentistry, present the total fee, the options for payment, get a commitment for one of those options (or a combination of options), and will close. Then, they will schedule that first appointment. Remember that you control a
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conversation with questions. When a person poses an objection—don’t freeze up and feel that you’ve hit a dead end. As you skillfully learn to handle objections, you will find that these objections are progressive steps taken to move ahead. Key Point • If you know something is going to be brought up as an objection, you bring it up. This gives an opportunity to turn a potential negative into a positive. Example Dentist/Team Member: “Mr. or Mrs. Patient, before I give you the results of my analysis (or before I present the recommendations of Dr. Jameson, and before I explain the treatment I/he recommend(s) for you to reach optimum oral health, first let me tell you that if you have any concerns about the financing of your treatment, we do have convenient, long-term financing right here in our office. I tell you this so that, for now, we can both concenFEBRUARY 2020
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You must establish a relationship of trust and confidence with a patient before treatment acceptance will result. Your on going internal marketing program should have this as its foundation. trate on your treatment. But please know that we will discuss financial options in full. We want to make sure that you are clear and comfortable with this important part of your treatment.” Let’s look at a step-by-step way to handle objections, specifically the objection of cost. 1. Validate Your Services and Your Quality to Yourselves Do you feel that the value of your services exceeds the fee you are asking for? Before anything else happens, you must believe in yourself, your own worth and the worth of your services. If a patient walks out your door not proceeding with treatment, does that patient win? Or lose? Key Points • Your entire team must believe in the services you are providing. • You must have a strong commitment to your work and to the patients you serve. • Know that you, as care providers, add value to the lives of your patients. • Make sure that the treatment your patients are receiving is an equitable exchange for the fee. Thus: value = value
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2. Validate Yourself to Your Paitients You must establish a relationship of trust and confidence with a patient before treatment acceptance will result. Your ongoing internal marketing program should have this as its foundation. In planning your marketing/educational program, ask this question, “Does this marketing tool make a statement (consciously or subconsciously) about who you are, what you do, and your mission/ purpose?” If the answer is yes, then the marketing tool is probably going to serve you well. If the answer is no, then you may need to rethink the project. 3. Validate Your Services In your efforts to validate your services to existing and potential clients, consider the following: Use testimonial letters from enthusiastic patients. Ask your patients to place reviews on your social media posts. Make this easy for your patients.
Exercise
Use before and after photographs of your patients to illustrate a particular service you provide (after obtaining written permission from your patient). Use these in the practice during interactive patient appointments and on your social media platforms.
List the services you provide for your patients—from the initial contact through the entire treatment. Now as a team, answer the following questions: a. What makes your services special? b. What added value touches do you provide that make your practice unique? c. What do you do that goes beyond the expected?
Provide civic presentations throughout your community using before and after slides of treatment you have provided. a. Concentrate on one subject at a time i.e., cosmetic dentistry, nonsurgical periodontal therapy, preventive dentistry, etc. b. The program must not be self serving—but rather, educational. c. Leave a written piece with each
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www.oralhealthgroup.com
participant. d. Keep the program short, 20–30 minutes. e. Use layman’s language. f. Use visual aids—Powerpoint is excellent. g. Be enthusiastic and energetic. Make Sure That Every Aspect of Your Practice Epitomizes the Professional Image you Wish to Project All of these foundational efforts work to establish a value for the service that far outweighs the fee. Key Point • You want to have the exchange of value be equitable—but perceived to tilt in the favour of the patient. Be confident in asking closing questions/sequences to your patients. Examples of Closing Sequences Dentist: “And so, Mr. or Mrs. Patient, the financing of the dentistry is a concern for you, correct?” Patient: “Yes.” Dentist: “Once we find a financial solution that works for you, this is the type of treatment you would like to receive. Is that correct?. or Dentist: “If I understand you correctly, this is the type of dentistry you would like to receive?” Patient: “Yes, it is.” Dentist: “Then, once we make the financing of the dentistry comfortable for you, is there any reason why we shouldn’t go ahead and schedule an appointment to begin your treatment?” or Dentist: “Now that we have agreed on the treatment that works best for you and meets your goals, and once Jan has worked out the details of your financial agreement, we will schedule you first appointment and go ahead. How does that sound?”
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Example: Patient: “I’ll have to think this over.”
Learning To Handle Objections Objections diminish when a person is allowed and encouraged to talk about them.
you feel that the fee is too high for the services I’m recommending for you? Or is the investment difficult for you at this current time?”
1. Restate the patient’s wants and needs.
Patient: “I’m sure the treatment is worth the fee but I can’t afford this right now.”
2. Actively listen to their concerns. Rephrase and feed back their objections. 3. Validate the person by using the “Feel, Felt, Found.” 4. Turn the patient’s objections around by asking a question to establish value. 5. Encourage the patient to share with you in the development of a solution. Key Point • “If a person is allowed to be a part of a decision-making process, he/she will be more likely to buy into the decision.” You can’t push anyone into making a decision (nor would you want to do so) but you can lead them carefully and caringly into making a decision by asking questions and listening. You can’t talk people into moving forward but you can listen to them through the process. One More Time – Examples of Verbal Skills that Identify and Overcome Objections A person says, “That’s just too much.” When a person tells you the fee is too much, actively listen to make sure you’re hearing them correctly. Dentist/Business Coordinator: “Do FEBRUARY 2020
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Dentist/Financial Coordinator: “Well, I appreciate that, Mr. or Mrs. Patient. I know that you wouldn’t take the time to think this over if you weren’t interested. So that I can make sure that I am clear, can you please tell me what is it that you need to think about? Is it whether or not this is the type of treatment that would be best for you?” Patient: “Oh, no. I know that I need this.”
Dentist/Business Coordinator: “Tell me, Mr. or Mrs. Patient, if we can make the financing comfortable for you with a convenient monthly payment plan, would this make it possible for you to proceed?”
Dentist/Financial Coordinator: “Do you need to think about whether or not I/Dr. Jameson would be the one to provide that treatment?”
Patient: “Probably.”
Patient: “No, if I do this, I want you/Dr. Jameson to do it. I don’t want anyone else to do this!”
Dentist/Business Coordinator: “How much per month could you invest?” His answer to this question would let you know if you could go ahead by offering him a bankcard or a HealthCare Financing Program. Example: Patient: “Well, I want those veneers because I hate my smile. But $7000 is just too much!” Dentist/Business Coordinator: “How much is too much?” Patient: “About $3000 too much. I saved $4000 for this but I had no idea it would be this much!” Dentist/Business Manager: “So, the solution we’re looking for is a way to finance the $3000 beyond your current savings, is that right?” Patient: “Yes.” Now you know that the $7000 isn’t the problem – it’s the $3000 that needs attention and assistance.
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Dentist/Financial Coordinator: “Then, tell me Mr. or Mrs. Patient, is it the money? Do you need to think about whether or not you are able to make this investment now?” Patient: “Yeah, money is a bit tight right now.” Dentist/Financial Coordinator: “If we are able to make the financing of the dental care affordable for you and your family, woud that make it possible for you to proceed with the care that Dr. Jameson has recommended for you?” Patient: “Yes, I think so.” What has happened in this example is that because of careful and caring questioning, the true problem has been identified and can now be addressed. The communication skills here make it comfortable and possible for the patient to say that they need to find a way to pay for the treatment. Many times a patient will say that they need to “think it over” and the dental professional
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An objection is a request for further informationand shows that the person is interested in acontinued discussion of the proposal. with whom they are conversing with will say, “Oh, okay. Well, give us a call when you are ready.” When a patient says, “I’ll call you”, all bets are off! You must keep control of all situations. At that moment, the whole issue drops in a bucket. You must identify what the problem is for the patient. You must make it comfortable for him/her to tell you if there is a financial issue. Some people are embarrassed or too proud to come out and tell you that they need some financial help. Let the patient know that you understand the situation and that you have alternatives. Open doors that historically have been closed. Example: Patient: “I can’t believe I need this much work! How is this possible?” Dentist/Financial Coordinator: “I can’t tell you that, Mr. or Mrs. Patient. There are many things that affect your oral health: age, nutrition, what and how you eat, home care, stress. etc. Have you been under stress over the last year or so?” Patient: “Man, have I ever!” Dentist/Financial Coordinator: “Our responsibility is to evaluate your situation and make a thorough diagnosis based on a comprehensive gathering of data and a complete analysis of that data. Then, after careful study, make recommendations that we believe would help you to achieve and maintain oral health for a lifetime. And that’s what we have done. You have total control in the decision-making. Whether or not you proceed with the treatment that I/we are recommending is com-
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pletely up to you and the choice is yours alone. However, my/our responsibility as your dentist/dental team is to do the very best job we can to diagnose, develop a treatment plan, and present to you a course of action that we believe would be in your best interest. Is that okay with you?” “I know I need this treatment and I want to do it but it’s so expensive! I can’t afford it right now. I’ll have to think about this.” Again, referring to Tom Hopkins, he believes that there is a difference between an objection and a condition. An objection is a request for further information and shows that the person is interested in a continued discussion of the proposal. But a condition is a situation that is going on in a person’s life that absolutely prevents them from going ahead—at least for the moment. Say that a person has just been released from the hospital and has many unpaid bills or that a person has lost their job or perhaps has four kids in college. All of these are conditions that might prevent him/her from accepting treatment. However, it doesn’t mean that he/she doesn’t want it! Referring back to Jeff Gelona, he woud ask, “Is that a no for now or a no forever?” You are responsibile for doing the very best job you can of diagnosing, treatment planning, presenting the dentistry, make the financing of the dentistry as comfortable as you can and then getting out of the way and letting the patient make his/her own decision. As you are presenting, ask closing questions that will identify objections—or in some cases—conditions. If you identify a condition, let the patient know that you will be there when he/she is ready and that
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you will stay in touch. Knowing the difference between a condition and an objection lets you know where to go and how to get there. The communciation skills for this type of identification are critical. The very best way to identify a condition or an objection is by asking questions and listening—actively! Here is an exercise for you. Practice will give you the necessary confidence to communicate financially. 1. List the main financial barriers or objections your patients give to you. 2. Using the skills from this article, formulate scripts that will help you deal with and overcome those objections. 3. Role play using these scripts. 4. After the role playing, answer these questions. a. Did I listen carefully? b. Did I repeat what I thought were the patient’s main concerns? c. Did I validate the patient? d. Did I answer each objection with a valued question? e. Did I go through the steps of dealing with an objection? f. When I overcame the objections, did I close?
IN SUMMARY
Do not fear an objection, even the objection of money. Rather, look at this as an opportunity. Know that, if you do your best and the person does not go ahead, they are rejecting the treatment proposal. They are not rejecting you. Combine a strong belief in your team and the services you provide with the skills to get that message across. Then you can deal effectively with, “Gee, Doc, it costs too much!” FEBRUARY 2020
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ORAL HYGIENE
AMAZING, INNOVATIVE, DENTAL HYGIENISTS!
Linda M. Douglas BSc, RDH Linda graduated as a dental hygienist from the Royal Dental Hospital in London, England, and also graduated from O’Hehir University with a Bachelor of Science degree in Oral Health Promotion.. Linda worked in periodontology before moving to Toronto, where she has worked in private practice since 1990. She is also the Clinical Director for Hygienetown, a supportive online community and publication for dental hygienists. Linda’s desire to help anxious patients has instigated in-depth study of the issues faced by survivors of childhood trauma, and other individuals with dental phobia. Linda also writes and speaks on xerostomia management, saliva testing and caring for dental patients with eating disorders.
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ccording to CDHA, the key responsibilities of dental hygienists are health promotion, education, clinical therapy, research, change agent, and administration. The following five hygienists are amazing dental hygiene professionals who have definitely demonstrated their commitment to continuous improvement. They have also elevated the roles of researcher and change agent to new
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heights, by offering ideas for problem solving that enhance our practice and benefit our patients. These innovative colleagues are Mark Frias, Susan Wingrove, Patricia Blunden, Becky Logue, and Debi Dencek. Here are their stories of what motivated them to develop their product, how they accomplished this, and advice for hygienists everywhere who might be aspiring inventors. FEBRUARY 2020
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SUSAN WINGROVE, Co-designer of the Wingrove Titanium Implant Set, ACE probes, and Queen of Hearts instruments by PDT, Inc Susan Wingrove, BS, RDH, is an innovator, writer, international speaker, and 2016 Sunstar RDH Award of Distinction recipient. Co-designer of the Wingrove Titanium Implant Set, ACE probes, Queen of Hearts instruments by PDT, Inc. Susan is a published author for multiple journal articles, Scientific Panel for ACP Clinical Practice Guidelines, as well as Implant Maintenance Textbook: Peri-Implant Therapy for the Dental Hygienist: Clinical Guide to Maintenance and Disease Complications. Contact: sswinrdh@ gmail.com or wingrovedynamics.com
Image courtesy of Susan Wingrove, RDH
We teamed up with Linda Miller to develop the Wingrove Titanium Implant Scaler Set; three instruments for all of your implant maintenance for restorations and prosthesis. It is a soft 28-30 Rockwell Hardness set that does not scratch and does not leave residue behind. Meeting and working with Linda Miller, CEO of PDT, Inc., changed my life. Linda truly understands ergonomics and wants to help hygienists last longer in the profession.
WHAT LED TO THE WINGROVE SET
As a hygienist, I wanted to expand my expertise to regeneration and implantology. I met my late husband Dr. Frank Wingrove, in 1995, and together we did over 13 years of regeneration research. He was a periodontist and implantologist who was tasked with resolving failing implant cases from all over Iowa. He recognized a pattern of debris left behind on implants, not related to cement but to instrument residue that was causing implantitis. Investigation into instrument residue led to our development of a set of implant scalers that did not scratch and did not leave residue behind. They were completed a month after he passed away and are dedicated to him: The Wingrove Titanium Implant Scalers by Paradise Dental Technologies, Inc. (PDT). It is an exciting time to be a hygienist, and my advice to other hygienists is to take the leadership role in education on Biofilm and the Oral Systemic Link to heart. If you want to work on design of new products you feel would help our profession, begin by reaching out to a company that follows what you are striving for. Outline your idea in a proposal and set up a time to talk to their R&D department or product development division with your idea. The WHY is very important, such as how it differs from similar, existing products. FEBRUARY 2020
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BECKY LOGUE, Inventor of the Dental RAT Becky Logue graduated from Idaho State University, Pocatello, Idaho in 1987 with a Bachelor of Science degree in Dental hygiene. I have more than 30 years’ experience as a dental hygienist. In January of 2005, I founded Beckmer Photo courtesy of Becky Logue, RDH Products to develop and market my patented invention, a foot operated computer data entry peripheral that solves the problem of cross contamination during periodontal charting. The first commercial application of this new dental technology device, the Dental R.A.T. TM, is focused on providing dental hygienists with a tool that allows them to enter data without cross contamination or the assistance of other dental office personnel. I invented and developed this new computer device, taking it from an idea on paper to a prototype, and then to a market-ready product, by creating and executing my research and development and commercialization plan. This computer input device is designed primarily to facilitate the work of dental hygienists and has gained wide acceptance in the field of dental hygiene in the U.S. I field-tested the prototype in my dental hygiene office. That first prototype took the form of a sturdy corded metal unit that ran any dental software answering a common problem in dental offices. The next generation model, the wireless Dental R.A.T. 2.0, has a sturdy plastic construction and an audio playback feature.
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Many dentists and medical doctors have seen the value of this new foot mouse. ‘Boomer The Foot Mouse’ has been a huge help for many people and who knew it would come from needing help with perio charting? Over the past three years I have travelled across the United States, training dental hygienists in offices, colleges and universities on use of the Dental R.A.T. with their specific software. Sales of the Dental R.A.T. 2.0. increased by 680% in our third year. With the commercial success of this first application of the technology, I have expanded to develop a foot operated mouse for anyone who has a hard time using a hand mouse. The potential for this new foot mouse has so many applications for anyone running a computer while their hands are busy, or if they are one of the 11 million people that don’t have full use of their hands or arms but want to run a computer. Many dentists and medical doctors have seen the value of this new foot mouse. ‘Boomer The Foot Mouse’ has been a huge help for many people and who knew it would come from needing help with perio charting?
PATRICIA BLUNDON, Designer of the Clip Mirror I graduated from the Dental Hygiene Program at Algonquin College in Ottawa, Canada in 1992. Dentistry has been my passion now for almost three decades. The Clip Mirror idea came to me when I was working on a patient with a super strong lower lip and a protruding tongue. With Cavitron in one hand and mirror in the other, and the patients tongue pushing out the saliva ejector, I thought to myself, “Why does this need to be so hard?” I imagined having a mirror clipped directly onto the saliva ejector to free up a Photos courtesy of hand. Then I thought to myself, who better to Patricia Blundon, RDH invent a dental tool than a dental hygienist? I decided I would learn everything I needed to know to become an inventor. I read all the books I could find on inventing, patents, licensing and intellectual property. I started by searching for prior art, which is just a fancy term for has anyone else who has made something like this. I learned to navigate the USPTO (patent and trade office) and read and researched every patent possibly similar to my own invention. I learned to proficiently write and file my patent application for the Clip Mirror. I began to delve into manufacturing mode; I knew the design I wanted and learned about dental mirror manufacturing. The steel for the clip had to be medical grade 400 series so it would not rust, and the clip itself would be designed to snap securely to the saliva ejector, while still allowing a clinician to rotate it if they needed. The rolled clip ends would allow a line of floss to be secured as an added precaution. The Clip Mirror is now a size four mirror made with the Ultravision mirror by Hahnenkratt in Germany. I began the manufacturing process, building my website and all the small business essentials including a Medical Device Establishment License with Health Canada. I then began market testing and research for a few years until introducing the Clip Mirror by DH Essentials at home and across the globe in January of 2017.
ERGONOMICS FOR DENTAL HYGIENISTS
I designed the Clip Mirror to make the job of the Dental Hygienist/Clinician easier on the body and with greater ease and efficiency. As we all know, dentistry takes a huge toll on your body. Advice for others: It’s super exciting to dream of something and then bring it to life through hard work and dedication. I would love to help others attain their dream; it is so important to believe in yourself and that anything is possible. I totally believe in paying it forward and helping others. I would not be where I am today without the help of others and the kindness of strangers. I invite anyone to contact me for advice through The Clip Mirror website at www.dhessentials.com.
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FEBRUARY 2020
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Advice for others: For the hygienist who has a product in mind but doesn’t know where to start, here are a few recommendations to get you started. Check to see if your idea has already been patented: go to https://patents.google.com and look around. A patent for your idea, or something very similar to it, might already exist but the patent might already be expired, or you might be able to purchase it or obtain the rights to use it. On the other hand, if you find nothing, then you are free and clear to apply for a patent to protect your idea. Create a drawing of your product, and create a prototype yourself. This will give insight into possible dimensional problems. Get advice from other hygienists; many dental products you see on the market today were created by hygienists. If you have a good idea and seriously want to create a dental product, just do it. We all doubt ourselves but ignore those doubtful thoughts and take action today!
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In 2008, I purchased an Isolite System (now known as Zyris), which provides simultaneous evacuation, retraction and a bite block in one disposable mouthpiece. It’s an impressive product but it proved costly to equip multiple operatories. In 2010 I decided to see if I could create something that would connect the disposable Isolite mouthpiece directly to the HVE valve. I used my new contraption for the next few months; even though it “worked”, I needed something better. I took a drawing of my prototype to a local small manufacturer in my city, and within five minutes, I was talking to the CEO. The next day, I had a quote for four protoPhoto courtesy of Mark Frias, RDH types. The product I had envisioned now existed! After posting a picture of the prototype on a popular dental forum, my primary intention quickly switched from personal use to sales. My inbox suddenly filled up with requests to pre-order! So, I initially ordered 300 units from the manufacturer thinking that would be enough, but those quickly sold out. The product is still selling well.
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DEBI DENCEK, Designer of CordEze My inspiration for CordEze was clear when I started working as a dental hygienist. I have always favored using the ultrasonic scaler during patient care but cord management was a struggle. I was taught in school to hold the ultrasonic cord with my pinky finger while scaling. After one workday of doing this, I knew that I had to figure out a better solution. Initially, my idea was to wedge the cord between my leg and the patient chair to reduce the cord drag (not too bright, I know). That put my body in even more of an awkward position: further increasing my risk for musculoskeletal disorders (MSD). I was then set on a mission to improve my ergonomics. I used the principles of fulcrum and decided that the wrist was close enough to the source of the handpiece, and would be the best place to relieve the undue stress of the cord drag: CordEze was born. Photos courtesy of Debi Dencek, RDH The motivation behind taking my product to market was to help fellow hygienists and other clinicians feel cordless too. It is beautiful soul food for me to hear from seasoned hygienists how CordEze has alleviated their wrist pain. Better still, new hygienists hope that by using CordEze they will never have to deal with managing pain. Hygienists are prevention specialists. It is important for us to apply those principals to ourselves. Self-preservation, and safety and comfort during patient care should be our top priority. The feeling of being cordless while still benefiting from the power of a corded handpiece is optimal. One of the bonuses that I learned while using CordEze was that I was able to adapt the working tip of the ultrasonic insert more accurately and thus, my efficiency was increased. This positively affected my time management and patient satisfaction through reduced chair time. Advice for others: There is a ton of opportunity in the dental industry for improvement and advancement. Just look around you and listen to your inner voice that will lead you into your creative zone. Then, take the leap of faith; the process of developing a product and selling it is not easy, but if your intention is to solve a problem and help people, the process is rewarding. My hope is that dental hygiene programs around the globe continue to incorporate CordEze into their clinical instruction so that future hygienists learn early, then carry their best ergonomic practices forward into the workplace. I regularly give webinars on ergonomics and demonstrate CordEze products for students and staff. If anyone is interested in scheduling an online educational demo, they can go to: https://cordeze. appointlet.com/s/product-demostudent-wergonomics-education-1-hour/ debi-dencek or contact hello@cordeze.com
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CONCLUSION
The stories and achievements of these colleagues are an inspiration. Especially for dental hygienists with a desire to contribute to our profession by developing problemsolving innovations. If you have an idea which could enhance dental hygiene practice, take their advice, and go for it!
References 1. https://www.cdha.ca/pdfs/Profession/ Resources/DefinitionScope_public.pdf 2. J Periodontal Implant Sci. 2019 Jun; 49(3): 193–204. Seong-Ho Jin,1 EunMi Lee,2 Jun-Beom Park,2 Kack-Kyun Kim,3,4 Youngkyung Ko,2 Published online 2019 Jun 25. doi: 10.5051/ jpis.2019.49.3.193 https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC6599751/ 3. Wingrove S. 2013. Peri-Implant Therapy for the Dental Hygienist: A Clinical Guide to Implant Maintenance and Disease Complications. 2013 wiley.com FEBRUARY 2020
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Dental Marketplace Contact: Karen Shaw | 416-510-6770 | 437-991-7187 | karen@newcom.ca fax: 416-510-5140 | toll free CDA & USA: 1-888-639-2669
H YG I E N I STS HYGIENISTS WANTED We are looking to hire hygienists to join our busy and well-established practices in Ontario, Saskatchewan, Alberta, and Manitoba. What you will benefit from: • Excellent remuneration • Mentorship and access to a large network of dental professionals • Work life balance with evenings/ weekends off • Additional perks for the right candidate New grads welcome! If interested please send your resume and cover letter: info@enspireopportunities.com
HINTON, AB FULL-TIME HYGIENIST NEEDED IMMEDIATELY Make $50-80 per hour! Solidly booked well in advance. We offer health-spending account, scrubs & paid sick-days. Great opportunity, busy from day one & make an exceptionally high income. Email CV to dentaljobs89@gmail.com
PRACT I C ES & OFFI C ES NORTH ALBERTA PRACTICE FOR SALE Well established 4 operatory dental practice in a strip mall location with great exposure, great potential, great parking. Good opportunity for one or more dentists. Owner will stay during transition. Please contact for more details: g_christoffel@hotmail.com
TORONTO, ON NORTH YORK START-UP
Move-in ready ground floor location with easy access, good visibility, on-site parking, including 1267 well-designed ft2, 2+2 ops, all equipment, signage, website & more. Contact Dr. Anthony Liscio T: 416-418-1258
EQUI P M E N T EDMONTON, AB FOR SALE One Seiler operating microscope hardly used asking $12,000 but open to offers. Tel: 250-920-9249 or e-mail: pcbradley@shaw.ca FEBRUARY 2020
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OPPORTUN ITIES IN TH E DEN TISTRY PROF ESSION
ASSO C I AT ES H I P S OTTAWA, ON
KAMLOOPS, BC
ASSOCIATE DENTIST OPPORTUNITY WITH A LEADING PRACTICE
Dental Associate Needed in Beautiful British Columbia. We are looking for a motivated dentist to join our busy family dental practice in Kamloops, BC.
Join our large customer-oriented multi-disciplinary group dental centre and build your practice through referral and extraordinary new patient flow. Let us help you rapidly advance a career to be proud of. Centrally-located in a major retail plaza, we offer extended hours and supply superb support staff, state-of-the-art equipment, and committed colleagues. Whether you’re just starting out, already have years of quality experience, or somewhere in between, if you want to love where you work, please contact us today!
We are a paperless, digital office with a busy recall system in place. Kamloops is home to world renowned skiing, golf, fishing, and mountain biking. Our practice is team orientated. The position is full time and is available for July 2 2020. New Graduates welcome. Please call 250-398-0532 or email vitoratos@shaw.ca
ORILLIA, ON Looking for a part time associate.
business@adcottawa.com
Please send resumes to dental_2010@live.ca
BELLEVILLE, ON FULL TIME ASSOCIATE DENTIST dentalcorp is currently looking to hire an Associate Dentist to join our busy and well-established practice located in Belleville, Ontario. This is a full-service dental practice offering a range of oral care services including general dentistry, cosmetic services, oral surgery, Invisalign and dental implants. The successful candidate will have a passion for building strong patient relationships and contributing to their ongoing oral health. As an Associate at the practice you will have the opportunity to work alongside a strong team of dental professionals, learn from the principal dentist and have access to online continuing education. By joining dentalcorp, you will benefit from: • Competitive compensation • Formal and structured mentorship opportunities • Access to continuing education through DC Institute (dcinstitute.ca) • A large network of experienced dental professionals Candidates must be legally eligible to work in Canada. We thank all applicants; however, only suitable applicants will be contacted. Job applicants with a disability who require reasonable accommodation for any part of the application or hiring process can contact the dentalcorp Talent Team at 416-558-8338. Reasonable accommodations will be determined on a case-by-case basis and your request will be responded to as soon as possible. E-mail: careers@dentalcorp.ca
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ASSO C I AT ES H I P S NORTH BAY, ON FULL-TIME ASSOCIATE WANTED dentalcorp, Canada’s leading network of dental practices, is currently looking to hire an Associate Dentist to join a busy and well-established practice in North Bay. The successful candidate will have a passion for building strong patient relationships and contributing to their ongoing oral health. As an Associate within the dentalcorp network, you will have the opportunity to work alongside a strong team of dental professionals, learn from the principal dentist and have access to online continuing education. By joining dentalcorp, you will benefit from: • Competitive compensation • Formal and structured mentorship opportunities • Access to continuing education through DC Institute (dcinstitute.ca) • A large network of experienced dental professionals Requirements: • Graduate from an accredited DDS/DMD program or completion of the NDEB Equivalency Exam • Certified with NDEB • Licensed and in good standing with provincial regulatory body • Valid CPR certification
Candidates must be legally eligible to work in Canada. We thank all applicants; however, only suitable applicants will be contacted. Job applicants with a disability who require reasonable accommodation for any part of the application or hiring process can contact the dentalcorp Talent Team at 416-558-8338. Reasonable accommodations will be determined on a case-by-case basis and your request will be responded to as soon as possible. E-mail: careers@dentalcorp.ca
WOODSTOCK, ON
BRITISH COLUMBIA – KAMLOOPS
P/T associate needed for growing, patient centered family practice that offers all disciplines of dentistry to its patients. The successful candidate will have experience and strive to create patient experiences that are both clinically sound with minimal discomfort to the patient. Please send resumes to woodstockdental@yahoo.com
Brand new 6 op build, general practice is seeking F/T Associate. Digital systems with Cerec dentary. Located in the interior of BC, Kamloops is close to world class skiing, fishing, golfing & mountain biking and offers spectacular scenery, endless recreational activities & affordable living. Forward your CV to drmstpaul@gmail.com
DOWNTOWN TORONTO, ON
NORTH YORK & MARKHAM, ON
Downtown practice requires Experienced Dentist full time Tuesday to Saturday. Only apply if you can work the schedule outlined and start by Feb 14th. Dentalebitda4sale@gmail.com
Part-time associate position available in North York & Markham, minimum 1 year experience, Endo, Surgical Extraction skills preferred. Please email: dentalmk@gmail.com
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EDMONTON, AB EDMONTON FULL-TIME COME JOIN US! Everything you need to be successful is at hand. Friendly experienced staff. Bright, modem office, fully equipped. Collegial community atmosphere…and most importantly, full patient load. Give us a call at 780-910-2123 to meet or send email to qdental@.shaw.ca
LONDON, ON
A female associate with at least 2 years experience needed for part time position in a modern and busy office. Please e-mail resume to m_atiya @hotmail.com or call #519-619-1113.
OTTAWA IS CALLING YOU! Highly reputable, multi-location, privately operated dental group, is looking for part-time associates in multiple locations across the city. All our facilities are equipped with the latest technology and are paperless. We look forward to meeting you.. T: 613-324-8411 E-mail: 7dentalann@gmail.com
KINGSTON, ON Greenwood Park Dentistry, a progressive clinic in Kingston is looking for a full time Associate. We have an amazing patient base along with an extraordinary staff. A great opportunity for mentorship. Apply today! E-mail: dr.tabesh@gmail.com
S o
SASKATCHEWAN We are looking to hire an Associate Dentist to join our busy and well-established practice in Saskatchewan! What you will benefit from: • Excellent remuneration • Mentorship and access to a large network of dental professional • Work life balance with evenings/ weekends off • Additional perks for the right candidate New grads welcome! If interested please send your resume and cover letter: info@enspireopportunities.com
S an
BARRIE, ON We are looking to hire a mature Dentist for a part-time leading to full-time associateship with a well established dental office in Barrie, Ontario. Please send your resume and cover letter to: karenbarriedentist@gmail.com
OAKVILLE, ON We are an established practice looking for a periodontist to join our practice 1 day a month. E-mail: info@trafalgarvillagedental.com FEBRUARY 2020
2020-01-31 12:00 PM
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ASSO C I AT ES H I P S FAIRVIEW, AB
VICTORIA, BC
SIMCOE, ON
Fairview Dental Clinic is seeking an enthusiastic skilled dentist with excellent communication skills for our well established practice. Patient care is our top priority. Our team is committed that our patients always leave our office smiling! We have a phenomenal support team with low staff turnover. Our team is committed to each other and works to achieve common goals within the office to ensure the associate’s success. The office is open from Monday to Friday with no evenings or weekends. The ideal candidate will have a warm and friendly demeanour, a passion to build strong patient relationships and thrives in a team environment. This position offers a very high income potential with a well managed, highly motivated staff. Sign-on and retention benefits are available to suitable candidates. Please submit your CV to caddsopp@gmail.com
Enjoy all that Southern Vancouver Island has to offer with the mildest climate in Canada. Enjoy golfing and hiking all year round! The lifestyle in unbeatable!
Our well established family oriented dental practice is currently seeking a compassionate associate for Wednesdays and Thursdays with additional days to come. The successful candidate will need to be passionate about delivering outstanding dentistry and must have excellent communication skills both with the team and the patients. Please send your CV to drnateghi@gmail.com
GTA & SURROUNDING AREAS, ON Associate opportunities available across the GTA and surrounding areas including Scarborough, Mississauga, Brantford, Hamilton, Barrie, Dundas, Brampton, Etobicoke, Oakville, Waterloo, and Owen Sound. E-mail: yourdentaldream@gmail.com
We can offer 3-4 days a week in our modern offices situated in a diverse neighborhood within walking distance of Victoria’s vibrant downtown. We are a paperless, digital office with a busy recall system. All aspects of dentistry are performed. Please email reception@vicwestdentistry.com
CENTRAL ALBERTA FULL-TIME & PART-TIME ASSOCIATES Seeking Associates for two busy practices. 1st location Wetaskiwin, AB (30 mins South of Edmonton). 2nd location Wainwright, AB (1hr 45 mins from Edmonton). Guaranteed $20,000 monthly salary or 40% whichever is greater. With a housing allowance. Contact Fayaz@AlbertaDentalCare.ca or Phone/Text 780-233-9300
FREDERICTON, NB F/T ENDODONTIST IN FREDERICTON, NEW BRUNSWICK!
Wanted! Full time associate to start May 2020 in a busy Northern Alberta Practice. Please email resumes to manager@hpdentalcentre.ca or call Nola @ 780-523-4448.
Fun, friendly, fast growing specialty clinic currently offering Prosthodontics and Periodontics with a strong focus on teamwork and providing superior client care. Prosthodontist owner has over ten years experience with an in house lab and is highly reputed in the community. To apply for this fabulous position, please email your resume to Phebe@EnspireOpportunities.com
THOMPSON, MB
BRAMPTON, ON
HIGH PRAIRIE, AB
ASSOCIATE DENTIST WANTED Our team at City Dental clinic is looking for motivated team player and experienced dentist in endodontics and oral surgery. To apply email: alln1963@yahoo.com
Seeking associate for part time, Fridays and Saturdays, leading to a full time position in a well established practice. Please send resume to docjoef@gmail.com
HIGHLY PRODUCTIVE DENTAL OFFICES WITH BUY IN POTENTIAL, SEEKING FULL TIME GENERAL DENTISTS AND ORTHODONTISTS TO WORK IN MAJOR CITIES OF ALBERTA. Each practice has multiple associates along with a Senior Dentist catering to all aspects of dentistry including cosmetic dentistry, Invisalign, implants, IV sedation, endodontics and surgeries and Orthodontics. Mentorship provided and expect to be busy from First Day. The successful candidate will have a passion for building strong patient relationships and be a Team Player. Please email resume to : thronejerry63@gmail.com
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ORANGEVILLE, ON Busy Practice of over 3000+ patients in search of an experienced Orthodontist and Endodontist to work out of our office one to two days a month depending on demand. Please email resumes to emilydufferindental@rogers.com
EDMONTON, AB Full time associate required for busy dental group servicing Edmonton and surrounding community. Long term associateships preferred. Please email resume to omar@infinitydental.ca
TORONTO, ON
Busy TO storefront dental office seeking “right” associate F/T. No weekends. Experienced, excellence in treatment planning and chairside manner and can work independently. Ideally looking for long term fit for our clinic. Reply to Oral Hygiene Box 62 – karen@newcom.ca
PETERBOROUGH, ON
ASSOCIATE WANTED IN WELL ESTABLISHED OFFICE Looking for a part time associate, leading to full time in a busy well established preventative/conservative patient focused dental office. Looking for someone to care for our long standing loyal patients in a friendly family dental clinic. Experience Preferred. Send resumes to: dentistryinpeterborough@gmail.com
AD INDEX Bisco Dental Products Canada Inc ������������������������������������������������� IBC Clinical Research Dental ��������������������������������������������������������������������15 Crest Oral-B, P&G ����������������������������������������������������������������������������� 7, 29 dentalcorp ��������������������������������������������������������������������������������������������12 Ivoclar Vivadent ��������������������������������������������������������������������������������IFC NSK America �����������������������������������������������������������������������������������������4 ODA – Ontario Dental Association ���������������������������������������������������25 Philips Oral Healthcare ����������������������������������������������������������������������17 Premier Dental Products Company ��������������������������������������������������21 Sable Dental Industries ���������������������������������������������������������������������33 SciCan ����������������������������������������������������������������������������������������������������� 11 VOCO Canada ������������������������������������������������������������������������������������OBC
www.oralhealthgroup.com
FEBRUARY 2020
2020-01-31 12:01 PM
ENJOY SHARPEN FREE PROPHYLAXIS AND PERIO LM Sharp Diamond instruments are completely sharpen free. These instruments are made from an exceptionally durable special metal alloy, and its wear resistance is enhanced by a protective micro membrane coating. SHARPNESS & COMFORT Sharp Diamond instruments with LM-ErgoSense handle are especially suitable for clinicians who use hand instruments frequently and want to minimize the time spent maintaining dental instruments. These instruments combine optimal characteristics of superior sharpness, tactile sensitivity and comfort.
“
LMSharpJack -
BETTER INSTRUMENTS, BETTER OUTCOMES Sharp Diamond instruments are well-suited for all forms of scaling. These instruments retain their original functionality, size and shape throughout their lifetime. The time saved from sharpening can be used for productive work and promotion of health. Choose sharp and work efficiently.
what a great instrument!
It has the best features you could wish for. It’s very narrow and thin which allows you to enter everywhere, even in the smallest areas. Perfect that the tip is so long so you can get in between molars. My favorite without competition, I’m in love!” Malin, Registered Dental Hygienist, Sweden
Rated best in clinical testing Excellent sensitivity and efficiency
Sharpen free
Great tactile feel and grip
Long-lasting superior sharpness
$79.00/ea BUY 4, Get 1 FREE Larger diameter (Ø 14 mm) & optimal design
Offer Expires April 30, 2020 Limit one per customer
Visit our website to see all Sharpen Free Instruments.
BISCO DENTAL PRODUCTS CANADA INC. 1.800.667.8811 www.biscocanada.com OHY Feb 2020.indd 39
2020-02-03 3:36 PM
What reaction do you want?
l, Carame , Gum Bubble erry h Mint, C on l M and e
THE THIN TRANSPARENT 5 % SODIUM FLUORIDE VARNISH IN A NON-MESSY SINGLEDOSE DELIVERY SYSTEM
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• No yellow discoloration of teeth • Five great tasting flavors without the unpleasant aftertaste of some other brands
www.vocoamerica.com
• Adheres well to moist surface • Sets quickly in seconds after contact with saliva
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• Enhanced flow characteristics with a thin spreadable consistency allow Profluorid Varnish to reach areas traditional varnishes may miss
Bubble Gum
• High immediate fluoride release to relieve hypersensitivity
Flavor
• Contains Xylitol • Available in both adult and child doses
• Does not contain tree nuts, peanuts, corn, shellfish, eggs, milk protein, soy, gluten, triclosan, petrolium, red dye/artificial coloring, saccharin or aspartame. • CDT Insurance code D1206 for HIPAA dental claims • CPT Insurance code 99188 for medical claims
Call 1-888-658-2584 VOCO Canada · toll-free 1-888-658-2584 · Fax 905-824-2788 · infousa@voco.com · www.voco.com
OHY Feb 2020.indd 40 VOCO_Ad_OralHygiene_PFV_11_2019_engl.indd 1
2020-02-03 3:36 PM 30.10.19 14:24