Amanda Hill

September 15th to October 15th marks Hispanic Heritage Month.  Hispanic Heritage Month recognizes the achievements and contributions of Hispanic Americans.  So for this month’s Difference Maker, we are recognizing the Latina RDH, Amber Lovatos.

Amber’s path into dentistry came out of necessity but without knowing it, was her calling.  As a teen mom that needed to provide for her children Amber learned about a grant for dental assisting training.  Her cousins were dental assistants and this seemed like a good opportunity to take care of her boys.  Amber quickly realized that she wanted to further her education and went to dental hygiene school.

Having had no regular dental care growing up Amber thought dentistry was only for people with resources.  But in dental hygiene school, Amber learned about public health dentistry and wondered where that had been her whole life.  As a teen, she had missed school because of tooth pain and was determined to do what she could to make sure other children didn’t have the same experience.

After hygiene school, Amber worked clinically, then became a health care science teacher, and eventually started an after-school dental assisting school to equip her students with a trade. And, more importantly, provide them with the career guidance that she never had growing up.  As she moved onto different roles Amber continued to be involved in community outreach, even becoming the Greater Houston Dental Hygienists’ Associations Community Outreach chair in 2015.  She has helped to organize over 40 outreach events.

Now Amber can be found as the director of Dental Administrations at TOMAGWA HealthCare Ministries, a non-profit community clinic.  TOMAGWA provides affordable comprehensive care to the local community near Tomball, Magnolia, and Waller Texas.  Recently they received a grant from the ADHA to buy mobile equipment and Amber is able to break away from paperwork and provide preventative hygiene services in rural Texas, the kind of services she never received as a child.  Amber’s passion is filled with working with underserved communities.  She sees and knows the struggles that her patients face every day.  And is driven to do more.

Amber and co-author Maxine Cordova recently released a book called Smiles Por Vida.  This book is written in Spanish and Spanglish to help children understand what happens at a visit to the dentist or mobile/school clinic.  The illustrations show characters that look like people in the Latin community to help bring an understanding of good oral health and that dental care is for everyone, including them. Proceeds from the book go towards community outreach initiatives in the community.

Amber is passionate about expanding access to care to all communities.  No one should think that dentistry is only for people with resources.  Everyone deserves a healthy mouth. They need not only clinical care but education to even know what a healthy mouth is.  We take for granted that everyone should know how to care for their teeth.  But Amber knows this isn’t the case.  Taking the time and care to educate the population will make a difference.

By expanding the voices and increasing the diversity within dentistry we are not only increasing the access to care, but we are also providing culturally competent care.  This has been shown to have better outcomes, improved accuracy, reduced errors, and increased trust and mutual respect.

The entire dental industry has an opportunity to get involved.  Volunteer in your community and share the word about other nonprofit organizations.  Amber’s next goal is to raise money for portable X-Ray equipment so she can serve patients in more ways when out in the community.  Her passion is contagious and it’s clear she is a true Difference Maker.

Amanda Hill, RDH, BS has been in the dental industry for over 30 years, she earned her B.S. in Dental Hygiene at Old Dominion University in Norfolk, Virginia and has had the opportunity to experience dentistry around the world.   Amanda  has a love for learning and is obsessed with continuing education in all its many forms.  Amanda practices part time clinically and is an industry educator for the nation’s largest dental job board, DentalPost.net.  Amanda is a proud Navy spouse and mom of 3.

You may find yourself wondering: what percentage of dental school students are female? In 2021, 51.6% of graduates from all U.S. dental schools were female. This was the third straight year that Female graduates outnumbered male graduates; a promising outlook on the future diversity of dentistry. Our projections indicate that by 2030, more than half of practicing dentists will be female.

As more women enter dental schools and establish themselves as practicing dentists, the dental field is witnessing an incredible shift in both culture and dynamics. This growing presence reflects broader changes in the profession, where gender diversity is increasingly recognized as a strength. Now more than ever before, there are a wide range of dental career options for women.

As we see more female dentists emerging, it's crucial to ensure that education and opportunities are accessible to aspiring women in dentistry. By fostering an inclusive environment, we can empower the next generation of female dental professionals to succeed in their field. In this post, we'll explore how education can be made more accessible to support this important trend.

Importance of Scholarships for Women in Dentistry

Supporting women who aspire to become dental professionals is crucial for fostering diversity and innovation in the field. As more women enter dentistry, they bring unique perspectives and skills that enhance patient care and contribute to the profession's growth. Unfortunately, financial barriers can sometimes hinder or prevent one’s ability to pursue dental education. 

Scholarships specifically designed for aspiring dental professionals play a vital role in overcoming these challenges. Scholarships provide the financial support needed to cover tuition and related expenses, allowing students to focus on their studies and clinical training. Additionally, scholarships often come with mentoring and networking opportunities, further empowering women to achieve their goals and succeed as prominent leaders in the dental profession.

Types of Grants & Scholarships for Women in Dentistry

Grants and scholarships are forms of financial aid that help students cover the costs of their education without the need to repay the funds. Scholarships are typically merit-based, awarded to students who demonstrate academic excellence, leadership, or various other personal achievements. Grants are usually need-based, given to students who require financial assistance to afford their education.

There are various types of scholarships and grants available to aspiring dental students. These can include academic scholarships for high-performing students, diversity scholarships aimed at underrepresented groups in dentistry, and need-based grants for those who require financial support.There are also scholarships specifically designed for women in dentistry, such as those offered by organizations like the American Association of Women Dentists (AAWD). 

Merit-Based Scholarships

Merit-based scholarships are awarded to students based on their academic achievements, leadership qualities, and community involvement. 

For dental students, there are several merit-based scholarships available, which may vary by region or state. Below are some examples:

• ADEA/Crest Oral-B Scholarships for Dental Hygiene Students Pursuing Academic Careers: This scholarship is awarded by the American Dental Education Association (ADEA) to dental hygiene students who exhibit academic excellence and are committed to pursuing careers in academic dentistry. It supports students who demonstrate a passion for teaching and research in the dental field.
• Washington State Dental Association Foundation Scholarship: This scholarship is offered to dental students who are residents of Washington State by the Washington State Dental Association Foundation. It recognizes students with outstanding academic records and a commitment to serving their communities. Most states offer a similar type of scholarship.
• National Dental Association Foundation Scholarships: The National Dental Association Foundation offers various dental scholarships ranging from $500 to $20,000. These awards support dental assistants, hygienists, students, and post-doctoral candidates, aiming to alleviate educational costs and foster leaders for underserved communities including the merit-based Audacity to Dream Scholarship

Need-Based Scholarships

Need-based scholarships, a type of financial aid, are awarded to full time students who are in need of assistance in covering the costs of their education. These scholarships are designed to ensure that talented and motivated students can pursue their education in dentistry, regardless of their financial circumstances. Below is an example of a need-based scholarship:

• ICD-WUDAA Scholarship Program: This scholarship is specifically aimed at supporting dental full time students who demonstrate financial need.

Specialty-Specific Scholarships

Specialty-specific scholarships are designed to support dental students who are pursuing a specific area of focus within the field of dentistry. These scholarships target students who have chosen to specialize in areas such as orthodontics, periodontics, pediatric dentistry, or oral surgery. 

For example:

American Academy of Periodontology (AAP) Foundation Scholarships: These scholarships are offered to full time students who are pursuing periodontics. 

American Association of Endodontists (AAE) Foundation Scholarships: This scholarship program is available for students specializing in endodontics. 

Research Scholarships & Grants

Research scholarships and grants are designed to support dental students who are interested in pursuing research within the field of dentistry. These opportunities provide financial assistance to students who wish to contribute to the advancement of dental science through research projects, studies, and innovations. 

For example:

AADOCR Student Research Fellowships: This program provides dental students with financial support to engage in research projects. 

ADEA/Crest Oral-B Laboratories Scholarship for Predoctoral Dental Students Pursuing Academic Careers: This scholarship is specifically aimed at students who are interested in academic dentistry and research. 

Scholarships for Underrepresented Groups

Scholarships for underrepresented groups are designed to support students from backgrounds that are traditionally underrepresented in dentistry. These scholarships aim to increase diversity within the dental profession by providing financial assistance to individuals who may face unique challenges in pursuing their education. Such scholarships often focus on racial and ethnic minorities, women, and other marginalized groups, helping to create a more inclusive and representative dental workforce.

For example:

The Dr. Jeanne Craig Sinkford Student Scholarship: This scholarship is specifically designed for female dental students who demonstrate leadership potential, academic excellence, and a commitment to advancing the role of women in dentistry. 

What is the largest provider of scholarships for women? The Miss American Foundation, Inc. currently provides the most scholarship opportunities for female students.

The HDS Dr. James & Ella Burr McManus Award: This scholarship supports prospective dental students that come from hispanic backgrounds. 

The Delta Dental Illinois Scholarship: scholarships to attend Midwestern University's College of Dental Medicine-Illinois offered to students in underrepresented minority groups showing exemplary academic performance; commitment to diversity, leadership, and community service; and demonstrated financial need.

Scholarship Application Process

Understanding the process of applying for scholarships and financial aid is crucial for aspiring or current dental students. Navigating this process effectively can significantly impact your ability to afford dental education and focus on your studies without the added stress of financial burdens.

By familiarizing yourself with the application procedures, eligibility requirements, and available resources, you can better position yourself to secure the funding needed for your educational journey. This knowledge not only helps in identifying suitable scholarships and grants but also prepares you to submit competitive applications, ultimately supporting your academic and professional goals in dentistry.

Eligibility Criteria & Required Documentation

Scholarships typically come with specific eligibility criteria that applicants must meet in order to qualify. These criteria can include academic achievements, financial need, field of study, or personal background. It's essential for applicants to carefully review these requirements to ensure they align with their individual profiles and aspirations.

Merit-Based Scholarships often require a strong academic record and proof of extracurricular achievements. An applicant may need to provide transcripts, letters of recommendation, and documentation of their accomplishments.

Need-Based Scholarships focus on financial need and may require applicants to submit financial statements, proof of income, and other documentation to demonstrate their financial situation.

Selecting a scholarship that aligns with your specific qualifications and goals is crucial. By choosing a scholarship that matches your strengths, background, and career aspirations, you increase your chances of securing the funding needed to support your dental education.

Application Deadlines

Meeting deadlines and submitting scholarship applications promptly are critical steps in securing financial aid for your dental education. Deadlines are non-negotiable and missing them can disqualify you from consideration, regardless of how well you meet the eligibility criteria.

Submitting your application early allows you to address any unforeseen issues and ensures that all required documents are complete and accurately submitted. By adhering to deadlines and being organized, you maximize your chances of receiving the financial support you need to pursue your dental career.

Tips for a Strong Application

• Prepare a Strong Personal Statement: Write a compelling and personalized essay that highlights your motivations, achievements, and career goals. Make sure it reflects your passion for dentistry and clearly articulates why you deserve the scholarship.
• Secure Strong Letters of Recommendation: Obtain letters from mentors, professors, or professionals in your lofe who can provide detailed insights into your abilities, character, and accomplishments. Ensure they are tailored to the scholarship’s criteria and provide specific examples of your strengths.
• Demonstrate Academic Excellence: Include a transcript and other proof of your academic achievements to show that you meet or exceed the scholarship’s academic requirements.
• Showcase Relevant Experience: Highlight any relevant clinical, research, or volunteer experiences that align with the scholarship’s focus. This demonstrates your commitment to the field and your readiness for advanced studies.
• Follow Application Instructions Precisely: Follow all guidelines and requirements outlined in the scholarship application. Ensure all documents are submitted correctly and before the deadline to avoid disqualification.

Resources and Support for Applicants

Online Databases and Search Tools: These resources provide a centralized platform to search for a wide range of scholarships tailo ed to dental students. They allow applicants to filter opportunities based on criteria such as field of study, location, and eligibility. Additionally, many online tools offer guidance on the application process, including tips on writing essays and securing recommendations, and can help students identify scholarships aligned with their career goals.

Professional Organizations and Associations: Organizations such as the American Dental Association (ADA) or the American Association of Women Dentists (AAWD) often offer scholarships specifically for dental students. These associations provide valuable resources, including detailed information on available scholarships, application guidance, and networking opportunities with professionals in the field. They also offer mentorship and career advice to help applicants navigate their educational and professional paths effectively.

This article is the third installment in our difference maker series.

While we have been highlighting individuals in the series this month, we now highlight a team of angels.

Hygienists for Humanity (H4H) was started in 2017 by Alicia Murria, RDH, MS(c). While attending a dental conference, Alicia couldn’t help but notice the homeless population around the conference center and wondered what she could do to make a difference. Then, when a sponsored lunch was finishing up, Alicia saw the piles of uneaten food and wondered where it went. And, as the conference was ending and Alicia noticed the exhibiting dental companies offloading products to avoid lugging them home, well, genius struck. Alicia decided to take all the things she noticed and do something. Hygienists For Humanity was born.

Since then, the organization has grown to a team of passionate volunteers and engaged partner companies. It’s an official 501(c)(3) organization with events going beyond distributing leftovers at dental conferences. The team has set up health kit giveaways in areas where persons experiencing homelessness congregate, and donating kits to schools, programs, and shelters, providing free screenings to those in need. It continues to grow in its reach.

The grand vision is to continue to expand on opportunities to reach neglected and underserved populations throughout the country, but not just once every few years like many dental missions. Hygienists for Humanity strives to help people on an ongoing basis.  

Tiffany Harrison, RDH, strategic partnership liaison for H4H, says, “we want for these communities exactly what we want for ourselves and our patients. High-quality dental products and care. Not just a toothbrush once a year or an emergency visit, but a dental kit every three months and preventive care for a lifetime. H4H wants to create a sustainable program that gives access to quality healthcare (including oral care) to everyone who will take advantage of it.”

H4H has its first hands-on mission planned in partnership with Volunteers of America Mid-States in 2022.  Moving forward, they are excited to continue to find ways to partner with organizations to meet their community’s needs.

The founding quote of H4H is by Luciano De Crescenzo

"We are each of us angels with only one wing, and we can only fly by embracing one another."

Hygienists for Humanity recognizes that the greater mission of service cannot be done alone. There are underserved people everywhere. In order to know what the needs are and how to serve each unique community best, they have been growing their team of angels to well over 500. Each angel comes with their own gifts to pour into the organization and help it grow. All are welcome, and not everyone is dental! Coming together with our single wing will help us all fly.

There’s an African proverb that says, “If you want to go fast, go alone. If you want to go far, go together.”

That’s why this Difference Maker spotlight highlights the entire organization and encourages you to look into this opportunity to join the team of difference makers. 

Need more information on how you can be the other wing?  Check out Hygienists for Humanity at https://hygienistsforhumanity.org/

Amanda Hill, RDH, BS has been in the dental industry for over 30 years, she earned her B.S. in Dental Hygiene at Old Dominion University in Norfolk, Virginia and has had the opportunity to experience dentistry around the world.   Amanda  has a love for learning and is obsessed with continuing education in all its many forms.  Amanda practices part time clinically and is an industry educator for the nation’s largest dental job board, DentalPost.net.  Amanda is a proud Navy spouse and mom of 3.

Most of us take our dental unit suction lines for granted. You turn them on, they suck spit, and off they go because they are noisy. But if your suction goes down, what happens to the office?

Here’s how to get the most from your suction in 5 easy steps

Know your devices

When most clinicians think of suction, they think about the devices they are using intraorally. After all, that’s what’s doing the work, right?

Actually, if your vacuum isn’t working, no device in the world will help you control fluids and aerosols. But we’ll get to that in a second.

There are lots of suction devices on the market. Some are designed to simply control fluids, and others are intended for both fluid and aerosols. Determine your needs. Are you looking for hands-free? Something with a mirror to help with indirect vision? Disposable for better infection control? Or autoclavable for sustainability?

Check your flow

Most offices weren’t designed for every operatory to be running high evacuation suction (HVE). The standard math in determining vacuum size usually accounts for the doctor operatories using HVE and the hygiene rooms using saliva ejectors (LVE). We now know that anyone performing aerosol-generating procedures (AGP) should be using their HVE to control aerosols at their source, the patient’s mouth.

Can your current vacuum handle the added demand? Have your tech or rep come out and perform a flow rate and vacuum assessment. Even if you aren’t quite up to maximum airflow, there are a few things you can do to get the most from your pump.

Traps

First, change your traps. Upon inspection, they might be occluded, affecting the vacuum’s performance for sure, not to mention the added strain on the vacuum.

There are a few traps to look out for. Typically, there are traps in the chair that should be changed weekly, if not more often. They catch all kinds of stuff, from prophy paste to amalgam. Speaking of amalgam, those used traps need to go into your hazardous waste receptacle, not your regular trash.

There is a big trap on the vacuum that catches what the chairside trap does not. This can fill up with a thick sludge and should be changed every two weeks to once a month depending on your vacuum’s instructions for use (IFU) or how fast it fills. It’s worth looking at once a week when you are changing the chair traps.

With the mandate of amalgam separators came yet another trap to check. Most IFUs say to change this trap once a year, but it could fill up in a few months, depending on your office. A full amalgam separator trap is sure to slow down your suction capabilities.

Beware of hidden traps. Sometimes there are filters or traps in the junction box under your chair. Check your IFUs or ask your rep to help you.

Daily maintenance

The key to clean lines is daily maintenance. All lines need to be run daily, if not more often, to clean out anything that might try and stick to the inside of the tubing and affect performance. To get the most from this task, choose a product that is EPA-approved for suction lines. Choosing the wrong product could hurt your lines and vacuum pump.

Use a dispenser to run the lines. A dispenser designed for this task allows for the right amount of air and fluid to enter the lines simultaneously. This helps reduce strain on the vacuum pump and aids in cleaning the inside of the tubing. Run the solution from the operatory farthest from the pump to the closest and preferably at the end of the day.

Change your lines

If you still have the same tubing that came with the practice 30 years ago, it might be time to change the tubing. Over time the suction tubing becomes rigid and no matter how good you are at running your lines, occluded. Thankfully this is an easy and cheap task. There is even ultralight tubing on the market now that is ergonomically friendly.

Caring for suction lines is one more thing on the long list of maintenance tasks in a dental office. We understand now more than ever the importance of controlling aerosols at the source. And well-functioning vacuum system will help keep patients and the dental team more comfortable and safer.

Amanda Hill, RDH, BS has been in the dental industry for over 30 years, she earned her B.S. in Dental Hygiene at Old Dominion University in Norfolk, Virginia and has had the opportunity to experience dentistry around the world.   Amanda  has a love for learning and is obsessed with continuing education in all its many forms.  Amanda practices part time clinically and is an industry educator for the nation’s largest dental job board, DentalPost.net.  Amanda is a proud Navy spouse and mom of 3.

To truly thrive in the healthcare industry, you have to care. After all, it is called healthCARE. The dental industry is full of some of the most caring and altruistic professionals. And on top of treating patients in traditional practice settings, dental professionals are making a difference in all sorts of creative ways.

This article begins the first in our “Difference Maker” series, where we will highlight people within the dental industry making a difference in their own unique way.

Meet Carrie Wucinich, RDH. Carrie is a dental hygienist, mom of two, and passionate about children. Carrie has been in the dental industry for almost twenty years but it wasn’t until she had her own children that figured out how to tap into her purpose.

Carrie has been talking about sugar bugs since she found her happy place in pediatrics. Helping children to understand the importance of good home care to prevent cavities was a passion. But when she had her own children she realized that it wasn’t as easy as a quick brush and floss lecture at the end of the appointment. It was hard to get kids to brush!

So Carrie had an idea. She took her Sugar Bug story to print and created the book Where the Sugar Bugs Live to help parents encourage brushing with their little ones. But as all good stories go, there was a twist. Carrie’s book launched right as the country was shutting down for the pandemic. All the book launch events were canceled and Carrie was left with a lot of books and nowhere to go!

Thankfully Carrie’s passion shined through adversity she was able to connect with dental professionals and spread the word about her book. Carrie was invited to read to children receiving care from Smiles Across Montana, a team of mobile dentistry clinics committed to eliminating oral health disparities across Montana. Through events like that, her vision expanded from a bedtime story parents would read to their kids with proceeds going to families of children with cancer (already an amazing vision) to an opportunity to lay a strong foundation of oral health to kids across the country.

What Carrie saw was kids struggling and parents not knowing what good oral health care looked like. She realized she had an opportunity to be a positive part of their lives. “It’s more than just a book, it’s bringing your light. When you educate a child you could change the game. They could be on a whole new path.” Some of the children Carrie encountered never get gifts and are so proud of their new Where the Sugar Bugs Live book. They couldn’t wait to read it and look at the colorful illustrations. “Kids are visual learners. Once they heard the book they were on a mission to get the blue sugar bug or the red one out of their mouth!”

Carrie has no intentions of stopping here. She is working on her non-profit status, writing grants, and working hard to get books into kids’ hands everywhere. She also has plans for a new book focused on classroom instruction and wants to translate it into Spanish so that more children can connect and learn. “There are 51 million hours of school lost to dental pain. We have to change that.”

When I asked Carrie how dental professionals could utilize her book she first suggested having it in the office and reading it to kids while you wait on an exam or for a procedure to start. Or email her to get the Sugar Bug coloring page for a fun activity. But then her wheels got turning and she recommended going out into your community and spreading the word about the importance of good oral health. “Look for Title One schools in your community. They would love to have someone come in and read. If everyone would do a little thing, it would be a big thing.”

To learn more about Carrie and Where the Sugar Bugs Live go to https://yellowribbonbooks.com/. There are opportunities to donate books to communities in need or stock up for your own practice!

Amanda Hill, RDH, BS has been in the dental industry for over 30 years, she earned her B.S. in Dental Hygiene at Old Dominion University in Norfolk, Virginia and has had the opportunity to experience dentistry around the world.   Amanda  has a love for learning and is obsessed with continuing education in all its many forms.  Amanda practices part time clinically and is an industry educator for the nation’s largest dental job board, DentalPost.net.  Amanda is a proud Navy spouse and mom of 3.

This April, we are observing the 22nd Annual Oral Cancer Awareness Month. This month is set aside to raise awareness on the importance of performing head and neck cancer screenings. As dental professionals, this is our time to shine. But do you feel confident in your skills? I know I had some questions about how to know I was doing the best for my patients. So I reached out to expert Susan Cotten, BS, RDH, OMT, an Oral Cancer Consulting owner.

Susan has been educating dentistry with the “Cotten Method,” a comprehensive office system specific to oral cancer, to build confidence in screening, aid in reducing liability, and build the dental team. And helping professionals like me feel more confident in our skills, verbiage, and knowledge!

Oral Cancer Today

Amanda: What are the current oral cancer statistics?  

Susan: The Oral Cancer Foundation reports that in 2021 approximately 54,000 Americans will be diagnosed with oral or oropharyngeal cancer, that is, 147 Americans every day and six every hour… and in five years, only a little more than half of those diagnosed will be alive. White, non-smoking males are most at risk for Human Papillomavirus/HPV oropharyngeal cancer, 4-1 over women. It is important to note that HPV affects the oropharynx. Very rarely does it involve the oral/anterior portion of the mouth. HPV oropharyngeal cancer is considered an epidemic.

Frequency

Amanda: How often should we be screening for oral cancer? 

Susan: EVERY VISIT – EVERY PATIENT!  From their very first visit to their very last, regardless of age and perceived risk.

Screening Aids

Amanda: Should we be using aids like Oral ID or Velscope, and if so, how often? 

Susan: The adjunct devices are just that, adjuncts to the gold standard – Extraoral and Intraoral exam (EOIO). Adjuncts should never take the place of the EOIO. The ADA position is: “The guideline does not recommend the use of salivary or light-based adjuncts for evaluating lesions for malignancy.” 

“The panel does not recommend autofluorescence, tissue reflectance, or vital staining adjuncts for the evaluation of potentially malignant disorders among adult patients with clinically evident, seemingly innocuous or suspicious lesions.” ADA website.

Do I personally believe we should use them? Yes. I believe we should use all we have at our disposal. The wrong reason to use an adjunct is purely for production.  

What to do?

Amanda: What the best screening protocol?  

Susan: Best practices/protocol is the thorough visual and tactile head and neck, oral, oropharyngeal cancer evaluation. The oral cancer evaluation is not just the hands-on visual and tactile evaluation. We know possible signs and symptoms, we should ask our patients if they are experiencing any of these.  We know risk factors; we should be inquiring about all the risk factors. In their 2017 oral cancer guidelines, the ADA also stated, “Clinicians should obtain an updated medical, social, and dental history and perform an intraoral and extraoral conventional visual and tactile examination in all adult patients.” 

Here’s a great step by step instruction Susan wrote for RDH magazine last year:

https://www.rdhmag.com/pathology/oral-pathology/article/14173681/how-to-perform-a-head-and-neck-oral-oropharyngeal-cancer-screening

What is wrong in a screening?

Amanda: What are most people getting wrong in the Oral Cancer Screening? 

Susan: I wouldn’t say that providers are getting things wrong; here is what I see after my years of coaching dental offices and providers in performing this evaluation, AND from my own personal experience.

1. Don’t do it: Many dentists and dental hygienists are not confident in performing this evaluation. Therefore they don’t do it (yes, that’s correct, some providers do not perform an oral cancer evaluation) or don’t perform it consistently. We are humans. When we aren’t confident in something, avoidance is common. I have not always been confident in performing an oral cancer evaluation. That is a big reason I do what I do now.
2. Time: Often, hygienists will report that they do not have the time to do all that we do now in the dental hygiene appointment. However, if time is of concern, this procedure should never be cut short or eliminated. I say that because I have personally cut this procedure short before having a patient as an oropharyngeal cancer survivor. She changed the importance I place on this procedure.
3. Production: While this evaluation requires more than it once did (compared to what I learned in hygiene school), there is no reimbursement for the time taken to do this life-saving evaluation. YET, the adjunct device that the ADA does not recommend has a code for submission and possible reimbursement.  The Oral Cancer Evaluation needs a separate code for the metrics. The oral cancer evaluation is currently listed as part of the comprehensive exam, periodic exam, and the periodontal exam. We know the oral cancer evaluation is performed at times when these exams are not performed, so we have no way to track that it was done and to gather data on this life-saving evaluation.

What needs to change?

Amanda: How can we do better? 

Susan: 

1. ADA Code Maintenance Committee/CMC can approve a code for this evaluation. A submission was made by Dental Codeology Consortium in 2020 to the CMC; it was not approved. Medical cancer screenings/evaluations have codes. Why not dentistry’s cancer?
2. Regular Required Education: I am advocating for every two years required didactic education and hands-on review of the visual and tactile EOIO.  We are required to have BLS/CPR education and hands-on training every two years for our license… in case we need to use it, we are confident and prepared……. We perform the oral cancer evaluation multiple times every day, yet many providers do not feel confident; this is from new graduates to seasoned professionals.   All dentists and hygienists should feel confident in performing this procedure. 
3. If you don’t feel confident in performing this screening, that’s ok. However, please don’t continue with a lack of confidence. Reach out for coaching.

Just Do it

Here’s your chance to head back into the operatory with newfound confidence to know you are doing the very best oral cancer assessment for every patient confidently. Just the stats alone are enough to remind us how critical this exam is to every appointment. Empower everyone in your office to know what to look for and how to follow up. You could save a life! 

Dental Hygiene has long been a misunderstood profession.  In the movies, it’s often the dental hygienist that the antagonist has an affair with or they are portrayed as the flighty best friend.  While all the while we are a well educated, smart, compassionate group of professionals.  When you talk to patients, they often say they stay with their dental office because of the relationship built with the hygienist.  But these same patients will somehow disregard their chronic periodontal disease in favor of teeth whitening.  Is this because they don’t understand that hygienists aren’t just there to catch up on their family happenings make their teeth feel slippery?  Do they not know that hygienists are indeed educated health care professionals that bring a wealth of knowledge on how to help them live longer healthier lives?

It’s time that changed.  There is too much publicly accessible scientific information that proves the mouth is connected to the body and it affects your overall health. But how does that happen without providing each patient a curriculum vitae at the beginning of their next recare appointment?

There’s a YouTube video circulating around social media sites produced by the Pennsylvania Dental Hygienists' Association featuring Lisandra Maisonet, RDH, BS, PHDHP that really highlights the modern role of a dental hygienist.  The video has 2 versions, a longer 7-minute piece with a compelling story by Charles Whitney, M.D. about how one of his patients was able to improve their cardiovascular health through periodontal therapy alone and a shorter 3+ minute version that still highlights the impact a dental hygienist can and do make.

The video’s host Lisandra Maisonet says, 

I am so honored to have served in my profession for the past 18 years. During this time, I have seen so many changes, some positive and some negative.

Being a part of many Facebook groups the thing that has impacted me the most are the thousands of hygienists who question their career choice on a daily basis. Initially, I couldn't understand it but as I read the comments and heard their voices, one thing resonated with me. These hygienists just want to be acknowledged for their expertise and for the passion they share when providing care to their patients. They want the world to know that they are not tooth cleaners, but are so much more than this.

This is what drove the making of this video. It was time to educate the world on the value of a dental hygienist, who we are and the difference we can make.

Hygienists didn't want another message or video on the importance of membership, they know the value it can bring. They want to know that they are heard and that someone out there cares to make a difference that can impact their profession, their career.

My prayer is that this video drives the message of our importance! That it drives the message of the importance of visiting your dental hygienist routinely.

Dental offices are often struggling with what information to put on their websites and social media platforms.  This video is the perfect educational tool to show patients.  Think of how this information will help them understand what skills their dental hygienist brings to the office and to their life.  Establishing this value will go a long way toward treatment acceptance, compliance, and improved health.  All the while benefiting not only the practice’s bottom line but the hygienist’s job satisfaction.  And that’s a win-win.

With all this talk of Coronavirus there is a mask buying frenzy happening.  Supply companies are limiting the number of masks you can buy to make sure there’s enough to go around for all of us.  That makes perfect sense, as we all need to ensure the entire team is wearing the proper PPE.  But are you even buying the right mask for the task?

A few years ago at my yearly infection control update, I was surprised to learn I was not wearing the recommended mask when using the ultrasonic scaler.  I promptly went into my office to let them know the Level 1 mask did not reach the standards set out by the CDC and we needed to change to Level 2.  Then just a year later, at my next infection control update, I learned the recommendation was actually a level 3 for procedures creating moderate to heavy amounts of aerosols--including tasks like ultrasonic scaling and the use of high-speed handpieces.  Many offices I encounter are still using level 1 masks exclusively.

So how do we know what mask is appropriate for what procedure?  Crosstex came up with a handy chart to help you understand the different ASTM levels of masks but it still doesn’t quite layout when to where what.  An article published in RDH magazine in November 2019 Leeann Keefer, MSM, RDH lays out the hard science of mask selection.  Keefer included tables from ASTM on the proper use of facemasks, including a particularly helpful one breaking mask usage down by tasks within the dental office. 

It is perfectly acceptable to have different levels of masks within your office for different tasks.  However, we need to make certain we understand the difference and choose appropriately.  Prior to my hygiene check I lay out a level 1 mask for my Doctor and when turning over my room I use a level 1 mask.  But for appointments where I’m using the ultrasonic scaler I am unquestionably wearing a level 3 mask.  While it may be a pain to purchase, store and track supply on different levels of masks this can not only save you money, it will help you during this mask shortage.

It is also key to remember proper mask usage. Read the instructions on the box and look at the pictures. Keep these common mistakes in mind:

Single use

• Masks are one-time use only, meaning you cannot use the same mask from patient to patient, regardless of how short or long you’ve worn it

Duration

• Masks should be changed hourly or if soiled or wet--whichever comes first.  

Proper Placement (walk around your office and you’re bound to see at least one of these mistakes)

• We should not be walking around with our masks below our chin (I’m totally guilty of this), when we touch the outside of the mask to pull it down, the mask is no longer as effective and you are spreading around whatever landed on that mask.
• The ear loops should be flat and not twisted.  When you twist them the mask no longer seals properly and it sits closer to your mouth so it will get wet faster.
• The mask must cover your nose.  It will not protect you unless you properly fit it to your face.  If your glasses are fogging get some antifog or warm them up.
• Don’t put your used mask in your pocket.  Consider that mask contaminated.  There are all kinds of aerosols that landed on that mask.

In the healthcare setting, it is key that we protect ourselves.  The number one reason dental professionals miss work is due to upper respiratory infections.  So when you are busy thinking about the added cost of level 3 masks, consider the cost of missing a day’s production or paying a temp service to fill in for your hygienist and that might just help you get compliant.

Shop Masks at Safco Dental Supply

Recently, dental unit waterline testing has become a frequent topic of conversation, both on social media and in print. As stories of illnesses due to contaminated dental waterlines are hitting the news cycle, this is something that dental offices need to make sure we are on top of. I don’t know about you, but I never learned about waterline testing in hygiene school, so this is certainly something I needed to get up to speed on and get our team on board!

Thankfully, there are lots of resources out there to help us be in compliance with infection control standards. OSAP and the CDC are great resources to find fact-based information. While social media is a great place to crowdsource opinions, this is not the place to get infection control information; there is way too much misinformation out there about waterline safety.

My waterline journey was a deep dive into some cool hard science. It was a great opportunity to geek out and relive that microbiology course I took back in college. I think it’s key to establish one person in the office that will be the point-person for this task. Make sure they think it’s fascinating or else the ball will get dropped and your and your patients’ safety will be compromised for sure. 

One Friday, after the office was done for the day, I spent an hour or so getting our office compliant. I started with a diluted bleach shock of all the waterlines in the office--and by all the lines, I mean ALL the lines, handpieces, air water syringes, ultrasonic scalers, any lines that have water in them—whether we use them or not, in each operatory. Then I used Quickpass in-office dental water test for each waterline to get a baseline. The instructions were simple and quick. I put the tabs away to incubate and count in a few days. When counting day came, I strapped in my loupes and got to counting. This was fun stuff. Some lines looked good. Others, not so much. For the questionable lines, another shock and a re-test was in order. Once everything was within standards we put Steri-straws in the self-contained water bottles and used Blu Tabs in the ultrasonic scaler.

The tough part was getting the team on board with compliance. Now that the lines were safe, it was key to keep them that way. Many offices are under the impression that once you put in the Steri-straw you are good to go. I wish it were that simple. It is critical to dry the lines each night and flush the lines each morning and in between patients, or else that biofilm is going to build right back up. Trust me, I know what I’m talking about. At the quarterly spot check, I discovered one room was failing again. An after-hours inspection showed someone in the office wasn’t fully on board with the nightly purging of the lines. So another re-shock of the lines and full testing of that unit happened right away, along with some delicate retraining of the staff to help them understand that this wasn’t just silly busywork--that this was directly impacting the health and safety of our office.

While this might seem like another thing to do in an already overloaded schedule, this is indeed important. Not only to be compliant with the CDC but for your safety. The aerosols from the handpieces and ultrasonic scalers travel up to eight feet through the air. We are inhaling this stuff all day long. Even with proper PPE, some bacterial aerosols can linger around your operatory for hours. The most common reason for dental professionals to miss work is a respiratory infection. We need to protect our patients and ourselves.

The takeaway here is shock, test, treat and retest, it’s that simple. There are some great online resources, checklists, and YouTube videos to help you. This task does not need to be as daunting as it may appear. Change is rarely easy or convenient. But overwhelmingly, we in the dental world have got to get on board, not only to be within the law, but to preserve our, and anyone that enters our office, health and wellness.