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Hygiene Dept. Visit: Evaluate, Educate and Motivate Benjamin Lund, Editor, Hygienetown Magazine

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by Benjamin Lund, Editor - Hygienetown Magazine

Welcome to the fourth installment of Hygiene Department Visit, where we visit Townies in their practices and profile their equipment, procedures and hygiene philosophies. If you would like to participate or nominate a colleague, please e-mail ben@hygienetown.com.

This month, we paid a visit to Geneane Stahl, RDH, at her practice in Portland, Oregon. Geneane thought it'd be fun to join a friend of hers at a dental assisting class when she was in high school. Little did she know it would lead to a career in dental hygiene. In this interview, she discusses her love for SRP, how Hygienetown has improved her confidence level, the challenges she faces in hygiene, and more.
Name: Geneane Stahl, RDH
Townie Name: beanbob
Graduate from: Portland Community College
Year graduated: 2000
Dentist/Employer: John Duncan, DMD
Practice Location: Portland, Oregon
Number of hygiene ops: Two
From left: Dana, Angie, Kiffen, Dr. John Duncan, Karen and Geneane.

Hygiene Highlights

Equipment
• Belmont X-ray Tube Standard
• Biosonic Ultrasonic Scaler		 • Cavitron SPS Dentsply Ultrasonic Scaler
• Midwest RDH Slow Speed Handpiece

Instruments
• 11/12 explorer
• Cotton forceps
• Double sided mirror
• Hu-Friedy 5/6 Gracey
• Hu-Friedy 7/8 Gracey
• Hu-Friedy 11/12 Gracey		 • Hu-Friedy 13/14 Gracey
• Hu-Friedy Colorvue probe
• Hu-Friedy SH6/76
• Hu-Friedy Sidekick sharpener
• Hu-Friedy SYG 7/86

Medications
• Arestin
• Debacterol Canker Sore Medication
 • OMNI Vanish Varnish
• PerioChip (chlorehexidine gluconate)

Oral Hygiene Products
• Colgate samples
• Eez-Thru Floss Threaders
• GUM Soft-Picks
• GUM Stimulators
• Henry Schein's Irrigation w/pocket probe tip
  (Vista Dental)		 • Oral-B SuperFloss
• Oral-B toothbrush samples
• Oral CDx's Oral Brush Biopsy
• Proxy brush
• Trace Disclosing Tablet

Supplies
• CloSYS Oral Care
• CloSYS Patient Care Pack
• Colgate PerioGard Oral Rinse
• Colgate Visible White 9% Hydrogen
• Comfort RX
• PerioMed Rinse

Click Here to view Geneane's Top 5		 • Peroxide Formula
• Pocket Care Oral Irrigator
• Protech Sonic Denture Machine
• Sonicare complete toothbrush
• Theramints Xylitol Mints

Why did you choose hygiene as a career?
As a high school senior I had extra time on my daily schedule. A friend of mine told me about a fun class that she took at a girls polytechnic high school here in Portland. It was a dental assisting course. It seemed like it would be a fun class and I thought, “What the heck.” I fell in love with the profession as soon as I started. I loved the instruments, the equipment, mixing the materials and above all I loved the instructor. She was one of those people who made assisting fun. She also encouraged us to think big and some day we could be a dentist or hygienist. We had the opportunity to assist the dental students at Oregon Health Science University. That was great fun.

What appealed to you about the current practice in which you work?
What appealed to me about this office was the organized, relaxed manor of the office. Dr. Duncan is brilliant and a very good dentist. He doesn't try to push his patients into unnecessary dental work. He is very caring and respects all of his staff. He is also a very giving person and the staff and patients all know that. He has had many patients for more than 20 years. They love him. He also doesn't take himself too seriously, so we have fun. He also really respects and wants to work well with the hygiene department. Most important is that I fit in with the staff. Please forgive the cliché, but it's kind of like how a glove fits a hand. The staff respects one another and we all pitch in to help. I also have a hygiene assistant, whom I love.
  
Geneane's regular tray set up.		   
Geneane's tray set up for periodontal cases.

Tell me something people would be surprised to know about you.
After assisting school I took a few years off and went into retail. I worked for Nordstrom. What a dream that was. I worked my way up to lead shoe buyer for Brass Plum Shoes in Oregon. Why, you ask, did I give it up? Because I had three small children at home and I needed to be with them more. I was traveling a lot to New York and Seattle, and I was working too many hours. Plus, believe it or not, the pay wasn't that great. Because my husband had the good paying job and my family was here in Portland I really couldn't move any where else in the company. So I stayed home for a few years then went back to dental hygiene school while the kids were in school.

What is your favorite dental hygiene procedure?
Root planing of course. I really love it when the tissue responds well and healing is happening. It is very rewarding to work with the patients. We have the patients come in for four one-hour appointments and one follow up probe and polish. This really gives me a great opportunity to work with them and their home care at each appointment. By the time they are done with the five appointments, they usually get it.

How has Hygienetown impacted the way you practice dental hygiene?
Hygienetown has been amazing and has dramatically changed my career. When you start as a new hygienist, you question yourself: “Am I doing everything correctly?” “Am I using the correct products?” “What are other hygienists doing?” “Are other hygienists having the same issues and problems as I am having?” Hygienetown provides an outlet for me to ask questions and discuss problems. On Hygienetown, I can always find someone who has had the same concerns and issues I've had. Just reading about how other hygienists practice and the products they use has given me confidence to move onward and upward in my professional adventure.

What are the biggest challenges you face as a hygienist?
Staffing. If dental hygiene or dentistry had a big human resources department to go to, wouldn't life be wonderful? I did a lot of temping in the first few years of my professional life and I was always amazed and shocked by some (not all) of the offices and the way they practiced and how they treated their employees. Not all have been tough, but there always seemed to be one person in each office who created trouble or drama. With the small office atmosphere in which we work, it is difficult to find a unit of people that can always work well together.
What is your periodontal therapy philosophy? (e.g.: What do you treat and what do you refer out?)
My philosophy is to evaluate and educate all patients about their periodontal health as it pertains specifically to their own mouth. Every person has a different knowledge base as to what they know and don't know about “gum disease.” My job is to find out what my patients know and guide them toward the correct direction through motivation and education. I especially lean toward motivation although I can be pretty direct about the facts also. I will tell them what they need to achieve optimum oral health. I usually will refer out a patient if, after working with him for a year, I see no progress toward improvement, especially in one or two areas that infection does not resolve.
Geneane from the early days as a dental assistant.
What is your typical day of appointments (how many children, adults, new patients and perio patients do you see on average each day)?
A typical day is very well rounded. I see one to two pedo patients. Then I'll see one or two SRP patients, then three perio maintenance patients (or three-month recall patients) then the rest are prophy patients. I see new patients under the age of 21 and the doctor sees the other new patients who are older than 21.

How do you explain your treatment to patients?
I like to have a dialogue. I resisted having a dialogue about periodontal disease for a long time. Although reading from all of the great hygienists of our day, I realized I needed to have a memorized basic explanation of the whole disease process. It doesn't have to sound like it is memorized. By Just saying the dialogue it gets the point across to the patient. It is all part of the educating process. For example, at a periodontal exam I usually say, “Mrs. Jones, today you are due for your yearly periodontal exam. This is where we take measurements of your gums. We measure the top of your gums to where the bone meets the tissue. We measure in millimeters. One to three millimeters are normal readings and anything higher than three shows you have some signs of gum infection or bone loss due to gum infection. We also look for signs of bleeding, recession, mobility and anything else that indicates that you have problems with your gum tissue. I will call the numbers off to Dana and she will record them in your chart. Do you have any questions before I start?” Then I will ask my assistant if there were any numbers higher than 4mm the last time we took measurements. It took me a while to get over the hurdles of a dialogue, but it really is helpful to have and the patients really do like their mouths examined by someone who sounds professional. I have dialogues prepared for oral cancer screening, scaling, calculus development and so on. I am still working on the treatment for crown and bridge dialogue.

How do you battle patient non-compliance? What do you do to motivate your patients?
A lot of the time patients motivate themselves. They work hard to get their gums healthy and they want to keep them that way. Again, educating, really listening to my patients needs as I work, and sometimes just keeping my mouth shut can speak volumes.

If you could add one new piece of equipment to your hygiene department, what would it be?
I would love an intraoral camera. It is the only way to describe to the patient and show them what you see in their mouth. They usually get the idea pretty quickly that they need a crown on that tooth.
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