Hygienist burnout? Ways to make sure you sizzle rather than fizzle

June 10, 2016

What kind of career can a dental hygienist evolve to as the future of dentistry continues to corporate with our medical community? Are you ready for limitless options?

How do we prevent our bodies from wearing out and our minds from burnout? The dental hygienist’s daily repetition could easily allow someone to fall quickly into a rut over a few decades of service.

As the dental industry continues to evolve and our medical world and dental world continue to move toward a corporate model, the dental hygienist’s role has more potential than ever before to evolve and morph into something so exquisite.

Here are a few unique ways that could prevent fizzle and turn it into sizzle.

Many hygienists have taken off running with all of the oral-systemic disease connections. These connections bridged the gap between medicine and dental years ago. As hygienists, we want to help our patients’ overall health. We are able to better help by understanding the connection between diabetes and cardiovascular disease with periodontal disease, as well as connections with cancer and dry mouth and increased caries risk.

For example, regarding your patients with diabetes, you want to have them on a more frequent recare schedule. If you see changes in pocketing and bleeding, you want to have them do periodontal therapy. Work closely with their doctor to evaluate blood sugar levels as they may need changes in their insulin doses.

For all our patients, we want to screen for risk of cardiovascular disease. If we see high-risk patients, we want to encourage them to see their medical doctor. We want to educate our patients as much as possible.

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With cancer patients, you also want to see them more frequently. Their immune systems are compromised and have a hard time fighting the bacteria. They need to be educated that cancer treatments can cause them to have dry mouth, which can lead to more caries. They need to be placed on fluoride and given saliva substitutes. We always want to keep learning and do all we can to help the overall health of our patients, not just their oral health.

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Then we moved into an era of more Oral Cancer Awareness and that has brought so much recognition to the role of the dental hygienist in screenings and education. Simply put, 90 seconds at the chair could save someone’s future.

RELATED: What you need to know about HPV, oral cancer and your patients

Now we have been a part of sleep breathing disorders and obstructive apnea screenings and our three to five minutes of medical review, questionnaires, blood pressure, pulse oximeter and mallampati score. Sleep apnea is a fatal disease that goes undiagnosed 18 to 25 million Americans. So how do we help these people?

We can see large tonsils, large necks, narrow arch forms, bruxism, TMD, mouth breathing, tongue ties, medical histories, people with high blood pressure, cholesterol, memory issues, stroke, diabetes … all of these are signs that someone may have sleep apnea. So what do we do when you see these patients?

RELATED: How a dentist discovered his own sleep apnea

First, you have your medical history … which is the crime scene for what all is going on. It takes more than asking, “Has anything changed in your medical history?” Those words are like fingernails to a chalkboard.

With self-medication being at its all-time highest and this epidemic of breathing disorders and mouth breathing, that question has never and will never be enough. We must all go deeper. This does not exclude dental assistants, administrative team members and dentists. We are the investigators of the crime scene and we must do our investigation rigidly. No patient will remember to tell us all of their changes in conditions, nor will they understand that they are applicable to their dental visit.

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With our world around us screaming “NOW!” and “Instant,” everyone is in a hurry … but we are responsible for slowing things down and making the risk assessment screening important.

The conversation can often go something like this, “Mrs. Jones, go ahead and have a seat. You don’t have to put your feet up just yet. Let’s sit and have a chat. The last time you visited us in October, we had concerns about your blood pressure and asked you to visit your physician for a checkup. How did that go?

“We discussed several options for the lower right of your mouth to get back to health. Do you recall what those options were? We also recorded your medical conditions and medication and I have those recorded as followed (medication/amount/frequency). Have any of those changed?”

Having a conversation about their heath is always a place to start. As hygienists, we have to learn to manage our social graces and gear our screenings into a conversation to gather all the data we are looking for. Asking questions gets us minimal results. Having conversations takes us closer to the goal of getting patients cared for.

Our obligation to our patients is to sift through all the conversations and collect pieces at the crime scene to put together and assist them in options and solutions available to them. We also have home sleep tests that we can operate and prescribe to our patients. Having the conversation and educational tools available in our dental treatment rooms is critical. We purchased these items from AMAZON! How fun is that?

We play show and tell with our patients now and they love having options for care. We discuss their options with them like, “Well, one way to help treat any breathing issues that are diagnosed by our care partners would be to use a CPAP machine.”

CPAP stands for continuous positive air pressure. It's a mask or a nasal canula that the patient has to wear while he or she is sleeping. We have some patients who tell us that will not be an option for them. They are not going to comply with wearing these as they will ruin their social life, marriage, partnerships and, well, they’re simply not convenient. This, in turn, is harmful to their health, because now they are not getting the oxygen they need to help their body rest and recover. All their organs are working harder, while they should be resting.

So we go on and show the second option that they may consider, which is an oral appliance (like Micro2 or Narval, to name a couple) that they can wear at bedtime. It's something that is worn that opens the airway while sleeping. 

This area of dentistry has become such an adrenalin rush as a dental hygienist to open these doors and help implement screening protocols into the practice. Fizzle out now and miss the excitement of care. We have smart consumers now and, with the media on our side, it is bringing patients to our doors asking about their sleep conditions. Are you prepared for the conversations that you are responsible for having each day? Are you confident and comfortable with having these conversations? From a dental hygienist chair, we have the opportunity to screen and save six to eight lives a day on average, 24 to 30 each week, and up to 120 each month!

 

As hygienists, we can make our goal for three consecutive days with one oral appliance. What in the world that will do for our department, wrists, necks, hands and brains as we open our minds to what appliance therapy can do for our department numbers, our patients and our practice? Why wouldn’t you want to be the one who was discussing this therapy option and actually doing these services in your practice? Are we not trusted individuals who could produce at a higher level out of our chairs while our doctors are doing restorative care? He can step over and take a bite at the end of the appointment for sure. 

Why are we not thinking out of the box as a dental hygienist? Doctors complaining about the hygiene schedule falling apart, team complaining about goals not being met, hours cut and here we hold some valuable keys that could bring the practice back into balance. 

What about Myofunctional Therapy? Right now, hygienists own that area in dentistry and can carve out their own path. Incorporating this therapy into your tool belt is another way to keep from the fizzle.

So what is a myofunctional therapist? It's someone who works with the muscles and functions of the face and mouth. Some conditions they treat are mouth breathing, thumb sucking, tongue thrusts, and tongue tie.

For instance with the mouth breather, they would be able to help teach them to be able to breathe through their nose which, in turn, will help them to receive better oxygen, prevent periodontal disease, and reduce caries risk.

Thumb sucking can cause malalignment and improper tooth development. By changing this habit, we can help with proper development. Tongue thrust can cause early ortho relapse. By retraining the tongue, we would be helping to make a beautiful lasting smile. Correcting tongue ties is beneficial to patients of any age. If corrected and found early in babies, it can allow better breastfeeding and prevent colic and stomach bloating. It can also allow for the child to be able to get palatal expansion because their tongue would be able to reach and rest where it is intended to.

It also helps prevent periodontal disease because the tongue is able to reach and cleanse all areas of the mouth. By becoming a trained myofunctional therapist, we are able to see these patients in our chair. It's a way to give our bodies a break, but continuing to give our patients what they need. By incorporating other options, it helps keep us challenged … and it's about always educating. There is always a way we can continue to help our patients and it benefits everyone.

 

What kind of career can a dental hygienist evolve to as the future of dentistry continues to corporate with our medical community? Are you ready?

Instead of just “cleaning teeth,” take the time to save a life.

Fizzle at 50 or burn out by 60? Are those really options that are worth considering?