Dental Assistants Key to Successful Practice

They help keep you organized and on schedule. They can charm a wiggly 4-year-old or calm an anxious senior citizen. They take radiographs, educate patients, and help build your practice. They are your dental assistants.

As a way to acknowledge them as an essential part of the dental office team, the American Dental Association, American Dental Assistants Association, Canadian Dental Association, and the Canadian Dental Assistants Association have designated March 2-8 as Dental Assistants Recognition Week. An established tradition for several decades, this week-long event is the perfect time to acknowledge the versatility and talents of dental assistants.

"Full utilization of our skills within our scope of practice provides greater access to care for patients," said California Dental Assistants Association President Diane Owens. "As an invaluable member of the dental team, being considered a professional ranks high as we assist in delivering dental care to our patients."

A Recognized Shortage

Not only are dental assistants a valued part of the dental team, they are also in demand due to a recognized shortage in the allied dental health field. The 1999 ADA Workforce Needs Assessment Survey reflected that 60 percent of California dentists agree there is an inadequate supply of chairside dental assistants.

To address this shortage, CDA is implementing an allied dental health personnel action plan. According to statistical evidence gathered for the plan, the causes of the dental assistant shortage include insufficient number of graduates and a short career length. The plan comprises four elements: a marketing program, component and member-based activity, collaboration with allied dental health personnel organizations, and professional development. Through marketing and greater public awareness, the ultimate goal of the plan is to inspire and encourage additional, qualified individuals to pursue allied dental health careers.

"The plan addresses both recruitment and retention of dental team members," said CDA Allied Dental Health Coordinator Evelyn Ingalls. "The plan is exciting in that it will allow us to actively promote dental careers as viable career choices and hopefully attract more people into the field."

Retaining Staff

Once a great dental office team is in place, dentists should turn their focus toward retention. While financial compensation is an important factor in employee retention, recognition and achievement are also essential pieces of the puzzle.

Virginia Moore of Insight Solutions -- a team of professional speakers, consultants, and authors -- said that the feedback she receives from dental assistants is that appreciation and respect are more important than salary.

"One of the things that we hear means the most to dental staff is a word of appreciation specific to the situation," Moore said. "Also important is for them to be able to use their knowledge and skills. When a doctor can delegate with confidence to a dental team member, it is a win-win situation for everyone."

In ADA’s Recruiting and Retaining Staff: A Guide for the Dental Office, the Council on Dental Practice highlights a number of factors that play a part in the satisfaction, or dissatisfaction of employees. Satisfaction factors include a sense of teamwork or camaraderie, job security, flexibility, appreciation for staff efforts, benefits, delegated autonomy in patient management, and subsidized continuing education. Factors that contribute to an employee’s dissatisfaction include lack of career advancement, lack of respect, monotony of daily routine, legal restrictions on procedures, and limited potential for income growth.

According to the ADA’s guide, ways of expressing appreciation on a daily basis, and especially during Dental Assistants Recognition Week, include unexpectedly bringing in lunch for everyone on a rainy day; posting an office bulletin board with each staff member’s photo; giving out tickets to the circus, zoo or an amusement park; and planning group activities or outings.

As Dental Assistants Recognition Week illustrates, making dental team members feel appreciated greatly contributes to their overall job satisfaction. CDAA President-Elect Cindy Ramirez, CDA, RDA, explained that loyalty to the doctors, staff, and her professional organization is the main reason she has remained in the field for 26 years.

"Respect, responsibility, and recognition are the three big ‘R’s, and, in my opinion, what most dental assistants strive for in the perfect office," Ramirez said. "I appreciate the respect that is shown to me, the responsibilities that have been entrusted to me, and the recognition I receive from being a licensed professional."

Many Children Miss out on Recommended Annual Dental Visits

While most children visit the physician for annual checkups and many see the dentist once a year, nearly half miss the second yearly dental exam recommended by the American Academy of Pediatric Dentistry, a recent study found.

Investigators from the Health Resources and Services Administration’s Maternal and Child Health Information Center used the 1999 National Survey of America's Families to examine trends in physician and dental visits for nearly 36,000 children and adolescents age 17 and under.

In all, slightly more than two-thirds of children made the annual physician visit recommended by the American Academy of Pediatrics and saw a dentist at least once a year. However, nearly half did not receive the AAPD-recommended second annual dental exam, the study found.

Twenty-one percent of the children studied received no preventive dental care at all, with the uninsured, those living in or near poverty, and Hispanic and African-American children least likely to get recommended dental care, according to the study. Very young children -- those 3 and 4 years old -- were also among the least likely to receive recommended preventive dental care, the study found.

"A substantial proportion of U.S. children do not receive preventive care according to professionally recommended standards, particularly dental care," the investigators wrote. "While publicly insured children experience higher rates of recommended well-child visits, much improvement is needed among public programs in providing recommended dental care, especially among adolescents and children in poor general health."

The study, "Factors that Influence Receipt of Recommended Preventive Pediatric Health and Dental Care" was published in the December issue of the journal Pediatrics.

Evidence-Based Search Engine and Perio Health Center Developed

A unique search engine for evidence-based dentistry and an international center for evidence-based periodontal health are now available to help dentists in their search for relevant research.

* The search engine, called EviDents, at http://medinformatics.uthscsa.edu/EviDents, allows patients and clinicians to sort through vast amounts of information to find the best oral health evidence available, according to Richard Niederman, DMD, director of the Forsyth Center for Evidence-Based Dentistry and the originator of the search engine. The search engine addresses all dental areas, including implants, periodontics, orthodontics, endodontics, prosthodontics, and oral surgery.

* The International Centre for Evidence-Based Periodontal Health has been established at the Eastman Dental Institute in London with the aim of enhancing the transfer of research into clinical practice and, thus, improving patient well-being, according to Ian Needleman, BDS, the center director. The new center will identify the most effective methods of diagnosing, preventing, and treating periodontal disease; develop a managed database resource of the best available evidence in periodontology; provide training in evidence-based oral health care and research; and provide consulting services for health care providers, researchers, and educators in periodontology.

For more information on the search engine or the International Centre for Evidence-Based Periodontal Health, please contact the Forsyth Institute at (617) 262-5200 or www.Forsyth.org.

CDC Issues New Hand Hygiene Guideline

To improve adherence to hand hygiene in health care settings, the Centers for Disease Control and Prevention has finalized its new Hand Hygiene Guideline for all health care personnel.

In addition, in 2003 the CDC and the American Dental Association will be issuing revised recommendations for infection control in the dental office.

According to the CDC, using gloves in health care settings will reduce hand- and cross-contamination by only 70 to 80 percent, so that the need for hand hygiene is clear.

In addition to regular hand washing with soap and water, the CDC recommends the use of alcohol-based hand rubs. This recommendation was made to address obstacles to frequent hand washing in health care settings.

"Clean hands are the single most important factor in preventing the spread of dangerous germs and antibiotic resistance in health care settings," says Julie Gerberding, MD, director of the CDC.

The guideline is available online at www.cdc.gov/handhygiene/ or by calling (404) 639-3286.

Communicating With People With Disabilities a Matter of Respect

From the Axis Center for Public Awareness of People with Disabilities in Columbus, Ohio, come these suggestions for communicating with people with disabilities. The items were published in the November 2002 ODA Today, a publication of the Ohio Dental Association.

* When talking with a person with a disability, speak directly to that person rather than through a companion or sign language interpreter who may be present.

* When introduced to a person with a disability, offer to shake hands. People with limited hand use or who wear an artificial limb can usually shake hands. Shaking hands with the left hand is acceptable.

* When meeting a person with a visual impairment, always identify yourself and others who may be with you. When conversing in a group, remember to identify the person to whom you are speaking.

* If you offer assistance, wait until the offer is accepted. Then listen to or ask for instructions.

* Treat adults as adults. Address people who have disabilities by their first names only when extending that same familiarity to all others present. Never patronize people who use wheelchairs by patting them on the head or shoulder.

* Leaning or hanging on a person’s wheelchair is similar to leaning or hanging on a person and is generally considered annoying. The chair is part of the personal body space of the person who uses it.

* Listen attentively when talking with a person who has difficulty speaking. Wait for the person to finish, rather than correcting or speaking for the person. If necessary, ask short questions that require short answers, a nod, or a shake of the head. Never pretend to understand if you are having difficulty doing so. Instead, repeat what you've understood and allow the person to respond.

* When speaking with a person in a wheelchair or a person who uses crutches, place yourself at eye level in front of the person to facilitate the conversation.
* To get the attention of a person who is hearing-impaired, tap the person on the shoulder or wave your hand. Look directly at the person and speak clearly, slowly, and expressively to establish if the person can read your lips. When talking to people who lip-read, place yourself facing the light source and keep your hands away from your mouth when speaking.

* Relax. Don’t be embarrassed if you happen to use accepted common expressions that seem to relate to the person’s disability, such as "see you later" or "did you hear about this?"

Be Prepared: Selling a Practice After Unexpected Loss

A dental practice is likely the largest asset most dentists have, but not many dentists think about what that practice might be worth if they’re not there to run it, wrote Alan A. Clemens in the New York State Dental Journal, November 2002.

Most dental practices are personal service businesses that depend primarily on one person -- the dentist. If the dentist is unable to see patients, the practice will deteriorate rapidly as patients seek other dentists for their treatment, Clemens wrote.

He said there is a critical period after a dentist becomes ill or disabled during which the practice must be sold to realize its full value. That period is usually 30 to 45 days, especially in the case of the death of the owner. Clemens said that during the first month, a grief-stricken spouse and heirs understandably do little or nothing regarding the practice, and others involved may not be well-versed in dental practice evaluation and may believe the practice has a wildly unrealistic value.

Clemens said the first step to prepare for the preservation of the value of a practice in the event of an unexpected loss of the dentist’s service is to get a professional evaluation while the practice is still active to determine its worth. He advises consulting an experienced and reliable dental practice transition expert to arrange for an appraisal and to arrange to have the appraisal updated regularly.

Part of the practice evaluation and appraisal should include plans for the transition expert to market the practice as quickly as possible while it still has value. Clemens said it is wise to involve key personnel, especially a spouse, in all aspects of the planning process, so that they know exactly where important papers and records are kept and who the advisers are.

Clemens said that everyone hopes plans such as these will never need to be implemented. But, he wrote, that can’t always be the case, and it is for the benefit of everyone involved that the dentists make the small effort to be prepared.

Rotational Oscillation Toothbrushes Best at Reducing Plaque

Powered toothbrushes with rotational oscillation action are more effective in removing plaque and reducing gingivitis than are manual toothbrushes or other types of powered brushes, according to an independent, international research team.

The finding was announced by the Cochrane Collaboration, an independent, international, nonprofit organization.

"Rotational oscillation toothbrushes removed up to 11 percent more plaque and reduced gingival bleeding by up to 17 percent more than did manual or other powered toothbrushes," said William Shaw, PhD, MScD, joint co-coordinating editor of the Cochrane Oral Health Group, which analyzed data from clinical trials conducted over 37 years.

Six reviewers independently extracted data from reports on 29 clinical trials involving 2,547 participants in North America, Europe, and Israel. The clinical trials, conducted between 1964 and 2001, compared the effectiveness of all forms of manual and six types of power toothbrushes with mechanically moving heads.

Shaw emphasized that the review results do not indicate that toothbrushing is only worthwhile with a powered toothbrush. "There is overwhelming evidence that toothbrushing reduces gingivitis," he said. "Brushing may prevent periodontitis, and brushing certainly prevents tooth decay if used with fluoride toothpaste. These benefits occur whether the brush is manual or powered."

Upcoming Meetings

2003

Feb. 5-8 American Academy of Dental Group Practice Annual Conference and Exhibition, Miami, (602) 381-1185, www.aadgp.org.

March 5-8 Academy of Laser Dentistry 10th Annual Conference and Exhibition, Destin, Fla., (954) 346-3776, www.laserdentistry.org.

March 13-15 Arizona Dental Association’s Western Regional Dental Convention, Phoenix, (602) 957-4777, www.azda.org.

March 23-29 United States Dental Tennis Association Spring Meeting, Amelia Island, Fla., (800) 445-2524.

April 24-27 CDA Spring Scientific Session, Anaheim, Calif., (916) 443-3382, Ext. 4470.

April 29-May 4 19th Annual American Academy of Cosmetic Dentistry Scientific Session, Orlando, Fla., (800) 543-9220, www.aacd.com.

June 6-8 Academy of Dental Sleep Medicine 12th Annual Meeting, Chicago, (708) 273-9335, www.dentalsleepmed.org.

June 19-22 OSAP 2003 Symposium, Tucson, Ariz., 800-298-OSAP.

July 17-20 Academy of General Dentistry Annual Meeting, Nashville, (888) AGD-DENT, www.agd.org.

Oct. 23-26, ADA Annual Session, San Francisco, (800) 232-1432.

Dec. 5-7 California Academy of General Dentistry Annual Meeting, San Diego, (877) 408-0738, www.cagd.org.

2004

April 15-18 CDA Spring Scientific Session, Anaheim, Calif., (916) 443-3382, Ext. 4470.

Sept. 8-11 International Federation of Endodontic Associations Sixth Endodontic World Congress, Brisbane, Queensland, Australia, www.ifea2004.im.com.au.

Sept. 10-12 CDA Fall Scientific Session, San Francisco, (916) 443-3382, Ext. 4470.

Sept. 30-Oct. 3 ADA Annual Session, Orlando, Fla., (312) 440-2500.

Nov. 1-9 United States Dental Tennis Association Annual Meeting, Palm Desert, Calif., (800) 445-2524.

To have an event included on this list of nonprofit association meetings, please send the information to Upcoming Meetings, CDA Journal, P.O. Box 13749, Sacramento, CA 95853 or fax the information to (916) 443-2943.