Assisted hygiene and the assistant's cornerstone role

2020 01 22 22 49 6802 Wadsworth Lisa 20200122224944

Many of you may scoff at the title. However, even if you do, please read on. By the end, you may learn something new or have a different perspective on assisted hygiene.

This position is often seen as the "cleanup crew." However, dental assistants, the possibilities for your growth and power are endless if you are working in a practice set to measure patient care, patient education, and case acceptance as a two-pronged approach.

Lisa Wadsworth, RDH.Lisa Wadsworth, RDH.

In today's busy world, providers are being asked to push harder, see more patients, chart note more specifically, and deal with the insurance companies. Providers are having a hard time keeping up with clinical duties, let alone all of the other tasks asked of a lone hygienist.

I began my career as a dental assistant, but I was always intrigued by the role of the hygienist and how much influence and control hygienists had with their patients. Working in concert with a hygienist, you too will have as much -- if not more -- influence! You will be the co-pilot, often the key motivator, and have the reins for elevating the patient experience and, ultimately, the success of the practice.

Interested? Let's explore how.

How does the patient present today? You will screen the patient's mood.

You become the welcoming first impression for the day, able to measure the patient's mood for the day and be the calming team member who does not hurt him or her. How many times have you heard that an appointment was abandoned because premedication was forgotten or there was a need to call the physician? You can be on top of this the day prior and become the keeper of the medical necessities. Think how much you will learn about medicine and the oral-systemic link!

Medical history review

By law, the provider must sign off on the final review. However, with your honest, disarming charm and trusted part in the practice, you can ask questions regarding the patient's health (hospital stays, premed needs, emergency room visits), changes in medication, and, of course, any critical concerns for the visit today.

Are images needed for diagnosis or planning?

Enhance your imaging skills and take charge of all the images needed. Digital technology allows for 80% less radiation with radiographs, yet allows the practitioner to share more with the patient via instant manipulation of the images. Just think, you will be the master of digital technology, CT scan technology, and the digital workflow of conquering the impression images needed for crowns, nightguards, bleaching trays, and many other laboratory needs! The hygienist and dentist will value your skills and time-saving efforts! All the while, you will know the provider will have diagnostic quality images that you provided.

Oh, let's not forget the intraoral photographs. The demands on providers today often charge the hygienist with working dual schedules, also known as assisted hygiene. You will make a huge impact because you are in charge of all procedures that do not require a registered dental hygienist (RDH) license. You will affect positive patient experiences, improve comprehensive treatment planning, and be the coordinator for keeping the hygienist moving through the day.

Participate in periodontal charting and status discussions

Annual charting is an arduous task, yet it is a must. As the co-pilot, you will record probing numbers that reflect the periodontal status of the patient. Beforehand, you can explain the importance of these numbers and what the hygienist will share with the patient after the numbers are documented. Remember, you are the trusted member of the team who will be asked questions after the hygienist leaves the room.

Hand off to the dentist

Know this: You are viewed as the most trusted member of the team. How do I know this? Seven years of dental assisting proved it every single day! The hygienist will share areas of concern that should be checked by the dentist on a treatment slip. Today, the hygienist is often not present for the exam. She has moved on to the next patient. The responsibility for the handoff of information now falls to you, oh trusted one!

Embrace these responsibilities. Remember, you know the mood of the patients, their periodontal status, have taken the images, and are ready to engage with explanations and treatment acceptance.

Here are some final thoughts for you, you amazing assistant. I have had the pleasure to work as a hygiene assistant, and it is rewarding, fast-paced, and full of opportunities to learn about the complete process of comprehensive dentistry. You can become a guiding member of comprehensive care. What are you waiting for?

Editor's note: If you are curious what functions and duties a dental assistant can legally do in your state, please visit the Meet State Requirements section of the Dental Assisting National Board's website ( and select your state from the drop-down menu.

Lisa Wadsworth, RDH, owns Lisa C. Wadsworth, Inc., a company focused on consulting, speaking, and personal coaching for the solo practitioner and the dental service organization landscape. She has received fellowship status with the Association of Dental Implant Auxiliaries and can be reached at [email protected].

The comments and observations expressed herein do not necessarily reflect the opinions of, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.

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