Sunday, December 22, 2013

Dental assistant's story of a new Scrub

To work, we, dental Assistants need scrubs. Recently, I started going to Mark's work Wearhouse 
I love their scrubs. The stitching is nice and the style, awesome!

The price is a bit more than what I love to spend. Yet, I wanted something to make feel good while I am working. Tried a few scrubs to find the one I love. I really love the people working in the store. When I bought the first pair, I received the "Scrub Club" card. It works like this: If I buy 5 from them on regular price, I can get the 6th one free. The "Health Pro" scrubs were my style. 

The following months, I went back to the store and bought more. 
Bright pink, grey, blue...Now I have filled all the 5 stickers on my card. Each time, I am getting a discount card to be used for next time. That makes me visit the store again and again. ( I love the store any way, right?)

Now, let me tell you what happened with my last pair of scrubs. It was perfect and i was glad to own it. 
At work, the dentist asked me to get the Pridex rince. It was kept underneath the sterilizer unit, in the lower shelf. While I was sitting on the floor to get it in a cup, the scrub pants went low. I didn't realize it. My back was clearly visible to the patient sitting on the chair in the treatment room. My dentist, who happened to see it, later told me secretly about the incident. 
Yes, DAs, it is very embarrassing... Now my question is how can we let the "Health Pro" know about our concern about the scrub pants...

Saturday, December 21, 2013

Do dentists really trained to work with assistants?

North America, dentists hire dental assistants to help them. The assistant is anticipating what the dentist might need next in delivering treatments. This co-ordinated working makes the procedure done faster and effectively. It helps the dentist to concentrate on the tooth they are working. This is also helpful in reducing the dentists fatigue. 

Then why dental assistants are taken for granted? 

Let us look into that:  One assistant told me she trained in India as a dentist and was working there several years. They did not have dental assistants. They don't have the high volume suction in the office. The patient has to get up and spit in between. The dentist does everything during the treatment. There is no one to help them keep the area dry or to adjust the light. They see fewer patients than an average North American dentist. To those dentists, a  dental assistant, is just another person to be paid and they don't value the skills of the assistant. 

The DA schools will teach us the transferring of instruments and how to retrieve the used instruments. But, what if the dentist is not used to giving back the instrument? 

I just passed the condenser for plugging the composite. Then, while transferring the burnisher, I am supposed to retrieve the condenser. But, what if the dentist just put it on the tray and grab burnisher from me? If there is a second tooth to be filled, I have to extend my hand over the patient to grab everything back from the tray. It is decreasing my efficiency and thereby slowing the dentist. 

Now I am left to wonder, didn't they got trained in their school with assistants?

Thursday, December 19, 2013

Bitter experiences in Dental Assisting

In the last post we tried to show the Dentist's point of view of a perfect dental assistant.
Now let us discuss about the Dentists, I worked for over the years.

 In the past I worked with dentists who believe there is no need to talk or appreciate a dental assistant. Then there was the one who don't like to respond to an enthusiastic, cheerful "Good morning Doctor". 
Then I had more than one  Dr.X who never want to pay the staff. They conveniently forgot the pay days. Then they changed the biweekly pay days to once a month, because, it is too much wastage of check leafs. Many do not like to print the pay slip, because "it is just a waste of paper, right"? 

I worked with one Dr.X, who has an office in upscale area. I was told, the office cannot give me a rise, because I cannot clean the aquarium without help. 
Then there is one who talks about money in every other sentence. For example, "people buy costumes and candy for halloween, it is just a waste of money right?" But, then, "I do take my kids for trick or treating", because "it is just for the kids". 
You will know when you have a mistake, but you will never know when you did something really right in that office. 

Another Dr.X was more interesting. The dentist who hugs and bullies... You never know what is going to come the next moment. With a high employee turnover, the dentist is still thinking why the assistants are not staying for long....

Let me tell you, I never offered medical or dental insurance in any of these offices. 
On the ODAA facebook page I have seen one assistant mentioned about the benefits. Like one of my receptionist friend said, "when you retire, and getting out of the office, we will give you a kick from your back, to help you get out faster."

I will tell you about the better experiences from dental office in one of the future postings. 

Now, do you wish to share any of your experience? 

Monday, December 16, 2013

Dentist's view of Good Dental Assistant

I was looking on the web for articles about dental assistants. 
I came across one question on Yahoo answers:
The question is "What makes a person a good dental Assistant". A dentist answered the following
"Obviously, personality goes a long way. Your personality should be similar to that of the doctor with whom you work. If you're loud and rambunctious and your doctor is quiet and reserved, he/she will not like you. 

Appearance is important. If you look like a punk, you'll be treated like one and your stay in the practice will be short-lived. We run a doctor's office, and our staff should dress and carry themselves accordingly.

Ability is also paramount. Some assistants don't know where to put the suction and don't know how to retract the cheek. Furthermore, some assistants are great at keeping the doctor's mirror clean. Others are terrible in that respect. Furthermore, a good dental assistant will never let the doctor "work underwater". Being skilled at keeping the tooth dry is of paramount importance.

Knowing how to take good x-rays. Unless the practice uses digital x-rays, an assistant who has to repeat x-rays is more of a detriment to the doctor than a help. Simply "getting" the tooth on the film isn't enough. The tooth shouldn't be elongated or shortened much in the film.

Knowing your instruments. There are few things more frustrating than asking an assistant for a Potts or a Woodson Periostial during a difficult surgery case and receiving a blank stare. When you start in your new practice, learn the names of all of the instruments ASAP, and know what they are used for. Do whatever you can to memorize this stuff. I work with assistants who have been in the practice longer than I have and STILL don't know some of the things I ask for. It's annoying, and it's shameful. But I love the ones who know the instruments and their uses.

Having things set-up properly. Don't cut corners. If your doctor is doing endo, have everything set up. It's exquisitely annoying when I reach for the endo handpiece and, oops, it's not there. Or when I'm placing a composite filling and, oops, the curing light isn't there.

Never pass blame on to someone else. That kind of nonsense doesn't fly with us. We don't care who forgot to replace the burs in the bur block, and we don't care who forgot to re-stock the anesthetic in that operatory. If you're assisting with the procedure, it's YOUR responsibility to make sure that everything we need is there.

Show initiative, and take responsibility for the upkeep of the operatories. I cannot tell you how many times I've worked on patients where I had no light coming from the handpiece because the bulbs on the hoses burned out. If I didn't mention it to the assistants, I could work for 10 years before any of them noticed it. Look around and see what needs to be fixed, replaced, cleaned, etc. You are the ones who keep us running smoothly.

NEVER try to diagnose patients. Some of the more experienced (or gutsy) assistants try. They seem to think that over the years they've heard us say to patients pretty-much everything there is to know about the science of dentistry, and therefore able to usurp some of the diagnostic responsibility. When you try to diagnose, you are going to be partially wrong or completely wrong on anything that isn't just plain obvious...even if you're an experienced assistant. When the doctor comes in and gives the patient the diagnosis, the patient responds, "but your assistant said.....". We hate that. We don't want our patients being primed with ideas in their heads that we wouldn't want there. Let the doctor do the diagnosing.

Never predict treatments. Never tell a patient "you are probably going to need a root canal on this tooth" unless the doctor told you to inform the patient. I've had assistants do this and it is patently inappropriate.

Know when to ask for help from the doctor. Some assistants with whom I work will spend up to an hour making a temporary crown when they should have asked me for help 45 minutes earlier. We don't mind helping you with such things. We don't expect you to be able to do such things all the time. We'd rather see it done right, regardless of who does it.

General attitude. As long as you're not a complete air-head, your attitude towards your work goes a long way. If you don't give a s**t, it's going to be evident to us.

That list above is pretty complete. Now, don't think that I'm a complete jerk because of this list. I treat my assistants very well, and take them out to lunch almost every week....whether they do a good job or not!"

Source :
I think this is very good for all assistants who want to do an excellent job. A dentist must be the best one to talk about the qualities of a good assistant.
Me and Bindu love comments. So, please go ahead and say what you think.
In the future posts we will discuss about my own dental assisting experiences and what do I like to see in a good boss.

Thursday, December 12, 2013

Tofflemire and Matrix bands: Tips for Dental Asstiants.

In Toothtalkings, let us talk about tofflemire and matrix bands today.
In restorative dentistry, all dental assistants are familiar with the use of matrix bands. We prepare the tofflemire and band when dentist is doing a posterior interproximal cavity. The band will create the interproximal wall and thereby prevent the composite or amalgam from coming in contact with the adjacent tooth.

When I got job with present Dr.X, I could tell, the previous assistant was not so sure about the tofflemires from the way the matrix bands were prepared in the restorative tub. So, when I got invited to be the writer of this blog, I thought, I would write about that. 

The picture below is a regular matrix band.

You can use a ball burnisher to contour the band before placing in the holder. Just use the burnisher to rub in the middle of the band. This will give a thinner interproximal wall when placed on the tooth. Do I have to say it will be more comfortable for the doctor to place it? 

Now, let us see how they look when placed properly in the Tofflemire or matrix band holder. 

I found this video helpful in placing the matrix band in the holder.
The picture above shows how to prepare it for different quadrants. 
My tip for Dental assistants is:
1.When you hold the holder with the slot facing up, if it resembles small letter "p" it is for quadrant 1 or quadrant 3.
If it seems like a small letter "q", it is for quadrant 2 or quadrant 4. 
2. Have a wedge ready to go after handling the holder to your dentist.

The video below is also useful. It shows the contra angle holder, which is useful if your dentist like to place the band lingually. 

How do you like this post? Whatever you think, please share it through comments. 
Remember, we won't use matrix band with IRM fillings.

Tuesday, December 3, 2013

Taking impression for Crown using putty and light body

In the last post, I was very excited about helping Dr.X for the Post and core. Now, I want to write about waht I have to do while the DDS is doing a crown preparation.
This is a video I found on youtube. In the dental office, there is a difference though. 

We use regular set light body. Dr.X doesn't use spacer. We do one step impression. 
Usually alginate impression is taken before crown prep. If a temporary crown is going to be made, the mould will be made as well.
Once the crown is prepared, Dr.X places a gingival retraction cord.  For the molars, it is usually one round around my thumb and for anteriors one round around my little finger, I just figured out.
If you have any other method of figuring the length of the cord, please share it.
 (I know, I am getting some views, but not sure it is from dental assistants though. So, dear readers, please share your ideas, if you don't mind).
When the dentist is packing the cord, I make the light body material ready to use.( we use the gun. So I load the cartridge and put a tip). Then the putty will be placed on a a paper pad with equal amount of base and catalyst. Before opening the putty, make sure to change the latex gloves and put vinyl gloves. (Putty won't set if mixed wearing latex gloves, right?)

I usually will have the same size tray used for the alginate impression, ready for the final impression. When the DDS gives the go ahead signal, start mixing the putty. ( I don't want to forget the cotton rolls....)Dr.X loves to get an indentation on the putty, as in the video. Dr.X place some of the light body in that indentation too. Then place the tray and take impression.
While the impression is getting set, I can make the lab box ready. The alginate impressions are wrapped in a wet paper towel and placed in a zip lock bag before putting in the box. When the putty impression is good to go, just spray the disinfectant on it and wash with water. Some dentists wanted to take bite registration with wax and some wants to take with another material. Send all impressions and bite registration to the lab.

Now, if they are making a temp crown, they are going to start now. So, I will have my temporary cement like tembond ready. Of course, articulating paper to check the bite is needed. 
Once again the steps are:
1. Alginate impression, Mould for temp. crown
2. crown prep.
3. Retraction cord placing
4. Final impression
5. Bite registration
6. making temporary crown
7. Cementing temporary crown
8. Checking bite registration
9.Prepare the lab box.