I occasionally supplement my public health wages by working as a temporary dental hygienist. I work in the District of Columbia and Maryland in private practices that range from high tech dental sanctuaries to places that I call hygiene horrors. Temping can be pretty intimidating initially because you never know where your job for the day falls on the spectrum. I do my due diligence to research the offices online and sometimes I will call to observe the professionalism of the administrative staff all in an effort to prepare myself for the day. 

  
There are some amazing dental practices but there are surely some hygiene horrors. 

  
One office I visited recently looked more like a museum.
 I mean I admit I am more of a fancy lady when it comes to material things, however this office was a baby boomer. The equipment was from the 1950s and required a nudge, kick or pull to work.   

  
The dental chair paid homage to the sister wife of dentistry; cosmetology. In the 1800s, the barbers were called barber surgeons and would not only cut your hair but would pull your teeth.

  
 I am convinced that the patient chair must have been left behind from the 1800s because you had to pump a pedal to get it to go up.

 I was alarmed and immediately fearful for my back and neck. An office that cares so little about their equipment surely does not care for ergonomics. According to my experiences a practice that does not invest in itself does not invest in its employees and can be a pretty miserable place to work.
As the day went on I learned that “schedule” was a relative term. Patients appeared on the schedule at random and I was ushered to the next patient by a very anxious office manager. 

  
She would all but rest her chin on my shoulder and watch me work in an effort to speed up my theoretically scheduled 20 minute “appointment”. 

  
It was later that I learned that she was the dentist’s wife. 

A wife/office manager and a dentist/husband duo can be a very powerful and dynamic force in dentistry. For hygienists, it is often a clear indicator that you have entered a hygiene horror. I have many colleagues that refuse to continue the application process once they find out the wife runs the practice. And as I was ushered to my 9 month pregnant patient awaiting a debridement, I realized why my colleagues avoid the husband and wife duo. This combination can create a level of intensity within the office that can be unnerving.  

  
A dentist understands to some extent the labor that hygienists do. His wife has no idea but thinks she does because she married a dentist. This combination of passion for production and love for her partner can swirl into a chaotic mess that leaves providers feeling as though they are working to supply her Louis Vuitton bags. I also feel that having another female that is above the clinical level of the wife/office manager can be a little intimidating. 
  
After my moment of clarity, I checked the clock and realized it was 11:00am. I had just a few more theoretical barnacles to clean off the boat and I would be done and have an entire hour to recover.

   

After finishing the full mouth debridement my patient was very appreciative and thanked me profusely. In that one day my pregnant patient had a root canal, surgical extraction of #17, three large restorations and the debridement. I know all things can be done through Christ but I feared that the dental police would come and escort us all to a paddy wagon. 
This office was what I call a mill.

  
 A dental mill sees every patient they can and they do as many procedures as they can while river dancing on things once held dear such as ethics and morale. I prepared to head out for lunch only to be told that I had another patient and I would be paid for half of my lunch break. When I finally got to my car I contemplated not coming back. 

  
I really like my staffing company and would not want to do anything to slander their name but this place was absolutely crazy. 
I called my agency and they profusely apologized and encouraged me to talk to the dentist or his wife about the scheduling. I went back in the museum with a game plan. 

  
I told them firmly that I would leave not one second after 4:00pm and I need my check before 4:00pm to avoid a delay. They obliged and I grabbed my shovel and got to work. I saw about 5 more patients between 2:00pm and 4:00pm and decided to write a blog about dental hygiene. 

  
Someone has to talk about the experiences that we embark on. The secret profession of highly educated and highly misunderstood men and women need some type of dialogue to educate others. My ultimate goal is to go into offices that are hygiene horrors or simply not producing what they would like to financially and offer consultations. I would love to sit down with a new dentist and explain how to make hygiene a profitable department, which instruments will help his or her hygienist work more efficiently and how the hygienist can avoid work related trauma. So from my horror came a great dream. 

  

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