A Revelation of sorts

(Got my game face on)

My satisfaction with work varies constantly throughout the day, as does yours I'm sure, mine directly correlates with the people I see. I look over my schedule multiple times a day, skimming over patient's names, reading through their chart, past notes of previous visits, reading their x-rays, preparing myself for a mouth I have forgotten or haven't seen before. Sometimes the notes spill forth a plethora of information, other times they leave no hint of what's to come. I like the former, chart notes that are succinct and detailed, painting a clear picture of the state of disarray and disease.

My day on Tuesday included a patient that had not been to the dentist in over 20 years. His chart notes indicated that he reports brushing 1x/week! Once a week!? Gasp! The hygienist who was lucky enough to see him the week before diagnosed him needing a deep scaling and root planing, bring on the nitty gritty! This is when we as hygienists whip out the big guns and get down and dirty. (It is fun! Sick but fun and satisfying.)

Here's the kicker. The front desk informs me he only wants a "cleaning", none of this dig down and deep rehab stuff. This is a problem folks. Legally and ethically I am bound to perform what he needs not what he wants. If I just do a regular "above the gums" cleaning (the happy easy polish one) I am neglecting the underlying disease and he will continue to get worse. The doctor and I concur that I will reassess and make my own diagnosis and perform at the very least a gross debridement (think deeper than a regular cleaning but not the full monty). The front desk calls the patient and informs him of our decision, he will be in at 3pm today.

I am nervous. I hate confrontation and the front desk reports he already has his panties in a wad since he didn't get his "cleaning" and the hygienist who saw him earlier was just a temp. Great, off to a good start. The gentleman comes in with his biker-esque attire, long scraggly beard that has a pony at the end of it and reeks of his most recent cigarette, which he informs me he just put out. How kind of him, since I will be occupying the vessel he just polluted with toxic smoke. How very thoughtful.

We begin the reassessment and I find that I can perform the necessary procedure in the hour we have together. I then launch into full super hygienist mode. I educate him extensively on the conditions of his mouth, what has caused his diseased mouth-even going into the microbiology happenings. I bravely ask why he chooses to brush only once a week. He replies that he has never had a problem (ie: cavity) and figures he doesn't want to "risk" upsetting this so called balance by brushing more. I get him to see things my way and convince him that he is not doing himself any favors by only brushing once a week.

He responds so well! Turns out he is an awesome patient and very enthusiastically embraces my bossy doctrine. He delights in my supreme "digging" skills as he incredulously remarks during the procedure that I "am even cleaning behind the teeth?" and "Wow, you really get in there!".

We part ways with him thanking me for my time and glorious skills. I find myself very satisfied at the moment. Today my job rocks. And I am good at it.

The old adage holds still. Don't judge a book (mouth) by it's cover, even if it reeks of cigs and has a ponytail beard.