 Hello everybody, Andrea Mayesky here with Dental Tutoring. So this is video, I guess, number two day in the life of a dental hygienist. My last one, my first video, was me just simply showing you guys what I take to work. My loops, like the type of makeup I wear that doesn't come up on the mask. My name tag, my name tag. So this is, I guess, the official video where I start talking about my day as a dental hygienist. Because as I mentioned before, when I was a new dental hygienist, even a student, it was just nice to hear what other people go through, their experiences with patients, dealing with difficult patients, how you handled it, because it takes time to get experience. It takes time to get comfortable in knowing how to handle every situation. I can honestly say now, after 14 years, that I'm comfortable handling a little bit of everything I have seen and heard almost everything. And I do have bad allergies today. So if you guys can see that my eyes are red, I have not been crying. It's just really, really bad allergy. So I apologize. But okay, so I'm going to try to keep this short and sweet and not too long. So it's 10 28 in the morning. So I'm just going to keep an eye on the time for you guys. I don't have a script or anything. So I'm just going to kind of talk about my day and I'm sure as I do more and more of these videos of day in the life of dental hygienist, I will get kind of a routine going, okay? So if you guys want to hear about something, if you have questions, comments, please make sure to comment below. So, okay. So I worked yesterday. So I typically work Tuesdays at the same office. It's anywhere from three till seven 30 or two till seven 30 or even three 30 till seven 30. It just sort of depends on the day and the shift. Well, yesterday was a perfect example of I was scheduled from three till seven 30. And my first patient canceled and I do like to check in with the receptionist a couple hours before to just kind of ask her what time I start because I tutor full time. So I don't mind coming in later. And I also don't mind coming in earlier if she needs me to see a patient who just hasn't been able to come in, you know, or who we are typically booked four months in advance, which is awesome. But if there's a patient that just really, really needs to be seen, I'm happy to help out right with some notice because I do tutor full time, which means I'm busy, but I can also move things around if needed. So anyway, so I had sent her a text a couple hours before and she said actually your first patient canceled. Your first patient isn't isn't here now until four o'clock. So I said, okay, you know, what perfect? I know a lot of hygienists might have a problem with that because less pay. But I don't mind. I don't mind starting later. It means I can maybe have a coffee in the afternoon. So I was actually pretty happy. So anyway, so I got there. I usually arrive half an hour early because that allows me to to get in, you know, to put my stuff away to put my shoes on to use the washroom to get some water. I'd like to look through all of my charts too at the beginning of the day. I do check to see that all of the appointments were scheduled properly, you know, like sometimes I will look in the computer and it says a nine month recall. Yet I check the ledger and the ledger is what shows you all of the appointments that the patient has had before. And I will see that, oh, well, they had a nine month recall last time and that was only four months ago. So actually this would be their four month cleaning because they would not be covered for a nine month recall in four months, you know, so I might change things on the computer so that it it will say actually today is a four month cleaning and not a nine month recall. So a the dentist is aware that she doesn't have to come in to do the check and that we charge accordingly because if it was a recall appointment, we would charge a recall, a half a unit of polish depending on how long the appointment is usually about two and a half units of scale or three units of scale. A recall exam, if they need x-rays so we typically take x-rays it depends on the patient but but either every once a year or once every two years even once every three years it depends on the patient. So if I were charging x-rays, we take four bite-wing x-rays if I'm doing that and some patients do get fluoride every year depending on if they if they always have a lot of cavities then yes we would give them fluoride at every checkup exam because it's usually not covered at the perio appointments but sometimes it is again, you never know, you have to check the insurance. But um anyways you guys so to make a long story short on that I will check to make sure that the appointment that it says in the computer is indeed the appointment for today. Now as a new hygienist this is hard for you to do because you don't have experience yet of you know insurance policies, how often the patient's coming in, how often they're coming in for a checkup because sometimes even if they come in for a cleaning every three months they might be covered for a cleaning and checkup every six months or it could be a cleaning and checkup every nine months or every year so you don't know that. It takes experience. I feel lucky that I was a dental receptionist first so I do have that knowledge on insurance a little bit things change a lot and then I was a dental assistant and then a dental hygienist and then a restorative hygienist so I do feel like I have a well range so I do know a little bit more but anyway so I do arrive half an hour early but okay so what happened yesterday was my four o'clock patient so she was having LA so local anesthetic with the dentist first and then I was seeing her actually at 420 but at four o'clock she wasn't here so the receptionist called and you know asked if she was coming and I guess she completely forgot about her appointment so she just kind of strolls in about 40 minutes later okay her appointment was an hour long so I obviously couldn't see her in 20 minutes you really can't do too much and it was it was local anesthetic with the dentist and quads one and four I believe so even if you wanted to do something there's no point because if you if you give local anesthetic to the patient well it's going to take at least 10 minutes so then you have 10 minutes to clean no but we had another hygienist working that day so what happened was I actually took her first patient and then she took that patient who I was supposed to see but even then even with moving things around she only had about 40 minutes to do a cleaning so what I would have done is said to the patient well we can't see you because you're 40 minutes late you had an appointment I apologize but we can't see you so let's just read book but the receptionist being so nice she did end up seeing the patient and the and the hygienist the other hygienist saw the patient but she could only do 40 minutes of work so she was able to give the dentist was able to give local anesthetic and she cleaned one quad instead of two okay so let's just kind of how we do things again if it was me I would have sent the patient home because I feel that they need to learn to show up on time when I have an appointment I show up half well not half an hour early but I show up about 15 minutes early it's I myself have an appointment whether it be to the dentist whether it be the chiropractor anything I show up 15 minutes early so I don't understand people who show up late things happen you know if you're coming from out of town um in our away and you got hit by traffic then yes I do think that we should accommodate you we might not be able to do everything but that's not our fault we have other patients who are waiting to see us right but anyway so that's just kind of how we handled it so that's a good explanation of different ways and different ideas to handle that patient who shows up 40 minutes late okay but I'm sure I'll have more stories about that because it does happen um but that was easy um so I saw um a patient of the other hygienist we each saw actually three patients that evening because it was a shorter shift so normally we'd see about five patients um in the morning and then five patients in the evening but since I was just working that kind of evening shift it was only three patients so easy stuff um but I want to talk to you guys about that patient that I saw so he was nice he seemed fine um but he was due or he is due for his complete oral exam next time so how it happens at least in my office is we do a complete oral exam every three years because that is what insurance covers and it's a good idea to have one so a complete oral exam is is when you do um the bite wing um the bite wing x-rays you take a panorax if needed um and you take an anterior and um an anterior pa of the top and the bottom you do all of the charting so like a new patient exam you look to see the existing conditions in the melt so if they have composites if they have a meldoms if they're tethered tipped crowded if they have attrition you would do the probing so pretty much everything that you would do at the new patient exam so it does take about a half an hour you know to go through everything um we take intraoral photos also but I like doing the complete oral exams because it does give us an overall look of the patient you know because otherwise we might be seeing the patient every three months or every nine months but we don't have that overall look so if things change we don't necessarily know because we didn't make a note of it before so anyways we do that every three years but um this dentist took over a practice of um another dentist who retired and he has never done complete oral exams a lot of his patients didn't even have a new patient exam yeah so having me explain to a lot of patients oh you know we are doing a complete oral exam the next time and they go whoa whoa what's this okay it's a complete oral exam it's no big deal it just takes a little bit longer we look inside the mouth we look to see your existing conditions so that we know what um meldoms you have what composite fillings you have if you have crowns you know we just like to go through everything to make sure that your chart is up to date because things change some patients still go whoa whoa i've never had that what is this what is that well it's covered by insurance so i don't see the big deal anyway but i guess it's the fear of the unknown or some patients go okay sure who you know what whatever i come here do what you have to do that's awesome um it's just the main reason why i tell them is because it does take a little bit longer so i want them to know how long to book off you know for their next appointment but this particular patient that i had he was just like no no i don't i don't need that i'm okay um and actually he didn't say this to me he said it to the receptionist um i explained everything to him in the room um and i i usually actually book their next appointment in the room so then that way i can tell them how important it is because it does happen where the patient will go up to the receptionist and go oh i don't know i don't have to come every three months i'm fine and the receptionist goes okay what so i i like to book appointments in my room so then that way they don't have that leeway of listening to me and then not the receptionist but i'll talk about more about that in another video but anyway so i was going to book his complete oral exam but i was running behind and that's what the receptionist is there for to book appointments so i thought that it'd be okay for her to book it for me and she's awesome she's fine with that so i brought him up to the front he didn't have questions things seemed fine he was a nice man but then the receptionist came to me afterwards and she kind of said to me like oh did you not explain the complete oral exam to your patient i i go oh yeah i did you know well like why do you ask um and she said well sorry allergy um she said well he was really upset he didn't understand why he needed a complete oral exam he said he's never had one he doesn't want one never mind i was like whoa okay like we're not doing a complete physical here like what's the big deal but a lot of patients if they've never had one i guess they're a little bit fearful i have no idea but so anyways he did book it so um when that happens you know it is up to the patient of course just leave notes in the chart i left a note on behalf of the receptionist just saying um um our receptionist talked to this patient you know no news mentioned um about the complete oral exam he declined because he felt he didn't need it and i put that in quotation marks um so he's just having a plain recall exam the next time because he did have his his four and a half month cleaning with me yesterday so he's having a complete or sorry the recall exam the next time because we see him for recalls every nine months so yeah that's all you have to do that's it done but it will happen okay it will happen um but then i just want to talk about one more patient at the end of the night that i had and then i will stop the video because it's been already 20 minutes i think actually no sorry now i kind of forget what time i started oh darn no i think it was 10 30 right so okay so it's been about 10 minutes so not too bad but anyway so for my last patient so this is what i would like to talk to you guys about too so this is a patient who she her last cleaning was a year ago not that long yes i know we say they have to come in every six months oh my goodness a year is such a long time it's really not you guys um but anyways her last appointment was a year ago um her teeth looked fine she's 29 she looked great you know i didn't expect there to be a lot there but this is a great learning experience for all of you guys um is that sorry i just had something pop up pop up on my screen her teeth looked fine i was like okay she was booked in to have local anesthetic with denis first and i kind of thought why is she having local anesthetic it's not like it's been 10 years i don't see the big deal right i looked in the x-rays i didn't see any calculus you know spurs in the x-rays so again i'm like why is she like sometimes i feel that dentists want to give local anest anesthetic just for the heck of it i don't know or the patients hear that we can give them local anesthetic and they won't feel pain so they just want it i wouldn't want a needle if i didn't have to have one but anyways so that's what i'm thinking is okay well we're going to give her local anesthetic all right and the appointment was for only quad one so i'm thinking okay her teeth look fine like what's the big deal here what am i missing but ten as soon as i checked with my explorer oh my god she had heavy black tenacious calculus rings of calculus pretty much around all of her teeth not thick enough to show up in the x-ray though but it was hard like i could tell that that was going to be hard to remove so either she builds up calculus really fast in a year yes a year is long but not long to build up that type i mean i don't know but i've seen patients before who haven't come in in three years and they don't have that victimaceous tartar anyways um so yeah it's a good thing i checked because here i'm thinking oh this is going to be so easy so the moral of the story is even if if things look healthy check underneath the gums because they might not be so anyways so i'm glad that the dentist froze quad one because i needed it i had a full hour to clean quad one and i needed it her gums were bleeding so much i couldn't see a thing so that that will show you very unhealthy um i did a probe to just kind of see what i was what um what i was working with in quad one five millimeter pockets her interiors have threes and four so that's too high so she needs a good cleaning for sure so i used the piezo first because keep in mind too she has local anesthetic so she's frozen she can't feel anything so do not think oh i don't want to hurt her you know she's frozen do what you have to do so i used the piezo first um amazing i and then i moved to my hand scalers and the gums were just bleeding so much i couldn't see anything i couldn't see anything so it's all by feel bleeding so much but i do always ask the patients how they are to so i'll clean maybe two teeth and then go oh how is everything so far oh okay awesome or you know oh it feels fine you know always ask them and keep in mind too with all of her bleeding you would think that she'd be uncomfortable she'd be sore but she was under local anesthetic so she didn't she she didn't feel that right so anyways just so much bleeding i was using piezo i was i was using hand scalers piezos hand scalers back and forth because i couldn't see at least with the piezo i could see but with the hands um hands hand scalers in my opinion you can get in there a little bit more so i do like to use both but every time i took out my hand scalers i couldn't see because the gums were just bleeding so much but anyways i did do a great job i cleaned all of quad one i sat the patient up and you know i like to ask them how how they did she's she's um she's never had local anesthetic with her two cleanings before so i did let her know so it will feel pretty frozen for the next couple hours it could be half an hour it could be two hours it could be six hours everybody's different but just eat soft foods tonight because you can't feel or sorry it was the right side you um you can't feel um the one side so just be careful if you drink anything too hot you might not be able to feel it until later and then you might go out i burned my lip you know so so we froze quad one so her lip would feel numb um and then i did say you know plus just so you know as i was cleaning the gums were bleeding a lot so that's a sign of them not being healthy but you have come to the right place because with us cleaning everything that will help to make things healthy again so see what i did there so i told her bad news the gums were bleeding a lot really unhealthy but i'm happy to see you because i can make things so much better i always like to give them positive news because if i'm that hygienist who says to them your gums are bleeding so much i couldn't see a thing it was disgusting this can't happen they're not going to want to come back if i was being yelled at i wouldn't want to i wouldn't want to come back like who are you are you my mother i would not want to come back so i like to be honest though and tell her the gums were bleeding a lot um and i said so if you um as you should be but i said start to floss every single night but as you're doing that the gums will still bleed a lot but don't be alarmed it's just because the gums need to toughen up so please keep up with it the bleeding will become less and less once we have everything clean okay um but i am so happy that you came in today because we are we are off to a great start i am excited for you to have everything cleaned up you know at some point because it will look amazing but don't forget to brush and to brush and floss so you know i kind of do that it helps you guys and then the patients leave happy they know that you are helping them they know that they need to do good work at home they know all of that okay so i left that day feeling pretty good i'm happy that i had that harder case at the end of the day because you know it's trickier to do perio because you have to get right in there and it was just nice to have that at the end of the day so that wasn't too bad you guys so yeah i did take about 45 minutes so thank you guys for watching please comment below and let me know your thoughts you know are you a student who's nervous to see a difficult patient are you still in clinic seeing a difficult patient right now where you have to tell them your teeth are horrible what are you doing but always be positive or are you a dental hygienist who's like ah that was easy or tell me some weird patient you know experiences that you've had you know i still don't understand why patients get so concerned about a complete oral exam maybe it's the name complete oral exam maybe they think we're doing a complete exam on them or something i have no idea but just some weird things right so it's nice to talk about it's nice to hear comments let me know and if you guys like these videos i will keep doing them so make sure to like make sure to subscribe and i'll see you guys in the next one thank you so much for watching