SFDHS Spring 2011 Newsletter

Hello! I am excited and honored to serve as SFDHS President 2011-2012. I have big shoes to fill since Michael Long set the bar so high. I want to thank him for serving as President for the last few years! Not that we are letting him go anywhere - he's still serving on the executive board. He has definitely had made a positive impact on myself, the SFDH component, and the SF community.

I also wanted to greet 3 new members to SFDHS:

Kelly Ly RDH

Erika Ortiz RDH

Krystel Feliciano RDH

Welcome to the component and we look forward to getting to know you better.

Lastly, I wanted to list the SF component members serving as delegates at the 2011 CDHA House of Delegates:

Susan Lopez RDH - Trustee

Michael LaFlamme RDH - Delegate

Blanca Pareto RDH - Delegate

Diane Okubo-Fond RDH - Delegate

Heather Steich RDH - Delegate

Thanks for spending your weekend working on the business side of our organization!

Heather Steich RDH

2011-2012 SFDHS President

Q & A

One of our members sent us a great question by e-mail, and it started a thread of responces. If you have a question, feel free to send it in to SFDHS and you may see it posted in an upcoming newsletter.

Question:

Do you have any suggestions for how to deal with a hefty, strongly opinionated, middle aged female patient who presents with evidence of purging? (Eroded enamel into dentin and erosion around fillings, plus reddish area on center of soft palate. Patient denied experiencing any reflux.) Because it is humiliating for the patient, we are seeking suggestions of sensitive ways to inform the patient of the health risks, without sendingthe patient out of the practice.

Answers:

I would probably use a mirror and show her a tooth that is of concern. And then say it looks like it is being exposed to acid and this can happen with acid reflux. I'd ask her if she's seen the ads on TV for medications for acid reflux and that acid reflux is a common medical condition. Although you did say she denies any acid reflux. I would target what her motivation for coming to the DDS is. It sounds like she will need restorations to repair damage. Is Saving money a motivator? Esthetics? When you were in hygiene school Didn't you have to make a chairside manual that had information on eating disorders and oral manifestations and where to seek help? You could try and get one from a recent graduate and have it available in your office. I would contact an eating disorder support group and ask for their help in how to help this patient. Good luck.

1. go with the denial and advise pt that if she was ever to experience acid whether it be through foods like tomato sauce, drinks like soda, coffee, red wine, sports drinks, or acid reflux and vomiting (covering all of these will not accuse her of any one) be sure to rinse with water or water with baking soda and don't brush immediately after.

2. if the patient is a long term pt you could tell her that you see changes, should her in the mirror and ask her if she has any idea. also I recently saw a slide of a pt's teeth who swims in a heavily chlorinated pool. Tons of erosion here.

3. Ask the patient to be mindful of the items (in #1) that cause erosion then ask her if it is OK to follow up with her on the next appt. then let her go think about it. tell her what you see, let her know that you're concerned and ask her permission for you to give her more information.

I'm curious. What are the patients concerns? If she is not concerned about acid or doesn't want to talk about it at this time, maybe it is not the right time to push this aspect of oral health. Follow her lead on a different aspect and recall her sooner to follow up with her concerns. Then give her a little more info, then a little more.

Can you take photos for permanent records? can you e-mail her a photo?

I usually stick to the acid education and act very surprised and concerned. I overemphasize how destructive acid is for the oral cavity and ask them to be screened for GERD at their next physical as they could be experiencing reflux in their sleep. Hope that helps!

Hello - possibility to refer the client to a throat specialist for

assessment of epiglottal valve and reflux during sleep -

and cross reference dental info with medical and share

strategy - for future tmt...(perhaps at outside a tissue evaluation

for possible pathology) ....does the client have a therapist?

another approach....perhaps coordinate all...(do we have the time?)

I have had bulimic patients in the past. I think it is important to just be very honest and up front. "This is the evidence that I have found and it has me concerned because your enamel is eroding etc..... According to research the only things that can cause these symptoms are GERD and bulimia. Then if the patient denies that she is bulimic I would just give her the risks associated with acid bathing the teeth so even if she won't admit to bulimia she is still aware of the consequences. The bulimic patient I had later went and sought treatment and appreciated me being upfront with her about the risks involved instead of enabling her to continue without being aware of the consequences to her actions.

I think the most difficult aspect of bulimia is determining whether or not it is a current issue or one from the past.. both being almost impossible to admit to for them. I try a couple different things and my goal is always to dispense information about oral health. First, I ask if they have any children to breach the subject. If they do, I ask if they had a lot of morning sickness. Whether they say yes or no I tell them at this point that I see erosion on the linguals of the max ants & show them in the mirror. Then I dispense info about how to avoid this in the future (baking soda rinse, do not brush right after.. so on) in the event they have any other children in the future. If they have no children (say no) I ask if they get food poisoning frequently & regardless of their answer I show them the erosion & talk as before. If I start to get the feeling that they really are currently bulimic through this discussion with them, I recommend they look online for information about bulimia because their symptoms are "mimicking" those of bulimia (I say the word).. I'm always careful not to say they are or I think they are bulimic. The compulsion to deny and hide is as strong as the compulsion to purge. I figure, maybe something I say or something they read online will get them thinking. They have to make up their mind to change. They have to make the realization that its having multiple effects on their body.. I don't think we really can make that connection for them.. just push them over in the direction.

CDHA Press Release:

California Children Continue to Face Oral Health Epidemic

Report Finds the State is "Off Track" in Meeting Dental Needs of Its Children

Click to read article

Save The Date

When: Thursday, October 20th, 2011

What: 2 Unit CE

Where: 450 Sutter Street, Mayan Room

Speaker: Karen Hays RDH

More details to follow!!

Remote Area Medical - UPDATE!!

Dear RAM Dental Volunteer:

We hope all of you had a joyous Easter holiday with your loved ones. It has been a few weeks since our RAM experience here in Northern California, and as promised we have some early statistics quantifying some of the wonderful services you provided to help those less fortunate.

In total, 6,600 patients were seen in Sacramento and Oakland with 4,700 of them treated by Dental. As much as you all tried to complete the pink treatment forms and see that they all were returned, we are pretty certain that there was considerable underreporting. We have a record of 5,500 fillings, 1,600 cleanings, 3,600 extractions (probably many more), and 1,400 great panorex x-rays taken by Craig Dial, DDI and his staff. The value of dental services was over 2.5 million dollars, but was priceless to those who received the benefit of your skills.

According to Stan Brock, the effort by Dental was a record breaker of his 640 missions. We were honored to be your dental volunteer coordinators and floor leaders and hope that we have a chance to work together again in the future. Remote Area Medical is very interested in returning to California as early as next year. Your spirit of volunteerism and the leadership of Pam Congdon and CALAOMS are the reasons why.

Again, thank you so much!

Sincerely,

Don Rollofson, DMD

Russ Webb, DDS

Leadership in our Profession

Consider ~ Being an ADHA Delegate

Future Meetings:

2011 - Nashville, TN June 15-21

2012 - Phoenix, AZ June 13-20

2013 - Boston, MA June 17-27

Dental Hygiene Process of Care and Standards of Practice

As a follow-up to the DH Code of Ethics, here is a reference to keep in mind.

SUMMARY

The Standards for Clinical Dental Hygiene Practice is a resource for dental hygiene practitioners seeking to provide patient-centered and evidence-based care. In addition dental hygienists are encouraged to enhance their knowledge and skill base to maintain continued competence. It is expected these Standards will be modified based on emerging scientific evidence, federal and state regulations, and changing disease patterns as well as other factors to assure quality care and safety.

Click here for more info!

A.M.A.
DENTAL POWER
OF SAN FRANCISCO, INC.
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Currently providing Bay Area with quality
temporary and permanent

Receptionists

Dental Assistants

Dental Hygienists

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450 Sutter Street, Suite 2010
San Francisco, CA 94108
(415)781-2909 ~ Fax: (415)781-6414

sfdentalpower@aol.com

Staff

American Heart Association

Basic Life Support (BLS) for

Healthcare Provider CPR classes

* Classes held 3-5 times per week

* $80 per person includes book, CD and handouts

* Friendly professional instructors

* Lots of free street parking

Safety Training Seminars

598 Vermont St. @ 18th St.

(415) 437-1600

www.CPRCPR.com

Professional Liability Insurance discounts are one of your ADHA member benefits!!

Members have access to a variety of insurance policies through Marsh Affinity Group Services. In collaboration with Marsh Insurance, ADHA has approved an insurance package specifically designed for the dental hygienist. With ADHA's Professional Liability Insurance from Marsh, you'll be financially protected in case you are named in litigation.

In addition to liability insurance, members are available to take advantage of other coverage including: Major Medical, Disability and Life insurance. Please note coverage and availability varies by state.

Call: 1-800-503-9230

We appreciate the difference that you make every day in the lives of your patients and the unique role that you play in the dental practice. Joining your association is just as important as getting your license to practice dental hygiene. Become a part of your future. Join / participate in the only association that represents you, the Registered Dental Hygienist.

Sincerely,

San Francisco Dental Hygiene Society