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Inside Dentistry
July 2018
Volume 14, Issue 7

Strong Relationships with Hygienists Help Provide Optimal Patient Care

Allman and hygienist Doffoney use DEXIS CariVu for seamless diagnosis and treatment acceptance

Relationships are the key to a successful practice for Scott Allman, DDS-both with his clients and his staff. Allman's goal is to educate patients as much as possible on the best options so they can feel comfortable with their diagnosis and treatment, and part of offering the best options is having a strong relationship with his hygienists.

"I could not work without that kind of a strong relationship," Allman says. "I have only ever had one associate practitioner, but my hygienists are my partners in diagnosis and treatment. They are a key part of what we do."

Erin Doffoney, RDH, BAS, joined Allman's staff 9 years ago, shortly after he had purchased a new practice, and she helped him implement the culture of patient relationships that he wanted.

"Dr. Allman lets me take the reins with the technology and diagnostic aids that we have in the office and bring the information to him," Doffoney says. "I am able to use everything in conjunction to serve the patient best."

While Allman needs to make the final diagnosis for each patient, the information his hygienists provide and their interactions with the patients are crucial.

"The hygienist's role in patient education is significant, so I empower them as much as possible," he says. "We are trying to foster co-diagnosis with the patient. The perfect situation is when the patient sees the issue and asks, ‘When can I get that fixed?'"

One tool that has proven invaluable in the pursuit of that goal is the DEXIS CariVu caries detection device. The compact, portable device uses patented transillumination technology to support the identification of occlusal, interproximal, and recurrent carious lesions and cracks.

Allman purchased the CariVu after being unsatisfied with another caries detection device that offered inconsistent results and could not be used on as many teeth. He searched online, found the CariVu, and purchased it-then Doffoney went to work learning how to best use it.

"In my 17 years as a hygienist, the CariVu has been one of the best diagnostic tools in conjunction with digital x-rays that I have ever used," Doffoney says. "It is plug-and-play and point-and-shoot. It erases any doubt because the patient can see everything. He or she can ask questions based on what they see. Seeing is believing."

Doffoney says she can scan a full mouth in approximately a minute and a half. She explains transillumination technology to patients as being similar to ultrasound technology but with light. She sometimes shows the patient an image of a tooth with no problems for comparison purposes.

"It is a very effective tool for patient education," Allman says. "We can show them landmarks such as a filling and the outline of the tooth, and when they see the V-shaped shadow, the problem is clear. It is objective and easily understandable for the patient."

Easier treatment acceptance results in tangible time savings, which Allman utilizes to further improve the patient relationship. "Dr. Allman can spend less time explaining to a patient that decay is there and more time focusing on the comfort and care that he will provide during the restoration," Doffoney says.

Patients are not the only ones who can see issues more clearly on CariVu images, however. Allman and Doffoney say they are diagnosing more problems earlier in the process now. Allman says they have been able to observe Class II decay on the CariVu image earlier than on a radiograph at least 50% of the time.

"It has changed my diagnostic hierarchy," he says. "I almost prefer to look at the CariVu image before I look at new x-ray images."

The fact that the CariVu works on teeth with previous restorative work is significant, Allman adds. "A large percentage of teeth that we look at today have some kind of a restoration in them," he says. "We are finding old amalgams or old composites with recurrent decay at an earlier stage than when we were relying solely on radiographs. Picking up on decay earlier in the process allows for a smaller repair."

The end result is a better relationship among the dentist, hygienist, and patient.

"Unfortunately, I  have spent a lot of money on unnecessary technology in my career," Allman says, "but this is the one product that paid for itself within 2 to 3 months. We want patients to be comfortable and their smiles to look good, and a tool that helps us diagnose better while making the patient more comfortable allows us to better fulfill that mission."

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