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A free self-evaluation process for dentists that can help them to better determine the effectiveness of their hygiene program.

This section is described as a "process" and not a "questionnaire" because, instead of dealing with procedures, it is more of a problem solving, systems evaluation.

The status/value of a hygiene program can be expressed in many different ways. Let's consider the following three: 1) As gross/net income; 2) as health benefits to patients; and 3) as the ergonomic impact on the hygienist. Most evaluations consider the first, assume the second and ignore the third. Needless to say, if the hygienist is negatively impacted ergonomically, first of all, the quality of service to the patient will suffer (but this is very difficult to quantitate), and last of all, production will fall when the hygienist can no longer function.

For the dentist that is interested in evaluating the hygiene program in his/her office, it is suggested that the hygienist be considered first. This is best done by completing sections "V. A self-evaluation questionnaire for hygienists that may wonder if they need help or not," and "VI. A self-evaluation questionnaire for hygienists that may wonder if their operatory and armamentarium are ergonomically sound."

After these systems are in place, the next thing to do, is to consider some ideas relevant to the quality of the health services/benefits to patients. The prophylaxis is a single event intended to prevent the development of periodontal disease. In linear thinking, this single event is metaphorically symbolical of one square in a sidewalk that can stretch for miles. If the prophylaxis has its desired effect, theoretically, at least, the patient would never develop periodontal disease. However, we know that uncontrollable factors make this an unattainable goal. Some patients experience the occurance or recurrence of periodontal disease in spite of having the best preventive care possible. Therefore, in long term care, one of the best services is providing a reevaluation procedure every two to three years on the average, and more frequently in high risk situations.

The author developed such a procedure in the early 70's and it proved to be one of the most valuable services in his periodontal practice, in more ways than one. Most cases of recurrence were detected before they would have been apparent otherwise. This prevented a lot of structural tissue loss to the patient, and provided considerable income in some days that could best be described as hard times. Considering the technologies of the day, it is amazing how effective a hand probe and conventional X-rays can be when applied in a precise manner. This is called The Reevaluation Procedure and is presented in detail on pages 80 - 86 in his textbook, "Ergonomics in Pain Management for Dental Professionals Including Carpal Tunnel Syndrome," which can be purchased in hard copy from the Office of Continuing Dental Education of the UTHSCSA Dental School in San Antonio, TX. The hard copy is recommended.

Two other systems to expedite the processing of information gathered in examination are presented in the book. The Decision-Making Flow Chart, pages 5 - 7, helps in evaluating the status of a new patient and determining treatment possibilities. The Perio Risk Profile, pages 74 - 79, was developed as an aid to communicating with patients. The secretary developed it from the examination chart and had it ready for the consultation, which, in our case, was the same visit. Its purpose was to confirm the patient's periodontal health status both numerically with the risk factor in ranges, and on a bar chart. Therefore, it appealed to the right and left sides of the brain.

These information processing systems can be important in increasing the quality of the service.

Last of all, the bottom line. And yet, this is not an ordinary "bottom line" approach. From a global view, much can be gained in paradigm alignment, that affects the bottom line, without looking at the balance sheet. Balance sheet analyses are to be found in many places. Our concern is with the many determining factors and how they impact figures on the balance sheet.

In the textbook, pages 64 - 69 present "The Impact of the BioCentric Technique on Pain, Productivity, and Attitude of Dental Hygienists." This brings us full-cycle, and once again looking at the role of the hygienist in the program, because the hygienist is the engine that drives the system. The two opening exercises looked at her personal situation and her workplace. Now, the dynamics of the system become the focus. The article becomes a check list for the office administrator.

If production falls, it is important to know why it fell. It is not sufficient to simply say it fell, if it is desirable to know how to fix it. Pages 38 - 40 of the textbook present the section "Suggestions for Evaluating a Hygiene Program." The bottom of page 38 has the "formula," if it can be called a formula. Knowing how to plug into the data from "The Impact of the BioCentric Technique on Pain, Productivity, and Attitude of Dental Hygienists" and evaluate situations as they occur requires some time and effort, but it can provide insight into otherwise blind alleys.

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