Newsletter

T H E P R E S I D E N T'S A D D R E S S

Motto: Education, Efficiency, Loyalty & Service

Here it is 2008 and the year is already flying by. We have come a long way, since I became a Dental Assistant in 1986. Indeed, there have been many life changes in the last twenty-two (22) years, from the explosion of the World Wide Web to other various changes. One such change is the required Registration of Dental Assistants in the state of Texas. TDAA.org continues to be a positive representation of TDAA and the Dental Assistants of Texas, but without your assistance and support, without each Local’s positive growth in Membership and without communication with other Associations, TDAA & TDAA.org will become stagnant.

Stagnant (adj.) means: Not circulating or flowing. “Stagnant not growing or changing without force or vitality.

I urge everyone to focus on SHINING as a Member of TDAA, on SHARING information & yourselves and SEEKING new Members, using our mainstay, our Motto.

It takes each one of us to continue what we know as TDAA and it takes Membership & New Members to walk with us. When one of us is missing, there is a torn remnant from TDAA. A hole is left in that person’s place, as other’s attempt to carry their part and fill the void.

YOU are important! If someone needs-a-hand or asks for guidance say, “ABSOLUTELY!!” Repeat after me, “ABSOLUTELY!!”

Texas will be SHINING bright this coming October when the American Dental Association (ADA) and the American Dental Assistants Association (ADAA) meeting convenes in San Antonio. You do not have to be a Delegate to attend the House of Delegates because any Member can come and sit in the gallery and listen. Also, any Member can attend the forums for free and learn so very much. The social events are available to anyone. SHARING the experience is well worth the time. Although TDAA has earned the representation of having nine (9) Delegates with increased membership, this is a time to SEEK and see what happens at the National meeting. On a National & International level, visiting and shopping at the Exhibits is like none other “Exhibit Hall” that I have ever seen!! Indeed, the ADA World Marketplace Exhibition will be a great place to meet other colleagues. I challenge you to get involved!! Come and be a part of the fun and enjoy learning at a national meeting because I guarantee you that it will not be on Texas soil again for many, many years! Registration: http://www.ada.org/prof/events/session/index.asp.

This is our time to SHINE, SHARE & SEEK!! If you would like to become a Member and be counted and enjoy the benefits! JOIN the ADAA!! Application: http://www.tdaa.org/memberapp.htm. After all, Education, Efficiency, Loyalty & Service are what we are all about. Feel confident, feel the excitement and know the camaraderie that we have in the Texas Dental Assistants Association. Thank you.

Sponsor ten (10) new ADAA members from October 1, 2007 to September 30, 2008 and be awarded $500.00. Membership must be for a full year. The one (1) ADAA Member, who sponsors the greatest number of new members, after the initial ten, will be awarded an additional $500.00.

· New Members are first time members or those who rejoin after a lapse of three (3) or more years. Members rejoining after a lapse of less than three (3) years are considered as renewing members.

· The sponsor’s name must appear on the sponsor line on the new member application when it is submitted.

Texas Dental Assistants Association’s quarterly publication, The Bulletin, an established newsletter, is filled with information, including photos and Dental Profession Articles. Presently what is available here is a condensed version.

D E N TA L A R T I C L E S

Volume 68 * Condensed Version * 2007-2008

Consider The Benefits of Joining . . .

A Professional Dental Assisting Association

By Ronda Vantroba Lane, CDA, RDA, BS, ADAA 9^th District Trustee, TDAA Past-President, January 2007

After reviewing Texas Senate Bill 610, which took effect on September 1, 2006, joining a professional organization makes a lot of sense, now more than ever! Dental Assistants across Texas who expose radiographs are required to attend a Course and pass an examination covering Radiology, Infection Control and Jurisprudence. After successfully completing the Course and Exam, application must be made to the Texas State Board of Dental Examiners (TSBDE) for Registration. Registered Dental Assistants must provide proof of approved Continuing Education (CE) to renew their registration annually. Good News…. help & support are available, just as they have been for the past 80 years. A Tri-partnership exists on the national, state & local levels to provide a wide variety of support services that include membership benefits, leadership development, exceptional CE and invaluable networking opportunities.

In Texas, the Texas Dental Assistants Association is comprised of professionals, just like you, who provide the leadership, vision, mission and values of the profession. Essentially, they are your cheerleaders, your best friends, and your greatest advocates for your job and position. Why is now a good time to join?

There are many reasons, and the very first is that you are a professional and the State of Texas and the Texas State Board of Dental Examiners (TSBDE) recognizes you as one! Membership in a professional organization helps communicate to those both inside and outside the field that your work has value and is worthy of their respect and recognition. Sure, it’s possible to develop your professional career just by studying textbooks, reading journals, and attending seminars here and there by yourself, but it’s much more fun and rewarding to do these activities with a group which shares your passion, knowledge and appreciation for your work.

Many in Texas have already joined and are already enjoying benefits such as:

News of new local organizations forming due to Senate Bill 610 requirements is anticipated this year and now would be a great time for you to get in as these groups form. Attending Local Organization meetings will help provide the TSBDE required CE in Dental Assisting, Radiology, Infection Control and Jurisprudence.

The cost is very reasonable at $135.00 per year. If you join within 30 days of a major dental meeting in Texas, such as the Texas Dental Meeting, Southwest Dental Conference or Star of the South Meeting, then a $25.00 discount off the regular membership fee is available.

This is a real bargain for dental assisting students as they begin their journey into the professional arena. Just getting your foot in the door of a new profession can be quite challenging, however it has been proven that “who you know” can get you much further and membership in a professional organization provides you with contacts in companies—or individuals—with whom you may like to work. Professional membership is an excellent addition to your resume and demonstrates to prospective employers your serious commitment to the field.

Want to do something great for your future career and job search? Consider joining as a student at a special student rate of $25. Students are extremely important to an organization’s growth, and the Texas Dental Assistants Association welcomes them with open arms.

A valuable opportunity is knocking at your door and the Texas Dental Assistants Association is ready to support your professional needs if you dare to do something just for YOU!

By Ronda Vantroba Lane, CDA, RDA, BS, ADAA 9^th District Trustee, TDAA Past-President, August 2007

The process of instrument recirculation begins immediately after a dental procedure is completed and needs to be safe, consistent, efficient, and repeatable. Since cleaning is the first step in every decontamination process, it is imperative that all instruments are cleaned thoroughly for the sterilization process to work.

Ultrasonic Cleaning has been proven to be 16 times more effective than manual methods and cleans areas that are unreachable (including microscopic crevices) by manual cleaning. But even these devices can fail to perform adequately if the appropriate steps are not followed.

Ideally, all instruments should be totally immersed into a holding tank or tub for presoaking prior to ultrasonic cleaning to keep biological matter from drying out and adhering to instrument surfaces. The ideal presoaking solution is a mildly alkaline solution (it feels slippery) with a pH of 10.0 – 10.5 and heated to a temperature of 110 -120 degrees. The instruments are then removed, while wearing heavy-duty utility gloves, from the presoaking solution, rinsed with clean water, and carefully placed into the basket of an ultrasonic cleaning unit. Instruments should always be suspended in a basket or other device, be free from tank bottom and sides, and be totally immersed with no tips above the solution level, so that true cavitation can take place.

When ultrasonic energy is introduced into a cleaning solution, cavitation {the foundation of ultrasonic cleaning} occurs. Microscopic bubbles are formed when ultra-high frequency sound waves are passed through a cleaning solution. This creates a high-energy vacuum effect, safely pulling debris, foreign particles, and organic matter from instruments. Cavitation provides an intense scrubbing action that leads to unsurpassed cleaning speed and consistency when compared with simple soaking or immersing with agitation. Additionally, the bubbles are small enough to penetrate even microscopic crevices, cleaning them thoroughly and consistently.

For effective cleaning, it is essential to use an ultrasonic solution at the correct concentration that properly matches the cleaning task. Always read the manufacturers label and don’t skimp, or the effectiveness of the cleaning process will be compromised. Before turning the unit on, the cover should always be in place for several reasons:

(1) Ultrasonic units create spatter & splashing and can create an aerosol effect, disseminating harmful microorganisms into the air.

(2) This spatter & splashing will contaminate the surface area immediately surrounding the unit.

(3) The cover provides a reduction of noise and the avoidance of solution loss through evaporation.

(4) A small amount of moisture contamination on the power connections will cause electrical breakdown.

Turn the unit on and a “hum” will be heard immediately and cavitation can be observed inside the tank. Cleaning times may vary, depending upon the amount and types of contamination on the instruments. Most manufacturers recommend cavitation for 3-12 minutes. Experience will quickly indicate the optimum cleaning times for your particular needs. Many units will stop automatically at the end of the preset time; however, some units have a “hold” position, which allows the operator to clean for a longer time period. It is not recommended to operate the unit for longer than 30 minutes. Longer times do not mean cleaner instruments and instruments exposed to excessive cavitation can become dull, corrode, and break down and/or cause hinged instruments to stop moving smoothly.

The final steps with ultrasonic processing are also important. The basket of instruments should be drained of fluid and thoroughly rinsed under running water with the operator wearing the heavy-duty utility gloves. The rising cycle is important to remove the debris suspended in the water and the ultrasonic solution. Instruments should be carefully laid out for inspection to be sure all debris has been removed and air-dried or placed into a commercially available drier. The instruments are now ready for packaging into their sterilization bags, wraps or cassettes.

The frequency with which you change your solution depends on the volume, amount of debris & usage. Most offices change solutions daily and should wipe down the inside tank to avoid build up. Disinfection of the unit should also be done when solution is changed.

The addition of heat helps soften and breakdown materials such as waxes and similar compounds for a quicker cleaning cycle. These materials would ultimately be removed at a slower rate without using heat.

Yes. Testing is recommended monthly because many units have two (2) capacitors and only one (1) may be working.

Aluminum Foil Test

1. Fill tank with fresh solution at room temperature. Run unit for about 5 minutes, with no instruments in it.

2. Cut or tear a piece of lightweight household aluminum foil so it will fit into the tank from top to bottom and side to side.

3. Place foil in the tank diagonally from corner to corner in a vertical position as close to the bottom as possible without touching.

4. Hold the foil as steady as possible and turn on the ultrasonic cleaner unit for 20-30 seconds.

5. The foil should show an even distribution of indentation (a pebbling effect). If an area of one-half inch or greater does not show this pebbling, the unit should be returned to the manufacturer for servicing.

6. Mark the date on the foil and file it as proof that a test was run on that date, and it produced an acceptable pattern.

MINNIE AND MAXINE

By Ms. Anna Spaulding, CDA, RDA, February 2007

I’m sure many of you are familiar with “Goofus and Gallant” from the popular magazine Highlights for Children. In dental offices I think we have similar characters, whom I will call “Minnie and Maxine” (my apologies to any real characters who just happen to have those names). Minnie just tries to get by with the least she can do, and has no team spirit. Maxine tries to do everything she can to get the job done, while helping others in the office as much as possible. She has a great team spirit. Doctors, hygienists, assistants (treatment coordinators), business administrators, hygiene coordinators, and any other auxiliary personnel, can be a Minnie or a Maxine. In fact, we all have some of both characters in us, but our goal should be to become more like Maxine and less like Minnie. That would make the office atmosphere better, the work would get done, the patients would get better care, and I think everyone would feel better about what was accomplished, knowing that we did it as a team.

Maxine truly believes that our motivation should be “to do the right thing for every patient.” She also believes in the Guiding Principle of “Countless unseen details are often the only difference between the mediocre and the magnificent.” Maxine understands that our purpose is to put patient care first! And to provide quality care and excellence in a caring professional atmosphere. She believes that she has a part in offering a supportive pleasant environment, and contributes to being very profitable and making a difference. She also understands that working together will create more profit to share, and will feel that she has truly earned her part. Minnie has heard all those things, but does not really understand the concepts and how she contributes to them. She wants to just come in and “do HER job” and collect her share of the profits.

Scenarios will be presented, showing how each of these characters would react to a given situation. Remember, we all have some of both, and even on different days and with different situations, may demonstrate Minnie or Maxine characteristics.

Minnie sees that both ultrasonic cleaners are full of instruments, but since some, or all, of the instruments are not hers, she decides to leave them for someone else, even though she has a little time in her schedule to spare. Maxine also notices that some, or all, of the instruments are not hers, but goes ahead and rinses the items in both cleaners, and prepares them for sterilization. She realizes that while she has time available, other staff members may not have that option at this time. Maxine also knows that getting those instruments out leaves room for the next batch, and perhaps helps speed someone else’s preparation for their next patient.

Minnie sees that the sterilizer should be loaded and run, but again, leaves it for someone else, because, after all, not everything in there was used by her or her doctor. Maxine loads the sterilizer and gets it started, because she knows that some of the items will be needed again soon, in order to ensure quality care for the patients. Minnie brings her trash into the lab and piles it on top of the already full trash can, so that when Maxine removes the bag to replace it with a new one, she has to pick up all the trash that falls onto the floor when moving the trash can out.

Minnie is the one who leaves the empty paper towel holder, and the empty toilet tissue roll so that the next person does not have these much-needed items, but may not realize it until they reach out to where they should have been. Maxine replaces the paper towels and toilet paper before they are completely gone. She does not want another staff member to come up empty-handed. She also realizes that the next person to need that item may well be a patient.

Minnie notices that the stack of charts to be filed has become quite high, but decides that this is not her job; and anyway some of those are the “other doctor’s files.” Maxine has some time between patients, so she checks to see what she can do to help the office administrator. The administrator has been working hard all day taking care of patients’ needs, but she has not had time to file the charts accumulating from the large number of patients who were seen.

Minnie puts X-rays in the developer, and then makes a personal call, while waiting for them to develop. While Maxine is putting her X-rays in, she notices that two of the hygienists have films that have already finished processing, so she mounts them and delivers them, remembering from the morning huddle that they had a very full schedule all day.

When Minnie gets to work in the morning, she does not even think about all the things that have to be done to get the office ready for patients that day. She just gets her charts and a cup of coffee and sits down. Maxine comes in, removes the items from the cold sterilization container, rinses and stores them. She knows that these items will be needed and that if contaminated items are placed in with those that have already been sterilized, the “clean items” are recontaminated and must remain the appropriate number of hours again to be sterile. In addition, to be ready to begin the day, Maxine sets up the ultrasonic unit as she knows this will assist everyone.

Maxine gets to work checking the X-ray, replenishing the X-ray solutions, turning on the processor to warm up for the first patient’s film, running the quality assurance film to ensure that the equipment is working properly, and turning on the safelight to get the dark room ready to go. She realizes that all this is important: to reduce films that are not diagnostic, meaning that they have to be retaken, and also to ensure that a quality image is projected in all that is done for the patient. Maxine also checks to see if Minnie left the film supply empty or low, and goes to get additional film from the refrigerator, if needed.

When Minnie gets behind, she cuts corners on disinfection and sterilization procedures, because that is something no one but her will know about. And, “Dr. Minnie” doesn’t really care or think it is necessary, because after all “no one ever catches an infectious disease in a dental office.” Maxine tries to follow universal standards with each patient, because she realizes that each one has the potential to spread infectious diseases, such as hepatitis, to another patient, or to anyone on the staff. Maxine knows that if she were to have treatment of any kind, in the office of a dentist, an oral surgeon, or in a medical office, she would want the staff to take the same careful precautions on her behalf. She also feels that real “quality of care” includes those behind the scenes activities that are important, even if no one but her knows whether it is being done or not.

Maxine tries to find time during her day to remove sterile impression trays from the cold solution, and clean and place additional trays so that they will be ready when needed. Minnie doesn’t worry about that, because if she needs a tray and it isn’t sterile, she can always clean it and use it, justifying her actions with the thought that “somebody should have already done these trays, and then I would not have to compromise with this patient.”

Minnie goes to the kitchen to have a snack, and when she gets through, leaves her dishes in the sink. This is not her day to clean up, and she doesn’t care if the person assigned has to stay after normal working hours to do them. She has some personal things to take care of, and since her schedule is clear for now, this would be the perfect time. Maxine has her snack, and then cleans her dishes, as well as any others in the sink, because she realizes that not everyone has the time. It would not be fair for the assigned person to stay late, when she had some time open in her schedule, and could get it done during normal office hours.

Minnie looks at her column and sees she has some open time. She says, “Oh boy, I have a light day today, I can take care of some of those personal things I need to do, that I didn’t have time to do over the weekend.” Maxine sees the same schedule in her column, and thinks “If that time does not get filled, I can help the others who have a packed schedule. That way the patients get great quality care, and everyone can stay on time and get out for lunch and at the end of the day on time.”

Maxine realizes that everything she does contributes to the office as a whole, gives the patients a better experience, quality care, and adds to the productivity of the practice. She understands that is what enables the practice to pay the salaries and benefits, and especially the bonuses that are based on the production of the whole office and not just her column or her doctor’s column. Minnie does not consider herself as a part of the whole picture, while Maxine understands that without each piece working with the other, we can never complete a masterpiece.

I’m sure you all can immediately think of other scenarios where you have seen Minnie, Maxine, Dr. Minnie and Dr. Maxine, in action. If you’d like a helpful hint on how to help Minnie improve, read on.

• Job descriptions are an excellent way to provide guidelines to employees, such as Minnie. That way they know exactly what is expected of them. These should be done in a way that indicates what that person’s order of priorities is. Then it should be stressed that employees are expected to help each other whenever possible. Part of the job description should include the criteria on which the employee will be evaluated. If an employee knows what is important to the employer, he or she is more likely to exhibit that behavior.

• Employees should have job performance reviews, and these should be based on the quality of the job, as well as the team attitude portrayed.

• Tasks that are not direct patient care can be assigned several ways. A list can be made of all these, and divided evenly among the number of employees responsible for them. Another method would be to divide the tasks up and assign by a specific period of time (i.e., day of the week, weekly, or monthly). The lists would be posted, so that everyone knew who was responsible for each task at any given time. If the task was not accomplished, or not done properly, the employer would know who to talk to about that specific item.

• Having job descriptions and posted tasks would result in employees feeling confident that they were doing what was expected of them. This would eliminate uncertainties, as well as avoid potential conflicts between employees. Reviews would be easily accomplished also, since the employer would continuously know who was performing as expected. Problems could be eliminated much sooner, and a positive environment maintained much easier.

Ms. Anna Spaulding has worked in the dental profession for 29 years, and has been a Certified Dental Assistant since 1982. She became a Texas RDA, April 2006. She has worked as a chairside assistant, performed business office procedure, and has taught Dental Assisting at Tarrant County College in Fort Worth, Texas.

Ms. Spaulding has been a member of the ADAA since 1982, is a Past President of the Texas Dental Assistants Association, and the Fort Worth District Dental Assistants Society. Anna is presently employed part time by Dr. Barry Stovall and Dr. Johnny Cheng in Fort Worth, Texas.

Disclaimer: "The information or opinions expressed or implied are strictly those of the authors and/or course presenters and do not necessarily represent the opinion, position or official policies of The American Dental Assistants Association (ADAA), The Texas Dental Assistants Association (TDAA), or The State Board of Examiners' Rules and Regulations enacted as mandated by Texas Legislation. Authors of published materials viewable on-line are solely responsible for their accuracy."