Ask Kara RDH: New Hygienist Doing Inferior Work

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I have 33 years experience and have worked in my current office for 13 years. I take pride in my care of my patients. We deal with a lot of perio, have successful results with SRP, and refer when needed. The doctors hired a new hygienist. I have brought to their attention a few situations where at the four-month recall after she performs treatment, the perio situation has declined at an alarming rate. There are also situations where heavy radiographic calculus remained after SRP. And I mean heavy! I’ve had to redo SRPs for her. When communicating my concerns with the doctors, they ask me what they and I can do to help her improve her skills. I am at a loss.

Assuming this isn’t a home care issue on the patient’s part, and the new hygienist needs help with instrumentation, the only thing you can really do is sit with her and work on it. She could also brush up on her skills by watching YouTube videos on instrumentation or even going to workshops on instrumentation (like at a dental conference). Hands-on is obviously a better option. I know this requires extra work on your part, but being a seasoned hygienist, showing her where to improve could be a positive influence on her. (Hopefully anyway, some people are not open to constructive criticism, and some people get defensive when they know they aren’t doing their best work.)

However, before sitting down with the hygienist, the doctors talk to her about it. This will avoid a potentially awkward situation where the newer hygienist feels you are telling her what to do and trying to be her boss. In reality, this situation is ultimately in the doctors’ hands, not yours.

Also, I dislike even saying or recommending this, but the doctors may want to check her work when they are doing their exam, so patients don’t have to come back and retreat. It would help her learn where she needs to focus, but on the other hand doing this could be  degrading to do in front of a patient. So that’s a double-edged sword. I only say it because not providing quality care, which ends up needing to be re-done, is not only a disservice to a patient, but the time taken to retreat will affect the office’s bottom line. Patients could be lost over this as well, due to the lack of confidence in the treating clinicians. Again, this is a situation the doctor/boss/owner of the practice needs to be dealing with, not you.

This is a tough one because you care about all the patients the practice treats, but ultimately you only have control over the treatment you provide. I wish you and her the best of luck!

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Kara Vavrosky, RDHEP
Kara Vavrosky, RDHEP, is a Co-founder and Chief Content Officer of Today’s RDH, a digital media company for dental hygienists, encompassing a daily publication, podcast, virtual continuing education events, and self-study continuing education. Kara is recognized as one of the largest social media influencers in dental hygiene, with a following of over 200,000 dental hygienists and other dental professionals. Kara was recognized in 2020 as one of the Top 100 Women in Media for her entrepreneurship as a Co-founder of Today’s RDH. In 2022, she was recognized by the American Dental Hygienists’ Association for their Standout Seven Award in the Entrepreneur category. A graduate of the Oregon Institute of Technology, Kara has a deep passion for spreading knowledge about the importance of oral health and its relation to systemic health. Kara’s passion extends to helping other hygienists understand the latest protocols, products, and research – all with the goal of pushing the dental hygiene profession forward. Kara currently lives in Vancouver, Washington, just outside Portland, Oregon, with her husband, Ben, and their four Chihuahuas. In her free time, you will find Kara on her quad riding the Oregon Dunes, spoiling her Chihuahuas, and cherishing every moment with her family and friends.