Ask Kara RDH: PSA Block Injection Complication

I recently administered a right PSA block on a patient. Seconds after, my patient expressed that it hurt more than when I had numbed the left side a week prior. She kept expressing that her cheek felt puffy and hard. I attempted to massage the anesthetic into the nerve, but the patient continued to tell me that it felt...

Ask Kara RDH: New Hygienist Doing Inferior Work

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...

Ask Kara RDH: Soaking gauze in disinfectant?

Is it OK to soak gauze in disinfectant or does disinfectant break down gauze to where the disinfectant is left ineffective? Both the Centers for Disease Control and Prevention (CDC) and the Organization for Asepsis and Prevention (OSAP) don’t recommend pre-soaking gauze in disinfectant. Cotton fibers in gauze can absorb and actually inactivate ingredients in disinfectants leaving them less effective or...

Ask Kara RDH: Do I really need to sterilize slow-speed handpieces after every patient?

I read one of your articles regarding infection control. Do slow-speed handpieces really need to be sterilized after every patient when using a disposable prophy angles? We are currently sterilizing at the end of each workday. Yes, slow-speed handpieces must be heat-sterilized in between every patient. Even though you use disposable prophy angles, and slow-speed handpieces are considered semi-critical devices,...

Ask Kara RDH: Patients Complain I Talk too Much

When I am uncomfortable, running late, stressed out, fill-in the blank—–, I talk too loud and tend to talk too much. This “she talks too much” has inspired two patients complaining this last year in our reviews. I really try not to, but sometimes I misread the patient and pow! Any advice? This can be a tough one because you...

Ask Kara RDH: What is the best way to suggest perio treatment to a patient?

I just started my first dental hygiene job, and I’m having a hard time on how to suggest perio treatment and referrals. What’s the best way to explain perio to a patient and how to stress the importance not to leave deep pocket depths and bleeding untreated? With time, the more patients you see and explain the need for referrals...

Ask Kara RDH: Is the office legally covered with signed informed refusal forms?

The new office I work for has informed refusal forms for everything; radiographs, perio chart, SRP, etc. To me, this is supervised neglect for over two years of no radiographs and one year for perio chart. I had one patient who had not had a perio chart in several years due to refusal. I explained to the patient why...

Ask Kara RDH: Rumors Being Spread About Work Ethic

I recently graduated from dental hygiene school and will be returning to my hometown to find a job. I’m from a small town with about 20-30 dental offices, and I have worked at two of them. In the process of trying to find a job, I have discovered an untruthful statement about my work ethic, specifically, my punctuality. A...

Ask Kara RDH: Holding X-ray Sensor While Exposing Radiographs

I work in a pediatric office, and the doctor won’t buy a size 0 sensor. Because of this, to “get the shot” we are having to hold the sensor while exposing radiographs multiple times per day because of our patients’ small mouths. How do you address exposure concerns with the doctor? This is a tough one because guidelines for operator...

Ask Kara RDH: Young Hygienist Doesn’t Scale Thoroughly

Our office has three hygienists; myself, who has been a hygienist for 35 years, my coworker “Lorna” who has been a hygienist 45 years, and our newest addition “Lucy” who graduated almost three years ago. Lucy gets done with ALL of her patients in 40 minutes. Lorna and I stay on time, but we usually aren’t as fast. The...

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