Ask Kara RDH

The new office I work for has refusal forms for everything; X-rays, perio chart, SRP, etc. To me, this is supervised neglect for over two years of X-rays and one year for periodontal charting. I’m not sure about non-surgical periodontal therapy/SRP. I had one patient who had not had a perio chart in several years due to refusal. I...

I’ve been a hygienist at my current office for two years now. When the doctor hired me, he told me he would pay me $30 per hour ON ONE CONDITION: he said I must have at least five patients per day. If I have less than five, he cuts my pay down to $16 an hour. I agreed only...

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...

I recently moved and started working at an office last week. After taking the position, I realized that it is very unorganized and patient care is not their main focus. There is negativity in the office and I actually sometimes feel very uncomfortable with the situations I have been put in. I am too nice of a person and...

I work for one doctor at 2 of his offices. They are each in 2 completely different areas and therefore have two different average salary rates for the areas. I get paid $43 at one office which is okay for the area, but then I get paid the same amount for the other office when the average salary is...

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...

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...

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...

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,...

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...