After graduating from the dental hygiene program, I temped for about a year since I had no previous dental experience, and I wanted to see what dental hygiene opportunities were out there. One office where I temped was interesting enough that I am here 17 years later writing about it. The office was a father/daughter dental practice, and he was on his way to retirement, working only a few days a week after practicing for over 35 years.
At one appointment, the doctor did the exam, called out all caries detected, and explained to the patient the needed treatment. As the dentist finished the exam, the patient asked how many cavities he had. There was silence for a few seconds. The dentist didn’t answer, so I promptly counted and answered with “Six.” The dentist looked at me and talked half to the patient and half to me, sternly stating that I didn’t have the authority to tell the patient how many cavities he had as I am not allowed to diagnose.
He then shifted his gaze to the patient and explained that I was “just a temp hygienist” and didn’t know better. There’s a lot to tackle with this in general, but the “just a …” comment stood out.
“Just a …” could be to make a point against the individual person, profession, or both. “Just a…” is commonly used in the context of meaning: simply, only, no more than, barely, narrowly, by a little, hardly, or nothing but.
I have heard patients say “just an assistant” or “just the front office.” It’s common language; I understand that completely. Is it meant to be degrading or insulting, or is it just harmless and oblivious? Either way, whoever is “just a…” is important to the practice because when a “just a…” doesn’t show up to work, it’s pretty obvious.
I don’t think everyone in the office always appreciates colleagues’ jobs in the office. In many offices I have been in either for a day or years, there’s a lot of complaining about each other. Hygienists complain about dentists, assistants, and the front office. Assistants complain about dentists, hygienists, and the front office. The front office complains about assistants, hygienists, and dentists. Then there’s the front office versus the back office complaints and vice versa.
Basically, there’s a lot of complaining about each other when we don’t do or really know their jobs or endure their daily struggles. So I thought writing this article could be helpful.
Just an Assistant
Well, let’s start with the obvious here. Dental assistants are the backbone of a practice. The proof is many dentists will cancel their schedule or scramble to get a temporary assistant for the day if their assistant is out of the office. So, an assistant is very important as a lack of one will halt a schedule.
A “just an assistant” is just as valuable as a dentist in many ways. I have only crossed paths with one dentist who worked on a patient solo. It was quite the feat (and I say this affectionally) as he didn’t know where anything was or how to use a suction well ‒ more confirmation of the importance of an assistant.
In many ways, an experienced assistant knows more than a green dentist and often “office trains” the rookies out of dental school. Assistants are invaluable in making the appointment efficient. They prepare by setting up the operatory, abiding by sterilizing/disinfecting standards so patients do not contract infectious diseases, and break down the operatory safely and effectively.
An assistant puts the patient at ease and comfortable in one of the last places a person prefers to be ‒ the dental office. Assistants don’t have an easy job as they are at the mercy of the dentist and the patient in relation to ergonomics. They have to accommodate the patient and the dentist at all times.
The education a dental assistant compiles is on-the-job training, a dental associate certification program, or an expanded function certification. Then, if they work within any dental specialty, there’s that training also. An assistant may have worked with multiple dentists over their career to attain various knowledge, skills, and abilities. They have quite an impressive resume with a broad range of competencies.
They are highly efficient in a wide range of skills of radiographs, dental software, chairside techniques, impressions, a variety of dental materials, and procedures; it’s really an exhaustive list. Not only can they be trained through courses to complete composite or amalgam restorations, but they know how to do extractions, root canals, crowns, bridges, implants, and oral and periodontal surgery procedures, all through assisting. If it was within their scope of practice to do those treatments, many assistants would be highly competent in doing so.
They are the ones in the office who knows where everything is. Many of them do the office inventory, and some even perform administrative work. When something can’t be found in the office on their day off, they are commonly the ones who are called at home to ask where something is.
Regularly enough, they also assist the dental hygienist. These assistants commonly keep the sterilizing area maintained and stocked as well as sterilize hygiene instruments.
Just a Dental Hygienist (temporary or permanent)
A dental hygienist is a licensed professional with an educational range from an associate’s degree to a master’s degree in dental hygiene (though many hygienists have completed their doctorate in leadership, education, and other fields). The occupation is a science-based discipline, and a requirement for continuing education classes (including CPR/BLS) exists for licensure.
Dental hygienists are also trained for medical emergencies, local anesthesia in many states, and nitrous oxide. In addition, we take radiographs, chart and perform periodontal evaluations, treatment plan, and educate patients about oral health.
Dental hygienists have a basic understanding of a wide range of oral health topics, including oral cancer, bruxism, oral abnormalities, orthodontics, restorations, periodontics, oral surgery, endodontics, removable appliances, TMJ disorders, whitening, systemic concerns, and treating pediatrics to geriatrics.
As with many dental assistants, dental hygienists have the advantage of working with multiple dentists to accumulate a variety of on-the-job knowledge, specialties, office flows, equipment and software use, and observing doctors’ decision-making processes.
Dental hygienists have considerable clinical skills ‒ from simply flossing a patient’s teeth to anesthetizing an area to be treated to great dexterity and tactile sense for instrumentation of a root concavity.
We have the knowledge to check for abnormalities of the mouth, determine the type of hygiene treatment, educate the patient on their oral health, and be knowledgeable of dental products to suggest. We maintain a patient’s comfort and even provide a listening ear. We need to interpret a medical history by knowing systemic diseases and pharmacology and their effects on oral health, being prepared for medical emergencies that may arise, and how to handle them.
Hygienists are a fixture of the practice with the rapport they build and maintain. In fact, many patients keep their recalls just to see the hygienist.
Just a Dentist
In a quote from the movie Hangover, Phil reminds Stu of his perception of Stu’s minimal achievements. “He’s a dentist. Don’t get too excited. And if someone has a heart attack, you should still call 911.” Dentists can be the butt of jokes until the dentist is needed.
A dentist is an expert in dentistry ‒ not only of the teeth but from the outside of the lips to the throat and everything in between. As research continues to surface, dentists become more of a jack of all trades with their extensive knowledge about oral health.
A dentist is a licensed dental professional who has eight years of school to earn a DMD or DDS, and if they become a specialist, it’s even more years. They have four years to gain their bachelor’s degree and four more years of dental education and skills before they get into “real life.” They have an extensive science-based discipline beyond just teeth. They have required continuing education classes to complete every licensure period, including CPR/BLS. They are trained in medical emergencies and levels of sedation.
Dentists are sometimes villains after diagnosing an expensive procedure, or they’re heroes in getting a patient out of pain.
General dentists perform a range of treatments, including root canal therapy, extractions, implant placement, restorations, crowns, dentures (full and partial), orthodontics, cosmetic work, and even full mouth reconstructions. They need to know how to treat an emergency patient who experiences pain on the spot as much as they need to know how to treat an aphthous ulcer. They not only know how to extract a tooth but how to resolve any aftermath issues such as a dry socket.
Dentists are steady workers and practically treat every patient within the day, either through hygienists’ exams or treatment in the doctor’s operatory.
Their hand-eye coordination is highly skilled to accomplish as close to perfection as possible while working in a small space. They require good judgment for diagnosing, treating, and knowing their abilities and when to refer.
On top of working within the practice, many dentists are business owners and employers. So, they are not only part of the production line; they are human resources, payroll, and management. In private practice, employees will go to the dentist for office issues and raises. If the employee goes to the office manager, the office manager still gets the final say from the dentist. Dentists set the office’s tone and are the key to holding the practice together.
Just a Front Office Person/Lady/Scheduler/Receptionist
They are so much more than “just a scheduler.” They greet, welcome, and interact with every patient who walks into the office. Front office folks gracefully take the brunt of the complaints from patients and coworkers. The angry patients who seem to be rude over the phone yet nice when they are in the office are buffered by the front office. These souls balance phone calls and people standing directly in front of them.
They answer questions, clarify treatment, communicate with patients’ insurances, give financial estimates of treatment, and do the billing and collections. They arrange the schedules for all employees, such as when they need time off, and they indirectly provide us a paycheck by keeping our schedules full.
I had a new patient recently who came from another dental office and referred to that staff as “just a dental assistant and front office lady.” Boy, if she only knew how “just a…” they really are.
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