Our Battery is Draining

We all know that a lithium battery only has so many charges (300500 charges according to Battery University). There are ways that we can use our devices that will drain the life of a battery faster and ways to preserve it, but at the end of the day, there are still only so many charges. It’s time we start thinking of our body as a lithium battery with an undetermined number of charges and consider the ways in which we can make our most valuable asset last.

Every stroke of the scaler on the surface of a tooth begins draining the lifespan of our career but it’s not just scaling that causes injury. It’s the entire clinical enchilada. The leaning over, the forward head posture, the contracted wrist flexion, the straining of the eyes, the chronically dehydrated bone, brain, and muscle tissue, and let’s not leave out the notorious chicken arms that plague our industry with musculoskeletal disorders (MSDs). Let’s face it, we typically don’t suffer from acute injury in dentistry. We most often suffer from MSDs, which in dentistry, are from cumulative injury.

Let’s say that a normal healthy patient requires 1,000 scaling strokes and a periodontal maintenance requires 3 times that (3,000). If 25% of our 8 patients a day were PMT’s, that historically put us at 12,000 strokes of a scaler per day. Fast forward to August 2021. Patients were finally returning to dental offices (after 18 months of not getting care), others had changed to at-home work schedules where home care habits were lacking, rendering them significantly heavier in debris, unhealthy gingiva, and needing more care… in the same number of minutes. Those normally “healthy” patients became 25% of the day and the rest of the day was with patients who were either launched into periodontal care needing scaling and root planning with more frequent PMT recare appointments. The workload of our day got significantly harder with less help for the increased demand. Using the same fictitious numbers, we went from 12,000 strokes per day to 20,000 strokes per day. That was quite a hit on our internal batteries, and most of us felt it.

Patients in 2022 are now being given more thorough screenings and medical history reviews. They have more general healthrelated medical issues and questions. As general health becomes commonplace in the dental operatory, the more questions/concerns patients have for the one health care provider they spend more time with than any other: their dental hygienist. They have burning desires to discuss the Covid19 situation before we ever get

into the mouth and these questions take up more of our precious minutes and zap our battery further.

Many providers are practicing with additional PPE/sterilization protocols that suck even more minutes from the available time to deliver the same standard of care. All this while dehydrated, due to the lack of ability to easily remove it to get a drink of water – despite the side effects of dehydration (headaches, dizziness, fatigue). As we fatigue, we run behind, make errors, and advocate for our patients less – because, let’s face it, by 4:00 pm we’re resentful that our patient (now seen as an energy vampire) walked in the door.

These issues all lead to mental stress, physical exhaustion, and an emotional toll that leaves many considering an exit strategy from hygiene during an unprecedented hygiene shortage. A hygiene shortage that is leaving offices asking for us to see more patients a day, work more days per week, and leave dentists frantically searching for ways to get dental assistants into a hygiene scope of practice to get care to patients.

If we compare our physical battery to a phone battery, it’s as if we are walking around at 3% with 45 windows open while streaming a movie and attempting to charge on our lunch breaks with a broken charger. The harsh truth is, that we are failing. We are in pain and headed for burnout. But I believe it’s not an inevitable ending for us.

There are ways to balance the needs of the patient and practice with the needs of the providers.

Work smarter, not harder. This means being attentive during assessments to what the patient's needs are before a scaler goes in the mouth. There is nothing like getting ¾ of the way through and running out of time. Take 30 seconds to put an explorer in the mouth and see what is present sub-gingivally.

Let them own their mouth. The patient owns their mouth and all of the disease or health therein. We’ve all heard this before. “Don’t presume a patient can’t afford treatment or isn’t interested in options.” That’s all fine and dandy until it’s no longer an assumption. How about that part where not letting them own their issues becomes enabling behavior on our part? Kindness, compassion, and an oral camera go a long way when guiding patients to owning their situation.

Don’t be a martyr. Hurting ourselves to get a non-compliant patient “clean” in 65 min (because let’s be real, now we’re running over) so that they can be done in a single visit isn’t helping them and it’s hurting us. We know it and they often do too. “I really made you work today!” is not a compliment, Mr. Jones.

Use the tools available to us. Yes, there are the obvious ones: mechanized scaling, intra-oral cameras, ergonomic tools (saddles,

loupes, lights, sharp instruments, cordless) that help keep the body neutral so that we aren’t as physically fatigued. There is also alternative practice management protocol like gross debridement, SRP, Prophy 1/Prophy 2, more frequent recare, etc. Don’t be afraid to use them.

Put your oxygen mask on first. That means properly preparing for the job ahead of you. Get adequate sleep, hydrate, stretch frequently, foam roll daily, and strengthen the body to meet the demands being put on it. For Pete’s sake, get out of the office for some fresh air and a lunch break!

Don’t put the cart before the horse. Seeing 9 patients a day (or 15-20 in assisted hygiene schedules) burns out the body faster than seeing 8. Every stroke and awkwardly held static position matters and cumulatively drain our battery.

Communicate! The last thing our doctors want to do is have to replace us right now, so it’s imperative that we speak up when we are in pain or are super stressed. Getting an ergonomic assessment is much easier than finding a replacement. Covering a massage therapy visit is better than losing a day of hygiene production.

Get an ergonomic program in place for the office. Implement stretches into morning huddles, incentive programs for obtaining ergonomic equipment, find ways to get water breaks in for clinicians donned with multiple layers of PPE, and consider a yoga or strength training class for a team-building experience. The sky is the limit!

Give yourself grace. It’s ok to say no thank you when that red light is showing at \>10%.

We are human. Dentistry is not assembly line work. We have a responsibility to our patients, our doctors, and our families to take care of ourselves!

Contact her at: ErgoFitLife@gmail.com, @ErgoFitLife\_Katrina, Facebook Page/Group; ErgoFitLife, www.ErgoFitLife.com