Dental Hygiene: Adopting Technology for Safety





By Back Lexi Marino July 16, 2020

Rolando Mia, from Zyris, hosts a video series focused on the latest news, topics, and conversations happening in dentistry featuring dentists across the nation. In this episode, Secilia Spellman, RDH gave us an important lesson on the importance of adopting new technology in your dental hygiene routine and having open conversations with your dentist.

Watch this video to learn the following:

  • The value of infection control
  • Having honest conversations with your team – being productive with change
  • Adopting new technology in your dental hygiene routine
  • Importance of high-volume suction in hygiene appointments

Rolando Mia:

Good morning, everybody. Welcome to Dental Voice with Zyris. My name is Rolando Mia. I have a special guest today. Her name is Secilia Spellman. She’s a Registered Dental Hygienist in Santa Barbara.

Dental Voice is an opportunity for our guests to express their perspectives, share with us their opinions and advice for people listening. So Secilia, first of all, thank you so much for joining us. How are you doing?

Secilia Spellman:

Good morning, Ro. I feel great and I’ll tell you why. It felt awesome to wake, put makeup on, do my hair and put jeans on.

Covid-19 From a Dental Hygiene Perspective

Rolando Mia:

So, the purpose of Dental Voice is to basically give you an opportunity to share what you’re experiencing right now. When you think about dentistry as a profession, we’ve been hit, I mean literally smacked upside the head with Covid-19. What’s your experience with this and how are you kind of dealing with it?

Secilia Spellman:

Initially I think it was that Friday, March 13th, I got my first picture of the graph chart of who is most at risk. I’m sure you’ve probably seen them. At the top of that list on that Friday I saw it said Registered Dental Hygienist. Of course, I went into work that Monday, we hadn’t quite gone through that protocol of what was next. I was in a sheer panic and I didn’t care what the doctor wanted or what the news wanted…I wanted to be home. There’s a comfort being in your own home and feeling safe. That was definitely my first initial reaction.

I think I can speak on behalf of our entire nation. I have gone through every wave of emotion you can think of in the last several weeks. It’s been very interesting. That hit me hard initially without a doubt. A lot of fear.

I have a genetic lung disorder. So, that is something that resonates very close to home with me. I do have to think about these things. Thankfully the second I went in on Monday, my doctor had already started cancellations. He was honest and he’s also senior and he said, “You know, if you don’t mind helping me cancel a couple of week’s worth of patients so we can try to figure things out, let’s get us all home.” So, that’s where I’ve been.

Rolando Mia:

Wow. It’s interesting. I have asthma. So, I’m especially particular about that. I can completely understand. When you look at hygiene and when you look at dentistry, we’re quite a few weeks into this and there’s a large body of information and aerosols. The fact that this is transferred during the course of even people speaking is a big thing. How have you gotten over the fear or the anxiety of what’s going on? How do you feel about it now?

Secilia Spellman:

Oh, man. Well, it’s interesting because as a dental hygienist we already are grossed out by all of the blood, spit, and pus that lands on our forehead. Let’s be honest. Like this is a no go – this is just disgusting zone. So, I think going forward, my emotions of paranoia are certainly heightened at this point. After being home and unemployed for so long, I’m anxious to see my patients. We build these relationships with people and all sorts, you name it, with our staff and our patients. I miss that relationship and knowing how they’re doing. I have a patient who’s turning 100 in July and she was inviting our office to go, and I don’t think that’s going to happen. So, there’s this anxiety about going back in, like a good anxious of wanting to see everyone and be around and talk to people.

However, there’s also a huge part of me that knows when I go back, it is not going to be the same there. The protocols are going to have to change. I think research and reading your part on the as much as you can without diving too deep in the internet because the internet is like a really dark hole sometimes. I think really sticking with the ADA and then the CDC, which are all pretty much on the same level haven’t changed much.

Talking to my boss, that’s been another one. My doctor, we’ve been in communication pretty much about once a week, so not too much and it’s been maybe like 30-minute conversations. He’s reached out to me. I’ve reached out to him. That gives me comfort. So with that anxiety, I’ve been able to find comfort and speaking and communicating with him because no matter what the end of the day when I walk into that office, it is his responsibility to make sure that we all feel safe, including our patients.

Building Trust With Your Dentist

Rolando Mia:

That is so cool. So, you work at Mesa Dental in Santa Barbara and that’s owned by Dr. Walter Dukes. Is that correct? And that the practice has been around for quite awhile?

Secilia Spellman:

Oh yeah. He built the entire building. This May will have been 32 years.

Rolando Mia:

Wow. That is awesome. From an operational perspective, we’re starting to hear rumblings that the States are going to start loosening up and letting people start slowly get into back into the rhythm of working and all that. What are some of the things that you’re doing to prepare – you and your practice or you personally?

Secilia Spellman:

Definitely being involved with the community and talking to people. There’s been a lot of emails. I am a part of a local component in town called, “The Santa Barbara Dental Hygienists Association”. I think communication with all of the women that I connect with there and hearing, I don’t want to say gossip, but information about different practices. For example, such as protocols that they’re implementing that might not be what’s recommended yet but could be a good thing to implement into our practice. That’s been one of the things we’ve been doing. I hate to say it as far as like the ADA and the CDA, the recommendations from them hasn’t changed too much unfortunately.

My doctor has been fantastic about making sure collectively every week he’s maxing out his PPE orders. You know, there’s a limitation obviously of what we can order and what we can have access to. I do think as far as accessing N95’s, those need to be priority for hospitals and people who are really dealing hands on.

So, he’s been able to access surgical Level 3 masks and is getting full stock of those. We’re getting the face shields; he’s getting them in bulk as much as he can have and also full gowns. You know, making sure that we have proper evacuation systems, things that can help us a suction, like the Isolite system. He’s also looking into different things that we can use for vacuuming the air quality in the rooms too. So, we’ve been really just trying to collect this stuff more than anything so that we at least have the products to be able to help our patients.

Adopting Technology to Keep Dental Hygiene Teams Safe

Rolando Mia:

That’s great. So, I love the preparation and all that. When you look at organizations like the WHO, CDC, ADA, they’re going to give guidance, but at the end of the day, from what we understand, you have a choice to do what you want to do. What specifically are you going to do in your practice and why?

Secilia Spellman:

Oh man, myself personally? My doctor and I actually talked about this and he recognize that there’s going to be staff that is not going to come back. They’re going to make that decision to not come just as patients are going to make that decision out of fear or worry that they should not to come too. People can play their precautions as they choose to, if that makes sense. Personally, surgical caps are perfect example. I started looking into what the nurses and the staff are wearing in the hospitals that I could wear. Remember, I’m at that 99.7% chance of contracting this virus.

So, however I can prevent myself from bringing it home, I will do. So, wearing a surgical cap that has a water resistance to it. My loops are also a perfect example of a huge potential for transmission. I’m not leaving my office with my scrubs on that. Nobody’s even discussed it to me, but it’s gross enough as it is on a normal non-covered day. So, there’s going to be a trash, we have washer and dryer. There is a Lysol disinfecting detergent you could use for clothing specifically. So, having that in the office and you know, leaving my scrubs, doing a load in the office so we’re not bringing it home. That’s my biggest concern is just making sure that I can keep my home safe too.

Rolando Mia:

That is cool. I love the precautions that you’re thinking about. I also think, like your scrubs, you mentioned getting covered with and having all that splatter on you from working on your patients. You mentioned that you’re a member of, “The Santa Barbara Dental Hygienists Association”. First of all, I’ve the opportunity to meet that team, the organization, and they do wonderful CE. I really appreciate kind of the energy that everybody has. What’s the discussion that you’re having with your colleagues and other members of that team? What’s the overall feeling that you have about coming back?

Secilia Spellman:

You know, I really haven’t heard too much reservation from anyone. Everyone seems pretty anxious. We live in a pretty expensive town, so everyone right now is kind of like, “Oh, I want money. I need to make money.” We love our patients, we hopefully love our bosses, we love our office, but we do need money at the end of the day.

So, I think you know, collectively speaking with everyone, a lot of the people I volunteer with, they all have families. They all have children. We do not have children. So they are enjoying every second they can have being with their children. I think it’s amazing. I’m enjoying just having a break that I didn’t even realize I needed. But collectively, one of the things that we had discussed was wearing a face shield.

Back in hygiene school we had to wear face shields, we had to wear the bonnets across our heads – super attractive times. We had to do all of that stuff. So, trying to find ways now to do it and make it more comfortable. That was a huge conversation we were having just this week. There’s been a lot of frustrations with some of the people that I’ve communicated to with about their offices saying stuff, you know, opening earlier than they’re supposed to and giving dates.

There’s a lot of anger towards it too and frustrations and fear because they don’t have an open line of communication with their boss, they need to have that in order to be able to feel comfortable going back and maybe they don’t have it.  That’s mainly with the association of the girls that I do get to talk to. Really, we haven’t gone much deeper than that.

Having Trust in Your Practice’s Operations

Rolando Mia:

Thank you for that. First of all, for the patients who might have happened to cross this video or who happen to be listening right now, what’s the message that you’d want to give them to reassure them or to help them overcome some of this?

Secilia Spellman:

They need to have trust and faith in their practice just as much as I do, period. So, if I’m going in there then you can go in there. To be completely honest, if I didn’t feel safe, like I said, I have a genetic lung disorder, I would not go in there if I didn’t think it was safe for myself.

You want to have that person to have the perception and visibly of seeing that we are making those changes, not just walking in and it’s a normal regular day. You know, having them wait outside in the car. That’s a perfect example. You don’t have to fill a waiting room for heaven sake, please don’t. I was just having a doctor’s appointment a couple of weeks ago. I had it booked a year, so I was really hoping they weren’t going to cancel on me.

It was a first thing in the morning appointment. I went in and another woman came in just about at the same time and then a third woman came in. The third woman came in, you know, covered head to toe in definitely more than just the N95 mask. I understand she was paranoid but because the waiting room had three people, she went into a sheer panic and that’s what we need to avoid. We need people to not panic.

So, preventing that panic, making sure that you have, a different set of protocols. Like for instance, “Hi, I’m in the parking lot right now and checking in.” Having them calling the front desk, and letting them know, “Okay, it should be a couple more minutes. We will call you as soon as it is time for you to come in for your appointment.” That’s a perfect example. Allowing them to come in and see hand sanitizer.

I know the country went a little crazy. I mean between hand sanitizer and toilet paper. We had patients stealing our toilet paper. We did – it was crazy cause we keep it in like a basket in the bathroom. But having, hand sanitizer, it’s becoming more readily available. I know it’s still not that easy. Trust me, I have tried. As it becomes available, even if it’s that one bottle you can get when you’re at CVS, start collecting things now having outside on a little table before they enter, having it at the front desk, having doors propped open, not closed where you have to touch door handles.

Viewing that kind of stuff from a patient’s perspective is going to make them just as comfortable as it’s going to make me comfortable. At the end of the day and seeing that we are doing all of the protocols, that’s what I want to achieve for them as well as myself.

Rolando Mia:

Right. It sounds like make sure patients who are considering going in, make sure they know that you’ve put things in place. I love this statement, “Hey, if I’m willing to go in, you need to also be, because I’m not just exposed to one, I’m exposed to everybody.” That’s a great message. I want to reassure you, I feel comfortable. Establish clarity around the things we’re doing in our offices specifically.

Secilia Spellman:

100%. I can’t stress it enough. I wouldn’t go do something if I didn’t feel safe and that should go for every single person. You should be able to feel comfortable with that thought process, period.

Honest Communication With Your Dental Team

Rolando Mia:

I love that. It’s clear or at least based on what I’m seeing here, you have a wonderful relationship with Dr. Duke’s and you’ve got the courage to say what you think. For other people who may not have that kind of courage or who are struggling with that, what advice would you give them with regard to how to communicate with their doctors, with their colleagues?

Secilia Spellman:

You know, I have a pretty broad experience in different offices. I originally worked in Florida at a practice, a couple different practices, and then I came out here. If you do not have a relationship with an office manager or your doctor in a way that you feel comfortable to be able to constructively speak with them, why are you there? That’s it.

At the end of the day, you really need to value some form of a relationship. Now, on behalf of my practice, I am a team lead. I supervise the back of the house. I have had multiple accounts where people have come to me specifically to discuss frustrations, worries, or they don’t understand something, you name it. I’ve helped everyone in the practice at some point or another.

So, having someone that you can designate as your “go to” person and be able to talk to them, I think is really valuable, but if you don’t have it, why would you? If you’re spending so much time at another place other than your home with your family and you’re not getting that kind of relationship with the people, it’s a waste of your time to be completely honest. I have this and I’m very lucky. My doctor and I have very constructive conversations. He does come to me for advice. I come to him for advice. We communicate very openly whether we agree or not and we are very different people too. It never gets heated. He takes everything I say into consideration vice versa.

So, I think that if you are not a boisterous person as I am, you need to have someone as your voice and someone that you feel like you can go to and communicate with. Tell them, “I’m not comfortable with this.” Or better yet, instead of saying what you don’t like, how about you come to somebody with an option like, “Hey, do you think we could do this instead? Or have you seen the research on this device? Or this is way to do something that will make a better atmosphere for everyone.” You need to have an advocate.

Rolando Mia:

That is awesome. Thank you for the sentiment around it, which is, “Hey, if, if this isn’t where you are comfortable, why are you there?” That really hit me hard because why expose yourself or why put yourself in a situation where you’re miserable for that amount of time.

I asked that because we had a guest on several weeks ago, her name is Michelle Strange. She’s also a Registered Dental Hygienist and runs a podcast, “A Tale of Two Hygienists”. She did a survey and one of the results of the survey had this context around, you know, she asked upwards of 700 RDH’s, you know, how they felt about what should be in place and almost half felt that things could be better. It sounds like from your perspective, you have an audience with your doctor, with Dr. Dukes that makes it easier to change those things. I think that’s really important.

What are your thoughts on so many dental hygienists feeling that their offices need to upgrade infection control protocols in their practice?

A Change For Infection Control

Secilia Spellman:

Oh man. Yeah. You’re talking to regards to if they think there should be a change in their infection control in their office, right?

Rolando Mia:

Yeah. It should be better.

Secilia Spellman:

Again, it goes to speaking up. So, at the beginning of my career I was very fortunate enough to be able to civilly work at an air force base in Florida. That protocol, there is no getting out of that box. You are set, there is a certain way you’re supposed to do something, and it is OSHA regulated to a T. It gave me a huge perspective of how things were supposed to be. I remember volunteering in Southern Florida. It was like a community kind of health dental clinic and people putting their hands in things with no gloves and that was a clinic on top of that. You can’t be in those environments.

If there are staff members that are not willing to do that no matter how many times you throw them a pair of gloves, why are they hired? Why are they here if they’re not going protocol? Cause at the end of the day of OSHA comes in that door and they see that assistant or doctor or hygienist or the front desk person in the back – that fine is hefty. It’s not worth even risking something like that. I’m sure about more than half of Santa Barbara offices do have things that need to be tweaked a bit and far as far as infection control goes, I think that this opportunity with Covid-19 is going to change offices a lot.

I think those doctors and offices who are really set in their ways, who didn’t want to buy, instruments for instance, they’re really going to have to change. I think this is going to hopefully scare them enough to make them change. This also might potentially make OSHA go a little more rampant. They might start circulating around a little bit more potentially just to avoid that spread. I think infection control needs to be important in a practice.

Again, if you’re working in a practice that doesn’t value infection control, are there staff members that don’t value infection control? Something as simple as just doing a lunch and learn with many groups who are willing to come in or doing it on behalf of your own staff and just going over protocols. It needs to be done. Period.

Rolando Mia:

I love the message. If it isn’t important, it needs to be important.  With regard to infection control, aerosols are a big issue right now.

Everybody’s talking about aerosols and the fact that you need constant hands-free evacuation, etc. What are your thoughts on aerosols and how do you feel about the fact that they can potentially float in the air for hours?

Isolite Isovac System and Safety In Dental Hygiene

Secilia Spellman:

Oh man, I think, well, it’s disgusting. However, we’ve always known that. Now with this Covid-19 virus, it’s not just like spit and blood that I’m concerned with, now I have to know this virus is floating for hours on end. Products are going to come out, they’re going to help with stuff like that. I am like a huge fan of the Isolite system. Especially when using the Ultrasonic scaler so that I can reduce that amount of aerosol spray.

You know, I’m very lucky my office, I have double doors that keep open out to the beautiful ocean. So, I do have that ability to have clean air. However, we’re going have to come up with some kind of air circulation process though. That’s going to have to happen I think in order to make people more comfortable. You know, the more, the better in my opinion. Your PPEs it’s not going to hurt to put on all this stuff. Is it going to suck? Yeah. Am I going to sweat to death? Probably. However, the more air circulation we can have, the better.

So, we’re looking into different air circulation as well as speaking you know, with our rep through Zyris about our Isolite products too. We’re, trying to get as much as we can to get that crap out of the air and get it filled or get it out so that we don’t have to sit in there all day long, you know, and just recycle one patient after another. Who knows what could come in?

Rolando Mia:

Awesome. Thank you for that. From a hygiene perspective, how do you feel? I get a sense that you love your profession. Does it change your opinion about your chosen profession given that there’s this crazy virus going on right now?

Secilia Spellman:

Oh, definitely doesn’t change my opinion. I’ve had a couple moments where I’ll be at the grocery store and I’m fully covered with my N95 mask and I see my patients and it’s like, I feel like it’s not even a time for me to go and talk to them and say, “Hi”, to them cause it’s not like I can touch them on the shoulder or I can take my mask off or anything like that.

I wouldn’t change what I chose as a career. I would never change it. It’s brought a lot of fulfillment for me and my success. I’ve been very lucky in all the practices, coming from Florida and to California, Santa Barbara has been very good to me. I have worked at a couple different offices, 3 different offices in town. I am at a home base with Dr. Dukes. I am full time with him five days a week. I wouldn’t change it for the world.

Rolando Mia:

Oh, that is awesome. I love that. That is so cool. So, if you were to sum up everything that we’ve been talking about and you wanted to get a message out there regarding, what’s happening, where we’re going, what message would you like to give people?

Secilia Spellman:

You know, what I just hope for people, is to learn to be patient. You know, this is a time for everyone. It’s not just dental hygienists, it’s everyone. We need to step back. We need to be patient and we need to be kind. I know a lot of that not being patient can come with some aggression, anger, and anxiety, you name it. However, if I could give any advice to people in general, and you know, my dental hygienists, my assistants, my people who are eager to go back to work is to be patient and step back, enjoy the time that you can with your family. I hope that it’s safe for people because I know some homes aren’t having a great time being home, but be patient and trust that our authorities are doing what they need to do in order for it.

Be a decent person. Go back to work and stay active in the internet world of your community. You know, talking to people, reaching out, everyone’s got access in their hand for the most part with their phone to be able to find information out. Be careful with your websites. I’m really staying on the ADA, the CDC, I’m staying very closely with those because there’s a lot of rubbish that comes through that is shocking. I could go into work wearing a snorkel, you know, whatever. But to be patient, be kind, and trust that our system is doing what they need to do.

Do your research, now’s a perfect time to do some home continuing education. I know I have several Spanish speaking patients, like there’s so many things that we could be doing to help keep our minds going and stimulated so that we don’t have this almost culture shock going back to work cause it is going to be hard and trust that the system is doing what they are doing for a reason.

Rolando Mia:

That is cool. That is awesome. I love that. If people had questions or wanted to reach out to you or ask you stuff, can they contact you? Would that be okay?

Secilia Spellman:

Yes, please. I hope I have answers. I can’t promise anything.

Like if people just need to have conversation, I think that’s important. So if people just need to talk to someone other than their family and about, you know, dental and they feel like they’re just trapped in their four walls with their family who don’t quite understand and want a conversation or they do have questions or maybe advice that I could possibly give. Yes. They most certainly can reach me.

Rolando Mia:

Awesome. They can also reach out to the Santa Barbara Dental Hygienists Association. From my experience, the members of that team have the same energy, the same passion.

Secilia Spellman:

We do have a Facebook and it is attached to mine. So if anything, if you do feel like messaging the Santa Barbara Dental Hygienists Association, there is a couple of us who are attached to it. So, one of us will get to the email. No problem.

Rolando Mia:

Awesome. Thank you for taking the time to spend with us this morning.

The energy that you bring, your perspective, it’s so wonderful. There’s a positiveness that I think we definitely need this time. I love the fact that you’re very pragmatic and direct about things. A really strong message that that came out is be direct. So thank you for that.

Secilia Spellman:

Yeah, just be direct. It is so important.

Rolando Mia:

There you go. So those of you who are listening, if you have any questions, please feel free to reach out to Secilia. Thank you for joining us. Please be safe

Have a great week. Thank you so much for your time.

Secilia Spellman:

Thanks – so good to see you.