Dental Hygienists Change Routines for New Safety Technology





By Lexi Marino September 28, 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 Season 2, we’re focusing on, “What’s Working and What’s Not”, where we’ll debunk myths by assessing trial and error since the start of Covid-19 in dentistry. 

In this episode, we interviewed Amy B. Rudnick to hear how in 40 years of practicing dental hygiene, COVID-19 has been the most difficult hurdle she’s had to overcome. Heavy emphasis in this episode surrounds adopting new technology into dental hygiene routines in order to stay safe from respiratory infection.

Watch this video to learn the following:

    • Importance of continuous HVE in addition to PPE
    • Understanding the role of dental hygiene and its relationship with viruses
    • Using intraoral high-volume evacuation and its relation to negative pressure
    • No routine is permanent – we always need to be adapting.

Transcription

Rolando Mia:

This is Rolando Mia with Dental Voice, Season 2 presented by Zyris. We are here with Amy B. Rudnick, RDH at One Manhattan Dental. We’ll dive right in here.

So, okay, you’ve been and continue to be a professional, a hygienist, and have been doing this for over 40 years. You’ve probably seen some incredible things and some crazy stuff. Let’s dive into the context around AIDS and bloodborne diseases. Have you ever seen anything that is anywhere close to what we’re seeing with COVID now or not?

COVID-19 And 40 Years of Dental Hygiene

Amy B. Rudnick, RDH:

No, this is by far the most profound change in dentistry. This is totally unexpected. We’d never planned for something like this. We never expected something like this would happen. So no, this is a big leap from what we were used to.

Rolando Mia:

How does it compare to some of the other, crisis’ or issues that you faced over the last 40 plus years of yout experience?

Amy B. Rudnick, RDH:

I have to say, this is the worst. This is one knocked us for a loop. It came out of nowhere and came very quickly. We had to come up with ways to deal with it.

Rolando Mia:

How has it affected what you’re doing? How has it affected the way you’re dealing with, treating, and caring for your patients?

Amy B. Rudnick, RDH:

It’s quite different. We had to really scramble to find the best way to treat our patients. Although Dr. Raimondi and Dr. Sclafani clearly took the time (during the time that office was closed) to come up with every way possible to keep our patients as safe as possible. They didn’t stop researching, calling, and getting everything that we needed to feel comfortable to be open, not only for our patients, but for ourselves.

Rolando Mia:

So, during the course of this series, Dental Voice, we’ve spoke with a lot of clinicians one of the most common comments we’ve received is anxiety around fear. For example, we hear dentists say “Oh, goodness gracious. Am I exposing myself? Is there the potential or possibility that I may get this in spread it?” How do you feel about that and what went through your head as you were preparing to come back?

Practicing Dental Hygiene In A Pandemic

Amy B. Rudnick, RDH:

I was terrified to come back. The whole thing was daunting, particularly since I’m here in Manhattan, New York. The numbers at that time were very high, probably one of the highest in the country and the thought of going out there and being with my patients again, produced a lot of anxiety for me.

However, the communication with Dr. Raimondi and Dr. Sclafani through the whole time that we were closed, eased up my anxiety a lot. Certainly, as time went on, I actually went back into the office for the first time and there was definitely anxiety the first few days. But we all calmed down when we realized that we are as safe as we possibly could be.

Rolando Mia:

Ah, it it’s, I can’t even imagine, especially given how much I’m going to call it hysteria, how much hype, how many things were being thrown out there about who’s at risk and what kind of risk and how to get it. Now that you’re in place, now that you’ve been war the office is now open. What are some of the things that you’re experiencing? What are you seeing? How are you feeling about it?

Amy B. Rudnick, RDH:

I’m feeling better about it myself. I’m seeing a lot of patients who are very nervous to come in, but I think that the way we communicated with our patients through social media, through newsletters, through emails, if they were that anxious, they wouldn’t have come in the office. So, I think there was bit of safety that they felt with the things that we were doing for them.

Rolando Mia:

I love the fact that you took the time to not only educate yourselves, but also to take the time to reassure, and communicate with your patients about what’s happening right now.

Across the country, there still continues to be a lot of things going on. And one those things is that there are hygienists out there feeling anxious because of tools like the Ultrasonics instruments, and they’re potential to produce a lot of aerosols and there’s a feeling of anxiety around that. What advice or insight could you share with them who might join us here?

Advice For Other Hygienists

Amy B. Rudnick, RDH:

Our office was quite prepared. Aerosols was the main focus. If you do the right thing in a dental office, the anxiety is lessened. We have air filter systems throughout our office. We have more of them than we need. I think we have 18 systems. Our dentists went above and beyond in terms of what we needed in our office. We use the correct PPE. I use a new cone system that’s attached to my high-speed suction so that patients aren’t rinsing in the sink. One device I use, that I’m particularly very fortunate to have, is the Isolite®. It’s a device that’s placed in the patient’s mouth attached to a high-speed suction and it has been a game changer for me.

Rolando Mia:

This is consistent with what we’ve heard – the importance of having multiple systems in place. Had you heard about our dental isolation systems, like the Isolite®, before you ever used it?

Amy B. Rudnick, RDH:

Never.

Rolando Mia:

Your entire career?

Amy B. Rudnick, RDH:

No. I know that Dr. Raimondi and Dr. Sclafani did their research and found that that was the best possible way to treat the aerosols coming from patients.

Rolando Mia:

Okay. I’m curious, what did you think of the system when you first saw it, honestly?

Opinions on Isolite For Dental Hygiene

Amy B. Rudnick, RDH:

How in the world is this thing going to fit in a patient’s mouth and how will my patients accept it? I have to say that we practiced on each other. Once I put it in the first time, it really wasn’t difficult after that. It’s a game changer. It’s as daunting as it looks to a patient, once it’s in their mouth, most of my patients were very accepting of it.

Rolando Mia:

So, did you have to change how you were working? We hear sometimes that especially with hygiene, it can be difficult to work with.

Amy B. Rudnick, RDH:

No, I didn’t find it difficult to work with. The first few times, I had to work with the patient to make sure that they were comfortable. I find that the best part of the Isolite, it has a tongue retractor. As any dental practitioner knows, working with the tongue is very difficult. That’s one of the most difficult parts of treating a patient and with the Isolite in place it just makes it easier.

Rolando Mia:

Oh, now there are other systems that you also integrated into the practice. How, what is your experience with them? How does it, how is it feeling having to kind of add all of those other systems into, you know, with what you’re doing? 

Amy B. Rudnick, RDH:

Well, the air filter systems are sitting on our counters. The cone evacuating system is simple to use patients find it easier than reaching over and rinsing in a sink. The PPE is the difficult part, and I have to say using a mask is not fun.

Rolando Mia:

How was that? What’s your experience with that? How are you getting through that?

Learning Curves With PPE

Amy B. Rudnick, RDH:

So, we have N95’s and are wearing a Level 3 surgical mask over the N95’s. We have shields that were actually custom made for our office, Dr. Raimondi and Dr. Sclafani worked with a company that created our shield so that they fit over our loops and our light. So I have to say the first couple of weeks, it was quite difficult. I think we were all exhausted when we finished work. There’s a learning curve to it, but like anything else over time, it gets easier.

Rolando Mia:

From a practice perspective, the patients are coming in, what are the most common things that they’re expressing to you? Do you feel that they’re apprehensive about coming into the dental office now?

Amy B. Rudnick, RDH:

You can tell the ones that are apprehensive. I had somebody come in with gloves and she shimmied down the hall because she didn’t want to get near anybody. She actually said to me, when I started working, “Should I take my mask off?” Which I thought, “Okay, this woman is quite anxious.”

There are people that are just fine, but I think there’s a trust in our office. The patients wouldn’t be coming back without the communication that they had through the doctors. They felt safe enough to come in during this epidemic.

Rolando Mia:

I can understand kind of that anxiety. You’re working in the mouth and you’re being asked, “Should I take my mask off?”

Amy B. Rudnick, RDH:

Exactly.

Rolando Mia:

It’s interesting. There there’s studies out there right now, and I’d love to get your perspective on them, the news about “Mask Mouth”. Are you experiencing, are you seeing any of that, or are you seeing any of the byproduct of people wearing masks all the time?

Infection Control in Dentistry

Amy B. Rudnick, RDH:

I mean, there have been some complaints about people’s skin breaking out there. People in general are complaining that they have to wear the masks. It’s not a comfortable thing to see. I have a few patients coming in. They were so happy to be in my office with their mask off, because it was the only place they were allowed to go out without a mask on.

 

Rolando Mia:

So, in terms of infection control and the process of dealing with airborne diseases, aerosols, droplets, what are your thoughts around that? What would you say it working for you all?

Amy B. Rudnick, RDH:

The air filter system and the Isolite’s are very helpful and I can see this because when I am done with a patient and I go to clean my shield and there are no droplets on the shield. It shows that the device is actually working quite well. As hygienists and dentists, we have always treated every patient as if there’s some communicable disease that we can get. That’s just how we practice. So, this is just an extra layer of that.

Rolando Mia:

Do you feel that as we go forward, that it’s going to settle more or do you feel that there’s going to be more that can be piled on?

Amy B. Rudnick, RDH:

I don’t know that it’s going to be more, my feeling is that this may be the norm. This is just something it’s not like when this is over, which it will never be completely over when this is over, we take everything off. I think that this is going to be the new way of practicing dentistry.

Rolando Mia:

Okay, for the young folks out there who are considering hygiene school or dental school. What advice would you give them, or what would you tell them?

Advice For Students in Dental Hygiene School

Amy B. Rudnick, RDH:

That if they want to practice dental hygiene, there’s a few things that come along with the job. We’re dealing with patients, we’re dealing with viruses, we’re dealing with bacterias – that’s part of the deal. You should keep in mind that you need to do what is right for you and keep your patients safe and then enjoy the job. After that there’s relationships that can be established through this job that are just priceless. That’s the part that I really cherish. I have friends that I’ve grown very close to in my practice. That’s why I look forward to going back to work. So if I have to wear a mask and I have to protect myself, that’s just part of the deal.

Rolando Mia:

Wow. So, would you say that it continues to be one of the most fulfilling and kind of enriching things you can have? If you understand that?

Amy B. Rudnick, RDH:

I wouldn’t be working this long if I didn’t find it fulfilling. I like being at work and working with my staff. We have an incredible staff at One Manhattan Dental. We’re very close. Our doctors are terrific and we’re a team. It’s not “the bosses” and “the workers”. We are all a team and we work together. So, to me that that’s a fulfilling part of my job. And then there’s the added relationships that I have with patients and teaching, educating, and keeping people healthy. Also, building a trust so that your patients listen and take your advice.

Rolando Mia:

Oh, that’s so cool. I’ve gotten to meet the different members of the One Manhattan Dental team and it’s astounding to me, the relationship, how well you all get along together. We’re hearing out there that, that’s not the norm in a lot of practices. What advice would you give people who may be struggling a little bit with that relationship since you have such a good one.

Importance of Working As A Team

Amy B. Rudnick, RDH:

I think the key is that we, as I said, we’re a team. It’s not as much of a hierarchy as a lot of dental offices where the bosses tell you what to do and you’re just “the staff”. We’re a team. We are all respected. All jobs are as important as each other’s. We have meetings every week. We asked for advice if there are issues, I don’t think anybody really has a problem going forward and expressing their issues. That’s an important aspect of working in a team.

Rolando Mia:

That is so cool. Here’s what I’m hearing: Be open, be direct, make sure that you express things that you’re feeling.

Amy B. Rudnick, RDH:

Yeah. Then they boil up and then things get ugly. So yeah, just be open, be transparent, and be respectful. Those are the three things that help.

Rolando Mia:

It’s the feeling that you get in engaging with the team, it’s absolutely wonderful. I appreciate the message that you give about the way you work together, the way you are and the energy to bring your entire group. I love that. So, as we kind of bring this together, what closing words would you like to share with the dental community out there?

Amy B. Rudnick, RDH:

Well, for our patients, the message is that we’re doing everything that we can possibly do to keep them safe. For doctors please be respectful of your staff, listen to them. As a staff member, if there are things that are really irritating or annoying, talk about it. You know, just bring it forward. There’s always a resolution if there’s respect amongst the staff.

Rolando Mia:

That is so cool. I personally feel it’s important to listen hear from people who have been in this industry for a while. You’ve been successful over the past 40 years in your craft in treating your patients, you know, or you’ve heard hygienists, dentists, they don’t just clean teeth or make beautiful smiles. They actually help the systemic health of people and because of that, people’s lives are better. I really appreciate you continuing to do that.

Amy B. Rudnick, RDH:

Thank you very much.

[gravityform id=2 title=false description=false ajax=true tabindex=49]
<div class='gf_browser_unknown gform_wrapper' id='gform_wrapper_2' ><div id='gf_2' class='gform_anchor' tabindex='-1'></div><form method='post' enctype='multipart/form-data' target='gform_ajax_frame_2' id='gform_2' action='/dental-hygienists-change-safety/#gf_2'> <div class='gform_body'><ul id='gform_fields_2' class='gform_fields left_label form_sublabel_below description_below'><li id='field_2_6' class='gfield gravityFormEmail gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_2_6' >First Name<span class='gfield_required'>*</span></label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_2_6' type='text' value='' class='large' tabindex='49' aria-required="true" aria-invalid="false" /></div></li><li id='field_2_7' class='gfield gravityFormEmail gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_2_7' >Last Name<span class='gfield_required'>*</span></label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_2_7' type='text' value='' class='large' tabindex='50' aria-required="true" aria-invalid="false" /></div></li><li id='field_2_8' class='gfield gravityFormEmail gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_2_8' >Practice Name<span class='gfield_required'>*</span></label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_2_8' type='text' value='' class='large' tabindex='51' aria-required="true" aria-invalid="false" /></div></li><li id='field_2_11' class='gfield gravityFormEmail gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_2_11' >Phone<span class='gfield_required'>*</span></label><div class='ginput_container ginput_container_phone'><input name='input_11' id='input_2_11' type='text' value='' class='large' tabindex='52' aria-required="true" aria-invalid="false" /></div></li><li id='field_2_1' class='gfield gravityFormEmail gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_2_1' >Email address:<span class='gfield_required'>*</span></label><div class='ginput_container ginput_container_email'> <input name='input_1' id='input_2_1' type='text' value='' class='large' tabindex='53' aria-required="true" aria-invalid="false" /> </div></li><li id='field_2_2' class='gfield field_sublabel_below field_description_below gfield_visibility_hidden' ><label class='gfield_label' for='input_2_2' >utm_campaign</label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_2_2' type='text' value='' class='medium' tabindex='54' aria-invalid="false" /></div></li><li id='field_2_3' class='gfield field_sublabel_below field_description_below gfield_visibility_hidden' ><label class='gfield_label' for='input_2_3' >utm_source</label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_2_3' type='text' value='' class='medium' tabindex='55' aria-invalid="false" /></div></li><li id='field_2_4' class='gfield field_sublabel_below field_description_below gfield_visibility_hidden' ><label class='gfield_label' for='input_2_4' >utm_content</label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_2_4' type='text' value='' class='medium' tabindex='56' aria-invalid="false" /></div></li><li id='field_2_5' class='gfield field_sublabel_below field_description_below gfield_visibility_hidden' ><label class='gfield_label' for='input_2_5' >utm_medium</label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_2_5' type='text' value='' class='medium' tabindex='57' aria-invalid="false" /></div></li><li id='field_2_12' class='gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_2_12' >Email</label><div class='ginput_container'><input name='input_12' id='input_2_12' type='text' value='' /></div><div class='gfield_description' id='gfield_description_2_12'>This field is for validation purposes and should be left unchanged.</div></li> </ul></div> <div class='gform_footer left_label'> <input type="image" src="https://www.zyris.com/wp-content/uploads/2019/10/submit-button-17.png" id="gform_submit_button_2" class="gform_button gform_image_button om-trigger-conversion" alt="Submit" tabindex="58" onclick='if(window["gf_submitting_2"]){return false;} window["gf_submitting_2"]=true; ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_2"]){return false;} window["gf_submitting_2"]=true; jQuery("#gform_2").trigger("submit",[true]); }'> <input type='hidden' name='gform_ajax' value='form_id=2&amp;title=&amp;description=&amp;tabindex=49' /> <input type='hidden' class='gform_hidden' name='is_submit_2' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='2' /> <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' /> <input type='hidden' class='gform_hidden' name='state_2' value='WyJbXSIsImQyMTNiNWE3MmNhZTQ4NWEwYWU2MGI4YjVhZjQ3YThjIl0=' /> <input type='hidden' class='gform_hidden' name='gform_target_page_number_2' id='gform_target_page_number_2' value='0' /> <input type='hidden' class='gform_hidden' name='gform_source_page_number_2' id='gform_source_page_number_2' value='1' /> <input type='hidden' name='gform_field_values' value='' /> </div> </form> </div> <iframe style='display:none;width:0px;height:0px;' src='about:blank' name='gform_ajax_frame_2' id='gform_ajax_frame_2' title='This iframe contains the logic required to handle Ajax powered Gravity Forms.'></iframe> <script type='text/javascript'>jQuery(document).ready(function($){gformInitSpinner( 2, 'https://www.zyris.com/wp-content/plugins/gravityforms/images/spinner.gif' );jQuery('#gform_ajax_frame_2').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_2');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_2').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){jQuery('#gform_wrapper_2').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_2').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_2').removeClass('gform_validation_error');}setTimeout( function() { /* delay the scroll by 50 milliseconds to fix a bug in chrome */ jQuery(document).scrollTop(jQuery('#gform_wrapper_2').offset().top - mt); }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_2').val();gformInitSpinner( 2, 'https://www.zyris.com/wp-content/plugins/gravityforms/images/spinner.gif' );jQuery(document).trigger('gform_page_loaded', [2, current_page]);window['gf_submitting_2'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}setTimeout(function(){jQuery('#gform_wrapper_2').replaceWith(confirmation_content);jQuery(document).scrollTop(jQuery('#gf_2').offset().top - mt);jQuery(document).trigger('gform_confirmation_loaded', [2]);window['gf_submitting_2'] = false;}, 50);}else{jQuery('#gform_2').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger('gform_post_render', [2, current_page]);} );} );</script><script type='text/javascript'> jQuery(document).bind('gform_post_render', function(event, formId, currentPage){if(formId == 2) {jQuery('#input_2_11').mask('(999) 999-9999').bind('keypress', function(e){if(e.which == 13){jQuery(this).blur();} } );} } );jQuery(document).bind('gform_post_conditional_logic', function(event, formId, fields, isInit){} );</script><script type='text/javascript'> jQuery(document).ready(function(){jQuery(document).trigger('gform_post_render', [2, 1]) } ); </script>
[if lte IE 8]
[if lte IE 8]