The Doctor-Hygienist Hand-Off

As a formerly practicing hygienist and now a dentist, I am respectfully sensitive to the time constraints and importance of the information exchange during a periodic exam in the hygienist’s treatment room. My team and I developed, practice, and teach this exchange for thoroughness, patient benefit, and emphasis of our professionalism.

When the doctor enters the hygienist’s treatment room, the hygienist is to highlight and summarize her findings in the most efficient and effective verbiage. For example, “Dr. Kern, Mrs. Jones is doing well. We reviewed her medical history and her diabetes is under control with a new medication, “x,” she continues to take “y” for her hypertension (BP), “z” for her allergies, and “v” for whatever systemic disease. She has just returned from a trip to see her family in Iowa, as her mother is ill,” or “her son is getting married in a few months.” In just a sentence or two, the hygienist has informed the doctor and confirms to the patient that the hygienist is aware of their medical condition(s) and stress level.

“The oral cancer screening was within normal limits except for an aphthous ulcer adjacent to #3 in the vestibule, could you please confirm that, Doctor?  On the restorative exam, I noticed the old mercury filling on #30 is chipping at the margins,” or “I felt a ‘soft spot’ around the margin of #3,” or “there are a couple of areas on the radiographs.  I’d like you to check between #3 and #4—Doctor, could you please check that during your exam?” If the doctor has recommended treatment at a previous appointment, the hygienist would also share that information aloud.

“Mrs. Jones says she is using a Sonicare™ brush as well as a Waterpik™ daily and she’s doing a good job reaching most areas.” Alternatively, you might review that “when she was on vacation, she was a bit lax with her homecare so there is room for improvement, and I will be reviewing technique with her today.” These comments about the patient’s oral hygiene homecare should be honest and factual, not condescending.

“During my periodontal assessment, I noted bleeding with probing/sweeping and pocket readings of generalized 4-5mm. I am concerned about a possible infection around #30 and #31 where there are pocket depths of 6mm with heavy bleeding.” This information is invaluable to the doctor. With active signs of disease, a recommendation for OralDNA® saliva testing is made.  The hygienist might conclude by stating, “I’m recommending 4 appointments of therapy to treat the infection in x areas, with an OralDNA® specimen collected first, to better understand the cause of the possible infection.”

We call this exchange of information the Hand-Off. In just a few sentences, the patient’s condition is summarized in front of them, in non-dental terminology, thus positioning the doctor to quickly direct his or her attention to the areas of most concern.

The Hand-Off can increase your time efficiency and includes:

  • Medically significant information
  • Oral Cancer screening review
  • Restorative needs or areas of concern description(s)
  • Periodontal assessment – homecare, infection and inflammation levels, hygienist’s recommendations

This is just one of the principles my training touches on. Please visit the OralDNA® Labs Protocol Directory for more information.

For more information on how to become an OralDNA Provider – scan HERE: 

Jeanette Kern DDS
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