Mickey Smith

DH 220A

Tammy Maahs

Specialty Office Visit

On November 9th, I went to observe at a pediodontists office from 1-4. The

dentist there was Dr. Wiggins. He employs 3 full time assistants and 2 front desk

ladies. The assistants would take x-rays, polish the patients teeth, would go over

home care and proper brushing, and assist the dentist when he would come over.

The front desk ladies would check in the patients and let the assistants know they

were ready. They would also place orders for things back in the clinic if anything was

running low. They would bill insurance, they would make reminder phone calls and

call anyone else that the dentist needed called. Also they would handle anything

that was on the computer that the doctor needed to have done.

I observed one extraction of a primary tooth K, due to the fact that the

patient was in braces, and it was to the point where they needed 19 to come in to

finish his orthodontic treatment. Everything else that I observed were cleanings or

checkup appointments (for orthodontics) where they had the wires changed for their

braces or they had to make changes to rubber bands to get the teeth to move the

way they wanted it to. I put cleaning in quotes because they would just polish the

patients entire dentition since they were not forming calculus yet. If for some

reason they did have some calculus, then the Dr. would be the one to scale it off.

They had a speaker in the back where the person who was at the front desk would

call in and say DeeDee your patient is ready to head back. So she would go up

and bring the patient back to the operatory. It was a wide open clinic, the same as

ours. As you walked down the hall, to your left was a room where they would take
their radiographs and to the right they had what they called a quiet room. Where

they could take PAs if need be, but it was mostly used for children they knew would

be difficult. They would be able to isolate them from the rest of the children so they

would not freak out the rest of the children if they started to act up. They had 4

dental chairs, one was an overflow chair if they were really busy. Above each chair

they had TVs so that the kids could watch whatever movie they had on at the time

(it was Minions when I was there).

They had three computers for each assistant to chart on. They used Dentrix

for their charting program. If they were seeing a patient for orthodontic work, then

they would use a separate page with different auto notes to chart on/with. They

would use the Palmer notation for teeth as well. When they would see a patient for

a cleaning they would use the International notation for teeth and again had a

separate page and auto note options for that. So if they were doing both a cleaning

and an othro appointment (which they do) they would have to use both windows to

properly chart what they did for that apt.

They had a J shaped sterilization area to the left when you walked in. They

had an open ultrasonic (without a lid) that was mounted into the counter top. They

had a large autoclave and a statum. They would run everything through in the same

sterilization pouches that we use, but once they were ran through, they would un-

bag them and either make up a tray and store it for the next patient or tomorrow, or

they would put it in the respective drawers that it went in. They would only have a

small bag over the head rest of the chair and that was is. They didnt barrier

anything else, they did cavi-wipe everything thoroughly after the patient was

dismissed though. I thought that their sterilization protocols were about the same as

any other dentist office, except the open ultrasonic. That would be the only thing
that I would change about their system. It did differ from our own system in that we

do not un-wrap the instruments and put them away like that, as well as the un-

covered ultrasonic. It also differed in the fact that they only had one small barrier

over the head rest and we (LCSC) barrier everything. I do like the fact having

everything covered, I feel like it adds another line of defense to helping keep

everything sterile and clean for the patient.

A reason why a general dentist would refer a patient (a kid in this case) to

see a pediodontist, would be if the patient was causing a scene or uncompliant due

to being stressed out due to the dentist. Going to a pediodontist office is a lot more

relaxed for the kids, they have colorful murals on the walls, they have TVs in the

operatory, and the dentist talks to them differently than he would an adult patient.

All that added together would help put the kid at ease and make his appointment

easier for everyone involved.