Hello Friends,

2012 is right around the corner, and I hope it will bring us more opportunities to step up and be recognized as THE association for the Dental Assistants of Texas!

I have a renewed faith that we can and will make things better.  My theme and our challenge for 2011 - 2012 is to “Step Up!”

First of all, you have my word that I will Step Up, I will work harder, I will make it my personal mission to help everyone who has never felt the passion, or even those that have somehow lost it, find and feel the passion that I have for this association.

I am asking that all of you Step Up, do a little more, and share your passion too.

As we step up together, we may struggle, we may stutter, but we must keep trying.  Now, more than ever, we are dependent on teamwork.  A team like ours can score many runs and we have pinch hitters waiting to help when we get tired.  Let’s support each other and pick up the slack when one of us needs a hand.  We have taken a few losses in the past; we took them as a team.  We can also win as a team.  A great team never looks at a loss as a defeat; they look at it as a way to improve.  Let’s figure out a new game plan and execute for a win!

I was recently approached and challenged by a friend to help her find and feel this passion I speak of, to renew a tired body and soul.  She said, “Make me feel your passion.”  My first response was, “I can’t make you feel my passion, it must be within you!” I thought long and hard, and it came to me - I had said, “I can’t.” Since when do I say, “I can’t?”  I always told my girls, “Never say you can’t.”

You will feel this passion and WE WILL once again be a strong and a proud association! “Step Up, feel my passion and spread yours!” Thank you my friends, now, Let’s Play Ball!

Hugs to All,

Rosie Perez, CDA, RDA, BS

President, Texas Dental Assistants Association

rosie84069@aol.com

My Dear Treasured Mentors, 

You know yourselves as members of TDAA; I thank you for having faith in me this last year as your President. Our goal of more and renewed Membership will always stand before us and You are the key to the lifeline of TDAA. It has been my great pleasure to be able to visit some of the dental assisting schools and meet and talk with the students. This is the treasure box of members and they are just waiting for us to reach out and touch them. If you show them the value of being student members, they will join. With mentoring, they will stay. I thank you for all your hard work to grow our goal. There is exciting news coming from ADAA about student members and this will help us mentor to the students.

The Board made the annual session very special to me. The reception was beautiful. Who knew there are purple potatoes? My husband, my daughter and I are still laughing from the luncheon. You all are beautiful people and there are not enough words to thank you for all your hard work and support it took to make this a really great year for me as your President. THANK YOU! 

I would sign this as your IPP and I may be technically, but instead I am your President-Elect.

I look forward to working with and supporting our President, Rosie, as we Step-up and take “baby” steps to accomplish our goals.

Thank You,                                                 

Kathleen R. Boyle, BS, MPA, RDH, RDA

President-Elect, Texas Dental Assistants Association

kathleenboyle@att.net

May 2010

A new rule has been adopted under Chapter 114 by the Texas State Board of Dental Examiners (SBDE).  Rule 114.9 relates to the criminal history evaluation of dental assistants that may be ineligible for certification due to a conviction or deferred adjudication for a felony or misdemeanor offense.

Rule 114.9 - Criminal History Evaluation Letter

E-Mail Address for General Information: information@tsbde.state.tx.us

September 2009

Regarding SB 455 and other Certifications: The State Board of Dental Examiners is charged with the responsibility of developing Rules and Regulations mandated by Texas law for regulating the practice of dentistry and the enforcement of those rules and regulations. 

Board Rules:

TDAA is a Texas State Board of Dental Examiner's Approved Provider for Dental Assistant Registration Course and Examination.

RONDA V. LANE, BS, CDA, RDA

Annual Session Table Clinic Awards May 2010

 C O N G R A T U L A T I O N S!!!

Continuing Education (CE) and the CALENDAR of EVENTS page have been updated on TDAA.org. To review and learn what is available, visit this page: http://tdaa.org/contedu.htm

Attention MEMBERS! To print your Membership Card, to print Evidence of Insurance, to download CE’s or to update your MEMBER information, including adding your E-mail address to assist your association in sending newsletters & CE Information. Visit this page and click Log-In: http://tdaa.org/contedu.htm#ADAA

ADAA/TDAA Membership Invitation

ADAA and TDAA invite you to join your professional organization, and allow us to meet some of your needs. Benefits of Membership: $50,000 Liability Insurance, Credit Card & Signature Loan Programs, Accidental Death & Dismemberment Insurance, Employment Service through Dentalworkers.com, Member Discounts for CE & Home Study Courses, The Dental Assistant Journal Subscription, the TDAA Quarterly Bulletin, Fellowship Program, Free CE via the DA Journal, Prescription Discount Service, 20% Discount on Membership in LifeLock’s Identity Theft Protection Service. Other Insurance Programs are available in most states for those who qualify. http://dentalassistant.org/ Membership is tripartite so if you are a Texas member already, then you belong to both associations!!

TDAA offers Continuing Education (CE) Courses, as a Texas SBDE Approved Provider of CE and DANB CEU Approval!!  If you would like to become a Member and be counted and enjoy the benefits! JOIN the TDAA & ADAA!! Applications: http://www.dentalassistant.org/membership.htm#applications

After all, Education, Efficiency, Loyalty & Service are what we are all about! Feel confident, feel the excitement and know the camaraderie that we have in the Texas Dental Assistants Association.

E-mail: TDAA2002@aol.com

Texas Dental Assistants Association’s quarterly publication, The Bulletin, an established newsletter, is filled with information, including photos and Dental Profession Articles. Presently what is available here is a condensed version.

One (1) Year Subscription - $11.00 check.

For more information contact the editor at: TDAA2002@aol.com.

To subscribe to the Bulletin write to TDAA at the address below.

Who are Dental Assistants?

Join The People Who Make Dental Assisting a Profession!

St. Apollonia, A Saint of Dentistry

Selinda Zuniga-Cantu, CDA, RDA, February 2009

At the TDAA in San Antonio, Texas, May 2008, I met an Artist name Stephen Shortt of Montreal, Canada.   He had a booth at the convention center with all his art displayed.  It was then that I learned about St. Apollonia from one of his paintings that he had for sale. The beauty of his work intrigued me. 

As you can see here; In a fifteenth-century illumination from the Hours of Catherine of Cleves, St. Apollonia is shown, dental forceps in hand, on a pavement of tiles ornamented with the heads of dogs, symbol of fidelity.

St. Apollonia, according to legend was an elderly Christian lady who fell victim to the Roman persecutors of the 3^rd Century AD in Alexandria, Egypt.  Apollonia spent her whole life preaching the word of God. She took a big risk doing this because Christians were being persecuted during the reign of Emperor Phillip. Apollonia still preached and bravely risked her life to visit Christians in prison to comfort them. She was seized and tortured; all her teeth were smashed with pinchers and then knocked out.  Apollonia was then taken outside the city gates to a pile of fagots and threatened to be burned alive, if she refused to renounce her Christian faith. Even this painful trial did not shake her faith. “Given, at her own request, a little freedom, Apollonia chose instead to martyr herself. She sprang quickly into the fire and was burned to death.”  When the pagans saw how heroic she was many were converted to Christianity.  In Rome, a church was erected in her honor.  However, the church no longer exists, but the square where it stood is called “Piazza Sant’ Apollonian.”  Thus, on February 9^th 249 AD, was born the Saint and ICON of comfort for anyone who suffers a toothache.  She is generally depicted in art holding a tooth with a gold pincher. I was excited to have met this artist who introduced this known Saint to me and wanted to share her with you.  I am always learning new things about dentistry everyday and everywhere I travel.

Selinda Y. Zuniga-Cantu, CDA, RDA

Artist Stephen Shortt (http://www.stephenshortt.org/)  

By Ronda Vantroba Lane, CDA, RDA, BS, ADAA 9^th District Trustee, TDAA Past-President, August 2007

The process of instrument recirculation begins immediately after a dental procedure is completed and needs to be safe, consistent, efficient, and repeatable.  Since cleaning is the first step in every decontamination process, it is imperative that all instruments are cleaned thoroughly for the sterilization process to work.

Ultrasonic Cleaning has been proven to be 16 times more effective than manual methods and cleans areas that are unreachable (including microscopic crevices) by manual cleaning.  But even these devices can fail to perform adequately if the appropriate steps are not followed.

A Step-by-Step Process

          Ideally, all instruments should be totally immersed into a holding tank or tub for presoaking prior to ultrasonic cleaning to keep biological matter from drying out and adhering to instrument surfaces.  The ideal presoaking solution is a mildly alkaline solution (it feels slippery) with a pH of 10.0 – 10.5 and heated to a temperature of 110 -120 degrees.  The instruments are then removed, while wearing heavy-duty utility gloves, from the presoaking solution, rinsed with clean water, and carefully placed into the basket of an ultrasonic cleaning unit.  Instruments should always be suspended in a basket or other device, be free from tank bottom and sides, and be totally immersed with no tips above the solution level, so that true cavitation can take place.

          When ultrasonic energy is introduced into a cleaning solution, cavitation {the foundation of ultrasonic cleaning} occurs.  Microscopic bubbles are formed when ultra-high frequency sound waves are passed through a cleaning solution.  This creates a high-energy vacuum effect, safely pulling debris, foreign particles, and organic matter from instruments.  Cavitation provides an intense scrubbing action that leads to unsurpassed cleaning speed and consistency when compared with simple soaking or immersing with agitation.  Additionally, the bubbles are small enough to penetrate even microscopic crevices, cleaning them thoroughly and consistently.

          For effective cleaning, it is essential to use an ultrasonic solution at the correct concentration that properly matches the cleaning task.  Always read the manufacturers label and don’t skimp, or the effectiveness of the cleaning process will be compromised.  Before turning the unit on, the cover should always be in place for several reasons:

(1) Ultrasonic units create spatter & splashing and can create an aerosol effect, disseminating harmful microorganisms into the air.

(2) This spatter & splashing will contaminate the surface area immediately surrounding the unit.

(3) The cover provides a reduction of noise and the avoidance of solution loss through evaporation.

(4) A small amount of moisture contamination on the power connections will cause electrical breakdown.

          Turn the unit on and a “hum” will be heard immediately and cavitation can be observed inside the tank.  Cleaning times may vary, depending upon the amount and types of contamination on the instruments.  Most manufacturers recommend cavitation for 3-12 minutes.  Experience will quickly indicate the optimum cleaning times for your particular needs.  Many units will stop automatically at the end of the preset time; however, some units have a “hold” position, which allows the operator to clean for a longer time period.  It is not recommended to operate the unit for longer than 30 minutes. Longer times do not mean cleaner instruments and instruments exposed to excessive cavitation can become dull, corrode, and break down and/or cause hinged instruments to stop moving smoothly.

          The final steps with ultrasonic processing are also important.  The basket of instruments should be drained of fluid and thoroughly rinsed under running water with the operator wearing the heavy-duty utility gloves.  The rising cycle is important to remove the debris suspended in the water and the ultrasonic solution.  Instruments should be carefully laid out for inspection to be sure all debris has been removed and air-dried or placed into a commercially available drier.  The instruments are now ready for packaging into their sterilization bags, wraps or cassettes.

FAQ’s About Ultrasonic Cleaning Units

1.  How often does solution have to be changed?

The frequency with which you change your solution depends on the volume, amount of debris & usage.  Most offices change solutions daily and should wipe down the inside tank to avoid build up.  Disinfection of the unit should also be done when solution is changed.  

2.   Do units that have heaters clean better?

The addition of heat helps soften and breakdown materials such as waxes and similar compounds for a quicker cleaning cycle.  These materials would ultimately be removed at a slower rate without using heat.

3.  Is there a way for me to test the effectiveness of my ultrasonic unit? 

Yes.  Testing is recommended monthly because many units have two (2) capacitors and only one (1) may be working.

Aluminum Foil Test

1.      Fill tank with fresh solution at room temperature.  Run unit for about 5 minutes, with no instruments in it.

2.     Cut or tear a piece of lightweight household aluminum foil so it will fit into the tank from top to bottom and side to side.

3.     Place foil in the tank diagonally from corner to corner in a vertical position as close to the bottom as possible without touching.

4.     Hold the foil as steady as possible and turn on the ultrasonic cleaner unit for 20-30 seconds.

5.     The foil should show an even distribution of indentation (a pebbling effect).  If an area of one-half inch or greater does not show this pebbling, the unit should be returned to the manufacturer for servicing.

6.     Mark the date on the foil and file it as proof that a test was run on that date, and it produced an acceptable pattern.

References:

1. Crooks L. Operating Room Techniques for the Surgical Team. Boston. Little, Brown & company; 1979.
2. Unisonics Australia PTY LTD @ www.unisonics.com.au
3. L & R Ultrasonic Cleaning Systems and Solutions. Kearny, New Jersey @ www.lrultrasonics.com

By Ms. Anna Spaulding, CDA, RDA, February 2007

I’m sure many of you are familiar with “Goofus and Gallant” from the popular magazine Highlights for Children. In dental offices I think we have similar characters, whom I will call “Minnie and Maxine” (my apologies to any real characters who just happen to have those names). Minnie just tries to get by with the least she can do, and has no team spirit. Maxine tries to do everything she can to get the job done, while helping others in the office as much as possible. She has a great team spirit. Doctors, hygienists, assistants (treatment coordinators), business administrators, hygiene coordinators, and any other auxiliary personnel, can be a Minnie or a Maxine. In fact, we all have some of both characters in us, but our goal should be to become more like Maxine and less like Minnie. That would make the office atmosphere better, the work would get done, the patients would get better care, and I think everyone would feel better about what was accomplished, knowing that we did it as a team.

Maxine truly believes that our motivation should be “to do the right thing for every patient.” She also believes in the Guiding Principle of “Countless unseen details are often the only difference between the mediocre and the magnificent.” Maxine understands that our purpose is to put patient care first! And to provide quality care and excellence in a caring professional atmosphere. She believes that she has a part in offering a supportive pleasant environment, and contributes to being very profitable and making a difference. She also understands that working together will create more profit to share, and will feel that she has truly earned her part. Minnie has heard all those things, but does not really understand the concepts and how she contributes to them. She wants to just come in and “do HER job” and collect her share of the profits.

Scenarios will be presented, showing how each of these characters would react to a given situation. Remember, we all have some of both, and even on different days and with different situations, may demonstrate Minnie or Maxine characteristics.

Minnie sees that both ultrasonic cleaners are full of instruments, but since some, or all, of the instruments are not hers, she decides to leave them for someone else, even though she has a little time in her schedule to spare. Maxine also notices that some, or all, of the instruments are not hers, but goes ahead and rinses the items in both cleaners, and prepares them for sterilization. She realizes that while she has time available, other staff members may not have that option at this time. Maxine also knows that getting those instruments out leaves room for the next batch, and perhaps helps speed someone else’s preparation for their next patient.

Minnie sees that the sterilizer should be loaded and run, but again, leaves it for someone else, because, after all, not everything in there was used by her or her doctor. Maxine loads the sterilizer and gets it started, because she knows that some of the items will be needed again soon, in order to ensure quality care for the patients. Minnie brings her trash into the lab and piles it on top of the already full trash can, so that when Maxine removes the bag to replace it with a new one, she has to pick up all the trash that falls onto the floor when moving the trash can out.

Minnie is the one who leaves the empty paper towel holder, and the empty toilet tissue roll so that the next person does not have these much-needed items, but may not realize it until they reach out to where they should have been. Maxine replaces the paper towels and toilet paper before they are completely gone. She does not want another staff member to come up empty-handed. She also realizes that the next person to need that item may well be a patient.

Minnie notices that the stack of charts to be filed has become quite high, but decides that this is not her job; and anyway some of those are the “other doctor’s files.” Maxine has some time between patients, so she checks to see what she can do to help the office administrator. The administrator has been working hard all day taking care of patients’ needs, but she has not had time to file the charts accumulating from the large number of patients who were seen.

Minnie puts X-rays in the developer, and then makes a personal call, while waiting for them to develop. While Maxine is putting her X-rays in, she notices that two of the hygienists have films that have already finished processing, so she mounts them and delivers them, remembering from the morning huddle that they had a very full schedule all day.

When Minnie gets to work in the morning, she does not even think about all the things that have to be done to get the office ready for patients that day. She just gets her charts and a cup of coffee and sits down. Maxine comes in, removes the items from the cold sterilization container, rinses and stores them. She knows that these items will be needed and that if contaminated items are placed in with those that have already been sterilized, the “clean items” are recontaminated and must remain the appropriate number of hours again to be sterile. In addition, to be ready to begin the day, Maxine sets up the ultrasonic unit as she knows this will assist everyone.

Maxine gets to work checking the X-ray, replenishing the X-ray solutions, turning on the processor to warm up for the first patient’s film, running the quality assurance film to ensure that the equipment is working properly, and turning on the safelight to get the dark room ready to go. She realizes that all this is important: to reduce films that are not diagnostic, meaning that they have to be retaken, and also to ensure that a quality image is projected in all that is done for the patient. Maxine also checks to see if Minnie left the film supply empty or low, and goes to get additional film from the refrigerator, if needed.

When Minnie gets behind, she cuts corners on disinfection and sterilization procedures, because that is something no one but her will know about. And, “Dr. Minnie” doesn’t really care or think it is necessary, because after all “no one ever catches an infectious disease in a dental office.” Maxine tries to follow universal standards with each patient, because she realizes that each one has the potential to spread infectious diseases, such as hepatitis, to another patient, or to anyone on the staff. Maxine knows that if she were to have treatment of any kind, in the office of a dentist, an oral surgeon, or in a medical office, she would want the staff to take the same careful precautions on her behalf. She also feels that real “quality of care” includes those behind the scenes activities that are important, even if no one but her knows whether it is being done or not.

Maxine tries to find time during her day to remove sterile impression trays from the cold solution, and clean and place additional trays so that they will be ready when needed. Minnie doesn’t worry about that, because if she needs a tray and it isn’t sterile, she can always clean it and use it, justifying her actions with the thought that “somebody should have already done these trays, and then I would not have to compromise with this patient.”

Minnie goes to the kitchen to have a snack, and when she gets through, leaves her dishes in the sink. This is not her day to clean up, and she doesn’t care if the person assigned has to stay after normal working hours to do them. She has some personal things to take care of, and since her schedule is clear for now, this would be the perfect time. Maxine has her snack, and then cleans her dishes, as well as any others in the sink, because she realizes that not everyone has the time. It would not be fair for the assigned person to stay late, when she had some time open in her schedule, and could get it done during normal office hours.

Minnie looks at her column and sees she has some open time. She says, “Oh boy, I have a light day today, I can take care of some of those personal things I need to do, that I didn’t have time to do over the weekend.” Maxine sees the same schedule in her column, and thinks “If that time does not get filled, I can help the others who have a packed schedule. That way the patients get great quality care, and everyone can stay on time and get out for lunch and at the end of the day on time.”

Maxine realizes that everything she does contributes to the office as a whole, gives the patients a better experience, quality care, and adds to the productivity of the practice. She understands that is what enables the practice to pay the salaries and benefits, and especially the bonuses that are based on the production of the whole office and not just her column or her doctor’s column. Minnie does not consider herself as a part of the whole picture, while Maxine understands that without each piece working with the other, we can never complete a masterpiece.

I’m sure you all can immediately think of other scenarios where you have seen Minnie, Maxine, Dr. Minnie and Dr. Maxine, in action. If you’d like a helpful hint on how to help Minnie improve, read on.

Helping Minnie Improve

• Job descriptions are an excellent way to provide guidelines to employees, such as Minnie. That way they know exactly what is expected of them. These should be done in a way that indicates what that person’s order of priorities is. Then it should be stressed that employees are expected to help each other whenever possible. Part of the job description should include the criteria on which the employee will be evaluated. If an employee knows what is important to the employer, he or she is more likely to exhibit that behavior.

• Employees should have job performance reviews, and these should be based on the quality of the job, as well as the team attitude portrayed.

• Tasks that are not direct patient care can be assigned several ways. A list can be made of all these, and divided evenly among the number of employees responsible for them. Another method would be to divide the tasks up and assign by a specific period of time (i.e., day of the week, weekly, or monthly). The lists would be posted, so that everyone knew who was responsible for each task at any given time. If the task was not accomplished, or not done properly, the employer would know who to talk to about that specific item.

• Having job descriptions and posted tasks would result in employees feeling confident that they were doing what was expected of them. This would eliminate uncertainties, as well as avoid potential conflicts between employees. Reviews would be easily accomplished also, since the employer would continuously know who was performing as expected. Problems could be eliminated much sooner, and a positive environment maintained much easier.

“Reprinted with permission of the American Dental Assistants Association, Copyright 2006.

    Ms. Anna Spaulding has worked in the dental profession for 29 years, and has been a Certified Dental Assistant since 1982.  She became a Texas RDA, April 2006. She has worked as a chairside assistant, performed business office procedure, and has taught Dental Assisting at Tarrant County College in Fort Worth, Texas.

    Ms. Spaulding has been a member of the ADAA since 1982, is a Past President of the Texas Dental Assistants Association, and the Fort Worth District Dental Assistants Society.  Anna is presently employed part time by Dr. Barry Stovall and Dr. Johnny Cheng in Fort Worth, Texas.

Disclaimer: "The information or opinions expressed or implied are strictly those of the authors and/or course presenters and do not necessarily represent the opinion, position or official policies of The American Dental Assistants Association (ADAA), The Texas Dental Assistants Association (TDAA), or The State Board of Examiners' Rules and Regulations enacted as mandated by Texas Legislation.  Authors of published materials viewable on-line are solely responsible for their accuracy."

Last updated on 04/09/12.

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