(800) 560-6066In this episode, we interviewed Secilia Spellman, RDH to understand the importance between oral and systemic health, especially during the COVID-19 era, and how her office has empowered her to feel protected using her Cavitron even with a genetic lung disorder.
Rolando Mia, from Zyris, is the host of our series, Dental Voice. In this show, we focus on the latest news, topics, and conversations happening in dentistry and asses differing views across the nation. In Season 2, we’re focusing on, “What’s Working and What’s Not”, where we’re debunking myths by assessing trial and error since the start of Covid-19.
Watch this video to learn the following:
- Why dental hygienists should try using an Isovac® or Isolite® system on themselves in a procedure before seeing a patient for the first time
- The growth of office walkouts relating to poor safety protocol implementation
- Finding your voice and expressing your needs as a hygienist to your dentist
- Building a relationship of trust and value with your dentist
Rolando Mia:
Welcome to Dental Voice Season 2. My name is Rolando Mia with Zyris. Today, we have a returning guest that we spoke with at the beginning of COVID-19. The purpose of Dental Voice is to hear directly from clinicians, to understand perspective and then also get advice. We talked to Secilia Spellman who is an RDH and she shared with us her perspective early on at the start of COVID-19. Now that she’s back working, we’re revisiting to hear what’s real and what’s not and what additional advice you would like to give. So Secilia, thank you for joining us and you look fantastic.
Secilia Spellman, RDH:
Thank you for having me. I’m so glad I had time to finally do this with you guys.
Rolando Mia:
We appreciate it. How is it going?
Secilia Spellman, RDH:
We’re doing good. We’re managing. There’s a lot of changes but it’s thankfully it’s going well.
Rolando Mia:
So, when we first talked, you had been out of working for a while and you were really excited to get back. You were eager to get reconnected with your patients but because of an underlying health condition you needed to make sure it was safe. And are you experiencing anything or are you okay?
Working as a Hygienist With a Lung Disorder
Secilia Spellman, RDH:
Thank you for asking. Yes, I have a lung disorder it’s called alpha one antitrypsin. It is a genetic disorder. So, coming back into work, I was freaking out and panicking. When we got the green light to come back in early May we chose not to come back right away, we waited for the ADA handbook to come out, which has been altered many times. However, we had waited to have that to properly get the office and rooms set up and get the supplies of course. That initial week coming back, I came back before the rest of the staff and it was very nerve wracking. I was extremely nervous. There is no telling, even though I am a young active person, it doesn’t make me bullet proof.
The first 3-4 weeks in total, it was nail biting. You’re just constantly trying to recycle through all the things you were told and figure out what’s next in each step, “Did I do this? Did I wipe that down? Is this sprayed?” You know, it’s a lot and you do have to find an order. It’s no different than jumping into dental hygiene school. We were like, “What in the world am I doing?” You’re fumbling with everything. I kind of did the same thing. I’m sure I’m not the only person.
I have a rhythm now and I’m going through the process every day and every procedure that might be different. I am very healthy, still. Thank goodness, knock on wood. I’ll be honest, I have taken a COVID-19 test this week. It was negative and I’m grateful for that. I’m doing everything that’s being recommended on my free time, getting my fresh air. I’m working out in mountains and the sun, taking my vitamins, eating healthy, and following the protocols as much as I possible. I feel good now and I’m not as nervous anymore.
Rolando Mia:
I want to understand your experience with all of the PPE. What’s your experience with that?
Stress in Obtaining PPE
Secilia Spellman, RDH:
It’s like really hot, to be honest. So, like the N95 masks, I’m sure many people initially had a lot of issues finding the N95 masks. Dental people were not number one on the list to be able to access these things, which is wrong. Especially considering that Registered Dental Hygienists for the longest time were at the number one top of the list in terms of risk. Well, now Respiratory Therapists are with us. The N95 mask needs to be accessible for us. It’s not fair that these last couple months, I’ve noticed that we are not “essential”. We should have been able to access these N95 and we were getting KN95 easily.
People are price gouging like crazy. It’s absurd. So, we do have an N95 now and I am wearing a, L3 surgical over that. There is no breathing all day if you’re in an N95. On top of the, N95 and that’s a moisture control situation. For limited purposes, the CDA president did a run through on what the ADA is recommending. So, you can wear an N95 mask three times a week, seven days in between each time you wear it for eight hours and it has to go into a brown paper bag. So, we were doing that and in order to keep it from getting moist on the outside, you put a level three surgical over it.
I am also wearing a face shield. Of course, I’ve got the surgical cap – kudos to my best friend made them all for the offices because we could not find any anywhere. It was crazy. We have surgical gowns that were changing in between every patient. We were lucky I got those ordered as soon as I came in, but we were still back ordered on a lot of stuff.
The surgical gowns, we just got our final shipment of them about two weeks ago, but they were coming in splotches and we’re doing a lot of laundry. We’ve even been washing the disposable ones because there was limited access, gouging on prices, and it was environmentally friendly to be disposing them as much as it was recommended.
So thankfully, we’re good on those things now. Our scrubs and shoes are staying at the office, we do not leave our practice with the clothing that we were at work.
Rolando Mia:
For everything that you’ve been through, you just are happy. What’s it like working with your patients now? Are they freaking out or are they feeling good?
Zero Hesitation in Patients Coming Back
Secilia Spellman, RDH:
I’d say about 25% have not come back. They’re either booked out several months from now or they’re coming back.
I don’t know if you guys remember from our last interview, I talked about my patient who is 100 years old and she was turning 100 in July. I got to see her. She came spicy as ever and she is well. She promised me she was going to see 100.
Most of the patients are very grateful. What’s interesting about coming back as a hygienist, is they feel comfortable after they’ve seen you for so many years to kind of voice what they want and how they feel.
It’s interesting how many people have zero hesitation to express their negative thought process about everything COVID-19. I have facts and I have no shame to spit those facts out, to stop that mentality and negativity in my room. Those are a few of the people that I’ve had to deal with it. They understand as soon as they open up about like, “Listen, I’m in your mouth and I’m exposing myself to this. I am a front-line worker and we should be essential. For your safety and everyone else safety this is what you need to do.” Everyone’s had a pretty decent response. A lot of people are definitely glad to come back and they’re glad to be here.
Many people overdue. We had over 300 dental hygiene patients that were canceled due to this. So backflow, like that list is just barely moving. It’s kind of like creeping. We still have a very long way to go. People are very understanding, thankfully.
Otherwise, everybody seems to be in a pretty good mindset. We’re really lucky. Santa Barbara has always had a pretty darn positive attitude for the most part. So I am happy and grateful to be here and going through the weeks, they are a lot longer than a lot more tough, but I’m here.
Rolando Mia:
So, you mentioned, “You have a lot of facts”. What facts do you share with your patients about what’s going on? How does that tie to reassuring them?
Secilia Spellman, RDH:
Well, it amazes me how many people don’t even consider or recognize the fact that we are one of the most likely professions to contract COVID-19. Who would have thought, I’m in your mouth, you’re breathing in my face? They normally say, “Oh my gosh, I would never have known.”
The people who have hesitancy, I explain to them the protocols that have been implemented in our office and let them know that these are the measures that we are taking. We’re very lucky, in Santa Barbara dental practices, there has not been many positive cases.
We’ve been really low on our cases in the dental field. So, those are things to pay attention to, and to be recognized so that you do come to your appointments and you do remember that your mouth is entirely connected to your entire body, your bloodstream, your brain, your heart, we know these facts, so it’s not to be ignored. Know that you need to come in and we all need to be safe.
Rolando Mia:
Awesome. When you look at the last four months and then compare that to today, what are some of the top or key learnings that you’ve run into that you were like, “Huh, here’s what I thought and here’s what’s really happening.” What are some of those look back moments based on your experience?
Using a Cavitron during COVID-19
Secilia Spellman, RDH:
I’ll be honest. One of the things that was really discussed was procedures that you do using a Cavitron. Do you really think I can do all of my job without that? I wouldn’t be able to open a jar at the end of the day. It’s not realistic, I’m going to say it.
So, I am fortunate enough to have a doctor, I preached this before, we put our brains together. I came in to discuss how we can change the practice and get it into a safe environment. I am very lucky to have doors that open right out the fresh air of the ocean. My doctor created and fabricated evac systems for every room that have an arm that actually that allows me to move straight to the patient’s face to pull any aerosols out.
Those are all things that help to get you through the day. So, at the end of the day, if I have a patient who has 5-millimeter pockets, they’re just loaded with calculus, and they were due March 16th, yes, I’m going to use that Cavitron. Their mouth matters to me. I have seen in a very short time coming back to work quite a lot of infections. I don’t know if its stress induced. I don’t know if it’s because they’re overdue for their appointments or what it is but at the end of the day, I am covered. I’m doing my part. I’m thoroughly disinfecting my room. I have airflow, I have evacuation. If that deep pocket and that tooth is at jeopardy of being lost and having periodontal abscess or whatever it might be, I’m going to clean it with a Cavitron. So, that’s kind of the one thing that was very interesting going back when I was not working. You get in the mindset of not doing this, not doing that. Even the health department said not to polishing the teeth, but to use a manual toothbrush.
You want me to take a manual toothbrush of somebody’s teeth, right? No, I’m not doing it. So yeah. I’m polishing teeth. I am using my evac.
Rolando Mia:
It’s great to hear that, that’s happening and that it’s not quite the same. Now we’re hearing a lot of, a lot of dialogue about dental teams, hygienists and dentists. What can you share with us with regard to kind of the dynamics going on? You clearly have a fantastic relationship with your doctor. You’re also a very strong person. So, I suspect that that helps, but not everyone is like that. So, what are you hearing out there?
The Dentist and Hygienist Dynamic
Secilia Spellman, RDH:
It’s interesting, when we first came back because you know, it wasn’t just me. A lot of people came back all within the same couple of weeks. So, I feel like I helped a lot of people try to get up, gain a voice. I’m a strong believer in constructive conversations. It’s one thing to have a strong opinion. I am a little intense but like my doctor respects my opinion. So other people who maybe don’t necessarily have that were reaching out to me like crazy. All kinds of offices, pediatric offices, orthodontic practices, general dentistry, lots of hygiene assistants, and front desk. I was hearing from a lot of people who were freaking out because they weren’t getting any of the help that they would expect from their office team during a pandemic. They were not getting the assistance, they weren’t getting face shields, proper masks or shields at the front desk.
So, I did have quite a few people initially really come at me left and right and it was nonstop for probably the first 3 weeks we were open. There’s an office in town where the entire staff walked out because they refused to do their recommended protocols in order to keep the office safe. I know of many people who were more seasoned hygienists who just chose not to come back. Several people who have little ones that need to be in Zoom classes for school, they needed to stay home with them. They decided, they’re done temporarily. It’s been quite a mix. So, Santa Barbara is definitely low with the number of hygienists we have in town right now.
Rolando Mia:
What advice would you give people who are, who are struggling right now with that? I mean, that must be huge for an entire team or even as an individual to make the decision to not going back. So what, what advice would you give people?
Secilia Spellman, RDH:
I’ve said it before. If you are not happy, what are you doing? You spend more time in your office than you typically do at home with your family. There will be a second home for you somewhere else. Also, we all need to be patient during all of this and know that it is going to pass and that it will get easier.
Moving on from your scenario or finding a different place is okay. It sucks. It does. I know we’ve had this discussion before about jobs and positions and everything else. I moved across the country and came out here and didn’t know a single person. I had to start from scratch, and it took me 2-3 years to find a place that I felt happy with full-time. Now, I’ve been at this practice for almost 7 years. So, you have to be patient, you have people willing to fight for it, and not willing to settle. You still need to be kind and recognize that these are very weird times for everyone, everyone is going through something and that it will be okay and know that your safety matters. If you are not feeling safe and you’re not comfortable, there is a place out there that will make you feel comfortable.
Rolando Mia:
That is, and it is consistent with what you said before. Be honest, be direct, be courageous, and ask for help.
Secilia Spellman, RDH:
I mean, what’s the worst that’s going to happen? They say, “No”, and you go, “Okay, time to move on.” It doesn’t hurt. That’s the worst thing that could happen.
Rolando Mia:
There are so many new protocols, you mentioned them. I started keeping a mental track and I lost count at like 14. How was that? Are you experiencing any kind of backlash because people are being asked or required to compile with these protocols?
The Importance of Having a System With New Safety Protocols
Secilia Spellman, RDH:
You know, it definitely has become part of what we’re doing, but every single person in this office has a role. That’s where it starts is in a situation like this, you cannot leave one person dependent on everything. For example, our front desk, we have a front desk person and we have an office manager in a private office. Each one of them have their own roles. If one person is out, another person needs to be able to gather those roles. We have a system and a flow. Flow is so important in a dental office. I speak on behalf of everyone without a flow – it’s just chaos and everyone’s grumpy. Having that flow established right from the beginning is so important. We had a protocol day before we came back where everyone came in and we established the rules and the flow.
I had talked about patients sitting out in their vehicles and waiting to be called on. Instead of doing that for us, what worked better, is we have stairs and an elevator to get to our office. There’s a timely factor too. If you don’t have the flow and everything kind of preset, you can get really behind. So, we set up outdoor seating with benches set up and are limiting how many people come into the practice at a time who sit in the waiting room. You’re not allowed to have a certain amount in there depending on your size.
We are sending a wellness screening out that was created by the American Dental Association. We’re sending that out 24 hours in advance for them to fill out. If they do not fill it out, we get notified and they have to do it. As soon as they come into the practice, we are declining patients who have traveled. It’s one thing for me and my husband to go camping nearby or and be just the two of us and then come back. It’s another, when you’re hopping into a big bird in the sky and taking a trip to Florida, that’s another ball game. That system has really worked for us in implementing a stage and giving everyone responsibilities.
Rolando Mia:
That’s cool. You systematized and there’s a structure. Now, I’ve spoken with other clinicians out there and we’ve run into this and I know you use the Isolite and we appreciate that some hygienists out there are struggling or don’t want to use it because it doesn’t quite work for them. What feedback would you give those folks about that? It eliminates our aerosols and keeps them safe. What advice would you tell those folks?
Why Hygienists Should Try Isovac® or Isolite®
Secilia Spellman, RDH:
You know, user error maybe. I don’t mean that in an offensive way, because if it doesn’t work for you or you’re not liking it, there could be a potential reason for that. I’ve used it for laser scaling and root planing, especially laser therapy, because laser therapy and the burnt tissue really gathers that material.
I’m very lucky because I’ve been here for so long. I really don’t see a lot of new patients who have a lot of comprehensive issues. Like I have some patients who I definitely have a handful of more comprehensive periodontally and comprehensive patients. I find that I don’t really have to do as many aerosol induced procedures because I see so many repeat patients. However, there’s been high fluctuation of new patients coming in, who haven’t been to the dentist in 10 plus years who need those procedures and the Isolite system is of course easier on the patient. It makes it easier on you. If you’re a hygienist or a clinician in general, if they’re having an issue with it, I think that they need to have a one-on-one with somebody who has experience with it and be sat down to try to show them maneuvers.
When I first used it, I was like, “This is too big. How is this going to work? “And I was wrong, you need a certain way to put things in and maneuver. Encouraging it for their safety to be able to use it. I know my doctor, he’s been using it forever and actually just on Friday, he had a procedure done on himself and used it. I came in on Monday and he went, “Wow, man. Yeah, that worked great.” He’s never had it used on himself. He’s just used it on everyone else. So, for clinicians who may not like it, maybe you should really try to have it used on yourself and see how it feels. It will keep yourself safe right now and if you’re trying to relearn how to use it, to maybe encourage that, why not?
Rolando Mia:
Oh, I appreciate that. That helps a lot. Reach out and go work with someone who knows. I’m hearing that there are some practices out there that haven’t even opened yet. Are you seeing patients who have been trying to get into other practices and can’t get ahold of them so now they’re coming to you?
Seeing Patients Who Can’t Get Into Their Current Office
Secilia Spellman, RDH:
Well, we’ve had a couple people where there’s just a lack of hygiene because hygienists have left and they’re not coming back. So, we’ve had a fluctuation of that where they, you know, they don’t want the dentist to do their cleaning or their, or their prophy or their peridental maintenance or whatever it is. I don’t blame them. I’ll say it. I don’t blame them, but we’ve had like weird, I would say they weren’t there, there wasn’t their intentions to leave. So I have seen that a couple of times, I think a lot of our high, the high volume of patients that are coming in, or because people have a little more of a flexible schedule, they’re working from home. They’re not as strict about their, their hours maybe. Or they can maybe take an extended lunch in the middle of the day. I mean, everyone always wants the first appointment in the last department. That’s like the number one or lunch. Those, they’re the number one appointments where now I have, you know, people who are like, yeah, I’ll take 10. O’clock I’m like, thank you. Where were you three years ago? And I couldn’t fill this.
Rolando Mia:
Awesome. You clearly are having to overcome the changes and you’re having to adapt to the extra things that you’re dealing with. However, what I’m feeling is that it’s doable, right?
Secilia Spellman, RDH:
Yep. It is doable. I think that if you just take the time to do your research, listen to people, reach out to one another, and recognize your importance as a hygienist you’ll be fine. Our career is very valuable and it is essential. If you have the abilities to be out there and doing it right now and you can feel comfortable enough, do it. It’s okay to be a little intimidated, worried, paranoid, scared, or all the above, because I know I’ve gone through every cycle of it. Literally every emotion I told you guys, I have had it. If you just process it and take a step back and try to get yourself into it, I think that people really will realize how much we are appreciated. I feel like I’m appreciated now more in my career than I have been ever, and I’ve been in dentistry for 12 years. So, this is a prime for me. It’ll definitely be a time to remember.
Rolando Mia:
That is awesome. So, the message other hygienists out there, you’re a member of the Santa Barbara dental hygiene association. You’re very active. In supporting that, you talk with a lot of them, a lot of the other hedges and other clinician’s assistance. What’s the kind of the message that you’d like to get out to them as we close this out?
Importance of Team Communication and Training
Secilia Spellman, RDH:
Well, I get it, you know, for everyone out there, the assistants, the hygienists, the front desk, and everyone’s a little, I think we’re all just kind of being pushed that little further than we were before. And it’s a very, this, this curriculum was already, you know, it can be very stressful and just know they’re not alone and know that this is temporary. And, you know, I said it before, but be continue to be patient and to communicate with one another, do not let those negative mentalities just sit in your system, talk through it and breathe it out, go a walk, get fresh hair, pull your mask off, rip it into pieces when you can and let it out. I know I do, like I got the red nose proof it’s at the end of the day. Know that you’re not alone in everything that you’re going through because it’s not just in our work field. You know, I don’t have children. People are dealing with a lot more right now than just being a clinician. You know, being a clinician and being in people’s mouths, they’re going through much more than that and it’s a lot of people and we get it. We all get it. We’re here for one another. We’re going to get through this, it’s going to be a great outcome, and know that you’re appreciated and that your time is valued.
Rolando Mia:
Awesome. To those of you who joined us, thank you so much. I love the energy that Secilia has and her insight. There’s a pragmatism to it, but then there’s also a directness about it. The message I hear when I listened to her is, “Hey, your function is important. There is help ask for it. This is not something you need to do by yourself.” There’s a lot of stuff that needs to be changed, but that’s part of everything. We look forward to seeing you again and thank you so much.
