Jessica Lee

DH 234
5-25-24

General Dental Office Visit Report

For this office shadow visit, I decided to shadow at Willamette Dental in Corvallis. At
this office there are four doctors. Three general dentists and one orthodontist. Each doctor has
their own dedicated team members they work with regularly (hygienist and assistants). Two of
the doctors travel between offices and will have some team members that travel with them and
some that are specific to that location. I personally worked and shadowed Izumi, one of the
dental hygienists that works with Dr. McCarley. Izumi has been a dental hygienist since 2014. It
was nice to shadow someone whose had several years out of school to develop their skills, to
observe their process of patient treatment and sequence.
Willamette Dental uses office teams (a Microsoft program) as a way for communication
along with secured email. Not only is it used for inter-office communication, but between other
Willamette Dental locations and staff. When communicating with patients, there is a built-in
recall system that will send out text reminders and phone calls for upcoming appointments to
patients if they choose to opt in for these communications. The offices no longer have direct
phone lines, so when patients call in, they call the call center and book appointments this way. At
the end of the appointment, the hygienists will add to the computer what re-care interval they are
due for next, and how long how (3,4,6,12 months and 50,60 or 90 minutes) so that when the
patient is checking out at the front desk or calling in, the staff knows exactly what to book the
patient for next.
Axium is the practice management software that Willamette uses. It is company wide
which is very helpful. A patient can switch offices if they move, and their records are still
available for the next hygienist or doctor who sees them. When a new patient comes into the
office, they ae scheduled to be on the hygienist’s schedule. At this initial visit they are scheduled
for a sixty-minute appointment. The hygienist is responsible for taking their own x-rays. The x-
rays they take include bitewings and periapicals of any teeth that are causing the patient pain and
teeth that have had previous crowns or root canal treatment (essentially selective PA’s vs. a
CMS). The hygienist also performs full assessments including perio charting, EO/IO and comes
up with a treatment plan. A comprehensive exam must be done by the doctor during this visit,
which the hygienist can point out any of their findings to the dentist. Once all these activities are
complete, the hygienists can use the rest of the time to start the patient’s treatment plan (i.e.
maintenance or SRP) or if there is not enough time have them re-appointed to start this treatment
(such as SRP by quad). They decided to do this because the hygienists have more training in
treatment planning and periodontal diagnosing. This way, the patient is diagnosed and scheduled
correctly. An adult prophy or re-care/maintenance patient is typically scheduled for fifty minutes,
and scaling and root planning patients are scheduled for ninety minutes for two quads.
 Willamette dental employs their own specialty staff and doctors; therefore, they will refer
their patients within their own system. Again, this is efficient for the doctors as the records are
already present in their Axium chart, which any staff would have access to. The referring dentists
will then fill out a form and send it over to the specialists they are referring to. The office staff at
the specialty location will reach out to schedule the patient for treatment or consultation.
Services provided to the patient are similar in sequence for maintenance and NSPT
patients. SRP is scheduled for ninety minutes for two quads. Maintenance patients are scheduled
from fifty to sixty minutes. Progress or re-evaluation will take place at the next visit for SRP
patients. At that visit, a perio maintenance may be performed or additional SRP as needed.
Patients will have the comprehensive exam upon their initial visit. After that, they will only have
an exam by the dentist once a year, unless the patient is in pain or requests to see the doctor for a
periodic or limited exam respectively. The hygienist provides the maintenance or SRP itself as
well as OHI and assessments. The cassettes you are provided with include universals, 13/14,
posterior scalers along with the cavitron and triple bend tip. They don’t typically have the other
inserts (such as the curved or thinsert). You can request other instruments as well as new ones at
your discretion, but it must be approved and ordered through the lead hygienist. You are also
responsible for sharpening your own instruments and must do so during any down time you may
have. They had several home care aids available. These included regular toothbrushes (adult and
pedo), distal end toothbrush, flossers, regular floss, superfloss, several toothpastes and
interdental brushes. The also sell Sonicare toothbrushes and waterpiks at cost in the office for
patients to purchase.
While I was shadowing Izumi, I observed two perio maintenance procedures and two
adult prophies. What she did for all of them was start with the cavitron. She would set it up each
time but stated that it wasn’t always necessary. However, the patients we saw that day had
particularly hard calculus (even though there was not much, it was tenacious). She would then go
back and hand scale with universals and posterior scaler. She said she would only use the 13/14
for particularly hard areas or calculus that was really rough. I only observed her using it a couple
of times throughout the time I spent observing her. She also didn’t polish everyone, only the
prophy patients. It was performed at the end of the procedures. This is also when I noticed she
went over OHI (at the end of the appointment). She also would have to make notes at the end of
the next appointment and essentially catch up if she ran a little bit behind. The system has
prompts depending on what type of hygiene appointment was done that day, which makes filling
out the notes even faster. Overall, I felt the quality of care she gave was great and thorough. She
asked patients questions and engaged them and was not so focused on documentation as she was
the actual patient care. The documentation was not neglected, but waited until she had a “lull” to
complete it with accuracy instead of rushing to get it done.
The office had a sterile tech who handled all things in sterile. I felt this was efficient
having a specific person the handle this. Sometimes when there are too many hands in the pot I
feel as though things can be mixed up or missed. Hygienists also receive help from assistants to
flip their rooms and perio chart. This helps with time efficiency and cross contamination. All
items are packaged in cassettes and run through a dishwasher and then wrapped and sterilized.
Handpieces are sterilized between each patient. Laundry service is hired out (just like LCC).
They do have a designated OSHA officer and have monthly and yearly meetings to address
several happenings and not just infection control. All team members must wear full PPE when
working in sterile areas and cleaning rooms (gowns, masks, eyewear, and gloves). Hygienists
could choose to wear a face shield but still had to have some sort of eyewear on during patient
treatment.
My overall impression of this office was that it was a professional yet relaxing
environment. This experience really helped me see what being a hygienist in the real world
looked like. I liked the fact that even though certain things were done differently than what we
were taught in school, nothing was ever missed. The care provided to the patients was excellent
and the patients seemed satisfied and happy with their care while there. The practice manager
Lacey, and hygienist Izumi were super helpful in answering any questions I had to regards to
working in that office. For confidentiality purposes I did not want to disclose other team
members names on which I did not work directly with (as I did not get their permission to
include their names), but they were all wonderful and demonstrated efficient and excellent
teamwork. I actually have a scheduled working interview (as an assistant) with them in June
which I am excited for!

Contact information:
Lacey Buchanan
541-537-0320
https://locations.willamettedental.com/or/corvallis/2420-nw-professional-drive/