I have seen some of her cases on line and am very impressed with this. The makers of the Perioscope have stopped manufacturing this product, but there are still some available for sale.
My conundrum is that I am planning to retire in 1 to 2 years and leave Washington.
If I purchased the Perioscope (approx $5,000, combined with a Satelitic (approx another $3 to $5 thousand dollar investment), I feel I could offer severe perio patients another alternative besides surgery via referral to the periodontist.
Also, I am not at all sure that my employer has any interest whatsoever in allowing me the freedom to provide this service for his paitnet's. He met the hygienist who developed RPE (she temped in the office) and he did not like her.
I feel that this technology and protocol will eventually be used in every dental office that provides non-surgical periodontal treatment and I would very much like to be a part of it. But with only 2 years to go, I am not sure the investment would be worth it.
I don't know about technology, but I have purchased my own instruments in the past, I pay for my own CE and have purchased Oraqix and fluoride varnish. The Oraqux and varnish have helped patient's be more comfortable chairside and I feel good about being able to offer it.
Paying for my own CE allows me to take what ever class or classes I choose that I feel will benefit me personally and clinically.
I have wanted to purchase a Diagnodent, and thought of a way that I could be reimbursed without my doc having to come out of pocket all at once, but this has not happened.
I've purchased loupes and I would never practice without them again. Other than that, I can't see purchasing technology for the dentist. I do not own the practice and if hygienists get in the habit of doing this, it will be expected. But I understand the frustration of hygienists who do purchase technology and products for their offices. Too many dentists are either uncaring or too cheap to provide hygienists with decent equipment and tools to do their job. So the RDH goes home every day with an aching back from sitting on a 30-year-old hand-me-down stool and finally breaks down and buys a stool for herself. I don't have a good solution to this problem but I feel strongly that enabling the dentist to be a cheapskate is definitely NOT the way to go!
I also have my own loupes and am getting ready to purchase a headlight.
I lauhed when I read about purchasing a stool because I have been looking into that too! My biggest problem is that my patient chair is difficult to work around. When I sit in the 12:00 position I cannot get close enough to the patient without bending over if I am sitting all the way back in my operator stool. So as a result I sit forward in my chair with no back support, my back ram-rod straight and my neck forward. Talk about a back ache!
The patient chair is 30 years old and is just plain difficult to work around. There are "wings" on either side that are supposed to support the patient's shoulders, instead they just make it more difficult to work when I am at the 9:00 position. I'm not sure if an operator stool with be the "fix", but at least I'll have arms support. I've been a hygienist for 28 years now and ergonomics are especially important for me at my age.
I cannot imagine continuning in DH without benefit of loupes and a proper operator chair.
Ergonomics is a biggie. And old chairs aren't just a problem in dental offices either. We have some ancient ones at PennWell too. When offices and cubicles get switched around, so do the chairs. People are constantly "upgrading" — but that just means you get a newer "old" chair. :-)
Ergonomics is a biggie, but only if the principles are applied correctly. For instance, a dental stool could be "ergonomically correct" for one person and not the next. The biggest issue with stools is the measurement of seat depth. Most stools are designed with a 17"-20" deep seat.....sized for the average size male practitioner who is 5"11" tall. For most women and some men (myself included), this average size seat is too deep, when compared to the length of my thigh. It causes me sit out on the front of it (what some people call "perching") when I want to go into the "active position" (leaning forward to access the oral cavity or work on my computer). While the act of perching allows me to drop my knees lower than my pelvis and thus naturally straighten my lower back, pretty soon my core muscles get tired and I start slumping because I am so far forward that the backrest cannot reach my back to support it. What I have found really helpful is to have the seat depth shorter than normal so I do not perch out on the front of it when I want to lean forward. A shorter seat pan also allows the backrest to function properly, so I take the strain off of my lower back. So, ergonomics are important, but only when applied in a way that meets the individual characteristics of the user.
Excellent points. And how many of us perch on the edges of our chairs for hours on end and wonder why we have backaches and headaches. Equipment must take gender into consideration as well as individual characteristics. Just buying a great, new chair won't cut it — it has to fit us and we have to use it properly too.
Regarding an office chair, there are two classifications: executive chairs and task ("secretary") chairs. The office chair manufacturers determined their preferred dimensions for the seat and the backrest from data taken from studies done by the British and American militaries after WWII. This is why most office chairs have a seat pan that is deep and wide. After further studies were done by noted ergonomists, including Keegan, Grandjean and Mandall, the manufacturers deemed it healthy to have the backrest recline up to 135 degrees, since the "executives" would oftentimes position themselves in a resting position to relieve compression pressure from their spinal region. At that time, "executives" did not preform many tasks in a forward declined position (like leaning forward to access a typewriter or computer), so there have not been many provisions in the seat design or backrest designs of office chairs to tilt the seat forward. All of these conditions end up with many computer users (or dental professionals) sitting on the front of their seats. Task chairs have not had the priority (attention) from the large office furniture manufacturers to incorporate advanced ergonomics in their designs, although I believe that more attention will be paid to this segment as workers comp claims rise.
In our ergonomic research, we test office chairs, and the best executive chair I have found is the Haworth Zody chair because its seat pan tilts forward more than any other model tested so far (6/2010).
Absolutely..mainly because ergonomically, it will benefit you. Loupes, cavitrons, etc. are sometimes deemed not needed. When told that by a former employer, I told him to put down his high speed, and pick up his excavator. Probably safer for the patient in the long run..no more exposures. I got my cavitron.
I started this thread in Nov. 2008. Much has changed for me since then.
After much thought, I did in fact end up purchasing a dental endoscope, Piezo scaler and training for my new technology.
Unfortunately my employer was not interested in having me provide the scope as an adjunct to periodontal therapy, even though common sense tell us that being able to see will provide better results than scaling blindly.
I have come to believe that things happen for a reason. Fast forward to today-- I am now employed with a wonderful periodontist who appreciates and values my ability and passion to provide perioscopy for his patients.
I am so THANKFUL for my boss. Every day I get to go to work with him I wake up with an attitude of gratitude.
Starting this thread in 2008 was the beginning of my exploration into the possibilities of what might be- if only. I took the plunge, invested in myself and came out on top.