Radiology Gems with Janet Simpson

Let's talk about radiology. My guest is Janet Simpson, who will share some GEMS with us today.

Hi, Janet. Welcome.

Janet:

Hi, thanks for having me Heather-Dawn.

Heather-Dawn:

Well, I know so much about you and your special skills. But could you take a few minutes to share with our listeners, just give us some insight as to who Janet Simpson is and what she brings to the world?

Janet:

I'd be happy to. I am a registered dental assistant in San Diego, California. I became a dental assistant by being trained on the job.

So, I learned everything from the good graces of my co-workers and the dentist that I've worked for.

They've been so educational. They've helped me to improve my skills along the way, but I've also had a deep sense of curiosity.

So, I pursue knowledge and I would recommend that everyone just keep pursuing and advancing their skills to become the best dental assistant they possibly can be. I started as an unlicensed dental assistant.

I got my Registered Dental Assistant license in 1991. I worked in general and pediatric dental offices.

And then, at one point, I began teaching dental radiography, and that just became my niche. I knew that I had found the place where I belonged in dentistry.

So I've been teaching in some capacity or another. All these years, I worked at the community college level.

I work at a dental clinic in an impoverished neighborhood in San Diego, and I get to teach dental assistants there at the clinic.

I also get to use my dental assisting skills to bring comfort and healing to people. And it's a joy for me to be a dental assistant. I love it.

We have people that walk in whether they're two years old or in their 80s, and people with dental anxieties.

One other thing I would say is that I own my own company. I am the owner of Dental Fundamentals and Continuing Education. I love to help dental assistants who really want to learn more because I started as an unlicensed assistant.

So I have courses on my website about how to take great dental X-rays and how to improve your infection control skills. And then I have another course that's more relevant to California. So that's me in a nutshell.

Heather-Dawn:

Well, Janet, you are certainly on the grow. And what I appreciate that you shared is that you started out learning on the job.

And even though we have programs that certify dental assistants, quite a few dental assistants start out learning on the job, and our course DAME Dental Assisting made easy, really speaks to those persons who are training on the job.

We supplement that training by providing On-Demand learning that you can pick up in the evenings or whenever it is convenient for you. So you're always, as you say, Janet, on the grow.

So it’s no wonder we are in sync. There are so many things that we view through a similar lens. So that's awesome.

It's also good to hear your mindset about caring, because at the end of the day, while we must have skills that make us proficient, it's really the soft skills -

• That keep people comfortable,
• That keep our teammates assured that we're here with them,
• That gives the dentist confidence that he can rely on you as a dental assistant to be his extension.

So thanks for sharing those words. Now, I know that you have a special love for dental radiology, and you have courses that help to boost and reassure dental assistants about skills to take proper X-rays.

Could you share with us some of the tips that you may have in your toolbox that you use when you're approaching a patient to do X-rays?

Janet:

Yes, I'd be delighted to do that. I break X-rays down into basically three different skill categories.

Number one is gaining the patient's cooperation. I had a woman in the clinic just the other day, a grown woman, and I needed to take her X-rays, but she was so conditioned to it being an uncomfortable experience and one that she should fight against that she balled up her cheeks, tighten the muscles in her cheeks, and her tongue.

And I mean, it was physically impossible to get the sensor back beyond the bicuspids. And so I just kind of looked at her and understood that this woman has had a traumatic experience in the past that she feels like she has to resist.

So to gain her cooperation, I had to explain to her that this is where I needed to place the sensor. And so I'll take my gloved finger and I'll place it on the palate where I need to place the sensor.

And then I will say “I need you to relax your cheeks and your tongue. And I know this can be uncomfortable. But I'm going to do this really quickly. You just breathe through your nose for a few moments. I'll place it, I'll take the image, and we'll move on”.

The other thing that I do in that situation is I will hand them a hand mirror and I will put the sensor in their hands.

And I will ask them to place it themselves. When a patient is given a sense of control over what to expect and what's expected of them, then they can assist you and work with you.

So that worked for her, and actually, that's a tip regarding the gag reflex. There are a variety of tips regarding the gag reflex.

• One tip is to ask the patient to breathe through their nose. Some people say to pull your toes back, pull your feet back and bring your toes up.
• And another tip is to put salt on the palm of the patient's hand, have them touch their tongues with salt, and then place the sensor.

So these are all wonderful tips. But what they really are is a diversion. We're trying to get the patient to not think about the sensor so much but to think about the salt, to think about their toes, to put their mind elsewhere.

You know, the best, most effective trick I've learned is to have them hold the hand mirror and look at their own eyes.

So I tell the patient “I want you to look into your own eyes while I'm doing this. I want you to just stare into your own eyes”.

There is nothing more diverting than ourselves. We love to look at ourselves. And it works. It's a wonderful trick that's effective, and it’s a great way to avoid the gag reflex.

I think that once you've seen the patient's cooperation, the next thing that's really important is that you understand projecting. If you think for a moment about shadows, making shadows.

If you take, for example, three coffee mugs and line them up on your table, and then you take a notebook or something that you can imagine to be like an X-ray sensor, and you place them behind your coffee mugs. And then you take a flashlight.

And if you imagine that the flashlight is your X-ray beam, and shine the flashlight through the coffee mugs onto that notebook, basically, what you're doing is making an example of a dental X-ray.

So, you can imagine that you're trying to place the sensor back far enough to capture the distal of the third molar and the roots.

So I would encourage your listeners to put the coffee mugs up, put the notebook up in one hand, hold the flashlight in the other, and then move the flashlight to the right and to the left, and see what happens to the shadows that are projected onto that notebook.

You can cast any number of different images just by playing with shadows.

The reason that this is an important concept for people to understand is that, again, back to that patient who won't allow you to place the sensor back.

So you can capture the distal of those third molars or even a second molar, so we can place the center back as far as we're able, but then we can project.

We can take those projecting skills, and transfer them to the task of taking great X-rays. When we can alter the angle from which we're projecting our X-ray beam.

And we can capture excellent X-rays that way.

We can play with shadows, we can play with visible light, and we can acquire new skills that way that our patients will definitely appreciate.

Heather-Dawn:

Janet, I don't know where to begin with all these fabulous tips that you've given us.

First of all, I would say most of the time, when patients are in defensive mode, they are not even aware.

So having a way to just relax the patient is so important because just telling them to relax, it's neither here nor there, because they're not even aware of what they're doing to tense up.

So I thought that was a very valid point. I too, have found that when you give the patient some degree of control, it de-stresses them in a way that you could not imagine.

Because what's going on in the head is a story.

“Okay, what's going to happen is they go too far back, but what's going to happen if this and that…”

But if you begin to tell them, “Hey, this is what you can do if you feel that or this is what we're going to do.”

So you change the story and then it begins to de-stress them and they're more likely to be in the moment working with you rather than anticipating and putting up all the defenses possible just in case you go too far.

So those two tips were great, but the thing with the coffee mug and using it to practice where to position the instrument so that you get a good image was priceless.

I have been practicing dentistry for over 33 years and I have never heard anybody give such a practical example as to how you can prepare yourself to improve the quality of the radiographs that we have at the end of the day.

Fantastic! I have used distraction methods like the toes, lifting your feet, and all that. I've never heard of salt before.

Sometimes I just spray a little topical in the mouth and have them swish it around for about a minute or two.

And when they empty out, they're not as likely to gag if they have a strong gag reflex as they would have had I not sprayed. What do you think about that?

Janet:

You know, to be honest, I've never used that trick. I have not tried that. So maybe I'll do that next week.

Heather-Dawn:

I've given you a trick and you've given me one.

Janet:

I think back to both you and me. Our driving mission is that we can always learn.

Just like I'm always receptive to trying new things, you just gave me something I'm going to try.

If we can carry that yearning for learning, that zest for being our best, if we can carry that through our career, what an inspiration we will be to those around us.

When you're a person in learning mode, you’re not threatening, right? We don't make other people feel less than; we build each other up. That's part of the chemistry of a great dental team.

There was a woman who wrote to me. She was just asking for help online. The gist of it was that she was new to this dental office, that at least three of her patients gagged every time, and that her co-workers gave her strange looks.

And she said, “Please help me. I'm afraid I'm going to lose my job”. And her last sentence was, “Please, no bashing”.

And I'll tell you what, that fills me with a great deal of empathy and a little bit of anger because there's way too much bashing that goes on at the dental office.

And it's not right. If we can just help each other, we can get over the bullying and the one-upmanship and this idea that just because you can physically take an X-ray better than somebody else, it makes you a better dental assistant.

No, it's the ability to get teammates to bring the whole team up. And, if you know a trick, share it. If you need some help, have the freedom to ask. And I know that for you and I both, we are presenting our material because we're a safe place to ask.

I want anyone to be able to come to me with a question, even if they feel like they should have known it but still don’t.

There's another example of that type of what I consider bullying. A man reached out to me online, and he said that he's struggling with understanding how to melt bitewings.

He was in a program and they were given four films, and he had to mount the bitewings in order and he was having trouble with it. And he said he was going to possibly be kicked out of the program because he didn't know how to mount bitewings.

You and I both know this is pretty fundamental, pretty elementary, but my thought was if your teacher doesn't know how to teach somebody how to mount dental bitewings, it's not you that should be kicked out of the program, it's the teacher.

Heather-Dawn:

I totally agree. I want to share the fact that teamwork makes the dream work. Whenever somebody compliments me, it's not about Dr. Lawson-Myers, it's about the team.  And I say,

“Thank you,” but I always say, “However, it's because of this great team that I have.”

And I think that we can make a difference in rephrasing, reshaping how we view and treat each other.

Teamwork makes the dream work.

So learning about different personalities and how people operate in the same space is important. Learning how to communicate so that the message sent is the message received is important.

But most importantly, care about your co-workers, your team members, because remember, the dentist doesn't pay salaries, it's the people who choose to come and get the care.

And so if we are working cohesively as a team, and people feel warm and welcome, and feel that this team is just working together everybody benefits; it's a win-win. I always end my conversations with a quote.

The quote of the day is, “The simple act of caring is heroic,” and it is credited to Edward Albert.

So, as we come to the end, and we focus on those words, can you remind us again where we can contact you if we have a desire to take one of your courses? Or to get further information about just sharpening our swords as it relates to dental radiographs?

Janet:

Yes, so my website is www.dentalxraycoach.com. And if you would like to email me, you can email me at [email protected].

Thank you so much for this opportunity to have a conversation with you. You're a lovely person, and it's an honor to meet you and get to know you a little bit better.

Heather-Dawn:

This has been a fantastic interaction, but I hope it won't be the last. I hope you will come back again sometime in the future. It was a blessing for me, and I'm sure it was a blessing for all our listeners today. Janet, have a wonderful day. God bless.

Janet:

God bless you, too. Thank you.

Heather-Dawn:

That was such a fabulous session with Janet Simpson.

Dental procedures are not always comfortable. But if we can learn little tricks to get our patients over the hump, to distract them just enough to do what we need to do, and keep them comfortable, it's gold.

And I think we got some serious treasures today from Janet. I'm going to encourage you to listen to this podcast again and again.

Use your flashlight and your coffee mug to practice positioning X-rays and the beam without the radiation risk and perfect your skills, because the better you are at something, the better you feel, the more confident you are, and the more trustworthy you are to your team members.

So this is a win-win. Listen, it's been great as usual. Janet gave you her contact information. You can check her on her website and look for her courses.

Obviously, she has a wealth of knowledge. We are definitely better together.

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This is Episode 9 of my Irreplaceable Dental Assistant podcast.

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